Tradition:

Western

Source / Author:

Galen

Preparation:

Beat them, then form a Pill mass with equal parts of Syrups of Wormwood and Purging Thorn, and make Pills the size of Pepper corns. Colocynth and Scammony must be used in their prepared forms (such as Troches of Alhandal, and Scammony prepared with Quince juice).
Some used the clarified juice of either Fennel, Wormwood or Black Nightshade to incorporate the powder.

Function:

Purges Bile and Phlegm from the Head, Stomach, Liver and Bowels

Use:

1. Headache, including after Trauma
2. Deafness, Tinnitus
3. Failing Eyesight, Cataract
4. Jaundice
5. Arthritis and Rheumatism
6. People prone to Lice, Worms or Parasites should use them occasionally.
7. Premature Greying of hair (due to excess Phlegm)

Dose:

1–2 scruples, or 8–11 pepper-corn sized pills. Often taken once per week in the long term treatment of chronic diseases.

Cautions:

None noted

Modifications:

1. Galen first relayed a version made of 2 parts each of Aloes and Scammony, 1 part each of Colocynth and Wormwood juice, to which a little Mastic and Bdellium were added.
2. Often Mastic was added. This is an important addition to moderate the harshness of the purgatives. This addition was listed in Pharmacopoeia Persica (1681).
3. Poor or failing Eyesight, take Electuary of Pope Innocent Against Blindness after purging with Pills of Cochia.
4. Edema or Moist Cough or Phlegm Asthma, take Oxymel of Squill for several days before purging with Pills of Cochia.
5. Contortion of the Mouth following Apoplexy, Pills of Cochia, Pills of Colchicum, 1 scruple ea., Diagrydium 2 grains; mix with Rue juice and form 7 pills. (Wirtzung)
6. Alopecia from Phlegm, add Bdellium and Mastic.
7. A related contemporary Unani formula contains Aloe, Scammony, Colocynth and Wormwood, of each 10 grams; Mastic, Bdellium and Tragacanth, 5 grams ea. This is better corrected, and is used for Hemiplegia, Bells Palsy and Alopecia. Dose: 125–250mg.
8. There was Cochia with prepared Hellebore (equal parts of each), used for Melancholy, Madness and Insanity.
9. Cochia with Mercury was used for virulent Gonorrhea and Syphilis.

Similar Formulas:

Golden Pills are very similar, but better corrected and far better to be used than Pills of Cochia.

Comment:

Wootton (Chronicles of Pharmacy, 1910) tells how these pills got their name. Galen originally said these pills were to be formed into katapotia (‘things to be swallowed’) made the size of a pea. Trallien talks of the same pill, but called them kokkion, for coccus, or lentil berry, in reference to the size of the pills. Some say the name Cochia was popularised by the Arab physician Rhasis.

Renodeus said that they are far better and milder with Prepared Scammony (prepared with Quince juice) and Troches of Alhandal, than if the powders of raw Scammony and Colocynth are used.

These Lesser Pills remained in common use well after the Greater Pills of Cochia, and in the London Pharmacopoeia of 1746, their name was changed to Pilulae ex Colocynthide cum Aloe, the Pills of Colocynth with Aloe.

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