mm •.•.'.■'A-AV.Vj' vMMM CORNELL UNIVERSITY. THE BostxteU p. Movant Cibrarg THE GIFT OF ROSWELL p. FLOWER FOR THE USE OF THE N. Y. STATE VETERINARY COLLEGE. 1897 CORNELL UNIVERSITY LIBRARY 'Ml Cornell University Library The original of tiiis book is in tine Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924104225861 REFERENCE-BOOK OF PRACTICAL THERAPEUTICS BY VARIOUS AUTHORS Edited by FRANK P. FOSTER, M. D. EDITOR OF THE NEW YORK MEDICAL JOURNAL AND OF FOSTER'S ENCYCLOPEDIC MEDICAL DICTIONARY IN TWO VOLUMES VOL. II NEW YORK D. APPLETON AND COMPANY 1897 Copyright, 1897, By D. APPLETON AND COMPANY. M 3 S" LIST OF CONTRIBUTOES TO VOLUME II. Samuel Treat Armstrong, M. D., Ph. D.. late Visiting Physician to the Harlem, Willard Parker, anci Riverside Hospitals ; ex-Passed Assistant Sure;eon, U. S. Marine-Hospital Service, New York. Samuel M. Brickner, A. M., M. D., New York. Edward Benmet Bronson, M. D., Professor of Dermatology, New York Polyclinic ; Visiting Physician to the City Hospital ; Consulting Physician to the Babies' Hospital, New York. William B. Coley, M. D., Assistant Surgeon to the Hospital lor the Ruptured and Crip- pled ; Attending Surgeon to the New York Cancer Hospital and to the Post-graduate Hospital, New York. Floyd M. Crandall. M. D., Adjunct Professor of Diseases of Children, New York Poly- clinic ; Consulting Physician to the Infants' and Children's Hospital, New York. Jeremiah T. Eskeidob, M. D., Professor of Nervous and Mental Diseases and. Medical Jurisprudence, Colorado School of Medicine, Medical Department of the University of Colorado, Denver. Matthias Lancktox Foster, M. D., Assistant Surgeon to the Manhattan Bye and Ear Hospital, New York. Aepad a. Gerstee, M. D., Visiting Surgeon to the Mt. Sinai and German Hospitals, New York. Henry A. Griffin, M. D., Assistant Physician to the Roosevelt Hospital (out-patient de- partment) : Attending Physician to the Ran- dall's Island Hospitals, New York. Charles Jewett, A. M., M. D., So. D., Profes- sor of Obstetrics and Diseases of Children, Long Island College Hospital ; Obstetrician to the Long Island College Hospital ; Con- sulting Obstetrician to the Kings County Hospital ; Consulting Gynaecologist to the Bushwick Hospital, Brooklyn. Howard Lilienthal, M. D., Lecturer on Sur- gery, New York Polyclinic ; Assistant At- tending Surgeon to Mt. Sinai Hospital, New York. Russell H. Nevins, M. D., Stamford, Connec- ticut. Austin O'Malley, M. D., Ph. D., LL. D., late Medical Sanitary Inspector and Bacteriolo- gist of the District of Columbia, Washing- ton. George L. Peabody, A. M., M. D., Professor of Materia Medica and Therapeutics, Col- lege of Physicians and Surgeons (Medical Department of Columbia University); Vis- iting Physician to the New York Hospi- tal and to the Roosevelt Hospital, New York. Frederick Peterson, M. D., Chief of Clinic, Department of Neurology, Vanderbilt Clin- ic, College of Physicians and Surgeons (Medi- cal Department of Columbia University) ; Neurologist to the City Hospital; Patholo- gist to the New York City Insane Asylums, .. New York. Samuel 0. L. Potter. A.M., M.D., M.R C.P.L.; Professor of Principles and Practice of Medi- cine and Clinical Medicine in the College of Physicians and Surgeons of San Francisco ; late Visiting Physician to St. Luke's Hos- pital, San Francisco. Charles Rice, Ph. D., Phar. D., Chemist of the Department of Public Charities, care of Bellevue Hospital, New York; Chairman of the Committee of Revision and Publication of the Pharmacopoeia of the United States of America (1890-1900), New York. Solomon Solis-Cohen, M. D., Professor of Clinical Medicine and Therapeutics, Phila- delphia Polyclinic ; Lecturer on Clinical Medicine, Jefferson Medical College ; Physi- cian to the Philadelphia and Rush Hospitals, etc., Philadelphia. James T. Whittaker, M. D., Professor of the , Theory and Practice of Medicine and Clin- ical Medicine, Medical College of Ohio, Cin- cinnati. HANDBOOK OF THERAPEUTICS. NAPBLLTNE NAPHTHALENE NAPELLINE.— This alkaloid, C.HstNO, (0H)4, obtained from Aconitum napellus, is almost identical with aconitine in action, but not quite so powerful. The dose is from ^ to J of a grain. (See Aconitine.) NAPHTHALENE, naphtalene, naphta- lin, naphtalinum (U. S. Ph.), naphthalin, naphthalinum (Ger. Ph.), is a hydrocarbon ob- tained from coal-tar. It occurs in transparent plates, without colour, of strong and peculiar odour and a burning, aromatic taste. It vola- tilizes slowly when exposed. It is insoluble in water, but when boiled with water imparts to it a faint odour and taste. It is soluble in al- cohol. Its formula is CioHs. The action of naphthalene is that of an an- tUeplic and antiparasitie. Locally, it is stim- ulant, and, though small doses may have a beneficial stomachic effect, large ones may cause gastric disorder. It is thought that when it is given by the mouth it passes into the intes- tines with little or no change, and there exerts its antiseptic power. To some degree the rem- edy is absorbed, but its absorption is slight in man, though its continued administration to animals is productive of cataract. It is elimi- nated by the lungs and kidneys, but principally in the f;eces. In passing through the kidneys, naphthalene may cause irritation of those or- gans, and in renal diseases, therefore, its use should be cautious. The external use of naphthalene in thera- peutics is small. It is occasionally used as an antiseptic in the treatment of wounds. It has been employed as a substitute for iodoform in chronic abscess, a solution consisting of 3 drachms of naphthalene, 2 oz. of alcohol, and 4 oz. of hot water being employed. Unless it is warmed, crystallization will occur in the solution. It is said to bo valuable, too, as a dressing for ulcers. As an antiparasitic naphtha- lene is valuable, especially in scabies. Its ex- tensive application, however, is said to have been the cause of nephritis. The popular use of it, under the name of " tar camphor," for the destruction of moths is well known. The internal use of naphthalene is chiefly for intestinal antisepsis. Among the condi- tions benefited by it are diarrhoeas, especially if fermentative or putrefactive, dysentery, and typhoid fever. The beneficial action is not in- variable, however, and the remedy is often dis- appointing. Roundworms are said to be re- moved by the action of naphthalene, and for seat worms an injection may be made which contains from 15 to 30 grains of the drug and from 2 to 3 oz. of olive oil. [Dr. A. Schmitz (Jahrb. f. Kinderheilk. ; litv. internat. de med. et de chir. prat., Apr. 25, 1895) describes his method of using naph- thalene in cases of intestinal worms in chil- dren : After having purged the patients several times he prescribes capsules each containing from 2-J^ to 6^ grains or more of naphthalene, according to the age of the child. Four of these capsules are taken during the day. Eight days afterward the same dose is re- peated, and after a second interval of fourteen days a third dose is taken. In some rare cases, he says, a fourth dose may have to be given. The naphthalene should not be given imme- diately after meals, and oily or fatty food should be avoided, in order not to cause de- composition of the drug in the digestive canal and thus hinder its action. If it causes consti- pation a purgative should be given. In forty- six cases in which this treatment was used, twenty-six children were completely cured. In twenty other cases the results were less favour- able; the symptoms were ameliorated, but there was no definitive cure. In three of the cases the return of the symptoms was so long delayed that they were thought to be cases of reinfection. In cases where success is doubt- ful Dr. Schmitz recommends repeating the treatment after an interval of several weeks, as the organism of children tolerates repeated doses of naphthalene very well. In one case only it caused strangury, but the symptoms were slight and transitory. The action of naphthalene, says Dr. Schmitz, is always more certain than that of santonin, and it is much less toxic] Naphthalene is beneficial in pyelitis and cystitis by its action to lessen urinary fer- mentation. It may bo efficient in bronchor- rhaea and foetid bronchitis, and has been recommended for whooping-cough. The dose of naphthalene is from 2 to 8 grains, and it is best administered in tablets or in capsules. — Henry A. Gkiffin. NAPHTHOL NARCOTICS NAPHTHOL, naphtholum (Ger. Ph.), naph- tol (U. S. Ph.), isonaphthol, beta-naphthol. beta-naphtol, $-naphthol, is a phenol occurring in coal-tar. It is generally prepared from naphthalene. It occurs in colourless or buif- coloured crystalline plates or a white or yellowish powder. Its odour is faint and re- sembles that of phenol ; its taste is pungent. It is permanent in the air and, though only slightly soluble in water, is freely soluble in alcohol. Its formula is CioH, OH. Though beta- naphthol alone is meant when the term naph- thol is used, there is another naphthol which is equally entitled to that distinction. This is known as alpha-naphthol. Its physical proper- ties in the main are those of beta-naphthol, but it is more irritant than that remedy, though said to be less toxic. The physiological action of naphthol is practically that of naphtha- lene, and, though it is certainly capable of poisoning, experimental death in animals hav- ing resulted from paralysis of respiration, the toxic dose for man would necessarily be very large. As an antiseptic, naphthol is said to be five times as strong as carbolic acid, but its insolubility in water, though of value in that it renders less the liability to poisoning from absorption, is an obstacle to its usefulness. As a local remedy, naphthol is useful in a variety of ailments, and is employed in oint- ments and alcoholic solutions which usually range in strength from 3 to 10 percent. If applied pure to the siiin, naphthol causes a brown discoloration and, subsequently, des- quamation. It has been used for the relief of psoriasis, but is generally inferior to chrysa- robin and pyrogallio acid, though often a desirable substitute for them. A 10- or 12-per- cent, ointment is suitable for the purpose, but if used extensively may cause poison- ing, the symptoms being similar to those of carbolic-acid poisoning and preceded by cloudy discolouration of the urine. In scabies an ointment containing from 5 to 10 per cent, of naphthol, with or without sulphur, is effec- tual. It should be applied nightly for about a week. Tinea circinata is relieved in the same way, as are other vegetable-parasitic skin diseases. Foul ulcers also are said to receive benefit from an application of naphthol. A solution containing 5 parts of naphthol, 100 of alcohol, and 10 of glycerin is highly spoken of as a remedy in hyperidrosis. In chronic sup- purations of the ear naphthol may be used by insufflation. In all conditions where it is lo- cally applied naphthol has the advantages of being colourless and nearly odourless. The internal use of naphthol is very like that of naphthalene. It is serviceable in gastric fermentalisn, particularly if there is also dila- tation of the stomach. In diarrhoeas and in dysentery it is often of much service, and the abdominal symptoms of typhoid fever are in many cases much ameliorated by its use, with the subsequent improvement of the constitu- tional symptoms. Its continued use, however, is occasionally the cause of gastric disturbance. Naphthol has been much praised in the treat- ment of cholera, both as a prophylactic and in the early days of the disease. Epidemic in- fluenza also is said to be favourably affected by its use. It is a desirable vermifuge against ascarides. The dose of naphthol is ordinarily between 2 and 5 grains, but much larger amounts may safely be administered. In fact, many authori- ties regard doses of 15 grains as by no means excessive. It is preferably given in capsules. It may be given in keratin-coated pills when its intestinal action is specially desired. A preparation called camphorated naphthol is sometimes employed. It is a clear brown liquid composed of 1 part of beta-naphthol and 2 parts of camphor. It has been recommended as an application for tuberculous ulceration of the tongue and, mixed with vaseline, has been employed in ozoena. [In regard to the value of camphorated naphthol in the treatment of tuberculosis, somewhat contradictory observations have been recorded. Spillmann (Rev. mid. de I'Est., Nov., 1894; Iiei\ mens, des mat. de I'enfance, Nov., 1895) reports the case of a child, thirteen years old, which showed all the symptoms of ad- vanced pleuro-pulmonary tuberculosis, and had tuberculous peritonitis with ascites. The gen- eral condition was bad, and the temperature varied from 100-2° to 103° P. in the morning, and from 102'1° to 103° in the evening. After the abdomen had been punctured and 36^ oz. of ascitic liquid been drawn off, 150 grains of a solution of camphorated naphthol was in- jected into the peritoniEum. This was well borne, but during the following month the fever and the pulmonary symptoms seemed to become more intense. About five weeks later, however, the fever disappeared, the appetite returned, the bowels became regular, and the pulmonary symptoms ceased. When last seen by the author, the child seemed completely transformed. The abdomen was elastic and not painful ; the digestive functions were nor- mal ; percussion and auscultation did not re- veal any trace of the pulmonary lesions, and the child was considered completely cured. On the other hand, Netter (Rev. mens, des mal. de I'enfance, Nov., 1895) relates the his- tories of three cases in which this treatment was employed. In the first two cases the re- sults obtained were not convincing either for or against the method. In the third case, however, it was different. The patient was a child, seven years old, and a diagnosis of tu- berculous peritonitis was made. M. Netter was rather inclined to think that there was cirrhosis complicated by peritonitis. However, on the advice of a hospital surgeon, the treat- ment with camphorated naphthol was adopted. After a puncture had been made through which more than a hundred ounces of liquid flowed, about 75 grains of camphorated naphthol were injected into the peritoneal cavity. No symp- toms immediately followed this injection", but at the end of half an hour agitation and con- vulsions supervened, which did not yield to treatment, and in a few hours death occurred. At the autopsy it was proved that the patient had suffered from hypertrophic cirrhosis, with acute generalized peritonitis which had mani- festly been caused by the injection of naphthol. NAPHTHOL NARCOTICS In view of this fact, while admitting that the healthy peritonasum does not act in the pres- ence of naphthol like the tuberculous peri- tonaeum, M. Netter states that he is unwilling to employ this treatment in tuberculous peri- tonitis.] Hydronaphthol is very similar to beta-naph- thol. In fact, the commercial preparation, though of unknown composition, yields beta- naphthol when purified by reorystallization. Theoretically, hydronaphthol is beta-naphthol in which 1 atom of hydrogen (H) has been re- placed by hydroxyl (OH). It occurs in phar- macy as a crystalline powder of grayish-white colour and a slight odour resembling that of iodine. Its uses are those of beta-naphthol, but it is said to have a lesser toxicity than that drug. It has been thought of special value in cholera and typhoid fever. The dose is the same as that of beta-naphthol. Bemonaphthol, or benzoyl-naphthol, is a white crystalline powder without taste and with but a slight odour. It is practically insoluble in water, but is soluble in alcohol. Chemically, tiie drug is the benzoate of beta-naphthol (C10H7O, CvHsO), and in the intestines a sep- aration into its components is believed to take place, the benzoic acid being then eliminated by the kidneys and acting as a diuretic, while the beta-naphthol remains in the intestines to act as an antiseptic. It is chiefly employed as a gastric and intestinal antiseptic and is useful in the conditions in which naphthol is given. The dose is from 4 to 8 grains, but small and frequently repeated doses are the most serviceable. [Dr. S. Solis-Cohen (Med. News, July 28, 1894) speaks highly of the use of benzonaph- thol in conjunction with bismuth salicylate in the treatment of summer diarrhoea. After the alimentary canal has been cleansed of irritat- ing matter by the most available means, which may be, he says, according to circumstances, lavage of the stomach, irrigation of the bowel, or the administration of a purge, usually calo- mel or a mixture of castor oil and spiced syrup of rhubarb (equal parts); and after the diet has been duly regulated he has observed very satisfactory results from the administration of the following combination : Benzonaphthol, ) Bismuth salicylate, >■ each. . . 5 grains. Dover's powder, ) In capsule, cachet, or powder. To an adult 1 capsule is given every three hours, or as often as may be necessary. It is rarely needful to exceed 4 doses in the twenty-four hours. To children the same preparation may be given in reduced doses ; thus, to a child of two years Dr. Solis-Cohen gives : E=Sc°y'iate,}-*---«^--' Dover's powder | grain. In the mildest cases benzonaphthol alone has proved efficient, and in many cases the opium is unnecessary ; but, as a rule, the com- bination of the three ingredients in the pro- portions stated he has found more promptly efficacious than any other routine treatment that he has used.] — Henry A. Griffin. NARCEINE.— See under Opium. IfABiCOTICS are drugs which lessen the relationship of the individual to the external world. Their action is very complex, depress- ing the sensory nervous system from its pe- ripheral nerve-endings to the perceptive centres, influencing also the motor side of the nervous system, and disturbing the sen- sory, motor, and metabolic functions of most of the viscera. At flrst more or less excitant to the higher brain and stimulant to the mind and to all the bodily functions, they at the same time blunt the perception of external im- pressions and bodily sensations, and to a greater or lesser extent substitute ideas for sensations. This stage of their action is usually a pleasant one, and is accompanied by feelings of high nervous tension and followed by a disposition to repose of the body. Their next stage is one of profound sleep characterized by increasing stupor, and, if the dose has been sufficient, is followed by coma, insensibility, and finally death by paralysis of the medullary centres which govern the functions of organic life. An autopsy shows nothing but great conges- tion of the brain, spinal cord, lungs, heart, and great vessels. Narcotics and stimulants are closely related, alcohol and opium being good illustrations, in the different stages of their action, of stimulant followed by narcotic ef- fects. Such agents, in proper medicinal doses, give us the power of lowering morbidly acute perception, of relieving pain and allaying irritation, nervous agitation, and spasm, of in- ducing sleep, and of regulating the vital func- tions by rest — all of which are means of great therapeutical value. It is for these effects, and not for their full narcotic action, that they are employed in medicine. (See the subtitle Narco-hypnotics, under the title Hypnotics.) Narcotics operate medicinally in smallerdoses than almost any other drugs, and their effects vary considerably with the size of the dose; under the smaller doses stimulation predomi- nates, under the larger narcotic sedation pre- vails. Their action is much more intense upon young persons than on adults, and to a greater degree than can be accounted for by the mere difference of age. They lose their effect by repeated administration, unless the dose is constantly increased, in which respect they agree with all agents acting directly upon the nervous system. If taken continuously for any length of time they are prone to induce a drug habit, and this is especially true of opium and chloral. The principal members of the narcotic group are briefly described below, their action in other respects being detailed under their respective titles throughout the work. Opium, and its chief alkaloid, morphine, are typical narcotics, as also the most potent and reliable. They are especially valuable as medicines, for of all the members of the class, they possess the most powerful anodyne action, enabling them to relieve pain in doses which do not cause sleep. There are few indications NAREGAMIA ALATA NBJRVINES for the use of narcotics which can not be filled by opium alone ; the principal exceptions are delirium tremens, in which chloral is more efficient and safer, and neuralgic affections, spasmodic action generally, and the relaxation of the sphincter muscles, in which belladonna and stramonium are more serviceable. Opium does not produce so much early excitement as alcohol does, though its stimulant stage is well marked, may be maintained by the admin- istration of small doses at proper intervals, and is apparently due to alterations in the relative functions of diif eren t parts of the brain. After a full medicinal dose (from 1 to 3 grains) the excitant stage is of shorter duration, and sleep soon comes on, during which external impressions are made with difficulty upon the peripheral nerves or on the organs of sense, are slowly and imperfectly conducted, and are im- perfectly perceived by the cerebrum. After a narcotic dose (3 grains or more) the excitant stage is very short ; sleep rapidly ensues, be- comes deeper and deeper, and passes into coma, from which the patient can no longer be aroused, the strongest external impressions having no influence upon him. This uncon- scious condition is accompanied by great de- pression of the medullary centres governing respiration and circulation, the breathing being slow and shallow, the pulse slow and full, be- coming very feeble towards the end, the pupils minutely contracted, and the body bathed in a cold sweat. Death occurs by asphyxia, respira- tion ceasing before the heart stops. Opium has no effect in muscular contractility, and com- paratively slight influence on the motor nerves, but it has a marked paralyzing action on the sensory nerves, on the conductivity and reflex function of the spinal cord, and on the cere- bral and medullary centres. Alcohol is primarily an excitant, then an intoxicant, and finally a narcotic. It first stimulates the cerebral circulation, and then proceeds to paralyze the several parts of the brain in the inverse order of their develop- ment. This order varies in different individ- uals, but in all, the powers of judgment and self-restraint are the first to be impaired, as they are the last to be completely developed. Imagination and memory fail next in some cases, while the emotions become prominent ; and on this follows disturbance of the power of co-ordination, and soon paresis thereof. In others the latter is impaired to a marked de- gree before the mental faculties are much affected; the speech becomes thick, and the gait is staggering and uncertain. At this stage reflex action still persists, but afterwards becomes diminished and then abolished. Final- ly, paralysis of the respiratory centre occurs. The action of alcohol exemplifies three great laws of drug action, viz. : 1. That all stimula- tion reacts into depression. 3. That most agents which at first stimulate the nerve-centres after- wards depress and finally paralyze them. 3. That when drugs so affect the functions of the body progressively they do so in the inverse order of their development, the highest and latest developed function being affected first, the lowest and oldest last. Ether, chloroform, and the other general anaesthetics have much the same effects as alcohol. Chloral hydrate in a large dose (45 grains) causes a deep sleep without preliminary ex- citement usually, which sleep may pass into coma, with slow respiration, slow and weak pulse, lowered temperature, relaxation of the muscular system, and diminished sensibility and reflex action. By a toxic dose (a drachm or more) all these symptoms are intensified, the coma is profound, the pulse is weak and thready, the pupils are contracted at first, but dilated afterwards, the temperature is greatly lowered, and the patient gradually sinks into death, paralyzed and anaesthetized. Death usually occurs by paralysis of the respiratory centre, but in many cases the cardiac action is simultaneously arrested; and fatal syncope may occur in any case, the heart stopping in diastole from paralysis of the cardiac ganglia. Bromal hydrate acts in the same way, but is poisonous in smaller doses, and has a more powerful paralyzing action on the heart. Butyl-chloral hydrate (croton-chloral) also acts in like manner, but much less potent- ly than chloral. The principal symptoms pi-o- duced by large doses are deep sleep, aniesthesia of the fifth nerve, and death by arrest of respi- ration ; but very large doses paralyze the heart. Belladonna and its principal alkaloid, atro- pine, also its congeners stramonium and hyos- cyamus, produce active delirium at first, the patient having a constant desire to speak, to move about, or to be doing something, while at the same time he feels great languor ; this effect is due to the combined stimulation of the cerebral and spinal nerve-centres and the paralyzing action on the peripheral ends of the motor nerves which is decidedly produced by these agents. Atropine is one of the most powerful of the alkaloids in proportion to its dose, a seven-hundred-thousandth of a grain affecting the pupil (Donders), and a two-hun- dredth of a grain producing marked physio- logical effects. Although antagonistic to morphine in most of its earlier actions, its final result is narcotism and death by paralysis of respiration. Hyoscyamus is much feebler than belladonna, but has a similar action, and has been used as a substitute for opium in children and where it is desirable to avoid tlie constipating action of opium on the bowels. Its derivative alkaloid, hyoscine, is a powerful depressant of the respiration in full doses, and efficiently hypnotic and calmative, after a pre- liminary stage of excitant action, in doses of rit) of a grain, hypodermically. Cannabis indica is primarily a producer of delirium, and, though its secondary action is of a decided narcotic character, the drug is not dangerous to life, no case of death thereby having ever been known. Some of the phe- nomena experienced under its influence are of unique character— namely, a sense of double consciousness and a semi-cataleptic state, be- sides which it produces a considerable degree of ansesthesia and confusion of thought as an after-affect. The dose necessary to produce its full action varies according to the activity of NAREGAMIA ALATA NERVINES the preparation and individual susceptibility to it, but may be placed at from 10 to 20 grains of a good alcoholic extract. It loses much of its power by repetition. Humulus (hops) and lupulin, its glandular powder, are feebly narcotic in action, produc- ing such effects only in large doses of active preparations, 2 fl. drachms and upwards of the fluid extract of the former, or a drachm and more of the oleoresin of the latter. Neither drug is capable of producing the extreme stage of narcotism. Lactucarium (lettuce) was considered high- ly soporific and narcotic by the ancients, and such qualities were again ascribed to it in the present century by JJr. Coxe, of Philadelphia, and others. It is now looked upon as a very feeble member of the class, if possessing nar- cotic power at all. The fresh juice of the wild plant was referred to by Dioscorides as nearly equal in power to opium ; but there is no case on record of poisoning, or any symptoms ap- proaching it, from any quantity of the modern preparations ever administered. Carbolic acid is a rapid and powerful nar- cotic poison, the symptoms developing almost immediately after its ingestion, and death may occur in a very few minutes. The minimum fatal dose is not determined, but i an oz. has frequently caused death, which occurs in most cases by paralysis of respiration, in a few by paralysis of the heart, and is preceded by paralysis of motion and sensation, coma, con- tracted pupils, and abolished reflexes. Oil of turpentine in a large dose (from ^ to 1 fl. oz.) is a powerful narcotic and excitant of delirium, producing primary symptoms of cerebral intoxication not unlike those of alco- hol, followed by paralysis of sensation and abolished reflexes, death occurring in coma or convulsions, or both. In the few fatal cases of turpentine poisoning on record the drug acted evidently through the nervous system, as but slight organic traces of its irritant action were found. The oils of eucalyptus, rue, savine, tansy, and wormwood have a similar narcotic action in large doses, being powerfully de- pressing to the brain, medulla oblongata, and spinal cord, abolishing sensation and reflex ac- tion, and causing death by paralysis of respira- tion. Hydrocyanic acid produces the symptoms of rapid asphyxia, and causes death by cardiac paralysis in the instantaneously fatal cases, by paralysis of the respiratory centre in those which occur more slowly. In the latter, after a convulsive stage, there are coma, complete loss of sensation, paralysis of the voluntary muscles, an almost imperceptible pulss, and slow, weak respiration — the phenomena of nar- cotic poisoning. Carbonic acid, nitrous oxide, carburet- ted hydrogen, and sulphuretted hydro- gen gases produce symptoms of general narcosis, and cause death by asphyxia from paralysis of the respiratory centre. Samuel 0. L. Pottbe. NAKEG-AMIA ALATA, or Ooa ipecacu- anha, is an East Indian meliaceous shrub said to contain an oil, wax, and the alkaloid narega- mine. The root is said to be emetic and chola- gogue, and to have been found efficient as a remedy in indigestion, rheumatism, and ca- tarrhal affections. The powder is given in daily amounts of 16 grains. NATRIUM.— See Sodium. NECTANDEiA.— See under Bebeerine. NERItriyr. — Several species of this echitide- ous genus of shrubs are reputed to have medici- nal properties. Merium antidysentericum is the same as Wrightia (or Holarrhena) antidysen- terica {q. v.). Nerium odoratum (or odorum), the kunarel, or sweet-scented oleander, of the Bast Indies, contains two non-nitrogenous glu- cosides, neriodorin and neriodorein. Nerium oleander, the common oleander, contains two alkaloids — oleandrine, bitter and very poison- ous, and pseudocurarine, tasteless and non- poisonous — also two glucosides, nerianthin (an inert substance resembling digitalin chem- ically) and neriin, which, according to Schmie- deberg, seems to be identical with digitalein and to have the same action as that principle upon the heart, causing cessation of its action in systole. Oleander is an active narcotico- acrid poison. It should not be used where there is irritation of the alimentary canal, and the therapeutic employment of it should al- ways be very cautious. It is used as a cardiac tonic, and its prolonged use is said to reduce the frequency of the paroxysms of epilepsy. There are no official preparations of oleander. The fresh leaves of the Italian plant are pre- ferred in pharmacy. A tincture made witli 1 part of the leaves to 5 parts of alcohol may be given in daily amounts of from 5 to 10 drops. NERVINES.— The nervines include those medicines that are supposed to have a special action on nerve tissue. There are but few agents that act as sedatives or stimulants to the nervous system in virtue of their primary effect on nervous matter. Some medicaments quiet nervous irritability on account of the anodyne influences which they exert. Among these may be mentioned opium, morphine, codeine, chloroform, ether, cannabis indica, belladonna, antipyrine, acetanilide, phenace- tine, croton chloral, Hoffman's anodyne, ure- thane, and many others ; some produce a similar result on account of their effect in producing hypnosis, among which may be mentioned sul- phonal, chloral, paraldehyde, hypnol, somnal, amylene hydrate, tetronal, trional, chloralose, hydrobromide of hyoscine, and numerous oth- ers belonging to this group ; some act as stimu- lants or sedatives, largely through their effect on the circulation, and foremost among these are the organic and inorganic nitrites and nitroglycerin ; others have a special influence on the nervous system from their apparent depressive action on the vaso-motor nerves, cimicifuga and calabar bean being the princi- pal ones. The nervines to which I shall briefly refer in this article are few in number, and consist of asafoetida, the bromides, hydrobromic acid, camphor; monobromated camphor, amber, musk, valerian, hops, sumbul, and strychnine. KERVOUS SUBSTANCES NITRIC ACID Some of these act as stimulants, some as seda- tives, and some as stimulants with a sedative influence on the nervous system, while others apparently influence the nervous system by their tonic action. The bromides constitute the purest type of nervous sedatives. Valerian, hops, and amber are usually considered among the pure nerve sedatives, but it is evident to any one who has carefully studied the influ- ence of these medicaments in quieting nerv- ous disturbances that part of their effect is due to a tonic influence. Asafoetida is usually classed as a stimulant, but it is capable of acting as a sedative in conditions of excessive nervous irritability. Strychnine and sumbul exert their quieting effects on the nervous sys- tem in appropriate doses, indirectly through their tonic effect. The rest-cure and forms of liydrotherapy are the best-known non-medici- nal means for allaying nervous irritability. Bromides. — When a purely sedative effect of the bromides is desired they should be given in 10-grain doses, well diluted with water, after each meal, and about double this quantity may with advantage be administered at bed- time. The indications for their use in this manner are found in nervousness from irrita- tion of the sexual organs, from worry, cerebral overwork, and prolonged mental strain. Bro- mide of sodium seems to act better as a pure nerve sedative than most of the other bro- mides. Hydrobromic acid is more acceptable to the stomach of some patients than the sodium salt, but its influence in producing sedation is usually less apparent. Asafoetida. — According to my experience, the nervine that stands pre-eminently first in allaying nervous irritability, especially in those hysterically inclined, is asafoetida. It appar- ently acts as a tonic and stimulant, and at the same time has a soothing effect in enabling the patient to suppress excessive nervous mani- festations. It has long been to me in the treatment of over-functional nervous mani- festations what cannabis indfca has proved to be in the treatment of various forms of head- ache and conditions of hyperalgesia. The only objection to its more frequent use is its exces- sively offensive odour. I hope to see the time when some enterprising manufacturing chem- ist will be able to extract a principle from asa- foetida that will contain its virtues but not its odour. To obtain the best effect from this drug, it must be given in large doses. Of the gum resin, 3 or 4 pills containing 3 grains each should be given three or four times daily, but most stomachs soon rebel against these large doses. When a speedy action of asa- foetida is desired, from 1 to 2 teaspoonfuls of the tincture, in water, may be administered by the stomach, or a tablespoonful by the rectum, in warm milk or water. The drug acts in re- lieving nervousness, both by its stimulating effects upon the brain and by its lessening in- testinal flatulence. Camphor is employed on account of its sup- posed sedative action in nervous manifesta- tions in women and children, and for its apparent stimulating effect in the depressive stages of the low fevers. It has seemed to me to be an agent of uncertain value when used alone for its sedative action on the nervous system, but its influence is undoubted in the treatment of headaches and nervousness from dysmenorrhoea, when it is combined with some of the analgetics, such as phenacetine or acet- anilide. Monobromated camphor combines the effects of the camphor and the bromides, but this is too feeble when used in non-irritating doses to produce a very decided sedative effect on the nervous system. Its best effects are obtained when combined with phenacetine or acetanilide and cannabis indica. Camphorated oil (1 part of camphor to 9 parts of aseptic sweet oil) is a prompt and powerful stimulant, given hypodermically, in cases of sudden pros- tration. The dose for this purpose is 15 minims. When camphor is given in combination with an analgetic, the dose need not exceed from 1 to 2 grains, and monobromated camphor may be administered in about the same doses when used in combination with an analgetic ; but when it is employed alone, two or three times these quantities will be necessary to obtain appre- ciable effects. Both pure camphor and the monobromated, in large doses, are gastric irri- tants, and should not be given to persons suf- fering from gastritis. Valerian is a less reliable agent for the relief of most forms of functional nervous manifestations tha,n asafoetida, but in some cases it seems to be superior to the latter drug. It is not always possible to determine without a trial which will better meet the indications in a given case, but I have thought that vale- rian is more indicated in nervousness and hys- terical manifestations due to loss of sleep and prostration following prolonged perioUs of uncertainty and intense anxiety. The best form for administration under such circum- stances is the elixir of the valerianate of am- monium in teaspoonful doses every hour or two until relief from the nervous strain is ob- tained. A hypnotic or a small dose of mor- phine increases the good effects of the valerian. V'alerian in combination with small quantities of morphine acts well in the treatment of de- lirium tremens. Hops, amber, and m.usk may be classed among the nervines, but their value as nerve sedatives or stimulants is slight, except to meet special indications. Hops, in the form of the hop pillow, have been popularly used to overcome nervousness and induce sleep, but their influence is rather questionable. Lupu- lin (the powder of the strobiles of the hops), in doses of from 3 to 5 grains, seems to do good in allaying nervousness from irritation of the urethra, bladder, or kidneys. The oil of am- ber, given in emulsion in from 2- to 5-minim doses, often promptly relieves hiccough of func- tional nervous origin. Musk acts as a tempo- rary, but as an effective and prompt, stimulant in cases of sudden nervous depression. It also quiets nervous excitement occurring in de- pressed states of the nervous system, and is said to be quite effective in relieving obstinate hiccough under such circumstances. The dose of the powder is from 5 to 10 grains, by the mouth, in pill, and from 10 to 16 grains, by NERVOUS SUBSTANCES NITRIC ACID the rectum, in starch water ; that of the tinc- ture from -i to 1 teaspoonful. The only occa- sion for resorting to this expensive medicine is in cases of great nervous depression, when tiding the patient over for a few hours offers a "fighting chance" for life. The cost of the pure drug is from twenty to twenty-live cents a grain. Stryclmine and sumbul may be classed among the nervines from their special tonic action on the nervous system. Strychnine in small doses has a happy effect in allaying nerv- ousness and in enabling the patient to suppress undue nervous manifestations in cases of the functional neuroses. It is an invaluable agent in the treatment of delirium tremens. Sum- bul, while less efficient than strychnine as a nerve tonic, is a medicine of considerable im- portance. The indications for its use in the functional neuroses are about the same as those for the use of strychnine, with which it may be advantageously combined in pill or capsule. It often seems to act well in the unrest of chronic nerve exhaustion and in the treatment of delirium tremens. Of the tincture, the usual dose is from 1 to 4 teaspoonf uls ; of the extract, from 1 to 3 grains ; and of the pow- dered root, from 10 to 40 grains. Jeremiah T. Eskbidge. NERVOUS SUBSTANCES.— See under Akimal Extracts and Juices. NEUBODfN. — This is a German trade name for acetylparaoxyphenylurethane, p rr ^ OCO.CHa ^«^'<-NH.C0.0CaH5' introduced into medicine in 1893 by J. von Mering, of Halle, as an antipyretic and anal- getic. Lippi (Policlinico, Feb. 15, 1895 ; Jour, of the Am. Med. Assoc, Aug. 17, 1895) has experimented with neurodin on persons free from pain, in order to ascertain the limits of tolerance of the drug and the toxic effects which might be caused by it ; also on persons suffering from pain of various kinds, either in the form of neuralgia, or as symptomatic of organic lesions. He thus treated four cases of sciatica ; one case of slight attacks of angina pectoris in a patient with atheroma of the aorta ; one case of intestinal pain caused by ma- lignant growth of the retroperitoneal glands ; one case of neuralgia in a person suffering from polyneuritis; one case of brachial neu- ralgia in a neurotic subject ; one case of gas- tric pain caused by epithelioma of the gall bladder ; one case of headache in a neurotic person who was the subject of a neuralgia simulating polyneuritis; one case of neuralgia of the bladder and stomach in a patient suf- fering from cancer of the liver; one case of muscular pains, probably rheumatic, in a tu- berculous subject ; and one case of pains in the arms symptomatic of spinal irritation. He found neurodin to have the property of sooth- ing and even abolishing pain, whether neural- gic in character or symptomatic of an organic affection ; its action, however, he considers un- certain and notably inferior to that of other similar remedies, such as phenacetine and anti- pyrine. Neurodin may be given in wafers, in doses of from 7 to 25 grams. It is said not to be poisonous, although in large doses it has been known to cause diarrhoea. NICOTIANA, NICOTINE.— See Tobac- NITRATES.— See under Nitric acid. NITBiE. — See Potassium nitrate. NITEIC ACID, acidvm nitricum (U. S. Ph., Br. Ph., Ger. Ph.), HNOa, should be a colourless 'fluid, but has usually a yellowish tinge, emits white or grayish fumes when ex- posed to the air, has a very powerful oxidizing action upon nearly all substances, and hence is an active caustic. When it comes in contact with organic matter it imparts to it a yellow stain not easily removed. This property is valuable in assisting in a diagnosis of the cause in cases of poisoning by acids, as the mouth and lips are usually of a yellower dark- brown colour. It is not often that accidental or intentional poisoning with it occurs, as the irritating vapours given off by it, except when freely diluted, prevent its being mistaken for other fluids. The treatment differs in no way from that appropriate for poisoning with the other acids, but must be undertaken promptly. As a caustic, it is more largely used than almost any of the other acids, being easy to control and yet sufBciently active to meet the conditions of nearly all cases in which a corrosive effect is de- sired. It may be applied with a stick, a pledget of cotton, or a glass rod or brush, and its action limited by greasing the parts around the point of application. Weak alkaline solutions may be used to check its action when this has been carried as far as is desired. Freely bleeding hcemorrhoids, when of small size, may usually be cured by the free use of this acid. It is applied through an anal speculum, and almost immediately after its application a considerable amount of any vegetable oil should be injected to prevent any extension of its action to the healthy tissues. Chronic cervical endometritis, all forms of intra-uterine granulations, and small fibroid tumours may be benefited by its application, the cervix being thoroughly di- lated so as to allow of free access to the in- terior of the uterus and as clear a view of it as possible. It may also be used to arrest hmmorrhage from the mucous membrane of the uterus after operations for the removal of polypi and other small foreign growths. For phagedcenic ulcers, chancroids, cancrum oris, and hospital gangrene it is the most manage- able escharotic in use, although for the last- named condition bromine is to be preferred. Warts and condylomatous growths may be re- moved by its aid, and in conditions such as cancer, where an operation is inadmissible, it may be used as a palliative. A 2-per-cent. aqueous solution may be employed as a stim- ulant application to unhealthy ulcerations and to bathe irritated and bleeding hcemorrhoids. In chronic cystitis anA phosphatic deposits in the bladder it may be used, as a vesical in- jection, in the proportion of 1 part to 500 parts of water. Baths containing about 1 fl. oz. to NITRIC ACID 8 the gallon of water are sometimes employed in the ti'eatment of cirrhosis and other chronic affections of the liver, but, while they are of advantage, it is doubtful whether the effect of the acid is anything more than that of an irri- tant of the skin. Pediluvia of the same strength often relieve the itching of chilblains. When taken internally for any considerable period, nitric acid has an effect upon the gums resembling that of mercury and its salts, but this is probably due to its local action rather than to a constitutional one. This condition should be an indication that its use is to be suspended for a while. Nitric acid may some- times be substituted for hydrochloric acid when the latter seems to be without avail in the con- ditions for which it is appropriate. Oxaluria, dyspepsia with phosphalic urine, summer and colliquative diarrhoea, lithcBmia, chronic bron- chitis, and hoarseness are all conditions in which it may be expected to be of use.. Al- though it has been recommended in the treat- ment of intermittent fever, it is hardly to be rfelied upon by itself, but is in many instances a valuable adjuvant to quinine, particular- ly when there are signs of hepatic engorge- ment. There would seem to be little doubt that it is of some value in the treatment of chronic diseases of the liver, but nitro- hydroohloric acid is more effective. Whooping- cough, after the catarrhal symptoms have dis- appeared, is often benefited by it. In intestinal indigestion it is to be preferred to hydrochloric acid when diarrhoea exists, but when it is ab- sent the latter acid is more useful. A number of cures of constitutional syphilis treated with this acid alone have been reported, but, as the starvation method has usually been conjoined, it is more than probable that it assisted, as it will in the ordinary methods, rather than acted as a specific. From 5 to 10 drops of the undiluted acid, in from 3 to 4 oz. of water, may be given three times .daily, or even oftener, the usual pre- cautions, such as must be observed in the use of the mineral acids, being taken. The acid of commerce, acidum nitricum crudum (Ger. Ph.), is hardly suitable for internal use, as it may contain impurities derived from materials em- ployed in its manufacture, but it may be used externally with entire propriety. The diluted acid, acidum nitricum dilutum, of the Br. Ph., contains a little more than 17 per cent, of the strong acid, while that of the P. S. Ph. con- tains but 10 per cent. The dose of the former is from 10 to 30 drops ; that of the latter from 15 to 40 drops, freely diluted with water. [Fuming nitric acid, acidum nitricum fu- mans (Ger. Ph.), contains nitrous acid and emits a brownish vapour copiously. It is pre- ferred by some practitioners as a caustic] The strong acid is very largely used m de- termining the presence of albumin in the urine. It may be used by placing a small quantity in a test tube and adding cautiously an equal bulk of urine, or by allowing the acid to trickle down the side of a tube into which the urine has been previously introduced, care being observed in each case that the two do not mingle but remain in distinct layers. If the manipulation has been proper and albumin is present, a white ring or disc of the latter will be observed at the point of contact of the two layers, or the acid may be added drop by drop to an indifferent amount of urine in a test tube to the upper portion of which heat has been applied. If albumin is present and has not been previously coagulated by the heat, which it will not have been if the urine is al- kaline, a white precipitate or cloudiness is formed. It must be remembered, however, that heat will cause a precipitate of phosphates under certain conditions, but this is redissolved by the acid, which, on the other hand, has no effect upon the coagulated albumin. [Some of the salts of nitric acid, notably certain organic nitrates, appear to have thera- peutical properties that call for some consider- ation under this heading, principally in the light of Dr. J. B. Bradbury's investigations of the vaso-dilator action of methyl nitrate, glycol (ethylene) dinitrate, glycerol trinitrate (nitro- glycerin), erythrol tetranitrate, arabinol penta- nitrate, and niannitol hexanitrate, as set forth by him in a Bradshaw Lecture delivered before the Royal College of Physicians of London and published in the Lancet and in the British Medical Journal for November 16, 1895. All these organic nitrates, says Dr. Bradbury, dilate the blood-vessels, but their activity varies within wide limits, and the variation appears to be due to their different solubilities and lia- bility to decomposition. Methyl nitrate — the most soluble compound — has a comparatively slight vaso-dilating effect. On the other hand, glycol dinitrate — the least stable — ^has a power- ful action closely resembling that of nitroglyc- erin. Its effect, however, is more transient. The erythrol and mannitol nitrates and the nitro- sugars, being less soluble than the other com- pounds, have a correspondingly weaker effect, but their action is more prolonged. In individ- ual cases slight differences in the extent and duration of action of these bodies are noticed, says Dr. Bradbury, and occasionally persons are met with comparatively insusceptible to their influence. Thus, in some eases of advanced heart disease where the artery presents a feel- ing of fulness, but yet remains easily com- pressible (the " virtual tension " of Broadbent), vaso-dilators have often little effect. In these cases the arteries, like the heart, have lost their normal tone, are considerably dilated, and, though possessing a sense of fulness and, on superficial examination, of resistance, are vet arteries of low tension. Coupling with this fact the tendency to fibrous-tissue formation in the various oVgans in this condition, the author finds some explanation of the compara- tive irresponsiveness of these cases. In some cases of not far advanced Bright's disease in which the tension is very high, and is evidently due to causes existent in the blood, a comparatively large dose of nitroglycerin or one of its allies is necessary to produce any marked reduction of tension. " But," says Dr. Bradbury, " apart from such pathological conditions, we now and then come across indi- viduals who can bear large doses of these drugs with impunity. Even in animals there seems 9 NITRIC ACID to be considerable variation of susceptibility to the action of vessel-dilating drugs, and par- ticularly of the organic nitrates. The reason is not always clear. Habitual use tends to diminish their action, but this is obviously not the explanation in many cases. With the solid nitrates the amount of food in the alimentary canal at the time of administration, as well as its reaction, will have. an important influence in determining the amount of drug dissolved, and therefore absorbed. It may be that under the influence of the alkaline juices of the in- testines these nitrates are converted into ni- trites (for example, sodium nitrite), but I am rather inclined to believe that this change, if it occurs at all, takes place in the blood or in the cells which form the walls of the blood- vessels." At the time of his lecture Dr. Brad- bury knew of only one case — that of a man suffering from, dilated heart, the result of alco- holism, in which these drugs had failed to have any distinct effect. " The action of organic nitrates upon other organs," he continues, " is of little practical importance. Upon the heart the direct effect of these compounds is very slight. Indirectly, owing to the diminished work consequent on dilatation of the blood-vessels, increased rapid- ity and sometimes palpitation (especially after glycol and glycerol nitrates) are noticed. Cer- tain nervous effects have been attributed to nitroglycerin, but none have, as yet, followed the administration of the solid organic nitrates. The effect upon the urinary excretion is prac- ticiiily nil. These bodies, as far as they have been investigated, are not diuretic. As ordi- narily administered, the organic nitrates pos- sess no cumulative action. The continued use of nitroglycerin produces a lessened suscepti- bility to its effects, but this has not yet been noticed after the administration of the ery- throl and mannitol compounds." Reviewing the action of these compounds upon the vascular system in regard to their practical application to the treatment of dis- ease. Dr. Bradbury thinks we may, for the present at least, discard methyl nitrate as being the least likely to prove of clinical value. Glycol dinitrate, again, is so similar in action to nitroglycerin and, at the same time, so much more expensive, that it also is not likely to enter into our stock of remedies. The longer-acting nitrates, however, may prove of value. Dr. Bradbury continued as follows : " From the pharmacological action of these two ni- trates, it would seem that the chief indication for their use is a condition in which the heart is labouring under increased work imposed upon it by contracted arteries. As life ad- vances, the hitherto elastic vessels become con- verted into more or less rigid tubes, the fibrous adventitia is thickened, and fibrous tissue replaces, to a greater or less extent, the muscu- lar and elastic tissue of the middle coat. As a result, increased work is put upon the heart, and hypertrophy results. Sooner or later, however, central or peripheral degeneration occurs; either the heart fails from the increased strain put upon it on the one hand, or causes rupture of a vessel from excessive power on the other. In disease the normal evolution may be compressed into a much shorter space of time ; thickened arteries and hypertrophied hearts may be found comparatively early in life ; and the final results may be the same. If by any means we can dilate the vessels we di- minish the work of the heart and the pressure upon each unit of area of the arteiy, and thus in both ways avert the tendency to death. Our difBculty hitherto has been, not so much to reduce arterial tension when desired as to keep the tension steadily below a certain level. Botn nitroglycerin and sodium nitrite have been used for this purpose, but their adminis- tration is attended with some inconvenience. As we have seen, these drugs have compara- tively little action after two hours, and it would therefore be necessary to give them at least every two hours to produce continuous low tension. Even then there would be con- siderable variation in the arterial pressure. By the substances I have described the tension is not brought so low, but the reduction is of longer duration and the pressure is less liable to fluctuation. They are also, as far as I am aware, free from poisonous properties, a qual- ity readily explained by their slight solubility." In cardiac pain, Under which name he in- cludes all forms of pain accompanying dis- eases of the heart or vessels, and adopts it in preference to angina pectoris. Dr. Bradbury thinks that obvious increase of tension is not always present. In a heart weakened by dis- ease, he remarks, a very slight increase of re- sistance may prove too much for the heart to overcome. This slight increase may be due to a general effect almost inappreciable in any one artery, or to an effect localized in one or more areas. Of greater significance is the fact that vaso-dilators do not always relieve angina- like pains, especially if these occur in cases of far-advanced heart disease with a low-tension pulse. In such cases morphine is of much greater value. ■ It is only, he says, by keeping arterial pres- sure below its normal level that the solid ' organic nitrates can be of service in the pre- vention of a seizure. " When an attack has come on," he says, " it is necessary to resort to more quickly acting drugs, and in cases of a sudden and severe nature inhalation of the fatty nitrites is advisable. For cases in which the pain is less severe and of longer duration the administration of nitroglycerin or sodium nitrite is perhaps more beneficial, But if we can prevent the advent of these attacks, a great stride ahead will have been made. Much may be done by the exhibition of purgatives and attention to the general health, but in the ma- jority of instances something more is needed. This something is, I believe, a vaso-dilator. Hitherto nitroglycerin and sodium nitrite have been the drugs mainly used ; but their evanes- cent and varying action render them unsuit- able. Nevertheless, I have seen cases in which the continuous administration both of nitro- glycerin and sodium nitrite seemed to prevent the occurrence of anginal attacks, and other physicians have reported similar results. In NITRITES 10 many of these oases, however, attacks occasion- ally developed, and it is quite possible that longer acting remedies, such as erythrol ni- trate, might have prevented them altogether." In regard to chronic Bright's disease. Dr. Bradbury says : " The most important change, and the one which affects us most closely, is the arterial thickening attending Bright's dis- ease. This leads to hypertrophy of the heart, and both combined to a high-tension pulse. Sooner or later, if the patient does not succumb to urajmia or some intercurrent disease, the in- creased vascular strain begins to tell either upon the heart or on the vessels, often on both. Either the symptoms of heart failure develop or attacks of apoplexy occur. Previous to such terminations, headache, mental inapti- tude, weariness, and similar symptoms are not uncommon, and sometimes these may be no- ticed, with a high-tension pulse, where no other direct evidence of renal disease exists. In all such cases the longer acting vaso-dila- tors are often beneficial. 1 do not wish to con- vey the impression that I regard the thickened condition of the arteries as the primary cause of the high tension of Bright's disease. This, I believe, is due in the first instance to an im- pure condition of the blood, and the correct treatment under the circumstances is to rid the blood as far as possible of this impurity. Once, however, the fibroid and muscular thick- ening in the arteries is produced it becomes a danger in itself. It is a condition we can not cure, and our treatment must therefore be symptomatic. By keeping down the arterial pressure in such conditions we may not only alleviate unpleasant symptoms, but may also prevent the onset of such disastrous conditions as cerebral hiemorrhage. The fibroid thicken- ing of the blood-vessels does not annul the action of these nitrates, though it diminishes to some extent their power." Tracings were shown, one series of which had been taken from a man in advanced Bright's disease ; the other from a man who had had slight attacks of cerebral haemorrhage. With regard to the action of these drugs upon the kidney disease itself, the author did not expect any beneficial action. "They are not diuretic," he said, "at the same time they are not irritant to the kid- neys, and, given even in acute inflammatory conditions of these organs, are not likely to produce ill effects." In cases of aneurysm — meaning those com- ing under the care of the physician — Dr. Brad- bury says It is very necessary to keep the circulatory system as far as possible in a state of physiolofjical rest. This is best accom- plished by dilating the peripheral arteries, and for this purpose iodide of potassium has for some time been the drug most in vogue. Without detracting in the least from the value of potassium iodide in this condition, he thinks that the nitrate of erythrol or of man- nitol will accomplish this end better, and will give more satisfactory results, in cases not of syphilitic origin. The pain which accom- panies aneai-ysm is not often relieved by vaso- dilators, and therefore he does not expect any benefit from the nitrates in such cases. Of other conditions connected with the con- traction of blood-vessels, Raynaud's disease, says Dr. Bradbury, is one that has been suc- cessfully treated with nitroglycerin. If vaso- dilators are of value in this condition, it_ seems to him that erythrol nitrate, as tending to keep up a more constant dilatation, would be of greater value. With regard to respiratory conditions, he does not expect any beneficial efllects from these bodies. In various forms of dyspnoea (uraemic, asthmatic, and bronchitic) nitroglyc- erin and the nitrites are sometimes of value, he remarks, but they often fail to relieve. Seeing, then, that the action of these compara- tively powerful vaso-dilators is not very dis- tinct, he says, we should not expect the less powerful drugs mentioned to exercise much influence. They may prove of prophylactic value in the dyspnoea occurring in Bright's disease, for example, but beyond that it would be useless to hazard conjectures. In cases of chronic hronchitis, however, and in other con- ditions where the dyspnoea is of cardiac origin, amelioration might be obtained from these compounds, he thinks. In such cases the weak heart is unable to drive the blood with suffi- cient power along the arteries; stagnation therefore occurs in the veins, and the pulmo- nary system is often the first to suffer. Thus aeration is limited by the pulmonary lesions on the one hand and the cardiac on the other. By dilating the vessels and thus relieving the heart, the circulation becomes more eiRcient and the blood is better aerated ; but under such conditions digitalis is usually of much greater benefit. He mentions that disappear- ance of the headache occurring in a chronic bronchitic, with full, rather tense pulse, fol- lowed the administration of erythrol nitrate. It is very probable, he thinks, that anmmic headaches occurring in patients with a high- tension pulse may be relieved by this drug, but his observations on this condition have been confined to those with a low-tension pulse, and the results have been somewhat conflicting. Although nitroglycerin has been given in many nervous affections. Dr. Bradbury does not think much beneflt will follow the use of erythrol or mannitol nitrate in these diseases. Migraine and neuralgia, he remarks, are often accompanied by reflex contraction of the blood-vessels, atid the use of vaso-dilators has sometimes proved curative. The solid organic nitrates, however, are, he says, much too slow in action to be of beneflt. though it is possible they may prevent attacks of migraine if ad- ministered continuously. The drugs might also be used by those who believe in the value of nitroglycerin in epi7eps2/, hut as he has rarely used this drug in this affection, his experience on this point is limited. Other nervous dis- eases — epileptic vertigo, cerebral congestion, tetanus, etc. — in which nitroglycerin has been used are not likely, he thinks, to yield to treat- ment with the nitrates. The dose of the solid organic nitrates, ac- cording to Dr. Bradbury, may be taken as 1 grain; more may be given if it is thought 11 NITRITES necessary, but usually this amount will suf&oe. They may be taken in the form of pills or tablets or in alcoholic solution. The last method he prefers. A solution of erythrol ni- trate in the strength of 1 in 60 may be made, and 1 fl. drachm may be taken in an ounce of water when necessary. Mannitol nitrate, he says, is not quite so soluble, but a 1-per-cent. alcoholic solution can be prepared, of which H or 2 fl. drachms may be taken in water. The additions thus made are stable and free from irritating properties. He knows of no evil effects having followed the administration of these drugs, but he adds that his investigation of them is not yet com- plete.] — Russell H. Nevins. NITRITES. — The compounds known as the nitrites have become quite numerous. They may be divided into two groups — the inorganic and the organic. Those constituting the former group are less numerous than those of the lat- ter. The nitrites of sodium, barium, calcium, potassium, and strontium are the principal ones whose bases are of mineral origin. The organic nitrites whose properties have been most extensively studied are compounds of methyl, ethyl, propyl, butyl, and amyl. From these we have the primary, iso-primary, sec- ondary, and tertiary nitrites. "The primary nitrites, both normal and iso-primary, differ from tlie secondary and tertiary compounds in containing nitroxyl joined to a methylene group (CHj), and all these primary compounds therefore contain the complex (CH2NO2) united with the different alkyl radicles. In the sec- ondary nitrites one atom of hydrogen in this group is replaced by methyl, (CHs)CH(CHs) KOj, while in the tertiary nitrites both the hy- drogen atoms are replaced by methyl, and these bodies therefore contain the group C(CH3)2 NOs. If the radicle takes the place of hydro- gen in one of the methylene groups, but not in that which is atl ached to nitroxy], the iso- Brimary butyl nitrite is formed" (Cash and lunstan, Phil. Trans, of thr, liny. Soc. of London, vol. clxxxiv [1893], R, pp. 505-639). Thus, of butyl we find normal (primary), iso- primary, secondary, and tertiary nitrites. Ni- troglycerin is sometimes erroneously regarded as a nitrite. It is a trinitrite of glyceryl. (See Nitroglycerin.) The influence of the nitrites on the general circulation is to lower the arterial tension and increase the rapidity of the pulse, with flush- ing of the face, the neck, and the upper por- tion of the chest, especially pronounced from the influence of the amyl nitrites. The dilata- tion of the capillaries of the skin over the other portions of the body is not often very marked. It has been demonstrated that the arterioles of the lungs dilate from the influence of these agents, thus pointing to their usefulness in relieving a distended right heart. The lowered arterial tension is mainly due to the direct effects of the nitrites in paralyzing the circu- lar muscular fibres of the arterioles, and the increased rapidity of the heart's action proba- bly results from their depressing influence on the inhibitory nerve of the heart and the im- 45 pression made upon the cardiac muscle by the sudden dilatation of the arterioles. According to the observations of Professor Cash and Pro- fessor Dunstan, the nitrites named below ac- celerate the pulse in the following order, the strongest being named first : Tertiary amyl nitrite, a-amyl nitrite, ;8-amyl nitrite, tertiary butyl nitrite, isobutyl nitrite, secondary butyl nitrite, butyl nitrite, secondary propyl nitrite, primary propyl nitrite, ethyl nitrite, and methyl nitrite. The pulse begins to show some accel- eration at the end of five seconds after inhaling a few drops of amyl nitrite, attains the great- est frequency about the end of the 35th second, when it begins gradually to decline, and reaches normal at the end of the 70th to the 90th sec- ond. The average greatest fi'equency from moderate doses of the amyl-nitrite prepara- tions is from 30 to 40 beats a minute. The primary butyl nitrite causes about 75 per cent, of the- pulse acceleration found to follow amyl nitrite. The greatest frequency of the pulse is reached between 25 and 28 seconds after begin- ning the inhalation, and the return to normal is a few seconds (3 to 5) sooner than follows after inhaling amyl nitrite. Isobutyl and secondary butyl nitrites increase the pulse a little more than primary butyl nitrite. Isobutyl nitrite causes about 82 per cent, and the secondary about 80 per cent, of that found to follow the inhalation of an equal quantity of amyl nitrite. The pulse after each returns to normal a few seconds sooner than after amyl nitrite. Pri- mary propyl nitrite accelerates the pulse about 62 per cent, and the secondary about 76 per cent, of what results from an equal dose of amyl nitrite. The acceleration and reduction of the pulse are effected in a shorter time than from amyl nitrite. Bthyl nitrite increases the pulse-rate only 10 or 15 beats a minute. The maximum influence on the pulse is reached about 25 or 80 seconds after inhalation is be- gun, but complete reduction does not take place until at the end of the 60th or 70th sec-' ond, when the pulse shows a tendency to fall below normal (Cash and Dunstan). Professor Leech's experiments (Brit. Med. Jour., July 1, 1893, p. 6) show a slower action of ethyl nitrite than that observed by Cash and Dunstan. So- dium nitrite acts much more slowly than the group of organic nitrites, and its influence is much more prolonged. There is no positive evidence of the nitrites having a direct stimulating effect upon the heart. In large doses they all lessen the strength of the cardiac systole, and especially is this effect well marked after large doses of sodium and ethyl nitrite. Leech, in compar- ing the influence of the nitrites with that of alcohol, says : " On the whole, it seems to me we must accord to the nitrites in small doses a certain degree of that kind of stimulating power which we attribute to alcohol, but it is exercised much more quickly, passes away more rapidly, and is far more readily followed by decreased cardiac power than is alcohol." By relieving the distended right heart of blood and depressing the cardiac inhibitory centres the nitrites act as indirect cardiac stimulants. Irregular action of -the heart may result from NITROBENZENE 13 large doses of the nitrites, and slight irregu- larity is said to be common after the inhala- tion of amyl, isobutyl, and propyl nitrites. The recorded observations of a number of cli- nicians are to the effect that previous irregular action of the heart is no bar to the adminis- tration of the nitrites, and that when such irregularity exists it is frequently lessened, sometimes made to disappear, and rarely in- creased by appropriate doses. Reduction of the Blond-pressure. — Reduc- tion of the blood-pressure is usually well marked after the administration of the nitrites. According to Cash and Dunstan, the organic nitrites may be arranged as follows, the nu- merals representing the relative strength of each in reducing the blood-pressure : The ter- tiary nitrites— butyl (9), amyl (6) ; the second- ary— propyl (10), butyl (8); the primary — iso-butyl (7), amyl (5), methyl (4), butyl (3), ethyl (2), and propyl (1). Respiration. — Very small quantities of the nitrite do not perceptibly affect respiration; medicinal doses increas'i the number of respi- rations to the minute, the increase amounting in the case of the primary amyl nitrite to 5 or 9, and occasionally to 12 respirations over the normal. Repeated inhalations without a long interval cause distinct slowing of the respira- tion. Toxic doses paralyze respiration before the heart ceases to beat. Leech believes that small medicinal quantities of the nitrites stim- ulate the respiratory centre. When these agents exert a depressing effect on the respira- tory centre it is probably through their influ- ence on the blood, which becomes dark, and even chocolate-coloured, before death, from in- terference with hiemic respiration. Stomach and Bowels. — The effect of the nitrites on the gastro-intestinal raucous mem- brane varies in different individuals. Many experience no inconvenience when the nitrites are administered in medicinal doses beyond emanations of nitrous gas in small quantities, especially following the ingestion of sodium and ethyl nitrites, while to others they act as gastric irritants, causing sickness and diar- rhoea. Leech thinks that when inhalation of the nitrites causes gastro-intestinal disturb- ance it is due to their excretion by the stomach and bowels. Kidneys — Dilatation of the vessels of the kidneys results from the administration of the nitrites, and an increased flow of urine takes place in some cases, but experimental observa- tions seem to show that they are rather unre- liable diuretics. Atkinson found in carefully conducted experiments on lower animals that small doses of nitrite of sodium either did not affect the flow of urine at all, or slightly dimin- ished or increased it. Leech's experimental observations on twelve persons free from fever, cardiac or kidney disease, to each of whom he gave 3 grains of nitrite of sodium thrice daily for a week, showed the urine increased in quan- tity in seven and decreased in five. In only one of the seven was the urine markedly increased, amounting in this one to 317'731 c. c. (7 fl. oz.) daily {Brit. Med. Jour., July 1, 1898, p. 7). The excretion of urea and that of uric acid seem to be unaffected by the use of the nitrites.' It should be remembered, as Leech reminds us, that, although the nitrites do not materially affect the action of the kidneys in health, it does not follow that they are inert in certain pathological states of these organs. Temperature. — Small quantities of the ni- trites, given to persons in health, do not mate- rially affect the temperature, but in toxic doses they lower it considerably. Perspiration. — Most nitrites, when given in sufficiently large doses to dilate the vessels of the surface of the body, will increase the per- spiration temporarily. Both sodium and ethyl nitrite possess this power in conditions favour- able for their action. The latter, in the form of spirit of nitrous ether, given in doses of ^ a fl. oz. in hot drinks, is the most reliable, but little effect may be expected from it when given in doses varying from 10 to 15 minims. The condition most favourable for the diaphoretic action of the nitrites is a febrile condition fol- lowing exposure to cold. The Nervous System. — The nitrites in ordi- nary medicinal doses do not seem to depress the nerve-centres or nerves, but in large thera- peutic and toxic doses they lessen cerebral ac- tivity, giving rise to heaviness and apathy, and sometimes even to stupor or unconscious- ness after inhalations of large quantities of the vapour of nitrous ether or nitrite of amyl. Leech is confident that no narcotic effect need be feared from the use of the nitrites in me- dicinal doses, and observes that " the sense of distention and throbbing in the head, the diz- ziness, and the headache felt by some after amyl, ethyl, or sodium nitrite are manifestly due to circulatory changes ; but the prolonged headache, which does not always come on im- mediately, but may last 'for twelve hours or more after some nitrites have been taken, is probably not due to the same cause. It is most frequent after amyl and isobutyl compounds. I have felt it myself after both, and also after propyl compounds, but not after ethyl nitrite or sodinm nitrite. I am inclined to think it is caused by the alcohol radicles, and not by the nitrite element, for other amyl, Isobutyl, and propyl compounds produce the same kind of long-lasting headache." The convulsions that sometimes occur in the lower animals and the slight muscular twitching that has been oc- casionally observed in man, after taking large doses of one of the nitrites, especially the amyl nitrite, are thought to be of cerebral origin and due to the asphyxiating infiuence of the poison. All observers seem agreed that the entire ab- sence of any serious or fatal brain disturbance following large doses of the nitrites makes the unpleasant cerebral symptoms no bar to their administration in medicinal doses. Motor con- duction and the reflex activity of the spinal cord are depressed after toxic quantities of the nitrites in the lower animals, and probably also in man, even after very large medicinal doses, but other symptoms than spinal are so promi- nent after using these agents in man that it is almost impossible to determine satisfactorily their effects on the functions of the cord. The activity of the motor nerves is undoubtedly 13 NITROBENZENE lessened, but not out of proportion to the irri- tability of the muscles. The sensory nerves do not seem to be directly afEected, and the relief of pain which sometimes follows the use of the nitrites is due to their influence on the circu- lation. Therapeutic Uses of the Nitrites. — The carefully conducted experiments of Professor Reicherl {Am. Jour, of the Med. Sci., July, 1880, p. 158) show that the physiological effects of the alkaline nitrites, especially of sodium and potassium, are almost identical with those of amyl nitrite, except that they are much slower in "their action and more permanent in their efEects. The investigations of Cash and Dun- stan (/. c.) demonstrated a marked similarity be- tween the effects of amyl nitrite and the other organic nitrites. And, finally, the admirable clinical observations of Professor Leech (Brit. Med. Jour., vols, i and ii, 1893), as well as the experience of various clinicians, enable us to conclude that the therapeutic indications whose value has been determined are nearly the same, and the choice of the nitrite to be employed in a given case will depend largely upon the ra- pidity of action and the permanence of the effects desired from a nitrite, modified by the unpleasant symptoms which are more likely to follow the use of certain nitrites than of oth- ers. The reader is referred to the article on Amyl nitrite for the general therapeutic in- dications of the nitrites. [Petrone {Riforma med., Aug. 31, 1895 ; Brit. 31ed. Jour. [Bpiiome], Nov. 33, 1895), having found that rabbits that had been inoculated subdurally with rabies had their period of sur- vival doubled by subcutaneous injections of sodium nitrite, tried the same treatment in two cases of syphilis with good results. The first case was that of a man suffering from marked malarial cachexia and enlarged spleen, who contracted syphilis in December, 1893. Dur- ing the early manifestations he took mercury and iodide of potassium, but as soon as the symptoms disappeared he ceased taking medi- cine. In March, 1894, he suffered from marked nocturnal osteocopic pains, periostitis of the skull and tibia, and an abundant papulo- pustular syphilide. From 5 to 10 grains of sodium nitrite, rapidly increased to 50 grains, were injected daily in two doses. The noctur- nal pains were relieved on the second day, and the rash and periostitis gradually disappeared, so that at the end of a month the patient was able to work and in much better health in every way. The second case was that of a woman, aged twenty-two, suffering from hereditary syphilis, which had first developed ten years before, and been treated with potassium iodide and mercury. In April, 1895, she presented loss of bony substance over an area equal in size to a 5-franc piece on the right frontal bone and on the left parietal, confiuent ulcerating gummata on the back, gummata on the thigh, and very extensive ulceration of the leg. The daily injection of 50 grains of sodium nitrite in two doses was practised, and the ulcers were merely cleansed with boric-acid solution. After twenty-six days the sores were almost all healed. The treatment was then interrupted for a few days by an attack of acute bronchitis. On the resumption of, the injections the patient was cured in ten days more and her general health much improved. No local troubles or general symptoms followed the injections. The solu- tions, says the author, should not be more con- centrated than 3 or 3 per cent.] Some of the Ifitrites Compared. — Headache is more common after the amyl, isobutyl, and propyl compounds, and least frequent after the nitrites of sodium and ethyl. The pulse is most accelerated by the amyl nitrites, but so- dium and ethyl nitrites cause only slight in- creased action. Gastric irritation occasionally follows the use of nitrites of sodium, potas- sium, and ethyl. When rapidity of action is desired, nitrite of amyl is to be preferred to all the other nitrites, but if a more prolonged influence of a nitrite is the object, nitrite of sodium is preferable. Cash found isobutyl and secondary propyl compounds most active in lowering blood-pressure, and Leech thinks that isobutyl nitrite is more reliable for the relief of anginal pain than the official amyl nitrite. In cases where it is desirable to in- crease the flow of urine temporarily, ethyl ni- trite or the spirit of nitrous ether is fairly efiBcient, if given in sufficiently large quanti- ties. Dose and Administration. — Half a fl. oz. of spirit of nitrous ether, or 1 fl. drachm of the 2'5-per-cent. solution of the nitrite of ethyl, should be given to an adult. The former con- tains, when pure, from 3'5 to 2-75 per cent, of nitrite of ethyl. It should not be mixed with water except in combination with an alkaline solution, such as the acetate of ammonium or potassium, until just before administration, as it rapidly deteriorates after water has been added. The nitrite of ethyl is soluble in absolute alco- hol, and must not be mixed with water until the time of its administration. Of the two alka- line preparations (of sodium and potassium) of which most is known, the nitrite of sodium is most commonly employed when a prolonged effect of a nitrite is desired. The sodium and potassium nitrites may be given in doses vary- ing from 1 to 5 grains. Two grains is the ordinary dose to begin with, but it is always safe to begin with the minimum dose of a medicine that is sometimes followed by un- pleasant symptoms, and increase the quantity after the susceptibility of the patient is ascer- tained. The nitrite of sodium or potassium may be given in water. When it is desirable to administer a nitrite hypodermically, a solu- tion of nitroglycerin, which acts like a nitrite, is to be preferred to the nitrite of sodium or potassium. (See Nitroglycerin.) Jeremiah T. Eskridge. NITROBENZENE, or nitrolenzol, C.Hs NOa, oil of mirbane, artificial oil of bitter almonds, is an oily liquid that has an odour resembling that of bitter almonds, and a very sweet taste. It is produced by the action of strong nitric acid on benzol, the resulting prod- uct being washed with water. If nitrobenzene is injected into the blood- I vessels of a rabbit, death with convulsions en- NITROGEX NITEOGLYOERIN 14 sues in a few seconds. Administered internally to an animal, it produces unconsciousness, epi- leptoid spasms, in some animals glycosuria, and sometimes death in consequence of paralysis of the motor-centres of the nervous system. The inhalation of the fumes of nitrobenzene produces in man headache, muscular weakness, drowsiness, mental disturbance, and a blue colour of the face. Taken internally, the drug is absorbed more or less slowly, and, in addi- tion to the foregoing symptoms, the entire body acquires the bluish colour, the pupils are dilated, the respiration is rapid, shallow, and irregular, the pulse is rapid and thready, soon becoming imperceptible, the muscles are com- pletely relaxed, and consciousness is lost. Fif- teen drops have caused death. Nitrobenzene has no therapeutic uses, but is employed in manufactures. In case of poison- ing with it, apomorphine or some other emetic should be administered at once so as to empty the stomach, which should be washed out by means of a stomach-pump or stomach-tube; hypodermic injections of strychnine should be administered as may be necessary ; the bodily temperature should be maintained with hot- water bottles or bags ; and massage and arti- ficial respiration should be used if necessary. Samuel T. Armsteosg. NITROCrEN, nitrogenium, or azote. — This gas is disengaged freely from certain mineral waters, such as those of Lippspringe and the Ottilien-Quelle at Paderborn. According to Dr. I. Burney Yeo (Manual of liedical Treat- ment, Philadelphia, 1893), the gases that those waters give off contain respectively 83'25 and 97 per cent, of nitrogen. Great improvement of the general- symptoms in cases of pulmonary tuberculosis, says Dr. Yeo, is stated to follow the inhalation of this gas, which is conducted with the aid of a special apparatus : the sleep is said to become calm, the appetite to increase, the night sweats to diminish, the diarrhoea, if there has been any, to be allayed, and the pul- monary capacity, the weight, and, except in desperate cases, the bodily strength and ac- tivity to be increased. But the fever has been reported as variously influenced. Treutler (Oertel's Respiratory Therapeutics, Yeo's trans- lation) says : " In slighter cases it soon dis- appeared, in others it was sometimes even exaggerated for the first week or two, after- ward diminishing somewhat rapidly or ceas- ing altogether, while in hopeless cases it was unaffected." Dr. Yeo refers to Oertel's book for a full description of the mode of conducting the in- halations, and makes the following quotation from his translation of it : " It is difficult as yet to express a decided opinion on the influence of nitrogen inhalations on chronic pulmonary infiltrations, as we have not nearly sufficient observations on the subject to exclude com- pletely all the casualties which always occur in the treatment of pathological processes running so varied a course, and to be able to separate the influence of the various other agents which come into operation. For the present it behooves us to give a fair trial of nitrogen inhalations in th e treatment of chrome pneumonia and its products." On the other hand, Rhoden, of Lippspringe (cited by Yen), is inclined to attribute the good effects of the treatment to the moist cli- mate, the inhalation of vapour of water, and the drinking of a great amount of warm water containing a considerable quantity of calcium salts, together with a little sodium sulphate, the patient fasting. ITITROG-LYCERIN, an organic nitrate, glyceryl trinitrate, 03H5(ON02)3, is an explo- sive compound, and to obviate the prejudice that some patients might therefore have against its use, it has been employed under the names of trinitrin and glonoin. It is an agent of con- siderable importance and is principally used in medicine when it is desirable to make a rapid and powerful effect upon the vascular appa- ratus by_dilating the arterioles. It occupies a place between amyl nitrite and sodium nitrite, being less rapid in its action and more per- manent in its effects than the former, but expending its influence on the vascular sys- tem more quickly than the latter, although the headache which is very common after a large dose of nitroglycerin persists much longer than one produced by sodium nitrite. The effects of nitroglycerin are first expe- rienced by the patient in from a few seconds to one or two minutes after the drug has been administered. In small doses, yet large enough to be appreciable, these consist of full and throbbing sensations in the head and slight dizziness, followed, in some instances, by head- ache. Larger medicinal doses give rise to sud- denly developed dizziness, full, throbbing, and constricting feelings in the head, amounting frequently to decided headache; a choking sensation in the throat, at times nausea, faint- ness, rapid action of the heart, lessened arterial pressure, dilatation of the arterioles, followed by languor, and. according to Bartholow, some- times pams in the stomach. In still larger, or lethal doses, the effects are rapidly developed and very pronounced, amounting to an ex- treme degree of languor and muscular relaxa- tion, weak and rapid action of the heart, small, feeble, or imperceptible pulse, cold, clammy perspiration, and even unconsciousness. The effects of nitroglycerin are most rapidly de- veloped when it is administered in alcoholic solution. On account of the variable susceptibility exhibited by different persons to the influ- ence of this medicament, considerable care is required that the initial dose should not be larger than is necessary to produce the desired results. One minim of a 1-per-cent. alcoholic solution has produced insensibility, and 3 minims have been followed by loss of conscious- ness and absence of the pulse at the wrists (II. C. Wood, Therapeutics and Materia Medica, 6th ed., p. 390). I have observed unpleasant effects to follow the use of yU of a grain. On the other hand, some persons experience no disagreeable symptoms after taking 2 or 3 minims of a 1-per-cent. solution. Persons soon become accustomed to increasing doses of 15 NITROGEN NITROGLYCERIN nitroglycerin. Dr. Murrell gave 10 minims eight times daily, the only effect being to re- lieve anginal pain and cause some headache (Croonian Lectures. Brit. Med. Jour., July 8, 1893, p. 57). Bartholow thinks that women and persons of feeble constitution are more susceptible to the druf; under consideration than the robust {Materia Medica and Ttiera- peutics, 8th ed., p. G(iT). Like nitrite of amy], nitroglycerin, in toxic doses, causes the blood to assume a chocolate colour, owing, no doubt, to its power of interfering with hifimic respira- tion. Death may be produced by large doses of nitroglycerin, and such a result is apparently due to paralysis of the muscles of respiration; but if ordinary care is used in the employment; of this powerful agent, nothing further than slight inconvenience will be encountered in those who are the most susceptible to its influ- ence. Even when unconsciousness has been produced by its too free use, recovery has taken place without an untoward symptom beyond headache that persisted for some hours. Dose and administration. — It is always safer to begin with a small dose in persons whose susceptibility to the influence of nitro- glycerin is unknown, and rapidly increase the quantity until slight inconvenience is experi- enced by the patient, or the desired results are obtained. The initial dose for weak and ner- vous persons should not exceed jjj- or T[h^ of ^ grain, and if no appreciable effects are experi- enced the same quantity may be repeated in ten minutes. If still no effects are observed, the dose may be doubled and repeated as often as is found necessary. There are two solutions of nitroglycerin in use — the alcoholic, spiritus glonoini (U. S. Ph.), and the aqueous. They are both 1-per-cent. solutions. The alcoholic solu- tion is more reliable than the aqueous, but the disadvantage of it is that it becomes explosive in proportion to the amount of evaporation that has talcen place of the alcohol holding it in solution. Hare recommends that it should be kept in tightly stoppered tins, in a cool place. The dose to begin with of either of these solu- tions should not exceed J a minim in persons whose susceptibility to nitroglycerin is not known. Tablets and pellets of nitroglycerin are made by manufacturing chemists. The amount of nitroglycerin contained in them varies from jirff to yi^ of a grain. 1 have known the weaker ones to cause unpleasant symptoms. [The British official tablets, tabeUm nitrogly- eerini(Jir. Ph.), are tablets of chocolate, each containing xhn oi a grain of pure nitroglyc- erin.] To Dr. Murrell, of London, belongs the credit of having first employed nitroglycerin for the relief of spasmodic attacks of angina pectoris. It seems to lessen or cut short the precordial pain and distress by suddenly dilat- ing the arterioles, especially of the pulmonary circulation, and thus relieving the distended cavities of the heart. When great promptness of action is required, inhalations of amyl ni- trite should be given for its temporary effect, followed by nitroglycerin for its more perma- nent influence. As soon as the susceptibility of the patient to the influence of this drug is ascertained it must be pushed to the point of tolerance. Larger doses are required in this disease than in almost any other spasmodic affection. Leech (Brit. Med. Jour., July 15, 1893, p. 109) states that he has had to gradually raise the dose to 30 minims, and a larger dose is frequently required. The nitrites generally, and nitroglycerin es- pecially, are useful in cardiac dyspnoea, both of puljponary and of cardiac origin. In cases in which the heart is weak or fatty, it is thought care should be exercised lest damage to the heart result, but, on the whole, the weight of testimony is in favour of the use of this agent, even under such circumstances. Some eases of spasmodic asthma are bene- fited by ni troglycerin, but in this affection, as in angina pectoris, the less the structural changes that have taken place, the better the effects of the nitrites; therefore it is in the early stages of these diseases that most may be expected from the use of any of the nitrite group. It is well known that the arterial tension is increased in Bright's disease, and, as nitroglyc- erin lessens this, it, as well as the other ni- trites, has been employed with, as is alleged, more or less advantage to the patient (Bar- tholow, Robson, et al.). Nitroglycerin has been employed with some success in hiccough, whooping-cough, laryngis- mus stridulus, tetanus, seasickness, reflex vom- iting,'gastralgia, sixiA hepatic and renal colic. It is not so effectnal in preventing an attack of epilepsy as amyl nitrite. In migraine attended with blanching of the face, and in neuralgia of the trigeminal nerve due to in- suffieient blood supply to the affected nerve ni- troglycerin acts promptly in cutting short an attack. Headaches due to anamia of the train are relieved by this agent. Bartholow speaks highly of the use of nitroglycerin in the cure of ancemia. The cold stage of intermittent fever may be aborted- by any of the promptly- acting nitrites. Gowers recommends the use of nitroglycerin thrice daily in persons who are subject to migrainous headaches, given during the interval of the attack for the purpose of increasing the blood supply of the brain. [Nitroglycerin has recently been found a very potent remedy in sciatica. A Russian physician. Dr. Milkhalkine (Semaine mid. ; Lyon med., Feb. 24, 1895), reports three cases of persistent sciatica that had been absolutely rebellious to the action of antipyrine, of acet- anilide, of chloral hydrate, of the bromides, and of other analogous drugs, as well as to the em- ployment of I'evulsives. Under the influence of nitroglycerin two of the patients were radi- cally cured of their sciatica, and in the third case it produced a considerable amelioration. It was administered sometimes in a 1-per-eent. alcoholic solution, of which three drops a day were taken, sometimes under the form of the following mixture : A 1-per-cent. alcoholic solution of nitroglyc- erin, 75 grains ; Tincture of capsicum, 113 grains ; Distilled peppermint-water, 235 grains. S. : From 5 to 10 drops three times a day. NITEOHYDROCHLORIC ACID NITROUS OXIDE 16 Dr. William C. Krauss, of Buffalo (N. Y. Med. Jour., Feb. 29, 1896), before he had seen Milkhalkine's report, and having only a vague knowledge that Lawrence had recommended the use of nitroglycerin in the treatment of sciatica, treated seven cases with the drug, using it indiscriminately in all his cases of sciatic pain. Dr. Krauss reports that all these seven pa- tients received decided benefit from the very beginning of this mode of treatment. In the acute cases they recovered in from ten days to a month ; in the chronic cases they improved notably and gained daily. Just how to explain the action of ,this drug on sciatic disturbances, says Dr. Krauss, is extremely difficult; to say that it has the eflfeet of dilating the arterioles of tJie nerve sheaths, affording more nourish- ment to the nerve, might answer in cases of neu- ralgic sciatica, but would hardly be accepted for neuritic sciatica. The action in these lat- ter cases can be explained in no satisfactoiy way, and therefore had better be left unex- plained. The only discomforts arising from the use of the drug noted by Dr. Krauss were congestive headaches and flushing of the face sometimes following the first dose of the medi- cine, while in other cases they did not supervene until the maximum doses were administered. To counteract these effects, he says, the bro- mides may be used, thus robbing the nitroglyc- erin of all the physiological effects where they are not wanted, and allowing them to proceed without hindrance in those places where they are desired. Dr. Krauss adds : " I do not wish to convey the idea that nitroglycerin will cure every case of sciatica — far from it ; but if it cures 50 per cent, of all cases in a period of from one to three weeks, it will be doing what no other drug or measure has heretofore done. If after a period of administration of ten days no per- ceptible effects have been obtained, it should be abandoned and kept in store for the nest case. The treatment of anaemic conditions, diatheses, and local causes, such as pressure — these, perhaps, provoking and setting up the sciatic pain — must, of course, be considered and carried out in conjunction with the special treatment. Prom my experience I should ad- vise beginning the treating sciatica with nitro- glycerin, and only after its inability to cure is apparent falling back upon the other drugs and measures with which we are all ac- quainted." Dr. G. Lindsay TurnbuU (Lancet, Feb. 8, 1896), who records a case of the successful use of nitroglycerin in the treatment of gallstone colic, suggests its use when morphine is not well borne.] — Jeremiah T. Eskridge. NITBOHYDROCHLORIC ACID, or ni- tromuriatic acid, aqua regia, acidum nitro- hydrochloricum (U. S. Ph.), contains 18 parts of nitric acid and 82 of hydrochloric acid, is of an orange-yellow colour, and is highly cor- rosive, but is somewhat unstable, and should be freshly prepared to be of the highest thera- peutic value. Although strongly escharotic, it is never employed as a caustic, and possesses no advantage over nitric acid. In the propor- tion of 1 fl. oz. to the gallon of warm water it is often used for sponging cachectic children that have a dry, wrinkled skin, white pasty stools, and an inclination to gseophagia. A somewhat stronger solution — from 2 to 8 fl. oz. of the acid to the gallon of watei- — is very ser- viceable in the treatment of jaundice due to duodenitis or malaria ; it is used for sponging the surface of the body and as a pediluvium, or a general bath in it may be taken. Nearly all chronic, but not the acute, diseases of the liver are beneflted by the constant wearing of a broad bandage moistened in a solution of this strength and covered with oiled silk, over the region of the liver. The efficacy of the external application of this acid is usually increased by its simultaneous internal admin- istration. Dysentery, jaundice, smA dropsy of hepatic origin, especially in persons residing in hot climates, are also generally alleviated by a continued use of it. In constitutional syph- ilis it is more useful than niti'ic acid, particu- larly after a long course of potassium iodide and mercury. It may be used in place of nitric acid in the various digestive disorders, lithcemia, etc., and often is more efficient, but no rule can be given for the selection of the cases in which it would be the more appro- priate. In xanthelasma, acne, and all cuta- neous affections due to or aggravated by digestive disturbances it is a highly useful adjuvant to anv special treatment which may he indicated. It is advisfed that it should not be combined with alcoholic solutions, as suf- ficient gas may be given off to cause an ex- plosion. The dose is from 3 to 6 drops, well diluted, three times daily. The dilute acid, acidum nitrohydrochloricum dilutiim (D. S. Ph., Br. Ph.), is of about one third the strength of the undiluted, and may be given in doses of from 10 to 20 drops, biit is not very reli- able, as the reaction between the diluted acids used in its preparation is very different from that which occurs when the undiluted acids are mixed. — Russell H. Nevins, NITROUS OXIDE, laughing ga.i, pro- toxide of nitrogen, or nitrogen monoxide, is a colourless, transparent gas of the specific grav- ity of 1-537 and of neutral reaction. It has a sweetish odour and scarcely any taste. It is made by careful heating of nitrate of ammo- nium, NHjNOa, which splits up into water and nitrous-oxide gas, N,0. To be freed from any trace of acid or nitric oxide, the gas should be passed through a solution of hydrate of potassium and a solution of ferrous sul- phate, and should be held over water in a jar for at least twenty-four hours. Xitrous-oxido gas supports combustion almost as well as oxygen. By pi'essure, a colourless liquid may be made of the gas, and further pressure will cause its solidification. Water will take up almost its own bulk of nitrous-oxide gas. Priestley discovered the gas, but Sir Hum- phrey Davy was the first to discover its aiias- thetic properties. It was his belief that it could be substituted for oxygen in inspired air ; but this has since been proved false by the researches of Hermann and of Amory [N. T. 17 NITROHYDROCHLORIC ACID NITROUS OXIDE Med. Jour., Aug., 18T0). Davy did not carry his experiments far enough, however, to realize the possibility of the use of nitrous-oxide gas for surgical purposes. Mr. Colton, now an aged man living in New York, was demon- strating the anaesthetic properties of the gas in one of his public exhibitions in which per- sons under its influence seemed to feel no sensibility to pain, when the notion was seized by Horace Wells, a dentist of Hartford, Conn., to use the substance for the painless extrac- tion of teeth. Dr. Wells made an unsuccessful effort in 1844 to induce the medical profession to adopt nitrous oxide as a general surgical ansesthetic, but his attempt failed. It was not until 1863 that it came fully into vogue among dentists. Since that time it has been used for ansBsthetic purposes on a gigantic scale all over the civilized world. For our knowledge of the physiological ac- tion of nitrous oxide we are indebted princi- pally to Hermann (Arch. f. Anat. u. Physiol., 18G4), Amory {loc. cit.), and Zuntz (Pflilger's Archiv, Bd. 17, 1878, i and ii). Though there is a difference in the methods employed by these observers, their results are almost iden- tical. Arterial blood shaken up witli nitrous- oxide gas becomes dark, .and venous blood remains dark. Inhaled pure, the gas pro- duces a feeling of sufEocation and at the same time of stimulation. The gas is, therefore, not respirable in the true sense of the word, for it does not give up its oxygen to the blood. All observers are agreed that asphyxia is pro- duced by this strong molecular cohesion, de- priving the blood temporarily of a suflScient supply of oxygen. The ansesthetic properties of the gas lie in close connection with its as- phyxiating tendencies. On inhalation of nitrous-oxide gas, there is first noticed a stimulation of the entire system, as in alcoholic intoxication. The entire body tingles, and the keenness of the senses is ac- centuated. The pulse becomes fuller and more rapid, and the respirations are increased in frequency and are shallow. Consciousness is maintained up to this point, and the subject answers questions rationally. The face is pale. If the administration of the gas is continued, the face and visible conjunctivEe become deeply cyanosed, and the breathing grows stertorous. Consciousness disappears and anEesthesia of the senses follows, sensation and muscular power being the last to disappear. Unless the use of the anaesthetic is continued, the aboli- tion of sensation lasts but a minute or two, the patient recovering from the influence of the narcotic as soon as oxygen is inhaled. Rhythmic muscular movements, twitchings, or rigidity may manifest themselves during the anaesthesia ; or, on recovery, there may be erotic symptoms or hysterical conduct. During the second period of ansesthesia, ■when the face is dark and the pulse scarcely perceptible, it is well to guard against the pos- sibility of complete asphyxia or the appearance of convulsions by giving the patient a few whiffs of atmospheric air. During the period of insensibility, dilatation of the pupil, im- peded respiration, irregularity of the heart, and diminished pulse-rate are often seen. Warner {Lancet, June 17, 1883, p. 985) reports that he has seen coma, hemiplegia, catalepsy, hysteria, and clonic convulsions follow the use of laughing gas. Cardiac disturbances are not rarely witnessed, and an interesting case is recorded by Ottley {Lancet, Jan. 30, 1883). Lafout has observed a transient albuminuria and glycosuria following the inhalation of nitrous-oxide gas {University Med. Mag., vol. ii, p. 348). The great majority of people may be narcotized without any disagreeable occur- rences. Occasionally, however, persons are met with who complain of an " anxious feel- ing" about the breast — something like that witnessed in pseudo-angina pectoris. Some- times the psychical effects of the gas are disagreeable rather than pleasing, and the occasional slight convulsions already noted indicate an irritation of the cerebral cortex. Long-continued anaesthesia with this gas may be followed by a venous condition of the arte- rial blood; due to the deprivation of oxygen from the haemoglobin of the red blood-cells. Erotic excitation is not uncommonly ob- served after nitrous oxide anaesthesia. The same precaution of having a third responsible person present during the narcosis of females should be observed as in ether ansesthesia. Vomiting and nausea practically never occur in the use of this gas. Minor operations under its influence can therefore be under- taken without consideration of a previous meal. Recovery from the infTuence of nitrous oxide is marked by a slight mental dulness, which rapidly disappears. The face and visible mu- cous membranes return to their normal colour, and within a minute or a minute and a half the patient is entirely conscious. He may laugh or cry for a few minutes, or may remain very solemn in his demeanour. That nitrous oxide is the safest of the three great anaesthetics is axiomatic. Deaths after or during its use are exti-emely rare. Thus, Darin, making a statistical comparison, gives these figures : Chloroform, one death out of 3,873 anaesthesias ; ether, one out of 33,303 ; and nitrous-oxide gas, one out of 100,000 {Brit. Med. Jour., Jan 84, 1885). The present writer has been able to find but eighteen cases of death from nitrous-oxide, one of these being an unrecorded instance. The gas is used, un- doubtedly, hundreds of thousands of times an- nually, and report is certain to be made of a fatal result in its administration. Evidence is almost unanimous that it is the safest of the general anassthetics. liolden has pointed out that inhalation of the gas may be followed by haemorrhagic tendency, and that its employment is always attended with pulmonary engorgement. He regards nitrous oxide, therefore, as contra-indicated in pulmonary disease, particularly when there has been a hfemoptysis, and in haemophiliacs (Kappeler, Anmsthetica, Stuttgart, 1880). Nitrous-oxide gas has its greatest use among dentists in the extraction, of teeth and their roots. Among surgeons it has gained wider and wider favour during the last decade for NOSOPHENB NUCLEINS 18 use in minor operations of short duration. Un- fortunately, its physiological action is so su- preme that it will not admit of prolonged employment. It is called into requisition for the opening of abscesses, tenotomies, and the re- daction of dislocations and fractures. Barton recommended it highly for the last-mentioned purposes, because of its safety and the qui..'k muscular relaxation it produces (Phila. Med. Times, vol. xvi, p. 108). It can be satisfactorily used in operating an ingrown toe nail and in circumcision. In fact, in any surgical pro- cedure which requires only a short anaesthesia, nitrous-oxide gas has its distinct indication. More extensive operations than those indicated have been performed with the use of nitrous oxide. Carnoohan, in England, removed a woman's breast, giving the patient alternate inhalations of the gas and of atmospheric air. The late Dr. J. Marion Sims extirpated an abdominal tumour with a nitrous-oxide anaes- thesia lasting twenty minutes. The use of the gas in labour has naturally been tried. Zweifel and Doderlein, of Erlan- gen, made a thorough research in regard to it (quoted in Brit. Med. Jour., Nov. 7, 1885), and found that it did not retard labour in the later stages, as chloroform does. Sensation is benumbed, but the patient remains conscious. This obtundity of pain lasts long enough to suture a ruptured perinmum. NH;rous-oxide gas could be introduced into private obstetrical practice only under peculiarly favourable cir- cumstances; and, indeed, so rare is a death from chloroform during confinement that the obstetrical use of laughing gas will probably always remain restricted to maternity hospitals. No great advantage seems to accrue from mix- ing it with oxygen in the proportion of 4 to 1, as has been proposed. At the present day English surgeons fre- quently begin an ether narcosis by rendering the patient unconscious with nitrous-oxide gas. By this means the primary disagreeable effects of ether are obviated. The gas may be administered in two ways. Both methods require, besides the iron reser- voir, a caoutchouc bag connected by rubber tubes with the reservoir on one side and with a mouthpiece on the other. This mouthpiece is furnished with a valve opening outward, allowing the expired air to escape. With each inspiration the valve closes, permitting only pure gas to enter the lungs. A lever-like ar- rangement renders it possible to administer gas and atmospheric air at the same time. In the first method, pure rjitrous oxide is given for inhalation for from one to two minutes, fol- lowed by an occasional whiff of atmospheric air. The second manner of inducing anaesthe- sia is characterized by permitting the simul- taneous inhalation of the gas and air. The latter requires a longer time to accomplish the purpose, and the narcosis is more difficult to produce. The method first described is the one in most common use. The only objection to the apparatus above defined is that an ap- preciable quantity of gas is lost. To overcome this loss, an apparatus has been devised for institutions where much gas is used in which the expired air is returned to the reservoir after being passed through limewater to rid it of its contained carbonic-acid gas. The advantages of nitrous-oxide gas as an anaesthetic may be said to be : 1. The rapidity of its action. 3 Its comparative and prac- tically absolute safety. S. The rapid return to consciousness and sensation. 4. The almost total absence of disagreeable sequelae. Among its disadvantages are its unfitness for prolonged operations and the difficulty of transporting the necessary apparatus for its use. Blake and Hamilton {Med. Record, Jan. 31, 1880) have recommended inhalations of ni- trous-oxide gas in cases of melancholia and nervous exhaustion, as a hypnotic and stimu- lant. Its use in this coTinection has entirely disappeared. Dr. George J. Ziegler (Researches on the Medical Properties and Application of Nitrous Oxide, Philadelphia, 1865) has also urged the employment of the gas in small quantities in " permanent chemico-organic, ar- terial, nervous, and cerebral changes," and as a "general stimulant" in all asthenic diseases. These suggestions undoubtedly rested upon the belief, now known to be false, that the oxygen of the gas was given up to the blood. JS'itrous-oxide water is water impregnated with nitrous oxide under pressure. This was known as " Searle's patent oxygenous aerated water," and about fifteen years ago had a large sale as a diuretic, stimulant, and alterative. Serullas employed it in Asiatic cholera. It possesses merely a historic interest. [In the Medical Record for May 11, 1895, Dr. Charles G. Pease treats of the use of nitrous- oxide gas as an anfesthetic in prolonged opera- tions. As anaesthesia, he says, may be prolonged with the gas up to one, two, three, and four hours, with so much greater safety to the pa- tient than with other anaesthetics, and with no unpleasant sequelae, it must surely come into more general use. fie admits that he finds it far more tiring to administer gas than to ad- minister the other aniEsthetics, but that, he says, should have no weight, in view of the great advantages to the patient. Dr. Pease has devised a portable outfit consisting of small cylinders containing 100 gallons of gas each (condensed) with a convenient case for carry- ing them, a gas-bag, tubing, and an inhaler, with valves to admit air and shut off gas, and mce versa. The gas, he says, should never be administered to an alcoholic patient, and alco- hol should not be allowed prior to the admin- istration, as the patient is very apt to become unmanageable. At a meeting of the New York Surgical So- ciety held on November 37, 1895 (Annals of Swg., Feb., 1896), Dr. Francis H. Markoe pre- sented the subject of the use of oxvgen in con- nection with that of nitrous oxide and ether (see under Oxygen).]— Samuel M. Beickner. NOSOPHENE, or tetraiodphenolphthalein, (CeHJ,.OH),.C each 20 parts; Starch, ) Liquid paraffin 40 " (3. Weak.) Resorcin 10 parts ; Zinc oxide, ) . „> ., Starch, \ ^^'^^ ■^^ Liquid paraffin 40 " Unna's Lead Paste. ¥?S\^^-^ 30 parts; Rice starch 10 " Vinegar 60 " Unna's Zinc Paste. i^?ch°"''''h-h ^^P-ts; Vaseline 50 " Charles Rice. PASTILLES, PASTILS, are small cones or tapers prepared from an aromatic mass which, when dry, can be made to burn slowly at a glow, and thereby cause the odorous substances to be diffused through the room. Their preparation on the small scale is best carried on in this wny: The ingredients, well mixed to a tenacious but pliable mass, are rolled out on a board or on the pill-ma- chine into uniform cylinders of a diameter of about J or J of an inch, which are out into pieces of equal length and shaped into small cones. They are then diied at a gentle heat. The following formula is recommended, but this may be modified in many ways to produce different odours : Med Pastils. — Moisten 725 parts of red Saunders, in No. 50 powder, with a solution of 75 parts of potassium nitrate in 1,000 of water, and dry the mixture. The object of this is to impregnate the powdered wood uniformly with the saltpetre. Pre[)are a mixture of 50 parts of tincture of benzoin, 30 of balsam of Peru, 40 of balsam of Tolu, 40 of storax, 2 of oil of sandalwood, and ^ part of cumarin, and if ne- cessary add to it just enough alcohol to render it homogeneous and capable of being [loured. Having mixed the powdered red saunders with 30 parts of powdered tragacanth, incor- porate with it the odorous mixture thoroughly, and finally work into it enough mucilage of tragacanth, containing 2 per cent, of potassium nitrate, to obtain a pliable dough, which is to be rolled out and formed as above directed. Before the pastils are quite dry they may be painted with a thin coating of some liquid metallic bronze, to give them a handsome ap- pearance. Pastils not only are useful for diffusing a pleasant aroma, but may also be made the me- dium of impregnating the air with medicinal vapours. Some examples (partly after Diete- rich) will show how this may be done : Carbolic-acid Pastils. — Mix 830 parts of charcoal, in No. 50 powder, with, a solution of 50 parts of potassium nitrate in 1,000 parts of water, and dry the mixture. Next mix it with 30 parts of powdered tragacanth, and then in- corporate with it thoroughly 100 parts of car- bolic acid and 1 part of oil of wintergreen, and finally work into it enough mucilage of traga- canth (containing 2 per cent, of saltpetre) to give the mass the proper consistence. Crcsol Pastils. — These are made like the pre- ceding, except that 100 parts of cresol (oresylic acid) are taken in place of the carbolic acid. Creosote Pastils. — These may be made with 50 parts of creosote. Tar Pastils inay be made to contain from 50 to 100 parts of tar. Chloride-nf-ammonium Pastils. — Six hun- dred and fifty parts of powdered charcoal are moistened with a solution of 250 parts of am- monium chloride, 75 of potassium nitrate, 5 of 65 PASTILLES PELLETIERIjSE sugar, and ^ part of oumarin in 700 parts of water, and then dried. The powder is mixed with 20 parts of powdered tragacanth, and the mixture made into a mass with mucilage of tragacanth (containing 2 per cent, of salt- petre). Lastly, 10 drops each of balsam of Peru and oil of rose are incorporated, and the mass is formed in the usual manner. Diete- rioh recommends giving them a coating of sil- yer-bronze. lodide-of-ammonium Pastils. — These are made like the preceding, the quantities of the first three ingredients being 825 parts of char- coal, 100 parts of ammonium iodide, and 50 of potassium nitrate. Iodine Pastils. — Eight hundred and eighty- five parts of powdered charcoal, 40 of potas- sium nitrate, 5 of sugar, and 20 of powdered tragacanth are combined as described in the preceding formula. To the mixture is added a solution of 50 parts of iodine and ^^ part of nerolin (the synthetic perfume) in 200 parts of ether ; the whole is spread out and exposed to the air for a few minutes, and then it is formed into a mass with mucilage of tragacanth. When the pastils have been formed they must be dried without heat. To prevent further loss of iodine as far as possible, they should be covered with a coat of benzoin by several times applying a tincture of benzoin of double strength. When they are perfectly dry, they must be kept in glass-stoppered vessels in a cool place. — Charles Kice. PATTIililNIA.— See Guaeaka. PEANUTS.— See Arachis. PEAT is a kind of carbonaceous earth found beneath the surface and composed principally of vegetable roots and fibres in various stages of decomposition. It is pro- duced under several different conditions of climate and topography, but usually in swampy or marshy places or where the atmos- phere is for a considerable portion of the year foggy. It is abundant in northern Europe, Scotland, Ireland, and India, and in some parts of the L^nited States. The principal vegetables which by their decomposition form peat are the different varieties of moss called Sphagnum and — especially in India — wild rice. It is probable that peat is a product of one stage in the formation of coal, and, indeed, it is in some countries extensively used, when dried, as fuel. Peat is usually of a dark or blackish colour ; it is spongy and in its more superficial layers contains much water. Its reaction is acid, due to the presence of humio, phosphoric, and sulphuric acids. When dried, peat is a light, very absorbent material which — because of these properties as well as by a supposed anti- septic quality, due, perhaps, to its acid constitu- ents — has been deemed suitable as a dressing for wounds. Like dry earth and charcoal, it causes the disappearance of foul odours and improves the appearance of granulations. When used for these purposes, the peat should be dusted upon the wound quite thick, and should be often renewed. It has been highly recommended in foul-smelling ulcers and in gangrene. Peat may also be used as an ordi- nary wet or dry surgical dressing, when it will be found convenient to have it sewed into bags of cheese cloth made in various sizes. It is supposed to have a special virtue as a wet dressing or poultice. It has been the practice since the beginning of the antiseptic era to moisten the wet peat dressing with one or another of the well-known antiseptic lotions, such as bichloride-of-mercury or carbolic-acid solution. The peat then, of course, has little or nothing to commend it over the more usual dressings. Still, in an emergency, such as may exist in time of war where for one reason or another the ordinary gauzes, etc., may be un- obtainable, if the country is one where peat abounds it may be found useful. Another use for it exists in certain parts of Europe and Africa — namely, as an immersion medium or kind of bath for the entire body. The peat for this purpose has such a large ad- mixture of water that it becomes a kind of thin mud or slime. (See Baths.) White peat is the name of a very finely powdered silicious earth formed from extinct varieties of diatoms. This is not, properly speaking, a true variety of peat, but is soriie- thing quite different. It is silicious, not carbonaceous; it will not burn, but may be sterilized by heat. It has in itself no antisep- tic qualities. White peat in bulk is used as a filter, and it is also used in the manufacture of dynamite. Arpad G-. Gerster. Howard Lilienthal. PECTORALS.— See Expectorants. PEDILXJVIUM.— The foot-bath (see un- der Baths, vol. i, p. 169). PELLETIEBINE, the active alkaloid of pomegranate, is, on account of the small bulk of the dose required, the most elegant icenia- cide known, but is hardly suited for gen- eral use, on account of its relatively high cost. In appropriate doses it appears to be without any marked effect upon the gen- eral economy, but in unduly large amounts it may give rise to vertigo, diplopia, and muscular weakness, and in some instances it has been known to cause temporary paraly- sis of the voluntary muscles. It is never used in its basic state, but either as the sulphate or the tannate, the latter being regarded as the most effective. From -J- to 1 grain may be given in the morning after the preliminary treatment given in the article on Anthel- MiNTHios has been followed out. It is usually followed by no general symptoms except perhaps a slight feeling of giddiness, • but may excite nausea and vomiting. As a rule, it may be depended upon to purge, but if it fails to do so within two or three hours a cathartic must be administered. The proprietary preparation known as " Tan- ret's pelletierine " is very largely used instead of the tannate and appears to be entirely free from objection. Pelletierine and its salts have been employed in the treatment of paralysis of the third and fourth cranial nerves, and with reported good results. The bark and stem of the root of Pimica PELLITORY PENTAL 66 granatum, or pomegranate, granatum (U. S. Ph.), granati radicis cortex (Br. Ph.), cortex granati (Ger. Ph.), may be substituted for pelletierine, of which they are the source, but, on account of the considerable bulk necessary to constitute a proper dose, the crude drug is open to objection and, besides, is rather more apt to cause nausea and vomiting. The pow- dered drug may be given in doses of -| oz., but a decoction made by soaking 3 oz. for twenty- four hours in a quart of water and afterward reducing it to oue half its bulk by boiling is preferable. The whole amount may be taken at once, but it is more usual to administer it in divided doses at such intervals as may seem appropriate in individual cases. [There is an official decoction, decoctum granati radicis (Br. Ph.), the dose of which is from 2 to 4 fl. oz.]. The rind of the fruit and the flowers also are said to have the same properties as the bark. They may be given in doses of from 30 to 30 grains. The rind is also astringent, and is sometimes used in the treatment of diarrhoea. (Of. Anthelminthics). — Russell H. Nevins. PELLITORY.— See Pyrethrum. FEIf OILS, also called bougies, are small cy- lindrical rods about -^t; to J of an inch in diam- eter and from about 8 to 6 inches long, pointed at one end, and weighing from 15 to 30 grains. They are intended to be introduced into cav- ities requiring this form, such as the urethra, sinuses, etc. They may be formed either by hand or by rolling on a pill- tile or board, or they may be made by pouring the melted mixture into glass tubes previously oiled inside, and then pushing the pencils out by means of a suitable glass rod. They may be made of cacao butter or of gelatin. Those made of cacao butter are apt to be very brittle and to break I easily. Those made of gelatin are preferable. For the latter, the following method may be employed : Soak 10 oz. of the best gelatin in water until it has become soft;, pour off the excess of water, melt the softened gelatin, add 16 oz. of glycerin, and heat the mixture on a water-bath, constantly stirring, for about an hour. Then incorporate or dissolve in it the medicinal ingredient, being care- ful to keep the mass well stirred if the reme- dial agent is insoluble in the mixture, and pour it into suitable glass moulds previously coated on the inside with oil or soap liniment. When the mass has set, push it out by means of a rod and cut the pencil into sections of suitable length. As glass tubes are usually slightly tapering, it is well tf remember that the pencils should be pushed out at the wider end. — Charles Rice. PENNYBOYAL.— See Hedeoma. PENTAL, tHmethylethylene, /3-isoamylene, CbHio, an isomer of amylene, is a colourless and very inflammable liquid which boils at 1004° P., and, though volatile, is not decom- posed on exposure to light or air. Its odour is strong aijd pungent and has been thought to resemble that of mustard. Pental is insol- uble in water, but with alcohol, ether, and chloroform it is misoible in all proportions. The physiological action of pental is in par- ticular that of a general ancesthetic of rapidly developed but transient effect. Prom its in- halation there results, usually within two or three minutes, loss of sensibility without abso- lute loss of consciousness, so that the command to open the mouth or perform some similar action may be complied with. A persistence in the administration ot the drug, however, results in narcosis. The unconsciousness produced by penfal is brief, unless the administration is continued, its duration seldom exceeding four minutes. The return to consciousness is rapid and is apt to be followed by a brief period of analgesia, during which operative procedures may sometimes be continued. The inhalation of pental is but slightly irritating to the respir- atory tract, and excitement is seldom an ac- companiment of its use, but occasionally there may be observed laughter, delirium, and slight convulsive movements. During the period of narcosis the pupils are usually widely dilated. The corneal reflex is late to disappear. Sali- vation is unusual, and muscular relaxation is generally absent. Upon the patient's re- covering some dizziness and unsteadiness of gait are apt to occur, but as a rule they disappear rapidly. It has been said that there are no undesirable sequels of pental amesthe- sia, but this is certainly a mistake, for there are credible accounts of excitability, tremors, difficulty of speech, headache, erythematous eruptions, and even convulsive movements. Albumin, casts, and blood cells have been found present in the urine after its use. That pental anassthesia may be safely conducted is no doubt true, but that it is a safe anaesthetic is questionable, to say the least. Temporary cessation of respiration with cyanosis is not infrequent during its administration, and Cheyne-Stokes respiration has also been ob- served. Moreover, the circulation has in some cases been much depressed, and death has un- doubtedly been produced by it. These things, indeed, are scarcely to be wondered at, since experiments upon animals would seem to indi- cate that pental is a circulatory and respira- tory depressant of considerable vigour. Pental may be administered for anaesthesia in the same manner as chloroform. For a brief effect it may simply be dropped upon a cloth, but many prefer to employ an inhaler for the purpose. Junker's in particular being thought desirable. The use of pental for pro- longed anaesthesia seems hazardous, but it has certainly been used thus with success. The amount of the remedy necessary to pro- duce anaesthesia is usually from 1 to 3 drachms. It is said that some few individuals are in- susceptible to its action. The operations suited to pental aufesthesia are those that are brief, such as the extraction of teeth and the opening of abscesses. It has been particularly recommended for producing anaesthesia in children. Pental maybe used as a local anmsihetic in the form of a spray. [The Lancet for January 4, 1896, after men- tioning Wood and Cerna's experiments on the physiological action of pental. and their conse- quent warning that it was a dangerous cardiac 67 PELLITORY PENTAL depressant, says : " Riith, as late as 1894, came to the opposite coticlusion, asserting pental to he a safer agent than chloroform and possess- ing many advantages over ordinary laughing- gas. It has not, however, been extensively employed, except in dental practice. Mr. Constant, after experience of some hundreds of cases, was satisfied with its action, but did not speak very enthusiastically about it. In 1893 a death was reported as having occurred during the employment of pental, but the evi- dence, so far as could be elicited, did not con- clusively prove that the an»sthetic was to blame in the case. In all these observers' hands the danger, such as was admitted, ap- pears to have been that incurred by heart fail- ure, although Riith has expressly stated that respiration fails before the heart's action ceases. In the following case the patient was a woman aged twenty-three. She attended at the Dental Hospital in Devonshire Street, Chorl- ton-on-Medlock, for the purpose of having several teeth extracted. She was examined by the medical attendant who administers anaesthetics at that hospital, and was, in his opinion, in a fit state to undergo the operation and to take pental. This he administered, and she rapidly passed under its influence. After the extraction of five teeth her respira- tion ceased, and none of the means adopted to restore her succeeded. The dental student who had operated stated that there was no particular difficulty in the operation. Pental had been used by the ana!sthetist for many patients, and he stated that he had never pre- viously met with any difHeulty or danger. We are not told whether the patient was at the moment of extracting the fifth tooth resuming consciousness. If so, possibly the mechanism of death was similar to what so often occurs under chloroform. On the other hand, Hol- lander in his first paper spoke of his patients being analgesic rather than unconscious, as if there were no danger of reflex shock under this anffisthetic. This, of course, is a point of great importance. At present pental is on its trial, and the fullest information concerning the action of the drug is desirable ; every acci- dent should be most carefully reported to see how far we can trust the favourable opinions so freely uttered about this substance, and how far Professor Wood is correct in his warning that 'pental will probably prove a most dan- gerous anaesthetic' " Dr. Prince Stallard, in a paper read before the London Societv of Anjesthetists (Lancet, March 14, 1896 ; M. Y. Med. Jour., April 4, 1896), said that at the ordinary temperature of a room pental was so volatile that it was ne- cessary to administer it by the closed method, with the admission of as little air as possible. If it was dropped on to a piece of lint, as was usual with chloroform, a large quantity was required. In a hundred and forty-eight cases Clover's portable ether inhaler had been used. Two drachms of pental were poured into the reservoir, the indicator was placed at 0, and the patient was encouraged to fill the small bag with his expirations; the indicator was then turned rapidly but evenly to 3; rarely was it necessary to turn to P. Pental was thus given more rapidly than was advisable with ether, and attention had been directed to the absence of coughing, struggling, and fight- ing for breath, so characteristic of the latter drug when given alone without the previous use of nitrous oxide gas. No restriction had been placed on the patients with regard to diet, and m only one ease had there been after- vomiting. I'he clothing should be quite loose around the throat and abdomen so that the thoracic and abdominal movements could be quite free. All the administrations had taken place at about 10 a.m. In all the cases the patients had been seated in a dental chair, the head having been placed in an easy position midway between flexion and superextension. The horizontal posture, said Dr. Stallard, would be much safer, as signs of cardiac failure had not infrequently occurred in the cases cited, for pental, in this respect, resembled chloroform. When this drug was inhaled the pulse was at first quickened, also the breathing, and then the pulse became fuller and bounding, with dilatation of the capillaries of the face, which was evinced by extreme flushing, similar to that observed when nitrite of amyl was in- haled; swallowing movements were observed, but never any coughing or struggling ; scream- ing might occur, and dreams of a pleasant na- ture were frequently experienced. Spasms, tonic and clonic, were occasionally present in the arms or in the legs. The lid reflex was usually present unless the anaesthesia was deep; when the patient was deeply under the influ- ence of the drug the pupils were dilated and the eyeballs turned upward under the upper lids, and, in some cases, the conjunctival ves- sels were prominent and congested ; the arm when raised dropped helplessly to the side. At the height of anaesthesia the pulse became small, and might be running. 'There was no cyanosis or duskiness of the features, and ster- tor was very rare. Micturition and defecation had never been observed. Opisthotonos and twitohings of muscles had been noted in a few cases, the patients having generally been tran- quil. The breathing could hardly be heard ; this, said the author, constituted one of the dangers, and, in this respect, pental again re- sembled chloroform. Recovery was extremely rapid, and was not followed by any stupor or drowsiness. As a rule, there were no after- effects; the patients felt quite well three minutes after the removal of the face-piece, and were able to walk out of the house. One case only of vomiting had occurred and three or four of nausea ; slight headache had been noted in a few cases, but this had rapidly passed off. The average time required to pro- duce anaesthesia had been fifty-six seconds, and the average anaesthesia obtained had lasted for seventy-six seconds. The preansesthetic stage had varied from thirty to one hundred and twenty seconds and the atiaesthetio period from twenty-five to two hundred and ten seconds. The advantages maintained for pental, said Dr. Stallard, were : 1. Longer anaesthesia than nitrous oxide gas yielded. 2. Simple appa- ratus. 3. No struggling, coughing, or dislike PENTANE PEPTOMANGAN 68 to the drug. 4. The small amount required, which averaged 2 drachms. 5. Rapid recov- ery. 6. The absence of after-effects. The dis- advantages -were: 1. The insidiousness of its action — an overdose could easily be admin- istered. 3. Xoiseless and shallow breathing. 3. Screaming. 4. The sudden cessation of respiration. 5. Sudden cardiac failure. Dr. Stallard said that he had frequently known decomposition of the drug to occur. With regard to albuminuria, he had examined the urine in twenty-five cases after its ad- ministration and found no albumin, but it must be remembered that all his cases had been short ones and the effect would not last long enough to injure the kidney. The fall of blood-pressure was marked. VVith regard to the length of ansesthesia obtained, he was of opinion that there was a marked personal fac- tor in many cases.]— Henry A. Gkiffin. PENTANE.— See Amyl hydride. PEPO (U. S. Ph.) consists of the seeds of the common field pumpkin. It has been very extensively employed as a tcBiiiafuge, and in many eases with gratifying results. Two ounces constitute an average dose. The seeds are bruised in a mortar or crushed in a coffee or spice mill and made with water into a sort of emulsion, the covering, or husk, being sep- arated by passing the mixture through a coarse sieve, although it has been advised that they also should be taken. The only drawback to its use is the considerable bulk of a dose, which may excite nausea in certain cases. If failure follows the first dose, it may be re- peated daily as long as the individual is will- ing. It is best taken in the morning, after the precautions mentioned in the article on Anthelminthics have been observed, and it should be followed by a laxative. No harm has ever followed the use of this remedy, and little seems to be known of the active agent in it. Fowls which have eaten the seeds and the soft portion of the fruit enveloping them are said to be affected with giddiness and a form of intoxication. An oil, an aloholic fluid ex- tract, and a resin are prepared which seem to vary considerably, as both successes and fail- ures have been reported as following their em- ployment. The fleshy portion of the pumpkin has also been used, but it seems to be less efficient than the seeds. — Russell H. N evens. PEPPER, BLACK.— See Piper nigeum. PEPPER, CAYENNE.— See Capsicum. PEPPERMINT. — See Mentha piperita. PEPSIN (Br. Ph.), pepsinum (U. S. Ph., Ger. Ph.). — What is known under this name is by no means the pure gastric ferment, a body having the property of converting proteids into peptones, but is a mixture of that sub- stance and various bodies derived from the mucous membrane of the pig's stomach, from which it is prepared. These latter are insep- arable from the true pepsin and are present in varying proportions, depending upon the care with which the processes of manufacture have been conducted. The purest samples oc- cur as a yellowish-white or white powder, either amorphous or somewhat grainy or scaly. They have a slight acid or saline taste and should be free from any unpleasant odour. Pepsin is soluble in 100 parts of water, but the addition of small amounts of hydrochloric acid renders it soluble in less than half that quantity. Many samples, while agreeing in appearance with those known to be active, are entirely in- ert, having deteriorated by keeping or having always been destitute of the slightest pepto- nizing powers in consequence of lack of care in their manufacture. The (J. S. Ph. calls for a pepsin which will completely digest — that is, render soluble — at least 3,000 times its own weight of the finely divided white of a hard-boiled egg when combined with 1,000 times its weight of a 2-per- cent, solution of hydrochloric acid and main- tained for six hours at a temperature of not less than 100-4° or more than 104° F., the ves- sel in which it is contained being gently agi- tated every fifteen minutes. At the end of the given time little or no residue should be observed, but a few thin flakes of the coagu- lated albumen need hardly be regarded. The Br. Ph. requires that it shall dissolve 50 times its own weight of finely sifted coagulated albu- men in thirty minutes when combined with a solution of 5 minims of hydrochloric acid in 1 oz. of distilled water and subjected to a tem- perature of 154° F. For practical purposes the latter test is the most readily applied, and is one which should be made in all cases save when the most satis- factory evidence is presented as to the activity of the sample to be prescribed. In accordance with the variations in the methods of preparation, three varieties of pep- sin are found — one form entirely soluble in water, another soluble in slightly acidulated water, and a third insoluble in either. There is but little difference in the activity of these varieties, but the insoluble variety is the most permanent and is but little liable to decomposition. The soluble specimens, when dissolved in water, are apt to spoil rapidly, and their solutions, when possessed of any un- pleasant odour, are unfit to use. The addi- tion of not over 20 per cent, of alcohol renders these solutions fairly permanent, although the activity of the pepsin is somewhat impaired. What is known as "crystal pepsin" is practically the substance obtained by the self- digestion of the gastric mucous membrane of various animals, which is dried in thin scales and sifted so as to give it a crystalline ap- pearance. It is usually quite active, but is not superior to the varieties prepared in the ordi- nary ways. No matter what precautions are exercised in the preparation of pepsin, it is undoubtedly true that there is a great dif- ference in the activity of the different lots turned out by the samemanfacturers, and often that made by those of indifferent reputation is entirely inert. Consequently it is of the high- est importance that a reliable brand should be selected. Unfortunately, nearly everv drug is incom- patible with this substance, the most notable 69 PENTANB PEPTOMANGAN exoeptinns being codeine, bismuth subnitrate (which retards but does not diminish its activ- ity), strychnine, nux vomica, lactate of iron, and lactic and hydrochloric acids. To obtain its maximum effects, it should be used in con- nection with either of the two last named, and nux vomica or strychnine may be advanta- geously added when a stomachic tonic appears to be indicated. Codeine or the bismuth salt may be added when gastralgia is a prominent symptom, and the latter when diarrhoea is present. Of the numerous vehicles for the preservation and administration of pepsin, glycerin is by far the best, and there is little reason for the employment of any other, al- though milk sugar is unobjectionable except when its presence in the stomach would be injurious. Saccharin has been suggested as a diluent, but there would seem to be no particu- lar advantage in its employment. It is well, however, to note its perfect compatibility, as the simultaneous administration of the two might be convenient in diabetes. As pepsin is only active in neutral or acid solutions, alkalies of any kind should not be administered with it or for some time after it has been taken. Exactly what takes place when it is combined with pancreatin is not well understood, but theory indicates that, as the one requires an acid medium to bring oiit its full effect, and the other an alkali, little benefit would be gained from their mixture. A number of preparations exist in which the two are found and from which good results have undoubtedly been derived, but there seems to be reason to believe that either the pepsin or the pancreatin alone would have been as effectual. As a rule, it is best to administer pepsin shortly after eating and before the food passes from the stomach into the intestines. In ad- dition to its peptonizing effect upon proteids it appears to act as a stimulant of the mucous membrane of the stomach, thereby increasing the natural secretions of that organ, and by some it is maintained that its beneficial action depends more upon the latter property than upon the former. The doses ordinarily given are inadequate, and many of the failures im- puted to it are undoubtedly due to this fact. It is safe to say that in conditions where it is ur- gently demanded not less than 30 grains of the average article should be administered. The conditions in which pepsin is indicated are dyspepsia, with a sense of weight in the stomach after eating and eructations, vomiting of undigested food, lienteric diarrhma, espe- cially in children, the indigestion of phthisis, mucous gastritis, atonic dyspepsia, and cancer and ulcer of the stomach. It is also very use- ful in the convalescence from acute diseases and in infants after weaning until the stomach has become accustomed to its new conditions. In some obscure cases of indigestion it may be necessary to adopt the procedure of testing the secretion of the stomach before it can be determined that there is a deficiency in the secretion of pepsin. This is performed by ob- taining a specimen of the gastric fluid by a stomach-bucket or an oesophageal tube. After careful straining, the specimen is divided into four equal parts, to one of which pepsin is added, to another pepsin and hydrochloric acid, to the third hydrochloric acid alone, while to the fourth nothing is added. To each por- tion an equal bulk of coagulated albumen is added and the solvent effect of each is noted, the temperature of all of them being main- tained a trifle over 100° P. In this way it can easily be determined whether the gastric Juice is normal or whether pepsin or hydrochloric acid or both are lacking. The procedure is one which is rather unpleasant to the person from whom the specimen is obtained, and is only indicated in aggravated conditions. A peptonized milk may be prepared, which may be used as a nutrient enema or for intro- duction into the stomach through the oesopha- gus or a fistula, by digesting 1 oz. of milk for an hour at a temperature of 100° F. with 5 grains of pepsin and 4 drops of hydrochloric acid. The product should be clear, and must be neu- tralized with a small amount of sodium car- bonate. Meat and other albuminoids may also be treated in the same manner, but they are not very palatable and are hardly to be used except in desperate cases or in the same manner as the peptonized milk. For the removal of the exudation of diph- theria, solutions of pepsin are sprayed into the throat, and often very great temporary re- lief is obtained, the effect, however, being purely local, so that the general constitutional treatment is not to be neglected. Similar so- lutions may be applied to unhealthy suppurat- ing surfaces with a view to dissolving the superficial morbid tissues. Saccharated pepsin, pepsinum saccharatnm (U. S. Ph.). contains 1 part of pepsin to 9 parts of milk sugar. Unless that diluent is objectionable, it may be used in nearly all cases in which pepsin is indicated. In conclusion, it may be stated that the greatest care should be taken that the purest possible brand is dispensed, and all tablets, troches, etc., are to be rejected. Nearly all of the elixirs and wines are inert, although, as already stated, a weak wine is entirely com- patible with pepsin. The best vehicle is glyc- erin, and in all cases, except those of infants, lactic or hydrochloric acid should be given simultaneously. — Bussell H. Kevins. PEPTOMANGAN, ' liquor mangano-ferri peptonatus, is a liquid peptone preparation containing iron, manganese, and a small per- centage of alcohol. Each half ounce contains the equivalent of 3 grains of metallic iron and 1 grain of metallic manganese. It is essen- tially a drug in its characteristics and in no sense a food. It occurs as a transparent, dark sherry-red liquid, of a slight agreeable odour and taste. It is neutral in reaction, non- astringent, and miscible with water, milk, or any wine fi'ee from tannic acid. It is used especially in the ancemia of rhachitis, chloro- sis, and phthisis. Von Ruck reports its use in two series of cases of pulmonary tubercu- losis. In the first series of twelve cases, with a single exception, after the use of this drug PEPTONIZED MILK PHENACETINE 70 the hiEmoglobin increased materially. The smallest amount of increase was 3 per cent., the largest 46 per cent., while the red blood- corpuscles showed in different patients an in- crease ranging from 83,000 to 1,990,000. Each of these patients had been receiving the ordi- nary iron mixture previously, but had gained comparatively little in either hajuioglobin or corpuscles. JEspecjally good results have also been reported in chlorosis and rhachitis. It is believed that in certain forms of anaemia man- ganese as well as iron is of material advantage, as it is fully demonstrated ithat this element occurs in the blood. The dose of peptoman- gan is a tablespoonful three or four times a day. It may be given alone, as it is not un- palatable. It may be diluted, if desired, with milk or water, or may be administered in any sweet wine free from tannic acid. [Dr. Hugo Summa, of St. Louis {N. Y. Med. Jour., Feb. 9, 1895), who has used Grude's pep- tomangan extensively in doses varying from a teaspoontul to a tablespoonful, in sherry or milk, three times a day, an hour after meals, reports excellent results in chlorosis and ance- mia. Dr. Summa lays stress on the fact that this preparation does not give rise to constipa- tion.] — Ployd M. Cbandall. PEPTONIZED MILK.— See under Milk. PEBMANGANATES. — Potassium per- manganate, potassii permanganas (U. S. Ph., Br. Ph.), kalium permanganicum (Ger. Ph.), is a highly oxidized salt, and, parting with its oxygen with great i-eadiness, is of considerable value as a deodorizer and disinfectant, but its relatively high cost and the property it pos- sesses of imparting a red stain, removable by oxalic acid, prevent its extensive employment. It may be advantageously used to disinfect or deodorize ulcerating surfaces from which of- fensive odours ai-e given off, as in hospital gangrene, carbuncles, etc., and as an injection in otorrlicea, ozaina, or leucorrhma. Its effects, however, are rather transient and it must be used oftener. than the other disinfectants em- ployed in the conaitions mentioned. Solutions of 1 grain in 1 oz. of water are often employed to overcome the axillary odours and those arising from sweaty feet, also as a tooth-wash. The ordinary strength of a solution for ap- plication to wounds, etc., is from 5 to 10 grains to the ounce of water. Stronger solutions act as stimulants, and are often employed upon raw surfaces where a stimulating effect is de- sired. Occasionally the finely powdered salt is sprinkled upon unhealthy wounds, etc., with the result of obtaining a mild esoharotic effect. Co7idy's fluid, or solution, is an aqueous so- lution of this salt to which aluminium sulphate is added under the belief that it greatly pro- motes the oxidizing effect of the permanganate. It may be employed for the same purposes as an extemporaneous solution. Internally, the permanganate has been used in the treatment of scarlet fever and of diph- theria, the throat being sprayed or swabbed with a 1-per-cent. solution. It has also been employed in all the so-called zymotic d seases, especially erysipelas, puerperal fever, and sep- ticmmia, but its efficacy in these affections is denied by many. In the treatment of the bites of poisonous reptiles and rabid aitimals it was long ago brought forward as almost a specific, but the evidence for and against its employment is rather conflicting, so that it would be wise neither to trust to it alone nor to neglect it if it is at hand, the wounds at the same time being washed out with a 4- or 5-per- cent, solution. In delayed or arrested menstruation, espe- cially in young women and those affected with ancBmia,\t, appears to ,be of considerable value. Prom 1 to 2 grains are to be given three times a day, and the doses are to be continued for two or three days after the establishment of the flow. It is also said to assist in the re- moval of fatty tissue, and has been vaunted as a cure for obesity. In some forms oi flatulence, especially that occurring in the obese it has been used with good effects, and by some is esteemed highly in lithiasis, in which it seems to be more effectual when inclosed in capsules which do not dissolve until they enter the in- testines. It is of importance that potassium perman- ganate should not be combined either in solu- tion or in substance with organic matters, as it is rapidly reduced in their presence, and spon- taneous combustion is said to have sometimes occurred. When it is administered in the pill form, which is by far the best form for its use, kaolin and vaseline are the best excipients, or it may be compressed into pills. The usual dose is 1 grain, although the size of the dose may be as large as 4 grains without any ill results. The liquor potassii permanganatis (Br. Ph.) is a solution of 4 grains to the ounce of distilled water. It may be given in doses of from 3 to 4 fl. drachms. AH solutions and the salt itself should be kept in tightly closed receptacles and in a dark place. [Kor further information concerning potas- sium permanganate, see under Manganese, vol. i, pages 596 and 597, and under Opium, vol. ii, page 44.] — Russell H. Nevins. PEBOSMIC ACID.— See Osmic acid. PEBOXIDE OF HYDROGEN. — See Hydrogen dioxide. PETBOLATUM.— See Vaseline. PETBOLEXJM, or the mineral oil which occurs in many parts of the world, varies in colour from a light green or red to black, and has a distinctive odour which in certain varie- ties is highly offensive on account of the pres- ence of numerous sulphur and phosphorus compounds. It is more largely used in the arts than in medicine, but enjoys some repute, more especially in domestic medicine, as a local application in the treatment of rheuma- tism, pulmonary affections, chilblains, and other conditions in which a moderate decree of irritation of the skin is desired. Combined with oil of turpentine, linseed oil, and the oils of amber and juniper, it constitutes " British oil," a rubefacient liniment, more eraploved in veterinary medicine than in practice on the human subject. Under the name of '■ Seneca " oil it was at one time regarded as a specific in 71 PEPTONIZED MILK PHENACETINE phthisis, but beyond producing a slight expec- torant effect it is of little value. Tapeworms are said to have been expelled by doses of from 20 to 40 drops given tliree times a day. Petroleum has been substituted for vaseline in the treatment of psoriasis, and may be used in the treatment of scabies. It is somewhat antiseptic, but is rather too oflEen- sive to be used except upon animals. I.i poultry houses and dovecotes it is probably the best agent that can be found for the de- struction of insects, the woodwork, etc., being painted with it from time to time. Refined petroleum, or kerosene (g. v.). is highly esteemed by many ignorant persons as a uni- versal remedy, but is probably without any ef- fective therapeutic action except as an irritant of the skin. — Russell H. Nevins. PETROSELINUM:, or parsley, Apium Petroselinum, is largely used for culinary pur- poses, and from a medical standpoint is chiefly interesting on account of its being the source of apiol, which possesses all the virtues as- sumed to exist in the plant, and is to be pre- ferred on account of its smaller bulk. The fresh root is reputed to be laxative and diu- retic, and the herb itself antiperiodic. The seeds are thought to be antiperiodic and em- menagogue, and play a more or less important part in domestic medicine. They are probably more active than any other part of the plant. They may be given in doses of half a teaspoon- ful. (Cf. Apiol.) [Fresh parsley, steeped in vinegar and eaten immediately after eating onions, is useful in removing the ofEensive odour of the breath.] Russell H. Nevins. PHELLANDBIXIM.— The fruit of Phel- landritim aquaticum, the water-hemlock, was formerly official in various pharmacopoeias, and was esteemed a useful sedative in the treatment of cough, al.so tonic and stomachic. From .5 to 8 grains may be given three times a day, and the dose may be gradually increased to 15 grains. In large doses, the drug is said to be a narcotic poison. PHENACEIIXE, phtnacetinum (Ger. Ph.), was first prepared by Hinsberg, chemist of the colourfactories of Bayer & Co., in Elberfeld, and was first subjected to trial by this author, with Kast and Freiberg,, in 1887. Soon afterward its value as an antipyretic was demonstrated at Bamberger's clinic in Vietma. Phenacetine, OP TT C,H4 (^jTfT/n fT pQv '^ *"■" acetyl compound of phenetidine — that is, of the ethyl ether of para- midophenol. Its composition is thus analogous to that of acetanilide. It is a colourless or slightly reddish. odourless, and tasteless powder, sparingly soluble in water, somewhat more soluble in glycerin, and readily soluble in alco- hol, especially hot alcohol. It is insoluble in acid or alkaline fluids, hence in the acid gas- tric juice and in the extract of pancreas. It is demonstrated in the urine by the red colour produced by liquor ferri sesquichloridi and by the green colour produced by sulphate of cop- per. It has no effect upon the temperature in health, but a remarkable antipyretic effect, even in small doses, in fever. From Muhnert's comparative tests it was found that 14 grains of phenacetine lowei'ed the temperature more than 15^ grains of anti- pyrine, quinine, or kairin, and more than 3'1 grains of thalline. It is less apt to be followed by perspiration thati thalline and acetanilide, by ringing in the ears than the salicylates, by dizziness than quinine, and by chills than acet- anilide. In summing up the evidence, it is found that phenacetine, while as prompt and efficient as any of the antipyretics, is the safest of all of them. After a dose of 15. grains the tempera- ture falls rapidly, reaching its lowest point in about three hours, and remains low for from eight to ten hours, when it again rises some- what, with the appearance of an abundant perspiration. Too great depression is followed by chilly sensations, attended occasionally, es- pecially in certain subjects, with a feeling of weakness, sometimes of faintness, due to heart failure. Small doses are, however, unaccom- panied with evil effects of any kind. Any sinking sensations may be speedily combated by alcohol, as by a glass of wine or a drink of whisky, and anything like excessive sweating may be prevented or controlled by the use of atropine. Phenacetine is a powerful analgetic, and, notwithstanding its insolubility, begins to act in twenty minutes. And although it may by no means be compared with morphine in the relief of pain, it has a more distinct anodyne influence than antipyrine or acetani- lide in the various neuralgias, and is especially valuable in the treatment of any ordinary headache, of migraine, gastralgia, sciatica, neuritis, and of the insomnia of diseases of the uterus, floating kidney, exhaustion from overwork, etc. (Cohn). A small dose, say 5 grains, of phenacetine, taken at bedtime, may have a very soothing effect in allaying the anxieties and hyperjEsthetic states which pre- vent sleep. Unplea.sant after-effects are at times due to unconverted paraphenetidine, which is poison- ous in small dose. This substance acts espe- cially upon the kidneys, causing nephritis with albuminuria. The presence of this impurity may be detected by the following test : If 38 grains of chloral hydrate are melted in a small test-tube in a water-bath with 7f- grains of perfectly pure phenacetine, the solution will remain absolutely colourless upon shaking for at least five minutes, but after that time will assume a rose-red colour. If any parapheneti- dine is present, the solution becomes coloured in two or three minutes to a more or less in- tense violet. Phenacetine is much less toxic. It seldom or never produces chill, cyanosis, or collapse. It very rarely causes nausea or other disturbance of digestion. Phenacetine is considered by most authori- ties as an ideal antipyretic. It should be given in doses of from 5 to 10 grains, never more than 15 grains. For children, the dose ranges from 3 to 4 grains, with 5 grains for the maximum. [There is some difference of opinion as to the efficiency of phenacetine as an antipyretic PHBNATES PHENYLACETAMIDB 72 and as to the non-ocourrence of ill efEeets from its use. For example, an editorial writer in the British Medical Journal for Dec. 23, 1894, says, with regard to the impression that phen- acetine does not produce evil eifects, that it has been " somewhat justified by experience " ; nevertheless, he goes on to say, we may meet with unpleasant and profuse diaphoresis, ren- dering its habitual use in phthisis and typhoid fever undesirable. Collapse and exhaustion are not unknown even after moderate doses, while palpitation and oppression of breathing followed by nausea and vomiting have also been observed. Cutaneous eruptions, chiefly urticarial, prevail with a frequency scarcely inferior to that observed in the employment of antipyrine, and cyanosis of the face, due to changes in the hsemoglobin, may be seen in a similar degree. The usefulness of phenacetine as an antipyretic remains small, he continues, as its power in that respect is not equal to that of the others, except when it is employed in doses that very often give rise to toxic symptoms. Kronig (Berlin. Uin. Woch., Nov. 18, 1895; University 3Ied. Magazine, March, 1896) has related a fatal case of poisoning with phena- cetine. The subject was a boy, aged seven- teen, who presented the general appearance of sepsis. He was the subject of a chronic sup- purative otitis media. The general condition, however, indicated some profound alteration in the blood, such as is not seen in cases of sepsis. An examination of the blood revealed the red cells in various stages of dissolution. Even the apparently healthy cells showed con- siderable changes in age and shape. Thus there was reason to suspect the presence of some blood-poison. The history was that three weeks before his admission the patient had been given by his physician five powders of phenacetine, each containing 15 grains of the drug, with the direction that not more than two should be taken in the day. Within three weeks he had taken four of these powders without much improvement in his condition. One evening he took another powder, and in the night he was seized with vomiting. On the following day he had headache, vomiting, and diarrhoea. He was somewhat cyanotic. His urine was of a chocolate colour, and sub- sequently contained blood. The cyanosis in- creased, and he died in two days, within three days after taking the last powder. The appear- ances resembled those of chlorate-of-potassium poisoning. In the discussion Prankel, Pur- binger, and Gerhardt, all strongly emphasized the importance of giving small doses of drugs like phenacetine in the first instance. Phenacetine has been much used in the early fever of influenza as an antipyretic and as an analgetic in migraine, rhenmatism, and vari- ous forms of neuralgia. Bocquillon-Limousin gives the following formula for its external use in acute rheumatism, which he attributes to Taylor : 5 Phenacetine 90 grains; Lanolin 300 " Olive oil, a sufficient quantity. Mix for an ointment to be rubbed gently on the painful parts.] — James T. Whittakeb. PHENATES. — Salts of carbolic acid (see Caebolio acid). FHENAZONE. — See Antipyrine. PHENEDINE. — See Phenacetine. PHENIC ACID. — See Carbolic acid. FHENIDINE, or paraacetphenetidine, ac- cording to Cerna, has been considei'ed superior to antipyrine as an analfjetic. He gives the dose as 15 grains. Phenidine seems to be one of the drugs that should not be used in prac- tice, unless with the greatest caution, until more is known of its properties. PHEIfOCOIiL, or amidophenacetine, is produced by the action of glycocoU, which is an amidoacetic acid, upon phenacetine. Phe- nocoU is a white crystalline powder, soluble in water in the proportion of 1 to 16 parts. It reduces fever much more rapidly than phenac- etine, and by diminution of heat production without affecting the radiation of heat. Phe- noeoll hydrochloride is given in doses of from 5 to 15 grains. It has no unpleasant after- effects, excepting occasionally profuse perspi- ration. But the remedy must be used with caution in cases of great prostration, as it may produce, in exhausted states, dyspnoea, cyano- sis, and heart failure. [The formula of phenocoll has been stated to be C.H4N— CHi— OCjHt. It is said to CHj— CO have been used in several of the Italian uni- versity clinics as an antipyretic and in the treatment of acute rheumatism, in daily amounts of from 15 to 45 grains. The usual statement is made that no bad effects have been noticed from its use, but prudence seems to dictate that we should refrain from employ- ing it in practice until we have further infor- mation concerning its action. PYBAZINE, PYK.AZOL, PYBAZO- LINE, PYRAZOLONE.— These derivatives of pyrrol have had various formulas assigned to them. According to A. H. Allen (Fharm. Jour, and Trans., 1890 ; Am. Jour, of Pharm., 1892), they are as follows : PymMHNJ;Nj^Ca [_ ( N ■ CH ) P2/m2oZme,HN|;cH^CH,[. Pyrazolone, w\-l^^^-^_\. These substances have been proposed as anti- pyretics, but Dr. Cerna says of pyrazol that it lacks antipyretic properties, but has been used as a diuretic. He gives' the dose as from 15 to 30 grains. It is doubtful if any of these compounds will take a lasting place among remedies ; certainly they can not now be said to have got beyond the "experimental stage. PYRETHBUM (U. S. Ph.). pyrethri radix (Br. Ph.), or pellitory, is the root of Anacyclus Pyrethrum. It is of little importance from a medical standpoint. When chewed, it acts as a sialagogue and stimulant of the mucous membrane of the mouth, and has been em- ployed in headache, toothache, paralysis of the tongue, and relaxation of the soft palate. From 20 to 60 grains may be used. In the shape of a tincture, tinctura pryethri (U. S. Ph., Br. Ph.), it is employed by dentists to re- lieve toothache and to add a local stimulating effect to tooth washes. The flowers of Pyrethrum Parthenium are often substituted for chamomile flowers, and apparently with as good results. Pyrethrum carneum and Pyrethrum roseum furnish the Persian or Caucasian insect pow- der of commerce, and Pyrethrum cineraricefo- lium, the Dalmatian variety, which is rather more active than the others. It occurs as a yellow or yellowish-brown powder, and is the most valuable insecticide known, as itis without any poisonous effects upon man or the higher animals, at least in the quantities commonly employed. It is not very rapid in its action, first stupefying or intoxicating the insects which come in contact with it, but death ordi- narily follows in a short time. Upon the eggs it appears to have but little effect, and on that account is less efficient than mercurials for tha destruction of bedbugs and roaches. Upon ants it seems to have rather less effect than upon the other insect pests of the household. It is of importance that it should be as widely disseminated as possible, and for this purpose a bellows is a very convenient appliance. One specially adapted for the purpose may be found nearly everywhere. In beds infested with bugs PYRETINE PYKOZONE 110 the powder may be scattered over the bedding as a temporary measure, and rarely causes any inconvenience beyond in some instances a slight and temporary irritation of the skin. A small quantity sprinkled on hot coals will clear a room of flies or mosquitoes, and it is proba- ble that for sovei-al hours the entrance of others will be prevented. Pastils are made, contain- ing small quantities of nitre, whicb may be employed in the same manner. In kitchens and other places where flies are abundant it may be scattered around at night, the apart- ment being tightly closed until morning, with the result of killing all there are present. A solution of from 30 to 30 grains in half a gal- lon of water is very suitable for spraying upon plants infested with insects, but its expense renders its range of usefulness rather limited. A 20-per-cent. alcoholic tincture, diluted as de- sired and applied to the body, is very effectual in keeping fleas, etc., from remaining upon the person. Dogs, cats, and other animals infested with fleas may be relieved of them by a thor- ough dusting, but it is wise to select some spot remote from the dwelling to do this in, and if possible a sandy spot .upon which the sun shines brightly is the best, as the dry heat insures the death of the insects ; as a matter of fact they are unable to endure exposure to the naked rays of the sun. Fowls may be treated in the same manner, being held head down- ward in a barrel and the powder sifted among their feathers. Poultry houses, pigeon lofts, etc., may be freed of vermin by its liberal and frequent employment. It is hardly necessary to specify every purpose to which it may be applied, but in addition to the foregoing it may be employed in cabinets for furs and woollen fabrics, and in almost every place where insects destructive to such objects are found. The recently introduced buffalo bug, which is so destructive to carpets and rugs, appears to be but little affected by it. Carbon bisulphide, naphtha, and similar petroleum products are almost the only agent effective for their destruction. It is of great importance that insect powder should be fresh, as it loses its virtues on keeping. Much of it is inert and worthless. — Russell H. Nevins. PYRETINE, an American proprietary an- tipyretic and analgetic, is said to be a mixture o± acetanilide, caffeine, calcium carbonate, and sodium bicarbonate. It has not come into general use. PYRIDINE is a basic substance obtained from bone oil, coal tar, naphtha, and other organic materials by distillation. It also oc- curs in tobacco smoke, a fact which has led some observers to credit it with the remedial action tobacco smoking has in asthma. When pure, it is a colourless, volatile liquid with a powerful and persistent empyreumatio odour and a pungent taste. It is freely miscible with water, alcohol, ether, chloroform, and fatty oils. Its formula is CoHaN. With acids pyri- dine forms crystallizable but imstable salts. Although the physiological action of pyridine has not been exhaustively studied, it would seem that it is an agent of most vigorous action. Locally applied, it is antiseptic. Given in small doses, according to De Renzi, it stimu- lates cardiac action and raises the blood- pressure. This action on the blood-pressure, however, is denied, and many maintain that the blood-pressure is lessened by it. Inhaled, it diminishes bronchial spasm when that is pres- ent, and experiments upon animals show that it quiets irritability of the respiratory centre. In large doses, however, the drug is actively poisonous, causing cyanosis and muscular feebleness and paralysis from action upon the motor centres and nerves. Death may result from respiratory paralysis. The chief therapeutical employment of py- i-idine is in the relief of bronchial asthma. The treatment was introduced by Germain See. A drachm of the drug is exposed in a saucer in a small room, the patient remaining in the room and inhaling the pyridine-charged atmosphere for a period of from fifteen to thirty minutes several times a day. Although the treatment is exceedingly disagreeable, be- cause of the offensive odour of the drug, it is said that much relief follows its use, the respi- rations becoming free and the disease often subsiding after a number of exposures to the treatment have been endured. Instead of in- haling pyridine thus, a solution containing from 5 to 20 drops in 3 oz. of water may be respired by atomization, or a few drops may be directly inhaled. Angina pectoris is said to be benefited by the internal use of pyri- dine, from 5 to 10 minims being taken daily and the dose gradually increased until 25 minims are taken in a day. In cardiac en- feehlement it is said to exercise a beneficial effect, and has even been thought a substitute for digitalis. The antiseptic action of pyridine may be made use of in the treatment of gonor- rhcea, an injection of a watery solution (1 to 300, or even stronger) being employed. Henky a. Griffin. PYROACETIC ETHER or SPIRIT.— See Acetone. PYRODINE.— See Htdbacetin. PYROGALLIC ACID, PYROGALLOL (U. S. Ph.), PYROGALLOLtTM (Ger. Ph.), is a trihydroxylbenzol with the formula CbHoOs. When gallic acid is heated to subli- mation it is decomposed and carbonic acid and pyrogallol are formed. The latter substance occurs in long, flattened, prismatic or needle- like crystals, very light in weight, of a pearly colour, bitter to the taste, soluble in from 2i to 3 parts of water and also in alcohol and in ether. It fuses at 339° F. and boils at 410° F. It is a strong reducing agent. A watery solution of it, with soda or potash, as well as the moistened crystals themselves, becomes soon of a reddish or dark-brown colour from oxidation, and it readily reduces the salts of mercury, silver, gold, and platinum. Pyro- gallic acid is largely used in connection with nitrate of silver in photography, and also in the compositions of hair dyes and marking inks. To its property as a reducing agent are chiefly ascribed also its therapeutic effect^. Pyro- gallic acid had seldom, if ever, been employed Ill PYRETINE PYROZONE in medicine prior to 1878, when Jariseh first introduced it as a remedy for certain cutaneous diseases. The diseases for which he especially recommended it were psoriasis and lupus, but it has also been found of more or less value in parasitic diseases, such as eczema marginatum, in epithelioma, and in simple chancre otphage- In psoriasis it is generally admitted to be of considerable value when applied locally. ■ It acts with less energy upon the. disease than chrysarobin, which in many respects it resem- bles, but is more energetic in its action than tarry preparations. It is odourless and but slightly irritating to the skin (rarely causing the dermatitis that so often follows applica- tions of chrysarobin). It is often preferable to chrysarobin where the skin does not tolerate the latter, as upon the face, or in individuals with unusually vulnerable or sensitive skins. It does, however, cause irritation at times, pro- ducing considerable pruritus and occasionally follicular papules or pustules, which may re- quire a temporary suspension of its use. It stains the skin and clothing only slightly less than chrysarobin. A more serious objection to its use when incautiously employed, so as to permit considerable absorption, lies in the fact that it may give rise to grave toxic efEects. Attention was first called to this danger by Neisser, who reported a case of fatal intoxica- tion following inunctions of one half the body with a 10-per-cent. ointment, the surface hav- ing afterward been covered by gutta-percha tissue and a bandage. The symptoms began in two hours after, with rigors, diarrhoea, vom- iting, and strangury. The next day the urine was very dark-coloured from the presence of haemoglobin; all the symptoms became aggra- vated, with apathy, dyspnoea, exaggerated re- flexes and collapse, followed by death two days later. The cause of death was stated to be decomposition of the blood with hfemoglobinu- ria and nephritis hsemoglobinurica. Though pyrogallic acid is a more dangerous remedy than chrysarobin to the general economy, when applied to limited areas thereis probably little to fear from it. It would be especially objection- able in a ease of psoriasis attended with much excoriation or eczema, or in that form which approaches the character of an exfoliative dermatitis. The mode of its employment in psoriasis is similar to that of chrysarobin. A 10- to 15-per-cent. ointment is thoroughly rubbed into the affected areas. The ointment is preferable to preparations with traumatioin .or gelatin, as well as to plasters. On the first indication of gastro-intestiual disturbance, strangury, or smoky urine, the remedy should be at once discontinued. In case of decided toxic symptoms Neisser recommends subcutaneous injections of ether, alcoholics frequently re- peated, energetic stimulation of the surface, and the inhalation of oxygen. In lupus pyrogallic acid has pro ved Itself a remedy of no little value. It is especially suited to the more superficial forms. It acts on continued application as a mild escharotic, and, while it has but little effect upon the epi- dermis, it has a selective action upon the diseased subepidermal tissue, in this respect resembling the action of the arsenical pastes. The rapidity of its action is increased when the epidermis is intact by first applying a moderately strong solution of caustic potash. An ointment of the strength of from 10 to 20 per cent, is applied on lint and covered with a piece of gutta-percha tissue, which may bo made to adhere to the surrounding skin by moistening its edges with chloroform. The applications are renewed daily and continued for from two to seven days or until the lupus patch has become converted into a gray pul- taceous mass, when the pyrogallic acid is replaced by an ointment of iodoform or the emplastrum hydrargyri. This treatment is repeated at intervals so long as any lupus tu- bercles are apparent. The scars left are smooth and supple. IBesnier uses a satui'ated solution of pyrogallic acid in ether, which is brushed over the lupus patch and covered in with traumaticin. repeating the applications as above described. Brocq prefers a solution of pyio- gallic acid with salicylic acid (10 per cent, of each) in collodion. Epithelioma of the skin has been treated successfully with pyrogallic acid employed ac- cording to the same methods as those recom- mended for lupus. In chancrous ulcerations Vidal has found this remedy eflScaeious. For simple chancre he used a salve consisting of 1 part of pyrogallic acid in 4 parts of lard or vaseline, and for phayedcena a powder composed of pyrogallic acid and starch in the proportion of one to four. — Edward Bennet Beonson. PYEOGLYCERIN.— See Nitroglycerin. PYEOLIGNEOTJS ACID.— This is an impure acetic acid, obtained by the destructive distillation of wood. It is the source of the acetic acid of commerce and of the pure acetic acid of the pharinacopoeias. Crude pyroligne- ous acid, acetum pyrolignosum crudum ((9er. Ph.), and the rectified acid, acetum pyroligno- sum rectificatum (Ger. Ph)., are used topically for the same purposes as acetic acid(}. v.). PYBOXYLIIT (Br. Ph.), pyroxylinum (TJ. S. Ph.), or gun cotton, is official only be- cause it is used in the preparation of collodion. PYROZONE. — This name was at first ap- plied by an American firm of manufacturing pharmacists, Messrs. McKesson and Robbins, of New York, to a thick syrupy liquid consist- ing of pure hydrogen dioxide, from the fact that when a fluffy fabric of silk or the like was saturated with the liquid and warmed slightly it took fire and burned "furiously, as sub- stances do in oxygen, presumably producing both fire and ozone " (Coblehtz). Pure pyrozone speedily undergoes decompo- sition ; hence it is furnished in solutions of certain standard strengths. The S-per-cent. solution in water corresponds in strength to the aqua hydrogenii dioxidi of the IT. S. Ph., and is said to be purer and more stable than that preparation ; also to admit of concentra- tion by evaporation without appreciable loss of hydrogen dioxide. The use of this solution is QUASSIA QUININE 112 the same as that of hydrogen dioxide (see vol. i, page 503). The 5-per-cent. solution in ether and the S5- per-cent. solution in ether have been found to be exceedingly &&c\eni stimulating and caustic applieations, particularly valuable in checking suppuration, notably that of pyorrhcea alveo- laris. QUASSIA (TJ. S. Ph.), quassicB lignum (Br. Ph.), lignum quassice (Ger. Ph.), is the wood of Picmna (Quassia) excelsa, a tropical and semi- tropical tree. It is a simple bitter tome which appears to have no injurious effects upon the economy unless it is talien in enormous doses, when it acts as an irritant of the mucous mem- brane of the stomach and as a uauseant. It is a very useful bitter in all cases of la^ck of ap- petite and atony of the stomach, and is particu- larly applicable in malarial afEections in which a stomachic is desirable. Its action depends upon a principle, quassiin, or quassin, which ■may be substituted for the drug or its preparar tions in doses of -J- a grain. The wood readily •imparts its properties to cold water, and cups ■are made of it in which water is allowed to •stand for two or three hours, or until it becomes distinctly bitter, and then drank. This method ■ of administering it used to be quite common •and is a very useful one, as the cups retain their properties for a long time and are always ready for use. The extract, extractum guassics (U. S. Ph., Br. Ph.), may be given in doses of from 1 to 2 grains. It is perhaps to be pre- ferred to the other preparations because, bulk for bulk, it contains a larger amount of the bitter-tonic principle than any of them. The fluid extract, extractum quassice fluidum (U. S. Ph.), is also a powerful preparation ; it is used in 5- to 10-drop doses. The infusion, infusum quassice (Br. Ph.). possesses all the properties of the drug, but is somewhat objectionable on account of the bulk of the dose, from 1 to 2 fl. oz. The tincture, tinctura quassice (U. S. Ph., Br. Ph.), is used oftener as an ingredient of tonic mixtures than by itself ;, it may be given in doses of from 1 to 2 fl. drachms. An infusion of 2 oz. of quassia in a pint of boiling water, when of the proper temperature, is used as an enema for causing the expulsion of ascarides, and is very efficient. The same eilect is said to be produced when quassia is administered by the mouth, but the enema is much surer. By macerating 10 parts of the wood in 50 of water for twenty-four hours and adding enough sugar or molasses to make the strained infusion somewhat syrupy, a mixture is formed which is very effectual as a, fly-poison. It may be exposed on a plate, or on cloth or paper soaked in it and hung up. It is perfect- ly harmless. — Russell H. Nevins. QXTEBB.ACHO, aspidosperma (XJ. S. Ph.), is- the bark of Aspidosperma Quebracho, or quebracho bianco, so named from the light colour of its wood. The bark employed is col- lected from old trees after the corky layer is well developed. The first detailed description of the drug came from Penzoldt, who asserted that by its use some forms of dyspnoea depend- ing upon • disturbances of the circulatory or respiratory apparatus could be diminished or entirely removed. He maintained that no deleterious effects were produced on other or- gans by its administration. Although the drug has a disagreeable taste, and occasionally causes nausea or diaphoresis, or salivation after its ingestion, there seemed to him to be no lowering of the pulse-rate accompanying the diminished respiratory frequency {Die Wir- kungen Quebrachodrogin, Erlangen, 1881). Penzoldt believes that quebracho acts by in- creasing the power of the haemoglobin to take up oxygen, but he found that when it was given in an overdose the oxygen was retained in the blood and metabolism was diminished. Five alkaloids have been derived from que- bracho : aspidospermatine, which is believed to hold the active principles of all the other alkaloids ; aspidosam-ine, quebrachine, hypo- quebrachine and quebrachamine. Of these, quebrachine is the one most frequently em- ployed. Aspidospermine, an impure mixture of the alkaloids, is sold in the market as a fluid extract and as a solid extract. The dose of the former is from i^ to •J a fl. drachm ; that of the latter, from 1 to 3 grains. Penzoldt rec- ommends quebracho in asthma accompanied by emphysema, even in the presence of pleurisy or bronchitis. He praises it, also, in bronchial asthma and in all cases of dyspncea arising from, cardiac disturbances, in which compensa- tion is well established. In dyspnoea, however, due simply to a weakly-acting, diseased heart, it is not recommended, since it lacks the in- fluence of digitalis upon the ventricles. Flint gave quebracho cordial praise in all cases of dyspnoea, particularly when this symptom was caused by mitral insufficiency. In the absence of other organic disease, he used quebracho for the symptom dyspnoea {Med. News and Ab- stract, May, 1881, p. 273). The drug has been employed, also, for the relief of urwmic dysp- noea, but it is to be doubted if it is as valuable in this emergency as other remedies ; as a stom- achic tonic, it formerly enjoyed some repute. After prolonged use, quebracho seems to cause some disturbance of the sympathetic nervous system. Like many other drugs, quebracho has been recommended for the protection and stimula- tion of wounds ; it has been superseded, of course, by other substances. The dose of the fluid extract, extractum aspidospermatis fluidum {U. S. Ph.), is from 15 mmiras to 1 fl. drachm. The non official preparations of quebracho are a tincture and a wine. The dose of the former is from 10 to 20 drops ; that of the latter, from J to 1 fl. drachm. Quebrachine, one of the most active of the alkaloids of quebracho, has been used instead of the original drug. It appears in the mar- ket as the hydrochloride and the sulphate, of which the dose is from 1 to 3 grains. Samuel M. Brickner. 113 QUASSIA QUININE QXniBCUS. — See Oak bark and Acorns. QTTICKLIME. — See under Lime (vol. i, p. 583). axnCKSILVEB..— See Mercury. QTJILLAIA, quillaja (U. S. Ph.), cortex mdllaim (Ger. Ph.), or soap bark, is the inner bark of Quillaia Saponaria, a rosaceous tree indigenous to Chile and Peru, and cultivated in northern India. It contains saponin, Cio HsoOio, by virtue of which it has the property of producing a froth when rubbed in the presence of water. It has been used topically to some extent as a detergent. The use of the powder as a sternutatory has been suggested. Kobert (GtrlU. f. Iclin. Med., July 25, 1885) has recommended quillaia as an expectormit. He says that it is five times as rich as senega in saponin, which he regards as its active prin- ciple ; that it is rich in sugar also, and is free from the substance to which the bad taste of senega is due ; that patients tolerate it better than senega; that it seldom gives rise to vomiting and diarrhoea ; and that it has a de- cided expectorant action. Kobert used a de- coction of the strength of 5 parts of quillaia to 200 of water, in tablespoonful doses for adults and in teaspoonful doses for children. These statements having been confirmed by Gold- schmidt, Maslovsky (Russh. Med., 1886, No. 36 ; Therap. Oaz., May, 1887) employed it in twelve cases, using the preparation recom- mended by Kobert, with the addition of syrup. Two of the patients had pulmonary emphy- sema, one had interstitial pneumonia with bronchiectasis, four had pulmonary iuhercv^ losis, one had pleuropneumonia, three had croupous pnettmonia, and one had syphilitic stenosis of the right bronchus. Maslovsky con- cluded from his observation of its action in these cases that quillaia did not irritate the gastro-intestinal tract : that it increased the discharge of sputa ; that it soothed cough ; and that, on the whole, it was preferable to senega as an expectorant, although it might give rise to an attack of haemoptysis if there was a tendency to that accident, in which case it was contra-indicated, and although in some cases of phthisis it might intensify the cough without facilitating expectoration. The tincture, tinc- tnra quillajoe (U. S. Ph.), is used almost wholly as an emulsifying agent ; it may be given in- tpi'nally in doses of from 5 to 35 minims. Powdered quillaia. mixed with sugar, may be given in doses of from 1 to 6 grains. It should be borne in mind that saponin is de- cidedly poisonous, acting as a paralyzer to the centrnl nervous system, and that some caution is therefore necessary in the employment of quillaia. aUILLAIN.— See Saponin. Q.TJINALGENE.— See Analgene and Ben- ZANALGENE. ainNASEPTOL.— See Diaphthol. aUINCE-SEED.— See Ctdonium. CtTTIIfETTTM. — This preparation is de- scribed as a mixture of other cinchona al- kaloids than quinine in which cinchonidine predominates. It is soluble in water. It has been recommended, in doses of from 1 to 8 grains, as an antiperiodic m malarial affec- tions. aUINIDINE.— This is an alkaloid occa- sionally found in cinchona bark. It is isomeric with quinine. The alkaloid itself and the bi- sulphate, the citrate, the dihydrobromide, the hydrochloride, the sulphate, and the tannate have been employed. The sulphate, quini- dince sulphas (U. S. Ph.), may be given in doses half as large again as those of quinine, and for the same purposes. It is very bitter. The tannate is almost tasteless. It does not appear that quinidine has any advantages over quinine. QTTININE is the principal alkaloid of the bark of the trees Cinchona flava. Cinchona pallida, and Cinchona rubra. To be accepted by the U. S. Ph., the barks must contain at least 5 per cent, of the total alkaloids and at least 2-.5 per cent, of quinine. Associated with many other alkaloids, quinine exists in greatest abundance in the bark of Cinchona flava (yel- low cinchona). It is isomeric with quinidine and quinicine, the latter an artificial compound. Quinine was first separated and identified in 1820, although the bark had been in use in Eu- rope for nearly two centuries, and in South America from time immemorial. From a solu- tion of its salts, quinine may be precipitated as a crystalline hydrate by an alkali ; after subse- quent dehydration, the alkaloid appears as a white, opaque crystalline mass. It is of an in- tensely bitter taste, and is but sparingly soluble in water, although it dissolves freely in alco- hol, in ether, in benzol, and in chloroform. To distinguish quinine from salicin, the former may be dissolved in concentrated sulphuric acid with the production of only a faint yel- low colour. Heated highly on platinum foil, quinine burns entirely, leaving no ash. The salts of quinine in solution have a beau- tiful blue fluorescence. They divert the polar- ized ray to the left. The salts vary as to their solubility. Thus the sulphate is but sparingly soluble in water, whereas the bisulphate and the hydrobromide and hydrochloride dissolve easily in water. This becomes of importance in the administration of the drug. Although the bark of the cinchona trees was introduced into Europe early in the seven- teenth century by the Countess Chinchon, who had been cured of an intermittent fever by its use in Peru, the influence of the Church was sufficiently strong to prevent its general use. And it was not until Jesuit missionaries later brought quantities of the bark to the conti- nent that its use, dictated by popular demand because of the cures it produced, overcame priestly prejudice. It has since then become one of the world's staple articles of commerce — so much so that when the South American supply threatened to run short, successful transplantation was resorted to. As a physio- logical study of the drug, this extract from the Thesaurus novus experientice medicm aureus (Basel, 1704) will prove of interest and most of it will bear the light of the present day : " On ac- count of its bitter taste, it is also known as QUININE 114 ' earth-gall.' Supreme virtues exist in it when used in liver, spleen, and joint diseases, jaundice, and dropsy ; for which purposes a powder [made from it] is mixed with anise-seeds and drunk in beer and wine. It induces the men- strual flow and restores a lost appetite. It rids the body admirably of pin-worms, if an infusion of it is spread on a cloth over the abdomen .... It is valuable above all in the treatment of tertian and quartan fever." Though old Helmont, the compiler, placed the most important indication of the drug, last in his category, one can see that the indications which call ior quinine have not varied much in the last two hundred years. The alkaloid and its salts are used to-day for many phases of disease for which there is no more primary indication than in the ancient medical tale of our fathers. Rheumatism and typhoid fever were formerly the diseases cured specifically by quinine ; and there are still many physicians who regard it as more than valuable in these ailments. Its efficacy in intermittent fevers is classical, however, and even fiction has helped to establish its permanency, as in Twenty ■Thousand Leagues under the Sea. In their physiological action, the alkaloid and its salts are so nearly identical that they will be considered together, only such pecul- iarities of each as recommend it for particular uses being specified. An enumeration of the ofBcinal salts follows : Quinina (U. S. Ph.), qui- nine (Br. Ph.), is the alkaloid proper. Its recog- nised salts are : quinince bisulphas (U. S. Ph.), acid quinine sulphate (Br. Ph.), quinines hydro- bromas (U. S. Ph.), quininm hydrochloras (U. S. Ph., Br. Ph.), chininum hydrochhricum (Ger. Ph.), quinines sulphas (U. S. Ph., Br. Ph.), chi- ninum sulfuricum (Ger. Ph.), quinince valeri- anas (U. S. Ph.), and chininum tannicum (Ger. Ph.). In the U. S. Ph. there is also an officinal double salt, the citrate of iron and quinine, /er«' et quinines citras (U. S. Ph., Br. Ph.), chininum ferro-citricum (Ger. Ph.), which contains 13 per cent, of quinine. Among other numerous salts of the alkaloid that have been praised for some virtue or other are the arsenite, the hydro- chloride with urea, the lactate, and the acetate. The bichloride of quinine is another salt but recently added to the long list of those that have been compounded for some special pur- pose. In general, it may be stated that the effects of quinine, as manifested upon the body and its organs, depend upon the dose. Whereas small doses are stimulating and tonic in their influence, large doses administered to the same individual are sedative and depressing. Par- ticularly is this true of the circulatory and nervous systems, which respond well and quickly to the action of the drug. The various peculiar manifestations observed in the organs of special sense, in the cerebrum, in the skin, and in the internal organs may be summed up in the universal harbour of medical refuge — personal idiosyncrasy. Yet, though it is un- questionable that some individuals are more susceptible to the subtleties of this than to those of other alkaloids, it should never be forgotten by the physician that quinine is not an indif- ferent drug which can be administered regard- less of dose and of the personal element. While it would be perfectly safe, for example, to administer from 6 to 10 grains of quinine to an otherwise healthy woman who was at the same time pregnant and suffering from mala- rial disease, it would probably induce an abor- tion or miscarriage in a woman with intermittent fever whose general condition was deteriorated by excessive work and worry. Again, a man who required a stimulant tonic might do very well on a pill or a mixture containing quinine, or he might show such decided personal suscep- tibility to the drug that its withdrawal would be imperative. The personal element, then, is as important in the administration of the cinchona alkaloid and its salts as it is in that of any othor drug which produces pronounced effects. In respect to the differences mani- fested by different alkaloids of cinchona, cin- ohonine seems no less inert than quinine, but its action is not so prolonged or so intense. The symptoms of the condition known as cinchonism appear after the use of either, but in the case of cinchonine the familiar buzzing in the ears is not so early a phenomenon, but an intense frontal dnlness accompanied by praecordial distress, subsultus tendinum, and faintness with other severe nervous manifesta- tions, appear. Indeed, it would seem that it requires a smaller dose of cinchonine to pro- duce a physiological effect than of quinine. The causation of cinchonism has been a puzzle to physiologists. Of its existence, how- ever, there is daily proof. There are few indi- viduals who have taken quinine in moderate doses for any length of time who have not ex- perienced some of the phenomena which mark its presence. Therapeutic doses of quinine (5 to 10 grains) produce the flrst symptoms. These are, usually, a buzzing or ringing, a feel- ing of fulness or heaviness or both in the head, and there may be partial deafness. If the drug is withdrawn, these symptoms disappear spontaneously. Should its use be continued or larger doses given, there is an exaggeration of the symptoms mentioned, with those of cerebral congestion. The deafness becomes almost complete, if not absolutely so ; an amau- rosis is developed which may well be called toxic ; the face is flushed, and there are de- cided giddiness and an intense feeling of dis- tention in the head. An ataxic gait may accompany the other functional disturbances. After the administration of more than a physio- logical dose, pronounced symptoms of poison- ing show themselves in rapid succession. At first there is a heaviness in the head, with tinnitus aurium ; then there are confused and disturbed trains of thought, followed often by delirium. If the dose has been sufficiently large, loss of consciousness, complete deafness, and blindness ensue. The sensibility of the skin disappears, and the limbs are powerless. Intense paresis, sometimes paralysis, follows. The respiratory movements are "not free, and death may take place in coma or in delirium, usually with symptoms of asphyxia. The treat- ment of such poisoning is direct and indirect. If the patient is seen sufiBciently early, gastric 115 QUININE lavage may be employed. If the systemic symptoms are already very pronounced, treat- ment must be directed toward them. The subcutaneous use of cardiac and respiratory stimulants is indicated, and all measures which tend to restore the flagging heart and circula- tion should be resorted to. Lesser degrees of poisoning by quinine evoke similar but not so mtense symptoms, the difference being in de- gree only. The toxic dose is difficult to esti- mate ; 44 grains given in divided doses in fifty hours have caused death, and 12 grains are recorded as having caused amaurosis. In this, as in the therapeutic effect to be obtained, personal idiosyncrasy plays an important r61e. The deafness frequently following the use of quinine usually vanishes on the withdrawal of the drug. The blindness, however, may be permanent, but is frequently only temporary. Von Graefe, Gruening, and Knapp have re- ported cases of permanent blindness, and there are many cases recorded of temporary loss of vision. If a patient recovers from quinine poisoning, he is likely to have great muscular weakness for some days. The other symptoms gradually subside, with the exceptions above noted. The influence of quinine upon the cerebrum, the spinal cord, and the organs of special sense can in part be determined by a consideration of the phenomena of cinchonism. Other con- siderations, however, require a somewhat more detailed investigation into the action of the drug upon the various organs of the body. When quinine is given in small doses (6 to 8 grains), the tone and elasticity of the cerebral vessels are enhanced, which would probably account for the observation of Brown-Sequard that quinine increases the number of epi- leptic seizures. The disturbances of sight and hearing after the administration of the drug are believed to be due to a direct or indi- rect congestion of the peripheral sense organs, as animals poisoned by quinine are found to have great congestion of the middle ear and labyrinth. So severe may this congestion be- come and under such pressure may it exist that serous or even bloody exudation ensues. In a series of experiments to determine the lesionin quinine blindness, DeSchweinitz(OpA- thal. Rev., February, 1891) found that the oph- thalmoscopic picture in dogs was similar to that seen in human beings with quinine amaurosis, blurring of the edges of the optic discs, and in one case obliteration of the vessels of the optic disc. In all, the pupils were immovably di- lated. In one case there was a decided dilata- tion of the blood-vessels, the central vein being plugged with a clot, and white thrombi filled the smaller veins. In the corneas were found dilatation of the circuracellular lymph spaces, and degeneration of the protoplasm of •the cell. Proof seems to exist that the action of quinine upon the cortical centres is a stimu- lant one. Thus persons who have been in the habit of taking the drug for some time seem to feel less energetic and less active after its withdrawal. Although the influence of quinine upon the spinal cord and the peripheral nerves m man has not been scientifically demonstrated, it is well known that in lower animals it produces, in small doses, lessening of reflex activity and, in larger doses, paresis of the reflex centres, which is usually permanent. It would seem that similar influences are produced upon the central and peripheral systems of man, for re- flex disturbances whose origin may be in the cord or in the cortex are inhibited by the judi- cious use of quinine. It is true that this result may be called forth by a stimulation of the inhibitory centres, but the influence of toxic doses upon the gait, producing as they do ataxic movements, would seem to imply an impairment of the reflex arc. The safest state- ment that can be made in the light of our present knowledge is probably that upon the spinal cord quinine has the same general effect as upon the body at large ; in small doses it is stimulant ; in larger, still therapeutic doses, it has a sedative effect. Upon the stomach and intestines quinine acts, in small or moderate doses, as a simple bitter. Gastric digestion and the production of gastric juice seem to be favoured by its ad- ministration. Given for a long period of time, it is apt, however, to bring about a catarrhal gastritis, and, when administered in too concen- trated a form, it is very irritating to the gastric mucous membrane. Nausea and even vomiting sometimes follow its introduction into the stom- ach. A constipating efl'ect is sometimes ob- served after the early use of the drug, which is subsequently superseded by diarihoea. These effects are undoubtedly local, due to liberation of the tannic acid which is innate in the alka- loid. When introduced into the rectum in somewhat larger doses than usual, quinine produces its physiological efi'ects upon the organism ; but frequently it is so irritating to the rectal mucous membrane that it can not be administered in this manner. Its absorp- tion from the alimentary tract is hastened by previous purgation, and in this instance the catharsis is best accomplished by mild meas- ures, hydragogues and cholagogues being con- tra-indicated. That quinine is readily dissolved by acids and precipitated by alkalies is well known. Thus the acid gastric juice renders it suitable to be absorbed from the intestinal mucous membrane, while the intestinal juices are apt to cause its precipitation. It has been shown that when a quinine salt passes unchanged into the intestine it is removed from the body with the fasces in the form of insoluble com- pounds. It would naturally be supposed, there- fore, that the alkaline blood would also cause its precipitation : but it is known that the gases of the blood, in some chemical manner, hold the quinine in solution. The alkaloid, however, is not deprived by this suspension of its power upon the blood-cells. It is dif- ficult to arrive at a satisfactory conclusion as to its effect upon the white corpuscles; some experimenters declare that leucocytosis follows its use, while others say that the white cells are diminished in number. If it is true, as is alleged for it, that quinine has a phagocytic action, enabling it to decrease suppuration, it QUININE 116 would seem likely that those who favour the view of leucocytosis are correct. Upon the red cells it is probable that the effect is to diminish their number to a slight degree, though the form of the red cells, according to the greater number of observers, remains un- changed. That the quinine solution, through its ability to modify or even destroy proto- plasmic structure, profoundly influences the contents of the blood-cells, is not in doubt. By the use of the drug the coagulability of the blood is diminished, and diapedesis and emi- gration — a " paralysis of the leucocytes " — are embarrassed. An effect upon the hjemoglobin seems to be a diminution in its oxygen-carry- ing properties. The fall in blood-pressure after the admin- istration of quinine is due, unquestionably, to two causes : 1. To a dilatation of the periph- eral capillaries and smaller arteries. 2. To a diminution in the force of the heart-beat. The former effect may be a local one, but it is more probably due to a slight paresis of the vaso-inhibitory centre. The action upon the heart is caused by the influence of the drug upon the heart muscle or its resident gan- glia. The pulse, naturally, shows variations which correspond to the degree of these changes, which, in the use of therapeutic doses, are gradually brought about. Poisonous doses succeed in paralyzing the heart muscle after having tirst rendered its beat very rapid with much diminished force. Small, tonic doses of quinine act as a stimulant to the cir- culatory as to the nervous system. After its absorption into the blood and when it is not excreted in the faeces, quinine is eliminated principally through the kidneys. It can be found in the urine shortly after its introduction into the system, though it takes some hours for the total quantity to be ex- creted. A peculiar effect on the urine is the decrease in nitrogenous elements excreted. Experimental evidence leads to the belief that it is not due to diminished excretion, but to a lessening of metabolic changes in the body, in- volving the destruction of proteid elements. During its passage through the genito-urinary tract, quinine may cause renal or vesical irri- tation with albuminuria, hasmoglobinuria, or cystitis. Increased frequency of micturition and retention of urine have been observed ; and occasionally erotic excitement has been manifested. Large doses of quinine, however, may allay vesical irritation or tenesmus. The primary effect of moderate doses upon the respiration is stimulant. The rate of breathing is increased, but the respiratory movements are not materially deepened. Toxic doses call forth dyspnoea with stertorous, em- barrassed breathing. Death may ensue from asphyxia, as described above. This is undoubt- edly due to central action. 'the reduction in the size of the spleen sub- sequent to the administration of quinine in malarial disease is due to the elimination of the disease. But experimental observers have recorded the fact that the spleen in lower ani- mals has shrunk in size and its capsule has be- come loosened and its parenchyma tougher after the administration of quinine. Be this as it may, it is probably true that the dimin- ished spleen, not only in malarial disease, but also in other infective processes, is due to the victory over the disease rather than to any spe- cific action on the organ. A variety of opinions have been expressed as to the influence of quinine upon the gravid uterus. The statements that follow are, how- ever, the best teaching of the profession at the present time. An otherwise healthy pregnant woman suffering from malarial disease may take quinine with safety to her offspring. A debilitated, overwrought, highly nervous preg- nant woman under the influence of malarial poison may miscarry whether she is given quinine or not ; but in precisely these eases in which malaria may induce abortion or mis- carriage the judicious use of quinine may pre- vent the mishap. When dystocia arises from exhaustion of the mother, generous doses of quinine, by their stimulation to the uterine muscles, frequently are of service. Mental en- couragement is of value, however, by inducing the patient to believe that the drug will have the action desired. Atkinson (Am. Jour, of the Med. Sci., February, 1890) concludes that qui- nine occasionally has an oxytocic action if there is an idiosyncrasy, and he advocates its use in prolonged laboursYii\h exhaustion of the mother or threatened uterine inertia. In this position he is indorsed by the bulk of the profession. The local action of quinine demands some consideration. Applied to the skin denuded of its epidermis, quinine and its salts, in powder or in solution, are active irritants. Upon an intact skin little or no irritating influence is perceived, but upon mucous membranes a distinct irritating and stimulant effect is ob- served. This is particularly marked in some individuals who can not take the drug by the mouth or by the rectum. The prolonged in- ternal administration of quinine, or even, in isolated cases, a single dose, has called forth eruptions. These may assume any character, from a mere erythematous blush to papules and vesicles. Allen (Med. Record, January 26, 1895) has reported a case in which the eruption was like that of scarlet fever, becoming suc- cessively urticarial, oedematous, and bulbous, leaving an excoriated surface. After a quinine eruption there is frequently an exfoliation of the skin. These instances are undoubtedly to be accounted for by the marked idiosyncrasy manifested by some persons against the drug. The antiseptic action of quinine has long been recognised. A solution of 1 part to 300 will preserve organic foods for a great length of time, and in a similar proportion quinine will check alcoholic fermentation in saccharine substances. Upon the higher and more viru- lent forms of bacteria its action is decidedly less powerful, although in the early antiseptic period it was used in a spray instead of car- bolic acid. It is principally upon fungi that its antiseptic influence is strongest. The antipyretic action of quinine has never been satisfactorily explained. Wood does not believe that it is due alone to the diminished oxygen-carrying function of the blood, but 117 QUININE rather to the drug's influence upon the spe- cialized nervous tissues of the body — in other words, the heat centre. Upon a normal bodily temperature quinine exerts but a feeble, if any, antipyretic action. But in febrile conditions of any kind, or at least of most kinds, the ther- mometer shows a marked fall after its admin- istration. Quinine is not a universal remedy for all febrile diseases, though its enormously wide clinical and therapeutical application would lead one to believe that it was a specific lor almost all diseases in which there was an abnormal rise of temperature. The first important therapeutic application of quinine is in the various forms of malarial disease. In this disease it is a specific. Al- though other antiperiodics have been tried, and although many other alkaloids have been vaunted as curing or aborting an attack, qui- nine stands forth pre-eminent in its ability to prevent, cure, or abort the various forms of malarial intoxication. Consideration must be extended in three directions in its application in malarial disease: 1. Its prophylactic use. 2. Its curative use. 3. Its specific action on the Plasmodium malariw. Laveran's work has received such almost unanimous recognition and acceptance that for the purposes of this article it will be assumed that his discovery of the malarial parasite is uni- versally believed. The clinical evidence of the value of quinine in malarial affections is only strengthened by the adoption of the view of the Plasmodium as the jetiological factor — and the sole one — in the causation of this group of diseases. In the classical report on The Ma- larial Fevers of Baltimore (Johns Sophins Sosp. Rep., 1895) it is stated, in the too brief chapter on the action of quinine, that the best time to attack the malarial organism is during the period of segmentation. In the tertian type of the disease this can be best accom- plished by giving one moderate dose just before the expected paroxysm, so that the qui- nine salt shall be in solution in the blood at the time of division. Blood examinations made immediately after the paroxysm show that entire groups of the Plasmodium disap- pear. It is found that in the intervening stages — in which the parasite is in the endo- glohular stage — quinine, administered in a single dose, has little effect upon the further development of the organism. In mild tertian cases a moderate dose, given from ten to twelve hours before an expected paroxysm, may avert the chill, but it is more efiioacious if given nearer the time of the expected attack. In tertian and quartan cases treated with quinine the Plasmodium disappears from the blood within the first four days. In the quotidian type, if the patient is energetically cinchonized, it may disappear even sooner. It is not known in what manner quinine is antagonistic to the specific organism which produces malarial dis- ease, but it is probably by some direct influence which destroys its vitality. Certain it is, that in addition to the clinical history of nearly three hundred years to substantiate the title of cin- chona as a specific in intermittent fever, we have the direct evidence that quinine attacks the cause. We have every right, therefore, to regard quinine as a specific antiperiodio (and antipyretic, incidentally) in the various mani- festations of malarial disease. Two recognised plans are followed in the treatment of intermittent fever with quinine. The first is the daily administration of a dose sulfioiently large to control the paroxysms. The second consists in giving the drug imme- diately after a paroxysm, on the supposition that the Plasmodium malaricB yields most easily at that time. Either plan may be fol- lowed, and both will give good results. But one thing is essential : the patient under treat- ment must receive his physiological dose of quinine — he must be cinchonized. By the for- mer plan the patient will receive daily from 15 to 30 grains of quinine, given in divided doses; less than 4 grains in one dose it is use- less to give to an adult, since that quantity produces no appreciable effect. In the so- called pernicious cases it is necessary, or it may become necessary, to increase the amount of quinine, for, to cure these cases, the patient must be fully under the influence of the drug, not only during the paroxysms, but during the intervals of the disease as well. When the symptoms are becoming less marked, the dose may be gradually diminished ; but the drug should not be wholly withdrawn until some weeks have elapsed. The second plan involves the giving of from 15 to 25 grains of quinine, as the temperature falls in the first paroxysm observed. This is said to be sufficient to avert the second attack ; but if slight symptoms should show themselves, the administration of a second dose of 10 or 15 grains is usually suf- ficient to control the disease. No further dose need be given until the seventh day, when from 15 to 35 grains are again given. Usually this suflices ; but if a tendency to relapse is noticed, or if some of the milder symptoms of malarial infection present themselves, full doses of qui- nine must again be resorted to. Sometimes a paroxysm seems to be best averted by giving quinine prior to a paroxysm, and, although some prefer giving divided doses, it seems more rational to give one or two large doses, for it would appear that small doses are able oidy to retard the development of the Plasmodium malarim, while larger ones are able to destroy the micro-organism. Pour hours is the shortest time in which a moderate dose (10 grains) of quinine can enter the blood in solution ; hence the best time for giving the drug previous to an attack is from five to six hours. A dose of 15 grains will maintain its action in the body for from four to five hours, while a dose of from 5 to 8 grains will exer- cise its influence for from two to three hours. Doses in other amounts act for lengths of time corresponding to their quantity. As pointed out above, it is necessary for a patient to be cinchonized for the drug to be of the greatest value in overcoming the malarial infection. Otherwise the disease may linger and be pro- tracted over many months, or relapses may oc- cur. Free purgation is essential during the administration of a quinine salt. This may be accomplished by mercurials, by vegetable ca: QUININE 118 thartics, or, in the case of the pernicious forms, by diuretics. The so-called " Jimmorrhagic " form of ma- larial fever demands einchonism at once. For this purpose, the administration of the alka- loid is much the same as in the ordinary inter- mittent type of the disease. From 15 to 20 grains may be given in one or in divided doses. For the condition known as malarial cachexia quinine is valuable ; but after a long period of its administration, if a cure or relief does not follow, other drugs, such as arsenic, may be employed. The cachexia is dependent, indeed, not only upon malarial infection, but also on some tissue changes, and it is probable that not all eases can be cured. But even in this symptom-complex, quinine, in doses of 5 or 6 grains daily, has well-marked curative effects more frequently than not. To refer briefly again to the pernicious va- riety of malarial infection, it is usually not sufficient to administer quinine alone. The grave phenomena presenting themselves on the part of the nervous system, the intestines, the lungs, and the kidneys render symptomatic treatment necessary as well. If, indeed, the gastric symptoms are pronounced, resort must be had to the giving of quinine by the rectum or hypodermically. Like all other drugs, qui- nine given suboutaneously acts more promptly than when administered by the mouth or by the rectum; but in this form of malarial disease the choice must rest upon the conditions present. In the treatment of remittent fever quinine is indicated. Its results are not always so gratifying as in intermittent fever, but it is frequently curative. Quinine has probably an antipyretic effect in remittent fever when given at its height, and there seems to be no theo- retical objection to administering it at this time. Many observers prefer to give the drug, however, as soon as the remission appears. Using drugs other than quinine with ther- molytic action to reduce the fever, or resort- ing to the full bath. Quinine frequently, however, succeeds in lowering the temperature and then exerts its speoiflo action upon the micro-organism of the disease. No symptoms which may arise during a remittent fever are contra-indications to the use of the cinchona alkaloid. Should a severe gastritis arise, the drug may be given in solution or suppository by the rectum or suboutaneously, as in the per- nicious type of the disease. In remittent fever, from 20 to 50 grains may be given in twenty- four hours, in one or in divided doses. (For the selection of quinine salts for hypodermic administration, see page 131.) There are some forms of what are called " masked intermittent " fever which seem to be benefited by quinine. These ailments rnanifest themselves by the periodical appearance of certain functional disturbances without accom- panying chill or fever. Intermittent neuralgia, very frequently of the trigeminal type, though it may appear in any of the plexuses or their branches, yields readily to quinine in sufficient doses. Sometimes, ' though not usually, the attack is of long duration, and the drug must be given for a considerable period of time. At the time of the onset a dose of from 15 to 35 grains may be given, which will usually relieve the symptoms. After the abatement of the attack, 5 grains, thrice daily, may be adminis- tered for a few days. Other phenomena have been described as occurring periodically, and have been attributed to malarial poisoning; but although they have seemed to yield to quinine, according to their reporters, the cases have not had the appearance of having been ■ accurately and acutely observed. They embrace such functional disturbances as intermittent haemorrhages, oedema, convulsions, and paraly- sis, and should probably be classified under other groups of disease than the malarial. How- ever, if any such symptoms arise after an attack of malarial disease of any type, and are inter- mittent in character, there can appear no valid objection to thorough dosing with quinine. There are other forms of neuralgia which, though intermittent, are not periodic in char- acter, that yield gracefully to quinine given for a few times. They can not, however, be supposed to be due to malaria, for any effect the quinine may have is soon lost. When a patient suffers from intermittent malarial fever, or any of its forms, or from remittent fever, or from any of the intermit- tent forms of disease which appear to be dependent upon the invasion of the specific parasite of the disease, he should be removed from the locality at once if it is known to be malarial. The mere administration of quinine, though curative in a single attack, will not prevent recurrence if re-infection is possible. Pernicious cases, indeed, follow frequently upon one or more mild attacks. Prophylaxis against the disease is possible, however, by the judicious use of quinine. The effect of the drug need not be carried to the extent of einchonism for this purpose. From 3 to 5 or even 8 grains may be given twice daily. It does not always succeed in preventing acquisition of the dis- ease, but even in dreaded malarial tropical countries it has succeeded in keeping the dis- ease aloof. When, after prophylactic treatment, malarial poisoning does make its appearance, it is altogether likely that it is less severe than it would have been had not such treatment been instituted. The experience of the British army in India in preventing a spread of the disease among the soldiers may be taken as a good example of the value of the prophylactic use of cjuinine. Quinine has been recommended at various times for all the acute infectious diseases. In acute articular rheumatism it was used two hundred years ago, and was thought to be specific. Probably this belief rested upon its antipyretic power. At the present day it is used by some clinicians, not as a specific, but as a tonic, in doses of from 1 to 2 grains thrice daily during the convalescent stage. In typhus fever it is still used at the present day, and is believed not so much to exert any specific ac- tion on the course of the disease as to give tone to the organism during the critical stage. The well-known Huxham's tincture is used in this connection. As a curative agent in typhus it is, of course, worthless ; but, together with 119 QUININE other tonics and stimulants, it may help to tide the patient over his crisis. In typhoid fever it is also no specific, of course, although it has had wide use as an anti- pyretic. Striimpell is doubtful if the quinine salts, by their mere reduction of temperature, have any favourable influence upon the course of the disease. That they do sometimes reduce the temperature 2° or j}° P. is unquestioned, and in cases in which the bath treatment is contra-indicated (see Hydriatics) quinine may be used as an adjuvant in the treatment of typhoid fever. It must not be forgotten, how- ever, that by its irritant action on mucous membranes it may injure the intestine which is the seat of the disease, and make a perfora- tion possible. For the purpose of reducing temperature it may be used in doses of from 15 to 25 giains, given at once. Of more value is it in small doses during convalescence as a tonic, both gastric and general. It may then be given either in pill or in substance. A very good formula for a tonic containing quinine is : 3 Quinine sulphate 1 grain ; Dried sulphate of iron 1 " Arsenious acid ^^ " Mix and make one pill. One such pill to be taken thrice daily. Or, 5 Quinine sulphate 1 grain ; Cried sulphate of iron 2 grains ; Extract of nux vomica -J grain. Mix and make one pill. One such pill to be taken, thrice daily, before m«als. These combinations may, of course, be modi- fled in many ways ; but the drugs, combined as in the two formulas given, have virtues as tonics of a high order. Quinine has been lauded in the treatment of puerperal fever, small-pox, scarlatina, and ery- sipelas, as well as in that of diphtheria. It has been given in these affections in the be- lief that it exerted some speciflo action on the poison of each disease. This is absolutely without foundation of proof. So far as its antipyretic action goes, it may relieve the pa- tient of some of the symptoms of pyrexia, if administered iu sufliciently large doses; but aside from this and from its tonic action, com- mon to it in all forms of disease, there is no proof that it has any action which should de- mand its use. Prophylaxis in the first men- tioned is of more importance than treatment, and for the other diseases of the group there is much to be hoped for in recent observations and investigations. Even in cholera quinine has been advocated on the ground that the difficulty of absorption from the intestines in this disease favours the antiseptic action of the drug on the comma bacillus. It is well known, though, that the antiseptic action of the cin- chona alkaloid is too weak to exert any such eileot on a bacillus of such virulence. In doses of from 20 to 40 grains it may help to combat the high fever of cholera,' and its supporting action may also be brought into play with a favourable result should recovery ensue. For many years the quinine treatment of pneumonia was a recognised form of treatment in New York. It does reduce the temperature in pneumonia, with a coincident falling of the pulse. Its use is not to be commended, for its indiscriminate employment may be productive of cardiac depression and failure. Certainly in the doses recommended in former years, 20 to 40 grains in one dose, it would be feared by many practitioners for its tintoward influence upon the heart. Here, as in most of the febrile diseases, its tonic influence is valuable when convalescence has been established. It has been maintained that, if given early in pneu- monia, as in follicular amygdalitis and inflam- mations of serous surfaces, it will modify the course of the disease. Indeed, one observer has alleged that the pneumonic process is less severe, that the cerebral, respiratory, and cir- culatory phenomena are less grave, if quinine is given in large doses early in the disease. It may cause, if given in a large dose, anorexia, nausea, and vomiting, and even cardiac weak- ness — symptoms which should be avoided or. guarded against in pneumonia, of all diseases. In some of the diseases of the respiratory tract quinine has had extended use. Like so many other dnigs, it has been recommended in the treatment of pertussis. In doses of from 5 to 10 grains twice a day (the doses for infants are, of course, correspondingly smaller) it is said to diminish the frequency and severity of the attacks. It should be given early in the disease, if at all. Laubinger {Jahrb. f. Kin- derheilkunde, xxxix, 2, 3) urges the subcutane- ous use of the dihydrochloride of quinine in cases in which the symptoms demand instant relief. In asthma good results have been alleged from the use of quinine in diminishing the spasmodic attacks. The same has been asserted for it in laryngismus stridulus. More eflScacious methods of treatment, however, are at our command. The hectic fever oi phthisis may be reduced by the use of quinine, and it may be used as a tonic in chronic phthisis when there are anorexia and general weakness. As a gentle stimulant in chronic bronchitis, quinine may form part of a mixture or pill. A very good formula for this use is : 5 Extract of belladonna 1 grain ; Extract of opium 2 grains ; Extract of nux vomica 3 " Powder of ipecac 4 " Quinine hydrochloride, or sulphate 5 " Mix and make 20 pills. One pill to be taken four times daily. In acute coryza and hay-fever, spraying the nostrils with an aqueous solution of from \ to iV per cent, has been reported to have cured cases. • Or the quinine may be in the form of a snuff in a mixture containing bismuth or salicylate of sodium. The internal administra- tion of 5 grains, three times daily, is advised in connection with the spray. In influema it is doubtful if quinine, locally or internally, is of great utility. In the albuminuria of scarlatina, quinine, combined with tincture of chloride of iron, is said to be efficacious ; but, QUININE 120 like many other reoomraendations of quinine, this assertion rests on very little evidence. For other internal and functional diseases, quinine has been praised. In the treatment of insolation, Binz (Bed. klin. Wochensclir., 1895, No. 29) recommends the hypodermic ad- ministration of the bichloride of quinine. He says that at least 3J grains should be injected at one time, and this dose may be repeated in one hour if necessary. He alleges good results. Quinine in doses of from 3 to 8 grains relieves many of the chronic cases of headache which are the bete noire of the physician. Taken at night in one dose, in black coffee, for five nights, it has accomplished a cure of migraine which lasted for five months. In cases of leucaemia quinine has been tried on account of its supposed effect in reducing the size of the spleen, but it has no curative effect on the disease. Hosier, quoted in Strilmpell's Text- booJc of Medicine, reported good results from its use. The drug has been tried in diabetes, on theoretical grounds, but it is valueless as a curative agent. In the treatment of a few of the parasitic skin diseases, quinine, in a o-per-cent. ointment, has been found valuable. In some forms of pityriasis and tinea it has been found effica- cious. Given in doses of from 5 to 10 grains previous to the passing of a sound into the male urethra, it will prevent the remarkable rise of temperature known as urethral fever. Moreover, after this temperature — sometimes reaching 106° P. — has made its appearance, quinine will quickly reduce it. The writer can not refrain from adding that he has always regarded this phenomenon as directly due to a surgically unclean instrument. In the treat- ment of gonorrhoea, cystitis, and growths at the neck of the bladder, injections of quinine, of a strength of from 3 to 3 grains to an ounce, are said to be curative and to relieve the tenes- mus which frequently accompanies these con- ditions. There are, however, better means of combating these ailments. Rectal injections of a similar strength are of value in treating an ammhie dysentery whose seat is low in the intestinal canal. On the nervous system quinine has decided effects, and has been used in various functional and organic nervous diseases. The pains of locomotor ataxia sometimes yield to the alka- loid of cinchona, though, of course, the anal- getic effect is due entirely to the sedative influence of the drug upon the peripheral nerves. Charcot's classical recommendation of quinine in Meniere's disease deserves the place it holds, for cases of cure are certain, and in some instances permanent. For this purpose, from 8 to 15 grains are taken daily in divided doses for a month. As mentioned above, malarial neuralgias yield to quinine in large doses (15 to 35 grains) it taken at once. And in the so-called " idiopathic " eases oineu- ralgia of the trigeminal <2/pe,qumine, pushed to the point of cinohonism, brings frequent relief. Sciatica yields less often to the influence of quinine. As a tonic, quinine is indicated in neurasthenia, in the combination of the formula given above. The drug has been used in steno- cardia to prevent a recurrence of the paroxysm, but its use is purely tentative. In the so-called hydrops articulorum intermittens, a vnre trophic disturbance, quinine may be used for its anti- periodic effect. As hinted at above, quinine is of use during labour when the mother has become exhausted and uterine inertia is threatened. (See also under Oxytocics, vol. ii, page 55). Initial abortifacient power does not reside in the drug. For the purpose of aiding uterine ac- tion, it may be given in doses of from 5 to 10 grains every hour or in a single dose of 15 or 30 grains. In cases of hmmaturia, even if not of malarial origin, quinine is often serviceable, particularly in those instances in which the attacks are paroxysmal. When inunctions of mercury are given in severe cases of syphilis, the simultaneous administration of from 15 to 30 grains of quinine daily will prevent stoma- titis and will help to cure cases which do not seem to yield to inunctions alone. (Dymnicki, Monatshft. f. praU. Dermat., 1889, No. 39.) Qninine lias some reputation as a tonic and stimulating drug in prolonged suppuration in any part of the body. It may be given in- ternally or applied locally as an irrigating fluid. Thus, in oases of empyema of long standing, in which there are discharging si- nuses, it mav be injected into the cavity in a strength of from 4 to 5 grains to an "ounce. Internally, it should be administered in the usual tonic dose. For pruritus ani or vulvce, a strong solution of quinine is recommended for topical application. Ophthalmic surgeons use quinine in acute glaucoma and blennorrhagic ophthalmia with variable results. In some cases of glaucoma the pain seems to be dimin- ished by the use of the drug. [Dr. George Reich-Hollender, of Seattle (Arch, of Ophthal., xxiii, 1 and 3), used a qui- nine lotion experimentally in an obstinate case of gonorrhmal ophthalmia, and found that after the third day the discharge became in- nocuous, and within two weeks not a vestige of the inflammation remained. By making cultures he satisfied himself that the gonococ- cus of Neisser was destroyed by a solution of quinine. He considers that the best way to employ quinine is in a solution containing hydrochloric acid. He believes it to be a specific in the ravages of the gonococcus. He makes a solution of 8 parts of quinine, 8 of dilute hydrochloric acid, and 720 of distilled water, and applies it every hour.] Knapp has recently used quinine in the chorea of children with good effect. It does not cure all cases, however. He does not con- sider the action of the drug to be due to its stimulation of the inhibitory motor functions of the spinal cord, but to some influence upon the toxines of the disease (Boston Med. and Surg. Rep., February 38, 1895). Good results are also alleged for the use of the alkaloid in nocturnal enuresis, especially in nervous chil- dren in whom the inhibitoryfunction seems to be disturbed. Four grains, three or four times daily, are given for this purpose. Finally, quinine in solution may be applied to unhealthy granulating wounds, or to slowly- 131 QUININE healing ulcers. So many better topical appli- cations are to be found, however, that it is scarcely worth while to discuss the use of quinine as a surgical aid. The onntra-indications to the use of quinine are inflammation of the middle ear — because of the congestion quinine produces in the mid- dle ear and labyrinth — and acute inflammatory processes of the gastro-intestinal canal, for reasons already stated. Very rarely the influ- ence of quinine upon the genito-urinary tract is irritating, so in acute processes in this region the use of quinine might be contra-indicated. Each of the salts of quinine has uses to which it is particularly adapted. The sulphate and the bisulphate are used for similar pur- poses, for internal administration, and for rectal use. For hypodermic use the bisulphate, the hydrobromide, and the hydrochloride are preferred on account of their solubility in water. The bichloride and the hydrochloride with urea are also capable of use by subcu- taneous injection. The administration of qui- nine varies with circumstances and with individuals. The intensely bitter taste of the alkaloid and its salts renders it necessary to disguise their taste. Quinine itself is rarely employed, the sulphate being the most com- monly used of the salts. It must be mentioned that the sulphate frequently varies in its sta- bility and in its effects. In two cases simul- taneously observed by the writer, suspected malarial infection was treated with the sulphate of quinine. After several weeks of its admin- istration with no improvement, the hydrochlo- ride of quinine was given, and a cure resulted within a week. A point in the administration of quinine is the fact that children excrete quinine more rapidly than adults ; but from the experiments of Oui it is no longer believed that suckling children suffer a cinohonic effect from the milk of their mothers. Quinine may be administered by the mouth, by the rectum — in suppository or by enema — hypoderraically, or dermically. The taste of quinine may be disguised by giving it in wafers, which is perhaps the most desirable method. It may be given in the form of pills, which may be coated to obscure the bitter taste. Mineral acids should follow the administration of the sulphate in order to facilitate the solu- tion of the salt in the stomach. Either the sulphate or the bisulphate is better tolerated by the stomach if given in a solution of potas- sium tartrate. The albuminate of quinine is said to be acceptable to a sensitive stomach ; but it is soluble in water only when hydro- chloric acid has been added. If a rapid result is desired, a solution of the salt should be given, and to accomplish this most satisfac- torily the bisulphate is usually employed. After its solution in water, aromatic sulphuric acid should be added, one drop for each grain of the drug. The tablets of the quinine salts in the market are not to be too cordiallv com- mended, for they are apt to defy solution. Tablets of tannate of quinine, in the form of chocolate lozenges, are sold in the shops, each tablet containing 1 grain of the drug. These are especially desirable for use among children, as the chocolate completely disguises the taste of the salt. [A simple and very effective way of masking the bitterness of quinine was taught some years ago by Dr. A. Jaoobi. The quinine is to be mixed in a tablespoon with enough strong black coffee, cold, to almost fill the spoon. The quinine does not wholly dissolve, but it gives the coffee the colour of cafe au lait. In this way most persons can take quinine without tasting it.] Suppositories containing quinine are apt to irritate the rectum, and enemata are not always retained. However, when the administration of the drug by the mouth is not feasible, and when it is desired to secure a local effect upon the lower bowel, it is Justifiable to give it by the rectum. Potassium iodide is chemictlly incompatible with the quinine salts and should never be given in combination by the rectum, since iodine is set free. For hypodermic use, as brought out above, the hydrochloride, bi- sulphate, and hydrobromide are to be chosen, because of their easy solubility. The first is soluble in 34 parts of water, the second in 10 parts, and the last in 54 parts. It is alleged for the hydrochloride that it is cheap, that its injection is free from pain, and that it does not produce an abscess at the site of introduction. The same statements are made for the bichlo- ride and the compound salt of the hydrochlo- ride with urea. The hydrochloride, however, according to Briquet, is not stable. Except in an emergency, as in insolation, or when an im- mediate effect is desired, it is not necessary to resort to the hypodermic needle to secure the effect of quinine. The possibility of producing an abscess by the use of an unclean needle must not be overlooked. The dermic method of administration may be resorted to in children ; but it has been shown that, although some of the quinine ap- pears in the urine shortly after its dermic application, the greater part of the drug does not enter the blood. This method, then, is practically valueless. The dose of quinine and its salts is elastic. It may be given for tonic effect in doses of ^ a grain ; or, to produce cinchonism, the dose may be as high as 75 grains. No set rule can, there- fore, be laid down. The hydrochloride is given in doses of about J less than the sulphate. The dose of the valerianate is from 1 to 2 grains. The doses of the other salts are the same as those of the sulphate, which varies with indi- vidual cases and with the diseases for which it is given. (Cf. Cinchona.) [An oiRcial wine of quinine, vinum quinines (Br. Ph.), contains a grain of the sulphate in each fl. oz. It is given in doses of from -J to 1 fl. oz. Dr. Erskine B. Fullerton, of Columbus, Ohio, professor of materia medica and therapeutics in Starling Medical College (N. Y. Med. Jour., August 18, 1894), urges the use of quinine in Asiatic cholera. He recognises that it has often been tried and found to fail, but this he attributes to its having been given in an im- proper manner. Ten grains, in powder, he says, diffused through a small quantity of QTJINOIDINE KECONSTITUENTS 122 water, or in acid solution, at hourly intervals, until 20 to 40 grains have been given, after- ward pro re nata, should be the ordinary in- structions; the same dose at half-hourly intervals for a sufficient time in collapsed or in foudroyanf cases ; smaller doses, perhaps, at longer intervals in choleraic diarrhoea. There should certainly be retained, of other treat- ment, adds Dr. FuUerton, appliances for the restoration of heat ; saline hypodermoclyses to supply lacking sernm to the blood; morphine hypodermics to allay pain and cramps, with enteroclyses of quinine where, as past experi- ence shows rarely to have been the case, the remedy is vomited ; and in the sequent enteritis or otherwise persistent diarrhcea, calomel in small doses should not be lost sight of. That by so treating our patients, says Br. FuUerton, we may hope tor a mortality among collapsed and collapsing patients of about 14 to 35 per cent, only; that by earlier administra- tion of the remedy, instead of the use of other agents that have heretofore permit- ted so many cases to run on into collapse and death, we may reduce the mortality In such cases to 2 to 5 per cent, only, seems a fair assumption for the best of reasons — i. e., it should be so, and so far it always has been so.] Samuel M. Bbickneb. aTTINOIDINE.— See Quinidine. aTTIlTOLINE, an oily alkaline liquid, CjHtN, obtained by distilling quinine with a caustic alkali, is colourless when pure. It has a disagreeable odour somewhat suggestive of bitter almonds, and is acrid and bitter to the taste. It is but slightly soluble in cold water, but dissolves more readily in hot water. It mixes in all proportions with alcohol, with ether, and with the essential oils. It has been employed as an antiseptic in a 5-per-cent. so- lution in equal parts of water and alcohol. ftTTIITOSOL, a German proprietary prep- aration, is described by the manufacturers as a neutral compound of oxyquinoline which, when used, gives up oxyquinoline in a nascent state and consequently of great efficiency as an anti- septic. R. Kossmann (Ctrlbl. f. G^ynakol., De- cember 28, 1895), states that trials of it made at the Munich Hygienic Institute go to show that it is relatively so non-poisonous that a dose of 45 grains, given to a rabbit, does not injure the animal, while a l-to-40,000 solution prevents the development of cultures of the Staphy- lococcus pyogenes aureus. For several months, he says, it has entirely supplanted corrosive sublimate and carbolic acid in his practice, and he has seen absolutely no toxic effects due to it. or any irritation, even eczema, when it has been insufflated in powder into suppurating wounds. He further states that it does not injure the skin, even in so strong a solution as that of 1 to 500, applied repeatedly; it does give the hands a yellowish tint, but this may be removed by washing with pure water. It is free from any unpleasant odour. Kossmann thinks it would prove a safe and efficient anti- septic in the hands of midwives. Solutions of it should be of the same strength as those of corrosive sublimate. It may be had in the form of tablets which are readily soluble. On the other hand, Ahlfeld, Vahle, and "W'itte (Ctrlbl. f. Gynak., February 29, 1896) report discouraging results as to its efficiency as an antiseptic and as to its being non-poisonous. Ahlfeld and Vahle found that even so strong a solution as one of 3 per cent, could not be altogether relied on. Eight grains of quinosol, injected subcutaneously into a rabbit, they report, killed the animal in eighteen hours ; its blood was found to be very dark-coloured, and all the organs were dusky, especially the kid- neys. Witte makes quinosol the text for some very forcible remarks about the quest for new antiseptics. In corrosive sublimate, in carbolic acid, and in lysol, he says, we have antiseptics that have been tried thoroughly ; years of ob- servation have taught us the bright and the shady side of their action. The case for quino- sol, he holds, has by no means been made out. As to Kossmann's experience in the employ- ment of the drug for a number of months without the occurrence of a single case of in- fection from a wound or any appearance of poisoning whatever, even so slight as eczema, he doubts if these results are to be ascribed to the quinosol. His own, he says, have been quite as good when he used only a steiile physiological solution of common salt. Fur- thermore, he argues, even if it is true that traumatic cavities, suppurating and yielding a foetid secretion, may be favourably affected by quinosol, the fact is of little consequence, for the thing to do is to remove the putrefying masses and use drainage, and it makes no' dif- ference whether this or that antiseptic is em- ployed, or, indeed, only sterile water. As to the statement that quinosol, even in substance, is in no wise iratating to wounds, his own ex- ferience, he says, has been to the contrary, n two instances he has applied quinosol in substance to the cavities left after the removal of glands, and each time -uch intense burning pain set in that the ]>atient begged to have it taken out. Although he himself has not ob- served symptoms of poisoning from quinosol, he insists that we can not be sure thev will not occur. A minor objection to quinosol is the fact that it stains the skin and the instruments, but the stain can be removed without much trouble. Quinosol is particularly unsuitable for vagi- nal irrigation during labour, says Dr. Witte, for it is highly astringent, so that, it would rob the vagina of its lubricity and make it rough and unyielding, as corrosive sublimate does. aXJINaTJINA.— See Cixoho.xa. RATANHIA.— See Keameria. BECONSTITTJENTS are remedies which promote reconstitution or reconstruction. They include a variety of therapeutic means of which only a part axe medicinal. Among the reconstituents are diet, exercise, climatic influences, travel, bathing, and personal hy- 123 QUINOIDINE RECOI^STITUENTS giene, as well as alterative, stomachic, and tonic medicines. These, for the greater part, are considered elsewhere in this work, and it therefore remains but to point out their special actions as reoonstituents. The action of food as a reconstituent is pro- nounced, and curable debility of any kind ■yields more quickly to it than to anything else. The most striking example of its powers is observed in the convalescence which follows acute disease. The reconstituent power, how- ever, does not reside in all varieties of food to the same degree ; indeed, from their indi- gestibility, certain of the richer foods not only fail at reconstitution when given in debility, but are even productive of debility if given excessively in a state of health. Fats are, as a class, our most useful reconstructive foods, for they combine with easy digestibility a maximum power to nourish, milk, of course, offering the best example of this action, and tuberculosis the condition in which its benefits are most striking. Nitrogenous foods rank second to fats in reconstituent value, being both more difficult of digestion and, as a rule, less nourish- ing, while carbohydrates come last, though they are certainly nourishing and in many cases highly to be recommended. As in health, so also in debility, no exclusive diet is ordi- narily to be advocated, but instead such a judicious mixture and combination of nitro- genous, fatty, and carbohydrate foods as ex- perience has shown to be most useful. In some cases of debility a positive distaste for food has to be combated ; the patient, if left to himself, would not consume a sufficient amount of food to maintain his nutrition. If this is the case there is often much benefit to be had from forced feeding, or garage. Cer- tain beverages may be regarded as indirectly reconstituent by virtue of the stimulating and sustaining power they exert over nerve func- tion, especially that of digestion, and by virtue of their action to lessen tissue waste. Those which contain alcohol or caffeine are undoubt- edly thus active, while some few drinks are directly reconstituent because of the food value of some of their ingredients. That a judicious amount of exercise is recon- stituent needs proof no more than that over- work is debilitating. Under its influence tissue metamorphosis is made more active, and elimination of waste products is increased. Digestion and absorption are in their turn augmented and, provided the food given in response to this demand is of the proper and nutritious sort, reconstruction takes place. It is not every exercise which performs this re- constructive duty, for if excessive in amount or violent in its nature, it may have quite the opposite effect — namely, to exhaust and depress. Exercise in the open air, too, is much to be pre- ferred to exercise within doors, though the latter is not inefficient. In some cases where debility is extreme, active exercise is an impos- sibility, and then we may usefully employ massage and passive motion until, with return- ing vigour, the ability to take active exercise returns. The influence of climate upon debility is 53 great, and no more convincing proof of this is needed than the rapidity of convalescence which takes place when a change of air is sought, as compared with the relative slowness of recovery at home. That the different at- mospheric conditions deserve some credit for this usefulness is no doubt true, but they cer- tainly do not deserve it all, for, as in the case of treatment by mineral waters at the spring from which they are obtained, a number of factoi'S must necessarily enter into the effect upon the patient. Of these factors the most important, besides atmospheric conditions, are change of scene and surroundings, relief from the cares of home or of business life, change of diet and occupation, change of hours, rest and repose, and, finally, a mental condition of hopefulness and expectation of benefit to be derived which in itself will favour recovery. That convalescence and debility in general should receive the benefits which change of residence will give needs no argument, but some cases are wrongfully treated thus. Of all conditions so mistreated, tuberculosis offers the most striking example, and we every day see patients sent from home that they may obtain the supposed benefits which change of climate can give, when it is quite evident that recovery, or even improvement, is impossible, and that deprivation of home surroundings and of home comforts to them means positive harm. The hopeless kinds and degrees of debility, there- fore, should, as a rule, receive treatment at home. As to the climate which should be sought in cases suitable for climatic treatment, there are no hard and fast rules. In many cases it is change that is the important factor rather than atmospheric conditions, and then almost any climate will be suitable, provided the element of change is present. In other cases the proper climate must be sought by ex- periment, and therefore the patient must go from place to place until he finds a locality in which he eats, sleeps, and feels well. In cer- tain diseases, however, one rather expects re- covery to be promoted by special atmospheric conditions ; thus, persons with catarrhal dis- eases, as a rule, are relieved by atmospheres which are relatively warm and dry ; those with renal diseases also are generally improved by the same sort of climate ; while those with nervous diseases, as a rule, are benefited by a warm and soothing air, and injured by one which is changeable in temperature and hu- midity, and, as a rule, by sea air. Patients with pulmonary tuberculosis are susceptible of improvement by a variety of climates, the chief determining elements being the purity of the atmosphere, the relative absence of moisture, and freedom from sudden changes. Further than these, the exact locality will be deter- mined by the degree of debility which is pres- ent ; those who are much enfeebled it is well to send to warm climates, while those whose vigour is preserved do well in the dry and cold mountain atmospheres, and for others still the suitable place must be sought by travel. In all tuberculous cases, however, the main requisite seems to be a continued out-of-door life. RECTAL MEDICATION RESORCIN 124 Travel as a reoonstituent agent may be of much benefit, and on the other hand may be productive of great harm ; the determination of the question rests upon the amount of vigour which the patient possesses and his ability to ■withstand fatigue. Certainly nothing could be more foolish than to hurriedly and continu- ously drag an enfeebled man from place to place and expect him to grow strong. Not only must the strength of the patient be con- sulted, but also the mode of travel, for, though an invalid might well be able to travel in the luxury of a yacht or a private car, he would be no fit occupant for the springless wagon or the saddle. In mental exhaustion from over- work travel is certainly at its best, provided anxiety can also be left behind, and in many another disturbance it may be of the greatest benefit, but in prescribing it one must care- fully consider many things, especially the patient's physical ability, the circumstances of the journey as regards comfort, the importance of the duties and interests he leaves behind, the itinerary, and the amount of benefit which it is possible for him to derive from his journey- ings. The observance of hygienic rules is highly reoonstituent. This is scarcely the place to impress the importance of regularity in all which pertains to our physiological life, as concerns eating, sleeping, exercise, the evacua- tions, and bathing. The rules which should govern these matters are well known, and it is equally well known how violation of them may result in a debility which will return only when the violation ceases. As a reoonstituent in convalescence and asthenia, generally, the cold hath deserves a particular mention, for its tonic power over nervous energy is very great. Whether the cold bath should take the form of sponging, of showering, or of the plunge will vary with circumstances, and for detailed information the reader is referred to the article on Baths. So far as reoonstituent drugs are concerned, it might seem that they were sufficiently de- scribed as tonics, but reconstituents would appear to be the larger class, including not only tonics, but also bitters and alteratives. Alteratives certainly possess a great infiuenc3 in certain cases of debility ; an example of this action is seen in the ancemia of syphilis, where other reconstituents are of little or no effect unless mercury or an iodide is simultaneously administered. It is doubtless true that in such conditions the alterative acts in a comple- mentary capacity to the other reoonstituent, and it is perhaps more exact, therefore, to re- gard alteratives as reconstituents rath-er by indirect than by direct action. Bitters pro- mote reconstitution by their action upon di- gestion, for the appetite and the. assimilative power become so much enhanced under their influence that larger amounts of food are taken and absorbed, to the end that general nutrition is much improved. It is for this reason that bitters are so generally employed in debilitated states, and in the convalescence from acute disease the use of the bitter remedies, like quassia, caluraba, and gentian, has become almost a routine. As reconstituents, the bit- ters act indirectly by virtue of their influence upon digestion ; the tonic remedies act thus as well, for stomachic and digestive virtues reside in most of them, but they act more upon the body generally, though, again, digestion plays a part, for bodily invigoration includes digest- ive improvement, and from digestive improve- ment the genei-al health is increased. The chief primary action of the tonics as recon- stituents is upon the body generally, and thus iron, arsenic, and strychnine become of so much service in debility. Finally, we must class cod-liver oil as in the highest degree reeon- stituent, though the manner by which it acts is not clear. It is credited, as we know, with alterative, tonic, and nutritious qualities by any or all of which it might be reoonstituent. Henkt a. Gbiffin. RECTAL MEDICATION. — See under Cacao-butter. RED POPPY.— See Rhceas. RED SATJlfDERS.— See Sandal- Wood. REFRIGERANTS are agents which effect cooling, either of the body generally or of a part. Strictly speaking, no reason exists why the name refrigerant should not be held syn- onymous with antipyretic ; it has, however, come to have the signification of producing sensations of cold, rather than of actually re- ducing the temperature of the body. Clinically, refrigerants have two uses. The first concerns their employment as cooling beverages, which are often so grateful to pa- tients suilering from fever, and are eflfective rather by quenching thirst than by appreciably reducing the fever. As refrigerant drinks, there may be used ice water, carbonated waters, lemonade, or water slightly acidulated with an acid, especially diluted phosphoric acid. Naturally, these drinks are more effective if used cold, and. with due regard for the amount of the acids they may contain, they may be taken freely, the sole eontra-indication to their generous employment being gastric disturbance, either present or impending. Should gastric disturbance be present, the proper refrigerant will be either cracked ice or iced water given cautiously, tentatively, in small quantities and at infrequent intervals. The second clinical use of refrigerants is for the production of local and, especially, cutane- ous cold for the purpose of diminishing local congestion and inflammation or of causing anassthesia. As refrigerant applications u:'n- ful in local inflammations may be cited cold water, cold air, and especially evaporaling lotions. The production by cold of local anaes- thesia sufficient for the performance of minor surgical operations, such as the opening of abscesses, may be brought about by the appli- cation of ice to the part ; but there are certain obvious disadvantages connected with this practice which do not apply to the spraying of very volatile liquids upon the area for opera- tion, the rapid evaporation which takes place insuring the necessary degree of cold. A num- ber of these liquids are in use; particularly serviceable are rhigolene, ethyl chloride, and 125 RECTAL MEDICATION RESORCIN ether. The Use of such remedies must be cau- tious, however, because of their inflammable and even explosive nature. The terra refrigerant is used by some writers to further describe the action of other remedies. Thus, refrigerant diuretics are those which act as general sedatives and render irritating urine bland. This class, naturally, consists mainly of alkalies and their salts, and the term re- frigerant used in this connection would seem to be more suggestive than exact. Refrigerant diaphoretics, too, are spoken of, the term ap- plying to drugs which promote perspiration by reducing circulatory excitement and are espe- cially useful in fever. Such are aconite and veratrum viride. — Henry A. Griffin. RELAXANTS are remedies which lessen the tension of body tissues. The power to re- lax resides in many agents ; relaxation of the skin is produced by diaphoretics, of the intes- tines by various cathartics, of the blood-vessels by vascular sedatives, and of the body gener- I ally by nauseantsand emetics, as well as by the hot-air bath, the prolonged warm-water bath, and remedies which debilitate. All these might properly be termed relaxants, and, indeed, the name not infrequently is employed as signifying laxative, but clinically the term is oftener used in describing remedies which produce relaxa- tion in the skin to which they are directly ap- plied and in the tissues immediately beneath it. Of relaxant remedies, poultices offer a good example, together with other and similar ap- plications to the surface of the body which are active by virtue of their heat and moisture. Of similar effect, though by a different mode of action, are fatty substances, which when locally applied are productive of softening and relaxation, an action which is constantly made useful in the application of ointments. The therapeutics of relaxants will have been inferred from what has already been said, and though for the relief of cutaneous and subcu- taneous tension poulticing was so constantly practised formerly, it is now but little esteemed, for fear of the injury which poultices may do, but the softening action of fatty sub.stances is constantly evoked in conditions in which the skin has become indurated, dried, or inflamed. Henry A. Griffin. RESINA (U. S. Ph., Br. Ph.).— See Rosin. RBSINS. — These are fieculiar principles, profusely distributed through the vegetable kingdom and almost entirely oonflned to it. They are mostly uncrystallizable solids, fusible but not volatile, insoluble in water, but soluble in one or more of the more volatile solvents, such as alcohol, ether, chloroform, benzin, etc. They are also soluble in volatile and fixed oils. Most of them have an acid character, which enables them to combine with alkalies to form so-called " resin-soaps," compounds which are soluble in water, and from which the resin may again be separated by acids. The nature of the resins is, as yet, not fully understood, but most of them are evidently oxidation products of certain hydrocarbons, such as terpenes, which are the chief constituents of most vola- tile oils. What are ordinarily called " resins," either in the classification of drugs or in pharmacy, are in most cases not pure, homo- geneous, chemical individuals, but more or less complex mixtures. Resins are most conveniently divided into " natural " and " pharmaceutical " resins. Natural resins are often accompanied, in their commercial form, by other proximate prin- ciples, which modify their properties to some extent and have induced pharmacologists to classify them in different ways. Pluckiger's classification, which appears the most natural, is as follows : 1. Resins mixed with gum (true gum-resins) : gamboge. 3. Resins mixed with gum and volatile oil : myrrh, olibanum, asafoetida, galbanum, and ammoniacura. 3. Resins mixed with notable amounts of volatile oil : turpentine (and its varieties, such as Burgundy pitch, etc.), elemi, copaiba, and gurjun oil. In the case of the two latter, the substance remaining after the removal of the volatile oil is a true resin. They are often (but incorrectly) called balsams. 4. Resins proper : common rosin (colophony), amber, sandarac, damar, Botany-Bay resin (red and yellow acaroid resin), dragon's blood, guaiac resin, mastic, shellac, and benzoin. The latter, however, does not properly belong here, as it contains other constituents, such as vola- tile acids. Pharmaceutical resins are the following, which are ofHcial in the U. S. Ph. : a. Resina copaibce, prepared by distilling off the volatile oil from balsam of copaiba. b. Resina jalapce, prepared by exhausting jalap with alcohol, concentrating the tincture, and precipitating the resin by water. c Resina podophylli, prepared like the pre- ceding, except that the water is acidulated with hydrochloric acid. Of all the official resins, this is the most complex in its composition. d. Resina scammonii, prepared like resina Jalapfe. — Charles Rice. RESINOL.— See Rosinol. RESOL. — This is a German proprietary disinfectant resembling creolin, said to be made by saponifying 100 parts of wood tar with 20 parts of caustic potash and adding 20 of methyl alcohol. It seems to have been used but little, if at all, clinically. RESOLVENTS. — See Sorbefacients. RESORBIN. — This is a German ointment basis said to be made from very pure oil of sweet almonds, wax, gelatin, soap, and water. It mixes freely with all fatty bodies, and facili- tates the penetration of drugs incorporated with it through the epidermis. RESORCIN, resorcinum (U. S. Ph., Ger. Ph.), resorcinol, or metadihydroxybenzene, Co HeOa, is a diatomic phenol prepared by melting a gum-resin with caustic potash or soda. It forms colourless or slightly reddish acicular crystals of a peculiar but faint odour, a dis- agreeable sweetish taste, and a pungent after- taste. It grows reddish or brownish on exposure, and should be kept in dark amber- coloured bottles. It is readily soluble in water, EEST-CURB 126 in alcohol, and in ether. Applied to mucous membranes, resorcin in strong solutions is irri- tating and may give rise to inHiimmation. Taken internally in . poisonous doses, it pro- duces tremor, convulsions, unconsciousness, and paralysis of the heart and of the respira- tion. In full medicinal doses (from 15 to 30 grains in twenty-four hours), resorcin acts as an anti- pyretic and intestinal antiseptic, but it is not so eligible as several other drugs, inasmuch as its action is apt to be accompanied by lan- guor, nausea, and sweating. It is chiefly as a topical application that resorcin has been found useful. Its action is antiseptic and germicidal. It may be used in solutions or ointments of from 1 to 10 per cent., or even greater strength. Tbusemployed, it has proved serviceable in a great number of morbid conditions. In diphtheria it is a valu- able topical remedy, also in various inflamma- tory skin diseases, such as erysipelas, herpes, acute and chronic eczema, lupus erythematosus, and psoriasis ; in purulent and ulcerative affec- tions of the mouth, the throat, the nose, the ear, etc. ; and in gonorrhoea, leucorrhcea, and chan- croids. Dr. Moncorvo, of Rio Janeiro, proceeding on the theory that whooping-cough is due to a microbe, has employed resorcin in that disease with great success. He sprays the larynx with a 1-per-cent. solution. Dr. C. Boeck. of Christiania (cited in the Rev. internal, de med. et de chir. prat., No- vember 10, 1895), has found that resorcin is very efHoacious against chilblains, especially when the drug is associated with iohthyol and tannin according to the following formula : Resorcin, Ichthyol, Tannin, each 30 parts ; Water 150 " This mixture must be thoroughly shaken be- fore it is used. The affected parts should be painted with it every night, and, after the first layer is applied, it forms in a few minutes a dry, glazed surface. Under the influence of resorcin the, skin becomes shrivelled, and the chilblains, as well as the extensive oedematous tumefaction of the fingers and of the hand, dis- appear rapidly. However, this mixture, in spite of its great efficacy, presents certain inconven- iences which may restrict its employment. It stains the skin, and the region to which it is applied will remain black for from one to two weeks after the cessation of the treatment. Sometimes the mixture is not well tolerated by subjects who have a very delicate skin, in which it produces cracks. Finally, it cannot be employed in cases o£ ulcerated chilblains. The following formula, which, says Dr. Boeck, is less efficacious than the preceding one, may be employed if the patient's work is such that he can not use a substance which blackens his hands : Resorcin 60 parts ; Gum arable 38 grains ; Water 115 parts ; Talcum powder 15 " This mixture should be applied every night to the ailected parts. Dr. Leo Leistikow (Ilonatsh. f. praki. Der- matol, October 1, 1894) reports great success in the treatment of leucoplakia with resorcin. He uses the following paste : Resorcin 6 parts; Siliceous earth 3 " Lard 1 part. With a thin layer of cotton wound round the pointed end of a stick, this paste is to be smeared over the patches several times a day, especially after eating and before going to bed. In from' eight to fourteen days the opaline patches begin to shrink and the mucous mem- brane becomes thin and rosy. It is now very sensitive, so that smoking and eating qiquant articles of food should be avoided and the mouth rinsed frequently with peppermint water to which borax has been added. The hyperferaia caused by the resorcin may be overcome in three or four days by applications of balsam of Peru. REST-CXTIIE.— Rest is one of the oldest forms of treatment in medical history. Doubt- less it was the chief remedy in prehistoric times, for that matter, because Nature herself has always insisted upon it, even to the extent of inflicting many a twinge of pain on such as disobeyed her precepts. One of the most in- structive books ever written on the scientific aspects of rest is that of John Hilton, who, some twenty years ago, collected in one volume, en- titled Rest ana Pain, a series of lectures de- livered in the years 1860. 1861, and 1862. In this book he points out the value of rest as a curative agent. In one place he says : " So inti- mate is the association between rest and growth as to make them appear, on a superficial view, to stand to each other in the relation of cause and effect." In another, in relation to the in- crease in weight caused by rest, he says : " The value of rest in fostering the production of that highly organized animal tissue which forms so large a portion of our staple food is well known to the stock-keeper and grazier." And thus he goes on to explain how rest is the great agent in growth and also in repair, which is but a repetition of the processes of growth. Hilton applied the principles of rest chiefly to surgical disorders, but the principles are in reality ap- plicable to many other conditions of disease. This is especially true of some disorders of the nervous system, and the phrase " rest-cure " as employed nowadays refers more particularly to a method of treatment in vogue in this class of cases, of which Dr. S. Weir Mitchell, of Philadelphia, may be considered the first and chief exponent. In 1875 he published a brief chapter in Seguin's series of American Clin- ical Lectures, entitled Rest in the Treatment of Nervous Disease, and he subsequently ex- panded his ideas in a small volume with the title Fat and Blood. He made use of the treat- ment in cases of neurasthenia and hysteria. Nowadays we apply the rest treatment to many varieties of nervous disorder. The essential feature of the treatment is rest. This promotes growth of tissue and 127 REST-CURE repair of waste. To hasten the attainment of these ends, overfeeding with easily digested foods is required. A part of the principle of true rest and repose is seclusion. In order to counterbalance any ill effects due to prolonged rest in bed, and to assist in tissue metabolism, massage and the exercise of muscles by faradi- zation are made adjuncts to .the treatment. Hydrotherapy is frequently employed as an adjuvant. With this original principle of rest as one of Nature's remedial processes in view, Dr. Mitchell evolved the system of therapy known as the rest-cure, which, as we have seen, con- sists in brief of rest, particular diet, artificial exercise, and isolation. Rest. — Usually what is meant by rest in the rest-cure is absolute rest in bed for a consider- able period of time — from six weeks, to two months. At first, for several weeks, the patient is not allowed to sit up, read, write, or use the hands in any way, except to clean the teeth. In many eases even the bladder and bowels are to be evacuated in the recumbent posture; when the bed is to be made up, the patient is lifted to a sofa and back again : and he is to be fed by the nurse. But not all cases require such absolute rest, and the amount of rest will vary with the needs of each patient as viewed by his physician, from absolute rest through every degree of " partial " rest-cure. Thus, there are patients who are permitted to feed themselves, to get up for stools, to read, to sew, or to write a little, and others, again, who may pursue their vocations within certain hours, being required merely to add some hours to their rest by going to bed early and rising late. Diet. — The aim in dieting the patient is to insure easy digestion and the assimilation of considerable quantities of nourishment. Milk constitutes, therefore, the major part of his food, and it is given every two hours generally, at first in small quantities, for some days (4 fl. oz.), and gradually increased until at the end of a week or ten days he takes from 8 to 13 oz. every two hours. When ordinary milk is not well borne, it may be diluted with carbonated waters or peptonized, or some digestible sub- stitutes employed, such as kumyss, matzoon, or somal. At the end of a few days a little stale bread and butter may be given twice and subsequently thrice daily ; later on, a soft- boiled egg may be added, and finally a chop or steak at noontime and boiled rice at supper- time. The stimulant drinks (tea. coffee, cocoa, etc.) are not given, nor are beef tea, broths, soups, and the like, because the former are needless and the latter not especially nutritious. Massage. — In order to overcome the disad- vantages of lack of exercise, the muscles of the entire body are kneaded by a masseur or mas- seuse (preferably the nurse) for from fifteen minutes to an hour in the evening. This should be begun in persons unaccustomed to it by gentle ^enrage for but a .short period of time, and the duration of the massage gradu- ally increased. Playfair advises its continu- ance for as long as three hours, but this is undoubtedly extreme. Electiicity. — The object of the use of electric- ity is the same as that of employing massage — to effect tissue metabolism by passive exercise of the muscles. The current should be that of the faradaic battery. General faradization of all the muscles of the body is given, either by the nurse or by the physician, each muscle being sought out and contracted a certain number of times at each seance. It is well not to begin at once with electricity, and when it is used to use very feeble currents at first, in order not to disturb or irritate the patient un- duly at the outset. This is particularly needful when patients are sensitive and unaccustomed to the current. Besides exercising the muscles, there is probably a certain amount of " refresh- ing effect" in electricity, and its suggestive value is obvious. Isolation. — The seclusion of the patient is naturally an inherent part of the theory of the rest-cure. In some cases it must be so rigid that no one sees the patient but the physician and nurse, and letters and news of the day are excluded from the sick-room. In others some relaxation of this rule may be made, but the physician must be very judicious in such ex- ceptions. The patient may be isolated in his own home, but in perhaps the majority of cases for which the rest-cure is adopted a complete change of environment is productive of better results. Such is, in succinct form, the idea of the rest-cure, slightly modified in minor details from its original conception by the experience of the writer. In many instances hydrothera- peutic measures may be added for their sooth- ing, tonic, or stimulating effects on the nervous system, as indicated by the symptoms of indi- vidual patients. Drugs are given as required to meet special manifestations. It is well to ascertain the weight of the pa- tient from time to time during the course of treatment, when possible, and where this is not practicable the effects of the method may be judged by the appearance of the face, limbs, and trunk. The duration of the treatment will naturally vary with different cases. The rest- cure is not terminated suddenly, but in every instance there is to be a gradual relaxation in the regulations of treatment above described. It is of great advantage to write down specifi- cally, for the instruction of the nurse and for the discipline of the patient, the duties for each hour of the day, the times for food, massage, electricity, recreation, hydrotherapy, and so on. It will be found that the personality of the physician and nurse will have much to do with the results of this treatment. As to the nature of the disorders apt to be benefited by rest-cure in its absolute or modi- fied forms, they are of many kinds. They are, taken somewhat in the order of their appropri- ateness, such diseases as neurasthenia, hysteria, exhaustion from any form of nervous or mfntal disease, chorea, acute mania, melancholia, exophthalmic goitre, epilepsy, and hypochondri- asis. But it must be remembered that there are exceptions in all classes of cases above enumerated. All neurasthenics, hysterical sub- jects, and other victims of nervous disorders RESTORATIVES RHUBARB 128 are not by any means to be put under such treatment. The rest-cure may be the very worst kind of therapy for some patients. The pliysieian must exercise great judgment and discretion in selecting patients adapted for a course of seclusion, absolute repose, and over- feeding. — Frederick Peterson. RESTORATIVES may be regarded as measures or remedies to be employed when there is loss of consciousness, or temporary flagging of the vital powers, or when the con- dition popularly known as suspended anima- tion exists, as after prolonged submersion in water. The loss of consciousness observed in fainting is the form oftenest met with and ■usually demands but little beyond a recumbent posture with tlie head lower than the rest of the body, a procedure which usually results in a speedy recovery; but in the cases where the return to consciousness is slow, the inhalation of the fumes of ammonia, which may be pro- vided extemporaneously by burning close to the patient's face two or three feathers ob- tained from a pillow, or the internal adminis- tration of the same. laraore pronounced eases it may be desirable to administer alcohol, apply counter-irritation over the heart, or even pass a ligature around one or more of the person's limbs, so as to turn the blood current toward the brain ; firmly grasping the ankles or wrists may be sufficient; but, whatever is done, the utmost gentleness must be observed, lest too violent a shook be inflicted upon the tempo- rarily weakened heart. It may be stated that in this condition and others in which alcohol appears to be indicated, the smallest amount possible consistent with the end in view — viz.. stimulation of the heart's action — should be administered, as often too large a quantity will overstimulate, and shortly the condition may be worse than in the beginning. There- fore it is best to measure the dose by drops rather than by drachms, and when unconscious- ness is profound to instil it into the mouth by means of a dropper and trust to its absorp- tion by the oral mucous membrane, and of that of its vapour by the lungs rather than by the stomach. Moreover, when considerable quantities are given and none of the fluid en- ters thelarynxa — a quite possible accident — the stomach is rarely in a condition to absorb, and when no appreciable effect upon the pulse is observed, more is apt to be given and thus a dose almost lethal in its effects is in the stomach ready for absorption as soon as the circulation is quickened. A few drops of sulphuric ether may be dropped between the lips or inhaled, or, as well as alcohol, employed hypoderraie- ally. Whatever method is employed, it is much wiser to administer only enough to cause a moderate strengthening of the action of the heart, and to repeat the dose at short intervals rather than to arouse the organ to vigorous action by a full dose. In addition to fainting, the principal con- ditions in which heart stimulation is desirable are asphyxiation from submersion in water and exposure to illuminating gas or carbonic oxide or dioxide in excavations, breweries, etc. Un- necessary movements of the person are to be avoided, and, as a rule, it is much better to adopt the measures needed as near as possible to the seat of the accident, unless the weather is too inclement, rather than convey the pa- tient to a more convenient locality. This is especially important in drowning, and the neg- lect of this precaution has led to many deaths which could have been prevented if the efforts at resuscitation had been undertaken imme- diately after the taking of the person from the water. In conditions that are not serious, all that may be necessary will be dashing cold water upon the face and exposure of the chest to the cold air, but chilling of the entire body is to be avoided. In the asphyxia of the new- born, immersion in a cold bath or cold-wa- ter effusions usually excite the respiratory movements. When the depression of the vital powers is great, faradization over the heart will usually strengthen its action, while the same application made to the back, over the lower portion of the lung, should stimulate the respiratory movements. Dry heat to the sur- face is a most efficient stimulant of both the chest and the lungs, and may be applied by bottles, etc., filled with hot water, or, when practicable, by a general hot-air bath. In ap- plying heated objects directly to the body cau- tion must be observed that the indifference of the patient may not prevent his appreciating too high a temperature, and thus troublesome burns be caused. Friction of the surface of the body with the hand, flannel, etc., is also useful ; but when there is marked depression the person should be protected by a blanket. In the asphyxia resulting from the inhalation of illuminating gas or of carbonic oxide or di- oxide, ammonia appears to be rather more serviceable than alcohol, and is the agent ordi- narily kept at hand in gas works, etc. To restore consciousness in alcoholic or opium coma a mustard plaster may be applied to the nape of the neck, but should not be allowed to remain in position long, lest too great irritation be set up and sloughing result. Among the less active restoratives may be included hot soups, tea, coffee, milk, and cocoa, which should be given in moderate amounts, as during periods of depression or fatigue the stomach is apt to reject too large quantities of fluids. — Russell H. Nevixs. RETINOL.— See Rosinol. RETRO JECTIONS. — See under Injec- tions. RHAIJININ. — This name has been ap- plied to several glucosides found in various species of Rhammis. also to an American con- centrated preparation of Rhamnus pnrshiana, said to be made in the same way that podo- phyllin is. RHAMNOXANTHIN.— See under Frangbla. RHAMNUS FRANGULA.— See Fran- GULA. RHAMNUS PURSHIANA (U. S. Ph.), rhamni purshianm cortex (Br. Ph.), cascara, or cascara sagrada, is the bark of the Califomian 139 RESTORATIVES RHUBARB buckthorn, a bush indigenous to the Pacific slope, which has recently been introduced into the pharmacopoeias. Its ellects are cathartic, and it is especially indicated in cases of chronic constipation. It acts without purging, is said to irritate hsemorrhoids, and in large doses sometimes has the efiect of a powerful gastro-intestinal irritant. Preparations made from the freshly gathered bark are somewhat apt to gripe, but if it has been kept for about two years this tendency disappears. In ad- dition to its cathartic effects, it is slightly tonic to the intestinal mucous membrane, and tends to correct the constipation for which it was given. The fluid extract, extraetum rliamni pursli- iancefluidum (U. S. Ph.), is the best preparation, and, as a rule, is most effectual when given in about dnuihm doses at bedtime, although some advise from 10 to 30 drops night and morning, gradually increased to 30 drops if necessary. The analogous British preparation, the liquid extract, extraetum, cascarcc sagradce liquidum (Br. Ph.), may be given in doses of from | to 2 t\. drachms. The dose of the extract, extrae- tum casearcs, sagradm (Br. Ph.), is from 3 to 8 grains. Nursing infants are apt to be affected by this drug when it is taken by the mother. Cascara amarga, or Honduras bark, is a drug having the same properties as quassia, but it is not often used, and is noted here only on account of the confusion sometimes caused by the similarity of names. Russell H. Nevins. RHATANHIA, RHATANY.— See Kra- MKRIA. BHEI RADIX (Br. Ph.), RHEUM (U. S. Ph.). — See Rhubarb. RHEUMIN. — See Chrysophanic acid. RHIGOLENE is a very volatile and in- flammable fluid obtained in the distillation of petroleum. Probably, like nearly all similar products, it is a mixture of a number of close- ly allied bodies, and not of any definite chemical composition. It is used in surgery to produce local ancesthesia. or, rather, freezing of parts, a spray from an ordinary hand atomizer being pro- jected upon the part to be affected. Its great volatility renders it the most effective agent for the purpose, and also requires its being kept in well-stoppered bottles in a cool place. The application of the spray is to be continued un- til the part upon which it is directed has be- come blanched and insensible to the touch. The procedure is one which may often be use- fid for the painless extraction of teeth and the incision into boils, abscesses, felons, etc., but, it the action of the cold extends beyond the skin, more or less sloughing of the parts will occur. The chief advantages attendant upon this method are the ease with which it can be carried out and the portability of the apparatus, but whenever it is practicable the use of nitrous-oxide gas is much to be pre- ferred when minor surgical operations are to be performed. Rhigolene is unsafe to use in the vicinity of lights, and if considerable amounts are needed, thorough ventilation is necessary, as, when combined with air in cer- tain proportions, its vapour is highly infiam- mable. An ointment containing 16 parts of rhigo- lene and 1 part each of camphor and sperma- ceti has been recommended in the treatment of burns ; it is spread or daubed on cotton, which is applied over the affected part. Russell fl. Nevins. RHODALLINE. — See Thiosinamine. RHODEOKRHETIN. — See Convolvu- LIN. RHCEADOS PETALA (Br. Ph.), RHCE- AS. — The fresh petals of the red poppy. Pa- paver Rhrnas, and preparations made from them, especially the syrup of poppies, syrupus rhaeados (Br. Ph.), were formerly much used as a mild anodyne and soporific, particularly for children. The dose of the syrup is 1 fl. drachm. It is now prescribed chiefly to im- part a pleasing colour to mixtures in which, such as cough mixtures, a feeble anodyne is unobjectionable. RHUBARB, rheum (TJ. S. Ph.), rhei radix (Br. Ph.), radix rhei (Ger. Ph.), is the root of various species of Rheum. The 0. S. Ph. and the Ger. Ph. name Rheum officinale only, but the Br. Ph. recognises the root as derived from Rheum palmatum. Rheum officinale, " and probably other species." The plants of this genus are native to Asia. Though certain varieties are cultivated elsewhere, medicinal rhubarb is chiefly obtained from China and Tartary. The root, having been dug up, is cleaned, divested of its cortex, cut into pieces of convenient size, perforated, and strung upon cords. In this state it is dried by exposure either to artificial heat or to the sun, some- times both. Much obscurity surrounds the precise origin and preparation of the Asiatic root, but in commerce two sorts are recog- nised, the Chinese and the European. Chinese, or India, rhubarb is the one most esteemed medicinally. It occurs in irregularly cylin- drical or conical, flattened pieces which are generally perforated. The object of the per- foration has already been alluded to. The surface of the pieces is covered with a light yellowish-brown powder, and is frequently wrinkled. Beneath the powder the colour of the root is reddish-brown and mottled with lighter hues. The root is hard and dense, its odour is aromatic and peculiar, and its taste bitter and somewhat astringent. When chewed, the root is gritty to the teeth and stains the saliva yellow. European rhubarb, though of considerable medicinal activity, is not compar- able in worth with the Chinese variety. At the present time it is little exported, and is used probably as an adulterant of the Asiatic drug. The plant has been cultivated in sev- eral parts of Europe, especially in England and Prance, but less now than formerly. A variety of rhubarb known as Russian, or Turkey, rhubarb was formerly exported, but is no longer to be had. Its exact origin is un- known. The chemistry of rhubarb is not completely determined as yet. The Asiatic root contains extractive, sugar, starch, pectin, lignin, and RHUS 130 inorganic salts. It contains also tannic acid of the variety known as rheotannic acid ; calcium oxalate, which occurs in crystals in large amount, and accounts for the grittiness of the drug when chewed ; and several colour- ing matters, among them chrysophanio acid. The existence of chrysophanio acid in rhubarb, however, has been denied, and it is stated that it occurs only when chrysophan, a glucoside which the drug is said to contain, is decom- posed under the influence of moisture, and a supposititious ferment. A crystalline sub- stance termed emodin is also described as pres- ent in the root. The medicinal power of rhubarb is thought to reside rather in the com- bination of constituents than in an active prin- ciple ; certainly no active purgative principle has been isolated. The European varieties of rhubarb contain more tannin and more starch than the Asiatic, but far less calcium oxalate ; they therefore lack much of the grittiness of the Asiatic drug on being chewed. In small doses, rhubarb is bitter and sto- machic, acting decidedly to increase digestive vigour. In larger doses it is purgative, causing loose faecal evacuations, but, owing to its tan- nin, rhubarb is secondarily astringent and even constipating, a circumstance which con- tributes much to its medicinal value. The purgation from rhubarb has been attributed rather to its action upon peristalsis than upon intestinal secretion, though it is . apparently proved that the drug is actively cholagogue. Occasionally it causes griping. The urine shows that a part of the drug at least is ab- sorbed, for under its influence the colour of the urine becomes more deeply yellow. The milk of a nursing woman is apt to be made yel- low it rhubarb is taken, and is said sometimes to exercise a laxative influence upon the child. The therapeutic value of rhubarb is chiefly manifested in atonic dyspepsia, where it is ac- tive because of its stomachic properties, and also valuable from its influence upon the con- stipation which is generally present. In such cases the administration of rhubarb before eating, and especially in combination with an alkali like sodium bicarbonate, is highly bene- ficial, a fact which would seem to have abun- dant confirmation in the extensive use of the familiar "rhubarb-and-soda mixture "for these purposes. Habitual constipation may be treated with rhubarb with benefit, for, though it is indeed secondarily astringent in its action, it is not injuriously so, and its strengthening properties more than compensate for its astrin- gency. Its mildness of action makes rhubarb a valuable purge for the enfeebled, and for the same reason it is practically worthless where revulsion or depletion is required. In diar- rhoea of the subacute rather than of the acute variety, rhubarb is often of much benefit, serv- ing to remove irritating materials from the in- testines as well as to exert upon them an astringent and a strengthening influence. In functional disturbance of the liver in which biliary production is deficient, rhubarb is an excellent remedy. The drug is sometimes used in combination with another purgative, that mutual increase of activity may oc- cur. Thus, rhubarb and blue mass may be given together when hepatic stimulation and bilious evacuation are desired, while rhubarb and aloes make an excellent cathartic combi- nation for those who are habitually consti- pated, provided, as is always the case in chronic constipation, curative hygiene is not neglected. Rhubarb is but little employed topically, but it has at times been applied to unheatthy ulcerations in powder with sup- posed benefit. The dose of rhubarb as a stomachic is from 2 to 5 grains ; as a purgative, from 20 to 30 grains. Its use in substance is uncommon, though those who suffer habitually from con- stipation may find benefit in chewing small pieces of the root from time to time. As a stomachic, rhubarb is most frequently given in a mixture ; as a purgative it may be given in a pill with soap. Of European rhubarb the dose will vary between two and three times that of the Asiatic variety. The preparations of rhubarb are numerous. Extract of rhubarb, extractum rhei (U. S. Ph., Br. Ph., Ger. Ph.), is a mass of pilular consistence obtained by macerating and percolating powdered rhu- barb with alcohol and water and evaporating the percolate. The dose is from 5 to 10 grains. Compound extract of rhubarb, extractum rhei compositum (Ger. Ph.), contains 6 parts of ex- tract of rhubarb, 3 parts of extract of aloes, 1 part of resin of jalap, and 4 parts of medicinal soap. The dose is from 2 to 5 grains. Fluid extract of rhubarb, extractum rhei Huidum (U. S. Ph.), is given in doses of from 5 to 10 minims as a laxative, and from 20 to 30 min- ims as a purgative. Infusion of rhubarb, in- fusum rhei (Br. Ph.), is composed of 1 part of thinly sliced rhubarb infused in a covered ves- sel for half an hour with 40 fl. parts of boiling distilled water, and the liquid strained. The laxative dose is from 1 to 3 fl. oz., and it may be repeated every three or four hours until it operates. It is incompatible with the stronger acids and with solutions of metallic salts. Pills of rhubarb, pilulm rhei (U. S. Ph.), con- tain 30 parts of powdered rhubarb and 6 parts of powdered soap mixed with a sufficient quanti- ty of water. Each pill contains 3 grains of rhubarb. Compound pills of rhubarb, pilulce rhei compositce (U. S. Ph.), and the compound rhubarb pill, pilula rhei composita (Br. Ph.), according to the U. S. Ph., are composed of 13 parts of powdered rhubarb, 10 of purified aloes. 6 of myrrh, -J- of oil of peppermint, with a sufiiciency of water; those of the Br. I'h. contain 6 parts of powdered rhubarb, 4J of Socotrine aloes, 3 of myrrh, 3 of hard soap, ^ of oil of peppermint, 3 of glycerin, and 6 of treacle. The dose of the Americaii prepara- tion as a laxative is from 3 to 4 pills ; of i he British preparation, from 5 to 10 grains. Cora- pound powder of rhubarb, puhtis rhei composi- ius (U. S. Ph., Br. Ph.), pulvis magnesim cum rheo (Ger. Ph.), Gregory's powder, according to the U. S. Ph., contains 35 parts of rhubarb in powder, 65 of magnesia, and 10 of ginger ; ac- cording to the Br. Ph., 3 parts of powdered rhubarb, 6 of light magnesia, and 1 of pow- dered ginger ; according to the Ger. Ph., 13 131 RHUS parts of magnesium carbornate, 8 of oleosac- charum of fennel, and 3 of powdered rhubarb. The powder is laxative and antacid. The dose is from -J to 1 drachm. Syrup of rhubarb, syr- upus rliei (U. S. Ph., Br. Ph.), sirupus rhei (&er. Ph.), according to the U. S. Ph., con- tains 100 parts of fluid extract of rhubarb, 4 of spirit of cinnamon, 10 of potassium carbonate, 50 of glycerin, 50 of water, and enough syrup to make 1,000. It is a mild cathartic of much value for infants. The dose for an infant is 1 fl. drachm. The British syr- up consists of 8 fl. oz. of rectified spirit mixed with 34 fl. oz. of distilled water and percolated through 2 oz. each of powdered rhubarb and powdered coriander, and afterward evapo- rated to 14 fl. oz. and filtered, with the final addition to it of 34 oz. of refined sugar. The adult dose is from 1 to 4 fl. drachms. Aro- matic syrup of rhubarb, syrupus rhei aromat- icus (U. S. Ph.), contains 15 parts of aromatic tincture of rhubarb and 85 of syrup. It is an excellent laxative in diarrhoea! conditions of infants ; for adults it is too feeble. The dose for an infant is 1 fl. drachm, repeated every two or three hours until the movements im- prove. Tincture of rhubarb, hncfura rhei (U. S. Ph., Br. Ph.), tinctiira rhei aquosa (Ger. Ph.), according to the U. S. Ph., is made with 100 parts of rhubarb, 20 of cardamom, 100 of glycerin, and a sufficient quantity each of al- cohol and water to make 1.000. The dose is from 1 to 3 fl. drachms. The British tincture is made with 2 oz. of rhubarb, i oz. of carda- mom seeds, J oz. of coriander fruit, i oz. of saffron, and 1 pint of proof spirit. The Ger- man tincture is made with 10 parts of rhu- barb, 1 of borax, 1 of sodium carbonate, 90 of water, 15 of cinnamon water, and 9 of alco- hol. The dose as a stomachic is from 1 to 2 fl. drachms ; the purgative dose is from 4 to 8 fl. drachms. Vinous tincture of rhubarb, tinctura rhei vinosa (Ger. Ph.), is made with 8 parts of rhubarb, 2 of orange peel, 1 of cardamom, and 100 of sherry wine. The doses are a little larg- er than those of the tinctures previously men- tioned. Aromatic tincture of rhubarb, tinctura rhei aromatica (U. S. Ph.), is made with 30 parts of rhubarb, 4 of cassia cinnamon, 4 of cloves, 3 of nutmeg, 10 of glycerin, and of alcohol, water, and diluted alcohol, each a quantity suflHoient to make 100. The adult dose is from ^ to 1 fl. drachm. It is used in making aromatic syrup of rhubarb. Sweet tincture of rhubarb, tinc- tura rhei dulcis (U. S. Ph.), is made with 10 parts of rhubarb, 4 of licorice, 4 of anise, 1 of cardamom, 10 of glycerin, and of alcohol, water, and diluted alcohol each a sufiicient quantity to make 100 parts. The dose is from 3 to 3 fl. drachms. Wine of rhubarb, vinum rhei (Br. Ph.), is made by macerating 1^ oz. of pow- dered rhubarb and 60 grains of powdered ca- nella bark with 1 pint of sherry for seven days, straining, filtering, and adding suiBoient sher- ry to make 1 piirt. The dose is from 1 to 2 fl. drachms. There is occasionally used for diar- rhoeal conditions what is known as torrefied rhubarb. This is rhubarb from which the purgative principles have been driven off by heating, the astringent property remaining. [The dose of rhubarb-and-soda mixture, mis- tura rhei et sodce (U. S. Ph.). is from -J to 1 fl. drachm for infants, and from 3 to 4 fl. drachms for adults. A more convenient form of rhu- barb and sodium bicarbonate is that of the un- official compressed tablets, from one to six of which may be taken in the course of twenty- four honrs.] — Henry A. Geiffin. BHTTS. — This is a genus of anacardiaceous trees and shrubs. Several of the species are poisonous, and medicinal virtues have been ascribed to some of them. Rhus aromatica. — The root-bark of this North American shrub, the sweet sumach, is diuretic, and is reputed to have a stimulating action on the muscular tissue of the bladder, the uterus, and the large intestine. It has been used with considerable success in inconti- nence of urine from vesical atony, in vesical haimaturia, in metrorrhagia due to fibroid tumours of the uterus, and in haemorrhage from the rectum. The powder may be given in daily amounts of from 15 to 45 grains. There is an unoifioial fluid extract of which from 10 to 30 drops may be given daily. Rhus diversiloba, the hiedra, or yeara, or poison oak, of the Pacific coast of the United States, is similar in its poisonous action to Rhus Toxicodendron, which it resembles in ap- pearance also. According to Dr. Colbert A. Garfield (Am. Jour, of Pharm., September^ 1860), a remedy which is invariably efficient in poisoning with Shus diversiloba is grin- delia (either Orindelia hirsutula or Grin- delia robusta). '• The mode of using it," says Dr. Canfield, " is as follows : One may bruise the fresh herb and apply it by rubbing over the parts affected, or, boiling it in a covered vessel, make a strong decoction of the fresh or dried herb with which to wash the poisoned surfaces. Its remedial properties appear to be contained chiefly in the resin or balsamlike juice of the plant, which is particularly abun- dant on the surface. One application is some- times sufficient for a cure, but if the disease has been of long duration, several days will elapse before relief is obtained." Probably the fluid extract of grindelia will be found equally serviceable and more convenient as a remedy for this distressing form of poisoning. Rhus glabra (U. S. Ph.).— The berries of this shrub, the smooth sumach, or upland sumach, indigenous to the United States and Canada, which are edible, are sour, astringent, and refrigerant. The fluid extract, extractum rhois glabrm fluidum (U. S. Ph.), diluted, forms an agreeable vehicle for gargles in various forms of sore throat. Rhus pumila, or dwarf-sumach, a small shrub found in North Carolina, is said to be the most poisonous species. Rhus radicans. — This is a climbing vari- ety of Mhus Toxicodendron, known as poison ivy. Its poisonous effects are the same as those of Hhus Toxicodendron. Rhus Toxicodendron.— Under this name, the fresh leaves of Jihus radicans, which is a variety of Rhus Toxicodeiidron, are ofiflcial in the U. S. Ph. The poison oak, or poison ivy, is a RHUS 133 familiar plant of the fields, woods, and road- sides of southern Canada and of the United States. Its trifoliolate leaves serve readily to distinguish this poisonous plant, the "three- leaved ivy," from the harmless Virginian creeper (Ampelopsis quinquefolia) with which it might otherwise be confounded. To most persons, Rhus Toxicodendron is a violent poison. Handling the plant or gentle contact with it — even, in the case of some in- dividuals, exposure to the emanations from it, without any contact with it whatever — is enough to cause the cutaneous form of rhus poisoning to ensue within a few hours, in the form of an intense -dermatitis. In rare in- stances the entire skin is affected, but usually the effects of the poison are shown only on those parts Co which the plant was originally applied or on those also to which the milky juice (some say, too. the contents of the vesi- cles incident to the inflammatory process) may be transferred by the patient's fingers. The face and the hands are the commonest seats of the cutaneous inflammation. In its character, it may range from a mere reddening of the skin through the phases of papular and vesicu- lar lesions up to a condition of redness, swell- ing, and vesication that constitutes a close counterfeit of genuine erysipelas. Whatever form the poisoning takes, it is always accom- panied by distressing itching and burning. Desquamation usually closes the progress of the affection, which generally begins to de- cline within two or three days, and almost al- ways in the course of a week. In severe cases, where the dermatitis is widespread, there may be a moderate degree of fever for a short time. There are some persons to whom Rhus Toxi- codendron is not poisonous ; they can handle the plant and rub its milky juice on their skin without suffering any unpleasant effect. In some others, on the contrary, troublesome se- quel* follow upon the regular course of the poisoning, such as protracted eczema and re- current crops of boils. Moreover, there is on record indubitable testimony going to show that, with a few individuals, one attack ot rhus poisoning entails upon the victim one or more annual recurrences at about the same time in the year without any fresh exposure to the plant. Thus, Mr. E. G. Lodeman {Garden and Forest, cited in Am. Jour, of Fharm., January, 1895), writing of his personal experience with this plant, states that the symptoms of poisoning re- appeared for six years consecutively, at about the same time of the year as that in which he had been poisoned, without his having been again exposed to the plant. An attack of ty- phoid fever occurred in the seventh year, and for several years afterward he escaped the affec- tion. Thinking himself then exempt from the influence of the poison, he rubbed a leaf of the plant on the back of his hand, and again for several years symptoms of poisoning recurred at the same time of the year. The treatment of this cutaneous form of rhus poisoning consists in the administration of cool- ing drinks and the topical application of sooth- ing remedies. The patient should always be cautioned against handling the affected parts, for fear of transferring some of the poisonous principle to other portions of the skin. The well- knovvn lead-and-opium wash (.see under Lead, vol. i, page 577) is very soothing: cloths wet with it maybe kept constantly applied, except to the eyes. This, however, has little if any cura- tive action, but is only palliative. The fluid extract of serpentaria has been highly recom- mended as both a soothing and a curative ap- plication. It is highly probable, in view of Dr. Canfield's experience with the use of griu- delia in cases of poisoning with Rhus diversi- loba (mentioned in the section on that species), that the fluid extract of grindelia will be found of substantial service in Rhus- Toxicodendron poisoning. Weak solutions of carbolic acid have sometimes proved efficacious. Mr. George M. Beringer {Am. Jour, of Pharm., Jan., 1895) has found hot soda baths efiioacious, but for a topical application he prefers the following lotion : ]^ Granular sodium sulphite. . 1 drachm ; Glycerin ^ fl. oz. ; Camphor water, enough to make 4 fl. oz. M. Mr. Beringer states that he has seemed to have good results from washing his face and hands with a solution of hydrogen dioxide as a preventive measure. The bastard nettle, dead nettle, rich weed, cool weed, or silver weed, XJrtica (or Pilea) pu- mila, which grows in damp, shady woods and occasionally along the roadsides, has been used for a number of summers by Dr. James Stokes, of Philadelphia {Med. and 'Surg. Reporter, No- vember 2, 1867), in cases of rhus poisoning, and always, he says, with decided beneflt, some- times when other remedies have proved slow or almost inoperative. If possible, he obtains full-grown plants, strips off the leaves, bruises the stems, and applies the juice directly to the affected parts. The coating is to be re- newed when it has become dry. In many cases, says Dr. Stokes, a complete cure is ef- fected by one or two thorough applications. Dr. Blackwell, of Philadelphia {Charlotte 3Ied. Jour., cited in Indian Lancet, April 16, 1896), urges the use of europhene, in an oint- ment of from 10 to 30 per cent., or that of a dusting powder of from 35 to 50 per cent, with talcum, in the treatment of rhus poisoning. Cases of poisoning from the internal use of Rhus Toxicodendron are rare. In the Ameri- can Journal of the Medical Sciences for April, 1866, Dr. J. W. Moorman, of Hardinsburg, Ken- tucky, relates two cases, communicated to him by a professional friend, of poisoning from eat- ing the berries. The subjects were children, one six and the other eight years old. The quantity eaten (whether by each or by both together is not stated) was nearly a pint. In a few hours the children became" drowsy and stupid, and in a short time they began to vomit, flrst the partially digested fruit, after- ward a thick, tenacious fluid of a wine-colour. Then convulsions of different parts of the body followed, accompanied by slight delirium. The breathing was hurried ; the pulse was at flrst 133 RHUS full and strong but slow, afterward small, frequent, and compressible; and the pupils were dilated. Warm water was given to pro- mote vomiting, and afterward a Inrge quantity of sodium carbonate [bicarbonate ?], dissolved in water, under the belief that it was an anti- dote. Both the children recovered, but the younger one's convalescence was very slow. Three oases of poisoning with the root have been recorded by Dr. J.'iines Stokes (loe. cit.). Pour children gathered what they supposed to be sassafras roots, and made a tea from them which they drank. One of them, a boy, twelve years old, broke out with a rash resembling that of measles; his face, neck, and throat were swollen, his eyes were sufEused and watery, his voice was husky, he had a dry, hoarse cough, there was soreness of his throat, with intense burning extending to the stomach, he had high fever, his tongue was coated, his urine was high-coloured, scanty, and irritating, there was intolerable itching of the skin, there were nervous twitchings, and at times his mind was wandering. He had then been ailing for a week, with catarrh and general indisposition. The scarlet appearance of the eruption on the face, with incipient vesication, and a crescentic arrangement of the rash on the body, together with the fever and catarrhal sym ptoms, led Dr. Stokes to a reluctant diagnosis of measles. He ordered small doses of magnesium sulphate, a tablespoonful of neutral mixture every two hours, demulcent drinks, and a farinaceous diet. On his next visit he found the oedema more diffused, extending to the hands and feet ; the eyelids were closed, their connective tissue was filled with serous fluid, and they seemed ready to burst; and the prepuce was so swollen as to cause difficulty in urinating. All resemblance to measles had disappeared. At his next visit. Dr. Stokes found two others of the children, girls fifteen and seventeen years old respectively, affected with the poison. It was then that he learned of the tea they had made ; among the roots they shovred him were some that he recognised as those of Rhus Ihxicodendron. The fourth child, a boy, being insusceptible, did not suffer. Lead water was now applied to the affected skin, and small doses of saline purgatives were given. All the patients recovered. The time that intervened between the tea-drinking and the onset of the symptoms is not mentioned. Therapeutics. — Rhus Toxicodendron was for- merly official in several of the pharmacopoeias, but it is now recognised only in the U. S. Ph., which, strangely enough, gives no preparation of it. The first edition of the Ger. Ph. au- thorized a tincture, tinctura toxicodendri, made by macerating 5 parts of the fresh leaves in 6 parts of alcohol. Dr. John Aulde, of Philadelphia, who has made two important contributions to the literature of the therapeu- tic use of the drug — one published in the Medi- cal Neics for April 20, 1889, and the other in the Therapeutic Gazette for October 15, 1889 — makes a tincture according to the directions given in the U. S. Ph. for making tinctures from fresh herbs, using 50 parts of the fresh leaves and 100 parts of alcohol. This strong tincture, the dose of which he finds does not exceed -J drop, he dilutes with nine times its bulk of diluted alcohol, and the dose of this weaker tincture is 5 drops. Dr. Aulde cites Dr. Phillips as stating that rhus was first brought to the notice of the pro- fession by Dr. Dufresnoy, of Valenciennes, in 1798, and that in ISiifi it was recognised in the London Pharmacopoeia. Dr. Phillips recom- mended it, both taken internally and employed topically, in various subacute and chronic rheu- matic affections of fibrous tissues. Dr. Whitla and Dr. Brunton, says Dr. Aulde, have recom- mended it in incontinence of urine. In his first publication (Med. News, April 20, 1889) Dr. Aulde gives the condensed histories of seven cases in which he used rhus. Three of them were examples of various forms of sub- acute and chronic rhetimati.im, one was a case of sciatica, one was a case of cramps in the legs occurring at night, and two were cases of vari- cose veins. He suggests some occult relation- ship letween rheumatism and the varicose state of the veins that gives rise to pain. In all these seven cases the employment of the remedy was promptly followed by the most satisfactory results. In his second article (Therap. Oaz,, October 15, 1889) Dr. Aulde reports his continued satis- factory employment of rhus in various manifes- tations of chronic rheumatism. " I do not think it would be of great benefit in acute at- tacks," he says, "and my experience does not justify the statement that it can be depended upon invariably for relief " in chronic cases. In this article Dr. Aulde gives extracts from reports that have been made to him by other physicians, as follows : Dr. B. W. Allen, of Jernigan, Alabama, says he considers the reme- dy of value in neuralgia. Dr. T. C. Fcnton, of Streator, Illinois, mentions a case of acute rheumatism in which four doses of the drug took away all the pain, but failed to do aw.iy with the stiffness ; a case of " rheumatism of the thigh, extending to the knee," in which six days' use of the remedy gave no relief ; a case of neuralgia of the face in a woman of a nervous temperament, seven months advanced in pregnancy, in which also no effect was pi'o- duced ; and a severe case of sciatica which was cured with five doses. Dr. J. B. Laidley, of Oarraichaels, Pennsylvania, reports a case of severe recurrent sciatica in an aged clergyman who was a sufferer from chronic cystitis. De- cided benefit seemed to be derived from the use of rhus. Dr. H. A. Mobley. of Byromville, Georgia, reports a case of sciatica in which the beneficial action of I'hus was doubtful, and one of " articular rheumatism " in a weak, anasmio lad, in which the remedy acted most satisfac- torily. Dr. B. Powell, of Houston, Texas, who had himself been for years a sufferer from rheumatism and hcemorrhoids, found the use of the remedy very beneficial as to both ail- ments. He began its use in a spirit of scepti- cism, but he says, with regard to his rheumatism : " In three days I began to feel better than I had done for months," and concerning his haemorrhoids : " While taking the rhus I was entirely free from all rectal annoyances. Im- RICE RUBBER 134 mediately, however, upon stopping the medi- cine the piles returned." Dr. J. Richard Taylor, of Charleston, has found the drug very efficient in subacute and chronic mus- cular rheumatism, always tolerated by delicate stomachs, but not quite so prompt as sodium salicylate. He says, however, that its action is very rapid in relieving muscular soreness due to hysterical convulsions. Dr. J. W. Welch, of New Hope, Missouri, reports its satisfactory employment in a case of rheumatism and, to a lesser degree, in one of sciatica. Dr. J. B. Whitehead, of Lovingston, Virginia, reports the cure of a case of sciatica with rhus, also the apparent failure of the drug in a ease of chronic rheumatism and neuralgia. In this case, he remarks, the patient thought, from the small size of the dose, that the medicine was very dangerous, and so did not talie it as she should have done. In the course of his comments on these re- ports Dr. Aulde says : " Dr. Powell speaks very highly of the value of rhus in connection with the pain and annoyance attending the presence of hiemorrhoids, all of which I can fully in- dorse. It is truly wonderful how quickly local irritations of this character and varicose veins are subdued, and my observations incline me to consider favourablv the use of some drug in connection with the rhus which will favour a more active discharge of tlie functions of the lower bowel, from the fact that hiEmorrhoids and constipation often go together. Pew phy- sicians would be willing, however, to say that there was any relation existing between rheuma- tism and hfemorrhoids, or between rheumatism and varicose veins ; but it seems to me that a relationship can be inferred, if not demon- strated, from the results which attend the ex- hibition of certain remedies. Knowing that cascara sagrada has been highly extolled for the relief of rheumatism, and knowing, further, that it acts mildly as a laxative, and is thus calculated to reduce the congestion of the pelvic organs, including the rectum, I have made a combination of the rhus with cascara sagrada cordial with the happiest effects." Rhus venenata. — This species, the swamp sumach, is reputed to give rise to severer poi- soning than that caused by Rhus Toxicoden- dron. The treatment is the same. Kh.us vemicifera. — This is the plant from which Japanese lacquer is made. According to Mr. Beringer (Joe. cif.), Mr. D. P. Penhallow reports serious poisoning resulting from stir- ring and smelling the lacquer. He says that after a few experiences it was always possible for him to ascertain whenever he came into an atmosphere charged with the poison. This was manifested by a well-defined acid taste in the mouth and a slight, somewhat acute pain directly between the eyes, which were invari- ably symptoms of the results to follow. The Japanese, he says, employ the flesh and juices of a fresh giant crab, the Alacroclieira Kmmp- feri, and apply it freely to the poisoned parts. KICIE. — Rice is the grain of Oriza ■' each 20 grains ; ^i;tT''b^^ '' " Menthol 5 " Oil of wintergreen 6 drops ; Glycerin 8i fl. oz. ; Alcohol 2 " Water, enough to make 16 pints. M, The essential ingredients of this solution are usually dispensed in tablet form, on ac- count of the much greater convenience, but the proportions and even the constituents of the tablets which are sold as Seller's vary to such a degree that no certain formula can be given. To make tablets conforming to the formula given above, omit the glycerin, alcohol, and water, add lOf drachms of sodium chloride, mix thoroughly, and divide into 128 tablets. One tablet is dissolved in 2 oz. of water for use as a spray. The following formula of a Seller's tablet to be found on the market shows how wide a variance exists : 5 Borax, ) , . . Sodium chloride, [ ®*°" ■■ ^ S™™^ ; Menthol, J ■ , , . Thymol, \ ''''°° A of a gram; Oil of eucalyptus -^ of a minim; Oil of wintergreen ^^^ " " M. ^ Frequently after cleansing the mucous mem- brane with this solution it is advisable to spray it with an oily solution to form a protective coating. In cases where stimulation is de- sirable, a solution of eucalvptol, thymol, and menthol in a pure hydrocarbon oil, like albo- lene, is very useful. In acute coryza this solu- tion, sprayed into the nostril, sometimes acts like a charm to lessen the congestion of the mucous membrane and relieve the feeling of oppression. It is also useful in simple chronic rhinitis. In atrophic rhinitis it is usually a pleasant application for the patient and relieves niany of the disagreeable symptoms for a time, though it can hardly be said to be curative. 221 SPURGE STAPHISAGRIA In all of the above-mentioned solutions drugs are included which tend to repress the development of pathogenic micro-organisms, , but in certain diseases, such as diphtheria and croup, sprays of peroxide of hydrogen or of bichloride of mercury are recommended. In using the latter, special care must be taken that the spray is fine, because a coarse spray is of less use and sometimes harmful by inducing absorption of a too great quantity of the drug when it is used for some time. As a prophylactic against diphtheria, some authors recommend the daily use of the follow- ing throat spray, particularly for persons who are suffering from nasal catarrh : 5 Listerine 1 fl. drachm ; Boric acid 6 grains ; Glycerin 1 fl. drachm ; "Water, enough to make 1 fl. oz. M. Matthias Lanckton Foster. SPTJE.GE. — See Euphorbia pilulifera, un- der Euphorbia (vol. i, page 401). SQUILL, scilla (U. S. Ph., Br. Ph.), hulhus scillm (Ger. Ph.), is the bulb of Urginea (Scilla) maritima, a liliaceous plant. It is possessed of expectorant, diuretic, emetic, and cathartic properties, but is used only when the first two are indicated. As an expectorant, it is indicated in chronic bronchitis, when the mucus is tough and viscid, and in acute bron- chitis, when the signs of congestion of the mu- cous membrane have subsided. ' When, in the last-named affection, the expectoration is scanty it is desirable to combine with the squill a nauseant expectorant, such as ipecac, and, on the other hand, when it is profuse, a stimulant expectorant is useful. Squill has been employed to some extent in croup, on ac- count of its emetic and expectorant properties, but it is hardly to be commended. As a diuretic, it is contra-indicated when- ever there is any inflammatory process occur- ring in the kidneys, and it would be safer to restrict its employment to cases of cardiac dropsy. It is usual to combine with it one or another of the preparations of digitalis when it is used as a diuretic. In overdoses it purges actively, and paralysis and convulsions may en- sue. The dose of the drug itself is from' 1 to 2 grains ; that of the vinegar, acetum scillm (U. S. Ph., Br. Ph., Ger. Ph.), from 15 to 40 drops ; that of the fluid extract, extractum scillcB fluidum (U. 8. Ph.), 2 to 3 minims; and of the syrup, syrupus scillce (U. S. Ph., Br. Ph.), from 40 to 60 drops. The compound syrup, syrupus scillce compositus (IT. S. Ph.), contains about a grain of tartar emetic in the ounce, also senega, and is a very useful expectorant mix- ture except for infants and persons of low vi- tality. It may be given in doses of from 10 to 30 drops. [The dose of the tincture, tinctura scillce (U. S. Ph., Br. Ph., Ger. Ph.), is from 10 to 20 minims; that of the oxyrael, oxymel scillce (Br. Ph., Ger. Ph.), is a teaspoonful for adults (from 5 to 20 drops for infants) as an expec- torant, and a teaspoonful, given in fractional amounts at short intervals, as an emetic for children. The dose of the compound squill pill, pilula scillce composita (Br. Ph.), is from 5 to 10 grains ; for the pilula ipecacuanha cum scilla (Br. Ph.), see vol. i, page 543.] Russell H. Nevins. STANNUM.— See Tin. STAPHISAGRIA (U. S. Ph.), stapMsa- grice semina (Br. Ph.). — The larkspur is a ge- nus of annual or biennial flowering herbs of the natural order Ranunculacece, and includes many species. The one most used in medicine is Delphinium Staphisagria, stavesacre, indig- enous to the countries bordering on the Medi- terranean and cultivated in many parts of southern Europe. Also the species Delphi- nium ConsoUda, that is common in central Europe and has been naturalized in tlie United States, is sometimes used as well as Delphinium exaltatum and Delphinium Ajacis. The seeds of Delphinium Staphisagria, stavesacre, are most commonly employed. In earlier editions of the U. S. Ph. more promi- nence was given to the seeds of Delphinium ConsoUda, which were officinally designated as delphinium. The most important ingredient of the seeds is delphinine, an alkaloid upon which the virtues of the drug are supposed chiefly to depend. It is insoluble in water; soluble in 21 parts of alcohol, in 11 of ether, and in 16 of chloroform. It is an acrid sub- stance, irritating to the skin and mucous membranes. The seeds contain a non-drying fixed oil in the proportion of from 25 to 30 per cent. Larkspur seeds have been used in the form of an outward "application for the destruction of vermin, both in man and in beasts, from time immemorial, and for this purpose are still somewhat in vogue, though largely superseded by more modern remedies. For such applica- tions the remedy is used either in the form of a lotion or that of an ointment. A decoc- tion made by boiling 1 oz. of the seeds in a pint of water has been employed both for phtheiriasis and for scabies. A lotion recom- mended for the destruction of pediculi capi- tis is made by macerating 1 oz. in a pint of vinegar. A tinctu'e in the same proportions is also used, as well as a solution of 1 scruple of delphinine in 2 fl. oz. of rectified spirit. Another effectual preparation is the expressed oil sufiiciently diluted with olive oil. Accord- ing to Balmanno Squire, "a cheap way of pre- paring the oil for application is to digest the seeds in melted lard and strain while ^hot. The flltrate is an ointment of the seeds of stavesacre. Two drachms of the bruised seeds should be used to an ounce of lard." Aside from these uses, larkspur, more par- ticularly Delphinium ConsoUda. has been rec- ommended as a vulnerary, and delphinine has been used as a topical remedy for the relief of neuralgia, earache, and toothache. The al- kaloid delphinine maybe used for this pur- pose either in alcohol (from 16 to 30 grains to the ounce) or in an ointment (10 to 40 grains to the ounce). The unguentum staphisagrice of the Br. Ph. contains about 10 per cent, of oil of stavesacre. STAR-ANISE STIMULANTS 222 Internally, the drug is seldom, if ever, now employed, though formerly it was used in spasmodic asthma, in dropsy, in gout, and in seasickness, usually in the form of a tincture of the seeds. The dose of delphinine is said to be ^ a grain, repeated at intervals of three or four hours. — Edward B. Bbonson. STAB-ANISE.— See Illicium. STARCH.— The amylum of the U. S. Ph- is starch obtained from maize ; that of the Br. Ph. includes starch from wheat, maize, and rice ; and the amylum tritici of the Ger. Ph., as the name implies, is wheat starch only. For the use of starchy substances as articles of food, see the article on Foods. Starch may be administered freely by the stomach as an anti- dote in cases of poisoning with iodine ; also, when irritant preparations of iodine, such as the tincture, have accidentally come in contact with the body or been applied too copiously, their irritating action may be cheeked by the immediate application of starch. Starch was formerly much employed, in the form of the starch bandage, for encasing a limb in an im- movable envelope in cases of fracture, but for this purpose it has now been almost wholly superseded by plaster of Paris. At present starch is chiefly used, finely powdered, as a topical application in intertrigo and other forms of superficial irritation of the skin, and to reduce the strength of medicinal powders used locally as dusting powders. Glycerite of starch, gtyceritum amyli (U. S. Ph.), is a jellylike mass made with 10 parts of starch, 10 fluid parts of water, and 80 parts of glycerin. Glycerine of staroh, glycerinum amyli (Br. Ph.), is also a jelly made with 1 part of starch, 5 fluid parts of glycerin, and 3 fluid parts of distilled water. These jellies are used as lubricants, as bases for ointments, and in the preparation of certain suppositories. Mucilage of starch, mucilago amyli (Br. Ph.), is employed chiefly as a vehicle for enemata. For iodized starch, see under Iodine (vol. i, page 537). STAVESACBE.— See Staphisagbia. STEAM. — The employment of the vapour of water by inhalation is treated of in the ar- ticle on Inhalants (vol. i, page 528). In cases of acne with decided induration of the lesions and a tendency to their appearance in succes- sive crops, also in those of chronic eczema with pronounced infiltration, the daily exposure of the affected parts to the action of steam, as hot as it can comfortably be borne, continued lor from fifteen minutes to half an hour, often proves of great service. Liberson (3Iedecine moderne, February 15, 1896; Iledical Record, March 38, 1896) finds that it not only aids in the absorption of superficial and deep infiltra- tion, but also diminishes or arrests purulent secretions, removes crusts, checks oozing, and provokes a regeneration of healthy tissues. Steam has been employed as a hccmostatic. In a series of lectures, etc., published under the auspices of the Imperial IJniversity of Mos- cow (1894, No. 4 [summarized in the Central- Natt fur Oyn&lcologie for January 19, 1895, and from that in the University Medical Maga- zine for August, 1895]), Dr. Snegirjoff advised its use for controlling hmmorrhage during op- erations, and said that for seven years he had employed it after dilatation and curetting of the uterine cavity. A small metal cannula, at- tached by a rubber tirbe to a kettle containing water at the boiling point, was introduced into the cervical canal. The steam was applied for a minute. This was always followed imme- diately by complete hasmostasis and was not associated with pain or other symptoms. When it was applied in carcinoma of the uterus the foetid discharge and hjemorrhage disappeared, and the pain was relieved. When it was ap- plied to the cavity of a uterus that was after- ward removed the endometrium was found to be cauterized and covered with a thin white membrane, showing that the steam had acted as a caustic hcemostatic, ancesthetic, and antiseptic. In a series of experiments on animals, the liver was extirpated with the loss of but little blood, and the animal survived ; also a portion of the spleen, lung, kidney, and brain. Haemorrhage from bone was controlled, and a new growth of bone tissue followed the operation. A horn of the uterus of a dog was excised. Bleeding from a longitudinal or transverse incision in the femoral artery ceased after the application. Muscular and cutaneous haemorrhage ceased immediately, and the operation was always followed by primary union. In 1893 Dr. Sneg- irjoff began to apply the method in a series of operations at the Alxina Hospital. In five cases of resection of the knee joint the oper- ation was performed without the use of an Esmarch tube, haemostatic forceps, or ligature. In amputation of the breast for cancer, and cancer, lipoma, and cavernous tumours of the skin, in amputation of the cervix uteri, and in hysterectomy for fibroid tumours, to control hfemorrhage from the stump, the application proved effective. After the incision of ab- scesses it was employed as a method of disin- fection ; in hfemorrhagC from a sinus or fistula, particularly if it was tuberculous, haemorrhage was controlled entirely. The writer in the University Medical Maga- zine adds an abstract of a subsequent article on the subject by Dr. Ludwig Pincus, of Dant- zic (Centralblatt fUr Gyndkologie, March 16, 1895). Pincus referred to Snegirjoff's publica- tion and reported nine cases in which steam had been employed in controlling haemorrhage from the uterine cavity and in treating endo- metritis. In a case of carcinoma of the fundus uteri, with severe pain in the pelvis, ha^mor- rhage, and foetid discharge, the application had immediately been followed by a discharge of dark-coloured fluid containing degenerated tissue, and the haemorrhage and foetid dis- charge had disappeared and not returned until after eleven days. The treatment was con- tinued for a minute and a half, and was not associated with any degree of pain. Steam was used in three cases of uncompli- cated hyperplastic endometritis, with severe menorrhagia. In one case three applications were made, each lasting a minute. The men- struation during the next two months was regular and normal, lasting from two to three 223 STAE-ANISR STIMULANTS days. In the two other eases which he had observed but two and three weeks respectively, the haemorrhage had not returned. About the third day after each application there had been a profuse leucorrhoeal discharge, which had completely ceased between the ninth and the twelfth day. In one of these last cases the treatment had been followed by uterine colic. Five cases of cervical endometntis were under treatment, but had not been observed long enough for any definite results to be reported. Pincus concludes that the method is of un- doubted value, particularly from a bacteri- ological standpoint, and that it should be of great value in septic puerperal endometritis. Superheated stea,m has been used as a caus- tic. Dr. Paneoki, of Dantzic (Therapeutische Monatshefte, .January, 1896 ; Deutsche Iledizi- nal-Zeitung, June 1, 1890; New York Medical Journal, June 20, 1896), thinks steam preferable to other caustics for destroying the diseased endometrium. The caustic action of steam at the temperature of its generation, he says, is superficial if it is used for a brief application only ; if it is applied for a long time or in a superheated state (heated to 248° F.), its action extends deeper, lie says the method of its ap- plication is very easy and simple, so that the physician needs no assistant; moreover, it is entirely painless, and he has never seen it do any harm. STESCTJIilA. — Sterculia (or Cola) acumi- nata is a tree of the Malvales indigenous to western Africa and cultivated in various trop- ical countries. The seeds, contained in a cap- sule known as the Icola nut, or garu nut, contain caffeine, a small amount of theobromine, a fixed oil, and a volatile oil. Kola, although not of- ficial, has of late come into use as a to7iic and stimulant to the nervous system. Like coca, it is credited with marvellous sustaining powers that enable persons to endure great and pro- tracted exertion, either bodily or mental, or dep- rivation of food without suffering from fatigue or hunger, also with aphrodisiac properties and with promoting the appetite for tood. It is an efficient and acceptable substitute tor tea and eoflee. It seems to act as a tonic to the heart. It is said that by chewing from 20 to 40 grains of the fresh seeds a person may often overcome seasiclmess in about three quarters of an hour. Kola has been used in France as a remedy for diarrhoea. Dr. Albert L. Gihon, of the United States Navy {Medical Times, April 17, 1886), was among the first in this country to use kola therapeutically, in an obstinate case of neuras- thenia which rapidly yielded to its use. It is probable that its chief virtue will be shown in such cases. There are many preparations of kola on the market, most of them proprietary. Probably the fluid extract is as satisfactory as any of the others ; it may be given in doses of from 15 to 20 drops. STEBESOL. — This is an antiseptic varnish said to consist of 135 parts of shellac, 5 of ben- zoin, 25 of tincture of Tolu, 3 of oil of cinna- mon, 50 of carbolic acid, and enough alcohol to make 500 parts. It is used topically in diph- theria. STERNUTATOBIES, or remedies or measures which excite sneezing, were formerly employed to stimulate the secretion of the mu- cous membrane of the nose, thus relieving the system of " peccant " substances, and to relieve vai'ious morbid conditions by repeated acts of sneezing. At the present time they hardly en- ter into medical practice and are only employed when it is desired to obtain the aid of sneezing to expel foreign bodies from the nose, and even then they may be dangerous, causing rupture of weakened blood-vessels. Snuff and black pep- per are obtainable almost everywhere, and are as suitable as any other sternutatory. Occasion- ally it will be found that small objects in the eye, such as particles of sand, can be removed by causing the person to close the affected eye while sneezing is excited. The rapid passage of air through the nose undoubtedly causes a partial vacuum in the tear duct, and the con- sequent sudden gush of tears from the eye is very apt to wash out the foreign body. The same effect may often be produced by closing the nostril of the same side as the affected eye and blowing the nose with considerable force. liUSSELL H. NeVINS. STIBIUM.— See Antimony. STILLINGIA, or queen's root, is the roof of Stillingia silvatica, an American herbaceous plant of the Euphorhiacece. In large doses, it is emetic and cathartic ; in the doses ordinarily employed, it is credited by some practitioners with alterative virtues similar to those ascribed to sarsaparilla, and is used in the treatment of syphilis, scrofula, and other dyscrasice. The fluid extract, extractum stillingice fluidum (XT. S. Ph.), may be given in doses of from 15 to 45 minims. STIMULANTS.— These may be defined as agents whose influence is to augment the vital activity or function of an organ or to increase the vital energy of the entire system. By the heightening of the physiological functions, stimulants may, at the same time, carry a corrective or an economical effect upon sys- tems weakened or partly disturbed by diseased conditions. Many of the substances used ther- apeutically as stimulant agents evoke an in- , tensifying action upon normal tissues or systems of the human organism. With few exceptions, however, the subject will be dis- cussed in this article from its therapeutical standpoint, such deviations being made only for the sake of lucidity. Colloquially, the word " stimulants " is used with reference to alcoholic liquors. Aside from the fact that these agents are of undoubted use in the treatment of disease, their ancient usage demands some consideration. Wine is referred to by Homer, and evidently its increased strength acquired by age was known to the an- cient Greeks, since the poet makes mention of wine eleven years old. The Brahmans used the moon-plant (Asclepias acida) as a sacrifice for the expiation of sin ; and the faithful were not allowed to touch the sacred plant except for religious purposes. The inhabitants of Egypt were acquainted with the intoxicating powers of grape wine, and fermented wine formed a STIMULANTS 234 conspicuous part in the religious services of the ancient Jews, as it does in the communion ser- vices of the present day. Every nation, sav- age or civilized, possesses some characteristic stimulant, from the coffee of the Javanese and the tea of the Chinese to the kumyss of the Tartars and the coca leaves of the South Amer- ican Indians. Stimulants in some form seem to be essential to the carrying out of routine duties ; and it is altogether likely that the stimulant required by the savage before his entrance into battle or previous to the under- taking of a Journey, is identical, so far as its purpose is concerned, with the exhilarant which the man of higher civilization demands in his struggle for maintenance and advancement. Whatever may be the purpose of its ingestion, it is true that every race and tribe is possessed of some stimulant in its armamentarium of life. The moral and political sides of the ques- tion can not be discussed in this place. Broadly, stimulants may be grouped into two great classes, general and local. By general stimulants are meant those agents which pro- duce their effect simultaneously upon the entire system. Theoretically, most of the stimulant substances would come under this head, since vital energy or the increase in the vital forces is recognised chiefly from the mani- festations of the circulatory and nervous appa- ratus. And yet a line must be drawn, for many of the agents under consideration induce their manifestations by their influence upon organs or sets of organs. Such stimulants are known as local stimulants, and when general "effects are produced by them it is by secondary action or by the ingestion of a dose larger than is necessary to call forth the merely local influ- ence. Again, not all stimulants possess alone a vivifying effect upon the organism or a part of it. Some of them, like opium, for instance, have in different doses a sedative influence ; while others — for example, carbonate of ammo- nium — may produce irritation. Yet the pri- mary effect of the stimulants is stimulation, and for the present purpose they will be so consid- ered. Before reviewing some of the properties of the main stimulants, it will be well to recog- nise the general principles underlying their use and the indications for their administration. The personal element and the individual tem- perament offer bases for study. A man ad- dicted to the use of coffee, for example, will respond but poorly in emergency, as a rule, to the alkaloid of the bean. Habit plays an im- portant rSle in the determination of the effect desired from a stimulant agent. A patient ex- hausted in a typhoid fever who has been a heavy user of alcohol in any of its forms will require a much larger proportion of this stimu- lant to secure a beneficial action than one whose system is not permeated with it. It is so well known that drunkards withstand severe disease poorly that it has become an established prin- ciple that such patients, especially when they suffer from grave injuries which shock the nervous system, shall receive copious libations of alcoholic stimulants, for without them they will most certainly succumb. The withdrawal of any accustomed stimulant evokes a shock which is often more to be feared than the im- pending or present disease. Exception should be made, perhaps, in the case of tobacco, for many users of the weed lose their taste for smoking or chewing during an acute disease, sometimes even permanently. The individual temperament, aside from habit, must be taken under consideration, too. Coffee or tea may make one person wakeful, and have the reverse effect upon another. Tobacco may calm one mind and distress another ; it may arouse the intellect on the one hand, or may cloud and obscure its workings on the other. Alcohol in any of its forms presents the most diverse ef- fects upon different persons. It may produce drowsiness or wakefulness ; it may constipate or cause diarrhcea ; it may relieve a headache or be responsible for the reverse condition ; its use may cause strength in one, weakness in another ; from one intellect it may call forth brilliancy and it may blunt another. Sex has an important bearing upon the ad- ministration of stimulants. Women yield to them much more easily than men, and require, therefore, smaller doses. The aged require stimulation, particularly in diseased conditions, while children, in health at least, are inde- pendent in this respect. The habitual use of some stimulant is preferred for old people by many authors as giving tone to the stomach, brain, and heart. The effects of stimulants vary with race and climate. Savages yield readily to the influences of stimulant agents to which they are not accustomed, and, like diseases 'which are generally innocuous in civ- ilization, such agents in large quantities may prove fatal. Stimulants can be used with greater freedom and less danger in their native places than elsewhere, as witness the prolonged and harmless chewing of coca leaves by trav- ellers in South America. The effects of stimu- lants are modified by disease. Enormous doses of alcohol can be given in typhoid fever, for example, without bringing about intoxication, and in cases of chronic debility immense quan- tities of alcoholic liquors may be taken with impunity. All agents used as stimulants depend upon some contained active principle for their effect, which is, in its turn, dependent upon the quan- tity administered. Within certain limits, too, they are all capable of replacing ordinary food for the sustenance of the system. In the case of alcohol this is probably due to the preven- tion of tissue waste by purely chemical means, since carbon and hydrogen are offered to the oxygen of the blood in place of the elements in the tissues. The coca leaves offer, on cor- roborated evidence, a large amount of suste- nance and great powers of endurance. Coffee and tea have sustaining powers to a marked degree, and in the case of perhaps the greatest proportion of civilized nations form the chief element of the first meal of the day. Some African tribes, when preparing for long jour- neys, take with them only coffee and butter as articles of food. Alcoholic stimulants may stand as a type for general stimulants. Under this head may 235 STIMULANTS be included whisky, bvaudy, wines of all kinds, ale, beer, porter, and stout. Whisky and brandy may be regarded as representing what are known as diffusible stimulants, those which are quickly absorbed and act with correspond- ing rapidity. In diseases marked by the so- called typhoid state — that is, in adynamic conditions — the alcoholic medicines are pre- eminently indicated, not for any curative in- fluence, indeed, but because their ingestion at the time when weakness is manifested in all the organs, and mental hebetude supervenes, produces a purely stimulant effect first, and secondarily acts as a food to the patient. The dose of alcoholic stimulants in such phases of disease demands, hovyever, careful considera- tion. Should intoxication, even of slight de- gree, supervene, the succeeding exhaustion and depression are dangerous in the extreme. The amount to be given must be accurately gauged and can be determined only by experiment. By administering these stimulants in small doses the dose for each individual may be as- certained with precision and the further ad- vantage may be gained of maintaining the stimulant action for a considerable time. The different degrees of susceptibility and their causes, as enumerated above, must be con- stantly in mind. The diffusible stimulants are of value in other conditions, too, than the mere exhaus- tion of disease. In the beginning of the milder infections, such as an acute coryza or amygda- litis, a hot alcoholic drink, taken during or immediately after the initiatory chill or chilly feeling, may abort the attack. Persons ex- posed to cold and wet feel an immediate re- newal of warmth after the ingestion of one of the diffusible stimulants, particularly if it is accompanied by immersion of the feet in hot water. In cases of temporary weakness of the heart, as in fainting, a warm alcoholic stimu- lant is of great service. In all instances of cardiac depression, whether from poisoning, shock, or hfemorrhage, alcohol is one of the best means at our disposal for stimulating tlie heart to act, and temporarily to bridge over the crisis. It has undoubtedly saved many lives when used subcutaneously in large doses in impending death in the instances mentioned. Whisky and brandy, being very diffusible, are to be preferred for rapid stimulation. The heavier wines, such as port, burgundy, sherry, and claret, are of greater service in the conva- lescent stages of prolonged disease ; they have a more agreeable taste and are tonic as well as stimulating. Champagne is an excellent stim- ulant after severe operations and tends to allay vomiting and nausea when given very cold in frequent small doses. All the alcoholic stimulants have the s^me effect upon the heart's action and the cerebral areas. The stimulation by these agents is evoked by an increase in the arterial pressure and by a reflex conti'action of the vessels. The heart-beat is accelerated and becomes more forcible by reason of reflex action from the sensory nerves of the mouth, oesophagus, and stomach when the fluid is taken internally. It is quite probable, too, that there ensues a local dilatation of the cerebral arteries as a consequence of the ingestion of the fluid, which accounts for the usual accompanying cerebral stimulation. The quantity and the quality of the blood sent to the brain, together with the varying contraction and dilatation of the blood- vessels and the force of the cardiac beat, also aid in giving rise to cerebral stimulation. Very small amounts of the other general stimulants, such as tea, coffee, betel nut, and the kola nut, have a rapid effect when taken by sipping. The influence is much more pronounced, and even a glass of cold water, slowly sipped, will produce a quick increase in the arterial press- ure and a stimulation of the circulation. Sim- ilar results may be obtained by stimulation of the nasal mucous membrane by the odour of volatile salts, such as carbonate of ammonium. The use of smelling salts is dependent for its restorative effects upon this principle. The cold lath is a highly valuable respira- tory and cardiac stimulant in cafes of insola- tion, and thus induces a general stimulating effect. In these instances it exerts a tonic ef- fect, too, upon the peripheral nervous system, the brain, and the spinal cord. In asthenic conditions provoked by prolonged fevers or by other exhausting causes, the cold bath, judi- ciously employed, exerts a favourable influence by its stimulation of the vital functions, liest- lessness is quieted, sleep may be induced, and delirium and prostration may be lessened by its use. The respiration and the circulation feel the influence of the stimulative process, the former being deepened and amplified, the lat- ter receiving a renewal of tone. In this in- stance stimulation is evoked by the calming and soothing sequel of the agent. The hot hath, also, by its sedative action, causes stimu- lation of the cardiac beat in a reflex way, and thus augments the energy of the system. Its good results are seen especially in atonic con- ditions of the lungs and kidneys and in some forms of heart disease. The local application of water in the form of sprays and douches and sheet baths induces a general stimulant effect which is of use in many nervous states. (For the indications and methods see under Htdriatics.) Dry heat, by affording a dilatation of the cutaneous and subcutaneous blood-vessels, ex- erts the influence of a general stimulant upon the organism. In cases of shock, whether or not it follows an operation, the application of hot-water bags, of heated sand, or of tin cases containing hot water to the sides and extremi- ties of the patient aids in keeping up the bal- ance of the circulation and in restoring the animal heat. In the algid stage of cholera and in asphyxia from immersion or from other causes, dry heat is valuable as a restorative having the subsequent effect of a general stim- ulant. In the treatment of all cases in which the temperature has fallen below the normal, dry heat in conjunction with two of the car- diac stimulants, atropine and digitalis, is pre- eminently indicated. In some manner not understood, opium may act as a supporting and stimulant agent in some forms of low fever and in conditions of STIMULANTS 226 adynamia from any cause. When there is vomUing and not enough food is retained to maintain life, opium is of service in tiding over the patient until such times as the func- tions are restored to the normal standard. In such cases, administered in small doses, it acts as a general stimulant, supporting the circula- tion, maintaining the heart and lungs, and keeping the mind clear. Electricity must be regarded as a general stimulant when its influence in restoring vital functions after deep narcotism or asphyxia is considered. After the cessation, or apparent cessation, of respiration in chloroform anaes- thesia, the faradaic current, applied to the phrenic nerve at the root of the neck, may renew respiratory movements. In asphyxia neonatorum and in impending apncea or in orthopnma. the faradaic current may evoke deeper and fuller breathing. Only in so far as electricity is of aid in stimulating the vital functions, however, can it be regarded as a general stimulant. The oxygen of the inspired air is one of the main stimulants which the body receives. It is as essential, too, as it is constant in its en- trance to the organism. Inhaled pure or as such, oxygen acts as a stimulant to the cardiac and vascular apparatus and produces a feeling of energy which is imparted to the entire sys- tem. The effects on the pulse are said to be transient, but the general exhilarating influ- ence remains as long as the oxygen is adminis- tered. In dyspnoea of cardiac or pulmonary origin, whether the mind is clear or obscured, oxygen, given by inhalation, may help to take the place of the impaired movements of the lungs, furnishing a sufficient supply of the gas to last until the aetio'logical difficulty is over- come. Frequently it may arouse a patient from a light coma in the condition specified. Strictly speaking, only alcohol in its various forms, dry heat, and electricity should be in- cluded among the general stimulants. But it is very difficult to draw a sharp dividing line between those agents which stimulate the en- tire system and those whose influence extends indirectly to the entire organism through their action upon the cerebro-spinal axis and the vascular apparatus. Among these may be mentioned coca, coffee and caffeine, tea and thebaine, tobacco and nicotine, chocolate, wines of all kinds, ammonia and many of the salts of ammonium, ether and chloroform, and cam- phor. Many of these are cardiac stimulants and are referred to under Cardiac stisiu- LANTS. It is of value in cases of general debility, in depressed conditions of the spinal cord, and in functional viealcness ot some of the internal organs to administer spinal stimulants. Where an inflammatory condition of the motor cen- tres of the cord exists, however, spinal stimu- lants are apt to do more harm than good. Little benefit can be expected from the use of these agents in paralyses of organic origin, but when a hemiplegia depends upon a toxic effect, as in lead poisoning, they are of a specially use- ful nature. The excellent results obtained from their administration in nocturnal enure- sis, in atonic retention of urine, and in loss of voluntary motion in groups of muscles are well known. When prolonged overwork or great excitement has caused mental and physical de- pression, some of the spinal stimulants are serviceable. All the spinal stimulants proba- bly act by increasing the excitability of the nerve cells in the spinal cord and thei-eby in- creasing the rate at which stimuli, particularly reflex impulses, are transmitted. Their influ- ence, like that of the general stimulants, ex- tends to the heart and circulation and in some part to the brain. The most prominent of the spinal stimulants is strychnine, and it may stand as a characteristic type of the group as alcohol does for the general stimulants. 'J'lie- baine and brucine are next in their power of action, and others, of less impoi-tance, are ab- sinthe, ammonia, gelsemine, calabarine, and nicotine. In very large doses, also, opium, morphine, and atropine may call forth convul- sions of spinal origin, so that in this sense they might be called spinal stimulants. One of the most important groups of medi- cines in all departments of therapeutics is the class known as cardiac stimulants. Their use is essential and is indicated in many conditions of acute and chronic disease. In the treatment of shock from any cause, where there is weak- ness in the cardiac beat or depression of the cardiac ganglia or muscle, cardiac stimulants are indicated. In the prolonged course of an acute disease, infectioiis or not, where asthenia or adynamia supervenes, the cardiac stimulants are of use to support the patient or to carry him over a crisis. Profound collapse with depres- sion of the circulation and respiration, instances of threatened death from sufocation or drown- ing, and the shocJc from an ancesthetic offer le- gitimate opportunities for the administration of stimulants for the heart. In the crises of pneumonia, when the I'ight heart is working against tremendous odds, it is doubtful if we could dispense with the cardiac stimulants. JSxhaustion from any cause, whether from dis- ease or from overwork, from great excitement or from prolonged emotional strain, demands the efficient and intelligent use of the medicines under consideration. There are two conditions, broadly speaking, which call for the use of cardiac stitimlants. The first is convalescence from disease in which the heart, like other organs, has become de- pressed and weakened, and added to this indi- cation might legitimately be appended certain forms of heart disease in which the viscus is not properly fulfilling its function, and the weakness of old age. The second indication is. to generalize, any sudden failure of the cardiac apparatus or any group of symptoms pointing to an impending cessation of the heart's beat. The symptoms are so plain and so easy to be recognised that it is not necessary in this place to rehearse them. Suffice it to say that it does not matter what the aetiology of the heart's poor action may be, the use of stimulants in the conditions enumerated is urgently demand- ed. The cardiac stimulants properly included in the first group mentioned should, strictly speaking, come under the head of cardiac ton- 237 STIMULANTS ios, although their influence is first a stimu- lant, later a tonic one. They will therefore not be discussed here. (See under Cardiac TONICS, vol. i, page 317.) The stimulants of the second group, however, come legitimately into this article. Alcohol stands foremost as a rapid and safe cardiac stimulant. In those instances in which it is used to prevent or to counteract sudden failure of the heart, it must be given in con- centrated form. Its most diffusible prepara- tions are whisky and brandy ; and to perform their work most quickly these should be ad- ministered subcutaneously. In cases in which the patient can not swallow the medicine, the alcoholic preparation may be given in the form of an enema ; but it is apt to be expelled from the rectum, for an unconscious or partly co- matose patient has little or no control over his sphincter muscles. In an emergency, alcohol is best given in small doses frequently repeat- ed, since its stimulant action is thus longer maintained. Its effect should be carefully noted, too, for it is apt to prove harmful rather than beneficial if it docs not succeed in bring- ing the pulse nearer the normal standard in force and frequency. Moreover, it is clinically well established that large doses of alcohol may paralyze the cardiac muscle, and in some cases even a temporary reduction of the power of the heart may prove fatal. In combination with alcohol, ether forms one of the most reliable of heart stimulants, although its good effects in an emergency are as often obtained when it is used alone or with camphor. Ether must be given subcutaneously when it is given for its stimulant effect ; or, rather, the injection must be made deep into the tissues. It is very prone to produce an abscess at the site of injection, but even this sequel would hardly be a formi- dable objection in the face of impending death. The field for which ether is particularly adapt- ed is that of the unexpected cardiac, failure sometimes seen in chloroform ancesthesia or even in ether narcosis. In Germany and Aus- tria it is chiefly depended upon as a cardiac stimulant, to the almost utter exclusion of other similar agents. In flagging of the heart evoked by a large or uncontrollable hsemor- rhage, neither ether nor alcohol can be substi- tuted for an intravenous or infra-arterial saline infusion, than which there is no better stim- ■ ulant for the heart. Particularly when the infusion is combined with the use of strych- nine is its effect upon the cardiac apparatus a strikingly stimulant one. A saline solution thrown into the rectum, if of the physiological strength, may accomplish beneficial results for the heart in instances of shock or hasmorrhage. Even the injection of the same solution into the intercellular spaces, as in cases of suffoca- tion from illuminating gas, evokes a powerful cardiac stimulation. (See under Tkansfusion.) Ammonia has long been recognised as an efficient cardiac stimulant in collapse and in intoxications with cardiac depression. It may be thrown directly into a vein, or its vapour may be applied to the nasal mucous membrane, or it may be given subcutaneously, alone or in combination with an alcoholic preparation. Ammonia, like alcohol, is reflex in its action on the cardiac apparatus, and accomplishes its stimulation not only by its influence upon the heart, but by its effect upon the vaso-motor centres also. The best preparation of ammonia for this purpose is the aqua ammonicB fortior (U. S. Ph.), or the liquor ammonia (Br. Ph.). Among the alkaloids which may be used in sudden cardiac failure, with results which vary, are atropine, strychnine, digitaline, and caf- feine. Of these, strychnine gives the greatest tone to the heart, while the others render its beat more efficient. The nitrites are excellent cardiac stimulants. While one is waiting for an effect from subcutaneous instillations, in- halations of nitrite of amyl will prove helpful in rousing a heart on the verge of collapse or failure. JSitroglycerin, hypodermically admin- istered, acts like nitrite of amyl in producing a lessening of arterial pressure with increase in the force and frequency of the pulse. Among agents not drugs which may be re- garded as reliable cardiac stimulants, heat, dry or moist, occupies a prominent position. A poultice or hot-water bag, placed over the heart, maybe serviceable in time of emergency. The use of large quantities of hot water by the rectum or by the mouth will prove benefi- cial to the heart in hemorrhage especially. The impression upon a flagging or collapsed heartof counter-irritation, particularly the fre- quently repeated (sixty to seventy times a min- ute) pressure of the thumb over the pra;cordia, is to awaken its muscles and ganglia to re- newed efforts, and it may be satisfactorily em- ployed in sudden cessation of the heat of the heart during ancesthesia. Some of the volatile oils also have a reputation as cardiac stimu- lants. Stimulation of a heart suddenly weakened demands, above all, rapidity. Hence the meth- od of evoking the stimulation should be, preferably, by subcutaneous or intravenous in- jection ; next, the rectum is to be chosen ; and lastly, the mouth. Vascular stimulants, although closely related in their action to cardiac stimulants, are use- ful in preventing the congestion of internal organs by equalizing the visceral and periph- eral circulations. After exposure to cold and wet, for instance, a chill may be aborted and the subsequent congestion prevented by the use of a hot alcoholic drink combined with pe- diluvia. All agents which dilate the peripheral vessels may be regarded as vascular stimulants when they increase the vigour of the circula- tion in these vessels simultaneously. Such agents are the nitrites, ether, alcohol, dry or moist heat, and to, a less degree ammonia. Stimulating expectorants are agents which increase the tone of bronchial mucous mem- branes which are over-secreting, and by so do- ing diminish the amount and improve the character of the expectorated material. Some of these act by increasing the blood-pressure, others by a direct action upon the mucous membrane. In this group should be included chloride of ammonium, the mineral acids, strychnine, benzoin, the balsams, licorice, sen- ega, terehene, and others of less importance. STCECHAS STRONTIUM 228 When the low pressure under which bile is secreted is interfered with, causing an ab- sorption of the biliary fluid or its partial sus- pension of secretion, hepatic stimulants are indicated. The condition of " biliousness " is so well known, even to the laity, that its de- scription is not needed here. The agents most frequently called into requisition to remedy this state are the mercurial and saline cathar- tics, the mineral acids, and some of the vege- table cathartics. The mere ingestion of food of the proper kind is frequently sufficient to call forth an abundant flow of bile. The stimulant diuretics have distinct indi- cations. When there is an accumulation of serous fluid in the tissues or cavities of the body, when the blood contains harmful toxic or metabolic products, or when the urine be- comes too concentrated, these agents are valu- able. If the excess of fluid is due to cardiac disease, digitalis and strophanthus, by their diuretic action, are of value. If the dropsy is dependent upon renal or hepatic influences, squill, uva ursi, buchu, or the potassium salts may be added. In febrile conditions, in which the solid elements of the urine are usually deficient and their retention is naturally harmful, the stimulant diuretics foster their elimination. For this purpose, and to in- crease the blandness of the renal secretion, the potassium salts, turpentine, caffeine, and ju- niper may be administered. The venous con- gestion of mitral and tricuspid disease and of chronic bronchitis may be relieved by the in- fluence of digitalis upon diuresis. For the de- tails as to all the agents used as stimulants, reference should be made to the separate arti- cles on those agents. — Samuel M. Brickner. STCECHAS.— See Lavandula. STOMACHICS.— By some authors sto- machics are held to include all remedies that promote digestion, such as the digestive fer- ments, etc., but generally the name is restrict- ed to the aromatics and bitters (q. v.). STOKAX, styrax (U. S. Ph.), styrax prce- paratus (Br. Ph.), styrax liquidus (Ger. Ph.), balsamum styracis. liquid storax, is a balsam extracted from the inner bark of Liquidambar orientate (sen imberbe). The tree from which storax is obtained re- sembles in appearance the maple or plane tree, is bushy, medium-sized, with smooth, lobed, stipulate leaves, and smooth, purplish-gray bark. It is indigenous to southwestern dis- tricts of Asia Minor, where it forms forests. Its range is a limited one, not extending to the north or to the islands of the Levant. The balsam is expressed from the inner bark which is scraped off with a sickle-shaped knife after the outer bark has been removed. The inner bark thus obtained is boiled in water from the sea, by which means a portion of the resinous matter is melted out and is skimmed off as it rises to the surface of the liquid. The boiled bark is next subjected to pressure in haircloth bags, with the addition of hot water, and a still further portion of the resin is ob- tained. The storax thus extracted is a soft, resinous compound, of honey-like consistence, and has a peculiar, balsamic, agreeable odour, and a pungent, burning taste. It is of a gray- ish-brown colour and contains a considerable amount of water, to which its opacity is due. The water separates after long standing or on heating, leaving a heavier, yellowish-brown substance which is more or less transparent. With age it improves in odour and hardens, though it always remains sticky. When pure, storax dissolves in alcohol, in ether, in chloro- form, and in most of the volatile oils. Storax is purified by melting and straining or by dis- solving in rectified spirit, filtering, and evap- orating the solvent. Among the more important constituents of storax are the hydrocarbon styrol, or cinna- mine, CsHs, a thin, colourless liquid of fra- grant odour; s0' "^ -^'^^'^l- line body. It is a powerful antiseptic and has been employed to some extent internally in gonorrhoea and in gastro-intestinal catarrh, but its use can not be recommended until further reports of its action are published. STYBAX.— See Stobax. STYRONE. — This is a compound of storax and Peruvian balsam, a yellow, oily, aromatic liquid. Its agreeable odour commends it as an antiseptic and deodorizer. Dr. James A. Spald-- SUCCINIC ACID SUGAR OP MILK 234 ing, of Portland, Maine (Archives of Otology, XX, 3), recommends its use particularly in cases of perforation of ShrapneU's membrane. Largely diluted with alcohol, so that the solu- tion contains from 1 to 5 per cent, of styrone, it may be used for syringing the auditory meatus. It reduces the amount of the dis- charge and overcomes its odour. STJCCINIC ACID, C.HoOi, is a colourless crystalline substance obtained by the distilla- tion o£ amber. Ammonium succinate has been used in medicine (see vol. i, page 58). SUCCINTJM.— See Amber. SUCBOIi. — See Duloin. STJDOBinCS.— See DrAPHORETios. SUET. — Mutton suet, sevum (U. S. Ph.), sevnm prcBparatum (Br. Ph.), purified and ren- dered almost odourless by melting and strain- ing, is employed as a bland application (see Pats and Tallow). STJGAB.— The carbohydrates are organic compounds containing in the molecule six or a multiple of six atoms of carbon and about twice as many of hydrogen. They are divided into three general groups: saccharoses (Cia HsjOii), glucoses (CbHijOs), and amyloses (CeHioOs). These groups are closely allied chemically, the first and third being readily converted into the second. They occur very widely distributed throughout the vegetable kingdom. The term sugar is applied to the saccharoses and glucoses, and in a more re- stricted sense to the saccharoses alone. The sugars have a more or less sweet taste and are very soluble in water. Chemically, they exhibit the properties of polyatomic al- cohols. Sugars, with one or two exceptions, possess the power of rotating the plane of polarized light. When this plane is rotated to the right they are known as dextrorotatory, and are represented by the mark +. When the plane is rotated to the left they are known as liEvorotatory, and are represented by the mark — . The saccharoses all belong to the first class. Of the glucoses, diastase and galactose are dextrorotatory ; levulose and sorgose are la3vorotatory. Bach element has a specific rotatory power peculiEr to itself which is measured in degrees. By taking advantage of these properties very accurate methods of quantitative analysis have been devised. Saccharoses. — The chief saccharoses are saccharose, lactose, and maltose. Saccharose, saccharum (U. S. Ph., Ger. Ph.), saccharum purificatum (Br. Ph.), or cane sugar, CijHjqOh, is the substance to which the term sugar is most commonly applied.' It is found in the juices of most sweet fruits, in honey, in the nectar of flowers, and in the juices of many plants. It is derived chiefly from the sugar cane {Saccharum offieinarum), from sorghum (Sorgho saccharatum), from beet-root (Beta vulgaris), and from the red maple (Acer saccharinum). The juice of the sugar cane is obtained by expressing it from the stalk. By a somewhat intricate process, the crvstallizable portions are removed. These, being 'refined, form the ordinary sugar of com- merce. A brown liquid containing the un- crystallizable portions is left. This is known as molasses, treacle, or syrup. Cane sugar crystallizes in large transparent, double oblique prisms. It is soluble in half its weight of cold water, in one fifth of its weight of boiling water, and in 175 parts of alcohol, but is not soluble in ether. It melts at 220° P. If heated above this point it loses its water, becomes dark in colour, and forms a brown amorphous substance of a slightly bitter taste known as caramel. Strong sulphuric acid chars sugar and leaves a blackened mass. Dilute nitric acid oxidizes it into oxalic acid. Sugar forms a number of metallic compounds Imown as saccharates. By fermentative action sugar yields carbon dioxide and alcohol. In the open air sugar keeps indefinitely, and for long periods of time in concentrated solutions. It is readily decomposed, however, in dilute solu- tion by the action of several fungi, the yeast plant being the most common. It may also undergo acetic, lactic, and butyric fermenta- tion on the addition of specific germs. Sugar has very slight medicinal properties, but is largely used in pharmacy, chiefly in the form of syrups. Simple syrup, syrupus (U. S. Ph., Br. Ph.), is a 6o-per-cent. solution of sugar in distilled water. The numerous medicinal syrups are made either directly from sugar or from simple syrup. They are used for a double purpose — to form a palatable vehicle and to preserve drugs in solution. Sugar enters largely into the composition of the various elixirs, a few tinctures, and some other preparations. ■ It is an important element in troches. It is largely used in cough syrups, and is believed to have some effect in relieving cough. Honey, met, is sometimes used for the same purposes as syrup. It contains a certain amount of glucose. As an article of food, sugar is used in enormous and steadily increasing quantities. It is largely used in the preservation of fruits and some other forms of food. Its excessive use is the cause of much indigestion and dys- pepsia, particularly among children and young adults, as it is prone to undergo acid fermenta- tion in the stomach. In the presence of sour milk it undergoes lactic fermentation with ex- treme rapidity. The addition of it to an in- fant's food may therefore do much to render any tendency to indigestion difficult of control. In diabetes it is necessary to prohibit its use entirely, although it is not the form of sugar which is found in the urine of these patients. [Sugar, either dry or in concentrated solution, may be used as an antiseptic application to wounds, ulcers, etc., in an emergency, when more energetic agents are not at hand. Sugar has been employed as an oxr/tocie. Dr. Bossi, whose account of his experience with it is summarized in the Revue internationale de hibliographie medicate, pharmaceutique et veterinaire for April 25, 1894, found that it answered the purpose well and was free from the inconveniences attending the action ol ergot. In eleven cases of uterine inertia dur- ing labour an ounce of sugar dissolved in wa- ter was given, and in ten of them it had a most 335 SUCCINIC ACID SUGAR OP MILK favourable effect on the pains. The eobolic action of sugar is said to be apparent in from twenty-five to forty-five minutes, and in many cases to be sufficiently prolonged to accomplish the expulsion of the child. In some of Dr. Bossi's eases it was found necessary to give a second dose of the same amount, an hour after the first oue, in order to terminate the labour. The contractions excited by sugar are described as always perfectly regular, never taking on a tetanic character. (See under Oxytocics.)] Lactose, saccliarum lacHs, sugar of milk, da HijOn.HiO, is the saccharose obtained from whey. It is used largely in pharmacy and for the feeding of infants. For a more complete description see Sugae of milk. Maltose, malt sugar, CuHgjOu.HaO, is formed by the action of the diastase of malt upon starch. It is the chief product resulting from the action of saliva and pancreatic juice upon glycogen and starch paste. It is soluble in water and in alcohol, but crystallizes with diificulty in fine needles. For a further de- scription of maltose, see under Malt. Glucoses. — The chief glucoses are dextrose, levulose, inosite, galactose, and sorbinose. Dextrose, or grape stigar, CeHuOe, usually passes under the name of glucose. It is widely diffused throughout the vegetable kingdom, and is found in the greatest amount in grapes, sprouting grains, honey, and sweet fruits. It is often found in the liver and blood of mam- malia, in the yolk of eggs, and in the urine of diabetics. It may be produced artificially by acting upon starch with dilute sulphuric acid. It is thus manufactured in enormous quanti- ties. Corn starch is chiefly used for this pur- pose. It is boiled with dilute sulphuric acid, then rendered neutral with lime, and the re- sulting liquid is drawn off and evaporated down to a syrup, which is allowed to crystal- lize. It crystallizes, however, with more diffi- culty than cane sugar does, and does not usually present the same crystalline appear- ance. It has much less sweetening power than cane sugar has, the proportion being as one to two and a half. Glucose readily forms com- pounds with many metallic salts, especially oxides, and is therefore considerably used as a reagent. It undergoes alcoholic fermentation with the greatest readiness, and is largely used in beer-making as a substitute for maltose. Glucose has no medicinal properties. Its value as an article of food is not wholly settled, but it is not regarded by the best authorities as entirely wholesome. It is believed that it may, if used in large quantities, predispose to diabetes. It is largely sold under the name of sugar, but fraudulently, as its sweetening power is far less than that of cane sugar, and in wholesomeness it is far inferior, ft enters largely into the composition of molasses and syrups designed for food purposes, and is used in very large quantities in making candy. Levulose is closely allied to glucose. It dif- fers from it chiefly in being less fermentable, in its rotatory power, and in a few minor points. Its sweetening power, however, is less than that of glucose. When pure it is easily assimilated. 59 Inosite is a rare compound which has been found in small amounts in the muscles and in diabetic urine. Galactose resembles glucose very closely, but ferments less easily and has greater rotatory power. Sorbinose is a very sweet soluble sugar found in mountain-ash berries. Floyd M. Crandall. SUGAR OF KILK, saccharum ladis (U. S. Ph.. Br. Ph., Ger. Ph.), or lactose, CisHjsOii.HjO, is the peculiar sugar derived from milk. It occurs in white, four-sided prisms, has a sweetish taste and gritty feel, and is soluble in seven parts of cold water. It is insoluble in alcohol, in ether, and in chloro- form. The sugar of milk of commerce is ob- tained chiefly from cow's milk by evaporating whey and crystallizing out the sugar. Cow's milk, according to the extensive observations of Leeds, contains from 3'5 to 55 per cent, of lactose, the average being 4'43 per cent. The lactose of cow's milk is usually stated as 4-5 per cent. The lactose of woman's milk, according to Leeds, varies from 5'4 to 79 per cent., the average being 7 per cent. The lactose at the two milks is iden- tical chemically, physiologically, and phys- ically. The carbohydrates in the food of adults are represented by starches and the va- rious forms of sugar. In milk they consist of lactose alone. Lactose in its chemical proper- ties is intermediate between cane sugar and starch. It occurs in lai;ger quantity than any of the other solid constituents of human milk, forming more than half the total solids. As it is readily soluble, it is easily assimilated and requires but little expenditure of energy to ef- fect its transformation preparatory to diges- tion. In this it differs materially from starch. This is clearly a wise provision of Nature, as the infant can not maintain its animal heat by locomotion. Milk sugar readily undergoes lactic-aeid fer- mentation, at least ten varieties of bacteria be- ing known to produce that result. Butyric fermentation also takes place quite readily. It does not, however, ferment readily under the action of yeast. Until recently it was difficult to obtain per- fectly pure sugar of milk, but the largely in- creased use of it has resulted in improvements in the method of its manufacture. It can now be obtained practically pure and occurs as a per- fectly white, transparent, crystalline powder. Its extreme hardness renders it admirably adapted for use in the trituration of drugs. It is now used for that pui'pose in the manufacture of Dover's powder and in nearly all triturations as well as the tablet triturates. In the manu- facture of these tablets the medicinal agent is triturated with sugar of milk until a thorough and complete division and complete distribution of it have been made. The resulting powder is then made into a paste with varying propor- tions of alcohol and water or other menstruum and afterward moulded into tablets. This method of administering medicine has become very popular during recent years. The medi- SUGGESTION SULPHONAL 236 cinal agent is thoroughly triturated and equal- ly divided, with a consequent perfect accuracy of dose. Most of the tablets containing drugs dissolve readily and are elegant in appearance. Sugar of milk is also considerably employed in the feeding of infants. It is almost universal- ly regarded by paediatric specialists as more satisfactory for this purpose than cane sugar. For further information see Milk, section on Infant feeding (vol. 1, page 633). Floyd M. Crandall. SUGGESTION.— See under Hypnotism. SULPHAMINOL is a thioxydiphenyl- amiue prepared bv B. Merck by boiling raetoxy- diphenylamine with soda and sulphur, filtering, and precipitating with ammonium chloride. < S, XOH. Its formula is given as | I I I XNHX It is an odourless and tasteless yellow powder, insoluble in water, but readily soluble in alka- lies and less readily in their carbonates. Sul- pharainol is an antiseptic and is used chiefly as a substitute for iodoform in the topical treat- ment of wounds, suppurating surfaces, tuber- culous deposits, etc. It is unirritating and non-poisonous. Taken into the system, it splits up into sulphur and phenol. It has been used internally in cystitis in doses of 3f grains, four times a day. Sulphaminol-creosote, an 8-per cent, solution of sulphaminol in creosote, is used topically for the same purposes as sulphaminol. So also are sulphaminol-eucalyptol, sulphaminol-guai- acol, and sulphaminol-menthol. " Sulphaminol salicylate," a mixture of 8 parts of sulphaminol and 92 of salicylic acid, is employed topically like sulphaminol and given internally, in doses of from 3 to 6 grains, in rheumatism. SULPHANILIC ACID.— The sulphanilic acid used in medicine is one of three isomeric compounds of aniline made by heating aniline with fuming sulphuric acid. It forms tabular, prismatic, or laminar crystals which are almost insoluble in cold water, in alcohol, or in ether, but more readily soluble in hot water. Ehrlich has proposed the use of sulphanilic acid as a urinary test and also as a remedy for iodism. It may be given in daily amounts of 90 grains, associated with sodium bicarbonate to facili- tate its solution in water. SULPHATES. — See under Sulphuric ACID. SULPHIDES.— See under Sulphur. SULPHIUriDE.- See Saccharin. SULPHITES. — See under Sulphurous ACID. SULPHOCARBOL.— See Aseptol. SULPHOCABBOLATES, or salts of sul- phocarbolic acid, a combination of equal weights of carbolic acid and strong sulphuric acid, are assumed to possess nearly all the medicinal properties of carbolic acid, but to exert less marked constitutional effects than the acid. Sulphocarbolates of calcium, mag- nesium, potassium, zinc, and sodium, sodii sul- phocarlolas (U. S. Ph., Br. Ph.), are found in the shops. With the exception of the last named, they are almost always used in solutions of varying strength as local applications in diph- theria, the sore throat of scarlet fever, amygda- litis, gonorrhoea, and all conditions in which an astringent and feeble antiseptic is^ indicated. They are sometimes employed in vaginal douches in the puerperal state, and with good results. The zinc salt is probably the most useful in any of the conditions mentioned, as it has the greatest astringent power. The sodium salt is employed internally, in doses of from 10 to 30 grains, in flatulent dys- pepsia, in the vomiting of pregnancy, and whenever there appear to be fermentative changes in the alimentary canal, but, as a rule, it has not proved of great value. Russell H. Nevins. SULPHOCYANATES.— Martinotte {Ri- forma medica, February 13, 1896; British Medical Journal, April 11, 1896) has experi- mented with potassium sulphocyanate as a remedy for pulmonary tuberculosis, but defi- nite results have not yet been reported. SULPHONAL, sulfonalum (Ger. Ph.), or dional, is a synthetical product which was brought into notice in Germany in 1886 by Baumann, and now appears in the market as a semi-proprietary preparation. It is obtained by the interaction of anhydrous mercaptan and anhydrous acetone in the presence of a stream of dry hydrochloric-acid gas. The liquid becomes turbid and separates into two layers, the upper one of which is mercaptol. This is separated, washed, and oxidized by means of permanganate of potassium into sul- phonal, or. in chemical language, diethylsul- phondimethylmethane, (CHs)jC(S02C2.H6)j. It may also be obtained by combining the chlo- ride or the bromide of ethyl with sodium thio- sulphate, treating the product with water to make ethyl mercaptan, which in the presence of alcoholic hydrochloric-acid solution and acetone is condensed to mercaptol, which is oxidized as before. It occurs in heavy colour- less, prismatic crystals, odourless and nearly or quite tasteless. Regarding its solubility in cold water, there appears to be considerable discrepancy of opinion, as various writers state that it may be dissolved in proportions from one to fifty to one to four hundred and fifty. It is certain that it is not very soluble in cold water, but dissolves freely in hot wnter and also in alcohol. It is a very stable body, not affected by concentrated acids, alkalies, or oxi- dizing agents either in the cold or when warm. The physiological action of sulphonal is by no means perfectly understood It would seem chiefly, if not wholly, to affect the cere- bral centres, and a large number of the symp- toms produced — such as somnolence, stupor, disinclination to mental or physical" effort, muscular weakness, inco-ordination and pare- sis, diplopia, aphasia, and slow and weak res- piration and pulse — may perhaps be explained by the theory that the irritability of the cen- tral nervous system is obtunded by its action. 237 SUGGESTION SULPHONAL But this alone does not seem competent to explain other symptoms, suoh as the depres- sion of reflex activity, disorders of the digest- ive tract, and eruptions on the skin. Dr. Seliick, of Easton, Pennsylvania, has investi- gated the physiological action of sulphonal by means of experiments on frogs and rabbits, and his conclusions may be quoted as the best data, on the whole, in our possession at the present time. He found' that moderate doses produced relaxation of the muscles and a stag- gering gait, but did not affect the irritability of the motor or sensory nerve-fibres. Reflex activity was usually depressed, but was some- times exalted. In large doses it depressed the respiration, and this depression was not af- fected by section of the pneumogastric nerve. When it was introduced into the system through the stomach very little if any effect was produced on the circulation, and spectro- scopic examination failed to reveal any change in the blood, but when it was injected directly into the circulation it caused a slight decrease, soon followed by an increase in the arterial tension. Possibly this may be explained by the fact that when it is introduced into the stomach it acts very slowly because of its in- solubility or of its slow absorption, but when it is given subcutaneously in a warm solu- tion its effect appears much more promptly. The method of the elimination of sulphonal from the system cannot be said to have been satisfactorily determined. It has been said by some writers to be excreted in the form of combined or uncorabined sulphuric acid, and it has been said that a certain amount of un- changed sulphonal could be found in the urine. The -theory latest advanced by Smith, of Lon- don, based upon experiments made on dogs, is that in its passage through the system sul- phonal is broken up in such a way as to yield ethylsulphonic acid, and that this is eliminated in the urine. The same experimenter found that moderate doses increased the amount of urea and the quantity of urine excreted, but to so slight a degree that it does not appear that in such doses the destruction of nitroge- nous tissue is materially affected. The phos- phates in the urine are said by some observers to be increased by small and decreased by large doses qf this drug. The colour of the urine is apt to be changed to a reddish brown by the presence of a colouring material which is closely allied to and has generally been sup- posed to be identical with haematoporphyrin. JBy almost every test the two are identical, but an examination with the spectroscope reveals a, difference. It is not certain whether this substance is present in the blood or is formed during or after the process of excretion. Other pigments also are usually present in the urine. The effect of sulphonal upon the blood-cor- puscles is uncertain. Some observers say that they are reduced in number during the use of the drug, but others assert that this is an error. An occasional annoying result of its use is the occurrence of a rash on the skin, of pruritus, or of both combined. In the report of the therapeutic committee appointed by the British Medical Association to investigate the utility of various hypnotics, the disagreeable after-effects of sulphonal are thus summarized : "In six out of ten cases in which 20 grains had been given disagreeable after-effects were noted ; drowsiness next day wag noted six times, giddiness four times, and headache and inco-ordination of gait each twice. In four cases where 10 grains had been given drowsiness was noted once; in five cases with 15 grains drowsiness was noted twice and giddiness twice; with 25 grains (four cases) drowsiness was noted twice, giddiness once, and headache once. In seven cases with 30 to 60 grains drowsiness was noted four times, giddiness twice, inco- ordination of gait and vomiting each once." Many other reports corroborate the frequent appearance of these symptoms, which may be termed mildly toxic, and it would seem as if a consideration of these and of the physio- logical action of sulphonal would cause the physician to exercise great care and discj-etion in its use, at least until the accumulated evi- dence of professional experience had demon- strated its action to be without danger. But such has not been the case. It has been loudly praised and highly vaunted as an absolutely safe hypnotic, and is still advertised as such, although there are numerous cases of death on record, some as the results of moderate doses. The most striking of these, perhaps, is reported by Pettit. A woman, twenty-eight years of age, who was suffering from melancholia with hysterical manifestations, but was not known to have any organic lesion, was given 30 grains of sulphonal in two equal doses an hour and a quarter apart. She slept for twelve hours and then could be roused and could swallow, but somnolence increased for the next twelve hours. The pupils began to contract eighteen hours after the last dose. At the end of forty hours the temperature began to rise, and the patient died in spite of active treatment such as is usually instituted in cases of narcotic poison- ing. iRehm reports a case in which the patient narrowly escaped death as the result of the ad- ministration of 18 grains for three successive days. The usual symptoms of poisoning ap- peared and finally resulted in a state of collapse marked by pallor, speech reduced so as to be hardly audible, a weak and rather rapid pulse, suppression of urine, hypersesthesia, diplopia, meiosis, and inability to move. After the lapse of two weeks the patient could walk with difiiculty. A very serious feature in most of the fatal cases of poisoning is that usually the patients have been under treatment for some time and have been apparently benefited by the drug up to the time of the appearance of the toxic symptoms. Such cases demonstrate that the drug is not so harmless as it has been alleged to be, even though it is not what one writer asserts— the most dangerous of the hypnotics. The symptoms of poisoning are numerous and of varying degrees of severity, and may possibly be explained as due to the action of the drug upon the nervous centres which main- tain a controlling influence over the parts of the SULPEOSALICYLIC ACID SULPHUR 338 body affected. They may be thus enumerated though all are not usually present in one case : Drowsiness, stupor, muscular inco-ordination, incapacity for mental or physical exertion, tin- nitus aurium, headache, vertigo, partial loss of the reflexes, nausea, vomiting, constipation, sometimes diarrhoea, ataxic nervous troubles, diplopia, muscular tremor or paresis, ptosis, oedema of the eyelids, slow and weak (possibly stertorous) respiration, slow pulse, elevation of temperature, general anjEsthesia, urine changed in colour to reddish brown, diminished in quan- tity or suppressed, aphasia, and cyanosis. Death results from cessation of respiration. In sev- eral fatal cases motor paralysis appeared to be the most prominent symptom. Recovery is usually rapid in the non-fatal cases of poison- ing, if the patient is thoroughly purged and the changes in the urine disappear after two or three days. There is no agreement in the observations made after death from sulphonal poisoning as to the lesion produced by the drug. In several cases the kidneys have been pronounced nor- mal. Stern found extensive necrosis of the epithelium of the convoluted tubules and of the ascending limbs of Henle's loops, together with minute haemorrhages in the kidneys due to toxic nephritis. Helweg found the cells of the anterior and posterior horns of the spinal cord degenerated and their number dimin- ished. [Schulz (Neurologisches Centralilatt, Octo- ber, 1896 ; British Medical Journal, Novem- ber 28, 1896) records a fatal case of chronic sulphonal poisoning. The patient, a woman, aged fifty-nine, had been under treatment some years for headaches, constipation, and restless- ness, and was extremely hysterical. On ac- count of sleeplessness she had recently been taking sulphonal in doses of 15 grains, and had taken altogether about half an ounce within a month. When she was admitted into a hospital for obstinate constipation with vomiting there was a smell of acetone in the breath, the tongue was dry and furred, and there was great thirst, with restlessness and insomnia. All the organs otherwise were nor- mal ; the urine was normal. The next evening 25 grains of sulphonal were given, and on the following day the urine was scanty and brown- ish-red, but free from albumin. Pour days later the gait was unsteady, and five days after this there were weakness of the limbs and anaesthesia of the legs down to the ankles ; the knee-jerks, previously normal, were now diffi- cult to obtain. Weakness increased, the knee- jerks disappeared, incontinence of urine and faeces occurred, and two days later the patient died suddenly. The urine, after the single dose of sulphonal mentioned, had continued brownish-red with no albumin, but contained a few altered red blood-corpuscles. The colour was found to be due to haematoporphyrin. Schulz considers that the toxic results after only one dose of sulphonal were due to the ob- stinate constipation present, causing the sul- phonal to be retained in the body longer than usual. Great caution, he says, should there- fore be exercised in ordering sulphonal for patients who are constipated, and where it is ordered a careful watch should be kept of the urine for haematoporphyrin. Mr. F. P. Hearder {Lancet, November 14, 1896; New York Medical Jo^irnal, December 5, 1896) reports the case of a man, forty-three years of age, who. four months previously to his admission, on May 2, 1896, into the Wake- field Asylum, had hurt the back of his head in an accident ; he had suffered much from shock, and had been very nervous afterward. Three weeks before his admission he had cut his throat. On his admission the pupils were un- equal, the right being more dilated than the left, which reacted more perfectly. His knee- jerks were exaggerated, and there was slight ankle clonus. His superficial arteries were thickened and tortuous ; the heart's action was irritable and irregular, and the sounds were accentuated, but there was no bruit. In the urine there was a copious mucous cloud ; it was acid, of the specific gravity of 1-022, and contained no albumin or sugar. His mental state was that of agitated or motor melan- cholia. He had a dejected and lacrymose expression, and he had aural and visual hallu- cinations and delusions that harm (murder, etc.) was happening to his mother and sister; he cried and prayed for their safety. During the next few days he continued restless and sleepless, needed forcible feeding, was con- stantly attempting to tear the bandage off his throat, and required continual supervision. A mixture of potassium bromide with chloral hydrate was given with no good effect. Sul- phonal was then tried (15 grains three times a day), administered in a warm drink, apparently with very good effect, as he took his food bet- ter, slept well at night, and was less restless during the day. On the fourth day his gait was ataxic and his expression and movements were like those of a drunken man. On the sixth day the urine was noticed to be becoming scanty and high-coloured. The use of sul- phonal was at once stopped and the urine ex- amined. It contained no blood and no albumin. On the following day there was marked oli- guria, about 5 ounces of urine having been passed in the twenty-four hours. The urine was- of about the colour of porter which had been shaken ; there was no deposit, it was acid, and of the specific gravity of 1-015. The amount of albumin was exceedingly copious, the urine, on being boiled, becoming almost solid. The patient was in a somewhat soporose state ; there was slight oedema ot the eyelids, but no swelling of the legs and ankles. The pulse was quiet and the temperature about normal. He was kept recumbent, a saline purge was administered, and a diuretic mix- ture containing citrate of potassium and ace- tate of potassium was given, with diluent drinks, milk and soda-water, and barley-water. On the following day the urine was still some- what scanty, high-coloured, acid, and of the specific gravity of 1-020, but it contained no blood or albumin. The patient was better and took food (fluid and semifluid) freely. After that he made considerable physical aiid mental improvement, but continued depressed. Sev- 339 SULPHOSALICYLIO ACID SULPH UR eral subsequent examinations of his urine re- vealed nothing abnormal.] Observers disagree in regard to the eifects produced by suddenly stopping the use of the drug after it has been employed for a consid- erable length of time. Some assert that no ill effects are thereby produced, while others ascribe to its sudden withdrawal a condition which resenibles that produced by the abrupt withdrawal of morphine in morphinism, marked by general weakness, digestive and motor dis- turbances, and vertigo. Sulphonal is slow in its action atid is with- out doubt cumulative in the system. Hence when it is given daily for some time there is danger that it may cause toxic symptoms. This should be guarded against as far as pos- sible by care that the bowels are kept open and that the kidneys act normally and eflB- ciently during its administration, as well as by its prompt discontinuance on the appearance of anorexia, nausea, gastric pain, or other dis- agreeable or toxic symptom. It is mainly employed as a hypnotic, and its use appears to be particularly indicated in cases of mental excitement or distress, over which it seems to exercise a distinct sedative action. Thus, in acute mania, melancholia, and de- lirium tremens, as well as in the milder forms of nervous insomnia, it induces sleep by night and quiet by day, a condition certainly condu- cive to the restoration of the mental equilib- rium. It is not an anodyne and does not re- lieve sleeplessness caused by pain. It has been used to relieve the paroxysms of asthma, hiccough, contyulsions due to teething, and trismus neonatorum. Good results are said to have been obtained from its use as an adjuvant to other treatment in cases of chorea and epilepsy. On account of the relaxation of the muscles which is induced as one of its physiological effects, it has been found eflfieient to arrest spasm of the muscles of broken limhs and to relieve muscular cramps. It is one of the numerous remedies recommended as a means of prophylaxis against seasickness and the similar affection sometimes called " train- sickness." In phthisis pulmonalis, 8 grains of sulphonal are said to be quite as competent as atropine to prevent night sweats equally and to exert this effect for a longer time. In diabetes it has been found to cause a diminution of the amount of sugar present in the urine, but to produce no permanent improvement, as the sugar increases to its former amount immedi- ately upon the withdrawal of the drug. Its use in typhoid fever, chronic opium poisoning, av.i nocturnal enuresis has not been sufficiently extensive to warrant the expression of any conclusion. Bad results have been reported from its use in angina pectoris, and it is now considered to be contra-indicated in this disease. It is difficult to determine the proper dose, not only because this differs with different persons, but also because it may vary at different times with the same person, so that the amount which at one time produced quiet, sound sleep from which the patient awoke refreshed may at another time be followed by unpleasant after- effects, or the expected soporifie effect may be replaced by mental excitement, headache, and other nervous symptoms, or there may simply be a failure on the part of the drug to produce any hypnotic or other apparent effect. In any given case the amount to be given must be de- termined by the judgment of the attending physician, but the average dose may be stated as from 15 to 30 grains once a day or every alternate day. As a rule, men require larger amounts than women. Sulphonal is best administered in hot liquids about two hours before it is desired that the patient shall sleep. A good plan is to dissolve it in boiling water and to give it as soon as it has cooled sufficiently to be potable, flavoured, if wished with a liqueur or cordial. Or it may be given in hot broth, milk, or coffee, and, as it is practically tasteless, it can thus be ad- ministered without the knowledge of the patient. In some cases it may be advanta-, geously combined with small doses of codeine or morphine. (See also under Hypnotics [vol. i, page 509]). — Matthias Lanckton Fostek. SULPHOSALICYIilC ACID, or salicyl- sulphuric acid, C6Hs(S0sH)(0H)C00H, is pre- pared, according to Professor Coblentz, by the action of fuming sulphuric on salicylic acid, and forms white crystals which are soluble in water and in alcohol. It is said to have been employed in the treatment of rhe^imatism. SULPHOTUMENOLIC ACID. — See TUMENOL. SULPHUR is a non-metallic element. It has an atomic weight of 31-98 and is variously bivalent, quadrivalent, and sexvalent. As it occurs in nature, it forms yellow, transparent, rhombic crystals. It is insoluble in water, slightly soluble in alcohol and in ether, but dissolves freely in carbon disulphide, in oil of turpentine, and in benzene. It gives forth a peculiar odour when rubbed and has a very faint taste. In nature it is found free and in combination with metals in the form of the sulphides in many ores, especially copper and iron pyrites. It is very widely distributed, al- though its most frequent occurrence is in vol- canic districts. Sulphur forms one of the constituents of the volatile oils of garlic and mustard and is found in albumins and other proteids. It is found in the Western United States, in Mexico, and in the West Indies, but the chief commercial supply comes from Italy and Sicily. Sulphur is popularly known as brimstone. The sulphur of coranjerce is obtained from the native ore by the action of heat, the sul- phur becoming volatilized. When this vapour is condensed, the sulphur is deposited as a fine, greenish-yellow powder with a slight charac- teristic alliaceous odour and a faintly acid taste from the presence of a trace of sulphlir- ous acid. The sulphurous acid is formed by a slight oxidation of the sulj)hur. This form of sulphur is known as sublimed sulphur, sul- phur sublimatum (U. S. Ph., Br. Ph.), sulfur sublimatum (Ger. Ph.), or flowers of sulphur. It is slightly soluble in oils and in fats, com- SULPHUR 240 pletely soluble in carbon disulphide, and insol- uble in water. When ignited, it burns with a blue flame with the formation of sulphurous- acid gas, and should leave no ash. Washed sulphur, sulphur lutum (U. S. Ph.), sulfur depuratum (G-er. Ph.), is obtained by digesting the flowers of sulphur with dilute ammonia, washing thoroughly, and gently drying and passing through a strainer. Its characteristics are those of sulphur, but it is inodorous. The U. S. Ph. directs that on the addition of water blue litmus paper must not be reddened by washed sulphur. Precipitated sulphur, sulphur prceeipitatum (U. S. Ph., Br. Ph.), sulfur prceeipitatum (Ger. Ph.), is also known as lac sulphuris, or milk of sulphur. It is obtained by boiling sulphur with slaked lime and water, by which process cal- cium sulphide and calcium hyposulphite are formed. The addition of hydrochloric acid decomposes the salts, and the sulphur is pre- cipitated in a fine powder. To be official, this sulphur must be washed until it is tasteless, must be free from acid, and must give no re- action with oxalic acid for carbonate of calcium and water. Because of its extreme fineness, precipitated sulphur is white instead of yellow. Its other properties are like those of sulphur. The antiseptic and antizymotic action of sulphur has been known for a long time. Ap- plied locally in powder, it has the power of de- stroying fungi and other vegetable parasites on man and the lower animals. When ignited, it gives oflE dense fumes of sulphurous-acid gas which are known for their bactericidal action. The fumes of sulphur dioxide destroy the germs of cholera, typhoid fever, diphtheria, glanders, and tuberculosis. The disinfecting qualities of the gas evolved by the burning of sulphur have been recognised by sanitary authorities, and it is the common practice to disinfect rooms that have been occupied by patients suffering from infectious or contagious disease by this means. The laboratory experiments of Squibb and those of Dubie'f and Bruhl (cited in New York IJedieal Journal, August 17, 1889) force one to . the conclusion that the destructive action of gaseous sulphurous acid, SOj, depends upon the moisture in the air aside from its own manifest bactericidal properties. Prolonged action of the pure gas may destroy germs even in a dry condition, according to these observers. To provide the desirable moisture in the air, a small kettle or vessel may be filled with water and heated previous to the disinfecting process, and the articles of furniture and the walls may be moistened with water or some disinfecting solution. All apertures into the room should be closed to prevent the escape of pungent gas ; if necessary, the frames of the windows and doors ftiay be stuffed with rags or cotton. Not less than 3 pounds of sulphur to each 1,000 feet of space must be burned. The powdered sul- phur or fragments of the element should be laid in a pan which rests on a support in a tub of water to prevent fire. In order to hasten the combustion of the sulphur it may be moist- ened with alcohol. This is the method in vogue with the board of health of New York city, and it seems to meet every »pquirement after the occupancy of a room by a patient sick with an infectious disease. Ships which have carried passengers suffeiing from cholera, yel- low fever, or typhus fever may be disinfected in the same way. Koch and Sternberg have shown that the spores of the anthrax bacillus are not killed by fumigation with sulphur, and that it can not be used successfully for the disinfection of clothing or bales of rags, be- cause the gas is lost by diffusion. Taken internally in doses of from 20 to 40 grains, sulphur produces soft stools. The fla- tus, after such a dose, smells strongly of sul- phuretted hydrogen, HjS. If the dose is repeated several times at short intervals, the odour of sulphur is given off by the breath and by the skin. Silver articles worn next the body are blackened, and the linen worn by the patient becomes yellow. Sulphur has also been found in the urine and milk after its ad- ministration. As sulphur is a constituent ele- ment of all albuminous bodies, it seems to be necessary to the animal economy for physiologi- cal purposes. Taurocholic acid contains the element, and it is believed that sulphur stimu- lates the bile-producing function of the liver. Poisonous effects have been observed from the ingestion and from the external use of sul- phur. These symptoms have manifested them- selves in nausea, dysentery, tonic contractions of the muscles of the extremities, the appear- ance of fever, and painful urination. In one case there were extreme prostration, a sulphu- rous breath, clammy perspiration, vomiting and purging, and intestinal colic. Sulphur ap- plied as an ointment is easily absorbed from the skin, and its possible poisonous action must be guarded against. Internally, sulphur may be given as a sim- ple laxative in doses of ifrom SO to 60 grains. It is especially valuable after pelvic or abdomi- nal operations, because of its depleting yet gentle action. On account of the soft stools it produces, it is useful also in piles. To con- ceal its taste, which is disagreeable to some patients, it may be administered in syrup, in milk, in molasses, or mixed with honey. Small doses of sulphur have an alterative effect, and in cases in which digestive disturbances are due to disordered or suspended hepatic func- tion sulphur may evoke good results. As an alterative the dose is from 5 to 30 grains. In colic due to impaction of a gallstone, or of any hepatic origin, daily doses of 5 grains tend to alleviate the symptoms. In cases of chlo- rosis, when iron is not well borne or has failed of its effpct, sulphur may be given in alterative doses. As a stimulant to the bronchial mu- cous membrane in chronic bronchitis, sulphur has some reputation. The formula of Germain See is given here : 9 Precipitated sulphur 50 grains ; Extract of belladonna leaves. . U grain ; Powder of ipecac and opium . 5 grains ; Sugar 20 " M. Make 10 capsules. Use from 2 to 10 capsules a day. In cystitis and in pyelitis of tuberculous or calculous origin sulphur has been recommend- 241 SULPHUR ed and its use has been praised in the treat- ment of dercmgemenf. of the menses. It has been alleged for sulphur that it relieves the muscular pains in gout and rheumatism. Com- bined with iodine, the iodides, or arsenic, it seems to produce beneficial results in rheumat- ic arthritis. The natural sulphur baths have long been reputed to be of benefit in rheuma- tism and gout, and in these ailments the warm baths seem productive of most good. For skin diseases it is likely that partial douching of the affected parts is more effectual than total immersion. The mineral waters containing sulphur are good as laxatives, since they usu- ally contain the earthy and alkaline sulphates. In muscular rheumatism sulphur has had some use, but it is of doubtful value. What is known as balsamum pulmonum is a solution of sulphur in linseed oil to aid in the expec- toration of a chronic or acute bronchitis with profuse sputum. In habitual constipation, hcBmorrhoids, and rectal hcemorrhages Garrod advises the employment of a lozenge contain- ing 5 grains of precipitated sulphur and 1 grain of cream of tartar. In skin diseases sulphur may be given for its tonic effect, and in dis- eases of the nails its use seems to be indicated to supply the element to those organs. Externally or locally, the most efficient em- ployment of sulphur is in the treatment of scabies. The agent destroys the path of the acarus and, as a sulphide, probably kills the parasite and its eggs. In the treatment of this parasitic disease the ordinary ointment of sul- phur or the alkaline ointment may be used ; it makes no difference in the result whether the element is used alone or in combination with alkalies, the main thing desired being the application of the sulphur to the diseased area. Hebra's perfected formula is here ap- pended : ^ OUofTade '"'^'"""' [ ^^"'^ ■ • • • 6 02- ; Grejnrp, J ^^„, ^ „, ^ Chalk 4oz. M. Before the application of this or a similar oint- ment the skin must be washed with soap and warm water. One inunction is made daily for a week, the clothing next to the body remain- ing unchanged. After seven days the patient should take a full bath and be inspected. Too vigorous use of the sulphur ointment may pro- voke a dermatitis which may be difficult to cure. An ointment containing sulphur has been recommended for a host of other skin diseases, among them acne, alopecia areata, sycosis, psoriasis, and tinea versicolor. In the first and last of these a treatment combining the application of an ointment and the use of sulphur baths is said to be particularly effica- cious. Tinea tonsurans is said to be amenable to cure by the use of a sulphur ointment after the clipping of the hair. The fumes of burn- ing sulphur are reputed to be beneficial in the treatment of inveterate forms of eczema, psori- asis, impetigo, and prurigo. For this method of treatment the patient's body, except his head, is inclosed and subjected to the sul- phurous fumes. The fumes of sulphur, like so many other agents, have been alleged to relieve the parox- ysms of whooping-cough. Amenorrhcea of functional origin and rheumatic and scrofulous affections have been known to yield to the fumes of burning sulphur. Care must be taken when the agent is thus employed that a dermatitis does not arise. Applied in the form of a powder, sulphur has been used since the days of Pliny as a rem- edy for lumbago. It is said to be eflBcient in the treatment of sciatica and of other periph- eral nervous disturbances. Sulphur ointment, spread over the body in 'cases of erysipelas, measles, and small-pox, is said to allay the heat of the skin and the cutaneous congestion and, in the last named disease, to disinfect the pus- tules. Before the days of the specific treatment of diphtheria the insufflation of powdered sul- phur was in high favour in the treatment of this disease and of croup. Baumler, of Frei- burg (cited in Practitioner, August, 1894), says that in diphtheria, judging from his observa- tion in a large number of cases, sulphur is better as a local application than any of the other agents he has used. Sublimed sulphur, applied with a camel's-hair brush every two or three hours or insufflated an equal number of times, has uniformly given good results in his experience. To be of service it must be applied thick. Even in cases of gangrene of the uvula and of part of the soft palate he has observed an improvement in a few days. He adds that this method of treatment is best when the disease is confined to the fauces, but urges the insufflation of sulphur in cases of laryngeal diphtheria. In the treatment of tuberculous joints and of tuberculous osteomyelitis sulphur has been used with excellent effect, applied as part of the dressing. In infectious bone processes, whether of tuberculous astiology or not, an emulsion of sulphur and glycerin may be injected into the cavity and allowed to remain for twenty-four hours, with satisfactory results. Ulcerative stomatitis yields to the local appli- cation of sulphur. At a meeting of the Royal Medical and Chirurgical Society of London Mr. Lane reported the results of a year's expe- rience with the use of sulphur in surgical prac- tice (cited in Medical News, January 19, 1895). He found that neither sulphur nor its by-prod- ucts had a deleterious influence upon the life or health of a patient. Its contact with re- cently incised healthy tissues for twenty-four hours sufficed to render the parts free from organisms. Advantageous results accrued from the local application of sulphur to parts poorly supplied with blood or already in a state of gangrene. In these instances the sulphur may be left on for a longer period of time. The same statement applies to granulating . surfaces. Sulphur, says this author, destroys all organisms, whether free in a cavity or lying in the surrounding tissues. Finally, the action of sulphur is painless, says this surgeon. An ointment, unguentum sulphuris, is prepared SULPHURIC ACID SUPPOSITORIES 243 by the direction of the U. S. and Br. Ph's, the former consisting of 30 parts of sulphur and 70 of benzoinated lard, that of the latter contain- ing 20 parts of sulphur and 80 of benzoinated lard. The Br. Ph. also recognises a eonfectio sulphuris containing 4 oz. of sublimed sulphur, 1 oz. of powdered acid potassium tartrate, 4 fl. oz. of syrup of orange peel, and 18 grains of powdered tragaoanth. Sulphur iodide, sulphuris iodidum (U. S. Ph., Br. Ph.), is a local stimulant and caustic. It is sometimes used topically in the treatment of shin diseases accompanied with infiltration. The Br. Ph. authorizes an ointment, unguentum sulphuris iodidi, consisting of 5 parts of sul- phur iodide, 15 of solid paraffin, and 55 of vaseline. Bousquet (Presse medicate, July 15, 1896) suggests its employment as an anti- septic. There are many preparations which contain sulphur or its derivatives. Thus, compound licorice powder, which is official, contains 8 per cent, of washed sulphur; iohthyol is rich in the element under consideration. Potassa sulphurata, sulphurated potassa, is official in the U. S. Ph. It is prepared by the simultaneous heating of carbonate of potassium and sulphur. It is brownish in colour and has a most disagreeable, alkaline taste. Locally, potassa sulphurata is a powerful irritant ; taken internally, it produces symptoms of irritation in the mucous membranes with which it comes in contact. It is employed in stimulating ointments in shin diseases of a scaly character and may be used to make sulphur baths, the strength varying from 1 to 3 oz. of the prepara- tion in 15 gallons of water. Employed in too great strength, the baths produce dermatitis. The baths have been recommended in rheuma- Galx sulphurata (U. S. Ph., Br. Ph.), calcavia sulfurata (Ger. Ph.), or calcium monosulphide, is a pale-gray powder with a nauseous alkaline taste. It decomposes on exposure to the air. It is sparingly soluble in water. The drug has had a wide use, based on reliable clinical re- ports, in the treatment of suppurative diseases, of boils appearing in successive crops, and of glandular enlargements due to tuberculous invasion. The dose is from iV to | of a grain, frequently repeated. This preparation is some- times wrongly called " calcium sulphide." [The action of the sulphides and that of sul- phuretted hydrogen are essentially that of sulphur.] — Samuel M. Briokner. STJIiPHXTB.IC ACID, acidum sulphuricum (U.S. Ph., Br. Ph.), acidum sulfuricum(GeT. Ph.), is a highly corrosive liquid of an' oily appear- ance, employed largely in the arts and to some extent in medicine. On account of the frequency with which it is met with it is often the cause of severe burns of the surface of the body and of death when accidentally taken internally. The symp- toms caused by it do not differ essentially from those due to other corrosive substances, but, as a rule, the parts with which it has come in contact are blackened and charred. Magnesia, lime, and soap are the appropriate chemical antidotes, but to be of avail must be adminis- tered promptly. As an escharotic, sulphuric acid is.hardly to be preferred to nitric acid, as by itself it penetrates deeply and is not easily controlled. Combined with charcoal (Ilicord's paste), asbestos (Jlichel's paste), saffron (Vel- poau's paste), or zinc sulphate, it is more man- ageable and may be used in the treatment of chancres and other superficial lesions requiring cauterization. A liniment containing about 1 part of the acid to 3 parts of olive oil is a de- cided counter-irritant. Diluted sulphuric acid, acidum sulphuricum dilutum (U. S. Ph., Br. Ph.), acidum sulfuricum dihitum(Gev. Ph.), and aromatic sulphuric acid, acidum sulphuricum aromaticum (U. S. Ph., Br. Ph.), are practically of the same strength and are adapted to the same purposes, the latter, however, being rather more agreeable to the taste, as it contains small amounts of ginger and oil of cinnamon. When the action of a mineral acid is desired in disturbances of digestion it is not advisable to employ sulphuric acid, as, although it may afford temporary relief, its prolonged use is followed by interference with the functions of the gastric juice. The same may be said of its employment in fevers. In such conditions hydrochloric or uitrohydrochloric acid is pref- erable. It is, however, of decided value in the treat- ment of nearly all forms of diarrhosa, provided the dose is not large, especially when combined with opium or carminatives, and it is particu- larly useful in Asiatic cholera and the diar- rhoeas prevalent during an epidemic of cholera. In the latter conditions small doses, from 3 to 5 drops, of the diluted varieties may be given every half hour until a beneficial action has been observed. As a prophylactic against cholera, it is usually held in high esteem. Per- sons exposed to the contagion may drink freely of a 1- or 3-per-cent. solution, which may be sweetened if it is desired. In the treatment of colliquative sweating sulphuric acid is sometimes employed with good results, and also in hcemorrhages of vari- ous kinds. The cathartic properties of magnesium sul- phate are increased by its combination with this acid. The dose of either the aromatic or the plain diluted acid is from 10 to 30 drops, well diluted. [A somewhat stronger preparation is the modern form of Haller's acid eli.rir. The mixtura sulfurica acida (Ger. Ph.), misturn sulphurica acida (N. F.), consists of 1 part of sulphuric acid and 3 parts of alcohol. The dose is from 5 to 20 drops.] Sulphates, or combinations of siilphuric acid and bases, are, as a rule, freely soluble in the ordinary menstrua, and are generally more or less astringent. The sulphates of the or- ganic bases are usually soluble in water, and those which are not are rendered so by a small amount of sulphuric acid, a soluble bisulphate usually resulting. The alkaline sulphates are cathartic, while those of the metallic bases de- pend upon the metal for their therapeutic ac tion.— Russell H. Nevins. 243 SULPHURIC ACID SUPPOSITORIES STJLPHTJE.OTJS ACID, acidum sulphuro- sum (U. S. Ph., Br. Ph.), is a 6'4-per-cent. solu- tion of sulphurous-acid gas (sulphur dioxide) in water. It is a colourless liquid having the odour of burning sulphur. It should be kept in dark amber-coloured, glass-stoppered bot- tles in a cool place and away from the lig:ht. It is an energetic antiseptic and germicide. It is chiefly used as a topical application in cases of tinea versicolor. The undiluted solu- tion may be rubbed on the affected skin once or twice daily ; if it is to be applied continu- ously, it should be diluted with three or four times its bulk of water. Internally, the acid has been used to some extent in the treatment ot fermentative dyspepsia and hay fever. The dose is from ^J to 1 fl. drachm, largely diluted. The sulphites are more suitable for inter- nal use than the acid, since they give oflE the acid in a nascent state in the stomach. ' They may be given, dissolved in an abundance of water, in daily amounts of 15 grains. The sodium compounds, sodii sulphis (U. S. Ph., Br. Ph.) and sodii hisulphis (U. S. Ph.), are most commonly used. A 10-per-eent. solution of sodium sulphite has been employed as an antiseptic. SUMACH BEBRIES.— See Rhus glabra. SUMACH, SWEET. — See Rhus aro- MATIOA. SUMBUL (U. S. Ph.), sumUa radix (Br. Ph.), or musk-root, is the root of Ferula Sumbul, an umbelliferous herb indigenous to the moun- tains between Russian Turkestan and Bu- charia. Sumbul is a stimulant to the nervous system, also a tonic. It has been used in cholera, in asthenic diarrhoea and dysentery, in delirium tremens, in hysteria, in neuras- thenia, and in chronic bronchitis. The dose of the powder is from 3 to 8 grains ; that of the tincture, tinctura sumbul (U. S. Ph., Br. Ph.), is from 10 to 30 minims. There is a non-ofB- cial extract, the dose of which is a grain. SUPPOSITORIES.— These'are solid bodies intended to produce a local action by the grad- ual liberation of some active constituent held in solution or suspension in a medium which fuses more or less slowly at the temperature of the body. According to the place of applica- tion, suppositories are of various shapes and sizes. Rectal suppositories are usually of a conical or double-cone shape and should weigh about 15 grains. Vaginal suppositories are globular, and shoiild weigh about 45 grains. tJrethral suppositories are pencil-shaped, and should weigh about 15 grains. Suppositories are usually made with cacao butter as the base. Frequently, also, a mixture of gelatin and glycerin is used. Suppositories may either be rolled by hand, cast in moulds, or formed by pressure. Rolled or hand-made suppositories are pre- pared by grating or scraping the required quantity of cacao butter into a mortar, then adding the prescribed amount of medicinal substance, either in fine powder or in the form of a smooth paste, and mixing the whole thor- oughly to a sort of pill mass, which is then rolled out to a cylinder. This is cut into the intended number of pieces, and each piece then rolled into a cone. To prevent adhesion, particularly in warm weather, the mass must be rolled in lyoopodium or some other neutral powder. Moulded or cast suppositories are prepared by melting the necessary amount of cacao but- ter and incorporating with it the medicinal ingredient either in powder or in the form of paste, or in solution in some liquid which will mix with the cacao butter (such as oleic acid, olive oil, etc.). The moulds having been pre- pared by carefully cleaning and wiping them with an oily cloth, they are filled with the melted mass, which must be not too far from the congealing point. It is best to fill them to overflowing, as the mass shrinks a little in the centre of the base on cooling. And if the medicinal constituent is a heavy powder, the mass must be constantly stirred in the capsule from which it is poured. The moulds are then placed on ice and, when the suppositories are sufficiently set, freed from the excess of adhering mass, whereupon the suppositories are removed. Pressed suppositories are prepared in special hand-machines. The mass is made in the usual manner and introduced into the apparatus, where it is allowed to set. By means of cer- tain pistons or plungers the mass is then forced into moulds by pressure. Various ma- chines are in use for this purpose, but they all work on the same principle. In warm weather, or when too much of a soft or liquid mass is to be incorporated with a given amount of cacao butter, some wax or spermaceti must be added to give consistence to the mass. This addition, however, must be carefully adjusted to the circumstances of the case. The melting point of the mass should never be higher than 95° F. For a number of years past some firms have put various sizes of ready-made hollow sup- positories on the market, which are intended to be filled with the medicinal mixture. They are very convenient, but care must be taken that the filling is of the proper composition, so that when the outer mantle is melted off the intended action upon the mucous mem- brane may take place in the manner desired. For urethral suppositories, or bougies, gela- tin is usually preferred, as it is not so likely to break or crumble while being introduced. Gelatin of the best quality is soaked in water until it has been softened, and the excess of water is poured off. For every 12 parts of soft gelatin 5 parts of glycerin are added, the mixture is melted in a water-bath, the medic- inal substance is then added, and the mass is poured into a suitable mould or into glass tubes the interior of which has been coated with oil. When the mass has been thoroughly cooled it may be removed from the glass tubes by means of an oiled glass rod. The U. S. Ph. gives only one working for- mula for a special kind of suppository, but gives general directions for all others. Glyc- erin suppositories are directed by the U. S. Ph. to be made in the following manner: 3 grammes of sodium bicarbonate are to be dis- SUPRARENAL CAPSULE 244 solved in 60 grammes of glycerin in a capsule on a water-bath ; then 5 grammes of stearic acid are to be added, and the whole carefully heated until this is dissolved, and no more carbonic- acid gas escapes. The mass is then to be poured into suitable moulds, so as to produce ten suppositories. When they are set, each should be wrapped in tin foil and introduced into a glass tube to be corked at each end. Dieterich recommends preparing glycerin suppositories by mixing 90 grains of finely powdered stearin soap with 3 oz, of glycerin, heating until solution has been efEected, mak- ing up any loss by evaporation of water, and then casting in moulds. This quantity is in- tended for from twenty-iive to fifty supposi- tories. (Cf. Cacao butter.) Charles Rice. STTPRAIlEirAL CAPSULE.— The su- prarenal capsule and an extract prepared from it have been further used since the article on Animal extracts and juices was written, and various observers have published accounts of their experience. In a communication pre- sented to the Physiological Society, of London, on March 16, 1893 {Journal of Physiology, April, 1895), Dr. G. Oliver and Professor B. A. Schafer referred to some earlier experiments showing that when an extract, whether pre- pared with water, alcohol, or glycerin, of the suprarenal bodies of the calf, sheep, or dog was injected — even in very small quantities — into a vein in a dog or a rabbit the following pronounced physiological effects were produced in a few seconds: 1. Extreme contraction of the arteries, which was shown to be of periph- eral origin. 2. A remarkable and rapid rise of the arterial blood-pressure, which took place in spite of powerful cardiac inhibition, and be- came further augmented when the vagi were cut. 3. Central vagus stimulation, so pro- nounced that the auricles came to a complete standstill for a time, although the ventricles continued to contract, but with a .slow, inde- pendent rhythm. 4. Great acceleration and augmentation of the contraction of the auricles and ventricles after section of the vagi, the au- ricular augmentation being especially marked. 5. A slight change in the respiration, which became shallower. A large number of subsequent observations made on dogs, cats, and rabbits had confirmed these results. As in their earlier experiments, watery decoctions of the glands had been chiefly employed by them. The suprarenals experi- mented with were derived from the calf, the sheep, the dog, the cat, the guinea-pig, and man. The physiological results were exactly the same whatever the source of the glands, except with regard to two which were taken from subjects of Addison's disease. The fol- lowing effects are given by the authors : 1. As a rule, when the intravenous mode of adminis- tration was adopted, a definite small quantity of the extract representing a known weight of the fresh gland was injected. In exceptional instances, however, a continuous flow of a 5- per-cent. solution of the extract was employed. In these instances the physiological effects were maintained during the entire time the injec- tion lasted, but without the development of other apparent symptoms and without causing death. In this way large doses of the extract were administered to the dog, thereby produc- ing the most violent cardio-vascular disturb- ance without causing a fatal result. 2. In a former communication the inference as to the extreme contraction of the arteries had been derived from observations on the blood-press- ure, from the use of the limb plethysmograph, and from the arrest of the flow of normal saline solution through the vessels of a frog caused by the addition of a small quantity of suprarenal extract. Several observations with the oncometer had confirmed this conclusion and shown that it might be extended to the vessels of the kidneys, for the tracings showed a well-pronounced reduction in volume of that organ during the suprarenal effect on the cir- culation. 3. It was observed that stimulation of the depressor nerve did not produce the usual reduction of the blood-pressure while the effects of the suprarenal injection lasted ; if the depressor nerve in the rabbit was stimu- lated at the height of the pressure caused by intravenous injection of suprarenal extract, the usual fall of blood-pressure was not produced, and no depressor result was' to be obtained un- til the blood-pressure had again become nearly or quite normal. The depressor result reap- peared simultaneously with the Traube-Hering curves, if these were seen at all in the tracing. 4. It was invariably found that the heart's action was remarkably accelerated and augmented in the dog, the cat, and the rabbit after section of the vagi. It was not found that solutions of less than 1 per cent, of suprarenal extract in Ringer's circulating fluid would affect the frog's ventricle with certainty, recording its pulsations In a heart plethysmograph. The following results, however, were obtained with this and with stronger solutions — up to 5 per cent. : 1. Reduction of diastole, with consequent acceleration. 2. The abolition of groups of contractions and the setting up of continuous pulsation. 3. The arrest of the ventricle in systole. As this extreme effect of the extract was not prevented or antagonized by potassium chloride, the conclusion was that it was due to calcium salts in the extract, for Ringer had shown that the calcium effect upon the con- traction of the frog's ventricle was counter- acted by potassium. Moreover, the individual contractions did not show the characteristic calcium effect. On the contrary, each individ- ual contraction remained normal, although the acceleration produced by the drug might ulti- mately be sufficient to prevent the completion of the diastole, and the contractions might thereby be caused to run together. 5. The paralyzing effect of the subcutaneous injection of the extract — about 1 or 2 grains — in the frog had not been observed in other animals experimented on in this way, except from lethal doses in the rabbit. It had been observed, however, in dogs subjected to intravenous in- jections of the extract, that when the muscles were electrically stimulated through the nerve supplying them, a modification of the normal 245 SUPilARENAL CAPSULE contraction was apparent, the relaxation being delayed, as in the case of the frog's muscle. This effect, moreover, not only was observed while the suprarenal rise of the blood-pressure was being recorded, but was traceable for some time after that rise had passed away. It was therefore inferred that the active material was probably taken up by the muscular tissues and remained for a time stored within them. 6. No definite effect upon the secretion of the submaxillary gland was observed as the result of injecting suprarenal extract into the blood. The chorda tympani was not found to be any less active in promoting the secretion of the gland in an animal the blood-vessels of which were contracted by the extract. 7. It was found that when two extracts were prepared of equal strength, one of the cortex and the other of the medulla of the perfectly fresh gland, the intravenous injection of the former would not produce the characteristic cardio- vascular disturbance, while that of the latter in the same dose would induce it in a marked degree. It is, however, the authors say, some- what difficult to prepare the cortical extract perfectly free from a trace of the medulla, so that it may happen that a comparatively large dose of cortical extract may produce a slight physiological effect ; but not more than that of a much smaller portion of the medullary extract. The conclusion, therefore, is that the active principle of the extract is present in the medulla only, the effects obtained from the extract of cortex being small and inconstant and probably to be explained by accidental contamination or post-mortem diffusion. 8. Experiments were made with suprarenals from three subjects — one in which the glands were healthy, and two others in which they were diseased (cases of Addison's disease). The healthy organs yielded an extract of great physiological activity, whereas the diseased adrenals afforded one which gave no result. 9. In regard to the oral administration of the ex- tract as a remedy, it seemed desirable to ascer- tain whether peptic digestion impaired its active properties. A little of the watery ex- tract of the gland was added to artificial gastric juice (pepsin + O'S per cent, of hydrochloric acid) and exposed to a temperature of 104° P. for twenty-four hours. The intravenous injec- tion of a small quantity of this and of an equal portion of the same extract diluted at the time to the same extent with 0-2 per cent, of hydro- chloric acid produced identical physiological effects. The injection of an equivalent amount of acid as a check experiment produced no effects. The authors, therefore, do not think it likely that gastric digestion will seriously lessen the physiological properties of the extract. Experiments were made with the view of as- certaining how the extract was eliminated or disposed of, and whether the active principle was destroyed in the blood. This seemed not improbable, as it was found that alkalies and oxidation destroyed the activity of the extract. It was observed, however, that when allowed to stand in freshly drawn blood with free ex- posure to the air, or with complete exclusion of air for twenty-two hours, the extract pos- sessed the same activity as when preserved in exactly the same manner in normal saline. As an altered contraction of the muscles was ob- served to persist after the subsidence of the cardio-vascular disturbance set up by the in- jection, it seemed probable that the active principle of the extract passed out of the blood into the muscles, and remained there for a time. The authors have shown that in Addison's disease the adrenals may become totally devoid of the physiologically active material. If these bodies are to be regarded as eliminators of toxic materials rather than as producers of materials which are of definite physiological value, they say the toxic materials they should remove or destroy might be expected, in cases in which their function is in abeyance, to pass out by the kidneys. They have found, how- ever, that an extract prepared from the urine in Addison's disease has precisely the same effect when injected into a vein as that of an extract prepared from normal urine. In fact, all the evidence they have leads them, says Dr. Oliver, to view the function of the suprarenal bodies — at least the medulla — as secretory rather than destructive, and the secreted product as being in all probability of great physiological impor- tance for maintaining the tonicity of the mus- cular tissues in general, and especially that of the heart and arteries. Dr. Richard C. Cabot, of Boston (Medical News, September 12, 1896), has collected ac- counts of twenty cases of the treatment of Addison's disease with suprarenal-capsule preparations. In nine of them the patients have been considerably improved. He thinks that the various fluid extracts are very inferior to the gland itself, dry or raw. Tonoli (Gazzeita medica lombarda, August 17, 1896 ; British Medical Journal, October 24, 1896) reports the case of a woman, aged twenty, who had suffered from Addison's dis- ease for some fourteen months. "When seen she presented all the classical signs and symp- toms of the disease. On February 26th 20 grains of the powdered suprarenal capsule were directed to be given daily in pills, the dose being gradually increased to 2-J- grains. On March 6th the patient already felt better ; the pains in the stomach and lower limbs had dis- appeared. By March 31st the pigmentation had become less marked, the appetite was better, and the strength had increased. On April 10th she walked well, and her strength was much greater. The menses returned after ten months' absence, and her weight increased. The patient then went out, and the treatment was suspended. Meantime the temperature had come down to normal, the weight had in- creased decidedly, the black patches had disap- peared from the mucous membrane, and the slight signs which had first been noticed at the apices of the lungs had disappeared. The author considers this was a case of cure (so far as it went), and not a mere spontaneous remis- sion in the course of the disease. In the Journal des praticiens for April 18, 1896, M. Huchard, writing on the use of the suprarenal capsule in neurasthenia, remarks SWEET OTL SYMPTOMATIC TREATMENT 246 that Brown-Sequard's experiments and the more recent ones of Abelous, Langlois, and Albanese established the fact that the physio- logical function of the suprarenal capsules was to transform or to destroy the toxic substances which are produced in the organism under the influence of muscular activity and of the nerv- ous system. We may thenci understand, he says, why the destruction of these organs ex- perimentally or by disease is capable of caus- ing in the organism an accumulation of toxic agents which is the principal cause of the seu- sation of extreme fatigue and of the profound and generalized asthenia experienced by pa- tients who , suffer with Addison's disease. In neurasthenia, then, he says, patients may be benefited by this treatment. Up to the present time, says M. Huchard, the observations have not been numerous enough to permit of absolute conclusions on the results obtained, but he thinks the remedy is worthy of attention. He thinks that the treatment should be persevered with, not only because it seems to be indicated by pathological physiology, but because it has not yet given rise to accidents when used in moderation. The fresh gland, to the amount of from 1.5 to 30 grains a day, may be taken by the mouth. Dr. W. H. Bates, of New York {New York Medical Journal, May 16, 1896), has employed an aqueous extract of the suprarenal capsule of the sheep topically in various diseases of the eye. The extract used by him is prepared by subjecting the dried and powdered suprarenal capsule of the sheep to the action of cold water for a few minutes, filtering the liquid, and evaporating it to dryness at a temperature be- low 105° P. It requires 16 oz. of the fresh glands or 8 oz. of the powdered desiccated glands to make an ounce of the aqueous extract. The active principle of the suprarenal gland is described by Dr. Bates as very soluble in wa- ter, 1 part of the extract dissolving in some- what less than 3 parts of water. It is insoluble in strong alcohol, but soluble in dilute alcohol on account of the presence of water. It is also insoluble in ether or chloroform. The dried ex • tract has remained immersed in strong alcohol, in ether, and in chloroform for several months without apparent injury. The dried aqueous extract is brown. The colour depends partly on the temperature at which it is dried ; the higher the temperature, the darker the colour. It does not crystallize. When moist, it is slight- ly sticky; when dry, it is brittle. It has a slight odour resembling that of extract of beef. The most chafacteristic chemical property is its reaction with tincture of iron. A drop of tincture of chloride of iron added to a neutral solution of the aqueous extract produces a green colour which gradually disappears. A precipitate is formed, and the addition of more of the iron solution may produce the green colour again, with the formation of more of the precipitate. The supernatant fluid loses its colour at the same time that the precipitate is formed. Finally, it is possible to add sufficient tincture of iron to make the solution of the extract clear, and the addition of more iron does not produce the green colour. The pre- cipitate contains the extract and the iron, be- cause the filtered finid evaporated to dryness leaves no residue except the excess of iron. The precipitate is black and Is composed in part of metallic iron, probably. Dilute hydro- chloric acid dissolves the precipitate and the solution becomes reddish. Dr. Bates's explanation of these phenomena is that the extract is a strong reducing agent. The green colour, he thinks, is due to the fact that the red perchloride is reduced to the green sesquiohloride by the extract. It changes to the black of metallic iron by further reduction with the extract. What becomes of the ex- tract will require further experiments to de- termine. The reducing action of the extract he regards as remarkable. The reaction of tincture of iron with the extract is very deli- cate. A solution of less than 1 per cent, of the extract will produce the green colour on the addition of tincture of iron. If the extract is in a very strong solution, it may reduce the chloride "of iron to the metallic state so quick- ly that the green colour may not be observed. 'This reaction, says Dr. Bates, does not occur with solutions of the thyreoid, thymus, testicle, or pineal gland. The extract does not keep unless it is steril- ized. It is incompatible with mercury bichlo- ride, silver nitrate, copper sulphate, and other astringents ; indeed. Dr. Bates declares that it " does not act well when combined with other substances." When he used it in solution with cocaine, he found that the eye was irritated and not anaesthetized, and he thinks that in such a solution the medicinal properties of both drugs are impaired. The extract employed by Dr. Bates may be administered by the mouth in considerable doses without harm resulting, but large doses, particularly it given subcutaneously, may pro- duce alarming results. A lady, aged eighty- seven years, had a pulse of forty, which was intermittent and irregular ; after the extract had been used in the eye for a few days the pulse became regular, increased to eighty, and remained so during a period of six months that the extract was used. A woman, aged thirty years, swallowed 60 grains at one dose. She vomited immediately, but felt no other ill effects. A man, aged sixty years, after taking 2 grains three times a day for a week, was sud- denly attacked with a peculiar eruption on his hands, which disappeared in ten days without treatment after stopping the use of the extract. In one case 10 grains given subcutaneously produced alarming symptoms. The face was livid; there was great pain in the head and chest, with a feeling of throbbing. Conscious- ness was not lost. The pulse was weak. In ten minutes the patient felt able to walk home from the dispensary, a distance of more than a mile. Dr. Bates regards the extract as a powerful astringent and hcemostatic. When it is in- stilled into the eye the conjunctiva of the globe and lids is whitened in a few minutes. The effect is very decided. None of the usual astringents, including cocaine, he says, can produce such an astringent effect. In normal 247 SWEET OIL SYMPTOMATIC TBEATMENT eyes the extract whitens the conjunctiva and sclera when used in very weali solutions — less than 1 per cent. The eflfeet is increased by repeated instillations or by the use of stronger solntions. He mentions the following diseases of the eye in which the extract has whitened the con- junctiva and solera : I'rachoma, acute catarrhal conjunctivitis, chronic conjunctivitis, phlyc- tmnular conjunctivitis an d keratitis, interstitial keratitis, rheumatic and syphilitic iritis, epi- scleritis, irido-cyclitis, sympathetic ophthal- mia, atrophy of the globe, si^condary glaucoma, traumatic conjunctivitis, traumatic keratitis, traumatic iritis, traumatic kerato-irifis, lacry- mal inflammations, and rheumatic ophthalmia. The extract is not iiTitating. It generally produces a cooling sensation when dropped into the eye. It does not dilate or contract the pu- pil, and it has no effect on the accommodation. A tolerance was not established in two oases in which the extract was instilled into the eye several times daily for more than three months. A third patient used the extract daily for more than twelve months, and it whitened the eye- ball and palpebral conjunctiva as well at the end of the twelve months as at the beginning. The astringent effect of the extract on the con- junctival vessels is temporary — usually in an hour the eye looks as il did before the extract was used. There is no congestion after the astringent effect has passed off. Dr. Bates is not positive that the extract is curative in any form of conjunctivitis ; but the immediate effect of its employment is very grateful to the patients. He has found it of material benefit by reducing congestion in in- terstitial keratitis, glaucoma secondary to cata- ract extraction, and iritis, and as an adjuvant to cocaine. "An operation on some nervous people is unsatisfactory, because cocaine does not produce ansesthesia. Such cases are quite common. A woman was operated upon re- cently for tenotomy of the inferior rectus. The cocaine did not whiten the ocular conjunc- tiva, dilate the pupil, or produce anaesthesia after being instilled frequently for an hour. A few drops of the extract whitened the ocular conjuneliva, and the cocaine in five minutes dilated the pupil and produced anjesthesia. The operation caused no pain. Traction on the tendon of the muscle with the hook was not painful. There was very little ha;mor- rhage. A previous operation on the same mus- cle, using cocaine alone, was painful, and there was an unusual amount of haemorrhage. The eye was bleeding six hours later. The eye was sore for two days. The extract in this case had a very happy effect by securing a painless operation without haemorrhage and without soreness afterward." Dr. Bates adds that an operation which re- quires more than a few minutes becomes pain- ful in some cases, although cocaine may be instilled frequently. Advancement of an ocu- lar muscle, he remarks, is generally so painful that many operators are compelled to use ether anajsthosia. The operation may begin pain- lessly, but subsequently the anaesthesia wears off, particularly if there is hcemorrhage. The extract, when frequently instilled, prevents haemorrhage, and the cocaine angisthesia is prolonged indefinitely for this reason. As soon as bleeding occurs, one notices very soon the sensitiveness of the eye returning. A numlDer of advancements have been done painlessly and almost bloodlessly by the use of the extract and cocaine together. The extract prevents hjemorrhage, says Dr. Bates, because of its property of contracting the small arteries. After haemorrhage be- gins it IS not very efficient. It is possible to perform an almost bloodless operation on the ocular muscles or lacrymal sac by instilling the extract frequently. The following case illus- trates its ^alue as a hfemostatic: A man was operated upon four times during three months for stricture of the nasal duct. After each operation the patient lost enough blood to saturate two towels and sometimes more. The hasmorrhage was unusually copious, and the operations were very painful. A fifth opera- tion was done in which the suprarenal extract was used with the cocaine. There was no pain and very little haemorrhage. The towel used had on it one spot of blood a quarter of an inch in diameter. SWEET OIL.— See Olive oil. SYMPHOROL.— The symphorols include sodium sulphocaffeinate, lithium sulphocaffe- inate, and strontium sulphocaffeinate, but the first-mentioned, called also sodium caffeine- sulphonate, is ordinarily meant. It is a crys- talline, bitter, non-poisonous substance, acting powerfully as a diuretic. The dose is 15 grains, to be given from three to six times a day. SYMPTOMATIC TREATMENT.— The symptomatic treatment of disease involves, in a certain degree, a confession of ignorance of cause and eliect, since it is an acknowledgment that the ultimate astiology has escaped detec- tion, and that it is therefore impossible to attack the fountain of origin. This do s not imply that the pathology of a disease, which we are forced to treat as its symptoms arise, is ill or not at all understood ; for although the morbid history may be perfectly clear, the therapeutic resources at our command may not be such as to admit of our applying them with invariably successful results. In consideration of repeated observation and of manifold expe- rience, certain substances which relieve certain symptoms, increase function, or limit diseased processes are relied upon to furnish a basis for restoration to health in conditions in which we lack specific remedies. The term specific must not be loosely employed. Every drug, at least almost every remedy, has a specific action upon some portion of the human organism ; but it can not be said to have a specific influence upon a disease as an entity unless by its innate virtues, without the intervention of other forces, it succeeds in limiting or eliminating the morbid process. Specific treatment is unfortunately limited at present to a few diseases. Quinine in malarial disease, mercury in syphilis; colchi- cum in gout, and antitoxine in diphtheria are specific ; possibly the results of the administra- tion of thyreoid extract in myxoedema and of SYMPTOMATIC TREATMENT 348 the salicylates in rheumatism may be regarded in a similar light. With these diseases and with these remedies the specific treatment of the present day comes to an end, unless one wishes to include in the category the homoeo- pathic system, than which there is no more exquisite example of putative specific treat- ment founded on array of symptoms. In the treatment of disease the fight against Nature has long since passed into deserved oblivion. The medical profession now recog- nises the force of the old Latin proverb, Medi- cus curat, natura sanat morbos, and directs its efl'orts toward assisting the healing power shown by Nature in diseases least influenced by artificial interference and in those which undergo spontaneous cure. Aside from the few exceptions cited above, in which accident, coincidence, or deductive inference has dis- covered a specific for disease, most physicians are obliged to treat disease from the sympto- matic point of view. It is not too much to hope, in the light of recent investigation and experience, that within a few years the treat- ment of the infectious diseases, at least, will be placed upon a specific basis. There is another sense, a broader and more generally accepted one, in which the phrase '• symptomatic treatment " may be regarded. This refers to the alleviation of symptoms arising in the course or progress of a disease, not intended to be curative in its sequel, but simply and solely to combat threatening or serious manifestations and to allay disagreeable phenomena. For such measures to be thor- oughly and conscientiously pursued, there must be a clear understanding on the part of the physician of the nature of the illness which is present. Thus, few men would be willing to risk the administration of chloral hydrate for the purpose of inducing sleep in pneumonia, or in any pronounced asthenic condition : and it would be a poor example of judgment which would allow a medical attendant to give strych- nine for incontinence of urine to a child suf- fering from chorea, although under other condition of health or disease both of the drugs referred to might be legitimately indicated. The pursuit of symptomatic treatment may lead into error, unless followed along lines of perfect knowledge of the processes presenting themselves. Sleeplessness, for example, in pneumonia may be due to disturbed nutrition, to high fever, to an embaixassed circulation or respiration, or even to pain. And success- fully to combat this symptom, the physician must determine, as accurately as his skill and experience permit, the source of the insomnia. If it is due to continued fever, an earnest effort must be made to reduce the temperature, with- out, however, interfering with, embarrassing, or obstructing other organs or functions. If car- diac weakness is responsible for the distressing symptom, or if impeded respiration is the fault, appropriate remedies acting upon the organs concerned must be chosen. And yet, although the patient may feel restored and refreshed after the sleep which is given artificially, it must not be assumed that the measure is cu- rative in any way further than that it conserves the patient's strength, and, like nourishing food, aids him to overcome the forces which are working against him. It is by such reasoning that we find the pur- poses and objects of the symptomatic treat- ment of disease justified in their immediate and remote results. No physician of experi- ence presumes to assert in any given case that a cure is certain, but he may, judging from his results in large numbers of cases, hope for a restoration to health, or a palliation of dis- tress in many diseases — frequently fatal — by the careful, wise, judicious employment of measures which will allay or conquer grave symptoms. There can be no more searching test of a physician's acumen and knowledge than the proper symptomatic treatment of disease. It involves not only an accurate acquaintance with the pathological and physiological pro- cesses at work, but also a well-grounded insight into the action, in health and in disease, of the therapeutic measures called into play. There must reside in the physician's mind an under- standing of the constructive and destructive effects of disease upon nutrition, its infiuence upon and relation to the blood, the normal balance between these factors and the great vital functions of the body; excretion and secretion must be carefully observed and as closely watched, and the sustaining and rest- producing functions of the organism must not escape consideration. In short, the physiology of disease must be as completely in the eye as the physiology of health. Nothing can super- sede the knowledge which experience brings in the proper choice of remedies to meet dis- turbed conditions, The differences manifested by the action of drugs in health and in diverse conditions of disease are of very wide range, and in the administration of any medicine for the relief of symptoms all the changes and modifications induced by personal peculiarities, by absorption, and by influence on the various organs of the body must be judged of. Bearing in mind that the purpose of the symptomatic administration of drugs depends upon two elements, the relief of immediate symptoms and through this the conservation of the patient's energy — in other words, the amelioration of conditions — renders the subject easy of comprehension. The relief of symptoms which threaten life or cause great discomfort is, all things considered, the first imperative duty of the physician, no matter what the causa morbi may be. Pain must be mitigated, from whatever source it springs— a pleurisy, a brain tumour, or an enteritis. By its depres- sion and sapping of the patient's strength it may so lower the vital forces, if not relieved, that the subsequent struggle against the de- structive agents of disease may be rendered futile. But even in the attempt to allay this symptom regard must be had for the effects of the chosen drug upon the organs involved. Though a general peritonitis— for instance, with paresis of peristalsis — may give rise to great pain, opium in any form would be contra- iiidioated, since it would lead only to further difficulty in securing evacuation of the bowels. 249 SYMPTOMATIC TREATMENT In an ordinary colic, however, brought about by an abnormal collection of intestinal gases, a simple condition only must be met, and, although the bowel here, too, requires empty- ing, the contra-indication to the use of opium is by no means so urgent, since no grave dis- ease threatens the strength of the sufferer. And so, in the treatment of the symptom pain, there is as great a difference in the degree of this "nerve lightning" in almost all diseases and their complications as exists in the two conditions mentioned as examples. The highest judgment must be called upon in this emer- gency as in the planning of any general outline of treatment. The actual subjugation of pain would con- stitute its symptomatic treatment, and yet the determination of its source is an important preliminary step. When this can be ascertained and directly attacked, it is, of course, unneces- sary to administer analgetic remedies unless ulterior conditions demand their employment. But always, in the attempt to obtund pain, the sequel upon the disease and its possible com- plications must be duly considered, for little is gained by respite from this or any other symp- tom if the subsequent result jeopardizes the life of a patient or renders a recurrence of the symptom more likely. On the part of the brain, symptoms should be considered and treated as they arise. DeU- rium, coma, and stupor can not, however, simply be treated as entities. Relief from the cause of the first must be sought when this is pos- sible, but no treatment should be instituted for this phenomenon which is apt, in the course of a disease, to increase a subsequent stupor or comatose condition. Delirium is but a symp- tom, and as such is not in itself to be feared. It is but the mark of some process whose influ- ence may lead to decrease of strength or of vital force, and hence must be fought as any other danger signal would be. The efforts, as in the treatment of all symptoms of a grave nature, must be directed to soothing the disturbed sensorium. And the same remedy will not always be efBcacious. The delirium of an acute infectious disease or of agonizing pain must receive essentially diflferent therapy from that of alcoholic intoxication or of mania. Coma and stupor arise from caused so mani- fold that in each individual case we must exer- cise a careful consideration of the remedies which are best fitted to arouse the dormant or flagging forces. Sleeplessness, too, may de- pend upon factors so varying that, when it is possible, the origin must be sought and the appropriate treatment be instituted. There is no more select field for the judicious choice of a remedial measure than in this very domain : one drug is contra-indicated in the presence of pain ; another, in the face of delirium ; another, when there is danger of a cardiac depression ; and the next, in disturbed gastric function. Yet insomnia is one of the direst symptoms to encounter, and, no matter in what disease or condition it appears, it must be satisfactorily met. The heart and lungs during the course of diseases of other organs, or when they them- selves are affected, give origin to symptoms which usually require therapeutic notice. Any embarrassment of the respiration, whether of local origin in the trachea or of cardiac source in an impaired heart, or local again in a con- solidated lung, must be met and at once. Even when a dyspnoea 'depends upon some in- curable disease, such as a malignant growth or an aneurysm, every intelligent efllort should be made to relieve the threatening symptom. And the same rule holds trug for any serious manifestation on the part of t^e heart." When weakened, through disease or innate condi- tions, it must be strengthened by appropriate means ; when overworked or pumping against greater odds than it is able to overcome, suit- able measures for its relief must be inaugu- rated. The conditions which are able to cause sudden cessation of the heart's beat in disease must be carefully watched for, and never, if it can be prevented, allowed to gain supremacy. Cough is a symptom which may or may not demand therapeutic consideration, depending upon whether it is the sole symptom or one of a group of symptoms, and whether its presence is annoying, painful, or aggravating to the pa- tient. If its source can jbe attacked and de- stroyed without damage to any of the functions or organs, therapeutic measures may be prop- erly inaugurated. If it springs from a pleurisy, a jjneumonia, or a pulmonary tuberculosis, it matters little how much the patient may cough if the distress is not great; but if a bi'on- chitis, or a chronic pharyngitis, or a long uvula, or disease of the tonsils is the origin of the cough, that disease may itself be treated. In other words, if a cough represents the effort of Nature to assist in the elimination of dele- terious material and does not cause the pa- tient too much effort or pain, it may well go untreated; if, on the other hand, it is due sim- ply to an irritation of the bronchial tract or part of it, the cough deserves and should have directed against it therapeutic interference. Constipation or diarrhoea and defective ab- sorption or elimination are such common ac- companiments of many diseases that their symptomatic treatment is almost a matter of routine. And yet even these every-day mani- festations of local or constitutional disease are frequently wrongly treated, since a diarrhoea may easily yield to a laxative which causes the removal of offending material, and a constipa- tion be cured by giving the intestines a much- needed rest. In general, vomiting and nausea and the conditions already mentioned require deliberation of a careful kind, and usually de- mand treatment based upon a recognition of their causes. In this particular field of thera- py, symptomatic treatment represents espe- cially the treatment of conditions, since it is usually difficult to attack the disturbing ele- ment directly. The limits of this article forbid an elabora- tion of the symptoms which may be CA'oked by disease in the several organs of the body. The underlying principles of the "rational empiri- cism " known as symptomatic treatment have been brought out, and a further multiplication of details is scarcely necessary. It may, how- SYNERGISTS SYRUPS 250 ever, not be out of place to emphasize the necessity, in this connection, of a careful watching of the general processes of the body, which, though they may not arouse special symptoms in the course of a disease, are yet so important in their bearings upon the causation of symptoms on the part of special organs that their consideration in any disease is part and parcel of the observation of the case. Refer- ence is made, of coarse, to the metabolic pro- cesses ; the proper exchange of gases in the blood and tissues ; the correct elimination of waste and toxic products ; the normal secre- tion and excretion of physiological fluids. A departure from the normal might not, in any given case, show symptoms; but eventually, if metabolism is impeded, all those evidences of a disturbance of nutrition so well known and easily recognised may make their ap- pearance. Emaciation, glandular enlargement, an excess of urea in the urine, a feeble heart, diminished secretion of bile, and the number- less other concomitants of malnutrition would make themselves felt. The physician should hold himself responsible for the non-appear- ance of this condition by observing closely the catabolio necessities of the body during the entire progress of an illness. In this direction symptomatic treatment becomes prophylactic at times, and than this there can be no higher aim in medicine. There still remain a few points toward which attention must be directed. Those conditions known as asthenic or adynamic, which may be part of any prolonged disease, acute or chronic, must always receive symptomatic treatment directed to the organs or sets of organs which are the principal seats of weakness. The treat- ment can not be specified, but must be general as indicated. If the heart shows signs of de- pression or failure, it must receive stimulants ; if the intestines are weakened in their func- tion, they must be strengthened. If there is exhaustion of the nervous system or of the muscular system or deterioration of the blood, these integers must be given the benefit of measures which will restore them or aid in restoring them to their normal condition. But whatever organ is thus found weakened in func- tion, the therapeutic measure applied must be in proportion to the disturbance, and so chosen as to inflict no further injury upon the dis- abled organ or upon other organs ; and this is of importance secondary only to that of the administration of some remedial agent. The giving of nourishing foods in the conditions under consideration may well come under this heading. No therapeutic agent at our com- mand can replace the nutriment to be ob- tained from proper food-stuffs which contain, in a concentrated and easily assimilable form, the essential, elementary physiological requi- sites. Conditions of malnutrition which fre- quently follow the acute diseases commonly yield in a remarkable manner to judicious feeding ; every organ and system of organs seems to respond almost immediately to the ingestion of the vital principles contained in the nourishment. It may be mentioned, too, that the proper nourishment of the sick during an acute illness is frequently, in more senses than one, a form of symptomatic treatment of higher value than the mere fighting of ob- jective symptoms. It has been considered better, in the course •of this article, not to refer to groups of diseases or the individual maladies ; but, by pointing out some of the broad principles which gov- ern symptomatic treatment in general, to de- duce the con<;lusions reached. To summarize briefly, it may be repeated that symptomatic treatment is indicated in all diseases or condi- tions whose processes give rise to local or con- stitutional manifestations, and whose seat of origin can not be attacked, or when, in our ignorance, we do not know how to attack it ; or, in a more limited sense, when symptoms or conditions arise in the course of any illness the treatment of which is unable to overcome the phenomena of local or general origin. Even when a cure is out of the question, the judi- cious treatment of symptoms may provide comfort and prolong life. Samuel M. Beickner. SYNERGISTS. — These are remedies which in some manner aid or intensify each other's actions. The synergistic property was formerly held to be of great importance, and an attempt was usually made to modify the complex action of the drug chosen as the prin- cipal reliance and known as the base, by com- bining with it an adjuvant to increase the desired effect, and a corrigent to neutralize such effects as were undesirable. To succeed in attaining such ideal results a much more accurate knowledge of the exact action of each drug, and the proportjionate influence exer- cised by it over the various organs of the body, as well as a genius for making accurate com- binations, would be necessary to a degree not yet attained in the human race, and as the at- tempts made were usually to a greater or lesser degree failures to obtain the desired re- sults, a severe simplicity has gradually taken their place and the plain drug, uninfluenced by adjuvant or corrigent intentionally intro- duced, is the rule of prescription-writing at the present day. Nevertheless, the advantage to be derived from the employment of reme- dies which are of assistance to each other is obvious. It was the crude attempt to use the knowl- edge that most drugs produce many effects, of which some are beneficial but others delete- rious in any given case, which caused those combinations of drugs that seem strange to us ; but it is of great advantage to remember that many drugs produce similar even if not iden- tical effects, and that by the combination of two, each of which produces a similar or iden- tical effect upon a certain organ, a better re- sult can be obtained than from either singly, because, as a smaller amount of each is needed, the other effects, whether deleterious or not, are produced in a minimum degree. Thus opium and ipecacuanha are both diaphoretics, while one is a narcotic and the other a nau- seant. By combining them a better diapho- resis may be obtained than would be the case 251 SYNERGISTS SYRUPS if either were given singly, unless in sufficient- ly large doses to produce the other and unde- sired physiological eflEects. In the same manner manganese may be advantageously combined with iron to aid it in producing its hsematinic effects. Sometimes the combination of a stronger and a weaker agent is of remarkable efficacy. Although cocaine can not compare with atropine as a mydriatic, still a more pro- nounced mydriasis may be obtained from their united action than from atropine alone, on ac- count of the mechanical expression of blood from the tissue by the contraction of the blood-vessels induced by the cocaine. This synergetic action of various drugs may possibly be explained in some cases by a close alliance in chemical composition, as is the case with metallic salts and with the members of the phenol group, or by the presence of iden- tical or closely related alkaloids or active prin- ciples, such as that of berberine in calumba and hydrastis. But such a relationship is not always necessary in order that two drugs may enhance each other's effect upon the system, as is demonstrated by the frequent and useful prescription of iron with bitter tonics. The employment of synergists in medicine should not be considered as confined to the prescription of drugs, which by their physio- logical action increase each other's force, but should also include all agencies by means of which the system is aided to respond to the in- fluence of the medicament upon which reliance is placed. Thus digestive ferments employed to improve the digestion and so contribute to furnish assimilable material for the support of the body are distinctly synergistic to the means used to combat the disease from which the patient is suffering. The same is true of tonics, stimulants, the inhalation of oxygen, and all other measures which aim at the main- tenance of the patient's strength and vitality. Water, when drank in large quantities as a di- luent, is of valuable service in inflammation of the geni to-urinary tract by flushing the emunc- tories and so permitting easier and better ac- tion of the organs. Counter-irritation may frequently act syner- gistically by inducing a change in the nervous or oirculatsry condition of an organ, as when it is used in the lumbar region in eases of nephritis, that it may assist the kidneys to re- spond to the diuretics administered. The regulation of other organs of the body than those primarily diseased is an important aid to the restoration of functional equilib- rium, hence the use of laxatives, diaphoretics, and other eliminatives is frequently indicated. Emetics, cathartics, and general depletion fa- vour the action ot depressant remedies. The synergistic effect of electricity in the rapid production of the local effects of cocaine, aconite, and other drugs has been mentioned and classed with other mechanical, chemical, and thermal aids to absorption, under Sorbe- FACIENTS. Hygienic measures of all kinds, pure air, proper food, exercise, massage, the various forms of baths, are most valuable synergists to proper medicinal treatment, not including sys- 60 temic depressants, and when properly carried out not infrequently become the principal in- stead of the accessory remedial measures. Un- favourable hygienic conditions increase the activity of drugs which depress the bodily functions. Finally, the synergistic effect of mental emo- tion must be considered. The modvs operandi here is difficult to explain, but it is universally acknowledged that a cheerful frame of mind is of much assistance to the action of restora- tive agents, while a mournful mood increases the force of depressant remedies. Matthias Lanckton Foster. SYNOVIAL EXTRACT.— Dr. Samuel Hyde, of Buxton, England, writes in the Brit- ish MedicalJournal for April 18, 1896, that he has had a glycerin extract prepared from the fresh synovial membranes and articular carti- lages of healthy animals, and is using it as a remedy for rheumatoid arthritis a,n6i some other forms of chronic joint disease. He gives it by the mouth in doses of from 15 to 30 minims two or three times a day. He reports that thus far his experience with it is encouraging. SYRUPS. — These are more or less concen- trated solutions of sugar in water, in most cases combined with some flavouring or me- dicinal agent. They may be prepared by vari- ous methods. When heat is not objectionable, they are most expeditiously made by this agent. Otherwise simple agitation or percolation must be resorted to. The hot process, if it can be applied to all, not only is the most expeditious, but produces the most stable product, as it destroys the vi- tality of any germs which may set up fermen- tation, or cause the formation of mould, etc., in the product. If it is necessary to avoid actual boiling in the preparation of a syrup, the product is usually not so clear and bright as would have been the case if the boiling point had been attained, because in the latter case the suspended matters would have all been carried to the top, where they could have been removed. In the preparation of syrups containing vola- tile or easily decomposable medicinal ingredi- ents, heat must be avoided. But such syrups, unless kept under special precautions, are very apt to deteriorate. It is therefore advisable never to prepare more of a stock than will sup- ply the demand for a short time ahead. The preservation of syrups is best accom- plished by keeping them in completely filled bottles, each holding an amount sufficient for a few days' supply, which must be hermetically sealed and kept in a cool place. If the syrup can be introduced boiling hot into the bottles, previously well cleaned and immersed in hot water, it will keep so much the better. When it is necessary to clarify a syrup which is tur- bid from minute suspended matters, this may be accomplished, if heat is not objectionable, by mixing with it, while cold, an aqueous solu- tion of white of egg and'then raising it to boil- ing without stirring. As the albumen contained throughout the solution coagulates, it envelops the suspended matters and they are all carried SYZYGIUM JAMBOLANUM TABLETS 252 to the top in the form of scum. When heat cannot be used, the clarification is best effect- ed by mixing the syrup with well-shredded and moistened paper-pulp, thoroughly agitat- ing it during some time, and then filtering through paper or flannel. The first portions of the liquid may be returned to the mixture until it runs through clear. In come cases the preservation of a syrup is secured by the addition of an acid, or of alco- hol, or of glycerin. Fruit syrups, which are largely used as flavouring agents in popular beverages, as well as in medicinal compounds, are usually pre- pared with the aid of a moderate degree of fermentation. As an example may be cited syrup of cherries, which is best prepared in the following manner: Crush the cherries, with their kernels, and let the mass stand in a cov- ered vessel for two days at a temperature of from 60° to 70° P., stirring it occasionally. Then express the juice, add for every 100 parts of the latter 3 parts of sugar, and, when this is dissolved, pour the juice into one or more narrow-mouthed bottles or other convenient vessels of such a nature that only a small sur- face of the juice is exposed to the air, and tie parchment paper over the orifice. Fermenta- tion will gradually set in, its rate depending greatly on the temperature, which should be so regulated that it will not be too rapid. The fermentation produces a certain amount of al- cohol, which causes the gradual coagulation of the mucilaginous constituents. As soon as a small sample, say 4 c. cm., of a filtered portion of the juice is found to mix, without becoming turbid, with 3 e. cm. of 90-per-cent. alcohol, the process should be interrupted. The juice is now filtered as rapidly as possible, the filtrate is transferred to a suitable vessel, and for every 350 parts of filtrate 650 parts of sugar are add- ed. The mixture is slowly raised to boiling and kept at this temperature until it no longer throws up a scum, which must, while it ap- pears, be constantly removed. The finished product is then, while still hot, strained through flannel and immediately transferred to suitable vessels, which must be filled as far as possible and securely stoppered. — Oharles Rice. SYZYGITIM JAMBOLANUM. — See Jambul. TABACTTM.— See Tobacco. TABELLiSE, TABLETS.— Tablets are small disc-like masses of medicinal powders the basis of which usually consists of cane sugar or milk sugar. They are prepared either in moulds or by compression. Moulded tablets, also called tablet triturates (more correct would be triturate tablets) are prepared by triturating an active substance with a sufficient amount of milk sugar (or, in some cases, other soluble medium), so that when they are moulded and finished, each tablet will contain the exact intended amount of the me- dicinal constituent. These tablets were first suggested and introduced by Dr. Robert M. Puller, of New York, in 1878, since which time their use and manufacture have assumed im- mense proportions. Since the tablets are usually of the same size, and since varying quantities of medicinal constituents occupy varying volumes, the maker has to devise a separate formula for each com- bination, so that a finished tablet will contain the exact dose of the medicine together with enough sugar of milk to make up the bulk of the tablet. The formula for each separate combination is arrived at in the following way : The mould is filled with powdered sugar of milk, previously made into a pasty mass with alcohol. The mould itself consists of a plate of hard rubber, glass, or metal, of the exact thickness of the tablets to be formed. It is pierced by a number of parallel rows of round holes of the diameter of the desired tablets. On either side are two additional single holes. The plate is laid on a flat surface, the prepared mass is forced, by means of a spatula, into the tablet holes, and all excess of the mass is care- fully removed. When the tablets are nearly set, the mould is brought over a plate contain- ing cylindrical pegs exactly corresponding to the tablet holes, the proper guidance of the mould being accomplished by two longer pegs, one on each side, which fit into the lateral holes of the mould. After the experimental tablets have been re- moved from the mould, they are thoroughly dried and weighed. They generally weigh 1'3 grain each, though this weight is slightly in- creased with any increase in the solvent action of the menstruum, since this causes more sugar to remain in a compact form in the tablet. Next it becomes necessary to ascertain how much milk sugar must be omitted from the ascertained amount to make room for the de- sired quantity of the medicinal ingredient. For this purpose 130 grains of milk sugar, corresponding to 100 plain tablets, are weighed off, and as much in bulk is removed from this as the apparent bulk of the medicinal sub- stance to be added. The amount of sugar of milk removed is ascertained by weighing. The active ingredient, if a dry solid, is now mixed by thorough trituration with the remaining sugar of milk. In the case of solid extracts, tinctures, and other fluids, these are mixed with the remaining sugar of milk, and the whole is brought to a solution by a suitable menstruum, to insure uniform admixture. The solution is then evaporated and the residue re- duced to powder. When the powder or triturate is ready, it is wet with a suitable menstruum (see below) and moulded, care Ijeing taken that the wliole mixture is transferred to the holes, which must all be filled, while none of the mass must re- main over. In most cases this is only an ex- perimental step, since, if there is either too much or too little of the mass, a new trial must he made, until there is just enough. But the proportions of sugar of milk and of me- dicinal ingredients thus ascertained will then hold good for the future, and it is only neces- 253 SYZYGIUM JAMBOLANUM TABLETS sary to keep a record of them for the particular combination in question. If at this trial it was found that there was not enough mass to fill all the holes, the weight of the deficiency is ascertained by finding the average weight of the finished tablets and de- ducting the calculated weight of the missing tablets from the weight of the bulk of sugar originally removed from the 130 grains. At the next trial the quantity to be removed should be less by the amount represented by the weight of the missing tablets. It is important that all the ingredients, as well as the mixture of powders ready for moulding, should be in the finest possible state of subdivision. The menstruum selected for moistening the mass should have a slightly solvent action upon one or more of the constituents, but the latter should not be too freely soluble, since the mass is then moulded with difficulty, and the tablets are apt to be uneven or become too hard. The solvent action should be so regulated that the resulting tablets will not crumble when shaken together in a phial, and yet will readily disinte- grate in water, either at once or at least after some time. The menstruum generally used is absolute alcohol, alcohol and water, or chloroform. For tablets consisting nearly altogether of sugar of milk, a menstruum of 3 volumes of alcohol and 1 volume of water is the most suitable. The larger the quantity of insoluble matters which is present in the mass, the more must the proportion of water be increased, the object being to dissolve enough of the sugar of milk to hold the particles together. This is, for instance, the case with tablets of re- duced iron, manganese dioxide, cerium oxalate, bismuth subnitrate, and similar substances. For tablets of codeine, leptandrin, aloin, etc., and bodies very soluble in alcohol, it is best to use only water. When a chemical reaction is expected to take place, so as to produce a new substance which is the desired active ingredient, the menstruum selected shoiild not dissolve all of the partici- pants in the reaction, since the latter is ex- pected to be completed in the stomach. When the powder is ready, it is wet to a pasty condition by the most suitable men- struum, and then pressed into the holes of the tablet mould lying on the pill tile or other flat surface by means of a horn or ivory spatula which is drawn over the mould. Sometimes it will happen that the mass adheres to the spat- ula and is thus drawn out of the holes. This may be avoided or remedied by dipping the spatula in the menstruum used for moistening the mass, and then drawing it over the surface. The mould is then reversed by sliding it toward and off the edge of the tile, and the spatula applied to the other side in the same manner as before described. It is then applied to the peg plate (or pin plate), and the tablets are pushed out. They are allowed to dry for a few minutes on the pegs, then removed by striking the peg plate upon the counter cov- ered with a sheet of paper to receive the tab- lets. If the tablets are to be finished quickly, a current of heated air is allowed to pass over the side which is to rest on the pegs. In drying tablets, it is best to use a sieve or wire cage, so as to permit of uniform drying on all sides. This is particularly necessary in the case of coloured tablets. Hypodermic Tablets. — These may be pre- pared in a similar manner with sugar of milk or some inert mineral salt as the base. Compressed Tahlets,or Tabloids. — These con- sist of some medicinal substance or mixture, compressed in the form of discs. The sub- stance in this case should not be in fine pow- der, but in a granular form, being brought to this condition, if necessary, by a special pro- cess. Of course, if a mixture is to be brought into the form of compressed tablets, the ingredients must first be mixed most thoroughly by tritu- ration to a fine powder, and then brought into a granular form. This granulation is generally effected by mixing the powder with one tenth of its weight of cane sugar and one twentieth of powdered gum arable, and moistening with water until the mass is of such consistence that it can readily be forced through a No. 13 sieve without sticking to it or clogging it. When it has thus been passed through the sieve it is dried. The finished granulation, which must be perfectly dry, is now forced through a No. 20 sieve, and the particles which do not readily pass through are forced through by the aid of a flat pestle. In moistening the granulated powder, the water must be added uniformly throughout, best in the form of a spray and in small portions at a time. Substances which can be bought already granulated, or may be brought to this condi- tion by grinding and sifting, usually require no further preparation, and may be compressed at once — for instance, ammonium chloride, po- tassium bromide, sodium bromide, potassium chlorate, etc. In the case of the last-named salt, if it is to be combined with sugar, its danger- ously explosive property must not be forgot- ten. No trituration or forcible compression of a dry mixture cf the salt with sugar must be attempted. Before the granulated substance is com- pressed, some lubricant must be added. The best has been found to be some hydrocarbon oil, which must be absolutely free from odour. A very small quantity is sufiioient — about 10 or 13 drops for each pound of granulated mass. It is best added in the form of a fine spray and distributed by stirring the mixture. The particles thus become faintly lubricated and will be enabled to glide upon each other freely, easily falling into the mould space, feed- ing the same amount each time, and thus making the finished tablets equal in weight. The aet of compression forces most of the oil to the surface of the tablet and lubricates the latter just enough to prevent it from sticking to the die. Finely powdered French chalk is generally used as an additional lubricant. It is added in small quantity, not to exceed 1 ounce for every 3 pounds, after the oil. Various forms of compressed-tablet moulds TABLOIDS TANNIC ACID 254 have been devised for preparing tablets on a small scale and for manufacturing purposes. A very important quality which compressed tablets should possess is that of rapid disinte- gration or solution, except in the case of those (for instance, of potassium chlorate) which are ..intended to dissolve slowly. In order to facili- tate their rapid disintegration, the mass to be granulated, if it requires it, is mi.xed with from one twentieth to one tenth of its weight of powdered starch. This is particularly neces- sary in the case of such substances as phenac- etine, acetanilide, sulphonal, trional, etc., as they would produce scarcely any effect at all if solution had to proceed gradually from the outside of a solid tablet. Indeed, without this addition such tablets would be likely to pass througli the whole intestinal canal without losing much substance. — Charles Rice. TABLOIDS. — This is a synonym used in England to denote compressed tablets. Con- cerning the latter, see the article Tablets. Charles Rice. TAKA-DIASTASE.— This is a powerful amylolytic ferment, prepared by a process sim- ilar to malting, devised by Mr. Jokichi Taka- mine, a Japanese chemist, from a fungous • growth on wheat bram. It is a tasteless and odourless powder capable of quickly convert- ing a hundred times its weight of starch into sugar, mostly maltose. It is used in the treat- ment of so-called amylaceous dyspepsia, and found to be exceedingly efficient. It may be given in doses of 2 grains, after eating. Dr. George Suttie, of Detroit (Medical Age, Sep- tember 25, 1895), has reported a number of cases in which its employment proved highly satisfactory. TALC. — What is generally known as talc, talcum (trer. Ph.), is, properly speaking, steatite, or more probably a mixture of talc and stea- tite. As used in medicine, it is grayish-white in colour and has a greasy texture. It is em- ployed as a dusting powder, either by itself or combined with small amounts of boric or carbolic acid, as a, soothing and protective application in intertrigo, eczema, and various other irritated conditions of the skin, and is probably the best agent of Its class, except when it is to be applied to a surface secreting any acid fluid, when magnesia or magnesium carbonate is preferable, on account of its alka- linity. It is especially adapted for use on parts where there is more or less friction, as its unctuous properties allow of the free move- ments of the surfaces upon each other. Puri- fied talc, talcum purificatum (N. F.), is talc deprived of certain of its impurities by hydro- chloric acid. It may be used as a filtering agent, and, under the name of " French chalk," it is very largely employed to remove grease from fabrics, being powdered and applied over the spot and allowed to remain for an hour or two. — Russell H. Nevins. TALLOW. — Properly speaking, all animal fats that are solid at ordmary temperatures are grouped under this head, but the term is usually limited to the solid fats obtained from beeves and shSep. (See Suet.) The tallow obtained from the internal part of beeves is hardly suitable for medical purposes, as, unless prepared with great care, it contains more or less water, and speedily decomposes with the formation of various fatty acids that are irri- tating to the skin. That prepared from the adipose tissue surrounding the kidneys, thf. '■ short fat " of commerce, contains, more stearin than the other varieties, and is the least objectionable. — Russell H. Nevins. TAMARIND, tamarindus (U. S. Ph., Br. Ph.), pulpa tamarindorum cruda and pulpa tamarindorum depurata (Ger. Ph.), is the acid- ulous pulp of the fruit of a semitropical and tropical tree, the Tamarindus indica, which is mildly laxative. It is often combined with other laxatives, and enters into the composi- tion of confection of senna. It may be given in doses as large as an ounce with safety, but larger amounts than that may give rise to griping. An infusion in water is an agreeable beverage in febrile conditions, when the stom- ach is in good order. Like nearly all vegetable preparations of the same class, it is moderately diuretic. — Russell H. Nevins. TANACETXTM:.— See Tansy. TANNAL. — There are two aluminum salts known under this name. The first, which is insoluble, is a basic aluminum tannate, Alj (OH)4(C,.Hb09)j -I- lOHjO, a brownish-yellow powder formed, according to Professor Cob- lentz, by precipitating a solution of an alumi- num salt with a solution of tannic acid in the presence of an alkali. The second, which is soluble, is aluminum tannic tartrate, AljfCjHe Oe)'}.(CnB-i,0,)i + 6H2O, obtained, according to the same author, by treating insoluble tannaJ with tartaric. Both forms are astringent and antiseptic. The insoluble form is used by in- sufflation, and the soluble form in solution in nasal, laryngeal, and pharyngeal catarrh. TANNALBIN.— This is a German pro- prietary preparation. Gottlieb (Deutsche medi- cinische Wochenschrift, March 12, 1896; Therapeutische Wochenschrift, March 29, 1896) describes it as a slightly yellowish, tasteless powder containing fifty per cent, of tannin, made by subjecting a compound of tannin and albumin to a heat of from 212° to 248° F. for five or six hours, whereby it acquires the prop- erty of resisting gastric digestion, while it still remains susceptible to the slow action of the intestinal juices. Yon Engel (ibid.) has found it serviceable in all diarrhceal affections in which an astringent is indicated, especially chronic intestinal catarrh. It proved efficient in twenty-five out of twenty-nine subacute or chronic cases, and in nine out of ten acute ones. He reports that he has observed no harm from its use. The dose for adults is 15 grains, and that for children under four years old half that amount from two to four times a day. Vierordt (Deutsche medicinische ^yoch- enschrift, June 18, 1896 ; British Medical Jour- nal, July 4, 1896) has used tannalbin in some thirty selected cases, mostly of subacute or chronic intestinal catarrh, including ulcerative enteritis, occurring usually in young subjects. Regulation of the diet, other drugs as well as 255 TABLOIPS TANNIC ACID other methods of treatment, such as injections, etc., had produced no good effect. The astrin- gent action of the drug was well marked in the various forms of diarrhoea, even including cases of suspected tuberculous ulceration of the howel. Inthe various forms of enteritis the stools be- came more solid and the mucus diminished, so that the dose of the tannalbin could soon be les- sened and its use discontinued. In four cases in which cod-liver oil containing either creosote or phosphorus produced diarrhoea, the stools became solid ana less frequent when tannalbin was given in addition. No unpleasant symp- toms were produced by the tannalbin. The author discusses the possibility of a favourable action being exerted on internal organs, such as the kidneys, etc., when large quantities of tannin can thus be introduced into the body without inconvenience. Of five cases of chronic renal disease, tannalbin produced good effects in three. The drug does not produce constipa- tion in the healthy alimentary canal. The author looks upon tannalbin as being the best tannie-acid preparation yet introduced. If a favourable action is not soon noted, the dose should be increased rapidly, the limit being 30 grains as a single dose, and 150 grains in the course of twenty-four hours. It. may be given between or after meals in water or milk. TANNIC ACID.— This is an organic acid obtained from nutgall (U. S. Ph.). It is known officially as tannin, acidum tannicum (U. S. Ph., Br. Ph., Ger. Ph.), gallotannic acid, and digallic acid. The term tannin, however, is usually restricted to a class of vegetable prin- ciples which have many differences among themselves in other respects, but are alike in causing a green or bluish-black colour or pre- cipitates when ferric salts are added to their aqueous solutions, and form insoluble com- pounds with albuminous or gelatinous solu- tions. The tannin derived from galls differs from that from other sources by being con- verted into gallic acid on exposure to atmos- pheric air in a watery solution. Although tannic acid may be prepared from cinchona, tanacetum, kino, uva ursi, and the barks and roots of many other plants, the official product is derived from the nutgall. It is prepared by the action of ether upon the powdered nut- gall and the evaporation of the product, with- out, however, being an ethereal extract. Tannic acid may be derived from catechu and kino of the TJ. S. Ph., and from the elm bark of the Br. Ph. The variety of tannic acid obtained from these sources is known as mimo- tannic acid, which gives a greenish precipitate with neutral solutions of ferric salts. Accord- ing to some chemists, an nnfermentable sugar results from its decomposition, together with an acid a little different from ordinary gallic acid. Bael fruit, oflRcial in the Br. Ph., is said to be efficient in diarrhoeal diseases beekuse of the presence of tannic acid. The leaves of the edible Spanish chestnut contain about 10 per cent, of tannin. Among the other substances which contain tannic acid are the rind of the fruit of the pomegranate, haematoxylon, kra- meria, larch bark, the rhizome of geranium, sumach (in its leaves, stalks, and fruit), the winterberry, and the blackberry. Tannic acid is a yellowish or yellowish- white, non-crystalline powder of a highly as- tringent taste. It is nearly odourless, or has but a faint odour of ether. Its formula is CnHioOg. The acid is soluble in water, less soluble in alcohol and in ether ; it dissolves in about its own bulk of glycerin. In solution it reddens litmus paper and it forms salts with alkalies. It precipitates albumin, starch, and gelatin, and furnishes, on the addition of a ferric-chloride test solution, a bluish-black pre- cipitate or colour. Tannic acid burns with a brilliant flame and, heated on platinum foil, it leaves little ash. The ready union of tannic acid with the vegetable alkaloids furnishes a test for the latter which is largely employed. It has a striking affinity for most of the mineral acids, forming precipitates. When it is rubbed with potassium chlorate an explosion of consider- able violence ensues. To distinguish tannic from gallic acid, the U. S. Ph. recognises two tests. One consists in adding to an aqueous solution of tannic acid a small quantity of calcium-hydrate test solu- tion. The production of a pale bluish-white precipitate, which is not dissolved on shaking, shows a distinction from gallic acid. The other difference lies in the fact that tannic acid causes a precipitate with most alkaloids and bitter principles and with solutions of starch, gelatin, and albumin. When tannic acid is applied to the skin or mucous membrane, in powder or in solution, it exerts a decided astringent effect. This is probably due to a contraction of the local blood-vessels, and the dryness of mucous membranes following its application may be attributed to the same influence. The astrin- gent action is persistent for some time, and it may be that this influence is enhanced by the coagulation of the mucus and to the constric- tion of the mouths of the mucous follicles. The local astringent influence of tannic acid takes place on all mucous membranes, whether it is actually applied cr taken internally. When it is ingested, it probably forms an in- soluble compound, or one soluble with diffi- culty, with the acid juices of the stomach. These compounds, possibly albuminates,_ are slowlv acted upon by the intestinal secretions, and the tannic acid may undergo changes which result in the production of gallic acid. Aftei- its administration tannic acid appears in the urine in the form of gallic acid, and one writer has recorded the finding of pyrogallic acid in the renal excretion after the ingestion of tannic acid. Locally, tannic acid is a more powerful astringent than gallic acid, and where it can be directly applied it is probably to be preferred, since the bulk of opinion inclines to the view that it is converted into its congener, gallic acid, when taken inter- nally. Individual susceptibility differs as to the effect wrought by tannic acid when ingested; but, although there are no fatal cases of poi- soning recorded, there are a number of pub- TANNIC ACID 256 lished instances in which it has produced pain in the stomach and abdomen and, in a few cases, fever and a constitutional disturbance of a more or less severe nature. It can not, however, be included among the poisonous drugs, although large doses have caused a purulent diarrhoea lasting for some weeks. Tannic acid is taken up by the blood as gallic acid, but the source and manner of its conversion are not known. For this reason, as stated before, tannic acid may be preferred to gallic acid when it can be directly applied, as to the skin, to the intestines, or to the lungs or throat by spray ; but for general internal use gallic acid should be chosen. Tannin is the chemical antidote of anti- mony, and where there has been poisoning by tartar emetic it should be given as promptly as possible in a strong solution. It forms a relatively insoluble precipitate with antimony, and with the vegetable poisonous alkaloids; but the precipitates are slowly dissolved in the intestines, and the tannic acid administration must therefore be accompanied by induced emeto-oatharsis. Locally, tannin has been recommended in a host of ailments. As a local astringent, it may be used whenever any drug of its class is indicated. Trousseau praised its use in the treatment of chronic coryza, in the form of a finely pulverized powder used as a snuff. A snuff containing 3 per cent, of tannin is also said to abort an impending coryza. In epis- taxis its astringent action may control the hsemorrhage. Good results have been ob- tained in the treatment of sore nipples by using a 1-per-oent. solution. Tannin in solution, in varying mild strengths, has been success- fully employed in excoriations about the anus and scrotum, in fissures of the anus, and in hmmorrhoids. Suppositories of tannin are of particular value in the last-named ailment, especially when the piles are irritated or in- flamed. They become reduced in size, if at all susceptible to the action of astringents, and may completely disappear. Prolapse of the rectum has been treated in the same way with good results. Tannin as part of a gargle has proved valuable in cases of hypertrophy or relaxation of the uvula, and in acute, non-ex- udative inflammatory conditions of the phar- ynx. Hypertrophied tonsils, when not acutely inflamed, may be reduced in size in a similar manner or by the use of the glyoerite of tannin, applied with a brush after a cleansing of the affected mucous membrane. In the treatment of chronic or acute inflammation of the eye- lids tannin has been employed with alleged satisfaction. Druitt praised its use in the form of powder or the glycerite in the treat- ment of aphthous ulcers of the mouth and of stomatitis of whatever origin. [Dr. M. A. Veeder, of Lyons, N. Y. (Medical Record, March 28, 1896), reports a rebellious case of extensive suppurating sinuses cured with a strong solution of tannin after various other applications had failed. At first a mod- erately strong solution was tried in one of the sinuses in the arm ; it acted so satisfactorily that its strength was increased until it was nearly a saturated solution and the entire tract of the cavity was filled with it. The immedi- ate effect was to coagulate the pus into a cheesy mass, which, when the parts were squeezed, came out of the various openings in the form of long worms. All this material was simply washed out with plain water and there was no longer any purulent secretion whatever, a clear fluid only appearing, and the sinuses and cavi- ties healed very kindly and with great rapid- ity. The interior of the abscess cavity and sinuses, in short, says Dr. Veeder, was simply " tanned."] Vesical catarrh is said to have yielded to daily injections of tannin, of a strength of 3 per cent., when other treatment had failed to cure. I u chronic urethritis in men and in ely Iri- tis of gonorrhcsal or other character, injections and douches' have resulted in cure. For the former, the glycerite of tannin or a 10-per- cent.' solution has been used ; for the latter, a powder containing equal parts of alum and tannin is employed. A teaspoonful of this powder dissolved in a quart of water and used as a douche is equal to any other means of treating gonorrhoeal elytritis, when combined with the other necessary hygienic and thera- peutic nieasures. When tannin forms a part of the medicating agent of a douche for a pregnant woman, however, its percentage must be reduced, because of the possibility of evok- ing contractions in the muscular layers of the cervix. Actual abortion, it is true, has prob- ably never been called forth by the drug ; yet the individual susceptibility of gravid women varies so greatly that due caution should be observed. In ordering a douche of alum and tannin for a pregnant woman with gonorrhoea, the proportion of 1 part of tannin to 4 or 5 parts of alum is a safe one ; or, if one's fear of cervical contraction should have a clinical foundation, the tannin may be omitted, de- spite its virtue in blennorrhagic elytritis. It is doubtful if the tannic-acid treatment of acute gonorrhcsal urethritis in men should be recommended. Although it still has advo- cates, it has been unquestionably superseded. Before plastic surgery on the genital organs of women had reached its present develop- ment, prolapsus uteri, proctocele, and cystocele were frequently treated by means of tampons soaked in a saturated solution of tannic acid, and good results were no doubt frequently obtained. Very often in these cases it is ad- visable to try douches of an astringent charac- ter before resorting to surgical measures, for by these innocuous means the symptoms may sometimes be relieved and an operation avoided. Tannin has been praised in some affections of the skin in which a local astringent action is desired. Ringer advised its use, in the form of the glycerites, in cases of eczema. He asserts that a specially valuable result is ob- tained in the early stages of the disease, when the skin is red and swollen and exudation is free {Practitioner, i). He alleges that by its use the itching and burning are subdued and that the irritation of the skin by scratching is thus avoided. Impetigo and intertrigo are 257 TANNIC ACID said to have yielded to the use of tannic acid in an ointment. The drug is usually a com- ponent in preparations intended to allay hyperidrosis of the hands and feet, and it has been recommended, in a 1-per-cent. solution, in the treatment of offensive axillary sweating. Tannin has been used, in ointment form, for all excoriations and abrasions of the skin, par- ticularly where they have been kept up by irritating discharges from neighbouring organs or lesions. It has also been recommended in the treatment of chilblains, and is probably as valuable as most other remedies used for the purpose. Tannic acid has been used in the treatment of bii/rns with good results, it is alleged, sub- duing pain and aiding in the formation of granulations. A solution of the acid in a strength of 1 to 4 in tincture of benzoin is said to prevent the formation of pustules in variola. As a vermifuge, tannin has some reputation in the treatment of threadworms in children. For this purpose it may be injected into the rectum in solution. As a styptic by internal administration, tannic acid is widely known. It was first used as a haemostatic agent in menorrhagia and subsequently in all forms of uterine hminorrhage whether of functional or organic origin. It is to be recommended for these conditions only when they are not otherwise controllable. In passive haemorrhages from the stomach and intestines its constricting and hsemostatic properties have been called upon to allay bleeding. Its use is favourably com- mented upon in cases of hematuria, even when this condition is dependent upon organic change. In the hmmoptysis of pulmonary tuberculosis its employment in a spray is some- times of benefit, and in oases of hcemophilia tannin may be used when other hfemostatic agents do not accomplish the desired result. As a local hcemostatic, as in the nose, in the rectum, or applied to bleeding varicose veins or to punctured wounds of any kind, it is valu- able, though probably interior to some other agents. It may be used in the.se instances in the form of styptic collodion or in a concen- trated aqueous solution. [Dr. Roswell Park, of Buffalo (Medical News, November 16, 1895), has called attention to a preparation made by mixing antipyrine and tannic acid in solution, by which there is pre- cipitated an intensely agglutinative and co- hesive substance which is the best styptic for certain purposes that he knows of. This com- bination he first resorted to in a case of appar- ently intractable haemorrhage after the removal of adenoid tissue from the vault of the phar- ynx, to which he was called in consultation. The surgeon in attendance happened to have ?t hand a bottle of alcoholic solution of tannin, while Dr. Park was provided with antipyrine in powder. The case being urgent, he sug- gested the combination of the two styptics, and added the dry powder to the solution. To the surprise of both gentlemen, there was formed at once a gummy mass, at first fiocoulent, which quickly cohered, the result being a com- bination the adhesiveness of which quite aston- ished them. A small sponge dipped into the fiuid containing this material in suspension was inserted into the post-nasal space, and the hsemorrhage was instantly checked, not to re- cur. Dr. Park has since experimented with these materials, and has found that they may be united in almost any proportion with the formation of the gummy mass. He suggests that the substances be mixed in proportion to the emergency of the case and to the desire for little or much of the resulting compound. It is possible, he says, by adding strong solutions, or by pouring the powder of one into the solu- tion of the other, to precipitate so much of the agglutinative compound as to make a gum that may be placed about the margin of bleeding bone— for instance, in operations upon the cra- nium. Or a small piece of sponge or cotton sopped in this material may be forced into a tooth-socket, or in various other ways its use may be made to result in benefit and satisfac- tion. There is but one attendant difficulty — it is so remarkably cohesive that when the time comes for detachment or separation of the tam- pon it is difficult to remove it. It may be even necessary to wait a sufficient time for the for- mation of granulations and separation by nat- ural processes.] By internal administration, tannin is said to combat successfully cases of atonic dyspep- sia. In diarrhoeas in which no active infiam- matory condition is present it is in frequent use, and usually is an element in the diar- rhoea and cholera mixture sold in the shops. If the lesion is in the lower part of the intes- tinal tract, enemata of tannin are efficient in chronic diarrhoeas and dysentery. It has been given internally for night sweats, bronchitis, and p^^^ms, although in the last-named dis- ease its reputation rests purely upon theoreti- cal grounds. The allegation once made for the drug that it diminished the albumin in albuminuria has not been substantiated by further investigation. In bacteriological work, tannin mixed with sulphate of iron has been employed by Lofder for the staining of the flagella of typhoid fever and cholera bacilli. In the arts, as is well known, it is used to convert hide into leather. During the epidemic of cholera in Italy in 1884 Dr. A. Cantani began the use of entero- clyses of tannin in the treatment of this dis- ease. His procedure was to inject into the intestinal canal of all patients, severely or mildly ill, from 2 to 4 pints of a 1-per-cent. solution of tannin in boiled water. The tem- perature of the solution was from 100° to 104° F., and the fluid was allowed to run into the intestine gently from a height of from three to six feet. This procedure was repeated sev- eral times daily with results, according to the statistics of Cantani and others, that were de- cidedly encouraging. The enemata were begun, in the first series of cases, when stubborn vomit- ing which could not be controlled by opium had set in. Subsequently the enteroclyses were liegun as soon as any symptoms of cholera manifested themselves, and in these cases, sometimes after one treatment, the diarrhoea and the vomiting ceased. TANNIGEN TANNIGBNE 258 The advantages alleged by Cantani were based on bacteriological and clinical evidence. He found, in conjunction with other observers, that the exposure of pure cultures of cholera bacilli to a 1-per-oent. solution of tannin at a temperature of 103° P. for an hour and a half killed the bacilli and rendered subsequent inoculations of gelatin or bouillon from the culture experimented with sterile. A half-per- cent, solution of tannin accomplished the same result in six hours. Since tannin is innocuous to man, it therefore formed the most valuable antiseptic agent for use against the cholera bacilli. By employing the solution in the manner indicated, Cantani believes that fre- quently the ileo-csecal valve is forced open and the diseased small intestine directly attacked.^ He maintains that the fluid reaches the small intestine, not only by the pressure it exerts, but by the antiperistaltic action evoked by the column of water. Farther, he argues, the con- striction of the mucous membrane determined by the tannin diminishes the absorption by the intestine of ptomaines and the other biological poisonous products of the bacilli present, at the same time emptying the intestine of its noxious contents. He modestly adds that, even if the enemata do not prevent the accumulation of toxic materials, at least they do not foster it. He lays stress, finally, upon the inability of the comma bacillus to thrive in an acid medium and gives the assurance that the return flow of the fluid invariably reddens blue litmus paper. By the employment of this method, after each defecation or diarrhoeal stool, Cantani asserts, the mortality record is materially lowered ; he adds that the earlier the treatment is begun the better are the results, that the heat of the solution and the absorption of fluid are bene- ficial to the patient in stimulating the heart, the lungs, and the nervous system, and that frequently patients so treated do not go into the algid stage. He maintains even that after the dreaded algidity has appeared life may be saved in some cases by the employment of the tannin enemata. He sometimes adds from 20 to 30 drops of laudanum to the solution injected, which may be made with inCasion of chamo- mile instead of water. The rectal treatment should be accompanied by general stimulation and, when necessary, by subcutaneous or intra- venous infusion of hot sterilized water (100" to 103° P.) containing in solution 3 per cent, of bi- carbonate of sodium and 4 per cent, of chloride of sodium. Animal experimentation seems to bear out Cantani's belief that the function of the tannin is to form insoluble tannates with the toxic materials in the intestine. {Die Er- gebnisse der Gholera-Behandlung mittelst Hy- podermoclyse und Enteroclyae wdhrend der Epidemie von 1884 *™ Italien, von A. Cantani, Leipzig, 1886; Die Cholera-Behandlung, von A. Cantani, Therapeutische Monatshefte, June, 1888 ; Berliner klinische Woehenschrift, Sep- tember 13, 1893.) Von Generisoh does not believe that the good results of Cantani's treatment resulted from the presence of tannic acid in the fluid used, but thinks that, with sufficient pressure, the ileo-cajcal valve can always be opened. He therefore proposes a modification of Can- tani's method by passing into the rectum a large quantity of water from a height of from 3 to 4 feet. He asserts that after allowing; from 15 to 30 pints to flow into the rectum, it will appear at the mouth, thus washing out the entire alimentary tract. Although this process of diaclysm (or diaclysis) is not attractive, the author asserts that the cleansing process is the main result desired. He employs tannin in a strength of 1 or 3 parts to 1.000, but believes that a salt solution or any indifferent fluid would be equally efficient (Deutsche medicin- ische Woehenschrift, 1893, No. 41). Tannin may be administered in the form of pills, capsules, or troches. Its dose is from 3 to 10 grains. When given for hsemorrhage, it is best administered in aqueous solution, sweetened and flavoured, or in an emulsion. For external employment, a watery solution of from 3 to 10 grains to the ounce may be used. A solution containing 3 parts of tannin and 1 part of gallic acid is more astringent than one of tannin alone. As solutions of the iron (ferric) salts are precipitated by tannin, they must not be given at the same time. Tannin bougies, cereoH cum acido tannieo, are bougies 3^ inches in length, containing J of a grain of tannic acid made up with syrup and gum arable. Collodium stypticum (U. S. Ph., Br. Ph.) contains 30 parts by weight of tannic acid, 5 of alcohol, 35 of ether, and of collodion a suf- ficient quantity to make 100. This is a modi- fication of the original styptic colloid of the late Sir Benjamin Ward Richardson, of London, which did not contain sufficient tannin for the required purposes. Styptic collodion may be applied to shaded or wounded surfaces to pre- vent the admission of air. The ether and alcohol evaporate, leaving a stifE coating which, if the wound is aseptic, forms an excellent pro- tective dressing. It may be applied with a camel's-hair brush or with cotton saturated with the solution. For special purposes, mor- phine, carbolic acid, or other antiseptic agents may be incorporated with it. For small, bleed- ing wounds or for ulcerated surfaces it forms a most efficient coating. It must be kept away from a flame, since the vapour of ether may take fire. Glyeerite, or glycerine, of tannin, glyceritum acidi tannici (U. S. Ph.), glycerimim acidi tannici (Br. Ph.), contains 30 parts of tannin and 80 of glycerin, and is prepared by heating the two substances over a water bath. It is the most valuable preparation of tannin for external use. It may be applied with benefit to suppurating surfaces of small extent and is of use in chronic ozwna, in chronic otitis media, and in chronic relaxation of the pharyngeal vault. It makes a good dressing for irntating cutaneous eruptions^ and, applied to the nip- ples during the late months of pregnancy, will frequently prevent the development of fissures of the nipples during the nursing period. In- ternally, it may be administered for any of the purposes for which tannin is used, in doses of from 10 to 40 minims. Suppositories of tannic acid, suppositoria 259 TANNIGBX TANNIGENE acidi iannici (Br. Ph.), contain each 3 grains of tannic acid and 12 grains of cacao butter. The suppositoria acidi tannici cum sapone (Br. Ph.), suppositories of tannic acid and soap, contain each 3 grains of tannic acid, 10 of glyo- erite of starch, 8 of curd soap in powder, and 7f of starch powder. Although the amount of tannin is small for rectal use in an adult, the suppositories are used in cases oi fissure of the anus and prolapse of the rectum. They are useful also in the treatment of internal hiem- orrhoids. Tannin troches, or lozenges, trochisei acidi tannici (U. S. Ph., Br. Ph.), are used in relaxed conditions of the mucous memliranes of the mouth, throat, and larynx, and to allay coughs arising from these states. In mild cases of angina they may be employed, allowing them to dissolve slowly in the mouth. In diarrhoeas, after washing out of the rectum, they may be administered for their astringent effect. The U. S. troches contain each about 1 grain of tan- nic acid, the British each | grain. The troches of the two pharmacopoeias differ also in the vehicles and sweetening elements. Ointment of tannic acid, unguentum acidi tannici (U. S. Ph.) contains 20 parts of tannin to 80 of benzoinated lard. It is very useful for local application in the treatment of external or prolapsed hcemorrhoids, sonetimes produc- ing a cure by causing contraction of these varicosities. Applied to indolent ulcers, it some- times induces granulations. Albuminate of tannin. — See Tannalbin. Aluminum tannate^ aluminii tannas, has been recommended for its efSoacy, in aqueous solution, in the treatment of acute gonorrhoea. The drug is not readily soluble in water, how- ever, and cannot be i-ecommended. Bismuth tannate, bismuthi tannas, is a light-yellow powder, insoluble in water and tasteless. It contains 53 per cent, of bismuth oxide and 47 per cent, of tannin. It is astrin- gent in its effect and has been employed in diarrhoeas, gonorrhoea, leucorrhoea, and puru- lent inflammations of the conjunctiva. Cannabene tannate is a yellowish-brown powder, insoluble in water and in ether, slightly soluble in alcohol. It has an odour which is not entirely unpleasant and a bitter taste. It is said to be the tannate of a glucoside. It is hypnotic in its effect, though not reliable. It is said to be devoid of the exciting effects of the extract of cannabis indica. The dose is from 4 to 20 grains. Iron tannate, ferri tannas, is prepared by precipitating cold solutions of ferric salts with tannin. A mixture of ferrous salts and tannin, exposed to atmospheric influences, will also deposit ferric tannate. It occurs in a black or bluish-black powder which is easily decomposed by the mineral and the stronger organic acids. It has been used in chlorosis and ancemia in amounts of from 8 to 30 grains in a day in pill form. Ink is a watery solution of ferric gallo- tannate, and is popularly supposed to be a remedy for ringworm. Mercury tannate, hydrarpyri tannas, is odourless and tasteless and is insoluble in ordinary media. Acted upon by alcohol or water, however, it liberates tannic acid. It may be prepared by precipitating a concen- trated solution of tannic acid and oxygenated mercurous nitrate, or by rubbing the two sub- stances together. It was first suggested by Lustgarten as a substitute for other mercuric preparations in the treatment of syphilis (Cen- tratblatt fur die gesammte Therapie, ii ; New York Medical Journal, March, 1892). Although it contains 50 per cent, of metallic mercury, it is alleged for it that its special advantage is that it is not affected by the acid juices of the stom- ach, but remains stable until it comes in contact with the alkaline secretions of the small intes- tine. Within twenty-four hours it appears in the urine as mercury and is absorbed from the intestine in minute globules of the metal. It does not salivate or cause gastro-intestinal dis- turbance. It may be given in doses of 3 grains thrice daily to an adult, increasing to 5 grains until from 100 to 150 grains are being taken. Potassium tannate has been proposed as a substitute for the sodium salt, but it presents no special advantages and is rarely used. Quinine tannate contains 40 per cent, of quinine. It is a very insoluble salt and has but from i to J the power of the sulphate. It is very slowly dissolved in the stomach and has little thermolytio influence. It is of value prin- cipally in nervous affections or as a substitute for the -cinchona bark. Its tastelessness, or, rather, lack of bitterness, may be attributed to its difEculty of solution, and renders it suit- able for administration to children in malarial diseases. The dose is three times that of the sulphate. It has been recommended for whoop- ing-cough. Tablets made up with chocolate, each containing 1 grain of the drug, are in the market. Sodium tannate, sodii tannas, is prepared by dissolving 75 grains of tannic acid in 5 oz. of water and saturating the solution with bicarbonate of sodium. It has been used in albuminuria in doses of -J oz. given every two hours ; but it not only failed to relieve the condition, but possibly caused death from urm- min (Centralblatt fiir die gesammte Therapie, i). Samuel M. Brickner. TANNIGEN, TANNIGENE, CHs (CHs. 00)209, is an acetic-acid ester of tannin in which two molecules, each, of three hydroxyl groups are replaced by one of acetyl. It oc- curs in the form of a yellowish-gray powder, without odour or taste. It is insoluble in cold water and in dilute acids, but dissolves freely in cold alcohol and in dilute alkaline solution. The experiments of Meyer, who first produced the drug, show that its influence on animals is not injurious. It produces no gastric disturb- ances, and is well tolerated even in large doses. Tannigene passes unchanged into the small intestine, where it is .split up into tannic acid and acetate of potassium. It has been found as such in the faeces, so it is probable that the alkaline juicesof the intestines do not break up all the tannigene ingested. Escherich (Therapeutische Woehenschrift, March 9, 1896) finds that even when tannigene is excreted in the feces some astringent effect is TANNIN TAR 260 exerted upon the intestinal mucous membrane. When there is increased secretion, however, and the intestinal juices are thoroughly alka- line, Escherich believes that tannigene is al- ways split up into its elements and exerts an elective influence upon those places where the exudation is most intense — that is, where the disease is most marlced. He finds its most use- ful application in cases where the lower part of the intestinal canal is affected by a non- acute inflammatory process, and alleges that nutrition and absorption are fostered by the diminished secretion of mucus. In the same article the author lays stress upon the disin- fecting properties of tannigene and on the for- mation of insoluble compounds with alkaloids and toxines, as lending to its virtues. The therapeutic indications for the use of tannigene include the summer diarrhcea of chil- dren and subacute and chronic diarrhosasocoar- ring in the ooavse of pulmonary phthisis, and dysentery. Some writers have professed to have treated successfully acute enteritis and gastro- enteritis with it, but the weight of evidence seems to be in favour of its employment in subacute and chronic intestinal disturbances. Tannigene is said to exert a beneficial influ- ence upon the stools in subacute enteritis as early as the second day of its use; and in chronic diarrhoeas, although it is not so rapidly effective, the faeces become formed and are free from mucus early in the treatment. Dietetic instructions must, of course, be simultaneously observed. The good results from the use of tannigene do not seem to be confined to the intestinal mucous membrane. Cases have been reported of gastro-enteritis in which tannigene is said to have stopped the vomiting after one or two doses. The drug has also been employed in hay fever with alleged good results. It is said to be excellent, used as a snuff, in acute and chronic coryza. Insufflations of tannigene have been used in acute otitis media, and the antiseptic and astringent effect of the drug relieved the existing symptoms. Good re- sults have been reported from the applica- tion of a 3-per-cent. solution of tannigene in a 5-per-cent. solution of phosphate of sodium in the treatment of acute and chronic pharyngitis and laryngitis. It is said that a disagreeable taste has followed its employment in these in- stances. The dose of tannigene is from 3 to 10 grains, given from three to six times daily, the dose varying with the age of the patient. Escherich found it advantageous to give a large initial dose— 15 grains to adults, and from 5 to 8 grains to children. It may be administered in milk or gruel, or taken dry on the tongue, followed by a drink of water. It may be combined with a salt of bismuth or with some other insoluble intestinal antiseptic if thought advisable. (See also AcETYLTANNiN.)— Samuel M. Bricknee. TANNIN.— See Tannic acid. TANNOFORM is a condensation product of tannic acid and formaldehyde, of the for- mula CsbHioO.s. It is a light reddish-white powder, insoluble in water and in acids, but dissolves in dilute alkalies. It is tasteless and odourless. Advantages have been alleged for it over tannic acid. It is said to have an in- different action upon the gastric mucous mem- brane and to cause no irritation in the stomach, as sometimes happens when tannic acid is ad- ministered. Since acids do not dissolve tanno- form, it is not assimilated by the stomach juices, but reaches the intestinal canal un- changed, where it can exert its action, which is said to be similar to that of tannic acid. Its advocates allege that tannin, on the contrary, is of harsh, astringent taste, and forms insoluble precipitates in the stomach with albumin, pep- tone, and gelatin, thus rendering it impossible for it to reach the intestines in an active form. They also maintain, what is not strictly true, that small doses of tannin corrode the gastric mucous membrane, diminish the appetite, and cause a sensation of weight and pain. These disagreeable effects are said to be absent after the use of tannoform. The new drug may be given in cases of diarrhoea and dysentery, for an astringent effect, in doses of from 5 to 15 grains three times daily. Applied locally, tannoform, it is alleged, checks excessive sweating, and it has been used with good results in hyperidrosis of the feet. In this affection it is said to surpass in elBcacy both tannic and salicylic acids. In the treat- ment of old wounds, ulcers, and moist erup- tions, it may be used pure in a 10-per-cent. ointment, or mixed with equal parts of starch or chalk. It has been used in a strength of 1 part to 4 parts of starch as a dusting powder for soft chancres, and is said to be useful in the treat- ment of diabetic pruritus vuhw. As a snuff in ozcena, .tannoform has also been recom- mended. (Therapeutische Wochenschrift, May 10, 1896.)— Samuel M. Beickner. TANOSAL.— This is a synthetical tannic- acid ester of creosote, an amorphous, dark- brown, very hygroscopic powder having a faint odour of creosote. On account of its prone- ness to deliquesce, it can not be dispensed as a powder. It is on the market in the form of a watery solution of a definite strength and in that of pills. Each pill contains about 5 grains of tanosal, equivalent to 3 grains of creosote. On account of the ready solubilitv of tanosal, it is easily administered in water, and it is not irritating to sound mucous membranes; yet, because of its harsh taste, the solution should be freely diluted— a tablespoonful with half a glass of sweetened water. Dr. G. Kestner, of the civil hospital in MQhl- hausen (cited in the Therapeutische Wochen- schrift, November 22, 1896), thinks that tanosal is better borne by the digestive organs than any other preparation of creosote. It seems to be excreted, he says, neither unchanged nor in the form of creosote. He has used it in more than seventy-five cases. The usual dose is a tablespoonful of the solution, three times a day, gradually increased in some cases to double that amount. There have been in- stances, he says, in which patients have taken as much as nine tablespoonfuls in a day with- 261 TANNIN TAR out any inconvenience. In three oases of tu- berculous intestinal ulceration, however, the remedy gave rise to colic and diarrhoea, even in small doses. In many cases it became dis- tasteful after being used for a long time, but generally the distaste was overcome. Among the patients there were thirty-three with pulmonary tuberculosis, fifteen with acute bronchitis, eleven with chronic bronchitis, one with chronic broncho-pneumonia, five with bronchitis incidental to infectious diseases, and ten with simple catarrh of the throat and bronchi, and it was in the last-mentioned class of cases that the best results were obtained. Reduction of the bronchial secretion is the chief effect of tanosal, and to accomplish such reduction Kestner thinks it at least equal to terpene. Its action is the more pronounced the more recent the case, but even in cases of long standing it diminishes the expectoration and the dyspnoea. Children, he has found, re- spond to it more readily than adults, and for them the amount to be taken daily is commonly a teaspoonful of the solution for each year of age. In phthisical oases, he states, it acts as well as any other preparation of creosote. TANSY, Tanacetum vulgare, is a perennial herbaceous plant indigenous to Europe, but naturalized in the United States. The parts used in medicine are the leaves and flowering tops. The herb grows to the height of from two to three feet. The leaves have a peculiar fragrance, and a bitter, slightly acrid, and aro- matic taste. Tansy has been employed in the treatment of intermittent fever, as a diuretic and stimu- lant in rheumatism and in hysteria, and the seeds are recommended as a powerful anfhel- minthic. The oil is. also an effective vermifuge. The drug is perhaps best known from its domestic use as an emmenagogue and an aborti- faeient. Its action, however, either as a stimu- lant to the menstrual flow or as an ecbolic, is extremely uncertain, and grave symptoms have followed its administration. Death has resulted even from the ingestion of small doses — a drachm — ■oi the oil, yet as much as four drachms have been taken without fatal effect. A case is reported in which a large quantity of the infusion, taken internally, pro- duced death. The toxic effects are abdominal pain, vomiting, purging, paralysis , of the mus- cles of deglutition and respiration, rapid and full pulse, convulsions, coma, asphyxia, and death. The powder is given in doses of from 30 to 60 grains. The dose of the oil as an emmena- gogue is from 1 to 3 drops. The infusion is made by steeping an ounce of the tops or leaves in a pint of water, and is given in quantities of 1 or 2 oz. — Charles Jbwett. TAPIOCA is an amylaceous food obtained from Manihot utilissima, indigenous to Brazil, where it is known as the manioc plant. It is cultivated also in the West Indies, where it is known under the name of cassava. It is culti- vated in other portions of tropical America and in Africa as well. It is perennial, and grows in the form of a bush, from six to eight feet in height. The roots are tubers of great size, sometimes weighing thirty pounds. Prom three to eight of these tubers grow in a cluster. They consist largely of starch, and are the edible part of the plant. Most varieties con- tain a bitter, acrid juice, which is intensely poisonous, owing to the presence of prussio acid. This is dissipated by washing, drying, and cooking. The starch obtained from the tubers is ground by the natives, dried, and again pulverized to form " cassava meal." The tapioca of com^meree is made by heating the meal on hot plates and stirring it with an iron. As the starch granules burst, a portion of the starch is converted into dextrin, and the whole conglomerates into small irregular masses. The uncooked starch is sometimes imported into this country under the name of Brazilian arrow- root. Tapioca, like arrowroot, sago, and other forms of simple starch, is used largely as a food, and is well adapted to the needs of the sick. Like them, it has no medicinal proper- ties. — Floyd M. Ckandall. TAR is a highly complex product of the destructive distillation of organic substances and bituminous minerals, more particularly of certain woods and of coal. The commonest variety of wood tar, pix liguida {q. v.), is de- rived from conifers, especially Pinus palustris (in this country), JPinus silvestris, and Larix sibirica (in Europe). It is a thick, dark-col- oured, viscid liquid, and has an acid reaction, a peculiar empyreumatic odour, and a bitter taste. It is produced by distillation per de- scensum. It may be described as an impure turpentine, containing, besides turpentine, as its most important constituents, various sub- stances of the phenol group and pyroligneous acid. When it is subjected to redistillation in stills, the " oil of tar " is separated from the pitch. Oil of tar, oleum picis liguidee, is a volatile, oily liquid, which is more or less colourless at first, depending upon the amount of impurities it contains, but gradually becomes darker with age, from oxidation. It has a complex com- position, containing oil of turpentine and acetic acid, with the phenols and most of the empyreumatic ingredients of crude tar, which it resembles in odour and in general properties. Like cnide wood tar, the oil is soluble in alco- hol, in ether, in chloroform, in volatile oils, and in solutions of caustic alkalis. Oil of cade, oleum cadinum, oleum juniperi empyreumaticum, is an empyreumatic wood tar, obtained by distillation per descensum from the wood of Juniperus oxycedrus (Linn., Ord. Co- niferce), a tree found chiefly in lands border- ing on the Mediterranean. It is thinner than common wood tar (pix liguida). black in mass, but brown or brownish yellow in thin layers. Its odour is pleasanter than that of the com- mon tar, which, however, in most respects it resembles. Its taste is acrid and bitter. It contains a large proportion of acetic acid. Oleum rusci is a tar obtained from the bark or other woody portions of Betula alba, chiefly in Poland and in adjacent parts of Russia proper. Birch tar has also been known as TAR 262 "Russian oil," oleum seu betuUnum musco- viticum. The origin of the terra oleum rusci is obscure. It has been suggested by MacEwan that it is derived from the Polish brzoza (birch), which became corrupted and Latinized into Bniscus and Jiuscus. The mode of obtaining the birch tar has varied. At present it is said to be produced by distillation per descensum, as was most com- monly the case in the past. All that is now in the market is said to be produced in this way. Formerly it was rectified by a second distilla- tion. The rootlets and twigs were subjected to dry distillation in crude olay retorts con- nected by wooden pipes with a receiver buried in the ground. Such a rectified product, how- ever, is rarely if ever obtainable at the present time. It is a thick, brownish-black liquid, having the fragrant odour that we are familiar with in Russia leather. It is said to contain a larger amount of pyrocatechia than oil of cade, but less pyroligneous acid, though in its general properties it closely resembles oil of cade. Beech tar, oleum fagi, is a wood tar similar to oleum rusci and oil of cade, and is the prod- uct of Fagus silvatica, or Fagus silvestris. It has been one of the chief sources of creosote. Though often mentioned by medical authorities abroad, especially German, commercially the name is said to have little significance, except as a synonym for wood tar, or as another name for oleum rusci. It is stated on good authority that real beech tar does not at the present time exist in the market. A beech oil obtained by expression from the fruit of the tree is occa- sionally met with, and is also known as oleum fagi. ' It is a bland oil of a yellow colour, has a slight odour and a mild taste, and resembles almond oil. Coal tar, pixliquida lithanthracis, pix liqui- da e liquo fossili, is a semi-liquid, viscid sub- stance, black in mass, greenish-black in thin layers, of a strong, penetrating odour, and but slightly acid or alkaline reaction. It is one of the by-products of the manufacture of illu- minating gas from bituminous coal. Its com- position is very complex, including carbolic acid in large quantity, together with rosolic acid; the alkaline bases ammonia, aniline, quinoline, and pyrrhol ; the neutral hydrocar- bons benzol, toluol, oresol, naphthol, naphtha- line, chrysene, anthracene, cumene, and many others. The neutral substances constitute the greater portion of it. In its physiological as well as in its thera- peutical action, tar is closely allied to turpen- tine, though certain of its effects, due to the large amount of carbolic acid or other phenols which it contains, are peculiar to it. To in- sects and other low forms of life it is destruc- tive, and in large doses it is toxic to the human organism. In moderate doses wood tar is an excitant, increasing the rapidity of the pulse and stimulating the secretions of the lungs, kidneys, and skin. If it is given in larger doses, the appetite is impaired, with more or less serious derangement of digestion, headache, and manifestations of general intoxication. These symptoms have been observed more par- ticularly after the external use of the drug. When it is freely applied, absorption may take place in sufficient degree to give rise to alarm- ing symptoms that correspond to those of car- bolic-acid poisoning. Their onset may be sudden, and occur soon after the beginning of the treatment, sometimes following a single application when the surface to which it is made is extensive. The condition is charac- terized by fever, headache, loaded tongue, belching, nausea, vomiting of black tarry mat- ter, colic, diarrhoea with tar-like evacuations, strangury, and ischuria, the urine becoming greenish, and finally black, emitting the char- acteristic odour of tar. After from twenty- four to forty-eight hours, if the applications have been suspended, the symptoms gradually abate, with copious diaphoresis and some diu- resis. First the urine turns from black to olive-green, and becomes lighter and lighter in colour till the condition finally becomes normal. It is said that if the use of the remedy is afterwards resumed the patient becomes less intolerant of it, and no further trouble is ex- perienced. Children and young persons are most susceptible. When tar in a concentrated form is applied directly to a sensitive skin, it is apt to cause irritation with an eruption of a spreading ery- thema, or of inflammatory papules, which may assume a peculiar and very characteristic ap- pearance. When the applications of tar have been extensive a follicular inflammation is apt to result, with occlusion of the sebaceous fol- licles by comedo-like plugs, composed of par- ticles of tar. It is most likely to occur over the exterior surface of the lower extremities where the hairs are abundant. Hard and more or less painful papules form, varying in size from that of a pin head to that of a pea, of a reddish- brown colour, with a black point showing in the centre of each. They may be accompanied with the formation of nodules of larger size, or with furuncles. The afEection is known as " tar acne," acne picealis. Sometimes the internal use of tar is attended with the production of a cutaneous rash, which may be either erythematous, rubeolous, or urticarial in character. In common with all balsaraics, tar has a specific action on mucous tissue, whereby it becomes an effective anticatarrhal agent. In health, it tends to increase secretion, but where there is supersecretion due to a subacute or chronic inflammatory congestion, the secretion is diminished. In the bronchorrhwa of phthisis and other pulmonary affections it is often a useful remedy, and also in chronic or subacute vesical, urethral, and vaginal catarrh. The usual dose is from -J a drachm to ^ oz. a day. It may be given in milk or beer, or in the form of pills or capsules. The glycerite is also a convenient and acceptable form of administra- tion. Tar water, for the same purposes, may be given to the extent of from 1 to 2 pints a day. The vapour of tar is used for inhalations in pulmonary troubles with excessive secretions, and also for deodorizing and purifying vessels and sick-rooms. The tar having "been mixed with carbonate of potassium in the proportion 263 TAE of 1 to 24, for the purpose of neutralizing the pyroligneous acid, which would irritate the lungs, is put into a cup which is placed in a small water bath over a spirit lamp. In this way the air of the room becomes gradually charged with the vapour. For the purpose ot inhalation, the same effect may be accomplished more simply by letting the patient inhale the fumes of tar water or wine of tar by means of the steam atomizer. In diseases of the skin, more particularly in those in which the mucous layer is specially implicated, tar is a much more effective remedy than it is in diseases of the mucous membrane proper. In eczema and psoriasis tarry appli- cations are especially efficacious. Though some (notably Dr. McCall Anderson) have re- ported good results from the internal use of tar in these affections, all are agreed that the remedy is vastly more effective when applied directly to the diseased surface. In eczema, the rule is generally observed to await the de- cline of active inflammatory manifestations before beginning tar treatment. If it is begun earlier, while there is still vesioulation, surface exudation, or erosion, it is apt to aggravate the disease, resembling in this respect the treat- ment of catarrhal diseases generally by bal- samics. It is well known, for example, that if the use of copaiba balsam, sandal-wood oil, and the like is begun while a gonorrhoea is in the acute stage, the, effect is bad. These remedies are not appropriate till, with the de- cline of inflammation, the purulent discharge has given place to one that contains a consid- erable proportion of mucus. In eczema where the remedy is directly applied to the diseased .parts, it is usually necessary to defer the use of tar till all discharge has ceased. Espe- cially in eczema of an impetiginous character is tar obiectionable. The Indications for its use is generally regarded to be a condition of subacute inflammation manifested by a dry scaling surface with more or less hypera3mia and pruritus, inflammatory products still re- maining in the tissues. Even at this stage it is not always well borne, the intolerance in some qases being apparently due to idiosyn- crasy. It is therefore advisable to begin al- ways with the milder preparations or with the tar in a diluted form, as in combination with an emollient ointment or with olive oil, or in weaker alcoholic or alkaline solutions. The weaker solutions ot coal tar, made either from Diihring's compound tincture or from liquor carbonis detergens, often answer well. Later, stronger applications may be made. Instead of making the applications continuous, it is sometimes preferable to make them intermit- tent, as, for example, by means ot the so-called " tar bath." This consists in first smearing the eczematous surface with tar or some of its preparations, afterward immersing the parts in a warm bath, washing off the tar with soap, and finally following with the application of some soothing and desiccating ointment like Lasgar's paste (2 parts each of zinc oxide and powdered starch and 4 parts of vaseline). This method of using tar may be adopted with advantage even at an early stage of the dis- ease and before the surface has ceased to ex- ude. Lassar first recommended it for such early treatment. After the daily use of the tar baths for a few days an exuding surface often becomes dry, yellowish, and scaly, when it is possible to proceed to more continuous and energetic applications. For psoriasis tar was formerly used much more than it is now. Latterly it has been largely superseded by ohrysarobin. As em- ployed by Hebra and others, the tar treatment was carried out very vigorously, and on this treatment the main reliance was placed. Two methods were employed — one continuous, the other interrupted or intermittent. In the for- mer the patient was first subjected to daily friction with green soap (see under Soap) or prolonged baths till the scales had been partly or wholly removed. Wood tar, preferably in the form of olewm cadini or oleum rusci, or some tarry preparation, such as tinctura rusci, was then well rubbed into the skin and allowed to dry on. To facilitate the drying, the patient was clothed in woollen or wrapped in woollen blankets, the advantage of which was that the wool did not absorb the tar as linen or cotton would. In from two to six hours, the surface having become quite dry, the patient resumed the usual clothing. The tarry inunctions were repeated once or twice a day, at each inunc- tion the tar from the previous application being first washed off. This was continued till scales ceased to form. For intermittent applications, the tar bath was used in the manner above described, ex- cept that each bath was preceded by green-soap frictions, and after the tar had been rubbed in the patient was made to remain in the bath for at least six hours. The tar that remained on the surface was then washed off with green soap, and finally the surface, having been dried, was dressed with a soothing ointment. Formerly tar was much used as a remedy for scabies. Though it still is often employed as one of the ingredients of various " itch ointments," it is rather for the sake of its anticatarrhal effect than for the purpose of destroying the acarus. As a disinfectant for unclean or putrid sores, the tar powders with gypsum or charcoal (more especially the coal-tar powder) are effica- cious. Coal-tar powder was recommended by Devergie for rupia, ecthyma, impetigo, herpes, and eczema. An objection to the gypsum powders is their tendency to adhere and cake on the parts to which they are applied. With the recently manufactured disinfectant pow- ders at harid, this preparation is seldom re- quired. Tar has a definite anticnesmatic action, chiefly owing to the carbolic acid or allied phenols which it contains, but partly, probably, because of its effect to reduce hypersemia. This action is exhibited even in watery solutions. For priclcly heat tar water is an excellent applica- tion, and also for itching of the scalp. The alkaline and alcoholic solutions as well as the coal-tar preparations with soap bark are espe- cially serviceable for dry eczematous patches attended with itching. TARACANIN TEA 264 The wood-tar preparations for internal use include syrupus picis Hquidm, of which the dose is from -J- to 1 fl. oz. ; glyceritum picis liquidcB, of which the dose is from -| to 1 fl. drachm ; and infusum picis liguidce,, aqua picis (sen picea), tar water, of which the dose is from 3 to 4 fl. oz. For external use, the prepartions of wood tar most commonly employed are the follow- ing : Oleum picis liguidce (U. S. Ph.), unguen- tum picis liquidce (U. S. Ph.), and unguentum picis betulm (8 parts of birch tar to 43 of simple ointment). Tar tinctures. — Tinctura picis betulce may be made by dissolving 1 part of birch tar m 10 parts of alcohol, and afterward filtering, The formula for Hebra's tinctura rusci is the following: 5 Birch tar 50 parts ; Sulphuric ether, )ga^j^___ ^g .. Alcohol, ) Oil of lavender 3 " Mix the tar, ether, and alcohol, and filter; then add the oil of lavender. Tinctura saponis cum pici consists of equal parts of wood tar, green soap, and alcohol. The formula for Bulkley's liquor picis alka- linus is as follows : 5 Tar 8 drachms ; Caustic potash 1 drachm ; Water 5 drachms. The potash is first dissolved in the water and the solutions gradually added to the tar while rubbing in a mortar. For use it is to be diluted at first with 8 parts or more of water, gradually using stronger and stronger solutions. For tar soaps see under Soap. Wood-tar powder is made by triturating 1 part of wood tar with 7 parts of gypsum. The preparations of coal tar are suited only to external use. Because of its irritating qual- ities, this tar is never used internally. Its preparations include tinctures, emulsions with alkalies, and mixtures in the form of powder. The best alcoholic solutions of coal tar are made with tinctures of soap bark. The tinc- ture of elm has also been used. The coal-tar saponine of Lebceuf is made as follows : 5 Coal tar 100 parts ; Tincture of qnillaia 3,400 " Mix and digest for six days in a closed vessel at a temperature of from 95° to 104° F. From time to time agitate the mixture and finally filter. Dilhring's formula {American Jotirnal of the Medical Sciences, May, 1894) is the fol- lowing : Digest 1 part of coal tar with 6 parts of soap- bark tincture (which should be of the strength of 1 to 4, and made with 95-per-cent. alcohol), with frequent agitation, for not less than eight days and preferably for a longer time, and finally filter. " It is a brown-black, clear tinc- ture which upon the addition of water forms a clearly yellowish emulsion, the colour and cer- tain other characters varying with the kind of coal tar employed." This preparation is called " compound tincture of coal tar," and is said to be very similar in its composition and thera- peutic qualities to " liquor carbonis deter- gens," a proprietary article made by Wright & Co., of England, which is much used in Great Britain. For use as a wash, Duhring's tinc- ture, as well as his liquor carbonis detergens, should be diluted with from 10 to 60 parts of water. Emulsions of coal tar are made with strong solutions of caustic potash and soda or ammo- nia or with alcohol, but the tar separates when water is added, and is apt to cause irritation. The following preparation, in which alcohol and glycerin are associated with the alkali, is recommended by Dr. McCall Anderson : 5 Coal tar 3 drachms ; Alcohol 2 oz. ; Stronger ammonia water. 8 minims ; Glycerin 6 drachms ; Distilled water, enough to make 13 oz. Mix the tar and the alcohol, strain the mix- ture, and add the other ingredients. It forms an opaque, milky, dirty-brownish emulsion which may be further diluted with water in all proportions without precipitation. A coal-tar powder (the poudre de coal-tar of the French) may be made with gypsum in the proportion of from 1 to 3 parts of the tar to 100 of gypsum. The tar is first heated till it liquefies in a pitch kettle, and is then thor- oughly triturated with the gypsum. In place of the gypsum, powdered wood charcoal has been used. The derivatives of coal tar, the so-called "coal-tar products," include many remedies of great value, especially among those of com- paratively recent adoption, and it is to these that this tar owes its chief importance in medi- cine. — Edward Bennet Bronson. TARACANIN.— See under Blatta. TARAXACUM (U. S. Ph.), taraiaci ra^ dix (Br. Ph.), is the root of Taraxacum offici- nale gathered in autumn. It is the ordinary dandelion plant, common in fields, gardens, and meadows. Under the name radix tarax- aci cum herba, the Ger. Ph. recognises both the root and the leaves. It is required to be free from the root of Chicorium intybus, or chicory, which it greatly resembles, the dif- ference being that the chicory root is usually paler and more bitter, and has the milk ves- sels in radiating lines. The root of the plant is the most efficacious part. A sugar is fre- quently found in the juices of the roots gath- ered in the spring, iniilin being more abundant when the plant is plucked between Septem- ber and February. An active principle, taraxacin, was isolated by Pollex in 1839. It is an amorphous, bitter, crystallizable mass obtained from the milk juice of the plant. It is somewhat acrid, fu- sible, and scarcely soluble in cold water, al- though very soluble in boiling water, in ether, and in alcohol. Kromayer obtained not only taraxacin, but also taraxacerin, CsHibO, which is insoluble in water, but is dissolved by alco- hol. A resin and a fermentable sugar have also been found in the juice of the root. The Arabs were the first to employ taraxa- 265 TARACANIN TEA cum, using it as a deobstruent and blood pu- rifier. During the eigliteentli century it was widely used in chronic affections of the abdom- inal viscera, especially those of the liver. It was praised in the treatment of renal calcu- lus and of some irritating diseases. Its popu- lar reputation as a diuretic is seen in the vulgar English and French names of the plant. At the present day it has a limited employ- ment as a ionic of slight power, as a diuretic, and as an aperient. It is said to act as a stomachic when there is diminished appetite, and it has been alleged for it that it promotes digestion. It has some reputation as an hepat- ic stimulant, although its powers in this di- rection are probably quite feeble, and it would require its prolonged administration to secure an increase of biliary secretion or a decrease of hepatic congestion. It has been used in atonic dyspepsia combined with constipation with reputed benefit. It has been praised even in the treatment ot pulmonary phthisis on ac- count of its supposed beneficial action on the stomach, liver, and intestines. The late Dr. George 1$. Wood, of Philadelphia, employed it with confidence in the treatment of chronic congestion and inflammation of the liver and spleen when there was no irritation or inflam- matory condition of the gastric and intestinal mucous membranes. The dried root of tarax- acum is sometimes mixed with ground coffee to be used in making a drinlf, and has some- times been substituted for coffee after powder- ing and roasting. Taraxacum, to be of any service, must be given continuously for several weelcs, and will probably be of value only in cases of hepatic torpor with constipation. It may be adminis- tered in decoction, decoctum taraxaci (Br. Ph.), the dose of which is from 2 to 4 fl. oz., though this is apt to ferment. The dose of the extract, extractum taraxaci (U. S. Ph., Br. Ph., Ger. Ph.), is from 20 to 60 grains ; that of the fluid, or liquid, extract, extractum taraxaci fluidum (U. S. Ph.), extractum taraxaci liquidum (Br. Ph.), is from 1 to 2 fl. drachms ; that of the fresh juice, succus taraxaci (Br. Ph.), is from 2 to 4 fl. drachms. — Samuel M. Beickneb. TAKTAR, CREAM OF.— Potassium bi- tartrate (see under Potassium tartrates). TABTAB. EMETIC— Antimony and po- tassium tartrate (see under Antimony). TARTARIC ACID, the acidum tartari- cum of the pharmacopoeias, belongs to the same group as citric acid, has essentially the same properties, although less agreeable, and may be substituted for it with entire propriety when the question of economy is of impor- tance. It may be employed in making a sub- stitute for lemonade, but is by itself rather flat and insipid, faults which, however, may be corrected by the addition of a few drops of es- sence or syrup of lemon, or of any fruit syrup which may be at hand. It may also be used in preparing extemporaneous effervescing mix- tures, about 3 parts of the acid neutralizing 4 of sodium bicarbonate. An ordinary dose is 120 grains, although double that quantity can be used with safety. The tartrates are soluble, as a rule, and those of the alkaline bases are cathartic, and generally mildly diuretic. Russell H. Nevins. TARTABLITHINE.— This is the name of an American proprietary preparation which is furnished in the form of effervescent tablets. It is described as " the lithium analogue of cream of tartar '' (Coblentz), and appears to be a bitartrate of lithium. It is used in gout, also in eczema and other affections attributed to an excess of uric acid in the blood, in doses of from 5 to 10 grains (one or two tablets), in water, four times a day. Equal parts of tar- tarlithine and sulphur, also in the form of 5- grain tablet s, to be taken in the same doses, are employed in the same diseased conditions, and particularly in cases associated with torpor of the liver. TARTARUS BORAXATXJS (Ger. Ph.). — This is a white powder, acid to the taste and in reaction, made by dissolving 2 parts of borax in 15 parts of water, with the aid of a vapour bath, and adding 5 parts of potassium bitartrate. It dissolves in its own weight of water. It is employed as a laxative in doses of from 1 to 2 oz. It has been supposed to be of service as a lithontripfic. TARTARUS DEPURATUS (Ger. Ph.). — Potassium bitartrate (see under Potassium tartrates). TARTARUS NATRONATUS (Ger. Ph.). — Roohelle salt (see Potassium and so- dium tartrate, under Potassium tartrates). TARTARUS STIBIATUS (Ger. Ph.).— Tartar emetic (see Antimony). TEA. — The plant which furnishes tea is the Thea chinensis, or Camellia Thea, an evergreen shrub which belongs to the natural order Camelliacece, indigenous to the southern part of Asia. It is extensively cultivated in China, Japan, and India, and to a lesser degree in South America, the United States, and else- where within 40° of the equator. In the United States its cultivation has not yet been attended by any marked success, possibly on account of tile soil and climate, but quite as probably on account of lack of skill in the preparation of the leaves. The plant naturally becomes a) small tree, which may attain to a height of thirty feet, but it is pruned when cultivated so as to prevent its growth upward more than from four to eight feet, and so cause it to be- come very bushy from a greater abundance of twigs and leaves. It was formerly described as of several species, but these are now considered to be varieties which have been produced by long cultivation, each of which possesses cer- tain distinguishing characteristics. They are called Thea bohea, Thea. viridis, Thea stricta, 2^hea assamica, etc. The India, Ceylon, and other teas are representatives of the same plant named from the countries in which they are cultivated, each of which presents certain characteristics of flavour, dependent mainly on the differences of soil and climate and pos- sibly on variations in the manner of prepara- tion. The most important division of tea is TEA 266 into green and black, a distinction which does not depend on the variety of the plant from which the leaves are taken, but chiefly, if not entirely, on the method of their preparation. For example, the I'hea viridis may be the va- riety cultivated in two districts of China, one of which produces green tea and the other black. At the same time, green and black teas are rarely if ever produced in the same district, and it is probable that different ex- •posures, soils, and cultivation are influential in the most satisfactory production of each. The plants are propagated from seeds planted at certain distances from one another in rows. When they are three years old they yield the first crop of leaves for collection, and increase yearly in value until they are eight years of age, when they begin to deteriorate. At about this time they are frequently cut down, so that a larger product of leaves may be ob- tained from the numerous shoots which arise from the stump. The leaves are picked by hand during the rainy season, from two to four pickings usually being made at intervals of about six weeks. In China the first pic-k- ing is made when the earliest buds are just opening into leaves. This first crop of buds and leaves form the very choicest quality of tea, very small quantities of which are ever seen in this country. It is largely purchased by the wealthy Chinese for home use, and it is difficult to export, because, when packed in large quantities, as in the great tea ships, it is quite apt to ferment. Considerable quantities are transported in small packages overland, principally to Eussia, or sent with great care to other parts of the world. This grade of tea scarcely colours the water in which it is infused, although it is very strong to the taste. The warm rains soon bring out more young leaves on the plants, and these are gathered during the second picking. At this time the best qualities for exportation are obtained, as the subsequent pickings supply only inferior grades of tea. The quality of the leaves de- pends upon a considerable variety of deter- mining causes. Other things being equal, the quality varies with the time of picking ; of the leaves picked from a plant at the same time, the smaller and more immature are of better quality than the larger, while the soil, situa- tion, climate, attention to cultivation, and the character of the individual plant contribute severally toward the determination of the quality,' and all unite to characterize numer- ous commercial varieties. The descriptions of the method of preparing and drying the leaves vary a great deal as given by different writers, and it is probable that the details of the procedure are not the same in all places, but the following may per- haps be considered to give the essential differ- ences in the manufacture of green and black tea, the most important of which is that the leaves intended to form black tea are allowed to undergo a certain amount of fermentation before they are dried. In the manufacture of black tea the leaves, after they have been plucked, are piled in heaps and left for several hours, frequently over night. They are then heated for a few minutes, then rolled and heated again. This alternate heating and rolling is repeated several times until the leaves are in a proper condition, and then they are dried slowly over a fire. The odour of these leaves is "rather slight, and numerous grades are flavoured by the admixture of aro- matic fiowers for a day or so, after which they are removed by sifting or otherwise. In this manner the so-called English breakfast teas are prepared. When green tea is to be made, the leaves are not allowed to lie and ferment, but, within an hour or so after they have been gathered, are placed in pans and heated for four or five minutes over a brisk, smokeless fire. They are then removed, rolled by hand, and again placed in the drying pans over the fire, where they are kept in rapid motion for an hour or two. Colouring matters are frequently added to the leaves intended for the foreign market, particularly when they are of inferior quality. The principal chemical difference be- tween green and black tea is that the green contains much more tannin, but the exact pro- portion is uncertain, as it varies to a consider- able degree according to the analyses reported by different chemists. The chemical constituents of tea are quite numerous, but the three most important ones are an alkaloid theine (see Theine), an essential oil, and tannin. The essential oil is that which determines the flavour of the tea and probably assists materially in the production of its physiological effects. It is citron yellow, light- er than water, is solidified by cold and resini- fied by exposure to the air, and yields the characteristic odour of tea. It is not present in the fresh leaf, but develops during the pro- cess of roasting and drying. The use of tea as a beverage has been com- mon among the Chinese from a very early period, but among the occidental races it is essentially modern. It was introduced into England in 1657 at Garraway's coffee house, where it was received with great favour. At first the cost was excessive, but as the impor- tation increased the price fell, until its use be- came general and supplanted that of sage tea, which had long been a favourite beverage. At; the present time enormous quantities are con- sumed in all parts of the world, more perhaps by English-speaking peoples than by those of other European origin. Writers on dietetics are accustomed to give explicit directions in regard to the preparation of the infusion, but it is to be feared that their rules are very frequently disregarded. To ob- tain the greatest benefit and enjoyment from a cup of tea, boiling water should be poured upon the leaves, allowed to stand in a closed and protected vessel for from three to eight minutes, and then poured off to be drank. In this manner the volatile oil, which deter- mines the flavour and possesses to no slight degree stimulating properties, is preserved, while the undesirable extractive matters large- ly remain in the leaf." Prolonged steeping or boiling causes this volatile oil to be dissipated, while it draws out the tannin and other ex- 267 TEA tractives which render the drink less palatable and more injurious to the digestive system. It is true that the finest young leaves contain proportionately less tannin than others and that on that account it is less objectionable to boil them, but no advantage, unless it may be the extraction of a larger amount of theine, can be obtained, while there is a very marked loss in the dissipation of the volatile oil. The inferior grades of tea are the ones most fre- quently boiled, and they make a dark, bitter, astringent decoction. The action of tea upon the system is very complex. Liebig is quoted as stating that there are no drinks which, in their complexity, have more resemblance to soup than tea and coifee. The Chinese are said to consider it " cooling, peptic, exhilarating, stimulating, both laxative and astringent, diuretic, em- menagogue, and, in large concentrated doses, emetic." Some years ago Mr. E. Smith insti- tuted a number of experiments from which he determined that tea caused an increase in the amount of carbon dioxide evolved in respira- tion as well as in the depth of inspiration. This would seem to indicate that it produces an increase in the waste of tissue, but the sus- taining power it frequently exhibits would seem to denote the opposite effect, as it does not furnish any nutriment to replace the waste. Smith considers that it promotes assimilation and the transformation of foods. This may be true, although it retards artificial digestion. We know that it is a gentle stimulant to the nervous system, that it is refreshing, that it relieves the sensation of fatigue, and that it permits of increased exertion without food. The latter effect is so marked that some au- thorities, among whom is Captain Woodruff, of the United States Army, highly recommend tea for the use of soldiers on a march. After a considerable experience with it in arctic ex- ploration. Dr. Hayes also warmly commended its sustaining power. Other effects which are produced by tea are the promotion of cheerfulness and the stimu- lation of a lively flow of ideas, as well as the relief of migraine and headache from overwork or worry, and the production of insomnia. It has also a sedative effect upon the circulation and promotes the action of the skin. Al- though it is difficult, in regard to the latter effects, to distinguish between the results pro- duced by the tea and those due to the intro- duction of the hot water in which it is infused into the system, we may with confidence ascribe a certain portion of the effect to the tea itself, and it is well known that after drinking a cup of tea the skin and mucous membranes are rendered moist, the perspira- tion is increased, and the temperature of the body is so regulated that it feels cooler in warm weather and warmer in cold. In large quantities, tea precipitates the di- gestive ferments, retards digestion, and may occasion irritability and catarrh of the stom- ach. This is usually associated with constipa- tion, but sometimes with diarrhoea with more or less flatulence. The nervous symptoms produced are, first, restlessness and insomnia, CI then muscular tremors, palpitation of the heart, and increased nervous worry. It has been considered doubtful by some writers whether such a condition as chronic tea intoxication, or theism, exists or not. But these writers are very explicit in regard to how the infusion should be made and when drank, and if those rules are constantly and habitually violated, if large quantities of strong and boiled tea are drank at all times during the day, it is not a matter of surprise that the physiological effects on the nervous and digestive systems should be plainly ap- parent. It is a well-known fact, at least in the city of New York, that many women of the poorer classes keep a teapot on the stove from morning till night, and drink the bitter de- coction at short intervals, adding fresh water to the stewed leaves from time to time and supplying more tea leaves as the strength begins to fail. These tea-drinkers are ill nour- ished, ansemic, dyspeptic, and morbidly nerv- ous. Such conditions as these may possibly not be due entirely to the action of the tea, and they may be in part ascribed to the starva- tion induced, for persons who drink tea in this manner usually take very little nourish- ment ; but the tea must be held primarily responsible for a large share of the toxic symptoms. The symptoms which have been ascribed to such an abuse of tea include ano- rexia, flatulent dyspepsia, sometimes nausea and vomiting, constipation, muscular tremor, irregular and feeble cardiac action, dyspncea, nervousness, hysteria, headache, neuralgia, tin- nitus, mental and physical exhaustion, night- mare, and hallucinations. Delirium is said to have been a result of chewing tea. Spratling has reported a very marked case of multiple neuritis caused by and dependent upon ex- cessive tea-drinking, and this habit has been mentioned by some authorities as a contribut- ing factor to the production of insanity. The appearance of such severe nervous manifesta- tions may be properly ascribed to the idiosyn^ crasy of the individual, but their occasional occurrence furnishes a strong evidence that the minor nervous troubles commonly attributed to the consumption of large quantities of tea are caused by the tea itself. Professional tea- tasters are, as a class, very nervous and are said by some writers to be abnormally consti- pated and to have a diminished excretion of urea. It is frequently the impression that be- cause tea-tasters simply rinse the mouth with the infusion none is swallowed, and whatever effect is produced upon them must be by ab- sorption of the constituents through the buc- cal mucous membrane. As a matter of fact, a very few drops remain in the mouth after each taste and find their way eventually to the stomach, so that after a large number of tastings quite a quantity of tea has been drank, a very little at a time, and physiologi- cal effects may be expected. Sometimes the nervous symptoms which are induced in this manner are of sufficient severity to oblige a tea- taster to abandon his business, but so marked an effect is usually referable to idiosyncrasy. The use of tea as a beverage should be TEABERRY TENTS 268 avoided in dyspepsia and in all irritable con- ditions of the stomach, as well as when there is a very marked tendency to constipation. But it is very useful to relieve the feeling of oppression which follows the ingestion of a very hearty meal. Persons who suffer from nervousness or insomnia should never drink tea, because it tends to increase these troubles. It is very frequently harmful when given to children. For medicinal purposes a hot infusion of tea is occasionally useful for the purpose of causing diaphoresis at the commencement of slight attacks of muscular rheumatism, bron- chitis, amygilalifis, or pharyngitis. It will also relieve fatigue and muscular soreness after excessive exertion, and so predispose to rest. In cases of poisoning with narcotics or with agents which cause cardiac depression, tea is a good antidote, though not so efficient as cof- fee. ■ In these cases it should be given in large qaantities and in a very concentrated form. It has been used as an injection in teucorrhcea, gonorrhoea, and gleet, as a collyrium in con- junctivitis, and as a gargle in pharyngitis and amygdalitis, but in all these affections its value depends on the tannin alone and not upon any of the constituents peculiar to itself, and usu- ally more satisfactory solutions of tannin can be obtained for these purposes. One use, which is only too common, is to be seriously depre- cated — the application of the stewed leaves as a poultice to an inflamed eye. It is very, very rarely that the application of a poultice to an eye is indicated, and much harm has resulted sometimes from such a procedure; moreover, when it is needed it is very easy to find ma- terials better fitted for the purpose than tea leaves. Lie tea. — For purposes of adulteration of tea, the dust and sweepings of tea warehouses are gathered together, cemented with rice water and gum, and rolled into grains which are col- oured green and black. This mixture of refuse is very appropriately named lie tea, and can be detected on infusion when true tea leaves become unrolled, but the lie tea separates into its constituent parts. Brick tea is another mixture of refuse, broken leaves, twigs, siftings, and sweepings, which are cemented together and moulded into forms. When it is to be used a piece is broken from the brick and infused like other tea. It is used to some extent in this country, and very largely by the Tartars, who reduce it to dust, infuse it, whip the infusion, powder it into a cream, and drink the whole. The same method of drinking powdered tea leaves in the infusion made from them is practised else- where, particularly in Asia. Matthias Lanokton Foster. TEABERRY.— See Gaultheria. TEAS. — The word tea is in common use to denote infusions of certain plants, either for beverages or for medicinal purposes. It is not ordinarily considered to denote an official in- fusion or decoction, or other similar drink, as is the case with the French word tisane, but its use is rather restricted to infusions which are prepared and drank in the domestic rathei? than the professional practice of medicine, or as substitutes for tea and coffee. An exhaust- ive enumeration is impracticable, because most of these herb teas enjoy purely local repute, and in almost every locality certain ones are found in high esteem, so only a few examples will be given. Teas may be divided into two classes, those used as beverages and those employed solely as medicines. Those of the first class have been to a great extent supplanted by tea and coffee, but the use of quite a number of other plants is occasionally met with, sometimes for pur- poses of adulteration, but for the most part upon their own merits. First in importance possibly is mate, or Para- guay tea, which is made from the dried leaves of Ilex paraguaiensis, or Brazilian holly, a tree fifteen or twenty feet high, indigenous to South America. Other names by which it is known are St. Bartholom,ew's tea and Jesuit's tea, the latter name having been given to it because it is said that the early Jesuit mission- aries in Brazil and Paraguay established plan- tations for the cultivation of the plant. For the the des Jesuites of the Fr. Cod. see the paragraph on Mexican tea (page 269). The leaves are first heated to develop the aromatic principle, then dried over a fire, and finally powdered. The chief constituents are an astringent principle analogous to tannic acid, which is present in so large a quantity that the leaves are in demand for dyeing purposes, a volatile oil which determines the flavour, and an alkaloid isomeric if not identical with theine. The infusion is sudorific, diuretic, a stomachic irritant, and, in large doses, emetic and purga- tive. It powerfully influences the nutritive functions, and in its effects shows a closer resemblance to coca than to tea. It is drank in large quantities by the natives of those parts of South America where the plant abounds and is much prized by those who have learned to enjoy its peculiar flavour. When taken in excessive quantities it is said to produce a kind of delirium tremens. Brazilian tea is almost the same as the pre- ceding. It is made from the leaves of Ilex gongonha and Ilex thcezans. The preparation of the leaves and the use and effect of the infusion are very closely similar to those of Paraguay tea. In Sumatra and other islands of the East Indian Archipelago coffee leaves are dried, powdered, and used after the manner of tea. It has, indeed, been called coffee tea. The leaves possess properties analogous to those of the fruit, and were found by Dr. Stenhouse to contain a larger proportion o'f caffeine. The infusion resembles in taste and odour one made from a mixture of tea and coffee, and is said to approach the most nearly to tea of any of its substitutes. Abyssinian tea is made from the dried leaves of Catha edulis, a plant which is cultivated in northern Africa. The use of the infusion is extensively practised as a beverage in Arabia as well as in Africa, where it is known as " chaat." Dr. Paul failed to obtain an alkaloid 269 TEABERRY TENTS from the leaves, and their composition is prac- tically unknown. BusJt. lea and Ilonig tea are made from the leaves of certain species of Cyclopia, and are used as substitutes for tea at the Cape of Good Hope. The leaves are said to contain an alka- loid called cyclopine, which differs from theine. Neiv Jersey lea is made from the dried leaves of Ceanothiis americanus. or red root, a shrub of the RhamnacecB. It has been pronounced " a good substitute for indifferent black tea." During the American Revolution, and also in the Southern States during the War of the Rebellion, this was used considerably as a substitute for tea when the latter was not to be obtained. Little is known of its constitu- ents except that it contains tannin, a resin, and a volatile oil. It has some repute as an alterative, is said to be purgative, and has been recommended in dysentery and as a local application in sore throat. Labrador tea is also said to have been used as a substitute for tea by the pati-iots during the American Revolution. It is made from the leaves of Ledum lalifolium, an evergreen shrub indigenous to the northern part of the United States and to Canada. They have an agreeable odour and taste, while the infusion is strong in astringent and narcotic properties. Marsh lea is made from Ledum palustre, a congener of the preceding, found in the north- ern part of Europe, Asia, and America. The leaves have a balsamic odour and an aromatic, bitter taste, and are said to have been substi- tuted for hops in the manufacture of beer in Germany. They are sometimes used, in the form of a decoction, in the exanthemata, in various slcin diseases, and to allay irritation in whooping-cough. It is not an infrequent occurrence for the same name to be applied in different places to two or more substances quite distinct in their nature. Mexican tea may be mentioned as an example, as this name is applied to the infu- sion of the dried leaves of Psoralea glandrtlosa, which resembles Paraguay tea, and also to that made from Chenopodium ambrosioides, which is an anthelminthic and also used for various nervous derangements. The latter is known in the Pr. Cod. as the des Jesuites, and as t6 de Espafla among the Spaniards, and will serve here to introduce the second class of teas, the medicinal. Oswego tea, spearmint tea, and peppermint tea are all made from various species of mint, and are much esteemed as stimiaant carminatives. Catnip tea. made from the leaves and tops of Nepeta cataria. bears a close resemblance to the mint teas, but has the reputation of being also antispasmodic and emmenagogue. Although it is not used to any great extent by the medical profession, it is employed as a domestic remedy in amenorrhoea, chlorosis, and anccmia, as well as for its carminative action. Boneset, or thoroughwort, tea is an infusion of the leaves and tops of Eupatorium perfolia- t'lm, a plant indigenous to the United States. When taken warm, it is a popular diaphoretic in fevers and for the purpose of aborting a cold. In the form of a warm, strong decoction it is an efficient emetic. When cold, the infusion is used with advantage in dyspepsia, general de- bility, and other conditions in which a bitter tonic is indicated. It has also been used as a tainiacide. The name "boneset" was given to this tea on account of its supposed power to relieve the bone pains in dengue or " break- bone fever," (See Eupatorium.) Saffron tea is an infusion of the ilowers of Carthamus tinctorius which enjoys some re- pute as a diaphoretic in measles and other ex- anthemata. Elderberry tea is made from the berries of several indigenous species of Sambucus, and is used as an aperient and diaphoretic. Tansy tea is made from the leaves and tops of Tanacetum vulgare, a perennial, herbaceous plant indigenous to Europe, but also cultivated and growing wild in this country. It is very widely known as an emmenagogue, a diuretic, an anthelminthic, an aromatic bitter, and an irritant narcotic. Although it is useful in amenorrhoea, it has no rightful title to its widespread repute as an abortifacient. Death has resulted in several instances when very large doses have been taken for the purpose of causing abortion, without this effect hav- ing been produced. Linseed, or flaxseed, tea is a demulcent drink made by the infusion of the whole seeds of Linum usifatissimum in water in the propor- tion of half an ounce to a pint. The mucilage present is thus extracted with only a small quantity of the oil, and thus a tea is made which may be advantageously employed in inflammations of the respiratory, gastro-in- testinal, and urinary mucous membranes. It is useful in dysentery, to relieve strangury, cys- titis, and renal colic, and to allay cough. When the seeds are boiled, more of the oily matter is extracted which renders the decoction less fit to be given by the mouth, but useful as a laxa- tive enema. German " breast tea," or marshmallow tea, is another demulcent drink which is made from the root of Althcea officinalis, and is official in the German Pharmacopoeia as compound althaea tea. It is much used in coughs, colds, and bron- chial affections. Occasionally the roots of other species of the Jilalvacece are substituted for the marshmallow, without disadvantage, as they all possess similar qualities. Worm tea is a popular anthelminthic for the roundworm, Ascaris lumbricoides. It is also known as the compound infusion of spigelia, and is composed of spigelia, senna, fennel, manna, and savine, infused in water, but the proportions in which these drugs are used is not always the same. Oarfield tea and Hamburg tea are two proprietary preparations which have beeri widely advertised, but hardly deserve notice. Garfield tea is said to consist chiefly of senna leaves and couch grass with aromatios, while Hamburg tea is a mixture of senna, manna,' and coriander. — Matthias Lanckton Poster. TEEL OIL. — See Sesame oil. TENTS, sometimes employed in gyna;colog- ical practice, are pencils of compressed sponge TBREBBNB TBRPIN HYDKATE 370 or other material capable of expanding on the absorption of moisture. They were formerly much used for dilating the cervical canal of the uterus. Besides sponge, cornstalk, slip- pery-elm bark, the stem of Laminaria digitata, and the root of Nyssa aquatica (tupelo) have been utilized for making tents. Of these ma- terials, sponge, laminaria, and tupelo are most epmloyed. Sponge tents are made from fine grained surgical sponges of small size. These are cleansed and disinfected, and are then sub- jected to pressure, either by winding them with twine or by some mechanical device until they are reduced to the size of the finger. They are allowed to dry and then are trimmed to the shape of a slender cylinder or cone 2-J- inches long and -J- inch or less in diameter. Sponge tents are effectual dilators, but are particularly objectionable from the standpoint of asepsis. Used in the cervical canal, they abrade the mu- cous surfaces, soften the tissues, and sink into the cervical folds. On the removal of the tent, fragments of the sponge are liable to be left behind. Sometimes the tent is found quite offensive when it is removed. The patient is thus exposed to septic infection, notwithstand- ing the utmost antiseptic precaution. Usually two or three tents have to be used in succession to effect the required dilatation. Laminaria tents are made of the stalk of Laminaria digitata turned into smooth pencils. Their dilating power is little inferior to that of sponge, but they are apt to expand unequally, leaving a constricted zone at the os internum, and are therefore withdrawn with' difficulty. The point of constriction, too, where the dila- tation fails, is the one where dilatation is most needed. riipeZoien^s possess great and equable expan- sile power and dilate more gently than lami- naria. A tupelo tent expands to two or three times the diameter it had in the dry state, it is smoother than sponge, and it does less injury to the cervical tissues. Tupelo is therefore the most suitable material for tents if they are to be used for dilating the uterus. Both laminaria and tupelo are open to the same objections that obtain in the case of sponge, though in less degree. It is practically impossible to maintain, even for a few hours, an aseptic condition of the cervical canal, even though it be primarily sterile to culture tests. Dilatation of the uterus with tents is always attended with danger, and the plan has fallen into disuse, except for cases in which the rigidity of the cervical tissues is so great as to resist the action of the steel dilators. Tents, if used at all, must first be sterilized and the passages prepared as carefully as for a surgical operation. A convenient and effectual method of sterilizing the tent is by exposure for several hours in a corked phial to a tem- perature of about 302° P. The vagina and the immediate external surroundings are to be thoroughly scrubbed with soap and hot water. The cervical canal is cleansed of mucus with a curette and repeatedly wiped out with a cotton- wrapped probe dipped in the mercurial solu- tion. The cervix and vagina are subjected to a prolonged douching with a l-to-2,000 bichloride-of-meroury solution, the parts being scrubbed with a swab of sterile cheese cloth during the irrigation. The cleansing of the cervical canal may be completed by introduc- ing for a few moments a cotton-wrapped pi-obe dipped into a mixture of equal parts of glycerin and carbolic acid or some other equally power- ful antiseptic. To introduce the tent, the patient is placed in the Sims posture, and the cervix brought into view with the aid of a Sims speculum. The cervix is drawn gently forward and steadied with a volsella caught in the anterior lip. The phial containing the tent is now un- corked, the tent seized with sterile dressing forceps and passed its entire length into the cervical canal. Sometimes several small tents are better than a single large one. As an ad- ditional precaution against sepsis, the tent, immediately before its insertion, may be wet with the antiseptic solution and dipped in sterilized iodoform powder till it is well coated with it. The tupelo tent, which is much the best of the varieties mentioned, is apt to slip out of the canal if left unsupported. A vaginal tampon of iodoform gauze should therefore be placed underneath it. A tent ought not be left in the cervix more than from eight to twelve or twenty hours, and it must never be followed immediately by another. The rapidity of dila- tation is greatly increased if the vagina is douched after introducing the tent into the cervix and the upper portion of the tamponade is well wet with the antiseptic solution. The patient must remain in bed until the tent is removed. A kind of tent occasionally employed in general surgical practice differs somewhat from the foregoing. These tents are used merely to keep wounds or fistulous tracts open. They consist of small masses of gauze, wioking, or similar material rolled or twisted into cylin- drical or conical shapes and inserted into the fistula or between the lips of the wound. The object is to maintain drainage. — Charles Jewett. TEREBENE, terehenum (U. S. Ph.), is a clear, colourless or slightly yellowish, thin fiuid. It is produced by the action of sul- phuric acid upon the oil of turpentine. The acid must be gradually added to the cooled oil of turpentine, 1 part of acid to 20 parts of oil. The mixture is boiled after twenty-four hours' standing, and, upon cooling, the oily layer is removed after freeing it from acid, and is rectified. Terebene has an agreeable, aromatic odour, something like that of freshly cut pine, and its taste is very similar to that of turpen- tine. It is isomeric with turpentine, having the formula doHie. It dissolves very slightly in water, but is soluble in equal volumes of alcohol, glacial acetic acid, and carbon disul- phide. It boils at 1.50° to 160° P. Exposed to the light, terebene gradually becomes resin- ous and, at the same time, acid. The U. S. Ph. requires that terebene shall not redden blue litmus paper and shall have but a very slight action on polarized light. On evapora- 271 TEREBEKE TERPIN HYDRATE tion, it should not leave more than a very slight residue, indicating a mere trace of resin- ous matter. Terebene has a specific gravity of 0-862 at a temperature of 59° P. Terebene was first brought to the attention of tlie profession in 1873 by Ribau, of Paris, but it was many years before it received gen- eral notice. Even since it came into quite common use its physiological properties have been but little investigated. It is likely that in its effects upon the general system it re- sembles its isomer, turpentine. Occasionally its continued ingestion has been known to give rise to pain in the lumbar region, and some- times diarrhoea has appeared after its use. Wimmer has called attention to an occasional hsmaturia, indicating renal congestion, and to an apparent diflficulty in passing urine after the administration of terebene. He concludes therefore that it is contra-indicated in the pres- ence of kidney disease. All the symptoms enumerated disappeared upon the withdrawal of the drug (New York Medical Journal, Feb- ruary 9, 1889). No records of poisoning by terebene are to be found in literature, and it is probable that only in exceptional cases in which some idiosyncrasy exists are toxic symptoms likely to be evoked. Dr. William Murrell, of London, was the first to direct attention to the therapeutic value of terebene {British Medical Journal, December 12, 1885). He recommended it for the so-called " winter cough " of chronic bronchitis, and re- ported in his first paper many cures. He praised the remedy not only for its curative effects but because of its advantages also. Its ease of administration, its agreeable taste and odour, and its lack of bulk appealed to him as ideal virtues for a remedy. He employed tere- bene — as it is still frequently employed — in increasing doses, from 5 to 6 drops every four hours to 20 drops at the same intervals, taken on a lump of sugar or on granulated sugar. Murrell had great success with this therapeutic measure, and its use for pulmonary disturb- ances rapidly became general. Murrell further stated that terebene possessed little or no toxic action, but remarked that its use endowed the urine with a peculiar odour. He found that terebene acted well not only in winter cough, but also when emphysema complicated the chronic bronchitis. He alleged that in phthisis, when there was old consolidation with no acti ve process going on. its employment was of bene- fit, and believed that it might prevent the occurrence of a Jicemoptysis. Murrell also found that when there were flatulence and hyperacidity present in addition to the cough, these were also alleviated. He had good re- sults, too, in the employment of terebene as a spray in the mouth and nostrils. He con- cluded, as is now generally accepted, that terebene is an excellent expectorant, possessing at the same time considerable stimulating power. Terebene may be employed in acute hron- chiiis after the earlier stages have been passed, as an expectorant and stimulant. It is effica- cious in clearing the larynx for singing and speaking. It has been recommended in asthma, emphysema, phthisis, pleurisy, and pleuro- pneumonia. In cases of pleuritic adhesions its employment is said to hasten the absorption of the exudate. In fcetid bronchitis and bron- chiectasis its administration is said to be as efficacious as that of turpentine. Barton praised its use in small doses in chronic rhinitis, alleging that the discharge ceased, the nasal passages became clear, and the head- ache disappeared. Terebene is employed with alleged good results in flatulence and in sub- aciUe inflammations of the genito-urinary tract. Its alleged diuretic action has not been clinic- ally proved. Murrell has found that tere- bene has active antiseptic properties, being able to check the action of the yeast plant in a solution of 1 part to 450, and in a solu- tion of a strength of 1 to 500 to hinder the development of bacteria. It is also known that the activity of vaccine virus is destroyed on contact with terebene. Practically, this anti- septic influence has been made use of by sub- stituting terebene for carbolic acid in the dressing of wounds, ulcers, and burns, and, it is stated, with success. It has a considerable deodorizing power, and thus destroys the odour of secretions while protecting the surface to which it is applied from contact with atmos- pheric air. Locally, it may be applied pure or in a strength of 1 to 6 in olive oil. Tampons soaked in terebene have been applied to slough- ing carcinomata of the cervix uteri for anti- septic and deodorizing purposes. "Whether its activity in these respects is due to a certain amount of untransformed turpentine, as is alleged by Bond (British Medical Journal, De- cember 19, 1885), or to the supposed presence of hydrogen dioxide, as believed by Cammann {Transactions of the American Climatological Association, 1888, p. 163), has not been deter- mined. Terebene may be administered on sugar, al- though it is likely that an insoluble mass may result from this method. It may be given in emulsion or in capsules or by atomization, as recommended by Murrell. It may be emulsi- fied by adding to it equal parts of olive oil and emulsifying with acacia or tragaeanth. A good prescription is the following (Wimmer, loc. cit.) : 5 Terebene 10-15 minims ; Spirit of chloroform. . . 10 drops ; Mucilage of tragaeanth. 1 drachm ; Simple syrup J drachm ; Distilled water, enough to make 1 oz. M. S. : For one dose. The dose of terebene is from 3 to 15 minims, repeated every four hours. An adult may take a drachm in divided doses in twenty-four hours. — Samuel M. Brickneb. TEE.EBI1TTHINA.— See Turpentine. TEBPIN HYDRATE, terpini hydras (U. S. Ph.), terpinum hydratum (Ger. Ph.), is the hydrate of the diatomic alcohol terpin. Its formula is C,oH,8(OH)j.HjO, and it has a molecular weight of 189'58. It occurs in col- ourless, rhombic, quite lustrous prisms. It is almost entirely odourless, and has a slightly aromatic yet somewhat bitter taste. It is per- TERPINOL THALLASOTHBRAPY 273 manent in the air. Terpin hydrate is soluble in about 250 parts of water at 59° P. It is dissolved in 10 parts of alcohol at tlie same temperature, and in boiling water and alcohol in lesser quantities. Ether, chloroform, and boiling glacial acetic acid also dissolve terpin hydrate In the respective proportions of 100, 300, and 1. '-At 496-4° F. anhydrous terpin distils over without decomposition, soon solidi- fying to a crystalline, hygroscopic mass which melts at 315-6° to 331° P. When strongly heated on platinum, it burns with a bright, smoky flame, leaving no residue. . . . Terpin hydrate should not have the odour of turpen- tine, and its hot, aqueous solution should not redden blue litmus paper (absence of adhering acid)." U. S. Ph. Lepine first investigated, in 1883, the physi- ological action of terpin hydrate and found that its influence upon the mucous membranes and nervous system was similar to that of tur- pentine. Because of its action on the kidneys he recommended its employment in chronic nephritis; and because of its sedative and stimulating influence upon the bronchial mu- cous membranes, he urged its use in chronic bronchitis. These observations were confirmed subsequently by clinicians, and terpin hydrate is much used to-day in these disorders and in the advanced stages of acute bronchitis, espe- cially when the expectoration and secretion are very free. It has been employed in chronic cystitis and in gonorrhoea with alleged good results. Terpin hydrate imparts the charac- teristic odour of turpentine to the renal secre- tion, and, given in too large or too long continued doses, it may evoke strangury, albu- minuria, or even haematuria. Its influence, therefore, may be very irritating to mucous membranes if it is given in overdoses. Penzoldt cordially commends the employ- ment of terpin hydrate in chronic disease of the heart and kidneys, particularly in chronic diffuse nephritis, accompanied by degenerative changes in the heart muscle, with albuminuria and widespread oedema. He has met with congestion of the kidneys, however, after its use, as indicated by haamaturia, and cautions against its careless or promiscuous employ- ment {Lehrbuch der klinische Arzeneibehand- lung, 1889). The drug has also been praised in the treatment of whooping-cough and hay, fever and has been recommended to prevent the for- mation ot flatus and assist its expulsion. Terpin hydrate may be given in doses of from 1 to 3 grains, from four to six times daily, in pill, emulsion, or lozenge. Samuel M. Bbickner. TERPINOL is a mixture of terpenes with varying properties and the alcohol terpineol, CioHnOH. It is a colourless, oily substance, and is prepared by boiling terpin with diluted mineral acids. It emits an odour like that of hyacinths. It is insoluble in water, but dis- solves readily in alcohol and in ether. It is said to be efficient in respiratory dis- eases and to have little or no effect upon the kidneys and nervous system, being eliminated almost entirely by the lungs. It is employed in chronic bronchitis as an expectorant when the cough irritates the bronchial mucous mem- brane. Terpinol may be given in doses of from 3 to 5 grains, from four to six times a day, in cap- sules or in pill form. — Samuel M. BrIcknek. TESTA PIl.ffiPAIlATA.— This is a prep- aration made by freeing oyster shells from all extraneous matter and reducing them to a fine powder. It is used as an antacid, in doses of from 10 to 40 grains, frequently repeated, in acid dyspepsia and diarrhoea. TESTICLE JTTICE, TESTICULAR LIQUID. — See under Animal extracts and JUICES (vol. i, page 73). TETANUS ANTITOXINE.— See under Animal extracts and juices (vol. i, page 84). TETRAETHYLAMMONIUM. — See Tetrethylammonium. TETRAHTDROBETANAPHTHYL- AMINE.— See Thermine. TETRAHYDROPARAUUINANISOL. — See Thalline. TETRAIODOPYRRHOL.— See Iodol. TETRAIO DPHENOLPHTHALEIN. — See NosoPHENE. TETRETHYLAMMONIUM.— Hofmann {Annalen der Chemie, Ixxviii) obtained this substance by decomposing its iodide with moist silver nitrate or its sulphate with baryta. It occurs in deliquescent hairlike needles. It ab- sorbs carbon dioxide from the air. It is strong- ly alkaline, saponifying fats. Concentrated, it burns the tongue. It is as bitter as quinine. It has a caustic action upon the epidermis and an unctuous, alkaline feel when rubbed be- tween the fingers. Its formula, or rather that of its hydroxide, is (CjH6)i]Sr.0H. It is not decomposed by the galvanic current. It forms numerous salts (sulphate, nitrate, phosphate, carbonate, hydrochloride, hydrobromide, io- dide, and bromide), and beautiful double salts with platinum, gold, mercury, etc. The drug was first used medicinally by the undersigned (see New York Jledical Journal, September 16, 1893). With Mr. Thomas A. Edison I sought the best solvent for uric acid, in order to make use of it with electricity (cata- phoretically) in gouty and rheumatic joints. We prepared several hundred of the small glass phials, each holding about two cubic cen- timetres of different liquid solvents, corked and labelled. Into each was dropped a small quantity of powdered uric acid as obtained chemically pure from Germany, and then we filled up the phials each with one solution. After shaking them up they were set aside for periodical examination. Only two of these phials showed that the uric acid had dissolved — ^that is, with anything like readiness. The two effective solutions were that of neurine and that of tetrethylammonium. On repeti- tion, these were found to dissolve uric acid quite freely. I compared the relative values of tetrethylammonium and piperazine, and found that the former was much more effective than the latter as a solvent for urea, uric acid. 273 TEEPIXOL THALLASOTHBRAPY and the like. I employed 10-per-cent. solu- tions of each for the experiments. Urate of sodium removed from the knee of a patient dissolved readily in both neurine and tetrethyl- ammonium. It seems that both nenrine and tetrethylammonium are normal constituents of the bodies of animals, and it may be that the diseases in which urates are produced and accumulate in the system are due to a defi- ciency of what seem to be normal elements of our structures. It was first tried on rabbits, to establish the dose, and then in some cases of acute and chronic rheumatism. In these patients it had beneficial effects, though doubtless its chief use would be in cases with uric-acid calculi and allied conditions. It is important to bear in mind that tetrame<%/animonium is poison- ous, giving rise to symptoms similar to those produced by curare, whereas tetrethylammoni- um may be employed with safety. The doses that may be safely used by the mouth are from 10 to 30 minims of a 10- per-cent. solution three times a day. Hypo- dermically, it would be better to have a 1-per-cent. solution and to inject not more than 10 minims of this until one was assured that no deleterious effect upon the tissues was produced. It may prove especially useful in the place of solutions of lithium salts when applied on positive galvanic electrodes about gouty joints or rheumatic tophi. The l-per-cent. solution may be used for cataphoretic purposes. Frederick Peterson. TETBONAL is a hypnotic of the disul- phone group, the difference between it and trional being that it contains four ethyl mole- cules, while trional contains but three. Its formula is (CaH6)j.C(SOj03H6)j,diethylsulphon- diethylmethane. It is produced by oxidiz- ing diethylketouemercaptol, (CsH6)'i.C(SC2H6)2, with potassium permanganate after substitut- ing diethylketone, (CjH6)aC0a, for acetone, (CsHaO), during the manufacture of sulphonal. Tetronal occurs in colourless, shining plates and laminae. It is soluble in 450 parts of cold water, in alcohol, and in ether, and has a neu- tral reaction. Its melting point is 193-3° F. Its solutions are odourless and tasteless. Although tetronal and trional are, for all practical purposes, interchangeable, each has slight advantages and disadvantages. Tetronal may be given as a sedative hypnotic in cases of insomnia due to nervousness or restlessness de- pendent upon organic nervous disease or func- tional disturbances. It has no great value as a hypnotic when sleeplessness is due to pain, and it is not to be recommended in the higher degrees of psychic disturbance or when de- lirium is present. It does not seem to be in- jurious when administered for the sleeplessness of the acute infectious diseases. Administered in doses of from 5 to 30 grains from a half to a quarter of an hour before bed- time, it produces a quiet, dreamless sleep of a puration varying with the dose. Its effects seem to depend upon the age, sex, constitution, and disease of the patient, and the dose must be regulated according to these conditions. It requires from fifteen minutes to halt an hour for tetronal to produce its effect, which is usu- ally more sedative than that of trional and equally hypnotic. Renewed too frequently, its hypnotic influence may become blunted, and in these instances trional will usually exert the desired effect. After the ingestion of tetronal, or on the day following its administration, there may be a complaint of lassitude and drowsiness, and, according to some observers, there is no other ill effect from its use. Other wj-iters have re- ported pain in the head, anorexia, nausea and . vomiting, vertigo and ineo-ordination, and dis- turbances on the part of the kidneys. When these symptoms arise, the drug must be at once withdrawn and emeto-catharsis and diu- resis must be evoked. Tetronal may be found in the urine as such, not being decomposed in the body, as might be expected from its composition. If not ex- creted at once, it may subsequently have a delayed or postponed action, like sulphonal. It is a usual practice, therefore, to discontinue its administration after it has been given for three or four nights. It is said that no tetronal habit is formed. Tetronal is most advantageously given in hot milk. The average dose is 15 grains, which may be repeated, if necessary, in an hour. (See Trional.)— Samuel M. Brickner. TEUCE.IN.— This is a dark-brown liquid, an aqueous extract of Teucrium scordium. It is furnished in the form of hermetically sealed glass tubes, each containing about 45 grains of the liquid. Professor von Mosetig- Moorhof has used teucrin extensively in the treatment of cold abscesses, tuberculous ade- nitis, lupus vulgaris, and actinomycosis. The contents of a tube are injected subcutaneously. The action of the remedy is to set up an in- flammatory action around the tuberculous or other deposit, after the manner of tuberculin, and so bring about its expulsion. Some ob- servers report that it causes a rise of the tem- perature, but others have not noticed any such effect. According to Dr. Cerna, 10 grains of teucrm, made into an ointment with lanolin and olive oil and applied to hcemorrhoids once a day, are said to give great relief. TEXTCBITJliI. — Teucrium scordium, the garlic-germander, or water-germander, of Eu- rope, an ajugeous herb, was formerly used as an anthelminthic, diaphoretic, and tonic. It has lately come into notice again as the source of teucrin (q. v.). THAIiLASOTHERAPY may be held to include sea bathing, residence upon the sea- shore, with such occupations as fishing, boat- ing, etc., and sea voyages. There are few conditions in which any of these would be contra-indicated, and they are those in which moist air has an injurious effect upon the mu- cous membranes of the air-passages, as in tu- berculosis, and catarrhal states in which there is a tendency to relaxation and flabbiness of the mucous surfaces and when the diminution of the amount of moisture exhaled by the skin THALLASOTHBRAPY THALLINE 274 and through the lungs would be injurious, as in Bright's disease. Also acute affections of the eyes in which a strong light is irritating would be a contra-indioation. Moreover, some persons with a rheumatic tendency are apt to puffier more from rheumatism at the seaside than in the interior. Those who receive the greatest benefit are convalescents from acute disease and those run down by overwork, mental anx- iety, or excesses of any kind. The relief some- times gained by the victims of hay fever by residence upon an arid shore is hardly to be attributed to any specific element in the air, but rather to the absence of the exciting cause, pollen. It is usual for removal to the seashore, even by those in robust health, to be followed by increased appetite and great capacity for sleep, which is usually profound and refreshing, al- though some, especially children, are made sleepless for a while by the noise of the waves on the shore. This, however, usually wears off in a day or two and is only one of the minor dis- advantages to be considered. Constipation or diarrhoea sometimes occurs at first, but either yields to the simplest treatment. When the question of bathing is of little importance, the most desirable points are upon the coast of Maine and the British provinces, as hot days are the exception and cool nights the rule. Many other points upon the Atlantic Ocean can be found, such as along the Rhode Island, New Jersey, and Long Island shores, where the conditions are nearly as favourable and are as a rule fairly satisfactory. It is desir- able that some locality not in the vicinity of wooded or marshy spots should be selected, as when they exist mosquitoes are almost sure to be found, and, while they may not be very an- noying to persons in good health, they are a se- rious complication for those out of health. In marshy places they may be kept down to a considerable extent by pouring small amounts of crude petroleum upon the surface of the water. This either destroys the larvae or pre- vents their escape, and the procedure, if car- ried out with regularity, will undoubtedly diminish the number in a very marked man- ner. The coasts of tropical and seraitropical lo- calities are freely visited during the winter months, but caution in selecting appropriate cases must be exhibited, as the humidity is generally greater than at the Northern resorts, and there is more temptation to exposure. For persons in good health there are no particular objections to be urged against them. It is safe to assume that malaria is absent from the large majority of seaside resorts in the northern portion of the United States, but in the warmer portions it may be found where the soil consists largely of decomposed vegetable matter, or where extensive marshes which are only semi-ocoasionally covered by water are found. Many such localities exist along the shores of the Gulf of Mexico, and they should be avoided during the warmer months. In many of the small settlements made up of cheaply constructed houses crowd- ed closely together the sanitary arrangements are very bad and the water supply is apt to be contaminated from the privy vaults. As a re- sult, numerous cases of typhoid fever have been directly traced to them. This point should therefore be carefully looked into in selecting a locality. It is also unfortunate that in too many instances the food, etc., are poor, and whatever benefit might be derived from the sea air is overbalanced by the lack of reason- able comforts. The belief that exposure to the night air of the seashore or fogs and being wet by salt water are less apt to be followed by " catching cold" than like occurrences inland is wide- spread and is certainly true in a measure. The fact is probably due to the better general con- dition of the person and to the moderate stimu- lation of the cutaneous circulation. The effect of the sun is an element not to be lost sight of in residence upon the seacoast, and the practice of spending hours upon the sand in the scantiest possible bathing suits is to be encouraged, especially among children, but unless they are very strong they should not be allowed to dash in and out of the water, although in those with a sluggish circulation the evaporating of the salt water upon the sur- face of the body and the stimulant effects of the salts left may be beneficial. When con- siderable time is spent upon the sand it is wise to protect the head from the direct rays of the sun by an umbrella or something of the sort, and persons with skins particularly sus- ceptible to the action of the sun should begin cautiously, so as to avoid blistering. When bathing is the principal attraction to the shore, the question as to whether still wa- ter or an ocean beach should be selected is one which will depend upon the physical strength of the persons concerned. Surf bathing, even under the best possible conditions, is danger- ous and, except to the very strong, exhausting, and it is safe to assume that its advantages rarely counterbalance its disadvantages. Still- water bathing, such as is found in bays and large arms of the sea, is much to be preferred ; yet shallow coves, etc., where the water becomes very warm, are not to be selected, as the effect of such water is enervating rather than stimu- lating, and. moreover, it is apt to be dirty and the bottom muddy. Children, however, do not appear to suffer from paddling around in such places. It is rather curious that corns are often cured by wading in the soft warm mud exposed at low tide in such localities. Young children in many instances have an unreason- ing fear of the water and should not be forued to enter it. If they are allowed to " paddle " and wade around the margin they will soon lose their fear and go in freely. The popular belief is that before breakfast is the proper hour for bathing, but it is rare that persons are found who are benefited by taking baths at that hour. The most fitting" time is midway between two meals, when the system is well provided with food and the processes of digestion are completed. Bathing with the stomach full of food is apt to check digestion, and there is little doubt that many cases of the so-called " cramp " are due to the sudden shock 275 THALLASOTHERA PY THALLINE and resultant circulatory changes. On the other hand, it is by no means a bad plan to eat a small amount of light food soon after leaving the water. The length of time which can be spent in the water withoiit disadvantage will vary greatly in accordance with the general health and strength of the person, and can be ascertained only by trial. It should not, however, reach the moment when the exhila- rating and stimulating effects cease, as when this occurs a feeling of depression follows which may continue for hours, and the effect of the bath be bad rather than good. For persons unaccustomed to sea bathing, convalescents, or the delicate, it is wiser to be- gin with a single dip and to lengthen the time progressively. As a rule, it is rare that the duration of a bath should be prolonged beyond fifteen minutes, and under all circumstances chilliness, blueness of the lips, or a fatigued feeling Indicates that the limit of beneiit has been exceeded. Long swims, diving, or strug- gling against a heavy surf should still further cut down the time, as exercise renders the sys- tem less resistant to the depressing effect of a bath. When diving, it is best to place small pieces of absorbent cotton in the ears to reduce the danger of rupture of the tympanic mem- brane. Severe exercise immediately after bath- ing is not to be recommended. The person should be dried as quickly as possible with rough towels, so as to cause a healthful glow upon the surface. It is common to shower with fresh water after a sea bath, but, although it is rather more agreeable to do so, it is wiser to omit this when the cutaneous circulation is sluggish, as the small amount of the salts left upon the skin acts as a stimulant to it. Often large numbers of medusw, popularly known as " jelly fish," are found in the water, and they are very apt to give rise to consider- able irritation of the skin if they come in con- tact with it. Usually the pain and redness subside quickly, and some relief may be gained by sponging the surface with a weak solution of carbonate or bicarbonate of sodium. Per- sons with delicate skins will do well to keep out of the water when the medusae are numer- ous, as sometimes a condition approaching der- matitis is set up by them. It is safe to assume that few morbid states contra-indicate sea bathing for those accus- tomed to it, provided the person does not be- come fatigued or chilled. As a rule, it would be hardly advisable to allow pregnant women to bathe indiscriminately, but if it has been customary, there would be little objection to it up to the eighth month, provided the_ water was calm. During menstruation it is not often proper, except when the process lasts but a few days and the condition of the pelvic or- gans is normal. In cases of chronic diseases the condition of the individual must be taken into account. Bathing and prolonged residence upon the seashore are held in high esteem, especially by the French, in the treatment of the conditions grouped under the name of scrofula, and there is little doubt that they are of great value, but the appropriate dietetic and medicinal treat- ment should not be neglected. In this condi- tion it is probable that the improved appetite and nutrition are rather more active factors than the iodine assumed to exist in sea air. During the Jirst dentition, when diarrhoea ex- ists, it is rare that sea air does not produce a rapid change for the better, even if its influ- ence is exerted for a few hours only. Sea voyages are usually of great benefit to coiwalescents or the broken down, as, when they are taken under proper conditions, there is absolute freedom from worry and the appe- tite is better and the sleep sounder and more refreshing. Of course there are some unfortu- nate individuals who suffer for many days with seasickness, and often to such an extent as to threaten life, and for them a voyage would be entirely inadmissible. For those who are not so unpleasantly affected, a day or two of seasickness is by no means a disadvan- tage, as enforced abstinence from food is usu- ally followed by an improved condition of the digestive apparatus. It is usual for constipation to exist during the first few days of a voyage, but it may be overcome by mild laxatives or the eating of fruit before breakfast. When the condition of the person approaches neurasthenia it is much wiser to select a trip longer than the ordinary transatlantic voyages, and, provided a com- fortable sailing vessel can be found, it is much better than a steamer. At almost any time vessels can be found about to make voyages of from thirty to ninety days, and usually the ofBcers enjoy the presence of passengers and endeavour to make them comfortable. The greatest objection to sailing vessels is that, al- though the accommodations are usually better than on steamers, the food is apt to be less tempt- ing; but this is generally no great drawback, for after a few days food which on shore would be rejected is eaten with relish. On a long voyage of this kind an abundance of under- clothing must be taken, as there is little op- portunity for its being satisfactorily washed and ironed.— Russell H. Nevins. THAIiXiINE, or tetrahydroparamethyloxy- quinoline, is a synthetical product first pre- pared by Skraup in 1885. Thorns gives the following as its formula: H HH I \/ C C ^\ /\ H CH3O — C C C 100-4° 100-0''-195-0° llOO" 85-0°- 90-0° 112-0°-122-0° 104-0° 105-0° 98-0° 103-0° 122-0°-141-0° 104-0° 114-0°-123-0° 168-0°-187-0° 190-0°-300-0° 94-0°-168-0° 93-0°-llT0° 60-0°-1100° 95-0»-1.38-4° 84-2° 95-0° 95-0°- 118-4° -102-2° 83-4° 84-0° 107-6°-116-6° 66-0°-158-(l° 107-6° 82-0°- 92-0° 96-8°-107-6° 91-4°- 98-6° 100-4° 92-0°-123-0° 98-6° rheumatism, in gout, and in neurasthenia, this treatment will prove useful. The external and internal use of such waters will benefit ulcers of the skin and gunshot wowids that suppurate chronically. Old cerebral, spinal, and peripheral paralyses are often benefited, if only by the improved condition of the pa- tient, while paralysis of toxic origin, especially that due to lead, is usually rapidly improved by the external and internal use of thermal waters. Hysteria, insomnia, neurasthenia, neuralgia, and peripheral neuritis may be treated beneficially by the combined use of such waters. The employment of these waters in the earlier stages of Bright's disease, in catarrh of the pelvis of the kidney, and in cys- tic catarrh will aid in preventing self-intoxica- tion and be likely to favourably influence the affected tissues. The accompanying list will show the situa- tion of a number of thermal springs. There Carbonated waters are those that contain carbonic acid, and that gas is nsually associa- ted with other chemical ingredients. Admin- istered internally, carbonic acid is a stimulant to the mucous membrane of the stomach and intestines, probably in consequence of excita- tion of the motor nerves, although it has a sedative effect on the sensory nerves when ad- ministered in small quantities. It also causes increased secretion of urine. Large quantities of carbonated water have produced gastric distention, eructations, cardiac irritability, and pulmonary and cerebral hyperjemia. A larger quantity of carbonic acid is tolerated if the water is cold than if it is warm. In gastric and intestinal atony a simple carbonated water will frequently afford marked relief. In nausea such waters are applicable ; and in the nausea associated with malarial and other fevers the free use of carbonated waters is in- dicated. Where a natural water is inaccessible. 365 WATERS, MINERAL the separate portions of a sekllitz powder may be dissolved in two glasses, and a tablespoon- lul of eaoli solution given in succession; the small quantity of carbonic-acid gas evolved in the stomach is very agreeable to the patient. In certain forms of vesical or prostatic irrita- bility the frequency of micturition is lessened by using these waters. [For the use of carbon- ated waters in the Sohott treatment of chronic heart diseases, see Baths (supplement)]. Chlorinated waters, which are also known as muriated or muriated saline waters, are those in which sodium chloride is the principal solid constituent, though it is frequently associated with other chloriae salts and gases. When the chlorinated waters contain iodine or bromine they are called iodine or bromine salt, or chlorinated, waters; if they contain such earthy salts as calcium or magnesium sulphate or carbonate they are termed earthy salt, or chlorinated, waters; if they contain sodium or magnesium sulphate they are known as saline chlorinated waters; if they are distin- guished by the presence of a definite quantity of an iron salt they are called chalybeate chlo- rinated waters : and if there is a large volume of carbonic acid they are called acidulous chlorinated waters. Sodium chloride plays an important part in the animal economy, and it forms the greater portion of the soluble constituents of the ash of all animal substances. The gastric juice is normally rich in sodium chloride, which is one of the sources of the hydrochloric acid in the stomach. It promotes digestion by facilitating the solution of albumin and casein, and plays an important role in furthering the processes of absorption and secretion, in consequence of its stimulating effect on the gastric and intes- tinal glands. The experiments of Braun, Griitzner, and Boas have shown that the addition of sodium chloride to the blood increases the secretion of gastric juice, and whatever quantity, in mod- eration, is in excess of the needs of the body is excreted chiefly by the kidneys. In moderate quantities it is quickly absorbed from the stomach, and Buchheim showed that within six hours it was excreted in the urine. As it is essential for the formation as well as the disintegration of cells, it stimulates not only the progressive, but also the retrogressive tis- sue changes of the animal orgailism. When a moderate quantity of sodium chloride is intro- duced into the stomach it stimulates the secre- tion of the gastric juice, and excites increased peristaltic action in that viscus, which favours the passage of the gastric contents into the in- testinal canal. The peristaltic action of the intestines also is increased by the salt. Bischoff, Kaupp, and Volt have proved that there is an increased excretion of urea after the administration of moderate quantities of sodium chloride. This is apparently due to the improvement in metabolism, the serum seeming to carry away albuminates, and favour their transformation into excretable products. Externally, chlorinated waters in baths in- crease the excretion of urea and decrease that of uric acid and that of phosphates. There is an increased consumption of oxygen and there is increased excretion of carbonic acid. The skin is macerated and cleansed, its functions are stimulated in consequence of the action of the sodium chloride and the usually associated carbonic acid on the peripheral nerves. Such waters are more eflBcacious if warm than if cold. Various theoretical influences have been ascribed to the use of baths of such water, but more exact observations are needed to deter- mine the entire scope of their therapeutic efficacy. The action of the chlorinated waters is in- creased if either carbonic acid or sulphuretted- hydrogen gas is present. As water will take up its own volume of carbonic-acid gas under pressure, the amount of that gas in natural mineral water differs according to the propor- tion of that gas forced into the source whence the water comes; the gas effervesces when the water escapes from the spring, and unless the liquid is kept in firmly closed bottles it soon loses its natural gas. The carbonated waters are usually bright, sparkling liquids which pos- sess an agreeable aeidnlous taste. These char- acteristics make such waters refreshing drinks in febrile and other diseases ; the sensitive nerves of the stomach seem to be quieted by the influence of the gas, there is some stimula- tion of the peristaltic action of the stomach and intestines, and the action of the kidneys is increased. The presence of hydrogen sulphide increases the palatability as well as the therapeutic use- fulness of saline waters, as is shown by the Kentucky Blue Lick water, in which 516 of the 660 grains of solids in each gallon are sodium chloride. When chlorinated waters are warm or hot they are more quickly absorbed, and thus may exercise an effect that is not obtained by the slow and imperfect absorption of cold water. Boas observed the changes in the secretion of gastric juice during the administration of warm chlorinated waters, and noticed that after from three to four weeks of this treat- ment there was a decided improvement in the secretion of gastric juice and a coincident ces- sation of the symptoms in chronic gastritis. The chlorinated waters are indicated in all cases of gastric catarrh in which there is less- ening of the secretion, either with or without the production of mucus. Such waters are useful for patients in whom there is a defi- ciency of the gastric and intestinal secretions. In gouty and rheumatic conditions the use of such waters, by improving metabolism, furthers the excretion of effete pi'oducts, and if begun in time is likely to delay the degenerative changes incident to those affections. In some forms of ancemia in which there is rapid de- crease in the proportion of red blood-corpus- cles, marked improvement will follow tho external and internal employment of thermal chlorinated waters. Hepatic congestion of a chronic type, with the associated aberration in the functions of the liver and the usually at- tendant constipation, is benefited by this treat- ment. In certain cases of neurasthenia in which there is self-intoxication these waters WATERS, MINERAL 366 will be useful and are to be preferred to the saline waters which contain the sodium and magnesium salts ; the latter are slowly ab- sorbed, are likely to cause gastric distress, and, by saturatmg the blood with neutral salts, which are improperly or slowly excreted, further involve the metabolic functions and thus contribute to do more injury to the nerv- ous system. Hypertrophy of the spleen, due to paludism, may be reduced by the use of this class of waters in conjunction with other treat- ment. Bronchial catarrh, associated with gen- eral asthenia, is bettered, if not cured, by a course of chlorinated waters, internally and externally. The improvement in the general nutrition produced by such waters may explain the benefit that has followed their administra- tion in caries, necrosis, and rhachitis. The principal springs of this class are the following, though in this table the difficulty of classification has been encountered, because a number of the chlorinated waters are also sul- phuretted and owe some of their properties to the presence of hydrogen sulphide : alkalies in small or moderate doses increases the secretion of gastric juice, and these alkaline waters may be administered for that purpose ; large doses of the salt impair digestion and diminish appetite and nutrition. The salt does decrease the proportion of solids and increase the fluids in the bile, and it makes the urine distinctly alkaline, in con- sequence of the neutralization of the sodium phosphate. The best effects of the drug may be obtained by its prolonged administration in small doses, rather than by the use of large doses. Consequently the value of alkaline wa- ters is apparent, because they are not likely to be taken in such large quantities or of such strength that the undesirable effects of the sodium salt will be manifested. In the case of the chlorinated alkaline waters the effects of both of the sodium salts are obtained, and these waters are best administered when it is neces- sary to improve the blood or to avoid emacia- tion. The alkaline waters are used in the treatment of those forms of dyspepsia associated with NAME OF SPRING. lola Mineral Well, Alien Co St. Clair Mineral Spring Ballston Spa, Saratoga Co Excelsior Spring:, Syracuse Saratoga Springs, Saratoga Aurora Saline Springs, Marion Co. Hall (near Steyer) laohl St. Catharine's Wells, Ontario Bourbonne les Bains Neuhaus, Bavaria Soden, Nassau Kreuznach, Valley of Nahe Kissingen, Bavaria Nauheitn, Wetterau Diirkheim, Bavaria Miinster am Stein Pyrmont, Hanover Connstadt, Wiirtemberg Wiesbaden, Nassau Salzbrunn, Bavaria Baden-Baden Kansas. Michigan. New York. New York. New York. Oregon. Austria. Austria. Canada. France. Germany. Germany. Germany. Germany. Germany. Germany. Germany. Germany. Germany. Germany. Germany. Germany. ElevatioD, in feet. 310 403 S65 21S 1,064 1,574 T60 1,200 440 3.30 590 450 377 400 600 323 1,200 616 Teoipetature. 49°- ,52° 4K° 49°- 51° 57° ■fifl' 130°- 150° 05° K6° 60°- 85° fi9°- 96° 55°- H0° 86° 60°- 70° 142°-166° 46° 140»-154° Solids, In gallons. 1,100-27 628-37 247-1,233 668-24 268-991 861-62 800-9 2,951-68 445-11 757-2 760 56-8 616 Carbonated ; 980-5 gr. so dium chloride.- 405-53 gr. sodium chloride. Carbonated ; ferruginous. 584-53 gr. sodium chloride. Carbonated ; calcic. Carbonated ; iodine and bro- mine. Calcic. Carbonated. Carbonated. Carbonated. Carbonated. Carbonated. Carbonated. The alkaline waters are those that contain a large proportion of sodium carbonate, whicli is usually as.sociated with a more or less carbonic acid. In the event of the carbonic acid being present in a fairly large percentage, the water is known as acidulous alkaline ; when the so- dium carbonate is associated with sodium chlo- ride it is called a chlorinated alkaline water ; and when sodium or magnesium sulphate is present in sufficient quantity to produce their characteristic effects the water is known as an alkaline-saline water. Gradeau injected large quantities of sodium carbonate into the blood-vessels of a dog, and Miinoh has administered large quantities of that salt to a man, but in each series of experi- ments the results were negative. The acids of the gastric juice decompose sodium carbonate, setting carbonic acid free, and forming sodium chloride, and, in certain fermentative condi- tions, sodium acetate, butyrate, and lactate.. Experiments have shown that the ingestion of hyperacidity, and in phases of gastric catarrh in which large quantities of mucus are secreted, and the ingestion of the water before breakfast loosens the mucus as in gastric lavage. In all gastropathies in which there is hyperacidity, and in gastric dilatation, alkaline waters are contra-indicated. Cases in which analysis of the gastric juice after a test meal shows that there is a large quantity of acid should be treated with the stronger alkaline waters; if gastric lavage and stimulation are desired, the chlorinated alkaline waters are most suitable ; and where gastric and hepatic torpidity are associated, the alkaline saline waters are most efficacious. As sodium bicarbonate acts more rapidly as a diuretic than sodium chloride, and in small doses it seems to be followed by a greater ex- cretion of the retrogressive products of metab- olism of the uropoietic apparatus, alkaline waters are indicated in pyelitis, ureteritis, and cystitis. The urine becomes alkaline and is 367 WATERS, MINERAL less irritating, the catarrhal exudation becomes thinner and is not retained, and the condition of the affected mucous membranes is improved. These waters are useful for renal or eystic calculus or the uric-acid diathesis, the water and its salts furthering the oxidation of uric acid and having a certain solvent influence on formations of this substance. The use of the water in cases of calculi of calcium phosphate or carbonate is not justified by chemical or physiological facts. The value of these waters in gout is due to - the effect of copious draughts of water with the contained salts on the processes of metab- olism. In such conditions they are rarely so useful as the saline waters, though a course of the latter may be advantageously followed by a course of alkaline waters. Headache and other conditions associated with the uric-acid diathesis are benefited by the use of alkaline waters. Sir William Roberts has referred to the fact that a considerable number of the springs to which gouty patients resort are strongly im- is either to provoke a downright attack of gout, or to aggravate the .symptoms under which he was suffering. This has been a common experience at spas, and the patients have been comforted with the assurance that this preliminary storm was a necessary prelude to the amendment that was to follow. In all likelihood the gouty exacerbation is due to the precipitation of the urates floating in the blood and lymph into the structure of the joint. Dr. Roberts advises that gouty persons should either entirely avoid springs that owe their activity to sodium salts, or should use them very sparingly: he considers that it is diflicult to believe that they can do any direct good, and easy to believe that they can do direct harm. Chlorinated alkaline waters have proved to be very useful in bronchial catarrh, and in acute and chronic pharyngitis and laryngitis. The following table gives a list of some of the more important alkaline springs, and the proportion in a thousand of the more impor- tant solid and gaseous constituents : NAME OF SPRING. Adams Spring, Lake Co .SStna Spring, Napa Co California Seltzer Spring Litton's Seltzer Spring Vichy Springs, New Almaden. Geyser Spa, Sonoma Co Highland Springs, Lake Co. . . Manitou Springs ApoUinaris Spring, Mill Creek Eohitsoh (Styria) Radein (Styria) — Giesshttbel (Bohemia) Chaudes-Aigues Mont-d'Or Neris Vichy Vals Le Boulou La Bourboule Royat Vic-sur-cere Szczawnica Fachingen (Nassau) Fellathalquellen (lUyria) Bilin (Bohemia) Obersalzbrunn (Silesia) ApoUinaris Geilnau Ems Weilbach Selters California. California. California. California. California. California. California. Colorado. Montana. Austria. Austria. Austria. France. France. France. France. France. France. France. France. France. Gallicia. Germany. Germany. Germany. Germany. (Germany. Germany. Germany. Germany. Germany. Temperature. 200-0° 60-82° 43°-60° 40-0° 55-4° 53-6° 60-0° 68°-180° 106°-108° 114<'-12B° 58-6°-100° 56- 4° eo°-68° 54°-125° 66°-96° 61-8° 60 0° 46-4° 53-6° 44-6° 69-8° 500° 96°-116° 53 6° 60-8° ]l-6 80 90 31-0 30 10-8-( 016-1-! 0-98 Sodium bi- carbonate. 8-6 4-3 1-2 27-47 0-5 24 -.38 40-5-0 7-1 141-75 1-86 1-3 124-36 8-4 3 6 4-2 4-2 2-4 1-2 1-0 1-3-2-0 1-3 1-2 Sodlnin chloride. 0-6 4-5 2-5 50 1-5 OOI-O-IO 0-13-0-47 0.37 0-3 0-6 3-67 0-3 10.39 0-5 01 49-55 3-15 1-7 90.34 4-6 0-6 0-2 0-3 0-1 0-4 6-9-i-6 1-2 2-2 0-5 019-0-51 0-94 0-2 '2-60' Sodium Bulpbate. 26-68 0-8 0-2 Trace. 0-30 0-1 41-58 0-5 0-8 0-4 0-3 0-3 carbonic acid. 1,315 251 Abun- dant. 180 348 879 1,537 460-5S2 1,039 360 Abun- dant. 379 711 945 609 1,337 680 1,600 1.468 653-59'; 151 1,149 199-48 gr. solids to gal. ; carbonated (acidulous). 136 gr. per gal. 186 gr. per gal. 228-69 gr, per gal. 433-64 gr, per gal. 67-12 gr, per gal, 73-103 gr, per gal. 14-43 gr. per gal. Chalybeate. Chalybeate. Arseniuretted, chlorinated. Arseniuretted, chlorinated. Arseniuretted, chlorinated, cold. Chlorinated, 301-6 gr, to gal. ; chalybeate. Chalybeate. Chlorinated. Lithia. pregnated with the salts of sodium, and to the fact that it has been conclusively demonstrated that all the sodium salts act adversely on the solubility of sodium bi-urate, and hasten its precipitation. It may be inferred that the in- troduction of these salts into the circulation must tend to favour the occurrence of uratic depositions in the body; therefore it is not surprising to learn that not infrequently the first effect of these waters on a gouty patient Sulphated, or bitter, waters are those saline waters in which there is a large proportion of sodium or of magnesium sulphate or of both these salts. When the principal constituents are the salts mentioned these waters have been called simple sulphated, or bitter, waters ; when they are combined with sodium carbonate, so- dium chloride, and other salts, they are known ' as alkaline sulphated waters. Neither magnesium nor sodium sulphate is WATERS, MINERAL 368 a normal constituent of the organism, and, while their action has been described in the sections devoted to those substances, some re- marlis may be pertinent here. Altiiough the nauseous taste of sodium sulphate has inter- fered with the general employment of that drug, it is less irritating than magnesium sul- phate, and is to be preferred to the latter salt in many instances. Braun is authority for the statement that the irritating effect of mag- nesium sulphate on the mucous membrane of the stomach is about fifty per cent, greater than that of sodium sulphate. Buohheim's investigations have shown that in the intestinal canal the potassium salts take a certain quantity of sulphuric acid from these sulphates, the salts being reduced to sulphides, which are decomposed by the acids of the in- testinal canal, with the generation of hydro- sulphuric acid. In general, these sulphates act by increasing the fluids of the intestinal canal. One of the most important uses of the waters of this class is for the treatment of the various disorders of the stomach. The researches of Jaworski on the effects of Carlsbad water have shown that, if it is taken in small quantities and for a short time, it stimulates the gastric secretion, but, if administered for a long time, it lessens and perhaps stops that secretion. Boas has stated that its prolonged use will cause atrophy of the glandular parenchyma of the stomach. Spitzer found that these waters increased the motor power of the stomach and the secretion of pepsin, but checked an excess- ive elimination of hydrochloric acid. Ewald's experience has been that the alka- line sulphated waters have such a high per- centage of alkali that they act as antacids in conditions of gastric hyperacidity. While the simple mechanical action of gastric lavage is incidental to the use of almost all mineral waters, the waters under consideration have a further action on the liver and intestines. Cordes has called attention to the fact that such waters, when given to nervous or anaemic persons, may cause an increase in the irritation and depression ; and Ewald adds an emphatic protest against the custom of sending persons so afflicted to springs where the water contains large quantities of sodium sulphate, because the waters operate badly in every case. Per- sons affected with pronounced neuroses should not be sent to such spas or treated with such waters, because of the reflexes that proceed from the stomach and intestines. In hyperacidity or increased secretion of gastric juice these waters are likely to prove beneficial, and it is on account of the existence of the flrst-named condition with gastric ulcer that these waters are useful in the treatment of that disease, as the water not only neutral- izes the acidity but lessens the secretion of the gistric juice. The sulphated waters are indi- cated in those gastropathies that complicate and are due to disorders of the liver and intes- tines. Simple chronic intestinal catarrh is often benefited by the use of a sodium-sulphate wa- ter, though in aiding in the removal of effete matter they may interfere in the final diges- tion of nutritious substances. In hepatic engorgement, jaundice due to ob- structions, and hepatic cirrhosis the waters containing sodium sulphate are very useful. The obstruction to the circulation in the por- tal vein reacts on all the veins of the intesti- nal tract, and the engorged capillaries are relieved by the exosmosis induced by the water. With an improvement in the local circulation there is improvement in the general nutrition of the affected region. Catarrh of the duode- num and of the gait bladder and duct are bene- fited in consequence of the depletion of the engorged intestinal vessels and mucous mem- brane and the removal of the mucus. Gall- stones are passed after a more or less prolonged course of saline waters. Corpulence has been successfully treated with saline waters, but no small part of the benefit attending their use is due to the rigorous di- etary regimen, including the abstinence from starchy and fatty foods and alcoholic or malt beverages. Too often the benefit derived from a course of the waters is lost by the patient's resuming the habits of living which originally tended to produce the corpulence. Duiing the use of the waters there is an increased elimina- tion of proteid matters and fats by the bowels, and a diminution in the phosphoric and sul- phuric acids and the chlorides and an increase of urea in the urine. In such conditions the use of the treatment should be indicated and supervised by a physician. Diabetes due to defective metabolism of the carbohydrates may be benefited by saline wa- ters. The depletion of the intestinal vessels that follows a course of sulphated waters is of de- cided value in the treatment of h(Emorrhoidal conditions, which so often occur in those who may be considered degenerative assimilators. Here also the improvement in metabolism is the cause of the particular improvement in the patient. But hsemorrhoidal conditions in thin individuals whose physique indicates de- fective assimilation are aggravated by such waters. In maladies due to the so-called uric-acid diathesis, as well as in gravel and stone in the kidney or bladder, the alkaline-saline waters promote the solution of uric acid. The degree of intensity of purgative action in the bitter waters varies necessarily, with the amount of sulphates that they contain. To a greater or lesser extent all of them increase the quantity of solids passed from the bowels during the day, because, in consequence of the purgative effects of the waters, the peri- staltic action of the intestines is increased, the food passes through and out of the digestive canal before all the nutrient ma- terial has been absorbed from it by the lac- teals, and, as the late Dr. Qeorge Harley re- marked, more feculent matter is excreted by the bowels than would have been the case had the digestive materials sojourned longer in the intestinal canal and have been absorbed to nourish the body. Another fact that must not be overlooked is 369 WATERS, MINEKAL that the thirst produced by the saline constitu- ents of these waters increases the quantity of liquids ingested, and the more liquids that are absorbed the greater the solution of solids and the greater the elimination by the kidneys of both fluids and solids. This latter, however, is but temporary, as the continued use of sul- phated waters decreases the time during which nutritive' material remains in the digestive tract; and in consequence of this there are lessened absorption by the laoteals and a smaller excess in the blood to be excreted in the urine. The following table includes the principal waters of this class : stimulates the appetite, and strengthens diges- tion by increasing the desire for food and the ability to dispose of it. But more essential in the treatment of chlorosis or ancemia at a spa is the change in the mode of life — the diet, the life in the open air, and the removal of dis- turbing local influences that may exist at the patient's home. The quantity of iron, varying from half a grain to two grains, that is con- tained in all the water that is drank in a day, seems too small to be considered as the sole factor in the improvement that occurs in the diseases mentioned. Ferruginous waters are of special value in those forms of anwmia due to haemorrhage, NAME OF SPRING. Situation. Magne- ■ium sulphate. Sodium Bulphate. Magne- sium chloride. Sodium chloride. Per 1,000 p arte wat er Kentucky. 007 002 0-01 Kentucky. 33-40 1-5 Pennsylvania. 6-0 01 009 Austria. 17-43 16-25 1-32 Austria. 84-7 831 1-7 Austria. 16-0 15-9 1-3 Austria. 13-5 0-3 Austria. 18-1 16-1 2-4 Austria. 10-9 6-0 0-2 Austria. 2-4 18-4 2-3 Austria. 40 18-1 14-4 Austria. 5-0 2-0 Austria. 3-5 1-1 Austria. 2-3 1-0 Austria. 2-3 10 Austria. 2-2 0-9 Austria. 0-7 France. 0-60 l-« 1-94 France. 9-3 50 0-8 Germany. 5-4 6-6 161 Germany. 51 60 7-9 3-9 Germany. 5-0 5-8 7-6 38 Germany. 6-2 0-8 Germany. 0-9 0-4 Spain. 8-17 93-23 1-99 Switzerland. 21 3-6 Switzerland. 82-0 7-0 Crab Orchard Springs Harrodsbur^ Springs Bedford Springs Arpad (Hungary) Kranz-tjosepn Bitterquell Hunyadi Janos (Ofev) Sedlitz (Bohemia) Piillna (Bohemia) Saidschutz (Bohemia) Ivanda (Banat) Unter-Alap (Hungary) Marienbad (Bohemia) Franzensbad (Bohemia) Karlsbad, Miihlbrunnen Karlsbad, Sprudel Karlsbad, Schlossbrun Fuered (Hungary) Brides-les-Bains Montmirail Mergentheim (Wiirtemberg) Friedrichshall (Saxe Meiningen). Kissingen (Bavaria) Elster (Saxony) Bertrich (Coblentz) Rublnat Tarasp (Engadine) Birmensdorf Chalybeate. Alkaline. Alkaline. Alkaline, 126° F. Alkaline, 158° F. Alkaline, 182° F. Alkaline. Carbonated, 95° F. Alkaline. Ferruginous, chalybeate, or iron waters are those in which there is a sufficient amount of some iron salt, usually the carbonate, chloride, or sulphate, to give the water a characteristic styptic taste and the therapeutic properties of those salts. While iron is contained in a large number of mineral waters, the quantity is usu- ally so small that it exercises no appreciable medicinal efieot. If an appreciable quantity of sodium bicarbonate is associated with the iron, the water is called an alkaline chalybeate water; if there is enojigh sodium sulphate to produce medicinal effect, the water is called a saline chalybeate water ; if sodium chloride is present in suflicient quantity, the water is termed chlorinated, or muriatic-acidulous cha- lybeate water ; and if it contains calcium car- bonate or sulphate, it is designated as earthy, or calcic-acidulous, chalybeate water. The iron is probably absorbed with the water from the stomach and intestinal tract, the pro- cess of absorption being furthered if there is carbonic-acid gas in the water. The latter is always present when there is carbonate of iron, which is only held in solution by an excess of acid. The iron increases the red blood-corpuscles, suppuration, or protracted acute or chronic diseases. In chlorosis, in the cachexia asso- ciated with chronic paludal poisoning, in that consequent on ttie prolonged use of mercury in syphilis, in chronic lymphadenitis, in chorea, in menstrual derangements of hcBmic origin, in albuminuria, and in neurasthenia these waters may be prescribed with advantage, and a saline or chlorinated chalybeate spring is preferable. Sometimes the administration of a chalybeate water causes intestinal torpidity, and, as in chlorosis there is often self-intoxication due to constipation, the use of iron water must be dis- continued or be associated with that of a saline water. , Dyspepsia or diarrhoea that appears during the use of iron waters indicates the ne- cessity of discontinuing the treatment, unless warming the water terminates the disorders mentioned. In chronic forms of paludal poisoning the iron waters that contain arsenic, such as those of Roncegno and Levico in the Austrian Ty- rol, are especially indicated. Such waters are excellent for weak and delicate persons who are affected with gastric neuroses, because their use may be continued for a long time. In all diseases these waters should be adminis- WATERS, MINERAL 370 tered at first in small doses, a tablespoonful half an hour after luncheon sufficing; this dose is gradually increased up to two or three tablespoonfuls three times a day. Atony of the stomach is improved by the ad- ministration of acidulated (carbonated) cha- lybeate waters. The following is a. partial list of chalybeate springs of the United States and of Europe : those of the salts with which it is associated. Sometimes waters that contain this gas will produce a sense of heat in the stomach, excite gastric distress, and eventually cause unpleas- ant eructations of sulphuretted hydrogen ; but in moderate doses, and if the waters con- tain also sodium chloride, they stimulate the secretions of the gastro-intestinal canal. Con- tinued for some time, these waters impair the NAME OF SPRING. Situation. Bailey Springs, Lauderdale Co Cullum's Springs, Choctaw Co Talladega Spring, Talladega Co Fulton Wells Linwood Spring Angler's Mineral Spring Schuyler County Spring Benham''s Carburetted Saline Well. Indian Springs Ott's Well Iowa Acid Spring Cherokee Magnetic Mineral Spring . Owosso Chalybeate Spring Bratton Spring Fairview Mineral Spring , Chittenango Sprmgs Oak Orchard Acid Spring Kittrell Springs Iron Spring (Warm Springs) Grerai Mineral Spring Stryker Mineral Well Payton Mineral Spring Cresson Springs Kittanning Mineral Spring Guylych and Gay lord's Spring Blossburg Springs Austin^'s Spring Pate Sour Well Sour Lake Mineral Springs Wootan Wells Montebello or Newbury Springs . Bath Alum Springs No. 2 Bedford Alum and Iron Springs. Church Hill Alum Spring Jordan Alum Springs Pulaski Alum Springs , Stribling Springs Rock Enon Springs Walla whatoola Alum Springs Sparta Mineral Wells Szliacs (Hungary) Pyrawarth Frauzensbad (Bohemia). . Spa Flltwick Harrogate Tunbridge Wells Bussang La Malou (Herault) St. Pardoux (AUier) Charbonnidres Homburg Elster (Saxony) Schwalbach (Taunus) ...... Bocklet Driburg (Westphalia) Pyrmont (Waldeckj Alexisbad (Black Forest).. St. Moritz (Ehgadine) Tarasp Alabama. Alabama. Alabama. California. Florida. Georgia. Illinois. Indiana. Indiana. Indiana. Iowa. Iowa. Michigan. Missouri. Missouri. New York. New York. North Carolina. North Carolina. Ohio. Ohio. Oregon. Pennsylvania. Pennsylvania. Pennsylvania. Pennsylvania. Tennessee. Texas. Texas. Texas. Vermont. Virginia. Virginia. Virginia. Virginia. Virginia. Virginia. Virginia. Virginia. Wisconsin. Austria. Austria. Austria. Belgium. England. England. England. France. France. France. France. Germany. Germany. Germany. Germany. Germany. Germany. Germany. Switzerland. Switzerland. Alkaline chalybeate. 9 "64 gr. iron bicarbonate in a gal. 8 '78 gr. iron carbonate in a gal. 13 gr. iron subcarbonate in a gal. ; sulphuretted. ^■& gr. iron bicarbonate in a gal. ; chlorinated. 12 '5 gr. iron sesquioxide in a gal. ; carbonated. 69 '96 gr. iron protosulphate in a gal. ; calcic. 10-71 gr. iron carbonate in a gal. ; saline. 24'28 gr, iron sulphate in a gal. ; calcic. 1466 gr. iron carbonate in a gal. ; calcic. 97 '3 gr. iron sulphate in a gal. ; acidulated. 11*26 gr. iron carbonate in a gal. ; calcic. 15"92 gr. iron bicarbonate in a gal. ; calcic. 36'74 gr. iron sulphate in a gal. ; calcic. 18"73 gr. iron bicarbonate in a gal. ; carbonated. 20 '78 gr. iron carbonate in a gal. ; acidulated. 14 to 39 gr. iron sulphate in a gal. ; acidulated. 9"2 gr. iron carbonate in a gal. ; acidulated. 3r9 gr. iron in a gal. ; acidulated. 19'7 gr. iron carbonate in a gal. ; acidulated. 9'93 gr. iron bicarbonate in a gal. ; chlorinated. 62 gr. iron carbonate in a gal. ; chlorinated. 23 to 33 gr. iron sulphate in a gal. ; saline. 24 gr. iron sulphate in a gal. ; calcic. 7306 gr. iron sulphate in a gal. ; calcic. 31*33 gr. iron persulphate in a gal. ; acidulated. J 6'4 gr. iron sulphate J j , } 11-2 gr. iron oxide f>Qagal. 69-16 gr. iron sulphate in a gal. ; saUne. 7 to 17 gr. iron sulphate in a gal. ; acidulated. 13'06 gr. iron sesquioxide in a gal. ; acidulated. J 45 '04 gr. iron carbonate ( ■ , 1 13-2 gr. iron sulphate f '° ^ ^^l" 26'7 gr. iron persulphate in a gal. ; chlorinated. 19 -26 gr. iron persulphate in a gal. ; carbonated. 15879 gr. iron salts in a gal. 18-54 gr. iron sulphate in a gal. 108-75 gr. iron sulphate in a gal. 12 13 gr. iron sulphate in a gal. 14*25 gr. iron oxide in a gal. 23 '74 gr. iron persulphate in a gal. 14'34 gr. iron carbonate in a gal. 46 gr. iron bicarbonate in a gal. ; carbonated. 50 gr. iron bicarbonate in a gal. ; carbonated. 8 gr. iron bicarbonate in a gal. ; sahne. Iron bicarbonate. Iron sulphate. 2*96 gr. u-on in a gal. 6 grs. iron salts in a gal. 1*7 gr. iron bicarbonate in a gal.; Iron bicarbonate. Iron bicarbonate. Irou bicarbonate. 7 gr. iron bicarbonate in a gal. Iron bicarbonate ; saline. Carbonated. saline. alkaline. alkaline. carbonated. ; chlorinated. Iron bicarbonate Iron bicarbonate Iron bicarbonate Iron bicarbonate, Iron bicarbonate Iron bicarbonate alkaline, alkaline. Sulphur waters are those that owe their chief characteristic to the presence of sulphur- etted hydrogen, either as a free gas or in com- bination with calcium, magnesium, potassium, or sodium. They are easily recognised by their fcetid smell, resembling the odour of rot- ten eggs. It is difficult to distinguish the remedial effects of the sulphuretted hydrogen from red blood-corpuscles, possibly in consequence of the action of sulphur on the hemoglobin, and aneemia, debility, and wasting result. The sulphuretted hydrogen is absorbed by the blood of the capillaries of the mucous mem- brane of the intestinal tract, and it is elimi- nated by the lungs and the skin, and possibly a small quantity is excreted by the urine. Rohrig immersed rabbits in water saturated 371 WATERS, MINERAL with sulphuretted hydrogen, but arranged the animals so that they breathed atmospheric air ; death ensued in eighteen minutes in conse- quence of the absorption of the gas. This permeability of the skin by sulphuretted hy- drogen is made use of in the treatment of certain diseases, especially saturnism and mer- curialium, by baths. Braun stated that he had personally expe- rienced the influence of sulphuretted waters in relieving congestion associated with enlarge- ment of the liver. The gas is transmitted by the blood of the portal vein, and it combines in the liver with the iron of degenerating blood-corpuscles, forming an iron sulphide, which is excreted by the feeces. Such treat- ment is particularly indicated for patients who can not use the saline waters because of intes- tinal catarrh. Hepatic congestion associated with bronchial catarrh, hmmoptysis, and even pulmonary tu- berculosis, is benefited by the use of these wa- ters. The Bergeon treatment of tuberculosis by inhalations and rectal insufflations of sul- phuretted hydrogen that Is obtained from some strongly impregnated water still has its advocates. Internally, these waters may be used as a laxative in constipation due to deficiency of intestinal secretion. Hcemorrhoida due to de- fective circulation in the intestinal vessels are benefited by these waters, as is engorgement of the pelvic viscera in women. Braun suggested that the fact that the liver was the main depot for retained metallic poi- sons afforded an explanation of the benefit derived from the administration of sulphur water in chronic poisoning by lead or mer- cury. In saturnism and merourialism they may be given as draughts, baths, and inhala- tions (nebulized). While the use of sulphur waters externally and internally has had great vogue in the treatment of various skin diseases, there is no good evidence to prove that they are thera- peutically useful. The use of baths of sulphur water or of sul- phur vapour, as in the case of Glenwood Springs, Colorado, has relieved certain cases of chronic and muscular rheumatism and gout. The influence of the heat and moisture and that of the salts contained in the water must not be overlooked. The value of sulphuretted-water baths in the various forms of syphilis and in paralysis is no greater than that of warm water. Most of these waters owe their therapeutic value to the salts they contain rather than to the sulphuretted hydrogen or the sulphides. The waters of Aix-la-Chapelle, or Aachen, enjoy a general European reputation for their efficacy in the treatment of rheumatism, gout, and syphilis. Dr. E. P. Philpots (Bristol Medico-chirvirgicalJournal, 1885, p. 104) states that after a person with syphilis has remained in water of a temperature of 95° P. for half an hour, he is dried and rubbed with about three drachms of mercurial ointment; the solaei muscles being rubbed one day, the thighs the next, then the abdomen, thorax, arm, fore- arm, and back, and then the solsei receive an inunction again. The patient is given a mouth wash of potassium chlorate, and if salivation occurs the inunctions are discontinued for a day or so. Prom twenty to eighty baths and inunctions are given in each course. Aix-les-Bains is frequented by the English and Prench because of ics proximity to London and Paris. Sir Alfred B. Garrod {Lancet, 1887, vol. i, p. 869) said he had known a patient to leave London at eleven o'clock one morning and finish the first day's treatment by the same hour the following day. He thought the best season there was from May 10th to June 10th, or from the end of August to the end of Sep- tember. The hot sulphur mineral douche, the massage, and the internal administration of the sulphur waters relieve rheumatoid ar- thritis, muscular rheumatism, sciatica, and other neuralgic affections, and cutaneous af- fections associated with rheumatoid arthritis and gout. The LTnited States is particularly rich in springs that contain this gas, and in the list there will be found mention of such waters. Of the European spas the more important hot springs are those of Baden (temperature 131° P.), near Vienna, the Herculesbad (111-2°) at Mehadia, the springs at Harkany (143-6°), Gro.sswardein (113°, saline), Pystjan (173-7°, carbonated), Trenchin-Teplitz (104°, calcic), and Warasdin (134-6°, carbonated), in Hun- gary; Abano and Battaglia (73-7° to 160°, chlorinated), in Italy; Bareges (88° to 111-2°, calcic), Bagneres-de-Bigorre, Bagneres-de-Lu- chon (154°), Amelie-les-Bains (108° to 141-8°, calcic), Cauterets (102-2°), Eaiix-Bonnes (89-6°), Saint-Sauveur (93-56°), and Vernet, in the Prench Pyrenees; Aix-la-Chapelle (131°, sa- line), in Germany; Aix-les-Bains (114-8°), in Savoy; Ponticosa (77° to 91-4°), in Spain; and Baden (114-8, saline), Lavey (109-4°, sa- line), and Schinznach (109-4°, saline), in Swit- zerland. Among the cold sulphur springs are those of Harrogate, in England ; Lisdoonvarna, in Ire- land ; Eilsen, Neundorf (calcic), Weilbach (carbonated), Meinberg (carbonated), Langen- briicken, Hohenstedt, Sebastiansweiler, and Kreuth, in Germany; Enghien, in Prance; Strathpeffer, in Scotland; and Alvenu, in Switzerland. Certain mineral waters which contain an appreciable quantity of lithium salts are re- ferred to as lithia waters, but the reports in regard to their therapeutic virtues are com moner in the secular press and in descriptive circulars than in the pages of medical Journals. The Londonderry lithia water, from Nashua, New Hampshire, the Buffalo lithia water, the Parm- ville lithia water, and the Bowden lithia water have been extolled as remedies for a number of diseases. How much of their efficacy is due to the quantity of water imbibed and how much to the lithium salt is a matter for scien- tific research. Sir William Roberts (On the Chemistry and Therapeutics of Uric-acid Oravel and Gout; Croonian Lectures, 1893) has called attention to the fact that, because aolutions of lithium carbonate and piperazino WATERS, MINERAL 373 possess a high solvent power for free uric acid, it has been inferred from this fact that their administration internally might exercise a fa- vouring influence on the solubility of sodium bi-urate in the bodily fluids, and thereby tend to prevent the formation of uratio deposits. This inference, however, he does not deem jus- tifiable. He found experimentally that the addition of lithium or piperazine, in the propor- tion of 01 per cent, and 0-2 per cent., to blood- serum or synovial fluid did not have the slightest effect in enhancing the solvent power of these media on sodium bi-urate or in retarding its precipitation from serum and synovia arti- ficially impregnated with uric acid. Sir William considered that if the remedies mentioned have any effect in gout, it is certainly not due, as has been supposed, to their solvent action on the material of gouty concretions. Dr. J. H. Claiborne (Virginia Medical Monthly, 1889, xvi, p. 708) says he has pre- scribed Buffalo lithia water for a number of years in cases of Uihiasis, urcBmia, Bright's disease, cystitis, and nepliriti6 colic with satis- factory results. The ingestion of large quan- tities of water, from half a gallon to a gallon in a day, often causes the solution of gravel, and it is passed as sabulous matter. Dr. James Shelton ( Virginia Medical Monthly, 1887, xiv, p. 440) has found that the water from spring No. 1 relieves functional neuroses, arnenor- rhma, dysmenorrhea, menorrhagia, the ca- chexia and sequelcB of paludal fevers, dyspepsia, scarlatinal tiephritis, diabetes mellitus, syphi- lis, gleet, hepatic engorgement, eczema, and acne. [Dr. George Halsted Boyland {Mew York Medical Journal, August 33, 1896), who was formerly resident physician at the Buffalo Lithia Springs, says he is satisfied that there is no other mineral water either in America or in Europe so singularly adapted to such a large number and variety of maladies. He says: "The solvent properties of all three springs on grape sugar is immediate (as can be readily proved by placing 10 or 30 grains in a test tube and adding half an ounce of water), and their great value in the treatment of dia- ietes mellitus is attested by numerous cases." He has found the waters useful also in jaun- dice, albuminuria, and those cases of inflam- mation of the vermiform appendix that are dependent on the formation of phosphatic de- posits in the appendix.] Earthy, or calcareous, waters are those which contain such earthy substances as cal- cium carbonate and sulphate and magnesium carbonate as prominent constituents. The calcium bicarbonate in mineral waters is usu- ally first reduced in the stomach to a carbo- nate before it can be changed into calcium chloride or lactate, and it reappears in the f£Eces as calcium carbonate or phosphate. Internally, the constituent salts of these waters have some action as antacids and act as astringents. The acidity of the urine is dimin- ished or that excretion may be made alkaline. The alkaline are preferable to the earthy waters in cases of gastric catarrh with hyper- acidity. The bactericidal property of the calcium salts may be of value in diarrhoea ac- companied by intestinal catarrh. There is no evidence to support the theory that these wa- ters are of value in caries, necrosis, osteoma- lacia, or other bone diseases, and they do not hasten the calcification of tubercles. External- ly, these waters have proved useful in gouty and rheumatic affections and some chronic exanthe- mata, probably because of the presence of car- bonic acid in the water. While these waters have been used in the treatment of bronchial catarrh, cystitis, hepatic and cystic calculi, and certain skin diseases, there is no good evidence to justify the belief that the calcium salts have exercised any therapeutic effect. These springs — in which the sum of mineral constituents does not exceed the amount pres- ent in ordinary potable water, in which there is no sodium, or only a small trace of it, and in which the principal ingredient is a small percentage of calcium carbonate or sulphate — are likely to be of value in the treatment of gout. Most if not all of the calcium salt proba- bly passes out in the faeces, so that such springs depend upon their watery constituents. As the waters are taken freely and usually on an empty stomach, they dilute the blood tem- porarily and lower its percentage of urates and sodium salts, and thus retard or prevent the precipitation of urates, and give the defective kidneys more time for the task of eliminating uric acid. Among the springs particularly indi- cated in gouty conditions are those of Bath and Buxton in England ; of Aix-les- Bains, Bareges, Contrexeville, and Vittel in Prance; and of Gastein, Pfaffers, and Wildbad in Germany. The list of springs in the various States makes mention of the calcic waters in the United States. In Europe, the better known spas are those of Bigorre, Crausac, Contrexeville, St. Armand, St. Galmier, and Vittel, in Prance; Inselbad, near Paderborn, Driburg and Lipp- spring, in Westphalia, and Wildungen in Wal- deek, in Germany; and Leuk, in Canton Wallis, and Weissenburg, in Canton Bern, in Switzer- land. Calcium sulphate is found in medium amounts in the Pullna, Sedlitz. Saidschiitz, Iwanda, and Priedrickshall saline waters; in the Mergentheim, Bourbonne, Cannstadt, Sehmalkalden, Rehme, Wildegg, and Mondorf ehlorinated waters ; and in tlie Neundorf, Schinznach, Eilsen, and Luben sulphur waters. Carbonate of calcium is found in the waters of a number of spas as an associated salt. Though the use of mineral waters is indi- cated at all seasons of the year, there are cer- tain times when the springs in this country and in Europe are in season. At a number of these resorts the hotels are open only during certain months in the year, and at other times accommodations are likely to be inferior. The use of the waters at home, while not without advantage, is less likely to be followed by the improvement that occurs when they are taken at the springs, where the change of air and scene add their influence to the medicinal properties of the water, and where the details of diet and mode of life are more punctiliously attended to. The season at most of the resorts extends from May to October, though at some it is 373 •WATERS, MINERAL from June to September, while some — like Glenwood Springs, Colorado, Warm Springs, North Carolina, or Hot Springs, Arkansas — are open all the year, the winter and spring months being most popular at the two last-mentioned resorts. Certain resorts in Europe are not closed at any season, such as Aix-les-Bains, Aix-la-Chapelle, Araelie-les-Bains, Baden-Ba- den, Bath, Dax, and Wiesbaden. The possibility of more outdoor life during a sojourn in the warm months of the year is a factor that should be considered by the physi- cian in selecting a resort, especially for persons with diseases that are likely to be affected by variability in the weather or by confine- ment in the house. The length of treatment may best be deter- mined by the resident physician at the springs. Power of recuperation, as well as impressibility, varies in different individuals, and there are instances in which an apparently suitable spa proves to be disadvantageous to a patient. It is therefore inadvisable for the physician who recommends a course of treatment to lay down any specific rule. If the resident physician at such a resort is a competent man, he can best report on the improvement, and, as the length of sojourn should be commensurate with the advantages that are derived from it, it would be best to direct patients to follow such advice. Obvi- ously, it would be impossible for a physician at a distance to know of the features of the change in a patient affected with aneemia, but the resident physician, who should make regu- lar observations with the hsemoglobinometer and h:ematocrite, is prepared to speak with positiveness on the benefit afforded by the re- sort. This same is true in the several forms of nephritis, in which regular urinary analysis affords positive information of the condition of the kidneys and of the influence of the water on their action. In gastric disorders the examination of the performance of stom- ach digestion is essential. In fact, few dis- eases should be treated at these places without the regular use of the methods of precise ex- amination rather than the perfunctory ques- tioning of the patient and advice based on interpretation ot his statement of his condi- tion. It is needless to say that there are very few resorts in this country where such system- atic methods are in vogue, and until such ad- vice can be secured the resorts of Europe are likely to be patronized by Americans rather than those of the United States. The empiri- cal administration of iron, mercury, potas- sium iodide, or quinine is likely to be less advantageous to a patient than the use of any of these drugs after careful consideration of the evidence afforded by the use of instru- ments of precision. The writer would not overrate tlie value ot the latter, which will prove of little use if unassociated with good judgment and experience; but it is only by the aid of all such methods that physicians can escape the old-time reproach that they were a class " engaged in pouring drugs of which they knew nothing into stomachs of which they knew less." The question in regard to the desirability of a person's returning home immediately after a course of treatment, or of going to some other place for a longer or shorter time, should be decided by the resident physician at the springs. In many instances, especially in gas- tric, renal, or hepatic affections, it is essential for the patient to enhance or fortify his con- dition after the improvement afforded by a course of mineral waters, and some weeks at a well-selected place will insure abstinence from work and a continued attention to the details of diet. The question in regard to the choice of min- eral waters and their applicability to different patients is as unsettled as that of the selection and administration ot other remedial agents. Every factor that plays a part in the choice of a suitable medicament must be considered as well in the selection of a mineral water that is likely to benefit a patient. But in choosing the latter it is necessary to con.sider not only the character of the disease, the degree to which the organs affected are involved, the general condition of the patient, and the analo- gous factors, but also the patient's ability to stand the journey to the springs, the effects of the various factors besides the waters that ex- ist at such resorts, and the season of the year when the visit shoidd be made. Dr. Julius Braun has very truly said {On the Curative Effeds of Baths and Waters. Trans- lated by Hermann Weber, M. D.) : " Cases of sickness of very different kinds are cured and improved by one and the same medicinal spring, and cases of similar nature are cured and improved by very different medicinal springs." Dr. A. C. Peale, who prepared the list of the mineral springs of the United States that was published in Volume V of the Bulletins of the United States Geological Survey, collected data that must serve as a basis for all future work in this field. The writer would acknowledge his obligation to that list, which has materially aided his per- sonal observations, and he reproduces herewith Dr. Peale's summary of the springs in the dif- ferent geographical divisions of this country : Northern Atlantic States Southern Atlantic States Southern Central States Northern Central States Western States and Territories Total No. of spring 405 371 721 601 724 2,822 .Vo. of Individual springe. 667 1,048 1,911 1,276 3,951 8,843 No. of eprlDgi) analyzed. 165 148 137 215 132 787 No. of springs nsed as resorts. 74 1.52 174 122 112 631 No. of springs used com- mercially. 72 42 55 18 223 Total Qamber of analyses of waters. 187 164 146 224 138 WATERS, MINERAL 374 From this table it may be seen that less than 10 per cent, of the number of mineral springs in.this country have had their waters analyzed, while but little more than 30 per cent, of the places where mineral waters are found are used as resorts. Alabama contains a number of mineral springs, though few of them have anything more than a local reputation, and the waters of but few have been analyzed. Those that are used as resorts have much to be desired in the matter of accommodation for visitors. Bailey Springs, in Lauderdale County, Chandler's Springs, in Talladega County, and Greene Springs, in Hale County, are chalybeate springs. Bladon Springs, in Choctaw County, is an alka- line, carbonated, and sulphuretted water, simi- lar to that of Aachen. At Blount Springs there are five saline sulphuretted springs, and a somewhat similar water is found at Cullum's Springs, in Choctaw County. There are sul- phuretted and chalybeate springs at Blue Grass Sulphur Springs, near Cornelia; at Coffee Springs, in Geneva County; at Tallahatta Springs, in Clarke County, and at White Sul- phur Springs, in Calhoun County. Alaska has within its area a number of hot springs, the better known of which are the sa- line-sulphuretted springs (temperature, 153° F.) north of New Archangel, Sitka Island. There are also cold springs of chalybeate, sa- line, and sulphuretted waters, no analyses of which have been made. In Arizona there are hot springs (tempera- ture, 130° P.) above the mouth of the San Francisco River; the Monroe Hot Springs (temperature, 150° to 160° F.), south of Prescott, are used for bathing, and there is a number of carbonated, sulphuretted, alkaline, and saline springs, none of which is used as a resort. Arkansas is better known from its hot springs than from any other feature of the State. There are some seventy "springs situ- ated in a picturesque valley that is easily ac- cessible and is supplied with excellent hotel accommodations — too frequently the feature that is lacking in the spas in the United States. There is no characteristic feature in either the temperature or the ingredients of this watei' to make it superior to many other thermal springs in this country. But it has had a certain popu- larity in the treatment of constitutional syphi- lis and chronic rheumatism and gout, and fashion has served to enhance its position among such resorts. The consensus of opinion of expert physicians at Hot Springs is that the therapeutic value of these waters is due more to physical properties than to chemical combination (Dr. T. M. Baird, Hot Springs Medical Journal, 1894, vol. iii, p. 3 ; Dr. W. H. Barry, ibid., 1893, vol. i, p. 103 ; Dr. G. W. Galvin, New York Medical Journal, 1887, vol. xlv, p. 656 ; Dr. J. T. Jelks, Atlanta Medical Register, 1881, vol. i, p. 513 ; Dr. .1. M. Keller, St. Louis Medical and Surgical Journal, 1879, vol. xxxvii, p. 88 ; Dr. E. R. Lewis, Journal of the National Association of Railway Surgeons, 1889, vol. ii, p. 6). As soon as this water is allowed to stand or to flow in the open air a large amount of deposit will occur. The ex- ternal and internal use of these waters is use- ful in gout, rheumatism, neuralgia, incipient BrighVs disease, cystitis, functional disease of the liver, chronic diarrhoea, chronic skin dis- eases, especially of squamous types, and ma- larial toxcemia. [An editorial writer in the New York Med- ical Journal for December 1, 1894, says : "If we were to base our judgment on chem- ical analyses alone, it would be puzzling to account for .the cures wrought by the waters ; practically, they contain nothing but silica. Nevertheless they do bring about unquestion- ably the recovery of many an invalid doomed without their aid to years of drooping health and an untimely death. How do they do it ? The local physicians say that it is by virtue of their occasioning a marvellous activity of the emunctories, whereby the system is enabled to tolerate huge doses of active drugs, while at the same time the patient, hoping for something akin to a miracle, subordinates all his- thoughts to the effort to get well and obeys his physi- cian's instructions implicitly. , " Recognising the efficacy of a sojourn in the romantic city of Hot Springs, together with a systematic use of its thermal waters, the Government has established on its reserva- tion there a general hospital for the benefit of officers and enlisted men actually in the serv- ice and suffering from ailments that have been contracted in the line of duty and have re- sisted treatment at other military or naval hospitals. . ; . A circular issued from the Ad- jutant-General's office says : '• ' Relief may reasonably be expected at the Hot Springs in the following conditions: In the various forms of gout and rheumatism, after the acute or inflammatory stage ; neural- gia, especially when depending upon gout, rheumatism, metallic or malarial poisoning; paralysis, not of organic origin ; the earlier stages of locomotor ataxia, or tabes ; the early stages, only, of Bright s disease; diseases of the urinary organs ; functional diseases of the liver ; gastric dyspepsia not of organic origin ; chronic diarrhoea ; catarrhal affections of the digestive and respiratory tracts; chronic skin diseases, especially the squamous varieties; and chronic conditions due to malarial infec- tion. Speaking generally, treatment by the Hot Springs water may be said to stimulate all the secretions and the organic functions, to promote digestion and assimilation, and to favour tissue metamorphosis and excretion, thereby relieving internal congestions, stimu- lating blood-mating, increasing the appetite, and favouring new and healthy tissues at the expense of the old and inactive. The Hot Springs water is contra-indicated in all acute inflammatory diseases, tuberculosis, organic disease of the heart or brain, cancer and other malignant diseases, aneurysm, and in all cases where stimulation of the circulation is to be avoided.' "] Dr. G. Adams has published an account of the Arkansas Lithia Spring (Therapeutic Ga- zette, 1889, V, p. 13), situated near Hope, Hampstead County. An analysis showed that each imperial gallon contained 75'86 grains, 375 WATERS, MINERAL including sodium chloride, 24-16 ; lithium chloride, 3-63 ; magnesium sulphate, 11'97; and iron oxide, 4-55 grains. The water had a di- uretic and laxative effect. There was no ac- commodation for patients. There are saline springs at Blanchard Springs, in Union County ; saline and chalybeate springs at Blood Spring, in Montgomery County; sul- phuretted saline springs near Dardanelle ; sul- phuretted springs at Gum Springs, in Cleveland County, at Pennywits Sulphur Springs, in Crawford County, and at White Sulphur Springs, near Pine Bluff. There are chalybeate springs at Mount Nebo Sprin ;s, near Darda- nelle. There are calcic springs at Eureka Springs, in Carroll County, the water of which contains but 5'85 grains of solids, including 4'43 grains of calcium bicarbonate in each gal- lon, and at Mountain Valley Springs, near Hot Springs, the water of which contains 31-82 grains of solids, 12-66 grains of which are calci- um bicarbonate, in a gallon. Except at Eureka Springs, the accommodations are primitive. California has probably a larger number of mineral springs, more of which are improved as resorts, than any other State. As is the case in most regions where there are evidences of ter's Springs, in Lake County. There are alka- line-sulphuretted springs at Castalian Mineral Wells, in Inyo County, and Pearson's Springs, in Lake County. The alkaline and saline springs are.Bartlett Springs, in Lake County. The alkaline springs are Geyser Springs, in Sonoma County, and Highland Springs, in Lake County. There are sulphuretted springs at Fulton Wells, in Los Angeles County ; Hot Mud Springs, in Siskiyou County ; Monticello Hot Springs, Mountain Glen Springs, and Las Cruces Hot Springs, in Santa Barbara County ; Matilija Hot Springs, in Ventura County ; Newsom's Arroyo Grande Warm Springs, in San Luis Obispo County; Simmon's Hot Sul- phur Springs, in Colusa County ; Warner's Ranch Springs, in San Diego County ; St. Helena Springs, in Napa County ; and Wilbur Springs, in Colusa County. Colorado includes within its territory both warm and cold springs, the waters of which are rich in various constituents. Among the most celebrated of these springs are the six springs at Manitou, a beautifully situated town at the foot of Pike's Peak. An analysis of the water by Oscar Loew, in 1875, showed the following ingredients : MANITOU SPRINGS. CONSTrrUENTS. Iron Ute Spring. Little Chief Spring. Manitou Spring. Navajo Spring. Ulo Soda Spring. Shoshone Spring. Parts in 100,000. 59-34 59-04 14-56 trace 5-r8 30-86 TOl 31 -59 8-69 ParU in 100,000. 15-16 7B-20 13 01 trace 1-80 51-88 6-24 47-97 222 Parts In 100,000. 52-26 111-00 20-51 0-21 trace 19-71 13-35 40-95 201 Parts in 100,000. 124-69 129-40 31-66 0-24 'i8-42 16-21 39-78 1-47 Parts in 100,000. 23-88 40-00 6-10 trace 1-40 12-24 trace 13-93 trace Parts in 100,000. 88-80 }■ 108-50 trace Lithium carbonate Iron carbonate . 37-08 5-12 42- )2 Silica Total 210-87 218-48 260-00 361-87 97-49 281-62 volcanic action, there are many thermal springs, some of which are popular resorts. There are alkaline carbonated springs at Adams Spring, in Lake County, which have proved of value in chronic dyspepsia, hepalic congestion, and rheumatism; jEtna Springs, in Napa Coun- ty; Allen Springs, in Lake County; Cali- fornia Seltzer Spring, in Mendocino County ; Pry's Soda Spring, in Siskiyou County ; Glen Alpine Mineral Springs, in El Dorado County ; Litton's Seltzer Spring, in Sonoma County; Summit Soda Springs, in Alpine County ; Tolenas Spring, in Solano County ; and Vichy Springs, in Santa Clara County. There are sulphuretted - saline springs at Alum Rock Springs, in Santa Clara County ; Byron Springs, in Contra Costa County; El Paso de Robles Springs (hot and cold), in San Luis Obispo County; on Pluton Creek, in Sonoma County; Harbin Springs and Mill's Mineral Springs (hot), in Lake County ; and Tuscan or Lick Springs, in Tehama County. There are sulphuretted-chalybeate springs at Bonanza Springs, in Lake County ; El Paso de Robles Springs, in San Luis Obispo County; Mark West Springs, in Sonoma County ; and Wit- All the waters contain free carbonic acid in large quantities. Dr. S. Edwin Solly (Manitou, Colorado, TJ. S. A. Its Mineral Waters and Climate) recommends the administration of the water of the Navajoe spring in catarrhs, hepatic or renal plethora, gout, gravel, gastric catarrh, in- testinal catarrh, pyrosis associated with chronic dyspepsia, and gastric irritability in incipient or threatened phthisis. He has found this water useful externally in skin diseases in which pruritus or excoriation of the epidermis is a prominent feature, and as an injection it relieves intractable leucorrhoea. He considers the Shoshone water useful in gallstones, ham- orrhoids, jaundice, and dyspepsia of hepatic origin. The Little Chief water is advised in those diseases in which the administration of iron is indicated. The Iron Ute spring is rec- ommended for the treatment of ancemia caused by parturition or prolonged lactation, in amen- orrhcea and menorrhagia of hsemic origin, in gastric and intestinal atony, and in functional neuroses. At Glenwood there is the Tampah spring. An analysis of the water by Professor Chandler WATERS, MINERAL 376 showed the following constituents in each gallon : Chloride of sodium 1089-8307 grains. Chloride of magnesium I3'0994 " Bromide of sodium 05635 grain. Iodide of sodium trace Fluoride of calcium " Sulphate of potassium 24-0434 grama. Sulphate of calcium 82-3861 Bicarbonate of lithium 0-2209 grain. Bicarbonate of magnesium 13-6532 grams. Bicarbonate of calcium 24-3727 " Bicarbonate of iron trace Phosphate of sodium " Biborate of sodium ^| Alumina Silica l-9712grams. Organic matter trace Total 1250-0411 grains. Dr. J. C. Blickensderfer. of Denver, has found that the external and internal use of these waters is of value in Brighfa disease, rheuma- tism, hepatic diseases, syphilis, and various skin diseases. Dr. Lewis R. Morris {New York Medical Journal, September 38, 1895) states that a glass or more of the water, either hot ox cold, taken in the morning before breakfast, seems to increase the appetite and relieve the nausea in dyspepsia and gastric catarrh. In chronic catarrhal gastro-enteritis, in const ijja- tion, in saturnism, and in rheumatoid arthritis Dr. Morris has found these waters useful. The Siloani springs, in Garfield County, have an outflow of water varying in temperature from 94° to 104° P., and containing 616-5 grains of salts, principally sodium chloride and calcium sulphate, in each gallon. It is stated that the waters act like those of Glenwood, but there are no such luxurious accommodations as exist at the latter place. In Gallon City there are several springs of therapeutic value. Dr. F. R. Blake {St. Louis Courier of Medicine, 1881, vol. vi, p. 178) states that the waters are palatable, though they purge if taken in large quantities. They act on the liver and kidneys, and he has found them especially useful in biliary obstruction. The hot springs are used for baths. Professor Loew gives an analysis of the waters in the following table : ham County ; at Oxford and North Haven, m New Haven County ; and at Stafford Springs, in Tolland County. The facilities of travel afford the residents of this State opportunity to visit springs where water more heavily im- pregnated with mineral substances may be ob- tained. There are no mineral springs of importance in Delaware, although water that is mildly chalybeate is found in several parts of the State. Florida is rich in springs that contain hydro- gen sulphide, and the presence of that gas is an objection to the water that is obtained from the artesian wells. As a rule, the waters con- tain but small percentages of mineral sub- stances. There are sulphuretted springs at Orange City and Enterprise (De Barry Springs), in Volusia County; at Clay Spring, near Apopka, and at Hoosier Spring, near Alta- monte Station, in Orange County ; at Tarpon Springs, in Hillsborough County ; and at White Springs, in Hamilton County. There are cha- lybeate springs at Newport Sulphur Springs, near Saint Mark's, in Wakulla County, and at Wesson's Iron Springs, in Hamilton County. The accommodations at some of these places are primitive, but the waters may be employed as adjuncts to the mild climate. Georgia contains a number of mineral springs, several of which have been improved so that the resorts are satisfactory. There are carburetted chalybeate springs in Fulton County, near Atlanta, the Angler's Mineral Springs. The sulphuretted chalybeate springs are Camp's Spring, near Atlanta, in Fulton County; Beall Spring, in Warren County; the Chalybeate Springs, Warm Springs, and White Sulphur Springs, in Meriwether County ; Magnolia Spring, in Sumter County ; Powder Springs, in Cobb County; and Watson's Springs, in Greene County. There are saline, calcic, chalybeate, and sulphuretted waters at Catoosa Springs, in Catoosa County ; at Co- h-utta Springs, in Murray County; at Ferro- lithic Springs, in Clarke County; at Garnet Springs, near Toccoa, in Habersham Coun- ty ; at Gordon Springs, in Whitfield County ; CONSTITCJKNTS. Sodium carbonate . . . . Calcium carbonate. . . . Magnesium carbonate Sodium sulphate Sodium chloride Total Parte In 100,000. 12-67 5-86 2-49 S-01 13-72 36-26 caSon city springs. Iron Duke. Little Duke. Parts in 100,000. 12-66 3-74 2-34 2-07 19-66 40-40 Big Ute. Aqua Vide. "^g");"" "«' Spring. Parts in 100,000. 6-94 7-32 2-67 2-80 22-68 41-22 Peru in 100,000. 12-58 6-78 3-02 2-49 20-7-0 46-69 Farts in 100,000. 3-32 4-82 300 3-10 6-52 20-63 Parts in 100,000. 1-19 6-63 2-11 1-34 3-01 13-20 There are no mineral springs of importance in Connecticut, although some weak chalybeate and sulphuretted springs possess a local repu- tation, while springs once used as resorts are now neglected. There are sulphuretted springs at Lebanon, in New London County, and at SufEeld, in Hartford County. There are cha- lybeate springs at North Woodstock, in Wind- and at Lawrence Mineral Springs, in Chat- tooga County. There is a small sulphuretted- saline spring at Indian Springs, in Butts County. Among the best springs in the State are the Bowden Lithia Springs, in Pulton County. These springs contain the following constitu- ents: 377 WATERS, MINERAL Bromine Lithia Spiings. Lithia Spring. Calcium bicarbonate Grains per gal. 17-24 •2-87 '4-44 21 121-78 8-03 1-46 0-53 1-22 12-15 'i'73 1-26 trace trace trace trace trace Grains per gal. 1418 Magnesium bicarbonate Magnesium sulphate 10-33 4-40 Lithium bicarbonate . . . 2-84 0-21 Sodium chloride ... 133-70 16-25 Potassium sulphate Aluminum sulphate 1-32 102 Calcium phosphate . 0-63 1-69 Silicic acid 113 Potassium bicarbonate 3-63 Manganese. trace Phosphoric acid ... . Total 172-92 191-31 Dr. T. S. Hopkins (Climatologist, 1891, vol. i, p. 97) says that these -waters are useful in the treatment of lithiasis, uriccBmia, chronic cys- titis, diabetes melUtus, cystitis, prostatitis, gleet, dyspepsia, gout, neurasthenia, and he- patic derangements. When the geological formation of Idaho is recalled, the presence of hot springs there would be expected. While many of the hot springs of that State are likely to be used for medicinal purposes in the future, few of them are improved at present. In Owyhee County there are the Bruneau Hot Spring, in Bruneau Valley, and Given's Hot Spring, near Reynolds. East of Boise City, in Ada County, there are ■warm and hot alkaline, chalybeate, and sul- phuretted springs. There are hot sulphuretted springs southwest of Idaho City, in Boise County, and near the Snake River, in Oneida County. The Soda Springs, at the bend of Bear River, in Oneida County, supply car- bonated, calcareous, and chalybeate waters. There are a number of springs in Illinois that contain small quantities of mineral in- gredients, but few of them are of even lo- cal importance. There are carbonated calcic springs at Alcyone Springs, in Cook County, which contain some 44 grains of solids, prin- cipally calcium and magnesium bicarbonates, to the gallon, and Zonian Spring, in Kane County, which contains 15 grains of solids to the gallon. The Ganymede Spring, in Ogle County, contains 20 grains, principally cal- cium and magnesium carbonates, of salts in each gallon. There are saline and chalyb- eate springs at Green Lawn Springs, Mount Vernon, in Jefferson County, and Perry Springs, in Pike County. The waters of the Glen Flora Springs, near Waukegan, in Pike County, con- tain magnesium, sodium, and calcium bicar- bonates in small quantities, the total salts be- ing less than 40 grains to the gallon. There is a chalybeate spring in Schuyler County that contains a large percentage of iron. There are a number of sulphuretted springs in various parts of the State. Indiana contains within its borders a num- ber of mineral springs, the sulphuretted and chalybeate waters beingmost numerous. There are chalybeate springs at Anderson Spring, at Hartsville Spring, and near Azalia, in Bar- tholomew County; at Anderson Mound Spring (carbonated), in Madison County; at Central Springs, near Shoals, in Martin County ; at Milburn Springs, in Pike County; and at Van Cleave Springs, in Crawfordsville, Montgom- ery County. There are chalybeate and saline springs at be Gonia Springs, in Warren County, the water of which is carbonated and contains 131 grains of solids, principally magnesium, potassium, and sodium sulphates and calcium and iron carbonates, in each gallon. Hawkins's Chalybeate Springs, in Richmond, Wayne Coun- ty, has a carbonated water that contains abovit thirty grains of solids, principally calcium bi- carbonate and sulphate, in each gallon. The sulphnretted saline springs are Hosea Saline Sulphur Spring, in Clarke County, the waters of which contain 897-29 grains of solids, includ- ing sodium sulphate (393-76 grains), calcium sulphate (221-42 grains), potassium sulphate (lll-25grains), calcium carbonate (88-20 grains), and sodium chloride (59-66 grains), to the gal- lon ; La Payette Artesian Well, in Tippecanoe County, a carbonated sulphnretted water con- taining 419-54 grains of solids, principally sodium chloride (324'77 grains) and calcium sulphate (56-01 grains), to the gallon ; Lodi Artesian Well, in Fountain County, the water of which contains 672-45 grains of solids, prin- cipally sodium chloride (502-46 grains), calcium sulphate (55-56 grains), and magnesium chloride (53-54 grains), to the gallon ; Trinity Springs, in Martin County, the water of which contains 32"08 grains of solids to the gallon ; Wyandotte Spring, in Crawford County, the water of which contains 50 grains of solids to the gallon ; and French Lick Springs, in Orange County, where the waters are carbonated and sulphuretted and average between 250 and 350 grains of solids to the gallon, the principal salts being sodium chloride, calcium and magnesium sul- phates, and calcium, magnesium, and sodium carbonates. Iowa has no mineral springs of special im- portance. Chamberlain, or Storm Lake, Min- eral Springs, in Buena Vista County, is an acidulated water that contains some 50 grains of solids, principally lime and magnesia, in each gallon ; Colfax Mineral Springs, in jas- per County, are carbonated saline chalybeate waters which contain some 140 grains of solids, principally sodium, magnesium, and calcium sulphates, to the gallon. The Iowa Acid Spring, at Bddyville, in Wapello County, contains 408-99 grains of sulphuric acid, 226-41 grains of alumina, 97'3 grains of iron sulphate, 44-65 grains of calcium sulphate, and small amounts of some other salts, to the gallon. There is a small alkaline-saline spring at Ottumwa, in Wapello County, the water of which contains 200 grains of sodium sulphate in each gallon. In Kansas there are some wells that furnish ferruginous, saline, and sulpho-saline waters, several of which enjoy considerable local repu- tation. There are carbonated saline-chalybeate springs at Arrington, in Atchison County. WATERS, MINERAL 378 There are chlorinated springs at Geuda Springs, in Sumner County ; at Cawker City (Great Spirit Spring), in Mitchell County; at Girard, in Crawford County; and at lola, in Allen Coun- ty. There are chalybeate springs at Louisville, inPottawatomie County, and at BaxterSprings, in Cherokee County. Kentucky is well known on account of several of its mineral springs, and in those counties where there are the Silurian and Car- boniferous formations it is impossible to bore an artesian well without striking underground sources of some kind of mineral water. The sulphuretted springs include Allen Springs, in Warren County ; Buffalo Springs, in Breckin- ridge County ; Fox Springs, in Fleming Coun- ty; Grayson Springs, in Grayson County; Hardin Springs, in Hardin County; Salubrian Springs, in Christian County; and Young's Springs, in Bath County. The sulphuretted and chlorinated springs include Beachville Springs, in Metcalfe County; Big Bone Lick Springs, in Boone County; Blue Lick Spring in Nicholas County ; Campbellsville Sulphur Spring, in Taylor County ; Drennon Springs, in Henry County; EUiston's Sulphur Spring, in Madison County; Estill Springs, in Estill County; Latonia Springs, in Kenton County; Olympian Springs, in Bath County; Paroquet Springs, in Bullitt County; and Sabree Springs, in Webster County. The saline springs in- clude Bedford Springs, in Trimble County ; the lower Blue Lick Spring, in Nicholas County ; Cerulean Springs, in Trigg County ; Harrods- burg Springs, in Mercer County ; Rochester Springs, in Boyle County; Tar Springs, in Breckinridge County; and Yates Mineral Spring, in Boyle County. The principal chalyb- eate springs are Bryant's Springs, in Lincoln County; Burgher's Spring, in Logan County; Davis Spring, in Hopkins County: Dripping Springs, in Garrard County; Esculapia Springs, in Lewis County; Hickman's Springs, in Daviess County; Howell Mineral Springs, in Hardin County ; and Rockcastle Springs, in Pulaski County. Lottisiana has no mineral springs of any particular importance. There are chalybeate springs at Abita Spring and at Claiborne Springs, both near Covington, in Saint Tam- many Parish ; they were popular resorts prior to the civil war, and still have some vogue with the residents of New Orleans. There is a sulphur spring at White Sulphur Springs, in Catahoula Parish. Maine contains mineral springs that supply waters of most of the different classes, except the thermal. Pew of the springs are strongly impregnated with salts or gases. Alkaline, calcic waters are supplied by the Addison Mineral Spring, in Washington County ; the American Chalybeate Spring and the Auburn Mineral Spring, at South Auburn, and the Lake Auburn Mineral Spring, at North Auburn, in Androscoggin County ; the Poland Spring, at South Poland, in Androscoggin County ; and the Rosicrucian Spring, in Lincoln County. Sulphuretted water is supplied by the Bethel Spring, in Oxford County ; Boothbay Medici- nal Mineral Spring, in Lincoln County; and Katahdin Mineral Spring, in Piscataquis Coun- ty. There are saline springs at Hartford Cold Springs, in Oxford County ; and at Lubec Saline Springs, in Washington County. The Poland Spring is the best known of the Maine springs. The water contains about 3-75 grains of solids to the gallon, principally calcium carbonate and silica. The Paradise Spring, near Brunswick, in Cumberland County, is a purer water, as it contains less than a grain of salts to the gallon, sodium carbonate and silica being the chief constituents. Ilaryland contains a number of springs the waters of which are impregnated with small quantities of mineral ingredients. Noneof them is of much importance, and several that were formerly used as resorts have been virtually abandoned. There are mild chalybeate springs at Bentley's Springs, in Baltimore County ; at River Springs, in St. Mary's County ; and at Spa Spring, in Prince George's County. There is an alkaline, calcic, carbonated spring, the Strontia Mineral Spring, at Brooklandville, in Baltimore County. The water contains r86 part of strontium bicarbonate in 100,000 parts. Massachusetts has no mineral springs that possess anything more than local importance ; the waters contain but small proportions of mineral ingredients. Alkaline calcic waters are obtained from the Allandale Springs, West Rox- bury, in Suffolk County; Bethlehem Spring, near Braggville, in Worcester County ; and the Commonwealth Mineral Spring, Waltham, in Midd lesex Con nty. Mild chalybeate waters are supplied by the Crystal Mineral Springs, at Stoneham, in Middlesex County; Coldbrook Mineral Springs, in Worcester County; and Hopkinton Springs, in Middlesex County. Michigan contains but few natural mineral springs, but in boring artesian wells a variety of mineral waters has been obtained. A num- ber of these wells have been referred to as magnetic; in no instance, it is credibly stated, has the water itself any magnetic properties, the magnetic phenomena being manifested in the vicinity of the springs. Alkaline calcic wa- ters are obtained from the Eaton Rapids Mag- netic Springs and the Grand Ledge Magnetic Wells, in Eaton County ; the Leslie Magnetic Wells, in Ingham County ; the St. Louis Mag- netic Spring, in Gratiot bounty; theHubbard- ston Magnetic Spring, in loiiia County; the Shawnee Mineral Springs, in Monroe County ; and Butterworth's Magnetic Spring, at Grand Rapids, in Kent County. Sulphuretted water is supplied by the Alpena Magnetic Well, in Alpena County ; Owen's Mineral Well, at Ypsi- lanti, in Washtenaw County; and the Wyan- dotte White Sulphur Spring, in Wayne County. Saline waters are supplied by the Fruitport Artesian and Magnetic Well, in Muskegon County ; the Lansing Magnetic Well, in Ing- ham County; the Midland Magnetic Well, in Midland County; the Spring Lake Magnetic Well, in Ottawa County; and the Ypsilanti Mineral Well, in Washtenaw County. The principal chlorinated waters are those of Mount Clemens Mineral Springs (sulphuretted), which contain from 9,000 to 11,000 grains of salts, principally sodium chloride, in each gal- 379 WATERS, MINERAL Ion ; and the Saint Clair Mineral Springs, in Saint Clair County. Minnesota mineral springs are compara- tively unimportant. There are aliialine calcic springs at Inglewood Springs, near Minneapo- lis, and at Owatonna Mineral Springs, in Steele County. Mississippi contains a number of mineral springs that supply almost all kinds of waters except the thermal. There are chalybeate springs near Camden, in Madison County ; near Aberdeen, in Monroe County; near Gra- nada, in Granada County ; near Holly Springs, in Marshall County ; at Ocean Springs, in Jackson County ; and near Columbia, in Mari- on County. The water of Lauderdale Spring, in Lauderdale County, and of Castalian Springs, in Holmes County, is chalybeate and sulphuretted. Saline waters are supplied by Cooper's Well, near Raymond, in Hinds Coun- ty, and La Fayette Springs, in La Payette County. An analysis by J. Lawrence Smith shows that each gallon of water from Cooper's Well con- tains — (Jrains, Sodium sulphate 11 71 Potassium sulphate 0*61 -Calcium sulphate 33"13 Aluminum sulphate 6"33 Magnesium sulphate 28'28 Sodium chloride 8*36 Calcium chloride.^. 4*.32 Magnesium chloride 3'48 Iron peroxide 3'36 Calcium crenate 0*31 Silicon crenate 1*80 Total 95-48 The late Dr. Joseph Jones (Times and Reg- ister, 1892, vol. XXV, p. 395) found that this water was purgative, diuretic, diaphoretic, and alterative. He recommended the water in cases of anasarca, ascites, whether of cardiac, he- patic, or renal origin, acute and chronic alco- holism, Brighfs disease, uratic or oxalic calculus, jaundice, whether due to portal de- rangement or to paludism, gout, paludal toxce- mia, chronic diarrhoea, chronic constipation, dyspepsia, and neurasthenia. Missouri has saline springs in Milford, in Barton County : in Climax, in Camden County ; in Elk Lick Springs, in Pike County : near Crescent Hill, in Bates County ; and at Reiger Spring, in Mercer County. There are sul- Eiiuretted saline springs near Marshall, in aline County, and at Rocheport, in Boone County. There are chlorinated and chalybeate springs at Aurora Springs, in Miller County ; at Cedar Springs, in Cedar County: at Choteau Springs, in Cooper County ; and at Zodiac Springs, in Vernon County. There are saline and chalybeate springs at Bowsher Mineral Springs, in Mercer County; at Bratton Spring, near Columbia, in Boone County ; at Lan- dreth's Mineral Well, near Knox City, in Knox County ; at Paris Chalybeate Springs, in Law- rence County; and at Spaulding Springs, in Ralls County. There are chalybeate springs at Cedar Springs, in Cedar County ; at Eldo- rado Springs, in Oregon County ; at Pairview Mineral Springs, in Worth County ; and at McAllister Springs, in Saline County. There 68 are chlorinated springs at Boonesborough, in Howard County ; at Harriman's Sulphur Springs, in Cooper County ; at Lewis Springs, near Glasgow, in Howard County ; and at Sweet Springs, near Huntsville, in Randolph County. There are sulphuretted and chlorin- ated springs at Montesano Springs, in Jeffer- son County, and at Nevada Mineral Springs, in Vernon County. There are alkaline saline springs at Siloam Springs, in Howell County. Montana contains a number of important springs, but very few of them have been im- proved. Probably the thermal springs will prove important ; those now used are the Al- hambra Springs, at Clancy, in JefEerson County ; Allan's Mineral Springs, in Bitter Root Valley, in Missoula County ; Big Hole Hot Springs, in Beaver Head County ; Boulder Hot Spring, in Jefferson County ; Clark's Warm Springs and Puller's Springs, in Madison County ; Helena Hot Springs, in Lewis and Clarke County ; Hunter's Hot Springs and Mat- thews's Warm Springs, in Gallatin County ; Ryan's Hot Springs, in Beaver Head County ; and White Sulphur Springs, in Meagher County. All of these waters contain mineral ingredients. In Yellowstone Valley, near Mill Creek, in Gallatin County, there is the ApoUi- naris Spring that supplies a delightful water, more palatable to the writer's taste than the imported ApoUinaris. Nebraska has no mineral springs of any im- portance. The waters of some of the artesian wells contain saline ingredients, but none of them is of medicinal value. Nevada, in consequence of its sparseness of population, has had but little improvement of its mineral «prings, which include hot and cold waters. There are hot springs at Elko, in Elko County ; near Carson City, in Ormsby County ; at Wellington, in Lyon County ; at Steamboat, in Washoe County : at Genoa, in Douglas County ; and in Pine Valley, in Eu- reka County. There are sulphuretted springs north of Columbus, in Esmeralda County ; near Mineral Hill, in Eureka County ; and at Golconda, in Humboldt County. It is likely that within a few years several other springs in this State will be improved so as to be used as resorts. Most of the mineral springs of New Hamp- shire have but local reputation, and their waters contain but a small proportion of min- eral ingredients. There is an alkaline spring at Conway, in Carroll County, the water of which contains but 2 grains of solids to the gallon. There is a carbonated chlorinated spring at Bradford, in Merrimack County. There is a calcic spring at Birchdale Springs, near Concord, in Merrimack County. There are chalybeate springs at Charlestown and East Unity, in Sullivan County ; at Milford, Am- herst, and Goffstown Centre, in Hillsborough County ; and at Moultonborough, in Carroll County. There is also the Londonderry lithia spring at Nashua, in Hillsborough County. New Jersey has no mineral spring of im- portance. At Schooley's Mountain, in Morris County, there is a chalybeate spring, the water of which contains a little more than half a WATERS, MINERAL 380 grain of iron carbonate in each gallon. Sev- eral artesian wells in the State supply water that contains mineral substances. New Mexico has a number ot mineral springs, some of which have been used for medicinal purposes since the time of the Span- ish occupation. There are saline chlorinated hot springs near Las Vegas, in San Miguel County ; near Barranca, in Taos County ; near Mimbres, in Grant County ; near Jemes, in Bernalillo County ; and near Rio Pajarito, in Taos County. The Aztec Spring, near Santa Pe, supplies a pleasant alkaline water. The Jemes Hot Springs, in Bernalillo County, yield alkaline chlorinated waters. New York State has been noted for the char- acter of its mineral springs for more than a hundred years, the famous Saratoga Springs having been a resort since the latter portion of the eighteenth century. In part, the notoriety of the various springs has been due to the facts that the State was well populated, and the fa- cilities for reaching the various spas were bet- ter than those afforded by other States as far as local springs were concerned. There are virtually no thermal springs, the Lebanon springs having an average temperature of 75° P., and therefore being scarcely eligible for admission to the list of such springs. There are chalybeate springs at Whitehall, in Washington County, and at Lebanon Springs, in Columbia County. There are chalybeate and sulphuretted springs near Dry- den, in Tompkins County, and at Riohfleld Springs, in Otsego County. The Oak Orchard Acid Springs, at Alabama, in Genesee County, are acid and chalybeate. Dr. I. Ott has made a careful investigation of the physiological action of Congress water (Medical Times, 1871, vol. i, p. 353), and found that when that water is ingested the excreta are increased and the intestinal excretion and insensible perspiration are diminished, while the urinary excretion is increased. In the lat- ter the amount of urea, of sodium chloride, and of sulphuric acid is increased, and the amount of uric acid lessened ; the amount of phos- phoric acid is little altered, but more of it is united in earthy salts than when this water is not taken. The carbonated chlorinated waters are those of Ballston Spa Springs at Ballston, in Sara- toga County. BALLSTON SPA SPRINGS. CONSTITUENTS. Artesian Llthia Spring. Franklin Artesian Well. Washington Lithia Well (Old Conde Denton ian). Grains to Grains to Grains to Solids. the gallon. the gallon. the gallon. Sodium bicarbonate. . . 11-93 94-60 34-40 Calcium bicarbonate. . 238-16 202-33 173-48 Magnesium bicarbon- ate 180-60 177-87 168-35 Strontium bicarbonate 0-87 trace 019 Lithium bicarbonate. . 7-75 6-78 15-51 Iron bicarbonate 1-58 1-61 2-30 Barium bicarbonate. . . 3-88 1-23 4-74 Potassium sulphate. . . Sodium phosphate .... 0-58 0-76 005 0-01 trace Sodium biborate trace trace trace Sodium chloride 750 03 659-34 646-48 Potassium chloride. . . . 33-S8 33-93 9-23 Sodium bromide 3-64 4-67 2-37 Calcium fluoride trace trace trace 0-12 0-08 0-76 trace 0-24 0-26 0-74 trace 0-22 Alumina 0-40 SiUca 103 Organic matter trace Total 1,223-25 1,184-87 1,047-70 GnseG. 426-114 460-066 368-346 The foregoing table gives the analysis of these waters made by Professor C. P. Chand- ler. Next to those of Saratoga, these are prob- ably the most popular springs in the State. There is a carbonated chlorinated spring at South Argyle, in Washington County, that is a local resort. But the most famous of the waters of this class are those of the Saratoga Springs, Professor Chandler's analyses of some of which are given herewith : CONSTITUENTS. Solids. Sodium bicarbonate — Calcium bicarbonate. . . . Magnesium bicarbonate Strontium bicarbonate. . Lithium bicarbonate Iron bicarbonate Barium bicarbonate — Potassium sulphate Sodium phosphate Sodium biborate Sodium chloride Potassium chloride Magnesium sulphate — Sodium bromide Calcium fluoride Sodium iodide Alumina Silica, Organic matter Total Gases. Carbonic acid champion Spouting Springs. Congress Spring. Gr. to the gal, 17-62 227-07 193-91 008 6-26 0-65 208 0-25 0-01 trace 702-24 40-45 3-68 trace 0-28 0-46 0-70 trace 1,195-68 466-46 Gr. to the gal. 10-77 143-40 121-76 trace 4-76 0-34 0-93 0-89 0-02 trace 400-44 805 8-66 trace 0-14 trace 0-84 Empire Spring. Gr. to the gal. 902 109-66 42-96 trace 2 0-79 0-07 2-77 0-02 trace 506-63 4-29 0-27 trace trace 0-43 1-46 trace 680-44 344-67 Flat Rock Spring. Geyser Spouting Spring. Gr. to the gal. 910 98-63 29-47 0-01 3-23 0-09 0-10 0-48 0-04 trace 108-85 7-99 10-83 0-32 0-01 0-04 1-34 trace 270-53 Gr. to the gal. 71-23 168-39 149-34 0-48 900 0-98 201 0.32 trace trace 662-08 24-64 2-21 trace 0-25 trace 0-66 trace 991-54 thorn Spring. Gr. to the gal. 4-29 170-65 176-46 trace 11-45 1-13 1-74 trace trace 509-97 9 60 1-53 trace 0-19 0-13 1-26 trace 888-40 High Rock Spring. Spring. Gr. to the gal. 34-89 131-74 64-92 trace 1-48 trace 1-61 390-13 8-60 0-73 trace 008 1-22 2-26 trace Gr. to the gal. 2-76 120 17 76-87 trace 9-49 2 -.57 0-S8 2-02 trace trace 459-90 7 0-99 trace 0-07 0-33 3- 16 trace 627-66, 687-28 409-46 338-46 Seltzer Spring. Gr. to the gnl. 29-43 89-87 40-34 trace 0-90 1-70 trace 56 trace trace 184-29 1-34 0-63 trace 003 0-37 2-56 trace 308-02 .324-08 United States Spring, Gr. to the gal. 4-67 93-12 72-88 002 4-85 0-97 0-91 trace 141-8- 0-84 trace 005 0-09 0-19 trace 331-84 246-73 Vichy Spring. Gr. to the gal. 82-.'-7 95-62 41 -.50 trace 1-76 0-05 59 trace trace trace 128-69 14-11 0-99 trace trace 0-48 0-76 trace 367-32 383-07 381 WATERS, MINERAL The most prominent chlorinated alkaline springs are the Sharon Springs in Schoharie County. Dr. Gr. A. Williams (Climatologist, 1891, vol. i, p. 119) has found that the inhala- tion of atomized Sharon Springs water benefits coryza, chronic nasal catarrh, bronckorrhma, acute laryngitis, chronic catarrhal laryngi- tis, laryngeal phthisis, laryngo-tracheitis, and acute bronchitis. Dr. G. E. Walton, in a mon- ograph on these -waters, commends their in- ternal and external use for rheumatism, gout, hepatic engorgement, gallstones, retial conges- tion, cystic catarrh, chronic metallic poisoning, uterine derangements, and skin diseases. J. G. Pohle's analysis of the waters gave the fol- lowing results : SHABON SPRINGS. CONSTITUENTS. Red Sulphur Spring. Gardner Mag- nesia Spring. Solids. Sodium bicarbonate Calcium bicarbonate Magnesium bicarbonate Grains to the gallon. 0-49 12-93 0-69 96 64 18-96 0-83 0-73 0-07 0-89 0-45 Grains to the gallon. 0-54 9-70 1-36 93-50 19-68 Sodium chloride 1-23 Magnesium chloride 0-44 0-16 0-63 Silica 0-40 Total 132-18 127-64 Gases. Sulphuretted hydrogen Cuhic inches. 10-60 4-58 4-00 Cubic inches. 6-00 2-22 3-00 Sulphuretted waters are obtained at Avon, in Livingston County ; at Cairo, in Green County : at Chittenango, in Madison County ; and at Clifton Springs, in Ontario County. There is an alkaline calcic spring at Dans- ville, in Livingston County. North Carolina contains almost all varieties of mineral springs. The warm springs in Madison County have a plentiful flow of a carbonated calcic water that has a tempera- ture which varies from 92° to 117° P. ; there are excellent accommodations at the place, and it is a deservedly popular resort. There are chalybeate springs at Cowhead Spring, near Washington, in Beaufort County ; near Hen- derson, in Vance County : at Jackson Springs and at Lemon Springs, in Moore County ; and at Piedmont Springs, in Stokes County. Cha- lybeate and sulphuretted waters are obtained at All-Healing Springs, in Gaston County ; at Alum Spring, in Onslow County : at Cleveland Mineral Springs, in Cleveland County ; at Copal Grove, in Stanley County ; and at Pied- mont Springs, in Burke County. There are a number of springs that supply carbonated, calcic, or sulphuretted waters ; but the locali- ties are virtually unimproved, and accommoda- tions for the treatment of invalids are lacking. North Dakota has within its territory a number of mineral springs, but all are virtu- ally unimproved. , Ohio contains no very important mineral springs. There are calcic springs at Bellbrook, in Green County; at Castalia, in Erie County; at Delaware, in Delaware County ; and at Mag- netic Springs, in Union County. There are chalybeate springs at Mineral Springs, in Adams County, and at Wilberforce, in Green County. There are chlorinated alkaline springs south of Cleveland, in Cuyahoga County, and at Stryker Mineral Well, in Williams County. Sulphuretted waters are obtained at Howland Springs, near Warren, in Trumbull County, and near Sandusky, in Wyandot County. Oregon contains hot and cold mineral springs, but very few of them have been improved so as to make suitable resorts. Among the thermal waters are Belknap Hot Springs (184° F.), near McKinzie Bridge, in Lane County; Canter's Blue Sulphur Springs (200° P.), in Baker County, and Des Chutes Hot Springs (143° F.), in Crook County. There is a chlorinated alka- line water at Wilhoit's Soda Springs, in Clacka- mas County. There is a number of sulphuretted and carbonated springs that have not been im- proved. Pennsylvania is especially rich in chalybeate springs. Chalybeate waters are obtained at Bed- ford Springs, in Bedford County ; at Blossburg Springs, in Tioga County ; and at Cresson Springs, in Cambria County. Dr. J. D. Mor- gan {Maryland Medical Journal, 1889, vol. xxi, p. 425) says that the Bedford Spring water is useful in diseases of the stomach, liver, kidney, and bowels. He advises that one or two glasses of the magnesia water should be taken on ris- ing in the morning, and a brisk walk taken before breakfast. Just before breakfast, din- ner, and supper a small glass should be taken ; a little salt may be added to increase the os- motic power of the water, which acts better if heated. Sulphuretted and chalybeate waters are obtained at Doubling Gap, in Cumberland County ; at Minnequa Springs, in Bradford County; at Three Springs, in Huntingdon County; and at Loretto, in Cambria County. Gettysburg water, according to Dr. I. Ott {Medical Times, 1871, vol. ii, p. 143), increases the daily excretion of urea and of sulphuric acid, and decreases that of uric and phosphoric acids and that of sodium chloride. Dr. John Bell) Medical and Surgical Reporter, 1867, vol. xvii, p. 262) reports that it is of value in the treatment of gout, rheumatism, diabetes, dyspepsia, and constipation. The chief con- stituents in the waters of the principal springs may be seen from the table at the top of page 382'. The analyses were made by F. A. Genth. Rhode Island contains no mineral springs that are of any importance from a therapeutic standpoint. South Carolina has no mineral springs the waters of which are other than mediocre in remedial properties. There are mild chalyb- eate waters at Cherokee Springs, in Spartan- burg County, and at Seneca, in Oconee County. There are sulphuretted waters at Chick's Springs, in Greenville County, and at Glenn Springs, in Spartanburg County. South Dakota contains an excellent hot spring at Hot Springs, in Pall River County. Mineral waters have been obtained from a num- WATERS, MINERAL 382 BEDFORD SPRINGS. CRESSON SPRINGS. Gettysburg CONSTITUENTS. Sweet Mag'nesia Sulphur MagneBia Large Iron Alum Lithia Spring. Iron Spring. Spring. Spring. Spring. Spring. Spring. Grains to Grains to Grains to Grains to Grains to Grains to Grains to Grains to the galloD. the gallon. the gallon. the gallon. the gallon. the gallon. the gallon. the gallon. Sodium bicarbonate 3 20 0-53 8-47 10-21 10-43 7 09 3-63 Calcium bicarbonate . 10-71 Magnesium carbonate 0-14 0-59 100 0-94 i-88 Magnesium bicarbonate. . . 6-31 Manganese carbonate trace trace trace trace trace 005 '6-61 90-46 0-08 '6-.M 7308 004 0-33 99-83 004 6-68 5-04 'i-64 48-93 3-75 'o-TO 40-20 0-03 Calcium sulphate 0-48 Potassium sulphate 0-30 0-41 0-18 0-27 0-32 0-43 0-15 Strontium sulphate 001 0-13 008 Magnesium sulphate 38-68 33-40 39-62 0-29 22-68 27 TO 3-36 Iron sulphate 23-48 49-64 Calcium phosphate Sodium chloride 002 002 0-01 trace 0-03 trace 0-53 0-37 0-46 0-23 0-04 0-02 0-28 Aluminum sulphate 1-60 21-20 6-65 trace 0-17 001 trace 0-54 0-08 trace 0-77 trace 0-47 trace 1-21 1-87 Silica. Hydrosulphuric acid 0-31 1-87 2-79 0-56 3-77 1-78 Total 1-62 141-17 122-40 153-30 14-70 108-39 25-24 ber of artesian -wells that have been constructed. There is a spring at Pierre that supplies a chlo- rinated alkaline -water the composition of which resembles that of the waters of St. Catherine, in Canada. 'Tennessee contains a number of mineral springs, especially the chalybeate and sulphu- rftted. There are chalybeate springs at Beer- sheba Springs, in Grundy County ; at Bon Air Springs, near Sparta, in White County ; near Williamsburg, in McMinn County ; near Elk- ton, in Griles County; near Erwin, in Unicoi County ; near Mooresburg, in Hawkins County ; at Howard Springs, in Cumberland County ; near Erie, in London County ; and at Robin- son Spring, in Van Buren County. Chalybeate and sulphuretted waters may be obtained at Alleghany and Blount Springs, near Mary- ville, and at Montvale, in Blount County ; at Black Water Springs, in Granger County ; near Dandridge, in Jefferson County ; at Blooming- ton, in Putnam County ; near Bolivar, in Harde- man County; at Epperson Springs, in Macon County ; near Rogersville, in Hawkins County ; at Kingston Springs, in Cheatham County ; and at Oliver Springs, in Anderson County. There are sulphuretted waters at Avoca Springs, near Bristol, in Sullivan County; near Dandridge, in Jefferson County ; at Beaver Dam Springs, in Hickman County ; at Clancy, in Robertson County ; near Bean's Station, in Granger County; and near Nashville, in Davidson County. Texas contains a number of mineral springs, but, as is the ease in most of the Southern States, few of them are improved so that they may be used as resorts. A number of so-called mineral springs are artesian wells in which the water contains mineral ingredients. Chalybeate waters are obtained at Dalby Springs, in Bowie County ; at Hughes's Spring, m Cass County ; and at Hynson's Iron Mountain Springs, near Marshall, in Harrison County. Water contain- ing sulphuric acid is obtained from Sulphur Springs, in Hopkins County, and from the springs near Sour Lake and Luling, in Cald- well County. Utah has a number of mineral springs, but most of them are undeveloped, especially the hot springs. Near Ogden and Salt Lake City there are hot chlorinated springs that are used for bathing. There are saline, chalybeate, and calcic springs in the State which will be im- proved, in all likelihood, within a few years. Vermont has saline sulphuretted springs at Alburgh Springs, in Grand Isle County. There are sulphuretted, springs at Barre and Plain- field, in Washington County; near Hartland, in Windsor County ; and near Berkshire, in Franklin County. There are sulphuretted springs at Brunswick, in Essex County, and at Newbury, in Orange County. There are car- bonated calcic springs at Clarendon, in Rutland County. Virginia, like New Fork, includes within its borders some of the most celebrated spas in the United States. One of the more prominent re- sorts is at Hot Springs, in Bath County, the waters of which have a temperature of from 50° to 110° P., and are saline and calcic in com- position. The Warm Sulphur Springs, in the same county, discharge water of a temperature of from 96° to 98° P, The chalybeate springs include Bath Alum Springs, in Bath County; the Bedford Alum Springs, in Campbell Coun- ty ; the Church Hill Alum Springs, in Henrico County ; the Clifton Springs, in Alleghany County; Harrison's Mineral Spring, in Taze- well County ; Jordan Alum Springs and Rock- bridge Alum Springs, in Rockbridge County ; Kern's Springs and Shenandoah Alum Springs, in Shenandoah County ; the Alum Springs near Ballsville, in Powhatan County ; Pulaski Alum Springs, near Dublin, in Pulaski County ; Raw- ley Springs, in Rockingham County; Sharon Springs, in Bland County; Variety Springs, in Augusta County; Washington Springs, in Washington County ; and Wytheville Springs, 383 WATERS, MINERAL in Wythe County. Dr. B. Blackford ( Virginia Medical Monthly, 1877, vol. iv, p. 778) com- mends the Bedford Alura Springs water in the treatment of uterine engorgement, chronic leu- corrhcea, amenorrhoea, dysmenorrhea, and chronic adenitis, the water being used inter- nally and as a douche. This use of these waters has been commended by Dr. J. W. Dil- lard ( Virginia Medical Monthly, vol. v, p. 718) in chronic diarrhoea. Among the more impor- tant chalybeate and sulphuretted springs are the Buckingham White Sulphur Springs, in Buckingham County ; Hagan's Springs, in Scott County; Huguenot Springs, in Powha- tan County ; Jordan's White Sulphur Springs, in Frederick County ; Millborough Springs, in Bath County ; Mungel's Springs, in Washing- ton County; Roanoke Red Sulphur Springs, in Roanoke County ; Rock Enon, or Capper's, Springs, in Frederick County ; and Valley view Springs, in Shenandoah County. The sulphu- retted springs include Botetourt, or Johnson's, Springs, in Roanoke County ; Cedar Bluff Sul- phur Springs, in Tazewell County ; Coyner's Sulphur Springs and Debrell Spring, in Bote- tourt County ; Crystal Sulphur Sprin, in Aug- gusta County ; Grayson's Sulphur Springs, in Carroll County; Montgomery White Sulphur Springs, in Montgomery County ; and Bggles- ton Springs, in Giles County. The saline calcic springs include Alleghany Springs and Yellow Sulphur Springs, in Montgomery County ; Blue Ridge Springs, in Botetourt County ; Healing Springs, in Bath County ; and Sweet Chalybeate Sprmgs, in Alleghany County. The alkaline, calcic, and chalybeate springs include the Buf- falo Lithia Springs, in Mecklenburg County ; the Farmville Lithia Springs, in Prince Edward County; the Orkney Springs, in Shenandoah County; and Wolf Trap Lithia Springs, in Halifax County. Washington has a number of mineral springs, but, as is the case in all of the more sparsely set- tled States, most of them are difficult of access and there are no accommodations for visitors. 'The Cascade Warm Mineral Springs, in Ska- mania County, supply a warm, saline, sulphu- retted water. An alkaline chlorinated water is obtained from Medical Lake, in Spokane County. West Virginia, like its mother State, Vir- ginia, contains a number of important mineral springs. There are alkaline carbonated springs at Capon Springs, in Hampshire County; and CONSTITUENTS. Solids. Calcium bicarbonate Magnesium carbonate. . . Magnesium bicarbonate. Potassium carbonate — Lithium bicarbonate — Barium bicarbonate Iron carbonate Iron bicarbonate Sodium sulphate Calcium sulphate Lithium sulphate Magnesium sulphate — Potassium sulphate Aluminium sulphate Manganese sulphate Iron protosulphate Iron persulphate Nickel sulphate Cobalt sulphate Copper sulphate Zinc sulphate Magnesium nitrate Ammonium nitrate Calcium phosphate Phosphates Sodium silicate Sodium chloride Calcium chloride Calcium fluoride Lithia Alumina Silica Iodine , Phosphoric acid Sulphuric acid Organic matter Total GaeaB. Carbonic acid Sulphuretted hydrogen. . Oxygen Nitrogen Carbon dioxide Bedford Alum and Iron SpriugB. Farmville Lithia Springs. BUFPAl .0 LITHIA SP RINGS. Spring No. 1. Spring No. 2. Spring No. 3. Grains to tte Grains to the Grains to the Grains to tbe Grains to the Grains to the gallon.* gallon.-l- gallon.^ Imp. gallon.§ Imp. gallon. § imp. gallon. 1-33 39-28 14-96 2-52 4-49 29-30 i-85 1-99 1-48 2-25 1-75 1-26 o-so 0-80 3-77 0-87 8-B9 4-99 18-67 1-81 19-35 83 07 2-SS 0-24 12-58 12-66 1-53 6-89 0-lS 0-71 1016 0-18 0-46 24-18 7-24 8-18 9-07 3-04 0-19 0-59 23-46 19-26 0-04 • • ■ ■ 0-06 .... 0-06 0-or 0-27 .... 0-24 0-30 '6-23 s-so 'i-36 ■4-92 6-22 trace 2-62 trace 1-69 3-92 1-72 1-87 0-57 trace trace trace trace trace trace 4-02 19-98 trace 0-29 , trace trace trace trace 70-88 92- 17 26-39 73-66 98-38 14-47 Cublo Inohes. Cubic inches. Cuhlc inches. 74-2 69-1 592 11-6 B-9 8-3 3-4 1-32 .... 3-33 6-98 •MB. Hardin, analyst (1877). t William Gilham, analyst. X E. T. Fristoe, analyst. § W. P. Tonry, analyst (1874). WAX WINES 384 at Mineral Wells, near Parkersburg, in Wood County. There are chlorinated smine -waters at Hart Well, near Willow Island, in Pleasants County; at Blue Sulphur Springs, in Green- brier County ; at Borland Mineral Well, in Pleasants County; and at Humphrey's Spring, in Monroe County. The sulphuretted -waters include the Floding, or Blue, Sulphur Springs, in Cabell County, and the Gray Sulphur and Red Sulphur Springs, in Monroe County. There are calcic, sulphuretted, and chalybeate waters at Greenbrier White Sulphur Springs, in Green- brier County, which have been used medicinal- ly since the last century. There are chalybeate springs at Shannondale Springs, near Charles- town, in Jefferson County, and at Spa Springs, in Morgan County. chiefly to the elimination of waste products that cause intoxication. The internal use of the water produces no effect on the circulatory organs, though the pulse-rate is increased by bathing in it as by any other hot baths. The waters cause a marked increase in the flow of bile, the fffical discharge, the quantity of urine and the proportion of urinary solids, and the perspiration. These waters are useful in anCB- mia and debility due to paludisra or self-in- toxication, and in diseases due to a defective action of the eliminative organs or to impair- ment of the excretory functions. Included among these latter are gout, rheumatism, chronic paludal poisoning, chronic duodenal catarrh, catarrh of the bile ducts, and certain phases of Bright's disease. The waters are CONSTITUENTS. CAPON SPRINGS. GREENBRIER WHITE SULPHUR SPRINGS. Main Spring. Bemty Spring. Name unknown. Solids. Sodium carbonate Gr. to the imp. gal. 0-59 8-33 1-44 trace trace 04 6-59 6*i7 trace trace trace O'OG trace 0'03 0-70 0-20 Gr. to the imp. gal.* 0-C3 8-36 1-27 trace trace 0-05 trace 0-41 6-16 trace trace trace o-os trace trace 002 0-67 0-19 Gr. to the imp. gaLf Calcium carbonate . ... 707 Magnesium carbonate Copper carbonate Calcium sulphate .... 78-35 Nitrates Calcium phosphate Silicates 3-46 Magnesium chloride 1-00 Alumina .... Silica Organic matter 4-36 Total 12-14 11-81 129-66 Gases. Cubic inches. 8-66 i'76 3-68 Cubic inches. 7-76 i-68 3-68 Cubic inches. 11-28 0-24 0-48 4-64 Sulphuretted hydrogen Oxygen Nitrogen Total 14-00 13-12 16-64 * J. W. Mallett, analyst. Dr. J. L. Le Conte {American Journal of the Medical Sciences, 1879, vol. i, p. 148) says that the waters of Capon Spring are beneficial for renal calculi composed wholly or in part of uric acid, and for cystic deposits of the same substance ; the alkalies of the water tend to disintegrate the agglutinating material of the calculi. Dyspepsia caused by too free a secretion of acid in the stomach, or due to a gouty diathesis, is also relieved. Hepatic con- gestion and enlargement due to derangement of the portal circulation, fwnctional neuroses due to disorders of the sexual organs in women, and chlorosis are benefited by a course at this spa. The late Dr. W. C. Dabney writes in regard to the Greenbrier White Sulphur Springs (Gail- lard's Medical Journal, vol. 1, 1890, p. 331) that its waters have little or no effect upon the nervous system of healthy persons ; the relief from neuralgia obtained from their use is due t A. A. Hayes, analyst. also valuable for persons who have no actual disease, but in whom the liver and bowels are inactive as a result of sedentary habits and over-indulgence in the pleasures of the table. Wisconsin mineral springs have acquired considerable reputation in the United States. The alkaline calcic waters are obtained from the Arctic Springs, at Galesville, in Trempea- leau County; the Bethesda, the Glenn, the Horeb, the Siloam, the Silurian, and the White Rock Springs, at Waukesha ; the Gihon Springs, at Delavan, in Walworth County: and the lodo Magnesian Springs, Beloit, in Rock County. Alkaline-saline waters are obtained from Bris- tol Soda Springs at Woodworth. in Kenosha County, and the Artesian Mineral Well at Prairie du Chien, in Crawford County. Chalyb- eate waters are obtained from the Black Earth Mineral Springs, in Dane County; the New Saratoga Springs at Star Prairie, in St. Croix 385 WAX WINES County; and the Sparta Mineral Wells, in Monroe County. Wyoming contains within its territory a number of mineral springs, few of which are improved as resorts. The liot springs in Yel- lowstone Park are not used for therapeutic purposes, but there is a hot spring at Saratoga, in Carbon County, that is a resort. Samuel T. Aemstrong. "WAX occurs in two forms, the yellow- and white, known respectively as cera flava (U. S. Ph.. Br. Ph., Ger. Ph.) and cera alba (U. S. Ph., Br. Ph., Ger. Ph.). The latter is prepared from the former by its exposure in thin sheets to the sunlight in a moist atmosphere. Their physical properties are essentially the same, but the white variety is preferable on account of its greater freedom from impurities. Hav- ing a moderately high melting point, it is em- ployed to impart consistence to the more fluid oils and fats in the preparation of ointments and cerates. It is also used in the preparation of suppositories and medicated bougies in cases where their slow liquefaction is prefer- able to the more rapid melting which occurs when cacao butter is the principal excipieut. Waxed cloth is prepared by saturating cloth with a mixture of 8 parts of white wax, 4 parts of olive oil, and 1 part of turpentine oil. It may be used as a protective, or in the prepara- tion of a blistering plaster. Internally, wax is practically inert and harmless. Chinese insect wax, or Pe la, is the secretion of a species of coccus upon a variety of ash. It may be substituted for the ofiicial variety. Japanese wax is obtained from the fruits of several varieties of Rhus, and possesses all the properties of the ordinary kind, but is apt to become rancid. Myrtle wax is the product of a number of species of Myrica. The popular name of the common United States species is bayberry. This wax is obtained by subjecting the fruit to the action of hot water. It is greenish in colour and of an agreeable odour, and may be substituted for the common variety. KussELL H. Nevins. WHEAT.— See Triticum. WHEY is the liquid remaining after coag- ulating and expressing the casein from milk. As the particles of fat are entangled with the casein the two elements are removed together. The following is the composition of ordinary whey, the figures representing percentages : Proteids, 0-83 ; fat, 0-25 ; sugar, 4-65 ; ash. 0-65 ; water, 93'30. The principal ingredient is, there- fore, sn a;ar, the ash being practically unchanged. Whey is prepared by 'the use of a inilk-ourdling ferment, essence of pepsin of liquid rennet be- ing commonly used for this purpose. A tea- spoonful of either preparation is used to a pint . of milk which is kept at a temperature of about 100° F. until coagulation has become complete. The coagulum is then broken up and the whey strained out. P.or the uses of whey and the " whey cure " the reader is referred to the arti- cles on Milk and Dietetic treatment. Floyd M. Ceandall. WHISKY, spiritus frumenti (U. S. Ph.). is " an alcoholic liquid obtained by the distilla- tion of the mash of fermented grain (usually of mixtures of corn, wheat, and rye), and at least two years old " (U. S. Ph.). Whisky should be of an amber colour, with a characteristic taste and odour and a slightly acid reaction. The pharmacopoeia prescribes that its specific gravity shall not be more than 0'930 or less than 0'914. It should be free from more than mere traces of fusel oil, added sugar, glycerin, and aromatic substances. Whisky is one of the best of alcoholic stimu- lants. It is ordinarily preferred to brandy in this country, because of its usual purity and its cheapness. Its tendency to constipate is less than that of brandy. It may be employed in any sudden collapse of cardiac power from syn- cope, hcemorrhage, or any other cause. When- ever a cardiac stimulant is indicated, whisky may be given by the mouth if possible, hypoder- mioally, or in an enema. In the first and last instances it is best given hot. In adynamic fevers, like typhus and typhoid, the benefits to be derived from a systematic administration of whisky are well known and have been discussed in another article. In cases of poisoning by substances which depress the heart, alcohol in the form of whisky is indicated. In chronic pulmonary tuberculosis whisky is an almost in- dispensable medicinal agent, particularly in the last stages of the disease. It is unnecessary to enumerate all the diseases in which whisky may be employed as a rational, proper therapeutic aid. In general it may be said that when car- diac stimulation is required, where general ady- namia prevails, when constitutional weakness demands a rapid general stimulant, whisky is indicated. As an antiseptic agent whisky possesses some value, but in its employment for surgical dress- ings it has long been superseded by other sub- stances. As to its administration, whisky may be given pure or in combination with other stimulants. In an emergency it may be administered hypo- dermically — from its proneness to cause' ab- scesses, the injection should always be made deep — or by the rectum. When given in fevers, the quantity must vary with the effects. In the form of eggnog and milk-punch it is agree- able to a convalescent. The usual dose of whis- ky for an adult is from half an ounce to an ounce. — Samuel M. Beicknbr. WILLOW.— See Salix. WINES.— The history of the use of wines begins with antiquity. Throughout the Bible mention is made of the employment of the juice of the grape in religious ceremonies and in social entertainment. The drunkenness of Noah and the prophecy made by Jacob on his deathbed, in which there is a reference to wine, show the great antiquity of the drink. The Hebrews of antiquity drank fermented wine and an artificial wine made from the palm. Bzekiel is authority for the statement that the drinking of wines at festive gatherings was a rare form of entertainment. Moses forbade the priests the drinking of wine or of any intoxi- WINES 386 eating liquor previous to their entrance to the temple. Hosea praised the peculiar virtues of the wines of Lebanon, although they were not suited for transportation for long distances. The best of these wines is known in Europe at the present time as vin cCor. This wine is not fermented in the usual way. Fermentation is induced by placing the grape-juice in clay ves- sels in the sun. It is said of the vin d'or that a few glasses drank at one sitting will produce syncope. The vines of Palestine are still, fa- mous for the size and sweetness of their grapes. The ancient Jews had a preference for red wine. The vintage, which lasted from September to N'ovember, was celebrated with joyful cere- monies. The mechanism of their wine presses was extremely crude ; part of the wine was fer- mented, part of it drank as must. The profane writings of antiquity, no less than the sacred, contain multitudinous refer- ences to the growth of grapevines, the drink- ing of wine, and its effects. Despite the testimony of Herodotus to the contrary, it seems to'be established that the ancient Egyp- tians cultivated the vine. The edge of the Nile valley, from Thebes to Memphis, contained soil well adapted to the growth of the grape. Sebennytus is celebrated by Pliny as having produced very fine wine. The ripe grapes were gathered in baskets or hampers, which were car- ried by men on their heads or by yokes upon their shoulders to the shed, where the pressing of the grapes was accomplished by squeezing in a bag or by treading. According to Gene- sis (xl, 11), the juice was sometimes drank un- fermented : " I took the grapes and pressed them into Pharaoh's cup and I gave the cup into Pharaoh's hand." Usually, however, fer- mentation was allowed to take place and the wine was kept in hermetically sealed jars of beautiful forms. The light wine was made in Coptos ; the heavier wines of good repute were derived from the neighbourhood of Anthylla and Lake Marea. Drunkenness among the Egyptians was by no means unknown. Men and women alike succumbed to the influence of the wine pro- vided at feasts. On the authority of Herodotus, it is believed by Egyptologists that a guest in an Egyptian household was always served with wine, although it is fair to assume that it was usually drank diluted with water. Drunken- ness was a vice in early Egyptian history, and to it must be ascribed the subjugation of the land by hardier races — the Assyrians, the Per- sians, and the Macedonian Greeks. Among the Greeks and Romans wine was employed as a drink and as a medicine. Homer mentions many varieties of wine which were celebrated for peculiar properties. He sings of the wines of Phrygia, Epidaurus, Arne, and Thrace ; and the products of Cyprus, Ohio, and Lesbos were equally celebrated. Horace fre- quently alludes to the virtues of Chian wine. 'The Chians are said to have first known the art of the cultivation of the vine, taught by Qilno- pion, the son of Bacchus. They probably made the first red wine. In some parts of Greece the wine of Lesbos was preferred to all others, be- cause of its sweetness and its delicious flavour. The wines of Naxos, celebrated as being the birthplace of Bacchus, had in aweient times, and still have, high repute. Thasos produced a wine which, though inferior to the other wines, was compared by Pliny to nectar. The Greeks always drank their wine diluted, in the proportion of two fifths wine and three fifths water. The mixing bowl usually stood near the hearth, often on a tripod, and the wine was poured from this into drinking cups. Athe- njeus quotes from a poet who says that if like parts of water and wine are used, lunacy fol- lows ; if the wine is drank pure, paralysis sure- ly results. Herodotus, too, speaks of drinking pure wine as " filling like a Scythian." Homer records several kinds of wine — the red, the sparkling, and the honey-sweet. A special wine seems to have been reserved in honour of elders at feasts {■yepoiaiov). The ancient medical writers of Greece and Rome "used wine, in one form or another, in almost all diseases. They studied carefully the effects of different kinds of wine upon the sys- tem. Thus they recognised that new wine had a tendency to upset the digestion, to promote diuresis, and to interfere with calm sleep. They record that unfermented wine produces colic, fiatulence, and diarrhoea. The appearance of headaches and impaired digestion was attrib- uted to sweet wines. Hippocrates recognised the muscular debility which follows the too habitual use of wine, and pointed out the dan- gers of the sudden cessation of drinking. As cited by Strumpf, Hippocrates also recommend- ed wine in cases of poisoning by opium, aco- nite, conium, and mushrooms, or whenever a narcotic poison had produced depression. He also used it as an antidote to the bites of ven- omous serpents, and praises white wine as a diuretic in calculous disorders. Wine was fre- quently used, on the same authority, as an ap- plication to wounds and ulcers. As a stimulant it was used in the algid stages of fevers. In hypercatharsis, flatulence, and diarrhoea it was supposed to act almost as a specific. Galen de- scribes a great many wines ; but, like Pliny, gives more contra-indications for their use than reasons for thinking that their employment would be beneficial. The ancient Arabs possessed wines made from the grape, raisins, figs, dates, honey, and the juice of sweet fruits, as well as from the cocoa and pomegranate. Rhazes (cited in Stille's Therapeutics and Materia Medica, Philadel- phia, 1874), speaking of the advantages of wines used moderately, remarks that the complexion and nutrition are thereby improved, that the excretions, particularly that of the urine, are promoted, that the sleep is rendered sound and refreshing, and that the mental faculties are quickened. He says wines should not be taken habitually, but only at intervals of several days. Intoxication he paints in fearful colours. Its repetition, he says, induces disease, headache, paralysis, shaking palsy, and acute affections. Visceral inflammation, abscesses, furuncles, mental weakness, apoplexy, emaciation, and palpitation of the heart are some of the dire things this Arabian physician predicts for the inebriate. He recommends emetics as a reme- 387 WINES dy for the nausea and headache following a de- bauch, and advises rest with the use of acid syrups diluted with water or barley water. Probably every nation or tribe, from the dawn of history and before that time, which possessed any fermentable substance made s.om6 kind of wine. And it is altogether likely that, observ- ing the stimulant effect of wine when taken in health, they all used it for medicinal effect when- ever it was deemed wise or necessary. Evidence is not lacking on this point in the writings quoted, as well as in those of Strabo, of Galen, of Paulus -SJgineta, and of Cicero. Whether or not the Egyptians made use of wines medi- cinally is not definitely known, but it may be surmised that such was the case from their con- tact with nations that did. Wine and oil al- ways stood as representing the fertility and the wealth of a country in ancient times ; and the fact that " a land flowing with milk and honey "' was offered as an inducement to the ancient Jews does not militate against their having had wine, since milk and honey, on competent authority, represented their chief articles of diet. The religious use of wine probably, or possibly, began in a sacrificial way, the fermented juice of the grape being, rare and therefore a thing worthy of sacrifice. Its use in the communion service is a heritage of an ancient custom. It is interesting to note that among the ceremonial usages in which wine plays a part is its administration, in the form of palm wine, to a mother among the negroes of Guiana immediately after the birth of her child. In Pranconian Switzerland the relatives of a parturient woman take turns in bringing her, during the entire puerperium, a soup of peculiar make which always contains wine. Among the Roman medical writers, Soranus of Ephesus forbade the use of wine early in pregnancy, because he feared an abor- tion. The Jewish women of ancient times were not allowed to drink wine during their period of pregnancy. The Chinese seem to be more liberal in this respect, permitting their preg- nant women to drink anything that has a pleas- ant taste ; but they must not drink to excess anything that is intoxicating or heating to the blood. The Laplanders, during pregnancy, may drink Sarakka wine ; but with them this is a religious ceremony, since Sarakka is the goddess who presides over pregnancy and child- birth. The German women of five centuries ago were advised to drink any strong wine, especially claret; but there is no evidence that similar usages prevail to-dav (Ploss, Das Weib, Leipsic, 1891, vol. ii, pp. 331, 336, 513, 514). Finally, it may be mentioned that wine is used in the performance of some ceremonies of a semi-religious, semi-social nature. In mar- riages and engagements the drinking of wine is customary among some peoples, being essen- tial to the function. The rite of baptism and that of circumcision are frequently accom- panied by the drinking of wine, a white wine being usually chosen for this purpose. For many hundreds of years the wine indus- try has been pursued in European countries par- ticularly, although at present American wmes are forging their way to the front, and the cul- tivation of the vine and its subsequent treat- ment until the perfected product is secured are very thoroughly understood. The grapevine grows luxuriantly in many places, especially in ground rich in the salts of phosphorus and po- tassium. The manure used is of importance as well, since it is found that the richer the fertilizing agent, the greater is the effect upon the taste of the grape-juice. In Germany and Prance the dung of cattle is preferred "to all other fertilizers, since it is very rich in phos- phorus and potassium. The finer wines, such as Burgundy and Riesling, show a difference in taste depending upon the agent used for fertilizing. Hundreds of varieties of grapes are recog- nised by viticulturists, but those most in favour are enumerated here : For white wines, Sau- vignon Vert, Golden Chasselas, and Bergher are used in America ; Riesling, Rulander, and white Burgundy are chosen in Germany. For the medium and light white wines of Germany, Elbling, Orleans, and Ortlioher are used. For the manufacture of red wines, Carbanet Sau- vignon, the various Burgundy grapes, Laska, Trollinger, Mataro, Carignau, Zinfandel, Le- noir, and St. Lawrence grapes are the princi- pal varieties. Pedro Ximenes, Black Burgundy, Trousseau,and Old Mission grapes are employed for the production of ports and sherries. IJn- less otherwise specified, grape wine will be re- ferred to in this article when wine is mentioned. Ripe grapes only are chosen for the produc- tion of wine. The expressed juice of the grape is received into vats and is known as must. At the ordinary summer temperature, or even at a temperature of 60° P., fermentation begins in the clear juice of the grape within half an hour. The juice becomes cloudy and thick and gives off bubbles of carbonic-acid gas which causes a froth to form at the surface containing the more solid parts. This is called the head. The grape-sugar formerly contained in the juice is now being converted into alcohol, and the fluid loses its sweet taste and becomes vinous. The fermentation is due, according to the best au- thorities, to the presence of Saccha/romyces apiculatus and to the moulds adhering to the grape-skins. "Within forty-eight hours after the beginning of the fermentation, Saccha/romyces ellipsoideus takes the place of the ferment above mentioned, and the process is contiimed for an indefinite period, varying with the ripeness of the grape, its previous nourishment, its treat- ment, and the climate. The fermentation ceases after avarying time and is renewed by stirring the contents of the vat. When the fluid be- comes perfectly clear it is considered wine and is placed in casks, where the fermentation is continued for from six to eight months. This continued fermentation is known as the sec- ondary, in contrast to that which first occurs, the primary. It is essential for its perfection that air should be excluded, and it is sometimes necessary to add wine to it. The secondary fer- mentation may not be complete, and sometimes years after the wine is pressed from the grape fermentation occurs, a sign that it was not fin- ished as it should have been when placed in the cask. During the entire time of fermentation WINES 388 a frothy matter is formed which, with the colouring matters and tartar, eventually sinks to the bottom of the cask, when it is called wine-lees. The shortest time for wine to be ready to be bottled is two years. Wines very rich in sugar may undergo occasional fermen- tation for years, always with an increase of alcohol and a decrease in the acids, the tartar, and th3 sugar. It is during the secondary fer- mentation that the bouquet of a wine is devel- oped, as the lees is formed. It consists of the odorous principles contained in the grape and those developed by the fermenting pro- cess. This is to be sharply distinguished from the aroma of the wine, which is recognisable by either taste or smell. From one and a half to three per cent, of the wine usually evaporates annually through the pores of the containing casks, and in order to avoid the germination of mould and the conse- quent acetous fermentation, the cask must be refilled. The longer wine is allowed to remain sealed in casks, secure from the advent of air, the finer will its bouquet become and the greater its percentage of alcohol. Very old wine, how- ever, is found to lose in alcohol. The preser- vation of wine is achieved by burning pure sulphur in the casks in which it is to be per- manently stored. This process frees the vat from the possibility of becoming mouldy and is now almost universally practised. Filtering the wine or the adding of gelatin or albumin- ous substances to it is the means employed to make it clear. Red wines usually lose some of their colour by the employment of these pro- cedures, and on these wines it is practised to a very small extent. Among the agents used now and formerly for the preservation of wines may be mentioned salicylic acid, boric acid, electricity, plaster of Paris, peroxide of hydrogen, and phosphate of calcium. Plaster of Paris is commonly used in France and in most of the southern countries. These various measures for preserving or im- proving wine have each a chemical basis, but the processes are so involved that they have not all been thoroughly worked out. Salicylic acid is employed to preserve wines by stopping the fermentative process. Its addition to food stuffs is prohibited in Germany, and Konig is of the opinion that the small quantity which can be added without giving the wine a disagreeable after-taste is ineffectual as a preventive of fer- mentation. Boric acid has been employed with the same intent, and, indeed, boric acid in mi- nute quantities is found in the ash of the wine ; but its effect upon the organism is by no means indifferent, and its employment is not to be recommended. Some Italian chemists have of late recommended electricity as a preservative of wines. The statement is made that the cur- rent aids in the improvement of the wine and helps to render it aseptic. But these results have not yet been confirmed. Experiments with hydrogen peroxide have also been made with a view to clearing the wine and ripening it quickly; but these, too, will require further elaboration to give the procedures a place among those regularly practised . Of all the measures which have gained a wide prestige for the preservation of wines, the ad- dition of plaster of Paris to the marc is the most constantly used. As mentioned above, it is freely practised in France, particularly in the southern portion, but it is generally em- ployed in southern Italy, Sicily, Spain, and Portugal. Oxidized and non-oxidized plaster of Paris are both employed, and the statement is made that by this means fermentation is hastened, that the colour of the wine is im- proved, and that its permanence is increased. However, platrage, as the process is known to the French, is not only superfluous, but posi- tively injurious, since it not only changes the wine chemically, but actually produces chem- ical bodies which may be injurious to the drinker. One of the dangers consists in the liberation of free phosphoric acid under cer- tain circumstances. The chemical changes may be briefly stated as follows: When plaster of Paris is added to soluble salts of tartaric acid, an almost insoluble calcium tartrate and the bisulphate of potassium are formed. The sul- phate of potassium may disintegrate some of the salts of phosphoric acid held in solution in the must, and free phosphoric acid result from this reaction. This is the German view. The French chemists think that through the influ- ence of the calcium sulphate (plaster of Paris) the stability of the wine and its acidity are in- creased by the introduction into the wine of the potassium bitartrate which is in the grape, and, on account of its insolubility, usually re- mains in the lees. Chemists do not agree as to the changes that then take place. But it is safe to assume that tartaric acid, sulphuric acid, and potassa are set free in the wine, with the ulti- mate formation of potassium bitartrate and potassium bisulphate, the latter salt contribut- ing to the increased acidity of the wine. The gravest danger lying in plastered wines is in the deleterious effects of the potassium sulphate upon digestion, upon the action of the lieart, and upon the blood. It tends to reduce the alkalinity of the blood, as has been proved ex- perimentally by Nencki, Lichtheim. and Loch- singer (Journal fur praMische Chemie, new series, vol. xxv, 1883, p. 384). These observers gave a dog for eight days, with its usual food, from 30 to 45 grains of acid potassium sul- phate, with the result of reducing the alkalin- ity of its blood 22 per cent. Concerning the plastering of wines they reach these conclu- sions : Wines which contain less than 15 grains of plaster of Paris to a quart have not proved injurious ; when heavily plastered wines are used for a considerable length of time, the health may, however, become impaired; the sale of plastered wines should be a subject of legislative interference, and no wine which con- tains more than 15 grains of neutral potassium sulphate to the quart should be sold in the market. Considering the possible dangers to health, it seems rational to discard all wines which contain more than 5 grains of neutral potassium sulphate to the quart. The detec- tion of the plastering of wines depends upon the demonstration of the presence of the acid potassium bisulphate or of the neutral potas- sium sulphate. 389 WINES Attempts have been made to neutralize the calcium sulphate of the plaster of Paris by cal- cium phosphate, and it has been suggested that the potassium bisiilphate may be neutralized by the addition of strontium tartrate and tar- taric acid ; .but it has been found that these agents do not entirely remove the potassium salt, that equal quantities of strontium salts replace it, and that the wine is even more harmful than before. Various baryum salts — the nitrate, the chloride, the carbonate, the acetate, etc. — have also been recommended for the neutralization of the plaster of Paris, but, on account of their direct poisonous effects, are not employed. On the recommendation of Hugounenq, dicalcium phosphate may be employed for the preservation of wines and to promote their clearing. This process is called phosphatage, and is said to have all the vir- tues of the use of plaster of Paris without in- creasing the sulphuric acid or diminishing the phosphoric acid. The following table shows the changes that take place in wines which have undergone pld- trage (Bersch, Die Praxis der Weinbereitung, 1889, p. 417). one half of a given quantity of wine having been plastered, the other half not : Specific gravity Alcohol Extractive matters Total acidity Volatile acids Tartaric acid Glycerin Tannic acid and colour- ing matters Sulphurous acids Potassium sulphate (HKSO4) Ash The ash contains : Sulphurous acid Phosphoric acid Ferric oxide and clay. . . Calcium Magnesia Potassium Plastered. 0-9960 10-99 vol. p. c. 2-76p. c. wgt. 6-6Q per cent. 0-71 1-50 8-20 1-57 " 1-52 " 2-68 4-38 " 360 " 8-9 0-9 Not plastered. 9955 80 vol. p. C. 50 p. c. wgt. 00 per cent. 69 60 " 20 68 " To procure a diminished acidity of wine, cal- cium carbonate, calcium saccharate, or neutral potassium tartrate may be added. The wine takes up little or none of the calcium salt, and it is therefore scarcely injurious. Chaptal gave the name to the process by which sugar and calcium carbonate are added to must which is hyperacid. An increase in the quantity and sweetness of wine may be obtained by the pro- cess of Gall. After the better grapes are se- lected from the poorer ones, the poor ones are made into must, and to that is added at once an aqueous solution of grape sugar, so that the must shall contain a proportion of sugar, acids, and water equal to that of must made from the best of grapes. The good taste of poor wine is enhanced by this process, which is certainly not an honest one. On the suggestion of Petiot, some inferior wines are made, especially in France, by fer- menting the marc of the grapes, from which wine has already been prepared, with an aque- ous solution of grape sugar. Some excellent wines may be manufactured in this way from grapes of superior quality ; but the oftener the marc is placed in the solution of sugar, the poorer is the quality of the wine. As a rule, these wines have an agreeable taste. They are frequently adulterated with tannin, glycerin, tartaric acid, etc. There are several other processes in vogue in wine-making countries for the improvement, adulteration, reduction of acidity, and increase of quantity of wines, but the main ones have been here mentioned, and the others are scarcely of sufficient importance to warrant their descrip- tion in this article. All wines have certain common properties. They are all spirituous liquors obtained by fer- mentation from fruit or grape juices, contain- ing a certain quantity of alcohol, which varies with the juice and its subsequent treatment. Even wines of the same class differ materially in their amounts of alcohol. The following table shows the average percentages of alcohol in the principal foreign wines : Port wine 19 to 23 per cent. Sherry 15 to 25 " Madeira 18 to 32 '• Bordeaux 9 to 15 " Burgundy 7 to 13 " Rhine wine 8 to 13 " Moselle wine 8 to 11 " Tokay 9 to 13 " Champagne 5 to 15 " (Johnston's Chemie des taglichen Lelens, Stutt- gart, 1887, p. 267.) The American wines contain from 10 to 25 per cent, of alcohol, according to their quality and variety. All grape wines contain a certain proportion of grape-sugar, to which the sweetness of their taste is due and which is responsible for their fermentation. They all contain a varying quan- tity of acid which is responsible for the more or less conspicuous '• vinosity " in the taste of the wine. The acids of wines are tartaric acid and acetic acid, the latter, as pointed out above, an impurity. Malic acid is found in- wines which have been derived from unripe grapes ; but it gradually disappears from the grape as it ripens, and its presence in unripe grapes is one of the reasons for choosing the ripe fruit of the vine for wine-producing purposes. The character- istic odour of wine is due to the presence of oenanthio ether, and it is possessed by all wines. This ether is a product of the fermentation of the must, and is said by Neubauer to contain as its principal elements caprylic and caprinic ethers. It is probably increased with the age of the wine, but is always present in very small comparative quantities, from 1 to 10,000 to 1 to 40,000 parts by volume. Aside from the general characteristic odour of wines derived from this source, each wine derives an aroma from the grape from which it is made which distinguishes it from all other wines. The proverbial improvement attained by wines with age springs from the facts already enunciated. It may be well to repeat them briefly. As long as wine contains grape-sugar, WINES 390 fermentation is induced which increases its percentage of alcohol. Wines that contain but little sugar do not improve much with age unless sugar-containing wine is added to them from time to time. The presence of cenanthic ether is fostered by the prolonged fermenta- tion, and hence the wine gets a stronger odour. The acids of the wine are diminished by the separation of tartaric acid, which increases as time passes. Lastly, the clearness and the purity of the taste of the wine are increased by the removal of the ferment. According to their colour, wines are divided into red and white. According to their taste, they are known as npirituous, siveet, dry, light, sparkling, rough, or acidulous. Red wines are made from the must of black grapes, fermented with the marc — i. e., their skins and seeds. White wines are derived from white grapes or from black grapes freed from the mare. The colour- ing matter of the skin of the grape is insoluble in water, but is dissolved by alcohol, and so the juice of grapes fermented with the marc be- comes red as fermentation proceeds. A spiritu- ous wine is produced from the Juice of a grape that is very saccharine, in which fermentation is easily induced and proceeds until checked by the presence of a certain amount of alcohol. If the ferment is deficient in quantity and the sugar superabundant, a sweet wine will result. A dry wine is one free from excess of sugar. The grapes that contain but little saccharine material furnish wines having a comparatively smaller proportion of alcohol, which are known as light wines. Sparkling wines are those which continue to undergo fermentation in bottles with a production of carbonic-acid gas. The presence of tannic acid derived from the marc of the grape distinguishes the rough or astrin- gent wines, while the acidulous wines are char- acterized by the presence of tartar or carbonic acid. Among the principal sweet wines are sherrj', Madeira, port, champagne, muscat, and Tokay. The principal sparkling wines are cham- pagne and Moselle. Madeira wine was formerly much in use. It is a white wine with a rich, aromatic flavour. Its frequent adulteration renders its quality uncertain. Teneriffe wine bears a close resemblance to Madeira, and when pure has a somewhat acid taste and a delight- ful aromatic odour. Claret is the most widely used French wine. It is a red. light wine. It is somewhat astringent and acid in taste, with a vinous flavour. The brands Chateau-Lafitte, Chateau-Latour, Chdteau-Haut-Brion, and St. Julien are the most celebrated. Sherry wine, vinum xerieum {U. S. Ph., 1870, Br. Ph.), and port, vinum portense (0. S. Ph., 1870), will be described under the official wines. The classification of wines according to their source is convenient, and the principal ones will be here mentioned : German Wines. — 1. Rhenish. The best of these are the white wines. The wines made from Riesling grapes are particularly known for their delicate, delicious, refreshing flavour and their characteristic bouquet. They are sometimes of value in nervous diseases. The Orleans wines are stronger and lack the aroma of the Eiesling products. The best known of these wines are Marcobrunner, Johannisberger, Riidesheimer, Hoehheimer, and Niersteiner. 2. Main wines, of which the Steinwein is the most celebrated. 3. Pfalzeryixaes. 4. Moselle wines. 5. Aar wines. 6. Nechar wines. 7. Margrave wines. 8. Baden wines. 9. Bohemian wines. 10. Ilungarianv/ines: white — CEdenberger; red — Ofener, Tokay, Erlauer. French Wines. — 1. Champagnes may be either red or white. The white champagnes of France are famous and are consumed in all parts of the world. 2. The Burgundy wines are noted for their agreeable and delicate fla- vour and for their stimulating properties. The most famous white varieties are Chablis and Pouilly, while the best-known red Burgundies are Ohambertin, St.-Georges, Pommard, and Blanue. 3. The Bordeatix wines are known for their agreeable, peculiar perfume and their slight astringenoy. The red varieties are the clarets above mentioned. The best-known white ones are Rions, Sauberne, and Barsac. Of Spanish wines, Malaga, sherry, and Ali- cante are widely known for their " body." The type of the white wines of Portugal is Bucellas ; of the red, port. Many of the Italian wines are known : Al- bano, AUiatico, Marsala, Orvietto. The African wines, Madeira and TeneriflEe, are described above. American wines have of recent years attract- ed attention for their increasing purity and strength. The first attempts to grow wines in this country failed early in the century, but the value of the Schuylkill muscatel grape and of the North Carolina Catawba grape was proved, and these varieties were subsequently employed in the manufacture of wine. It is only within very recent years, however, that the quality of American wine has attracted the attention of home consumers. Wines of great diversity of flavour, acidity, and alcoholic strength are now manufactured in America. Although most of them contain alcohol and sugar which have been added for preservation or improvement, American wines can be secured, as a rule, free from harmful adulteration and in a condition of assured purity. Among the dry red wines made in this country are Concord, Clinton, Cyn- thiana, Sonoma, Red Mission, Zinfandel, and California claret. Well-known dry white wines are California muscatel, California Sonoma hock. Pleasant Valley, Catawba, Sonoma Ries- ling, and white Concord. Sweet wines are made in many parts of the United States. Port wines, sherry wines, and sweet Catawbas appear in the market in several varieties. Many American champagnes have attracted notice of late years and will undoubtedly supersede the foreign product in time. Prominent among these wines are " grand prize," medium dry ; " eclipse," ex- tra dry ; " gold seal," and Cook's imperial. Vines for the product of their grapes are grown in California, in Texas, in western New York, and in southern Ohio. California leads, her output in 1893 being 20,000,000 gallons of wine. While this can not be compared in point of quantity to the product of some of the wine-making countries of Europe, the produc- tion will no doubt be increased as the merits 391 WINES of American wines become better known and the demand for them is augmented. Besides the juice of the grape, there are juices of several other fruits that undergo vinous fermentation. Cider is the fermented juice of the apple. It is consumed in large quantities in southern Germany, Prance, Eng- land, and the United States. The expressed juice of the apple soon undergoes fermentation without the addition of a ferment agent. It contains a large percentage of grape-sugar, which becomes converted into alcohol in the manner above described. The taste and the quality of cider depend upon the variety and ripeness of the apples from which it is made, the climate, the soil, and the care of the trees. Cider is not permanent and easily undergoes acetous fermentation. Ferry is the fermented juice of the pear and resembles cider in its properties. The juice of all varieties of palms is rich in grape-sugar, and is therefore easily ferment- able. Palm wine is made and drank in the islands of the Indian Archipelago, in Sumatra, in India, and in the Philippine Islands. The best palm wine is said to be found on the western coast of Africa. In the oasis of Tosar, the residents of which are Mohammedans, palm wine is a customary drink and is known as " lagmi." The drinkers justify themselves, it is reported, by saying : " Lagmi is not a wine ; the edict of the prophet is against the use of wine only." The wine of the palm is produced in Chile and in most tropical countries. In Africa it is the only native alcoholic drink. In Asia it is consumed in enormous quantities. A wine may be derived from the sugar ca7ie by spontaneous fermentation. No chemical analysis has ever been made of it, although it is highly prized by the negroes of the Southern United States. Pulque, octli, or the wine of agave, is a favourite drink, intoxicating in character, of the lower classes of Mexico. It is obtained by the fermentation of the juice of the maguey, or Agave americana. The juice has a sweetish taste and soon acquires a dis- agreeable odour. It undergoes spontaneous fermentation, and when mixed with other juice from the same species which has already begun to ferment, it ferments very rapidly. In twenty- four hours the pulque has its pleasantest taste and effects. It acquires the peculiar odour of putrefying or gamy meat, and is therefore not easily partaken of by those not accustomed to drink it. It is very refreshing and cooling in its effects, but even a small quantity may be sufficient to produce intoxication. The Mexi- cans maintain that pulque possesses many therapeutic properties of value : It aids diges- tion, promotes sleep, and is helpful in many gastric diseases. The juice of the Mrch provides a sweet, agreeable, sparkling wine. The wine of honey, or mead, was formerly popular in Germany, and is said to be drank at the present day in Russia. The best known of the berry wines are currant, gooseberry, strawberry, blackberry, and raspberry wines. They are all agreeable drinks and are commonly drank diluted as refrigerants in summer. Blackberry wine or brandy has some reputation as a remedy in diarrhoea. The famous wine of the Tartars, Jcumyss, or koumyss, is the fermented milk of the ass. It is now prepared in most civilized countries by the artificial fermentation of cow's milk, and possesses some nutritious properties. It is easily digested and assimilated, and is frequently employed as a substitute for milk in conditions in which the stomach can not digest the raw product. For such usage it is a valuable adjuvant in the treatment of asthenic conditions and as a food in the vomiting fol- lowing anmsthesia. (See Kumyss.) The lehan of the Arabs and the yaurt of the Turks are wines similar to kumyss. In some parts of Ireland and Scotland and in the Orkney Islands buttermilk is sometimes kept nntil fermenta- tion has set in. It then acquires intoxicating properties. The juice of the orange is some- times allowed to ferment, giving rise to a typical wine. An infusion of malt is capable of undergoing fermentation, giving rise to the malt liquors — ale, brown stout, porter, and lager beer. They are practically wines, but their consideration does not properly come under this heading. Champagne was first made in the latter half of the seventeenth century by Perignon, a priest in the convent of St. Peter at Haut- Villers, althougb the crude article had been known and prized for centuries. Its manufac- ture rapidly spread, and to-day good qualities of champagne are made in the United States, France, Germany, Austria, and Italy. In this country French champagne is the favonrite, although the American brands ' are making their way to the front. Blue grapes make the best champagne, and those containing a mini- mum quantity of colouring matter are usually chosen. Burgundy, Rulander, and Riesling are used for fine champagnes. For the infe- rior qualities Ortlieber, Steinschiller, and Gu- tedel are frequently employed. The preparation of champagne has been brought to a state of perfection in France. The selected grapes are rapidly pressed and the must obtained is allowed to undergo complete fermentation in order that all traces of sugar may be removed. After this wine has cleared itself it is mixed with other wines of chosen type and character {coupage). This mixed wine, which is the basis of the champagne, is repeatedly cleared and drawn off, and in the spring of the year, as a rule, has added to it from 1 to 2 per cent, of sugar for the produc- tion of the carbonic-acid gas. This is accom- plished by adding a liqueur which contains ordinary candy sugar, wine, and cognac in the proportions of 150, 125, and 10. This is used for the better champagnes; beet-sugar is em- ployed for the cheaper ones. Sometimes port, Madeira, muscatel, or cherry-water is added to the liqueur if it is desired to produce a par- ticular flavour. The amount of liqueur added depends upon the pressure it is intended to secure and the absorptive ability of the specific wine. French champagne producers distin- guish three kinds of carbonated wines: Cre- mant, which has a carbonic-acid gas pressure of about four atmospheres ; mousseux, with a WINES 392 pressure of from four to four and a half at- mospheres ; and grand mousseux, with a pres- sure as high as six atmospheres. The familiar form of champagne bottle is employed because it enables the gas to remain at the original pressure. The bottles are now carefully corked, leaving a space at the top of from twelve to fifteen cubic centimetres. They are placed horizon- tally in the fermentation cellar, which has a temperature of from 68° to 75° P. As the fermentation proceeds, the position of the bot- tle is gradually changed every few days until at the end of about two weeks it stands ver- tically, cork downward. During this process a precipitate has been, formed which falls against the cork. As soon as the workmen are certain that precipitation is complete, degorge- ment is practised. This consists in removing the cork, when the precipitate, together with a small quantity of tlie wine, is hurled from the bottle by the force of the pressure behind it. The bottle is again filled to its former degree by dosage with a liqueur which varies for dif- ferent champagnes. It can be made sweet or dry, mild or strong, according to desire. The bottle is then so handled as to avoid the loss of any more carbonic-acid gas than is neces- sary, it is corked, the cork is secured with cord and wire, and all this is covered as far down as the empty space extends with tin-foil or seal- ing-wax. The other methods of making cham- pagne are inferior, but it is of historic interest to note that the older method consisted in forcing carbonic-acid gas into bottles contain- ing wine already " dosed " by means of a force- pump. A champagne must naturally, to be pure, have the basis of an aerated water, as outlined above. Chemically, it must contain no im- purities injurious to health. Saccharin, oxalic acid, and salicylic acid are used in France to some extent as adulterating agents, and should be tested for if their presence is suspected. After champagne has been poured out into glasses, evidence that it is not an artificially aerated water may be adduced by stirring it. If it foams as it did when first poured out it is a pure or at least a natural champagne. If not, it is to be condemned as artificial. The medicinal uses of champagne are those of a stimulant. It may be given in convales- cence from any adynamic disease, and is serv- iceable when a patient is suffering from the effects of severe shock or collapse and when he is able to take fluids by mouth. It is of real value in cases of vomiting due to almost any cause. At these times, when the stomach re- fuses to retain anything else, cold dry cham- pagne in small doses will usually be retained and may frequently stop the vomiting alto- gether. It is of special use in the vomiting following ansesthesia when this is prolonged beyond the usual time. In cases of anmmia and chlorosis, when iron is not well borne by the stomach, it may sometimes be found use- ful to give It with small doses of a dry cham- pagne. It is a good stimulant after fatigue or overexertion, but a too long-continued use of this wine is apt to produce cirrhosis. The effects of champagne are those of other diffusible stimulants, but that it does excite especially the intellectual centres, producing an unusual flow of wit and humour, its popu- larity at dinners and among postprandial speakers testifies. When drank as other fluids are, two or three glasses of champagne will rarely intoxicate one accustomed to any alco- holic drink, but when slowly sipped it may give rise to the symptoms of acute alcohol poisoning after half a glass has been taken. Although the effect of wines is dependent, to some extent, on the alcohol they contain, the liquid is so complex that much of its influence upon the human body must be ascribed to the salts, ethereal bodies, sugars, and acids in which it abounds. The action of wine is mainly stimulant, and this effect is derived mainly, it is true, from its alcohol. It is probably, how- ever, not correct to state that an equal quantity of water containing the same percentage of alcohol will accomplish the same result. After drinking wine, the whole organism responds to it. The activity of the nervous system is quickened, the special senses become more susceptible to impressions, and the intellectual faculties are more active and alert. The pulse becomes more rapid, and the cheeks usually become flushed and the eyes bright. It de- pends, of course, upon the variety of wine taken, whether these effects are more or less pronounced. The sparkling wines produce them rapidly to a high degree, stimulating the mental faculties particularly. The still wines have a less marked stimulant effect. On the other hand, the sparkling wines have a ten- dency to derange gastric digestion ; the still wines have little influence in this direction. In a physiological study of the influence of alcoholic drinks' upon the chemical processes of digestion, R. H. Chittenden and L. B. Men- del {American Journal of the Medical Sciences, April, 1896) conclude that wines in small amount have little or no deleterious action upon the chemical processes of gastric diges- tion. In small amount they may even increase the rate of digestive action. In larger quanti- ties they have more or less of a retarding effect, which is dependent more upon the character and amount of the solid matter present than upon the alcohol. On pancreatic digestion, however, they find that wines have a greater inhibitory action than the stronger alcoholic liquors. This action seems to be entirely inde- pendent of the amount of alcohol, but is closely connected with the acidity of the fluid. On salivary digestion, wines as a class show a very powerful inhibitory action, due almost entirely to their acid properties ; for when the acidity of a wine was experimentally neutralized, it lost completely its inhibitory effect upon sali- vary digestion. An exaggeration of these physiological effects of wine is found in the condition of acute alco- hol poisoning, commonly called drunkenness or intoxication. A condition approaching de- lirium appears after the ingestion of more wine than can be tolerated by the system. Depend- ing upon the temperament of the individual, he may be joyful or morose, combative or 393 WINES peaceful, erotic, benumbed, or active. These symptoms gradually subside, the speech be- comes incoherent and thick, the head whirls, and \isioii and perception, of space and objects become blunted. It is a curious fact, frequently observed and commented upon, that those fac- ulties most constantly employed are the last to succumb to intoxication. An educated person will continue to reason long after he has lost the support of his limbs, while a labourer, though unable to talk, finds himself able to carry on his work. An intoxication ends in two ways : Either there is gastric derange- ment, with vomiting, diarrhoea, and sometimes evacuation of the bladder, or a condition of somnolence supervenes, characterized by an alcoholic breath, a flushed face, dilated pupils, a slow, full pulse, stertorous breathing, and sweating. Recovery is the rule, although a fatal result has often been known. The habitual dietetic use of wines is possibly harmless, but it is certainly useless in health. Yet it is an established fact that, in the wine- drinking countries of Europe, one sees little of the bad effects of the constant use of the bev- erage ; and in Prance and Germany it is used by persons of all ages and of both sexes. It is said that gout and calculous disease are scarce- ly known along the Rhine. The light wines of Germany and France, diluted, may be drank with safety for many years. But the heavier wines, such as sherry, port, and Madeira, are apt, after prolonged use, to induce diseases of the liver (cirrhosis), gout, apoplexy, and those conditions which are due to overstimu- lation. The light wines are refreshing after exertion, and exert a protective influence when the organism is subjected to a severe tax. In one of the hospitals of New York an old cus- tom prevails of giving claret, well diluted, to all those resident in the building during an epidemic of cholera, typhus, or small-pox. It is possible that wine produces a deleterious effect upon the complexion, and that it may prematurely arouse adult passions in children who drink it frequently. The habitual use of saccharine wines must be forbidden to persons who have gout or a tendency to obesity or to the gouty diathesis. In an investigation as to the medical prop- erties of the Bordeaux and Burgundy wines, the Lancet commission decided that the white Bordeaux wines excited the appetite, were a direct aid to gastric digestion, and were slight- ly aperient. The sauternes, it was found, were at first stimulating and later had a sedative effect. This action was more pronounced upon nervous and easily excitable persons. The white Burgundy wines had not, as had been believed, a constipating influence, but the re- verse. The clarets were found to have neither a stimulant nor a sedative influence, which the commission attributed to the combination of tannin with a small percentage of alcohol. Taken with the meals, claret was found to have an influence beneficial to digestion. The red Burgundy wines are not so helpful to digestion as claret, and seem to show a tendency to cause obesity. These wines are not well suited to the gouty, and diabetics can not take them, because of the sugar they contain. {Lancet, June 26, July 3, July 24, October 33, 1880.) As to the sustaining qualities of wine, there can be little difference of opinion. Druitt (Medical Times and Gazette, 1878, vol. ii, p. 364) prints his correspondence with a French army surgeon and a French lady who wei'e in Paris during the siege. Both of them give high testimony to the worth of vin ordinaire, at a time when it was impossible to obtain other nourishment, in sustaining the vital powers. The surgeon gives evidence as to how his soldiers withstood severe injuries with no other food than the wine given them. This question is discussed fully in the article Al- cohol. In the treatment of disease, wine is used differently from the more ardent spirits. In an acute aniemia, for example, dependent upon a severe haemorrhage, alcohol in a more rapidly assimilable form is called for, such as whisky or brandy ; but if the patient recovers, wine would be indicated as a tonic to help him over his debility. In eases in which the prolonged use of an alcoholic stimulant is demanded and when the disease is of a mild grade, or when the stomach can not tolerate whisky or brandy, wine is pre-eminently the agent to use. This is not the place, and the writer has not the wish, to discuss the mooted question as to the wisdom of employing wine in disease. He as- sumes that the intelligent employment of some alcoholic stimulant is to be taken for granted. When wine is used medicinally it is essential that a genuine wine and a good wine be em- ployed. Adulterated wines will prove injurious only, deranging the digestion and impairing the appetite, if not inflicting more serious in- jury. In general, it may be said that sherry, containing little acid, is indicated when the stomach is weak and there is acid dyscrasia. Port is to be preferred in cases oi pure debility. Claret is useful as an aperient and diuretic. Champagne is given in the debility of old age and in the collapse of low fevers. Acidulous wines are not to be given to gouty subjects, nor sweet wines to diabetics. Young infants may receive marked benefit from the judicious administration of port wine, given at hours other than meal times, when suffering from marasmus from any cause, ca- tarrhal affections of long standing, tuberculosis, or rhachitis. The appetite and nutrition are improved materially. Sherry promotes sleep and aids digestion in senile debility, depending for its effects not only upon the alcohol, but upon the ethers developed in it. In fevers of all kinds, those of the acute infectious diseases as well as in those coming from acute inflam- matory processes, wine fortifies the system and helps it to get rid of the deleterious materials circulating in the blood. It is particularly valuable when there is high delirium or great nervous prostration, with a rapid dicrotic pulse which has a tendency to become arrhythmical. In typhoid fever and in typhus fever when there is absence of the impulse and first sound of the heart, port wine is a valuable agent, adminis- tered in large doses. In the pneumonia and bronchitis of the aged it is a helpful remedy as WINES 394 well. In the exhaustion of fevers, marked by insomnia and feebleness of the heart, as seen in the third and fourth weeks of typhoid fever, port wine is good. The use of wine is indicated, too, when derangements of digestion and flerv- ous prostration appear, entirely out of propor- tion to the gravity of the disease. For these purposes, from six to twelve ounces may be given daily in divided doses at half-hourly intervals. In threatening cardiac failure in the acute delirium of some form of insanity, wine is a useful remedy. It has been recommended in catarrhal inflammations accompanying epi- demic influenza, in the intestinal catarrhs of summer and autumn, and as a stimulant in amygdalitis. In purulent inflammations of long standing and in chronic discharges of blood, pus, or mucus from the uterus, vagina, urethra, intestines, or lungs, or from fistula; or ulcers, claret wines are highly recommended. According to Binz, the alcohol tends to check the emigration of leucocytes and, on the au- thority of Anstie, it helps to overcome the excessive metabolism of the tissues. In addi- tion to this, it is no mean stimulant and sup- porting agent to one whose vitality has been drained by a long-continued discharge of pus. After recovery from a hemorrhage, strong wines may be given for their tonic eflfect upon the heart and peripheral blood-vessels. Half an ounce, from five to six times daily, is the proper dose. In the a^ute neuroses, such as infantile convulsions and acute chorea, the patients are very tolerant of wines, and the affections are sometimes decidedly relieved by them. In acute neuralgia the ethereal wines occasionally give great relief from pain. Cham- pagne is an excellent agent, given cold in small, often-repeated, doses, with which to control the vomiting following ancesthesia and the vomiting of seasickness and pregnancy. In general debility which has its origin in anorexia or dyspepsia a Burgundy or a red Hungarian wine is of good service. Anfemic and chlorotic patients do not require wine ; but a progressive chlorosis may be benefited by its use. The use of wine in pulmonary tuberculosis has been fought by physicians for years. It is probably correct to state that, when the wine chosen for the purpose, which must be care- fully considered in every case, reduces the fever and the night-sweats and strengthens the pulse, it is an eminently fit agent. Anything which will favour the fortification of the pa- tient's strength is a legitimate remedy in this disease, and wine frequently does. Wines — pure wines — have been recommend- ed in debility arising from protracted pain or scurvy, and in the chronic affections of the scalp and eyes of poorly nourished children. It has been advised to give it by enema in cases of gastralgia in which the stomach can not tolerate preparations of iron. Tetanus is said to have been cured by wine, and its injec- tion has been recommended in chronic dis- charges from the vagina and urethra and to lessen the discharge from fistulm. Claret has also been used as an injecting fluid into the tunica vaginalis for the cure of hydrocele. The white wines of Bordeaux have been praised as tonics where there is a capricious appetite and for the decrease of corpulency, and they have been found useful in cases of biliary indiges- tion. Sauterne wines are praised for their tonic influence in pulmonary cases when there are insomnia and troublesome cough. The white Burgundy wines have been found of service in convalescence from any prolonged disease. Clarets are widely used as tonics to be taken with the meals ; they rarely upset the stomach, and are agreeable to the majority of debilitated patients. In ancemia and debility from any cause and in atonic gout they are useful. Diluted, they are excellent refriger- ants in the course of a febrile disease. In mal- nutrition not dependent on gastric or intestinal irritation, and as a tonic for convalescents, the red Burgundy wines are widely employed. Since they are ultimately sedative in their ac- tion, their use may preclude the administration of any narcotic agent. The quantity of wine to be administered must vary, of course, with the disease and the patient. In low fevers sometimes a pint, frequently a quart, may be given in twenty- four hours. It may be administered pure, di- luted with water or mineral waters, or in the form of wine whey. This is made by adding to a pint of boiling milk half a pint of some white wine, straining through a cloth, and adding loaf-sugar to the filtered product. The adulteration of wines is frequently prac- tised oftener in this country and France than in other European countries. Although at the present day these adulterations are not directly poisonous, they usually provoke disturbances of the stomach, and are reprehensible for this reason not only, but because the products are sold as genuine wines. The most frequently adulterated wines are port and Maderia, al- though claret, too, is frequently imitated. Lead is frequently found in minute quantities. This may spring from the shot with which the bot- tles are cleansed or from some analogous source. In the early part of this century English wine- dealers were in the habit of putting large quan- tities of shot into the barrels containing wine to keep it from turning sour. The use of oxalic acid was suggested if the lead did not answer the purpose. (Citation from The Wine Dealer's Manual, British and Foreign Medical and Chirurgical Bevieiv, April, 1858.) Cider or perry, diluted with water, may be palmed off as genuine wine. Frequently inferior wines may be made more easily salable by the addi- tion of a small quantity of a higher grade of wine. Alcohol is added to thin wines, sour wines are sweetened with sugar, honey, or raisins, and pale ones are coloured with burnt sugar. Acetate of lead may be added to wines to give them arStringency, and acidulous wines are sometimes neutralized by the addition of lime or alkalies. Red wines are often made out of alcoholic dilutions, the colouring mat- ter being beets, litmus, rhatany, or logwood, and astringency is given to them by the addi- tion of alum, tannin, or oak or willow bark. Colouring matter is employed by many wine- dealers, usually made of alum and elder berries. 395 WINES Free sulphiirio acid can not be detected by barium, since all wines contain some soluble sulphates. If a few drops of the suspected wine, however, are dropped on a piece of glazed paper containing starch, the texture of the paper will be unaltered and the spot, when dry, will be violet if the wine is pure ; but if it contains only a trace of sulphuric acid, the spot will be rose-red and the paper will be friable. Adulteration has been known from Pliny's time, and this historian inveighs bit- terly against the decadence of the times since "no one can get pure wine to drink." It is known at the present day in Germany, more in Prance, and less in England, but most of all it is found in the United States. Wines are subject to a number of disorders, which will be briefly considered here. One of the commonest of these is the viscosity of wine, by which it becomes slimy, thick, and threadlike. It appears more frequently in wines poor in tannic acid, and is therefore more commonly found tn white than in red wines. In acidulous wines this disorder some- times disappears spontaneously, particularly if they contain a considerable percentage of al- cohol. It may be cured by shaking the wine and allowing ithe entrance of air, or by adding grape-sugar to induce a new fermentation. Acetous fermentation may take place in wines through the growth of the fungus Myco- derma aceti. It is the most dangerous of all the disorders of wines, since it may make the wine unfit to drink in a very short time. This fermentation occurs chiefly in old wines with a small percentage of albuminous matter, in warm cellars, and when the barrel is not kept full. When a wine has become decidedly tainted with acetic acid, it is best to allow it to be converted entirely into vinegar. Pasteur- ization (vid. infra), electrolysis, and the pour- ing of the wine into another cask impregnated with sulphur have been suggested as cures. Lactic-acid fermentation may be caused in wines by chain-forming bacteria which are even noticeable to the naked eye as masses. The wine attains a smell and a taste which render it unfit for drinking. Other bacteria affect wines differently. It may become pu- trid, developing carbonic-acid gas and becom- ing turbid. The colouring matter of white as well as of red wines changes to brown, and a disagreeable odour and taste are developed. This change occurs chiefly in wines poor in alcohol which have been made from poor or rotten grapes. Through the action of a ferment not yet de- scribed, wines may become bitter. This is a peculiarity of red wines, and was first noted by Pasteur. It may take place through the action of ammonia and air on an aldehyde which sometimes develops in the wine. There is a decided lessening of the colour and of the iannic acid in this disease, and the wine is not palatable. Wines may become mouldy. This occurs only in wines deficient in alcohol, and is accomplished by the growth of a mould on the surface of the urine. Red wines may lose their colour from a va- riety of causes. It is normal for all red wines 69 to become somewhat lighter in colour as their age advances. But the wine may acquire a pallor, which is usually due to the cleaning' of the containing casks with lime or with water impregnated with lime and the presence of too much air during the priiLary fermentation. To preserve its colour, it may be mixed with a proportionate quantity of darker -wine. By chemical action, red wines may become black and white wines green, gray, or brown. This condition is usually cured spontaneously if the wine is allowed to lie for a period. Among the other disorders to which wines are subject may be mentioned the smell of sul- phur, which is usually attributable to the earth in which the grape has grown or to some ex- ternal influence ; a mouldy taste, acquired by the wine if it is preserved in mouldy vats ; and the taste of the barrel in which it is kept. The same holds true of the wood from which the casks are made. The oak, larch, and mulberry barrels, for instance, give the wine a peculiar taste. The taste acquired by the wine from the ground in which the grape was grown, which is usually very characteristic, may be diminished by repeated withdrawal of quantities of the wine and refilling the cask with fresh wine (Die menscMiche Nahungs- und Oenussmittel, von Dr. J. Konig, Berlin, 1893; Eandhuch der chemischen Technologie, von Dr. F. Fischer, Leipsic, 1893). Pasteur suggested a method of ridding wines of most of the disorders to which they are sub- ject by warming them to a temperature of 140° F. This process is technically known as " Pasteurization," and may be easily accom- plished by the apparatus of Ballo (Fischer, op. cit.). As a rule, wines clear themselves; but to augment or hasten the process, sweet wines may be rendered clear by clay or albuminous bodies, which gradually cause the insoluble substances to sink and to be thus easily re- moved. The colour of red wines is said to be heightened by the addition of plaster of Paris to the must. Vinum album (U. S. Ph.), white wine, is " made by fermenting the juice of fresh grapes, the fruit of Vitis vinifera, freed from seeds, stems, and skins." When a white wine is pre- scribed without further specification, a domes- tic dry white wine is recommended ; such are California Riesling and Ohio Catawba. Pert wine and sherry wine were formerly ofBcial in the U. S. Ph., but the increasing excellence of domestic wines induced the committee of re- vision in 1880 to return to the old nomencla- ture of white and red wines, and to allow any white or red wine to be used which was of the required purity and alcoholic strength. Any German or other white wine is called vinum album (Ger. Ph.). Vinum album fortius (U. S. Ph.), stronger white wine, is a mixture of white wine with one seventh as much of alcohol of a specific gravity of 0'820. It must contain from 20 to 25 per cent, by weight of absolute alcohol. Vinum rubrum (U. S. Ph.), red wine, is " made by fermenting the juice of fresh col- oured grapes, the fruit of Vitis vinifera, in WINTERGREEN X RAYS 396 presence of their skins." The pharmacopoeia recommends, when no speeiflcation is made, the use of a domestic dry red wine, or a native claret or Burgundy ; any German or other red wine is allowed by the Ger. Ph. (For the pharmacopoeial requirements of vinum album and rubrum, see the dispensatories and phar- macopoeias.) Vina medicata, medicated wines, possess the advantage, because of their alcohol and acid, of rendering some drugs soluble which do not easily dissolve in water. They are not stable, and few are at present in use. The purest wines should always be chosen when they are prescribed. — Samdel M. Briokner. "WINTERGREEN.— See Gaultheria. WITCH-HAZEL.— See Hamamelis. ■WITHEBITE.— See Barium carbonate, under Barium. WOOL- FAT.— See Lanolin. WORMWOOD.— See Absinthium. WBXG'KTIA.— WrighHa (or Holarrhena) antidysenterica, an East Indian apocynaoeous tree, has a bitter bark which was formerly an article of European commerce under the names of conessi bark and TelUcherry bark. It was used in diarrhcea and dysentery. It contains a poisonous alkaloid, wrightine, which is sup- posed to be the active principle, but has not yet been sufficiently studied to warrant a rec- ommendation of its use in medicine. XANTHOXYLXJM (U. S. Ph.) is the bark of Xanthoxylum americanum and of Xanthox- ylum Clava Merculis. Its common name is prickly ash. The former species grows in the Northern, Middle, and Western United States, in rocky forests. It is a shrub from five to ten feet in height, and its alternate branches are covered with strong prickles, whence its popu- lar name. The shrub is a polygamous plant, flowering in April and May before the appear- ance of the foliage. The leaves and capsules possess a lemon-like odour. Xanthoxylum Clava Herculia is indigenous to the territory extending from the Atlantic coast to western Texas and from Virginia to the Gulf of Mexico. It varies in size from a large shrub to a small tree. Its bark and branches are also covered with sharp, warty prickles. Both varieties belong to the natural order Rutacem. In addition to the official shrubs recognised, there are several other varieties of the plant which are used medicinally in the localities in which they grow. In the Argentine Republic Xanthoxylum naranjillo is employed as a diu- retic. a,nd sudorific. The Brazilians make a decoction of Xanthoxylum singuassiba which is alleged to have powerful sudorific properties and is widely used as a gargle in inflammatory and non-inflammatory affections of the throat. A tincture is used locally for severe toothache, with a reported analgetic influence. In the bark of this tree an alkaloid similar in its properties to pilocarpine has been found. Under the name of yellow Hercules's club and yellow thorn, the bark of Xanthoxylum caribcBum has made its appearance in com- merce. This is the satin-wood of southern Florida and the West Indies. Its baric is thin, with a bitter, disagreeable taste, and has a canary-yellow colour which is imparted to the saliva when the bark is chewed. An alkaloid derived from this bark, when hypodermically injected into frogs, rabbits, or guinea-pigs, produces paralysis and subsequent death. In India Xanthoxylum alatum is used as an an- thelminthic and sudorific. The Xanthoxylum nitidum of China is said to possess febrifuge properties. On the west coast of Africa IXan- thoxylum senegalense has its habitat. Several alkaloids have been isolated from its bark, artarine the principal one, and one that re- sembles cubebine in its effects. The drug ar- tar root is said to be derived from this shrub." In 1829 Staples isolated from Xanthoxylum americanum a crystalline principle which he called xanthoxylin. The same result was ob- tained fifty years later by Lloyd. MofEet, in a subsequent analysis, obtained an alkaloid of yellow crystals which were soluble in alcohol and in chloroform, insoluble in ether and in benzene. Colton, who examined Xanthoxylum Clava Herculis, isolated crystals which formed colourless, tasteless, silky needles, soluble in alcohol, in ether, and in chloroform, insoluble in water (American Journal of Pharmacy, 1880, p. 191). An alkaloid resembling berber- ine has been found in Xanthoxylum Clava Herculis. The bark of Xanthoxylum ameri- canum occurs in curved or quilled fragments. The bark of Xanthoxylum Clava Herculis resembles it but is thicker, and is marked by many conical, corky projections and by stout, brown spines rising from a corky base (Bridges, Proceedings of the American Pharmaceutical Association, 1864). The bark is brittle, very light, and almost without odour. The taste is at first sweetish, then bitterish, and finally acrid. Xanthoxylum is said to resemble guaiac in its remedial action. It evokes a sense of heat in the stomach when ingested, increases the force and frequency of the pulse, and produces to some extent diaphoresis. Upon the nervous system it is stimulant as well. On account of its acridity, it has been employed locally as a sialagogue. An infusion, used on compresses, is said to have a revulsive action which is taken adv.bacteria, while the bismuth oxide tends to check fermentation and acts as a desiccant. Xeroform is inferior to iodoform as a promoter of granulation. Its antiseptic power seems to be somewhat impaired by mixing it with fatty substances ; hence it is better to use paste or a gauze impregnated with it. Its cost is about the same as that of iodoform, but it is cheaper to use it, because only about half the amount is required that would have to be employed of iodoform. It may be given internally in doses of from 7 to 15 grains, three times a day, in intestinal catarrh, including the summer diarrhoea of children, also in chronic urticaria and in cer- tain forms of eczema in children. X RATS. — The X rays, or Rontgen rays, are chiefly of interest to tHe medical profession from the point of view of diagnosis, but they have been employed therapeutically also. Our knowledge of them has been so recently ac- quired that some account of their nature and the processes of making use of them is appro- priate. The following, therefore, is condensed from a paper read before the Medical Society of Victoria in August, 1896, by Dr. F. J. Clen- dinnen, of Melbourne {Intercolonial Medical Journal of Australasia, August 20, 1896) : The labours of Hertz, Lenard, Crookes, Hittorf, and others led up to Rontgen's discovery. The or- dinary Geissler tube was the first step in the process, then came the Crookes tube. This con- sists of a tube, pear-shaped or otherwise shaped, with platinum teiminals fused into opposite ends, and exhausted of air. When a high-ten- sion current from an induction coil is passed through, a violet g^ow is seen in the tube. If the tube is further exhausted the glow seems to be in bands, and if the tube is still further exhausted the glow disappears, and then the glass of the tube becomes fluorescent, and glows with a bottle-green colour, provided it is made of soda glass. When the tube is in this condition the X rays are given off from the cathode. The late Professor Hertz was engaged in in- vestigating this phenomenon produced in Crookes's tube just before his death, and he instructed his assistant, Lenard, to continue these researches. He ascertained that the eathodic rays would act on a sensitive plate, and also that they would pass through wood, so that he came very close to ROntgen's dis- covery that these rays would pass through the tissues of the human body, and that some sub- stances were more easily penetrated by them than others — the soft tissues of the body more than the bones, aluminum more than other metals. What these rays are is not known ; all we know is that they travel in straight lines, can . not be refracted or polarized, cast a shadow, act on a sensitive plate, pass through objects opaque to light, and cause fluorescence. It has been suggested that they are ultra-violet rays of the spectrum, with which they agree in some respects, though their wave length has not been determined. In this connection, says Dr. Clendinnen, some observations made by himself on the effect produced on colour may be of interest. When taking a photograph by this process of some articles inclosed in a box painted like a tartan plaid, he found that the negative was striated, and comparing the strise with the colours on the box, he found that they coiTesponded with the red colours, and it flashed into his mind that these X rays were absorbed by certain colours as light was. He then tried to take a photograph of a picture painted in colours on a half-inch board, and got a contrast result. This, however, was not satisfactory, as the opacity might have been due to the lead in the paint, and the surface was uneven. To obviate this source of fallacy he next took a playing card, the knave of dia- monds, and the red colours came out opaque, the rest transparent ; then, on the suggestion of Professor Lyle, he tried aniline colours, X RAYS 398 soaking blotting-paper in them, and found that red was opaque, blue semi-transparent, and white transparent to the X rays. He then cut pieces of coloured tissue paper into various shapes, so as to recognise the different colours, pink (as he had no I'ed), orange, yellow, green, blue, violet, and white. On passing the X rays through them, he found pink semi-transparent, yellow and orange opaque, green opaque (but not so opaque as the former), blue and violet more transparent, and white quite transparent. These experiments seemed to show that the X rays obeyed some of the laws of ordinary light in that red and yellow are non-actinic. There are three things required for produc- ing these rays : First, power or current ; this may be obtained from Grove, Bunsen, or bi- chromate cells. Grove's and Bunsen's are the best, as their current is given off more evenly and lasts longer, but the fumes that arise are too pungent for comfort. This is not the case with bichromate cells, but their current is un- even. The number of cells to use must be in proportion to the strength or sparking of the coil. Accumulators may be used — such as Professor Lyle uses — a dynamo, the main, the Tesla coil, and the Wimshurst machine have all been used. Second, a Ruhmkorffi induc- tion coil which gives a spark of from two to six inches ; this must be in good working order. Third, a vacuum tube. The positive and negative terminals of the battery are to be connected to the coil, and the termi- nals of the secondary wire of the coil con- nected to the external terminals of the tube, which is supported on the stand, with the plate lying underneath, face upward. Owing to the capability of these rays of penetrating paper and wood with such ease, we may photograph on the plate inclosed in a box. Although these rays are invisible in them- selves, tliey stimulate visible fluorescence in certain salts upon which they are allowed to fall. The salts which have been found to fluo- resce best are barium platinocyanide and calci- um tungstate. The fluorescent screen is made by painting evenly a thick piece of paper, such as drawing paper, with a mixture of gum and glycerin, and then dusting over it before it is quite dry a powder of the salts mentioned. Not only are the shadows cast on this screen, but it is used for shortening the exposure. It appears from certain experiments made by Mr. J. A. M'Clelland, an account of which is given by Professor J. J. Thomson (Proceed- ings of the Royal Society, No. 360), that the X rays are not homogeneous, but that some of them are absorbed by one set of substances and others by other sets. This lack of homogeneity is the more pronounced the smaller the amount of residual air in the Crookes's tube. Mr. M'Clelland found that with some substances there was no selective absorption, while with others it was very marked. Glass gave none, with mica and paraffin the effect was small, and with fuchsine, eosine, fluorescine. aesculin, and barium sulphide the effect was very de- cided. With several fluorescent screens the effect was great. Pure water also gave a dis- tinct though smaller effect. When the X rays first came into use some physicians expected that they would be found to have some physiological action that could be turned to account therapeutically, and espe- cially that they would prove destructive of morbific germs. It seems, however, from De Renzi's experiments {Qazzetta degli ospedale, August 30, 1896 ; British Medical Journal, October 31, 1896) that they have no such effect, at least not on the tubercle bacillus, the bacillus of Finkler, or the cholera spirillum. Dr. P. I5osc (Nouveau Montpellier medical, April 25, 1896; New York Medical Journal, July 4, 1896), having seen the opinion expressed in print that the curiosities of vision observed in the hysterical might perhaps be due to their perceiving these rays, examined a girl, fifteen years old, who was affected with heraiancesthe- sia and astasia-abasia, but whose vision seemed normal. Between the Crookes's tube and the girl's eye he placed a broad screen of two thicknesses of black paper. The light was ob- tained with a Holtz-Carre static machine. Under these conditions, neither he himself nor the girl's mother could see anything. The pa- tient, on the contrary, saw very clearly, and with each °ye separately, a light which she said was "like a lamp." As long as the current was passing she saw distinctly ; as soon as it was interrupted she could see nothing. At the time of making the interruption Dr. Boso kept up a production of sparks, so that the girl did not know that he had stopped the current. He remarks that it was curious that the girl's per- ception of light varied with the luminous inten- sity of the cathode rays, the tube being the same. Dr. Frederick S. 'Kolle, of Brooklyn {New York 3Iedical Journal, January 16, 1897), re- ports that of seven persons with amaurosis, subjected to the Rontgen rays, six observed a peculiar shooting-star light, the Sternschup- penlicht of the Germans. Four of the patients could count the individual stars, ranging be- tween six and thirty-two in number. Cancer is one of the diseases in which the X rays have been expected to prove remedial, and possibly they may yet be of advantage in the treatment of some forms of malignant growth. Dr. V. Despeignes (Lyon medical, July 26 and August 9, 1896) reports a case in which they were used in the treatment of cancer of the stomach. At first a notable amelioration was observed, but unfortunately it did not continue. The Rontgen rays did, however, continue to diminish the size of the tumour, and at the time of the patient's death it was considerably smaller. M. Despeignes says that the treatment con- siderably ameliorated the general condition and prolonged the patient's life for fully two weeks, it absolutely suppressed the pain near the tumour, and, finally, it notably diminished the volume of the growth. He adds, however, that he thinks the amelioration of the general condition was mainly attributable to injections of artificial serum, for when their use was sus- pended at the patient's request, because they were painful, the general condition "became worse. With regard to the cessation of the 399 X RAYS pain, when morphine injections ceased to have any further action, it did not seem warrant- able, he says, to attribute it to anything but the employment of the Rontgen rays, for from the beginning of the first sitting the pain ceased entirely. Before the employment of the rays the patient had been taking daily doses of 4^ oz. of chloroform water, and very often two pills containing f of a grain of ex- tract of opium, and he frequently had one or two injections of morphine. After the em- ployment of the rays the use of the opium pills was discontinued and only very small quanti- ties of chloroform were given for two or three days. In regard to the diminution of the size of the tumour, says M. Despeignes, the action of the rays was still more distinct. As there was no sectio cadaveris, it was impossible to say what part of the tumour was influenced by the rays, but it is certain, he thinks, that the regression did not take place on the sur- face alone, but that the action of the rays was felt in the cancer ; the epigastric region, which had been very much swollen on the 4th of July, was almost flat at the time of the par tient's death, on the 34th. This diminution extended also to the right extremity of the stomach, the part which encircled the left lobe of the liver. When death occurred it was found on palpation and percussion that this lobe of the liver was completely free, and it seemed as if the cancer had entirely disap- peared, on that side at least, for, M. Despeignes argues, if the regression had taken place in the stomach only, it is probable that the contrary wotild have been the case. In the presence of these results, and although the termination was fatal, he asks if there may not be hope, if not of recovery, at least of a considerable pro- longation of life by employing this treatment if the cancerous affection is not advanced or not progressing rapidly. On the other hand, some observers have put on record certain pathological phenomena that, are thought to have been produced by the X rays. In the New York Medical Journal for August 29, 1896, an editorial writer says : " So far as our knowledge goes at present, these morbid results seem to affect chiefly if not ex- clusively the skin and its appendages. Dr. Marouse (Deutsche medicinische WocJien- schrift, July 33, 1896 ; British Medical Jmm-- nal, August 15, 1896) relates the case of a lad, seventeen years old, on whom he experimented with the Rontgen rays once or twice a day for a period of four weeks, the sittings lasting from five to ten minutes, and longer when the chest was being illuminated. Hittorf's tube was sometimes placed close to the body and never more than eight or ten inches away from it. The heat from the tube is said to have been very slight. The lad was completely clothed when his head was undergoing examination, and wore his shirt when his chest was sub- jected to the apparatus. At first a slight diffuse redness was observed in one half of the face, especially above the ear, with some des- quamation. Subsequently there was a sharply defined area above the ear where the hair was very thin. The hairs could be plucked out without pain, and showed signs of degenera- tion — in short, there was incipient alopecia. There was pronounced injection of the con- junctiva of the eye that was situated on that side of the face that was affected. On the back there was a space ' as large as a plate ' over which the epidermis was completely sepa- rated, and the exposed corium showed hemor- rhages and exudation. The patch was quite tender, but there had been no pain until shortly before the lesions were noticed. There were similar changes, but not so advanced, over a space of about the same size on the front of the chest. The dermatitis resembled that caused by a burn. Prom other sources we hear of loss of the nails as a result of ex- posure to the X rays." Dr. A. B. Kibbe, of Seattle, Washington (New York Medical Journal, January 16, 1897), reports that during a certain week he devoted considerable time to experimenting with an X-ray apparatus. In general, the cur- rent strength used was about ten amperes. He found that the most convenient manner of testing the working of the tube was by using his left hand in front of the fluoroscope, and this he did frequently ; but as this method gave less sharp and well-defined pictures than by using a sensitive plate and taking pictures, the fluoroscope was solely used to test the ac- tivity of the tube in producing the radiations, and, when the latter were satisfactory, pictures of the hand, wrist, and arm were taken with exposures varying from thirty seconds to five minutes. Just how often the hands were ex- posed he is unaible to say, but certainly not fewer than twenty times for the left with the fluoroscope, and at least five for the right, placed on the plate holder; in no instance, however, for a longer period than five minutes. In order to obtain a picture of his elbow joint he placed it about four inches below the tube, which was of the ordinary focus pattern, the cathode a cup-shaped aluminum disc, the anode a plate of platinum set at an angle of forty-five degrees to the long axis of the tube. The focus he endeavoured to have directly over the joint. The arm was partly flexed and resting semipronated on the plate holder. A second exposure, lasting seven minutes, was tried a day or two later, and a third, lasting ten minutes, on the evening of the following day. This last was on the 8th of September. At the time a slight tingling of the skin was noticed, so slight, however, that he was not certain that it was not due to the effects of imagination, as during the " sitting " he had been going over, mentally, Tesla's arguments in favour of the assumption that the so-called rays are really due to minute particles thrown off from the cathode. In each instance the arm was covered with his usual clothing, con- sisting of heavy woollen underclothing, shirt and coat sleeve. A day or two later his attention was attracted to the appearance of the dorsal surfaces of both hands by a slight sensation of irritation and itching. At first sight the appearance suggested sunburn, but, as the weather had been cloudy for a number of days, and further, XYLENE ZINC 400 as his skin had always been more than ordi- narily free from any of the common afEections ^eczema, etc. — ho half jokingly attributed it to the X-rays. On September 18th he felt a slight itching near the elbow which had been exposed to the rays, and that night he found an extensive discoloration of the skin, ex- tending from a point two inches above the joint to a distance of about six inches down- ward toward the wrist, and including about one third the circumference of the arm. In colour it was of a brownish red, punctated at the upper and lower borders and ends and more confluent at the centre. Examination with a lens showed the punctated area to be due to an apparently greater hypersemia around the hair follicles. No vesicles were apparent, and there appeared to be no tendency to their formation. Pressure caused the redness to disappear to a great extent, but not entirely. There was no sensitiveness, but the tempera- ture was decidedly raised above that of the adjacent healthy skin. Traction on the hairs showed no loosening. On September 20th, the affection showing no tendency to become worse. Dr. Kibbe cut out a piece of skin, a centimetre square, from the most deeply discoloured area, without using a local ansesthetic, for he feared to interfere with the structures by injecting cocaine. The stratum corneum was apparently unchanged ; the stratum lucidum was not clearly visible, excepting over small areas, where the under- lying disturbance was seen to be slight. The outer layers of the cells composing the rete mucosum presented the most striking altera- tions, particularly in their nuclei. Taking the stain both with haematoxyiin and lithium car- min very feebly, the nuclei showed in addition a peculiar granular change, which was first indicated in those retaining a more normal reaction to the stain by the formation of a fine nucleolus, which could be seen here and there in the process of division. Near the stratum granulosum the bodies of the cells were appar- ently becoming converted into keratohyalin as a first step to the increase in bulk, as it were, of the stratum granulosum by a development in their interior of coarse granules, staining deeply with hsematoxylin, and also with carmin. With the former they appeared like blotches of India ink ; in some places giving the impres- sion as though the cells had been charred by heat. This was particularly the case around the hair follicles. The corium exhibited the ordinary changes found in a mild dermatitis: capillary dilatation, with collections of round cells scattered through its structure, particu- larly around the hair follicles. No extravasa- tions of blood were noticed. On October 3d Dr. Kibbe noted that des- quamation of the entire discoloured area on his arm was going on, with absolutely no pain, excepting in the locality from which the skin had been exsected. A slight itching was all that now annoyed him. Where the flakes had been detached the hairs seemed to be as abun- dant and as firm as in the healthy skin. There appeared to have been no interference with the healing process of the raw surface pro- duced by the exsection, further than what might have been expected in removing a piece of skin over a joint where every movement would tend to delay cicatrization. He suggests that the few reported instances of pathological phenomena pi-oduced by the X- rays are to be regarded as due to individual susceptibility. XYLENE, or xylol, or dimethylbenzene, CeH4(CHs)2, is a colourless liquid resembling benzene in general properties. Some years ago it had a temporary repute in the treatment of small-pox. Given internally, in quantities not exceeding 45 minims a day in divided doses, it was supposed to mitigate the severity of the disease and to shorten its course. It is reputed to be antiseptic. XTLENOL. — There are four isomeric xyle- nols, three of which, orthoxylenol, metaxylenol, and paraxyUnol, are used in medicine, chiefly in the form of salicylates, the xylenolsalols, in doses of from 3 to 6 grains. The indications for their employment are the same as for that of salol {g. v.). XTLOL. — See Xylene. YARROW.— See Achillea. YEAST. — Beer yeast, or brewer's yeast, cerevisim fermentum (Br. Ph.), is a frothy, semifluid substance somewhat resembling soft soap in appearance, having a peculiar sourish odour and a bitter taste, consisting of the cells of Saccharomyces cerevisice. Brewer's yeast is occasionally used in medi- cine, in doses of one or two tablespoonfuls three times a day. Its employment in this way has been found to prevent the recurrence of boils. It may be given in a glass of beer at meal times. Dr. Cassaet (Semaine midicale, August 31, 1895; British 31edieal Journal, August 31, 1895 ; llierapeutic Gazette, December 16, 1895) reports good results in three cases of diabetes from the administration of brewer's yeast in daily amounts of an ounce, although the ad- ministration of the substance could not be continued long, on account of the practical difficulty in summer of preventing acetous or putrid fermentation. It was taken readily by the patients. The immediate effect was the expulsion, during the few minutes following its absorption, of a very large quantity of gas by eructation ; then in the course of the first or second day extremely fcEtid diarrhoea with abundant gas occurred. After a few days tol- erance was established, and the patient felt better than he had felt for a long time ; his general state improved, his appetite returned, his strength inci'eased, and pain diminished. The weight of the three patients on whom the treatment was tried increased three, five, and eight pounds respectively after the yeast had been administered for a fortnight. The gain in weight was particularly remarkable, inas- much as one of them was phthisical as well as diabetic, and another had diabetes of the grav- 401 XYLENE ZINC est type. On discontinuing the treatment loss ot weight was soon observed again. As to the strength as tested by the dynamometer, an im- provement o£ from twelve to twenty kilo- grammes was noted in the right hand and of Irom seventeen to twenty-two in the left. The urea remained stationary or increased and the proportion of sugar in the urine diminished, in one case by three fourths and in another by two thirds in the fortnight. Brewer's yeast is used externally in the form of a poultice, eataplasma fermenti (Br. Ph.), made by mixing 6 fl. oz. of the yeast with its own bulk of water heated to 100° F., stirring in 14 oz. of wheaten flour, and keeping the mass in a warm place until it rises. This poultice gives offi carbonic-acid gas, and thus proves stimulixnt and slightly anodyne. There are, however, other and better means of accom- plishing all that it can effect. Balier's yeast, or German yeast, yeast freed from water and pressed into cakes, has been used in the treatment of enteroptosis by Dr. A. Giinzburg {Munchener medicinische Wochen- schrift. July 7, 1896; Presse medicale, August 19, 1896) in a large number of cases, with suc- cessful results. Every day a quantity of about the size of a bean was given, and the fermen- tation provoked by the yeast caused a certain degree of flatulence which held and immobi- lized the intestine. Occasionally this flatu- lence became too great and provoked a feeling of distention ; in this case the quantity of yeast had to be diminished. In a general manner, says Giinzburg, this treatment gives the patients a sensation of comfort. They are no longer inconvenienced with flatus, and this is attributed by the author to the peculiar action on the intestine of the carbonic acid which, under the influence of the yeast, is developed in the digestive tract. The stools become regular' and abundant, and the distention of the intestine carries the aorta away from the abdominal wall so that the pa- tients do not feel the beating of this vessel. Finally, the appetite becomes better and large quantities of food can be taken without diffi- culty. Yeast is one of the sources of nuclein (q. v.). YELLOW ROOT.— See Hydrastis. YERBA SAGRADA.— See Lantana. YERBA SANTA, eriodictyon (U. S. Ph.), is the leaves of Eriodictyon glutinosum (or californicum), or Oalifornian tar-bush, a hy- drophyllaoeous plant. Yerba santa has some reputation as a means of palliating chronic pulmonary inflammations. The dose of the fluid extract, extractum eriodictyi fluidum (U. S. Ph.), is from 20 minims to a fl. drachm. The aromatic syrup of yerba santa, syrupus eriodictyi aromaticus (Nat. Form.), is em- ployed as a vehicle to mask the taste of qui- nine and other bitter drugs. ZEA. — See Corn-silk. ZlUC, zincum (TJ. S. Ph., Br. Ph.).— This metal is not itself used in medicine, but is ofiS.- cial for pharniaoeutical purposes. It is de- scribed as " a bluish-white metal showing a crystalline fracture and having a specific grav- ity ranging from 6'9 when oast to 7'3 after it is rolled. Soluble in dilute sulphuric or hy- drochloric acid with evolution of hydrogen gas." It has a peculiar taste and a slight odour when rubbed. It is to be found in the market in the form of thin sheets or of irregu- lar, granular pieces, zincum granulatum (Br. Ph.), or in a fine powder, or moulded into pencils. For therapeutical purposes, zinc is repre- sented by several oificial and a large number of unotficial salts which present nearly every phase of activity in direct proportion to their solubility and power of diffusion, a variation which causes very marked differences in their physiological action. In moderate doses the soluble salts determine emesis which, though less severe than that induced by the salts of copper, is very prompt and thorough, while the insoluble salts tend to allay irritation of the gastro-intestinal tract. In regard to the lat- ter, however, it must be noted that large doses often cause nausea and vomiting, possibly on account of the conversion of a portion into a more soluble salt on contact with the contents of the stomach. Almost all the salts are as- tringent, and the soluble ones are caustic and corrosive agents which in large doses produce severe gastro-enteritis with all the accompany- ing symptoms of irritant poisoning. When applied externally, the insoluble compounds form soothing and protective dressings to irri- tated surfaces, while the soluble ones are as- tringent, irritant, and even caustic. In medicinal doses the zinc salts act as a tonic upon the nervous system and exert a cer- tain, not very powerful, influence to ameliorate spasmodic nervous disorders, such as chorea and epilepsy. It is probable that at some time between the moment of ingestion and that of absorption into the system these salts are changed into the form of an albuminate, and as such exist and are carried about in the blood. Zinc has a tendency to accumulation, though to a lesser degree than mercury, lead, or cop- per, and is excreted from the system more rapidly than those metals. The elimination of the drug is accomplished principally by the liver and intestinal glands, but it has been alleged that it is excreted to a slight degree by the kidneys. The long-continued ingestion of considerable quantities of zinc, whether given for medicinal purposes or inhaled in the form of fumes of the molten metal, may give rise to disturb- ances of the nervous, respiratory, digestive, and haematopoietic systems, characterized by headache, muscular tremor, feebleness, paresis or paralysis, cough, dyspnoea, haemoptysis, vom- iting, diarrhoea or constipation, colic, cramps, anfemia, and other symptoms of interference with the nutrition of the body. The treat- ment of this condition of chronic zinc poi- soning is to hasten the elimination of the metal by means of potassic iodide, laxatives, and warm baths. Dr. Stephen J. Maher, of New Haven, de- ZINC 403 scribes in the New York Medical Journal for December 21, 1895, under the name of " spelter shakes," attaolcs of severe chills followed by fever and profuse perspiration, common among workmen in brass-foundries, and attributed by them to the inhalation of the fumes of molten zinc. These chills are said not to be associated with headache, nausea, or vomiting, and not to exhibit any periodicity or tendency to re- currence except on renewed exposure. As the workmen know that the attacks are of brief duration and consider them without danger, they are not accustomed to summon medi- cal assistance, but endeavour to obtain sleep as quickly as possible, for which purpose it is customary to imbibe considerable whisky. After a few hours they awake exhausted, but otherwise recovered. Cases of acute poisoning by the soluble zinc salts exhibit either the toxic symptoms refer- able to the acid with which the zinc is com- bined or the usual characteristics of corrosive poisoning. In the former case the patient is to be treated for poisoning by the combined acid ; in the latter the acute symptoms must be relieved by washing out the stomach and the administration of bicarbonate of sodium or some other alkaline carbonate, as the best chemical antidote, followed by the ingestion of demulcents, such as milk or flour and water, together with the hypodermic injection of mor- phine in sufHcient quantity to control the pain and vomiting. When an alkaline carbonate can not otherwise be quickly obtained, it is a good method to dissolve soap in water and cause that to be drank. Solutions of the soluble salts are useful for purposes of disinfection in the same manner as most soluble metallic salts and are preferred to many because they do not stain. The therapeutic applications of the zinc salts are as varied as might be inferred from a consideration of their widely dififerent physio- logical actions. In suitable doses they agree in producing a beneficial effect upon certain diseases of the nervous system which is supe- rior to that induced by the salts of any other heavy metal, though not equal to that of the bromides, which have superseded them in the treatment of such diseases. Aside from this property, there is but little agreement in their action, and each salt needs a separate consid- eration. The zinc salts which are official in the United- States, Great Britain, or Germany are the acetate, bromide, carbonate, chloride, iodide, oxide, phosphide, sulphate, and valerianate. These will be considered first, the description of each taken from the U. S. Ph., and will be followed by a number of unofiicial salts, some of which are but little used, while others are employed to a considerable extent. All which are not permanent in the air should be kept in small, well-stoppered bottles. Zinc acetate, zinci acetas (U. S. Ph., Br. Ph.), zincum aceticum (Ger. Ph.). — This salt occurs in "soft, white, six-sided, monoclinic plates of a pearly lustre, having a faintly ace- tous odour and an astringent metallic taste. Exposed to the air, the salt gradually efflo- resces and loses some of its acid." It i3 soluble in about three parts of water and thirty-six of alcohol at ordinary temperatures, in about one and a half part of boiling water, and in three parts of boiling alcohol. When subjected to protracted boiling in watei-, it is rendered less soluble, a portion of the acid be- ing lost and a basic salt formed. Zinc acetate is seldom employed for internal administration, though it has been used as a nervine and to check diarrhoeas. In doses of from 8 to 30 grains it is an efficient emetic. Its principal use is as a local astringent, par- ticularly in gonorrhoea, leucorrhcea, and con- junctivitis, where its action is essentially the same as that of the sulphate, though somewhat less irritating. As a collyrium, it is usually prescribed in the strength of from i to 4 grains to the ounce of water, a drop of which is to be instilled into the eye once a day or oftener. Like all astringent coUyria,' this should be used only in conjunctivitis, and will do harm in certain diseases of the eye which are frequent- ly distinguished with some difficulty from that disease, such as keratitis, iritis, or scleritis. Solutions of about the same strength are used as injections in gonorrhcea, after the acute symptoms have abated, and also in leu- corrhcea. Sir Astley Cooper recommended in gonorrhoea a solution of zinc sulphate and lead acetate, in which a double decomposition ensued and resulted in the production of zinc acetate and lead sulphate. This is not infre- quently useful, as" the astringent action of the zinc salt is complemented by the protection afforded to the urethral mucous membrane by a coating of the insoluble lead sulphate. An ointment containing zinc acetate is fre- quently useful in erythema and herpes. The late Dr. Tilbury Fox recommended as an as- tringent wash in erythema and eczema the following : . 9 Zinc acetate 2 grains ; Rose water 1 fl. oz. M. Zinc 'bromide, zinci bromidum (U. S. Ph.), occurs as a white granular powder, odourless, and having a sharp saline and metallic taste. It is very deliquescent, and is freely soluble in water and in alcohol. This salt is very little used. It was prob- ably introduced into medicine for the purpose of combining the tonic effect of zinc upon the nervous system with the sedative action of the bromides, but it has not proved of special effi- cacy in the treatment of nervous diseases. It is said to have been used in epilepsy in doses of from 1 to 25 grains, but Gowers appears to have voiced the general opinion when he stated that it seemed of small value and to be badly borne. The dose usually recommended is from -i to 3 grains. Zinc carbonate. — This salt is found in an impure condition in Nature as a mineral which is usually amorphous, but sometimes crystal- line, and varies in colour from white to red or green. This mineral, when powdered, is one of the oldest local remedies we possess, com- monly known as calamine, or tutty, and forms 403 ZINC an important ingredient of calamine ointment, which was formerly a favourite dressing for abrasions and superficial cutaneous inflamma- tions and diseases. The place of calamine has been taken in modern therapeutics by the precipitated zinc carbonate, zinci carbonas prcecipitatus (U. S. Ph.), zinci carbonas (Br. Ph.), which is made by the interaction of zinc sulphate and sodium carbonate. It is "an impalpable white pow- der of somewhat variable chemical composi- tion, without odour or taste. Permanent in the air. Insoluble in water or alcohol ; solu- ble in diluted acids with copious efferves- cence." When strongly heated it loses water and carbon dioxide, leaving a residue of zinc oxide. Zinc carbonate may be given in small doses to allay vomiting and irritation of the gastro- intestinal tract, but is seldom used for this purpose. It is slightly astringent and is use- ful as a surgical dressing, particularly for superficial infiammations which need a slight stimulation in addition to protection from the air. For this purpose it may be used as a dry powder, in a lotion, or in an ointment. The powder is also used to dust upon cutaneous surfaces which are in apposition with each other, as a prophylaxis against intertrigo, A lotion recommended by Crocker in acute inflammatory conditions of the skin is : 9 Precipitated zinc carbonate. 8 scruples; Zinc oxide 4 drachms ; Glycerin 3 11. drachms ; Eose water, enough to make 3 fl. oz. M. A good ointment for most purposes is this : B Precipitated zinc carbonate. 3 drachms; Lard ointment 10 " M. Zinc chloride, zinci chloridum (U. S. Ph., Br. Ph.), zirwum chloratum (Ger. Ph.), occurs as a white granular powder or in porcelainlike masses, irregular, or moulded into pencils, odourless, of such intensely caustic properties as to make tasting dangerous, unless the salt is dissolved in much water, when it has an as- tringent, metallic taste. It is very deliques- cent. It is soluble in 0-3 part of water at 15° C. (59° F.), forming a clear solution which, on protracted boiling, deposits a basic salt. It is very soluble in alcohol, less soluble in ether, and has an acid reaction. An impure zinc chloride was obtained and described by Glauber in 1648, and another im- pure form was described as " butter of zinc ' by Hellot in 1735. When applied to the denuded tissues of the body, this salt exhibits a great affinity for the water there present, coagulates the albumin, shrivels the blood-vessels, and converts the whole into a dry, grayish, odourless mass, or eschar, which is thrown off in a week or two by the living tissue beneath. The coagulation of the albumin of the destroyed tissue serves to form a barrier which limits the caustic ac- tion of the salt and prevents its deeper pene- tration. When zinc chloride is thus applied to living tissue it causes pain for from six to eight hours, which, though said to be less se- vere than that occasioned by arsenic or corro- sive sublimate, is sufficiently intense. Internally, the action of zinc chloride in small doses is that of a weak nerve tonic, but larger quantities produce the symptoms of acute irritant poisoning, the treatment for which has already been described. It is not oftcTi used for internal medication, but when such administration is desired it is best to dissolve the salt in spirit of ether, in the pro- portion of a drachm to an ounce. Of this solution from 4 to 8 minims may be given twice a day. It has been alleged that in the early stage of pulmonary tuberculosis hypo- dermic injections of a solution of this salt tend to promote the formation of fibrous tis- sue and check the progress of the disease. It is recommended to be given in doses of 3 minims every three or four days, for five or six times, and it is slated that no objection- able local or constitutional effects are pro- duced by such administration. The escharotic, or perhaps it might better be called mummifying, property of zinc chloride has been made use of for the removal of malig- nant and other morbid growths, such as n(si'i, warts, and condylomata, to destroy " inoper- able " aneurysms, to open abscesses in situa- tions where puncture or incision would be dangerous, and to cleanse the surfaces of gan- grenous ulcers. The absence of .danger of absorption of the drug and the natural limita- tion of its caustic action, together with its power, render it one of the most useful agents which we possess for the purpose of removing neoplasms, but the advisability of using any such agent for the removal of cancerous growths when extirpation with the knife is possible is very questionable. Although the pain caused by the caustic action of zinc chloride is considered to be less than that oc- casioned by other powerful caustics, it is never- theless far greater than that of excision, even when performed without anassthesia, and it is doubtful if the statements of those who main- tain its superior efficacy can be substantiated. It has no selective affinity for the diseased rather than the healthy tissue, but destroys both alike, and the complete extirpation of a cancerous growth certainly appears to be as likely to prove curative when performed with a knife as when done by the chemical action of a caustic. Sometimes and for vari- ous reasons excisions of a malignant tumour is impracticable, and then in a certain number of cases this method of removal is valuable. A certain amount of danger, albeit very small, attends the use of zinc chloride as a caustic for the purpose of removing cancerous growths, as is demonstrated by a case reported by Dr. Nichols in the Boston Medical and iSurgioal Journal. An epithelioma of the lip was first washed with a solution of caustic potash, and then a paste containing nearly 25 per cent, of zinc chloride was applied. This caused great pain in the growth, fol- lowed by pain in the region of the stomach, and then succeeded by unconsciousness, ster- torous breathing, dilated and fixed pupils, a ZINC 404 small and weak pulse of 110, flushed face, cold perspiration, convulsions, coma, and death in about eight hours. The autopsy failed to re- veal any internal lesions which could account for the sudden death. The epithelium acts in a measure as a pro- tection against the action of this salt upon the subepithelial structures, so when zinc chloride is to be used for the purpose of removing mor- bid growths the cuticle, it present, should first be removed by means of acid nitrate of mer- cury or by a blister, and the preparation should then be applied to the raw surface. The satu- rated solution has been used for this purpose, but usually the salt is applied in the form of a paste of a strength proportioned to the situa- tion and depth of the growth which it is de- sired to extirpate. The oldest, and perhaps best known, paste is Canquoin's, which is made by mixing zinc chloride with wheaten flour in proportions which vary from one to two to one to five, and adding a sufficient quantity of water to make a paste. This is to be applied to the denuded surface, which should be surrounded by some protective covering to the neighbouring skin, such as a thick layer of simple cerate satu- rated with chloroform, which serves this pur- pose very well. The paste is applied from one twelfth "to one third of an inch in thickness and allowed to remain several hours, both the thickness and the length of time to be deter- mined by the depth to which it is desired that the caustic action should penetrate. After removal of the eschar, renewed applications are necessary until the neoplasm has been re- moved. The paste is frequently moulded into pointed pieces, known as "caustic arrows," which are plunged into the substance of large tumours to secure their removal. Other pastes have been recommended which differ from Canquoin's in that they contain various admixtures of other drugs or are made with other diluents than flour, such as an- hydrous sulphate of calcium, gutta-percha, gluten, and zinc oxide, but all are used in the same manner, and with the same precautions, to accomplish the same purpose and present very few practical differences. But another method of applying zinc chloride for its caus- tic action is that of Cooke, in which lint is saturated with the deliquesced salt, cut into pieces of the size required and applied in a similar manner as the paste. Zinc chloride is a very active antiseptic and disinfectant. A 5-per-cent. sokition is sufB- cient to destroy most micro-organisms, but a SO-per-cent. solution is necessary for the de- struction of anthrax spores. The official so- lution, liquor zinci chloridi (Br. Ph.), contains about 50 per cent, of the salt dissolved in water, and is a clear, colourless liquid of a very astringent, sweetish taste and acid reaction. Burnett's disinfecting fluid is a similar but somewhat stronger preparation. Both are useful as disinfectants and deodorizers for sinks, water-closets, drains, and other places where such an agent is needed. They are dangerous poisons, and fatal results have been occasioned by their ingestion. Useful antiseptic lotions for suppurating wounds and putrid ulcers may be made by di- luting the official solution to the strength of from 2 to 10 minims in an ounce of water. Such a lotion serves to cleanse the surface, and will not infrequently stimulate old and indo- lent ulcers to a coudition of healthy activity and repair. A stronger solution is useful for the irrigation of dissection wounds. Small cystic tumours, ganglia, ranulm, and nasal polypi have been injected with weak so- lutions of zinc chloride in order to destroy them, but this is not usually so satisfactory a method of treatment as removal by the ordi- nary surgical procedures. Polaillon asserts that he has obtained as good results in the treatment of hydrocele by the injection of weak solutions of zinc chloride as from the similar use of tincture of iodine, and that less pain is caused by the former. [M. Leon Derville (Journal des sciences medicates de Lille, January 18, 1896 ; JVew York Medical Journal, February 22, 1896) de- scribes a mode of treating lupus when it is in the form of isolated nodules by what he calls dilaceration followed by applications of zinc chloride. The procedure is as follows : A scarificator is introduced into the centre of the tubercle and pushed until it is arrested by the cicatricial tissue which surrounds the lupous nodule ; a rotatory movement is then rapidly made which tears the tuberculous tissue and often removes fragments at the same time. Employed in this manner, says the author, it not only dilacerates the diseased tissue, but it removes a part of it in the same way as a sharp curette does. After the tubercle has been torn away, a small crystal of zinc chloride is put into the little cavity, and almost immediately the bleed- ing stops. A small black patch then forms, and this is surrounded by a whitish circle, a small eschar. This becomes dry and forms a crust over the lesion, and under it cicatrization takes place. This crust usually falls off be- tween the tenth and the fifteenth day, leaving only a reddish mark. The advantages of this process, says M. Der- ville, are the following: 1. It is scarcely pain- ful, and consequently is well borne by the patients. 2. It does not interfere with the patient's occupation ; it leaves a few crusts only on the face, and does not require any dressing. 3. It gives rapid results. It is not rare to see a small nodule destroyed at the first application and replaced by a sclerotic tissue which, by becoming retracted, can have only the most favourable influence on the sur- rounding tissue. The disadvantages are that zinc chloride leaves cicatrices, often irregular and promi- nent, but this, says M. Derville, is of slight importance if they are on the body, but on the face they become deformities, and for this reason it should not be employed on the latter. Another disadvantage is the sclerotic action of zinc chloride on the tissue, which, by becom- ing shrivelled, may cause a shrinking of the natural oriflces. If the nodules are situated near the mouth or the nostrils, says the au- 405 ZINC thor, other procedures are preferable, except in cases in whicli the lupous patches are very small. M. Derville says that he does not maintain the absolute efBcacy of this treatment, for re- covery after a single application can not be hoped for unless the tubercles are superficial and not very extensive. When they are, the treatment has to be repeated several times. Usually an interval of tvpo weeks should elapse between the applications ; at the end of this time the crusts fall off or are easily detached, and dilaceration and cauterization may be re- sorted to again. This procedure, he says, if used prudently in the beginning, may be of some use in practice ; it may cut short a long and tiresome treatment, and also rapidly check a relapse in the same region.] In diphtheria Wilhelmy recommends the local application of a 20-per-cent. solution on pledgets of cotton to the false membrane on the tonsils and pharyngeal walls. This se- cures the removal of the false membrane and, though it causes severe pain, the treatment is said to be remarkably efBcacious. Solutions of from 15 to 60 grains to the ounce are useful local applications in cases of chronic pharyngitis, or, in general terras, to mucous membranes which have undergone fibroid degeneration or show the results of chronic inflammation. In chronic laryngitis such applications have occasionally been made to the vocal cords and the epiglottis. A solu- tion of 2 grains to the ounce is sometimes use- ful for the purpose of irrigation in cases of empyema of the accessory nasal sinuses, as well as in chronic suppurative otitis media. Solutions of from ^ to 2 grains to the ounce of water have been used in chronic conjuncti- vitis, and, according to some authors, may be advantageously alternated with silver nitrate in the treatment of trachoma. Zinc chloride has also been used in gonorrhoea! and diphthe- ritic conjunctivitis, but if used at all in con- junctival diseases, it should be with great caution and in very weak solutions. The same caution should be observed in its use as an injection in gonorrhoea and leucorrhoea, for which purpose it is sometimes employed. Zinc iodide, zinci iodidum (U. S. Ph.), oc- curs as a white, granular powder, odourless and having a sharp saline and metallic taste. It is of acid reaction, very deliquescent, and apt to absorb oxygen from the air and to ac- quire the colour of the iodine thus liberated. It is readily soluble in water, alcohol, or ether. Zino iodide has not become a popular drug. It has been given internally In chorea and in scrofulous diseases of the skin and eyes, but not with especially brilliant results. For this purpose it is best administered dissolved in syrup, in doses of from -J- grain upward. It possesses caustic properties which, though not so powerful, closely resemble those of the chloride, but it is seldom, if ever, used as a substitute for that salt. In the form of a 10-per-cent. ointment, it has been used as a substitute for potassic iodide to promote the resorption of tumours, but it does not appear to possess any advantage over the potassic salt as a sorbefacient. The best results obtained from the use of zinc iodide have been in the treatment of chronic inflammations of the mucous mem- branes. Thus a 3-per-cent. solution may be used as a lotion in post-nasal catarrh, and Lefferts considers that a nascent zinc iodide, made by the addition of a mixture of 240 grains of potassic iodide, 480 grains of iodine, and 3 drachms of water, drop by drop, to 200 grains of zinc sulphate and 140 minims of dis- tilled water, forms an escharotio well adapted for use in the throat and nose. Solutions of zinc iodide have been successfully used to re- duce the size of chronically enlarged tonsils. In 1859 Lente recommended the application of a solution of from 5 to 10 grains to the ounce to be thrown against the mucous membrane at the mouth'of the Eustachian tube, in cases of its catarrhal swelling, for its astringent effect. He says that it is as efficacious as silver nitrate, which is frequently used for this purpose, and at the same time possesses a less disagreeable and persistent taste. In chronic conjunctivitis a J-of-1-per-cent. solution has been employed as a collyrium. The following ointment may be of service in acne : 5 Zinc iodide 5 grains ; Vaseline 1 oz. M. The ofiicial zinc oleate, oleatum zinci (U. S. Ph., Br. Ph.), is composed of five parts of zinc oxide in ninety-five parts of oleic acid, and con- sists of a fine pearl-coloured powder, soft and soaplike to the touch. This preparation is use- ful in cutaneous diseases where ointments are not well borne, and is recommended as a useful application in hromidrosis and in hyperidro- sis, particularly of the axillie, genitals, and feet. With salicylic acid or French chalk it has been used in the treatment of comedo and acute vesicular eczema. In the combination of one part of zinc oleate to two parts of iodo- from, it has been recommended for erosions of the OS uteri. [The official ointment of zinc oleate, un- guentum zinci oleati (Br. Ph.), consists of equal parts by weight of zinc oleate and soft paraf- fin,] Zinc oxide, zinci oxidum (U. S. Ph., Br. Ph.), zincum oxydatum (Ger. Ph.), is an amor- phous white powder without odour or taste. It gradually absorbs carbon dioxide from the air. It is insoluble in water or in alcohol, but soluble without effervescence in diluted acids and in ammonia water. This salt of zinc is found in Nature combined with the red oxide of manganese to form the mineral zincite. It is known in commerce as zinc white. Although zinc oxide is insoluble in the ordi- nary solvents, it is certain that some portion does enter into the circulation after ingestion into the stomach, and it is probable that a chemical change takes place in the salt on con- tact with the contents of that viscus. which converts a portion into a more soluble salt. ZINC 406 Possibly this conversion is into the albuminate, or perhaps into the lactate or chloride, which may be in turn changed into the albuminate. But whatever may be the nature of the chem- ical changes which take place, the absorption of zinc into the system after ingestion of the oxide is proved by the appearance of physio- logical symptoms after repeated doses. The experiments of D'Amore, Falcone, and Mara- maldi have demonstrated that sufficiently large doses, steadily repeated, will cause intoxication and death, at least in dogs. They gave these animals 7f grains of zinc oxide by the mouth daily, and noted as results the following symp- toms : Vomiting, feebleness, great emaciation, partial loss of sensation, a diminution in the number of the red blood-corpuscles, and a less- ened excretion of urine, which was found to contain albumin, sugar, zinc, and blood. The dogs lived from ten to fifteen days, and the post-mortem examination revealed extreme pallor everywhere, with disseminated areas of fatty degeneration in the liver, kidneys, and pancreas, surrounded by vascular and inter- stitial disturbances. The most marked lesions of the central nervous system were atrophy of the cells of the anterior cornua of the spinal cord, with some swelling of the nuclei. In medicinal doses, zinc oxide acts as a mild intestinal astringent and nerve tonic. In com- bination with bismuth and pepsin, it has proved an excellent remedy for the summer diarrhoea of children. Combined with carminatives and morphine, it is efficacious in gastralgia. It has had a fair trial in epilepsy and other nervous diseases, and, while it is as good as any zinc compound and better than a salt of any other metal, it is really of little value. Bartholow considers that the cases of epilepsy in which this drug is most efficient are those in which the disease is the result of peripheral irrita- tion, having its origin in the stomach. The same author believes zinc oxide to be of pro- phylactic value in spasmodic asthma. Bene- fit is said to have been obtained from its use in the muscular tremor and unsteadiness of chronic alcoholism or poisoning with mercury and arsenic. It has also been used in doses of about 3 grains to check the night sweats of phthisis and the profuse secretion of bronchor- rhoea. Zinc oxide is much used as an ingredient in cosmetics, but when so employed is apt to in- jure the skin. The principal medicinal value of zinc oxide is as a protective,, slightly astringent dressing for cutaneous affections, such as abrasions, excoriations, blisters, burns, fissures of the nipples, lips, and other parts of the body, in- tertrigo, herpes, and eczema. For this purpose it is used in the form of powders, ointments, pastes, and lotions. As a powder, it may be used pure, but in certain diseases, such as ery- thematous and Vesicular eczema, it is frequently too astringent and needs to be diluted with some inert powder, such as lycopodium, kaolin, or starch. Sometimes in eczematous inflammation of the eyelids, especially when due to irritating discharges from the eyes, as in the scrofulous conjunctivitis of children, a powder containing zinc oxide is an efficient application. Occa- sionally a powder 20 per cent, in strength may be applied to the conjunctiva. The following has been pronounced useful in acute eczema of the auricle and also as an ap- plication to ulcers of the sceptum nasi : 5 Zinc oxide 1 drachm ; taf-i^ 1- M. The powdered zinc oxide has also been used, either pure or mixed with alum or tannin, for insufflation into the larynx in cases of laryn- gitis. The official ointment, unguentum zinci oxidi (U. S. Ph.), unguentum zinci (Br. Ph., Ger. Ph.), was first brought into use by Sir Erasmus Wilson. That of the TJ. S. Ph. is composed of 20 parts of zinc oxide with 80 of benzoinated lard ; that of the Br. Ph., of 2 parts of zinc oxide and 11 of benzoated lard ; and that of the Ger. Ph., of 1 part of crude zinc oxide, zincum oxydatum crudum (Ger. Ph.), and 9 parts of lard. This has long been a favourite ointment in cutaneous diseases, and frequently other drugs, such as carbolic acid, tar, and oil of cade, are incorporated with it for their medicinal effect. Other ointments than the official may be made by varying the proportion of the lard, or by using some other fatty excipient, such as vaseline or lanolin. When a non-fatty excipient is chosen, the preparation may- be known as a paste, and is a useful substitute for the ointment in hot weather or when a fatty excipient is disagree- able. A good example of such a paste is the following : 5 Zinc oxide 50 parts ; Salicylic acid, ) , „ „ Carbolic acid, r^^'* " Mucilage of gum J arabic, [-each... 10 " Glycerin, ) M. Neumann recommends in seborrhcea and pityriasis — E Zinc oxide, ) -l. i j i. Lead carbonate, \ ^^^^- • • ^ '^™''^'° ' Spermaceti 1 oz. ; Olive oil, enough to make a soft oint- ment. Another which has been recommended for the same purpose is — E Zinc oxide, ) i, o i Honey, h'"''' 3 scruples; Yellow wax 2 drachms : Almond oil 6 fl. drachms. M. Before either of these, or any other paste or ointment which contains zinc oxide, is ap- plied to the scalp, the hair should be cut short. In the form of a lotion, zinc oxide has some- times been used as a collyrium in conjunctivitis, and the following is recommended as of good 407 ZINC service in dermatitis, irritable acne, and other acute inflammations of tlie sliin : 5 Zinc oxide 2 drachms ; Glycerin 3 fl. drachms ; Lead water li fl. drachm ; Lime water i pint. M. For use in gonorrhma, it has been suggested to mix the salt with lanolin or some other bland oil, and to allow it to remain for some time in the urethra. Zinc oxide has also been recommended as a component of firm surgical dressings. When it is mixed with the chloride and made into a paste, the basic oxychloride is formed, which will be mentioned later. A 10-per-cent. paste made with equal parts of glycerin, gela- tin, and water is recommended by Unna to be rubbed into a bandage which is immediately applied. As the mixture dries, it hardens and incases the limb bandaged in a stiff, immov- able dressing. Zinc phosphide, zinci phosphidum (U. S. Ph.), is a gritty powder of a dark-gray colour, or crystalline fragments of a dark, metallic lustre, having a faint odour and taste of phos- phorus. In contact with the air it slowly emits phosphorus vapour. It is insoluble in water or in alcohol, but soluble in diluted hy- drochloric or sulphuric acid, with the evolu- tion of hydrogen phosphide. This salt has been recommended by Reclus as very satisfactory in some cases of lymph- adenoma. It is readily decomposed in the stomach, and the physiological eflfeets pro- duced by its administration are those of phos- phorus, of which, rather than of zinc, it should be considered a preparation. Zinc sulphate, zinci sulphas (U. S. Ph., Br. Ph.), zincum sulfuricum (Ger. Ph.), occurs in colourless, transparent rhombic crystals, without odour and having an astringent me- tallic taste. It effloresces in drv air. It is soluble in 0-6 part of water at 15° C. (59° P.) and in 0-2 part of boiling water, also in about three parts of glycerin. It is insoluble in alcohol. In small doses given internally, this salt is a tonic and astringent, in larger quantities an emetic, and in still larger an irritant poison. As a tonic it may be used in the same class of nervous diseases as all the other zinc salts, and as an astringent it is sometimes, especially when combined with opium and ipecac, of good effect in diarrhoea and dysentery. Occasion- ally it is useful in hronchorrhcea and in dyspep- sia, but, unless benefit is soon obtained, the use of this remedy should not be persisted in. For these purposes the dose is from i^j to 2 grains, preferably in pill form. Zinc sulphate is a systemic emetic, and causes vomiting when injected into the blood as well as when ingested into the stomach. As it is also but very slightly depressant, it is a valu- able emetic for use in narcotic poisoning as well as in such diseases as croup and whoop- ing-cough and whenever simple evacuation of the stomach is desired. To produce emesis it is usual to divide from 3 to 15 grains into several portions and to give one portion every five minutes until vomiting occurs. A curious result of the long-repeated administration of zinc sulphate is that the stomach becomes re- markably tolerant after a time, so that enor- moiis doses may be taken without causing nausea, but the course of treatment necessary to produce this tolerant condition may result in a superficial ulceration of the mucous mem- brane of the stomach. When an overdose has been taken the symp- toms of irritant poisoning appear and the treatment already described should be insti- tuted. Very few cases of this nature with fatal results are on record. Solutions of zinc sulphate are very useful for topical applications to mucous membranes, on account of the stimulant and astringent ac- tion of the drug. As a coUyrium in conjunc- tivitis it is very popular, although rather more irritating than the acetate. It is adapted to chronic rather than acute cases, and should be used in solutions of from !■ to 4 grains to the ounce of water once a day or oftener. Care should be taken, as with the acetate, not to use such a coUyrium in scleritis, iritis, or kera- titis, conditions which are frequently distin- guished with difficulty from acute conjunctivitis. Solutions of about the same strength have been applied to the vocal cords to relieve vocal fatigue, and may sometimes be of service in acute coryza. Zinc sulphate is an efScient hmmostatic when applied to bleeding surfaces, and is of service in checking epistaxis when applied in the form of a powder or in a strong solution. A solution of 40 grains to the ounce has been employed by Dr. Bean to arrest laryngeal hcemorrhage. Weak solutions have been employed to irri- gate the accessory nasal sinuses in cases of empyema, and to cleanse the nasal mucous membrane in atrophic rhinitis. In catarrhal inflammation of the mucous membrane of the Eustachian tube a solution of 1 to 2 grains to the ounce may be applied to its mouth, and solutions of from 2 to 5 grains to the ounce are frequently useful in acute or chronic cases of purulent otitis media. In inflammation of the external ear weak solutions of from J of a grain to the ounce upward are sometimes of service, but when furuncles are present in the canal the solution needs to be as strong as from 30 to 60 grains to the ounce in order to be useful. Many practitioners consider zinc sulphate one of the best remedies for gonorrhoea which we possess. It is used as an injection, begin- ning with a weak solution and increasing the strength as the urethra becomes more toler- ant. When dry powdered zinc sulphate is sprinkled over the surface of an epithelioma, lupus, or unhealthy ulcer, a, slough is cast off, but as this salt has not the same power of penetration as the chloride, it is not as efficient for the re- moval of malignant neoplasms. Sir James Y. Simpson recommended its use in cancer of the uterus, but it has not been very generally adopted. It is useful for the purpose of re- moving caruncles of the female urethra, warts. ZINC 408 condylomata^ and similar small neoplasms or excresee?ices. Villate's solution has been successfully em- ployed as a local injection for the cure of caries. It consists of — B Copper sulphate, ) ^^^^ _ ^ ^ ^g Zinc sulphate, ) ^ Lead water 30 " . Vinegar 300 " M. The sinuses which lead to the carious bone are washed out with this solution so as to de- calcify and bring away the dead portions. It should not be necessary to state that in ne- crosis no such solution can be expected to re- move a sequestrum unless it is a very small one. Good results may sometimes be obtained in acne by bathing tlie surface with a solution of this salt with equal parts of potassium sul- phate and resorcin. The late Dr. Tilbury Pox recommended as a lotion in erythema, intertri- go, and eczema the following : 5 Zinc sulphate 10 grains; Alum 30 " Glycerin 1 fl. drachm ; Rose water 7-i fl. oz. M. In dermatitis venenata a solution of 30 grains of zinc sulphate to the ounce of water is said to be an excellent lotion. Zinc valerianate, zinei valerianas (IT. S. Ph., Br. Ph.), has already been considered un- der Valerian. The number of unofficial salts of zinc which are used in medicine is very great. Most of them are not of great importance, but some have won prominence and are quite extensive- ly employed at the present time. Zinc albuminate. — This combination is the form into which it is supposed that the various other salts are changed in the digestive organs before they enter the circulation, and this preparation has been introduced into medi- cine with the hope of securing a readier assimi- lation of the drug. It appears in the form of yellowish scales which are slightly soluble in water. It is intended for internal administra- tion in those diseases in which the use of zinc is indicated. Zinc arsenate and zinc arsenite are two preparations which are on the market, but are very little used. Each is a white powder solu- ble in acids and in sufficient quantities pro- duce the symptoms of irritant poisoning when taken internally. Zinc borate, or tetraborate, is an amor- phous white powder obtained by the interac- tion of zinc sulphate and sodium biborate in hot water. This powder has beei^i.used to a slight extent in surgical practice, dusted over the surface of wounds for its antiseptic action. Zinc bromate is a white, deliquescent pow- der, soluble in an equal part of water. It may be used in the same manner as the preced- ing, dusted over wounds as an antiseptic pow- der. Zinc carbolate is a white powder, slightly soluble in water and alcohol. This salt is slightly tonic and antiseptic in its action when given internally and has been used in cases of croup, diphtheria, and foul stomach in doses of | to 5 grains. It is also recommended as an antiseptic for surgical dressings and for use in skin diseases. Zinc chrysophanate is a brownish red powder, readily soluble in slightly alkaline wa- ter and in the alkaline secretions of wounds. The latter quality has suggested its availability as a surgical dressing. Zinc citrate is an amorphous white powder with a sharp metallic taste, not perfectly solu- ble in water, which has been very slightly used in epilepsy in doses of from 3 to 13 grains. •- Zinc cyanide is a snow-white powder, odourless, tasteless, insoluble in water or alco- hol, soluble in diluted acids and in solutions of the cyanides of ammonium and jjotassium. After a while it decomposes and acquires a sweetish, metallic taste. The physiological action of this salt is very similar to that of hydrocyanic acid and its alkaline compounds, sufficiently so that it is sometimes used therapeutically as a substitute for that drug. It has also been used in the same category of nervous diseases as the other zinc salts with about the same effect. It is fre- quently useful in neuralgia, particularly of the trigeminus, and has been employed to relieve gastralgia, dysmenorrhma, and certain cardiac neuroses characterized by pain, palpitation, and disordered rhythm. It may be occasionally given in whooping-cough with good effect, but should never be continuously administered in that disease. Formerly zinc cyanide was used in acute articular rheumatism, but it has been super- seded by other remedies because benefit is un- certain and its administration is apt to be followed by headache. The drug is also said to be anthelminthic. The usual dose is from I to 1-J grain repeat- ed as frequently as every hour or two, because the physiological action appears to be tran- sient. See also under Cyancgen. Zinc and potassium cyanide. — This salt, which is obtained by dissolving zinc cyanide in a solution of potassium cyanide, occurs in colourless or white octahedrons of a sweet and metallic taste. It is permanent in the air and freely soluble in water. The physiological action of this salt is the same as that of zinc cyanide, to which it is frequently preferred in therapeutics on ac- count of its greater solubility. It is pre- scribed in the same doses and may be given very nicely in aromatic sweetened water, but the addition of a small quantity of acid will precipitate zinc cyanide from the solution. Zinc ferrocyanide is a white, tasteless powder, insoluble in water, alcohol, and di- luted acids. The medicinal properties of this salt are the same as those of the cyanide, and it is used in the same diseases. The usual dose is given as from 1 to 4 grains. A good form of adminis- tration is — 409 ZINC B Zinc ferrocyanide 5 grains ; Magnesia 40 '■ Powdered cinnamon. ... 1 drachm. M. Divide into 10 powders. Sig. : One pow- der every four hours. See also under Cyano- Mercury and zinc cyanide. — This is a white powder obtained by precipitation from a solution of potassium and mercury cyanides by means of zinc sulphate, and is probably a mixture rather than a true double cyanide. It was proposed in 1889 by Sir Joseph Lister as a non-irritating, antiseptic, surgical dressing, but was soon declared to be in no way supe- rior to the dressings previously in use. Its germicidal power is said to be slight, but a l-to-1,200 solution will prevent putrefaction in animal fluids. A ready means of preparing a dressing with mercury and zinc cyanide is said to be to dip gauze impregnated with zinc cya- nide into a l-to-4,000 solution of mercury bichlo- ride. This cyanide may also be used in the form of an ointment in the treatment of ec- zema and other cutaneous diseases, taking the place of the oxide. See also under Cyanogen. Zinc gynocardate is a yellowish, granular powder, insoluble in water and dilute acids, readily soluble in alcohol, ether, and chloro- form. This salt has been recommended in the form of an ointment for the treatment of syphilUic skin diseases, psoriasis, prurigo, leprosy, and other cutaneous diseases in which gynocardie acid and chaulmoogra oil have been used. (See Chaulmoogra oil.) Zinc liydrochlorite. — A solution of zinc hydrochlorite is recommended as possessing advantages over the solution of chlorinated soda as an antiseptic in that it is not allcaline and is astringent. It may be used as a lotion or as a gargle. Zinc iodate is a salt, insoluble in water, produced by the union of zinc and iodic acid, which has been used to no great extent as a topical application to affections of the mucous membranes. Zinc lactate. — This salt occurs in short, quadrangular crystals of an acid reaction and an acidulous metallic taste, obtained by dis- placing the carbon dioxide of zinc carbonate with lactic acid. It is soluble in fifty-eight parts of cold and six of boiling water, nearly insoluble in alcohol. This is the most readily tolerated of all the zinc salts, and is therefoi-e preferable to any other for internal administration. It has been used with good results in hysterical amblyopia, and is employed in the same class of nervous diseases as the oxide. The usual dose is from •J- to 1 grain several times a day. Zinc nitrate. — This salt occurs in striated, colourless, pointed, quadrilateral, prismatic crystals, is very deliquescent, is soluble in water and alcohol, and very caustic in its ac- tion. Its chief if not its only use is as a caus- tic in a similar manner to and for the same purposes as the chloride. When mixed with flour and water it forms a paste which can be easily spread, remains soft, and does not con- tract or spread at the edge through absorption of water. It may also be made into pencils in the same way as the chloride, but they must not be dried by means of heat, as that will cause some decomposition of the salt. The late Dr. Tilbury Fox recommended in severe and chronic cases of lupus erythematosus the following : 5 Zinc nitrate 1^ drachm ; Distilled water, ) Glycerite of starch, [■ each ... 1 " Flour, ) M. This is formed into a paste and applied to the surface of the lupus. When the paste is withdrawn a poultice is applied and the raw surface left by the removal of the eschar is dressed with an ointment like diachylon or zinc oxide. Eeapplication may be needed, and the strength of the paste may be increased according to circumstances. Zinc oleostearate. — This is a semifluid, white, oreamlike product of the combination of zinc stearate with benzoinated liquid albo- lene. It is of neutral reaction, almost taste- less, with the odour of benzoin, tenacious to the mucous membrane, to which it is non- irritant and acts as a protective. It is espe- cially intended for use in diseases of the naso-pharynx, pharynx, and larynx, to which it is comparatively easy of application, and as a vehicle for the application of other drugs, many of which may be combined with it, to the mucous membranes of those parts. [Dr. Walter F. Chappell {New York Medical Journal, May 30, 1896) says, speaking of the use of zinc oleo-stearate in conjunction with other drugs, that the following combinations have, in his experience, proved most valuable : Oleo-stearate of zinc with balsam of Peru, in conditions requiring stimulation and healing ; with liquor plumbi subacetatis, in acute rhini- tis or the coryza accompanying a common cold ; with boric and carbolic acids, in copious wa- tery nasal discharges and hypermmic condi- tions ; with iodine, in dry and atrophic rhinitis and ozcena; with tannic acid, in nosebleed, and catarrhal conditions characterized by yellow discharges; with camphor and menthol, it is cooling, and therefore available in hay fever and coryza; with acetanilide, it is applied after operations as an antiseptic and protec- tive ; with antipyrine, as a hfemostatic in re- curring epistaxis, and as a sedative in irritable conditions of the raucous membrane ; with ole- um pini pumilionis and eucalyptol, it is sooth- ing and curative as an intratracheal injection, in chronic bronchitis and asthmatic affections ; with oleum pini pumilionis, as a sedative in irritable conditions of the nasal mucous membrane characterized hy excessive S7ieezing ; and with orthochlorphenol, it is valuable in syphilitic ulcerations and ozcena.] Zinc oxy chloride. — When a solution of zinc chloride is added to the oxide a basic, insoluble compound, called the oxychloride, is formed, which soon dries and becomes very hard. It is used by dentists for temporary and some- times for permanent fillings for the teeth. ZINC 410 The characteristics which recommend it for this purpose are that after it has hardened in the cavity in which it has been placed it neither expands nor contracts, that it is of about the same density as dentin, and that it retains its white colour. When the wet mixture of zinc oxide and chloride is to be introduced into a dental cavity care must be taken that the pulp is not exposed to its action, because in that case it acts immediately as a painful escharotio. The hardness, firmness, and insolubility of this salt have also been made use of to some extent in the preparation of resistant surgical dressings. Zinc oxide mixed with one tenth as much zinc chloride and made into a paste with an equal weight of water has been recommended as an air-tight, firmly adherent and non-irri- tating dressing to be applied to sutured wounds, particularly when they are in situations which render them liable to infection from the bodily secretions. Thus, if applied after an operation for harelip the nasal secretions pass harmlessly over its surface, and the wound is effectually protected. After an operation for strangulated hernia also it may perhaps be of service. Such a dressing should be removed by the fifth or sixth day. It will very likely have become somewhat loosened by that time, but when it is still adherent it will need to be cut away with scissors. [Dr. G. Betton Massey, of Philadelphia {Journal of the American Medical Associa- tion, August 24, 1895), finds nascent zinc oxy- chloride valuable as an adjuvant to the gal- vanic treatment of hcemorrhagic endometritis and incipient malignant conditions of the uterus. The positive electrode, made of zinc, is inserted into the uterine cavity, and the passage of the current leads to the formation of the oxychloride. Owing to the practical difBoulty that has, 'he says, at times resulted from the adhesion of the electrode to the sur- face after a prolonged application, and also on account of the roughened surface rapidly at- tained by the electrode, he has been led to amalgamate the zinc freely with mercury be- fore using it, and is convinced that the expe- dient is a valuable one. Not only does this keep the zinc surface always smooth, lubri- cated, and non-adhesive, says Dr. Massey, but a new value is attained in the use of a nascent oxychloride of mercury in addition to the oxy- chloride of zinc and a far more efficient altera- tive and antiseptic action results.] Zinc permanganate occurs in crystals which closely resemble those of potassium per- manganate. It is hygroscopic, soluble in water, and unites with organic substances and with alcohol to form explosive mixtures. This salt was recommended by the late Mr. Berkeley Hill as an injection in acute gonorrhoea. For this purpose it should be used alone, dissolved in distilled water, in the strength of 1 to 4,000, which is not irritating to the urethra. [Dr. A. S. Hotaling, resident physician to the Bay View Hospital, Baltimore (Medical I^ews, November 7, 1896), reports that zinc perman- ganate has proved more satisfactory in his hands than any other remedy in both acute and chronic cases of gonorrhoea. Its effect, he says, is discernible almost immediately, the discharge in the majority of cases becoming greatly re- duced after a few injections. After the stage of acute inflammation has subsided, the injec- tions are made four or five times a day, after urination, with an ordinary blunt-pointed hard-rubber syringe, with a capacity of from 3 to 4 drachms. His rule is to begin with a solution of half a grain to the ounce of water, gradually increasing it to a grain and a half. An alkaline diuretic is given, and the hygienic part of the treatment is followed closely in every case. The treatment is conducted under his personal supervision, instead of by the patient. He reports fifty-eight cases, of which fifty were permanently cured. In thirty-three cases it was the first attack of gonorrhoea. The average duration of urethritis before the be- ginning of the treatment was about three weeks. The average time that elapsed be- tween that of beginning the treatment and that of the cessation of the discharge was nine days. The cure was pronounced permanent in an average of twenty days after the treat- ment was begun. Zinc phospliate is a white powder, insoluble in water, but soluble in acids, which is obtained by the interaction of zinc sulphate and an al- kaline phosphate. It may occur as the diphos- phate or triphosphate, the former of which is the more soluble. This salt was introduced by Mr. Barnes, of London, who thought it pos- sessed special advantages for the treatment of certain forms of nervous diseases. Hpilepsy attended with disorders of the uterine func- tions, and the nervous disorders which occur in enfeebled persons, especially in exhaustion from over-excitemeiit, seemed much benefited by doses of from 2 to 5 grains, especially when combined with free phosphoric acid. In com- bination with quinine it was pronounced valu- able in oases of insanity duriiig convalescence from fevers. It has been tried with but little success in locomotor ataxia and general par ralysis. Zinc salicylate occurs in long, colourless, satiny, needlelike crystals, which have a sweet, somewhat bitter and styptic taste, are soluble in about twenty-five parts of cold water, freely in boiling water, and in three and a half parts of alcohol. This salt is used solely for topical applications as an astringent and antiseptic agent. It may be sprinkled over the surfaces of ulcerous and other inflammatory cutaneous diseases, may be insufflated into the nose in the treatment of nasal catarrh, and may be applied as acoUyrium in conjunctivitis in solu- tions of from one half to one per cent, in strength, but it does not present any special advantages over other better-known prepara- tions. Zinc sozoiodolate. — This salt occurs in colourless, needlelike crystals, which are solu- ble in twenty parts of water and in alcohol. It has been used in solutions of from one half to one per cent, in strength in acute and chronic blennorrhoea and gonorrhoea, usually in combi- nation with other drugs. In acute gonorrhoea the admixture of opium to the solution is fre- 411 ZINC quently advisable, while in chronic oases the salicylate of bismuth has been recommended as a useful combination. A stronger solution has been used as a mouth wash. It has also been used mixed with some inert powder to the strength of from 5 to 20 per cent, in catarrhal inflammation of the nasal and pha- ryngeal mucous membranes. Zinc stearate compound. — This is the pro- prietary name of a light powder obtained by the combination of a soluble zinc salt with a mix- ture of stearic and other fatty acids. It is insoluble in water, slightly soluble in alcohol, and soluble in oil and turpentine. It may be used as a toilet powder, or as a protective in intertrigo, abrasions, and acute cutaneous dis- eases, but is intended principally as a vehicle for the local application of drugs used in the treatment of diseases of the cutaneous and mucous surfaces. Zinc subgallate. — This is an odourless, non-toxic, non-irritating, greenish gray powder, of neutral reaction, insoluble in water or alco- hol, containing 44 per cent, of zinc oxide and 56 per cent, of gallic acid. Internally it has been used in doses of from ^ to 4 grains in fermentative dyspepsia and in night sweats. Its chief'use is externally as an antiseptic and desiccant dressing in the treatment of eczema, fresh and septic wounds, and hem- orrhoids, applied pure or diluted with inert powders, or in the form of an ointment. It has also been used in affections of the nasal mucous membrane, in chronic purulent otitis media, and in gonorrhea. For the latter dis- ease it is used suspended in the proportion of one to sixteen in mucilage and water as an in- jection. Zinc sulphide. — This compound occurs in Nature as " blende," but as prepared for med- ical use is in the form of an impalpable powder. It was recommended by Duhring as a local ap- plication in subacute forms of lupus erythema- tosus and in seborrhea of the face. For r.his purpose the following lotion, in which this salt is obtained by double decomposition, should be applied to the surface and the sediment allowed to adhere : R Zinc Sulphate, ) „„„i. i a j, . Potassium sulphide, \ ^^"^^ • • * A- ^r. ; Rose water 3 fl. oz. ; Alcohol 3 to 6 fl. dr. M. Zinc sulphite. — This salt is obtained by the interaction of six parts of zinc sulphate and five and a quarter parts of sodium sulphite in solu- tion, a reaction which takes place slowly, but is said to progress gradually to completion. It is not very soluble in water, but is soluble in excess of sulphurous acid, and is recommended as neither poisonous nor irritating. Tichborne says, in the Medical Press and Circular for October 13, 1893, that he introduced this salt many years ago as one especially adapted for antiseptic purposes. Any fabric can be im- pregnated with it without the use of any ad- hesive material by first boiling it in water to cleanse and sterilize it, then pouring over it a boiling solution of the above-named salts and 70 allowing the whole to stand for twelve hours. The double decomposition leaves the sulphite entangled in a semisoluble condition in the meshes of the fabric. He claims that this salt exhibits not only the antiseptic properties of zinc chloride, but also the special action of the sulphites and combines with these the healing qualities of zinc oxide. He also states that this salt is sufficiently soluble to maintain a germi- cidal condition in any supernatant fluid, and ascribes this power to the slow absorption of oxygen by the sulphite and its consequent change into the more soluble sulphate. This property gives it, in his opinion, a peculiar ad- vantage as a disinfectant for the stools of pa- tients with typhoid fever and cholera. Zinc sulphocarbolate, zincisulphocarbolas (Br. Ph.), is described in the British Pharma- copoeia as occurring in " colourless, transparent, tubular, efflorescent crystals, soluble in about twice their weight of rectified spirit or of water." The appearance of the crystals varies from col- ourless to reddish according to the process of manufacture. They are odourless, of acid or neutral reaction, and have a sfimewhat bitter and astringent taste. During the past few years zinc sulphocarbo- late has come to be considerably used in the treatment of intestinal disorders, particularly those of childhood, and appears to act both as an astringent and as an intestinal antiseptic. It is thus indicated in all cases in which the oc- currence of foetid stools with tympanites shows the presence ot fermentative processes in thegas- tro-intestinal tract, and excellent results have been obtained from its use in cholera infantum, cholera morbus, and typhoid fever. As com- pared with the other sulphocarbolates, the zinc salt seems to have the better effect in these diseases, possibly on account of its astringent and nerve-tonic action. In cholera infantum it may be given in doses of from J^ to 1 grain as often as necessary, usually every two hours, until the stools reassume their normal appear- ance and lose their offensive odour. As the symptoms pass away the intervals between the doses should be lengthened. In cholera mor- bus and diarrhoea of adults the usual dose is 2^ to 5 grains every two hours until the fer- mentative processes in the stomach and intes- tines are checked. The benefit is frequently quite marked and rapid, the temperature falls, vomiting, tympanites, and diarrhoea subside, and then the drug is to be given at longer in- tervals until stopped. When the first doses are rejected by the stomach they may be repeated every fifteen minutes until one is retained. When the lower bowel is involved in either children or adults enemas of from 5 to 40 grains of zinc sulphocarbolate to the pint of warm water may be of good effect. In the treatment of these diseases it may often be of advantage to combine with this drug others which are indicated in these conditions, such as bismuth or chalk. In typhoid fever this drug has done good service in controlling the diarrhoea, and it has been said to be able to abort attacks of this disease if given during the incipient stage in doses of 2 grains every three or four hours. Good results have also ZINC 412 been reported from its use in chronic intes- tinal catari'h and heematemesis. It is also said to have been of service in the vomiting of preg- nancy, given in combination with small doses of calomel, and to have been beneficial in scarlet fever. On account of its unpleasant taste it is best administered in the form of tablets. Externally, zinc sulphooarbolate has been used in solutions of from 1 to 5 per cent, as an antiseptic lotion, and as such is less apt to cause irritation than carbolic acid. The same lotion is useful in balanitis, and a solution from 0-5 to 3 per cent, in strength has been recommended for irrigation of the urethra in gonorrhma. In syphilitic and catarrhal laryngitis and pharyngitis a spray of a 1-per- cent, solution has been used with some bene- fit. Similar solutions have also been employed as douches for chronic purulent otitis media and for eczema of the external auditory canal. This drug has also been used for pityriasis capitis. Zinc sulplioiclitliyolate, or ichthyol- sulphonate, is a brownish-bla;ck, tarlike mass which was introduced into medicine together with the other compounds of sulphoichthyolic acid for the purpose of facilitating the use of iehthyol. The zinc salt is not so good as the other sulphoichthyolates for internal adminis- tration and is seldom used, but may be given in doses of from 4 to 15 grains in cases of chronic rheumatism, chronic catarrhal dis- eases of the stomach and lungs, chronic ca- tarrhal cystitis, chronic nephritis, chronic gonorrhma, and diabetes. Externally it may be used in the form of a liniment, incorpo- rated in soap, or in the form of an ointment, 45 grains to the ounce, in cases of acute or chronic rheumatism, neuralgia, sciatica, lum- bago, intrapelvie inflammatory exudations, frostbites, burns, varicose veins, eczema, pso- riasis, acne, erysipelas, and favus. Zinc sulphydrate. — This is a white, solid precipitate which decomposes on exposure to the air and must therefore be kept under water. It has been recommended for internal use in intestinal troubles dependent on bacterial in- fection in doses of from 0-5 to 2 grains, given preferably in pill form. Externally, it is useful in the treatment of chronic eczema, psoriasis, and vegeto-parasific shin diseases, applied in a 10-per-cent. ointment with lanolin or lard. Zinc tannate is a fine, nearly white powder, insoluble in water, alcohol, or ether, obtained by the interaction of zinc acetate and tannic acid. It has been used to a slight extent in dyspepsia, phthisis, and diarrhceal affections and rather more as a topical application to the mucous membranes. Bonnewyn recommended in conjunctivitis with a muco-purulent discharge — 3 Zinc tannate 30 grains ; Mucilage -J fl. oz. ; Distilled water 6 oz. M. It has some effect as an astringent when ap- plied to the nasal mucous membrane, and has been used as an injection in gonorrhoea. The dose internally is given as from 1^ to 4J grains. Zincohsemol is a dark-brown powder which contains about 1 per cent, of zinc in hsemol. It is slightly soluble in water and is a mild astringent and tonic in its action. It has been used in ancBmia, chlorosis, and diarrhceal affec- tions in doses of from 4 to 8 grains three times a day. Zymoidin is a proprietary article which is said to be composed of the oxides of zinc, bis- muth, and aluminum with iodine, boric, car- bolic, gallic, and salicylic acids, quinine, and other drugs. It has been placed on the market for use as an antiseptic in the form of powder, ointment, solution, or bougie. Matthias Lanokton Foster. SUPPLEMENT. Much has been added to our knowledge since the articles contained in the body of this work were prepared. Thus far, most of the literature of this additional knowledge has remained scattered through periodicals. Besides supplying accidental omissions, it is the function of this Supplement to give the substance of that literature, or at least of its more important portions, and it has been thought best to present it in many instances in almost the original authors' own words. ABRASTOL AIK ABRASTOL.— See Asapbol. ABB.IN. — See under Jequieity (vol. i, page 563). ACETONE. — This substance has recently acquired some fresh importance in medicine as a solvent of celluloid (g. v., in Supplement). , ACETYLENE.— See under Calcium oar- bide. ACTOL. — See Silver lactate, under Silver. ADH.SSOL. — See under Varnishes. AIR, CONDENSED OR RAREFIED. — The use of the pneumatic cabinet is consid- ered by Dr. Chanes E. (Juimby (New York Medical Journal, August 1, 1896) to be a spe- cific and practically certain remedy for pul- monary hemorrhage. The flow of blood, says Dr. Quimby, can be permanently arrested only by the formation of a clot, and the formation of a clot is determined by one or more of three causes : (a) Modification of the blood elements ; (6) reduction of vascular tension with slowing of circulation ; and (c) compression of the bleed- ing vessels. Upon the first of these the cabi- net lias no direct influence. For effecting the two others it is, facile princeps, our most pow- erful measure. To accomplish this we employ continuous respiration under negative differ- entiation with rarefactions of from a half to three quarters of an inch of mercury — differ- ential respiration. In such conditions, a pa- tient respires with the pulmonary circulation under existing barometric pressure, while the entire cutaneous expansion is relieved of from a quarter to half a pound of pressure to the square inch. The result is capillary dilatation with lowering of the systemic vascular tension, by which the venous system is filled to disten- tion, while the pulmonary vessels suffer cor- responding depletion and slowing of their circulation under lowered tension. Should the differentiation obtained by the cabinet alone not suffice, says Dr. Quimby, the use of com-, pressed air for inhalation in connection with the cabinet must certainly cause compression of superficial bleeding vessels. 413 " With hsemorrhage thus arrested," he con- tinues, " we have to consider secondly the pre- vention of its recurrence. For our present purposes the causes of pulmonary haemorrhage may be condensed into two : Increased vascu- lar tension and diminished nutrition, of the vascular walls, resulting in weakening and di- minished resistance. To fully appreciate the beauties of the cabinet action in diminishing tension and increasing nutrjtion, if is neces- sary to bear in mind that vascular tension serves solely the purpose of moving the blood through the vessels, for, if I mistake not, it is now generally admitted that nutritive inter- change depends upon cellular action and not upon mechanical transudation. It is certainly well recognised that the vessels of an organ in functional activity are dilated, while vascular contraction marks those parts in which the cir- culation is relatively diminished. Tissue nu- trition may therefore take place under lowered tension, provided the flow of blood is main- tained. The evident indications in the condi- tion under consideration, then, are to hasten pulmonary circulation as a means of augment- ing tissue nutrition, without increased and, if possible, with decreased vascular tension. It is precisely this which is accomplished by the cabinet, by the motion termed force inspira- tion. When, after a few days', possibly a week's, treatment by differential respiration alone, we feel sure that the protective clots are firmly established, that motion is replaced by forced inspiration. At first, the rarefaction employed is but little more than has been used for differential respiration. But day by day it is increased until the maximum that is deemed advisable for the case in hand is reached. This may require anywhere from two to ten days. What now is the physics of this motion ? Dur- ing inspiration the condition is that just de- scribed for differential respiration, and the action that of a general cutaneous cupping. With the higher rarefaction the effect is greater, and at two inches of mercury, if the breath is held for two or three seconds after the lungs have reached full inflation, the capillary hyper- AIROL ANESTHETICS 414 semia of the skin and the venous distention be- come very evident. At this point the breathing tube is dropped from the patient's mouth, as the controlling valve is closed, and the pul- monary pressure instantly drops to that upon the skin." AIKOIi. — This is a German patented sub- stitute for iodoform as an antiseptic, and is de- scribed as an iodine substitution compound of basic bismuth gallate (dermatol). Professor Coblentz gives the formula as f— OH p „ J —OH ^»ii^ i -OH ^j, [ — COO.Bi<^"- This compound, he says, possesses the absorb- ent properties of subgallate of bismuth as well as the antiseptic properties of its iodine com- bination. It is a greenish-gray, fine, inodorous, and tasteless powder. Light produces no effect on it, while moist air causes it to turn red with loss of iodine. In contact with water, particu- larly when heated, the powder undergoes slow decomposition, becoming red with loss of io- dine. Dilute alkalies and acids dissolve it readily. Haegler (Beitrage zur Mmische Chirurgie, XV, 1 ; Centralblatt fur Chirurgie, January 18, 1896) has made comparative trials of airol, der- matol, and iodoform, and has satisfied himself that airol is less poisonous than iodoform. Moreover, he says, it is free from odour and does not irritate the sound skin. Two points of its superiority to iodoform are its property of parting with a portion of its iodine in the presence of the warm fluids of the body and the fact that, by reason of the bismuth con- tained in it, it is in a high degree desiccative. It is applied for the most part with a powder blower ; it is used also in the form of a 10- or 20-per-eent. gauze, in that of a 10-per- cent, solution in collodion, and, for tuberculous affections, in that of a 10-per-oent. emulsion in a mixture of equal parts of glycerin and water. In the course of a year Haegler has used airol in about two thousand cases, and has observed its decided effect on the tuberculous process, but no untoward action. He regards it as a useful substitute for iodoform. De Sanctis, of Rome (Qazzetta degli ospedali, November 1, 1896 ; British Medical Journal, December 36, 1896), reports having used airol with results which he characterizes as brilliant in intertrigo, both of the secreting and of the pruriginous type. Dusted over the affected parts, he says, it gives immediate relief, sooth- ing pain, subduing itching, and healing exco- riations. He gives as examples of its use two very severe cases. One of these was that of an old woman who had intertrigo of the whole hypogastric region, both groins, one thigh, and part of the external genitals ; the whole sur- face was reddened, raised, and partially cov- ered with a greasy, grayish layer, and in some places eroded to such an extent that the slight- est touch caused bleeding. Local treatment of various kinds had been tried in vain. The ap- plication of airol at once got rid of the burning feeling, which was replaced by an agreeable sense of freshness, and sleep ceased to be inter- rupted by the pain and itching. The powder was applied daily and kept on with a bandage. In four days the eroded surface was completely healed ; a few days later the cure was com- plete, and there had been no complaint of re- currence four months after treatment. De Sanctis recommends airol as one of the best remedies for intertrigo ; it is non-toxic, and its use is not attended with any drawbacks. AKTOL. — See Silver lactate, under Silver. ALBOIiENE. — This is an American pro- prietary refined product of petroleum which is employed as a base for ointments and as a lu- bricant. It is odourless and does not become rancid. Liquid Albolene, which is very readily dif- fused in the form of spray, is a suitable solv- ent for drugs that it is desired to apply to the nasopharyngeal passages. ALLYL STJLPHOCABBAMIDE, AL- LTL SULPHOUE.EA, ALLYL THIO- tJBiEA. — See Thiosinamine. ALLYL TRIBROMIDE, CaHsBra, is de- scribed by Professor Coblentz as a colourless or slightly yellowish liquid which has been rec- ommended as a sedative and anodyne to be given subcutaneously in doses of from 3 to 4 drops, dissolved in ether, in hysteria, asthma, whooping-cough, etc. ALXTMINUM BOBOTANNICOTAR- TR.ATJ!.— This is made by dissolving alumi- num borotannate in a solution of tartaric acid. It is called also cutal. It is astringent and an- tiseptic, and is employed topically, pure or at- tenuated, in catarrhal states of the skin or mucous membranes attended with supersecre- tion. Cf. Tannal. AMBER.— Dr. William Murrell. of Lon- don (Clinical Sketches. February, 1896), says that for some years he has used oil of amber, both internally and externally, in the treat- ment of whooping-cough. He has not kept notes of his cases, but the results have been so satisfactory that the custom of giving it has degenerated into a routine. He has found it useful also in chronic bronchitis and winter cough. In whooping-cough he generally orders a teaspoonful to be rubbed in along the course of the spine, night and morning, before the fire. For rheumatism he finds it better to have it made into a liniment with equal parts of aro- matic spirit of ammonia and spirit of camphor. For internal administration, from 3 to 10 drops may be taken every four hours, on a piece of sugar or on a crumb of bread, but this mode of administration presents some difficulty in the case of children. The following mixture. Dr. Murrell thinks, is preferable : 5 Oil of amber 10 minims ; Powdered gum acacia. . . 1 drachm ; Syrup of orange flowers. 3 drachms ; Oil of anise 3 minims; Water, to 1 oz. M. The difficulty is, he says, in covering the somewhat disagreeable taste of the amber oil. He has made some experiments with the view 415 AIROL ANJi:STflETlCS of obtaining a tasteless amber oil, but the re- sults have been unsatisfactory. He gives the following formula for a liniment : g Oil of amber 6 drachms ; Oil of rosemary, Lach . . . 1 drachm; Oil of origanum, j ' Oil of turpentine 1 oz. ; Linseed oil, to 4 oz. M. Dr. Murrell is satisfied that more extensive trials will show that oil of amber is a useful therapeutic agent. AMMONIUM CHLOBIDE, in drachm doses, has been used successfully in one case of delirium tremens by Dr. Gilbert G. Cottam (Medicine, November, 1896 ; New York Medi- cal Journal, November 31, 1896). Having some knowledge of the patient and his tolerance of drugs. Dr. Cottam began by administering a grain of morphine hypoderraically. This was without the slightest effect. Several hours after the administration of the morphine, and after the symptoms had all become aggra- vated, he gave a drachm of chloride of ammo- nium. This was promptly vomited. After a short time another was given, which was re- tained. It acted quickly and favourably. In fifteen minutes the hallucinations of snakes and lizards had disajipeared, and the patient had become quite rational. In forty minutes he was asleep, and it was not thought neces- sary to continue the administration of the drug. Dr. W. Bourne Gossett, of Independence, Missouri (New York Medical Journal, January 23, 1897), reports the case of a lewd woman who had been "on a drunk" for eight days, and just before he saw her had had the usual " reptile hallucinations." He found her very restless, moving incessantly, and she had to be forced to stay in bed. At once he sent to a neighbouring apothecary's for a drachm of chloride of ammonium, but before it was brought she was beginning to get more ex- cited and seeing " snakes." As soon as he got the ammonium he at once gave her half a drachm in a large quantity of water — four ounces — and had her drink it in one or two gulps. In fifteen minutes she was quieter, and in fifteen minutes more he gave her the other half drachm. In a short time she was asleep and slept for six hours. She awoke feeling much better, and had no more trouble. Dr. Gossett says he would not hesitate to give a drachm and repeat the dose in half an hour if the patient was not better. AMMONOIi. — Am moniated phenylacet- amide ^see under Phenylaoetamide). AMYGDOPHENINE. — This substitu- tion derivative of paramidophenol, /^OCOOCHs H / ^ H H H ,H N< ^COCHOHCeHj, has been employed by Dr. B. Stiive, of Prank- fort on the Main, in the treatment of rheu- matism (Centralblatt fur innere Medicin, November 16, 1895), and found to be very ser- viceable. One of the twenty rheumatic patients to whom he gave it was suffering severely from aortic insufficiency, and this patient was cured of his rheumatism in a few days. In only one of the twenty cases did the remedy prove of no benefit. Dr. Stiive found it use- ful also in neuralgia. He gave it in 15 grains from once to six times a day, in the form of Engel's compressed tablets or in powder, and observed no unpleasant effects,, except .in the case of a woman who, while taking 75 grains a day, complained of slight dizziness on the sec- ond day. AMYL NITRITE.— M. Hayem (Journal des pratieiens, 1895 ; Medical Record, January 18, 1896) says this drug can be given in much larger doses than is usually believed, for he has more than once given from 50 to 100 drops to be inhaled at once, without meeting with any dangerous symptoms. The following is his method of employing the remedy in pneu- monia (Medical Press): 15 drops were poured on a compress and inhaled in the recumbent posture without effort ; a few seconds after- ward the same dose was renewed, and yet 15 drops more were given, so that in the space of five minutes about 50 drops were inhaled. Redness of the face, acceleration of the pulse, and precipitation of the respiratory move- ments followed. These phenomena soon gave place to a slight cough, a thready pulse, dysp- noea, lividity of the face, and cyanosis of the extremities and of the lips. In ordinary cases only one series of inhalations was given daily, while two (morning and evening) were ordered where the symptoms were grave. It did not appear to M. Hayem that the treatment had any marked effect on the duration of the dis- ease, or on the thermic cycle ; the effects seemed to be entirely local, consisting in de- crease of the dyspncea, modification of the expectoration, and attenuation of the stetho- scopic signs. -The drug did not destroy the virulence of the pneumoeocci ; its chief influ- ence was on the pulmonary circulation, pro- ducing a strong flux which facilitated the return of the blood into the alveoli and hast- ening the absorption of the exudation. In a period of two years he had treated seventy- seven cases of pneumonia, with sixteen deaths, by inhalations of the nitrite. Several of the fatal cases had occurred in hard drinkers. AMYLGEORM.— According to the Wiener medizinisehe Blatter for September 3, 1896, this is a chemical compound of formaldehyde and starch, made by a patented process devised by Professor A. Classen. On its coming in contact with living tissue or with the secre- tions, formaldehyde is set free. It is thought to be an excellent antiseptic and deodorizer for wounds, far more energetic than iodoform, odourless, unirritating, and harmless. ANiESTHETICS.— Dr. P. Hewitt and Mr. A. M. Sheild (British Medical Journal, October 36, 1896) have called attention to the impor- tance of the patient's posture during general anaesthesia. They think that, so far as may AN^STILE APOMORPHINE 416 be practicable, the head should be kept in a Kne with the long axis of the body and the face turned to one side when the patient is in the supine posture ; that the lateral posture is of advantage in most major operations within or about the mouth and nose ; and that, pro- vided there is no special contra-indication, the patient should be turned upon his side at onee when the operation is finished. The Laborde method of resuscitation by rhythmical tractions on the tongue has been made the subject of laboratory experiment by Dr. H. A. Haubold, of Bellevue Hospital Medi- cal College (New York 31edical Journal, Janu- ary 23, 1897). His observations have led him to conclude that the Laborde method leaves much to be desired, and he thinlfs it should not be employed to the exclusion of the other methods now in use. AN.a!STILE.^This name has been given to a mixture of ethyl chloride and methyl chloride. It is employed as a local anmsihetic. It does not render the skin so hard as methyl chloride alone does. (Dr. W". C. Daish, Aus- tralian Medical Journal, December 20, 1895.) ANETHOL, or anise camphor, a camphor- like constituent of oil of anise, has been em- ployed to some extent as an antiseptic. ANHALONIXJM LEWINII.— In a pa- per read before the Association of American Physicians in May, 1896 {Medical Record, August 23. 1896), Dr. D. W. Prentiss and Dr. Francis P. Morgan, of Washington, gave an account of their investigation of the medicinal properties of inescid, or muscate, buttons, which they find to " possess properties which are re- markable, the exact likeness of which is not found in any other known drug, and also that it possesses virtues which, when applied in the treatment of certain diseased conditions, may prove the drug a valuable addition to our pres- ent list of therapeutic agents." Prentiss and Morgan experimented on eight young men, and found that the most remark- able visions were the result, the beauty and variety of which were much enhanced by drumming or otherwise marking regular time, after the manner of the Indians. One of the young men described his experience as follows : " The first sensations that followed my tak- ing the drug came upon thoughtlessly closing my eyes. Instantly there sprang into the field of view a host of little tubes of shining light, down which green and red balls the size of peas were constantly rolling. The tubes of light bent themselves into the shape of letters, but they would spell nothing, and slowly curving themselves into grotesque shapes, began to re- volve rapidly, the green and red balls going in the opposite direction with even greater veloc- ity. All the field of view between these silent wheels was filled in with a shifting mass of green. The colours were wonderful. They were the colours of the spectrum intensified as though bathed in the fiercest sunlight. No words can give an idea of their intensity or of their ceaseless persistent motion. The figures constantly changed in form and colour, but always remained a series of fantastic curves, revolving rapidly back and forth upon their own axis. The forms changed through rich arabesques, Syrian-carpet patterns, and plain geometric figures, and with each new form came a new flush of colour, every shade ap- pearing, from pure white to deepest purple. When the eyes opened and the light was turned up, the visions faded like stars going out in daylight, and the room, tables, chairs, and all surroundings came back into real exist- ence and within reach of the hands." In some cases no effect whatever was pro- duced upon the reason or will of the individ- ual. In others there were some slowness of thought and loss of power of expression, and in one of the experiments there was a marked delusion. Dilatation of the pupil was well marked in every case, and persisted for from twelve to twenty-four hours after the drug was taken. The dilatation was accompanied by a slight loss of the power of accommoda- tion and consequent disturbance of vision. More or less depression of the muscular sys- tem existed in every case, and this was the first effect noticed after the drug was taken. It ranged from a feeling of lazy contentment to decided muscular depression. Partial anses- thesia of the skin was present in three of the cases, appearing when the effects of the drug began to wear oS. The heart's action was at first rendered slower and stronger. This was followed by a rise to the normal which contin- ued during the period of greatest activity of the drug. In the cases in which the muscular depression was greatest, slight, if any, depres- sion of the heart was present. The respiration was unaffected in all eases but one. In this it seemed to partake slightly of the general mus- cular depression. Upon the stomach the drug produced an effect which varied from a feel- ing of uneasiness and fulness at intervals to nausea and vomiting. Inability to sleep for at least twelve hours after the infiuence of the drug passed off was a uniform effect. Appre- ciation of the duration of time was lost in all cases — as in the effect of cannabis indica. In one case a snowstorm appeared to last an hour, although in fact the vision continued not more than a minute. There was no constant effect upon the bowels, skin, temperature, or any secretion. Prentiss and Morgan think that the condi- tions in which it seems probable that the use of mescal buttons will produce beneficial re- sults are the following : General " nervous- ness," nervous 'headache, nervous irritative cough, colic, hysterical manifestations, and other similar affections in which an antispas- modic is indicated ; that they will be found useful as a cerebral stimulant in neurasthenia and in depressed conditions of the mind — hypochondriasis, melancholia, and allied con- ditions—as a substitute for opium and chloral in conditions of great nervous irritahility or restlessness, in active delirium and mania, and in insomnia caused by pain. In the last con- dition, they remark, it acts to produce sleep, not as a hypnotic, but by relieving the cause of the insomnia. In full physiological doses 417 AN^STILB APOMORPHINE it produces insomnia, but in therapeutic doses it does not have this effect. Prentiss and Morgan give the dose of an- halonium in substance as from 7 to 15 grains ; that of a 10-per-cent. tincture as from 1 to 3 teaspoonfuls; and that of a fluid extract as from 7 to 15 drops. Dr. D. A. Richardson, of Denver {New York Medical Journal, August 8, 1896). reports a case of occipital and frontal cephalalgia in which the attacks were kept in abeyance by nightly doses of 4 drops of the tincture. In that case these small doses seemed to Dr. Richardson to have a decided diuretic action, and he suggests that anhalonium may act as a solvent of uric acid. One of the alkaloids of anhalonium, aiihalo- nine, has been recommended as a cardiac and respiratory stimulant in the treatment of an- gina pectoris and asthma, but clinical data are thus far insufficient to warrant its use in prac- tice. Not even the dose is stated in the few publications accessible in which it is men- tioned. ANHYDBOGLTJCOCHLORAL. — See Chloralosb. ANTINOSINE.— This is a compound of sodium and nosophene, used for the same pur- poses as nosophene. ANTIPYKINE MANDELATE, AN- TIPYBINE PHENYLGLYCOLATE.— See Tdssol. ANTIPYBINE SALICYLATE. — See Salipyeine. ANTISTREPTOCOCCIC SEBUM, AN- TISTEEPTOCOCCIN, ANTISTREPTO- COCCTJS SERUM. — See under Serum TREATMENT (vol. ii, page 178). ANTIVENENE. — See under Serum TREATMENT (vol. ii. page 188). . APENTA WATER.— This is a Hunyadi water, formerly known as Rakoczy water, that has recently appeared on the market. It is particularly rich in magnesium sulphate, and is a valuable purgative, APOLYSINE.— De Nencki and de Jawor- ski (Presse medicate, October 26, 1895 ; Jtfew York Medical Journal, November 30, 1895) describe this as a yellowish-white crystalline powder of a sour taste, less acid than citric acid, and of a specific odour. It is soluble in cold wa'.er in the proportion of one in twenty- five, and quite soluble in boiling water. It melts at a temperature of 161-3° F. It is easily dissolved both in alcohol and in cold glycerin. In its origin apolysine may be compared to phenacetine. Both compounds spring from paraphenetidine, and there is no difference be- tween them, except that an atom of hydrogen in phenacetine, in the amide group (NHa), is replaced by the element of acetic acid, while in apolysine the same atom of hydrogen is replaced by the citric-acid nucleus. On com- paring the chemical formulas of these' combi- nations, their origin, their formation, and their difference may be more readily understood. They show that apolysine is very closely allied to phenacetine. Apolysine, according to the authors, pos- sesses remarkable antipyretic and analgetic properties. They administered the drug both as an antipyretic and analgetic and as an anti- pyretic only. They employed it in many cases, and in the febrile affections a lowering of the temperature of from one to two degrees was observed, which was maintained tor three or four hours at a time. In painful affections, such as neuralgia, etc., the pain disappeared rapidly after the administration of a few doses, which varied from 8 to 45 grains once a day. The authors state that in many of these cases other analgetics had been used previous- ly without success. Their clinical observations have led them to the following conclusions : 1. Apolysine ad- ministered to fever patients lowers the tem- perature and at the same time prevents a series of coexisting symptoms, particularly pain. 3. Given to patients suffering from neuralgia, etc., it diminishes the violence of the pain, allays hypersesthesia, shortens the duration of the attack, and often completely suppresses the symptoms. 3. Owing to its chemical prop- erties, it acts promptly and regularly, and exercises no injurious effect on the organism. Its employment is contra-indicated during fast- ing and when there are excessive acid secre- tions in the stomach. 4. Finally, apolysine is more soluble than other drugs in the same group, and consequently more promptly and more easily absorbed. Dr. David Cerna, of Galveston {Journal of the American Medical Association, June 20, 1896), who gives the following formula of apolysine : OCjHs C,H,< H OH N< — C< — CH,COOH, COCHj COOH has verified some of de Nencki and de Jawor- ski's statements in experiments on animals, and has found apolysine a prompt and efficient remedy in a case of lumbago, and in one of muscular rheumatism. The dosb for an adult is from 15 to 30 grains. Although apolysine has been said not to be poisonous, Dr. Cerna has known it to kill an animal, and he gives a warning against its routine and indiscriminate employment. APOMORPHINE.— Mr. Edward Balm, of Hyderabad {Indian Medical Record, July 1, 1895), has found apomorphine of great value as an antispasmodic. He says that in the Af- zulgunj Hospital, Hyderabad', Dr. Lawrie used it in the treatment of tetanus on the sugges- tion of Dr. Bomford, of Calcutta, in doses of from tV to i of a grain hypodermically twice or three times a day, and the results were not disappointing. When, in 1894, Mr. Balm took charge of the hospital, he had a unique and distressing case of hiccough in a man fifty years old. He had suffered from it for about six months, and the acts numbered from 30 to 40 a minute. He had been a well-built man, but was reduced to a skeleton, and the sight of food was most loathsome to him. He had tried a lot of native medicines without any re- ARACHIS HYPOG^A BATHS 418 lief, and Mr. Balm's predecessor had prescribed for him almost all the drugs of the pharmaco- poeia without the slightest good. Mr. Balm subsequently tried atropine, morphine by the mouth and subcutaneously, bromide of potas- sium, camphor, chloroform, emetics, a mustard plaster over the region of the diaphragm, and a host of other measures without the least good. He then gave him J of a grain of apomorphine dissolved in 107 parts of water hypodermicaily. In less than three minutes the symptom sub- sided, and in five minutes more he vomited. He was not troubled with the symptom for two days, but on the third day he came again to the hospital with it, but it was less trouble- some than before. Mr. Balm gave him J of a grain of apomorphine more, hypodermicaily. The symptom subsided in about the same time as before and there were retching and vomit- ing for the whole day, but the hiccough never recurred. Mr. Balm has also tried apomor- phine in a very bad case of hysteria, in a young woman, that had defied every other treatment, also in cases of asthma, and in all these instances it afforded temporary re- lief. ARACHIS HYPOG-ffiA.— Dr. Heinrich Stern (Food and Sanitation, August 17, 1895 ; New York Medical Journal, September 14, 1895) has employed peanut meal as the chief constituent of a bread for persons with dia- betes. Peanut meal, he says, is the residue left after the oil has been expressed. He has devised the following method for preparing peanut flour in the household : Tlie peanut kernels, including their inner coating, which is also nutritious and not very rich in car- bohydrates, are put into a tin kettle in which small holes have been previously made. This is kept uncovered and placed on or in a pan filled with water, and this has to be kept boil- ing for about half an hour to allow of par- tial extraction of the superfluous oil. After the kernels have been dried they are pounded into fine particles with the aid of a rolling pin. The pounded or bruised kernels are then placed in boiling water acidulated to some de- gree with tartaric acid or vinegar, preferably with the latter. The boiling in the acidulated water has to be continued for some time for different reasons : For the extraction of sac- charine elements, which occur to some amount in nuts of American growth ; to overcome the smell and taste characteristic of the peanut ; and to prevent emulsifioation of the remain- ing oil, which, to some degree, is essential to a rational diabetic food, as fats must supply the deficiency of the carbohydrate elements. It is true, says Dr. Stern, that a partial emulsifioa- tion of the oil might relieve the pancreatic juice of some work, and this might be espe- cially beneficial in grave cases of diabetes mel- litus in which the pancreas seems to be involved, but he leaves it to future investiga- tion to determine whether the oil in peanut flour shall be introduced in its natural state into the alimentary tract or in the form of a partial or complete emulsion. Having undergone a thorough boiling with acidulated water, the ground kernels are sub- jected to dry heat, to effect complete evapora- tion of that fluid ; but great care must be exercised, says Dr. Stern, that they do not be- come browned or roasted. An additional treatment with the rolling pin, he says, will produce nearly as fine a fiour as the common wheat flour of commerce. Prom 30 to 40 per cent, of the oil, he says, is necessary for a complete and rational diabetic food. More iiydrocarbons are not required and would interfere with digestion. It is not possible to control the amount of oil expressed by the do- mestic process and to determine its percentage with any degree of certainty ; if the flour is manufactured in mills, however, this could be readily controlled and ascertained. Dr. Stern has made use of the flour in dif- ferent ways, the simplest of which is that of giving it in the form of a porridge, some milk being added to it. Bread and biscuits can also be made from it, but the most agreeable and most easily digestible form in which to use it is, he thinks, the German pancake. He has used this flour with four diabetics, and a num- ber of other patients. In the non-diabetic cases, mostly tuberculous in character, he ob- tained satisfactory results, inasmuch as diges- tion was not to any extent taxed, and in some cases the weight of the patient did not de- crease, while in one instance there was actual gain in weight noticed. With the first dia- betic patient to whom he recommended the fiour its use was a complete failure at first, as the digestion became very much impaired, thereby aggravating the general condition of the patient, an old man. A more careful and rational preparation of the flour, however, and the employment of smaller quantities when starting with it, increased its digestibility, and at the time of Dr. Stern's writing this patient enjoyed, as far as circumstances permitted, a comfortable state of health. The three other patients were also thriving well on this flour, the German pancake being the usual form in which they employed it. In conjunction with eatables made of this flour, Dr. Stern allowed those patients only such food stuffs as are gen- erally recognised as permissible in diabetes mellitus. He has done this, he says, not be- cause he is a believer in the complete exclusion of carbohydrates in diabetes (for he says that fats and even nitrogenous substances are capable of producing glycogen), but to investigate the intrinsic value of peanut flour as a food, and its ability to reduce the glycogenic sugar of the urine. ABGONIN.— See under Silver (vol. ii, page 197). ASBESTOS.— A Moscow surgeon. Dr. Vo- lintzefi (Gazette des hopitaux ; Union mSdi- cale, July 18, 1896), remarks that the density of this material is much greater than that of cotton or of tarlatan ; it is less porous than either of them and less hygroscopic. The escape of vapours takes place more slowly under a dressing of asbestos than under any other. It is not so good a conductor of heat as cotton is, but on this point, says the writer, 419 ARACHIS HYPOG^A BATHS the results of the investigation are not yet perfectly satisfactory. Asbestos, he says, ab- sorbs the albuminoid secretions better than absorbent cotton or tarlatan does. In regard to clinical observations. Dr. Volintzeff thinks they are yet too small in number to enable him to give a definitive judgment. Asbestos is not expensive, he remarks, because it may be used several times. Dr. B. O'N. Kane, of Kane, Pennsylvania (Medical Record, February 18, 1896), recom- mends asbestos as a useful substance for sur- gical dressings. These dressings, he says, may be handled by dirty hands or spattered with blood or any sort of filth, and yet can be rendered absolutely aseptic in less than two minutes by tossing them upon the coals or into the blaze of an ordinary kitchen stove. However, repeated burnings, he says, seem to injure the quality of the material some-what. The form of asbestos most used is the asbestos fibre ; it is as soft as silk floss, and its absorbent qualities are greater than those of absorbent cotton. Asbestos wicking, packing, and cord- ing are adapted for drainage tubes. ATBOFINE. — Aubert (Lyon medical, Jan- uary 3, 1897; New York Medical Journal, January 33, 1897) calls attention to the effi- ciency of atropine in the correction of several inconveniences caused by quinine. Among the symptoms which are produced by the ad- ministration of quinine, even in doses of from C to 8 grains, the most frequent are buzzing and ringing in the ears, a sound like that of rushing water, deafness, vertigo, and head- ache. In certain eases these symptoms are rather accentuated, and the patients refuse to continue the use of the quinine. ]\1. Aubert relates the histories of three cases of neuralgia in which he was able to attenuate to a very great degree, and even to suppress, these disagreeable symptoms by the addition of a small dose of atropine sulphate. Prom 5 to 7 grains of quinine were given at a time, and to each dose the author added 0'007 of a grain of atropine sulphate. In one case this prevented the disagreeable symptoms, and in the two others greatly moderated them. The periodical pains were allayed, and no appre- ciable symptom of atropinism was experienced. He states that he has not had occasion to use larger doses of quinine, and does not know what the results would be with larger quanti- ties. He is not aware that atropine has before been employed for the purpose of mitigating the disagreeable symptoms provoked by quinine. BATHS.^Under this heading it is proper to class what is known as the Schott treat- ment of diseases of the heart practised at the baths of Nauheim, at the foot of the eastern end of the Taunus range of mountains. An excellent account of the place and of the treat- ment has been given by Dr. William C. Eives, lecturer on diseases of the chest and on gen- eral medicine in the New York Polyclinic (New York Medical Journal, April ll,'l896). The hotels, says Dr. Eives, furnish good ac- commodation, and are most of them provided with lifts, a matter of much importance for heart patients. They are apt to be very full in the height of the season, and it is almost impossible to obtain rooms at the Kaiserhof in particular, which at the time of Dr. Rives's writing was being altered and enlarged, with- out securing them weeks or even months beforehand. The villas, which are very nu- merous and usually stand in the midst of small grounds, are large, spacious, and well man- aged ; the food and cooking are essentially German in character. Arranf;ements should be made beforehand as to whether board is to be provided or not, as many will prefer to take one at least of their meals at one of the hotels. Rolling chairs are to be hired by the week at reasonable prices, as well as attend- ants to push them. All ordinary articles likely to be needed can be obtained in the town ; others can bo quickly sent from Frankfort. The summer climate of Nauheim, like that of the other Taunus re- sorts, is somewhat changeable, often cold and rainy, but seldom oppressively hot. The soil is good, and the position of the town favour- able for health. The place is furnished with a water supply and a system of drainage said to be good, but the sanitary conditions are probably suscepti- ble of some further improvement. Although the surrounding country is less attractive than at many other resorts, there are walks, drives, and excursions of much interest for those who are able to undertake them. The Kurhaus is large and handsome, and furnishes the usual means of recreation. Subscriptions have been already taken for an English church, and a piece of land secured upon which one will probably soon be built. The regular season at Nauheim lasts from the 1st of May to the end of September, but the bath houses are open also in April and October. The following table, showing the composi- tion of the waters, is taken from Eulenburg's Real-Encyclopddie der gesammten Heilkunde : Kriedrich Wil- helmsqaelle. Grosser Sprudel. Cnrbrunnen. Cariabmnnen. Sodium chloride ... .... .... Parts In 1,000. 89-894 1-119 3-324 0-525 0-035 2-601 0-048 Farts in 1,000. 21-824 0-497 1-700 0-440 0-034 8-354 0-038 Faits in 1,000. 15-421 0-587 1-034 0-738 0-083 1-146 0-026 Parts In 1,000. 9 860 078 Calcium chloride 1-057 Magnesium chloride 0-804 0-227 Calcium carbonate 0-951 Iron carbonate .... .... 0-014 Total solids 35-357 578-93 95 ST. 86-353 718-65 88-8° F. 18-682 995-22 70-5'- F. 12-119 720-93 BATHS 420 In the midst of the park, near the banks of the little river Ursa, says Dr. Rives, burst forth the springs that supply the bath houses on which the fame of 2Slauheira depends. These oome from a great depth (five hundred and twenty-three and five hundred and ninety feet), and were found by means of borings made at difllerent times in the course of this century. The two now in use — No. 7, the Grosser Sprudel, and No. 13, the Priedrich Wilhelmsquelle (the figures being used to des- ignate the number of the boring) — spout forth as white foaming liquids, only thirty-two feet apart, high above the surface of the ground, and are connected with five bath houses, four in the immediate neighbourhood, and a fifth (bath house No. 4) which provides only simple saline baths from spring No. 7 out- side the park at a little distance from the others. At the present time there are in the whole establishment at Nauheira a hundred and ninety-six bathrooms with two hundred and four tubs. The tubs are of wood, painted, which has been found to be the most satisfac- tory material, and are of large size, so that when a tub is filled the body of the bather is entireJy immersed up to the neck, and the pressure of the water on its surface is very considerable. Everything connected with the baths, which are under government control, is admirably systematized, and the attendants are well fitted by long experience for the dis- charge of their duties. Drinking the waters, says Dr. Rives, plays but a secondary part at Nauheim, but their internal use is of some value in gouty condi- tions and disorders of the liver, and the Cur- brunnen water, diluted, is said to resemble that of the Ragoczy spring of Kissingen, and the Carlsbrunnen, the Elizabeth-Brunnen of Homburg. The Ludwigsbrunnen is also used as a table water. The Schwalheim spring, two miles distant, yields a ferruginous water con- taining carbonic acid. The first bath house at Nauheim, according to Dr. Rives, was opened in 183o, and the baths have been used for many years with ad- vantage in gotit, rheumatism, rickets, and so- called scrofulous diseases, and have acquired a well-merited repute in the treatment of lo- comotor ataxia and other diseases of the spinal cord. Professor F. W". Beneke, of Marburg, was the first to show, contrary to the views then prevailing, not only that patients with heart disease, more especially those recovering from acute rheumatism, could bear balneo- logical treatment, but that they were actually benefited by such a course. Beneke, who was physician to the Nauheim baths from 18.57 to 1866, and continued to visit them up to his death, in 1883, wrote several articles upon the effects he had observed there, the earliest of which appeared in 1859. After the publica- tion of his more important work, Zur Thera- pie des Oelcnkrheumatismus und der ihm verbundenen Merzkrankheiten, in 1873, patients with heart disease began to frequent Nauheira in greater numbers, and, on the lines of inves- tigation suggested by his observations, the baths began to be studied more closely by other physicians. In 1880 Dr. August Schott, who had been making independent studies since 1871, pub- lished a paper (Berliner klinische Wochen- schrift, 1880, No. 30) by far the most important and exhaustive of any that had yet appeared, and the first to do full justice to the remark- able effect of the baths upon the heart. Nu- merous articles relating to the same and allied subjects have since been written by himself and his brother. Dr. Theodor Schott, and to their joint labours the present celebrity of Nauheim is largely due. Within the last ten years the annual num- ber of visitors during the season, a large pro- portion of whom are heart patients, has more than doubled, amounting to over twelve thou- sand in 1895. The foregoing is substantially in Dr. Rives's own words. He describes the effect of the baths as that of regulating the action and strengthening and improving the nutrition of the diseased heart, whether its inability to perform its functions properly depends upon valvular lesions and their consequences or upon malnutrition or disease of the cardiac muscu- lar substance. These results, he says, are chiefly due to the chloride of sodium, to the more irritating chloride of calcium, and to the free carbonic acid which these waters are said to contain in larger amount than almost any other baths in Germany. They contain, more- over, a considerable percentage of iron, to which may also be attributed a tonic influence. The most powerful though more temporary stimulation, as proved experimentally, is caused by the carbonic acid. By means of the action of these saline and gaseous contents of the bath upon the terminal branches of the sen- sory nerves of the skin an impression is made upon the cardiac and vaso-motor centres by which the heart is stimulated in a reflex way to more powerful and vigorous contraction and the arteries are more completely filled, and at the same time the cutaneous vessels dilate, peripheral resistance is lessened, and the whole circulation is rendered freer and more active, while metabolism is promoted and a marked influence exerted upon the trophic centres, as must be inferred from the striking evidences of improvement in the bodily nutrition in general, and in that of the heart in carticular, and the persistence and even increase of the good effects long after the patient has com- pleted the course. The immediate objective results of the baths are stated by Dr. Rives as follows: "Exami- nation of the pulse, confirmed by sphygmo- graphie tracings and the sphygmomanometer, shows it to be made slower,"stronger, and of increased volume, the cardiac sounds become more distinct, and in cases of dilatation an unmistakable contraction of the heart, demon- stra,ble by percussion and by the change in the position of the apex beat, is observed. This contraction is most noticeable in the transverse diameter of the heart, and takes place to little or no extent when the enlargement is solely compensatory, as in many cases of organic 421 BATHS mitral and aortic regurgitation. Dr. Bezly Thoriie, however, affirms that there is a diminu- tion in the area of cardiac dulness, as measured in the oblique transverse diameter, of a third to about half an inch even in the healthy heart. The respiration becomes easy, and is slower and deeper, and there is usually in- creased action of the kidneys. Subjectively, a sense of weight and oppression on the chest, greater than in an ordinary bath, is at first ex- perienced, which quickly passes ofE ; the skin soon becomes warm, and tingling, accompanied with redness, is felt in its more sensitive parts. Afterward, the patient feels invigorated, and is generally conscious of a sense of drowsiness." Dr. Robert H. Baboock, of Chicago, in a paper read before the Mississippi Valley Medi- cal Association (Journal of the American Medi- cal Association, November 11, 1893), says that during the baths there is a slowing of the pulse with increased volume and strength, and irregularity, if any exists, is lessened or disap- pears. The cardiac contractions are increased in vigour and the cavities better emptied, thus permitting of a diminution in the size of a dilated heart. This marked and beneficial effect on the action of the heart does not ap- pear at once, but persists for a considerable time subsequent to the baths. If properly ad- ministered, says Dr. Babcock, the baths occa- sion a gradual and perceptible amelioration of the symptoms. During the gymnastics the rate of the pulse falls and the volume and strength are increased. While Oertel's method is limited to cases of heart disease in which compensation has not been lost, the Schott method, says Dr. Bab- cock, is applicable to a greater variety of cases, and, as the treatment can be carried out in this country by artificially prepared baths and the gymnastics, it seems that by careful selec- tion patients subjected to this treatment may be greatly benefited. In a subsequent communication, read before the American Climatological Association (New York Medical Journal, December 8, 1894), Dr. Babcock says that the baths owe their elBcacy chiefly to free carbonic acid, sodium chloride, and calcium chloride, for the other saline in- gredients are present in amounts too small to lend more than feeble aid to those named. The next important feature of the baths, he says, is their temperature. "Warm baths are debilitating, and exert a decided weakening effect on the heart even in health ; so they are recognised as inadmissible in the treat- ment of disease of the heart. The tempera- ture of the Nauheim baths ranges between 92° or 93° P. at first and 87° or a little lower toward the end of a course of treatment. At these temperatures, says Dr. Babcock, baths are cool, and even at 93° P. they impart a dis- tinct feeling of chilliness to the patients as they enter them. The duration of each bath is limited, and is increased cautiously with the progress of the treatment and improvement of the patient's condition. Prom five or eight minutes as the initial limit, the baths gradually reach a dura- tion of twenty minutes. If the pulse is watched during the bath, it will be found to become slower, fuller, and stronger, and if it was irregular in rhythm be- fore, it is likely to improve even to the extent of attaining perfect regularity. Efforts on the part of the bather — such as speaking, forced breathing, moving about, etc. — generally occa- sion temporary irregularity and acceleration of the pulse. The respirations are generally slow and deep, partly in consequence of a feel- ing of oppression of the chest experienced by most individuals. This sensation of weight is not complained of by all in equal degree, how- ever, and it 'is usually lost after a iew baths. The improvement in the rate and quality of the pulse is an index of the degree of benefit derived by the patient. If not counteracted by exercise, this effect on the pulse will persist for an hour or two subsequently. Changes for the better in the size of the area of cardiac dulness and in the sounds may be noted like- ' wise. This has been demonstrated repeatedly, says Dr. Babcock, both on himself by a com- petent Russian physician and by himself on others. Careful percussion immediately before and after a bath of from eighteen to twenty minutes' duration showed a demonstrable re- traction of the deep limits of cardiac dulness, and the heart sounds were improved in strength, the second pulmonary being less accentuated, the second aortic stronger, the abnormal differ- ence between the two sounds before being ap- preciably less marked after the bath. Murmurs that are almost inaudible before become in- tensified ; and, conversely, some loud bruits are lessened in intensity. In short, so far as can be determined by physical examination, these baths appear to lessen the rapidity and increase the force of the heart's contractions, thereby occasioning a better filling of the great arterial system with corresponding depletion of the engorged veins. This is borne out by experiments on animals conducted by Dr. August Schott, which demon- strated, by means of a mercurial manometer placed in the trachea, that a rise of arterial pressure was the result of nearly complete im- mersion in a saline solution. In this respect, therefore, the effect of these baths is similar to that following the administration of digi- talis : both lengthen diastole and augment the force of systole. In addition, digitalis exerts a powerful influence as a vaso-motor constric- tor, which action sometimes offsets its bene- ficial effect on the heart. This action on the vascular system is felt by all the arteries alike. Herein, it seems to Dr. Babcock, lies the differ- ence between the effect produced by digitalis and that exerted by these baths. Experiments have demonstrated that the contraction of cutaneous vessels effected by cold baths occa- sions at first increase of blood-pressure and of the frequency and strength of the heart's con- tractions, hut that later on the acceleration gives place to a retardation of the rate. The pulse, therefore, becomes slower and stronger during a cold bath, provided this is not con- tinued until vaso-motor paresis sets in. Thus far a cold bath of moderate duration affects the heart in its contractions in the same way BATHS 423 as digitalis, although the mechanism by which this result is accomplished differs. On the other hand, says Dr. Baboock, Schiller has shown that the application of cold to the abdomen — that is, contraction of the cutaneous vessels of the abdomen— is followed by prompt dilatation of the vessels of the pia mater; whereas heat applied to the abdomen is suc- ceeded by constriction of the vessels of the pia mater. Prom these experiments it is probable that the effect of a cold bath is not to cause contraction of internal as well as of cutaneous vessels, but that a cold bath is fol- lowed by dilatation of internal vessels. In short, during and after a cold bath of moderate length, the heart contracts more slowly and forcibly. Furthermore, although there is not a consensus of opinion as to the balneological effect of mineral waters, whether or not their saline and gaseous constituents serve as mild stimuli to the sensory nerves of the integu- ment, it is probable, as remarked by Leiehten- stern, that they act as vaso-motor dilators, since cutaneous redness follows their prolonged use in degrees of considerable strength. From the foregoing facts, and from the em- pirical knowledge of the beneficial effect of a balneological treatment of many cases of heart disease. Dr. Babcock deduces the following as the modus operandi of these baths: Upon the patient's entering the bath there is an initial or primary constriction of the cuta- neous vessels produced by the cold. This is promptly followed by a dilatation of the inter- nal vessels and stimulation of the heart; its con- tractions, at first perhaps accelerated, become subsequently reduced in rate and augmented in force. After a moment or two the sensation of chilliness gives place to one of warmth, when it is probable the contraction of the cutaneous vessels grows less ; the gentle stimulation of the sensory cutaneous nerves produced by the salt serves, however, to maintain the increased energy in the cardiac contractions. This sec- ondary feeling of warmth does not act like a primary application of heat to the surface of the body by causing contraction of internal vessels ; their dilatation persists. Under these conditions, says Dr. Babcock, the heart not only has less labour to perform, but is actually aided in the accomplishment of its decreased task. Like digitalis, the baths slow and strengthen the cardiac contractions, but, un- like digitalis, they dilate rather than contract the arterial system, or, in other words, reduce rather than increase peripheral resistance. The light exercises, or, as the Schott brothers choose to designate this part of their cardiac therapeutics, the gymnastics, says Dr. Babcock, are an extremely simple but important adjunct to the baths. The individuality of this treat- ment lies in the application of counter-resist- ance made by an attendant trained for that purpose. He must see to it that the move- ments are performed slowly and steadily, that they are interrupted by short periods of repose, and that the effort exerted by the patient is not so great as to cause embarrassment of respira- tion or undue acoelei'ation of the pulse. The attendant must watch lest the patient hold his breath and thereby overstrain the already feeble right ventricle, and must at once call a halt upon evidence of dyspnoea. Finally, he must so apply his counter-pressure as to offer resist- ance but not hinder free movement of the extremity. This requires some judgment and skill, yet is not so difficult as to be beyond the acquirement of an intelligent friend or relative, who can then help the patient to continue his exercises indefinitely after the latter has passed from the physician's daily superintendence. These exercises exert an effect on the heart and circulation similar to that of the baths, and therefore supplement and re-enforce the balneological treatment. If the^ are properly performed, and if the resistance is judiciously apportioned to the patient's endurance, they slow the rate and augment the force and vol- ume of the pulse, as has been repeatedly shown by the sphygmograph and sphygmomanometer. Percussion and auscultation reveal the same improvement in the size of the dilated heart and in the character of its sounds as after a bath. Patients not infrequently comment on their feeling of euphoria succeeding this form of treatment ; dull precordial pain, discomfort, or sense of oppression gives place to a condi- tion of ease and lightheartedness. On the other hand, if too great resistance is applied, there is produced a sensation of cardiac dis- tention with a variable degree of dyspncea, while the pulse grows more rapid and feebler. Improved arterial circulation is so manifest a result of these exercises that Dr. Schott has known them to lessen the frequency, nay, even the severity of attacks of angina pectoris in in- dividuals with arteriosclerosis who had been unable to indulge in even very moderate phys- ical exercise taken in the ordinary ways of walking, etc. Permanent amelioration of the sufferer's condition has been achieved in some of these cases. In regard to contra-indications. Dr. Babcock thinks there can be no doubt of the dangers of the treatment in degenerative changes of the blood-vessels and myocardium, such as aneu- rysm and advanced arteriosclerosis, acute soft- ening, and great fatty degeneration of the heart. In tliese conditions rupture might result from heightened intravascular and intracardiac pres- sure. Furthermore, the query has been made as to whether chronic interstitial nephritis is not also a contra-indication on account mainly of the danger of setting up acute inflammation of the kidneys. It might be urged, in the sec- ond place, that the increased vascular tension produced might prove disastrous by augment- ing the heightened arterial tension already ex- isting. To the former objection Dr. Babcock replies that when Dr. Schott was questioned on this point, he stated that he did not consider chronic interstitial nephritis a contra-indication to the baths. It would seem, adds Dr. Babcock, as if the stimulating action of the salts and carbonic acid on the skin rendered the effect on the kid- neys different from that of a bath in plain water at the same low temperatures. As regards the dangerous augmentation of existing vascular tension to the extent of either 433 BATHS rupture of a blood-vessel or of stretching the cavity of the left ventricle, Dr. Baboock sug- gests that such baths would not be adminis- tered so long as the hypertrophied heart was adequate to the peripheral resistance to be over- come. They would be given only when the cardiac energy was threatening to fail or had actually failed. Under such circumstances the only thing that could preserve the patient would be a restoration of the heart's power. This might be possible if the heart's walls were not too degenerate and the kidneys not greatly contracted. Moreover, if the baths in question brought about even a slight degree of dilatation of the internal vessels, he adds, then the peripheral resistance would be lessened rather than increased ; and if the circulation was thereby improved, so likewise would be the action of the kidneys. The resisted exercises, the Widp.rstandsgym- nastik of Ling, are fully described and figured in Dr. W. Bezly Thome's work entitled The Schott Methods of the Treatment of Chronic Diseases of the Heart (London, 1895). Dr. Rives (foe. cit.) gives the following synopsis of them: 1. Movements of the extended arms in three directions. (a) From the ordinary position by the sides of the body forward and upward until they reach the temples, and back again. (6) Prom the same position laterally outward and upward to the temples^ and back. (c) From the horizontal position, with the palms of the hands meeting in front of the body, as far apart as possible, and back. Rotation of the extended arms about their axes as fully as possible, causing pronation and supination. 3. For the elbow, wrist, and finger joints the natural flexions and extensions; radial and ulnar abduction and adduction. 3. (a) Flexion of the trunk forward, from a little beyond the erect position, and back. (6) Lateral flexions of the trunk to right and left, and back. (c) Rotations of the trunk on its axis to right and left, and back. 4. Movements of each extended leg forward and upward, outward and upward, backward and upward, and back. 5. 'Tlie natural flexions and extensions of the knee and ankle joints. The resistance, says Dr. Rives, is always made by the attendant with the palm of "the hand in the direction exactly opposite to that of the movement, and in applying it to the wrist and ankle these parts are placed in the fork formed by separating the thumb and fin- gers ; but a limb is never actually grasped, lest support rather than resistance should be the result. The degree of force employed, says Dr. Rives, should be as much as the patient can overcome without the slightest discomfort, and should be so uniformly applied as to en- able him to perform the movements slowly, evenly, and without jerks. He must be able to breathe quietly, and the mouth and alse nasi must be watched carefully, so that at the slightest indication of loss of breath a pause may be made. Some of the movements may be omitted according to circumstances; the most trying to the patient are the elevation of the arms above the head and the trunk exer- cises. The limbs are not allowed by the at- tendant to fall suddenly after the completion of a movement ; a considerable interval of time is always allowed between the movements, and this is prolonged if the patient seems at all fatigued. The clothing should, of course, be perfectly loose and easy. The exercises are usually given for about half an hour, the series being gone over twice in that time, but they are often employed for shorter or longer periods. Dr. Rives adds that Dr. Schott has also de- vised a scheme by which the services of the attendant may sometimes be dispensed with. In carrying out these self-resisted exercises (Selbsthemmungsgymnastik),as they are called, the patient endeavours, as it were, to resist his own movements by partially contracting at the same time the antagonistic muscles. This de- mands some intelligence on his part, and it would often be unsafe to allow its employ- ment. The action of these exercises. Dr. Rives re- marks, is to produce an effect similar in many respects to that caused by the baths ; the cold extremities become warm, the sense of oppres- sion in the chest is relieved, and the breathing is deepened. The pulse usually becomes fuller, stronger, and slower, and an immediate dimi- nution in the area of dulness of the dilated heart, not due to increased overlapping by the lung, with a sim,ultaneous lessening of the di- mensions of the passively congested liver, have been frequently demonstrated. The effect is often very speedy and striking ; according to Dr. August Schott, an attack of cardiac asthma which would otherwise continue for hours may be charmed away, as it were, in a few minutes, and an extreme dilatation be for the time be- ing so completely dispelled that hardly a ves- tige remains. In fresh endocarditis after rheumatism, says Dr. Rives, the baths promote to a high degree the absorption of the inflammatory products and offer hopeful prospects of a more or less complete cure. In chronic valvular disease, where there is serious damage to the valve segments, they can not ordinarily produce the slightest effect upon the injured valve itself, and those murmurs which disappear during the course are due to relaxation of the orifices or want of tone in the papillary muscles. Dr. Groedel, of Nauheim, however, states that he has met with a very few remarkable cases pre- senting evidences of fully developed valvular disease which have been cured at Nauheim, one of which is mentioned in Professor Eich- horst's Handbuch der speciellen Pathologie und Therapie, fifth edition, vol. i, p. 56. This patient had all the signs of pronounced mitral insufficiency, and these so entirely disappeared after two seasons at Nauheim that he was ac- cepted as sound by a very strict life-insurance company. At the end of ten years there was still no trace of the disease. Although we BATHS BKLIjADONKA 424 can not expect, says Dr. Rives, that seriously injured valves should be restored to their nor- mal condition, failure of compensation result- ing therefrom is signally benefited, and it is in those cases especially in which digitalis is not tolerated or has not proved useful that the results are so astonishing. It is v?ell known that in aortic regurgitation digitalis is not al- ways beneficial. Good results are secured at Nauheim, however strange it may at first ap- pear, in lack of compensation both from aortic and from mitral disease, as well as in cases of combined disease of both valves and in many instances of patent foramen ovale. The grad- ual influence exerted upon the nutrition of the heart, without the other accompanying unde- sirable effects which are often a cause for the failure of medicinal treatment, offers an im- mense advantage. In weak hearts without serious organic le- sion, from ansemia, chlorosis, and convales- cence -from acute diseases, and the myocardial affections resulting from influenza, most excel- lent results are obtained, according to Dr. Rives, particularly in young subjects, as well as in cases of heart strain and dilatation due to over-exertion. In the chronic sclerotic changes (arteriosclerosis, chronic myocarditis) of the heart and vessels and fatty degenera- tion, with or without dilatation, so frequent in persons of advancing years, of which the ordi- nary treatment is usually palliative, the bene- fit to be derived is naturally more uncertain and generally requires long and persistent treatment. Some of the most remarkable re- sults of the Schott methods, howevei', have been obtained in apparently hopeless cases, and even patients suffering from angina pecto- ris have been practically cured at Nauheim. While many cases of angina pectoris are hope- less under any circumstances, says Dr. Rives, yet the effect of the Nauheim baths upon the cardiac nutrition is so remarkable that where the lesions are not too far advanced or only incipient the results of the treatraen t are emi- nently gratifying. He cites Balfour's state- ment that the expression pseudo-angina is often misleading, and should not be applied to cases presenting symptoms identical with those of true angina, merely because the heart lesion happens to be curable. Such eases it is often impossible to distinguish from the in- curable ones, and Balfour consequently ex- presses himself in regard to the prognosis to the effect that this is often more hopeful than we should at first be led to suppose. The results in cases of heart disease depend- ent upon or complicated with disease of the kidney, says Dr. Rives, are less encouraging and more variable, but albuminuria due mere- ly to secondary renal congestion may alto- gether disappear. Cases of functional nervous disturbance of the heart are usually, but not always, benefited. The contra-indications to the Nauheim treat- ment are stated by Dr. Rives, as by Dr. Bab- cock, to be advanced arteriosclerosis and aortic aneurysm. Patients with the latter affection, he says, have used the baths with some allevia- tion of symptoms, but on account of the danger of raising the blood pressure they must be em- ployed with the greatest caution. Many per- sons with very serious heart disease come to Nauheim, he remarks, and, as is only to be ex- pected, some deaths occasionally take place during the season ; but such is the care taken by the local physicians, who write their orders with exact directions, that fatal accidents direct- ly attributable to the baths are practically un* known. Groedel states that during a practice of many years at Nauheim he has never had a case of sudden death during the bath, although he has known of two cases of apoplexy which occurred during the exertion of dressing. As to the exact length of time required for a cure, it is, of course, says Dr. Rives, impossible to say ; improvement is usually observed after a week or two, and some patients are relieved by a single course, but many others require a much longer period, and there are compara- tively few who are ill enough to undertake a long journey to Nauheim in search of relief for whom it is not advisable that they should return for another or several successive sea- sons, while in some desperate cases the treat- ment will necessarily fail. In an excellent article on this method of treating heart disease {Lancet, March 21 and 28. 1896). Dr. R. F. C. Leith, of Edinburgh, says: "The physiological problems raised by ' the system ' are both many and complex, and there must be much still hidden from us which the future may reveal, and which may bring about a more perfect understanding of its ac- tions. So far as they are at present known to us, it is readily seen that its scope of appli- cation is far wider than that of any individ- ual drug; but to assert its applicability to all classes of cardiac derangements, reserving only advanced arterio-capillary sclerosis, aneurysms, and serious rayocarditis,"is surely in so many words to proclaim its impotence. It is but natural that it should fail. Evil habits of nutrition which measure their existence by months or years are not to be got rid of by one or even two courses of ' the system ' of a few weeks' duration at Nauheim or anywhere else. I have already met with failures and re- currences such as the present literature of the subject makes no mention of, and they have but served to increase my belief in its value when used in suitable cases. While we re- member that it is also capable of doing much good we must not forget that it is also capable of doing harm. It has now been sufficiently proved to warrant its trial in suitable cases, but they must be chosen with judgment. To use it rashly, and with too great expectations, is certain to lead to disappointment and to re- flect injuriously upon the system itself. More- over, as at present enunciated, it does not seem to me to be as useful as it might be. It is at once too wide and too restricted ; too wide in its claims and too restricted in its limitations. Why, for instance, should we pause at 86° P. ? Why not go further in suit- able eases and make use of the well-known effects of still lower temperatures, inasmuch as we can so easily regulate their influence by the duration of time we employ them. The resist- 435 BATHS BELLADONNA ance exercises are good as far as thejr go, but why should they not be combined with mas- sage or passive or active exercises ot difiEerent kinds'? Eccles, Campbell, and others have testified to their value. An intelligent use of dumb-bells and other gymnastic appliances ought to prove quite as effectual as the resist- ance exercises themselves, and they have done so in my hands in the opportunities I have so far had of putting them into practice." Artificial Nauheim baths, says Dr. Rives {loc. cit.), may be prepared by dissolving the requisite percentage of required salts, or, as Dr. John Broadbent points out, by the use of sea water, which contains 2'7 per cent of chlo- ride of sodium, and by adding for the pro- duction of carbonic acid suitable proportions of commercial muriatic acid and bicarbonate of sodium or chalk, or, as has been suggested, a mixture of the bicarbonate and bisulphate of sodium. The gas, however, when thus evolved, he remarks, escapes more rapidly than it does from the natural baths. Dr. Rives thinks good results may undoubt- edly be obtained in this way, and he adds that such baths have been employed by Dr. Bezly Thorne in London and by Dr. Babeock in Chicago, as well as in the Middlesex Hospital, with success ; but the greater freedom from counteracting injurious conditions to be had at a spa, and the various advantageous mental and hygienic influences to which the patient is there subjected, he thinks, are sufficient rea- sons, even allowing the artificial baths to be as effective as the natural waters, why the results obtained at Nauhei)n are more striking than those reported from the cities. Mineral springs in the country, especially when possessing a part of the requirements, offer more promising opportunities, and provision has been or is be- ing made at Harrogate and various places in England tor carrying out the treatment. In administering the Nauheim baths to pa- tients with heart disease, says Dr. Rives, sev- eral varieties are employed, for when the effect of one kind of bath becomes less and less marked, owing to the nervous system gradually becoming habituated, a fresh stimulus is im- parted by changing to a stronger bath, and thus a longer course can be taken than would otherwise be advantageous. The method em- ployed by Dr. Theodor Schott, which is in the main practised by the other Nauheim physicians, is the following : The first bath or- dered (thermal Soollad) is supplied by the water taken from the receiving basins, from which by exposure to the air a large part of the carbonic acid has escaped, and a considerable proportion of iron and salts has been precipi- tated, so that it is of a muddy colour and con- tains few or no bubbles of gas. No. 7 is the spring usually first employed, as it contains the smaller proportion of salts, 3'18 per cent, of ohloride of sodium and 0'17 of chloride of calcium. Dr. Schott recommends for some cases, at the beginning of treatment, baths containing only 1 per cent, of chloride of sodium and 0-1 per cent, of chloride of cal- cium. The natural temperature is 88 8° P., but this at first is raised to one varying from 92° to 95° P. Temperatures above that of No. 12 spring, 9.5'5° P., are not suitable for heart patients. The duration of the bath, at first six to eight minutes, is gradually lengthened every few days, one minute at a time, while at inter- vals the temperature is lowered about one de- gree (half a degree centigrade). At first every second or third day, afterward every fourth or fifth, the bath is omitted. The percentage of salts is now gradually increased, which may be done at first by mixing the waters of Nos. 7 and 12, but is usually accom- plished by adding a quart of Nauheim " Mut- terlauge " (mother-lye) — the unorystallizable liquid left behind in the manufacture of salt — • which is subsequently increased to two and three quarts, or occasionally even more. The main ingredient of this is chloride of calcium, which may be raised eventually in the bath to the amount of 0'5 per cent. When the pro- portion of salts is thus rendered sufficiently large, the temperature by this time having been lowered several degrees, and the duration extended to not more than twenty minutes, the patient is ready to continue treatment by a course of Sprudel baths from either No. 7 or No. 12, the former containing the greater amount of carbonic acid, the latter of salts. These differ from the others in being supplied with water direct from the springs, before it has undergone the action of the air, so that it appears of crystal clearness and filled with sparkling bubbles of carbonic acid, which it retains in undiminished quantity. They are likewise at first taken warm, usually at their natural temperatures, and for a short time — about eight minutes — and as they are con- tinued the temperature is lowered in the same cautious way and the duration prolonged in like manner. The saline contents may also be increased by successive additions of '• Mutter- lauge." In consequence of the powerful exci- tation of the cutaneous circulation by the carbonic acid, which creates an agreeable feel- ing of warmth, says Dr. Rives, the tempera- ture can be lowered to a degree which could not be otherwise tolerated, but is seldom if ever reduced^ below 80° P. The final, most powerful forni of stimulation is the Sprudel- strombad, in which the supply and overflow pipes of the bath tub are left open, so that in addition to the fresh supplies of carbonic acid, the shock of the running water against the body is experienced. BEIiLADONNA.— Dr. Douglass W. Mont- gomery, of San Prancisco {Medical News, No- vember 16, 1895), has observed decided beneflt from the use of belladonna in the form of pemphigus known as hereditary inclination to the formation of blebs. After a trial of arsenic and then of potassium iodide (on the possibility that the trouble was syphilitic) without result, Dr. Montgomery prescribed for the patient, a boy fifteen years old, 3 drops of tincture of belladonna, and the dose was increased in a few days to 4 drops. Decided improvement then set in and for about a week no new blebs formed. A few new blisters then appeared and the dose of belladonna was increased up BENZONAPHTHOL CALCIUM CHLOfllDB 426 to 6 drops three times a day, but without en- tirely controlling the formation of the blebs. The patient now disappeared for a number of months, and on his return Dr. Montgomery hit upon the probable mode of action of the belladonna. One of the best-known actions of belladonna, he remarks, is its power of con- trolling perspiration, and he was then led to think that if this was the only action of the drug, it would be as well to use it locally ; a srhall amount was applied to the soles, and with satisfactory results. Blebs formed, but not in sufficient numbers to especially incom- mode the boy, and the disease was rendered tolerable. BENZONAPHTHOL.— Dr. Jos^ A. Clark (cited in the Lancet for July 20, 1895) reports having employed benzonaphthol in an epidemic of dysentery which occurred in Alquizar, Cuba, during which he had one hundred and thirty- seven cases of the disease under treatment, of which he considered twenty-three as serious and a hundred and fourteen as of a mild type. The mortality among those treated with ipecacuanha and calomel, opium, etc., amounted to 9 per cent., while that among those treated with benzonaphthol was scarcely more than 3 per cent. This drug had the great advantage of not causing vomiting, salivation, or depression of the circulation, and it also brought patients through the attack more rap- idly than the drugs generally used. Forty-flve grains per diem were given to adults and but little less to children. BENZOYLANILIDE. — See Bbnzanilide. BENZOYL - BETA- NAPHTHOL.— See Benzonaphthol. BISMUTH.— The Deutsche Aerzte-Zeitung for February 1, 1896 {New York Medical Jour- nal, February 23, 1896), calls attention to a soluble ^Ao.sp/ia^e of bismuth, " bismutum phos- phoricum solubile," a salt that contains about 30 per cent, of oxide of bismuth. Even concentrated solutions of it remain clear for some hours, and a solution containing from 1 to 2 per cent, of the salt will remain clear for days, but it is rendered turbid by boil- ing, also by the addition of an acid or of an alkali. The reaction of such a solution is fee- bly alkaline, and its taste is not very pro- nounced. Soluble bismuth phosphate has no effect on the micro-organism of anthrax or on other like resistant germs, but it seems capable of arresting the development of the Bacterium, coli. Experiments on animals have shown it to be harmless. The dose necessary in its ther- apeutical employment is much smaller than that of any of the powdery preparations of bis- muth ; from 3 to 8 grains are to be given three times a day. It has been used as a remedy for cholera infantum with good results. The following formula is attributed to DOrf- fler: B Soluble bismuth phosphate . 1^ to 2 parts ; Distilled water 90 " Syrup of marsh mallow .... 8 " M. A child's spoonful to be given every hour In most cases the vomiting ceased after the first few doses, and the intense odour of the stools was mitigated as soon as they became black in appearance, denoting that the drug was doing its work in the intestine. From profuse diarrhoea, the intestinal evacuations were reduced to two or three in twenty-four hours. No milk was given. In the majority of cases the disease was at an end in the course of a few days. The writer thinks it advisable to continue the use of the remedy for some days after the diarrhoea has ceased. BLANCOLINE. — This is a white, odour- less substance prepared in two forms, solid and liquid. It is used like vaseline. BLENNOSTASINE.— This is a bromine derivative of cinchonidine, CisIIaiNsOBrj. Dr. Walter F. Chappell (New York Medical Jour- nal, December 5, 1896) says that it crystallizes from dilute solutions in large, prismatic crys- tals, or from concentrated solutions in the form of small, needle-shaped crystals, very soluble in water and quite as bitter as quinine. He says that it has a marked contractile effect on the vaso-motor system of the upper respira- tory tract, and, being non-toxic, is especially valuable as a substitute for belladonna, atro- pine, and similar drugs in hay fever, acute influenza, rhinitis, intermittent rhinorrhma, laryngorrhcca, and bronchorrhcea, has a power- ful sedative influence on the brain and spinal cord, and decidedly diminishes reilex move- ments. Blennostasine may be administered in cap- sule form, when combinations are required; but for many reasons Dr. Chappell thinks one- grain gelatin-coated pills are preferable. The dose ranges from 1 to 4 grains or more every hour, according to the effect desired. BOBOLYPTOL.— This is an American proprietary antiseptic preparation, presumably so named because boric acid and oil of euca- lyptus are prominent ingredients of it. BBOMATED H.a:M:OL, BIlOMH.a!- MOL. — This is a derivative of haemogallol (g. V.) said to contain 2■^ per cent, of bromine. It has been recommended in the treatment of epilepsy. CAJEPTJT, CAJUPTJT.— Mr. Ram Dhari Sinha, L. T. M. S. (Indian Medical Gazette, December, 1896), reports having used cajuput oil internally as an expectorant in eighteen cases of pneumonia, with satisfaotorv results. Ordinarily he gives 5 minims, either made into an emulsion or simply shaken with water, every four or five hours. In all the eighteen cases the dyspnoea and cough were diminished and expectoration became easier. All the patients recovered. CALCIUM CARBIDE.- This compound, CaCj, is in the form of irregular lumps of vari- ous shades of gray. On contact with water it decomposes and acetylene gas is generated. Some of the French surgeons have lately em- ployed it in the treatment of cancer of the uterus. M. Peyrot, according to M. Guinard {Gazette medicate de Paris, April 18, 1896), has 427 BBNZONAPHTHOL CALCIUM CHLORIDE employed it in the following manner : A piece of the calcium carbide is placed directly in the vault of the vagina, where it very soon becomes decomposed into calcium oxide and acetylene by contact with the moisture. At the end of several days the oxide is removed by means of irrigation with corrosive sublimate. This treatment may be repeated several times. The ^results are very appreciable, says M. Guinard, ^for the diseased parts assume a grayish tint and become smooth, and the hiemorrhages, the fcetid discharge, and the pain are suppressed. With regard to the mode of action of calcium carbide, says M. Guinard, it is rather complex. The nascent quicklime acts, he thinks, in con- cert with the acetylene, which passes into the urine, where it has been found. Perhaps, he says, by contact with the cancerous elements,, it leads to a sort of special coagulation of the blood, analogous to that observed in persons poisoned with gas. M. Livet (These de Paris; Revue interna- tionale de medecine et de chirurgie, September 25, 1896), acting on M. Guinard's idea, has em- ployed calcium carbide, not only in the treat- ment of uterine cancer, but also in that of other ailections accompanied by rebellions hcemorrhages, pain, and fcetid odours, such as certain forms of fibroma and metritis. He re- ports eight cases, four of which demonstrate that the treatment with calcium carbide is always followed by an amelioration, whether in cancer of the breast, metritis, or epithelioma of the uterus. In cases of cancer of the neck of the uterus, he says, the vulva and the vagina should first be thoroughly washed and disin- fected, and then pieces of calcium carbide should be placed in the inequalities of the tumour. It a calcium-carbide crayon is to be introduced into the cervical cavity, it must be done very rapidly, for when it comes in con- tact with the moist mucous membrane it pro- duces a bubbling and nothing more is seen of it. In cancer of the breast the cavities are simply filled with pieces of calcium carbide. In order to confine the acetylene, an ordinary dressing is used on the breast and tamponing is employed in the vagina. The action of cal- cium carbide is very rapid ; the patient feels at once a burning sensation which lasts for an hour or two, and at the end of that time the pain, the discharge, and the fcetid odour have disappeared. The clot which is formed by the coagulant action of the acetylene presents a temporary barrier, which is sometimes defini- tive, to the haemorrhage, and when the foetid discharge is dried up the nauseous odour dis- appears. When the tampon of iodoform gauze which confines the acetylene is removed the vegetations will be seen to be diminished in volume and covered with a grayish eschar which is easily detached with a blunt curette. It is not necessary to renew the applications of the carbide oftener than every four or five days, unless the hiemorrhage should reappear on the day following the first application. If it is necessary to use the nascent lime to hasten the destruction of the neoplasm, the applica- tions of the carbide may be more frequent. In all cases the treatment, being purely symp- 71 tomatic, should be continued until the fatal termination, which will be more or less re- tarded. According to M. Livet, the unpleasant ef- fects of this treatment are few ; in one case he observed diarrhoea and in another burns on the vaginal wall. Unfortunately, he says, the treatment is painful ; the burning sensation is very intense and occasionally persists for a long time. CALCIUM CHLOKISE, according to Dr. Thomas D. Savill (Lancet, August 1, 1896; New York Medical Journal, August 32, 1896), is a very efHcacioiis remedy for the itching that accompanies certain skin diseases. In all the cases which have come under his observation, he says, the itching has been re- lieved, and the eruption, if anv existed, has disappeared at the same time. He states fur- ther that he has not met with any absolute failures so far, although sometimes the dose has had to be considerable and the employment of the drug continued for several weeks. The opportunity of trying the remedy in children for the itching that accompanies urticaria, he says, has not presented itself, but there is every reason to believe that it would be equally efS- cacious in such cases. Dr. Savill says that the doses must be con- siderable, not less than 30 grains three times a day, and they should be gradually increased. Thirty and even 40 grains have often suc- ceeded where smaller doses have failed. If ad- ministered after meals and in a wineglass of water it is surprising how little these large doses upset the stomach, and he states that he has never known them to produce vomiting. Patients sometimes complain, he says, that it makes them thirsty, and to cover the salt taste it is best administered with a drachm of tinc- ture of orange peel and an ounce of chloroform water, in which form it is really an agreeable medicine and would be well taken by children. It is important, says Dr. Savill, that at the same time the diet should be regulated, no beer, sugar, or sweets being allowed, and meat only in very moderate quantity. It is also important to keep the bowels acting freely. Although improvement is generally noted after the first dose, he says, complete recovery is sometimes not obtained until the blood becomes saturated, and the dose must be increased until this is accomplished. In long-standing cases perseverance is necessary. When recovery is oblained the dose should be gradually, not suddenly, reduced, and it is very important that the use of the remedy should be continued for at least from one to three weeks after all symptoms have disap- peared. It is not possible yet, he thinks, to indicate precisely which cases are most suit- able for this treatment, but it is worth trying in all cases where itching is a pronounced feature. In most of his cases an actual cure resulted, but in a few of very long duration relief was obtained only so long as the drug was being taken. Nevertheless, a cure, he thinks, will probably result with perseverance even in these. CALCIUM SULPHIDE CARBOLIC ACID 428 Dr. William Huntly, of Kotah (Indian Medical Record, May 1, 1894; iVew York Medical Journal, June 16, 1894), speaks highly of calcium chloride as a hmmostatic. In a case of bleeding after the extraction of a tooth the flow was arrested by the administration of opium, but returned on the following day, when Dr. Huntly gave the patient calcium chloride, and by evening the bleeding had stopped. In this ease the use of calcium chlo- ride was continued for three days. In ano,ther case vomiting of blood had gone on all night, and every native remedy had been tried un- successfully. Dr. Huntly thought it clear that the hcematemesis was due to an irritant powder having been swallowed by mistake, and he or- dered some soap pills to be taken at once. After the use of calcium chloride, together with other measures, there was no recurrence of the bleeding. In a case of severe epistaxis the same measures proved effectual without resort to plugging. Dr. Saundby, says Dr. Huntly, has obtained good results in a case of purpura hcemorrhagica from 6-grain doses of calcium chloride repeated every two or four hours. Dr. Huntly thinks better results are to be obtained from the combination of opium and calcium chloride than from either drug alone, although opium by itself has often proved successful, as nature mends the broken surfaces while the opium is exercising its re- straining influence ; but when calcium chloride is added. Nature's efforts are supplemented. Opium, he continues, acts on the smaller ar- terioles and capillaries, while calcium chloride acts through and on the blood, and the combi- nation is all the more valuable because their spheres of action do not clash. As a combina- tion, he thinks that calcium chloride and opium should be found superior to lead and opium. CAIiCITJia: SULPHIDE.— Dr. J. Sinclair Coghill (British MedicalJournal, May 4, 1895 ; Therapeutic Gazette, September, 1895) reports a large experience in the use of calcium sul- phide for the prevention of influenza. He gives it in pills, each containing a grain, and one pill is to be taken daily. During the first epi- demic in which he used it all his household took it, with the exception of two servants, who, for some reason or other, did not, and the result was that all escaped except the two servants. The next year, when the epidemic again broke out, the writer asked the authori- ties of the Isle of Wight Railway to supply all their employees with the pills, and all who took them regularly escaped. The manager of the Central Railway also asked Dr. Coghill to sup- ply his men with them, and he afterward in- formed him that, so far as he could ascertain, none of the men who had taken the pills regu- larly had had influenza. During the next outbreak the pills were again given, with like results ; but on the Isle of Wight Railway they were not given out to each workman as for- merly, consequently but few took them, and the result was that a large number of influenza cases occurred among those who had not used the remedy. It takes about three days, says Dr. Coghill, before the system becomes sufficiently satu- rated with the drug to prevent infection; therefore it is rarely of use to those who have ' already been exposed to it, though even then it appears to modify the attack. When a case appears he believes the 5-grain dose of quinine to be more rapid in its action than the sulphide of calcium, and therefore safer to give, but he would afterward carry on the efl^ect with the sulphide of calcium, which is equally efficacious and much easier for many to take, as it never appears to disagree in any way, although taken regularly for many weeks. Its modus operandi is thought to be that of rendering the blood unfit to receive and support the germ of the disease. CAMPHORIC ACID.— Dr. Ralph Stock- man (Edinburgh Medical Journal, January, 1897 ; New York Medical Journal, January ]6, 1897) refers to the early experiments made by Gormanni and Brugnatelli, the results of which showed that this drug readily destroyed the tubercle bacillus, and that sputum after treatment with it failed to infect rabbits. Piirbringer, he says, used it as an intestinal antiseptic in typhoid fever, and found that it greatly diminished the number of organisms in the alvine discharges, but had no effect on the duration or the severity of the fever. In the course of these observations it was noticed by Piirbringer that it checked the secretion of sweat, and he then began to use it in cases of phthisical sweating. Other trials, says Dr. Stockman, by Dreesmann, Bohland, Niesel, Combemale, and others have confirmed this observation ; and all these investigators speak highly of its action and place it in the very first rank as an anthidrotie. Dr. Stockman states that it has been used only to a comparatively limited extent, and that, although it is said to act more power- fully than either atropine or agariein, the ex- perience on which this opinion is founded is not very extensive. He himself began to use the drug four years ago, and since then he has given it pretty largely in phthisical and other cases of sweating. One ease was that of a lady who had been treated by electricity for a myoma of the uterus. She suffered greatly at night from excessive sweating, and occasion- ally also during the day. Dr. Stockman or- dered her 15 grains of camphoric acid at night, and this completely stopped the sweating. After taking it for two weeks she found that the tendency to excessive sweating had com- pletely disappeared, and since then it has not recurred. Shortly afterward Dr. Stockman again used it successfully in a patient with en- larged prostate, who suffered from profuse sweating without any apparent cause. Tliis tendency to perspire profusely has recurred at intervals, but is always stopped by 15 grains of camphoric acid taken once or twice a day, and sometimes one dose is sufficient. Dr. Stock- man has also used it in cases of hyperidrosis after influenza and in other cases in which there was certainly no tubercle present, and in all of them doses of from 15 to 30 grains have given good or fairly satisfactory results. 429 CALCIUM SULPHIDE CARBOLIC ACID Dr. Stockman emphasizes its value in non- tuberculous cases, because it has been stated that its usefulness is confined to the sweating of phthisis, in which its value is quite com- parable to that of belladonna or atropine. Ac- cording to his experience, camphoric acid acts as efficiently as atropine, but in one or two ob- stinate cases it has not shown itself so power- ful an anthidrotic as picrotoxin. It exercises, he says, no specific germicidal action on tu- bercle bacilli in the tissues, and it does not afi:ect the fever or local lung condition. With regard to its administration. Dr. Stockman thinks that the best plan is to give 30 grains at night two or three hours before the sweating would begin, or it may be given in two doses at short intervals. It is best ad- ministered in powder or in capsules or cachets, as the alcoholic solution is very bitter. Owing to its insolubility, he says, it is only slowly ab- sorbed from the intestinal canal, and this is the reason why it must be given so long before the time of sweating. This slowness of action is. Dr. Stockman thinks, undoubtedly a draw- back as compared with that of atropine or picrotoxin, which can be given hypodermically and act rapidly. Camphoric acid is excreted in the urine within twelve hours after its ad- ministration by the mouth, so that its action is usually not very prolonged. The only unpleasant effect seen by Dr. Stockman has been slight irritation of the stomach after its use. It is said, however, to cause renal irritation, and in one case it was apparently the cause of a skin eruption. It seems to be non-poisonous, he says, even in large doses, and in this respect has distinctly an advantage over belladonna, picrotoxin, and agaracin. Furbringer has given as much as 75 grains a day in typhoid fever, and Niesel gave 750 grains in four weeks in a case of cys- titis, without any toxic or unpleasant symp- toms being produced. He adds that his own experience also bears this out, as he has never noticed any depression of the heart or nervous system, and Wagner has found that camphoric acid has much the same effect as camphor on the circulation, that it acts as a stimulant to the heart and raises the blood-pressure. In order to ascertain its mode of action, Dr. Stockman made some experiments on frogs and on sweat secretion in cats. The experi- ments on frogs showed that it was not very toxic to these animals. Doses of from 2 to 4 grains by the mouth or subeutaneously caused slight depression which lasted for some hours and was then succeeded by great increase in the spinal reflexes which lasted for several days. Given in this way, it scarcely affected the motor nerves and muscles, but if the same dose was injected directly into the aorta of pithed frogs, both motor nerves and muscles were paralyzed. Its action differs, therefore, very considerably from that of camphor. Doses up to 75 grains had very little effect on rabbits beyond causing slight depression sometimes followed by a very slight increase of reflexes. The toxicity of camphoric acid is therefore, remarks Dr. Stockman, very slight in animals as well as in man. CANNABIS INDICA.— The Therapeut- ische Woehenschrift for March 1, 1896 (New York Medical Journal, March 21, 1896), men- tions a new watery fluid extract of cannabis indica termed extractum cannabis indices aquosnm fluidum, and states that, according to R. Cowan Lees, it possesses all the benefi- cial properties of the plant, but does not give rise to that state of intoxication, bordering on poisoning, which sometimes follows the use of even meaium doses of the alcoholic prepara- tions. It has no efieet on the secretion of bronchial mucus, and consequently in suitable cases it seems more efficient than opium, and it has a manifest anodyne and hypnotic effect in pulmonary affections. Lees has observed the best results from its use in tuberculous dis- ease of the lungs, in which it materially allevi- ates the paroxysms of coughing, while at the same time it exerts the precious stimulat- ing and cheering effects of cannabis indica. It is, furthermore, of value in digestive disturb- ances connected with constipation and as a soporific in the diseases of children. The me- dium dose for an adult is from 30 to 60 drops ; for a child less than a year old, from 0-15 to 030 of a drop for each month of age; for older children, from 1^ to 3 drops for each year of age. ' CABBAZOTIC ACID.— See Piceio acid. CAKBOLIC ACID.— In the Lancet for January 16, 1897, Mr. Arthur Eddowes, of Loughborough, reports a new case of trau- matic tetanus cured by the subcutaneous ad- ministration of carbolic acid. A man, aged forty-one years, received a punctured wound on the inner side of the ball of the left great toe from a boot nail on or about May 19th. Ijittle notice was taken of the wound at the time, and he continued his work. On the 26th he got very wet, and thought he had contracted a chill. About June 2d the wound was ob- served to suppurate slightly, but he still did his work. On the 9th he felt slight stiffness of the lower jaw and of the nape of the neck ; the latter sensation was described " as if some- thing was constantly pulling his head back- ward." On the 10th, the symptoms being slightly worse, he consulted his medical man, who prescribed for him. He visited the prac- titioner again on the 11th and 12th, but he still continued his work. On the morning of the 13th he was advised by the medical man to go home and go to bed, but he did not do so till 6 p. M. During these days the symp- toms had been steadily increasing in severity, and by the 13th his condition was as follows : His jaws were quite closed, so that slops only could be taken. The muscles of the back were slightly rigid, sufficiently so to make move- ment difficult. By the next morning (June 14th) there was fully developed trismus with severe aching pains in the muscles around the lower jaw, rigidity and arching of the neck, rigidity and slight arching of the back, and some contraction of the abdominal walls ; the lower extremities were not much complained of except for shooting pains round the knees ; the upper extremities were free. The urine CARBONIC ACID COCAINE 430 passed normally ; the bowels were acted upon by 3 grains of calomel given the previous even- ing ; the surface of the body was somewhat clammy. The pulse was 66 and of good vol- ume, and the temperature was 98° F. His intellect was clear ; the power of swallowing was not perceptibly affected, the pati«nt being easily fed with slops owing to the absence of several teeth. The treatment consisted in the administra- tion of chloral hydrate and bromide of potas- sium every four hours and liquid food. On the 15th the arching of the neck and trunls was somewhat more extreme ; the trismus was still marked, and there was some degree of risus sardonious observable. Also there was considerable pain complained of, beginning in the spiue and shooting forward. The power of the extremities, however, remained good; the urine passed normally, but; the bowels were not open. The pulse and temperature were the same as on the 14th. On the 16th his con- dition remained unchanged. On the 17th occasional momentary convulsive movements of the trunk, simulating hiccough, were ob- served, the arching of the neck and trunk was increased, and the power of the lower extremi- ties was slightly lessened. There were consid- erable pain and' some tenderness of the spinal column. The pulse was 72 and the tempera- ture was normal ; the urine passed normally, but it was highly concentrated and loaded with urates; the bowels were opened by an aperient and an enema. On the 18th the rigid- ity of the neck was less extreme, the convulsive twitohings were more frequent, and intense fcEtor of the breath was noticed ; otherwise the condition remained the same as on the 17th. A consultation was held, and the following treatment was adopted: Highly nourishing diet was ordered, consisting of eggs with milk and brandy, milk with soda water, jellies, and cocoa, frequently administered in small quan- tities. Ten grains each of chloral hydrate and bromide of potassium were administered every two hours. Five minims of carbolic acid (2- per-cent. solution) were injected hypodermically morning and evening. The chloral aivd bro- mide of potassium were given at 8 p. M., and were followed by intense excitement with numbness in the extremities half an hour later, which continued during the greater part of the night. The carbolic acid was injected at 10 p. M., and no after-effects were noticeable, the pulse being 102 and the temperature 100'8°. On the 19th, at 10-45 A. m., the pulse was 96 and the temperature 100'8°. The patient had become quieter, the convulsive movements were less frequent and less severe ; he took his food well ; his intellect was somewhat clouded, but he was conscious of his surroundings. There was less rigidity of the back, chest, and abdomen, and there was more power in the legs ; there was no change in the degree of the trismus. The bowels were inactive, and an aperient and an enema had to be resorted to. On the 20th the pulse was 90 and the tempera- ture was 99-8°. The convulsive movements were very slight during the night, but the pa- tient was very restless. The rigidity of the back, chest, and abdomen was much lessened, the back completely resting on the bed ; there was greater power in the lower extremities, but there was little change in the rigidity of the neck. The mouth could be opened slightly, but not sufficiently to allow of protrusion of the tongue. The bowels were still inactive, and an enema was given. The patient's con- dition had considerably improved by the after- noon, and the treatment was slightly changed, the hypodermic injection of carbolic acid being reduced to once daily and the chloral and bro- mide being given every three hours instead of every two hours as before. On the 21st the pulse was 72 and the temperature normal. The patient had had a restless night, but less so than the preceding one. The rigidity of the muscles was lessening, with the exception of those of the neck, which remained firm. The movement of the jaw was more complete, and there was less risus sardonicus. The bowels, however, had not been opened, in spite of a dose of castor oil. The use of the hypodermic injections was discontinued, and 15 grains of chloral hydrate were given three times a day. On the 22d the pulse was 78 and the tempera- ture 98'2°. The rigidity had almost disap- peared except in the neck and jaw. The patient was still restless, evidently from being confined to bed, and the bowels were still inactive, but the patient's condition was improving. On the 23d the pulse was 73 and the temperature normal. He had had a good night, but felt depressed. There were no paroxysms, but there was some pain in the back. The rigidity had considerably dimmished, and the lower jaw was slightly more movable. As the bowels re- mained inactive, an aperient was given. Food was well taken. A tonic was prescribed. From this time the patient made a steady and uninterrupted recovery, and, after a month at Scarborough, returned in perfect health. CAE.BONIC ACID.— This gas was for- merly thought to have a remedial action when inhaled in cases of nasal catarrh. In 1864 Herpin said of it : " Douches or injections of carbonic-acid gas have been successfully used in certain affections of the pituitary mem- brane ; in cases of suppuration it corrects and diminishes the bad odour, and it favours and hastens recovery." Ml Joal {Revue interna- tionale de rhinologie, d'otologie, et de laryn- gologie, May, 1896), who quotes this passage from Herpin, reports two cases of anosmia cured by the use of the gas in the form of a nasal douche, and mentions its favourable ac- tion in hypertrophic rhinitis and acute coryza. He describes a simple device for the inhalation. An ordinary " siphon " of carbonic-acid water is turned upside down and the valve pressed in order to allow that portion of the liquid which is above the extremitv of the tube to run out. On the tip of the outlet is placed a rubber tube about six inches in length, on the end of which a nasal cannula is attached, and the apparatus is ready for use. The cannula is introduced into the nostril and the valve pressed gently, and the carbonic acid pene- trates the nasal fossae; or the valve may be 431 CAEBONIC ACID COCAINE brought, near the nostril so that the patient may inhale the gas. and in this way it is drawn through the respiratory and olfaccory parts of the nasal passages. CARDOL. — Under this name two oily liq- uids are on the market — one obtained from Anacardium occidentale, which is a vesicant ; and the other from Anacardium orientale, which is a rubefacient. CABNIFERBIN.— According to Profes- sor Coblcntz, this German meat preparation contains 30 per cent, of iron in combination with phosphoric acid. It is said to be taste- less. It may be given to children in doses of from 3 to 5 grains, and to adults in doses of 8 grains, as a tonic and nutrient. CELLOIDIN.— Dr. R. T. Williamson (Brit- ish Medical Journal, April 18, 1896) thinks that a solution of celloidin is superior to collodion in adhesive power. He says the strength of the solution he has employed has been the same as that used in microscopical work — namely, 2 parts of celloidin dissolved in a mixture of 15 parts of absolute alcohol and 15 parts of pure ether (specific gravity, 0'720). It is important, he says, to use pure absolute ether of this specific gravity, and not the sulphuric ether which has a specific grav- ity of 0-735. If the latter is used the celloidin does not adhere to the skin so well. CEIiLTJLOID.— Professor Landerer and Dr. E. Kirsch {Centralhlatt fur Chirurgie, July 18, 1896; New York Medical Journal, August 1, 1896). after mentioning the great drawbacks of plaster of Paris as a splint ma- terial — its weight and its proneness to become foul by absorbing sweat, urine, etc. — say that in the Medico-mechanical Institute of Stutt- gart celluloid has been found an excellent sub- stitute free from these disadvantages. A wide-moiithed bottle is packed for about a quarter of its height with celluloid cut into small pieces, and then it is filled with acetone. It is provided with an air-tight stopper to guard against evaporation. Prom time to time it is opened, and the contents are stirred with a stick. The celluloid dissolves in course of time. A plaster cast of the diseased or in- jured part is covered with a moderately thick layer of felt or flannel, and the celluloid solu- tion is rubbed into this covering with the hands, which are to be protected with leather gloves. This process should be repeated from four to six times. The advantages of the cel- luloid splints and corsets are their lightness, hardness, stability, elasticity, and cleanliness. CHELIDONITTiyr.— A Russian physician. Dr. Denissenko ( Vratch, 1896, No. 30 : Deutsche Medizinal-Zeitung, September 34, 1896 ; New York Medical Journal, October 10. 1896), has tested the action of the juice of Chelidonium majus on cancer in the municipal hospital in Brjansk. In his early experiments he used the fresh juice of the herb, but since February, 1895, he has been using the extract found in the shops. His method of employing chelidonium is as follows : He directs that from 23 to 75 grains of the extract be taken internally, dissolved in distilled water or peppermint water, every day throughout the treatment. Into the substance of the tumour, as close as possible to the boun- dary between it and the healthy tissue, he throws a number of injections of from 2 to 4 drops of a mixture of equal weights of the ex- tract, glycerin, and distilled water, not exceed- ing a Pravaz's syringeful in all. The frequency with which these injections are given is not stated. If the tumour is ulcerated, he paints its surface twice a day with a mixture of 1 or 3 parts of the extract and 1 part of glycerin. Iron, quinine, and other supporting remedies are employed according to the indications. Except in a few cases, he says, the internal use of the drug caused no disturbance of the stomach, but the painting of the ulcerated surfaces gave rise to a slight and transitory burning. It was different with the parenchy- matous injections; in all instances, after tlie injections, especially after the first one, there was burning pain at the site of the operation, the patient felt weak, there was a more or less severe chill, and then the temperature rose to between 100° and 102° P. Although these symptoms disappeared on the following day. Dr. Denissenko saw reason to exercise a certain amount of caution in the use of the injections. The eifects of this treatment were shown in the course of a few days. They were the following : 1. The sallow hue of the skin dis- appeared. 2. Softening of the tumour set in. 3. After from three to five days there formed at the points of injection fistulous tracts about which the softening process went on with special rapidity. 4. In from fifteen to twenty days a line of demarcation could be distin- guished between the morbid and the healthy tissues ; the one seemed to be forced away from the other. In general, the tumour diminished more than half in circumference, and the affected lymphatic glands of the neighbour- hood underwent involution. CHLORALIMIDE.— This substance, CCl, CH : NH, must not be confounded with chlo- ralamide. Chloralimide is a crystalline pow- der obtained by the action of heat on chloral ammonium. It is hypnotic and analgetic. The dose is from 15 to 45 grains, and not more than 90 grains should be given in twen- ty-four hours. Clinical data concerning its use are still so defective as to call for caution in its employment. CHLOBOSALOL.— See under Salicylic ACID AND THE SALICYLATES (Supplement). CHOCOLATE.— See under Cocoa. CITB,OPHEN,acompound of citric acidand paraphenetidine, CsHiOElf QQ''^rT >CeH4Ja, is closely allied to apolysine (q. v.). It is em- ployed as an antipyretic and analgetic in doses of from 7 to 15 grains. COCAINE.— The Therapeutische Wochen- schrift for June 21, 1896, contained an inter- esting summary of several oases of poisoning with cocame, the substance of which is given in the New York Medical Journal for July 11, 1896. The writer first remarks upon the ex- traordinary variability of the symptoms in CODEINE ERODIUM CICUTARIUM 433 cases of cocaine poisoning:. There may, he says, be intellectual torpor, tonic or clonic convulsions, or maniacal exaltation. Respira- tory disturbances are particularly intense ; the breathing is shallow, in severe cases it may be of the Cheyne-Stokes type, and death may oc- cur from respiratory paralysis. Phenomena pertaining to the circulation are less pro- nounced. Poisoning has been known to fol- low the use of so small an amount of cocaine as 0077 of a grain, and in many cases that have been reported there has been no reason to suppose that the preparation was impure or that the recognised maximum dose was ex- ceeded ; idiosyncrasy must therefore be as- sumed to have taken a part in giving rise to the results. After making these remarks, the writer pro- ceeds to give condensed accounts of four cases of cocaine poisoning. The first and second eases were reported by Dr. M. Weiarieh in the Berliner klinische Wochenschrift. In one of t.'iem the patient, who had a tumour of the bladder, had been examined with the cysto- scope several times and operated upon with the aid of that instrument and the use of a one-to-fifteen solution of cocaine. On the third day after the operation the same solu- tion was injected, and immediately signs of poisoning showed themselves — unconscious- ness, epileptoid convulsions, Cheyne-Stokes respiration, and slowing of the pulse, which was imperceptible in the wrist and hardly to be felt in the thigh. The patient was saved by means of prolonged and energetic artificial respiration. A week later there was occasion to use an injection of half the strength of the preceding ones, and no signs of poisoning showed themselves. Dr. Weinrich's other pa- tient was a man eighty years old. Similar phenomena of poisoning were observed after a urethral injection of a one-to-fifteen solution • of cocaine. The first case is remarkable, says the Thera- peutische Wochenschrift, from the fact that the 'Cocaine had been used six times without any ill ■ effect, and then on the seventh occasion, with- • out there being any condition especially favour- able to absorption, severe poisoning resulted. It seems that the raucous membrane of the ■urethra absorbs drugs more readily than that • of the bladder, the writer goes on to say, but it may be assumed that the vesical mucosa ^absorbs them more readily when it is diseased than when it is healthy, on account of losses of epithelium, etc. The third case was reported by Dr. E. Pfister, of Cairo, in the Berliner klinische Wochenschrift, 1896, No. 14. The man had suffered with retention of urine a number of times in consequence of vesical calculi. He received an injection of a 20-per-cent. solution of cocaine into the bladder, and died almost immediately. A Pravaz's syringe, the writer remarks, will hold four times the amount of such a solution as would contain the maxi- mum dose of cocaine, and it is probable that in this case a still larger syringe was used, for only thus, he says, can the lightninglike ra- pidity with which the drug acted be explained. The fourth case was observed by Dr. Gr. Duchesne, of Orbec, and reported in the Annee medicate de Caen for 1896. A man thirty- eight years old had two injections of cocaine into the gum, in order to have a tooth ex- tracted without pain. On the following day he had oedema of the lids of each eye, espe- cially of the upper lid, which increased for forty-eight hours and then subsided entirely. Repeated examinations of his urine showed no trace of albumin. In this case, the writer in the Therapeutische Wochenschrift thinks, there was probably a vaso-motor paralysis in conse- quence of the action of the drug on the ter- minations of the inferior dental nerve, which is a branch of the inferior maxillary, or of a part of the trigeminal, which by its ophthalmic branch of Willis is in close connection with the skin and the mucous membrane of the lids. Great caution must be observed in the use of cocaine within the urinary passages, says the writer, but he adds that the capricious ac- tion of the drug is as difiicult to guard against as that of chloroform. The use of cocaine is contra-indicated in anaemic persons and in those that are the subjects of respiratory or circulatory disease. When cocaine poisoning occurs, amyl nitrite and chloroform should be used, also opium and chloral hydrate for the convulsions, but above all artificial respiration and injections of camphor dissolved in ether. CODEINE.— According to Mr. Joseph W. England (American Journal of Pharmacy, July, 1894), a mixture for coughs, known as the "C. — C." cough mixture, is very largely used in the Philadelphia Hospital. The for- mula is as follows : 5 Codeine sulphate 1 grain ; Diluted hydrocyanic acid. . 16 minims; Chloroform, ) , c a -, , Mucilage of acacia, \ ^^"^^ ■ ^ ^- drachms ; Syrup of wild cherry to 1 fl, oz. M. Dose, a teaspoonful. A somewhat similar formula is given on page 386 of vol. i. CODOii.— See Rosinol. COPAIBA has been recommended by Pro- fessor Monti, of Vienna, in the treatment of scabies in children. Waring [Manual of Prac- tical Therapeutics, Philadelphia, 1886) states that Dr. Monti employed the balsam in twenty- seven instances, and in each case effected a complete cure. Each child was first washed with soap and water and then rubbed all over twice daily with the balsam. No other appli- cation was used. He found that the itch insect could not live in the balsam beyond two or three hours. COTARNINE HYDROCHLORIDE.— See Stypticin. COTTON ROOT.-Dr. George A. Blakeley, of Albany, Wisconsin {3Iedical News, April 11, 1896), reports a case of poisoning with cotton root. A woman, supposing herself to be preg- nant, took 4 oz. of the fluid extract during the interval from 9 to 10 p. m. At about 11 o'clock her husband arrived home and found her un- conscious, lie summoned Dr. Blakeley, who 433 CODEIKE ERODIUM CICUTARIUM soon reached her and .found her in a state of complete muscular relaxation. The pupils were both widely dilated ; the respiration was 10, sighing and shallow; the pulse was 150, very weak and compressible ; and the temper- ature was 95° P. in the axilla. There was a faint, peculiar odour to the breath, but there were no blisters on the lips or tongue, though the latter was very dark coloured. Dr. Blake- ley gave i of a grain of apomorphine hypo- dermically and diluted alcohol by the same method. Thorough eraesis occurred in five minutes, and the vomited matter was reddish- brown. The symptoms showed rapid improve- ment, and in half an hour she could swallow, when the stomach was thoroughly washed out, getting rid of some more reddish-brown ma- terial, which appeared like extract of cotton- root bark. In about two hours she was able to talk. She improved rapidly and the next morning was able to sit up. No further trouble occurred except that she was quite weak for a few days. It turned out that she was not pregnant. CREOSAL. — This is described as a dark- brown hygroscopic powder, readily soluble in water, made by heating beechwood creosote with tannic acid and phosphorus oxychloride. It has been recommended in the treatment of catarrh of the respiratory organs, in doses of 15 grains three time a day. CE.EOSOL.— This is an oily liquid, called also homoguaiacol and homopvrocatechinmethyl ette.r, CoHa.CH3(OCH3).(OH),' obtained by dis- tilling beechwood tar or gum guaiacum (Merck). It has been recommended as an antiseptic. CREOSOTE.— Dr. J. P. West, of Bellaire, Ohio (Archives of Pmdiatrics, May, 1896), re- cords the cases of two children with enlarged bronchial glands in which the beneficial efEect of creosote was very prompt and decided. creosote-calcium: chlorhy- DROPHOSPHATE.— This is described as a wh te syrupy mass consisting of creosote car- bonate and calcium chlorhydrophosphate. It has been recommended in the treatment of tuberculosis and scrofula in doses of from 3 to 8 grains, in an emulsion, twice a day. Pro- fessor Coblentz gives the following formula : 5 Creosote-calcium chlorhydro- phosphate 5 to 10 parts ; Mucilage of chondrus 15 " Oil of sweet almonds, ) , „_ „ Syrup of Tolu, f ®^°°- '^'* Orange-flower water 75 " M. Dose, a teaspoonful twice a day. CRESALOL, CRESOL SALICYLATE. — See under Salicylic acid and the sali- cylates (Supplement). CRYOSTASE.— This is the name of an an- tiseptic preparation said by Professor Coblentz to be a mixture of equal parts of carbolic acid, camphor, and saponin, with traces of oil of turpentine. CTJTAL. — See Aluminum bobotannicotab- TEATE (Supplement). DERMATIN. — According to Professor Coblentz, thisis a mixture of from 5 to 7 parts ot salicylic acid, from 7 to 15 parts of starch, from 25 to 50 parts of talc, from 30 to 60 parts of silicic acid, and from 3 to 9 parts of kaolin, used as a protective to the skin. DESOXYALIZARIN.— See Anthrako- BIN. DEXTROSE. —See under Sugar (vol. ii, page 235). DIABETIN.— See Levulose. BIACETAITILIDE. — This compound, C6H6N(C2H302)a, is made by heating acetani- lide with glacial acetic acid. It is said to be similar to acetanilide in its action, but more powerful. DIACETYLTANNIN.— See Tannigen. DIETHYLENEDIAMINE.— See Piper- AZINE. DIETHYLSULPHONEDIETHYLME- THANE.— See Tetronal. DIETHYLSTJLPHONEDIMETHYL- METHANE.— See Sulphonal. DIETHYLSTJLPHONEMETHYL- ETHYLMETHANE.— See Trional. DIMETHYLETHYLCARBINOL.— See Amylene hydrate. DIOXYANTHRANOL. — See Anthea- EOBIN. DISPERMINE.— See Pipeeazinb. DITHYMOL IODIDE.— See Aeistol. DITHYMOL TRIIODIDE.— See Anni- DALIN. DUOTAL. — Guaiacol carbonate (see under Guaiacol). EMBELIC ACID.— See under Bmbelia RiBES. ERODIUM CICUTARIUM.— This gera- niaceous plant, the hemlock stork's-bill, wild mush, or pine grass, has been used as an astringent and diuretic. Dr. Komarovitch (Vratch, February 29, 1896; Cancel!, April 4, 1896) states that he has made considerable use of it in uterine hwmorrhage with excellent re- sults, often after better-known drugs, such as ergot and hydfastis, had failed. He believes that the effect of the erodium is to increase the elasticity of the muscular fibres and thus to favour their contraction. In one case where a polypus was the cause of the haemorrhage, after a fortnight's treatment the tumour was extruded into the vagina, which had never occurred with other drugs previously tried. Twenty of the cases where erodium succeeded after the failure of ergot and hydrastis were due to metritis, but others were dependent on myoma and abortion. The preparation used was an infusion made with 12 parts of water to 1 part of the plant, to which a little pepper- mint was added to improve the taste. Of this a tablespoonful was prescribed every two hours. In no case were any unpleasant by-effects pro- duced, though sometimes the use of the medi- ETHYL CARBAMATE EUCASIN 434 cine was continued for some weeks. The active principles of the plant are stated to be " an ethereal oil, a bitter principle called geramin, and tannic acid." ETHYL CAE.BAMATE.— See Uke- TBANB. ETHYL CHLOK.IDE.— In addition to its use as an anaesthetic, ethyl chloride is often of service as an analgetic. The spray may be applied repeatedly to the painful part, which it may not be necessary to freeze. Dr. W. C. Daisch, of Melbourne (Australian Medical Journal, December 30, 1895), has found it to give great relief in such forms of pain as that of migraine, the headache of influenza, and toothache. It will relieve the pain of iritis or conjunctivitis if sprayed round the orbit. In epididymitis it relieves and reduces inflamma- tion, and it has been used in meningitis and sunstroke. Itching, pleurodynia, and the pain of shingles may be relieved by its use. In spasmodic dyspncea, asthma, and hiccough it should be sprayed round the base of the chest, says Dr. Daisch, who adds that it will stop epi- staxis if applied to the base of the nose, or sprayed directly into the nostrils, and might be advantageously used in persistent bleeding after tooth extraction. According to Dr. Daisch, ethyl chloride is very serviceable as a dental ancesthetic. Before it is applied, he says, the gum should be thor- oughly dried and smeared with vaseline, and the neighbouring parts protected by packing with wool. The patient is instructed to breathe through the nose. During thawing, care must be observed in the use of hot water ; if it is used too hot or too soon, sloughing may result. For the extraction of a tooth the gum may be frozen on each side of the tooth ; it checks Heeding in addition to its action as an anaes- thetic. It is said not to be necessary to spray into the mouth at all to prevent pain in ex- tractions. If the jet is thrown on to the jaw outside, near the entrance of the dental nerve in front o£ the ear for the upper, behind the ramus of the inferior maxilla for the lower jaw, anaesthesia of the whole jaw on one side will be caused, and teeth may be extracted painlessly, says Dr. Daisch; he remarks that this is useful in the case of molars, which are not so accessible to the spray as the front teeth. ETHYLENE PEBIODIDE.— See Di- lODOFORH. ETHYLURETHANE.— See Urethane. ETJCAINE, CioHt^NO,, is the methyl ester of a benzoylated oxypiperidinecarbonic acid. The hydrochloride obtained by crystallization from a methyl-alcohol solution bears the for- mula CioHa,N04.HCl.H02. Eucaine is insolu- ble in water, but dissolves freely in alcohol, in ether, in chloroform, and in benzene. Evapo- rated from its ethereal solution, it appears in large, brilliant, colourless crystals, which melt at 219° F. It combines with mineral acids to form more or less freely soluble salts, also crystalline in character. Eucaine hydrochlo- ride occurs in the form of brilliant platelets or crystals which dissolre readily in six parts of water at the temperature of the room. There are some points of chemical similarity and difference between the hydrochloride of cocaine and that of eucaine. Both, in solution, change in colour to yellow aud orange-red when boiled with ferric chloride. The addition of a 5-per- cent, solution of chromic acid to a solution of eucaine gives rise to a beautiful yellow, crys- talline precipitate. With cocaine it does not. Again, a solution of the eucaine salt, treated with a 10-per-cent. solution of potassium iodide, presents at first a milky turbidity, and gradu- ally deposits fine colourless plates after stand- ing. In this respect it differs from cocaine. The hydrochloride of eucaine is stable in the air, and it does not undergo decomposition or change, as cocaine does, when subjected to boil- ing. Cocaine, as is well known, splits up into benzoylecgoniu and methyl alcohol, which ren- ders its subsequent use upon mucous mem- branes irritating. Solutions of eucaine salts remain clear, moreover, and require, therefore, no preservative agent to be added. Dr. Gaetano Vinci, of Messina, as a result of clinical and laboratory experiments, finds (Therapeutische Monatshefte, June, 1896) that a solution of eucaine hydrochloride of a strength of from 2 to 5 per cent, induces prompt anass- thesiaof the conjunctiva and cornea in from one to three minutes. The anassthesia lasts from twenty to thirty minutes and may be prolonged by the further application of the solution. The pupil does not become dilated, and during the local anaesthesia reacts normally to light. Irri- tation of the conjunctiva is almost always ab- sent, but the observer reports an occasional hyperaemia following the use of cocaine. The effect of large or medium doses upon animals is a general excitation of the central nervous system, followed ultimately by pa- ralysis. Severe tonic and clonic convulsions sometimes appear, which are succeeded by paralysis. Some central irritation of the vagus nerve diminishes the frequency of the heart's beats, and because of the irritation of the vaso- motor system of nerves the blood-pressure rises. In Vinci's experiments, only fatal doses suc- ceeded in giving rise to a sudden diminution of the blood-pressure. When doses of from ^ to i of a grain for each thirty-five ounces of the animal's weight are given, coma, dyspncea, and opisthotonos, with paresis of the posterior limbs, supervene. Fatal doses kill by respira- tory failure after a preliminary hastening of the respiration with marked dyspnoea. In man, toxic symptoms have never been evoked, and if it is given in therapeutic doses — according to Kiesel as much as 30 grains — no bad effects upon the heart or respiration are likely to follow. Vinci points out the similarity of the physi- ological action of eucaine and that of cocaine, with their differences. Eucaine is distinctly less poisonous to man than cocaine, and of animals injected with the same quantities of both drugs, those treated with eucaine sur- vived, those with cocaine died. Eucaine pro- duces a primary decrease in the frequency of the heart s action ; cocaine an acceleration. So 435 ETHYL CARBAMATE EUCASIN far as their anmslhetic properties are concerned, the two drugs are very similar, except that eucaine possesses the advantage that it favours hyperaemia, while cocaine induces ischaeraia. Upon the eye, eucaine does not cause mydriasis, and it does not interfere with the reaction of the pupil to light, an advantage of importance in ophthaimological operations. Upon the mucous membranes of the nose and throat eucaine produces a strong ana3s- thetic influence, with no bad effect upon the heart. Kiesel obtained good results in dental work with solutions of the hydrochloride of a strength of from 1 to 5 per cent. Schleich has found that, in the same strength, it produces a strong anaesthetic influence when subcutane- ously administered ; for infiltration anmsfhesia — as first advocated by Schleich — a solution of the strength of from 1 to 3 per cent, is suf- flciently strong. He believes that eucaine will replace cocaine in instances where its simple ap- plication upon mucous membranes is required. In ophthaimological practice many other workers have substantiated Vinci"s work. Carter, o£ London {Lancet, July 11, 1896), highly recommends eucaine hydrochloride as being less toxic than cocaine and as having no mydriatic effect, two advantages which appeal to him strongly. In cases in which a contrac- tion of the smaller vessels is desired, however, cocaine had better be employed. Vollert (iliinchener medicinische Wochenschrift, 1896, No. 22) has seen occasional hyperaemia follow the local use of eucaine in the eye, as was, how- ever, stated in Vinci's original paper {Deutsche Medizinal-Zeitung, April 27, 1896). Anaesthesia of mucous membranes follows the instillation of eucaine h3'drochloride in from one to three minutes, and lasts, according to different ob- servers, from ten to thirty minutes. Gorl {Therapeutische Monatshefte, July, 1896) has used eucaine as an anaesthetic for eystoscopic work, and says that patients com- plain at first of some irritation and burning, but that the anaesthesia is as profound as that of cocaine. He used a 0'5-per-cent. solution. Cystoscopy is succeeded by a slight bleeding, winch he attributes to a hyperaemia induced by the eucaine. He finds that eight cubic centi- metres of the same solution occasion some burning in the urethea, but this is followed by an anSBsthesia sufficiently strong for the manip- ulation of instruments. Gorl has also found the agent satisfactory in laryngological work. It has been suggested that in order to avoid the smarting sometimes incident to the use of eucaine on raucous membranes, a 1-per-cent. solution should be first instilled, and this fol- lowed in from two to three minutes by the instillation of a 2-per-cent. solution. In order to overcome the ischaemia produced by cocaine, Berger has proposed this formula for the pur- poses of local anaesthesia : ]J Eucaine hydrochloride, ) ~ 'e, \ each. 3 grains ; Cocaine hydrochloride, Distilled water 300 minims. M. For the other requirements of local anes- thesia, eucaine seems to be the equal of cocaine in rapidity, in intensity, and in duration. It may be employed for subcutaneous ana'sthesia in any part of the body in strengths of from 1 to 6 or 7 per cent, for the opening of abscegsen, the removal of small tumours or growths of any kind, or for the general purposes of minor surgery, with perfect safety. The writer has recently used, subcutaneously, a 6-per-cent. so- lution for the extirpation of a very large wart, and perfect anaesthesia was procured. It lasted twenty minutes and allowed of extensive sutur- ing. An additional virtue of the hydrochlo- ride of eucaine rests upon the fact that it is not decomposed by repeated boiling, and may thus be sterilized as often as desired. The dose of eucaine is the same as (hat of cocaine. As mentioned above, Kiesel {Zahn- drztliche Rundschau, April 5, 1896 ; New York Medical Journal, May 9, 1896) says that 30 grains may be employed safely by subcuta- neous or submucous injection. Samuel JM. Beicknee. EUCALYPTUS.— In the British Medical Journal for August 29, 1896, there is an ab- stract from an Italian journal of an article by Dr. Monfrida Musmeci, who, while studying the action of eucalyptus, found that a decoction of the leaves and a solution of a salt of strychnine formed a flocoulent precipitate of a clear col- our, while there remained above a solution of citron-yellow tint, the strychnine at the same time losing completely its characteristic bitter taste. On this account the author raised the questions of whether the strychnine lost its toxic action, and if accordingly eucalyptus could be used as an antidote. To ascertain, he carried out a series of experiments On frogs, rabbits, and dogs. He found that a solution of nitrate of strychnine, 1 per cent., when injected with a Pravaz syringe, would kill a frog in from eight to ten minutes after a dose of O'OOl of a gramme, while a dog was killed in thirty-nine minutes by a dose of O'OOl of a gramme for each kilogramme of its weight. When a decoction of eucalyptus was adminis- tered at the same time the animal survived the same dose used for the check experiment, and even became tolerant of a much larger dose. In other experiments the eucalyptus was administered after convulsions had ap- peared, and then these became much less marked and even disappeared. Prom these experiments Musmeci believes that eucalyptus has a true antidotal action in strychnine poi- soni7ig, and recommends that practiciil appli- cation should be made of it by using a decoction for washing out the stomach in such eases. EUCASIN.— This is a German nutrient preparation made by subjecting the casein of milk to the action of ammonia. Dr. A. Cohn {Centralblatt fur imiere Medicin, July 11, 1896 ; New Fork Medical Jourjial, August 1, 1896) describes it as a white powder of a some- what gritty aspect, without any special taste, and having a faint odour of milk. Mixed with cold water, it forms a gelatinous mass. On shaking it with boiling water, a uniform clear- white solution is formed. This tastes like groats, but is more glutinous. EUDOXINE GEOSOTE 436 He has used it in the form of a mush of oatmeal or rice, to each plateful of which a teaspoonful of eucasin has been added, to- gether with a little salt. This mixture is read- ily taken two or three times a day. A choco- late preparation containing 20 per cent, of eucasin has been put on the market by Hart- wig & Vogel, of Dresden. Dr. Cohn gives brief accounts of several eases in which he has found eucasin of advantage, including cases of pulmonary and laryngeal tuberculous dis- ease, armemia, peritoneal irritation, typhlitis, parametritis, and perimetritis. Particularly striking were the effects of its employment in a case of acute anaemia following abor- tion. Dr. E. Salkowsky (Deutsche Wochenschrift, April 9, 1886 ; Wochenschrift, April 19, 1896) thinks that one of the advantages of eucasin is that it con- tains no nuclein, so that it is well fitted as an article of diet for persons of the uric-acid di- athesis arid predisposed to gout. ETJDOXINE.— This is a uosophene com- pound said by Professor Coblentz to contain 53-9 per cent, of iodine and 14'5 per cent, of bismuth. It is described as a reddish-brown powder, odourless and tasteless, employed as a gastric and intestirtal antiseptic. Prom 3 to 6 grains may be given to an adult three times a day (Presse medicale ielge, August 11, 1895 ; Revue illustree de polyteehnique medi- cate, October 31, 1895). EUaUININE. — This substance is de- scribed by von Noorden {Gentralblatt fur innere Medicin, November 28, 1896 ; New Fork Medical Journal, January 2, 1897) as the ethylcarbonic-acid ester of quinine, having the constitutional formula CO <,^r^' ti xt r> L'U2ona3J^J aU It occurs in white needles which are soluble with difficulty in water, but readily soluble in alcohol, in ether, and in chloroform. It has an alkaline reaction and forms crystalline salts with acids. The chloride is readily sol- uble in water, the sulphate dissolves with some difficulty, and the tannate is almost in- soluble. The alkaloid itself, which is the form in which von Noorden has used euquinine most largely is entirely tasteless at fii-st, but has a slightly bitter after-taste, reminding one of the taste of a very weak solution of quinine. If it is taken in sherry, milk, soup, cocoa, or the like, he says, no unpleasant taste is perceived. Healthy persons can take 15 grains, and in most instances twice that amount, daily with- out experiencing any unpleasant feeling in the head. Even after a prolonged use of these doses there were no disturbances attributable to them in any of von Noorden's patients. Euquinine is said to be a derivative of qui- nine, of which it has the characteristic reme- dial virtues without any of the unpleasant properties of that drug. This is implied in its name. It may be used in all cases in which guinine is indicated, but for any reason is ob- jectionable. ETTRYTHBOL.— See Splenic extract. EXEBCISE.— For the Schott method of treating chronic heart disease, see under Baths (Supplement). riLMOGEN'. — This fanciful name has been applied to an English preparation, apparently- proprietary. According to the British Medi- cal Journal for December 19, 1896, it consists of a solution of pyroxylin in acetone, and in order to render flexible the film of nitrated cellulose left after evaporation of the acetone, a small quantity of oil is added. The solution possesses considerable solvent powers upon many drugs employed in dermatological prac- tice, such as salicylic acid, resorcin, iodoform, pyrogallic acid, mercury bichloride,- chrysaro- bin, cocaine, ichthyol, and carbolic acid. Its viscosity permits of the easy suspension of such insoluble substances as sulphur, lead ace- tate, zinc oxide, etc. Eilmogen, when painted on the skin, quickly forms a film, which ad- heres firmly, is flexible, and is unaffected by washing with water; the film can be removed easily by means of alcohol. FORMALDEHYDE.— Dr. Elmer Grant Horton, of the laboratory of hygiene of the University of Pennsylvania [Medical News, August 8, 1896), has experimented with for- maldehyde as a means of disinfecting books. His conclusions are as follows : 1. Books can be disinfected in a closed space simply by vapour of commercial formalin by using 1 cubic centimetre of formalin to 800 cubic centimetres, or less, of air. 2. The vapour of formalin is rapid in its disinfecting action. The effect produced in the flrst fifteen min- utes is practically equivalent to that observed after twenty-four hours. 3. An increase in the amount of air to each cubic centimetre of formalin is not counterbalanced by an increase in the length of time of exposure. 4. In case the disinfection has been incomplete, the vital- ity of the organisms has been so weakened that they survive only if transferred in a few hours to media suitable for their development. 5. The use of vapour of formalin has not been found detrimental to the books, and it is not objectionable to the operator beyond caus- ing a temporary irritation of the nose and eyes, somewhat similar to that produced by ammonia. Dr. J. N. Hurty, of Indianapolis (Indiana Medical Journal, December, 1896), speaks of a lamp invented by Professor F. C. Robinson, of Bowdoin Col lege, as probably the best formalde- hyde lamp thus far devised. Dr. W. S. Alexander, of Oxford, Ohio (New York Medical Joui-nal. January 9, 1897), re- ports having cured a rebellious case of pruri- tus vulvm with formaldehyde. He says also that cases of whooping-cough are treated suc- cessfully by spraying with an atomizer three times daily for fifteen minutes at a time, using a 1-per-cent. solution. He speaks of formal- dehyde as surpassing all other remedies in the treatment of hay-fever — spraying with a half-per-cent. solution' and directing" the pa- 437 EUDOXINE GEOSOTE tient to inhale the fumes of a 3-per-cent. so- lution. FORMAIiOSE.— See Formaldehyde. FORMOGELATIN is stated {British, Med- ical Journal, December 19, 188()) to be a com- pound of formaldehyde and gelatin. It is a gray, somewhat gritty, mobile, and odourless powder, intended to be used in the dressing of wounds as a substitute for iodoform. It is said to be a convenient preparation of formaldehyde in a dry form. Cf. Glutol. FORMYL CHLORIDE.— See Chloro- FORM. FORMYIi TRIBROMIDE.— See Beomo- FOEM. FORMYI, TRIIODIDE.— See Iodoform. FRAXININ.— See under Manna. GA.DXJOL.— See Mobehuol. GALACTOSE.— See under Shgae (vol. ii, page 235)._ GALACTOTHERAPY.— See under Se- EUM TREATMENT (vol. ii, page 187). GARGLES. — In a paper read before the British Laryngological, Khinological, and Oto- logical Association, Mr. Lennox Browne (Jour- nal of Laryngology, Rhinology, and Otology, March, 1896; New York Medical Journal, March 21, 1896) argued in favour of abolishing gargling in the treatment of diseases of the throat by general practitioners. He said that for the purpose of laving the posterior pillars and wall of the pharynx von Troltseh's method must be used. The following were the direc- tions : " Take a portion — say a tablespoonful — of the gargle in the mouth, hold it in the back of the throat with the head thrown back ; then, closing the nose with the finger and thumb to prevent entrance of air. open the mouth and make the movements of swallow- ing without letting the liquid go down the throat." But this process, says Mr. Browne, is by no means easy to carry out efficiently, and is im- possible when any acnte inflammation of the throat is present, on account of the pain caused by the necessary muscular action. The mus- cular acts required for ordinary gargling are entirely irregular, he adds, being unlike those called for in the exercise of the normal func- tions, such as breathing, speaking, swallowing, or even laughing. In all cases, therefore, of acute inflammatory disease of the throat in which the act of swallowing causes severe pain, and even movements of the tongue are attended with discomfort, and in cases (such as those of amygdalitis) in which the mouth can be opened but very slightly, the act of gargling by any method can not but tend to increase the inflammation and the patient's distress. Gargles are also contra-indicated, says Mr. Browne, in cases where the patient requires to be kept in the recumbent posture in bed — notably in cases of diphtheria, in which cardiac failure has to be especially guarded against — since the act requires him to rise from that position. And as, according to the well-known law, paralytic sequelae attack earliest and to the greatest extent muscles in proportion to the constancy of their use, palatal and faucial paralyses, early and frequent as they always are, can not but be accentuated by the irreg- ular and excessive functional exercise involved in the act of gargling. Lastly, gargles, however employed, whether by the ordinary method or by von TrOltsch's, lie says, can not be safely prescribed unless the ingredients are harmless should any portion be inadvertently swallowed. All these objec- tions to gargles in the adult apply with still greater force, he adds, in the case of children, in whom the act of gargling is in the majority of cases simply impossible. Gargles, therefore, should be employed only as emollient and antiseptic mouth washes, harmless ingredients being used. As a substitute Mr. Browne would recommend the more general use of mouth ir- rigations, sprays, lozenges, and, in the case of children, medicated confections. In the discussion that followed. Dr. Dundas Grant said that there was one aspect of the gargling question which he thought would come up, to which we might attach at least a theoretical and also a practical value, which was that, in practising von Troltseh's method, it was not altogether useless as a method of massage, and there was a school in which mas- sage of the throat was given a prominence which he thought was quite unnecessary, but still not to be despised. He stated that he had seen some advantage from the employment of massage of the outside of the pharynx ; pos- sibly, also, the Eustachian tubes might be im- proved by the patient's practising von Troltseh's method of gargling at the same time. The swallowing part of it was, he said, the most essential feature, and he thought that in sub- acute cases where a degree of congestion and thickening remained we might yet find it of some use, although it might be limited. GELANTH, GELANTHTJM.— See under Varnishes. GEOSOTE.— This substance is described by Dr. Rieck, of Bassum (Deutsche Medizinal- Zeitung, December 24, 1896 ; New York Medical Journal, January 23, 1897), as the valerianio- acid ester of guaiacol, a yellowish, oily liquid of the specific gravity of 1-037, but slightly soluble in water, but readily soluble in acid and alkaline liquids, in alcohol, in ether, in benzene, and in chloroform. It has a sweetish and smoky odour and a sweetish taste passing into a slight bitter, unaccompanied by burn- ing and not persistent. Applied to the skin and covered with gutta-percha tissue, it is rapidly absorbed and causes no irritation. In- jected subcutaneously in amounts of from 15 to 80 grains, it causes transitory burning and does not give rise to general symptoms. If the injection is thrown into a diseased part, slight oedema with a sensation of heat may re- sult and persist for a few days. Geosote is given internally in 3-grain gelatin GLUCOSE GUAIACOL 438 Ccipsules. It is said not to disturb the stomach in any way when given in daily amounts of from 15 to 45 grains and used continuously for months, and not to give rise to the eructiitions occasioned by creosote — that is. Dr. Rieck has known it to cause eructations in only one in- stance, and in that case there was gaseous dis- tention of the stomach to begin with. He says he has given as much as 75 grains a day without giving rise to any unpleasant effects. He has found it useful iii chlorosis, acute gas- tric and intestinal catarrh, tuberculosis, and articular rheumatism. GLUCOSE.— See under Sugar (vol. ii, page 235). GLTJSIDE. — See Saccharin. GIiTJTOIi.— This is a German proprietary preparation consisting of gelatin impregnated with formaldehyde. As at first prepared, it was a whitish powder insoluble in water; it is now furnished only in the granular, or "grated" form, which i)r. Schleich considers preferable to the powder. It is highly recommended as an antiseptic application ro loounds, ulcers, and weeping affections of the skin and mucous memhrajies. J)t. C. L. Schleich, of Berlin, who introduced it into practice (Therapeutische Monatshefte, February, 1896), says that when it is in contact with living animal tissue the action of the cells of the tissue is to decompose the compound and set formaldehyde free. Glutei has been found to be particularly effi- cacious in sealing up lacerated wounds, even those communicating with a fracture. Prob- ably glutei is substantially the same thing as formogelatin {q. v). GLYCERIN. — This familiar substance oc- casionally acts as a mild poison, even when used in small amounts. Antichievich (Archiv fur Kinderheilkunde, xx; Fortschritte der Medicin, August 1, 1896) reports an instance of acute nephritis produced by it in the case of a boy who was being treated with injections of a solution of iodoform in glycerin. The nephritis disappeared after three weeks' use of a milk diet. In another case hjemoglobinuria came on after the second injection, and there was polyuria for eight days. Olive oil was sub- stituted for the glycerin, and the injections were then well borne. Glycerin is incompatible with potassium per- manganate. GLYCEEOPHOSPHATES.— During the past two years a few articles have appeared in the Paris medical journals with regard to the use of the glycerophosphates of calcium, so- dium, potassium, magnesium, and iron, which were first brought to the notice of the profes- sion by JI. Robin, in the Bulletin de I'Academie de medecine de Paris, April 24, 1894, and have since then been recommended by him as of great therapeutic value. Comet (Progres medical, August 11, 1894) gives a description of the glycerophosphate of calcium and of the method of its preparation which may perhaps be taken as applying to the glycerophosphates in general. It is a white powder, slightly crystalline, soluble in fifteen parts of cold water, almost insoluble m boil- ing water, and insoluble in alcohol. The first step in its preparation is the manufacture of glycerophosphoric acid. A mixture of 3,600 grammes of pure glycerin and 3,000 grammes of phosphoric acid is maintained at a temper- ature of from 100° to 110° C. for six days, and thoroughly shaken three or four times each day. It gradually becomes darker in colour and gives off a vapour until, on the fifth day, it is brown and the vapour ceases to rise. After the sixth day the mixture is allowed to cool. It then becomes clear and transparent, and is known as glycerophosphoric acid. A solution of 500 grammes of calcium carbonate in 2 litres of water is now added very slowly to the acid and causes copious effervescence, from the formation of a large amount of carbon di- oxide. This process is continued for two days, at the end of which time the preparation is filtered, neutralized with a weak solution of milk of lime, and precipitated by means of alcohol. This precipitate is gray in colour and resembles glyoerole of starch. It is poured out at the end of an hour, redissolved in water, filtered, and evaporated at a low temperature. Robin states that he has experimented with the salts of glycerophosphoric acid already mentioned, both singly and in combination, since 1888. He was induced to investigate their therapeutic action by the observations that a relatively large quantity of phosphorus in combination with organic substances could be found in the urine of certain patients, a condition which seemed to indicate an increased loss of the lecithin of the nervo^is system, and that most of the phosphorus in the nervous system was to be found in the form of glycero- phosphoric acid, which is one of the constitu- ents of lecithin. Another consideration which impelled him to the investigation was that drugs which contained phosphorus were as- similated with some difficulty, while an organic compound which resembled in form that pres- ent in the nervous system might be more ac- ceptable and productive of greater benefit. The physiological action of the glycerophos- phates is said by Robin to be to accelerate metabolism and the nitrogenous exchanges, to favour the assimilation of albuminoid sub- stances, and to increase the excretion of nitro- gen, which tends to lower the proportion of uric acid to urea, though it does not influence the formation of uric acid to any extent. They increase the oxidation of broken-up sulphur products and the elimination of sodium chlo- ride. Possibly they favour the assimilation of the phosphates in the food, and so afford a protective influence to the combined phosphor- us in the nervous system. The indication for the use of the glycero- phosphates is a condition of nutrition fre- quently met with in many and diverse diseases, but not always present. This is a diminution of nitrogen metabolism or oxidation changes in the tissues, evidence of which may be found in an increased amount of phosphoric acid as compared with the urea in the urine. When this is absent, and particularly when the oppo- site condition, that of increased oxidation 439 GLUCOSE GUAIACOL changes, is present, the use of these remedies is contra-indicated. Hence one patient with a certain disease may be benefited and another harmed by tiie administration of these drugs. The best results are said to be obtained in exhaustion of the nervous system, as in con valescenee from acute diseases, some forms of neurasthenia, and muscular atrophy. They have been used in nervous asthma from various causes — chlorosis, gout, diabetes, phthisis pul- monalis, obesity, chronic nephritis, Addison's disease, the uric-acid diathesis, phosphaturia, and phosphaturic albuminuria. They are said to be adequate to relieve the pain of lumbago, sciatica, and trigeminal neuralgia, and also the lancinating paitis of locomotor ataxia. Lafage is inclined to think them of some efficacy as galactagogues. The glycerophosphates may all be adminis- tered by the mouth, and the calcium, sodium, and magnesium salts may also be given hypo- dermically. For the latter purpose Robin recommends a 5-per-cent. solution of the cal- cium salt and a 30-per-eent. solution of the sodium salt. Of these, 3 or 4 minims may be injected daily. As the solutions are not of themselves antiseptic, but readily become con- taminated, they should be freshly prepared, and the injections made with antiseptic pre- ca.utions. Then they usually cause no local disturbance beyond some pain occasionally. For the administration of glycerophosphates by the stomach Robin gives several formulae, of which the following is one : 5 Glycerophosphate of calcium. . 90 grains; " of sodium, ) " of potassium, j- each. 30 " " of magnesium, ) " of iron 15 " Tincture of St. Ignatius's bean . 30 drops ; Pepsin 45 grains ; Maltine 15 " Tincture of kola 2-i drachms ; Syrup of cherries, sufficient to make 8 fl. oz. M. Sig. : A tablespoonful at breakfast and dinner. This syrup should be cherry-red. clear, and without deposit. The principal objections to it are that it is difficult to prepare and that it is very expensive. Moreover, M. Robin does not consider the commercial preparations of the glycerophosphates satisfactory. [The following prescription is recommended by M. Delage {Nouveaux remedes, April 24, 1896), who frequently substitutes it for the syrup : g Glycerophosphate of calcium ... 5 grains ; " " " " magnesium 1'75 grain; " iron 0-9 Powdered ignatia 0-5 " Maltine 0-9 Pepsin 2-9 grains. M. This quantity is for one capsule, and the dose is a capsule taken at breakfast and din- ner. M. Delage considers glycerophosphate of iron the best chalybeate that can be employed in the treatment of chlorosis and in anmmia with insufficiency of the oxidation of nitroge- nous food. It is preferable, he says, to give it in the form of pills, as in the following formula : g Glycerophosphate of iron. . . from 0'9 grain to 1-75 grain; Powdered rhubarb 0'9 grain ; Extract of cinchona 2'9 grains. M. This is for one pill ; three such pills are to be taken during the day. one at each meal.] Matthias Lanckton Poster. GXJAIACOCAINE.— Dr. W. J. Morton {Dental Cosmos. January, 1896) has given this name to a compound of 12 parts of guaiacol' and 1 part of cocaine hydrochloride, which he has used successfully as a local ancesihetic by cataphoresis. GUAIACOL has been praised by Tavitain in the treatment of swelled testicle (MMecine moderne, March 18. 1896). He applies it either pure, in amounts of from 30 to 45 grains, or in the form of an ointment, as follows : 5 Guaiacol 5 parts ; Vaseline 30 " M. In mild cases, he asserts, three or four applica- tions will suffice. Dr. S. Solis-Cohen {Philadelphia Polyclinic, 1896, No. 16) says that guaiacol, used early in diphtheria, seems to have a germicidal effect and to prevent the spreading oif the false mem- brane. Ten parts each of guaiacol and sterilized olive oil are used, with one part of menthol. In examinations of cultures after the applica- tion of this mixture no bacilli are met with where they had been found before. Prophy- lactically the mixture seems to be efficacious. In follicular amygdaliiis it seems to cut short the course of the disease if applied early ; and in parenchymatous amygdalitis it is said to mitigate the severity of the disease. Dr. Maldaresco, of Bucharest, has used gua- iacol in pneumonia, apparently with excellent results (cited in Journal des praticiens, March 28, 1896). He paints the drug over the poste- rior surface of the thorax corresponding to the area of pneumonic infiltration. In from six to seven hours the. temperature sinks and, if the process is repeated three or four times daily, the temperature remains down. At the same, time the cough diminishes, the tongue becomes moist and soft, the expectoration is more easily accomplished, and the sjiutum be- comes more fluid. The temperature usually falls from two to three degrees, and some- times not more than two applications are necessary to achieve this result. The author has never seen a relapse and has used no other drugs during this treatment. Maldaresco has obtained equally good results with the same procedure m pulmonary gangrene and broncho- pneumonia. Should repeated applications ir- ritate the skin, they may be made to the sides or to the anterior aspect of the thorax. The author uses a mixture of guaiacol and almond oil, the latter constituting 4 per cent, of the mixture. By this method of treatment he has had 83 recoveries and 18 deaths out of 101 pa- tients. The contention that guaiacol is an anms- 'GUAIECETIN HYDROCHLORIC ACID 440 thetic is not a new one. Laurens _ maladies de roreille, xxii, 1896) has found that the drug, applied to the nasal and pharyngeal mucous membranes and to the ear in a 5-per- cent, solution in olive oil, produces local anies- thesia sufficient for the performance of minor operations. He applies it on probes armed with cotton and rubs the nose and pharynx with it briskly. Anesthesia appears in from fifteen to twenty minutes. In the ear he places 5 or 6 drops of the same solution warmed slightly and allows it to remain about twenty minutes, when it is withdrawn by ab- sorbent cotton. Paracentesis, says Laurens, may then be done painlessly. Dr. J. Petrasko reports an abortion in a woman twenty-nine years of age, three months pregnant, who received i of a grain of pure guaiacol twice daily in addition to an infusion of senega (cited in 'New York Medical Journal, June 27, 1896). The patient was suffering from an infiltration of the apex of the left lung. On the eighth day, after she had re- ceived in all 13 grains of guaiacol, abortion took place which could not be accounted for in any other way than as having been due to the influence of the drug. The reporter re- marks that phenol and its derivatives exert a paralyzing action on the vaso-motor centres, so that they may cause abortion by inducing de- fective nutrition of the foetus. It js added that the patient was of a nervous nature and may have had an idiosyncrasy for guaiacol. [Dr. E. K. Morris, of Sturgeon Bay, Wiscon- sin {Medical News, January 9, 1897), reports having used guaiacol for rhus poisoning in two cases. The first patient was a man, forty-five years old, suffering from an aggravated form of the poisoning, the face being swollen to such an extent as to wholly obliterate the fea- tures, and the eyes being entirely closed. Dr. Morris made an application of zinc-oxide oint- ment, and ordered applications of a solution of 3 drachms of carbonate of sodium in 3 oz. of water, on absorbent cotton. The result was negative. On the third day after the onset he made an application of pure guaiacol, freely painting it over the inflamed area with a cam- el's-hair brush, and then covering the parts. On the next day there was marked ameliora- tion of the trouble, and on the fourth day after beginning the guaiacol treatment the poisoning and its resulting inflammation had entirely disappeared. The other patient was a boy of eleven years with the same trouble, one side of the face and neck being affected to about the same extent as in the previous ease. Dr. Morris used gua- iacol, and on the second day the boy was out and at school, the trouble having entirely abated. G-uaiacol cinnamate. — See Sttbacol.] Guaiacol phosphate, PO(C6H40CHsO)a, occurs in hard, colourless tablets, melting at 98° C. It is insoluble in water, in alcohol, and in ether, but is easily soluble in acetone and in chloroform. The dose has not been determined. Guaiacol succinate is an ester of guaiacol. Its formula is CiHi04(C6H40CHs)j. Its crys- tals are silky needles. It is insoluble in water, slightly soluble in ether and in alcohol, and freely so in chloroform. Samuel M. Brickneb. GXTAIECETIN. — According to Dr. J. Strauss {Centralblatt fUr innere Medicin, June 20, 1896; New York Medical Journal, July 111 1896), who has experimented with this sub- stance, which is a pyrocatechin-monaoetie acid, 0^^,(9'!^'^^'^^, obtained by introducing the carboxyl group into guaiacol, it is a taste- less powder. He gave it in doses of 7 grains, several times a day. On the whole, he thinks that it is not quite so apt to produce unpleas- ant effects as either creosote or guaiacol car- bonate. GYMNASTICS.— For the Sohott method of treating chronic heart diseases, see under Baths (Supplement). GYMNEMA. — The leaves of Oymnema silvestre, ati Bast Indian asclepiadaceous shrub, when chewed, have the effect of temporarily destroying the sense of taste for sweet and bitter substances. Their active principle, gym- nemic acid, C3H66O12, has the same property, and a 13-per-cent. solution of the acid in water containing enough alcohol to dissolve it has been employed as a mouth-wash to dissipate the taste of bitter medicines (Coblentz, op. cii.). HEAT. — The local application of dry hot air in the treatment of rheumatism has lately been attended with most gratifying results. It is essential that the hot air should be as dry as possible ; otherwise, it will cause pain. Special appliances have been devised for dry- ing and heating the air, and for restricting its contact with the body. At a recent meeting of the Harveian Society of London (British Medical Journal, November 21, 1896; New York Medical Journal, December 12, 1896) Dr. Knowsley Sibley presented a woman, twenty-six years old, who had been a complete cripple from rheumatism for nearly three years. Her mother and her mother's grandfather had suffered from the same complaint! The patient had had very fair health up to three years before. She had never been laid up with fever and there was no cardiac lesion. She had been for many months under treatment at Bath, but without getting any better. She was sent up to Lon- don for treatment on September 30, 1896. On her admission, the following note was made : " The patient has used a pair of crutches for two years, and can just manage to get about on the level with the aid of these ; she can not get up or down stairs, wash or dress herself, or do her hair. She feeds herself with great dif- ficulty, and only with a large spoon and fork, as she can not get either hand within several inches of her mouth. She can not rotate the elbows, which are nearly fixed at right angles. There is considerable thickening of the middle fingers of both hands, and grating and limita- tion of movements at the shoulder ioints. The right knee is ankylosed nearly at a right 441 GUAIECETIN HYDROCHLORIC ACID angle ; there is absolutely no movement of any kind to be elicited ; the thigh and especially the calf muscles of this leg are much wasted ; the patient can just touch the ground with the tip of the toes, but is unable to put any weight on the limb, and in fact can not raise it off the bed when lying on her back ; there is con- stant pain of this joint; she wears a gutta-per- cha splint round it as a protection." The localized hot-air treatment, continues Dr. Sibley, was begun on October 1st. After the second application it was possible to rotate the left elbow, and after the third the patient was able to see the palms of both hands, which she had not done for two years. After the sixth bath she was able to do her front hair, and after the tenth she was able to walk a few steps without her crutches, and there was dis- tinctly some movement to be obtained in the knee joint. She had now had twenty-seven baths, and could get her left hand all over her face, head, and neck, and get up and down stairs with ease. There was also a fair amount of movement in the right knee joint ; the pa- tient could flex and extend it some few inches. All these results had been obtained without at any time putting her under an ansesthetic and breaking down the adhesions, as was origi- nally suggested ; and at no time had she any pain or effusion in any of the joints under treatment. Before and after each application of the dry air, which was heated to a tempera- ture of 260° P., the limbs were gently manipu- lated and massaged. She had been taking some syrup of iodide of iron, and the bowels were regulated with Condal water. Dr. Virgil P. Gibney (Medical Record, Jan- uary 23, 1897) reports seven eases of stiff and painful joints, including the rheumatic, the tuberculous, and the traumatic, also a case of apparent deformity due to chronic sciatica, in which he has applied this treatment in the Hospital for the Ruptured and Crippled. In all these cases more or less relief from pain and stiffness was afforded, and in several of them it was very decided. HELIOTROPIN.— See Pipeeonal. HOMOGrUAIACOL.— See Ceeosol. HONEY.— Dr. E. Lerede Chalke, a civil surgeon of Negapatam (Indian Medical Rec- ord, May, 1896 ; New York Medical Journal, June 13, 1896), says that he has had hundreds of oases of scorpion stings to deal with and has tried various remedies to relieve the sting- ing pain and burning sensation which invari- ably are the chief symptoms for which relief is sought, and he finds that the application of honey to the affected part acts the best, pro- ducing almost instant relief. The stinging and burning sensations vary in degree accord- ing to the species of the scorpion which causes the sting. He has seen the small, pale, red- dish-brown scorpions in the ceded districts evoke unbearable pain in the part stung, while the black, huge ones so common in the Kur- nool district (about six inches in length, with hair on the back and claws like those of crabs) cause great agony to the victim, making him simply writhe under the pain. He recalls the case of a delicate middle-aged woman, who was suffering from heart disease, and was stung by one of the black kind, a huge monster with formidable claws and a big sting. The woman was carried to his bunga- low in great agony, cold and clammy, and begged of him to relieve her of the intense pain which, she said, she could bear no longer. There was a large gathering in his place at the time, including two physicians. He im- mediately brought the honey, which he applied gently but freely over the affected part. The relief was almost instantaneous, to the aston- ishment of the patient and the spectators, par- ticularly the physicians. At the same time he gave her 10 minims of chlorodyne with brandy, which roused her spirits within a short time. He applied the honey again after an interval of five minutes, when the patient expressed hei'self nearly rid of the pain and comfortable. This, he says, was one of several cases he has treated with honey, and he has always found it a very reliable and prompt medica- ment. If honey is not procurable at the time, a sti'ong solution of sugar in water will be found a very effective substitute. He has also tried over-ripe plantains squeezed and applied as a poultice over the affected part, which acts speedily in subduing the pain and burning sensation. HYDRIATICS.— For the Schott method of treating chronic heart diseases, see under Baths (Supplement). HYDROCHLOmC ACID.— At a meet- ing of the American Orthopsedio Association held in IVIay, 1896 (New York Medical Journal, August 8, i896), Dr. Jerome Hilton Waterman reported eight cases of necrosis of hone of tu- berculous, origin which he had treated by the use of hydrochloric acid at the Hospital for the Ruptured and Crippled. New York, eases some of which had not done well under the usual methods of treatment. In some of these the most radical operative means had been em- ployed, the bone being thoroughly curetted and all the necrosed tissue supposed to have been removed. Sinuses subsequently formed, and an examination under anaesthesia revealed the fact that necrotic bone was still present. In the other cases of the series, irrigation with solutions of bichloride of mercury, ap- plications of hydrogen peroxide, packing with various kinds of gauze, and the injection of creosote and protonuclein into the sinuses had been employed for many months without favourable results, either in decreasing the amount of discharge or in allaying the pro- gressive character of the pathological condi- tion. Confronted with these unsatisfactory results. Dr. Waterman resolved to try the ap- plication of hydrochloric acid. The theory was that the action of the acid on healthy bone was limited to the decomposition of the mineral constituents, consisting principally of phosphates and carbonates of calcium, together with small quantities of the alkaline salts, not affecting the animal matter, and that in ne- crosed bone there were only these mineral salts remaining, to which the chemical action of HYGIAMA ICHTHYOL 443 the acid was more particularly confined, dis- solving it without exerting any destructive influence on the underlying tissue. In this fact, says Dr. Waterman, lies one of the real merits of the treatment, for, the diseased tissue being removed, the process of repair can go on unobstructed. The acid was used in the concentrated form, whereas before for the most part dilute so- lutions and solutions in combination with various substances had been used by other sur- geons. The number ot minims injected in each individual case depended on the amount of bone which was diseased and on the general condition of the patient. It is preferable, says Dr. Waterman, not to use the acid more than twice a weeir, owing to the reaction and pain which might result. However, in his cases but little pain was experienced, and this he attributes in part to the fact that the patients were accustomed to more or less manipulation, having been dressed daily for several months, and also to the anaesthetic effect of the acid. In case it should produce undue discomfort, he says, it is advisable to spray the tissues with a 4-per-cent. solution of cocaine or cocaine and morphine a few minutes before injecting the acid, or else employ the chloride-of-ethyl spray. He washed out the sinus thoroughly with sterilized water in order to remove any pus or detritus, and thus permit the acid to penetrate all of the diseased bony tissue. An ordinary sterilized glass pipette was found convenient for the application of the acid. The tube was introduced to the bottom of the sinus and the contents were deposited directly upon the necrosed structure. After this he usually allowed a minute to elapse, then irrigated the sinus with a saturated solu- tion of bicarbonate of sodium, and then ap- plied a wet myrrh dressing. His object in using the latter in preference to dry dressings, he says, was because of the marked foetor no- ticed in many instances after the first two or three injections, which is accounted for by the destruction of soft tissue? ; consequently it is more pronounced when the patient moves dur- ing the application, so that it is not made directly to the bone, but partly on the sur- rounding tissues. In certain cases of the series it was neces- sary to enlarge the opening during the course of treatment, particularly when the granula- tions were so exuberant as to protrude into the lumen ot the sinus, but in the majority of in- stances they could be removed by the intro- duction of a probe. Of Dr. \yaterman's eight cases he reports four apparent cures. He suggests the possi- bility that in two of the others either the necrosed area was larger than the probe indi- cated, so that not sufficient acid had as yet been applied to effect the solution, or another area of necrosis existed at some distant point not indicated by the probe. Should these con- ditions be present, he says, operative methods are necessary. For the use of dilute hydrochloric acid in conjunction with pyrozone in suppurative oti- tis media, see under Pyeozone (Supplement). HYGrlAMA. — This is the name of a pro- prietary food made of condensed milk with the addition of certain cereals specially prepared and of cocoa deprived of its fat. It contains 20'4 per cent, of albuminous matter, 10 per cent, of fat, and 6'Si per cent, of carbohy- drates. According to von Noorden, it is par- ticularly useful in diseases of the stomach and intestines, in pulmonary consumption, in the debility of convalescence, in typlioid fever, and in weakly children. (Berliner Minisctie Woclh- ensctirifi, 1896, No. 20 ; Deutsche Medizinal- Zeitung, May 21, 1896.) HYOSCYAMINE.— Dr. Chalmer Pren- tice, of Chicago (New York Medical Journal, January 2, 1897), calls attention to the action of hyoscyamine in paralysis agitans, and re- ports three cases. The first was that of a clergyman, sixty-five years old, first seen by Dr. Prentice in January, 1891. Shaking of the head and right upper and lower extremi- ties had continued for a period of four years, gradually increasing in severity. Dr. Prentice used a solution of hydrobromide of hyoscya- mine, 2 grains to the ounce of water. This was dropped into each eye. In twenty min- utes the shaking of the upper and lower ex- tremities and head had entirely ceased. At the end of three quarters of an hour there was such a general relaxation that the patient was unable to rise from the chair. The intelli- gence did not seem to be disturbed, but the organs of speech were very much interfered with, so that it was difficult for the patient to talk. Dr. Prentice says that he anxiously watched the patient, sitting and talking with him for a period of two hours, at the end of which time he was able to get up from his chair and walk again. At the end of three hours there was no impediment to the speech and the shaking had not returned. At the end of about six hours the patient said the symptoms had gradually begun to present themselves again. On the following day the strength of the solution was reduced to 1 grain to the ounce. This did not interfere with the locomotion or the power of speech, but again put the shaking in abeyance. Dr. Prentice followed this case up for a month, during which time the paralysis agitans was kept un- der almost complete control by instilling a drop into each eye morning and evening, a so- lution of the strength of a grain to the ounce being used. The second case, that of a farmer, sixty years old, was seen in 1892. He had suffered with paralysis agitans for twenty years. No lesions were present to which anvVeflex action could be attributed. In this case Dr. Pren- tice started with hyoscyamine, a grain to the ounce. In thirty minutes the shaking had al- most entirely ceased, and the patient renaained quiet during the day. A return of the symp- toms came on the following morning, bnt"they were not so severe as usual. Dr. Prentice re- duced the strength of the solution to half a grain to the ounce, and advised its use three times daily. By following this treatment this case was kept entirely under control for a pe- 443 HYGIAMA ICHTHYOL riod of about two montlis, at which time Dr. Prentice lost sight of the patient. The third patient was an unmarried lady, aged forty-five years, first seen in May, 1893. In this case there were some strong evidences of tabes dorsalis with slight curvature in the dorsal region of the spine. The shaking was general and most torturing. A solution of hyoscyamine hydrobromide, a grain to the ounce, reduced the shaking to a minimum, and gave almost perfect relief. In this case, says Dr. Prentice, hyoscyamine seems to have been the only remedy that has ever affected the pa- tient, and for a period of three years she has depended upon it. There has been no neces- sity to increase the dose, and during all this time there has been no period in which she could stop using the hyoscyamine without a return of the violent shaking. Dr. Prentice says he hardly believes the ef- fect can be due to the action of the drug after it has been absorbed into the circulation, for the amount so taken in from one small drop in each eye, accounting for the amount washed away by lacrymation, he remarks, would not be over -jJiy of a grain, whereas the administra- tion of ^5 of a grain by the mouth will not produce any like effect. He suggests that per- haps the reason for the marked effect of such a small amount of hyoscyamine in the eye is the fact that the site of its application is in close proximity to the cause of some reflex dis- turbance through the visual and other allied centres. ICHTHYOL. — Guintsburg {Medecine mo- derne. May 13, 1896 ; Therapeutic Gazette, September, 1896) strongly recommends the use of iohthyol in intestinal disorders, particu- larly those which accompany affections of the genito-urinary tract in women. The dose is 4 or 5 grayis a day, preferably in keratin-coated pills, which are believed to pass through the stomach undissolved ; thus a disagreeable taste and eructations are avoided. The medicine is best given some little time after meals. Good results were obtained in oases of diarrhoea : the appetite improved, the abdominal pains were much decreased, and the patient gained in weight; at the same time, if there was a tendency to menorrhagia, the menstrual func- tion became more nearly normal. The best results were in cases of rehellious constipation. He failed to meet with any disagreeable symp- toms such as are recorded by Bouchonieff, who found that in persons suffering from renal disease or from chlorosis iohthyol was apt to produce loss of appetite, nausea, and vomiting. He attributes these disagreeable results to too large doses. Dr. Le Tanneur (Journal de medecine de Paris, August 9, 1896; Journal of the Ameri- can Medical Association, September 13, 1896) has experimented with iohthyol to determine its antiseptic power and its effects in pulmo- nary tuberculosis. He states that absolute sterility is secured with a 5-per-eent. solution, although the shape of the Koch bacillus is al- 72 tered and its development much retarded with a 2-per-cent. solution and even a weakei^ one. He administered it to his patients in capsules (Chiron's) which contained 4 grains each, giv- ing from four to twenty-four a day. No effect followed the administration of six or eight capsules. M. Le Tanneur began with two cap- sules and increased the number to twenty a day, taken three times a day, during the meals. None of the fifty patients treated suffered any inconvenieoce from its use, and sevei'al patients with diarrhoea and gastric disturbances were cured of those complications by it. The cough was much improved owing to the liquefaction of the sputa produced by the iohthyol, which also cured the congestion of the bronchial tubes. The colour of the expectoration changed from green to yellow, then to gray, and finally to the ordinary colour of mucous secretions. The dyspnoea was relieved at once by the lique- faction of the sputa and the decreased con- gestion, which rested the heart and raised the general tone of the system. Pain in the inter- costal regions was also much relieved, probably for the same reason. The general health did not show improvement so soon as with hypo- dermic injections of guaiacol, but it arrived and progressed none the less surely, and the patients gained flesh much more than with guaiacol. Several gained from seven to eight pounds in the first month, others gained four pounds, and two thirds of the patients showed a marked increase in weight. The sweats also diminished, but apparently only as the general health improved, as this effect was not noticed so promptly as with creosote or guaiacol. The appetite was not unfavourably affected as is frequently the case when guaiacol is used, but it was improved and restored to normal in many cases. Le Tanneur concludes that, while ichthyol is by no means the long-sought specific for consumption, yet great benefit is derived from its use as a substitute for creosote and guaiacol, when, as often happens, the system has become so habituated to them that they fail to affect it. It is especially indicated in bronchial tuberculosis, which it most promptly relieves. Its disagreeable odour renders the use of the capsule imperative. Dr. William J. Robinson (New York Med- ical Journal, November 14, 1896) reports a re- markable case of lymphangeio- phlebitis in which ichthyol proved speedily efficacious. The patient was a thin, badly nourished man, fifty-three years old. The disease affected the left lower limb, which was swollen to about double its normal size, of an erysipelatous red, and exquisitely painful. The long saphenous vein was felt as a hard, rigid cord, exceedingly sensitive to the touch. There was an ulcer on the leg, described as small, superficial, and altogether insignificant. The man had two inguinal hernise, which descended through the canals at the least strain. On the back, at the point of pressure of the truss, there was slight ulceration. He had intense headache, absolute loss of appetite, constipation, chills, and occa- sionally syncope. His temperature was 101-8°, and his pulse 120, small and compressible. Dr. Robinson prescribed phenacetine and salol, also IODOFORM MENTHOL 444 a mixture of cardiac stimulants, and ordered for the leg continuous hot fomentations of a 3- per-oent. solution of carbolic acid with lead- and-opium wash. The fomentations relieved the pain, but the inflammation did not abate. Dr. Robinson then used creolin, a l-to-1,000 solution of corrosive sublimate, and carbolic and salicylio-acid ointments in succession, but without being able to check the continuous, uninterrupted upward progress of the disease. Not only the entire limb was intensely in- flamed and oedematous, but the left side, to about the level of the umbilicus, was in the same condition. The scrotum and penis at- tained enormous proportions. The man was unable to move, and his sufferings were ex- treme. In about a month Dr. Robinson was hastily summoned early in the morning and found his condition such as to give rise to the gravest apprehension. The pulse was thread- like, 140 a minute ; the temperature was 104° ; the first heart sound was almost inaudible. He administered a hypodermic injection of digitalis, strychnine, and nitroglycerin, and ordered a 25-per-cent. solution of ichthyol in glycerin. He enveloped the inflamed parts in lint soaked in that solution, and covered it with cotton and oiled silk. At this time he entertained little hope of the patient's recovery, but in the afternoon of that day the picture had completely changed. The temperature was 100°, the pulse was 96, and the redness and cedema had diminished to a remarkable degree. The applications were repeated three times a day. On the next day the svvelling had completely disappeared from the le* and genitals ; on the back it persisted for two days longer. His convalescence from that day on was uninterrupted. In a week every trace of inflammation had disappeared, but he felt very weak. The man afterward had an attack of phlebitis in the right leg. The symptoms were practically the same as in the first at- tack, though not quite so severe. The treat- ment was repeated, but in addition Dr. Robinson ordered very large doses of ichthyol internally — a pill of 4-J grains every hour through the day and two or three times dur- ing the night. The result was highly satis- factory ; in three days the man was quite well. Hard nodules were still to be felt in the course of the veins at the time of the report, but were disappearing rapidly under the internal and ex- ternal use of ichthyol. For external use Dr. Rob- inson prescribed ammonium sulphiehthyolate, and for internal use sodium sulphiehthyolate. Dr. W. Ottinger, of Exbrilcke {Milnchener medicinische Wochenschrift, December 8, 1896 ; Wiener medizinisehe Blatter, December 17, 1896), has found ichthyol an admirable rem- edy in numerous cases of the stings of flies, gnats, bees, and wasps, and has found that it quickly and surely causes the phenomena of inflammation to subside. He attributes its effect to its vaso-constrictor action. It is best to apply it pure in a pretty thick layer, but it may be used in the form of an ointment. lODOrOBM.— The iodoform treatment of suppurating bul>oes has of late come into ex- tensive use. It is described by Dr. William K. Otis (Journal of Cutaneous and Genito- urinary Diseases, May, 1893) as follows : The skin for some eight or ten inches about the affected area is rendered thoroughly asep- tic by scrubbing with green soap and washed with sulphuric ether and then with bichloride- of-mercury solution (1 to 1,000). A narrow bistoury is then inserted into the abscess cav- ity, the contents are gently but thoroughly squeezed out, and the cavity is irrigated with biohloride-of-meroury solution (1 to 1,000) and immediately filled to moderate distention with warm iodoform ointment (10 per cent, iodo- form and 90 per cent, vaseline), care being taken not to use a suflBoient degree of heat to liberate iodine. The syringe used for intro- ducing the ointment is the ordinary cone- pointed glass syringe. The plunger being removed, the barrel is warmed in the flame of an alcohol lamp and filled with ointment by means of a spatula. On finishing the injec- tion, at the instant of withdrawing the syringe from the wound, a compress wet with cold bi- chloride-of-mercury solution is applied, which instantly solidifies the ointment at the orifice and prevents the escape of that in the abscess cavity. A large compress of sterilized gauze is then applied by means of a firm spica. The patient is told to return in four days, when, if all is well, the dressing is reapplied, but if any evidence of inflammatory action is found the wound is thoroughly irrigated and cleansed and the injection repeated. Out of sixteen cases. Dr. Otis reports nine cured in six days, three in twelve days, one in fourteen days, and one in twenty-three days. He alleges the fol- lowing advantages for this method : 1. It is simple and safe. 2. In suitable cases the cure, as a rule, seems more rapid than by any other method. 3. The patient is not prevented from going about during treatment. 4. The flrst gland being rendered thoroughly aseptic makes it less likely that other glands in the chain will become infected. 5. It leaves no telltale soar. 6. It in no way interferes with any sub- sequent surgical procedure, should such be deemed advisable. Dr. Otis says that his ex- perience has demonstrated that this method is available only in those cases of infection by the staphylococcus in which there is an appre- ciable pus cavity, and thus a storage place for ointment until absorption can take place. In diffuse phlegmons, in which no pus cavity ex- ists, the method has not been found applicable. Dr. Otis gives the warning that there is a probability of failure unless two cardinal points are observed: 1st, absolute cleansing of the cavity of all traces of pus ; and 2d, the injec- tion of ointment into it in quantity barely sufficient to produce moderate distention. ITROL. — See Silver citrate (vol. ii, paee 198). ^ ^ JERVINE. — See under Veratrum viride. KAOLIN. —See Fuller's earth, under Earths (vol. i, page 353). 445 IODOFORM MENTHOL KEirMMHOLZ OIL.— See under Pine PEEPARATioNS (vol. ii, page 88). LACTOSE. — See Sugar of milk. LAB.D Dr. George Boody, of the Iowa State Hospital {American Journal of Insanity, July, 1896), reports the results of experiments made by himself with leaf-lard inunctions in cases of malnutrition with emaciation. The time over which they extended, he says, was very short and the number of oases few, but they were carefully carried out and the im- provement in each case was noted. Pour oases were selected, of each of which a brief account is given, with the following conclu- sions: 1. The integument plays an important role as an organ through which food may be taken, carried to the circulation, and assimi- lated, nutrition improved, and wasted tissue repaired. 3. Inunction with lard is indicated in every case of extreme emaciation with malnu- trition in which diet and tonic treatment with massage fail to produce the expected results. 3. It is the author's belief that if the condi- tions were such that food could not be taken through the stomach, nutrition could be im- proved and the patient made to gain in weight by inunctions of leaf lard, olive oil, or other fats, twice or three times a day. LEVTTLOSE, or fruit sugar (see vol. ii, page 235), has been employed, under the name of diabetin, as a sweetening agent for persons aflected with diabetes. MAGNESIA. — Vergely (Revue medicate, February 16, 1696 ; New York Medical Jour- nal, March 14, 1896) reports favourable results from the use of calcined magnesia in the treat- ment of burns of moderate severity. The af- fected parts are covered with a thick layer of a paste which is prepared by mixing the calcined magnesia with a certain quantity of water. This paste is allowed to dry on the skin, and when it becomes detached and falls oflE it is re- placed by a fresh application. Very soon after the paste is applied the pain ceases, and under the protective covering formed by the magne- sia the parts recover without the cutaneous pigmentation which is often observed to follow burns that have been allowed to remain exposed to the air. MARROW.— Dr. William 0. Mann, of the Fergus Falls State Hospital, in Minnesota (American Journal of JnsoraiYy, January, 1897), gives his experience in the use of bone marrow among the insane, extending over a period of four months. Two preparations of bone mar- row were used : One which was made at the hospital by finely chopping ribs of sheep and adding glycerin in the proportion of a pound to twelve ribs. This was allowed to macerate four days. It was then strained through gauze and was ready for use. The other preparation was that manufactured by Armour &Co. Twenty-two male patients were selected, eleven of whom took one form of the extract, and the other eleven the other form. Those patients were chosen whose general appear- ance was ansemic. Extract of bone marrow was given for a month, a drachm three times a dav, at the end of which time the percentage of hiBmoglobin and the number of corpuscles were again ascertained, the same time of day being taken as at first. During this time no medicine was administered and the regular diet was given. Fifteen of the twenty-two cases were regarded as chronic, and the seven remaining were acute cases in which improve- ment had been slow and had reached a stand- still. Dr. Mann gives tables showing that in some cases the number of red corpuscles was nor- mal, while the leucocytes were increased and the percentage of haBmoglobin was diminished ; also that the ratio of the percentage of haemo- globin to the number of red blood-cells was irregular. The average increase in red cor- puscles was 1,361,489, and those that took the extract made at the hospital gained more than the others. The proportion of hasmoglobin in- creased on an average of 13'5 per cent. The leucocytes, which in nearly all had been abnor- mal at first, decreased in number at the end of the month. The general appearance in the majority of the cases had improved. The ap- petite was better and the action of the bowels more regular. In only one case was there a tendency to diarrhoea. In the twenty- two cases there was an aggregate gain of forty-seven pounds, and on discontinuing the use of the marrow those that had lost immediately began to gain, and three months later weighed more than they ever had during their residence in the hos- pital. One man especially, that had weighed for months from ninety-six to ninety-nine pounds, now weighed a hundred and twenty- eight. Dr. Mann's experiments seem to have been chiefly directed toward ascertaining the ac- tion of marrow on anaemia rather than on I'n- sanity, but he says that, mentally, one patient began to improve at once and soon went home recovered. Three were regarded as much im- proved, and four others were brighter and had lost a great deal of the apathy they had for- merly had. In the fourteen others the only improvement noticed was in their physical condition. Dr. Mann concludes that the use of bone marrow in anseraia results in an in- crease in the red corpuscles of the blood, and in cases of insanity associated with ansemia improvement in the mental condition may be expected in at least a third of the cases. MEDULLADEN.— This is the fanciful name of an extract of bone marrow. See Mar- row. MEDULLARY GLYCERIDE.— See un- der Marrow (vol. ii, page 599). MENTHOL.— Dr. Sidney A. Bontor (West London Medical Journal, July, 1896 ; New York Medical Journal, August 1, 1896) has used men- thol spray in forty casesof whooping-cough, most MERCURY NAPHTHALAN 446 of them selected, he says, on aecotint of their severity, and the result has been most satisfac- tory; in thirty-nine of them the beneiit was decided, and in only one did the spray seem to have no effect ; this was a case complicated by acute bronchitis. One patient died, a weakly infant of only seven weeks, the immediate cause of death being convulsions in the third week of illness ; in two the spray was not persevered with, although the paroxysms were relieved by it. because, as the attacks were not very severe, the parents thought the little smarting of the eyes an unnecessary infliction. About 20 grains of menthol were dissolved in an ounce of liquid vaseline in an ordinary nasal spray-producer ; as soon as the paroxysm began, or preferably as soon as the patient felt that one was impending, a fine cloud of spray was diffused in front of the face, the spray- producer being held about two feet away ; by this means the air in front of the nose and mouth was saturated with the oily particles, and at each inspiration they were drawn into the air passages; this was quite painless, but occasionally a slight spasm of the glottis oc- curred. The effect of this inhalation is quickly seen, says Dr. Bontor, for the mucus is rap- idly expectorated and the paroxysm is soon over, so that convulsions are less frequent and vomiting is rare, with the result that the pa- tient loses his dread of taking food and eats with a better appetite, his general condition be- ing thus kept at a much higher level. Among the forty cases there were none of prolonged debility, none followed by gastro-intestinal ca- tarrh, and none at the time of the report with tuberculosis. The author does not, however, maintain that this result is wholly attributable to the form of treatment, because, he says, he practises in a healthy country district where ■the tubercle bacillus does not flourish and where the death-rate is naturally low, but he adds that the results among patients in the same district treated by other methods have not been so satisfactory. MERCTJItT. — Rabinschek's method of treating whooping-cough with mercury bichlo- ride is described in. the BuUeiin medical de Paris for September 13, 1896 (Lyon medical, October 11, 1896), as consisting in the intro- duction into the back of the mouth of a small tampon of cotton saturated with a 1-to- 1,000 solution of corrosive sublimate, and press- ing it against the lower part of the tongue in such a way that the liquid will bathe the epiglottis and the neighbouring mucous mem- brane. The method has been applied in sev- enty-one cases by Dr. Rocco Gentile ; thirty-five patients were cured after from three to twelve applications, thirteen were considerably im- proved, and the others interrupted the treat- ment or had complications which did not depend upon the whooping-cough. One of the greatest benefits to be derived from this treat- ment is said to be the rapid cessation of the vomiting which contributes so much to weaken the patients. Gentile has never employed more than one application a day. In a very small number of cases he has observed temporary disturbances, such as haemorrhages of the con- junctiva and of the ear, buccal ulcerations, and slight fever; but he says these complications are not serious. Surgeon-Major Harold Hendley, of the British Indian Medical Service (British Medi- cal Journal, January 16, 1897). refers to Celli's successful treatment of tetanus with subcutane- ous injections of corrosive sublimate (mentioned in the 3Iedical Annual for 1896), and reports a case of his own. A Hindu boy, aged nine, son of a hillman in the Kangra District, Punjab, was first seen on August 10, 1896, when it was stated by the father that he had been suf- fering for two days from stiffness of the neck and difficulty in mastication, associated with a considerable amount of pain. On examination, marked rigidity of the muscles connected with the lower jaw, the neck, and the right arm and thigh was discovered, and any movement of these parts was attended with very considerable pain. The temperature was 101-2° F., the pulse was 96, the bowels were constipated. On the 11th his temperature was 99-8° P., the bowels had been moved once ; his condition was about the same. On the 12th a very considerable amount of pain was complained of over the front of the chest, more especially over the cardiac area, and a slight systolic bruit was audible at the apex. A belladonna plaster applied over the area of greatest pain resulted in some re- lief. On the 13th slight spasms became evi- dent over the whole body at intervals of from fifteen to twenty minutes. Two grains of chloral hydrate were given thrice daily. A fair amount of sleep was obtained. On the 16th risus sardonicus and opisthotonos were well marked ; theparoxjsms became very fre- quent, occurring at times every two or three minutes, and any movement of the patient in- creased their frequency. The. bowels were again constipated, the temperature was 100'2°, P., and the pulse was 100, small and weak. Pain was very considerable ; next to no sleep was obtained, and, in spite of the considerable amount of fluid nourishment taken in the shape of milk and soup, the patient had be- come considerably emaciated. Two grains of chloral hydrate were now given every hour, and the dose of calomel, 4 grains, which had been given on his admission, was repeated. From the 17th to the 26th, by pushing the chloral hydrate and so producing sleep, some control over the paroxysms was obtained. On the latter date, however, the patient became much worse ; the paroxysms increased in se- verity and frequency, and a fatal ending seemed not far off. As the chloral hydrate appeared to have no longer any effect upon the course of the disease, it was determined to have recourse to Celli's treatment. The use of chloral hydrate was continued, and subcutane- ous injections into the buttocks of corrosive sublimate in doses of about 0-09 of a grain were given twice daily, beginning on August 27th. After the first two injections the spasms decreased decidedly in frequency and severity. On September 2d — that is, after eleven in- jections — the paroxysms had entirely ceased, and from this date, when the injections were 447 MERCURY KAPHTUALAN stopped, recovery was sure, and, considering the previous state of the patient, fairly rapid. Small doses of chloral hydrate were continued up to September 8th. It is noticeable, remarlcs Surgeon - Major Hendley, that, as in Oelli's case, very marked amelioration in the patient's condition occurred after the second injection. After a very care- ful inquiry, no cause for the occurrence of the disease could be discovered. The early symp- toms seemed to point to conditions which might admit of the case being classified as one of rheumatic tetanus. METADIHYDROXYBENZEITE.— See Kesorcin. miLK. — Lachmann's so-called " vegetable milk," says a writer in Medecme moderne for September 9, 1896 {Lyon medical, October 4, 1896), when made with almonds and sugar, does not contain any starchy substances and has a sufflciently large quantity of emulsified fat. Its composition is as follows : Fat 24-60 per cent. ; Vegetable casein 7-50 Cane sugar 41-80 Vegetable dextrin 1-30 Lime, potassium, etc. . . . 0-68 "Water 24-13 This vegetable milk may be used to dilute cow's milk which is too rich in albuminoids. For this purpose it is superior to water, as it does not precipitate the casein in large flakes, but in small and soft ones. Furthermore, the addition of vegetable milk to cow's milk in- creases the fatty substance of the latter and ac- celerates its digestion. MOBINGA. — The Moringa Fiery gosperma, the Oriental horse-radish tree, or drumstick tree, has been used in medicine. Mr. L. B. Dhar- galkar, of Bombay (Indian Lancet, September 1, 1896 ; Neio York Medical Journal, October 19, 1896), has used the root-bark in the treat- ment of jaundice. He says the root, the gum, the leaves, the flowers, and the fruit are all useful in medicine. The root has a strong, pungent odour and is said to have the flavour of horse-radish. When distilled with wafer, it yields an essential oil which is very pungent to the taste. The bark is rubefacient and is used externally by the poorer classes as a coun- ter-irritant in chrome rheumatism. Some authors state, says Mr. Dhargalkar, that it is supposed to act as an emmenagogue and is used to produce abortion. The stimulant and pun- gent properties of the root-bark have been de- scribed by other observers, but Mr. Dhargalkar thinks that no one has as yet mentioned its usefulness in the treatment of jaundice. He himself accidentally found that, if adminis- tered in proper doses, it was useful in that dis- ease, and he has made several experiments with it. He relates the histories of eight cases in which he obtained satisfactory results with the tincture of moringa, the action of which was very rapid. In regard to the toxic effects of the drug, he states that he has had no opportunity to ob- serve them, as it did not produce any un- favourable symptoms in any of the patients treated by him. In order to try its effects on the healthy system, he took on an empty stom- ach a drachm of the tincture in an ounce of water. It tasted, he says, something like an infusion of bitter almonds and produced a sen- sation of warmth at the pit of the stomach for two or three minutes, but it had no other effect. The physiological action of the drug is, he says, still unknown to him. MONOCHLORMETHANE.— Seeil/ei!%i chloride, under Methyl. MONOPHENETHYDEIN.— See A poly- sine. SETBROL. — This name has been given to a new mydriatic said to be an iodomethylate of phenylpyrazol, which is a white, odourless, bit- ter powder readily soluble in water. It seems from experiments made under the direction of Professor Albertoni, of Bologna (Therapeu- tische Wochenschrift, December 6, 1896 ; JVew York Medical Journal, December 36, 1896), that mydrol dilates the pupil in animals that have a round pupil, but has no such effect on those in which the pupil is oblong. Dr. Cattaneo, of Professor Tartuferi's clinic, is cited as hav- ing found that, by reason of the short duration of its mydriatic action, when employed in a solution of from 5 to 10 per cent., and its transitory effect on the accommodation and especially on the tonicity of the eye, its diag- nostic use is of advantage in cases in which there is reason to apprehend harm from the in- crease of intra-ocular pressure caused by other mydriatics. Albertoni adds that it is absolute- ly unirritating and non-poisonous, and that it excels cocaine in diminishing the amount of blood not only in the vessels of the conjunc- tiva, but also in those of the iris and most probably in those of the deeper structures. By virtue of these properties, while it has no actual anaesthetic action, it is serviceable in ciliary and supraciliary pain, blepharospasm, lacrymation, and many diseases of the iris, the cornea, the sclera, and the conjunctiva, espe- cially that of the globe. Mydrol is said to be absorbed rapidly and to be eliminated un- changed in the urine. MYELOTHERAPY.— See under Seeum TEEATMEKT (vol. ii, page 187). MYRTILLIIT.— A thick extract of the berries of Vaccinium Myrtillus. See under Vaccinium (Supplement). NAPHTHALAN.— This is described by Dr, Rudolf Isaac, of Berlin (Deutsche medi- cinisehe Wochenschrift, December 24, 1896), as an ointment-like mass obtained by the frac- tional distillation of crude naphtha from the highlands of Armenia. It melts at about 158° F. It is insoluble in water and in glycerin, but dissolves readily in ether and in chloro- form, and mixes easily with fats. Naphthalan seems to have been first employed, early in 1896, in the Michael Hospital in Tiflis, in vari- ous skin diseases. Dr. Isaac reports upon its NITROUS OXIDE NUX VOMICA 448 use in about fifty eases in Dr. Max Joseph's Polilclinik for skin diseases in Berlin. ^ Most of the oases were chronic eczema, especially the so-called " occupation - eczema " a few were acute eczema, and the remaining ones were single cases of prurigo, pruritus, psoriasis mdgaris, ichthyosis, eczema impetiginosum, eczema occurring as a sequel of scabies, dia- betes, ulcer of the leg, etc. The results were various. In several cases of eczema rapid im- provement leading to a cure was observed, in others the good effect was only temporary, and in a few so much irritation was produced that the use of the remedy had to be abandoned. There was no noteworthy effect in the cases of psoriasis. Naphthalan is absorbed by the skin very rapidly, but Dr. Isaac thinks it doubtful on that very account if its employment as a con- stituent of a mercurial ointment for the in- unction treatment of syphilis would be of advantage, since by the ordinary method time is given for the vaporization of the mercury and its absorption by the respiratory mucous membrane. Another disadvantage of naph- thalan is that it soils the linen, but the stains are readily removed. NITROUS OXIDE.— Dr. Hobart A. Hare ( Therapeutic Gazette, December, 1896 ; Neiv York Medical Journal, January 2, 1897) reports a case of death after the inhalation of this gas — not, he says, as one of death due to the direct influence of nitrous-oxide gas, but as an in- stance of the fact that the decided rise of arterial pressure which is produced by the ad- ministration of this drug during the period of ansesthesia may cause the rupture of a blood- vessel in persons who have a tendency to apo- plexy. A man between fifty and sixty years of age, with atheromatous arteries, visited the office of a well-known dentist who makes a specialty of extracting teeth under the influence of nitrous- oxide gas, in order that he might have removed one or two molar teeth which were giving him trouble. He had often taken nitrous-oxide gas in the same dentist's oflioe on previous occasions, and always without any ill effects whatever. On this occasion he took the ordi- nary quantity, his teeth were extracted, and he returned to consciousness with the usual ra- pidity. -He left the dentist's chair, walked to a washstand, and began to rinse out his mouth with water. While doing this he stated that his right hand felt numb, then complained of the extension of this numbness up his arm, and rapidly to his leg and side. He was helped to a sofa, where in the course of a very few min- utes he became partially unconscious. When Dr. Hare saw him the attack had already lasted about twenty minutes. The patient was breathing stertorously. He seemed to under- stand questions put to him, but was unable to answer them clearly, and in the course of a very few minutes passed into absolute insensi- bility, which, notwithstanding the use of vene- section and other measures, deepened into coma, in which he died about twelve hours after taking the ansesthetic. N'TJCLEIN'S.— Dr. John Ferguson, of To- ronto (Canadian Medical Review, March, 1896 ; New York Medical Journal, June 6, 1896), re- cords a case of progressive ancemia in which protonuolein proved curative after a failure of other drugs. Preparations of iron and arsenic had been tried fairly, but could not be toler- ated. The patient was a gentleman, aged fifty- four years, who had resided in India for several years. His health had not been good for about two years. During this period he had suffered loss of flesh, strength, and appetite. In April, 1895, the symptoms became more distressing, and it was necessary for him to give up his work as a tutor and rest. He became a patient of Dr. Ferguson's about the end of September, 1895. At this date he was a pronounced vic- tim to insomnia. His digestion was extremely bad ; he had much pain and frequent nausea after taking nourishment, either liquid or solid. There was an excessive amount of flatulence. The bowels were very torpid. The pulse was weak, and usually as frequent as 100 a minute. There was always some elevation of tempera- ture, sometimes as high as 102° F. Continu- ous headache was another feature of the case. The lips and conjunctivae were almost colour- less, and the tongue was exceedingly pale. The skin had a pale lemon tint. The red blood-corpuscles were only 1,200,000 to the cubic millimetre. The urine was normal. No organic disease could be discovered. In spite of all efforts of treatment and feeding, he gradually grew worse. Dr. J. E. Graham saw the patient in consul- tation. No other disease could be discovered than progressive anaemia. It was agreed to place him in some hospital for a time. He was admitted into the Toronto Western Hos- pital on January 7, 1896. Dr. Ferguson went with him in the coupe, and says he really feared he would collapse on the way. When he arrived at the hospital he was in such a state of exhaustion as to be unable to walk up- stairs. On being taken into his room he be- came unconscious, and in this condition he was hurriedly undressed and put to bed with hot bags around him. In the course of an hour or so he gradually regained conscious- ness. At this stage of his disease there were vary- ing elevation and a subnormal condition of the temperature. He had intense headache and almost continuous insomnia. 'The bowels were constipated, and nearly everything in the way of nourishment was vomited. The pa- tient was in a state of extreme emaciation and asthenia. There were frequently low delirium and confusion of thought. He often regarded himself as a duality. On his admission the bowels were washed out daily with a large enema containing some boric acid. Daily he was given a sponge bath. The stomach was washed out every day except occasionally when he felt too weak. He was fed on peptonized milk, egg albumen, and beef juice. The headache continued, however, in a most intense degree, and there was no improve- ment in the insomnia. For the headache, aoetanilide, phenaoetine, salol, and other agents 449 NITROUS OXIDE NDX VOMICA were employed, but with only the most tem- porary relief. Opium, chloral, paraldehyde, and sulphonal were administered from time to time for the insomnia. On one occasion 30 grains of sulphonal were given, with the result of causing only a few hours' imperfect sleep, followed the day after by much vomiting, great restlessness, extreme headache, and a feeble pulse. He had been in the hospital a little over two weeks, and all the appearances pointed to an unfavourable termination of the case, when he was now placed on the use of protonuclein (tablets), as prepared by Eeed & Carnrick. The eneraata, lavage of the stomach, and the same nourishment were continued. Tablets were given every three hours. By the third day it became apparent that the patient was improving. The headache was the first symp- tom to become modified. In a week it had almost wholly disappeared, and at the date of the report was entirely gone. The sleep soon became better. By the end of the first week of the use of protonuclein he would sleep three and four hours at a time. At the time of the report he could sleep from six to eight hours, and woke with a rested and refreshed feeling. The appetite was good ; he could take eggs, meat, toast, porridge.. oysters, beef juice, bread and butter, milk, and light puddings without the slightest discomfort. There was no nausea or vomiting ; the bowels were quite regular, and no enemata or aperi- ents had been administered for at least ten days. The temperature was constantly nor- mal. The patient was gaining in flesh and could walk about the ward and in the hall for an hour and experience no ill effects. The lips and nails had a good colour, and the tongue had lost its pallor. The abdominal walls, which had been extremely retracted, were now filling with adipose tissue. The most marked change, however, was to be found in the red blood-globules. When the proto- nuclein was first ordered there had been not quite 1,000,000 to the cubic millimetre. Now there were 3,500,000. The progress of the pa- tient had been one of daily improvement. He was to leave the hospital in two or three days, when the same line of treatment would be maintained, with the addition of a mild course of massage to assist in the development of the muscles. NTJTROSE.— According to Dr. R. Stilve,' of Prankfort-on-the-Main {Berliner klinische Wochenschrift, 1896, No. 20 ; Deutsche Medi- zinal-Zeitung, May 21, 1896), nutrose is another name for a certain compound of casein and sodium. He has found it of particular value in the case of children in convalescence from scarlet fever, measles, diphtheria, or pneu- monia. Added to a milk or soup diet, it en- riches the food in albumin, and thus hastens recovery. Its taste is agreeable, and it is utterly unirritating to the intestines, from which it is readily absorbed. NUX VOMICA.— Dr. Thomas J. Mays, of Philadelphia, who regards the state of the nervous system as playing an important part in giving rise to pulmonary tuberculosis, says (Journal of the American Medical Association, October 10, 1896 ; New York Medical Journal, October 27, 1896) that, of all the drugs in the materia mediea, there is none that compares favourably with strychnine in the treatment of this disease. 'Aside from its elective affinity for the whole nervous system, it possesses a special influence on the nerves which preside over the function of respiration. There is rea- son for believing that it also affects the periph- eral sensory nerves. In small doses it stimulates, in medium doses it tetanizes, and in large doses it paralyzes the nervous system. The dose is a relative or a movable quantity, however, he says, for that which produces tetanus or pa- ralysis at one time may act as a stimulus at another. In regard to the action of strychnine in pul- monary consumption, continues Dr. Mays, if it is taken for granted that the lung disease is merely a superficial manifestation of disorder of the pulmonary nerve supply, the strychnine primarily raises the tone of the nervous system as a whole and that of the respiratory nerves in particular. In this way it not only in- creases the resistance of the lung to disease, but aids digestion, assimilation, and blood- building. In employing strychnine great care must be taken to avoid the danger point, yet at the same time this point must be ap- proached as closely as is consistent with safety. The best way to bring about this object, says the author, is to begin with a moderately small dose of the drug, ^q- of a grain four times a day ; give this for a week, then increase it to ^ of a grain for another week: during the next give ijV of a grain, the following week raise the dose to about I'g of a gi'ain, and so on, making a slight increase every week until nervousness, restlessness, or twitching of the muscles is observed, the signs of the beginning of strychnine intoxication. In most cases these symptoms do not develop until -jV or | of a grain or even a larger dose is reached. It must be understood that the drug is to be given in these doses four or even five times a day. The object is to impress the nervous system with the full stimulant effect of this drug. The sooner this end is attained the bet- ter will it be for the patient. For this reason, begin with small doses and work upward as rapidly as can be done with safety. After the desired point has been reached the question arises whether it is better to continue the largest dose or to resume the original. Dr. Mays thinks it best not to vary from this line during the remainder of the treatment, in order not to lose what has been accomplished. Keep the strychnine treatment up to the high- * est level of safety, he says, but shun the point where its stimulus extends into the region of tetanus and of paralysis. It is best, however, to reduce the dose somewhat at this point. If, for example, it is found that ^ of a grain is a maximum dose, reduce it to ^^^ of a grain, then gradually increase the dose again until i of a grain is reached, and then return to ^ or to ^ of a grain. After the dose has been in- creased and decreased several times it will OPICTM OXYGEN 450 probably be found that ^ of a grain no longer prodiioes any dangerous symptoms, and that as much as ^ of a grain can be given. When ad- ministered in this way the drug may be given for an indefinite period to the majority of phthisical patients. The remedial effects of the drug show them- selves in various ways. The nervousness, sleeplessness, and pain in the chest will be ameliorated, and perhaps entirely disappear ; the cough, expectoration, and dyspnoea will diminish ; vomiting will abate ; the appetite improves ; the patient gains in flesh and colour ; the weak and rapid acting of the heart will become slower and stronger ; the red corpuscles increase in number, and the patient becomes more hopeful and brighter. Evenhoff ( Vrateh ; Union medicate, July 11, 1896) has experimented with strychnine as a remedy for cardiac failure during chloroform ancBsthesia. Tracheotomy was practised on dogs, and a tube was introduced into the larynx and put in communication with a small bottle which contained chloroform. Artificial respiration was made in such a way that the air passed through the bottle, and it could be charged or not with chloroform. Before ohloroformization the pressure was noted, then the air, charged with chloroform, was injected and, when the pressure fell to 0, pure air was thrown in and an intravenous injection of from 2 to 3 milligrammes of strychnine was admin- istered. When the pressure finally became normal the animal again received inhalations of chloroform. In this way the action of the chloroform before and after the injection of strychnine was ascertained. The results of these experiments showed that, owing to these injections, dogs, which usually tolerate chloro- form badly, could support the drug without inconvenience for a greater length of time. The favourable action of strychnine on ohloro- formization was thus demonstrated. Strych- nine, however, has two inconveniences : it may possibly provoke a tetanoid attack, and, given in the dose employed by Evenhoff, it increases parenchymatous haemorrhage. Strychnine is often particularly valuable in the treatment of pneumonia. Dr. Hobart A. Hare, of Philadelphia {Therapeutic Gazette, April, 1895), says that the three sheet-anchors of treatment for pneumonia after the exudation has taken place are digitalis, strychnine, and belladonna. Of these, strychnine is the only one which we can use alone with advantage. The digitalis nearly always fails to stimulate the vaso-motor system sufficiently, and the belladoima has to be added to regulate the blood-flow by its vascular action. Often, when digitalis is used in pneumonia, the pulse is full, but soft and boggy, if such a term may be used ; and, while the regularity and slowness, as well as the volume, may indicate the full action of digitalis, the patient fails to receive beneflt and may have a leaky skin. Under these circumstances, belladonna, given in the dose of about 5 drops of the tincture every three or four hours, while the digitalis is given in 10-drop doses every six or eight hours, will produce marked improvement. The strych- nine finds its great value as a whip to the entire system — as a whip which will pull the patient out of collapse or syncope, or overcome the peculiar torpor which is so dangerous a symp- tom in this disease, indicating, as it does, that carbon dioxide is accumulating in the blood, or that the poison of the disease is obtundiug the nerve-centres. Particularly are strychnine and belladonna useful about the time of crisis, when the rapid fall of temperature takes away the stimulating effect of the heat and produces collapse. Dr. Hare then alludes to a case exemplifying most strikingly the value of the drugs he is speaking of. A child of five years, having passed through the earlier stages of pneumonia rather uneventfully, arrived at the period for crisis. On the day that crisis occurred it sat up in bed for an instant, although the pulse was already weak from the fall in fever, and at once called out, " Light the gas, it's getting dark," and then passed into profound collapse. The case was a desperate one, and, in addition to external heat. Dr. Hare gave hypodermically ^ of a grain of strychnine and '-^ of a grain of atropine every fifteen minutes till three doses were used, when the child showed signs of re- newed vitality, became flushed from the atro- pine, and eventually recovered without any further symptoms of note. Dr. Percy Kidd, of London (Practitioner, September, 1894), says he has used strychnine in the treatment of croupous pneumonia ever since he read an article published in St. Bar- tholomew's Hospital Reports, in the volume for 1886, by Dr. Herbert Habershon, who reported a series of cases of cardiac failure and two cases of double pneumonia treated with the drug. The indications for the use of strychnine, says Dr. Kidd, are mainly derived from the pulse. If the tension begins to sink, or if the frequency of the beats is much increased, strychnine should be used at once, and by subcutaneous injection, as Dr. Habershon rightly insisted, for in cases of grave disease absorption from the stomach is slow and imperfect. OPIUM. — The occasional value of opium in stopping hcemorrhaqe is strikingly shown by a case reported by Dr. William Huntlv. of Kotah (Indian Medicnl Record, May 1, 1894). A man came to him on the morning following the extraction of a lower molar tooth. The bleeding had been verv severe, and blood still flowed from the gum. Dr. Huntly stuffed the cavity with lint soaked in liquor ferri per- chloridi, but this did not stop the bleeding. The man was very weak. Kemembering the effect of opium, he gave him a full dose of the tmcture, and in less than a minute the pupil contracted and the bleeding stopped. The patient was then ordered to take 30 grains of calcmm chloride in an ounce of rain-water every two hours until he had taken 3 drachms. Ihe bleedmg never recurred. Dr. Huntly's views of the value of calcium chloride as a hoimostatic will be found in the supplementary article on that drug (vol. ii, page 438). 451 OPIUM OXYGEN OPOTHERAPY.— This term is occasion- ally applied to treatment with animal juices and extracts. OREXINE HYDROCHLORIDE.— Dr. Hohn, o£ Wiesbaden {TherapeuHsche Monat- shefte, January, 1896 ; Wiener Hinische Woeh- ensckrift, April 30, 1896), remarks that orexine chloride should always be given in wafers, but that the uncombined alkaloid may subse- quently be administered without the use of wafers, when one has made sure that it does not give rise to a sense of burning in the mouth or the oesophagus. Not more than 4 grains should be given at one dose, and the entire amount given in the course of twenty-four hours should not exceed 8 grains. A dose should be taken half an hour before the mid- day meal, and perhaps another shortly before the evening meal. Hohn has used orexine in thirty-three cases, and gives the histories of ten, including three of miwmia, one of gastric catarrh, one of sequela (loss of appetite, pallor, debility, etc.) of catarrh of the large intestine of several weeks' duration, two of supposed incipient tuberculous pulmonary disease, one of such disease positively recognised, and two of vomiting of pregnancy. In twenty-three other cases there was loss of appetite caused by ansemia in eight, gastric catarrh in six, and vomiting of pregnancy in one, and attendant upon convalescence in three. As regards the results, in five of the thirty-three cases they are not siated ; in nine success was attained, according to the patients' accounts ; in twelve, increase of the appetite was noted ; in four, the result was doubtful ; and in two, failure occurred (one was that of a phthisical patient in the last stages of the disease, and the other was that of an hysterical woman). OROTHERAPY, ORRHOTHERAPY. — See Serum treatment and The whey cure, under Dietetic treatment. OVARIAN JXTIGE, OVARIAN STTB- STANCE, OVARINE.— The expressed juice of the fresh ovaries of healthy young animals, filtered and treated by the method described under Animal extracts and juices, an ex- tract, ovarine, made as described in that arti- cle, and the dried substance of the ovary, have all been used as remedies. The Presse medi- cate for August 15, 1896 (New York Medical Journal, September 12, 1896), publishes a report of a meeting of the Congres fran5ais de medecine interne at which M. Spillmann and M. Etienne presented a paper on the treatment of chlorosis with these preparations. They thought that the morbid symptoms which often preceded men- struation .might be considered as the result of an intoxication which disappeared after this function was established. If chlorosis, they said, was a disease of the ovaries, their func- tions were changed or abolished, and with the suppression of menstruation chlorosis appeared. And, on the other hand, a defective general con- dition interfered with and impeded recovery of the ovarian gland. If, however, the ovarian internal secretion was restored to the organ- ism in any way, it was possible, perhaps, to stop the intoxication, to influence the organ- ism in general, and to ailord a means of re- covery of the local ovarian aSeotion. The authors had made use of three products : The fresh ovaries of the sheep, dried ovarian sub- stance, and ovarian juice prepared by the Brown- Sequard-d'Arsonval method. These remedies had been given to six chlorotic subjects, with the results that after the first dose very sharp pains, especially in the abdominal region, had been felt; there had also been headache and vague muscular pains. In two of the patients the temperature had risen to 99'1° and 100-2° P., and the pulse increased from 76 to 100. In three of the patients the remote results had been dis- tinctly favourable ; the general condition had been rapidly improved, the pallor diminished, the number of white globules increased, and the strength restored. In amenorrhcea, men- struation, which had been suppressed for over three months, had returned in one case in fifteen days after the beginning of the treat- ment; in another ease it had returned at the end of three months. The authors concluded that, in the treatment of chlorosis, ovarine fa- voured the elimination of the toxines and intro- duced into the organism an antitoxic principle, and in this way exerted a favourable action on the general condition, on the formation of red globules, and on menstruation. Dr. Mond (JHunchener medicinische Wochen- schrift, 1896, No. 36 ; Gazette hebdomadaire de medecine et de chirurgie, December 13, 1896) reports twelve cases of the use of ovarine in the treatment of disturbances following oophorec- tomy and the menopause, and says that in every case the effect of the treatment was remarkable. There was progressive attenuation of the dis- turbances from the beginning of the third or fourth day, followed by their complete disap- pearance at the end of ten or twelve days. The quantity employed was ten tablets a day, each containing 8 grains of fresh ovarian substance. He advises the employment of large doses in the beginning, which may be progressively di- minished and increased again if the dose seems to be insufficient. He states that he has never seen the least symptom of poisoning in any case. In several cases he substituted for the ovarine tablets others which had the same taste, the same colour, and the same appearance, but contained only meat extract and salt. The administration of these tablets was regularly followed by the return of all the troubles, so that the administration of the real ovarine tablets evidently did not act by suggestion. OXYGEN. — At the eighteenth annual meet- ing of the American Laryngological Associa- tion, that of the year 1896 (JS/ew York Medical Journal, August 29, 1896), Dr. George Stoker, M. R. C. P. I., of London, presented a paper in which he described his method of using oxygen in the treatment of syphilitic and chlorotic ozmna and chronic suppurative otitis media. The oxygen is contained in a wedge-shaped bag made of mackintosh. This bag is placed between two boards, such as are used with the oxyhydrogen light. Prom the bag leads a tube, which terminates in a nose or ear piece. There are two taps — a large one on the bag, lor the PRLLOTINE PIPERIDINB 452 purpose of filling it, and a small one to regu- late the stream of oxygen during treatment. This bag contains a cubic foot of gas, or of gas and purified air mixed in equal quantities, and this amount should sutriee for six hours' treatment. In the great majority of oases he uses equal parts of oxygen and purified air. This latter is prepared by being pumped by means of a bellows or hand ball through two wash bottles, the first containing some water and the second Oondy's fluid. The bottles are attached to the bag for this purpose, and when the bag is half full it is detached from the bot-. ties and filled up with oxygen. The bag being filled, the nose piece is passed into onenostril, the other nostril being plugged with cotton wool ; the patient is directed to breathe through the mouth, the taps are turned dh, and the treat- ment is begun. In ear cases the only differ- ence is that the terminal piece is placed in the external auditory meatus, and in case of either ears or noses it is desirable to have several dif- ferent-sized terminals to fit different-sized ori- fices. The oxygen should be allowed to pass into either the nose or ear from three to six hours daily. In nose oases it is best to use it about half an hour to an hour at a time, giv- ing intervals of rest between the times. If used for more than an hour in nose cases it is apt to cause headache. The only additional treatment is using warm water to cleanse the parts during the day. never less than twice a day. Dr. Stoker stated that of late he had been using the same treatment in cases of purulent discharge from the antrum of Mighmore. the frontal sinus, or the ethmoidal cells, and up to that time the results had been satisfactory. Injections of oxygen into the peritonieum have been recommended by M. Potain in the treatment of ascites. M. Teissier (Province medicate, July 4, 1896; New York Medical Journal, August 1, 1896) relates the case of a woman with ascites and general oedema. He punctured the abdomen and withdrew about fourteen pints of liquid, but the liquid collected again in six days. A second puncture was then made and followed by the injection of 1,300 cubic centimetres of oxygen. The operation was very well borne, and it did not provoke any pain or local reaction ; there was also com- plete absence of fever during the following days. The circumference of the abdomen di- minished from 138 to 103 centimetres, and the oedema of the lower limbs disappeared very rapidly. The oxygen was easily absorbed by the peritonasum. For a few days there was some gurgling, but this disappeared at the end of eight or ten days. At the time of the report the abdomen still measured 103 centimetres and sonorousness existed everywhere, even in the iliac fossa when the patient lay on her side. She was able to get up every day and walk in the open air. These results had been obtained in three weeks. PELLOTINE.— This is an alkaloid ob- tained from Anhalonium Williamsii. Dr. Jolly (Deutsche medicinische Wochenschrift, 1896, No. 34 ; British Medical Journal, Octo- ber 84, 1890) records some observations on the use of it as a hypnotic. It may be adminis- tered by the mouth or subcutaneously. The dose is from ^ to J of a grain, which may be repeated if necessary. In one case as much as 11 grain was given in two hours. Dr. Jolly has used pellotine in forty cases, and the re- sults have been satisfactory, though in vary- ing degree. In no Case were any unpleasant after-effects noticed. He considers that this drug should receive further trial. PHENETIDINE.— See Phenacetine. PHENOL. — Dr. Sbrana (Riforma medico,, March 16, 1896 ; British Medical Journal, May 3, 1896) reports the ease of an Arab, aged twenty-five, who, on November 10th, wounded his left big toe near the nail by striking it against a stone. The wound was immediately dressed with cobwebs full of earth. Two or three days later, as the part became painful, the wound was washed with urine, then cov- ered with chalk, and over this a sheep's blad- der was laid. On the 33d there was some diificulty in masticating. When the man was seen, on the 35th, there was well-marked tetanus, the temperature was 101-3° P., and there were risus sardonicus, complete trismus, opisthotonos, and general clonic convulsions. A hypodermic injection of a 3-per-cent. solu- tion of phenol was given in the foot on the evening of the 35th, and three times a day afterward. On the 36th the necrosed last phalanx and part of the first were removed. On the 30th, the inguinal glands were en- larged and painful. On December 4th there was smart intestinal haemorrhage, also a copi- ous eruption of sudamina on various parts of the body. On December 11th the patient left his room quite cured. Of. Carbolic acid. PICRIC ACID.— Jlr. 'William Maclennan (British Medical Journal, December 26, 1896 ; New York Medical Journal. January 16, 1897) says that the admirable results which he has seen follow the free application of picric acid in solution to painful and extensive burns led him to try its effects in the treatment of cer- tain skin diseases. He has employed it locally in a large number of cases, and has found it more efficacious than any other of the reme- dial agents commonly in use, and he thinks it worthy of a more extensive trial. Acute eczema, he says, is rapidly relieved under the influence of picric acid, and, owing to the powerful astringent properties which this chemical possesses, it forms, when applied over a discharging or denuded surface, a pro- tective layer of coagulated albumin and epi- thelial dilris under which healing rapidly proceeds; and as a potent antiseptic, by in- hibiting the action of the microbes on which the formation of pus depends, or destroying them, it completely prevents suppuration. Applied as a pigment with a brush or piece of absorbent wool, even to an extensive sur- face, it is quite free from danger, and causes not the slightest pain, however vascular the surface may be. Almost immediately itching and smartmg abate, and in a few days, when 453 PELLOTINE PIPEKIDINE the protective crust is removed or separates, the undei'lying skin is found to be compara- tively dry, free from redness, and covered writh a young epidermis. Mr. Maclennan states that in that very troublesome form of acute eczema occurring in children (eczema capitis et faciale) which is usually so intractable to the ordinary methods of treatment, he has had most encouraging re- sults from the use of picric acid. If the hair on the child's head happens to be long it should be cropped short, and all adherent crusts removed by means of poulticing. The raw surface should then be freely painted over, morning and evening, for three or four days in succession with a saturated watery solution. During this treatment the scalp and the face, when it is involved, should be protected by means of a calico mask. After the lapse of a few days the pellicle which has been formed by the action of the picric acid can be removed, with some emollient if it has not previously separated, and, it any undue redness or moisture remains, a fresh applica- tion may be made. The cessation of irritation Eermits the child to sleep, and its general ealth soon improves. When the disease be- comes quiescent, the local treatment can be combined with, or followed by, the internal administration of alteratives like arsenic or gray powder. Although picric acid is so specially valuable in acute discharging eczemas, says the author, it will be found an eiHcient remedy in almost any superficial inflammatory affection. Thus, in three cases of erysipelas he has found a saturated solution of picric acid superior to any local remedy he has hitherto tried. It arrested the inflammation and prevented the disease from spreading, and much more rap- idly diminished local discomfort than carbolic- acid dusting powder or ichthyol. Aspland, he says, narrates the case of a soldier suffering from diabetes mellitus, who contracted ague. He was treated with picric acid. Under its influence the polyuria rapidly disappeared and the specific gravity fell from 1'03S to 1"018, and in a few weeks sugar was entirely absent from the urine. In those very troublesome cases of chronic simple diarrhoea, and so-called putrid diar- rAoso, with very offensive stools, Mr. Maclennan has employed picric acid largely. Often, when opiates and other astringents have failed, picric acid in grain doses has given rapid re- lief. The powerful astringent and antiseptic properties of picric acid diminish secretion and disinfect the intestinal canal. In this re- spect the action of earbazotic acid resembles that of carbolic acid, to which it is constitu- tionally related. M. P. Broeq {Revue iniernationale de mede- cine et de. chirurgie, July 10, 1896) employs the following formulae in the treatment of itching of the scrotum : (1) 9 Picric acid 4i grains ; yaseline.) j^ 235 " Lanohn, ( M. S. : For external use. (2) 5 Picric acid 15 grains ; y!fi,™'Uach 225 " Lanolin, M. S. : For external use. PIPERIDINE. — Piperidine guaiaoolate is described by Dr. Arnold Chaplin and Dr. P. W. Tunnicliffe {British Medical Journal, January 16, 1897) as a compound formed by the action of piperidine on guaiacol in a suitable solvent, such as benzol or petrolic ether, having the formula CsHuNCyHsOj, although its exact chemical composition is still under investiga- tion. It crystallizes in prismatic needles or plates. It is soluble to the extent of 3'5 per cent, in water ; it is also easily soluble in most organic solvents. It is decomposed into its constituents by mineral acids and alkalies. The chemical property which from a pharma- ceutical standpoint is most worthy of note is its relative solubility. When the insolubility of the carbonate of guaiacol is borne in mind this becomes emphasized. The solubility is such that 10 grains may be administered in an ounce draught of simple water, or if the spe- cific gravity of the medium is raised by the addition of a little glycerin or mucilage, a dose of from 20 to 30 grains may be given. The salt is decomposed into guaiacol and piperidine, probably not in the acid medium of the stomach, but in the alkaline one of the duodenum. The reason for this assumption ia that large doses — a drachm — can be given with- out the slightest eructation of guaiacol. The guaiacol acts in the intestine as an antiseptic ; in the structures through which it is excreted, for example, the respiratory mucous membrane, it acts also as an antiseptic. As to the piperidine, its pharmacology forms in part the subject of a research to be published by Dr. Tunnicliffe in conjunction with Dr. Lauder Brunton. For the present, Chaplin and Tunnicliffe simply say that when hydrochloride of piperidine, suitably diluted, is injected into the circula- tion in doses of 0'05 of a gramme to the kilo- gramme of weight, the heart is slowed and the vessels are contracted, a considerable rise of blood-pressure taking place. When it is in- jected under the skin in doses of from 1 to 2 centigrammes to the kilogramme, an increase in reflex excitability occurs, so that if the drug is pushed convulsions may develop. Thus in suitable doses piperidine must be regarded as a cardio-vasoular tonic and spinal stimulant. For three months, the authors say, an in- quiry as to the value of piperidine guaiacolate in the treatment of pulmonary tnherculosis has been carried out at the City of London Hos- pital for Diseases of the Chest. The patients to whom the drug was given were subjected to close observation, and the effects of the medi- cine were from time to time noted. In all, fourteen cases were placed under observation, of which eight were in out-patients and six in in-patients. The duration of the observations varied, but six weeks was about the average. In order to test the value of the drug effi- ciently, cases were chosen more or less at hap- hazard, some being early cases in which improvement might be expected under appro- PYRAMIDONB SALICYLIC ACID 454 priate treatment, others being more advanced, while yet others were in such a stage as to make it improbable that much good from any form of treatment would accrue. In all cases the dose to begin with was fixed at 5 grains three times a day, and this was gradually in- creased until 30, and in one ease 35 grains, were given for a dose. So far as could be gathered from questioning the patients and from personal observation, no unpleasant effects were noticed. All of them stated that the medicine had agreed with them. Pains were taken to ascertain if the drug produced any gastric or intestinal irritation, but in no ease could it be determined that the processes of digestion were in any way interfered with by it. The authors think this worthy of special stress, because experience has so often taught us that when other derivatives of creosote, such as crude guaiacol, are given over a length- ened period their use has to be discontinued from time to time owing to the gastric and in- testinal disturbances caused by them. But in these cases no such untoward event happened. With regard to the varied symptoms of phthisis, it is difficult to say with certainty, they remark, that the guaiaoolate of piperidine had any distinct effect upon them, for in all cases of phthisis it is so frequently foiind that improved hygienic conditions (good food, rest, and attention), such as a residence in a hos- pital affords, plays a large part in the restora- tion of the patient's health. This much, however, they think, may be said, that in many instances the cough appreciably im- proved while the treatment was in progress. The temperature was in no case affected ad- versely by the drug ; in most cases it receded to normal. The appetite, for the most part, was maintained, and very often patients ex- pressed the belief that the medicine improved it ; indeed, in some cases it seemed that it had a decidedly good effect upon the appetite. Some patients gained in weight while the treatment was going on, and in two instances it was thought that more flesh was put on than would have been the case had ordinary remedies been tried. The expectoration in most eases decreased while the drug was being taken. Among the out-patients especially there was a general improvement in strength and vitality. In the case of out-patients it must be remembered, they suggest, that im- proved hygienic conditions do not come into operation to the advantage of the patient as they do in in-patient practice. As to the changes noted in the physical signs, it must be admitted, they say, that dis- cussion of this subject is full of difficulty, for it so often happens that, although conside'rable improvement takes place in the patient's gen- eral condition, yet no marked change occurs in the physical signs. Some of the out-patients whose condition was found to be improving were examined week by week to see if any change could be found in the physical signs. Consolidation and excavation were of course unaffected, but in not a few instances the lungs were noticed to become drier with less moist crepitant rales. This change was attributed to the fact that the area of simple inflamma- tion around the tuberculous infiltration itself had passed from an active to a more quiescent condition. The same improvement in physical signs could not be seen in most of the persons under treatment as in-patients. Two out-pa- tients considered that the medicine relieved their dyspnoea, and, to judge from the lung signs, which were under the treatment improv- ing rapidly, it might very well be the case. Dr. Chaplin and Dr. Tunnicliffe conclude with the following general statements : 1. Experience has shown that piperidine guaiacolate is a perfectly safe drug in doses of from 5 to 30 grains three times a day. 2. It causes no unpleasant efliects. 3. It is exceedingly well borne by the stom- ach, and in this respect it is equal to any other derivative of creosote. 4. Patients while under its influence improve in appetite and general strength. PYBAMIDONE.— Professor Filehne, of Breslau {Berliner klinische Wochenschrift, November 30, 1896 ; ITierapeuHsche Wochen- schrift, December 6, 1896), describes this sub- stance as a substitution compound of antipyrine in which an atom of hydrogen is replaced by the group Nprr"- It is a white crystalline, tasteless powder soluble in ten parts of water. The effects of pyramidone on the nervous system are analogous to those of antipyrine throughout, and the mechanism of its antipy- retic action is the same — that of increasing the dissipation of heat. Thorough observation, however, discloses certain differences of effect. Pyramidone acts on man in doses only a third as large as those of antipyrine ; its action is mani- fested more gradually and subsides more slowly. Its antipyretic action is much milder and lasts longer. Animals poisoned with very large doses of pyramidone show no material altera- tion of the blood, either microscopically or spectroscopically, and no hiemorrhages, throm- boses, or organic degenerations. In the healthy human subject, doses of 8 grains produce neither subjective nor objective effects ; doses of from 5 to 8 grains were given to patients three times a day with advantage. The author has always found it promptly efficacious in re- lieving pain of various sorts, such as febrile headache, pain in the lymph-glands and the spleen in pseudoleucmmia, that of tuberculous peritonitis, anmmia, and multiple neuritis, and intercostal neuralgia occurring as a sequel of influenza. In headache it is sufficient to give 6 grains. In four cases of nephritis it had no effect on the symptoms, except on the headache in one case of contracted kidney. Its antipyretic ac- tion was proved in twelve oases, including those of tuberculosis, typhus, scarlet fever, pseudoleucaemia, influenzal pneumonia, etc. The promptness of its action as an analgetic and the mildness of its febrifuge action, the author thinks, entitle it to further trials. PYROZONE.— Dr. William Cheatham (Medical Record, September 13, 1896 ; New York Medical Journal, September 26, 1896) '455 PYRAMIDONE SALICYLIC ACID calls attention to a line of treatment which, he says, has rendered him the best service in two cases of suppurative otitis media. In both cases the curette, chromic acid, pyrozone, for- malin, boric acid, and many other remedies were employed, but no permanent relief was obtained. Finally Dr. Cheatham directed that 10 drops of a mixture of 10 drops of dilute hydrochloric acid and an ounce of pyrozone should be put into the ear three times a day after cleansing it ; the mixture was to be left in for five minutes after having been forced in deep by firm pressure upon the tragus. In the first case a remarkable change was noticed in a few days ; in a short time there was no secretion from the cavity, and there has been no return of it for several months. In the second case the patient began to improve rap- idly in a few weeks, and recovery set in with no relapse. Dr. Cheatham states that he has treated sev- eral similar cases with but one failure, and that occurred in a tuberculous subject. He has treated many cases of lesser severity with only an occasional failure, and he has not seen this treatment fail in acute cases. Of course in the primary stage of acute cases, he says, such medication is contra-indicated, but after pain, throbbing, and swelling have subsided, and suppuration continues, notwithstanding ordi- nary treatment, the acid and pyrozone check it very promptly. As to drainage in these cases, he says, the iodoform or some other of the gauzes cut into narrow strips has given him by far the best results. This treatment is not a cure-all by any means, continues Dr. Cheatham, but he hopes his brief report will lead others to try the acid-and-pyrozone combination. Of course, when the deeper sinuses are involved, surgery is first indicated, then the pyrozone and acid. Under its use, he states, he finds mastoid-cell involvement much less frequent, and he does not believe these effervescing preparations in- crease such dangers. Q.triN'INE. — ftuinine arsenate is a white crystalline powder obtained by dissolving qui- nine in a hot aqueous solution of arsenous acid. It contains about 69 per cent, of quinine. It is soluble in hot water, slightly so in cold wa- ter. It may be used as an antiperiodic in doses of from -J to iV of a grain. Cluinine dihydrocliloride carbamate oc- curs in colourless crystals easily soluble in water. It contains 70 per cent, of quinine. Its free solubility renders it especially useful for subcutaneous employment. Quinine ferrichloride appears in the mar- ket in the form of brown scales or a reddish- brown powder highly hygroscopic. It is freely soluble in alcohol and in water. It has been praised as a hcemostatic, used as a dusting powder to be applied over a bleeding area. In a 2-per-cent. solution, its employment in uterine hmmorrhaffe is alleged to have been successful. Quinine hydrocliloTsulphate is obtained by dissolving the hydrochloride and the bisul- phate of quinine in warm water in molecular proportions. The solution is evaporated, and the colourless crystals of the double salt ap- pear. It is soluble in an equal quantity of water. It has been recommended for hypo- dermic use. Quinine salicylate occurs in fine white crystals. It is soluble with difliculty in water. As an antipyretic it has been recommended in typhus fever, in gout, and in rheumatic condi- tions. The dose is from 1 to 8 grains, three times daily. — Samuel M. Bbickneb. RONTGEN RAYS.— See X-rays. SALICYLIC ACID AND THE SALI- CYLATES. — Thiersch's solution contains 1 part of salicylic acid and 6 parts of boric acid, dissolved in 500 parts of hot water. It is a bland, harmless antiseptic, and may be freely used on surfaces and in areas where more vigorous antiseptic fluids might be absorbed and produce poisoning. The peritonseum and pleura are especially adapted to its employ- ment. Aluminum and ammonium salicylate, aluminum salicylate. — See Salumine. Bismuth and cerium salicylate is an insoluble pink powder. It has been recom- mended in acute diseases of the gastro-intesti- nal tract in doses of from 15 to 30 grains. Caflfeine and sodium salicylate, or caf- feine and sodium cinnamate, is a freely soluble double salt, well adapted for hypodermic use. Camphor salicylate is a crystalline prepa- ration employed in the treatment of lupus anA parasitic skin diseases. Internally, it has been recommended in doses -of from 3^ to 5 grains for the relief of chronic dysentery and chro7iic diarrhoea. Chlorosalol is the chlorophenylic ether of salicylic acid. Its indications and dose have not yet been determined. Cresalol, cresol salicylate is the cresalol analogue of betol and salol, for which it is sometimes employed. In the system they are split up into cresol and salicylic acid. Dithiochlorosalicylic acid appears as a reddish-yellow powder. It is reputed to have an antiseptic influence. ftiiinine salicylate. — See under Quikikb (Supplement). Sodium sulphosalicylate, a white crys- talline powder, with no special advantages, has been proposed as a substitute for sodium sali- cylate. Sulphosalicylic acid, or salicylsul- phuric acid, is obtained from the action of fuming sulphuric acid on salicylic acid. White crystals, soluble in water and in alcohol, are the result. Albumoses and peptones will be precipitated on the addition of this salt to a solutien containing them, but will be redis- solved on boiling, while albumins and globu- lins, if present, will remain precipitated. The salt is therefore a valuable testing agent. Samuel M. Brickner. SALUBROL SILVER 456 SAIiTJBIlOL. — This is a new substitute for iodoform described by Dr. M. Silber, of Bres- lau (Deutsche medicinische Wochenschrift, December 24, 1896 ; Therapeutische Wochen- schrijt, January 3, 1897), as made by the action of bromine on a compound of methylene and antipyrine. It is stable under ordinary cir- cumstances, but on coming in contact with organic matter it gradually gives off bromine. The powder applied to the skin sometimes gives rise to a burning pain, but a 20-per-cent. gauze has no irritating action. Salubrol has been given to animals subcutaneously in daily amounts of 150 grains without their manifest- ing any poisonous action. SALXJFER, according to Dr. Squibb {Sph- emeris, January, 1897), is the trade name given by a manufacturer in Leeds, England, to po- tassium silicofluoride. It is reported to be an effieient antiseptic and deodorizer, but the chief applications in which it has made its. record are in chronic otorrhcea and as a uter- ine wash in puerperal fever. It readily dis- solves in water, and a saturated solution may be made in boiling water. It is non-toxic, but stains instruments. Often the best effects are to be obtained from the saturated solution. Mr. F. Faulder White, F. E. C. S., of Coven- try, England, reports having even freely dusted very foul wounds with the powder, rapidly washing it off. Recovery takes place without local inflammation or rise of temperature. Nothing has been heard of it in America as yet. SALVIA. — Krahn (cited in Fortschritte der Medicin, November 15, 1896) gives a resume of the literature of salvia, and says that he has used it in thirty-eight cases of profuse sweating, mostly in tuberculous per- sons. He employs a tincture made with 1 part of the leaves and 10 parts of alcohol, and he has convinced himself of its harmlessness by taking as much as 40 drops of it twice a day for six weeks. He has generally given his pa- tients 30 drops in the morning and from 80 to 40 drops in the evening. For dispensary patients he orders an infusion made with a tablespoonful of the leaves and a pint of water, of which they take a cupful night and morning. In all but two of the thirty-eight cases it acted favourably, but the action was not sustained when it was given for weeks at a time. Fever, he says, is not a contra-indica- tion, and he has observed no unpleasant effects. SENECIO.— Mr. \V. E. Fothergill {Medical Chronicle, November, 1896 ; New York Medi- cal Journal, December 19, 1896) has sum- marized the work of Dr. William Murrell, Dr. Dalch6, Dr. Heim, Dr. Bardet, and Dr. Bolog- nesi bearing on the therapeutic value of the senecios, and their conclusions, substantially as follows ; Murrell, among other remarks, says he has found that it acts admirably in those oases of amenorrhna in which the menstrual function, having been established and performed regu- larly for some months or even years, is delayed or suspended as the result of exposure to cold or some similar cause. In cases in which the amenorrhoea is associated, with or dependent on anjEmia, senecio uniformly failed to do any good until the anaemic condition had been re- moved with iron. In cases in which the men- strual flow had never been established, senecio was frequently most useful, and in four cases of vicarious menstruation — the blood coming from the mouth or gums — nothing could have been more satisfactory. He is satisfied that senecio not only anticipates the period, but also increases the quantity of the flow. In many cases of dysmenorrhoea it promptly re- lieves the pain, and not infrequently the men- strual headache from which many women suffer. Senecio is apparently not an ecbolic. Dalche and Heim conclude that the drug re- lieves painful menstruation if the reproductive organs are healthy, but not otherwise. They remain doubtful whether senecio provokes the menstrual flow, and they offer no hypothesis as to its mode of action. Bardet and Bolognesi conclude that senecio has the constant property of provoking men- struation, though administered in. small and harmless doses. They hold that it always tends to regulate menstruation, but that it does not relieve pain at the periods, and does not increase the quantity of the discharge. They suggest that it both produces congestion of the reproductive organs and also excites contraction of the uterine muscle. M. Bardet mentioned one of the cases on which the latter supposition is based in a dis- cussion at the Societe de therapeutique. A woman, aged thirty-eight years, suffered from nausea and hypogastric sensations recalling to the mind those of pregnancy, on three occa- sions after she had taken senecio. But sub- jective phenomena described by a patient, says the writer, are very slight evidence on which to base a statement, as M, Bardet does, to the effect that her uterus contracted. M. Blondel thinks that the reports on the physiological action of senecio are both vague and contradictory, and that until the action of a drug is definitely known its indications and eontra-indioations can not be established. AmenorrhcEa, he says, is not a disease but a symptom ; its causes must be discovered before they can be attacked, and the treatment should always be indirect, on account of the risk of causing abortion. The drugs which act di- rectly in provoking menstruation, he thinks, are unreliable, dangerous, and of merely tem- porary effect. Now, these remarks of M. Blondel, contin- ues Mr. Fothergill, though likely to catch the sympathy of the superficial reader, are not really calculated to deter any one from giving respectful study to the work of these authoi-s. For, to go over his objections in reverse order, granting that the so-called emmenagogues in use are unsatisfactory, there is no reason a priori why it should not be discovered that one or other of the active principles of the senecios is a true emmenagogue, reliable, safe, and perhaps even permanent in its action. Next, in certain cases, amenorrhoea is not a symptom of any pre-existent disease, but is 457 SALUBROL SILVER due to the action on the nervous system of various external and temporary causes. Sec- ondary bad effects, both mental and physical, follow the amenorrhcea, which in such cases is a primary disorder, and is certainly one suit- able for direct treatment. Thus, Edelheit mentions four cases in which amenorrhcea in- augurated a primary and serious affection, fatal in two of them, recovery in the other two following the re-establishment of menstruation. Again, the difficulties in diagnosticating early pregnancy, if great, are not insuperable to all ; and there is no necessity for any one to admin- ister a possible ecbolic while still in doubt as to the diagnosis. Lastly, if no drug may be used until its action is definitely known and its indications are clearly defined, there is an end to the introduction of new therapeutic agents. All that the most exacting can demand is that the introducer of a new drug shall give a working hypothesis according to which the drug may reasonably be supposed to act. Menstruation, he continues, expresses an anabolic surplus produced by the healthy hu- man female from puberty to the menopause, except during pregnancy and lactation, the time of its occurrence probably being deter- mined by the activity of a special centre in the lumbar part of the cord. In the light of this view of menstruation, he says, substances like iron, which affect the quality or quantity of the blood, are only indirectly emmena- gogues. In like manner, substances which, by causing renal or gastro-intestinal irritation, pro- mote pelvic congestion and uterine heemorrhage, are also indirect in their emmenagogue action. To be a direct emmenagogue, a substance must act upon the nervous mechanism which initi- ates the discharge — namely, the hypothetical centre for menstruation. Thus an emmena- gogue is quite distinct from an ecbolic, which is supposed to cause contraction of the uterine muscle by acting either on the fibres them- selves or on their motor nerves. It is possi- ble, he thinks, that senecio may be found to contain an active principle which is a direct emmenagogue in the proper sense of the word, and it does not follow that this principle must be an ecbolic. Several kinds of amenorrhcea, continues Mr. Pothergill, may be classified according to treatment, and the indications defined by the use of the direct emmenagogue which senecio may prove to be. Prom the reports of these authors, it does not seem likely that the drug will be of much use in dysmenorrhoea. The following is his classification according to treatment : No Treatment. — Physiological amenorrhcea • — i. e., before puberty, during pregnancy, dur- ing lactation, and after the menopause. Amen- orrhcea due to congenital or acquired deficiency or to absence of essential reproductive organs. Surgical and other Local Treatment. — Amenorrhcea due to local defects, such as atresia vaginae, atresia cervicis uteri, congeni- tal or acquired neoplasms, etc. Indirect Treatment. — Amenorrhcea due to general disease which so disturbs metabolism that there is no anabolic surplus — e. g., anae- mia and phthisis — where menstruation would be an unnecessary drain on the patient. Direct Treatment by Emmenagogues. — Amenorrhcea due to want of activity of the nervous mechanism initiating menstruation, caused by nervous disease, shock (mental or physical), fear or hope of pregnancy, etc.. in- cluding those cases in which the function has never been established, but wliere there is no local defect or general disease sufRcient to ac- count for its absence. SILVER.— Dr. E. Abrahams, of the Mt. Sinai Hospital, New York {Journal of the American Medical Association. January 30, 1897), writes in praise of the action of silver nitrate in a number of morbid conditions. One of these is the epidermal callosity com- monly known as a corn. Soak the corn in hot soapy water, he says, then shave down the horny layers, and apply a 30-per-cent. solution of silver nitrate. The corn will never, or hardly ever, recur after the silver has been applied to it. Certain forms of Ivpus vulgaris, says Dr. Abrahams, are eminently aiiapted to the local application of nitrate of silver. The first in- dication is found in the small lupus papules which characterize the beginning of the de- structive disease. By effectively cauterizing the primary lesions the disease will be pre- vented from taking root. The second indica- tion is suggested by the lupus nodules which are formed by the coalescence of the initial pap- ules. Lupus in both these forms, he says, can be radically cured by the thorough application of silver caustic. The third indication is the serpiginous form of lupus. Here silver is used as a means only to stop the downward march of destruction. Kaposi thus speaks of silver in the treatment of lupus vulgaris: "Apart from mechanical treatment, the use of caustic is important. The most practicable is solid nitrate of silver. It has sufficient resistance to penetrate the individual lupus nodules, thus uniting mechanical and caustic action. It also possesses the advantage that it does not enter healthy tissues. Large nodules of lupus tumidus, and particularly superficial infiltra- tions, may be burned out as thoroughly as with the sharp spoon. Since the solid stick not only destroys the vessels of the border and base mechanically, but also causes thrombosis, the cauterization furnishes all the require- ments for effecting a cure." In the face of this eminently authoritative statement, says Dr. Abrahams, it is hai'd to see why some writers of distinction fail to include this agent among the local remedies for lupus. Lunar caustic finds a fitting place in suita- ble cases of epillielioma of the skin and mucous membranes, says Dr. Abrahams. Generally speaking, he says, the method of applying the caustic in cutaneous cancers is the same as in lupus or in the other growths above men- tioned, but the indications are fewer. As in lupus, when the cancerous nodule or ulcer is small, nitrate of silver is an effective and curative remedy. It is also indicated in "in- operable" cases, in recurrent nodules, and in the serpiginous forms of epithelioma. SODIUM SULPHOSALICYLATB X KAYS 458 SODIUM SULPHOSALICYIiATE.— See under Samoylio acid and the salicylates (Supplement). STJGAB. — For the use of sugar in scorpion stings, see under Honey (Supplement). VACCINIUM.— Dr. Karl Ullmann ( Wiener medizinische Wochenschrift, 1895, No. 41 ; Monatshefte furpraktische Dermatologie, June, 1896) relates his experience in the use of Win- ternitz's myrtillm (an inspissated extract of Vaccinium Myrtillus) in a hundred cases of skin diseases in Hans Hebra's clinic. The ex- tract is applied to the affected skin in a thick layer, over this a thin coat of cotton is laid, arid the part is bandaged. The diseased part is cleansed daily with a l-to-200 solution of sodium chloride and with alcohol or French brandy. Seventy of the oases were of eczema ; the others included various itching affections, hy- perkeratoses, psoriasis, local formations of wheals, and burns to the degree of rubefaction or of vesication. The cases of eczema were chiefly those of occupation-eczema, the next most numerous were those of mycotic eczema, and finally came those of idiopathic and arti- ficial eczema. In the matter of a cure the re- sults were not so good as had been expected. In the cases of occupation-eczema, especially where there was much scaling, there was tran- sient improvement, but in the weeping, vesicu- lar, and pustular forms there was not. The effect was better, however, in cases of eczema of the fingers and feet characterized by the formation of wheals and rhagades. Mycotic eczema was improved, and the seal- ing seemed to subside, but in no instance was there an actual cure. There was no good ef- fect in cases of intertrigo and eczema of the scrotum. In cases of mycosis flexurarum, es- pecially if there was much scaling and thick- ening of the skin, a better effect was produced. The remedy acted well in seborrhceal eczema of the face in children, but not so well in the seborrhoea of adults. It had no effect, or only the most transitory one, in acute idiopathic eczema, acute dermatitides, so-called trophic eczema, and psoriasis. In three instances burns to the degree of rubefaction or vesica- tion were quickly cured with it. It was used in the following compounds : (1) Purified extract of the ber- ries of Vaccinium Myr- tillus 50 parts ; Bpidermin 10 to 15 " (2) Purified extract of the berries of Vaccinium Myrtillus 50 parts ; Myrrh 3 " The author comes to the following conclu- sions : Extract of myrtillus is no specific against eczema. It is of advantage only in redness, scaling, and wheallike thickening in consequence of chronic eczema affecting the hairless parts of the body and in the sebor- rhceal eczema of children. Mycotic and itch- ing affections of the skin are hardly influenced by it or only in a very transitory way. Wheals and chronic , inflammatory infiltrations are softened by it. In burns of the first or second degree its action is remarkably quick and sat- isfactory. The active principle of the extract is probably a material containing tannic acid, and it possesses pronounced antizymotic prop- erties. The extract is astringent and kerato- plastic. It is in no wise irritating or poisonous. X RAYS. — M. Rendu (Progres medical, January 30, 1897) relates the case of a lad, twenty years old, who presented all the symp- toms of infectious pneumonia, although a bacteriologist professed to have found Koch's bacilli in the sputa. The patient's father asked that the Rontgen rays be used in the treatment. Daily applications of fifty-five minutes' dura- tion were begun, and after the third applica- tion a very distinct amelioration was manifest. The fever fell, there was natural perspira- tion, and there was a very abundant diuresis. After the first application there was produced on the skin where the rays had penetrated an intense erythema which was followed by blis- ters, then an eschar which did not heal for several weeks. M. Rendu questions whether recovery was the result of the acute revulsion produced by the erythema, or the result of the action of the X rays on microbes. He thinks that the patient was not tuberculous. The idea has recently been entertained that the ROntgen rays may be of service in tubercu- losis. In the Fortschritte der Medicin for Feb- ruary 1, 1897, there is an abstract of an account, published in the Semaine midicale, of some experiments undertaken by M. Lortet and M. Genoud nearly a year before. On April 23, 1896, eight Guinea-pigs were inoculated in the fold of the right groin with bouillon that had been infected with a Guinea-pig's tuberculous spleen. Two days later three of the animals were stretched out on a board and the inocu- lated region was exposed to the influence of the Rontgen rays. This was done daily for about an hour for fifty-three days. On the 9th of June the five check animals were observed to have spontaneous abscesses, and their in- guinal glands of the affected side were sof- tened. On the other hand, the three that were under treatment with the Rontgen rays had no abscesses and their inguinal glands were firm and sharply defined. Nine days later the five check animals showed abundant suppura- tion in the inguinal fold or on the thigh, and they had manifestly grown thin. The three that were under treatment were in good con- dition and had gained in weight ; their ingui- nal glands were small, having gradually shrunk, and showed no tendency to suppuration. 'The Rontgen rays, therefore, are held to have pre- vented the acute development of tuberculosis in this instance. The authors suggest the therapeutical employment of them in cases of tuberculous disease of the thoracic and ab- dominal organs, especially in children. GENERAL INDEX. A. B. C. balsam, i, 1. A. B. C. ointment, i, 1. Abelmoschus, i, 1. Abies,"Xl- Abluents. See Detergents. Abortifacients, abortives, i, 1. Abrastol. See Asjvprol. Abrin. See under Jequikity (i, 563). Abrus precatorius. See Jequirity. Absinthe, i, 1. Absinthium, i, 1. as an antispasmodic, i, 1. in the treatment of taenia, i, 101. Absorbents, i, 1. See also Sobbefacients. Abstergents, abstersives. See Detergekts. Acacia, i, 1. A. C. E. mixture, i, 1. Acetal, i, 1. (as a hypnotic) in mental disturbances, i, 1. Acetaldehyde. See Aldehyde. Acetanilide, i, 3. effects of, on the heart, i, 3. " " on the kidneys, i, 3. " " on the liver, i, 2. (as an antispasmodic) in asthma, i, 4. " " " chorea, i, 4, in epidemic influenza, i, 3. " epilepsy, i, 4. " epistaxis, i, 4. " facial neuralgia, i, 3. " fever, i, 3. " gastralgia, i, 3. " grippe, i, 3. " headache, i, 3. " influenza, i, 3. " lobar pneumonia, i, 4. " locomotor ataxia (lightning pains), i, 3. " migraine, i, 3. " myalgia, i, 3. " neuralgia, i, 3, 69. " neuritis, i, 3. " optic neuritis, i, 3. " pulmonary phthisis, i, 8. " rheumatism, i, 4, 135. " sciatica, i, 3. " the crises of tabes, 1, 3. " tremors associated with multiple sclero- sis of the spinal cord, i, 4. " tuberculosis, i, 3. " typhoid fever, i, 3. " whooping-cough, i, 4. " zoster, i, 3. poisoning with, i, 3. 73 Aoetbromanilide. See Beomacetanilide. Acetic acid, i, 4. (diluted), as an antidote to poisoning with the caustic alkalies, i, 5. (glacial), for corns, condylomata, fungous growths, and warts, i, 5. (by inhalation), in colds and headache, i, 5. (diluted), in pruritus, i, 5. (externally), in rheumatism, i, 5. in shallow or venereal ulcers, i, 227. poisoning with, i, 4. Acetic aldehyde. See Aldehyde. Acetic ether, i, 5. (by inhalation) in collapse, i, 5. " " faintness, 1, 5. Acetone, i, 5 ; ii, 413. Acetophenone, i, 5, as a hypnotic, i, 5. Acetphenetidine. See Phenacetinb. Acetum, i. 5. " pyrolignosum. See Ptroligneous aoid. Acetylaldehyde. See Aldehyde. Acetylamidobenzene. See Acetanilide. Acetylamidophenol, i, 5. as an antipyretic, i, 5. Aeetylamidosalol, i, 5. Acetylene. See under Calcium carbide. Acetylmethyl. See Acetone. Acetylphenylhydrazine. See Hydracetin. Acetyltannin, i, 5, Achillea, i, 6. Acids, i, 6. antidotes for poisoning with, i, 6. mineral, i, 6. as haemostatics, i, 6. as astringents, i, 6. in pruritus, i, 6. " the treatment of taenia, i, 101. " vomiting, i, 100. poisoning with, i, 6, 7, 230. Aconite, i, 7. as a gastric sedative in vomiting, i, 100. effects of internal administration of, i, 7. in acute articular rheumatism, 1, 9. " " otitis, i, 8. " " peritonitis, i. 9. " " pleurisy, i, 9. " " sthenic inflammation, i, 118. " asthma due to exposure, i, 8. " catarrhal fever, i, 8. " chilblains, i, 9. " congestive dysmenorrhoea, i, 9. 460 GENERAL INDEX. Aconite, in congestive neuralgia, i, 69. in coryza, i, 8. " croup, i, 8. " dysmenorrhcea, i, 9. " epistaxis (of the full-blooded), i, 9. " erysipelas, i, 8. " exophthalmic goitre, i, 9. " fever of children, i, 8. " " " tuberculosis, i, 9. " gonorrhoea (early stages), i, 9. " gout (for its anaesthetic effect), i, 9. " measles, i, 8. " meningitis, i, 9. " neuralgia, i, 9, 69. " palpitation from nervousness, i, 9. " pericarditis, i, 9. " pneumonia, i, 9. " pruritus (locally), i, 9. " quinsy, i, 8. " scarlatina, i, 8. " " smoker's heart," i, 9. " tuberculosis, i, 9. " urethral fever, i, 9. " vomiting of pregnancy, i, 9. physiological action of, i, 8. poisoning with, i, 7, 343. root, tincture of, and tincture of iodine in toothache, i, 186. Aconitine, i, 10. in chronic rheumatism, i, 11. " congestive neuralgia, i, 69. " gout, i, 11. " myalgia, i, 11. " neuralgia, i, 11, 69. " pneumonia, i, 11. " pruritus, i, 11. poisoning with, i, 10. Acorns, i, 11. Acorus calamus. See Calamus. Actsea raoemosa. See Cimioifuqa. Actinomeris helianthoides, i, 11. in chronic cystitis, i, 11. " dropsy, i, 11. " urinary lithiasis, i, 11. Active principles, i, 11. Actol. See Silver lactate, under Silver. Adansonia, i, 15. Adeps. See Pat, Lard, and Lanolin. Adhaesol. See'under Varnishes. Adjuvants, i, 15. Adonidin, i, 15. Adonis, i, 15. effects of, on the heart, i, 15, 16. in palpitation of the heart, i, 15, 16. Adrue. See Ctperus aeticulatus. ^gle marmelos. See Bela fruit. Aerotherapeutios. See Air, compressed or RAREFIED. Aerozol, i, 16. .3ilrugo, i, 16. jEsculin, i, 16. ^ther. See Ether. ^ther anaestheticus, i, 16. " chloroformiatus, i, 16. jEtherolea, i, 16. Aflfusion, i, 16. cold, Currie's method of, in fever, i, 16. " in asphyxia, i, 17. " " chorea, i, 17. " " coma, i, 17. Affusion, cold, in frostbite, i, 17. cold, in functional disturbances, i, 17. " " hysterical manifestations, i, 17. " " narcotism, i, 17. " '' sunstroke, i, 16. " " syncope, i, 17. hot and cold, in chronic inflammatory thick- enings and deposits, i, 17. how to apply the, i, 17. Agaric, i, 17. Agaricin, i, 17. to diminish bronchial secretions and to stop the flow of milk, i, 17. Agaricus albus, i, 17. in night-sweats of phthisis, i, 17. Agaricus chirurgorum, i, 17. in hEemorrhage, i, 17. Agaricus muscarius. See Muscarine. Agathin, i, 17. in neuralgia, i, 17. " rheumatism, i, 17. Agglutinants, i, 18. Agrimony, i, 18. Agropyrum repens. See Triticum eepens. Aiiantus, i, 18. Air, absolute-pressure method, i, 19. apparatus for inspiration of condensed, and expiration into rarefied, i, 21, 22. bath, condensed, in anaemia, i, 28. " " " bronchial asthma, i, 37. " " " catarrh, i, 27. " " " catarrhal deafness, i, 37. " " " chlorosis, i, 28. " " " convalescence after pleu- risy and pneumonia, i, 27. bath, condensed, in hyperaemia of the cutane- ous and respiratory surface, i, 27. bath, condensed, in obesity, i, 28. " " " pleuritic effusions, i, 27. " " " pulmonary emphysema, i, 27. bath, condensed, in pulmonary tuberculosis, i, 27. bath, condensed, in whooping-cough, i, 27. " or rarefied, contra-indica- tions for use of, i, 27. compressed, in asthma, i, 96. condensed or rarefied, i, 18 ; ii, 413. " " in pulmonary hasmor- rhage, ii, 413. continuous respiration of condensed, i, 25. density of, i, 18. differential-pressure method, i, 20, 31. effect of, upon pathological conditions, i, 24. effect of, on respiration, i, 24. " " " the circulation, i, 24. " " " respiration and circulation, i, 26. expiration into condensed, i, 24. " in chronic pulmo- nary catarrh, i, 28. expiration into condensed, in consolidation after pneumonia, i, 28. expiration into condensed, in heart affec- tions, i, 38. expiration into condensed, in pulmonaiT tuberculosis, i, 29. expiration into rarefied, i, 25, 28. " in asthma depend- ent on emphysema, i, 39. GENERAL INDEX, 461 Air, expiration into rarefied, in bronehorrhcEa, i, 28. expiration into rarefied, in pulmonary tuber- culosis, i, 28. inspiration of condensed, i, 24. " " " in asthma, i, 28. " " " " atelectasis, i, 28. " " " " chlorosis, i, 28. " " " " chronic bronchi- tis, i, 28. inspiration of condensed, in chronic broncho- pneumonia, 1, 28. inspiration of condensed, in chronic pulmo- nary tuberculosis, i, 28. inspiration of condensed, in convalescence from croupous or catarrhal pneumonia, i, 28. inspiration of condensed, in dyspnoea, i, 28. " " " " lipocardiao asth- ma, i, 28. inspiration of condensed, in mitral insuffi- ciency, i, 28. inspiration of condensed, in pulmonary con- gestion, i, 28. inspiration of condensed, in stenosis, i, 28. " " " " " and in- sufficiency of the aortic valves, i, 28. inspiration of condensed, with expiration into rarefied, i, 25. inspiration of rarefied, i, 25. " " " for strengthening the muscles of inspiration, i, 29. inspiration of rarefied, with expiration into condensed, i, 25. inspiration of rarefied, with expiration into the same medium, i, 35. localized hot-, treatment in rheumatism, ii, 440. phvsiological and therapeutical action of, i, 24. physiological effects of the method of abso- lute pressure, i, 25. pneumatic cabinet, i, 19. " chambers, description of, i, 19, 20. rarefied, i, 18. " in asthma, by exhaling into, i, 93. residual, pump, i, 33. respired, i, 18. therapy of respiratory differentiation, i, 28. " " the absolute method, i, 27. Airol, ii, 414. as an antiseptic, ii, 414. " a desiocative, ii. 414, in intertrigo, ii, 414. " tuberculous affections, ii, 414. Aiowan. See Ammi. Aktol. See Silver lactate, under Silver. Alanin. See Amidopeopionio acid. Albolene, ii, 414. liquid, ii, 414. Albumin, i, 29. Albuminates, i, 29. Alcohol, i, 29. and ether as heart stimulants, ii, 237. as a cardiac stimulant, ii, 227. " cleansing agent for the skill, i, 30. " narcohypnotic, i, 506. " narcotic, ii, 4. as an excitant, ii, 4. " intoxicant, ii, 4. Alcohol, as a stimulant, i, 33. as a tonic, i, 34. constitutional effects of, in health, i, 31, 33. diagnosis of chronic alcoholism, i, 36, 37. effects of, on the digestive apparatus, i, 35. " " " " kidneys, i, 36. " " " " nervous system, i, 35. " " " " vascular system, i, 136. external uses of, i, 31. in A. C. E. mixture, i, 1. (by hypodermic injection) in aconite poison- ing, i. 7. in anorexia, i, 33. (externally) in aphthae of the throat and mouth, i, 31. in asthma, i, 33. " atonic dyspepsia, i, 33. " erysipelas (after Behrend's method), i, 30. " fevers, i, 30, 33. inhalations of, in collapse, i, 31. " " " extreme asthenia, i, 31. " " inanition, i, 33. " " shock, i, 31. (subcutaneously) in heart failure (sudden), ii, 227. injections (interstitial) of, in cancer of the uterus, i, 31. in infiammations, i, 30. " insect-poisoning, i, 30. " neiiralgia, in small quantities as a nerve stimulant, i, 69. in neurotic affections, i, 33. " shock, i, 34. internal administration of, i, 31. in toxic conditions, i, 33. " treatment of contusions, wounds, and sprains, i, 29, 30. (as a stimulant) in typhoid fever, ii, 325. (externally) in ulcers, i, 31. medicinal application of, i, 29. toxic effects of, i, 34, 290. treatment of chronic alcoholism, i, 38. uses of, in disease, i, 32, 33. Aldehyde, i, 39. Aldehydum trichloratum. See Chloral. Alder. See Alnus. Alembroth. i, 39. Aletris, i, 39. Alexins, i, 89. Alexipharmacs. See Antidotes. Alimentation, i, 39. Debove's powder in rectal, i, 43. in disease, i, 41. " health, i, 40. meat injections in rectal, i, 43. peptonized milk in rectal, i, 43. " • suppositories in, i, 43. rectal, i, 42. table showing daily supply of food necessary for an adult doing ordinary work, i, 4. Alisma, i, 43. in irritative affections of the urinary pas- sages, i, 43. Alkalies, i, 43. and their carbonates as antidotes to poison- ing by acids, i, 6. alkaline baths in dry and scaly eruptions, i, 45. alkaline baths in the itching of lichen, i, 45. 462 GENERAL INDEX. Alkalies, as germicides, i, 447. in asthma, i, 96. " atonic dyspepsia, i, 44. " cirrhosis of the liver, i, 45. " cystitis without decomposition, i, 44. " diarrhoeas with acid, fluid, irritating stools, i, 44. " eczema, i, 44. " gonorrhoea, i, 44. " hepatic and splenic dropsy, i, 45. " hepatic diabetes, i, 45. " jaundice, i, 45. " leucorrhoea, i, 44. " lithiasis, i, 45. " measles, to hasten desquamation, i, 44. " rheumatism, i, 45, 125. " scarlet fever, to hasten desquamation, i, 44. " sluggish liver, i, 45. " strangury, i, 44. " the moist stage of eczema, i, 44. " undue acidity of the blood, i, 44. Alkaloids, i, 45. poisoning with, i, 333, 433. Alkanet, i, 45. AUamanda cathartica, i, 45. Allspice. See Pimenta. Allyl, i, 45. sulphocarbamide. sulphourea. thionrea. See Thiosinamine. tribromide, ii, 414. " as an anodyne and sedative, ii, 414. " in asthma, ii, 414. " " hysteria, ii, 414. " " whooping-cough, ii, 414. Almonds, i, 45. Aloes, i, 46. action of, on the intestines, i, 47. as a laxative, i, 48. as an anthelminthic, i, 48. contra-indications for the use of, i, 48. enema of, in asoarides vermiculares, i, 103. in ameuorrhoea, i, 49. " anaemia, i, 48. " atony of the sexual apparatus in women, i, 49. " catarrhal jaundice, i, 49. " constipation, i, 48. " gonorrhoea, i, 49. " hsemorrhoids, i, 48. " intestinal indigestion, i, 48. locally, in bedsores, and fissures in mucous membranes, i, 49. Alpha-naphthol, i, 49. Alphol, i, 49. in acute articular rheumatism, 1, 49. " gonorrhoeal cystitis, i, 49. Alstonia, i, 49. Alstonidine, i, 49. Alstonine, i, 49. Alterants, i, 49. Alteratives, i, 49. Althsea, See Marshmallow. Alum, i, 50. as a styptic in haemorrhage from mucous membranes, i, 50. burnt, i, 50. curd applications in chilblains, i, 50. " " " granulating tissue, i, 50. Alum, dried, for destruction of flabby and un- healthy granulations, i, 235. in catarrhal affections, i, 50. " diarrhoea, i, 50. " dysentery, i, 50. " enlarged tonsils, i, 50. " granular lids, i, 50. " lead colic, i, 50. " vomiting of chronic gastric disease, i, 50. poisoning with, i, 109. powder (faucial irrigation) in croup and diphtheria, i, 50. tannate of, in gleet and gonorrhoea, i, 50. water in colliquative sweats (by sponging the body), i, 50. whey in diabetes, i, 50. Aluminium or aluminum and its salts, i, 50. acetate of, as a surgical dressing, i, 51. as an antisepcic, ii, 414. " " astringent, ii, 414. benzoinated solution of, in foetid leucorrhoea, i, 51. boroformate, i, 50. borotannicotartrate, ii, 414. chloride, i, 51. in catarrhal states of the skin or mucous membranes, ii, 414. hydrate, i, 51. sulphate, i, 51. '• In solution as an antiseptic for the nose, throat, and vagina, i, 51. sulphate, in weak solution, as a lotion for ulcers and foetid vaginal discharges, i, 51. sulphophenate of, and potassium, as a haemo- static and disinfectant, i, 51. tannate, in acute gonorrhoea, ii, 859. Alumnol, i, 51. application in skin diseases, i, 51. as a dressing for venereal sores, i, 51. for checking lacrymation and epiphora, i, 51. for the irrigation of abscesses and wounds, i, 51. injections in gonorrhoea, i, 51. Alveloz, i, 51. as an application to cancerous and syphilitic ulcers, i, 51. Amanita niuscaria. See under Agaric, i, 53. Amanitine. See Muscarine. Amara. See Bitters. Amber, i, 52 ; ii, 414. oil of, in chronic bronchitis, ii, 414. " " " gout, i, 53. " " " infantile diarrhoea, i, 52. " " " whooping-cough, i, 53 ; ii, 414. " " " winter cough, ii, 414. Amblotics. See Abortifacients. Ambrosia, i, 53. ^ in epistaxis, i, 53. Ame, i, 52. Amidobenzene. See Aniline. Amidopropionic acid, i, 52. (subcHtaneously) in syphilis, i, 53. Ammi, i, 52. Ammonia, i, 53. externally, as a counter-irritant, i, 53. foetid spirit of, in gastro-neuroses, i, 53. " " " " hysterical conditions, i, 58. in aconite poisoning, i, 7. " collapse, ii, 337. GENERAL INDEX. 463 Ammonia, inhalation of the vapour of, in opium narcosis, i, 53. inhalation of the vapour of, in cardiac de- pression, i, 52. inhalation of the vapour of, in syncope, i, 52. in intoxication v?ith cardiac depression, ii, 227. in poisonous insect bites and stings, i, 53. liniment, in neuralgia and rheumatism, i, 53. physiological action of, i, 52. solution of, in collapse (by hypodermic injec- tion), i, 53. solution of, in snake-bite (by hypodermic in- jection), i, 53. spirit of, in headache, i, 53. " " in post-febrile asthenic conditions, i, 53. water, i, 52. " as an antiseptic, i, 53. " for emesis in acute alcoholism, i, 53. " in colic and flatulence of children, i, 54. water in gastric fermentation, i, 53. " " " superacidity, i, 53. Ammoniac, i, 54. as a stimulating expectorant, i, 54. Ammoniated mercury ointment in the treat- ment of pediculi, i, 116. Ammonium, i, 54. acetate, i, 54. " as a lotion in bruises, i, 54. " " " " " glandular enlarge- ments, i, 54. acetate as a lotion in sprains, i, 54. " in delirium due to biliousness, i, 54. " " exanthemata, i, 54. " " fever, i, 54. " " headache, i, 54. " " infantile coryza, i, 54. " " influenza, i, 54. " locally, in porrigo, i, 54. benzoate, i, 177. for phosphatic calculi, i, 177. in incontinence of urine, i, 177. " irritability of the bladder, i, 177. Ammonium biborate. See Ammonium bokate. bicarbonate, i, 54. as an antacid, i, 55. in cystic catarrh, i, 55. '• intermittent fever, i, 55. " malarial disease, i, 55. " phthisis, i, 55. " renal colic, i, 55. carbazotate, i. 55. carbonate, i, 55. as an antacid, i, 55. as a stimulant expectorant in chronic bron- chitis and pneumonia, i, 56. effect of, on urea, i. 55. in asthma associated with cardiac disorders, i, 55. " chorea, i, 56. " chronic bronchitis, i, 55. " colic, i, 55. " cystinuria, i, 56. " diabetes mellitus, i, 56. " epilepsy, i, 56. " erythema, i, 56. " fatty liver, i, 56. " flatulence, i, 55. Ammonium carbonate, in hysteria, i, 56. in roseola, i, 56. " rubeola; i, 56. " scarlatina, i, 56. " typhoid fever, i, 56. " urticaria, i, 56. carbonicum pyro-oleosum in hysterical con- ditions, i, 56. chloride, i, 56. in amenorrhoea, i, 57. " amyloid liver, i, 57. " bronchitis, i, 56. " chronic bronchitis, i, 418. " chronic nasal catarrh, i, 528. " delirium tremens, ii, 415. " dropsy, i, 57. " facial neuralgia, i, 57. " functional hepatic derangement associated with lithsemia, i. 56. " gastric catarrh, i, 56. " haemorrhages, i, 57. " headache, i, 57. " hepatic abscess, i, 57. " hepatic congestion, i, 56. " hepatic inflammations, i, 56. " intercostal neuralgia, i, 57. " intermittent fever, i, 56. " intestinal catarrh, i, 56. " laryngitis, i, 57. " myalgia, i, 57. " ovarian neuralgia, i, 57. " pharyngitis, i, 57. " senile gangrene, i, 57. " subacute bronchitis, i, 57. " whooping-cough, i, 57. vapour inhalations in coryza, i, 57. " " " inflammations of the bronchi, i, 57. vapour inhalations in inflammations of the larynx, i, 57. vapour inhalations in inflammations of the pharynx, i, 57. citrate, i, 57. embellate, i, 57. as a taeniafuge, i, 57. in diseases of the bladder, i, 57. fluoride, i, 57. •' liquor ammonii fluoridi in hyper- trophied spleens, i, 57. fluoride, liquor ammonii fluoridi inhalations in phthisis, i, 57. formate, i, 57. in muscular paresis, i, 57. " reflex paralysis, i, 57. hydrosulphide, i, 57. in catarrh, i, 57. " diabetes, i, 57. " dysuria, i, 57. " rheumatic diseases, i, 57. nitrate, i, 57. phosphate. See under Phosphorus. physiological action of, i, 54. picrate. See Ammonium carbazotate. picronitricum, i, 55. salicylate. See under Salicylic acid. succinate, i, 57. in delirium tremens, i, 58. (ethereal solution of) in the convulsive dis- orders of children, i, 58. solution of, in asthma, i, 58. 464 GENERAL INDEX. Ammonium, succinate, in convulsive disorders, i, 58. in hysterical disorders, i, 58. " rheumatism, i, 58. sulphate, i, 58. as a stimulant, i, 58. sulphichthyolate. See Iohthtol. sulphydrate. See Ammonium hydeosdl- PHIDB. tetrethylate, i, 58. in acute articular rheumatism, i, 58. " gouty deposits, i, 58. urate, i, 58. in eczema, i, 58. Ammonol, ii, 415. Amplosia, i, 58. Amygdala, amygdalin, amygdalus. See under Almonds. Amygdophenine, ii, 415. in aortic insufficiency, ii, 415. " neuralgia, ii, 415. " rheumatism, ii, 415. Amylasther nitrosus. See Amyl nitrite. Amyl alcohol, i, 58. chloride, i, 58. as an an.-csthetic, i, 58. hydride, i, 59. as an anaasthetic, i, 59. iodide, i, 59. nitrite, i, 59. as an antidote in cocaine poisoning, i, 62. doses and administration of, i, 60. effects of, on the circulation, i, 59. " " " " nervous system, i, 59. " " " " temperature, i, 60. " " " " urine, i, 60. in angeiospasm, i, 60. " angina pectoris, i, 60, 61, 538. " asthma (for temporary relief), i, 95. " bronchial spasm (by inhalation), i, 133. '• cardiac failure, i, 528. " cardiac, pulmonary, and nervous disor- ders, i, 60. " cocaine poisoning, i, 62. inhalations in aortic insufficiency, i, 61. " " asthma, i, 61. " " cardiac dyspnoea, i, 61. " " cardiac failure, i, 61. " " catalepsy, i, 61. " " cerebral anjemia, i, 61. " " dyspnoBa due to asthma and bronchitis, i, 61. inhalations in epilepsy, i, 61. " " headache due to auEemia of the brain, i, 61. inhalations in heart failure, ii, 227. " " hystero-epilepsy, i. 61. " " migraine attended with an- geiospasm, i, 61. inhalations in strychnine poisoning, i, 63. " " syncope, i, 61. " " tetanus, i, 61. " " ursemio dyspnoea, i, 61. in hay asthma, i, 529. " increased blood-pressure, i, 60. " neuralgia as a nerve stimulant, i, 69. " pneumonia, ii, 415. " Raynaud's disease, i, 63. " reflex vaso-motor disturbances, i, 61. " seasickness, i, 61, 99. Amyl nitrite, in strychnine poisoning, 1, 528. in trigeminal neuralgia, i, 61. " urEcmic convulsions, i, 538. symptoms caused by inhaling, i, 59. tertiary, i, 61. tertiary, inhalations as a hypnotic, i, 61. Araylamine chloride, i, 58. Amylene, i, 58. as an anaesthetic, i, 58. Amylene hydrate, i, 58. as a hypnotic, i, 58, 507. as an anajsthetic, i, 58. Amyloform, ii, 415. as an antiseptic and deodorizer for wounds, ii, 415. Amylonitrous ether. See Amyl nitrite. Amylum. See Starch. Amyl valerianate, i, 63. as an antispasmodic, i, 62. " a calmative, i, 62. in hepatic colic, i, 62. " hysterical paroxysms, i, 63. " migraine, i, 63. " muscular rheumatism, i, 63. " nephritic colic, i, 62. " neuralgia, i, 62. " spasmodic dysmenorrhoea, i, 63. Anacardium occidentale. See Cashew nut. Anacyclus. See Pyrethrum. Anesthesia, i, 63. breathing and pulse during, i, 64. general, i, 63. hypnotic. See under Hypnotism. Laborde's method of resuscitation from, i, 64 ; ii, 416. . local, i, 66, 397. mixed, i, 66. primary, i, 63. resuscitation from, i, 64, 65 ; ii, 416. vomiting during, i, 63. Anesthetics, i, 63. administration of, i, 63, 64. Anaestile, ii, 416. as a local auiBsthetic, ii, 416. Anagallis, i, 66. in rabies, i, 66. Anagyrine, i, 66. Analeptics, i, 66. Analgene, i, 66. in neuralgia, i, 66. " rheumatism, i, 66. " spasmodic asthma, i, 66. Analgesics. See Analgetics. Analgesine. See Antipyrine. Analgetics, i, 66. Anaphrodisiacs. See Antaphrodisiacs. Anatriptics, i, 69. Anda oil, i, 70. Andira, i, 70. in lumbricoid worms, i, 70. Andrographis paniculata, i, 70. Andropogon, i, 70. Anemone pratensis. Anemone Pulsatilla. See Pulsatilla. Anemonin, i, 70 ; ii, 107. in dysmenorrhoea, i, 70. Anethol, ii, 416. as an antiseptic, ii, 416. Anethum foeniculum. See Dill. Angeioneurosine. See Nitroglycerin. GENERAL INDEX. 465 Angelica, i, 70. Angine, i, 70. Angostura, Angustura. See Cusparia, i, 70. Anhalonine, i, 70; ii, 417. as a cardiac and respiratory stimulant in angina pectoris, ii, 417. in asthma, ii, 417. Anhaloniuin Lewiuii, i, 70 ; ii, 416. in colic, ii, 416. " cough (nervous), ii, 416. " delirium, ii, 416. " frontal cephalalgia, ii, 417. " hypochondriasis, ii, 416. " hysteria, ii, 416. " insomnia of pain, ii, 416. " mania, ii, 416. " melancholia, ii. 416. Anhydroglucochloral. See Chlokalose. Anhydrosuiphamenebenzoio acid. See Sac- charin. Anidrotics. See Anthidrotics. Aniline, i, 70. Aniline caraphorate, i, 70. in chorea, i, 70. , " epilepsy, i, 70. Animal extracts and iuices, i, 70. hypodermic method of administering, i, 73. preparation of, for hypodermic administra- tion, i, 71. Anise, Aniseed, i, 85. Annidalin, i, 85. Anodyne colloid, i, 393. in lumbago, i, 393. " muscular pains, i, 393. " neuralgia, i, 293. Anodynes. See Akalgetios. Anodynine. See Antipyrine. Antacidine, i, 85. Antacids, 1, 85. in acid diarrhcea, i, 86. " aphthous sore mouth, i, 86. " colic, i, 86. " pyrosis with acid eructations, i, 86. Antagonism, physiological, i, 86. toxicological, i, 87. Antagonists, i, 86. table of, i, 89. therapeutical, i, 89. Antaphrodisiacs, i, 90. Antarthritics, i, 90. Antasthraatics, i, 91. Antatrophics, i, 97. Antemetios, i, 97. Antennaria. See Gnaphalium. Antepileptics, i, 100. Anterotics. See Antaphrodisiacs. Anthelminthics, i, 101. Anthemis. See Chamomile. Anthemis inhalation in catarrh of the upper air-passages, i, 331. Anthidrotics, i, 103. Anthracite, i, 103. powdered coal in treatment of teenia, i, 103. Anthrarobin, i, 103. in erythrasma, i, 103. " psoriasis, i, 103. " ringworm, i, 103. Anthydropics, i, 103. in dropsical effusions, i, 103. Anthydropin. See under Blatta. Anthysterics, i, 103. Antiarin, i, 104. Antiaris, i, 103. Antibaoteria, i, 104. Antibakterikon, i, 104. Antiblennorrhagics, i, 104. Anticnesmatics, i, 106. Anticolics, i, 107. Anticonvulsives. See Antispasmodics. Antideperditories, i, 107. Antidiphtherine, i, 107. application of, i, 107. in diphtheria, i, 107. Antidiphtheritics, i, 107. Antidiphtheritic serum. See under Antitox- INES. Antidotes, i, 86, 107. chemical, i, 108. mechanical, i, 108. Antidotum arsenici, i. 111, Antidyscratics, i, 111. Antidysenterics, i. 111. Antifebrine. See Acetanilide. Antifermentatives. See Antizymotics. Antifungin, i. 111. Antigalactics, i, 111. Antigonorrhoics. See Antiblennoeehaqics. Antihydropin. See Blatta, Antikamnia, i. 111. in influenza, i, 113. " melancholia, i, 113. " neuralgia, i, 113. Antikol, i, 112. Antilithics, i, 113. Antiluetics. See Antisyphilitics. Antimiasmatics. See Antiperiodics. Antimonial powder, i, 114. wine, i, 114. Antimony, i, 112. acute poisoning with, i, 113. chronic poisoning with, i, 113. compound pills of, in cutaneous disorders, i, 114. effects of small doses of, i, 113. pills of, in rheumatism, i, 114. in acute indigestion of children, i, 114. " acute sthenic inflammations, i, 118. " asthma, i, 114. " catarrhal disorders, i, 114. " dislocations, i, 114. " mammitis, i, 114. " mania, i, 114. " noisy sthenic delirium, i, 114. " orchitis, i, 114. " puerperal fever, i, 114. " ri'gidity of the os uteri during labour, i, 114. " sthenic fever, i, 114. " strangulated hernia, i, 114. " treatment of poisoning by, i, 113, 113. Antinarcotics, i, 115. Antinervin, i, 115. Antineuralgics. See under Analgetics. Antinosine, ii, 417. Antiparasitics, i, 115. Antiperiodics, i, 117. Antiperiodio tincture, i, 118, 358. Antiphlogistics, i, 118. Antiphtheirics, Antiphthirics, i, 119. Antiphthisin, i, 119. in fever, i, 119. 466 GENERAL INDEX. Antiphthisin, in pulmonary tuberculosis, i, 119. in tuberculous ulcers, i, 120. (hypoderraieally) in tuberculosis (early stages), i, 120. preparation of, i, 119. rectal injections of, in early stages of tuber- culosis, i, 120. Antiplastics, i, 120. Antipruritics. See Anticnesmatios. Antipyonine, i, 120. for prevention of suppuration in affections of the cornea and conjunctiva, i, 120. (in weak solution) in conjunctivitis, i, 120. in corneal ulcers, i, 120. (in weak solution) in keratitis, i, 120. in panophthalmitis (after enucleation), i, 130. " pannus, i, 120. " purulent conjunctivitis, i, 120. Antipyretics, i, 120. in fever, i, 130, 131. Antipyrine, i, 133. (as an anodyne) in cystitis, i, 124. in bronchial asthma, i, 124. '■ cliorea, i, 124. " delirium, i, 133. " fever, i, 123. " locomotor ataxia (for fulgurant pains), i, 124. (solution) in haemorrhage, i, 466. in hectic tuberculosis, i, 123. " hemicrania, i, 134. " measles, i, 123. " nervous dysmenorrhcsa, i, 34 " neuralgia, i, 69. " pneumonia, i, 133. " rheumatism, i, 125. " scarlatina, i, 123. " sciatica, i, 124. " typhoid fever, i, 123. " whooping-cough, i, 134. phenylglycolate. See TussoL. salicylate. See Salipyeine. table of doses for children, i, 138. Antirrheumatics, i, 134. Antirrheumatin, i, 136. in rheumatism, i, 136. Antiscorbutics, i, 136. Antisepsin, i, 136. in ulcers, i, 136. " wounds, i, 126. Antiseptic precautions in the siok-chamber, i, 441. Antiseptics, i, 126. in obstetrics, i, 130. " surgery, i, 136. " " dressings in, i, 139. " " the operating room, i, 129. " " the operation before and after, i, 130. " surgery, the personal cleanliness of the operator and his assistants, i, 139. " surgery, the preparation of instruments, i, 138. " surgery, preparation of the genito-urinary passages of the male, i, 138. " surgery, preparation of the nasal and oral cavities, i, 137. " surgery, preparation of the pelvic organs in the female, i, 128. Antiseptics, in surgery, preparation of the rec- tum and anus, i, 137. in surgery, preparation of the skin of the head, trunk, and extremities, i, 137. " surgery, sutures and ligature material, i, 138. internal use of, i, 133. Antiseptol, i, 133. Antispasmin, i, 133. " in whooping-cough, i, 133. Antispasmodics, i, 133. Antistreptococcic serum, Antistreptocoeein, Antistreptococous serum. See under Sebum teeatment (vol. ii, page 178). Antisudin, i, 134. Antisudorifics. See Anthideotics. Antisudorin, i, 134. in local hyperidrosis, i, 134. Antisyphilitics, i, 134. Antitsenia, i, 134. Antitetanics, i, 184. Antitetraizine, i, 134. in influenza, i, 134. " neuralgia, i, 134. " rheumatism, i, 134. Antithermics. See Antipybetics. Antithermin, i, 134. Antitoxine, " double " or " dual," ii, 175. Antitoxines, i, 134. Antivenene. See under Sekum teeatment (vol. ii, page 188). Antizymotics, i, 135. Antodontalgics, i, 135. Anuretics, i, 136. Aparine. See Galium. Apenta water, ii, 417. Aperients, Aperitives. See under Cathartics. Aphrodisiacs, i, 136. Apiol, i, 137. in amenorrhoea, i, 138. " dysmenorrhoea, i, 137. " intermittent fever, i, 137. " malarial neuralgia, i, 137. " neuralgic dysmenorrhoea, i, 138. Apoeodeine, i, 138. Apocynum, i, 138. in dropsy, i, 138. Apolysine, ii, 417. as an analgetic, ii, 417. as an antipyretic, ii, 417. in lumbago, ii, 417. " muscular rheumatism, ii, 417. " neuralgia, ii, 417. Apomorphine, i, 138 ; ii, 417. as an antispasmodic, ii, 417. effects of on the bronchial secretion, i, 189. " " " " circulation, i, 139. hypodermic use of, i, 139. in asthma, ii, 418. " bronchial catarrh (as an expectorant), i, loU. " bronchorrhoea, i, 189. " chronic bronchitis, i, 139. " hiccough, ii, 417. " hysteria, ii, 418. " pulmonary emphysema, i, 189. " tetanus, ii, 417. physiological action of, i, 138. Apone, i, 139. in dyspepsia, i, 139. GENERAL INDEX. 467 Apone, in haemorrhoids, i, 139. in muscular rheumatism, i, 139. " neuralgia, i, 139. Apozemata, i, 189. Apyonine, i, 139. Aqua. See Water. Aquozone, i, 140. Arachis hypogaea, i, 140 ; ii, 418. in constipation, i, 140. " diabetes (as a bread), ii, 418. Aranea, i, 140. . Araroba. See under Chrysaeobin. Arbor vitaj. See Thhja. Arbutin, i, 140. Arbutus. See UvA URSi. Archangelica. See Angelica. Arctium. See Lappa. Aretostaphylos, i, 140. Arecane, Arecoline, Arekane, i, 140. Areoa nut, in treatment of tienia, i, 103. Argentamine, i, 140. in gonorrhoea, i, 140. Argentum. See Silver. Argonin. See under Silver (vol. ii, page 197). as an antiseptic, ii, 197. in catarrhal conjunctivitis, ii, 197. " gonorrhoea, ii, 197. " purulent conjunctivitis, ii, 197. Aristol, i, 140. for vegetable parasites, i, 140. in chronic rhinitis, i, 140. " interstitial keratitis, i, 140. " ozsena, i, 140. " psoriasis, i, 140. " suppurative diseases of the middle ear, i, 140. " syphilitic ulceration, i, 140. " tuberculosis (hypodermioally), i, 140. " ulcers, i, 140. " ulcers of the leg, i, 140. Aristolochia. See Serpentaria. Armoraeia. See Horseradish. Arnica, i, 141. and honey, as a plaster for boils, i, 141. jn abrasions, i, 141. " bruises, i, 141. (in small doses) in congestive dysmenorrhcea, i, 141. in cutaneous eruptions, i, 141. " delirium tremens of an asthenic type, i, 141. " fevers, i, 141. " inflammation of pelvic cellular tissue, i, 141. " inflammatory conditions, i, 141. " melancholia of an asthenic type, i, 141. " rheumatic gout, i, 141. " rheumatism, i, 141. " shock, i, 141. " sprains, i, 141. Arnioin, i, 141. Aromatics, i, 141. Arrowroot, i, 141. Arsenauro, i, 143. Arsenic, i, 143. after-treatment of poisoning by, i, 143. and iron in neuralgia, i, 68. as a stimulant, i, 143. bromide of, in asthma, i, 97. chloride of, in asthma, i, 97. Arsenic, effects of internal doses of, i, 143, 143. effects of on the respiration and circulation i, 143. for warts, i, 144. in acne, i, 144. " amenorrhoea, i, 146. " anaemia, i, 145. " angina pectoris, i, 146. " asthma, i. 96. " cancer, as a caustic, i, 144. •' cardiac dyspnoea, i, 146. " cardiac neuroses, i, 146. " chlorosis (as an emmenagogue), i, 374. " chronic bronchitis, i, 146. " chronic gastric catarrh, i, 146. " chronic malarial poisoning, i, 145. ." chronic oophoritis, i, 146. " chronic rheumatism, i, 145. " chronic urticaria, i, 144. " cirrhosis of the liver, i, 146. " cystic goitre, i, 146. " diabetes, i, 145. " diarrhoea, i, 146. " eczema, i, 144. " epithelioma, i, 144. " gastralgia, i, 146. " gastric neuroses, i, 146. " gastrodynia. ii, 146. " hemorrhoids, i, 146. " Hodgkin's disease, i, 144. " intermittency of the pulse, i. 146. " intermittent fever, i, 117, 145. " intestinal indigestion, i, 146. " leucaemia, i, 145. " lichen planus, i, 144. " " ruber, i, 144. " lupus erythematosus, i, 144. " lymphoma, ii, 144. " malarial cachexia, ii, 145. " malarial infection, as a prophylactic, i. 145. " morning vomiting of drunkards, i, l46. " multiple sarcoma, i, 144. " neuralgia, i, 146. " neurotic asthma, i, 146. " pain of aortic regurgitation, i, 146. " palpitation of the heart, i, 146. " pelvic peritonitis, i, 146. " pemphigus, i, 144. " psoriasis, i, 144. " pulmonary emphysema, i, 146. " pulmonary phthisis, early stages, i, 146. " regurgitation of food, i, 146. " rheumatic gout, i, 145. " seborrhoea, i, 144. " secondary syphilis, i, 145. " snake-bites, i, 146. " the wasting diseases of the puerperal pe- riod, i, 145. " tremor of central nervous lesions, i, 146. " ulcer of the stomach, i, 146. " uterine congestion, i, 146. " vaginal leueorrhoea, i, 146. " vomiting due to gastric irritation, i, 99. " vomiting of drunkards, i, 146. " vomiting of pregnancy, i, 146. " weak heart accompanied by pain, i, 146. ointment in pediculosis, i, 145. ■ " " scabies, i, 145. poisoning with, i, 143, 553, 591 ; ii, 400. therapeutics of, i, 143. 468 GENERAL INDEX. Arsenium. See Arsenic. Arsenous acid in asthma, i, 97. Arsenous oxide, i, 142. Arsenura. See Aksenic. Artemisia, i, 147. Asafoetida, i, 147. (as a stimulant expectorant) in chronic bron- chial and laryngeal affections, i, 147. in asthma, i, 147. " chorea of young girls, i, 147. " constipation, i, 147. " flatulence, i, 147. " hypochondriacal affections, i, 147. " hysterical attacks, i, 147. " indigestion, i, 147. " nervous irritability, ii, 6. " threatening abortion, i, 147. (enema) in tympanites of typhoid fever, i, 147. in whooping-cough, alter the acute stage has subsided, i, 147. Asaprol, i, 148. as an anodyne, i, 68. in fermentative dyspepsia, i, 148. " influenza, as an antipyretic, i, 148. " neuralgia, for immediate relief, i, 69. (as an antipyretic) in pneumonia, i, 148. (as an antipyretic) in typhoid fever, i, 148. in rheumatism, i, 148. " treatment of boils, i, 148. Asarum, i, 148. Asbestos, ii, 419. as a surgical dressing, ii, 418. Asclepias curassavica, i, 148. Asolepias tuberosa, i, 148. in acute exanthemata, i, 148. " catarrh of the respiratory tract, i, 148. " fever, i, 148. Asepsin. See Antisepsin. Aseptol, i, 148. Asparagin, i, 148. (by hypodermic injection) in syphilis, i, 148. Asparagus, i, 149. Asparamide. See Asparagin. Aspidium, i, 149. in the treatment of taenia, i, 102, 149. Aspidosamine, Aspidosperma, Aspidosperma- tine, Aspidospermine, i, 149. Aspiration, i, 149. Dieulaloy's rules for, in empyema, i, 151. in absces.ses, i, 153. " ascites, i, 152. " chronic congestive hepatitis, i, 151. " chronic hydrocephalus, i, 150. " cystic tumours of the ovaries and broad ligaments, i, 152. , " diagnosis and treatment of abscesses, cysts, etc., i, 149. " fluctuating enlargements of the joints, i, 152. " haemothorax, i, 151. " hepatic echinococcus, i, 151. " hernia, i, 152. " hydropericardium. i, 151. " hydrothorax, i, 151. " iliac phlegmon, i, 153. " intestinal occlusion, i, 153. " nephrydrosis, i, 151. " pericarditis, i, 150. " pericarditis with effusion, i, 151. " perityphlitic abscess, i, 152. Aspiration, in pleurisy with effusion, i, 150. in pneumonia, i, 150. " pneumothorax, i, 151. " retention of urine due to stricture, hy- pertrophied prostate, or ruptured urethra, i, 152. " spina bifida, i, 150. " suppurative hepatitis, i, 151. " valvular heart disease, i, 150. preparation of needles, tube, air-pump, etc., before, i, 149, 150. Asteracantha longifolia, i, 153. Astringents, i, 152. in checking exudation, i, 153. " chronic and subacute diarrhoeas, i, 153. " chronic inflammations of mucous mem- branes, i, 153. " haemorrhage, i, 153. " subacute inflammation, i, 153. " ulcerations, i, 153. Atropa belladonna. See Belladonna. Atropine, i, 154. anaesthetic effect of, i, 154. as a mydriatic, i, 649. as an anthidrotic, i, 103. effect of external application of, i, 154. for inflamed and swollen parts (externally), i, 154. hypodermically for its general and systemic effects, i, 156. hypodermically for local and constitutional effects, i, 156. in hepatic colic, i, 67. " inflammation of the sciatic nerve, i, 67. " spasmodic dysmenorrhcea, i, 67. (by hypodermic injection) in aconite poison- ing, i, 7. in blepharitis, i, 155. " cancerous tumors (externally), i, 154. " cardiac syncope, i, 156. " collapse of fevers, sunstroke, etc., i, 156. " conjunctivitis with granulation, i, 155. " diseases of the eye, i, 155. " earache, i, 156. " erysipelas, i, 156. " erythematous dermatitis, i, 156. " glaucoma, i, 154, 156. (externally) in infiltrations, i, 154. in neuralgia of the trigeminus, i, 156. (externally) in neuralgia, i, 154. in opium poisoning, i, 156. " phlyctfenular conditions of the cornea, i, 155. . " photophobia of acute conjunctivitis, i, 155. " poisoning by Calabar bean, i, 156. (locally) in sciatica, i, 156. in serious collapse, i, 156. " swelling of the mammary glands, i, 156. internal application of, i, 157. in ulcerations of the cornea, i, 155. " vomiting, i, 99. physiological effect of, i, 154. poisoning (see under IJelladonna, vol. i, p. 175). sulphate (1-per-cent. solution) in toothache, i, 136. small doses, as a corrective of the unpleasant effect of quinine, ii, 419. therapeutics of, i, 155. Auramine, i, 157. GENERAL INDEX. 469 Aurantium, i, 157. juice of. in scurvy, i, 157. Aiirum. See Gold. Ava. See Kava. Avena. See Oatmeal. Axeromaticon, i, 157. in hyperidrosis, i, 157. Axungia. See Laed. Aya-pana, i, 157. Azederach, i, 158. in helminthiasis, i, 158. Azote. See Nitrogen. Bacilli, i, 158. Bacteriotherapy, i, 158. treatment of tuberculosis by, i, 158, 159. Bael fruit. See Bela. Baffine, i, 159. Balneotherapeutics. See under Baths. Balsamios, Balsams, i, 159. as local stimulants, i, 159. in asthma, i, 160. " atonic catarrhal inflammation, i, 160. " laryngeal catarrh, i, 529. " pulmonary catarrh, i, 529. " pulmonary tuberculosis, i, 529. " whooping-cough, i, 529. Balsam, friar's, i, 159. Balsaraura pulmonum, ii, 241. in acute and chronic bronchitis, ii, 341. Bantingisra, i, 160. Baptin, i, 160. Baptisia tinetoria, i, 160. Baptisin, i, 160. Baptitoxine, i, 160. Bardana. See Lappa. Barium, 1, 160. bromide. See under Bromine. carbonate, i, 161. chloride, i, 161. in cardiac disease, i, 161. " cutaneous diseases, 1, 162. " diffuse and multiple cerebral sclerosis, i, 161. " dry eczema, i, 162. " functional cardiac disorder, i, 161. " paralysis agitans, i, 162. " tetanus, i, 161. " valvular disease of the heart, i, 161. " varicose veins, i, 162. " white swelling, i, 161. dioxide, i, 162. hyperoxide, i, 163. iodide. See under Iodine. oxide, i, 162. peroxide, i, 163. poisoning with, i, 161. salts, effect of, on the ventricles of the heart, i, 160. sulphide, i, 163. sulphocarbolate, i, 163. in colliquative diarrhoea, i, 163. " gastro-intestinal disturbances, i, 163. Barley. See Hordeum. Barley water in febrile conditions, i, 351. Barosma. See Buchu. Baryta. See Barium oxide, under Barium, vol. "i, page 162. Baryum. See Barium. Basilicon ointment, i, 162. Basilicon ointment, in burns, ii, 135. in indolent ulcers, ii, 135. Baths, i, 162 ; ii, 419. acid, i, 171. alkaline, i, 170. in chronic rheumatism, i, 171. " " vesicular skin diseases, i, 171. " functional nervous disorders, i, 171. " gout, i, 171. " ichthyosis, i, 171. " jaundice, i, 171. " prurigo, i, 171. " psoriasis, i, 171. " squamous skin diseases, i, 171. " urinary lithiasis, i, 171. alternating, i, 166. aromatic, i, 171. arsenical, in rheumatic arthritis, i, 171. artificial Nauheim, ii, 425. " Plombieres. i. 171. Vichy, i, 171.' bromine, in syphilis and squamous skin dis- eases, i, 170. cold, i, 165. " action of, on the constitution, i, 482, 488, 484. " effect of, on the red blood-corpuscles, i, 164. - " effect of, on the respiration, i, 164, 468. " effects of, on the nervous system, 1, 486. " foot, in chilblains, i, 170. " " " bromidrosis, i, 170. " " " frostbite, 1, 170. " " " menorrhagia, i, 170. " for the insane, to induce sleep, i, 488. " in acute articular rheumatism, i, 488. " " " infectious diseases, i, 486. " " " hyperpyrexia, i, 486. " " asphyxia of the newborn, ii, 128. " " cardiac diseases, i, 165. " " cerebro-spinal meningitis, i, 488. " " cholera infantum, i, 488. " '" diphtheria, i, 488. " " epilepsy, i, 488. " " erysipelas, i, 488. " (as a stimulant) in insolation, ii, 335. " manner of giving, i, 165. " in neuralgia, i, 165. " " neurasthenia, i, 165, 488. " " pulmonary diseases, i, 165. " " quinsy, i, 488. " " rheumatic conditions, i, 165. " " scarlatina, i, 488. " " sepsis, i, 488. " " small-pox, i, 488. " " sunstroke, i, 486. " " typhoid fever, i, 486. " " typhus fever, i, 488. " (permanent or continuous immersion) in variola and pemphigus vegetans, i, 488. cold sitz, contra-indicated in heart disease, i, 169. cold sitz, in amenorrhoea, i, 169. ' " " atony of the bladder, i, 169. ' " " cerebral hyperaemia, i, 169. ' " " chordee, i, 489. ' " " chronic diarrhoea, i, 169. ' " " " dysentery, i, 169. ' " " " engorgement of the liver and spleen, i, 169. 470 GENERAL INDEX. Baths, cold sitz, in chronic posterior urethritis, i, 489. cold sitz, in dysmenorrhcea, i, 169. " " " external and internal haemor- rhoids, i, 489. cold sitz, in genito-urinary affections, i, 488. " " " hemorrhoids, i, 169. " " " nocturnal incontinence of urine in children, i, 169. cold sitz, in obstinate constipation, i, 169. " " " paresis of the bladdei', i, 169. " " " passive uterine congestion, i, 169. " " " pregnancy, i, 169. " " " prostatorrhoea, i, 169. " " " pulmonary hyperaemia, i, 169. " " " rectal prolapse, i, 169. " " " spermatorrhoea, i, 169. condensed air, i, 18, 36, 27. continuous, i, 167. " in extensive burns, i, 167. " " pemphigus, i, 167. " " psoriasis, i, 167. " variola, i, 167. drip, in chronic nervous disease, i, 490. elbow, i, 171. emollient, in acute arthritis, i, 170. " " acute inflammatory skin dis eases, i, 172. emollient, in cold abscess, i, 171. " " lymphangeitis, i, 171. " phlebitis," i, 171. foot, i, 169. gelatin, in skin diseases, i, 172. graduated, i, 170. " in typhoid fever, i, 170. half, i, 168. hand (cold), in cerebral hyperemia, i, 170. " in epistaxis, i, 170. hot-air, i, 167. " contra-indications for use of, i, 168. " in bronchial irritation, i, 168. " " chronic articular rheumatism, i. 168. ' hot-air, in chronic dropsies of serous cavities i, 168. hot-air, in chronic neuralgia, i, 168. " " congestive pulmonary conditions, i, 168. hot-air, in diabetes, i, 168. " " dryness of the skin, i, 168. " " gouty conditions, i, 168. " " hepatic congestion, i, 168. " " kidney disease, i, 468. " " lumbago, i, 168. " " megrim, i, 168. " " mercury poisoning^ i, 168. " " obesity, i, 168. " " opium poisoning, i, 168. " " paludal cachexia, i, 168. " " poisoning by illuminating gas, i, hot-air, in rheumatism, i, 168. " " splenic congestion, i, 168. " " syphilis, i, 168. " " urreimia, i, 100, 468. "method of administering, i, 167. hot, in articular rheumatism, i, 166. " " asphyxia neonatorum, i, 166. " " atony of the lungs and kidneys, ii, 225. " " chronic muscular rheumatism, i, 160. Baths, hot, in convulsions, i, 166. hot, in cystitis, i, 166. " " dropsy, i, 489. " " dysmenorrhcea, i, 166. " " erysipelas, i, 166. " " heart disease (some forms), ii, 335. " " hysterical mania, i, 166. " " inflamed wounds, i, 166. " " inflammations, i, 166. " " insomnia, i, 166. " " lassitude, i, 166. " " maniacal excitement, i, 166. " " metritis, i, 166. " " metrorrhagia, i, 166. " " muscular fatigue, i, 166. " " nervous excitability of pregnancy, hot, in orchitis, i, 166. " " pemphigus, i, 166. " " phlebitis, i, 166. '■ ," phlegmasia alba dolens, i, 166. " " preliminary pains of labour, i, 166. " " psoriasis, i, 166. " " rheumatism, ii, 420. " " sexual disorders, i, 489. " " strangulated hernia, i, 166. " " urethritis, i, 168. " " uterine disorders in nursing women, i, 166. hot, in variola, i, 166. " " vesical spasm, i, 166. " foot, in amenorrhcea, i, 170. " " " cerebral congestion, i, 170. " " " plantar anaesthesia, i, 170. " " " rheumatic arthritis, i, 170. " " " sprains, i, 170. " " " tarsalgia, i, 170. " hip, for the stimulation of the menstrual flow, i, 375. ''^ mustard, in cholera infantum, i, 490. sitz, in acute inflammation of the pelvic organs, i, 169. " sitz, in acute parametritis, i, 489. " " " amenorrhcea, i, 169. " " " anal pruritus, i, 169. " " " dysmenorrhcea, i, 169. '' " " hiemorrhoids, i, 169. " " " lochial suppression, i, 169. " " nervous aid circulatory erethism of the pelvic organs, i, 169. " sitz, in neuralgia of the bladder, i, 169. " " " oophoritis, i, 169. " " " perimetritis, i, 489. " " " rectal prolapse, i, 169. " " " retention of urine, i, 169. " " " spasmodic conditions of the blad- der and urethra, i, 169. " sitz, in strangulated hernia, i, 489. " " subacute inflammation of the pelvic organs, i, 169. iodated, in scrofula, i, 172. " " squamous skin diseases, i, 173. ". " syphilis, i, 173. leg, 1, 171. medicated, i, 171. mercurial, in treatment of syphilides, i, 173. moor. See Mud BATHS, mud, in debility, i, 172. " " neuralgia, i, 172. " rheumatic conditions, i, 173. GENERAL INDEX. 471 Baths, mud, in syphilis, i, 172. mustard, in cholera, i, 173. " " congestion of the abdominal vis- cera, i, 172. narcotic, in acute inflammation of the genito- urinary. organs, i, 172. narcotic, in enteritis, i, 172. " " external hEemorrhoids, i, 172. " " peritonitis, i, 172. Nauheim, ii, 419. " in angina pectoris, ii, 424. " " diseases of the heart (Schott treatment), ii, 419. Nauheim, in endocarditis after rheumatism, ii, 428. Nauheim, in gout, ii, 420. " " locomotor ataxia, ii, 420. " " rheumatism, ii, 420. " " rickets, ii, 420. " " scrofulous diseases, ii, 420. " " mitral insuflSeieney, ii, 423. " " valvular disease, ii, 423. " " weak heart, ii, 424. pine, in gout, i, 172. " " paralysis, i, 172. " " rheumatism, i, 172. " " scrofula, i, 172. " " skin diseases, i, 172. reducing, i, 170. " in typhoid fever, i, 170. Roman, i, 162. saline, i, 172. sand, in chronic rheumatism, i, 172. " " paralysis, i, 172. sea, in conditions of malassimilation, i, 172. " " functional nervous disorders, i, 172. " " scrofulous diathesis, i, 172. sedative, in hysteria, i, 173. " " neurasthenia, i, 178. sheet, i, 169. " in anffimia, i, 169, 490. " " chronic nervous diseases, i, 490. " " fever, i, 169, 490. " " metabolic disturbances, i, 490. " " neurasthenia, i, 169, 490. " " nutritional disorders, i, 169. sitz, i, 169. slime. See Mud baths. sponge, in fever, i, 491. stimulating, i, 173. sulphurous, i, 173. " in anaemia, i, 178. , " " catarrh, i, 173. " " chlorosis, i, 173. " " lead palsy, i, 173. " " scabies, i, 173. " " scrofulous diseases, i, 173. " " treatment of syphilides, i, 173. table of temperature for, i, 165. temperature of, i. 166. tepid, in bronchitis, i, 489. " " multiple sclerosis of the spinal cord, i, 489. tepid, in progressive general paralysis of the insane, i, 489. Turkish, i, 171. vapour, i, 170. " in insomnia, i, 171. " " nervous irritability, i, 171. " " trophic cutaneous diseases, i, 171. Baths, warm, and massage in paralysis agitans and paralysis of the extremities, i, 489. warm, in acute neuritis, i, 489. " " cardiac disease, i, 489. " " cerebral hypersemia, i, 489. " " chronic myelitis, i, 489. " " diseases of the liver, i, 489. " " pyelitis, i, 489. " " suppression of urine, i, 489. Bebeerine, Beberine, i, 173. Beef juice, i, 333. " preparations. See under Dietetic treat- ment. " tea, i, 333. Bela fruit, i, 173. in diarrhoea and dysentery, i, 173. Belladonna, i, 173 ; ii, 425. and alum in whooping-coug;h, i, 174. " morphine in inflamed muscles (by in- jection), i, 67. and morphine in inflamed nerves (by injec- tion), i, 67. and morphine in hepatic colic, i, 67. " " " lead colic, i, 67. " " " renal colic, i, 67. " " " spasmodic dysmenorrhoea, i, 67. applications in lymphatic glandular swell- ings, i, 174. applications in sprained or inflamed joints, i, 174. as an anthidrotic, i, 102. in anal spasm, i, 133. " cancer of the rectum, i, 175. " epidemic cerebro-spinal meningitis of children, i, 175. " hereditary inclination to the formation of blebs, ii. 435. (ointment) in inflammation of the mammary glands, i, 173. in myelitis, i, 175. " neuralgia, i, 69, 174. " nocturnal incontinence of urine, i, 175. " pemphigus, ii, 425. " spasmodic asthma, i, 174. " " contraction of the rectum (by the mouth or in a suppository), i, 175. " spasmodic coughs, i, 175. (internally) in spasm of muscular fibres of the intestines, i, 68. in spasm of the urethra, i, 133. " tetanus, i, 175. " vesical spasm, in a suppository or in- ternally, i, 133. " vomiting, i, 99. " whooping-cough, i, 174. (ointment) in rigidity of the os uteri, i, 174. Benzanalgene, i, 176. Benzanilide, i, 176. Benzene, i, 176. in chronic bronchitis, i, 176. " diphtheria, i, 176. " eczema, i, 176. " scabies, i, 176. " winter cough, i, 176. Benzeugenol, i, 176. as an internal antiseptic, i, 176. Benzoic acid and the benzoates, i. 176. as an intestinal antiseptic, i, 133. il-Z GENERAL INDEX. Benzoic acid in acute septic diseases, i, 178. and the benzoates, in articular rheumatism, i, 177. in chronic bronchitis, i, 177. " cystitis, i, 177. " diphtheria, i, 178. " erysipelas, i, 178. " gonorrhcea, i, 177. " infectious diseases, i, 178. " lithfcmia, i, 177. " puerperal fever, i, 178. " scarlktiua, i, 178. " septiciemia, i, 178. " whooping-cough, i, 178. Benzoin, i, 178. as an intestinal antiseptic, i, 159. compound tincture of (externally), in abra- sions, bedsores, leech bites, and small wounds, i, 178. compound tincture of (externally), in chapped and fissured hands and lips, i, 178. compound tincture of (externally), in chil- blains, i, 178. compound tincture of (externally), in excori- ated and fissured nipples, i, 178. compound tincture of (externally), in eczema (as an anticnesmatie), i, 179. compound tincture of (externally), in frost- bite (as an anticnesmatie), i, 179. compound tincture of (externally), in granu- lating wounds, i, 179. compound tincture of (externally), in urti- caria (as an anticnesmatie), i, 179. (by inhalation) in acute laryngitis, i, 178. " " " chronic bronchitis, i, 178. " " " chronic laryngitis, i, 178. " " " laryngeal affections, i, 178. Benzol. See Benzene. Benzonaphthol, i, 179; ii, 436. as an intestinal antiseptic, i, 179. in dysentery, ii, 426. Benzoparacresol, i, 179. Benzophenoneid, i, 179. in phlyetjenular ophthalmia, i, 179. " purulent keratitis, i, 179. " ulcers of the cornea, i, 179. Benzophenoneide. See Aptonine. Benzosol, i, 179. in diabetes, i, 179. " intestinal diseases, i, 179. " pulmonary tuberculosis, i, 179. Benzoylaconine. See Aconitine. Benzoylanilide. See Benzanilide. Benzoyl-beta-naphthol. See Benzonaphthol. Benzoylguaiacol. See Benzosol. Berberine, i, 179. Betanaphthol. See under Naphthol. Betanaphthol salicylate in acute articular rheumatism, ii, 145. in cystitis with animoniacal fermentation, ii, 145. Betnl, i, 179. in articular rheumatism, i, 179. " cystitis, i, 179. " fermentative diarrhcsa, i, 179. " infectious diarrhoea, i, 179. Birch tar. See under Tar. Bismuth, i, 179. and carbolic acid in vomiting of pregnancy, i, 180. Bismuth and cerium oxalate in vomiting of pregnancy, i, 180. and pepsin in typhoid fever, i, 181. benzoate, i, 178. " in sluggish ulceration, i, 178. " " specific sores, i, 178. " " unhealthy ulcerations, i, 178. citrate, i, 180. effects of, on the blood, i, 180. in acute diarrhrea, i, 180. " " indigestion, i, 80. " coeliao disease of children, i, 181. " carcinoma, i, 180. " diarrhcEa of phthisis, i, 181. " gastric pains, i, 180. " " ulcer, i, 180. " summer diarrhoea of infants, i, 180. oleate, i, 181. phosphate in cholera infantum, ii, 426. salicylate as an antiseptic dressing for ulcers, i, 182. salicylate as an antiseptic dressing in epi- thelioma, i, 182. salicylate as an antiseptic dressing in indo- lent sores, i, 182. salicylate in cholera infantum, ii, 145. " " chronic intestinal catarrh, ii, 145. salicylate in gastro-intestinal diseases, i, 180. subbenzoate, i, 181. subcarbonate, i, 179. subgallate. See Deematol. subiodide, i, 181. subnitrate, i, 179. " as a dusting powder, i, 181. " " snuff in acute nasal catarrh, i, 181. subnitrate in fissures and erosions of the rectum, i, 181. subnitrate, injections of, in dysentery, i, 181. " " " " urethritis, i, 181. " in rectal irritation, i, 181. " " tenesmus, i, 181. " " vomiting, i, 180. " " " due to gastric irritr tion, i, 99. tannate in diarrhoea, ii, 259. " " gonorrhcea, ii, 259. " " leucorrhoja, ii, 259. " " purulent inflammations of the conjunctiva, ii, 259. Bistort, i, 182. Bitters, i, 182. action of, i, 183. aromatic, i, 182. and simple, in malaria, i, 118. astringent, i, 182. contra-indications for the employment of, i, 183. in atonic dyspepsia, i, 183. " cachexia, i, 183. " convalescence from acute disease, i, 183. " debility, i, 183. " diarrhoea (without inflammation), i, 183. " digestive atony, i, 183. injections of, for thread-worms, i, 183. in malarial diseases, i, 183. " malnutrition, i, 183. " marasmus, i, 183. " morning vomiting of drunkards, i, 183. GENERAL INDEX. 473 Bitters, in obstinate vomiting, i, 183. in ttEnia, i, 101. " vomiting of drunkards, i, 100. " " pregnancy, i, 183. "" " seasickness, i, 183. simple, i, 183. Blackberry. See RuBUS. Black draught, i, 183. Black drop, i, 184. Black wash, in venereal ulceration, i, 635. Blancoline, ii, 436. Blatta, i, 184. decoction of, for infantile intestinal disor- ders, i, 184. in cirrhosis of the liver, i, 184. " dropsy due to Bright's disease, i, 184. " heart disease, i, 184. Bleeding. See Bloodletting. Blennostasine, ii, 436. in acute influenza, ii, 436. " bronchorrhoea, ii, 436. " hay fever, ii, 426. " intermittent rhinorrhcea, ii, 436. " laryngorrhcea, ii, 426. " rhinitis, ii, 426. Blisters, i, 184. application of, i, 185. flying, i, 185. In acute articular rheumatism, i, 186. " " pleurisy, i, 186. " " rheumatism, i, 186. " cerebral meningitis, i, 185. " chronic rheumatism, i, 186. " colic, i, 186. " collapse and coma, i, 186. " epilepsy, i, 185. " gastric ulcer, i, 186. " heai' 185. " herpes zoster, i, 186. " hysterical paralysis, i, 185. " inflammation of the mastoid cells, i, 185. " intercostal neuralgia, i, 186. " iritis, i, 185. " meningitis, i, 185. " motor paralysis, i, 185. " neuralgia, i, 184. " oophoritis, i, 185. " otitis media, i, 185. " peritonitis, i, 185. " persistent nausea, 1, 186. " pneumonia, i, 186. " sciatica, i, 186. " sensory paralysis, i, 185. " spinal meningitis, i, 185. " trigeminal neuralgia, i, 186. " typhlitis, i, 185. Blood, i, 186. cooked, i, 186. in pernicious anaemia, i, 186. '• pulmonary phthisis, i, 186. " simple anaemia, i, 186. " wasting diseases, i, 186. serum, for alimentation by the rectum, i, 186. Bloodletting, i, 187. general, 1, 187. in acute cerebral congestion, i, 188. " bronchial hsemorrhage of the plethoric, i, ■ 188. Bloodletting, in cerebral apoplexy, i, 189. in cerebral congestion, i, 188. " circulatory excitement, i, 187. " convulsions of adults, i, 188. " insolation, i, 188. " ineningitis, i, 188. " peritonitis, i, 188. " pleurisy, i, 188. " pneumonia, i, 188. " poisoning by illuminating gas, i, 188. " puerperal convulsions, i, 188. " pulmonary gangrene, i, 188. " pulmonary haamorrhage of the plethoric, i, 188. " venous engorgement, i, 187. " " stasis, i, 188. manner of performing the operation of, i, 187. Boldine, i, 189. Boldo, i, 189. in biliary lithiasis, i, 189. " gonorrhcea, i, 189. Boldoglucin, i, 189. Boletus. See Agaric. Bonduc, i, 189. in malarial disease, i, 189. Bondncin, i, 189. Bone marrow. See Marrow. Boracic acid. See Boric acid. Borax, i, 189. and honey, in laryngitis, i, 189. as a douche for leucorrhoeal discharges, i, glycerine of, i, 190. in abrasions oJE mucous surfaces, i, 189. (in solution) in conjunctivitis, i, 189. " cutaneous disorders, for removal of scabs, i, 189. " epilepsy, i, 189. " fissures of the nipples, i, 189. " superficial burns, i, 189. " ulcerative stomatitis, i, 189. " uterine haemorrhage, i, 189. " uric-acid lithiasis, i, 189. ointment in chilblains, i, 189. with honey and myrrh, in treatment of spongy gums, i, 189. Boric acid, i, 190. as a gastric antiseptic, i, 133. (in solution) as a spray in coryza of hay fever, i, 191. (in solution) as a spray in nasal catarrh, i, 191. (in solution) as a spray in ozsena, i, 191. (in solution) as a spray in pharyngitis, i, 191. for irrigating the peritoniEum after laparot- omy, i, 190. in ammoniacal cystitis, i, 190. " " decomposition of the urine, i, 190. " conjunctivitis (as a wash), i, 191. " contagious ophthalmia, i, 191. " diarrhoea, i, 190. " flatulence, i, 190. " foetor of the feet, i, 191. " granular lids, i, 190. " inflammation of the vagina, i, 190. " otorrhoea, i, 190. " powder, for bromidrosis, i, 103. " pulmonary tuberculosis, i, 191. 474 GENERAL INDEX. Boric acid (in solution) in pruritus, i, 191. (in solution) in tinea, i, 191. in treatment of ulcers, i, 190. " " of wounds, i, 190. " unhealthy suppurating surfaces, i, 191. (in solution) in urticaria, i, 191. Borobenzoate, ii, 204. Boro-borax, i, 191. Boroglyceride, i, 191. Borolyptol, ii, 426. Boudin's solution, i, 146. Bougies. See under Pencils. Boulton's solution, i, 310. Boussingaulthia baselloides, i, 191. in uterine haemorrhage after parturition, i, 191. Brain and spinal cord substance in epilepsy, i, 80. " extract in neurasthenia, i, 80. " " " paralysis, bulbar, i, 80. " " '• tabes dorsalis, i, 80. Bran, i, 191. in eczema, i, 191. Brandy. See under Alcohol. Brayera. See Cusso. Bread and milk in preparatory treatment of taenia, i, 101, 102. Brein, i, 197. Bromacetanilide. See Antisepsin. Bromal, i, 191. hydrate, i, 191. " in chorea, i, 191. " " convulsive diseases, i, 191. " " epilepsy, i, 191. " " lightning pains of locomotor ataxia, i, 191. Bromal hydrate in neuralgia, i, 191. Bromalin, i, 191. in epilepsy, i, 191. Bromalum. See Bromal. Bromalura hydratum, i, 191. Bromamide, i, 191. in acute articular rheumatism, i, 192. " " fibrinous pneumonia, i, 193. " cardiac dropsy, i, 192. " chronic nephritis, i, 193. " " rheumatic arthritis, i, 193. " hepatic dropsy, i, 192. " neuralgia, i, 193. " renal dropsy, i. 193. " typhoid fever, i, 193. Bromated hsemol, ii, 486. Bromethyl. See Ethyl bromide. Bromethylformin. See Bromalin. Bromhaemol, ii, 426. Bromides, i, 192. administration and dose of, i, 195. and potassium iodide in neuralgia due to lead, i, 69. as hypnotics, i, 507. bromism from, i, 193. comparison of the effects of the different, i, 193. effects of, on nutrition and temperature, i, 193. effects of, on the heart and circulation, i, 192. effects of, on the mental faculties, i, 193. effects of, on the motor regions of the brain and spinal cord and the motor nerves, i, 193. Bromides, effects of, on the muscular system, i, 193. effects of, on the sensory nerves, i, 193. " " " " sexual functions, i, 193. " " " " vaso-motor nerves, i, 193. elimination of, i, 193. eruption from, i, 193. in asthmatic paroxysms, i, 94, 95. " cerebral overwork, ii, 6. " cholera infantum, i, 194. " congestive neuralgia, i, 69. " delirium tremens, i, 194. influence of, on the alimentary tract, i, 193. in insomnia, i, 507. " maniacal excitement, i, 194. " melancholic frenzy, i, 194 " menorrhagia of nervous origin, i, 194. " migraine, i, 194. " nervous excitement, i, 194. " " " of the heart, i, 194. " " irritability, i, 194. " nervousness from irritation of the sexual organs, ii, 6. " numbness, i, 194. " ovarian pains, i, 194. " painful flushings, 1, 194. " prolonged mental strain, ii, 6. " seasickness, i, 99. " shooting pains (of the plethoric), i, 194. " spasm due to cerebral irritation, i, 133. " " of the larynx, i, 133. " spasmodic reflex neuroses, i, 194. " tetanus, i, 194. " uterine disorders, i, 194. " vomiting due to cerebral disease, i, 99. " vomiting of pregnancy, i, 194. reflex action of, i, 193. therapeutic use of, i, 193. Bromidia, i, 195. Bromine, i, 195. as a germicide, i, 445. in cancer of the uterus, i, 195. " erysipelas, i, 445. " parasitic cutaneous diseases, i, 445. (locally) in hospital gangrene, i, 445. (locally) in putrid sores, i, 445. treatment of poisoning by, i, 109, 196. vapour in nasal catarrh, i, 196. Bromoform, i, 196. dose and administration, i, 196. in asthma, i, 196. " laryngismus stridulus, i, 196. " singultus, i, 196. " vertigo from reflex causes, i, 196. " whooping-cough, i, 196. Bromol, i, 196. as an antiseptic to wounds and ulcers in diphtheria, i, 196. in cholera infantum, i, 197. " pulmonary abscess, i, 197. " tapeworm, i, 197. " typhoid fever, i, 197. Bromum. See Bromine. Broth, egg, i. 356. mutton, i, 333. Brousnika, i, 197. Brucine, i, 197 ; ii, 26. in chronic pruritus, ii, 29. " inflammation of the external ear, ii, 39. GENERAL INDEX. 475 Bryonia, i, 197. as a haemostatio in haemoptysis, i, 197. in haematoma, i, 197. " inflammation, i, 197. " " of the serous membranes, 1, 197. " post-partum haemorrhage, i, 197. " rheumatism, i, 197. " whooping-cough, i, 197. Bryonine, i, 197. Buchu, i, 197. in chronic and subacute catarrh of the uri- nary mucous membranes, i, 197. " chronic vesical irritation, i, 197. " dropsy, i, 197. " cystitis, i, 197. " pyelitis, i, 197. " urethritis, i, 197. Buckthorn. See Rhamnus. Buena. See Oascarilla. Burdooli. See Lappa. Buttermilk cure for gastric disorders, i, 333. lor nephritis, i, 338. Butternut. See Juglans. Butyl-chloral hydrate, i, 197. in cough, i, 197. " dysmenorrhoea, i, 197. " facial neuralgia, i, 197. " sciatica, i, 197. " trigeminal neuralgia, i, 69. Buxine, i, 197. Caoao-butter, i, 198. (by inunction) in fever, i, 198. rectal medication with, i, 198. suppositories of, for pelvic pain, i, 198. Cactine, i, 199. Cactus grandiilorus. See Cereus grandi- FLORUS, i, 199. Cadmium, i, 199. bromide, i, 199. " in epilepsy, i, 199. Cadmium poisoning, i, 199. Cadmium salicylate in gonorrhoea, i, 200. in keratitis, i, 200. " purulent ophthalmia, i, 200. Cadmium sulphate in acute ophthalmia, i, 300. in blennorrhoea, i, 200. " gleet, i, 200. " otorrhoea, i, 200. " ulcer of the cornea, i, 200. CsBsalpinia. See Bonduc. Cafeeine, i, 200. and antipyrine in migraine, i, 201. " " " nervous headache, i, 201. Caffeine citrate, i, 200. effervescent citrated, i, 200. in chronic nephritis, i, 201. " dropsy, i, 201. " headache, i, 201. " migraine, i, 201. " neuralgia, i, 201. " opium poisoning (as a stimulant to nerve activity), i, 201. " organic disease of the heart, i, 201. " spasmodic asthma, i, 201. physiological action of, i, 200. poisoning from, i, 200. Cahinca, i, 201. Cahinic acid, i, 201. 74 Cainca, i, 201. Cajeput, Cajuput, i, 201. as an expectorant, ii, 436. in colic, i, 301. " cough, ii, 426. " dysmenorrhoea, i, 201. " dyspnoea, ii, 426. " neuralgia, i, 301. " pneumonia, ii, 436. " rheumatism, i, 201. Calabar bean. See Physostigma. Calamine, i, 201. Calamus, i, 201. in atonic dyspepsia, i, 301. " flatulence, i, 301. " flatulent colic, i, 201. Caloaria chlorata, i, 201, usta, i, 201. Calcium, i, 201. bromide in hysteria, i, 203. " " insomnia, i, 201. " (as a sedative) in typhoid fever, i, 303. carbide, ii, 426. in cancer of the breast, ii, 437. " " " uterus, ii, 426. " epithelioma of the uterus, ii, 437. " fibroma, ii', 437. " foetid odours, ii, 437. " metritis, ii, 437. " pain, ii, 427. " rebellious hsemorrhages, ii, 427. carbonate. See Chalk. chloride, ii, 427. as a haemostatic in epistaxis and puerperal haemorrhage, ii, 438. in acne, i, 202. " acute lobar pneumonia, i, 203. " indurated glands, i, 202. " furuncles, i, 203. " lupus, i, 202. " ovarian and uterine tumours, i, 202. " rickets, i, 303. " strumous cutaneous affections, i, 303. " suppuration, i, 202. " tabes mesenterica, i, 203. " tuberculous deposits, i, 202. glycerinophosphate, i, 303. hydrate, i, 303. hypophosphite, i, 203, hyposulphite, i, 302. iodide, i, 203. oxide as a germicide, i, 447. phosphate, i, 303. in chronic phthisis, ii, 78. " conditions where there is a deficiency of lime and phosphorus, i, 202. " debility of young children, ii, 78. " dental caries, i, 302. " fractures, i, 302. " mollities ossium, i, 303. " rickets, ii, 78. " scrofulous ulcerations, i, 202. " sinuses, i, 202. " syphilis, ii, 78. " tuberculous tracts, i, 202. salicylate in chancres, ii, 145. '"' " diarrhoea of children, ii, 145. in syphilitic ulcers, ii, 145. sulphate. See Plaster of Paris, sulphide, i, 303, 476 GENERAL INDEX. Calcium sulphide, as a depilatory, i, 303. baths in lead poisoning, i, 203. " " rheumatoid arthritis, i, 203. in abscesses, i, 203. " acne, i, 203. " carbuncles, i, 203. " furuncles, i, 203. '■ glandular enlargements, i, 308. " prevention of influenza, ii, 428. " suppurative cutaneous disorders, i, 303. Calendula, i, 303. tincture of, in bruises and sprains, i, 303. Calisaya. See under Cinchona. Calolactose, i, 303. Calomel. See under Mercury. (fractional doses) as a diuretic, i, 624. as an antemetic, i, 624. " " anthelminthio, i, 634. compound pills of, in cutaneous disorders, i, 114. compound pills of, in rheumatism, i, 114. fumigation in laryngeal diphtheria, i, 530. " " croup and diphtheria, i, 625. " syphilis, i, 624. in Ascaris vermicularis, i, 102. •' biliousness, i, 624. " cholera, i, 634. " constitutional syphilis, i, 634. (by insufflation) in corneal opacities, i, 556. in dysentery, i, 634. " functional disturbances of the liver, i, 624. " infantile diarrhoea, i, 624. " jaundice, i, 624. " malarial fever, i, 634. (by insufflation) in phlyctaenular conjuncti- vitis, i, 556. in pneumonia, i, 634. " venous engorgement, i, 345. " vomiting of nervous origin, in small doses, i, 99. " weak cardiac action, i, 345. " yellow fever, i, 624. ointment in eczema of the chronic type, i, 635. powder as a dusting powder for herpetic eruptions and venereal ulceration, i, 635. powder (by insufflation) in diphtheria, i, 635. " ■' " " syphilitic laryn- gitis, i, 635. Calotropis, i, 203. in dysentery, i, 203. " epilepsy, i, 203. " hectic fever, i, 203. " intermittent fever, i, 203. " leprosy, i, 203. " snake bites, i, 203. " syphilis, i, 203. Calumba, Calumbae radix, i, 203. and capsicum in vomiting of drunkards, i, 100. and cinnamon in vomiting of drunkards, i, 100. . and ginger in vomiting of drunkards, i, 100. Calx. See Lime. Cambogia. See Gamboge. Camomile. See Chamomile. Camphoid, i, 303. Camphor, i, 203. artificial, ii, 335. as a sedative in dysmenorrhcea, i, 305. Camphor, by hypodermic injection, as a stim- ulant in aconite poisoning, i, 7. carbolate in small-pox, ii, 73. cerate, i, 205. elixir, i, 206. for sprains and enlarged joints, i, 204. in adynamic fever, i, 205. " angina pectoris, i, 305. " atonic ulcers, i, 304. " bronchitis, i, 205. " broncho-pneumonia, i, 305. " cholera, i, 305. " chorea, i, 205. " colic, i, 205. " coryza, i, 204, 539. " delirium tremens, i, 205. " endometritis, i, 204. " erysipelas, i, 204. " fungous ulcers, i, 204. " galactorrhcea, i, 204. " gastralgia, i, 205. " headaches, ii, 6. " hospital gangrene, i, 204 " hysterical vomiting, i, 205. " idiopathic gangrene, i, 204. " influenza, i, 205. " insanitv, i, 205. (powdered) in intertrigo, i, 304. in low fevers, ii, 6. " mastitis, i, 204. " migraine, i, 205. " myalgia, i, 204. " nervousness, i, 205 ; ii, 6. " " from dysmenorrhcea, ii, 6. " pharyngo-laryngitis, i, 205. " pneumonia, i, 205. " restlessness, i, 205. (as an ointment) in swellings and extravasa- tions from bruises, i, 304. in toothache, i, 204. " uterine endotrachelitis, i, 304. monobromated, in nervous excitement, i, 305. in cholera morbus, i, 205. " colic, i, 205. powdered, in eczema, i, 304. in pruritus ani, i, 304. " pruritus pudendi, i, 204. salioylated, in lupus, i, 204. " " rodent ulcer, i, 204. sassafras, in neuralgia, ii, 138. spirit of, applied to the skin for bedsores, i, 204. in boils, i, 304. suppositories in rectal spasm, i, 304. " " urethral spasm, i, 304. " " vaginismus, i, 304. " " vesical spasm, i, 304. Camphora. See Camphor. Camphorated chalk, i, 306. chloral in neuralgia, i, 235. ether in cerebral affections, i, 204. " " peritonitis, i, 304. oil (hypodermically) in sudden prostration, ii, 6. injections in fever and cough of tuberculosis, i, 205. salol, ii, 150. vinegar, i, 205. wine, i, 305. GENERAL INDEX. 477 Camphoric acid. See under Camphor, i, 206. as an anthidrotic, ii, 428. " " intestinal antiseptic, ii, 428. " a stimulant (cardiac), ii, 429. in hyperidrosis after influenza, ii, 428. " phthisical sweating, i, 205 ; ii, 428. " typhoid fever, ii, 428. irrigations in cystitis, i, 205. Canella. i, 206. bark, i, 206. in congestive dysmenorrhoea, i, 206. " convalescence, i, 206. " digestive atony, i, 206. " flatulent dyspepsia, i, 206. " menorrhagia, i, 206. " " during pregnancy, i, 206. " metrorrhagia of cancer, i,206. " " of chlorosis, i, 206. " persistent bleeding after delivery, i, 206. Cannabene tannate, ii, 259. as a hypnotic, ii, 259. Cannabine, i, 206. Cannabis indica, i, 206. as a hypnotic, i, 507 ; ii, 429. as an anodyne, ii, 429. in anorexia, i, 207. " constipation, i, 207. " dysmenorrhoea, i, 307. " hay asthma, i, 307. " headache in the neurasthenic, i, 69. " insomnia, i, 207. " nervous headache, i, 67. " in neuralgic aflEections, i, 207. " ovarian or uterine pain, i, 67. " pulmonary affections, ii, 429. " sciatica, i, 307. " tetanus, i, 207. " tuberculous disease of the lungs, ii, 429. physiological effects of, i, 206. with acetanilide, in neuralgia hypodermic- ally, i, 69. Cantharidates. See under Cantharidic acid. Cantharides, i, 207. in affections of the bladder and urethra, i, 308. " amenorrhoea. i, 208. " catarrhal inflammations of the genito- urinary tract, i, 345. " chronic cystitis, i, 208. " in chronic desquamative nephritis, i, 308. " diabetes insipidus, i, 308. " dysuria, i, 308. " fissure of eczema, i, 808. " gleet, i, 308. " irritability of the bladder in old men, i, 308. " irritability of the bladder in women, i, 308. " menorrhagia, i, 308. " prostatorrhoea, i, 308. " in small superficial burns, i, 308. " spermatorrhcea, i, 208. " tuberculous processes, i, 308. poisoning with, 1, 307. Cantharidic acid, i, 308. in pulmonary tuberculosis, i, 208. Cantharidin, i, 209. Cantharis. See Cantharides. Capraol, i, 306. Capsicum, i, 309. Capsicum and calumba in vomiting of drunk- ards, i, 100. and gentian in vomiting of drunkards, i, 100. " serpentaria in vomiting of drunkards, i, 100. in atonic dyspepsia, i, 209. " chronic affections of the genito-urinary tract, i, 209. " collapse, i, 209. " delirium tremens, i, 309. " diphtheria, i, 309. '• dipsomania, i, 309. " dyspepsia of hard drinkers, i, 209. " flatulent colic, i, 309. " haemorrhoids, i, 809. " intermittent fever, i, 809. " seasickness, i, 809. " sore throat of scarlet fever, i, 809. " suppurating surfaces, i, 209. " unhealthy ulcers, i, 209. plaster for painful joints, i, 209. " in chilblains, i, 209. " " lumbago, i, 809. " " neuralgia, i, 809. Caraway. See Carum. Carbazotic acid. See Picric acid. Carbolate of camphor in sraall-pox, ii, 73. Carbolic acid, i, 310. and bismuth in cholera infantum, i, 812. in cholera morbus, i, 212. " diarrhcea, i, 212. " nausea and vomiting, i, 218. and tincture of iodine in malarial cachexia, i, 212. as a caustic for the destruction of morbid growths, i, 213. as a gastric sedative, i, 99. " germicide, i, 448. (solution) as a mouth-wash, i, 441. (inhalation) in abscess of the lung, i, 213. (enema) in aScarides vermicularis, i, 102. in chronic inflammatory processes, i, 213. " flatulent dyspepsia, i, 312. " ganglion, i, 813. " gastric fermentation, i, 133. " glands which threaten suppuration, i, 313. inhalation for gangrene of the lung, i, 813. " in chronic bronchitis, i, 313. " " phthisis, i, 813. " " whooping-cough, i, 213. in hepatic diabetes, i, 212. injections of the solution of, in abscess, fur- uncles, erysipelas, lupus, chancroid, and buboes, i, 213. injections of the solution of, in hasmorrhoids, i, 313. " hydrocele, i, 313. " morbid growths, i, 313. " na!vi, i, 213. " nasal polypi, i, 213. " parasitic skin diseases, i, 312. " synovitis, i, 213. " tetanus, i, 813. " traumatic tetanus, ii, 439. " treatment of pediculi, i, 116. " typhoid fever, i, 212. local applications of, in burns and scalds, i, 313. " cutaneous diseases, i, 218. " eczema, i, 218. 478 GENERAL INDEX. Carbolic acid, local applications of, in foul ul- cers, i, 213. local applications of, in pseudo-membranous inflam mations, i, 313. " skin diseases, i, 313. (as a spray) solution for hay asthma and nasal catarrh, i, 213. (as a spray) for sore throat, i, 313. solution for stomatitis, i, 313. 1-per-cent. solution, in toothache, 136. poisoning, i, 311. Carbolized gauze, i, 310. oil, i, 210. Carbon and its gaseous compounds, i, 213. dioxide, i, 213. in pertussis, i, 527. " pulmonary tuberculosis, i, 527. (by insuiHation) in pulmonary tuberculosis, i, 583. in spasmodic asthma, i, 527. monoxide, i, 313. Carbonic-acid gas in carbonated waters, as an antemetic, i, 98. in acute eoryza, ii. 430. " anosmia, ii. 430. " hypertrophic rhinitis, ii, 430. " nasal catarrh, ii, 430. oxide, i, 215. water, i, 214. " as a douche in uterine troubles, i, 314. Cardamom, i, 215. Cardiac sedatives, i, 217. in abnormally forcible action of the heart, i, 316. stimulants and tonics, i, 215. " in collapse, i, 216. in pericarditis, peritonitis, pleurisy, and pneumonia, i, 317. " shock, i, 216. Cardiac tonics, i. 317. Cardiiie, i, 218. in disease of the heart, i, 318. Cardol, ii. 431. as a rubefacient and vesicant, ii, 431. Carduus benediotus. See Centaueea bene- DICTA, i, 217. Carica papaya. See Papaw. Carminatives, i, 318. Carniferrin, ii, 431. as a nutrient and tonic, ii, 431. Carpaine, i, 318. in aortic stenosis, i, 318. " diseases of the hearl, i, 318. " mitral insufficiency, i, 318. Carrageen. See CHONDnns. Carron oil, i, 219. as a dressing to the face in small-pox, i, 582. in burns and scalds, i, 583. " eczema, i, 583. Carnm, i, 318. Carvacrol, i, 318. in toothache, i, 136. Caryophylli, Caryophyllum, Caryophyllus. See Cloves. Cascara amarga. See under Rhamnus pur- SHIANA. Cascara sagrada. See Rhamxus purshiana. Cascarilla, i, 219. Cascarin. See Rhamnin. Cashew nut, i, 219. in eczema, i, 219. " general debility, 319. " psoriasis, i, 319. Cassia acutifolia. Cassia aethiopica. Cassia alba, Cassia angustifolia, Cassia elongata. See Senna. Cassia fistula, i, 319. Cassia lanceolata. Cassia marylandica, Cassia obovata, i, 319. Cassia occidentalis, i, 319. in intermittent fever, i, 219. " remittent fever, i, 219. Castanea, i, 219. in paroxysms of whooping-cough, i, 819. Castoreum, i. 219. in hiccough, i, 219. " hysterical manifestations, i, 219. " nervous exhaustion, i, 219. " the typhoid state, i, 319. Castor oil, i, 319. for breaking up a cold, i, 320. in cholera infantum, i, 230. " constipation, i, 330. " diarrhoea, i, 320. " dysentery of a mild type, i, 330. several methods of taking, i, 330. Cataphoresis. See under Blectkioity, and cf. Coca and cocaine. in local pain, i, 377. Cataplasms. See Poultices. Catechu, i, 221. as an application to sore and chapped nip- ples, i, 221. as an injection in gleet, gonorrhoea, and leu- corrhoea, i, 221. in aphthas, i, 231. " gingivitis, i, 221. " haematemesis, i, 221. " hoarseness, i, 331. " ptyalism, i, 331. " relaxation of the uvula, i, 221. " sore throat, i, 231. " tickling cough, i, 221. Catgut, dry method of sterilization of, i, 139. wet method of sterilization of, i, 129. Cathartics, i. 321. drastic, i, 333. hydragogue, in dropsical effusions, i, 334. " " inflammatory effusions, i, 334. in pleurisy with effusion, i, 234. " acute sthenic inflammation, i, 119. " atonic uterine conditions, i, 323. " cerebral congestion, i, 224. " relief of constipation, i, 333. " " " intestinal colic, i, 334. " uraamia, i, 324. saline, in vomiting, i, 100. Cathartinic acid, i, 225. in habitual constipation, i, 225. Catheretics, i, 225. Catramine, i, 226. in lupus and tuberculosis, i, 236. Caudle," i, 356. Caulophyllura, i, 226. Caustics, i, 226. arsenical, in lupus vulgaris, i, 144. in contracting cicatrices, i, 826. " internal hfemorrhoids, i, 237. " non-malignant growths, i, 227. GENERAL INDEX. 479 Caustics, in spinal irritation, i, 226. in treatment of long-standing neuralgias, i, 326. potential, i, 227. Caviare, i, 228. Cayaponine, i, 228. C. C. cough mixture, ii, 432. Celandine. See Chblidonium. Celastrine. i. 228. Celerv, i, 338. Celluloid, ii, 431. for making splints, ii, 431. Centaurea benedieta, i, 328. in intermittent fever, i, 229. Centaurium, i, 239. Cephaelis. See Ipecacuanha. Cephalanthis, Cephalanthus, i, 229. Cera. See Wax. Cerasus. See Lauuocerasus. Cerates, i, 339. Cerobrine, i, 329. Cereus grandiflorus, i, 339. in angina pectoris, i, 229. " aortic regurgitation, i, 229. " palpitation of the heart, i, 229. " rheumatism, i, 229.' " sexual exhaustion, i, 239. Cerevisise fermentum. See Yeast. Cerium, i, 329. oxalate in chronic diarrhoea, i, 229. in chorea, i, 339. " cough, i, 329. " diarrhoeal conditions, i, 339. " epilepsy, i, 229. " gastralgia, i, 339. " vomiting due to uterine disease, i, 329. " " of pregnancy, i, 339. Cerussa, i, 330. Cetaoeum. See Spermaceti. Cetraria, i, 380. in constipation, i, 230. " diarrhcea, i, 280. " pulmonary diseases, i, 330. Cetrarin, i, 330. Cevadilla. See Sabadilla. Chaat, ii, 368. Chalk, i, 230. as a dusting powder in chafing, ulcers, eczema, etc., i, 230. as an antidote in poisoning by acids, i, 330. camphorated, i, 306. precipitated, as a dentifrice, i, 335. in acid eructations, i, 230. " cholera infantum, i, 230. " diarrhoea, i, 330. " pyrosis, i, 330. Chalyijeate bread, i, 551. Chalybeates. See Iron. Chamomile, i, 330. compound mixture of, in neurasthenic and hysterical conditions, i, 331. in convalescence, i, 231. " digestive atony, i, 231. " flatulent colic of children, i, 231. inhalations of the vapour of, in catarrh of the upper air-passages, i, 231. in rheumatism, i, 331. " simple fevers, i, 331. poultice, in abdominal distress, i, 231. in otalgia, i, 231. Champagne, i, 231. as a stimulant after severe operations, ii, 225. iced, as an antemetic, i, 99. in pulmonary troubles of the aged, i, 231. Charcoal, i, 282. as a douche for ofEensive leucorrhoeal dis- charges, i, 232. as a germicide, i, 440. in cancer of the stomach, i, 233. " choleraic diarrhcea, i, 332. " dyspepsia, i, 383. " epidemic dysentery, i, 232. " poisoning with alkaloids, i, 233. " pyrosis, i, 333. " ulcer of the stomach, i, 233. poultice, in foul-smelling suppuration, i, 282. poultice, in gangrene, i, 383. wood, i, 85. Charpie. See Lint. Chartae, Chartulae. See Powders. Chaulmoogra oil, i, 333. effects of, given internally, i, 233. in bruises, sprains, and stifE joints, i, 238. " leprosy, i, 338. " neuralgia, i, 233. " phthisis, i, 233. " rheumatism, i, 233. " scabies, i, 333. " sciatica, i. 233. " scrofula, i, 233. " skin diseases, i, 333. " syphilis, i, 333. " toothache, i, 333. Chelidonium majus, i, 333. in cancer, ii, 481. " corns and warts, i, 233. Chemical restraint, i, 233. Chenopodium, i, 234. in lumbricoid worms, i, 234. oil of, in Ascaris lumbricoides, i, 103. Cherry laurel. See Laurocerasus. " wild. See Prunus virginiana. Chestnut leaves. See Castanea. Chimaphila, i. 334. in treatment of dropsy, i, 234. China. See Cinchona. Chininum. See Quinine. Chinoline. See Quinoline. Chionanthin, i, 234. Chionanthus virginica, i, 334. as a cholagogue, i, 234. " diuretic, i, 384. " vulnerary, i, 334. in jaundice, i, 334. " portal congestion, i, 334. Chirata, i, 334. as a tonic in exhaustion, i, 334. in acidity of the stomach, i, 234. " dysentery, i, 334. " dyspepsia, i, 334. " flatulence, i, 334. " malarial fever, i, 234. Chiratin, i, 234. Chloracetic acid, i, 234. in nsBvi, papillomata, and warts, i, 284. " ozaena, i, 334. Chloral, i, 334. camphorated, in neuralgia, as a sedative nar- cotic, i, 235, 480 GENERAL INDEX. Chloral, in spasmodic contraction of the ar- teries, i, 133. alcoholate, i, 335. ammonium, in nervous insomnia, i, 385. caffeine, in asthmatic attaolis, i, 835. in neuralgia, i, 335. cream, i, 288. formamide. See Chlobalamide. hydrate, i, 335. and camphor, in toothache, i, 136. as a hypnotic, i, 507. " narcotic, ii, 4. contra-indications to the use of, i, 337. in after-pains, i, 337. " asthma, i, 337. " chorea, i, 337. " convulsions of childhood, i, 237. " " " strychnine poisoning and tetanus, i, 337. " delirium of fever, i, 236. " " tremens, i, 337. " epilepsy, i, 387. " excitement of insanity, i, 337. " gonorrhoea, i, 337. " hiccough, i, 337. " insomnia, i, 336. " laryngismus stridulus, i, 337. " nervous insomnia, i, 336. " paralysis agitans, i, 337. " puerperal convulsions, i, 337. " restlessness, i, 236. " rigidity of the os uteri, i, 337. " scarlet fever, i, 237. " seasickness, i, 337. " toothache, i, 237. " whooping-cough, i, 237. local action of, i, 235. locally in foul ulceration, i, 237. physiological effects of, i, 235. poisoning by, i, 336. treatment of poisoning by, i, 236. Chloralamide, i, 238 ; ii, 431. as a hypnotic, i, 507 ; ii, 431. " an analgetic, ii, 431. in chorea, i, 238. " epilepsy, i, 338. " insomnia, i, 338. " neuralgia; i, 288. " seasickness, i, 339. " spasmodic asthma, i, 238. Chloralose, i, 339. in hysterical chorea, i, 239. headache, i, 239. " neurasthenia, i, 239. " psychical troubles, i, 239. " sleeplessness, i, 339. " uterine pains, i, 239. Chloralum. See Chloral and also under Aluminum and its salts. Chloranodyne, i, 239. Chloric ether, i, 339. Chlorinated cotton, i, 240. Chlorine, i, 339. as a disinfectant, i, 444, 537. inhalation in phthisis, i, 340. in treatment of gangrene, i, 445. " " " ulcers, i, 445. Chlorine water, as a douche in septic condi- tions after childbirth, i, 240. as a gargle in diphtheria, i, 340. Chlorine water, in ill conditioned and foul- smelling ulcerations, i, 340. Chlorobrom, i, 340. in active melancholia, i, 240. " seasickness, i, 100, 340. " simple melancholia, i, 340. Chlorodyne, i, 340. in acute attacks of diarrhoea, i, 340. Chloroform, i, 340. anesthesia, physiology of, i, 242. " preparation of the patient for, i, 343. and morphine on the heart and respiration, i, 88. applied locally, in chronic rheumatism, 1, 241. applied locally, in lumbago, i, 241. " " " neuralgia, i, 241. as a lotion in pruritus, i, 241. " " " urticaria, i, 241. " an antemetic, internally, i, 99. " a solvent, ii, 313. condition during full ansesthesia by, i, 248. deaths under, i, 243. in A. C. E. mixture, i, 1. " acute coryza. i, 528. " angina pectoris, i, 588. inhalation, effects of, i, 341. in coryza of iniluenza, i, 528. " flatulency as an antispasmodic and seda- tive, i, 841. injections of, in hydrocele, i, 241. " " hypodermic, in sciatica, i, 341. in nausea, i, 99. " puerperal eclampsia, i, 538. " rigid perinasum in labour, i, 341. " strychnine poisoning, i, 528. " tetanus, i, 528. " toothache, i, 341. " treatment of asthma, i, 528. " uraemia, i, 528. " vomiting, as an antispasmodic and seda- tive, i, 341. method of administration of, i, 243. methods of resuscitation from overdose of, i, 344. rhythmic tractions on the tongue in as- phyxia from, i, 344. spirit, in asthmatic paroxysm, i, 94. " " intermittent fever, i, 241. " " persistent hiccough, i, 241. syncope by direct action of, i, 344. vapour inhalation, in biliary colic, i, 345. " " convulsions, i, 245. "^ " " earache, i, 533. " " " hysterical spasm of the larynx, i, 345. vapour inhalation, in the second stage of labour, i, 245. versus ether, i, 397. Chloral, 1, 245. Chloropercha, i, 245. Chlorophenols, Chlorphenols, i, 245. in solutions, locally, in tuberculous affections of the larynx, i, 245. Chocolate. See under Cocoa (vol. i, page 285). Cholagogues, i, 246. direct, i, 346. in bilious conditions, i, 347. indirect, i, 347- GENERAL INDEX. 481 Chlorosalol. See under Salicylic acid and THE salicylates (Supplement). Chondrus, i, 347. in diarrhoea, i, 247. " dysentery, i, 247. " gastritis, i, 247. " irritated conditions of the urinary tract, i, 247. Chromic acid, i, 247. as an anthidrotic, i, 103. for goitre, i, 248. in carcinoma, i, 248. " lupus, i, 248. " malignant ulcers, i, 248. " naevi, i, 248. " uterine cancer, i, 248. paste, in condylomata, i, 248. " " neoplasms of the mucous mem- branes, i, 248. paste, in neoplasms of the skin, i, 248. solution, in chronic endometritis, i, 248. " " intra-uterine growths, i, 248. " " laryngitis, i, 248. " " pharyngitis, i, 248. " " sycosis, i, 248. " " syphilitic glossitis, i, 248. " " ulcerated gums, i, 248. in warty growths, i, 248. Chrysarobin, i, 248. for Sarcina lutea, i, 249. " Staphylococcus pyogenes aureus, 1, 249. in eczema seborrhoicum, i, 116. " psoriasis, i, 249. " ringworm, i, 117. Chrysophanic acid. See Chrysarobin. Cieatrizants. See Vulneraries. Cicuta, i, 249. in local pains, i, 250. " migraine, i, 250. " nervous headache, i, 250. " rheumatism, i, 250. Cigarettes, Cigars, i, 250. Ciraicifuga, i, 250. as a uterine stimulant in labour, ii, 55. in acute rheumatism, i, 250. " amenorrhoea, i, 250. " bronchial catarrh, i, 250. " caseous pneumonia, i, 250. " chorea, i, 250. " delirium tremens, i, 250. " dysmenorrhoea, i, 250. " fatty heart, i, 250. " fevers, i, 250. " headache, i, 250. " impotence, i, 250. " lumbago, i, 250. " nervousness, i, 250. " neuralgia and muscular pains, i, 250. " pleurodynia, i, 250. " post-partum hasmorrhage, i, 250. " rheumatic taint, i, 250. " spermatoi-rhoea, i, 250. " wry-neck, i, 250. Cinchona, i, 2.50. in locomotor ataxia, ii, 120. (in powder) in ulcerations, i, 253. " " " unhealthy wounds, i, 253. physiological action of, i, 252. Cinch onidine salicylate in chronic articular rheumatism, ii, 145. Cinchonidine salicylate in subacute articular rheumatism, ii, 145. Cinchonine iodosulphate. See Antiseptol. Cineraria, i, 258. in amenorrhcea, i, 258. " cataract, i, 258. " hysteria, i, 258. Cinnabar, i, 258. Cinnamic acid and glycerin in tuberculosis of joint cavities, i, 259. Cinnamon, i, 259. and calumba in vomiting of drunkards, i, 100. and gentian in vomiting of drunkards, i, 100. and serpentaria in vomiting of drunkards, i, 100. in acute dysentery, i, 259. " diarrhoea, i, 259. " flatulence, i, 259. " indigestion, i, 259. injections in pulmonary and intestinal tu- berculosis, i, 259. in tuberculosis of joint cavities, i, 259. " vesical hjemorrhage, i, 259. Cinnamyl-eugenol. See under Cloves. Cissampelos. See Parbira. Citric acid, i, 259. in Asiatic cholera, i, 260. solution, as a gargle in diphtheria, i, 260. Citrine ointment. See under Mercury. Citrophen, ii, 481. as an analgetic and antipyretic, ii, 431. CitruUus colocynthis. See Colocynth. Clavethyl, i, 260. Climatic influence in asthma, i, 96. treatment, i, 260. " in chronic bronchitis, i, 271. " of consumption or phthisis, i, 270. treatment, sea voyages in chronic empyema, i, 271. treatment, sea voyages in chronic pleurisy, i, 271. treatment, sea voyages in chronic hsemor- rhagic phthisis, i, 271. treatment, sea voyages in neuroses, i, 271. " sea voyages in scrofulous disease, i, 271. treatment, sea voyages in tuberculous exca- vation, i, 271. treatment, why coolness or cold is preferable to warmth or heat in, i, 263. treatment, why diathermancy is to be pre- ferred to dense, moist, or smoky atmos- phere in, i, 268. treatment, why dryness is preferable to moisture and is placed first in, i, 262. treatment, why rarefaction is better than sea-level pressure in, i, 265. treatment, why sunshine is superior to cloud- iness in, i, 267. treatment, why variability can be substituted for equability in, i, 267. Cloves, i, 272. as a plaster to relieve nausea and vomiting, i, 272. in dental caries, i, 272. injections of the tincture of, in cold abscesses, i. 272. 482 GENERAL INDEX, Cloves, oil of, in toothache, i, 136, 272. in tuberculous affections, i, 372. Clysters. See Enemata. Cnious benediotus. See Centaurea bene- DICTA. Coal tar, i, 272. in foul ulcers and wounds, i, 273. powder, ii, 364. " in ecthyma, eczema, herpes impetigo, and rupia, ii, 263. saponine, i, 273. Cobalt, i, 273. oxide, in rheumatism, i, 273. poisoning by, i, 378. Cobweb. See Abanea. Coca and cocaine, i, 374. Coca, effects on the organism of, 1, 274. in anaemia, i, 374. " neurasthenia, i, 374. leaves as a stimulant, ii, 334. Cocaine, action of, on the general system, i, 384. application of, in dental surgery, i, 375. " " gynfecology, i, 275. " " to the eye, i, 275. " " " genito-urinary tract i, 375. application of, to the mucous surfaces, i, 275. " " " nose, pharynx, and larynx, i, 275. application of, to the rectum, i, 275. " " skin, i, 276. as a mydriatic, i, 649. cantharidate, subeutaneously, in pulmonary tuberculosis, i, 209. hydrochloride, in neuralgia, hypodermically, i, 68. in toothache, i, 136. " neuralgia, by the mouth and hypodermic- ally, i, 69. internally, in hysteria, i, 284. " " melancholia, i, 384. " " neurasthenia, i, 384. introduction of, into the skin, i, 276. in vomiting, in small doses, i, 99. localization of the action of, in circumscribed nexiritis, i, 280. localization of the action of, on the brain, i, 283. local medication of the spinal cord with, i, 380. methods of perpetuating, upon the peripheral nerves, i, 377. poisoning, ii, 431. solution, irrigation of the Cauda equina with, 1,380. therapeutic thrombosis, or the localization and prolongation of the action of, i, 378. Coccus, Cochineal, 1, 384. Cochlearia, i, 384. CooillaiJa bark, i, 384. in acute bronchitis, i, 385. " bronchitis, i, 285. " bronchopneumonia, i, 285. " phthisis, i, 385. " subacute bronchitis, i, 385. Cocoa, i, 285. Codeine, i, 286. as an anodyne, i, 67. in asthma, i, 93, 94. Codeine, in colic, i, 886. in cough, ii, 433. " irritable and nervous cough, i, 386. " nervous and irritable conditions, i, 286. " " insomnia, i, 386. " the cure of the morphine habit, i, 286. " saccharine diabetes, i, 386. " whooping-cough, i, 386. Cod-liver oil, i, 287. by inunction in marasmus, i, 288. " " " perverted nutrition, i, S88. in cachexia, i, 288. " chorea, i, 288. " chronic diarrhoea of young children, i, 388. " " eczema, i, 288. " laryngitis, i, 388. " " rheumatism, i, 288. " conjunctivitis of children, i, 288. " dizziness, i, 288. " epilepsy, i, 288. " favus, i, 288. " functional disturbances of the nervous system, i, 288. " gout, i, 288. " impetigo, i, 288. " lupus, i, 288. " measles, i, 388. " neuralgia, i, 288. " " from impaired nutrition, 1, 68. " pharyngitis, i, 288. " phthisis, i, 388. " psoriasis, i, 388. " scarlet fever, i, 388. " scleroderma, i, 288. " scrofula, i, 288. " strumous enlargement of the glands, i, 288. " vertigo, i, 288. Codol. See Rosinol. Coffee, i, 289. effects of, as a beverage, i, 389. in alcoholic poisoning, i, 390. " asthmatic paroxysms, i, 290. " circulatory enfeeblement, i, 391. " headache, i, 290. " malarial disease, i, 290. " migraine, i, 290. " neuralgia, i, 290. Cognac. See under Alcohol. Colchicine, i, 291. Colchicum, i, 391. in gout, i, 391. " recurrent boils, i, 391. poisoning, i, 291. Coley's treatment of sarcoma, ii, 313. Collodion, i, 292. as a protection to catarrhal or purulent ophthalmia, i, 394. bichloride-of-mercury, in nasvi, i, 392. " " " in venereal warts, i, 292. cantharidal, i, 293. carbolic acid. See under Styptic collo- dion. cocaine, in chilblains, i, 393. " " pruritus, i, 292. creosote, in carious teeth, i, 292. ferruginous, in erysipelas, i. 293. flexible, i, 293. " as a protection to the skin in small- pox, i, 294. GENERAL INDEX. 483 Collodion, flexible, in erysipelas, i, 294. flexible, for relief of entropion, i, 394. glyoerized, i, 293. ichthyol, in skin diseases, i, 393. in acute orchitis, i, 294. " congenital hydrocephalus, i, 294. " distichiasis, i, 394. . " Assures of the nipple, i, 294. " mammary congestion, i, 294. " meningocele, i, 394. " spina bifida, i, 294. " toothache, i, 136. " trichiasis, i, 294. " umbilical hernia, i, 394. iodine or iodized, i, 393. iodoform, in orchitis, i, 293. " ■' rheumatic inflammations, i, 393. " " venereal sores, i, 393. iodo-sulphural, i, 293. salicylated, in inflamed joints, i, 393. salicylic-acid, and cannabis indioa, i, 393. " " " zinc-chloride, i, 293. " and lactic-acid, i, 393. salol, i, 293. saturnine, in aneurysms, i, 394. " " condylomata, i, 294. " " contusions and wounds, i, 293. " " erysipelatous inflammations, i, 293. saturnine, in varicose veins, i, 394. sedative, in painful nerve tracts, i, 293. sinapis, i, 393. styptic, for ruptured perinaeum, i, 393. in fistula, i, 293. " " harelip, i, 393. " " scalp wounds, i, 293. " " superficial burns, i, 393. sulphurous, in skin diseases, i, 293. with croton oil, i, 292. Collyria, i, 394. in gonorrhoeal ophthalmia, i, 295. " ophthalmia neonatorum, i, 295. Coloeynth, i, 395. in cerebral disorders, i, 296. " dropsy, i, 396. " fluid effusions, i, 396. " occasional constipation, i, 396. poisoning by, i, 296. Cologne water, i, 297. Columbo. See Calumba. Condurango, i, 397. in cancer, i, 397. " syphilis, i, 397. " ulcer, i, 397. Condy's fluid, ii. 70. Confections, i, 397. Conine, Coniine. i, 297. in hydrophobia, i, 299. " pleurisy, i, 299. " pneumonia, i, 299. " strychnine poisoning, i, 299. " tetanus, i, 299. Conium, i, 397. as a motor depressant, i, 644. e£Eect of the local application of, i, 297. in acute laryngitis, i, 399. '• angina pectoris, i, 298. " asthma, i, 398. " blepharospasm, i, 298. " cancer, i, 398. Coniura, in chronic glandular enlargements, i, 398. in delirium tremens, i, 299. diabetes, i, 399. dysuria, i, 398. ■' epilepsy, i, 398. '' genito-urinarj'^ affections, i, 398. hiccough, i, 398. inhalation of, in asthma, i, 539. in irritative cough, i, 399. laryngismus stridulus, i, 398. mania, i, 299. melancholia, i, 399. muscular spasms, i, 299. neuralgia, i, 399. ovarian monorrhagia, i. 398. paralysis agitans, i, 298. spasm from irritative lesions of nerve trunks, i, 133. spasmodic torticollis, i, 398. spinal sclerosis, i, 398. tumours, i, 298. ulcerations, i, 298. whooping-cough, i, 398. Contrayerva, i, 899. Convallamarin, i, 399. Convallaria, i, 300. in aberration of the cardiac rhythm, i, 300. " aortic disease, i, 300. " cardiac incompetency resulting from over- strain, i, 300. " chronic phthisis, i, 300. " irregularities of the circulation, i, 300. " mitral regurgitation, i, 300. " stenosis, i, 300. " passive congestion, i, 300. physiological action of, i, 300. in pleuritic effusions, i, 300. " pneumonia, i, 300. " valvular disease, i, 300. Convallarin, i, 301. Convalvulin, i, 301. Copaiba, i, 301. in cirrhosis of the liver, i, 302. " gonorrhoea, i, 301. " psoriasis, i, 303. " scabies, ii, 432. Copper, i, 303. acetate in aphthae, i, 303. " " conjunctivitis, i, 303. " " gonorrhoea, i, 303. aluminated, in granular conjunctivitis, i, 308. ammoniated, in chorea, i, 303. " " epilepsy, i, 303. " "■ neuralgia, i, 303. arsenite as an enema in cholera, i, 304. " " " " membranous enteri- tis, i, 304. arsenite as a spray, for asthma, i, 303. " " " in acute nasal catarrh, i, 803. arsenite in aphthse, i, 303. " chlorosis, i, 303. " " cholera, i, 303, 305. " " chronic catarrh, i, 303. " cystitis, i, 304. " diarrhoea, i, 303. " " dysentery, i, 303. " " enteritis, i. 305. " " enterocolitis, i, 303. 484 GENERAL INDEX. Copper arsenite in functional anaemia, i, 303. arsenite in gastritis, i, 305. " " glanders, i, 304. " " inflammations of the mouth, i, 304. arsenite in inflammatory derangements of the mucous membranes, i, 304. arsenite in intestinal affections, i, 305. " iritis, i, 305. " '• keratitis, i, 305. '■ " otitis externa diffusa, i, 304. " " phlyctaenuliB, i, 305. " " proctitis, i, 304. " " rhinitis, i, 304. arsenite solution in amygdalitis, i, 304. " gleet, i, 304. " glossitis, i, 304. " " ■' gonorrhoea, i, 304. " " " chronic gonorrhoea, i, 304. " " " hay fever, i, 304. " " " influenza, i, 304. " - " intertrigo, i, 304. " " " leucorrhoea, i. 304. " " " oedema of the glottis, i, 304. arsenite solution in phthisis, i, 304. " " " prolapsus ani, i, 304. " " " puerperal fever, i, 304. " " " scurvy, i, 304. " " " sore nipples, i, 804. " " " spongy gums, i, 304. " stomatitis, i, 304. " " " the form of a spray in incipient tuberculous affections, i, 304. arsenite solution in tympanites, i, 304. " " " yellow fever, i, 304. carbonate in phosphorus poisoning, i, 306. in ganglionic abscesses, i, 303. " tuberculous arthritis, i, 303. oleate for tinea trichophytina, i, 305. in ringworm, i, 117. " warts, corns, etc., i, 305. ointment in indolent ulcers, i, 305. in ringworm, i, 305. sulphate of, as a germicide, i, 448. in acne rosacea, i, 306. Coriander, i, 306. Corn silk, i, 306. in albuminuria, i, 306. " chronic nephritis, i, 306. " in cystitis, i, 300. " enfeebled heart, i, 306. " gonorrhoea, i, 306. " hfematuria, i, 306. " lithiasis, i, 306. " oedema, i, 306. " prostatitis, i, 306. " pyelitis, i, 306. " renal colic, i, 306. " " congestion, i, 306. " suppression of urine, i, 806. " vesical irritability, i, 306, smut. See Ergot of maize. Cornu cervi. See under Ammonium carbon ATE. Cornus, i, 307. in malarial disease, i, 118, 307. Cornutine, i, 307. in haemorrhage, i, 307. " menorrhagia, i, 307. Cornutine, in metrorrhagia, i, 307. in spermatorrhoea, i, 307. " uterine inertia, i, 307. Coronilla, i, 307. Coronillin, i, 307. Correctives, Corrigents, i, 307. Corrosive sublimate. See IVEebcurt. Coryl, i, 307. Cosmetics, i, 307. Cosmoline. See Vaseline. Cotarnine hydrochloride. See Stypticin. Coto bark, i, 309. in atrophic pharyngeal catarrh, i, 309. " diarrhoea, i, 309. Cotoin. See under Coio bark. Cotton, i, 310. absorbent, for burns, scalds, and blisters, i, 310. iodized, in ulceration of the cervix uteri, i, 310. root, i, 311. " poisoning with, ii, 432. Cotton-seed oil, i, 311. styptic, in superficial haemorrhage, i, 310. Coumarin, i, 311. Counter-irritants, i, 311. in encephalitis, i, 318. " gastric colic, i, 313. " pleuritic effusion, i, 312. where to apply, i, 812. Counter-poisons. See Antagonists and anti- dotes. Cowhage. See Mucdna. Cream, i, 636. See under Milk. as an article of diet, i, 636. in constipation of young children, i, 222. Creasote. See Creosote. Creolin, i, 312. as a germicide, i, 448. in chlorosis, i, 313, " cholera, i, 313, " infantile diarrhoea, i, 313. " leprosy, i, 313, " scrofula, i, 313. Creosal, ii, 433, Creosol, ii, 433. in catarrh of the respiratory organs, ii, 433. Creosotal, i, 313. Creosote, i, 313. administration of, in different -jvays, i, 315. and boric-acid injections in gonorrhoea, i, 314. applications in leucorrhoea, i, 314. in burns, with suppuration, i, 314. " chilblains, i, 314. " cholera infantum, i, 314. " " morbus, i, 314. " chronic eczema, i, 314. " diabetes, i, 314. " dysentery, i, 314. " enlarged" bronchial glands, ii, 433. " erysipelas, i, 314, " fistula, i, 314. " foetid otorrhcea, i, 314. " gangrenous surfaces, i, 314. " gastric fermentation, i, 314, inhalation in abscess and gangrene of the lung, i, 314, inhalation in bronchiectasis, i, 314, " chronic bronchitis, i, 314. " laryngitis, i, 814. GENERAL INDEX. 485 Creosote inhalations in pulmonary tuberculosis, i, 314. in intestinal dyspepsia, i, 314. " laryngeal tuberculosis, i, 316. " lienterie diarrhoea, i, 314. " naevi, as a caustic, i, 314. " psoriasis, i, 314. " puerperal metritis, i, 314. " seasicliness, i, 314. " sloughing ulcers, i, 314. " suppurating surfaces, i, 314. " toothache, i, 136, 314. " tuberculous laryngitis, by injections, i, 316. " typhoid fever, i, 314. " ulcers of the larynx, i, 314. " vomiting, i, 99, 314. of hysteria, i, 314. " " " pregnancy, i, 314. " warts, as a caustic, i, 314. physiological action of, i, 313. water as a hasmostatic in bleeding from leech bites, i, 314. water as a haemostatic to uterine hEemor- rhage, i, 314. Creosote-calcium chlorhydrophosphate, ii, 433. in scrofula, ii, 433. " tuberculosis, ii, 433. Cre.salol, Cresol salicylate. See under Salictl- 10 ACID AND THE SALICYLATES (Supplement). Cresol, Cresylic acid, Cresylol, i, 318. Cresol as a germicide for the bacilli of tuber- culosis, i, 448. Creta. See Chalk. Cristalline, i, 318. Crocus. See Saffron. Croton chloral as a hypnotic, i, 508. in neuralgia, for immediate relief, i, 69. Croton-ohloral hydrate. See Butyl-chloral HYDRATE and under Hypnotics. Croton oil, i, 318. by inoculation, for nsevi, i, 318. in apoplexy, for rapid evacuation of the bowels, i,"318. " chronic bronchitis, i, 318. " " inflammation of joints, i, 318. " " headache, by application to the nape of the neck, i, 318. " dropsy, i, 318. " dysmenorrhoea, by applications to the ab- domen, i, 318. " hydrocephalus, i, 318. " hysteria, by application to the spine, i, 318. " obstinate constipation, i, 318. " oophoralgia, by application to the abdo- men, i, 318. " paralyses of functional origin, by applica- tion to the spine, i, 318. " phtiiisis, i, 318. " pleurisy, i, 318. " puerperal convulsions, i, 318. " retention of urine, i, 318. " in sciatica, i, 318. " tinea tonsurans, i, 318. " tuberculous meningitis, by application to the head, i, 318. poisoning by, i, 318. Cryostase, ii, 433. Cryptopine, i, 318. Cu'beb, i, 318. Cubeb cigarettes in acute coryza, i, 430. cigarettes in acute nasal catarrh, i, 319. " " bronchial catarrh, i, 430. " " subacute bronchitis, i, 430. in affections of the bladder, i, 319. " " urethra, i, 319. " atonic dyspepsia, i, 319. " chronic iDronchitis, i, 319. " ■' catarrh of the rectum, i, 319. " " cystitis, i, 319. " cystorrhoea, i, 319. " diphtheria, i, 319. " functional irritability of the bladder, i, 319. " gonorrhoea, i, 319. " influenza, i, 319. " leucorrhcea, i, 319. " prostatorrhcea, i, 319. " pseudo-membranous enteritis, i, 319. troches, in chronic irritability of the air- passages, fauces, and pharynx, i, 319. Cubebin, i, 318. Cucumber ointment, i, 319. for cutaneous irritation, i, 319. Cucurbita. See Pepo. Cupping, i', 319. for bites by rabid or venomous animals, i, 320. dry, i, 319. " in acute inflammation of the kidneys, i, 320. " in congestion of the kidneys, i, 320. " " dyspnoea due to cardiac disease, i, 320. " in the pain and cough of acute pulmo- nary and pleuritic diseases, i, 320. in intracranial congestion and inflamma- tions, i, 320. wet, i, 320. Cupric acetate in aphthse, i, 303. in conjunctivitis, i, 303. ■' gonorrhoea, i, 303. oxide in gingivitis, i, 305. in chronic induration of the lymph glands, i, 305. " taenia, i, 305. phosphate in incipient tuberculosis, i, 305. sulphate as an emetic in pseudo-membranous laryngitis, i, 306. in acne rosacea, i, 306. " diarrhoea and dysentery, i, 306. " ecthyma, i. 306. " epilepsy, i, 306. " erythema, i, 306. " gangrenous pharyngitis, i, 306. " gleet, i, 306. " gonorrhoea, i, 306. " haemorrhage, i, 306. " ichthyosis, i, 307. " indolent ulcers, i, 306. " intermittent fever, i, 306. injections in buboes, i, 306. " " hydrocele, i, 306. " malignant sore throat, i, 306. " mercurial stomatitis, i, 306. " phosphorus poisoning, i, 110; ii, 76. " phthisis, i, 306. " psoriasis, i, 306. " scrofula, i, 306. " tinea tarsi, i, 306. 486 GENERAL INDEX. Cupric sulphate in trachoma, ii, 314. in typhoid fever, i, 306. " ulcerative colpitis, i, 306. " " proctitis, i, 306. " venereal ulcers, i, 306. Cuprohsemol, i, 320. Cuprum. See Copper. Curare, i, 320. as a motor depressant, i, 644 in chorea, i, 331. '• epilepsy, i, 331. " grave convulsive conditions, i, 331. " hydrophobia, i, 331. " strychnine poisoning, i, 321. " tetanus, i, 321. Curarine, i, 320. Curcuma, i, 321. in paludal fever, i, 333. Cure, bichloride-of-gold, for inebriety, i, 454. buttermilk, for diabetes, i, 333. " " gastric disorders, i, 333, " " nephritis, i, 333. grape, i, 333, 455. whey, for acute febrile disease, i, 333. " " irritability of the stomach, i, 383. Currant shrub, i, 352. Cusparia, i, 323. in diarrhoea, i, 333. " dysentery, i, 333. Cusso, i, 332. for tapeworms, i, 333. Cutal. See Aluminum boeotannico-tartrate (Supplement). Cutin, 1, 322. Cyanides. See under Cyanogen and cf. Hy- drocyanic ACID. Cyanogen, i, 333. Cyanurets. See under Cyanogen. Cydonium, i, 333. in dysentery, i, 333. " poisoned wounds, i, 323. " skin diseases, i, 333. Cyperus articulatus, i, 323. Cypripedium, i, 323. Cytisus laburnum, i, 323. in migraine, i, 333. Damiana, i, 333. in cerebral exhaustion, i, 334. " functional impotence, i, 334. " general atony of the nervous system, i, 334. " migraine, i, 324. " nervous dyspepsia, i, 334. " neuralgia, i, 334. Datura. See Stramonium. Decoctions, i, 324. Delphinine in earache, ii, 231. (topically) in neuralgia, ii, 321. " toothache, ii, 321. Delphinium. See Staphisagria. Demulcents, i, 334. Dentifrices, i, 334. Deodorizers, i. 336. Depilatories, i, 337. Depressants. See Cardiac stimulants, Tonics, and Depressants. Derivatives, i, 337. Dermatin, ii, 4.33. Dermatol, i, 339. Dermatol, in burns, i, 339. " eczema, i, 329. " excoriations, i, 329. " fermentative dyspepsia, i, 839. " suppurating surfaces, i, 339. Desiccants, i, 329. Desoxyalizarin. See Anthearobin. Detergents, i, 329. De Valangin's solution, i, 144. Dewees's emraenagogue, i, 875. Dextrose. See under Sugar (vol. ii, page 235). Diabetin.' See Levulose. Diacetanilide, ii, 433. Diaoetyltannin. See Tanniqen. Diachylon, i, 329. Dialyzed preparations, i, 330. Diaphoretics, i, 331. Diaphtherin, i, 333. in otorrhcea, i, 333. " oziEna, i, 883. " ulcers, i, 333. " wounds, i, 333. Diaphthol, i, 833. in gastro-intestinal affections accompanied by fermentation, i, 883. " urinary affections, i, 333. Diastase, i, 333. Dibromethane. See Ethylene bromide. Dibromogallic acid. See Gallobromol. Diohloracetic acid, i, 338. Dieleetrolysis. See under Electricity and cf. Coca and Cocaine. Diet, dry, in asthma, i, 96. in diabetes, i, 333. " dilatation of the stomach, i, 333. •' dropsy, i, 383. meat, i, 333. skim-milk, i, 833. Dietetic treatment, i, 333. in acute diarrhoea, i, 336. " cancer of the stomach, i, 336. " chronic diarrhoea, i, 336. " constipation, i, 336. " continued fever, i, 834. " diabetes, i, 337. " fever, i, 333, 334. " functional dyspepsia, i, 885. " gastritis, acute and subacute, i, 835. " lithiemia and gout, i, 338. " nephritis, i, 388. " obesity, i, 339. " phthisis, i. 838. "rickets, i, 338. " scurvy, i, 337. "summer diarrhoea of children, i, 336. " typhoid fever, i, 384. " ulcer of the stomach, i, 335. Diethylacetal, i, 1. Diethylenediamine. See Pipeeazine. Diethylsulphonediethylmethane. See Tetro- NAL. Diethylsulphonedimethylmethane. See Sul- PHONAL. Diethylsulphonemethylethylmethane. See Trional. Digitalein, Digitalin. See under Digitalis. Digitalis, i, 340. in aconite poisoning, i, 7, 343. " asthma, i, 343. " bronchial congestions, i, 843. GENERAL INDEX. 487 Digitalis, in chronic bronchitis (as a diuretic), ii, 228. " congestion of the Itidneys, i, 342. " delirium tremens, i, 342. " dilated heart, i, 341. " diseases of the mitral and tricuspid valves of the heart, i, 341. " dyspnoea, i, 343. " epistaxis, i, 342. " erysipelas, i, 343. " exophthalmic goitre, i, 342. " hsemorrhages, i, 342. " hsmorrhagio diathesis, i, 343. " irritable heart, i, 343. " local inflammations, i, 342. " menorrhagia, i, 342. " migraine, i, 342. " mitral insufficiency, i, 341. " " stenosis, i, 341. " muscarine poisoning, i, 343. " palpitation of the heart, i, 343. " pericarditis, i, 343. " pneumonia, i, 342. " post-partum haemorrhage, i, 343. " renal dropsy, i, 342. " rheumatic fever, i, 342. " scarlet fever (early stages), i, 342. " spermatorrhoea, i, 342. " stenosis of the tricuspid oriflce, i, 341. " typhoid fever, i, 342. " venous congestion of mitral and tricuspid disease (as a diuretic), ii. 228. " venous en'gorgement, i, 345. " weak cardiac action, i, 345. Digitin i, 340. Digitonin, Digitoxin. See under Digitalis. Diiodoform, i, 343. for boils, burns, carbuncles, wounds, i, 343. " the relief of pelvic pains, i, 343. in neuropathic hysteralgia, i, 343. Diiodosalicylic acid, i, 343. in articular rheumatism, i, 343. Diiodothiophene, i, 343. Diisobutylorthocresol iodide. See Burophene. Dill, i, 344. in flatulent colic of infants, i, 344. Diluents, i, 344. Diraethylacetal. See under Acetal. Dimethylethylcarbinol. See Amylenb hy- drate. Dimethylketone. See Acetone. Dimethyloxyquinieine. See Antipyrine. Dimethylpiperazine tartrate. See Lycetol. Dioleylleoithin. See Phosphoalbumin. Diosma. See Bdchu. Dioxyanthranol. See Anthbarobin. Diph'therin. See Oxyquinaseptol. Discutients. See Sorbefacients. Disinfectants. See Antiseptics. Disinfection of the sick-room, i, 443. Dispermine. See Pipeeazinb. Dita bark. See Alstonia. in malaria, i, 118. Dithiosalicylic acid, i, 344. in acute articular rheumatism, i, 344. Dithymol iodide. See Aristol. triiodide. See Annidalin. Diuretics, i. 344. in cystitis, 1, 346. Diuretics, in dropsy due to cardiac or pul- monary disease, i, 346. " urethritis, i, 346. stimulant, ii, 228. Diuretin. See Sodio-theobromine salicyl- ate. Djamboe, i, 346. in acute gastro-enteritis, i, 346. •' dyspepsia, i, 346. " infantile diarrhoea, i, 346. DobelFs solution, i, 210. Dolichos. See Mucuna. Donovan's solution, i, 146, 627. Dorstenia. See Contbayerva. Doses, i, 346. Dr. Clarke's method for determining, ac- cording to weight, i, 347. Dr. Cowling's rules for determining, i, 347. Dr. Young's rule for determining, i, 347. effect of habit on, i, 347. method of administration of, i, 348. time for administration of, i, 348. Douche, ascending, i, 349. aural, i, 349. bell, i, 349. cold effects of, i, 348. in chlorosis, i, 491. " chronic gastric disease, i, 491. " gout, i, 491. " rheumatism, i, 491. " simple aniemia, i, 491. columnar, i, 349. compressed-air, i, 349. concentric, i, 349. descending, i, 348. gas, i, 349. horizontal, i, 349. lumbar, i, 349. nasal, i, 349. ocular, i, 349. rain, i, 349. ring, i, 349. sheet, i, 349. splenic, i, 349. steam, i, 349. vapour, i, 349. warm, in diseases of the spinal cord, i, 491. Douches, i, 348. Drastics, i, 349. Draughts, i, 349. Dressings, i, 129. Drinks, i, 350. effects of cold or iced, i, 350. Drops, i, 352. Duboisine, i, 352. as a mydriatic, i, 649. in acute mania, i, 353. " cardiac failure, i, 353. " insanity, i, 353. " morphine poisoning, i, 353. " night sweats of phthisis, i, 358. " paralysis agitans, i, 353. " puerperal mania, i, 353. " respiratory neuroses, i, 353. Dulcamara, i, 353. in bronchitis, i, 353. " chronic catarrh, i, 353. " dropsy, i, 353. 488 GENERAL INDEX. Dulcamara, in gout, i, 353. " jaundioo, i, 353. " lepra, i, 353. " psoriasis, i, 353. " rheumatism, i, 353. Buloin, i, 353. in diabetes, i, 353. Ductal, ii, 433. Earths, i, 353. Ecballium. See Elaterium. Ecbolics. See Abortifacients and Oxytocics. Eeboline. See under Eegot. Eoooprotics, i, 354. Edulcorants. See Coerigents. Effervescing preparations, i, 355. Egg broth, i, 356. flip, in asthenic conditions, i, 355. Eggs, i, 355. and brandy in anaemia, i, 355. " " " cardiac feebleness, i, 355. and coffee in malniitrition, i, 354. " " " nervous exhaustion, i, 355. and liraewater for dandruff, i, 356. white of, in poisoning with corrosive sub- limate, i, 355. yolk of, and ginger, for dyspepsia, i, 355. , Elseomyenchysis, i, 356. Elaeosacchara, i, 857. Elastic compression of the chest in asthma, i, 92. Elastica. See Rubber. Elaterin, i, 357. in dropsy, i, 357. Elaterium, i, 357. in ascites, i, 358. " cerebral affections (as a revulsive and de- pleting agent), i, 358. " congestion (as a revulsive and depleting agent), i, 358. " dropsy, i, 358. " pericarditis, i, 358. " pleurisy, i, 358. " uraemia, i, 358. Electrical stimulation in asthma, i, 93. Electricity, i, 358. alternating sinusoidal current, i, 359. as an emmenagogue, i, 375. " oxytocic, ii, 55. cataphoresis, i, 361. condensed list of nervous disorders and the modes of application of, where it is indi- cated, i, 366. destruction of aneurysms by, i, 361. frictional, i, 359. (as a stimulant) in apncea, ii, 326. " " " asphyxia, ii, 226. in blepharospasm, 365. " clonic spasm, i, 365. " hypochondriasis, i, 366. " narcotism (as a stimulant), ii, 226. " neuralgia from impaired nutrition, i, 68. " neurasthenia, i, 366. " orthopnosa (as a stimulant), ii, 226. " paralysis, i, 365. " railway brain, i, 366. " " spine, i, 366. " the removal of superfluous hairs, i, 361. " tic convulsif, i, 365. " tonic spasm, i, 365. " torticollis, i, 365. Electricity, in writer's cramp, i, 365. methods of employing, i, 365. physiological effects of, i, 362. production of heat and light by, i, 361. refreshing effects of, i, 368. resistance of the human body to, i, 361. _ resuscitation of persons apparently killed by, i, 369. static, i, 359. testing the hearing by, i, 363. " sight by, i, 363. " " smell by, i, 363. " " taste by, i, 363. tumours treated by, i, 361. vaso-motor effects of, i, 362. Electrolysis, i, 361. Electro-magnet, i, 360. Electrozone, i, 369. Electuaries, i, 369. Elerai, i, 369. in indolent ulcers (externally), i, 369. Elixirs, i, 369. EUer's drops, i, 58. Elm. See Umius. Embelia ribes, i, 370. in tapeworm, i, 370. Embelic acid. See under Embelia kibes. Embrocations. See Liniments. Emetics, i, 370. action of, i, 370. centric, i, 371.. direct, in narcotic poisoning, 371. in bronchitis of children, 373. peripheral, i, 371. systemic, i, 371. Emetine. See Ipecacuanha. Emeto-oathartics, i, 374. Emmenagogue, Dewees's, i, 875. Goodell's, i, 375. Emmenagogues, i, 374. Emol, i, 876. for the removal of horny growths, i, 376. in eczema of the palm and sole, i, 376. " itching of urticaria, i, 376. keratosis of the soles and palms, i, 376. Emollients, i, 376. Emplastra. See Plasters. Emulsions, i, 376. Endermic medication, i, 377. Enemata, i, 377. Ephedra, i, 385. antisyphilitica in gonorrhoea, i, 385. in acute articular rheumatism, i, 385. " " muscular rheumatism, i, 385. " chronic articular rheumatism, i, 385. " " muscular rheumatism, i, 385. " constipation, i, 385. " diarrhoea, i, 385. " gout, i, 385. •' rheumatic osteomyelitis, i, 385. " sciatica, i, 385. trifurcata (as a styptic) in gonorrhoea, i, 385. (. ti (( ' - - — Ephedrine, i, 385. homatropine. i, 386. Epidermin, i, 386. Epilation in favus of the scalp, i, 117. Epispastics. See Blisters. Epithems, i, 886. Ergot, i, 386. GENERAL INDEX. 489 Ergot, and sodium phosphate in algidity of fevers (first stages), i, 389. and sodium phosphate in cholera (first stage), i, 389. and sodium phosphate in neuroses accom- panied by mental depression, i, 389. and sodium phosphate in senile exhaustion, i, 389. and sodium phosphate in tardy convales- cence, i, 389. and sodium phosphate in tuberculosis, i, 389. as an anthidrotic, i. 103. " oxytocic, i, 387. for after-pains, i, 388. in congestion of the spinal cord, i, 388. " deficient tone of the genital organs, i, 388. " dysentery, i, 388. " enlarged prostate, i, 388. " enuresis, i, 388. " epilepsy (to increase the action of bro- mides), 1, 388. " epistaxis, i, 388. " galaotorrhcea, i, 388. " hsematuria, i, 388. " hsEmorrhaLje, i, 388. " hiemorrhoids, i, 388. " impotence (hypodermically), i, 388. " metrostaxis, 1, 388. " night sweats, i, 388. " pulmonary haemorrhage, i, 388. " spermatorrhoea, i, 388. " uterine haemorrhage, i, 388. " varicose veins, i, 388. Ergotin, Ergotine, Ergotinine, i, 389. Ergotinura, i, 390. Ergot of maize, i, 389. in primary uterine atony, i, 389. Ergotole, i, 389. in erysipelas (locally), i, 389. " hyperaemia (locally), i, 389. " phlegmonous inflammation (locally), i,389, Erigeron, i, 390. in dropsy, i, 390. oil of, in diarrhoea, i. 390. " " dysentery, i, 390. " " epistaxis, i, 390. " " gonorrhoea, i, 390. " " haemoptysis, i, 390. " " intestinal haemorrhage, i, 390. " " menorrhagia, i, 390. " " metrorrhagia, 1, 390. " " uterine haemorrhage, i, 390. Eriodictyon. See Yeeba santa. Erodium cicutarium, ii, 433. as an astringent and diuretic, ii, 433. in uterine haemorrhage, ii, 433. Errhines. See Steknutatories. Erysipelatous inoculation. See under Toxines. Erythrophloeine, i, 390. (hypodermically) in locomotor ataxia), i, 390. " " sciatica, i, 390. " " spinal irritation, i, 390. Erythroxylon. See Coca. Eseridine, i, 391. Eserine, i, 391. in accommodative asthenopia, i, 392. " cataract, i. 392. (internal administration) in chorea, i, 393. in episcleritis, i, 392. " glaucoma, i, 391. Eserine, in gonorrhoea! ophthalmia, i, 393. in mydriasis, i, 392. " neuralgia of the eyeball, i, 393. (internal administration) in night-sweats of phthisis, i. 393. in ophthalmia neonatorum, i, 393. " paralytic mydriasis following diphtheria, i, 393. " phlyctaenular keratitis, i, 392. " photophobia, i, 392. " ulcerative keratitis, i, 392. physiological action of, i, 391. with bromides, in strychnine poisoning, i, 392. Essences, i, 393. Ether, i, 393. and alchohol, as a heart stimulant, ii, 227. nitrous oxide, as a preliminary measure be- fore inhaling, i, 3i34. and oxygen, as an angesthetic, ii, 53. as an antemetic, i, 99. as a sedative, i, 538. " solvent, ii, 312. camphorated, in cerebral affections, i. 304. " " peritonitis, i, 204. cardiac failure during anjesthesia by, i, 396. cone, i, 394. eflfect of, on the respiration, i, 395. for puerperal eclampsia, i, 397. (internally) in abdominal colic, i, 397. in A. C. E. mixture, i, 1. (by hypodermic injection) in aconite poison- ing, i, 7. (internally) in ascarides, i, 397. (hypodermically) in cardiac failure, i, 397: "ii, 227. (subcutaneouslv) in chloroform anaesthesia, ii, 227. (subcutaneouslv) in collapse, i, 397. in croup, i, 528. (subcutaneously) in infantile convulsions, i, 397. (subcutaneously) in intense depression of acute infectious diseases, i, 397. (subcutaneously) in narcosis, ii, 226. in nausea, i, 99. (internally) in nervous headache, i, 397. in pathological work, i, 397. " severe pains of labour i, 397. (internally) in spasmodic vomiting of preg- nancy, i, 397. (internally) in tapeworm, i, 397. manner of administering, i, 395. position of patient during anaesthesia by, i, 394. preparation of patient for anaesthesia by, i, 394. spray in earache i, 397. " " nervous headache, i, 397. " " neuralgic affections, i, 397. " " toothache, i. 397. sulphuric, in neuralgia, i, 69. treatment of shock (3uring anassthesia, i, 396. versus chloroform, i, 397. vomiting during anaesthesia by, i, 396. Ethoxycaffeine, i. 398. in migraine, i, 398. Ethylate of sodium in ringworm, i, 117. bromide, i, 398. (internally) in neuralgia, i, 399. Ethyl carbamate. See Urethane. 490 GENERAL INDEX. Ethyl chloride, i, 399, as a dental ansesthetic, ii, 434. (spray) as an analgetic, ii, 434. " in asthma, ii, 434. " " conjunctivitis and iritis, ii, 434. " " epididymitis, ii, 434. " " epistaxis, ii, 434. " " hsemorrhage, ii, 434. " " headache of influenza, ii, 434. " " hiccough, ii, 434. in meningitis, ii, 434. " migraine, ii, 434. " pleurodynia, ii, 434. " pruritus, ii, 434. " shingles (for relief of pain), ii, 434. " spasmodic dyspnoea, ii, 434. " in sunstroke, ii. 434. iodide, i, 399. " in bronchitis, i, 399. " inhalations in hay asthma, i, 538. " " " spasmodic dyspnoea, i, 528. iodide in syphilitic disease of the air-pas- sages, i, 528. Ethylene bromide, i, 399. in epilepsy, i, 399. periodide. See DiroDOFORM. Ethylphenacetine. See under Phenacetine. Ethylurethane. See Ueethane. Bueaine, ii, 434. as an anaesthetic, ii, 435. for infiltration ansesthesia, ii, 435. for subcutaneous ansesthesia for the opening of abscesses or removal of tumours or growths, ii, 435. Eucalypteol, i, 399, 400. in acute bronchitis, i, 401. " chronic bronchitis, i, 401. Euoalyptol. See under Eucalyptus. in acute and subacute inflammations of the larynx, i, 529. " cholera, i, 400. " enteritis, i, 400. " gastric catarrh, i, 400. inhalation in amygdalitis, i, 539. in chronic bronchitis, i, 539. " diphtheria, i, 529. " whooping-cough, i, 529. " tuberculosis, i, 539. " intestinal catarrh, i, 400. " typhoid fever, i, 400. Eucalyptus, i, 399. and terebene, oils of, in headache of malarial disease or congestion, i, 400. cigarettes in asthma, i, 400. in malarial fevers, i, 118. oil of, in acute bronchitis, i, 400. in acute catarrh, i, 400. " chronic bronchitis, i, 400. " enteritis, i, 400. " gastric catarrh, i, 400. " headache, i, 400. " intestinal catarih, i, 400. (internally) in scarlet fever, i, 400, in strychnine poisoning, ii, 435, " typhoid fever, i, 400. " ulcers, i, 400. " wounds, i, 400. Eucasin, ii, 435. in anaemia, ii, 436. Eucasin, in gout, ii, 436. in laryngeal tuberculosis, ii, 436. " pararaet' itis, ii, 436. " perimetritis, ii, 436. " pulmonary tuberculosis, ii, 436. " typhlitis, ii, 436. " uric-acid diathesis, ii, 436. Eudoxine, ii. 436. as an intestinal antiseptic, ii, 436. Buquinine, ii, 436. Eugenic acid, i, 401. Eugenol, i, 373, 401. acetamide, i, 401. iodized, i, 401. Eulachon oil, i, 401. Eulyptol, i, 401. Euonymin in torpor of the liver, i, 401. Euonymus, i, 401. Eupatorium, i, 401. Euphorbia, i, 401. chilensis, i, 401. heterodoxa. See Alvbloz. hypericifolia, i, 401. " in diarrhcea, i, 401. '• " dysentery, i, 401. " " leucorrhoea, i, 401. " " menorrhagia, i, 401. maculata. See Euphorbia hypericifolia. ocellata, i, 401. " in bites of poisonous snakes, i, 401. pilulifera, i, 401. " in asthma, i, 401. '■■ " chronic bronchitis, i, 401. " " dyspnoea, i, 401. prostata. See Euphorbia ocellata. Euphorbium, i, 401. in indolent ulcers, i, 401. " unhealthy suppurating surfaces, i, 401. Euphorin, i, 401. in chronic articular rheumatism, i, 402. " fevers, i, 402. " migraine, i, 403. " muscular rheumatism, i, 402. " rheumatic fever, i, 402. " skin diseases of parasitic origin, i, 402. " surgical fever, i, 402. (as a local disinfectant) in aphthous stoma- titis, i, 402. (as a local disinfectant) in burns, i, 403. " herpes, i, 402. in sciatica, i, 403. (by insufflation) in uterine endotrachelitis, i, 402. in venereal ulcers, i, 402. (in powder or solution) in ulceration of the cervix uteri, i, 402. Europhene (as a dressing) for burns, i, 402. (by insufflation) in catarrhal conditions, i, 403. in epistaxis, 1, 403. (by insufflation) in ozaena, i, 403. in syphilitic ulceration, i, 403. in powder or ointment in cliancre, i, 402. " chancroid, i, 402. " " " " " condvloma. i, 402. " " " " " lupus, i, 403. " " " " scrofuloderma, i, 402. " powder or ointment in ulcerations, i, 402. Eurythrol. See Splenic extract. GENERAL INDEX. 491 Evaeuants, i, 402. Exalgine, i, 403. as an anodyne, i, 68. in angina, i, 403. " gouty arthritis, i, 403. " headache of melancholia, 1, 403. " hemicrania, i, 403. " insomnia of melancholia, i, 403. " lumbago, i, 403. " nervous headache, i, 403. " neuralgia, i, 69, 403. " rheumatism, i, 403. " sciatica, i, 403. " simple chorea, i, 403. " the lightning pains of tabes, i, 403. Excitants, i, 403. Exercise, i, 404; ii, 436. effect and importance of, i, 408. effects of, on the muscles, i, 407. for old people, i, 410. in flat-foot, i, 416. (vocal and respiratory) in laryngeal disor- ders, i, 417. . in lateral curvature of the spine, i, 416. " the development and culture of the mind, i, 414. " the treatment of cardiac and circulatory affections, i, 415. Ling's system of, i, 413. proper conditions under which, should be taken, i, 409. Swedish system of, i, 418. systemic passive respiratory, in Basedow's disease, i, 415. therapeutics of, i, 411. treatment of the insane by, i, 413. Exodyne, i, 4:|.7. Expectant treatment, i, 417. Expectorants, i, 417. stimulating, ii, 227. Extracts, i, 419. Faba calabarica. See Physostigma. Pabiana imbricata. See PioHi. Paradaism, i, 359. Paradizatiou. See under Electeicity. Parfara. See Tussilago. Pats, i, 419. in poisoning with carbolic acid, i, 109. " " " corrosive acids, i, 109. " " " metallic oxides, i, 109. " " by metallic salts, i_, i09. (by inunction) in scarlet fever, i, 430. Pebrifuges, i, 421. Febriline, i, 421. Feeding, forced. See under Alimentation and Gavage. Feeding. See Alimentation, Dietetic treat- ment. Foods, and Milk. Pel bovinum. See Ox gall. Fennel. See Fcenioulum. Fern, male. See Aspidium. Ferratin, i, 421. Perripyrine. See Fbreopyrine. Perrohjemol, i, 422. Perropyrine, i, 422. (by injection) in blennorrhagia, i, 422. in nasal hEemorrhage, i, 422. Ferruginous preparations. See Iron. Ferrum. See Iron. 75 Picus, Pigs, i, 422. Pilix mas. See Aspidium. Filmogen, ii, 436. Fir-wood oil in rheumatism, ii, 87. inhalation in chronic laryngitis, ii, 88. Fir wool, i, 422. Flaoourtia, i, 423. in diarrhoea, i, 422. " general debility, i, 422. " hoarseness, i, 423. " nausea, i, 422. Flag, blue. See Iris. sweet. See Calamus. Flaxseed. See Linseed. Flaxseed tea, i, 351. in dysentery, i, 351. " irritable conditions of the genito-urinary tract, i, 351. Flour, i, 423. baked, as a food in infantile diarrhoea, i, 423. boiled, in gastro-intestinal indigestion, i, 423. wheat, in burns, i, 423. " " erythematous eruptions, i, 433. " " pruritic eruptions, i, 433. Fluorescein, i, 433. Pluoral, i, 423. Poeniculum, i, 434. Fomentations, i, 434. hot, in colic, i, 469. Poods, i, 424. animal, i, 426. preservation of, i, 427. vegetable, i, 425. Forced feeding, i, 43. Formaldehyde, i, 427 ; ii, 436. as a disinfectant, ii, 436. in acute conjunctival diseases, i, 428. " blennorrhagic cystitis, i, 428. " " urethritis, i, 428. " catarrhal affections of the vagina and cer- vix uteri, i, 428. " gonorrhoeal affections, i, 428. " hay fever, ii, 436., " pruritus vulvae, ii, 436. " purulent cystitis, i, 428. " tuberculous cystitis, i, 428. " whooping-cough, ii, 436. Formalin. See Formaldehyde. Formanilide, i, 429. Pormalose. See Formaldehyde. Formic-acid compounds, i, 439. (in powder) for ulcerated surfaces, i, 429. in laryngeal carcinoma, i, 439. (in spray) in laryngeal tuberculosis, i, 429. Formic aldeliyde. Formal. See Formalde- hyde. Pormogelatin, ii,'437. Pormyl chloride. See Chloroform. tribromide. See Bromoform. triiodide. See Iodoform. Foxglove. See Digitalis. Franciscea. See Manaca. Prangula, i, 429. in constipation, i, 429. Fraxinin. See under Manna. Friction. See Massage. Prigotherapy, i, 439. in dyspepsia, i, 439. Fruit syrups, ii, 253. 492 aENBRAL INDEX. Fuller's earth. See under Earths.^ in undue secretions of the siiin, i, 354. Fumigation, i, 430. calomel, in cramp and diphtheria, i, 625. " " in syphilis, i, 634. mercurial, in croup, i, 430. " " laryngeal diphtheria, i, 430. " •' syphilis, i, 430. stramonium, in spasmodic asthma, i, 430. sulphur, in chronic skin diseases, i, 430. " " muscular rheumatism, i, 430. " " neuralgia, i, 430. " " sciatica, i, 430. Gaduol. See Mobrhuol. Galaotagogues, i, 430. Galactose. See under Sugar (vol. ii, page 235), Galactotherapy. See under Serum treat- ment (vol. ii, page 187). Galangal, i, 431. Galazyme, i, 431. Galbanum, i, 481. (internally) in amenorrhoea, i, 432. " " chronic bronchitis, i, 432. " chlorosis, i, 433. " " chronic rheumatism, i, 432. " hysteria, i, 432. Galega, i, 432. Galium, i, 432. Galla. See Galls. Gallacetophenone, i, 432. (externally) in psoriasis, i, 432. Gallal, i, 433. Gallanilide, i, 432. (topically) in chronic eczema, i, 432. " " psoriasis, i, 433. Gallanol, i, 432. Gallic acid, i, 433. (internally) in haemoptysis, i, 432. " for hasmorrhages, i, 432. in acute nephritis, i, 432. " albuminuria, i, 432. " bronohorrhcea, i, 432. " colliquative sweating, i, 432. " diabetes insipidus, i, 433. " hsematuria, i, 432. " haemophilia, i, 432. " metrorrhagia, i, 433. " ulcers, i, 432. Gallioin, i, 432. in conjunctivitis, i, 432. " keratitis, i, 432. Gallobromol, i, 433. (by compress) in acute eczema, i, 433. (by injection) in chordee, i, 433. (internally) in chorea, i, 433. " " epilepsy, i, 433. (by injection) in gonorrhcea, i, 433. Gallol. See Gallanol. Galls, i, 433. in chronic diarrhoea, i, 433. " painful hsemorrhoids, i, 433. " poisoning with an alkaloid, i, 433. Galvanism. See Electricity. Gamboge, i, 433. and calomel in malarial congestion of the liver, i, 433. in engorgement of the portal circulation, i, 433. " flatulence, i, 433. Gamboge in intestinal indigestion, i, 433. Gargles, i, 433 ; ii, 437. Garlic, i, 434. Gaultheria, i, 434. in rheumatism, i, 124, 135, 434. " gastro-enteritis, i, 435. Gavage, i, 435. and lavage in chronic disorders of the stom- ach, i, 436. for infants prematurely born, i, 436. in anorexia, i, 436. " brain disease, i, 436. " broncho-pneumonia, i, 436. " diphtheria, i, 436. " empyema, i, 436. " irritable stomach of phthisis, i, 436. " phthisis, i, 435. " scarlet fever, i, 436. " spasm of the oesophagus, i, 436. " typhoid fever, i, 436. " vomiting, i, 436. Geissospermine, i, 436. Geissospermum laeve, i, 436. Gelanth, Gelanthum. See under Varnishes. Gelanthum (Unna's treatment) in dry eczema, ii, 349. in eczema of the hand, ii, 349. " excessively dry skin, fissures, etc., ii, 349. preparation of, ii, 349. Gelatin in poisoning by alum, i, 109. in poisoning by bromine, i, 109. Gluten in poisoning by corrosive sublimate, i, 109. Gelsemine, i, 436. Gelsemium, i, 436. as a motor depressant, i, 644. in asthma, i, 437. " chorea, i, 437. " dysmenorrhcea, i, 437. " eczema, i, 437. " facial spasm, i, 437. " fever, i, 436. " hacking cough of phthisis, i, 437. '• inflammation, i, 437. " laryngismus stridulus, i, 437. " malarial disease, i, 437. " mania with motor excitement and wake- fulness, i, 437. " neuralgia, i, 69, 437. " ovarian neuralgia, i, 69. " pleurisy, i, 437. " pneumonia, i, 437. " sciatica, i, 437. " spasmodic conditions, i, 437. " trigeminal neuralgia, i, 69. " whooping-cough, i, 437. Gentian, i, 437. and capsicum in vomiting of drunkards, i, 100. and ginger in vomiting of drunkards, i, 100. Geoffraea. See Andira. Geosite, ii, 437. in acute gastric catarrh, ii, 437. " chlorosis, ii, 437. " rheumatism, ii, 437. " tuberculosis, ii, 437. Geranium, i, 437. in diarrhoea, i, 438. " dysentery, i, 438. by injection in gonorrhoea, 1, 438. GENERAL INDEX. 493 Geranium in haemorrhages, i, 438. (topically) in indolent ulcers, i, 438. " " inflammatory affections of the throat, i, 438. in leucorrhoea, i, 438. Germander, i, 438. Germicides, i, 438. Gin, i, 449. in dysmenorrhoea, i, 449. Ginger, i, 449. and oalumba in vomiting of drunkards, i, 100. " gentian in vomiting of drunkards, i, 100. " serpentaria in vomiting of drunkards, i, 100. troches of, in catarrhal aflections of the mouth and throat, i, 449. Glacialin, i, 449. Glonoin. See Nitroglycerin. Gluco-chloral. See Chloralose. Glucose. See under Sugar (vol. ii, page 235). Glucosides. "See under Active principles. Glue, i, 449. suppositories of, in habitual constipation, i, 449. Gluside. See Saccharin. Gluten, i, 449. bread in diabetes mellitus, i, 449. -peptone sublimate, i, 450. Glutei, ii, 488. as an antiseptic, ii, 438. in ulcers and wounds, ii, 438. " weeping affections of the skin and mucous membranes, ii, 438. GlyoelsBum, i. 450. Glycerates, Glycerides. See Gltceeites. Glycerin, i, 450. and carbolic acid in acute coryza, i, 450. " " " " acute pharyngitis, i, 450. " " " " amygdalitis, i, 450. " " " " hay fever, i, 450. as a laxative, i, 450. " solvent, ii, 212. (internally) for flatulence, i, 451. " " hEemorrhoids, i, 451. " " heartburn, i, 451. in acne, i, 450. enema in acute diarrhoea, i, 451. (intra-uterine injections) in atony of the uterus, i, 450. in biliary lithiasis, i, 451. '• chapping of the hands and lips, i, 450. " eczema, i, 450. " fissures, i, 450. " hepatic colic, i, 451. injections in constipation, i, 450. " " fsecal impaction, i, 451. " " haemorrhoids, i, 450. " (between the ovum and uterine wall) in labour, ii, 55. injections in ulcer of the rectum, i, 450. (intra-uterine injections) in placenta praevia, _ i, 450. in pruritus, i, 450. '■ psoriasis, i, 450. " trichiniasis, i, 451. " tuberculosis, i, 451. poisoning, ii, 438. suppositories in dysmenorrhoea, i, 450. " " endometritis, i, 450. " " endotrachelitis, i, 450. Glycerin suppositories in pelvic cellulitis, i, 450. suppositories in salpingitis, i, 450. " " uterine congestion, i, 450. Glycerines, Glycerites, Glyceroles, i, 451. Glycerophosphates, ii, 438. in Addison's disease, ii, 439. " anaemia, ii, 439. " chlorosis, ii, 439. " chronic nephritis, ii, 439. " convalescence from acute disease, ii, 439. " diabetes, ii, 439. " gout, ii, 439. " cbesity, ii, 439. '' phosphaturia, ii, 439. " pulmonary phthisis, ii, 439. " sciatica, ii, 439. " trigeminal neuralgia, ii, 439. " uric-acid diathesis, ii, 439. Glyceryl nitrate. See Nitroglycerin. Glyconin, i, 451. Glycozone, i, 451. Glycyrrhiza. See Licorice. Glycyrrhizinum ammoniatum, i, 451. Gnaphalium, i, 451. in diarrhoea, i, 451. " dysentery, i, 451. Goa powder. See under Chrtsarobin. Gold, i, 451. and arsenic in cancer, i, 454. " phthisis, i, 454. and sodium chloride in sclerosis, i, 454. bromide for inebriety, i, 454. " in chorea, i, 454. " " epilepsy, i, 454. " " exophthalmic goitre, i, 454. " " hysteria, i, 454. chloride in habitual abortion, i, 453. " " nervous dyspepsia, i, 454. " (as a caustic) in ulceration of the cervix uteri, i, 453. cure in inebriety, i, 454. cyanide in scrofula, i, 322, 453. " " syphilis, i, 322. in amenorrhcea, i, 453. " anaemia, i, 454. " catarrh of the duodenum and bile ducts, i, 454. " chlorosis, i, 454. " chronic metritis, i, 453. " decline of the sexual power in men, i, 453. " dropsy, i, 451, 453. " hypertrophy of the tongue, i, 453. " hypochondriasis, i, 453. " impotence, i, 453. " indurated glands, i, 453. " jaundice, i. 454. " lupus, i, 453, 454. " ozaena, i, 453. " scrofulous ulcers, i, 453. " squamous skin disease, i, 453. " sterility, i, 453. " suicidal mania, i, 453. physiological action of, on animals, i, 452. " " " " man, i, 452. therapeutics of, i, 453. Goodell's emmenagogue, i, 375. Gossypium. See Cotton. Goose grease, i, 454. (liniment) in affections of the chest, i, 454. 494 GENERAL INDEX. Goose grease (liniment) in bronchitis, i, 454. (internally) in influenza, i, 454. (liniment) in muscular rheumatism, i, 455. Granatum. See Pelletierise. Grape cure, i, 455. in chronic diarrhoea, i, 455. " engorgement of the portal circulation, i, 455. '• enlargement of the spleen, i, 455. " functional disorders of the liver, i, 455. " haemorrhoids, i, 455. " intestinal catarrh, i, 455. " phthisis, i, 455. " plethora, i, 455. " scrofula, i, 455. " tuberculosis, i, 455. Green soap. See under Soap. Grindelia, i, 455. as a dressing for blisters, i, 456. for the dressing of burns, i, 456. in bronchitis, i, 456. " chronic cystitis, i, 456. " dyspnoea, i, 456. " elytritis, i, 456. " hay fever, i, 456. " herpes zoster, i, 456. " spasmodic asthma, i, 456. " " coughs, i, 456. " uterine catarrh, i, 456. Grindeline i, 455. Gruel, flour, i, 433. in diarrhcea, i, 423. •' dysentery, i, 433. Guaiac, i, 456. in chronic skin disease, i, 456. ■' " rheumatism, i, 456. " gout, i, 456. " pharyngeal inflammation, i, 456. " syphilis, i, 456. Guaiacooaine, ii, 439. as a local anaesthetic, ii, 439. Guaiacol, i 457. and glycerin in gout, i, 461. as a local ansesthetic, i, 461. carbonate in pulmonary tuberculosis, i, 461. " typhoid fever, i, 461. cinnamate. See Styracol. effects of, administered hypodermically, i, 458. effects of, on the temperature, i, 459. in acute nephritis, i, 458. " amygdalitis, i, 460 ; ii, 439. " arthritic tuberculosis, i, 457. " bronchopneumonia, ii, 439. " chronic catarrh of the gastro-intestinal and genito-urinary tracts, i, 457. " chronic nephritis, i, 458. " dental surgery, i, 461. " dermatitis, i, 461. " diabetes mellitus. i, 458. " diphtheria, ii, 439. (external application) in erysipelas, i, 460. in fever, i, 457. " foetid bronchorrhoea, ii, 459 " follicular amygdalitis, ii, 439. " influenza, i, 460. " parenchymatous amygdalitis, ii, 439. (topical application) in pleurisy with effusion, i, 460. in pneumonia, i, 460 ; ii, 439. Guaiacol in pulmonary gangrene, ii, 439. iu pulmonary tuberculosis, i, 457, 458, 459. " pyaemia, i, 460. (ointment) in blennorrhagie epididymitis, i, 461. (ointment) in swelled testicle, ii, 439. (topical applications) in typhoid fever, i, 459, 460. phosphate, ii, 440. salicylate, ii, 145. succinate, ii, 440. Guaiacum. See Guaiac and Guaiac wood. as an emmenagogue in amenorrhoea of rheu- matism, i, 375. Guaiac wood, i, 457. in chronic gout, i, 457. " " rheumatism, i, 457. " " skin diseases, i, 457. " scrofula, i, 457. " syphilis, i, 457. Guaiecetin, ii, 440. Guarana, i, 461. in convalescence, i, 461. " debility, i, 461. " migraine, i, 461. " sick headache, i, 461. Gum arable. See Acacia. water in diarrhoea of infants, i, 351. Gun cotton. See Pyroxylin. Gurjun balsam, i, 461. as an expectorant, i, 463. in gonorrhoea, i, 463. " leprosy, i, 462. " vaginal blennorrhagia, i, 463. Gutta percha, i, 462. applied to fractures or injuries of the jaw, i, liquid, for abrasions, excoriations, etc., i, 463. Gutti. See Gamboge. Gymnastics. See under Exekcise. Gymnema, ii, 440. Gynocardia, Gynoeardic acid. See under Chaulmoobra oil. Gypsum. See Plaster of Paris. Haemalbumin, i, 463. in anaemia, i, 463. " chlorosis, i, 463. " rickets, i, 463. " scrofula, i, 463. " ulcer of the stomach, i, 463. Hiematics, i, 463. Haematin-albumin, i, 463. in aniemia. i, 463. Haematinics. See under HyEMATOPOlETlcs. Hoematopoietics, i, 463. Hfematoxylon, i, 464. in diarrhoea, i. 464. Hsemogallol, i, 464. in anaemia, i, 464. Hiemoglobin, i, 464. in anemia, i, 464. Hasmol. See H.smogallol. Hasmostatics, i, 464. Hamaraelis, i, 467. as a hismostatic, i, 467. as a mouth gargle in sore throat, i, 467. as an application to haemorrhoids, i, 467. as a sedative, i, 467. in bruises, i, 467. GENERAL INDEX. 495 Hamamelis (externally) in epistaxis, i, 467. in gastric catarrii, i, 467. " hsemorrhage from the mouth, i, 467. (externally) in hasmorrhoids, i, 467. in pulmonary hffimorrhages, i, 407. '• renal haemorrhage, i, 467. " sprains, i, 467. " uterine haemorrhage, i, 467. Hartshorn. See under Ammonium carbonate. Headine, i, 467. Heat, i, 467. and cold, action of, on the system, i, 163, 164. application of, in drowning, i, 468. ■' " exhaustion, i, 468. " " laryngismus stridulus, i, 469. as a cardiac stimulant, i, 468. " germicide, i, 443. " haemostatic, i, 466. drv (applications), in cholera (algid state), ii, 225. in chronic sciatica, ii, 441. " rheumatism, ii, 440. dry (applications), in shook, ii, 225. " in toothache, i, 136. in hajmorrhagje (algid state), i, 468. " menorrhagia and metrorrhagia, i, 469. " pelvic congestion, i, 469. " poisoning by aconite, i, 7. " rheumatism, ii, 440. " treatment of narcotic poisoning, i, 469. Hedeoraa, i, 469. in colic, i, 469. " nausea, i, 469. Helenin, Helenium. See under Inula. in leuoorrhoea (as an antiseptic), i, 534. " tuberculosis (as an antiseptic), i, 534. Heliotropin. See Pipeeonal. Hellebore, American. See Veeatrum viride. black, i, 469. " in sthenic febrile conditions, i, 470. " physiological action of, i, 469. green. See Veratrum viride. white, i, 470. " for the destruction of the itch mite, lice, etc., i, 470. white, in acute gastritis, i, 470. " " " pleurisy, i, 470. " " croupous pneumonia, i, 470. " " pericarditis, i, 470. Helleborein, Helleborin. See under Helle- bore, BLACK, and Hellebore, white. Helleborus albus. See Hellebore, white. Helleborus niger. See Helleborus, black. Helmerich's ointment, i, 116. Hemidesmus, i, 470. Hemlock. See Cicuta and Conium. Hemp. See Apooysum and Cannabis indica. Henbane. See Hygsctamus. Hepatics, i, 470. Hexamethylenetetramine. See LTrotropine. Hidrotics. See Diaphoretics. Hirudo. See Leeching. Hive syrup. See under Squill. Hoang-nan, i, 471. in leprosy, i, 471. " rabies, i, 471. " scrofula, 1, 471. Hoffmann's anodyne in dyspnoea of asthma, i, 94. Homatropine, i, 471. in incipient cataract, i, 472. " night sweats of phthisis, i, 471. Homoguaiacol. See Cbeosol. Honey, i, 472. and rye meal (paste) in abscess of the ear, i, 473. in scorpion stings, ii, 441. Hops. See Humulus and Lupulin. Hordeum, i, 472. 473. intestinal inflammation, i. decoction of, in intestinal irritation, i, 473. Horehonnd, i, 473. in catarrhal bronchitis, i, 473. " chronic pulmonary disorders, i, 473. " colds, i, 473. " sore throat, i, 473. Horseradish, i, 473. dried root of, chewed for toothache, i, 473. in atonic dyspepsia, i, 473. " dropsy, i, 473. " flatulence, i, 473. infusion of, for hoarseness, i, 473. Hot applications in inflammatory exudations, i, 469. in itching, i, 469. Humulus, i, 473. for breaking off the opium habit, 1, 474. in chordee, i, 474. " delirium tremens, i, 474. " diarrhoea, i, 474. " dyspepsia, i, 473. " incontinence of urine, i, 473. " irritable bladder, i, 474. " irritation of the genito-urinary tract, i, 474. " priapism, i, 474. " sexual erethism, i, 474. poultice for toothache and earache, i, 475. Hunyadi Janos, i, 474. _ for indigestion, i, 474. " disordered liver, i, 474. in acute congestion, i, 474. " chronic congestion of the pelvic organs, i, 474. " diarrhoea, i, 474. " dropsy, i, 474. Hysenanehin, i, 474. in amblyopia, i, 474. " deafness, i, 474. Hydracetin, i, 474. Hydragogues, i, 222, 475. indications for the use of, i, 475. Hydrargyrum. See Mercury. Hydrastine, Hydrastiuine. See under Hydras- tis. in acne, i, 476. '■ bromidrosis, i, 476. " chronic nephritis, i, 476. " dry seborrhoea, i, 476. (as a douche) in gonorrhoea, i, 476. (internally and by injection) in gonorrhoea, i, 476. in granular coniunctivitis, i, 476. (as a lotion) in hyperidrosis, i, 476. in indolent ulcers, i, 476. " intermittent fever, i, 476. " paludal cachexia, i, 476. 496 GENERAL INDEX. Hydrastine (internally) in puerperal haemor- rhage, i, 476. in spermatorrhoea, i, 476. " ulcerating carcinoma, i, 476. (as a douche) in vaginal leucorrhcea, i, 476. Hydrastis, i, 475. canadensis as an eobolio. ii, 55. in catarrh of the cystic duet, i, 476. gall duets, 1, 476. (internally and topically) in catarrh of the vesical, vaginal, and uterine mucous mem- branes, i, 476. in chronic enteritis, i, 475. " '■ gastric catarrh, i, 475. (local applications) in follicular amygdalitis, i, 476. .(local application) in hemorrhage from the lower bowel, i, 476. :in membranous dysmenorrhcea, i, 476. " old ulcers, i, 476. " otorrhoea, i, 476. (local applications) in pharyngitis, i, 476. " " " stomatitis, i, 476. in syphilitic affections of the throat and nares, i, 476. " the alcohol habit, i, 475. " ulcers of the rectum, i, 476. Hydriatics, Hydriatrics, i, 476. Hydriodic acid, i, 492. in acute rheumatism, i, 492. " asthma, i, 492. " delayed resolution of the lungs after pneu- monia, i, 492. " pleuritic exudation, i, 492. " scrofulous diathesis, i, 492. ether. See Ethyl iodide. Hydrobromic acid, i, 492. and the bromides in epOepsy, i, 492. in headache, i, 492. " nervous cough, i, 492. " neuralgia, i, 492. ether. See Ethyl bromide, i, 492. Hydrochloric acid, i, 492. as a disinfectant, i, 446. in acid dyspepsia, with pyrosis, i, 493. " acute rheumatism, i, 493. " anaemia, -i, 493. " chlorosis, i, 493. " diarrhcea of typhoid fever, i, 493. " fever, i, 493. " heart disease with deficient compensation, i, 493. " indigestion, i, 493. " necrosis of bone of tuberculous origin, ii, 441. " neurasthenia, i, 493. " poisoning with silver and alkalies, i, 493. (by sponging) in pruritus of urticaria, i, 493. (as a gargle) in scarlet fever, i, 493. in superficial cutaneous growths, i, 227. " vomiting due to alcoholic overindulgence. i, 100. ^ ether. See Ethyl chloride. Hydrocotyle asiatica, i, 493. in catarrhal enterocolitis, i, 493. " fever, i, 493. " leprosy, i, 493. " lupus, i, 493. " scrofulodermata, i, 493, " syphilis, i, 493. Hydrocyanic acid, i, 493. action of, i, 496. antidotes for poisoning with, i, 501. chronic poisoning with, i, 498. in heart affections, i, 495. (dilute) in vomiting of pregnancy, i, 99. in whooping-cough, i, 495. poisoning with, i, 496. tests for, i, 499. uses of, i, 495. ether, i, 323. Hydrofluoric acid in pulmonary tuberculosis, i, 527. Hydrogen as an antipyretic, i, 527. as a sedative, i, 527. cyanide. See HyDEOCYANio acid. dioxide, i, 502. " as a disinfectant, i, 502. " as a germicide, i, 445. " in abscesses, i, 502. . " " amygdalitis, i, 503. " " chancroid and chancre, i, 503. " " diphtheria, i, 503. " injections in gonorrhoea, i, 503, 531. " in scarlet fever, i, 503. " " superficial ulcerations, i, 503. " " unhealthy suppurating surfaces, i, 503. gas in abdominal surgery, i, 533. peroxide. See Hydrogen dioxide. sulphide. See under Sulphur, i, 503. Hydronaphthol, i, 503 ; ii, 3. Hydroquinine, i, 503. Hydroquinone, i, 503. Hydrotherapeuties. See HvDRLiTios. Hydroxylamine hydrochloride, i, 503. in lupus, i, 503. " parasitic skin disease, i, 503. " pityriasis, i, 503. , " psoriasis, i, 503. Hygiama, ii, 442. in debility of convalescence, ii, 442. " diseases of the stomach and intestines, ii, 442. ' ' " pulmonary consumption, ii, 443. '■ typhoid fever, ii, 443. Hyosoine, i, 503. effect of, on the insane, i, 504. in acute mania, i, 508. " delirium tremens, i, 508. " insomnia, i, 508. " paralysis agitans, i, 504. Hyoscyamine, i, 504. as a mydriatic, i, 649. " sedative to the nervous system, i, 504. in insanity, i, 504. " paralysis agitans, ii, 443. " spasms, i, 504. " vesical pain, i, 504. Hyoscyamus, i, 504. as a sedative to the nervous system, i, 504. in griping pains, i, 504. " insomnia, i, 508. " neuralgia, i, 505. " spasmodic conditions, i, 504 " vesical pain, i, 504. Ilypnal, i, 505. in insomnia with pain, i, 505. Hypnone. See Aoetophenone. Hypnotic measures, i, 506. GENERAL INDEX. 497 Hypnotics, i, 505. indirect, i, 505. medicinal, i, 506. narco-, i, 505. pure, i, 505. Hypnotism, i, 509. dangers of, i, 513. induction of, i, 510. in functional disorders of the nervous sys- tem, i, 514. " functional gastro-intestinal disorders, i, 515. " labour pains, i, 514. " masturbation, i, 515. " menstrual disorders, i, 515. " nocturnal enuresis, i, 515. " onanism, i, 515. " organic diseases, i, 514. " the alcohol and drug habit, i, 515. precautions necessary in the therapeutic use of, i, 513. therapeutic value of, i, 513. Hypodermic medication, i, 515. advantages of, i, 517. disadvantages of, i, 517. manner of performing, i, 518. preparation of the solution for, i, 516. Hypophosphites, i, 518. in bone diseases, i, 518. " chronic pulmonary tuberculosis, i, 518. " disorders of the nerve-centres, i, 518. " furuncles, i, 518. " scrofula, i, 518. " styes, i, 518. Hypophosphorous acid, i, 519. Hyposulphites, i, 519. (locally) in cutaneous diseases of a parasitic nature, i, 519. in gastric fermentation, i, 519. (locally) in pityriasis versicolor, i, 519. in porrigo, i, 519. (locally) in ringworm, i, 519. Ice, i, 519. applied to the spine in amenorrhoea, i, 530. " " " " " scanty menstruation, i, 520. applied to the spine in seasickness, i, 530. bag in bronchitis, i, 530. " " encephalitis, i, 520. " " epididymitis, i, 530. r " " inflammation of the pelvic organs, i, 520. bag in meningitis, i, 520. " " myelitis, i, 530. " " orchitis, i, 530. " " pericarditis, i, 530. " " peritonitis, i, 520. " " pleurisy, i, 530. " " pneumonia, i, 530. cradling in pneumonia, i, 530. (topically) in capillary hsBmorrhage, i, 530. " " inflammations, i, 519. " " strangulated hernia, i, 519. " " superficial congestions, i, 519. to the spine for stimulation of the menstrual flow, i, 875. Iceland moss. See Cetearia. Ichthyocolla. See Isinglass. Ichthyol, i, 531. as an analgetic, i, 533. " a sorbefaoient, i, 523. in acute elytritis, i, 533. " " perimetritis, i, 533. " bronchial tuberculosis, ii, 443. " burns, i, 533. " chronic constipation, ii, 443. metritis, i, 523. " " ^ parametritis, i, 533. " cicatricial atrophy of the vagina and cer- vix uteri, i, 533. " diarrhoea, ii, 443. " eczema, i, 533. " " seborrhoicum, i, 116. " elephantiasis, i, 533. " endometritis, i, 528. " endotrachelitis, i, 523. " erysipelas, i, 538. " fissures of the nipples, i, 523. " gastric disturbances, ii, 443. " gout, i, 538. " gynaecological practice, i, 533. " hyperemia, i, 538. " inflammation, i, 533, 533. " " caused by the stings of in- sects, ii, 444. injections in gonorrhoea, i, 538. (salve or solution) in intertrigo, i, 588. in intestinal disorders, ii, 443. " leprosy, i, 522. " lymphangeio-phlebitis, ii, 443. " nervous eczema, i, 523. " parasitic eczema, i, 523. " pruritus, i, 523. " " of the vulva and of the anus, i, 534. " pulmonary tuberculosis, ii, 443. " rebellious constipation, ii, 443. (externally and internally) in rosacea, i, 523. in salpingo-oophoritis, i, 533. " scars of acne, keloid, and variola, i, 583. " scleroderma, i, 582. " swollen glands, i, 522. Ignatia, i, 524. Ignipuncture, i, 524. in chronic articular inflammation, i, 534. " " hypertrophy of the tonsils, i, 524. " fungous arthritis, i, 584. " hypertrophy of the nose, i, 584. " neuralgia, i, 534. " petit mal, i, 524. " synovial cysts, i, 534. lUiciu'm, i, 584. India rubber. See Rubber. Indigo in dysmenorrhcEa, i, 375. Infiltration anaesthesia, i, 534. Infusion. See under Transfusion. and the subcutaneous injeotion of strychnine in shock, ii, 324. in acute hydrocephalus, ii, 824. " " pericarditis, ii, 334. " brown atrophy of the heart muscle, ii, 338. " cerebral anaemia, ii, 884. " cholera, ii, 384. " chronic gastro-enteritis, ii, 334.' " collections of fluid (in the serous cavities), ii, 334. " epistaxis, ii, 334. " gastric hemorrhage, ii, 824. 498 GENERAL INDEX. Infusion in intestinal hsemorrhage of typhoid fever, ii, 323. in iodoform poisoning, ii, 323. (of an isotonic saline solution) in placenta prsevia, ii, 324. in poisoning with carbonic oxide, ii, 333. " " " chloral, chloroform, ether, morphine, opium, or phosphorus, ii, 323. " poisoning with illuminating gas, ii, 328. " puerperal septicaemia, ii, 324. " septicaemia, ii, 325. intra-arterial, of sodium chloride solution in acute anaemia and in collapse, ii, 328. intramuscular, in anasarca, ii, 325. " ■ " albuminuria, ii. 325. " " pulmonary oedema, ii, 325. " " urffimia, ii, 325. intraperitoneal saline, ii, 325. intravenous or subcutaneous, in acute peri- tonitis, ii, 825. intravenous or subcutaneous, in cholera, ii, 325. , intravenous or subcutaneous, in pneumonia, ii, 324, 325. intravenous or subcutaneous, in puerperal septicaemia, ii, 325. intravenous or subcutaneous, in septicaemia, ii, 325. intravenous or subcutaneous, in tetanus, ii, 325. Infusions, i, 525. Ingluvin, i, 526. in dyspepsia, i, 536. " vomiting of pregnancy, i, 526. Inhalants, Inhalation, i, 526. Ink, li, 259. in ringworm, ii, 259. Injection Brou in gonorrhoea, i, 531. Injections, abortive, i, 531. " hypodermic. See Hypodermic medi- cation. intravenous, i, 580. rectal. See Enbmata. simple, i, 531. urethral, i, 580. Inoculation against rabies by the method of Tizzoni and Cenbanni, i, 82. cholera, i, 83. Instillation, i, 532. Insufflation, i, 583. of hot air in tuberculous peritonitis, i, 533. " powders in deep wounds, cold abscesses, affections of the mouth, nose, etc., i, 533, 534. Inula, i, 534. as a tonic in amenorrhoea, i, 534. Inunction, i, 534. lodamylum, i, 534. lodantipyrine, i, 534. Iodide of ethyl in asthma, inhalations of, i, 95. Iodides. See under Iodine. in chronic lead or mercury poisoning, ii, 214. Iodine, i, 534. as a germicide, i, 445. bath, for constitutional effects, i, 537. enema in chronic diarrhoea, i, 536. " " dysentery, i, 536. hypodermic injection of, in chronically en- larged tonsils, i, 536. hypodermic injections of, in goitre, i, 536. Iodine, hypodermic injections of, in hydatid cysts, i, 536. hypodermic injections of, in hypertrophied prostate, i, 536. hypodermic injections of, in hypertrophy of lymphatic glands, i, 536. in articular involvements, i, 535. (externally) in atrophic rhinitis, i, 536. in chilblain, i, 536. " chloasma, i, 536. (externally) in chronic cystitis, i, 536. in chronic glandular enlargements, i, 535. " " indurations of the breast, i, 536. " " phthisis, i, 586. (externally) in enlarged glands, 1, 536. in enlargements of the liver, mammae, testes, and uterus, i, 586. (externally) in erysipelas, i, 536. (internally) in glandular enlargements, ii, 214. (externally) in goitre, i, 536. (internally) in goitre, ii, 214. (externally) in inflammation of the pharynx and larynx, i, 536. injection in ascites, i, 536. " " cystic bronchocele, i, 536. " " dropsy of the joints, i, 536. " " hernia, i, 536. " " hydrocephalus, i, 536. (externally) in leucorrhoea, i, 536. in lupus, i, 536. (externally) in muscular rheumatism, i, 536. (small doses) in nausea, i, 536. (externally) in ophthalmia, i, 536. " " orchitis, i, 536. " " ovarian tumours, i, 536. in oziena. i, 536. (externally) in pitting of small-pox, i, 536. " " pityriasis, i, 536. " " pleurisy, i, 536. " " psoriasis, i, 586. " " ringworm, i, 536. in scrofulous diseases, i, 535. " tuberculosis, i, 527. (as an intestinal antiseptic) in typhoid fever, i, 586. in ulcers, i, 536. (externally) in urethritis, i, 536. (small doses) in vomiting, i, 536. salts in chronic rheumatism, i, 536. " " " skin disease, i, 536. " " " gout, i, 536. " " " lead poisoning, i, 536. " " tertiary syphilis, i, 536. terchloride as a germicide, i, 445. tincture in ringworm, i, 117. vapour in chronic bronchitis, i, 586. " " pulmonary tuberculosis, i, 536. Iodoform, i, 537. in chronic dysentery, i, 537. " cirrhosis of the liver, i, 537. (hypodermically) in cold abscesses, i, 538. in diabetes, i, 537. (hypodermically) in goitre, hydrocele, and tuberculous affections, i, 538. in inflamed mucous membrane of the genito- urinary organs, i, 538. inhalation in bronchitis, i, 540. " " coryza, i, 540. in suppurating buboes, i, 539 ; ii, 444. GENERAL INDEX. 499 Iodoform injection in suppurating inguinal buboes, i, 539. in meningitis, i, 537. " obesity, i, 537. " painful septic diseases of the rectum, uterus, and vagina, i, 538. " phthisis, i, 537. " recent wounds, i, 538. " ulcerated throats, i, 445. poisoning, i, 539. powder in septic wounds, i, 538. lodoformin, i, 540. lodol, i, 540. in balanitis, i, 540. " carbuncles, i, 540. " caseous glands, i, 540. (by insufBation) in chronic bronchial catarrh, i, 540. (by insufflation) in chronic inflammation of the Eustachian tube, i, 540. (by insufflation) in granular pharyngitis, i, 540. (by insufflation) in otitis media, i, 540. " " " posterior rhinitis, i, 540. in psoriasis, i, 540. " soft chancre, i, 540. " suppurative bubo, i, 540. " tinea tonsurans, i, 540. (by insufflation) in trachoma, i, 540. " " " tuberculous laryngitis, i, 540. in ulcers, i, 540. " vaginal catarrh, i, 540. lodophenacetine, lodophenine, i, 540. lodopyrine. See Iodantipyrine. Ipecac, Ipecacuanha, i, 541. as a counter-irritant, i, 543. " an emetic in croup, i, 418. in acute bronchitis, i, 373. " dysentery, i, 543. " gastritis, i, 543. " laryngitis, i, 543. " asthma (as an expectorant), i, 95. (as an emetic) in bilious attacks, i, 543. in bronchial catarrh, i, 543. "■ bronchitis, i, 543. ■ catarrhal jaundice, i, 543. ' chronic bronchitis, i, 548. " dysentery, i, 543. ' diarrhcEa of young children, i, 543. ' diarrhcEal conditions, i, 542. ' emphysema, i, 542. ' epistaxis, i, 543. ■ hsemoptysis, i, 543. ' hay fever, i, 543. ' laryngismus stridulus, i, 542. malarial disease, i, 542. membranous croup, i, 542. menorrhagia, i, 543. migraine, i, 542. narcotic poisoning, i, 541. pharyngitis, i, 543. post-partum haemorrhage, i, 543. spasmodic aifections of the respiratory apparatus, i, 373. ■ spasmodic croup, i, 373. ' vomiting of gastric atony, i, 543. ' " " nervous origin, i, 543. (small doses) in vomiting of pregnancy, i, 99, 541. Ipecac in whooping-cough, i, 542. Ipomcea. See Jalap. Iridin, i, 543. Iris, i, 543. Irish moss. See Chondrus. Irisin. See Iridin. Iron, i, 543. acetate in chronic nephritis, i, 551. albuminate in chlorosis, i, 553. ammoniochloride in amenorrhoea, rickets, and scrofula, i, 549. and arsenic in neuralgia, i, 68. as a general tonic, i, 545. " stomachic, i, 545. bromide in chorea, i, 553. " " scrofula, i, 553. carbonate in anaemia, i, 547. " " chlorosis, i, 547. " " digestive atony, i, 547. " " menstrual irregularities, i, 547. chloride (tinctuie) in albuminuria, i, 548. " (ethereal tincture) in ansemia and chlorosis, i, 548. chloride (in solution) in aneurvsms and vari- ces, i, 547, 548. chloride (tincture) in arsenic poisoning, i, 143. " in Bright's disease, i, 548. " (tincture) in chronic bronchitis, i, 548. " " " diphtheria, i, 548. " " " emphysema (if ansmia is present), i, 548. chloride (tincture) in epistaxis, i, 548. " " " erysipelas, i, 548. " gleet, i, 548. " (solution) in haemorrhage, i, 548. " (tincture) in haemorrhages of the bowels, Icidneys, etc., i, 548. chloride (tincture) in hysteria, melancholia, and mania, i, 549. chloride (tincture) in neuralgia of anaemia, i, 549. chloride (tincture) in neurotic disturbances, i, 549. chloride (tincture) in passive heemorrhage (if aneemia is present), i, 548. chloride in post-partum haemorrhage, i, 548. " (tincture) in prostatorrhoea, i, 548. " " " pseudoleuciTmia, i, 549. " " " purpura, i, 548. " " " pysemia, i, 549. " " " rheumatism, i. 548. " " " scarlatina, i, 549. " " " septicaemia, i, 549. " in soft vegetations and growths, i, 548. chloride (tincture) in spermatorrhoea, i, 548. " " internally and externally in sore throat, i, 549. chloride (tincture) injections in varicosities, i, 549. citrate in anffimia, i, 550. " " malarial disease, i, 550. hydrate as an antidote in arsenic poisoning, i, 552. hydrate in myalgia, i, 552. in amygdalitis, i, 546. " anaemia, i, 544 ; ii, 310. " chlorosis as an emmenagogue, i, 374. " erysipelas, i, 546. " fatty degeneration of the heart, i, 317. 500 GENERAL INDEX, Iron hydrate in pharyngitis, i, 546. iodide in atony of mucous surfaces with re- sultant discharges, i, 551. iodide in atonic amenorrhcea, i, 551. " " chlorosis, i, 551. " " nocturnal enuresis of children, i, 551. iodide in scrofula, i, 551. " " syphilis, i, 551. lactate in chlorosis, i, 551. malate, i, 553. (Monsel's solution) in acute follicular amyg- dalitis, i, 550. nitrate in chronic diarrhoea, i, 551. " " leucorrhcea, i, 551. " " menorrhagia, i, 551. oxalate, i, 553. oxide as an antidote in arsenic poisoning, i, 553. oxide, magnetic, i, 553. phosphates in ansemia with cerebral debility, i, 551. precipitated, dialyzed, in arsenic poisoning, i, 143. reduced, in anaemia, i, 547. " " chronic eczema, i, 547. " " lepra, i, 547. " " psoriasis, i, 547. " " ulcerating caroinomata, i, 547. saccharated oxide of, in arsenic poisoning, i, 143. succinate in jaundice, i, 553. sulphate (Monsel's solution) in acute follicu- lar amygdalitis, i, 550. . sulphate in ansmia accompanied by consti- pation, i, 549. sulphate in chronic ophthalmia, i, 549. " debilitated conditions associated with chronic discharges, i, 549. sulphate (solution) in external haemorrhages, i, 550. sulphate in gastric atony of anaemia, i, 549. " " gleet, i, 549. " " ha3matemesis, i, 550. " " haemoptysis, i, 550. " '■ hiemorrhoids, i, 550. " " post-partum haamorrhage, i, 550. " '■ syphilis, i, 550. " '• uterine hasmorrhage, i, 550. tannate in anaemia, ii, 359. " " chlorosis, ii, 359. " " ringworm, i, 553. tartrate, i, 553. valerianate in anasmia, i, 553. " " " chlorosis, ii, 348. , " " diabetes insipidus, i, 553. Irrigation, i, 553. antiseptic, of joints, i, 556. methods of, for various parts of the body, i, 553. of the ear, i, 553. " eye, i, 553. " mouth, i, 554, " nose, i, 554. " rectum and colon for septic colitis and diarrhoea of children, i, 554. of the rectum and colon in acute dysentery, i, 491. of the stomach for intestinal ob.struotion, i, 491. Irrigation of the stomach in summer diarrhoea of infants, i, 491. of the urethra and bladder, i, 555. " uterine cavity, i, 555. " vagina, i, 555. of wounds, i, 555, 556. Irritants, i, 556. Isinglass, i, 556. Isonaphthol. See Naphthol. Issue-peas, i, 543. Itrol. See Silvee citrate (vol. ii, page 198). Izal, i, 556. as a disinfectant and germicide, i, 556. Jaborandi, i, 558. as a diaphoretic, i, 558. " sialagogue, i, 558. in acute congestive conditions following cold, i, 559. (by subcutaneous injection or by the mouth) in alopecia, i, 560. in ascites, i, 559. " asthma, i, 559. " bronchitis, i, 559. " diabetes insipidus, i, 559. " diphtheria, i, 559. " dropsy, i, 559. " dry skin diseases, i, 560. " erysipelas, i, 560. " hydrothorax, i, 559. (by spraying) in laryngitis with scanty secre- tion, i, 560. in nephritis, i, 559. " pleurisy with effusion, i, 558. " poisoning with atropine, i, 560. " prurigo, i, 560. " pulmonary oedema, i, 559. " urticaria, i, 560. " uraemia, i, 559. Jalap, i, 560. in dropsical affections, i, 560. (resin) in malarial disease, i, 560. in portal congestion, i, 560. Jambol. See Jambul. Jambul, i, 561. as an astringent, i, 561. as a stomachic, i, 561. in diabetes, i, 561. Japanese belladonna. See Scopoleine. Jasmine. See Gblsemium. Javelle water, i, 340. Jecoris aselli, oleum. See Cod-liver oil. Jecjuirity, i, 561. in granulation of the tyelids, i, 563. " pannus, i, 563. Jervine. See under Vekatruji vieide. Juglans, i, 563. in constipation, i, 563. Juice, beef, i, 333. Juices, i, 563. Juniper, i, 563. in dropsy, i, 563. " impotence, i, 137. Junket, i, 43. Jute, i, 563, Kairine, 1, 563. in fever, i, 563. Kalium. See Potassium. Kamala, i, 563. GENERAL INDEX. 501 Kamala in ascarides vermiculares, i, 103. in intestinal worms, i, 563. Kaolin. See Puller's earth and Earths. Kara, Kava-kava, i, 563. as an anaesthetic, i, 563. " a motor depressant, i, 563. " a diuretic, i, 563. " a sialagogue, i, 563. in cystitis, i, 564. " dropsy, i, 564. " elytritis, i, 5t)4. " gleet, i, 564. " gonorrhcEa, i, 564. " gout, i, 564. " incontinence of urine, i, 564. " retention of urine, i, 564. Kefir, i, 564. in gastro-intestinal nephritis, i, 637. Keratin, i, 564. Kermes mineral. See under Antimony (vol. i, page 14). as an emetic, i, 114. Kerosene, i, 565. in atonic and indolent ulcers, i, 565. " destruction of parasites, i, 116. Kinetotherapy. i, 565. Kino, i, 565. in diarrhoea, i, 565. " epistasis, i, 565. " indolent ulcers, i, 565. " leueorrhoea, i, 565. " passive hajmorrhage, i, 565. " polyuria, i, 565. " relaxed conditions of the mouth and throat, i, 565. Kochin, i, 565. Kola. See Sterculia. Koumyss. See Kumyss. Kousso. See Cusso. in treatment of taenia, i, 103. Krameria, i, 565. in chronic diarrhoea, i, 566. " dysentery, i, 566. " leueorrhoea, i, 566. " passive bleeding from the intestines, i, 566. " visceral haemorrhage, i, 566. Kresin, i, 566. Kristaline. See Cristalline. Krummholz oil. See under Pine prepara- tions (vol. ii, page 88). Kumyss, i, 566. as an antemetic food, i, 98. in acute febrile conditions, i, 567. " chronic bronchitis, i, 567. " convalescence of acute diseases, i, 567. " diseases of the stomach and bowels, i, 567. " impaired digestion, i, 567. " phthisis, i, 567. Laburnum. See Cytisus laburnum. Lac. See Milk. Lactic acid, i, 567. in atonic dyspepsia, i, 567. " corneal ulcers, i, 568. " croup, i, 567. " diabetes, i, 567. " diarrhoea, i, 567. " diphtheria, i, 567. " epithelioma, i, 568. " gastric superacidity, i, 567. Lactic acid in lingual and in nasal tubercu- losis, i, 568. in papillomata, i, 568. " photophobia, i, 568. " tuberculous laryngitis, i, 567. " " ulceration, i, 568. Lactol, Lactonaphthol, i, 568. Lactopeptine, i, 568. Lactophenine, i, 568. in influenza, i, 568. " rheumatism, i, 568. " scarlet fever, i, 568. " typhoid fever, i, 568. Lactose. See Sugar of milk. Laotuca, i, 568. Lactucarium, i, 568. in nausea following the use of opium or morphine, i, 568. Laotucin, i, 568. Lamellae, i, 568. Laminaria, i, 568. Lanolin, i, 569. (injection) in gonorrhoea, i, 569. Lantana, Lantanine, i, 570. Lantanine in malarial fevers, i, 570. Lappa, i, 570. in hsemorrhoids, i, 570. " scrofula, i, 570. " syphilis, i, 570. Larch. See Larix. Lard, i, 570 ; ii, 445. in poisoning by acids or alkaloids, i, 570. inunctions in malnutrition with emaciation, ii, 445. Larix, i, 570. in chronic irritable affections of the genito- urinary tract, i, 570. Larkspur. See Staphisaqria. Laudanum. See under Opium. Laurel, i, 571. in acute eczema and dermatitis, i, 571. " atonic diarrhoea, i, 571. (extract) in cerebro-spinal meningitis, i, 571. in erythema, i, 571. (extract) in megrim, i, 571. in rheumatism, i, 571. " tinea, i, 571. Laurocerasus, i, 571. Laurus. See Laurel. Lavage, i, 571. in acute indigestion, i, 578. " " vegetable poisoning, i, 491. " chronic gastritis, i, 491, 573. " dilatation of the stomach, i, 491, 573. " gastralgia, i, 578. " intoxication, i, 573. " lead poisoning, i, 491. " mercury poisoning, i, 491. " motor disturbances of the stomach, i, 573. Lavandula, i, 573. in digestive atony, i, 573. " flatulence, i, 573. " headache, i, 573. " nervous exhaustion, i, 573. Lavements. See Bnemata. Lavender. See Lavandula. Laxatives, i, 233 ; i, 573. Lead, i, 574. acetate and opium in diarrhcBa, i, 577. " in diarrhoea, i, 577. 503 GENERAL INDEX. Lead acetate in hsemorrhage from the stomach, i, 577. acetate in hajmoptysis, i, 577. " " intestinal haemorrhage, i, 577. and opium wash in erysipelas, bruises, and irritable surfaces, i, 577. and opium wash in rhus poisoning, i, 577 ; ii, 133. compound suppositories of, in dysentery and ii-ritable condition of the rectum, i, 577. Goulard's extract of, in sprains, blisters, bruises, etc., i, 577. iodide ointtuent in enlarged glands, i, 578. " " " hypertrophy of the spleen, i, 578. liniment in burns and raw surfaces, i, 578. " " eczema of the anus and genitals, i, 577. liniment in psoriasis, i, 577. nitrate in fissured nipples and chapping, i, 578. " " onychia, i, 578. oxide ointment in eczema, i, 578. " plaster in raw or excoriated surfaces, i, 578. poisoning, i, 576. tannate in bedsores, i, 578. Unna's, paste, ii, 64. Leeching, i, 578. application of the leech, i, 579. for local depletion in children, i, 578. " conjunctivitis, i, 579. " meningitis, i, 579. " orchitis, i, 579. " otitis, i, 579. Lemon, i, 579. -juice and coffee in intermittent fever, i, 360. " as an antidote for poisoning from the fumes of ammonia water, i, 53. -juice (diluted, as a gargle) in aphthous af- fections, i, 360. -juice in corpulence, i, 260. " (diluted, as a gargle) in gangrenous affections, i, 360. -juice in jaundice, i, 200. " " poisoning by Indian hemp, i, 580. " " post-partum haemorrhage, i, 360. " (diluted) in pruritus, i, 360. " in rheumatism, i, 360. " with glycerin lotion in sunburn, i, 260. Leontodon. See Taraxacum. Leptandra, i, 580. in constipation, i, 580. (as a tonic) in dyspepsia, i, 580. Lettuce, i, 580. Levisticum. See Lioustioum. Levulose, ii, 445. in diabetes, ii, 445. Lichen. See Cetrakia. Licorice, i, 580. and flaxseed in diarrhoea, i, 581. " " " pharyngitis and laryngitis, i, 581. compound powder of, in constipation, i, 581. in bronchial catarrh, i, 580. " bronchitis, i, 580. Lignosulphite, i, 581. in pulmonary tuberculosis, i, 581. Ligusticum, i, 581. in amenorrhoea, dropsy, and flatulent dys- pepsia, i, 581. Lily of the valley. See Convallaria. Lime, i, 581. as a germicide, i, 447. " an antidote to sulphuric-acid poisoning, ii, 342. in carbolic-acid poisoning, i, 583. incompatibility and toxicology of, i, 582. -juice in scurvy, i, 360. physiological action of, i, 583. syrup of, in poisoning by carbolic or oxalic acid, i, 582. vapour of slaked, inhaled, in diphtheria, i, 582. -water and milk in nausea, i, 98, 582. " as a lotion in eczematous surfaces, i, 582. -water as a lotion in fissured nipples, i, 583. " " vaginal wash in threadworms, i, 583. -water as a wash in aphthae, i, 583. " in acid dyspepsia, i, 582. " " mucous enteritis, i, 583. " " stone in the bladder, i, 583. " " typhoid fever, i, 582. Liniments, i, 583. Linseed, i, 583; infusion of, in bronchial inflammations, i, 584. infusion of, in diarrhoea and dysentery, i, 584. " " " inflammation, i, 584. " " " irritation and infliammation of the urinary organs, i, 584. oil as a nutrient in cachectic conditions, i, 584. Lint, i, 584. in burns, i, 584. Linum. See Linseed. Lipanin, i, 585. Lippia mexicana, i, 585. in asthma, i, 585. Liquorice. See Licorice. Liriodendron tulipifera in malarial disease, i, 585. Listerine, i, 585. Litharge. See Lead oxide under Lead. Lithium, i, 585. in gout and lithiasis, i, 585, 586. salicylate in acute articular rheumatism, ii, 145. salicylate in fever, ii, 145. Lithontriptics, i, 585. Lobelia, i, 586. in asthma, i, 587. " " as an expectorant, i, 95. " bronchial cough, i, 587. " chorea, i, 587. " convulsions, i, 587. " epilepsy, i, 587. (enema) in fascal impaction, i, 587. infusion of, in intestinal intussusception, i, 587. infusion of, in strangulated hernia, i, 587. in habitual constipation, i, 587. " spasmodic croup, i, 587. " tetanus, i, 587. " whooping-cough, i, 587 Lobeline, i, 587. Loco-weed, i, 587. Logwood, i, 588. London paste, ii, 303. GENERAL INDEX. 503 Lorctin, i, 588. in cancer, i, 588. Losophan, i, 589. in acne, i, 589. " clironic eczema, i, 589. " prurigo, i, 589. " pruritus, i, 589. " rosacea, i, 589. " sycosis, i, 589. " tinea tonsurans, i, 589. " " versicolor, i, 589. Lotions, i, 589. yellow mercurial, in chronic ulcers of the skin and in syphilis, i, 589. Lovage. See Ligusticum. Jjozenges. See Troches. Lupulin, i, 589. in nervousness from irritation of the blad- der, kidneys, or urethra, ii, 6. Lupuline, i, 474. Lupulus. See Humulus. Lycetol, i, 589. in gout and lithiasis, i, 589. Lycopodium, i, 589. in flatulent dyspepsia, i, 590. powder in excoriated surfaces, i, 590. tincture in incontinence of urine, i, 590. " " uric-acid deposits, i, 590. Lysol, i, 590. (injection) in dysentery, i, 590. in dyspepsia, i, 590. " eczema, i, 590. " gonorrhoea, i, 590. " inflammatory affections of the throat, i, 590. " leucorrhoea, i, 590. " lupus, i, 590. Lytta. See Cantharides. Mace, i, 590. Magendie's solution in asthma, i, 93. Magnesia and rhubarb in diarrhoea, i, 591. and the salts of magnesium, i, 590. as an antidote in sulphuric-acid poisoning, ii, 243. fluid, in colic, i, 591. in arsenical poisoning, i, 591. " burns, ii, 445. " headache of indigestion, i, 591. " phosphorus poisoning, ii, 76. " poisoning with acids, i, 591. Magnesium borocitrate, i, 591. carbonate as a dentifrice, i, 591. chloride, i, 591. citrate in fever of children, i, 591. hydrate and carbonate in poisoning with arsenic, i, 109. hydrate and carbonate in poisoning with corrosive sublimate, i, 109. hydrate and carbonate in poisoning with metallic salts, i, 109. hydrate and carbonate in poisoning with phosphorus, i, 109. salicylate in fevers, i, 591. silicate, i, 592. sulphate in early stages of dysentery, i, 592. Magnolia, i, 592. in colds, i, 592. " gout, i, 592. " intermittent fever, i, 593., Magnolia in malarial disease, i, 118. in rheumatism, i, 592. Malakin, i, 593. in croupous pneumonia, i, 593. " neuralgia, i, 593. " rheumatic fever, i, 592. Male fern. See Aspidium. Mallein, i, 593. Mallow. See Marshmallow. Malt, i, 594. extract in tuberculosis, i, 595. " " wasting diseases, i, 595. Maltine. See under Malt. Malto-carnis, i, 595. Maltose. See under Malt. Malva. See Marshmallow. Manaca, i, 595. in rheumatism, i, 595. " scrofula, i, 595. " syphilis, i, 595. Manganese, i, 595. and iron in amenorrhcea and chlorosis, i, 596. in chlorosis as an eminenagogue, i, 374., dioxide, in amenorrhcea or anaemia, i, 596. iodide, in aniemia, i, 596. oxide, in gastrodynia, i, 596. " " gastralgia, i, 596. " " pyrosis, i, 596. sulphate (ointment) in glandular indura- tions and in painful joints, i, 596. Mango, i, 597. Manna, i, 598. Mannitol hexanitrate. See bracketed section under Nitric acid. Maranta. See Arrowroot. Marrol, i, 598. Marrow, i, 598. in ansemia, i, 598, 599 ; ii, 445. " haemophilia, i. 598. " insanity, ii. 445. Marrubium. See Hobehound. Marshmallow, i, 599. in chafed or excoriated skin, i, 599. " inflammation of the mucous membranes, i, 599. " renal complications of children, i, 600. Massage, i, 600. abdominal, i, 603. " in ascitic accumulations, i, 608. " " dilatation of the stomach, i, 608 " gallstones, i, 608. " " intestinal inertia, i, 605, 608. " " jaundice, i, 608. " " suppression of urine, i, 608. k friction in bruises, in lacerated muscles or ligaments, and in traumatic synovitis, i, 609. a frictions, i, 603. douche, i, 603. effleurage, i, 601. electro-, i, 603. for cataract, i, 610. " chronic catarrh of the middle ear, i, 610. general, i, 603. " in functional dyspepsia, 1, 608. hydraulic, in rheumatism and paralysis, i, 603. in burns, i, 609. " chronic inflammatory processes of the an- terior segment of the eye, i, 610. 504 GBNEEAL INDEX. Massage in embolism of the central artery of the retina, i, 610. in fractures, i, 609. (neck) in headache, i, 608. in health, i, 607. (neck) in hemiorania, i, 608. (Brandt's method) in incontinence of urine, 1, 609. in insomnia, i, 608. " lateral curvature of the spine, i, 610. " locomotor ataxia, i, 608. " lumbago, i, 608. " muscular rheumatism, i, 608. " myositis, i, 608. " nervous disorders, i, 607. " neuralgia, i, 608. " " from impaired nutrition, i. 68. " palsy, i, 608. " pelvic disorders of women, i, 609. " pianist's cramp, i, 608. " prolapse and other malpositions of the uterus, i, 609. " rheumatoid arthritis, i, 608. " sciatica, i, 608. " spasmodic affections, i, 608. " sprains, i, 609. " surgery, i, 609. " telegrapher's cramp, i, 608. (in the Brand treatment) in typhoid fever, i, 000. in ulcers, i, 609. " vaso-motor paresis, i, 608. " writer's cramp, i, 608. mechanical, i, 603. of the ear for deafness, i, 610. " " " " the dislodgment of foreign bodies, i, 610. of the eye in asthenopia, i, 610. petrissage, i, 601. physiological effects of, i, 603. posture during, i, 600. tapotement, i, 603. therapeutics of, i, 606. Mastic, i, 610. Masticatories, i, 610. Mate, i, 611 ; ii, 368. Matieo, i, 611. in acute inflammation, i, 611. " cystitis, i, 611. " diarrhoea^ i, 611. " dysentery, i, 611. " epistaxis, i, 611. '■ gonorrhoea, i, 611. " hsematemesis, i, 611. " heematuria, i, 611. " hjemoptysis, i, 611. " leucorrhcBa, i, 611. " raenorrhagia, i, 611. Matricaria, i, 611. Matzol, i, 611. Matzoon, i, 611. as an antemetic food, i, 98. May-apple. See Pouophyllum. Meat powder, i, 333. Meconaroeine, i, 611. in broncho-pulmonary affections with cough, i, 611. " insomnia, i, 611. " neuralgia, i, 611. " the morphine habit, i, 611. Mediate treatment, i, 611. in syphilis, i, 613. Medication, rectal, i, 198. Medulladen, ii, 445. Medullary glyceride. See under Marrow (vol. ii, page 599). Meiotics, i, 613. Mel. See Honey. Melilotus, i, 613. Melissa, i, 613. ' as a diaphoretic in fever, i, 613. Menispermum, i, 613. Menthacetic ether, i, 613. Mentha piperita, i, 613. (oil) externally in acute rheumatism, i, 613. " " " arthralgia, neuralgia, etc., i, 613. in abdominal pain, i, 613. " colds, i, 613. (infusion) in colic and flatulence, i, 613. (poultice) in diarrhoea, i, 613. (infusion) in dysmenorrhoea, i, 613. inhalation of vapour of, in pulmonary tu- berculosis, i, 614. (poultice) in nausea, i, 613. in rheumatism, i, 613. (oil) in toothache, i, 613. to promote the menstrual flow, i, 618. Mentha viridis, i, 614. Menthiodol. See under Menthol. Menthol, i, 614. as a local amiesthetio, i, 614. in croup, i, 529. " diarrhoea, i, 614. in furuncle of the external auditory meatus, i, 616. inhalation in chronic nasal catarrh, i, 539. in headache, i, 614. " nervous dyspepsia, i, 614. " neuralgia, i, 614. " otitis media, i, 616. " pruritus, i, 614. " toothache, i, 136. . " whooping-cough, i, 539 ; ii, 445. plaster in neuralgia (mild forms), i, 614. solution (by injection) in dyspnoea of phthi- sis, i, 615. solution (by injection) in hay fever and nasal catarrh, i, 614. solution (by injection) in laryngeal and pul- monary affections, i, 614. solution (by injection) in pulmonary tuber- culosis, i, 614. solution (by injection) in ulceration of the larynx, i, 614, 615. Mentho-phenol, i, 616. in abscess, i, 616. " facial ervsipelas, i, 616. " otitis, i, 616. " phagedEenic chancroid, i, 616. " syphilis, i, 616. " toothache, i, 616. Mercauro, i, 454. in syphilis, i, 454. Mercurial purge at the beginning of a course of quinine, i, 117. Mercuric cyanide in diphtheria, i, 323. Mercury, i,'617. ammoniated, in psoriasis, i, 627. " " syphilitic eruptions, i, 627. GENERAL INDEX. 505 Mercury, ammoniated. in tinea, i, C27. ammoniated, ointment of, in treatment of pedieuli, i, 116. and oantharidin in syphilis, i, 621. " potassium iodide in neuralgia caused by syphilis, i, 69. " zino cyanide, i, 322 ; ii, 409. as a cholagogue, i, 618, 619. " diuretic, i, 618. as an alterative, i, 617. bichloride, as a germicide, i, 447. " as an antisyphilitic, i, 626. " as a parasitic, i, 626. " (small doses) as a systemic tonic, i, 625. bichloride, in chronic skin disease, i, 626. " " deficient secretion of bile, i, 626. bichloride (small doses), in diphtheria, i, 626; ii, 221. bichloride, in gastric fermentation, i, 626. " (injections) in gonorrhoea, i, 531. bichloride, in lentigo, i, 626. " " malignant onychia, i, 626. " " " pustule, i, 626. " " naevi, i, 636. " " ringworm, i, 117. " " " of the scalp, i, 626. " " telangeiectases, i, 626. ' " " treatment of poisoning, i, 625. " (solution), surgical employment of, i, 626. biniodide, as a germicide, i, 447. by fumigation, i, 621. " intravenous injection, i, 621. " inunction, i, 621. chlorides, i, 624. chronic poisoning with, iodides in, ii, 214. compound pill of subchloride of, in chronic rheumatic or gouty conditions, i, 625. compound pill of subchloride of, in syphi- litic skin diseases, i, 625. fumes of, in laryngeal diphtheria, i, 530. hypodermioally, i, 621. in angina pectoris, i, 620. sine dolore, i, 620. " biliousness, i, 619. " diarrhoea, i, 619. " gout, i, 619. " heart disease, i, 620. " inflammations of serous membranes, i, 619. " intestinal dyspepsia, i, 619. " iritis, i, 619. " rheumatism, i, 619. " skin diseases, i, 619. " syphilis, i, 630, 621. " whooping-cough (Rabinschek's method), ii, 446. (subcutaneous injections) in tetanus, ii, 446. iodide and arsenic in chronic gout, i, 627. " " " " " rheumatism, i, 627. iodide and arsenic in lepra, lupus, psoriasis, and venereal eruptions, 1, 627. iodide in late syphilis, i, 637. liniment, in chronic glandular enlargemer.ts and indurations, i, 638. metallic, i, 621. nitrate, for moles and njevi, i, 638. Mercury, nitrate, in phagedaenic and syphilitic ulcerations, i, 638. nitrate, in ulcers of the cervix uteri, i, 628. " ointment in eczema, psoriasis, and ulcerative conditions, i, 628. ointment in acute and subacute articular in- flammation, i, 622. ointment in epididymitis, i, 623. " " general peritonitis, i, 632. " " infantile syphilis, i, 632. " (inunction) in local indurations and enlargements, i, 622. ointment (inunction) in enlargement of the lymph glands, i, 633. ointment in orchitis, i, 632. " (inunction) in syphilis, i, 622. oleate, i, 624. " and ether in treatment of pedieuli, i, 116. oleate, in ringworm, i, 117. " " syphilis, i, 624. oxides, i, 623. oxide (ointment) in acute conjunctivitis, i, 633. " " " chronic marginal blepha- ritis, i, 623. oxide (ointment) in chronic rhinitis, i, 633. " " " eczema of the lids, i, 623. " " " phlyctenular ophthal- mia, i, 623. plaster in pitting of small-pox, i, 623. " " syphilitic nodes, i, 623. red iodide, in syphilitic ulcers, i, 637. " oxide (ointment) in parasitic skin dis- ease, i, 623. red oxide (ointment) in ringworm of the scalp, i, 633. red oxide (ointment) in venereal ulceration, i, 623. sozoiodolate in parasitic skin disease, ii, 215. " " skin disease, ii, 215. " " syphilitic ulcers, ii, 215. subchloride (ointment) in skin diseases, i, 635. sulphates, i, 628. tannate, ii, 259. " in syphilis, ii, 259. with chalk in diarrhoea, i, 623. " " " intestinal disorders, i, 628. " " " syphilis of children, i, 622. Metadihydroxybenzene. See Resoroin. Metaldehyde, i, 628. Methacetin, i, 628. Methoxycaifeine, i, 628. as a local anEesthetio, i, 688. in migraine, i, 628. " neuralgia, i, 628. Methyl, i, 629. alcohol, i, 638. chloride, i, 638. " in lumbago, i, 69. " " neuralgia, trigeminal, i, 69. " " sciatica, i, 69. ether, i, 628. iodide, i, 629. nitrate. See under Nitric acid, bracketed section, salicylate, i, 639 ; ii, 146. violet. See under Pyootantnb. Methvlaeetanilide. See Exalgine. Methylal, i, 629. 506 GENERAL INDEX. Methylal as a hypnotic, i, 629. inhalation in asthma, i, 629. " " neuralgia, i, 629. in insomnia, i, 629. " neuralgia (by the mouth and hypodermic- ally), i, 69. " tetany, i, 629. Methylene blue, i, 629. in amoebic dysentery, i, 630. '• beri-beri, i, 630. " chronic cystitis, i, 630. " gonorrhosa, i, 630. (by the stomach or hypodermioally) in gout, i, 629. in malarial disease, i, 630. " neuralgia, i, 630. " neuralgic pains of chronic malarial origin, i, 68. " posterior spinal sclerosis, i, 630. (by the stomach or hypodermioally) in sci- atica, i, 629. (by the stomach or hypodermioally) in syno- vitis, i, 629. Methylpyrocatechin. See Guaiacol. Mezereon, Mezereura, i, 630. in cutaneous disorders, i, 630. " rheumatism, i, 630. " syphilis, i, 630. Mica panis, i, 630. Miorocidine, i, 630. Migrainin, Migranin, i, 631. in headache of influenza, i, 631. '■ migraine, i, 631. Millc, i, 631. adulteration, i, 637. and limewater as an antemetic, i, 98. as a food, i, 426. condensed, i, 633. cream, i, 635. dietetic uses of, i, 633. efEect of food and drugs on the, i, 632. in diabetes, i, 337, 636. infant feeding with, i, 633. in parenchymatous nephritis, i, 637. " poisoning with alkaline salts, i, 109. " " " metallic salts, i, 109. ' " scarlet fever, i, 335. modified, i, 635 ; ii, 447. peptonized, ii, 69. " in cancer of the intestines, i, 836. peptonized, in nausea, i, 98. pi'eservation of, i, 632. production of disease through, i, 632. Mineral acids in treatment of taenia, i, 101. in vomiting, i, 100. oils, ii, 31. waters. See Waters, Mineral. Mint. See Mentha piperita and Mentha VIRIDIS. Mistletoe. See VisouM album. Mixtures, i, 643. MoUin, i, 127, 643. Momordica. See Elateridm. Monobroraacetanilide. See Antisepsin. Monochloracetic acid. See under Chloracbtio ACID. Monoehlormethane. See Methyl chloride, un- der Methyl. Monochlorphenol. See under CnLOROPHENOLS. Monophenethydrin. See Apolysine. Moringa, ii, 447. as a counter-irritant, ii, 447. '• an emmenagogue, ii, 447. in chronic rheumatism, ii, 447. " jaundice, ii, 447. Morphine. See under Opium. and atropine in hepatic colic, i, 67. '• " " inflammation of the sciatic nerve, i, 67. and atropine in lead colic, i, 67. " " " renal colic, i, 67. " " " spasmodic dysmenorrhoea, i, 67. as a cardiac stimulant, ii, 38. " hypnotic, i, 508. as an adjuvant to expectorant mixtures, i, 419. biraeconate in asthma, i, 93., in angina pectoris, i, 67 ; ii, 36. " asthma, i, 93. " Bright's disease, ii, 37. " chronic alcohol poisoning, ii, 87. " delirium of nervous exhaustion in acute fevers, ii, 37. (small doses) in diarrhceai ii, 38. in dysentery, ii, 38. " dyspnoea, ii, 37. " heart disease, ii, 36. " hysterical anorexia, ii, 88. (subcutaneously) in mitral insufficiency, ii, 36. " " " stenosis, ii, 36. in peritonitis, ii, 38. " ursemic convulsions, ii, 87. valerianate, ii, 846. Morrhuol, i, 643. Morns. See Mulberry. Mosohus. See Musk. Moss, Iceland. See Cetraria. Irish. See Ohondrus. Motor depressants, i, 643. Moussena, i, 645. Moussenine, i, 645. Movement cure. See under Exercise, (vol. i, page 413). Mucilages. See Demulcents. Mucuna, i, 645. in Ascaris lumbricoides, i, 103. " treatment of teenia, i, 103. Mulberry, i, 645. Mullein. See Verbascum. Miiller's fluid, ii, 95. Muriatic acid. See Hydrochloric acid. ether. See Ethyl chloride. Muscale buttons. See Anhalonium Lewinii. Muscarine, i, 645. as a meiotic, i, 612. •' an anthidrotic, i, 103. in belladonna poisoning, i, 645. " cholera infantum, i, 645. " diabetes insipidus, i, 645. " gout, i, 645. " hiccough, i, 645. " laryngismus stridulus, i, 645. " meningitis, i, 645. " paralysis of respiration, i, 645. " pertussis, i, 645. " spasmodic affections, i, 645. cough, i, 645. Muscle extract in muscular dystrophies, i, 81. GENERAL INDEX. 507 Musk, i, 645. in adynamic pneumonia of drunkards, i, 645. " obstinate hiccough, ii, 6. " sudden nervous depression, ii, 6. " typhoidal disease, i, 645. root. See Sumbul. Mussana, Mussanine, Mussena, Mussenine. See MOUSSENA. Mustard, i, 646. and molasses in dyspepsia with constipation, i, 646. as a counter-irritant, i, 646. " deodorizer, i, 647. as an antiseptic, i, 647. " emetic, i, 647. as a rubefacient, i, 646. bath, hot, in eruptive fevers, i, 647. foot bath, hot, in amenorrhoea, i, 647. " " " " headache due to indiges- tion, i, 647. plaster (applied to chest and lungs) in bron- chitis, i, 647. plaster (applied to the abdomen) in diarrhoea, i, 647. plaster (applied to the stomach) in nausea, i, 98, 647. plaster in neuralgia, i, 647. poisoning, i, 648. Mutton suet. See Suet, Mydriatics, i, 649. effects of, i, 650. in glaucoma, i, 651. " iritis, i, 650. Mydrin, i, 651. Mydrol, ii, 447. as a mydriatic, ii, 447. in blepharospasm, ii, 447. " ciliary and supraciliary pain, ii, 447. " lacrymation, ii, 447. Myelotherapy. See under Sekum treatment (vol. ii, page 187). Myotics. See Meiotics. Myrcia, i, 651. Myristica. See Nutmeg. Myronin, i, 651. Myrrh, i, 651. tincture of (internally), in amenorrhcea, i, 651. " " (locally), in aphthous inflamma- tion, i, 651. tincture of (internally), in catarrhal gastritis, i, 651. tincture of, in diphtheria, i, 652. - " " (internally), in gastralgia, i, 651. " " (locally), in indolent ulcers, i, 651. " " in leucorrhoea, i, 651. " " (locally), in Riggs's disease, i, 651. " " (locally), in sore throat, i, 651. " " (locally), in spongy gums, i, 651. Myrrholin, i, 652. in laryngeal and pulmonary phthisis, i, 652. Myrtillin, ii, 447. Myrtol, i, 652. in chronic catarrh, i, 653. " bronchitis, i, 653. " weak digestion, i, 653. Napelline, ii, 1. Naphthalan, ii, 447. in chronic eczema, ii, 448. " diabetes, ii, 448. 76 Naphthalan in eczema, ii, 448. in prurigo, ii, 448. " pruritus, ii, 448. " syphilis (by inunction), ii, 448. " ulcer of the leg, ii, 448. Naphthalene, ii, 1. in bronchorrhoea, ii, 1. " cystitis, ii, 1. " diarrhoea, ii, 1. " dysentery, ii, 1. " foetid bronchitis, ii, 1. " pyelitis, ii, 1. " roundworms, ii, 1. " scabies, ii, 1. " seat worms, ii, 1. " treatment of wounds, ii, 1. " typhoid fever, ii, 1. " ulcers, ii, 1. " whooping-cough, ii, 1. Naphthalol. See Betol. Naphthol, ii, 3. as an antiseptic, i, 448. camphorated, ii, 3. " in ozsena, ii, 3. " " tuberculosis, ii, 2. " " tuberculous ulceration of the tongue, ii, 3. in cholera, ii, 2. (by insufllation) in chronic suppuration of the ear, ii, 3. in diarrhoea, ii, 3. " dilatation of the stomach, ii, 3. " dysentery, ii, 2. " foul ulcers, ii, 2. " gastric fermentation, ii, 3. (in solution) in hyperidrosis, ii, 3. in influenza, ii, 2. " typhoid fever, ii, 1. Lassar's, paste, ii, 64. ointment in scabies, ii, 3. " " tinea ciroinata, ii, 3. plaster in ringworm, i, 117. salicylate. See Bbtol. Naphthosalol. See Betol. Narceine. See under Opium. Narcotics, ii, 3. Naregamia alata, ii, 5. in catarrhal affections, in indigestion, and in rheumatism, ii, 5. Natrium. See Sodium. Neotandra. See under Bebeerine. Nerium, ii, 5. as a cardiac tonic, ii, 5. in epilepsy, ii, 5. Nervines, ii, 5. Nervous substance. See under Animal ex- tracts AND JUICES, dose and administration, i, 81. ' in epilepsy, i, 80. " functional and organic nervous disorder, i, 80. " insomnia, i, 80. " neurasthenia, i, 80. " paralysis, bulbar, i, 80. " tabes dorsalis, i, 80. Neurodin, ii, 7. in intestinal pain, ii, 7. " neuralgia, ii, 7. " " of the bladder and stomach, ii, 7. 508 GENERAL INDEX. Neurodin in pains in the arms (from spinal ir- ritation), ii, 7. in sciatica, ii, 7. Niootiana, Nicotine. See Tobacco. Nitrates. See under Nitric acid. effects of, in cardiac pain, ii, 9. " " in chronic Bright's disease, ii, 10. Nitre. See Potassium nitrate. Nitric acid, ii, 7. and quinine in intermittent fever (with he- patic engorgement), ii, 8. as a germicide, i, 446. in cancrum oris, i, 227 ; ii, 7. " chancroids, ii, 7. " chronic bronchitis, ii, 8. " " cervical endometritis, ii, 7. " " cystitis, ii, 7. " cirrhosis of the liver, ii, 8. " colliquative diarrhoea, ii, 8. " condylomata, i, 227. " constitutional syphilis, ii, 8. " dyspepsia with phosphatic urine, ii, 8. " hsemorrhage, ii, 7. " haemorrhoids, ii, 7. " hospital gangrene, ii, 7. " intra-uterine granulations, ii, 7. " lithsemia, ii, 8. " oxaluria, ii, 8. " phagedaena, i, 227. " phagedaenio ulcers, ii, 7. " small fibroid tumours, ii, 7. " summer diarrhoea, ii, 8. " syphilis, ii, 8. " venereal ulcerations, i, 237. " warts, i, 337; ii, 7.^ " whooping-cough, ii, 8. Nitrites, ii, 11. dose and administration of, ii, 13. effects of, on the bowels and stomach, ii, 12. " " " kidneys, ii, 12. " " " " nervous system, ii, 13. " " " " perspiration, ii, 13. " " " " respiration, ii, 12. " " " " temperature, ii, 13. reduction of the blood-pressure by, ii, 13. some of the, compared, ii, 13. therapeutic uses of the, ii, 13. Nitrobenzene, ii, 13. Nitrogen, ii, 14. inhalation in chronic pneumonia, ii, 14. monoxide in asthma, i, 538. " " pulmonary tuberculosis, i, 528. " " spasmodic affections, i, 538. " " whooping-cough, i, 528. Nitroglycerin, ii, 14. dose and administration of, ii, 15. effects of, ii, 14, 15. in anaamia, ii, 15. " angina pectoris, ii, 15. " asthma, i, 95. " Bright's disease, ii, 15. " cardiac dyspnoea, ii, 15. " dyspnoea, ii, 10. " gastralgia, ii, 15. " headache due to anaemia of the brain, ii, 15. " hepatic colic, ii, 15. " hiccough, ii, 15. " intermittent fever (cold stage), ii, 15. " laryngismus stridulus, ii, 15. Nitroglycerin in migraine, ii, 15. ,, . »„ in neuralgia (as a nerve stimulant), i, o9 ; " neuralgia of the trigeminal nerve, ii, 15. " Raynaud's disease, ii, 10. " reflex vomiting, ii, 15. " renal colic, ii, 15. " sciatica, ii, 15. " seasickness, i, 99 ; ii, 15. " spasmodic asthma, ii, 15. " " contraction of the arteries, i, 133. " tetanus, ii, 15. " whooping-cough, ii, 15. Nitrohydrochlorie acid, ii, 16. as an escharotic, ii, 16. in acne, ii, 16. (sponging) in cachexia of children, ii, 16. in constitutional syphilis, ii, 16. " cutaneous affections, ii, 16. " digestive disorders, ii, 16. " diseases of the liver, ii, 16. " dropsy, ii, 16. " dysentery, ii, 16. (sponging) in jaundice, 11, 16. in syphilis, ii, 16. " xanthelasma, ii, 16. Nitrous oxide, ii, 16. administration of, ii, 18. death from inhalation of, ii, 448. in extraction of teeth, ii, 17. " melancholia, ii, 18. " nervous exhaustion, ii, 18. " labour, ii, 18. " minor operations of short duration, ii, 18. physiological action of, ii, 17. water, ii, 18. Nosophene, ii, 18. in balanoposthitis, ii, 19. " dry rhinitis, ii, 19. " nasal diphtheria, ii, 19. " rhinitis witli excessive secretion, ii, 19. " soft chancre, ii. 19. " traumatic weeping eczema, ii, 19. Nuclein, spleen, in tuberculosis, ii, 34. yeast, in amygdalitis, ii. 24. " " indolent ulcer, ii, 34. " " pharyngitis, ii, 24. " " tuberculosis, ii, 24. Nuoleins, ii, 19. dose and administration of, ii, 25. germicidal properties of the, ii, 23. " value of, in the treatment of dis- ease, ii, 33. in anasmia, ii, 24. " bronchitis, ii, 24. " chronic Bright's disease, ii, 34. " " eczema, ii, 34. " diphtheria, ii, 23, 35. " general debility, ii, 24. " hip-joint disease, ii, 34. " influenza, ii, 24. " malarial poisoning, ii, 24. " neurasthenia, ii, 35. " naso-pharyngeal catarrh, ii, 34. " night sweats, ii, 34. " pleurisy, ii, 34. " pneumonia, ii, 34. (protonuclein) in progressive anaemia, ii, 448. in scarlet fever, ii, 35. GENERAL INDEX. 509 Nucleins in tuberculous adenitis, ii, 35. raanner of extracting, ii, 20. prevention of disease by the use of, ii, 23. therapeutics of, ii, 22. Nutgalls. See Galls. Nutmeg, ii, 25. (oil) as a rubefacient, ii, 35. (powdered) in colic of infants, ii, 25. in enteritis, ii, 35. " gastralgia, ii, 25. " nausea, ii, 25. (oil) in neuralgia (as a rubefacient), ii, 25. " " rheumatism (as a rubefacient), ii, 35. Nutrose, ii, 449. in convalescence from scarlet fever, diph- theria, measles, or pneumonia, ii, 449. Nux vomica, ii, 20. in amblyopia, ii, 29. " cardiac failure, ii, 28. " " " during chloroform anaes- thesia, ii, 450. (tincture) in diarrhoea (due to atony of the bowels), ii, 28. in flatulence, ii, 28. " flatulent dyspepsia, ii, 38. " frontal headache, ii, 28. " gastric catarrh, ii, 28. (extract) in habitual constipation, ii, 28. in headache of gastric origin, ii, 28. (injections) in "insolation" of the eyes, ii, 39. in morning vomiting of drunkards, ii, 38. " nervous cough, ii, 38. " neuralgia from impaired nutrition, i, 68. " pneumonia, ii, 450. " pulmonary tuberculosis, ii, 449. " pyrosis, ii, 38. (small doses) in vomiting associated with gastric atony, i, 99. in vomiting of phthisis, ii, 38. " " " pregnancy, ii, 28. physiological action of, ii, 26. poisoning, eucalyptus in, ii, 435. therapeutics of, ii, 38. Oak bark, ii, 30. in diarrhcea, ii, 31. " flabby ulceration, ii, 31. (enema) in hseraorrhoids, ii, 31. in hyperidrosis, ii, 31. (injections) in leucorrhcea, ii, 31. Oatmeal, ii, 31. in chronic constipation, ii, 31. Odontine, ii, 31. Odontol, ii, 31. in toothache, ii, 31. Oils, ii, 31. fixed, ii, 33. in poisoning with alkalies, i, 109. " " " corrosive salts, i, 109. " " " carbolic acid, i, 109. " " " metallic salts, i, 109. mineral, ii, 31. volatile, ii, 33. Ointment mulls, ii, 33. Ointments, ii, 33. Oleander. See Nemum. Oleates. See under Oleic acid. Oleoresins, ii, 34. Oleum cadinum, ii, 34. Olibanum, ii, 34. Olibanum in bronchitis, ii, 34. in laryngitis, ii, 34. Olive oil, ii, 34. as an enema, ii, 33. for the protection ot raw surfaces, ii, 35. in biliary colic, ii, 35. " wasting diseases, ii, 35. Opium, ii, 35. and belladonna in uterine pain, i, 67. " cannabis indica in uterine pain, i, 67. " its derivatives, i, 67. as a hypnotic, i, 508. as an adjuvant to expectorant mixtures, i, 419. as a narcotic, ii, 3. chronic poisoning with, ii, 44, 45, 46. fumes in asthma, i, 539. " " bronchitis, i, 539. " " cardiac pain, i, 539. " " laryngitis, i, 539. " " thoracic pain, 1, 539. " " whooping-cough, i, 539. by hypodermic injection, in the early stages of meningitis, i, 67. (as a stimulant) in adynamia, ii, 226. (small doses) in bronchitis, ii, 37. in collapse from cholera, ii, 36. " excessive intestinal peristalsis, i, 67. " diarrhoea of typhoid fever, ii, 36. '• enfeeblement, ii, 35. " hfemoptysis, ii, 35. " haemorrhage, ii, 450. " haemorrhage from typhoid ulcer, ii, 36. " hectic fever of phthisis, ii, 36. (small doses) in inflammation of the sciatic nerve, i, 67. " insomnia due to cardiac dyspnoea, i, 508. " intestinal spasm, i, 133. (as a stimulant) in low fever, ii, 225. in nausea, i, 99. " neuralgia, i, 69. " pain, ii, 37. " pain from enteritis, i, 67. " " from rheumatism, i, 125. (small doses) in pleurisy, ii, 37. " " " pneumonia, ii, 37. in prostration from hsemorrhage, ii, 35. in tenesmus, i, 67. " vomiting, i, 99. poisoning, ii, 40, 41, 42, 43, 44. vinegar of, in asthma, i, 93. wine of, in asthma, i, 93. Opodeldoc, ii, 46. Oranges. See Aueaktium. Orchitic extract. See Animal extracts and juices. Orchitic liquid, i, 73. administration and dose, i, 76. in cancer, i, 75. " contractures, i, 76. " chorea, i, 75. " debility, i, 76. " diabetes mellitus, i, 75. " epilepsy, i, 76. " hysteria, i, 76. " hystero-epilepsy, i, 76. " impotence, i, 76. " leprosy, i, 75. " locomotor ataxia, i, 74. " neurasthenia, i, 76. " nocturnal emissions, 1, 76. 510 GENEliAL INDEX. Orohitio liquid in nocturnal incontinence of children, i, 76. in senility, premature, i, 76. " skin diseases, i, 75. " tuberculosis, i, 74. Orexine hydrochloride, ii, 46. in anaemia, ii, 451. " anorexia, ii, 46. " gastric catarrh, ii, 451. " incipient phthisis, ii, 451. " vomiting of pregnancy, ii, 451. Organic extracts. Organotherapy. See Animal EXTEAOTS AND JUICES. Origanum, ii, 46. Orotherapy, ii, 451. Orphol, ii, 46. in diarrhoea (of children), ii, 46. Orrhotherapy, ii, 451. Orris root, ii, 46. Orthine, ii, 47. Orthochlorophenol. See under Chloeophe- NOLS. Oryza sativa. See Rice. Osmic acid, ii, 47. as a hardening and staining agent, ii, 47. injections in muscular rheumatism, ii, 47. " " intercostal neuralgia, ii, 47. " " sciatica, ii, 47. therapeutics of, ii, 47. Osmium hydroxide. Osmium tetroxide. See Osmic acid. ■Ouabain, ii, 48. in whooping-cough, ii, 48. 'Ovarine, ii, 48, 451, Ovarian juice, Ovarian substance, in amenor- rhcea, in chlorosis, and in disturbances following the menopause and oophorec- tomy, ii, 451. Ovi albumen, Ovi vitellus. See under Eggs. Oxalic acid, ii, 48. as a corrosive poison, ii, 48. as an emmenagogue, i, 367 ; ii, 49. in dysmenorrhoea, ii, 49. " strangulated hernia, ii, 49. treatment of poisoning with, ii, 48. Oxalis, ii, 49. ■Ox-bile, Ox-gall, ii, 49. ■Ox-bile enema in ftecal impaction, ii, 49. in habitual constipation, ii, 49. " intestinal dyspepsia, ii, ■49. " malnutrition, ii, 49. Oxygen, ii, 49. and ether for anaesthesia, ii, 53. biological relations of, ii, 49. ethereal, ii, 50. in acute lobar pneumonia, ii, 53. " anaemia, ii, 52. I (injections) in ascites, ii, 453. in asphyxia, ii, 53. " capillary bronchitis of children, ii, 53. ■" chlorosis, ii, 52. " chronic suppurative otitis media, ii, 451. " collapse due to acute disease, ii, 53. " coma, ii, 52. " croup, ii, 52. " diabetes, ii, 53. " diphtheria, ii, 53. (as a stimulant) in dyspnoea of cardiac or pulmonary origin, ii, 336. in gangrene, ii, 51. Oxygen in gout, ii, 53. ^ in hypochondriasis, ii, 53. (as a stimulant) in indolent ulcers, ii, 51. in infected wounds, ii, 51. " insomnia due to mental fatigue, ii, 53. " leucaemia, ii, 53. " narcotic poisoning, i, 537. " neurasthenia, ii, 53. " neurotic dyspepsia, ii, 53. " ozaena, ii, ■451. " pernicious anaemia, ii, 52. " prostration due to acute disease, ii, 53. " pulmonary tuberculosis, ii, 52. " purulent discharges from the antrum of Highmore, the frontal sinuses, or the ■ ethmoid cells, ii, 452. " rhachitis, ii, 52. " scrofulosis (of children), ii, 52. " sloughing, ii, 51. " surgical anaesthesia, ii, 53. " syphilitic rupia, ii, 52. " temporary obstruction of the air-passages, i, 527. " toxic narcoses, ii, 53. " tuberculosis, ii, 53. " tuberculous ulcer, ii, 53. medical history of, ii, 50. physiological effects of, ii, 51. preparation and administration of, ii, 50. therapeutics of, ii, 51. triatomio, as a germicide, i, •445. Oxygenated water and hydrogen-dioxide solu- tion (by inhalation) in chronic gastric ca- tarrh, ii, 52. (locally through the stomach-tube) in gastro- intestinal catarrh, ii, 53. Oxymels, ii, 54. Oxynaphthoic acid, ii, 54. Oxyquinaseptol. See Diaphtherin. Oxysparteine, ii, 54. Oxytocics, ii, 54. Oyster shell. See Testa pe^paeata. _ Ozone, ii, 56. as a disinfectant, i, 445. chemistry of, ii, 56. in diabetes, ii, 58. " diphtheria, i, 445. " gout, ii, 58. " pernicious anaemia, ii, 58. inhalation in asthma, ii, 58. " " bronchitis, ii, 58. " cholera, ii, 58. " diphtheria, ii, 58. " " emphysema, ii, 58. " " ozaena, ii, 58. " " pulmonary tuberculosis, ii, 58 " " whooping-cough, ii, 58. preparation and properties of, ii, 56. physiological effects of, ii, 57. therapeutics of, ii, 58. Pack, wet, in cardiac disorders, i, 490. in diabetes, i, 490. " gout, i, 490. " organic cardiac disease, i, 490. " rheumatism, i, 490. Palmetto wine, ii, 58. as a tonic, ii, 58. in amygdalitis, ii, 58. " bronchitis, ii, 58. GENERAL INDEX. 511 Palmetto wine in follicular pharyngitis, ii, 58. Painbotano, ii, 58. as a stomachic tonic, ii, 58. in fever of tuberculosis, ii, 58. " influenza, ii, 58. " malarial disease, ii, 58. " typhoid fever, ii, 58. Pancreatic emulsion, ii, 59. in tuberculosis, ii, 59. extract. See IPancreatin and under Ani- mal EXTRACTS AND JUICES. extract, i, 80. extract in pancreatic diabetes, i, 80. Panoreatin, ii, 59. Pansy. See Viola trioolok. Papain, Papaiva. See under Papaw. and sodium bicarbonate (as a dusting pow- der) in unhealthy sores and sloughing tis- sue, ii, 60. in accumulation of cerumen in the ear, ii, 60. " dilatation of the stomach, ii, 60. ■ " diphtheria, ii, 60. " dysentery, ii, 60. " gastric catarrh, ii, 60. " roundworms, ii, 60. " ta;nia, i, 103. Papaver. See Poppy. Papaw, ii, 59. as a gastric sedative, ii, 60. in fissure of the tongue, ii, 60. " gastric irritation, ii, 60. ■" syphilitic ulcerations of the tongue, ii, 60. " ulcer of the stomach, ii, 60. " warty growths, ii, 60. Para-acetphenetidine. See Phenaoetinb. Parabromaoetanilide. See Antisepsin. Parachlorophenol, Pharachlorphenol. See un- der Chlorophenols. Paraohlorphenol, topically, in lupus, i, 246. Paracotoin, Paracotoinic acid. See under Goto BARK. Paraeresalol, Paracresol salicylate, ii, 60. Paracresalol as an intestinal antiseptic, ii, 60. Paraffin, ii, 60. Paraform, ii, 61. as an intestinal antiseptic, ii, 60. in cholera, ii. 61. " cholera infantum, ii, 61. " typhoid fever (incipient stage), ii, 61. (diluted) in wounds and ulcers, ii, 61. Paraldehyde, ii, 61. as a hypnotic, i, 509. dose and administration of, ii, 63. habit, ii, 62. in asthma, ii, 62. " broncho-pneumonia, ii, 63. " Cheyne-Stokes respiration associated with broncho-pneumonia, ii, 63. " delirium tremens (early stages), ii, 63. " hysteria, i, 509. " insanity, ii, 62. " insomnia of insanity, ii, 62. " " " mania, i, 509. " puerperal convulsions, ii, 63. poisoning with, ii, 61. therapeutics of, ii, 63. Parasiticides. See Antiparasitics and An- thelmiitthics. _ Parataloid. See Tuberculin. Paregoric, ii, 63. Paregoric in diarrhoea, ii, 63. Pareira, ii, 63. in chronic cystitis, ii, 63. Parilla, yellow. See Menispermum. Paris green. See under Arsenic. Parodyne. See Antipyrine. Parsley. See Petroselinum and Apiol. Parsley camphor in dysmenorrhoea, i, 137. in intermittent fever, i, 137. Parthenicine, ii, 63. Parthenine, ii, 63. Paste, Canquoin's, ii, 64. Latour's, ii, 64. Smith's, in cancer, ii, 64. Vienna, ii, 64. Pastes, ii, 63. Pastilles, Pastils, ii, 64. Paullinia. See Guarana. Peanuts. See Arachis. Pearson's solution, i, 146. Peat, ii, 65. (as a dusting powder) in foul-smelling ulcers, ii, 65. (as a dusting powder) in gangrene, ii, 65. Pectorals. See Expectorants. Pediluvium. See under Baths (vol. i, p. 169). Pelletierine, ii, 65. in paralysis of the third and fourth cranial nerves, ii, 65. " t»nia, i, 103. " worms, ii, 65. Pellitory. See Ptrbthrum. Pellotine, ii, 453. Pencils, ii, 66. Pennyroyal. See Hbdeoma. Pental, ii, 66. as a general anaesthetic, ii, 66. Pentane. See Amyl hydride. Pepo, ii, 68. Pepper, black. See Piper nigrum. cayenne. See Capsicum. Peppermint. See Mentha piperita. Pepsin, ii, 68. and bismuth in diarrhcEa, ii, 69. " codeine in gastralgia, ii, 09. for eructations, ii, 69. in atonic dyspepsia, ii, 69. " cancer of the stomach, ii, 69. " dyspepsia, ii, 69. " indigestion of phthisis, ii, 69. " lienterie diarrhoea, ii, 69. " mucous gastritis, ii, 69. " treatment of tienia, i, 101. " ulcer of the stomach, ii, 69. " vomiting of undigested food, ii, 69. solution (by spray) in diphtheria, ii, 69. Peptomangan, ii, 69. in ansemia of rhachitis, ii, 69. " chlorosis, ii, 69, 70. " phthisis, ii, 69. Peptonized beef, i, 43. gruel, i, 43. milk. See under Milk. milk as an antemetic, i, 98. " in nausea, i, 98. " punch, i, 42. Peptonizing tubes, i, 43. process for, i, 43. Permanganate of potassium in bromidrosis, i, 103. 513 GENERAL INDEX. Permanganate of potassium in unhealthy wounds, i, 446. of potassium in ulcers, i, 446. Permanganates, ii, 70. in aniemia, ii, 70. " bites of poisonous reptiles, ii, 70. " carbuncles, ii, 70. " delayed menstruation, ii, 70. (internally) in diphtheria, ii, 70. in flatulence, ii, 70. " hospital gangrene, ii, 70. (injections) in leucorrhcea, ii, 70. in obesity, ii, 70. (injections) in otorrhoea, ii, 70. " " ozaena, ii, 70. (internally) in scarlet fever, ii, 70. in ulcerating surfaces, ii, 70. Perosmic acid. See OsMic acid. Peroxide of hydrogen. See Hydeogen di- oxide. Petrolatum. See Vaseline. Petroleum, ii, 70. in chilblains, ii, 70. " psoriasis, ii, 71. " pulmonary affections, ii, 70. " rheumatism, ii, 70. " scabies, ii, 71. " tapeworm, ii, 71. Petroselinum, ii, 71. Phellandrium, ii, 70. as a sedative in cough, ii, 71. Phenacetine, ii, 71. as an anodyne, i, 68. in exhaustion from overwork, ii, 71. " gastralgia, ii, 71. " headache, ii, 71. " influenza, ii, 73. " insomnia of diseases of the uterus, ii, 71. " migraine, ii, 71. " neuralgia, i, 69 ; ii, 71. " neuritis, ii, 71. " rheumatism, for temporary relief of pain, i, 125. " sciatica, ii, 71. Phenates, ii, 73. Phenazone. See Antipybine. Phenedine, Phenetidine. See Phenacetine. Phenic acid. See Carbolic acid. Phenidine, ii, 73. PhenocoU, ii, 73. (as an analgetic) in acute articular rheuma- tism, ii, 72. in fever of influenza, ii, 72. " " " phthisical subjects, ii, 72. " malarial fever, ii, 72. " neuralgia, ii, 72. salicylate. See Salocoll. Phenol, ii, 72. as a germicide, i, 448. camphorated, ii, 73. injections in tetanus, ii, 452. iodized, ii, 73. Phenol sodique, ii, 73. in abrasions and wounds, ii, 78. Pheriosalyl, ii, 73. (internal application) in septic fever due to retained portions of placenta, ii, 73. Phenylaoetamide, ii, 73. in neuralgia, ii, 73. " rheumatism, ii, 78. Phenylaoetamide in the sequelae of. alcoholio excess, ii, 73. Phenylamine. See Analine. Phenyl formamide. See Poemanilide. Phenylhydrazine, ii, 74. liBvulinate, i, 134. Phenyl hydride. See Benzene. Phenyl salicylate. See Salol. Phenylio alcohol. See Caebolio acid. Phenylurethane. See Euphoeine. Phlebotomy, ii, 74. Phloridzin, ii, 74. as an antipyretic in malarial fevers, ii, 74. Phosphates. See Phosphokus. Phosphate of ammonium in rheumatism, ii, 78. in uric-acid conditions, ii, 78. " osteomalacia, ii, 78. " rickets, ii, 78. " tuberculosis, ii, 78. Phosphergot, ii, 74. Phosphide of zinc as a ^nic in anaemia, i, 68. Phosphides, Phosphites. See under Phos- PHOEHS. Phospho-albumin, ii, 74. in anaamia, ii, 74. " circulatory derangements of the climac- teric, ii, 74. " neurasthenia, ii, 74. " phthisis, ii, 74. Phosphoric acid as a germicide, i, 446. in chronic bone diseases, ii, 77. " " ulcers, ii, 77. " diabetes, ii, 77. " hysteria, ii, 77. " leucorrhcea, ii, 77. " phosphaturia, ii, 77. " sexual debility, ii, 77. Phosphorus, ii, 74. as a germicide, i, 440. " nutrient, ii, 75. " tonic, ii, 75. in acne, ii, 77. " cerebral atony, ii, 76. " " endarteritis, ii, 76. " " softening, ii, 76. " chronic eczema, ii, 77. " impotence, ii, 77. " insomnia of cerebral ansemia and malnu- trition, ii, 76. " locomotor ataxia, ii, 76. " lupus, ii, 77. " mania, ii, 76. " melancholia, ii, 76. " mental enfeeblement, ii, 76. " neuralgia of the asthenic type, ii, 76. " osteomalacia, ii, 77. " paralysis agitans, ii, 76. " " of cerebral origin, ii, 76. " pernicious anaemia, ii, 77. " pseudorleucasmia, ii, 77. " psoriasis, ii, 77. " rickets, ii, 77. " spinal sclerosis, ii, 76. poisoning with, ii, 75, 76. therapeutics of, ii, 76. Photoxvlin, Photoxylon, ii, 79. Phulluah, ii, 79. in frostbites and chilblains, ii, 79. " rheumatism, ii, 79. " sciatica, ii, 79. GENERAL INDEX. 613 Phulluah in sprains, ii, 79. Physiological action of drugs, ii, 80. antagonism, i, 86. salt solution, ii, 821. Physostigma, ii, 81. as a meiotio, i, 613. " motor depressant, i, 644. in haeraaturia, ii, 81. Physostigmine, ii, 81. salicylate in diarrhoea, ii, 146. " " dysentery, ii, 146. Phytolacca, ii, 81. in chronic eczema, ii, 81. " " rheumatism, ii, 81. " granular conjunctivitis, ii, 81. " inilammation of the lymphatic glands, ii, 81. " maramitis, ii, 81. " ulcers, ii, 81. Pichi, ii, 83. in cancer of the bladder, ii, 83. " cystitis, ii, 83. " hfematuria, ii, 83. " haemorrhage, ii, 83. " hepatic diseases, ii, 83. " prostato-cystitis following gonorrhoea, ii, 82. " renal colic, ii, 83. " urinary diseases, ii, 83. Picraena excelsa. See Quassia. Picric acid, ii, 82. as a test for albumin in the urine, ii, 83. in burns, ii, 83. " chronic diarrhoea, ii, 453. " diabetes mellitus, iii, 453. (locally) in eczema, ii, 83, 453. " " erysipelas, ii, 83, 453. in fissured nipples, ii, 83. (locally) in fungous endometritis, ii, 83. " " itching of the scrotum, ii, 453. " " lymphangeitis, ii, 83. in malarial disease, ii, 83. " putrid diarrhoea, ii, 453. " trichiniasis, ii, 83. Picrol, ii, 83. Picrotoxin, ii, 83. as an antiparasitic, ii, 84. in chorea, ii, 84. " colliquative sweating, ii, 84. " epilepsy, ii, 84. " night sweating of tuberculosis, ii, 84. " paralysis agitans, ii, 84. Pictet liquid, i, 527. Piliganine. See under Lycopodium. Pilocarpine, ii, 85. as a meiotic, i, 613. in asthma, i, 95. " broncho-pneumonia, ii, 86. " conjunctivitis, ii, 86. " croup, ii, 85. " croupous pneumonia, ii, 85. " diphtheria, ii, 85. " influenza, ii, 86. " Meniere's disease, ii, 87. " pneumonia due to influenza, ii, 86. " rhinitis, ii, 86. Pilocarpus. See Jaborandi and Pilocarpine. Pills, ii, 84. Pimenta, ii, 87. " in flatulence, ii, 87. Pimpernel, Pimpinella, ii, 87. Pine preparations, ii, 87. Pinkroot. See Spigelia. Pinol. See under Pine preparations. Pinus canadensis, ii, 88. in leucorrhcea, ii, 88. pumilio, oil of, in catarrh, ii, 88. " " " " rheumatism, ii, 88. silvestris. See under Pine preparations. strobus, ii, 88. " as an expectorant, ii, 88. Piper. See Piper nigrum. Piperazidine, Piperazine, ii, 88. Piperazine in cystic irritation, ii, 89. in diabetes, ii, 89. " gout, ii, 89. . " gravel, ii, 89. " lumbago, ii, 89. " renal colic, ii, 89. " rheumatism, ii, 89. " uric-acid accumulation, ii, 89. " " " diathesis, i, 586. poisoning with, ii, 89. Piperidine, ii, 90. in pulmonary tuberculosis, ii, 453, 454. Piperin, Piperine, ii, 90. in malarial disease, ii, 90. Piper nigrum, ii, 90. as a carminative, ii, 90. " haemostatic in small wounds, ii, 90. in malarial disease, ii, 90. Piperonal, ii, 90. Pipsissewa. See Chimaphila. Piscidia, ii, 90. (as an antispasmodic) in asthma, ii, 91. in bronchitis, ii, 91. " burns and scalds, ii, 91. " chorea, ii, 91. (as a sedative) in cough, ii, 91. in haemorrhoids, ii, 91. " hysteria, ii, 91. " nervous insomnia, ii, 91. " " irritability, ii, 91. " neuralgia, ii, 91. " pains of abortion, ii, 91. " phthisis, ii, 91. " spasmodic dysmenorrhoea, ii, 91. " toothache, ii, 91. (as an antispasmodic) in whooping-cough, ii, 91. Pistacia lentiscus, ii, 91. Pitch. See Pix burqundica, Pix canadensis, and Tar. Pituitary-body extract, ii, 91. in acromegaly, i, 81. Pix burgundiea, ii, 91. as a rubefacient, ii, 91. in pulmonary affections, ii, 91. " rheumatism, ii, 91. canadensis, ii, 91. liquida, ii, 91. " in chronic bronchitis, ii, 91. " " " cystitis, ii, 92. " " pulmonary affections, ii, 91. Pixol, ii, 93. in acute dermatitis, ii, 93. " psoriasis, ii, 93. " simple chancre, ii, 93. " wounds, ii, 93. Placebos, ii, 93. 514 GENERAL INDEX. Plaster of Paris, ii, 93. Plasters, ii, 92. Pleurisy root. See Asclepias tuberosa. Plumbum. See Lead. Pneumatic cabinet, i, 19, 20. resistance valves, i, 22, 23. tub. See under Air, Condensed oe rare- fied (vol. i, pages 18, 19, 20, 21). Podophyllin, ii, 98. in biliousness, ii, 93. " constipation, ii, 93. " functional disturbances of the liver, ii, 93. " haemoptysis, ii, 93. " malarial infection, ii, 93. " portal congestion, ii, 93. " respiratory catarrh, ii, 93. " vomiting, i, 100. Podophyllotoxin, ii, 94. Podophyllum, ii, 94. Poisons, ii, 94. list of, and their antidotes, i, 110, 111. table of antagonistic, i, 89. Pokeberry root, Pokeroot. See Phytolacca. Polygala. See Senega. Polygonum bistorta, ii, 94. hydropiper, ii, 94. " in amenorrhoea, ii, 94. Polyporus fomentarius. See under Agaric. Polysolves, ii, 94. Pomegranate. See under Pelletieeine. -. root in tisuia, i, 102. Pommades. See Ointments. Poplar. See Populus. Populin. See under Populus. as an antipyretic, ii, 94. Populus, ii, 94. in malarial fevers, ii, 94. Poppy, ii, 94. Potash, Potassa, Potassa eaustica, ii, 94. as a germicide, i, 447. in acidity of the stomach, ii, 94. " boils, i, 328. " cancer, i, 228. " carbuncles, i, 228. " cutaneous aiiections, ii, 95. " deep-seated or indolent abscesses, i, 228. " gout, ii, 94. " rheumatism, ii, 94. " uric-acid diathesis, ii, 94. Potassium acetate, ii, 94. as a laxative, ii, 95. in acute rheumatism, ii, 95. and sodium tartrate. See under Potassium TARTRATES. and sodium tartrate in acute rheumatism, ii, 100. bicarbonate. See under Potassium carbon- ates. bichromate, ii, 95. " in corns, warts, etc., ii, 95. " " solution for the destruction of small growths, venereal excrescences, and mucous patches, i, 225. bisulphate. See under Potassium sul- phate. bitartrate. See under Potassium tartrates. bromide, ii, 95. " as a motor depressant, i, 644. " in asthmatic paroxysms, i, 94. Potassium bromide in preparatory treatment of taenia, i, 101. bromide in strychnine poisoning, i, 194. " " tetanus, i, 194. cantharidate as a hypodermic in early stages of pulmonary tuberculosis, i, 209. cantharidate in cough of tuberculosis, i, 209. carbonate, ii, 95. " as an antilithic, ii, 95. " in acute rheumatism, ii, 95. chlorate, ii, 96. " in diphtheria, ii, 96. " " hoarseness, ii, 96. " " pharyngitis, ii. 96.' " " salivation, ii, 96. " " scarlet fever, ii, 96. " " sore throat, ii, 90. " " stomatitis, ii. 96. " " tumours of the gums and of the tongue, ii, 96. chlorochromate, ii, 96. citrate in acute rheumatism, ii, 96. " " measles, ii, 96. " " scarlet fever, ii, 96. " " uric-acid diathesis, ii, 96. Potassium cobaltonitrite. See under Cobalt (vol. i, page 273). cobaltonitrite, i, 273. " in dyspnoea, i, 273. " " high arterial pressure, i, 273. " " ura3mia, i, 273. cyanide, i, 322 ; ii, 97. " in pruritus vulvae, i, 323. " " severe headache, i, 323. " " skin diseases, i, 323. " stains of the conjunctiva, i, 323. cyanides, ii, 97. ferrocyanide in colliquative sweating, i, 323. " " poisoning by the copper salts, i, 110. hydrate. See Potassa. hypophosphite. See under Phosphorus, ii, 97. iodide, ii, 97. " and bromide in neuralgia due to lead poisoning, i, 69. iodide and mercury in neuralgia caused by syphilis, i, 69. iodide and potassium bromide in asthma, i, 97. iodide as a sorbefacient, ii, 99. " in actinomycosis, ii, 99. " " acute broncho-pneumonia, ii, 98. " " aneurysm, ii, 10. " " arterio-sclerosis, ii, 98. " " asthma, i, 97 : ii, 99. " " Bright's disease, ii, 98. " " chronic bronchitis, ii, 98. " " " copper poisoning, ii, 98. " " " enlargements of the lym- phatic glands, ii, Q9. iodide in chronic lead poisoning, ii, 98. " " " mercury poisoning, ii, 98. " " " rheumatism, ii, 98. " " hypertrophy of various organs, ii, 98. iodide in inflammatory exudates, ii, 98. " " internal aneurysm, ii, 98. " " salicylic-acid poisoning, ii, 143. " " tertiary syphilis, ii, 97. GENERAL INDEX. 515 Potassium nitrate, ii, 99. nitrate, belladonna, and stramonium, fumes of, in asthma, i, 529. nitrate fumes in asthma, ii, 99. " in burns, ii, 99. nitrite. See under Nitrites. oxalates. See under Oxalic acid. permanganate, ii, 99. " as a gargle in diphtheria, i, 597. permanganate as a germicide, i, 446. " as an antidote to morphine poisoning, i, 596. permanganate as an antidote to phosphorus poisoning, i, 597 ; ii, 76. permanganate in acute articular rheuma- tism, i, 596. permanganate in bromidrosis, i, 103. " " caries of bones, i, 597. " " diabetes, i, 596. " " diphtheria, i, 596. " " gangrene, i, 597. " injections in gonorrhoea, i, 531. " (as a spray) in oziena and pur- ulent otitis, i, 597. permanganate in sloughing malignant growths, i, 597. permanganate in snake-bite poisoning, i, 597. " ulcers, i, 446, 596. " " unhealthy wounds, i, 446. " solution as an injection in subacute gonorrhoea, i, 597. permanganate solution in eczema, i, 596. " frostbite, i, 596. " " " hyperidrosis of the feet, i, 597. permanganate solution in leucorrhoea, i, 597. phosphate, ii, 99. salicylate, ii, 146. salts in renal dropsy, i, 345. silicate, ii, 99. sozoidolate in suppurating wounds, ulcers, etc., ii, 215. sulphates, ii, 99. sulphite, ii, 100. sulphocyanate, ii, 100. " in pulmonary tuberculosis, ii, 236. tannate, ii, 257. tartrate as a diuretic, ii, 100. " in dropsy due to acute nephritis, ii, 100. tartrate in valvular heart disease, ii, 100. tartrates, ii, 100. tellurate, ii, 100. " in night sweats of phthisis, ii, 100. Potio Riveri, ii, 100. Poultice, iodide of starch, ii, 103. jacket in pneumonia, ii, 102. Poultices, ii, 100. as counter-irritants, ii, 101. bran, ii, 103. bread, ii, 103. charcoal, in offensive ulcers, ii, 103. chlorine, in unhealthy sores, ii. 103. flaxseed, in eozematous incrustations, ii, 101. general rules for the employment of, 11, 102. hot, in toothache, i, 186. Indian meal, ii, 103. mustard, in deep inflammation, ii, 103. Poultices, yeast, ii, 103. Powders, ii, 103. Prescriptions, ii, 104. Propylamine. See Tkimethtlamine. Protonuclein. See under Nucleins (vol. ii, page 21). Prunes, ii, 105. Prunum. See Prunes. Prunus virginiana, ii, 105. in cough, ii, 105. Prussic acid. See Hydrocyanic acid. Pseudaconitine, ii, 106. Pterocarpus. See Sandalwood. Ptisans. See Drinks.' Ptyalagogues. See Sialagogues. Ptyalin, ii, 106. in dyspepsia, ii, 106. Ptvchotis ajowan. See Ammi. Pulsatilla, ii, 106. in acute catarrhal affections, ii, 107. " " cerebral meningitis, ii, 107. " " rheumatic gout, ii, 107. " " rheumatism, ii, 107. " asthma, ii, 107. " blepharophthalmia, ii, 107. " bronchitis, ii, 107. " catarrhal deafness, ii, 107. " chronic nasal catarrh, ii, 107. " conjunctivitis, ii, 107. " delayed menstruation, ii, 107. " dysmenorrhcea, ii, 107. " earache (of children), ii, 107. " eczema, ii, 107. " epididymitis, ii, 107. " functional amenorrhoea, ii, 107. " gonorrhoeal ophthalmia, ii, 107. " heart disease, ii, 106. " indolent ulcei-s, ii, 107. " inflammation of the middle ear, ii, 107. " irritative cough, ii, 108. " mucous leucorrhoea, ii, 107. " nervous headache, ii, 107. " oophoritis, ii, 107. " orchitis, ii, 107. " purulent ophthalmia, ii, 107. " rhinitis, ii, 107. " spinal meningitis, ii, 107. " subacute gastritis, ii, 107. " syphilides, ii, 107. " tapeworm, ii, 108. therapeutics of, ii, 107. Pumiline. See under Pine preparations (vol. ii, page 88). Pump, residual air, i, 22. Pumpkin seeds. See Pepo. in taenia, i, 102. Punica, Punioine. See Pelletierine. Punk. See under Agaric. Purgatives. See Cathartics. Pustulants. See under Counter-irritants. Pyoctanine, ii, 108. (internally) in acute nephritis, ii, 109. " adenitis, ii, 109. " " chronic nephritis, ii, 109. in chronic ulcers, ii, 108. " conjunctivitis, ii, 108. " corneal opacities, ii, 108. " dacryocystitis, ii, 108. " diphtheria, ii, 108. (internally) in endometritis, ii, 109. 516 GENERAL INDEX. Pyoctanino in furuncles, ii, 108. (internally) in gonorrhcea, ii, 109. in herpetic ulcers of tlie cornea, ii, 108. " idiopathic ptyalism, ii, 108. (internally) in malarial fever, ii, 109. (injections) in malignant neoplasms, ii, 108. in otorrhoea, ii, 108. " pleurisy, ii, 109. (injections) in pulmonary phthisis, ii, 109. in suppurating wounds, ii, 108. " trachoma, ii, 108. (internally) in typhoid fever, ii, 109. Pyramidone, ii, 454. Pyrantine, ii, 109. in acute rheumatism, ii, 109. Pyrazine, Pyrazol, Pyrazoline, Pyrazolone, ii, 109. Pyrethrum, ii, 109. as an insecticide, ii, 109. in headache, ii, 109. " paralysis of the tongue, ii, 109. " toothache, ii, 109. Pyretine, ii, 110. Pyridine, ii, 110. fumes of, in angina pectoris, i, 530. " " asthma, i, 530. in angina pectoris, ii, 110. " bronchial asthma, ii, 110. " cardiac enfeeblement, ii, 110. injections in gonorrhcea, ii, 10. Pyroaoetic ether or spirit. See Acetone. Pyrodine. See Hydraoetin. Pyrogallic acid, Pyrogallol, Pyrogallolum, ii, 110. Pyrogallic acid in chancre, ii. 111. in eczema marginatum, ii. 111. " epithelioma, ii, 111. " lupus, ii. 111. " phagedjena, ii, 111. " psoriasis, ii. 111. Pyroglycerin. See Nitrooltcekin. Pyroligneous acid, ii, 111. Pyroxylin, ii, 111. Pyrozone, ii, 111, 454. in pyorrhoea alveolaris, ii, 113. " suppuration, ii, 113. " suppurative otitis media, ii, 455. Quassia, ii, 118. as a bitter tonic, ii, 113. in anorexia, ii, 113. " ascarides, ii, 113. (enema) in ascarides vermicularls, i, 103. in atony of the stomach, ii, 113. Quebrachamine. See Quebracho. Quebrachine. See Quebracho. Quebracho, ii, 113. in asthma, ii, 113. '■ dyspnoea, ii, 113. " emphysema, ii, 113. " mitral insufficiency, ii, 113. Querous. See Oak bark and AcoRUS. Quicklime. See under Lime (vol. i, page 583). Quicksilver. See Mercury. Quillaia, ii, 113. in croupous pneumonia, ii, 113. " interstitial pneumonia with bronchiecta- sis, ii, 113. " pleuropneumonia, ii, 113. " pulmonary emphysema, ii, 113. Quillaia in pulmonary tuberculosis, ii, 113. in syphilitic stenosis of the bronchus, ii, 113. Quillain. See Saponi>'. QuinaJgene. See Analgene and Benzanal- GENE. Quinaseptol. See Diaphthol. Quince seed. See Cydonium. Quinetum, ii, 113. in malarial affections, ii, 118. Quinidine, ii, 113. Quinine, ii, 113. action of, on the cerebrum, i, 353. " " " " uterus, i, 853. antipyretic power of, i, 853. arsenite, ii, 455. as an oxytocic, ii, 55. contra-indications for the use of, ii, 131. dihydrochloride carbamate, ii, 455. ferrichloride, ii, 455. hydroohlorsulphate, ii, 455. hypodermically in pernicious intermittent fever, i, 117. in acute articular rheumatism, ii, 118. (as a spray or a snuff) in acute coryza, ii, 119. in acute glaucoma, ii, 130. " albuminuria of scarlatina, ii, 119. (rectal injections) in amcebic dvsentery, ii, 130. in antemia (in non-malarial cases), i, 68. " asthma, i, 356; ii, 119. " atonic dyspepsia, i, 354. " blennorrhagic ophthalmia, ii, 130. " cholera, ii, 119, 131, 133. " chorea, ii, 130. " chronic bronchitis, i, 356; ii, 119. " " gastric catarrh, i, 354. (as a tonic) in chronic phthisis, ii, 119. in convalescence, i, 354. " coryza, i, 856. (injections) in cystitis, ii, 130. in debility, i, 854. " diarrhoea, i, 355. " diphtheria, ii, 119. " dysentery, i, 355. " dystocia, ii, 116. " early stages of amygdalitis, i, 356. " " " " meningitis, i, 356. " " " " pleurisy, i, 356. " " " " pneumonia, i, 356. (injection) in empyema, ii, 130. in erysipelas, i, 855 ; ii, 119. " gonorrhoea, i, 854. " hasmaturia, i, 855. " hay fever, i, 853. influence of, on the gravid uterus, ii, 116. in follicular amygdalitis, ii, 119. (injections) in gonorrhoea, ii, 180. (lotion) in gonorrhoeal ophthalmia, ii, 130. (injections) in growths at the neck of the bladder, ii. 130. in hajmaturia, ii, 130. " haemorrhagic malarial fever, ii, 118. (as a spray or a snuff) in hay fever, ii, 119. in hectic fever of phthisis, ii, 119. " hydrops articulorum intermittens, ii, 180. " inflammations of the serous surfaces, ii, 119. (hypodermically) in insolation, ii, 180. in intermittent fever, i, 117 ; ii, 117. GENERAL INDEX. 517 Quinine, in intermittent fever, as an antipe- riodic, i, 354. in intermittent neuralgia, ii, 118. " laryngismus stridulus, i, 356 ; ii, 119. " malarial cachexia, i. 355 ; ii, 118. • " " disease, ii, 117, 118. " " neuralgia, ii, 130. " " poisoning and malarial paroxys- mal diseases, ii, 310. " masked intermittent fever, ii, 118. " Meniere's disease, ii, 130. " migraine, ii, 130. " neuralgia, ii, 118. " neurasthenia, ii, 130. " paroxysms of intermittent fever, i, 117. " pertussis, ii, 119. " phthisis, i, 856. " pityriasis, ii, 130. " " versicolor, i, 253. " pneumonia, ii, 119. " prolonged labour, ii, 116. " " suppuration, ii, 130. " " suppurative processes, i, 256. (topically) in pruritus ani, ii, 130. vulvffi, ii, 120. in puerperal fever, ii, 119. " remittent fever, i, 355 ; ii, 118. " rheumatism, i, 256. " ringworm, ii, 130. " scarlatina, i, 255 ; ii, 119. " sciatica, ii, 130. " septic diseases, i, 255. " small-pox, ii, 119. " stenocardia, ii, 120. " surgical fever, i, 256. " syphilis, ii, 130. " tinea circinata, i, 353. " trigeminal neuralgia, ii, 130. " typhoid fever, i, 355 ; ii, 119. " typhus fever, ii, 118. " ulcers, ii, 131. " unhealthy granulating wounds, ii, 120. " urethral fever, i, 256 ; ii, 120. " uterine inertia, i, 356 ; ii, 116, 130. " whooping-cough, i, 253. physiological action of, ii, 114. salicylate, ii, 455. tannate, ii, 259. " in malarial diseases, ii, 359. " " nervous affections, ii, 359. " " whooping-cough, ii, 259. valerianate, ii, 346. with antidiphtheritic serum in malarial fe- ver, ii, 174. Quinoidine. See Quinidine. Quinoline, ii, 132. Quinosol, ii, 123. irrigation in labour, ii, 123. Quinquina. See Cinchona. Raspberry vinegar, i, 351. Ratanhia. See Kbameeia. Reconstituents, ii, 123. Rectal etherization, i, 63. medication, i, 198. Red poppy. See Rhcbas. saunders. See Sandalwood, Refrigerants, ii, 124. Relaxants, ii, 125. Resina. See Rosin. Resinol. See RosiNOL. Resins, ii, 135. Resol, ii, 135. Resolvents. See Sokbefacients. Resorbin, ii, 135. Resorcin, ii, 125. and ichthyol in chilblains, ii, 136. as a gastric sedative, i, 100. " an intestinal antiseptic, i, 133. in chancroids, ii, 126. (topically) in diphtheria, ii, 126. in eczema, ii, 126. " " seborrhoicum, i, 116. " erysipelas, ii, 136. (antipyretic) in fever, ii, 136. in herpes, ii, 136. " lencopiakia, ii, 136. " leucorrhoea, ii, 136. " lupus erythematosus, ii, 136. " psoriasis, ii, 126. " ulcerative affections of the mouth, throat, ears, etc., ii, 136. (by spray) in whooping-cough, ii, 126. Rest, absolute, in anfemia, i, 68. cure, ii, 136. . " in acute mania, ii, 137. " " anasmia, i, 68. " " chorea, ii, 127. " epilepsy, ii, 137. " " exophthalmic goitre, ii, 127. " " hysteria, ii, 137. " " melancholia, ii, 137. " " mental or nervous exhaustion, ii, 127. " " neurasthenia, ii, 127. Restoratives, ii, 138. Retinol. See Rosinol. Retroinjections. See under Injections. Retrojeetions, i, 531. Rhamnin, ii, 128. Rhamnoxanthin. See under Fkangula. Rhamus purshiana, ii, 138. in chronic constipation, ii, 129. Rhatanhia, Rhatany. See Krameria. Rhei radix. Rheum. See Rhubarb. Rheumin. See Chrtsophanio acid. Rhigolene, ii, 129. in burns, ii, 139. Rhceados petala, Rhoeas, ii, 139. Rhubarb, ii, 139. as a cholagogue, ii, 130. in atonic dyspepsia, ii, 130. " constipation, ii, 130. " diarrhoea, ii, 130. " functional disturbances of the liver, ii, 130. , " haemorrhage from the rectum, ii, 131. (topically) in unhealthy ulcerations, ii, 130. therapeutics of, ii, 130. Rhus, if, 131. aromatica, ii, 131. " in incontinence of urine from vesical atony, ii, 131. aromatica in metrorrhagia due to fibroid tu- mours of the uterus, ii, 131. aromatica in vesical haematuria, ii, 131. diversifolia, ii, 131. glabra in sore throat, ii, 131. pumila, ii, 131. radicans, ii, 131. toxicodendron, ii; 131. " in incontinence of urine, ii, 133. 518 GENERAL INDEX. Rhus toxicodendron in hEemorrhoids, ii, 133. toxicodendron in muscular soreness due to hysterical convulsions, ii, 134. ^ toxicodendron, poisoning with, ii, 133. " therapeutics of, ii, 133. " treatment of poisoning with, ii, 133, 133. venenata, ii, 134. vernioifera, ii, 134. Rice, ii, 134. Ricinus, ti, 134. Rontgen rays. See X rays. Rosa eanina, Rosa centifolia, Rosa damascena, Rosa gallica. See Rose. Rosaniline hydrochloride, Roseine. See PnCH- SINE. Rose, ii, 134. Rosemary, ii, 135. in indolent ulcers, ii, 135. Rosin, ii. 135. Rosinol, ii, 135. in foul ulcers, ii, 135. " pruritus, ii, 135. " uterine and vaginal catarrh, ii, 135. Rosmarinus. See Rosemary. Rottlera. See Kamala. Rubber, ii, 135. Rubefacients. See under Counter-irritants, and vol. i, page 313. iQ colic, i, 313. " lumbago, i, 313. " neuralgia, i, 313. " pleurodynia, i, 313. " sciatica, i, 313. Rubidium, ii, 136. and ammonium in epilepsy, ii, 136. in syphilis, ii, 136. Rubijervine, ii, 351. Rubus, ii, 136. in atonic diarrhoea, ii, 136. Eue, ii, 137. in araenorrhcea, ii, 137. " epilepsy, ii, 137. " hysteria, ii, 137. " ovarian atony, ii, 137. " uterine atony, ii, 137. Rum, ii, 137. pineapple, ii, 137. shrub, ii, 137. Rumex. ii, 137. " Rusma of the Turks," i, 337. Ruta graveolens. See Rue. Rye, ii, 137. flour in acute dry eczema, ii, 137. " " burns,, ii, 137. " " erysipelas, ii, 137. in habitual constipation, ii, 137. Sabadilla, ii, 137. Sabbatia, ii, 137. as an appetizer, ii, 137. in malarial fever, ii, 137. Sabina. See Savine. Saccharin, ii, 137. in aphthous sore throat, ii, 137. " diabetes raellitus, ii, 138. " indigestion, ii, 138. " obesity, ii, 138. " purulent affections of the ear, ii, 137. Sacoharum. See Sugar. Saccharum laotls. See Sugar of milk. Saffron, ii, 138. tea as a diaphoretic in measles and exan- themata, ii, 369. Safrol, ii, 138. Sage. See Salvia. Sago, ii, 138. Salaoetol, ii, 138. in acute articular rheumatism, ii, 139. " biliary lithiasis, ii, 139. " chronic rheumatism, ii, 139. " choleraic diarrhoea, ii, 139. " muscular rheumatism, ii, 138. Salaotol, ii, 139. Salazolon, ii, 139. Salep, ii, 139. Saleratus. See under Potassium carbonates and Sodium bicarbonate. Salicin, ii, 139. in acute articular rheumatism, ii, 140. " " coryza, ii, 140. " " inflammatory processes, ii, 140. " catarrhal jaundice, ii, 140. " chronic articular rheumatism, ii; 140. " diphtheria, ii, 140. " gout, ii, 140. " hay fever, ii, 140. " lumbago, ii, 140. " neuralgia, ii, 140. " pneumonia, ii, 140. " rheumatism, ii, 140. Salicylacetol. See Salacetol. Salieylaldehyde-methylphenylhydrazine. See . Agathin. Salicylamide, ii, 140. in acute amygdalitis, ii, 141. " neuralgia, ii, 141. " " of peripheral nerves, ii, 141. " ovarian neuralgia, ii, 141. " rheumatism, ii, 141. Salicylates in gastric fermentation, i, 133. in intestinal fermentation, i, 138. Salicylic acid and the salicylates, ii, 141. applications in desquamative eruptions, ii, 144. applications in pustular acne, ii, 144. as an analgetic, ii, 143. " antipyretic, ii, 143. " antiseptic, ii, 142. chronic, poisoning, ii, 143. douche in chronic ozaena, ii, 143. enema in dysentery, ii, 143. for the destruction of small growths, i, 225. in acute articular rheumatism, ii, 142. (on tampons) in carcinoma of the uterus, ii, 143. in chronic ui'ticaria, ii, 143. " corns and warts, ii, 143. " coryza, ii, 143. " dysidrosis, ii, 144. " eczema seborrhoicum, i, 116. " erythema, ii, 144. (ointment) in erythematous eczema, ii, 144. in exophthalmic goitre, ii, 146. " fever, ii, 143. " gastric catarrh, ii, 143. " " fermentation, i, 132. " gonorrhoeal rheumatism, ii, 142. " gout, ii, 143. " hay fever, ii, 143. GENERAL INDEX. 519 Salicylic acid and the salicylates (for pain) in herpes zoster, ii, 143. in hyperidrosis, ii, 144. (locally) in hyperidrosis of the feet and hands, ii, 143. in impetigo contagiosa, ii, 145. " intertrigo, ii, 143. " intestinal flatulence, ii, 143. " lichen asstivus, ii, 145. " lupus erythematosus, ii, 144. (on tampons) in metrorrhagia, ii, 143. in nail deformities, ii, 145. " neuralgia, ii, 143. (ointment) in papular eczema, ii, 144. in phthisis, ii, 143. " psoriasis, ii, 143. " " guttata, ii, 144. (for swollen joints) in purpura haemorrha- giea, ii, 143. in relapsing fever, ii, 143. " rheumatism, i, 124. " sciatica, ii, 142. " sclerotitis, ii, 143. ". slight haemorrhages, ii, 143. " squamous eczema, ii, 144. " syphilitic ulcerations, ii, 145. " urticaria, ii, 145. inhalation in fcEtid bronchitis, ii, 143. in gangrene of the lung, ii, 143. injections in cancer of the uterus, ii, 145. (ointment and solution) in inflammations of the sebaceous glands, ii, 144. ointment in eczema, ii, 148, 144. in eczema rubrum, ii, 144. " epithelioma, ii, 145. " ichthyosis, ii, 144. " lentigo, ii, 144. " pityriasis, ii, 144. " pustular eczema, ii, 144. " rhus poisoning, ii, 145. " seborrhcea, ii, 144. " vesicular eczema, ii, 144. " zoster, ii, 143. Salicylidene paraphenetidine. See Malakin. Saligenin, ii, 147. in acute articular inflammation, ii, 147. " " rheumatism, ii, 147. " cholera, ii, 147. " dysentery, ii, 147. " influenza, ii, 147. " malarial fevers, ii, 147. " typhoid fever, ii, 147. Salinaphthol. See Betol. Saline cathartics in abdominal haemorrhage, ii, 147. cathartics in vomiting, i, 100. Salines, ii, 147. in abdominal inflammations, ii, 147. " acute inflammations, ii, 147. " appendicular inflammation, ii, 147. " ascites of hepatic cirrhosis, ii, 147. " congestive conditions, ii, 147. " dropsical conditions, ii, 147. " gout, ii, 147. " peritonitis, ii, 147. " rheumatism, ii, 147. injections for increasing red corpuscles, i, 464. solution injections in haemorrhage, i, 467. Salipyrine, ii, 147. as a hypnotic, ii, 148. Salipyrine as an analgetic, ii, 148. as an antipyretic, ii, 148. in acute and chronic rheumatism, ii, 148. " facial neuralgia, ii, 148. " headache, ii, 148. " intermittent fever, ii, 148. " menorrhagia, ii, 149. " metrorrhagia, ii, 149. " myalgia, ii, 148. " neuralgia, ii, 148. " trigeminal neuralgia, ii, 148. " typhoid fever, ii, 148. Salithymol, ii, 149. Salivin. See Ptyalin. Salix, ii, 149. as a sedative to the sexual organs, ii, 149. in dysmenorrhoea, ii, 149. " hypersesthesia, ii, 149. " prostatorrhcea, ii, 149. " spermatorrhoea, ii, 149. " uterine neuralgia, ii, 149. SalocoU, ii, 149. Salol, ii, 149. and antipyrine applications in fungous en- dometritis, ii, 150. and antipyrine applications in uterine haem- orrhage, ii, 150. as an analgetic, ii, 150. " " antipyretic, ii, 150. " " antiseptic dressing for sores and ulcers, ii, 150. camphorated, in carbuncles and furuncles, ii, 150. in catarrh of the bile ducts, ii, 150. " cystitis, ii, 150. " diarrhoea, ii, 150. " grippe, ii, 150. " hepatic catarrh, ii, 150. " influenza, ii, 150. " intestinal catarrh, ii, 150. " " fermentation, i, 132. " jaundice, ii, 150. " migraine, ii, 150. " muscular rheumatism, ii, 150. " neuralgia, for immediate relief, i, 69. " neuritis, ii, 150. " pains of locomotor ataxia, ii, 150. " pyelitis, ii, 150. " rheumatism, ii, 125, 150. " summer diarrhoea of children, ii, 150. " urethritis, ii, 150. Salophene, ii, 151. as an intestinal antiseptic, ii, 151. in acute muscular rheumatism, ii, 151. " " rheumatism, ii, 151. " influenza, ii, 151. " migraine, ii, 151. , " neuralgic affections, ii, 151. " rheumatism, i, 125; ii, 151. " subacute gouty arthritis, i, 125. " the nervous form of influenza, ii, 152. Salt, Carlsbad, artificial, ii, 152. " in hepatic cirrhosis, i, 224. common. See under Sodium. " enema in asoarides vermiculares, i, 102. common, in poisoning by the silver salts, i, 110. Epsom. See Magnesium sulphate (vol. i, page 592). 520 GENERAL INDEX. Salt, Monsell's, ii, 153. Rochelle. See Potassuim and sodium tar- tlrae, under Potassium takteates. Saltpetre. See Potassium nitrate. Salubrine, ii, 152. in bruises, ii, 152. " inflammatory sicin diseases, ii, 152. " muscular rheumatism, ii, 152. " ozasna, ii, 153. Salubrol, ii, 456. Salufer, ii, 456. Salumine, ii, 152. (by insufflation) in dry catarrh of the nose and pharynx, ii, 152. Salves. See Ointments. Salvia, ii, 153. in atonic dyspepsia, ii, 153. " in profuse sweating, ii, 456. Sal volatile. See Ammonium oaebonate. Sarabuous, ii, 153. Sandal-wood, ii, 153. oil in bronchitis, ii, 153. " " diarrhoea, ii, 153. " " gonorrhoea, ii, 153. Sandarac, ii, 1.53. Sanders-wood. See Sandal-wood. Sanguinal, ii, 154. in debility with nervous symptoms, ii, 154. " nervousness, ii, 154. " neurasthenia, ii, 154. Sanguinaria, ii, 154. as an escharotic, ii, 154. (externally) as a. stimulant, ii, 154. as a stimulant expectorant, ii, 154. for unhealthy surfaces, ii, 154. in asthma, ii, 154. " atonic amenorrhoea, ii, 154. " chronic nasal catarrh, ii, 154. " gastro-duodenal catarrh, ii, 154. '■ impotence, ii, 154. " jaundice, ii, 154. " scrofula, ii, 154. " syphilis, ii, 154. Sanguinariiie. See under Sanguinaria. Sanguis. See Blood. Sanitary wood wool as an absorbent dressing, ii, 88. ^ Sanoform, ii. 154. in buboes, ii, 154. " hard chancre, ii, 154. " open abscesses (after-treatment), ii, 154. " paronychia, ii, 154. " phimosis, ii, 154. " soft chancre, ii, 154. " wounds from excision of ulcers, ii, 154. Santalura rubrum, Santal-wood. See Sandal- wood. Santonica, ii, 155. Santonin. See under Santonica. in amenorrhcea, ii, 155. " " of chlorosis, i, 375. " ascarides vermieulares, i, 103. " nocturnal incontinence of urine in chil- dren, ii, 155. " threadworms, ii, 155. " tobacco amaurosis, ii, 155. Santoninoxime, ii, 155. Sapo. See Soap. Sapocarbol, ii, 155. Sapolanolin, ii, 155. Saponaria. ii, 155. as a local aniesthetic, ii, 156. as an antipyretic, ii, 156. Saponin, ii, 156. Sapo viridis. See under Soap. Saprol, ii, 156. as a disinfectant, ii, 156. Sarraoenia purpurea, ii, 156. in atonic dyspepsia, ii, 156. Sarsa. See Sarsapakilla. Sarsaparilla as a blood purifier, ii, 156. Sassafras, ii, 156. in flatulent colic, ii, 156. mucilage in painful affections of the mouth and throat, ii, 156. Sassy-bark. See under Erythrophlceine. Saunders. See Sandal-wood. Savine, ii, 156. in atonic menorrhagia, ii, 157. " chronic gout, ii, 157. " worms, ii, 157. Saxol, ii, 157. Saxoline. See Vaseline. Scammony, ii, 157. in dropsical effusions, ii, 157. " fever, ii, 157. " obstinate constipation, ii, 157. Scarification, ii, 158. in conjunctivitis, ii, 158. " inflammation of the tonsils, ii, 158. " local congestion, ii, 158. " oedema of the glottis, ii, 158. " subcutaneous dropsy, ii, 158. Scilla. See Squill. Scillain, Scillin, Scillipiorin, Scillitin, Scilli- toxin, ii. 158. Scillain (subcutaneously) in dropsy, ii, 158. Sclerotic acid, ii, 158. Dragendorii's, ii, 158. in epilepsy, ii, 158. " internal hjemorrhage, ii, 158. Podwyssotzki's, ii, 158. Scoparii caonmina. See Scoparius. Scoparin, ii, 158. Scoparius, ii, 158. in venous engorgement, i, 345. Scopolamine, ii, 158. as a mydriatic, ii, 159, 649. hydrobromide in plastic iritis (incipient stages), ii, 159. in inflammation of the iris and cornea, ii, 159. ' ' " insomnia, ii, 159. " posterior synechise, ii, 159. Scopoleine, Scopolenine, ii, 159. Scurvy-grass. See Cochlearia. Scutellaria, ii. 159. Sea-tangle. See Laminaeia. Sebum ovile, ii, 160. Seoale in deafness from quinine, i, 389. in deafness from salicylic acid, i, 389. " fibroid tumours, i, 388. cereale. See Rye. cornutum. See Ergot. Sedatine. See Antipyrine. Sedatives, ii, 160. circulatory, ii, 161. " in sthenic fevers, ii, 161. gastric, ii, 160. general, ii, 160. GBNBEAL INDEX. 521 Sedatives, local, ii, 160. pulmonary, ii, 161. spinal, ii, 160. urinary, ii, 161. Seidlitz powders, ii, 161. in constipation, ii, 161. " vomiting, i, 100. Selenium, ii, 161. in skin diseases, ii, 161. Seneoin, ii, 161. in amenorrhoea, ii, 161. " dysmenorrhoea, ii, 161. " hiemoptysis, ii, 161. " jaundice, ii, 161. Senecine, ii, 161. Seneoio, ii, 161. in amenorrhoea, ii, 163, 456. " dysmenorrhcBa, ii, 162, 456. " epilepsy, ii, 163. " haemoptysis, ii, 163. " jaundice, ii, 163. " menstrual headache, ii, 456. " pruritus, ii, 163. " vicarious menstruation, ii, 456. Senega, ii, 162. in bronchitis (as a stimulating expectorant), ii, 163. " pneumonia, ii, 162. Senegin. See Saponin. Seneka. See Senega. Senna, ii, 162. in constipation, ii, 163. Septentrionaline, ii, 162. in rabies, ii, 163. " strychnine poisoning, ii, 163. " tetanus, ii, 162. Sequardine, ii, 163. Sero-therapy. See Serum therapy. Serpentaria, ii, 163. and capsicum in vomiting of drunkards, i, 100. and cinnamon in vomiting of drunkards, i, 100. and ginger in vomiting of drunkards, i, 100. in intermittent fever, ii, 163. Serpyllura, ii, 162. Serum, ii, 162. antidiphtheritic, administered by the mouth, ii, 174. antidiphtheritic, in malarial fever, ii. 174. " " scarlet fever, ii, 178. antistreptococcus. See under Serum treat- ment. antistreptococcus, in acute hsemorrhagic sep- ticffimia, ii, 177. antistreptococcus, in erysipelas, ii, 175. " " phlegmons, ii, 175. " " puerperal fever, ii, 175. " " " septicaemia, ii, 175. " " ulcerative endocarditis, ii, 178. artificial, ii, 163. " as a hfpmostatic, ii, 164. " in acute anjcmia from haemorrhage, ii, 163. artificial, in acute pneumonia, ii, 165. •' (intravenous injections) in anaemia, ii, 164. artificial, in ascites, ii, 163. " " Asiatic cholera, ii, 164. Serum, artificial, in asphyxia due to inhalation of oxide of carbon, ii, 165. artificial, in exanthematous typhus, ii, 165. " " neurasthenia, ii, 163, 164. " (intravenous injections) in septicae- mia after operations, ii, 164 artificial (intravenous injections), in shock, ii, 164. cow's (subcutaneous injections), in summer diarrhoeas of children, ii, 163. de Dios Carrasquilla's, in leprosy, ii, 184. dose of, for diphtheria, ii, 170. horse (subcutaneous injections), in pulmo- nary tuberculosis, ii, 163. (saline solution) in scarlet fever, ii, 178. insmall-pox, ii, 179. laotis. See Whev. Maragliano's, in tuberculosis, ii, 182, 183, 184. paste, ii, 166. powder, ii, 166. sublimate, ii, 166. treatment, ii, 166. " of anthrax, i, 85. " " cancer, ii, 185, 186. " cholera, i. 83 ; ii, 187. " diphtheria, i, 83 ; ii, 170, 171. " " diphtheritic laryngitis, ii, 173. " " hog cholera, ii, 188. " " hydrophobia, i, 84. " " influenza, i, 85. " " leprosy, ii, 184. " (Maragliano's) of lupus, ii, 184. " of measles, ii, 178. " '■ pneumonia, i, 85. " " scarlet fever, ii, 178. " " small-pox, ii, 179. " " snake-bite, ii, 188, 189. " " swine plague, ii, 188. " syphilis, i, 85 ; ii, 186. " " tetanus, i, 84. " the plague, ii, 188. " " tuberculosis, i, 85; ii, 179, 180, 181, 182, 183. treatment of typhoid fever, i, 84. " Paquin's, of tuberculosis, ii, 183. " preparation of toxinefor, ii, 167, 168. " reports of, in diphtheria, ii, 173, 174. Sesame oil, ii, 190. in chronic intestinal catarrh, ii, 190. " excessive acidity, ii, 190. " febrile pleurisy, ii, 190. " gastric catarrh, ii, 190. " habitual constipation, ii, 190. " phthisis with obstinate diarrhoea, ii, 190. " septic fever, ii, 190. " typhoid fever, ii, 190. " ulcer of the stomach, ii, 190. Sevura, Sevum praeparatum. See Fats and Tallow. Shikimol. See Safkol. Sialagogues, ii, 190. general, ii, 191. Silica, ii, 191. (internally) in cancer (for relief of pain), ii, 191. in ephelis, ii, 191. hydrated, in buboes, ii, 191. " " chancroids, ii, 191. " " suppurating surfaces, ii, 191. 532 GENERAL IXDBX. Silicates, ii, 191. Silver, ii, 191. and sodium hyposulphite in diseases of the throat, ii, 197. and sodium hyposulphite in locomotor ataxia, ii, 197. citrate in chronic cystitis, ii, 198. " " gonorrhoeal inflammation of the Tulvo-vaginal gland, ii, 198. citrate in gonorrhoeal urethritis (in women), ii, 198. iodide in dysmenorrhcsa, ii, 197. " " epilepsy, ii, 197. " " gastric troubles, ii, 197. " " trachoma, ii, 197. lactate in erysipelas, ii, 197. metallic, as an antiseptic, ii, 193. nitrate, ii, 192. " as a haemostatic, ii, 193. " " an astringent, ii, 193. " " a stimulant, ii, 193. " (as a oanstic) for warts, and mollus- cum contagiosum, ii, 196. nitrate in acute coryza, ii, 195. " " " dysentery, ii, 194. " " amygdalitis, ii, 195. " " atrophic rhinitis, ii, 195. " " aural polypi, ii, 195. " " balanoposthitis, ii, 196. " " bedsores, ii, 196. " " blepharitis marginalis, ii, 195. " (injections) in buboes, ii, 196. " in catarrh of the biliary ducts, ii, 194. " " cervical endometritis, ii, 196. " " cholera infantum, ii, 194. " " chronic cystitis, ii, 196. " " chronic gastric catarrh, ii, 194. " " chronic gastritis (by irrigating the stomach), ii, 194. nitrate in chronic inflammation of the intes- tines, ii, 194. nitrate in chronic laryngitis, ii, 196. " " " pharyngitis, ii, 195. " " " purulent inflammation of the middle ear, ii, 195. nitrate in corns, ii, 457. " (injections) in cysts, ii, 196. " " " dacryocystitis, ii, 195. " in eczema, ii, 196. " " " of the external ear, ii, 195. " " eyelids, ii, 195. " " epilepsy, ii, 194. " " epistaxis, ii, 195. " " erosions of the os uteri, ii, 196. " '■ erysipelas, ii, 196. " " erythema, ii, 196. " " external otitis, ii, 195. " " exuberant granulations, ii, 195. " " fissured nipples, ii, 196. " " fissures of the lips and tongue, ii, 195. nitrate in gastric ulcer, ii, 194. " gleet, ii, 196. " " gonorrhoea, ii, 196. " " hsematuria, ii, 196. " " hydroceles, ii, 196. " " indolent sinuses, ii, 196. " " infiammation of the raucous mem- brane of the Eustachian tube, ii, 195. nitrate in irritable stomach, ii, 194. Silver nitrate in laryngeal ulcers, ii, 196, 457. nitrate in lichen, ii, 196. " " lupus, ii, 196. " " naso-pharyngitis, ii, 195. " " ophthalmia neonatorum, ii, 194. " " ozaena, ii, 195. " " persistent vomiting, ii, 194. " " prostatorrhoea, ii, 196. " " prurigo, ii, 196. " " pruritus of the external auditory meatus, ii, 195. nitrate in psoriasis, Ii, 196. " " purulent conjunctivitis, ii, 195. " " ringworms, ii, 196. " " subacute laryngitis, ii, 196. " " tabes dorsalis, ii, 194. " internal uses of, ii, 193, 194. " in trachoma, ii, 195, 214. " " ulcers of the mouth, ii, 195. " (locally) in ulcers of the rectum, ii, 194. nitrate in ulcers of the nasal sajptum, ii, 195. " " vascular granulations, ii, 195. " " venereal sores, ii, 196. " " vomiting (by irrigation of the stomach), ii, 194. nitrate in vomiting of chronic gastric dis- ease, i, 99. nitrate, solid, in toothache, i, 136. " solution in whooping-cough (by sponging the throat), ii, 196. oxide in diarrhoea, ii, 197. " " dysraenorrhoea, ii, 197. " " gastric hasmorrhage, ii, 197. " " gastric neuralgia, ii, 197. " " gastritis, ii, 197. " " gonorrhoea, ii, 197. " " irritable dyspepsia, ii, 197. " " irritability of the stomach, ii, 197. " " profuse sweating, ii, 197. " " pulmonary haemorrhage, ii, 197. " " pyrosis, ii, 197. " " venereal sores, ii, 197. " " vomiting, ii, 197. Simulo, ii, 198. in epilepsy, ii, 198. Sinapis, Sinapisms. See Mustard. Skullcap. See Scutellaria. Slaked lime. See under Calx and Lime. Slippery elm. See XJlmus. Smilacin, ii, 198. Smilasin, ii, 198. Smilax, ii, 198. Snakeroot. See Serpentaria. Soap, ii, 198. alkaline fluid, ii, 201. as a lubricant for the fingers in making vagi- nal and rectal examinations, ii, 201. as an antidote to poisoning by acids, i, 6. " '■ " " sulphuric-acid poisoning, ii, 242. Castile, ii, 199. glycerin, ii, 199. green, ii, 199. " in eczema rubrum (of the leg), ii, 200. " " inveterate psoriasis, ii, 300. in acid poisoning, ii, 199. in poisoning with zinc salts, i, 109. " " " corrosive sublimate, i, 109. " " metallic salts, i, 109. GENERAL INDEX. 523 Soap, in poisouina: with potassium bichromate, 1, 109. in poisoning with salts of tin, i, 109. liquid glycerin, ii, 199. marble, ii, 201. marine, ii, 199. Marseilles, ii, 199. mercurial, ii, 200. \ neutral fluid, ii, 201. soft, ii, 201. " alkaline, ii, 201. superfatted fluid, ii, 201. transparent, ii, 199. Soapbark. See Quillaia. Soaps, medicinal, and their uses, ii, 199. Soapsuds as a laxative enema, ii. 199. Soapwort. See Saponaria and Saponine. Socaloin. See under Aloin. Soda, Soda caustica, ii, 201. Soda as a germicide, i, 447. tartarata, ii, 202. water, i, 214. Sodio-theobromine salicylate, ii, 203. for arrhythmia, ii, 202. in acute nephritis, ii, 203. " " " of scarlatina, ii, 203. " aneurysm, ii, 208. " arteriosclerosis, ii, 203. " chronic nephritis, ii, 202. " dropsy, ii, 202. " " of cardiac origin, ii, 203. " heart disease, ii, 202. " interstitial nephritis, ii, 203. " mitral insufficiency, ii, 208. " myocarditis, ii, 203. " nephritis, ii, 203. " in pericarditis, ii, 203. " pleuritic effusions, ii, 303. " serous effusion, ii, 202. " valvular heart disease, ii, 203. Sodium acetate, ii, 203. and caffeine sulphonate. See Stmphokol. " magnesium borocitrate, ii, 203. " " " in urinary lithi- asis, ii, 203. and magnesium tartrate, ii, 303. arsenate, Sodium arseniate, ii, 204. auroohloride, ii, 204. benzoate in lithaemia, ii, 204. " " rheumatism, ii, 204. biborate. See Boeax. bicarbonate, ii, 204. " in acid diarrhoea of children, ii, 304. bicarbonate in coryza, ii, 205. " " deficiency of hydrochloric acid in the gastric juice, ii, 304. bicarbonate in diabetes (to reduce the amount of sugar), ii, 304. bicarbonate in excess of hydrochloric acid, ii, 304. bicarbonate in influenza, ii, 205. " (injections) in intestinal intus- susception, ii, 204. bicarbonate in rheumatism, i, 124. " (locally) in stings of bees, wasps, etc., ii, 204. bicarbonate (locally) in superficial bums, ii, 205. bisulphite. See under Sulphurous acid. V7 Sodium borate. See Borax. bromide. See under Bromides. " in asthmatic paroxysms, i, 94. " " nervous excitement, i, 194. " " " irritability, i, 194. cantharidate in pulmonary tuberculosis, ii, 300. carbolate, ii, 206. " in diarrhoea (as an intestinal anti- septic), ii, 206. carbolate in dysentery (as an intestinal anti- septic), ii, 306. carbolate in typhoid fever (as an intestinal antiseptic), ii, 306. carbonate, ii, 206. cetrarate, ii, 306. chlorate, ii, 206. " (for palliative treatment) in cancer of the uterus, ii, 206. chloride, ii, 206. " in capillary hsemorrhages, ii, 206. " " epistaxis, ii, 306. " injections in hydrocele, ii, 163. " in intermittent fever, ii, 206. " (as a gargle) in nasal catarrh, ii, 206. chloride in nitrate-of-silver poisoning, ii, 193. " (as a gargle) in pharyngitis, ii, 207. " in poisoning with the silver salts, i, 110. oholeate, ii, 207. citrate, ii, 207. citro-tartrate, ii, 207. diiodoparaphenolsulphonate. See Sodium so- ZOIODOLATE. diiodosalicylate. See under Diidosalictlic ACID. dithiosalicylate. See under Dithiosaliotlic ACID. dithiosalicylate in rheumatism, i, 125. ethylate, ii, 207. " in psoriasis, ii, 207. " " warts, corns, etc., ii, 207. ethylsulphate. See Sodium sulphovinate. fluoride. See Fluoride. fluosilicate. See Sodium silicofluoeide. formate, ii, 207. " in tuberculous diseases, ii, 307. glycerinoborate, ii, 207. hypophosphite. See under Htpophosphites. (vol. i, page 519). hyposulphite in ringworm, i, 117. iodide, ii, 207. " and sodium bromide in asthma, i, 97. lactate, ii, 207. " in insomnia, ii, 207. nitrate, ii, 207. " in dysentery, ii, 207. nitrite. See under Nitrites (vol. ii, page 13). paraoresotate, ii, 207. " in catarrhal pneumonia, ii, 207. paracresotate in gastro-intestinal disorders, ii, 207. paracresotate in rheumatism, ii, 307. " " typhoid fever, ii, 307. phenolsulphonate, ii, 307. phosphate, ii, 207. " as a cholagogue, ii, 207. " " laxative, ii, 207. 524 GENERAL INDEX. Sodium phosphate in biliary calculi, ii, 208. phosphate in biliary inspissation, ii, 79. " " boils and carbuncles, ii, 208. " " catarrhal jaundice, ii, 79. " " diarrhoea, ii, 79. " " epidemic jaundice of warm climates, ii, 208. phosphate in gastro-duodenal catarrh, ii, 208. phosphate (subcutaneous injections) in hemi- plegia, ii, 208. phosphate in hepatic torpor, ii, 79. " intestinal dyspepsia, ii, 79. " jaundice, ii, 208. " lithasinia, ii, 79, 208. " malnutrition, ii, 208. (subcutaneous injections) in neu- rasthenia, ii, 208. phosphate in progressive myopathic paraly- sis, ii, 208. phosphate in sclerosis of the liver, ii, 208. " sick headache, ii, 208. " (subcutaneous injections) in tabes dorsalis, ii, 208. pyrophosphate. See under Phosphorus (vol. ii, page 79). saccharinate. See under Salicylic acid. salicylate in acute articular rheumatism, ii, 146. salicylate in acute follicular amygdalitis, ii, 146. salicylate in acute glaucoma, ii, 146. " " infectious diseases, ii, 146. " cholera infantum, ii, 146. " diarrhoea, ii, 146. " dry pleurisy, ii, 146. " dysmenorrhoea, ii, 146. " facial neuralgia, ii, 146. " iritides of gonorrhcea, ii, 146. " migraine, ii, 146. " neuralgic affections of peripher- al nerves, ii, 146. salicylate in pertussis, ii, 146. '• " pleurisy with effusion, ii, 146. " " rheumatic iritis, ii, 146. " " rheumatism, i, 125. santoninate. See under Santonioa. silicates. See under Silicates. silicofluoride, ii, 208. sozoiodolate, ii, 308. " as an intestinal antiseptic, ii, 208. sozoiodolate in diabetes, ii, 208. " " nasal catarrh, ii, 208. " " syphilitic ulcers, ii, 208. " " whooping-cough, ii, 208. sulphate in constipation, ii, 208. " " sluggishness of the liver, ii, 208. sulphite. See under Sulphurods acid. sulphobenzoate, ii, 208. sulphocarbolate. See under Sulphooarbo- lates. sulpholeate (ointment) in skin diseases, ii, 309. sulpholeate as a base for ointments, ii, 209. sulphomethylate, ii. 209. sulphoricinate, sulphoricinoleate. See under Sodium sulpholeate. sulphovinate, ii, 209. Sodium tannate in albuminuria, ii, 259. tartrate in fevers, ii, 209. " " nausea, ii, 309. taurocholate. See Sodium choleate. tellurate, ii, 209. " in night-sweats, ii, 209. tetraborate, ii, 209. thiophene-sulphonate in prurigo, ii, 30&. " " " skin diseases, ii, 309. thiosulphate, ii, 209. tumenol sulphonate. See under Tumenol. valerianate, ii, 209. Soja hispida, ii, 209. in diabetes, ii, 209. Solanin, ii, 209. in neuralgia, ii, 209. Solanine. See under Dulcamara. Solanum carolinense, ii, 209. in chorea, ii, 209. " epilepsy, ii, 209. " puerperal eclampsia, ii, 209. " tetanus, ii, 809. dulcamara. See Dulcamara. paniculatum, ii, 210. " in biliary colic, ii, 210. " " catarrh of the bladder, ii, 310. paniculatum in chronic dyspepsia, ii, 210. " " diseases of the liver and of the spleen, ii, 210. Solidago, ii, 210. Solis-Cohen's apparatus for inspiration of con- densed air and expiration into rarefied air, i, 21, 22. pneumatic resistance valves, i, 23, 23. Solphinol, ii, 311. in treatment of wounds, ii, 311. Solution, Boudin's, i, 146. Boulton's, i, 210. De Valangin's, i, 144. Dobell's, i, 210. Donovan's, i, 146. Fowler's, i, 144, 146. Pearson's, i, 146. Solutol, ii, 211. Solvents, ii. 211. Solveol, ii, 212. Solvines. See Polysolves. Somatose, ii, 212. in agalactia, ii, 213. " anaemia, ii, 212. " cancer of the stomach, ii, 213. " chlorosis, ii, 213. " gastro-enteritis, ii, 313. " irritation of the gastro-intestinal mucous membrane, ii, 312. " mercurial cachexia, ii, 312. " pericarditis, ii, 313. " phthisis, ii, 313. " typhus fever, ii, 213. " ulcer of the stomach, ii, 313. Somnal, ii, 313. in acute melancholia, ii, 313. " insomnia, ii, 313. Sophora tinotoria. See Baptisia tinctoria, i, 160. Soporifics. See Hypnotics. Sorbefacients, ii, 313. Sorbinose. See under Sugar, Sorrel. See Oxalis. GENERAL INDEX. 525 Soy, Soya bean. See Soja hispida. Sozal, ii, 215. in cystitis, ii, 215. " suppurating surfaces, ii, 215. " tuberculous abscesses, ii, 215. Sozoiodol, ii, 215. Sozoiodolate, mercury, in parasitic skin dis- ease, ii, 215. Sozoiodolate, potassium, in suppurating wounds, ulcers, etc., ii, 215. Sozolic acid. See Asbptol. Spanish flies. See Cantharides. Sparteine, ii, 216. in aortic regurgitation, ii, 216. as a heart stimulant in anesthesia, ii, 216, in anasarca, ii, 216. " asthma (of cardiac origin), ii, 216. " diseases of the myocardium, ii, 216. " heart disease, ii, 216. " measles, ii, 216. " mitral regurgitations, ii, 216. (subcutaneously) in phthisis, ii, 216. in scarlatina, ii, 216. " stenosis of the mitral valve, ii, 216. Spas. See Waters, mineral. Spasmotin, Spasmotoxine, ii, 216. Spearmint. See Mentha viridis. Species, ii, 217. Specifics, ii. 217. Spermine, ii, 317. in anaemia, asthma, chorea, chronic ulcers, diabetes, dyspepsia, locomotor ataxia, neu- ralgia, neurasthenia, ii, 217. in self-poisoning by absorption from the in- testines, ii, 217. " syphilis, ii, 217. " tuberculous disease, ii, 217. Sphacelotoxine. See Spasmotin. Spigelia, fluid extract of, in ascaris lumbri- coides, i, 102. in roundworms, ii, 217. Spinal-cord emulsion. See under Animal ex- tracts AND JUICES (vol. i, page 82.) in rabies, i, 82. Spinants, ii, 817. Spirits, ii, 218. Spleen extract, Splenic extract, i, 81 ; ii, 218. in constipation, ii, 218. " debility, ii, 218. " dysmenorrhcea, ii, 218. . (hypodermically) in Hodgkin's disease, i, 81. (hypodermically) in enlarged spleen, i, 81. in headache, ii, 218. (hypodermically) in leucocythsemia, i, 81. in loss of appetite, ii, 218. Sponge, ii, 218. grafting in unhealthy granulating sores, ii, 219. tents, ii, 219. " (impregnated with vinegar) in post- partum haemorrhage, ii, 219. Sponges and their substitutes, i, 128. Spongiopiline, ii, 103, and see under Poul- tices. Sprays, ii, 219. Springs. See Waters, mineral. Springs, Aachen, ii, 371. Abano and Battaglia, ii, 371. Springs, Abita, ii, 378. Adams, ii, 375. Addison Mineralj ii, 378. ^tna. ii, 375. Aix-Jes-Bains, ii, 371, 372, 373. Al burgh, ii, 383. Alcyone, ii, 377. Alhambra, ii, 879. AUandale, ii, 378. Allan's Mineral, ii, 379. Alleghany (Va.), ii, 383. Alleghany, ii, 382. Allen, it; 375, 378. All-Healing, ii, 381. Alpena Magnetic Well, ii, 878. Alum, ii, 381. Alum Rock, ii, 375. Alum (Va.), ii, 383. Alvenu, ii, 371. Amelie-les-Bains, ii, 873. American Chalybeate, ii, 878. Anderson, ii, 377. Anderson's Mound, ii, 377. Angler's Mineral, ii, 376. Apenta, ii. 417. ApoUinaris, ii, 879. Arctic, ii, 384. Arrington, ii, 877. Artesian Mineral Well, ii, 384. Auburn Mineral, ii, 378. Aurora, ii, 379. Avoca, ii, 383. Aztec, ii, 380. Baden, ii, 371. Baden Baden, ii, 378. Bagneres-de-Bigorre, ii, 371. Bagneres-de-Luchon, ii, 371. Bailey, ii, 374. Ballston Spa. ii, 380. Bareges, ii, 371, 373. Bartlett, ii, 375. Bath, ii, 373, 378. Bath Alum, ii, 382. Baxter, ii, 378. Beachville, ii, 378. Beali, ii, 876. Bedford, ii, 878, 381. Bedford Alum, ii, 382, 383. Beersheba, ii, 883. Belknap Hot, ii, 381. Beloit, ii, 384. Bentley, ii, 378. Bethel, ii, 378. Bethesda, ii, 384. Bethlehem, ii, 378. Big Bone Lick, ii. 378. Big Hole Hot, ii, 379. Bigorre, ii, 372. Black Earth Mineral, ii, 384 Black Water, ii, 382. Bladon, ii, 874. Blanohard, ii, 375. Blood, ii, 375. Blossburg, ii, 381. Blount, ii, 374, 882. Blue Grass Sulphur, ii, 374 Blue Lick, ii, 378. Blue Ridge, ii, 383. Blue Sulphur, ii, 384 Bon Air, ii, 383. 536 GENERAL INDEX. Springs, Bonanza, ii, 375. Boothbay Medicinal Mineral, ii, 378. Borland Mineral Well, ii, 384. Botetourt, ii, 383. Boulder Hot, ii, 879. Bourbonne, ii, 373. Bowden Lithia, ii, 376. Bowsher Mineral, ii, 379. Bratton, ii, 879. Bristol Soda, ii, 384. Bruneau Hot, ii, 377. Bryant, ii, 378. Buckingham White Sulphur, ii, 383. Buffalo, ii, 378. Buffalo Lithia, ii, 372. Buffalo Lithia (Va.), ii, 383. Burgher's, ii, 378. Butterworth's Magnetic, ii, 378. Byron, ii, 375. California Seltzer, ii, 375. Campbellsville Sulphur, ii, 378. Camp's, ii, 376. Cannstadt, ii, 372. Canter's Blue Sulphur, ii, 381. Canton Bern, ii, 373. Capon, ii, 383. Cascade Warm Mineral, ii, 383. Castalian, ii, 879. Castalian Mineral Wells, ii, 875. Catoosa, ii, 376. Cauterets, ii, 871. Cedar, ii, 379. Cedar BluflE Sulphur, ii, 388. Central, ii, 377. Cerulean, ii, 378. Chalybeate, ii, 376. Chamberlain, ii, 877. Chandler's, ii, 874. Cherokee, ii, 381. Choteau, ii, 379. Church Hill Alum, ii, 883. Claiborne, ii, 878. Clark's Warm, ii, 379. Clay, ii, 376. Cleveland Mineral, ii, 381. Clifton, ii, 381, 383. Coffee, ii, 374. Cohutta, ii, 376. Coldbrook Mineral, ii, 378. Colfax Mineral, ii, 877. Colorado, ii, 371, 873. Commonwealth Mineral, ii, 378. Congress, ii, 380. Contrexeville, ii, 372. Cooper's Well, ii, 879. Cowhead, ii, 381. Coyner's Sulphur, ii, 383. Cresson, ii, 381. Crusac, ii, 372. Crystal Mineral, ii, 378. Crystal Sulphur, ii, 383. Cullum's, ii, 374. Dalby, ii, 383. Davis's, ii, 378. Dax, ii, 373. Debrell, ii, 388. De Barry, ii, 376. De Gonia, ii, 877. Des Chutes Hot, ii, 381. Doubling Water Lap, ii, 381. Springs, Drennon, ii, 378. Driburg, ii, 872. Dripping, ii, 378. Eaton Rapids Magnetic, ii, 378. Eaux-Bonnes, ii, 371. Eggleston, ii. 383. Eilsen, ii, 37i, 372. Elk Lick, ii, 379. EUiston's Sulphur, ii, 378. El Paso de Robles, ii, 375. Enghien, ii, 871. Epperson, ii, 383. Esoulapia, ii, 378. Estill, ii, 878. Eureka, ii, 375. Pairview Mineral, ii, 379. Parmville Lithia, ii, 388. Ferrolithic, ii, 376. Fox, ii, 378. French Lick, ii, 377. Priedrickshall, ii, 373. Fruitport Artesian and Magnetic, ii, 378. Fry's Soda, ii, 375. Fulton Wells, ii, 375. Ganymede, ii, 377. Garnet, ii, 376. Gastein, ii, 372. Geuda, ii, 378. Geyser, ii, 375. Gihon, ii, 384. Given's Hot, ii, 877. Glen Alpine Mineral, ii, 375. Glen Flora, ii, 377. Glenn, ii, 884. Glenwood, ii, 378. Gordon, ii, 376. Grand Ledge Magnetic, ii, 378. Grayson, ii, 378. Grayson Sulphur, ii, 883. Gray Sulphur, ii, 384. Great Spirit, ii, 378. Greenbrier White Sulphur, ii, 384. Greene, ii, 374. Green Lawn, ii, 377. Grosswardien, ii, 371. Gum, ii, 875. Hagan's, ii, 883. Harbin, ii, 375. Hardin, ii, 378. Harkany, ii, 371. Harriman's Sulphur, ii, 379. Harrison's Mineral, ii, 383. Harrodsburg, ii, 378. Harrogate, ii, 371. Hartford Cold, ii, 378. Hartsville, ii, 377. Hart Well, ii, 384. Hawkins's Chalybeate, ii, 377. Healing, ii, 383. Helena Hot, ii, 379. Herculesbad, ii, 371. Hickman, ii, 878. Highland, ii, 375. Hohenstedt, ii, 371. Hoosier, ii, 376. Hopkinton, ii, 878. Horeb, ii, 884. Hosea Saline Sulphur, ii, 877, Hot, ii, 381. Hot Mud, ii, 375. GENERAL INDEX. 527 Springs, Hot (Va.), ii, 383. Howard, ii, 383. Howell Mineral, ii, 378. Howland, ii, 881. Hubbard Magnetic, ii, 878. Huguenot, ii, 383. Hughes, ii, 382. Humphrey's, ii, 384. Hunter's Hot, ii, 379. Hynson's Iron Mountain, ii, 383. Indian, ii, 876. Inglewood, ii, 379. Inselbad, ii, 372. lodo Magnesium, ii, 384. Iowa Acid, ii, 377. Iron Ute, ii, 375. Iwanda, ii, 373. Jackson, ii, 881. Jemes Hot, ii, 380. Johnson's, ii, 383. Jordan Alum, ii, 383, Jordan's White Sulphur, ii, 383. Katahdin, ii, 378. Kern's, ii, 883. Kingston, ii, 383. Kreuth, ii, 371. La Fayette, ii, 879. La Fayette Artesian Well, ii, 376. Lake Auburn Mineral, ii, 878, Landreth's Mineral Well, ii, 379. Langenbrucken, ii, 371. Lansing Magnetic Well, ii, 378. Las Cruces Hot, ii, 375. Latonia, ii, 878. Lauderdale, ii, 379. Lawrence Mineral, ii, 876. Lebanon, ii, 380. Lemon, ii, 381, Leslie Magnetic Wells, ii, 878. Leuk, ii, 373, Levioo, ii, 369. Lewis, ii, 379. Lick, ii, 375. Lippspring, ii, 373. Lisdoonvarna, ii, 371. Little Chief, ii, 375. Litton's Seltzer, ii, 375. Lodi Artesian, ii, 377, Londonderry Lithia, ii, 379. Loretto, ii, 381, Lubec Saline, ii, 378. Luben, ii, 372. Magnolia, ii, 376. Manitou, ii, 375. Mark West, ii, 875, Matilija Hot, ii, 375, Matthews's Warm, ii, 379. Magnetic, ii, 381 , McAllister, ii, 379, Medical Lake, ii, 383. Meinberg, ii, 371. Midland Magnetic Well, ii, 378. Milburn, ii, 377. Millborough, ii, 383, Mill's Mineral, ii, 375. Mineral Wells, ii, 384. Minnequa, ii, 381. Mondorf, ii, 373. Monroe Hot, ii, 374. Montesano, ii, 379. Springs, Montgomery White Sulphur, ii, 383. Monticello Hot, ii, 375. Mountain Grlen, ii, 375, Mountain Valley, ii, 375, Mount Clemens Mineral, ii, 378. Mount Nebo, ii, 375, Mungel's, ii, 383. Nauheim, ii, 419. Navajoe, ii, 375, Nevada Mineral, ii, 379. Neundorf, ii, 371, 373. Newport Sulphur, ii, 376. New Saratoga (Wisconsin), ii, 384. Newsom's Arroyo Grande Warm, ii, 375. Oak Orchard Acid, ii, 380. Oliver, ii, 382. Olympian,, ii, 378. Orkney, ii, 383. Owalonna Mineral, ii, 379. Owen's Mineral Well, ii, 378. Paris Chalybeate, ii, 379. Paroquet, ii, 378.. Paradise, ii, 378. Pearsons, ii, 375. Pennywits Sulphur, ii, 375. Perry, ii, 377, PfaSers, ii, 372, Piedmont, ii, 381. Poland, ii, 378. Ponticosa, ii, 871. Powder, ii, 376. Pulaski Alum, ii, 383. Puller's, ii, 379. PuUna, ii, 369, 372. Pystjan, ii, 371, Rawley, ii, 383. Red Sulphur (W. Va.), ii, 384. Rehme, ii, 372. Reiger, ii, 379. RichBeld, ii, 380. River, ii, 378, Roanoke Red Sulphur, ii, 383. Robinson, ii, 382, Rochester, ii, 378, Rockbridge Alum, ii, 362, 383. Rockcastle, ii, 378. Rock Bnon, ii, 383. Roncegno, ii, 369. Rosicruoian, ii, 378. Ryan's Hot, ii, 379. Sabree, ii, 378. Saidschutz, ii, 373. St. Armand, ii, 373. St. Galmier, ii, 373, St. Helena, ii, 375, St, Louis Magnetic, ii, 378. Saint Clair Mineral, ii, 379. Saint-Sauveur, ii, 371. Salubrian, ii, 378. Saratoga, ii, 380, 385. Schmalkalden, ii, 372. Schurznach, ii, 371, 372. Sebastianweiler, ii, 371. Sedlitz, ii, 372. Shannondale, ii, 384. Sharon, ii, 381, 882. Shawnee Mineral, ii, 378. Shenandoah Alum, ii, 383. Shoshone, ii, 375. Siloam, ii, 376, 379. 528 GENERAL INDEX. Springs, Silurian, ii, 384. Simmons Hot Sulphur, ii, 375. Soda, ii, 377. Spa, ii, 378, 384 Sparta Mineral, ii, 885. Spaulding, ii, 379. Spring Lake Magnetic Well, ii, 378. Stafford, ii, 376. Storm Lake, ii, 377. Strathpeffer, ii, 371. Stroutia Mineral, ii, 378. Stryker Mineral Well, ii, 381. Sulphur, ii, 383. Summit Soda, ii, 375. Sweet, ii, 379. Sweet Chalybeate, ii, 383. Tallahatta, ii, 374. Tar, ii, 378. Tarpon, ii, 376. Three, ii, 381. Tolenas, ii, 375. Trenchin-Teplitz, ii, 371. Trinity, ii, 377. Tuscan, ii, 375. Valley View, ii, 383. Van Cleave, ii, 377. Variety, ii, 383. Vemet, ii, 371. Vichy, ii, 375. Vittel, ii, 373. Warasdin, ii, 371. Warm, ii, 373, 376. Warm Sulphur (Va.), ii, 382. Warner's Ranch, ii, 375. Washington, ii, 383. Watson's, ii, 375. Weilbaoh, ii, 371. Weissenburg, ii, 373. Wesson Iron, ii, 376. White, ii, 376. White Rock, ii, 384. White Sulphur, ii, 874, 375, 376, 378, 879. Wiesbaden, ii, 373. Wilbur, ii, 375. Wildbad, ii, 373. Wildegg, ii, 373. Wildungen, ii, 873. Wilhoit*s Soda, ii, 381. Witter's, ii, 375. Wolf Trap Lithia, ii, 388. Wyandotte, ii, 377. Wyandotte White Sulphur, ii, 878. Wytheville, ii, 883. Yampah, ii, 375. Yates Mineral, ii, 378. Yellow Sulphur, ii, 383. Young's, ii, 378. Ypsilanti Mineral Well, ii, 878. Zodiac, ii, 379. Zonian, ii, 877. Spurge. See Euphorbia piluUfera, under Eu- phorbia (toI. i, page 401). Squill, ii, 331. as a stimulant expectorant, i, 418. in acute bronchitis, ii, 331. " asthma, as an expectorant, i, 95. " cardiac dropsy, ii, 331. " chronic bronchitis, ii, 331. " croup, ii, 331. " venous engorgement, i, 845. Squill in weak cardiac action, i, 345. Stannura. See Tin. Staphisagria, ii, 331. as a vulnerary, ii, 331. (decoction) in phtheiriasis, ii, 331. in scabies, ii, 331. in wounds, ii, 231. Star-anise. See Illicium. Starch, ii, 332. (powdered) for intertrigo, ii, 333. in poisoning with bromine, i, 109. " " " copper sulphate, i, 109. " " " corrosive sublimate, i, 109. " iodine, i, 109 ; ii, 323. " " " zinc sulphates, i, 109. iodized, in lupus erythematosus, i, 537. " " scrofula, i, 537. " " tuberculous ulceration, i, 537. Stavesacre. See Staphisaoeia. Steam, ii, 333. in acne, ii, 323. " acute inflammations of the air-passages, i, 528. " carcinoma of the uterus, ii, 233. " capillary bronchitis of children, i, 538; ii, 330. " catarrhal affections, i, 418 " cervical endometritis, ii. 233. (spray) in chronic bronchitis (dry form), ii, 320. in chronic eczema, ii, 333. " diphtheria, i, 538. " endometritis, ii, 233. " haemorrhage (during operations), ii, 233. " hyperplastic endometritis, ii, 333. " inflammatory conditions of the throat, i, 469. " laryngeal croup, 1, 528. " menorrhagia, ii, 223. " septic puerperal endometritis, ii, 323. of benzoin and paregoric in acute laryngitis, i, 538. superheated, as a caustic, ii, 223. Sterculia, ii, 333. as a heart stimulant, ii, 233. " stimulant to the nervous system, ii, 228. in neurasthenia, ii, 223. Steresol, ii, 333. in diphtheria, ii, 338. Sterilization of catgut sutures, dry method of, i, 138.' wet method of, i, 139. Sternutatories, ii, 223. Stibium. See Antimony. Stillingia, ii, 223. in scrofula, ii, 333. " syphilis, ii, 333. Stimulant diuretics, ii, 228. Stimulants, ii, 238. cardiac, ii, 326. general, ii, 234. hepatic, ii, 238. local, ii, 334. spinal, ii, 326. vascular, ii, 237. Stimulation, electrical, in asthma, i, 93, StoBchas. See Lavandula, Stomachics, ii, 328. Storax, ii, 338. GENERAL INDEX. 539 Storax (as an expectorant) in bronchial troubles, ii, 228. in diphtheria, ii, 228. " gonorrhcea, ii, 228. " leucorrhoea, ii, 228. " pseudo-membranous croup, ii, 328.' " scabies, ii, 228. liquid, in frostbites, ii, 229. Stramonium, ii, 229. and belladonna in asthma, i, 529 ; ii, 229. fumigation in spasmodic asthma, i, 430. in convulsive coughs, ii, 229. Streptococcus serum. See under Sekum treat- ment. Strontium, ii, 329. bromide as an antemetio, i, 99. " in acute gastritis, ii, 239. " " diabetes, ii, 339. " " epilepsy, ii, 229. " " vomiting of nervous origin, i, 99. carbonate as a dentifrice, ii, 229. iodide, ii, 339. lactate as an intestinal antiseptic, ii, 339. " in acute parenchymatous nephritis, ii, 330. lactate in albuminuria, ii, 339. " " dyspepsia due to an excess of hy- drochloric acid in the gastric juice, ii, 330. lactate in interstitial nephritis, ii, 230. " " mixed nephritis, ii, 230. " nephritis, ii, 230. " " parenchymatous nephritis, ii, 329, 230. phosphate, ii, 230. salicylate, ii, 147, 230. " as an intestinal antiseptic, ii, 330. " in chronic gouty conditions, ii, 330. salicylate in fermentative changes in the intestines, ii, 147. salicylate in flatulent dyspepsia, ii, 147, 230. •' " muscular rheumatism, ii, 147, 330. salicylate in subacute rheumatism, ii, 147, 230. Strophanthidin, Strophanthin. See under Strophanthus. Strophanthus, ii, 330. (hypodermic injection) as a stimulant in aconite poisoning, i, 7. diuretic value of, ii, 331. in angina pectoris, ii, 283. " asthma, ii. 231. " cardiac dropsy, ii, 331. " " dyspnoea, ii, 331. " " troubles, ii, 331. " " weakness, ii, 331. " cerebral anaemia, ii, 233. " chlorosis, ii, 232. " collapse, ii, 331. " congestion of the kidneys, ii, 331. " " " lungs, ii, 231. indications for the use of, ii, 231. in exophthalmic goitre, ii. 232. " general ansemia, ii, 232. " hemiplegia, ii, 231. " irritable heart when no organic disease of the heart is present, ii, 233. " low fever, ii, 231. Strophanthus in malarial chills, ii, 232. in oedema of the lungs, ii, 231. " pneumonia, ii, 231. " pulmonary tuberculosis, ii, 231. " renal calculi, ii, 281. " shock, ii, 231. " stenosis, ii, 231. " threatened syncope, ii, 331. " ursemia, ii, 331. " urethral chills, ii, 332. " vertigo (of the aged), ii, 233. physiological effects of, ii, 230. Strychnine. See under Nux vomica. (by hypodermic injection) as a stimulant in aconite poisoning, i, 7. in abdominal cramps, i, 28. " alcoholism, acute and chronic, ii, 29. " bronchial asthma, ii, 28. " chorea, ii, 38. " delirium tremens, ii, 7. " diphtheritic paralysis, ii, 38. " dysentery, ii, 38. " dyspnoea of pulmonary affections, ii, 38. " epilepsy, ii, 38. " functional anaesthesia, ii, 28. " heart affections, ii, 38. " hemiplegia, ii, 38. " hypochondriasis, ii, 38. (hypodermically) in hysterical paralysis, ii, 29. in idiopathic tetanus, ii, 28. (hypodermically) in local paralysis, ii, 28. in nervousness, ii, 7. " neuralgia, ii, 28. " " from impaired nutrition, i, 68. " paralysis of the bladder in old people, ii, 38. _ " prolapsus ani, ii, 38. " snake poisoning, ii, 39. " torpid liver, ii, 38. " urinary incontinence of children, ii, 38. with iron and quinine in ansemia, ii, 38. " " " " " chlorosis, ii, 38. Stupes, ii, 383. Styptiein, ii, 233. and hydrastis in congestive menorrhagia, ii, 338. as a haemostatic, ii, 233. in dysmenorrhcEa, ii, 233. " fungous endometritis, ii, 233. " haemorrhages due to uterine fibroids, ii, 333. " haemorrhages of the climacteric, ii, 333. " uterine hjemorrhage, ii, 333. " " subinvolution, ii, 233. Styptics. See Haemostatics. Styracol, ii, 333. Sty rax. See Stoeax. Styrone, ii, 233. in perforation of Shrapnell's membrane, ii, 234. Succinic acid, ii, 284. Succinum. See Amber. Sucrol. See Duloin. Sudorifics. See Diaphoretics. Suet, ii, 284. Sugar, ii, 234. as an antiseptic, ii, 284. " ecbolic, ii, 55. " oxytocic, ii, 334. 530 GENERAL INDEX. Sugar in ulcers and wounds, ii, 234. in uterine inertia, ii, 234. of milk, ii, 235. Suggestioji. See under HrPNOTiSM. Salphaminol, ii, 286. as an antiseptic, ii, 236. creosote, ii, 236. eucalyptol, ii, 236. guaiacol, ii, 236. in suppurating surfaces, ii, 236. " tuberculous deposits, ii, 236. " wounds, ii, 236. menthol, ii, 236. salicylate in rheumatism, ii, 236. Sulphanilio acid, ii, 236. Sulphates. See under Sulphuric acid. Sulphides. See under Sulphue. Sulphinide. See Saccharin. Sulphites. See under Sulphurous acid. Sulphocarbol. See Aseptol. Sulphocarbolates, ii, 236. in amygdalitis, ii, 286. . " diphtheria, ii, 236. " gonorrhcEa, ii, 286. " sore throat of scarlet fever, ii, 236. Sulphocyanates, ii, 236. Sulphonal, ii, 236. as a hypnotic, ii, 239. disagreeable effects of, ii, 237. effects of, on the blood-corpuscles, ii, 287. in acute mania, ii, 289. " asthma, ii, 239. " chorea, ii, 239. " chronic opium poisoning, ii, 239. " convulsions due to teething, ii, 239. " delirium tremens, ii, 239. " diabetes, ii, 239. " epilepsy, ii, 239. " hiccough, ii, 289. " insomnia, i, 509. " melancholia, ii, 289. " mental distress, ii, 239. " " excitement, ii, 339. " muscular cramps, ii, 239. " nervous insomnia, ii, 339. " night-sweats of plithisis, ii, 239. " nocturnal enuresis, ii, 239. " pulmonary phthisis, ii, 239. (as a prophylactic) in seasickness, ii, 339. in spasm of the muscles of broken limbs, ii, 239. " trismus neonatorum, ii, 339. " typhoid fever, ii, 339. " vomiting, i, 99. poisoning, ii, 337. Sulphosalicylic acid, ii, 239. in rheumatism, ii. 339. Sulphotumenolic acid. See Tumbnol. Sulphur, ii, 239. and cream of tartar in habitual constipation, ii, 241. and cream of tartar in haemorrhoids, ii, 241. " " " " " rectal hsemorrhages, ii, 241. and glycerin injections in infectious bone processes, ii, 341. and milk as an anthidrotic, i, 103, as a laxative, ii, 240. effects of, internally, ii, 240. for disordered liver, ii, 240. Sulphur fumes as an antiseptic, ii, 240. _ fumes in amenorrhoea of functional origin, ii, 241. fumes in chronic skin disease, i, 430. " " eczema, i, 430 ; ii, 241. " " impetigo, ii, 241. " " neuralgia, i, 430. " " prurigo, ii, 241. " " psoriasis, ii, 341. " " scabies, i, 430. " " sciatica, i, 430. " " scrofula, ii, 341. " " whooping-cough, ii, 241. in chlorosis, ii, 240. chronic bronchitis, ii, 240. '' colic due to impaction of a gallstone, ii, 240. cystitis, ii, 240. derangement of the menses, ii, 241. diseases of the nails, ii, 241. eczema seborrhoicum, i, 116. gout, ii, 241. muscular rheumatism, ii, 241. pyelitis, ii, 241. rheumatism, ii, 241. sciatica, ii, 241. skin disease, ii, 241. tuberculous joints, ii, 241. " osteomyelitis, ii, 241. (locally) in ulcerative stomatitis, ii, 341. ointment in acne, ii, 241. " " alopecia areata, ii, 241. " " erysipelas, ii, 241. " " measles, ii, 241. " (with sulphur baths) in psoriasis, ii, 241. ointment in scabies, ii, 241. " " small-pox, ii, 241. " (with sulphur baths) in sycosis, ii, 241. ointment (with sulphur baths) in tinea versi- color, ii, 241. powder (by insufaation) in croup, ii, 241. " " " " diphtheria, ii, 341. " in lumbago, ii, 341. waters in gout, i, 126. " " rheumatism, i, 126. Sulphuric acid, ii, 242. and asbestos in treatment of chancres, ii, 242. charcoal " " saffron " " " " in cholera, ii, 242. " colliquative sweating, ii, 243. " diarrhoea, ii, 342. " haemorrhages, ii, 243. Sulphurous acid, ii. 243. as an antiseptic, ii, 243. " a germicide, ii, 243. in fermentative dyspepsia, ii, 243. " hay fever, ii, 243. " tinea versicolor, ii, 243. Sumach, berries. See Rhus glabra. Sumach, sweet. See Rhus aromatica. Surabul, ii, 243. as a germicide, i, 443. as a nervous stimulant, ii, 248. in asthenia, ii, 243. " asthenic diarrhcEa, ii, 243. " cholera, ii, 243. " chronic bronchitis, ii, 243. ii,241. ii,242. GENERAL INDEX. 531 Sumbul in delirium tremens, ii, 7 ; ii, 243. in dysentery, ii, 343. " hysteria, ii, 248. " nerve exhiaustion, ii, 7. " neurasthenia, ii, 243. Suppositories, ii, 243. Suprarenal capsule, ii, 244. as a hasmostatio, ii, 246. " an astringent, ii, 246. in Addison's disease, ii, 245. " conjunctivitis, ii, 247. " diseases of the eye, ii, 246, 247. " glaucoma (secondary to cataract extrac- tion), ii, 247. " hsemorrhage, ii, 247. " interstitial keratitis, ii, 246. " iritis, ii, 247. '' neurasthenia, ii, 245. physiological action of, ii, 244. Sweet oil. See Olive oil. Symphorol, ii, 247. as a diuretic, ii, 247. Symptomatic treatment, ii, 247. Synergists, ii, 250. Synovial extract, ii, 251. in rheumatoid arthritis, ii, 251. Syrups, ii, 251. fruit, ii, 252. of cherries, ii, 252. preservation of, ii, 251. Syzygium Jambolanum. See Jambul. Tabaeum. See Tobaoco. TabellsB, ii, 252. Table of antagonistic poisons, i, 89. Tablet triturates, ii, 252. Tablets, ii, 252. compressed, ii, 253. hypodermic, ii, 253. moulded, ii, 252. Tabloids, ii, 254. Taka-diastase, ii, 254. in amylaceous dyspepsia, ii, 254. Talc, ii, 54. powder in eczema, ii, 254. in intertrigo, ii, 254. Tallow, ii, 254. Tamarind, ii, 254. as a laxative, and in fever, ii, 254. Tanacetum. See Tansy. Tannal, ii, 254. in laryngeal, nasal, and pharyngeal catarrh, ii, 254. Tannalbin, ii, 254. in chronic intestinal catarrh, ii, 254. " " ■ renal disease, ii, 255. " diarrhoea, ii, 254. " subacute intestinal catarrh, ii, 254. " tuberculous ulceration of the bowel, ii, 255. " ulcerative enteritis, ii, 254. Tannate, basic aluminum, ii, 254. Tannic acid, ii, 255. and antipyrine in hasmorrhages, ii, 257. as a germicide, i, 447. " local haemostatic, ii, 257. " styptic, ii, 257. in burns, ii, 257. '• hsematuria, ii, 257. " hyperidrosis of the hands and feet, ii, 257. " menorrhagia, ii, 357. Tannic acid in offensive axillary sweating, ii, 257. in passive hsemorrhage from the stomach and intestines, ii, 257. " poisoning with digitalis, i, 86, 108. " uterine haemorrhage, ii, 257. ointment in abrasions and excoriations, ii, 257. ointment in corns, ii, 257. " " external or prolapsed hsemor- rhoids, ii, 259. ointment in impetigo, ii, 256. " " indolent ulcers, ii, 259. " " intertrigo, ii, 856. solution and glycerin in diseases of the ton- sillar follicles, i, 446. sol ation in diseases of the nose and throat, i, 446. Tannigen, Tannigene, ii, 259. in acute eoryza, ii, 260. " enteritis, ii, 260. " otitis media, ii, 260. chronic caryza, ii, 260. " diarrhoea, ii, 260. dysentery, ii, 260. gastro-enteritis, ii, 260. hay fever, ii, 260. laryngitis, ii, 260. pharyngitis, ii, 260. subacute diarrhoea, ii, 257. summer diarrhoea (of children), ii, 360, Tannin. See Tannic acid. albuminate. See Tannalbin. and alum douche in gonorrhoeal elytritis, ii, 256. and iodine in vegetable poisoning, i, 109. as an antidote to tartar-emetic poisoning, ii, 256. glycerite of, in hypertrophied tonsils, ii, 256. in albuminuria, ii, 357. (solution) in aphthous ulcers, ii, 356. in atonic dyspepsia, ii, 357. " bronchitis, ii, 357. (Cantani's treatment) in cholera, ii, 257. in chronic eoryza, ii, 256. " " diarrhoea, ii, 257. " diarrhoea, ii, 257. " eczema, ii, 256. " epistaxis, ii, 256. (solution) in excoriations of the anus, ii, 256. " " " " " scrotum, ii, 256. (solution) in fissures of the anus, ii, 257. in haemophilia, ii, 257. " haemoptysis of pulmonary tuberculosis, ii, 257. (solution) in inflammation of the eyelids, ii, 256. injections in chronic urethritis, ii, 256. " " elytritis (of gonorrhoea), ii, 256. " " gonorrhoea, ii, 256. " " vesical catarrh, ii, 256. in night sweats, ii, 257. " phthisis, ii, 257. (internally), ii, 257. (solution) in sore nipples, ii, 256. " " stomatitis, ii, 256. in threadworms, ii, 257. (locally), ii. 256. suppositories in haemorrhoids, ii, 256. 533 GENERAL INDEX. Tannin suppositories in prolapse of the rec- tum, ii, 256. (strong solution) in suppurating sinuses, ii, 356. tampons in cystooele, prolapsus uteri, and proctocele, ii, 356. Tannoform, ii, 260. in diarrhoea and dysentery, ii, 260. (locally) in excessive sweating, ii, 260. in hyperidrosis of the feet, ii, 260. ointment in old wounds, ulcers, and moist eruptions, ii, 260. powder in diabetic pruritus vulvK, ii, 260. (as a snuff) in ozaena, ii, 260. in soft chancre, ii, 260. Tanosal, ii, 260. in catarrh of the throat and bronchi, ii, 361. " chronic broncliitis, ii, 361. " " broncho-pneumonia, ii, 361. " tuberculosis, ii, 261. Tansy, ii, 261. as a vermifuge, ii, 261. in hysteria, ii, 361. ■' intermittent fever, ii, 361. " rheumatism, ii, 261. Tapioca, ii, 261. Tar, ii, 261. beech, ii, 262. camphor, ii, 1. coal, ii, 262. in eczema (scaly forms), ii, 93, 363. " lupus, ii, 92. " psoriasis, ii, 93. " putrid sores (as a disinfectant), ii, 363. inunctions in psoriasis, ii, 363. in scabies, ii, 363. " tinea capitis, ii, 93. Kussian, ii, 363. tincture of, ii, 364 vapour in chronic inflammation of the re- spiratory tract, i, 529. vapour in pulmonary troubles, ii, 263. water in itching of the scalp, ii, 263. " " prickly heat, ii, 263. wood, ii, 264. powder, ii, 264. Taracanin. See under Blatta. Taraxaoerin, ii, 364. Taraxacin, ii, 264. Taraxacum, ii, 264. as an hepatic stimulant, ii, 365. in atonic dyspepsia, ii, 265. "chronic congestion and inflammation of the liver and spleen, li, 265. " constipation, ii, 265. " pulmonary phthisis, ii, 364. Tartar, cream of, ii, 365. emetic, ii, 265. " (by injections) for bodies impacted in the oesophagus, i, 112. ointment as a counter-irritant, i, 114. Tartaric acid, ii, 265. Tartarlithine, ii. 365. in eczema, ii, 365. " excess of uric acid in the blood, ii, 265. " gout, ii, 265. " torpor of the liver, ii, 365. Tartarus boraxatns, ii, 365. depuratus, ii, 265. natronatus, ii, 265. Tartarus stibiatus, ii, 365. Tartrate, aluminum tannic, ii, 254, Tea, ii, 265. Abyssinian, ii, 268. action of, on the system, ii, 269. as a beverage, ii, 266, 267. boneset, as a diaphoretic in colds and fevers, ii, 369. boneset, cold, in dyspepsia, general debility, etc.. ii, 269. Brazilian, ii, 268. brick, ii, 268. Bush, ii, 269. catnip, in amenorrhoea, ii, 269. " " ansemia, ii, 269. " " chlorosis, ii, 369. chronic, intoxication, ii, 367. coffee, ii, 268. elderberry, ii, 269. Garfield, ii, 369. German breast, in coughs, colds, and bron- chial affections, ii, 369. Hamburg, ii, 269. Honig, ii, 269. hot, as a diaphoretic in fevers, rheumatism, bronchitis, etc., ii, 368. hot, for relief of fatigue, ii, 268. in cardiac depression, ii, 268. •' narcotic poisoning, ii, 268. Jesuit's, ii, 268. Labrador, ii, 269. lie, ii, 268. linseed, as a laxative enema, ii, 269. " " sedative in coughs, ii, 269. " in cystitis, ii, 269. " dysentery, ii, 269. " " inflammations of the respiratory, gastro-intestinal, and urinary mucous membranes, ii, 269. linseed, in renal colic, ii, 269. " " strangury, ii, 369. marsh, ii, 369. " in skin diseases, ii, 269. marshmallow, ii, 269. method of drying, ii, 266. Mexican, ii, 369. New Jersey, ii, 369. Oswego, ii, 369. peppermint, ii, 269. saffron, as a diaphoretic in the exanthemata, ii, 269. spearmint, ii, 269. St. Bartholomew's, ii. 268. tansy, as an anthelminthic, ii, 269. " " emmenagogue, ii, 269. " " irritant narcotic, ii, 269. " in amenorrhoea, ii, 269. thoroughwort, ii, 269. warm, ii, 269. " in roundworms, ii, 269. Teaberrv. See Gaulthebia. Teas, ii,'268. Teel oil. See Sesame oil. Tents, ii, 369. laminaria, ii, 370. manner of introducing, ii, 270. sponge, ii, 270. sterilization of, ii, 270. tupelo, ii, 270. Terebene, ii, 270. GENERAL INDEX. 533 Terebene and olive oil (locally) in sloughing carcinoma of the cervix uteri, ii, 271. as an antiseptic, i, 529. " expectorant, ii, 371. in acute bronchitis, ii, 271. " asthma, i, 97 ; ii, 271. " bronchiectasis, ii, 371. (as a dressing) in burns, ulcers, and wounds, ii, 271. in chronic bronchitis, ii, 271. " " rhinitis, ii, 271. " emphysema, ii, 371. " flatulence, ii, 271. " foetid bronchitis, ii, 271. " haemoptysis, ii, 371. " phthisis, ii, 371. " pleurisy, ii, 271. " pleuritic adhesions, ii, 271. " pleuro-pneumonia, ii, 271. (inhalation) in pulmonary tuberculosis, i, 529. in subacute inflammations of the genito-uri- nary tract, ii, 271. " winter cough of chronic bronchitis, ii, 371. Terebinthina. See Turpentine. Terpin hydrate, ii, 371. in acute bronchitis, ii, 373. " chronic bronchitis, ii, 273. " " cystitis, ii. 373. " " diffuse nephritis, ii, 373. " " disease of the heart and kidneys, ii, 373. " chronic nephritis, ii, 272. " flatulence, ii, 272. " gonorrhoea, ii, 373. " hay fever, ii, 272. " whooping-cough, ii, 373. Terpinol, ii, 272. in chronic bronchitis, ii, 378. " respiratory diseases, ii, 372. Testa prseparata, ii, 273. Testicle juice. Testicular liquid, i, 73 ; ii, 373. Testicular liquid in cancer, i, 75. in chorea, i, 75. " diabetes mellitus, i, 75. " epilepsy, i, 76. " leprosy, i, 75. " locomotor ataxia, i, 74. " neurasthenia, i, 76. " skin diseases, i, 75. " tuberculosis, i, 74. Tetanus antitoxine, ii, 373. Tetrabromide. See under Thiophene. Tetraethylammonium. See Tetbethtlammo- NIUM. Tetrahydrobetanaphthylamine. See Thee- MINE. Tetrahydroparaquinanisol. See Thalline. Tetraiodopyrrhol. See Iodol. Tetraiodphenolphthalein. See Nosopheije. Tetrethylammonium, ii, 373. as a solvent for urea and uric acid, ii, 373. in acute and chronic rheumatism, ii, 373. " goutv joints or rheumatic tophi, ii, 373. Tetronal,'ii, 278. (as a sedative hypnotic) in insomnia due to nervousness or restlessness, ii, 273. in sleeplessness of the acute infectious dis- eases, ii, 373. Teucrin, ii, 373. in actinomycosis, ii, 273. Teucrin in cold abscess, ii, 373. in lupus vulgaris, ii, 378. " tuberculous adenitis, ii, 373. Teucrium, ii, 873. Thallasotherapy, ii, 873. Thalline, ii, 375. in hyperpyrexia, ii, 876. injections (as an antiseptic) in gleet and gonorrhoea, ii, 376. in tuberculosis, ii, 876. " tvphoid fever, ii, 376. Thapsia, ii, 876. Thea. See Tea. Theine, ii. 376. as an analgetic and local anassthetic, ii, 376. (for relief of pain) in locomotor ataxia, ii, 377. in lumbago, ii, 277. " myalgia, ii, 277. " neuralgia, ii, 377. " neuralgic pain, ii, 877. " sciatica, ii, 377. Theism, ii, 867. Theobroma. See Cacao buttee. Theobromine, ii, 877. as a diuretic, ii, 277. in anasarca of Bright's disease, ii, 277. " dropsy of cardiac origin, ii, 277. Therapol, ii, 277. Theriaca. See Teeacle. Thermifugin, ii, 377. Thermine, ii, 377. as a mydriatic, ii, 377. Thermodine, ii, 878. Thialdin, ii, 378. as a heart stimulant, ii, 378. Thilanin, ii, 378. Thiocamphor, ii, 878. Thioform, ii, 878. (internallTr) in acute enteritis, ii, 278. in burns, ii, 278. " conjunctivitis, ii, 278. " purulent otitis media, ii, 378. " ulcerated surfaces, ii, 378. " ulcer of the cornea, ii, 878. " " " " leg, ii, 878. Thiol, ii, 378. ointment^ in eczema, erysipelas, erythema, inflammatory deposits, lupus, and ulcers, ii, 878. solid, in treatment of burns, ii, 378. Thiolin, Thiolinic acid, ii, 378. Thiooxydiphenylamine. See Sdlphaminol. Thiophene, ii, 379. diiodide as an antiseptic, ii, 279. Thioresorcin, ii, 279. Thiosalicylic acid. See Sulphosalicylic acid. Thiosaprol, ii, 379. in skin diseases, ii, 379. Thiosinamine, ii, 379. in ankylosis (of the knee), ii, 381. " cicatrices, ii, 380, 381. " corneal opacities, ii, 380, 881. " ectropion, ii, 881. " glandular swellings, ii, 880. injections in keloid, ii, 881. in lupus, ii, 379. 880. " " erythematosus, ii, 880. " " vulgaris, ii, 880. " malignant neoplasms, ii, 381. 534 GENERAL INDEX. Thiosinamine in neoplasms, ii, 379, 280. in serous exudations, ii, 280. " stricture of the uretiira (cicatricial), ii, 280. " stricture of the urethra or rectum, ii, 281. " talipes equinus, ii, 281. " ulcer of the leg, ii, 280. " uterine myoraata, ii, 281. Thiosulphates. See Hyposulphites. Thiuret, ii, 281. Thorn apple. See Stramonium. Thoroughwort. See Eupatomum. Thuja in malarial fevers, ii, 282. in rheumatism, ii, 282. Thus Americanum. See Olibanum. Thymacetine, ii, 382. as a hypnotic, ii, 282. " an analgetic, ii, 283. in nervous headaches, ii, 383. physiological effects of, ii, 383. Thyme, ii, 383. as a carminative, ii, 283. " stimulant, ii, 282. Thymol, ii, 383. and gallic acid in ohyluria, ii, 383. as a germicide, i, 448. " tseniacide, ii, 384. in abnormal fermentative processes in the alimentary tract, ii, 383. " acne, ii, 384. " acute articular rheumatism, ii, 283. " " intestinal disorders, ii, 383. (as an anthelminthio) in ankylostomiasis, ii, 384. in atrophic rhinitis, ii, 383. " chronic intestinal disorders, ii, 383. " diabetes, ii, 383. " eczema, ii, 284. " erosions of the os uteri, ii, 284. " favus, ii, 284. " inflammation of the dental pulp, ii, 284. inhalation in bronchitis, ii, 283. " " diseases of the upper air-pas- sages, ii, 383. in headaches, ii, 383. " laryngitis, ii, 384. " leuoorrhcea, ii, 384. " offensive lochia, ii, 284. " pharyngitis, ii, 284. " phthisis, ii, 383. " pityriasis, ii, 384. " pruritus, ii, 384. " psoriasis, ii, 284. " purulent rhinitis of children, ii, 383. " ringworm of the scalp, ii, 284. " tympanites, ii, 383. " typhoid fever, ii, 383. " whooping-cough, ii, 283. physiological action of, ii, 383. Thymus extract, Thymus feeding, ii, 284. extract in dyspnoea, ii, 285. in palpitation, ii, 285. " tremors, ii, 285. " typhoid fever, ii, 285. Thyraden, ii, 287. Thyreoantitoxine, ii, 387. Thyreoid extract. Thyreoid feeding. Thyreoid gland, Thyreoid medication, Thyreoid treatment, i, 76 ; ii, 287. extract, dose and administration of, i, 80. " in dermatitis exfoliativa, i, 79. Thyreoid extract in exophthalmic goitre, i, 78. extract in ichthyosis, i, 79. " insanity, i, 79 ; ii, 396. " mvxoedema, i, 76, 77, 78 ; ii, 289. " " obesity, i, 79 ; ii, 295. " " psoriasis, i, 79 ; ii, 393. " " skin diseases, i, 79 ; ii, 298. " syphilis, i, 79 ; ii, 295. " " xeroderma, i, 79. treatment, administration of the, ii, 289. " for checking the growth of the foetus in utero, ii, 399. treatment, history of the origin of, ii, 288. " in acromegaly, i, 80 ; ii, 295. " " anaemia, i, 80 ; ii, 395. " " " obesity, ii, 395. " " catalepsy, ii, 298. " " catatonia, ii, 399. " " circumscribed sclerodermia, ii, 293. treatment in cretinism, i, 78 ; ii, 290. " " deformity of the nails, ii, 292. " " eczema, i, 79 ; ii, 293. " " epilepsy, ii, 293. " " fibrous tumours of the uterus, ii, 298. treatment in general paresis, ii, 291. " " goitre, ii, 297. " " leprosy, ii, 295. " lupus, ii, 394. " " melancholia, ii, 399. " myopathy, ii, 298. " " primary dementia, ii, 291. " " puerperal insanity, ii, 291. " " secondary dementia, ii, 391. " stunting of the growth, ii, 300. " " stuporous insanity, ii, 299. " " suicidal melancholia, ii, 391, " tetany, ii, 398. Thyreoiodine, Thyreoiodinin, ii, 300. in cretinism, ii, 302. " ichthyosis, ii, 302. " infantile cretinism, ii, 303. " lupus, ii, 303. " myxoedema, ii. 303. " psoriasis vulgaris, ii, 303. " sclerodermia, ii, 302. " sporadic cretinism, ii, 302. " xerodermia, ii, 302. Thyreoprotein, ii, 303. Tiglium. See Croton oil. Tin, ii, 303. Tinctures, ii. 303. Tobacco, ii, 304. enema in impaction of feeces, ii, 804. in intussusception, ii, 305. " painter's colic, ii, 305. " strychnine poisoning, ii, 305. " tetanus, ii, 305. Toddalia, ii, 308. in chronic diarrhoea, ii, 308. " convalescence from fevers, ii, 308. (as a tonic) in general debility, ii, 808. Tokay, ii, 308. (as a tonic) in debility of convalescence, ii, 308. in influenza, ii, 308. " neurasthenia, ii, 308. Tolu balsam, ii. 308. in catarrh of the bronchial apparatus, ii, 309. GENERAL INDEX, 535 Tolii balsam in chronic bronchitis, ii, 309. in chronic diarrhoea, ii, 809. " " dysentery, ii, 309. " " mucous fluxes of the bronchi, ii, 309. " chronic mucous fluxes of the urinary or- gans, ii, 309. " skin diseases, ii, 809. " suppurating and inflamed areas, ii, 309. Toluene, Toluidine, Toluol, ii, 309. in diphtheria, ii, 309. Tolylantipyrine. See Tolypyeine. Tolylhypnal, ii, 309. Tolypyrine, ii, 309. (as an analgetic and antipyretic) in rheuma- tism and in neuralgia (rheumatic), ii, 309. Tolysal, ii, 309. Tonga, ii, 309. in neuralgia, ii, 309. Tongaline, ii, 309. in gout, influenza, nervous headache, neu- ralgia, and rheumatism, ii, 309. Tongue traction. See under Anesthetics (vol. i, page 64). Tonics, ii, 309. gastric, ii, 310. general, ii, 310. nervous, ii, 310. specific, ii, 310. vascular, ii, 310. Tonquinol, ii, 310. Tormentilla, ii, 311. in diarrhoea and dysentery, ii, 311. Touchwood, ii, 311. Toxalbnmins. See Toxines. Toxicodendron, ii, 311. Toxieological antagonism, i, 87. Toxines, ii, 311. in anthrax, ii, 315. " cancer, ii, 315. " carcinoma, ii, 313. " erysipelas, ii, 313. " " inoperable " sarcoma, ii, 311. " sarcoma, ii, 312, 314. (mixed) in syphilis, ii, 316. in tumours, ii, 313. local and constitutional effects of the, ii, 313. method of preparing, ii, 311. result of cases treated by Dr. Coley with, ii, 313. Tragacanth, ii, 316. Transfusion and infusion, ii, 316. depletory (Landois's), ii, 323. " in asphyxia, ii, 323. " " neonatorum, ii, 323. " cholaemia, ii, 323. " " puerperal eclampsia, ii, 323. " " urasmia, ii, 323. direct and indirect, ii, 318-320, 326, 337. hypodermic, ii, 323. in acute anaemia, ii, 322. " " infectious diseases, ii, 333. " anaemia, ii, 322. " cachexia, ii, 323. " chlorosis, ii, 322. " cholera, ii, 333. indications for performing, ii, 333. in haemorrhage from traumatism, ii, 383. " inanition, ii, 333. " pernicious anaemia, ii, 333. Transfusion and infusion in pysBmia, ii, 323. in septicffimia, ii, 333. " severe burns, ii, 333. " small-pox, ii, 323. (with lamb's blood) in typhoid fever, ii, 323. nervous, ii, 328. (Baccelli's method) of mercury in syphilis, ii, 322. peripheral, in freezing of the extremities, ii, 323. reciprocal, ii, 328. rectal, ii, 325. (von Ziemssen's method), ii, 320, 323. Traumaticin, ii, 328. and calomel (locally) in syphilis, ii, 329. as a solvent for drugs employed in skin dis- eases, ii, 329. in abrasions or slight excoriations, ii, 328. " cutaneous eruptions and fissured lips, ii, 328. (as a protective) in superficial injuries or in- flammations, ii, 328. Traumatol, ii, 339. as an antiseptic, ii, 329. in eczema, ii, 339. " endometritis, ii, 339. " metritis, ii, 329. " varicose ulcers, ii, 329. " soft chancres, ii, 329. " vaginal gonorrhoea, ii, 329. " wounds, ii, 329. Treacle, ii, 339. whey in colds, ii, 339. Trefusia, ii, 329. in anjemia and chlorosis, ii, 339. Tribromaeetyl oxide. See Beomal. Tribromaldehyde. See Beomal. Tribromaniline hydrobromide. See Beoma- MIDE. Tribromhydrin, ii, 330. as a stimulant expectorant, ii, 830. in acute bronchitis, ii, 330. " angina pectoris, ii, 330. " asthma, ii, 330. " chronic bronchitis, ii, 330. " convulsions of infancy, ii, 330. Tribromomethane. See Beomofoem. Tribromphenol. See Bkomol. Tribromsalol, ii, 330. as an intestinal antiseptic, ii, 880. Tribulus lanuginosus, ii, 330. in colic, ii, 330. " gonorrhoea, ii, 330. " dyspnoea, ii, 330. " spermatorrhoea, ii, 330. " urinary irritation, ii, 330. Trichloracetic acid, ii, 330. in enlarged tonsils, ii, 330, Triehlorphenol, ii, 330. applications in erysipelas, ii, 330. in dysentery, ii, 330. " foul ulcers, ii, 380. " leucorrhoea, ii, 330. Tricresol, ii, 330. inhalation in diseases of the respiratory passages, ii, 331. Tricresolamine, ii, 330. Trifolium fibrinum, ii, 381. Triformal. See Poemaldehydb. Triformol, ii, 331. 536 GENERAL INDEX. Triiodometacresol. See. Losophan. Trikresol. See Tricresol. Trimethylamine, ii, 331. in acute rheumatism, ii, 331. Trimethylethylene. See Pental. Trinitrin. See Nitroolycerin. Triiiitrocellulose. See Photoxylin. Trinitrophenol. See Picric acid. Trional, ii, 331. as a hypnotic, ii, 331. for functional psychoses, ii, 332. in chorea, ii, 333. " delirium, i, 509. " dysmenorrhoea, ii, 333. " insomnia, i, .509 ; ii, 833. " " of dentition and indigestion, ii, 333. (for insomnia) in neurasthenia, ii, 332. in opiam poisoning, ii, 332. " organic brain disease, ii, 333. " pavor nocturnus, ii, 333. poisoning by, ii, 333. Trioxybenzol. See Gallaoetophenone. Trioxymethylene. See Parafobm. Triphenine, ii, 333. Triticum, ii, 333. in cystitis, ii, 333. " gonorrhoea, ii, 333. Triturates, tablet, ii, 352. Troches, ii, 333. Tropacooaine, ii, 333. as a local ansesthetic, ii, 334. in keratitis, ii, 334. Trypsin, ii, 334. applications in diphtheria, ii, 334. (as a solvent) in diphtheritic membrane, ii, 384. Tuberculin, i, 81 ; ii, 384. dose of, i, 83. in lupus, i, 81. " tuberculosis, i, 81. Tuberculocidin, ii, 334. Tumenol, ii, 334. oil and oxide of zinc in impetigo pemphigus and superficial ulcerations, ii, 334. -sul phonic acid in acute recurrent eczema of the hands and face, ii, 834. tincture in itching of eczema and prurigo, ii, 334. Turmeric, Turmerol. See under Curcuma. Turpentine, ii, 884. and olive-oil enema after coeliotomy, ii, 335. " milk of asafcetida enema in meteorism from functional causes, ii, 335. as a rubefacient, ii, 335. Canada, ii, 385. Chian (locally and internally), in cancer, ii, 335. " inflammatory processes, ii, 335. injections, rectal, in narcotic poisoning, ii, 335. in parasitic diseases of the scalp, ii, 335. " rheumatism, ii, 335. liniment in burns, ii, 335. " " " and scalds, ii, 336. " " carbuncles, ii, 336. " " eczema, ii, 335. " " erysipelas, ii, 335. " " furuncles, ii, 336. " " local gangrene, ii, 335. Turpentine oil, ii, 335. oil as a hoemostatic, ii, 336. " " vermifuge, ii, 337. " baths of the vapour of, in chronic rheu- matism, ii, 336. " in amenorrhcea, ii, 386. " " ascarides, ii, 386. " (internally) in bronchitis, i, 418 ; ii, 336. " in chronic pyelitis, ii, 336. " " " urethritis, ii, 336. '• " cystitis, ii, 836. " " erysipelas (of traumatic origin), ii, 336. " " hemorrhage following the extraction of teeth, ii, 336. " in impotence, ii, 336. " " incontinence of urine, ii, 336. " (internally) in low fevers, ii, 885. " in lumbago, ii, 386. " (locally) in neuralgia, ii, 336. " in phosphorus poisoning, ii, 336. " (internally) in pneumonia, ii, 336. " in post-partum hfemorrhage, ii, 336. " (locally and internally) in puerperal fever, ii, 386." " (inhalation) in pulmonary tuberculosis, i, 529. " in sciatica, ii, 336. " " scurvy, ii, 387. " " spermatorrhoea, ii, 336. " " tEenia, 1, 102 ; ii, 836. " (internally) in typhoid fever, ii, 835. " " ' " ulcerative processes of the intestines and stomach, ii, 335. " in whooping-cough, ii. 336. " vapour of, in asthma, ii, 386. " " '■ " fcetid bronchitis, ii, 336. " " " " gangrene of the lungs, ii, 336. " vapour of (thrown on the bedclothes), in scabies, ii, 336. stupes as a counter-irritant, ii, 885. " in bronchitis, ii, 335. " " peritonitis, i, 313 ; ii, 335. Turpeth mineral, ii, 337. Tussilago, ii, 387. Tussol, ii, 337. in whooping-cough, ii, 337. Tntty. See under Zinc. Tylophora, ii, 837. as a diaphoretic, emetic, and expectorant, ii, 337. in asthma, ii, 337. " dysentery, ii, 387. Tylophorine, li, 387. Ulexine, ii, 337. as a diuretic, ii, 837. in cardiac dropsy, ii, 337, TJlmus, ii, 337. in diarrhoea, ii, 337. " dysentery, ii, 337. " inflammatory cutaneous affections, ii, 338. Ulyptol. See Eulyptol. Unguents. See Ointments. Ural, ii, 838. • in functional and organic mental disease, ii, 338. " insomnia of chronic heart disease, ii, 338. " nervous conditions, ii, 338. Uraline, Uralium, Uralum, ii, 338. GENERAL INDEX. 537 Uranium, ii, 338. nitrate, ii, 338. " in diabetes mellitus, ii, 338. " " treatment of diabetes, ii, 338-343. Urethane, ii, 343. as a hypnotic and sedative, ii, 343. in acute mania, ii, 342. " delirium tremens, ii, 343. " functional disturbances and organic dis- eases of the brain, ii, 343. " insomnia, ii, 343. " tetanus, ii, 343. Uricedin, ii, 343. in gout, ii. 343. " uric-acid diathesis, ii, 343. Uropherine, ii, 342. as a diuretic, ii, 343. Urotropine, ii, 342. as a diuretic, ii, 343. in cystitis, ii, 343. " gouty and rheumatic conditions, ii, 343. " suppuration of the urinary tract, ii, 343. " uric-acid calculi, ii, 343. " " diathesis, ii, 343. Urtica, ii, 343. as a diuretic and haemostatic, ii, 343. in rhus poisoning, ii, 343. " uterine haemorrhage, ii, 343. Ustilago maidis. See Ergot of Maize (vol. i, page 389). Uva;, ii, 343. Uva ursi, ii, 343. as a diuretic, ii, 343. " an astringent, ii, 343. " a tonic, ii, 343. in chronic cystitis, ii, 343. " diarrhoea (later stages), ii, 343. " gleet, ii, 343. " pyelitis, ii, 343. Vaccinin, ii, 344. Vaccinium, ii, 344. as an astringent, antiscorbutic, detersive, and refrigerant, ii, 344. in acute rheumatism, ii, 344. " chronic articular rheumatism, ii, 344. " eczema, ii, 458. " mycosis flexurarum, ii, 458. " mycotic eczema, ii, 458. " occupation eczema, ii, 458. " rheumatism, ii, 344. " seborrhoeal eczema of the face and hands in children, ii, 458. Valerian, ii, 344. as a general stimulant, ii, 345. " an antispasmodic, ii, 345. " a sedative to the nervous system, ii, 345. in chorea, ii, 345. " coma of typlius fever, ii, 845. " convulsions, ii, 345. " cough of nervous origin, ii, 345. " delirium with depression, ii, 345. " flatulence of infants, ii, 345. " hysteria, ii, 345. " hystero-epilepsy, ii, 345. " insomnia of hysteria, ii, 345. " nervous disorders dependent upon intes- tinal parasites in children, ii, 345. " nervous excitement, ii. 345. " " headache, ii, 345. Valerian in nervous phenomena of exophthal- mic goitre, ii, 345. in nervousness of the menopause, ii, 345. " petit mal, ii, 345. " pruritus of neurotic origin, ii, 345. " whooping-cough, ii, 345. Valerianate, ammonium, in headache, insom- nia, neuralgia, and palpitation of the heart, ii, 346. amyl. See vol. i. page 63. antipyrine, ii, 346. atropine. See vol. i, page 157. bismuth, ii, 346. caffeine, as a general stimulant, ii, 346. " in hysteria, ii, 346. " " nervous vomiting, ii, 346. " " whooping-cough, ii, 346. cerium, in vomiting of pregnancy, ii, 346. creosote, ii, 346. iron, ii, 346. " in anaemia, ii, 346. " " chlorosis, ii, 346. " " hysterical symptoms, ii, 346. morphine, ii, 346. quinine, ii, 346. " in hysteria and nervousness, ii, 347. sodium, in functional derangements of the nervous system, ii, 347. zinc, in hay fever, ii, 347. " " incontinence of urine from a neurotic cause, ii, 347. zinc, in neuralgia, ii, 347. Valerianates, ii, 346. Valerianic acid. See under Valerian and Vi- burnum PRUNIFOLIUM. Valerol. See under Valerian. Valzin. See DuLciN. Vanilla, ii, 347. Vanillic aldehyde, Vanillin, ii, 847. Vapours, ii, 347. moist, ii, 348. Varnishes, ii, 348. Vascular sedatives, Vascular stimulants. See Cardiac stimulants. Tonics, and De- pressants. Vaseline, ii, 349. as a lubricant, ii, 849, liquid, ii, 349. oxygenated, ii, 349. Vaselone, ii, 349. Vasogen, ii, 349. in nodes, ii, 349. iodized, in mucous patches, ii, 350. " " sciatica, ii, 350. " " secondary syphilis, ii, 349. Venesection. See Bloodletting. Veratrine, ii, 350. as an antiparasitic, ii, 350. former use of, internally, ii, 350. in alopecia areata, ii, 350. " aspergillus infection, ii, 350. " " in the ear, ii, 351. " chronic enlargement and stiffness of the Joints, ii, 350. " chronic pleurisy, ii, 350. "infantile paralysis, ii, 350. " myalgia, ii, 350. " phtheiriasis, ii, 350. " pleurodynia, ii, 350. " superficial neuralgias, ii, 350. 538 GENERAL INDEX. Veratrine in tic douloureux, ii, 350. Veratroidine. See under Vekatrum tieide. Veratrol, ii, 351. Veratrum album. See Hellebore, White. nigrum. See Helleboee, Black. viride, ii, 351. and gelsemium in traumatic tetanus, ii, 355. as a cardiac depressant, ii, 351. in abnormal cardiac tension of renal disease, ii, 353. " acute mania, ii, 352. " amygdalitis, ii, 353. " aneurysm, ii, 353. " cerebral irritation from drink, ii, 353. " exophthalmic goitre, ii, 353. " hjemorrhage, ii, 353. " hepatitis, ii, 353. " hypertrophy of the heart, ii, 353. (iiuid extract or the tincture) in incipient inflammations, ii, 353. in irritability of the heart, ii, 353. " parenchymatous and serous inflammation, ii, 353. " pleurisy, ii, 353. " pneumonia, ii. 353. " priapism, ii, 353. (Norwood's tincture) in puerperal convul- sions, ii, 354. (large doses) in puerperal eclampsia, ii, 353. (to reduce vascular excitement) in puerperal peritonitis, ii, 353. in puerperal phlebitis, ii. 353. physiological action of, ii, 351. therapeutic value of, ii, 353. treatment of puerperal convulsions with, ii, 354, 355. Verbascum, ii, 356. decoction of, in diarrhoea, as a demulcent and astringent, ii, 356. Verdigris. See Cuprio acid (vol. i, page 303). Vernonia, ii, 356. as an anthelminthic, ii, 356. " a stomachic, ii, 356. Vesicants, Vesicatories. See Blisters. Viburnum opulus, ii. 356. prunifolium, ii, 356. " as a diuretic, ii, 356. " as an antispasmodic, ii, 356. " " astringent, ii, 356. " as a nervine, ii, 356. " " uterine sedative, ii, 356. " in after-pains, ii, 357. " " colicky diarrhoea, ii, 357. " " dysentery, ii, 857. " " dysmenorrhcea, ii, 356, 357. " " " with menor- rhagia, ii, 356. prunifolium in false pains, ii, 357. . " " habitual abortion, ii, 357. " " hyperEemia of the pelvic or- gans, ii, 356. prunifolium in hysteria, ii, 357. . " " hystero-epilepsy, ii, 357. " " menorrhagia, ii, 356. " " metrorrhagia, ii, 356. " " paralysis agitans, ii, 357. " " petit mal, ii, 357. Viburnum prunifolium in threatening abor- tion, ii, 357. prunifolium in vaginal dysmenorrhcea, ii, 357. prunifolium, physiological eflEect of, on man, ii, 358. Vichy, ii, 358. water m cystitis, ii, 358. " " diabetes, ii, 358. " " diseases of the liver, ii, 358. " " dyspepsia, ii, 358. " " enteritis, ii, 358. " " gastritis, ii, 358. " " gout, ii, 358. " " hepatic colic, ii, 358. " " icterus, ii, 358. " " lithaimia, ii, 358. " " rheumatism, ii, 358. Vieirio acid, Vieirin, ii, 358. in malarial fevers, ii, 358. Vinca, ii, 858. Vinegar, ii, 358. in poisoning with alkalies, ii, 359. " " " carbolic acid, ii, 359. " vomiting after anaesthesia with chloro- form, ii, 359, 360. sponging with a solution of, in fevers, ii, 359. Vinum. See WiNB. Viola cucuUata in rattlesnake poisoning, ii, 360. -quercitrin, ii, 360. tricolor, ii, 360. " (syrup) in bronchial affections as a demulcent and laxative, ii, 360. tricolor in crusta lactea, ii, 360. " " eczema, ii. 360. " " infantile eczema of the head and face, ii, 860. Violets. See under Viola tricolor. Violine, ii, 360. Virginia snakeroot. See Serpentaria. Virol, ii, 361. Viruses. See under Animal extracts and JUICES (vol. i, page 83) and Toxines. Viscum album, ii, 361. as an oxytocic, ii, 361. in amenorrhoea, li, 361. " menorrhagia, ii, 361. " uterine hasmorrhage, ii, 361. Vitellus, ii, 361. Vitis idsea. See Vaocintum. Vitriol, blue. See Cupric sulphate, under Copper. green. See Iron sulphate, under Iron (vol. i, page 549). oil of. See Sulphuric acid. white. See Zinc sulphate, under Zinc. Vulneraries, ii, 361. Wafers, ii, 361. Wahoo. See Buonymus. Washes. See Lotions. Water, ii, 361. as a lithontriptic, i, 586. " solvent, li, 311. barley, in fevers, i, 351. cold (internally), in fevers, i, 479. effects of, on the stomach and intestine, i, 477. GENERAL INDEX. 539 Water, enema of hot, in shook, i, 491. general effect of, on the interior of the body, i, 476. hot, applications of, in plastic iritis, ii, 213. hot, applications of, in ulcer of the cornea, ii, 213. hot, douche of, in catarrh of the vagina and cervix uteri, i, 480. hot, douches of, in neuralgic conditions of the ovaries, i, 480. hot, douches of, in parametritis, ii, 213. hot (by the mouth or rectum), in hiemor- rhage, ii, 227. iced, injections of, in post-partum hemor- rhage, i, 480. (rectal applications) in acute and chronic dysentery, i, 479. in cancer of the stomach, i, 479. (rectal applications) in chronic haemorrhoids, i, 479. in constipation, i, 479. " cystitis, i, 346. (rectal applications) in fsecal impaction, i, 479. in functional disorders of the stomach and intestines, i, 479. in gastro-intestinal catarrh, i, 479. " gouty and rheumatic diatheses, i, 350. " lithBBmia, i. 479. " the pelvic diseases of women, i, 480. " ulcer of the stomach, i, 479. " urethritis, 1, 346. Javelle, i, 240. therapeutic effects of, i, 479. warm, as an emetic for cleansing the stomach in continued vomiting, i, 372. Waters, carbonated, ii, 364. chlorinated, ii, 365. mineral, ii, 363. " in amenorrhoea, ii, 375, 383. " " anjemia, ii, 375, 384. " " anasarca, ii, 379. " ascites, ii, 379. " " biliary obstruction, ii, 376. " Bright's disease, ii, 364, 384. " (Arkansas Hot Springs), in Bright's disease, ii, 374, 879. mineral, in calculus, ii, 379. " " catarrh, ii, 375. " (Arkansas Hot Springs), in catarrhal affections of the digestive tract, ii, 374. mineral, in catarrh of the bile ducts, ii, 384. " " chlorosis, ii, 384. " " chronic adenitis, ii, 383. " " " alcoholism, ii, 379. " " " catarrhal gastro-enteritis, ii, 376. mineral, in chronic constipation, ii, 379. " " cystitis, ii. 377. " (Arkansas Hot Springs), in chronic diarrhoea, ii. 374, 379. mineral, in chronic duodenal catarrh, ii, 384. mineral, in chronic inflammations of the in- testines, stomach, or throat, ii, 364. mineral, in chronic leuoorrhcea, ii, 383. " " " metallic poisoning, ii, 381. mineral, in chronic paludal poisoning, ii, 384. 78 Waters, mineral, in chronic rheumatism, ii, 364. mineral (Arkansas Hot Springs), in chronic skin diseases, ii, 374. mineral, in constipation, ii, 876. " (Arkansas Hot Springs), in constitu- tional syphilis, ii, 374. mineral, in cystic catarrh, ii, 881. " (Arkansas Hot Springs), in cvstitis, ii, 374. mineral, in debility, ii, 384. " " diseases of the stomach, liver, kidney, and bowels, ii, 381. mineral (Arkansas Hot Springs), in diseases of the urinary organs, ii, 374. mineral, in disorders of the sexual organs in women, ii, 884. mineral, in dysmenorrhoea. ii, 383. " dyspepsia, ii, 377, 379, 384. " " " of hepatic origin, ii, 875. mineral, in excoriations of the epidermis, ii, 875. mineral (Arkansas Hot Springs), in function- al diseases of the liver, ii, 374. mineral, in functional neuroses, ii, 375, 884. " gallstones, ii, 375, 381. " " gastric atony, ii, 875. " " gastric catarrh, ii, 375, 376. " " gleet, ii, 377. " gout, ii, 364, 374, 375, 877, 379, 381. mineral (Manitou Springs), in gravel, ii, 375. " in hfemorrhoids, ii, 375. " " hepatic congestion and enlarge- ment, ii, 384. mineral, in hepatic derangements, ii, 377. " " " engorgement, ii, 881. mineral (externally and internally), in hyste- ria, ii, 364. mineral (externally and internally), in insom- nia, ii, 364. mineral, in intestinal atony, ii, 875. " jaundice, ii, 375, 379. " (injections), in leucorrhoea, ii, 375. " in lithiasis, ii, 377. " (Arkansas Hot Springs), in locomo- tor ataxia, ii, 375. mineral (Arkansas Hot Springs), in malarial poisoning, ii, 374. mineral, in menorrhagia, ii, 875. " neuralgia, ii, 364. 374, 384. " neurasthenia, ii, 364, 377, 379. " " paludal poisoning, ii, 879. " (Arkansas Hot Springs), in paraly- sis (inorganic), ii, 374. mineral (internally and externally), in pa- ralysis due to lead, ii, 864. mineral, in peripheral neuritis, ii, 364. " " plethora, hepatic or renal, ii, 375. " " prostatitis, ii, 377. " (Manitou Springs), in pyrosis asso- ciated with chronic dyspepsia), ii, 375. mineral, in renal calculi, ii, 384. " " " congestion, ii, 381. " rheumatism, ii, 881, 384. " " rheumatoid arthritis, ii, 376. " " saturnism, ii, 376. " (Manitou Springs), in skin diseases, ii, 375, 381. 540 GENERAL INDEX. Waters, mineral, in uricaemia, ii, 377. mineral, in uterine derangements, ii, 381. " " " engorgement, ii, 383. alkaline, ii, 363, 366. " " in acute laryngitis, ii, 367. " " " bronchial catarrh, ii, 367. mineral, alkaline (carbonated), in chronic dyspepsia, hepatic congestion, and rheu- matism, ii, 375. mineral, alkaline, in chronic laryngitis, ii, 367. . . .. mineral, alkaline, in chronic pharyngitis, u, 367. , , ,. mineral, alkaline, in cystic and renal calculi, ii, 367. mineral, alkaline, in cystitis, ii, 366. '■ " " dyspepsia (associated with hyperacidity), ii, 366. mineral, alkaline, in gastric catarrh, ii, 366. mineral, alkaline, in gout, ii, 367. " " " pyelitis, ii, 366. " " " ureteritis, ii, 366. " " " urio-aoid diathesis, ii, 367. mineral, bitter, ii, 367. " Buffalo lithia, ii, 371. " " " in acne, ii, 373. " " " " albuminuria, ii, 373. mineral, Buffalo lithia, in amenorrhcea, ii, 373. mineral, Buffalo lithia, in Bright's disease, ii, 373. mineral, Buffalo lithia, in cachexia, ii, 373. ■' " " " cystitis, ii, 373. " " " " diabetes mellitus, ii, 373. mineral, Buffalo lithia, in dysmenorrhoea, ii, 373. mineral, Buffalo lithia, in dyspepsia, ii, 373. mineral, Buffalo lithia, in eczema, ii, 373. " gleet, ii, 373. " " " " hepatic engorge- ment, ii,, 373. mineral, Buffalo lithia, in inflammation of the vermiform appendix (from phosphatic deposits), ii, 373. mineral, Buffalo lithia, in jaundice, ii, 373. mineral, Buffalo lithia, in lithiasis, ii, 373. " " " " menorrhagia, ii, 373. mineral, Buffalo lithia, in nephritic colic, ii, 373. mineral, Buffalo lithia, in paludal fever (se- quela;), ii, 373. mineral, Buffalo lithia, in scarlatinal nephri- tis, ii, 373. mineral, Buffalo lithia, in syphilis, ii, 373. " " " " uraemia, ii, 373. mineral, carbonated, ii, 364. " carbonate, in gastric atony, ii, 364. mineral, carbonated, in intestinal atony, ii, 364. mineral, carbonated, in nausea, ii, 364. " " " prostatic or vesical irritability, ii, 365. Waters, mineral, chalybeate, ii, 369, 381. mineral, chlorinated, ii, 365. " " (externally and inter- nally), in anfemia, ii, 365. mineral, chlorinated, in bronchial catarrh, ii, 366. mineral, chlorinated, in caries, ii, 366. " " (warm), in chronic gas- tritis, ii, 365. mineral, chlorinated, in gastric catarrh, ii, 365. mineral, chlorinated, in general asthenia, ii, 366. mineral, chlorinated, in gout, ii, 365. " " (externally and inter- nally), in hepatic congestion with constipa- tion, ii, 365. mineral, chlorinated, in hypertrophy of the spleen, ii, 366. mineral, chlorinated, in necrosis, ii, 366. " " " neurasthenia, ii, 365. " " " rhachitis, ii, 366. " " " rheumatism, ii, 365. '■ ferruginous, in albuminuria, ii, 369. " " " anaemia, ii, 369. " " " atony of the stom- ach, ii, 370. mineral, ferruginous, in cachexia associated with chronic paludal poisoning, ii, 369. mineral, ferruginous, in chlorosis, ii, 369. •' " " chorea, ii, 369. " " " chronic lymphade- nitis, ii, 369. mineral, ferruginous, in gastric neuroses, ii, 369. mineral, ferruginous, in menstrual derange- ments of hsemic origin, ii, 369. mineral, ferruginous, in neurasthenia, ii, 369. mineral, ferruginous, in paludal poisoning, ii, 369. mineral, sulphated, ii, 367. " " in catarrh of the duode- num, ii, 368. mineral, sulphated, in catarrh of the gall bladder and ducts, ii, 368. mineral, sulphated, in chronic intestinal catarrh, ii. 368. mineral, sulphated, in diabetes, ii, 368. " " " disorders of the stom- ach, ii, 368. mineral, sulphated, in haemorrhoids, ii, 368. " " " hepatic cirrhosis, ii, 368. mineral, sulphated, in hepatic engorgement, ii, 368. mineral, sulphated, in jaundice due to ob- structions, ii, 368. mineral, sulphated, in uric-acid diathesis, ii, 368. mineral, sulphur, ii, 370. " " in saturnism, ii, 371. " " " mercurialism, ii, 371. " " " congestion associated with enlargement of tne liver, ii, 371. mineral, sulphur, in hepatic congestion, ii, 371. mineral, sulphur, in bronchial catarrh, ii, 371. mineral, sulphur, in hemoptysis, ii, 371. GENERAL INDEX. 541 Waters, mineral, sulphur, in pulmonaiy tuber- culosis (Bergeon s treatment), ii, 371. mineral, sulphur, in constipation (due to de- ficiency of intestinal secretion), ii, 371. mineral, sulphur, in hsemorrhoids, ii, 371. " " " engorgement of the pel- vic viscera of women, ii, 371. mineral, sulphur, in chronic lead poisoning, ii, 371. mineral, vapour of, in acute bronchitis, bron- chorrhoea, chronic catarrhal laryngitis, chronic nasal catarrh, coryza, laryngeal phthisis, and laryngotracheitis, ii, 381. Wax. ii, 385. Chinese insect, ii, 385. Japanese, ii, 385. myrtle, ii, 385. Whe'at. See Tkiticum. Whey, i, 43; ii, 385, 394. cure for acute febrile disease, i, 333. " " irritability of the stomach, i, 333. Whisky, ii, 385. as a hypnotic, i, 506. as an antiseptic, ii, 385. in adynamic fevers, ii, 385. " chronic pulmonary tuberculosis, ii, 385. " hsemorrhage, ii, 385. " poisoning (as a heart stimulant), ii, 385. " sudden cardiac collapse, ii, 385. " syncope, ii, 385. " typhoid fever, ii, 385. " typhus fever, ii, 385. Willow. See Salix. Wine, blackberry, in diarrhoea, ii, 391. claret, ii, 390. " in ansemia, ii, 394. " " atonic gout, ii, 394. " " chronic discharges of blood, pus, or mucus, ii, 394. claret, in debility, ii, 394. " (by injection), in flstulse (to lessen the discharge), ii, 394. claret, in purulent inflammations, ii, 394. " (injections into the tunica vaginalis) in hydrocele, ii, 394. Madeira, ii, 390. palm, ii, 391. port, in bronchitis of the aged, ii, 393. *' " catarrhal afieotions (of young in- fants), ii, 393. port, in debility, ii, 393. " " marasmus of young infants, ii, 393. " " pneumonia, ii, 393. " " tuberculosis of young infants, ii, 393. " " typhoid fever, li, 393. " " typhus fever, ii, 393. sauterne, in insomnia and troublesome cough, ii, 394. sherry, ii, 390. " for indigestion, ii, 393. " in acute inflammatory processes, ii, 393. sherry, in fevers, ii, 393. " senile debility, ii, 393. whey, ii, 394. Wines, ii, 385. acidulous, ii, 390. American, ii, 390. (white, of Bordeaux) as a tonic for a capri- cious appetite, ii, 394. Wines, astringent, ii, 390. champagne, ii, 390, 391, 393. " in collapse from fever, ii, 393. " " debility of old age, ii, 393. " " seasickness, ii, 394. " " vomiting of pregnancy, ii, 394. dietetic use of, ii, 393. dose of, ii, 394, dry, ii, 390. effect of, ii, 393. French, ii, 390. German, ii, 390. " in nervous diseases, ii, 890. in acute chorea, ii, 394. " " neuralgia, ii, 394. " " neuroses, ii, 394. (as a stimulant) in amygdalitis, ii, 394. in cardiac failure, ii, 394. " epidemic influenza, ii, 394. " eye affections (of children), ii, 394. (as a stimulant) in htemorrhages, ii, 394. in infantile convulsions, ii, 394. injections of, in chronic discharges from the vagina and urethra, ii, 394. in insomnia of typhoid fever, ii, 394. " progressive chlorosis, ii, 394. " pulmonary tuberculosis, ii, 394. " rhachitis of young infants, ii, 393. " scalp affections of children, ii, 394. " tetanus, ii, 394. " the treatment of diseases, ii, 393. " intestinal catarrh, ii, 395. " weak heart of typhoid fever, ii, 394. Italian, ii, 390. light, i, 390. medicated, ii, 396. Orleans, ii, 390. red, ii, 390. Rhenish, ii, 390. rough, ii, 390. Spanish, ii, 390. sparkling, ii, 390. / Teneriffe, ii, 390. white, ii, 390. Wintergreen. See Gaultheria. Witch-hazel. See Hamamelis. Witherite. See Barium carbonate, under Barium. Wood charcoal, i, 85. Wool-fat. See Lanolin. Wool, sanitary wood, as an absorbent dress- ing, ii, 88. Wormwood. See Absinthium. Wrightia, ii, 396. in diarrhoea and dysentery, ii, 396. Xanthoxylum, ii, 396. (as a gargle) in affections of the throat, ii, 396. (infusion) in chronic constitutional syphilis, ii, 396. in chronic rheumatism, ii, 396. (as a diaphoretic) in rheumatic pains, ii, 396. (tincture) in toothache, ii, 396. Xeroform, ii, 397. as an intestinal antiseptic in cholera, ii, 397. as a surgical antiseptic, ii, 397. 543 GENERAL INDEX. Xeroform in buboes, ii, 397. in chronic urticaria, ii, 397. " eczema in children, ii, 397. " foul ulcers, ii, 397. " infected wounds, ii, 397. " intestinal catarrh, ii, 397. " necrotic affections, ii, 397. " paronychia, ii, 397. " suppuration, ii, 397. X rays, ii, 397. in cancer, ii, 398. " " of the stomach, ii, 398. Xylene, ii, 400. as an antiseptic, ii, 400. internally in small-pox, ii, 400. Xylenol, ii, 400. Xylol. See Xylene. Yarrow. See Achillea. Yeast, ii, 400. in boils, ii, 400. Yellow root. See Hydrastis. Yerba sagrada. See Lantana. santa, ii, 401. Zea. See Coen-silk. Zinc, ii, 401. acetate, ii, 402. " as an emetic, ii, 403. " as a nervine, ii, 403. " (as a local astringent) in conjunc- tivitis, ii, 402. acetate in diarrhoea, ii, 403. " (as a local astringent) in gonorrhoea, ii, 403. acetate (as a local astringent) in leucorrhcea, ii, 403. acetate ointment in erythema, ii, 403. " " " herpes, ii, 402. albuminate, ii, 408. and potassium cyanide, ii, 408. arsenate and zinc arsenite, ii, 408. borate, ii, 408. bromate, ii, 408. bromide, ii, 402. " in epilepsy, ii, 403. carbolate, ii, 408. carbonate, ii, 403. " (as a prophylactic) in intertrigo, ii, 403. carbonate (as a surgical dressing) in super- ficial inflammation, ii, 403. chloride, ii, 403. " as an antiseptic, ii, 404. " " " escharotic, ii, 403. " in abscesses, ii, 403. " " chronic conjunctivitis, ii. 405. " " " laryngitis, ii, 405. " " " pharyngitis, ii, 405. " " " suppurative otitis media, ii, 405. chloride in condylomata, ii, 403. " " diphtheritic conjunctivitis, ii, 405. chloride in empyema of the accessory nasal sinuses, ii, 405. chloride in ganglia, ii, 404. " " gangrenous ulcers, ii, 403. " " gonorrhoea, ii, 405. " " gonorrhoeal conjunctivitis, ii, 405. Zinc chloride in hydrocele, ii, 404. chloride in " inoperable " aneurysms, ii, 403. " " leueorrhoea, ii, 405. " (by dilaceration, JI. Leon Derville's method) in lupus, ii, 404. chloride in malignant growths, ii 403. " " morbid growths, ii, 403. " njEvi, ii. 403. " " nasal polypi, ii, 404. " " pulmonary tuberculosis, ii, 403. " " ranula, ii, 404. " " small cystic tumours, ii, 404. chrysophanate, ii, 408. citrate, ii, 408. cyanide, ii, 408. " in abdominal pain, i, 323. " " cardiac neuroses, i, 333 ; ii, 408. " " chorea, i, 833. " " dysraenorrhoea, ii, 408. " " epilepsy, i, 333. " " neuralgia, i, 833 ; ii, 408. " " whooping-cough, ii, 408. ferrocyanide, ii, 408. gynocardate, ii, 409. " in leprosy, ii, 409. " " prurigo, ii, 409. " " psoriasis, ii, 409. " " syphilitic skin diseases, ii, 409. hydrochlorate, ii, 409. " as an antiseptic, ii, 409. iodate, ii, 409. iodide (internally) in chorea, ii, 405. " (locally) in chronically enlarged ton- sils, ii, 405. iodide (as a collyrium) in chronic conjunc- tivitis, ii, 405. iodide (locally) in chronic inflammation of the mucous membranes, ii, 405. iodide llocally) in post-nasal catarrh, ii, 405. iodide (internally) in scrofulous diseases of the skin and eyes, ii, 405. iodide (ointment) in tumours, ii, 405. lactate, ii, 409. " in hysterical amblyopia, ii, 409. nitrate, ii, 409. " in lupus erythematosus, ii, 409. oleate and iodoform in erosions of the os uteri, ii, 405. oleate (locally) in bromidrosis, ii, 405. in hyperidrosis, ii, 405. " (with salicylic acid or French chalk) in acute vesicular eczema and in comedo, ii, 405. oleostearate, ii, 409. oleostearate and a solution of lead subacetate in acute rhinitis and coryza, ii, 409. oleostearate and boric or carbolic acid in nasal discharges and hypersemic condi- tions, ii, 409. oleostearate with acetanilide as an antiseptic and protective after operations, ii, 409. oleostearate with antipyrine in recurring epistaxis, ii, 409. oleostearate with balsam of Peru as a stimu- lant and healing agent to the mucous membranes, ii. 409. oleostearate with camphor and menthol in hay fever and coryza, ii, 409. GENERAL INDEX. 543 Zinc oleostearate with iodine in atrophic and dry rhinitis and ozsena, ii, 409. oleostearate with oleum pini pumilionis and eucalyptol (intratracheal injections) in asthma and chronic bronchitis, ii, 409. oleostearate with orthoohlorphenol in ozsena and syphilitic ulcerations, ii, 409. oleostearate with tannic acid in catarrh and nosebleed, ii, 409. oxide, ii, 405. " applications in abrasions, burns, blis- ters, excoriations, fissures, etc., ii, 406. oxide as an anthidrotic, i, 103. " in acute eczema of the auricle, ii, 406. oxide in arsenic poisoning, ii, 406. " " bronchorrhoea, ii, 406. " (for muscular tremor) in chronic alco- holism, ii, 406. oxide in conjunctivitis, ii, 406. " " eczema, ii, 406. " " epilepsy, ii, 406. " " gonorrhoea, ii, 407. " " mercury poisoning, ii, 406. " " night sweats of phthisis, ii, 406. " " scrofulous conjunctivitis of chil- dren, ii, 406. oxide (as a prophylactic) in spasmodic asthma, ii, 406. oxide insufflations in laryngitis, ii, 406. •' in ulcers of the sseptum nasi, ii, 406. " with bismuth and pepsin in summer diarrhcea of children, ii, 406. oxide with carminatives and morphine in gastralgia, ii, 406. oxychloride, ii, 409. " as a surgical dressing, ii, 410. " (as an adjuvant) in the galvanic treatment in haemorrhagic endometritis and incipient malignant conditions of the uterus, ii, 410. permanganate in gonorrhoea, ii, 410. phosphate, ii, 410. '■ in epilepsy, ii, 410. " " exhaustion from over-excite- ment, ii, 410. phosphate in insanity during convalescence from fevers, ii, 410. phosphide as a tonic in ansemia, i, 68. " ill lyraphadenoma, ii, 407. salicylate as an antiseptic, ii, 410. " as an astringent, ii, 410. " (as a collvrium) in conjunctivitis, ii, 410. salicylate in inflammatory cutaneous dis- eases, ii, 410. salicylate in nasal catarrh, ii, 410. sozoiodolate, ii, 215. " in blennorrhcea and gonorrhoea, ii, 410. stearate, compound, ii, 411. subgallate, ii, 411. " as a dressing in eczema, hsemor- rhoids, and wounds, ii, 411. subgallate in chronic purulent otitis media, ii, 411. subgallate in gonorrhoea, ii, 411. sulphate, ii, 407. " and corrosive sublimate in onychia maligna, i, 328. Zinc sulphate as a haemostatic, ii, 407. sulphate (internally, in small doses) as an as- tringent and as a tonic, ii, 407. sulphate in atrophic rhinitis, ii, 407. " " cancer of the uterus, ii, 407. " (injections) in caries, ii, 408. " in caruncle of the female urethra, ii, 407. sulphate (weak solutions) in catarrhal in- flammation of the mucous membrane of the Eustachian tube, ii, 407. sulphate in condylomata, ii, 408. " (as a collyrium) in conjunctivitis, ii, 407. sulphate (as an emetic) in croup, ii, 407. " in diarrhoea, ii, 407. " " dysentery, i.i, 407. " " eczema, ii, 408. " " epistaxis, ii, 407. " " epithelioma, ii, 407. " " erythema, ii, 408. " " gonorrhoea, ii, 407. " (weak solutions) in inflammation of the external ear, ii, 407. sulphate in intertrigo, ii, 408. " " laryngeal haamorrhage, ii, 407. " lupus, ii, 407. " (as an emetic) in narcotic poison- ing, ii, 407. sulphate in purulent otitis media, ii, 407. " " small neoplasms, ii, 408. " unhealthy ulcers, i, 228 ; ii, 407. " " warts, ii, 408. " " whooping-cough, ii, 407. sulphichthyolate (externally) in acute or chronic rheumatism, ii, 412. sulphichthyolate in burns, ii, 413. " " chronic catarrhal dis- eases of the stomach and lungs, ii, 413. sulphichthyolate in chronic gonorrhoea, ii, 413. sulphichthyolate in chronic nephritis, ii, 413. sulphichthyolate in eczema, ii, 413. " " erysipelas, ii, 413. " " favus, ii, 413. " " intrapelvic inflamma- tory exudations, ii, 413. sulphichthyolate in lumbago, ii, 413. " " psoriasis, ii, 412. " '■ varicose veins, ii, 413. sulphide, in lupus erythematosus, ii, 411. " " seborrhcea of the face, ii, 411. sulphite, ii, 411. sulphocarbolate, ii, 411. " as an antiseptic in intestinal disorders, ii, 411. sulphocarbolate (externally) in balanitis, ii, 412. sulphocarbolate in catarrhal laryngitis, ii, 413. sulphocarbolate in cholera infantum, ii, 411. " " " morbus, ii, 411. " (douches) in chronic puru- lent otitis media, ii, 413. sulphocarbolate in eczema of the external auditory canal, ii, 413. sulphocarbolate in pharyngitis, ii, 413. " " pityriasis capitis, ii, 413. " " syphilis, ii,413. 544 GENERAL INDEX. Zinc sulphoearbolate in vomiting of pregnancy, ii, 413. sulphydrate, ii, 412. " in chronic eczema, ii, 412. " " psoriasis, ii, 412. " " vegeto-parasitio skin diseases, ii, 413. tannate, ii, 412. " in conjunctivitis, ii, 412. " " diarrhoea, ii, 413. " " dyspepsia, ii, 413. " " phthisis, ii, 413. " injections in gonorrhoea, ii, 413. Zinc tetraborate, ii, 408. valerianate, ii, 408. " in hay fever, ii, 347. " " incontinence of urine from nervousness, ii, 347. valerianate in neuralgia, as a sedative, i, 68 ; ii, 347. Zincohaemol, ii, 413. as an astringent and tonic, ii, 413. in anjemia, ii, 412. " chlorosis, ii, 413. " diarrhoea, ii, 412. Zymoidin, ii, 413. INDEX OF DISEASES AND REMEDIES. Abdominal pain. See Colic. Aberration of tlie cardiac rhythm. Convallaria, i, 300. Abortion. Gold chloride, i. 453. Viburnum prunifolium, ii, 357. Abortion, jpains of. Piseidia, li, 91. Abortion, threatening'. Asafoetida, i, 147. Abrasions. Arnica, i, 141. Benzoin, tincture of, i, 178. Chalk, powdered, i, 230. Gutta pereha, i, 463. Phenol sodique, ii, 73. Tannic-acid ointment, ii, 257. Traumaticin, ii, 328. Zinc oxide, ii, 406. Abrasions of mucous surfaces. Borax, i, 189. Abscess. Alumnol irrigations, i, 51. Ammonium chloride, i, 57. Aspiration, i, 153. Baths, i, 171. Bromol, i, 197. Calcium sulphide, i, 203. Carbolic acid (parenchymatous injections), i, 213. Carbolic acid (solution) inhalation, i, 213. Chlorine water, i, 240. Cloves, tincture of, i, 272. Iodoform, i, 538. Mentho-phenol, i, 616. Sanoform, ii, 15. Sozal, ii, 215. Abscess, cold. Baths, i, 171. Cloves, tincture of (injections), i, 272. Iodoform (hvpodermically), i, 538. Teucrin, ii, 273. Abscess, deep-seated. Vienna paste, i, 228. Abscess, ganglionic. Copper salts, i, 303. Abscess, hepatic. Ammonium chloride, i, 57. Abscess, indolent. Vienna paste, i, 228. Abscess of the ear. Honey and rye meal, i, 472. Abscess of the lung. Carbolic acid, i, 213. Abscess, open. Sanoform (for after-treatment), ii, 154. Abscess, perityphlitic. Aspiration, i, 152. Abscess, pulmonary. Bromol, i. 197. Abscess, tuberculous. Sozal, ii, 215. Accumulation, feecal. Aloes, combined with strychnine, i, 224. Acidity of the stomach. See Dyspepsia, Acid. Acne. Alumnol applications, i, 51. Arsenic, i, 144. Calcium chloride, i, 202. " sulphide, i, 203. Collodion, i, 294. Cupric sulphate, i, 306. Hvdrastine, i, 476. le'hthyol, i, 522. Losophan, i, 589. Nitrohydrochloric acid, ii, 16. Phosphorus, ii, 77. Salicylic acid, ii, 144. Steam, ii, 222. Sulphur ointment, ii, 241. Thymol, ii, 284. Waters, Buffalo lithia, ii, 372. Acne, pustular. Salicylic acid, ii, 144. Acne rosacea. Cupric-sulphate solution, i, 806. Acne Tulgraris. Collodion, i, 294. Acromegaly. Pituitary-body extract (hypodermically), i, 81. Thyreoid treatment, ii, 295. Actinomycosis. Carbolic-acid injections, i, 213. Potassium iodide, ii, 99. Teucrin, ii, 273. Adenitis. Belladonna, i, 174. Cloves, tincture of, i, 273, 273. Ichthyol, i, 522. Iodine, i, 536. Iodoform, i, 538. Mercury ointment, i, 622. Nuclelns, ii, 25. Plytolacca, ii, 81. 545 546 INDEX OF DISEASES AND EEMEDIES. Adenitis. Pyoctanine (internally), ii, 109. Teuorin, li, 173. Adenitis, clironic. Waters, mineral, ii, 383. Adenitis, tuberculous. Cloves, tincture of (injections), i, 272, 273. Iodoform, i, 538. Nucleins, ii, 25. Teucrin, ii, 173. Adynamia. Opium (as a stimulant), ii, 226. After-pains. Chloral hydrate, i, 237. Ergot, i, 388. Viburnum prunifolium, ii, 357. Albuminuria. Asaprol, i, 148. Corn silk, i, 306. Gallic acid, i, 432. Infusion, intramuscular, li, 325. Iron chloride, i, 548. Sodium tannate, ii, 259. Strontium lactate, ii, 229. Tannin, ii, 2-57. Waters, Buffalo lithia, ii, 372. " ferruginous, ii, 369. Albuminuria, phosphatic. Olycerophosphates, ii, 439. Alcohol habit. Ammonia water (after gastric lavage), i, 53. Bath, half, i, 169. Coffee, i, 290. Cold plunge, i, 488. Gold bromide, i, 45. Hydrastis, i, 475. Hypnotism, i, 515. Mercauro, i, 454. Nux vomica, ii, 29. Strychnine, ii, 29. Waters, mineral, ii, 379. Alcohol habit, treatment of the chronic, i, 38. Alopecia. Cantharides, i, 208. Galvanism, i, 368. Jaborandi (subcutaneous injections, or by the mouth), i, 560. Sulphur ointment, ii, 241. Veratrine, ii, 350. Alopecia areata. Sulphur ointment, ii, 241. Veratrine, ii, 350. Amaurosis, tobacco. Santonin, ii, 155. Amblyopia. Hyaenanchin, i, 474. Nux vomica, ii, 28. Zinc lactate, ii, 409. Amblyopia, hysterical. Zinc lactate, ii, 409. Amenorrhcea. Aloes, i, 49. Ammonium chloride, i, 57. Apiol, i, 138. Arsenic, i, 146. Baths, i, 169, 170. " hot foot, i, 170. Cantharides, i, 208. Cimicifuga, i, 250. Amenorrhcea. Cineraria, i, 258. Galbanum (internally), i, 433. Gold, i, 453. Ice applied to the spine, i, 520. Inula (as a tonic), i, 534. Iron, ammonio-ehloride of, i, 549. " iodide, i, 551. Ligustieum, i, 581. Manganese and iron, i, 596. Mustard foot-bath, hot, i, 647. Myrrh, tincture of (internally), i, 651. Ovarine, ii, 451. Pulsatilla, ii, 107. Rue, ii, 137. Santonin, ii, 155. Seneoio, ii, 162. Sulphur fumes, ii, 241. Tansy tea, ii, 269, 456. Turpentine, ii, 336. Viscum album, ii, 361. Waters, Buffalo lithia, ii, 373. " mineral, ii, 375, 388. Amenorrhcea, atonic. Iron iodide, i, 551. Sanguinaria, ii, 154. Amenorrhcea, functional. Pulsatilla, ii, 107. Sulphur fumes, ii, 241. Amygdalitis. Aconite, i, 8. Baths, cold, i, 488. Cfipsicum and hot water (as a gargle), i, 309. Cinchona, i, 256. Copper-arsenite solution, i, 304. Eucalyptol inhalation, i, 529. Glycerin and carbolic acid, i, 450. Guaiacol, ii, 439. Hydrastis, i, 476. Hydrogen dioxide, i, 503. Iron (Monsel's solution), i, 550. Xuclein, yeast, ii, 24. Palmetto wine, ii, 58. (early hours of). Quinine, ii, 256. Quinine, ii, 119. Salieylamide, ii, 141. Silver nitrite, ii, 195. Sodium salicylate, ii, 146. Veratrum viride, ii, 353. Wine (as a stimulant), ii, 394. Amygdalitis, acute. Guaiacol, i, 460. Amygdalitis, acute follicular. Iron sulphate (Monsel's solution), i, 550. Sodium salicylate, ii, 146. Amygdalitis, "follicular. Guaiacol, ii, 439. Hydrastis (local applications), i, 476. Quinine, ii, 119. Amygdalitis, suppurative. Aconite, i, 8. Anaemia. Air, condensed, inspiration of, i, 38. Aloes, i, 48. Amyl nitrite, i, 61. Arsenic, i, 145. Baths, i, 173. " condensed-air, i, 38, " sheet, i, 169. " sulphur, i, 178. INDEX OF DISEASES AND REMEDIES. 647 Anaemia. Blood, i, 186. Champagne, ii, 393. Coca (as an adjunct), i, 274. Cold douche, i, 491. Copper arsenlte, i, 303. Euoasin, ii, 436. Gold, i, 454. HaBmalbumin, i, 463. Haematin-albumin, i, 463. Hsemoglobin, i, 464. Hydrochloric acid, i, 493. Iniusion, ii, 324, 328. Iron, i, 544. " carbonate, i, 547. " chloride (ethereal tincture), 1, 547, 548. " citrate, i, 550. " sulphate, i, 549. " tannate, ii, 259. " valerianate, i, 552 ; ii, 346, 348. Manganese dioxide, i, 596. Marrow, extract of bone, i, 81, 598, 599 ; ii, 445. Nitroglycerin, ii, 15. Nucleins, ii, 24. Orexine, ii, 451. Oxygen, ii, 52. Ozone, ii, 58. Peptomangan, ii, 69. Permanganates, ii, 70. Phospho-albumin, ii, 74. Protonuolein, ii, 448. Pyramidone, ii, 454. Serum, artificial (intravenous injections), ii, 164. Somatose, ii, 212. Spermine, ii, 217. Splenic douches, i, 349. Strophanthus, ii, 232. Strychnine with iron and quinine, ii, 28. Thyreoid treatment, ii, 295. Transfusion and infusion, ii, 322, 323. Trefusia, ii, 329. Waters, chlorinated (externally and inter- nally), ii, 365. (due to hsemorrhage). Waters, ferruginous, ii, 369. Waters, mineral, ii, 375, 384. Zincohsemol, ii, 412. Anaemia, acute (from hemorrhage). Serum, artificial, ii, 163. Transfusion and infusion, ii, 322. Anaemia, cerebral. Amyl nitrite, i, 61. Copper arsenite (small doses), i, 303. Infusion, ii, 324. Infusion, intra-arterial, of sodium-chloride solution, ii, 328. Stro[5hanthus, ii, 232. Anaemia, pernicious. Ozone, ii, 58. Phosphorus, ii, 77. Anaemia, progressiye pernicious. Arsenic, i, 145. Protonuclein, ii, 448. Anaemia, rhachitic. Peptomangan, ii, 69. Anaemia, Tvitli constipation. Iron sulphate, i, 549. Anaestliesia, chloroform. Ether (subcutaneously), ii, 237. Anaestliesia, chloroform. Paradaism, i, 366. Anaesthesia, plantar. Bath, hot foot, i, 170. Anasarca. Infusion, intramuscular, ii, 325. Sparteine, ii, 216. Waters, mineral, ii, 379. Anasarca of Briglit's disease. Theobromine, ii, 277. Aneurysms. Electricity, i, 361. Potassium iodide, ii, 10. Sodio-theobromine salicylate, ii, 203, Veratrum viride, ii, 353. Zinc chloride, ii, 403. Aneurysms, " inoperable." Zinc chloride, ii, 403. Aneurysms, internal. Potassium iodide, ii, 98. Angina pectoris. Amyl nitrite, i, 60, 538. Anhalonine, ii, 417. Arsenic, i, 146. Baths, Nauheira, ii, 419. Camphor, i, 205. Cereus grandiflorus, i, 229. Chloroform, i, 528. Conium, i, 298. Exalgine, i, 408. Mercury, i, 620. Morphine, ii, 36. " (hypodermic injection), i, 67. Nitroglycerin, ii, 15. Pyridine, ii, 110. fumes of, i, 530. Schott treatment, ii, 432. Strophanthus, ii, 282. Tribromhydrin, ii, 330. Ankylosis. Thiosinamine, ii, 281. Ankylostomiasis. Thymol, ii, 284. Anorexia. Alcohol, i, 33. Cannabis indica, i, 207. Morphine, ii, 38. Orexine hydrochloride, ii, 46. Quassia, ii, 112. Splenic extract, ii, 318. Anorexia, hysterical. Morphine, ii, 88. Anthrax. Serum treatment, i, 85. Toxines, ii, 315. Aortic disease. Convallaria, i, 300. Aortic insufficiency. Air, condensed, inspiration into, i, 28. Amyl nitrite, i, 61. Aphonia, hysterical. Paradaism, i, 366. Aphthae. Alcohol applications, i, 31. Antacids, i, 86. Bismuth subnitrate, i, 181. Borax, i^ 189. Catechu, i, 231. " infusion or tincture, i, 331. Chlorine water, i, 240. 548 INDEX OF DISEASES AND REMEDIES. Aphthae. Citric acid, i, 2G0. Gopper-arsenite solution (locally and inter- nally), i, 303. Cupric acetate (topically), i, 303. Lemon-juice (diluted, as a gargle), i, 260. Apncea. See Asphyxia. Apoplexy. Bloodletting, i, 189. Croton oil (for rapid evacuation of the bowels), i, 318. Paradaism, i, 366. Sodium phosphate, ii, 208. Strophanthus, ii, 231. Strychnine, ii, 28. Arrhythmia. Sodio-theobromine salicylate, ii, 203. Arterial tension, lii^h. Potassium cobaltonitrite, i, 273. Arteriosclerosis. Sodio-theobromine salicylate, ii, 203. Arthralgia. Mentha piperita (oil), i, 613. Arthritis, fungous. Cloves, tincture of (injections), i, 372. Arthritis, gonty. Exalgine, i, 403. Arthritis, rheumatoid. Baths, hot foot, i, 170. Calcium sulphide, i, 203. Synovial extract, ii, 251. Arthritis, tuberculous. Copper salts, i, 303. Articular troubles. See Rheumatism. Ascarides. Aloes, i, 103. Bitters (injections of), i, 183. Carbolic acid, i, 103. Ether (internally), i, 397. Limewater (as a wash), i, 583, Quassia, ii, 112. Salt, ii, 102. Santonin, ii, 55. Tannin, ii, 257. Turpentine oil, ii, 336. Ascites. Aspiration, i, 152. Iodine injection, i, 536. Jaborandi, i, 559. Massage, abdominal, i, 608. Salines, ii, 147. Serum, artificial, ii, 163. Waters, mineral, ii, 379. Ascites of hepatic cirrhosis. Salines, ii, 147. Serum, artificial, ii, 163. Aspergillus infection. Veratrine, ii, 350. Asphyxia. Cold affusions, i, 17. Electricity, ii, 226. Paradaism, i, 366. Heat, dry, ii, 225. Oxygen, ii, 52. Stimulants, cardiac, ii, 236. Transfusion, depletory, ii, 323. Asphyxia from oxide of carbon inhalation. Serum, artificial, ii, 165. Asphyxia, local. Amyl nitrite, i, 62. Nitroglycerin, ii, 10. Asphyxia neonatorum. Baths, cold, ii, 128. " hot, i, 166. Electricity, ii, 226. Transfusion, depletory, ii, 323. Asthenia. See Debility. Asthenopia. Massage of the eye, i, 610. Asthenopia, accommodatire. Eserine, i, 392. Asthma. Acetajiilide, i, 4. Aconite, i, 8. Air. condensed, inspiration of, i, 38. Alcohol, i, 33. Alkalies, i, 96. Allyl tribromide, ii, 414. Ammonium succinate, i, 58. Amyl nitrite, i, 95. Analgene, i, 66. Anhalonine, ii, 417. Antipyrine, i, 124. Apomorphine, ii, 418. Arsenic, i, 96. Arsenious solution, i, 97. Asafoetida, i, 147. Asaprol, i. 148. Balsamic fumes, i, 529. Baths, condensed-air, i, 37. Bromide of ammonium, i, 94. " " potassium, i, 94. " " sodium, i, 94. Bromoform, i, 196. Caffeine, i. 201. Cannabis indica, i, 207. Carbolic acid, i, 213. Chamomile, i, 231. Chemical means, i, 93. Chloralamide, i, 238. Chloral caffeine, i, 235. Chloral hydrate, i, 94, 237. Climatic treatment, i, 96. Conium, i, 298. " vapour inhalations, i, 299, 539. Copper-arsenite solution (spray), i, 303. Diet, careful, i, 96. Digitalis, i, 342. Elastic compression of the chest, i, 93. Electrical stimulation, i, 93. Ether (as a sedative), i, 538. Ethyl, iodide of (inhalations), i, 95. Eucalyptus cigarettes, i, 400. Expiration into rarefied air, i, 28, 93. Fowler's solution, i, 97. Galvanism of the neck, i, 368. Gelsemium, i, 437. Glycerophosphates, ii, 439. Hoffmann's anodyne, i, 94. Hydriodic acid, i, 493. Inhalation of conium, i, 529. Jaborandi, i, 559. Lippia mexicana, i, 585. Lobelia, i, 373, 587. Methylal (by inhalation), 1, 639. Morphine (hypodermic injection), i, 93. Nitrogen monoxide, i, 538. INDEX OP DISEASES AND REMEDIES. 549 Asthma. Nitroglycerin, i, 95 ; ii, 15. Opium, "fumes of, i, 529. Oxygen inhalation, i, 95. Ozone inhalation, ii, 58. Paraldehyde, ii, 63. Pilocarpine, nitrate and hydrochloride, 1, 95. Pine leaves, oil of, i, 96. Piscidia (as an antispasmodic), ii, 91. Potassium iodide, i, 97 ; ii, 99. " nitrate, belladonna, and stramo- nium, fumes of, i, 530. Potassium-nitrate fumes, ii, 99. Pulsatilla, ii, 107. Pyridine, fumes of, i, 530. Quebracho, ii, 113. Quinine, i, 356 ; ii, 119. Sanguinaria, ii, 154. Sodium iodide, i, 97. Spermine, ii, 317. Stramonium, ii, 339. " and belladonna, i, 539. Strophanthus, ii, 331. Strychnine, ii, 38. Sulphonal, ii, 239. (paroxysm), Sulphuric ether, i, 94. Tartar emetic, i, 114. Terebene, i, 97 ; ii, 27. Tonics (as an adjunct to other treatment), i, 97. Tribromhydrin, ii, 380. Turpentine oil, vapour of, ii, 336. Tylophora, ii, 337. Zinc oleostearate with oil of pine, ii, 409. " oxide, ii, 406. Asthma, bronchial. Antipyrine, i, 124. Baths, condensed-air, i, 37. Pyridine, ii, 110. Quebracho, ii, 112. Strychnine, ii, 38. Asthma, cardiac. Sparteine, ii, 316. Asthma, ha^. Amyl nitrite, i, 528. Arsenic, i, 146. Cannabis indica, i, 307. Carbolic-acid solution (by spray), i, 318. Ethyl-iodide inhalation, i, 538. Asthma, lipocardiac. Air, condensed, inspiration of, i, 38. Asthma, nervous. Amyl nitrite, i, 61. Glycerophosphates, ii, 439. Asthma, spasmodic. Analgene, i, 66. Belladonna, i, 173. Caffeine, i, 201. Carbon dioxide, i, 527. Chamomile oil, i, 331. Chemical means of combating, i, 93. Chloralamide, i. 238. Chloral caffeine (hypodermically), i, 235. Grindelia, i, 456. Nitroglycerin, ii, 15. Physical means of combating, i, 93. Potassium iodide, ii, 99. Stramonium fumigation, i, 430. Zinc oxide, ii, 406. Atelectasis. Air, condensed, inspiration of, i, 38. Douches, cold rectal, 1, 349. Atony. Aloes, i, 324. Bitters, i, 183. Canella, i. 306. Chamomile, i, 231. Damiana, i, 324. Electricity, i, 368. Ergot of maize, i, 389. Glycerin,'!, 450. Iron carbonate, i, 547. " iodide, i, 551. Lavandula, i, 573. Phosphorus, ii, 76. Quassia, ii, 112. Rue, ii, 137. Atony, cerebral. Phosphorus, ii, 76. Atony, digestive. Bitters, i, 183. Canella, i, 206. Chamomile, i. 231. Iron carbonate, i. 547. Lavandula, i, 572. Atony, gastric. Waters, acidulated (carbonated) chalybeate, ii, 370. Waters, carbonated, ii, 364. " mineral, ii, 375. Atony, general, of the nervous system. Damiana, i, 334. Atony, intestinal. Waters, carbonated, ii, 364. " mineral, ii, 375. Atony of anaemia. Iron sulphate, i, 549. Atony of tlie bladder. Baths, cold, i, 169. Atony of the lungs and kidneys. Baths, hot, ii, 235. Atony of the nervous system. Damiana. i, 324. Atony of the sexual apparatus in women. Aloes, i, 49. Atony of the stomach. Electricity, i, 368. Quassia, ii, 113. Atony, ovarian. Rue, ii, 137. Atony, uterine. Aloes with iron and with myrrh, i, 234, Ergot of maize, i, 389. Glycerin (intra-uterine injections), i, 450. Rue, ii, 137. Atrophy, brown, of the heart. Saline infusion, ii, 338. Atrophy, muscular. Glycerophosphates, ii, 439. Atrophy of the vagina and cervix uteri. Ichthyol, i, 523. Atrophy, progressive muscular. Galvanism, i, 367. Balanitis. lodol, i, 540. Zinc sulphoearbolate, ii, 413. Balanoposthitis. Nosophene, ii, 19. 550 INDEX OP DISEASES AND REMEDIES. Balanoposthitis. Silver nitrate, ii, 196. Basedow's disease. See Goitre, Exophthalmic. Bedsore. Benzoin tincture, i, 178. Copper-arsenite solutions (in form of a spray), i, 303. Lead-tannate applications, i, 578. Silver nitrate, ii, 196. Berl-beri. Methylene blue, i, 630. Biliary lithiasis. See Calculus, Biliary. Biliousness. Calomel, i, 634. Ipecac (as an emetic), i, 543. Mercury, i, 619. Podophyllin, ii, 93. Bites, leecli. Benzoin tincture, i, 178. Bites, snake. Alcohol, i, 30. Ammonia (hypodermically), i, 53. Arsenic and opium, i, 146. Calatropis, i, 303. Honey, ii, 441. Serum treatment, ii, 188, 189. Strychnine, ii, 29. Bites, venomous. Cupping, i, 320. Honey, ii, 441. Bladder, alTections of tlie. Ammonium citrate, i, 57. Cantharides, i, 208. Cubeb, i, 319. Bladder, irritable. Humulus, i, 474. Blebs, hereditary inclination to the for- mation of. Belladonna, ii, 425. Bleeding. See HvBmorrhagb. Blennorrhagia. See GONORRHCEA. Blennorrhoea. Cadmium sulphate (solution) injections, i, 200. Zinc sozoiodolate, ii, 410. Blepharitis. Atropine, i, 155. Copper-arsenite solution (in form of a spray), i, 303. Silver nitrate, ii, 195. Blepharitis, chronic marginal. Mercury oxide, i, 633. Blepharitis marginalis. Silver nitrate, ii, 195. Blepharophthalmia. Pulsatilla, ii, 107. Blepharospasm. Conium, i, 398. Electricity, i, 365. Galvanization, anodal, i, 366. Mydrol, ii, 447. Blisters. Cotton, absorbent, i, 810. Grindelia, i, 456. Lead, Goulard's extract of, i, 577, Zinc oxide, ii, 406. Blood-poisoning. See Septicemia. Boils. Alkalies (poultice of hardwood ashes), i, 45. Arnica plaster, i, 141. Asaprol (as an internal antiseptic), i, 148. Calcium sulphide, i, 203. Camphor, spirit of, i, 304. Carbolic acid (parenchymatous), i, 313. Colchicum, i, 391 Hypophosphites, i, 518. Menthol, i, 616. Pyoetanine, ii, 108. Sodium phosphate, ii, 208. Turpentine liniment, ii, 336. (opening of), Vienna paste, i, 238. Yeast, ii, 400. Boils of the external auditory meatns. Menthol, i, 616. Boils, recurrent. Colchicum, i, 391. Bone diseases. See Caries and Necrosis. Bowel complaints, fermentative. Bismuth naphtholate, i, 182. Brain disease. See Cerebral affections. Bright's disease. Diet in, i, 338. Iron chloride, i, 548. Nitroglycerin, ii, 15. Nucleins, ii, 34. Potassium iodide, ii, 98. Strontium lactate, ii, 230. Theobromine, ii, 277. Waters, Buffalo lithia, ii, 372. mineral, ii, 374, 376, 379. " thermal, ii, 364. Bromidrosis. Boric acid (in powder), i, 103. Chromic acid, i, 103, 248. Diachylon ointment, i, 103. Hydrastine, i, 476. Zinc oleate, ii, 405. Bronchial affections. Asafcetida, i, 147. Viola tricolor (synip), ii, 360. Bronchial congestion. Digitalis, i, 342. Storax (as an expectorant), ii, 238. Bronchiectasis. Creosote by inhalation, i, 314. Terebene, ii, 271. Bronchitis. Air, inspiration of condensed, i, 28. Alum whey, i, 50. Ammonium carbonate, i, 55, 56. Ammonium chloride, i, 56, 418. Amyl nitrite, i, 61. Apomorphine, i, 139. Arsenic, i, 146. Benzene, i, 176. Benzoic acid, i, 177. Benzoin i, 178. Camphor and sweet almond oil (internally), 1, *uo. Carbolic-acid inhalations, i, 213, CocillaBa bark, i, 285. Creosote inhalations, i, 314. Croton oil, i, 318. IKDEX OP DISEASES AND REMEDIES. 551 Bronchitis. Cubeb, i, 319. Digitalis, ii, 228. Dulcamara, i, 353. Ethyl iodide, i, 399. Eucalyptol inhalations, i, 529. Eucalyptus, i, 400. Galbanum, i, 432. Goose-grease liniment, i, 454. Grindelia, i, 456. Guaiacol, i, 459. Ice bag, application of the, i, 520. Iodine vapour, i, 536. Iodoform inhalation, i, 540. Ipecac, i, 543. Jaborandi, i. 559. Kurayss, i, 567. Licorice, i, 580. Mustard plaster, i, 647. Myrtol, i, 652. Nitric acid, ii, 8. Nuclein, ii, 34. Olibanum, ii. 34. Opium (small doses), ii, 37. " fumes of, i, 539. Oxygen, ii, 53. Ozone inhalation, ii, 58. Palmetto wine, ii, 58. Piseidia, ii, 91. Pix liquida, ii, 91. Potassium iodide, ii, 98. Poultices, ii, 101. Pulsatilla, ii, 107. Quinine, i, 526 ; ii, 119. Sandal-wood oil, ii, 153. Sanguinaria, ii, 154. Senega (as a stimulating expectorant), ii, 162. Squill, ii, 331. Steam, ii, 330. Sulphur, ii, 340. Sumbul, ii, 243. Tanosal, ii, 361. Tepid baths, i, 489. Thymol inhalation, ii, 383. Tribromhydrin (as an expectorant), ii, 330. Turpentine oil (internally), ii, 336. " stupes, ii, 335. Zinc oleostearate with oil of pine, ii, 409. Bronchitis, acute. Balsaraum pulmonum (as an expectorant), ii, 241. Eucalyptus, oil of, i, 400. Ipecac, i, 373. Sanguinaria, ii, 154. Squill, ii, 221. Terebene, ii, 371. Terpin hydrate, ii, 372. Tribromhydrin, ii, 330. Waters, chlorinated alkaline, ii, 381. Bronchitis, capillary (of children). Oxygen, ii, 53. Steam, i, 538 ; ii, 220. Bronchitis, catarrhal. Horehound, i, 473. Bronchitis, chronic. Air, inspiration of condensed, i, 28. Alum whey, i, 50. Ammonium carbonate (as an expectorant), i, 55, 56. Bronchitis, chronic. Ammonium chloride, i, 418. Apomorphine, i, 139. Arsenic, i, 146. Benzene, i, 176. Benzoic acid, i, 177. Benzoin, i, 178. Carbolic-acid inhalation, i, 313. Creosote by inhalation, i, 314. Croton oil, i, 318. Cubeb, i, 319. Digitalis (as a diuretic), ii, 238. Eucalyptol inhalation, i, 529. Eucalyptus, oil of, i, 400. Galbanum (internally), i, 432. Guaiacol, inhalations of, i, 459. Iodine vapour, i, 536. Ipecac, i, 543. Iron chloride (tincture), i, 548. Kumyss, i, 567. Nitric acid, ii, 8. Opium, i, 508. Pix liquida, ii, 91. Potassium iodide, ii, 98. Quinine, i, 356 ; ii, 119. Squill, ii, 331. (dry form). Steam spray, ii, 380. Sulphur, ii, 340. Sumbul, ii. 243. Tanosal, ii, 261. Terebene, ii, 371. Terpin hydrate, ii, 373. Terpinol, ii, 372. Bronchitis, foetid. Naphthalene, ii, 1. Salicylio-aoid inhalation, ii, 143. Terebene, ii, 271. Turpentine oil, vapour of, ii, 336. Bronchitis of the a^ed. Wine, port, ii, 393. Bronchitis, subacute. Ammonium-chloride troches, i, 57. Cubeb cigarettes, i, 430. Bronchocele, cystic. See GoItre. Bronchopneumonia. Aconite (as a sedative), i, 9. Camphor and sweet-almond oil (internally), i, 305. CooillaHa bark, i, 385. Gavage, i, 436. Guaiacol applications, ii, 437. Paraldehyde, ii, 63. Pilocarpine, ii, 86. Bronchopneumonia, acute. Potassium iodide, ii, 98. Bronchopneumonia, chronic. Tanosal, ii, 261. Bronchorrhoea. Air, condensed, inspiration of, i, 28. " rarefied, expiration into, i, 28. Apomorphine, i, 139. Blennostasine, ii, 436. Gallic acid, i, 432. Naphthalene, ii, 1. Waters, chlorinated alkaline, ii, 381. Zinc oxide, ii, 406. " sulphate, ii, 407. Bronchorrhflea, foetid. Guaiacol, inhalation of, i, 459. 552 INDEX OF DISEASES AND REMEDIES. Bruises. Ammonium acetate, i, 54. Benzoin tincture, i, 178. Calendula, i, 203. Chaulraoogra oil, i, 233. Hamamelis, i, 467. Lead, Goulard's extract of, i, 577. Massage h, friction, i, 609. Salubrine, ii, 152. Stupes, hot-water, ii, 238.. Buboes. Carbolic acid (parenchymatous injections), i, 213. Cupric sulphate solution (injections), i, 306. Sanoform, ii, 154. Silica, hydrated, ii, 191. Silver nitrate (injections), ii, 196. Xeroform, ii, 397. Buboes, suppurating. Iodoform injection, i, 539 ; ii, 444. lodol, i, 540. Burns. Aristol, i, 140. Basilicon ointment, ii, 135. Borax, i, 189. Cantharides tincture (topically), i, 208. Carbolic acid, i, 213. Carron oil, i, 583. Chalk powder, i, 230. Chloral hydrate, i, 237. Collodion, i, 293. Cotton, absorbent, i, 810. Creosote, i, 314. Dermatol, i, 329. Euphorin (as a local disinfectant), i, 402. Europhene, i, 402. Flour, wheat, i, 423. Ichthyol, i, 522. Lead liniment, i, 578. Lint, i, 584. Magnesia, calcined, ii, 445. Massage, i, 609. Picric acid, ii, 88. Piscidia, ii, 91. Potassium nitrate, ii, 99. Rhigolene, ii, 129. Rye flour, ii, 137. Sodium bicarbonate, ii, 205. Tannic acid, ii, 257. Terebene, ii, 271. Thioform, ii, 278. Thiol (solid), ii, 278. Transfusion, ii, 323. Turpentine liniment, ii, 335, 336. Xeroform, ii, 397. Zinc oxide, ii, 406. Cachexia. Cod-liver oil, i, 288. Linseed oil (as a nutrient), i, 584 Transfusion, ii, 323. Cachexia, malarial. Arsenic, i, 145. Carbolic acid and iodine, i, 213. Hydrastine, i, 476. Quinine, i, 255 : ii, 118. Waters, Buffalo lithia, ii, 873. " ferruginous, ii, 369. Cachexia, mercurial. Somatose, ii, 212. Cachexia of children. JJitrohydrochloric acid (for sponging), ii, 16. Calculus. Waters, mineral, ii, 879. Calculus, biliary. Boldo, i, 189. Chloroform, i, 245. Glycerin, i, 451. Limewater, i, 582. Massage, abdominal, i, 608. Olive oil, ii, 35. Salacetol, ii, 89. Sodium phosphate, ii, 79, 208. Strophanthus, ii, 231. Urotropine, ii, 343. Waters, chlorinated alkaline, ii, 381. mineral, ii, 375, 876. Calculus, cystic. Urotropine, ii, 343. Waters, alkaline, ii, 867. Calculus, renal. Strophanthus, ii, 231. Waters, alkaline, ii, 367. " mineral, ii, 384. Calculus, uric-acid. Urotropine, ii, 343. Calculus, resical. See Calculus, Cystic, Cancer. Alcohol, i, 31. Alveloz, i, 51. Arsenic (as a caustic and in superficial forms), i, 144. Atropine applications, i, 154. Bismuth and morphine (for relief of pain), i, 180. Bromine, i, 195. Calcium carbide, ii, 437. Carboriic water, i, 314. Chelidonium, ii, 431. Chromic acid, i, 248. Condiirango, i, 297. Conium, i^ 298. Formic-acid compounds, i, 429. Gold, i, 454. Hydrastine, i, 476. lo'dol, i, 540. Iron, reduced, 1, 547. Loretin, i, 588. Orchitic liquid, i, 75. Pepsin, ii, 69. Permanganates, ii, 70. Potash, i, 228. Salicylic acid, ii, 145. Salol, camphorated, ii, 150. Serum treatment, ii, 185, 186. " " (Richet and Hericourt's method), ii, 185. Silica (for relief of pain), ii, 191. Smith's paste, ii, 64. Sodium chlorate, ii, 206. " phosphate, ii, 208. Steam, ii, 323. Terebene and olive oil, ii, 371. Testicle juice, i, 75. Toxines, ii, 318, 315. X rays, ii, 398. Cancer, larj'ngeal. Pormic-acid compounds, i, 429. INDEX OF DISEASES AND REMEDIES. 553 Cancer, slongrhin^, of the cerrlx uteri. Terebene and olive oil, ii, 271. Turpentine, Chian, locally and internally, ii, 335. Vienna paste, i, 338. Cancer or the bladder. Piohi, ii, 82. Cancer of the breast. Calcium carbide, ii, 437. Cancer of the rectum. Belladonna, i, 175. Cancer of the stomach. Charcoal, i, 333. Condurango, i, 397. Pepsin, ii, 69. Somatose, ii, 313. Water, i, 479. X rays, ii, 398. Cancer of the uterus. Alcohol (interstitial injections), i, 31. Bromine, i, 195. Calcium carbide, ii, 426. Chromic acid, i, 248. Salicylic-acid injections, ii, 145. Sodium chlorate (for palliative treatment), ii, 306. Zinc sulphate, ii, 407. Cancer, ulcerating. Conium applications, i, 398. Hydrastine, i, 476. Cancrnm oris. Copper-arsenite solution (in form of a spray), i, 803. Nitric acid (fuming), i, 337. Carbuncle. Calcium sulphide, i,'203. Carbolic acid (parenchymatous injections), i, 213 Iodol,'i, 540. Permanganates, ii, 70. Salol, camphorated, ii, 150. Sodium phosphate, ii, 208. Turpentine liniment, ii, 336, Vienna paste, i, 228. Carcinoma. See Cancbe. Cardiac depression. Tea, ii, 265. Cardiac disease. See Heart disease. Cardiac excitement. Bromidia, i, 195. Cardiac failure. Amyl nitrite, i. 538. Duboisine, i, 353. Ether (hypodermically), i, 397. Cardiac feebleness. Egg and brandy, i, 355. Cardiac incompetency from overstrain. Convallaria, i, 300. Cardiac neuroses. Arsenic, i, 146. Zinc cyanide, i, 333 ; ii, 408. Cardiac pain. See Angina pectoeis. Cardiac tension, abnormal, of renal dis- ease. Veratrum viride, ii, 853. Caries. Calcium chloride, i, 303, Caries. Cod-liver oil, i, 388. Hydrochloric acid, ii, 441. Hypophosphites, i, 518. Phosphoric acid, ii, 77. Potassium permanganate, i, 597. Waters, chlorinated, ii, 366. Caries, dental. Collodion, i, 293. (in children), Calcium phosphate, i, 203. Creosote collodion, i, 293. Silver nitrate, solid, i, 136. Caruncles of the female urethra. Zinc sulphate, ii, 407. Caseous glands. See Glands, Caseous. Catalepsy. Amyl nitrite, i, 61. Earadaism, i, 366. Thyreoid treatment, ii, 398. Cataract. Cineraria, i, 358. Bserine, i, 392. Massage, i, 610, Cataract, incipient. Homatropine, i, 472. Catarrh. Air, condensed, inspiration of, i, 28. Alum (by irrigation), i, 50. Aluminum borotannicotartrate, ii, 414 Ammonium hydrosulphide, i, 57. Anthemis inhalations, i, 331. Arsenic, i, 146. Balsamic fumes, i, 259. Baths, condensed-air, i, 27. " sulphur, i, 173. Bismuth powder, i, 181. Boric acid (saturated solution), i, 191. Bromine vapour, i, 196. Cantharides, i, 346. Carbonic-acid inhalation, ii, 430, Cimicifuga, i, 250. Copaiba, i, 445. Copper-arsenite solution, i, 303. Goto bark, i, 309, Cubeb, i, 319. " cigarettes, i, 43. Eucalyptol, i, 402. Europhene (by insufflation), i, 402. Formaldehyde, i, 438. Geosite, ii, 438. Ginger troches, i, 449. Guaiacol, i, 457. Hydrastis, i, 475. Ipecac, i, 542. Ijicoriee, i, 580. Menthol solution (by injection), i, 614. Nucleins, ii, 24. Orexine hydrochloride, ii, 457. Oxygenated water and hydrogen-dioxide so- lution (by inhalation), ii, 52. Pinus purailio, oil of, ii, 88. Pulsatilla, ii, 107. Quinine, i, 355. Salol, ii, 150. Salumine, ii, 153, Sanguinaria, ii, 154. Sesame oil, ii, 190. Silver nitrate, ii, 194. Sodium chloride, ii, 306. 554 INDEX OP DISEASES AND REMEDIES. Catarrh. Sodium sozoiodolate, ii, 208. Solanum panioulatum, ii, 210. Steam, i, 418. Tannal, ii, 254. Tannalbin, ii, 254. Tanosal, ii, 261. Tartar emetic, i, 114. Turpentine, i, 345. Water, i, 479. Waters, alkaline, i, 45. " mineral, ii, 375, 384. " sodium sulphate, ii, 368. " thermal, ii, 304. Wine, ii, 394. " port, ii, 393. Xeroform (internally), ii, 397. Zino salicylate, ii, 410. " sulphichthyolate, ii, 412. Catarrh, acute. Ammonium acetate, i, 54. Baths, condensed-air, i, 27. Pulsatilla, ii, 107. Catarrh, acute nasal. Bismuth powder (used as a snuff), i, 181. Copper-arsenite solution (in form of a spray), i, 303. Cubeb, i, 319. Catarrh, apical. Air, condensed, inspiration of, i, 28. Catarrh, atrophic pharyngeal. Goto bark, i, 309. Catarrh, bronchial. Apomorphine (as an expectorant), i, 139. Baths, condensed-air, i, 37. Cimicifuga, i, 250. Cubeb cigarettes, i, 430. Ipecac, i, 542. Licorice, i, 580. (associated with general asthenia). Waters, chlorinated (externally and internally), ii, 366, 867. Waters, sulphuretted, ii, 371. Catarrh, chronic. Ammonium chloride, i, 528. Copper-arsenite solution (in form of a spray), i, 308. Dulcamara, i, 353. Myrtol, i, 652. Zinc sulphichthyolate, ii, 412. Catarrh, chronic bronchial. lodol (by insufflation), i, 540. Catarrh, chronic duodenal. Waters, mineral, ii, 384. Catarrh, chronic gastric. Arsenic, i, 146. Hydrastis, i, 475. Oxygenated water and hydrogen-dioxide so- lution (by inhalation), ii, 52. Quinine, i, 255. Silver nitrate, ii, 194. Catarrh, chronic gastroduodenal. Alkaline mineral waters, i, 45. Catarrh, chronic intestinal. Ammonium borate, i, 55. Sesame oil, ii, 190. Tannalbin, ii, 254. Waters, sodium-sulphate, ii, 368. Catarrh, chronic nasal. Ammonium chloride, i, 528. Catarrh, chronic, of the bladder. Pulsatilla, ii, 107. Catarrh, chronic, of the gastrointestinal and genito-urinary tracts. Guaiacol, i, 457. Catarrh, chronic, of the middle ear. Massage, i, 610. Catarrh, chronic, of the rectum. Cubeb, i, 319. Menthol inhalation, i, 539. Ozone inhalation, ii, 58. Sanguinaria. ii, 154. Waters, chlorinated allcaline, ii, 381. ■' " ", (externally and internally), ii, 381. Waters, thermal, ii, 364. Catarrh, dry, of tlie nose and pharynx. Salumine (by insufflation), ii, 152. Catarrh, gastric. Eucalyptol, i, 400. Hamamelis, i, 467. Nux vomica, ii, 28. Papain, ii, 60. Salicylic acid, ii, 148. Sesame oil, ii, 190. Waters, chlorinated, ii, 366. " mineral, ii, 875. Catarrh, gastro-duodehal. Sanguinaria, ii, 154. Sodium phosphate, ii, 308. Catarrh, gastro-intestinal. Water, i, 479. Catarrh, hepatic. Salol, ii, 150. Catarrh, intestinal. Eucalyptol, i, 400. Grape cure, i, 455. Oxygenated water and hydrogen-dioxide so- lution (locally through the stomach-tube), ii, 53. Pulsatilla, ii, 107. Salol, ii, 150. Waters, mineral, ii, 375, Wine, ii, 394. Xeroform (internally), ii, 897. Catarrh, laryngeal. Balsamic fumes, i, 529. Baths, condensed-air, i, 27. Catarrh, nasal. Boric acid (saturated solution), i, 191. Brcmine vapour, i, 196. Carbolic-acid solution (by spray), i, 218. Menthol solution (by injection), i, 614. Sodium chloride (as a gargle), ii, 306. " sozoiodolate, ii, 308. Zinc salicylate, ii, 410. Catarrh, naso-pharyngeal. Nucleins. ii, 34. Catarrh of the air-passages. Steam, i, 418. Catarrh of tlie bile ducts. Salol, ii, 150. Silver nitrate, ii, 194. Waters, mineral, ii, 384. Catarrh of the bladder. Solanum paniculatum, ii, 210. Tannin injections, ii, 256. Catarrh of the digestive tract. Arsenic, i, 146. Cubeb, i, 819. INDEX OF DISEASES AND REMEDIES. 555 Catarrh of the digestive tract. Buoalyptol, i, 400. G-eosite, ii, 438. ' Guaiaool, i, 457. Hydrastis, i, 475. Orexine hydrochloride, ii, 451. Oxygenated water and hydrogen-dioxide so- lution (by inhalation), ii, 53. Quinine, i, 255. Salol, ii, 150. Sanguinaria, ii, 154. Sesame oil, ii,- 190. Silver nitrate, ii, 194. Tannalbin, ii, 254. Water, i, 479. Waters, alkaline, i, 45. " mineral, ii, 384. " sodium sulphate, ii, 368. Wine, ii, 394. Xeroform, ii, 397. Catarrh of the gall bladder and ducts. Waters, sodium-sulphate, ii, 368. Catarrh of the genito-urinary tract. Bismuth, i, 181. Cantharides, i, 345. Formaldehyde, i, 428. Guaiaool, i, 457. Pulsatilla, ii, 107. Solanum Pulsatilla, ii, 210. Turpentine, i, 345. Waters, thermal, ii, 364. Catarrh of the respiratory tract. Air, condensed, inspiration of, i, 28. Anthemis inhalations, i, 231. Apomorphine (as au expectorant), i, 139. Asolepias tuberosa, i, 148. Balsamic fumes, i, 259. Baths, condensed-air, i, 27. Bismuth powder, i, 181. Boric acid (saturated solution), i, 191. Bromine vapour, i, 196. Carbonic-acid inhalation, ii, 430. Ciraioifuga, i, 250. Copper-arsenite solution, i, 303. Goto bark, i, 309. Cubeb cigarettes, i, 43. Ginger troches, i, 449. Ipecac, 1, 542. Licorice, i, 580. Menthol solution (by injection), i, 614. Nucleins, ii, 24. Salumine (by insufflation), ii, 153. Sodium chloride, ii, 206. " sozoiodolate, ii, 308. Steam, i, 418. Tanosal, ii, 261. Tartar emetic, i, 114. Waters, chlorinated, ii, 366, 367. Zinc salicylate, ii, 410. " sulphichthyolate, ii, 412. Catarrli of the throat and bronchi. Tanosal. ii, 261. Catarrh of the throat and mouth. Ginger, troches of, i, 449. Catarrh of the upper air-passages. Anthemis inhalation, i, 231. Catarrh of the urinary mucous membrane. Buchu, i, 197. Catarrh of the vagina and cervix uteri. Formaldehyde, i, 428. 79 Catarrh of the vagina and cervix uteri. lodol, i, 540. Kosinal, ii, 135. Catarrh, pharyngeal. Baths, condensed-air, i, 27. Catarrh, pulmonary. Balsamic fumes, i, 529. Catarrh, respiratory. Chamomile, i, 231. Podophyllin, ii, 93. Catarrh, subacute intestinal. Tannalbin, ii, 254. Catarrh, subacute nasal. Baths, condensed-air, i, 27. Catarrh, uterine. Douche, hot, i, 480. Grindelia, i, 456. Rosinal, ii, 135. Catarrh, vaginal. Formaldehyde, i, 428. lodol, i, 540. Rosinal, ii, 185. Catarrh, vesical. See Catarrh or the bladder. Catatonia. Thyreoid treatment,- ii, 299. Cellulitis, pelvic. Arnica, fluid extract of (internally), i, 141. Baths, hot sitz, i, 169. Electricity, i, 368. Glycerin suppositories, ii, 450. Heat, i, 468. Ice applications, i, 530. Ichthyol, i, 528. Cephalalgia. See Headache. Cerebral affections. Bloodletting, i, 188. Cathartics, i, 234. Colooynth (as a revulsive), i, 296. Blaterium, as a revulsive and depleting agent, i, 858. Electricity, i, 366. Gavage, i, 436. Salicylated camphor, i, 204, Trional, ii, 332. Urethane, ii, 342. Cerebral excitement. Cold plunge, i, 488. Cerebr.il exhaustion. Damiana, i, 824. Cerebral exhaustion from overwork. Bromides, ii, 6. Cerebral irritation from drink. Veratrum viride, ii, 353. Chancres. Alumnol, i, 51. Calcium salicylate, ii, 145. Bnrophene (in powder or ointment), i, 402. Hydrogen dioxide, i, 503. Iodoform collodion, i, 393. Nosophene, ii, 19. Pixol, ii, 93. Pyrogallic acid, ii. 111. Sanoform, ii, 154, 360. Silver nitrate, ii, 196. " oxide, ii, 197. Sulphuric acid and asbestos, ii, 341. " " " charcoal, ii, 243. 556 INDEX OF DISEASES AND REMEDIES. Chancres. Sulphuric acid and saffron, ii, 242. Traumatol, ii, 329. Chancroids. Alumnol, i, 51. Carbolic acid (parenchymatous injections), i. 313. Europhene (in powder or ointment), i, 402. Hydrogen dioxide, i, 503. Iodoform collodion, i, 293. lodol, i, 540. Mentho-phenol, ii, 61. Nitric acid, ii, 7. Resorcin, ii, 126. Silica, hydrated, ii, 191. Silver nitrate, ii, 196. " oxide, ii, 197. Xeroform, ii, 897. Chapped and Assured hands and lips. Benzoin and glycerin, i, 178. Chilblains. Aconite, i, 9. Alum curd (cataplasm), i, 5a. Baths, cold foot, i, 170. Capsicum paper, i, 209. Cocaine collodion, i, 292. Creosote, i, 314. Iodine, i, 536. Petroleum, ii, 70. Phulluah, ii, 79. Resorcin and ichthyol, ii, 126. Chills, malarial. See Fever, Malarial. Chills, urethral. Quinine, ii, 117. Strophanthus, ii, 232. Chloasma. Iodine, i, 536. Chlorosis. Air, condensed, inspiration of, i, 28. Arsenic, i, 145. " (as an emmenagogue), i, 374. Baths, sulphur, i, 173. " condensed-air, i, 28. Champagne, ii, 393. Cold douche, i, 491. Copper arsenite, i, 303. Creolin, i, 313. Perratin, i, 422. Galbanum (internally), i, 433. Geosite, ii, 438. Glycerophosphates, ii, 439. Gold, i, 454. HEemalbumin, i, 463. Hydrochloric acid, i, 493. Iron (as an emmenagogue), i, 374. " albuminate, i, 553. " carbonate, i, 547. " chloride (ethereal tincture), i, 548. " iodide, i, 551. " lactate, i, 551. " tannate, ii, 259. " valerianate, ii, 346, 848. Manganese (as an emmenagogue), i, 374. " and iron, i, 596. Ovarine, ii, 451. Oxygen, ii, 52. Peptomangan, ii, 69, 70, Somatose, ii, 212. Strophanthus, ii, 333. Chlorosis. Strychnine, with iron and quinine, ii, 38. Sulphur, ii, 240. Transfusion and infusion, ii, 322. Trefusia, ii, 329. Waters, ferruginous, ii, 369. Wines, ii, 394. Zincohsemol, ii, 412. Chlorosis, progressive. Arsenic, i, 145. Wines, ii, 394. Cholsemla. Transfusion, depletory, ii, 333. Cholera. Acids, mineral, i, 6. Baths, hot, i, 160. (algid state). Baths, mustard, i, 173. Calomel, i, 634. Camphor, i, 306. Cantani's treatment, ii, 257. Carbolic acid, i, 212. (algid state). Chloral hydrate (hypodermical- ly), i, 237. Copper arsenite (enema), i, 304. Goto bark (injections), i, 307. Creolin, i, 313. Creosote, i, 314. Eucalyptol, i, 400. (algid state), Heat, i, 468. " dry, ii, 235. Infusion, intravenous or subcutaneous, ii, 324, 325. Naphthol, ii, 2. Opium, ii, 36. Paraform, ii, 61. Quinine, ii, 119. Saligenin, ii, 147. Serum, artificial, ii, 164. " treatment, i, 83 ; ii, 187. Sulphuric acid, ii, 242. Sumbul, ii, 243. Tannin (Cantani's treatment), ii, 257. Transfusion, ii, 323. Cholera, collapse from. Opium, ii, 36. Cholera, hog. Serum treatment, ii, 188. Cholera Infantum. Baths, hot mustard, i, 490. Bismuth phosphate, ii, 436. " salicylate, ii, 145. Bromides, i, 194. Bromol, i, 197. Carbolic acid and bismuth, i, 212. Castor oil, i, 220. Chalk, i, 230. Copper arsenite, i, 303, 305. " " (enema), i, 304. Creosote, i, 314. Muscarine, i, 645. Paraform, ii, 61. Serum, cow's (subcutaneous injections), ii, 163. Silver nitrate, ii, 194. Sodium salicylate, ii, 146. Zinc sulphocarbolate, ii, 411, Cholera morbus. Camphor, oil of, i, 205. Carbolic acid and bismuth, i, 213, Copper arsenite, i, 303, 305. INDEX OP DISEASES AND REMEDIES. 557 Cholera morbus. Copper arsenite (enema), i, 304. Creosote, i, 314. Zinc sulphocarbolate, ii, 411. Cholerine. Camphor, i, 205. Chordee. Cold sitz baths, i, 489. Gallobromol (by injection), i, 433. Humulus, i, 474. Ice, applications of, i, 90. Veratrum viride, i, 90. Chorea. Acetanilide, i, 4. Ammonium carbonate, i, 56. Antipyrine, i. 124. Arsenic, i, 145. Baths, allcaline, i, 171. Cerium oxalate, i, 229. Chloralamide, i, 238. Chloral hydrate, i, 237. Chloralose, i, 239. (of uterine trouble), Cimicifuga, i, 250. (of rheumatic taint), Cimicifuga, i, 250. Cod-liver oil, i, 288. Cold affusions, i, 17. Conium, i, 298. Copper, ammoniated, i, 303. Curare, i, 321. Eserine, 1, 892. Bxalgine, i, 403. Paradaism, i, 366. Gallobromol, i, 433. Gelsemium, i, 437. Gold bromide, i, 454. Heat, i, 468. Iron bromide, i, 553. Lobelia, i, 587. Orchitio liquid, i, 75. Picrotoxin, ii, 84. Pisoidia, ii, 91. Quinine, ii, 120. Rest-cure, ii, 127. Solanum earolinense, ii, 209. Spermine, ii, 317. Strychnine, ii, 28. Sulphonal, ii, 239. Tartar emetic, i, 113. Testicle juice, i, 75. Trional, ii, 333. Valerian, ii, 345. Warm pack, i, 469. Waters, ferruginous, ii, 369. Wines, ii, 894. Zinc cyanide, i, 323. " iodide (internally), ii, 405. " salts, ii, 401. Chorea, acute. Wines, ii. 394. Chorea, hysterical. Chloralose, i, 239. Chylnria. Thymol and gallic acid, ii, 283. Cicatrices. Thiosinamine, ii, 280, 281. Circulation, engorgement of the hepatic and portal. Alkaline mineral waters, i, 45. Circulation, irregularities of. Convallaria, i, 300. Cirrhosis. Potassium iodide, ii, 98. Cirrhosis of the liver. Alkaline mineral waters, i, 45. Arsenic, i, 146. Carlsbad salts, i, 224. Copaiba, i, 303. Iodoform, i, 537. Nitric acid, ii, 8. Waters, sodium-sulphate, ii, 368. Coecygodynia. Galvanization, stabile anodal, i, 366. Coeliac disease (in children). Bismuth (in large doses), i, 181. Colds. See CoEYZA. Colic. Alcohol, i. 33. Alum, i, 50. Ammonia water, i, 54. Ammonium borate, i, 55. Amyl valerianate, i, 63. Anhalonium Lewinii, ii, 416. Antacids, i, 86. Blisters, small flying (to the abdomen), i, 186. Cajeput, i, 301. Camphor, i, 205. oil of, i, 205. Capsicum, i, 209. Chamomile poultice, i, 281. Chloroform, i, 345. Cinnamon, i, 359. Codeine, i, 386. Corn silk, i, 306. Ether (internally), i, 397. Glycerin, i, 451. Linseed tea, ii, 269. Mustard applications, i, 312. Nitroglycerin, ii, 15. Nutmeg, ii. 25. Peppermint infusion, i, 613. Pichi, ii, 82. Piperazine, ii, 89. Sassafras, ii, 156. Stupes, hot, with oil of turpentine, ii, 233 Sulphur, ii, 240. Tribulus lanuginosus, ii, 330. Zinc cyanide, i, 328. Colic, biliary. Chloroform inhalation, i, 345. Electricity, i, 586. Glycerin, i, 451. Nitroglycerin, ii, 15. Olive oil, ii, 35. Solanum paniculatum, ii, 210. Sulphur, ii, 340. Vichy water, ii, 358. Water, i, 586. Colic, Hatulent. Calamus, i, 301. Capsicum, i, 309. Chamomile, i, 381. Sassafras, ii, 156. Colic, lead. Colic, painter's. Alum, i, 50. Olive oil, ii, Sn. Potassium iodide, ii, 98. Tobacco-smoke enema, ii, 304.. 558 INDEX OF DISEASES AND REMEDIES. Colic, renal. Amyl valerianate, i, G2. Chloroform inhalation, i, 245. Corn silk, i, 306. Linseed tea, ii, 269. Nitroglycerin, ii, 15. Pichi, ii, 82. Piperazine, ii. 89. Colic, saturnine. See CJoLic, Lead. Colic, spasmodic. Alcohol, i, 33. Waters, Buflfalo lithia, ii, 372. Colitis. Bismuth injections, i, 181. Colitis, chronic catarrhal. Balsams, i, 160. Colitis, septic. Irrigation of the rectum and colon, i, 554. Collapse. Acetic ether, i, 5. Ammonia (intravenously), i, 53 ; ii, 227. Atropine (hypodermioally), i, 156. Blisters, i, 186. Camphorated oil (hypodermioally), ii, 6. Capsicum tincture, i, 209. Champagne, ii, 393. Ether (subcutaneously), i, 397. Heat, application of, i, 468. Oxygen, ii, 52. Strophanthus, ii, 231. Collapse from cholera. Opium, ii, 36. Collapse of fevers. Champagne, ii. 393. Colpitis, ulcerative. Cupric-sulphate solution, i, 306. Coma. Blisters, 1, 186. Cold affusions, i, 17. Oxygen, ii, 52. Coma of typhus fever. Opium treatment of, ii, 128. Valerian, ii, 345. Condylomata. Aeetic acid, i, 5. Chromic acid, i, 248. Europhene, in powder or ointment, i, 403. Nitric acid, ii, 7. " (fuming), i, 227. Salicylic acid and (glacial) acetic acid, i, 225. Congestion (hepatic or splenic). Baths, hot-air, i, 168. Elaterium, as a revulsive and depleting agent, i, 358. Congfestion, acute. Hunyadi Janos, i, 474. Congestion, acute abdominal. Poultices, ii, 101. Congestion, acute cerebral. Bloodletting, i, 188. Congestion, cephalic. Baths, cold foot, i, 170. Congestion, cerebral. See Cerebral affections. Congestion, chronic. Taraxacum, ii, 265. Congestion, chronic, of the Intestines, liver, and pelvic organs. Hunyadi Jinos, i, 474. Congestion from cold, . Jaborandi, i, 559. Congestion, hep.atic. Ammonium chloride, i, 56. Hepatic douches, i, 349. "Waters, alkaline carbonated, ii, 375. " chlorinated (externally and inter- nally), ii, 365. Waters, sulphuretted, ii, 371. Congestion, intracranial. Cupping applied to the nape of the neck, i, 320. Congestion, local. Scarification, ii, 158. Congestion, malarial, of the liver. (Jamboge and calomel, i, 433. Congestion, mammary. Collodion (applied to the whole breast), i, 294. Congestion of the abdominal viscera. Baths, mustard, i, 172. Congestion of the kidneys. Digitalis, i, 342. Strophanthus, ii, 231. Congestion of the lungs. Digitalis, i, 342.^ Strophanthus, ii, 231. Congestion of the spinal cord. Ergot, i, 388. Congestion, passive. Convallaria, i, 300. Congestion, passive uterine. Baths, i, 169. Cong:estion, portal. Chionanthus virginica, i, 234. Jalap, i, 560. Podophyllin, ii, 93. Congestion, prostatic. Rectal douches, i, 349. Congestion, pulmonary. Air. condensed, inspiration of, i, 28. Baths, cold foot, i, 170. Convallaria, 1, 300. Congestion, renal. Corn silk, i, 306. Poultices, ii, 102. Waters, chlorinated alkaline (externally and internally), ii, 381. Congestion,"superflcial. Ice (topically), i, 519. Congestion, uterine. Arsenic, i, 146. Glycerin suppositories, i, 450. Congestion, venous, of mitral and tricus- pid disease. Digitalis (as a diuretic), ii, 228. Conjunctivitis. Antipyonine (weak solutions), i, 120. Argoriin, ii, 197. Bismuth tannate, ii, 259. Borax (5-per-cent. solution), 1, 189. Boric acid, i, 191. Calomel insufflation, i, 556. Cod-liver oil, i, 288. Collodion, i, 294. Copper arsenite, i, 305. Cupric acetate applications, i. 303. sulphate solution (locally), i, 306. Ethyl chloride, ii, 424. Formaldehyde, i, 428. INDEX OP DISEASES AND REMEDIES. 559 ConjnnctiTitis. Gallicin, i, 433. Hydrastine, i, 476. Leeching, i, 579. Mercury oxide, i, 623. Phytolacca, ii, 81. Pilocarpine, ii, 96. Pulsatilla, ii, 107. Pyoctanine, ii, 108. Scarification, ii, 158. Silver nitrate, ii, 195. Suprarenal capsule, ii, 247. Thioform, ii, 378. Zinc acetate (as a local astringent), ii, 403. " oxide (as a collyrium), ii, 406. " tannate, ii, 412. Conjunctivitis, acute. Copper arsenite, i, 305. Mercury oxide (ointment), 1, 633. Conjunctivitis, aphtlious. Collodion, i, 394. Conjunctivitis, catarrlial. Argonin, ii, 197. Conjunctivitis, clironic. Zinc-chloride applications, ii, 405. Zinc iodide (as a collyrium), ii, 405. Conjunctivitis, diplitheritic. Zinc-chloride applications (with caution), ii, 405. Conjunctivitis, gonorrlioeal. Zinc-chloride applications (with caution), ii, 405. Conjunctivitis, granular. Copper, aluminated, applications, i, 303. Hydrastine, i, 476. Phytolacca, ii, 81. Conjunctivitis, phlyctscnular. Calomel (by insufflation), i, 556. Conjunctivitis, purulent. Antipyonine (strong solution), i, 130. Argonin, ii, 197. Silver nitrate, ii, 195. Conjunctivitis, scrofulous, of childreu. Zinc-oxide applications, ii, 406. Conjunctivitis, subacute. Copper arsenite, i, 305. Constipation. Aloes, i, 48. Asatoetida, i, 147. Baths, coldj i, 169. Cannabis indica, i, 207. Castor oil, i, 220. Cathartinic acid, i, 235. Cetrarin, i, 230. Colocynth. i, 296. Cream, i, 222. Croton oil, i, 318. Electricity applied to the abdomen, i, 368. Ephedra, i, 385. Frangula, i, 429. Glycerin injections, i, 450. Hunyadi JAnos, i, 474. Ichthyol, ii, 443. Juglans, i, 568. Leptandra, i, 580. Licorice, compound powdered, i, 581. Lobelia, i, 587. Nux vomica, ii, 38. Oatmeal, ii. 31. Olive oil, ii, 35. Constipation. Ox-gall, ii, 49. Podophyllin, ii, 93. Rhaninus purshiana, ii, 129. Rhubarb, ii, 130. Rye, ii, 137. Seammony, ii, 157. Seidlitz powders, ii, 161. Senna, ii, 163. Sesame oil, ii, 190. Sodium sulphite, ii. 208. Splenic extract, ii, 218. Sulphur and cream of tartar, ii, 241. Taraxacum, ii, 265. Water, i, 333, 479. Waters, chlorinated (externally and inter- nally), ii, 365. Waters, mineral, ii, 376. Constipation, chronic. Hunyadi Janos, i, 474. Nux vomica (extract), ii, 28. Oatraeal, ii, 31. Ox-bile, ii, 49. Rhamnus purshiana, ii, 129. Rye, ii, 137. Sesame oil, ii, 190. Sulphur and cream of tartar, ii, 241. Waters, mineral, ii, 379. " simple thermal (internally), ii, 364. Constipation, obstinate. Baths, cold, i, 169. Croton oil, i, 318. Ichthyol, ii, 443. Seammony, ii, 157. Consumption. See TuBERcnLOSis. Pulmonary. Contractions, uterine, Induction of. Faradaism, i, 366. Mammary irritation, ii, 56. Contusions. Alcohol, i. 29. Collodion, saturnine, i, 393. Convalescence. Canella, i. 306. Chamomile, i, 231. Guarana, i, 46l. Convalescence from fevers, Nutrose, ii, 449. Convalescence of acute disease. Kumyss, i, 567. Convalescence of prolonged disease. Wines, ii, 325. Convalescence, tardy. Ergot and sodium phosphate, i, 389. Convulsions. Ammonium succinate, 1, 58. Amyl nitrite, i, 528. Baths, hot, i. 166. (of adults), Bloodletting, i, 188. Chloral hydrate, i, 237. Chloroform inhalation, i, 245. Curare, i, 331. Lobelia, i, 587. (of dentition), Sulphonal, ii, 389. Valerian, ii, 345. Convulsions, infantile. Amber, oil of (applied to the spine), i, 58. Chloral hydrate, i, 237. Ether (subcutaneously), i, 897. Tribromhydrin, ii, 330. 560 INDEX OF DISEASES AND REMEDIES. Convulsions, infantile. Water applied to the head, i, 349. Wines, ii, 394. Convulsions of epilepsy. Chloral hydrate, i, 237. Convulsions, puerperal. Bloodletting, i, 188. Chloral hydrate, i, 237. Chloroform, i, 528. Croton oil, i, 318. Paraldehyde, ii, 62. Transfusion, depletory, ii, 323. Convulsions, nrsemic. Amyl nitrite, i, 528. Chloroform, i, 528. Morphine, ii, 37. Warm bath, i, 166. Convulsive diseases. Bromal hydrate, i, 191. Corneal opacities. Calomel (by insufflation), i, 556. Thiosinamine, ii, 280, 381. Corns. Acetic acid, i, 5. Chelidonium, i, 233. Collodion, salieylie-acid and zino-chloride, i, 293. Copper oleate, i, 305. Potassium bichromate, ii, 95. Salicylic acid, ii, 143. Silver nitrate, ii, 457. Sodium ethylate, ii, 207. Tannic-acid ointment, ii, 257. Corpulence. See Obesity. Coryza. Aconite, i, 8. Ammonium-chloride inhalations, i, 57. Arsenic, i. 146. Boric acid, i, 191. Camphor (internally and by inhalation), i, 205. 539. Carbonic-acid inhalation, ii, 430. Castor oil, i, 220. Chamomile, i, 231. Chloroform, i, 528. Glycerin and carbolic acid, i, 450. Horehound, i, 473. Iodoform inhalation, i, 540. Magnolia, i, 592. Quinine, ii, 119. Salicylic acid, ii, 143. Sodium bicarbonate, ii, 205. Tannigene, ii, 260. Tannin, ii, 256. Waters, chlorinated alkaline, ii, 381. Zinc oleostearate with camphor and menthol, ii, 409. Coryza, acute. Carbonic-acid inhalation, ii, 430. Chloroform, i, 528. Cubeb cigarettes, i, 430. Glycerin and carbolic acid, i, 450. Quinine (as a spray), ii, 119. Salicin, ii, 140. Silver nitrate, ii, 195. Tannigene, ii, 360. Coryza, chronic. Tannigene, ii, 360. Tannin, ii, 356. Coryza, infantile. Ammonium acetate, i, 54. Coryza of liay fever. Boric acid (saturated solution), i, 191. Coryza of influenza. Chloroform, i, 528. Cough. Anhalonium Lewinii, ii, 416. Benzene, i, 176. Bromides, i, 194. Butyl chloral hydrate, i, 197. Cajupnt, ii, 426. Cannabis indica, i, 207. Catechu lozenges, i, 221. Cerium oxalate, i, 239. Codeine, i. 286. Conium vapour, i, 299. Grindelia, i, 456. Hydrobromic acid, i, 493. Linseed tea, ii, 369. Lobelia, i, 587. Meconarceine. i, 611. Muscarine, i, 645. Nux vomica, ii, 28. Opium, fumes of, i, 539. Phellandriura, ii, 71. Prunus virginiana. ii, 105. Pulsatilla, ii, 108. Stramonium, ii, 329. Stupes, hot, to the front of the neck, ii, 333. Terebene, ii, 271. Cough and pain of acute pulmonary and pleuritic diseases. Dry cupping applied to the back and chest, i, 320. Con^h, bronchial. Lobelia, i, 587. Cough, broncho-pulmonary. Meconarceine, i, 611. Cough, convulsive. Stramonium, ii, 229. Cough, irritable. Codeine, i, 286. Conium, vapour inhalations, i, 399. Pulsatilla, ii, 108. Cough, nervous. Anhalonium Lewinii, ii, 416. Codeine, i, 386. Hydrobromic acid, i, 493. Niix vomica, ii, 38. Valerian, ii, 345. Cough, reflex. Bromides, i, 194. Chamomile oil, i, 331. Congh, spasmodic. Grindelia, i, 456. Muscarine, i, 645. Cough, tickling. Catechu lozenges, i, 331. Cough, whooping-. See Whooping-cough. Cough, winter. Benzene, i, 176. Cough, winter, of bronchitis. Terebene, ii, 271. See also Coeyza. Cramp, abdominal. Strychnine, ii, 28. Cramp, pianist's. Paradaism and galvanism, i, 367. INDEX OP DISEASES AND REMEDIES. 561 Cranip, pianist's. Massage, i, 608. Cramp, telegrapher's. Massage, i, 60^. Cramp, writer's. Electricity, i, 365. Massage, i, 608. Crarjps, muscular. Sulphonal, ii, 231). Cretinism. Thyreoid treatment, i, 79 ; ii, 290. Croup. Aconite, i, 8. Alum (by insufflation or irrigation), i, 50. Calomel fumigation, i, 625. Copper-arsenite inhalation (or in form of a spray), i, 304. Ipecac, i, 418. Lactic acid, i, 567. Menthol inhalation, i, 529. Mercurial fumigation, i, 430. Oxygen, ii, 52. Pilocarpine, ii, 85, Squill, ii, 221. Steam, i, 538. Storax, ii, 228. Sulphur powder (by insuf&ation), ii, 241. Croup, membranous. Ipecac, i, 543. Steam, i, 528. Storax, ii, 328. Zinc sulphate (as an emetic), ii, 407. Croup, spasmodic. Belladonna, i, 175. Ipecac, i, 373. Lobelia, i, 587. Crusta lactea. Viola tricolor, ii, 360. Curvature, lateral, of the spine. Exercise, i, 416. Massage, i, 610. Cystic irritation. Piperazine, ii, 89. Cystinuria. Ammonium carbonate, i, 56. Cystitis. Alkalies, i, 44. Alphol, i, 49. Antipyrine (as a local anodyne), i, 134. Baths, hot, i, 166. Benzoic acid and the benzoates, i, 177. Beta-naphthol salicylate, ii, 145. Betol, i, 179. Boric acid, i, 190. Buchu, i, 197. Camphor irrigations of the bladder, i, 205. Calcium iodate irrigations, i, 201. Cantharides. i, 208. Copper arsenite, i, 304. Corn silk, i, 306. Cubeb, i, 319. Formaldehyde, i, 428. Glycerin and carbolic-acid applications, i, 450. Grindelia, i, 456. Iodine, i, 536. Kava, i. 564. Linseed tea, ii, 269. Matico, i, 611. Methylene blue, i, 630. Cystitis. Naphthalene, ii, 1. Nitric acid, ii, 7. Pareira, ii, 63. Pichi, ii, 83. Pix liquida, ii, 93. Pyoctanine, ii, 108. Quinine injections, ii, 130. Salol, ii, 150. Sodium bicarbonate, ii, 366. Sozal, ii, 215. Sulphur, ii, 240. Terpin hydrate, ii, 373. Triticum, ii, 333. Turpentine oil, ii, 336. Urotropine, ii, 343. Uva ursi, ii, 343. Waters, Buffalo lithia, ii, 873. " mineral, ii, 374, 377. Cystitis, ammoniacal. Beta-naphthol salicylate, ii, 145. Boric acid, i, 190. Formaldehyde, i, 438. Cystitis, chronic. Glycerin and carbonic-acid applications, i, 450. Grindelia, i, 456. Iodine, externally, i, 536. Methylene blue, i, 630. Pareira, ii, 63. Pix liquida, ii, 93. Silver citrate, ii, 198. " nitrate, ii, 196. Terpin hydrate, ii, 373. Uva ursi, ii, 343. Waters, mineral, ii, 377. Cystitis, gonorrlioeal. Alphol, i, 49. Cantharides, i, 208. Cystitis, prostato-, following gonorrhoea. Pichi, ii, 83. Cystitis, purulent. Formaldehyde, i, 428. Cystitis, tuberculous. Formaldehyde, i, 428. Cystitis, without decomposition. Alkalies, i, 44. Cystocele. Tannin tampons, ii, 256. Cystorrhcea. Cubeb, i, 318. Cysts. Silver nitrate (injections), ii, 196. Cysts, hydatid. Iodine (injections), i, 536. Cysts, ovarian. Iodine injections, i, 536. Dacryocystitis. Pyoctanine, ii, 108. Silver nitrate (injections), ii, 195. DandrnfT. Egg and limewater, i, 356. Deafness. Baths, condensed-air, i, 27. Hyaenanchin, i, 474. Massage of the ear, i, 610. Deafness, catarrhal. Baths, condensed-air, i, 27. Pulsatilla, ii, 107. 563 INDEX OP DISEASES AND REMEDIES. Deafness from qninine. Ergot, i, 389. Deafness from salicylic acid. Ergot, i, 389. Debility. Alcohol, i, 31. Baths, mud, i, 172. Calcium phosphate, ii, 78. Cashew nut, i, 319. Champagne, ii, 393. Cold plunge, i, 481. Placourtia, i, 422. Guarana, 1, 461. Hygiama, ii, 442. Iron sulphate, i, 549. Niicleins, ii, 24. Orohitic liquid, i, 76. Quinine, i, 254. Splenic extract, ii, 218. Stimulants, spinal, ii, 226. Sumbul, ii, 243. Testicle juice, i, 76. Waters, mineral, ii, 384. Wine, Burgundy, ii, 394. " Hungarian (red), ii, 394. " port, ii, 393. " sherry, ii, 393. Debility, cerebral. Iron phosphates, i, 551. Debility, general. Cashew nut, i, 219. Placourtia, i, 423. , Nucleins, ii, 34. Stimulants, spinal, ii, 826. (of dyspepsia). Wines, Burgundy or red Hun- garian, ii, 394. Debility of old age. Champagne, ii, 393. Debility of the young. Calcium phosphate, ii, 78. Debility, senile. Wine, sherry, ii, 393. Debility, sexual. See Impotence. Debility with nervous symptoms. Sanguinal, ii, 154. Decomposition, ammoniacal, of the urine. Boric acid, i, 190. Deflciencjr of hydrochloric acid in the gastric juice. Sodium bicarbonate, ii, 204. Deficiency of lime and phosphorus. Calcium phosphate, i, 203. Deformities, nail. Salicylic acid, ii, 145. Thyreoid treatment, ii, 393. Delirium (due to biliousness). Ammonium acetate, i, 54. Anhaloniura Lewinii, ii, 416. Antipyrine, i, 133. Morphine, ii, 37. Trional, i, 509. Delirium of alcoholism. See Delirium tremens. Delirium of fever. Bath, half, i, 169. Chloral hydrate, i, 236. Delirium of nervous exhaustion of acute fever. Morphine, ii, 37. Delirium, sthenic noisy. Tartar emetic and opium, i, 114. Delirium tremens. Ammonium chloride, ii, 415. " succinate, i, 58. (early stages), Bromides, i, 194. Camphor, i, 305. Capsicum, i, 309. Chloral hydrate, i, 337. (tremors), Cimicifuga, i, 250. Cold bath, i, 488. " plunge, i, 488. Coniine, i, 299. Digitalis, i, 343. Humulus, i, 474. (early stages). Paraldehyde, ii, 07. Strychnine, ii, 7. Sulphonal, ii, 239. Sumbul, ii, 7, 243. Urethane. ii, 343. Delirium with depression. Valerian, ii, 345. Dementia, primary. Thyreoid treatment, ii, 291. Dementia, secondary. Thyreoid treatment, ii, 391. Depression, mental. 1 aradization, general, i, 366. Depression, mental and pliysical. Spinal stimulants, ii, 226. Depression, sudden nervous. Musk, ii, 6. Depression, simple. Cocaine, i, 283. Dermatitis. Bismuth subnitrate (as a dusting powder), i, Pisol, ii, 92. Dermatitis, acute. Laurel, i, 571. Dermatitis, erythematous. Atropine, i, 156. Dermatitis exfoliativa. Thyreoid feeding (dry powder), i, 79. Dermatitis venenata. Zinc sulphate, ii, 408. Desquamative eruptions. Salicylic- acid applications, ii, 144. Diabetes. Alkaline mineral waters, i, 45. Alum whey, i, 50. Ammonium hydrosulphide, i, 57. Arsenic, i, 145. Baths, hot-air, i, 168. Codeine, i, 386. Conium, i, 399. Creosote, i, 314. Dulcin, i, 353. Ergot, i, 389. Gluten bread, i, 449. Iodoform, i, 537. Iron valerianate, i, 552. Jaborandi, i, 559. Jambul, i, 561. Lactic acid, i, 567. Lajvulose (as a sweetening agent), ii. 445. Milk, i, 636. o b „ , Muscarine, i, 645. Naphthalan, ii, 448. Oxygen, ii, 57. INDEX OP DISEASES AND REMEDIES. 563 Diabetes. Ozone, ii, 58. Pancreatic extract, i, 80, Peanut meal, ii, 418. Phosphoric acid, ii, 77. Picric acid, ii, 453. Piperazine, ii, 89. Potassinm permanganate, i, 596. Saccharin, ii, 138. Sodium bicarbonate, ii, 204. " sozoiodolate, ii, 208. Soja hispida, ii, 209. Spermine, ii, 217. Strontium bromide, ii, 239. Sulphonal, ii, 239. Thymol, ii, 288. Uranium nitra,te, ii, 838. Vichy water, ii, 358. Waters, Buffalo lithia, ii, 372. " saline, ii. 3G8. Wet pack, i, 490. Yeast, ii, 400. Zinc sulphoiehthyolate, ii, 412. Diabetes, hepatic. Alkaline mineral waters, i, 45. Carbolic acid, i, 212. Diabetes insipidus. Ergot (hypodermically), i, 389. Iron valerianate, i, 552. Jaborandi, i, 559. Muscarine, i, 645. Diabetes mellitus. Codeine, i, 286. Gluten bread as a food, i, 449. Morphine, ii, 37. Picric acid, ii, 453. Saccharin, ii, 138. Uranium nitrate, ii, 338. Waters, Buffalo lithia, ii, 372. Diabetes, pancreatic. Pancreatic extract, i, 80. Diarrlioea. Alkalies, i, 44. Alum (in pills), i, 50. Arsenic, i, 146. Barium sulphocarbolate, i, 163, Bismuth, i, 180. " tannate, ii, 259., Bitters, i, 183. Boric acid, i, 190. (of children). Calcium salicylate, ii, 145. Calomel, i, 634. Camphor salicylate, ii, 450. Carbolic acid and bismuth, i, 212. Castanea leaves, i, 219. Castor oil, i, 220. Cerium oxalate, i, 329. Cetraria, i, 230. Chalk, i, 330. Charcoal, i, 233. . Chloroform, i, 341. Cinnamon, i, 359. Copper arsenite (minute doses), i, 303. Coto bark, i, 309. Creolin, i. 313. Creosote, i, 814. Cnpric sulphate, i, 306. Diet, i. 336. Ephedra, i, 385. Erigeron, oil of, i, 390, Diarrlioea. Placourtia, i, 432. Flour gruel, i, 433. Galls, i, 433. Geranium, i, 438. Gnaphalium, i, 451. Grape cure, i, 455. HEBmatoxylon, i, 464. Humulus, i, 474. Ichthyol, ii, 443. Iodine enema, i, 536. Ipecac, i, 543. Iron nitrate, i, 551. Irrigation, i, 554. Kino, i, 565. Krameria, i, 566. Lactic acid, i, 567. Laurel, i, 571. Lead acetate and opium, i, 577. Licorice and flaxseed, i, 581. Linseed, infusion of, i, 584. Magnesia and rhubarb, i, 591. Matico, i, 611. Menthol, i, 614. Mercury, i, 619. " with chalk, i, 623. Morphine (small doses), ii, 38. Moss, Irish, i, 347. Mustard plaster (applied to the abdomen), i, 647. Naphthalene, ii, 1. Naphthol, ii, 3. Nitric acid, ii, 8. (due to atony of the bowels), Nux vomica, ii, 38. Oak bark, ii, 31. Opium, ii, 36. Peppermint poultice, i, 613. Paregoric, ii, 68. Pepsin and bismuth, ii, 69. Physostigmine salicylate, ii, 146. Picric acid, ii, 483. Quinine, i, 355. Rhubarb, ii, 130. Rubus, ii, 136. Salaoetol, ii, 189. Salol, ii, 150. Sandal-wood oil, ii, 153. (of dentition), Sea air, ii, 275. Serum, cow's, ii. 168. Sesame oil, ii, 190. Silver nitrate, ii, 197. " oxide, ii, 197. Sodium bicarbonate, ii. 204. " earbolate (as an intestinal antiseptic), ii, 306. Sodium phosphate, ii, 79. " salicylate, ii, 146. Sulphuric acid, ii, 342. Sumbul, ii, 243. Tannalbin, ii, 254. Tannigene, ii. 260. Tannin, ii, 257. Tannoform, ii, 260. Toast water, i, 351. Tolu balsam, ii, 309. Ulmus, ii, 337. Viburnum prunifolium. ii, 357. (late stages), Uva ursi, ii, 343. Waters, mineral, ii, 374, 379. 664 INDEX OF DISEASES AND REMEDIES. Diarrhoea. Zinc acetate, ii, 403. " sulphate, ii, 407. " tannate, ii, 412. Zincohasmol, ii, 412. Diarrhoea, acid. Antacids, i, 86. Diarrhoea, acid (of children). Sodium bicarbonate, ii, 204. Diarrhoea, acute. Bismuth, i, 180. Diet, i, 336. Diarrlioea, atonic. Laurel, i, 571. Rubus, ii, 136. Diarrhoea, clioleraic. Charcoal, i, 233. Salacetol, ii, 139. Diarrhoea, chronic. Baths, cold, i, 169. Bismuth, i, 180. Camphor salicylate, ii, 455. Cerium oxalate, i, 229. Diet, i. 336. Galls, i, 433. Grape cure, i, 455. Iodine, enema of, i, 536. Iron nitrate, i, 551. Picric acid, ii, 433. Tannigene, ii, 260. Tannin, ii, 257. Tolu balsam, ii, 309. Waters, mineral, ii, 374, 379. Diarrhoea, colicliy. Viburnum prunifolium, ii, 357. Diarrhoea, colliquative. Barium sulphocarbolate, i, 163. Nitric acid, ii, 8. Diarrlioea from undigested food. Castor oil, i, 324. Diarrhoea, infantile. Baked flour (as a food), i, 423. Calomel, i, 634. Creolin, i, 313. Irrigation of the rectum and colon, i, 554. Toast water, i, 351. Diarrhoea, infectious. Betol, i. 179. Diarrhoea, lienteric. Creosote, i, 314. Pepsin, ii, 69. Diarrhoea of phthisis. Sesame oil, ii, 190. Diarrhoea of typhoid ferer. Alum whey, i, 50. Ilydroohloric acid, i, 493. Opium, ii, 36. Diarrhoea, putrid, Picric acid, ii, 453. Diari'hoea, subacute. Rhubarb, ii, 130. Tannigene, ii, 257. Diarrhoea, summer. Benzonaphthol and bismuth salicylate, ii, 3. Bismuth, i, 180. Irrigation of the stomach, i, 491. Nitric acid, ii, 8. Salol, ii, 150. Serum, cow's, intravenous injections, ii, 163. Tannigene, ii, 260. Diarrhoea, summer. Xeroform (internally), ii, 397. Zinc oxide, ii. 406. Diarrhoea with intestinal catarrh. Calcium salts, ii, 372. Dilatation of the stomach. Electricity, i, 368. Lavage, i, 491, 573. Massage, abdominal, i, 608. Naphthol, ii, 2. Papain, ii, 60. Dilatation of the heart. See under Heart. Diphtlieria. Alum (by insufflation), i, 50. Antidiphtherine, i, 107. Benzene, i, 176. Benzoic acid, i, 178. Bromal, i, 197. Calomel powder (by insufflation), i, 635. " fumigation, i, 530. Capsicum and hot water (as a gargle), i, 309. Chlorine water, 1, 240. Cold baths, i, 488. Copper-arsenite inhalation (or in form of a spray), i, 804. Creosote, i, 314. Cubeb, i, 319. Eucalyptol inhalation, i, 539. Gavage, i, 436. Hydrogen dioxide, i, 503. Iron chloride (tincture), i, 548. Jaborandi, i, 559. Lactic acid, i, 567. Lime, inhalation of the vapour of, i, 583. Menthol inhalations, i, 529. Mercuric cyanide, i, 333. Mercury bichloride (in spray), i, 636 ; ii, 321. Myrrh, tincture of, i, 653. Nosophene, ii, 19. Nucleins, ii, 33, 35. Oxygen, ii, 53. Ozone, i, 445. " inhalation, ii, 58. Papain, ii, 60. Pepsin in solution (by spray), ii, 69. Peroxide of hydrogen, ii, 331. Pilocarpine, ii, 85. Potassium chlorate, ii. 96. " permanganate, i, 596 ; ii, 70. " " (as a gargle), i, 597. Pyootanine, ii, 108. Quinine, ii, 119. Resorcin (topically), ii, 136. Salicin, ii, 140. Serum treatment, i, 83 ; ii, 170, 171. Steam, i, 330. 538. Steresol, ii, 233. Storax, ii, 228. Sulphur powder (by insufflation), ii, 341. Trypsin (as a solvent for diphtheritic mem- brane), ii, 334. Zinc chloride applications, ii, 405. Diphtheria, laryngeal. Calomel fumigation, i, 530. Mercurial fumigation, i, 430, 530. Steam spray, ii, 330, Diphtheria, nasal. Myrrh, i, 683. Nosophene, ii, 19. INDEX OP DISEASES AND REMEDIES. 565 Dipsomania. See Alcohol habit. Bistichiasis. Collodion, i, 294. Dizziness. See Vertigo. Dropsy. Alkaline carbonates, i, 45. Aspiration, i, 153. Baths, hot, i, 489. Caffeine, i, 201. Cahinca, i, 301. Chimaphila, i, 234. Convallaria, i, 300. Croton oil, i, 318. Digitalis, i, 342. . Dulcamara, i, 353. Elaterin, i, 357. Gold, i, 451, 453. Horseradish, i, 473. Hunyadi Janos, i, 474. Iodine injections, i, 536. Jaborandi, i, 559. Jalap, i, 560. Juniper, i, 563. Kava, i, 564. Ligusticum, i, 581. Nitrohydrochloric acid, ii, 16. Potassium salts, i, 345. tartrates, ii, 100. Salines, ii, 147. Scamraony, ii, 157. Scarification, ii, 158. Soillain (subcutaneously), ii, 158. Squill, ii, 321. Sodio-theobromine salicylate, ii, 203. Strophanthus, ii, 331. Theobromine, ii, 377. Ulexine, ii, 337. Dropsy, cardiac. Squill, ii, 321. Strophanthus, ii, 231. Theobromine, ii, 377. Ulexine, ii, 337. Dropsy, due to acute nephritis. Potassium tartrates, ii, 100. Dropsy, hepatic. Alkaline carbonates, i, 45. Nitrohydrochloric acid, ii, 16. Dropsy of the joints. Iodine injection, i, 536. Dropsy, renal. Digitalis, i, 342. Potassium salts, i, 345. Dropsy, splenic. Alkaline carbonates, i, 45. Dropsy, subcutaneous. Scarification, ii, 158. Drowning. Heat, i, 469. Stimulants, heart, ii, 226. Tongue traction, i, 64. Drunkenness. Treatment of, i, 34. Dysentery. Alum (in pills), i, 50. Arsenic, i. 146. Baths, hot, i, 166. Benzoiiaphthol, ii, 426. (with tenesmus), Bismuth injections, i, 181. Dysentery. Calomel, i, 624. Calotropis, i, 308, Camphor salicylate, ii, 455. Carbonic-acid gas, i, 314. Castor oil, i, 221, Charcoal, i, 333. Chirata, i, 234. Cinnamon, i, 259, Copper arsenite, i, 305. " " (niinute doses), i, 303. Creosote, i, 314. Cupric sulphate (by the mouth or by ene- mata), i, 306. Cvdonium, i, 323, Ergot, i, 388. Erigeron, oil of, i, 390. Flour gruel, i, 423. Geranium, i, 438. Glycerin enema, i, 451. Gnaphalium, i, 451, Iodine, enema of, i, 536. Iodoform, i, 537. Ipecac, i, 543. Irrigation of the rectum and colon, i, 491. Krameria, i, 566. Lead, compound suppositories, i, 577. Linseed, infusion of, i, 584 ; ii, 369. Lysol injections, i, 690. (early stages). Magnesium sulphate, i, 593. Matico, i, 611. Morphine, ii, 38. Moss, Irish, i, 247, Naphthalene, ii, 1. Naphthol, ii, 2. Nitrohydrochloric acid, ii, 16. Papain, ii, 60. Physostigmine salicylate, ii, 146. Quinine, i, 355. Salioylic-aoid enema, ii, 148. Saligenin, ii, 147. Silver nitrate, ii, 194. Sodium nitrate, ii, 307. Strychnine, ii, 28. Sumbul, ii, 243, Tannigene, ii, 360. Tannoform. ii, 260. Trichlorphenol, ii, 330. Tylophora, ii. 337. Ulmus, ii, 337. Viburnum prunifolium, ii, 357. Water (rectal applications), i, 479. Zinc sulphate, ii, 407. Dysentery, acute. Cinnamon, i, 259. Glycerin enema, i, 451. Ipecac, i, 543. Irrigation of the rectum and colon, i, 491. Silver nitrate, ii, 194. Water (rectal applications), i, 479. Dysentery, amoebic. Methylene blue, i, 630. Quinine injections, rectal, ii, 120. " rectal irrigation with, i, 254. Dysentery, chronic. Baths, cold, i, 169. Camphor salicylate, ii, 455. Carbonic-acid gas, i, 214. Iodoform, i, 537. Ipecac, i, 542. 566 INDEX OP DISEASES AND REMEDIES. Dysentery, chronic. Water (rectal applications), i, 479. Dysentery, epidemic. Charcoal, i, 232. Dysidrosis. Salicylic acid, ii, 144. Dysmenorrhcea. Aconite, i, 9. Amyl valerianate, i, 62. Anemonin, i, 70. Antipyrine, i, 124. Apiol, i, 137. Arnica, fluid extract of (small doses), i, 141. Baths, cold, i, 169. " hot, i, 166. " hot hip, i, 375. Belladonna and morphine, i, 67. Butyl chloral hydrate, i, 197. Cajeput, i, 201. Camphor, i, 205. Canella, i, 206. Cannabis indica, i, 207. Cimioifuga, i, 250. Croton oil (applications to the abdomen), i, 318. Clipping (applied to the thighs), i, 375. Douches, hot vaginal, i, 375. Gelseminm, i, 437. Gin, i, 449. Glycerin suppositories, i, 450. Oxalic acid, ii, 49. Peppermint, infusion of, i, 613. Pisoidia, ii, 91. Pulsatilla, ii, 107. Salix, ii, 149. Senecin, ii, 161. Senecio, ii, 162, 456. Silver Iodide, ii, 197. " oxide, ii, 197. Sodium salicylate, ii, 146. Splenic extract, ii, 218. Stvpticin, ii, 233. Trional, ii, 383. Viburnum prunifolium, ii, 356, 357. Waters, Buffalo lithia, ii, 372. " mineral, ii, 383. Zinc cyanide, ii, 408. Dysnienorrhoea, congestiye. Aconite, i, 9. Arnica, fluid extract of (in small doses), i, 141. Canella, i, 206. Dysmenorrhoia, nervous. Antipyrine, i, 124. Dysmenorrlioea, spasmodic. Amyl valerianate, i, 62. Belladonna and moi'phine, i, 67. Pisoidia, ii, 91. Dysmenorrlioea, virginal. Viburnum prunifolium, ii, 357. (with menorrhagia). Viburnum prunifolium, ii, 356. Dyspepsia. Acids, mineral, i, 6. Alcohol, i, 33. Alkalies, i, 44. Alkaline waters, i, 45. Ammonium carbonate, i, 55. Antizymotics, 1, 135. Apone, 1, 139. Dyspepsia. Asalcetida, i, 147. Bitters, i, 188. Charcoal, i. 232. Chirata, i, 234. Cinnamon, i, 259. Cubeb, i, 319. Prigotherapy, i, 429. Glycerin (internally), i, 451. Horseradish, i, 473. Humulus, i, 473. Hunyadi Janos water, i, 474. Hydrochloric acid, i, 492. Lactic acid, i, 567. Leptandra (as a tonic), i, 580. LycopodiuiQ, i, 590. Lysol, i, 590. (with constipation). Mustard and molasses, i, 646. Pepsin, ii, 69. Ptvalin. ii, 106. Pulsatilla, ii. 107. Quinine, i, 254. Rhubarb, ii, 130. Saccharin, ii, 138. Salvia, ii, 152. Sarracenia purpurea, ii, 156. Spermine, ii, 217. Strontium lactate, ii, 230. (with hyperacidity). Waters, alkaline, ii, 866. Waters, alkaline carbonated, ii, 375. Buffalo lithia, ii, 372. mineral, ii, 376, 379, 384. Yolk of egg and tincture of ginger, i, 355. Zinc sulphate, ii, 407. " tannate, ii, 412. Dyspepsia, acid. Chirata, i, 234. Hydrochloric acid, i, 498. Limewater, i, 582. Potash, ii, 94. Dyspepsia, acute. Lavage, i, 572. Tartar emetic, i, 114. Dyspepsia, amylaceous. Taka-diastase, ii, 254. Dyspepsia, atonic. Alcohol, i, 33. Alkalies (before eating), i, 44. Alkaline mineral waters, i, 45. Ammonium carbonate, i, 55. Bitters, i, 183. Calamus, i, 201.' Capsicum, i, 209. Cubeb, i, 319. Horseradish, i, 478. Lactic acid, i, 567. Lumbar douches, i, 349. I'epsin, ii, 69. Quinine, i, 254. Rhubarb, ii, 130. Salvia, ii, 152. Sarracenia purpurea, ii, 156. Tannin, ii, 257. Taraxacum, ii, 265. Dyspepsia, biliary. Wmes, white, ii. 394. Dyspepsia, chronic. Solanum panioulatum, ii, 210. INDEX OF DISEASES AND HEMEDIES. 567 Dyspepsia, fermentative. Asaprol, i, 148. Dermatol, i, 329. Sulphurous acid, ii, 243. Dyspepsia, Hatulent. Canella, i, 206. Carbolic acid, 1, 313. Nux vomica, ii, 28. Strontium salicylate, ii, 147, 230. Dyspepsia, functional. Diet, i, 335. Massage, general, i, 608. Dyspepsia, gastric. Waters, alkaline sulphuretted, ii, 368. " mineral, ii, 374. Dyspepsia, hepatic. Waters, mineral, ii, 375. Dyspepsia, intestinal. Aloes, i, 48. Arsenic, i, 146. Creosote, i, 814. Flour, boiled, i, 423. Gamboge, i, 438. Mercury, i, 619. Ox-bile, ii. 49. Sodium phosphate, ii, 79. Dyspepsia, irritable. Silver oxide, ii, 197. Dyspepsia, nervous. Damiana, i, 324. Faradaism, i, 366. Gold chloride, i, 454. Menthol, i, 614. Oxygen, ii, 53. Dyspepsia of hard drinkers. Capsicum, i, 208. Dyspepsia, with acid ernctations. Charcoal and bismuth, i, 232. Dyspepsia with phosphatie urine. Nitric acid, ii, 8. Dyspnoea. Air, condensed, inspiration into, i, 38. . Amyl-nitrite inhalation, i, 61. Arsenic, i, 146. Cajuput, ii, 426. Cupping, dry, i, 330. Digitalis, i, 842. Ethyl-iodide inhalation, i, 538. Grindelia, i, 456. Morphine, ii, 37. Nitroglycerin, ii, 10. Oxygen inhalation, ii, 226. Potassium cobaltonitrite, i, 373. Quebracho, ii, 112. Strophanthus, ii, 331. Strychnine, ii, 38. Thymus extract, ii, 385. Tribulus lannginosus, ii, 330. Dyspnoea, cardiac. Amyl-nitrite inhalation, i, 61. Dry cupping, i, 330. Nitroglycerin, ii, 15. Oxygen inhalation, ii, 326. Strophanthus, ii, 281. Dyspnoea of asthma. Amyl nitrite, i, 61. Dyspnoea of phthisis. Menthol solution (by injections), i, 615. Dyspnoea, pulmonary. Oxygen inhalation, ii, 226. Dyspnoea, pulmonary. Strychnine, ii, 38. Dyspnoea, spasmodic. Ethyl iodide inhalation, i, 538. Dyspnoea, ursemic. Amyl nitrite, i, 61. Morphine, ii, 87. Dystocia. Quinine, ii, 55, 116. Thyreoid treatment, to check the growth of the foetus, ii, 399. Dystrophies, muscular. Muscle extract, i, 81, Dysuria. Ammonium hydrosulphide,' i, 57. Cantharides, i, 308. Conium, i, 398. Earache. Chamomile fomentations, i, 331. Chloroform vapour, i, 533. Cloves, oil of, i, 273. Delphinine, ii, 321. Ether, as a spray, i, 897. Hop poultice, i, 474. Leeching, i, 578. Pulsatilla, ii, 107. Echinococcus, hepatic. Aspiration, i, 151. Eclampsia, puerperal. See Convulsions, Puekperal. Ecthyma. Cod-liver oil and iron, i, 388. Cupric-sulphate solution, i, 306. Ectropion. Thiosinamine, ii, 281. Eczema. Alumnol applications,.!, 51. Arsenic, i, 144. Barium chloride, i, 163. Benzene, i, 176. Benzoin (compound tincture), i, 179. Bran, i, 191. Calomel ointment, i, 635. Camphor powder (with starch), or ointment, i, 204. Can-on oil, i, 583. Cashew nut (topically), i, 219. Chalk powder, i, 230. Chrysarobin, i, 116. Cod-liver oil, i, 388. Creosote, i, 314. Dermatol, i, 839. Gallanilide, i, 433. Gelanthum, ii, 349. Gelsemiura, i, 437. Ichthyol, i, 522. Iron, i, 547. Lead-oxide ointment, i, 578. Limewater as a lotion, i, 583. Losophan, i, 589. Lysol, i, 590. Mercury nitrate (ointment), i, 628, 628. Nosophene, ii, 19. Nuoleins, ii, 24. Phosphorus, ii, 77. Phytolacca, ii, 81. Picric acid, ii, 83. Potassium permanganate, i, 596. Pulsatilla, ii, 107. 568 IKDBX OF DISEASES AND REMEDIES. Eczema. Pyrogallic acid, ii, 111. Eesoroin, ii, 126. Salicylic-acid ointment, ii, 143, 144. Silver nitrate, ii, 196. Soap, green, ii, 300. Steam, ii, 322. Sulphur fumes, i, 4.30 ; ii, 341. Talc powder, ii, 354. Tannin, ii, 356. Tar, ii, 93, 363. Tartarlithine, ii, 265. Thiol ointment, ii, 278. Thymol, ii, 384. Thyreoid treatment, ii, 393. Traumatol, ii, 335. (itching of), Tumenol tincture, ii, 334. Tumenol siilphonic acid, ii, 334. Turpentine liniment, ii, 335. Viola tricolor, ii, 360. Waters, Buffalo lithia, ii, 373. Xeroform, ii, 396. Zinc oxide, ii, 406. " sulphate, ii, 408. " sulphichthyolate (as a liniment), ii, 413. Eczema, acute. Gallobvomol (by a compress), i, 433. Laurel, i, 571. Picric acid, ii, 452. Eczema, acute dry. Rye flour, ii, 137. Eczema, chronic. Calomel ointment, i, 625. Cod-liver oil, i, 288. Creosote, i, 314. Gallanilide, i, 433. Iron, reduced, i, 547. Naphthalan, ii, 448. Nucleins, ii, 34. Phosphorus, ii, 77. Phytolacca, ii, 81. Steam, ii, 322. Thyreoid feeding, i, 79. Zinc sulphydrate, ii, 413. Eczema, dry. Barium chloride, i, 163. Gelanthum (Unna's treatment), ii, 349. Eczema, erythematous. Salicylic-acid ointment, ii, 144. Eczema impetiginodes. Xeroform, ii, 397. Eczema madidans. Xeroform, ii, 397. Eczema marginatum. Ichthyol, i, 532. Pyrogallic acid, ii, 111. Eczema, nervous. Ichthyol, i, 533. Eczema of the anus and genitals. Lead liniment, i, 577. Eczema of the external auditory canal. Silver nitrate, ii, 195. Zinc sulphocarbolate, ii, 413. Eczema of the eyelids. Silver nitrate, ii, 195. Eczema of the hand (in very dry skin). Gelanthum (Unna's treatment), ii, 349. Eczema of the hands, knees, and face. Tumenol-sulphonic acid, ii, 334. Eczema of the lids. Mercury oxide (ointment), i, 623. Eczema of the nostrils. Myrrh, i, 653. Eczema, old. Ichthyol, i, 533. Eczema, papular. Salicylic acid, ii, 144. Eczema, parasitic. Ichthyol, i, 532. Eczema, pustular. Salicylic-acid ointment, ii, 144. Eczema rubrum. Salicylic-acid ointment, ii, 144. Eczema rubrum of the leg. Soap, green, ii, 200. Eczema seborrhoicum. Chrysarobin, i, 116. Ichthyol, i, 116. Mercury bichloride, i, 116. Resorcin, i, 116. Sulphur, i, 116. Eczema, squamous. Salicylic acid, ii, 144. Eczema, traumatic weeping. Nosophene, ii, 19. Eczema, vesicular. Salicylic-acid ointment, ii, 144. Effusion, serous. Sodio-theobromine salicylate, ii, 303. Elephantiasis. Ichthyol, i, 533. Elytritis. Bismuth, i, 181. Boric acid, i, 180. Grindelia, i, 456. Ichthyol, i, 523. Kava, i, 564. Tannin and alum douche, ii, 356. " injections, ii, 356. Vaginal douches, i, 349. Elytritis, acute. Ichthyol, i, 533. Elytritis, gonorrhoeal. Tannin and alum douche, ii, 356. " injections, ii, 356. Emissions (involuntary), seminal. See Spermatobehcea. Emphysema. Apomorphine, i, 139. Arsenic, i, 146. Baths, condensed-air, i, 37. Convallaria, i, 300. Expiration into rarefied air, i, 28. Ipecac, i, 543. Iron chloride, i, 548. Ozone inhalation, ii, 58. Quebracho, ii, 112. Quillaia, ii, 118. Terebene, ii, 371. Emphysema, pulmonary. Apomorphine, i, 139. Arsenic, i, 146. Baths, condensed-air, i, 37. Quillaia, ii, 113. Emphysema with anaemia. Iron chloride (tincture), i, 548. Empyema. Aspiration (Dieulafoy's method), i, 151. Gavage, i, 436. INDEX OF DISEASES AND REMEDIES. 569 Empyema. Quinine injections, ii, 120. Encephalitis. Blisters to the back of the neck, i, 313. Cupping, i, 320. Ice iipplications, i, 520. Endarteritis, cerebral. Phosphorus, ii, 76. Endocarditis after rhenmatism. Baths, Nauheim, ii, 438. Schott treatment, ii, 433. Serum, anti^treptococous, ii, 178. Endocarditis, ulceratiye. Serum, antistreptococcus, ii, 178. Endometritis. Camphor, i, 204. Chromic acid, i, 348. Euphorim, i, 403. Glycerin suppositories, i, 450. Iclithyol, i, 533. Nitric acid, ii, 7. Picric acid, ii, 83. Pyoctanine (internally), ii, 109. Salol and antipyrine, ii, 150. Silver nitrate, ii, 196. Steam, ii, 333. Stypticin, ii, 333. Traumatol, ii, 329. Zinc oxyohloride, ii, 410. Endometritis, cervical. Camphor, i, 304. Euphorin, i, 403. Glycerin suppositories, 1, 450. ' Ichthyol, i, 523. Silver nitrai e, ii, 196. Steam, ii, 223. Endometritis, chronic. Chromic-acid applications, i, 348. Endometritis, chronic ceryical. Nitric acid, ii, 7. Endometritis, fnngrons. Picric acid, ii, 83. Salol and antipyrine, ii, 150. Stypticin, ii, 333. Endometritis, haemorrhagic. Zinc oxychloride, ii, 410. Endometritis, hyperplastic. Steam, ii, 333. Endometritis, septic puerperal. Steam, ii, 233. Endotrachelitis. See Endometritis, Cervical. Engorgement, hepatic. Baths, cold sltz, i, 169. Waters, Buffalo lithia, ii, 373. " chlorinated alkaline (externally and internally), ii, 371, 381. "Waters, sodium-sulphate, ii, 368. Engorgement of the pelvic viscera (in women). Waters, sulphuretted, ii, 371. Engorgement of the portal circnlation. Gamboge, i, 433. Grape cure, i, 455. Engorgement, uterine. Waters, mineral, ii, 383. Engorgement, venous. Bloodletting, i, 187. Digitalis, i, 345. Seoparius, 1, 345. Engorgement, venous. Squill, i, 345. Enlargements, chronic, and stiffness of the joints. Veratrine, ii, 350. Enlargements, chronic, of the lymphatic glands, ii, 99. Enlargements, fluctuating, of joints. Aspiration, i, 153. Enlargements, glandular. Cod-liver oil, i, 288. Iodine {internally), ii, 214. Enlargements, glandular, of children. Calcium sulphide, i, 303. Thiosinamine, ii, 380. Enteritis. Baths, narcotic, i, 173. Copper arsenite, i, 804, 805. Cubeb, i, 319. Eucalyptol, i, 400. Hydrastis, i, 475. Limewater, i, 583. Nutmeg, ii, 35. Somatose, ii, 312. Tannigene, ii. 360. Thioform, ii, 378. Vichy water, ii, 358. Enteritis, acute. Tannigene, ii, 360. Thioform, ii, 278. Enteritis, chronic. Hydrastis, i, 475. Enteritis, gastro-. Somatose, ii, 213. Enteritis, membranous. Copper-arsenite enema, i, 304. Enteritis, mucous. Limewater, i, 582. Enteritis, pseudo-membranous. Cubeb, i, 319. Enteritis, ulcerative. Tannalbin, ii, 354. Enterocolitis. Copper arsenite, i, 303. Hydroeotyle asiatica, i, 493. Enteroptosis. Yeast, ii, 401. Entropion. Collodion, i, 294. Enuresis. Belladonna, i, 175. Ergot, i, 388. Enuresis, nocturnal. Belladonna, i, 175. Faradization, vesical, i, 866. Hypnotism, i, 515. Iron iodide, i, 551. Stimulants, spinal, ii, 226. Sulphonal, ii, 239. Epididymitis. Ethyl chloride, ii, 434. Ice applications, i, 530. Mercury iodide, i, 633. Pulsatilla, ii, 107. Epilepsy. Acetanilide, i, 4. Ammonium carbonate, i, 56. Amyl nitrite, i, 61. Baths, cold, i, 488. Blisters (to abort an attack), 1, 185. 670 INDEX OF DISEASES AND REMEDIES. Epilepsy. Borax, i, 189. Brain and spinal cord substance (hypoder- mically), i, 80. Bromalin, i, 191. Bromated hseinol, ii, 426. BromhfEmol, ii, 426. Calcium bromide, i, 202. Calotropis, i, 203. Cannabis indica, i, 207. Cerium oxalate, i, 229. Cfiloralamide, i, 238. Cod-liver oil, i, 288. Conium, i, 298. Cupric sulphate, i, 306, Curare, i, 321. Ergot (to increase the action of bromides), i, 388. Ethylene bromide, i, 399. Gallobromol (internally), i, 433. Gold bromide, i, 454. Hydrobromic acid and tlie bromides, i, 493. Lobelia, i, 587. Nerium, ii, 5. Picrotoxin, ii, 84. Rest-cure, ii, 127. Rubidium and ammonium, ii, 136. Rue, ii, 137. Sclerotic acid, ii, 158. Senecio, ii, 162. Silver iodide, ii, 197. " nitrate, ii, 194. Simulo, ii, 198. Solanum carolinense, ii, 209. Strontium bromide, ii, 229. Strychnine, ii, 28. Sulphonal, ii, 239. Thyreoid treatment, ii, 293. Zinc salts, ii, 401. Epiphora. Alumnol (in solution), i, 51. Episcleritis (clironic form). Eserine, i, 392. Epistaxis. Aconite, i, 9. Agaric (for plugging the nose), i, 17. Ambrosia, i, 52. Baths, cold hand, i, 170. Digitalis, i, 342. Ergot, i, 388. Erigeron, oil of, 1, 390. Europhene, i, 402. Hamamelis, i, 467. Ipecac, i, 543. Iron chloride (tincture), i, 548. Kino, i, 505. Matico, i, 611. Silver nitrate, ii, 195. Sodium chloride, ii, 206. Tannin, ii, 256. Zinc sulphate, ii, 407. Epittielioma. Arsenic, i, 144. Bismuth salicylate, i, 183. Collodion, salicylic- and lactic-acid, i, 398. Lactic acid, i, 568. Pyrogallio acid, ii, 111. Salicylic-acid and zinc-chloride collodion, i, 293. Salicylic-acid ointment, ii, 145. Epithelioma of the serous membranes. Silver-nitrate applications, ii, 457. Erethism, nervous and circulatory, of the pelvic organs. Baths, hot sitz, i, 169. Erethism, sexual. Humulus, i, 474. Erosions of the os uteri. Silver nitrate, ii, 196. Thymol, ii, 284. Zinc oleate and iodoform, ii, 405. Eructations, acid. Chalk, i, 230. Erysipelas. Aconite, i, 8. Atropine, i, 156. Bath, hot, i, 166. Benzoic acid, i, 178. Bromine, i, 195, 445. Camphor, i, 204. Carbolic acid (parenchymatous injections), 1, ^lo. Chalk and lard ointment, i, 230. Cold baths, i, 488. Collodion, ferruginous, i, 293. flexible, i, 294. Creosote, i, 314. Brgotole (local applications), i, 389. Guaiacol (external application), i, 460. Ichthvol. i, 533. Iodine, i, 536. Iron, i, 546. " chloride (tincture), i, 548. Jaborandi, i, 560. Lead-and-opium wash, i, 577. Mentho-phenol, i, 616. Picric acid, ii, 83 ; ii, 453. Quinine, 1, 355 ; ii, 119. Resorcin, ii, 136. Rye flour, ii, 137. Serum, antistreptococcus, ii, 175. Silver lactate, ii, 197. " nitrate, ii, 196. Sulphur ointment, ii, 341. Thiol ointment, ii, 378. Toxines, ii, 313. Trichlorphenol applications, ii, 830. Turpentine liniment, ii, 335. (of traumatic origin). Turpentine oil, ii, 336. Vaseline, ii, 349. Zinc sulphichthyolate (as a liniment), ii. Erythema. Bismuth subnitrate (as a dusting powder), i, Laurel, i, 571. Salicylic acid, ii, 144. Silver nitrate, ii. 196. Thiol ointment, ii, 278. Zinc-acetate ointment, ii, 403, Zinc sulphate, ii, 408. Erythema, clironic. Collodion, i, 2&4. Erythrasma. Anthrarobin, i, 103. Exanthemata. Ammonium acetate, i, 54. Saffron tea (as a diaphoretic), ii, 369. Exanthemata, acute. Asclepias tuberosa, i, 148. INDEX OF DISEASES AND REMEDIES. 571 Exanthemata, chronic. Waters, alkaline (externally), ii, 372. Excitement, circulatory. Bloodletting, i, 188. Excitement, maniacal. Bath, hot, i, 166. Excitement, mental. Sulphonal, ii, 239. Excitement, nervous. Valerian, ii, 345. Excitement of insanity. Chloral hydrate, i, 237. Excitement, sexual. Camphor, i, 205. Humulus, i, 474. Excoriations. Dernaatol, i, 329. Lycopodium powder, i, 590. Tannio-aeid ointment, ii, 257. Waters, mineral, ii, 375. Excoriations of the anus. Tannin (solution), ii, 256. Excoriations of the scrotum. Tannin (solution), ii, 256. Exhaustion. Chirata, i, 234. Stimulants, cardiac, ii, 226. Exliaustion, cerebral. Damiana, i, 324. Exhaustion from nervous disease. Rest-cure, ii, 127. Exhaustion from over-excitement. Zinc phosphate, ii, 410. Exhaustion from overwork. Phenacetine, ii, 71. Exhaustion, mental or nervous. Rest-cure, ii, 127. Exhaustion, nervous. Castor, i, 219. Damiana, i, 324. Glycerophosphates, ii, 439. Lavandula, i, 572. Nitrous-oxide inhalation, ii, 18. Sumbul, ii, 7. Exhaustion, senile. Ergot and sodium phosphate, i, 889. Exhaustion, sexual. Cereus grandiflorus, i, 229. Exudates, inflammatory. Potassium iodide, ii, 98. Exudations, serous. Thiosinamine, ii, 280. Fainting. See Syncope. Fatigue, muscular. Baths, hot, i, 166. Fatty liver. See LivEK, Fatty. Favus. Alumnol applications, i, 51. Carbolic-acid ointment, i, 212. Cod-liver oil, i, 288. Felons. Alkalies (poultice of hard-wood ashes), i, 45. Fermentation, gastric. Ammonia water, i, 53. Creosote, i, 314. Diaphthol, i, 333. Hyposulphites, i, 519. 80 Fermentation, gastric. Naphthol, ii, 2. Fermentative changes in the intestines. Strontium salicylate, ii, 147. Fever, acute. Kumyss, i, 567. Fever, adynamic. Camphor, i, 204. Fever, algidity of. Ergot and sodium phosphate, i, 389. Fever, catarrhal. Aconite, i, 8. Fever, eruptive. Mustard bath, hot, i, 647. Fever, hay. See Hay fevee. Fever, hectic. Calotropis, i, 203. Fever, hectic, of phthisis. Quinine, ii, 49. Fever, intermittent. See Intermitiebt fever. Fever, low. Camphor, ii, 6. Opium (as a stimulant), Ii, 225. Opium (as a supporting and stimulating agent), ii, 225. Strophanthus, ii, 231. Turpentine oil (internally), ii, 335. Fever, malarial. Calomel, i, 624. Chirata, i, 234. Cinchona, i, 254. Cornus, i, 307. Curcuma, i, 322. Pyoctanine (internally), ii, 109. Quinine, i, 254 ; ii, 174. Sabbatia, ii, 137. Saligenin, ii, 147. Serum, antidiphtheritic, and quinine, ii, 174. Thuja, ii, 282. Vieiric acid, ii, 358. Fever of children. Aconite, i, 8. Fats by inunction, i, 420. Magnesium citrate, i, 591. Potassium tartrates, ii, 100. Fever of influenza. PhenocoU, ii, 72. Fever of phthisis. Opium, ii, 36. PhenocoU, ii, 72. Fever of tuberculosis. Aconite, i, 9. Fever, paludal. See Fever, Malarial. Fever, puerperal. Copper-arsenite solution, i, 304. Quinine, ii, 119. Salufer, ii, 456. Serum, antistreptococcus, ii, 175. Tartar emetic, i. 114. Turpentine oil (internally and locally), ii, 336. Fever, relapsing. Salicylic acid, ii, 143. Fever, remittent. See Remittent fever. Fever, rheumatic. Euphorin, i, 402. Malakin, i, 592. 572 INDEX OF DISEASES AND REMEDIES. Fever, scarlet. See SOAELET FEVER. Fever, septic. Sesame oil, ii, 190. Fever, surgical. Euphorin, i, 402. Quinine, i, 256. Fever, typhoid. See Typhoid fever. Fever, typhus. See Typhus fevee. Fever, urethral. Aconite, i, 9. Quinine, i, 256 ; ii, 120. Fever, yellow. See Yellow fever. Fevers. Acetanilide, i, 2. Acetylamido phenol, i, 5. Aconite, i, 8. Alcohol (sponging with), i, 421. Antipyrine, i, 123. Arnica, fluid extract of (internally), i, 141. Bath, sheet, i, 169. Baths, cold, i, 486. Calomel, i, 624. Camphor, ii, 6. Chamomile, i, 231. Cimicifuga, i, 250. Cinchona, i, 255. Cold affusions (Currie's method), i, 16. " water (internally), i, 479. Copper-arsenite solution, i, 304. Cornus, i, 307. Curcuma, i, 322. Ergot and sodium phosphate, i, 389. Euphorin, i, 402. Gelsemium, i, 436. Guaiacol, i, 457. Hydrocotyle asiatica, i, 493. Injections of iced water, i, 480. Kairine, i, 563. Kumyss, i, 567. Lithium salicylate, ii, 145. Magnesia citrate, i, 591. Malakin, i, 592. Nitre, i, 421. Phosphergot, i, 389. Pyoctanine, ii, 109. Quinine, i, 255; ii, 174. Resorcin, ii, 126. Salicylic acid, ii, 142. Sabbatia, ii, 137. Scammony, ii, 157. Serum antistreptococcus, ii, 175. Sesame oil, ii, 190. Sodium tartrate, ii, 209. Sponge bath, i, 491. Tartar emetic, i, 114. Thalline, ii, 276. Turpentine oil, ii, 336. Vinegar solution, sponging with, ii, 359. Water, rectal enema of, i, 479. Wine, sherry, ii, 393. Fibroids, uterine. Cimicifuga, i, 250. Ergot, i, 38,8. Galvanism, i, 368. Nitric acid, ii, 7. Fissures. Gelanthum (Unna's treatment), ii, 349. Iodoform, i, 538. Zinc oxide, ii, 400. Fissures, anal. Benzoin, i, 178. Glycerin injections, i, 450. Tannin, ii, 257. Fissures, eczematous. Cantharides, tincture of (topically), i, 208. Fissures of the lips and tongue. Silver nitrate, ii, 195. Fissures of the nipples. Alcohol applications, i, 31. Borax, i, 189. Collodion, i, 294. Ichthyol, i, 523. Lead nitrate, i, 578. Limewater as a lotion, i, 582. Picric acid, ii, 83. Fissures of the rectum. Bismuth injections, i, 181. Iodoform, i, 538. Fissures of the tongue. Papain, ii, 60. Fistula. Collodion, i, 293. Creosote, i, 314. Silver nitrate, ii, 195. Flat foot. Exercise, i, 416. Flatulence. Ammonia water, i, 54. Ammonium carbonate, i, 55. Asafoetida, i, 147. Boric acid, i, 190. Calamus, i, 201. Chirata, i, 234. Chloroform, i, 241. Cinnamon, i, 259. Gamboge, i, 433. Glycerin, i, 451. Horseradish, i, 473. Lavandula, i, 572. Nux vomica, ii, 28. Peppermint infusion, i. 613. (eructations). Pepsin, ii, 69. Permanganates, ii, 70. Pimenta, ii, 87. Salicylic acid, ii, 143. Terebene, ii, 271. Terpin hydrate, ii, 272. Flatulence of children. Asafcetida, i, 147. Flatulence of infants. Valerian, ii, 345. Flooding. See HAEMORRHAGE. Flushing of the face. Cimicifuga, i, 250. Flnshiugs, painful. Bromides, i, 194. Foetor of the feet. Boric acid, i, 191. Feetor of the urine. Cinnamon, oil of, i, 259. Fractures. Massage, i, 609. Fractures of the jaw. Gutta percha, i, 462. INDEX OF DISEASES AND REMEDIES. 673 Freckles. See Lentigo. Freezing of the extremities. Transfusion, peripheral, ii, 323. Frostbite. Baths, cold foot, i, 170. Benzoin, compound tincture of, i, 179. Cold affusions, i, 17. Phulluah, ii, 79. Potassium permanganate, i, 596. Storax, liquid, ii, 3S9. Fungous growtlis. See Growths. Fungus hsematodes. Chromic acid, i, 248. Furuncles. See Boils. Galactorrhoea. Camphorated oil, i, 204. Ergot, i, 388. Gallstones. See Calculus, Biliary. (Janglion. Carbolic-acid injections, i, 213., Gangrene. Bromine, i, 195, 227, 44o. Camphor, i, 204. Carbolic-acid inhalation, i, 213. Charcoal poultice, i, 232. Chlorine, i, 445. Citric acid, i. 260. Creosote, i, 314. Guaiaool, i, 459 ; ii, 489. Lemon-juice, i, 260. . Nitric acid, ii, 7. Oxygen, ii, 51. Permanganates, ii, 70. Peat (as a dusting powder), ii, 65. Potassium permanganate, i, 597. Gangrene, hospital. Bromine, 1, 195, 227, 445. Nitric acid, ii, 7. Permanganates, ii, 70. Salicylic acid, ii, 143. Turpentine oil, ii, 386. Gangrene, idiopathic. Camphor, i, 204. Gangrene, local. Turpentine liniment, ii, 335. Gangrene of the lung. Carbolic-acid (solution) inhalation, i, 213. Creosote (by inhalation), i, 314. Guaiacol, i, 459 ; ii, 489. Salicylic-acid inhalation, ii, 143. Turpentine oil, vapour of, ii, 336. Gastralgia. Acetanilide, i, 3. Camphor, 1, 205. Cerium oxalate, i, 229. Gal vanization, anodal, i, 366. Ijavage, i, 572. Manganese oxide, i, 596. Myrrh, tincture of (internally), i, 651. Nitroglycerin, ii, 15. Nutmeg, ii, 35. Pepsin and codeine, ii, 69. Phenaeetine, ii, 71. Wines (by enema), ii, 394 Zinc cyanide, ii, 408. Gastric disease, chronic. Douche, cold, i, 491. Silver iodide, ii, 197. Gastric pain. Bismuth, i, 180. Gastritis. Copper arsenite, i, 305. Diet, careful, i, 335. Geosite, ii, 438. Hellebore, white, i, 470. Ipecac, i, 542. Lavage, i, 491, 573. Moss, Irish, i, 247. Myrrh, i, 651. Pepsin, ii, 69. Silver-nitrate irrigation, ii, 194. Silver oxide, ii, 197. Strontium bromide, ii, 239. Vichy water, ii, 358. Waters, chlorinated, ii, 365. Gastritis, acute. Copper arsenite, i, 305. Diet, careful, i, 335. Geosite, ii, 438. Hellebore, white, i, 470. Ipecac, i, 542. Strontium bromide, ii, 239. Gastritis, catarrhal. Myrrh, tincture of, i, 651. Gastritis, chronic. Copper arsenite, i, 305. Lavage, i, 491, 572. Silver nitrate (by irrigation of the stomach), ii, 194. Waters, chlorinated, ii, 365. Gastritis, mucous. Pepsin, ii, 69. Gastritis, subacute. Copper arsenite, i, 305. Diet, i, 335. Pulsatilla, ii, 107. Gastrodynia. Manganese oxide, i, 596. Gastro-enteritis. Infusion, ii, 324. Tannigene, ii, 360. Waters, mineral, ii, 376. Gastro-enteritis, chronic. Infusion, ii, 324. Gastro-enteritis, chronic catarrhal. Waters, mineral, ii, 376. Gastro-neuroses. Ammonia, foetid spirit of, i, 53. Genital neuroses and psychoses. Faradization, general, i, 366. Genito-urinary irritation. Baths, cold sitz, i, 488. Capsicum, i, 309. Conium, i, 298. Iodoform, i, 538. Larix, i, 570. Terebene, ii, 371. Gingivitis. Catechu, infusion or tincture, i, 221. Cuprlc oxide, i, 305. Glanders. Copper arsenite (locally and internally), i, 304. Glands, caseous. lodol, i, 540. 574 INDEX OF DISEASES AND REMEDIES. Glands, indurated. Gold, i, 453. lehthyol, i, 522. Iodine, i, 536. Iodoform, i, 535, 536. Glauconia. Eserine (in solution), i, 391. Quinine, ii, 120. Sodium salicylate, ii, 146. Suprarenal capsule, ii, 247. Glaucoma, acute. Quinine, ii, 130. Gleet. See GoNOERHCEA, Chronic. Glossitis. (/opper-arsenite solution, i, 304. Glossitis, syphilitic. Chromic acid (as a wash), i, 248. Goitre. Aconite, i, 9. Arsenic, i, 146. Chromic-aoid injections, i, 248. Digitalis, i, 342. Exercise, i, 415. Galvanization, i, 366. Gold bromide, i, 454. Iodine, i, 536. " (externally), i, 536. " (hypodermic injections), i, 536. " (internally), ii, 214. Iodoform (hypodermicaliy), i, 538. Rest-cure, ii, 137. Salicylic acid, ii, 146. Strophanthus, ii, 232. Thyreoid treatment, i, 178 ; ii, 297. Veratrum viride, ii, 353. Goitre, cystic. Arsenic, i, 146. Goitre, exoplithalmie. Aconite (tincture), i, 9. Digitalis, i, 343. Exercise, systemic passive respiratory, i, 415. Galvanization, stabile, i, 366. Gold bromide, i, 454. Rest-cure, ii, 137. Salicylic acid, ii, 146. Strophanthus, ii, 233. Thyreoid feeding, i, 78. Veratrum viride, ii, 353. Gonorrheea. Aconite (tincture), i, 9. Alkalies, i, 44. Aloes, i, 49. Aluminum tannate, ii, 259. Alumnol injections, i, 51. Argentamine, i, 140. Argonin, ii, 197. Baths, hot. i, 166. Benzoic acid, i, 177. Bismuth injections, i, 181. " tannate, ii, 259. Boric acid (2-per-cent. solution), i, 191. Buchu, i, 197. Cadmium-salicylate injections, i, 200. Camphor, i, 30.5. Catechu injections, i, 331. Chloral-hydrate injection, i, 237. Copaiba, i, 301. Copper-arsenite solution, i, 304. Corn silk, i, 306. Gonorrhoea. Creosote and boric acid by injection, i, 314. Cubeb, i, 319. Cupric acetate (topically), i, 303. sulphate solution (injections), i, 306. Ephedra antisyphilitica, i, 385. " trifurcata as a styptic, i, 385. Erigeron, oil of, i, 390. Perropyrine, i, 423. Formaldehyde, i, 438. Gallobromal (by injection), i, 433. Geranium (topically), i, 438. Gurjun balsam, i, 462. Hydra.stine (internally and by injection), i, 476. Hydrogen-dioxide injections, i, 503, 531. lehthyol injections, i, 523. Iodine, i, 536. Kava, i, 564. Lafayette mixture, i, 301. Lanolin injection, i, 569. Lysol, i, 590. Matico, i, 611. Mercury bichloride (injections), i, 531. Methylene blue, i, 630. Palmetto wine, ii, 58. Potassium permanganate (injections), i, 531, 597. Pyridine injections, ii, 110. Pyoctanine, ii, 108. (internally), ii, 109. Quinine injections, ii. 126. " hvdrochloride (locally), i, 354. Salol, ii, 150. Sandal-wood oil, ii, 153. Silver citrate, ii, 198. " nitrate, ii, 196. " oxide, ii, 197. Storax, ii, 238. (in pregnant women). Tannin and alum douche, ii, 256. Tannin injections, ii, 356. Terpin hydrate, ii, 273. Thalline injections, ii, 376. Traumatol, ii, 339. Tribulus lanuginosus, ii, 330. Triticum, ii, 333. Turpentine oil, ii, 836. Water, i, 105. Zinc acetate (as a local astringent), ii, 403. " oxide, ii, 407. " permanganate, ii, 410. " sozoiodolate, ii. 410. " subgallate, ii, 411. " sulphate injection, ii, 407. " siilphocarbolate, ii, 412. Gonorrhoea, acute. Aluminum tannate, ii, 359. Gonorrhoea, chronic. Cadmium sulphate, i, 300. Cantharides, i, 208. Catechu injections, i, 221. Copper arsenite, i, 304. Cuprio-sulphate solution (injections), i, 806. Iron, i, 549. " chloride (tincture), i, 648. Kava, i, 564. Silver nitrate, ii, 196. Tannin injections, ii, 256. Thalline injections, ii, 276. INDEX OP DISEASES AND REMEDIES. 575 Gonorrhoea, chronic. Uva ursi, ii, 348. Waters, Buffalo lithia, ii, 373. " mineral, ii, 377. Gonorrlioea, subacute. ?otassium-j)ermang:anate injection, i, 597. Gonorrhoea, vaginal. Formaldehyde, i, 428. Gurjun balsam, i. 462. Traumatol, ii, 329. Gont. Aconite (as an anaesthetic), i, 9. Alkaline mineral waters, i, 45. Amber, oil of, i, 52. Baths, Nauheim, ii, 420. " pine, i, 172. Cod-liver oil, i, 288. Colohieum, i, 291. Dulcamara, i, 353. Ephedra, i, 385, Glycerophosphates, ii, 439. Guaiac, i, 456. Guaiacol and glycerin, i, 461. lehthyol, i, 522. Kava, i, 564. Lithium, i, 586. Lycetol, i, 589. Magnolia, i, 592. Mercury, i, 619. Methylene blue, i, 629. Muscarine, i, 645. Oxygen, ii, 52. Ozone, ii, 58. Piperazine, ii, 89. Potash, ii, 94. Quinine salicylate, ii, 455. Salicin, ii, 140. Salicylic acid, ii, 143. Salines, ii, 147, Salophene, i, 125. Strontium lactate, ii, 230. Sulphur, ii, 241, Tartarlithine, ii, 265, _^ Tetrethylammonium, ii, 273. Uricedin, ii, 342. Drotropine, ii, 343, Waters, alkaline, ii, 367, 372, " chlorinated, ii, 365, mineral, ii, 374, 375, 377, 379, " simple thermal (internally), ii, 364. " sulphur, or vapours, ii, 371. Wet-pack, i, 490. Gout, acute rheumatic. Pulsatilla, ii, 107. Gout, chronic. Guaiac wood, i, 457, Iodine salts, i, 536, Mercury iodide and arsenic, i, 627. Savine, ii, 157, Gout, rheumatic. Arsenic, i, 145, Cod-liver oil, i, 288. Massage, i, 608, Granular lids. Atropine, i, 155, Boric acid, i, 190, Granulating sores. Sponge-grafting, ii, 219, Granulation of the eyelids, Jequirity, i, 562. Granulations, exuberant. Silver nitrate, ii, 195. Granulations, intra-uterine. Nitric acid, ii, 7. Granulations, vascular. Silver nitrate, ii, 195. Gravel. See LiTHiASis. Grippe. See Influenza. Growths, intra-uterine. Chromic-acid applications, i, 248. Growths, malignant. Zinc chloride, ii, 403. Growths, naso-pharyngeal. Chromic-acid applications, i, 248. Growths, sloughing malignant. Potassium permanganate, i, 597. Growths, sort. Iron chloride, i, 548. Growths, superficial cutaneous. Hydrochloric acid, i, 227. Gums, spongy. Borax, myrrh, and honey, i, 189. Copper-arsenite solution, i, 304. Myrrh, tincture of, i, 651. Hsematemesis. Calcium chloride, ii, 428. Catechu lozenges, i, 221. Iron sulphate, i, 550. Matioo, i, 611. Hsematocele. Electricity, i, 368. Hsematoma. Bryonia, i, 197. Electricity, i, 368. Hsematuria. Corn silk, i, 306. Ergot, i, 388. Gallic acid, i, 433. Matico, i, 611. Physostigma, ii, 81. Pichi, ii, 83, Quinine, i, 255 ; ii, 120. Rhus aromatica, ii, 131. Silver nitrate, ii, 196, Tannic acid, ii, 257. Haemophilia. Gallic acid, i, 432. Marrow, i, 598. Tannin, ii, 257. Haemoptysis. Air, condensed, inspiration of, i, 28. Bryonia, i, 197. Cupric sulphate and opium, i, 306. Ergot, i, 388. Erigeron. oil of, i, 390. Gallic acid, i, 432. Ipecac, i, 542. Iron sulphate, i, 550. Lead acetate, i, 577. Matico, i, 611, Opium, ii, 35, Podophyllin, ii, 93. Senecin, ii, 161. Senecio, ii, 162. Tannin, ii, 257. Terebene, ii, 271. Waters, sulphuretted, ii, 371. 576 INDEX OP DISEASES AND REMEDIES. Haemorrhage, passive. Iron chloride (tincture), i, 548. Kino, i, 565. (from the stomach and intestines), Tannic acid, ii, 257. Haemorrhage, post-partum. Boussingaulthia basselloides, i, 191. Bryonia, i, 197. Canella, i, 200. Ciraicifuga, i, 250. Ergot, i, 388. Faradization, i, 368. Hot saline solutions (injections), i, 467. Ioe,'i, 520. Injections of iced water, i, 480. Ipecac, i, 548. Iron chloride, i, 548. " sulphate, i, 550. Lemon-juice, i, 260. Sponge tents (impregnated with vinegar), ii, 219. Turpentine oil, ii, 336. Vinegar, ii, 219. Haemorrhage, pulmonary (of the plethoric). Bloodletting, i, 188. Ergot, i, 388. Hamamelis, i, 467. Pneumatic cabinet, ii, 413. Silver oxide, ii, 197. Haemorrliage, rectal. See H.EMOREHAGES FROM THE RECTUM. Hfemorrhage, renal. Hamamelis, i, 467. Haemorrhage, slight. Salicylic acid, ii, 143. Haemorrhage, uterine. Boussingaulthia baselloides, i, 191. Creosote, i, 314. Ergot, i, 388. Erigeron, oil of, i, 390. Erodinm cicutarium, ii, 433. Hamamelis, i, 467. Ice, i, 520. Quinine feri-ichloride, ii, 455. Saiol and antipyrine applications, ii, 150. Styptic! n, ii, 233. Tannic acid, ii, 257. Urtica, ii, 343. Viscum album, ii, 361. Haemorrhages. Antipyrine, i, 466. and tannin, ii, 257. Baths, warm, i, 489. Calcium carbide, ii, 426. chloride, ii, 428. Cimioifuga, i, 250. Cinnamon, i, 359. Cornutine, i, 307. Creosote, i, 314. Cuprio-sulphate solution (locallv), i, 306. Digitalis, i, 343. Electricity, i, 368. Ergot, i, 388. Erigeron, oil of, i, 390. Perropyrine, i, 433. (from tooth extraction). Ethyl chloride, ii, 434. Gallic acid (internally), i. 432. Geranium, i, 438. Hamamelis, i, 467. Haemorrhages. Heat, i, 408. Hydrastine (internally), i, 476. Hydrastis, i, 476. Ice, i, 520. Infusion, ii, 323. Injection of hot saline solution, i, 467. Ipecac, i, 543. Iron chloride (solution), i, 548. " sulphate, i, 550. Kino, i, 565. Lead acetate, i, 577. Ligation of arteries in, i, 465. Nitric acid, ii, 7. Opium, ii, 36, 450. Pichi, ii, 82. Pneumatic cabinet, ii, 413. Posture in the arrest of, i, 465. Khubarb, ii, 131. Saline solution (by the rectum), ii, 237. Salt, ii, 206. Sclerotic acid, ii, 158. Silver oxide, ii, 197. Sodium chloride, ii, 206. (during operations). Steam, ii, 223. Stypticin, ii, 230. Sulphur and cream of tartar, ii, 241. Sulphuric acid, ii, 243. Suprarenal capsule, ii, 347. Surgical means for arresting, i, 464, 465. Tannic acid and antipyrine, ii, 257. Torsion or twisting as "a means of arresting, i, 465. (from traumatism). Transfusion and infusion, ii, 323. Turpentine oil. ii, 336. Urtica, ii, 343.' Veratrum viride, ii, 353. Vinegar, i, 5 ; ii, 219. Viscum album, ii, 361. Water, hot (by the mouth or the rectum), ii, 337. Wines, strong, as a tonic, ii, 894. Haemorrhages, abdominal. Saline cathartics, ii, 147. Haemorrhages after labour. Ergot, i, 388. Hasmorrhages, bronchial (of the plethoric). Bloodletting, i, 188. Haemorrhages, capillary. Ice (topically), i, 520. Sodium chloride, ii, 206. Haemorrhages, cerebral. Baths, warm, i, 489. Haemorrhages, climacteric. Stypticin, ii, 333. Hemorrhages, external. Iron sulphate (solution), i, 550. HiBmorrhages from fibroids. Stypticin, ii, 233. Haemorrhages from leecli bites. Creosote, i, 314. Hiiemorrhages from tlie extraction of teeth. Turpentine oil, ii, 336. HajMiorrhages from tlie rectum. 1 1 ydrastis. i, 476. Rhubarb, ii, 131. Sulphur and cream of tartar, ii, 341. Haemorrhages from the stomach. Lead acetate, i, 577. INDEX OF DISEASES AND REMEDIES. 577 Haemorrhages from typhoid ulcer. Opium, ii, 36. Haemorrhages, gastric. Infusion, ii, 333. Silver oxide, ii, 197. Hsemorrhages, internal. Sclerotic acid, ii, 158. Haemorrhages, intestinal. Biigeron, oil of, i, 390. Hydrastis, i, 476. (of typhoid fever). Infusion, ii, 333. Krameria, i, 566. Lead acetate, i, 577. Haemorrhages, nasal. Ferropyrine, i, 433. Haemorrhages of malarial feyer. Quinine, ii, 118. Haemorrhages of scurvy. Ergot, i, 388. Haemorrhages, vesical. Cinnamon, i, 359. Krameria, i, 560. Haemorrhoids. Apone, i, 139. Arsenic, i, 146. Baths, cold, i, 169. " cold sitz, i, 489. . (strangulated). Baths, hot sitz, i, 169. Baths, narcotic, i, 173. Carbolic-acid injections, i, 313. Chromic-acid applications, i, 348. Ergot, i, 888. Galls, i, 433. Glycerin injections, i, 450. Grape cure, i, 455. Ilamamelis, i, 467. Iron sulphate, i, 550. Lappa, i, 570. Nitric acid, ii, 7. Oak bark (enema), ii, 31. Pisoidia, ii, 91. Rhus toxicodendron, ii, 133. Sulphur and cream of tartar, ii, 341. Tannio-acid ointment, ii, 356. Tannin suppositories, ii, 356. Water (rectal applications), i, 479. " in form of an ascending douche, i, 349. Waters, mineral, ii, 371, 375. Zinc subgallate, ii, 411. Haemothorax. ."Aspiration, i, 151. Ilallneinations. Galvanism and Faradaism, i, 366. Hay fever. Blennostasine, ii, 436. Copper-arsenite solution, i, 304. Poimaldehyde, ii. 436. Glycerin and carbolic acid, i, 450. Grindelia, i, 456. Ipecac, i, 543. Menthol solution (by injection), i, 614. Quinine hydrochloride (either by spray or painted on the mucous membrane), i, 353 ; ii, 119. Salioin, ii, 140. Salicylic acid, ii, 143. Sulphurous acid, ii, 343. Tannigene, ii. 360. Terpin hydrate, ii, 373. Hay fever. Zinc valerianate, ii, 347. Headache. Acetanilide, i, 3. Acetic acid (by inhalation), i, 5. Alcohol, i, 30. (of anaamia), Amyl nitrite, i, 61, Anhalonium Lewinii, ii, 417. Antipyrine, i, 301. Blisters, i, 185. Bromoform, i, 196. Caffeine, i, 301. Camphor, ii, 6. Chloralose, i, 339. Ciouta maculata, i, 350. Cocaine, i, 383. Coffee, i, 390. Croton oil, i, 318. Ether, i, 397. Eucalyptus, oil of, i, 400. Exalgine, i, 403. (ilalvanization, stabile, i, 366. Guarana, i, 461. Hydrobromic acid, i, 493. Lavandula, i, 578, Magnesia, i, 591. Massage of the neck, i, 608. Menthol, i, 614. Migrainin, i, 631. Mustard foot-bath, i, 647. Nitroglycerin, ii, 15. Nux vomica, ii, 88. Phenacetine, ii, 71. Potassium cyanide, i, 333. Pulsatilla, ii, 107. Pyrethrum, ii, 109. Salipyrine, ii, 148. Splenic extract, ii, 318. Thymacetine, ii, 383. Thymol, ii, 383. Valerian, ii, 345. Headache, chronic. Croton oil, by application to the nape of the neck, i, 318. Headache due to anaemia of the hrain. Nitroglycerin, ii, 15. Headache due to intra-cranial lesions. Blisters, i, 185. Headache, febrile. Pyramidone, ii, 454. Headache, frontal. Anhalonium Lewinii, ii, 417. Cocaine, i, 383. Galvanization, stabile, i, 366. Nux vomica, ii, 88. ■ Headache, liysterical. Chloralose, i, 839. Headache, menstrual. Senecio, ii, 456. Headache, nervous. Anhalonium Lewinii, ii, 416. Cannabis indica, i, 67. Caffeine and antipyrine, i, 301. Cicuta maculata, i, 350. Ether, as a spray, i, 397. " (internally), i, 397. Exalgine, i, 403. Pulsatilla, ii, 107. Thymacetine, ii, 383. Valerian, ii, 345. 578 INDEX OF DISEASES AND REMEDIES. Headache, occipital. Anhalonium Lewinii, ii, 417. Galvanization, stabile, i, 366. Headache of indigestion. Ammonia water, i, 53. Ammonium valerianate, ii, 346. Magnesia, i, 591. Mustard foot-bath, i, 647. Headache of influenza. Ethyl chloride, ii, 434. Migrainin, i, 631. Headache of melancholia. Exalgine, i, 403. Headache, sick. See Migraine. Heart aHections. Hydrocyanic acid, i, 495. Strychnine, ii, 28. Heart, dilatation of the. Air, condensed, expiration into, i, 28. Digitalis, i, 341. Heart disease. Adonis, i, 16. Alcohol, ii, 235, 227. Amyl nitrite, i, 60 ; ii, 227. Aspiration, i, 150. Baths, hot, Ii, 325. " Nauheim, ii, 419. Bromides, i, 194. Caffeine, i, 301. , Cardine, i, 218. Carpaine, i, 218. Cereus grandiflorus, i, 339. Cimicifuga, i, 350. Convallaria, i, 300. Corn silk, i, 306. Digitalis, i, 341. Hydrochloric acid, i, 493. Mercury, i, 620. Morphine, ii, 36. Nux vomica, ii, 28. Opium, ii, 36. Pulsatilla (as a sedative), ii, 106. Saline infusion, ii, 227. Schott treatment, ii, 419. Sodio-theobromine salicylate, ii, 303. Sparteine, ii, 216. Squill, i, 345. Strophanthus, ii, 333. Strychnine, ii, 38. " injections, ii, 450. Veratrum viride, ii, 358. Heart disease, valvular. Aspiration, i, 150. Barium chloride, i, 101. Heart disease with deficient compensa- tion Hydrochloric acid, i, 493. Heart failure (sudden). Alcohol (subcutaneously), ii, 237. Amyl nitrite, ii, 337. Ether (subcutaneously), i, 397. Nux vomica, ii, 38. (in acute delirium of some forms of insanity), Wine, ii, 394. Heart failure during anaesthesia. Strychnine injections, ii, 450. Heart, fatty. Cimicifuga, i, 350. Iron, i, 317. Heart, flagging of the. Counter-irritation, ii, 237. Saline infusion, intra-arterial or intra- venous, combined with strychnine, ii, 337. Heart, irregular. Sodium salicylate, ii, 146. Heart, irritable. Digitalis, i, 343. Strophanthus, ii, 333. Veratrum viride, ii, 353. Heart, nervous excitement of the. Bromides, i, 194. Heart, organic disease of the. Caffeine, i, 201. Heart, palpitation of the. See Palpitation of the heart. Heart, smoker's. Aconite (tincture), i, 9. Heart, weak. Alcoholic stimulants, ii, 325. Cimicifuga, i, 250. Com silk, i, 306. Digitalis, i, 345. Scoparius, i, 345. Squill, i, 345. Wine, port, ii, 394. Heartburn. See Dyspepsia, Acid. Hemicrania. See MiGKAiKE. Hemiplegia. See Apoplexy. Hepatitis. Veratrum viride, ii, 352. Hepatitis, congestire. Aspiration, i, 151. Hepatitis, suppurative. Aspiration, i, 151. Hernia. Aspiration, i. 152. Iodine injection, i, 536. Hernia, strangulated. Bath, hot, i, 166, 489. Collodion, i, 394. Ice (topically), i, 519. Lobelia, infusion of, i, 587. Oxalic acid, ii, 49. Tartar emetic, i, 114. Tobacco-smoke enema, i, 304. Hernia, umbilical. Collodion, i, 394. Herpes. Acetanilide, i, 3. Baths, sulphurous, i, 173. Blisters, i, 186. Collodion, i, 294. (for pain). Ethyl chloride, ii, 434. Euphorin (as a local disinfectant), i, 403. Grindelia, i, 456. Resorcin, ii, 126. Salicylic acid, ii, 143. Zinc-acetate ointment, ii, 402. Zinc oxide, ii, 406. Herpes labialis. Collodion, i, 394. Herpes praBputialis. Collodion, i, 394. Herpes zoster. See Zoster. INDEX OF DISEASES AND REMEDIES. 579 Hiccoiig:]!. Apomorphine, ii, 417. Chloral hydrate, i, 287. CUiloroform, spirit of, i, 241. Conium, i, 298. Muscarine, i, 645. Musk, ii, 6. Nitroglycerin, ii, 15. Sulphonal, ii, 239. Hip-joint disease. Nucleins, ii, 24. Hives. See Urtioaria. Hoarseness. Catechu lozenges, i, 221. Placourtia, i, 422. Potassium chlorate, ii, 96. Hodglfin's disease. Arsenic, i, 144. Hydrocele. Chloroform (iniection), i, 241. Claret (by injection), ii, 394. Electricity, i, 368. Iodine injections, i, 536. Silver nitrate, ii, 196. Sodium chloride, ii, 163. Zinc-chloride injections, ii, 404. Hydrocephalus. Croton oil, i, 318. Iodine injection, i, 536. Hydrocephalus, acute. Infusion, ii, 324. Hydrocephalus, clironic. Aspiration, i, 150. Hydrocephalus, congenital. Collodion, i, 294. Hydropericardi urn. Aspiration, i, 151. Hydrophobia. Conium, i, 229. Curare, i, 321. Serum treatment, i, 84. Hydrops articnlornm intermittens. Quinine, ii, 120. Hydrosalpinx. Electricity, i, 368. Hydrothorax. Aspiration, i, 151. Jaborandi, i, 559. Hyperacidity, gastric. See Dyspepsia, Gastric. Hyperseinia. ^aths, cold, i, 169, 170. " condensed-air, i, 27. " warm, i, 489. Collodion, i, 294. Ergotole (local application), i. 389. Ichthyol, i, 522. Viburnum prunifolium, ii, 356. Hypersemia, cerebral. Baths, cold, i, 169, 170. " warm, i, 489. Hyperajmia, ocular. Collodion, i, 294. HyperiBmia of the pelvic organs. Viburnum prunifolium, ii, 356. Hyperaeniia, pulmonary. Baths, cold, i, 169. Hvpersesthesia. Baths, hot sitz, i, 1C9. HypersBSthesia. Electricity, i, 368. Salix. ii, 149. Hyperaisthesia, ovarian. Electricity, i, 368. Hyperidrosis. Belladonna, i, 103. (after influenza). Camphoric acid, ii, 438. Goto bark, i, 309. Dover's powder, i, 103. Ergot, i, 102. Gallic acid, i, 432. Hydrastine, i, 476. Mineral acids, i, 103. Muscarine, i, 103. Naphthol (in solution), ii, 2. Nux vomica, i, 102. Oak bark, ii, 31. Picrotoxin, i, 103. Salicylic acid, ii, 144. Salvia, ii, 456. Silver oxide, i, 197. Strychnine, i, 102. Sulphuric acid, ii, 242. Tannic acid, ii, 257. Tannoform, ii, 260. Zinc oleate. ii, 405. " oxide, i, 102. Hyperidrosis of the feet. Boric acid, i, 102. Potassium permanganate, i, 597. Tannic acid, ii, 257. Tannoform, ii, 260. Hyperidrosis, partial. Sulphur, i, 103. Hyperityrexia. See Fevers. Hypertrophy of the heart. Veratrum viride, ii, 353. Hypertrophy of the liver. Iodine salts, i, 536. Hypertrophy of the lymphatic glands. Iodine injections, i, 536. Hypertrophy of the nose. [gnipuncture, i, 534. Hypertrophy of the prostate. Aspiration, i, 152. Iodine (injection), i, 536. Hypertrophy of the spleen. Ammonium fluoride, i, 57. Grape cure, i, 455. Lead-iodide ointment, i, 57. Waters, mineral, ii, 366. Hypertrophy of the testicles. Guaiaeol applications, ii, 439. Iodine salts, i, 536. Hypertrophy of the tongue. Gold, i, 453. Hypertrophy of the tonsils. Catechu, infusion or tincture, i, 221. Ignipuncture, i, 524. Iodine (injections), i, 536. Tannin, glycerite of, ii, 256. Trichloracetic acid, ii, 330. Hypertrophy, uterine. Galvanism, i, 368. Iodine salts, i, 536. Hypochondriasis. Anhalonium Lewinii, ii, 416. Electricity, i, 366. 580 INDEX OP DISEASES AND REMEDIES. Hvpochondriasis. Faradization, general, i, 366. Gold, i, 453. Oxygen, ii, 53. Rest-cure, ii, 127. ' Strychnine, ii, 38. Hysteria. AUyl tribromide, ii, 414. Ammonia, fcetid spirit of, i, 53. Ammonium carbonate, i, 56. " succinate, i, .^8. Amy] nitrite, i, 61. Anlialoniura Lewinii, ii, 416. Apomorphine, ii, 418. Asafcetida, i, 147. Bromides, i, 193. Caffeine valerianate, ii, 346. Camphorated oil, ii, 6. Castor, i, 219. Chamomile, i, 231. Cineraria, i, 358. Cocaine (internally), i, 284. Cold affusions, i, 17. Creosote, i, 314. Croton-oil application to the spine, i, 318. Paradaism, i, 367. Galbanum, i, 433. Gold bromide, i, 454. Iron chloride (tincture), i, 549. " valerianate, ii, 346. Orchitie liquid, i, 76. Paraldehyde, i, 509. Phosphoric acid, ii, 77. Pisoidia, ii, 91. Quinine valerianate, ii, 347. Rest-cure, ii, 137. Rue, ii, 137. Sumbul, ii, 343. Tansy, ii, 261. Valerian, ii, 345. Viburnum prunifolium, ii, 357. Waters, thermal (externally and internally), ii, 384. Hysteria, vomiting of. See Vomiting, Hysterical. Hystero-epilepsy. Amyl nitrite, i, 61. Bromides, i, 193. Orchitie liquid, i, 76. Valerian, ii, 345. Viburnum prunifolium, ii, 357. Ichthyosis. Baths, alkaline, i, 171. Cuprio-sulphate solution, i, 306. Naphthalan, ii, 448. Salicylic-acid ointment, ii, 144. Thyreoid feeding, i, 79. Icterus. See Jaundice. Impaction, faecal. Gflycerin injections, i, 451. Lobelia (enema of the infusion), i, 587. Ox-bile enema, ii, 49. Tobacco-smoke enema, ii, 304. Water (rectal applications), i, 479. Impetigo. Cod-liver oil, i, 288. Salicylic acid, ii, 241. Sulphur fumes, ii, 341. IiTipetigo. Tumenol oil nnd oxide of zinc, ii, 334 Impetigo contagiosa. Salicylic acid, ii, 145. Impotence. Apiol, i, 137. Asafcetida, i, 147. Cantharis, i, 136. Carbonic-acid gas. i, 314. Carrot seeds, i. 137. Cashew nut, i, 219. Cimieifuga, i, 137, 350. Damiana, i, 334. Douches, hot and cold, i, 137. Electricity, i, 137. Ergot, i, i37. Flagellation, i, 137. Gold chloride, i, 137. Juniper, oil of, i, 137. Lotions, stimulating, i, 137. Nux vomica, i, 137. Orchitie liquid, i, 76. Pepper (black and red), i, 136. Phosphorus, i, 137 ; ii, 77. Polygonum hydropiperoides, i, 137. Rue, oil of, i, 137. Sanguinaria, ii, 154. Savine, oil of, i, 137. Strychnine, i, 137. Testicle juice, i, 76. Turpentine, i, 137 ; ii, 336. Wines, i, 137. Zinc phosphide, i, 137. Inanition. Transfusion, ii, 333. Incontinence of urine. Ammonium benzoate, i, 177. Cantharides, i, 308. (in young boys), Collodion, i, 394. Humulus, i, 474. Kava, i, 564. Lycopodium tincture, i, 590. Massage (Brandt's method), i, 609. (from vesical atony), Rhus aromatica, ii, 131. Rhus toxicodendron, ii, 133. Turpentine oil, ii, 336. (from nervousness). Zinc valerianate, ii, 347. Incontinence, nocturnal, of urine (in chil- dren). Baths, cold, i, 169. Belladonna, i, 175. Orchitie liquid, i, 76. Santonin, ii, 155. Testicle juice, i, 76. Indigestion. See Dyspepsia. Indurations, glandular. Calcium chloride, i, 303. Cupric oxide, i, 305. Manganese sulphate (ointment), i, 596. Inebriety. See Alcohol habit. Inertia, intestinal. Massage, abdominal, i, 605, 608. Inertia, uterine. Abdominal binder, ii, 56. Cold applications, ii, 56. Cimieifuga, ii, 55. Cornutine, i, 307. Cotton root, extract of, ii, 55. INDEX OF DISEASES AND REMEDIES. 581 Inertia, uterine. J51ectricity, ii, 55. Ergot, i, 388. Glycerin (intra-uterine injections), i, 450; ii, 55. Heat, i, 468 ; ii, 56. Hydrastis canadensis, ii, 55. Mammary irritation, ii, 56. Quinine, i, 356; ii, 116, 120. Rue, ii, 137. Sugar, ii, 234. Infiltrations. Atropine, i, 154. Inflammation. Aconite, i, 9, 118. Ammonium cliloride, i, 56. Arnica, i, 141. Arsenic, i, 146. Baths, hot, i, 166. Belladonna and morphine injections, i, 67. " ointment, i, 173. Bismuth, i, 181. Boric acid, i, 196. Brucine, ii, 29. Caffeine, i, 201. Carbolic acid, i, 212. Collodion, salioylated, i, 293. " saturnine, i, 293. Copper arseuite, i, 805. Croton oil, i, 318. Cupping, i, 320. Digitalis, i, 342. (joose grease, i, 455. Ice (topically), i, 519. Iodoform collodion, 1, 293. Linseed tea, ii, 269. Opium, ii, 37. Phytolacca, ii, 81. Poultices, ii, 101. Pulsatilla, ii, 107. Salines, ii, 147. Scopolamine, ii, 159. Silver nitrate, ii, 194, 195. Tannin, ii, 255. Taraxacum, ii, 265. Terebene, ii, 271. Thymol, ii, 284. Veratrum viride. i, 118; ii, 352. Waters, mineral, ii, 372. Wines, ii, 894. Xanthoxylum, ii, 396. Yerba santa, ii, 401. Zinc iodide, ii, 405. Inflammation, abdominal. Salines, ii, 147. Inflammation, acute, of tlie serous mem- branes. Aconite, i, 9. Inflammation, acute stlienic. Aconite, i, 118. Veratrum viride, i, 118. Inflammation, clironic, of tlie intestines. Silver nitrate, ii, 194. Inflammation, clironic, of the joints. Croton oil, i, 318. Inflammation, clironic pulmonary. Yerba santa, ii, 401. Inflammation, chronic purulent, of the middle ear. Silver nitrate, ii, 195. Inflammation, chronic uterine. See Metritis, Chronic. Inflammation, intracranial. See Encephalitis and Meningitis. Inflammation, local. Digitalis, i, 342. Inflammation of joints. See Rheumatism. Inflammation of muscles. See Rheumatism. Inflammation of nerves. See Neuritis. Inflammation of the dental pulp. Thymol, ii, 284. Inflammation of the external ear. See Otitis, External. Inflammation of the eyelids. See Blepharitis. Inflammation of the iris. See Iritis. Inflammation of the kidney. See Nephritis. Inflammation of the liver and spleen. Taraxacum, ii, 265. Inflammation of the lymphatic glands. See Adenitis. Inflammation of the mammary glands. See Mastitis. Inflammation of tlie middle ear. See Otitis media. Inflammation of the mouth. See Stomatitis. Inflammation of the mucous membranes. Zinc iodide, ii, 405. Inflammation of the mucous membrane of the Eustachian tube. Silver nitrate, ii, 195. Inflammation of the pelvic cellular tissue. See Cellulitis. Pelvic. Inflammation of the pharynx. See Pharyngitis. Inflammation of tlie respiratory, gastro- intestinal, .ind urinary membranes. Linseed tea, ii, 269. Inflammation of the serous membranes. Quinine, ii, 119. Xanthoxylum, ii, 396. Inflammation of the uterus. See Metritis. Inflammation of the vagina. See Elytritis. Inflammation of the vermiform appendix. Waters, Buffalo lithia, ii, 372. Inflammation, parenchymatous. Veratrum viride, ii, 352. Inflammation, perimetric. See Perimetritis. Inflammation, pseudo-membranous. Carbolic acid, i, 312. Inflammation, purulent. Wines, ii, 394. Inflammation, rheumatic. See Rheumatism. Inflammation, serous. Veratrum viride, ii, 352. Inflammation, subacute rheumatic. Goose-grease liniment, i, 455. Inflammatory, chronic, thickening and deposits. Cold and hot affusions, i, 17. 583 INDEX OP DISEASES AND EEMEDIES. Inflammatory cutaneous affections. Ulmus (local applications), ii, 338. Inflammatory deposits. Thiol ointment, ii, 378. Inflammatory derang'ements of tlie mucous membranes of tlie body. Copper arsenite, i, 304. Inflammatory processes. Turpentine, ii, 335. Inflammatory processes, acute. Wine, ii, 393. Inflammatory throat affections. Xanthoxylum (as a gargle), ii, 396. Influenza. Acetanilide, i, 3. Ammonium acetate, i, 54. Antikamnia, i, 112. Antitetraizine, i, 134. Asaprol, i, 148. Blennostasine, ii, 426. Calcium sulphide, ii, 428. Camphor and sweet-almond oil (internally), i, 205. Cinnamon, oil of, i, 259. Copper-arsenite solution, i, 304. Goose grease (internally), i, 454. Guaiaool, i, 460. Laotophenine, i, 568. Naphthol, ii, 2. Nucleins, ii, 24. Pambotano, ii, 58. Phenacetine. ii, 73. Pilocarpine, ii, 86. Saligenin, ii, 147. Salol, ii, 150. Salophene, ii, 151. Scopolamine hydrobromide, ii, 159. Serum therapy, i, 85. Sodium bicarbonate, ii, 205. Wine, ii, 394. Insanity. Baths, cold, i, 488. Camphor, i, 205. Chemical restraint, i, 233. Exercise, i, 413. Forced feeding, i, 43. Hyoscyamus, i, 504. Marrow, bone, ii, 445. Paraldehyde, ii, 62. Thyreoid feeding, i, 79 ; ii, 296, 299. Zinc phosphate, ii, 410. Insanity during convalescence from fevers. Zinc phosphate, ii, 410. Insanity, puerperal. Thyreoid treatment, ii, 291. Insanity, stuporous. Thyreoid treatment, ii, 299. Insolation. AflEusions, cold, i, 16. Atropine, hypodermically, i, 156. Baths, cold, i, 165. 486 ; 'ii, 225. Bloodletting, i, 188. Ethyl chloride, ii, 434. Ice applications, i, 16. Quinine, hypodermically, ii, 126. Insolation of the eyes. Nux vomica (injections), ii, 39. Insomnia. Alcohol, i, 506. Insomnia. Ammonium valerianate, ii, 346. Amylene hydrate, i, 507. Bath, half, i, 169. •' hot, i, 166. Baths, vapour, i, 171. Bromides, i, 194, 507. Calcium bromide, i, 201. Cannabis indica, i, 207, 507. Chloralamide, i, 238, 507. Chloral ammonium, i, 235. hydrate, i, 236, 507. Chloralose, i, 239. Chlorobrom, i, 240. Codeine, i, 286. Croton chloral, i, 508. Exalgine, i, 403. Hyoscine, i, 504, 508. Hyoscyamus, i, 504, 508. Hypnone, i, 5. Hypnotics, i, 500. Massage, i, 608. Meconarceine, i, 611. Methylal, i, 629. Morphine, i, 508. Opium, i, 508; ii, 36. Oxygen, ii, 53. Paraldehyde, i, 409 ; ii, 63. Phenacetine, ii, 71. Phosphorus, ii, 76. Piscidia, i, 509 ; ii, 91. Sodium lactate, ii, 207. Scopolamine hydrobromide, ii, 159. Somnal, ii, 213. Sulphonal, i, 509 ; ii, 239. Tetronal, ii, 278. Trional, i, 509 ; ii, 382. Urethane, ii, 342. Waters, thermal, ii, 364. Whisky, i, 506. Wine, port, ii, 394. Insomnia from pain. Anhalonium Lewinii, ii, 416. Insomnia, nervous. Chl'.ral hydrate, i, 236. Codeine, i, 286. Exalgine, i, 403. Opium, i, 508. Piscidia, ii, 91. Sulphonal, ii, 239. Tetronal, ii, 273. Insomnia of acute infectious diseases. Tetronal ii, 373. Insomnia of anajmia. Phosphorus, ii, 76. Insomnia of chronic heart disease. Ural, ii. 838. Insomnia of delirium tremens. Opium, i, 508. Insomnia of dentition and indigestion Trional, ii, 333. Insomnia of diseases of the uterus. Phenacetine, ii, 71. Insomnia of hysteria. Valerian, ii, 345. Insomnia of insanity. Paraldehyde, i, 509 ; ii, 62. Scopolamine hydrobromide, ii, 159. Insomnia of melancholia. Exalgine, i, 403. INDEX OP DISEASES AND REMEDIES. 583 Inspissation, biliary. Sodium phosphate, ii, 79. Intermittent fever. Ammonium carbazotate, i, 55. Arsenic, i, 117, 145. Calotropis, i, 203. Capsicum and quinine, i, 309. Carbolic acid, i, 212. Cassia occidentalis, i, 319. Chloroform, i, 341. Cupric sulphate, i, 306. Hydrastine, i, 476. Lemon-iuioe and salt, or coffee, i, 260. Magnolia, i, 592. (with hepatic engorgement), Nitric acid and quinine, ii, 8. (cold stages). Nitroglycerin, ii, 15. Quinine, i, 117. Salipyrine, ii, 148. Serpentaria, ii, 163. Sodium chloride, ii, 206. Tansy, ii, 361. Intermittent fever, masked. Quinine, ii, 118. Intermittent fever, pernicious. Quinine (hypodermically), i, 117. Intertrigo. Airol, ii, 414. Bismuth subnitrate (as a dusting powder), i, 181. Camphor powder (with starch) or ointment, i, 304. Chalk powder, i, 330. Collodion, i, 394. Copper-arsenite solution, i, 304. Ichthyol (salve or solution), i, 523. Salicylic acid, ii, 143. Starch, powdered, ii, 333. Talc powder, ii, 354. Tannic-acid ointment, ii, 356. Zinc oxide, ii, 406. Intestinal disorders. Copper arsenite, i, 305. Ichthyol, ii, 443. Irrigation of the stomach, i, 491. Mercury and chalk, i, 632. Thymol, ii, 383. Water, i, 479. Zinc sulphocarbolate, ii, 411. Intussusception, intestinal. Lobelia, infusion of, i, 587. Sodium bicarbonate (injections), ii, 304. Tobacco smoke, enemata of, ii, 304. Irido-chorioiditis, rheumatic. Salicylic acid, ii, 143. Iritis. Atropine, i, 155. Blisters (on the temple), i, 185. Ethyl chloride, ii, 434. Mercury, i, 619. Scopolamine hydrobromide, ii, 159. Suprarenal capsule, ii, 347. Water, hot applications of, ii, 213. Iritis, gonorrliaeal. Sodium salicylate, ii, 146. Iritis, plastic. Scopolamine hydrobromide, ii. 159. Water, hot applications of, ii, 313. Iritis, rlieumatic. Sodium salicylate, ii, 146. Irritability, nervous. Asafoetida, ii, 6. Irritability of the bladder. See Incontinence op urine. Irritability, vesical. Corn silk, i, 306. Irritation, chronic vesical. Buchu, i, 197. Irritation, gastric. Papain, ii, 60. Irritation, rectal. Bismuth injections, i, 181. Irritation, spinal. Baths, halt, i, 169. Cupping, i, 320. Erythrophloiine, i, 390. Paradaism, i, 367. Ice, i, 530. Neurodin, ii, 7. Irritation, urinary. Tribulus lanilginosus, ii, 330. Itching. See Pbueitus. Jaundice. Acid baths, i, 171. Aloes, i, 49. Calomel, i, 634. Chelidonium (as a purgative), i, 233. Chionanthus virginica, i, 234. Dulcamara, i, 353. Gold, i, 454. Ipecac, i, 543. Iron succinate, i, 553. Lemonade, i, 360. Massage, abdominal, i, 608. Moringa, ii, 447. Nitrohydrochloric acid (for bathing), ii, 16. Podophyllin, ii, 93. Quinine, i, 355. Salicin, ii, 140. Salol, ii, 150. Sanguinaria, ii, 154. Senecin, ii, 161. Senecio, ii, 162. Sodium phosphate, ii, 79, 308. Viehv water, ii, 358. Waters, Buffalo lithia, ii. 373. " mineral, ii, 375, 379. " sodium-sulphate, ii, 368. Jaundice, catarrhal. Aloes, i, 49. Ipecac, i, 543. Podophyllin. ii, 93. Salicin, ii, 140. Sodium phosphate, ii, 79. Jaundice, epidemic. Sodium phosphate, ii, 308. Keloid. Chromic acid, i, 348. Ichthyol, i, 532._ Thiosinamine, ii, 381. Keratitis. Antipvonine i, 120. Aristdl, i, 140. Benzophenoneid, i, 179. Cadmium saliovlate injections, i, 200. Collodion, i. 394. Eserine, i, 392. 584 INDEX OP DISEASES AND REMEDIES. Eeratitig. Gallicin, i, 433. Suprarenal capsule, ii, 246. Tropacocaine, ii, 334. Keratitis, interstitial. Aristol, i, 140. Suprarenal capsule, ii, 346. Keratitis, phlyctaenular. Eserine, i, 393. Keratitis, ulceratiye. Eserine, i, 393. Keratosis of the soles and palms. Emol, i, 376. Labour. Ctiloral hydrate, i, 337. (second stage). Chloroform inhalation, i, 345. Ergot, ii, 55. Ether, i, 397. Glycerin (intra-uterine injections), i, 450. Hypnotism, i, 514. Nitrous oxide, ii, 18. Quinine, ii, 116. Quinosal irrigation, ii, 123. Labour, difficult. See Dystocia. Labour pains. Chloroform, i, 245. Glycerin (intra-uterine injections), i, 450. Hot douche, ii. 55. Labour, preliminary pains of. Baths, hot, i, 166. Labour, prolonged. Quinine, ii, 116. Lacrymation. Alumnol (in solution), i, 51. Exercise, vocal and respiratory, i, 417. Mydrol, ii, 447. Laryngismus stridulus. Bromoform, i, 196. Chloral hydrate, i, 337. Coniura, i, 398. Gelsemium, i, 437. Ipecac, i, 543. Muscarine, i, 645. Nitroglycerin, ii, 15. Quinine, i, 356 ; ii, 119. Laryngitis. Ammonium-chloride troches, i, 57. Asafoetida, i, 147. Benzoin, i, 178. Borax and honey, i, 189. Calomel powder, i, 635. Chromic acid (as a wash), i, 348. Conium vapour, i, 399. Creosote, i, 314. Cupric sulphate, i, 306. Fir-wool oil, ii, 88. Forinic-aoid compounds, i, 429. Ipecac, i, 543. Jaborandi (by spray), i, 560. Lactic acid, i, 507. Licorice and flaxseed, i, 581. Olibanum, ii, 34. Opium, fumes of, i. 539. Palmetto wine, ii, 58. Serum treatment, ii, 173, Silver nitrate, ii. 196. Tannigene, ii, 260. Thymol, ii, 284. Laryngitis. Waters, chlorinated alkaline, ii, 367. Zinc chloride, ii, 405. " sulphocarbolate, ii, 412. Laryngitis, acute. Benzoin and paregoric inhaled from steam- ing water, i, 538. Benzoin inhalation, i, 178. Conium-vapour inhalations, i, 299. Ipecac, i, 543. Waters, chlorinated alkaline, ii, 381. Laryngitis, catarrhal. Zinc sulphocarbolate, ii, 412. Laryngitis, chronic. Benzoin inhalation, i, 178. Cod-liver oil, i, 388. Creosote by inhalation, i, 314. Fir-wool oil inhalation, ii, 88. Silver nitrate, ii, 196. Waters, chlorinated alkaline, ii, 367. Zinc-chloride applications, ii, 405. Laryngitis, diphtheritic. Serum treatment, ii, 172. Laryngitis, pseudo-membranous. Cupric sulphate (as an emetic), i, 306. Laryngitis, subacute. Silver nitrate, ii, 196. Laryngitis, sypliilitic. Calomel powder (by insufflation), i, 635. Zinc sulphocarbolate, ii, 412. Laryngitis, tuberculous. Chlorophenols, i, 245. Diaphthol, i, 333. Formic-acid compounds, i, 429. lodol (by insufflation), i, 540. Lactic acid, i, 567. Pichi, ii, 82. Laryngorrhoea. Blennostasine, ii, 426. Laryngo-tracheitis. Waters, chlorinated alkaline, ii, 381. Lentigo. Borax (in 5-per-cent. solution), i, 189. Mercury bichloride, i, 636. Salicylic-acid ointment, ii, 144. Lepra, Leprosy. Calotropis. i, 303. Chaulmoogra oil, i, 333. Creolin, i. 312. Gurjun balsam, i, 462. Hoang-nan, i, 471. Hydrocotyle asiatioa, i, 498. Ichthyol, i, 533. Iron, reduced, i, 547. Mercury iodide and arsenic, i, 637. Orohitic liquid, i, 75. Serum, de Dios Carrasquilla's, ii, 184. " treatment, ii, 184. Testicle juice, i, 75. Thyreoid treatment, ii, 395. Zinc gynooardate, ii, 409. Lencatmla. Oxygen, ii, 53. Leucoplakia. Resorcin, ii, 126. Leucorrhoea. Arsenic, i, 146. Bismuth tannate, ii, 259. Borax and hot water (douche), i, 189. Carbonic water (douche), i, 314. INDEX OF DISEASES AND REMEDIES. 585 Leucorrhoea. Catechu injections, i, 221. Charcoal douche, i, 232. Copper-arsenite solution, i, 304. Cubeb, i, 319. Ephedra trifurcata, as a styptic, i, 385. Geranium (topically), i, 438. Helenin (as an antiseptic), i, 534. Hydrastine, i, 476. Iodine, externally, i, 536. Iron nitrate, i, 551. Kino, i, 565. Krameria, i, 566. Lysol, i, 590. M'atico, i, 611. Myrrh, tincture of, i, 651. Oak bark, ii, 31. Potassium permanganate, i, 597. Potassium permanganate (injections), ii, 70. Phosphoric acid, ii, 77. Pinus canadensis, ii, 88. Pulsatilla, ii, 107. Resorcin, ii, 126. Storax, ii, 228. Thymol, ii, 284. Trichlorphenol, ii, 330. Waters, mineral (injections), ii, 875, 383. Zinc acetate (as a local astringent), ii, 402. LencoiThoea, chronic. Waters, mineral, ii, 383. Leucorrhcea, chronic vaginal. Arsenic, i, 146. Leucorrhcea, mucous. Pulsatilla, ii, 107. Leucorrhoea, vaginal. Arsenic, i, 146. Hydrastine (as a douche), i, 476. Lice. See Phtheiriasis capitis. Lichen. Silver nitrate, ii, 196. Lichen sestivus. Salicylic acid, ii, 145. Lichen, itching of. Alkaline baths, i, 45. Lichen planus. Arsenic, i, 144. Lichen ruber. Arsenic, i, 144. Lithsemia. Ammonium chloride, i, 56. Calcium benzoate, i, 201. Lithium benzoate, i, 177. Nitric acid, ii, 8. Nitrohydrochloric acid, ii, 16. Sodium benzoate, ii, 204. " phosphate, ii, 79, 208. Water, flushing the alimentary and urinary tracts with, i, 479. Lithiasis. Actinomeris helianthoides, i, 11. Alisma, i, 43. Alkalies, i, 45. Alkaline mineral waters, i, 45. Soldo, i, 189. Corn silk, i, 306. Glycerin, i, 451. Lithium, i, 586. " benzoate, i, 585, 586. " carbonate, i, 586. Lithiasis. Lithium citrate, i, 586. Lycetol, i, 589. Piperazine, i, 586 ; ii, 89. Water, i, 586. " Carlsbad, i, 586. Waters, Buffalo lithia, i, 586 ; ii, 372. Waters, mineral, ii, 368, 377. Lithiasis, biliary. See Calculus, Biliaey. Lithiasis, urinary. Ammonium benzoate, i, 586. borate, i, 55, 586. Hydrochloric acid, i, 493, 586. Lithium benzoate, i, 585, 586. " carbonate, i, 586. citrate, i. 586. salts, i, 585. Nitric acid, i. 586 ; ii, 7. Pichi, i, 586 ; ii, 82. Piperazine, i, 586; ii, 89. Potassium acetate, i, 586 ; ii, 95. " bicarbonate, i, 586. Sodium and magnesium borooitrate, ii, 303. " bicarbonate, i, 586. borate, i, 189, 586. Sulphuric acid, i, 586. Triticum ripens, i, 586. Turpentine, oil of, i, 586. Water, i, 479. Liver, amyloid. Ammonium chloride, i, 57. Liver, chronic engorgement of the, and spleen. Baths, cold, i, 169. Liver, cirrhosis of the. See Cirrhosis oi' the liver. Liver, diseases of the. Baths, acid, i, 171. Colocynth, i, 296. Mineral acids, ii, 228. " cathartics, ii, 238. Nitrohydrochloric acid, ii, 16. Saline cathartics, ii, 228. Solanum paniculatum, ii, 210. Vichy water, ii, 358. Liver, disordered. Hunyadi Janos, i, 474. Sulphur, ii, 240. Water, i, 479. Waters, mineral, ii, 374. Liver, fatty. Ammonium carbonate, i, 56. Liver, functional disorders of the. Grape cure, i, 455. Hepatic douches, i, 349. Podophyllin, ii, 93. Liver, torpid. Alkaline carbonates, i, 45. Ammonium chloride, i, 56. Calomel, i, 624. Colocynth, i, 296. Sodium phosphate, ii, 79. " sulphate, ii, 208. Strychnine, ii, 28. Tartarlithine, ii, 265. Lochia, offensive. Thymol, ii, 284. Locomotor ataxia. Acetanilide, i, 8. 586- INDEX OP DISEASES AND REMEDIES. Locomotor ataxia. Antipyrine, i, 124. Baths, Nauheira, ii, 420. Cinchona, ii, 120. Erythrophloeine (hypodermically), i, 390. Paradaism, i, 367. (pains), Glyceropliosphates, ii, 439. Massage, i, 608. Orohitic liquid, i, 74. Phosphorus, ii, 76. Salicylic acid (for the pain), ii, 142. Salol", ii. 150. Silver and sodium hyposulphite, ii, 197. Spermine, ii, 217. Testicle juice, i, 74. Theine (for the relief of pain), ii, 277. Waters, mineral, ii, 374. Locomotor ataxia, fulgurant, or liglit- ning;, pains of. Acetanilide, i, 3. Antipyrine, i, 124. Lumbago. Anodyne colloid, i, 292. Apolysine, ii, 417. Capsicum paper, i, 209. Chloroform liniment, i, 241. Cimicifuga, i, 250. Exalgine, i, 403. Faradaism and galvanism, i, 367. Glycerophosphates, ii, 439. Massage, i, 608. Piperazine, ii, 89. Poultices, ii, 101. Spice bag, application of, i, 209. Salicin, ii, 140. Sulphur powder, ii, 241. Theine, ii, 277. Turpentine oil, ii, 336. Lupus. Aristol, i, 140. Arsenic, i, 144. Calcium chloride, i, 202. Camphor salicylate, ii, 455. Carbolic acid (parenchymatous injections), i, 213. ' Catramine, i, 226. Chromic acid, i, 248. Cod-liver oil and iron, i, 288. Europhene, in powder or ointment, 1, 402. Gold, i, 453, 454. Hydrocotyle asiatica, i, 493. Iodine, i, 536. Lysol. i, 590. Mercury bichloride (ointment), i, 115. " iodide and arsenic, i, 627. Phosphorus, ii, 77. Potassium permanganate, i, 115. Pyrogallio acid, ii. 111. Resorcin, ii, 126. Salicylated camphor, i, 204. Salicylic acid, ii, 144. Serum treatment, Maragliano's, ii, 184. Silver nitrate, ii, 196. Starch, iodized, i, 537. Tar, ii, 92. Teucrin, ii, 373. Thiol ointment, ii, 278. Thiosinamine, ii, 279, 280. Thyreoid treatment, ii, 294. Tuberculin, i, 81. Lupus. Zino-chloridc applications, ii, 404. Zinc nitrate, ii, 409. 457. " sulphide, ii, 411. Lupus erytliematosus. Arsenic, i, 144. Resorcin, ii, 126. Salicylic acid, ii, 144. Starch, iodized, i, 537. Thiosinamine, ii, 280. Zinc nitrate, ii, 409. " sulphide, ii, 411. Lupus vulgaris. Arsenic (arsenical caustics), i, 145, Silver nitrate, ii, 457. Teucrin, ii, 273. Thiosinamine, ii, 280. Lymphadenitis, chronic. Waters, ferruginous, ii, 369. Lymphadenomn. Zinc phosphide, ii, 407. Lymphangeitis. Baths, hot, i, 160. Picric acid, ii, 83. Lymphangeio-phlebitis. Ichthyol, ii, 443. Lymphoma. Arsenic, i, 144. Malarial cachexia. Quinine, i, 255. Malarial chills. Strophanthus, ii, 233. Malarial disease. Ammonium carbazotate, i, 55. Arsenic, i, 145. Baths, hot, i, 166. Bitters, i, 118. Calomel, i, 624. Coffee, black, i, 290. Eucalyptus, i, 118. Qelsemium. i, 437. Ipecac, i, 543. Iron citrate, i. 550. Jalap (resin), i, 560. Lantanine, i, 570. Liriodendron tulipifera, i, 585. Methylene blue, i, 630. Nueleins, ii, 24. Pambotano, ii, 58. Phenocoll, ii, 72. Phloridizin, ii, 74. Picric acid, ii, 83. Piperin, ii, 90. Piper nigrum, ii, 90. Podophyllin, ii, 98. Quinetum, ii, 113. Quinine, i, 255; ii, 117, 118. " with antidiphtheritic serum, ii, 174. Saligenin, ii. 147. Serum, antidiphtheritic, ii, 174. Waters, mineral, ii, 874. Malarial fever. See Pever, Malaeial. Malnutrition. Alcohol, i, 33. Baths, i, 169. Bitters, i, 183. Cod-liver oil, i, 388. INDEX OF DISEASES AND REMEDIES. 587 Malnntrition. Cream, i, 636. Egg and coffee, i, 355. Pats, i, 420. Lard inunctions, ii, 445. Linseed, i, 584. Maltose, i, 595. Somatose, i, 213. Mammitis. See Mastitis. Mania. Anhalonium Lewinii, ii, 416. Baths, hot, i, 166. Coniine (hypodermic injections), i, 299. Duboisine, i, 353. Gelsemium, i, 437. Gold, i, 453. Hyoscine, i. 508. Morphine, ii, 37. Phosphorus, ii, 76. Best-cure, ii, 127. Sulphonal, ii, 239. Urethane, ii, 342. Veratrum viride, ii, 353. Mania, acute. Duboisine, i, 353. Hyoscine, i, 508. Rest-cure, ii. 127. Sulphonal, ii, 239. Veratrum viride. ii, 353. Mania, liysterical. Bath, hot, i, 166. Mania, {tuerperal. Duboisine, i, 353. Mania, suicidal. Gold, i, 453. Mania witli excitement. Gelsemium, i, 437. Morphine and hvoscine hydrobromide, ii, 37. Water to the head in form of a douche, i, 349. Marasmus (of children). Cod-liver-oil inunctions, i, 288. Marasmus (of young infants). Wine, port, ii, 393. Mastitis. Belladonna ointment, i, 173. Camphorated oil, i, 204. Phytolacca, ii, 81. Tartar emetic, i, 114. Mastodynia. Galvanization, anodal, i, 367. Masturbation. Antaphrodisiacs, i, 90. Belladonna, i, 90. Hypnotism, i, 515. Lactuearium, i, 90. Malt liquors, i, 90. Measles. Aconite, i, 9. Alkaline baths, i, 44. Antipyrine, i, 12.3. Cod-liver oil, i, 288. Saffron tea (as a diaphoretic), ii, 269. Serum treatment, ii, 178. Sparteine, ii, 316. Sulphur ointment, ii, 341. Megrim. See Migraine. 81 Melancholia. Anhalonium Lewinii, ii, 416. Antikamnia, i. 111. Chlorobrora, i, 240. Cocaine (internally), i, 284. Coniine, i, 299. Exalgine, i, 403. Faradization, i, 367. Iron chloride (tincture), i, 549. Nitrous-oxide inhalation, ii, 18. Phosphorus, ii, 76. Rest-cure, ii, 127. Somnal, ii, 313. Sulphonal, ii, 239. Thyreoid treatment, i, 79 ; ii, 299. Melanclioliii, acute. Somnal, ii, 213. Melancholia, headache of. Bxalgine, i, 403. Melancholia, simple. Chlorobrora, i, 240. Melancholia, stuporous. Faradization, general, i, 367. Melancholia, suicidal. Thyreoid treatment, ii, 291. Meniere's disease. Pilocarpine, ii, 87. Quinine, ii, 120. Meningitis. Aconite, i, 9. Belladonna, i, 175. Blisters, i, 185. Bloodletting, i, 189. Croton oil, i, 318. Cupping, i, 320. Ethyl chloride, ii, 434. Ice bag, i, 520. Iodoform, i, 537. Laurel, i, 571. Leeching, i, 579. Morphine (hypodermically), i, 67. Muscarine, i, 645. Pulsatilla, ii, 107. Quinine, i, 256. Meningitis, acute cerebral. Pulsatilla, ii, 107. Meningitis, cerebral. Blisters (over the mastoid process), i, 185. Cold batli, i, 488. Meningitis, cerebro-spinal. Laurel (extract), i, 571. Belladonna, i. 175. Blisters (at the nape of the neck), i, 185. Pulsatilla, ii, 107. Meningitis, tuberculous. Croton oil, by application to the head, i, 318. Meningocele. Collodion, i, 294. Menorrhagia. Aloes, i, 49. Arsenic, i, 146. Bromides, i, 194. Canella, i, 206. Cantharides, i, 308. Conium suppositories, i, 398. Cornutine, i, 307. Digitalis, i, 343. Electricity, i, 368. Erigeron, oil of, i, 390. 588 INDEX OF DISEASES AND REMEDIES. Menorrhagia. Heat applied to the spine, i, 469. Hydrastis, i, 476. Ipecac, i, 543. Iron nitrate, i, 551. Lemon-juice, i, 360. Matioo, i, 611. Salipyrine, ii, 149. Savine, ii, 157. Steam, ii, 233. Styptiein and Hydrastis, ii, 233. Tannic acid, ii, 357. Viburnum prunifolium, ii, 356. Visoum album, ii, 361. Waters, Buffalo lithia, ii, 373. " mineral, ii, 375. Menorrhagia, atonic. Savine, ii, 157. Menorrhagia, congestiye. Styptiein and hydrastis, ii, 333. Menorrliagia occurring during preg- nancy. Canella, i, 306. Menorrhagia of nervous origin. Bromides, i, 194. Menorrhagia, ovarian. Conium suppositories, i, 298. Menstrual disorders. Hydrastis, i, 476. Hypnotism, i, 515. Iron carbonate, i, 547. Senecio, ii, 163, 456. Mental distress. Sulphonal, ii, 239. Mental hehctude. Cocaine, i, 283. Mental strain, prolonged. Bromides, ii, 6. Mercurialism. Waters, sulphuretted, ii, 371. Metritis. Arnica, fluid extract of, i, 141. Baths, hot, i, 166. Calcium carbide, ii, 427. Carbonic water (douche), i, 214 Electricity, i, 368. Traumato"l, ii, 329. Waters, mineral, ii, 381. Metritis, chronic. Arsenic, i, 146. Gold, i, 453. Ichthyol, i, 523. Metritis, puerperal. Creosote, i, 314. Metrorrhagia. Baths, hot, i, 166. Cornutine, i, 307. Digitalis, i, 342. Electricity, i, 368. Ergot, i, 388. Brigeron, oil of, i, 390. Faradization, i, 368. Gallic acid, i, 432. Heat applied to the spine, i, 469. Hydrastis, i, 476. (due to fibroid tumours of the uterus), Rhus aromatica, ii, 131. Salicylic acid (on tampons), ii, 143. Salipyrine, ii, 149. Steam, ii, 222. Metrorrhagia. Viburnum prunifolium, ii, 356. Metrorrhagia of chlorosis. Canella, i, 206. Migraine. Aoetanilide, i, 3. Amyl nitrite, i, 61. " valerianate, i, 63. Antikamnia, i, 111. Antipyrine, i, 124. (congestive form), Bromides, i, 194. Caffeine, i, 301. " and antipyrine, i, 201. Camphor, i, 205. Carbonic-acid gas, i, 214. Cicuta maculata, i, 250. Coffee, i, 290. Cytisus laburnum, i, 333. Damiana, i, 324. Digitalis, i, 342. Ethoxycaffeine, i, 398. Ethyl chloride (by spray), ii, 484. Euphorin, i, 402. Bxalgine, i, 403. Galvanism, i, 367. Guarana, i, 461. Ipecac, i, 542. Laurel, i, 571. Massage of the neck, 608. Methoxyeaffeine, i,.628. Migrainin, i, 631. Nitroglycerin, ii, 15. Phenacetine, ii, 71. Pulsatilla, ii, 107. Quinine, ii, 120. Salol, ii, 150. Salophene, ii, 151. Sodium salicylate, ii, 146. Mitral insufficiency. Air, condensed, expiration into, i, 38. " inspiration of condensed, i, 38. Digitalis, i, 341. Morphine (subcutaneously), ii, 36. Quebracho, ii, 113. Sodio-theobromine salicylate, ii, 203. Mollifies ossium. Calcium phosphate, i, 803. MoUuscnm contagiosum. Silver nitrate, ii, 196. Myalgia. Aoetanilide, i, 3. Camphor liniment, i, 204. Iron hydrate, i, 552. Salipyrine, ii, 148. Theine, ii, 277. Veratrine, ii, 350. Mydriasis. Eserine, i, 392. Mydriasis following diphtheria. Eserine, i, 392. Myelitis. Ice bag, i, 520. (acute forms). Belladonna, i, 175. Galvanism, i, 367. Myelitis, chronic. Baths, warm, i, 489. Myocarditis. Sodio-theobromine salicylate, ii, 203. Myomata, uterine. Thiosinamine, ii, 281. INDEX OP DISEASES AND REMEDIES. 589 Myopathy. Thyreoid treatment, ii, 298. Myositis. Massage, i, 608. Myxoedema. Thyreoid treatment, i, 78 ; ii, 389. Nsevus. Arsenic, i, 145. Bichloride-o£-meroury collodion, i, 392. Carbolic-acid injections, i, 313, Chromic acid, i, 848. Collodion, salicylic- and lactic-aoid, i, 393. Creosote as a caustic, i, 314. Mercury bichloride, i, 686. Monochloraoetic acid, i, 335. Trichloracetic acid, i, 885. Narcotism. Ammonia inhalation, i, 53. water (after gastric lavage), i, 58. Cold affusions, i, 17. Electricity (as a stimulant), ii, 236. Ether (subcutaneously), ii, 337. Naso-pliaryngitis. Silver nitrate, ii, 195. Nausea. Apomorphine, i. 98. Carbolic acid and bismuth, i, 313. Carbonic-acid gas in carbonated waters, i, 98. Champagne, iced, i, 99 ; ii, 835. Chloroform (internally), i, 99. Copper sulphate, i, 98. Placourtia, i, 483. Iodine, i, 536. Ipecac, i, 98. Kephir, i, 98. Kumyss, i, 98. Lactucariura, i, 568. Limewater and milk, i, 98. Matzoon, i, 98. Milk and limewater, i, 98. " and sodium bicarbonate with cerium oxalate, i, 98. Mustard plaster (applied to the stomach), i, 647. Nutmeg, ii, 35. Peppermint poultice, i, 618. Sodium tartrate, ii, 309. Zinc sulphate, i, 98. Nansea of drunkards. Hydrochloric acid, i, 100. Nausea, persistent. Blisters, small flying (to the abdomen), i, 186. Necrosis of bone. Calcium chloride, i, 303. Cod-liver oil, i, 388. ; Hydrochloric acid, ii, 441. Hypophosphites, i, 518. Waters, chlorinated, ii, 366. Xeroform, ii, 397. Necrosis, tuberculous. Hydrochloric acid, ii. 441. Neoplasms of tlie skin. See Keloid and Lupus. Nephritis. Baths, hot, i, 489. " hot-air, i, 468. Nephritis. Caffeine, i, 301. Diet in, i, 338. Gallic acid, i, 433. Guaiacol, i, 459. Iron, i, 548, 551. Jaborandi, i, 559. Milk, i, 338, 637. Morphine, ii, 87. Neurodin, ii, 7. Nitrites, ii, 13. Veratrum viride, ii, 353. Water, i, 105, 586. Waters, ii, 364, 374, 379. Buffalo lithia, ii, 373. Nephritis, acute. Guaiacol, i, 459. Pyoctanine (internally), ii, 109, Sodio-theobromine salicylate, ii, 303. Nephritis, acute parenchymatous. See Beiqht's disease. Nephritis, chronic. Caffeine, i, 801. Corn silk, i, 306. Glycerophosphates, ii, 489. Guaiacol, i, 459. Hydrastine, i, 476. Iron, i, 551. Pyoctanine, ii, 109. Sodio-theobromine salicylate, ii, 303, 203. Terpin hydrate, ii, 378. Zinc sulphoichthyolate, ii, 418. Nephritis, chronic desquamative, Cantharides, i, 808. Nephritis, chronic diffuse. See Nephritis, Interstitial. Nephritis, gastro-intestinal. Kephir, i, 687. Nephritis, interstitial. Kephir, i, 637. Milk, i, 637. Strontium lactate, ii, 330. Terpin hydrate, ii, 330. Nephritis, mixed. Strontium lactate, ii, 830. Nephritis, parencliymatous. Milk, i, 637. Strontium lactate, ii, 839, 380. Nephritis, scarlatinal. Waters, Buffalo lithia, ii, 372. Nephrydrosls. Aspiration, i, 151. Nerve tracts, painful. Collodions, sedative, i, 393. Nervous affections, Nervous 'conditions, Nervous disorders, Nervousness. Aconite tincture, i, 9. Anhalonium Lewinii, ii, 416. Camphor, i, 305 ; ii, 6. Cimicifuga, i, 350. Codeine, i, 386. Hyoscyamine, i, 504. Massage, i, 607. Quinine tannate, ii, 359. " valerianate, ii, 347. Sanguinal, ii, 154. Strychnine, ii, 7. Valerian, ii, 6, Nervousness from dysmenorrhoea. Camphor, ii, 6. 590 INDEX OP DISEASES AND EEMEDIES. Nervousness from irritation of tlie sexual organs. Bromides, ii, 6. Nervousness of tlie menopause. Valerian, ii, 345. Neuralgia. Acetanilide, i, 3, 69. Aconite, i, 9. Aconitine, i, 11. Agathin, i, 17. Alcohol, i, 33. Ammonia (locally), i, 53. Ammonium valerianate, ii, 346. Amydophenine, ii, 415. Amyl nitrite, i, 69. " valerianate, i, 63. Analgene, i, 66. Anodyne colloid, i, 293. Antikamnia, i, 113. Antipyrine, i, 69. Antitetraizine, i, 134. Apolysine, ii, 417. Apone, i, 139. Arsenic, i, 146. (of ansemia). Arsenic and iron, i, 68. Asaprol, i, 69, 148. Atropine, i, 154. Baths, hot-air, i, 168. " mud, i, 172. Belladonna, i, 69, 174. Blisters, i, 186. Bromal hydrate, i, 191. Bromides, i, 1C9. Caffeine, i, 301. Cajepnt, i, 301. Camphor sassafras, ii, 138. Camphorated chloral (locally), i, 335. Canella, i, 207. Cannabis indica, i, 307. Capsicum paper, i, 309. Carbolic acid (topically), i, 313. Cautery, actual, i, 226. Chloralamide, i, 238. Chloral caffeine (hypodermioally), i, 335. Chloroform liniment, i, 241. Cimioifuga, i, 250. Cocaine, i, 69. Cod-liver oil, i, 68. (of impaired nutrition), Cod-liver oil, i, 68, 288. Coffee, i, 390. Conium, i, 399. Copper, ammoniated, i, 803. Croton chloral, i, 69. Damiana, i, 324. Delphinine, ii, 231. Electricity, i, 68, 367. (of impaired nutrition). Electricity, i, 68. Bserine, i, 392. Ethyl bromide, internally, i, 399. Exalgine, i, 403. Paradization, i. 367. Gelsemium. i, 437. Hydrobromic acid, i, 493. Hydrotherapy, i, 68. (of impaired' nutrition), Hydrotherapy, i, 68. Hyoscyamus, i, 505. Ignipunctnre, i, 534. Iron chloride, i, 549. Neuralgia. Iron lactate, i, 68. " pyrophosphate, i, 68. Malakin, i, 593. Massage, i, 68, 608. (of impaired nutrition). Massage, i, 68, 608. Meconarceine, i, 611. Menthol, i, 614. " plaster, i, 614. Methoxycaffeine, i, 628. Methyl chloride, i, 69. Methylal (inhalation of), i, 69, 629. Methylene blue, i, 680. Mustard plaster, i, 647. Neurodin, ii, 7. Nitroglycerin, i, 69. Nutmeg oil (as a rubefacient), ii, 35. Nux vomica, i, 68. Opium, i, 69. Osmic acid, ii, 47. Peppermint oil, i, 613. Phenacetine, i, 69 ; ii, 71. Phenocoll, ii, 73. Phenylacetamide, ii, 73. Phosphorus, i, 68. Piscidia, ii, 01. Potassium cyanide, i, 832. (due to lead). Potassium iodide and bromide, i, 69. Poultices, ii, 101. (without malaria). Quinine, i, 68 ; ii, 118. Rest, absolute, i, 68. Saliein, ii, 140. Salicylamide, ii. 141. Salicylic acid, ii, 143. Salipyrine. ii, 148. Salix," ii, 149. Salophene, ii, 151. Silver oxide, ii, 197. Sodium salicylate, ii, 146. Solanin, ii, 209. Spermine, ii, 217. Strychnine, i, 68. (of impaired nutrition). Strychnine, i, 68; ii, 28. Sulphur fumigation, i, 430. Theine, ii, 277. Turpentine oil (locally), ii, 336. Veratrine, ii, 350. Waters, sulphuretted (externally and inter- nally), ii. 871. Wines', ii, 894. Zinc cyanide, i, 333 ; ii, 408. " sulphichthyolate (as a liniment), ii, 412. Zinc valerianate, i. 68 ; ii, 347. Neuralgia, abdominal. Galvanization, i, 366. 368. stabile, i, 366. Neuralgia, acute. Wines, ethereal, ii, 394. Neuralgia, astlienic. Phosphorus, ii, 76. Neuralgia, cervico-brachial. Galvanization, stabile anodal, i, 360. Neuralgia, chronic. Baths, hot-air, i, 168. Neuralgia, congestive. Aconite, i, 69. Bromides, i, 69. INDEX OP DISEASES AND REMEDIES. 591 Neuralgia, facial. Butyl-chloral hydrate, i, 197. Salipyrine, ii, 148. Sodium salicylate, ii, 146. Neuralgia, gastric. Silver oxide, ii, 197. Neuralgia, intercostal. Osmic-aoid injections, ii, 47. (occurring after influenza), Pyramidone, ii, 454. Neuralgia, intermittent. Quinine, ii, 118. Neuralgia, malarial. Methylene blue, i, 68. Quinine, ii, 120. Neuralgia of anaemia. Iron chloride (tincture), i, 549. Neuralgia of the bladder. Baths, hot sitz, i, 169. Neurodin, ii, 7. Neuralgia of the eyeball. Eserine, i, 393. Neuralgia of the stomach. Neurodin, ii, 7. Neuralgia, ovarian. Bromides, i, 194. Cannabis indica, i, 67. Croton-oil applications to the abdomen, i, 318. Gelsemium, i, 69. Douche, hot, i, 480. Salicylamide, ii, 141. Neuralgia, peripheral. Salicylamide, ii, 141. Sodium salicylate, ii, 146. Neuralgia, sacral. Galvanism, i, 367. Neuralgia, superficial. Veratrine, ii, 850. Neuralgia, syphilitic. Potassium iodide and mercury, i, 69. Neuralgia, trigeminal. Amyl nitrite, i, 64. Butyl-chloral hvdrate, i, 69. Electricity, i, 867. " with analgetic agents, i, 69. Gelsemium, i, 69. Glycerophosphates, ii, 439. Methyl chloride, i, 69. Nitroglycerin, ii, 15. Quinine, ii, 120. Salipyrine, ii, 148. Neuralgia, uterine. Arsenic, i, 146. Belladonna and opium, i, 67. Bromides, i. 194. Salix, ii, 149. Neurasthenia. Anhalonium Lewinii, ii, 416. Bath, cold, i, 165. " half, i, 168. Baths, sheet, i, 169, 490. Brain extract, i, 80. Cephalic douches, i, 349. Chamomile, i, 231. Chloralose, i, 239. Coca (as an adjunct), i, 274. Cocaine (internally), i, 284. Cold baths, i, 488. Electricity, i, 366. Faradization, general, i, 367. Neurasthenia. Glycerophosphates, ii, 439, Hydrochloric acid, i, 493. Nueleins, ii,- 25. Orchitic liquid, i, 76. Oxygen, ii, 52. Phospho-albumin, ii, 74. Quinine, ii, 130. Rest-cure, ii, 137. Sanguinal, ii, 154. Sea air, ii, 275. Serum, artificial, ii, 168, 164. Sodium phosphate (subcutaneous injections), ii, 208. Spermine, ii, 217. Sterculia, ii, 233. Sumbul, ii, 348. Suprarenal capsule, ii, 245. Testicle juice, i, 76. Trional (for insomnia), ii, 883. Waters, chlorinated, ii, 365. " ferruginous, ii, 869. " mineral, ii, 364, 377, 879. Neuritis. Acetanilide, i, 8. Belladonna and morphine injections, i, 67. Paradaism and galvanism, i, 367. Phenacetine, ii, 71. Salol. ii, 150. Neuritis, acute. Baths, warm, i, 489. Neuritis, multiple. Pyramidone, ii, 454. Neuritis, peripheral. Salicylic acid, ii, 142. Waters, thermal (externally and internally), ii, 364. Neuroma. Cocaine cataphoresis, i, 367. Neuroses. Alcohol, i, 33. Waters, Buffalo lithia. ii, 372. " mineral, ii, 384. Wine, ii, 894. Neuroses, professional. Paradaism and galvanism, i, 367. Duboisine, i, 358. Neuroses with mental depression. Ergot and sodium phosphate, i, 389. Night sweats. See Sweats, Night. Night terror of children. Trional, ii, 332. Nipples, retraction of the. Collodion, i, 294. Nipples, sore. Alcohol, i, 31. Borax, i, 189. Catechu, i, 331. Copper arsenite, i, 304. lehthyol, i, 523. Lead nitrate, i, 578. " water, i, 577. Silver nitrate, ii, 195. Tannin, i, 256. Nodes. Mercury plaster, i, 633. Vasogen, ii, 349. Nosebleed. See Epistaxis. 592 INDEX OF DISEASES AND REMEDIES, Nutritional disorders, Nutrition, per- verted (of children). See Malnutrition. Nymphomania. Treatment of, i, 90. Obesity. Bantmgism, i, 160. Baths, condensed-air, i, 28. hot-air, i, 168. Diet, i, 338. Exercise, i, 415. Glycerophosphates, ii, 439. Iodoform, i, 537. Permanganates, ii, 70. Saccharin, ii, 138. Thyreoid treatment, i, 79 ; ii, 295. Obesity, anaemic. Thyreoid treatment, ii, 295. Occlusion, intestinal. Aspiration, i, 153. (Edema of the glottis. Copper-arsenite solution, i, 304. Scarification, ii, 158. (Edema, pulmonary. Infusion, intramuscular, ii, 325. Jaborandi, i, 559. Strophanthus, ii, 231. (Esophagitis. Copper arsenite, i, 305. Oligemia. Marrow, extract of bone, i, 81. Onanism. See Masturbation. Onychia. Lead nitrate, i, 578. Onychia, malignant. Mercury bichloride, i, 626. Zinc sulphate and corrosive sublimate, i, 238. Oophoralgia. See Neuralgia, Ovarian. Oophoritis. Arsenic, i, 146. Baths, hot sitz, i, 169. Blisters, i, 185. Electricity, i, 368. Pulsatilla, ii, 107. Ophthalmia. Iodine, externally, i, 536. Iron sulphate, i, 549. Ophthalmia, acute. Cadmium sulphate, i, 300. Ophthalmia, blennorrhagic. Quinine, ii, 120, Ophthalmia, chronic. Cadmium sulphate, i, 800. Ophthalmia, gonorrhoeal. Bserine, i, 393. Pulsatilla, ii. 107. Quinine (as a lotion), ii, 130. Silver-nitrate solutions, i, 295. Ophthalmia neonatorum. Copper arsenite, i, 305. Bserine, i, 393. Silver nitrate, i, 295 ; ii, 194. Ophthalmia, phlyctainular. Benzophenoneid, i, 179. Mercury oxide (ointment), i, 683. Ophthalmia, purulent. Cadmium salicylate injections, i, 200. Ophthalmia, purulent. Collodion, i. 294. Pulsatilla, ii, 107. Orchitis. Baths, hot, i, 166. Collodion, i, 294. Ice bag, i, 520. Iodine, externally, i, 586. Leeching, i, 579. Mercury ointment, i, 622. Pulsatilla, ii, 107. Tartar emetic, i, 114. Orthopnoea. Electricity (as a stimulant), ii, 386. Osteomalacia. Phosphates, ii, 78. Phosphorus, ii, 77. Osteomyelitis, rheumatic. Ephedra, i, 385. Osteomyelitis, tuberculous. Sulphur, ii, 341. Otalgia. See Earache. Otitis. Aconite, i, 8. Blisters, i, 185. Copper arsenite, i, 804. lodol, i, 540. Menthol oil, i, 616. Leeching, i, 579. Mentho-phenol, i, 616. Potassium permanganate, 1, 597. Otitis, acute. Aconite, i, 8. Otitis, external. Brucine, ii, 339. Silver nitrate, ii, 195. Otitis externa dilfnsa. Copper arsenite, i, 304. Otitis media. Blisters, i, 185. lodol (by insufflation), i, 540. Menthol oil, i. 616. Pulsatilla, ii, 107. Tannigene, ii, 360. Otitis media, chronic purulent. Oxygen, ii, 451. Pyrozone, ii, 455. Thioform, ii, 378. Zinc-chloride applications, ii, 405. Zinc subgallate, ii, 411. " snlphooarbolate, ii, 413. Otitis, purulent. Potassium permanganate (as a spray), i, 597. Otorrhoea. Boric acid, i, 190. Cadmium sulphate, i, 300. Creosote, i. 314. Diaphtherin, i, 382. Hydrastis, i, 476. Permanganates (injections), ii, 70. Pyoctanine, ii, 108. Salufer. ii, 456. Otorrhoea, chronic. Salufer, ii, 456, Otorrhtea, foetid. Creosote, i, 314. Ovarian pains. See Neuralgia, Ovarian. INDEX OF DISEASES AND REMEDIES. 693 OTaritis. See Oophoritis. Oxaluria. Nitric acid, ii, 8. Oza)na. Boric acid (saturated solution), i, 191. Carbolic acid, i, 213. Chloracetic acid, i, 234. Diaphtherin, i, 332. Europhene. by insufflation, 1, 403. Gold, i, 453. Hydrastis, i, 476. Iodine (externally), i, 536. Naphthol, camphorated, ii, 2. Oxygen, ii, 451. Ozone inhalation, ii, 58. Permanganates (injections), ii, 70. Potassium permanganate (as a spray), i, 597. Salicylic acid (douche), ii, 143. Salubrine, ii, 152. Silver nitrate, ii, 195. Tannoform powder, ii, 260. Zinc oleostearate, ii, 409. Ozsena, chlorotic. Oxygen, ii, 451. Ozxna, syphilitic. Carbolic acid, i, 213. Europhene, i, 402. Hydrastis, i, 476. Oxygen, ii, 451. Zinc oleostearate, ii, 409. Pains, preliminary, of labour. See under Labour. Pains, uterine. Cannabis indioa, i, 67. Chloralose, i, 239. Palpitation of the heart. Aconite (tincture), i, 9. Ammonium valerianate, ii, 346. Cereus grandiflorus, i, 229. Digitalis, i, 343. Thymus extract, ii, 385. Palsy. See Paralysis. Fannus. Antipyonine, i, 130. Jequirity, i, 563. Panophthalmitis. Antipyonine (strong solution), 1, 130. Papillomnta. Acetic acid, i, 5. Alumnol, i, 51. Arsenic, i, 337. Carbolic acid, i, 213. Caustics, i, 336, 337. Chloracetic acid, i, 334. Chromic acid, i. 348. Europhene, in powder or ointment, i, 403. Lactic acid, i, 568. Nitric acid, i, 337 ; ii, 7. Zinc chloride, ii, 403. Paralysis. Ammonium formate, i, 57. Baths, pine, i, 173. " sand, i, 173. Brain extract, i, 80. Croton-oil applications, i, 318. Electricity, i, 365, 367. Paralysis. Massage, i, 489, 608. hydraulic, i, 603. Muscarine, i, 645. Pelletierine, ii, 65. Phosphorus, ii, 76. Pyrethrum, ii, 108. Sodium phosphate, ii, 308. Strychnine, ii, 38, 39. Waters, thermal, ii, 364. Paralysis agitans. Barium chloride, i, 163. Baths, warm, and massage, i, 489. Chloral hydrate, i, 237. Conium, i, 898. Hyoscine, i, 504. Hyoscyamine, ii, 443. Phosphorus, ii, 76. Picrotoxin, ii, 84. Viburnum prunifolium, ii, 367. Paralysis, bulbar. Brain extract, i, 80. Paradaism or galvanism, i, 366. Paralysis, cerebral. Phosphorus, ii, 76. Waters, thermal (externally and internally), ii, 364. Paralysis, deltoid (circumflex nerve). Faradaism, i, 366. Paralysis, diphtheritic. Faradaism or galvanism, i, 366. Strychnine, ii, 38. Paralysis, Erb's. Faradization or galvanization, i, 366. Paralysis, facial. Faradization or galvanization, i, 366. Paralysis, functional. Croton-oil applications to the spine, i, 318. Paralysis, hysterical. Strychnine, ii, 39. Paralysis, infantile. Veratrine, ii, 350. Paralysis, lead. Baths, sulphur, i, 173. Electricity, i, 577. Epsom salts, i, 577. Iodine, i, 577. Potassium iodide, ii, 98. Waters, mineral, ii, 364. Paralysis, local. Strychnine (hypodermically), ii, 28. Paralysis, musculo-spiral. Faradization, i, 367. Paralysis of respiration. Atropine, i, 87. Paralysis of the bladder. See Paralysis, Vesical. Paralysis of tlie extremities. . Baths, warm, and massage, i, 489. Paralysis of the third and fourth cranial nerves. Pelletierine, ii, 65. Paralysis of the tong'ue. Pyrethrum, ii, 109. Paralysis of toxic origin. Waters, thermal (externally and internally), ii, 864. Paralysis, peripheral. Waters, thermal (externally and internally'), ii,364. " 594 INDEX OF DISEASES AND REMEDIES. Paralysis, progressive general, of the in- sane. Baths, tepid, i, 489. Paralysis, progressive myopathic. Sodium phosphate, ii, 208. Paralysis, pseudohypertrophic. Galvanization, local, i, 367. Paralysis, reflex. Ammonium formate, i, 57. Paralysis, vesical. Faradization, vesical, i, 367. Strychnine, ii, 38. Parametritis. Eucasin, ii, 436. Water, hot-, douches, ii, 313. Parametritis, acute. Baths, hot sitz, i, 489. Parametritis, chronic. Ichthyol, 1, 523. Massage (Brandt's method), i, 609. Paraplegia, ataxic. Galvanism, i, 366. Parasites. Bromide, i, 445. Hydrogen peroxide, i, 115. Mercury chloride, i, 626. Picrotoxin, ii, 84. Rectal injections of water, i, 480. Parasites, sliin. Bromine (locally), i, 445. Camphor salicylate, ii, 455. Carbolic acid, i, 212. Chrysarobin, i, 248. Mercury, red oxide of (ointment), i, 628. " sozoiodolate, ii, 215. Sodium diiodosalioylate, ii, 146. Sfaphisagria, ii, 221. Paresis, general. Thyreoid treatment, ii, 391. Paresis, muscular. Ammonium formate, i, 57. Paresis of the bladder. Baths, cold, i, 169. Paresis of tlie brain. Phosphorus, ii, 76. Paresis, vaso-motor. Massage, i, 608. Paronychia. Sanoform, ii, 154. Xeroform, ii, 397. Pavor nocturnus. See Night teerok of children. Pediculi capitis. See Phtheibiasis capitis. Pediculi pubis. See Phtiieiriasis pubis. Pediculosis. See Phtheibiasis. Pediculus corporis. See Phtheibiasis coeporis. Pemphigus. Arsenic, i, 144. Bath, hot, i, 166. Belladonna, ii, 425. Tumenol oil and oxide of zinc, ii, 334. Pemphigus vegetans. Baths, cold (permanent or continuous im- mersion), i, 488. Perforation of Shrapnell's membrane. Styrone, ii, 334. Pericarditis. Aspiration, i, 150, 151. Digitalis, i, 343. Hellebore, white, i, 470. Ice applications, i, 520. Poultices, ii, 101. Sodio-theobromine salicylate, ii, 303. Somatose, ii, 213. Pericarditis, acute. Infusion, ii, 324. Perimetritis. Baths, hot sitz, i, 489. Douches, hot-water, ii, 213. " uterine, i, 349. Ichthyol, i, 533. Peritonitis. Arsenic, i, 147. Baths, narcotic, i, 173. Blisters, i, 185. Bloodletting, i,. 188. Ether, camphorated, i, 304. Ice applications, i, 520. Naphthol, ii, 3. Opium, ii, 38. Poultices, ii, 101. Salicylated camphor, i, 304. Salines, ii, 147. Stupes, hot, with oil of turpentine applied to the abdomen, ii, 833. Turpentine stupes, i, 312; ii, 335. Veratrum viride, ii, 353. Peritonitis, acute. Aconite, i, 9. Infusion, intravenous or subcutaneous, ii, 335. Mercury ointment, i, 633. Opium, ii, 87, 88. Salines, ii, 147. Peritonitis, pelvic. Arsenic, i, 147. Baths, hot sitz, i, 489. Douches, hot-water, ii, 313. Ichthyol, i, 533. Peritonitis, puerperal. Veratrum viride (to reduce vascular excite- ment), ii, 353. Peritonitis, tuberculous. Air, hot (by insuflflation), i, 533. Naphthol, ii, 2. Pyramidone, ii, 454. Pertussis. See Whooping-cough. Petit mal. Valerian, ii, 345. Viburnum prunifolium, ii, 357. Phagedajna. Bromine, i, 195, 337. Carbolic acid, i, 318. Europhene, i, 402. Hydrogen dioxide, i, 508. Iodoform, i, 536. Mentho-phenol, i, 616. Mercury nitrite, i, 628. Nitric acid (fuming), i, 227 ; ii, 7. Pyrogallic acid, ii. 111. Resorcin, ii, 126. Silica, hydrated, ii, 191. Xeroform, ii, 397. Pharyngitis. Ammonium-chloride troches, i, 57. INDEX OP DISEASES AND REMEDIES. 695 Pharyngitis. Boric acid (saturated solution), i, 191. Chromic acid, i, 248. " " applications, i, 348. Cod-liver oil, i, 388. Copper arsenite, i, 305. Ipecac, i, 542. Iron, i, 546. Licorice and flaxseed, i, 581. Nuclein, yeast, ii, 34. Potassium chlorate, ii, 96. Resorcin, i, 534. Sodium bicarbonate, i, 534. " chloride (as a gargle), ii, 307. " salicylate, i, 534. Tannigene, ii, 260. Thymol, ii, 284. Zinc sulphocarbolate, ii, 412. Pharyngitis, acute. Glycerin and carbolic acid, i, 450. Phosphate of sodium, ii, 260. Tannigene, ii, 26. Pharyngitis, chronic. Silver nitrate, ii, 195. Sodium phosphate, ii, 360. Tannigene, ii, 360. Waters, chlorinated alkaline, ii, 367. Zinc-chloride applications, ii, 405. Pharyngitis, follicular. Palmetto wine, ii, 58. Pharyngitis, gangrenous. Cupric-sulphate solution, i, 306. Pharyngitis, granular. lodol (by insufflation), 1, 540. Pharyngo-laryngitis. Camphor and sweet-almond oil (internally), i, 305. Phimosis. Sanofonn, ii, 154. Phlebitis. Baths, hot, ii, 166. Phlebitis, puerperal. Veratrum viride, ii, 353. Phlegmasia alba dolens. Baths, hot, i, 166. Phlegmons. Serum, antistreptococcus, ii, 175. Phlegmons, iliac. Aspiration, i, 153. Phosphaturia. Phosphoric acid, ii, 77. Photophobia. Atropine, i, 155. Eserine, i. 392. Lactic acid, i, 568. Phtheiriasis. Arsenic, i, 145. Bromine, i, 445. Carbolic acid, i, 116. Kerosene oil, i, 116. Larkspur, i, 116 ; ii, 331. Mercury bichloride, i, 116. Mercury oleate, i, 116. Naphthol, i, 116. Staphisagria, i, 116; ii, 221. Vinegar, i. 116. Phtheiriasis capitis. Acetic acid, i, 116. Carbolic acid (alcoholic solution), i, 116. Cocculus indicus (decoction), i, 116. Phtheiriasis capitis. Kerosene oil, i, 116. Larkspur (decoction or tincture), i, 116. Mercury, ammoniated, ointment, i, 110. " oleate and ether, i, 116. " bichloride, i, 116. Kaphthol (5-per-eent. solution in oil), i, 117 Staphisagria. i, 116 ; ii, 221. Steam, i, 116. Veratrine, ii, 350. Vinegar, common, i, 116. Phtheiriasis corporis. Bromine, i, 445. Carbolic acid, i, 212. Chrysarobin, i, 116, 243. Mercury chloride, i, 626. " red oxide of, i, 623. " sozoiodoiate, ii, 215. Sodium diiodosalicylate, ii, 146. Phtheiriasis pubis. Acetic acid, i, 116. Carbolic acid, i, 116. Kerosene oil, i, 116. Larkspur, i, 116; ii, 231. Mercury bichloride, i, 116. oleate, i, 116. Naphthol, i, 116. Staphisagria, i, 116 ; ii, 331. Vinegar, i, 116. Phthisis. See Tuberculosis. Pitting of small-pox. See under Sjiall-pox. Pityriasis. Acetic acid, i, 5. Iodine, i, 536. Quinine, ii, 120. Salicylic-acid ointment, ii, 144. Thymol, ii, 284. Pityriasis capitis. Zinc sulphocarbolate, ii, 412. Pityriasis versicolor. Carbolic-acid ointment, i, 212. Hyposulphites, i, 519. Quinine applications, i, 258. Plague (bubonic). Serum treatment (Versin's), ii, 188. Plague, swine. Serum treatment, ii, 188. Plethora. Grape cure, i, 455. Plethora, hepatic. Waters, mineral, ii, 375. Plethora, renal. Waters, mineral, ii, 375. Pleurisy. Air, condensed, inspiration of, i, 28. Baths, condensed-air, i, 27. Blisters, i, 186, 812. Bloodletting, i, 188. Conium, i, 299. Conrallaria, i, 300. Croton oil, i, 318. Gelseniium, i, 437. Guaiacol, i, 460. Hellebore, white, i, 470. Ice applications, i, 520. Iodine, i, 536. Jaborandi, i, 588. . Xuclein, ii, 24. 596 INDEX OP DISEASES AND REMEDIES, Pleurisy. Opium (small doses), ii, 37. Poultices, ii, 101. Pyootanine (internally), ii, 109. Quinine, i, 256. Sesame oil, ii, 190. Sodio-theobromine salicylate, ii, 203. Sodium salicylate, ii, 146. Terebene, ii, 371. Veratrine, ii, 350. Veratrum viride, ii, 352. Pleurisy, acute. Blisters, i, 186. Hellebore, white, i, 470. Pleurisy, chronic (with effusion)._ Air, condensed, expiration into, i, 29. Veratrine, ii, 350. Pleurisy, dry. Sodium salicylate, ii, 146. Pleurisy, febrile. Sesame oil, ii, 190. Pleurisy witii effusion. Aspiration, i, 150. Blisters, i, 312. Guaiacol (application), i, 460. Jaborandi, i, 588. Sodium salicylate, ii, 146. Pleurodynia. Cimiciluga, i, 250. Ethyl chloride, ii, 434. Galvanization, stabile, i, 367. Veratrine, ii, 350. Pleuropneumonia. Quillaia, ii, 113. Terebene, ii, 371. Pneumonia. Acetanilide, i, 4. Aconite, i, 9. Aconitine, digitaline, and strychnine (com- bined), i, 11. Air, condensed, inspiration of, i, 38. Ammonium carbonate, i, 56. Amyl nitrite, ii, 415. Antipyrine, i, 123. Asaprol, i, 148. Baths, condensed-air, i, 27. " hot, i, 489. Bloodletting, i. 188. Cajuput, ii, 426. Calcium chloride, i, 202. Calomel, i, 624. Camphor and sweet-almond oil, i, 205. Cimicifuga, i. 350. Conium, i, 299. Convallaria, i, 300. Digitalis, i, 342. Gelsemium, i, 437. Guaiacol, i, 460 ; ii, 439. Hellebore, white, i, 470. Ice cradling, i, 530. Infusion, intravenous or subcutaneous, ii, 325. Malakin, i, 593. Musk, i, 645. Nucleins, ii, 34. Opium (small doses), ii, 37. Oxygen, ii, 52. Pilocarpine, ii, 85. Poultice JMcket, ii, 103, Poultices, ii, 101. Pneumonia. Quillaia, ii, 113. Quinine, i, 356; ii, 119, liOntgen rays, ii, 458. Salicin, ii, 140. Senega, ii, 163. Serum, artificial, ii, 165. " treatment, i, 85. Sodium paracresotate, ii, 307. Stimulants, cardiac, ii, 226. Strophanthus, ii, 231. Turpentine oil (internally), ii, 336. Veratrum viride, ii. 353. Wine, port, ii, 393. X-rays, ii, 458. Pneumonia, .acute. Serum, artificial, ii, 165. Pneumonia, acute croupous, ■ Hellebore, white, i, 470. Pneumonia, acute lobar. Calcium chloride, i, 202. Oxygen, ii, 53. Pneumonia, adynamic (of drunkards). Musk, i, 645. Pneumonia, caseous. Cimicifuga, i, 250. Pneumonia, catarrhal. Air, condensed, inspiration of, i, 28, Sodium paracresotate, ii, 207. Pneumonia, chronic. Nitrogen by inhalation, ii, 14. Pneumonia,' chronic interstitial. Air, condensed, inspiration of, i, 38. Pneumonia, croupous. Malakin, i, 593. Pilocarpine, ii, 85. Quillaia, ii, 113. Pneumonia from influenza. Pilocarpine, ii, 86. Pneumonia, lobar. Acetanilide, i, 4. Aconite (as a sedative), i, 9. Bath, cold, i, 488. Pneumonia of the apex. Infusion, ii, 324. Pneumonia, typhoid. Ammonium carbonate, i, 56. Pneumothorax. Aspiration, i, 151.- Poliomyelitis. See Myelitis. Polypi, aural. Silver nitrate, ii, 195. Polyuria. Kino, i, 565. Porrigo. Ammonium acetate, i, 54. Carbolic-acid ointment, i, 212. Hyposulphites, i, 519. Pregnancy, extra-uterine. Galvanism, i, 368. Priapism. Baths, cold sitz, i. 489. Humulus, i, 474. Veratrum viride, ii, 353. Prickly heat. Tar water, ii, 36. Proctitis. Copper arsenite, i, 304. Cuprio-sulphate solution, i, 806. INDEX OP DISEASES AND EEMBDIES. 597 Proctocele. Tannin tampons, ii, 256. Prolapse, anal. Copper-arsenite solution, i, 304. Prolapse of the uterus. Massage, i, 609. Tannin tampons, ii, 356. Prolapse, rectal. Baths, cold, i, 169. Tannin suppositories, ii, 356. Prostatitis. Carbonic-acid gas, ii, 314. Corn silk, i, 306. Waters, mineral, ii, 377. Prostato-cvstitis (following gonorrhoea). Piohi, ii, 83. Prostatorrhoea. Baths, cold, i, 169. Cantharides, i, 308. Cubeb, i, 319. Iron chloride (tincture), i, 548. Salix, i, 149. Silver nitrate, ii, 196. Prurigo. Jaborandi, i, 560. Losophan, i, 589. Naphthalan, ii, 448. Silver nitrate, ii, 196. Sodium thiophene-sulphonate, ii, 309. Sulphur fumes, ii, 241. Tumenol tincture, ii, 334. Zinc gynocardate, ii, 409. Pruritus. Aconite (locally), i, 9. Baths, hot, i, 169. Brucine, ii, 29. Camphor powder, i, 204. Chloral hydrate, i, 237. Chloroform (as a lotion), i, 241. Cocaine collodion, i, 293. Formaldehyde, ii, 436. Hydrochloric acid, i, 493. Ichthyol, i, 533. Lemon-juice (diluted), i, 260. Losophan, i, 589. Menthol ointment, i, 614. Naphthalan, ii, 448. Picric acid, ii, 453. Potassium cyanide, i, 323. Quinine, ii, 120. Eosinol, ii, 135. Senecio, ii, 162. Tannoform, ii, 260. Thymol, ii, 284. (of neurotic origin). Valerian, ii, 345. Water, tar, ii, 263. Waters, mineral (externally), ii, 375. Xeroform, ii, 397. Pruritus, anal. Baths, hot sitz, i, 169. Camphor powder (with starch) or ointment, i, 204. Quinine (topically), ii, 120. Pruritus, chronic. Brucine, ii, 29. Pruritus of the external auditory me- atus. Nitrate of silver, solution of, ii, 195. Pruritus of urticaria. Hydrochloric acid, sponging with, i, 493. Pruritus pudendi, Pruritus, Tulyar. Baths, hot sitz, i, 169. Camphor powder (with starch) or ointment, i, 204. Formaldehyde, ii, 436. Potassium cyanide, i, 323. Quinine (topically), ii, 120. (of diabetes), Tannoform powder, ii, 260. Pseudoleuciemia. Iron chloride (tincture), i, 549. Phosphorus, ii, 77. . (pain of), Pyramidone, ii, 454, Psoriasis. Alumnol applications, i, 51. Anthrarobin, i, 103. Aristol, i, 140. Arsenic, i, 144. Baths, hot, i, 166. " alkaline, i, 171. Cashew nut (topically), i, 319. Chrysarobin, i, 348. Cod-liver oil (internally), i, 288. Copaiba oil, i, 302. Creosote, i, 314. Cupric-sulphate solution, i, 306. Gallaoetophenone, i, 432. Gallanilide, i, 432. Iodine, i, 536. lodol, i, 540. Iron, reduced, i, 547. Lead liniment, i, 577. Mercury, ammqniated, i, 627. '• iodide and arsenic, i, 637. " nitrate (ointment), i, 638. Petroleum, ii, 71. Phosphorus, ii, 77. Pixol, ii, 93. Pyrogallic acid, ii, lH, Resorcin, ii, 136. Salicylic acid, ii, 143, Silver nitrate, ii, 196. Soap, green, ii, 200. Sodium ethylate, ii, 307. Sulphur fumes, ii, 341. " ointment and sulphur baths, ii, 241. Tar, ii, 92. " inunctions, ii, 263. Thymol, ii, 284. Thyreoid treatment, i, 79 ; ii, 393. Zinc gynocardate, ii, 409. " sulphydrate, ii, 412. Psoriasis giittata. Salicylic acid, ii, 144. Psoriasis, inveterate. Soap, green, ii, 300. Ptyalism. See Salivation. Purpura. Iron chloride (tincture), i, 548. Purpura hainiorrhagica. Salicylic acid (for swollen joints), ii, 143. Pustule, malignant. Mercury bichloride, i, 636. Pyaemia. Guaiacol, i, 460. Iron chloride (tincture), i, 549. Transfusion, ii, 333. Pyelitis. Baths, hot sitz, i, 169. " warm, i, 489. 598 INDEX OF DISEASES AND REMEDIES. Pyelitis. Buohu, i, 197. Corn silk, i, 306. Naphthalene, ii, 1. Salol, ii, 150. Sodium bicarbonate, ii, 366. Sulphur, ii, 241. Turpentine oil, ii, 336. Uva ursi, ii, 343. Pyelitis, chronic. Turpentine oil, ii, 336. Pyorrlitea alreolaris. Mentho-phenol, i, 616. Myrrh, tincture of, i, 651. Pyrozone, ii, 112. Pyrexia. See Fever. Pyrosis (with acid eructations). Antacids, i, 86. Chalk, i, 230. Charcoal, i, 232. Manganese, oxide of, i, 596. Silver oxide, ii, 197. Waters, mineral, ii, 375. Quinsy. See Amygdalitis. Babies. Hoang-nan, 1, 471. Serpentrionaline, ii, 162. Spinal-cord emulsion, i, 82. Railway brain. Eleotrioity, i, 366. Railway spine. Electricity, i, 366. Bannla. Chromic acid, i, 248. Raynaud's disease. See Asphyxia, Local. Regurgitation, aortic. Arsenic, i, 146. Cereus grandiflorus, i, 229. Regurgitation, mitral. Convallaria, i, 300. Sparteine, ii, 216. Regurgitation of food (without nausea). Arsenic, i, 146. Relaxation of tlie fauces and nrnla. Oak bark (as a gargle), i, 31. Relaxation of the uvula. Catechu, i, 221. Remittent fever. Cassia occidentalis, i, 219. Quinine, i, 255 ; ii, 118. Salicylic acid, ii, 143. Renal disease. See Nephritis. Restlessness. Chloral hydrate, i, 236. Retention of urine. See Urine, Retention op, Rhachitis. See Rickets. Rheumatism. Acetanilide, i, 5. Aconite, i, 9. Agathin, i, 17. Alphol, i, 49. Amber, oil of, i, 52 ; ii, 414 Rheumatism. Ammonia (locally), i, 53. Ammonium hydrosulphide, i, 57. " succinate, i, 58. " tetrethylate, i, 58. Amygdophenine, ii, 415. Amyl valerianate, i, 62. Analgene, i, 66. Antirrheuinatin, i, 126. Antitetraizine, i, 134. Apolysine, ii, 417. A pone, i, 139. Arnica, i, 141. Arsenic, i, 145. Asaprol, i, 148. Baths, hot-air, i, 168. mud, i, 173. " Nauheim, ii, 430. " pine, i, 172. " sulphur, i, 173. Belladonna and morphine injections, i, 67. Benzoic acid, i, 177. Beta-naphthol salicylate, ii, 145. Betol, i, 179. Blisters, i, 186. Bryonia, i, 197. Cajeput, i, 201. Calotropis, i, 203. Cannabis indiea, i, 207. Cereus grandiflorus, i, 229. Chamomile, i, 231. Chaulmoogra oil. i. 238. Chloroform liniment, i, 241. Cicuta virosa, i. 250. Cinehonidine salicylate, ii, 145. Cold baths, i, 488. " douche, i, 519. Douches applied to the dorsal region, i, 349. Dulcamara, i, 353. Electricity, i, 368. Euphorin, i, 402. Exalgine, i, 403. Fir-wool oil, ii, 87. Galbanum, i, 432. Gaultheria, oil of, and olive oil, i, 124. Geosite, ii, 438. Goose grease, i, 455. Guaiac, i, 456. " wood, i. 457. Guaiacol and glycerin, i, 461. Heat, dry, ii, 440. Hot-water stupes, i, 124. Hydriodio acid, i. 492. Hydrochloric acid, i, 493. Hydrotherapeuties, i, 126. Iodine 'Salts, i, 536. Iodoform collodion, i, 293. Iron chloride (tincture), 1, 548. Laotophenine, i, 568. Laurel, i, 571. Lemon-juice, i, 260. Lithium salicylate, ii, 145. Magnolia, i, 592. Manaca, i, 595. hydraulic, i, 603. Mentha piperita, i, 613. Mercury, i, 619. " iodide and arsenic, i, 627. INDEX OF DISEASES AND REMEDIES. 599 Rheumatism. Methylene blue (by the stomach or hypo- derraically), i, 639. Mezereon, i, 630. Moringa, ii, 447. Morphine and belladonna injections, i, 67. Nutmeg oil (as a rubefacient), ii, 35. Opium (at the beginning of an attack), i, 135. Osmic acid, ii, 47. Peppermint, i, 613. Petroleum, ii, 70. Phenocoll, ii, 73. Phenylacetamide, ii, 73. Phosphate, ammonium, ii, 78. PhuUuah, ii, 79. Phytolacca, ii, 81. Pinus pumilio, oil of, ii, 88. Piperazine, ii, 89. Pix burgundica, ii, 91. Potash, ii, 94. Potassium acetate, ii, 95. " and sodium tartrate, ii, 100. " carbonates, ii, 95. " citrate, ii, 96. " permanganate, i, 596. Pulsatilla, ii, 107. Pyrantine, ii, 109. Quinine, i, 256. " salicylate, ii, 455. Rhus toxicodendron (internally and topic- ally), ii, 133. Salaoetol, ii, 139. Salicin, ii, 140. Salicylamide, ii, 141. Salicylated collodion, i, 393. Salicylic-acid compounds, i, 134, 143. Salines, ii, 147. Salipyrine, ii, 148. Salol, i, 135 ; ii, 150. Salophene, i, 125 ; ii, 151. Salubrine, ii, 153. Sodium benzoate, ii, 204. - " bicarbonate (locally), i, 124. " dithiosalicylate, i, 125. " paracresotate, ii, 307. " salicylate, ii. 146. Spice bag, application of, i, 309. Strontium salicylate, ii, 147, 380. Sulphaminol salicylate, ii. 236. Sulphosalicylic acid, ii, 239. Sulphur, ii, 341. •' fumigation, i, 430. Tansy, ii, 361. Tea, hot (as a diaphoretic), ii, 368. Tetrethylammonium, ii, 373. Thuja, ii, 382. Thymol, ii, 383. Trimethylamine, ii, 344. Turpentine, ii, 335, 336. Urotropine, ii, 343. Vaccinium, ii, 344. Waters, alkaline (externally), ii, 373, 375. Buffalo lithia, ii, 373. " chlorinated alkaline (externally and inlernallv), ii. 381. Waters, mineral, ii. 374, 384. " sulphur, ii, 371. " thermal, ii, 364. Wet-pack, i, 490. Blienmatism. Wintergreen oil, i, 134. Xanthoxylum, ii, 396. Zinc sulphoichthyolate, ii, 413. Rheumatism, acute. Aconite, i, 9. Alphol, i, 49. Ammonium tetrethylate, i, 58. Baths, hot, i, 166. " sulphur, i, 173. Benzoic acid, i, 177. Beta naphthol salicylate, ii, 145. Betol, i, 179. Blisters, i, 186. Cimicifuga, i, 250. Cold baths, i, 488. Electricity, i, 368. Ephedra, i, 385. Geosite, ii, 438. Hydriodic acid, i, 493. Hydrochloric acid, i, 493. Lemon-juice, i, 260. Lithium salicylate, ii, 145. Mentha piperita (oil), i, 613. Phenocoll (as an analgetic), ii, 73. Potassium and sodium tartrate, ii, 100. " carbonates, ii, 95. " citrate, ii, 90. " permanganate, i, 596. Pulsatilla, ii, 107. Pyrantine, ii, 109. Quinine, ii, 118. Salacetol, ii, 139. Salicin, ii, 140. Salicylic acid, ii, 143. Saligenin, ii, 147. Salipyrine, ii, 148. Salophene, ii, 151. Sodium salicylate, ii, 146. Tetrethylammonium, ii, 273. Thymol, ii, 283. Trimethylamine, ii, 331. Vaccinium, ii, 344. Rheumatism, chronic. Aconite (as an anaesthetic), i, 9. Baths, hot-air, i, 168. " sand, i, 173. Blisters, i, 186. Cannabis indiea, i, 207. Chloroform liniment, i, 241. Qinchonidine salicylate, ii, 145. Coohlearia, i, 284. Cod-liver oil, i, 388. Ephedra, i, 385. Euphorin, i, 408. Pir-wool (local application), i, 423. Galbanum (internally), i, 432. Guaiac, i, 456. " wood, i, 457. Iodine salts, i. 536. Mercury iodide and arsenic, i, 627. Moringa' (as a counter-irritant), ii, 447. Phytolaoea, ii, 81. Potassium iodide, ii, 98. Salacetol, ii, 139. Salicin, ii, 140. Salipyrine, ii, 148. Tetrethylammonium, ii, 373. Turpentine vapour baths, ii, 336. Vaccinium, ii, 344. 600 INDEX OP DISEASP]S AND REMEDIES. Kheumatism, chronic. Waters, mineral, ii, 374. " simple thermal (internally), ii, 304. " sulphur, or vapours, ii, 371. Zinc sulphoiohthyolate, ii, 412. Eheumatisin, gonorrhoeal. Salicylic acid, ii, 143. Rheumatism, muscular. Aconite, i, 9. Amyl valerianate, i, 62. Apolysine, ii, 417. A pone, i, 139. Baths, hot-air, i, 168. Euphorin, i, 403. Goose grease (liniment), i, 455. Iodine (externally), i, 536. Massage, i, 608. Osmic-auid injections (solutions), ii, 47. Salacetol, ii, 138. Salol, ii, 150. Salubrine, ii, 152. Strontium salicylate, ii, 147, 230. Sulphur, ii, 241. " fumigation, i, 430. Waters, sulphur, or vapours, ii, 371. Kheumatism, subacute. Cinchonidine salicylate, ii, 145. Goose-grease liniment, i, 455. Strontium salicylate, ii, 147, 230. Rhinitis. Blennostasine, ii, 426. Carbonic-acid inhalation, ii, 430. Chromic-acid applications, i, 248. Copper arsenite, 1, 304.. Iodine, i, 536. lodol, i, 540. Mercury-oxide ointment, i, 633. Nosophene, ii, 19. Pilocarpine, ii, 96. Pulsatilla, ii, 107. Thymol, ii, 283. Zinc oleostearate and iodine, ii, 409. Rhinitis, atrophic. Iodine (externally), i, 536. Silver nitrate, ii, 195. Terebene. ii, 271. Thymol, ii, 283. Zinc sulphate, i, 407. Rhinitis, chronic. Mercury oxide (ointment), i, 638. Terebene, ii, 371. Rhinitis, chronic hypertrophic. Chromic-acid applications, i, 248. Rhinitis, dry. Nosophene, ii, 19. Rhinitis, hypertrophic. Carbonic-acid inhalations, ii, 430. Rhinitis, posterior. lodol (by insufflation), i, 540. Rhinitis, purulent (of children). Thymol, ii, 383. Rhinorrhoea, intermittent. Blennostasine, ii, 436. Rieliets. Baths, Nanheim, ii, 430. Calcium chloride, i, 303. " phosphates, i, 303 ; ii, 78. Cod-liver oil, i, 338. Diet in, i, 338. Hsemalbumin, i, 468. Rickets. Iron, ainmonio-chlonde of, i, 549. Oxygen, ii, 52. Phosphates, ii, 78. Phosphorus, ii, 77. Waters, chlorinated, ii, 366. Wine, port, ii, 393. Rlgi?s's disease. See Pyorehcea, Alveolae. Rigidity of the os uteri. Belladonna ointment (or by injection into the vagina), i, 174. Tartar emetic, i, 114. Ringworm. Acetic acid, i, 5. Anthracite, i, 108. Chrysarobin, i, 248. " (applied in flexible collodion), i, 117. Copper (10-per-cent. solution), i, 117. Croton oil (to produce suppuration), i, 117. Hyposulphites (locally), i, 519. Ink, ii, 259. Iodine, i, 536. " tincture of, i, 117. Iron tannate, i, 553. Laurel, i, 571. Mercury, ammoniated, i, 637. " bichloride, i, 117. " oleate, i, 117. Naphthol plaster, i, 117. Quinine, ii, 120. Salicylic-acid ointment, ii, 144. Salt, common, applications, ii, 206. Silver nitrate, ii, 196. Sodium, ethylate of, i, 117. " hyposulphite of, i, 117. Sulphurous acid, i, 117. Thymol, ii, 384. Ringworm of the body. See Tinea trichophytina. Ringworm of the scalp. See Tinea tonsurans. Rosacea. Ichthyol (externally and internally), i, 533. Losophan, i, 589. Roundworms. See WoEMS, Lumbricoid. Salivation. Catechu, i, 331. Creosote solution, i, 314. Potassium chlorate, ii, 96. Pyoctanine, ii, 108. Salpingitis. Electricity, i, 368. Glycerin suppositories, i, 450. Ichthyol, i, 523. Iodoform, i, 538. Salplngo-oophorltis. Ichthyol, i, 533. Iodoform, i, 538. Sarcoma. Arsenic, i, 144. Thiosinamine, ii, 381. Toxines, ii, 312, 314. Sarcoma, multiple. Arsenic, i, 144. Saturnism. Baths, hot-air, i, 168. INDEX OP DISEASES AND REMEDIES. 601 Saturnism. Calcium sulphide, i, 203. Epsom salts, i, 536, 576. Iodine, i, 576. Lavage, i, 491. Magnesia, i, 111. Magnesium carbonate, i, 109. " hydrate, i, 109. Milk, i, 109, 111. Oils, i, 109, 111. Potassium bicarbonate, i. 111. " carbonate, i, 111. " iodide, i, 69 ; ii, 98. Waters, mineral, ii, 376. " sulphuretted, ii, 371 , Scabies. Arsenic (externally), i, 145. Balsam of copaiba, ii, 432. " " Peru (after a prolonged bath), i, 116, 160. Baths, sulphur, i, 173. Benzene, i, 176. Calcium sulphide, sublimed sulphur, lime and water, i, 203. Carbolic-acid ointment, i, 212. Chaulmoogra oil, i, 233. Hebra ointment, i. 116. Hyposulphites, i, 519. Naphthalene, ii, 1. Naphthol ointment, ii, 2. Petroleum, ii, 71. Potassium sulphide bath, i, 116. Staphisagria, ii, 221. Storax, liquid, i, 116, 160 : ii, 228. Sulphur fumigation, i, 430. " ointment, ii, 241. Tar, ii, 263. Turpentine oil, vapour of (thrown on the bed- clothes), ii, 336. Scalds. See Burns. Scarlatina, Scarlet fever. Aconite, i, 8. Affusion, cold, ii, 16. Ammonium carbonate, i, 56. Antipyrine, i, 123. Baths, alkaline, i, 44. Baths, cold, i, 488. Benzoic acid, i, 178. Chloral hydrate, i, 237. Chlorine water, i. 240. Cod-liver oil, i, 288. Cold bath, i, 488. Copper-arsenite solution, i, 304. Digitalis, i, 343. Eucalyptus, oil of (internally), i, 400. Pats (by inunction), i, 420. Gavage; i, 436. Hydrochloric acid (as a gargle), i, 493. Hydrogen dioxide, i, 503. Iron chloride (tincture), i, 549. Lactophenine, i, 568. Nucleins, ii, 25. (convalescence from), Nutrose, ii, 449. Permanganates (internally), ii, 70. Potassium chlorate, ii, 96. " citrate, ii, 96. Quinine, i, 255 ; ii, 119. Serum, antidiphtheritic, ii, 178. " treatment, ii, 178. Scarlatina, Scarlet ferer. Sparteine, ii, 216. Sciatica. Acetanilide, i, 3. Antipyi'ine, i, 124. Butyl chloral hydrate, i, 197. Cannabis indica, i. 207. Chaulmoogra oil, i, 233. Chloroform (hypodermic injection), i, 241. Croton oil, i, 318. . Electricity, i, 367. Ephedra, 'i, 385. Erythrophlceine (hypodermically), i, 390. Euphorin, i, 402. Exalgine in, i, 403. Galvanism, i, 367. Gelsemium, i, 437. Glycerophosphates, ii, 489. Heat, dry, ii, 441. Massage, i, 608. Methylene blue (by. the stomach or hypoder- mically), i, 629. Neurodin, ii, 7. Nitroglycerin, ii, 15. (for inflammation). Opium, i, 67. Osmic-aeid injections (in solution), ii, 47. Phenacetine, ii, 71. Phulluah, ii, 79. Quinine, ii, 120. Salicylic acid, ii, 144. Spice bag, application of, i, 209. Sulphur, ii, 241. " fumigation, i, 430. Theine, ii, 277. Turpentine oil, ii, 336. Vasogen, iodized, ii, 350. (externally and internally). Waters, sulphur- etted, ii, 371. (as a liniment), Zinc sulphoichthyolate, ii, 412. Sciatica, clironic. Heat, dry, ii, 441. Sclerodermia. Baths, gelatin, i, 172. " stimulating, i, 173. Cod-liver oil (internally), i, 288. Ichthyol, i, 523. Sclerodermia, circumscribed. Thyreoid treatment, ii, 293. Sclerosis, amyotrophic lateral. Galvanism, i, 366. Sclerosis, arterio-. Potassium iodide, ii, 98. Sclerosis, dilTiise and multiple. Barium chloride, i, 161. Sclerosis, multiple spinal. Acetanilide (for tremors), i, 4. Galvanism, i, 367. Sclerosis of the liver. Sodium phosphate, ii, 208. Sclerosis, posterior spinal. Methylene blue, i, 630. Sclerosis, spinal. Acetanilide, i, 4. Barium chloride, i, 161. Baths, tepid, i, 489. Conium. i, 298. Galvanism, i, 367. Gold, i, 454. Methylene blue, i, 630. 603 INDEX OF DISEASES AND REMEDIES. Sclerosis, spinal. Phosphorus, ii, 76. Potassium iodide, ii, 98. Tepid baths, i, 489. Sclerotitis. Salicylic acid, ii, 143. Scorbutus. See SooRVT. Scrofula. Barium chloride, i, 161. Baths, iodated, i, 172. ■' Nauheim, ii, 420. pine, i, 173. " sulphurous, i, 173. Calcium benzoate, i, 301. Chaulmoogra oil, i, 333. Cod-liver oil, i, 383. Creolin, i, 313. Cupric-sulphato solution, i, 306. Gold, i, 453. " cyanide, i, 333. Grape cure, i, 455. Guaiac wood, i, 457. Hiemalbumin, i, 463. Hoang-nau, i, 471. Hydriodic acid, i, 493. Hypophosphites, i, 518. Iodine, i, 535. Iron, ammonio-chloride of, i, 549. " bromide, i. 553. " iodide, i, 551. Lappa, i, 570. Manaea, i, 595. Oxygen, ii, 53. Sanguinaria, ii, 154. Sea air, sea bathing, ii, 375. Starch, iodized, i, 537. Stillingia, ii, 333. Sulphur lumes, ii, 341. Thalassotherapy, ii, 375. Scrofulodermata. Europhene, in powder or ointment, i, 403. Hydrocotyle asiatica, i, 493. Scurvy. Citric acid, i, 136. Copper-arsenite solution, i, 304. Dietetic treatment, 1, 333. Ergot, i, 388. Fresh fruits, i, 136. " milk, i. 136. " vegetables, i, 136. Lemons, i, 136. Lime-juice, i, 136, 360. Orange-juice, i, 157, 338. Raw scraped meat, i, 136. Turpentine oil, ii, 337. Vinegar, i, 136. Wines, i, 136 ; ii, 394. Scurvy, haeinorrliage of. Ergot, i, 388. Seasickness. Bromides, i, 99. Capsicum, i, 309. Chloralamide, i. 339. Chloral hydrate, i, 337. Chlorobrom, i, 340. Creosote, i, 314. Ether (internally), i, 397.^ Ice applied to the spine, i, 530. Nitroglycerin, ii, 15. Seasickness. Sulphonal, ii, 339. Seasickness, vertigo of. See under Vertigo. Seborrlioea. Arsenic, i, 144. Hydrastine, i, 476. Salicylic-acid ointment, ii, 144. Zinc sulphide, ii, 411. Seborrhoea, dry. Hydrastine, i, 476. Seborrhoea of the face. Zinc sulphide, ii, 411. Secretions, gastric. Waters, alkaline sulphated, ii, 368. Secretions, undue, of the skin. Fuller's earth, i, 354. Senility, premature. Orchitic liquid, i, 76. Septicemia. Benzoic acid, i, 178. Cold baths, i, 488. Infusion, intravenous or subcutaneous, ii, 335. Iron chloride (tincture), i, 549. Quinine, i, 355. Serum, antistreptoooccus, ii, 175. Sodium benzoate, i, 159. Transfusion, ii, 333. Septicsemia, acute hasmorrhagic. Serum, antistreptococcus. ii, 177. Septicsemia after operations. Serum, artificial (intravenous injections), ii, 164. SejpticBBmia, puerperal. Chlorine water (as a douche), i, 240. Infusion, intravenous or subcutaneous, ii, 325. Serum, antistreptococcus, ii, 175. Shock. Alcohol, i, 31, 34. Ammonia inhalation, i. 53. Arnica, infusion of, i, 141. Champagne, ii. 393. Enema of hot water, i, 491. Heat, dry applications of, ii, 335. Infusion and the subcutaneous injection of strychnine, ii, 334. Saline infusion (by the rectum), ii, 227. Serum, artificial (intravenous injections), ii, 164. Stimulants, cardiac, ii, 226. Stroplmnthus, ii, 231. Singultus. Bromoform, 1, 196. Faradization of the phrenic nerve, i, 367. Sinuses. Calcium-phosphate solution, i, 202. Sinuses, indolent. Silver nitrate, ii, 196. Sinuses, suppurating. Tannin (strong solution), ii, 256. Sloughing. Bromine, i, 195. Creosote, i, 314. Iodoform, i, 538. Oxygen, ii, 51. Papain and sodium bicarbonate, ii, 60. Potassium permanganate, i, 597, Terebene and olive oil, ii, 271, INDEX OP DISEASES AND REMEDIES. 603 Sluggishness of the liver. See Liver, Torpid. Small-pox. Carbolate of camphor, ii, 73. Carron oil (as a dressing for the face), i 583. Cold baths, i, 488. Collodion, flexible, i, 294. Iodine, i, 536. Mercury plaster, i, 633. Quinine, ii, 119. Serum treatment, ii, 179. Sulphur ointment, ii, 341. Transfusion, ii, 838. Xylene, ii, 400. Small-pox, pitting of. Iodine, i, 586. Mercury plaster, i, 633. Snake bite. See under Bites. SneeziJbg (of hay fcTer). Copper-arsenite solution, i, 304. Sore nipples. See Nipples, Sore. Sores. See Ulcers. Sores, bed. See Bedsores. Sores, chancroid. See Chancroids. Sores, indolent. See Ulcers, Indolent. Sores, pntrid. See Ulcers, Putrid. Sores, unhealthy. See Ulcers, Unhealthy. Sores, venereal. See Chancres and Chancroids. Sore throat. Capsicum and hot-water gargle, i, 309. Carbolic-acid solution, i, 318. Catechu lozenges, i, 331. Cupric sulphate, i, 306. Horehound, i, 473. Iron chloride (tincture), internally and ex- ternally, i, 549. Myrrh, tincture of (as a gargle), i, 651. Potassium chlorate, ii, 96. Rhus glabra, ii, 181. Saccharin, ii, 137. Sore throat, aphthous. Saccharin, ii, 137. Sore throat, malignant. Cupric sulphate, i, 306. Sore throat of scarlet fever. Capsicum and hot water (as a gargle), i, 309. Spasmodic affections. Massage, i, 608. Spasmodic affections of the respiratory apparatus. Ipecac, i, 373. Spasmodic conditions. Gelsemiura, i, 437. Spasmodic conditions of the bladder and urethra. Baths, hot sitz, i, 169. Spasmodic contraction of the arteries. Amyl-nitrite inhalation, i, 138. Chloral, i, 138. Nitroglycerin, 1, 133. 82 Spasmodic contraction of the rectum. Belladonna (by the mouth or by supposi- tory), i, 175. Spasmodic reflex neuroses. Bromides, i, 194. Spasms. Amyl-nitrite inhalation, i, 183. Baths, hot, i, 166. Belladonna, i, 68, 133. Bromides, i, 133. Camphor, i, 204. Chloroform, inhalation, i, 245. Coniine and morphine, i, 399. Conium, i, 133. BlEeomyenchysis, i, 356. Electricity, i, 367. Gelsemium, i, 437. Hyosoyamine, i, 504. Opium, i, 138. Sulphonal, ii, 239. Spasms, anal. Belladonna, i, 133. Spasms, bronchial. See Asthma. Spasms, cerebral. Bromides, i, 138. Spasms, clonic. Electricity, i, 365. Spasms, facial. Gelsemium, i, 437. Spasms from irritative lesions of nerve trunks. Conium, i, 133. Spasms, hysterical, of the larynx. Chloroform inhalation, i, 245. Spasms, intestinal. Opium, i, 133. Spasms, muscular. Coniine and morphine (hypodermic injec- tions), i, 299. Spasms of the larynx. Bromides, i, 133. Spasms of the muscles (of broken limbs). Sulphonal, ii, 239. Spasms of the muscular fibres of the intes- tines. Belladonna, i, 68. Spasms, rectal. Camphor suppositories, 1, 204. Spasms, tonic. Electricity, i, 365. Spasms, urethral. Belladonna, i, 133. Camphor suppositories, i, 304. Opium, i, 133. Spasms, vesical. Bath, hot, i, 166. Camphor suppositories, i, 304 Spermatorrhoea. Baths, cold, i, 169. Cantharides, i, 208. Cimicifuga, i, 350. Cornutine, i, 307. Digitalis, i, 343. Douches, rectal, i, 349. Ergot, i, 888. Humulus, i, 474. Hydrastine, i, 476. Iron chloride (tincture), i, 548. Salix, ii, 149. 604: INDEX OF DISEASES AND EEMEDIBS; Spermatorrhoea. Spermatorrhoea ring, i, 90. Tribulus lanuginosus, ii, 330. Turpentine oil, ii, 336. Spina bifida. Aspiration, i, 150. Collodion, i, 294. Iodine injections, i, 536. Spinal irritation. See Irkitation, Spinal. Spongy gums. See Gums, Spongy. Sprains. Alcohol, i, 29. Ammonium acetate, i, 54. Arnica, i, 141. Baths, hot, i, 170. Calendula, i, 203. Chaulmoogra oil, i, 233. Hamamelis, i, 467. Lead, Goulard's extract of, i, 577. Massage, i, 609. Phulluah, ii, 79. Salicylated camphor, i, 204. Stupes, hot-water, ii, 233. Stenocardia. See Angina pectoris. Stenosis, aortic. Carpaine, i, 218. Stenosis, laryngeal. Air, condensed, inspiration of, 1, 28. Morphine, ii, 37. Stenosis, mitral. Convallaria, i, 300. Digitalis, i, 341. Morphine (subcutaneously), ii, 36. Stenosis of the mitral orifice. Sparteine, ii, 216. Strophanthus, ii, 281. Stenosis of the tricuspid valve. Digitalis, i, 341. Stenosis, syphilitic, of the bronchus. Quillaia, ii, 113. Stenosis, tracheal. Air, condensed, inspiration of, i, 38. Sterility. Gold, i, 453. Stings of flies, wasps, etc. Arnica, i, 141. Ichthyol, ii, 444. Sodium bicarbonate, ii, 204. Stomatitis. Boric acid (saturated solution), i, 191. Carbolic-acid solution, i, 213. Copper-arsenite solution, i, 304. Copper-sulphate solution, i, 306. Euphorin, i, 403. Hydrastis (local applications), i, 476. Potassium chlorate, ii, 96. Sulphur, ii, 241. Tannin (solution), ii, 356. Stomatitis, aphthous. Euphorin (as a local disinfectant), i, 403. Stomatitis, mercurial. Cupric-sulphate solution, i, 306. Stomatitis, ulcerative. Sulphur (locally), ii, 341. Strangury. Alkalies, i, 44. Linseed tea, ii, 369. Stricture of the urethra. Electricity, i, 368. Thiosinamine, ii, 380, 281. Styes. Hypophosphites, i, 518. Subinvolution, uterine. Cimicifuga, i, 250. Stypticin, ii. 253., Suffocation. See Asphyxia. Sunstroke. See Insolation. Suppuration. Antipyonine, i, 120. Calcium sulphide, i, 303. Capsicum tincture (diluted), i, 309. Carbolic acid, i, 213. Charcoal, i, 213. Cinnamon oil, i, 259. Creosote, i, 314. Dermatol, i, 329. Euphorbium, i, 401. Naphthol, ii, 3. Potassium sozoiodolate, ii, 215. Pyoctanine, ii, 108. Pyrozone, ii, 112. Quinine, i, 256 ; ii, 120. Silica, hydrated, ii, 191. Sozal, ii," 215. Sulphaminol, ii, 336. Urotropine, ii, 343. Xeroform, ii, 397. Suppuration, chronic, of tlie ear. Naphthol (by insufHation), ii, 2. Suppuration, foul-smelling. Charcoal, i, 232. Siippuration of glands. Carbolic acid (parenchymatous injections), i, 213. Siippuration of the mucous membranes. Cinnamon oil, i, 359. Suppuration of the urinary tract. Urotropine, ii, 343. Suppuration, prolonged. Quinine, ii, 130. Sweating. Agaricin, i, 103. Agaricus, i, 103. Atropine, i, 103, 156. Belladonna, i, 103. Boric acid and permanganate of potassium, i,103. Boric acid and salicylic acid, 1, 103. Camphor, i, 205. Dover's powder, i, 103. Duboisine, i, 353. Ergot, i, 103. 338. Eserine, i, 393. Homatropine, i, 471. Mineral acid, i, 103. Muscarine, i, 103. Nucleins, ii, 34. Nux vomica, i, 103. Picrotoxin, i, 103. Pilocarpine, i. 103 ; ii, 84. Potassium tellurate, ii, 100. Quinine, i, 103. Strychnine, i. 102. Sulphonal, ii, 239. Tannin, ii, 257. Index of diseases and ebmedies. 605 Sweating. Vinegar (locally), i, 103. Zinc oxide, i, 103. Sweating, colliquatiTe. See Hypebidrosis. Sweating, profuse. See Hypbrideosis. Sweats, night. Ergot, i, 388. Nucleins. ii, 24. Tannin, ii, 257. Sweats, night, of plithisis. Agaricin, i, 17. Camphor, i, 205. Duboisine, i, 353. Eserine (internal administration), i, 393. Homatropine, i, 471. Pierotoxin, ii, 84. Potassium tellurate, ii, 100. Quinine, i, 102. Sulphonal, ii, 339. Tannin, ii, 257. Zinc oxide, ii, 406. Swelling, lymphatic glandnlar. See Adenitis. Swelling of glands. See Adenitis. Swelling of the breasts. See Mastitis. Swelling, white. Barium chloride, i, 161. Ignipuncture, 1, 534. Sycosis. Chromic-acid applications, i, 248. Ijosophan, i, 589. Sulphur ointment and sulphur baths, ii, 241. Syncope. Ammonia inhalation, i, 53. Amyl nitrite, i, 61. Atropine, i, 156. Cold affusions, i, 17. Paradaism, i; 367. Whisky, ii, 385. Syncope, cardiac. Atropine (hypodermically), i, 156. Syncope, threatened. Strophanthus, ii, 331. Synechise, posterior. Scopolamine, ii, 159. Synovitis. Carbolic-acid injections, i, 313. Massage, i, 609. Methylene blue (by the stomach or hypoder- mically), i, 629. Synovitis, traumatic. Massage a friction, i, 609. Syphilis. Amidopropionic acid (subcutaneous injec- tions), i, 62. Antimony, compound pills of, i, 114. Arsenic, i, 145. Asparagin (hypodermic injection), i, 148. Baths, iodated, i, 172. " mercury, i, 173. " mud, i, 173. " sulphur, i, 173. Calcium phosphate, ii, 78. Calomel fumigation, i, 634. Calotropis, i, 303. Syphilis. Condurango (as an alterative), i, 397. Europhene, i, 403. Gold, i, 451, 453. " cyanide, i, 333. Guaiac, i, 456. " wood, i, 457. Hydroootyle asiatica, i, 493. Infusion of mercury (Bacelli's method), ii, o3«. Iodine salts, i, 536. Iron iodide, i, 551. " sulphate, i, 550. Lappa, i, 570. Manaca, i, 595. Mentho-phenol, i, 616. Mercurial fumigation, i, 430. Mercury, i, 620, 631. " ammoniated, i, 637. " and oanthardin, i, 621. " and chalk, i, 622. " cyanide, i, 333. iodide, i, 627, " ointment inunction, i, 633. oleate of, i, 634. " tannate, ii, 359. Mezereon, i, 630. Nitric acid, ii. 8. Nitrohydrochloric acid, ii, 16. Oxygen, ii, 53. Potassium iodide, ii, 97, 98. Pulsatilla, ii, 107. Quinine, ii, 120. Rubidium, ii, 136. Sanguinaria, ii, 154. Sarsaparilla, i, 324. Serum treatment, i, 85; ii, 186. Spermine, ii, 217. Stillingia, ii, 223. Thyreoid extract, i, 79. " treatment, ii, 295. Toxines, mixed, ii, 316. Traumaticin and calomel (locally), ii, 329. Vasogen, iodized, ii, 349. Waters, Buffalo lithia, ii, 373. " mineral, ii, 374. " sulphuretted, ii, 371. Xanthoxylura (an infusion as a compress), ii, 396. Zinc gynocardate, ii, 409. Syphilitic aifection of the throat and nares. Hydrastis, i, 476i Syringomyelitis. Paradaism, i, 367. Tabes. - Brain extract, i, 80. Calcium chloride, i, 303. Exalgine, i, 403. Galvanization, i, 367. Silver nitrate, ii, 194. Sodium phosphate, ii, 308. Tabes, crises of. Acetanilide, i, 3. Tabes dorsalis. Brain extract, i. 80. Silver nitrate, ii, 194. Sodium phosphate (subcutaneous injections), ii, 208. 606 INDEX OP DISEASES AND KEMEDIES. Tabes, lightning pains of. Exalgine, i, 403. Tabes mesenterica. Calcium chloride, i, 202. Tsenia. Absinthium (for preparatory treatment), i, Ailantus, i, 18. Aloes (for preparatory treatment), i, 102. Ammonium chloride (for preparatory treat- ment), i, 101. Anthracite coal, powdered, i, 103. Areca nut, i, 102. Aspidium, i, 101. Bitter tonics (for preparatory treatment), i, Calomel, i, 103. Carbolic acid, i, 102. Chenopodium, oil of, i, 102. Cuprie oxide, i, 305. Gamboge, i, 101. Hot water (to the abdomen in preparatory treatment), i, 101. Kamala, i, 103. Kousso, i, 103. Mineral acids, i, 101. Mucuna, i, 102. Papain, i, 102. Papoid, i, 103 ; ii, 60. Pelletierine, i, 102. Pepsin, i, 101. Pumpkin seed, powdered, i, 102. Quassia, i, 103. Salt, common (in preparatory treatment), i, Salted meats (in preparatory treatment), i, Santonin, i, 102. Spigelia, fluid extract of, i, 103. Tin, powdered, i, 103. Turpentine oil, i, 103 ; ii, 836. Talipes equinus. Thiosinamine, ii, 281. Tapeworm. Aspidium, i, 101. Embelia ribes. i, 370. Ether (internally), i, 397. Petroleum, ii, 71. Pulsatilla, ii, 108. Tarsalgia. Bath, hot foot, i, 170. Teleangeiectasis. Mercury bichloride, i, 626. Tenesmus. Camphor, i, 67. Opium, i, 67. Tetanus. Amyl nitrite, i, 61. Apomorphine, ii, 417. Atropine, i, 175. Barium chloride, i, 161. Bromide of potassium, i, 194. Cannabis indica, i, 207. Carbolic acid (hypodermic injections), i, 312. (convulsions). Chloral hydrate, i, 237. Chloroform, i, 528. Conium, i, 399. Corrosive-sublimate injections, ii, 446. Curare, i, 331. Tetanus. Infusion, intravenous or subcutaneous, ii, 335. Lobelia, i, 587. Methylal, i, 639. Nitroglycerin, ii, 15. Phenol injections, ii, 453. Serpentrionaline, ii, 163. Serum treatment, i, 84. Solanum carolinense, ii, 309. Tobacco, ii, 306. Urethane, ii, 342. Tetanus, idiopatliie. Strychnine, ii, 38. Tetanus, traumatic. Carbolic acid, ii, 439. Conium, i, 399. Veratrum viride and gelsemium, ii, 855. Tetany. Thyreoid treatment, ii, 398. Threadworms. See AscAEiDES. Tic convulsif. Electricity, i, 866. Tic douloureux. Paradaism, i, 367. Veratrine, ii, 350. Tinea capitis. Tar, ii, 93. Tinea circinata. Carbblio-acid ointment, i, 313. Copper oleate, i, 305. lodol, i, 540. Losophan, i, 589. Naphthol ointment, ii, 2. Quinine applications, i, 253. Salicylic-acid ointment, ii, 344. Sulphur ointment, ii, 341. Sulphurous acid, ii, 343. Tinea tarsi. Cupric-sulphate solution (injection), i, 806. Tinea tonsurans. Carbolic-acid ointment, i, 313. Croton oil, i, 818. lodol, i, 540. Losophan, i. 589. Mercury bichloride, i, 626. " red oxide of (ointment), i, 633. Thymol, ii, 284. Tinea trichophytina. Copper oleate, i, 305. Iodine, i, 117. Salicylic-acid ointment, ii, 244. Tinea versicolor. Losophan, i, 589. Sulphur ointment and sulphur baths, ii, 241. Sulphurous acid, ii, 343. Toothache. Aconite, i, 9. " and iodine tinctures, and chloro- form, i, 136. Atropine sulphate, i, 136. Calotropis, i, 208. Carbolic acid, i, 218. Carvacrol, i, 186. Chaulmoogra oil, i, 333. Chloral hydrate (as an anaesthetic), i, 387. ." " and camphor (equal parts). Chloroform, i, 136. INDEX OF DISEASES AND REMEDIES. 607 Toothache. Cloves, oil of, i, 136, 372. Cocaine hydrochloride (solution), i, 136. Collodion and carbolic acid, i, 136. Creosote, i, 136, 314. Delphinine, ii, 231. Ethyl chloride, ii, 434. Heat, dry, i, 136. Hop poultice, i, 474. Horseradish, dried root, chewed, i, 473. Menthol, i, 136. Odontine, ii, 31. Odontol, ii, 31. Peppermint oil, i, 613. Mentho-phenol, i, 616. Piscidia, ii, 91. Pyrethrum, ii, 109. Torpor, hepatic. See Liver, Tokpid. Torticollis. Capsicum (infusion of the pods), i, 309. Cimicifuga, i, 350. Conium, i, 298. Elasomyenchysis, i, 356. Electricity, i, 365. Galvanization, labile anodal, 1, 867. Torticollis, spasmodic. Conium, i, 398. Elseomyenohysis, i, 356. Trachoma. Copper sulphate, ii, 214. lodol (by insuflation), i, 540. Pyootanine, ii, 108. Silver iodide, ii, 197. " nitrate, ii, 195, 314. Tremors. Thymus extract, ii, 385. Zinc oxide, ii, 306. Tremors of central neryous lesions. Arsenic, i, 146. Trichiasis. Collodion, i, 394. Trichiniasis. Glycerin, i, 451. Picric acid, ii, 83. Trismus neonatorum. Sulphonal, ii, 339. Tuberculosis. Acetanilide, i, 3. Agaricin, i, 17. Air, expiration into condensed, i, 39. " rarefied, i, 28. " inspiration of condensed, i, 38. Airol, ii, 414. Ammonium borate, i, 55. Ammonium-fluoride inhalation, i, 57. Antiphthisin, i, 130, 131. Aristol (hypodermically), i, 140. Arsenic, i, 146. Balsamic fumes, i, 529. Baths, condensed-air, i, 37. Benzoic acid (internally and by inhalation), i, 178. Benzosol, i, 179. Bismuth, i, 181. Boric acid, i, 191. Calcium phosphate, ii, 78. (cough of), Camphorated-oil injections, i, 305. Cannabis indica, ii, 429. Cantharides injections, i, 308. Tuberculosis. Cantharidic acid, i, 208. Carbolic-acid (solution) inhalation, i, 213. Carbon dioxide, i, 527. (by insufflation), i, 533. Catramine, i, 336. Cetraria, i, 330. Chaulmoogra oil, i, 333. Cinnamio acid and glycerin, i, 259. Cloves, tincture of, i, 273. Cocillafia bark, i, 285. Cod-liver oil, i, 388. Conium and cod-liver oil, i, 399. Copper-arsenite solution, i, 304. Copper salts, i, 303. Creosote inhalation, i, 314. Croton oil, i, 318. Cupric sulphate, i, 306. Diet in, i, 338. Ergot and sodium phosphate, i, 389. Ethyl iodide, i, 538. Eucalyptol inhalation, i, 529. Eucasin, ii, 436. Exercise, open-air, i, 415. Gavage, i, 435. Gelsemium, i, 437. Geosite, ii, 438. Glycerin, i, 451. Glycerophosphates, ii, 439. Gold and arsenic, i, 454. Grape cure, i, 455. Guaiacol carbonate, i, 457, 461. Helenin (as an antiseptic), i, 534. Homatropine, i, 47. Hydrofluoric acid, i, 527. Hydrogen, i, 537. Hygiama, ii, 443. Ichthyol, ii, 443. Inhalations and rectal insuf&ations of sul- phuretted hvdrogen (Bergeon's treatment), ii, 371. Iodine, i, 527. " vapour, i, 536. Iodoform, i, 537. Lignosulphite, i, 581. Malt extract, i, 595. Menthol solution (by injection), i, 614. Monochlorophenol (in form of a spray), i, 24. Myrrholin, i, 652. Naphthol, camphorated, ii, 2. Nitrogen monoxide, i, 528. Nucleins, yeast, and spleen, ii, 24. Nux vomica, ii, 28. Oxygen, ii, 52. Ozone, ii, 58. Pancreatic emulsion, ii, 59. Peppermint inhalation, i, 614. Pepsin, ii, 69. Peptomangan, ii, 69. Petroleum, ii, 70. Phosphates, ii, 78. Phospho-alburain, ii, 74. Piperidine, ii, 453. Piscidia, ii, 91. Pix burgundica, ii. 91, Potassium phosphate, ii, 79. " sulphocyanate, ii, 236. Pyootanine injections, ii, 109. Quillaia, ii, 113. Quinine, i, 256 ; ii, 119. 608 INDEX OP DISEASES AND REMEDIES. Tuberculosis. Kontgen rays, ii, 458. Salicylic acid, ii, 143. Serum, horse (subcutaneous injections), ii, 163. Serum, Maragliano's, ii, 188, 184. treatment, i, 85 ; ii, 179, 183. Sesame oil, ii, 190. Sodium cantharidate, ii, 306. " formate, ii, 207. Somatose, ii, 313. Sparteine (outaneously), ii, 216. Spermine, ii, 217. Strophanthus, ii, 331. Strychnine, ii, 449. Sulphaminol, ii, 336. Sulphonal, ii, 239. Sulphuretted hydrogen (Bergeon's treat- ment), ii, 371. Tannin, ii, 257. Tanosal, ii, 261. Tar, ii, 91. Taraxacum, ii, 364. Terebene, creosote, eucalyptol, and chloro- form, equal parts, inhalation of, i, 539. Thalline, ii, 276. Thymol, ii, 283. Tuberculin, i, 81. Turpentine oil, inhalation of steam from, i, 530. Waters, chlorinated alkaline, ii, 381. Whisky, ii, 385. (of young infants). Wine, port, ii, 393. Wines, ii, 394. X-rays, ii, 458. Zinc chloride (hypodermic injections), ii, 403. Zinc tannate, ii, 413. Tuberculosis, arthritic. Guaiaool, i, 457. Iodoform, i, 538. Tuberculosis, broucliial. Ichthyol, ii, 443. Tuberculosis, chronic laryngeal. Chloroform, i, 538. Tuberculosis, chronic pulmonary. Calcium phosphates, ii, 78. Hypophosphites, i, 518. Iodine, i, 536. Quinine (as a tonic), ii, 119. Tuberculosis, fever of. Aconite, i, 9. Antipyrine, i, 133. Pambotano, ii, 58. Tuberculosis, incipient. Copper arsenite (vapour or spray), i, 304. Tuberculosis, intestinal. Cinnamic-acid injections, i, 359. Tuberculosis, laryngeal. Ethyl-iodide inhalation, i, 528. Eucasin, ii, 436. Iodine, i, 527. Myrrholin, i, 052. Waters, chlorinated alkaline, ii, 381. Tuberculosis, lingual. Lactic acid, i, 568. Tuberculosis, local. Cloves, tincture of (injections), i, 373. Iodoform, i, 537, 538. Tuberculin, i, 81. Tuberculosis, miliary. Gold and arsenic, i, 454. Tuberculosis, nasal. Lactic acid, i, 568. Tuberculosis of joint cavities. Cinnamio acid and glycerin, i, 359. Iodoform, i, 537, 538. Tuberculosis, pulmonary. Acetanilide, i, 3. Air, condensed, expiration into, i, 89. " •' inspiration of, i, 28. " rarefied, expiration into, i, 28. Arsenic, i, 140. Balsamic fumes, i, 539. Baths, condensed-air, i, 27. Benzosol, i, 179. Boric acid, i, 191. Cannabis indioa, ii, 439. Cantharidio acid, i, 308. Carbon dioxide, i, 527. " •' (by insufflation), i, 533, Cinnamio acid, i, 259. Creosote, by inhalation, i, 314. " internally, i, 315. Ergot and sodium phosphate, i, 889. Ethyl iodide inhalations, i, 528. Guaiacol, i, 457-^60. Hydrofluoric acid, i, 537. Hydrogen, i, 527. Hygiama, ii, 443. Ichthyol, ii, 443. Iodine, i, 537. " vapour, i, 536. Lignosulphite, i, 581. Monochlorophenol (in form of a spray), i, 246. Myrrholin, i, 652. Nitrogen monoxide, i, 538. Oxygen inhalation, ii, 53. Ozone inhalation, ii, 58. Peppermint, inhalation of the vapour of, i, 614. Phosphergot, i, 889. Piperidine, ii, 453. Potassium sulphocyanate, ii, 336. Pyoctanine injections, ii, 109. Quillaia, ii, 118. Serum, horse (subcutaneous injections), ii, Sodium cantharidate, ii, 206. Strophanthus, ii, 331. Strychnine, ii, 449. Sulphonal. ii, 339. Sulphuretted hydrogen (Bergeon's treat- ment), ii, 371. Taraxacum, ii, 364. Terebene, creosote, eucalyptol, and chloro- form, equal parts, inhalation of, i, 529. Tuberculin, i, 81. Turpentine oil, inhalation of steam from, i. 530. Whisky, ii, 385. Wines," ii, 394. Zinc chloride (hypodermic injections), ii, 403. Tuberculous deposits. Calcium chloride, i, 203. Sulphaminol, ii, 386. Tuberculous joints. Iodoform, i, 538. Sulphur, ii, 341. INDEX OP DISEASES AND REMEDIES. 609 Tuberculous tracts. Calcium-phosphate solution (for washing out), i, 303. Tumours. Electricity, i, 361. Toxines, ii, 313. Vienna paste, i, 338. Tumours, cancerous. See Cancer. Tumours, cystic, of the ovaries. Aspiration, i, 153. Tumours, fibroid. See Fibroids, Uterine. Tumours of the broad ligament of the uterus. Aspiration, i, 153. Tumours of the gums and tongue. Potassium chlorate, ii, 96. Tumours, orarian. Calcium chloride, i, 303. Iodine (hypodermic injection), i, 586. Tumours, uterine. Calcium chloride, i, 303. Thyreoid treatment, ii, 298. Tympanites. Copper-arsenite solution, i, 304. Thymol, ii, 283. Typhlitis. Blisters, i, 185. Eucasin, ii, 436. Typhoid icTer. Acetanilide, i, 3. Alcohol, as a stimulant, ii, 335. Antipyrine, i, 133. Asaprol, i, 148. Bath, half, i, 168. " reducing or graduated, i, 170. Baths, cold, i, 600. Bismuth and pepsin, i, 181. Brand treatment, i, 600. Broraol, i, 197. Calcium bromide, i, 308. Camphoric acid (as an intestinal antiseptic), ii, 438. Carbolic acid and iodine, i, 313. Castor, i, 319. Cold bath, i, 486. Creosote, i, 314. Cupric sulphate, i, 306. Digitalis, i, 343. Euoalyptol, i, 400. Gavage, i, 436. Guaiacol (topical applications), i, 459, 460. " carbonate, i, 461. Hydrochloric acid, i, 493. Hygiama, ii, 448. Iodine (as an intestinal antiseptic), i, 536. Lactophenine, i, 568. Limewatcr, i, 582. Massage (Brand's treatment), i, 600. Naphthalene, ii, 1. Naphthol, ii, 1. Pambotano, ii, 58. (incipient stage), Paraforra, ii, 61. Pyootanine (internally), ii, 109. Quinine, ii, 119. Saligenin, ii, 147. Salipyrine, ii, 148. Serum treatment, i, 84. Sesame oil, ii, 190. Typhoid fever. Sodium earbolate (as an intestinal antiseptic), ii, 306. Sodium paraoresotate, ii, 307. Sulphonal, ii, 339. Thalline, ii, 376. Thymol, ii, 383. Thymus extract, ii, 385. Transfusion (with lamb's blood), ii, 323. Turpentine oil (internally), ii, 335. Water (copious drinks), ii, 361. Wine, port, ii, 393. Zinc sulphocarbolate, ii, 411. Typhus fever. Cold bath, i, 488. Emetics, i, 374. Quinine, ii, 118. " salicylate, ii, 455. Serum, artificial, ii, 165. Somat6se, ii, 313. Wine, port, ii, 393. Ulceration. See Ulcers. Ulcer of the rectum. Glycerin injections, i, 450. Hydrastis, i, 476. Silver nitrate (locally), ii, 194. Ulcer of the stomach. Arsenic, i, 146. Bismuth and morphine, i, 180. Blisters, small flying, i, 180. C^harooal, i, 232. Diet in, i, 335. Hjemalbumin, i, 463. Papain, ii, 60. Pepsin, ii, 69. Sesame oil, ii, 190. Silver nitrate, ii, 194. Somatose, ii, 313. Water, i, 479. Ulcer, rodent. Salicylated camphor, i, 204. Ulcers. Alcohol, i, 31. Alum, i, 50. Alumnol (as a dressing), i, 51. Alveloz, i, 52. Antiphthisin, i, 130. Antipyonine, i, 120. Aristol, i, 140. Atropine, i, 155. Benzophenoneid, i, 179. Bismuth salicylate, i, 180, 182. Borax, i, 189. Boric acid, i, 190. Calcium phosphate, i, 203. Carbolic acid, i, 313. Chalk powder, i, 330. Charcoal poultices, ii, 103. Chlorine, i, 340, 445. Chromic acid, i, 348. Cinchona powder, i, 253. Condurango, i, 397. Copper oleate, i, 305. Cupric-sulphate solution (locally), i, 306. Diaphtherin, i, 332. Elemi, as a stimulant application, i, 369. Eucalyptus, oil of, i, 400. Euphorbium, i, 401. 610 INDEX OF DISEASES AND REMEDIES. Ulcers. G-allie acid, i, 432. Geranium, i, 438. Glutol, ii, 438. Hydrastine, i, 476. Iodine, i, 536. Iodoform collodion, i, 293. lodol, i, 540. Kerosene, i, 565. Kino, i, 565. Massage, i, 609. Monochloraoetio acid, i, 225. Myrrh, tincture of, i, 657. Naphthalene, ii, 1. Naphthol, ii, 2. Nuclein, yeast, ii, 24. Oak bark, ii, 31. Oxygen (as a stimulant), ii, 51. Paraform (diluted), ii, 61. Peat, ii, 65. Phosphoric acid, ii, 77. Phytolacca, ii, 81. Potassium permanganate, i, 597. " sozoiodolate, ii, 215. Pulsatilla, ii, 107. Pyoctanine, ii, 108. Quinine, ii, 121. Resorcin, ii, 126. Rosemary, ii, 135. Rosinol, ii, 135. Salol (as a dressing), ii, 150. Sozoiodol-potassium, ii, 215. Spermine, ii, 217. Sugar, ii, 234. Tannic-acid ointment, ii, 259. Tannin, ii, 256. Tannoform ointment, ii, 260. Terebene (as a dressing), ii, 271. Thioform, ii, 278. Thiol ointment, ii, 278. Trichloracetic acid, i, 225. Tumenol and zinc oxide, ii, 334. Turpentine oil, ii, 335. Waters, mineral (externally and internally), ii, 364. Xeroform, ii, 397. Zinc chloride, ii, 403. " sulphate, i, 228. Ulcers, aphthous. Potassium chlorate, ii, QG. Tannin, ii, 256. Ulcers, atonic. Camphor (externally), i, 204. Kerosene, i, 565. Ulcers, cancerous. See Cancer. Ulcers, chronic. Phosphoric acid, ii, 77. Pyoctanine, ii, 108. Spermine, ii, 217. Ulcers, corneal. Antipyonine, i, 120. Atropine, i, 155. Benzophenoneid, i, 179. Cadmium sulphate, i, 200. Lactic acid, i, 568. Thioform, ii, 278. Water, hot, applications of, i, 813, Ulcers, foul. Trichlorphenol applications, ii, 330. Ulcers, foul. Carbolic acid, i, 212. Charcoal poultices, ii, 103. Naphthol, ii, 2. Rosinol, ii, 135. Peat (as a dusting powder), ii, 65. Ulcers, fungous. Alum, i, 50. Camphor, i, 204. Ulcers, gangrenous. Bromine, i, 195. Zinc chloride, ii, 403. Ulcer, gastric. See Ulcer of the stomach. Ulcers, herpetic, of the cornea. Pyoctanine, ii, 108. Ulcers, indolent. Basilicon ointment, ii, 135. Bismuth salicylate, i, 182. Cupric-sulphate solution (locally), i, 306. Elemi, as a stimulant application, i, 3G9. Euphorbium, i, 401. Geranium, i, 438. Hydrastine, i, 476. Kerosene, i, 565. Monochloracetic acid, i, 225. Myrrh, tincture of, i, 657. Nuclein, yeast, ii, 24. Oxygen (as a stimulant), ii, 51. Pulsatilla, ii, 107. Rosemary, ii, 135. Tannic-acid ointment, ii, 259. Trichloracetic acid, i, 225. Ulcers, laryngeal. Creosote, i, 314. Menthol, i, 614, 615. Silver nitrate, ii, 196. Ulcers, malignant. See Cancee. Ulcers of the leg. Naphthalan, ii, 448. Thioform, ii, 278. Thiosinamine, ii, 280. Ulcers of the mouth. Silver nitrate, ii, 195. Ulcers of the nasal sseptnm. Silver nitrate, ii, 195. Ulcers of the uterus. Carbolic acid, i, 213. Euphorin (in powder, or an alcoholic solu- tion), i, 402. Gold, i, 453. Iodized cotton tampons, i, 310. Mercury nitrate, i, 628. Ulcers, phagedenic. Bromine, i, 195. Mercury nitrate, i, 628. Nitric acid, ii, 7. Ulcers, putrid. Bromine, i, 445. Tar, ii, 263. Ulcers, scrofulous. Gold, i, 453. Ulcers, sloughing. Bromine, i, 195. Creosote, i, 314. Papain and sodium bicarbonate, ii, 60. Ulcers, suppurating. Potassium sozoiodolate, ii, 215. " permanganate, i, 440. INDEX OF DISEASES AND REMEDIES. eix. Ulcers, syphilitic. Alveloz, i, 53. Aristol, i, 140. Calcium salicylate, ii, 145. Europhene, i, 402. Mercury nitrate, i, 628. red iodide of, i, 627. " sozoiodolate, ii, 215. Papain, ii, 60. Salicylic acid, ii, 145. Sodium sozoiodolate, ii, 208. Zinc oleostearate, ii, 409. Ulcers, tuberculous. Antiphthisin, i, 120. Lactic acid, i, 568. Naphthol, camphorated, ii, 2. Oxygen, ii, 52. Starch, iodized, i, 537. Tannalbin, ii, 255. Ulcers, unhealthy. Benzoic acid, i, 178. Charcoal poultices, ii, 103. Chlorine poultices, ii, 103. Potassium chlorate (externally), ii, 96. Rhubarb powder, ii, 130. Ulcers, varicose. Traumatol, ii, 329. Ulcers, venereal. Black wash, i, 625. Cupric-sulphate solution, i, 306. Euphorin (as a local disinfectant), i, 402. Mercuric nitrate, i, 228. Mercury, red oxide of, i, 623. Nitric acid, i, 227. Uraemia. Baths, hot-air, i, 100. Chloroform, i, 528. Elaterium, i, 358. Hot-air bath, i, 468. Infusion, intramuscular, ii, 325. Jaborandi, i, 559. Potassium cobaltonitrite, i, 273. Strophanthus, ii, 281. Transfusion, depletory, ii, 328. Waters, Buffalo lithia, ii, 372. Ursemia, vomitingr of. Baths, hot-air, i, 100. Ureteritis. Sodium bicarbonate, ii, 366. Urethritis. See GONOBRHCEA. Uric-acid diathesis. Benzoic acid, i, 177. Glycerophosphates, ii, 439. Lycopodium tincture, i, 590. Phosphates, ammonium, ii, 78. Piperazine, i, 586 ; ii, 89. Potash, ii, 94. Potassium citrate, ii, 96. Tartarlithine, ii, 265. Uricedin, ii, 342. Urotropine, ii, 348. Waters, alkaline, ii, 367, 368. Uricaemia. See LiTH^MiA. Urine, retention of- Aspiration, i, 152. Baths, acid, i, 171. Com silk, i, 306. Croton oil, i, 318. Urine, retention of. Kava-kava, i, 564. Kidney extract, i, 181. Massage, abdominal, i, 608. Stimulants, spinal, ii, 226. Urticaria. Alumnol applications, i, 51. Benzoin, compound tincture of, i, 179. Calcium chloride, ii, 427. Chloroform (as a lotion), i, 241. Emol in itching of, i, 376. Jaborandi, i, 560. Salicylic acid, ii, 145. Urticaria, chronic. Arsenic, i, 144. Salicylic acid, ii, 143. Taginismus. Belladonna, i, 174. Camphor suppositories, i, 204. Electricity, i, 365. Yaginitis. See Elytritis. Varicosities. Iron-chloride (tincture) injections, i, 549. Variola. See Smallpox. Vegetations. Carbolic acid, i, 313. Catheretics, i, 225. Iron chloride, i, 548. Veins, varicose. Barium-chloride ointment, i, 162. Ergot, i, 388. Vertigo. Bromoform, i, 196. Vertigo of the aged. Cod-liver oil, i, 288. Strophanthus, ii, 332. Vertigo of seasicliness. Amyl nitrite, i, 61. Vomiting. Aconite, i, 100. Amyl nitrite, i, 99. Arsenic (Fowler's solution), i, 99, 146. Bismuth subnitrate, i, 180. Bitters, i, 183. Bromides, i, 99. Caffeine, valerianate, ii, 346. Calomel (small and repeated doses), i, 99. Calumba, i, 100. Camphor, i, 205. Carbonated waters, i, 99. Carbonic-acid gas, i, 314. Champagne, iced, i, 99; ii, 235, 392. Chlorobrom, i, 100, 240. Chloroform, i, 99, 241. Cocaine, i, 99. Creosote, i, 314. Emetics, i, 98. Ether, i, 99, 397. Gavage, i, 436. Ice, i, 520. Ingluvin, i, 526. Iodine (small doses), i, 536. " tincture of, i, 99. Ipecac, wine of, i, 543. Kephir, i, 98. Kumyss, i, 98. Limewater and milk, i, 583. 613 INDEX OF DISEASES AND REMEDIES. Vomiting. Matzoon, i, 98. Milk and limewater, i, 98. '• cerium oxalate and sodium bicarbon- ate, i, 98. Milk, peptonized, i, 98. Mustard plasters applied to the epigastrium, i, 98. Nitrate of silver, i, 99. Nitroglycerin, i, 99. Nux vomica, ii, 23. Opium, ii, 37. Pepsin, ii, 69. Podophyllin, i. 100. Salicylic acid, i, 100. Serpentaria. i, 100. , , ^ i,\ Silver nitrate (by irrigation of the stomacn;, ii, 194. Silver oxide, ii, 197. Sulphonal in milk, i, 99. Vinegar fumes, ii, 359. Vomiting' after anaesthesia. Champagne, ii, ^94. (with chloroform). Vinegar fumes, ii, 359. Vomiting, liysterical. Camphor, i, 205. Creosote, i, 314. Galvanization, i, 867. Vomiting, morning, of drunltards. Arsenic, i, 146. Bitters, i, 100, 183. Calumba, i, 100. Gentian, i, 100. Nux vomica, ii, 28. Serpentaria, i, 100. Vomiting, nervous. Caffeine valerianate, ii, 346. Galvanization, i, 367. Ipecac, i, 542. Vomiting, obstinate. Bitters, i, 183. Chlorobrom, i, 240. Gavage, i, 436. Opium, ii. 37. Silver nitrate, ii, 194. Vomiting of cerebral disease. Bromides, i, 99. Vomiting of chronic gastric disease. Alum, i, 99. Nitrate of silver, i, 99. Vomiting of gastric atony. Ipecac, i, 542. Vomiting of indigestion. Pepsin, ii, 69. Vomiting of pregnancy. Aconite, i, 9. Arsenic, i, 146. Bismuth, i. 180. Bitters. 1, i83. Bromides, i, 194. Carbonic-acid gas, i, 214. Cerium oxalate, i, 229. " valerianate, ii, 346. Champagne, ii, 394. Creosote, i, 314. Ether (internally), i, 897. Ingluvin, i, 526. Ipecac, i, 542. " wine of (in small doses), i, 99. Nux vomica, ii, 28. Vomiting of seasicliness. Amyl nitrite, i, 99. Bitters, i, 183. Champagne, ii, 394. Chlorobrom, i, 100, 240. Nitroglycerin, i, 99. Vomiting of uraemia. Baths, hot-air, i, 100. Vomiting of uterine disease. Cerium oxalate, i; 229. Vomiting, reflex. Nitroglycerin, ii, 15. Warts. Acetic acid, i, 5. Arsenic (internally), i, 144. Chelidonium, i, 233. Chromic acid, i, 248. Collodion, salicylic acid, and zinc chloride, i, 293. Copper oleate, i, 305. Creosote as a caustic, i, 314. Monochloracetic acid, i, 235. Nitric acid, i, 227 ; ii, 7. Potassium bichromate, ii, 95. Salicylic acid, ii, 143. Silver nitrate, ii, 196. Sodium ethylate, ii, 207. Trichloracetic acid, i, 225. Zinc sulphate, ii, 407. Weakness of old age. Stimulants, cardiac, ii, 227. Weakness, seminal. See Spekmatobrhcea. Whitlows. Alkalies (poultice of hard-wood ashes), i, 45. Whooping cough. Acetanilide, i, 4. ADyl tribroniide, ii, 414. Amber, oil of, i, 52 ; ii, 414. Anemonin, ii, 108. Antipyrine, i, 124. Antispasmin, i. 133. (paroxysms), Asafoetida, i, 147. Balsamic fumes, i, 529. Baths, condensed-air, i, 27. Belladonna, i, 174. Benzoic acid, i, 178. Bromoform, i. 196. Bryonia, i, 197. Caffeine valerianate, ii, 846. Carbolic-acid (solution) inhalation, i, 213. Carbonic-acid gas. i, 214. Castanea leaves. Chestnut leaves, i, 319. Chloral hydrate, i, 237. Coccus, Cochineal, i, 284. Codeine, i, 386. Conium, i, 298. Copper dioxide, i, 527. Eucalyptol inhalation, i, 529. Eucalyptus and terebene, oils of, i, 400. Formaldehyde, ii, 436. Gclsemium, i, 437. Hydrocyanic acid, i, 495. Ipecac, i, 543. Lobelia, i, 587. Menthol (by spray), ii, 445. " inhalation, i, .539. Mercury-bichloride applications, ii, 446. Muscarine, i, 645. INDEX OF DISEASES AND REMEDIES. 613 Wh«oping"COugrli. Naphthalene, ii, 1. Nitric acid, ii, 8. Nitrogen monoxide, i, 538. Nitroglycerin, ii, 15. Opium, fumes of, i, 539. Ouabain, ii, 48. Ozone inhalation, ii, 58. Piscidia (as an antispasmodic), ii, 91. Quinine, ii, 119. " insufflation, i, 353. " tannate, ii, 359. Resorcin (by spray), ii, 136. Silver-nitrate solution (by sponging the throat), ii, 198. Sodium salicylate, ii, 146. " sozoiodolate, ii, 308. Sulphur fumes, ii, 341. Terpin hydrate, ii, 373. Thymol, ii, 383. Turpentine oil, ii, 336. Tussol, ii, 337. Valerian, ii, 345. Zinc cyanide, ii, 408. " sulphate (as an emetic), ii, 407. Worms, intestinal. Aloes, i, 103. Ammonium embellate, 1, 57. Aspidium, i, 108. Bitters (injections), i, 183. Carboiic-acid injections, i, 103. Kamala, i, 568. Quassia, i, 103. Savine, ii, 157. Thymol, ii, 284. Worms, lumbricoid. Andira, i, 70. Chenopodium, i, 334. Ether, i, 397. Naphthalene, ii, 1. Papain, ii, 60. Spigelia, ii, 217. Quassia, ii, 113. Tea. worm, ii, 269. Worms, seat. See AscAEiDES. Wounds. Alcohol, i, 29. Alumnol (irrigation), i, 51. Amyloforni (as a deodorizer), ii, 415. Antiseptics, i, 129. Benzoin, i, 179. Boric acid, i, 196. Bromine, i, 195. Bromol, i, 190. Chloral hydrate (locally), i, 337. Cinchona powder, i, 253. Cinnamon oil (as a dressing), i, 259. Collodion, saturnine, i, 293. Cydonium, i, 323. Diaphtherin, i. 333. Diiodoform, i, 343. Eucalyptus, oil of, i, 400. Eucasin, ii, 435. Formaldehyde, ii, 436. Glutei (as an antiseptic), ii, 438. Hydrochloric acid, i, 493. Wounds. Hydrogen dioxide, i, 503. Insufflation, i, 533. Iodine, i, 537. Iodoform, i, 538. Irrigation, i, 555. Izal, i, 556. Mentho-phenol and warm water, i, 016. Naphthalene, ii, 1. Olive oil, ii, 35. Oxygen, ii, 51. Phenol sodique, ii, 73. Piper nigrum, ii, 90. Pixel, ii, 92. Potassium permanganate, i, 446. Sanoform, ii, 154. Solphinol, ii, 211. Sozoiodol-potassium. ii, 315. Sugar, ii, 334. Sulphaminol, ii, 336. Tannoform, ii. 154. " ointment, ii, 260. Terebene (as a dressing), ii, 371. Traumatol, ii, 329. Xeroform, i, 397. Zinc oleastearate, ii, 409. " oxychloride, ii, 410. " subgallate, ii. 411. Wounds, gunshot, chronic suppurating'. Waters, mineral (externally and internally), ii, 364. Wounds, infected. Antisejitics, i, 129. Oxygen, ii, 51. Xeroform, ii, 397. Wounds, poisoned. Alcohol, i. 30. Cydonium, i, 333. Wounds, septic. Iodoform powder, i. 538. Zinc subgallate, ii. 411. Wounds, suppurating. Iodoform, i, 538. Potassium sozoiodolate, ii, 315. Wounds, sutured. Zinc oxychloride, ii, 410. Wounds, unhealthy. Cinchona powder, i, 353. Permanganate of potassium, i, 446. Quinine, ii, 120. Wryneclc. See ToKTicoLLis. Xanthelasma. Nitrohydrochloric acid, ii, 16. Xerodermia. Thyreoid feeding (dry powder), i, 79. Yellow ferer. Calomel, i, 624. Copper-arsenite solution, i, 304. Zoster. Aoetanilide, i, 3. Blisters, i, 186. Grindelia, i, 436. Salicylic acid (for pain), ii, 143. LIST OF AUTHORS CITED. Abbe, R., ii, 53. Abbott, P. C, ii, 177. Aberororabie, P. H., ii, 347. Abernethy, K., i, 592. Abrahams, R., ii, 457. Abrajanoff, ii, 39. Adams, G., ii, 374. Agnew, H., i, 195. Ahlfeld, ii, 123. Albertoni, ii, 447. Alexander, W. S., ii, 436. Allen, A. H., ii, 109. Allen, B. W., ii, 133. Allen, C. W., ii, 116. Anderson, T. P., 1, 373. Anstey, i, 395 Anthoire. i, 400. Arendt, B., i, 609. Arnheitn, A., ii, 154. Aronson, H., ii, 61. Atkinson, ii, 116. Attaeld, ii, 140. Aubert, ii, 419. Auerbach, ii, 47. Aulde, J., i, 303 ; ii, 33, 24, 133, Babcoek, R., ii, 431. Babcock, W. L., ii, 393. Babes, i, 84. Bacoelli, ii, 333. Bailey, P., ii, 390. Baldwin, E. R., i, 614. Ballance, C. A., ii, 177. Balm, B., ii, 417. Balz, i, 309. Barber, C. F., ii. 309. Barbour, J. P.. ii. 60. Barcklay, J., ii, 293. Bard, ii, 185. Bardet, i, 438; ii, 456. Barker, P.. ii, 353. Barr, G. W., ii, 38. Barrows, 0. C, ii, 354. Barth, i, 394. Bartholow, i, 386, 451 ; ii, 15, 98. Barton, ii, 18. Baruch, i, 448. Barwell, ii, 39. Bassi, ii, 165. Bales, W. H., ii, 346. Battey, R., ii, 73. Baumann, ii, 300. Baumler, ii, 241. Beehtine, P., i, 385. Beolere, A., ii, 179. Beddell, W. M. 0., ii, 79. Behring, i. 84. Bell, J., ii. 381. Bellamy, R., ii, 333. Berg, H. W., i, 625. Beringer, G. M., ii, 133. Barman, ii, 150. Bicente, ii, 98. Bidder, ii. 378. Bigelow, S. L., i, 292. Biggs, H. M., i, 84. Billings, J. S., i, 599. Binz, li, 120. Blackford, B., ii, 383. Blackwell, ii, 132. Blake, P. R., ii, 376. Blake, J. B., ii, 18. Blakely, G. A., ii, 433. Blano, ii, 73. Bleyer, J. M., ii, 23. Bliokensderfer, ii. 376. Blooh, Dr. 0., i, 524. Blondel, ii, 456. Blum, i, 429. Boal, ii, 357. Boas, ii, 365. Bocquillou-Limousin, i, 343; ii, 230. Boeck, C, i, 577 ; ii, 126, 186. Bohland, ii, 89. Bondurant. ii, 209. Bontor, S. A., ii, 445. Boody, G., ii, 445. Boso, ii, 325, 398. Bossi, ii, 334. Boucher, ii. 206. Bowen, J. T., ii, 150. Boyer, H. P., ii, 332. Bradbury, J. B., ii, 8. Bramwell, B., i, 79. Braun, ii. 365, 371. 373. Brocq, i, 291 ; ii. 453. Brodie, B., i, 586. Brodier, i, 343 ; ii. 165. Bronowsky, i, 302. Brouowski, ii, 329. Brown, B. IL, i. 400. Browne, L., ii, 487. Brown-Sequard, i, 74; ii, 163. Bruce, L. C, ii, 290. 614 Brunton, T. L., i, 54, 341 ; ii, 80. Buchheim, ii, 368. Buiza, i, 570. Bnlkley, L. D., ii, 205. Bunge, i, 545. Burcq, i, 303. Buzzi. ii, 301. Cabot, R. C, ii, 245. Caille, A., i, 191 ; ii, 58. Calmette, A., ii, 188. Cantani, ii, 258. Cantrell. J. A., i, 302; ii, 144. Cao, i. 403. Garfield, C. A., ii, 131. Carleton. ii, 359. Carpenter, J. S., i, 460. Carrasquilla, J. de Dies, ii, 184 Carron. i. 433. Carselli, ii, 229. Carter, ii, 23, 435. Carter, B. W., i, 459. Cassaet, ii, 400. Castex, i, 609. Cattaneo, ii, 182. Cauchard. ii. 339. Cautley, B., i, 635. Cerna, D., i, 563. 638, 645 ; ii, 60, 109. 208, 373, 417. Cesaris, P., i, 403. Chadwiek, ii, 357. Chalke, E. L., ii, 441. Championt iere, i, 461 ; ii, 104. Chandler, W. J., ii, 355. Chanteraesse, i, 84; ii, 171. Chaplin, A., ii. 453. Chappell, W. F., i, 316, 409, 436. Charcot, i, 491. Charteris, ii. 330. Chaumier, B., ii. 46. Cheatham, W., ii, 454. Cheron, ii, 83. Chilret, ii, 146. Chittenden, R. H., ii, 392. Claiborne, J. H., ii, 372. Claisse, A., ii, 165. Clapton, i, 303. Clark, A., 1, 450. Clark, H. M., i, 55. Clark, J. A., ii, 426. Clark, L. P., ii, 292. LIST OF AUTHORS CITED. 615 Claus, ii, 47, 333. Olendinnen, F. J., ii, 397. Clouston, ii, 63. Coblentz, V., ii, 163, 166, 265, 431, 433, 436. Coghill, J. S., ii, 428. Cohen, (j., ii, 97. Colin, A., ii, 435. Cohnstein, W., ii, 318. Cole, ii, 53. Coley, F. C, i, 615. Colombini, ii, 150. Combemale, i, 629 ; ii, 35, 108. Comstoclc, A. J., i, 590. Conway, J. R., i, 315. Cooif, A. B., ii, 63. Cooper, A., ii, 402. Cornet, ii, 438. Cottam, Q. G., ii, 316, 415. Courraont, .1., ii, 85. Cozzolino, i. 631. Cred6, ii, 192, 197. Crespin, ii, 58. Csatdry, ii, 331. Cumston, C. G., i. 399. Cunningham, R. H., i, 427. Curgfinven, J. B., i, 400. Curtis, B. F., ii, 53, 313. Curtis, C, i, 402. Curtis, H. H., i, 417. Czerny, ii, 313. Dabney, W. C, ii, 384. Da Costa, i, 397, 459. Dahman, M., i, 463. Daish, W, C, ii, 416, 434. Dalche, ii, 456. Dana, i, 403. D'Arsonval, i, 71. Darwin, i, 645. Davies, N. W., i, 596. Dawbarn, ii, 328. Day, ii, 53. Debove, i, 435. De Bueck, ii, 278. De Hart, I. M., ii, 54. De Jaworski, ii, 417, Delage, ii, 439. Delepine, S., i, 556. Delshenkoft, i, 568. De Mentyel, M., i, 403 ; ii, 213, 282. De Minicis, ii, 174. Demontporoelet, ii, 161. De Ifeneki, ii, 417. Denissenko, ii, 431. De Renzi, ii, 398. Derville, L., ii, 404. De Sanctis, ii, 415. De Schweinitz, ii, 188. Desnos, i, 630. Despeignes, V., ii, 398. De Weeker, i, 562. Dhargalkar, L. B., ii, 447. Dillard, J. W., ii, 383. Dittrich, J. C, ii, 58. Dobell, H., ii, 59. Dodd, A., ii, 324. Dori, i, 553. Dornblath, O., ii, 154. Doukalsljy, ii, 92. Downie, J. W., i, 614. Drews, R., ii, 152. Druitt, ii, 393. Dubois, ii, 38, 185. Duchesne, G., ii, 432. Duclos, i, 433. Duhring, ii, 264. Duiardin-Beaumetz, i, 335, 487. Duniarest, P., ii, 325. Dumontpallier, ii, 96, 164. Dunwody, J. A., ii, 163. Ebstein, L., ii, 143. Eddowes, A., ii, 439. Edgar. .1. C, ii, 355. Edson, C, i, 84. Bhrlioh. P., i, 629. Elder, T. A., ii, 73. Elkins, F. A., ii, 62. Elliot. R. H., ii, 30. Bngelhardt, i, 474. England, J. W., ii, 433. Esoherioh, ii, 259. Etienne, ii, 451. Evans, B. D., ii, 63. Evans, H., ii, 231. Bvenhoff, ii, 450. Ewald, ii, 300, 368. Pafiourse, ii, 145. Faulder, P., ii, 456. Pawcett, ii, 89. Penwick, E. H., i, 590. Penwiok, W. S., i, 520. Ferguson, J., ii, 448. Perrand, i, 451. Perreira, C, i, 630. Feulard, i, 85. Pilehne, ii, 454. Pinsen, i, 463. Flemming, C, i, 239. Plexner, J. A., ii, 343. Flint, A., i, 630. Flint, W. H., ii, 62. Floershein, ii, 329. Flourens, i, 395. Forlanini, ii, 194. Pothergill, W. E., ii, 456. Pox, G. H., ii, 209. Pox, T.. ii. 409. Fraenkel, E., ii, 285. FranQois, i, 629. Frangois-Franck, i, 340. Prankel. S.. ii, 387. Praser, T. R., i, 598. PuUerton, B. B., ii, 121. Pullington, C. P., i, 588. Furneaux, J., i, 311. Gaethgens, i, 496. Gahn, i, 595. Gallois, i, 637. Gambler, P., i, 588. Garrod, A. B.. ii, 371. Gaucher, i, 637. Gepner, i, 428. Gerdes, ii, 212. Gerster, A. G., ii, 313. Gibbs, W., i, 273. Gibier, P., i, 74; ii, 175. Gibney, V. P., ii, 441. Gihon, A. L., ii, 223. Gillette, i, 293. Giovanni, ii, 81. Girdner, J. H., i, 567. Girtnert, i, 458. Glass, ii, 86. Glenn, J. H., ii, 333. Gompertz, i, 616. Goodman, ii, 81. Gordon, J., i, 403. Gorl, ii, 435. Gorman, A., i, 588. Gossett, W. B., ii, 415. Gottlieb, ii, 254. Gottsohalk, S., ii, 333. Gowers, ii, 15. Graoomeni, i, 407. Gradeau, ii, 366. Graham, i, 610. Grant, C. G., i, 259. Grawitz, ii, 303, 346. Greene, R. H., ii, 316. Gregg, W. H., i, 458. Grinnell, P., ii, 355. Griswold, G., i, 63. Gniening, ii, 115. Grutzner, ii, 365. Gruzdeff, V. S., i, 389. Guiuard, ii, 436. Guintsburg, ii, 443. Guladze, ii, 384. Gull, W. W., ii, 388. Qilnzburg, A., ii, 401. Guttmann, P., i, 630 ; ii, 151. Haegler, ii, 414. Hagnos, i, 597. Haig, ii, 140. Hallopeau, i, 343. Halsted, G., ii, 372. Hamilton, A. McL., i, 599 ; ii, 18. Hammarsten, ii, 20. Hammond, L. M.. i, 571. Hardwicke, W. W., i, 400. Hare, H. A., i, 384, 435; ii, 448, 450. . Harold, J., i, 422. Harrington, i, 631. Harrison, C. H. R., i, 50. Harrison, R., ii, 82. Hartmann. ii, 284. Haubold, H. A., ii, 416. Hayem, ii, 415. Hearder, P. P., ii, 63, 338. Hederich, i, 483. Hendley, H., ii, 446. Hennig, ii, 148. Hermann, T. T., ii, 344. Hern, i, 275. Herriek. J. B., ii, 293. Hertz, ii, 397. Heuss, E., ii, 397. Hewitt, P., ii, 415. Hiller, i, 496. Hinton, J., ii, 357. Hirschfeld, E.,,ii, 314 616 LIST OP AUTHORS CITED. Hitchoock, C. W., ii, 24. Hohn, ii, 451. Hood, ii, 146. Hopkins, T. S., ii, 377. Hoppe-Seyler, i, 496. Horing, ii, 108. Horton, E. G., ii, 436. Howell, W. H., ii, 4S. Hrdlicka, A., i, 304; ii, 291. Huchard, i, 493 ; ii, 245, 277. Humplirey, ii, 63. Huntley, W., ii, 438, 450. Hurty, J. W., ii, 436. Hutinel, ii, 171. Ignatieff, ii, 63. Isaac, R., ii, 447. Jaoobi, A., ii, 121. Jaoobi, C, ii, 216. Jacobsohn, W., ii, 25. Jamieson, W. A., i, 376. Jankau, L., ii, 305. Joal, ii, 430. Jolly, ii, 452. Joseph, ii, 357, 448. Josias, ii, 178. Jouin, ii, 298. Kahn. i, 652. KampHer, i, 590. Kanasz, J., i, 272. Kane, E. O'JST., ii, 419. Kappeler, i, 395. Keay, J., ii, 240. Kestner, G., ii, 360. Ketchart, i, 458. Keyes, E. L., ii, 98. Khmelewskv, ii, 313. Kibbe, A. B., ii, 399. Kidd, P., ii, 450. Kiesel, ii, 435. Kirscli, E., ii, 431. Kitasato, i, 84 : ii, 185. Kloman. W. C. i, 389. Knapp, ii, 115, 120. Knapp, 0. P., ii, 25. Robert, ii, 113. Koch, i, 306. Kocher, ii, 288, 397. Koenig, i, 385, 631. Kohos, ii, 308. Kolisko, i. 398. KoUe, R S., ii, 398. Koller, K., i, 375. Komarovitcli, ii, 433. Korff, i, 588. Kossmann, R., ii, 123. Koster, ii, 349. Krafft-Ebing. ii, 63. Krahn, ii. 456. Krauss, W. C, ii, 16. Krieger, G. B., ii, 217. Krogius, i, 279. KrOnig, ii, 72. Labbe, ii. 58. Labit, ii, 87. Laborde, i, 611. Ladeire,.ii, 329. Ladenburg, A., i, 503. Lafout, ii, 17. Laidley, J. B., ii, 133. Lamarque, i, 428. Lambert, A., ii, 286. Landerer, ii, 431. Landois, ii, 318, 323. Lane, ii, 241. Langmaid, S. W., ii, 307. Lannois, i, 459. Lashkevieh. i, 55. Laubinger, ii, 119. Le Conte, J. L., ii, 384. Lederer, ii, 140, 147. Leech, D. J., i, 59, 60, 373 ; 11, 15, 62. Lee, R., ii, 331. Leeds, i, 631, 642. Lees, R. C, ii, 439. Leiohtenstern, ii, 364. Leistikow, L., ii, 136, 349. Leith, R. P. C, ii, 434. Lepine, ii, 205, 398. Leppmann, A., i, 629. Lc Tanneur, ii, 443. Letzel, i, 433. Levi-Dorn, ii, 298. Leventlial, G., i, 630. Lewin, i, 390, 359. Lilienthal, H., ii, 54. Linossier, i, 459 ; ii, 204. Livet, ii, 437. Loderaan, E. G., ii, 133. LSffler, ii. 309. Loomis, H. P., i, 339. Lourier, A., ii, 187. Love, ii, 354. Lowenthon, v., i, 581. Lustgarten, ii, 359. Luton, A., i. 303, 389. Lydston, G. F., i, 454. Maealister, C. J., ii, 52. Maeallum, A. B., i, 545. Mackenzie, H. W. G., i, 78. JMaoKenzie, T., ii, 61. jMaclennan, ii, 452. iVIacMunn, J., i. 259. Maher, S. J., ii, 401. Maillart H., ii, 361. Mai ret, i, 639. Maisoh, A., i, 629. Maitland, C. B., ii, 295. Maldareseo, ii, 439. Mann, J. D., i, 598. Mann, W. 0., ii, 445. Manotti, i, 272. Maragliano, E., ii, 179. Marcuse, ii, 399. Marinesco, ii, 91. Markoe, P. H., ii, 18, 53. Marsden, A., i, 145. Maslovsky, ii, 113. Matagne.'ii, 318. Maurel, i, 540. Maxwell, A., ii, 209. Mayet, i, 343. Mayne. N., ii, 336. Mays, T. J., ii, 449. McCosh, A. J., ii, 54. MoKinlock, J., ii, 89. Meisels, i, 429. Mellinger, i, 433. Meltzer, S. J., ii. 289, 326. Mendel. L. B., ii, 392. Mendelsohn, i, 585. Mengus, ii, 163. Menzies, J. D., i, 79. Metral, ii, 229. Milkhalkine, ii, 15. Miller, R. E., i, 383. Miloslawski, i, 653. Mitchell, €. L., i, 470. Mitcliell, S. W., i, 607; ii, 126. Mittra, ii, 60. Moblev, H. A., ii, 183. Molliere, H., ii, 86. Moncorvo, i, 403 ; ii, 126. Mond, ii, 451. Montgomery, D. W.. ii, 425. Monti, ii, 432. Moor, W., i, 597. Moorman, J. W., ii, 132. Morgan, P. P., ii, 416. Morgan. J. D., ii, 381. Morris, E. K., ii, 440. Morris. L. R., ii, 876. Morton, J., ii, 330. ' Morton, T. S. K., ii, 53. Morton, W. J., ii, 56. Mueller, A., ii, 29. Mulhall, J. C, ii, 306. MilUer, G. J., i, 569. Murray, W., i, 620 : ii, 194, 288. Murreil, W., ii, 15, 159, 270, 329, 414. Musmeci, M., ii, 435. Mya, i, 630. Myers, 0. M., i, 199. Nakawaga, ii, 187. Kemann, J., i, 051. Kesbitt, ii, 140. Netter, ii, 2, 99. Newconib, J. E., ii, 307. Newton, R. C, ii, 354. Nicolaier, i, 84 ; ii, 342. Notkin, J. A., ii, 301. Noyes, H. D., i, 275. Oberlander, ii. 200. Ochsner, A. J., i, 30. Olderogge, W. W., ii, 159. Oliver, C. A., ii, 159. Oliver, G., ii. 244. Ormsby, 0. B.. i, 587. Orthmann. ii, 149. Osier, W.. i, 487. Otis, W. K., i, 540 ; ii, 444. Ott, I., ii, 380. Ottinger, W., ii, 444. ■ Oudin, ii, 58. Overlach, M., i, 631. Owen, D., ii, 284. Pander, H., i, 247. Panecki, ii, 223. Paquin, P., ii, 183. Park, R., i, 647 ; ii, 457. Parker, L., i, 480. LIST OP AUTHORS CITED. 617 Parker, W. R., ii, 293. Parkes, i, 440. Paul, C, i, 630. Pavesi, i, 287. Payne, R. L., ii, 357. Peale, A. C, ii, 373. Pearse, H. S., ii, 151. Pease, C. G., ii, 18. Pelzer, i, 450. Penhallow, D. P., ii, 134. Penzoldt, ii, 112, 272. Peroni, ii, 329. Personal!, i, 639. Peterson, P., i, 277 ; ii, 63, 233, 290. Petrasko, J., ii, 440. Petrone, ii. 13. Pettit, ii, 237. Peyrot, ii, 436. Pfister, E., ii, 433. Philpots, E. P.,ii, 371. Pliisalix, ii, 189. Pictet, R., i, 429. PifEard, fl., ii, 191, 360. Pinard, ii, 164. Pinous, L., ii, 233. Poehl, A., ii, 317. Poggi, ii, 99. Poole, i, 337. Poppi, ii, 338. Porteous, J. L., ii, 23. Porter, I. W., ii, 58. Post, S. E., i, 409. Potter, S. 0. L., ii, 39. Pottevin, i, 428. Potts, C. S., ii, 209. Poulet, ii, 48, 86. Powell, B., ii, 133. Power, F. B., i, 588. Pozzi, ii, 164. Preisach, i, 439. Prentice, C., ii, 443. Prentiss, D. W., ii, 416. Preyer, i, 496. Purdon, H. S., ii, 161. Purdy, ii, 74. Qiiimby, 0. B., ii, 413. Rabinsohek, ii. 446, RadolifEe, H., ii, 144. Raderaaker, C. J., ii, 94. Raymond, ii, 47. Rehn, ii, 337. Reichert, 1, 59, 493. Reich-HoUender, G., ii, 130. Reilly, F. J., ii, 206. Reinach, 0., ii, 163. Reinbaoh, ii, 285. Rekowski, L., ii, 186. Rendu, ii, 458. Rennie, S. J., ii, 189. Reynier, ii, 150. Rhazes, ii, 386. Rice, C. i, 283. Richardiere, i, 459. Richardson, B. W., i, 376, 490 ; ii, 50, 53, 203. Richardson, D. A., ii, 417. Richet, i, 610. Richter, ii, 280. Rieck. ii, 437. Ringer, S., i, 636 ; ii, 256. Rives, W. C, ii, 419. Roberts, i, 586. Roberts, W., ii, 367, 371. Robertson, W., i, 176. Robin, ii, 438. Robinson, W. J., ii, 443, Rochard, J., i, 593. Roche, A., ii, 239. Roger, ii, 178. Rogers, J. G., ii, 398. Rohrig, ii, 370. Roosa, D. B. St. J., i, 650. Roosevelt. J. W., i, 373. Rose, A., i, 314. Rotch, i, 631. Rothschild, ii, 337. Rougon, ii, 49. Ruhrah, J., ii, 186. Rullier, i, 539. Rumpf, T., ii, 285. Rusbv, Henrv H., ii, 82. Russell, W. ii., i, 401. Ruth, ii, 67. Saalfeld, i, 589. Sachs, B., ii, 98. Sainsbury, H., ii, 178. Salkowskv, E., ii, 436. Sandwith", ii, 284. Sapelier, ii, 165. Sasse, ii. 337. Sattler, i, 563. Saundbv, ii, 438. Savill, T. D., i, 403 ; ii, 437. Sayre, i, 588 Sbrana, ii. 452. Scarpa, L. G., i, 523. Schaefer, E. H., i, 616. Schaeter, T. W., i, 616. Schafer, L. A., ii, 244. Schapiro, ii, 47. Sehepers, i, 453. Schick, ii, 237. Schirman, A., i, 565. Schleieh, C. L., ii, 438, 524. Schmidt, J. J., ii, 300. Schraitz, A., ii, 2. Schoenbein, C. F., i, 293. Schonbein, i, 496. Schott, A., ii, 420. Sohott, T., ii, 425. Schroder, C, ii, 47. Schroff, i, 375. Sohulz, ii, 238. Schwarz. i, 84 ; ii, 315. Sears, G. G., ii, 295. See, Germain, i, 400, 422; ii, 143. Seifert, ii, 19. Semmola, i, 85. Sevestre, ii, 171. Sewall, H., ii, 24. Sharp, G., i, 329 ; ii, 89. Sheild, A. M., ii, 415. Shennan, T., ii, 356. Sherwell, S., i, 313. 584. Shively, H. L., ii, 314. Shurly, E. L., i, 439. Siblev, K., ii, 440. Siebel, ii, 151. Silber, M., ii, 456. Simon, C..E., i, 648. Simpson, W. K., ii, 307. Sinha, R. D., ii, 436. Skerritt, E. -M.. i, 301. Slaughter, H. P., ii, 89. Smirnoff, S. P., ii, 344. Smith, A. C, i, 630. Smith, A. H., i, 338, 380; ii, 335 Smith, H., i. 503. Smith, P. B., i. 530. Smith, S., ii, 64. Smith. T., i, 502 : ii, 188. Snegirjoff, ii, 333. Snow, H., i, 588. Solis-Cohen, J., i, 433, 459. Solis-Cohen, S., ii, 3, 47, 439. Solly, S. E., ii, 375. Soulier, ii, 73. Sous, ii, 29. Spalding, J. A., ii, 233. Spillman, ii, 2, 451. Squibb, i, 614 ; ii, 456. Stallard, P., ii, 67. Stern, H., ii, 418. Sternberg, i, 597. Stieglitz, L., ii, 293. Stimson, L. A., ii, 313. Stockman, R., ii, 438. Stockwell, A., i, 70. Stoker, ii, 52, 451. Stokes, J., ii, 133. Storer, M., i, 533. Stuart, T. P. A., i, 373. Stucky, R. H., i, 454. Stuve, R., ii, 190, 415, 449. Suker, G. P., i, 386. Summa, H., ii, 70. Susewind, ii, 213. Suttie, G., ii, 254. Swain, H. L., ii. 308. Swayze. B. W., ii, 48. Swiatecki, ii, 185. Szenes, i, 455, 616. Sziklai, ii, 85. Tarnier, ii, 164. Tasano, ii, 183. Taube, H.. ii, 212. Tavitain, ii, 439. Tavlor, J. R., ii, 134. Taylor, R. W., ii, 98. Tchervinsky, ii, 63. Thaver, i, 630. Thiele, W. A., ii, 316. Thomas, i, 596. Thornton, E. Q., ii, 76. Thur. U. W. E., i, 630. Tichborne, ii, 411. Tizzoni, i, 84. Tommasoli, ii, 186. Tonoli, ii, 245. Tournier, ii, 20.5. Tourrier. ii, 178. Tousev, S., ii, 279. Treille, A., ii, 174. 618 LIST OP AUTHORS CITED. Trillat, i, 428. Tunniolieee, P. W., ii, 453. Turnbull, G. L., ii, 16. Ullraann, K., ii, 458. Ulrici, ii, 63. , Unna, ii, 33, 300, 348. Vahle, ii, 122. Van Arsdale, W. W., ii, 54. Van der Warker, E., ii, 337. Van der Willigen, i. 534. Van Hook, W., i, 525. Van Schaick, G. W., ii, 175, 332. Vargas, ii, 72. Vauglian, V. C, ii, 19, 31, 33, 34. Veasey, C. A., ii, 334. Vedel, ii, 334. Veeder, M. A., ii, 256. Vergely, ii, 445. Videll, i, 84, Vierordt, ii, 254. Vinci, G., ii, 434. Vintras, ii. 303. Vogl, i, 487. Vogt, ii, 333. Volintzeff, ii, 418. Vollert, ii, 435. Von Engel, ii, 254. Von Generisch, ii, 258. Von Graefe, ii, 115. Von Mering, J., ii, 7. Von Mosetig-Moo'rhof, ii, 373. Von Noorden, i, 544; ii, 19, 424, 436, 447. Von Ruck, ii, 69. Von Ziemssen, i, 490 ; ii, 334. VuUiet, i, 31. Wade, J. P., i, 340. Wade, W. C, i, 51. Wadleigii, W. K., ii, 332. Wagner, i, 276 ; ii, 145. Warden, i, 561. Waterhouse, W. D., i, 76. Waterman, J. H., ii, 441. Waters, B. H., ii, 151. Watson, C, i, 588. Weinrich, M., ii, 433. Weir, R. P., i, 393. Weisbecker, ii, 178. Welch, E. A., i, 189. Welch, J. W., ii, 134. Werler, 0., ii, 198. West. S., ii, 338-343. Wheeler, G. A., i, 199. Whipple, T. S., i. 587. White, W. J., ii, 97. Whitehead, J. B., ii, 134. Whittaker. J. T., i, 403. Williams, J. D., ii, 175. Williamson, R. T., ii, 431. Willis, P. P., ii, 355. Wilson, E., i, 394. Winkler, P., ii, 398. Witte, ii, 133. Wood, H. C. i, 31, 56, 59, 194, 311,430,435,486,597; ii, 14, 91, 330, 351. Wyss, i, 458. Yeo, i, 338 ; ii, 14. Younger, E. 6., i, 403. Zaeslein, ii, 179, 180. Ziegenspeck, R., i, 609. Ziegler, i, 333. Zuhoff, i, 597. END OP VOLUME U. ^SftSS ''.>K>i:'S»i^"