A Practitioner's Handbook OF Materia Medica and Therapeutics Based upon Established Physiological Actions AND The Indications in Small Doses. TO WHICH IS ADDED Some Pharmaceutical Data AND The Most Important Therapeutic Developments of Sectarian Medicine as Explained Along Rational L,ines. By THOS. S. BLAIR, M.D. Member American Medical Association, Pennsylvania State Medicae Society, Harrisburg Academy of Medicine, Member Visiting Staff of Harrisburg City Hospital, &c. Published by THE MEDICAL COUNCIL, 4105 Walnut Street, Philadelphia, Pa, gr. Always begin with small dose. Never apply over 2-3 grain at any one time to a mucous surface. Local uses — In eye, nose, and throat, 1 to 5% solution, and, in extreme instances, 10% if to small area. Care- fully, with children. Urethra and bladder, y 2 to 4%. Ointments, 3 to 5 gr. to 3. Vomiting of pregnancy, 5% to cervix. Hay fever, 1 to 4% solution with cotton ap- plicator. Hypodermically about teeth, 1 or 2%. Schleich's infiltration anesthesia, gr. y> to gr. 8 to fgi. Rarely in- dicated in solution stronger than 5% for anything. Its internal employment is fraught with so much danger 90 Cocculus Indicus. from many points of view that such uses as have been advocated are wisely passed by in the work of the careful practician. Cocculus Indicus, Fish Berries. This agent is simi- lar to strychnine in physiologic action, but the convul- sions caused by toxic doses are less tetanic than are those of strychnine. It produces more stupor than does strych- nine. Therapeutically, it is used in much the same indications as nux vomica, and presents no advantages over it except it possibly is less irritating to the nerves. F.e. (not offi- cial), y 2 to 3 HI. Pictrotoxin, i-ioo to 1-30 gr. The homoeopaths use its 3X dilution in indigestion, marked by great repugnance to food, headache with ver- tigo, and uncomplicated dysmenorrhea. They also value pictrotoxin in night sweats. Coccus, Cochineal. The tincture of this well-known coloring agent has long been used in small doses through- out Germany in whooping cough where clear, stringy and ropy mucus is vomited. Some of our American practi- cians add Tr. Cardamomi Co. to whooping-cough mixtures because of the cochineal contained in it. Personally, cochineal would never be depended upon alone. I add drosera to the Tr. Cardamomi Co., and get encouraging results toward the latter end of the spasmodic stage. Codeine and Codeine Sulphas. Hypnotic, analgesic, sedative. Not used in case of severe pain. Greatest use in irritating coughs, where it has been very unwisely dis- placed by heroin by many physicians. Also used in ovarian pains, vesical affections, and in diabetes mellitus. Dose of either codeine or its sulphate, T / 2 to 2 gr., or less if for continuous administration. Never give to young children. It is a very valuable agent in small doses. See Heroin. COLCHICUM. 91 Colchicum. This agent has come into much unde- served disrepute. It must be remembered that large doses are cathartic and produce a very feeble pulse and cool skin, It is a valuable agent, but has been given in alto- gether too large doses. It is only after the pulse and temperature are reduced to near the normal that colchi- cum acts well. It is more valuable in chronic than in acute forms of rheumatism. It should usually be pre- ceded by a saline laxative, and seems to act peculiarly well in combination with cimicifuga. Use doses of f.e. (seed), 1 to 2 TTt ; tr. of seed, 10 nx ; ec. tr., 1 TTL, and you will be pleased with its action. A really good fluid- extract is usually effective in doses of 1 TTt. Wine of col- chicum is unnecessary. It impresses me as illogical to give wine to a rheumatic or gouty patient even in small quantities. Colchicine is used in doses of 1-120 to 1-30 gr. Colchicine salicylate in doses of 1-200 to 1-80 gr. These agents are very active, and should be employed with the utmost of conservatism. Coujnsonia Canadensis, Stone Root. This tough, fibrous root is exceedingly difficult of extraction, and the quickly made percolated fluidextracts of it are very in- ferior. It requires prolonged maceration, and only the green root should be used. Collinsonia is a tonic to the digestive organs and to en- feebled muscular structures, particularly non-striated mus- cular tissue. For this reason, it influences the heart and blood-vessels. In large doses it is the remedy in clergyman's sore throat and all straining of the vocal organs marked by aphonia, cough, and a sense of constriction. Dose, 15 TTt ec. tr., in simple syrup, four times a day. In moderate doses Dr. John V. Shoemaker considers it an antispasmodic of great value in gastralgia. It is of 92 COLOCYNTHIS. recognized value in catarrhal gastritis, and is usually com- bined with hydrastis. (Ec. tr., 5 to 10 1TL.) In small doses it is highly useful in hemorrhoids and relaxed conditions of the lower bowel with imperfect venous capillary circulation. I regard it as the most valu- able internal remedy we possess in such rectal states. In cardiac debility, especially that associated with chlorosis, it is of value. It is not a heart stimulant, but adds tone to the heart muscle and blood-vessels. (Ec. tr., 1 or 2 TH,.) There is no reason why a slowly made fluidextract should not be as active as the ec. tr., but, as a matter of fact, few makers take proper care with this non-official drug. It is a very valuable remedy, and should be largely used. Colocynthis. This is a peculiar drug, long misunder- stood. The official Extractum Colocynthidis is a reliable preparation for its usual employment. The ec. tr. is too violent in action. The mother tincture is a 10% prepara- tion of the pulp of the dried fruit freed from outer rinds and seed. I would advise the extract for its purgative effect and © for small doses. If the ec. tr. is used at all it should be diluted with nine volumes of 76% alcohol and used as the tincture. In large doses colocynth is a hydrogogue cathartic, very violent in action, and should not be given in the presence of feebleness or inflammation. The average dose of the extract is y 2 gr., and in this dose, or even 1 gr. doses, it is safe and often useful. In small doses it is useful in sharp, cutting pain and cramp in the bowels. The form of colic bending one double and relieved by pressure. This sounds like homoe- opathy, but it is really nothing of the sort, because it is not diarrhea but temporary neuralgic pain that small doses of colocynth cures. It has the same effect in uterine neu- CONDURANGO. 93 ralgia of a transient nature, and also in temporary sciatica. Enter algia, gastralgia, neurotic pains and tenesmus is its field. In infantile colic use ®, 5 TTL in half-glass of water, and give a teaspoonful every fifteen minutes. For adults use somewhat larger doses, usually 1 or 2 TTt, ©, at a dose. Colocynth cannot be classed with the usual "cramp and colic" cures. It is not a direct remedy for diarrhea, but it is a remedy giving quick relief from pain within its indications. Condurango was lauded as a cure for gastric ulcer and cancer of the stomach some years ago. Needless to say, it disappointed. It has quite a history in the camp of the homoeopaths, from whom we borrowed it and returned it in a damaged condition. They say its guiding symp- tom is "painful crack in corner of mouth." It impresses me we have had lots of smoke for a very little fire. It is probably of some service in catarrhal gastritis, since its influence resembles hydrastis. (F.e., 15 to 60 Tl\.) Coniine. See Cicuta Virosa and Conium. Conium, Poison Hemlock. In the absence of its char- acteristic odor this drug is of little value. Insist upon fresh preparations ; keep well corked, and dilute only as used. The expressed juice of the plant, preserved with alcohol, is its best preparation, but is hard to get. An assayed fluidextract is reliable. For the physiologic action in detail, read Plato's descrip- tion of the death of Socrates or the text-books. It is of value in diseases characterized by extreme ac- tivity of the motor nerves, such as paralysis agitans, chorea, hysteria, delirium tremens, laryngeal spasm, torti- collis, some cases of asthma and whooping cough, and irritable laryngeal cough. It is highly useful in visceral pain and the pain of cancers, 94 CONVALLARIA. Dose, f.e., 2 to 6 1TL, but may be run up to 20 TT\, in cancer; ec. tr., 1 to 5 TTL ; expressed juice, 1 to 5 TTL. For hypodermic use, Merck's Coniine Hydrobromate, 1-20 to 1-6 gr. with caution and only in severe cases. ConvalIvAria, Lily of the Valley. An infusion of the whole plant is an active and satisfactory preparation. The root is more commonly employed, and should, preferably, be worked in a recent state. The solid extract is usually unsatisfactory. Convallaria increases blood pressure and the flow of urine, has no cumulative action, and is very slightly toxic. It is of use when the ventricles are overdistended and dilatation begins in an absence of compensatory hypertro- phy and in venous stasis. Its most effective range, according to Germain-See, is cardiac paresis, palpitation, arhythmia, mitral constric- tion and insufficiency, dilatations, and cardiac dropsy. It does not take the place of digitalis when an imme- diate and decided impression is demanded, but for long- continued administration it is superior, since it is not cu- mulative, does not interfere with digestion, and exerts its diuretic action gently except in very large doses. Dose, infusion, from 1 to 3 tablespoonfuls, the large dose only temporarily ; U. S. P. f.e., 5 to 20 TTt ; green root fluidextract or ec. tr., 1 to 5 Til. Tinctures are too weak. The glucoside Convallamarin, 1-12 to 1 gr. Copaiba. A stimulant balsam with diuretic and ex- pectorant properties. Used in gonorrhea and inflamma- tions of urinary and respiratory tracts after subsidence of acute stage. Dose, oil, 5 to 15 TTt ; resin, 5 to 15 gr. Copper Sai/ts. Copper is a great oxygen carrier and is thought to favorably influence the hemoglobin when given in minute amounts, supplying oxygen and, as Grau- Copper Salts. 95 vogl said, "neutralizing an overplus of ioclosmone in the blood." Thus, it is an antiseptic of great value. Apart from this, copper influences spasmodic affections and nausea and vomiting resulting reflexly from the absorp- tion of ptomaines and organic poisons. Precipitated metallic copper, in minute doses triturated with sugar, is sometimes used to get the uncombined ac- tion of copper, but Cupric acetate acts in a similar man- ner. The normal acetate, in doses of % gr., is used in chlorosis, spasmodic diseases, as a stimulant to blood mak- ing, and in diseases of the ductless glands. Externally, it is used in gonorrhea and conjunctivitis in 34 to 1% solution. There is a tincture made and used quite largely in Germany. It is a convenient way to use it. The dose is Va to 5 Til. Arsenite of copper is a powerful poison, of use in mi- nute doses. All three schools agree upon its indications and its dose. Its indications are diarrhea, with large and frequent discharges and accompanied by watery vomiting, colic, green and offensive stools. It is valuable in cholera infantum in frequent doses of i-iooo gr. or 3X and in- creased gradually. In doses of 1-50 to 1-100 gr. or 2x it is a valuable intestinal antiseptic for adults, sometimes of value even in typhoid fever. Sulphate of copper. Emetic, 2 to 5 gr. Nervine and alterative, *4 g r - Externally, to eye, 1 gr. to §, but as styptic to other tissues up to saturated solution. Corn Silk. See Zea. Cotton Root Bark. See Gossypi Cortex. Crat^gus Oxyacantha, English Hawthorn Fruit. This remedy is of too recent introduction to speak posi- tively regarding it. Very enthusiastic reports are appear- ing favoring it as an improvement over digitalis in the 96 CrkoIvIN. treatment of heart disease. It is beneficial in chronic heart affections with a weak and irregular action. What more can be affirmed of it time will tell. Dose, f.e., 5 to 10 TTt. If for long-continued administration, tr., 8 to 15 HI- "Creoun," "Cresol,," "Lysol,," Crude; Carbouc Acid, Etc. The new U. S. Pharmacopoeia drops crude carbolic acid, calls purified carbolic acid "Phenol," and makes official "Cresol." The heavy oil of coal tar, which distils over at from 325 to 375 Fahr., is the usual source of these products. Crude carbolic acid is a very complex substance, contain- ing "Phenol" and three isomeric cresols, hydrocarbons, and water. For many uses as a disinfectant it is just as serviceable and is much more economical than "Cresol." "Cresol" is the combination of the three isomeric cre- sols, and contains no phenol. It may be given internally in doses of 1 or 2 drops, well diluted. It is much more expensive than crude carbolic acid, and is to be preferred in surgical work. "Creolin" is practically saponified cresol. It is described as "saponified coal-tar creosote." Its advantage consists in being in such a state as to form at once an imperfect admixture with water. One fluidounce to a gallon is its usually employed aqueous mixture. Its disadvantage is that the mixture is turbid. "Lysol" is a 50% creosol product, the cresylic acid being in a free and soluble state. Its aqueous solution is clear. It is used in y 2 to 2% solution in surgery. Its disadvantage is that hands and instruments immersed in it are slippy. Bichloride solution washes the slippy coat- ing off the hands. AH of these agents are of much greater bactericidal Creosotum. 97 power than phenol, and they are rapidly displacing it in surgery. Cr£osotum. "A mixture of phenols and phenol deriva- tives, chiefly guaiacol and cresol, obtained during the dis- tillation of wood tar, preferably of that derived from the beech, Fagus silvatica." Guaiacol, creosote, and cresol are somewhat similar in action, and can be administered after meals in cream, cod liver oil, whisky, or in cap- sules. Creosote is used in phthisis of a non-febrile character, sympathetic vomiting (in small doses), chronic bronchitis, fetid diarrhea. Locally, to carious dental pulp, and, di- luted, to burns and as an antiseptic. Dose, I to 5 n\. While cresol or "coal-tar creosote" can be used inter- nally, it is so apt to contain the toxic elements in excess that the safe plan is to use only beechwood creosote. Even this sometimes contains ccerulignol, and only re- liable makes should be used. Croton Oil.. See Ol. Tiglii. CubEba, Cubeb. Employed in the treatment of gonor- rhea after the active stage has subsided. Also used in gleet, catarrh of the bladder, and in some bronchial affec- tions with free secretion. F.e., 15 to 60 TTL ; oil, 5 to 15 Vf[ ; oleoresin, 10 to 30 Tl\. ; tr., I to 4 f5. Cucurbita. There are two remedies known by this name : Cucurbita citrullus, or the ordinary watermelon (the seeds being employed), is quite markedly diuretic. The infusion of the seeds is a most excellent non-irritat- ing diuretic, valuable in the diseases of children who cry during urination, and who stain the diapers a deep color. It is useful in the active stage of cystitis in adults. Give them teaspoonful doses of the fluidextract. Cucurbita Pepo is the pumpkin. The U. S. P. desig- 98 Cyprip^dium. nates it as "Pepo," the homoeopaths as "Cucurbita." They use small doses in the vomiting of pregnancy. The seeds are used to expel the tapeworm. Scald 2 ounces of the seed and peel off the outer skin when softened. Break up the inner pulp and eat with cream in the morning after a twelve to fifteen hours' fast. Two hours later take a dose of castor oil. Cyprip^dium, Lady's Slipper. Nervous stimulant, anti- spasmodic, analgesic. Only preparations of the fresh root carry the full activity of this drug, although the fluid- extract and oleoresin are of some value. This rather feeble agent finds its greatest field of use- fulness in cerebral hyperemia and functional nervousness of infants and in mild convulsive affections due to teeth- ing or to irritation of the brain in scrofulous children. With those children who are wakeful at night and yet are not ill and want to laugh and play, it is a very satisfactory drug. It will frequently take the place of an opiate and is not apt to do any harm, but it must be remembered that it is not a remedy for pain and its influence is in func- tional diseases, not in organic affections. It is of some service in the case of adults who suffer from nervousness, restlessness, and hyperesthesia induced by genito-urinary diseases, but is not to be depended upon in severe cases. Dose, ec. tr. or f.e., 10 to 60 TTL for adults. The former is the more active. Damiana, Tumera aphrodisiaca, is a native of Mexico and employed there in exactly the same manner as we use tea here, and is regarded as a pleasant, gentle stimulant without after-effects, and is not generally regarded in the light of a drug. There is no scientific evidence in favor of the claim that it possesses marked aphrodisiac prop- Digitalis. 99 erties. See the Pharmaceutical Review, Vol. 22, p. 126, for an exhaustive study of the plant. Digitalis. A full consideration of this important drug will not be attempted here, but a few views will be pre- sented. The action of this drug depends very much upon how it is administered. If given in the way this little book advocates the administration of many remedies, viz., in small and frequent doses, it will do more harm than good, acting in an irregular and ofttimes in a depressing manner and irritating the gastro-intestinal tract. It is in this way that the cumulative action is apt to be brought about. If larger doses are given six to ten hours apart and not too long continued, there is no more reliable remedy as a heart stimulant. Heart stimulants should not be used for every trifle, but in prostration, surgical shock, in the crisis of debilitating disease, to slow a rapid and feeble pulse in sthenic fever with high temperature, compressible pulse and vital failure, the failing heart of pneumonia, cyanosis, impending death from mitral dis- ease, failure of heart in child-birth, these and many more serious conditions are promptly met with digitalis in free doses of the tincture or fluidextract. Do not combine with other heart stimulants or follow the dose with food or water or bulky medication. If the other heart stimu- lants are needed and are specifically indicated, each in its place, give the one indicated and reserve digitalis. Mixtures of three or four heart stimulants are highly ir- rational. F.e., 1 to 3 m, ; tr., 5 to 20 rri- In my hands, tinctures made of the recent herb are not superior to the U. S. P. preparations. Infusum Digitalis (U. S. P. 1^2%), in doses of y 2 to 1 §, is a positive and most valuable diuretic; but do not give many doses as large as this, and keep patient in the recumbent position. The average dose of the infusion is tora. ioo DioscorEa. 2 teaspoon fuls, and I § doses should not be given initially except where urgently demanded. A poultice of digitalis leaves applied directly over the kidneys will manifest the diuretic action in a short time. DioscorEa, Wild Yam. This antispasmodic and ano- dyne is usually incorporated in the formulae of "female regulators." Its action is upon griping pain or colic in the stomach or bowels. It is especially useful in bilious colic and the pain of muscular spasm in the intestines. The pain occasioned by the passing of gall-stones is much relieved by it. Spasmodic affections of the pelvic viscera and after-pains come within its sphere of action. F.e. or ec. tr., 3 to 60 nx ; seldom above 20 or 30 n\. DiurETin. An active diuretic recommended in dropsy and nephritis, especially that following scarlet fever. Dose, 15 gr. in powder or capsule, followed by water, four or five times a day. Drosera, Sundew. This is a very valuable drug, but has well-defined limitations. Only preparations of the green plant are really active. The imported German tinc- ture, the ec. tr., and the mother tincture are reliable. Drosera is antispasmodic, expectorant, and a respira- tory sedative; highly useful in dry, irritable cough of a hoarse, resonant, and spasmodic nature. In my experi- ence it is, generally speaking, the best agent we have in whooping cough. Spasmodic dry coughs generally are much relieved by it, and especially the cough of measles. Laryngeal phthisis is relieved somewhat by this agent. It combines nicely with other expectorant agents and with aconite and bryonia. Dose, small and frequent doses are most useful. Ger- man tincture, 10 to 40 1TL ; ec. tr., 1 to 5 Til ; ©, 5 to 20 TTt- DuboisinE is used principally as a mydriatic. It is Dulcamara, ioi much stronger than atropine, and is sometimes employed hypodermically in mental diseases. Dose, 1-80 to 1-30 gr. Externally, in 0.2 to 0.8% solution. Homoeopathic ophthalmologists use the 3X dilution of Duboisia, or corkwood tree, in the treatment of conjunc- tivitis, hyperemia of the retina, and for pain over the eyes. Personally, I have had no experience in its homoeopathic employment, but from its resemblance to belladonna, which we know relieves capillary hyperemia in small doses, it is reasonable to expect results of a similar nature from this more active drug. Dulcamara, Bitter-Sweet. In large doses narcotic, producing so many disagreeable symptoms as to be almost abandoned as a narcotic drug. Its physiologic action is quite complicated, and it is hard to work out its action in small doses. However, all schools agree in all essentials concerning it. Parke, Davis & Co. in their literature state it briefly as follows: "In large doses narcotic, but used principally as an alterative diuretic, diaphoretic, and discutient. Employed in the treatment of cutaneous eruptions, particularly of a scaly nature; also in chronic rheumatism and chronic catarrh." The homoeopaths arrive at the same place by the route of subjective symptomatology. I quote a homoeopathic au- thor (William Boericke, M.D.) : "Hot days and cold nights towards the close of summer are especially favor- able to the action of dulcamara, and it is one of the reme- dies that correspond in their symptoms to the conditions found as effects of damp weather, colds after exposure to wet, especially diarrhea. It has a specific relation also to the skin, glands, and digestive organs, mucous membranes secreting more profusely while the skin is inactive. The rheumatic troubles induced by damp cold are aggravated by every cold change and somewhat relieved by moving 102 Dulcamara. about. Results from sitting on cold, damp ground. Con- gestive headache, with neuralgia and dry nose. Patients living or working in damp, cold basements." Now for an eclectic view of dulcamara in small doses : "Dulcamara is a remedy for all conditions resulting from suppression of secretion from exposure to cold and damp- ness. It will restore normal excretion and secretion. It is an excellent alterative if administered with care." This drug is one of very many instances in which I could quote three harmonious views expressed in a dif- ferent manner according to the school point of view. Any one studying materia medica in this way will soon dis- cover little reason for a divided profession. In small dose therapy, dulcamara is given in doses of f.e., 2 to 20 Til ; ec. tr. (very active), y 2 to 5 TT\, ; for chil- dren, ©, 1 or 2 TTt- The smaller doses are well to begin with, and may be carefully increased. DuoToiv. See Guaiacolis Carbonas under Guaiacol. Echinacea, Purple Cone Flower. This remarkable drug is rapidly coming into prominence. Several firms make excellent fluidextracts, but by far the best prepara- tion is a purified, decolorized, and assayed fluidextract given the trade name of Bchafolta. Its uses and doses are the same as the f.e. or ec. tr., but it is suitable for surgical purposes while they are not. Echinacea mildly irritates the terminal nerve endings, causes a feeling of constriction of the throat, promotes the flow of saliva, is diaphoretic and diuretic, stimulates the glandular organs, actively stimulates secretion and excretion, retrograde tissue metabolism, the lymphatic system, and the hematogenic processes. Thus, this agent actively opposes septic tendencies and blood poisoning. It does not appear to possess active toxic properties, but is somewhat sedative to the nervous system in large doses. Echinacea. 103 This agent is used by all three schools in exactly the same doses and indications. The present author has used it largely, and esteems it most highly. It corrects blood depravation (so far as a drug can) when due to auto-in- fection of an acute type, progressive blood taints due to non-elimination or the slow development of toxins, ten- dencies to sepsis or non-traumatic gangrene, foul dis- charges and depraved states of the secretions, and morbid puerperal discharges. Secondarily, it opposes sepsis or zymosis from without. Naturally, this action is less marked and cannot be exercised quickly enough to be of any material advantage in most instances. It has long been the dream of therapeutists to get an antiseptic into the blood that would kill bacteria and not kill the patient. In introducing echinacea the most effective step in this direction thus far has been taken, and I have hopes that its principles will be isolated and be made suitable for hypodermic injection as we employ diphtheria antitoxin. As an intestinal antiseptic, echinacea takes first rank, and I firmly believe it to be of the most positive use in the initial stages of typhoid fever. In the eclectic wards of Cook County Hospital, Chicago, it has been carefully studied in this connection, and is much relied upon. In puerperal sepsis, next to mechanical or surgical measures, it is undoubtedly the most generally praised remedy we have. I cannot speak from personal experience in that matter. I can speak highly of it in septic laryngeal and throat affections, and, after antitoxin, uniformly employ it in diphtheria. In this disease it seems to be of most use in the after-stages, or at least its influence is not much manifest until then. Cases recover more quickly than when antitoxin alone is used. Subacute uremic poisoning, recurrent appendicitis with a mild septic but not necrotic io4 Echinacea. element, erysipelas and cholera infantum all appear to be benefited by it. It has been highly recommended in syphilis. Personally, I use it after a course of mercury, but the eclectics claim to cure syphilis without mercury. They rely upon echinacea, stillingia, iris, kalmia, and iodides, and do not use mercury unless the case fails to prosper. On the other hand, the homoeopaths use more salts of mercury and for more varied conditions than we do. So there you are. My advice would be to use it and afterwards depend upon echinacea, iodides, and stil- lingia, but do not give iodides and echinacea at the same time unless the iodides are given in small doses. Poisonous venoms from snakes, rabid animals, tarantu- las, and insects are effectively treated by echinacea and stimulants. Locally applied, echinacea is of use in boils and septic conditions, old ulcers, bed sores, carbuncles, and syphilitic skin lesions. Dose, "echafolta," or f.e. echinacea, 5 to 30 TTL. Usu- ally 5 to 8 nx every hour in acute, or every three hours in chronic, cases. Initial dose may be 1 teaspoonful. For surgical uses, "echafolta," 1 f§ to water, 1 pint. In severe cases and in dentistry twice this proportion. Do not ex- pect echinacea to displace the curette or to cure appendi- citis. Elaterinum, Blaterium. In large doses, a hydrogogue cathartic and diuretic, but is of variable activity. It may be cautiously employed in dropsy or as a depleting agent. The average dose of the U. S. P. Elaterin is 1-10 gr. Merck's crystalline elaterin is a much more definite agent, and is to be preferred. Its dose is 1-20 to 1-10 gr. The maximum dose of ec. tr. is 15 TTt. In small doses it has some reputation in the treatment of cystitis and inflammations of the neck of the bladder. For this purpose doses of 1-3 to 1 TTt oi ec. tr. will serve Elecampane. 105 nicely. It is deserving of trial in this connection, but more direct methods with larger doses of drugs, such as triticum or corn silk, have acted better in my hands. Sometimes small doses will control violent vomiting and purging, but it should not be depended upon. Elecampane. See Inula Helenium. Epicea, Trailing Arbutus. The action is similar to uva ursi; chronic cystitis, dysuria, vesicae tenesmus, conditions due to uric acid and accompanied with muco- pus, are benefited by this agent. F.e., 30 to 60 Hi ; ec. tr., 10 to 30 Tit. An infusion of the leaves is very prompt and satisfactory in action. Ergot, Spurred Rye. The chemists have never agreed regarding the constituents of ergot. Dr. Edward R. vSquibb has done more than any other man to perfect an ergot product for therapeutic use. The fluidextract con- tains a trace of acetic acid, which supposedly fixes the trimethylamine of ergot. The solid extract is a thor- oughly reliable preparation also. "Ergo tin" is a purified fluidextract adapted to hypodermic use, but rather thick for such use. It is very active. The sp. m. is quite alco- holic and not adapted to hypodermic use. It is free of acetic acid and ergot fat. It mixes clearly with water, and is suitable for the action in both large and small doses but must not be combined with alkalies. "Lloyd's Br got' is especially adapted to hypodermic use, as it contains no fat, alcohol, and inorganic salts. Its menstruum is glyc- erine and water, and it contains 0.20% of phenol. Parke, Davis & Co. put up ergot in hermetically sealed glass bulbs for hypodermic use. Bou jean's Brgotin is practi- cally the same as the German Pharmacopoeia extract. Ergot is used too much in obstetrics and too little for its other indications. It is only necessary to say that 106 Ergot. ergot causes contraction of unstriped muscular tissues in all parts of the body to open up for it a wide field in therapeutics. Look up in your works upon histology how widely this tissue is distributed in the body, and you will appreciate ergot. Briefly, it is found in the hollow viscera and the blood-vessels. Hemorrhage of a non-traumatic nature from mucous membranes is best treated with a few full doses, or I f3 "Lloyd's Ergot" hypodermically in ex- treme cases. In cerebral apoplexy give such doses at fre- quent intervals until the full physiologic action of use in the case is reached. Do not temporize with apoplexy, even of mild type. If you use "Ergotin," it is best to dilute it a little with glycerine and water before injecting. For the relief of shock, ergot is most valuable. Shock is a vaso-motor paralysis with relaxation of the sphincters and non-striated tissues generally. Give in somewhat less dose than in apoplexy, but give it hypodermically. A dose just before general anesthesia reduces the danger of shock. It is a good thing to give ergot before a lapar- otomy, as the bowels move better afterwards, due to the stimulated peristalsis. Heat prostration responds well to large doses of ergot, since there is vascular relaxation. Dr. A. B. Conklin gives the indications for ergot in cases of shock and collapse, as follows: "A pale, cool, relaxed skin, bathed in cold, clammy perspiration, the mucous secretions being likewise increased, with involun- tary passages from the bowels and bladder. The pulse is soft and easily compressed, rapid, feeble, and possibly in- termittent. The heart's action is increased in frequency, but lacking in force, and well expressed by the word flut- tering. Its cavities are not filled, and the heart lacks blood on which to act, instead of being itself weak. The vessels must be made to return to their normal caliber, thus re- storing blood pressure." Ergot. 107 Thus we can see the value of ergot in collapse from severe diseases in an algid, congestive, or paralytic stage. Delirium tremens and the induced mania is conquered more quickly by ergot than by narcotics. Insomnia from cerebral hyperemia, salivation from mercury, the diar- rhea of fright, meningitis, congestion of the brain, miliary aneurisms, and other diseases in which the circulation is at fault in the way ergot corrects are all directly benefited by its use. Very often it is well to alternate it with small doses of belladonna. The walls of hollow viscera and the sphincters being amenable to the action of ergot, it is ofttimes indicated in pulmonary vesicular emphysema, relaxed laryngitis, lack of intestinal peristalsis, incontinence of urine, enlarged spleen, relaxed pelvic viscera, and rectal tissues, relaxed scrotum, spermatorrhea, and other relaxed states of or- gans. In obstetric practice it arrests hemorrhage after de- livery. Works upon obstetrics should be consulted for the detailed indications in that sphere of work. Ergot is contraindicated where tonicity of non-striated tissues exists, in high blood pressure, or when endocarditis exists, or degenerative changes have occurred in the heart or vessels. Spinal anemia, or cerebral or spinal neurotic states, contraindicate ergot. Large doses too long contin- ued are apt to cause retention of urine. Spasmodic affec- tions are aggravated by ergot. Dose : F. E., ec. tr., or Lloyd's Ergot, 20 TTL to 2 f3; ext, 5 to 10 gr. ; Boujean's, 1 to 5 gr. ; Yvon's Ergotin (fluid), 5 to 15 Til ; "Ergotole," 5 to 20 Til. Small doses of ergot are seldom effective. Erigeron, Fleabane. This is a very valuable agent in passive hemorrhages without fever. It is especially ap- plicable in uterine hemorrhage, and has, in lesser degree than ergot, an action upon unstriped muscular tissues. io8 Eriodicyton. As a local application, it acts somewhat like turpentine, but is less irritating. Its application is in uterine, vesical, and intestinal hem- orrhage, chronic diarrhea, gonorrhea, leucorrhea, bron- chitis, phthisis, tympanites, and irritation from vesical calculi. Dose, oil of erigeron, 5 to 10 TTL upon sugar; ec. tr., 5 to 30 rrt. Eriodictyon. See Yerba Santa. Eserine, Physostigmine. This substance and its sul- phate are used to restore normal optic conditions after the induction of mydriasis. One grain to the ounce of distilled water, dropping 1 T\ three or four times a day into the eye. Internally, 1-150 to 1-30 gr. very cau- tiously. See Physostigma. Ether. Anesthetic. Rarely used internally, but is sedative or stimulant according to dose. It is used in nausea from gastric depression, colic, angina pectoris, spasmodic asthma, and neuralgia of stomach or bowels — 10 to 60 TTL. Ethyl. Acetate or acetic ether is a stimulating anti- spasmodic, while irritating yet positive in its control of convulsions in children. Give them 5 to 10 TTt in water every half hour or hour as needed until controlled. Bro- mide (not bromide of ethylene) is a general anesthetic, very depressing upon respiration, but is suitable for transient anesthesia in minor surgery and dentistry. It is imperative that it be absolutely pure. Chloride, put up in tubes and spray therefrom, used as local anesthetic and to freeze parts. Hold tube six to ten inches from parts. Highly inflammable. Iodide, an antispasmodic suggested in several states, but of too unstable a chemical nature and too disagreeable in use to be recommended. EUCAINE. IOQ Eucaine (A. and B.). Both substances are closely re- lated. Eucaine is a local anesthetic somewhat slower in action and slightly less toxic in action than cocaine. Used in 2, 4, and 10% solutions. Eucalyptus, Blue gum tree. The preparations of this valuable drug are many, but Bucalyptol is probably the most definite and generally useful. Tinctures and fluid- extracts depend in value upon how recent a leaf is used in making them up, since the eucalyptol soon evaporates from the dried leaves. The antimalarial influence of the drug seems to be better represented in a good fluidex- tract, and the antiseptic properties in eucalyptol. Eucalyptus is antimalarial, antiperiodic, febrifuge, and tonic, producing great increase of urea and possessing antiseptic properties. In large doses (f.e. or ec. tr., 20 to 30 lit) it is anti- malarial, rather slow in action, but peculiarly well adapted to cases where quinine irritates the nervous system, and to masked intermittents and so-called "dumb ague." Ma- larial neuralgia and ague with jaundice yield nicely to its persistent use. In low forms of fever, such as typhoid or scarlet fevers, its antiseptic and tonic properties are often of very distinct value, and it serves to keep the kidneys active. In small doses (f.e. or ec. tr., 3 to 10 TTt) it appears to be eliminated by the skin to just sufficient degree to stimu- late it, producing a feeling of warmth, while very large doses are known to cause vaso-constriction, which makes a cold surface. The secreting mucous membranes of the respiratory and gastro-intestinal system are affected simi- larly. Hence, this agent is useful in a cold and clammy skin and a heavy, inert sensation in the viscera. It should be combined with other indicated agents to remove the underlying cause of these subjective symptoms. HO EUONYMUS. Bucalyptol is a very valuable antiseptic as well as pos- sessing, in almost full measure, the virtues of eucalyptus. A few drops upon the surface of hot water is, next to calomel, the best inhalation to loosen diphtheritic mem- brane. At the same time give eucalyptus and jaborandi internally. As a gargle, spray, or inhalation (properly diluted), it is of value in bronchial catarrh, asthma, phthisis, etc. In chronic ulceration of the stomach and in septic, renal, and vesical troubles, as well as in most of the indications for eucalyptus, it is of value. Dose, 5 to 15 TTL in capsules or on sugar. Locally, it can be used combined with oils. Euonymus, Wahoo. This drug is said to be the most direct of cholagogues. In very large doses it is a drastic cathartic. In moderate doses (f.e., 20 to 30 Til ; ec. tr., 5 to 15 TTt; or Buonymin, y^ to y 2 gr.) it is a valuable hepatic stimulant, especially adapted to bilious malarial conditions. It markedly improves digestion, and is tonic in action. The homoeopaths esteem the ix trituration tab- lets (1-10 gr.) of euonymin in the treatment of albu- minuria. Eupatorium, Boneset. In very large doses is emetic. Moderate doses of the hot infusion are diaphoretic and valuable in colds, especially where the patient is sore and aches in the back and limbs. Masked intermittent fever is promptly benefited by it. If the herb is not at hand, add 10 or 12 TTL of ec. tr. to a cup of boiling water, and an excellent "tea" is the result. In small doses it acts upon the gastro-hepatic organs and bronchial mucous membranes, and is valuable in in- digestion, soreness in the chest, influenza, and catarrhal troubles generally. (F.e. or ec. tr., 5 to 15 TT\,.) If used as a "tea" the ec. tr., being- more aromatic and less bitter Euphorbia. hi than the fluidextract, is to be preferred. If boneset were a rare and expensive drug it would be highly esteemed. It is really very valuable within its proper field. Euphorbia. Several of the Euphorbiaceae are em- ployed in medicine. E. Corollata is employed in small doses (f.e., I to 5 Ity,) in atonic dyspepsia. E. Dathyris is employed by the homoeopaths for a host of conditions for which I can see no definite reason. In large doses it is a drastic purgative. E. Heterodoxa is a violent irri- tant. Its juice preserved with salicylic acid is the "secret cancer cure" employed by those who use "a purely vege- table preparation." There are authentic instances re- corded in which it has succeeded. E. Pilulifera has long been employed by the homoeopaths in humid asthma and hay fever, and has been introduced into regular medi- cine, but the dose usually employed (f.e,, 30 to 60 TT\,) is altogether too large. Use 5 to 15 TTt and it is fairly useful, although Sticta piihnonaria (q. v.) is much better. E. Resinfera is used in drop doses of the tincture in vesicular erysipelas and in the pains of cancer when not severe. It is toxic in large doses. Eupion is a distillation from wood tar, employed in low dilution by the homoeopaths for chronic uterine dis- eases resulting in displacements. One hears so much of the practicians of this school claiming to cure uterine dis- placements with internal medicines, but this is the basis of it. Probably it would act like small doses of turpen- tine. They use Abies canadensis, which is a terebinthin- ate, in the same connection. Exalgin. A synthetic analgesic to be given to chil- dren with great care, but they tolerate small doses very well. The agent is of value in chorea of recent char- acter and in pain of a nervous character. Adult dose, 4 gr. ; maximum, 8 gr. U2 Fe)RRUM. Ferrum, Ferri Arsenas, is administered in certain dis- eases of the skin with anemia, notably in dry eczema and impetigo. In pill form, 1-16 to % gr. Ferrous bromide is used in scrofula and swollen glands in doses of 10 to 40 TTt of the syrup. Ferri carbonas sac char atus of the U. S. P. is a valuable preparation possessing great re- storative powers. It is non-irritating, nearly tasteless, and not astringent. Persons who object to a pill can take powders of this preparation in place of Blaud's pill. It is a form of iron of peculiar value in anemic young peo- ple with pustular conditions of the face with acne, and in atonic conditions of the stomach, combined with hydras- tine and capsicum. Dose, 2 to 6 gr. Ferri Moridum, employed in U. S. P. tincture, in restoring red blood cor- puscles, in anemia, chlorosis, in chronic inflammation of the kidneys and albuminuria, and in acute erysipelas and diphtheria in cases in which the mucous membranes are red and the tongue not heavily furred. Average dose of tincture, 8 TTt. Ferri citras, tonic, astringent, hematinic. Dose, 3 to 10 gr. Ferri et ammonii citras is a good form of iron to dispense in solution. Both the citrate and am- monia citrate combine nicely with other drugs in solu- tion and do not injure the teeth. Do not give when there is gastric irritation. The dose of both salts is the same, 3 to 10 gr. Ferri et ammonii sulphas requires larger do- sage, 5 to 15 gr. Ferri et ammonii tartras and the cor- responding potash salt act much as do the citrates, but may be given in larger doses. They are well adapted to children, and make up nicely in solution. Ferri et qui- nines citras and the Ferri et strychnine? citras are valu- able salts, but are too disagreeable to dispense in extem- pore prescriptions. The "Elixir Ferri, Quinines et strych- nines phosphatum, is to be recommended when these fer- ruginous elements are desired. There is no better general Ferrum. 113 tonic, none of the expensive proprietary iron tonics being nearly so efficient. Ferri hydroxidum cum magnesii oxido is the official arsenic antidote of the U. S. P. Dose, 2 to 8 f§. Ferri hypophosphis is used in an average dose of 3 gr. Ferri iodidi, tonic, alterative, U. S. P. syrup. Dose, 5 to 30 T1X. Ferri phosphas solubilis is of great value in debility following exhausting diseases. The average dose is 4 gr. Ferri sulphas, a tonic and restorative, and, in atonic conditions, an emmenagogue. Average dose, 3 gr. Ferrum reductum is one of our best iron tonics and of great value in the diseases of children. Dose, 1 to 3 gr. The many and important questions involved in the therapeutics of iron do not properly come within the province of a book such as this. Any possible point of view may be taken, yet, after all, iron enters into the system largely by its incorporation with hemoglobin, and the way in which it may be best administered is a mere matter of detail. Manufacturers of proprietary and so- called "organic iron" preparations to the contrary not- withstanding, we do not yet know just how iron reaches the hemoglobin nor just how it is taken up by it. Hemo- globin may be regarded as a mere organic iron com- pound, if you please. Personally, I do not believe the matter is one-half so simple as that. It is probable we are giving iron empirically. In a state of nature our food would contain all we needed of it, and that would perhaps be empiricism, too. Be that as it may, we have had alto- gether too much ultra-scientific pseudo-science about iron, and I am content to give it for much the same reason that I would place a little clean clay in the feeding trough of my horse now and then when I cannot turn him out to grass. Aside from the cravings of the tissues for iron as a food, its value in disease is too well known to re- quire comment. The U. S. P. recognizes so many avail- ii4 Ferrum. able forms of iron that we know are active and satisfac- tory that there is no occasion to employ the proprietaries. Some of them really contain very little iron, and others an unnecessary amount of wine. In small doses iron does not impress the system dif- ferently from large doses. It is simply a question of degree. The tendency is to give smaller doses than were formerly used. A careful study of sectarian literature upon iron has revealed little of value. An analysis of the "provings" of iron shows little but what we have long known along with much irrelevant and doubtful matter. They use one salt of iron we do not employ, the picrate, claiming that the second trituration cures senile hyper- trophy of the prostate. That is a fairly reasonable prop- osition. The sectarians use most iron salts in actual prac- tice just about as we do, and their pharmaceuticals are most excellent preparations of iron. Formaldehyde. This pungent gas can be produced by passing the vapor of wood alcohol over coarsely powdered platinum heated to redness. Various forms of generators and formaldehyde candles are in trade, and many of them are highly efficient. "Formalin" (pure medicinal) is a 35% aqueous solution formaldehyde. It is a non-corro- sive antiseptic used in surgery in }4 to y 2 % solution usu- ally, and up to 2%. As a vapor or spray, i to 2% ; for collyria, 1-20% solution. "Cystogen" is an ammonia for- maldehyde salt, valuable internally to prevent the decom- position of urine in the bladder. It prevents or arrests the growth of pyogenic bacteria in the urine. Dose, 5 to 7 gr., two to four times a day, dissolved in hot water. "Formin" "Aminoform" and "Urotropin" are practically the same thing. The U. S. P. has an official title for it — Hexamethylenamina, and the average dose is given as 4 gr. All these preparations are the same thing practi- Fucus Vssiculosis. 115 cally, and liberate formaldehyde by their decomposition in the body. Fucus Vssiculosis, Bladder Wrack. This is a sea- weed, active because of its contained iodine. It is used as an alterative and to reduce unhealthy fat in adipose persons, and in goitre. Dose, f.e., y 2 to 4 3; solid ex- tract, 5 to 30 gr. In Japan many species of seaweed are used regularly as food. The Eskimo and other maritime peoples use it. It has been noted that these people are markedly free of glandular troubles and tuberculosis. Gambir, Pale Catechu. This substace is now official, displacing Acacia catechu, formerly in use. The new compound tincture is given in teaspoonful doses. It con- tains, besides gambir, cinnamon and spirit, and is a grate- ful astringent carminative. The British Pharmacopoeia rejected catechu and substituted gambir some years ago; and our change is a wise one, since catechu is not so sweet as is gambir, and contains substances more apt to produce spontaneous gelatinization. Gamboge is a harsh and very toxic hydragogue ca- thartic, very wisely rarely prescribed except in small quantities to intensify the action of milder agents. The dose used to be given at 1 to 4 gr., but is now rated at % to % gr. in such combination. It thus enters into many formulae. Gaui/th^ria, Winter green. The oil is the most use- ful preparation, and contains about 90% of methyl-sali- cylic acid. Its dose is 5 to 10 TTt- Salicylic acid prepared from true (not synthetic) oil of wintergreen is far safer and more efficient than the ordinary acid. The various tinctures of gaultheria are eligible ways for its adminis- tration in small doses for various forms of neuralgia, n6 Gelsemium. gonorrheal rheumatism, inflammation of the bladder, and hepatic congestion. Dose, ec. tr., 5 to 15 Til ; tr., 30 to 120 TTt. Do not mix with aqueous menstrua until mo- ment of administration. Gelsemium. This official drug comes into prominence through the efforts of the eclectics, who have always maintained that the recent root should be employed in making extracts and tinctures. They probably overstate the matter, but the present author has made almost daily use of gelsemium for sixteen years (it being a favorite drug with me), and I am satisfied that green root fluid- extracts of gelsemium give better results, if not more marked physiologic reactions, than does the U. S. P. preparation. There is a peculiar honey-like odor to green gelsemium largely dissipated by drying. The alkaloids extracted from gelsemium do not represent the thera- peutic values of the drug itself, but possess a certain use- fulness. Merck's Gelseminine is an antispasmodic and antineuralgic used in doses of 1-120 to 1-30 gr. An ini- tial dose of 1 -10 gr., followed by smaller ones, is a good physiologic antidote for strychnia poisoning. The U. S. P. f.e. and tr. are very representative preparations of the dried, and the ec. tr. and ® of the green gelsemium. Gelsemium directs its action principally to the central nervous system. By inhibiting nerve action it tends to diminish the blood supply to the brain and cord. It in- hibits excessive nerve action, relieving irritation in sthenic conditions, but doing harm in asthenic states. The indication for gelsemium is acute cerebral hyper- emia manifested by a flushed face, bright eyes, contracted pupils, and increased heat of the head. In the acute fevers of infants and children this agent is very generally indicated, and is most prompt and yet safe in its effects. Aconite could with great advantage Gelsemium. 117 be displaced by gelsemium in many of these cases. If there is a spasmodic tendency manifested, pretty good doses can be given to a babe. Gelsemium is, like aconite, useful in the early stage of acute inflammation, but more particularly when there is hyperemia of the brain or cord. Never give it in asthenic congestions. With adults the early stages of cerebral, spinal, or meningeal inflamma- tions usually call for gelsemium, and it should be used in place of the bromides in a great many such states. Nervous wakefulness or nervous headache are often re- lieved by it at once. The surgeon finds it useful in the nervous excitation incident to peritonitis, salpingitis, and puerperal fever. Acute colds, some spasmodic coughs, acute nephritis from colds as well as post-diphtheritic or post-scarlatinal nephritis, spasmodic pain in the genito- urinary tract, and spasmodic urethral stricture, the first stages of gonorrhea, spasmodic ovarian neuralgia, uterine colic, a rigid os uteri in labor, excessive after-pains, hys- teria, initial stages of tetanus, chorea, facial neuralgia, torticollis, rheumatic fever, the irritable heart of hysteria, and many other conditions call for gelsemium as a part at least of the indicated medication. Dose, adults, f.e., y 2 to 5 TTL ; tr., 5 to 30 TT\, ; ec. tr., y 2 to 5 TTt ; ©, 3 to 20 TTt. Maximum single dose, f.e. or ec. tr., 10 TTL. In small doses. The therapeutics of this drug being so sharply defined by its rather circumscribed physiologic action, we have not attempted to separate the considera- tion into two groups of diseases since the actions of large and small doses differ only in degree. It is proper to state that successful homoeopaths use it in the first dilu- tion for its physiologic indications and in higher dilution for its homoeopathic indications, viz., "prostration, loss of muscular power, drowsiness, lassitude, dullness, and vertigo." n8 Gentians. Gentian^ Gentian, is probably the most reliable sim- ple bitter; possessing valuable tonic properties, it stimu- lates appetite and digestion and relieves atonic condi- tions unattended with pyrexia. F.e., 5 to 30 TTL ; com- pound tincture, 30 TTl to 2 3. The citro-chloride and the pyrophosphate of iron are frequently combined with it in the form of an elixir or a syrup. Geranium, Crane's bill. This is a valuable drug, but its preparations are unsatisfactory. In domestic practice the fresh root is boiled in milk, and in this form is moder- ately satisfactory. Few fluidextracts of this root are made from sufficiently recent material ; the eclectic tinc- ture is active, but is very liable to disintegration. The solid extract in 6 to 8 gr. doses or 1 gr. pills of geranin is fairly effective. Geranium is actively astringent, employed in gastro- enteric troubles with excessive mucous discharges and in throat difficulties as a gargle. It does not cause dryness of the mucous surfaces, and has no unpleasant influences. Besides the ordinary use in diarrhea and as an astringent, the eclectics esteem it in night sweats of tuberculosis, while the homoeopaths employ 30 TTL doses of the mother tincture in gastric ulcer, claiming that it will destroy the pyogenic membrane. It is an excellent remedy in tuber- cular hematuria. In general, it may be said that this agent is unduly neglected, and even though its prepara- tions are not ideal they are useful. F.e., 10 to 60 TTt ; ec. tr., 3 to 30 TTt ; ©, 10 to 60 TTt- Green root, f.e., 3 to 30 TTt. It is difficult to make a full strength fluidextract of geranium. GivANDUiv^E Suprarenai.es Sicoe. Average dose, 4 gr. See Adrenalin. Glandule Thyroid^ Sicc^, used in myxedema, Ginseng. 119 psoriasis, goitre, obesity, mammary tumor, uterine fibroid, and in cretinism. Average dose, 4 gr. Watch the pulse when giving large doses. The homoeopaths employ this agent as above and also (in 3X attenuation) for tachy- cardia, palpitation, and in amblyopia. Ginseng. Two varieties of Panax, or ginseng, are employed. They are mild tonics of some little use in nervous and digestive disorders. Glonoin. See nitroglycerine. Gnaphauum, Cud Weed. This is a remedy valued by some physicians in cases of sciatica associated with numb- ness of the parts involved. Give in small doses. Gold. In ancient medical practice gold was used m scrofulous, and, somewhat more recently, in syphilitic dis- eases. Modern practicians have held that it is of especial value in syphilis in subjects of a scrofulous constitution. It is employed in secondary syphilis or to take the place of mercury. The 2x and 3X triturations of Aurum metal- licum are convenient and effective. Aurum arsenicum, in 3X trituration, is useful in syph- ilitic headaches, is said to increase appetite, and to benefit chlorosis. Auric chloride is alterative and antitubercular and use- ful in sclerotic and exudative nerve degenerations. Used in 1-50 gr. doses, and by the homoeopaths in 2x tritura- tion. Aurum and sodium chloride is alterative and nervine and of much value in doses of 1-24 to 1-6 gr., in nervous exhaustion, the early stages of Bright's disease, dipso- mania, syphilis, and chronic diarrhea. It is quite toxic, and small doses are to be preferred. The homoeopaths call it Aurum muriaticum natronatum, and use 2x and 120 Gold. 3x triturations in much the same indications, but also in ovarian and uterine lesions of a chronic nature. Aurum iodide, in 1-60 to 1-12 gr. doses, is a useful alterative in scrofula. The 3X and 4X triturations are employed in arterio-sclerosis and senile paresis. Aurum sulphuratum is used in 3X for paralysis agitans. In general, it can be said that gold and its salts are of decided value. When we consider that gold is similar to mercury in its alterative effects and combines with this nerve tonic and general restorative influences, its value can be well understood. The homoeopaths have gone more into its detailed study than has the regular school, and I know they have obtained highly satisfactory results with it in practice. Golden Seal. See Hydrastis. Gossypii Cortex, Cotton Root Bark. This is a power- ful emmenagogue and abortifacient in large doses. In smaller doses it is of value to control hemorrhages of uterine fibroids and incipient cancer. Most of the fluidextract of cotton root bark upon the market is nearly inert. Only the fresh or very recent bark is active. In consequence, the green fluidextract or ec. tr. should be used in doses of from 5 to 20 Til. Granatum, Pomegranate Bark. Employed as a vermifuge for the expulsion of tapeworm. Macerate 2 ounces of the bark in a quart of water for one day and night, and then boil down to 1 pint. After a day's fast the patient can take this in four portions an hour apart. Follow with a laxative if necessary. Pelletierine, as de- rived from pomegranate, is effective in doses of from 1-5 to y 2 gr., and the tannate of pelletierine, 5 to 15 gr., for an adult. Some authorities claim 5 gr. doses to be suffi- cient. Graphites. 121 In small doses of the tincture or fluidextract this agent has been recommended in salivation. The mouth and throat may also be gargled with a decoction of the bark. It tends much to the comfort of the patient even if it does fail to cure. Graphites, Black Lead. This is a homceopathic rem- edy much derided by others. We will try herein to be at least fair to it. Graphite is a crystalline form of car- bon with an unctuous quality due to some substance not well defined. The present author has handled many grades of it in large quantity, and believes there is some peculiar hydrocarbon combined in it. At all events, long handling of it and ingestion of its dust produces ugly eczemas and cracked or fissured sores that exude a sticky or glutinous fluid with considerable gastrointes- tinal disturbance. The powdered graphite in 10 gr. doses has been given as an "anti-psoric," but the crystals are insoluble, and if it really possesses medicinal virtues it is probably not due to the carbon itself but to the substance taking the place of the water of crystallization, and it would require the disintegration of the crystals to free this substance and render it capable of absorption into the system. I know very well from disagreeable experience that there is an irritant in some graphite, and have no doubt that a trituration containing an appreciable amount of it would exert some influence not to be derived from pure carbon. On the other hand, I really cannot see what "high potencies" of this agent could do. Alcohol seems to extract the medicinal element of long triturated graph- ite, and one can taste and see the color of graphite in 3x trituration. Personally, I believe it to be an alterative that influences markedly the secreting surfaces rather than the deeper tissues. In the absence of sufficient ex- 122 Graphites. perience or definite data concerning its therapy, I will have to be content with what its sectarian advocates say of it and give its "indications" in brief for what they are worth, and would suggest that ix or 2x triturations will do whatever graphite can do. "Eatients inclined to an unhealthy obesity and a con- dition of the epidermis inclined to crack and fissure with an eruption that exudes a honey-like fluid; patient is in- clined to be sad, irritable, melancholy; moist eczema on the face; erysipelas, burning and stinging; eczema capi- tals which forms massive dirty crusts, matting the hair together ; unhealthy skin, every injury suppurates, and the skin oozes a watery, transparent, sticky fluid; leucor- rhea in gushes day and night ; crippled nails; old sores break open ; skin dry and inclined to crack. The remedy is especially indicated in females with a tendency to un- healthy corpulence, with deformed nails, menstrual troubles, and a characteristic exudation of the skin." (Wm. Steinrauff, M.D., "Materia Medica.") Locally, cerates of graphite have been employed from Hippocrates down to to-day. It is useful in fissured sores and sore nipples. Grindeua, Gum Plant or Rosin Weed. This agent is toxic in overdoses, producing a paresis of the pneumo- gastric. It is similarly used by all schools. It is indi- cated in asthmatic breathing and Cheyne- Stokes respira- tion, chronic spasmodic bronchial coughs, irregular heart action in chronic cough, and to relieve some of the symp- toms of hay fever and whooping cough. Locally applied, it has some reputation in poisoning by rhus toxicodendron, although alcohol and lead acetate are displacing it for this purpose. Dose, f.e., 30 to 60 Til ; ec. tr., 2 to 15 TTt ; solid extract, 5 to 15 gr. GUAIACOL. 123 Guaiacol acts in a similar manner to creosote, but is more readily tolerated by the stomach. Dose, 2 TTl grad- ually increased to 15 1TL, in pills, or in 1 or 2% solution in brandy, wine, or other vehicle, after meals. Guaia- colis carbonas (Duotol) is given in doses of 4 to 8 gr. in powder and gradually increased to 15 or 20 gr. Maxi- mum dose, 90 gr. in twenty- four hours. Guarana. This is the Brazilian cocoa. The natives, who roast and grind the seeds and make a beverage of them, much value this sort of chocolate as a tonic and mild nerve stimulant. It contains considerable caffeine and volatile oil, and possesses a tonic and restorative ef- fect in the gastro-intestinal disorders, inclining toward chronic diarrhea. The fluidextract is successfully used in sick headache in doses of 10 to 30 n\. In a great many cases in which the official fluidextractum cocse is used, guarana would give just as good results without the danger of implanting a drug habit. The average dose of the U. S. P. f.e. coca contains 1-7 gr. of coca alkaloids. H^maToxylon, Logzvood. A tonic astringent used in 10 to 20 gr. doses of the extract in dysentery and re- laxed intestinal conditions. It has been claimed, but it is not substantiated, that small doses of this agent re- lieve the sense of constriction incident to angina pectoris. Hamamdus, Witch Hazel. A valuable astringent and antiseptic. The fluidextract of the leaves is probably its most available form for internal administration. The average dose is 30 Til, but 5 to 10 TTt is quite sufficient if for continued administration. The Aqua Hamamclidis is given in teaspoonful doses. The ec. tr. and distilled extract are similar. Wood alcohol is used in the making up of some cheap extracts and is to be strictly avoided. Therapeutically, it is indicated in bleeding from small 124 Hamameus. vessels where their walls are at fault, and especially in case of slow inflammatory changes in venous tissues and in varicosities, purpura, phlegmonous ulcerations, oozing hemorrhages, and relaxed venous states generally. In sore throat with dark-colored membranes, spongy gums, catarrh with slight hemorrhage, hemorrhoids with bleeding and soreness, too frequent menstruation with soreness in abdomen, and in muscular soreness with a bruised feeling this agent is indicated. Externally, the distilled extract is used in a host of minor affections, and is peculiarly effective when applied to the rectal tissues, the vaginal walls, sore breasts, and superficial burns. Applied hot, it is of marked utility in the local and pelvic soreness following a hard confine- ment. Ten grains of menthol to 4 fluidounces of dis- tilled extract witch hazel is recommended by Ellingwood as an application to relieve the pain of burns. The rectal suppositories of witch hazel and buckeye have a large range of usefulness. This agent is much valued by homoeopathic physicians, who insist that it acts best in most cases by using it externally and internally at the same time, giving 10 TTt doses of the tincture and applying the distilled extract in 25% solution or the tincture in full strength. Some of the older homoeopaths still employ it in dilutions or "potencies." Hexleborus Niger, Snow Rose or Christmas Rose. This is a toxic agent, in large doses producing drastic, hydrogogue catharsis, sensorial depression, convulsions, weak heart, and muscular weakness. Very large doses are fatal. It has been considerably used in proprietary pills advocated for dropsy. The older eclectics used it combined with bryonia, in hydrothorax, but if so used it should be carefully watched. Hexleborus. 125 In small doses (ec. ti\, Y^ to 1 TTt at frequent intervals) it is advocated by the eclectics in mental states in which the abdominal organs are seriously at fault and are a causative factor. The homoeopaths make a very rational use of it in the state of effusion of hydrocephalus (ix to 3x), and small doses ® in mania of a melancholy type. In these doses it is a stimulant to all the glands of the gastro-intestinal tract. In adults, the lower dilutions (ix or 2x) probably have some effect in mental troubles asso- ciated with low states of vitality, but these effects are not very marked. With children, however, these small doses often serve a useful purpose, especially when they have disturbed sleep in the course of disease, screaming with- out awaking, boring the head into the pillow, and irregu- lar respiration. It seems to equalize the circulation in the brain in these conditions. If there is fever or a flushed face give the little one small doses of gelsemium in alternation with helleborus. Be very careful in giving large medicinal doses if given at all, as they are apt to suddenly depress the heart. Hexonias Dioica, Starwort or False Unicorn. This is another of the loosely prescribed uterine tonics. In large doses it is a cardiac depressant, emetic, and vermifuge. Cattle are killed by eating it, and its decoc- tion is fatal to insects and small animals. It is usually prescribed in doses altogether too large. In moderate doses (f.e. or ec. tr., 5 to 10 TTt) its in- fluence is upon the glandular tissues of the digestive and urinary systems, improving digestion, and toning the liver. It is a tonic to the genito-urinary apparatus, over- coming the phosphatic diathesis, relieving albuminuria if due to irritation, and favorably influencing diabetes mel- litus and insipidus. It relieves a tender, aching kidney, but is not applicable in degenerative processes. 126 H^PAR SuivPHURIS. In small doses (f.e. or ec. tr., i to 3 TT\, ; ©, 5 TT\, every two hours) it is distinctly curative in pelvic engorgement, resulting in a dragging sensation or uterine prolapsus with too frequent or profuse menses. Tlw is all it does effectively in uterine diseases, and the small dose is more prompt in action than the large dose usually given. Re- member the toxicity of this drug. Hepar SuivPURis, Impure Calcium Sulphide. The salt employed by the homoeopaths in ix to hasten suppuration and in 6x in the treatment of scrofula and ulcerations generally. It probably presents no advantages over ordi- nary calcium sulphide (q. v.) unless it be to eliminate mercury from the system. Heroin, Diacetyl-Morphine. This allotropic form of morphine is an acetic ester of morphine insoluble in water but soluble in very dilute solution of acetic acid. It should not be combined with alkaline mixtures. It is ad- vocated as a substitute for codeine, and is used in doses of 1-32 to 1-6 gr. It is a cough sedative and antispas- modic. It is a very frequent constituent of proprietary expectorants sold to the public generally. In these mix- tures it is more dangerous than is morphine, since it should never be administered to children. The present author has seen heroin give rise to very sudden depression even in quite small doses. The journals frequently re- port such cases, and it is developing that heroin some- times induces a drug habit much more intractable than the morphine addiction. If employed at all, heroin should be used with the utmost of care. Hexame)Thyi,Enamina. The U. S. P. designation for hexa-methylene tetramin, an ammonia condensation prod- uct of formaldehyde. It is the same general type of product as are "Urotropin," "Formin," and "Cystogen." HOM ATROPINE. 127 These products increase the excretion of urine and uric acid and carry an antiseptic direct into the urinary tract. The dose is from 1 to 10 gr. Average dose, 4 or 5 gr., dissolved in hot or carbonated water, after meals. Homatropin^ Hydrobromidum. This agent is seldom employed internally. The U. S. P. wisely gives its dose as 1 -128 gr. (average). This is safe, but it has been advised in 1-20 gr. for excessive night sweats. In regard to this, it may be said that it takes doses verging upon the toxic to control severe night sweats with any of the belladonna derivatives. On the other hand, the experi- ence of some of the tuberculosis sanitoria is that proper diet and fresh air render such agents almost unnecessary. Personally, I have frequently controlled excessive sweats with small doses of muscarine in some form. In the determination of refraction in ophthalmic prac- tice this mydriatic is prompt but evanescent. Use 4 gr. to the ounce of distilled water. Humulus, Hops. This homely remedy is successfully employed in nerve irritation and insomnia due to mental distress, especially when associated with poor digestion. Locally, a muslin bag filled with hops is applied, after immersing in hot water, to local inflammations and pain- ful areas. Dose, tr., 1 to 2 fo. "Lupulinum" (U. S. P.). Lupulin contains to the full the virtues of hops. It is anaphrodisiac, used in priapism and chordee. It acts in harmony with camphor mono- bromate (lupulin and monobromate, 5 gr. each in cap- sule) in this connection. The ec. tr. in 10 Tl\ doses, com- bined with Tr. Gentianae Co., is a tonic in irritable nerv- ous states vastly superior to beer or the so-called malt tonics. Hydrargyrum. See Mercury. 128 Hydrastis. Hydrastis, Golden Seal. This highly useful but ex- pensive drug has many preparations. The fluidextract well represents its activities. The U. S. P. gives the average dose as 30 TTL - Personal experience leads me to believe it would be wise to divide this figure by three. It can be given in diluted and flavored glycerine or in some simple elixir. The U. S. P. tincture is preferable in some regards. Dose, 20 to 60 1TL. The ec. tr. is an alcoholic fluidextract containing a bitter coloring prin- ciple, berberine, the so-called white alkaloids, hydrastine, canadine, resin, and oily principles. Use in half the fluid- extract dose. Lloyd's colorless hydrastis is non-alcoholic and contains the colorless alkaloids, inorganic salts, and considerable glycerine. Hydrastine is given in doses of from y 2 to 3 gr. as usually made, but the hydrastine (al- kaloid) as made by Merck and others in one-third this dose. Merck's hydrastine hydrochlorate is given in doses of ^4 to 1 gr. It is a white powder, whereas Merck's hydrastinine hydrochlorate is a yellow, crystalline powder, and the maximum dose is J^ gr. The alkaloids are very high in price, and are apt to disappoint in practice when given internally. Where something cheaper will do plants containing considerable berberine, such as berberis aquifolium, or else berberine phosphate, serve very nicely. Really, hydrastis is overrated to-day and ber- beris is not sufficiently appreciated. Berberis combines in ordinary mixtures much better than does hydrastis. In physiologic action hydrastis stimulates the nervous system in a manner somewhat similarly to brucine. Strychnine, brucine, and hydrastis are a descending scale in intensity of nerve stimulation, but each successive step downward is one toward more prolonged action. They bear the same relationship as do nitroglycerine, dyna- mite, and gun powder. Hydrastis. 129 Hydrastis stimulates respiration and circulation; it stimulates muscle tonus and inhibits fatty and other de- generative muscle changes. In the gastro-intestinal re- gion it stimulates peristalsis and increases normal secre- tions. The therapy naturally divides into three headings. When the nerve and muscle stimulating properties are called for, give large doses; to influence secretion, small doses as a rule. It is also used locally. In large doses it is employed in chronic alcoholism in conjunction with gold, strychnine, gentian, and capsicum. It is useful in general debility with defective assimila- tion and nerve atony. In this connection it operates in harmony with iron, quinine, and ignatia. In uterine sub- involution and passive post-partum hemorrhage give in large doses with other indicated remedies. Large doses are recommended in night sweats and in altered states of the heart muscle. In marked atonic dyspepsia with jaun- dice large doses are demanded at first. In small doses it applies to many functional disorders of the stomach, especially when catarrhal in character. Capsules containing the powdered drug act well in this connection. It may be combined with laxatives, digest- ants, and bismuth. In irritable states of the stomach the fluid preparations, especially the colorless hydrastis, prob- ably act better. In dilatation of the stomach, long-con- tinued use of small doses of hydrastine hydrochlorate is effective. The homceopathic's 2x tablet triturates seem to act nicely. In chronic constipation with hepatic con- gestion it acts nicely combined with leptandra, and, when there is nausea or sick headache, iris or chionanthus. In the second stage of gonorrhea and when ulcers upon the skin resist local treatment give hydrastis. In all catarrhal conditions characterized by a thick, yel- 130 Hydrogen Peroxide. low, ropy secretion, no difference where located, give small doses of hydrastis. (F.e., 3 to 5 TTL.) Locally, in varying strength, to relaxed and unhealthy mucous membranes and as a gargle in ulcerated sore mouth, colorless hydrastis in 5 to 30% solution. Hydras- tine hydrochlorate (Merck) in conjunctivitis, 1-10 to 1-5% solution; gonorrhea, Y^ to y 2 % solution; in skin diseases, 1%. The glycerite of hydrastis is used in cer- vical erosions. Hydrogen Peroxide, "Aqua Hydro geni Dioxidi." (U. S. P.) Disinfectant, deodorant, styptic, and antizymotic. Used externally in diphtheria, gonorrhea, abscesses, and wounds. Internally, in flatulence, catarrhal gastritis, fetid diarrhea, etc. Dose, 15 to 40 nx diluted with water. In spray, 10% and stronger. Externally, up to full strength according to uses. Hyoscyamus, Henbane. This good old remedy of our fathers has been, for some reason, pushed aside, although its powerful derivatives, hyoscyamine and hyoscine, have recently been given a dangerous prominence. For a dis- cussion of them see Belladonna. Prof. Locke has well said of hyoscyamus: "Compared with opium as a hypnotic and anodyne, though not so re- liable, it is many times preferable for these reasons: It relieves spasms, quiets the nervous derangement, and pro- duces sleep, with no arrest of secretions, and it does not constipate, nor does it arrest the flow of bile or urine. It may be employed when opium is contraindicated. It is a very successful agent in pulmonary affections. It lessens the cough and irritability, and does not arrest the secretions. In inflammatory conditions of the liver and kidneys it may be used to relieve pain, and here it is better than opium, for it acts without producing head- ache." Hyoscyamus. 131 In large doses hyoscyamus must be employed with care, since it sometimes causes delirium and an eruption upon the skin. In tremors and contractures of paralysis agi- tans give full doses (f.e., 15 to 20 Til). In hallucina- tions and sleeplessness of the insane the same dose or a full dose of hydrobromate of hyoscine. In mania, de- lirium tremens, and puerperal insanity give fairly large doses, but where the delirium is "low and muttering" do not give large doses in any form of disease. Painful hem- orrhoids, cancerous ulcers, and other painful visceral le- sions are given ease by but moderate doses. In small doses there is no doubt at all that hyoscyamus is a useful but neglected remedy. The eclectic indica- tions are given as follows : "In all conditions where there are busy delirium, hallucinations, weight in the front part of the brain, extreme activity of the mind, disturbed sleep with wild and frightful dreams, coma vigil, flushed face, wild, red, and restless eyes, it is a remedy. In the rest- lessness, ceaseless agitation, and insomnia of exhaustion, and in diseases of infants and of the extreme aged and feeble, it is especially applicable." They give it by drop- ping from 5 to 15 drops (according to age) of the f.e. or ec. tr. in half a tumblerful of water and giving a tea- spoonful of the dilution every fifteen minutes. They em- ploy it a great deal in pneumonia in infants and the aged, in bronchitis and irritable cough, neuralgia of exhaustion, the bone pains of syphilis, ovarian and other visceral pain, nervous palpitation of the heart, and in hysteria. The eclectics are pretty careful therapeutists, and I doubt not they get good results from these small doses. In case of cough and other conditions with longer dose intervals they increase dose to some extent. Homoeopathic indications add little of any value, as they employ it in much the same manner as the eclectics. 132 Hypericum. They use the third dilution, however, in the muttering de- lirium of typhoid, but that is about as far as a level- headed homoeopath will dilute this drug. Most of them use the tincture or the ix. Personally, I get good results from small doses of the f.e. Hypericum, St John's Wort. This is purely a homoeo- pathic remedy, and many writers make the ridiculous claim for it that its dilutions will prevent tetanus follow- ing punctured wounds. So far as I can determine, the drug possesses astrin- gent and sedative properties especially influencing ter- minal sensory nerve filaments. In larger doses it influ- ences the nervous system at large. In large doses (©, 5 to 20 TTt ) it is recommended in nervous and spinal injuries due to shock or concussion, in painful spinal irritation without fever and in suppres- sion of urine due to nervous shock. Probably other agents would serve as well or better in all these indica- tions. Locally (1 to 2 f§ © to 1 pint water), it is really a use- ful remedy in relieving the pain of lacerated and painful wounds in which nerves have been cut or bruised. It very promptly relieves the pain, and can be applied to advantage after proper antisepsis has been first carried out. Upon the unbroken skin it has little effect. The hypericum oil is largely used throughout Europe as an application to recent and painful contusions and excoria- tions. It appears to give satisfaction when the lesion is superficial. The non-alcoholic hypericum is used by homoeopathic surgeons in the treatment of superficial burns. The ones among them who reject the "potency" theory employ this preparation internally in pretty large doses. Iberis Amara. 133 IbEris Amara, Bitter Candytuft. This is one of the remedies used from antiquity and recently reintroduced. It is used in enlarged heart to control vascular excitement and allay reflex irritability. In dyspnea and bronchial spasm, vertigo, and dropsy of cardiac origin it is highly recommended by many authorities. Its mother tincture appears to be the best preparation. Give in doses of 3 to 8 TTL- IchthyoIv. An antiphlogistic, antiseptic, and altera- tive. Internally, its action is akin to sulphur, but its in- dications are not very clear and it is seldom so used. Some cases of nephritis respond to it. The homoeopaths extol its lower "potencies" in chronic rheumatism and chronic hives and in stomach troubles with nausea and increased appetite. Externally, it is used in from 5 to 50% proportions in ointments, lotions, etc., in erysipelas, lymphatic indura- tions, rheumatism, indolent injuries, scrofulous enlarge- ments, and a host of skin diseases. Glycerine tampons to uterine os, 10% ; bougies in gonorrhea, 1 or 2 n^. Use pure in ivy poisoning; 10% in oil sweet almonds, as an application in variola; in rheumatism, oii to adeps 51. Before applying ichthyol, wash the parts with warm water and dry. After application to joints or severe le- sions, it is well to cover parts with flannel and gutta- percha tissue. There is no occasion to give over 30 TTL (or grains) per day in any case, and it is wise to begin in any case except in ivy poison with ointments not exceeding 25%. Ignatia Amara, Bean of St. Ignatius. This is a milder remedy than nux vomica, containing less strychnia. For stimulation and the general influence of large doses, nux vomica is to be preferred to it. This is also the case 134 Indigo. when small doses are given to stimulate intestinal peri- stalsis. In small doses ignatia has a field of its own, since it is less irritating to the nerves and possesses a more kindly influence in cases in which the emotional element pre- dominates. Hence, it is serviceable in the illnesses of women of sensitive and excitable nature where nux vomica often aggravates the case. It can also be given for a great length of time where a mild nerve tonic is demanded. Its influence in hysterical and sexual neuras- thenias and in prolonged nervous depression is much bet- ter than is that of nux vomica. Give of f.e. or ec. tr. 1-6 to y 2 TTt several times a day. It combines well with vegetable bitter tonics, generally. Indigo possesses a marked influence upon the nerv- ous system. The homoeopaths use the 3X in epilepsy with melancholia and in sciatica. Its value is problemati- cal. Inula, Elecampane. A tonic to the nutritive functions and to the respiratory and urinary tract. Its extractive principle, helenin, is said to possess antiseptic properties useful in typhoid, tuberculosis, and erysipelas. This drug is given in three leading indications, viz., in atonic conditions of the gastro-intestinal tract, as a tonic following prolonged respiratory diseases, and in catarrhal states of the genito-urinary organs. Dose, f.e , 20 to 60 TTt. Helenin, 1-12 to % gr. Infusions (U. S. P.) ordinarily contain 5% of the drug, but digitalis is directed in ij^% and wild cherry 4%. Iodine (U. S. P. "Iodum"). See the text-books for a detailed consideration of this drug. The crystals are occasionally given in 1-10 gr. doses incorporated with Iodine. 135 some inert substance, as a triturate. The maximum close is 1 gr. The tincture may be given internally in 1 to 5 drop doses, well diluted. Iodized sesame oil is given in doses of 1 to 3 f3 in emulsion. It liberates its iodine slowly when ingested. The decolorized tincture, used in- ternally, is absorbed without precipitation. The brown iodide of lime, originated by Nichols, is a loose combi- nation of iodine and calcium oxide, and sets nascent iodine free when taken into the stomach. Give in doses of y$ to 1 gr. Spongia or burnt sponge (q. v.) is another available way for giving iodine. There has been a good deal of dissatisfaction with the iodides when prompt results are desired, and iodine is coming more into use as an internal remedy. Either iodized lime or spongia may be used with assurance in non-diphtheritic croup or glandular troubles. The other preparations are available, but are more irritating. IodoFormum, Iodoform. This agent is used more or less internally, being of real value in the treatment of tuberculosis with intractable hemorrhage and of some utility in tubercular meningitis. It is exceedingly dis- agreeable to the patient, however. Dose, ^ to 2 gr. Locally, iodoform is much used, although one must avoid its toxic influences by the exercise of due care. It is used in wounds freely discharging and in putrid sores. It does not appear to stimulate granulation to any great extent. Vaginal suppositories may contain 5 gr. of iodo- form; rectal suppositories 2 or 3 gr. Ointments usually contain 5 to 10%. In tubercular joint affections, injec- tions of 10% oily emulsions are used. The soluble ure- thral bougies should seldom contain over 1 gr. Ipecacuanha, Ipecac. In large doses (10 to 20 gr. ; f.e. or ec. tr., 10 to 20 Tit in hot water ; or syrup, 3 or 4 136 Ipecacuanha. teaspoonfuls) ipecac is a most valuable and safe emetic, acting without prostration. It is the best emetic for chil- dren or to relieve sick headache due to undigested food in adults. In cases of poisoning, ipecac is not sufficiently prompt unless combined with other emetics. It is well to remember that continued large doses of ipecac will produce a most obstinate diarrhea. In moderate doses it is expectorant, and is indicated in coughs with deficient secretion. One TTt doses of the fluidextract at greater or less intervals, in accordance with degree of relaxation desired, is the average for an adult. In the sudden bronchitis of childhood, 5 to 10 TTt doses of the syrup every hour until nausea is in- duced gives excellent results. In the later stages of pneumonia in adults the powdered ipecac is used in y 2 gr. doses three or four times a day. Small doses of Dover's powder and quinine, combined in a capsule, may be given, and seems to promote the process of resolution. Some authorities recommend moderate doses of ipecac in hem- orrhage. It is a vascular sedative, relieving blood press- ure, and hence its discreet use in this connection is to be commended. In small doses (f.e. or ec. tr., 1-10 to % TTt) ipecac is indicated in irritation of the mucous membranes, espe- cially of the gastro-intestinal tract when there is deficient or defective secretion. Nausea and vomiting, where the mucous membranes are relaxed and a white coating upon the tongue, very promptly yield to small doses of ipecac. The small dose in combination with aconite is of peculiar value in many of the diarrheas of infancy. In dysen- tery or in cholera infantum the same combination is effec- tive in alternation with an antiseptic or following a chola- gogue. Soon as the acute stage is over, discontinue the ipecac and aconite. If there is dysenteric tenesmus use Iridium. 137 gelsemium in the place of aconite. In the pneumonia of childhood small doses act well in combination with the other remedies indicated. Ipecac, bryonia, and aromatic spirits of ammonia make a serviceable mixture for these cases. Iridium. In homoeopathic practice, 3X triturations of this metal are used in anemia and as a restorative after exhausting disease. Iris Versicolor, Blue Flag. In large doses a reliable preparation of iris containing the unchanged oleoresin is purgative, cholagogue, and diuretic, but large doses are irritant and should not be long used except in intractable diseases of the liver. Give 10 to 15 Til doses of ec. tr., as the fluidextract is seldom active. The trouble with this drug is that its oleoresin is gradually replaced with red tannates during growth. This is particularly the case with all southern-grown iris. The eclectics value this drug very highly and take the utmost care in its manipulation, whereas it has been dropped from the U. S. P., since the official preparations failed to give results. In small doses it is a highly useful remedy, being markedly alterative and directly stimulant to the entire glandular system, but more particularly influencing the pancreas and the intestinal glands. It promotes retro- grade tissue metamorphosis. It is indicated in deficient elimination from the skin and kidneys accompanied by jaundice and clay-colored stools, in irritable conditions of the gastro-enteric mucous membranes occasioned by al- tered or morbid secretion and by inaction of glandular tissues. The oleoresin in 1 or 2 gr. doses is valuable in chronic and malarial jaundice, but in most of the indi- cations for small doses of iris a fluid preparation is pref- erable. Iris is peculiarly effective in sick headache and 138 Iron. cholera morbus, nausea, pyrosis, and gastralgia. One or 2 n\ doses of ec. tr. every hour suffice in these indica- tions, and some cases do well upon even smaller doses. As an alterative, in 3 to 5 TTt doses, it is effective in many glandular enlargements and in pustular and chronic skin diseases. The dose may be run up to 10 17\,, espe- cially in the treatment of syphilis marked by glandular inactivity, but do not begin with such large doses. There is no reason why a reliable fluidextract of this drug cannot be made, and doubtless some makes are re- liable. The U. S. P. revisers made a distinct mistake in dropping it from the eighth revision. The homoeopaths claim that dilutions of this drug are effective in a host of subjective phenomena that proper analysis resolves into physiologic indications similar to those stated above. Their lower triturations of Irisin are effective, and are used by them in gonorrheal rheumatism as well as in digestive disturbances. Iron. See Ferrum. Jaborandi. See Pilocarpus. Jacaranda, Caroba Tree. The homoeopaths use the tincture of jacaranda in venereal diseases and rheuma- tism. Jalapa, Jalap. This is an old remedy little used at present. It is an active cathartic, principally influencing the small intestine. The doses as now given are — extract, 2 to 5 gr ; compound powder, 20 to 60 gr. ; resin, 1 to 3 The old "Beach's anti-bilious physic" was composed of powdered jalap, 8 §; powdered senna, 1 pound; ginger, 1 §. Triturate together and give a large teaspoonful, in sweetened water, at one dose. This mixture is effective in case of impacted rectum. A dose can be given every Jambul. 139 six hours until free evacuation results. Jalap combines well with santonine as a vermifuge, and is a useful laxa- tive, in moderate doses, in cases where hemorrhoids con- traindicate stimulating purgatives. Jambul, Syzygium Jambolanum. The seed of this tree possesses an inhibitory influence upon diastasic fermenta- tion, and its administration in saccharine diabetes is fol- lowed by a reduction in the sugar eliminated. Aside from this action it increases renal blood pressure, stimulates respiration and intestinal peristalsis, and is non-toxic in very considerable doses. It is a remedy highly esteemed by intelligent physicians in India and recently taken up by American homceopathists who confirm the statements of these gentlemen. The powdered seeds are given in 5 to 10 gr. doses three or four times a day. It acts best in chronic cases in which only a moderate amount of sugar is found, and it also exerts a healing influence upon diabetic ulcers. A good fluidextract is on the market. Jequirity, Abrus Precatorius or Indian Licorice. This is a highly toxic agent, the seeds containing proteid poi- sons with properties similar to the toxic agents of snake venom. A solution of jequiritol applied to the eye causes a purulent inflammation of a most violent character. By means o! very weak infusions a moderate inflammation is induced that displaces an existing purulent state by engrafting a new one. Hence, it is used in pannus and chronic trachoma and sometimes in chronic conjunctivitis and purulent ophthalmia. Merck's jequiritol is a sterile preparation of this agent. Begin by instilling into the eye 1 drop daily of "Solution No. 1" and increasing by 1 drop daily until the desired reaction results. All preparations of jequiritol soon spoil after being diluted with water, and should always be made up fresh as desired. This is a valuable agent, but must be handled with great caution. 140 JUGLANS ClNERiE. Juglans CinEM, Butternut. The inner bark of the root was at one time much employed in medicine, an aqueous extract being used in doses of from I to 5 gr. This remedy is an instance of the therapeutic iconoclasm of to-day. The whole effort is to develop new remedies. From the very dawn of medical science, good old reme- dies, such as juglans, have been produced by nature and to-day do just the same things as they did for our fore- fathers, only we are forgetting all about them in our foolish haste to have the chemist make for us remedies seldom the equal of those elaborated by nature. In large doses (f.e., 20 to 30 TTL ; ec. tr., 20 n\, ; jug- landin, 1 gr) it is cathartic and cholagogue, producing large, bilious motions without griping. It is as gentle as rhubarb, but much more thorough. The extract is made up into pills, and is effective in 5 gr. doses. It is highly useful in malarial fevers in cathartic doses. In moderate doses (extract, 1 gr; f.e. or ec. tr., 3 to 10 TTL) it is a mild laxative, valuable in habitual constipation and the resulting dyspepsia, and exercising a most excel- lent influence upon the liver. In small doses (f.e. or ec. tr., 1-3 to 1 TTt) it is indi- cated in skin diseases induced by gastro-intestinal trou- bles and faulty elimination, such as eczema, acne, impet- igo, pemphigus, and several of the scaly skin diseases. Small doses will also relieve occipital headache associ- ated with hepatic disturbances. Juniperus Communis, Juniper. A diuretic used in nephritis, cystitis, and renal hyperemia after subsidence of acute symptoms. Use an infusion (1 § berries to 1 pint boiling water) in doses of a wineglass or the Oleum juniperi in 3 TTt doses upon sugar. Kali Bichromicum and other kali salts. See under Potassium Salts. Kalmia LatiFoua. 141 Kaxmia LatiFoua, Mountain Laurel. This plant pos- sesses slight toxic influences due to andrometoxin. It is an alterative with mild sedative properties and may, with advantage, enter into vegetable alterative mixtures used in glandular troubles and as an adjuvant to specific treat- ment in secondary syphilis. It has some slight reputa- tion in the treatment of cardiac hypertrophy. The ho- moeopaths value it in painful rheumatic affections and facial neuralgia, and use it more or less in "tobacco heart." In my own experience, it has acted markedly as a sedative, but seems to possess no advantages over vera- trum except in nerve pain. As an alterative it cannot be pushed to the point usually necessary without unduly slowing the pulse. Ec tr., y 2 to 5 TIX ; ®, 3 to 15 Tl\. Be careful with large doses. Kamala, Mallotus Philippinensis. This is an efficient remedy for tapeworm, but it tends to gripe and should be administered in combination with carminatives or a small dose of opium. (F.e. or ec. tr., 30 to 60 n\, re- peated if necessary.) Kaounum, Kaolin or China Clay. One of the inscru- table acts of the revisers of the U. S. P. was to make this native silicate official as an ingredient of "Cataplasma kaolina," an official imitation of the proprietary paste of kaolin, glycerine, and antiseptics. Following this, in the very excellent but plenarily inspired series of articles in the Journal of the American Medical Association, all the proprietary mud poultices (uninspired and non-canonical) are denounced as heretics and deceivers of the elect. As a practical matter of fact, no druggist will ever care to make up a batch of the official cataplasma in a mortar more than once. Furthermore, it cannot be well made except by machinery. It needs very little study of the ingredients of these "mud poultices" to define their lim- 142 Kaolin um. its in therapeutics. While the literature issued concern- ing them is utterly ridiculous in some of its phases, still these preparations have a very positive usefulness in many conditions not very markedly inflammatory or pain- ful. Personally, I object to using heavy clay poultices upon the chest in severe diseases like pneumonia. The troublesome details of application and removal, as well as the weight, distress the patient, and, after they are removed, he is very apt to chill. I use a rather homely plaster in these cases of chest trouble. Take y 2 % each of capsicum and Scotch snuff and 2 § of powdered lo- belia seed. Triturate this well together and spread more or less thickly (according to patient's age) upon a cloth spread with lard or vaseline, and place upon the chest; or this powder can be mixed with mustard and hot water, or ground flaxseed and boiling water, and applied as a wet poultice. These agents have a real medicinal influ- ence, whereas the action of clay and glycerine is very slight in severe disease. Kava-Kava, Piper Methysticum. This agent slows the pulse, produces vigorous cardiac contraction, inhibits reflex action, is sudorific, and is somewhat anesthetic. In large doses it is employed by the natives of the South Sea Islands as the main ingredient of a peculiar and slightly intoxicating beverage. Very large doses are not employed in medicine. In moderate doses (i.e. or ec. tr., 5 to 20 TTt ; solid ex- tract, 2 to 5 gr.) its influence upon the mucous mem- branes of the genito-urinary apparatus makes it highly useful in chronic gonorrhea, gleet, chronic catarrh of the bladder, and nocturnal enuresis. Incidentally, this drug markedly stimulates the appe- tite and improves digestion. This fact makes it of pecu- liar value in many genito-urinary cases. It is an agent worthy of more general employment. Kino. 143 Kino. An astringent to mucous surfaces and useful in night sweats, polyuria, leucorrhea, and watery diar- rhea characterized by relaxation. U. S. P. tincture in doses of 1 teaspoonful. Kola, Cola Acuminata, is a heart tonic inducing diure- sis and retarding tissue waste, and indicated in depressed and enfeebled states of the heart, muscular system, and in depressed states of the mind and nervous system. It has also been recommended in chronic diarrhea with lack of tone. Dose, f.e., 10 to 30 Til. KramEria, Rhatany. An astringent, used chiefly in diarrhea. Average dose, 15 gr., or f.e., 15 TTL- The U. S. P. Trochisci kramerico are a pleasant astringent use- ful in relaxed forms of sore throat. Lachesis, Vims or Venom of Lance Headed Viper. Like all snake venoms, this substance decomposes the blood, rendering it more fluid and inducing septic states. It is well known that a degree of immunity results from doses of attenuated virus, very minute at first and gradu- ally increased. The homoeopaths use lachesis very promi- nently upon some such basis. They do not claim that this agent inhibits micro-organisms, but they do claim that it is a remedy in septic intoxication in which pus is not a factor or not the main one. They use it in diphtheria, peritonitis, erysipelas, and other grave diseases in the sixth to two hundredth "potency," and have devoted an astonishing amount of study to this peculiar drug. It is illustrative of a rather long list of organic poisons em- ployed in their practice. We can well omit detailed con- sideration of the rest of them. So long as we use various forms of serum treatment and find success therein, we cannot altogether combat the homoeopathic employment of these organic poisons. Per- 144 Lachssis. sonally, I believe they have gotten hold of the fringe of a big question which neither school knows much about as yet. As we look upon the matter, it certainly does appear foolish to contend that infinitely attenuated snake venom has any influence when taken into the stomach in view of the fact that one can suck the pure virus out of a wound and not be harmed thereby. However, they claim that there are toxines in an assimilable form in their triturations. We cannot deny that, and so the mat- ter rests. In view of the fact that many homceopaths use attenuations of vaccine virus in tablet triturate or pow- dered form and make the claim, with no more substantial basis than the "law of similars," that this form of al- leged vaccination protects against smallpox, it is high time our laboratory experts looked into these matters. Personally, with all deference to our homceopathic friends, it looks as if they are running their similar prop- osition so far into the ground that they will wake up to the fact that they have buried it. If lachesis influences blood sepsis, and if we can cure tuberculosis by attenu- ated tubercular nodules, and cancer by attenuations of its own juices ; if the poison of the toad cures epilepsy and feeblemindedness; triturated plant lice, toothache; tritu- rated bedbug, malaria; triturated ladybug, neuralgia; triturated mosquito, hives ; potatobug, gonorrhea ; crushed live ants, gout; meconium from the amniotic fluid of the colt, chorea; grease in horses, smallpox; triturated gonorrheal virus, chronic rheumatism; tritu- rated "polecat perfume," whooping cough ; and a long list of other abominations, each a "potentized" cure in its way, we may just as well go to China for our thera- peutics. As a matter of fact, live ants contain formic acid, which has some influence in gout and rheumatism, and possibly the rest of these agents might, in some Lactucarium. 145 round-about way, slightly influence certain diseases ; but it is unworthy of a school of therapeutics to resurrect these old Oriental horrors in medical practice. The mod- ern school of homoeopaths largely agree with what is here said. If lachesis and other organic poisons ever do attain a place in scientific therapeutics, it will be by sterile attenuations employed hypodermically. Lactucarium, Lactuca Virosa. This U. S. P. sub- stance is apt to be unreliable, but the tincture (50%), when made before changes occur in the drug, is a fairly dependable remedy in doses of 10 to 60 TTL. Squibb makes an excellent fluidextract of lettuce. It is a nerve sedative and mild hypnotic quite useful in functional disturbances. In irritable coughs it finds quite a field of usefulness. With some women it acts as a galactagogue. Lapis Albus, Silico-Fluoride of Calcium. In doses of the ix trituration this substance is asserted to be useful in goitre and scrofulous sores. Lappa, Burdock Root. An alterative used in skin dis- eases and valuable in irritation of the urinary apparatus. F.e. or ec. tr., 10 to 60 nx. LaurocERASUS, Cherry Laurel. This agent is of vary- ing strength, depending upon the amount of its contained hydrocyanic acid. Therapeutically, either bitter almond or peach bark is more dependable, although not so pleas- ant. Cherry laurel water is a pleasant adjuvant if care is taken not to exceed doses of 20 Tit. For therapeutic purposes the mother tincture in 1 or 2 fit doses is prefer- able. Spasmodic, tickling cough is quickly relieved by this agent, and an irritable stomach is ofttimes soothed by small doses taken upon cracked ice. Lead. See Plumbum, 146 Ledum PaIvUSTre. Ledum PalustrS, Marsh Tea. This plant and the allied Labrador Tea have been long used in medicine for a host of rather contradictory conditions. The homoeo- paths use small doses of the tincture in rheumatism be- ginning in the feet and to antidote the effects of the stings of insects. It has no established place in thera- peutics. Leptandra, Culver's Root. This agent is cholagogue, laxative, and alterative, and stimulates the portal circu- lation. In malarial and jaundiced conditions it is a very superior laxative, but its fluid preparations are so dis- agreeable to the taste and so readily precipitate that it is usually best to use Leptandrin, either pure or preferably in ix trituration ; Merck's leptandrin, 1 to 5 gr. ; or the homoeopathic ix in 5 to 30 gr. doses ; solid extract, 3 to 8gr. Leptandra is more markedly tonic than are most of the alterative cholagogues. It takes very considerable doses to be distinctly purgative. It is a good laxative for chil- dren who respond nicely to leptandrin ix. It is in small and continued doses that this agent is most useful. In jaundiced malarial conditions with indigestion, capsules containing leptandrin, quinine, and hydrastis in proper doses give most happy results. Liuum TiGRiNUM, Tiger Lily. The pollen and bulbs of various species of lily have long been known to be somewhat toxic. Among the aborigines and in domestic practice they have justly been esteemed as useful remedies in various uterine conditions, and so much evidence in their favor has accumulated that we will here consider the most representative agent of the class. Where uterine or ovarian engorgement or congestion gives rise to reflex neuralgias, headache, or nausea, tiger lily is a useful agent. These are chronic conditions, and L,INIM3NTUM. 147 the remedy must be used for several weeks at least. It gives results in proper cases combined with adequate local attention. The ec. tr. is given in 1 to 5 Tit doses, four times a day, for two to four months. The dilutions used by the homoeopaths are inadequate in practice, although their indications are quite suggestive. The physiologic action has never been adequately worked out, so far as I can learn. Linimentum, Aconiti et Chloroformi N. F., a useful but toxic anodyne embrocation. Ammonia, U. S. P., a stimulant anodyne. Belladonna, U. S. P., an anodyne. Camphorce, or "Camphorated Oil" (2% camphor), ano- dyne and rubefacient. Cantharidis (15% in turpentine), a counter-irritant to be used with care. Calcis, U. S. P., or "Carron Oil," for burns. Chloroformi, U. S. P. (30%), anodyne. Iodi, N. F. (i2j^%), discutient. Plumbi subacetatis (35%), antiphlogistic. Saponis, U. S. P. (6% soap, 4^% camphor), stimulant, rubefacient. Saponis mollis, U. S. P., formerly known as "Tincture of Green Soap," used in surgery and dermatology. Stil- lingia comp. (eclectic; made of ol. stillingia, 1 f 5 ; ol. cajeput, y 2 f§; ol. lobelia, 2 f5; alcohol, 2 f§), a power- ful stimulant and relaxant used in chest affections, croup, sprains, and spasmodic affections. Terebinthince, U. S. P., counter-irritant rubefacient. Terebinthince aceticum, N. F., "Stokes' or St. John Long's Liniment," antineu- ralgic. Lippia Mexicana. A remedy of comparatively recent introduction, said to be of great value in chronic bron- chial cough without secretion and the recurring cough incident to every cold following an attack of whooping cough. F.e., 10 to 20 Tl\. Liquors, Acidi Arsenosi, U. S. P. (1%), average dose, 148 Liquors. 3 HX. Ammonii aeetatis, U. S. P. (7%), diaphoretic and diuretic, average dose, 4 f3. "Squibbs's Liq. am. acet. concentratus" is three times the strength of the U. S. P. preparation. Antisepticus, a new U. S. P. preparation of aromatic vegetable antiseptics with 2% boric acid, 1-10% benzoic acid, and 1-10% thymol; externally, % to full strength; internally, 30 T1X to 2 f3. Arseni et hydrargyri iodidi, U. S. P. (1% of each salt), average dose, iy 2 Tit ; this is known as "Donovan's Solution." Bismuthi, N. F., each f3 containing 1 gr. bismuth and ammonium citrate. Calcis, 0.14%), U. S. P., lime water. Chlori comp., U. S. P., chlorine water, average dose, 1 f3. Cresolis comp., U. S. P. (50% cresol), a saponaceous antiseptic and dis- infectant, used externally in 1 to 3% solution. Ferri chloridi (10% metallic iron), average dose, 1V2 HI. Fe. et am. acet. (Basham's Mixture), average dose, 4 f3. Ferri subsulphatis (Monsel's Solution), used externally. All these iron solutions are from U. S. P., which also unwisely lists : Ferri tersulphatis, very liable to be mis- taken for the subsulphatis. The tersulphate is irritating and less efficient than the former preparation. Formalde- hyde, in practice of varying strength, but officially should be 37% absolute formaldehyde gas ; use in ^4 to 2% solution. Hydrargyri nitratis, U. S. P. (60%), a power- ful caustic. Iodi comp. (Lugol's Solution, I. 5% ; K.I., 10%), average dose, 3 T\[. Magnesii citratis, U. S. P., laxative in average dose of 12 fg. Plumbi subacetatis. U. S. P. (25%), known as Goulard's Extract, astringent and antiseptic; used in making Plumbi subacetatis dilu- tus (1%), used externally undiluted. Potassi arsenitis (1%), Fowler's Solution; average dose given in U. S. P. as 3 TTL ; in practice most physicians give less. Potassi citratis, U. S. P. (8n^), average dose, 4 f3. Potassi Lithium. 149 hydroxidi, average dose, 15 TTL- Soda chlorinate? (La- barraque's Solution), average dose, 15 Tl\. Sodii arsena- tis, U. S. P. (1%), average dose, 3 TTL- The National Formulary has a similar title, but this preparation is only one-tenth the strength of the U. S. P. preparation. Be exceedingly careful not to confound the two. The N. F. preparation should be dropped entirely in view of the concentrated U. S. P. product. Sodii hydroxidi, U. S. P. (5%), "average dose, 15 TTL." This is "caustic soda," and its internal use is open to question. If used at all, it should be much diluted. Sodii phosphatis comp., U. S. P. This is a liquefied sodium phosphate, and con- tains traces of sodium nitrate and citric acid. It is a use- ful laxative in doses of 2 f3, well diluted. Zinci chloridi, U. S. P. (50% by weight), caustic. As a disinfectant, use 1 pound to 2 gallons of water. Lithium, Lithii Benzoas, antilithic and internal anti- septic. Both natural and synthetic preparations are avail- able, and are used in doses of 5 to 20 gr. The Bromide is used in the same dose as a nerve sedative. The Car- bonate in 3 to 10 gr. doses is an antacid diuretic. The Citrate in 3 to 10 gr. doses is probably the most valuable salt of lithia, used to neutralize or dissolve uric acid and as a remedy in rheumatism and gout. It is freely soluble in water. The Salicylate in 5 to 20 gr. doses is em- ployed in rheumatism. The effervescent lithia preparations are to be com- mended. Natural lithia water is ofttimes preferable to the salts, but the ingestion of large quantities of water with the salts overcomes, in a measure, the deficiency of the U. S. P. preparations. Lobelia, Indian Tobacco. This old-fashioned drug is not sufficiently appreciated by the "regular" physicians 150 LOBEXIA. of to-day. In moderate and small doses it is an exceed- ingly valuable agent. The fluidextract is a good prep- aration, the average dose of which is 8 Til, but a more uniform preparation is the ec. tr., which is made from the seed. It is equivalent to the fluidextract of the seed. The seed contains twice as much lobeline (the narcotic principle) as does the herb. They also contain a fixed oil. Emetic properties are not so marked in the preparations of the seed as in that of the whole plant; in consequence, physicians who have used only the U. S. P. preparations cannot apprehend the eclectic appre- ciation of this drug. I have stated that the average dose of the fluidextract is 8 TO,. That is what the U. S. P. gives, and it is therefore not to be wondered at that two or three experiences with lobelia, used as thus directed, is usually all the practician cares for when we remember that 10 rrt of this preparation is the emetic dose. The maximum dose of ec. tr. is 30 nt. In large doses (f.e., 10 Til ; ec. tr., 20 to 30 n\) lobelia is emetic and very depressing, with relaxation and a feeble pulse. Owing to its depressing respiration in a similar manner to tobacco, its use as an emetic is seldom justified except in sthenic conditions or in emergency. In large medicinal doses not emetic (f.e., 7 or 8 TTL ; ec. tr., 10 to 20 TTt) it is useful where there is nerve ten- sion and a spasmodic tendency, with flushed face and contracted pupils. Thus, it is useful in spasmodic asthma during a paroxysm, in puerperal eclampsia, tetanus, the spasms of hydrophobia and strychnia poisoning, hysteri- cal convulsions, angina pectoris, where the patient is not feeble, and in obstetric practice, where a rigid os and too great fullness of perineal tissue delay labor. In all these conditions judgment must be used, and these large doses not be often repeated. From large experience with this Lobelia. 151 drug, I prefer the ec. tr., and find that capsicum in full doses administered with it overcomes depression. That was a combination of the old-time herb doctor, but it was a good one. In moderate doses (f.e., 1 to 3 TTt ; ec. tr., 2 to 5 TTL, if at long interval; f.e., 1 TTt, or ec. tr., 2 TTt or less, if given frequently) lobelia is indicated in oppressed breath- ing and in respiratory troubles of an irritating character. In spasmodic croup the dose may be gradually run up to the point of slight nausea, since children tolerate the drug well. In whooping cough and spasmodic coughs generally it is useful. In some cases of congestion of the lungs it is very effective. In many conditions of disease its use to relax the muscles is effective, and this is par- ticularly true in sthenic fevers and some forms of ma- laria. In small doses (f.e., ]/ 2 to 1 TTt ; ec. tr., 1 to 2 TTt) lo- belia, like narcotic agents generally, has a transient stim- ulating effect upon the nervous system and augments the secretions. Its influence is directed largely to the sym- pathetic nervous system, and thus promotes secretion and nutrition. Because of this, alterative properties have been attributed to it, but these effects are too transient to class it as a true alterative. In these small doses it appears to promote digestion when there is a tendency to colic, and is a useful remedy with children. The homoeopaths use it in dyspnea with good effect and in gastric disturb- ances caused by drunkenness. They also use the tincture of Lobelia syphilitica in cases of influenza with Eustachian catarrh and coryza. In the nervous prostration of influ- enza they use the Purple lobelia. The homoeopathic tinc- tures, in doses of 1 or 2 n\, are of some degree of utility in the indications noted, but the doses must be frequently repeated, and it must be remembered that febrile states 152 LyYCOPODIUM. are not met by these small doses. They relieve symptoms, and that is about all they do. These tinctures are much weaker than the f.e. or ec. tr. Lycopodium, Club Moss. The sporules are used as a dusting powder in regular medicine. In sectarian prac- tice, lycopodium is esteemed as a valuable remedy. As a matter of fact, the sporules are inert when ingested in their natural state, but when triturated or comminuted 47% of the resulting paste is a bland oil with properties said to resemble santal-wood oil therapeutically. In addi- tion to this oil, there are volatile bases which have not been adequately investigated, but presumably have an influence in stimulating tissue metabolism. They are irri- tants, but are carminative when well diluted. Hence, although the sectarians are derided for using this agent internally, a little thought will show that the alcoholic tincture and the low triturations contain quite active sub- stances. It is with regret that I cannot supply full physio- logic data, but chemically the active bases are akin to methylamine and probably are partially combined with phosphoric anhydride, and to work out the physiologic action would be a complex proposition. In large doses (ec. tr., 10 to 15 TTt) lycopodium is of value in gonorrhea after the subsidence of acute symp- toms, and in gleet. Give well diluted in water and glycerine. In small doses (ec. tr., y 2 to 2 ITt ; ©, 1 to 4 tt\,) it is adapted to urinary and digestive troubles where the uric acid diathesis and inactive liver and glandular functions are a factor. It is a gastric sedative, relieving pyrosis and flatulence. Cystic catarrh and lithemia are markedly re- lieved by this agent. In homceopathic practice minute doses of this drug are used symptomatically in a host of chronic conditions due Lycopus Virginica. 153 to defective metabolism. It is a drug they value highly and use in high dilution. The present author pleads igno- rance in the use of the dilutions, but has found small doses of the ec. tr. a most satisfactory drug, and uses it almost daily. The sectarian literature concerning this drug is well worth careful study. Lycopus Virginica, Bugleweed. A remedy used largely by the eclectics. The ec. tr. is made from the green herb, and is very active. The maximum dose is 20 TTL- In diseases of the heart, in moderate to full doses, it slows the pulse and relieves irritability and tumultuous action. It is recommended in hypertrophy and dilatation, and has been suggested in exophthalmic goitre. It is given to advantage in palpitation. In respiratory diseases it is asserted to be of value in hemoptysis and incipient phthisis and in irritable coughs. It is not definitely ascertained that it has any direct action upon the lung tissue, but by its action in controlling the circulation and because of a mild nerve sedative influ- ence it is a remedy of secondary importance in this con- nection. In my own experience, small doses are not effective. Macrotys. See Cimicifuga. Magnesium, Borocitrate. Antilithic and antiseptic in doses of 15 to 30 gr. Magnesii carbonas, U. S. P., in large doses is laxative (Si), or in small doses of 10 to 20 gr. is antacid, quite agreeable in action. These doses, once an hour until a laxative effect is produced, consti- tute an excellent treatment in sick headache and nausea due to acidity. The granular effervescent citrate is well tolerated by an irritable stomach, and is preferable for a purely laxative effect. The glycerophosphate, in 3 to 154 Magnesium. 6 gr. doses, is an excellent nerve tonic, but its solutions do not keep well. The hypophosphite in slightly larger doses is also useful in nervous debility. Care should be taken in combining it, since it explodes in contact with oxidizing agents. The muriate is employed in homoeo- pathic practice in liver diseases with constipation char- acterized by sparse and knotty stools. Magnesii oxidum, V, S. P., is the light, calcined magnesia, and acts simi- larly (but in somewhat less dose) to the carbonate. It is a valuable alkali to neutralize concentrated acids when taken in poisonous doses. Average dose, 30 gr. Mag- nesii oxidum ponderosum, U. S. P., is the heavy, calcined magnesia. Action and dose similar to the light. The phosphate is given in small doses dissolved in hot water, in homoeopathic practice, in neuralgic pains relieved by warmth and in enteralgia and flatulent colic. Magnesii sulphas, U. S. P., or "Epsom Salt," is a cathartic of great value in doses of 4 to 6 3. If given in hot solution a less quantity suffices. It should always be well diluted. Doses of 20 to 30 gr. are aperient. This agent is of supreme value in abdominal surgery, since it does not cause active peristalsis. It is of value in lead poisoning. Meltzer and Auer assert that 1^2 to 2 fo of a 25% solution in- jected into the subarachnoidal space of the spinal cord produces motor paralysis and anesthesia in the portion of the body below the site of injection. The anesthesia comes on within four hours, and continues for several hours. The heart is not affected, although respiration is slowed. Intravenous injections are not so efficient. This old drug is coming to be recognized as a remarkable agent, and is being exploited in a number of new direc- tions. The homoeopaths use small doses of the pure salt or the ix trituration in diabetes and in conditions of the skin giving rise to warts. The effervescent salt is offi- Mai/tum. 155 cial. The sulphite is a valuable intestinal antiseptic, less disagreeable in taste than sodium sulphite. Dose, 5 to Mai/tum, Malt, is now official. It is diastasic, tonic, nutrient, and (in the form of Hxtr actum malti, U. S. P.) an excellent vehicle for disagreeable drugs. The so- called malt tonics made by brewers differ little from the better grades of beer, ale, and , porter. Several drug houses sell liquid malt preparations rich in diastase and containing very little alcohol. Manganese, Acetate. Employed homceopathically in inflammation of the bones and joints and in syphilis. The carbonate is tonic in doses of 5 to 20 gr., while the chloride is used, in half this dose, as a tonic alterative. The citrate, in doses of 1 to 3 gr., is used in chlorosis. Man- gam dioxidum precipitatum, U. S. P., is alterative and emmenagogue, and is given in pill form in doses of 2 to 5 gr. The glycerophosphate is a valuable nerve tonic in doses of 3 to 6 gr. Like glycerophosphates generally, its solution does not keep well. Squibb's peptonized man- ganese is a mild remedy useful in chlorosis in doses of 10 to 20 gr. Mangani hypophosphis, U. S. P., is a nerve tonic, and is recommended in tuberculosis. Give in doses of 1 to 5 gr. Mangani sulphas, U. S. P., alterative, tonic, and cholagogue. Average dose, 4 gr. Externally, in 10 to 20% ointment, in stiff joints from gout and rheuma- tism. Manna, Fraxinns Ornus. A mild purgative given m doses of 1 to 5 3. Mannite, or manna sugar, is used in diabetes in place of cane-sugar, and as a laxative for children. Dose, 6 to 8 5 for adults. Marrubium, Hoarhound. A mild expectorant used principally in the form of a syrup. Macerate an ounce 156 Mass. of the dried herb for three hours in ^2 pint of boiling- water, strain, and add water sufficient to make y 2 pint in- fusion ; add 1 pound of sugar. This makes an agreeable syrup, suitable as a vehicle for any indicated active ex- pectorant. Mass. There are two U. S. P. preparations designated by this title, viz., Massa ferri carbonatis, or "Vallet's Mass," and given in doses of 2 to 5 gr., and Massa hydrargyria or "Blue Mass," the average dose being 4 gr. Matico, Piper Angustifolium. Intestinal astringent and aromatic. Used also in cystitis and gonorrhea. Dose, i.e., 1 f3. Matricaria. See Chamomilla. Meulotus, Yellow Melilot, or Sweet Clover. This is a homoeopathic remedy used for congestions and hemor- rhages, in the "lower potencies," and should not be con- founded with Mallotus or Kameela. Mentha Viridis, Spearmint. Carminative and altera- tive. Spearmint is official, whereas peppermint is not, except in the oil and the spirit made from the oil. Spear- mint tea is really of considerable service in the treatment of infantile colic and in the suppression of urine in chil- dren. Menthol. Used externally as an analgesic, anesthetic, and antipruritic. It may be used full strength upon the unbroken skin. For tampons or use in contact with mu- cous membranes, use 1 part in 5 to 10 parts of oil or unguent. Its average dose internally is 1 gr., but other agents serve its indications much better. It is carmina- tive and antispasmodic. Mercury. The official U. S. P. title for mercury is Hydrargyrum. The homoeopaths call it Mercurius, and Mercury. 157 they have the better title. We usually abbreviate it to "Hydrarg.," or even to "Hydr." A great many drugs have Hydr. and conflict occurs, as witness — hydras- tin, hydrangea, hydrated salts, hydriodic acid, hydrobro- mates, and hydrochlorates, hydrocyanic acid, hydrogen, hydrous wool fat, and a long list of synthetic chemicals. Acetate, antisyphilitic in doses of 1-10 to ]/ 2 gr. Am- moniated, used in ointments, 1 to 10%, as a parasiticide. Hydrargyri chloridum corrosivum, U. S. P., antiseptic, alterative, and antisyphilitic. Average dose, 1-20 gr. In small doses a tonic (1-100 gr). Hypodermically used by dissolving i l / 2 gr. and 15 gr. of sodium chloride in 25 io of water and using from }4 to 1 syringeful at a dose. For surgical antiseptic purposes, in solution 1 15000 to 1 :iooo. In homoeopathic practice, the 3X is used with success in rectal tenesmus. Their ophthalmologists use a 1 :iooo solution, injected hypodermically under the con- junctiva, in choroiditis with progressive myopia and ach- ing pain. Hydrargyri chloridum mite, U. S. P. The tendency now is to use calomel in fractional doses (1-10 gr. triturates), hourly or half hourly, to effect. Large doses are cholagogue, and small ones at long intervals alterative. Quite apt to salivate. A very valuable in- testinal antiseptic. The homoeopaths call it Mercurius dulcis. Their ix (1-10 gr.) tablet triturates are well made and are very active. They use the 3X in catarrhal inflammations of the ear and Eustachian tubes, and in diarrhea with soreness of the anus. Fumigations of calo- mel are of great value in membranous croup. Hydrargy- rum cum creta, U. S. P. (38%), an intestinal antiseptic, cholagogue, and antisyphilitic. Average dose, 4 gr. After saturation with the protoiodide this is a good form of mercury for prolonged administration in syphilis. Cya- nide, alterative and antiseptic, in use in 1 : 10,000 to 1 :2000 158 Mercury. in solution externally, and in 1-10 gr. doses internally. It is similar in action to the bichloride, but is less irri- tating. Both the regular and homoeopathic profession use it in malignant cases of diphtheria, but very small doses should be used. The 3X trituration serves well. Hy- drargyri iodum flavum, U. S. P., or Protoiodide, is used principally in syphilis in the average dose of 1-5 gr. Two things should be remembered with reference to this drug : when purgative effects are produced, it should be con- servatively employed, and, as its dose is four times that of the biniodide, it should never be combined with soluble iodides, which convert it into the biniodide. The homoeo- paths use 1 -10 gr. doses when there is a heavy yellow coating upon the tongue, and 1-100 gr. doses (2x) in throat affections with swollen glands. Hydrargyri io- didum rubrum, U. S. P., or Biniodide. Used in obsti- nate cases of syphilis in an average dose of 1-20 gr. Highly toxic. The 2x and 3X are of marked value in ulcerated sore throat and diphtheria. Massa hydrargyri, U. S. P., or Blue Mass (33%), is used principally as a purgative. Average dose, 4 gr., usually in pill form. Oxide (Black), or Hahnemann's soluble mercury, is not soluble in water or alcohol, and decomposes upon expo- sure. Dose, }i to 2 gr., but is unreliable. Hydrargyri oxidum Havum, U. S. P., is used externally in 10% oint- ment in chancres, indolent ulcers, ringworm, and for skin parasites, and in ^ to 1% ointment in ophthalmia. Hy- drargyri oxidum rubrum, U. S. P., has the same uses and in the same strength. Subsulphate is the yellow sulphate or turpeth mineral, and is peculiar in that it possesses emetic properties that render it valuable in croup in doses of Y\ gr., repeated at intervals. The adult emetic dose is 2 to 5 gr. The ix or 2x is valued in cases of dyspnea with rapid respiration and burning in the chest and in Mercury. 159 hydrothorax. Mercurius vivus is the homoeopathic prepa- ration of metallic mercury. The globules are in a very much finer state of subdivision than they are in blue mass or mercury with chalk, the excipient being milk sugar. Mercurius vivus is really a very fine pharmaceutic, and, in the ix trituration, is very useful in syphilis and to take the place of blue mass. Ten grains is a full dose for an adult, and represents 1 gr. of minutely commi- nuted mercury. The higher triturations are mildly altera- tive, but I believe the homoeopaths vastly overdo the ad- ministration of mercury in a host of' chronic conditions. Mercurial inunctions are so valuable as to justify a separate paragraph. In my hands, the U. S. P. Ungu- entum hydrargyri has served admirably, but it is impor- tant that it be well made and not rancid. Squibb makes it up in suitable form, departing slightly from U. S. P. directions. The oleates of mercury are not sufficiently stable to be relied upon. In employing homoeopathic preparations of insoluble mercury, such as calomel or metallic mercury, it must be remembered that they triturate such substances for many hours by means of electrically operated apparatus, and, grain for grain, the actual drug incorporated is much more active than in similar U. S. P. products. The ec- lectics make very little use of mercury in any form. It is a drug whose action does not differ in large or small dose except in degree. The recent tendency in the treat- ment of syphilis has been to use it to saturation, and then maintain the effect with small doses. It is proper to say, however, that mercury is a tonic alterative in small doses, and its use for short periods in sore throat and other acute conditions is to be highly commended. It is sur- prising how quickly many intractable cases of disease yield to small doses of the bichloride or biniodide and old, 160 Methyi/thionin^. obscure chronic cases to mercurial inunctions. "When in doubt give mercury" need not apply exclusively to syphilis. Methylthionim Hydrochloridum is what the U. S. P. calls Methylene Blue. Tetramethyl-thionine hydro- chlorate is the true chemical name, and the matter is men- tioned here as a protest against a whole tribe of hybrid synthetic nomenclature in the eighth revision. In large doses, 2 to 6 gr. in capsules, it is an antiseptic eliminated chiefly by the kidneys, and hence is of value in gonorrhea, cystitis, nephritis, diabetes, and pyelitis. In small doses, 1-10 to J / 2 gr., it has some reputation in neuralgias and neurasthenia with a septic or malarial etiology. MezerEum, Spurge Olive. Rubefacient and epispastic, used as a stimulant to foul ulcers in the form of oint- ment. The fluidextract is occasionally used in doses of 5 to 15 TIX, well diluted, as an alterative, but it is apt to give rise to very disagreeable symptoms. The ® made from the fresh bark is of utility in doses of 1 or 2 TTL in eczema, shingles, and skin diseases characterized by in- tense itching, but even that dose must be watched and a smaller dose given if the drug is long continued. Mistletoe, Viscum Album. Preparations made from the green plant are active, and are dangerously toxic in very large dose, causing convulsions. In large doses (ec. tr., 5 to 10 TTL ; ©, 30 to 60 TTt) it is oxytocic, causing intermittent uterine contractions and not markedly influencing the cervix. In labor with weak contractions it is adapted, if, indeed, any drug of this class should be used. In such conditions it is preferable to ergot. Capable authorities have commended it in car- diac hypertrophy with valvular insufficiency. MlTCHELLA RIPENS. l6l In small doses ( to 2 gr. ; tr., 10 to 20 TTt ; Dover's Powder, 15 gr.) is indicated in spasmodic pain of bowels, bladder, uterus, common bile duct, ureters, and urethra when pain is not too acute, or to follow an initial dose of morphine when acute; in cholera morbus, lau- danum, or opium per rectum ; peritonitis, until sharp pain is relieved; to check excessive secretion in diarrhea, and in many surgical conditions. When sleeplessness is due to pain, opium in grain doses is indicated, and 2 gr. doses may frequently be required. Morphine in large doses (% gr. hypodermically or by mouth, as indicated by conditions or urgency) is indicated in wakefulness, with excessive muscular action in acute spasmodic diseases, such as chorea and epidemic cerebro- spinal meningitis. In traumatic tetanus it should be in- jected into the muscles. Spasmodic asthma demands fairly large doses at times, as do violent cramps. Acute neuralgic and sciatic pain and the pain and shock of traumatism demand full doses, often hypodermically. Puerperal convulsions may demand doses as high as Yz gr. Opium in moderate doses (y 2 to 1 gr. ; tr., 5 to 10 TIX ; i^o Opium. Dover's Powder, 5 to 8 gr.) is indicated in many cases of diarrhea and for a diaphoretic effect. The moderate dose, especially of Dover's Powder, is indicated. Moder- ate doses in suppositories are applicable in painful pelvic, rectal, and genito-urinary troubles. Morphine in moderate doses (% gr.) is applicable in the less acute indications noted under large doses, and in cardiac dyspnea and angina pectoris, as well as in rectal tenesmus and threatened miscarriage. Opium in small doses (% to 1-3 gr. ; tr., 2 to 4 TTt) is a stimulant to the nervous system and tends to prevent exhaustion, and is quite useful in typhoid fever with nerv- ous exhaustion. Give by rectum. Similarly used in pneumonia and pleurisy, it frequently does good. There are a good many cases of spasmodic contraction of the intestines that result in constipation. Small doses of opium following oil or a saline relieve promptly. Morphine in small doses (1-20 gr.) is of value in reflex vomiting and in dry, spasmodic cough. Codeine is fre- quently to be preferred in cough, but in doses of % gr. or more. These small doses of morphine hypodermically are of value in melancholia marked by loss of appetite and muscular weakness. Opium in minute doses, as employed in the 3X by homoeopaths, is indicated in sluggish conditions of the nervous system with stupid sleep, stertorous breathing, relaxed jaw, and dark, suffused face. There is no doubt that the stimulating effects of opium could be secured by these minute doses if very frequently repeated, but it im- presses me that such symptoms involve a study of the underlying pathology and the use of very much more direct remedies to meet the state of the case. (Do not forget the difference between the drop and minim of Tr. Opii.) Oxgall. 171 Oxgall, Fel Bovis, in purified form, is employed in intestinal indigestion. The U. S. P. recognizes Fel bovis purificatum, and it is used in pills or capsules in 5 to 10 gr. doses. P^onia is employed in 2x and 3X in rectal irritation and itching, as well as in fissures and hemorrhoids. It is asserted to relieve the pain, but is not used to the exclu- sion of local treatment. Large doses cause vertigo and diarrhea. Palladium. Triturations of this metal are employed in ovarian diseases associated with mental disturbances. If it is really of therapeutic value, its action is probably akin to that of platinum. Pancre;atinum. In a test tube this agent is amylo- lytic, proteolytic, and emulsifiant. In the stomach it is destroyed in the presence of pepsin or over 0.5% of hy- drochloric acid ; hence it should be administered in the intervals between gastric activity in order to reach the duodenum, where it possesses marked digestive powers. Do not administer in combination with other digestive agents, acids, or alcohol. Dose, 5 to 15 gr. Papaya. Several proprietary digestants, among which are "Papain," "Papoid," "Car old," and "Papaotin," are prepared from the fruit of the carica papaya, which con- tains ferments and nitrogeneous principles rather remark- able in plant life. These proprietaries are of consider- able value, but they do not digest everything, as is claimed by some enthusiasts, and they are very feebly active in an acid medium. In a weak, alkaline solution they are powerfully digestant, taking the place of pancreatin more than that of pepsin, but these agents are not without utility in gastric digestion, and, in their several combina- tions, are of frequent value in dyspepsia. Unfortunately, T-7 2 Parald^hydum. the high price has induced some so-called pharmaceutic houses to market tablets only pretending to contain this agent. It is best to buy direct from the makers of these articles under their trade names as herein given. In my own experience, they possess a peculiar value in dissolving and digesting mucus that I take advantage of in cases of gastric ulcer, gastric catarrh, intestinal troubles with an excess of mucus, and where intestinal parasites lodge in mucous secretions. These agents clear away the mucus and permit the local action upon mucous mem- branes or the absorption of remedies administered. Dose, 2 to 5 gr. with sodium bicarbonate. A 5% solution in equal parts of glycerine and water dissolves false mem- brane in diphtheria and croup. Parai,d£hydum. Hypnotic and antispasmodic. Of slight use in nervous insomnia and in the treatment of alcoholism and insanity. The average dose is 30 Tl\, well diluted, in an elixir. An impure article may contain fusel- oil derivatives, but a well-made paraldehyde is moder- ately safe in use. Pareira. An alterative diuretic of value in urinary troubles, dropsy, and rheumatism. Large doses are laxa- tive. This agent markedly relieves gleet and chronic cys- titis. (F.e., 30 to 60 ni.) Parthenium, Bitter Broom. Small doses of a tincture are used in Cuba as a remedy for fevers, following the administration of quinine. It is said to favorably influ- ence Cheyne- Stokes respiration. Excessive doses cause headache and disordered vision. Passiflora Incarnata, Passion Flower. The physio- logic action of this remedy has not been well studied, but animals eating of it in large quantities suffer from spasm and paralysis. Passi£i,ora Incarnata. 173 In moderate doses in man it is classed as a narcotic and antispasmodic. It has been exploited in proprietary cir- cles, and is overstated in the literature issued. I have made large use of the agent, and find the fluidextracts to vary. The ® is excellent, but too weak for a feeble drug like passiflora. The ec. tr. is made of the root and stem stalks, and is claimed to be more potent than fluidex- tracts, but I believe some of them equal it in strength. As an antispasmodic it is of more value than as a narcotic. A few cases of tetanus are recorded in which large doses were effective. It seems to cure tetanus in horses very promptly, but is not nearly so successful in man, and must be given in tablespoonful doses of the fluidextract. The spasms of meningitis yield to it more readily, while in epilepsy it seems to have an effect in reducing the frequency of the paroxysms, but large doses must be given. In the convulsions of children it is quite a reliable drug in doses of 10 to 15 TT\, of the fluidextract. As a narcotic it produces normal sleep, and the patient can be readily aroused. No disagreeable symptoms follow its use, but it must be steadily borne in mind that passi- flora does not relieve pain and is utterly worthless as a hypnotic in insomnia with flushed face and cerebral con- gestion. Bromides are demanded in this condition. On the other hand, in asthenic insomnia due to exhaustion and depressing fevers, in insomnia due to functional nerve disturbances, neuroses without pain, and in in- somnia of infants and the aged, it is a useful and en- tirely harmless drug. It acts nicely with children. Small doses are of no value. PEXivETiERiM. See Granatum. PenThorum, Virginia Stonecrop. The f.e. or ec. tr. in 5 to 20 TTt doses increases the functional activity of the 174 Peppermint. stomach. The homoeopaths use smaller doses in chronic coryza. Pepo. See Cucurbita. Peppermint, Mentha Piperta. The warm infusion is diaphoretic, while the oil is antiseptic and anesthetic, and may be given in 2 to 5 TTt doses in fermenting stomach. Add the oil to a small quantity of glycerine, then incor- porate with a quantity of hot water and administer. Lo- cally, the oil serves somewhat the same purposes as the solutions in oil of the more active menthol, which is to be preferred. The oil is a good application to aching carious teeth, but a better plan is to first apply "Echa- folta" and follow with equal parts plantago (q. v.) and oil of peppermint. PEpsinum. An active proteolytic agent employed in several forms of dyspepsia and in peptonizing milk. In cases of malnutrition in infants, pepsin in small doses triturated with milk-sugar is often of most direct benefit. It should also be remembered that following shock or severe disease a deficiency of pepsin in the gastric secre- tion is ofttimes a marked factor in the case. It combines rationally with hydrochloric acid and the bitter tonics. Dose, 3 to 10 gr. A few makers extract direct from the hog's stomach the pepsin therein. These essences of pep- sin are probably the most active form of the drug, and are utterly free of decomposition products. PETrosEUNum, Parsley. The ® and first dilution are employed in urethral irritation with constant desire to micturate. It is fairly efficient. PhEnacetin, Acetphenetidinum , U. S. P. This agent is incompatible with iodine, salicylic acid, and oxidizing agents, and liquefies when triturated with carbolic acid or chloral hydrate. The patent upon it has recently expired, and it can now be procured at a reasonable price. Phenacetin. 175 This drug is probably the safest of its class. While it induces the formation of met-hemoglobin and may cause cyanosis, it does not have the awful record of mortality incident to the unwise use of other coal-tar derivatives. There is no scientific basis for a sweeping condemnation of these synthetics, but it is well to be upon the safe side and employ this comparatively safe chemical instead of acetanilid. Phenacetin is of value in the initial stages of sthenic fevers, especially when associated with pain. It markedly reduces fever, but less decidedly relieves pain. Its stimu- lation of secretion renders it a valuable drug with which to prepare the system for the exhibition of quinine. Its average dose is 7^ gr., but 10 gr. may be given as an antipyretic and 12 gr. may be demanded for its analgesic effects. Never exceed 3 gr. with children, and do not give to infants at all. Phenol, Carbolic Acid. Antiseptic, antipyretic, and caustic. Used internally in doses of 1-6 to y 2 gr. in pill or emulsion, in fermentative dyspepsia, and obstinate vom- iting. Locally, full strength as caustic, and 1 part to 500 to 1 in 1000 as a wash or injection. In ointments, usually 5%. This agent is being largely displaced by other anti- septics, but should not be forgotten as a safe caustic pos- sessing local anesthetic properties. Phenyl Saucylas. See Salol. Phosphorus. This is a neglected but valuable remedy. Its great affinity for oxygen makes it a little difficult of administration. Its alcoholic solutions should not be dis- pensed in water, the contained air of which soon reduces it to phosphoric acid, and thus the physicians who ad- minister it in this way fail to get results. The Liquor phosphor i. N. P., or "Thompson's Solution," contains 176 Phosphorus. 1-24 gr. to a f3, and in doses of 10 to 20 1TL, diluted as administered, is a satisfactory preparation. The ec. tr. and © are of about the same order, but are saturated alcoholic solutions, and may be given in doses not ex- ceeding 5 TTL- The Pilules phosphori, U. S. P., contain 1 -100 gr., and they are well constructed chemically and can be depended upon. In large doses (2 pills ; Liq. Phosphori, 20 to 30 drops) phosphorus is seldom demanded. Large doses should be given with great care, but when a powerful general stimu- lant and nerve tonic are demanded these doses give in- creased strength. Acute sexual debility may justify large doses. In paralytic conditions due to functional derange- ments of the cord, in long-standing cases of neuralgia, and in some cases of epilepsy 1-60 gr. doses may be given. In moderate doses (1 pill; Liq., 10 to 15 drops) it is a remedy in nervous exhaustion with the accompanying occipital headache and insomnia, chronic sexual debility, the diseases of senility, glandular diseases marked by de- bility, and in tubercular states. In small doses (Liquor, 1 to 3 drops; first decimal dilu- tion, 1 to 3 drops ; and in children and chronic cases, the second dilution). The ec. tr. or any saturated solution in alcohol may be used in glycerine or to saturate sugar disks, but these disks should be kept well corked. Prac- tically, the first dilution, given to the patient with direc- tions to take 1 to 3 drops in a little water at a dose, serves well. We must give the homoeopaths credit for develop- ing a good thing in these indications for phosphorus in small doses, as they are really very effective. In these doses phosphorus overcomes pulmonary engorgement, re- lieving the cough of tuberculosis and favorably influ- encing the dyspnea and diarrhea. In pneumonia and Phosphorus. 177 bronchitis with engorgement and muco-purulent expector- ation and in chronic laryngitis and the sequelae of pneu- monia it is highly useful. Fatty degenerations are directly helped by small doses, and especially such changes in the heart, brain, and spinal cord. In cases of malignant jaundice, associated with fatty degeneration of the liver, it sometimes aids in the cure. A whole class of degenerative nerve changes responds to small doses of phosphorus, such as myelitic paraplegia from excessive venery, asthenic amaurosis following nerve lesions or defects, some cases of dementia and paralysis agitans, and prostration of the ganglionic system with impaired cerebration. Certain gastro-enteric states marked by debility are aided by small doses. A painful, irritable stomach, asso- ciated with deficient pancreatic digestion and painless but debilitating diarrhea, may be helped, and the whole train of symptoms disappear under a nerve-tonic course of phosphorus. Physostigma, Calabar Bean. This highly toxic drug has been employed in tetanus, tonic convulsions, severe neuralgia, phantom tumors, muscular rheumatism, and in strychnia poisoning, as well as in spasmodic conditions generally. Dose, extract, 1-10 to % g r -> the average being % gr. The average dose of the tincture is 15 TTt ; ec. tr., 1 to 3 TT\,. See under "Eserine" also. Its average dose is 1-64 gr., and the maximum 1-30 gr. Before using this drug in the doses and for the indications given above, it would be well to study the physiologic action as related to the case in hand. It is a powerful agent, both for good and for harm, but usually for the latter. In small doses (extract, 1-20 gr. ; tr., 3 to 5 TT\. ; ec. tr., % TTt) it is employed in inactivity of the bowels with 178 Phytolacca. flatulence and muscular weakness, paretic diarrhea, dis- eases of the nerve centres, ocular paralysis, and writers' cramp. It has been commended in many other condi- tions by sectarian physicians. In general, it may be said that its influence in small doses is too uncertain to be depended upon, and it is little used in practice, although commended in the books. Eserine is highly useful in ophthalmic practice. The U. S. P. Physostigmince salicy- las or sulphas are the salts commonly used, and are ap- plied to the eye in 0.2 to 0.5% solution. Phytolacca, Poke Root. Some years ago an altera- tive mixture compounded from the fresh juices of stil- lingia, sarsaparilla, lappa, xanthoxylum, and phytolacca was suggested by Dr. J. Marion Sims, and has been used largely in syphilis with a considerable degree of satisfac- tion. The same combination made from fluidextracts has disappointed. It is a well-known illustration of the ad- vantages of fresh plant pharmaceutics. The drug now under consideration is one I wish I had it in my power to adequately present in such a light as to impress not merely the value of phytolacca, but to use as an illustra- tion of the radical differences between green and dried plants in the making of tinctures and fluidextracts. As a matter of fact, no fluidextract of phytolacca is of any particular therapeutic value unless made of the recent root dug in the early fall. A trial of the matter will soon demonstrate this to the satisfaction of any observing man. This is a very useful drug fallen into disuse, like many other good things, on account of vitally defective pharmacy. In excessive doses phytolacca is cathartic and emetic, and, in very large doses, a narcotic poison, one-half ounce of the berries or root in a fresh state having produced fatal results. Phytolacca. 179 In large doses (ec. tr. or green root, f.e., 3 to 6 nx, or 10 TTt, if for only a few doses) phytolacca might be likened somewhat to the iodides in action. While not taking their place, certainly it works in harmony with them, and is most valuable in following the iodides. It is employed in syphilis, scrofulous affections, ulcerations, and chronic rheumatism. It does not have the power of the iodides over effusions and plastic exudates, but in lymphatic and glandular involvements and to eliminate freely circulating toxines it is of equal value. Its known value in rheu- matism may be somewhat due to its narcotic action, and in those cases apparently not due to uric acid rather large doses of phytolacca are demanded and seem to be well tolerated. In acute rheumatism it does not do so well. In ulcers and ulcerating skin diseases it is a most ex- cellent agent, but must be given in full doses. It seems to have a direct and positive effect upon ulcerations of all mucous surfaces and the outlets of the body. It is not at all probable that it directly opposes the toxic ele- ment of syphilis, but it does oppose the suppurative ten- dencies of the disease and thus limits the development of these toxic elements. Phytolacca is not the only vege- table drug of value in syphilis. It does not eliminate or even antidote these elements, but it appears to clean the field and thus inhibit development. Mercury and the iodides seem to act as antidotes (if indeed there be an antidote). Phytolacca is not very markedly an elimi- nating agent, and hence is wisely combined with other alteratives and eliminating agents, although, in large doses, it is somewhat diuretic. Syphilitic sciatica, gonor- rheal rheumatism, venereal buboes, quinsy, suppurative sore throat, follicular tonsilitis, orchitis, rheumatic peri- ostitis, and diphtheria are all more or less amenable to full doses, not, of course, to the neglect of other indi- 180 Phytolacca. cated measures. In diphtheria, for instance, it is a mere adjuvant to the direct remedies used. In moderate doses (ec. tr. or green, f.e., i to 3 TTt) it manifests its primary action, which is upon the glandular and lymphatic structures. It is the best agent in the materia medica for non-suppurative inflammation of the breasts in nursing women. Give small doses combined with aconite at frequent intervals, and apply the cerate or solution externally and support breast with adhesive strapping. Use equal parts ec. tr. and heated glycerine and apply upon absorbent lint, or else use the phytolacca cerate, made in 25% strength of the green root by homoe- opathic pharmacies. This cerate is of value in irritable breasts occurring before and during the menses. Minute doses of phytolacca are not effective. In domestic practice the poke berries are used in chronic rheumatism. The usual formula is 2 § of the fresh berries macerated in 1 pint of Holland gin. The dose is from 1 teaspoonful to a tablespoonful, not too frequently repeated. It is quite effective. The berries are also used to reduce fat. Procure the berries, after having been slightly frosted, and express the juice. Filter this and add about 20% of glycerine to preserve, or use less glycerine and a little salicylic acid. Commence with 5 7Tt doses and increase carefully. Pilocarpus, Jaborandi. This is a drug presenting a whole train of difficulties to the honest pharmaceutic chemist. There are twenty-one varieties of pilocarpus leaves in trade, and of these species only two conform to official requirements. The other leaves are used. Com- ment upon the cheap fluidextracts is unnecessary. An honestly made assayed fluidextract is prepared by several houses, and is thoroughly representative. The ec. tr. is Phytolacca. 181 made entirely from pilocarpus microphyllus, the eclectics claiming it to be much superior to the other official leaf, pilocarpus jaborandi. As a matter of fact, the chemistry of pilocarpus is so involved that it is a difficult matter to pass upon this question or to assign any therapeutic place to the several alkaloids derived from it, with the excep- tion of the official pilocarpine salts. The average dose of the U. S. P. assayed fluidextract is given as 30 TT[, which I consider too high. However, it must be said that a trace of jaborine exists in most fluidextracts, and official standards do not require its removal. This alkaloid is antagonistic to pilocarpine, and this renders the large dose necessary. Some chemists claim that pilocarpine is partially converted into jaborine by heating. If this is true, a fluidextract should be made absolutely without the aid of heat. Whatever views may be entertained as to the eclectic idea of rejecting pilocarpus jaborandi, the fact remains that their eclectic tincture or fluidextracts of pilocarpus microphyllus should be given in less dose than the other preparations. The maximum single dose of the ec. tr. is 1 3, and the eclectics consider this dan- gerous. The full dose is 20 to 30 Til. My own idea is that it contains very little jaborine, and hence the small dose. The U. S. P. requirement of 0.5% total alkaloids is very unsatisfactory as an assay standard in view of the involved alkaloidal chemistry. In large doses some practicians employ 1 3 of the ec- lectic tincture or 2 of the fluidextract at one single dose to establish crisis in severe febrile diseases where a fatal outcome is threatening. It is claimed that under such circumstances it equalizes the circulation and relieves in- ternal congestion. In some cases a hypodermic of y 2 gr. of pilocarpine hydrochlorate is preferable. The maximum single dose of this salt is 2-3 gr. This large dose should 1 82 Phytolacca. never be given in ordinary ailments nor in threatened heart failure, but in semi-moribund cases it does not re- act upon the skin to any great extent. In proportion to age, nearly as large doses are now given in diphtheria with impending suffocation from accumulation of dry membrane, but in very young infants it does not do very well. In general, it may be said that when we want the action of large doses of pilocarpine, it is best to employ the alkaloidal salts, since no jaborine is to be contended with. The average dose is 1-5 gr., but Y^ to 1-3 gr. may be given in robust patients with sthenic disease. The physician should take atropine and brandy along, and re- main with the patient for an hour after administering pilocarpine. These doses are indicated in some acute febrile and inflammatory conditions with rigor and a bounding pulse, and sometimes as a sedative to the heart in other conditions. It is much employed in dropsy when the heart is not weakened. It appears to be of distinct value in markedly sthenic puerperal eclampsia and uremic convulsions. If in parturition the skin is hot and dry, the os very rigid, the pains severe but ineffective, and the pulse bounding, a full dose of pilocarpus gives excellent results. Large doses are sometimes given in croup. Pilo- carpus antidotes atropine poisoning, and, to some extent, the venom of snakes, rabid animals, and the ptomaines of decomposed fish and meats, but it is not employed to the exclusion of other indicated remedies. In moderate doses (f.e., 15 Trt ; ec. tr., 6 to 8 TTt ; pilo- carpine, % gr.) it is of value in inflammatory rheuma- tism, in inflammation of the lungs and pleura with exu- dation, stridulous laryngitis (dose reduced to suit age), laryngeal diphtheria, bronchial asthma, acute orchitis and ovaritis, sthenic erysipelas, lumbago, pleurodynia, serous iritis and rheumatic iritis, simple glaucoma, retinal hem- Phytolacca. 183 orrhage, chorioretinitis, interstitial keratitis, and in effu- sion into the labyrinth of the middle ear. In small doses its action upon the skin is sufficient to aid in exanthematous fevers (ec. tr., y 2 to 2 TTt). Quite small doses are of value in sthenic fevers, especially where there is dry, bronchial irritation with imperfect secretion (ec. tr., 2 to 4 fl],). Where there is relaxation of the cutaneous vessels, due to tuberculosis and other de- bilitating diseases and causing excessive sweating, the little 1 -100 gr. granules of pilocarpine give relief. They are also useful in mumps, the salivation of pregnancy, scanty urination, edema from Bright's disease, laryngeal and pulmonic edema. These little granules can be fre- quently repeated. As an active galactagogue, small but larger doses than these are required. Used externally, pilocarpine is directed in 1 to 2% aqueous solution as a collyrium to contract the pupil. The alkaloid, instead of its salts, is used. Fluidextract of pilocarpus is a constituent of some hair tonics. Atro- pine in 1 -100 gr. dose antagonizes or antidotes 1-6 gr. pilocarpine. Homoeopathic physicians employ the third dilution of pilocarpus in exophthalmic goitre with as- serted benefit. Yum^m, U. S. P. Aloes (2 gr.), 1 to 3 pills. Aloes et ferri (1 1-13 gr. each, a laxative emmenagogue in doses of 1 to 4 pills. Aloes et mastiches (aloes, about 2 gr.), 1 to 3 pills. Aloes et myrrhce (aloes, 2 gr., myrrh, 1 gr.), a laxative carminative in doses of 1 to 3 pills. Asafoe- tidce (3 gr.), 1 to 3 pills. Cathartic® compositce (co. ext. colocynth, 1%. gr. ; calomel, 1 gr. ; res. jalap, 1-3 gr. ; gamboge, % gr.), 1 to 3 pills. Catharticce vegetabiles (co. ext. colocynth, 1 gr. ; ext. hyoscyamus, y 2 gr. ; ext. leptandra, *4 gr. ; res. jalap, 1-3 gr. ; res. podoph., ^ gr.), 1 to 3 pills. Ferri carbonatis, or "Blaud's Pills" (1 gr.), i&j. Pineapple. i to 3 pills. Perri iodidi (i gr.), i to 3 pills. Laxatives composite? (aloin, 1-5 gr. ; strych., 1-130 gr. ; ext. bellad. fol., }i gr. ; ipecac, 1-16 gr.), 1 to 3 pills. Opii (1 gr.), 1 to 2 pills. Phosphori (1-100 gr.) ; dose, 1 pill, rarely 2. Podophylli belladonna et capsici (podoph. res., T /\. gr. ; ext. bellad. fol., y gr. ; capsicum, y 2 gr.), 1 to 2 pills, rarely 2. Rhei composites (rhei, 2 gr. ; aloes, \y 2 gr. ; myrrh, 1 gr.), 1 to 3 pills. Pineapple. The fresh juice contains a digestive fer- ment known as Bromelin and acting similarly to caroid. The juice itself is of some value as a local application to the diphtheritic exudate as a solvent. PiPERAZiNE. An antilithic. Dose, 15 to 30 gr. per day, in water. The chemical is hard to keep, but the pharmacist can put it up in solution, freshly made, every two or three days. It is a most excellent agent, but rather expensive. PipERINA. A feebly basic substance derived from vari- ous species of pepper. It should be administered in pill form. In large doses (6 to 8 gr.) it is an antiperiodic. In small doses (y 2 to 1 gr.) it is a stomachic and car- minative. Pix Liquida, Tar. Antiseptic, anticatarrhal, antispas- modic. Glyceritum picis liquidco, N. P., is a valuable ex- pectorant in teaspoonful doses. It is a good vehicle for other agents acting in harmony with it. The syrup is similar, but the sugar therein is apt to disorder digestion. Vinum picis is another N. F. preparation, very much stronger in tar than the foregoing. It is a stimulating expectorant in teaspoonful doses. The oil of tar may be taken in 3 TIX doses upon block sugar. Ungiientam picis liquidee (50%) is used in scabby eruptions, psoriasis, tinea capitis, and other skin troubles. Plant ago Major. 185 Plantago Major, Plantain Weed, Ribwort. This is a common pest in old lawns and by roadsides, and is a peculiar weed esteemed in domestic practice. A pulp of the crushed leaves is applied to insect bites, poisoned wounds, and painful sores. My experience in country practice leads me to remark that it is really of very con- siderable value. The homoeopathic cerate of plantago is made of 25% fresh leaves, and is recommended by them in many forms of poisonous and malignant inflamma- tion, phlegmonous erysipelas, indolent ulcers, ulcerations of the rectum and os uteri, chilblains in the inflamed stage, and the small boils that develop in the nose. The ec. tr. plantago is esteemed as a remedy in earache and toothache. It is applied full strength upon pledgets of cotton. Internally (ec. tr., 1 to 10 TIL ), it has some repu- tation in neuralgias due to reflex irritation from the ears and teeth. Small doses are asserted to cure nocturnal enuresis due to relaxed sphincter vesicas. It is "the harm- less remedy for bed-wetting in children" advertised by some mail-order "specialists." Plasters, Bmplastrum Adhcesivum, is 2% rubber, 2% petrolatum, and 96% lead plaster. Aromaticum, N. F., is a good, ready-made spice plaster. Belladonnce is 30% ext. bellad. fol. and 70% adhesive plaster. Bryonia and Rhus Tox. is a homoeopathic formula used to relieve pain of rheumatism, lumbago, and sciatica. Capsici contains 4 gr. oleoresin capsicum in 36 square inch plaster. Hy- drargyri is 30% mercury with lanoline and lead plaster. Opii is 6% extract opium. Phimbi or Diachylon plaster is now made of lead acetate and soap. Saponis is 10% soap and 90% lead plaster. Platina. The 3X triturations are employed in sexual, nervous, and mental diseases, especially where there are paralytic tendencies with anesthesia, and in nympho- 1 86 Plumbum. mania and satyriasis. The precipitated metal, and not a salt, is used. Since the heavier metals generally possess therapeutic properties, it is reasonable to suppose platina should not be an exception. It is asserted that it is an- tagonistic to lead, and is of value in chronic lead poison- ing. Plumbum, Lead Acetate, used externally in conjuncti- vitis and gonorrhea (1-5 to 1% solution), and sometimes in the diarrhea of tuberculosis in 1 or 2 gr. doses. The ix to 3X are used in enteralgia and muscular and intes- tinal cramps. The Liq. plumbi subacetatis is used in moist eczema, pruritus, and other affections. lodidum, used externally, in 10 to 20% ointments, in indolent ul- cers, swollen glands, etc. Internally, as an alterative in doses of J/£ gr. in indurated glands, arterio-sclerosis, and spinal cord degenerations. Reduce dose to 1-10 gr. after first few days. Nitras, used in 5% ointment in cracked nipples, chapped lips, etc. Plumbum metallicum, in 3X to 6x, is used in sclerotic conditions, tremor paralyses, and muscular atrophies. Possibly it may do good, but I would advise caution. Podophyllum. In large doses (5 to 15 gr; resin, % to y 2 gr.). It has been unwisely recommended in doses as high as 1^2 gr. of the resin. The brown resin is to be preferred to the yellow, since it does not gripe so much. Large doses are hydrogogue cathartic. There is really no reason for employing podophyllum itself, since its resin (Resina podophylli) so well represents it. In malarial regions and with phlegmatic persons these large doses are indicated, but it is a mistake to give large doses to nerv- ous, high-strung individuals. It looks simple enough in the books, and quite innocent at that, but, as a matter of fact, these large doses are apt to make a city dweller so sick that he will hunt another doctor. However, large Podophyllum. 187 doses are often of marked value in the removal of small gall-stones. Give ]/ 2 gr. doses, and follow with as much olive oil as the patient will take. The griping and nausea of large doses are not so marked if it is combined with leptandrin and small quantities oi ipecac. When a de- cided laxative but not a cholagogue effect is desired, ^ gr. doses are indicated. In small doses. It has been noted that triturations of the resin act much more comfortably than does the crude resin. I can highly recommend the 2x trituration. Small doses of it suffice for young children, and one does not fear overdoing the dose, while a 1 gr. tablet of the 2x every half hour until ten are given is an admirable way to give it to adults. We do give calomel that way. These small 1-100 gr. doses of the triturated resin are indi- cated in inactive conditions of the digestive tract with a dirty yellow coating at the base of the tongue, sluggish circulation, and abdominal torpor. Conditions of consti- pation with so-called biliousness and jaundice, more espe- cially if chronic, are really more permanently relieved by small doses than by large ones. Besides that, these con- tinued doses are alterative. All in all, small doses of podophyllin cover a great many cases, and in the rational use of it here suggested is not apt to nauseate. Polygonum Punctatum, Smart-zvced. Only fresh plant preparations are of any value. In large doses (ec. tr., 30 to 60 TTt) used in amenorrhea in young girls and suppression due to cold. In small doses (5 to 10 ITt) use- ful in flatulent colic with griping pain. The drug is a carminative antispasmodic of secondary importance. Polymnia Uvedalia, Bearsfoot. Employed in condi- tions of vascular atony with functionally enlarged and painful glands, as in enlarged spleen, hypertrophy of the liver, and uterine subinvolution. (Ec. tr., 3 to 10 TTt.) 1 88 PoivYTRICHUM JUNIPERUM. Externally, it is employed in spinal irritation (ext. 25% in ointment), and as a hair tonic (ec. tr., 25% combined with other agents) . This drug is in use principally by the older eclectics, who consider it of positive value in glandu- lar troubles, although in general a weak agent. PolyTrichum JunipERUM, Hair-Cap Moss. This common moss is a hydrogogue diuretic. An infusion made from a handful of the green plant is one of the most positive diuretics of a non-irritating character. It has been known to increase the flow of urine in dropsy to the extent of voiding forty pounds in twenty-four hours. Its preparations are not very reliable. Probably the ec. tr., in 20 to 60 TIX doses, is about the most active of them, but the infusion is to be preferred. Populus Candicans, Balm of Gilead. A fluidextract of the leaf buds is used in making the "syrup of white pine." The agent is an excellent one, used alone, in doses of 30 TTt. Its range of utility is in acute colds with bron- chial irritation and hoarseness. Potassium, Acetate. Diuretic, refrigerant, alterative. Used in dropsy, gout, and rheumatism in 30 gr. doses. Bicarbonate, antacid, antilithic, and diuretic in 4 to 5 gr. doses. It is a valuable salt. Bichromate. See Dichro- mate. Bitartrate, "Cream of Tartar," aperient in 2 to 3 5 doses and diuretic in 30 gr. doses. Bromide. This im- portant drug will not be discussed in detail here. Person- ally, I do not believe it can be of any permanent use, and may be very harmful in diseases produced or accom- panied by organic lesions or nutritive changes. Its unwise use has done a vast deal of harm in epilepsy. We should not forget that brominism is manifested by a general failure of the mental powers, anesthesia of the mucous membranes, partial paralysis of a peculiar nature, acne, Potassium. 189 loss of sexual power, and weakened heart, In large doses (20 to 40 gr.) it is employed in great nervous excitement following nervous strain, sleeplessness, and delirium, nightmare (according to age), mania, some cases of epi- lepsy (with caution), chorea, and tetanus. In strychnia poisoning single doses of 60 gr. may be given. In moder- ate doses (10 to 20 gr., usually 15 gr.) in sleeplessness from exhaustion, migraine from irritable nerves, neu- ralgia from same cause, palpitation at climacteric, seminal emissions, nymphomania, and priapism. In small doses (1 to 3 gr.) in infantile wakefulness, colic, convulsions from tooth or bowel irritation, and in whooping cough. In adults, give small doses for acne occurring at puberty or menstrual periods. The homoeopathic use in minute doses is absolutely useless and a waste of time. Car- bonate, in 15 gr. doses, is antacid, antilithic, and chola- gogue, of value in acid dyspepsia, jaundice, etc. The ix trituration taken for long periods is asserted to be of value in hip-joint disease, anemia with constant back- ache in young girls, and ulcerative pulmonary phthisis. Chlorate, alterative, antiseptic, antisialagogue, employed now principally in mercurial salivation in doses of 3 or 4 gr. Internally, it is apt to cause inflammation of the kidneys, and its general use is almost abandoned. Ex- ternally, in 3 to 5% solution in ulcerated states, particu- larly in mouth and throat. Citrate, diaphoretic and re- frigerant in 15 gr. doses. Cyanide. This is an antispas- modic and sedative that markedly depresses the heart. The U. S. P. has unwisely incorporated it. We have al- ready in use altogether too many dangerous cough seda- tives. It is suggested in 1-6 gr. doses in certain mental diseases, angina pectoris, etc. We have borrowed it from the homoeopaths, who use 1-100 to 1-20 gr. doses in ag- gravated neuralgias in temporal, orbital, and supramaxil- 190 Potassium. lary regions, and the agonizing pain of cancer of the tongue. In my opinion, its only safe use is in removing silver nitrate stains (1% solution), although in desperate pain we may properly use it as a last resort. Its use in whooping cough is exceedingly dangerous in all cases. Bichromate (or bichromate). I do not know who has played a practical joke upon the regular writers in hav- ing them assign this agent to the list of internal remedies under the classical homoeopathic indications of long, long ago. However, he did a good thing, but a ix or a 2x triturate is strong enough, and 1-5 gr. doses are hardly required and are apt to lead to gastric irritation. Both our recently revised materia medicas and the old homoeo- pathic ones recommend it in aphonia, due to catarrh, with viscid mucus, chronic coryza, gastric ulcer, syphilis, and syphilitic ulcers and vegetations. In order to get a good working idea of the mental processes involved, read a homoeopathic materia medica in comparison with the "made in Germany" therapeutics of to-day. It is exceed- ingly easy to "discover" new therapeutics when it is already worked out and presented in symptomatic indi- cations rather than in a nosologic classification in litera- ture with which the regular profession are not familiar. It would not be at all hard to prognosticate a whole list of future "made in Germany" ideas from homoeopathic literature, and the coming "ethical proprietary" pharma- ceutics from eclectic formulae not yet scooped up. Ferro- cyanide, yy^ gr. doses, in phthisical night-sweats. Hy- droxide, escharotic in gangrene and warty excrescences. Used very unwisely internally in y^ to 1 gr. doses, well diluted. Hypo phosphite, a valuable nerve tonic recon- structive, in 5 to 20 gr. doses. Iodide, in large doses, a most valuable alterative if discreetly used. It should not be given when there is irritation of the gastroenteric or Potassium. 191 renal membranes. It is indicated in blood dyscrasias, chronic glandular inflammations, and in indurations. Naturally, this covers a whole class of diseases too well known to demand discussion here. In small doses (J4 to 1 gr.) useful in catarrhal pain in frontal sinus, catar- rhal neuralgia of face with acrid nasal discharges, lachry- mation with injected conjunctiva, raw feeling in larynx with greenish expectoration, descending colds, and in pneumonia when hepatization commences. (Iodide of ammonia when desired to combine with ammon. carb.) Very small doses (1-10 gr.) sometimes effective. Muri- ate ("Kali Muriaticum" of homoeopathy) is used in 3X trituration in catarrhal affections, subacute inflammations, fibrinous exudations, and glandular swellings. Nitrate, a diuretic refrigerant in 5 to 30 gr. doses. Doses of Y /z to 1 gr. are sometimes used in suppurative nephritis. Per- manganate, an emmenagogue in 1 gr. dose in pill. A valuable antidote for morphia. As a wash in throat troubles (diphtheria, etc.), 5%. In general surgery as an antiseptic wash (10 to 20 gr. to 1 pint water). When applied to mucous membranes, only enough to cause slight reaction. Better commence with only enough to give a carmine pink tint to the water, and run up as case de- mands. Potassium and Sodium tartrate, or "Rochelle Salt," saline, cathartic, refrigerant. Average dose, 2 3. Sulphate in doses of 2 to 4 5 is actively cathartic, while 30 gr. is diuretic and aperient. It is also classed as anti- galactic. Doses of 1 or 2 gr. are suggested in oxaluria. Prunus Virginiana, Wild Cherry. This name is de- ceptive. The true Prunus virginiana is the choke cherry, whereas the bark used in medicine is from the Prunus serotina. The U. S. P. syrup of wild cherry while in no sense an active expectorant, yet has been proven by ex- perience to be a very useful agent. Besides its soothing i9 2 Pt^ea Trifouata. properties, it is tonic, agrees well with the stomach, seems to be especially adapted to subacute and chronic coughs, and is an admirable vehicle. Dose, i f3. PtelDa Trifouata, Wafer-Ash. The bark of this shrub contains considerable berberin. The fluidextract in 15 to 20 TTt doses is of value in atonic states of the stom- ach. It is rather pungent and astringent, and serves ad- mirably in atonic diarrhea. Pulsatilla, Wind Flower. This very valuable drug has been badly used by the regulars. For many years it has been very highly esteemed by the sectarians, who es- tablished it in popular favor. It finally became official, but the tincture was made of the dried herb, although it was well known that its active principle, anemonin, is very volatile and is quickly dissipated by drying. Frankly, a tincture of hay or cornhusks would exercise about the same influence as did most of the tincture of pulsatilla. Naturally, it disappointed the profession, since it was usu- ally almost inert. Since it is no longer official, and indi- vidual initiative, rather than official standards, is fol- lowed, some houses are making fairly active preparations of the drug. On the other hand, physicians who were sent the mother tincture by wholesalers who were out of stock and sent to a homoeopathic pharmacy for a supply, gave the drug, very unwittingly, in vastly excessive doses, and got bad results. Botanically, it is closely allied to aconite, and in large doses is a dangerous and highly irri- tating drug, depressing the circulation and temperature. It paralyzes the nerves and induces coma. The best pulsatilla grows in Germany, and both the imported mother tincture and the German tincture are about identical and are thoroughly reliable. The ec. tr. is much more concentrated, and is very active. I em- ploy it when using pulsatilla in moderate doses, but pre- Pulsatilla. 193 fer the imported tincture or the first decimal dilution when using small doses. All tinctures of Pulsatilla deteriorate in time, and should be purchased in small quantities. Ane- monin is readily decomposed by alkalies and metallic salts, and hence Pulsatilla should not be combined with such agents. In moderate doses (ec. tr., 1 TTX ; ®, 5 or 6 nx) it is of value in diseases of the reproductive organs caused by deficient or defective innervation, and also, inversely, in hysterical, melancholic, and spasmodic manifestations in- duced by sexual derangements. Amenorrhea with men- tal perturbation, spermatorrhea, menstrual disorders with headache, chilliness, languor, nausea, water-brash, and nervousness, as well as some cases of hysterical convul- sions and the urinary irregularities of pregnancy, all re- spond nicely to this drug if properly pushed, but it is not a remedy for pain except incidentally as it relieves spasm. Homceopathists assert that Pulsatilla exercises a greater influence over women than over men, and more partic- ularly women of lax fibre, of mild and yielding dispo- sition. Probably that is true. We know the susceptibility of blonde women to belladonna. At all events, it is prob- able smaller doses will suffice than with women of the opposite type. In small doses (©, J / 2 to 1 TTt, or even the first dilu- tion) it exercises an influence upon the circulation par- taking somewhat of the natures of both aconite and cac- tus, reducing inflammation in mucous membranes and equalizing the circulation. It differs from aconite in that it is more antispasmodic in small doses, and it influences the catarrhal stage of congestions and inflammations rather than the initial stage. For this reason, it fre- quently should follow aconite and sometimes alternate with it. Pulsatilla, like a great many other remedies, 194 Pulsatilla. should seldom be used in combination. We get most of our best results from the single drug. This is the single drug directed to catarrhal congestions, and it is a wide field. The thick, bland, and yellow or yellowish-green discharge is most affected. Potassium dichromate affects the thick, tenacious, and ropy discharge ; arsenic and iodide of arsenic the irritating discharge. One may alter- nate with any of these when demanded, or give different ones during different stages of congestion, or full doses of ammonium chloride to liquefy or establish discharge, but Pulsatilla, more than any of the others, can be de- pended upon in catarrhal disturbances of an acute char- acter. The following will simply suggest its range in this direction : Temporal neuralgia with lachrymation of affected side, otorrhea, catarrhal otitis, styes, agglutin- ated eyelids, ophthalmia neonatorium, subacute conjunc- tivitis, effects of "colds" upon eyes and ears, coryza with yellow discharge, toothache relieved by cold and due to acute congestion, catarrhal states of gastro-intestinal tract, creamy leucorrhea, catarrhal stage of gonorrhea, orchitis, acute prostatitis, greenish expectoration with cough, ca- tarrhal symptoms of measles, and in fevers when patient seeks the open air. One teaspoonful of the tincture to a quart of water is an excellent application in many of these conditions, especially to the eyelids. Understand, Pulsa- tilla is not here indicated as an exclusive remedy in these cases. It does overcome these symptoms of catarrh, but general systemic and local treatment should not be neg- lected. The sectarians have worked out a great many useful things, such as the indications for pulsatilla, but we have more resources for the deep underlying pathology than these small doses of drugs with an evanescent effect. On the other hand, in 60% of our cases there is no espe- PULVERES. 195 rial pathology, and by relieving the symptoms nature com- pletes the cure. We may just as well not impede nature in these cases with massive doses of drugs. Our pa- tients will appreciate the small dose. PuivVERES, U. S. P. Acetanilid Compo situs (acetanilid, 70% ; caffeine, 10% ; sod. bicarb., 20%). Average dose, 73/2 gr. This is an official substitute for several proprie- tary mixtures. Its range of safe utility is much more restricted than the literature upon the proprietaries assert, and it should be used with care. Aromaticns, a carmina- tive in 10 to 20 gr. doses. Cretce comp., an antacid used in 30 gr. doses in diarrhea. Bifervescens comp., the U. S. P. name for "Seidlitz Powder." Glycyrrhizce comp., a. laxative containing senna, licorice, sulphur, fennel, and sugar. Dose, 60 gr. Ipecacuanha et opii (ipecac, 10% ; opium, 10%) ; "Dover's Powder." Anodyne, antispas- modic, and diaphoretic. Average dose, 7^ gr. The pres- ent U. S. P. formula omits potassium sulphate. Some authorities think the omission a mistake. The old 1870 formula is made by Squibb and several other houses, and is readily obtainable. Jalapce comp. (jalap, 35% ; potas- sium bitartrate, 65%), a hydrogogue cathartic used in obstinate constipation and "bilious dropsy." Average dose, 30 gr. Morphines comp. ("Tully's Powder"). This is a mixture of camphor, 32%; morphine, 1^2% with excipients. It is anodyne, nerve sedative, and antispas- modic. Average dose, 7^ gr. Rhei comp. (rhubarb 2 5%)> an antacid, laxative, and carminative in 30 gr. doses. Its employment is principally in the diseases of children. Several effervescent powders are official, such as lithium citrate and magnesium sulphate. Quassia, Bitter Wood. In large doses (f.e., 30 nt) it acts as an emetic with some persons and is an anthel- 196 Quebracho. mintic, but is seldom given in such doses. In small doses (f.e., 3 to 5 nx) it markedly stimulates all the glands con- cerned in digestion and increases intestinal peristalsis. It is highly useful in debilitated states of the digestive tract with inactivity of the secreting organs. Infusions of quassia, used as enemata, destroy worms in the lower intestinal tract, and, used upon the skin re- peatedly, will kill pediculus capitis and pediculus pubis. Quebracho, Aspidosperma. Mariasi y Larrion, who has investigated quebracho, says of it: "The principal action of this drug is to cause a diminution of the num- ber of pulse-beats per minute and lessen the frequency of the respiratory act." The homoeopaths use it as we do, but prefer the 2x and 3x trituration of the alkaloid, aspidospermine. Full doses of it are given by some (% to y2 gt*.). The fluidextract is representative, and is used in doses of 10 to 60 Vi{. In large doses it possesses some value in malarial fever, and is so used in South America. The fluidextract, in 15 trt doses, is of value in dyspnea due to asthma or heart disease, asthma with emphysema, uremic asthma, and dyspnea due to fatty degeneration of the heart. Hale calls it "the digitalis of the lungs." It is a safe remedy, and prompt in action. QuERCUS, White Oak. The fluidextract of the bark is an astringent, antiperiodic, and tonic in 15 to 30 TTt doses. It is of value in certain bowel troubles as an astringent, in obstinate intermittents, exhausting sweats, diabetes, and passive hemorrhages. The decoction is employed upon ill-conditioned ulcers, in sore throat as a gargle, and as a wash upon the skin in debilitating disease with re- laxation and exhaustion. Spiritus glandium quercus, or distilled spirit of acorns, is given to allay the craving for alcoholic drinks. (Ten drops in water, two or three times a day.) QuiUvAJA. 197 Qujxlaja, Soap Bark, is used pharmaceutically, and the tincture, in 15 Til doses, is classed as expectorant. It is expectorant, but is altogether a minor remedy. Two or 3 TTt doses are large enough, and exercise some in- fluence in the early stages of coryza and catarrhal sore throat. Quinina, Quinine. The alkaloid, the bisulphate, the hydrobromide, the hydrochlorate, the salicylate, and the sulphate are official in average doses of 4 gr. For local use the alkaloid is to be preferred. Subcutaneously, the bisulphate is most reliable as a rule, and its ready solu- bility makes its internal use ofttimes preferable to the sulphate. Its 0.2% solution is used as a douche in coryza. The salicylate is markedly antiseptic. The official oleate (25%) is well adapted for inunctions. In large doses (6 to 20 gr.) quinine is so important a drug that space precludes any adequate presentation in a small volume like this. It is antipyretic, antiperiodic, antiseptic, and emmenagogue; employed to reduce fever in typhoid, pneumonia, and other states; to destroy the malarial parasite in the many forms of malarial fever ; as an antiseptic in the intestinal canal ; and in amenorrhea and to hasten labor as an emmenagogue. Since the plasmodium malariae is destroyed in solutions of 1 part of quinine to 20,000 of water, the excessive doses formerly used do not seem necessary. Moderate doses, given during the intermission, are effective, and do not so disturb the nervous system. In continued types of fever it is best to give quinine when the temperature is at its lowest point or the secretions the most active. Qui- nine always acts best when the skin and tongue is moist and the pulse soft and open. Phenacetin is a valuable agent to promote these conditions and prepare the system for quinine. Where there is no remission in fevers, qui- I98 QUININA. nine should be employed cautiously, if at all, but once the fever subsides quinine is highly necessary. In intermit- tents, I like broken doses of the sulphate in the intermis- sion. In congestive chill, we want full doses with stimu- lants and local heat. As an antipyretic, quinine is less used than formerly, but cannot be entirely shoved aside. Probably we have given too large doses. In amenorrhea, it is best to give a warm bath and follow with good doses. In labor, 10 or 15 gr. of the bisulphate at one single dose is indicated in uterine inertia, and the lack of nervous force upon the part of the patient. In small doses (2 gr.) it is a valuable bitter tonic, the bisulphate being preferable to the sulphate. It may be used in many conditions, but is commonly employed in convalescence from pneumonia and other debilitating dis- ease, especially where there has been sepsis, prostrating discharges, or nervous debility. In states of debility in chronic disease with night sweats or congestive visceral states marked by atonicity, it is quite useful alone or combined with other indicated drugs. Quite adequate doses of quinine can be administered to infants by in- unction. In minute doses (1-10 gr. or ix trituration) quinine has a certain range of utility in cases marked by periodicity and spinal sensitiveness. Headache of malarial origin, neuralgia relieved by pressure, the aching sensitiveness along spine and back of the neck, and subacute facial neu- ralgias are ofttimes much relieved by these small doses if frequently repeated. The homoeopathic Chininum ar- senicosum, or arsenite of quinine, in the 2x, is an excel- lent tonic, markedly benefiting persons inclined to neu- ralgia and where there is a sense of weariness and pros- tration. In uncomplicated diarrhea it is effective. The ix is full dosing, but can be carefully employed in obsti- nate intermittents. Ranunculus Bulbosus. 199 Ranunculus Bulbosus, Buttercup. In large doses (©, 10 to 30 drops, repeated as necessary) this rather toxic drug is used in delirium tremens. In small doses (©, 1 or 2 TTL, or even the first decimal dilution) this drug in- fluences spasmodic troubles of the chest wall, such as pleurodynia, soreness in the intercostal spaces, muscular soreness about shoulder blades, and stabbing pain in the chest, such as results from pleurisy. It is not wise to depend upon this drug to cure the pleurisy itself. Her- petic eruptions, shingles, and vesicles upon the cornea are said to be relieved by this agent. Large doses should never be used, since the plant is an acrid narcotic. It is of secondary importance as a remedy, and is not very uniform in action. Rlsorcinol, Resorcin. This chemical was originally derived from natural resins and used internally as an anti- septic in doses of 2 to 5 gr., and as an antipyretic in 15 to 20 gr. doses, and was a valuable drug. The present U. S. P. drug is made synthetically, and the average dose is given as 2 gr. Large doses are dangerously depress- ing. Since the drug is so changed, it is very much open to question whether it presents any advantages over phe- nol. Externally, it is more convenient, probably, and is used in 5 to 30% solution or ointment in various skin diseases and gonorrhea. It has a large list of incom- patibles. Rhdum. In large doses rhubarb is cathartic, combin- ing an astringency that renders its action easy, yet satis- factory. Used to free the bowels of offending matter in diarrhea and in atonic states of the bowel. It combines well with aloes. Powdered root, 20 to 40 gr., purgative ; 10 to 20 gr., laxative. The extract is given up to 15 gr., and the fluidextract as high as 1 f3, but usually not over 30 171. 200 Rhododendron. In small doses the tonic properties of rhubarb are se- cured. It is not used uncombined to any extent, but enters into various formulae. For infants with acid diarrhea and the gastro-intestinal irritation incident to dentition, quite small doses of the Syr. rhei aromat. are indicated. The old eclectic formula, now incorporated into the National Formulary as Syr. rhei et potassii comp. and known as "neutralizing cordial," is the very best antacid stomachic ever devised for children. The dose is from ^ to 4 f3, according to age and conditions. Children seldom de- mand over 1 teaspoonful. Rhododendron, Snow Rose. The "first potency" of this agent is used in rheumatic and gouty disorders, cili- ary neuralgia, and hydrocele. It is very doubtful whether such small doses would be of any service. In Russia it is customary to make a decoction of 2 5 of the leaves and take at one dose, repeated daily until relieved. These doses are said to be quite effective. Rhus Aromatica, Fragrant Sumach. This plant has attained a place in the treatment of polyuria, nocturnal enuresis, diabetes insipidus, urinary incontinence, hema- turia, and cystitis. F.e. or ec. tr., 10 to 30 171 ) ®, 3° to 60 TTl. Rhus Glabra, Smooth Sumach. The dried fruit is official. The fluidextract, in 10 to 30 1TL doses, is astrin- gent, and used in diarrhea and ulcerated states of the stomach and bowels. Locally, it is applied to soft, spongy gums, apthse, and pharyngitis. Rhus Toxicodendron, Poison Ivy. In large doses (f.e. of leaves, 6 to 30 Tit) it is a stimulant narcotic, some- what irritant to the stomach and bowels and irritant to the nervous system like large doses of nux vomica. These Rhus Toxicodendron. 201 doses have been suggested in a number of conditions, but they are apt to be very erratic in action and are much more liable to do harm than good, and, despite certain authors to the contrary, it is very unwise under any circumstances to give them. The probable reason these men have not met with disaster is that the preparations they used were nearly inert. In small doses the fluidextracts and tinctures as usually made are of practically no value at all. The therapeutic agents in this leaf are the acids and oils dissipated by drying, and only preparations from the freshly gathered leaves should ever be used in medicine, and even these preparations should be destroyed when a year old and fresh stock secured. A good plan is to order direct from the factory 1 § of ec. tr. and dilute this with 9 § of j6% alcohol, thus making a reliable tincture, as the ec. tr. is rather dangerous to one's own hands. This tincture can be used in doses ranging from % to 10 Til, or the © can be used in the same doses. Usually 1 drop doses or even less give better results than do the larger doses. The drug can be said to be fairly effective up to the third decimal dilution, but in acute conditions it impresses me that larger doses than the 3X should be used. Higher than that I have never used it, since I do not believe in the so-called dynamization theory. Prof. G. Hardy Clark, of Hahnemann Medical College, Chicago, says : "One or 2 drops of the tincture have been used with satisfac- tion, but doses ranging from the first to the fourth deci- mal dilution are more generally employed." Extreme homoeopaths do not agree with him, and seldom use it be- low the I2x. Frankly, it is a peculiar drug. I have se- cured unexpectedly good results with it in some cases, and no results whatever in other similar cases. When it 202 Rhus Toxicodendron. does benefit at all it does so in no uncertain way. It is undoubtedly a very powerful and useful remedy, but there is something about it not understood as yet. The indica- tions subjoined are by Ellingwood, an eclectic, and Boe- ricke, a homoeopath. Eclectic indications: "In inflammatory fevers with sharp, hard pulse ; acute inflammation involving the skin, with bright, circumscribed redness ; extreme soreness or sharp, burning pain ; extreme redness of local parts in- flamed, with great local heat and sharp pain ; sharp supra- orbital pain, especially of the left orbit; burning in the eyes with flushed face ; inflammation with constitutional impairment, evidenced by a sharp, red tongue and deep red mucous membranes. The tongue has a pointed tip upon which the papillse are elongated and pointed." Their "specific medication" theory aside, they practically use it in acute erysipelas ; typhoid fever with sordes, red tongue, flushed face, and evidences of sepsis ; cerebral irritation in the course of fevers ; in the latter stages of severe types of the exanthemata^ ; in acute inflammatory rheu- matism and some forms of chronic rheumatism; in gas- trointestinal disorders of children with cerebral irrita- tion ; in septic cholera morbus ; and in suppurative dis- eases of the skin with redness. They esteem it very highly. Homoeopathic indications: "Mind — extreme restless- ness and delirium. Head — vertigo when rising, heavy feeling, occipital pain. Eyes — swollen, red, edematous. Lids inflamed, scalding tears. Face — swollen, irritation in articulations of jaws. Mouth — tongue red and cracked, corners of mouth ulcerated. Throat — swollen glands. Stomach — want of appetite, great thirst. Abdomen — pain, relieved by lying upon abdomen. Urine — dark, turbid, scanty. Respiratory — dry, teasing cough. Heart Ricinus. 203 — pulse is quick, weak, irregular, and intermittent. Ex- tremities — hot, painful swelling of joints. Fever — adynam- ic, restless, trembling. Skin — red, swollen, vesicles, in- tense itching. Sleep — heavy, stupor. Modalities — worse, cold and wet weather, at night, during rest. Better, warm dry weather, motion." This is a mere abridgment of four pages of symptoms, but it illustrates the complicated in- dications of homoeopathy. Practically, they arrive at just about the same place as the eclectics, with the addition of sprains, granulated eyelids, smallpox, hypertrophy of the heart, and some menstrual difficulties. If our pharmacologists investigated the matter in de- tail, they would probably arrive at indications amounting to about this : An inhibitory agent in cerebral engorge- ment, influencing the vasomotor mechanism ; a sensorial sedative inimical to toxic irritation, increasing nerve tonus and promoting the functional activity of the terminal nerve filaments ; a vital alterative, influencing defective metabolism. Ricinus, Castor Oil. A valuable cathartic in ]/ 2 to 1 f,5 dose. Its disagreeable taste can be overcome by adding to it a small quantity of an alcoholic solution of saccharin and some essential oil. Cinnamon serves admirably. The mixture may require a "shake" label, depending upon the kind of alcohol used, since the oil does not combine well with alcohol below 98% absolute. Rubus, Blackberry. The fluidextract of the bark of the root is an agreeable tonic astringent, in 10 to 30 TTt doses, in syrup or elixir. Its field is in the diarrheas of infancy marked by large, watery discharges of a clay color. An infusion of the fresh root is quite effective. Rum£x Crispus, Yellozv Dock. In large doses (f.e., 30 Tl\) a valuable alterative, tonic, and laxative of direct 204 Sabadiixa. utility in cutaneous disorders affecting persons of the strumous diathesis. In small doses (©, I or 2 TTt) it is esteemed in tickling cough, aggravated by talking and night air, and with rawness of larynx and trachea. It is said to cure exhausting morning diarrhea marked by brown, watery discharges. SabadiIvIvA, Cevadilla Seeds. The ® is employed in small doses in cases of intestinal worms and in hay fever, lachrymation, spasmodic sneezing, etc. Quite material doses are given for worms. This is the Indian caustic barley, a species of asagrsea containing veratrine (q. v.). It is a highly toxic agent with no reliable antidote and is very erratic in action. It is not a safe agent at all for intestinal worms. The fluid- extract was at one time used in 2 to 4 fix doses, but has gone out of favor. It is an exceedingly disagreeable drug that I do not care to use at all. Possibly, the small doses are of value, but homoeopathy offers so much better drugs I do not see why they use this one. Sabal, Saw Palmetto. This is a sedative to genito- urinary irritation, and is a nutritive tonic with mild, aphro- disiac properties. It influences all mucous membranes more or less, but more particularly the membrano-prostatic portion of the urethra. It is prescribed in enlarged pros- tate, epididymitis, impotence, sexual neurasthenia, enu- resis, chronic gonorrhea, tender ovaries and breasts, and chronic bronchitis. (F.e., 10 to 30 TTt-) This is a valuable remedy, now official, but the wonder- ful claims made for it in permanently curing the enlarged prostate of old men and increasing the female breast are not borne out. If used for a long time it is of some value in these directions. Small doses are not effective. Sabina, Savin. This gum resin is very disagreeable Saccharin. 205 in substance, and is rarely used. It is rubefacient, em- menagogue, and vermicide. The f.e. is used in 5 to 15 TTL doses in amenorrhea. The oil may be used in 1 to 4 1T|, doses for worms. In small doses (©, 1 Tl\ every hour) it is used in gout and uterine pains with a tendency to miscarriage. Smaller doses, if miscarriage appears imminent. The tincture is also applied to warts. These homoeopathic claims have not received any very general support, and the small dose should not be depended upon. Saccharin, Benzosulphinidum. A non-fermentable sweetener, 550 times as sweet as cane sugar. Used phar- maceutically. Saffron, Crocus Sativus. "Saffron tea" is a domestic remedy of little real value, but used to promote efflores- cence in the exanthemata?. The American saffron, or Carthamus tinctorius, is really much more active. It is laxative in large doses. The homoeopaths formerly used crocus in chorea and hysterical affections and dysmenor- rhea with black, tenacious discharges. Some of them still use 5 TTt doses ® in this connection. Saucinum, Salicin. Antirheumatic, antiperiodic, and bitter tonic. Large doses (20 to 30 gr.) are of value in acute rheumatism. It is safe in large doses, and while not so potent as the salicylates, can be used when they are contraindicated. As an antiperiodic, it is used in chronic forms of malaria, in 10 to 15 gr. doses. In small doses (2 to 5 gr.) it is a gastric tonic of value in chronic atonic dyspepsia with a tendency to diarrhea. Saux Nigra Aments. Pussy-Willow Buds. This drug is urged as of marked value in controlling sexual hyperesthesia. It is used in satyriasis, erotomania, nymphomania, and spermatorrhea. It is suggested in dif- 206 Salol. ficult menstruation, hysteria, and ovarian congestion. (Ec. tr., 10 to 30 Til ; ©, 30 to 60 TTL.) This remedy has not been very extensively used as yet, and it is altogether probable that its advocates claim too much for it. Small doses are not effective. In my hands large doses have given fair satisfaction. Use only green bud preparations. Salol, Phenylis Salicylas, U. S. P. This synthetic chemical is broken up into phenol and salicylic acid by the action of the pancreatic juice ; hence its action is that of these two agents. Its advantage consists in the fact that these valuable antiseptics thus pass the stomach intact and really reach the intestinal tract. About 40% of phenol is liberated, and large doses should be given very guardedly and not at all if the kidneys are inactive. The larger doses used are indicated as an intestinal antiseptic and in rheumatism, and the smaller doses in cystitis, urethritis, etc. The U. S. P. states the average dose as 7^2 gr., which I consider too high, as it is equivalent to 4 gr. of phenol, the average dose of which is 1 gr. Personally, 2 to 5 gr. seem a proper dose, especially since they are quite effective. As an antipyretic and analgesic too large doses are required to be within the bounds of assured safety. As high as 90 gr. in twenty-four hours have been recommended, but some gentlemen become overenthusi- astic with internal antiseptics. These same men would not think of giving 36 gr. of phenol in enteric pills in twenty-four hours, yet that is what, in effect, they are doing. "Sai/ts/' Sal Acetosella, is potassium binoxalate ; Sal ammoniac, ammonium chloride ; Tartar, potassium car- bonate ; Bpsom, magnesium sulphate ; Glauber's, sodium sulphate ; Monsel's, iron subsulphate ; Rochelle, potassium and sodium tartrate ; Seignette, the same ; Sorrel, same as acetosella ; Volatile, ammonium carbonate. Salvia. 207 Salvia, Sage. The dried leaves are official, but not any preparations. The infusion and the ® (in 20 to 30 drop doses) are reliable. Sage is used as a condiment, carminative, and antihydrotic. As a gargle it is a useful astringent and antiseptic. A fluidextract is made and used in 10 to 60 Til doses, but the ® as made from the fresh leaves tastes better and mixes with hot water nicely. A cold tea, made in this way, is effective in night sweats. Sali/ia sclerata possesses nerve tonic influences, and 1 or 2 teaspoonfuls of its tincture to a pint of hot water is useful for sponging the skin of debilitated persons. Sambucus Canadensis, American Elder. The recent flowers in warm infusion are diaphoretic and stimulant ; the cold infusion, diuretic. The ec. tr. is made from the green inner bark. The eclectics esteem it in edametous skin diseases and in depraved deposits and watery infil- tration. Ten drop doses are employed as an alterative. Very large doses are hydragogue cathartic and emetic. The ec. tr., in 15 to 30 nt doses, is safe and effective in dropsy, most markedly so in post-scarlatinal dropsy. The f.e. (flowers) is given in doses of ^ to 2 f3. Sambucus Nigra, European Elder, is used as an altera- tive and laxative in doses of ^ to 1 teaspoonful of the fluidextract of the bark, and, in 10 drop doses, as an ad- junct to bitter tonics. Small doses of the ® are employed in dry coryza and the dry and obstructed nasal catarrh of infants. Sanguinaria, Blood-root. In large doses (f.e., 15 Vtl ; ec. tr., 10 Tf\) a harsh emetic very seldom used. In moderate doses (f.e., \y 2 HI ; ec. tr., 1 nO a stimulating expectorant. It does not act well in these doses with chil- dren. With adults it is of value in atonic conditions of the lungs or bronchi, but should not be loosely prescribed in all manner of acute and chronic coughs. 208 Santoninum. In small doses (f.e., Y^ TTL ; ec. tr., 1-6 1T\, ; ©, i Ti\) it is indicated when there is irritable cough with the air passages dry, hot, and swollen. Especially useful when there is a sense of constriction in the throat, with a raw, sore feeling. In chronic cough, with a dry throat and circumscribed redness of the cheeks, and also in nasal polypi with mucous discharges, it is a valuable drug. These small doses promote the activity of the stomach and liver, are alterative, and influence the respiratory system in an eminently satisfactory manner. We have long been giving sanguinaria in doses entirely too large, and have failed to appreciate its great value. The nitrate of san- guinarine, in i gr. tablet triturates of the 3x, is an ad- mirable way to give small doses. Santoninum, Santonin. A very reliable vermicide in I gr. doses combined with calomel or a laxative. Young children should not be given over y 2 gr. Do not give during fever or constipation. One to 3 gr. of the ix trituration is used by homoeopathic practicians. Santo- nine is an uncertain emmenagogue, and has been recently suggested as a nerve stimulant in tobacco amaurosis, loco- motor ataxia, epilepsy, etc. There is no very tangible reason why it should be a nerve stimulant except that some old sectarian writers said so many years ago. Sarracenia Purpurea, Pitcher-Plant. Every few years someone exploits this plant as a sure cure for small- pox. As a matter of fact, 1 teaspoonful doses of the tinc- ture are laxative and eliminative, somewhat increasing the flow of urine. An infusion of the fresh root is bitter, containing a substance decomposed by drying, and quite reliable observers assert that such an infusion can be freely given during the course of zymotic diseases, mod- ifying their course somewhat and preventing sequelae. It Sarsaparilla. 209 was so used by the Indians of Canada, and was intro- duced into homoeopathic medicine. They use it empiri- cally, more or less, but it is not "homoeopathic" to small- pox. It has no established place in therapeutics. For its interesting history, see "Scudder's Specific Medication." Sarsaparilla. The sources of supply of sarsaparilla root are so uncertain and its preparations so variable that, as an alterative, the drug is not usually very dependable. The fluidextract is useful as a flavor, and sometimes use- ful as a medicine. The best plan is to select a crude drug that when chewed for a while develops the peculiar acrid taste of a good grade of sarsaparilla. Make a decoction of this and administer in ounce or 2 tablespoonful doses, running up to 4 tablespoonfuls. It has long enjoyed a reputation in secondary syphilis. In small doses it is of no value. Sassafras is aromatic, astringent, and alterative, and is esteemed as a preventive of contagion by some of our foreign population, who eat onions and drink sassafras tea as soon as contagious diseases appear. Some physi- cians practicing among them think these agents exercise some influence in the matter. Possibly! The oil of sas- safras in large doses is a narcotic poison. Most narcotics, in minute doses, exercise more or less of a stimulating in- fluence, and probably sassafras may possess more reme- dial influence than we have thought. The popular idea that it "thins the blood" simply reflects a belief in its alter- ative properties. Scammonium. A hydrogogue cathartic used in doses of 2 to 8 gr., but seldom employed now except in combina- tion with other agents. Scilla, Squill. In large doses (f.e., 10 111 ) it is an emetic, but it is unwise to use it in this connection except 210 SCOPARIUS. in the form of the compound syrup, or so-called "hive syrup/' in case of croup, to the point of nausea, or slight emesis in severe cases. This useful syrup is given to children in doses of 10 to 30 TTL, and to adults, 20 to 60 Til, as an expectorant. In general, squill is not given to children to any great extent. In moderate doses (f.e., 1 to 2 TT|, ; syr., 15 to 30 trt ; vinegar, 10 TTl) it is an expectorant used in dry, irritating bronchial coughs and as a diuretic in cardiac dropsy. Smaller doses are employed in the chronic bronchitis of old people with mucous rales, dyspnea, and scanty urine. Scoparius, Broom. In large doses (f.e., 2 f3) ca- thartic. In moderate doses (f.e., 30 TTL) a valuable diu- retic in cardiac dropsy, the anasarca of chronic disease of the kidneys, and scarlatinal albuminuria. See also Spar- teine sulphas. Scutellaria, Skullcap. A mild nervine antispasmodic, in 30 to 60 HI doses of the fluidextract. Little can be expected of it except in functional disorders. It is a seda- tive useful in functional "nervousness" and mild hysteria. Senecio Aureus, Life Root. Another "uterine tonic" indicated in a general hyperemic, irritable, and atonic con- dition of the pelvic organs. (F.e. or ec. tr., 10 to 40 TTt.) Senega. In moderate doses (syr., 1 f3; f.e., 15 TTt) it is used in deep, hoarse cough, with mucous rales and free secretion. Scaly skin diseases are benefited by its continued administration, due to its diuretic and alterative properties. In small doses of the ® the homoeopaths claim results in catarrhal diseases of the eyes generally, but more par- ticularly in blepharitis, muscular asthenopia, and opacities of the vitreous humor. Senna. An efficient and safe cathartic. An infusion Sepia. 211 of 30 to 60 gr. of the leaves is taken at one dose. A con- venient way to prepare it is to pour a pint of boiling water upon an ounce each of senna leaves and peppermint herb, let stand until cold, filter, and administer in doses of 1 wineglassful every morning. The so-called "antibilious physic" is made of powdered ginger, 1 g; jalap, 8 g; and senna, 16 g. Dose, 1 teaspoonful. The aqueous fluid- extract is given in twice the dose of the U. S. P. fluid- extract, but is less griping. (F.e., ^ to 2 f3.) Small doses (1 or 2 gr. pills, extract) are a gastro-intestinal tonic, and are recommended in oxaluria and conditions of nitrogenous tissue waste. Sepia, Dried inky juice of cuttlefish. The ancients used a decoction of the cuttlefish for affections of the generative organs, urine, and skin. Hippocrates referred to it in his writings, and as long ago as Paracelsus it was known to influence what we know as the portal circu- lation ; then Hahnemann dug it up from the old literature (as he did a great many other things) and limited its use to the inky juice in small doses. Sepia is used by artists as a water color. The alcoholic mother tincture is a disagreeable, rather oily substance with a taste of propylamine. I cannot find any authority for the state- ment, but I believe it does really contain that substance. Propylamine and trimethylamine are supposedly isomeric. These substances are rather widely distributed. Cod-liver oil, shark-liver oil, herring brine, ergot, and several me- dicinal plants contain it. While possessed of the same number of atoms, these various amines have differing graphic formulae and quite different properties. Tri- methylamine has a more or less established place in thera- peutics, being used in rheumatism and chorea. Some authorities consider the trimethylamine content of ergot quite an important factor in its therapy. It is known, in 212 Sepia. some of its combinations, to markedly influence the circu- lation. It is, therefore, altogether likely that if sepia con- tains it, as most visceral fish products do, it would have an influence upon the circulation, and probably also upon the womb. More definite statements would be rash, in view of the present lack of data. The homoeopaths must get some action from it, since they esteem it most highly. Their detailed provings or symptoms of this drug are elaborate, but amount to about this: Indicated in hepatic and venous congestion in lower abdominal and pelvic regions, with yellow spots upon face; flushes of heat, nausea, flatulence, yellow or greenish leucorrhea, and a marked bearing-down sensa- tion. Personal experience is sadly wanting, but I am inclined to think there is something worth while in this remedy. I bought a quantity of the 2x tablet triturates, and used only in cases of leucorrhea of the character in- dicated. Upon the whole, the results were good. Some of the eclectics use it, contending that it does not act ac- cording to the "similia" idea, but is of value, as indicated above, in uterine and liver troubles. Very probably, the homoeopaths overrate the value of sepia. Serpent aria, Virginia Snakeroot, is a vascular stimu- lant, promoting secretion from the skin and mucous sur- faces. It is used in the suppression of secretions from colds and in the course of fevers. In my own experience, a full teaspoonful of the fluidextract every three hours until three or four doses are taken is effective ; but in the many chronic diseases in which it is recommended, it does not impress me at all favorably. Siucea, Precipitated Silica. This is a supposedly me- dicinal substance peculiar to the biochemists. They be- lieve it to be indicated in a great many conditions. There is a small amount of silica in the skin and the nails and SlUCEA. 213 traces of it in some other tissues ; and indurated and sup- purative states are frequently characterized by a lack of this substance. It is, therefore, probably of some use in these conditions, and may be of service in rachitic chil- dren, suppurative processes upon the skin, quinsy, styes, affections of the finger nails, and indurated tumors. I have had no experience with it at all, except that in cast- ing about for a remedy for mild indurations and cracked finger nails, due to x-ray burns, I hit upon silicea. For several years in my hospital service I have been very much overexposed to the x-ray, and find the ix of silicea to be of considerable aid in some of the lesions. While some of the contentions made in its favor by its advocates ap- pear very ridiculous, yet it must be classed as a tissue food neglected in regular medicine, but probably just as much indicated as manganese and other substances found in traces in living tissues. If one does not care to use this sectarian preparation, Squibb can supply the wet process silicic acid, which is really silicic oxide or pre- cipitated silica. The natural silicic acid is infusorial earth, and is used for filtering acids. This would not do. The wet process silica should, of course, be well triturated. See thiosinamine under heading "Sinapis." Sinapis, Mustard. Both white and black mustard are emetic in doses of 1 or 2 teaspoonfuls, and are used as counterirritants. In small amounts are used as condi- ments. Thiosinamine is the active principle of black mus- tard, and is valuable in the gradual removal of scar tissue or low-grade connective tissue ; as in corneal opacities, urethral stricture, visceral and connective-tissue adhesions, and chronic glandular tumors. Reference was made un- der "Silicea" to indurations. When tolerated well by the stomach thiosinamine is more active in such removal than is silicea, but it is not adapted to suppuration. Half gr. 214 Sodium Sai/ts. doses in capsule, tablet triturate, or solution, three times a day. Gradually increase doses to I or iy 2 gr. Sodium Salts, U. S. P. Sodii Acetas, a diuretic used in cystitis and dropsy. Dose, 10 to 30 gr. Arsenas, alter- ative, tonic, antiseptic, and antiperiodic in malaria, ane- mia, and nervous diseases (1-20 to % gr.). In small doses (1-100 gr., or 2x, or in the form of cigarettes) in asthmatic cough and nasal catarrh. The exsiccated salt should be used in doses of half the above. Benzoas. See "Acidum Benzoicum." Bicarbonas, antacid, alterative, and antipruritic in average doses of 15 gr. Very large doses (2 % per day) in iodism and diabetic coma. Never use as an acid antidote unless no other alkali is available, as it liberates carbon dioxide too rapidly for safety in such cases. Bisulphis, antiseptic, used in sore mouth, yeasty vomiting, etc. Dose, 5 to 15 gr. Boras, or borax, antiseptic and mildly emmenagogue in doses of 5 to 20 gr. Largely used externally. The transparent glass-like "bangles" sold as the "neutral" borax is the tetraborate, and is somewhat astringent as well as antiseptic, and is used externally in varying strength up to saturated aque- ous solution. Bromidum, sedative and diuretic. Actions and doses about same as potassium bromide (q. v.). Car- bonas monohydratus, used externally as an antacid anti- pruritic in 2 to 5% solution. Chloras should be handled carefully, as it explodes in a number of combinations. Deo- dorant, antiseptic, and alterative in doses of 2 to 6 gr. In very small doses ( V 2 gr. ) it is said to be useful in con- gested and atonic states of the uterus or in violent metror- rhagia and leucorrhea. Three or 4 n\ doses of Labar- raque's solution is preferable to the salt when small doses are indicated. Citras, diuretic and antilithic in 10 to 30 gr. doses. Hypophosphis, nerve tonic and reconstructive. Dose, 10 to 30 gr. Iodidum. See Potassium Iodide. Sodium Salts. 215 Nitras, antiseptic, diuretic, diaphoretic. Dose, 10 to 30 gr. Nitris, antispasmodic, vaso-dilator, diuretic. Dose, y 2 to 2 gr. Phenolsulphonas, a valuable antiseptic well adapted to internal use in doses of 1 to 10 gr. and in y 2 to 1% solution externally. Phosphas, antilithic, laxative, cholagogue. Doses of ^ to 1 f y are purgative ; 10 to 40 gr. are antilithic and mildly laxative. Doses of 1 or 2 gr. have been suggested in ailments arising from excess of lactic acid with flatulence and from irritation of the stomach. Sometimes small doses cure hives. Salicylas. See "Acidum Salicylicum." Sulphas, a hydrogogue ca- thartic in % to 1 5- The dried salt in half this dose. Sulphis, a rather disagreeable antiseptic, but peculiarly effective (when pure) to overcome sarcina ventriculi. When present the tongue is pallid, broad, and coated with a pasty white or yellow white fur. Give in 10 to 30 gr. doses. When patient objects to the taste, magnesium sulphite may be used in its place. Sulphocarbolate. See Sodium Phenolsulphonas. Thiosulphas, or hyposulphite, antiparasitic and antizymotic. Average dose, 15 gr. Solanum CarolinEnsis, Horse Nettle. This is a nar- cotic antispasmodic exploited as a remedy in the treatment of epilepsy and other convulsive diseases. The reports available are too vague to justify classing the drug as a sufficiently promising agent to warrant its trial in these conditions. It is a feeble agent. Probably the recent reports of its value in whooping cough may be warranted. (Ec. tr., 10 to 30 TT\,.) Solatium lycopersicum, the garden tomato plant (leaves), is used by some homoeopaths in rheumatism and influenza. (©, or first dilution, in small doses.) It is very much open to question whether their use of it is really justified. Solanum nigrum is the black nightshade, and its action is somewhat akin to belladonna. It is of real value in coryza and meningeal irritation, but 2l6 SOUDAGO VlRGAUR^A. there is little reason for expecting anything more from it, in most cases, than is accomplished by belladonna. SoiyiDAGo VirgaurEa, Golden Rod. A diuretic of value in ascites, due to cirrhosis of the liver, and in cardiac dropsy. Bright's disease is ofttimes favorably influenced by small doses. Adminster from i to 8 f3 of the f.e. during the twenty-four hours according to amount of diu- resis demanded. An infusion of the flowering herb may also be used. Sparteine Sulphas. This alkaloidal salt is valuable in functional and organic heart disease, and especially so where digitalis fails or is contraindicated. In the irregu- lar heart following grippe and marked by muscular weak- ness, it is very effective. It is potent as a diuretic, and is used in albuminuria. The average dose is 1-5 gr., but it may be used hypodermically in doses of 1-10 to T 4 gr. Here it is of value in meeting the depression incident to the breaking off of drug habits. Spigeua, Pink Root. In large doses (f.e., 1 to 2 f3 for adults; for children, 10 to 20 Hi) spigelia is a powerful anthelmintic, but must be used with care, since it is de- cidedly narcotic and excites the circulation. Combined with senna, it is highly efficient in removing lumbracoid worms. In small doses (tr. or ©, 5 Tit) it is suggested in neu- ralgia of the fifth nerve, neuralgic heart affections, peri- carditis, and rheumatic endocarditis, but has no estab- lished place in therapeutics. Its physiologic action would warrant using it in these difficulties. Spirits, U. S. P. Spiritus Mtheris (32^%), an anal- gesic and antispasmodic. Dose, 60 Ht- Mtheris comp. (32^% ether, 2^% ethereal oil), "Hoffman's Anodyne." Dose, 60 TTt. Mtheris nitrosi (4% ethyl nitrite), diu- Spirits. 217 retic, diaphoretic, antispasmodic. Average dose, 30 TTt- Ammonia: (10%), stimulant and antispasmodic. Aver- age dose, 15 n\. Ammonice aromaticus (3 4-10% ammon. carb., 9% ammon. water). Dose, 30 TTt. Amygdala amarcE (1%), cough sedative. Dose, 8 Tr[. Anisi (10%), aromatic and carminative. Dose, 15 to 60 TTL. Aurantii comp. (orange peel, lemon, coriander, anise), a flavor. CamphorcB (10%). Average dose, 15 TTt. Chloroformi (6%). Average dose, 30 TTL. Cinnamomi (10%). Dose, 10 to 40 n|. Gaultherice (5% true oil). Average dose, 30 TTt. Glycerylis nitratis (1% nitroglycerine). Average dose, 1 TTL. Juniperi (5%), diuretic in 30 TTL doses. Ju- niperi comp. (juniper, fennel, caraway). Average dose, 2 f3. Lavandula? (5%), carminative, stimulant, aromatic. Average dose, 30 TTt- Menthce piperita: (10%), carmina- tive, stomachic. Average dose, 30 Vf{. Mentha: viridis (10%), carminative, stimulant. Average dose, 30 Tl\. Spongia Tosta, Roasted Turkish Sponge. Early in the nineteenth century Girtanner used burnt sponge in the treatment of venereal ulcers of the throat. This con- tains iodine, bromine, potash, magnesia, and lime salts, and in our books of not many years ago was highly com- mended. After a time it fell into disuse in regular medi- cine, but the homoeopaths make a strong tincture of it, which they quite unnecessarily dilute and use in croup, throat affections, difficult breathing, and many glandular affections in the 2x and 3X. Adequate personal experience with the tincture leads me to say that it is probably the best form in which to give small doses of iodine. Its action is similar to the iodized lime so aggressively pushed by the alkaloidal en- thusiasts as a remedy in certain types of croup. It is a good remedy, and so also is tincture of burnt sponge. Recently, some of the throat specialists have revived the 2i8 Stan num. ' use of burnt sponge. In doses of 5 to 30 drops of the tincture a pretty prompt manifestation of the effects of iodine can be secured and with very little irritation, and I am inclined to think that the total medicinal content of burnt sponge, as naturally associated, is less irritating and more useful than the separated iodine in the treat- ment of glandular and throat troubles. This tincture is of very similar composition to the analyses given of the inorganic salts and bases in cod-liver oil, and I have used it to iodize nutritive oils, such as olive oil and peanut oil, and have had very good therapeutic results from them. Stannum, Tin. The homoeopaths claim that tritura- tions of the precipitated metal are useful in debility asso- ciated with chronic bronchial and pulmonary conditions marked by mucopurulent discharges. They also use it in spasmodic and paralytic conditions, neuritis, and type- writers' paralysis. The 3X to 6x is used, with what re- sults I cannot state, having never used it in any form. Staphisagria, Stavesacre. In large doses is an emetic, cathartic, and narcotic, rather unsafe in use. In small doses (f.e. or ec. tr., 1-5 to 1 TTL) it is a stimulant tonic to the nervous system, of value in melancholic and hys- terical conditions, but its chief value is as a soothing agent upon the genito-urinary organs. It has considerable repu- tation in irritation of the prostate, testicles, and vesiculae seminales, arresting mucopurulent discharges, such as gleet. Nocturnal emissions in nervous and anemic men and incomplete urethral evacuations are relieved by it. The homoeopaths employ it in recurrent styes, salivation, and crural neuralgia, as well as in "sexual sins." The ec. tr. contains the fixed oil of the seed, and makes a milky admixture with water. Most tinctures are made of seed from which this oil has been expressed. The contention has been made, but not well sustained, that Sticta Pulmonaria. 219 the oil possesses therapeutic value. Equal parts of the fluidextract and cologne water are used to destroy pedicu- lus pubis and p. capitis. It must not be forgotten that staphisagria is very poi- sonous, and its preparations must be used with care and discrimination. In my own experience, fairly good re- sults have been obtained from small doses of the drug. Sticta Pui,monaria, Lungwort, a lichen found grow- ing upon rocks and trunks of old trees. Possesses a sedative action upon the vagus, lessening irritation and controlling cough with pain in the occipital region and between the scapulae and in the respiratory muscles. It is used in short, hacking coughs, and in influenza with irritating catarrhal discharges. In hay fever it has given me better results than has any other internal remedy. Many cases yield to its influence promptly, and are mark- edly relieved, while others take pretty full doses. Dose, ec. tr., y 2 to 10 TH, ; ®, 2 to 30 TTL. Stigmata Maydis. See Zea. StiIvUNGia, Queen's Root. In large doses is emetic and cathartic, causing gastro-enteric irritation and pros- tration. Pharmaceutically, stillingia presents the difficulty of the red tannates, and its preparations are liable to be either inert or to readily disintegrate. While the dried root is active, the recent root is far preferable. The pres- ent writer has used stillingia very largely, and believes a decoction of the recently dried root to be a most potent vegetable alterative. Several makes of f.e. and the ec. tr. and N. F. tr. are reliable, but the U. S. P. average dose of 30 TTL is too high when reliable preparations are used. One-third of this amount is quite effective, and may be long continued without irritation. To me it is exceedingly annoying that the revisers of the U. S. P. do not take more into consideration the many statements 220 STIUJNGIA. in the U. S. and National Dispensatories as to the dif- ferences between recent and old herbs and roots. A great many instances are noted in these most excellent works where long-continued drying is deleterious to or ruins the drug. Stillingia is an instance. As a matter of fact, when we write for fluidextract of stillingia, U. S. P., it is purely a guess whether we will get an active drug or an inert mess. There exists not one scientific reason why the U. S. P. should ignore the chemical and botanical data of the dispensatories. It is certainly to be hoped that the U. S. P. preparations of the large class of drugs, of which stillingia is a type, will, at the next revision, be placed upon some reasonable basis of requirements as to the state of the crude drug. Physicians who have never properly exhibited stillingia have little idea of its great value. In small doses, long administered, we have a remedy in secondary syphilis, scrofula, lymphatic and glandular troubles, and chronic skin and throat troubles truly second only to the iodides. Stramonium, Thornapple or Jimson Weed. In large doses (f.e. [assayed] of leaves, 2 to 5 trt ; of seed, 2 to 4 nx) a potent antispasmodic and anodyne, similar in in- fluence to belladonna, but preferred in asthmatic attacks. It does not act so well as does belladonna in inflammatory and febrile states. In spasmodic asthma, 10 to 20 gr. of the dried leaves may be smoked in a pipe. It can be used in large doses in mania and convulsions, dysmenorrhea, chorea, and hydrophobia, but is inferior to other agents. In small doses (f.e. or ec. tr., *4 to 1 TTt) it is a good cough sedative, is employed in retention of urine from spasm of the neck of the bladder, and in various con- ditions of brain irritation and sexual excitement. Small doses are said to remove the globus hystericus and to re- lieve muscular tremblings of functional or reflex origin. Strontii Bromidum. 221 An ointment composed of i part opium. 4 parts extract of stramonium, and 16 parts of vaseline is used in rheu- matism, hemorrhoids, glandular swellings, and painful areas. Fresh leaves stewed in lard make an excellent ointment. Daturine has no well-established chemical iden- tity, being usually a mixture of alkaloids. Atropine is similar in action, and much more reliable. Strontii Bromidum. This most excellent drug is now official, and is distinctly less irritating than is potassium bromide. It is nerve sedative, while its influence upon circulation and the gastro-intestinal tract is most kindly. Germain- See highly commends it in fermentative dys- pepsia. It is also employed in nephritis. Average dose, 15 gr. The Carbonate is employed in very small doses by the homoeopaths in affections of the bones and joints associated with or caused by rheumatism and sprains. The Iodide is official, and is used like potassium iodide. The Lactate is highly commended in albuminuria in 5 to 15 gr. doses. The Salicylate is official, and the aver- age dose is 15 gr. Strontium salts promise to largely dis- place the much more irritating salts of potassium. Strophanthinum, Strophanthin. A glucoside, or mixture of glucosides, obtained from strophanthus. A very toxic agent, to be handled with great care. Its aver- age dose is stated in the U. S. P. to be 1-200 gr. Some authorities state it much lower. The 1-500 gr. granules are probably the most convenient way to give the drug. When there is urgent need for a heart stimulant, from one to three of these granules may be given in hot water, and then use one or two every half hour to two hours, accord- ing to urgency. It is not diuretic, and can be classed as a heart irritant. It is seldom wise to administer it for long periods. 222 STROPHANTHUS. Strophanthus. This active agent is of value if used with discrimination, but a few cautions are advisable. Do not prescribe the tincture in an aqueous medium, since the glucoside is precipitated. As it is customary to have pa- tients use so many drops in water, it is the best plan to use the U. S. P. tincture and not the fluidextract or eclectic tincture. The tincture is double its former strength, and the average dose is 8 rrt. It is seldom advisable to exceed 15 or 20 Tl\. Remember that strophanthus acts directly upon the heart muscle, increasing the systole and slowing the pulse without vasomotor effects. It is contraindicated in active hyperemia, visceral hemorrhages, vasomotor dis- turbances, and the ascites of tumors. Give strophanthus when the heart muscle is weak and the pulse rapid without pyrexia. It is indicated in valvu- lar lesions incident to muscular weakness and in dyspnea. Persistent anemia, due to a weak heart, and acute anemia following uterine hemorrhage, are aided, and ofttimes most materially benefited, by strophanthus. In small doses (tr., 1 to 3 nx) it is useful in the irri- table heart of tobacco smokers in arteriosclerosis. In exophthalmic goitre it has been highly commended. Be- gin with small doses and run up to 8 or 10 drops. Some cases of urticaria yield to a similar course of treatment. Strychnina. The alkaloid and its nitrate and sulphate are official. The average dose of each one is 1-64 gr., but may be used, cautiously, up to 1-20 gr. Under twelve years of age from 1-200 to 1-60 gr. It is best given hypodermically when used as a stimulant to the respira- tory centres and in the embarrassed breathing of pneu- monia, as well as in its employment to arrest progressive muscular atrophy. In general, its action is along the lines of mix vomica (q. v.), and is employed in general and local paralyses, in neuralgia, impotence, neurasthenia, de- Strychnina. 223 ficient peristalsis, and as a cardiac and general tonic. When the effects of minute doses are desired, it is best to use nux vomica or ignatia as a rule. This is especially true of visceral and hysterical troubles. The homoeo- pathic indications for strychnia do not "pan out" in prac- tice, but they employ some unusual and really very useful salts. The 2x tablet triturates of strychnium phosphori- cum are excellent in spinal anemia, and the 3X in the anemia of pregnancy. Strych. arsenicum 3X is used very rationally in chronic diarrhea with paralytic symptoms. The alkaloidalists make most excellent 1-134 gr. granules of this salt. It antagonizes vasomotor paralysis, is a su- perb tonic, and strengthens the heart nicely in septic and malarial fevers. Strych. et ferri cit., in 2x triturates, are used in chlorotic and paralytic conditions, and in dyspepsia with vomiting. Strych. valerianate in 2x triturates are used in exhaustion of brain power and with women of high nervous erethism. Of the official preparations, the alkaloid and the sulphate are similarly employed, while the nitrate is preferred in dipsomania. Sulphon:ethyi,methanum. See Trional. Sulphomethanum. See Sulfonal. SulfonaIv. A coal-tar hypnotic that, in my judgment, should be rarely used, but it does possess a place in the insomnia of alcoholics and certain types of insanity. Give from 15 to 30 gr. in hot water two or three hours before sleep is desired, but do not be alarmed if its action is somewhat erratic or some disagreeable symptoms arise. The fact that it is tasteless renders it eligible in some cases, but in general it is a rather unreliable drug. Sulphur, Lotum or Washed S. and S. Prcecipitatum are identical in effects and are classed as alterative, laxa- tive, and antiparasitic. S. Sublimatum is rarely used as 224 SULPHUR. a laxative, but excels in local skin affections. Sulphuris iodidum acts largely as sulphur, and the dose is I to 4 gr. It is not a very stable chemical. In large doses (30 to 120 gr.) sulphur has been very unwisely used. In the system it is subject to so many chemical changes as to be unreliable in action, and its protracted administration causes anemia, muscular weak- ness, torpor of the venous capillaries, boils, and skin rashes. Externally, it has many uses, especially in scabies, and, as a lotion, in acne and other skin diseases; but in- ternally, beyond a dose or two for its laxative effect, I believe it does vastly more harm than good in the large dose. In small dose it is an open question just how much of a place sulphur should fill. The homoeopaths make very extensive use of it in scrofulous indurations, mucous ca- tarrhs, ulcerations, complaints that relapse, suppurating skin lesions, and diseases characterized by inertia and re- laxation of tissue. They claim that minute doses pro- mote resolution of pneumonic hepatization and relieve venous capillary stagnation, but they cloud the subject with a maze of subjective symptomatology verging upon the ridiculous. My own experience with their ix and 2x triturations leads me to say that while they will do very little in most conditions they designate, yet I have gotten better results with them in skin diseases than I have with the crude drug. Sumbui,, Musk Root. This is a drug borrowed from the sectarians and much overexploited by certain manu- facturers. It is used in nervine and antispasmodic mix- tures with apparent success, but how much of the result is due to the sumbul and how much to the well-established agents incorporated with it is an open question. Musk or sumbul in an aromatic wine will make an impression- Syrups. 225 able woman feel "perfectly lovely." So will rose-water in wine. The dose of the fluidextract is 30 n\. Syrups, official and non-official, are so numerous and present no especial points of differentiation from the oils, tinctures, and fluidextracts or the chemical substances en- tering into them, so we will not enter into details con- cerning them. The general tendency is to limit their use, since they are cumbersome and the sugar is seldom rel- ished by sick persons, and usually deranges the stomach. The syrup of the iodide of iron is an exception to the general rule that syrups are unnecessary in that the sugar in this syrup acts as a preventive of chemical destructive changes. Emetics, such as ipecac, squill, and sanguinaria, may at times be given with advantage in syrup, and syrups of the hypophosphites and other agents taken by persons engaged in their daily labor and capable of properly di- gesting the sugar may fill a useful place in therapeutics. TanacETum VulgarE, Tansy. Tonic, anthelmintic, and diaphoretic, employed in flatulent dyspepsia, jaun- dice, and worms. The hot infusion is employed in dys- menorrhea and to prevent the paroxysms of gout. Dose, f.e., 20 to 60 TTL. Taraxacum, Dandelion. Tonic, alterative, diuretic, and mildly laxative. Employed, usually in combination, in chronic functional liver derangements and cutaneous derangements due thereto. (E.e., 1 to 2 f3.) TerEbenum. A mixture of hydrocarbons derived by the action of acid upon turpentine. It is expectorant, antiseptic, and antifermentative ; used in chronic bron- chitis, flatulent dyspepsia, and genito-urinary diseases. Dose, 4 to 20 TTL on sugar. Externally, in 1% solution, in uterine cancer and gangrene. 226 TerSbinthina. T^rebinThina, Turpentine. A valuable stimulant, hemostatic, anthelmintic, antiseptic, and counterirritant. Best exhibited in gelatine capsules and emulsion. In large doses (f3i to f3iv) it is a reliable anthelmintic, and is used in conjunction with castor oil when first aris- ing in the morning. In small doses (i to 10 TTt) a valuable stimulant in low fevers, used when the tongue is dry and red, the pulse feeble, tympanites, and the mind wandering. Give 5 TTL doses every three hours, and if hemorrhage, 10 TTL doses. Small doses are effective as a diuretic in atonic states of the genito-urinary tract. Fifteen TTt each of turpentine and sulphuric ether, in capsules, are given in biliary cal- culi. In strangury, with bloody urine, give quite small doses. In typhoid, I like an emulsion made by mixing 2 f3 of turpentine with 1 % of castor oil, and rubbing up with 3 3 each of powdered acacia and white sugar and enough peppermint water to make a 4 § mixture. Shake well, and give 1 or 2 teaspoonfuls every three hours. Tur- pentine is given in case of trichina spiralis, in small and persistent doses, and in the subacute stage of dysentery, in quite small doses. One TTt doses do well with children where the trouble is due to the formation of lactic and butyric acids. Locally, turpentine stupes, turpentine in olive oil (10 to 25%), and inhalations of the vapor from hot water and turpentine have a wide range of utility. Chian tur- pentine is applied to cancerous growths. Canada turpen- tine, or "balsam of fir," is a liquid oleoresin, and is some- times used in pill form. Tsrpini Hydras. In large doses (10 to 15 gr.) is diu- retic. Give in pills or capsules. As a diuretic, it is rather irritating. In small doses (1 to 3 gr.) it enters into a number of elixirs used in bronchitis, cystitis, etc. Theobromine. 227 Theobromine. An alkaloid from theobroma cocao and possessing diuretic properties in 5 to 15 gr. doses. Sec- ondarily, it is a mild nerve stimulant. Merck makes a salicylate of theobromine that is a valuable diuretic and genito-urinary antiseptic. Dose, 15 gr. Thlaspi Bursa Pastoris, Capsella. In large doses (i.e. or ec. tr., % to 1 f3) is hemostatic and antiscorbutic, and is used in chronic diarrhea and passive hemorrhage. In small doses (®, 3 to 5 TT\,) the homceopaths esteem it highly in renal and vesical irritation as a soothing diu- retic. Where uric acid or insoluble phosphates or car- bonates produce irritation of the urinary tract, they use it. Also in albuminuria during gestation. From pretty adequate testimony their use of the green plant mother tincture in this class of affections seems to be well sus- tained by the results. Thuja Occidentalism Arbor Vitce. The ec. tr. is al- coholic, but free from extractives and suitable for surgi- cal use. Aqueous thuja contains the astringent but none of the oily and resinous principles. Long's thuja contains no alcohol. Oil of thuja is a colorless, campohraceous body destitute of astringency. Internally, thuja is a terebinthinate. The oil is most too irritating for internal use. The ec. tr. is used in affections of the mucous tracts, especially dribbling of urine in the aged, enuresis of children, vesical atony, sup- pressed gonorrhea, and gonorrheal rheumatism. (Ec. tr. in doses of 3 to 15 drops.) Not very miscible with water. Locally, thuja is very valuable in many conditions, but the proper preparation (alcoholic, non-alcoholic, etc.) must be used, or failure, if not great pain, will result. Fungoid granulations, fistulous openings, gangrene, pa- pillomata, condylomata, venereal warts, hemorrhage from malignant growths, bleeding moles, purpura hemorrha- 228 Thuja Occidentals. gica, umbilical hemorrhage, bulging nevi, small, soft chancres, ulcerations upon uterine os, fissures, ptyalism, urethral carbuncles, syphilitic psoriasis, and many other conditions are treated by ec. tr., full strength, if upon the skin or directly upon warts or granulations. Upon mucous membranes or excoriated surfaces, 1-5 to full strength. Usually diluted with glycerine. In hydrocele, mix 1 3 each of ec. tr. and warm water. Insert a large exploring needle into sac, and permit serous fluid to es- cape. Now inject through the needle, by means of a small syringe, the 2 f3 of the diluted ec. tr., and knead scrotum vigorously. Withdraw needle. For a half hour or so the pain is pretty severe, but a cure usually results. In hernia, the same solution, or even full strength (y 2 f3 every two weeks) is injected into the rings. Practice rigid asepsis in all injections, and be caatious. In trachoma, pass wetted alum pencil over the everted lid (lightly), dry parts, and apply an ointment made of Long's thuja, 1 part, and vaseline, 3 to 8 parts. Aqueous .thuja (y 2 strength) may also be used. Further diluted, it is used in pterygium with conjunctivitis. In general, the aqueous thuja is preferable upon sensitive membranes, as in granular urethritis and catarrhal conditions of the mucous channels, or in nasal polypi, gonorrhea, granu- lated cervix, mucous patches in vagina and throat, and in fistula (1 part in 6, up to full strength). Thuja cerate (25%) is used in old skin troubles. Thymol. In large doses (10 to 30 gr.) a powerful anthelmintic of great value in "hook worm disease" and nematod infections of intestinal tract generally. Smaller doses destroy the filaria sanguinis hominis as found in chyluria. In small doses (1 to 3 gr.) it is antiseptic, and used in gastric fermentation. Locally, it is a pleasant antiseptic, used in nasal catarrh and in washes, gargles, Thymol. 229 and spraying solutions. Unfortunately, it is rather ex- pensive and also attracts flies, which will not do in sur- gery. Thymous Iodidum. See Aristol. ToivU. A mild expectorant, stimulant to the bronchial mucous membranes. It is seldom used alone, but the syrup carries nicely and promotes the action of more positive expectorants. The dispensing physician will find the "soluble fluid tolu" useful in compounding the syrup or extemporaneous mixtures. Tonga, Premna Taitensis. The fluidextract, in 30 to 60 TTt doses, has given good results in the treatment of neuralgia. Tongo, Tonka Bean, Dipterix odorata. Used as a flavoring agent. Possesses very mild anodyne properties taken advantage of in making up mixtures for whooping cough. TriFouum PratensE, Red Clover. The fluidextract of the blossoms, in 30 TTL doses, is alterative and used largely in combination with other agents. It is reputed to be of value in the cancerous diathesis. In doses of 10 TIX it is used in spasmodic coughs, whooping cough, and hay fever. The agent has been pushed largely by the proprietary interests, who have derived their data con- cerning it largely from homoeopathic sources. It is of moderate utility. TrionaIv. A synthetic derived from another synthetic (sulfonal). A hypnotic and nerve sedative. Does not relieve pain. Average dose, 15 gr. In my experience, it is a very unreliable agent, and just about as uncertain in action as sulfonal and tetronal. Triticum Rep^ns, Conch Grass. A soothing diuretic, 230 Triturations. increasing the flow of the watery portion of the urine. It is of positive value when the urine is dense and causes irritation of the mucous surfaces. Since it is non-irri- tating and entirely harmless, it can be given freely in irritable bladder, dysuria, cystitis, gonorrhea, lithemia, prostatitis, and many other conditions. (F.e. or ec. tr., 10 to 60 171.) Triturations. What might be called ix triturations are now official. Elaterin is the only specific drug thus far designated in the U. S. P., but several enterprising manufacturers very wisely list a great many triturations. Trochisci, Acidi Tannici, U. S. P. (1 gr.), astringent in throat troubles. Ammonii chloridi (1^2 gr.), expec- torant. Cubebce (3-10 gr.), in bronchial troubles and sore throat. Gambir (1 gr.), in mouth and throat inflamma- tions. GlycyrrhizcE et opii (Wistar's lozenges, 1-12 gr. opium), in cough. Kramerice (1 gr.), in mouth and throat inflammations. Potassi chloratis (2^ gr.), apthae. Santonini (y 2 gr.). Dose, 1 or 2 with a laxative. Sodii bicarb onatis (4^ gr.), antacid. Tuberculin (Koch), a glycerine extract of pure cult- ures of tubercle bacillus. Used in diagnosis. Dose, 1-12 to 1-6 gr. subcutaneously, once, in 0.8% salt solution; or four doses at intervals of three to seven days, giving, respectively, 1-128 gr., 1-32 gr., 1-12 gr., 1-6 gr. The reaction raises temperature 1^ to 2 degrees. The "New Ttibercidin" is used as a remedy in lupus and phthisis. Homoeopathic writers assert that minute doses are very valuable in the treatment of broncho-pneumonia. Aviaire, tuberculin from birds, is asserted to be useful in influenzal bronchitis, and, homceopathically, a solution of the third centesimal potency is injected, or the 30X •given internally. Bacillimim is made from tubercular Unguentum. 231 nodules, and is an attenuation of the toxines found there- in. It is asserted to be of value in incipient tuberculosis in infrequent doses. The whole subject is in a somewhat nebulous state as yet, but doubtless some one or more of these substances will ultimately prove to be of real value. UnguEntum ; Acidi Borici (10%). Acidi tannici (20%). Belladonna (10%). Chyrsarobin (6%), anti- parasitic. Too toxic to use upon large surfaces. Diachy- lon, or lead plaster (50%), astringent and dermic. Gallce (20%), astringent in piles, prolapsus ani, flabby ulcers, etc. Hydrargyri (50%). The U. S. P. preparation is inferior to that made by Squibb by mechanical means. Antisyphilitic, discutient, and antiparasitic. Dose (by in- unction), 1 5. Hydrargyri ammoniata (10%). Hy- drargyri dilutum (mercurial ointment, 67%). Hydrar- gyri nitratis, or "citrine ointment" (mercury, 7% ; nitric acid, 17^%). Hydrargyri oxidi Hamim (10%), and Oxidi rubri (10%), are used in diseases of the eyelids and in indolent ulcers. Iodi (4%). Iodoformi (10%). Phenolis (3%). Picis liquids (50%). Potassi iodidi (10%). Stramonii (10%). Sulphuris (15%). Vera- trince (4%). Use carefully, as it is very toxic. Zinci oxidi (20%). Zinci stearatis (50%). Principal Homoeopathic Cerates. Most of them are made 25% of the strength of the plant. Rhus toxicoden- dron is made much weaker. Aconite, in inflammation and pain. JEsculus, in piles. Arnica, sprains and bruises. Bryonia, rheumatism and pleurisy. Calendula, antiseptic and healing. Carrot, in deep burns. Eucalyptus, an anti- septic. Graphites, sore nipples and fissured sores. Quite useful. Hamamelis, piles, burns, inflammations, etc. Hy- pericum, penetrating and painful wounds. Hydrastis, catarrhal conditions of mucous surfaces. Iris, in tinea capitis. Phytolacca, in glandular inflammation before 232 Upas Tiente. suppuration takes place. A very valuable application in induration and congestion of mammary gland. Plantago, another excellent cerate of use in poisonous and malig- nant inflammation, ulcerations, pruritis, and phlegmon- ous erysipelas. Rhus tox, in rheumatism of joints, but must be used with great care. Stramonium (50%), in inflamed hemorrhoids. Thuja, in old sores, salt rheum, warts, and pimply eruptions. Homoeopathic cerates are very active, being made from the green plants. Their ointments made from chemicals are quite similar to our own. Upas Tiente, Upas Tree. This very poisonous plant is used in sectarian practice, but has no advantages to recommend it over other agents. Large doses produce tonic spasms and asphyxia. Small doses are a nerve and sexual tonic (3x). Uranium Nitrate. The 2x is esteemed in diabetes, gastro-intestinal ulceration, and chronic diseases of the liver. In the "made in Germany" regular practice, it is used for similar indications, but in doses of 1 gr., gradu- ally increased. UrEThanE. A hypnotic, in doses of 30 gr. Sedative, in doses of 5 to 15 gr. It is moderately effective, and safer than most synthetic hypnotics. UrTica UrEns, Stinging Nettle. The ®, in 5 drop doses, is used in agalactia, and is said to give good re- sults. UsTiivAGo Maydis, Corn Smut. The contention is made that corn ergot has similar actions upon the cen- tral nervous and capillary systems to the ergot of rye, but produces its action more regularly and safely and has the advantages of rye ergot in labor and post-partum hemorrhage without the disadvantages. A more conserv- Uva Ursi. 233 ative view is that in chronic uterine hemorrhages ; and when there is uterine inertia before delivery, it is supe- rior to rye ergot, but not in active hemorrhage, or for the indications in small doses. (See Ergot.) A few makers of fluidextracts list ustilago. (F.e. or ec. tr., 5 to 30 TTL.) Uva Ursi, Bearberry. An astringent diuretic, useful in relaxed states of the bladder walls and where mucous discharges are profuse. It is employed in ulceration of the bladder wall, cystitis, pyelitis, diabetes, and in uri- nary calculi. (F.e., 10 to 60 TIX-) Valeriana. A gentle nerve stimulant, useful when the face is pale and the skin cool, in hysterical conditions, and nervous excitement. Employed in nervousness with depression, hysteria, hypochondria, the restlessness of fever, and mild, spasmodic affections. (Tr., 1 f3 to 2 f3; f.e. or ec. tr., 30 TTL.) Veratrina. Derived from asagrcea. Cardiac depres- sant and analgesic. Dose, 1-30 gr. A good drug to let alone. Externally, 2 to 4% ointments are used, but they are dangerous. See "Sabadilla." Veratrum Album, White Hellebore. An exceedingly toxic vasomotor depressant employed occasionally as a cardiac depressant, in doses of 1 to 3 ni of the fluidex- tract. Veratrum viride is much safer, and there is really no good reason to employ white hellebore when the for- mer agent is available. See the following article, "Vera- trum." Veratrum. The U. S. P. veratrum is either veratrum album or veratrum viride. In order to give reliable in- formation herein and endeavor to solve the problem why the revisers class these two agents as practically one, I read up a dozen authorities, and infer that as recent in- 234 VERATRUM. vestigators declare that the two plants are of similar alka- loidal content, the revisers accepted these conclusions as final and the plants identical. In my humble opinion, the history of the. investigations of these two plants has always been so involved as to the alkaloidal content and the conclusions of equally able chemists so contradictory as to render it a very rash proceeding to base the therapy of such toxic agents upon them. As a matter of fact, a good deal of veratrum album grown in high, mountainous regions is very similar to veratrum viride, but the plant varies according to its habi- tat. Our source of supply is Europe, and we get very dry and uncertain crude white hellebore from there as a rule. Until the U. S. P. veratrum preparations are upon a much more scientific basis than at present, or until assay methods are devised that really determine something tangible about these complex drugs, it is best to not use the U. S. P. veratrum at all. I say this regretfully and against the statements of excellent authorities, but I have used a good deal of veratrum upon sick people, and that is the real test and punches holes in considerable theory and laboratory data. Read the dispensatories of a few years back upon veratrum album, with the marked cau- tions given therein, and you will appreciate my point of view. See "Veratrum Viride." Veratrum Viride, American Hellebore. Toxic doses depress the circulation and respiration and produce coma and incessant vomiting. While not apt to lead to fatal results, veratrum viride must be used with great care, since it may cause death by asphyxia. Never push be- yond slight nausea, and rarely to that point. The action of the drug is prompt, and should be given in doses not over two hours apart, and the patient be rigidly kept in the recumbent position when full doses are administered. VERATRUM VlRIDK. 235 It is contraindicated in valvular heart lesions and in asthenic states. Pharmaceutical^, it is hard to work. Green root tinc- tures are apt to be slimy and weak. The recently dried root is fully effective. The Norwood's tincture is thor- oughly reliable. The © is excellent if sufficiently large doses are given. Squibb's tincture veratrum viride can be depended upon. The ec. tr. is a high-grade fluidex- tract made of partially dried root, and is probably not so concentrated as to alkaloidal constituents as are fluidex- tracts from dry but recent root. The numerous alkaloids derived from veratrum viride have no established place in therapeutics. In large doses it is of decided value only in puerperal convulsions. It is apparently harmless in quite large doses in this condition. Give 10 TQ, ec. tr., or 8 Tl\ f.e., or, hypodermically, 6 to 8 Til ec. tr. According to con- ditions, repeat with doses half as large. In one aggra- vated case I gave 30 nx ec. tr. within two hours, but such heroic doses are rarely safe, although as high as 10 nx hypodermically every fifteen minutes, to effect, have been suggested. The hypo, is really seldom necessary, since veratrum is so prompt in action. Be very cautions with these large doses. In small doses it is used to slow the pulse when it is full, strong, and large, viz. : in sthenic states. It is in- dicated in many conditions, such as erysipelas, malignant types of scarlet fever and diphtheria, sciatica, uremic con- vulsions, exophthalmic goitre, determination of blood to the brain, acute pneumonia, acute tonsilitis, peritonitis, meningitis, some cases of cardiac hypertrophy, acute rheumatism, and sthenic inflammations generally when patient is in bed and stays there. Do not give to persons who are asthenic or to those who are up and about, (F.e. 236 Verbascum. or ec. tr., 1-5 to 2 rrt every half hour to two hours. Tinc- tures, 1 to 15 TTX-) The small dose is safe and effective within its indications, but 1 1TL f.e., or 10 TTt tr., is seldom to be exceeded in this connection. Verbascum, Mullein, Demulcent, mildly diuretic, ano- dyne, and antispasmodic ; used in bronchial irritation, cys- titis, diarrhea, and hemorrhoids. (F.e. root or ec. tr., 15 to 60 TTL.) For its use in deafness and ear troubles, see "Mullein Oil," which is said to influence the inferior maxillary branch of the fifth pair of the cranial nerves as well as the ear, and to be valuable in neuralgias of parts so supplied. VerbKna Hastata, Vervain, is employed by a few physicians, who commend it in intermittent fever, vesicu- lar erysipelas, and epilepsy (rather diverse conditions), but there is little evidence of its value. Viburnum Opulus, Cramp Bark. Tonic, antispas- modic, and alterative. It is indicated in cramps, spas- modic uterine pain, "bearing-down pain," spasmodic dys- menorrhea, spasm of sphincters, and as an antiabortive agent. (Ec. tr. or f.e., 10 to 30 Til.) The larger doses commonly suggested are not one bit more effective. It cooperates nicely with gelsemium and cimicifuga. Viburnum Prunifouum, Black Haw. This valuable drug is the best agent we have for irritable states of the womb in nervous patients, being especially indicated in a chronic disposition to miscarry. Give regularly for six weeks before the time when this event usually occurs. It controls after-pains and promotes uterine involution. Black haw relieves the gastric discomfort following alco- holic indulgence. (F.e. or ec. tr., 10 to 60 tr\,.) Vinum ; Antimonii (}i gr. tart. emet. in 1 fo). Cocce (f.e., 6*4%). Dose, 4 f5. Colchici seminis (f.e., 10%). Viola Odorata. 237 Average dose, 30 TT^. Ergotce (i.e., 20%). Ferri (4% fe. et am. cit.). Ferri amarum (5% fe. et quin. cit.). Ipecac (f.e., 10%). Opii (10%). Average dose, 8 TO,. Viola Odorata. Small doses © are used in supra-or- bital pain, choroiditis, and otorrhea. Viola pedata has some reputation as an alterative. Waters, Medicated, U. S. P. Aqua amnionic? (10%). Average dose, 15 rr[. Amnionic? fortior (28%). Amyg- dalce amarce (0.1%) . Dose, 1 f3. Anisi (0.2%). Dose, 4 f3. Aurantii floram, dose, 4 f3. Aurantii Horum fortior, dose, 2 f3. Camphorce (0.8%). Dose, 2 f3. Chlori (0.4%), disinfectant and zymotic. Average dose, 1 f3, well diluted. Externally, pure. Chloroformi (%%). Dose, 4 f3. Cinnamomi, dose, 4 f3. Creosoti, dose, 2 f3. Fcenicula, dose, 4 f3. Hamamelidis, dose, 2f5. #3'- dro genii dioxidi (10 volumes oxygen), dose, 1 f3. ik/Vn- f&# piperitce, dose, 4 fo. Mentha? viridis, dose, 4 f3. Rosce, dose, 4 f3. i^o^^ fortior, dose, 2 f3. Xanthium Spinosum, Cocklebur. A diuretic of use in passive hematuria, chronic cystitis, but more espe- cially where gravelly deposits in the folds of the bladder cause irritation and an excess of mucus. (Ec. tr., 5 to 15 1U-) Xanthoxylum, Prickly Ash. Primarily a stimulant, and useful as such in many languid and debilitated states. Highly valuable to add stimulating properties to indicated remedies combined with it. (F.e., 10 to 60 Til.) Yerba dE la FlECha, Sapium. A new purgative and diuretic, pleasant to the taste, and effective in doses of 1 to 5 m, of the fluidextract. Large doses are poisonous and highly dangerous. It has not been sufficiently studied to establish its range of safe employment. 238 Yerba Santa. Yerba Santa, Briodictyon. A tonic expectorant quite agreeable to the taste. Of value in chronic, subacute in- flammations of bronchial mucous membranes, especially when the cough is dry. Dispensing physicians will do well to stock with the aromatic fluid yerba santa (four times strength of syrup), and use in doses of 15 to 30 TIX- One teaspoonful of the syrup masks the bitterness of 5 gr. quinine sulphate. Yohimbinum, Johimbin. An aphrodisiac recently ex- ploited for the cure of neurasthenic impotence. Use Merck's yohimbine in 1-10 gr. doses, or the homoeopathic 1% solution in 10 drop doses. Hypodermic tablets con- tain 1 -12 gr. Z^a, Corn Silk. It is quite refreshing away on at the end of the alphabet in the U. S. P. to read : "The fresh styles and stigmas of zea mays." It is a wonder they did not designate the "dried." Probably, after the next two or three revisions eliminate nearly all our vegetable remedies except the ones containing poisonous alakloids, and, in process of years, the pendulum swings back, the then revisions will be full of fresh or green plant prepa- rations. Zea is really a valuable drug in inflammatory affections of the bladder, acute or chronic. It contains maizenic acid, which is a soothing antiseptic. It is especially valu- able where intravesical decomposition of urine has given rise to irritation. Zea is a harmless, non-irritating, non- depressing, and yet highly efficient remedy. (F.e., 20 to 60 in,.) Zinc Salts, Zinci Ac etas, used externally as an as- tringent and antiseptic (2 to 5:1000 solution) in gonor- rhea, conjunctivitis, etc. Occasionally used as a nervine in y 2 to 2 gr. doses. Rademacher's solution is used in Zinc Salts. 239 5 Til doses in water, three times a day, as a nerve tonic for persons under strain and losing sleep. Bromidum, employed in epilepsy, in 1 or 2 gr. doses, well diluted. Carbonas prcecipitatus, a dermic, used in abrasions and in face powders. Chloridum, used externally as a caustic in nevi, exuberant granulation, and to cancerous growths. In solution, 1 :iooo, is used in gonorrhea and eye troubles ; upon wounds, 1 :ioo; tuberculous joints, 1 :io. Internally in 1 -10 gr. doses in epilepsy, chorea, etc. Iodidum, an alterative antiseptic, used in doses of 1 or 2 gr. Metal- licum, a homoeopathic triturate, used in 3X, in defective nerve vitality with impending paralysis, spinal affections, hypochondriasis, etc. Oxidum, an antispasmodic, anti- septic, and mild sedative, used in diarrhea, gastroenteri- tis, gastralgia, etc., in doses of 1 to 5 gr. Externally, in 5 to 20% ointment, in skin diseases requiring desiccation and protection. The pure powder may also be used ex- ternally. Phosphide, a nerve tonic in 1-20 to Y^ gr. doses. and used homoeopathically in neuralgias of head and face, brain fag, sleeplessness, etc. 2x and 3X triturations. Phenolsulphonas , or sulphocarbolate, an antiseptic astrin- gent, used in ^ to 1% solution externally, and in 1 to 3 gr. doses internally, in typhoid, diarrhea, etc. Stearas, an antiseptic dusting powder. Sulphas, an emetic, in 15 gr. doses. Externally, in y 2 to 2% solution, or 5 to 10% ointment as an astringent. The homoeopaths use minute doses in muscular cramps and convulsive disorders. Va- leras, an antispasmodic tonic used in nervous affections, neuralgia, and diabetes insipidus, in doses of 1 to 3 gr. Zingiber, Ginger. A stimulant, diaphoretic, and an anodyne in gastric and intestinal pain. A teaspoonful of the tincture in a cup of hot water is a more valuable and certainly less harmful emergency stimulant than is whis- key or brandy. Smaller doses (tr., 10 to 20 TTt) are 240 Zingiber. useful in flatulent colic and atonic gastric states. As a diaphoretic, it is used in the early stages of a cold with better results than with alcoholic stimulants. Give hot ginger tea and quinine, and cover warmly in bed. A Request Dear Doctor : No one can realize more fully than myself the deficiencies necessarily incident in the concrete results of any attempt to mingle our rational and physiological therapeutics with the involved literature and data of sectarianism and make a harmonious union of the whole There is no doubt at all that many men will note more or less faulty statements in this book. It is my earnest desire to eliminate them from a second edition, should it be called for in course of time. Criticism is frankly solicited and will be appreciated. Honestly believing in the principles of regular med- icine, it is not -to be expected that all sectarians will approve what I have endeavored to make moderate and reasonable views as to their own essential therapeutics; especially since this book is meant more as an answer than as a tribute to sectarianism On the other hand, we regulars cannot afford to complacently ignore the earnest, painstaking work of anyone in the field of thera- peutics, especially in view of its present rather unsatis- factory status I would request that my colleagues in- dulge me somewhat in the rather trying position involved in the authorship of such a book as this, and that our sectarian friends will realize that no attempt is made to treat their data from their points of view. To both regular and sectarian I would say that I will welcome definite and tangible data in criticism, but not the mere expression of prejudice No one is quali- fied to condemn the usefulness of a drug, either in large or small doses, until he has personally used a thoroughly representative preparation of that drug, strictly within its indications and in a number of clinical cases. I would appreciate the views of pharmacists and chemists. I do not favor polypharmacy and wish to ex- plain that while a great many unimportant drugs are noted in these pages, they appear largely as a matter of reference. I rarely employ them except in cases to which more reliable medication has been unsuccessfully directed. But disease is a strange entity. Quinine will not cure all cases of malaria, nor mercury and the iodides all cases of syphilis . These intractable cases may prompt- ly yield to relatively unimportant vegetable drugs In this view of the case all reasonably effective drugs are im- portant both in their pharmacy and in their therapeutics . I wish to say that I have read up all the fads in therapeutics Please do not send criticism based upon them. While there is more or less substantial basis in the claims of all of them , a small work cannot undertake their consideration. Fraternally yours, THOS. S. BLAIR 403 N. Second Street INDEX OF REMEDIES The drugs and preparations appearing in this book are, with few exceptions, given their official titles and appear in alphabetical order. Cross references are used where their importance justifies the use of space, but there are so many common, chemical, and botanical names, synonyms, and sectarian titles that they are gathered together in this index. Page numbers are not needed, as all indexed names appearing in bold type are found in their alphabetical order, while those in less conspicuous type are immediately followed by the title under which they are treated, placed in brackets, as, for instance : Pilocarpus Jaborandi (Pilocarpus) Jimson weed (Stramonium) Phenylis salicylis (Salol) Rhus toxicodendron Thus, Pilocarpus appears under its own title, while Jimson weed will be entered as Stramonium. Salts are not indexed. Sulphate of zinc appears under Zinc salts. Individual preparations are not indexed. Tinctures, fluidextracts, etc., are not indexed, but preparations having no uniform basis of strength are briefly noted in the text and are indexed as Unguentum, Spirits, etc., the U. S. P. ointments, for instance, all appearing under the one heading. Complicated chemical names, except U. S. P. titles, will not appear, nor will common names not generally in use. Many drugs, doubtless of some utility, are not found here because of their having fallen into pretty general 241 242 Index. disuse. On the other hand, some very inferior reme- dies are noted because in regular use in some school of medicine, and they appear as a matter of reference. No attempt is made to list the multitude of synthetics. U. S. P. agents used pharmaceutical^ only are not touched upon. Abies Abrus precatorius (Jequi- rity) Acetanilide Acetous tinctures Acetphenetidinum (Phe- nacetin) Acidum : Aceticum (Acids of minor importance) Arsenous (Arseni tri- oxidum) Benzoicum Boricum Camphoricum (Ac. of minor import.) Carbolicum (Phenol) Citricum (Ac. of mi- nor import.) Hydriodicum Hydrochloricum Hydrocyanicum (Ac. of minor import.) Lacticum (Ac. of mi- nor import.) Nitricum Nitrohydrochloricum Oxalic (Ac. minor imp.) Phosphoricum Picricum Salicylicum Sulphuricum (Ac. mi- nor imp.) Tannicum (Ac. minor imp.) Tartaricum (Ac. mi- nor imp.) Trichloraceticum (Ac. minor imp.) Acids of minor therapeu- tic importance. Aconitina Aconitum Acorn kernels (Quercus) Adonidin Adonis vernalis Adrenalin Aesculus Aether (Ether) Aethusa cynapium Aethylis carbonas (Ure- Agaricin (Agaricus) thane) (Ac. minor imp.) Agaricus muscarius Index. 243 Ailanthus glandulosa Alder (Alnus) Aletris farinosa Allium cepa Alnus rubra Aloes Aloin (Aloes) Alumen American Hellebore (Ve- ratrum vir.) Ammonium Bromide Carbonate Chloride Iodide Valerianate Amygdalus persica Amyl nitrite Anemone (Pulsatilla) Anhalonium Anthemis (Chamomilla) Antimonii et pot. tart. Antipyrin Apiol Apis mellifica Apocynum cannabinum Apomorphine Aquae (Waters, medicat- ed) Arbor vitae (Thuja) Arbutus (Epigaea) Argenti nitras Aristol Arnica Arsenicum album (Arse- nii trioxidum) Arsenic Bromide Iodide Arsenii trioxidum Arsenite of copper (Cop- per arsenite) Artemisia pauciflora (Cina) Asafoetida Asclepias tuberosa Aspidium Aspidosperma (Quebra- cho) Atropine (Belladonna) Aurum (Gold) Avena sativa Aviaire (Tuberculin) Bacillinum (Tuberculin) Balm of Gilead (Populus candicans) Balsam Peru Balsam tolutani (Tolu) Baptisia tinctoria Barosma (Buchu) Baryta carbonate Muriate Bayberry (Myrica) Bearberry (Uva ursi) Bearsfoot (Polymnia) Bee virus (Apis mellifica) Belladonna Benzosulphinidum (Sac- charin) Berberine Berberis aquifolium 244 Index. Bismuth beta-naptholate Subnitrate Bitter broom (Parthe- nium) Bitter candytuft (Iberis) Bittersweet (Dulcamara) Bitter wood (Quassia) Blackberry (Rubus) Black cohosh (Cimici- fuga) Black haw (Viburnum prun.) Black lead (Graphites) Black nightshade (Sola- num) Black snakeroot (Cimici- fuga) Blood-root (Sanguinaria) Blue cohosh (Caulophyl- lum) Blue flag (Iris) Blue mass (Mass) Boneset (Eupatorium) Bromelin (Pineapple) Bromine Bromoform (Bromine) Broom (Scoparius) Bryonia alba Buckeye (Aesculus) Buchu Bugleweed (Lycopus) Burdock (Lappa) Buttercup (Ranunculus) Butternut (Juglans) Butyl-chloral hydrate Cactus Caffeine Cajuput Calabar bean (Physostig- ma) Calcarea (Calcium) Calcium salts Calx (Calcium) Calendula Calomel (Mercury) Calotropis Caltha palustris Cambogia (Gamboge) Camphora Canadian hemp (Apocy- num) Candytuft (Iberis) Cannabis indica Cantharidin (Cantharis) Cantharis Capsella (Thlaspi bursa pastoris) Capsicum Carbolate of camphor (Camphora) Carbo ligni Caroba tree (Jacaranda) "Caroid" (Papaya) Cascara sagrada Cataplasma kaolini (Kao- lin) Catechu (Gambir) Caulophyllum Index. 245 Causticum Ceanothus Cedron Celandine (Chelidonium) Ceratum (Unguentum) Cereus (Cactus) Cerii oxalas Cevadilla (Sabadilla) Chamomilla Charcoal (Carbo ligni) Chelidonium Cherry laurel (Laurocera- sus) Chimaphila China (Cinchona) Chinese sumach (Ailan- thus) Chionanthus virginica Chloralamide (Chloralfor- mamidum) Chloralformamidum Chloral hydratum Chloroformum Christmas rose (Hellebo- rus) Chrysarobinum Cicuta virosa Cicutine (Cicuta) Cimicifuga racemosa Cina Cinchona Cineraria Cinnabaris (Mercurius) Cinnamomum (Cinnamon) Club moss (Lycopodium) Cobalt Coca Cocainae Cocculus indicus Coccus Cochineal (Coccus) Cocklebur (Xanthium) Codeina Cola (Kola) Colchicine (Colchicum) Colchicum Collinsonia Colocynthus Condurango Cone flower (Echinacea) Conicine (Cicuta) Coniine (Cicuta and Co- nium) Conium Convallamarin (Convalla- ria) Convallaria Copaiba Copper salts Couch grass (Triticum) Cuprum (Copper) Corn silk (Zea) Corn smut (Ustilago) Corkwood tree (Dubois- ine) Cotton-root (Gossypii) Cowslip (Caltha) Cramp bark (Viburnum op.) 246 Index Cranesbill (Geranium) Crataegus oxyacantha Creolin Cresol (Creolin) Creosotum Crocus (Saffron) Croton Chloral (Butyl- chloral hydrate) Cubeba Cucurbita Cud weed (Guaphalium) Culver's root (Leptandra) Cypripedium "Cystogen" (Formalde- hyde) Damiana Dandelion (Taraxacum) Digitalis Dioscorea Diuretin Dock (Rumex) Drosera Duboisine Dulcamara Duotol (Guaiacol) Dusty miller (Cineraria) Echinacea Elaterinum Elder (Sambucus) Emplastrum (Plasters) Epigaea Ergot Erigeron Eriodictyon (Yerba San- ta) Erythroxylon coca (Coca) Eserine Ether Ethyl Eucaine Eucalyptol (Eucalyptus) Eucalyptus Euonymin (Euonymus) Euonymus Eupatorium Euphorbia Eupion Exalgin Fel bovis (Oxgall) Ferrum Fish berries (Cocculus) Flag (Iris) Fleabane (Erigeron) Formaldehyde and "For- malin" Fragrant sumach (Rhus aromatica) Fraxinus (Manna) Fringe tree (Chionanthus) Fucus vesiculosis Gambir Gamboge Gaultheria Gelsemium Gentianae Geranium Indsx. 247 Glandulae suprarenales Siccae (Adrenalin) Thyroideae Siccae Ginger (Zingiber) Ginseng Glonoine (Nitroglycerine) Gnaphalium Gold Golden rod (Solidago) Golden seal (Hydrastis) Gossypii cortex Granatum Graphites Grindelia Guaiacol Guaiacolis carbonas (Guai- acol) Guarana Gum plant (Grindelia) Hair-cap moss (Polytri- chum) Hamamelidis Haw, black (Viburnum prun.) Hawthorn (Crataegus) Helleborus niger Helonias Hemlock, poison (Co- nium) Hemp, Canadian (Apocy- num) Henbane (Hyoscyamus) Hepar sulphuris Heroin Hexamethylenamina Hoarhound (Marrubium) Homatropinae Homoeopathic animal products (See Lachesis) Homoeopathic organo- therapy (See Lachesis) Hop, wild (Bryonia) Hops (Humulus) Horse chestnut (Aesculus) Horse nettle (Solanum) Humulus Hydrargyrum (Mercury) Hydrastine (Hydrastis) Hydrastis Hydrogen peroxide Hyoscine (Belladonna) Hyoscyamine (Belladon- na) Hyoscyamus Hypericum Iberis amara Ichthyol Ignatia amara Indian licorice (Jequirity) Indian tobacco (Lobelia) Indigo Indigo, wild (Baptisia) Inula Infusions Iodine Iodoformum Ipecacuanha Iridium 248 Index. Irisin (Iris) Iris versicolor Iron (Ferrum) Jaborandi (Pilocarpus) Jacaranda Jalapa Jambul Jequirity Jimson weed (Stramo- nium) Johambin (Yohimbinum) Juglans Juniperus Kali (Potassium) Kalmia Latifolia Kamala Kaolinum Kava-Kava Kino Kola Krameria Lachesis Lactucarium Lady's slipper (Cypripe- dium) Lapis albus Lappa Laurel (Kalmia) Laurocerasus Lead (Plumbum) Ledum palustre Leptandra Leptandrin (Leptandra) Lettuce (Lactucarium) Life root (Senecio) Lilium tigrinum Lily of the valley (Con- vallaria) Linimentum Lippia mexicana Liquores Lithii Lobelia Logwood (Haematoxy- lon) Lungwort (Sticta) Lupulinum (Humulus) Lupulus (Humulus) Lycopodium Lycopus Lysol (Creolin) Macrotys (Cimicifuga) Madar bark (Calotropis) Magnesia salts (Magne- sium) Magnesium Male fern (Aspidium) Mallotus (Kamala) Maltum Manganese Manna Mannite (Manna) Marigold (Calendula) Marrubium Marsh tea (Ledum) Mass Matico Matricaria (Chamomilla) Index. 249 May apple (Podophyllum) Mentha piperta (Pepper- mint) Mentha viridis Menthol Mercury Mescale button (Anhalo- nium) Methylene blue (Methyl- thioninae hyd.) Methylthioninae hydro- chloridum Mezereum Mistletoe Mitchella repens Morphina (Opium) Muscarine (Agaricus) Moschus Mullein (Verbascum) Mullein Oil Muscarine (Agaricus) Musk (Moschus) Musk root (Sumbul) Mustard (Sinapis) Myrica Myristica Myrrha Myrtle (Myrtus) Myrtus Napthalenum Natrum (Sodium) Nettle (Urtica) New Jersey tea (Ceano- thus) Nickel bromide Nicotiana tabacum Nitroglycerine Nutmeg (Myristica) Nux vomica Oat (Avena) Oenanthe (Cicuta) Oenanthe crocata Ohio buckeye (Aesculus) Oils Ointments (Unguentum) Oleates Oleum (Oils) Onion (Allium) Opium Opuntia (Cactus) Oregon grape (Berberis) Organo-therapy, Homoeo- pathic (Lachesis) Oxgall Paeonia Palladium Pale Catechu (Gambir) Panax (Ginseng) Pancreatinum Papain (Papaya) Papaya Papoid (Papaya) Paraldehydum Pareira Parsley (Petroselinum) Parsley, fools (Aethusa) Parthenium 250 Index. Partridge berry (Mitch- ella) Passiflora Passion flower (Passiflora) Peach (Amygdalus per- sica) Pelletierinae (Granatum) Penthorum Pepo (Cucurbita) Peppermint Pepsinum Peru, balsam (Balsam Peru) Petroselinum Pheasant's eye (Adonis) Phenacetin Phenol Phenylis salicylas (Salol) Phosphorus Physostigma Physostigmine (Eserine) Phytolacca Pilocarpine (Pilocarpus) Pilocarpus Pills (Pilulae) Pilulae Pineapple Pink root (Spigelia) Piper augustifoliurri (Ma- tico) Piperazine Piper methysticum (Kava- kava) Piperina Pipsissewa (Chimaphila) Pitcher plant (Sarracenia) Pix liquida Plantago Plantain (Plantago) Plasters Platina Pleurisy root (Asclepias) Plumbum Podophyllum Poison hemlock (Conium) Poison ivy (Rhus tox.) Poke root (Phytolacca) Polygonum Polymnia Polytrichum Pomegranate (Granatum) Populus candicans Potassium salts Powders (Pulveres) Premna (Tonga) Prickly ash (Xanthoxy- lum) Prunus virginiana Ptelea trifoliata Pulsatilla Pulveres Pussy willow (Salix ni- gra) Quassia Quebracho Queen's root (Stillingia) Quercus Quillaja Index. 251 Quinina Ranunculus bulbosus Rattlesnake bean (Ce- dron) Red clover (Trifolium) Red onion (Allium) Resorcinol Rhamnus purshiana (Cas- cara) Rhatany (Krameria) Rheum Rhododendron Rhubarb (Rheum) Rhus aromatica Rhus Glabra Rhus toxicodendron Ribwort (Plantago) Ricinus Rosin weed (Grindelia) Rubus Rumex Sabadilla Sabal Sabina Saccharin Saffron Sage (Salvia) Salicinum Salix nigra aments Salol "Salts" Salvia Sambucus canadensis Sambucus nigra Sanguinaria Santoninum Sapium (Yerba de la fle- cha) Sarracenia Sarsaparilla Sassafras Saw palmetto (Sabal) Savin (Sabina) Scammonium Scilla Scoparius Scopolamin (Belladonna) Scutellaria Senecio Senega Senna Sepia Serpentaria Shepherd's purse (Thlas- pi) Silica (Silicea) Silicea Silico-fluoride of calcium (Lapis albus) Silver (Argenti) Sinapis Skull-cap (Scutellaria) Smart weed (Polygonum) Snow rose (Rhododen- dron) Soap bark (Quillaja) Sodium salts Solanum 252 Index. Solidago Sparteinae sulphas Spearmint (Mentha viri- dis) Spigelia Spirits Sponge, roasted (Spongia) Spongia tosta Spurge olive (Mezereum) Spurred rye (Ergot) Squaw vine (Mitchella) Squill (Scilla) Stannum Staphisagria Star grass (Aletris) Starwort (Helonias) Stavesacre (Staphisagria) Sticta pulmonaria Stigmata maydis (Zea) Stillingia St. John's wort (Hyperi- cum) Stone root (Collinsonia) Stramonium Strontii bromidum Strophanthinum Strophanthus Strychnina Sulphomethylmethanum (Trional) Sulphonmethanum (Sulfo- nal) Sulfonal Sulphur Sumach (Ailanthus and rhus) Sumbul Sundew (Drosera) Sweet clover (Melilotus) Syrups Syzygium (Jambul) Tag alder (Alnus) Tanacetum Tansy (Tanacetum) Tar (Pix liquida) Taraxacum Tartar emetic (Antimonii et P. T.) Terebenum Terebinthinae Terpini hydras Theobromine Thlaspi bursa pastoris Thornapple (Stramonium) Thuja Thymol Thymolis iodidum (Aris- tol) Tiger lily (Lilium tigri- num) Tin (Stannum) Tobacco (Nicotiana) Tomato (Solanum) Tonga Tongo Tonka (Tongo) Trailing arbutus (Epi- gaea) Indkx. 253 Trifolium Trional Triticum Triturationes Trochisci Tuberculin Turnera (Damiana) Turpentine (Terebinthi- nae) Unguentum Upas Uranium nitrate Urethane Urotropin (Formalde- hyde) Urtica Ustilago Uva ursi Valeriana Veratrina Veratrum album Veratrum (U. S. P.) Veratrum viride Verbascum Verbena Vervain (Verbena) Viburnum opulus Viburnum prunifolium Vinum Viola Violet (Viola) Viper virus (Lachesis) Virginia snakeroot (Ser- pentaria) Virginia stonecrop (Pen- thorum) Viscum album (Mistletoe) Water ash (Ptelea) Wahoo (Eunonymus) Water dropwort (Oenan- the) Waters, medicated White arsenic (Arseni trioxidum White hellebore (Vera- trum album) White oak (Quercus) Wild cherry (Prunus virg.) Wild hop (Bryonia) Wild indigo (Baptisia) Wild yam (Dioscorea) Willow-buds (Salix nigra aments) Wind flower (Pulsatilla) Wintergreen (Gaultheria) Witch hazel (Hamameli- dis) Xanthium Xanthoxylum Yam, wild (Dioscorea) Yellow melilot (Melilo- tus) Yerba de la flecha Yerba santa Yohimbinum Zea Zinc Salts Zingiber Qh >, -,v <& '