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HANDBOOK 
 
 OF 
 
 MATERIA MEDICA, PHARMACY, AND 
 THERAPEUTICS. 
 
 POTTER. 
 
NOTICES'OF THE PRESS 
 
 OF PREVIOUS EDITIONS OF 
 
 DR. POTTER'S HANDBOOK 
 
 From the Medical Record: 
 
 "This is an old and valued friend which needs no commendation, much less an 
 introduction. It ought to be in the library of every physician and student. It is the 
 most convenient and most concise work on therapeutics and materia medica in the English 
 language, and is at the same time thoroughly reliable. Though necessarily largely a 
 compilation, nevertheless there is much that is original, the author being one of the most 
 prominent of American therapeutists." 
 
 From the American Journal of the Medical Sciences : 
 
 " The author has very skilfully steered his course between the pessimism that marks 
 a system of therapeutics based solely on the results given by experiments and observations 
 in the chemical and physiological laboratories, and the optimism of hasty empirical general- 
 izations upon meagre clinical data, and upon this we consider that the greatest claim can 
 be made, that this book is a safe one for the junior practitioner. . . . The author, 
 then, has fully attained the purpose which he set before him at the commencement." 
 
 From the Lancet, London, England : 
 
 "The third part is entitled 'Special Therapeutics,' and in its compilation a very 
 large number of the works of accepted authorities have been laid under contribution. It 
 forms a very complete and reliable index of treatment which will be a godsend to many 
 a busy practitioner who has no time to wade through the copious literature that accom- 
 panies each new drug into the market." 
 
 From the Australasian Medical Gazette : 
 
 "It is a monument of persistent industry. There is no better book in the 
 English language for the student and practitioner. . . . Dr. Potter's book is thor- 
 oughly practical, and Part III contains an enormous amount of information, for which the 
 student ought to be grateful. . . . The chapter on prescriptions is especially well 
 done, in fact the best we have seen." 
 
 From the Journal of the American Medical Association : 
 
 " Dr. Potter has embodied many original ideas in the preparation of this work, 
 some, if not all of which will prove of very great value to the reader." 
 
 From the Therapeutic Gazette : 
 
 " The author has aimed to embrace in a single volume the essentials of practical 
 materia medica and therapeutics, and has produced a book small enough for easy carriage 
 and easy reference, large enough to contain a carefully-digested, but full, clear, and well- 
 arranged mass of information. No new remedy of any acknowledged value is omitted 
 from this list. Under each the section on physiological action and therapeutics has been 
 written with care. ... In the enumeration of drugs suited to different disorders a 
 very successful effort at discrimination has been made, both in the stage of disease and in 
 the cases peculiarly suited to the remedy. It is no mere list of diseases followed by a 
 catalogue of drugs, but is a digest of modern therapeutics, and as such will prove of 
 immense use to its possessor." 
 
 From the New York Medical Joiirnal : 
 
 " Dr. Potter's Handbook will find a place, and a very important one, in our colleges 
 and the libraries of our practitioners. It contains almost everything that can be found in 
 the larger works in a more concise form and brought up to a rather more recent date. 
 . Under the head of prescription writing considerable attention is paid to the sub- 
 ject of incompatibilities, and the student will here find many valuable hints for his guidance 
 in this difficult subject. Besides this, there are, under the head of special therapeutics, very 
 many formulas for the treatment of particular diseases and abnormal conditions, arranged 
 alphabetically for easy reference. This will be especially valuable to young practitioners, 
 and will frequently save the trouble of looking through large works and monographs for 
 suitable formulae in the treatment of special cases. This department is fuller in this 
 book than in any with which we are acquainted." 
 
 *£* The price of this book is $5.00, net, in cloth binding, or $6.00, net, in full 
 leather ; for which it will be delivered free to any address. Thumb Index in each copy. 
 
A HANDBOOK 
 
 OF 
 
 MATERIA MEDICA, PHARMACY 
 AND THERAPEUTICS 
 
 INCLUDING THE 
 
 PHYSIOLOGICAL ACTION OF DRUGS, THE SPECIAL THERA- 
 PEUTICS OF DISEASE, OFFICIAL AND PRACTICAL 
 PHARMACY, AND MINUTE DIRECTIONS FOR 
 PRESCRIPTION WRITING: 
 
 BY 
 
 SAM'L O. L. POTTER, A.M., M.D., M.R.C.P. Lond., 
 
 FORMERLY PROFESSOR OF THE PRINCIPLES AND PRACTICE OF MEDICINE IN THE COOPER MEDICAL 
 
 COLLEGE OF SAN FRANCISCO; AUTHOR OF THE " QUIZ-COMPENDS OF ANATOMY AND 
 
 MATERIA MEDICA," " AN INDEX OF COMPARATIVE THERAPEUTICS," SEVERAL 
 
 ARTICLES IN FOSTER'S " PRACTICAL THERAPEUTICS," AND " SPEECH 
 
 AND ITS DEFECTS"; MAJOR AND SURGEON OF 
 
 VOLUNTEERS, U. S. ARMY. 
 
 IFUntb JEtotion, 1Rex>isefc> anfc> j£nlaroefc< 
 
 PHILADELPHIA: 
 
 P. BLAKISTON'S SON & CO 
 
 IOI2 WALNUT STREET. 
 I902. 
 
THE LIBRARY OF 
 CONGRESS, 
 
 Two Cop»i£6 Received 
 
 2 1902 
 
 Copyright entry 
 
 CLASS <fo/XXa No. 
 
 COPY R. 
 
 V- Se <V 
 
 f 
 
 
 Copyright, 1 902, 
 By P. BLAKISTON'S SON & CO. 
 
 Press of Wm. F. Fell & Co., 
 
 I220-24 SANSOM ST., 
 
 PHILADELPHIA. 
 
-gift 
 
 $*- 
 
 TO MY WIFE 
 
 WHOSE DEVOTED CARE AND 
 
 PATIENT ENCOURAGEMENT, 
 
 DURING THE PAST TWENTY-THREE YEARS, 
 
 HAVE SUPPORTED THE AUTHOR 
 
 IN EVERY EXIGENCY OF 
 
 HIS PROFESSIONAL LIFE. 
 
PREFACE TO THE NINTH EDITION 
 
 The revision for the eighth edition of this book was commenced at 
 Manila, Philippine Islands, while the author was serving as Attending 
 Surgeon at the Headquarters of the Department of the Pacific and 
 Eighth Army Corps. The present edition contains material gathered 
 from the writer's experience in active professional practice in a tropical 
 climate, among soldiers and civilians, men, women, and children, dur- 
 ing a period of over three years' duration. 
 
 In the section on Materia Medica thirteen articles were rewritten and 
 forty new articles were inserted. The rewritten ones are those on Adre- 
 nal Extract, Argentum, Cinchona, Coca, Coffea, Digitalis, Dulcin, Ergot, 
 Ferrum, Ipecacuanha, Myrrha, Saccharinum and Veratrum Viride. The 
 new matter includes paragraphs on Actol, Airol, Argentamin, Argentol, 
 Argonin, Chinosol, Creosotal, Dionine, Dormiol, Equinine, Eucaine, 
 Eudoxin, Glycerophosphates, Heroine, Holocaine, Iodomuth, Iodothyrin, 
 Itrol, Largin, Nirvanin, Nosophen, Orphol, Orthoform, Passiflora, Pello- 
 tine, Peronine, Phloridzin, Piperidin Protargol, Tuberculin-R, Urotro- 
 pin, Xeroform and Zinc Stearate. 
 
 In the section on Therapeutics new articles were inserted on Local 
 Anesthesia, Beriberi, Dhobie Itch, Tropical Fevers, Heat-stroke, Hemo- 
 globinuric Fever, Lymphadenoma, Miliaria, Bubonic Plague, Sprue, 
 Tinea Imbricata, Tinea Versicolor and Toxemia. Thirty-two articles in 
 this portion of the book were rewritten, including those on Amenorrhea, 
 Asthma, Boils, Cholera, Diabetes, Dysentery, Dyspnea, Eczema, Gonor- 
 rhea, Gout, Insomnia, Leprosy, Leucocythemia, Lichen, Myxedema, 
 Pemphigus, Phthisis, Pneumonia, Remittent Fever, Typhoid Fever, Sep- 
 ticemia, Shock, Suppuration, Ulcers, Uremia, Urinary Disorders, Variola 
 and Wounds. The text of many other articles has been expanded by 
 the incorporation of more than three hundred items from current medi- 
 cal literature and from the author's personal experience in practice. 
 The articles on Poisoning, on Temperature in Disease, and on the Clini- 
 cal Examination of the Urine have been transferred to this part of the 
 book from the Appendix, in the belief that they will be more frequently 
 consulted when found in their alphabetical order in the section on 
 Therapeutics. 
 
 The text throughout the book has again been subjected to a thorough 
 and critical revision, has been largely rewritten, and has been expanded 
 
 vii 
 
Vlll PREFACE. 
 
 by the introduction of much new matter. The latter has to some extent 
 taken the place of material considered obsolete or comparatively unim- 
 portant, so that the increased size of the book over the seventh edition 
 is only twenty pages. 
 
 The favor with which this book has been received during the last 
 fourteen years by medical teachers, students and practitioners is very 
 gratifying to the author, and will stimulate him to renewed effort to the 
 end that his work may continue to maintain its position in professional 
 esteem and confidence. 
 
 Samuel O. L. Potter. 
 
 Manila, Philippine Islands. 
 
 EXTRACTS FROM THE 
 PREFACE TO THE FIRST EDITION 
 
 The author's intention has been to produce a book which would em- 
 brace in a single volume the Essentials of practical Materia Medica and 
 Therapeutics, treating of each subject in as concise phraseology as possible 
 consistent with the delineation of every important feature. He has also 
 endeavored to formulate such minute and definite directions for the fram- 
 ing of Prescriptions as might elucidate what to many is a very difficult 
 problem. Furthermore, he has tried to present as much information 
 upon the subject of Pharmacy as every physician should possess, in order 
 to handle the implements of his profession with confidence and to direct 
 their use by others with pharmaceutical accuracy. 
 
 The complete fulfilment of these aims would be realized if the book 
 should take rank as a working companion to the advanced student and 
 the junior practitioner, and be deemed by them a reliable guide through 
 the forest of observations and experiments on drug actions and uses, which 
 make progress slow for the already over-burdened mind, when ploughing 
 through the more exhaustive and exhausting text-books. 
 
 Although this book is essentially a compilation, as all books of its class 
 must be, there will be found iri its pages much original matter derived from 
 the writer's own experience in professional life. The arrangement of the 
 
PREFACE. IX 
 
 matter will be found to be in some respects unique. After full consider- 
 ation of the many arrangements of the Materia Medica in vogue, a modified 
 alphabetical plan was adopted, by which the advantages of the alphabetical 
 order might be retained, while permitting the grouping together of agents 
 which are closely related, physiologically and therapeutically, under the 
 title of the principal member of the class — the chief, as it were, of that 
 particular clan. Thus, under the title Amyl Nitris will be found mention 
 also of the Ethyl, Sodium and Potassium Nitrites, and their congener Nitro- 
 Glycerin, all of which are closely allied to the first-named and to each 
 other, in respect of their actions and uses. A very elaborate section on 
 Drug Classification is placed before the Materia Medica, in order to 
 supplement such deficiencies in grouping as are inevitable in an alpha- 
 betical arrangement. 
 
 In detailing the characteristics of an important drug, its physical prop- 
 erties and chemical constituents are first briefly enumerated, then its 
 preparations are described in the official language of the pharmacopoeia, 
 usually somewhat abbreviated ; any important unofficial preparations are 
 also noted, and all the compounds into which it enters are enumerated. 
 Next the physiological action is taken up, its characteristic features being 
 first described ; then the actions resulting from an ordinary medicinal 
 dose, next those produced by small doses continued, and finally those from 
 a toxic dose. These are followed by a brief account of its antagonists, 
 antidotes and incompatibles, if any, and a concise summary of its thera- 
 peutical applications closes the article ; — the whole presenting, it is hoped, 
 a clearly defined word-picture of the drug under consideration. Every 
 article and preparation comprised in the last edition of the U. S. Pharma- 
 copoeia is fully noticed, while all the prominent unofficial agents receive 
 such mention as their respective importance seems to demand. 
 
 The second part of the book is devoted to Pharmacy, and has been 
 written from the standpoint of a conviction that many young practitioners 
 would gladly dispense their own medicines, if provided with a few prac- 
 tical directions on the subject; thereby saving many a dollar from the 
 drugstore, preventing in their own practices at least the "renewals" 
 which constitute so bad a feature of modern pharmaceutics, and gaining 
 for themselves a practical acquaintance with their professional weapons 
 which cannot but make them better physicians and more accurate pre- 
 scribes. In this section of the book Prescription Writing receives full 
 consideration, and many standard formulae are given as samples of pre- 
 scriptions of each kind in extemporaneous use. 
 
 In the third part the subject of Special Therapeutics is treated of elab- 
 orately, in the form of an alphabetically arranged Index to the treat- 
 ment of diseases, as laid down by the most recent authorities. Every 
 indication for the use of a drus: is referred to its author bv his name or 
 
X PREFACE. 
 
 initial, and to the most prominent articles are appended a few selected 
 formulae, to serve as guides to the neophyte in prescribing. 
 
 Nearly all the regular text-books have been laid under contribution in 
 the preparation of the book, but especial use has been made of the works 
 of Brunton, Ringer, Wood, Phillips, Waring and Bartholow, in their 
 latest editions ; as well as of the writer's verbatim notes of two courses of 
 didactic and clinical lectures delivered by Professors Da Costa and Bartho- 
 low in the Jefferson Medical College and Hospital and in the auditorium 
 of the Pennsylvania Hospital. On page 603 will be found a list of the 
 authorities referred to by initials in the section on Special Therapeutics. 
 
 The Appendix contains numerous Tables, comprising diagnostic hints, 
 Latin terms and phrases, formulae for hypodermic use, metric equivalents, 
 and specific gravities and volumes ; also Formulae representing the most 
 noted patent medicines. 
 
 The Index has received special attention, from a conviction that, if well 
 made, it is the best part of a good book. Every title, synonym and other 
 reference of importance is included therein, double and treble entries 
 being made in every instance which seemed to require such repetition. 
 
 The term "officinal," as applied to drugs recognized by the pharma- 
 copoeia, has been discarded, the word " official " being used instead ; for 
 the simple reason that the idea to be conveyed is expressed more correctly 
 by the latter term than by the former one. When none but official drugs 
 and preparations were kept in the officina or drug store, it was eminently 
 proper to call them " officinal," but inasmuch as this class does not now- 
 adays constitute much over one-fourth part of the officinal stock, it is a 
 wilful debasement of our professional weapons, as well as an inexcusable 
 misnomer, to apply the shop-title to them any longer. 
 
 Cooper Medical College, San Francisco, 
 December, 1886. 
 
TABLE OF CONTENTS. 
 
 PAGE 
 
 INTRODUCTION, . . 17 
 
 Pharmacy, 17 
 
 Materia Medica, , 17 
 
 Therapeutics, 17 
 
 Empirical Therapeutics, 18 
 
 Rational Therapeutics, 19 
 
 Constituents of Organic Drugs, 21 
 
 Active Principles, 21 
 
 Carbohydrates, 21 
 
 Alkaloids, 22 
 
 Glucosides, 23 
 
 Neutral Principles, 24 
 
 Organic Acids, 25 
 
 Coloring Matters, 25 
 
 Resins, 25 
 
 Fixed Oils and Fats, 26 
 
 Waxes, 26 
 
 Volatile or Essential Oils, 27 
 
 Camphors, 27 
 
 Miscellaneous Compounds, 27 
 
 Albuminoids or Protein Bodies, 28 
 
 Ferments, 28 
 
 Classification of Medicines (alphabetically arranged), 29-67 
 
 Administration of Medicines, 67 
 
 Transfusion, 69 
 
 The Hypodermic Method, 69 
 
 Dosage of Medicines, 72 
 
 Average Adult Doses of Official Preparations 73 
 
 PART I.— MATERIA MEDICA AND THERAPEUTICS 75 
 
 Aurus to Zingiber (alphabetically arranged), 75~53° 
 
 PART II.— PHARMACY AND PRESCRIPTION WRITING, . . . 531 
 
 Pharmacopoeias and Dispensatories, 531 
 
 Weights and Measures, 532 
 
 Metric System, 534 
 
 Approximate or Domestic Measures, 535 
 
 Specific Gravity and Specific Volume, 53^ 
 
 xi 
 
Xll TABLE OF CONTENTS. 
 
 PAGE 
 
 Prescriptions, • . . . 536 
 
 Analysis of a Prescription, 537 
 
 Procedure in Writing a Prescription, 537 
 
 Use of Latin in Prescriptions, 541 
 
 Principles of Combination, 542 
 
 Metric Prescriptions, 544 
 
 Abbreviations, 545 
 
 Renewals of Prescriptions, 546 
 
 Prescription Blanks, 548 
 
 Incompatibility, 548 
 
 Chemical Incompatibility, 54S 
 
 Pharmaceutical Incompatibility, 551 
 
 Therapeutical Incompatibility, 552 
 
 Rules for the Avoidance of the Dangers of Incompatibility, 552 
 
 Extemporaneous Pharmacy, 554 
 
 Filling a Prescription, 554 
 
 Stock Solutions, 556 
 
 Rules for the Pharmaceutical Student, 556 
 
 Official Pharmacy, 556 
 
 Official Operations, 556 
 
 Pharmaceutical Operations, 557 
 
 Preparations, 565 
 
 Official Preparations, 565 
 
 Pharmaceutical Preparations, 565 
 
 Aceta to Vina, in alphabetical order, 565-602 
 
 Excipients for Emulsions, 577 
 
 Excipients for Mixtures, 582 
 
 Excipients for Pills, 587 
 
 PART III.— SPECIAL THERAPEUTICS, 603 
 
 References and Bibliography, 603 
 
 Applied Therapeutics, 604 
 
 Abasia to Yellow Fever, 604-882 
 
 Poisoning, 803 
 
 General Principles of Treatment, 803 
 
 Antagonists, 804 
 
 Antidotes, 804 
 
 Poisons, their Antidotes and Antagonists, 808 
 
 Temperature in Disease, 850 
 
 Average Normal Temperature, 850 
 
 Clinical Thermometry, 850 
 
 Abnormal Temperature, 851 
 
 Temperature in Phthisis, 851 
 
 Temperature in Typhoid Fever, 851 
 
 Temperature in Scarlatina, 851 
 
 Temperature in Measles, 852 
 
 Temperature in Diphtheria, 852 
 
 Co-relation of Pulse and Temperature, 852 
 
TABLE OF CONTENTS. Xlll 
 
 PAGE 
 
 Clinical Examination of the Urine, 868 
 
 Color, Specific Gravity, etc., 868 
 
 Tests for Albumin, 868 
 
 Tests for Bile, Chlorides, Sugar, etc., 869 
 
 Mucus and Pus, 870 
 
 Deposits in Urine, 870 
 
 Necessary Apparatus, 870 
 
 APPENDIX, 883 
 
 Latin Phrases, Contractions, etc., used in Prescriptions, .... 883 
 
 Latin Numerals, . 895 
 
 Latin Verbs, Participles, Prepositions," etc., 896 
 
 Genitive Case-endings, 896 
 
 Hypodermic Formul.-e, 897 
 
 Patent Medicines, 899 
 
 Tables of Differential Diagnosis. 
 
 Forms of Bright's Disease, 903 
 
 Cancer, 904 
 
 Carditis, Endo- and Peri-, 904 
 
 Cerebral Concussion and Compression, 904 
 
 Chancre and Chancroid, 904 
 
 Cholera, 905 
 
 Croup and Diphtheria, 905 
 
 Epilepsy and Hysteria, 905 
 
 Gout and Rheumatism, 905 
 
 Pleurisy and Pneumonia, . , 906 
 
 Scarlet Fever, Measles and Smallpox, 906 
 
 Typhus and Typhoid Fevers, 907 
 
 Vomiting, Cerebral and Gastric, 907 
 
 Yellow Fever and Bilious Remittent Fever, 907 
 
 Tables. 
 
 Table of Specific Gravities and Volumes, 908 
 
 Chlorodyne, A Comparison of Ten Formulae therefor, 909 
 
 Table of Drops in and Weights of a Fluidrachm, 910 
 
 Table of Weights and Measures, 910 
 
 Table for Metric Conversions, 911 
 
 Table of Equivalent Weights and Measures, Inside of Cover. 
 
 Table of Prescription Doses and Quantities, Inside of Cover. 
 
 INDEX, 913 
 
EXPLANATION. 
 
 Numerals unqualified, under the subtitles Preparations in Part I, denote grammes for 
 solids and cubic centimeters for liquids. 
 
 For Signs and Abbreviations used, see pages 533 to 545- 
 
 XIV 
 
INTRODUCTION 
 
 Drugs (drugan, to dry), — is a term which was formerly applied to dried 
 medicinal plants, and is still employed by writers and others in that sense. 
 By extension, however, it has been made to cover all material substances 
 used for the treatment of disease, including remedial agents from the 
 animal and mineral kingdoms as well as those belonging to the vegetable 
 kingdom. 
 
 Pharmacology (pdpfteaov, a drug, X6yo^, a discourse), — is the science 
 which treats of drugs and therefore properly embraces in its scope all of 
 materia medica and therapeutics relating to drugs. By some writers this 
 term is employed in a more restricted sense, including only the physio- 
 logical action of drugs, a subject which is more correctly designated by 
 the word Pharmacodynamics (see below). 
 
 Pharmacy is the name of the art which supplements the science of 
 pharmacology, namely — the art of preparing drugs according to the re- 
 quirements of the pharmacologist and of dispensing them on the pre- 
 scriptions of the therapeutist. It includes a thorough knowledge of the 
 materia medica, an acquaintance with the theories and manipulations of 
 chemistry and an intimate practical experience in many operations pecu- 
 liar to itself. 
 
 Materia Medica is the branch of Pharmacology which treats of the 
 substances used as medicines and describes their origin, composition, phys- 
 ical characteristics, chemical properties, modes of preparation and admin- 
 istration, also their physiological and toxicological actions. Two of its 
 divisions are — 
 
 Pharmacodynamics (oap/uanov, a drug, dvvauic, power), which means the discus- 
 sion of the physiological action of drugs, their modifying power upon the normal physio- 
 logical activity of the human organism. 
 
 Toxicology ( to^lkov, a poison, /.6}oc, a discourse), describes the effects of drugs ad- 
 ministered in poisonous doses, and treats of the antagonists and antidotes by which their 
 effects may be neutralized or the poisons themselves rendered innocuous and removed 
 from the organism. 
 
 Therapeutics (Oepaneueiv, to attend upon), comprises all the science 
 and art of healing, and includes the use of medicines and all other agents 
 
 2 I 7 
 
1 8 INTRODUCTION. 
 
 and measures which are known to alleviate or cure disease. The opera- 
 tions of Nature herself are properly embraced in the general term Thera- 
 peutics, which may be subdivided as follows: — 
 
 Natural Therapeutics, includes the operations of the Vis Medicatrix 
 Natures, the healing power of Nature, — those modes and processes of heal- 
 ing which occur independently of art and tend to the spontaneous decline 
 and cure of disease. There is no scientific dogma better established than 
 this, that the living organism is in itself adequate to the cure of all its 
 curable disorders. This natural law sustains the medical skeptic in his 
 infidelity as to the value of medicines, enables the homeopathist to report 
 his sugar-cures, and helps all physicians out of more close places in prac- 
 tice than they are generally willing to acknowledge. This part of the 
 subject is taught only casually in the schools, in connection with pathology 
 and the other subjects embraced in the chair of Principles and Practice 
 of Medicine, but it deserves a special chair and more systematic treat- 
 ment than it receives. 
 
 Applied Therapeutics embraces the application by Art of agents for- 
 eign to the living organism, for the purpose of aiding Nature to restore 
 the body to a healthy condition. This division is the portion of the 
 subject which is taught separately and systematically in the schools, and 
 therefore is alone considered in the following pages. 
 
 Other divisions of the general subject employed in professional litera- 
 ture and conversation are those entitled Empirical Therapeutics and 
 Rational Therapeutics. 
 
 Empirical Therapeutics is a term applied to the use of medicinal 
 or other therapeutical agents for the sole reason that they have been tried 
 previously with successful results in cases apparently identical with the 
 one under treatment. By those who advocate this method it is styled 
 the Therapeutics of Experience, and is claimed to be an accumulation 
 of means of combating disease simply by observation and experiment 
 independently of physio-pathological reasoning (Hartshorne). It was 
 necessarily the original method in therapeutics, has conferred many rich 
 gifts upon medical science, and has been advocated by many great physi- 
 cians, its latest and ablest expounder being the eminent and lamented 
 Niemeyer. 
 
 The use of Opium to relieve pain, of Cinchona for malarial fevers, of Colchicum in 
 gout, of Potassium Iodide in syphilis, of the Bromides in epilepsy, and of Cod-liver Oil 
 in phthisis, are examples of the empirical use of remedies. But, after all has been said 
 for it that can be said, the fact remains that it is essentially an unscientific method, a 
 mere elaboration of the prevailing popular habit of recommending Mrs. A. to use pepper 
 tea, because it cured Mrs. B. of " the very same trouble." Permitted to reign supreme, 
 it would be destructive to all exactness in therapeutical progress. The so-called 
 " experience " of one observer is too often overbalanced by the experience of another 
 equally competent and trustworthy ; and as few are encouraged to record their failures 
 with remedies, there can be no scientific comparison of the failures with the reported 
 
INTRODUCTION. I9 
 
 successes. For this reason empirical methods would tend to a minimum degree of 
 accuracy in a science which, in the very nature of things, can never be an exact one ; — 
 though undoubtedly such methods will always prevail to some extent. 
 
 Rational Therapeutics means the use of remedies for reasons based 
 on a knowledge of the pathological conditions present in the subject and 
 the physiological action of the agent employed. This method is the very 
 antithesis of empiricism, and has been the leading idea in every revolt 
 against empirical therapeutics in the past. Humoralism, Chemicism, 
 Solidism, Stimulism, Galenism in the 2d century, Paracelcism in the 16th, 
 and Hahnemannism in the 19th, all originated in efforts to find a more 
 rational system of administering medicines than the prevailing empiricism 
 of the day. 
 
 The illustrious Albrecht von Haller, the father of Physiology and the 
 author of the doctrine of Irritability, was the real originator of modern 
 physiological therapeutics. In the preface to his Swiss Pharmacopoeia 
 {circa A.D. 1755), occur the following remarkable directions, — the first 
 recorded of their kind ; — 
 
 " Nempe primum in corpore sano medela tentanda est, sine peregrina ulla miscella ; 
 odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et ad omnes quse inde 
 contingunt affectiones, quis pulsus, quis calor, quse respiratio, qusenam excretiones 
 attendendum. Inde adductum phsenominorum in sano obviorum, transeas ad experi- 
 menta in corpore segroto." 
 
 " In the first place the remedy is to be tried on the healthy body, without any foreign 
 substance mixed with it ; having been examined as to its odor and taste, a small dose is to 
 be taken, and the attention directed to all effects which thereupon occur ; such as upon the 
 pulse, the temperature, the respiration, the excretions. Having thereby adduced their 
 obvious phenomena in health, you may pass on to experiment upon the sick body.'" 
 
 Forty or more years after these rules were laid down ex cathedra by 
 Haller, the central idea therein was incorporated as one of the main 
 pillars into a medical edifice then being erected in Germany. In the 
 course of construction this pillar became so hidden beneath a super- 
 structure of palpable absurdities, that the medical profession, in its 
 anxiety to steer clear of the whole mass, almost forgot the corner-stone 
 of truth appropriated from the teachings of one of its own greatest 
 teachers. While, however, the mass of the medical profession, blinded 
 by prejudice, turned away from everything which savored of drug- 
 experiment, a few physicians were quietly working on the lines of Haller's 
 dogma that drug-proving is the only true basis of drug-using. As a result 
 of their labors the present generation sees the development of an idea, 
 announced nearly 140 years ago, but now inspiring the minds of teachers 
 and students all over the civilized world. Medical colleges are recog- 
 nizing physiological drug-experimentation as a part of their regular cur- 
 ricula; laboratories are fitted up in many of the schools with costly 
 instruments of precision, for the more exact prosecution of this study ; 
 
20 INTRODUCTION. 
 
 and under the direction of such men as Wood, Ringer, Murrell, Brun- 
 ton, Hildebrandt, Fraser, Binz, Liebermeister, Husemann, Schmiedeberg, 
 etc., systematic researches are being conducted upon animals to ascertain 
 the physiological action of every agent hitherto used in medicine. The 
 alkaloids and other active principles of vegetable drugs, together with 
 the numerous synthetic compounds which chemistry is giving to medi- 
 cine, are subjected to the same rigid experimentation. The medical 
 press of every civilized country is filled with the results of these labors, 
 and no medical student is permitted to pass the graduating ordeal until 
 he has mastered the essential characteristics of the physiological action 
 of the important medicaments so far as established. What has hitherto 
 been the conviction of but a few, is daily growing into a fixed canon of 
 professional belief, that physiological experimentation with drugs must 
 be the basis of their therapeutical employment, and that all real advance 
 towards the establishment of therapeutics as a science, must be made 
 upon the lines laid down by Haller, namely, drug-proving upon the 
 healthy human organism. Still, in the words of Brown-Sequard, 
 " Therapeutics will cease to be empirical, only when this last kind of 
 knowledge shall be fully obtained; " but its fulness will never be fully 
 realized unless the results have been thoroughly considered with regard 
 to the differences due to the action of drugs in different doses on the 
 human organism in health and disease. 
 
 A thoroughly-prepared materia medica of half-a-dozen standard drugs, 
 such as Aconite, Arsenic, Belladonna, Mercury, Opium and Quinine, 
 based upon their actions and uses in different doses and under different 
 states of the organism, would be of more real value to the physician who 
 wishes to do his work accurately and with his eyes open, than all the 
 contents of the dispensatories, plus the entire literature of the "new 
 remedies,' 1 and every symptom in the ten quarto volumes of the largely 
 discredited and partly repudiated homeopathic materia medica. If 
 medical students would devote but one month of their annual college 
 vacation to the personal investigation of some one feature of the action 
 of some one drug, under such safe-guards against error as would secure 
 the acceptance of the resulting observations, a mine of therapeutic gold 
 would soon yield its solid truth to eager eyes. Formally laid down by 
 Haller in 1755, cultivated to some extent by Alexander in 1768, Crumpe 
 in 1793, Thommassini, Curtis, etc., urged by John Hunter, Sir Thomas 
 Watson, Dr. King Chambers, and many other luminaries of the medical 
 profession, the scientifically guarded proving of drugs on the human 
 organism has lain, like the similar work of Jenner, neglected these many 
 years, waiting for another Koch to re-inaugurate the work. 
 
CONSTITUENTS OF ORGANIC DRUGS. 21 
 
 CONSTITUENTS OF ORGANIC DRUGS. 
 
 Drugs are derived from all the three kingdoms of nature. Those 
 which belong to the mineral kingdom may be termed inorganic drugs and 
 are resolved by chemical analysis directly into their ultimate principles, 
 the elementary bodies of which they are composed. Organic drugs are 
 those which are taken from the animal and vegetable kingdoms. They 
 are to some extent composed of inorganic materials (water, gases, salts, 
 etc.), but chiefly consist of organic compounds (proximate principles) 
 obtained by a proximate analysis. The further reduction of these proxi- 
 mate principles to their elementary constituents shows that Carbon plays 
 the leading role therein, associated with Hydrogen, Oxygen, Nitrogen 
 and other elements. The proximate principles of vegetable drugs may 
 be divided into insoluble and soluble groups ; the first containing those 
 which resist the action of ordinary solvents, the second including those 
 which may be dissolved in suitable menstrua and thereby separated from 
 those which are not soluble in a particular menstruum. 
 
 The Insoluble Constituents are substances which make up the cell-walls of vegetable 
 drugs, namely — Cellulin (Cellulose), Lignin and Sclerogen. They are extremely intract- 
 able to the action of solvents and yet find places in the materia medica under various 
 forms. Cellulin in the form of Cotton is used extensively by both the surgeon and the 
 pharmacist, and by the action of strong acids or alkalies thereon, there is obtained 
 Pyroxylin (Gun-cotton), which dissolved in ether makes Collodion. By the destructive 
 distillation of cellulin and lignin a large number of solid, liquid and gaseous products 
 are obtained, including acetic acid, methylic alcohol, phenol, creosote and tar. From 
 their natural decomposition result amber, coal, coal-tar and the many derivatives of the 
 latter substance. The Soluble Constituents include some principles which are medicinally 
 inert and also many active principles. 
 
 The Active Principles include carbohydrates, alkaloids, glucosides, 
 neutral principles, organic acids, resins, fixed oils and fats, waxes, volatile 
 oils, camphors, miscellaneous principles (phenols, ketones, etc.), protein 
 bodies (albuminoids) and ferments. Some of these are not proximate 
 principles from the strict chemical point of view, as they are not simple 
 bodies (e. g., fixed oils, fats, waxes, and many of the volatile oils), but for 
 the purposes of the materia medica it is convenient to so classify them. 
 Others are active chiefly as foods, though in some cases they are employed 
 as medicinal agents. For the methods of extracting the soluble princi- 
 ples from drugs see the articles entitled Maceration and Percolation, 
 in Part II of this book. 
 
 Carbohydrates are properly regarded as foods rather than as medi- 
 cines, yet many of them possess remedial qualities due to their neutral, 
 
22 CONSTITUENTS OF ORGANIC DRUGS. 
 
 bland, demulcent, lubricant, protective or soothing action. They in- 
 clude the Amyloids , cellulose, starch, dextrin, inulin, etc., the Sugars , as 
 glucose, levulose, lactose (milk sugar), maltose (malt sugar), saccharose 
 (cane sugar), etc., and the Gums and Pectin Bodies, as arabin, pectin, 
 bassorin, cerasin, etc. 
 
 Gums are not proximate principles but amorphous, transparent substances which are 
 widely disseminated in plants and yield Mucic ^4<r?'<^when treated with nitric acid. They 
 form sticky preparations with water and are precipitated by alcohol. Arabin is the main 
 constituent of soluble gums. Bassorin, which swells up in water, is one of the constitu- 
 ents of gum tragacanth, also of cherry and plum gums. [Compare the articles entitled 
 Acacia and Tragacantha, in Part I.] 
 
 Alkaloids (alkali, eI<5oc, resemblance) — are organic basic substances 
 existing in many plants, usually in combination with organic acids. They 
 readily combine with acids to form crystalline salts which are soluble in 
 water, the alkaloids themselves being almost insoluble therein though dis- 
 solving in alcohol. They are odorless, of more or less bitter taste, and 
 generally possess powerful physiological actions. They are easily decom- 
 posed by alkalies or alkaline carbonates, and are precipitated from their 
 solutions by several reagents, including iodine in a solution of potassium 
 iodide, potassio-mercuric iodide, auric chloride, also picric, tannic, phos- 
 pho-molybdic and phospho-tungstic acids. Their Latin names terminate 
 in — ina, their English name in — ine, as Morphina, Morphine. 
 
 Chemically the alkaloids may be regarded as derivatives of Ammonia (NH 3 ) or ammo- 
 nias in which one or more atoms of H are replaced by various radicles. They are 
 believed to be decomposition products of vegetable albumin occurring in the plant-cells 
 during the process of growth. They all contain the elements of C, H and N ; most of 
 them also contain O (amides), and usually occur as crystalline solids which (except Ber- 
 berine) are colorless. A few containing O occur as liquids, namely — Lobeline, Lupu- 
 line, Muscarine, Pelletierine and Pilocarpine. Some are devoid of O (amines) and 
 occur as volatile, oily liquids, namely — Coniine, Nicotine, Piperidine, Pyridine, Sparteine 
 and Trimethylamine. In their chemical composition the latter are closely related to 
 Pyridine, C b H 5 N, an alkaloid which seems to underlie the molecular structure of many 
 others. Some of them may be synthetically prepared from the pyridine bases (picoline, 
 collidine, etc.). By changing the chemical constitution of an alkaloid its physiological 
 action can be completely altered. 
 
 Alkaloids are sometimes called organic or vegetable alkalies, to distin- 
 guish them from the inorganic or mineral alkalies, which they resemble 
 in little except their reaction and basic qualities. The term artificial 
 alkaloid is applied to secondary alkaloids derived from natural ones, as 
 Apomorphine. The term synthetic alkaloid should be restricted to those 
 which occur in nature but have been prepared synthetically, and should 
 never be applied to bases which are only obtained by synthesis and do not 
 occur naturally, as Antipyrin, Thallin, etc. 
 
 Many so-called alkaloids are in reality mixtures of different alkaloids, e. g. , Vera- 
 trine. Some plants contain more alkaloids than one, including a second which may be 
 similar in action to the first but weaker (as Brucine) or antagonistic in action to the 
 principal one (as Calabarine). 
 
CONSTITUENTS OF ORGANIC DRUGS. 23 
 
 The first alkaloid discovered was Morphine, isolated and described by the apothecary 
 Sertiirner in 1816. Within sixteen years after that date Strychnine, Brucine, Quinine, 
 Cinchonine, Narcotine, Codeine, Veratrine, Confine, Atropine, Nicotine, Aconitine and 
 Hyoscyamine were discovered by different chemists. 
 
 Of the alkaloids 15 are official, under either their own names or those 
 of their salts, besides Veratrine which is described as a mixture of alka- 
 loids. Of the official salts of alkaloids there are 10 Sulphates, 6 Hydro- 
 chlorates, 3 Hydrobromates, and 1 each Bisulphate, Acetate, Salicylate 
 and Valerianate. The official alkaloids are the following named : — 
 
 Apomorphina, Apomorphine, — a derivative of the alkaloid Morphine. 
 Atropina, Atropine, — from Belladonna and some allied plants. 
 Caffeina, Caffeine, — the active principle of Caffea, the coffee plant. 
 Cinchonina, Cinchonine, — a minor alkaloid from Cinchona (Peruvian Bark). 
 Cinchonidina, Cinchonidine, — another alkaloid from Cinchona. 
 Cocaina, Cocaine, — from the plant Erythroxylon Coca. 
 Codeina, Codeine, — the second in rank of the Opium alkaloids. 
 Hyoscina, Hyoscine, — one of the alkaloids of Hyoscyamus (Henbane). 
 Hyoscyamina, Hyoscyamine, — another alkaloid from Hyoscyamus. 
 Morphina, Morphine, — the principal alkaloid of Opium. 
 Physostigmina, Physostigmine, — also called Eserine, — from Physostigma. 
 Pilocarpina, Pilocarpine, the principal alkaloid of Pilocarpus (Jaborandi). 
 Quinina, Quinine, — the chief alkaloid of Cinchona (Peruvian Bark). 
 Quinidina, Quinidine, — a powerful but scanty ingredient of Cinchona. 
 Strychnina, Strychnine, — the principal alkaloid of Nux Vomica. 
 Veratrina, Veratrine, — a mixture of alkaloids from Asagraea officinalis. 
 
 Unofficial but Important Alkaloids are the following : — 
 
 Aconitina, Aconitine, — the active principle of Aconite. 
 
 Berberina, Berberine, — from Berberis, Hydrastis, Calumba, and other plants. 
 Brucina, Brucine, — the second alkaloid of Nux Vomica. 
 Colchicina, Colchicine, — the active principle of Colchicum. 
 Coni'ina, Coniine, — the principal alkaloid of Conium (Hemlock). 
 Curarina, Curarine, — the active ingredient of Curare (Woorara). 
 Duboisina, Duboisine, — from Duboisia ; identical with Hyoscyamine. 
 Emetina, Emetine, — the alkaloid of Ipecacuanha. 
 Gelsemina, Gelseniine, — the active principle of Gelsemium. 
 Homatropina, Homatropine, — a derivative of the alkaloid Atropine. 
 Muscarina, Muscarine, — from the Fly-agaric, a poisonous mushroom. 
 Pelletierina, Pelletierine, — from Punica Granatum, Pomegranate. 
 Sparteina, Sparteine, — a volatile alkaloid obtained from Scoparius. 
 
 Allied to the alkaloids are the organic products termed Leucomaines and Ptomaines, 
 the former being alkaloidal substances produced by the decomposition of albuminous 
 matter in the living animal tissues during the normal destructive metamorphosis, the 
 latter being similar substances produced by the process of putrefaction. Many of the 
 ptomaines are identical with certain vegetable alkaloids. 
 
 Glucosides (yXu-/.b<:, sweet), — form a group of organic principles, exist- 
 ing in plants and generally neutral in character. They may be resolved 
 by boiling with dilute acids or alkalies, or by the action of ferments, into 
 glucoses (chiefly dextrose) or other bodies (mannite, phloroglucin) which 
 themselves yield glucoses, also one or more other bodies (alcohols, alde- 
 hydes, phenols, etc.) which are different in each case. Thus, Salicin, 
 C 13 H 18 7 , which is a glucoside, by the action of a dilute acid is split 
 
24 CONSTITUENTS OF ORGANIC DRUGS. 
 
 up into glucose and saligenin, according to the following reaction, 
 C 13 H 18 7 + H 2 = C 6 H 12 6 (glucose) + C 7 H 2 2 (saligenin). Under the 
 supposition that glucose and its congeners are alcohols it is probable 
 that glucosides are the corresponding ethers. Few of them, if any, con- 
 tain N, but they all contain C, H and O. They are often the most 
 active of the principles in the plants containing them, but they are more 
 frequently associated with other active principles, as alkaloids, oils, 
 resins, etc. Like other neutral principles, the glucosides have Latin 
 names which end in — inum, and English names ending in — in. The 
 official glucosides are two, namely — 
 
 Glycyrrhizinum, Glycyrrhizin, — from Liquorice -root. 
 Salicinum, Salicin, — obtained from Willow and other barks. 
 
 Unofficial but important Glucosides are those named in the following 
 list :— 
 
 Adonidinum, Adonidin, — from Adonis vernalis. 
 
 Arbutinum, Arbutin, — from Bearberry leaves. 
 
 Cathartic Acid, — one of three glucosides in Senna leaves. 
 
 Colocynthinum, Colocynthin, — the active principle of Colocynth. 
 
 Convallamarinum, Convallamarin, — from Convallaria majalis. 
 
 Digitalin, Digitalein, Digitoxin and Digitonin, — the four active principles contained 
 
 in Digitalis, the last-named one antagonizing the other three. 
 Ipecacuanhic Acid, — existing in Ipecacuanha. 
 Jalapinum, Jalapin, — the active principle of Scammony. 
 Saponinum, Saponin, — obtained from Quillaja, the Soap-bark. 
 Strophanthinum, Strophanthine — the active principle of Strophanthus, and one of the 
 
 most powerful poisons known. 
 Tannins, except Tannic Acid, which is an organic acid, are considered to be glucosides ; 
 
 the chief ones being Caffetannic Acid, Chinotannic Acid and Quercitannic Acid. 
 
 Neutral Principles, — are all neutral in character, of various com- 
 position and powers, and characterized by the absence of basic or other 
 properties which would place them in the other groups. Many have a 
 very bitter taste and have been therefore called Amaroids or Bitter Prin- 
 ciples. Like the glucosides their Latin names end in — inum, their 
 English names in — in. Those which are official are the following- 
 named : — 
 
 Aloinum, Aloin, — from various species of Aloes. 
 
 Chrysarobinum, Chrysarobin, — a mixture of proximate principles obtained from 
 
 Goa-powder. 
 Elaterinum, Elaterin, — extracted from Elaterium. 
 Picrotoxinum, Picrotoxin, — obtained from Cocculus Indicus. 
 Piperinum, Piperin, — from Black Pepper. 
 Santoninum, Santonin, — the active principle of Wormseed. 
 
 Unofficial, but important Neutral Principles are — 
 
 Anemoninum, Anemonin, — a camphoraceous principle from Pulsatilla. 
 Cantharidinum, Cantharidin, — the active principle of Spanish Flies. 
 Cotoinum, Cotoin, — an acrid principle in Coto Bark. 
 Quassinum, Qtiassin, — a bitter principle in Quassia- wood. 
 
CONSTITUENTS OF ORGANIC DRUGS. 2$ 
 
 Besides the above-mentioned principles, there are several other sub- 
 stances bearing pharmacopceial names ending in — inum or — in, which 
 have no relationship to either of the groups previously described. 
 Among them are — 
 
 Chinoidinum, Chinoidin, — a mixture of alkaloids from Cinchona. 
 
 Glycerinum, Glycerin, — the sweet principle of fats and fixed oils. 
 
 Lupulinum, Lupulin, — the glandular powder of the Hop plant. 
 
 Also Abrin, a toxic albumose in Jequirity-seeds ; Ricin, a poisonous ferment in Castor- 
 oil seeds ; and Antipyrin, Benzin, Chinolin, Kairin, Lactophenin, Naphtalin, Pancreatin, 
 Pepsin, Phenacetin, Piperazin, Pyroxylin, Resorcin, Thallin and other organic com- 
 pounds which are not derived from either the animal or vegetable kingdoms, but are 
 manufactured in the chemical laboratory. 
 
 Organic Acids or Carbon-acids, contain the univalent group C0 2 H 
 (carboxyl) linked with a hydrocarbon residue. They contain no N, but 
 have acid properties, forming salts with bases. The principal organic 
 acids are — 
 
 Official. Unofficial. 
 
 Acetic Acid. Oleic Acid. Agaricic Acid. Fonnic Acid. 
 
 Benzoic Acid. Salicylic Acid. Angelic Acid. Malic Acid. 
 
 Citric Acid. Stearic Acid. Butyric Acid. Meconic Acid. 
 
 Gallic Acid. Tannic Acid. Camphoric Acid. Oxalic Acid. 
 
 Lactic Acid. Tartaric Acid. Cerotic Acid. Succinic Acid. 
 
 Coloring Matters form a group of bodies having very different prop- 
 erties and the nature of many being not yet understood. Among them 
 are — Carminic Acid, in the cochineal insect, also in some plants ; Cartha- 
 min, from the safflower ; Chlorophyll, in all green parts of plants ; Curai- 
 min, the coloring matter of turmeric ; and Hozmaloxylin, from logwood. 
 
 Resins. The proximate principles called by this name are neither the 
 commercial resins nor the resins of pharmacy (see under Resin^e in Part 
 II), all of which are complex bodies, but include only the chemical indi- 
 viduals of resinous character existing in nature, as those in Copaiba, 
 Cannabis, Gamboge, Guaiac, Gurgun, etc. Even these, in their commer- 
 cial form, are accompanied by other principles. It is difficult to define 
 the resins correctly, but they are generally considered to be oxidation 
 products of hydrocarbons* such as terpenes. They are mostly brittle, 
 amorphous, uncrystallizable solids, insoluble in water but soluble in alco- 
 hol, ether, chloroform, benzin, etc. Most of them are of acid character, 
 combining with alkalies to form a kind of soap, these ' ' resin-soaps ' ' being 
 soluble in water and giving up their resins again to the action of acids. 
 They soften or melt when heated and solidify again on cooling. They 
 may be obtained from oleo-resins, as turpentine, by simple distillation, 
 the volatile oil passing over and the resin remaining behind ; or by heat- 
 ing the part of the plant in which they are contained, as in the case of 
 guaiacum resin. 
 
26 CONSTITUENTS OF ORGANIC DRUGS. 
 
 • The substances ordinarily called Resins are usually classified as follows : — 
 
 True Resins are hard, compact products of oxidation, and are made up chiefly of 
 resin acids. Such are Copal, Damar, Mastic, Sandarach, Dragon's blood, Gum-lac and 
 Amber. 
 
 Gum-resins are natural mixtures of gum and resin. When they are rubbed up with 
 water the gummy matter dissolves and the resin is suspended in the form of an emulsion. 
 [Compare the title Emulsa, in Part II, also the subtitle Gums, ante, p. 22.] Such are 
 Olibanum (frankincense), Myrrh, Ammoniac, Asafetida, Galbanum and Tragacanth. 
 
 Oleo-resins include all mixtures of volatile oils and resins of whatever consistency, 
 also the Balsams or mixtures of resins with benzoic and cinnamic acids. Such are 
 Copaiba, crude Turpentine, Storax, and the true balsams — Benzoin, Balsam of Peru and 
 Balsam of Tolu. There are six official oleo-resins, which are described under the title 
 Oleoresin^e in Part II. 
 
 Pharmaceutical Resins are solid preparations obtained by precipitating the resinous 
 principles of plants from their alcoholic solutions by the agency of water. Three such 
 preparations are official in the U. S. Pharmacopoeia, and are described under the title 
 Resins in Part II. 
 
 Fixed Oils and Fats, though usually placed among the constituents 
 of animal and vegetable drugs, are not proximate principles, being com- 
 pound bodies containing the radicle Glyceryl, C 2 H 5 in combination with 
 anhydrides of the various fatty acids. The decomposition of these 
 bodies by heating with water and an alkali yields the triatomic alcohol 
 Glycerin, G^ 5 (OH) 3 and one or more fatty acids (stearic, palmitic, 
 oleic, etc.). " The latter combine with the alkali, forming soaps, and the 
 glyceryl is converted into glycerin, a portion of the water being consumed 
 in the reaction. [See the subtitle Saponification under the title Sapo, in 
 Part I.] An exception to this rule is the case of Cod-liver Oil, which 
 does not yield glycerin when saponified but oxide of propyl. The fol- 
 lowing-named official fixed oils and fats are those which are chiefly 
 employed in medicine, viz. — 
 
 Adeps, Lard, — the abdominal fat of the hog. 
 
 Adeps Lanae Hydrosus, Hydrous Wool Fat, — the purified fat of the wool of the 
 
 sheep. 
 Sevum, Suet, — the abdominal fat of the sheep. 
 Cetaceum, Spermaceti, — obtained from the sperm whale. 
 Oleum Adipis, Lard Oil, — expressed from lard. 
 Oleum Amygdalae, Almond Oil, — expressed from almonds. 
 Oleum Gossypii Seminis, Cottonseed Oil, — from cottonseed. 
 Oleum Lini, Linseed Oil, — expressed from flaxseed. 
 Oleum Morrhuae, Cod-liver Oil, — from the liver of the cod-fish. 
 Oleum Olivae, Olive Oil, — expressed from ripe olives. 
 Oleum Ricini, Castor Oil, — from the seed of the castor-oil plant. 
 Oleum Sesami, Sesamum Oil, — from the seed of the Benne plant. 
 Oleum Theobromatis, Oil of Theobroma, Cacao-butter, — expressed from the seed 
 
 of the Chocolate-tree. 
 Oleum Tiglii, Croton Oil, — expressed from the seed of Croton Tiglium, an Indian 
 
 plant. 
 
 Waxes are also compound bodies, closely allied to fats but containing 
 no glyceryl, and are usually placed among the proximate principles for 
 sake of convenience. The official wax (Cera) is prepared by the honey- 
 bee. Chinese insect wax is the secretion of a coccus upon a variety of 
 
CONSTITUENTS OF ORGANIC DRUGS. 2J 
 
 ash. Japanese wax is obtained from the fruits of several varieties of 
 Rhus. Myrtle wax is obtained from the fruits of various species of Myrica. 
 Wax is used in pharmacy ; internally it is practically inert and harmless. 
 
 Volatile or Essential Oils form a large group of organic bodies 
 existing in plants, from which they are usually extracted by distillation 
 with water, being volatilizable at the temperature of boiling water. 
 They are generally liquid at ordinary temperatures, and when exposed 
 to cold many of them separate into a solid, crystalline portion, called 
 stearopten, and a liquid portion, called elceopten. They are highly odor- 
 ous, oily, sparingly soluble in water, more or less soluble in alcohol and 
 in ether, colorless, or yellowish, inflammable, and prone to become 
 resinous on exposure to the air. A few consist of but a single proximate 
 principle, for example — Oil of Beiula, which is wholly methyl salicylate. 
 Most of them are complex bodies, consisting of two or more principles 
 which can be separated from each other. The list of the volatile oils is 
 quite an extensive one, 36 being official in the U. S. Pharmacopoeia and 
 described in Part I of this book under the titles of their respective 
 sources. The group may be subdivided into the following classes, viz. — 
 
 Hydrocarbon Oils (or Terpenes), — consist of C and H, most of them having the 
 formula C 10 H ]6 and being therefore isomeric with rectified Oil of Turpentine, which is 
 the type of this class. 
 
 Oxygenated Oils, — contain C, H and O, are highly aromatic and usually consist of 
 a terpene mixed with an oxygenated principle (an acid, an aldehyde, etc.). The oils of 
 Cinnamon and Peppermint are examples of this class. 
 
 Sulphuretted Oils, — contain Sulphur in addition to their other elementary constitu- 
 ents, and are pungent and disagreeable in odor and taste ; as the oils of Garlic and 
 Mustard. In the latter case the oil is formed by the reaction of the constituent princi- 
 ples in the presence of water and does not preexist in the plant. 
 
 Nitrogenous Oils, — contain N, as the compound Cyanogen, CN, in the form of 
 Hydrocyanic Acid, which is formed only after maceration with water. Examples are 
 the oils of Bitter Almond, Peach-kernels, etc. 
 
 Camphors are volatile, aromatic principles, composed of ten atoms 
 of C with various proportions of H and O. They are solid and crys- 
 talline at ordinary temperatures, and closely related to the terpenes, 
 with which they are associated in plants and by the oxidation of which 
 they seem to be formed. The principal member of the group is the 
 official Camphora, C 10 H 16 O, which is described under its own title in 
 Part I. Stearoptens obtained from various essential oils are often, though 
 incorrectly, called camphors, as Borneol, Menthol, Eucalyptol, etc. 
 
 Borneol, or Borneo-camphor, C 10 H 18 O, — is a secondary alcohol occurring in a tree 
 which grows in Borneo and Sumatra. It may be formed artificially by heating common 
 camphor with alcoholic potash or by treating it with sodium. 
 
 Menthol, or Mint-camphor, C ]0 H 20 O, occurs in Oil of Peppermint together with a 
 terpene and separates in crystals on cooling the oil. It is a secondary alcohol, is official, 
 and is described under the title Mentha Piperita in Part I. 
 
28 CONSTITUENTS OF ORGANIC DRUGS. 
 
 Miscellaneous Compounds include several organic bodies (phenols, 
 ketones, etc.) which occur as proximate principles in plants but are not 
 referable to the other groups. Among them are — 
 
 Anethol, C 10 H 12 O, — from the oils of Anise and Fennel. 
 
 Apiol, C 12 H u 4 , — from the Oil of Parsley. 
 
 Carvol, C 10 H n O, — from the Oil of Caraway. 
 
 Cineol, Cajuputol or Eucalyptol, C ]0 H 18 O, — a liquid obtained from the volatile oils of 
 
 several species of Eucalyptus, also from the oils of Cajuput, Myrtle, Rosemary, 
 
 Sage and Wormseed. 
 Eugenol, C ]0 H 12 O, — from Oil of Cloves and other volatile oils. 
 Guaiacol, C T H 8 2 , — the essential constituent of Creosote. 
 Safrol, C 10 H 10 O 2 , — obtained from the oils of Sassafras and Camphor and the bark of 
 
 several plants. 
 Thymol, C 10 H 14 O, — a phenol from Oil of Thyme and other volatile oils. 
 
 Albuminoids or Protein Bodies all contain N, as well as C, O, H 
 and Sulphur. They are formed exclusively in plants, in every part of 
 which they occur in small amounts but in larger quantities in the seeds. 
 When consumed and assimilated by animals they undergo little alteration 
 but enter into the animal tissues and form the chief part of the solid 
 constituents of the blood, muscles, nerves, glands and other organs. 
 They are chiefly valuable as foods, and may be conveniently divided into 
 the following classes : — 
 
 Native Albumins, are soluble in water ; as Serum-albumin, Egg-albumin, Plant- 
 albumin (in the juices of plants). 
 
 Derived Albumins or Albuminates, are insoluble in water but soluble in very 
 dilute acids or alkalies; as Syntonin (acid-albumin), Alkali-albumin, Casein, the chief 
 proteid in milk, Legumin or plant-casein. Gluten, the chief nitrogenous constituent of 
 the seeds of cereals ( wheat, rye, etc. ) , is believed to be a combination of four albuminoids, 
 gluten-fibrin, gluten-casein, gliadin and mucedin. 
 
 Globulins, are insoluble in water but soluble in dilute saline solutions and in very 
 dilute acids or alkalies, and include — Globulin (Crystallin), Myosin, Fibrinogen, Vitellin, 
 Para -globulin and Globin (residue of Hemoglobin, which forms the chief part of the red 
 blood-corpuscles ; contains Iron and is closely related to the proteids). 
 
 Fibrin (Animal Gluten), is insoluble in water and sparingly soluble in neutral saline 
 solutions and in dilute acids and alkalies. It has a filamentous structure and possesses 
 remarkable elasticity. 
 
 Coagulated Proteid, is formed from albumin, fibrin, etc. by the action of heat or 
 alcohol, and is insoluble in water or alcohol but soluble in strong hydrochloric acid and 
 gradually in acetic acid. 
 
 Peptones, are formed from albumins by the action of the acid gastric juice. They 
 are highly diffusible and readily soluble in water, but are insoluble in alcohol or ether. 
 
 Amyloid Substances, include Ichthin, Ichthidin, Ichthulin and Emydin, which 
 occur in the eggs of fishes and amphibii, also Lardacein or Amyloid Substance, a patho- 
 logical infiltration into various organs. 
 
 Collagenes and Mucilaginous Bodies, include Ossein, Collagen (and their deriva- 
 tive Gelatin), also Elastin, Chondrin, Keratin and Mucin. 
 
 Ferments are known only by their power of effecting peculiar 
 changes in other organic bodies. The true ferment-substances have not 
 yet been isolated, but they are present in certain preparations obtained 
 from animals and plants, the most important of which are named in the 
 following list, viz. — 
 
CLASSIFICATION OF MEDICINES. 20, 
 
 Pepsin, — contained in the gastric juice of animals. 
 
 Pancreatin, — obtained from the pancreas of animals. 
 
 Papayotin (Papain), — from the sap of Carica papaya. 
 
 Bromelin, — contained in the juice of the Pineapple. 
 
 Ptyalin, — the peculiar ferment of animal saliva. 
 
 Diastase, — formed during the germination of seeds. 
 
 Emulsin, — the ferment occurring in almonds. 
 
 Myrosin, — the ferment contained in mustard-seeds. 
 
 The first four above-named are fully described under the title Pepsinum, Diastase 
 under Maltum, Eimdsin under Amygdala, and Myrosin under Sinapis, in Part I of 
 this book. 
 
 CLASSIFICATION OF MEDICINES. 
 
 In the present state of knowledge respecting the actions and uses of 
 medicinal agents, no really scientific classification of these substances is 
 possible. Some writers have adopted a system based on the natural rela- 
 tions of the various articles to each other, while many classify them 
 according to their effects on the human system, and others make no 
 attempt at arrangement but treat of them in alphabetical order. The 
 latter method has been chiefly followed in this work, from a conviction 
 that every medicine should first be studied as an individual, both with 
 respect to its physiological actions and its therapeutical applications. 
 When the student has thus made himself familiar with the characteristic 
 features of each article of the materia medica, he may begin, by compar- 
 ing one with another, to seek acquaintance with their more delicate lights 
 and shades. Some system of classification then becomes imperative as an 
 aid to the memory, and as the titles of the groups to which the various 
 agents belong in any physiological classification are also used to express 
 their actions and uses, the following synopsis is inserted as an appropriate 
 introduction to the section on Materia Medica and Therapeutics. 
 
 Accommodation of the Eye is impaired or paralyzed by the fol- 
 lowing named drugs, acting upon the ciliary muscle, viz.— 
 
 Atropine. 
 
 Homatropine. 
 
 Cocaine. 
 
 Daturine. 
 
 Physostigmine. 
 
 Gelsemine, 
 
 Hyoscyamine. 
 
 Pilocarpine. 
 
 
 Intraocular tension is increased by Atropine (large doses), Hyoscyamine and Daturine; 
 and is decreased by Physostigmine and by Cocaine. Gelsemine paralyzes the external 
 ocular muscles, especially the levator palpebrce and external rectus, by its action on the 
 terminal nerve filaments. 
 
 Acids, considered therapeutically and physiologically, are medicines 
 which in concentrated form act usually as caustics to destroy the tissues; 
 but when administered internally in medicinal doses they check the pro- 
 
30 CLASSIFICATION OF MEDICINES. 
 
 duction of glands having acid secretions if coming in contact with the 
 mouths of their ducts, — and increase the production of those having 
 alkaline secretions. Thus, a dilute acid given before meals will check the 
 production of the acid gastric juice but will stimulate that of the alkaline 
 pancreatic juice. They should always be largely diluted for internal 
 administration. The principal Acids are Acetic, Citric and Benzoic, from 
 the vegetable kingdom, and Nitric, Phosphoric, Sulphuric and Hydro- 
 chloric, from the mineral kingdom. 
 
 Alkalies, or Ant-acids, from the same standpoint, (see above), are 
 agents which neutralize acids, also act as escharotics on the tissues, and 
 check alkaline and stimulate acid secretions, when in contact with the 
 mouths of the ducts of the glands producing them. Thus, a dilute alkali 
 given before meals will stimulate the production of the acid gastric juice, 
 and if applied to the mouth of the pancreatic duct will check the secretion 
 of the alkaline pancreatic juice. Alkalies may be subdivided into two 
 groups, named, from their physiological actions, Direct Antacids, those 
 which lessen acidity in the stomach, and Indirect or Remote Antacids, 
 which have no power over acidity of the stomach, but are oxidized in the 
 blood, and excreted as carbonates in the urine, and lessen its acidity. 
 The following List of Alkalies comprises the chief members of both 
 groups, and also some which have the actions of both. They should all 
 be largely diluted before administration. 
 
 Direct Antacids. Remote Antacids. 
 
 {Lessen Acidity in the Stomach.') {Lessen Acidity of the Urine.') 
 
 Liquor Potassae, Liquor Sodse. Liquor Potassae, Liquor Sodae. 
 
 Carbonates and Bicarbonates of Potas- Carbonates and Bicarbonates of K, Na, Li, 
 
 sium, Sodium, Lithium, Magnesium Mg and NH 4 . 
 
 and Ammonium. Potassium Acetate and Citrate. 
 
 Calcined Magnesia (Magnesia). Sodium Acetate, Citrate and Phosphate. 
 
 Lime-water. Chalk. Lithium Citrate. 
 Aromatic Spirit of Ammonia. 
 
 Alteratives are remedies which alter the course of morbid conditions 
 in some way not yet understood, perhaps by promoting metabolism. 
 They certainly modify the nutritive processes and thereby cure many dis- 
 eases of chronic type. Mercury and Iodine are the most prominent agents 
 of this class, the former being endowed with the power of breaking up 
 newly deposited fibrin and disorganizing syphilitic deposits, while the 
 latter acts energetically upon the lymphatic system and promotes absorp- 
 tion. Arsenic also is almost specific in many chronic skin affections, and 
 has remarkable power over chronic pulmonary consolidations, probably 
 producing fatty degeneration and softening of the effusion, so that it may 
 be absorbed or expectorated. The principal alteratives are — 
 
CLASSIFICATION OF MEDICINES. 3 1 
 
 Arsenic. Mercury. Iodine. 
 
 Antimony. Colchicum. Iodides. 
 
 Aurum. Guaiacum. Stillingia. 
 
 Mezereum. Sanguinaria. Sarsaparilla. 
 
 Sulphur. Xanthoxylum. Cod-liver Oil. 
 
 Sulphides. Calcium Chloride. Phosphorus. 
 
 Certain therapeutists of laboratory type have, of late years, seen fit to denounce the 
 term Alterative as a "cloak for ignorance," but have never been able to present a better 
 designation for a class of agents whose effects are among the most thoroughly established 
 of clinical facts. 
 
 Amblyopia, or impairment of vision from nerve-changes, is produced 
 temporarily by Quinine, and may be permanently induced by Tobacco 
 and Alcohol, also by Lead and Urea poisoning. 
 
 The sensibility of the eye is increased by Strychnine, the field of vision becoming 
 enlarged, and the vision rendered more acute. If the drug be administered hypodermi- 
 cally the improvement will be more marked in the eye corresponding to the side of the 
 body where the injection was made. The sensibility for color is affected by drugs, 
 Strychnine increasing the field for blue, Eserine diminishing it for red and green, and 
 Santonin causing objects to appear at first of a violet and afterwards of a greenish, yellow 
 color. 
 
 Analgesics or Anodynes (av, without, alyo>z, pain, dduvq, pain), — 
 are remedies which relieve pain either by direct depression of the centres 
 of perception and sensation in the cerebrum, or by impairing the con- 
 ductivity of the sensory nerve fibres. Opium is the most efficient of all 
 analgesics, because it arrests the afferent impressions at every step of their 
 track — at their formation, along the course of their conduction, and at 
 the point where they impinge on the sensorium. The Local Anodynes are 
 described under Anesthetics ; the list of General Anodynes includes the 
 following-named agents: — 
 
 Opium, Morphine. Antipyrin. Aconite. 
 
 Belladonna, Atropine. Acetanilid. Chloroform, Ether, etc. 
 
 Cannabis Indica. Phenacetin. Conium. 
 
 Stramonium. Phenocoll. Chloral Hydrate. 
 
 Hyoscyamus. Exalgin. Croton-chloral. 
 
 Gelsemium. Lupulus. 
 
 Anaphrodisiacs (a\>, without, Acppodizrj, Venus), — are medicines and 
 measures which lower the sexual function and diminish the sexual appe- 
 tite. They act by lessening the excitability of the nerves of the genital 
 organs, by depressing the genital centres in the brain and cord, or by de- 
 creasing the local circulation. The principal anaphrodisiacs are named 
 in the following list. [Compare Aphrodisiacs.] 
 
 Bromides. Tobacco. Nauseants. 
 
 Potassium Iodide. Digitalis. Purgation. 
 
 Camphor (at last). Conium. Venesection. 
 
 Opium (at last). Belladonna. Ice, locally. 
 
 Lupulin. Stramonium. Cold Baths. 
 
 Cocaine. Gelsemium. Vegetable Diet. 
 
32 CLASSIFICATION OF MEDICINES. 
 
 A few drops of a 4 per cent, solution of Cocaine upon the glans penis will destroy all 
 erection-power for a quarter to half an hour. 
 
 Anesthetics (dv, without, dtadrjacz, perception), — are agents which 
 temporarily destroy sensation. The Local Anesthetics are described 
 below. The General Anesthetics include certain volatile substances, 
 mostly belonging to the chemical groups named alcohols and ethers, 
 which when inhaled sufficiently produce complete unconsciousness and 
 loss of sensation (anesthesia), also lessened motor power. Narcotics also 
 produce more or less anesthesia, but this term is usually restricted to the 
 effects of the volatile agents referred to above. The principal members 
 of this group are — 
 
 Ether (Ethyl Oxide). Chlorofonn. 
 
 Methylene Bichloride. Chlorinated Ethyl Chloride. 
 
 Ethylene Bichloride. Ethyl Bromide. 
 
 Nitrous Oxide. Pental (Tri-methyl-ethylene). 
 
 The list of General Anesthetics also includes Alcohol and many substitution products 
 derived from alcohols and ethers. [Compare the articles entitled Alcohol, ^Ether and 
 Chloroform in Part I.] 
 
 Local Anesthetics and Anodynes (dv, without, oduvq, pain), — 
 reduce the functions of the sensory nerves until they lose the power of 
 receiving or conducting sensations. Some act by direct depression of 
 the end-organs in the skin, etc., others by impairing the conductivity 
 of the sensory nerves, while some act indirectly by reducing the local 
 circulation. The Anodynes diminish, and the Anesthetics destroy, for a 
 time, the sensibility of the skin and mucous membranes to which they are 
 applied. The chief members of this class are named in the following 
 list :— 
 
 Local Anodynes. Local Anesthetics. 
 
 Acetanilid. Extreme Cold, Ice. 
 
 Aconite, Aconitine. Ether Spray. 
 
 Belladonna, Atropine. Ouabain. 
 
 Opium, Morphine. Cocaine. 
 
 Carbolic Acid. Antipyrin. 
 
 Chloroform. Erythrophlcein. 
 
 Chloral. Hydrocyanic Acid. 
 
 Veratrum, Veratrine. Carbolic Acid. 
 
 Volatile Oils. Creosote, Guaiacol. 
 
 Oil of Turpentine. Iodoform. 
 
 Galvanism. . Orthoform. 
 
 Anhidrotics (dv, without, Idpioq, sweat), — are agents which check 
 perspiration, and are the opposites of the Diaphoretics, which promote 
 this secretion. They usually act either — 
 
 1. By depressing the action of the sweat-glands. 
 
 2. By depressing the excitability of the sweat-centres. 
 
 3. By reducing the circulation in the skin. 
 
CLASSIFICATION OF MEDICINES. 33 
 
 The most important agents of this class are those named in the follow- 
 ing list, the figures indicating their mode of action as above arranged. 
 
 Belladonna. 1 Acids, locally. 3 Chloralami. 
 
 Atropine. 1 Jaborandi. Quinine (?). 
 
 Hyoscyamus. x Pilocarpine. Picrotoxin. 
 
 Stramonium. x Nux Vomica. Dover' s Powder. 
 
 Muscarine. 2 Strychnine. Opium 2 (small doses). 
 
 Agaricus Albus. 2 Ergot. 3 Zinc Salts. 3 
 
 Salvia (Sage). Sulphuric Acid. Local Cold. 3 
 
 Strychnine, Atropine, Dover's Powder, Jaborandi, Picrotoxin and Zinc Salts are all 
 respiratory stimulants, and very efficient against the sweating of phthisis, though most 
 of them are classed as diaphoretics. This is explained by the theory of accumulation of 
 carbonic acid in the blood by depressed respiration caused by severe coughing, this 
 stimulating the sweat-centres, and being opposed by agents which stimulate the respira- 
 tory centre. 
 
 Antagonists are agents which directly oppose each other in some or 
 all of their physiological actions, and may be used against each other to 
 counteract their effects upon the organism. Antagonistic action takes 
 place in the blood and tissues, after the absorption of both the poison 
 and the antagonist ; it is available against poisons administered hypoder- 
 mically as well as by other channels, and so far as drugs are concerned it 
 is applicable chiefly to vegetable poisons or to those which produce their 
 toxic effects after absorption. In most cases of poisoning by vegetable 
 principles absorption has proceeded so far before professional assistance 
 is obtained that the time for antidotes has passed, and reliance can be 
 placed only upon the physiological antagonists and such antagonistic 
 measures as may support vitality until the poison can be eliminated by 
 the excretory organs of the body. There may be an exception to this 
 rule in the case of Morphine, which, after making the round of the cir- 
 culation, constantly returns in part to the stomach until finally eliminated, 
 so that repeated washing of that organ with a solution of potassium per- 
 manganate, or the ingestion thereof from time to time, may have a 
 continuous antidotal action on such portion of the poison as may have 
 been absorbed. [Compare Antidotes.] 
 
 Antagonistic Measures include all such procedures as may tend to 
 antagonize any remote effects of poisons, as artificial respiration, faradi- 
 zation of the respiratory muscles, constant motion or absolute repose, 
 application of heat or cold, douching, etc. 
 
 Thus, in the case of poisoning by Digitalis, the antagonists which will counteract the 
 effects of such portion of the drug which has been absorbed are the following : Aconite 
 or Morphine against the cardiac action, the former for the effects of large doses, the 
 latter for those of the long-continued use of the drug. Saponin and Senegin are the 
 most complete antagonists against Digitalis, their counteraction extending throughout 
 nearly its entire range of action. Alcohol is also indicated, as a cardiac stimulant, and 
 absolute Rest in the recumbent posture is an antagonistic measure of prime importance, 
 by reason of the liability .to sudden cessation of the lowered cardiac action on the assump- 
 tion of the erect posture by the patient. 
 
 In Part I of this book, under the several titles of the poisonous drugs, their most 
 
 3 
 
34 CLASSIFICATION OF MEDICINES. 
 
 efficient Antidotes and Antagonists are mentioned ; but these are more fully described, 
 and are arranged in a form suitable for reference, under the caption Poisoning in 
 Part III. 
 
 Physiological Antagonism means a balance of opposed actions on par- 
 ticular organs or tissues, excited by medicinal agents and measures or by- 
 disease. It may extend throughout the whole or the greater part of the 
 range of action of the opposing agents, or, as is usually the case, may be 
 limited to a few points thereof. There is no instance in which the 
 antagonism of two drugs is absolutely complete along their whole line of 
 action. In a few cases it is nearly so; as with Morphine and Atropine 
 (except as to narcotism), Digitalis and Saponin, and Atropine and Mus- 
 carine, the latter being considered the most complete instance known. 
 In most cases the antagonism extends only to certain definite spheres of 
 action, and the antagonists therein may be synergists to each other in 
 other spheres, as the narcosis produced by both Morphine and Atropine. 
 It may be local, affecting a single organ or function, or it may extend to 
 a group of organs, to several associated functions, or over the distribution 
 of the nerves proceeding from a single nerve-trunk (as the vagus) or 
 controlled by a single nerve-centre. Antagonism implies a balance of 
 functional disturbance, not an alteration of structure. 
 
 Drugs are rarely antagonistic to each other in the same degree, but, by 
 reason of differences in their mode and time of action, the action of one 
 preponderates over that of the other, so that the latter will not counteract 
 the former to the extent of averting a fatal result, though in the reverse 
 order their counteraction may be most satisfactory. For example, while 
 Chloral is the antagonist to Strychnine, opposing as it does the spinal 
 action of the latter drug, the reverse is true to a very limited extent; 
 and, while Atropine may prevent death from a lethal dose of Aconitine, 
 Morphine or Bromal Hydrate, no one of these three will do so in atropine 
 poisoning. 
 
 Two mutually antagonistic principles may exist in the same plant, as 
 the alkaloids Pilocarpine and Jaborine in pilocarpus, and the glucoside 
 constituents of digitalis, one of which, Digitonin, antagonizes the actions 
 of the other three, Digitalin, Digitoxin and Digitalein. 
 
 Toxicological Antagonism is a very ancient idea in medicine. Mithridates of 
 Pontus (b. c. 164-124) and other monarchs of the heathen world occupied themselves 
 with the study of poisons and their antidotes and antagonists, established botanical 
 gardens for the purpose of their investigation, and gave their names to what were sup- 
 posed to be universal preventives against the results of poisoning. In the 1 6th century 
 Prosper held that theriaca (opium) was an antagonist to all poisons. From 1570 to 1677 
 many observations were made and published on the treatment of belladonna poisoning 
 by opium, and in 1810 the same matter was made the subject of an inaugural thesis by 
 Lipp. The scientific investigation of drug action and antagonism was not possible until 
 the discovery and isolation of the alkaloids, but followed immediately thereafter, and 
 was begun in 1809 by Magendie upon the upas poison (nux vomica) and its newly dis- 
 covered alkaloid, strychnine. In 1869 Schmiedeberg and Koppe made their researches 
 
CLASSIFICATION OF MEDICINES. 
 
 35 
 
 on muscarine and atropine, and Liebrich discovered chloral and proved the antagonism 
 of strychnine to its action, the converse of which was shown by Bennett in 1875. 
 In 1870 Fraser published his investigations upon atropine and physostigma, and Preyer 
 his on the antagonistic influence of atropine and hydrocyanic acid on respiration. In 
 1875 a committee of the British Medical Association made an extended investigation and 
 report on the antagonisms of several drugs, which was supplemented by the work of 
 Vulpian on atropine and pilocarpine in the same year, that of Fothergill in 1877 on 
 aconite, atropine and digitalis, and that of Huseman on the antagonisms of chloral. 
 Much good work has also been done in England by Brunton and Ringer, and in the 
 United States by Wood and Bartholow, on the same lines. The name of Brunton is 
 unalterably associated with the antagonism between amyl nitrite and the spasmodic 
 paroxysm of angina pectoris, a discovery in therapeutic antagonism which was made 
 by him through the exercise of purely scientific reasoning, and which has since been 
 applied to the similar paroxysm induced in poisoning by certain drugs, as cocaine. 
 Bartholow has collected a list of 120 cases of poisoning by opium and belladonna, in 
 which each poison was treated with the other as an antagonist, and in which only 15 
 proved fatal, a mortality of 12^ per cent. 
 
 The following table, modified from Brunton, gives the antagonistic poisons, also their 
 mutual antagonistic and lethal doses in each case in which they have been determined. 
 The doses are expressed in grains or fractions of a grain per pound weight of the animal. 
 
 ANTAGONISTS. 
 
 Aconitine and Atropine, 
 
 " " Digitalin, 
 
 " " Strychnine, 
 
 Alcohol and Strychnine, 
 
 Atropine and Aconitine, 
 
 Chloral, 
 
 " " Hydrocyanic Acid, 
 
 " " Jaborandi, . . . 
 
 " " Muscarine, . . . 
 
 " " Morphine, . . . 
 
 " " Pilocarpine, . . 
 
 " " Phytolaccine, . . 
 
 " " Physostigmine, 
 
 " " Quinine, .... 
 
 Bromal Hydrate and Atropine, 
 Chloral and Atropine, .... 
 
 it a Picrotoxin, .... 
 
 " " Physostigmine, . . 
 
 " " Strychnine, . . . 
 
 Chloroform and Amyl Nitrite, . 
 Digitalin and Aconitine, . . . 
 
 " " Muscarine, . . . 
 
 " " Saponin, .... 
 
 Gelsemium and Opium, .... 
 
 " " Atropine, . . . 
 
 Morphine and Caffeine, . . . 
 
 " " Chloroform, . . 
 Muscarine and Atropine, ... 
 Opium and Atropine, 
 
 " " Gelsemium, .... 
 
 " " Veratrum Viride, 
 
 ANTAGONIS- 
 TIC DOSE. 
 
 600 
 
 1 
 73"0 
 
 LETHAL 
 DOSE. 
 
 9CT0 
 TcTO 
 
 1 
 288 
 
 1 
 28T 
 
 9F0 
 
 1.S 
 
 H 
 
 7 
 7 
 
 1 
 
 28"g- 
 90"0 
 
 2 
 
 7 
 
36 CLASSIFICATION OF MEDICINES. 
 
 Anthelmintics (dm', against, iAfuvq, a worm), — are agents which 
 destroy (vermicides) or expel (vermifuges) worms inhabiting the intes- 
 tinal canal. The principal vermifuges are the purgatives Castor Oil, 
 Jalap and Scammony, — and the vermicides are classed according to the 
 worm they are each most efficient against, thus, — 
 
 Thread Worms 
 
 Round Worms 
 
 Tape Worms 
 
 (Oxyuris Vermicula7'is) . 
 
 (Ascaris Lumbricoides). 
 
 ( Tenia, etc. ) . 
 
 Alum. 
 
 Santonica. 
 
 Filix Mas. 
 
 Sulphate of Iron. 
 
 Santonin. 
 
 Kamala. 
 
 Lime Water. 
 
 Spigelia. 
 
 Kousso. 
 
 Quassia. 
 
 Chenopodium. 
 
 Granatum. 
 
 Eucalyptol. 
 
 Azedarach. 
 
 Pelletierine, 
 
 Sodium Chloride. 
 
 Senna \ with the 
 Calomel J above. 
 
 Pepo. 
 
 Tannin. 
 
 Turpentine. 
 
 Veg. Astringents. 
 
 Naphtalin. 
 
 Chloroform. 
 
 Naphtalin. 
 
 
 Naphtalin. 
 
 The substances enumerated in the first column are all used locally by enema. Adjuncts 
 to these remedies are such agents as prevent the excessive secretion of intestinal mucus, 
 which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, 
 also Ammonium Chloride and Sodium Chloride. 
 
 Antidotes (dm, against, didwfit, I give), — are agents which affect a 
 poison either physically or chemically, or both, so as to remove it from 
 the body or alter its character by forming with it an insoluble or inert 
 compound before its absorption, with the object of preventing its toxic 
 action upon the organism. Antidotes do their work in the alimentary 
 canal or in the respiratory passages, and are applicable to vegetable as 
 well as mineral poisons, but are not available against poisons adminis- 
 tered hypodermically. They include sundry chemical substances, also 
 measures of various kinds, and may be divided into two classes: (1) 
 Chemical or True Antidotes, which unite chemically with the poison, 
 converting a soluble and absorbable substance into a compound which 
 is more or less insoluble and non- absorbable, or harmless though 
 soluble; (2) Mechanical Antidotes or Antidotal Measures, which include 
 such medicinal or mechanical processes as tend to remove a poison from 
 the body, either before or after the use of an antidote ; and include emesis, 
 the use of the stomach-pump, purgation, etc. The term Antidotal Treat- 
 ment covers the employment of both antidotes and antidotal measures, 
 and is often used in a still wider sense, namely, to mean all the treatment 
 of a case of poisoning, including the use of Antagonists as well as that of 
 Antidotes. [Compare Antagonists.] 
 
 Thus, Tannic Acid is the antidote for poisoning by Digitalis, as it forms with the 
 active toxic principles of the drug chemical compounds (tannates) which are almost insol- 
 uble and therefore comparatively harmless. But as these tannates are not entirely inert, 
 an antidotal measure, evacuation of the stomach, must also be employed, by the adminis- 
 tration of Zinc Sulphate or any other emetic, or by the use of a stomach-pump. 
 
CLASSIFICATION OF MEDICINES. 37 
 
 Antiperiodics are remedies which affect certain periodical febrile 
 diseases, lessening the severity of their paroxysms or preventing their 
 return. They act probably by arresting the development in the blood of 
 successive crops of pathogenic organisms, upon which the disorders are 
 supposed to depend. The principal antiperiodics are — 
 
 Cinchona Bark and its alkaloids, especially Quinine. Arsenic. 
 
 Bebeeru Bark and its alkaloid Berberine. Eucalyptol. 
 
 Salicin, Salicylic Acid, Salicylates. Iodine. 
 Opium and its alkaloid, Narcotine. 
 
 Quinine is the most powerful antiperiodic and Arsenic ranks next in order of effi- 
 ciency. 
 
 Antiphlogistics (dvri, against, (pkoyiZco, I burn), — are measures and 
 medicines which are supposed to have some specific power in reducing 
 inflammation. The term is becoming obsolete, but frequent references 
 are still seen to the influence of Mercury and Opium in inflammations of 
 serous membranes, Antimony and Aconite in inflammations of the respi- 
 ratory tract and organs, and to the power of Veratrum Viride over 
 puerperal metritis. The chief antiphlogistics are — 
 
 Aconite. Opium. Digitalis. Venesection. 
 
 Veratrum Viride. Ergot. Local Depletion. 
 
 Tartar Emetic. Ipecacuanha. Purgation. 
 
 Mercury. Potassium Nitrate. Counter-irritation. 
 
 Gelsemium. Rest (recumbent position). Cold (locally). 
 
 Antipyretics (avri, against, nuperdq, fever), — are agents or measures 
 which reduce the body-temperature when abnormally high. This may be 
 done by two principal methods, and the agents doing either accomplish 
 the result by five different actions, as follows, viz. — 
 
 , s T ■ .7 r, j ,. r tt , r (I. Diminishing tissue-change. 
 
 (a) Lessening the Production of Heat, by. ^ Reducing the circulation! 
 
 "3. Dilating the cutaneous vessels, and 
 producing increased radiation. 
 
 4. Producing perspiration, and its evap- 
 oration. 
 
 5. Abstracting heat from the body. 
 
 (b) Promoting the Loss of Heat, by 
 
 The following list contains nearly all the antipyretics, the numbers 
 following each referring to its proper method of action, as enumerated 
 above: — 
 
 Quinine. 1 Salicylic Acid. x Phenacetin. 1 - 4 
 
 Quinidine. x Sodium Salicylate. 1>4 Chinolin. 1 
 
 Cinchonine. l Quinine Salicylate. 1 Resorcin. 1 
 
 Cinchonidine. x Methyl Salicylate. 1 Kairin. 1 - 4 
 
 Berberine. 1 (Oil of Gaultheria.) Kairolin. 1,4 
 
 Benzoic Acid. x Trimethylamin. 2 Hydroquinon. x 
 
 Carbolic Acid. 1 '3 Salol. 1 Thallin. 1 - 4 
 
 Picric Acid. l Acetanilid. 1 - 4 Pyrocatechin. l 
 
 Salicin. 1 Antipyrin. 1 - 4 Pheno-resorcin. J 
 
38 
 
 CLASSIFICATION OF MEDICINES. 
 
 Eucalyptol. x 
 
 Thymol. 1 
 
 Other Essential Oils. 1 
 
 Alcohol. 1 ' 3 
 
 Digitalis. 2 
 
 Aconite. 2 
 
 Camphor. 1 
 
 Antimonials. 2 - 4 
 Veratrine. 2 
 Colchicum. 2 
 Leeching. 2 
 Cupping. 2 
 Blistering. 2 
 Poulticing. 2 
 
 Nitrous Ether. 3 .4 
 Dover's Powder. 4 
 Cold Bath, s 
 Cold Drinks. 5 
 Ice to Surface. 5 
 Cold Sponging. 5 
 Wet Packing. 5 
 
 Purgation and Venesection produce antipyretic results, but their mode of action is 
 doubtful (Brunton). The Body-temperature is raised by Belladonna (or Atropine) and 
 by Cocaine, but not to such a degree as to constitute fever or enable them to be classed 
 as pyretics. Tuberculin, various albumoses, and certain animal poisons, as that of shell 
 fish, will also produce a rise of temperature. 
 
 Antiseptics (olvt{, against, <rrjTtrixbq t putrefaction), — are agents 
 which prevent or retard septic decomposition, by destroying the bacteria 
 which produce it, or by arresting their development. The chief antisep- 
 tics are named in the following list, the first column containing the most 
 powerful ones, the middle column those which are moderately antiseptic, 
 and the third column the weakest members of the group. 
 
 Strong. 
 
 Corrosive Sublimate. 
 Formaldehyde. 
 Oxygenated Water. 
 Silver Nitrate. 
 Gold Chloride. 
 Zinc Chloride. 
 Copper Sulphate. 
 Iodine. Bromine. 
 Chlorine. 
 
 Potassium Permanganate. 
 Carbolic Acid. Creosote. 
 Chloroform. Orthoform. 
 Thymol. Menthol. 
 Hydronaphtol. 
 Alum. Tannin. 
 Acetanilid. Antipyrin. 
 
 Moderate. 
 
 Boric Acid. 
 
 Chloral Hydrate. 
 
 Ferrous Sulphate. 
 
 Zinc Sulphate. 
 
 Arsenic. 
 
 Quinine. 
 
 Salicin. 
 
 Sodium Salicylate. 
 
 Salol. 
 
 Mercuric Iodide. 
 
 Eucalyptol. 
 
 Sulphurous Acid. 
 
 Sulpho-carbolates. 
 
 Bismuth Subgallate. 
 
 Resorcin. 
 
 Coffee. 
 
 Feeble. 
 
 Benzoic Acid. 
 Sodium Borate. 
 Sodium Bicarbonate. 
 Calcium Chloride. 
 Sodium Chloride. 
 Barium Chloride. 
 Strontium Chloride. 
 Ammonium Chloride. 
 Ammonium Sulphate. 
 Alcohol (pure). 
 Sodium Hyposulphite. 
 Potassium Chlorate. 
 Potassium Arsenate. 
 Potassium Iodide. 
 Manganese Chloride. 
 Glycerin. 
 
 The first four named are the most powerful. Corrosive Sublimate is probably the most 
 powerful of all, but it is very poisonous. The best are those which act sufficiently on the 
 microbes without injuring the tissues. Chlorine, Bromine and Iodine are too irritant for 
 general use. Salol is the best intestinal antiseptic, though A T aphtol will destroy micro- 
 organisms in the stomach and intestines. We do not know any drugs which, taken in- 
 ternally or inhaled, will certainly destroy micro-organisms in the body, unless sufficiently 
 concentrated to be fatal to the patient. 
 
 Antispasmodics (dm, against, anaaiio^, a spasm), — are agents 
 which prevent or allay spasm of voluntary or involuntary muscles in any 
 portion of the organism. Some of the agents belonging to this class act 
 by tonic stimulation of the higher nervous centres, the coordinating 
 power, and the circulation, as Alcohol and Ether in small doses, Camphor, 
 Musk, Valerian, etc. ; others by a depressant influence on the motor 
 centres, as the Bromides, and still others by paralysis of the end-organs 
 of the vaso-motor nerves, as Amyl Nitrite. A few depress all the vital 
 
CLASSIFICATION OF MEDICINES. 39 
 
 functions, as Aconite, Tobacco, Lobelia, Hellebore, and Prussic Acid ; 
 and a number stimulate the muscular fibres of the intestines to expel 
 gaseous accumulations, namely — Asafetida, Cajuput, Valerian, Musk, 
 Aromatic Oils, etc. They are used in convulsive affections, especially 
 asthma and other spasmodic diseases of the respiratory organs, hysteria, 
 chorea, angina pectoris, epilepsy, etc. The principal antispasmodics are 
 named in the following list : — 
 
 Alcohol. Ether. Aconite. Ammoniac. 
 
 Paraldehyde. Lobelia. Castor. 
 
 Chloroform. Tobacco. Musk. 
 
 Amyl Nitrite. Hellebore. Galbanum. 
 
 Nitrites. Opium. Sumbul. 
 
 Bromides. Belladonna. Ipecacuanha. 
 
 Potassium Iodide. Stramonium. Senega. 
 
 Potassium Nitrate. Hyoscyamus. Silver Salts. 
 
 Arsenic. Hydrocyanic Acid. Zinc Salts. 
 
 Valerian. Physostigma. Copper Salts. 
 
 Conium. Curare. Asafetida. 
 
 Antizymotics (dm, against, ZotKoai^, fermentation), — are agents 
 which arrest the fermentative processes, which depend upon the action of 
 unorganized ferments (enzymes), as diastase, ptyalin, pepsin, etc., or upon 
 that of organized ferments, as the yeast-plant, bacteria, etc. The Anti- 
 zymotics are usually subdivided into two groups, respectively entitled 
 Antiseptics and Disinfectants, (which see). 
 
 Fermentation is a general name for certain processes of decomposition, during which 
 certain carbon compounds called Ferments act upon other carbon compounds, as on their 
 food, — splitting these latter up, setting free their elementary constituents, and thereby 
 leading to the formation of still other carbon compounds, by the rearrangement of the 
 freed molecules. These processes are of two kinds, viz. : — 
 
 (i) — Those in which water is taken up, (hydration), — chiefly carried on by enzymes. 
 
 (2) — Those in which O is transferred from the H to the C association, as in lactic and 
 
 alcoholic fermentation, and the putrefactive processes, — and which are chiefly carried 
 
 on by the agency of organized ferments. 
 
 The Ferments producing these fermentative changes are also carbon compounds, 
 
 and are divisible into two groups, viz. : — 
 
 Enzymes, or Organic Ferments, — have no definite structures, and are unorganized, 
 
 i. e., not living, — as Diastase, Ptyalin, Pepsin, etc. 
 Organized Ferments, — are minute, living organisms, as the moulds, yeast-plant, 
 bacteria, and other members -of the Protophytes, the lowermost class of plants, 
 which, in the course of their life history, split up the carbon compounds in which 
 they live, appropriating some part of their elements. 
 Antizymotic Drugs are drugs which arrest or inhibit these fermentative processes, 
 either by destroying or by rendering inactive the causative ferments. 
 
 Aphrodisiacs {A<ppodi-r h Venus), — are medicines which stimulate 
 the sexual appetite and power. They act by reflex or direct action upon 
 either the cerebral or the spinal genital centre. Tonics are indirectly 
 aphrodisiac, as are all measures which promote the general bodily nutri- 
 tion. The chief agents used as direct aphrodisiacs are named in the fol- 
 lowing list. [Compare Anaphrodisiacs.] 
 
40 CLASSIFICATION OF MEDICINES. 
 
 Nux Vomica. 
 
 Strychnine. 
 Cannabis. 
 
 Cimicifuga. 
 Serpentaria. 
 Sanguinaria. 
 
 Ergot. 
 
 Iron. 
 
 Alcohol. 
 
 Cantharis. 
 
 Opium (at first). 
 
 Bitter Tonics. 
 
 Phosphorus. 
 Aurum. 
 
 Camphor (at first). 
 Damiana (?). 
 
 Flagellation. 
 Meat Diet. 
 
 Strychnine acts by increasing general nutrition and exalting the reflex excitability of 
 the genital centres. Hemp probably only causes a mild delirium which may or may not 
 take a sexual direction. Cantharides acts by direct irritation of the mucous lining of 
 the urethra, and is dangerous in aphrodisiac doses. Alcohol in small doses excites the 
 genital centre in the brain ; so also Opium and Camphor, the latter being decidedly an- 
 aphrodisiac after a time. The power of Damiana is doubtful. Urtication and Flagella- 
 tion of the nates produce priapism by irritation of the genital centre in the cord through 
 the sensory nerves of the part. Ergot is considered useful by contracting the dorsal vein 
 of the penis, preventing its emptying too rapidly. 
 
 Astringents (ad, to, stringo, I bind), — are agents which produce con- 
 traction of muscular fibre and condensation of other tissues, the first 
 probably by direct irritation, the second by precipitating its albumin and 
 gelatin. They also lessen secretion from mucous membranes. The 
 principal astringents are — 
 
 Acids. Tannic Acid. Bismuth Subnitrate, etc. 
 
 Alcohol. Gallic Acid. Cadmium Sulphate. 
 
 Alum. Catechu. Copper Sulphate. 
 
 Chalk. Galls. Ferric Chloride. 
 
 Lime. Kino. Lead Acetate. 
 
 Creosote. Oak-bark. Silver Nitrate. 
 
 Carbolic Acid. Uva-Ursi. Zinc Sulphate. 
 
 Sulphuric Acid, Gallic Acid, and Lead Acetate are examples of Remote Astringents, 
 acting on internal organs through the blood. Those which affect the part to which they 
 are applied are Local Astringents, and include the others named above. 
 
 Cardiac Sedatives lessen the force and the frequency of the heart's 
 action. They are used to control palpitation and overaction of that 
 organ, and to slow the pulse in febrile conditions in sthenic subjects, 
 especially when local inflammation is the exciting cause of the fever. 
 The chief cardiac sedatives are — 
 
 Aconite. 
 Antimony. 
 Veratrum Viride. 
 
 Pilocarpine. 
 
 Digitalis. 
 
 Ouabain. 
 
 Senega, Saponin. 
 Hydrocyanic Acid. 
 Potassium Salts. 
 
 Muscarine. 
 
 Emetine. 
 
 Cold. 
 
 Quinine, in full doses. 
 
 
 
 Aconite, Veratnun, Muscarine, Pilocarpine, Saponin and Hydrocyanic Acid, are 
 direct cardiac poisons, depressing the heart muscle and the cardiac motor ganglia; Mus- 
 carine and Pilocarpine also stimulate the inhibitory ganglia. Digitalis stimulates the 
 vagus centre and the cardiac muscle, and acts as a sedative in many cases by slowing the 
 cardiac rate and giving it a regular rhythm. Aconite is said by some authorities to relax 
 inhibition, by others to stimulate the vagus centre. Antimony depresses the motor 
 ganglia, Potassium depresses the cardiac muscle. 
 
 Cardiac Stimulants rapidly increase the force and frequency of the 
 pulse in depressed conditions of the cardiac apparatus. One of the most 
 useful agents of this class is Alcohol in some form, its action being largely 
 due to a reflex influence excited through the nerves of the mouth and 
 
CLASSIFICATION OF MEDICINES. 4 1 
 
 stomach. It should therefore be given in but slightly diluted form, and 
 in small quantities frequently. Ether is next in value and still more 
 rapid in action, and the local application of Heat is one of the most 
 powerful and available. Ammonia has an energetic action as a stimulant 
 to the vaso-motor centre, as well as a reflex one upon the heart similar to 
 that of Alcohol. The chief cardiac stimulants are — 
 
 Alcohol. Hydrastinine. Sparteine. 
 
 Ammonia. Cocaine. Camphor. 
 
 Atropine. Ether. Chloroform. Aromatic Oils. 
 
 Nitroglycerin. Heat (locally). Turpentine. 
 
 Orchitic Extract. Continuous Galvanic Current. Opium and Morphine, in 
 
 Spermine. Counter-irritation. small doses. 
 
 Cardiac Tonics, when given in moderate doses, stimulate the cardiac 
 muscle, slowing and strengthening its contractions. In large doses they 
 are apt to produce irregular action of the heart, and some of them have 
 more or less of a tendency to cause sudden death by syncope if pushed 
 to any great extent. The most important of these agents are — 
 
 Digitalis. Squill. Strophanthus. 
 
 Convallaria. Erythrophlcein. Strychnine. 
 
 Cimicifuga. , Caffeine. Helleborein. 
 
 Sparteine. Saponin. Adonidin. 
 
 Digitalis acts partly by stimulation of the vagus end-organs in the heart, thus in- 
 creasing cardiac inhibition, and partly by direct stimulation of the cardiac centre in the 
 medulla, as well as by a direct influence on the heart muscle itself. It contracts the 
 arterioles and raises the blood-pressure greatly. Convallaria, Erythrophlcein, Squill, 
 and Cimicifuga act similarly but less powerfully, and are correspondingly safer. Stro- 
 phanthus is still better, as it does not affect the vessels, and therefore does not raise the 
 blood-pressure. 
 
 Carminatives (carmino, I soothe), — promote the expulsion of gas 
 from the stomach and intestines by increasing peristalsis, stimulating the 
 circulation, and relaxing the cardiac and pyloric orifices of the stomach. 
 They also act as diffusible stimulants, both of the bodily and mental facul- 
 ties. The principal carminatives belong to the aromatic oils, alcohols or 
 ethers, and are named in the following list: — 
 
 Asafetida. Mace. Oil of Cloves. 
 
 Camphor. Mustard. Oil of Coriander. 
 
 Capsicum. Pepper. Oil of Eucalyptus. 
 
 Cardamom. Serpentaria. Oil of Fennel. 
 
 Chloroform. Spirits. Oil of Peppermint. 
 
 Ether. Oil of Anise. Oil of Spearmint. 
 
 Fennel. Oil of Cajuput. Oil of Nutmeg. 
 
 Ginger. Oil of Caraway. Oil of Pimento. 
 
 Horse-radish. Oil of Cinnamon. Oil of Valerian. 
 
 Cathartics or Purgatives (xaOaiput, purgo, I cleanse), — are agents 
 which increase or hasten the intestinal evacuations. According to their 
 respective degrees and direction of action they are subdivided into several 
 groups, as follows : — 
 
 Laxatives (Jaxo, I loose), or Aperients (aperio, I open), — include those 
 which excite moderate peristalsis, and produce softened motions without 
 irritation. Sulphur is the typical laxative. 
 
4 2 
 
 CLASSIFICATION OF MEDICINES. 
 
 Simple Purgatives, — cause active peristalsis, and stimulate the secretions 
 of the intestinal glands, producing one or more copious and semifluid 
 motions with some irritation and griping. Senna is the type of this 
 group, which also includes Aloes, Rhubarb, Castor Oil, etc. 
 
 Drastic Purgatives (dpdo, I act), — act still more intensely, producing 
 violent peristalsis and watery stools, with much griping pain, tenesmus, 
 and borborygmi. They irritate the intestinal mucous membrane, cause 
 exosmosis of serum from its vessels, and in large dose set up inflammation 
 and symptoms of irritant poisoning. Jalap is a typical drastic. 
 
 Saline Purgatives. — This group includes the neutral salts of metals of 
 the alkalies or alkaline earths. They stimulate the intestinal glands to 
 increased secretion, and by their low difTusibility impede reabsorption, 
 causing an accumulation of fluid in the intestinal tract, which, partly from 
 the effect of gravity and partly by gentle stimulation of peristalsis excited 
 by distention, reaches the rectum and produces a copious evacuation. 
 Magnesium Sulphate and Sodium Sulphate are the typical salines. They 
 should be given in plenty of water and during active movement (as in 
 walking) in order to produce their best effects. 
 
 Hydragogue Purgatives (odujp, water, ayu), I bring away), — include 
 the most active of the drastic and saline groups, especially those which 
 remove a large quantity of water from the vessels. Elaterium is a typical 
 hydragogue cathartic. 
 
 Cholagogue purgatives (/ofy, bile, ayw, I bring away), — are those 
 agents which stimulate the discharge of bile and produce free purgation 
 at the same time, the stools being green-colored (" bilious ") and liquid. 
 Podophyllin is the type of this group. 
 
 The principal Cathartics are the following-named : — 
 
 Laxatives. 
 
 Simple Purgatives. 
 
 Drastics. 
 
 Sulphur. 
 
 Senna. 
 
 Jalap. Gamboge. 
 
 Magnesia. 
 
 Aloes. 
 
 Colocynth. 
 
 Cassia. 
 
 Rhubarb. 
 
 Elaterium. 
 
 Manna. 
 
 Castor Oil. 
 
 Scammony. 
 
 Figs. Prunes. 
 
 Rhamnus Frangula. 
 
 Croton Oil. 
 
 Tamarinds. 
 
 Ox-gall. 
 
 Cathartic Acid, hypoder- 
 
 Honey. 
 
 Calomel. 
 
 mically. 
 
 Cascara Sagrada. 
 
 Small doses of drastics, 
 
 
 Physostigma. 
 Ergot. 
 Belladonna. 
 Stramonium. 
 
 salines or cholagogues. 
 
 Hydragogues. 
 
 Saline Purgatives. 
 
 Elaterium. 
 Gamboge. 
 
 
 Potassium Bitartrate. 
 
 Hyoscyamus. 
 
 Magnesium Sulphate. 
 
 Croton Oil. 
 
 Almond Oil. 
 Olive Oil. 
 
 Magnesium Citrate. 
 Potassium Sulphate. 
 
 Salines in large doses. 
 
 Soap. 
 
 Potassium Tartrate. 
 
 
 Taraxacum. 
 
 Potassium Bi tartrate. 
 
 Cholagogues. 
 
 Glycerin. 
 
 Sodium Sulphate. 
 
 Podophyllin. 
 
 Oatmeal. 
 
 Sodium Phosphate. 
 
 Mercurials. 
 
 Bran Biscuit. 
 
 Sodium Chloride. 
 
 Aloes. Rhubarb. 
 
 Brown Bread. 
 
 Pot. et Sodium Tartrate. 
 
 Euonymin. 
 
 
 Manganese Sulphate. 
 
 Iridin. 
 
CLASSIFICATION OF MEDICINES. 43 
 
 Cerebral Depressants lower or suspend the functions of the higher 
 cerebrum after a preliminary stage of excitement. Under this head may- 
 be included the Hypnotics, Narcotics, General Anesthetics, and several 
 of the Antispasmodics, all acting on the cells of the convolutions ; at 
 first stimulating the brain-functions, they produce after a time stupor, 
 coma and insensibility. 
 
 The most useful of this class are the Bromides, Zinc Salts and Caffeine, as they also 
 diminish reflex excitability and thus secure rest of the nervous system. Some of them 
 are decidedly dangerous, as they may paralyze the heart or the medulla and its centres 
 of organic life before the consciousness is much disturbed ; such being Chloroform, 
 Aconite, Opium, and the irritant poisons, also Carbolic Acid. 
 
 Cerebral Excitants are remedies which increase the functional activ- 
 ity of the brain, without producing any subsequent depression, or any 
 suspension of the cerebral functions. They act partly by increasing the 
 action of the heart and consequently the rapidity of the circulation, 
 partly by a direct action upon the gray matter of the brain. The chief 
 members of this group are — 
 
 Acetic Acid (inhaled). 
 
 Cannabis. 
 
 Ether. 
 
 Alcohol (at first). 
 
 Coffee, Caffeine. 
 
 Quinine. 
 
 Ammonia (inhaled). 
 
 Tea, Theine. 
 
 Tobacco, 
 
 Ammoniac. 
 
 Guarana, Guaranine. 
 
 Strychnine. 
 
 Asafetida. 
 
 Coca, Cocaine. 
 
 Valerian. 
 
 Camphor. 
 
 
 
 The Cerebellum is markedly disturbed by the few drugs which affect it specifically, 
 their action upon its different lobes producing various disturbances of coordination and 
 equilibrium. Alcohol in considerable dose causes a staggering gait, and a tendency to 
 fall ; and different preparations thereof seem to affect different portions of the cerebel- 
 lum. Intoxication by wine or beer is said to be accompanied by a tendency to fall side- 
 ways, — that by whiskey, especially Irish whiskey, an inclination to fall on the face, — and 
 that by cider, a backward tendency ; and these disturbances correspond exactly with 
 those caused by injury to different lobes of the cerebellum (Brunton). Apomorphine in 
 large doses seems to act upon the cerebellum or corpora quadrigemina, as the animal 
 poisoned by it does not vomit, but moves round and round in a circle. 
 
 Ciliary Excitants are substances which, when dissolved in the 
 mouth, promote the expectoration of bronchial mucus by their reflex 
 excitation of the tracheal and bronchial cilia. This group includes such 
 agents as the Chlorides of Ammonium and Sodium, Potassium Chlorate 
 and Gum Acacia. 
 
 Deliriants excite the functions of the higher brain to such a degree 
 as to disorder the mental faculties, producing intellectual confusion, loss 
 of will-power, delirium and even convulsions. They are all narcotics 
 (though all narcotics are not deliriants), and the most important may be 
 listed as follows : — 
 
 Belladonna. 
 
 Alcohol. 
 
 Cannabis Indica. 
 
 Stramonium. 
 
 Chloral. 
 
 Lupulus (at first). 
 
 Hyoscyamus. 
 
 Ether. 
 
 Opium (at first). 
 
 Turpentine. 
 
 Chloroform. 
 
 Nitrous Oxide Gas. 
 
44 CLASSIFICATION OF MEDICINES. 
 
 Demulcents {demulceo, I soothe), — are substances usually of oleagi- 
 nous or mucilaginous nature, which soothe and protect the parts to which 
 they are applied. This term is generally used for substances employed 
 for mucous membranes, and the term Emollients for similar agents used 
 on the skin. The chief agents belonging to this class are : — 
 
 Acacia. 
 
 Starch. 
 
 Honey. 
 
 Olive oil. 
 
 Cetraria. 
 
 Glycerin. 
 
 Marsh-mallow.- 
 
 Isinglass. 
 
 Barley. 
 
 Flaxseed. 
 
 White of Egg. 
 
 Tragacanth. 
 
 Liquorice. 
 
 Gelatin. 
 
 Almond. 
 
 Bland Oils. 
 
 Dental Anodynes are substances employed locally in toothache 
 due to caries exposing a nerve filament. Such are Aconite, Opium and 
 Cocaine salts, — also Carbolic Acid, Creosote, Chloral, and Potassium 
 Chlorate. A solution, containing the three first named, applied on a 
 pledget of cotton, will promptly relieve whenever the nerve is accessible. 
 Chloral should never be employed for this purpose, as in solution suffi- 
 ciently strong to be of any service it is very apt to cause sloughing of the 
 gum, especially if injected thereinto by a hypodermic syringe, as is fre- 
 quently done by ignorant dentists, who advertise the " extraction of teeth 
 without pain." 
 
 Dentifrices {dens, a tooth, frico, I rub), — are medicated powders or 
 pastes applied with a stiff brush to cleanse the teeth and gums. Chalk is 
 the basis generally used, for its mechanical action and its alkaline quality. 
 Antiseptics, as Borax, Quinine, Carbolic Acid, etc., should also be em- 
 ployed, so as to prevent the acid fermentation of food products between 
 the teeth and the consequent decay of the dentine. Tincture of Myrrh is 
 an excellent ingredient, being an aromatic local stimulant and disinfectant. 
 
 Many drugs affect the teeth injuriously, such being the Mineral Acids, Persalts of 
 Iron and Alum. The first two should be taken through a glass tube, and the mouth 
 should be rinsed afterwards with a weak alkaline solution. 
 
 Deodorants are agents which destroy foul odors. The Volatile De- 
 odorants are chiefly oxidizing and deoxidizing substances, acting chemic- 
 ally on the obnoxious gases ; while the Non-volatile ones are mainly 
 absorbents, which condense and decompose the effluvia. The deodorants 
 in general use are the following-named : — 
 
 Formalin. Hydrogen Dioxide. Charcoal. 
 
 Chlorine Gas. Potassium Permanganate. Earth. Lime. 
 
 Sulphurous Acid Gas. Coffee, freshly roasted. Ferrous Sulphate. 
 
 For removing the fetid exhalations emitted by the feces, the following powder is a very 
 efficient and cheap deodorizing and disinfecting agent. Zinc Sulphate, lbs. ij, Sulphuric 
 Acid, 3Jss to ^ijss, Essence of Mirbane, 7,], Indigo Blue, gr. ij. About a dessert- 
 spoonful of this salt is placed in the bed-pan or chamber utensil before it is used. Con- 
 tact with urine or a liquid stool causes its prompt solution, deodorization is instantaneous, 
 the liquid excreta are at once sterilized, and the fetor is changed to a rather agreeable 
 odor. Oil of Eucalyptus has the property of spreading rapidly over water in a thin film, 
 and if a few drops are sprinkled over the water in the pan of a water closet before using 
 the latter, no fecal odor will arise therefrom. 
 
CLASSIFICATION OF MEDICINES. 
 
 .45 
 
 Destructive Metamorphosis of the tissues is promoted by a num- 
 ber of agents, most of which are classed as Alteratives or as Astringents, 
 the most important of which are the following-named: — 
 
 Alkalies. Sulphides and Iodides. 
 
 Vegetable Acids. Sarsaparilla. 
 
 Metals and their salts. Stillingia. 
 
 Colchicum. Xanthoxylum. 
 
 Tannic and Gallic Acids, and substances containing them. 
 
 Destructive Metamorphosis may be diminished by many substances, the 
 following-named being the chief ones : — 
 
 Alcohol. 
 
 Salicin. 
 
 Resorcin. 
 
 Glycerin. 
 
 Salicylates. 
 
 Chinoline. 
 
 Oils and Fats. 
 
 Quinine. 
 
 Cocaine. 
 
 Diaphoretics and Sudorifics (piayopiw, I carry through; sudor, 
 sweat, facio, I make), — are remedies which increase the action of the 
 skin and promote the secretion of sweat. When they act energetically, 
 so that the perspiration stands in beads upon the surface, they are known 
 as Sudorifics. They may be subdivided into the following groups, viz. — 
 
 (i ) Simple Diaphoretics, which enter the circulation and are eliminated by the sudor- 
 iferous glands, which they stimulate to increased action. 
 
 (2) Nauseating Diaphoretics, which produce relaxation and the dilatation of the super- 
 ficial capillaries. 
 
 (3) Refrigerant Diaphoretics, which reduce the circulation, at the same time acting 
 directly on the sweat-centres in the spinal cord and medulla. 
 
 The principal diaphoretics are the following-named, the figures refer- 
 ring to their respective supposed modes of action as indicated above ; — 
 
 Aconite. 3 Ipecacuanha. 2 Mezereon. x 
 
 Veratrum Viride. 3 Opium 2 - 3 (large doses). Sarsaparilla. 1 
 
 Tobacco. 2 - 3 Dover's Powder. 2 Guaiacum. 1 
 
 Lobelia. 2 ' 3 Tartar Emetic. 2 Serpentaria. 1 
 
 Alcohol. 2,3 Sulphur. 1 Sassafras. 1 
 
 Ether. 2 - 3 Camphor. 1 Senega. 1 
 
 Nitrous Ether. 2 > 3 Cocaine. 3 Vapor Bath. 2 
 
 Salicylates. l Ammonium Acetate. x Turkish Bath. 2 
 
 Jaborandi. 1 . 3 Ammonium Citrate. x Wet Pack. 2 
 
 Pilocarpine. 1 ' 3 Potassium Salts. 3 Warm Drinks. 2 
 
 Diluents (diluo, I dilute), — are indifferent substances which, after 
 their absorption, dilute the excretory fluids and enable the latter to hold 
 more solid material in suspension. Water is the one true diluent, what- 
 ever form it may be disguised in, as teas, weak fluid foods, acid drinks, etc. 
 
 Discutients or Sorbefacients {discutio, I dissipate ; sorbere, to 
 suck), — are agents which promote absorption, and may be divided into 
 two classes ; (1) those which stimulate the lymphatics to the removal of 
 morbid or inflammatory deposits, (2) those which promote the imbibition 
 of nutritive or medicinal material into the system. [Compare Altera- 
 tives.] These agents include the following-named : — 
 
46 , CLASSIFICATION OF MEDICINES. 
 
 Arsenic. 
 
 Ichthyol. 
 
 Vapor Bath. 
 
 Mercury. 
 
 Lanolin. 
 
 Hot Water Bath, 
 
 Iodine. 
 
 Oleic Acid. 
 
 Poultices. 
 
 Iodides. 
 
 Cacao Butter. 
 
 Counterirritation, 
 
 Cadmium. 
 
 Massage. 
 
 Galvanism. 
 
 Lanolin and Oleic Acid have remarkable power of penetration through the skin and 
 are used as excipients for drugs which are to be administered by cutaneous absorption. 
 Cacao Butter possesses the same penetrative property, and is usually employed in making 
 medicated suppositories. 
 
 Disinfectants destroy the specific germs of communicable diseases, 
 many of which belong to the microbe class, hence many antiseptics are 
 also disinfectants. They act in several modes, some as oxidizants, others 
 by combining with albumin, others by chemical combination forming 
 substitution-compounds, others by arresting molecular changes, and still 
 others by altering the reaction of the media containing the germs. The 
 principal disinfectants are — 
 
 Corrosive Sublimate. Carbolic Acid. Chlorine. 
 
 Formaldehyde. Creolin. Chlorinated Lime. 
 
 Heat (230 to 250 F.). Lysol. Chlorinated Soda. 
 
 Potassium Permanganate. Potassium Bichromate. Iodine. Bromine. 
 
 Zinc Chloride. Ferrous Sulphate. Lime (fresh). 
 
 Zinc Sulphate. Sulphurous Acid. Thymol. 
 
 Hydrogen Dioxide. Nitrous Acid. Camphor. 
 
 Condy 's Fluid is an aqueous solution of Potassium Permanganate, 2 parts in 100, or 
 gr. 176 in 320. Burnett's Fluid is a solution of Zinc Chloride, containing about 50 per 
 cent, of the salt, and equivalent to the official Liquor Zinci Chloridi. Labarraque' s 
 Solution is the same as the official Liquor Sodse Chlorate. Sanitas is an aqueous solu- 
 tion of oxidized Turpentine and contains Hydrogen Dioxide, also Thymol and Cam- 
 phor. 
 
 The popular idea of disinfecting the air of a room by burning sulphur, etc. , is an 
 absurdity, because foul air is easily removed by simple ventilation. In disinfecting a 
 room in which there has been a case of contagious or infectious disease, the true aim is 
 to kill the germs contained in the dust on ledges, in the crevices between the boards, or 
 adhering to the walls, and a dry gas is powerless for this purpose, which is best accom- 
 plished by using a Corrosive Sublimate Solution of the strength of 1 in 1 000 ; or by Lime 
 washing, provided that the lime be freshly burnt, and caustic ; or by spraying with Form- 
 alin, or by dropping the latter on hot plates or sheets of hot metal. 
 
 Diuretics {dtooprjaiq, urination), — are agents which promote the 
 secretion of urine, either by raising the local or general blood-pressure 
 and so increasing the renal circulation, by stimulating the secreting cells 
 or nerves of the kidneys, or by flushing the kidneys with water. Diu- 
 retics may be classified according to their physiological action or accord- 
 ing to the different purposes for which they are employed. Refrigei-ant 
 Diuretics, especially the salines, excite the renal epithelium, induce a 
 hyperemic condition of the kidneys and increase the water of the urine. 
 They possess a sedative action upon the heart and the general circulation, 
 but used to excess they depress the heart and impoverish the blood. 
 Potassium Chlorate is a decided renal irritant, and should never be used 
 as a diuretic. Hydragogue Diuretics increase the water of the urine 
 
CLASSIFICATION OF MEDICINES. 
 
 47 
 
 largely, and in general act by raising arterial pressure, either — (a) 
 throughout the body, or (£) locally in the kidneys. This they accom- 
 plish in various ways, direct and indirect, — increasing the action of the 
 heart, counteracting the efferent vessels or dilating the afferent vessels, so 
 as to raise the blood-pressure in the glomeruli, etc. The action of the 
 Stimulant Diuretics is directly upon the renal tissue, by which they are 
 largely eliminated from the body. In small or moderate doses they 
 dilate the renal arterioles, increase the renal blood-supply, and so induce 
 diuresis, but in large doses they irritate the renal epithelium, contract 
 the renal arterioles, diminish the renal blood-supply, excite renal inflam- 
 mation, render the urine albuminous and bloody, and may even induce 
 suppression of the urine. All the members of this division should be 
 used with caution. 
 
 Individual members of the diuretic class act in various modes, some of 
 them in more than one manner, and probably as follows, viz. — 
 
 i. By increasing the action of the heart (Alcohol, Digitalis, etc.) or by contracting 
 the intestinal and other vessels, thus raising the general blood-pressure. 
 
 2. By dilating the afferent renal vessels, thereby increasing the renal blood-supply 
 and raising the pressure in the glomeruli. 
 
 3. By contracting the efferent vessels, raising the pressure in the glomeruli and lessen- 
 ing absorption in the tubules, or both. 
 
 4. By stimulating the secreting cells or nerves of the kidneys. 
 
 5. By flushing the kidneys, as by the ingestion of Water in large quantity. 
 
 The following list contains the most important agents of this group, 
 which are usually subdivided into the three classes indicated by the sub- 
 titles. The numbers refer to the probable modes of action of the drug 
 in the above synopsis : — 
 
 Refrigerant Diuretics. 
 Potassium Acetate. 4 
 Potassium Bitartrate. 4 
 Potassium Citrate. 4 
 Potassium Chlorate. 4 
 Potassium Nitrate. 4 
 Sodium Acetate. 4 
 Sodium Chlorate. 4 
 Sodium Chloride. 4 
 Ammonium Acetate. 4 
 Calcium Chloride. 4 
 Lithium Carbonate. 4 
 Lithium Citrate. 4 
 Magnesium Citrate. 4 
 Magnesium Sulphate. 4 
 Water. 5 Milk. 5 
 Carbonic Acid. 
 Cold to surface. x 
 
 Hydragogue Diuretics. 
 
 Digitalis. 1 - 2 
 
 Strophanthus. 2 
 
 Convallaria. 1 
 
 Cimicifuga. 1 » 2 
 
 Adonis vernalis. 1 < 2 
 
 Erythrophlceum. 1 
 
 Squill. 1.2 
 
 Broom. 3 Sparteine. 3 
 
 Calomel. 4 
 
 Caffeine. 1 - 4 
 
 Theobromine. 4 
 
 Apocynum. 1 » 2 
 
 Nitrous Ether. 2 Nitrites. 2 
 
 Strychnine. 1 
 
 Colchicum. 4 
 
 Tobacco. 3 
 
 Sugar of Milk. 1 - 4 
 
 Stimulant Diuretics. 
 Alcohol. 2 
 Blatta orientalis. 4 
 Cantharides. 4 
 Turpentine. 4 
 Juniper. 4 
 Savine. 4 
 Capaiba. 4 
 Cubeb. 4 
 Cannabis. 4 
 Capsicum. 4 
 Buchu. 4 
 Asparagus. 4 
 Guaiac. 4 
 Fennel. 4 
 Urea. 4 
 Uva Ursi. 4 
 Zea. 4 
 
 Diuretics are employed in medicine for certain definite purposes, as 
 follows : — to remove fluid from the tissues and cavities of the body in 
 cases of dropsy ; to promote the elimination of waste-products and other 
 
48 . CLASSIFICATION OF MEDICINES. 
 
 poisons from the blood ; to maintain the action of the kidneys ; to dilute 
 the urine, and to alter morbid conditions of that excretion. 
 
 In Dropsies from Cardiac Disease, or other dropsies due to venous congestion, the 
 most efficient diuretics are those which act on the general vascular system, as Digitalis, 
 Strophanthus, Squill, etc. Calomel is often very efficient in this form of dropsy, also 
 Theobromine Sodio-Salicylate (Diuretin). 
 
 In Dropsy from Renal Disease, Diuretin, Broom-tops, Nitrous Ether, Oil of Juniper, 
 Digitalis and Squill are the most reliable diuretics, in the order named. 
 
 In Ascites from Hepatic Cirrhosis, Copaiba is the best diuretic when the kidneys are 
 healthy. In this form and the previous ones a little Pil. Hydrargyri given occasionally 
 will often aid the diuretic action of the other agents. 
 
 To Eliminate Waste-products from the Blood, Potassium Nitrate and Bitartrate, Tur- 
 pentine, Juniper, Caffeine, and Water in large quantity. [Compare Lithontriptics.] 
 
 To Dilute the Urine, Water is the best agent, its most efficient form being Distilled 
 Water charged with Carbonic Acid gas. 
 
 As Adjuvants to Diuretics, when pressure on the urinifer'ous tubules or venous conges- 
 tion prevent their action, — paracentesis abdominis, purgation, cupping over the loins, 
 and even venesection, are often necessary to start the diuretic action. 
 
 The activity of the renal cells is directly depressed by the Renal De- 
 pressants, which thereby lessen or suspend the secretion of urine. Mor- 
 phine, Quinine and Ergot act in this manner through their influence on 
 the circulation. Instead of acting as a diuretic Digitalis may stop the 
 secretion of urine, by so stimulating the vaso-motor centre as to greatly 
 contract the renal vessels, and arrest the renal circulation (Brunton). 
 This it might do if a preparation were used which was deficient in Digi- 
 toxin or Digitalein, the dilators of the renal arteries: (see under Digi- 
 talis.) The same is true of Caffeine and Strychnine, hence it is well to 
 combine these with other diuretics which dilate the renal vessels, as the 
 Nitrites, (Nitrous Ether, etc.), and Alcohol. Digitalis contains in itself 
 the power of doing both these actions, and hence it is the ideal diuretic. 
 
 Emetics (J,p.(a>, I vomit), — are agents which produce vomiting. 
 They may be subdivided into two groups, Local Emetics, or those 
 which act by irritating the end-organs of the gastric, pharyngeal or eso- 
 phageal nerves, and General or Systemic jE?netics, which act through 
 the medium of the circulation. The members of both these groups pro- 
 duce emetic action by irritation of the vomiting centre in the medulla, 
 the first by reflex, the second by direct stimulation. The principal 
 emetics are the following named : — 
 
 Local Emetics. Getieral Emetics. 
 
 Alum, Mustard, Salt. Ipecacuanha. Emetine. 
 
 Ammonium Carbonate. Apomorphine. 
 
 Zinc and Copper Sulphates. Tartar Emetic. 
 
 Subsulphate of Mercury. Veratrine. 
 
 Tepid Water, in quantity. Senega. 
 
 Vegetable Bitters, as Quassia, Squill, 
 
 in strong infusions. Ouabain. , 
 
CLASSIFICATION OF MEDICINES. 49 
 
 Tartar Emetic, Ipecacuanha and probably Apomorphine, act locally as well as sys- 
 temically, for if injected subcutaneously they are excreted by the stomach in part, thus 
 irritating the gastric nerves as well as the vomiting centre. Pilocarpus is a local emetic, 
 and Digitalis and its congeners, also Muscarine, are systemic emetics, but none of these 
 agents are used medicinally for that purpose. Opium, Morphine and Codeine usually 
 produce emesis as one of their after effects. 
 
 Vomiting is an evacuant act which consists in compression of the stomach by the 
 simultaneous spasmodic contraction of the diaphragm and abdominal muscles ; also in 
 relaxation of its cardiac orifice by contraction of the radiating muscular fibres in the 
 gastric wall. If both acts occur at the same time, the contents of the stomach are 
 expelled and vomiting occurs ; if, however, the two acts do not take place simultaneously, 
 the contents of the stomach are retained, and the abortive efforts are called retching. 
 These acts are controlled and regulated by a nerve-centre in the medulla oblongata, 
 which is closely connected with the respiratory centre, the muscular movements of 
 vomiting being merely modified respiratory movements. This vomiting centre is ordina- 
 rily excited in two ways, — (i) by the peripheral stimulation of afferent nerves going to 
 it from other parts of the body, (2) by impulses sent down to it from the brain (Brunton). 
 
 Nausea and vomiting are diminished by agents termed Anti-emetics, 
 including gastric sedatives and general sedatives ; some of which act by 
 means of a local sedative influence upon the end-organs of the gastric 
 nerves, others by reducing the irritability of the vomiting centre in the 
 medulla. The act of vomiting being occasioned by irritation of afferent 
 nerves from many regions of the body or impulses from the brain excited 
 by impressions on the nerves of special sense, the measures and agents by 
 which it may be combated are very diversified. [Compare the article 
 entitled Vomiting, in Part III.] The most important anti-emetics are 
 named in the following lists : — 
 
 Local Gastric Sedatives. General Sedatives. 
 
 Alcohol. Creosote. Opium. 
 
 Alum. Ether. Morphine. 
 
 Arsenic. Ice. Codeine. 
 
 Belladonna. Opium. Hydrocyanic Acid. 
 
 Bismuth. Hydrocyanic Acid. Bromides. 
 
 Carbonic Acid. Silver Nitrate. Chloral. 
 
 Cerium Oxalate. Calomel \ small Nitro- glycerin. 
 
 Chloroform. Ipecac j doses. Alcohol. 
 
 Carbolic Acid. Hot water. Amyl Nitrite. 
 
 Potassium Nitrate. Cocaine. Food. 
 
 Ice, swallowed in small pieces, is probably the most efficient of the local sedatives. 
 Carbolic Acid and Cocaine are also effective anti-emetics, given in small doses by the 
 mouth at short intervals. Astringents are very useful where there is congestion of the 
 gastric mucous membrane, as in the vomiting of alcoholism and phthisis, when Silver 
 Nitrate and Alum are especially to be recommended. Opium and its principal alkaloid, 
 Morphine, will produce nausea and vomiting in many persons, even when given in very 
 small doses. 
 
 Emmenagogues (sri/ir^ta, the menses, ayu), I move), — are reme- 
 dies which restore the menstrual function, either directly by stimulation 
 of the uterine muscular fibre, or indirectly by improving the blood and 
 toning up the nervous system. Some of the direct emmenagogues are 
 oxytocic in large doses. The principal members of this class are named 
 in the following list ; — 
 4 
 
50 CLASSIFICATION OF MEDICINES. 
 
 Direct Emmenagognes. Indirect Emmenagognes. 
 
 Ergot. Apiol. Iron. 
 
 Savine. Borax. Manganese. 
 
 Tansy. Rue. Myrrh. Cinnamon. 
 
 Digitalis. Guaiacum. Quinine. 
 
 Cantharis. Polygonum Hydropip. Strychnine. 
 
 Pulsatilla. Potass. Permanganate. Aloetic Purgatives. 
 
 Asafetida. Cimicifuga. Cod-liver Oil. 
 
 Alcohol. Oxalic Acid. Hot Hip-baths. 
 
 Indigo. Hedeoma, Leeching the genitals. 
 
 Hydrargyrum Biniodide. Origanum. Rubefacients to thighs. 
 
 Caulophyllum. Viscum Flavescens. Tonic Remedies. 
 
 Emollients (emollio, I soften), — are substances which soften and 
 relax the tissues to which they are applied. They relieve tension, dilate 
 vessels, diminish pressure on the nerves, and protect inflamed surfaces 
 from the air and from friction. The principal articles which may be 
 classed under this heading are the following : — 
 
 Hot Fomentations. Linseed Oil. Petroleum. 
 
 Poultices. Olive Oil. Soap Liniment. 
 
 Glycerin. Spermaceti. Starch. 
 
 Lard. Almond Oil. Cacao Butter. 
 
 Errhines and Sternutatories (Sv, in, pb, the nose ; siernuto, I 
 sneeze), — are agents which produce increased nasal secretion and sneez- 
 ing, when locally applied to the mucous membrane of the nose. The 
 first term is usually applied to substances which cause increase of the 
 mucus without sneezing, the latter to those which invariably produce 
 sneezing. The drugs should be applied in powder. The stimulus pro- 
 duced by these agents is transmitted by the nasal branches of the fifth 
 nerve to the respiratory centre, exciting the sudden and forcible expira- 
 tory effort called sneezing; also to the vaso-motor centre, contracting 
 the smaller vessels throughout the body and producing a general rise in 
 the blood-pressure. The principal agents of this class are — 
 
 Tobacco, as snuff. 
 
 Euphorbium. 
 
 Capsicum. 
 
 Ipecacuanha. 
 
 Sassy Bark. 
 
 Hellebore 
 
 Sanguinaria. 
 
 Saponine. 
 
 Ammonia. 
 
 Veratrum Album. 
 
 Ginger. 
 
 Cubebs. 
 
 The last two named may be used as simple Errhines, as the vapor of dilute Ammonia- 
 water or the smoke of burning Cubebs do not excite sneezing generally. 
 
 Escharotics or Caustics (£<j/dpa, a slough or scab ; xaiaj, I burn), 
 — are agents which destroy a tissue to which they are applied, and produce 
 a slough. They may be divided into two classes, the actual, or those in 
 which heat is the active agent, and the potential, by which a chemical 
 process is called into play. Escharotics act usually in one of the follow- 
 ing modes : — 
 
CLASSIFICATION OF MEDICINES. 5 I 
 
 1. By abstracting the water of the tissues. 
 
 2. By combining with the albumin of the tissues. 
 
 3. By corrosive deoxidation of the tissues. 
 
 4. By conversion of the tissues into carbon or gaseous bodies. 
 
 The principal escharotics are named in the following list, the numbers 
 pointing out the mode of action as stated above : — 
 
 Mineral Acids. 1 Caustic Potash. x Mercuric Chloride. 2 
 
 Glacial Acetic Acid. x Caustic Soda. x Mercuric Oxide. 2 
 
 Carbolic Acid. 1 Dried Alum. 2 Mercuric Nitrate. 2 
 
 Chromic Acid. 3 Silver Nitrate. 2 Bromine. 3 
 
 Arsenous Acid. 1 Copper Sulphate. 2 f Cautery. 4 
 
 Antimony Chloride. x Zinc Sulphate. 2 High Heat. < Moxa. 4 
 
 Lime. 1 Zinc Chloride. 2 ( Boiling Water. 4 
 
 Nitric Acid and Zinc Chloride are probably the safest and most generally useful of the 
 potential caustics where any decided escharotic action is desired. Silver Nitrate is the 
 best for superficial use, its action being limited to the part with which it comes in con- 
 tact, and being stopped at once by the application of a solution of common salt. 
 Chromic Acid is one of the most efficient escharotics, but it must be carefully used. 
 
 Expectorants (ex, out of, pectus, the breast), — are remedies which 
 modify the secretion of the broncho-pulmonary mucous membrane, and 
 promote its expulsion. They may be divided into the following groups : 
 
 Nauseating Expectorants in large doses act mechanically by expelling 
 the mucus in the act of vomiting, in small doses by increasing osmosis 
 from the inflamed mucous membrane. The members of this subdivision 
 generally increase secretion and tend to lower the blood-pressure. The 
 chief ones are the following named : — 
 
 Antimony, Tartar Emetic. Apomorphine. Potassium Iodide. 
 
 Ipecacuanha, Emetine. Quebracho. Lobelia. 
 
 Pilocarpus (Jaborandi). Alkalies. Lobeline. 
 
 Stimulant Expectorants are largely eliminated by the bronchial mucous 
 membrane, which they stimulate, altering the secretion and facilitating 
 expectoration. These remedies generally diminish secretion and increase 
 blood-pressure. This subdivision includes the following named : — 
 
 Ammonium Chloride. 
 Ammonium Carbonate. 
 Benzoin and Benzoic Acid. 
 Balsams of Peru and Tolu. 
 Wood Tar, and Tar. 
 Oleum Pini Sylvestris. 
 
 Besides the above many other remedies may act as expectorants, some by relieving 
 bronchial spasm, as Opium, Stramonium and Tobacco ; others by soothing the irritable 
 respiratory centre, as Opium and Chloral ; and the ciliary excitants by reflex action 
 through their impression on the nerves of the mouth. 
 
 Galactagogues (ydXa, milk, ayio, I bring away), — are agents which 
 are supposed to increase the lacteal secretion. The value of most of 
 
 Acids. 
 
 Nux Vomica. 
 
 Squill. 
 
 Strychnine. 
 
 Garlic. 
 
 Senega. 
 
 Onion. 
 
 Saponine. 
 
 Turpentine. 
 
 Liquorice. 
 
 Sulphur. 
 
 Saccharine Substances, 
 
52 CLASSIFICATION OF MEDICINES. 
 
 them is very doubtful, probably the only efficient one being Pilocarpus 
 (Jaborandi), but its influence is very transient and the excessive perspira- 
 tion and salivation caused by it are objectionable. The leaves of Ricinus 
 communis, the castor-oil plant, locally applied, have been highly recom- 
 mended; but general measures are more trustworthy, such as the correc- 
 tion of anemia, attention to sore nipples, administration of tonics and good 
 food. [Compare the article entitled Lactation in Part III.] Other agents 
 reputed to have galactagogue properties are the following-named: — 
 
 Anise. Gallega. Beer, Ale, Porter. 
 
 Dill. Physostigma. Black Tea. 
 
 Fennel. Strychnine. Sinapisms. 
 
 Vanilla. > Potassium Chlorate. Electricity. 
 
 Galactophyga (jdXa, milk, <peuyaj, I shun), — are agents and measures 
 which diminish or arrest the secretion of milk. Belladonna or its alka- 
 loid Atropine is the most efficient, acting whether applied locally or ad- 
 ministered internally. Antipyrin has similar power, so also has Camphor 
 applied locally and Potassium Iodide, Colchicum with Magnesium Sul- 
 phate, Tobacco, Sage, Quinine, Tannin, etc. Compression of the 
 breasts, by bandaging or strapping with adhesive plaster, has positive 
 antigalactic action. 
 
 Hearing is affected by several drugs. Strychnine and Morphine 
 increase the excitability of either the auditory nerve or the centre for 
 hearing in the superior temporo-sphenoidal convolution, making that 
 faculty much more acute. Quinine, Antipyrin and Salicylates produce 
 hyperemia of the auditory apparatus, causing subjective noises, as hum- 
 ming, buzzing, or ringing, which are very unpleasant. Hydrobromic 
 Acid and the Bromides, also Ergot, will diminish the congestion and 
 thus neutralize or prevent these noises to a great extent. 
 
 Quinine in large doses is believed by some to have produced permanent injury of the 
 sight and the hearing, but authentic cases of such action are extremely rare, if indeed 
 they can be found at all. Temporary deafness is often caused by Quinine, but it usually 
 disappears soon after the administration of the drug is stopped. 
 
 Hepatic Depressants lower the functional activity of the liver, 
 some reducing the secretion of bile, others lessening the production of 
 glycogen, and others diminishing the production of urea. Lead Acetate 
 is a direct hepatic depressant, especially in large doses, and is probably 
 the only drug which lessens the biliary secretion without causing purga- 
 tion. Many Purgatives diminish the secretion of bile by lowering the 
 blood-pressure in the liver and by carrying off material from which bile 
 may be formed. The list of hepatic depressants includes the following- 
 named agents : — 
 
CLASSIFICATION OF MEDICINES. 
 
 53 
 
 Lessening 
 
 Bile. 
 
 Diminishing Glycogen 
 
 n. Lessening Urea. 
 
 Lead Acetate. 
 
 Opium. 
 
 Opium. 
 
 Atropine. 
 
 
 Morphine. 
 
 Morphine. 
 
 Calomel. 
 
 
 Codeine. 
 
 Codeine. 
 
 Chloral. 
 
 
 Arsenic. 
 
 Alcohol. 
 
 Castor Oil. 
 
 
 Antimony. 
 
 Colchicum. 
 
 Gamboge. 
 
 
 Phosphorus. 
 
 Quinine. 
 
 Magnesium 
 
 Sulphate. 
 
 
 
 Contrary to the generally accepted opinion, Opium and Morphine do not affect the 
 biliary secretion (Murrell). 
 
 Hepatic Stimulants and Cholagogues (x°fy, bile, ayco, I bring 
 away), — are two groups of agents acting upon the biliary secretion, the 
 first-named increasing the functional activity of the liver-cells and the 
 amount of bile formed, the second removing the bile from the duodenum 
 and preventing its reabsorption into the portal circulation. Some hepatic 
 stimulants are also cholagogues, others are not, while cholagogues proper 
 generally act indirectly as hepatic stimulants by carrying off the bile and 
 thereby urging the liver to secrete more. The discovery of the entero- 
 hepatic circulation of bile has cleared up many of the discrepancies 
 formerly existing with regard to the action of drugs upon this gland and 
 its secretion, yet neither this subject nor hepatic chemistry has yet 
 attained such results as would enable us to formulate positive doctrines 
 thereon. Bile, Bile Salts and Sodium Salicylate are at present the only 
 agents which have been experimentally proven to have the direct power 
 of increasing the biliary secretion, though a number of drugs are believed 
 to act in this manner upon clinical and other evidence. The following 
 list includes the principal agents which are generally credited with the 
 actions defined above : — 
 
 Hepatic Stimulants. 
 
 Cholagogues. 
 
 Bile, Bile Salts. 
 
 Ipecacuanha. 
 
 Mercury with Chalk. 
 
 Sodium Salicylate. 
 
 Colocynth. 
 
 Calomel. 
 
 Nitro-hydrochloric Acid. 
 
 Colchicum. 
 
 Pil. Hydrargyri. 
 
 Corrosive Sublimate. 
 
 Podophyllin. 
 
 Sodium Phosphate. 
 
 Mineral Acids. 
 
 Euonymin. 
 
 Sodium Sulphate. 
 
 Arsenic. 
 
 Iridin. 
 
 Potassium Sulphate. 
 
 Sulphurated Antimony. 
 
 Aloes. 
 
 Aloes. 
 
 Benzoic Acid. 
 
 Jalapin. 
 
 Podophyllin. 
 
 Sodium Benzoate. 
 
 Scammony. 
 
 Colchicum. 
 
 Sodium Phosphate. 
 
 Rhubarb. 
 
 Colocynth. 
 
 Sodium Sulphate. 
 
 Sanguinarine. 
 
 Rhubarb. 
 
 Sodium Sulphocarbolate. 
 
 Hydrastin. 
 
 Jalapin. 
 
 To secure the best cholagogue effect it is advisable to combine an hepatic stimulant 
 with an intestinal stimulant which shall produce increased secretion from the intestinal 
 mucous membrane and excite peristalsis. Hydrochloric Acid which has been kept long 
 and has become a light or golden-yellow color, is relatively inert as an hepatic stimu- 
 lant, but the freshly combined, deep red acid is active and valuable (Wood). 
 
 The glycogenic function of the liver, and the production of urea are 
 stimulated by the following-named drugs ; — 
 
54 CLASSIFICATION OF MEDICINES. 
 
 Increasing Glycogen. Increasing Urea. 
 
 Amyl Nitrite. Arsenic. Iron. 
 
 Sodium Bicarbonate. Antimony. Phosphorus. 
 
 Nitro-hydrochloric Acid. Ammonium Chloride. 
 
 Hypnotics (u7rvoe, sleep), — are remedies which produce sleep. In 
 this wide sense the term includes the narcotics and the general anesthetics, 
 but it is usually restricted to those agents which, in the doses necessary to 
 cause sleep, do not disturb the normal relationship of the mental faculties 
 to the external world (Brunton). Another definition of hypnotics is — 
 that they produce sleep without suspending the consciousness of pain, 
 narcotics doing both. Hypnotics may be subdivided into the following 
 classes : — 
 
 {a) Pure Hypnotics, — which directly induce a sleep closely resembling 
 the normal, without causing narco.tic or other dangerous cerebral symp- 
 toms. The Bromides are the type of this subdivision, but the list is con- 
 stantly growing smaller as experience reveals toxic powers in the action 
 of its members. 
 
 (J?) Narco-hypnotics , — which induce sleep by direct depression of the 
 cerebral functions and in larger doses are narcotic, suspending the con- 
 sciousness of pain and producing coma. Opium is the type of this class. 
 
 (c) Indirect Hypnotics, — which induce sleep by removing or suppressing 
 any cause (not mental) which interferes therewith. Such are the non- 
 narcotic analgesics,* acting against pain ; the respiratory stimulants, f 
 relieving dyspnea; the pulmonary sedatives,| relieving cough; the 
 motor depressants,§ restraining excessive motor activity; also the vascu- 
 lar and cardiac tonics,^" antagonizing cerebral hyperemia and regulating 
 the cardiac action. 
 
 The principal members of each of the above subdivisions are named in 
 the following lists : — 
 
 Pure Hypnotics. 
 
 Narco-hypnotics. 
 
 Indirect Hypnotics. 
 
 Potassium Bromide. 
 
 Chloral Hydrate. 
 
 *Antipyrin. 
 
 Sodium Bromide. 
 
 Opium, Morphine, Narceine. 
 
 *Acetanilid. 
 
 Paraldehyde. 
 
 Hyoscine. Duboisine. 
 
 *Phenacetin. 
 
 Sulphonal. 
 
 Cannabis Indica. 
 
 "("Strychnine. 
 
 Trional. 
 
 Pellotine. 
 
 ^Hydrocyanic Acid. 
 
 Tetronal. 
 
 Passiflora Incarnata. 
 
 |Conium. 
 
 Urethane. 
 
 Piscidia Erythrina. 
 
 fGelsemium. 
 
 Chloralamid. 
 
 Amylene Hydrate. 
 
 IfErgot. 
 
 Alcohol. ^"Digitalis. 
 
 Chloral Hydrate is undoubtedly the most efficient of all hypnotics. Paraldehyde is 
 one of the most reliable and safe, but its sleep is transient, lasting only a few hours. 
 Sulphonal and Trional are very efficient in some cases, but often fail entirely. Urethane 
 is feeble and uncertain, and the same may be said of Humulus and some other agents 
 which are not mentioned above. Piscidia is also somewhat uncertain in action, though 
 its hypnotic and anodyne powers have proved very decided in many cases. 
 
 Dr. Wilcox rejects the dangerous, unreliable and objectionable hypnotics, and retains 
 four as amply sufficient for all ordinary cases of insomnia. These he classifies as fol- 
 lows : — 
 
CLASSIFICATION OF MEDICINES. 55 
 
 As to Potency : Paraldehyde, Chloralamide, Pellotine, Trional. 
 
 As to Rapidity : Pellotine, Paraldehyde, Chloralamide, Trional. 
 
 As to Freedom from causing Habituation : Pellotine (slight), Trional, Chloralamide, 
 
 Paraldehyde (considerable). 
 As to Safety : Chloralamide, Pellotine, Paraldehyde, Trional. 
 
 Intestinal Astringents contract the walls of the intestinal vessels, 
 diminishing the exudation therefrom, and lessening the fluidity of the 
 fecal discharges. The more powerful members of this group have also a 
 constringing action on the intestinal mucous membrane. The principal 
 agents of this class are named in the following lists: — 
 
 Astringents. Constringents. 
 
 Phosphoric Acid. ") Tannic Acid. 
 
 Nitric Acid. -,-,., . , Vegetable Astringents. 
 
 c i v • a -j \ Diluted. C\ 
 
 Sulphuric Acid. Alum. 
 
 Acetic Acid. J Zinc Oxide. 
 
 Lead Acetate. Copper Sulphate. 
 
 Silver Nitrate. Persalts of Iron. 
 
 Irritants are substances which, when applied to the skin, produce a 
 greater or less degree of vascular excitement. When used to produce a 
 reflex influence on a part remote from their site, they are termed counter- 
 irritants. They may be subdivided into the following groups : — 
 
 (a) Rubefacients, are those which produce temporary redness and con- 
 gestion of the skin, unless left too long in contact with the surface, when 
 they may cause exudation between the cuticle and the true skin (vesicants), 
 or may destroy the tissue and form a slough (escharotics). They may 
 also induce muscular atrophy. 
 
 {U) Vesicants, Epispastics or Blisters, are those which cause decided 
 inflammation of the skin and the outpouring of serum between the epi- 
 dermis and the derma. Cantharides is the agent generally used for 
 blistering purposes. 
 
 (J) Pustulants, affecting isolated parts of the skin, namely — the orifices 
 of the sweat-glands, giving rise to pustules. 
 
 The following list includes the principal agents and measures belong- 
 ing to these three groups : — 
 
 Vesicants. 
 
 Cantharides. 
 
 Euphorbium. 
 
 Mezereon. 
 
 Iodine. 
 
 Rhus Toxicodendron. 
 
 Ammonia (the confined vapor). 
 
 Glacial Acetic Acid. 
 
 Volatile Oil of Mustard. 
 
 Heat / Boilin g Water - 
 
 ' \ Corrigan s Hammer. 
 
 'ubefacients. 
 
 Rubefacients. 
 
 Mustard. 
 Capsicum. 
 Camphor. 
 Ammonia. 
 
 Oil of Cajuput. 
 Oil of Turpentine. 
 Volatile Oils. 
 Pitch. 
 
 Mezereon. 
 
 Friction. 
 
 Arnica. 
 
 Hot Water. 
 
 Alcohol. 
 
 
 Ether. 
 
 Pustulants. 
 
 Chloroform. 
 
 Croton Oil. 
 
 Iodine. 
 
 Tartar Emetic. 
 
 Menthol. 
 
 Ipecacuanha. 
 Silver Nitrate. 
 
56 
 
 CLASSIFICATION OF MEDICINES. 
 
 Lithontriptics and Antilithics (Xidoq, a stone, rp{i3w, I wear 
 down), — are agents which are supposed to promote the solution of con- 
 cretions in the excretory passages (lithontriptics) or to prevent their for- 
 mation (antilithics). These terms are generally restricted to remedies 
 affecting the urinary calculi, but those directed against the biliary form 
 are included in this arrangement for the sake of consistent classification. 
 The chief agents coming under these titles are the following-named : — 
 
 Biliary Calculi. 
 Ether and Turpentine. 
 
 (Durande's Solvent.) 
 Sodium Bicarbonate. 
 Sodium Salicylate. 
 Sodium Phosphate. 
 Castile Soap. 
 Alkaline Waters, especially Vichy. 
 
 Calcium Oxalate Calculi. 
 Dilute Nitro-hydrochloric Acid. 
 Carbonated Water. 
 Lactic Acid (for digestion). 
 
 Uric Acid Calculi. 
 Distilled Water. 
 Potassium Salts. 
 Lithium Salts. 
 Magnesium Citroborate. 
 Piperazin. 
 Lysidin. 
 Lycetol. 
 
 Phosphatic Calculi. 
 Ammonium Benzoate. 
 Benzoic Acid. 
 Dilute Nitric Acid. 
 
 There is probably little or no solvent value to the agents recommended for biliary cal- 
 culi. In the case of uric acid calculi the administration of Potassium or Lithium Salts 
 is based on their power of combining with the acid in the calculus, thus forming urate of 
 potassium or of lithium, which salts are more soluble than uric acid itself. Piperazin is 
 still more efficient in this respect, forming a piperazin urate which is seven times more 
 soluble than lithium urate. Lysidin is still more powerful. 
 
 Motor Depressants lower the functional activity of the spinal cord 
 and other parts of the motor apparatus and in large doses paralyze them. 
 Drugs which depress the cerebral motor convolutions, the motor centres 
 in the medulla, the motor nerve-trunks and nerve-endings, or the muscular 
 contractility itself, produce impairment of the motor power, and in large 
 doses may cause complete paralysis of the part or parts involved. Some 
 act indirectly by reducing the spinal circulation, as Aconite, Digitalis and 
 large doses of Quinine, others by a direct paralyzant action on the centres. 
 The principal members of this class are named in the following list : — 
 
 Curare. 
 Physostigma. 
 Conium. 
 Gelsemium. 
 Opium, Morphine, 
 
 Apomorphine. 
 Belladonna, Atropine. 
 Stramonium. 
 Hyoscyamus. 
 Muscarine. 
 Pulsatilla. 
 Grindelia. 
 Phytolacca. 
 Pilocarpus. 
 Quebracho. 
 
 Aconite. 
 
 Veratrum. 
 
 Tobacco. 
 
 Lobelia. 
 
 Digitalis. 
 
 Arnica. 
 
 Ailanthus. 
 
 Saponin. 
 
 Sparteine. 
 
 Ergot (at last). 
 
 Quinine (large doses). 
 
 Camphor. 
 
 Alcohol (large doses). 
 
 Ether (large doses). 
 
 Chloroform (large). 
 
 Chloral. 
 
 Bromides. 
 
 Potassium Salts. 
 
 Many metallic Salts. 
 
 Amyl Nitrite. 
 
 Nitroglycerin. 
 
 Hydrocyanic Acid. 
 
 Potassium Cyanide. 
 
 Methyl-strychnine. 
 
 Many Methyl compounds. 
 
 Ammonium Cyanide. 
 
 Ammonium Iodide. 
 
 Many compound Ammonias. 
 
 Galvanism. 
 
 Cold. 
 
CLASSIFICATION OF MEDICINES. 57 
 
 The motor centres in the medulla are powerfully depressed bv Opium, Morphine, Aco- 
 nite, Conium, Chloral, Physostigma, and large doses of Alcohol, Ether and Chloroform. 
 These last three are also paralyzers of the motor convolutions in the brain, arresting all 
 voluntary movements when administered in sufficient quantity. The anterior cornua of 
 the cord are greatly depressed by Physostigma, Carbolic Acid, and other agents, and the 
 motor nerves by Conium, Methyl-strychnine, etc., both actions resulting in paralysis of 
 the limbs. Curare, even in small doses, paralyzes the end-organs of the motor nerves, 
 and Belladonna, the compound Ammonias, Methyl-compounds, etc. , exercise a similar but 
 less powerful influence. Galvanism is also an effective local depressant of motor activity. 
 
 Motor-Excitants are agents which increase the functional activity 
 of the spinal cord and the motor apparatus, producing disturbances of 
 motility, heightened reflex excitability, and tetanic convulsions when 
 given in large doses, their ultimate effect being motor paralysis from 
 over-stimulation. 
 
 The most important members of this class are Nux Vomica and Ignatia, with their 
 alkaloids Strychnine and Brucine, also Thebaine, the tetanizing alkaloid of Opium. The 
 group also includes Morphine and Atropine, which, though at first sedative, when given 
 in large doses produce convulsions. The respiratory centre in the medulla is stimulated 
 by Strychnine, Atropine, Ammonia, and small doses of Alcohol, Ether and Chloroform. 
 The motor convolutions in the brain are stimulated by Alcohol in moderate doses, also 
 for a brief period by Ether and Chloroform. The end-organs of the motor nerves are 
 stimulated by the local use of Electricity, Strychnine and friction ; and are irritated by 
 the internal administration of Aconitine, Nicotine, Camphor, Pilocarpine and Pyridine. 
 Other members of this class are named in the following list : — 
 
 Nux Vomica. Alcohol (small dose). Ergot. Digitalis. 
 
 Ignatia. Ether (small dose). Ustilago. Convallaria. 
 
 Strychnine. Chloroform (small dose). Gossypium. Cimicifuga. 
 
 Brucine. Ammonia. Picrotoxin. Pilocarpine. 
 
 Thebaine. Absinthe. Aconitine. Pyridine. 
 
 Morphine (large dose). Buxine. Nicotine. Rhus Toxicodendron. 
 
 Atropine (large dose). Calabarine. Camphor. Electricity. 
 
 Mydriatics (f±udp{a<jiq, mydriasis), — are agents which produce dilatation 
 of the pupil of the eye (mydriasis). Some act locally, others when given 
 internally, but the principal ones {Atropine and its congeners) act both 
 locally and internally, producing at the same time paralysis of the ciliary 
 muscle, resulting in temporary loss of accommodation, the eye remaining 
 focussed for distant objects, and the intra-ocular tension being increased. 
 The principal mydriatics are the following-named : — 
 
 Atropine. Homatropine. 
 
 Belladonnine (internally only). Gelsemine (locally only). 
 
 Hyoscyamine. Muscarine. 
 
 Daturine. Cocaine. 
 
 Duboisine. Anesthetics (at last). 
 
 The dilating action of Atropine and its congeners is due to stimulation of the end- 
 organs of the sympathetic nerve, increasing the power of the radiating muscular fibres of 
 the iris, and also to paralysis of the end-organs of the motor oculi (3d cranial) nerve, 
 lessening the power of the circular fibres or sphincter iridis. When administered inter- 
 nally the drug is carried by the circulation to the eye, acting thereon locally as if instilled 
 directly upon the conjunctiva. Cocaine acts by stimulating the terminations of the sym- 
 pathetic. Anesthetics produce mydriasis late in their action, which is central. Atropine, 
 Duboisine and Homatropine are the mydriatics chiefly used by ophthalmologists. 
 
58 CLASSIFICATION OF MEDICINES. 
 
 Myotics (/zL«t),' I close), — are agents which produce contraction of 
 the pupil. The alkaloid Physostig??iine (Eserine) is the chief local myotic, 
 and the only one used in ophthalmic practice. It acts by stimulating the 
 circular muscular fibres of the iris, at the same time contracting the 
 ciliary muscle so that the eye is accommodated for near objects only, 
 also diminishing intra-ocular tension; in all of which it exactly antago- 
 nizes the action of Atropine. 
 
 Muscarine, Pilocarpine and Nicotine are also local myotics, acting upon the end- 
 organs of the oculo-motor nerve. Anesthetics in the early stage of their action cause 
 contraction of the pupil by lessening reflex action ; later, when they begin to paralyze 
 respiration, the accumulation of venous blood irritates the centres and produces dilatation, 
 which during anesthesia is a sign of failing respiratory power. The myotic action of 
 Opium is of central origin, probably paralysis of local reflex excitability. The chief 
 myotics are — 
 
 Physostigma, Eserine. Muscarine. Lobeline (internally). 
 
 Opium, Morphine. Gelsemine (internally). Nicotine (locally). 
 
 Pilocarpus, Pilocarpine. Carbolic Acid (internally). Anesthetics (at first). 
 
 Narcotics (ydpxq, stupor), are agents which lessen the relationship 
 of the individual to the external world. At first more or less excitant to 
 the higher brain and stimulant to the mind and to all the bodily func- 
 tions, the next stage of their action is one of profound sleep characterized 
 by increasing stupor, and this, if the dose has been sufficient, is followed 
 by coma and insensibility (narcotism), and finally death occurs from 
 paralysis of the medullary centres which govern respiration and the other 
 functions of organic life. Narcotics and stimulants are closely related, 
 Alcohol and Opium affording good illustrations, in the different stages of 
 their action, of stimulation followed by narcosis. Narcotics, in proper 
 medicinal doses, give us the power of lowering morbidly acute percep- 
 tion, of relieving pain and allaying irritation, nervous agitation and 
 spasm, of inducing sleep, and of regulating the vital functions by rest — 
 all of which are means of great therapeutical value. The chief narcotics 
 are : — 
 
 Opium, Morphine. Alcohol. Carbolic Acid. 
 
 Belladonna, Atropine. Ether. Hydrocyanic Acid. 
 
 Hyoscyamus. Chloroform. Oil of Turpentine. 
 
 Stramonium. Chloral Hydrate. Other Essential Oils. 
 
 Cannabis -Indica. Bromal Hydrate. Carbonic Acid Gas. 
 
 Opium is the typical member of the group. Humulus (hops) and Lactucarium 
 (lettuce) are generally included among the narcotics, but their action is so feeble that 
 they are seldom used for such purpose. 
 
 Oxytocics or Ecbolics (o^uq, quick, roxoq, childbirth; ixfioAi), 
 abortion), — are agents which stimulate the muscular fibres of the gravid 
 uterus to contraction, and may therefore produce abortion. In small 
 doses the same remedies are emmenagogue as a rule. Their mode of 
 action has not been clearly made known, but it is generally believed to 
 
CLASSIFICATION OF MEDICINES. 59 
 
 be due in some cases to direct stimulation of the uterine centre in the 
 cord, in others to congestion of the uterus producing reflex stimulation. 
 The principal oxytocics are those named in the following list : — 
 
 Ergot. Hydrastis. Pilocarpine. 
 
 Ustilago. Borax. Viscum Flavescens. 
 
 Savine. Cotton-root Bark. Strong Purgatives. 
 
 Potassium Permanganate. Oil of Rue. 
 
 Any drastic purgative, or gastro-intestinal irritant, may produce abortion by reflex 
 action. The Volatile Oils act in this manner, also Colocynth and many other agents used 
 by women to produce abortion, as Tansy, Pennyroyal, etc. , all of which are dangerous 
 to life in doses sufficient to excite the action of the gravid uterus. 
 
 According to Boissard there are no abortifacient drugs in the strict sense of the term, 
 though some drugs given in toxic doses may cause abortion and the death of the woman. 
 Such drugs are therefore useless in any except the most reckless hands. The oxytocic 
 and ecbolic drugs belong to another class, having the power of strengthening the intensity 
 of the uterine contractions after they have been aroused (oxytocics),' or of arousing and 
 aiding uterine contractility (ecbolics). The action of the former is certain, that of the 
 latter is very doubtful. 
 
 Pancreatic Stimulation may be obtained by the administration of 
 Ether, or by galvanism of the gland itself. The secretion is depressed 
 by Atropine, also by any agent inducing nausea and vomiting. 
 
 Parasiticides {jzapaaixoz, a parasite, cozdo, I kill), — are agents 
 which destroy the animal and vegetable parasites found upon the human 
 body. They are generally applied in the form of lotions, ointments or 
 oleates, and include the following-named substances : — 
 
 Sulphur. Mercury. Carbolic Acid. 
 
 Sulphides. Ammoniated Mercury. Petroleum. 
 
 Sulphurous Acid. Mercuric Chloride. Storax. 
 
 Sulphur Iodide. Mercuric Nitrate. Staphisagria. 
 
 Iodine. Mercuric Oxide. Balsam of Peru. 
 
 Protectives are agents of a mechanical nature employed to cover and 
 protect an injured part from the air, water, friction, etc. Collodion and 
 Gutta-percha are those in general use, but certain plasters, as the adhesive, 
 the lead or the soap plaster, may be employed for this purpose, also 
 cotton. 
 
 Pulmonary Sedatives diminish cough and dyspnea by lessening the 
 irritability of the respiratory centre or that of the nerves of respiration. 
 Some act by directly depressing the respiratory centre ; others by remov- 
 ing some irritant from the passages, or by lessening local congestion, as 
 the expectorant group; and others by lowering the excitability of the 
 vagus end-organs in the lungs and that of other afferent filaments through- 
 out the respiratory tract. The principal pulmonary sedatives are named 
 in the following list : — ■ 
 
6o 
 
 CLASSIFICATION OF MEDICINES. 
 
 Opium. 
 
 Morphine. Codeine. 
 Belladonna. 
 Stramonium. 
 Hyoscyamus. 
 
 Hydrocyanic Acid. 
 Potassium Cyanide. 
 Amyl Nitrite. 
 Quebracho. 
 Cannabis. 
 
 Turpentine. 
 Ethyl Iodide. 
 Conium. 
 Tobacco. 
 Lobelia. 
 
 Opium has the most powerful influence as a sedative to the respiratory centre, and 
 mucilaginous or saccharine substances soothe the local irritation, hence the latter are so 
 frequently used as vehicles for the former in cough mixtures. Hydrocyanic Acid has a 
 similar sedative action, hence the use of Prunus Virginiana and other substances contain- 
 ing it against cough. Belladonna stimulates the respiratoiy centre, but at the same time 
 lessens the excitability of the vagus terminations in the lungs, and completely arrests 
 secretion from the bronchi. Stra?nonium acts similarly. 
 
 Refrigerants (refrigero, I cool), — are remedies which allay thirst and 
 impart a sensation of coolness. They include the Vegetable Acids, the 
 Mineral Acids (greatly diluted), Ice, Water if cold, effervescing drinks, 
 fruit juices, and many diaphoretics. 
 
 Respiratory Depressants lower the activity of the respiratory 
 idering the respirations slow and shallow. The chief agents of 
 
 centre, ren 
 
 this class are : — 
 
 Cold. 
 
 Opium. 
 
 Physostigma. 
 
 Muscarine. 
 
 Lobeline. 
 
 Gelsemium. 
 Aconite. 
 Veratrine. 
 Hydrocyanic Acid. 
 Conium. 
 
 Alcohol. 
 
 Ether. 
 
 Chloroform. 
 
 Chloral. 
 
 Saponin. 
 
 Caffeine. 
 
 Colchicine. 
 
 Nicotine. 
 
 Quinine. 
 
 Camphor. 
 
 Carbolic Acid. 
 
 The eleven last named first excite the centre for a brief period and then depress it. 
 
 Respiratory Stimulants exalt the function of the respiratory centre, 
 quickening and deepening the breathing. Such agents are : — 
 
 Strychnine. 
 
 Brucine. 
 
 Atropine. 
 
 Duboisine. 
 
 Emetine. 
 
 Chloralamid. 
 
 Opium (small doses). 
 
 Thebaine. 
 Apomorphine. 
 Ammonia. 
 Hydrocyanic Acid. 
 Digitalis. 
 
 Quebracho. 
 
 Zinc and Copper Salts. 
 Tobacco (briefly). 
 Alcohol (briefly). 
 Ether (briefly). 
 Cold Douche. 
 
 Strychnine also stimulates the vagus tract. Electricity, applied to the nerve-trunks or 
 to the inspiratory muscles, is a direct respiratory stimulant. Veratrine, Eserine and 
 Alascarine stimulate the vagus terminations, quickening the respiration, but afterwards 
 slow it by depressing the respiratory centre. Aconite stimulates the end-organs of the 
 vagus when given in small doses. 
 
 The Respiratory Centre is situated in the medulla oblongata, close to the termination 
 of the calamus scriptorius. It probably consists of thoracic and diaphragmatic Inspira- 
 tory Centres, the act of expiration being considered normally a passive one, due to the 
 natural contraction of the walls of the air-vesicles, and the return of the diaphragm and 
 thoracic walls to the position from which they were moved by the inspiratory effort. An 
 Expiratory Centre must also exist for the initiation of forced expiration, as in the pro- 
 duction of voice, cough, sneezing, etc. The chief Inspiratory A T erves are the pulmonary 
 branches of the vagus. The Expiratory ATerves are the nasal branches of the fifth, the 
 superior and inferior laryngeal, and the cutaneous nerves of the chest and abdomen. 
 
CLASSIFICATION OF MEDICINES. 6 1 
 
 Restoratives are agents which promote constructive metamorphosis, 
 including the Foods, Hematics and Tonics, as well as many agents called 
 Stimulants in other classifications. 
 
 Foods, are substances which, when introduced into the body, supply 
 material to renew some structure or to maintain some vital process ; 
 being distinguished from medicines in that the latter modify some vital 
 action but supply no material to sustain such. 
 
 The food of man is derived from all three of the kingdoms of nature, the animal, 
 vegetable, and mineral, and includes many substances treated of in the Materia Medica, 
 as Oils and Fats, Sugar, Starch, Gum, Alcohol, Beverages like Coffee and Tea, Water, 
 Phosphate of Lime, Sodium Chloride, etc. 
 
 Hematics (dtfia, the blood), are medicines which augment the quan- 
 tity of hematin in the blood, and thus restore the quality of that tissue 
 by enriching its red corpuscles. They consist chiefly of Iron and Man- 
 ganese and their compounds. 
 
 Tonics (rovoq, tension), are agents which improve the tone of the 
 tissues on which they have specific action, restoring energy and strength 
 to debilitated subjects by a scarcely perceptible stimulation of all the 
 vital functions, their effects being apparent in an increased vigor of the 
 entire system. The chief tonics are enumerated in the foregoing lists 
 under the heads of the organs or tissues particularly affected by them. 
 [Compare the articles entitled Stimulants, Respiratory Stimulants, 
 Cardiac Tonics, Vascular Tonics, Gastric Tonics, etc.] 
 
 The most typical medicinal agents which impart general tone and strength are Strych- 
 nine, Quinine, Iron and Vegetable Bitters. Those specially acting upon the stomach, 
 are Arsenic, Bismuth, Cinchona, Hydrastis and Nux Vomica, — on the spinal cord and 
 general circulation, Strychnine, — on the heart, Digitalis, Squill, Convallaria and Cimi- 
 cifuga, — on the nervous system, Phosphorus, Quinine and the Valerianates, — on muscular 
 tissue, Tannin, — on the blood, Iron, Manganese, Cod-liver Oil, and other fats. 
 
 Sedatives {sedo, I allay), — are agents which exert a soothing influ- 
 ence on the system by lessening functional activity, depressing motility 
 and diminishing pain. 
 
 General Sedatives include the narcotics and anesthetics. Local Sedatives include 
 Aconite, Opium, Ice, etc. Pulmonary Sedatives, as Hydrocyanic Acid, Veratrine and 
 the nauseants and emetics. Spinal Sedatives, as Physostigma, Gelsemium, Potassium 
 Bromide. Stomachic Sedatives include Arsenic, Bismuth, Silver Nitrate, Sodium Bicar- 
 bonate. Vascular Sedatives, as Digitalis, Tobacco, Aconite, Veratrum, and the emetics. 
 A T ervous Sedatives, among which are Potassium Bromide, Tobacco, Lobelia, and the 
 group of spinal depressants. 
 
 Sialogogues (aiakov, saliva, ayw, I carry off), — are agents which 
 increase the secretion and flow of saliva and buccal mucus, either by 
 reflex action from the local irritation produced when anything is taken 
 into the mouth, or by stimulating the glands during their elimination. 
 The principal sialogogues are divided into two groups, the first or topical 
 
62 CLASSIFICATION OF MEDICINES. 
 
 sialogogues acting by reflex stimulation ; the second, general sialogogues, 
 acting through their systemic influence on the glands or their secretory 
 nerves ; and include the following-named substances : 
 
 Topical Sialogogues. General Sialogogues. 
 
 Acids and Alkalies. Pilocarpus (Jaborandi). 
 
 Ether, Chloroform, etc. Muscarine. 
 
 Mustard. Ginger. Physostigma. 
 
 Pyrethrum. Mezereon. Mercurials. 
 
 Tobacco. Cubebs. Iodine compounds. 
 
 Capsicum. Rhubarb. Antimonials. 
 
 Horse-radish. Tobacco. Ipecacuanha. 
 
 Agents which diminish salivary secretion are termed Antisialics. The 
 principal member of this group is Atropine, which paralyzes the terminals 
 of the nerves of secretion. Physostigma counteracts this paralysis, but 
 in large doses acts also as an antisialic by lessening the blood supply to 
 the glands. Opium diminishes the reflex excitability of the reflex centre 
 and also lessens the secretion directly. Others acting locally are — 
 
 Borax. Soda. Lithia. 
 
 Potassium Chlorate. Lime. Magnesia. 
 
 Insipid or nauseous articles of food or medicine. 
 
 Smell is one of the senses which is increased by Strychnine. It is 
 decreased by all cerebral depressants and by those agents which produce 
 changes in the nasal mucous membrane, as Potassium Iodide. 
 
 The cerebral centre for this faculty is situated at the tip of the temporo-sphenoidal 
 lobe, and the terminal branches of the olfactory nerve are distributed upon the mucous 
 lining of the upper portion of the nasal fossae. Strychnine probably stimulates the 
 former, and all drugs acting upon the latter region have more or less effect upon the 
 power of distinguishing smells. 
 
 Stimulant {stimulus, a goad), — is a term which is used in various 
 senses when applied to medicinal agents. Alcoholic preparations, which 
 are true narcotics, are commonly termed "stimulants," and the same 
 expression is employed to designate any agent which excites even briefly 
 the organic action of any part of the system. All excessive stimulation 
 reacts into depression, and most of the agents which stimulate the nerve 
 centres at first will soon depress and finally paralyze them. In many 
 cases the action is one of progressive stimulation primarily and progress- 
 ive paralysis afterwards, affecting the centres in the inverse order of their 
 development, the highest or latest developed centres being affected first, 
 the lowest or oldest ones last. These laws are well exemplified in the 
 action of Alcohol upon the nervous system. [Compare the article 
 entitled Alcohol in Part I.] 
 
 Diffusible Stimulants are those which have a prompt but transient effect on the general 
 system, such as Alcohol, Ammonia, Camphor, etc. Spinal Stimulants exalt the functions 
 of the cord, as Strychnine, Picrotoxin, Ergot, Atropine, Phosphorus. Cardiac Stimu- 
 
CLASSIFICATION OF MEDICINES. 63 
 
 lants increase the action of the heart, as Alcohol, Atropine and Morphine in small 
 doses, Strychnine, etc., also Squill, Convallaria, Cimicifuga and Digitalis, which slow 
 but strengthen the cardiac action. Respiratory Stimulants directly stimulate the respira- 
 tory centre, as Ammonia, Strychnine, Apomorphine, Belladonna, etc. Vaso-motor Stim- 
 ulants, as Alcohol, Chloroform, Ether (all three in very small quantities), Ammonia, 
 Strychnine, Digitalis and Squill, acting on the vaso-motor centre ; and the Nitrites, Bella- 
 donna, Electricity, Volatile Oils, etc., acting as local dilators of the vascular system. 
 Cerebral Stimulants, as Alcohol, Opium, Belladonna, Caffeine, Cocaine, Theine, Canna- 
 bis, Chloroform, Ether, Tobacco, etc. Renal Stimulants, as the diuretic group. Stom- 
 achic Stimulants, as the Aromatics, Volatile Oils, Vegetable Bitters, Mineral Acids, Nux 
 Vomica, Mustard, Capsicum, etc. Hepatic Stimulants, as Nitro-muriatic and Nitric acids, 
 and the cholagogue purgatives Podophyllum, Jalap, Leptandra, Euonymin, Iridin, etc. 
 Intestinal Stimulants, as Mercurials, Elaterium, Colocynth, Jalap, Scammony, Podophyl- 
 lum, etc., which affect the glandular apparatus, — and Belladonna, Physostigma, Nux 
 Vomica, Rhubarb, Senna, Aloes, Frangula, Cascara, etc., which chiefly affect the mus- 
 cular fibres and the intestinal nerves. Cutaneous Stimulants, as the diaphoretic group, 
 and the rubefacients Mustard, Capsicum, Turpentine, Ammonia, etc. 
 
 Local Stimulants increase common sensibility to the extent of producing pain, chiefly 
 by direct action upon the end-organs of the sensory nerves in the skin, though some act 
 probably by stimulating the local circulation, as in inflammation. The principal members 
 of this subdivision are — 
 
 Faradism. Chloroform. Volatile Oils. 
 
 Heat. Carbolic Acid. Acrid Essential Oils. 
 
 Cold. Creosote. Metallic Salts. 
 
 Alcohol. Mineral Acids. Veratrine (at first). 
 
 Ether. Ammonia. Cantharis (at first). 
 
 Stomachics or Gastric Tonics are agents which increase the 
 appetite and promote gastric digestion. They include a number of sub- 
 stances, dietetic and medicinal, some acting by stimulating the produc- 
 tion of gastric juice, others by stimulating the local circulation, and 
 several by exciting the activity of the nervo-muscular apparatus of the 
 stomach. The first indication is met by the use of dilute alkaline solu- 
 tions before meals, — the second by administering any of the pungent 
 carminatives, as the Aromatic Oils, Pepper, Mustard, etc., or by Alcohol 
 and Ether in small doses, or by the Aromatic Bitters, as Gentian, Orange, 
 etc., or the simple bitters, as Calumba ; — while the third desideratum is 
 secured by the use of such agents as Nux Vomica, Hydrastis, Arsenic, 
 the dilute Mineral Acids and the Volatile Oils. 
 
 Adjuvants to digestion are the digestion-ferments, Pepsin, Ingluvin, Papain, and also 
 dilute HO acid; all of which maybe used to supplement the gastric juice when deficient 
 in quantity or quality. The juice of the Pineapple contains a very active digestive prin- 
 ciple, and may be employed as an aid to digestion with excellent results. Pepsin acts in 
 acid media, and is only applicable to gastric indigestion ; Pancreatin acts in alkaline 
 media, is destroyed by acids, and is only applicable to intestinal indigestion ; while 
 Papain exercises its proteolytic power in either acid, alkaline or neutral solutions, and is 
 equally applicable to either gastric or intestinal indigestion. 
 
 Styptics and Hemostatics {axucpo), I contract, afca, blood, 
 ardai^, a standing), — are agents which arrest bleeding ; Styptics being 
 those which are applied locally, and Hemostatics those which are admin- 
 istered internally. Some of the former act mechanically, by promoting 
 the formation of a clot in the mouths of the bleeding vessels ; others 
 
64 CLASSIFICATION OF MEDICINES. 
 
 cause the vessels themselves to contract, thereby checking the flow of 
 blood. The principal members of this class are the following-named : — 
 
 Styptics. Hemostatics. 
 
 Acids. Matico. Ergot. Digitalis. 
 
 Alum. Spider's- web. Gallic Acid. Matico. 
 
 Antipyrin. Tannic Acid. Lead Acetate. 
 
 Collodion. Gelatin. Lead Acetate. Dilute Sulphuric Acid. 
 
 Ferric Chloride. Zinc Sulphate. Ipecacuanha. 
 
 Ferric Sulphate. Vegetable Astringents. Hamamelis. 
 
 Silver Nitrate. Cold (locally). Oil of Turpentine. 
 
 Adrenal Extract. Cauterization. Heat (locally). 
 
 Taste is not much affected by drugs except as each drug makes its own 
 peculiar impression on the nerves of taste, and may overcome that of 
 another agent. Smell has much to do with taste in many instances, the 
 expedient of holding the nose while swallowing Castor Oil being familiar 
 to every one. 
 
 The "after- taste" of drugs is often different to their original taste; thus Bitters axe. 
 said to leave a sweet after-taste, and the same is claimed for Quinine if given in acid 
 solution so as to be entirely dissolved, and if washed out of the mouth with water imme- 
 diately after swallowing. Substances which are excreted from the system in the saliva 
 (as Iodides) leave a very persistent after-taste. 
 
 Urinary Acidifiers include Benzoic and Salicylic Acids and several 
 of their salts, Vegetable Acids in excess, also excess of proteids, sugar and 
 starch in the food, and certain wines and spirits. The Mineral Acids 
 have little or no influence on the acidity of the urine, being excreted as 
 neutral sulphates, chlorides, phosphates, etc. 
 
 Benzoic Acid and its salts are among the very few agents by which morbid alkalinity 
 of the urine can certainly be neutralized. Salol is much quicker in its action on the urine 
 than is Ammonium Benzoate ; as ordinarily in a day or so, under its administration, the 
 urine in chronic cystitis loses its alkalinity and foul odor, and becomes clear (Dr. Mansel 
 Sympson). Potassium Bitartraie, being an acid salt, will in most cases acidify an alka- 
 line urine. 
 
 Urinary Alkalinizers include the alkalies, particularly Potassium and 
 Lithium Salts, but excepting Ammonia which is broken up in the organ- 
 ism. Sodium salts, being partly excreted by the bile and the bronchial 
 mucus, and partly locked up in the system as the neutral chloride, while 
 sodium urate is insoluble, are not so efficient in this regard as are other 
 alkalies. Fruits, milk and fish also act in the same manner by means of 
 the salts which they convey into the economy, and a strictly vegetable 
 diet plays an important part towards the same end. 
 
 Urinary Sedatives and Astringents, when administered inter- 
 nally, act in a sedative manner upon the whole extent of the urinary 
 tract through the medium of the urine, which, being charged with them, 
 brings them into contact with the genito-urinary mucous membrane. 
 Some of them may be applied locally as far as the urethral and vesical 
 
CLASSIFICATION OF MEDICINES. 65 
 
 mucous surfaces, the portion above the latter being inaccessible to direct 
 local medication. 
 
 Instances of the application of these agents are the use of Potassium and Lithium 
 Salts to diminish the acidity of the secretion, — Cubebs, Copaiba, and Sandal-wood Oil as 
 antiseptics and astringents, — and urethral injections of Alum, Acetates of Zinc and Lead, 
 Boracic Acid, Chloral and Zinc Chlorides, etc. , for a simple purpose. Copaiba is one of 
 the most efficient agents for rendering the urine antiseptic, and should be more employed 
 in cystitis and urethritis than it is. Oil of Eucalyptus is nearly as efficient, and Stigmata 
 Maidis (Corn Silk), in tincture, is well thought of for its general alterative influence on 
 the urinary tract. 
 
 Uterine Depressants lower the activity of the nervo-muscular appa- 
 ratus which controls the uterine contractions. The most important of 
 these agents are — 
 
 Opium. Chloral. Tobacco. 
 
 Bromides. Chloroform. Sulphate of Copper. 
 
 Cannabis. Tartar Emetic. Emetics. 
 
 Viburnum Prunifolium. Piscidia Erythrina. 
 
 Uterine Stimulants — See Oxytocics, ante, page 58. 
 
 Uterine Tonics and Alteratives, are medicines which are consid- 
 ered to have such specific influence over the uterus. Authorities differ 
 very much regarding the action and use of these agents, but those named 
 in the following list are generally believed to have considerable value in 
 uterine therapeutics, viz. — 
 
 Uterine Tonics. Uterine Alteratives. 
 
 Potassium Bromide. Iodine. 
 
 Potassium Chlorate. Iodoform. 
 
 Pulsatilla. Iodized Phenol. 
 
 Helonias Dioica. Glycerin. 
 
 Cimicifuga. Hydrastis. 
 
 Savine. Silver Nitrate. 
 
 Astringents (locally). Galvanism. 
 
 Those in the first list, except Astringents, are used internally ; those in the second 
 column are employed as topical applications to the uterine cavity or cervix. 
 
 Vascular Contractors increase the contractile power of the vessels, 
 lessening the circulation therein and raising the blood-pressure ; hence 
 they are used to check hemorrhage and cut short inflammations. The 
 principal agents included in this group are — 
 
 Cold. 
 
 Antipyrin. 
 
 Opium (small doses) 
 
 Ergot. 
 
 Adrenal Extract. 
 
 Cocaine (locally). 
 
 Barium Salts. 
 
 Belladonna. 
 
 Sulphuric Acid. 
 
 Lead Salts. 
 
 Digitalis. 
 
 Hamamelis. 
 
 Silver Salts. 
 
 Squill. 
 
 Iron. 
 
 Zinc Salts. 
 
 Strophanthus. 
 
 Strychnine. 
 
 These agents act upon the local vaso-motor mechanism in the walls of the vessels, 
 Hamamelis affecting the venous system especially. Cold is one of the most powerful 
 agents of this class, and is also a cardiac sedative. Adrenal Extract produces an enor- 
 mous rise of the blood-pressure, due to its extraordinary contractile power over the 
 muscular fibres in the walls of the arterioles. 
 
66 CLASSIFICATION OF MEDICINES. 
 
 Vascular Dilators produce dilatation of the peripheral vessels, and 
 increase the rapidity of the circulation, thus equalizing the blood-pressure 
 and relieving internal congestions. The most useful are Alcohol and 
 Ether, as they stimulate the action of the heart simultaneously with the 
 vascular relaxation. The chief members of this group are : — 
 
 Alcohol. Belladonna, Chloral. 
 
 Ether. Stramonium. Chloroform. 
 
 Nitrous Ether. Hyoscyamus. Ammonium Acetate. 
 
 Nitroglycerin. Opium (at first). Tartar Emetic. 
 
 Amyl Nitrite. Dover's Powder. Camphor. 
 
 Thyroid Extract. Ipecacuanha. Heat, by poultices, etc. 
 
 The dilating action of Amyl A T itrite and other Nitrites is due either to weakening of 
 the muscular walls of the arterioles or to paralysis of the vaso-motor ganglia in them. 
 Alcohol, Ether and Opium probably depress the vaso-motor centre. Aconite does not 
 affect the vaso-motor centre or the vaso-motor nerves, hence the lessened arterial tension 
 induced by it is due to its depressant action on the heart alone (Ringer). 
 
 The Vascular Dilators are often called Vascular Stimulants or stimulants of the cir- 
 culation ; but there is this difficulty of speaking of stimulants or sedatives of the circula- 
 tion, that if both the heart and the vessels are stimulated at the same time, the action of 
 the one tends to counteract that of the other. On the other hand, a drug which weakens 
 the heart may increase the circulation by dilating the vessels, thus acting as a vascular 
 stimulant (Brunton). 
 
 Vesical Sedatives are substances which lessen irritability of the 
 bladder, relieving pain and decreasing the desire to micturate. Opium, 
 Belladonna, Hyoscyamus, Stigmata Maidis, Cannabis, etc., lessen the 
 irritability of the nerves, Calcium Carbonate relieves that due to the 
 presence of calculi; mucilaginous drinks, such as Barley-water or Linseed 
 tea, also astringents like Buchu, Uva Ursi, Pareira, etc., diminish the 
 irritation due to chronic cystitis, and antiseptics, as Copaiba, and Cubebs, 
 act in like manner, being carried by the urine to the bladder. 
 
 Vesical Tonics increase the contractile power of the muscular fibres 
 in the wall of the bladder. By strengthening the detrusor they prevent 
 retention of urine and by stimulating the sphincter they prevent inconti- 
 nence. The most important members of this group are Cantharides, 
 Belladonna, Strychnine and Potassium Bromide by internal administra- 
 tion, Silver Nitrate locally, and the use of a urethral bougie. 
 
 Cantharides stimulates the sphincter vesicae by rendering the urine irritant thereto; 
 Strychnine, by increasing the irritability of the nerve-centre which governs it. Potassium 
 Bromide lessens reflex susceptibility from the bladder, so that the detrusor is less fre- 
 quently called into action. Belladonna probably decreases the sensibility of the bladder 
 to changes of pressure within it. Silver Nitrate, locally applied to the neck, acts in the 
 same manner as the passing of a urethral bougie, namely — by altering the direction of 
 reflex action (Brunton). 
 
 Visions are caused by several drugs, the action of which is probably 
 exerted on the sight-centres in the cerebrum (angular gyrus and occipital 
 lobes), rather than on the eye itself. The delirium and hallucinations 
 produced by Alcohol are familiar examples, — the objects raised thereby 
 
ADMINISTRATION OF MEDICINES. 6j 
 
 being usually animals, as snakes, toads, dogs, etc. Sodium Salicylate in 
 some persons produces very disagreeable visions. The Bromides, if taken 
 in continued large doses may, during the typhoid condition which fol- 
 lows, cause visions of such intense character that they are often impressed 
 permanently on a brain which, at the time, was utterly unconscious of all 
 its real surroundings. Digitalis may produce subjective sensations of the 
 continued presence of light, and Cannabis Indica, among the many curi- 
 ous effects produced by its ingestion in large doses, frequently gives origin 
 to similar disturbances of the visual function, of an indefinite and varied 
 but usually pleasant character. 
 
 ADMINISTRATION OF MEDICINES. 
 
 Medicines may be introduced into the circulation by various routes, 
 including the mouth, the stomach, the rectum, the respiratory tract, the 
 veins and arteries, the subcutaneous cellular tissue, and the integument. 
 
 The Mouth is the usual receptacle for medicines intended for the 
 stomach, but may itself be employed for the introduction of minute quan- 
 tities of powerful agents. A drop of the tincture of Aconite placed on 
 the tongue is quickly absorbed, and soon manifests that fact by its symp- 
 toms. Many of the small tablets used for hypodermic administration, if 
 placed under the tongue, are readily conveyed into the system, and used 
 in this way form a very convenient means of medication with alkaloids 
 and other active principles. 
 
 The Stomach is the most convenient organ for the absorption of 
 medicines and the one most frequently employed. After being swallowed, 
 the remedies find their way into the current of the circulation through the 
 walls of the gastro- intestinal blood-vessels and the lacteals. When the 
 stomach is empty and its mucous membrane healthy crystalloidal sub- 
 stances in solution pass through the walls of its vessels with great rapidity. 
 Colloidal Substances (fats, albumin, gum, gelatin, etc.) require to be 
 digested and emulsified before they can be absorbed. Iodine and Iodides 
 should be given on an empty stomach, so that they may diffuse rapidly 
 into the blood ; if administered during digestion, the acid gastric juice 
 and the starch of the food will alter their chemical constitution and 
 weaken their action. Acids should be given, as a rule, on an empty 
 stomach, especially when they are intended to check the secretion of the 
 
68 ADMINISTRATION OF MEDICINES. 
 
 acids of the gastric juice. Alkalies, of which Sodium Bicarbonate may 
 be taken as the type, are given after meals to neutralize excessive acidity, 
 and before meals to stimulate the acid gastric secretions. Silver Oxide 
 and Silver Nitrate should be administered after the digestive process is 
 ended; if given during digestion, chemical reactions destroy or impair 
 their special attributes and defeat the object for which they were pre- 
 scribed. Metallic Salts (especially corrosive sublimate), also Tannin and 
 pure Alcohol, impair the digestive power of the active principle of the 
 gastric juice, and should be given by the stomach only during its period 
 of inactivity. Malt Extracts, Cod-liver Oil, Phosphates, etc., should be 
 administered with or directly after food, so that they may enter the blood 
 with the products of digestion. Bisinuth should be given before meals, 
 as it is usually employed for its local sedative action on the gastric mucous 
 membrane. Potassium Permanganate should be given after meals ; on an 
 empty stomach it would irritate the mucous membrane and might possi- 
 bly produce ulceration thereof. Arsenic and other irritant and dangerous 
 drugs (such as copper, zinc and iron salts), should be given directly after 
 food, except where local conditions require their administration in very 
 small doses on an empty stomach. Morphine should only be given by 
 hypodermic injection when the patient is lying down, unless he is previ- 
 ously habituated to its use. Pilocarpine, administered to produce sweat- 
 ing, should be given when the patient is in bed in a warm room. Ammo- 
 nium Acetate acts as a diaphoretic when the recipient is warm in bed, but 
 as a diuretic when the patient is in a cold atmosphere. Sulphonal should 
 be given two or three hours before its hypnotic action is desired, as it is 
 very slowly absorbed. 
 
 Under some circumstances it becomes necessary to introduce medicines directly into 
 the stomach, as in cases of the patient's inability to swallow, through narcotic poisoning 
 or other causes. The stomach-pump or the stomach-tube may then be employed to 
 convey both food and medicine to that organ. In obstruction of the esophagus, as from 
 stricture or malignant disease thereof, it may become necessary to make an opening 
 through the abdominal wall and the wall of the stomach itself. Nasal feeding, by the 
 use of a small catheter with a hard rubber funnel inserted into its end, is a very efficient 
 method of conveying liquids into the stomach. The eye end of the catheter is oiled and 
 passed gently along the floor of the nose and down the pharynx ; the fluid being then 
 poured into the funnel. This method is particularly serviceable in cases of acute tonsil- 
 litis or other painful affections of the mouth or palate, also after excision of the tongue, 
 when swallowing is to be avoided as much as possible. In many cases, especially insane 
 ones, the patient will so constrict the muscles of the throat as to force the catheter into 
 the mouth ; but if it is withdrawn until nearly out of the pharynx, the presence of the 
 fluid as it drops down will excite swallowing, and the patient may be fed as well as if 
 the tube were in the esophagus. 
 
 The Rectum will absorb many substances applied in the form of 
 enemata or suppositories. Those most suited to this route are the salts 
 of the alkaloids in solution, especially those of Morphine, Atropine and 
 Strychnine, the latter being absorbed more rapidly by the rectum than by 
 
ADMINISTRATION OF MEDICINES. 69 
 
 the stomach. Acid solutions, if not too frequently repeated, are also well 
 administered by this channel. Nutritive enemata must be small, not ex- 
 ceeding three or four fluid ounces, or they will not be retained. They 
 become necessary in many cases, especially in cases of gastric ulcer, in 
 order to afford rest to the stomach. It is often found advantageous to have 
 the food predigested before being administered by the rectum, for which 
 purpose Pancreatin is used. [Compare the articles entitled Injectiones 
 and Suppositoria in Part II and Enemata in Part III.] 
 
 The Respiratory Tract admits of the rapid absorption of medicinal 
 substances through its extensive blood-supply. The inhalation of vapors 
 or atomized fluids, the insufflation of powders into the nares, fauces, 
 larynx, etc., and the use of a medicated nasal douche, are methods 
 whereby this channel may be utilized. [Compare the article entitled 
 Inhalationes, in Part II.] 
 
 The Veins are only used as a route of medication in emergencies, 
 when the other channels are not available, and where immediate action 
 is necessary to the preservation of life, the operation being a highly dan- 
 gerous one. The injection intravenously of Saline Solutions in the col- 
 lapse of cholera, diabetic coma, etc., Blood or Milk as a last resort in 
 excessive hemorrhage, epilepsy, uremia, the collapse of cholera, etc., and 
 a solution of Ammonia for the bites of venomous reptiles, Hydrocyanic- 
 acid poisoning, opium-narcosis, chloroform-asphyxia, etc., are the in- 
 stances admitted in practice. 
 
 Arterial Transfusion has also been performed successfully in a number of cases, and 
 is considered safer than venous transfusion when a large quantity of fluid has to be intro- 
 duced into the circulation. A special apparatus is employed for these purposes, known 
 as Aveling's transfusion syringe, but the ordinary Dieulafoy's aspirator slightly modified 
 may be used with safety and convenience. The danger of the operation lies in the lia- 
 bility of the introduction of air into the circulation, an occurrence which may cause 
 instant death in the human subject. 
 
 The Hypodermic Method is the introduction of medicines into 
 the organism by injecting them into the subcutaneous areolar tissue, from 
 which they are quickly absorbed by the lymphatic and capillary vessels. 
 The great advantage of this method is the absolute certainty as to the 
 quantity of drug actively affecting the organism, a very essential question 
 when using small quantities, as when powerful alkaloids are employed. 
 Another advantage is the avoidance of reaction between the drug and 
 the contents of the stomach, which may destroy the activity of the 
 former, or seriously change its character. The medicine must be in solu- 
 tion, and the latter should be of neutral reaction and f?'eshly prepared ; 
 the usual menstruum being distilled water, though filtered spring water 
 will answer just as well, and much better than distilled water which has 
 been standing several days and frequently exposed to the air. The solu- 
 tion is to be injected beneath the skin, not into it, by a hypodermic 
 
JO ADMINISTRATION OF MEDICINES. 
 
 syringe, care being taken to avoid puncturing a vein. The most suitable 
 localities for the injection are the external aspect of the arms and thighs, 
 the abdomen, the back, and the calves of the legs. On the external 
 aspect of the thigh, just in front of the great trochanter, there is an area 
 of some two inches square, over which the insertion of a fine hypodermic 
 needle is not felt, so barren is the skin of sensitive nerve filaments in that 
 region. A few years ago the sight of a hypodermic syringe in a physi- 
 cian's hand suggested an injection of morphine to the patient and to the 
 patient's friends, and many a physician has acquired the reputation of 
 giving morphine on every possible occasion because he administered 
 drugs by the hypodermic method. It is therefore well to inform the 
 patient that another drug is being so administered when such is the fact. 
 In this age of toxin and antitoxin treatment the hypodermic syringe has 
 become a necessity, as many of these agents are inert when given by the 
 stomach. Whenever such preparations are employed their injection must 
 be administered under strict aseptic conditions, applied to the syringe 
 and needle as well as to the site of the operation, and the contents of the 
 syringe should be discharged very slowly into the tissues beneath the skin, 
 giving time for the fluid to diffuse itself without rupturing the connective 
 tissue. 
 
 The classic practice of pinching up a fold of the integument before inserting the hypo- 
 dermic needle is entirely wrong both in theory and in practice. It is never done by per- 
 sons who habitually use this instrument on themselves, and they are admittedly the most 
 expert of all operators in this line. It increases the liability to local soreness, and often 
 produces bruises and ecchymoses which might be avoided by following the method de- 
 scribed below. 
 
 After nearly filling the syringe with the solution to be used, the needle, if separate, 
 should be screwed on tightly ; and with the instrument held in a vertical position, point 
 uppermost, the excess of solution over the amount required should be ejected, thus ex- 
 pelling air-bubbles and filling the needle itself. A site having been selected, where there 
 is no danger of penetrating a vein or artery, the needle should be quickly inserted at a 
 right angle with the surface, and carried on for fully one-half its length into the subcuta- 
 neous tissue, except when a solution of Cocaine is to be injected for the production of local 
 cutaneous anesthesia, in which case it is injected into the skin itself. The syringe should 
 be held steadily, not moved around, so as to avoid injuring the tissue. The piston should 
 be pressed down slowly, and when the injection has been delivered the needle should be 
 quickly withdrawn, and no attention paid to the few drops of solution which may follow 
 it. The very finest needles should alone be used, except in cases where the patient is 
 struggling and liable to break the needle off by his movements. The point of the needle 
 should be perfect and its surface highly polished. It is far better to use a new needle 
 every day than to risk one's reputation for skill on a blunt-pointed and rough-surfaced 
 instrument. The writer buys Green's short and finest needles by the dozen and uses a 
 new one on every patient. He has injected a strychnine solution in this manner on some 
 300 patients during the last three years, three or four times daily in the same upper arm 
 for a month in each case, without having produced any more serious result than a hyper- 
 emic zone around some punctures in a very few instances. If the solutions are freshly 
 prepared with clean water, the needles sharp, clean and bright, and the injections deliv- 
 ered beneath the skin and not into it, there is no danger of producing abscesses or even 
 indurations with the agents ordinarily employed in this manner. After using the syringe 
 force out all liquid, and wipe the needle-point dry between the fingers, before returning it 
 to the case ; the sebaceous matter on the fingers will keep it free from rust. Avoid punc- 
 turing a vein ; if you do so, watch the patient and prepare an injection containing gr. ■£% 
 
ADMINISTRATION OF MEDICINES. 
 
 71 
 
 of Atropine Sulphate, to administer if dangerous symptoms arise. Never, except under 
 special circumstances, administer the Salts of Morphine or Atropine hypodermically to 
 children less than 15 years of age. 
 
 Acetanilid, in minute proportion, added to aqueous solutions for hypodermic use, is 
 said to preserve them from decomposition more efficiently than any other agent hitherto 
 employed for that purpose, but Carbolic Acid, a drop or two to the fluid ounce, is gen- 
 erally effective in this respect. 
 
 Compressed Tablets for hypodermic use are prepared by the prominent manufac- 
 turers, and are furnished in glass tubes containing from 20 to 25 tablets each. The writer 
 prefers those made by Wyeth, of Philadelphia, for many reasons. They are very small, 
 are entirely free from any foreign material, are sufficiently soluble, and are put up in 
 short tubes which can be carried in cases to fit the vest pocket. The tablets may be 
 readily dissolved in a teaspoon at the bedside, or in the syringe itself if the instrument 
 has a screw-hole large enough to admit the tablet before screwing on the needle. A 
 regular line of Hypodermic Tablets includes the agents named in the following list, 
 though many others are prepared by the manufacturing chemists. 
 
 List of Hypodermic Tablets. 
 
 Aconitine (crystals), gr. T ^. 
 Apomorphine Hydrochlorate, gr. fa. 
 Atropine Sulphate, gr. ^, jfo, fa. 
 Caffeine, gr. 1. 
 
 Cocaine Hydrochlorate, gr. i, i. 
 Coniine Hydrobromate, gr. i. 
 Colchicine, gr. -fa. 
 'Corrosive Sub. and Urea, gr. fa. 
 Digitalin (soluble), gr. T fa. 
 Duboisine Hydrochlorate, gr. j^g-. 
 Ergotin, gr. i. 
 
 Gelsemine Hydrochlorate, gr. fa. 
 Hyoscine Hydrobromate, gr. y^, fa 
 Hyoscyamine, gr. ^, fa. 
 
 1. i. A. 
 
 Morphine & Atropine, No 
 
 Morphine Sulph., gr. J. 
 
 Atropine Sulph., gr. 5 ^. 
 Morphine & Atropine, No. 
 
 Morphine Sulph., gr. £. 
 
 Atropine Sulph., gr. jf^. 
 Nitroglycerin, gr. T ^ 5 , 
 Physostigmine Sulphate, gr 
 Picrotoxin, gr. fa. 
 Pilocarpine Hydrochlorate, 
 Sodium Arsenate, gr. fa. 
 Sparteine Sulphate, gr. fa. 
 
 10 0' 3o- 
 
 1 
 
 TOO" 
 
 Strychnine Sulphate, gr. jfa, 
 [For Formulae for Hypodermic Solutions, see Appendix.] 
 
 Parenchymatous Injection is the delivery of a medicine deeply into the tissues, 
 either to affect a muscle itself or to locally influence some important nerve-trunk. The 
 principal agents used in this manner are Strychnine for palsied muscles. Chloroform for 
 sciatic and other neuralgias, Salts of Cocaine for local anesthesia, and Carbolic Acid for 
 deep-seated inflammations. 
 
 The Integument is an active absorbent of crystalloidal substances 
 when its epidermis or cuticle is removed, and many substances may be 
 made to pass through the latter and produce their characteristic effects on 
 the system. By this route there are four methods of introducing medica- 
 ments into the circulation — the Endermic, Enepidermic and Epidermic 
 Methods and Inoculation. 
 
 The Endermic Method obviates the difficulty of absorption through the 
 cuticle by removing the latter with a blister, and then powdering the 
 medicament over the surface of the denuded derma. Before the intro- 
 duction of the hypodermic method this procedure was quite common, but 
 it is rarely employed now, as it is both painful and unpopular. 
 
 An ordinary Cantharides-plaster, followed by a poultice to raise the blister, may be 
 employed ; but a quicker method is to place upon the skin a piece of lint soaked in 
 Stronger Water of Ammonia, covering it with a watch-glass or a piece of oiled silk to 
 
72 DOSAGE OF MEDICINES. 
 
 prevent evaporation. The blister raises rapidly and should be removed with scissors 
 and the medicine in powder is then placed on the raw surface. Morphine, Atropine, 
 Quinine and Strychnine are the agents generally used in this manner. 
 
 The Enepidermic Method consists in placing the medicine in simple 
 contact with the epidermis, no friction being used to hasten its penetra- 
 tion. Chloroform and oleic acid solutions of the alkaloids pass by osmo- 
 sis in this manner with comparative ease, but aqueous solutions act very 
 slowly, and alcoholic ones with great difficulty if at all. Drugs are readily 
 absorbed from the surface of hot, moist poultices, a fact to be remem- 
 bered in directing such applications for children, as narcotic poisoning 
 may follow the liberal use of opium in this manner. A good belladonna 
 plaster will cause dilatation of the pupils and may produce the character- 
 istic rash all over the body. 
 
 The Epidermic Method or Inunction consists in the use of friction to 
 promote the passage of the medicament between the cells of the epider- 
 mis. Mercurial ointment, cod-liver oil, and other fats, oleates, etc., are 
 rubbed into the skin of the armpits, the popliteal space, and other parts 
 of the body, for their local and systemic effects. Oil inunctions are an 
 excellent method of introducing fatty substances into children and per- 
 sons who cannot take oils by the stomach. The inunction of castor oil 
 will produce a purgative effect. 
 
 Inoculation is the introduction of medicinal agents through the scraped 
 or punctured skin by an operation which is similar to that employed for 
 vaccination. 
 
 DOSAGE OF MEDICINES. 
 
 The Doses given throughout this book are for adults ; for children the 
 following rule (Young's) will be found the most convenient. Add 12 to 
 the age and divide by the age, to get the denominator of a fraction, the 
 numerator of which is 1. Thus, for a child two years old, ^^- 2 - = 7, 
 and the dose is one-seventh of that for an adult. Of powerful narcotics 
 scarcely more than one-half of this proportion should be used. Of mild 
 cathartics, two or even three times the proportion may be employed. 
 
 Children bear Opiates badly: — but on the other hand they stand comparatively large 
 doses of several other drugs ; such being Arsenic, Belladonna, Ipecacuanha, Calomel 
 and other preparations of Mercury, also Squill, Rhubarb and several other purgatives. 
 Pilocarpine has very little effect on children, though it readily induces perspiration and 
 salivation in adults. 
 
 For Hypodermic Injection, the dose should be two-thirds or three-fourths of that 
 used by the mouth ; by rectum five-fourths of the same. Strychnine acts more actively 
 when given per rectum than by the stomach. 
 
DOSAGE OF MEDICINES. 73 
 
 Conditions which modify the action of medicines, and therefore 
 affect their dosage, are — age, body-weight, temperament and idiosyn- 
 crasy, drug-habits, intervals between doses, time of administration, con- 
 dition of the stomach, temperature of the body, cumulative drug-action, 
 mode and form of drug-administration, disease, climate, race, etc. 
 
 The Dosage of Medicines is the weakest part of the therapeutic 
 armament, the flaw in our weapons which may be the cause of their fail- 
 ure at any moment, perhaps the most critical one for a life. If the accu- 
 mulated rubbish of ages, which has been called therapeutic knowledge, is 
 ever to be given scientific shape, or placed in process of becoming a sci- 
 ence, the question of dosage must form one of the principal corner-stones 
 in the foundation. Drugs have widely differing actions on the human 
 organism in health and in disease, according as they are administered in 
 different doses, in different menstrua, and during different conditions of 
 the subject's health. This difference, when between extremes of dosage, 
 is often so wide as to separate actions directly contrary to each other, the 
 action of the very large dose opposing that of the very small one: — a 
 truth hidden by one set of dogmatists under their former doctrine (now 
 rule) of "similars," and avoided by the great mass of the medical pro- 
 fession, through dread of the bogy-name " irregular." 
 
 In the British Pharmacopoeia a minimum and maximum dose is stated for all the 
 more important medicines, the quantities being intended to represent average doses in 
 ordinary cases for adults. In the preface to that work it is however distinctly stated that 
 these doses "are not authoritatively enjoined," and that "the practitioner must rely on 
 his own judgment and act on his own responsibility in graduating the doses of any thera- 
 peutic agents which he may wish to administer to his patients." As a matter of fact, 
 most British practitioners ignore the doses given in their pharmacopoeia, or at best con- 
 sider them as mere indications. The German Pharmacopoeia has appended to it a 
 table giving the maximum single dose and the maximum daily dose for a number of 
 drugs and preparations, but they are of little value in practice except to catch an unwary 
 physician in a legal proceeding for mal-practice. 
 
 In the following pages an effort has been made, whenever possible, to 
 indicate the different doses of active agents for different purposes, and 
 the proper intervals for repetition in certain cases, as determined by the 
 accumulated experience of clinicians, which is the only safe guide in this 
 respect at present. The average doses of the official preparations should 
 be memorized by the student, and the following rules will be found use- 
 ful for that purpose. 
 
 Average Adult Doses of Official Preparations. 
 
 Acids (dilute), Tt\,x ; — except Dilute Hydrocyanic Acid, the average dose of which 
 is tt\,iij. 
 
 Alkalies, — Liquor Potassae, IT^x, well diluted ; Carbonates, gr. xv ; Sodium Borate 
 (Borax), gr. xx ; Bicarbonates, gr. xxx. 
 
 Alkaloids and their Salts, form three groups, (i) those of the Solanacece, etc., the 
 average dose of which is gr. t ^q ; (2) those from Nux Vomica, gr. -^ ; (3) those from 
 
74 DOSAGE OF MEDICINES. 
 
 Opium, gr. ]^ ; — except Codeine, gr. j, Narcotine (which is not a narcotic), gr. iij, 
 Quinine and the other Cinchona alkaloids, gr. x. 
 
 Aquae (Waters), ^j ; — except Aqua Ammoniae, TT\x, Aqua Chlori, TT^xv, and Aqua 
 Creosoti, gij. 
 
 Extracts, gr. v ; — except Ext. Physostigmatis, gr. Jg-, Ext. Aconiti, gr. J^, Ext. 
 Belladonnae, gr. y^, Ext. Colchici Radicis, gr. j, Ext. Colocynthidis, gr. j, Ext. Cannabis 
 Indicae, gr. %, Ext. Opii, gr. ]/ 2 , Ext. Strarnonii, gr. %, and Ext. Aloes, gr. iij. 
 
 Fluid Extracts, TT\x ;— except the fluid extracts of Aconite, Try, Belladonna, mjj, 
 Colchicum-root, TT\,v, Colchicum-seed, TTyj, Digitalis, Try, Nux Vomica, TTlJj, Sanguina- 
 ria, Tryj, Squill, TTyj, Stramonium, TTyj, and Veratrum Viride, TT^ij. 
 
 Infusions and Decoctions, ^j ; — except Infusion of Digitalis, ^ij. 
 
 Mixtures, %] ; — except the Mistura Glycyrrhizae Composita (for children), gj, and 
 Mistura Ferri Composita, 3 iij. 
 
 Oils, Fixed, ^ss; — except Oleum Phosphoratum, TTyij, and Oleum Tiglii (Croton 
 Oil), TllJ. 
 
 Oils, Volatile, Tryj ; — except Oleum Amygdalae Amarae, TT\,ss, and the Oils of Co- 
 paiba, Erigeron, Cubeb, Eucalyptus, Juniper, Sandal-wood and Amber, of each Y(\x. 
 
 Pills, gr. v ; — except those of Phosphorus, Ferrum Iodide, Opium, Blue Mass, and 
 Compound Antimony, which are given in smaller doses. 
 
 Powders, form two classes : (1) those given in grains, including Pulvis Antimonialis, 
 gr. v ; Pulvis Morphinae Comp., gr. x ; Pulvis Ipecac, et Opii, gr. x ; Pulvis Opii, gr. j ; 
 Pulvis Cretae Comp., gr. xx ; and Pulvis Jalapae Comp., gr. xxx ; (2) those given in 
 doses of a drachm or more, including Pulvis Glycyrrhizae Comp., Pulvis Rhei Comp., 
 and Pulvis Effervescens Comp. 
 
 Resins, gr. v ;— except Resin of Podophyllum, the average dose of which is gr. ss, 
 and Resin of Copaiba, gr. ij. 
 
 Spirits, gss or more, according to the amount of alcohol desired to be taken; — 
 except Spirit of Camphor, Vl\x, and Spirit of Nitroglycerin (Spt. Glonoini), Tryij. 
 
 Syrups, 3J ;— except Syrup of the Iodide of Iron, Tryc, and Compound Syrup of 
 Squill, TT\x. 
 
 Tinctures, ^ss ; — except the tinctures of Aconite, Try, Belladonna, Tryc, Cantharides, 
 TTyv, Capsicum, TTyv, Colchicum-seed, Trycx, Digitalis, TT\x, Chloride of Iron, TT\x, Gel- 
 semium, TT\x, Iodine, TT\v, Ipecac and Opium, TTyc, Lobelia, Tryc, Nux Vomica, TTyc, 
 Opium, TT\,xv, Physostigma, TTyc, Stramonium, TTyc, Strophanthus, YX\v ; also the tinctures 
 given in larger doses, namely that of Hyoscyamus, £ij, and Camphorated Opium, ^ij. 
 It is well to remember that children bear the above dose of tincture of Belladonna 
 without difficulty, and that tincture of Aconite should always be given in doses of a drop 
 or less. 
 
 Wines, 3 j ; — except those of Antimony, Colchicum, and Opium, the average dose of 
 each of which is Ti\x. 
 
 Vinegars, are only two in number, — that of Opium, TT\x, and that of Squill, TT\xxx. 
 
PART I. 
 
 MATERIA MEDICA AND THERAPEUTICS. 
 
 ABRUS, Jequirity (Unofficial), — is the seed of Abrus firecatorius, 
 the Wild Liquorice, a plant of thenat. ord. Leguminosse, indigenous in 
 India, but growing wild in most tropical countries. The seeds are small, 
 hard, of a bright scarlet color, and contain some fixed oil, Abric Acid, 
 C 12 H 2i N 3 0, and two proteid poisons, a paraglobulin and an albumose, the 
 latter of which is named Abrin. The root, leaves and branches contain 
 sugar and a principle which closely resembles glycyrrhizin. 
 
 Preparation. 
 
 Infusum Abri, Infusion of Jequirity (Unofficial) , — prepared by macerating three 
 powdered seeds in ^ ss of cold water for twelve hours, adding 3 ss of boiling water, and 
 filtering when cold. It should be used while fresh, as after two or three days it is worth- 
 less, and is found in a short time swarming with bacteria. Another formula contains 
 gr. ix to the ^ , with gr. iv of Boric Acid to prevent decomposition. 
 
 Physiological Action and Therapeutics. 
 
 Jequirity seeds, when moistened with water, become highly poisonous. 
 If applied to the conjunctiva, a severe inflammation is set up, with edema 
 and false membrane, ulceration of the cornea, and extension to the lids, 
 face, neck, and submaxillary glands. Inserted into a wound in cattle, 
 they cause death in a few hours. Sidney Martin has shown that the pro- 
 teid poisons contained in Jequirity seeds are almost identical in their 
 physiological and toxic properties with the similar principles found in 
 snake venom, although less powerful. 
 
 Jequirity is used for the purpose of producing a purulent or croupous 
 conjunctivitis, by which to destroy old granulations (trachoma) and 
 pannus. A mild infusion is applied to the eye two or three times a day 
 for two days, and followed by weak solutions of Alum or Borax. This 
 should be repeated af[er three weeks if necessary. An emulsion of the 
 seeds in water is a useful application to unhealthy ulcers and lupus. 
 
 75 
 
76 ABSINTHIUM ACETANILIDUM. 
 
 ABSINTHIUM, Wormwood, — the leaves and tops of Artemisia Absinthium, a 
 perennial garden herb of the nat. ord. Compositae, indigenous in Europe, but cultivated 
 in the United States. It contains a volatile oil and a bitter principle, Absintkin. Dose, 
 gr. xx-xl, in infusion. There are no official preparations, but of the formerly official 
 Vinum Aromaticum, Absinthium constituted one per cent. 
 
 Absinthe, the French liqueur, is an alcoholic solution of the oil, containing also ex- 
 tracts of Anise, Marjoram and Angelica. Its continued use produces various nervous 
 symptoms, morning nausea and vomiting, also a tendency to epileptiform convulsions. 
 
 The bitter constituent of Absinthium is stimulant to the digestive organs, but the oil is 
 a narcotic poison. It increases the cardiac action, and produces tremor, stupor, epilepti- 
 form convulsions, involuntary evacuations, and stertorous breathing. It is but little used 
 in medicine, only as a stomachic tonic in dyspepsia. 
 
 ACACIA, Gum Arabic, — is a gummy exudation from Acacia Sene- 
 gal, a small tree of the nat. ord. Leguminosse, indigenous in Africa. It 
 occurs in spheroidal tears of various sizes, breaking with a glassy, some- 
 what iridescent fracture ; insoluble in alcohol, but soluble in water, form- 
 ing a thick and mucilaginous liquid. It consists of Arabin or Arabic 
 Acid, C 12 H 22 O n , combined with calcium, potassium and magnesium. 
 
 Mucilago Acaciae, Mucilage of Acacia, — has of Acacia 35, Water to 100 parts. It 
 should not be prescribed with tinctures or spirits except in very small quantity. Dose, 
 indefinite. 
 
 Syrupus Acaciae, Syrup of Acacia, — has of the Mucilage 25, Syrup 75. Should be 
 freshly made. Dose, indefinite. 
 
 Acacia enters into the composition of Mistura Amygdalae, Mistura Glycyrrhizse Com- 
 posita, Pulvis Cretae Compositus, Trochisci Cretae, Trochisci Cubebae, and Trochisci 
 Glycyrrhizae et Opii. 
 
 Gum Arabic has no activity except the negative one of a demulcent, 
 and is chiefly used in coughs, sore throats, catarrhal inflammation of the 
 stomach and intestines, and irritant poisoning. It is much employed in 
 pharmacy to suspend insoluble powders in mixtures, for which purpose 
 the mucilage is generally used. 
 
 ACETANILIDUM, Acetanilid, Antifebrin, — is a derivative of 
 Anilin, from which it is obtained by the action thereon of glacial acetic 
 acid, substituting the organic radicle Acetyle for an atom of hydrogen. 
 Chemically, it has the name of Phenyl-acetamide, and the formula C 6 H 5 - 
 NHC 2 H 3 0. 
 
 The name Antifebrin is copyrighted by its original promoters for trade purposes, and 
 therefore should be dropped from professional usage. 
 
 Acetanilid is a white crystalline powder of neutral reaction, and odor- 
 less, but of slightly burning taste. It is freely soluble in alcohol, wine, 
 etc., but very sparingly (1 in 200) in cold water, more readily in hot 
 water. In solution it turns orange-red (Antipyrin, grass-green) upon the 
 addition of a few drops of sodium nitrite solution and a few drops of 
 concentrated sulphuric acid. 
 
ACETANILIDUM. JJ 
 
 The Dose ranges from gr. ij to gr. x, repeated twice, and not exceeding gr. xxx in the 
 24 hours. As much as 3) has been swallowed without ill effects supervening. It may- 
 be administered in the very convenient form of compressed tablets ; — also in powders, or 
 in dilute alcoholic solution. ^j may be dissolved in ^ ivss of brandy, to which, if we 
 add ^vj each of simple syrup and water, we get a six-ounce mixture, of which a table- 
 spoonful ( ^ ss) contains 5 grains of Acetanilid, a fair adult dose. As an antipyretic, 
 gr. iij may be administered every % to y^ hour, until 12 or 15 grains have been given, 
 which will usually be a sufficient quantity, especially if given at the acme of the febrile 
 movement. 
 
 Unofficial Derivatives and Allied Compounds. 
 
 Acetanilid Compound (Aulde), — is a mixture containing Acetanilid 70, Caffeine 10, 
 and Sodium Bicarbonate 20 per cent., and is put up in the form of compressed tablet 
 triturates, each containing ^ grain of the mixture. It is intended to replace the numer- 
 ous proprietary preparations sold under fancy names, and having acetanilid and caffeine 
 as the active constituents. Dose, from 10 to 30 tablets. 
 
 Agathin, Salicyl-aldehyde-a-methyl-phenyl-hydrazone, — is a synthetic compound, 
 which has been used extensively in Europe as an anti-neuralgic and anti-rheumatic rem- 
 edy. Dose, gr. v-x, two or three times a day, but from 3 ss to 3 jss must be given before 
 any effect is produced. 
 
 Ammonol, Ammoniated Phenytacetamide, — a proprietary antipyretic and analgesic, 
 claimed to possess unusual stimulating and expectorant properties due to the loosely com- 
 bined Ammonia in its composition. Beringer concludes that it is merely an admixture of 
 Acetanilid 2 parts, Sodium Bicarbonate I and Ammonium Carbonate I, with a minute 
 quantity of the dye Metanil-yellow. A similar mixture is used at the Philadelphia Hos- 
 pital under the name Ammoniated Acetanilid, which consists of Acetanilid, 2j^ grains, 
 Sodium Bicarbonate, \y z grains, Ammonium Carbonate, 1 grain; this for a minimum dose. 
 Dose, of Ammonol or Ammonol Salicylate, gr. v— xx. 
 
 Analgen, Ortho-oxy-ethyl-ana-mono-acetyl-amido-chinolin, — a Chinolin derivative ; 
 was reformed by inserting benzoyl instead of the acetyl radicle, and re-christened QuiN- 
 algen. (See next page.) 
 
 Analgesine, — a proprietary preparation, consisting of Acetanilid 60, Ammonium 
 Chloride 20, Citrated Caffeine 10, Sodium Bicarbonate IO. Dose, gr. v-xv. 
 
 Antikamnia, — is a proprietary preparation widely advertised as an antipyretic and 
 analgesic. Analyses of several samples have been made by different chemists, all of 
 which agree in finding the chief ingredients to be Acetanilid and Sodium Bicarbonate in 
 varying proportions. By some observers Caffeine was detected, also Tartaric Acid, etc. 
 The preparation is formulated by the latest analysis as a mixture of Acetanilid 70, Sodium 
 Bicarbonate 20, and Caffeine IO per cent. Dose, gr. v-xv, in powder or tablets. 
 
 Antikol, — contains Acetanilid 75, Sodium Bicarbonate I7j4, Tartaric Acid 7^ per 
 cent. (Squibb ). Dose, gr. v-xv. Another " AntikoV is advertised by its manufacturer 
 to consist of Acetanilid, Quinine Bisulphate, Sodium Bicarbonate, and Caffeine Citrate, 
 the latter in the proportion of IO per cent. Antilupin is a similar preparation. 
 
 Antinervin, Salbromalide {Salicylbromalide), — is a mixture of Acetanilid 2, with I 
 part each of Salicylic Acid and Ammonium Bromide (Ritsert). Dose, gr. v-xv. 
 
 Antipyrinum, Antipyrin (Phenazone), — is described under its own title. 
 
 Caffacemon and Caffenol, — are mixtures of Acetanilid and Caffeine, and are given 
 in doses of gr. v-xv. 
 
 Exalgin, Methyl-acetanilid, — is a crystalline compound allied to Acetanilid, occurring 
 in acicular needles, readily soluble in dilute alcohol, less so in warm water, and with 
 difficulty in cold water. Dose, gr. j-v,in wine, or other dilute alcoholic mixture. Alco- 
 hol 3SS, and Water ^j form a permanent solution with gr. xvj of Exalgin. Its name, 
 derived from eg, out of, a/,yog, pain, denotes its principal therapeutic action. 
 
 Exodyne is a mixture of Acetanilid 90, Sodium Salicylate 5, and Sodium Bicarbon- 
 ate 5. The name (from ef, out of, odvvq, pain) sufficiently states its claims to medicinal 
 virtue. Dose, gr. iij-x. 
 
7$ ACETANILIDUM. 
 
 Febrinol, Methyl-para-acet-phenetidin, — so called by its proprietors, is a mixture of 
 Acetanilid and other inert substances, advertised at one-half the price of similar coal-tar 
 preparations. 
 
 Malakin, Salicyl-para-pheneiidin, — is a combination of Phenacetin and Salicylic 
 Acid, and is described under Salicinum, in this book. 
 
 Migranin, — is a double Citrate of Antipyrin and Caffeine, and is described under 
 Antipyrinum, in this book. 
 
 Neurodin, Acetyl-para-oxy-phenyl-urethane, — an analgesic, antineuralgic and anti- 
 rheumatic remedy. Its antipyretic action is too sudden for it to be used as a general anti- 
 pyretic. Its action is uncertain and much inferior to that of phenacetin or antipyrin 
 (Lippi). Dose, gr. v-xxv, but 3 jss has been taken in 24 hours without ill effects. 
 
 Phenacetin, Methacetin and Phenocoll, — are closely allied to Acetanilid, both 
 chemically and medicinally, and are described under the title Phenacetinum, et seq. 
 
 Phenatol, — contains Acetanilid, Sodium Carbonate, Bicarbonate, Chloride and Sul- 
 phate, also Caffeine. Dose, gr. v-x. 
 
 Phenolid, — is a mixture of Acetanilid 58, and Sodium Salicylate 43, and competes 
 with the above as a panacea. Dose, gr. v-xv. 
 
 Pyretine, — contains Acetanilid, Caffeine, Sodium Bicarbonate and Chalk, in varying 
 proportions. Dose, gr. v-x. 
 
 Quinalgen, Ortho-ethoxy-ana-mono-benzoyl-aniido-qtiinolin, — is a derivative of Quin- 
 olin (Chinolin), and is a reformation and renaming of the preparation named Analgen 
 (see p. 77). It is described under Chinolinum. Dose, gr. vij-xv, up to gr. xlv daily. 
 
 Salfene and Kaputin are Acetanilid mixtures, the latter being simply powdered 
 Acetanilid colored with some indifferent substance. 
 
 Thermodin, Acetyl-para-ethoxyphenyl-methane, — is closely allied to Neurodin (see 
 above), which it resembles in all respects except its smaller dose, gr. v-x. 
 
 Physiological Action. 
 
 Acetanilid is strongly analgesic, somewhat hypnotic and antispasmodic, 
 a moderately efficient antipyretic, also a decided antiseptic and local 
 anesthetic. It lessens the reflex action of the spinal cord, and inhibits 
 the sensibility of the sensory nerves. It raises arterial tension somewhat, 
 and slows the heart in a corresponding degree, quiet sleep often following. 
 
 Compared with the action of Antipyrin, the effect of Acetanilid on 
 the body-temperature is manifested more slowly (1 hour against ^ hour), 
 but lasts a longer time (6 against 2 hours). It is markedly diuretic, and 
 somewhat diaphoretic ; is a cerebral, muscular and vaso-motor stimulant, 
 and leaves no ill after-effects ; — while Antipyrin is powerfully diaphoretic, 
 a cerebral sedative, and produces great depression. Furthermore, Ace- 
 tanilid frequently produces nearly the same degree of reduction of body- 
 temperature as Antipyrin, with the ingestion of only one-fourth the dose ; 
 and, like the latter agent, it has little or no effect on the normal tempera- 
 ture, but its continued use begets tolerance of its action. Its antipyretic 
 action, is, however, less reliable than that of Antipyrin, and corresponds 
 in degree and in duration to the size of the dose. There is neither vomit- 
 ing nor diarrhea afterwards, but there is a tendency in some cases to col- 
 lapse with chills and cyanosis, especially the latter, during the period of 
 
ACETANILIDUM. 79 
 
 depressed temperature. The cyanosis often caused by this drug without 
 other toxic symptoms is probably due to the liberation of free anilin in 
 the blood. 
 
 A toxic dose destroys the ozonizing function of the blood, decoloriz- 
 ing its corpuscles and forming methyl-hemoglobin. The heart, liver and 
 kidneys of animals poisoned thereby are found in a state of acute fatty 
 degeneration. Its continued use in large doses is highly injurious to the 
 blood, especially in diseases (as typhoid fever) which are themselves de- 
 structive to the blood-elements. 
 
 Therapeutics. 
 
 Besides being a fairly efficient antipyretic, Acetanilid has marked anal- 
 gesic and antispasmodic powers ; and these, together with its great ad- 
 vantages of a small dose, comparative efficiency and safety, and the 
 absence of the severe rigors and cardiac depression which mark the chino- 
 lin derivatives, combine to make it an agent of wider therapeutical 
 range than most of its analogues. It is especially useful in phthisis and 
 typhoid fever for its action on pyrexia, thereby relieving wakefulness, 
 lessening delirium, and upholding a failing heart ; but if long used in 
 large doses in the latter disease it may increase the liability to serious 
 sequelae, especially periostitis of the ribs, gangrene of tissues, etc. For 
 the pains of locomotor ataxia, and in those of rheumatic origin, as sciatica 
 and lumbago, it is a most efficient remedy. In acute rheumatism, influ- 
 enza, and scarlet fever it is highly praised ; and in acute bronchitis doses 
 of four grains every two hours have often arrested the attacks within 
 twenty-four hours. In epilepsy it has been tried, with the view of mod- 
 erating reflex excitability. Added in minute proportion to aqueous solu- 
 tions for hypodermic use, it is said to preserve them from decomposition 
 more efficiently than any other agent hitherto employed for that purpose. 
 It acts very well with children, when used in proper doses; but in all 
 cases overdosing must be avoided, both as to quantity and repetition. 
 
 Acetanilid is now extensively employed in surgical practice as a dry 
 dressing for wounds, burns, scalds, and other injuries involving breach 
 of the tissues. Dusted in fine powder over the surface of a wound it 
 promotes healing, prevents suppuration, relieves pain, and is odorless, 
 unirritant and non-toxic, though a few cases of very young children are 
 reported in which its topical application to wounds caused cyanosis and 
 symptoms of collapse. It has also been used with much benefit as an 
 application to mucous patches and rectal ulcers. 
 
 Antinervin attracted much attention during the epidemic of influenza in Scotland, 
 as an analgesic and antipyretic. It relieved the pains in the back and head, reduced the 
 fever and produced copious perspiration, without being followed by unfavorable sequelae. 
 It has proven to be of great benefit in acute rheumatism, and may be used with advan- 
 
80 ACIDUM ACETICUM. 
 
 tage in all abnormal excitement of the nervous system, either against neuralgia or as a 
 general nerve sedative. The best way to prescribe it is as an extemporaneous mixture, 
 containing the proper proportions of its ingredients, viz. — Acetanilid 50, Salicylic Acid 
 25, and Ammonium Bromide 25 per cent., mixed secundum artem, and administered in 
 doses of gr. v-xv every two hours until relief is obtained. 
 
 Exalgin resembles Acetanilid and Antipyrin in its antipyretic and analgesic powers. 
 Compared with the latter it is less efficiently antipyretic, but more powerful as an anal- 
 gesic and antiseptic. In overdose it is highly dangerous, having produced symptoms 
 resembling those of angina pectoris, also toxic effects resembling those of carbolic acid, 
 with delirium, dyspnea, cyanosis, and renal disturbances. It has been used with most 
 excellent results in neuralgias ; also in chorea. In the latter affection daily doses of 3 
 grains were sufficient. 
 
 ACIDUM ACETICUM, Acetic Acid,— is a liquid composed of 
 36 percent, of absolute Acetic Add, HC 2 H 3 2 , and 64 per cent, of water. 
 It is a clear, colorless liquid, of a distinctly vinegar odor, a purely acid 
 taste, and a strong acid reaction ; miscible in all proportions with water 
 and alcohol, and wholly volatilized by heat. It is prepared from wood 
 by destructive distillation and purification. Acetic Acid is also official 
 in two other degrees of concentration, viz. — 
 
 Acidum Aceticum Glaciale, Glacial Acetic Acid y HC 2 H 3 2 , — is nearly or quite 
 absolute Acetic Acid, solid below 59 F., above that temperature a colorless liquid. Is 
 strongly escharotic and only used locally. 
 
 Acidum Aceticum Dilutum, Diluted Acetic Acid, — consists of Acetic Acid 10, Dis- 
 tilled Water 50 parts, contains 6 per cent, of absolute Acetic Acid, and has a sp. gr. of 
 1.008. Dose, gj-ij. 
 
 Acetum, Vinegar (Unofficial), — is an impure diluted Acetic Acid, produced by the 
 acetous fermentation of any liquid susceptible of the vinous fermentation. 
 
 Diluted Acetic Acid is used in the preparation of the two official Aceta (Vinegars). 
 
 Physiological Action and Therapeutics. 
 
 Acetic Acid, like the other vegetable acids, in concentrated form is 
 escharotic and produces gastro-enteritis if swallowed. In dilute form it 
 acts as a refrigerant, diminishing thirst and allaying restlessness. It forms 
 salts in the stomach, thus enters the blood, and is there oxidized, produc- 
 ing carbonic acid and thereby increasing the acidity of the urine. It is 
 also diuretic. Long used, it causes emaciation and poverty of the blood, 
 producing a general scorbutic condition. It is a hemostatic and anthel- 
 mintic, and the vapor inhaled causes reflex contraction of the vessels and 
 raises the blood-pressure. Lately, investigations into its germicidal 
 powers have given it high rank among germ-destroyers, a solution con- 
 taining 7 per cent, of this acid proving as efficient as mercuric chloride. 
 
 The glacial acid is used as a caustic in many skin affections, as warts, 
 condylomata, etc., and to destroy the parasite in ringworm and pityriasis. 
 It has been employed locally in carcinoma, with the view of dissolving 
 the supposed cancer-cells. The dilute acid is used locally in superficial 
 inflammations of the skin, and may be sponged over the body to check 
 
ACIDUM BORICUM. 8 1 
 
 perspiration and reduce the surface temperature in fevers. It is often 
 administered internally to reduce obesity, which it does by impairing 
 digestion. Locally, it may be employed to arrest slight hemorrhages, 
 as epistaxis ; and it is occasionally used by enema for the destruction of 
 ascarides. Acetic acid is highly praised by Squibb as a solvent for the 
 active principles of drugs, which it extracts completely, so that it may be 
 substituted for alcohol in the preparation of both fluid and solid extracts. 
 
 ACIDUM BORICUM, Boric Acid, Boracic Acid, H 3 B0 3 ,— is a 
 weak acid occurring in transparent, colorless, six-sided plates, of unctu- 
 ous touch, odorless, of a cooling and slightly bitter taste, soluble in 25 of 
 water, in 15 of alcohol and in 10 of glycerin. Its aqueous solubility is 
 increased by the addition of hydrochloric acid or borax. It is produced 
 from Borax by the action of sulphuric acid ; also by the purification of 
 the native acid. Dose, gr. v-xv. There are two official Borates, viz. — 
 
 Sodii Boras, Sodium Borate (Borax), Na 2 B 4 7 + loH 2 0, — colorless, transparent 
 prisms, of cooling and sweetish, afterwards alkaline taste, and alkaline reaction, soluble 
 in 16 of water at 59° F., ar id in 0.5 of boiling water; insoluble in alcohols. Occurs 
 native in ancient lake beds in the Death Valley region, California, and various other 
 parts of the world. Dose, gr. v-xxx. 
 
 Glyceryl Borate, Boroglycerin, — official in the following preparation, — 
 
 Glyceritum Boroglycerini, Glyce7-ite of Boroglycerin (Glycerite of Glyceryl Borate, 
 Solution of Boroglyceride), — prepared by heating together Boric Acid 301 and Glycerin 
 460, until reduced to 500 grammes, then adding an equal weight of Glycerin. 
 
 Unofficial Preparations. 
 
 Boracic Ointment, — has of Boracic Acid 1, White Wax 1, Paraffin 2, Almond Oil 
 2, thoroughly mixed together. 
 
 Boracic Lotion, — is a saturated solution of the acid in water. 
 
 Boracic Lint, — prepared by steeping lint in a boiling saturated solution and drying. 
 It contains nearly one-half its weight of the acid. 
 
 Borine, — is a proprietary antiseptic preparation, advertised to be ''composed of the 
 active constituents of Benzoin, Wintergreen, Meadowsweet, Golden Rod, Witch Hazel, 
 combined with the stearoptenes of Wild Thyme, Eucalyptus, Peppermint, and Boracic 
 Acid." What the stearopten of Boracic Acid is the advertisers do not say. It is in- 
 tended chiefly for external use, diluted, 1 part to 1-4 of water ; but may be used inter- 
 nally in doses of ^j-ij. 
 
 Boroglyceridum, Boroglyceride, — is a solid chemical compound, prepared by heating 
 together Boric Acid and Glycerin. It is soluble in water, but is generally used in solu- 
 tion with glycerin, as the above official glycerite. It combines readily with Chrysarobin, 
 Carbolic Acid, Atropine and Morphine, and is used as a local application in eye diseases 
 and skin affections. 
 
 Borolyptol, — is a proprietary preparation intended for use as an antiseptic, both in- 
 ternally and locally. It is said to be composed of Aceto-boro-glyceride 5 per cent., 
 Formaldehyde 2 per cent. , together with the active antiseptic constituents of Pinus pu- 
 milio, Eucalyptus, Myrrh, Storax and Benzoin. Dose, £j-ij, as an intestinal antiseptic. 
 
 Euthymol and Euphormol are similar preparations, advertised as containing Boric 
 Acid, Thymol, Menthol, Oil of Eucalyptus, etc. 
 6 
 
82 ACIDUM BORICUM. 
 
 Listerine, — is a proprietary preparation, advertised to be " the essential antiseptic 
 constituent of Thyme, Eucalyptus, Baptisia, Gaultheria and Mentha Arvensis, in com- 
 bination. Each fluid-drachm also contains two grains of refined and purified Benzo- 
 boracic Acid," — whatever that may be. It is chiefly intended for external use, but may 
 be given internally, in doses of 3J three or more times a day (as indicated), either full 
 strength, or diluted with water, or in combination with other drugs. 
 
 Magnesii Bora-citras, Magnesium Borocitrate, — prepared extemporaneously thus: 
 R . Magnesii Carbonatis 3], Acidi Citrici gij, Sodii Biborat. ^ij, Aquae Bullientis 
 ^ viij. A tablespoonful three or four times daily as a solvent of uric acid calculi. 
 
 Potassii Tartra-boras, Potassium Tartraborate , — is a better solvent of uric acid 
 calculi than the Magnesium salt, and is soluble in 2 parts of cold water. Prepared by 
 heating together Boracic Acid I, Potassii Bitartras 4, Water 10 parts. Dose, gr. xx, 
 largely diluted with water, three or four times a day. 
 
 Sodium Tetraborate is a new preparation (or salt?) obtained by heating together 
 equal parts of Boric Acid, Borax and Water. The resulting compound is neutral, and is 
 supposed to be an entirely new salt. It was introduced to furnish a more soluble form 
 of Boric Acid, and may be used wherever the latter is indicated, but it has the disad- 
 vantage of forming hard crusts upon dressings, which irritate abraded surfaces. 
 
 It has long been known that the addition of Borax to Boric Acid in aqueous solution 
 greatly increases the solubility of the acid, — and the above may explain the observed fact. 
 
 Physiological Action and Therapeutics. 
 
 Boric Acid is an efficient antiseptic, disinfectant and deodorant, arrest- 
 ing fermentation and putrefaction, and very destructive to all low organ- 
 isms. A solution of i in 133 arrests the activity of bacteria. It is feebly 
 acid and but slightly irritant, and is used in the form of a dusting powder 
 as a surgical dressing for its antiseptic and unirritating qualities. Its 
 lotion and ointment have been successfully employed in ulcers, eczema, 
 burns and scalds, pruritus ani, fetid perspiration, wounds, tinea tonsurans, 
 and tinea circinata. 
 
 Sodium Borate is a powerful antiseptic and disinfectant, as it destroys 
 low vegetable organisms. It removes the epidermis when locally applied, 
 has power to increase uterine contraction, and aids the solution of benzoic 
 and boric acids. It is employed as a wash to remove the epidermis from 
 the skin, and as a sedative lotion in acne, freckles, chloasma, leucorrhea, 
 aphthae, etc., also to allay itching in urticaria, psoriasis, impetigo, and in 
 pruritus pudendi, scroti et ani. It has been used internally in amenor- 
 rhea, dysmenorrhea, puerperal fever, and puerperal convulsions, for its 
 supposed specific action on the uterus ; and has been found beneficial in 
 epilepsy, though far inferior to potassium bromide in efficacy and far 
 more dangerous in toxic effects. It is apparently of most service in cases 
 where the bromides fail and in those in which the epilepsy is associated 
 with gross organic disease. 
 
 When administered in large doses Borax produces certain toxic symp- 
 toms to which the term Borism is applied. These include intestinal dis- 
 turbance, nausea, vomiting and anorexia, also dryness of the skin, with 
 redness and even inflammation of the mucous membranes. There is 
 
ACIDUM CARB0L1CUM. 83 
 
 great general weakness, the hair is dry and falls out, and there is an erup- 
 tion on the skin, which may assume the forms of seborrheic eczema, red- 
 dish patches which desquamate like psoriasis, or papules attended with 
 much itching. In severe cases albumin may appear in the urine, and 
 edema of the face and extremities may occur, so that whenever this drug 
 is given in full doses, a careful watch should be kept upon the state of the 
 urine (Fere). 
 
 Boro-glyceride in aqueous solution (i to 40), or as an official Glycerite, is also a 
 powerful antiseptic, and is used as a lotion in purulent ophthalmia and in the treatment 
 of wounds, also as a local application to diphtheritic membranes. It is an efficient pre- 
 servative of milk and food against putrefactive changes, and is entirely harmless. 
 
 An elegant cosmetic cream may be made by dissolving Boric Acid in Glycerin, and 
 then incorporating it with White Wax and Almond Oil. 
 
 ACIDUM CARBOLICUM, Carbolic Acid, Phenol, Phenic 
 Acid, Phenyl Alcohol, C 6 H 5 OH, — occurs in Castoreum, in the urine of 
 man and of herbivorous animals, and in the products of the dry distilla- 
 tion of various organic substances, such as resin, bones, wood and coal. 
 It is obtained by the fractional distillation of coal-tar, and subsequently 
 purified; occurring in colorless, interlaced, needle-shaped crystals, of 
 characteristic, aromatic odor, deliquescent on exposure to damp air, and 
 acquiring a reddish tint with age and light. When copiously diluted 
 with water it has a sweetish taste, and a slightly burning after-taste. It 
 is soluble in about 15 of water, very soluble in alcohol, ether, chloroform, 
 benzol, glycerin, oils and carbon bisulphide ; almost insoluble in benzin. 
 It is melted by gentle heating, and is liquefied by the addition of about 
 8 per cent, of water. Dose, gr. %-\), well diluted. 
 
 Acidum Carbolicum Crudum, Crude Carbolic Acid, — is obtained 
 as above stated, but by a lower degree of heat; and contains various 
 other constituents of coal-tar besides Phenol, chiefly Cresol (Cresylic 
 Acid) and Xylic Acid, in varying proportions. Is used as a disinfectant. 
 
 Peculiarities about Carbolic Acid are that the addition of about 8 per cent, of water 
 liquefies it, while a further addition of water produces a turbid mixture, until about 15 
 parts of water to I of the acid is reached, when a stable and clear solution is formed. 
 One volume of the liquefied acid, containing 8 per cent, of water, forms with one volume 
 of Glycerin a clear mixture, which is not rendered turbid by the addition of 3 volumes 
 of water (absence of Creosote and Cresol). 
 
 Hitherto described as neutral to litmus paper, it is now officially given a faintly acid 
 reaction. Its claims to be considered an acid are, however, very feeble, as, though it 
 combines with salifiable bases, it is incapable of neutralizing the alkalies, and its combi- 
 nations are decomposed by the feeblest acids (carbonic, etc.), sometimes, it is asserted, 
 even by water. Chemically, it is considered to be the Hydroxyl (HO) derivative of Ben- 
 zene (C 6 H 6 ), which would ally it to the alcohols ; but as it does not yield the same pro- 
 ducts on oxidation (yielding finally oxalic instead of acetic acid), it is taken as the type of 
 a class called phenols, which are simple HO derivatives of the aromatic hydrocarbons. 
 [For the chemical theoiy of the Benzene derivatives see the sub-title Substitutes FOR 
 Quinine, under the title Cinchona.] 
 
 Carbolic acid is converted by concentrated sulphuric acid into Sulpho-carbolic Acid, 
 C 6 H 5 HS0 4 ; by nitric acid into several substitution-products, the most important of which 
 
84 ACIDUM CARBOLICUM. 
 
 is Picric Acid. The reddish tint which it acquires with age and light, does not impair 
 its properties ; but is not accounted for satisfactorily, though supposed to be due to the 
 presence of Aurin and Rosolic Acid, impurities which form a red compound by the 
 absorption of C0 2 and oxygen. 
 
 Carbolic Acid coagulates albumin and collodion, Creosote does not. 
 
 Official Preparations. 
 
 Unguentum Acidi Carbolici, Ointment of Carbolic Acid, — strength 5 per cent. 
 Carbolic Acid 5, Unguentum 95. For external use. 
 
 Glyceritum Acidi Carbolici, Glycerite of Carbolic Acid, — has of Carbolic Acid I, in 
 Glycerin 4. Dose, TT\v-x in water. It should be diluted with an equal quantity of 
 water for external use. 
 
 Sodii Sulpho-carbolas, Sodium Sulpho-carbolate, NaS0 3 C 6 H 4 (OH) -|- 2H 2 0, — is 
 prepared by dissolving Carbolic Acid in an equal part of strong Sulphuric Acid, thus form- 
 ing sulpho-carbolic acid, which is neutralized with barium carbonate, and then treated 
 with water and sodium carbonate, forming a solution of Sodium Sulpho-carbolate, which 
 is evaporated to crystallization. It occurs in transparent, rhombic prisms, soluble in 5 of 
 water, less freely in alcohol and in glycerin. Dose, gr. x-xxx. 
 
 Sulpho-carbolates of Ammonium, Magnesium, Potassium and Sodium crystallize in 
 tufts of acicular crystals, more or less white ; Sulpho-carbolate of Copper, in transparent, 
 light blue, interlacing prisms ; of Iron, in small brown, micaceous crystals ; of Zinc, in 
 transparent, rectangular, colorless plates. That of Sodium is the only one official. 
 
 Unofficial Preparations. 
 
 Aqua Acidi Carbolici, Carbolic Acid Water, — has of the Glycerite of Carbolic Acid 
 £x, to Aquae Oj. Dose, gj-iv. 
 
 Carbolic Acid Solutions, — for antiseptic surgery, are — 
 
 5 per cent, in Water, (n\xxv to the 3), as a spray or wash. Is decidedly 
 
 irritant. 
 2.y 2 per cent, in Water, (tt\xij to the ^ ), for sponges, hands, or as a lotion. 
 5 per cent, or less in Olive Oil, as a special dressing. 
 
 Carbolic Acid Gauze, — is Gauze medicated with Carbolic Acid 1, Resin 5, Paraffin 
 7, and may be used as a surgical dressing. 
 
 Carbolic Acid Plaster, — an unofficial plaster composed of Carbolic Acid 25, Shellac 
 75, coated with Gutta-percha dissolved in Carbon Disulphide. 
 
 Phenol Sodique, — is composed of Carbolic Acid, gr. 188, Caustic Soda, gr. 31, 
 Distilled Water, | iv. 
 
 Phenol-camphor, — has of Carbolic Acid and Camphor, equal parts. A colorless, 
 refractive liquid ; soluble in alcohol, ether, chloroform and oils ; insoluble in water or 
 glycerin. Used as a local anesthetic, chiefly for toothache ; also in the proportion of 
 Carbolic Acid I, Camphor 3, as an application to false membrane in diphtheria, and as 
 subcutaneous and intrapulmonary injections in phthisis. Campho-phenique is a similar 
 preparation. (See under Camphora.) 
 
 Phenol Iodatum, Iodized Phenol, — a mixture of Iodine and crystallized Carbolic 
 Acid. (See under Iodum.) 
 
 Pheno-resorcin, — is a mixture of Carbolic Acid 67 with Resorcin 33 and Water 10, 
 forming a liquid which mixes readily with water. It is supposed to combine the virtues 
 of both its ingredients. 
 
 Phenosalyl, — is a clear, syrupy liquid, consisting of a mixture of Carbolic, Salicylic 
 and Benzoic Acids, melted together and dissolved in Lactic Acid. It is very soluble in 
 water, has a pleasant and non-persistent odor, and is used in a I per cent, solution as an 
 antiseptic application. 
 
 Aseptol, — is the trade name of a 33.3 per cent, solution of Sozolic or Ortho-phenol- 
 sidphonic Acid, which is formed when Carbolic Acid is dissolved in concentrated Sul- 
 phuric Acid. Aseptol occurs as a syrupy liquid which crystallizes in small deliquescent 
 needles, decomposes when distilled and is very soluble in water, also in alcohol and in 
 glycerin. It has a faint odor of carbolic acid, and is asserted to be antiseptic but neither 
 poisonous nor irritant, and hence of especial value in abdominal and ophthalmological 
 
ACIDUM CARBOLICUM. 85 
 
 surgery. In spite of these allegations it is probably toxic, and at any rate has been shown, 
 by a careful series of comparative experiments, to have not more than one-third the anti- 
 septic power of carbolic acid. It has been recommended for internal use as a substitute 
 for Salicylic Acid, on account of its greater solubility. It has been employed in concen- 
 trated solution for the treatment of pharyngitis and diphtheritic laryngitis. Externally it 
 is used so diluted as to contain from 3 to 10 per cent, of the active principle. 
 
 Aseptolin, — is a solution containing about 23^ per cent, of absolute Carbolic Acid 
 and 0.02 per cent, of a new pilocarpine salt named Pilocarpine-phenyl- hydroxide. It is 
 intended for hypodermic use only, in one daily dose of 50 to 250 minims for adults, 
 injected into the abdominal parietes or into the muscles of the back. 
 
 Allied Products and Derivatives. 
 
 Creosotum, Creosote, — is a similar product, obtained from wood-tar. It consists of 
 a mixture of phenols, chiefly Guaiacol (C 7 H 8 2 ), and Creosol (C 8 H 10 O 2 ) ; and by the 
 action of nitric acid is converted into oxalic acid principally, while Carbolic Acid is con- 
 verted into picric acid by that reagent. Creosote does not coagulate albumin or collodion, 
 Carbolic Acid does. It is described under its own title. 
 
 Resorcinum, Resorcin, C 6 H 6 2 , — is also a phenol, obtained from certain resins by the 
 action of fusing alkalies, and is described under its own title. 
 
 Creolin (Unofficial), — was the first form in which the cresols were presented in a 
 liquid condition for use in medicine. It is a coal-tar product, occurring as a dark brown, 
 alkaline, semi-fluid substance, of the consistence of honey. It forms a white cloud when 
 added to water, with which, however, it is miscible, as an emulsion, up to about 10 or 12 
 per cent, strength. The Solutions in general use vary from ^ to 2 per cent. ; the Oint- 
 ments to 5 per cent., and Creolin Gauze is prepared of 10 per cent, strength of the drug. 
 Dose, n^iij— v, in capsules. 
 
 Lysol (Unofficial), — one of the latest disinfectants and antiseptics, is a saponified 
 product of coal-tar. It is essentially a solution of tar-oils (cresols) in neutral soap, and 
 occurs as a clear, brown, oily liquid, miscible readily with water, and forming clear solu- 
 tions with glycerin, alcohol, chloroform and various other fluids. It is employed as a 
 local application only, generally in a I per cent, solution. 
 
 Trikresol (Unofficial), — is a mixture of the three isomeric cresols, respectively named 
 the ortho-, meta- and para-methyl phenols, and also contains the hydroxy 1 group, which 
 seems to be a characteristic constituent of antiseptics and germicides. It occurs as a 
 white liquid, of creosote-like odor, sp. gr. 1,042 to 1,049, and is soluble in water to the 
 extent of 2. 55 per cent. Its solutions are clear and do not impart any sensation of numb- 
 ness to the fingers. It is a powerful germicide in solutions of 1 per cent, strength, which 
 are said to be as efficient as a 5 per cent, solution of carbolic acid. Trikresol Water 
 (i part to 1000) is used as a menstruum for the ordinary collyria employed in ophthal- 
 mological practice. 
 
 Saprol, Disinfection Oil (Unofficial), — is a dark brown, oily mixture, highly inflam- 
 mable, and composed of the crude cresols in a great excess of the liquid hydrocarbons 
 obtained from the refining of petroleum. It floats on water and yet gives up its soluble 
 constituents as disinfectants to the offending fluid, leaving the remainder as an oily film 
 on the surface to hinder the escape of disagreeable odors, and the spread of infecting 
 spores. It is a cheap disinfectant, and can be employed on a large scale in barracks, 
 prisons, schools, etc., if no light or fire is brought into proximity with it. Sewage treated 
 with it still retains its value as a manure ; and so small a quantity as one per cent, of it 
 will effectually sterilize urine and fecal matter impregnated with micro-organisms, as the 
 bacilli of cholera and typhoid fever (Laser). 
 
 Solutol and Solveol (Unofficial), — are disinfectants of the same class as the preceding, 
 both being soluble forms of the insoluble Cresol (Cresylic Acid). Solutol is an alkaline 
 solution of Sodium Cresylate in an excess of Cresol, and is not suited for surgical use, by 
 reason of its caustic alkalinity ; but is of marked utility in the preservation of the 
 cadaver, and for general and copious use in disinfecting water-closets, sinks, infected 
 bed-clothing, sputa, and deleterious discharges of all kinds. 
 
 Solveol differs from Solutol in containing sodium cresotate instead of sodium cresy- 
 
86 ACIDUM CARBOLICUM. 
 
 late, is devoid of the causticity so characteristic of the latter substance, and is also free 
 from the greasiness of creolin and lysol. It is a dark-colored, nearly odorless liquid, 
 of neutral reaction, soluble in water in all proportions. It is especially applicable to 
 surgical uses, a )4 P er cent, solution being employed for dressing, being more active (it 
 is claimed) antiseptically, than a 2 per cent, solution of carbolic acid. 
 
 Physiological Action. 
 
 Carbolic Acid is antizymotic and antiseptic, a good disinfectant, some- 
 what antipyretic, also a local anesthetic, and a depressant of the cardiac, 
 respiratory, cerebral and spinal functions. In strong aqueous solutions 
 it is destructive to low forms of life, rapidly destroying all organized fer- 
 ments, both animal and vegetable. On unorganized ferments (enzymes), 
 such as pepsin and ptyalin, it does not act so readily, but in large doses 
 it likewise destroys their activity, and it is an efficient parasiticide against 
 certain vegetable parasites which infest the skin. The foregoing is true 
 of the liquefied acid and its aqueous and glycerin solutions, but not of 
 its solutions in oils, which have no antizymotic properties. 
 
 Applied to the skin in weak or moderately strong solutions, it produces 
 local anesthesia with a sensation of numbness, which lasts for several 
 hours. Applied in concentrated form, it is irritant and superficially 
 escharotic, with burning pain of brief duration, and produces at the point 
 of application a white spot, changing to red if the acid is soon removed. 
 It does not vesicate, but if the application be prolonged, a white eschar 
 or slough results, from coagulation of the albumin of the tissue, and this 
 is bordered by a red zone of inflammation. Even a 3 per cent, aqueous 
 solution, kept on a part for several days, has produced dry gangrene of 
 the tissues (Czerny). 
 
 Taken internally, the concentrated acid has the same effect on the 
 mucous membranes as on the skin, producing white, superficial eschars, 
 after burning pain of short duration, in the mouth, gullet and stomach. 
 To the latter viscus it is a powerful irritant, and causes a violent gastritis. 
 In medicinal doses, when acted upon by the gastric secretions, it is con- 
 verted into a sulpho-carbolate, and is so diluted by the contents of the 
 stomach that it loses its antizymotic power, and hence is of no value as 
 an internal antiseptic remedy. In the blood it probably circulates as an 
 alkaline carbolate, in medicinal doses having no effect upon the circu- 
 lation or respiration. Its antipyretic power is incapable of being utilized, 
 requiring a dosage which would be dangerous. 
 
 A toxic dose paralyzes the vaso-motor centre in the medulla before 
 markedly affecting the heart. The blood-pressure and body-temperature 
 fall ; the respiration, at first accelerated by stimulation of the vagi, is 
 quickly depressed and ultimately paralyzed ; cardiac inhibition is stimu- 
 lated, the heart being first slowed and then depressed. The anterior 
 cornua of the spinal cord are first stimulated, producing convulsions ; and 
 
ACIDUM CARBOLICUM. Sj 
 
 subsequently depressed, causing suspension of reflexes, impaired motility 
 and sensibility, and finally paralysis of both motion and sensation. The 
 cerebrum is profoundly depressed, producing stupor deepening into 
 coma, with minutely contracted pupils. Death occurs, in most cases, 
 by paralysis of respiration ; in a few, by paralysis of the heart. 
 
 Carbolic Acid is readily absorbed and rapidly diffused ; many fatal 
 cases having resulted from its external use in undiluted form. A single 
 vaginal injection of a moderately weak solution has produced very severe 
 constitutional results. It is partly oxidized in the blood, and partly 
 eliminated by the lungs and kidneys. It imparts to the urine a peculiar 
 smoky or olive-green color, which is not due to blood, and may be seen 
 after moderate doses, or even as a result of its absorption from dressings. 
 When ingested in a large dose, the acid itself may appear in the urine; 
 but the smoky color is due to the presence of its intermediate oxidation 
 products, viz., pyrocatechin (only in alkaline urine), and hydrochinon, 
 also salts of sulpho-carbolic acid and glycuronic acid. In poisoning 
 thereby the sulphates are absent from the urine. 
 
 A case of poisoning by Carbolic Acid shows white, corrugated eschars 
 in the mouth and fauces, if the drug has been swallowed in concentrated 
 form. These eschars are also found on the mucous lining of the esopha- 
 gus and stomach, at the autopsy. The patient has complained of an 
 intense, burning sensation along the same tract, immediately after the 
 ingestion of the poison, and soon passes into a state of collapse; the 
 skin being cold and clammy, the pupils contracted, respiration becomes 
 more and more feeble and shallow; the urine, if not entirely suppressed, 
 is of a dark-green color; reflexes are then abolished, stupor and coma 
 supervene, and finally the breathing ceases. The blood, after death, is 
 dark in color, and coagulates imperfectly ; and fatty degeneration of the 
 liver and kidneys may be found. When poisoning occurs by absorption, 
 an early symptom is the peculiar, smoky color of the urine. There may 
 be pain in the lumbar region, indicating renal irritation, and slight rest- 
 lessness or cerebral disturbance ; after which comes the impairment of 
 respiration and stupor. 
 
 A toxic dose of Carbolic Acid, taken internally, is one of the most 
 rapidly acting poisons known, sometimes equalling Prussic Acid in this 
 respect. The symptoms develop almost immediately, and death may 
 occur in a very few minutes ; but usually the patient lives from one to ten 
 hours; rarely over two days. In some cases, a great amendment has 
 occurred, with restoration of consciousness, but after some hours sudden 
 and fatal collapse has supervened. The minimum fatal dose is not deter- 
 mined, but ^ss has frequently caused death; and doses as small as rr^vj 
 have given rise to dangerous symptoms. Cases of suicidal and accidental 
 
88 ACIDUM CARBOLICUM. 
 
 poisoning by this drug are very frequent, by reason of the facility with 
 which it may be obtained for use as a disinfectant. 
 
 Professor Mann has shown that during the ten years previous to 1895 there were 917 
 deaths from Carbolic Acid, a yearly average of nearly 100 ; while in the year 1 894 alone 
 the number of deaths from this cause reached the appalling total of 202. 
 
 Treatment of Poisoning by Carbolic Acid. 
 
 If the case is seen shortly after ingestion, Apomorphine may be administered hypoder- 
 mically, as a rapidly acting emetic ; but, in any case, the stomach should be washed out 
 freely. The chemical antidote is any soluble sulphate to form the harmless sulpho-car- 
 bolates ; as Magnesium Sulphate 25 j, or Sodium Sulphate ^ ss, dissolved in ]/ 2 pint of 
 water. Even if several hours have elapsed since the ingestion of the poison, the sulphates 
 should be used, as their antidotal action proceeds in the blood current. Alcohol, is a 
 perfect antidote to the corrosive effects [see under Poisoning by Carbolic Acid in Part 
 III]. Stimulants, as ether or brandy hypodermically, should be used freely; also hot 
 water bottles and hot blankets if signs of collapse appear. Vegetable demulcents may 
 be given (but no oils or glycerin), to protect the mucous surfaces. Liquor Calcis Sac- 
 charatus, or Syrupus Calcis, is also antidotal to the poison in the stomach, but is much 
 less efficient than the sulphates. Atropine, hypodermically, is a very complete physio- 
 logical antagonist to the systemic symptoms, maintaining the heart and respiration until 
 elimination occurs (Post). Cider Vinegar may prove antidotal, as it removes the effects 
 of the local application of the strong acid. Soap, in strong, watery mixture (suds), is 
 said to have acted as a perfect antidote ; but its action would be confined to the poison in 
 the stomach. Oils should not be used, as they increase the absorption of the poison. 
 
 Therapeutics. 
 
 Carbolic Acid owes much of its prominence to its having been the 
 principal agent at first used in the antiseptic method of treating wounds ; 
 but its employment in that connection has become much restricted, and 
 many of the most prominent surgeons have abandoned it altogether in 
 favor of other germicides. Recent investigations have proved beyond 
 doubt that this agent has a reputation as a germicide far above that which 
 it deserves ; that in the ordinary solutions it is almost useless as a germi- 
 cide though actively antiseptic ; and that very many hours of exposure 
 to very strong solutions are required to kill pathogenic germs. In the 
 estimation of many, however, it still retains high favor as a surgical anti- 
 septic lotion ; and it is in general use as a disinfectant for surgical instru- 
 ments, hospital apparatus, soiled linen, etc. The carbolic spray, formerly 
 so commonly used during operations, has been entirely discarded. For 
 disinfectant purposes about drains, privies, on floors, walls, etc., the crude 
 acid is to be preferred, not only on account of its less cost, but also for 
 the reason that its principal impurity, Cresol (Cresylic Acid), has very 
 high power as a disinfectant. 
 
 As a local application, Carbolic Acid has extensive and varied uses. 
 Unna calls it the opium of the skin, as it relieves pruritus of almost any 
 form, if applied in 5 per cent, aqueous solution over the itching surface ; 
 and a lotion, composed of gr. xx to gss each of water and glycerin, 
 
ACIDUM CARBOLICUM. 89 
 
 makes a very efficient application for the itching of jaundice. The gly- 
 cerite, diluted, effectively destroys the fungus of tinea tonsurans or tinea 
 versicolor, and may be applied as a stimulant to indolent ulcers, or to the 
 patches of aphthous stomatitis. A one per cent, solution in water and 
 glycerin (r^v to ^j) makes an excellent anesthetic and cleansing gargle 
 for the painful sore throat of diphtheria, tonsillitis, etc. Cotton soaked 
 in the strong acid will stop the pain of a decayed tooth, but care must 
 be taken, by covering it with dry cotton, to prevent its access to the 
 gums, or sloughing thereof may result. For burns, one of the best 
 dressings is carbolized sweet oil (gj to §vj) to relieve the pain. For local 
 anesthesia in minor surgical operations, such as that for ingrowing toe- 
 nail or opening a felon, the part may be soaked for ten minutes in a 30 
 per cent, solution, or the pure acid may be brushed over the line of 
 incision. 
 
 As a parenchymatous injection, which should be not over 3SS of a 2 
 per cent, solution, Carbolic Acid has been employed with much success 
 in combating deep-seated inflammations. The skin being first anesthet- 
 ized by the local application of the acid, a hypodermic needle is intro- 
 duced obliquely, to the centre of the inflamed tissue, and should not be 
 connected with the syringe if any blood escapes through it, lest the in- 
 jection be introduced into a vein. This method has been successfully 
 used in glandular swellings, 5 to 10 minims of the solution for each gland 
 being sufficient in phlegmons of every grade and character, erysipelas, 
 poisoned wounds, inflamed bursae, hydrocele, acute and subacute rheu- 
 matism, chronic synovitis, buboes, relapsing tonsillitis, and in some 
 severe cases of tetanus. Under the trade-name Aseptolin (see ante, page 
 85) Dr. Edson has recently put forth a solution, containing 2^ per cent. 
 of carbolic acid and a minute quantity of a pilocarpine salt, for hypo- 
 dermic use in curable cases of tuberculosis, malaria, and other diseases 
 due to germ infection. There is nothing original in this treatment, it 
 being a repetition of the phenic acid injection of Declat combined 
 with the pilocarpine treatment of phthisis announced about four years 
 ago as the "discovery" of Dr. Waldstein. It has gone through the 
 usual puffing methods of trade promotion, and the few independent 
 reports upon its use show no evidence of any special merit for it in these 
 diseases. 
 
 Internally, Carbolic Acid is not much employed. It has been given 
 to relieve flatulence and dyspepsia, and is often an efficient remedy against 
 vomiting. It has proven of considerable temporary benefit in diabetes 
 of hepatic origin ; and has been used against intermittents, typhoid 
 fever and various zymotic diseases ; but is probably of no efficacy in 
 constitutional affections. A mixture containing carbolic acid and spirit 
 of chloroform has been lately used as an internal remedy for typhoid 
 
90 ACIDUM CARB0L1CUM. 
 
 fever by Dr. Quill, of the Indian army, without the loss of a single case, 
 and in a country where enteric fever has a very high rate of mortality. 
 
 In phthisis and other chronic pulmonary diseases, Carbolic Acid has 
 been much employed as a spray by inhalation, and certainly does do 
 good therein by relieving cough and irritation of the throat. In these 
 affections, Creosote is preferred to it both for internal and local use. An 
 acute conjunctivitis is greatly relieved by holding the open eye in the 
 spray of a steam atomizer, the cup of which contains a 5 per cent, solu- 
 tion of carbolic acid. This measure may also be used for acute coryza 
 with beneficial results; or a mixture of Carbolic Acid and Tincture of 
 Iodine may be dropped on to a sponge in a wide-mouthed bottle and 
 volatilized for inhalation by being wrapped in a cloth wrung out of hot 
 water, or even by being held in the hand. 
 
 The Sulpho-carbolates of Sodium, Potassium, etc., have been em- 
 ployed internally with advantage in the septic diseases, as the exanthe- 
 mata, diphtheria, puerperal fever, etc., with the object of obtaining the 
 antiseptic action of carbolic acid without the dangers attending its use in 
 efficient doses. They may be used locally with good results in aphthae, 
 tonsillitis, otorrhea, gonorrhea, and for inflamed mucous membranes 
 generally. 
 
 Creolin was highly vaunted, by Professor von Esmarch and other authorities, as the 
 ideal antiseptic for external use, being possessed of great germicidal power, and a most 
 efficient deodorant and disinfectant, while its absorption caused no toxic results whatever. 
 Experience has justified these claims in the main, but the drug has, however, given rise 
 to serious symptoms, when used to excess. As a vaginal wash, in puerperal cases, the 2 
 per cent, solution is reported as fully equal to sublimate solutions, while better as a de- 
 odorant, and free from danger by absorption. The weaker solutions have given satisfac- 
 tion as local applications in the treatment of otorrhea, nasal ulcers, rhinitis (I to 1000), 
 blepharitis, keratitis, etc. ; and in female cystitis a I per cent, solution as a vesical wash, 
 gradually increased to 2 per cent., is highly praised by Parvin. The Ointments and 
 Gauze are used for wounds and other solutions of continuity, in the same manner as car- 
 bolized preparations, and with better satisfaction, Creolin being less volatile than Carbolic 
 Acid, and of a more agreeable, though powerful, odor. Internally it has been employed 
 in gastric fermentation, dysentery, and typhoid fever. 
 
 Lysol is said to be superior to carbolic acid, creolin and the other analogous coal-tar 
 products as a germicide, but it has no advantage over the antiseptics of established repu- 
 tation ; and is only really efficient in solutions of such strength as to be irritating or 
 caustic. Although not destined to play any great part in surgery, it may be useful in the 
 prophylaxis and arrest of epidemics ; and is likely to be particularly serviceable in the 
 disinfection of premises, privies, ships and stables, being readily soluble, reasonably 
 active, and very cheap (Squibb). Dr. Pee, who has had very favorable results from 
 Lysol, recommends a 1 per cent, solution in obstetrics and gynecology, and says that a 
 solution of one part in 200 destroys streptococci in fifteen minutes. 
 
 Trikresol possesses very high germicidal power, and is said to be practically non- 
 toxic and less irritating to wounds than either carbolic or sublimate solutions. A I in 
 1000 solution dropped into the eye did not produce the slightest irritation, and the I to 
 500 solution dropped into my own eyes produced no burning sensation whatever (De 
 Schweinitz). These solutions may therefore be advantageously employed as menstrua 
 for the stock collyria, especially for those of cocaine, physostigmine and atropine, which 
 are most liable to contamination. Trikresol is particularly fatal to pyogenic cocci, a I 
 per cent, solution invariably killing them in half a minute in watery solutions, and in a 
 minute and a half in rich albuminous fluids (Griiber). 
 
ACIDUM CARBONICUM. 9I 
 
 Phenosalyl is said to possess antiseptic power which is considerably superior to that 
 of carbolic acid, a I per cent, solution immediately killing the staphylococcus pyogenes 
 aureus, the most resistent microbe known. In order to attain the same result with car- 
 bolic acid it is necessary to expose the staphylococcus to the action of a i]/ z per cent, 
 solution for at least one minute. Phenosalyl does not irritate the skin, has no corrosive 
 action on instruments, is very soluble in water, is non-toxic, and leaves a pleasant and 
 non-persistent odor which does not cling about the hands or the clothes. Its solutions 
 have no corrosive action on the skin, and the mucous surfaces treated with it remain 
 smooth and slippery and do not become dried up, as is the case after washing with car- 
 bolic acid or corrosive sublimate solutions (Frankel). 
 
 ACIDUM CARBONICUM, Carbonic Acid, Carbon Dioxide, 
 C0 2 (Unofficial). The body which is commonly called Carbonic Acid, 
 but should be called Carbon Dioxide, is a colorless and odorless gas, of 
 sp. gr. 1.526, slightly sharp taste, soluble in its own volume of pure water 
 at the ordinary temperature and pressure, much more soluble under in- 
 creased pressure and lowered temperature of the water, also more soluble 
 in water containing phosphates. In water it promotes the solution of 
 phosphates and carbonates. Its aqueous solution gives an acid reaction, 
 and is "sparkling " from rapid escape of the gas, especially when agitated. 
 It is prepared by treating any carbonate (usually calcium carbonate in 
 the form of marble-dust) with dilute hydrochloric acid ; the resulting gas 
 is passed into water under pressure, and the solution is thus obtained. 
 
 Carbon Dioxide occurs in the atmosphere in the proportion of 2 to 6 parts in 10,000, 
 also in all water in varying quantity. Certain sparkling waters contain it in the propor- 
 tion of more than one half their volume, Johannis having more than 90 per cent. It 
 occurs also in all the liquids of the body, especially in the blood, originating in the oxida- 
 tion processes which are constantly taking place in the tissues, and readily passing by 
 osmosis through animal membranes. It is continuously produced by the action of the 
 yeast-plant, and by all other fermentation processes, and accumulates in brewers' vats, 
 old wells, some caves, grottoes and deep valleys, also in mines, forming the well-known 
 "choke-damp " of miners. It is constantly evolved during respiration and in the burning 
 of gas, fires, etc. When the air of a room contains o. I per cent, of this gas it is unfit for 
 continued respiration. 
 
 True Carbonic Acid, C0 3 H 2 , or Hydrogen Carbonate, is an organic acid which is not 
 known in the separate state, but only in aqueous solution. It is supposed to exist in a 
 solution of carbon dioxide in water. 
 
 Preparation. 
 
 Aqua Carbonata, Carbonated Water, Soda-water (Unofficial), — is water highly 
 charged with carbonic acid gas, the excess of gas being dissolved in the water by 
 pressure, and escaping in bubbles when the pressure is taken off. It was official in the 
 U. S. P., 1870, under the title Aqua Acidi Carbonici, the formula requiring that the water 
 be charged with five times its volume of gas, for which a pressure of five atmospheres is 
 required. 
 
 Carbonated Mineral Waters. 
 
 Selters, Nassau, Germany, 30 cubic inches "] 
 
 Apollinaris, Neuenahr, Prussia, 47 " of C0 2 
 
 Old Sweet Spring, West Virginia, 11 " to the pint. 
 
 Sweet Chalybeate Spring, Virginia, .... 13 " J 
 
 There are 10 official Carbonates and 2 official Bicarbonates, which are severally de- 
 scribed under their basylous titles. 
 
92 ACIDUM CARBONICUM. 
 
 Physiological Action. 
 
 Carbon Dioxide is highly antiseptic and preservative. D'Arsonval 
 employs it, under 30 atmospheres pressure, for the sterilizing of orchitic 
 extract. Beef will remain perfectly fresh and its taste unchanged for 
 eight days if hung in a chamber filled with the gas. Externally, applied 
 to the skin, mucous membranes or wounded tissues, the undiluted gas 
 produces slight hyperemia, with prickling and a sense of heat, followed 
 by a certain degree of local anesthesia. Internally, given by the stomach 
 in aqueous solution, it is refreshing and quenches thirst, slightly stimu- 
 lates the heart's action, quickens respiration and causes a brief sense of 
 exhilaration. It increases somewhat the gastro-intestinal secretions and 
 excites peristalsis, but diminishes the sensibility of the mucous lining of 
 the alimentary canal. Inspired, the gas is highly toxic, a proportion of 
 10 per cent, thereof in the air being irrespirable and fatal. Even 0.1 
 per cent, produces unpleasant symptoms, as headache, sleeplessness and 
 depression; 0.3 per cent, causing a throbbing headache, fulness and 
 tightness across the temples" and giddiness; and a larger quantity 
 profoundly affects the nervous system, inducing fainting, muscular 
 weakness, somnolence or insensibility, and coma or convulsions. The 
 inhalation of the undiluted gas at first excites irritation and sometimes 
 spasmodic closure of the glottis with consequent asphyxia, but in any case 
 it soon arrests the respiration. It hinders the exhalation of the carbon 
 dioxide normally existing in the blood, and is itself absorbed in small 
 quantity, inducing dyspnea, cyanosis, slow and labored pulse, and ulti- 
 mately arrest of the heart's action. In toxic quantity it abolishes at 
 once the functions of nerve and muscle by stopping the process of oxi- 
 dation in the tissues. 
 
 The symptoms of Carbon Dioxide poisoning may be divided into three 
 stages, which are the stages of Asphyxia. They are : (1) that of dyspnea, 
 in which the blood pressure rises from excitation of the centres in the 
 medulla by the venous blood, the vessels of the surface become dilated, 
 and insensibility comes on ; (2) that of convulsions, in which the respira- 
 tory movements become more violent and spread to all the muscles of 
 the body; (3) that of paralysis, in which the convulsions cease, the 
 blood pressure falls, the respiration gradually fails, and finally the heart 
 stops. The autopsy shows great venous congestion everywhere, the right 
 side of the heart distended with blood, the brain much congested, with 
 exudation and even extravasation therein, and the blood exceedingly 
 dark in color. 
 
 Treatment of Carbon Dioxide Poisoning. 
 
 The antagonists are Oxygen and stimulants of the peripheral circulation. The prime 
 object of treatment is to get the blood oxygenated as quickly as possible. The patient 
 
ACIDUM CHROMICUM. 93 
 
 should be brought at once into, the open air, and if the respiratory movements have 
 ceased, cold water should be dashed on the face and chest, in order to awaken them by 
 reflex action. If no effect is thereby produced, recourse must be had to artificial respir- 
 ation, which should be maintained for at least an hour. [Compare the article entitled 
 Asphyxia and Apnea in Part III.] If the heart does not begin to beat shortly after 
 artificial respiration has been begun, the jugular vein should be opened, with care to 
 prevent the entrance of air, in order to relieve the distention of the right ventricle and 
 prevent the consequent paralysis of the heart. This vein is selected because there are 
 no valves of any importance between it and the heart. A series of sharp, quick blows 
 upon the chest in the cardiac region will sometimes start the heart into action after it has 
 stopped. 
 
 Therapeutics. 
 
 Carbon Dioxide has been locally employed as a stimulant in ulcers 
 and as an anesthetic in cancers, either by directing a stream of the gas 
 upon the part or by the application of a yeast poultice. It has been 
 applied to the eyes, ears, nose, vagina and rectum, in catarrhal inflam- 
 mations of these parts, also to the bladder, for irritability of that viscus, 
 and its application is beneficial when there is no acute inflammation 
 present. It is injected into the vagina with good results in dysmenorrhea 
 and in many other painful affections of the pelvic viscera, whether neu- 
 ralgic in character or arising from organic disease. Diluted with 90 to 
 95 per cent, of air, its inhalation is serviceable in chronic laryngitis and 
 pharyngitis, also in asthma, chronic bronchitis and chronic cough. 
 
 Carbonated water, or Soda-water as it is popularly named, is a grateful 
 beverage in warm weather, especially when flavored with certain syrups 
 and fruit juices. It is a useful drink in febrile affections, as it relieves 
 thirst, allays nausea and gastric irritability, and is both diaphoretic and 
 diuretic in slight degree. It is an efficient remedy for vomiting, and in 
 the form of iced champagne is one of the numerous agents which have 
 proven efficacious in the vomiting of pregnancy. It forms an excellent 
 vehicle for the administration of saline cathartics, the various carbonates 
 and piperazin. The free use of carbonated mineral waters is of service 
 in gout, especially when they contain the salts of lithium in solution. 
 At many European spas the course of treatment is largely based on the 
 use of carbon dioxide, administered in the forms of baths and inhalations 
 as well as by the ingestion of the waters containing it. Bathing in the 
 natural carbonated waters is sometimes beneficial in catarrh, gout, rheu- 
 matism, anemic amenorrhea and leucorrhea, the gas acting as a gentle 
 stimulant of the cutaneous circulation and promoting slight diaphoresis. 
 [Compare the article entitled Aqua.] 
 
 ACIDUM CHROMICUM, Chromic Acid, Chromic Trioxide, 
 Chromic Anhydride, Cr0 3 , — is obtained by the action of Sulphuric Acid 
 upon Potassium Bichromate, and occurs in small, crimson, needle-shaped 
 crystals, which are deliquescent and very soluble in water. This sub- 
 
94 ACIDUM CHROMICUM. 
 
 stance is not true Chromic Acid, which does not occur in the free state, 
 and the formula of which would be H 2 Cr0 4 . It should be known by one 
 of the chemical synonyms mentioned above. It should he kept in glass- 
 stoppered bottles, and great caution should be observed to avoid bringing 
 it in contact with organic substances, such as cork, tannic acid, sugar, 
 alcohol, glycerin, etc., as dangerous accidents are liable to result. It is 
 not used internally. 
 
 Potassii Bichromas, Potassium Bichromate, K 2 Cr 2 7 , — large, orange-red prisms of 
 disagreeable, metallic taste and acid reaction, soluble in io of water at 59 F., and in 
 iy z of boiling water, insoluble in alcohol. It is used locally in aqueous solution (gr. 
 V- 3J to tri e %), and internally in doses of gr. Yo~gr. ij in trituration. 
 
 Physiological Action and Therapeutics. 
 
 Chromic Trioxide is a powerful escharotic and penetrates deeply, but 
 it is slow of action and is not very painful. It coagulates albumin and 
 parts readily with its oxygen, oxidizing organic matter and decomposing 
 ammonia and sulphuretted hydrogen ; and is therefore an energetic 
 disinfectant and deodorizer. When used as a caustic it is mixed with 
 sufficient water to make a paste, which may be employed for the destruc- 
 tion of warts, hemorrhoids and other superficial growths ; the neighbor- 
 ing parts being protected by cotton soaked in a strong alkaline solution. 
 For syphilitic warts and condylomata, lupus, tinea tonsurans, etc., a 
 solution of 100 grains to the g of distilled water is generally used. A 
 solution of 1 in 40 is an excellent and inexpensive antiseptic lotion for 
 putrid sores and wounds, syphilitic affections of the tongue, mouth and 
 throat, ozena, leucorrhea and gonorrhea. In uterine catarrh and hem- 
 orrhages a solution of 120 grains to the % has been injected into the 
 uterine cavity with good results. 
 
 Potassium Bichromate is a good antiseptic and escharotic of milder 
 action than the trioxide. In doses of 31J— iv it has proved fatal to life in 
 adults, with symptoms of gastro-enteritis, suppression of urine, and 
 cardiac paralysis. It is chiefly employed as a local application in satu- 
 rated solution to warts and venereal condylomata ; and in dilute solution 
 (gr. j-x to the £) for catarrhal conditions of the nasal, buccal or vaginal 
 mucous membrane. Internally it has been employed with benefit in 
 locomotor ataxia and in dyspepsia simulating gastric cancer ; also in 
 chronic gastric catarrh, the tongue having a thick yellow coat, in chronic 
 diarrhea from intestinal ulceration, and in chronic ulcers of the pharynx 
 and mouth. It is a good remedy in syphilitic sore throat, local rheuma- 
 tism of the fibrous tissues, periosteal and syphilitic rheumatism, and 
 acute catarrh and influenza, chronic nasal catarrh, chronic laryngitis, and 
 chronic catarrhal affections of the bronchial mucous membrane, especially 
 when the expectoration is tough and stringy. It has also been used with 
 
ACIDUM FLUORICUM ACIDUM TANNICUM. 95 
 
 some success in diphtheria. In pharmacy it is employed in preparing 
 Chromic Acid and Valerianic Acid, and as a test solution. Most of the 
 medical galvanic and faradic batteries are run by a mixture of this salt 
 with sulphuric acid. Poisoning by it should be treated as directed for 
 mineral acids 
 
 ACIDUM FLUORICUM, Fluoric Acid, HF (Unofficial),— is a strong escha- 
 rotic, acting deeply and leaving a dry and painful slough. The dilute acid (i in 200) is 
 prepared by acting on fluor spar by Sulphuric Acid, the resulting gas being dissolved in 
 water. Its dose is rr\xx-xxx, well diluted. 
 
 Dilute Fluoric Acid has been successfully used as an internal remedy in goitre, and 
 the gas has been inhaled with benefit in laryngeal diphtheria. 
 
 ACIDUM GALLICUM, Gallic Acid, HC 7 H 5 5 .H 2 0,— is a 
 
 nearly colorless solid in long needles and triclinic prisms, having a 
 slightly acid and astringent taste, soluble in ioo of water and in 5 of 
 alcohol at 59 F., and in 3 of boiling water. It is prepared from a paste 
 of powdered galls (see Galla), by fermenting for six weeks, boiling and 
 reboiling in water, filtering and crystallizing. According to some au- 
 thorities, the Tannic Acid of the galls is split up into Gallic Acid and 
 glucose by fermentation ; but according to others the glucose is an im- 
 purity and the Tannic Acid is simply converted into two parts of Gallic 
 Acid, C u H 10 O 9 -f- H 2 = (HC 7 H 5 5 ) 2 . Dose, gr. v-xv, in solution, pill 
 or powder. 
 
 Acidum Tannicum, Tannic Acid, Gallotannic Acid, Digallic 
 Acid, Tannin, HC u H 9 9 , — is a solid body in light-yellowish scales, of 
 strongly astringent taste and acid reaction, obtained from powdered galls 
 (see Galla), by exposure for three days in a damp atmosphere, then 
 macerating with ether, pressing, and drying the liquid portion. It is 
 soluble in 1 of water, in 0.6 of alcohol, at 59 F., and in about 1 of gly- 
 cerin with moderate heat ; very soluble in boiling water and in boiling 
 alcohol, almost insoluble in ether, chloroform, benzol or benzin. Dose, 
 gr. j-xx, in wafer, pill or capsule. 
 
 Preparations. 
 
 Unguentum Acidi Tannici, Ointment of Tannic Acid, — is a 20 per cent, ointment, 
 made with Benzoinated Lard. 
 
 Trochisci Acidi Tannici, Troches of Tannic Acid, — each troche contains nearly 
 one grain of Tannic Acid. 
 
 Glyceritum Acidi Tannici, Glycerite of Tannic Acid, — has a strength of 1 part in 
 4 of Glycerin. 
 
 Suppositoria Acidi Tannici, Suppositories of Tannic Acid (Unofficial), — have I 
 part of Tannic Acid in 5 of Cacao Butter. 
 
 Collodium Stypticum, Styptic Collodion, — has of Tannic Acid 20, Alcohol 5, Ether 
 25, Collodion to make 100 parts. 
 
96 ACIDUM TANNICUM. 
 
 Vegetable Astringents contain some form of Tannic Acid, as Quercitannic Acid 
 from Oak-bark, Rhatania-tannic Acid in Rhatany, etc. The official acid is Gallolannic 
 Acid, being that produced from Galls. These astringents depend for their medicinal 
 value upon the Gallic and Tannic Acids contained in them. Such are — 
 
 Alnus, Alder Bark. Granatum, Pomegranate. Myrica, Wax Myrtle. 
 
 Castanea, Chestnut. Hamamelis, Witch Hazel. Nymphsea, Pond Lily. 
 
 Catechu, Catechu. Haematoxylon, Logwood. QuercusAlba, Oak Bark. 
 
 Diospyros, Persimmon. Heuchera, Alum Root. Rosa Gallica, Red Rose. 
 
 Galla, Nut Galls. Kino, Kino. Rubus, Blackberry. 
 
 Geranium, Cranesbill. Krameria, Rhatany. Statice, Marsh Rosemary. 
 
 Physiological Action and Therapeutics. 
 
 Gallic Acid, and its congener Tannic Acid, are astringents, the former 
 being the feebler of the two. They differ in that tannic acid coagulates 
 albumin and gelatin, while gallic acid does not. According to some 
 authorities the difference between gallic and tannic acids is one of oxida- 
 tion, according to others of hydration ; the latter assuming tannic acid 
 to be simply gallic acid anhydride. They constringe the muscular tissue 
 in the walls of the minute vessels, thus checking secretion and hemor- 
 rhages and cutting short local inflammations. Except in enormous doses, 
 they are harmless. 
 
 Tannic Acid is a powerful astringent. It precipitates pepsin and co- 
 agulates albumin, impairs digestion, stops peristalsis, and causes consti- 
 pation. A part of that taken into the stomach unites with the pepsin 
 and albumin, while a part is converted into Gallic and Pyrogallic 
 Acids, and in this form is both absorbed and excreted. It is a crystal- 
 loidal body, but combines with colloids, and is a valuable antidote in 
 poisoning by the alkaloids and tartar emetic, with which it forms tan- 
 nates which are nearly insoluble. Its continued use disorders digestion, 
 irritates the mucous membranes, and produces emaciation. Injected 
 into the veins it forms emboli and thus may cause death, but by the 
 stomach it is non-toxic. Tannic Acid is a more powerful astringent 
 than Gallic Acid, and hence it is preferred for local use and for astringent 
 effect on the intestinal canal. It is well employed in hemorrhoids and 
 hemorrhages from the lower bowel, in hematemesis, epistaxis, rectal 
 ulcers or fissures, catarrhs and chronic affections of the mucous mem- 
 branes, endocervicitis, conjunctivitis, dysentery and diarrheas, eczema, 
 impetigo and other forms of skin-disease, otorrhea, bed-sores, prolapsus 
 ani, and many other affections. 
 
 Styptic Collodion is used to stanch the bleeding from an open wound, 
 to unite and protect incised or lacerated wounds, and to cover and change 
 the character of foul ulcers. 
 
 Gallic Acid is preferred to Tannic Acid when an astringent action is 
 desired upon remote parts, as the lungs, kidneys, etc., which can only be 
 reached through the circulation. In hematuria, distant passive hemor- 
 
ACIDUM HYDROCHLORICUM. 97 
 
 rhages, albuminuria, diabetes insipidus, bronchorrhea, night-sweats, 
 chronic diarrhea, and chronic cystitis, it is a most useful remedy. 
 
 Mineral Acids, Alkalies, per-salts of Iron and salts of Antimony, Lead, and Silver are 
 chemically incompatible with preparations containing Tannic or Gallic Acid. Vegetable 
 Alkaloids and Gelatin form insoluble precipitates with Tannic Acid. 
 
 Gallobromol, Dibromogallic Acid, C 6 Br 2 (OH) 3 COOH, (Unofficial), — occurs in small 
 white, needle-shaped crystals, soluble in io parts of lukewarm water. The solution 
 gradually darkens and after a few days becomes brown. Lepine states its internal action 
 as similar to that of potassium bromide. In I or 2 per cent, solutions it has been used 
 with remarkable success as a local application in gonorrhea of all stages. It seems to 
 i-eadily destroy the gonococcus. , 
 
 Pyrogallol, Pyrogallic Acid, Tri-hydroxy-benzene, C 6 H 3 (OH) 3 , — is a triatomic 
 phenol, obtained chiefly by the dry distillation of Gallic Acid. It occurs in light, white, 
 shining laminae, or fine needles, of bitter taste ; soluble in water, alcohol and ether. 
 Dose, gr. j-ij. 
 
 Pyrogallol may act as an intense poison. It has been absorbed from the surface with 
 fatal results, preceded by vomiting and diarrhea, rigors and fever, black urine full of 
 globulin, and disorganization of the blood-corpuscles. It has great affinity for oxygen 
 and may be used as an antiseptic and disinfectant in I to iy z per cent, solutions. It 
 has been used internally in two-grain doses for internal hemorrhages. As an ointment 
 ( 3J~"3J) it ran ks next to Chrysarobin as an efficient palliative in psoriasis, and has been 
 used with good results in lupus and epithelioma, being supposed to attack the diseased 
 nodules only, leaving the adjacent skin uninjured. 
 
 Tannigen Diacetyl-tannin (Unofficial), — is an acetic acid ester of tannin, prepared 
 by the action of glacial acetic acid on tannic acid. It occurs as an odorless and tasteless 
 powder, insoluble in cold water and dilute acids, but soluble in cold alcohol and in dilute 
 solutions of soda, sodium phosphate and borax. It is said to pass through the stomach 
 unchanged and to be gradually decomposed in the intestines, thus exerting an astringent 
 effect upon the entire intestinal canal. Its uses have been those of an intestinal astrin- 
 gent. It appears to be absolutely innocuous. Dose, gr. iij-viij, up to gij daily. IS 
 
 ACIDUM HYDROCHLORICUM, Hydrochloric Acid, 
 
 Muriatic Acid, — is a liquid composed of about 32 per cent, of absolute 
 Hydrochloric Acid Gas, HC1, and 68 per cent, of water. It is colorless 
 and fuming, of specific gravity 1.163, pungent odor, intensely acid reac- 
 tion and taste, and is obtained by the action of Sulphuric Acid upon 
 Sodium Chloride, the resulting gas being carried through water, which 
 dissolves it. It is sometimes used as a caustic. Its union with basic sub- 
 stances forms salts, called Hydrochlorates (Muriates), of which four are 
 official, viz. — Apomorphine, Morphine, Pilocarpine, and Quinine Hy- 
 drochlorates, described under the title of their respective bases. 
 
 Acidum Hydrochloricum Dilutum, Diluted Hydrochloric Acid, — is a 10 per cent, 
 solution of the absolute acid in water. Dose, TTyij-x. 
 
 Acidum Nitro-hydrochloricum, Nitro-hydrochloric Acid, — is described under 
 Acidum Nitricum. 
 
 Physiological Action of the Mineral Acids. 
 The mineral acids (Hydrochloric, Sulphuric, Nitric, Nitro-hydro- 
 chloric, and Phosphoric) resemble each other in general action so closely 
 that they may all be described in this place. 
 
 The strong acids are escharotic, abstracting the waters of the tissues, 
 7 
 
98 ACIDUM HYDROCHLORICUM. 
 
 combining with the albumin and other bases, and destroying the proto- 
 plasm. They are very diffusible, redissolving the albumin after precipi- 
 tating it (except Nitric Acid). Sulphuric and Phosphoric have a strong 
 affinity for water, completely decomposing tissues to which they are 
 applied, and are therefore the most powerfully escharotic. Nitric Acid 
 does not readily redissolve the albumin precipitated by it, which thus 
 forms a barrier against the deep action of the acid. Sulphuric Acid 
 chars or carbonizes the tissues black, while Nitric and Hydrochloric tan 
 them yellow. 
 
 The dilute acids produce a peculiar taste in the mouth and a sensation 
 of roughness on the teeth. They stimulate the flow of saliva from the 
 parotid and submaxillary glands, but have no action on the sympathetic 
 saliva. They promote the alkaline intestinal secretions and excite the 
 flow from glands having an alkaline secretion (bile, etc.), when applied 
 to the mouths of their ducts, but check that from those whose secretion 
 is acid (gastric, etc.). Secretion generally is promoted by Nitric Acid, 
 and lessened by Sulphuric, Hydrochloric acting between the other two. 
 Given before meals, in small doses, they relieve acidity of the stomach by 
 checking the production of the acid gastric juice. At first they aid diges- 
 tion, being synergistic to the action of pepsin, but if continued they im- 
 pair digestion by lessening the production of the gastric juice. They 
 check fermentation and constipate the bowels, except Nitric Acid, which 
 relaxes them. They render the urine slightly more acid than its normal 
 reaction, but do not acidify alkaline urine as the vegetable acids do. 
 They are all astringent to the tissues, Hydrochloric being the weakest 
 and Sulphuric the strongest in this respect. 
 
 Antidotes and Antagonists . 
 
 Alkalies to neutralize the acid ; Oil, Albumin, or Milk, to protect the mucous mem- 
 brane ; Stimulants, Opium, Ammonia (intravenously), to combat the resulting depression 
 of the vital powers. 
 
 Therapeutics of the Mineral Acids. 
 All the members of this group are useful in fevers, if well diluted, 
 Hydrochloric being usually preferred, especially in typhoid. In atonic 
 dyspepsia, acidity of the stomach, and locally in ulcerations of the throat, 
 Hydrochloric Acid is best used. Nitric is the acid generally preferred as 
 a caustic, its action being effectual and superficial. As such it is applied 
 undiluted to phagedenic ulcers and sloughs, warty growths, and to the 
 cavity of the womb in chronic inflammation thereof. Dilute Nitric Acid 
 is used internally in oxaluria and lithemia, intermittent and remittent 
 fevers, and aphonia of singers. Dilute Nitro-hydrochloric is more suit- 
 able in chronic hepatic disorders due to malaria ; Sulphuric in hemor- 
 rhages, diarrheas, colliquative sweating, and as a prophylactic against 
 
ACIDUM HYDROCYANICUM DILUTUM. 99 
 
 lead-poisoning. Dilute Sulphuric Acid is used as an acid drink in fevers, 
 and before meals in acidity of the stomach. It is very doubtful whether 
 the latter has any special influence on the nervous or osseous systems. 
 
 All these acids act injuriously on the teeth, by attacking the enamel. 
 They should always be administered largely diluted, taken through a straw 
 or glass tube, and the mouth should be thoroughly rinsed at once with an 
 alkaline wash. 
 
 ACIDUM HYDROCYANICUM DILUTUM, Diluted Hy- 
 drocyanic (Prussic) Acid, — is a liquid composed of 2 per cent, of 
 absolute Hydrocyanic Acid, HCN, and 98 per cent, of water. It is 
 colorless, faintly acid, of peculiar odor, and is prepared by distilling solu- 
 tions of Potassium Ferrocyanide and Sulphuric Acid together, or extem- 
 poraneously by adding 6 grammes of Silver Cyanide to a solution of 5 cc. 
 of Hydrochloric Acid in 55 of distilled water, shaking together and pour- 
 ing off the supernatant liquid. ttlxI have proved fatal. Dose, nij-v, of 
 a recent preparation ; as, even under the most favorable conditions, it 
 will decompose within a year. 
 
 Preparations containing Hydrocyanic Acid. 
 
 Aqua Laurocerasi, Cherry-laurel Water (Unofficial), — is a water distilled from the 
 fresh leaves of Prunus laurocerasus, the common Laurel or Cherry Laurel, a small tree 
 of the nat. ord. Rosaceae, sub-order Amygdaleae. The leaves contain a variable amount 
 of Hydrocyanic Acid and a volatile oil. Dose, TT^v-xxx, cautiously. 
 
 Scheele's Dilute Hydrocyanic Acid (Unofficial), — is a 4 or 5 per cent, solution, 
 and is highly dangerous even by inhalation. 
 
 Amygdala Amara, Bitter Almond (see its title) and its essential oil ; also, various 
 other members of the sub-order Amygdalese, including the official Prunus Virginiana, 
 perhaps the unofficial Prunus laurocerasus, and the leaves and kernels of the peach and 
 cherry trees, contain a proximate principle Amygdalin, and a ferment Emulsin, which 
 in the presence of water react on each other, forming Hydrocyanic Acid, a volatile oil, 
 and glucose. C 20 H 27 NO„ (Amygdalin) + 2H 2 == C 7 H e O (Oil of Bitter Almond) + 
 HCN (Hydrocyanic Acid) -f- 2C 6 H 12 6 (Glucose). 
 
 Hydrocyanic Acid exists ready formed to a considerable extent in the juice of the 
 bitter cassava. 
 
 Other Cyanogen Compounds. 
 
 Potassii Cyanidum, Potassium Cyanide, KCN, — a white, opaque salt, of alkaline 
 reaction, bitter-almond taste, and a peculiar odor when moist ; soluble in 2 of water, 
 sparingly soluble in alcohol. Dose, gr. ^V - !- Locally, a solution of gr. j-v to the £ 
 is as strong as should be employed. 
 
 Potassii Ferrocyanidum, Potassium Ferrocyanide, K 4 Fe(CN) 6 3H 2 0, — large, lemon- 
 yellow prisms or tablets, efflorescent, odorless, of sweetish taste and neutral reaction, 
 soluble in 4 of water, insoluble in alcohol. Employed in pharmacy as a test solution, 
 and in the preparation of Iron Ferrocyanide, Diluted Hydrocyanic Acid and Potassium 
 and Silver Cyanides. Rarely used medicinally. Dose, gr. v-xv. 
 
 Physiological Action. 
 Hydrocyanic Acid is one of the most powerful and rapid poisons known, 
 half a grain having proved fatal almost immediately. Its action on the 
 organism is one peculiar to itself, the inhalation of a strong preparation 
 
 LoFC. 
 
100 ACIDUM HYDROCYANICUM DILUTUM. 
 
 producing rapid insensibility and almost immediate exhaustion ; — death 
 from a full dose occurring by sudden paralysis of the heart, from a less 
 but still a fatal dose, by paralysis of respiration. The symptoms are those 
 of sudden and complete asphyxia, but some volitional movements may be 
 made before death, unless the dose be very large. In cases in which the 
 dose, though fatal, permitted of the observance of its effects, they were 
 usually divisible into two marked stages, viz.: (i) dyspnea, slow and 
 full pulse, giddiness, loss of muscular power; — (2) vomiting, dilated 
 pupils, unconsciousness, spasms, muscular rigidity, and cessation of the 
 heart's action. In poisonous, but not fatal doses, the following effects 
 have been observed : feeble pulse, dilated pupils, turgid and dusky face, 
 insensibility, convulsions or rigidity, but no paralysis. Large medicinal 
 doses may produce salivation, irritation of the throat, dizziness, buzzing 
 in the ears, headache, numbness, dusky countenance, staggering gait, 
 sense of constriction of the chest, palpitation of the heart, a frequent or 
 an abnormally slow pulse, a sense of great weariness and drowsiness. 
 Post-mortem examination usually shows dilated pupils, the eyes having a 
 marked glassy lustre, the cadaveric rigidity very great. The blood, in 
 cases which have been rapidly fatal, may show the arterial color in both 
 the arterial and the venous systems ; but in slower cases it is dark and fluid, 
 engorging both sides of the heart, the venous trunks, and the cerebral 
 sinuses. The paralyzant action of the drug is chiefly exercised on the 
 nerve-centres in the medulla ; next on the peripheral afferent nerves, the 
 spinal cord, the motor nerves, and finally on the muscular tissue. It stops 
 the heart by irritation of the vagus-roots in the medulla, as well as by 
 paralyzing the cardiac motor ganglia. It is said to form with hemoglobin 
 a compound (cyan-hemoglobin), which does not readily give up oxygen. 
 The odor of the acid is fragrant, resembling that of bitter almonds or 
 peaches, and may be detected in the lungs shortly after death. The effects 
 of a medicinal dose pass off in an hour at the farthest. 
 
 Locally applied to the skin, Hydrocyanic Acid penetrates the epider- 
 mis and paralyzes the end-organs of the sensory nerves in the derma. It 
 is rapidly absorbed from mucous surfaces. 
 
 Potassium Cyanide has similar action, but in addition has some few 
 peculiar to itself. Locally used it produces dermatitis, with an eczema- 
 tous eruption, and if applied to an abraded surface freely may cause fatal 
 effects. Internally it has proved fatal in doses of 3 to 5 grains, with all 
 the symptoms of Hydrocyanic Acid poisoning, but its action is less rapid. 
 It is much used in photography, and many cases of poisoning by it have 
 occurred in persons employed in that art. 
 
 Antagonists and Antidotes. 
 Atropine has antagonistic action, but is too slowly diffused to be of any value. 
 Ammonia by inhalation, by the stomach, and by intra- venous injection, with cold affu- 
 
ACIDUM LACTICUM. 101 
 
 sion to the spine, and artificial respiration, are the measures most likely to avail in cases 
 of poisoning where there is time to do anything. Ferrous Sulphate has been considered 
 an antidote against Potassium Cyanide, to form Ferrocyanide of Iron (Prussian Blue), 
 but it is not efficient. Sodiu?7i Thiosulphate is said to be a good antidote. Cobaltous 
 Nitrate is an efficient antidote (Antal). 
 
 Therapeutics. 
 
 Hydrocyanic Acid is used for its antispasmodic and sedative effects. 
 In vomiting, whooping-cough, and coughs of spasmodic character, in 
 asthma and other neuroses of the respiratory organs, in affections involv- 
 ing the pneumogastric nerve, vertigo and headache from stomachal de- 
 rangements, gastralgia, painful dyspepsia, vomiting, etc., it Is very effi- 
 cient as a palliative. In acute mania and melancholia it has. been used 
 with advantage ; and in various skin diseases, accompanied by itching, 
 tingling, etc., its use as a lotion (n^ xxx-gj ad gj Aquae Rosae) to the un- 
 broken surface is prompt in relieving the pruritus and other distressing 
 sensations. Only when recently prepared is it of any service; as, even 
 under the most favorable conditions, it will undergo decomposition 
 within a year. 
 
 Potassium Cyanide in ointment (gr. v ad gj) is used to allay pruritus, 
 and in solution (gr. iij-v ad ^j) is applied locally with benefit in reflex 
 headaches, and is used as a wash to remove nkrate of silver stains. It 
 has been used internally in doses of gr. j for acute articular rheumatism, 
 but such employment of it is highly dangerous. In smaller doses (gr. 
 }£-}(), it is a useful ingredient of cough mixtures, where Opium or its 
 alkaloids are not admissible. 
 
 Potassium Ferrocyanide has been used in doses of 8 to 15 grains as an 
 astringent and anodyne, but it is seldom employed in medicine. 
 
 Cherry-laurel water has been extensively used as a flavoring agent, 
 having a very agreeable taste. It is official in the British Pharmacopoeia, 
 and is supposed to be a rather elegant mode of administering Prussic 
 Acid ; but the uncertainty of its strength is such that it should never be 
 used internally, except in very small quantities. It has been employed 
 as an anesthetic injection into the urethra prior to catheterization, and 
 was formerly employed by ophthalmologists as an eye-wash in painful 
 affections of that organ. 
 
 ACIDUM LACTICUM, Lactic Acid, — is a liquid composed of 75 per cent, of 
 absolute Lactic Acid (HC 3 H 5 3 ) and 25 per cent, of water ; nearly colorless, syrupy, 
 odorless, of acid taste and reaction, freely miscible with water, alcohol and ether, but 
 nearly insoluble in chloroform. It is produced by the lactic fermentation of sugar of 
 milk or grape sugar, has a sp. gr. of 1. 213, and is difficult to obtain pure. It enters into 
 Syrupus Calci Lactophosphatus. Dose, 3 ss-^ss, well diluted. 
 
 Lactic Acid is found in the stomach as the product of the food, and combines with bases 
 in the blood, forming lactates, which, being oxidized, are converted into carbonates. It 
 aids digestion and promotes the appetite, but in large doses causes flatulence and much 
 epigastric pain. Injected into the peritoneal cavity of animals, it excites endocarditis, 
 
102 ACIDUM NITRICUM. 
 
 and given in diabetes it has produced acute rheumatism and rheumatic endocarditis. 
 Hence its supposed causation of acute rheumatism when in excess and free in the blood. 
 It dissolves false membranes and also calcium phosphate. Hypnotic properties have 
 been ascribed to it. 
 
 Lactic Acid is used with benefit in diabetes, atonic dyspepsia, oxaluria, and in the 
 lithic and phosphatic diatheses when due to imperfect digestion and assimilation. As a 
 solvent of false membrane in diphtheria it is unquestionably of great service but painful. 
 In chronic cystitis it arrests the ammoniacal decomposition of the urine. As the acid 
 found in the shops is generally of poor quality, disappointment in its use may be expected. 
 
 ACIDUM NITRICUM, Nitric Acid,— is a liquid composed of 
 68 per cent, of absolute Nitric Acid, HN0 3 , and 32 per cent, of water. 
 It is colorless, fuming, very caustic and corrosive, of sp. gr. 1.414, 
 strongly acid in reaction, and is obtained by the action of Sulphuric 
 Acid on Potassium Nitrate. It is only used externally as a caustic. 
 
 Preparations. 
 
 Acidum Nitricum Dilutum, Diluted Nitric Acid, — has of the above 10 parts in 58 
 of Distilled Water, and contains 10 per cent, of absolute Nitric Acid. Dose, n\nj-xv, 
 well diluted. 
 
 Acidum Nitrohydrochloricum, Nitrohydrochloric Acid, Nitromuriatic Acid, Aqua 
 Regia, — a golden-yellow, fuming, corrosive liquid, composed of Nitric Acid 18 vols., 
 Hydrochloric Acid 82 vols. Is wholly volatilized by heat, usually dissolves gold-leaf, 
 and a drop added to test-solution of potassium iodide liberates Iodine in abundance. 
 Dose, TT\j-viij, well diluted. 
 
 Acidum Nitrohydrochloricum Dilutum, Diluted Nitrohydrochloric Acid, — con- 
 sists of Nitric Acid 4, Hydrochloric Acid 18, Water 78 vols. Dose, TT\v-xx, well 
 
 diluted. 
 
 The action and uses of these agents described with those of the 
 other mineral acids, under the title Acidum Hydrochloricum. Some 
 special properties are as follows : — 
 
 Nitric acid is an exceedingly powerful escharotic, but, as it coagulates 
 and does not redissolve the albumin of the tissues, it forms a barrier to 
 its own excessive action. The vapor may cause edema of the glottis, 
 intense bronchitis, etc., and death from suffocation. It is used for the 
 destruction of chancres, warts, hemorrhoids, phagedenic ulcers, etc. ; and 
 internally in dilute form for bilious affections, as it is supposed to have a 
 selective action on the liver. It also lessens phosphatic deposits in the 
 urine, and acts as an astringent in the system, diminishing profuse secre- 
 tion in bronchorrhea and phthisis. 
 
 Nitrohydrochloric Acid is also supposed to specially affect the liver. 
 It is usefully employed in jaundice, dyspepsia, and the so-called bilious 
 condition ; also in acidity of the stomach and in frontal headache situ- 
 ated just above the eyebrows when unaccompanied by constipation. In 
 hepatic disorders it may be used in dilute form as baths, or applied to 
 the hepatic region on compresses. The official dilute acid is of little use 
 
ACIDUM OLEICUM. IO3 
 
 therapeutically, as it rapidly deteriorates, and the same is true of the 
 strong acid when old enough for the color to change to a lemon-yellow. 
 The most efficient is the strong acid freshly prepared, which is of an 
 orange-red color. This should be properly diluted when required for 
 use, and should be constantly protected from light. 
 
 ACIDUM OLEICUM, Oleic Acid, HC 18 H 33 2 ,— is one of the 
 constituent acids of oils and fats, obtained commercially as a secondary 
 product in the manufacture of stearin candles. It is a yellowish, oily 
 liquid, semi-solid at 39 F., odorless, tasteless, and of neutral reaction, 
 insoluble in water but soluble in alcohol, chloroform, benzol, benzin, 
 turpentine, and the fixed oils. It dissolves most of the metallic oxides 
 and the uncombined alkaloids, forming the so-called Oleates, which, 
 however, are not pure chemical compounds, but merely compounds of an 
 oxide or an alkaloid, as the case may be, with oleic acid, dissolved in a 
 great excess of the latter. Three of these are official, viz. — 
 
 Oleatum Hydrargyri, Oleate of Mercury, — has 20 of the Yellow Oxide of Mercury 
 with 80 of Oleic Acid. 
 
 Oleatum Veratrinae, Oleate of Veratrine, — has 2 of Veratrine in 98 of Oleic Acid. 
 Oleatum Zinci, Oleate of Zinc, — has 4 of Zinc Oxide in 95 of Oleic Acid. 
 
 Unofficial Preparations. 
 
 Oleates (Oleata) of Aconitine (2 per cent.), Atropine (2 per cent.), Morphine (10 
 per cent.), Morphine and Mercury (2 per cent, morphine and 20 percent, mercuric 
 oxide), Quinine (25 per cent.), Strychnine (2 per cent.), Arsenic (gr. xx of arsenic 
 oleate to the %), Aluminum, Bismuth, Copper, Iron, Lead, Silver, etc., are prepared 
 by the manufacturing pharmacists, and are to be obtained in the shops. Most of them 
 answer to the description given above, but several are Oleo-palmitates, or double salts 
 of Oleic and Palmitic Acids, being prepared from oils which yield the latter acid in con- 
 siderable quantity. Drs. Shoemaker and Wolff, of Philadelphia, have introduced, under 
 the above names, several solid or semi-solid preparations, which they claim to be chemi- 
 cally true oleates, salts having no excess of either their acids or basic radicles. They are 
 produced by the double decomposition of sodium oleates with solutions of neutral salts, the 
 precipitates, washed and dried, being the oleates required. These oleates are claimed 
 to be more stable than the official oleic solutions, and having less oleic acid are much less 
 costly. Many of them may be used as dusting powders, or mixed with oil or lard to 
 form ointments. 
 
 Oleic Acid is used only in making the Oleates, which were introduced 
 by Marshall as substitutes for ointments, being cleaner, more elegant, 
 and more penetrating, but decidedly more irritating if applied with 
 friction. Their medicinal properties depend upon the bases employed, 
 hence their actions and uses will be described under the corresponding 
 basic heads. They should usually be diluted with an equal bulk of vaselin 
 or olive oil before being rubbed into the skin, as they may produce a 
 cutaneous eruption or even pustulation. As a rule, they should be lightly 
 spread over the surface with the finger or a brush. As parasiticides, the 
 Oleates of Copper and Mercury are most efficient, and in skin diseases 
 generally these preparations are rapidly gaining favor. 
 
104 ACIDUM PHOSPHORICUM — ACIDUM SULPHURICUM. 
 
 ACIDUM PHOSPHORICUM, Phosphoric Acid,— is a liquid 
 composed of 85 per cent, of Orthophosphoric Acid, H 3 P0 4 , and 15 per 
 cent, of water, and is obtained by oxidizing phosphorus with nitric acid. 
 It is strongly acid, odorless, colorless, and of sp. gr. 1.710 at 59 F. 
 
 Acidum Phosphoricum Dilutum, Diluted Phosphoric Acid, — has of Phosphoric 
 Acid 10 parts in 75 of Distilled Water, and contains 10 per cent, of Orthophosphoric 
 Acid. Dose, rt\v-xxx, in sufficient water. 
 
 Phosphates of Ammonium, Ferrum, and Sodium, also the Glycero-phosphates, 
 Syrupus Ferri, Quininae et Strychninse Phosphatum, and Acidum Hypophosphorosum 
 Dilutum, are described under Phosphorus. 
 
 The action and uses of Phosphoric Acid are described with those of 
 the other mineral acids under Acidum Hydrochloricum. It may be 
 given in larger doses than these other acids without deranging digestion, 
 and is therefore preferred in cases requiring acid treatment for a long 
 period, as in diabetes, etc. It is considered of especial value in strumous 
 affections, and it is thought to diminish the growth of osseous tumors, 
 and to dissolve phosphatic deposits. As it contains no free phosphorus 
 it cannot be used to obtain the effects of that drug. 
 
 ACIDUM PICRICUM, Picric Acid, Carbazotic Acid, Trinitrophenol, C 6 H 3 - 
 (N0 2 ) 3 (Unofficial), — is obtained by the action of Nitric Acid on Carbolic Acid or 
 many other substances. It is an efficient test for albumin and sugar in the urine. A satu- 
 rated solution is used locally in erysipelas and burns with great advantage. Some of its 
 salts (Picrates of Ammonium, Iron, etc.) have been tried therapeutically, without any 
 particular results. Antiperiodic and anthelmintic properties and power against trichinae 
 have been urged for it, but experience has not supported these claims. Dose, gr. v-xv 
 per diem. 
 
 Ammonium Picrate, in doses of gr. % to gr. jss, in pill four times daily, has been 
 used in the malarial fevers of India, in over 10,000 cases with most effective results. 
 
 ACIDUM SULPHURICUM, Sulphuric Acid— is a strongly 
 caustic and corrosive liquid, oily, inodorous, of strongly acid reaction, 
 and is composed of not less than 92^ per cent, of absolute Sulphuric 
 Acid (H 2 S0 4 ) and 7^ per cent, of water. It is obtained from the com- 
 bustion of Sulphur and its oxidation by nitrous fumes. Its specific gravity 
 should not be below 1.835, an d it is miscible in all proportions with 
 water and alcohol, with evolution of heat. It is occasionally used as a 
 caustic. 
 
 Acidum Sulphuricum Dilutum, Diluted Sulphuric Acid, — has of the strong acid 
 I part to 8^ of distilled water, and contains 10 per cent, by weight, of absolute sulphuric 
 acid. Dose, TTLv-xv, well diluted. 
 
 Acidum Sulphuricum Aromaticum, Aromatic Sulphuric Acid, Elixir of Vitriol, 
 is Sulphuric Acid 10 per cent, by volume, 20 per cent, by weight, diluted with Alcohol 
 and flavored with Cinnamon and Ginger. It is not an acid, but rather an ether formed 
 by reaction between the acid and the alcohol. Dose, TT\v-xv, well diluted. 
 
 The action and uses of Sulphuric Acid generally are described with 
 those of the other mineral acids under Acidum Hydrochloricum. Its 
 
ACIDUM SULPHUROSUM. 105 
 
 chief use internally is in lead-poisoning to form the insoluble sulphate, 
 and as a remote astringent in diarrhea, hemorrhoids, hemorrhages, night- 
 sweats and mucous discharges. In choleraic diarrhea and lead-poison- 
 ing it is generally administered in combination with Opium. The only 
 hemorrhages in which it is efficient are those from mucous surfaces. It 
 is excreted chiefly by the kidneys, part escaping by the bowels as sul- 
 phates, part also by the skin. Like the other mineral acids, it does not 
 increase the acidity of the urine to any considerable extent. Its princi- 
 pal actions are those of an astringent, an anhydrotic and a hemostatic. 
 
 ACIDUM SULPHUROSUM, Sulphurous Acid —is a color- 
 less liquid of sulphurous taste and highly acid reaction, composed of not 
 less than 6.4 per cent., by weight, of Sulphurous Acid Gas (S0 2 ) and 93.6 
 per cent, of water. It is prepared by heating Sulphuric Acid with char- 
 coal and dissolving the evolved gas in distilled water. Dose, r^v-3j, 
 largely diluted with water. 
 
 Sodii Sulphis, Sodium Sulphite, Na 2 S0 3 .7H 2 0, — colorless, transparent, monoclinic 
 prisms, efflorescent in dry air, of cooling, saline, and sulphurous taste, and neutral or 
 feebly alkaline reaction ; soluble in 4 of water and in 0.9 of boiling water, very slightly 
 soluble in alcohol. Dose, gr. v-xxx or even up togj. 
 
 Sodii Bisulphis, Sodium Bisulphite, NaHS0 3 , — opaque prismatic crystals, of faint, 
 sulphurous odor, a disagreeable taste, and acid reaction ; soluble in 4 of" water and in 
 72 of alcohol, in 2 of boiling water, and in 49 of boiling alcohol. By strong heat it is 
 converted into sulphur and sulphate of sodium. Dose, gr. iij-xxx. 
 
 Sodii Hyposulphis, Sodium Hyposulphite, Na 2 S 2 3 .5H 2 0, — large, colorless, mono- 
 clinic prisms or plates, efflorescent in dry air, of cooling and bitter taste, and neutral or 
 faintly alkaline reaction; soluble in 1.5 of water and in 0.5 of boiling water, which 
 partly decomposes it ; insoluble in alcohol. Dose, gr. v-xx. 
 
 In conipatibles . 
 
 All oxidizing substances change the sulphites into sulphates, and the Mineral Acids 
 decompose them. 
 
 Sulphurous Acid has great affinity for oxygen, and is a powerful dis- 
 infectant and deodorizer, and very destructive to all plant life. The gas 
 is irritant to the glottis when inhaled, and may produce dangerous inflam- 
 mation of the respiratory passages. 
 
 Sulphurous Acid Gas (Sulphurous Anhydride) is extensively used as a 
 disinfectant, being the most powerful and convenient agent for this pur- 
 pose. Sulphur is burned on a shovel or plate in the room to be fumi- 
 gated, all outlets having been carefully closed. The gas is injurious to 
 many fabrics. Sulphurous Acid is used locally in many throat affections 
 as a spray or by a mop. In diphtheria, stomatitis, aphthae, ulcers of the 
 tonsils, syphilitic and tuberculous laryngitis, chronic bronchitis, etc., it 
 may be thus applied with great benefit. Morbid fermentation .in the 
 
106 ACIDUM TARTARICUM ACONITUM. 
 
 stomach, with growth of penicillium and sarcinae, is quickly stopped by 
 5 to 6o-minim doses in water, or by the sulphites in 20-grain doses. In 
 parasitic skin diseases and foul wounds these agents are extremely useful 
 as local applications. 
 
 The Sulphites and Hyposulphites are partly decomposed by the acid 
 of the stomach, sulphurous acid being given off, and the balance being 
 converted into sulphates act as purgatives, and are absorbed, undergoing 
 elimination as sulphates by the kidneys and bowels. They were formerly 
 supposed to enter the blood and tissues as sulphites, and to arrest morbid 
 processes of the zymotic character, but both these assumptions have 
 proven erroneous. The Sulphites were formerly used in zymotic and 
 septic fevers as internal antiseptics on theoretical grounds, but their 
 supposed value has not been realized. 
 
 ACIDUM TARTARICUM, Tartaric Acid, H 2 C 4 H 4 6 — is a crystalline acid, 
 prepared from Potassium Bitartrate by neutralizing a solution thereof with chalk and 
 calcium chloride, then decomposing the calcium tartrate thus formed by sulphuric acid, 
 evaporating and purifying. It occurs in colorless, transparent prisms, which are odorless, 
 of acid taste and reaction, and soluble in 0.8 of water and in 2^ of alcohol at 59 F. 
 Twenty grains exactly neutralize 27 of Potassium Bicarbonate, 22 of Sodium Bicarbon- 
 ate, or 15^ of Ammonium Carbonate. Dose, gr. x-xxx. 
 
 Tartaric Acid is an ingredient of the Effervescing Powders (see under Potassium). 
 Four Tartrates and one Bitartrate (see Index) are official, and are described, with their 
 actions and uses, under the titles of their respective bases. For Potassium Bitartrate see 
 under Potassium. The Alkaline Cupric Tartrate Volumetric (Fehling's) Solution is 
 described in Part III under the title Poisoning. 
 
 The actions and uses of Tartaric Acid are similar to those of the other Vegetable 
 Acids, as described under Acidum ACETICUM. It is chiefly employed in the preparation 
 of effervescing refrigerant drinks and effervescing granulated salts. 
 
 ACONITUM, Aconite, — is the tuber of Aconitum Napellus, the 
 Monk's-hood or Wolf's-bane, a perennial plant of the nat. ord. Ranun- 
 culacese, found in mountainous regions of Europe, Asia and N. America. 
 This plant has deep-blue, helmet-shaped flowers, and leaves which have 
 deeply-cut, wedge-shaped segments, exciting slowly when chewed a sen- 
 sation of tingling in the tongue and lips. The root is conical and taper- 
 ing, with a thick bark enclosing a seven-rayed, star-shaped pith, odor- 
 less, taste sweetish at first, soon becoming acrid. A minute portion, 
 cautiously chewed, causes prolonged tingling and numbness. Its active 
 principle is the alkaloid Aconitine (see p. 107), which it contains in the 
 proportion of .03 per cent. It also contains gum, sugar, Aconitic Acid, 
 and several other principles, viz. — Aconine, Napelline, Pseudaconitine, 
 Lyctonine, etc., concerning which there is much diversity of opinion. 
 Dose, gr. i^-ij. 
 
 Other aconite-roots are those of A. Canwiarum, A. ferox, and the Chinese or Japan- 
 ese Aconite, A. Chinense vel Japonian)i. From the latter an alkaloid is obtained, 
 named Japaconitine, which is even more poisonous than Pseud-aconitine. The Indian 
 variety (A. ferox) contains Pseud-aconitine, but does not yield Aconitine. The former is 
 
ACONITUM. 107 
 
 considered to be more active than the latter, and Japaconitine more so than either of the 
 other two. 
 
 Preparations. 
 
 Extractum Aconiti, Extract of Aconite, — is at least four times as strong as the 
 extract official in the U. S. P., 1870, which was prepared from the leaves, and is yet to 
 be found in the shops. Dose, gr. l /e-]A,- 
 
 Extractum Aconiti Fluidum, Fluid Extract of Aconite, — an alcoholic preparation, 
 of which each drop represents nearly one grain of the powdered drug. Dose, TT\,^-ij. 
 
 Tinctura Aconiti, Tincture of Aconite, — has of Aconite 35, Alcohol and Water to 
 IOO. Is about 25 times stronger than the tincture of the leaf. Dose, Tu^-iij. 
 
 Tinctures of Aconite-root vary greatly in strength. In Fleming's Tincture 79 parts 
 of aconite are used in preparing 100 of the tincture, in that of the B. P. 16, in the 
 French 20, the German 10, while the Linimentum Aconiti (B. P. ) is really a very strong 
 tincture, of the strength of I to 1*4. Probably the best and safest preparation for ordi- 
 nary use is a 10 per cent, tincture, of which the maximum single dose for an adult is 
 stated in the P. Ger. at Tr^ix, and the maximum daily dose at IT^xxxv. 
 
 The best rule for the administration of Aconite is to give fractional parts of a minim 
 of the tincture (tt\^ to^) every 15 minutes until the desired effect is produced. 
 
 Unofficial Preparations. 
 
 Aconitina, Aconitine, C 33 H 43 NO ]2 , — a white, and usually amorphous solid, of alka- 
 line reaction, soluble in 150 of cold and 50 of hot water; much more soluble in alcohol 
 and ether. Is difficult to obtain of constant strength, some samples being all but inert, 
 others extremely active. As obtained in the shops it is usually a mixture of several 
 alkaloids. The Aconitine Crystalisee of Duquesnel, which, according to Squibb, is a 
 nitrate of aconitine, is considered to be the most active of those in the market. Dose, 
 &- izo Wo- 
 
 Oleatum Aconitinas, Oleate of Aconitine, — is a 2 per cent, solution in Oleic Acid, 
 for external use. Duquesnel' s crystals will not dissolve in Oleic Acid (Squibb). 
 
 Napellina, Napelline, — is weaker than Aconitine, and has been used in doses of 
 gr. ^-f . It has been studied by Laborde, who claims for it most valuable hypnotic 
 properties, and proposes to use it as a substitute for opium and chloral. , 
 
 St. Jacob's Oil (a patent medicine), — is a weak Aconite Liniment, which also con- 
 tains Ether, Alcohol, Turpentine, red coloring matter and water (Squibb). It contains 
 Turpentine (82 per cent.), Aconite, Ether, Alcohol, Carbolic Acid, Capsicum and a 
 small quantity of Origanum (Murrell). 
 
 Physiological Action. 
 
 Aconite is a powerful depressant of the sensory nerve ends, the ner- 
 vous and muscular apparatus of the heart and respiration and the spinal 
 nervous system. It is also antipyretic, diaphoretic and diuretic. It acts 
 directly on the peripheral ends of the sensory nerves, but paralyzes both 
 the motor and sensory nerves — the sensory being affected first and from 
 the periphery inwards, while the motor nerves are affected from the 
 centres outwardly. It stimulates at first but soon relaxes the inhibitory 
 apparatus of the heart, and paralyzes finally the vagus ends, the cardiac 
 muscle and its contained ganglia, the respiratory centres, and the spinal 
 cord in all its functions — sensory, reflex and motor; but does not affect 
 the cerebrum. 
 
 The primary stimulation which the drug produces upon the vagus centre 
 in the medulla slows the heart-rate at first ; but its depressant action upon 
 the motor cardiac centres and the vagus end-organs in the heart is soon 
 
108 ACONITUM. 
 
 manifested, and finally the vagus centre shares in the increasing, paralysis, 
 which affects the vaso-motor centre as well as the cardiac nervous appa- 
 ratus. The heart-rate becomes very rapid near the end, from paralysis 
 of the vagus terminals in its structure. 
 
 The taste of Aconite is bitter, acrid and pungent. Soon after the in- 
 gestion of even a small quantity, a sensation of numbness and persistent 
 tingling are felt in the tongue and lips. Full medicinal doses cause a 
 sense of constriction in the fauces, irritation of the gastro-intestinal mu- 
 cous membrane with increased secretion ; sometimes nausea and vomiting, 
 and severe pains in the joints and muscles; always more or less salivation, 
 diaphoresis and diuresis ; reduced respiratory power, cardiac rate and 
 force ; lowered arterial tension and temperature. 
 
 A lethal dose produces great muscular weakness, dim sight, dilated 
 (sometimes contracted) pupils ; shallow, irregular, and labored respiration, 
 slow and weak pulse, cold surface, clammy sweat, great anxiety, numbness 
 and tingling in the extremities, lowered body-temperature (2 to 3 ), 
 abolished sensation, impaired reflexes and motility, and finally death from 
 paralysis of the heart and respiration, with or without convulsions, con- 
 sciousness being preserved until near the end, when C0 2 narcosis sets in. 
 In two recorded cases, edema of the entire body resulted from eating 
 the leaves of the growing plant. 
 
 Aconite is rapidly diffused and slowly excreted, the effects of a full 
 
 medicinal dose continuing for three or four hours. Applied externally, 
 
 it paralyzes the sensory nerves of the part, producing its characteristic 
 
 numbness and tingling. 
 
 Antagonists. 
 
 Caffeine, Atropine, Morphine, Ether, Ammonia and Amy I Nitrite antagonize its 
 effects on the heart and respiration. Digitalis counteracts its cardiac action and the 
 relaxation of cardiac inhibition. In Aconite poisoning, the stomach should be evacuated, 
 warmth applied to the extremities, stimulants administered, artificial respiration if nec- 
 essary, and the recumbent posture strictly maintained. Caffeine may be administered 
 hypodermically and by the mouth. 
 
 Therapeutics. 
 
 Aconite was well known to the ancients, by whom it was regarded as 
 the most virulent of all poisons. It was introduced into medicine by 
 Aaron Storck, of Vienna, in 1762, and its pharmacology and therapeutics 
 were the subject of an essay by Fleming in 1844, for which he was 
 awarded a gold medal by the University of Edinburgh. 
 
 Aconite antagonizes the fever process, and rightly used is therefore one 
 of the most valuable drugs we possess. It has well been called the " thera- 
 peutic lancet," and is certainly responsible to a great extent for the 
 disuse of venesection. Its power over the circulation, respiration and 
 transpiration renders it of the greatest value in all affections characterized 
 by a high, resisting pulse, a dry, hot skin, and elevated body-temperature. 
 
ACONITUM. IO9 
 
 The chief indication for its use is vascular excitement in sthenic sub- 
 jects ; it is contra-indicated when there is adynamia, weak action of the 
 heart, cardiac degeneration or dilatation, and gastro-intestinal irritation 
 or inflammation. Aconite is not a remedy for use in continued fevers, 
 and its prolonged administration is not indicated except under very 
 exceptional circumstances. Even in the inflammatory and febrile con- 
 ditions for which it is usefully employed it will be found of greatest value 
 in their early and sthenic stages, its later use being often injurious. 
 
 Aconite is very efficient in acute affections of the bronchial mucous 
 membrane, in coryza, tonsillitis and asthma due to exposure, also in both 
 catarrhal and spasmodic croup. One of the best methods of "breaking 
 up a cold " is to administer small doses of the tincture at frequent inter- 
 vals for several hours, followed by 10 grains of Dover's powder at bed- 
 time. As a febrifuge and sedative it is useful in simple and catarrhal 
 fever, also in scarlatina, measles and erysipelas. In the early stage of 
 acute inflammations of serous membranes, as meningitis, pleurisy and 
 pericarditis, it has great power for good, but its employment in these 
 affections should be restricted to the period before the stage of effusion. 
 In acute peritonitis it is a valuable adjunct to Opium in cases presenting 
 the sthenic characteristics which indicate its employment. In the early 
 stage of pneumonia its sedative influence upon the respiration may be 
 utilized with benefit, but it should not be used beyond the time when the 
 heart begins to undergo much strain. In acute articular and muscular 
 rheumatism it is frequently of great service, and if used from the begin- 
 ning of the attack in rheumatic fever it will generally prevent the cardiac 
 complications which are so dreaded in that disease. 
 
 Aconite has proved very efficient in neuralgia, especially if the attack 
 is accompanied by high vascular excitement, also when the branches of 
 the fifth nerve are affected. In cardiac affections characterized by over- 
 action or hypertrophy and absence of dilatation or valvular lesions it 
 gives great satisfaction, particularly in exophthalmos, nervous palpitation, 
 and tobacco heart. Even when valvular disease is present it may be 
 cautiously used in extreme hypertrophy to control the forcible cardiac 
 action. 
 
 When diarrhea or dysentery follows a chill and can be ascribed to cold 
 and exposure, the patient having high fever and cutting pains in the 
 abdomen, Aconite will be found a very serviceable remedy. In sudden 
 suppression of menstruation following a chill, getting the feet wet, or 
 similar evidences of exposure, this agent is efficient in removing the 
 discomfort and causing the reappearance of the flow. In congestive 
 dysmenorrhea it frequently gives marked relief. In the early stage of 
 gonorrhea drop doses of the tincture, given hourly until some physio- 
 logical effect is produced, will lessen the severity of the inflammatory 
 
110 ADEPS. 
 
 symptoms and prevent chordee. In the so-called urethral fever it is 
 highly recommended, and a drop or two of the tincture given immedi- 
 ately after the passage of a urethral sound will prevent the chill which 
 often succeeds that operation. 
 
 Externally, Aconite is used with benefit as a local anodyne in super- 
 ficial neuralgias, herpes zoster, pruritus and chilblain. For the relief of 
 vague, wandering pains in the limbs, liniments containing this tincture 
 will prove more effective than those of any other form. For odontalgia 
 the tincture may be rubbed on the gum in the vicinity of the aching 
 tooth, or it may be introduced upon a pledget of cotton into a dental 
 cavity. Any preparation containing this drug should be used with great 
 caution upon an abraded cutaneous surface, as it is rapidly absorbed by 
 the unprotected derma. 
 
 Aconite is best administered in small doses of the tincture well diluted 
 and frequently repeated. Doses of i\}i to x / 2 every 15 minutes give 
 better results than larger ones at longer intervals. 
 
 Aconitine has proved remarkably efficient in trigeminal neuralgia. 
 Napelline has also been praised for its influence over this affection, and 
 as a hypnotic it is commended by several authorities. 
 
 ADEPS, Lard, — is the prepared internal fat of the abdomen of 
 Sus scrofa (the Pig), purified by washing, melting and straining. It 
 occurs as a soft, white, unctuous solid, of bland taste and neutral reac- 
 tion, entirely soluble in ether, benzin, and bisulphide of carbon ; com- 
 posed of 38 per cent, of stearin and margarin, and 62 per cent, of olein. 
 Lard forms 70 per cent, of Ceratum, and 80 per cent, of Unguentum, 
 and enters into the composition of several of the official cerates. 
 
 Fats are formed of the immediate principles, Stearin, Margarin and Olein, which are 
 regarded as salts composed of stearic, margaric and oleic acids with a common base, 
 glycerin ; also odorous and coloring principles. 
 
 Preparations. 
 
 Adeps Benzoinatus, Benzoinated Lard, — has 2 per cent, of Benzoin in powder, in- 
 corporated by stirring. 
 
 Oleum Adipis, Lard Oil, — is a fixed oil expressed from lard at alow temperature. 
 
 The action of the Oils and Fats is described under Morrhile Oleum 
 (which see). 
 
 Lard is only used as an ingredient of ointments and cerates. Lard Oil 
 is used in making the Unguentum Hydrargyri Nitratis, but has been pro- 
 posed as an inferior substitute for Cod-liver oil in cases where the taste of 
 the latter is particularly offensive. 
 
ADONIS. I 1 I 
 
 Official Derivative and Analogues. 
 
 Acidum Stearicum, Stearic Acid, — is an organic acid, usually obtained from the 
 more solid fats, chiefly tallow. In its impure, commercial form, it occurs as a hard, 
 white, glossy solid, odorless and tasteless, permanent in the air ; insoluble in water, sol- 
 uble in 45 of alcohol, also in ether. It is used as a substitute for wax, and is an ingre- 
 dient of the Suppositoria Glycerini. Zinc Stearate is described on page 528. 
 
 Adeps Lanae Hydrosus, Hydrous Wool-fat, Lanolin, — is a purified fat of the 
 wool of sheep, mixed with not more than 30 per cent, of water. A yellowish- white, 
 ointment-like mass, having a faint, peculiar odor ; insoluble in water, but miscible with 
 twice its weight thereof. 
 
 Under the name Lanolin this substance was in use for several years before it became 
 official. It is a cholesterin fat, and a very old medicament, having been mentioned by 
 Ovid, Herodotus, Pliny and Aristophanes ; yet the process of obtaining it from the suds 
 from the washings of sheep's wool is patented in this country by Liebrich. It differs 
 from all other fatty substances chiefly in resisting saponification and the action of water, 
 having no tendency to become rancid ; and readily passes through the integument, car- 
 rying with it any medicament with which it is charged. It is a perfectly neutral base, 
 and therefore is not liable to decompose any ordinary substance. The difficulty about its 
 use has been its very disagreeably sheepy smell, but recent samples seem in great measure 
 to be devoid of this objectionable quality. It is particularly useful in chronic skin dis- 
 eases where there is infiltration, and where a penetrative action is desired for medica- 
 ments locally applied. In a few cases of acute and subacute eczema it has proved 
 irritating, but as a rule it is perfectly bland. Where a simple protective action is alone 
 desired it is inferior to Lard, Vaselin or Cold Cream. 
 
 Cetaceum, Spermaceti, — is a peculiar, concrete, fatty substance obtained from the 
 sperm whale. It occurs in white, pearly masses, which are odorless, of bland taste and 
 neutral reaction, becoming rancid in the air, soluble in ether, chloroform, carbon disul- 
 phide and boiling alcohol. It is a constituent of — 
 
 Ceratum Cetacei, Spermaceti Cerate, — contains Spermaceti 10 parts, White Wax 35, 
 Olive Oil 55. 
 
 Unguentum Cetacei, Spermaceti Ointment (B. P.), — contains Spermaceti 5, White 
 Wax 2, Almond Oil 18, Benzoin y 2 . The last-named ingredient renders the ointment 
 irritating and therefore unsuitable for use on the eye, for hemorrhoids, etc. 
 
 Unguentum Aquce Roscb, Ointment of Rose Water, Cold Cream, — contains Spermaceti, 
 Almond Oil, Rose Water, etc. [See under Rosa.] 
 
 Spermaceti consists of Cetin (Cetyl Palmitate) with several other fats in small quanti- 
 ties. Its action is solely that of an emollient, and it is rarely used internally, though an 
 alcoholic preparation was once a regular prescription for coughs, bronchial irritation, and 
 for a recently delivered woman. The Cerate is employed as a bland ointment for 
 blisters, abrasions and ulcers, but it is too stiff for easy application, and the unofficial 
 Ointment is preferred in practice. The latter on lint to broken blisters from walking af- 
 fords great relief, and may be smeared on the feet to prevent injury from a rough tramp 
 over broken ground. 
 
 Sevum, Suet, — is the internal fat of the abdomen of Ovis Aries (the Sheep), purified 
 by melting and straining. It should be kept in well-closed vessels and not used after it 
 has become rancid, as it will on exposure to air. It is a white, smooth, solid fat, of 
 bland taste and neutral reaction, insoluble in water or cold alcohol, soluble in 44 of boil- 
 ing alcohol, 60 of ether, and slowly in 2 of benzin. It consists chiefly of Stearin, but 
 also has Palmitin and Olein, and is a constituent of Unguentum Hydrargyri. It is a 
 harder fat than lard and more liable to turn rancid. It is used in ointments and lini- 
 ments to give them greater consistency, but may be applied alone as a dressing to ulcers. 
 In physiological action and therapeutics it follows the other oils and fats. [See under 
 Morrhu^e Oleum and Oliv^e Oleum.] 
 
 ADONIS (Unofficial), — is the plant Adonis vernalis, the Pheasant's 
 Eye or False Hellebore, a perennial herb of the nat. ord. Ranunculaceae, 
 which grows wild in Europe and Asia. It contains Aconitic Acid, also 
 
112 .ETHER. 
 
 the toxic glucoside Adonidin, which is the active principle and is found 
 in small quantity in all parts of the plant. 
 
 Preparations* 
 
 Tinctura Adonis, Tincture of Adonis, — Dose, Jss-ij. 
 
 Infusum Adonis, Infusion of Adonis, — has from 4 to 8 parts of the plant in 200 of 
 water. Dose, 3 ss every 4 to 6 hours. 
 
 Adonidinum, Adonidin, — a canary-yellow, hygroscopic powder, of intensely bitter 
 taste and neutral reaction, soluble in water and in alcohol. Dose, gr. ^ to |, repeated 
 3 or 4 times a day. 
 
 Physiological Action and Therapeutics. 
 
 Adonis, when fresh, has acrid, irritant and vesicant properties, which 
 disappear when the plant is dried. It affects the heart in the same man- 
 ner as Digitalis, but more promptly, slowing, regulating and strengthen- 
 ing the beats and thereby raising the blood-pressure in the arteries. In 
 consequence of the latter action it is a diuretic and removes edema and 
 dropsy. It also slows and deepens the respiration, and relieves dysp- 
 nea. In toxic dose it paralyzes the terminals of the vagus, excites the 
 accelerator apparatus of the heart, and finally causes paralysis of the 
 cardiac motor nerves. It is rapidly eliminated and does not accumulate 
 in the system. Adonidin has similar action, which is almost exactly like 
 that of digitalin, but stronger, and about ten times as powerful as that of 
 digitoxin (Brunton). In large doses it causes either vomiting or diar- 
 rhea (Huchard). 
 
 In Russia this plant is a household remedy for cardiac and renal 
 dropsy, and in Siberia it is used as an abortifacient. It is useful in 
 cases of uncompensated heart disease, in which, by reason of arrhythmia, 
 and feeble cardiac energy, grave circulatory disorders exist, especially 
 dyspnea and dropsy. It is recommended in functional irregularity of 
 the heart and in palpitation without any cardiac lesion (Da Costa). It 
 acts more promptly than digitalis and may be administered for months 
 without cumulative effect, hence it is preferred to digitalis in those 
 cases of mitral or aortic regurgitation in which the latter drug is not well 
 tolerated. In general it is less certainly beneficial in valvular disease 
 than digitalis, and should only be used when the latter fails (Nothnagel). 
 In connection with the bromides this drug has been successfully used in 
 epilepsy. 
 
 jETHER, Ether, Ethyl Oxide (C 2 H 5 ) 2 0,— in its absolute form is 
 not official, the strongest preparation containing 4 per cent, of alcohol 
 and some water. Considered as a generic term an ether is analogous to 
 a salt as an alcohol is to a metallic hydrate. The particular ether offi- 
 cially so named is Ethyl Oxide, prepared from Ethyl Hydrate (Ethylic 
 
jETHer. 113 
 
 Alcohol) by a dehydrating agent with the aid of heat, and then purified 
 by various processes. The agent used is Sulphuric Acid, hence this ether 
 is improperly called "Sulphuric Ether," but the acid simply dehydrates 
 the alcohol and remains in the retort, becoming constantly more diluted 
 by the abstraction of water from the alcohol. Consequently H 2 is the 
 difference between Alcohol and Ether. (C 2 H 6 0) 2 — H 2 = (C 2 H 5 ) 2 0. 
 The official ethers are the two first named in the following list. 
 
 ./Ether, Ether, — is a volatile and inflammable liquid, composed of 
 about 96 per cent, of absolute Ether (Ethyl Oxide), and about 4 per 
 cent, of Alcohol containing a little water. Sp. gr. 0.725 to 0.728 at 
 59 F. It is the preparation employed for anesthetic use, and is gener- 
 ally though improperly called " Sulphuric Ether," a term which belongs 
 to Ethyl Sulphate (C 4 H 10 SO 4 ). The dose of Ether for internal adminis- 
 tration is tTLx-gj, in syrup ; hypodermically for heart failure, ttlxv-xx. 
 It is best prescribed as Spirit of Ether, which mixes readily with water. 
 
 Water dissolves a tenth of its volume of Ether, and reciprocally Ether takes up about 
 the same proportion of water. It is colorless, of a strong and characteristic odor, hot 
 and pungent in taste. It evaporates speedily in the open air, with the production of 
 considerable cold. When good, it evaporates from the hand, without leaving a disa- 
 greeable odor. It boils at about the temperature of the body (98. 6° F.), and its vapor is 
 very heavy and very inflammable. It dissolves Hydrargyrum Bichloride, Hydrargyrum 
 Iodidum Rubrum, Iodine and Bromine freely ; Sulphur and Phosphorus sparingly. It 
 is also a solvent of the fixed and volatile oils, many resins and balsams, caoutchouc, and 
 most of the organic vegetable alkaloids. It does not dissolve Potash or Soda, in which 
 respect it differs from Alcohol. 
 
 ,/Ether Aceticus, Acetic Ether, Ethyl Acetate, C 2 H 5 C 2 H 3 0, — is an 
 inflammable liquid, transparent and colorless, of ethereal and acetous 
 odor, soluble in alcohol, ether, chloroform, and in 8 of water. It is a 
 constituent of Spiritus Odoratus and Tr. Ferri Acetatis. Dose, n^x-gj. 
 
 Hydrobromic Ether, Ethyl Bromide, C 2 H 5 Br (Unofficial), — is not 
 inflammable. Dose internally and hypodermically, Kbx-^j. 
 
 Hydriodic Ether, Ethyl Iodide, C 2 H 5 I (Unofficial), — is a colorless 
 liquid, non-inflammable, and insoluble in water. Dose, inhaled, tiixv. 
 
 For the Chlorinated Ethers see under Chloroform. 
 
 Preparations. 
 
 Oleum iEthereum, Ethereal Oil, — is a volatile liquid, consisting of equal volumes 
 of heavy Oil of Wine and Ether. Used to prepare the Spt. yEtheris Comp. As it occurs 
 in commerce is usually a worthless preparation. 
 
 Spiritus ./Etheris, Spirit of Ether, — has of Ether one-third, Alcohol two-thirds. 
 Dose, rrix-sj. 
 
 Spiritus /Etheris Compositus, Hoffmann" 1 's Anodyne, — contains Ether 32^ per 
 cent., Alcohol 65, Ethereal Oil 2]/ z . Dose, n\v-3J- 
 
 Spiritus j*Etheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre, — is an 
 alcoholic solution of Ethyl Nitrite, C 2 H 5 N0 2 , containing 5 per cent, of the crude ether. 
 It turns acid with age, and should not be kept long. It is a constituent of Mist. Glycyr- 
 rhizae Co. (3 per cent.). Dose, gss-^ss. Its incompatibles are Potassium Iodide, 
 Ferric Sulphate, Tinct. Guaiaci, Tannic and Gallic Acids, and Antipyrin. 
 
114 .ETHER. 
 
 Anesthetic Mixtures. 
 
 Nnssbawrt s has — Ether 3 parts, Chloroform 1, Alcohol I. 
 
 Vienna General Hospital uses — Ether 9, Chloroform 30, Alcohol 9. 
 
 The "Vienna Mixture,''' 1 — Ether 3, Chloroform 1. 
 
 Medico- Chirurgical Society of London (1864) approved a mixture originally introduced 
 by Dr. Geo. Harley, and known as the " A. C. E. Mixture." It consists of Alcohol 1, 
 Chloroform 2 and Ether 3 parts. 
 
 Schleich's Solutions— are three in number, and are made up by volume and not by 
 weight, as follows : (No. i), Ether 6, Chloroform 1*4, Benzin (Petroleum Ether) ]/ z . 
 (No. 2), Ether 5, Chloroform i l / 2 , Benzin l / 2 . (No. 3), Ether 2 2 / 7t , Chloroform 1, 
 Benzin ]/ 2 ; or Ether 80 cc, Chloroform 30 cc, Benzin 15 cc. The latter is adapted 
 to major operations and has a boiling point of 107.4 . 
 
 Physiological Action of Ether. 
 
 Ether is anodyne, antispasmodic, diaphoretic and anthelmintic; a 
 cardiac and cerebral stimulant, an anesthetic, and a narcotic poison. 
 Given internally, it is a most powerful stimulant of secretion, acting 
 especially on the secretions of the stomach, salivary glands and pancreas. 
 On the cerebrum and the motor and sensory nerves its action is similar 
 to that of alcohol, but more prompt and less protracted. It is eliminated 
 rapidly, chiefly by the lungs. Externally it is a powerful refrigerant and 
 local anesthetic ; also rubefacient when rubbed into the skin. 
 
 Ether when inhaled produces at first faucial irritation, a sense of stran- 
 gulation and cough ; then a stage of excitement (cerebral intoxication), 
 in which the face is flushed and the respiration and pulse are accelerated. 
 A tetanic convulsive stage generally follows, the face being cyanosed, 
 the muscles rigid, and the respiration stertorous. This soon subsides, 
 and complete insensibility is established, the muscles being then relaxed, 
 the reflexes abolished, and the cerebral functions suspended, the lower 
 centres in the medulla carrying on the processes of respiration and circu- 
 lation. If the inhalation be continued, these also become paralyzed, 
 death usually resulting from slow paralysis of respiration, the heart pul- 
 sating long after breathing has ceased. If the inhalation be discontinued 
 before the lower centres are affected, the patient gradually emerges from 
 the condition of insensibility, and, as the narcosis subsides, vomiting is 
 usually experienced. 
 
 Dr. Brunton found that in a hot climate Ether will decompose within a few hours, 
 and hence, during his investigations for the Hyderabad Chloroform Committee, he found 
 it impossible to obtain pure ether. This may account for the preference for Chloroform 
 as an anesthetic which is so universal in the Southern States. 
 
 Ether is less irritant than Chloroform to the mucous membranes when 
 swallowed, but its vapor is more irritant to the air-passages. The one 
 grave danger following its administration is the subsequent development 
 of a broncho-pneumonia, rarely a lobar pneumonia. Acute mania has 
 followed its inhalation for anesthesia, but only in a few cases. Ether is 
 a cardiac and vaso-motor stimulant and raises the blood-pressure ; Chlo- 
 
.ETHER. 115 
 
 roform is a cardiac and vaso-motor depressant and lowers the blood-pres- 
 sure. Ether has been often administered with safety in cases of organic 
 heart disease. It does not clot the blood. Its vapor is very inflammable, 
 less pleasant to inhale than that of Chloroform, is slower in action, has 
 a longer stage of excitement, and a less profound narcosis, and causes a 
 greater degree of vomiting. It is much less dangerous than Chloroform, 
 death from the inhalation of Ether occurring slowly and usually by par- 
 alysis of respiration- — from Chloroform, it is almost always sudden, and 
 is generally believed to occur by paralysis of the heart. Ether has un- 
 doubtedly been the direct cause of a number of deaths, besides several 
 which occurred some hours after the termination of its anesthesia; but 
 the sudden deaths produced by it have nearly all occurred in patients 
 who had some lung disease or some enervating lesion, as intestinal 
 obstruction, tumor of the brain, cancer or kidney disease. When bron- 
 chitis or renal disease exists Ether is positively dangerous. The mortality 
 of ether-anesthesia is about 1 in 16,500 cases. 
 
 Modes of Dying in Anesthesia. 
 
 (1.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by reflex 
 action proceeding from some peripheral injury before complete anesthesia is produced. 
 Thus, in the extraction of teeth, a small quantity of Chloroform having been administered, 
 the heart is enfeebled, and the action of the cerebral hemispheres suspended, but not 
 that of the basal or medullary ganglia. If at this stage the 5th nerve be irritated, by 
 the intimate relation of its nucleus with that of the pneumogastric reflex inhibition may 
 be transmitted over the latter, arresting the cardiac ganglia. The stage of incomplete 
 anesthesia is always a dangerous one in which to perform any operadon around the dis- 
 tribution of the 5th nerve. 
 
 2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, the blood 
 backing up on the venous side, and arresting the heart's action, respiration ceasing before 
 the cardiac action is stopped. 
 
 (3. ) In the stage of complete relaxation, by paralysis of respiration ; or by paralysis of 
 the tongue, causing obstructed respiration. 
 
 (4.) In the same stage, by paralysis of the motor ganglia of the heart. 
 
 (5.) From depression of the functions by chloroform narcosis, and from shock, — and 
 may occur in the anesthetic state, or afterwards. 
 
 Contraindications for Anesthesia are : fatty degeneration or dilatation 
 of the heart, renal and pulmonary disease, fainting fits, enlarged tonsils, 
 cerebral tumor, diabetes mellitus and chronic alcoholism — particularly the 
 first and last named. 
 
 Dangerous Symptoms should be met by withdrawing the vapor and in- 
 verting the patient head downwards, drawing the tongue forwards, and 
 applying a cold douche to the face and chest. Atropine hypodermically 
 is an agent of great value in combating the cardiac failure, — artificial 
 respiration and faradization of the respiratory muscles if breathing ceases. 
 Strychnine, hypodermically, as a cardiac and respiratory stimulant, has 
 many advocates, and has done good service, especially in chloroform 
 narcosis. Amy I Nitrite by inhalation, or Ammonia, hypodermically. 
 Heat to the body and limbs. 
 
Il6 AETHER. 
 
 Comparative Safety of Anesthetics. 
 
 A comparison of these agents in respect to their safety has been made by Dr. Richard- 
 son, who considers Methylic Ether to be the safest of all, and the others as follows : 
 
 Safe are — Ethyl Bromide, Ethyl Chloride, Ether, Ethene (defiant gas), Ethene Chlo- 
 ride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene Chloride, Methane 
 (marsh gas), Nitrous Oxide. 
 
 Of doubtful value are — Amylene, Amyl Chloride, Butyl Chloride, Benzene (benzol), 
 Carbon Disulphide, Carbon Dioxide, Carbon Tetrachloride, Methyl Alcohol, Methylal, 
 Spirit of Turpentine. 
 
 Dangerous are — Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl Hydride. 
 Chloroform and Ethene Dichloride are considered useful, but requiring care. 
 
 Physiological Action of Other Ethers. 
 
 Hydriodic Ether is an antispasmodic and a general stimulant ; also an 
 anesthetic if inhaled for a sufficiently long time. Its use as a medicinal 
 agent is chiefly to bring the system rapidly under the influence of Iodine. 
 It increases appetite, stimulates the action of the heart, gives vivacity to 
 the general feelings and activity to the intellect. 
 
 Hydrobromic Ether has a not unpleasant odor, produces but little irri- 
 tation of the air-passages, has very brief stages of excitement and rigidity, 
 and but a short stage of insensibility, with prompt awakening and but 
 little of the mental confusion and excitement consequent on the use of 
 the other anesthetics. It is not inflammable, acts quickly, and is a good 
 local anesthetic. Its action in other respects corresponds with that of 
 Ether. 
 
 Nitrous Ether is a mild diaphoretic, a diffusible stimulant, a carmin- 
 ative, and an efficient diuretic. On the blood it acts similarly to Amyl 
 Nitrite, diminishing oxygenation, relaxing the peripheral vessels, accel- 
 erating the heart's action, and thus lowering arterial tension. Relaxing 
 the renal and cutaneous vessels, it is diuretic and diaphoretic. 
 
 Acetic Ether has a pleasant odor and taste, forming agreeable combi- 
 nations with other carminatives as a stimulant and antispasmodic. 
 
 Therapeutics. 
 
 When diluted with alcohol Ether mixes readily with water, and may be 
 administered internally with advantage in indigestion of fats, and to aid 
 the digestion of cod-liver oil. It is also given in hysteria to relieve the 
 paroxysm and flatulence, and in hepatic colic from calculi, Ether with 
 Turpentine (Durande's solvent remedy), which acts only as an anodyne 
 and antispasmodic, is considered by some as of great value. Subcu- 
 taneously Ether is used in the algid stage of cholera, sudden cardiac de- 
 pression, neuralgia, and in the adynamia of hemorrhage, pneumonia and 
 the eruptive fevers. Local anesthesia by the Ether-spray affords great 
 relief in neuralgia of superficial nerves, lumbago, chorea, and spinal irri- 
 tation. In minor surgical operations it is a valuable method. 
 
 As a General Anesthetic the vapor of Ether is less prompt than that of 
 
AETHER. 117 
 
 Chloroform, but is equally efficient and much safer. It should be inhaled 
 in as concentrated a form as possible, and will then produce insensibility 
 in from 5 to 10 minutes. If a light be in the room it should be high 
 above the patient. A grate-fire or gas-stove in the vicinity is very dan- 
 gerous. [Compare the article on Chloroform.] Besides its surgical 
 uses ether-anesthesia is employed in neuralgia, cancer, tetanus, chorea, 
 colic, delirium, puerperal mania and convulsions, infantile convulsions, 
 hystero-epilepsy, epileptic seizures, laryngismus stridulus, whooping- 
 cough and asthma. The unpleasant after-effects may be greatly modified 
 if not entirely prevented by the previous administration of Morphine 
 (gr. $— |) and Atropine (gr. y^-) subcutaneously. 
 
 Schleich' 's Method 'is based upon the theory that the safest general anesthetic is one 
 which has a maximum evaporation point slightly above the body- temperature of the 
 patient, so that its elimination by the lungs during each act of expiration may be nearly, 
 but not quite, as much as its absorption during the previous act of inspiration. Such an 
 anesthetic is obtained by mixing Ether, Chloroform and Benzin in various proportions, 
 the result giving true chemical solutions [only- mixtures according to some chemists], 
 the evaporation points of which may be varied at the will of the anesthetist and adapted 
 to the patient's body-temperature at the time of administration. By this method the 
 dangers belonging to either agent when given alone are avoided. Ether, having a low 
 evaporation point, 93 F. , must expand in the pulmonary alveoli, distending them, 
 obstructing respiration, causing cyanosis, and promoting bronchial secretion and liability 
 to subsequent pneumonia. Chloroform, having a high evaporation point, 149 F., must 
 be eliminated by the lungs more slowly than it is absorbed, and accumulating in the 
 blood it endangers the heart and strains the organs of elimination to remove it subse- 
 quently. The maximum evaporation point of the A. C. E. mixture is about 119° F., a 
 good deal nearer the body- temperature than the evaporation point of chloroform, and 
 hence it is safer than the latter anesthetic alone. Schleich' s three solutions (see ante, 
 page 1 14) have been used by many anesthetists with great satisfaction. Dr. Meyer of 
 New York has reported on 100 cases, in which there were scarcely any unpleasant 
 symptoms, no ill results whatever, and in only 4 per cent, was there albuminuria subse- 
 quently, and that was slight and transient. Stone of Omaha reports on 250 cases with- 
 out a death, the operations being of all degrees, the anesthesia quickly produced and 
 practically no unpleasant results following ; but he attributes much of his success to his 
 use of his own mask and the Overholt dropper. Dr. Rodman of New York has re- 
 ported on 700 cases, with very unfavorable conclusions. {Jour. Amer. Med. Ass., Nov. 
 
 4 ' l8 99-.) 
 
 Hezuitf s Method, which is preferred in England, is to administer nitrous oxide gas 
 first and follow with ether in a closed inhaler. This method is rapid and safe, the pre- 
 liminary choking sensation of ether is avoided, and unconsciousness is quickly produced. 
 
 Hydrobromic Ether had a short period of popularity as an anesthetic, 
 but fell into disrepute after a few cases of death under its influence, which 
 were probably not due to the agent used (Levis' and Sims' cases). Its 
 action is less prolonged than that of Ether, but it has many advantages, 
 requiring only 3J to %\), rapidly given, and being noninflammable. Its in- 
 halation has been of especial value in hysteria, epilepsy, chorea and other 
 spasmodic disorders ; and it has been employed subcutaneously in place 
 of Ether in the treatment of such spasmodic affections as whooping- 
 cough, chorea, etc. 
 
 The Compound Spirit of Ether (Hoffmann's Anodyne) is an admira- 
 ble agent in gastralgia, colic, flatulence, syncope, etc., also in the various 
 
115 AGARICUS ALBUS AGARICUS MUSCARIUS. 
 
 manifestations of the hysterical paroxysm. In combination with the 
 camphorated tincture of Opium it is often remarkably efficient in check- 
 ing the diarrhea of hot weather. 
 
 Spirit of Nitrous Ether is used as a diaphoretic, a diuretic and a 
 carminative; also in expectorant mixtures, as an antipyretic in febrile 
 affections, and to relieve pain in angina pectoris, dysmenorrhea and 
 asthma. When its diuretic effect is desired it should be administered in 
 iced water, and the patient should be lightly covered : but when its dia- 
 phoretic action is required, it should be preceded by a hot drink, and 
 the patient should be well covered. 
 
 Hydriodic Ether may be obtained in glass capsules containing five 
 minims each, and is used by inhalation in chronic pulmonary disorders, 
 cardiac dyspnea, spasmodic affections of the bronchi and larynx, asthma, 
 and catarrhal laryngitis. It is not employed as an anesthetic. 
 
 Pental, Tri-methyl- ethylene ; C 5 H 10 (Unofficial), — is a colorless liquid, highly inflam- 
 mable, insoluble in water, but miscible in all proportions with alcohol, ether and chloro- 
 form. Sp. gr. 0.678. It is obtained by heating amylene hydrate in the presence of acids. 
 
 Pental is an efficient anesthetic, equal to Nitrous Oxide in its rapidity of action and 
 safety, but superior thereto in its more prolonged action and its having no unpleasant 
 after-effects. Under it there is seldom any stage of exhilaration, and consciousness is 
 sufficiently retained to enable response to commands, even when insensibility to pain is 
 reached. It does not lose its effect by repeated inhalations. Compared with Chloroform, 
 it acts more promptly, and has no evil after-effects ; with Ethyl Bromide, it is somewhat 
 slower in action but more lasting in effect, and can be prolonged as may be necessary ; 
 with Nitrous Oxide, it can be continued for a longer time, is more safe, and free from 
 after-effects of unpleasant character. 
 
 AGARICUS ALBUS, White or Purging Agaric (Unofficial),— is the fungus 
 Polyporns officinalis, which grows on the European larch. It occurs in large, white, 
 spongy pieces ; and contains Agaricic or Laricic Acid, also from 40 to 70 per cent, of 
 resins. The term Agaricin was formerly applied to the impure Agaricic Acid containing 
 about 3 per cent, of Agaricol, which is physiologically inert. 
 
 The taste of Purging Agaric is first sweetish, then becoming very acrid and bitter. 
 The powder inhaled causes violent sneezing, and taken internally in full doses it produces 
 watery stools. Small doses check diarrhea and dysentery, and diminish the secretions 
 of the bronchi and mammae. 
 
 Agaricus Albus was formerly employed as a drastic purgative, in doses of gr. xxx 
 to 3J. It has lately been used, with much success, in 15-grain doses of the powder, or 
 3 grains of the alcoholic extract, to check the night-sweats of phthisis. Agaricic Acid 
 has proved very valuable in checking persistent sweating from any cause, especially that 
 occurring after influenza. The dose is gr. y 1 ^ to i : and it should not be given hypoder- 
 mically. 
 
 AGARICUS CHIRURGORUM, Surgeon's Agaric (Unofficial),— is the inte- 
 rior portion of the fungus Polyporas fomentarins, which grows on the trunks of beeches, 
 birches, and oaks in Europe. It is prepared for use by boiling in weak lye and beating 
 with mallets, and then occurs in light, thin, yellowish-brown pieces, soft and pliable, 
 without odor or taste. It is almost pure cellulose. It was formerly used as a mechan- 
 ical hemostatic, and for the purpose of moxa. When soaked in a strong solution of the 
 Nitrate or Chlorate of Potassium and dried, it is very inflammable, and is called Spunk. 
 
 AGARICUS MUSCARIUS, Amanita Muscaria, Fly-Agaric 
 (Unofficial), — is a poisonous mushroom, of disagreeable odor and burn- 
 ing acrid taste, used in infusion with milk for poisoning flies, and by the 
 
AGARICUS MUSCAR1US. I 1 9 
 
 Tartars as an intoxicant. It contains an actively toxic alkaloid, Musca- 
 rine, C 5 H 13 N0 2 , of syrupy consistence, odorless and tasteless, soluble in 
 water and alcohol, and readily dissolved out by water and dilute acetic 
 acid, so that a doubtful mushroom may be easily rendered innocuous. 
 Muscarine is produced synthetically by the oxidation of choline, but it 
 is doubtful whether the article so prepared is as active as the natural 
 alkaloid. 
 
 Muscarinae Nitras, Muscarine Nitrate (Unofficial), — a viscid, yellowish-brown 
 liquid. Dose, gr. ^V~tV (Merck) ; gr. \-\ (Ringer). It may be used hypodermically. 
 
 Physiological Action. 
 Agaricus acts as an intoxicant to the cerebrum, producing more vertigo 
 and delirium than Alcohol, followed by profound sopor with lowered re- 
 flexes, perhaps coma and death. The action of Muscarine is very like 
 that of Pilocarpine and almost completely opposed to that of Atropine. 
 It is a powerful respiratory and cardiac depressant, paralyzing the respira- 
 tory centre and arresting the heart in diastole by paralyzing its motor 
 ganglia while stimulating its inhibitory apparatus. It lowers the arterial 
 tension, produces profound salivation, lachrymation and sweating, con- 
 tracts the pulmonary vessels, causing intense dyspnea, and increases the 
 intestinal, hepatic and pancreatic secretions, but markedly diminishes the 
 renal. It disturbs the gastrointestinal tract, causing tetanic intestinal 
 contractions, severe colic, vomiting and purging. It produces spasm of 
 the accommodation, marked myosis and contraction of the pupil when 
 given internally, but dilates the pupil widely when locally applied. 
 [Gelsemium does so also.] Under its action the body-temperature is 
 decidedly reduced, and the excretion of waste-products is lessened. It 
 is eliminated unchanged by the kidneys. 
 
 Antagonists. 
 
 Atropine exactly opposes Muscarine, and vice versa; no example of physiological 
 antagonism being so complete in all particulars. When a frog's heart is arrested by the 
 topical action of a minute quantity of Muscarine, the application of a little Atropine 
 will immediately paralyze the inhibition and restore the pulsations. An equally prompt 
 antagonism runs through their entire spheres of action. Digitalin is to some extent 
 antagonistic ; so also is Physostigmine. 
 
 Therapeutics. 
 Muscarine has been as yet little used in medicine, but it will probably 
 prove to be a valuable drug. It has been long used, with marked benefit, 
 for the night-sweats of phthisis, given in doses of 5 minims of a one per 
 cent, solution, hypodermically. It promises to be of great value in in- 
 flammation characterized by copious exudation, especially eye-inflam- 
 mations, catarrhal jaundice, recent hemorrhoids, acute bronchitis, pul- 
 
120 AILANTHUS ALBUMIN AND ALBUMINOIDS. 
 
 monary hemorrhage, incipient pulmonary congestion, diabetes of both 
 forms, and in constipation due to intestinal torpor and deficient secre- 
 tion, accompanied by a torpid liver and difficult digestion of fats. In 
 the latter affection it should be given in small doses, gr. g 1 ^-, thrice daily. 
 A tincture of Agaricus has been found beneficial in ataxic typhus, chorea 
 and chilblain. 
 
 AILANTHUS, Tree of Heaven (Unofficial),— is the bark of AilantJms glandulosa, 
 a well-known shade tree, of the nat. ord. Simarubacese, indigenous to China, but culti- 
 vated elsewhere. It contains an oleo-resin and a volatile oil, on which its properties 
 probably depend. Dose, gr. x-^j. 
 
 Extractum Ailanthus Fluidum, Fluid Extract of Ailanthus, — Dose, Tr^x-^j. 
 
 Tinctura Ailanthus, Tincture of Ailanthus, — Dose, n\x-gij. 
 
 Ailanthus is a decided nauseant, and a drastic purgative, causing also vertigo, weak- 
 ness, cold sweats, dull headache, pains in the back, numbness and tingling in the limbs. 
 It paralyzes the cerebrum and spinal cord of animals, impairment of motility beginning 
 in their hind extremities. The cardiac action, at first increased, soon slows, the pulse 
 becoming small and weak, and the respiration depressed, death occurring from paralysis 
 of respiration. It is a good teniafuge. 
 
 Ailanthus is used against tapeworm, a decoction of the fresh bark ( gj to ,^iv), or the 
 oleo-resin in drachm doses, being very efficient. It has also been well employed in 
 malignant scarlatina, with dark and partial eruption, insensibility, delirium and other 
 cerebral symptoms. 
 
 ALBUMIN AND ALBUMINOIDS.— Albumin (Albumen) is 
 the typical member of a group of organic proximate principles which 
 have the same general chemical composition but very different physical 
 properties, and are called albuminoids, proteids, or nitrogenous princi- 
 ples. They all contain N, together with C, O, H, and Sulphur. The 
 chief members of the group are Albumin, Fibrin and Casein, often 
 termed the histogenetic bodies, because they are essential to the build- 
 ing up of the animal organism. Each of the three is resolved by 
 caustic potassa and heat into Protein, which may then be thrown down 
 by acetic acid. The albuminoids are originally formed in the vegetable 
 kingdom, occurring in all parts of plants but especially in their seeds. 
 [See ante, page 28.] When eaten by animals they undergo digestion 
 into soluble compounds (peptones), which pass into the blood and are 
 retransformed into serum-albumin before being built into the tissues. 
 Albumin is the most important member of the group, as it forms the 
 principal portion of all animal tissues, varying from 1 part per 1000 in 
 the cerebro-spinal fluid to 383 per 1000 in the crystalline lens. The com- 
 position of its molecule is very complex and varies widely within cer- 
 tain limits in different organs and conditions, but C 72 22 H 112 N 18 S is given 
 as its approximate formula. 
 
 Albumin is amorphous, soluble in water, coagulated by heat, and occurs in three native 
 forms, viz. — (i) Serum-albumin, which is yellow, elastic, transparent, soluble in water 
 but precipitated by alcohol and by strong acids, and coagulated by heat at 104 F. (2) 
 Egg- albumin, differs from the first by precipitating when shaken with ether, and in other 
 
ALBUMIN AND ALBUMINOIDS. 121 
 
 respects. It is soluble in water and coagulated by heat. (3) Plant- albumin, occurs in 
 nearly all vegetable juices and especially in the seeds of plants. It is coagulated by heat 
 and strongly resembles egg-albumin. 
 
 Official Albuminous Substances. 
 Albumen Ovi, Egg-albumen, — the liquid white of the egg of the do- 
 mestic hen, Gallus Bankiva, var. domestica, is official in the B. P., and 
 contains, in ioo parts, Albumin 12, with 3 of mucus and salts, dissolved 
 in 85 of water. 
 
 Many writers use the spelling albumen for the name of the proximate principle albu- 
 min. Others distinguish between the white of egg (albumen) and its chief constituent 
 (albumm). 
 
 Vitellus, Yolk of Egg, — is the yolk (or yelk) of the hen's egg, and 
 occurs as a viscid, reddish-yellow, opaque liquid, of bland taste and al- 
 kaline reaction, coagulated by heat and by alcohol. It may be regarded 
 as a dense emulsion of oil suspended in water by means of albumin. It 
 contains, in ioo parts, Vitellin 16 to 18, Cholesterin 0.4, Lecithin 7, Fat 
 21 to 31, also salts, etc., and from 48 to 55 of water. Vitellin is described 
 as a mixture of albumin and casein (Fowne), or as a proteid related to 
 casein mixed with about one-fourth of albumin (Nat. Disp.). 
 
 Glyceritum Vitelli, Glycerite of Yolk of Egg, Glyconin, — consists of Vitellus 45, 
 Glycerin 55, rubbed together until thoroughly mixed. 
 
 Gelatin,— ^is a derivative of the proteids ossein and collagen, and 
 is obtained from bones, tendons, cartilage, skin, and other fibrous 
 animal structures by prolonged boiling in water. It swells up in cold 
 water, is soluble in boiling water, and its aqueous solution solidifies 
 (gelatinizes) on cooling. Its composition is similar to that of albumin 
 but it does not yield protein. Gelatin is the basis of soup, beef-tea, and 
 other preparations made from meat with boiling water. It is official in 
 the form — 
 
 Ichthyocolla, Isinglass, — the swimming-bladder of several species of sturgeon, 
 occurs in horny, semi-transparent sheets, iridescent, soluble in 24 of boiling water, and 
 forms on cooling a transparent jelly. It is the purest form of Gelatin known. 
 
 Emplastrum Ichthyocollae, Isinglass Plaster, Court Plaster, — consists of Isinglass 
 10, Glycerin 1, Alcohol 40, Water and Tincture of Benzoin, spread on taffeta and 
 allowed to dry. 
 
 Chondrus, Irish Moss, Carragheen, — is a Sea-weed consisting of two 
 algae, Chondrus crispus and Gigartina mammilosa, dried and bleached. 
 It contains mucilage 55^, water 19, mineral matter 14, albuminoids 9^, 
 and cellulose 2 per cent. A jelly may be prepared by boiling 2 oz. in a 
 quart of water for an hour, then straining and adding 3 oz. of sugar 
 while hot. The dose is indefinite. 
 
 Irish moss is horny, translucent, pale yellowish-white, of sea-weed odor and mucilag- 
 inous saline taste. It swells in cold water but does not dissolve. On boiling with 
 30 parts of water for 10 minutes it yields a solution which gelatinizes on cooling. It is 
 
122 ALBUMIN AND ALBUMINOIDS. 
 
 a demulcent and nutrient of some slight value in bronchial and catarrhal affections ; but 
 as it contains no starch it is not as valuable as Iceland Moss (Cetraria) as a food for the 
 sick. [See under the title Amylum.] Another member of the Algae is the Fucus 
 Vesiculostis, which is described under its own title. 
 
 Unofficial Analogues of Albumin. 
 
 Fibrin, — is the proteid which causes the clotting of plasma, lymph, 
 
 and the blood when shed. It does not exist in the living, circulating 
 
 blood, but is formed by the mutual action of fibrinogen, fibrino-plastin 
 
 and fibrin-ferment, which arise as products of the breaking up of white 
 
 blood-corpuscles. In normal blood it occurs to the extent of 0.2 per 
 
 cent., is increased in inflammation and diminished in hemophiles. 
 
 Fibrin has the same general composition as albumin but contains more O and S. Its 
 special characteristic is its power of spontaneous coagulation. It is insoluble in water 
 and in ether, and is changed into syntonin (acid-albumin) by dilute hydrochloric acid. 
 
 Casein is the proteid contained in milk. Its composition is the same 
 as that of albumin, but it differs therefrom in not being coagulated by 
 heat and by being thrown down by organic acids which do not precipitate 
 albumin. It is, by some authorities, supposed to be a combination of 
 albumin and potash. 
 
 Gluten, is a nitrogenous constituent of the seeds of wheat and other 
 cereals, the former containing it in the proportion of from 8 to 15 per 
 cent. It is made up of a number of albuminous principles which differ 
 but slightly from each other, the chief ones being gluten-fibrin, gluten- 
 casein, gliadin and mucedin. 
 
 Unofficial Albuminous Preparations. 
 Beef, among meats, has the highest nutritive value. The average of 
 many analyses shows its composition to be as follows: In 100 parts, total 
 albuminoids 20^, fat 2^, extractives 1^, salts 1}^, water 73^2, also a 
 minute quantity of creatin. 
 
 Extracts of Meat prepared by boiling down the flesh of animals, as Liebig's 
 Extract, are stimulants, not nutrients, as they contain practically none of the nutritious 
 (albuminous) constituents of meat but only the salts and flavoring matter (E. Smith). 
 
 Meat -juices, prepared by a cold process of extraction and partial digestion, are 
 claimed to retain the fibrin, gelatin and coagulable albumin. Many such are on the 
 market, under the trade-names Bovinine, Bovril, etc. 
 
 Chittenden, by analyses of various meat extracts, has shown that they possess very 
 little nutritive value as compared with fresh lean beef. In most of them the fat is less 
 than I per cent. , and the total amount of available proteid is far below I per cent. Some 
 are even less nutritious than ordinary beef-tea. 
 
 Beef Peptonoids is the trade-name of a powdered preparation which is claimed to 
 consist of the nutritive constituents of beef with milk and wheat gluten, partially pep- 
 tonized and containing 95 per cent, of nutritious material. Liquid Peptonoids is intended 
 to represent the same combination in liquid form, all the constituents being entirely 
 digested and ready for assimilation. Panopepton is a similar preparation. 
 
 Sanose is a food preparation which is claimed to contain IOO per cent, of albuminous 
 material, of which 80 is casein and 20 is albumose. 
 
ALBUMIN AND ALBUMINOIDS. 1 23 
 
 Somatose is a dry powder, which is said to contain nearly 90 percent, of albumoses, 
 80 grains corresponding in nutrient value to about i l / z ounces of fresh beef. 
 
 Milk contains all the elements necessary for the growth and nutrition 
 of animal tissues in the most digestible form. Its chief albuminoid con- 
 stituent is Casein, but it also contains fat, sugar, salts and water, which 
 vary in proportion according to the animal and its food. Cow's Milk, 
 of sp. gr. 1,030, averages, in 100 parts, of albuminoids 4, fat 4, sugar 5, 
 salts y 2 , and water 86)4 • Goafs Milk is very near to that of the cow 
 in composition, but Asses' Milk has much less of casein and salts, very 
 little fat, and more sugar and water. Woman' s Milk contains about the 
 same proportion of casein as asses' milk, more fat than cow's milk, more 
 sugar than the others, and less salts than any except asses' milk. 
 
 Buttermilk contains, in 100 parts, casein 4^, sugar 2^, fat %, salts y z , lactic acid 
 %, and water 92. 
 
 Condensed Milk is prepared by adding refined sugar and an alkali to fresh cow's 
 milk, then evaporating the mixture in vacuum pans until it has a thick, semifluid consist- 
 ency. Desiccated Milk occurs in the form of a dry powder, and is highly esteemed by 
 the armies of Europe. 
 
 Peptonized Milk is prepared by adding to fresh cow's milk one-third part of water, 
 in which, after boiling and cooling, there is dissolved a pinch of Sodium Bicarbonate, 
 and gj or gij of Liquor Pancreaticus is added to each pint. The mixture is then al- 
 lowed to stand in a warm place for an hour, when it is ready for use. Peptogenic Milk 
 Powder, containing the requisite proportions of the alkali and the pancreatic ferment, 
 may be obtained in the drugstores and will prove satisfactory. 
 
 Cheese is obtained from the milk of animals, especially the cow, by coagulating the 
 casein by means of rennet or an acid, and after separation submitting it to pressure. It 
 contains, in 100 parts, albuminoids (casein, etc.) 28 to 45, fat 6 to 30, salts 4 to 5, and 
 water 36 to 44 ; the proportions of each varying according to the quality of the milk 
 used. 
 
 Kumyss, Koomiss, — is an effervescing fermented liquor originally pre- 
 pared by the Tartars from mare's milk, but now imitated with cow's milk 
 by adding sugar of milk, fermenting in open tanks, skimming off the 
 casein and butter, then bottling during active fermentation. Its success- 
 ful preparation depends on its undergoing slow fermentation in a cold 
 room, at 50 F. or less. If the temperature be higher, the fermentation 
 will be of the acetous variety, and will result in sour milk with heavy 
 curd, feeble effervescence and repulsive taste. 
 
 Wolff's Formula, for its preparation in small quantity, is as follows : — Dissolve ^ ss 
 (a tablespoonful) of grape sugar in J|iv of water. Dissolve gr. xx (a teaspoonful) of 
 Fleischmann's compressed yeast or well washed and pressed out brewer's yeast in ^ ij 
 of cow's milk. Mix the two solutions in a quart champagne bottle, and fill it within 
 two inches of the top with good cow's milk. Cork well, secure the cork with wire, 
 keep it in a cellar or ice chest, maintaining a temperature of 50 F. or less, and agitate 
 twice daily. In three or four days it is ready for use, but should not be kept longer than 
 four or five days. Draw it with a champagne tap. 
 
 Kumysgen is a powder containing the elements necessary for the preparation of 
 Kumyss, for which a special bottle and tap are also furnished by the manufacturers. It 
 is a very convenient manner of making this preparation, and the product tastes just as 
 well as that made in the ordinary way. Whether it acts as well therapeutically remains 
 to be ascertained. 
 
Kumyss. 
 
 Kefir. 
 
 I 
 
 4 
 
 2 
 
 2 
 
 2K 
 
 2 
 
 I 
 
 I 
 
 I# 
 
 I 
 
 92 
 
 90 
 
 124 ALBUMIN AND ALBUMINOIDS. 
 
 Kefir is the name of a fermented drink prepared from the milk of a cow or mare 
 by the addition of a mushroom-like ferment found near the snow-line in the Caucasian 
 Mountains. It is used by the natives of the Asiatic plains as a remedy for struma, 
 anemia, lung and stomach diseases. Kefir is richer in albuminoids than Kumyss, is less 
 alcoholic and less acid. 
 
 The following table shows the average composition of Milk, Kumyss and Kefir : — 
 
 Cow's milk. 
 
 Albuminoids (casein, etc.), 4 
 
 Butter, 4 
 
 Sugar of milk, 5 
 
 Lactic Acid, — 
 
 Alcohol, — 
 
 Water and salts, 87 
 
 Physiological Action. 
 
 The normal adult human organism, doing ordinary work, loses daily 
 by its metabolism 4*^ oz. of albuminous or proteid matter, besides 14^ 
 oz. of carbo-hydrates, 3 oz. of fat, 1 oz. of salts and 2^ quarts of water, 
 these quantities being largely increased during the performance of labo- 
 rious work. A corresponding amount of these substances must be daily 
 ingested in order to supply material for the repair of the tissues and for 
 the production of heat and other forms of force. The albuminoids are 
 most important alimentary principles, their chief office being the repair 
 of the tissues, and they being the only foods containing nitrogen, an essen- 
 tial element in the formation of every structure which manifests any form 
 of energy. They can replace each other in supplying nutrition to the 
 tissues, their composition is identical with that of the same substances in 
 the blood and other tissues, and they consist wholly of nutritive material 
 in concentrated and digestible form. They undergo digestion in the 
 stomach by the acid gastric juice, also in the intestine by the pancreatic 
 juice, the respective ferments of which convert them into soluble peptones, 
 the form in which they enter the blood. The digestive changes through 
 which they pass are — (1) proteid, the albuminoid, as ingested ; (2) acid- 
 albumin or syntonin in the stomach, alkali-albumin in the intestine; (3) 
 propeptone or hemialbumose ; and (4) peptone. The chief products aris- 
 ing from their oxidation within the body are C0 2 , H 2 and Urea, the 
 latter containing nearly all their nitrogen. They are mainly obtained 
 by the ingestion of animal food, as flesh, milk, eggs, etc., but they are 
 also contained in vegetable products, especially the seeds of certain 
 plants, and those of leguminous plants (peas, beans, lentils, etc.) contain 
 more proteid material than any kind of meat. 
 
 The increased ingestion of albuminoid food, by persons who have 
 previously used it sparingly, improves the quality of the blood by increas- 
 ing the number of the red corpuscles, and causes a rise in the sp. gr. of 
 the urine and a greater excretion of urea and uric acid. Individuals who 
 consume albuminoids in excess of their requirements are lean but muscular, 
 
ALBUMIN AND ALBUMINOIDS. 125 
 
 irritable in temper and prone to excessive sexual appetite. The exclusive 
 use of animal food develops a superabundance of muscular force, so that 
 a nation of meat eaters is usually one of hunters possessing a warlike and 
 savage disposition. 
 
 Disease may be produced by food of any kind through excess or defi- 
 ciency in quantity, special characteristics of quality, or imperfect diges- 
 tibility. Albuminoid food in excess produces congestion and enlarge- 
 ment of the liver and probably of other organs. If exercise is not taken 
 at the same time, the albuminoids are imperfectly oxidized, and dele- 
 terious products are retained in the system, or the eliminating organs 
 are irritated by the passage through them of material which they are not 
 adapted to remove. A great excess of albuminoids, without other food, 
 produces in a few days marked febrile symptoms, malaise and diarrhea; 
 and if persevered in albumin appears in the urine. Gout probably arises 
 in the same way, partly from the use of alcohol, which delays metamor- 
 phosis, partly from using too much albuminoid food, and partly from 
 want of exercise. A diet which is deficient in albuminoids causes a les- 
 sening of bodily activity and the gradual oncome of an adynamic condi- 
 tion which predisposes the subject to infectious diseases and modifies the 
 course of many affections, typhoid fever running its course in such cases 
 with less elevation of temperature than is usual and with less excretion of 
 urea. Complete deprivation of albuminoids produces loss of muscular 
 strength, mental debility and feverish and dyspeptic symptoms, followed 
 by anemia and prostration. 
 
 The advantages of a meat diet are : — its large amount of nitrogenous 
 material, the presence in it of iron and important salts, and also much 
 fat, the latter performing to great extent the office of the carbo-hydrates 
 in supplying fuel to the body. It is easily cooked, is very digestible 
 whether raw or cooked, and is more readily assimilated than any vegetable 
 food. Its great disadvantage is that it contains neither starch nor sugar, 
 hence it cannot supply all the carbon needed by the body unless so large 
 a quantity of it be taken (4^ lbs. of beef daily) as would soon impair 
 the digestive organs. 
 
 Beef contains alimentary principles which are most important for the 
 nutrition of the body. When of good quality, neither too old nor too 
 young, having the fat and muscle suitably proportioned and unaltered by 
 disease, and properly cooked, it is the best of the animal foods. 
 
 Milk is an excellent albuminous food, but its proteid, casein, is coag- 
 ulated by the acids in the stomach, even by the acid of the gastric juice, 
 and is tolerated with difficulty by many persons, especially in the large 
 quantity which must be taken to itself maintain the nutrition of the 
 organism. As an exclusive diet, for anyone above the infant age, it soon 
 palls upon the appetite, and causes a sense of emptiness at the epigas- 
 
126 ALBUMIN AND ALBUMINOIDS. 
 
 trium, a coated tongue and an unpleasant taste in the mouth. The sub- 
 ject of an exclusive milk diet is usually constipated, the stools being hard 
 and of ochre-yellow color, but if diarrhea is produced it shows that the 
 milk is not digested. The urine is greatly increased in quantity and the 
 body-weight is gradually diminished to a certain point, where it remains. 
 The pulse is quickened at first and arterial tension is lowered, but the 
 pulse-rate falls as soon as the body ceases to lose weight. A sense of 
 weakness is usually experienced, but many persons are greatly debilitated 
 and some complain of vertigo. 
 
 Kumyss has an acidulous and peculia'r taste. In large quantity it can 
 take the place of other food for a time, each quart equalling 4 oz. of 
 solids. It is a powerful diuretic, especially in cold weather, and in warm 
 weather it causes free perspiration. It is stimulant and tonic, increases 
 the nutrition of the body and produces considerable somnolence. The 
 stomach tolerates it well, even when it rejects all other food. It is easily 
 assimilated and very nutritious. 
 
 Eggs, like milk, constitute an almost complete food, as they contain 
 all the elements required by the blood. According to Pavy an egg 
 weighing 2 oz. has no grains of albuminous material, 82 grains of fat 
 and n grains of saline matter. The white, consisting chiefly of albumin 
 dissolved in water, contains the larger proportion of nitrogenous material, 
 and the yolk contains the greater quantity of fat. 
 
 Gelatin is undoubtedly a food, as it increases vital action in the same 
 direction, if not in the same degree, as albumin (E. Smith). Like albu- 
 min, however, it must not be relied on alone, but should be mixed with a 
 proper quantity of other foods. It is an efficient styptic. 
 
 Therapeutics. 
 The chief affections in which nitrogenous food is required are diabetes 
 mellitus, anemia, obesity, phthisis and other wasting diseases, and long- 
 continued fevers. In fever there is an excessive consumption of the 
 proteids of the body and the eliminative processes are very active, the 
 discharge of urea being often enormous. All this increases the demand 
 of the organism for albuminoid food, but the digestive power of the 
 stomach is, at the same time, greatly reduced, the secretion of gastric 
 juice being diminished. In carcinoma of the stomach and some other 
 affections hydrochloric acid is absent from the gastric juice, and in many 
 diseases gastric digestion is feeble or imperfectly performed. Hence it 
 becomes important to furnish albuminoid foods in such form that they 
 may be assimilated with the least possible expenditure of digestive 
 energy. Peptones can be prepared outside the body and administered as 
 food, but when artificially made they have little nutritive value, are un- 
 able to supply the need of the organism and are exceedingly disagreeable 
 
ALBUMIN AND ALBUMINOIDS. \2J 
 
 to the patient. Albumoses, the intermediate products, are readily 
 absorbed, and being free from taste and not causing digestive troubles 
 they are suitable foods for invalids and for subjects of weak digestion. 
 
 Raw beef, scraped to a pulp, freed from fat and seasoned with salt and 
 pepper, is used in the treatment of chronic diarrheas, also in debilitated 
 conditions from any cause wherein it becomes necessary to administer an 
 easily digested nitrogenous aliment. Its chief objection is the liability 
 of tape-worm following the use of uncooked meat. 
 
 Blood is rich in nutritive elements and has been much employed as a 
 food in wasting diseases, especially phthisis, the subjects of which often 
 resort to slaughter-houses to drink the fresh blood of animals. The 
 result is that the nutrition is improved, often to a remarkable extent, but 
 the practice is open to the danger of the patient swallowing parasites. 
 
 Beef-tea, when made with boiling water, contains less than one per cent, of gelatin, 
 the only nutritive principle yielded by meat to a hot aqueous solution. The other ex- 
 tractives obtained by boiling (creatin and creatinin) are simply effete muscular material 
 on the way to the formation of urea. Hence beef-tea, bouillon and similar preparations 
 of meat contain little except the stimulating salts and are almost wholly devoid of nutri- 
 tive properties. Cold drawn infusions of meat are of considerable value as foods as they 
 contain much albuminous material. 
 
 Albumen Ovi (white of egg), besides being a valuable food, is used in 
 medicine as an antidote in poisoning by corrosives and irritants, espe- 
 cially corrosive sublimate, copper sulphate, silver nitrate and the lead 
 salts. Shaken with alum it coagulates and forms the so-called Alum 
 Curd, which is highly esteemed as an astringent and cooling application in 
 acute conjunctivitis, also for burns and erysipelas. White of egg, diluted 
 with water, sweetened and flavored, forms an agreeable and nutritious 
 drink in gastritis. It is spread on silk or gold-beater's skin to make an 
 adhesive plaster, which only requires moistening before application. 
 
 Yolk of Egg is more nutritious and digestible than the white, and is 
 highly esteemed in dyspepsia. The yolk of a hard-boiled egg crumbles 
 easily and is readily acted on by the gastric juice. It is a useful article 
 of diet in exhausted conditions of the system, but its chief use in medi- 
 cine is for emulsionizing oils and camphors. The Glycerite has the con- 
 sistence of honey and forms an opaque emulsion with water. It is a 
 good vehicle for cod-liver oil, and an excellent protective application for 
 burns, erysipelas, fissure of the nipples, and many cutaneous disorders. 
 It is used as a cosmetic, and may be employed as an aliment. 
 
 Gelatin is somewhat nutritious, but is usually employed as the basis of 
 flavored jellies, which are esteemed rather as delicacies than as foods. It 
 is highly praised as a styptic application in epistaxis and other hemor- 
 rhages, acting well in 2 to 10 per cent, solutions with 1 per cent, of 
 sodium chloride. It has lately been used subcutaneously by Lancereaux 
 and Osier in the treatment of aneurisms, 250 c.c. of a 1 per cent, solu- 
 
128 ALCOHOL. 
 
 tion in normal saline solution being injected every other day slowly into 
 the thigh or abdominal wall. Isinglass has no advantage over any other 
 form of gelatin. It is used for clarifying liquids and in solution as a test 
 for tannic acid. The plaster, commonly called court-plaster, is a useful 
 protective agent for cuts, sores, etc. 
 
 Milk is the only food which is proper for infants up to the age of eight 
 months, their digestive organs being unable to manage the farinaceous 
 aliments. For those who are deprived of their natural milk the best 
 substitute is cow's milk diluted with about one-third part of water and 
 sweetened with sugar, which should be given at a temperature of ioo° F. 
 and at intervals of about three hours. The addition of lime-water in- 
 stead of ordinary water will make it more digestible. As an exclusive 
 diet for older children and adults, milk is employed with great benefit in 
 many gastric and intestinal disorders ; also in albuminuria, diabetes, 
 ascites, anasarca, eczema, gout, aneurism, and in irregular and tumultu- 
 ous cardiac action due to valvular disease of the heart. Skimmed milk 
 is better borne than unskimmed milk in many affections of the gastro- 
 intestinal tract. Milk is the one food available in typhoid fever and 
 may be wholly depended on as aliment in that disease. It is especially 
 useful in scarlet fever, both as a nutrient and a diuretic. In intes- 
 tinal indigestion, cholera morbus, cholera infantum, and the ileo-colitis 
 of children, it is necessary to supply only such foods as are digested in 
 the stomach, in order to give the intestine rest, hence milk, eggs, meat- 
 juices and meat-broths are the suitable articles of diet in these affec- 
 tions. 
 
 Buttermilk contains lactic acid, which does not exist in ordinary milk, 
 and in consequence it is more easily digested than the latter. It is partic- 
 ularly useful in gastric disorders, albuminuria and diabetes. 
 
 Kumyss is an invaluable article of diet in many wasting diseases, espe- 
 cially phthisis. It is of great benefit in dyspepsia, the diarrheas of 
 children, convalescence from acute maladies, chronic affections of the 
 kidneys, and other cachexias. In cases of feeble digestive power an 
 ounce every hour is sufficient, but as its digestion and assimilation increase 
 it may be given almost ad libitwn, and when used with other food a half- 
 pint may be taken after each meal. Each quart is estimated to contain 
 four ounces of solid food, besides from i to 3 per cent, of alcohol. 
 
 ALCOHOL, Alcohol, Ethyl Alcohol, Ethyl Hydrate, C 2 H 5 OH. 
 The official alcohol is Ethyl Alcohol, which is represented in the pharma- 
 copoeia by the several preparations named Brandy, Whiskey, and Wine, 
 as also under the following four forms, viz. — 
 
 Alcohol Absolutum, Absolute Alcohol, C 2 H 5 OH, — is Ethyl Alcohol, 
 containing not more than 1 per cent, by weight of water. A transparent, 
 
ALCOHOL. 129 
 
 inflammable, colorless, mobile and volatile liquid, very hygroscopic, of 
 characteristic, agreeable odor, and burning taste. Sp. gr. not higher 
 than 0.797 at 59° F. Used in the manufacture of Chloroform. 
 
 Alcohol, — a liquid composed of about 91 per cent, by weight, or 94 
 per cent, by volume, of Ethyl Alcohol, C 2 H 5 OH, and about 9 per cent., 
 by weight, of water. It is a transparent, inflammable, colorless, mobile 
 and volatile liquid, of agreeable odor and burning taste, of sp. gr. 0.820 at 
 59 F. Miscible with water in all proportions and without any trace of 
 cloudiness; also miscible with ether or chloroform. Obtained by the 
 distillation of fermented saccharine fluids. Used in preparing all the 
 tinctures and spirits, also in some liniments, liquors and mixtures. 
 
 Alcohol Deodoratum, Deodorized Alcohol, — a liquid composed of 
 about 92^ per cent., by weight, or 95.1 per cent., by volume, of Ethyl 
 Alcohol, and about 7^ per cent., by weight, of water. Sp. gr. about 
 0.816 at 59 F. Dose, 3 s s-ij, diluted with water. 
 
 Alcohol Dilutum, Diluted Alcohol, — a liquid composed of about 41 
 per cent., by weight, or about 48.6 per cent., by volume, of Absolute 
 Alcohol, and about 59 per cent, of water. It is prepared by mixing 
 together equal volumes of Alcohol and Distilled Water. Sp. gr. about 
 0.936 at 59 F. 
 
 An Alcohol is a volatile organic compound, which contains no N, has a great affinity 
 for water, and reacts with acids, forming therewith H 2 and ethers. Alcohols are there- 
 fore analogous to the metallic hydrates, as are Ethers to salts. Methyl Alcohol is 
 obtained by the destructive distillation of wood, Phenyl Alcohol (Phenol) by that of 
 coal-tar, and the fermented Alcohols (Ethyl, Amyl, etc. ) from any vegetable substance 
 containing sugar (or starch and the ferment Diastase, which converts the starch into 
 sugar), by fermentation through the agency of the yeast-plant, which splits the sugar into 
 Alcohol and C0 2 . The product contains much water, and is then distilled in order to 
 separate the alcohol, which passes over first, with a certain amount of water, the greater 
 part of the latter being left behind. In this country Alcohol is so produced from grain 
 (chiefly barley), and is termed High Wine, being disposed of by the distillers to certain 
 wholesale liquor dealers, many of whom proceed to "rectify" it by mixing and blend- 
 ing it with water, essential oils of corn, rye, etc., ethers, burnt sugar, and occasionally 
 small quantities of genuine whiskey, brandy, etc. The product is then labeled "Old 
 Tom Gin," "Old Crow Whiskey," etc., according to the requirements of the retail 
 dealers. True Whiskey is distilled from the mash of fermented grain (corn, wheat, and 
 rye, or a mixture of all three), and should be not less than two years old, to be official ; 
 Brandy from the fermented juice of fresh grapes, and should be not less than four years 
 old. Wines are the product of the fermented juice of grapes, without distillation. 
 
 Alcohol may be produced synthetically by shaking Olefiant Gas (C 2 H 4 ) with strong 
 Sulphuric Acid, then diluting and distilling. Absolute Ethyl Alcohol, which is only 
 used for chemical testing and for the manufacture of Chloroform, is obtained by shaking 
 Alcohol with Potassium Carbonate, decanting and distilling with slaked lime. 
 
 Alcohol very slowly oxidized forms Aldehyde (C 2 H 4 0) ; if less slowly Acetic Acid 
 (C 2 H 4 2 ) ; if quickly, as in burning, C0 2 and H 2 6, which are in all cases the ultimate 
 products of its continued oxidation. 
 
 An Aldehyde is obtained from an alcohol by removing therefrom two atoms of hydro- 
 gen, hence its name — Al (cohol) dehyd (rogenatum). Aldehydes lie in chemical consti- 
 tution between the alcohols and the acids, and have the power of reducing silver salts 
 in darkness, which is shared also by living protoplasm. The principal aldehydes are — 
 
 Acetic Aldehyde, Aldehyde, Ethyl Aldehyde, Ethylidene Oxide, C 2 H 4 0, — a colorless, 
 mobile liquid, antiseptic, locally irritant, anesthetic when inhaled, and a powerful de- 
 pressant of the respiration, too dangerous for use. 
 
130 ALCOHOL. 
 
 Formic Aldehyde, Formaldehyde, CH 2 0, — is a gaseous body prepared by subjecting 
 methyl alcohol to oxidation. It is readily absorbed by water, and is put on the market 
 in the form of a 40 per cent, aqueous solution named Formalin, which is a powerful 
 antiseptic, disinfectant and deodorant, and is described under its own title. 
 
 Paraldehyde, C 6 H 12 3 , — is a polymeric form of Aldehyde and a valuable hypnotic. 
 It is described under its own title. 
 
 A Ketone bears the same relation to an aldehyde that an Ether does to an alcohol, 
 being an aldehyde in which the hydrogen has been replaced by a radical. The most 
 important Ketone is — 
 
 Hypnone, Phenyl-methyl-acetone, C 6 H 5 (CO) (CH 3 ), — a hypnotic agent of moderate 
 energy, described under the title Chloral. 
 
 Principal U?iofficial Alcohols. 
 
 Methyl Alcohol, Methyl Hydrate, Wood- spirit, CH 3 OH, — also called 
 Carbinol, Methol, Hydroxymethane, is a non-fermented alcohol, obtained 
 from the destructive distillation of wood. Ordinarily it contains many 
 impurities, which give it a very disagreeable odor, and mixed with ethyl 
 alcohol it renders the latter so disagreeable as to be unfit for drinking. 
 Such a mixture is sold, under the name Methylated Spirit, for use as a 
 solvent in the arts, as a combustible in lamps, etc. 
 
 Amyl Alcohol, Amy I Hydrate, Potato-spirit, Fusel Oil, C 5 H n OH, — 
 is a fermented alcohol obtained from the potato, also occurring in the 
 crude spirit produced by the fermentation of saccharine solutions with 
 yeast, and separated by the excessive distillation thereof, passing over 
 after the ethyl alcohol. It is oxidized into Valerianic Acid. From it is 
 prepared Amyl Nitrite, by distilling with nitric and sulphuric acids and 
 copper wire. It is an oily liquid, of penetrating and oppressive odor 
 and burning taste : sparingly soluble in water, but soluble in all propor- 
 tions in alcohol, ether and essential oils. 
 
 Official Alcoholic Preparations. 
 
 Spiritus Frumenti, Whiskey, — obtained from the distillation of the mash of fer- 
 mented grain ; rye, wheat or corn (U. S.), barley (Scotch), and at least two years old. 
 Sp. gr. 0.917 to 0.930. Has an alcoholic strength of 44 to 50 per cent, by weight ; also 
 Ethers developed by the action of acetic and butyric acids on the alcohol, and traces of 
 Amyl Alcohol (fusel-oil) even in the best. Dose, ^ij-^ ij. 
 
 Spiritus Vini Gallici, Brandy, — obtained from the distillation of the fermented 
 juice of grapes, and at least four years old. Sp. gr. 0.925 to 0.941. Has an alcoholic 
 strength of 39 to 47 per cent, by weight, and (Enanthic and other Ethers developed by 
 age. Pale Brandy is colored by the cask, the dark has caramel to color it. Is often 
 prepared artificially by adding to high wines Acetic or Nitric Ether, Caramel, and Log- 
 wood or Catechu for astringency. Dose, 3 ij- 5 ij . 
 
 Spiritus Rectificatus, Rectified Spirit, — official in the B. P., is Alcohol with 16 per 
 cent, of water, obtained by the distillation of fermented saccharine fluids. Sp. gr. 
 0.838. Is often spoken of as "56 over proof," meaning that to reduce 100 volumes of 
 it to the strength of proof spirit requires 56 volumes of water. 
 
 Spiritus Tenuior, Proof Spirit, — official in the B. P., is prepared by mixing Recti- 
 fied Spirit 5 volumes with 3 of Distilled Water; has a sp. gr. of 0.920, and contains of 
 absolute alcohol about 49 per cent, by weight, about 57 per cent, by volume. 
 
 Vinum Album, White Wine, — should contain from 10 to 14 per cent, by weight of 
 absolute alcohol, and is made by fermenting the unmodified juice of the grape, freed 
 from seeds, stems and skins. California Riesling, Ohio Catawba, etc. Dose, ^j-Jiv. 
 
ALCOHOL. I3I 
 
 Vinum Rubrum, Red Wine, — should contain from 10 to 14 per cent, by weight of 
 absolute alcohol, and is made by fermenting the juice of colored grapes in presence of 
 their skins. Native Claret, Burgundy, etc. Dose, j§j-j|iv. 
 
 Unofficial Alcoholic Preparations. 
 
 Rum, — is obtained from the distillation of fermented molasses, and has about 42 per 
 cent, by weight of alcohol. 
 
 Gin, has about the same alcoholic strength as rum, and approaches very nearly to the 
 official Spiritus Juniperi Compositus. It is usually distilled from rye or barley, and fla- 
 vored, in Holland, with juniper berries and hops, in England, often with oil of turpen- 
 tine, various cheap aromatics, acetate of lead, sulphate of zinc, cayenne pepper, etc. 
 Pure gin is slightly diuretic, from the oil of juniper contained in it. 
 
 Spiritus Odoratus, Perfumed Spirit, Cologne-water, — prepared by adding to 800 
 parts of Alcohol, Water 158, Acetic Ether 2, Oil of Bergamot 16, Oil of Lemon 8, Oil 
 of Rosemary 8, Oil of Lavender Flowers 4, and Oil of Orange Flowers 4 parts. A 
 perfume and ingredient of lotions. 
 
 Vinum Aromaticum, Aromatic Wine, — consists of Stronger White Wine 94 per 
 cent., with Lavender, Origanum, Peppermint, Rosemary, Sage and Wormwood, of each 
 I per cent. It was official in the U. S. P. 1880. 
 
 Vinum Portense, Port Wine, — is not a natural wine, spirit being added during the 
 process of manufacture, and the alcoholic strength raised to 30 or 40 per cent. 
 
 Vinum Xericum, Sherry Wine, — a dry, spirituous white wine, generally made to 
 order by the dealers, and having from 20 to 35 per cent, of alcohol. 
 
 Sparkling Wines, as Champagne, Hock, Catawba, — are more or less sweet, and 
 charged with carbonic acid, being bottled before fermentation is-completed and the grape 
 sugar all converted into alcohol. They contain 8 to 10 per cent, of absolute alcohol. 
 
 Sweet Wines, as Burgundy, Tokay, Muscatel, Malaga, Angelica, Madeira, etc., — 
 are of low alcoholic strength, 6 to 7 per cent, unless fortified. 
 
 Light Red Wines, as Claret, Red Rhine, Concord, — have 5 to 7 per cent, alcohol, 
 tannic acid, grape coloring matter, etc. 
 
 Dry Acid Wines, as Rhine and Moselle, California Hock, Kelley Island Catawba, — 
 in these fermentation is complete, and the alcoholic strength from 5 to 7 per cent. 
 
 Beer, Ale and Porter, — are fermented liquors, made from malted grain, with hops 
 and other bitters added. Beer is made by slow fermentation, the yeast sinking ; Ale by 
 rapid fermentation, the yeast floating. Their alcoholic strength is from 2 to 3 per cent, 
 in beer, to 4 to 6 per cent, in ale and porter, — and they also contain malt extract, car- 
 bonic acid, lactic acid, various aromatics, potassium and sodium salts, etc. 
 
 Kumyss, — is obtained by the fermentation of milk, that of the mare being used in 
 Tartary, where it is employed as a food. It contains from I to 3 per cent, of alcohol, 
 sugar, lactic acid, casein, fat, salts, carbonic acid and ethers. [See page 1 23.] 
 
 Physiological Action of Alcohols. 
 The Alcohols of the series to which the above-mentioned belong are 
 all narcotic poisons when taken in sufficiently large doses ; and have the 
 general effect of paralyzing the nerve-centres in the inverse order of their 
 development. The symptoms produced may be divided into stages, 
 viz. — (1) Stimulant, (2) Narcotic and Anodyne, (3) Anesthetic, (4) Para- 
 lytic ; therein closely following the action of the volatile anesthetics 
 derived from them, though wanting in the profound degree of anesthesia 
 which the latter produce. Ethyl Alcohol, the effects of which are detailed 
 below, has the most typical action, and in poisoning by it at all these stages 
 follow each other in regular order. In poisoning by Methyl Alcohol the 
 
132 ALCOHOL. 
 
 excitement is greater, the subsequent stages succeed each other more 
 rapidly, and if the dose be insufficient to cause death, the effects pass off 
 more quickly. They all lower the body-temperature. 
 
 The post-mortem appearatices, after acute poisoning by the alcohols, show changes in 
 the blood, stomach, intestines, liver, lungs and kidneys ; some of which are probably due 
 to the asphyxiation resulting from the paralysis of respiration. The Blood is dark and 
 clotted in the heart. The Stomach and Intestines are congested and softened, especially 
 so if the ingested alcohol has been undiluted. The Liver is very much* congested, soft 
 and friable. The Spleen is gorged with blood and softened. The Lungs are congested 
 and show small extravasations of blood, and in the Kidneys also hemorrhages are found. 
 
 Physiological Action of Ethyl Alcohol. 
 
 Externally applied, Alcohol is a powerful antiseptic and disinfectant, 
 also refrigerant, astringent, anhidrotic, rubefacient, and slightly anes- 
 thetic. Applied to the exposed skin it quickly evaporates, cooling the 
 surface, temporarily contracting the superficial vessels, and checking the 
 secretion of the sweat-glands. If its evaporation is prevented, as by cov- 
 ering with a watch-glass or a piece of rubber, or if the alcohol is rubbed 
 in, it absorbs water from the tissue and hardens it. It also coagulates the 
 albumin of the part, but the coagulum is soon redissolved by the fluids of 
 the tissues. It then dilates the vessels of the derma, producing a sensa- 
 tion of warmth and a rubefacient effect upon the skin. Upon the mucous 
 membrane of the mouth and pharynx similar effects are produced by the 
 same application. If the alcohol is concentrated, a burning sensation is 
 felt immediately ; also an increased flow of saliva and quickened pulse, 
 due to reflex action. Then follows a slight local anesthesia of the part, 
 and if the alcohol be held there for some time, the mucous membrane 
 becomes whitish and opaque, from coagulation of the albumin, abstrac- 
 tion of water from the tissue and congestion of its vessels. This soon 
 disappears, as resolution of the albumin occurs. 
 
 Internally, in moderate quantity and single dose, Alcohol acts briefly 
 as a cerebral, cardiac and general stimulant ; in large doses as an anes- 
 thetic, an intoxicant and deliriant, and finally as a narcotic poison and 
 paralyzant of the nerve-centres. It is somewhat antipyretic, also diuretic 
 and antispasmodic, and is hypnotic in many cases. 
 
 A single dose of a strong alcoholic preparation, for example an ounce 
 of neat brandy, introduced into the stomach, immediately produces im- 
 portant and valuable reflex effects. The cardiac rate is quickened, and 
 its force is increased ; the vessels of the entire body are dilated, especially 
 those of the skin ; the blood-pressure is raised, and a sense of glowing 
 heat is produced. These reflex effects are well seen in the prompt resto- 
 ration of a fainting person by the administration of a single dram of 
 whiskey or brandy. By the same means the nausea, paleness and other 
 unpleasant symptoms produced by tobacco are promptly counteracted. 
 
ALCOHOL. I33 
 
 Internally, in small quantity diluted, Alcohol dilates the gastric vessels, 
 reddens the mucous membrane of the stomach, produces a sense of 
 warmth and comfort, stimulates the gastric glands to increased production 
 of gastric juice, and increases the activity of the gastric movements. 
 Taken moderately, immediately before or during meals, it promotes the 
 appetite and assists digestion ; lessens the elimination of waste-products 
 (urea and C0 2 ), causes a subjective sensation of heat, and slightly raises 
 the body-temperature. It briefly stimulates the heart, prolonging its 
 systole and reducing the length of the diastole, and increases the func- 
 tional activity of all the organs. The effects of large doses are very in- 
 jurious ; the vaso-motor nerves are partially paralyzed for a time, causing 
 dilatation of the arterioles throughout the body ; the pepsin of the gastric 
 juice is precipitated, the gastric and hepatic vessels are congested, the 
 walls of the stomach are rendered hyperemic, and the gastric glands and 
 hepatic cells are over-stimulated to the production of pathological secre- 
 tions. If the ingestion is continued, even in moderate quantities fre- 
 quently repeated, chronic gastritis ensues, gastric mucus is poured out 
 in large amount, the gastric glands soon atrophy, and the permanent 
 dyspepsia of drunkards is set up, with morning vomiting of glairy mucus. 
 The further effects of large doses are the total arrest of digestion, the 
 production of intoxication, perhaps hallucinations and delirium, also 
 great incoordination of thought and motion, depressed sensibility, depres- 
 sion of the heart and respiration, lowered arterial tension and body- 
 temperature, abolished reflexes, stupor, and, if the dose be sufficient, 
 coma and death. 
 
 Upon the Blood Alcohol acts to first increase and then diminish the 
 ameboid movements of the white corpuscles, and so affects the red cor- 
 puscles as to prevent the oxyhemoglobin from readily parting with its 
 oxygen. It consequently- diminishes the oxidation of the tissues, and 
 may lead to imperfect combustion of fat, which then accumulates. The 
 result is obesity in many persons who habitually consume large quantities 
 of alcoholic beverages, especially if these contain much saccharine 
 material. 
 
 Upon the Heart and Circulation the first effects of Alcohol are those 
 of slight and brief stimulation by reflex action. After its absorption the 
 same effects are exhibited in a more marked degree. The pulse becomes 
 fuller, the action of the heart is quickened and its force increased, due 
 mainly to direct stimulation of its accelerator nerves. The vaso-motor 
 system is inhibited, causing dilatation of all the vessels of the body, espe- 
 cially those of the periphery, and producing a sense of increased body- 
 heat. The blood-pressure is raised, the great increase of cardiac action 
 overcoming the results of the vascular dilatation. The mental and bodily 
 functions are all stimulated for a time, the person feels better for the dram, 
 
134 ALCOHOL. 
 
 his muscular power seems to be increased, more urine is passed, and per- 
 spiration is freer. But these effects are very transitory, and after a brief 
 period of stimulation reaction sets in, and the entire organism is depressed 
 to a lower point than where it was before the ingestion of the alcoholic 
 stimulant. Large doses do not stimulate the heart at all, but immediately 
 depress it, both by reflex action and by direct paralysis after their absorp- 
 tion. A toxic dose may paralyze the heart almost immediately by direct 
 depressant action, but usually, after a very brief period of excitement, 
 insensibility is produced, also stertorous breathing, dilated or contracted 
 pupils, complete muscular resolution, and death by paralysis of the heart 
 and respiration. The action of alcohol upon the heart clearly exemplifies 
 two therapeutic laws : (i) That excessive stimulation is necessarily fol- 
 lowed by depression, and (2) that drugs which in moderate doses excite 
 a function are very apt in large doses to paralyze it. 
 
 The extremists, who find no good whatever in alcohol, hold that it is a fallacy to apply 
 the term " stimulant" thereto, — that alcohol is a paralyzant from first to last, — that its 
 apparent cardiac stimulation is in reality the result of its narcotism of cardiac inhibition, — 
 and that every special sense is blunted by even small doses of this poison. They calmly 
 ignore the fact that their premises apply to every stimulant in its special field of action as 
 well as to alcohol in its sphere, and forget that their conclusion (that alcohol has no place 
 in medicine except as a poison) applies by the same reasoning to every other stimulant. 
 Hence, to be consistent, they should advocate the banishment of all stimulant drugs from 
 the materia medica. 
 
 On the Skin and Kidneys Alcohol is mildly diaphoretic and diuretic, 
 acting partly by its vascular dilatation, partly by stimulation of glandular 
 activity. On the Intestines it has a slightly astringent effect at first, but 
 in those who use it habitually to excess the bowels are always very loose, 
 and the evacuations watery. 
 
 Upon the Nervous System Alcohol has specific and selective action. 
 By a moderate dose this entire system is briefly stimulated, chiefly as a 
 result of increased blood supply due to the vascular dilatation and car- 
 diac elevation. Reaction, however, soon occurs, and if the dose be very 
 large, the period of exaltation quickly passes into one of profound cere- 
 bral depression, but this is usually preceded by marked incoordination of 
 thought and of muscular movement, shown by incoherency of language, 
 difficult speech, and staggering gait. The reflex activity of the spinal 
 centres is abolished next, the urine and feces are discharged involunta- 
 rily ; the depression extends to the respiratory centre, breathing becomes 
 difficult and the face cyanosed ; profound coma supervenes, respiration 
 and the heart are paralyzed, and the patient dies. 
 
 The reflex depression occurs early in the case, and accounts for the 
 impunity with which a drunken man will often bear an injury which 
 would cause death by shock to a sober one. 
 
 The action of Alcohol upon the nervous system illustrates well, in the order of its 
 events, the physiological fact that excessive stimulation is followed by depression ; as well 
 
ALCOHOL. 135 
 
 as the law that drugs which affect the functions progressively exhibit their earliest powers 
 upon those functions which are highest in development (being those latest acquired by 
 the individual and last to appear in the species), and influence next the next lower, until 
 finally the lowest, namely those of respiration and circulation. The primary stimulation 
 and subsequent depression of function proceeds therefore, in a descending scale from the 
 highest or least firmly fixed and latest acquired function, to the lowest or most firmly fixed 
 one. Thus, by Alcohol, the intellect is affected very early and the judgment abolished 
 very soon, even though the imagination, the emotions and the powers of speech remain stim- 
 ulated. Soon these follow the same course, imagination is abolished, the patient loses 
 command over his emotions, cries and laughs immoderately and without reason ; next 
 loses control over his organs of speech, talking incoherently and thickly, and then can 
 only make a noise. At the same time other delicate and lately developed movements, as 
 those required for writing, feeding, etc. , are incoordinately performed and soon paralyzed. 
 General muscular movements, being less highly and earlier developed, are next to become 
 implicated, being first incoordinated, and soon abolished. The paralysis of reflex action 
 follows, though lowered earlier in the case, then paralysis of respiration and finally 
 paralysis of the heart. 
 
 The antipyretic action of Alcohol is partly due to its power of lessen- 
 ing oxidation, but chiefly to the dilatation which even moderate doses 
 produce in the vessels of the surface. This dilatation subjects the warm 
 blood from the interior of the body to the cooling influence of the at- 
 mosphere, also to the cooling due to evaporation from the skin ; and if 
 kept up by repeated drams in a freezing temperature will soon so chill 
 down the blood as to kill the subject. 
 
 Under ordinary conditions the contraction of the cutaneous vessels, in a person ex- 
 posed to cold, prevents the warm blood from approaching the surface in any great quan- 
 tity and becoming cooled ; but this mechanism is temporarily paralyzed by every dose of 
 alcohol, admitting the hot blood to circulate freely over the suriace, and to be rapidly 
 cooled down until the patient maybe absolutely frozen to death as a result of repeatedly 
 taking " something to keep him warm." This fact is well known to Arctic travelers and 
 to the lumbermen of the northern forests, who have been taught by bitter experience to 
 let alcohol alone when exposed to severe cold. 
 
 Delirium Tremens occurs after an alcoholic debauch, usually in cases 
 where the stomach is so deranged as to prevent the ingestion or assimila- 
 tion of food. So long as the toper can eat and digest his food he is 
 practically not liable to this affection. It generally begins in from two 
 to four days after the patient has lost his appetite and commenced to 
 reject or vomit his food ; and is marked by great restlessness, obstinate 
 insomnia, a peculiar tremor of the tongue and limbs; also delusions 
 connected with the sense of sight, the patient imagining that he sees 
 animals around him (dogs, rats, snakes, beetles, etc.). The delirium is 
 constant and active, may become violent and pass into mania, or the 
 patient may die suddenly while in this state, without any warning symp- 
 toms. In several cases observed by the writer the delirium appeared four 
 and five days after the last alcoholic dose was taken, though the patient 
 was eating, sleeping, and working during the interval, apparently conva- 
 lescent. Under treatment, and especially if sleep is brought on, the 
 delirium usually subsides gradually, and the patient recovers. 
 
 Chronic Alcoholism is the result of the ingestion for a considerable 
 
1 36 ALCOHOL. 
 
 length of time of an excessive quantity of alcohol, even though perhaps 
 never sufficient to cause acute intoxication. One of the earliest symptoms 
 usually observed is the vomiting of watery fluid or glairy mucus in the 
 morning after rising. The bowels are generally loose, and the evacua- 
 tions watery. The skin has a greasy look and a satiny feel, and the 
 cutaneous capillaries on the face may become permanently dilated, giving 
 to the cheeks a characteristic, dusky-red hue, and a flaming red color to 
 the nose. In old drunkards, the latter organ often becomes covered on 
 its tip with dusky-red tubercular enlargements, making it a very unsightly 
 appendage. The stomach and liver are in a state of chronic congestion, 
 the food is not digested and often to a great extent abandoned, the 
 patient, in fact, living upon alcohol. Eructations of gas and flatulence 
 are constant and distressing ; the body is usually puffed and bloated, the 
 eyes bleary, red and watery. [One of the most graphic descriptions of 
 the drunkard's personal appearance is that by Trollope, in "Orley Farm," 
 Chapter 57.] 
 
 After a time the connective tissue of the liver increases (hyperplasia), 
 its parenchymatous structure atrophies or undergoes fatty degeneration, 
 the organ contracts (sclerosis), the portal circulation is impaired, the 
 veins of the abdominal integument become prominent, and soon ascites 
 ushers in the final stage. Sclerosis of the kidneys may accompany that 
 of the liver. The general impairment of function extends early to the 
 nervous system, the mental powers are dulled, the temple becomes irri- 
 table, and tremor appears in the tongue, lips and hands. As a result of 
 the prolonged use of alcohol very serious pathological changes take place 
 throughout the organism. It exerts its essential and most injurious influ- 
 ence on the vital organs by its presence in the circulation, being thus 
 brought into direct contact with the cellular tissues of the vital organs. 
 It sets up hyperplasia of the connective tissue, resulting in sclerosis, espe- 
 cially in the stomach, brain, liver and kidneys ; produces fatty degenera- 
 tion (steatosis) of the blood, the arterial walls and the parenchyma of the 
 various organs, depresses the brain, the heart and the arterial tension. 
 Chronic disease of the heart, the arteries and the mucous lining of the 
 stomach and intestines, gout, diabetes, Bright's disease of the kidneys, 
 paralysis, ataxia, peripheral neuritis, epilepsy, amaurosis, and insanity 
 may result from the continued use and abuse of alcohol. The malt liquors 
 (beer, ale, etc.) are less prone than spirits to affect the brain, but are even 
 more apt to set up fatty degeneration of the heart and liver. The heart 
 is very liable to undergo gradual hypertrophy, partly by reason of the 
 constant whipping up it receives from every dram of alcohol taken, and 
 partly as a result of renal sclerosis. Several of the largest hearts ever 
 seen by the writer at autopsies, some of which were veritable instances 
 of cor bovinum, occurred in subjects of chronic alcoholism associated with 
 
ALCOHOL. I37 
 
 employment involving exposure and great anxiety, as in masters of steam- 
 ships, superintendents of mines, etc. 
 
 Impurities in Alcohol increase greatly its toxic action ; so that inferior 
 brandy from a public liquor shop has a lethal action nearly one-half 
 greater than that of pure ethyl alcohol. (Dujardin-Beaumetz.) 
 
 Alcoholic Coma may be easily confounded with that of apoplexy, opium narcosis, con- 
 cussion of the brain, acute pneumonia, uremia and epilepsy, the differential diagnosis 
 being almost impossible to make with accuracy when the coma is deep. The pupils afford 
 no trustworthy indication, as they may be either dilated or contracted in alcoholism. 
 They are often unequally contracted in apoplexy, and in apoplexy of the pons varolii they 
 may be equally and minutely contracted, as in opium-poisoning. The difficult}* of diag- 
 nosis is increased by the common practice of giving a dram of whiskey as a reviver, so 
 that a stranger found insensible on the street and brought to a hospital may smell of 
 alcohol without having been the subject of alcoholism. When no accurate history of the 
 case can be obtained the diagnosis is impossible in many cases. 
 
 Alcohol is rapidly diffused throughout the organism, which oxidizes a 
 portion of it, about an ounce and a half for the adult in 24 hours, the 
 oxidation yielding force, which is utilized as nervous, muscular, and 
 glandular power. A large quantity is decidedly poisonous, as it sets up 
 structural changes in the various organs, and lowers the power of resist- 
 ance to morbific influences. It renders its victims particularly liable to 
 phthisis, and has frequently caused directly an intractable form of that 
 disease, pulmonary sclerosis. It makes patients bad subjects for with- 
 standing any severe illness, especially pneumonia, or to successfully 
 undergo severe surgical operations. 
 
 The portion not oxidized is excreted unchanged by the lungs, the skin 
 and the kidneys, but does not appear in any quantity in the urine unless 
 very large amounts have been ingested. The very young and the very 
 old bear more alcohol relatively than the adult. It has been proven to 
 exist normally in the human organism, and within the limit above stated 
 it is undoubtedly a food, as is shown by the fact of its retention and com- 
 bustion in the body, supplying the place of other foods, so that the quan- 
 tity of food which without it would be insufficient, with its aid becomes 
 sufficient to maintain the body-weight. 
 
 Treatment of Acute Alcoholic Poisoning. 
 
 If a very large dose has been taken recently, the stomach should be evacuated of what 
 is unabsorbed. Then Ammonia may be given by inhalation cautiously, warmth applied 
 to the extremities, cold affusion to the head, faradism of the muscles of respiration. 
 Milk, mucilaginous drinks, black coffee, are useful afterwards. Lupidin as a substitute 
 stimulant, or Capsicum in 20 to 30 grain doses. Chloral, in doses of 30 grains, repeated 
 in two hours, to secure sleep, is very efficient, or 30 grains each of Chloral and Potas- 
 sium Bromide, for the same purpose. Chloral is said by teachers to be dangerous in old 
 alcoholic cases, but the daily experience of physicians of inebriate asylums does not cor- 
 roborate this statement. Xutritious, digestible diet in liquid form and small quantity fre- 
 quently repeated, is an essential feature of the treatment. Ammonium Chloride. % ss in 
 y 2 pint of water at one draught, and the Liquor Ammonii Acetatis, in doses of 5 j. are 
 said to have marvellous power in straightening up a drunken subject, restoring the facul- 
 ties and antagonizing stupor. 
 
I38 ALCOHOL. 
 
 Treatment of Delirium Tre??iens. 
 Two principal objects are aimed at, — to support the strength by nutritive diet, and to 
 overcome the obstinate and exhausting insomnia and restlessness. For the latter pur- 
 pose the mixture of Chloral and Potassium Bromide above mentioned is by far the most 
 efficient agent, and the dose (gr. xxx of each) may be repeated every two hours until 
 sleep is secured. Digitalis has been administered in large doses to quiet the delirium, 
 and successfully in some cases, but this is a very dangerous treatment. (Brunton. ) 
 Opium or Morphine may be used in cases which show signs of exhaustion, but should be 
 confined to such alone. Its general employment in this affection is decidedly injurious. 
 Bismuth, with Magnesia and Hydrocyanic Acid, for the vomiting. Nutrient Enemata 
 may be required, if the patient is unable to retain food. Alcohol should not be given. 
 
 Treatment of Chronic Alcoholism. 
 
 The continued ingestion of alcohol in excessive quantities is not a disease, as sentimen- 
 talists would have us believe, but is simply a vicious drug-habit, and may be overcome, 
 like any other drug-habit, by the exercise of the subject's will-power alone in abstaining 
 therefrom. The effort to gradually reduce the amount consumed simply prolongs the 
 agony and is much less efficient than the total and immediate withdrawal thereof entirely. 
 This should be carried out in an inebriate asylum in most cases. Strychnine is a specific 
 remedy for alcoholism, and the basis of all the so-called "cures" which are extensively 
 advertised under the gold-extracting title of " Gold Cure." Ten to twelve minims of a 
 solution of Strychnine Nitrate, gr. iij in % x of distilled water, should be injected hypo- 
 dermically 3 or 4 times a day for two weeks, and less often for two weeks more, gradually 
 reducing the dose and frequency of administration. 
 
 Therapeutics of Alcohol. 
 
 The external and local use of alcohol in medicine includes many appli- 
 cations of its antiseptic, astringent, refrigerant and rubefacient qualities. 
 Diluted, in the proportion of four parts to one of water, it makes an 
 excellent lotion for bruises, sprains, and other slight injuries, where it is 
 desired to cool the part and check impending inflammation. A per- 
 fumed spirit, as Cologne Water, is commonly used as a lotion to the fore- 
 head for the relief of headaches. Alcohol does good service as an appli- 
 cation to prevent bed-sores and cracked nipples, as it hardens the inflamed 
 skin by abstracting water therefrom and coagulating the albumin tempo- 
 rarily. Diluted alcohol is applied on the surface of the body in fevers, 
 to cool the skin and check excessive sweating. Alcoholic liniments (Lin- 
 imentum Camphorae, etc.) are rubbed into the cutaneous tissue for their 
 rubefacient effect, to aid the absorption of inflammatory products and to 
 relieve pain, in chronic rheumatism, lumbago, myalgia, etc. As a gargle 
 or spray, diluted alcohol is one of the very best local agents in tonsillitis, 
 pharyngitis, and other inflammatory affections of the throat, especially 
 diphtheria, in which disease it fulfils several important purposes, acting 
 as an efficient local antiseptic, astringent and anesthetic. Among miners, 
 hunters, frontiersmen and others, lotions of whiskey or brandy are in 
 common use as applications to wounds and sores, and they could not find 
 a more efficient agent for the purpose, when conjoined with thorough 
 cleanliness of the lesions. 
 
 Internally, in small quantities taken just before or during a meal, alco- 
 hol is an efficient aid to digestion, especially in the aged and feeble, or 
 
ALCOHOL. 139 
 
 persons who are greatly exhausted by overwork. In the atonic indigestion 
 of nervous and depressed subjects and in cholera infantum, good brandy 
 is universally found to be beneficial. Care must be taken, however, not 
 to exceed the amount which agrees with the case, for large quantities 
 precipitate pepsin, paralyze the gastric secretions, and set up a subacute 
 gastritis, which will become a chronic one if the indulgence is persisted 
 in, with eventual atrophy of the gastric glands. 
 
 In the form of a sparkling wine, as champagne, or as brandy and soda- 
 water, alcohol may control vomiting from many causes, especially that of 
 yellow fever and sea-sickness. A single full dose of strong whiskey or 
 brandy is often a very efficient combatant of fainting or of collapse, by 
 its prompt reflex stimulation of the circulation. Diarrhea of simple 
 form may be checked by a dram of good brandy, acting as a tonic 
 astringent to the intestines. An attack of acute coryza, or a cold from 
 exposure beginning with a chill, may frequently be aborted by a full dose 
 of spirits in hot water taken just before going to bed, for the purpose of 
 relaxing the peripheral vessels and thus promoting diaphoresis and restor- 
 ing the disturbed balance of the circulation. In anemia and chlorosis 
 good red wines are almost indispensable, also in convalescence from 
 acute diseases, sudden and profuse hemorrhages, and many other morbid 
 conditions. In phthisis alcohol does good service if it promotes assimila- 
 tion and assists digestion, shown by increase of the body-weight during 
 its employment. It is invaluable in poisoning by cardiac depressants and 
 snake-venom, and in cardiac failure from any cause. 
 
 In many fevers, Alcohol is often very serviceable, but may do harm if 
 used therein without discrimination. Its powers of lessening oxidation, 
 of being itself oxidized in the body and acting as a food, of reducing 
 body-temperature and promoting perspiration and sleep, are all indica- 
 tions for its beneficial employment in most febrile conditions ; while its 
 stimulant action on the heart may be available in such diseases as typhoid 
 fever, lobar pneumonia, etc., to tide that organ over a brief period of 
 depression or a condition of impending collapse. Furthermore, for some 
 unexplained reason, it often slows the pulse in fever, and when it does so 
 its moderate use will be of general benefit to the patient. The danger is 
 that if continuously given in such affections it may fail to make the 
 required impression when an emergency calling for it occurs. The best 
 rule to observe for its administration in typhoid, diphtheria, pneumonia 
 and other fevers is to withhold it until the first sound of the heart becomes 
 feeble and dull, and then to use it boldly but not excessively. Many 
 authorities urge its continuous administration in diphtheria, probably 
 from a belief in its antiseptic action on the poison in the blood, similar 
 to that which it undoubtedly exercises against the venom of the rattle- 
 snake. It is an absolute necessity in the treatment of acute lobar pneu- 
 
140 ALETRIS — ALLIUM. 
 
 monia, if the patient has been accustomed to its daily use as a beverage \ 
 but in other subjects of this disease it is best given at the crisis only, to 
 tide the patient over a brief period of extreme danger. 
 
 Recent researches as to the action of alcohol upon vital resistance to infection, by Drs. 
 Abbott and Delearde, seem to show that it has a decidedly injurious influence upon 
 animals inoculated with cultures of the germs of certain infectious diseases. Alcoholized 
 rabbits died when inoculated with Streptococcus pyogenes and Bacillus coli communis in 
 attenuated cultures which did not kill non-alcoholized control ones. Animals vaccinated 
 against tetanus and afterwards alcoholized, soon lose their immunity ; and those vacci- 
 nated against tetanus and at the same time alcoholized, do not readily acquire immunity. 
 Similar results we're obtained with regard to rabies and anthrax. The conclusion is drawn 
 that strong doses of alcohol should not be administered to persons suffering from certain 
 infectious diseases, as pneumonia, or from certain intoxications, as that produced by snake- 
 venom, during which an increase in the number of leucocytes appears to be a necessary 
 part of any process leading to the cure of the patient. 
 
 The use of alcoholic beverages in moderate quantity by healthy persons 
 is violently condemned by extreme total abstinence advocates, who make 
 use of garbled quotations from medical authorities to support their argu- 
 ments. Physicians generally agree with Mr. Lawson Tait, who declared 
 himself " fully persuaded after thirty years of life, as hard in work and 
 as full of responsibility as well could be, that the moderate use of alcohol 
 is a necessity in our modern life." Dr. Robert Farquharson sums up the 
 case for moderate drinking as follows : " All stimulant is unnecessary for 
 the young and for people living perfectly healthy lives. But, under the 
 stress and struggle of modern civilization, few of us beyond middle age 
 are placed under normal physiological conditions, and a little alcohol 
 helps us to round the corners, and to plane away the asperities of 
 existence. In turns it may be a stimulant, or a sedative, or a tonic, or a 
 digestive, or an actual food ; and unless we run on into excess, no 
 physical damage can possibly be done to our tissues. The argument 
 in its favor, when wisely and prudently used, seems complete. It does 
 us good, and can do us no harm." 
 
 ALETRIS, Colic-root (Unofficial), — is the rhizome of Aletris farinosa, the Star- 
 wort, an indigenous perennial plant which grows in grassy places and in sandy woods. It 
 contains starch, and a bitter principle, but no tannin. This plant was formerly official, 
 and is now widely advertised by the proprietors of an Aletris Cordial, as being tonic, 
 emetic, purgative, diuretic, carminative, sialogogue and anti-rheumatic, also " the most 
 powerful of uterine stimulants," a specific for dysmenorrhea and a wonderful remedy 
 for colic, dropsy, and chronic rheumatism. It is little more than a simple bitter in small 
 doses, though in very large ones it may prove emeto-cathartic. Dose, of the powdered 
 root, gr. x; of the infusion (^j to the pint), J ss. 
 
 ALLIUM, Garlic, is the bulb of Allium sativum, a plant of the nat. ord. Liliacese, 
 indigenous to Asia, but cultivated in Europe and America. Its odor is pungent and dis- 
 agreeable and its taste warm and acrid. It contains a Volatile Oil, which consists 
 mainly of the Sulphide of Allyl (C 3 H 5 ~) 2 S, on which its qualities depend. Allied species 
 are Allium Cepa, the Onion, and Allium Porrum, the Leek. 
 
 Syrupus Allii, Syrup of Garlic, — contains 20 per cent, of Garlic, Sugar and Dilute 
 Acetic Acid. Dose, gj-iv, according to age. 
 
ALNUS ALOE. I4I 
 
 Garlic, Leeks and Onions are stimulants to the digestion and to the nervous system, and 
 are supposed to have a special influence upon the bronchial secretion. Garlic is also 
 thought to be emmenagogue and anthelmintic. It promotes diaphoresis and diuresis, and 
 acts as a tonic and carminative. Many persons use it as a condiment. Large doses will 
 often produce gastric irritation, flatulence, hemorrhoids, headache and fever. In domes- 
 tic practice it is frequently employed as an external application in the cutaneous eruptions 
 of children, and as a poultice or liniment in infantile disorders of many kinds. Inter- 
 nally it is of real benefit in feeble digestion and flatulence, chronic catarrhal affections of 
 children, nervous and spasmodic coughs, and nervous vomiting. 
 
 ALNUS, Alder-Bark (Unofficial), — is the bark of Alnus serrulata, the common 
 American Alder, a small tree of the nat. ord. Betulaceae. It has similar properties to 
 those of A. glutinosa, the European Alder, and A. urcana, the Tag Alder, and contains 
 a tannic acid, an oil, and a resin. The bark and leaves are astringent and bitter, and are 
 chiefly used as gargles for the throat, as local applications to wounds and ulcers, and to 
 restrain the secretion of milk. Dose of the powerful bark gr. x, in decoction or infu- 
 sion, several times a day. The Tag Alder is highly recommended as a hemostatic. 
 
 ALOE, Aloes, — is official in the two following-named varieties, also 
 as the Purified Aloes preparation, and the neutral principle, Aloin. 
 
 Aloe Barbadensis, Barbadoes Aloes, — is the inspissated juice of the 
 leaves of Aloe vera, a plant of the nat. ord. Liliacese. It occurs in 
 opaque, hard, orange-brown masses, of saffron-like odor and bitter taste. 
 
 Aloe Socotrina, Socotrine Aloes, — the inspissated juice of the leaves 
 of Aloe Perryi, nat. ord. Liliaceae, inhabiting the island of Socotra and 
 the eastern coast of Africa near the Red Sea. The plant has orange- 
 colored flowers and resembles in appearance the American aloe or cen- 
 tury-plant {Agave americand). Aloes occurs in soft masses of a yellowish- 
 brown color, fragrant odor and bitter taste, soluble in alcohol and in 
 boiling water. It contains a peculiar volatile oil, a resin, and Soaloin, 
 C 15 H 16 7 , a variety of the principle Aloin,' which is common to all 
 varieties of aloes, — also Aloetic and Chrysammic Acids. Dose, gr. j-v. 
 
 Aloe Capensis, Cape or Natal Aloes, from Aloe ferox, is another 
 variety of the same plant. 
 
 Aloinum, Aloin, — a neutral principle obtained from several varieties 
 of Aloes, chiefly the above-named, which yield respectively Barbaloin and 
 Soaloin. These principles are soluble in 60 parts of water, 20 to 30 of 
 alcohol, and in 380 to 470 of ether. Soaloin is soluble in 9 parts of 
 acetic ether. Dose, gr. ss-ij. 
 
 Preparations. 
 
 Aloe Purificata, Purified Aloes, — prepared from Socotrine Aloes by melting and 
 mixing with Jth of Alcohol, straining and evaporating. The product is in irregular, 
 dull-brown, brittle pieces, almost entirely soluble in alcohol. From it are prepared the 
 following preparations. Dose, gr. j-v. 
 
 Extractum Aloes, Extract of Aloes, — prepared by mixing I part of Socotrine Aloes 
 with 10 parts of Boiling Distilled Water, standing 12 hours, decanting, straining and 
 evaporating. Dose, gr. ss-v. 
 
 Tinctura Aloes, Tincture of Aloes, — has of Aloes 10, Glycyrrhiza 20, Diluted 
 Alcohol to 100 parts. Dose, 3 ss-ij. 
 
142 ALTH^A. 
 
 Tinctura Aloes et Myrrhae, Tincture of Aloes and Myrrh, — Aloes 10, Myrrh 10, 
 Glycyrrhiza 10, Alcohol and Water to loo parts. Dose, gss-ij. 
 
 Pilulae Aloes, Pills of Aloes, — each has Aloes and Soap, 2 grains of each. 
 
 Pilulae Aloes et Asafetidse, Pills of Aloes and Asafetida, — each pill contains gr. 
 1^ of each ingredient. 
 
 Pilulae Aloes et Ferri, Pills of Aloes and Iron, — each pill contains gr. j each of 
 Aloes, Sulphate of Iron and Aromatic Powder, with Confection of Rose. 
 
 Pilulae Aloes et Mastiches, Pills of Aloes and Mastic, Lady Webster's Pill, — each 
 pill has of Aloes gr. ij, Mastic gr. ss, Red Rose, gr. ss. 
 
 Pilulae Aloes et Myrrhae, Pills of Aloes and Myrrh, — each pill contains of Aloes 
 gr. ij, Myrrh gr. j, Aromatic Powder gr. ss, mixed with Syrup. 
 
 Pulvis Aloes et Canellae, Powder of Aloes and Canella (Unofficial), — contains the 
 powdered bark of Canella alba. Dose, gr. v-xx. 
 
 Pilulae Lapacticae, Lapactic Pills (Unofficial), — each pill contains of Aloin gr. \, 
 Strychnine gr. -^, Extr. Belladonna gr. \, Ipecac gr. y 1 ^. Dose, ij-viij. 
 
 Aloes is also a constituent of Pilulae Rhei Composite and Tinctura Benzoini Com- 
 posita (which see, under Rheum and Benzoinum respectively). 
 
 Physiological Action and Therapeutics. 
 
 Aloes is a tonic-astringent and resin-bearing purgative, an emmena- 
 gogue and an anthelmintic against the thread-worm. As a cathartic it 
 acts chiefly on the lower half of the large intestine, doses of gr. j-iv 
 producing in about 10 hours copious soft evacuations with some griping 
 pain. This effect is produced whether the drug be taken internally or 
 absorbed from an exposed surface, so that it probably diffuses into the 
 blood and is eliminated by the mucous membrane of the colon. It is a 
 stomachic tonic in small doses, a stimulant of the hepatic functions, and 
 an excitant of the pelvic circulation. It may cause abortion in the 
 female and priapism in the male, and is said to have frequently produced 
 hemorrhoids, which if existing it will aggravate. Given to nursing 
 mothers it imparts a purgative quality to their milk. 
 
 Aloes is chiefly used in combination with Iron, Myrrh, Nux-vomica, 
 etc., for amenorrhea and chronic constipation with atonic dyspepsia and 
 hypochondriasis. It is curative in certain forms of hemorrhoids, espe- 
 cially those occurring after delivery and where the condition is not one 
 of active pelvic congestion. It is also used internally and as an injec- 
 tion in gonorrhea, and for simple atonic jaundice. It must be avoided 
 in irritable rectum, hemorrhoids of active form, menorrhagia and preg- 
 nancy, unless given in small doses and with care. The Pil. Aloes et 
 Ferri is perhaps the most generally used agent in the anemia, amenor- 
 rhea and constipation of girls at the period of puberty. 
 
 ALTH/EA, Marsh-Mallow, — is the root of Althcea officinalis, a European plant 
 of the nat. ord. Malvaceae. It contains about 35 per cent, each of vegetable mucus and 
 starch, with 2 per cent, of Asparagin, also pectous matter, sugar, fixed oil, but no tan- 
 nin. It is a constituent of Massa Hydrargyri and Pilulse Phosphori, and is much used 
 as an excipient in extemporaneous pharmacy. Dose, indefinite. 
 
 Syrupus Althaeae, Syrup of Althcea, — has of Althaea 5 per cent., and should be 
 freshly made. Dose, indefinite. 
 
ALUMEN ALUMINUM. I43 
 
 Althaea is one of the best mucilaginous drugs, but has no active medicinal properties. 
 It is used in Europe to make pectoral teas and syrups, and is extensively employed as a 
 mucilaginous demulcent. The powdered root makes a good emollient poultice. In the 
 Phar. Ger. a Compound Althaea Tea is official, which under the common name, "Ger- 
 man Breast Tea," is a popular demulcent drink in bronchial affections, coughs, etc. 
 
 Asparagin is an organic principle, occurring in large rhombic crystals, and found in 
 many other plants, as in the shoots of asparagus, vetches, potatoes, liquorice, the sweet 
 almond, the root of the locust, etc. It is considered a derivative of Succinic Acid, and 
 has diuretic properties, besides being sedative to the circulation. It may be used in 
 ascites, especially in children, in the anasarca of Bright' s Disease, and in gout. Dose, 
 gr. ij-iij, in water. 
 
 ALUMEN, Alum, Potassium Alum, — is Aluminum and Potassium 
 Sulphate, A1 2 K 2 (S0 4 ) 4 -j- 24.H 2 0, which, when the 24 molecules of water 
 are driven off, becomes Alumen Exsiccatum, Dried Alum, A1 2 K 2 - 
 (SOJ 4 . Alum occurs in large, octahedral crystals, or cubes, of sweetish 
 astringent taste and acid reaction. It is soluble in 9 parts of water and 
 in 0.3 of boiling water, but is insoluble in alcohol. The Ammonia-alum 
 (Alumini et Ammonii Sulphas) was formerly official, and is still sold and 
 dispensed as Alum. Dose, gr. x-xx, — as an emetic gj for a child. 
 
 Alumen Exsiccatum, Dried Ahtm, — is a white, granular powder, slowly soluble in 
 20 parts of water at 59 F., and quickly soluble in 0.7 of boiling water. Dose, gr. x-xx. 
 
 Alum is an astringent, coagulating albumin and stimulating muscular 
 contraction. At first it excites the flow of saliva and then markedly 
 diminishes it. It coagulates pepsin and arrests digestion, stops peristal- 
 sis, and usually causes constipation, though sometimes inducing diarrhea. 
 Although coagulating albumin, even in weak solution, it enters the blood, 
 constricts the capillaries, arrests secretions, especially those of mucous 
 surfaces, and stops capillary hemorrhage. In teaspoonful doses it is an 
 efficient and non-depressant emetic. In large doses it is a gastrointes- 
 tinal irritant, one ounce and five-eighths of dried Alum having caused 
 the death of an adult in eight hours. 
 
 Alum is used locally as an astringent in chronic catarrhs, leucorrhea, 
 gonorrhea, hemorrhoids, bed-sores, ulcers, relaxed throat, colliquative 
 sweats, catarrhal ophthalmia and granular lids. The dried powder is 
 escharotic, destroying granulations and warty growths, and is used by in- 
 sufflation in chronic nasal catarrh. Internally it is beneficial in gastric 
 catarrh, gastralgia, enteralgia, passive hemorrhages, lead colic and con- 
 stipation. As an emetic it is employed in croup, and it is a good anti- 
 dote in lead-poisoning. Alum is best administered alone, as it forms 
 precipitates with a large number of drugs. 
 
 ALUMINUM.— This metal is not official, though of its salts two are official besides 
 Alum. They are — 
 
 Alumini Hydras, Aluminum Hydrate, Hydrated Alumina, Al 2 (OH) 6 , — is a white, 
 light, amorphous, tasteless powder, insoluble in water or alcohol, but soluble in strong 
 alkaline or acid solutions. Dose, gr. iij-xx in powder or mixture. 
 
144 AMMONIACUM AMMONIUM. 
 
 Alumini Sulphas, Aluminum Sulphate, A1 2 (S0 4 ) 3 -)- i6H 2 0, — is a white crystalline 
 powder, soluble in 1.2 of water at 59 F., almost insoluble in alcohol. Used locally. 
 
 The Hydrate is a feebly astringent and desiccant powder, occasionally used in inflam- 
 matory skin affections as a local application, and internally in diarrhea. 
 
 The Sulphate is antiseptic and astringent. It has been used internally in diarrheas, 
 but is chiefly employed in a 5 per cent, solution locally to ulcers, or in stronger solution 
 ( ^iij ad 3 vj) in foul discharges from mucous surfaces. A saturated solution is a mild 
 caustic, and may be used daily as a local application to enlarged tonsils, nasal polypi, 
 ulceration of the os uteri, and various chronic enlargements. The Benzoinated Solution 
 of Alumina is an unofficial preparation used for the same purposes. 
 
 Alumnol (Unofficial), — is an aluminum salt of naphtol-sulphonic acid, and is 
 readily soluble in cold water. It is markedly antiseptic and astringent, and though pre- 
 cipitating gelatin and albumin, the precipitate is soluble in an excess of ether, so that 
 when it is used on purulent discharges they do not clog up cavities, and desirable pene- 
 tration below the surface is accomplished. It has been used both dry and in solution, 
 as a dressing for wounds, ulcers, etc., also for acute inflammatory and parasitic affections 
 of the skin, and in acute and chronic inflammations of mucous membranes. In 1 to 3 
 per cent, solution it makes a good injection for gonorrhea, the weaker solution destroy- 
 ing gonococci without increasing inflammation (Chotzen). A 4 per cent, solution is 
 used by ophthalmologists to check lachrymal discharge during an examination of the eye. 
 It neither irritates nor causes pain. It is four times as expensive in this country as in 
 Germany, where it originated. 
 
 AMMONIACUM, Ammoniac, — is a gum-resin, obtained from Dorema Ammo- 
 niacum, a Persian plant of the nat. ord. Umbelliferae. When triturated with water it 
 readily yields a milk-white emulsion, and contains a Volatile Oil, which differs from that 
 of Asafetida, in that it is neither sulphuretted nor phosphoretted. It also contains resin, 
 gum, gluten, etc. Dose, gr. x-xxx. 
 
 Emulsum Ammoniaci, Emulsion of Ammoniac, — an emulsion with water of 4 per 
 cent, strength, the resin being suspended by the contained gum. Dose, ^ss-j. 
 
 Emplastrum Ammoniaci cum Hydrargyro, A??imoniac Plaster with Mercury. — 
 Ammoniac 72, Mercury 18, Oleate of Mercury 8 per cent., containing also Lead-plaster 
 and Dilute Acetic Acid. 
 
 Ammoniac is a stimulating expectorant and a laxative, and has a mildly irritant action 
 on the skin. Its actions are similar to those of Asafetida, but much less powerful. It 
 is not much used, but may be employed with benefit in chronic bronchial affections, 
 especially of the aged, the mixture with Ammonium Chloride or Carbonate facilitating 
 expectoration and lessening wheezing. It is also recommended in asthma, and in glan- 
 dular enlargements and indolent swellings the plaster is employed as a stimulating alter- 
 ative and resolvent. 
 
 AMMONIUM, NH 4 , — is a hypothetical compound radical, which 
 does not exist in the free state, but in combination with acids forms salts 
 which closely resemble those of the elements Potassium and Sodium. 
 Many of its salts are official, as well as the aqueous solutions of the gas 
 Ammonia, NH 3 , which is produced during the putrefaction of all organ- 
 isms and many organic nitrogenous compounds. Ammonia exists in the 
 air and in the soil in the free state, and is contained in the products of 
 the dry distillation of many nitrogenated compounds. The so-called 
 "gas-liquor," a by-product in the manufacture of illuminating gas, when 
 neutralized by hydrochloric acid, yields Ammonium Chloride, NH 4 C1, 
 and from this salt are derived all the other ammonium compounds em- 
 ployed in medicine. 
 
AMMONIUM. I45 
 
 Preparations of Ammonia. 
 
 Aqua Ammoniae, Ammonia Water, — is an aqueous solution of Ammonia, contain- 
 ing 10 per cent, by weight of the gas. It is a colorless liquid of pungent odor, acrid 
 taste and strongly alkaline reaction. Dose, V(\v-£ ss, well diluted. 
 
 Aqua Ammoniae Fortior, Stronger Ammonia Water, — contains 28 per cent, by 
 weight of the gas. Sp. gr. 0.901 at 59 F. 
 
 Spiritus Ammoniae, Spirit of Ammonia, — is a 10 per cent, solution of the gas in 
 alcohol. Sp. gr. about 0.810. Dose, TT^x-^j, diluted. 
 
 Spiritus Ammoniae Aromaticus, Aromatic Spirit of Ammonia, — contains Ammo- 
 nium Carbonate, Aqua Ammoniae, Oils of Lemon, Lavender, and Nutmeg, Alcohol and 
 Water. Used in the Tinct. Guaiaci Ammoniata and the Tinct. Valerianae Ammoniata. 
 Dose, gss-ij. 
 
 Linimentum Ammoniae, Ammonia Liniment, — has of Aqua Ammoniae 35 parts, 
 Cotton-seed Oil 60, Alcohol 5 parts. 
 
 Ammonium Salts and their Preparations. 
 
 Liquor Ammonii Acetatis, Solution of Am?nonium Acetate {Spirit of Minder ems'), 
 is prepared by neutralizing dilute acetic acid with ammonium carbonate. It contains 
 about 7 per cent, of the acetate and is an ingredient of Liquor Ferri et Ammonii Ace- 
 tatis. It should be freshly made as it soon deteriorates. Dose, 3J-,^j. 
 
 Ammonii Benzoas, Ammonium Benzoate, NH 4 C 7 H 5 2 , — minute four-sided, lami- 
 nar crystals, soluble in 5 of water and 28 of alcohol at 59 F. Dose, gr. v-xv. 
 
 Ammonii Bromidum, Ammonium Bromide, NH 4 Br, — prismatic crystals or a gran- 
 ular salt, soluble in \)/ 2 of water and 30 of alcohol at 59 F. Dose, gr. ij-xx, well 
 diluted. Children bear it well if epileptic from reflex causes ; a child I year old will 
 tolerate gr. v every 4 hours (Barton). 
 
 Ammonii Carbonas, Ammonium Carbonate, NH 4 HC0 3 .NH 4 NH 2 C0 2 , — occurs in 
 white masses consisting of both the bicarbonate and carbonate, which on exposure to 
 air become a white powder (acid carbonate). Soluble in 5 parts of water. Dose, gr. 
 iij-x. For children small doses, gr. ]i~\}, frequently repeated. 
 
 Ammonii Chloridum, Ammonium Chloride [Sal-ammoniac], HN 4 C1, — a white, 
 crystalline powder, of saline taste, and slightly acid reaction ; soluble in 3 of water and 
 very sparingly in alcohol. Dose, gr. j-xx. 
 
 Trochisci Ammonii Chloridi, Troches of Ammonium Chloride, — each contains 1^ 
 grains of the Chloride. Dose, j-x troches. 
 
 Ammonii Iodidum, Ammonium Iodide, NH 4 I,— a deliquescent, granular, white 
 salt, soluble in I of water and in 9 of alcohol at 59 F. Dose, gr. ij-x. 
 
 Ammonii Nitras, Ammonium Nitrate, NH 4 N0 3 , — colorless crystals or fused masses, 
 soluble in 0.5 of water and in 20 of alcohol at 59 F. Only used to prepare Nitrous Oxide 
 Gas for anesthesia by heating to 365 ° F. 
 
 Ammonii Valerianas, Ammonium Valerianate, NH 4 C 5 H 9 2 , — in white, quad- 
 rangular plates, deliquescent ; very soluble in water and alcohol. Dose, gr. j-v. 
 
 Raspail's Eau Sedative (Unofficial), — consists of the Aqua Ammoniae !| ij, Sodii 
 Chloridum ^ij, Spiritus Vini Camphorat. ^iij, Aqua ^xxxij. For local use. 
 
 Physiological Action. 
 The gas Ammonia is intensely alkaline and irritant to mucous mem- 
 branes; inhaled producing spasmodic cough and a sense of suffocation. 
 Its prolonged inhalation will produce violent -inflammation of the air-pas- 
 sages and edema of the glottis. It stimulates the nasal branch of the fifth 
 nerve, exciting the vaso-motor centre by reflex action, and thus raising 
 the arterial tension. Applied to the skin and allowed to evaporate, it has 
 a slight rubefacient effect, but if evaporation be prevented it penetrates 
 the epidermis, and has a powerfully vesicant action. The Aqua, swal- 
 
I46 AMMONIUM. 
 
 lowed undiluted, may cause death quickly by suffocation from the action 
 of its vapor upon the air-passages ; if not, it may excite gastro-enteritis 
 accompanied by coma, differing in the latter respect from potassium or 
 sodium poisoning. After absorption it stimulates both the respiration 
 and the circulation by direct action on their respective nerve-centres. 
 Ammonia exists normally in the circulation, where it keeps the fibrin in 
 solution and thus maintains the fluidity of the blood. It increases the 
 glycogenic function of the liver, and is converted finally into urea. It 
 is a powerful irritant to muscular tissue, causing tetanic contraction and 
 subsequent rigor mortis when directly applied. 
 
 All Ammonium Salts stimulate and finally paralyze the spinal cord, 
 motor nerves and muscles, in animals, but the order and intensity of 
 the action vary with the salts employed, some having a predominating 
 influence on the cord, others on the motor nerves. In general they may 
 be said to form a series, of which the members at one end stimulate the 
 cord, and those at the other paralyze both the cord and the motor nerves. 
 At the stimulant end are Ammonia and the Chloride ; at the paralyzant 
 end the Iodide ; the Bromide, Phosphate and Sulphate lying between 
 (Brunton). In medicinal doses they act on man as stimulating expec- 
 torants, in large quantity they injure the structure of the red blood- 
 corpuscles, and if long continued they produce rapid emaciation by im- 
 pairing digestion and increasing tissue-waste. 
 
 The Chloride has decided cholagogue powers, increases the excretion 
 of urea, in 20-grain doses is purgative, and is considered to have a select- 
 ive action upon the gastric mucous membrane. The Carbonate is a pow- 
 erful and very diffusible stimulant ; when administered internally in 
 moderate doses it is probably decomposed by the HC1 of the gastric 
 juice, nascent ammonia being set free and absorbed. It stimulates the 
 respiratory centre, acts as a stimulating expectorant, and in very small 
 doses stimulates the secretion of the gastric juice. It is also emetic, and 
 has been supposed to prevent iodism when administered conjointly with 
 Potassium Iodide. The Solution of the Acetate is an active diaphoretic 
 if the body be warm, or a diuretic if it be cool. In wineglassful doses it 
 will counteract many of the immediate effects of alcohol. The Phosphate 
 is diuretic, and is believed to decompose the insoluble sodium urate in 
 the blood, converting it into the soluble salts ammonium urate and sodium 
 phosphate, and thus promoting its elimination. The Benzoate is also 
 diuretic, and like Benzoic Acid passes out of the system in the urine as 
 hippuric acid. It stimulates the liver, and acidifies the urine where there 
 is phosphatic tendency thereof. The Nitrate and Sulphate are only used 
 for the preparation of other salts, while the Iodide, Bromide and Vale- 
 rianate correspond in action to that of their titular bases, and are described 
 under their respective titles, Iodum, Bromum and Valeriana. . 
 
AMMONIUM. I47 
 
 Antidotes and Antagonists. 
 
 When Ammonia is inhaled in excess give HC1 vapors by inhalation to form the chlo- 
 ride ; if taken in solution, give Vegetable Acids, also demulcents to protect the mucous 
 surfaces. Its physiological antagonists are the cardiac sedatives, Aconite, Digitalis, 
 Veratrum, etc. 
 
 Therapeutics. 
 The strong Solution of Ammonia may be used as a rubefacient and 
 vesicant, and its vapor, by cautious inhalation, in syncope and the results 
 of shock. Locally, it is a good application to bites of the less venomous 
 reptiles and to the stings of insects. The Carbonate is used internally in 
 the eruptive fevers, delirium tremens, continued fevers, pneumonia, etc., 
 where much depression exists ; as a stimulating expectorant in chronic 
 bronchitis, in the broncho-pneumonia of children, and in cardiac asthma. 
 It is highly recommended in scarlet fever in doses of 3 to 5 grains every 
 one, two, or three hours, all acid drinks or fruits being prohibited while 
 it is being administered. With ten-minim doses of tincture of capsicum 
 in an ounce of some bitter infusion it is exceedingly efficient, in 5- to 10- 
 grain doses, for the sinking sensations and craving for stimulants experi- 
 enced by subjects of alcoholism. It may be used as an emetic in 
 bronchitis, when the tubes are choked with mucus and the circulation of 
 the patient is weak. It may also be employed by inhalation, and admin- 
 istered internally, for similar purposes as Liquor Ammoniae. 
 
 In doses of 5 grains, administered hypodermically in the vicinity of wounds caused by 
 poisoned arrows, the Carbonate was repeatedly used by Dr. Parke, Stanley's surgeon in 
 Africa, with entire success in saving life when so employed immediately after injury. 
 Those so wounded at too great a distance to receive this treatment invariably died within 
 a short period of time. 
 
 The Chloride has high repute in catarrh of the stomach, with anorexia, 
 bad taste in the mouth, flatulence, coated tongue, etc., in short, the 
 symptoms of so-called " biliousness " ; also, in chronic congestion of the 
 liver, jaundice from catarrh of the bile-ducts, nervous and sick headaches, 
 myalgia, amenorrhea, muscular rheumatism and neuralgia. In the latter 
 affection it should be given in 30-grain doses several times a day. It is 
 also efficient in bronchial catarrh without fever, and in chronic bronchitis 
 when the secretion is scanty and tough. It is remarkably efficient in 
 straightening up a victim of acute alcoholism ; administered to one on 
 the verge of delirium tremens, in dose of j4 drachm in half a pint of 
 water, swallowed at one draught, it is said to restore the patient's faculties 
 so quickly as to astonish those who have never seen it so employed. 
 Locally, in solution, it has been well employed as a lotion for inflam- 
 matory swellings, as sprains, inflamed joints, orchitis, etc. ; also to allay 
 itching in prurigo, to remove ecchymoses and glandular enlargements. 
 Eau Sedative is often a good local application in headaches. 
 
 The Solution of the Acetate is especially beneficial in the exanthemata, 
 
I48 AMYGDALA. 
 
 influenza, coryza, anomalous febrile conditions of children, acidity and 
 vomiting ; also in acute alcoholism and in erysipelas when there is feeble 
 circulation, cyanosis and delirium. It is frequently combined with spirit 
 of nitrous ether, as a diuretic and diaphoretic in febrile affections. The 
 Phosphate is particularly applicable to gout and lithemia, and is a very 
 efficient cholagogue. The Benzoate is useful in cystitis with alkaline urine 
 and phosphatic deposits, as it acidulates the urine, at the same time 
 stimulating and disinfecting the mucous coat of the bladder. 
 
 Aqua Ammoniae has been administered by intra-venous injection, with 
 efficacy and safety, in sudden or threatened thrombosis, impending car- 
 diac paralysis during chloroform anesthesia, and in poisoning by hydro- 
 cyanic acid and other cardiac depressants. In the same manner, it has 
 been employed, but unsuccessfully, in poisoning by the bite of venomous 
 reptiles. Ten drops of the strong Liquor are diluted with three parts of 
 water, and carefully injected into a vein, all air being rigorously excluded 
 from entrance thereinto. 
 
 The therapeutics of the Iodide, Bromide and Valerianate are enume- 
 rated under the titles Iodum, Bromum and Valeriana respectively. 
 
 AMYGDALA, Almond. — The seeds of two varieties of Prunus 
 Amygdalus, nat. ord. Rosaceae, namely Amygdala amara and Amygdala 
 dulcis, are official, together with several preparations, some prepared from 
 one variety, some from another, while one is from either and one from 
 both. Amygdalin, C 20 H 27 NO n , is a crystalline glucoside, existing in 
 Amygdala amara but not in Amygdala dulcis ; while the ferment Emulsin 
 is common to both varieties. The reaction which occurs between these 
 two substances in the presence of water produces Hydrocyanic Acid. 
 (See ante, page 99.) 
 
 Amygdala Amara, Bitter Almond, — is the seed of Prunus Amygda- 
 lus, var. amara, a tree of the nat. ord. Rosacese, indigenous to Asia, but 
 cultivated in many other parts of the world, especially in Spain and the 
 Balearic Islands. The seed has an embryo of bitter taste, which, when 
 triturated with water, emits an odor of Hydrocyanic Acid. 
 
 Amygdala Dulcis, Sweet Almond, — is the seed of Prunus Amygdalus, 
 
 var. dulcis, a tree of the nat. ord. Rosaceae. The bitter and sweet almond 
 
 trees are identical botanically, and the fruits and seeds of the two varieties 
 
 resemble each other closely, only differing in taste and the presence of 
 
 Amygdalin (see above). The sweet almond is largely cultivated about 
 
 Malaga and in California. 
 
 Preparations. 
 
 Oleum Amygdalae Amarae, Oil of Bitter Almond, — is a volatile oil, of peculiar and 
 aromatic odor, bitter, burning taste, and neutral reaction ; soluble in 300 of water, but 
 freely in alcohol and ether. Dose, tt\,^-j, in mixture. 
 
AMYL NITRIS. I49 
 
 This essential oil, one of the products of the reaction between Amygdalin and Emul- 
 sin (see ante, p. 99), contains a varying quantity of Hydrocyanic Acid (3 to 14 per cent.), 
 which may be removed by distillation with caustic potash. Nitrobenzol, Oil of Mirbane, 
 closely resembles the oil of bitter almond, and like it is used for flavoring. It contains 
 no Hydrocyanic Acid, but is a dangerous poison, producing toxic effects when inhaled, 
 even in small doses. 
 
 Aqua Amygdalae Amarae, Bitter Almond Water, — is a weak solution of the Oil in 
 Distilled Water (1 to 1000). Is only a flavored water. Dose indefinite. 
 
 Spiritus Amygdalae Amarae, Spirit of Bitter Almond, Essence of Bitter Almond, 
 has of the Oil 1, dissolved in Alcohol 80, and Water added to 100 volumes. Dose, to 
 be regulated by the quantity of alcohol desired. 
 
 Syrupus Amygdalae, Syrup of Almond, — has of Bitter Almond 4 per cent., of Sweet 
 Almond 14. Dose indefinite. 
 
 Emulsum Amygdalae, Emulsion of Almond, — made of Sweet Almond 6 per cent., 
 with Acacia, Sugar and Water. A demulcent drink, used as a vehicle for cough mix- 
 tures. Dose, 3 ij— ^ ss. 
 
 Oleum Amygdalae Expressum, Expressed Oil of Almond, — is the fixed oil which 
 is expressed from either Bitter or Sweet Almond. Used in Unguentum Aquae Rosse, and 
 as a bland local application in skin affections. 
 
 Physiological Action and Therapeutics, f 
 The bitter and sweet varieties of the species Prunus Amygdalus differ 
 in action only through the agency of the principle Amygdalin contained 
 in the former. The Sweet Almond is demulcent and nutritive, while the 
 fixed oil expressed from either variety is a bland application, having the 
 same action as Olive Oil. The action of the Bitter Almond and its oil is 
 due to the Hydrocyanic acid contained in them (see ante, p. 99). 
 
 The Oil of Bitter Almond is used as a flavoring agent, and may be 
 employed locally or internally in lieu of Hydrocyanic acid. The Syrup 
 is somewhat sedative, but is generally used as a demulcent or for flavoring 
 purposes. The Emulsion is used in catarrhal affections and as a vehicle 
 for cough-mixtures. The poisonous character of the Bitter Almond and 
 its essential oil (Oleum Amygdalae Amarae) should be kept in mind when 
 prescribing them. Of 39 cases of poisoning by bitter almond prepara- 
 tions, the oil caused 28, the spirit 4, the almonds themselves 4, the water 
 2, and the emulsion 1. 
 
 The Expressed Oil of Almond is a good demulcent, also laxative in 
 doses of 3J to gij. It is used externally for excoriations, chapped hands 
 and inflammatory affections of the skin, and may be applied in the ex- 
 ternal auditory canal for earache. Almond Bread is made from the cake 
 remaining after the fixed oil is expressed from the sweet almond. The 
 cake is ground into a meal or flour, and is an excellent substitute for 
 wheat bread in the diet of diabetics, as it contains no starch. 
 
 AMYL NITRIS, Amyl Nitrite, — is a liquid containing about 80 
 percent, of Amyl Nitrite, C 5 H n N0 2 , together with variable quantities of 
 undetermined compounds. It occurs as a clear, yellowish liquid, of 
 
I50 AMYL NITRIS. 
 
 ethereal and fruity odor, aromatic taste, and neutral or slightly acid 
 reaction, extremely volatile, insoluble in water but freely soluble in 
 alcohol, ether, chloroform and benzin. It is produced by the action of 
 nitric acid upon amylic alcohol, and when impure may contain nitric or 
 hydrochloric acid. Dose, — internally n^i^-j dissolved in alcohol, — by 
 inhalation Tnjj-v ; but larger doses are probably safe. 
 
 Analogous Compounds. 
 
 Glonoinum, Glonoin, Nitroglycerin, Trinitrin, Glyceryl Trinitrate, C 3 H 3 (N0 3 ) 3 , — 
 is a clear, oily liquid, insoluble in water, but soluble in alcohol, ether, oils, etc., produced 
 by the action of Nitric and Sulphuric acids upon Glycerin. It is a dangerous explosive, 
 and should not be kept in stronger solution than I per cent. Dose, TT\, acTo to ^0 or 
 more, according to susceptibility. Official in the Spirit. 
 
 Spiritus Glonoini, Spirit of Glonoin, Spirit of Nitroglycerin, — is a I per cent, solu- 
 tion in alcohol. Dose, TTV,^-x. The strong tinctures sold by the homeopathic pharma- 
 ceutists and official in their American Pharmacopoeia is a 10 per cent, solution, or ten 
 times the strength of the above. It is an extremely dangerous preparation, both as an 
 explosive and as a medicine. (See American HoTnceopathic Pharmacopeia, 2d ed., 
 Boericke & Tafel, 1883, page 235.) 
 
 Tabellae Nkroglycerini (B. P.), Tablets of Nitroglycerin, — are tablets of chocolate, 
 each containing gr. yl^- of pure Nitroglycerin. Dose, j-ij. 
 
 Sodii Nitris, Sodium Nitrite, NaN0 2 , and Potassii Nitris, Potassium Nitrite (the 
 latter unofficial), — are used as substitutes for Amyl Nitrite and Nitroglycerin. The 
 former is a white, crystalline powder, deliquescent in the air, in which it gradually oxi- 
 dizes to sodium nitrate ; has a mild, saline taste, but no odor ; very soluble in water, 
 slightly in alcohol. Dose, gr. ss-iij, according to individual susceptibility. 
 
 Ethyli Nitris, Ethyl Niti'ite, C 2 H 5 N0 2 , — constitutes about 5 per cent, of Spiritus 
 ^Etheris Nitrosi. (See page 113 ante.) 
 
 Physiological Action. 
 
 Amyl Nitrite and the other Nitrites agree closely in their general 
 action, producing great vascular dilatation by paralyzing either the sym- 
 pathetic system, the vaso-motor centre or the muscular coat of the arteri- 
 oles, — which, is yet undecided. They cause tumultuous action of the 
 heart by relaxing its inhibition ; lowered respiration, from paralysis of 
 the respiratory muscles and impairment of the ozonizing function of the 
 blood ; diminution of sensation, motility, and reflexes ; a sense of heat, 
 but lowered body-temperature ; also throbbing pain in the head, beating 
 carotids, quickened pulse, flushed face and vertigo. The effect of an 
 ordinary inhalation of Amyl Nitrite on man is very transitory, excepting 
 the headache, which may last several hours. Of all the nitrites it is the 
 most prompt but least enduring in action, and is best administered by 
 inhalation. It causes sugar to appear in the urine and increases the 
 quantity of urine voided. Mixed with blood it forms methemoglobin, 
 which is not so readily deoxidized as hemoglobin, and under its influence 
 the blood in the body becomes of a dark chocolate color both in the 
 arteries and in the veins. 
 
 Nitroglycerin acts similarly, but less promptly, and its action is more 
 
AMYL NITRIS. I 5 I 
 
 enduring. Its headache is of intensely frontal character, and persists for 
 hours after the other effects have passed off. It is more suitable than 
 amyl nitrite for internal administration. Sodium Nitrite is also slower 
 in action than amyl nitrite, and does not cause so much throbbing head- 
 ache as nitroglycerin. It may be given in solution with water. The 
 action of all these agents is probably due to the nitrous acid contained 
 in them. 
 
 Antagonists. 
 
 Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin and all other agents 
 which increase the functional activity of the spinal cord and sympathetic are antagonistic, 
 though by reason of their slower rate of diffusion the antagonism may not be always 
 available. Stimulants, artificial respiration, the alternate cold and hot douche, with cold 
 to the head, and Ergotin or Atropin, subcutaneously, are the best means to be used in 
 cases of poisoning by the Nitrites. 
 
 Therapeutics. 
 
 The inhalation of Amyl Nitrite is a useful palliative in angina pectoris, 
 epilepsy, tetanus, and many of the respiratory neuroses, as spasmodic 
 asthma, whooping-cough, laryngismus stridulus, etc. It is also indicated 
 in migraine of the pale-face form, and in the cold stage of intermittents 
 and pernicious remittents, to prevent internal congestion, — also in con- 
 vulsions of various kinds, including the puerperal form. It has been 
 sometimes used in threatened death from chloroform anesthesia, and in 
 poisoning by strychnine. 
 
 Nitroglycerin is employed with benefit in neuralgic dysmenorrhea and 
 sea-sickness ; also in chronic interstitial nephritis, by redistributing to 
 the kidneys their blood-supply cut off by degeneration of the renal gan- 
 glionic centres. It promptly relieves hiccough, also migraine of spas- 
 modic character, and has afforded immediate relief in neuralgia of the 
 fifth and in sciatica. . Its administration in angina pectoris, though not 
 producing such prompt results as that of Amyl Nitrite, gives excellent 
 and much more lasting effects. It is useful in the weak heart of the aged, 
 or that from fatty degeneration, or when, as in Bright's disease, the 
 arterial tension is above normal ; also in irritable and overacting heart, 
 which it relieves by rapidly dilating the arterioles and thereby lowering 
 arterial tension. 
 
 Sodium Nitrite has been successfully used in angina pectoris, in hemi- 
 crania, and in asthma of purely bronchial and neurotic origin. It has 
 also proved decidedly beneficial in the abnormally high arterial tension 
 of chronic desquamative nephritis, especially when complicated with a 
 weakened and dilated heart. Disagreeable symptoms caused by it may 
 be prevented by prescribing it with spirit of chloroform or ammonia 
 water and small doses of morphine. 
 
152 AMYLUM. 
 
 AMYLUM, Starch, C 6 H 10 O 5 ,— is the fecula of the seed of Zea Mays, 
 the Maize or Indian Corn, a plant of the nat. ord. Graminese. Though 
 corn-starch is the only official kind, any other might be properly used, as 
 the starch occurring in wheat, barley, oats, arrow-root, sago and tapioca, 
 all of which were official in the U. S. P. of 1870. The last three are 
 almost entirely composed of starch; wheat contains about 70 per cent., 
 and rice nearly 90 per cent. The B. P. recognizes the starches from 
 Maize {Zea Mays), Wheat (Triticum sativum) and Rice (Oryza sativa) ; 
 the Ph. Ger. recognizes that from wheat alone. 
 
 Starch occurs in distinct grains (granules) which form irregular, angular masses, white, 
 odorless and tasteless, of neutral reaction, easily pulverized and insoluble in alcohol, ether 
 and cold water. In boiling water they swell, burst and form a mucilage which gelatin- 
 izes on cooling and gives a deep blue color on the addition of Iodine, the color disap- 
 pearing on warming and returning on cooling. Under the microscope the granules are 
 seen to be lenticular in form and differing somewhat in size and shape according to the 
 plant from which they are derived. Those from wheat are large and small mixed and 
 show concentrated striae formed around a nearly central spot (hilum). Those from maize 
 are smaller, have a hilum but no striae. Those from rice are very minute, polygonal in 
 shape, with a small hilum but no striae. 
 
 Starch is converted into grape-sugar (glucose) by the action of diastase, 
 ptyalin and pancreatin, also by boiling it with a dilute mineral acid, 
 Dextrin being formed as an intermediate product. [See the article en- 
 titled Pepsinum.] By hot, concentrated nitric acid it is converted into 
 oxalic acid, but cold, fuming nitric acid dissolves it, forming an explosive 
 compound. By the action of ferments it is finally converted into alcohol 
 and carbon dioxide. C 6 H 10 O 5 = 2C 2 H 5 OH -j- 2C0 2 . 
 
 Glyceritum Amyli, Glycerite of Starch, — has of Starch 10 parts, Water 10, Gly- 
 cerin 80, triturated and heated to a transparent jelly. A vehicle for external applica- 
 tions. 
 
 Cetraria, Iceland Moss, — is the lichen Cetraria islandica found in northern latitudes, 
 and contains JLichenin or lichen starch, which forms as a jelly when the plant is boiled 
 in water ; also Cetraric Acid. 
 
 Decoctum Cetrariae, Decoction of Cetraria, — 5 per cent, strength. Dose, ^ij-iv. 
 
 Unofficial Derivatives and Analogues. 
 
 Dextrin, — is produced by the action of dilute acids on starch, and is an intermediate 
 product in the conversion of starch into glucose. It is a transparent, brittle solid, soluble 
 in water and dilute alcohol, is not fermentable, and is not colored by Iodine. 
 
 Maltum, Malt, — is the seed of Hordeum distichum, Barley (nat. ord. Gramineae), 
 caused to enter the incipient stage of germination by artificial means and dried. The 
 germination is allowed to go far enough to develop the maximum amount of Diastase, 
 the peculiar ferment by which the starch of the grain is converted into glucose. Malt is 
 the source of beer, ale and whiskey, and is composed of the germinated, dead grains 
 with their acrospires and radicles. It should be fresh, not darker in color than a pale 
 amber, and of agreeable odor and sweet taste. 
 
 Extractum Malti, Extract of Malt, — is a liquid of the consistence of thick honey, 
 containing all the soluble principles of malt in permanent form. It consists chiefly of 
 diastase and glucose. Dose, 3J-iv. 
 
AMYLUM. I 5 3 
 
 Horlick's Food, — is, like Mellin's and many other foods for children, a granulated 
 Extract of Malt. Ifoff's Malt Extract is another such preparation, containing alcohol, 
 and corresponding to a concentrated beer. 
 
 Cellulose, C 6 H 10 O 5 , — forms the basis of all vegetable fibre, and is isomeric with 
 starch. It exists almost pure in cotton and in Swedish filter paper. Pyroxylin, Gun- 
 cotton, is dinitro-cellulose. 
 
 Glycogen, Animal Starch, — closely resembles starch in its properties, being con- 
 verted into glucose by the same agents which so act on starch. It exists in the liver of 
 all animals. 
 
 Physiological Action. 
 
 Starch and its derivative grape-sugar are the chief members of the non- 
 nitrogenous group of alimentary principles designated hydrates of carbo?i 
 or carbo-hydrates, so called because in them the constituent elements H 
 and O exist in multiples of the same proportions as in water. Starch is 
 met with only in the vegetable kingdom, occurring in the form of gran- 
 ules in many seeds, roots, stems, and in some fruits. It is formed by 
 plants from inorganic material under the influence of light, and is stored 
 up in their seeds as food for the young seedlings. In order to be ab- 
 sorbed by the animal organism starch must undergo digestion by the 
 action of the secretion of the pancreas and intestinal glands, which con- 
 vert it first into soluble dextrine and then into grape-sugar, in which form 
 it passes into the blood. 
 
 Food is required by the animal organism for two purposes, (i) to gen- 
 erate heat and other forms of force, (2) to repair the waste of the tissues. 
 Both are essential to continued life, but the first is even more important 
 than the second, for though the body may live a long time while wasting, 
 it dies rapidly when the source of heat is removed or greatly lessened. 
 The doctrine taught by Liebig — that the nitrogenous principles (albu- 
 minoids) are exclusively concerned in tissue repair, and the non-nitrog- 
 enous (starches, sugars and fats) in heat-production, — though not strictly 
 accurate, still holds good as describing the leading office of each 
 group. 
 
 The carbo-hydrates (starches, sugars, etc.) represent in vegetable food 
 the same office which the hydrocarbons (fats) represent in animal food, 
 namely — the maintenance of heat-production and other forms of force. 
 The glycogen in the liver and the muscles is a store of insoluble fuel for 
 emergencies, and is given up in the form of soluble grape-sugar as 
 required. Any surplusage of carbo-hydrates goes to form fat, the adipose 
 tissue of the body, another reserve of body-fuel. Being devoid of 
 nitrogen the carbo-hydrates cannot enter into the actual structure of the 
 tissues, the instruments of energy, but their oxidation supplies the motive 
 power, they being the fuel of the body. When they are entirely burnt 
 up and no more supplied the organism perishes of exhaustion. The 
 adult human body of average size and weight requires according to its 
 
154 AMYLUM. 
 
 activity from 12 to 18 ounces of water-free carbo-hydrate material daily 
 in some form of food. 
 
 Starch and sugar occur in vegetable foods in from three to five times 
 greater amount than proteid material. The latter exists in greater pro- 
 portion in the leguminous vegetables (peas, beans, lentils) than in meat, 
 but in other vegetables the proteid is much less. Cereal grains are by far 
 the most important vegetable foods, and among them Wheat is the one 
 most generally used. Its constituents correspond with the requirements 
 of the human organism more closely than those of any other grain ; in fact 
 both life and health can be maintained on wheat alone for a very long 
 period. As ordinarily used, however, it is deprived of much of its nutri- 
 tive value, white bread being made from wheaten flour from which not 
 only the indigestible cellulose has been removed but part of the starch 
 and sugar and a large proportion of the gluten, which is the proteid mate- 
 rial of the grain. Brown or Graham bread contains nearly all the 
 nutritive elements of wheat and is much more nutritious than white bread. 
 Rye is a valuable grain, containing nearly the same proportions of starch, 
 sugar, fat and proteid as wheat. Rice contains more starch than the 
 others and its starch is very digestible, but it has practically no fat and 
 only the smallest quantity of proteid. Its nutritive value is small, and it 
 requires an oil and some albuminoid to be taken with it in order to make 
 it a suitable diet. Maize is more nutritious than rice, but is less digestible. 
 It contains much starch and some fat, but is deficient in proteid material 
 (gluten). Oats are rich in fat but contain less starch than the other 
 grains and require prolonged cooking to render them digestible. Barley 
 ranks about as wheat, contains rather more proteid and is rich in 
 phosphates and iron. It is highly nutritious and was the principal diet 
 on which the Grecian athletes were trained. The Potato contains nearly 
 24 per cent, of a very digestible starch, is rich in salts and its juice is 
 highly acid. It is an excellent antiscorbutic and is extensively used for 
 food. Arrow-root, Sago and Tapioca consist almost entirely of starch, 
 without fat or proteid, and are readily digested. Peas and Beans contain 
 about 50 per cent, of starch and sugar, also 22 per cent, of legumin or 
 vegetable casein, albumin, etc. — a very large proportion of proteid 
 material, more in fact than exists in any kind of meat. They are rich 
 also in fat and salts, and form the best vegetable substitute for animal 
 food. They are somewhat indigestible and require prolonged cooking 
 before being eaten ; but they are an excellent food, alone nourishing 
 both men and beasts for a long time. 
 
 The excessive consumption of starchy food delays tissue-metamorphosis, 
 produces a superabundance of adipose tissue, and often causes acidity and 
 flatulence. Undigested starch passes into the feces and the urine becomes 
 saccharine in many cases. Profound disease does not necessarily follow, 
 
AMYLUM. I55 
 
 but if decided corpulence is produced the muscular fibres of the heart and 
 many voluntary muscles decrease in size, the cardiac action becomes 
 enfeebled and the usual results thereof are manifested. The deprivation 
 of starch can be borne well for a long time if fat is taken with the food, 
 but if both starch and fat are excluded and nitrogenous material is alone 
 supplied, illness results in a few days. [See the article entitled Albumin, 
 ante, page 120.] 
 
 Therapeutics. 
 
 The principal affections in which the carbo-hydrates are imperatively 
 required are gastric disorders, diarrhea, dysentery, excessive secretion of 
 bile and other hepatic disorders, Bright's disease, alcoholism, gout and 
 rheumatism. In acute and continued fevers there is often an almost com- 
 plete inability to take and digest any kind of food. This may last for 
 weeks, the result being that the patient dies from so-called exhaustion, 
 in reality starvation due to want of fuel-food, the human fire going out in 
 the absence of material to feed it. In such cases the need of soluble 
 carbo-hydrate food must be supplied. Well-baked flour which contains 
 much soluble dextrin, also milk-sugar or grape-sugar, should be added to 
 the beef-teas which are so much used in the sick-room. Grape-sugar is 
 digested starch and a very soluble carbo-hydrate; it may therefore be 
 administered in lemonade or any other drink which the patient fancies. 
 In gastric disorders accompanied by much acidity an uncrystallizable 
 sugar like grape-sugar is preferable to cane-sugar or beet-sugar, the latter 
 being crystallizable sugars and readily undergoing the acetous fermenta- 
 tion. In diarrheal conditions the proper food is milk with some digestible 
 carbo-hydrate, as arrow-root, sago, or tapioca. Rice-water makes an 
 excellent drink in diarrhea and dysentery, and has often arrested these 
 conditions without medicinal aid. In the treatment of Bright's disease and 
 chronic alcoholism a diet of carbo-hydrates should be inculcated and 
 animal food reduced to a very small quantity. The same rule is impera- 
 tive in the management of gout, especially when this disease occurs in 
 persons of sedentary habits. In acute rheumatism the diet should be 
 wholly non-nitrogenous, except for broken-down and debilitated subjects, 
 or where serious nervous or cardiac complications exist. 
 
 Starch is medicinally inert. It is employed as a vehicle for medicated 
 enemata, as an antidote in poisoning by Iodine or Bromine, and as a pro- 
 tective and absorbent powder applied by dusting over the skin. Mixed 
 with glue it makes an excellent stiff bandage for surgical purposes. 
 
 Malt Extract, containing good food elements, is directly nutritive, and indirectly so 
 from the presence of the ferment Diastase, which converts the starch of bread or other 
 farinas into sugar. It is usefully employed in wasting diseases, and mixed with milk or 
 oleaginous foods it aids their digestion and assimilation. It may be used to form a syrupy 
 mixture with preparations of Iron or Cinchona. 
 
156 ANIMAL EXTRACTS. 
 
 Cetraria is nutrient, demulcent and feebly tonic. It has a popular reputation in pul- 
 monary affections, and is of value in chronic catarrhs, chronic bronchitis, purulent dis- 
 charges from mucous surfaces generally, also in chronic diarrhea and dysentery. 
 
 ANIMAL EXTRACTS (Unofficial).— The organs, tissues and 
 secretions of animals were extensively employed as medicinal agents in 
 ancient times, and many of them were official in the pharmacopoeias of 
 the last century. At present the only ones so recognized are the di- 
 gestive ferments (pepsin and pancreatin), ox-gall (fel bovis), and the 
 secretion of the preputial follicles of the beaver (castoreum) and of the 
 musk-ox (moschus). The first definite attempt in recent regular practice 
 to apply animal tissues to the cure of disease was made in 1852 by Dr. 
 Jackson of Philadelphia, who used as a tonic the blood of bullocks care- 
 fully dried in vacuo, giving 5 to 10 grains thereof at a dose. Since then 
 the drinking of fresh bullocks' blood has become a common practice in 
 certain diseases. Raw meat was administered as a remedy for diabetes at 
 St. Bartholomew's Hospital in London in 1874. The powdered Russian 
 cockroach (Blatta orientalis) is still used as an efficient diuretic in drop- 
 sies, and preparations of the bodies of various spiders and toads, also bee 
 and serpent venoms, are recognized remedies in homeopathic practice. 
 
 The use of glandular extracts as remedies in disease is very old. It 
 was revived in 1889 by Brown-Sequard's advocacy of orchitic (testicular) 
 extract for impotence and several nervous affections, and was profoundly 
 stimulated by the results of Dr. Murray's suggestion in 1891 of thyroid 
 extract for the cure of myxedema. 
 
 Testicle Extract is fully noticed in the " Seplasium or the Druggist' s Shop Opened" 
 by W. Salmon, published about 1685. In this book the author describes the testicles 
 taken from man or beast as consisting of "a Flegm, Spirit, Sulphur and Volatile Salt 
 joined with some Earthy Particles ; the chief used are from Bull, Horse, Goat, Ram, 
 Boar and Buck," which were cut out, carefully dried, and used to make a tincture, a 
 spirit, an oil and a volatile salt. Salmon further says that " their virtues are very great, 
 for they refocillate the Spirits, — Natural, Vital and Animal, — comfort the Head, Brain 
 and Nerves, and resist all Diseases afflicting them, .... they restore in Con- 
 sumptions, .... are also good against the Collick, and particularly strengthen 
 the Instruments of Generation and provoke Lust." The same extract was also recom- 
 mended by J. Fr. Leaulte, who wrote in 17 17. According to Pliny the ancient Greeks 
 and Romans ate the testicle of the ass for the purpose of curing impotence. 
 
 According to the theory promulgated by Brown-Sequard, all glands, in 
 addition to their ordinary secretions, elaborate certain materials of un- 
 known chemical composition, which pass into the blood and perform 
 therein definite functions of some kind. We now know that such is the 
 case with the thyroid gland, we suspect that it is equally true of the 
 thymus, the spleen and the adrenals, and we have reason to believe it 
 highly probable that the other glands of the body exert influences here- 
 tofore unsuspected over distant parts of the organism. 
 
ANIMAL EXTRACTS. I 57 
 
 The effect of the entire removal of the thyroid, the pancreas or the adrenal glands is 
 to produce the symptoms of characteristic and fatal disorders ; but if a portion of either 
 gland be left behind these toxic symptoms do not develop, and the same is true of the 
 thyroid and pancreas if, after their entire ablation, a portion be engrafted upon the peri- 
 toneum. It is evident therefore that the disorders so produced are of auto-toxic origin, 
 the result of chemical poisons in the blood which were previously neutralized, destroyed 
 or eliminated by the removed gland or some of its secretions. It has also been shown 
 that the subcutaneous injection of an aqueous extract of the dead gland will dispel the 
 toxic phenomena which follow the removal of that gland, proving that the active principle 
 thereof is a chemical substance existing in the gland itself, and that the previous immu- 
 nity was not due to any action of its living cells other than that required to produce the 
 active agent. The discovery that ablation of the testicles causes retrogression of the 
 hypertrophied prostate, and that removal of the ovaries will cure osteomalacia, as also the 
 long-known facts that castrated individuals usually grow very obese and develop massive 
 skeletons, while giants are generally endowed with atrophied testicles, — clearly point to 
 the same conclusion. 
 
 The animal extracts form a group of active medicinal agents which are 
 proving worthy of careful investigation both physiologically and clin- 
 ically. The study already given to them has yielded much new knowl- 
 edge, and has shown indubitably that their employment as therapeutic 
 agents rests on a scientific basis ; but most of them are as yet on trial, 
 and the limits of their utility in medicine are by no means defined. They 
 contain leucoma'ines, extractives and other chemical substances, all of 
 which possess physiological powers, many proving distinctly poisonous 
 when their excretion is prevented. Excepting thyroid extract and per- 
 haps some others, the animal extracts are active medicinally only when 
 injected subcutaneously or by the rectum, as most of them when given by 
 the mouth are destroyed or altered in the stomach, or prevented by the 
 liver from entering the general circulation. Physiological chemists are 
 endeavoring to separate their active principles, a line of research which 
 promises more accurate and positive results. It is already demonstrated 
 that some of their principles are the most powerful of all alteratives, and 
 that others possess the most energetic action upon the muscular fibres in 
 the walls of the arterioles. 
 
 The initial doses of many animal extracts should be very small, in 
 order to avoid the possible systematic disturbance which has been fre- 
 quently noticed by clinical observers as following on their administration. 
 
 Sodium Phosphate in solution, administered hypodermically, is considered by Luton 
 and Crocq, of Rheims, to be equally effective in reconstructive power with the animal 
 extracts. (See under the title Phosphorus.) 
 
 Thyroid Extract is the most efficient member of the group of animal 
 extracts. Its administration has been eminently successful in the treat- 
 ment of myxedema, which a few years ago was classed among the incurable 
 diseases, but is now considered curable by thyroid feeding, or by the use 
 of an extract of the thyroid gland of the sheep. Myxedema is a com- 
 bination of symptoms due to thyroid absence or inadequacy, and occurs 
 as a result of the removal of the gland or of disease impairing its func- 
 
I58 ANIMAL EXTRACTS. 
 
 tional activity. It is characterized by imperfect oxygenation of the 
 blood, lowered body-terriperature, impairment of intellect, memory and 
 speech, also increase of the fibrous tissue and subsequent mucoid degen- 
 eration thereof, with thickening of the skin, drying of the surface and 
 shedding of the epithelial structures. When caused by ablation of the 
 thyroid the disease is fatal to cats and dogs in a very few days, but their 
 life has been saved by engrafting a portion of the removed gland in 
 other situations, and also by intravenous injections of thyroid extract. 
 This treatment of the idiopathic form of myxedema was suggested and 
 commenced by Professor George R. Murray, of the University of Dur- 
 ham, in 1 89 1, and has since proved remarkably successful. At first the 
 remedy was administered hypodermically, but it was soon found that the 
 raw gland fed to the patient was equally efficient, or that a dry extract 
 may be used. The latter represents the entire thyroid, divested only of 
 its water, is easily administered and proves very efficient, improvement 
 being usually noticed within a very few days, and going on steadily to 
 apparent perfect recovery if the remedy is continued. The thickening 
 of the skin disappears, the normal body heat returns, and speech, memory 
 and intelligence are restored. In mild cases recovery is effected in a few 
 weeks, but in severe ones several months of treatment are necessary; and 
 in most cases the symptoms of the disease return when the thyroid treat- 
 ment is stopped, disappearing again when it is resumed. It is probable 
 that the subjects of this disease will require to take a certain quantity of 
 the remedy regularly and continuously for many years, perhaps for life. 
 
 A large dose of thyroid extract gives rise to marked constitutional 
 symptoms, and several cases are recorded in which it has caused death. 
 Nausea, vomiting, neuralgic pains in the back and limbs, and cardiac 
 irritability and weakness even to syncope, are the principal symptoms 
 observed during its excessive use. It produces a distinct fall of the 
 blood-pressure, even though the cardiac rate and force may remain unaf- 
 fected, this effect being evidently due to its increasing the calibre of the 
 vessels (Schafer and Oliver). In one case all the symptoms of diabetes 
 developed under its continuous administration for psoriasis (James). In 
 another instance a typical attack of gout came on, but subsided when the 
 extract was stopped, and reappeared when it was again administered 
 (Harris). 
 
 Thyroid extract has produced great amelioration in cretinism (congeni- 
 tal myxedema) which is a thyroid disease, and the improvement has been 
 steady and progressive in many cases while the remedy was used, but 
 ceased as soon as it was discontinued. In psoriasis, eczema, ichthy- 
 osis, pityriasis rubra, lupus, universal alopecia and some other skin affec- 
 tions, it has been employed as a stimulant of the cutaneous functional 
 activity with most satisfactory results ; several cases of psoriasis treated 
 
ANIMAL EXTRACTS. I 59 
 
 with this remedy alone recovering completely in the course of a few weeks 
 (Bramwell). In exophthalmic goitre thyroid extract has been beneficial, 
 and though some observers report ill effects from its use in this disease, 
 others show that they were due to a primary aggravation of symptoms 
 which subsides when the dose is largely reduced, and is then followed by 
 distinct improvement under the administration of a very small quantity 
 of the remedy (Bruns, etc.). Complete disappearance of the goitre has 
 however rarely been observed (Kinnicut). In the insanity of the ado- 
 lescent, climacteric and puerperal periods, the thyroid treatment has 
 seemed to be especially beneficial (Bruce) ; but in several cases of insan- 
 ity where there was parenchymatous (not cystic) enlargement of the thy- 
 roid, the extract was used without result upon the mental affection though 
 it diminished the size of the goitre and caused a marked loss of weight 
 (Reinhold). In many cases its continued administration has produced 
 emaciation, which fact suggested its employment for the reduction of 
 obesity, and it has been successfully used for this purpose in many cases 
 (Guttmann). A loss of weight at the rate of from 2 to n pounds per 
 week is produced in some cases ; but after a time a limit is reached, 
 beyond which further loss does not occur. Thyroid extract has given 
 satisfaction in several other affections, including tetanus, ozena, uterine 
 fibroma and carcinoma, and some forms of syphilis. It has been success- 
 fully used to promote consolidation in obstinate fractures, having well- 
 recognized effects in disordered nutrition of osseous tissue (Gauthier). 
 It has seemed to act as an efficient galactagogue in some cases, increasing 
 both the flow and the quality of the milk (Stawell). 
 
 The chemical constituents of thyroid extract include lodothyrin, which 
 seems to be the active principle. It exists in combination with the pro- 
 teids (albumin and globulin) which are found in the colloid secretion of 
 the follicles of the gland. lodothyrin contains Iodine in varying amount 
 and a large proportion of nitrogen, also sulphur and phosphorus. So far 
 as studied it appears to represent the therapeutic power of the extract, 
 and is administered in tablet form and in doses of gr. -g 1 ^ gradually 
 increased. 
 
 Liquid Thyroid Extract is prepared from the fresh thyroids of the sheep, by macerat- 
 ing them in equal parts of glycerin and water for 24 hours, and then squeezing through 
 fine calico. For hypodermic use the water employed in the menstruum should contain 
 0.5 per cent, of carbolic acid. A dry extract, three times stronger than the liquid one, 
 is made by expressing the juice from the glands, mixing it with sugar of milk, and drying 
 it on glass plates at a temperature of 90 F. The dose of this product is from 2^ to 5 
 grains at first, thrice daily by mouth ; which dose may be gradually increased as long as 
 it causes no systemic disturbance. The Thyreoidin prepared by Parke, Davis & Co. of 
 Detroit, is a dry powder, each grain of which represents 10 grains of the fresh gland or 
 1.6 grain of desiccated thyroid. The dose of this preparation is ]/ 2 grain two or three 
 times a day, to be increased at the discretion of the physician. 
 
 Thyreo-Antitoxin is a substance obtained by Dr. Frankel from the thyroid gland, 
 to which he has given the above name and assigned the formula C 6 H u N 3 5 . It is in- 
 
l60 ANIMAL EXTRACTS. 
 
 odorous and tasteless, and produces rapid emaciation. It is improperly named an anti- 
 toxin. 
 
 Thymus Extract. The thymus gland is active only during the developmental period 
 of life, and becomes atrophied about the age of two years. The suggestion has been 
 made that an extract thereof may prove useful in diseases characterized by defective de- 
 velopment, as rachitis and pseudo-hypertrophic paralysis. It has been used with reported 
 benefit in leucocythemia, chlorosis, idiopathic and pernicious anemia, and in Paltauf's 
 so-called " status thymicus." It appears to be useless in exophthalmic goitre, but bene- 
 ficial in the other form. Of 30 cases of goitre treated with it 20 were improved but only 
 2 were cured (Kinnicut). The mode of preparation and dose are similar to those of 
 thyroid extract. 
 
 Bone Marrow Extract. — Red bone marrow has been long known 
 as one of the sources of the red blood corpuscles, and it is thought prob- 
 able that it contains chemical ingredients which may stimulate the 
 production of blood cells by other blood-forming organs in which such 
 natural stimulus may be lacking. In pernicious anemia the marrow of 
 the long bones shows characteristic changes, which fact suggested the 
 administration of red bone marrow as a remedy for that disease. This 
 treatment has proved remarkably successful even in cases which were 
 apparently hopeless. It was first suggested by Dr. Dixon Mann, who ad- 
 ministered a glycerin extract thereof in cases of hemophilia, chlorosis,- 
 profuse hematemesis and other anemic affections, with good results. Its 
 employment is indicated in disorders characterized by hyperfluidity of 
 the blood, from whatever cause ; and it may render good service in any 
 debilitating or blood-impoverishing affection, and in convalescence after 
 severe osteitis. The raw marrow, freed from spicules of bone, may be 
 administered to the amount of about 3 ounces daily in divided doses ; or 
 it may be given as a paste made with wine, glycerin, and gelatin. Tab- 
 lets, containing from \ x / 2 to 5 grains each of the dried marrow, are on 
 the market and may be used if preferred. Carnogen is a proprietary 
 preparation containing red bone marrow and hemoglobin. 
 
 One of the most striking cases recorded is that of the gardener patient of Professor 
 Fraser of Edinburgh. Under the use of raw bone marrow by the stomach his blood cor- 
 puscles increased in number from less than 900,000 to over 4 millions per c.c, the pro- 
 portion of hemoglobin rose from 18 to 35 per cent., and the man became well enough to 
 resume his occupation. 
 
 Nuclein is a proteid substance, possessing a large proportion of Phos- 
 phorus in the form of Nucleinic Acid, which is combined with a highly 
 complex base, the latter being different in the various tissues. Nucleins 
 are the chief chemical constituent of cell nuclei, and their number is 
 limited only by the varieties of the cells. They are found in both animal 
 and vegetable tissues ; wherever there is a nucleus we find a nuclein. 
 They are generally insoluble in dilute acids, but are soluble in dilute 
 alkalies, and resist peptic digestion. Their functions in the organism 
 are supposed to be (1) that of a natural antiseptic, to destroy toxic prod- 
 ucts which may accumulate through faulty elimination, and (2) that of 
 
ANIMAL EXTRACTS. l6l 
 
 a natural bactericide, to resist microbic invasion. Two nucleins only 
 have been clinically studied in this country, that obtained from yeast- 
 cells and that from the thyroid and thymus glands. 
 
 Nuclein is harmless, causing no functional derangement when admin- 
 istered by the stomach or subcutaneously, even in very large doses. 
 When injected hypodermically its principal effect is to produce a very 
 marked increase of leucocytic activity (an artificial leucocytosis), both in 
 healthy and in tuberculous subjects. The increase is observed to affect 
 chiefly the polynuclear leucocytes ; it varies in degree with the indi- 
 vidual, appears within three hours after administration of the nuclein, 
 and disappears after forty-eight hours or thereabouts (Huber). The effect 
 is to energize any existing inflammation, or to awaken such when com- 
 paratively quiescent, as in latent tuberculosis (See). 
 
 Nuclein was introduced into medicine by Professor Vaughn of the 
 University of Michigan. Its employment as a therapeutic agent is based 
 on the assumption that for immunity against and the cure of bacillary 
 diseases we should look to non- toxic germicides of cellular origin, and to 
 substances which stimulate the activity of those organs whose function 
 it is to protect the body against such invasion. As the nucleins appar- 
 ently fulfil these requirements they have excited considerable attention 
 among the advocates of animal extracts. Nuclein has been successfully 
 used in diphtheria, suppurative tonsillitis and other suppurative disorders, 
 also in chronic rheumatism and malaria, chronic bronchial catarrh and 
 neurasthenia, and has been employed in tuberculosis with encouraging 
 results (Vaughn). In one case an ulcer of twenty years' standing was 
 cured in four months by the local application of nuclein. A physician 
 reports his own case, one of genito-urinary tuberculosis, as apparently 
 cured by nuclein injections. In simple anemia, chlorosis, typhoid fever, 
 debility from any cause, and convalescence from acute diseases, such as 
 pneumonia and influenza, the beneficial results of nuclein medication are 
 prompt and permanent (Aulde). As bactericides the nucleins may prove 
 useful by reason of their harmlessness to the human subject. 
 
 Nucleins are prepared from separate animal tissues and glands, as the 
 thyroid, thymus, liver, spleen, etc. {animal nucleins) ; also from all the 
 tissues and glands combined (protonuclein), and from yeast cells (vege- 
 table nuclein). Vaughn uses a solution of yeast nuclein, containing i per 
 cent, of nucleinic acid, prepared by Parke, Davis & Co. The dose of 
 this solution is 30 minims, administered hypodermically, and increased 
 daily as long as no unfavorable symptoms appear. Tablets of nuclein 
 are on the market, for administration by the mouth, the dose being 1 
 grain or more, as may be deemed advisable. 
 
 Protonuclein is the trade-name of an extensively advertised product, which is said 
 to be a combination of nucleins obtained from all the available lymphoid structures of 
 II 
 
1 62 ANIMAL EXTRACTS. 
 
 bullocks and pigs, including the entire brain, the pancreas, liver, spleen, salivary glands, 
 thyroid, thymus, gastric and intestinal glands, etc. The manufacturer claims that it is 
 "the true tissue-builder of the organism " and its "natural antitoxic agent," and pub- 
 lishes the usual florid literature, which includes clinical reports of the therapeutic efficacy 
 of protonuclein in some forty-five different affections. It is sold in tablets and powder ; 
 also in a special powder containing no milk-sugar, and intended for inhalations and in- 
 jections. The dose is 3 grains every 3 or 4 hours. 
 
 Orchitic Extract, Didymin, Testicular Juice, — was the subject of a 
 communication to the Societe de Biologie at Paris, in 1889, from Pro- 
 fessor Brown -Sequard, in which the aged and distinguished writer declared 
 that he himself had experienced a wonderful degree of rejuvenescence 
 after its use, and recommended it as a general tonic for the aged and for 
 subjects of impotence or a debilitated nervous system. In subsequent 
 communications made to the Academie des Sciences by Brown-Sequard 
 and his assistant D'Arsonval, it was claimed that general paralysis, loco- 
 motor ataxia, contractures, and certain forms of insanity, also affections 
 due to organic lesions of the nervous system or impairment of its func- 
 tions, are cured or ameliorated by injections of testicular juice; and that 
 organic or constitutional diseases due to defective nutrition of the organs, 
 as anemia, glycosuria and tuberculosis, may be arrested by this procedure. 
 Its remedial effects they held to be due to the action of a ferment or 
 diastase contained in the fluid, which replaces the natural ferments pro- 
 duced by normal testes and other glandular organs of the body. Although 
 Brown-Sequard's claims for this agent were undoubtedly extravagant, and 
 his assertions as to the results obtained therefrom were exaggerated, sub- 
 sequent experience has confirmed his general statement regarding its 
 effects, and the restorative power of testicular juice when injected sub- 
 cutaneously is now admitted. 
 
 Testicular extract injected into the human subject produces a steady 
 increase of oxyhemoglobin in the blood, the cardiac force is strengthened, 
 the vascular tone is exalted, and the oxygenation of waste products is 
 promoted, as shown by the increased excretion of urea and the lessened 
 amount of phosphoric acid in the urine. Intestinal peristalsis is slightly 
 stimulated, the mind becomes clearer and more active, and the body 
 temperature is usually raised but may remain unaffected. The crude ex- 
 tract is said to be mildly bactericidal. These effects closely coincide with 
 those produced by Spermine (see p. 164), and this substance is believed by 
 Poehl to be the active principle of the juice, but it does not possess the 
 powerful reconstructive properties of the latter, and cannot be efficiently 
 substituted therefor. 
 
 This extract has been employed by many competent physicians in 
 several diseases, often with most beneficial results. It is a powerful 
 tonic, especially in the decrepit subject of old age or exhaustion from 
 wasting disease, as it stimulates the tissues and organs to renewed activity 
 
ANIMAL EXTRACTS. 163 
 
 and endows the body with greater strength and with a feeling of increased 
 well-being. It has been used in general adynamia, anemia, atonic gastro- 
 intestinal affections, scurvy, malaria, epilepsy, cancer, nymphomania, 
 perverted sexual habits, impotence, neurasthenia, hysteria, melancholia, 
 diabetes, tuberculosis, hemiplegia, paralysis agitans and locomotor ataxia. 
 In the last-named disease this remedy has shown the best results obtained 
 therewith; and under its administration the characteristic pains have 
 ceased, steadiness and accuracy of motion have increased, and in some 
 cases the ataxia has wholly disappeared. In diabetes it has been more 
 satisfactory than pancreatic or any other organic extract. Under its 
 administration in anemia one physician observed the hemoglobin to in- 
 crease from 3 to 14 per cent, every three weeks; and in tuberculosis it 
 has caused the temperature to recede to normal, the cough to lessen, the 
 appetite and weight to increase, and the general condition to improve in 
 every way. In sexual neurasthenia it has frequently proved to be of great 
 benefit. No specific action is claimed for it in any of these affections, 
 but all observers agree that it acts by stimulating functional activity. 
 Many of the results observed have been ascribed to mental suggestion, 
 but after the application of check experiments in similar cases the weight 
 of evidence was found to be in favor of the remedy. 
 
 D'Arsonval prepares this extract or emulsion in the following manner. The testicles 
 of bulls, enveloped in their membranes, are washed in a 10 per cent, solution of subli- 
 mate, and again with sterilized water, are each divided into five or six parts, placed in 
 aseptic glycerin (a pint to the pound of testicle) and allowed to macerate therein for 24 
 hours. An equal quantity of a 5 per cent, solution of common salt in boiled water is 
 then added, the mixture is filtered and sterilized by being subjected to a pressure of 30 
 atmospheres of carbon dioxide. The dose is 10 to 20 minims, hypodermically once daily 
 or every other day, with strict aseptic precautions as to the syringe used and the site of 
 injection ; the latter should be washed with a 1 to 1000 sublimate solution or a 2 per 
 cent, solution of carbolic acid. The extract seems to have little or no effect when given 
 by the mouth, but is efficient when used by the rectum. Some observers believe that it 
 is dangerous by hypodermic administration, on account of its proneness to decomposition 
 when prepared by the above method ; and one experimenter has made an extract from the 
 crude juice for administration by the mouth, which he claims to have used in a thousand 
 cases. 
 
 The composition of the emulsion prepared by the above process is very 
 complex, but it is supposed to include at least four active principles, viz. — 
 Phosphorized Albumins, in large quantity, Lecithin, known as phosphorized 
 fat, Spermine, and Nuclein. The first two have undoubted value as nerve 
 foods, the third is believed to increase the oxygen-carrying power of the 
 blood corpuscles, and the last possesses bactericidal properties. The com- 
 bination should prove of value as a remedy in many morbid conditions. 
 
 Phospho- Albumen. Under this trade-name and the sub-title Syrup of Di-Oleyl- 
 Lecithin, an animal extract is prepared in Chicago, which is said to be derived solely 
 from the testes, spinal cords and brains of bulls. The juice is sterilized by D'Arsonval' s 
 carbon dioxide process, and is mixed with simple syrup as a preservative menstruum and 
 some flavoring material. It is supposed to contain lecithins, spermine, nuclein, and 
 phosphorized albumins, and is apparently a favorite tonic with many prominent physi- 
 
164 ANIMAL EXTRACTS. 
 
 cians of Chicago. It is not patented, copyrighted or advertised, is sold only on physicians' 
 prescriptions, and its manufacturers assure the profession that so far as their methods of 
 promotion are concerned it will remain practically inaccessible to the laity. 
 
 Spermine has been found in the form of a phosphate in the thyroid and thymus 
 glands, the spleen, the ovaries and the blood, as well as in the testes. Dr. Poehl believes 
 it to be an alkaloidal product of the retrogressive metamorphosis of albumins (a leuco- 
 mai'ne), and a most powerful intraorganic restorative of the oxidizing properties of the 
 blood. He states that it should not be regarded as a specific for any particular malady, 
 but should be used as a means of promoting oxidation in the body. It has been em- 
 ployed with decided benefit in ataxy and delirious epilepsy (Poehl), as a tonic in tuber- 
 culosis (Upenski), also in senile marasmus and the nervous affections of the aged 
 (Victoroff). The Hydrochlorate is used hypodermically, in doses of ]^ grain twice 
 daily, in the morning and at noon, avoiding evening administration, as it may cause in- 
 somnia. No reaction follows its injection. 
 
 Brain Extract, Cerebrinin, — is obtained from the gray matter of the 
 sheep's brain by digestion in 5 times its weight of pure glycerin and then 
 adding an equal quantity of a 12 per cent, solution of common salt. Its 
 effects are almost identical with those of orchitic extract, the most notice- 
 able being increased strength and a feeling of well-being, regulation of 
 the organic functions and increase of the cardiac force. It has been em- 
 ployed with benefit in locomotor ataxia, neurasthenia and allied affections, 
 nymphomania, perverted sexual habits of cerebral origin, hysteria, melan- 
 cholia, insomnia, the general debility of malaria, chlorosis and even more 
 profound anemias (C. Paul) ; also in cases of defective development of 
 the spinal apparatus, as Friedrich's ataxia. Mental derangement is not 
 helped by it, or at most but temporarily. The dose is 16 minims (1 cc.) 
 once daily or every other day, administered subcutaneously. 
 
 Cerebrine is an extract of the entire brain of the ox, prepared by Dr. Hammond of 
 Washington, by digestion for six months in a mixture of glycerin, alcohol, and a satur- 
 ated solution of boric acid, and filtration through porous stone. The dose is 5 minims 
 diluted with an equal quantity of distilled water at the time of administration by hypo- 
 dermic injection. Dr. Hammond prepared similar extracts of the spinal cord [medulline), 
 the heart {car dine), the pancreas (pancreatine), etc., and advocated their use medicinally 
 on the organopathic theory that they are curative of depressed conditions of the corre- 
 sponding human organs. 
 
 Pineal Extract. — The pineal gland is present during the entire life of the individual, 
 and its removal has been followed in animals by structural changes in the central nervous 
 system. It is thought that the substance of this gland may act remedially in organic and 
 functional affections of the brain attended with failure of cerebral nutrition, as chronic 
 softening, chronic mania and dementia. 
 
 Pituitary Extract. — The complete removal of the pituitary body (or gland) gives rise 
 to symptoms which occur in a definite order, beginning with lowered temperature and 
 loss of appetite, then twitchings, tremors and nervous phenomena, and finally dyspnea 
 and death. Many of these symptoms have abated considerably after the administration 
 of pituitary gland substance or an extract thereof. This organ has been found enlarged 
 in cases of myxedema in which the thyroid was functionally absent, and other observa- 
 tions point to some connection between it and the disease known as acromegaly. Inter- 
 nally administered it causes increase of the cardiac force and rate, and a rapid rise of 
 the blood-pressure due to direct contraction of the vessels. It is administered with the 
 view of reestablishing perverted brain nutrition and function, and also with the object 
 of supplying tone and structural growth to the entire nervous and muscular systems, on 
 which its secretion seems to act as an alterative. Of 13 cases of acromegaly treated with 
 pituitary preparations 7 showed varying degrees of improvement, 5 none, and I became 
 
ANIMAL EXTRACTS. 1 65 
 
 worse. In 2 cases the violent headache and neuralgic pains in the limbs were diminished, 
 and in one case decrease of the affected extremities occurred (Kinnicut). 
 
 Adrenal Extract. Ablation of the suprarenal glands in guinea-pigs 
 and frogs is followed by serious nervous disturbances, shown by lowering 
 of the body-temperature and progressive paralysis, and culminating in 
 convulsions and death by failure of respiration. Brown-Sequard made 
 these observations in 1856, and later showed that the subcutaneous injec- 
 tion of extracts of the healthy glands in such cases restored the animals to 
 almost a normal state for a time. In 1895 Schafer and Oliver demon- 
 strated that the secretion of these glands strongly stimulates the muscular 
 system by direct action, especially affecting the vaso-motor apparatus and 
 the cardiac muscle, causing contraction of the arterioles and an extraordi- 
 nary rise of the blood-pressure, followed by slowing and strengthening 
 of the heart's action through the vagus and the cardiac motor ganglia. 
 These effects are of short duration and are produced by a very small 
 quantity, the -^-th of a grain of the dried gland causing a maximal result 
 on the heart and arteries in a dog of twenty pounds weight : hence it is 
 concluded that the active principle is capable of producing a marked 
 physiological effect in the dose of -g-^th of a grain for an adult man. 
 The active principle, Epinephrine, C 17 H 15 N0 4 , is an unstable alkaloid 
 found only in the medulla of the gland and rapidly destroyed in the sys- 
 tem. Though produced in very small quantity its probable function is 
 to preserve the normal tone of muscular tissue, especially that of the 
 blood-vessels. 
 
 By internal administration this extract has given good results in nasal, 
 pulmonary and gastric hemorrhage, acute and chronic bronchitis, bron- 
 chial asthma, congestion and edema of the lungs, edema of the glottis 
 and diabetes insipidus. Internally and locally it has proved of very great 
 benefit in the treatment of hay-fever. It has been employed in Addi- 
 son's disease, pernicious anemia and diabetes mellitus with some benefit 
 in a few cases. It may be found useful in chronic muscular affections, 
 especially those involving loss of tone or degenerative changes, and will 
 probably be found valuable in all conditions in which the vaso-motor 
 tone is impaired. Being a powerful but temporary stimulant of the heart 
 it may be used cautiously in cardiac weakness, in failure of the heart from 
 any cause and in valvular diseases of that organ. 
 
 By local application the angiostenotic properties of suprarenal extract 
 have been successfully utilized in the treatment of local congestions, 
 inflammations and hemorrhages, especially those of the eye, nose and 
 throat. It is an excellent hemostatic for hemorrhage following opera- 
 tions on the nose, and it is used as an application to inflamed tissues prior 
 to their being anesthetized by cocaine, also to the mucous membrane of 
 the turbinated bodies in ulceration or hypertrophy thereof. 
 
1 66 ANIMAL EXTRACTS. 
 
 The preparation employed is the powdered gland of the sheep, dried in vacuo, the dose 
 of which is gr. iij-v, in tablets or capsules, every two or three hours. For local use 4 to 
 50 per cent, sterile, aqueous solutions are applied, as a spray or by cotton swabs or a brush, 
 directly to the affected part. It should not be used hypodermically. 
 
 Splenic Extract. — Excision of the spleen, or the serious impair- 
 ment of its functions by disease, is usually followed by marked tissue 
 changes and great susceptibility to alterations of temperature, especially 
 in malarial subjects. The substance of this organ has been used medi- 
 cinally in various disorders of the blood, with the idea of supplying to 
 that tissue some material which may be necessary to its health. The 
 possession of bactericidal power by some secretion of the spleen is 
 strongly indicated by certain facts, among which are the evident incom- 
 patibility of tuberculosis and malaria and the enlargement of the spleen 
 in acute infectious diseases, as though working against the germs 
 thereof. It has therefore been suggested that the splenic substance of 
 animals naturally immune against certain of these diseases be employed 
 as a remedy therein, — for example, in tuberculosis, malaria and typhoid 
 fever. By this treatment it is hoped that some light may be thrown on 
 the functions of this organ, as has so recently been done in the case of 
 the thyroid gland. Dr. H. C. Wood has reported excellent results from 
 splenic extract in the treatment of exophthalmos. The improvement in 
 some of his cases began soon after the commencement of the hypodermic 
 administration of the remedy, and continued until the thyroid enlarge- 
 ment had entirely disappeared. The general nervousness vanished and 
 the extrusion of the eyeball lessened, but while the cardiac action was 
 greatly reduced the heart remained irritable on excitement. 
 
 Lymphatic Extract. — An extract prepared from the lymphatic glands of animals has 
 been employed in exophthalmic goitre, lymphadenoma, and other glandular swellings, 
 but there are no trustworthy reports as to the results. 
 
 Pancreatic Extract. — In many cases of diabetes decided structural changes have 
 been observed in the pancreas after death, and the ablation of this gland in animals is 
 followed by emaciation and glycosuria ; but these symptoms will not occur if a portion 
 of the pancreas is left, or if a part of it be engrafted on the peritoneum after its removal 
 from its proper location. These facts have suggested the probability of the possession 
 by the pancreas of power over carbohydrate metamorphosis, through the action of some 
 substance elaborated by the peculiar, vascular epithelioid tissue which occurs in isolated 
 patches throughout its substance, and which is not found in any other duct-bearing gland 
 in the body. Upon this theory the pancreas, both in substance and extract, has been 
 administered as a remedy for diabetes, but the results have been negative in nearly all the 
 cases. A few instances are recorded in which its use was followed by some temporary 
 amelioration of the symptoms of the disease. 
 
 Parotid Extract. — An extract of the parotid gland has been employed, by Dr. Robert 
 Bell, of Glasgow, with good results in ovarian disorders, particularly enlarged and tender 
 ovaries associated with dysmenorrhea, metrorrhagia, chronic endometritis and subinvolu- 
 tion of the womb. 
 
 Ovarian Extract. — The substance of the ovaries has been administered with some 
 benefit in the nervous manifestations and pathological conditions which occur when the 
 ovarian functions are partially or wholly arrested, as in cirrhosis or malignant disease 
 thereof, or after the operation of ovariotomy. It is said to be a serviceable remedy in 
 cases of depression or other mental disturbance coincident with the climacteric. 
 
ANISUM ANTIMONIUM. 1 67 
 
 Uterine Extract. — The substance of the uterus has been employed as a remedy in 
 those disorders and cachexias which seem to be consequent on the removal of this organ 
 and its appendages. The available data are not, however, sufficient to enable any con- 
 clusions to be formed as to its efficacy. 
 
 Mammary Gland Extract has given satisfaction in fibroma and carcinoma of the 
 uterus, also in menorrhagia, dysmenorrhea and enlarged and sensitive womb (Bell). 
 
 ANISUM, Anise, — is the fruit of Pimpinella Anisum, a European 
 plant of the nat. ord. Umbelliferae. It occurs in ovate bodies, y& inch 
 long, hairy, of grayish color, aromatic odor, and sweet, spicy taste, re- 
 sembling conium fruit in appearance. Dose, gr. x-xx. 
 
 Oleum Anisi, Oil of Anise, — is a volatile oil distilled from Anise, and represents the 
 medicinal qualities of the plant. It contains Anethol (C 10 H 12 O) or Anise-camphor, con- 
 geals at 50 to 59 F., is soluble in an equal part of alcohol, and is an ingredient of 
 Tinctura Opii Camphorata, Trochisci Glycyrrhizae et Opii, and of the two following 
 preparations. Dose, rry-v. 
 
 Aqua Anisi, Anise Water, — has in 500 parts I of Oil of Anise triturated with Calcium 
 Phosphate, and mixed with distilled water. Dose, indefinite. 
 
 Spiritus Anisi, Spirit of Anise, — is a 10 per cent, solution of the oil in alcohol. 
 Dose, gj-ij. 
 
 The Volatile Oil is the active constituent of Anise. It has a slightly 
 stimulant action on the heart and the digestive organs, and liquefies the 
 bronchial secretion, being probably excreted in part by the bronchial 
 mucous membrane. It is a favorite flavoring ingredient of cough-mix- 
 tures, and relieves slight intestinal colic and flatulence in children. In 
 full doses it has weak narcotic power. 
 
 ANTHEMIS, Chamomile, — the flower heads of Anthemis nobilis, a European 
 perennial of the nat. ord. Compositse, collected from cultivated plants. They contain a 
 volatile oil, a camphor and a bitter principle, but no alkaloid. There are no official 
 preparations. An infusion (^iv to Oj) may be given in doses of ^j-ij. 
 
 Oleum Anthemidis, Chamomile Oil (Unofficial), — the volatile oil, is of a dark blue 
 or green color, and is composed of various ethers, the Angelates and Valerianates of 
 Butyl predominating. Dose, Ttyj-x, on sugar. 
 
 Chamomile is a stomachic tonic. It improves the appetite and aids digestion by in- 
 creasing the vascularity of the gastric mucous membrane. In large doses the warm 
 infusion is emetic, and perhaps diaphoretic, though the latter action is chiefly due to the 
 hot water. The oil is remarkably efficient in reducing reflex excitability in frogs, even 
 after its excitation by Strychnine or Brucine. 
 
 Chamomile is popular in domestic practice. An infusion is used internally for many 
 infantile complaints, and externally as a fomentation to relieve pain, as in colic, etc. The 
 oil is very efficient in reflex cough, pulmonary catarrh, acute dyspepsia, diarrhea of chil- 
 dren, spasmodic asthma, whooping-cough, colic, and the spasmodic and pseudo-neuralgic 
 affections of hysterical women. It should prove extremely useful in poisoning by 
 Strychnine, from its power over reflex excitability. 
 
 The Chamomilla of the homeopaths is the Matricaria Chamomilla, or German Cham- 
 omile, official in the U. S. Pharmacopoeia as Matricaria, which see. 
 
 ANTIMONIUM, Antimony, Sb. — Metallic antimony is not offi- 
 cial, and is not used in medicine. It is represented, however, by the 
 following official salts and preparations, viz. — 
 
l68 ANTIMONIUM. 
 
 Compounds of Antimony and their Preparations. 
 
 Antimonii et Potassii Tartras, Antimony and Potassium Tartrate, Tartar Emetic, 
 2KSbOC 4 H 4 6 . H 2 0, — small white crystals or a granular powder of sweet, disagreeable 
 metallic taste, soluble in 17 of water at 59 F., and in 3 of boiling water, insoluble in 
 alcohol. Dose, gr. J— \, but after tolerance is established as high as gr. ij may be given. 
 It is an ingredient of the first two following, viz. — 
 
 Vinum Antimonii, Wine of Antimony, — has of Tartar Emetic 4, Boiling Distilled 
 Water 65, Alcohol 150, White Wine to 1000. Contains about 2 grains of Tartar Emetic 
 to the ^ , and is an ingredient of Mistura Glycyrrhizae Composita. Dose, n\v-xv. 
 
 Syrupus Scillae Compositus, Compound Syrup of Squills, Cox's Hive Mixture, 
 Hive Syrup (see under Scilla), — contains about 1 grain of Tartar Emetic to the J , 
 with Squill, Senega, etc. Dose, Try-^j, cautiously in children. 
 
 Antimonii Oxidum, Antimony Oxide, Sb 2 3 , — a heavy gray powder, insoluble in 
 water or alcohol, but readily and wholly soluble in Hydrochloric or Tartaric Acid solu- 
 tions. Dose, gr. j-iij. It constitutes y^d of — 
 
 Pulvis Antimonialis, Antimonial {or James') Powder, — consists of the Oxide of 
 Antimony 33 parts, with 67 of Calcium Phosphate. Dose, gr. iij-viij, every 3 hours as 
 a diaphoretic, larger doses for emetic and cathartic effects. 
 
 Antimonii Sulphidum, Antimony Sulphide, Sb 2 S 3 , — is the native sulphide, purified 
 by fusion, and as nearly free from Arsenic as possible ; steel gray masses, or a black, lus- 
 treless powder, insoluble in water or alcohol. Dose, gr. X~J- 
 
 Antimonii Sulphidum Purificatum, Purified Antimony Sulphide, — Sb 2 S 3 , — is puri- 
 fied by maceration in Aq. Ammoniae, washing and drying. Dose, gr. %-). 
 
 Antimonium Sulphuratum, Sulphurated Antimony, Kermes Mineral, — is chiefly 
 Sb 2 S 3 , with a very small amount of Sb 2 O s . A reddish-brown, tasteless powder, insoluble 
 in water or alcohol, and a constituent of Pil. Antimonii Composite. Dose, gr. j-v. 
 
 Pilulae Antimonii Compositae, Plummer' 's Pills, — each pill contains about gr. y^ 
 each of Calomel and Sulphurated Antimony, with Guaiac and Castor Oil. 
 
 Physiological Action. 
 Tartar Emetic in its action represents the other official antimonial 
 preparations, being a cardiac, arterial and general depressant, a proto- 
 plasmic poison, a systemic and local emetic, a specific gastro-intestinal 
 irritant, an expectorant and a diaphoretic. Like Aconite, Arsenic, Hy- 
 drocyanic Acid and Potassium, it is destructive to protoplasm, destroy- 
 ing function in all nitrogenous tissue, and paralyzing the spinal cord, the 
 motor nerves, the muscles and the sensory nerve terminations. It is espe- 
 cially depressant to the heart-muscle and the cardiac motor ganglia ; it 
 combines with the red blood-corpuscles, lessening their oxidizing power, 
 lowering the blood-pressure and reducing the body-temperature. Its 
 taste is styptic and one of its earliest effects is the production of constric- 
 tion of the fauces. It promotes waste and rapid excretion of waste 
 products, carbonic acid and urea being especially increased. Being 
 eliminated by all the excretory organs, including the skin, it excites fol- 
 licular inflammation at the points of elimination ; resulting in an eruption 
 which is popular at first, then becomes vesicular, and finally pustular, the 
 pustules being umbilicated like those of variola. This same eruption is 
 also produced by the application of the drug to the skin with friction. 
 Aphthous ulcerations, extending from the mouth to the stomach, with 
 salivation and painful deglutition, may also result from its continued use. 
 
ANTIMONIUM. 1 69 
 
 In small doses Tartar Emetic stimulates secretion in the bronchial and 
 salivary glands, the stomach, intestinal canal, liver and pancreas. In 
 larger doses it excites nausea, vomiting and purging, with evacuations 
 like the "rice-water discharges" of cholera, and great prostration of the 
 vital powers. Toxic doses produce similar symptoms, besides epigastric 
 pain, cyanosis, delirium, cramps, motor and sensory paralysis, suppression 
 of urine and collapse, — the same phenomena as in Asiatic cholera. 
 
 The Sulphide occurs native, and is the source from which the other 
 compounds are prepared. It seems to be inert medicinally. Sulphurated 
 Antimony owes its efficacy to the small quantity of the oxide contained 
 in it, and as this is variable, the action of the preparation is uncertain. 
 The Oxide has similar action to that of Tartar Emetic, but being insoluble 
 in water, it is of much less certain activity. 
 
 Antidotes, Antagonists, and Inco7npatibles. 
 Tannic Acid, or any substance containing it, is the antidote, forming the insoluble 
 tannate. Opium, Alcohol, Ether, and other antispasmodics are physiological antago- 
 nists. Demulcent drinks should be freely administered to protect the mucous mem- 
 branes. Alkalies and Salts of Lead decompose Tartar Emetic. 
 
 Therapeutics. 
 Tartar Emetic was formerly much employed as an antiphlogistic on 
 account of its power to cut short acute inflammations of sthenic type, but 
 its use was greatly abused, so that it has now gone out of fashion as a 
 remedy. The contra-stimulant treatment of pneumonia and other inflam- 
 matory diseases, by large doses of this salt after tolerance was established, 
 is only worthy of reference as an historical fact. The same may be said 
 of its external use as a counter-irritant as well as of its employment as an 
 emetic, in both of which capacities it is too severe, while its emesis is too 
 tardy in action to be of any value in poisoning. It is, however, a very 
 efficient agent in many grave affections, if used in small doses (gr. -gV^V) '> 
 being highly efficacious in acute inflammatory affections of the respiratory 
 tract, especially pneumonia, broncho-pneumonia, acute edema of the 
 lungs, feverish and catarrhal colds, bronchitis, laryngitis and tonsillitis. 
 In many respects it acts like Aconite in these and kindred affections, 
 producing copious diaphoresis, slowing the pulse and allaying restlessness. 
 It is considered a good remedy in puerperal peritonitis, mammitis, and 
 orchitis, in lumbago and other muscular rheumatisms, also in photophobia 
 and in gastric indigestion after beer-drinking. In still smaller doses 
 (gr. -j-1-q hourly) it is particularly efficient in catarrhal inflammations of 
 the respiratory mucous membrane in children, accompanied by rattling 
 breathing and much mucus, which is expelled with difficulty. Such cases 
 often simulate asthma, the attacks being marked by cough, wheezing, and 
 difficult respiration, with sibilant rales in the chest, and usually follow on 
 severe colds or on measles. The Compound Syrup of Squill is commonly 
 
I/O ANTIPYRINUM. 
 
 used as an expectorant and nauseant in the treatment of bronchitis and 
 croup. The quantity of Tartar Emetic in it (gr. j to the 5) should be 
 remembered when administering it to children. (See under Scilla.) 
 
 The Oxide is chiefly employed in the form of James' Powder (Pulvis 
 Antimonialis) for its mild diaphoretic qualities. The Sulphide is not 
 used in medicine. Sulphurated Antimony is very uncertain in action 
 and is but little used. The Compound Pill of Antimony (Plummer's 
 Pill) was devised to obtain mercurial results without writing Hydrargyrum 
 on a prescription. 
 
 ANTIPYRINUM, Antipyrin, Phenyl-dimethyl-pyrazolon, C 20 H 18 - 
 N 4 2 , — unofficial in the United States, but official in the Br. Ph. under 
 the name Phenazonum, Phenazone, — is a crystalline substance obtainable 
 from phenyl-hydrazine, and prepared by a patented and complicated pro- 
 cess. It is a synthetical base, forming salts which are analogous to those 
 of Ammonium; and occurs as colorless and inodorous scaly crystals, with 
 a bitter taste, freely soluble in water, alcohol and chloroform, less soluble 
 in ether. It gives a deep red color with ferric chloride, a deep green 
 with nitrous acid, and with nitric acid a yellow color which deepens to 
 crimson on warming. It is not irritant to the stomach or the tissues and 
 may be administered hypodermically. 
 
 Dose and Administration. 
 
 The Br. Ph. states the dose, at from gr. iij to gr. xx. An average adult dose may be 
 placed at gr. x. For children the dose is gr. % per year of age between 2 and 5 years, 
 gr. y z per year from 5 to 10, not exceeding gr. v at a dose for any child under 15 years. 
 
 Antipyrin has but little flavor, is not unpleasant, and is therefore readily taken by 
 children, in which respect it is greatly superior to Quinine. It may be administered in 
 compressed tablets, each having from 1 to 5 grains ; — or in Aromatic Elixir, — say 
 gr. lxxx in 3iv, of which solution each g contains gr. ijss. If vomiting result, the same 
 dose may be dissolved in half its weight of hot water, and injected hypodermically while 
 warm. 
 
 Incompatibles. 
 
 Antipyrin may be decomposed when brought into contact with Nitrous compounds, a 
 new and poisonous substance being supposed to be formed, of uncertain composition, but 
 resembling the Anilin greens The mixture of this drug with Spiritus Athens Nitrosi is 
 therefore highly dangerous if this supposed reaction is at all likely to occur. 
 
 It is more or less decomposed or thrown out of solution by a large number of chemical 
 compounds and other preparations, of which the following are the most important, viz.: — 
 
 Acid, Hydrocyanic, Dilute. Arsenic and Mercury, Solution of the 
 Acid, Tannic. Iodides of. 
 
 Butyl -chloral Hydrate. Mercuric Chloride. 
 
 Chloral Hydrate. Naphtol /3 (solid). 
 
 Cinchona, Decoction. Nitrites in solution (acid). 
 
 Cinchona, Fluid Extract. Sodium Bicarbonate. 
 
 Catechu, Infusion (cone). Sodium Salicylate (solid). 
 
 Ferrum, Sulphate. Tinctures containing Tannin, Iron, or 
 Ferric Salts in Solution. Quinine. 
 
 Hamamelis, Tincture. Rose, Infusion. 
 
 Iodine, Tincture. Uva Ursi, Infusion. 
 Antipyrin and Phenyl-urethan liquefy when rubbed together. 
 
ANTIPYRINUM. I/I 
 
 Unofficial Preparations and Derivatives. 
 
 Salipyrin, Antipyrin Salicylate, — is formed by combining Salicylic Acid 57.7, and 
 Antipyrin 42.3 parts; and is the only salt of the base which has any therapeutic impor- 
 tance. Described under Salix. 
 
 Hypnal, — is a combination of Antipyrin and Chloral, heated together, which is 
 credited with hypnotic and analgesic power. It is described under Chloral. 
 
 Migranin, — is a double Citrate of Antipyrin and Caffein, lately brought forward in 
 Germany as a specific for sick headache and neuralgia. A report is published that the 
 police authorities of Hamburg have issued a notice forbidding its free sale in the local 
 pharmacies, and warning the public against using it except under a physician's direction 
 (Squibb). The dose is placed at about gr. xv. 
 
 Phenopyrin, — is prepared from equal parts of crystalline Phenol and Antipyrin. It 
 is an oily liquid, colorless and odorless, insoluble in cold and sparingly soluble in hot 
 water. It has as yet no medicinal importance. 
 
 Pyramidon, Ditnethyl-amido-antipyrin, — is a derivative of Antipyrin by a substitution 
 process, and is highly praised as an antipyretic and analgesic. It occurs as a yellowish- 
 white, crystalline powder, soluble in 10 parts of water. Its applications are the same as 
 those of Antipyrin, but it is less soluble, slower in action, more lasting in effect, and the 
 same results may be produced by it with about one-third the dose. Dose, gr. iv-viij, 
 thrice daily. 
 
 Physiological Action. 
 
 Antipyrin is a powerful antipyretic, a local anesthetic, and a general 
 analgesic, also possessing diaphoretic, mydriatic, antiseptic, disinfectant, 
 hemostatic and slight hypnotic powers. After the ingestion of a full 
 medicinal dose (gr. xx), there is a stimulant stage of short duration, in 
 which the heart's action is increased, and a subjective sense of heat is 
 experienced, with flushing of the face. This is soon followed by profuse 
 sweating, coldness of the surface, slowed pulse, considerable depression, 
 and if fever be present by lowered temperature ; the latter coming on 
 within half an hour after taking the drug and its degree being in direct 
 ratio to the quantity administered, as also its continuance, — the former 
 being usually from 3 to 5 degrees, and the latter from 1 to 10 hours, a 
 fair average being about 2 hours. In one case a fall of 12 F. was ob- 
 served. When given with Kairin, the mixture of the two drugs has been 
 found to produce a much greater fall of temperature, with longer continu- 
 ance down, than that produced by an equal quantity of either drug given 
 alone. After the antipyretic effect of the dose has passed off, the tem- 
 perature (in fever) commences to rise again, — the onset being usually 
 preceded by a chill, which is of slight degree when compared with the 
 severe rigors and dangerous depression occurring under the action of 
 Kairin, Chinolin and other members of the group. 
 
 In health the administration of a full dose gives rise to slight nausea, 
 singing in the ears, and a reduction of the body-temperature of scarcely 
 any extent, about y 1 ^ F. It slightly raises the arterial tension and blood- 
 pressure ; sometimes induces vomiting, and may cause such a degree of 
 depression as to almost amount to collapse. It has little or no effect 
 upon the respiration, but acts as a sedative upon the cerebrum, leaving 
 
1^2 ANTIPYRINUM. 
 
 behind a somewhat depressant influence on the brain. It dilates the 
 pupils and is rapidly eliminated by the kidneys, appearing in the urine 
 within half an hour after its ingestion. The profuse sweating which it 
 causes may be prevented by giving in advance a small dose of Atropine 
 or Agaricine. In some persons a single dose of ten grains produces an 
 urticarial eruption on the skin, and this is occasionally accompanied by 
 swelling and irritation of the mucous membrane of the respiratory tract, 
 the subject feeling as if the nose and throat were swollen so that breath- 
 ing became difficult. 
 
 In toxic dose Antipyrin probably acts as a primary stimulant and a sec- 
 ondary depressant of the spinal cord, paralyzes both the motor and sen- 
 sory nerve trunks, decreases the arterial pressure, and exerts a poisonous 
 influence on the blood, altering the shape of the red corpuscles, separat- 
 ing the hematin, and causing decomposition of that tissue. A peculiar 
 livid discoloration of the surface is one of the most characteristic symp- 
 toms of antipyrin poisoning, and is probably due to the formation in the 
 blood of methemoglobin or some similar compound. 
 
 As an antipyretic, Antipyrin, like Alcohol, acts by a double mode of 
 operation, — (1) by diminishing oxidation, and (2) by promoting heat- 
 loss. The latter is attained by dilating the cutaneous vessels, allowing 
 free radiation from the surface, and by the refrigerant action due to 
 evaporation of the sweat. 
 
 As an analgesic, Antipyrin has a very considerable degree of power, in 
 common with all the Chinolin derivatives ; but its property in this 
 respect is found to act almost entirely upon pain due to manifestations of 
 the rheumatic diathesis. In general anodyne action, it is not to be com- 
 pared with the derivatives of Opium. Its hemostatic power is claimed 
 to be superior to that of Ergotin. 
 
 Therapeutics. 
 One of the most popular of the modern antipyretics, Antipyrin de- 
 serves high rank in professional esteem, being an excellent analgesic and 
 one of the most certain and most powerful depressants of temperature, 
 though somewhat dangerous, and devoid of any other influence upon the 
 course of any febrile disorder. Its principal applications are as follows : 
 (1) As an antipyretic it has been employed in all diseases with high tem- 
 perature, and it may be used in asthenic fevers, as it has little effect upon 
 the circulation. It has held a high place for several years in the treatment 
 of acute rheumatism, and affords valuable aid in the pyrexia of intermit- 
 tent fever, a stage in which the slow action of quinine prevents that drug 
 being available for immediate relief. (2) As an analgesic it is highly 
 efficient except when the pain is dependent upon a local inflammation, in 
 which case it is of no value for this purpose. It is often remarkably effi- 
 
ANTIPYRINUM. I73 
 
 cient in migraine and other headaches, in the fulgurant pains or the pain- 
 crises of locomotor ataxia, and in other paroxysms of suffering dependent 
 on disease of the nerve centres, or having the character of nerve storms. It 
 is very serviceable in neuralgia, neuritis and other painful affections, espe- 
 cially when of rheumatic origin, as lumbago, sciatica, hemicrania, supra- 
 orbital neuralgia, etc., in which ten-grain doses are generally sufficient 
 and may be given hypodermically. It often relieves dysmenorrhea, also 
 the painful affections of hysteria, pain from cerebral tumors, and that due 
 to cardiac disease. In acute gout, a preliminary dose of 25 grains, fol- 
 lowed by 10-grain doses every two hours, promptly relieved the pain and 
 shortened the duration of the paroxysms in one very carefully observed 
 and thoroughly reported case. In chronic gout, very remarkable results 
 are reported as due to it, indicating a specific and curative influence on 
 that disease. For the relief of pain, the conjoint administration of Anti- 
 pyrin and Morphine is said to be much more efficient than the use of 
 either agent alone. (3) To allay nervous irritation; — thus it has been 
 used with extraordinary success in nervous urticaria, and is often employed 
 with benefit in the restlessness of hysterical subjects. In the urticaria- 
 like eruptions of children its action Jias been so promptly efficient as to 
 indicate for it a direct influence upon the vascular nerves ; and as a 
 symptomatic remedy against itching it is equally efficient in nervous 
 pruritus, true prurigo, urticaria, erythema, pemphigus vulgaris and lichen 
 ruber. (4) To antagonize excitability of the motor nerve centres, as in 
 laryngismus stridulus, whooping-cough, tetanus, epilepsy and chorea. In 
 the latter disease Antipyrin is held in high esteem as a curative remedy, 
 and although it often fails entirely in epilepsy, it sometimes acts therein 
 with extraordinary power, especially when given in combination with 
 ammonium bromide. (5) To affect secretion, as in infantile diarrhea, in 
 which it has rendered signal service, administered in doses of y 2 to 1^ 
 grain; and as an antigalactagogue, when it is desired to arrest the secre- 
 tion of milk, doses of gr. iv every two hours will prove efficient. It has 
 also been employed with benefit in both forms of diabetes, and has been 
 found to be remarkably effective in promoting the absorption of pleuritic 
 effusions. (6) As a local anesthetic it is equal if not superior to cocaine, 
 if applied to the mucous membranes in a 30 to 50 per cent, solution 
 (St. Hilaire). (7) As a local hemostatic, it is highly efficient in 15 per 
 cent, solution as a spray for epistaxis, and hemorrhages of almost any kind 
 are checked by the application of stronger solutions. It has the advan- 
 tage of constricting the small vessels without causing any external clot 
 which may break down. (8) As an antiseptic it possesses properties 
 which compare favorably with most of the anilin and coal-tar derivatives. 
 Antipyrin has rendered good service in bronchial asthma, in sea-sick- 
 ness, in cerebro-spinal meningitis, and in croupous pneumonia. In the 
 
174 ANTITOXINS. 
 
 latter affection it has been employed in combination with camphor and 
 small doses of morphine with excellent results. In erysipelas it is thought 
 to be contraindicated, as when administered in that disease it has usually 
 caused anuria and a profound fall of temperature (Spanoudis). 
 
 ANTITOXINS (Unofficial). The remarkable reports which have 
 been published during the last few years upon the antitoxin treatment of 
 diphtheria and tetanus have excited fresh interest in bacterio-therapy, 
 and seem likely to dispel the cloud which has rested thereon ever since 
 the failure of Koch's tuberculin. After the discovery of the bacillus 
 tuberculosis in 1882 several other micro-organisms were found to be con- 
 stantly associated with certain acute infectious diseases, notably tetanus, 
 diphtheria, cholera, pneumonia, erysipelas and typhoid fever. The spe- 
 cific microbes of these affections were at first believed to be the immediate 
 cause of their respective disorders, but later researches have shown that 
 such diseases are due to the action of chemical poisons (toxins and tox- 
 albumins) produced by their specific bacteria growing on suitable soils 
 either within the animal organism or outside it. [Compare the article 
 entitled Toxins.] 
 
 It was shown by Von Fodor in 1887 and subsequently by Nuttall that 
 the blood serum of healthy animals is naturally bactericidal, that it 
 possesses this quality in varying degrees of efficiency, and that it may be 
 sufficiently powerful in this respect to prevent certain pathogenic bacteria 
 from gaining lodgment on the organism, thereby conferring natural 
 immunity against a particular disease upon the individual so protected, 
 and in some cases even upon the species. Further study and experiment 
 established the fact that temporary artificial immunity against certain dis- 
 eases may be imparted to an individual animal naturally susceptible by 
 repeated inoculations of the specific bacteria or their toxic products in 
 gradually increasing degrees of virulence (Behring, Kitasato, Roux). 
 The crowning discovery that the blood serum of such an immunized 
 animal may be successfully employed for curative as well as prophylactic 
 purposes against its particular disease upon other animals of the same or 
 different species, was made by Professor Emil Behring of Berlin, in 1891. 
 This was no chance discovery, but was the legitimate result of logical 
 reasoning and hard work, and is formulated under the title Behring' s 
 Law, as follows : That the blood seru?n of an animal which has been arti- 
 ficially rendered immune against a certain infectious disease, when injected 
 into the body of another animal, has power to protect the latter individual 
 against the same disease and to cure the disease after infection has occurred. 
 
 An Antitoxic Serum or Antitoxin is a blood serum possessed of 
 these immunizing and curative properties. The term Antitoxin is also 
 
ANTITOXINS. 175 
 
 applied, and more correctly, to the suppositious defensive proteids, which 
 are chemical substances assumed to be contained in the antitoxin serum, 
 and believed to be produced by the blood or tissue cells for the defence 
 of the organism against the foreign bacterial toxins. Alexins are similar 
 substances, natural antitoxins, which are supposed to exist in the blood 
 of naturally immune animals. 
 
 Ehrlich has shown that Behring's law is valid also for the chemical poisons, Rici7i 
 and Abrin, the respective toxalburains of the ricinus palm and the jequirity bean. The 
 blood of animals slowly immunized by increasing doses of these toxins contains antitoxic 
 substances named Antiricin and Antiabrui, which, if added to their respective poisons, 
 will attenuate and even neutralize the latter. These facts are advanced as proof that the 
 slowly increasing artificial immunity is not a simple tolerance acquired by the organism, 
 as Sternberg taught, but is due to the production of new antagonistic and defensive sub- 
 stances by the living cells of the organism. 
 
 Theories deduced from the observed facts are as follows: (1) That, as 
 the various pathogenic bacteria produce the causative toxins of their re- 
 spective diseases, so the organic cells of the body, reacting under the 
 stimulus of the poisons thus introduced, immediately proceed to elaborate 
 defensive antitoxins, which if produced in sufficient quantity will neutral- 
 ize the effects of the toxins. (2) That residual antitoxins remaining in 
 the blood after recovery render the animal immune for a time against the 
 disease. (3) That the immunizing and curative effects obtained by the 
 injection of the blood serum of an immunized animal into the circulation 
 of another animal are due — either to direct chemical neutralization of the 
 toxins themselves by the antitoxins so introduced (Behring, Kitasato), 
 or to a particular influence exerted by the antitoxins upon the living cells 
 of the organism, which, being affected in two opposite directions, remain 
 neutral to the disease (Buchner). 
 
 Specific action is a characteristic of the antitoxins with perhaps a few 
 exceptions ; which means that the serum from an animal inoculated with 
 the toxin of the diphtheria bacillus is effective only against diphtheria, 
 and the tetanus antitoxin only against tetanus. A dose of an antitoxin 
 followed by a dose of the corresponding toxin produces no effect from 
 either, the action of the one being rendered ineffective by that of the 
 other. The corresponding toxin and antitoxin may be mixed together 
 outside the body and then injected with like result, though of course there 
 must be a certain amount of antitoxin present to counteract a given dose 
 of toxin. The immunizing or vaccine property of the antitoxins, though 
 transient, is probably destined to be of considerable importance. In- 
 stances are already recorded in which epidemics of diphtheria in schools 
 were apparently stopped by vaccinating all the children therein with 
 diphtheria antitoxin. 
 
 An Antitoxic Serum is prepared as follows. Either a highly virulent culture of the 
 specific micro-organism of the particular disease, or still better, a strong toxin of tested 
 
1/6 ANTITOXINS. 
 
 strength prepared therefrom, is injected into the cellular tissue of a suitable animal, gen- 
 erally a horse, at first in very small quantity. The effect is soon shown by the onset of 
 fever and other symptoms of acute disease, which are known as the " reaction." After 
 an interval of time sufficient for recovery from these symptoms, the injection is repeated 
 with a stronger toxin or with a culture of greater virulence, or with a larger quantity of 
 the original toxin. With proper care the amount injected may be gradually increased, 
 until ultimately a dose many hundred times greater than one which would have been 
 fatal at first can be given with impunity. This process is continued for several months, 
 or until the animal no longer "reacts" to the poison, and then sufficient antitoxin is 
 presumed to exist in its blood to render it immune to the toxin and to the disease. After 
 each inoculation the animal's blood serum is tested as to its value by experiment on 
 guinea-pigs of definite weights. When the desired degree of immunity is reached the 
 animal is bled from the jugular vein under strict aseptic conditions, from 6 to 12 pints 
 being taken from a horse, according to his size and general condition. The blood is 
 received in sterilized flasks, which are carefully stoppered and stored on ice until the 
 clot has separated from the serum. The latter is tested to determine its value in anti- 
 toxin, has carbolic acid added to it in the proportion of 0.5 per cent., and is bottled in 
 vials which contain in each the dose for one patient. The vials are labeled with a state- 
 ment of the number of normal antitoxin units per cc. of the contents, expressed in mul- 
 tiples of a standard normal serum. The effective antitoxin value of a serum intended for 
 protective purposes is much less than that of one intended for curative action, and the 
 earlier in the course of the disease that the latter serum is employed the smaller will be the 
 quantity capable of producing a certain remedial effect. 
 
 Serum-therapy properly means the prophylactic and curative treat- 
 ment of certain acute infectious diseases by the subcutaneous injection of 
 a blood serum containing an antitoxin specific to the particular disease. 
 As generally used, however, this term includes the treatment of the same 
 disorders by the toxins produced by attenuated cultures of their respective 
 microbes ; but these toxins, though sometimes grown on blood serum, 
 may be cultivated on other media, and are never administered in a serum 
 as the antitoxins invariably are. The antitoxins at present employed in 
 serum-therapy are those of diphtheria, tetanus, tuberculosis, erysipelas, 
 pneumonia, cholera, syphilis, plague, and typhoid fever, but only the 
 first three have come into anything like general use. Toxin treatment 
 is described under the title Toxins. 
 
 Diphtheria Antitoxin, though not the first antitoxin discovered, is 
 by far the first in practical importance. The bacillus of diphtheria was 
 discovered by Loeffler and Klebs in 1884, its toxic products were isolated 
 by Roux, and the antidote to them was found by Behring, who established 
 the preventive and curative properties of this antitoxin. In the meantime 
 Sidney Martin had proved the chemical identity of the laboratory toxins 
 discovered by Roux with those produced in the body by the bacillus. 
 The clinical results obtained in Paris by the use of Behring's diphtheria 
 antitoxic serum were announced by Roux at the Buda-Pesth Congress of 
 Hygiene in 1894, and attracted universal attention. Since then the sta- 
 tistics of diphtheria serum-therapy have grown voluminous, have included 
 a large number of reports from official and private sources of the highest 
 professional authority, and the weight of evidence has steadily grown 
 more and more favorable to this treatment. 
 
ANTITOXINS. 177 
 
 The statistics first presented by Roux covered 300 cases of true diphtheria, treated at 
 the Hopital des Enfants Malades in Paris, with a mortality under the serum treatment 
 of 26 per cent., against a mortality of 51.7 per cent, in the same hospital during the 
 previous four years in 3971 cases, and a mortality of 60 per cent, in 520 cases during the 
 six months immediately preceding. Professor Virchow stated, at a.ftte of the Empress 
 Frederick Hospital in Berlin, that from April to November, 1895, out of 335 diphtheria 
 cases treated therein with the serum 305 were cured ; and that the diphtheria mortality 
 in that hospital, formerly 43 per cent., had declined to 9^ per cent, under the antitoxin 
 treatment. Professor Welch of Baltimore has collected and analyzed the statistics avail- 
 able in July, 1895, covering 7,166 cases from 80 different sources, and showing a gen- 
 eral mortality under the antitoxin treatment of 17.3 per cent., against a previous general 
 mortality of 42 per cent. Tabulating the results according to the time at which the treat- 
 ment was commenced, he shows for 814 cases treated on the first and second days of the 
 .disease a mortality of ^ l / 2 per cent.; for 531 cases treated on the third and fourth days 
 .15.2 per cent., and for 286 cases treated after the fourth day 31.8 per cent. A collective 
 investigation of 5794 cases treated with antitoxin in private houses, made by the Ameri- 
 can Pediatric Society in 1896, showed a mortality for the whole of 12.3 per cent. ; ex- 
 cluding moribund cases and those which died w 7 ithin 24 hours after injection, a mortality 
 of 8.8 per cent.; for those treated within the first three days of the disease, a mortality 
 of 7.3 per cent; and excluding the moribund cases from the latter, a mortality of 4.8 
 per cent, in 4013 cases. 
 
 The clinical history of the disease under the antitoxin treatment, as 
 recorded by its observers, is equally favorable and shows an extraordinary 
 decrease in the severity of the symptoms. The membrane loosens and 
 clears off rapidly, high temperature is lowered, and the pulse slows and 
 gains in force (Washbourn). Evident signs of distress vanished within 
 24 hours, and apparent strength and good-humor took the place of a pre- 
 viously low mental and physical condition (Kossel). In no case did the 
 larynx become involved after the use of the serum if not so previously, 
 and many cases showing laryngeal symptoms recovered without tracheot- 
 omy. Even in the fatal cases life was prolonged (Caiger). 
 
 While diphtheria antitoxin properly prepared and used under aseptic 
 precautions is generally conceded to be harmless, some ill effects are 
 recorded as caused by it. An urticarial eruption on the skin, also pains in 
 and swellings about the joints, occur in about 5 per cent, of the cases, but 
 these symptoms are usually transient and without serious consequences. 
 Abscess at the site of the injection has occurred, but rarely forms if proper 
 aseptic measures are used. Welch states that in over 100,000 injections 
 given the serious mishaps directly attributable to the serum can be counted 
 on the fingers. Two deaths are reported, one in Berlin and one in 
 Oregon, as having occurred within a few minutes after the injection of 
 the antitoxin in healthy children. 
 
 The following seem to be established facts as to the use of antitoxin in 
 diphtheria. The immunized serum is far more efficient as a curative agent 
 than any remedy heretofore employed, the general mortality of the dis- 
 ease having been reduced by its use to about 17 per cent, from a previous 
 rate of about 42 per cent. A marked improvement in both the local and 
 general symptoms is usually noticed within 24 to 48 hours after the injec- 
 tion of the serum. The remedy has decided power to prevent the spread- 
 
I78 ANTITOXINS. 
 
 ing of the false membrane into the larynx and trachea. It is powerless 
 to repair damage already done to the tissues by the diphtheria toxins, 
 hence the earlier the serum is administered the better are its results. It 
 is decidedly more efficient in the fibrinous form of the disease than in the 
 septic form, and in cases of simple infection than in those of double or 
 mixed infection. The liability to paralysis and albuminuria is not les- 
 sened but is perhaps somewhat increased by this treatment, though genu- 
 ine nephritis is less frequently seen under its use than in cases treated by 
 other methods. The serum may cause certain untoward symptoms, as 
 cutaneous swellings, eruptions, etc., but these are not serious and are 
 not attended with danger to life. Its injection is very rarely followed by 
 serious local disturbances, as abscess, and probably would never be com- 
 plicated thereby if the serum were always pure and used with strict aseptic 
 precautions. Recent improvements in the methods of preparation and 
 more definite knowledge as to the dose and manner of employment have 
 made the later reports even more favorable than the earlier ones. At the 
 1895 meeting of the British Medical Association, Professor Klein made 
 the statement that "the scientific basis for the application of antitoxic 
 serum is as firmly founded and as thoroughly established as the use and 
 application of any known drug." 
 
 Local antiseptic treatment of the throat is still insisted on in connec- 
 tion with the serum injection in every case of the disease. If thoroughly 
 carried out in the incipiency it may destroy the dangerous streptococci 
 and other microbes, thereby preventing the mixed infection which proves 
 so virulent; if continued throughout the case and during convalescence 
 it will minimize the danger of infecting other persons. In some instances 
 bacilli were found as long as two months after recovery. 
 
 Behring's Diphtheria Antitoxin is standardized in comparison with a "normal 
 therapeutic serum" of which one-tenth of a gramme will neutralize one gramme of 
 diphtheria toxin, and I cc. of which is termed equivalent to one "normal" or "immu- 
 nizing unit." As distributed the serum contains at least 100 such normal units in each 
 cc, the label on every vial showing the potential strength of its contents, thus: "This 
 phial contains 6 cc. of 100 times normal strength = 600 normal units." Four different 
 potentials are furnished, — one with a yellow label, possessing 200 units, and intended 
 only for prophylaxis, and three for therapeutic employment, viz. : (1) that with a green 
 label, counting 600 units, for use only in fresh cases on the first or second day; (2) 
 that with a white label, possessing 1,000 units, to be used in more serious cases on the 
 first or second day, or in less serious cases of longer standing; (3) that with a red label, 
 possessing 1,500 units, and meant for adults or for very severe cases in children. 
 
 A Concentrated Serum is recommended by the committee of the American Pedi- 
 atric Society, in order to obtain the requisite number of antitoxic units in as small a bulk 
 as possible. Parke, Davis & Co. furnish high-potency serums in hermetically-sealed 
 glass bulbs, containing as many as 1,750 units per cc. These very concentrated prepara- 
 tions are not so stable as those of lower potency and must be used while fresh, as they 
 rapidly lose their antitoxic value. 
 
 The Dose for Prophylaxis is 500 units, to be repeated after two or three 
 weeks if the case is still exposed to infection. The immunity is only 
 
ANTITOXINS. 1/9 
 
 temporary, its duration depends on the quantity of antitoxin injected, 
 and it gradually decreases as the latter is eliminated, but can be main- 
 tained for a long time by the repeated use of smaller doses at short 
 intervals. 
 
 The Dose for Curative Purposes should be rather large than small, in 
 order to guard against a virulent infection, 500 units for a light or sus- 
 pected case, 1,000 to 1,500 for a severe or advanced one; to be repeated 
 on the next or even on the same day if the case seems grave, until 2,000 
 or even 3,000 units have been given. The maximum quantity decided on 
 may be administered in one dose, and then will not usually require to be 
 repeated. The necessary amount for any case can be determined only 
 by comparative estimation of the quantity of toxin present as indicated 
 by the symptoms ; remembering that this quantity increases rapidly with 
 every day after infection. The prognosis is unfavorable if the case is so 
 far advanced before treatment that the toxin has had time to accumulate 
 and to exert its paralyzing influence on the nervous apparatus of the heart. 
 
 Diphtheria Antitoxin is now prepared in all European countries and in the labora- 
 tories of several boards of health, manufacturing druggists and others in this country. 
 The serum on the English market differs somewhat in strength, Aronson's being a highly 
 concentrated form obtained by precipitating the greater part of the inert constituents, 
 while Klein's is prepared by injecting both the toxins and the bacilli into the animal to 
 be immunized. In Germany the preparation of the serum is conducted by a private firm 
 under the supervision of Professors Behring and Ehrlich, and is tested by official experts 
 before its distribution is permitted by the government authorities entrusted with the con- 
 trol of its manufacture. In this country the favorite serums are Parke, Davis & Co.'s, 
 Mulford's, and that furnished by the New York Board of Health. 
 
 Double Diphtheria Antitoxin is a serum obtained from a horse which has been 
 immunized against streptococcus virus after having been previously rendered immune 
 against the diphtheria bacillus. It is supposed to contain both the diphtheria and strep- 
 tococcus antitoxins, and is intended for the virulent cases due to a mixed infection with 
 these two poisons, but it may be used in any case of diphtheria. 
 
 Tetanus Antitoxin. Tetanus was one of the first diseases to be 
 studied successfully by the bacteriologists, and its antitoxin was the first 
 one prepared. Breiger (1880) showed that a crystalline substance of high 
 toxicity could be obtained from tetanic fluids, and that it would repro- 
 duce the symptoms of tetanus when injected into healthy animals. 
 Rosenbach found the tetanus bacillus in human cases of the disease, and 
 Nicolaier demonstrated its existence in soils. Kitasato soon afterwards 
 obtained pure cultures of the bacillus, and demonstrated the immunizing 
 power of the serum of animals inoculated with its toxin. As human 
 tetanus is a comparatively infrequent disease there are but few available 
 statistics of its treatment with antitoxin serum, but its previous mortality, 
 as shown by the two largest sets of statistics, covering 2,789 cases, was 
 88 percent., which has been reduced to 20 per cent, under the serum 
 treatment (Kreiger). Dr. Marson has reported a series of 38 cases so 
 treated by various physicians, with 25 recoveries, a mortality of 34.2 per 
 
l8o ANTITOXINS. 
 
 cent. Kanthack quotes the total statistics of treatment as giving 68 cases 
 with 26 deaths, a mortality of 38.2 per cent. 
 
 In spite of its failure in many instances, the antitoxic serum is unques- 
 tionably the most efficient remedy known for this disease. As tetanus is 
 recognizable only by symptoms due to nerve lesions, which symptoms 
 are not manifested until the nervous system has been damaged by the 
 toxin, an early diagnosis is impossible; and when first seen by the physi- 
 cian the disease has usually advanced too far for the curative action of the 
 remedy to be available. For this reason, and as the immunizing proper- 
 ties of this antitoxin are very potent, it is advised that a preventive 
 inoculation thereof should be given in all cases where infection is possible, 
 such as lacerated wounds soiled with earth or rust, especially when occur- 
 ring in those tropical countries where the disease is most common. For 
 this purpose a dose of 10 cc. would suffice, if repeated at intervals of two 
 or three weeks. For curative purposes the serum should be injected as 
 soon as possible, the quantity being determined according to its stated 
 strength, the gravity of the symptoms, the patient's age and the time 
 since infection. The shorter the time of incubation or the more serious 
 the symptoms, the larger should be the initial dose. As a rule one injec- 
 tion should be given every other day, using a smaller quantity at each 
 repetition, so as to maintain sufficient immunity and prevent relapse. 
 Along with the serum treatment the usual remedial measures should be 
 employed, namely : excision of the part or the actual cautery if the wound 
 is recent, chloroform anesthesia, chloral, etc. The actual cautery, or the 
 application of a strong solution of corrosive sublimate with tartaric acid, 
 are the most efficacious means of neutralizing the tetanus germs in the 
 wound. 
 
 Tetanus Antitoxin prepared at the New York Pasteur Institute is dispensed in dry 
 form only, may be transported any distance without injury by heat or frost, and is said to 
 preserve its qualities for an indefinite time if kept in a dark and dry place. It represents 
 as many antitoxic units as are contained in about 12 times the weight of liquid serum. 
 The powder is put up in 25 cc. bottles, each containing 3 grammes, to be filled with ster- 
 ilized water when required for use, and shaken thoroughly until the powder is dissolved. 
 Each bottle then contains two doses of antitoxic solution, and this amount is to be admin- 
 istered daily for four or five days, beginning on the very first appearance of symptoms of 
 the disease. For prophylactic use I to 2 cc. of the solution should be injected immedi- 
 ately after the infliction of a suspicious wound. 
 
 Tuberculosis Antitoxin has superseded Koch's tuberculin, which 
 was a toxin treatment, in the serum-therapy of tuberculous disease. 
 Boinet immunized goats with injections of tuberculin, and claims to have 
 used the resulting serum in eight cases of tuberculosis with marked bene- 
 fit. Professor Maragliano, of Genoa, has treated a large number of cases 
 with serum obtained in a similar manner from the dog, the ass and the 
 horse. His published statistics cover 445 cases observed in his own prac- 
 tice and in that of his colleagues and other practitioners. He concludes 
 
ANTITOXINS. 151 
 
 that cases of unmixed infection, with circumscribed foci of disease, slight 
 surrounding consolidation, and but little fever, are distinctly benefited 
 by the treatment and some are even cured thereby ; but that those with 
 much broncho-pneumonic consolidation or with cavities do not show any 
 great improvement. The local signs of the disease disappeared in 27 per 
 cent, of the cases, the weight increased in 57 per cent., and the bacilli 
 disappeared in 43 per cent. 
 
 Dr. Maragliano administers in apyretic cases or those with slight fever I cc. of the 
 serum every second day for the first ten days, then a similar dose every day for another 
 ten days, then two similar injections daily for the next ten days. If there is high fever 
 10 cc. should be given at once, and after three days a daily injection of I to 2 cc. if the 
 fever does not rise again, but if it persists a second dose of 10 cc. is given eight days after 
 the first one. Improvement is noticeable often within two weeks but sometimes not until 
 after two months have elapsed. Even when a cure seems complete the injections should 
 be continued for at least a month and even for a year. General hygienic measures must 
 not be neglected, and the efficiency of the digestion must be especially attended to. 
 
 Dr. Paul Paquin of St. Louis reported in 1S95 upon 22 serious cases of 
 this disease, treated by him in the city hospital with a serum- obtained 
 from horses immunized by injection of the toxins of the bacillus tuber- 
 culosis. He stated that a large percentage of these cases increased in 
 weight from 5 to 16 pounds each during 6 to 8 weeks, and at the same 
 time showed other evidences of general improvement without the use of 
 tonics or any special diet, only the regular fare of the city hospital or 
 poor-house being available for them. After the lapse of six months the 
 entire 22 were alive, all having improved and more than one-half the 
 number having been discharged from the hospital as well enough to work. 
 In 1897 Dr. Paquin read a report before the American Medical Associa- 
 tion in which he dealt with the results obtained in 393 cases of tubercu- 
 lous disease, and claimed 93 complete recoveries, or 23^3 per cent, of all 
 the cases. Numerous reports from other observers testify to good results 
 obtained with Paquin's serum in the worst cases, e. g., knee-joint tuber- 
 culosis (Cale), laryngeal tuberculosis (Loeb), and acute pulmonary tuber- 
 culosis (Lemen). The effects observed after injecting Paquin's serum 
 include erythema, urticaria, local swellings, pain, swelling and stiffness 
 of joints, numbness, pain in the spine, in the head and in the stomach. 
 The most serious complication is a sudden disturbance of the circulation, 
 caused by the injection entering a vein or the muscular tissues, which 
 requires the prompt administration of cardiac stimulants, as alcohol, 
 nitroglycerin, etc. 
 
 Paquin administers a beginning dose of 10 minims, with strict aseptic precautions, 
 hypodermatically into the subcutaneous tissue of the back, avoiding vessels and muscular 
 tissue. He repeats the injection once daily, increasing the dose by 5 minims so long as 
 it does not raise the temperature more than i° F. above the normal. A dose of 25 
 minims is usually sufficient as a maximum. He advocates the use at the same time of a 
 continuously acting vaporizer containing creosote and other antiseptics ; also the in- 
 halation of the vapor of" the essential oils of peppermint, eucalyptus and cinnamon from 
 
1 82 ANTITOXINS. 
 
 a "lip-trough inhaler" worn under the nose, and repeated disinfection of the mouth and 
 throat by an antiseptic gargle. He stated that a fever rising above ioi° F. usually indi- 
 cates a mixed infection, in which the serum treatment is not indicated ; the cases amen- 
 able to it being the incipient ones and those in the first and second stages of the disease. 
 
 Dr. Carl Fisch of St. Louis immunizes selected horses by injections of 
 Koch's new tuberculin. (See under the title Toxins). The injections 
 are given in gradually increasing quantity, during a period of four 
 months, until the enormous dose of 50 cc. of tuberculin-R is reached. 
 The resulting serum is claimed to be " a really antitoxic and bactericidal 
 antiphthisic serum," by which "it is possible to immunize and cure 
 guinea-pigs with perfect certainty." This preparation is named Anti- 
 phthisic Serwn T. R., and is put up in vials containing 10 cc. each by 
 John F. Milliken & Co. of St. Louis. It has been used in some 20 cases 
 of human tuberculosis with results which are stated to be "exceedingly 
 gratifying." 
 
 Niemann has obtained good results in the treatment of tuberculosis of moderate 
 severity with a serum obtained from young goats inoculated with increasing doses of a 
 tuberculin prepared from a virulent culture of tubercle bacilli. The general condition 
 of the patients showed marked improvement, the tubercle bacilli disappeared from the 
 sputum, and the cough and expectoration considerably diminished. High elevation of 
 the temperature rarely followed the injection of the serum, even in large doses, while 
 albuminuria was never observed. 
 
 Lemen has treated 31 cases of pulmonary tuberculosis with various serums, including 
 Paquin's and Fisch' s. He reports 8 apparent recoveries, of which 6 were in the first 
 stage of the disease and 3 in the second. Of those in the third stage, that of cavity- 
 formation, numbering 15, all died. 
 
 Streptococcus Antitoxin has been employed successfully in erysip- 
 elas, puerperal fever, and several forms of septicemia and pyemia due to 
 streptococcus infection. The credit for the suggestion and preparation 
 of this antitoxin is due to Dr. Marmorek, of the Pasteur Institute, Paris, 
 who has treated therewith 411 cases of erysipelas with a mortality of 3.4 
 per cent. He also treated 16 cases of puerperal fever with this serum; 
 seven of which, due to streptococcus infection, recovered ; one, due to 
 bacterium coli, died ; and among eight of mixed infection with strepto- 
 coccus, bacterium coli and staphylococcus, five died. Though puerperal 
 infection may be set up by several other organisms, in the majority of 
 cases it is due to the streptococcus pyogenes, and in such cases only will 
 this serum be successful. Furthermore, as strepto-infection is at first 
 essentially a local disease and later becomes a blood disorder, local 
 treatment should be carried on from the commencement and in con- 
 junction with the serum treatment. Several cases of puerperal fever, 
 erysipelas and other forms of streptococcus infection, are reported by 
 Pozzi, Charrin, Roger, and others, as having been treated successfully 
 with this antitoxin, including 14 severe cases of puerperal septicemia 
 with only 2 deaths (Williams). It has been used with benefit in scarlet 
 fever (Josias), in phlegmon following infection during operations (Van 
 
ANTITOXINS. I83 
 
 Schaick), and in acute hemorrhagic septicemia resulting from a wound 
 received while making an autopsy on a case of suppurative peritonitis 
 (Ballance). The treatment is not entirely free from risk, several French 
 observers having reported deaths which were apparently due to the serum 
 (Hirst). Many of the most virulent cases of diphtheria are due to a 
 double infection with the diphtheria bacillus and the streptococcus, and 
 for the treatment of such a combination antitoxin has been prepared by 
 Marmorek and also by Gibier. (See under Diphtheria Antitoxin, ante 
 page 179.) The treatment of sarcoma and carcinoma by injections of 
 streptococcus antitoxin is noticed under the title Toxins, and the sub- 
 title Erysipelas and Prodigiosus Toxins. 
 
 Streptococcus Antitoxin is obtained from the horse immunized against streptococcus 
 erysipelatis by inoculations with the toxins of cultures which have been rendered highly 
 virulent by passage through a certain series of animals. The serum possesses great 
 activity, and is dispensed in vials containing a quantity sufficient for four injections of 6 
 cc. each, two of which may be given immediately and two on the following day. 
 
 Syphilis Antitoxin. — A serum obtained from the blood of lambs and 
 dogs has been used by Tommasoli and other Italian experimenters in the 
 secondary and tertiary manifestations of syphilis, with encouraging results. 
 It has been suggested that the natural insusceptibility shown by certain 
 animals to this disease may be increased by injecting into them the blood 
 serum from human subjects in the primary or active secondary stages of 
 syphilis. This has been carried out by Triboulet and others, without 
 prejudicial effect on the animals injected, and their serum was used in the 
 treatment of extensive tertiary ulcerations, with the result that these lesions 
 almost completely disappeared, although they had resisted a six months' 
 course of the ordmaryj^atment. Hericourt records a striking improve- 
 ment in a case of syphilitic tabes under the same method, and other simi- 
 lar observations have been reported with equally favorable results. The 
 doses employed were 2 cc. of the serum on successive or alternate days. 
 The only complications observed were a transitory roseolar eruption, 
 slight albuminuria, and a brief elevation of temperature. 
 
 Antivenene is the name given to an antitoxin prepared by Fraser in 
 consequence of Calmette's discovery that the serum of an animal immu- 
 nized by the injection of increasing doses of serpent venom possesses 
 antidotal and immunizing properties against the effects of the bites of 
 poisonous snakes. The active principle of serpent venom is of albumi- 
 nous nature and is analogous to the so-called toxalbumins, active ingredi- 
 ents of the bacterial toxins. Antivenene does not seem to be specific, as 
 are the antitoxins in general, for Fraser finds that when obtained by the 
 inoculation of cobra-poison it is equally effective against the venom of 
 several serpent species, including the cobra, the rattlesnake, etc. Cal- 
 mette states that tetanus antitoxin antagonizes the effect of cobra venom 
 
I84 APIOLUM. 
 
 to a certain extent, also that intra-venous injections of calcium hypochlo- 
 rite produce a blood serum which possesses antitoxic properties against 
 the effects of the cobra poison. 
 
 Other Antitoxins have been prepared by inoculating the cultures or the toxins of 
 Frankel's pneumococcus, the typhoid bacillus, and the bacteria of cholera, erysipelas, 
 anthrax, vaccinia and the plague. Even rabies has its so-called antitoxin, though its 
 bacterial origin has never been demonstrated. The blood of lepers and cancer elements 
 have been used as toxins for the inoculation of animals in order to obtain antitoxic serums 
 for use in the treatment of these diseases. The results have so far been few and unim- 
 portant. Typhoid Antitoxin is obtained by injecting sheep for three months with broth 
 cultures of the typhoid bacillus. The resulting serum is found to be efficient in neutral- 
 izing the effects of the typhoid toxins in guinea-pigs, and a few cases of human typhoid 
 have been treated with it, apparently with good results. Vaccinia Antitoxin is supposed to 
 exist in the serum of vaccinated heifers, and M. Beclere has treated a few cases of variola 
 with such a serum, in one case using 1,560 cc. , with the result that the patient recovered 
 rapidly without suffering any inconvenience. In another case an infant 21 days old 
 received injections of the serum to the amount of ^Lth of its weight, and was cured of a 
 serious form of small-pox. Plague Antitoxin is prepared at the Pasteur Institute and 
 was used by Dr. Yerson at Amoy in 23 cases, with only 2 deaths. As the previous mor- 
 tality of this disease was about 80 per cent., this result of the serum treatment proves 
 decidedly encouraging. 
 
 APIOLUM, Apiol, (Unofficial), — is an oily liquid, of green color, 
 acid reaction and pungent taste, soluble in alcohol, ether, chloroform, and 
 in glacial acetic acid. It is extracted from the fruit of Petroselinum sativum 
 (Parsley), a biennial plant of the nat. ord. Umbelliferag, which also con- 
 tains a gelatinous substance named Apiin, and a Volatile Oil which is by 
 some considered to be the true emmenagogue principle of the plant. 
 Apiol is probably a mixture of several substances, and as found in com- 
 merce is often an impure oleoresin. Dose, iTLiij— x in capsule two or three 
 times a day ; as an emmenagogue, v^xv in one (^ly dose. 
 
 A camphor, also named Apiol, C 12 H 14 4 , is obtained from the same source, and occurs 
 in white needles, of a feeble parsley odor, insoluble in water, but freely soluble in alco- 
 hol or ether. Dose, gr. xv as an antiperiodic, gr. v-x against dysmenorrhea. 
 
 In small doses (ntiij-v) Apiol is carminative, diuretic, diaphoretic, ex- 
 pectorant and stimulant to the circulation. In full doses (rt^xv) it is 
 decidedly emmenagogue and feebly antiperiodic, but produces headache, 
 tinnitus aurium, intoxication, giddiness, etc., its action generally resem- 
 bling that of Quinine. Large doses (rr^xxx-^j) are decidedly narcotic. 
 
 Apiol has had some reputation in intermittents and in malarial neural- 
 gias, but is most frequently employed in amenorrhea and dysmenorrhea, 
 being of especial advantage in the amenorrhea of anemia, also when the 
 menstrual discharge is fetid. It is becoming fashionable as a supposed 
 abortifacient, but is useless for this purpose, and if freely used may pro- 
 duce decided narcotism, especially if the preparation employed should 
 happen to be an active one. The capsules of Apiol put up in France and 
 sold in this country over the counters of drug-stores to any applicant are 
 generally inert ; hence cases of poisoning by this drug are seldom 
 
APOCYNUM AQUA. 1 85 
 
 observed. They are, however, an important source of revenue to the 
 retailers, as, being "imported" preparations, they command a high 
 price, which is readily paid by gullible women who wish to "bring 
 around" their "courses." 
 
 APOCYNUM, Canadian Hemp, — is the root of Apocynum cannabinum, an indi- 
 genous perennial plant of the nat. ord. Apocynaceae, and is inodorous, but of bitter, dis- 
 agreeable taste. It contains a peculiar active principle, Apocynin, also tannic and gallic 
 acids, resin, wax, caoutchouc, etc. Dose of the powdered root, gr. v-xxx. A decoction 
 ( 3 ss to the pint) may be given in doses of ^j-ij thrice daily. 
 
 Extractum Apocyni Fluidum, Fluid Extract of Apocynum, — Dose, TT^ v-xxx. 
 
 Apocynum is powerfully emetic and cathartic in full doses, also diaphoretic, expecto- 
 rant and sometimes actively diuretic. It lowers the pulse-rate, produces much nausea, 
 and induces drowsiness. It should not be confounded with the Indian and American 
 Hemps (Cannabis sativa), which have entirely different qualities. 
 
 The only condition in which Apocynum has proven of much value is dropsy, especially 
 ascites and the anasarca of Bright' s disease, in which 1 5 -grain doses are indicated. The 
 active principle, Apocynin, is a good expectorant, in doses of gr. ^ to gr. %. 
 
 AQUA, Water, H 2 0, — is natural water, in its purest attainable 
 state ; a colorless limpid liquid, devoid of odor or taste, and of neutral 
 reaction. Besides entering into the composition of most of the official 
 extracts, fluid extracts, and many other pharmaceutical preparations, from 
 it are prepared the 17 official Waters (Aquae), and also the following: — 
 
 Aqua Destillata, Distilled Water, — H 2 0, — 1000 parts of water are distilled, the first 
 100 parts obtained being thrown away, 800 parts are preserved. It is as near chemically 
 pure water as can be obtained. 
 
 Aqua Carbonata, Carbonated Water, Soda Water, — is described under AciDUM 
 Carbonicum, ante, page 91. 
 
 Nomenclature of Water. 
 
 Aqua Fluvialis, River-water. Aqua Destillata, Distilled Water. 
 
 Aqua Pluvialis, Rain-water. Aqua Bulliens, Boiling Water. 
 
 Aqua Fontana, Spring or Well-water. Aqua Fervens, Hot Water. 
 
 Aqua Marina, Sea-water. Aqua Communis, Common Water. 
 
 Aqua Carbonata, Carbonated Water, Balneum Maris, Warm- water Bath. 
 
 Soda Water. Balneum Vaporis, Vapor Bath. 
 
 Mineral Waters. 
 Natural Water differs from distilled water in containing saline and 
 other constituents in varying proportions, — from common water (Aqua 
 Communis), in which they are so small in quantity as not to alter the 
 taste, color, etc., up to the Sea-water, having 3^ per cent., and that of 
 the Dead Sea with 26^ per cent. Spring waters, impregnated with for- 
 eign substances so as to have a decided taste and a marked action on the 
 human system, are called Mineral Waters, which may be subdivided into 
 various groups, according to their prevailing constituents, as Carbonated, 
 Alkaline, Saline, Sulphuretted, Silicious, etc. Full analyses of all the 
 principal mineral waters of Europe and America are given in Squire' s 
 
1 86 AQUA. 
 
 Companion to the British Pharmacopoeia, also in the 15th edition of the 
 United States Dispensatory, but a few of the most prominent will be men- 
 tioned here. 
 
 Alkaline Mineral Waters. 
 
 Ems, Germany. Perry Springs, Ills. 
 
 Salzbrunn, Germany. St. Louis Spring, Mich. 
 
 Gleickenberg, Austria. Buffalo Lithia Spring, Va. 
 
 Vichy, France. Hot Spring, Va. 
 
 Vals, France. Warm Spring, Va. 
 
 Bladon Spring, Ala. Berkeley Spring, Va. 
 
 Congress Spring, Cal. Bethesda Spring, Wis. 
 
 Seltzer Spring, Cal. Gettysburg Spring, Pa. 
 
 These waters are generally cold, those of Vichy and Ems being warm. They contain 
 a considerable amount of Sodium Carbonate, also Sodium Chloride and Sulphate, and 
 various other Chlorides, Carbonates and Sulphates, with Carbonic Acid gas in varying 
 quantity. Vichy and Vals waters depend for their efficacy almost wholly on the quantity 
 of Sodium Carbonate contained in them, which is for Vichy from 26 to 50 grains and for 
 Vals about 60 grains to the pint. 
 
 Saline Mineral Waters. 
 
 Friedrichshall, Germany. Cheltenham, England. 
 
 Hunyadi Janos, Germany. Kissingen, Bavaria. 
 
 Baden-Baden, Germany. Reichenhall, Bavaria. 
 
 Wiesbaden, Germany. Adelheidsquelle, Bavaria. 
 
 Carlsbad, Bohemia. Kreutznach, Prussia. 
 
 Pullna, Bohemia. Saratoga Springs, N. Y. 
 
 Seidlitz, Bohemia. Ballston, N. Y. 
 
 Marienbad, Bohemia. Hot Springs, Arkansas. 
 St. Catherine's, Ontario, Canada. 
 
 These waters are of more complex composition, the various waters of Saratoga con- 
 taining more than thirty constituent salts. Those usually present are the Sulphates and 
 Carbonates of Sodium, Calcium, Magnesium, etc. {Magnesian waters) ; Chlorides of 
 Sodium, Potassium and Lithium {Chlorinated waters) ; Ferrous salts {Chalybeate waters), 
 with Iodine, Bromine, Manganese salts, and Phosphates in some few. Carbonic Acid 
 gas is present in all. Most of them are purgative, some are considered alterative, and 
 many are warm (ioo°-i6o°). 
 
 The most powerful member of the saline group is Hunyadi Janos, which contains 
 about 150 grains each of Magnesium and Sodium Sulphates to the pint, and is, therefore, 
 effectively purgative. Nearly as strong is Pullna water, with 124 grains of Sodium Sul- 
 phate and 93 grains of Magnesium Sulphate to the pint. Friedrichshall is less powerful, 
 but perhaps a better aperient water in doses of 6 to 10 fluid ounces. Marienbad contains 
 no Magnesium Sulphate, but has 36 grains of Sodium Sulphate, 9 of Sodium Carbonate, 
 1 1 of Sodium Chloride, and a small quantity of Ferrous Carbonate to the pint ; in trans- 
 portation, however, it loses its Carbonic Acid and deposits the Iron. It is not aperient 
 in ordinary doses. Carlsbad water contains 20 grains of Sodium Sulphate and 9 each of 
 Sodium Carbonate and Chloride to the pint. The so-called "Carlsbad Salt" is simply 
 Sodium Sulphate with a trace of the Carbonate. Hartnack gives the following formula 
 for its artificial preparation : Sodium Sulphate 100 parts, Sodium Bicarb. 80, Sodium 
 Chloride 40 ; a dessertspoonful in water as a mild saline purgative. These waters are 
 imported into, and made in the United States in large quantities, and may be ordered 
 through any druggist. 
 
 Sulphurous Mineral Waters. 
 
 Aix-la-Chapelle, Prussia. Blue Lick Spring, Ky. 
 
 Bareges, S. France. Sharon Spring, N. Y. 
 
 Eaux-Bonnes, S. France. Yellow Sulphur Spring, Va. 
 
 Llandrindrod, Wales. White Sulphur Spring, W. Va. 
 
 Harrowgate, England. Salt Lake Warm Springs, Utah. 
 
AQUA. 187 
 
 These waters all contain Sulphuretted Hydrogen gas, also Carbonic Acid gas and Car- 
 bonates, Chlorides and Sulphates of Sodium, Potassium, Magnesium and Calcium ; some- 
 times Carbonate and Oxide of Iron, Iodide and Bromide of Sodium. 
 
 Carbonated Mineral Waters. 
 
 These waters are cold, contain generally Carbonates of Calcium, Magnesium and 
 Sodium (in some, Iron), which are held in solution by the excess of Carbonic Acid, also 
 Chlorides of Sodium and Potassium, Sulphates, Phosphates, etc. They are described 
 under Acidum Carbonicum, ante, page 91. 
 
 Silicions Mineral Waters. 
 Hot Springs, Iceland. Geysers of Yellowstone Park. 
 
 The constituents of these waters are chiefly alkaline Silicates. 
 
 Physiological Action of Water. 
 
 Water is an essential constituent of all the tissues of the body, forming 
 from 0.2 per cent, of the enamel of the teeth to 77 per cent, of the liga- 
 ments. In the liquids of the organism it is contained in the proportions 
 of 78 per cent, of the blood to 93 of the urine, and 99 of the tears. In 
 moderate quantity it is necessary to digestion, but in large amount it 
 weakens digestion by diluting the gastric juice. Ice-cold water, if freely 
 used, suspends the action of pepsin, depresses the nerves of the stomach, 
 and lowers its blood supply. The free use of water internally produces 
 increased cutaneous and renal excretion, and promotes the elimination of 
 some of the products of tissue-change, as urea, phosphoric acid, etc. In 
 some subjects it favors the deposition of fat. 
 
 Cold water applied externally, as by a bath (4o°-6o° F.), abstracts a 
 portion of the body-heat, lowering the surface temperature and depressing 
 the cutaneous nerves, producing spasmodic breathing and a quickened 
 pulse. If the temperature of the water is not too low and the bodily vigor 
 is good, reaction soon occurs, and the general effect is tonic to the mus- 
 cular power, to the circulation and the respiration. If this does not take 
 place a secondary chill occurs, and serious depression may result. 
 
 Warm water (95°-ioo° F.) applied to the surface of the body, as by 
 baths of water or steam, packing, etc., acts in the opposite manner at 
 first, increasing the circulation in the skin, the rapidity of the pulse and 
 respiration and the body-temperature. Rapid tissue-change occurs, the 
 waste products being eliminated chiefly by the skin and the pulmonary 
 mucous membrane. If long continued, precordial oppression, giddiness 
 and muscular debility are experienced. 
 
 Hot water (no°-ii2° F.) at first dilates the vessels of the part to 
 which it is applied, and soon afterwards contracts them. It is a valuable 
 means of relieving congestion and inflammation, and is a most effective 
 hemostatic when the bleeding is from small vessels or of capillary char- 
 
1 88 AQUA. 
 
 acter. Whether generally or locally applied it is one of the most reliable 
 means of relieving spasm. Hot vapor applied to the surface accelerates 
 the circulation and produces profuse sweating. Its general action is sim- 
 ilar to that of warm water. 
 
 Mineral waters taken internally act chiefly by virtue of the water, partly 
 in accordance with the effects of their various constituents. As baths, 
 their action is doubtless entirely due to their temperature. 
 
 Pathogenic Microbes of several diseases, notably those of cholera and typhoid 
 fever, are conveyed to the human system in drinking water contaminated therewith. But 
 these organisms are destroyed by a temperature of 144 F. in the absence of their spores, 
 while a temperature of 212° F., that of boiling water, maintained for five minutes, 
 destroys the spores of all pathogenic organisms which have been tested (Sternberg). 
 This fact is of the highest practical importance, as it shows that no germs of disease need 
 ever gain entrance to our bodies through our drinking water, if only we will boil it. Many 
 years ago an English physician's report was quoted in Braithwaite's Retrospect, in refer- 
 ence to the immunity of the Chinese from typhoid fever, though he said that in Pekin 
 there was no system of sewerage, but that all excreta were thrown on the ground to 
 find their way into the watercourses by which the city was supplied, to soak into wells, 
 etc. Yet, the author said, that contrary to all experience elsewhere, typhoid fever was 
 unknown in Pekin. The reason is to be found in the fact that the Chinese boil all the 
 water they drink. Those who know them best say that they never drink cold water, but 
 always tea, i. e., boiled water. There must be some reason for their remarkable health 
 under adverse hygienic surroundings. 
 
 Therapeutics of Water. 
 
 Cold water (or ice) has many external applications of value in the treat- 
 ment of disease. As a wet pack it is used in tonsillitis, diphtheria and 
 croup. Cold baths are the most effective antipyretic in the high temper- 
 ature of fevers, and the cold wet pack is used for the same purpose. Ice 
 or cold water is applied to the head in acute cerebral congestion, and to 
 the spine in chorea, etc. ; also locally in hemorrhoids, bubo, orchitis and 
 to the uterus in post-partum hemorrhage. Cold affusion to the body is 
 employed as a preventive of spasmodic croup, as well as to lessen suscep- 
 tibility to taking cold. 
 
 Hot water externally, as fomentations, hot wet packs, baths, etc., is most 
 effective in reducing local congestion and setting up resolution of local 
 inflammation. Hot fomentations to the renal region are useful in func- 
 tional inactivity of the kidneys. The hot spinal douche is used in affec- 
 tions of the spinal cord and meninges, and in the backache of women. 
 The hot wet pack is highly esteemed in inflammation of the thoracic 
 organs. The vaginal hot water douche is highly valued by gynecolo- 
 gists for many morbid conditions of the uterus and its appendages, espe- 
 cially catarrh of the vaginal and cervical mucous membrane, subinvolution 
 of the uterus, also congestive, swollen and neuralgic conditions of the 
 ovaries, tubes and adjacent tissues. The continuous hot water bath was 
 highly commended in skin diseases by Hebra, who administered it in 
 cases of extensive burns, psoriasis, pemphigus and variola. The contin- 
 
AQUA. I89 
 
 uous immersion in very hot water of an indolent wound, ulcer or sore, is 
 a method of great efficiency for the promotion of the healing process in 
 cases which have resisted the ordinary stimulant applications. Hot water 
 dressings for wounds are strongly favored by many high surgical authori- 
 ties. Vapor and Turkish baths are used as diaphoretics in advanced kid- 
 ney disease, in acute and chronic rheumatism, mineral poisoning, and 
 syphilis. Warm baths, with cold applications to the head, are esteemed 
 of value in infantile convulsions and chorea. 
 
 Internally, water is chiefly of value as a diuretic, and if hot as a dia- 
 phoretic. A glass of cold water before breakfast daily is often an effective 
 means of overcoming constipation, while the drinking of hot water an 
 hour before each meal has been of great value to many dyspeptics. The 
 value of the popular teas in chronic diseases is almost entirely due to the 
 diluent, diuretic and diaphoretic actions of the hot water used. 
 
 Therapeutics of the Mineral Waters. 
 
 An undue value is placed by the laity and interested proprietors on the 
 medicinal value of mineral waters, causing the various localities of the 
 best advertised springs to become resorts for invalids and idlers from every 
 civilized country. The benefit derived is in most instances due to the 
 change of climate and scene, freedom from home cares and business 
 worry, regularity of life and diet, drinking of water in quantity, and in 
 many cases the substitution of water for alcoholic beverages. In order 
 to get the worth of their money, people will gladly submit to rigid 
 hygienic and dietetic restrictions at a watering-place which they would 
 totally ignore under treatment at home. The same may be said of the 
 treatment at the so-called "hydropathic" or "water-cure" establish- 
 ments. As a rule, those springs will prove of most value which are 
 furthest removed from the patient's residence, — for "distance lends en- 
 chantment " in these matters as well as in many others. Invalids whose 
 homes are in the vicinity of some wonder-working spring will not usually 
 derive much benefit from its water, but will by that of another spring, 
 similar in constituents, but located several hundred miles away. 
 
 The principal affections in which mineral waters are esteemed most 
 highly are the following : dyspepsia, cirrhosis of the liver, gout, rheu- 
 matism, lithiasis, diabetes of hepatic origin, constipation, strumous dis- 
 orders, obesity, plethora of the pelvic organs, hypochondriasis, skin 
 diseases, especially those dependent on gastric derangement, phthisis, 
 constitutional syphilis, metallic poisoning, etc., in all of which the influ- 
 ences above mentioned are especially efficacious, and are no doubt the 
 chief factors in producing any benefit which may be attainable. Aperient 
 and purgative waters are useful in many cases where a prejudice exists 
 against purgative medicine, but none against the same agents in a natural 
 
I9O ARGENTUM. 
 
 water. The strong saline-aperient waters, as Carlsbad, Hunyadi, Fried- 
 richshall, etc., have considerable repute in the treatment of the uric-acid 
 diathesis and calculous affections, and the waters of St, Catherine's Wells 
 are credited with decided influence upon local and chronic rheumatism. 
 
 The special therapeutics of mineral waters are to be found in this volume under the 
 heads of their principal constituents, as Acidum Carbonicum, Sodium Chloride, Sodium 
 Sulphate, Magnesium Sulphate, etc. ; also in the therapeutical part of the book. 
 
 ARGENTUM, Silver, Ag,— is represented by the following four 
 official salts, viz.: — 
 
 Silver Compounds and their Preparations. 
 
 Argenti Nitras, Silver Nitrate, AgN0 3 , — occurs in colorless rhombic crystals, of 
 bitter caustic taste and neutral reaction, soluble in 0.6 of water and in 26 of alcohol. Is 
 best given in pill with Kaolin, or in distilled water ; never with tannin or a vegetable 
 extract, lest an explosive compound result. Dose, gr. Ye-yi, — if watched, up to gr. j 
 may be given. When melted with 4 per cent, of Hydrochloric Acid, it makes — 
 
 Argenti Nitras Fusus, Moulded Silver Nitrate, Lunar Caustic, — for local use as 
 a mild caustic and astringent. Argenti Nitras Dilutus, Diluted Silver A T itrate, Miti- 
 gated Caustic, — is the same salt melted with twice its weight of Potassium Nitrate. It is 
 used locally by ophthalmologists. 
 
 Argenti Cyanidum, Silver Cyanide, AgCN, — has no medicinal use except for the ex- 
 temporaneous preparation of Hydrocyanic Acid. (See ante, p. 99.) 
 
 Argenti Iodidum, Silver Iodide, Agl, — a greenish yellow powder insoluble in water 
 or alcohol. Is used instead of the nitrate internally, as it is supposed not to discolor the 
 skin. Dose, gr. j^-j in pill. 
 
 Argenti Oxidum, Silver Oxide, Ag 2 0, — a brownish black powder, nearly insoluble 
 in water and insoluble in alcohol. It is liable to decompose with violence when mixed 
 or triturated with readily oxidizable or combustible substances, as creosote, phenol, potas- 
 sium permanganate and many others. It should not be brought into contact with ammo- 
 nia. Dose, gr y z — ij in pill with Kaolin. It is not a dangerous internal remedy. 
 
 All the silver salts should be protected from light in dark blue or amber-colored vials. 
 
 Physiological Action. 
 Metallic Silver is antiseptic, probably by forming a lactate with the 
 lactic acid produced by microbes. In contact with colonies of germs it 
 kills them without exercising any inimical action on the animal tissues 
 (Crede). Locally the silver salts are antiseptic, astringent, irritant and 
 caustic, according to the strength of the applications. They are less irri- 
 tant than the salts of mercury and more so than the salts of lead. The 
 soluble salts of silver, taken internally in medicinal doses, are tonics to 
 the nervous system, increase tissue change and promote the secretion of 
 bile ; in larger doses they depress the heart, reduce the temperature and 
 impair the respiration ; in overdoses they act upon the central nervous 
 system, producing tetanic convulsions or paralysis. In mammals they 
 affect the medullary centres particularly, at first stimulating and then de- 
 pressing them, causing a primary rise of blood-pressure which afterwards 
 falls, also slowing and embarrassing the respiration, which finally fails 
 
ARGENTUM. I9I 
 
 from paralysis of the respiratory centre. The heart is but slightly affected 
 and often continues to beat for some time after the breathing has stopped. 
 The mucous membrane of the stomach and intestines shows congestion, 
 ecchymoses and ulceration, the kidneys are irritated and edema of the 
 lungs often occurs. None of these effects have been observed in man, 
 but in him the prolonged use of the silver salts will produce chronic silver 
 poisoning, known as Argyria. The first sign of this condition is a slate- 
 colored line along the margin of the gums, with some inflammatory 
 swelling. Subsequently grayish patches appear on various parts of the 
 skin and mucous membranes, and extend over the whole integument 
 which becomes slate-colored. No organ of the body, except the paren- 
 chymatous cells and the epidermis, is exempt from this pigmentation, 
 which is due to the deposit of silver, either in the metallic state or as an 
 oxide or some organic compound, in the connective tissues. In the skin 
 it is found in the corium, not in the epidermis. As a rule argyria does 
 not produce any serious effect upon the health of the subject, though 
 some authorities have ascribed to it gastro-intestinal catarrh, faulty assim- 
 ilation, changes in the blood and fatty degeneration of the heart, liver, 
 and kidneys. It is probable that in most cases some degree of deranged 
 nutrition is produced. A local argyria may be caused by the frequent 
 topical application of a soluble silver salt for a long time. In a few 
 cases general argyria has resulted from the local use of a silver salt, usu- 
 ally in the mouth or throat ; and it appears in workers in the manufacture 
 of artificial pearls, who use silver as a pigment. Argyria is incurable, 
 though many attempts have been made to remove the discoloration by 
 the administration of iodides. The only solvent is Potassium Cyanide, 
 which is inadmissible by reason of its violent toxicity. 
 
 Silver salts unite with albumin to form albuminates, which are soluble 
 in the digestive fluids, but it is not certain that silver is thus absorbed. 
 According to some authorities the salts are reduced in the stomach and 
 also in the intestinal canal, the tendency of such action being towards 
 the separation of the metal, most of which passes through the alimentary 
 canal unabsorbed, a very small portion finding its way through the lymph- 
 atics to the tissues and remaining imbedded therein indefinitely. 
 
 The Nitrate is the most soluble of the silver salts. It is antiseptic, 
 astringent, hemostatic, irritant, and a limited escharotic, also antiphlo- 
 gistic, antispasmodic and tonic. It has a strong affinity for albumin, 
 with which it unites to form an albuminate. Locally applied in dilute 
 solution it causes a marked contraction of the bloodvessels, but in 
 stronger solutions it is irritant, dilating the vessels and acting as a super- 
 ficial caustic by coagulating the albumin of the tissues to which it is 
 applied and destroying their vitality. A dense layer is thus formed 
 which prevents the further penetration of the salt and so limits ifs 
 
192 ARGENTUM. 
 
 escharotic action. This albuminous coating is at first white but soon 
 turns black under the influence of light. The stains made by handling 
 or applying it to the skin may be removed by washing with a strong solu- 
 tion of Potassium Cyanide, and may in great part be prevented by 
 immediately neutralizing the silver salt with a solution of common salt. 
 Internally, in small doses, the Nitrate stimulates the heart, promotes 
 nutrition and acts as a nerve tonic. In large doses it produces violent 
 gastro-enteritis, corrosion and ulceration of the gastro-intestinal mucous 
 membrane, due to thrombosis of its veins. Burning pain is felt in the 
 throat and stomach, followed by nausea, vomiting and often by purging. 
 Central impairment of the nervous system may occur, with loss of co- 
 ordination power and paralysis. Collapse follows, with weak pulse, 
 pinched face, coldness of the surface and shallow respirations; and this 
 condition may be followed by coma, convulsions and finally death from 
 paralysis of the respiratory centre. The lethal dose has not been deter- 
 mined. 
 
 Antagonists and Incompatibles . 
 
 Common Salt freely used is the antidote, precipitating the silver as the insoluble chlo- 
 ride and acting as an emetic. The Nitrate is exceedingly sensitive to organic material and 
 to light, which readily decompose it. Incompatibles are Alkalies and their carbonates, 
 Alkaloids, solutions of Arsenic and Tannin, most of the Mineral Acids and their salts, 
 also all Bromides, Chlorides, Iodides, and Phosphates. Distilled Water should be speci- 
 fied when prescribing the Nitrate in aqueous solution. In spite of the most careful 
 choice of an excipient it is doubtful if the Nitrate ever reaches the stomach in its own 
 form, and if it does it is probably changed at once upon arrival. 
 
 A course of silver medication should be regulated by suspending the remedy after 5 or 
 6 weeks' use, then promoting elimination by purgatives, diuretics and baths. To pre- 
 vent the general discoloration Potassium Iodide may be given conjointly with the silver, 
 and baths of Sodium Hyposulphite used frequently. The dark line at the margin of the 
 gums is removable by a course of the Acid Tartrate of Potassium. Argyria has been 
 produced in three months and after the use of 3 ss-j of the nitrate. 
 
 Therapeutics. 
 The local uses of Silver Nitrate, which are the most important, depend 
 on its antiseptic, hemostatic, astringent, caustic and stimulant properties. 
 As an antiseptic it has proved an efficient prophylactic against ophthalmia 
 neonatorum, a drop of a 1 per cent, solution being instilled into each eye 
 of the new-born infant. In this disease, when the discharge is purulent, 
 a similar solution should be applied to the conjunctiva daily, and when 
 the discharge is very profuse a 2 per cent, solution is not too strong. A 
 solution of the latter strength is commonly employed in the purulent con- 
 junctivitis of adults, applied once daily to the everted lids by a brush, 
 after cleansing and drying the surface; the excess being removed by 
 washing with warm water or by neutralization with a solution of common 
 salt. When the cornea is intact a solution of ^ to ^ of one per cent, 
 strength may be occasionally dropped into the conjunctival sac, but care 
 must be taken that it does not come in contact with an inflamed or ulcer- 
 
ARGENTUM. I 93 
 
 ated cornea, as it is not well borne in such cases and may cause a perma- 
 nent corneal opacity by the deposit of silver. 
 
 In chronic purulent inflammation of the middle ear Silver Nitrate is one 
 of the most valuable applications, in solutions varying from ^ of one per 
 cent, to saturation, applied by a special syringe through the perforated 
 tympanic membrane or by dropping them into the external meatus. Aural 
 polypi have been successfully treated with solutions of from 6 to 20 per 
 cent, strength. Weak solutions are useful in eczema of the ear and in 
 external otitis, also for chronic inflammation of the lining membrane of 
 the Eustachian tube, to abort aural furuncles and to relieve pruritus of the 
 external auditory meatus. 
 
 In the local treatment of the nose and throat Silver Nitrate is useful 
 but should be employed with care. The stick of caustic is brittle and 
 liable to break off while in use, hence it might be swallowed and produce 
 acute poisoning. The danger of general argyria occurring from the pro- 
 longed use of the salt in this situation should be remembered. For ulcers 
 on the nasal septum, vascular granulations arising after operations on the 
 nose, fissures of the tongue and lips, and mucous patches and ulcers of 
 the mouth, the fused stick or a moderately strong solution is a good ap- 
 plication. In subacute and chronic laryngitis a weak solution is some- 
 times very effective, as it is also in ulcer of the larynx when not due to 
 laryngeal tuberculosis. 
 
 In genito-urinary surgery Silver Nitrate has many uses. In solutions 
 of various strengths, 1 in 2000 to 1 in 500, it is an old remedy for gon- 
 orrhea, applied to the urethra during the course of the disease. Stronger 
 solutions, up to 5 per cent., have been employed in the early stage with 
 the view of aborting the inflammation, but this procedure causes great 
 pain and has many opponents as well as many advocates. If it fails to 
 cut the disease short it will probably aggravate the inflammation consider- 
 ably. The milder solutions are useful applications in chronic gleet, 
 prostatorrhea, urethritis, vaginitis and chronic cystitis. In the form of 
 gelatin bougies impregnated with the salt it maybe applied to the urethral 
 mucous membrane with more facility and with better results than by in- 
 jection with a syringe. A 2 percent, solution injected into the substance 
 of buboes in their early stage has given satisfaction. Indolent sinuses 
 from buboes or abscesses may be stimulated to healing by the application 
 of lunar caustic lightly or a strong solution of the salt. It has been much 
 used in the treatment of cervical endometritis and erosion of the os uteri. 
 
 In diseases of the skin the Nitrate is employed to destroy parasitic 
 fungi, to cause exfoliation of the epidermis and for a stimulant effect 
 upon indolent ulcers and sores. Lunar caustic is used to destroy warts 
 and other small growths, to arrest capillary hemorrhage and for other 
 similar purposes. Solutions of various strengths are useful in some forms 
 13 
 
194 ARGENTUM. 
 
 of eczema, relieve the itching in prurigo and lichen, and are said to pre- 
 vent pitting in variola. It is a very efficient application in pemphigus, 
 if used in a 4 per cent, solution to the surface of the derma, after remov- 
 ing the epidermis over the blebs and cleansing their bases of all secretion. 
 Chilblains may be painted with a strong solution to relieve the irritation, 
 and in lupus, psoriasis, erythema and ringworms solutions of this salt 
 have been applied with satisfactory results. In erysipelas a concentrated 
 solution, 20 grains to the drachm, was formerly applied on the inflamed 
 surface and over the healthy skin beyond to the extent of two or three 
 inches, after washing and drying the part, with the object of checking the 
 spreading inflammation or at least rendering it less severe ; but this pro- 
 cedure has been superseded by other methods of treatment. For appli- 
 cation to the skin a solution in Spirit of Nitrous Ether is recommended. 
 This solution deposits a light-colored precipitate but itself does not turn 
 black like the simple alcoholic solution. It blackens the skin however in 
 a shorter time than any other solution. 
 
 In general surgery the moulded stick (lunar caustic) is much employed 
 to cut down exuberant granulations in suppurating wounds and to stimu- 
 late the healing of indolent ulcers, sores and sinuses. Bedsores may 
 often be prevented by painting the red but unbroken skin with a 2 to 4 
 per cent, solution. Cysts and hydroceles may be cured by the injection 
 of a strong solution into them after evacuating their contents, the result 
 being the exciting of an adhesive inflammation which obliterates the sac. 
 In chronic dysenteric ulcers a mild solution, 60 grains in 60 ounces of 
 water, is used by enema after clearing away the contents of the lower 
 bowel. 
 
 The internal use of Silver Nitrate is almost wholly confined to the treat- 
 ment of affections of the gastro-intestinal tract. Its astringent and tonic 
 actions are sometimes very efficient in cases of weak and irritable stomach 
 accompanied by great depression of spirits, morbid apprehensions and want 
 of courage. It is employed in persistent vomiting, in chronic gastric 
 catarrh, in hematemesis, and in gastric ulcer. When given for stomach 
 affections it should be administered when the viscus is empty. Chronic 
 gastritis has been treated with benefit by irrigating the stomach with solu- 
 tions of various strengths, from 2 to 4 grains gradually increased to 20 
 grains in 6 drachms of water, immediately followed by a 3 to 5 per cent, 
 solution of common salt. The Nitrate has often proved of value in 
 chronic inflammation of the large and small intestine, especially where 
 there was ulceration of the intestinal mucous membrane. It has done 
 good service in some epidemics of acute dysentery, has been praised in 
 cholera infantum after the acute symptoms abated, and has given marked 
 relief to the pain in catarrh of the biliary ducts. Its employment in spinal 
 sclerosis, labio-glosso-laryngeal paralysis and similar affections has not 
 
ARGENTUM. I95 
 
 proved very successful, but it is said to be one of the few remedies which 
 are of any service in locomotor ataxia. It was formerly used as a nerve 
 tonic in epilepsy, but has been superseded by other agents which are less 
 objectionable and more efficient. It has cured epilepsy where the bro- 
 mides have failed, and it is well established that patients who have been 
 subjected to a course of silver medication which has produced a deposit 
 of the metal in the tissues secure a remarkable degree of immunity from 
 various minor nervous ailments. It may be inferred that a remedy which 
 is deposited in the tissues may interfere by its presence with the chemical 
 activity of adjacent atoms, preventing their explosive union (Murray). 
 
 The Oxide is the least irritant of the silver salts and does not discolor 
 the skin so quickly as the nitrate, but eventually the same result follows 
 its continued administration. It has been employed with more or less 
 success in gastric neuralgia, irritable dyspepsia, pyrosis, gastric and pul- 
 monary hemorrhages, dysmenorrhea, menorrhagia and other uterine 
 affections, also to check profuse sweating, to relieve vomiting even in 
 severe gastritis, and to control diarrhea depending on reflex nervous irri- 
 tation. As an ointment, 5 to 10 grains to the drachm of lard, it is em- 
 ployed for application to venereal sores and to the urethra in gonorrhea. 
 The Iodide has been used in gastric affections, dysmenorrhea and epi- 
 lepsy, but has no advantage over the other silver preparations. 
 
 Unofficial Silver Compounds. 
 
 As the Nitrate is precipitated by proteids and by chlorides its disinfectant action is 
 more limited than that of many other antiseptics. To avoid this precipitation and ob- 
 tain more penetrating action several new silver compounds have been introduced, many 
 of which possess special trade names and all are highly vaunted for their efficiency in 
 the treatment of gonorrhea. The following are the most important of these preparations. 
 
 Actol, Silver Lactate, — is a white, inodorous and tasteless powder, which coagulates 
 albumin and is soluble in 20 of water. It lessens putrefaction in the bowel and consti- 
 pates to some extent. The compounds which it forms with the juices of the tissues or 
 the secretions of wounds are soluble ones, which gradually permeate the tissues and ex- 
 tend its action to some distance from the surface. Crede considers that this salt fulfils 
 all the requirements of an efficient antiseptic better than any other silver compound. A 
 solution of 1 in 1000 destroys all pathogenic microbes within five minutes. For gargles, 
 mouth-washes, etc., solutions of 1 in 8000 to I in 4000 are used, though stronger ones 
 do not irritate. In surgical affections it may be employed hypodermically. In erysipe- 
 las the amount thus administered daily ranges from 7 to 20 grains, but the solution used 
 must not be stronger than 1 in 200, lest coagula of the albumin form and prevent the 
 remedy getting into the circulation. 
 
 Argentamin, — is a patented preparation consisting of Silver Phosphate 10 per cent., 
 dissolved in a 10 per cent, solution of Ethylene-diamine. It is an efficient antiseptic 
 and astringent, but the alkaline diamine renders it somewhat irritant. Aqueous solutions 
 of various strengths, from I in 5000 to I in 1000, are recommended as urethral injections 
 in gonorrhea. 
 
 Argentol, Silver Oxy-chinolin-sulphonate , — is a combination of Silver and Quina- 
 septol, and occurs as a sparingly soluble yellowish powder, which is used as a substitute 
 for iodoform in wounds, skin diseases, syphilitic sores, etc. , also as an injection for gon- 
 orrhea. In ointment the usual strength is 1 or 2 per cent., for injections 1 to 3 in 1000. 
 
 Argonin, — is a patented combination of Silver (4 per cent.), Casein and an alkali, 
 occurring as a white powder which is soluble in hot water, non-irritant, not precipitated 
 
I96 ARNICA. 
 
 by chlorides or albumin, and does not stain the hands or clothing. It is a weaker anti- 
 septic than argentamin or silver nitrate, and has no effect on intestinal microbes. In 
 the conjunctival sac its solutions are non-irritant, but it is said to give good results in 
 catarrhal and purulent conjunctivitis. In gonorrhea a 2 per cent, aqueous solution is 
 first used, the strength being gradually increased up to 10 per cent. Its solutions should 
 be protected from the action of light. 
 
 Itrol, Silver Citrate, — is a fine, light, inodorous and tasteless powder, soluble in 3800 
 of water. Even in very weak solutions it is an energetic antiseptic, disinfectant and 
 germicide, has a powerfully destructive action on gonococci, is readily borne by the 
 urethral mucous membrane, has deep-reaching power but no injurious effect on the 
 tissues, and therefore meets all the requirements of an efficient injection for gonorrhea 
 (Werler). In that affection the solutions should be very weak at first, I in 8000, gradu- 
 ally increased as the inflammation subsides until the full strength of I in 3800 is 
 reached. It is very efficient in acute and chronic gonorrhea, in gonorrheal inflamma- 
 tion of the vulvo-vaginal gland and in chronic cystitis. As an ointment for the treatment 
 of wounds and skin diseases the strength is I in 100 or 1 in 50 of Lanolin. Solutions 
 should be protected from light in amber-colored bottles. 
 
 Largin, — is an albumin-silver compound, containing in the air-dried condition 1 1 per 
 cent, of silver. It occurs as a gray powder, soluble in 10 of water, and is a powerful 
 astringent and germicide, non-irritant and not precipitated by chlorides or albumin. It 
 is used in gonorrhea, the solutions being of \ to ii per cent, strength, according to the 
 stage of the affection. 
 
 Protargol, — is a protein-silver compound, containing 8 per cent, of metallic silver, 
 and occurring as a yellow powder, readily soluble in water. It is claimed to be absolutely 
 non-irritant, either in the conjunctival sac or the urethra. It is highly praised by Neisser 
 as an antiseptic and astringent application in | to 2 per cent, solutions for affections of 
 the conjunctiva, also for wounds and gonorrhea. 
 
 Silver and Sodium Hyposulphite,— is very soluble in water, does not coagulate 
 albumin, and may be given by the stomach or hypodermically. It has been used inter- 
 nally for locomotor ataxia and is preferred to silver nitrate for local application to the 
 throat, being more agreeable to the taste. It does not stain the skin or the clothing. 
 Dose, by the mouth, gr. ss-iij ; hypodermically, gr. A-f daily. 
 
 ARNICA, — is the plant Arnica montana or Leopard's Bane, a peren- 
 nial of the nat. ord. Compositae, indigenous to the mountains of Northern 
 Europe and Siberia, and said to have been found in the mountains about 
 the headwaters of the Missouri and Columbia rivers. It has large orange- 
 yellow flowers and a small, curved rhizome with several rootlets. Both 
 the flowers and the roots are official. Its most important constituent is 
 Trimethylamine, C 2 H 9 N, an ammoniacal alkaloidal principle, which is 
 probably the active ingredient. It also contains Arnicin, Inulin, Capronic 
 and Caprylic Acids, tannin, mucilage, resins, and two essential oils, one 
 of which exists in the flowers, the other in the root. 
 
 Arnicse Flores, Arnica Flowers, — the flower-heads of Arnica mon- 
 tana, large and yellow, of feebly aromatic odor and bitter, acrid taste. 
 
 Arnicse Radix, Arnica Root, — the rhizome and rootlets of Arnica 
 montana, is externally brown and rough from leaf-scars, internally whitish, 
 with a thick bark containing a circle of resin-cells and a large, spongy 
 pith. Odor somewhat aromatic, taste pungent, aromatic and bitter. 
 Resembles Valerian, which is distinguished by its smell ; Serpentaria, 
 which has many contorted rootlets ; and Veratrum Viride, which has 
 thicker rootlets. Dose, gr. v-xx. 
 
ARNICA. I97 
 
 Preparations of the Flowers. 
 
 Tinctura Arnicae Florum, Tincture of Arnica Flowers, — strength 20 per cent. 
 Dose, rr^v-xxx. 
 
 Infusum Arnicae, Infusion of Arnica (Unofficial), — Arnica flowers 20, to 100 parts 
 of water, is thought by many observers to be the best form for local use, as it does not 
 excite dermatitis, probably from containing none of the Volatile Oil, nor the insoluble 
 principle Arnicin. 
 
 Preparations of the Root. 
 , Extractum Arnicae Radicis, Extract of Arnica Root, — Dose, gr. j-iij. 
 Extractum Arnicae Radicis Fluidum, FL Extr. of Arnica Root, — Dose, tt\v-xx. 
 Tinctura Arnicae Radicis, Tincture of Arnica Root, — 10 percent. Dose, Tt\v-xxx. 
 Emplastrum Arnicae, Arnica Plaster, — contains Extract of Arnica Root 33 parts to 
 67 of Lead Plaster. 
 
 Derivative. 
 
 Trimethylamina, Trimethylamine, C 3 H 9 N (Unofficial), — is a thin, colorless, strongly 
 alkaline liquid, boiling at 49 F., and at ordinary temperatures a colorless, inflammable 
 gas. The Hydrochlorate is the most stable salt, crystallizing in white or colorless prisms, 
 nearly odorless, of pungent taste, very deliquescent, freely soluble in water and in alco- 
 hol. Dose, gr. ij-iij in syrup every 2 hours. 
 
 Trimethylamine has been obtained from Arnica flowers and those of several other 
 plants, from Ergot, Hops, Codeine, Cod-liver Oil, and decomposing albuminous sub- 
 stances, such as human urine, herring-pickle, and the residue left in making sugar from 
 beets. It is sometimes incorrectly named Propylamine, a term also applied to an impure 
 trimethylamine, but in reality an allied and isomeric compound. 
 
 Physiological Action and Therapeutics. 
 
 Arnica is irritant, stimulant, depressant, antipyretic, diuretic and vul- 
 nerary. It irritates the gastrointestinal tract, and in some persons the 
 local use of alcoholic preparations of the flowers will excite erysipela- 
 tous inflammation of the skin, though those of the root have not been 
 observed to do so. In small doses internally it increases the action of the 
 heart, raises the arterial tension and stimulates the action of the skin and 
 the kidneys. Large doses produce a transient excitement, followed by 
 depression of the circulation, respiration, and nerve-centres; headache, 
 unconsciousness, and even convulsions being induced, the body-tempera- 
 ture lowered, the pupils dilated, and muscular paresis produced. A toxic 
 dose paralyzes the nervous systems of animal and organic life, causing 
 collapse and death. 
 
 Arnica is a popular remedy with those who patronize the so-called 
 homeopathic school of practice, but like many other agents which the 
 homeopathists claim to have given to medicine, it is a remedy much 
 older than homeopathy, and was investigated originally by regular physi- 
 cians, notably by Van der Kolk in the sphere of mental affections. Ex- 
 ternally, the tincture in water has a popular reputation in sprains, bruises, 
 etc., though an infusion is better for local use. Ecchymoses are rapidly 
 dispersed by its administration internally as well as externally ; and for 
 internal bruises from shock or concussion its internal use has proven 
 
I98 ARSENUM. 
 
 very efficacious. The aqueous preparation applied locally promotes the 
 rapid union of cut surfaces. 
 
 Internally, besides its value as previously noted, Arnica is undoubtedly 
 employed effectively in typhus and typhoid fevers as a stimulant and 
 antipyretic ; also in delirium tremens, rheumatism and rheumatic gout, 
 hemorrhages, epistaxis, hemoptysis, amaurosis, concussion of the brain, 
 chronic dysentery and paralysis of the bladder, it has rendered good ser- 
 vice. In idiopathic mania, after the first excitement has diminished. 
 Arnica, in aqueous preparation internally, has given great satisfaction. 
 It has often checked an exhausting diarrhea after many other remedies 
 have failed. 
 
 Trimethylamine is an active escharotic and a gastro-intestinal irritant. It lowers the 
 rate and force of the heart, decreases the body-temperature, and diminishes (though 
 sometimes increases) the excretion of urea. The Hydrochlorate is a powerful antipyretic 
 in doses of gr. ij every 3 hours. It has been found useful in acute rheumatism and gout, 
 relieving pain, reducing temperature, and diminishing the frequency of the pulse. In 
 chronic rheumatism, as a liniment ( I to 3 of Glycerin), it is said to give relief equal to 
 that produced by any anodyne. It has been used with benefit in chorea, moderating 
 the spasmodic movements when not suspending them entirely. 
 
 ARSENUM, Arsenic, As. — The metal Arsenic is not used in 
 medicine, but is represented by one of its Oxides, a salt of another Oxide, 
 and the Iodide, which are official ; together with four preparations of 
 these compounds, or of their salts, viz.: — 
 
 Arsenic Compounds and their Preparations. 
 
 Acidum Arsenosum, Arsenous Acid(Arsenic Trioxide, White Arsenic), As 2 3 , — is 
 a heavy, white solid, occurring as an opaque powder, or in semi-transparent masses 
 having usually a striated appearance, soluble in 30 to 80 of water at 59 F., the solu- 
 bility varying with its physical condition, also soluble in 15 of boiling water, in alkalies 
 and their carbonates, in hydrochloric acid and in glycerin. It is volatilized at 424. 4 F. 
 without melting, and when thrown on ignited charcoal it emits an alliaceous odor. 
 Arsenous Acid is obtained by roasting native arsenides, and condensing the fumes in a 
 long horizontal chimney. Dose, gr. 3L to y 1 ^. 
 
 Liquor Acidi Arsenosi, Solution of Arsenot/s Acid, — is a I per cent, solution in 
 HC1 and Distilled Water. Dose, H\jj-viij, thrice daily in water after meals. 
 
 Liquor Potassii Arsenitis, Solution of Potassium Ar senile [Fowler'' s Solution), — is 
 a I per cent, solution, prepared by boiling together Arsenous Acid I, Potassium Bicar- 
 bonate 2, Comp. Tincture of Lavender 3, and Distilled Water to 100. Dose, nyj-viij, 
 in water thrice daily after meals. 
 
 Sodii Arsenas, Sodium Arsenate, Na 2 HAs0 4 -f 7H 2 0, — is a salt of the second 
 oxide, Arsenic Acid, As 2 5 . Occurs in colorless prismatic crystals, of feebly alkaline 
 taste and a feebly alkaline reaction, soluble in 4 of water at 59 F., very soluble in 
 boiling water, hardly soluble in alcohol. Dose, gr. T *£-| ; of the dried salt, gr. 2? - tV 
 
 Liquor Sodii Arsenatis, Solution of Sodium Arsenate [Pearson'' s Solution), — is a I 
 per cent, solution of the dried Arsenate in Distilled Water. Dose, nvj-viij, in water 
 after meals. 
 
 Arseni Iodidum, Arsenic Iodide, Asl 3 , — occurs in glossy, orange-red crystalline 
 masses or scales, gradually losing iodine by exposure to the air, soluble in 7 of water and 
 in 30 of alcohol at 59 F.; is gradually decomposed by boiling water and by boiling 
 alcohol, and is completely volatilized by heat. Dose, gr. ^V - !- 
 
ARSENUM. I99 
 
 Liquor Arseni et Hydrargyri Iodidi, Solution of Arsenic and Mercuric Iodide 
 {Donovan" 1 s Solution), — has Arsenic Iodide and Mercuric Iodide, of each I part in 100 
 of Distilled Water. Dose, TTyj-viij, in water after meals. 
 
 Unofficial Arsenic Compounds. 
 
 Cupri Arsenis, Cupric Arsenite, — occurs in the various cupro-arsenical pigments 
 used for wall-paper coloring and as insect-poison, viz. — Scheele's green, Mineral green, 
 Paris green, etc. Is highly poisonous. Dose, gr. y^ daily, in divided doses. 
 . Liquor Arseni Bromidi, Solution of Arsenic Bromide ( Clemens' Solution) , — so named 
 by Dr. Clemens, who described it as a chemical union of Arsenic and Bromine, but the 
 action of Bromine on Arsenous Acid results in the formation of Arsenic Acid and Hydro- 
 bromic Acid, and the preparation is rather a Liquor Potassii Arsenatis et Bromidi. It 
 contains Arsenic equal to I per cent, of Arsenous Acid ; and is prepared by boiling to- 
 gether Potassium Carbonate and Arsenous Acid, 3J of each in ^x of distilled water, 
 until a clear solution is formed ; when cold 3 ij of Bromine and % xij of water are added, 
 and the mixture is allowed to stand until all color disappears, when it is ready for use. 
 Dose, TTL j-v, thrice daily in water after meals. 
 
 Solutions of the Bromides of Arsenic and Gold (Arsenauro), of Arsenic, Gold 
 and Mercury (Mercauro), of Arsenic, Gold and Calcium (Calcauro), and of Arsenic, 
 Gold and Manganese (Manganauro), are described under the title Aurum. 
 
 Physiological Action. 
 
 Arsenous Acid, when applied to the skin denuded of its epidermis, acts 
 as a painful escharotic, producing violent inflammation and resulting in a 
 slough which forms a barrier to its absorption. If applied in dilute solu- 
 tion over a large surface, it will be absorbed, and may produce the 
 systemic effects to be described. 
 
 In small doses it is a stomachic and general tonic, promoting the appe- 
 tite and digestion, increasing the cardiac action, the respiratory power, 
 and the intestinal secretions ; stimulating peristalsis, exalting mental 
 activity and the sexual appetite, and producing a fair skin and a rotund 
 form. When tolerance of the drug is established, large doses are used 
 with impunity, as by the arsenic eaters of Styria, who can swallow at once 
 as much as 5 grains with safety. They are careful, however, not to take 
 any water into the stomach at the same time, so that the dose is slowly 
 absorbed, and probably eliminated rapidly. Not all those who begin its 
 use can acquire tolerance of it, but those who do so seem to continue it 
 without injury, and live to an old age, undergoing great exertion without 
 exhaustion, and being enabled to ascend steep mountains without diffi- 
 culty of respiration. 
 
 In full medicinal doses, continued for some time, it causes itching and 
 edema of the eyelids, ptyalism, nausea and vomiting, diarrhea or dysen- 
 tery, epigastric pain and soreness, feeble and irritable heart, dyspnea, 
 disordered sensibility, herpes zoster, urticaria, eczema and other skin 
 eruptions, jaundice and albuminuria. 
 
 In large doses it is a powerful irritant to the gastro-intestinal and 
 bronchial mucous membranes. Toxic doses may produce either symp- 
 toms of gastro-enteritis, or those of profoundly narcotic character. In 
 
200 ARSENUM. 
 
 the first and most usual form of acute arsenical poisoning, there is burning 
 pain in the throat and stomach extending over the abdomen, vomiting, 
 thirst, bloody stools, strangury, suppressed, albuminous or bloody urine, 
 rapid and feeble heart, great anxiety, cold breath, finally exhaustion and 
 collapse, — a group of symptoms much resembling cholera. The autopsy 
 shows erosions, ecchymoses, and softening of the gastro-intestinal mucous 
 membrane, congestion of the lungs and bronchi, and fatty degeneration 
 of the liver, kidneys and cardiac muscle. The poison is found in the 
 urine, saliva, tears, sweat, etc., and may be detected even in the paren- 
 chymatous tissues. In the nervous form of poisoning by arsenic, pro- 
 found coma and insensibility come on suddenly without any gastro-intes- 
 tinal symptoms. 
 
 Arsenical preparations are generally classed as alteratives, but they are 
 valuable tonics and antiseptics, and possess antiperiodic powers second 
 only to those of Quinine. 
 
 Chronic Arsenical Poisoning may occur from the inhalation of arsenical 
 vapors or dust arising from wall-papers or other substances containing the 
 poison. The quantity necessary to produce symptoms of poisoning when 
 inhaled seems to be very small. The most prominent symptoms are, at 
 first increased appetite, next colicky pains, mucous or dysenteric stools, 
 irritation of the eyes, coryza, a short, dry cough, and a white and silvery 
 tongue, all accompanied by great bodily prostration. 
 
 The long-continued use of arsenic may induce peripheral neuritis, the 
 chief symptoms of which when so caused are — severe darting pains in the 
 limbs, paralysis of the muscles of the extremities, especially the extensors 
 of the hands and feet, ataxic gait, herpes zoster, and rapid muscular 
 atrophy. In several cases it has caused general brown pigmentation of 
 the skin, and may give rise to the same pigmentation of psoriasis patches. 
 After death from chronic poisoning, in addition to the gastro-intestinal 
 and nervous lesions, there is found wide-spread fatty degeneration, affect- 
 ing most of the organs, but particularly the liver, kidneys, stomach and 
 muscles, including the heart. 
 
 To avoid arsenical poisoning during a course of the drug, full doses 
 (n^x of Fowler's Solution) should be used at the commencement, and 
 always taken on a full stomach. The dose should then be steadily re- 
 duced. Susceptible persons often tolerate it better if a few drops of 
 laudanum are administered with each dose. 
 
 Antidotes and Incompatibles. 
 
 Poisoning by Arsenic is treated by prompt evacuation of the stomach, and washing it 
 by means of the stomach pump, then Magnesia, Chalk, and Lime-water freely, or better 
 still, the chemical antidote to Arsenic in solution, viz., the Hydrated Oxide of Iron, 
 freshly precipitated and in a soft magma, in the proportion of gr. viij for each grain of the 
 poison ingested. (See Ferri Oxidum Hydratum for the preparation of this antidote.) 
 Oil or mucilaginous drinks should be given to protect the mucous membranes, and dilu- 
 
ASAFCETIDA. 201 
 
 ents, alkaline mineral waters or Iodide of Potassium to promote elimination. Dialyzed 
 Iron has been shown to be quite efficient as an antidote, and is more easily obtained 
 than the hydrated oxide. It has rendered good service in many cases of poisoning from 
 inhalation of arsenical fumes. 
 
 Incompatibles are salts of Iron, Magnesium and Calcium, also Astringents. 
 
 Therapeutics. 
 
 Externally, Arsenic has been employed in the form of paste as a depila- 
 tory, and as an escharotic in cancers, but is excessively painful. Most of 
 the secret " cancer cures " have arsenous acid for their basis. Internally, 
 it is used as a tonic and astringent to the intestinal canal, as a tonic and 
 antispasmodic in nervous diseases, and for its action on tissue change. 
 It is of especial value in irritative dyspepsia, gastralgia, pyrosis, gastric 
 ulcer or cancer, regurgitation of food without nausea, diarrhea coming 
 on immediately after taking food, vomiting of drunkards and chronic 
 alcoholism. It has proven of signal service in the commencement of 
 phthisis, also in catarrhal pneumonia, probably by causing fatty degen- 
 eration of the exudation in the alveolar cavities, thus breaking it up and 
 quickening its absorption. It is often very serviceable in chronic bron- 
 chitis with copious expectoration, in acute catarrh, hay fever, whooping- 
 cough, asthma, chorea, epilepsy, angina pectoris and other spasmodic 
 nervous disorders. In many forms of neuralgia it frequently gives prompt 
 and permanent relief, especially in cases due to malarial poisoning. As 
 an antiperiodic, it has high rank, being, however, of particular value in 
 chronic malarial poisoning, and as an adjunct to Quinine in the intervals 
 between the paroxysms of intermittents. Anemia and chlorosis are re- 
 markably benefited by it, and in rheumatic arthritis and chronic rheuma- 
 tism it is sometimes of great service. In chronic scaly and papular skin 
 diseases its value is very great, but it is not serviceable in acute forms, 
 and the more chronic the cutaneous affection the more likely it is to be 
 amenable to Arsenic. Epithelioma may be retarded by small doses long 
 continued, and it has certainly been useful in delaying the progress of 
 other cancers, particularly scirrhus of the stomach and uterine carcinoma. 
 Hypodermically its solutions have been extremely efficient in histrionic 
 spasm, local chorea of the head and neck, obstinate cases of general 
 chorea, and in lymphadenoma. 
 
 The so-called Bromide of Arsenic, in the form of Clemens' Solution, 
 has rendered good service as a remedy for diabetes mellitus of hepatic 
 origin. Cupric Arsenite is highly recommended in typhoid fever. 
 
 ASAFCETIDA, Asafetida, — a gum-resin obtained by incision from 
 the living root of Ferula foetida, a perennial herb of the nat. ord. Urn- 
 belliferae, native of Persia and Afghanistan. It occurs in whitish tears 
 
202 ASAFGETIDA. 
 
 embedded in a grayish sticky mass, of alliaceous odor and taste, soluble 
 in alcohol to at least 60 per cent., and when triturated with water it yields 
 a milk-white emulsion. Its principal constituent is a Sulphuretted Vola- 
 tile Oil, consisting chiefly of Allyl Sulphide, C 6 H 10 S ; it also contains a 
 gum and a resin, with ferulaic, malic, acetic, formic and valerianic acids. 
 Dose, gr. v-xx. 
 
 Preparations. 
 
 Tinctura Asafcetidae, Tincture of Asafetida, — strength 20 per cent. Dose, gss-ij. 
 
 Emulsum Asafcetidae, Emulsion of Asafetida, Milk of Asafetida, — strength 4 per 
 cent, in water. Dose, ^ss-ij. 
 
 Pilulae Asafcetidae, Pills of Asafetida, — each pill has gr. iij of Asafetida with gr. j 
 of Soap. Dose, j-iv pills. 
 
 Pilulae Aloes et Asafcetidae, Pills of Aloes and Asafetida, — each pill has gr. 1^ of 
 each constituent named and the same quantity of Soap. Dose, j-iv pills. 
 
 Mistura Magnesiae et Asafcetidae, Mixture of Magnesia and Asafetida, Deiuees* 
 Carminative (Unofficial), has of Magnesium Carbonate 5, Tinct. Asafcetidae 7, Tinct. 
 Opii I, Sugar 10, Aqua Dest. q. s. ad 100 parts. Dose, gss-^ss. 
 
 Spiritus Ammoniae Fcetidus (Unofficial), — Asafetida \y 2 , Liquor Ammoniae For- 
 tior 2, Alcohol 20 parts. Dose, ^ss-j. 
 
 Physiological Action and Therapeutics. 
 
 Asafetida is a powerful antispasmodic, a stimulant to the brain and 
 nervous system, a stimulating expectorant, also tonic, laxative, diuretic, 
 diaphoretic, emmenagogue, aphrodisiac and anthelmintic in action. Its 
 odor and taste are extremely nauseous and persistent. In small doses 
 continued it causes impaired digestion, alliaceous eructations, acrid sen- 
 sation in the fauces, gastralgia, flatulent distention, fetid flatulence, 
 burning urination, diarrhea and tenesmus. Full doses produce various 
 nervous or hysterical phenomena, with nausea, vomiting and purging. 
 The Volatile Oil diffuses into the blood and tissues, and is excreted in the 
 urine, sweat, breath, etc. By its action the circulation is stimulated, the 
 arterial tension raised, the power of the cardiac motor ganglia is increased 
 and the. cardiac inhibition relaxed. Asafetida also stimulates the brain 
 even to pleasant intoxication, and produces a subjective sensation of 
 warmth without any rise of body-temperature. It stimulates the nervous 
 system, the secretions and excretions, the menstrual flow and the sexual 
 appetite. In Asia it is used as a condiment with food, and though at 
 first it is extremely nauseous to most people, a taste for it may be readily 
 acquired. 
 
 The disgust which is generally felt for this remedy makes its use very 
 restricted, though a valuable medicine. The Emulsion is extremely ser- 
 viceable in the flatulent colic of infants, and as an enema in infantile con- 
 vulsions. There is no better remedy in hysteria and hypochondriasis 
 with indigestion and flatulence ; in constipation with amenorrhea of 
 anemic subjects, due to ovarian and intestinal torpor; in bronchial 
 
ASCLEPiAS ASPIDIUM — ASPIDOSPERMA. 203 
 
 affections, cough of habit, chronic catarrhs, and flatulent indigestion. It 
 has been highly praised in the treatment of habitual abortion. 
 
 ASCLEPIAS, Pleurisy Root, — is therootof Asclepias tuberosa, a plant of the nat. 
 ord. Asclepiadacere and a native of the Eastern and Southern States. Two other species 
 of Asclepias are used in medicine and were formerly official. 
 
 Extractum Asclepiadis Fluidum, Fluid Extract of Asclepias, — Dose, gss-j. 
 
 An Infusion or Decoction may be made in the proportion of ^ j of the powdered root 
 to a quart of water, and given in teacupful doses every 2 or 3 hours. 
 
 Asclepias contains two resins, a peculiar principle, tannic and gallic acids, albumin, 
 pectin, gum, various salts and a volatile, odorous, fatty matter. It is emetic and cathar- 
 tic in full doses, also diaphoretic and expectorant, as well as depressant to the action of 
 the heart, and probably slightly sedative and astringent. It is a popular remedy in the 
 Southern States for pleurisy (hence its common name), and has been used in medicine 
 for catarrh, pneumonia, phthisis, diarrhea, dysentery, rheumatism, gastralgia, and to pro- 
 mote the eruption in exanthematous fevers. It is undoubtedly a powerful diaphoretic. 
 
 ASPIDIUM, — is the rhizome of Dryopteris Filix-mas (Male Fern) 
 and of Dryopteris marginalis (Marginal Shield Fern), plants of the nat. 
 ord. Filices, the former found in most parts of the world, the latter indi- 
 genous to N. America. The active principle is Filicic Acid, C u H 18 5 , 
 which is extracted in the oleoresin. It also contains a green, fatty oil, 
 a volatile oil, resin, tannin, etc. Dose, 3SS-3JSS in a single dose fasting, 
 or in divided doses at short intervals, followed by a purgative. 
 
 Oleoresina Aspidii, Oleoresin of Aspidium, — is an ethereal extract and deposits 
 Filicic Acid on standing. It should be well shaken before being used. Dose, .^ss-^j, 
 in capsules, repeated every 3 hours for 2 or 3 doses. 
 
 Aspidium is an efficient vermicide against tapeworm, particularly the 
 unarmed variety (Bothriocephalus latus). The Oleoresin is the best form 
 in which to use it, the patient having fasted for the previous day, or used 
 only a milk diet, 3J may then be given in 4 doses ^ hour apart. This 
 may be repeated the next morning and followed by three drops of croton 
 oil in emulsion. This is one of many methods. Cusso may be com- 
 bined with it advantageously. A formula for a mixed treatment by As- 
 pidium, Pomegranate and Pumpkin-seed is given under the title Grana- 
 tum. 
 
 ASPIDOSPERMA, Aspidosperma, Quebracho,— is the bark of 
 Aspidosper?)io Quebracho-blatico, a large evergreen tree of the nat. ord. 
 Apocynacese, growing in Chili and the Argentine Republic. The name 
 is one given in S. America to any very hard wood (quebrar hacho, to 
 break the axe), and the particular tree above named is known as Quebra- 
 cho-bianco, from the white color of its wood. It contains several alkaloids, 
 no one of which represents the action of the bark itself; the most impor- 
 tant being Aspidosper?nine, C 22 H 30 N 2 O 2 , and Quebrachine, C.^H^NjOg. 
 
204 AURANTIUM. 
 
 Several false Quebrachos are found on the market, that most frequently 
 seen being the bark of Loxopterygium Lorentzii, or Quebracho Colorado, 
 an Argentine tree of the order Terebinthaceae. 
 
 Extractum Aspidospermatis Fluidum, Fluid Extract of Aspidosperma, — is the 
 only official preparation. Dose, rr^v-^j. 
 
 Tinctura Quebracho, Tincture of Quebracho (Unofficial), — strength 20 per cent. 
 Dose, 3J-iv. 
 
 Vinum Quebracho, Wine of Quebracho (Unofficial). Dose, gj-^fj. 
 
 Extractum Quebracho, Extract of Quebracho (Unofficial). Dose, gr. ij-x. 
 
 Aspidosperma is a bitter tonic of disagreeable taste, increasing appe- 
 tite and promoting digestion. It lowers the action of the heart, reduces 
 arterial tension, and slows respiration, also decreasing the sensation of 
 need of air after active exercise. In large doses it causes severe saliva- 
 tion, nausea, vomiting, vertigo and headache. In animals it paralyzes the 
 motor nervous system and lowers the reflexes, producing great dyspnea 
 and finally death, apparently from asphyxia. 
 
 This drug has long been used in Chili as an antiperiodic, a stomachic 
 tonic and a remedy for dyspnea. In the latter condition it is reported 
 to be remarkably palliative, especially when due to emphysema, uremic 
 and spasmodic asthma, spasmodic cough and chronic bronchitis. It is not 
 efficient in dyspnea from organic diseases of the heart, or in that of aged 
 subjects of atheroma. 
 
 Aspidospermine is actively poisonous to the respiratory apparatus and 
 circulation in both cold- and warm-blooded animals, in the former the 
 respiration being chiefly affected, in the latter motor ganglia of the 
 heart. Lowered temperature, dyspnea, stupor and convulsions occur 
 before death. It has been used as an antipyretic, also in cardiac neu- 
 roses and in asthma. Its salts are freely soluble in water, but the alkaloid 
 itself is soluble only in oils and fats, 6 to 8 parts being readily incorpo- 
 rated with 100 of cod-liver oil by the aid of heat. The average dose is 
 about gr. j-ij. 
 
 AURANTIUM, Orange, — occurs in two official varieties of fruit 
 and flowers, viz. — those of Citrus vulgaris, the Bitter Orange, and Citrus 
 Aurantium, the Sweet or Portugal Orange, both trees of the nat. ord. 
 Aurantiacese, cultivated in almost all warm countries. Other varieties are 
 described under Limon. The official titles are — 
 
 Aurantii Amari Cortex, Bitter Orange Peel, — the rind of the fruit 
 of Citrus vulgaris, characteristics well known. Contains a Volatile Oil 
 isomeric with Oil of Turpentine, C 10 H 16 , and a bitter crystalline prin- 
 ciple, Hesperidin or Aurantiin. 
 
AURUM. 205 
 
 Aurantii Dulcis Cortex, Sweet Orange Peel, — is the rind of the 
 fresh fruit of Citrus Aurantium. It contains a Volatile Oil differing from 
 that of the bitter orange, and less of the bitter principle. 
 
 Preparations. 
 
 Extractum Aurantii Amari Fluidum, Fluid Extract of Bitter Orange Peel. — 
 Used as flavoring. Dose, ^ss-j. 
 
 Tinctura Aurantii Amari, Tincture of Bitter Orange Peel, — strength 20 per cent. 
 Dose, gj-ij. A flavoring preparation. 
 
 Tinctura Aurantii Dulcis, Tincture of Szveet Orange Peel, — strength 20 per cent. 
 Dose, 3J— ij. A flavoring preparation. 
 
 Syrupus Aurantii, Syrup of Orange, — Sweet Orange Peel 5, Calcium Phosphate 
 Precip. 5, Sugar 70, Alcohol and Water to 100. Dose, 3J-ij. Used for flavoring. 
 
 Syrupus Aurantii Florum, Syrup of Orange Flowers, — Sugar 85, Orange-flower 
 Water to 100. Dose, 3J-1J. A delicate flavoring agent, but having to some persons an 
 extremely sickish taste. 
 
 Spiritus Aurantii, Spirit of Orange, — Oil of Orange Peel 5, Deodorized Alcohol 
 95. Dose, to be regulated by the quantity of alcohol desired. 
 
 Spiritus Aurantii Compositus, Compound Spirit of Orange, — Oil of Orange Peel 
 20, Oil of Lemon 5, Oil of Coriander 2, Oil of Anise ]/ 2 , Deodorized Alcohol to 100. 
 Dose, as for alcohol. 
 
 Aqua Aurantii Florum Fortior, Stronger Orange-flower Water, — is water saturated 
 with the volatile oil of fresh orange flowers. Dose, indefinite, for flavoring. Used to 
 prepare— 
 
 Aqua Aurantii Florum, Orange-flozver Water, — consists of equal volumes of the 
 preceding and Distilled Water, mixed immediately before use. Dose, indefinite. 
 
 Oleum Aurantii Corticis, Oil of Orange Peel, — a volatile oil, obtained by expres- 
 sion from the fresh peel of either orange. Is soluble in about 4 times its volume of alco- 
 hol, and is an ingredient of the two official Spirits of Orange and also of Spiritus Myrcire 
 (Bay Rum). Dose, gtt. j-v. 
 
 Oleum Aurantii Florum, Oil of Orange Flowers {Oil of Neroli), — a volatile oil, 
 distilled from the fresh flowers of the bitter orange. Is the most important constituent 
 of Cologne Water (Spiritus Odoratus), and is soluble in an equal volume of Alcohol. 
 Dose, gtt. j-v. 
 
 Elixir Aromaticum, Aromatic Elixir [Simple Elixir), — has of the Comp. Spt. of 
 Orange 1.2, Precipitated Calcium Phosphate i l / z , Syrup 37^, Deodorized Alcohol and 
 Distilled Water to 100. A flavoring vehicle. Dose, ^j-^j, or more. 
 
 Orange is aromatic and tonic, also more or less bitter, but has little 
 action except a mild stimulant influence on the nervous system due to 
 its volatile oil. Persons much exposed to its fumes are liable to cutaneous 
 eruptions and various nervous disorders. The oil may produce violent 
 colic and convulsions in children, one case being reported in which death 
 resulted from eating the rind. Its use in medicine is confined to flavoring 
 purposes, though the preparations of the Bitter Orange may be used as 
 gentle tonics and stimulants to the digestion, but they are usually com- 
 bined with more energetic agents. 
 
 AURUM, Gold, Au, — is represented by only one official salt, the 
 Gold and Sodium Chloride, but triturations of the metal itself may be 
 prepared, according to the general pharmacopceial formula for such prepa- 
 
206 AURUM. 
 
 rations. The unofficial solution of Gold and Arsenic Bromide is a very 
 efficient preparation. Fine gold and a solution of the perchloride are in 
 the Br. Ph., and powdered gold, also the oxide, chloride, sodio-chloride, 
 iodide and cyanide, are official in the French Codex. 
 
 Official Preparation. 
 
 Auri et Sodii Chloridum, Gold and Sodium Chloride, — is a mixture composed of 
 equal parts of dry Gold Chloride, AuCl 3 , and Sodium Chloride, NaCl ; and occurs as an 
 orange-yellow powder, of saline and metallic taste, slightly deliquescent in damp air, 
 very soluble in water, partly soluble in alcohol, and contains about 32 per cent, of pure 
 gold. Its solutions are decomposed by organic substances, by light, and by almost all 
 salts. Dose, gr. -i§-\, once or twice a day. The Ph. Ger. gives the maximum single 
 dose as gr. J£, and the maximum daily dose as gr. iij, but these doses are too high. 
 
 Unofficial Preparations. 
 
 Auri Pulvis, Powdered Gold, — may be obtained by triturating gold leaf with ten 
 times its weight of sugar of milk or potassium sulphate until brilliant particles are no longer 
 visible in it, and then washing the diluent away with boiling water. A Trituration of 
 Gold may be prepared in the same manner, retaining the sugar of milk, as directed by 
 the pharmacopoeia under the title Triturationes. Dose of powdered gold is gr. |-gr. j, 
 or a little of it may be applied by friction to the sides of the tongue. 
 
 Auri Chloridum, Gold Chloride, — also called the perchloride or terchloride of gold 
 (AuCl 3 ), the "potable gold" of the alchemists, — occurs in needle-shaped prisms of a 
 deep orange color, very deliquescent and freely soluble in water, in alcohol and in ether. 
 Dose, gr. ^-g 1 ^, in pill or solution, preferably the latter. The commercial salt so named, 
 and much used by photographers, is not the pure chloride but a crystallized double salt 
 of gold and sodium, containing 50 per cent, of metallic gold. 
 
 Auri Bromidum, Gold Bromide, AuBr 3 , — occurs as a yellowish-gray, friable mass, 
 which is insoluble in water but soluble in ether, and contains 55 per cent, of Bromine. 
 Dose, gr. -}^-\, but against migraine the minimum quantity should be used twice daily 
 an hour before meals. 
 
 Auri et Sodii Bromidum, Gold and Sodium Bromide, AuBr 3 NaBr.2ri 2 0, — may be 
 used hypodermically in solution, 2 parts to 100 of distilled water, the dose of which is 
 rr^viij increased to lTLxxxij, respectively representing -\ to § of a grain. 
 
 Liquor Auri et Arseni Bromidi, Solution of Gold and Arsenic Bromide (Barclay), — 
 is marketed under the trade-name " Arsenauro" and contains gr. ^ °f eacn sa ^ m Tr L x ' 
 Dose, TTLv-xv in water, thrice daily after meals, or hypodermically. 
 
 This solution may be prepared as follows : (i) Take of Nitric Acid gj and of Hydro- 
 chloric Acid 5 iij, mix them and dissolve in the mixture 21 grains of pure Gold, then 
 evaporate to dryness in a water-bath. Dissolve the resulting Chloride of Gold in distilled 
 water 3 j, and add slowly a solution of 35 grains of Ammonium Bromide in 3 iv of water. 
 Shake with Squibb' s ether until all the gold is taken out, separate in a separating funnel, 
 and treat the ether solution with fused calcium chloride to remove all water. Distil off 
 the ether, and dissolve the remaining Gold Bromide in 3; iv of water to make Solution 
 No. 1. (2) Dissolve 48^ grains of Arsenous Acid in % iv of distilled water by the aid 
 of heat, and when cold add gj of Bromine and let the mixture stand for 24 hours. Then 
 drive off the excess of bromine by boiling in a sand-bath until the solution is colorless, 
 which gives Solution A T o. 2. (3) Mix the two solutions and add sufficient water to make 
 I quart. 
 
 Liquor Auri, Arseni et Hydrargyri Bromidi, Solution of Gold, Arsenic and Mer- 
 cury Bromide (Barclay), — is marketed under the trade-name " Mercauro" and con- 
 tains gr. -gL of each bromide in rt^x. Dose, TT^v-xv in water, thrice daily after meals, 
 or hypodermically. 
 
 Similar solutions of the bromides of gold, arsenic and calcium (" Calcauro") and of 
 the bromides of gold, arsenic and manganese (" Manganauro" ) , are on the market and 
 may be used in like doses. 
 
AURUM. 207 
 
 Physiological Action. 
 
 The action of the salts of gold upon the human organism is analogous 
 in many respects to that of mercury, causing local irritation and escha- 
 rotic effects when applied in substance or in strong solution. In continued 
 medicinal doses given internally they produce a condition of general 
 erethism which closely resembles the mercurial fever, and is accompanied 
 by salivation but without tenderness or ulceration of the gums. The 
 Chloride is one of the most active salts, being, according to Chrestien, 
 even more toxic than corrosive sublimate. Locally, it produces irritant 
 and caustic effects, and imparts a yellow stain to the skin, which later on 
 turns violet and even black, from reduction of the metal therein. In 
 overdoses it causes gastric pain and inflammation, also ulceration of the 
 gastro-intestinal mucous membrane, and otherwise acts as a corrosive 
 poison; toxic doses produce a violent gastro-enteritis with such nervous 
 phenomena as convulsive tremor, cramps, priapism, insomnia and insen- 
 sibility (Magendie). 
 
 The salts of gold, administered in small medicinal doses, increase the 
 
 appetite and the digestive power and stimulate the functional activity of 
 
 the secreting organs, especially the skin and the kidneys. They also 
 
 stimulate the generative apparatus, causing diaphoresis, diuresis, and 
 
 exciting the menstrual flow in women and the sexual appetite in men. 
 
 The observations of several competent physicians have established the 
 
 power of these salts to excite the vascular and muscular systems and to 
 
 produce fever, to increase the urine and the sweat, to cause salivation 
 
 without stomatitis, a sense of heat in the stomach, headache and diarrhea, 
 
 to promote menstruation, excite the genitalia, and profoundly affect the 
 
 nervous system. In large or continued doses they cause dryness of the 
 
 tongue, redness of the pharynx, gastric and intestinal colic, nausea and 
 
 vomiting, and even erosion of the gastric mucous membrane. The 
 
 Bromide, though containing only 55 per cent, of bromine, is found to be 
 
 many times more active, weight for weight, than the ordinary bromides. 
 
 Administered in doses of from y 2 grain to 3 grains per kilogramme of 
 
 body-weight, it depressed the cortical motor centres to such a degree that 
 
 the strongest electrical stimulation thereof failed to produce an epileptic 
 
 seizure (Shtcherbak). 
 
 Antidotes and Antagonists. 
 
 Poisoning by gold salts is treated like that by corrosive sublimate. The Antidote is 
 Albumin in some form, followed by evacuation of the stomach, as the albuminate is not 
 wholly inactive. The Antagonists are Bismuth, Tannin, Sodium Sulphite, and diluted 
 Nitric Acid, in water, as gargles and mouth washes for the salivation ; Belladonna to 
 lessen the salivary secretion, Hyoscyamine for the tremor and Morphine for shock. 
 
208 AURUM. 
 
 Therapeutics. 
 
 The literature of gold shows that it is one of the most ancient medi- 
 cines. Pliny, in the first century, recorded its use as a recognized remedy 
 for several conditions for which it is still employed, including lichenoid 
 eruptions, fistula, hemorrhoids, warts, putrid ulcers, and sores emitting 
 an offensive smell. In the finely divided metallic state it was employed 
 as a panacea by the Arabian physicians and by the alchemists. During 
 the 17th and 18th centuries it was highly esteemed as an antisyphilitic, 
 also for leprosy, dropsies, epilepsy, the pest, fevers, amenorrhea, sterility 
 and uterine diseases. During the first quarter of the present century it 
 was in high repute among the Continental physicians as a remedy for 
 syphilis and for scrofula. 
 
 Mitchill (1818) administered gold salts for syphilis in the New York Hospital, with 
 excellent results. In his opinion " the muriate of gold will effect all that is achieved by 
 the muriate of quicksilver, with incomparably less inconvenience to the patient, who gets 
 well under the former without the hazard of a sore mouth or a salivation, and with very 
 little wear and tear of constitution." Trousseau (1851) says that the happy results of 
 gold in the treatment of venereal diseases are incontestable ; and von Schroff of Vienna 
 (1868) gave it great praise for the restoration of a case of syphilis in which the strongest 
 mercurials had failed to avert destruction of the nasal bones or the deep, spreading ulcers 
 of the skin. Phillips (1894) says that its efficacy is best seen in the later developments 
 of syphilis, such as ulceration of the nose and larynx, cutaneous syphilides, hard nodes, 
 etc., also that it may especially be employed in long-standing cases with chronic peri- 
 ostitis and when mercury has already been given to saturation. Still it has never obtained 
 general professional favor in the United States or in England until recently. Professor 
 Barton, of Jefferson Medical College, Philadelphia (1827), pronounced the following 
 judgment upon it in his lectures on materia medica. " On the whole view of what has 
 been said in favor of gold, I am not inclined to attach great importance to it as a remedy. 
 It is well enough in its proper place and for its proper purposes, for which it is more use- 
 ful than as a medicine. Plenty of it would doubtless cure many diseases of mind and 
 body." Such has been the general opinion since the above words were printed, but of 
 late years a number of compounds of gold with other elements (chlorine, bromine, iodine, 
 arsenic and mercury) have been employed as medicines with considerable satisfaction. 
 
 Dr. Piffard of New York finds that Gold is unquestionably useful in 
 the later stages of syphilis, and says that its best effects are obtained with 
 very small doses, gr. -^ or less, which he rarely continues for more than 
 one or two weeks at a time. Several other observers have given it great 
 praise as a remedy in constitutions which are broken down by the com- 
 bined influence of syphilis and mercury, for syphilis in strumous subjects, 
 and for the various manifestations of scrofula. Under its use the auric 
 fever may develop, and the local affections for which it is administered 
 may assume an aggravated intensity, and even new ones appear; but 
 these phenomena do not call for the suspension of the remedy, for the 
 disease retrogrades rapidly in a few days after they appear (Trousseau) ; 
 and on lessening the dose pyrexia subsides and good effects are more 
 conspicuous (Phillips). 
 
 Strumous affections have been frequently reported cured by the internal 
 
AURUM. 209 
 
 and local use of auric preparations, including scrofulous ulcers, lupus, 
 ozena, enlarged and indurated cervical glands, and hypertrophy of the 
 tongue with induration thereof. Gold has been credited with many 
 cures of cancer of the uterus, mammae and tongue, but it is probable that 
 such have really been cases of scrofulous ulceration. Squamous skin dis- 
 eases, the "dartres" of the older writers, are, next to syphilis, the most 
 successful field for the action of gold. In cutaneous diseases it is used 
 locally as well as internally. Dropsy is one of the affections in which it 
 was anciently recommended, and in which modern therapeutists have 
 found it efficient, especially ascites due to chronic hepatic disease or to 
 induration of the abdominal organs, also post-scarlatinal dropsy and 
 ovarian dropsy. 
 
 Many disorders of the female generative organs have proved amenable 
 to gold when persistently employed. Amenorrhea due to ovarian torpor 
 and chronic metritis with scanty menstruation are often benefited thereby, 
 while sterility dependent on these states or due to coldness, is more 
 certainly cured by the auric preparations than by any other merely 
 medicinal means. The tendency to habitual abortion may be averted 
 by the use of the Chloride, which is also beneficial for mental symptoms 
 of hysterical character, especially when connected with uterine disease. 
 Many competent clinicians have highly commended gold in suicidal 
 melancholia, in hypochondriasis accompanying hepatic or testicular dis- 
 ease, in decline of the sexual power in men, and as a tonic for low-spirited, 
 pining boys with undeveloped testes. 
 
 Sclerosis of the internal organs, especially the liver and kidneys, may 
 be retarded by the persistent use of the Gold and Sodium Chloride, in 
 doses of gr. -g^-^o thrice daily. Nervous dyspepsia, characterized by a 
 red and glazed tongue, epigastric pain increased by food, and relaxation 
 of the bowels after eating, is greatly benefited by the same salt in equally 
 small doses. Catarrh of the duodenum and bile-ducts, and jaundice 
 therefrom, also vertigo and vertiginous sensations connected with gastric 
 disorders or due to cerebral anemia, are often removed by a course of 
 treatment with the salts of gold. The Bromide has been employed in 
 doses of from gr. % to gr. y^ with decided benefit in obstinate cases of 
 hysteria and epilepsy. Goubert used it successfully for migraine, epilepsy, 
 chorea and exophthalmic goitre, in daily doses of gr. yi to ^5, continued 
 until its characteristic headache was produced. He claims for it greater 
 efficacy in epilepsy than is possessed by the other bromides, and says that, 
 as compared with them, it is better tolerated and does not induce depres- 
 sion and emaciation or the other pronounced symptoms of bromism. 
 
 A combination of Gold and Arsenic (Auri Arsenas) was introduced by 
 Chrestien and extensively employed by Massart in cancer and phthisis, 
 with sufficient success to merit the approval of the medical societies of 
 H 
 
2IO AVENA SATIVA. 
 
 Lyons and Toulouse. It is said to be particularly serviceable in scrofu- 
 lous affections, especially lupus, and to exercise a highly beneficial influ- 
 ence on anemia and chlorosis. A solution of the Bromides of Gold and 
 Arsenic has been successfully employed for several years by Dr. Barclay 
 and others in the various diseases of which sclerosis is the chief factor, 
 such as cirrhosis of the liver and lungs, interstitial nephritis, atheroma 
 and calcareous degeneration of the arteries, senile degenerative changes 
 and neurotic disease, fibroid phthisis, locomotor ataxia, etc. ; also in 
 cervical adenitis, arthritis deformans, syphilitic neuralgia and iritis, mili- 
 ary tuberculosis, epilepsy, chronic neuritis, sciatica, chronic muscular 
 rheumatism and neurasthenia. Arsenauro is the trade-name of this solu- 
 tion, which has been the subject of extended reports from many compe- 
 tent observers, some of whom claim to have obtained from the use of 
 this combination results which neither of its constituents are capable of 
 when administered alone. It is held to have marked alterative power 
 upon the glandular system and upon all non-malignant scleroses; to be 
 not only a blood-maker but a blood-builder, increasing the number of 
 the corpuscles and improving their quality, and also increasing the amount 
 of hemoglobin therein. It is eliminated by the kidneys and produces no 
 irritation when administered either by the mouth or hypodermically. A 
 similar solution of the Bromides of Gold, Arsenic, and Mercury, named 
 Mercauro, is on the market, and is highly praised in the treatment of the 
 late manifestations of syphilis, particularly those affecting the nervous 
 system. 
 
 A so-called il Bichloride-of- Gold Cure" for inebriety has become highly 
 notorious through extensive advertising and other commercial methods, 
 but from the most reliable information obtainable it is reasonably certain 
 that the only preparation of gold which plays a prominent part therein is 
 the gold coin which passes from the patient's pocket to that of the 
 manager of the " institute." The physiological symptoms produced by 
 the remedy employed are those of strychnine and atropine, the adminis- 
 tration of which hypodermically several times daily for three or more 
 weeks is decidedly dangerous. In many cases cardiac failure has occurred 
 soon after the completion of the treatment, and in a large number of 
 instances insanity or other serious psychoses have developed immediately 
 after the subjects had been through one of these so-called " cures." 
 
 AVENA SATIVA, — the common Oat, a plant of the nat. ord. Graminaceae, — was 
 official in the U. S. P. 1870, as Avence Farina, or Oat-meal. A concentrated tincture 
 or fluid extract has been extensively advertised by drug manufacturers as a nerve stimu- 
 lant and tonic, especially efficacious in the treatment of chorea, epilepsy, insomnia, ner- 
 vous exhaustion, alcoholism and the opium-habit. The seeds contain starch, gluten, 
 gum, etc., and form a nutritious food, the meal being made into a porridge, or gruel. In 
 the latter form it is a good demulcent for coughs. The pericarp contains an amorphous 
 alkaloid, which has doubtless some stimulant and narcotic power ; but the claims 
 
BALSAMUM PERUVIANUM — BALSAMUM TOLUTANUM. 211 
 
 advanced for it, as a specific remedy for the cure of the opium-habit, have been strenu- 
 ously denied by many competent observers. Dose of the concentrated tincture or fluid 
 extract may be stated at W\x-£ ij. 
 
 AZEDARACH (Unofficial),— is the bark of the root of Melia Azedarach, or Pride 
 of China, a handsome tree of the nat. ord. Meliacese, indigenous to China and India, but 
 naturalized in the Gulf States. A decoction of the fresh bark ( 5 ij to Oj boiled to 
 0]/ z \ may be used in tablespoonful doses. 
 
 This drug is known to produce symptoms of narcotic poisoning, as giddiness, dimness 
 of sight, mental confusion, stertorous breathing, dilated pupils and stupor. Large doses 
 are necessary to cause these effects, and some authorities question their occurrence. It 
 is, however, a gastro-intestinal irritant, producing vomiting and purging, and also an 
 anthelmintic against the round-worm. Its active principle has not been isolated. It is 
 only employed as an anthelmintic against lumbricoid worms, and as the fresh bark is dif- 
 ficult to obtain in any region where it does not grow, other agents are more generally 
 used. It is given to horses affected with "bots." 
 
 BALSAMUM PERUVIANUM, Balsam of Peru —is a bal- 
 sam obtained from Toluifera Pereircz, a Central American tree, of the 
 nat. ord. Leguminosae. It occurs as a thick, brown-black liquid, its odor 
 reminding of benzoin and vanilla, soluble in 5 of alcohol, almost insolu- 
 ble in water, which extracts from it only some Cinnamic Acid and Cin- 
 namein. It is not a true balsam, as it contains no volatile oil. Its com- 
 position is: Cinnamein (Benzyl Cinnamate, C 16 H u 2 ) 60 per cent., Cin- 
 namic Acid 6 per cent., Resins 30 per cent.; also Benzoic Acid and 
 other bodies. Dose ttlx-xxv, in emulsion. There are no official prepara- 
 tions. 
 
 The action of Balsam of Peru is that of its several constituents, namely, 
 antiseptic, disinfectant, stimulant to the circulation, and sedative to the 
 nervous system ; acting chiefly on the mucous membrane, it is tonic and 
 expectorant, diuretic and diaphoretic. In large doses, it causes gas- 
 tralgia, nausea and vomiting, colic and diarrhea. It closely resembles in 
 physiological action its congeners, Styrax and Benzoin. 
 
 Balsam of Peru is used locally in chronic skin diseases of inflammatory 
 type and sore nipples, to relieve itching, cleanse bed-sores, promote the 
 healing of wounds and ulcers, and to kill the acarus scabiei, being con- 
 sidered by some authorities the best of all applications in itch. Inter- 
 nally, it is used as a stimulant and disinfectant expectorant in chronic 
 bronchitis, asthma, etc., as well as in gonorrhea, gleet, leucorrhea, and 
 other discharges from mucous membranes. Incorporated with Iodoform 
 it partially covers the odor of that drug. 
 
 BALSAMUM TOLUTANUM, Balsam of Tolu,— is a balsam obtained from 
 Toluifera Balsamum, a tree of the nat. ord. Leguminosse, native in Venezuela and New 
 Granada. Its composition and properties are similar to those of Balsamum Peruvianum, 
 except that it is of lighter color, more agreeable odor, and contains a volatile oil, Tolene, 
 in the proportion of about I per cent. 
 
 Tinctura Tolutana, Tincture of Tolu, — contains 10 per cent, of the Balsam dis- 
 solved in alcohol. Dose, tt\x-xxx. 
 
212 BAPTISIA — BELLADONNA. 
 
 Syrupus Tolutanus, Syrup of Tolu, — has of the Balsam I per cent., with Sugar 85, 
 Alcohol 5, and Water to 100. It is much used in cough mixtures, and covers the taste 
 of Chloral Hydrate well. Dose, gj-ij. 
 
 Balsam of Tolu has similar action to that of Balsam of Peru, but being more agree- 
 able in flavor it is more used internally than the latter. It is chiefly employed as a 
 pleasant excipient in cough mixtures, and is a constituent of the Compound Tincture of 
 Benzoin. 
 
 BAPTISIA, Wild Indigo (Unofficial),— is the root bark of Bap- 
 tisia tinctoria, a plant of the nat. ord. Leguminosae, native in North 
 America, and contains an alkaloid and a resin, neither of which have been 
 examined critically. The so-called Baptisin is an impure resinoid, ob- 
 tained by precipitation from the alcoholic extract with water. 
 
 Unofficial Preparations. 
 Extractum Baptisiae, Extract of Baptisia, — Dose, gr. j-x. 
 Extractum Baptisiae Fluidum, Fluid Extract of Baptisia, — Dose, TT\jj-xx. 
 Tinctura Baptisiae, Tincture of Baptisia, — Dose, rt\v-xxx. 
 Baptisin, — the resinoid. Dose, gr. j-v. 
 
 Baptisia has a bitter and acrid taste ; in small doses it is laxative, in 
 large ones violently emeto-cathartic, and may excite severe gastrointesti- 
 nal inflammation. It is a decided stimulant of the liver, and increases 
 the secretions of the glandular appendages of the gastro-intestinal mucous 
 membrane. It has considerable power as an antiseptic. 
 
 Baptisia has been used locally in decoction or cataplasm to obstinate 
 and painful ulcers, in threatening or existing gangrene and gangrenous 
 sores. Internally, it is a useful remedy in amenorrhea, typhoid and 
 typhus fevers, variola, scarlatina, and epidemic dysentery. In the 
 common continued fever, or in the first stage of typhoid, it will be 
 found of great service in drop-doses of a fresh tincture, repeated every 
 hour. 
 
 BARII DIOXIDUM, Barium Dioxide, Barium Peroxide, Ba0 2 , — is the commer- 
 cial anhydrous Barium Dioxide, a heavy, grayish-white, amorphous powder, odorless 
 and tasteless : gradually decomposed by exposure to the air, from which it slowly takes 
 up moisture and carbon dioxide. Used to prepare the Aqua Hydrogenii Dioxidi. 
 
 Though almost insoluble in cold water, Barium Dioxide forms therewith a definite 
 hydrate, and imparts thereto an alkaline reaction. It is decomposed by most of the 
 mineral acids, producing the corresponding barium salts, and liberating Hydrogen 
 Dioxide, H 2 2 , which remains in the solution for a considerable length of time, if the 
 reaction has taken place in the cold, and if an excess of the acid is present. In this 
 way is prepared the official Aqua Hydrogenii Dioxidi (Solution of Hydrogen Peroxide), 
 for which see the title Oxygenium. 
 
 BELLADONNA, Deadly Nightshade.— The Atropa Belladonna 
 
 is an herbaceous, perennial plant, of the nat. ord. Solanaceae, having 
 
 dark-purple, bell-shaped flowers, and glossy, purplish-black berries about 
 
 the size of cherries. It is indigenous in the mountainous districts of 
 
 • Central and Southern Europe and Asia, and is cultivated in Europe and 
 
BELLADONNA. 21 3 
 
 in the United States. It contains two alkaloids, — the official Atropine 
 (see below), and Belladonnine, the latter being considered by many- 
 authorities as identical with Hyoscyamine, Daturine, and Duboisine. 
 They exist in the plant in combination with Malic Acid. The plant also 
 contains the usual vegetable constituents, as albumin, gums, etc., and a 
 coloring principle named Atrosin. The official titles are as follows : — 
 
 Belladonnae Folia, Belladonna Leaves, — ovate and tapering, brown- 
 ish-green above, grayish-green below, of slight odor and bitter, disagree- 
 able taste. Stramonium leaves are more wrinkled, Hyoscyamus leaves 
 are more hairy. Dose, gr. j, gradually increased. 
 
 Belladonnae Radix, Belladonna Root, — cylindrical, tapering, 
 wrinkled pieces, ^ to i inch thick, nearly odorless, taste bitter and 
 acrid. Dose, gr. j, cautiously increased. 
 
 Preparations of the Leaves. 
 
 Extractum Belladonnae Foliorum Alcoholicum, Alcoholic Extract of Belladonna 
 Leaves. — Dose, gr. y 1 ^ to \. 
 
 Tinctura Belladonnae Foliorum, Tincture of Belladonna Leaves, — 15 per cent. 
 Dose, try-xxx. 
 
 Emplastrum Belladonnae, Belladonna Plaster, — has of the above extract 20 per 
 cent., mixed with Resin and Soap Plasters, of each 40 per cent. It may produce the 
 physiological action of the drug. 
 
 Unguentum Belladonnae, Belladonna Ointment, — has of the above extract 10, 
 Diluted Alcohol 5, Benzoinated Lard 85. 
 
 Preparations of the Root. 
 
 Extractum Belladonnae Radicis Fluidum, Fluid Extract of Belladonna Root. — 
 Dose, try-v. 
 
 Linimentum Belladonnae, Belladonna Liniment, — has of Camphor 5, dissolved in 
 Fluid Extract of Belladonna Root to 100. 
 
 Atropine and its Derivatives. 
 
 Atropina, Atropine, C 17 H 23 N0 3 , — white, acicular crystals, odorless, of bitter taste 
 and alkaline reaction ; very soluble in alcohol and in chloroform, also in 130 of water at 
 59 F. Is decomposed by prolonged contact with caustic alkalies and is resolvable into 
 Tropin and Tropic Acid. 
 
 Atropinae Sulphas, Atropine Sulphate, (C 17 H 23 N0 3 ) 2 H 2 S0 4 , — a white powder of 
 bitter taste and neutral reaction, soluble in 0.4 of water and in 6.2 of alcohol at 59° F. 
 Dose, gr. jhnfa- 
 
 Homatropina, Botn atropine, C ]6 H 21 N0 3 ( Unofficial"), — is a derivative alkaloid, ob- 
 tained by the action of dilute HC1 on Amygdalate of Tropin. The Hydrobromate is 
 used by ophthalmologists as a mydriatic, its effects passing off much sooner than those of 
 Atropine. Homatropine slows the heart, Atropine quickening it. 
 
 Tropeius (Unofficial), — is a result of the action of a mineral acid on Tropin. 
 
 Physiological Action. 
 Belladonna is an irritant narcotic, a mydriatic, an antispasmodic and 
 an anodyne; in small doses a cardiac, respiratory and spinal stimulant; 
 in large doses a paralyzer of the cardiac and respiratory centres, the spinal 
 
214 BELLADONNA. 
 
 cord, the motor nerves and the involuntary muscles. It produces conges- 
 tion and dryness of the mucous membrane of the throat, mouth, nose, and 
 larynx, and at first lessens the gastric and intestinal secretions, but soon 
 reproduces these in large quantity. The heart rate is at first slowed, but 
 soon becomes very rapid and vigorous, the pulse being doubled in rapid- 
 ity; the arterial tension being at the same time raised, the circulation is 
 greatly increased. This is accomplished by stimulation of the cardiac 
 sympathetic, and paralysis of the pneumogastric, thus stimulating the 
 accelerator apparatus while lessening the inhibitory. [Digitalis increases 
 both.] The vasomotor ganglia are stimulated all over the body, but are 
 afterwards paralyzed by over-stimulation, the heart weakens, the vessels 
 relax, and the blood-pressure becomes greatly reduced. Complete motor- 
 paralysis follows, delirium, stupor, and finally death, which usually occurs 
 by asphyxia. 
 
 The pupils are dilated by either the local or systemic use of the drug, 
 which stimulates the end-organs of the sympathetic and paralyzes those of 
 the motor oculi, thus increasing the power of the radiating iris fibers and 
 lessening the action of its circular ones. Atropine applied locally also 
 paralyzes accommodation and increases the intraocular pressure. The 
 least quantity of atropine which will affect the pupil is stated at gr. 10 ^ o0 
 (Wood), gr. 2ircRr<r (Roosa), gr. ^^ (Ely), gr. 128 \ 00 (Trousseau), 
 g r - 46(H)oo (Lonng), gr. u < ? 000 (Donders). 
 
 The brain is congested by Belladonna, headache, vertigo, busy delirium, 
 and hallucinations being produced, the latter from a selective action on 
 the cells of the gray matter. The spinal cord is stimulated from the 3d 
 cervical vertebra to the 10th dorsal, resulting in complete motor paraly- 
 sis, central and peripheral, power being lost first in the lower extremities. 
 Sensation is also impaired somewhat, but the muscular irritability is not. 
 Respiration is increased and the body-temperature elevated. Metamor- 
 phosis is greatly promoted by the increased activity of the circulation. A 
 diffused eruption of scarlet color, closely resembling the eruption of scar- 
 let fever, is often produced on the skin and fauces by Belladonna, with 
 dysphagia and sore throat, and is sometimes followed by desquamation of 
 the epidermis. It is due to capillary congestion caused by the greatly 
 increased circulation. 
 
 Belladonna is rapidly diffused and quickly eliminated, particularly by 
 the kidneys. The urine of an animal under the action of the drug will 
 dilate the pupil of another animal. Herbivorous animals and birds are 
 scarcely susceptible to it, and pigeons are not affected by it at all. 
 
 Atropine has the same actions as those above described, being the active 
 principle of the plant. Belladonnine was long supposed to be inert, but 
 has recently been shown to be identical with Hyoscyamine. It is a myd- 
 riatic when given internally, but not when used locally. 
 
BELLADONNA. 215 
 
 Antagonists, Antidotes, and Incompatibles. 
 
 Opium is the physiological antagonist to the effects of Belladonna on the cerebrum, 
 pupil, heart, respiration, arterial tension and kidneys. Physostigmitie, Aconite, Pilocar- 
 pine and Quinine are each antagonistic to some of its effects, Muscarine, to most of them. 
 In poisoning by this drug, Tannic Acid and emetics should be used, then Morphine, 
 Physostigmine or Pilocarpine for the nervous disturbance. Caustic alkalies decompose 
 Atropine and are therefore incompatible with the preparations of Belladonna. 
 
 Therapeutics. 
 
 Belladonna is one of the most valuable drugs in the Materia Medica, 
 ranking with Aconite, Arsenic and Opium in efficacy and wide range of 
 use. It is especially efficient in the pain of inflammation, particularly 
 that of rheumatism, gout, neuralgia due to peripheral disturbance, sciatica, 
 cancer and pelvic affections. In cerebral and spinal hyperemia, conges- 
 tive headaches, encephalitis, meningitis and myelitis it proves one of the 
 very best remedies. In erysipelas of superficial and non-vesicular charac- 
 ter and when cerebral, it is really curative when locally and internally 
 administered. Inflammations of the lungs, iris, bladder, kidneys and 
 breasts are all amenable to it. In constipation from atony of the bowels 
 it is remarkably effective, and in the enuresis of children it is equally so 
 if used freely, 10 to 20 drops of the tincture thrice daily. In recent cys- 
 titis from chill, spasm of the urethra, bladder and sphincter ani, typhus 
 and typhoid fevers, acute nasal catarrh, sore throat with fever, inflamed 
 and swollen tonsils, in many skin diseases, in asthma and whooping- 
 cough, epileptic and puerperal convulsions, spermatorrhea and seminal 
 losses, Belladonna is often a highly useful agent. Its local application is 
 efficiently used in ulcers of the rectum, anal fissure, abscesses, boils, car- 
 buncles and other superficial inflammations. In scarlet fever it relieves 
 many of the symptoms, and is especially indicated in this disease when 
 the rash is imperfect, the pulse feeble and the condition one of adynamia. 
 Its prophylactic power against scarlet fever is believed in by many of our 
 best practitioners, though questioned by many others. 
 
 Atropine is used in poisoning by Opium, Physostigma, and Hydrocy- 
 anic Acid; in ptyalism from mercury, pregnancy, etc.; in the sweats of 
 phthisis, in sudden cardiac failure, and by eye-surgeons to paralyze 
 accommodation, dilate the pupil, contract the vessels, lessen pain, and 
 diminish (?) intra-ocular tension. In opium-poisoning it should be given 
 in very small doses, and repeated for effect, as most of the unsuccessful 
 cases of its use in this connection were due to overdosing with the antag- 
 onist, superinducing belladonna-narcosis upon the opium-narcosis. In 
 cases of heart-failure from Chloroform or Ether inhalation, the hypoder- 
 mic injection of Atropine has, in the writer's hands, saved several lives 
 when all other methods of resuscitation had failed. It is highly efficient 
 in lead poisoning, if used in combination with Potassium Iodide; and 
 
2l6 BENZINUM BENZOINUM. 
 
 has given the most satisfactory results as a hemostatic in profuse metror- 
 rhagia after abortion, in metrorrhagia of obscure origin, and in phthisical 
 hemoptysis. 
 
 BENZINUM, Benzin [Petroleum Ether), — is a purified distillate from American 
 petroleum, and consists of a mixture of hydrocarbons, chiefly of the marsh-gas series 
 (C 5 H 12 .C 6 H U , and homologous compounds). It is a transparent, colorless liquid, very 
 diffusive, highly inflammable, insoluble in water, soluble in alcohol, ether, chloroform, 
 benzol and fixed and volatile oils. Its sp. gr. is 0.670 to 0.675, ano ^ its boiling point 
 122° to 140 F. It should be carefully kept in well -stoppered bottles or tin cans, in a 
 cool place, remote from lights or fire. Dose, gtt. v-x, on sugar or in mucilage. 
 
 Benzin taken internally in overdose is known to produce gastro-enteritis, and such a 
 case is reported which terminated fatally. In the ordinary medicinal doses it does not 
 produce either vomiting or diarrhea. Benzin-poisoning may be produced by its inhala- 
 tion, which is becoming quite a practice among glove-cleaners, and alcoholics have been 
 known to take to inhaling benzin in place of drinking spirits. It has been used with 
 some success externally as a remedy for rheumatic pain, neuralgia, itch, and prurigo ; 
 and internally as a vermicide against tapeworm. In pharmacy it has many uses on 
 account of its power as a solvent for oils, fats, resins, caoutchouc and some alkaloids. 
 In the household it is used as a solvent application for removing grease from clothing. 
 
 BENZOINUM, Benzoin, — is a balsamic resin obtained from 
 Styrax Benzoin, a tree of the nat. ord. Styracese, native in Sumatra and 
 Siam, by incision of its bark. It occurs in agglutinated tears or a brown, 
 mottled mass, is soluble in alcohol and solution of potassa, and is com- 
 posed of Resins 80 per cent., Benzoic Acid 10 to 20 per cent., and a 
 trace of Volatile Oil. Some varieties yield also Cinnamic Acid. 
 
 Adeps Benzoinatus, Benzoinated Lard, — is prepared by suspending the powdered 
 Benzoin, tied up in coarse muslin, in melted Lard, in the proportion of 2 parts to 100, 
 for 2 hours, then removing the residual benzoin, and occasionally stirring the lard as it 
 cools. When intended for use in warm weather 5 per cent, or more of the lard should 
 be replaced by White Wax. 
 
 Tinctura Benzoini, Tincture of Benzoin, — has of Benzoin 20 parts, Alcohol 100. 
 Dose, 3 ss-j. 
 
 Tinctura Benzoini Composita, Compound Tincture of Benzoin {Friar" 1 s Balsam), — 
 has of Benzoin 12, Aloes 2, Styrax 8, Balsam of Tolu 4, Alcohol to 100. Dose, ^ss-ij. 
 
 Benzoic Acids and Salts. 
 
 Acidum Benzoicum, Benzoic Acid, HC 7 H 5 2 , — occurs in light, feathery plates and 
 needles, and is obtained from Benzoin by sublimation, or prepared artificially, chiefly 
 from Toluol. It is soluble in 500 of water, and in 2 of alcohol at 59 F., but its solu- 
 bility in water is aided by Borax, one part of each being soluble in 100 parts. It is a 
 constituent of Tinctura Opii Camphorata. Dose, gr. x-xxv, in wafers. 
 
 Ammonii Benzoas, Ammonizwi Benzoate, — is soluble in 5 parts of water and in 28 
 of alcohol. Dose, gr. v-xxx. 
 
 Lithii Benzoas, Lithium Benzoate, — soluble in 4 parts of water and in 12 of alcohol. 
 Dose, gr. v-xxx. 
 
 Sodii Benzoas, Sodium Benzoate, — is efflorescent on exposure to air, soluble in about 
 2 parts of water and in 45 of alcohol. Dose, gr. v-^j. 
 
 Physiological Action and Therapeutics. 
 Benzoin is decidedly antiseptic and disinfectant, and when used exter- 
 nally is slightly stimulant to the vessels. Its action is due to its Ben- 
 
BENZOLUM. 217 
 
 zoic Acid, which taken internally produces slight epigastric heat, increases 
 the pulse-rate, and stimulates the action of the skin, the salivary glands, 
 and the bronchial mucous membrane. It is principally excreted by the 
 kidneys, in part as hippuric acid by combination with glycocoll, and in 
 part unchanged. It renders the urine acid and increases its quantity. 
 It is irritant to the fauces, and the powder when inhaled excites sneez- 
 ing and coughing. 
 
 Benzoin is principally used as a stimulant expectorant, especially in the 
 chronic bronchitis of the aged, and by atomization in laryngeal affec- 
 tions. The compound tincture, 3J to % in a pint of boiling water, is a 
 useful sedative inhalation for the irritation and cough of subacute laryn- 
 gitis and tracheitis. It has also been used beneficially in chlorosis and 
 some uterine disorders. The compound tincture is a good local applica- 
 tion (1 part to 4 of glycerin and water) for sore nipples and chaps of the 
 hands and lips. For use as a cosmetic, either tincture is mixed with 20 
 parts of water, and employed to remove freckles and for other skin affec- 
 tions, especially urticaria. The tinctures are excellent applications to 
 foul-smelling wounds, and form the basis of all the proprietary pre- 
 parations sold for that purpose. 
 
 Benzoic Acid and its salts are the only certain means we possess, by 
 which to neutralize morbid alkalinity of the urine. In cystitis, with 
 phosphatic deposits and alkaline urine, they are extremely valuable, acid- 
 ulating the secretion, and stimulating and disinfecting the mucous sur- 
 faces involved. Phosphatic calculi are said to be dissolved by the long- 
 continued use of Ammonium Benzoate. 
 
 Sodium Benzoate has been largely used as a substitute for the salicy- 
 lates in the septic diseases, being equally antiseptic and antipyretic. 
 Though slower in action, its effects are more permanent, and it is capable 
 of being used in larger doses (5ij-iij daily). In diphtheria and scarlet 
 fever it has been highly efficient, and in acute rheumatism, typhoid and 
 the malarial fevers it has rendered good service. In phthisis, its use by 
 inhalation to the extent of 1Q 1 00 of the body-weight daily has seemed to 
 be of value. It has also proved very efficient in whooping-cough. 
 
 Lithium Benzoate is intended for use in gout and the uric acid 
 diathesis, with the object of forming the very soluble urate of lithium in 
 the system, as also on the theory that, as benzoic acid is converted into 
 hippuric acid at the expense of nitrogenous material which would other- 
 wise become uric acid, the latter product will be lessened. 
 
 BENZOLUM, Benzol, Benzene, Phenyl Hydride, C 6 H 6 (Unofficial),— is a con- 
 stituent of coal-gas tar, obtained by distilling coal naphtha. It is a thin, colorless, 
 oleaginous liquid, very inflammable, of agreeable odor, and sp. gr. 0.850. It is very 
 diffusible, and the vapor, when inhaled, acts as an anesthetic. Dose, gtt. v-x, on sugar, 
 in emulsion or capsules, up to ^jss daily. 
 
 Benzol is a reliable pulmonary antiseptic, and has been used successfully in the treat- 
 
215 BERBER1S BERGAMOTTjE OLEUM BISMUTHUM. 
 
 ment of whooping-cough, the vapor being diffused throughout the room, and proximity 
 to a light or fire being carefully avoided. It has made quite a reputation in the treatment 
 of influenza, and has been found effectual in destroying both head and body lice, for 
 which purpose a single application is usually sufficient. It has also been given internally 
 for the destruction of trichinae, followed by a brisk laxative ; and, mixed with lard, it 
 is used externally in parasitic skin diseases, especially scabies, also in rheumatism and 
 neuralgia. 
 
 BERBERIS, Barberry (Unofficial), — is the root of several species of the nat. ord. 
 Berberidacese, the one generally used being the Berbei'is aquifolium, or Oregon grape, 
 which grows on the Pacific slope of the United States. Its value is probably due to its 
 alkaloid, Berberine, C 20 H 17 NO 4 , a yellow, crystalline body, soluble in hot water and 
 alcohol, but not in ether, which is found also in several other plants, as Hydrastis, Coptis, 
 Podophyllum, Menispermum, Calumba, Xanthoxylum, etc. 
 
 Extractum Berberidis Fluidum, Fl. Extr. of B. (Unofficial), — Dose, Tt\v-xxx. 
 
 Tinctura Berberidis, Tincture of Berberis (Unofficial), — I to 5. Dose, n^x-^j. 
 
 Berberina, Berberine (Unofficial), — Dose, gr. j-x. It usually occurs in commerce 
 as Hydrastin, which is a Berberine Hydrochlorate prepared from Hydrastis. 
 
 Berberis is an astringent bitter, a tonic and stomachic in small doses, but in large 
 doses it is cathartic, producing watery diarrhea with abdominal pain. It is also believed 
 to possess considerable alterative powers. It has been successfully used as a local appli- 
 cation in conjunctivitis, and internally as a remedy for intermittent, remittent and typhoid 
 fevers, diarrhea and dyspepsia. As an alterative and tonic it is useful in syphilitic and 
 strumous affections, and in pain, soreness and burning sensations along the biliary or 
 urinary tracts with a tendency to gravel or gall-stones it will be found a useful remedy. 
 
 Berberine has some antiseptic and antiperiodic value, but in large doses is a gastro- 
 intestinal irritant. The Hydrochlorate is a useful injection in gonorrhea, in which it acts 
 by virtue of its antiseptic and astringent powers. 
 
 BERGAMOTT.E OLEUM, Oil of Bergamot,— is a volatile oil extracted from 
 the rind of the fresh fruit of Citrus Bergamia, an orange-tree of the nat. ord. Aurantia- 
 cese, native in Southern Europe. It is of greenish color, faintly acid, and is soluble in 
 alcohol, glacial acetic acid and liquor potassae. It contains several hydrocarbons of the 
 formula C 10 H ]6 , together with Be?-gaptene or Bergamot Camphor. It is an ingredient of 
 Spiritus Odoratus, and is exclusively used as a perfume in the manufacture of toilet 
 articles. 
 
 BISMUTHUM, Bismuth, Bi.— This metal is represented in med- 
 icine by four official salts and several unofficial ones, the most impor- 
 tant of which are the following: — 
 
 Official Salts of Bismuth. 
 
 Bismuthi Citras, Bismuth Citrate, BiC 6 H 5 7 , — a white, amorphous powder, odor- 
 less and tasteless, insoluble in water or alcohol, soluble in Water of Ammonia. Used 
 only for pharmaceutical purposes. 
 
 Bismuthi et Ammonii Citras, Bismuth and Ammonium Citrate, — is a combination 
 of the citrate with aqua ammonia?, and has no definite chemical composition. Small, 
 pearly scales, very soluble in water, sparingly in alcohol. Dose, gr. j-v. 
 
 Bismuthi Subcarbonas, Bismuth Subcarbonate, — a white or yellowish-white pow- 
 der, of somewhat varying chemical composition, tasteless and odorless, insoluble in water 
 or alcohol. Dose, gr. v-xxx, in powder or emulsion. 
 
 Bismuthi Subnitras, Bismuth Subnitrate, — a heavy, white powder, of somewhat 
 varying chemical composition, odorless and almost tasteless, of slightly acid reaction ; 
 insoluble in alcohol, almost insoluble in water. Dose, gr. v-xxx, several times a day, in 
 powder, pill, or milk ; often combined with opium, morphine or belladonna. 
 
 Unofficial Bismuth Preparations. 
 Bismuthi Salicylas, Bismuth Salicylate, — exists in two forms, the acid salt and the 
 basic salt, the latter being the one used therapeutically. It contains 76 per cent, of the 
 
BISMUTHUM. 219 
 
 oxide of bismuth, and 23 per cent, of salicylic acid; and occurs as a white, crystalline 
 salt, almost entirely insoluble in water, alcohol or glycerin. It should give no reaction 
 with perchloride of iron. Dose, gr. v-xx. 
 
 Bismuthi Subiodidum (Oxyiodidum), Bismuth Subiodide, — a brick-red, heavy, 
 amorphous powder, insoluble in water, insoluble in any reagent without decomposition. 
 Used locally as an antiseptic dusting powder, and internally in doses of gr. jss-iij. 
 
 Bismuthi Subgallas, Bismuth Subgallate (De?-matot), — a fine odorless, saffron- 
 yellow powder, insoluble in all ordinary solvents. Dose, gr. v-xxx. 
 
 Bismuthi Oleas, Bismuth Oteate, — a pearly-gray, soft, bland substance. [See under 
 Acidum Oleicum, ante, p. 103.] 
 
 Airol, Bismuth Oxy-iodo-gallate, — is a patented combination of Bismuth Subgallate 
 and Iodine, occurring as a bulky, gray powder, odorless and tasteless, insoluble in water 
 or alcohol. It is used as a dusting powder for ulcers and wounds, or mixed with Vaselin 
 or Lanolin as an ointment. 
 
 Eudoxin, Bismuth Tetra-iodo-phenol-phtalein, — is a bismuth salt of Nosophen and 
 contains about 53 per cent, of Iodine and 14 per cent, of Bismuth. It occurs as a red- 
 dish-brown, odorless and tasteless powder, insoluble in water. It is said to be an effi- 
 cient internal antiseptic for gastric and intestinal affections. Dose, for children, gr. j-iij ; 
 for adults, gr. iij-viij. 
 
 Iodomuth, — is a proprietary bismuth preparation, said to contain 25 per cent, of 
 Iodine, and occurs as a reddish-brown, impalpable powder, both odorless and tasteless. 
 It is used locally as an alterative and stimulating antiseptic for ulcers, sores and wounds, 
 also internally for gastro-enteritis, dysentery and cholera infantum. Dose, gr. j-x. 
 
 Orphol, Bismuth Beta-naphtolate, — contains from 50 to 70 per cent, of Bi 2 3 also 
 Beta-naphtol, and is a reddish-brown powder, insoluble in water, and recommended as an 
 intestinal antiseptic and astringent. Dose, gr. v-xx, up to a daily quantity of gr. xv for 
 children and gr. xlv for adults, given with honey or milk. 
 
 Xeroform, Bismuth Tri-brom-phenol, — is a patented preparation which contains 
 about 50 per cent, of Bi 2 3 and occurs as a yellow, insoluble powder, having a faint 
 odor of carbolic acid. It is almost non-toxic and unirritating to mucous surfaces. It is 
 an excellent surgical and intestinal antiseptic, and has been used locally with benefit in 
 chancroids, buboes, foul ulcers, infected wounds, burns, eczema and other skin diseases. 
 It has been given internally with satisfactory results in cholera, intestinal catarrh and the 
 summer diarrhea of children, also for chronic urticaria and certain forms of infantile 
 eczema. Dose, gr. vij-xv, three times a day. 
 
 Physiological Action and Therapeutics. 
 The action of the insoluble Bismuth salts is chiefly a local one, they 
 being sedative to the end-organs of the nerves, though a minute quantity 
 passes into the blood and acts as a tonic, promoting constructive meta- 
 morphosis by increasing the appetite and digestion. They are also feebly 
 astringent, and produce constipation after a time, coloring the stools and 
 tongue a dark clay color, from their conversion in part into the sulphide. 
 Toxic effects when occurring are ascribed to Arsenic, with which the 
 commercial preparations were formerly contaminated. Lately, however, 
 it has been shown that Bismuth salts possess toxic powers of their own, 
 and that the symptoms of bismuth-poisoning may develop when these 
 preparations are applied as dressings to a large, denuded surface, or 
 taken internally in large doses for a long period of time. A black line 
 along the margins of the gums, headache, nausea, vomiting, pale face, 
 elevated temperature, rapid pulse, edema of the lower extremities, 
 diarrhea, and an odor of urine on the breath are some of the symptoms 
 
220 BISMUTHUM. 
 
 observed in such cases. Black and gangrenous sloughs may occur in the 
 intestines, and the urine may contain albumin. 
 
 The insoluble Bismuth salts are used internally in many forms of dis- 
 ordered digestion, gastralgia, vomiting and diarrhea, especially in chil- 
 dren, but large doses are necessary for efficiency. The best vehicle for 
 them is milk. Locally they are used with advantage in acne rosacea, 
 stomatitis, nursing sore mouth, eczema, intertrigo, ulcers, conjunctivitis, 
 coryza, gonorrhea, gleet and leucorrhea. The Subnitrate is regarded by 
 many practitioners as almost a specific in cholera infantum, given in 
 hourly doses of 3 to 6 grains: also in the diarrhea of phthisis, in dysen- 
 tery and intestinal ulceration, it is highly efficient, in doses of 15 grains 
 every hour or two. Externally, it is employed as a dusting powder, 
 either pure or mixed with starch (1 to 5) ; as a drying application for the 
 nasal, pharyngeal and laryngeal mucous membranes; in suspension as an 
 injection in gonorrhea (4 to 10 per cent.); and with vaselin (10 to 15 
 per cent.) as an ointment in eczema, also for burns and wounds. 
 
 The Bismuth and Ammonium Citrate being soluble, is more rapid in 
 action, but also more astringent and irritant than the other salts, though 
 it is probably precipitated in the stomach by the hydrochloric acid of the 
 gastric juice. It is serviceable in diarrhea without irritation of the intes- 
 tinal mucous membrane, but rather with relaxation thereof. The Sali- 
 cylate (basic salt) when pure is well borne by the stomach, and can be 
 used for longer periods than the subnitrate. It has been especially 
 serviceable in the diarrhea of phthisis, in that of typhoid fever, and in 
 chronic gastric and intestinal disorders also as an internal antiseptic in 
 dilatation of the stomach. 
 
 The Subgallate, also known as Dermatol, is one of the many proprietary 
 substitutes for Iodoform, and has been patented in this country. It has 
 great stability, as well as valuable drying and bactericidal qualities, and 
 is an excellent vulnerary for wounds and burns. It has proven useful in 
 the treatment of moist eczema, ulcers, and other affections of the eye, 
 diseases of the middle ear and dental caries. It occasionally produces 
 dermatitis, and Dr. Cantrell holds that it is decidedly irritating, is a 
 stimulant rather than an astringent, does not check but rather increases 
 discharge, and does not fulfil the claims made for it. Efforts are made 
 to show value for it as an internal remedy in fermentative dyspepsia and 
 gastric catarrh. It is efficiently employed internally for diarrhea in doses 
 of 20 or 30 grains every two or three hours. 
 
 The Oleate is credited with mildly astringent and emollient properties, 
 having been used with benefit in pustular affections of the skin and in 
 acne. The Subiodide is an exceedingly valuable agent in the treatment 
 of burns, wounds, ulcers, and similar affections as a substitute for Iodo- 
 form. (See under Iodum.) 
 
BOLDUS BROMUM. 221 
 
 BOLDUS, Boldo (Unofficial), — the leaves and stems of Peumus Boldus, an ever- 
 green shrub of the nat. ord. Monimiaceae, found in Chili. It contains a volatile oil and 
 a bitter alkaloid, Boldine. A tincture is made (i to 5), of which the dose is TT\v-viij, 
 gradually increased, but large doses have a somewhat narcotic effect, besides causing 
 vomiting and purging. 
 
 Boldo is used in anemia, rheumatism, dyspepsia'and general debility, also in catarrhal 
 affections of the urinary passages, and as a substitute for Quinine. In France it is em- 
 ployed as a tonic, especially for cases with chronic torpor of the liver; and in South 
 America it is much used in gonorrhea and in chronic cystitis. 
 
 BROMUM, Bromine, Br, — is a dark, brownish-red, volatile liquid, 
 evolving an irritant vapor of peculiar and suffocating odor. It is soluble 
 in 30 of water at 59 F., very soluble in alcohol, ether, chloroform and 
 carbon disulphide ; is a non-metallic element found in sea-water and in 
 the mother-liquid of certain salt-works, usually in combination. On ex- 
 posure to air or heat it is completely volatilized. It destroys the color 
 of solutions of litmus and indigo, and imparts a yellow color to solution 
 of starch. It is used only by inhalation and locally as an escharotic. 
 
 Bromides and their Preparations. 
 
 Potassii Bromidum, Potassium Bromide, KBr, — colorless, cubical crystals, soluble 
 in 1.6 of water and in 200 of alcohol. Dose, gr. ij-gj, well diluted. 
 
 Sodii Bromidum, Sodium Bromide, NaBr, — colorless, monoclinic crystals, soluble 
 in 1.2 of water and in 13 of alcohol. Dose, gr. ij-gj, well diluted. 
 
 Lithii Bromidum, Lithium Bromide, LiBr, — a white, granular, deliquescent salt, 
 very soluble in water and in alcohol. Dose, gr. ij-xx, well diluted. 
 
 Ammonii Bromidum, Ammonium Bromide, NH 4 Br, — colorless, prismatic crystals, 
 soluble in 1.5 of water and in 30 of alcohol. Dose, gr. ij-xx, well diluted. This Bromide 
 is well borne by children in comparatively large doses if epileptic from reflex causes. A 
 child one year old can tolerate gr. v every 4 hours (Barton). 
 
 Calcii Bromidum, Calcium Bromide, CaBr 2 , — a white, granular, deliquescent salt, 
 very soluble in water and in alcohol. Dose, gr. ij-gj, well diluted. 
 
 Strontii Bromidum, Strontium Bromide, SrBr 2 (H 2 0) 6 , — colorless, hexagonal crys- 
 tals, very deliquescent, very soluble in water and in alcohol ; insoluble in ether. Dose, 
 gr. ij-xxx, well diluted. 
 
 Zinci Bromidum, Zinc Bromide, ZnBr 2 , — a white, granular, deliquescent powder, 
 very soluble in water and in alcohol. Dose, gr. ^-ij, well diluted. 
 
 Syrupus Ferri Bromidi, Syrup of Iron Bromide (Unofficial), — is a syrupy liquid 
 containing 10 per cent, of Ferrous Bromine, FeBr 2 , prepared by acting on Iron Wire 35 
 parts with Bromine 75, adding Sugar 600 and Water up to 1000 parts. A translucent, 
 pale-green, odorless liquid of sweet, ferruginous taste and neutral reaction. Dose, g ss-j. 
 
 Bromoformum, Bromoform, Tri-bromo-methane, CHBr 3 , (Unofficial), — is prepared 
 by the action of sodium hypobromite on acetone, or by the action of bromine upon a 
 solution of equal parts of caustic potash and methyl alcohol. A clear and colorless 
 liquid, of pleasant odor and sweet, agreeable taste ; slightly soluble in water, readily 
 soluble in alcohol and glycerin. Dose, TT\v-xx. If it has color it should be rejected 
 as unsafe by reason of decomposition. 
 
 Acidum Hydrobromicurn Dilutum, Diluted Hydrobromic Acid, — is composed of 
 10 per cent, of absolute Hydrobromic Acid (HBr), and 90 per cent, of water. It is a 
 clear, colorless, and odorless liquid, of a pungent acid taste, produced by decomposing 
 Potassium Bromide by Sulphuric Acid and distilling. Dose, n\xx-3ij. 
 
 Arsenic Bromide is described on page 199, Aurum Bromide on page 206, Ethyl 
 Bromide on pages 113 and 116, and Camphora Monobromata under Camphora. 
 
222 BROMUM. 
 
 Physiological Action. 
 
 Bromine is an active and very painful escharotic, a deodorant and an 
 antiseptic, setting free ozone. Its vapor is highly irritant to the respira- 
 tory mucous membrane and the eyes, producing cough, hoarseness and 
 dyspnea. Internally, it is an active, corrosive poison, causing violent 
 gastritis, depression and collapse. 
 
 The Bromides are powerful depressants of the cerebral and spinal func- 
 tions, also alterative, antispasmodic and hypnotic. The Potassium salt 
 is a cardiac and muscular paralyzant. Bromides have a saline taste 
 and are very diffusible, but slowly eliminated. They are decomposed 
 in the blood, and re-formed at the points of elimination (fauces, bronchi, 
 intestines, skin and kidneys), where they irritate the mucous mem- 
 branes. Continued for some time, they produce severe gastric catarrh. 
 They reduce the number of the respirations, and the heart's action 
 and force; and though diminishing the calibre of the arterioles, they 
 lower arterial tension. They lessen the activity of the brain cells, pro- 
 ducing somnolence ; and diminish the sensibility of the peripheral nerves, 
 causing anesthesia of the skin and mucous membranes. They impair 
 motility and the sexual function, cause great pallor and emaciation, low- 
 ered body-temperature, acne on the face and upper extremities, fetid 
 breath, dysphagia, sluggish reflexes and defective coordination ; and if 
 long continued may even impair the mental faculties, producing halluci- 
 nations in some cases, in others melancholia with suicidal tendency ; also 
 incompetence of the sphincters and paralysis, beginning at the periphery 
 and extending to the centres. They sometimes cause maniacal excitement, 
 as in the case of a physician who committed suicide in a frenzy caused by 
 bromidizing himself for sea-sickness. 
 
 The general result of their action is termed Bromism, and is heralded 
 by the acne and lowered faucial sensibility. It is probably due to the 
 sedative influence of these agents on the sympathetic system, causing 
 general anemia of the brain, spinal cord, sexual organs, and skin. It is 
 believed that a previous prolonged use of opium or morphine renders the 
 organism extremely susceptible to the action of the bromides. 
 
 Dr. Hammond mentions several cases of fatal bromide-poisoning in one of the last 
 chapters of his treatise on Nervous Diseases, and several cases of poisoning by Potassium 
 Bromide have been published by Dr. Greenless. The first was that of an epileptic who 
 took 75 grains a day for three weeks, when stupor, coma, and extreme prostration and 
 death followed. The post mortem showed intense congestion of the meninges. In an- 
 other case, an epileptic, the same amount of potassium bromide, 75 grains a day, was 
 given, and in ten days coma and death followed. Both the brain and meninges were 
 congested and the kidneys were in the advanced stage of cirrhosis. The other cases were 
 less prominent and clearly resulted from bromism due to long use of the drug. In some 
 cases of inebriety large doses of bromides produce stupor and prostration, from which re- 
 covery is slow, and is followed by continued prostration. 
 
 The action of Hydrobromic Acid on the nervous system and circulation is identical 
 
BROMUM. 223 
 
 with that of the Bromides. Added to a mixture of quinine and water (rr^ij to each grain 
 of quinine) it will produce a clear solution. 
 
 Differences in Action betrueen the ordinary Bromides. 
 
 Potassium Bromide is the most toxic to the heart and the muscular system, and is the 
 least hypnotic. It contains 66 per cent, of Bromine. 
 
 Sodium Bromide is the least toxic, but the most hypnotic, and acts more energetically 
 on the circulation. It contains 78 per cent, of Bromine. 
 
 Ammonium Bromide resembles the Potassium salt in action, except that it exerts less 
 influence on the heart and on the muscular system, and is somewhat more stimulating. 
 
 Lithium Bromide contains the most Bromine, 92 per cent., and resembles the sodium 
 salt in action. It has proved better than the others in some cases of epilepsy, and is by 
 several authorities considered the best hypnotic of the series. 
 
 Calcium Bromide is an efficient hypnotic, but otherwise much less active than the 
 other bromides. 
 
 Strontium Bromide is said to be less apt than the other bromides to produce the 
 bromic acne and the other results of bromism. 
 
 Zinc Bromide, in large doses, is violently irritant. It is supposed to combine the 
 tonic effects of zinc with the sedative action of the bromides. 
 
 Ferrous Bromide is not official. It is supposed to combine the actions of iron and 
 the bromides, and to produce the effects of a sedative chalybeate tonic. It is not an 
 eligible chalybeate. 
 
 Antagonists and Incompatibles. 
 
 Vaso-motor stimulants, as Digitalis. Ergot, Belladonna, antagonize many of the effects 
 of the Bromides, but Morphine is the most efficient antagonist, especially for the mental 
 symptoms. Nitrous Ether is incompatible with the Bromide of Ammonium, and Acids 
 and metallic salts are so with all the Bromides. 
 
 Therapeutics. 
 The Bromides are used as sedatives to the nervous system, to lower 
 reflex activity, to produce sleep, to subdue excitement of the genital appa- 
 ratus, and to antagonize congestion of the brain. Their use in epilepsy- 
 is that of a specific, but therein they are terribly abused, by patients, 
 nurses, and even by physicians. They should not be used in anemic 
 conditions, and never for any length of time without the daily supervision 
 of a physician. If Opium be administered in ascending doses for four- 
 to six weeks before commencing a course of treatment by bromides, the 
 latter will be much more effective in smaller doses than otherwise. The 
 mixture of Potassium Bromide and Chloral is very unsafe in cases where 
 fatty or weak heart exists, both drugs being active cardiac depressants. 
 In convulsive and spasmodic affections, the bromides are very efficient, 
 and in epilepsy, especially when the seizures are diurnal, the sodium salt 
 is used with great advantage over a long period, in sufficient quantity to 
 maintain anesthesia of the fauces. It requires occasional purgation to 
 prevent its accumulation, and arsenic to combat the acne. In diabetes 
 of nervous origin, the ammonium salt, long used, has proved curative by 
 its sedative influence on the medulla ; and in acute rheumatism it is an 
 excellent alkali. In muscular rheumatism, rheumatic arthritis and myal- 
 gia, also in the uric acid diathesis and various affections due to undevel- 
 oped gout, the lithium salt gives good results. In tetanus and strychnine- 
 
224 BROMOFORM. 
 
 poisoning the potassium salt, in large doses, is antagonistic. These 
 agents are generally efficient in nervous erethism, insomnia with conges- 
 tion, infantile colic, cholera infantum, vomiting of cerebral origin, car- 
 diac irritability when not due to anemia, in delirium tremens, melancho- 
 lia, whooping-cough and other reflex coughs, seminal losses when plethora 
 exists, and nymphomania. The potassium salt is, by some writers, con- 
 sidered almost specific in subinvolution of the womb, also in uterine 
 hemorrhage not due to a mechanical cause. 
 
 Strontium Bromide has been favorably known for some time for its 
 beneficial action in gastric affections, particularly in dyspepsia, acetic and 
 lactic fermentation, flatulence from decomposition and vomiting of various 
 origin, including the vomiting of pregnancy. In severe cases of the 
 latter affection it proved entirely successful, administered in doses of gr. 
 xv with meals, twice daily for a month. In epilepsy it has been employed 
 with advantage, in doses ofgr. xx thrice daily, gradually increased: and 
 it has been used in the treatment of nervous and sick headaches, sea- 
 sickness, insomnia and other conditions for which the bromides are con- 
 sidered suitable. It is said to be less productive of the bromic acne than 
 any other bromides in general use. 
 
 The Syrup of Iron Bromide has been reported by some observers as 
 very efficient in chorea, and its usefulness therein is as strenuously denied 
 by others. 
 
 In hysteria, congestive headaches, neuralgia, and nervous exhaustion, Hydrobromic 
 Acid has been found useful. Used as a solvent of Quinine it retards Cinchonism, and 
 prevents the headache resulting from the full action of Quinine and Iron. As a substi- 
 tute for the Bromides of Sodium and Potassium it is highly recommended, being much 
 less depressant. It has been especially recommended in tinnitus aurium. Fothergill 
 used it for coughs of a reflex or spasmodic nature, also for simple continued fever where 
 there is cerebral disturbance. 
 
 Bromine is not much used. Its vapor may be inhaled from hot water 
 in acute coryza, hay-asthma, etc., and for chancre and hospital gangrene 
 and is the best escharotic. In diphtheria and membranous croup, a solu- 
 tion of TThviij to the B> used internally, and inhalation of the vapor, have 
 been used successfully in the most severe cases. 
 
 Bromoform is an analogue of Chloroform, and was discovered in 1832 by Lowig. 
 Inhaled, it produces anesthesia on animals, but of shorter duration than that of ether or 
 chloroform. Deep narcosis has been produced in children by overdoses taken inter- 
 nally ; the little patients having been tempted, by the pleasant taste of the medicine, to 
 the surreptitious ingestion of more than was prescribed. It has proven of special efficacy 
 in whooping-cough, administered in daily doses of 5 to 20 minims in glycerin and 
 alcoholic solution. It aborts the paroxysms of coughing and reduces their number some- 
 what, but has little influence otherwise on the regular course of the affection. Increasing 
 doses must not be pushed very far for fear of toxic symptoms, and the drug must be 
 absolutely colorless if pure. Inhalations of Bromoform have been used with some suc- 
 cess in the treatment of diphtheria , and it has been employed locally with benefit, as a 
 deodorizer, disinfectant and analgesic, in ozena and in tuberculous and other ulcers of the 
 larynx. 
 
BRYONIA. 225 
 
 BRYONIA, Bryonia, Bryony, — is the root of Bryonia alba and of 
 Bryonia dioica, European perennial plants of the nat. ord. Cucurbitaceae. 
 Its taste is acrid and bitter, but it is inodorous. The active principle is 
 the glucoside Bryonin, C^H^O^, which is intensely bitter, and soluble 
 in water and in alcohol, but insoluble in ether. Dose, of the powdered 
 root, gr. x-xxx. 
 
 Preparations. 
 
 Tinctura Bryonia?, Tincture of Bryonia, — a 10 per cent, solution of the root in 
 alcohol. Dose, rr^v- 5 ss. 
 
 Bryonin (Unofficial), — is a violent poison in doses of from 3 to 4 grains. Dose, as a 
 drastic purgative, gr. yt>-yi> 
 
 Physiological Action and Therapeutics. 
 
 Bryonia is a pure irritant, setting up local inflammation wherever applied, 
 with febrile phenomena. It has a vesicant action on the skin, and is 
 violently irritant to the serous and mucous membranes. Taken internally, 
 it has caused fatal gastritis \ introduced into the pleura, fatal pleuritis has 
 resulted with fibrinous effusion. It has a specific determination to serous 
 and synovial membranes, especially the pleurae, and is also irritant to 
 muscular fibre and to the bronchial mucous membrane, causing dry, con- 
 tinuous, shaking cough, with soreness behind the sternum. It produces 
 cerebral congestion, with frontal headache, vertigo and epistaxis; also 
 hepatic and renal congestion, burning pain and tenderness in the hepatic 
 region with bilious disturbance amounting sometimes to severe jaundice, 
 vesical tenesmus, and depression of the action of the heart. It is a drastic 
 purgative and a powerful diuretic. 
 
 Bryonia is a very old medicine, its most ancient reputation having 
 been in epilepsy, hysteria and mania, conditions in which it is now 
 superseded by other agents. It is a most valuable drug in the second 
 stage of serous inflammations, after Aconite has reduced the pyrexia, 
 especially in pleurisy, pleuro-pneumonia and pericarditis, to limit the 
 extent of the effusion and to promote its absorption. For this purpose 
 small doses frequently repeated are required. Also, in rheumatic fever, 
 after the swelling of the joints has been reduced by other means, Bryonia 
 is extremely efficient for the pain and stiffness. It is one of the best rem- 
 edies for a " cold-on-the-chest," with dry, shaking cough, soreness, or 
 shooting pains. It has been used with success in common, continued 
 or "gastric" fever, relapsing fever, congestive headaches increased by 
 stooping, bilious headache with vomiting, gastralgia with pyrosis and 
 soreness of the epigastrium, constipation, cholera infantum during dry, 
 hot weather, congestion of the liver, croup, and threatened mammitis. 
 Pains of shooting or tearing character, increased by movement, are 
 often quickly relieved by this drug. In dropsies it is used as a drastic 
 purgative and diuretic to remove the accumulated fluid. 
 15 
 
226 BUCHU CACTUS GRANDIFLORA CADMIUM. 
 
 BUCHU, Buchu, — is the leaves of Barosma betulina, B. crenu- 
 lata and B. serratifolia, S. African shrubs of the nat. order Rutaceae. 
 They contain a Volatile Oil, which is probably the active principle, and 
 gives them a peculiar and penetrating odor, resembling that of pepper- 
 mint; also Barosmin, a bitter extractive, and resin, gum, lignin, etc. 
 Dose, of the leaves, gr. xv-xxx. 
 
 Preparations. 
 Extractum Buchu Fluidum, Fluid Extract of Btichu, — Dose, TT^x-^j. 
 Infusum Buchu, Infusion of Buchu (Unofficial), — ^j to the pint. Dose, ^ss-ij. 
 
 Physiological Action and Therapeutics. 
 
 Buchu in small doses causes a sense of heat in the stomach, which is 
 gradually diffused over the body. It increases the pulse-rate, stimulates 
 the appetite, and produces slight moisture of the skin. It increases the 
 flow of urine, which becomes of darker color and strongly aromatic odor, 
 and deposits a brownish sediment. In large doses it produces vomiting, 
 purging and strangury, with a burning sensation at the stomach. 
 
 Buchu is of especial value in chronic affections of the genito-urinary 
 mucous membrane, on which the volatile oil acts topically, being elimi- 
 nated by the kidneys. It is a very useful remedy in pyelitis, cystitis and 
 urethritis ; also in lithiasis, in chronic bronchitis, and in affections of the 
 prostate gland. It is recommended in atonic dyspepsia, chronic rheuma- 
 tism and affections of the skin, also for dropsy, but it is not so actively 
 diuretic as to be very efficient in the latter condition. 
 
 The Infusion makes an excellent vehicle for saline diuretics. 
 
 CACTUS GRANDIFLORA, or Night-blooming Cereus (Unofficial),— is a native 
 of tropical America, and has long had a local reputation as a remedy for dropsy, but was 
 brought into notice as a cardiac remedy by Dr. Rudini. Its active principle, Cactine, a 
 supposed alkaloid, has been physiologically studied by Dr. Myers, who finds it possessed 
 of very decided stimulant action upon the heart, the arterial tension and the spinal motor 
 centres. Therapeutically, this drug has been employed as a cardiac stimulant in the 
 functional disorders of the heart connected with anemia, neurasthenia, dyspepsia, tobacco- 
 poisoning, exophthalmos, sexual exhaustion and low fevers, also in pseudo angina pec- 
 toris. It does not prolong the diastole, as Digitalis does, and on this account it has been 
 especially recommended in complicated aortic regurgitation. A tincture is prepared of 
 the strength of % iv of the fresh stems to a pint of strong alcohol, the dose of which is 
 TT^xx-xxx every 4 hours. 
 
 Pellotine, C 13 H 19 N0 3 (Unofficial), — is an alkaloid obtained from Anhalonium 
 Williamsii, a member of the cactus family growing in Mexico. This alkaloid is a power- 
 ful hypnotic and also somewhat analgesic, though not possessing the pain-relieving power 
 of morphine. It has the advantage of being capable of hypodermic administration, and 
 has given relief to the pains of locomotor ataxia and peripheral neuritis. The dose is 
 about gr. j for an adult. Mezcaline, another alkaloid from the same plant, seems to be 
 the cause of the exaltation produced by drinking the fermented liquor Mezcal prepared 
 therefrom. 
 
 CADMIUM, Cd (Unofficial).— This metal was official in the Pharmacopoeia of 1870, 
 but is no longer so. In its physiological action it resembles both Antimony and Zinc, 
 being escharotic, astringent, and a very depressant emetic. In over-doses its salts act as 
 
CAFFEA. 227 
 
 irritant poisons, with cerebro-spinal symptoms, such as coma and convulsions. It is 
 never used internally. Its salts in general use are — 
 
 Cadmii Sulphas, Cadmium Sulphate (Unofficial), — transparent oblique prisms, efflor- 
 escent, and very soluble in water. Used externally in a solution of gr. ss-iv ad ^j aq. 
 destil., or as an ointment (1 to 40 of fresh lard). 
 
 Cadmii Iodidum, Cadmium Iodide (Unofficial), — large, white, pearly crystals, soluble 
 in water and alcohol. Used as an ointment, I to 8 of lard. 
 
 The Sulphate has been used almost exclusively as a stimulating astringent in gonor- 
 rhea and diseases of the eye. Corneal opacities are absorbed under the use of a 
 solution of gr. ij to the 3, and in gonorrhea a mild injection (gr. % ad !|j) is very 
 beneficial. An ointment of the Iodide has been usefully employed for enlarged glands, 
 chronic joint affections, cutaneous diseases, nodes and chilblains. 
 
 CAFFEA, Coffee, the seed of Coffea Arabica, is officially repre- 
 sented only by its active principle, Caffeine. The coffee-plant is a small 
 tree of the nat. ord. Rubiaceae, 15 to 30 feet high, native of South Arabia 
 and Abyssinia, but cultivated in various parts of the world. Its seeds 
 contain the alkaloid Caffei?ie (partly free, partly as a tannatej, also tannic 
 and caffeic acids, sugar, legumin, etc. By roasting them, part of the 
 caffeic acid is converted into methylamin, the sugar is changed into cara- 
 mel, and several volatile substances are formed, which give to coffee its 
 peculiar aroma and some of its stimulant qualities, and are collectively 
 known as Caffeone, one of them being called Caffeol. 
 
 Caffeina, Caffeine, Tri-?nethyl-xanthin, C 8 H 10 N,O 2 -f-H 2 O. The U. 
 S. Pharmacopoeia of 1890 defines Caffeine (Theine) as " a feebly basic, 
 proximate principle, obtained from the dry leaves of Thea Sinensis, . . . 
 or from the dried seeds of Coffea Arabica, . . . and found also in 
 other plants." In the edition of 1880, Guarana was included by name 
 among its sources. Therefore, the principles named Caffeine and Theine 
 are now officially declared to be identical, and their identity with Guara- 
 nine is left unsettled. That all three are identical was the general opinion 
 until recently, their composition being expressed by the formula C 8 H 10 N 4 - 
 2 , and the physiological action of one being accepted for the others. 
 Some investigators, however, doubt the identity of the first two, and some 
 observers maintain that Guaranine also is a separate body, distinct from 
 either of the others. The Caffeine of commerce is usually obtained from 
 old tea leaves, and is in reality Theine. It contains more nitrogen than 
 almost any other proximate vegetable principle. It occurs in colorless, 
 flexible, silky crystals, which are soluble in 80 of water and in 33 of alco- 
 hol at 59 F. Dose, gr. j-v. 
 
 Theine is contained in the leaves of Thea Sinensis, the tea-plant, a native of China 
 and Japan, and a member of the nat. ord. Ternstromiacese. The tea-plant also contains 
 much Tannic Acid, and a volatile oil, the latter being most abundant in green teas. 
 Theine is found on the market, Merck's being considered the most reliable. Its sol- 
 ubility in water is much increased by adding an equal part of Sodium Benzoate, say 
 3J of each to the fluid ^, with gr. x of Sodium Chloride. Of this, rr\,vj equals gr. % 
 of Theine. Dose, gr. J/&-J, hypodermically, several times a day, for relief of pain. 
 
228 CAFFEA. 
 
 Preparations. 
 
 Caffeina Citrata, Citrated Caffeine, — is a very uncertain mixture, and is not consid- 
 ered to be a definite compound. It is prepared by dissolving equal weights of Caffeine 
 and Citric Acid in double the quantity of hot distilled water, evaporating the solution to 
 dryness and powdering the product, which is white, odorless, of acid taste and acid 
 reaction, soluble in about 3 parts of water, precipitated as Caffeine on further dilution 
 with water, and redissolved with about 25 parts of water. Dose, gr. ij-x. 
 
 Caffeina Citrate Effervescens, Effervescent Citrated Caffeine, — composed of Caf- 
 feine I, Citric Acid I, Sodium Bicarbonate 33, Tartaric Acid 30, Sugar 35, triturated, 
 mixed with Alcohol to a paste, dried and powdered. Dose, Sjj-ij, in a glassful of water, 
 as an effervescing drink. 
 
 Extractum Caffeae Viridis Fluidum (Squibb), Fluid Extract of Green Coffee (Un- 
 official), — is intended as a substitute for the fluid Extract of Guarana. Dose, gss-ij. 
 [Compare the title Guarana.] 
 
 Physiological Action. 
 
 Coffee is a cerebro-spinal stimulant, a stomachic tonic, and a laxative. 
 It is decidedly diuretic, and is somewhat antiperiodic and highly anti- 
 septic. The green bean produces effects very different from those of the 
 roasted one, exhibiting the action of Caffeine alone, unmodified by that 
 of the empyreumatic products. A tincture of green coffee, besides being 
 an efficient diuretic, has marked anti-lithic powers, and promotes the 
 elimination of the poison of gout from the system. 
 
 As a beverage, if used with moderation Coffee assists digestion, pro- 
 motes intestinal peristalsis, allays the senses of fatigue and hunger, lessens 
 tissue-waste and consequently decreases the formation and excretion of 
 urea (?). Used to excess it disorders digestion, and causes functional 
 disturbances of the nervous system, shown by headache, vertigo, mental 
 confusion, and palpitation of the heart. It increases secretion, blunts 
 sensation, exalts reflex excitability, increases mental activity, and may 
 produce insomnia and great nervous restlessness. It first briefly stimu- 
 lates the heart and raises arterial tension, but soon depresses both. The 
 wakefulness is usually preceded by a brief period of drowsiness. 
 
 The brief stimulation of the intellect, consequent on drinking a cup of 
 good coffee, cannot be obtained from an infusion of raw coffee, and is 
 probably due to the volatile constituents developed in roasting. Caffeone 
 opposes Caffeine in its action on the circulation, as it quickens the pulse 
 and lowers arterial tension. Its action, however, is of brief duration, and 
 soon gives way to the influence of the principal constituent. The Tannin 
 is the ingredient which enables it to produce dyspepsia, and is most abun- 
 dant in those infusions which are kept a long time on the stove before 
 being served. 
 
 The Common Stimulant Beverages Compared. 
 The qualities possessed in common by these substances, and for which 
 they are so universally esteemed by mankind, are three-fold. They all 
 
CAFFEA. 229 
 
 retard the retrograde metamorphosis of the body-tissues (tissue-waste), 
 thereby enabling the work of the individual to be done upon a smaller 
 supply of reparative material (food), and with less fatigue. Furthermore, 
 when used in moderation, they are more or less stimulating to the mental 
 processes, and sedative to the nervous system. 
 
 This similarity of action they owe to the possession of principles, which, if not identi- 
 cal, are so closely related to each other that until very recently they have been so con- 
 sidered both by chemists and pharmacologists. The divergence from each other, in the 
 finer shades of their action, depends most probably on the existence in each of differing 
 aromatic and volatile principles, which modify the action of the alkaloid in some degree. 
 Similar principles are developed in them by the various processes of preparation (as 
 roasting, drying, etc.), all of which have some part in determining the general action of 
 the beverages containing them. 
 
 Coffee (Coffea Arabica, nat. ord. Rubiacese), is more stimulating than 
 Coca and less sustaining. It is apt to cause severe palpitation of the 
 heart in some persons, and may disorder the digestion if long infused 
 before ingestion. The coffee-bean contains only from 0.2 to 0.8 per 
 cent, of caffeine. 
 
 Tea (T/iea sinensis, nat. ord. Ternstromiacese), is one of the most 
 refreshing and stimulating members of the group. Used to excess, it 
 powerfully affects the stability of the motor and the vaso-motor nerves, 
 the action of the heart, and the digestive function, producing flatulent 
 dyspepsia, tremulousness of the limbs, pallor of the surface, irregular 
 cardiac action and feeble impulse, hallucinations, nightmare, anorexia, 
 headache, nausea and vomiting, obstinate neuralgias, especially of the 
 supra-orbital and occipital nerves ; also constipation and a pain in the 
 left side are not infrequent. The condition of chronic tea-poisoning is 
 termed Theism, and is very often seen among women of the lower class 
 in cities, who do not indulge in alcoholic beverages, but freely accept the 
 dominion of the "cup that cheers " and worse than inebriates. Tea con- 
 tains much more Tannin than coffee, and that used as a beverage by the 
 poorer classes is little more than a decoction of tannin, and a fruitful 
 source of dyspepsia and other forms of gastric disorder. 
 
 Mate {Ilex Paraguay ensis, nat. ord. Aquifoliacese), is supposed to be 
 intermediate as to its effects between tea and coffee. It contains Theo- 
 bromine as well as Caffeine, the latter in the proportion of 1.2 per cent., 
 also a little tannin. 
 
 Guarana {Paullinia Cupa?ia of Brazil, nat. ord. Sapindacese), contains 
 an alkaloid — Guaranine, in the proportion of 5 percent., which is prob- 
 ably identical with Caffeine, though some think it more nearly analogous 
 to Theine. It is especially noted for relieving a nervous headache, for 
 which purpose the official fluid extract may be used in doses of rn^xx, 
 three or four times daily, when the basis of that preparation happens to 
 be of good quality. [Compare the article on Guarana.] 
 
23O CAFFEA. 
 
 Coca, or Cuca {Erythroxylon Coca, nat. ord. Lineae), is probably more 
 sustaining than either tea or coffee and less of a direct stimulant, at least 
 as used by the Peruvian natives. Its habitual and excessive use produces 
 a very serious train of nervous symptoms. [Compare the article entitled 
 Coca.] Its alkaloid, Cocaine, is allied in action to Caffeine, but is more 
 powerful, and its proportion in the leaves of the plant varies greatly in 
 the different samples which occur in commerce. 
 
 Cocoa (Theobroma Cacao, the Chocolate-tree, nat. order Sterculiacese), 
 pronounced Ko-ko, — is more nutritious than any other of the group, 
 containing a large quantity of fat, Oleum Theobromatis (cacao-butter), 
 which makes it difficult of digestion to many persons. Its alkaloid, 
 Theobromine, is chemically a Dimethylxanthin, and is closely allied to 
 Caffeine, the latter being considered a Methyl-theobromine. The various 
 preparations of this agent are made from the seeds, after the oil has been 
 expressed from them. They are ground in a mill, mixed with rice, barley, 
 sugar, flour, etc., and put up in powdered form, called Cocoa, — but when 
 flavored with vanilla and pressed into a cake the product is named Choc- 
 olate. The thin husks which envelop the seeds are known as Shells, and 
 are used to make a beverage similar to but milder than cocoa or choco- 
 late. [Compare the article entitled Theobromatis Oleum.] 
 
 Kola {Cola acuminata, nat. ord. Sterculiaceae), is the nut or seed of 
 the Kola plant, a handsome tree growing 30 to 60 feet high in the trop- 
 ical forests of Africa and in the West Indies. It contains both Caffeine 
 and Theobromine, the former in larger proportion than any member of the 
 group except Guarana ; also Tannic Acid and a glucoside substance named 
 Kolanin, which, in the presence of a ferment, splits up into free caffeine 
 and glucose, its yield of caffeine being 3 per cent. The Kola nut is 
 highly valued by the negroes as a stimulant beverage and food and as an 
 aphrodisiac, the latter quality being ascribed to the essential oil, which 
 is not present in the dried nuts. It improves the appetite and the diges- 
 tion, and promotes cheerfulness of the spirits and inclination to exertion. 
 It is becoming a fashionable stimulant under the commercial methods 
 which are employed in pushing the sale of the various preparations on 
 the market. 
 
 Physiological Action of Caffeine. 
 
 Caffeine is in general terms at first a stimulant and subsequently a 
 paralyzant to the nerve-centres in the cerebrum, medulla and cord. In 
 small doses it quickens the action of the heart and raises arterial tension ; 
 stimulates the cerebral functions, by increasing the supply of blood to 
 the brain ; and increases the respiration rate and the secretion of urine. 
 Larger doses (gr. v-viij) often over-stimulate the cerebral circulation, 
 causing great heaviness of the head, flashes of light before the eyes, tinni- 
 tus aurium, insomnia, restlessness, and even delirium, the pulse becoming 
 
CAFFEA. 23I 
 
 rapid, feeble, irregular and intermittent, and the general body-temper- 
 ature elevated, though that of the periphery may be lowered. Large doses 
 depress the heart and respiration, and lower the blood-pressure; in the 
 smaller animals it exalts the reflex excitability of the cord, producing 
 tetanic convulsions, and in lethal doses paralyzing the cardiac muscle as 
 well as its motor ganglia, but causing death by paralysis of respiration. 
 It powerfully affects muscular fibre, both voluntary and involuntary kinds, 
 throwing it into a state of tetanic contraction resembling rigor mortis. 
 Caffeine is a reliable hydragogue diuretic, acting by stimulation of the 
 secreting apparatus in the kidney, as well as by generally raising the arte- 
 rial tension (Brunton). The action of caffeine on the kidneys is two-fold ; 
 during the first stage it causes a fall of general blood-pressure and con- 
 striction of the renal vessels ; during the second stage, which persists 
 much longer than the first, the blood-pressure returns to its normal height 
 and the kidney undergoes great expansion (Murrell). If administered in 
 sufficient quantity it would doubtless prove fatal to man, but its lethal 
 dose for him would be large. Zenetz has recently published the details 
 of three cases of sudden death during the use of full doses of caffeine, in 
 all of which the heart was found at the autopsy to be so firmly contracted 
 that it was cut with difficulty. He infers therefrom that caffeine may 
 cause sudden arrest of the heart in systole. 
 
 Caffeine is excreted as such very slightly and slowly by the kidneys. 
 In its passage through the body it largely loses its methyl groups, most of 
 it being transformed into xanthin which probably breaks up into urea. 
 
 Theine, according to Dr. Mays, agrees in most respects with Caffeine in its action 
 upon small animals, except that it requires much larger doses to produce the same 
 effects. It differs from caffeine in some important particulars. Theine chiefly affects the 
 sensory, Caffeine the motor system. Theine causes spasms and convulsions and impairs 
 the nasal reflex, early in the course of the poisoning process; while Caffeine does so late, 
 if at all. Theine decreases the body-temperature, — Caffeine increases it. Theine causes 
 convulsions in frogs, a power now denied to Caffeine, though hitherto ascribed to it. 
 Both alkaloids tend to produce muscular contraction, but Theine causes a peculiar rhyth- 
 mical contraction in voluntary muscles, which lasts for several hours, and seems to act 
 transversely across the fibre, as the muscle is elongated at each contraction. In man, the 
 principal action of the hypodermic injection of Theine is the production of a profound 
 local anesthesia at and below the point of injection, acting therefore outwards along the 
 nerve-trunk, and not towards the centre. It does not affect the motor apparatus, nor 
 does it seem to produce narcosis. 
 
 Guaranine is generally considered to be identical with Caffeine, though some few ob- 
 servers find in its action a closer analogy to Theine. It affects both sensory and motor 
 nerves, the sensory first, paralyzing them from the centres outwards. \_Cocaine and 
 Brucine act from the periphery inwards.] It causes general hyperesthesia, and subse- 
 quently convulsions of spinal origin, — at first increases and afterwards depresses respira- 
 tion and the action of the heart. It seems to have a stronger affinity for the sensory than 
 for the motor nerves, and hence resembles Theine more than Caffeine. 
 
 Theobromine has the formula C 7 H 8 N 4 2 , and is closely allied to Caffeine, both phy- 
 siologically and chemically. In fact, Caffeine may be considered a Methyl-theobromine, 
 C ? H 9 (CH 3 )N 4 2 . During roasting the cocoa-bean develops an aromatic principle which 
 gives to chocolate its peculiar flavor. In large doses Theobromine is fatal to small 
 animals. 
 
232 CAFFEA. 
 
 Therapeutics. 
 
 Although without a very extensive range of usefulness, Caffeine is a 
 valuable stimulant in many forms of nervous and cardiac depression, and 
 has proved especially efficacious in headaches of neuralgic or nervous 
 type, the pain being general over the head ; gr. j of Caffeine every half 
 hour, or the fluid extract of Guarana, in 20-minim doses every 2 or 3 
 hours. In choleraic diarrhea, and that of phthisis, it checks outward 
 osmosis by stimulating the depressed nervous apparatus. In cervico- 
 brachial neuralgia, Caffeine may be used hypodermically in doses of gr. j, 
 increased to gr. v. In lithemia and gout, a tincture of the green bean 
 has marked diuretic and antispasmodic powers, and is very useful in these 
 conditions. In the insomnia of chronic alcoholism gr. y 2 of Caffeine 
 hypodermically is often efficient. For adynamic fevers, it may well be 
 used in place of alcoholic stimulants. In intermittents Coffee has a cur- 
 ative reputation among the inhabitants of the Philippines, which is cor- 
 roborated by the Dutch physicians. In asthma, Coffee is valuable for the 
 paroxysm if not used habitually. In opium narcosis, Caffeine hypoder- 
 mically, or better still, strong black coffee by the mouth, will antagonize 
 the increasing torpor of the nervous centres. 
 
 Although Caffeine is an efficient diuretic in cardiac and renal dropsies, 
 there are many objections to its use for this purpose. It sometimes acts 
 as a purgative as well as a diuretic, and although at first it produces copi- 
 ous diuresis, tolerance is soon established and it loses its diuretic power. 
 Moreover, it is a powerful cardiac stimulant, and in many persons it 
 exerts a very marked excitant action upon the central nervous system. 
 Lastly, and as a minor disqualification, it sometimes sets up considerable 
 smarting in the penis and produces a mild form of urethritis (Murrell). 
 Its tendency to produce tetanic contraction of muscular tissue and its 
 possible influence to arrest the heart in systole should be kept in mind 
 when it is being administered for any prolonged period. 
 
 Caffeine is contained in many proprietary preparations of which Acetanilid is the active 
 ingredient (see page 77). Its office therein is that of a corrigent, to antagonize the 
 depressant action of the latter drug upon the heart. A double citrate of caffeine and 
 antipyrin, named Migranin is described on page 171. 
 
 Theine, according to Dr. Mays, is a valuable analgesic, especially so 
 by reason of its prolonged influence over sensation. Its great field of 
 employment is in neuralgia of any kind, in which doses of gr. y& to gr. x / 2 
 hypodermically are efficient, and may be kept up as long as required. 
 To make a cure, however, the nutrition of the nerves must be attended to. 
 In locomotor ataxia and lumbago it has been used with prompt benefit, 
 in the same manner, quickly relieving pain without producing any 
 narcotic effect. 
 
CAJUPUTI OLEUM CALAMUS. 233 
 
 Kola is a useful agent in gastric catarrh and in the dyspepsia of alco- 
 holic subjects, as an adjunct to other treatment. After an alcoholic 
 debauch it will do much in restoring the nervous system to its normal 
 condition. It will counteract the depressing effects of tobacco, and has 
 been employed with benefit in asthma of both the nervous and cardiac 
 forms. As it contains a good deal of tannin, it is especially efficient in 
 atonic diarrhea, and in gastro-intestinal irritation with looseness of the 
 bowels, a restricted diet and Kola-wine are frequently all that is needed. 
 As an aphrodisiac it deserves high rank, though it acts in this respect not 
 so much by stimulating the sexual appetite as by enabling the organism 
 to escape the sense of exhaustion and extreme debility which neurotic 
 patients are apt to complain of (Woodbury). 
 
 Sodio-Theobromine Salicylate, Diuretin (Unofficial), — was introduced under the 
 latter title as a proprietary preparation. It occurs as a colorless powder, of sweetish, 
 saline and alkaline taste, soluble in y z its weight of water, and should contain 46^ per 
 cent, of Theobromine. Being a very unstable compound, it should not be prescribed in 
 combination with other drugs, and when dispensed it should be well sealed from contact 
 with the air, from which it rapidly absorbs carbonic acid, thereby undergoing decomposi- 
 tion. If ordered under its chemical name the cost should be less than y 2 that of the 
 same article under its proprietary title (Squibb). Dose, gr. x-xv, in powder or aqueous 
 solution, several times a day, as a diuretic. 
 
 Diuretin was introduced as a soluble preparation of Theobromine, of value for its 
 prompt diuretic action, influencing the kidneys without causing serious or dangerous 
 results upon the heart, the action of which, however, it strengthens and regulates. Given 
 to healthy persons it does not increase the quantity of the urine, but during its adminis- 
 tration in morbid conditions of the renal or cardiac apparatus the volume of urine in- 
 creases three- and four-fold, and exudations of non-inflammatory character are rapidly 
 absorbed. It may give rise to slight diarrhea, and the author has found the body-tem- 
 perature uniformly subnormal in non-febrile patients while under its influence. 
 
 Diuretin has been employed with marked benefit in both cardiac and renal dropsy, in 
 hepatic cirrhosis, and in various diseases of the heart and kidneys accompanied by 
 edema. The author has seen a large pleuritic effusion disappear rapidly under its use, 
 the fluid having re-accumulated after having been once removed by tapping the pleural 
 cavity. It should be administered in aqueous solution, avoiding acids or acid vegetable 
 juices, which are chemically incompatible, as they precipitate the alkaloid in the form of 
 a thick white sediment. 
 
 CAJUPUTI OLEUM, Oil of Cajuput,— is a volatile oil distilled from the leaves 
 of Melaleuca Leucadendron, a tree of the nat. ord. Myrtaceae, native of the Molucca 
 Islands. It is a bluish-green or colorless liquid, of camphoraceous odor and neutral 
 reaction, freely soluble in alcohol. It contains Cajuputol or Bihydrate of Cajuputene, 
 which forms ^ of it, the other y^ being another oil. Dose, TT\J-v. 
 
 Cajuput Oil resembles Oil of Turpentine, and has similar action to that of the other 
 volatile oils, being a stimulant carminative, somewhat diuretic and diaphoretic, antiseptic, 
 parasiticide and anthelmintic. Externally used it is irritant to the skin. Swallowed, it 
 produces a sense of warmth in the stomach and accelerates the pulse. 
 
 It is not much used internally, though it has been given with benefit in flatulent colic, 
 dropsy, hysteria, chronic rheumatism , scrofula, and syphilis, also in elephantiasis and 
 other cutaneous disorders. Externally, as a strong, stimulating rubefacient, it is efficient 
 in chilblains, muscular rheumatism and nervous headaches. 
 
 CALAMUS, Sweet Flag,— is the rhizome of Acorns Calamus, a plant of the nat. 
 ord. Araceae, native in Europe and North America, having an aromatic odor and pung- 
 ent taste. Only the unpeeled root should be used, peeled or bleached calamus being 
 almost inert. It contains a volatile oil and Acoriu, which is a nitrogenous, bitter 
 principle, also benzoic acid, starch, etc. Dose, indefinite. 
 
234 CALCIUM. 
 
 Extractum Calami Fluidum, Fluid Extract of Calamus, — is made with Alcohol as 
 a menstruum. Dose, rtlxv-^j. 
 
 Calamus is an aromatic bitter, and a stomachic tonic, increasing the appetite and stimu- 
 lating digestion. It is one of the constituents of the preparations termed "bitters," and 
 is chewed as an appetizer. 
 
 CALCIUM, Ca, — is the metal characteristic of Lime, Chalk, and all 
 calcareous substances, and although itself unofficial it is represented by 
 several official salts and preparations. Lime (Ca/x) and Chalk (Creta) 
 are respectively the Oxide (CaO) and the Carbonate (CaC0 3 ) of Calcium, 
 the carbonate occurring in the native forms called chalk, marble, lime- 
 stone, oyster-shells, etc., which are converted into lime by heating to 
 full redness (calcination), thereby driving off carbonic acid and leaving 
 the oxide behind. The latter, in this form, is known as "burnt lime" 
 or "quicklime"; and, by the addition of ^ to ^ its weight of water, 
 combines with one molecule of H 2 to form Calcium Hydrate, Ca(HO) 2 , 
 or "slaked lime," the process being termed "slaking" and being 
 accompanied by the evolution of a high degree of heat. 
 
 Lime is one of the four alkaline earths, the other three being Baryta, Magnesia, and 
 Strontia. As such, however, it never occurs naturally, though in combination with 
 various acids it is found in all the three kingdoms of nature ; its base, the metal Calcium, 
 being a widely distributed element, forming the basis of all calcareous and cretaceous 
 substances. Besides the forms mentioned above, Calcium occurs as a sulphate (gypsum), 
 also as a phosphate in bones, shells and various organic tissues, and as a silicate and a 
 fluoride in certain minerals and vegetables. 
 
 Official Salts of Calcium. 
 
 Calx, Lime, Calcium Oxide, CaO, — is Lime prepared by burning white marble, 
 oyster-shells, or the purest varieties of native Calcium Carbonate. Occurs in hard, white 
 masses, gradually resolving to a white powder in the air, odorless, of sharp, caustic taste 
 and alkaline reaction, soluble in 750 of water and 1300 of boiling water, insoluble in 
 alcohol. Not used internally except in solution. Is a constituent of Potassa cum Cake. 
 
 Calcii Hydras, Calcium Hydrate, Slaked Lime, Ca(HO) 2 , — official in the Br. Phar. ; 
 is prepared by pouring 1 pint of water over 2 pounds of Lime in a metal pot. It should 
 be recently prepared and kept excluded from the air. It is sparingly soluble in water 
 (gr. xj in Oj) and less soluble in hot water, but its solubility is greatly increased by the 
 addition of sugar. 
 
 Calcii Carbonas Prsecipitatus, Precipitated Calcium Carbonate, CaC0 3 , — a fine 
 impalpable, white powder, odorless and tasteless, insoluble in water or alcohol, but solu- 
 ble in mineral acids or acetic acid with effervescence. Creta (chalk) is native Calcium 
 Carbonate. (See next page.) Dose, gr. v-gj. 
 
 Calcii Chloridum, Calcium Chloride, CaCl 2 , — hard, colorless masses, deliquescent, 
 of sharp, saline taste, soluble in I ^ of water and in 8 of alcohol. Dose, gr. iij-x in 
 solution. This salt should not be confounded with Chlorinated Lime. 
 
 Calcii Sulphas Exsiccatus, Dried Calcium Sulphate, Dried Gypsum, — contains 
 about 5 per cent, of water. A fine, white powder, without odor or taste, insoluble in 
 alcohol, soluble in 410 of water at 59 F. , in 388 of water at ioo° F. , and in 476 of water 
 at 212° F. Used in the preparation of Calx Sulphurata. 
 
 Calcii Sulphidum, Calcium Sulphide, is described under Sulphur ; Calcii Bro- 
 midum, Calcium Bromide, under Bromum ; Calcii Hypophosphis, Calcium Hypo- 
 phosphite, and Calcii Phosphas Prsecipitatus, Precipitated Calcium Phosphate, under 
 Phosphorus. 
 
CALCIUM. 235 
 
 Preparations of the Oxide. {Lime.) 
 
 Liquor Calcis, Solution of Lime, Lime-water, — contains about 0. 17 per cent, of 
 Calcium Hydrate, Ca(HO) 2 . A clear, colorless liquid, of saline taste and alkaline reac- 
 tion. Dose, 5 ss-iv. 
 
 Syrupus Calcis, Syrup of Lime, Saccharated Solution of Lime, — contains &y z per 
 cent, of Lime, and 40 of Sugar, the latter aiding the solvent power. Dose, TT^x-^j. 
 Is an antidote to poisoning by Carbolic or Oxalic Acid. 
 
 Linimentum Calcis, Lime Liniment, Carroti Oil, — contains equal volumes of 
 Lime-water and Linseed Oil, mixed by agitation. For local use. 
 
 Calx Chlorata, Chlorinated Lime, is described under Chlorum ; Potassa cum 
 Calce, Potassa tvith Lime, under POTASSIUM, and Calx Sulphurata, Sulphurated 
 Lime, under Sulphur. 
 
 Preparations of the Carbonate. {Chalk.) 
 
 Creta Praeparata, Prepared Chalk, CaC0 3 , — is native Calcium Carbonate, freed from 
 most of its impurities by elutriation ; a white, amorphous powder, odorless and tasteless, 
 insoluble in water or alcohol. Dose, gr. x-^j. It is a constituent of Hydrargyrum cum 
 Creta, and also of the following : 
 
 Pulvis Cretae Compositus, Compound Chalk Powder, — has of Prepared Chalk 30, 
 Acacia 20, Sugar 50 parts. Dose, gr. v-gj. 
 
 Mistura Cretae, Chalk Mixture, — has of the preceding 20 parts, Cinnamon Water 
 40, Water to 100, rubbed together and made fresh as required. Dose, £ss-ij. 
 
 Trochisci Cretae, Troches of Chalk, — each contains of Prepared Chalk 4 grains, 
 Acacia I, Sugar 6, with a little Nutmeg. Dose, indefinite. 
 
 Testa Praeparata, Prepared Oyster-shell (Unofficial), — contains animal matter inti- 
 mately mixed with the Carbonate of Calcium. Dose, gr. x-xx or more. 
 
 Allied Substances. 
 
 Substances allied to Chalk, and derived from the animal kingdom, are — Crabs' - 
 eyes, which are concretions obtained from the stomach of the craw-fish, Coral, Cuttlefish 
 Bone, Egg-shell and Oyster-shells (Testa, see above) ; all of which are mainly composed 
 of Calcium Carbonate, but also contain the phosphate and sulphate of calcium and other 
 metallic salts in small quantity, as well as organic material. In the past special virtues 
 have been ascribed to these substances, and even now some authorities maintain that the 
 animal carbonates derange the stomach less than the mineral ones, and are to be pre- 
 ferred for infants and delicate persons. 
 
 Physiological Action. 
 
 Lime, in its unslaked form (quick-lime), has a great affinity for water 
 and readily combines with sulphur, thereby decomposing and destroying 
 organic matter. Upon the skin its action is irritant and superficially 
 caustic, but more severe on the mucous membranes, and if inhaled or 
 swallowed it may produce dangerous local inflammation, followed by 
 ulceration. In weak solution it has an astringent and sedative effect 
 both locally and internally, and acts as an absorbent and an antacid. 
 Chalk possesses the astringent and antacid qualities of lime without its 
 irritant properties. 
 
 Calcium Chloride is a very diffusible salt, and in small doses has re- 
 markably alterative action, being apparently a powerful antagonist to the 
 condition known as the strumous diathesis. Full doses produce symp- 
 toms of muscular poisoning similar to those caused by potassium salts, 
 
236 • CALCIUM. 
 
 with lowered temperature, slowed pulse, and a tendency to cardiac paral- 
 ysis. In large doses it is an irritant poison. It increases the amount of 
 the urine and probably promotes the excretion of urea. It has a great 
 affinity for water, and is used in pharmacy to abstract water from other 
 substances, as in the preparation of absolute alcohol and ether. In solu- 
 tion it is used as a test for tartrates, citrates and oxalates. . 
 
 Calcium Salts play an important part in the circulation and in most 
 of the other functions of the body. The heart or any other muscle, de- 
 prived of calcium, will no longer contract. These salts have a remark- 
 able influence on the nutrition of plants and animals, the Phosphate 
 being as essential to the nourishment of the organs of locomotion (carti- 
 lage, bone, tendon and muscle) as iron is to the blood or phosphorus to 
 the nerve tissue. They possess high coagulating power on the blood ; their 
 deficiency gives rise to lymphatic and osseous disease, and their absence 
 results in emaciation and finally death. They are excreted almost entirely 
 by the intestines, a very small portion being absorbed and but little of 
 that passes out by the kidneys. Their absence from water renders the 
 latter flat and insipid to the taste, but if present in excess (above 20 
 grains of the carbonate to the gallon) the water containing them is be- 
 lieved to be one of the factors of goitre. The Sulphate, in even so 
 small a proportion as 6 grains to the gallon, is unwholesome, as it is liable 
 to irritate the bowels and produce constipation and diarrhea alternately, 
 according as its astringent or irritant effect predominates. 
 
 Antidotes, Antagonists and Incompatibles. 
 
 In poisoning by Caustic Lime the antidotes are a dilute Vegetable Acid or Lemon- 
 juice or Carbonated Water freely, followed by demulcents or fixed oils to protect the 
 mucous membranes. Opium or Alcohol as an antagonist against the vital depression. 
 Potassium salts and Calcium salts are mutually antagonistic. Poisoning by Calcium 
 Chloride is treated by Albumin, mucilaginous drinks, oils, milk, flour and water, but no 
 acids. 
 
 Incompatible with preparations of Lime and Chalk are all the Acids and metallic 
 salts, especially the Sulphates and Tartar Emetic ; and borates, alkaline carbonates and 
 astringent vegetable infusions are also incompatible with the preparations of Lime. 
 
 Therapeutics. 
 Lime may be used as a caustic and depilatory, but is better known as 
 an agent for hastening decomposition, which it does by its great affinity 
 for water, the resulting hydrate absorbing many of the products. The 
 Chlorinated Lime is an excellent antiseptic and disinfectant, but as it owes 
 its energy entirely to its power of evolving chlorine it will be described 
 under the title Chlorum. Lime-water is a favorite remedy for vomiting, 
 especially in children, and is added to milk to increase its digestibil- 
 ity. A mixture of milk and lime-water will be retained by the stomach 
 when no other food can be borne. Lime-water is an efficient agent in 
 acid dyspepsia, mucous enteritis and typhoid fever, as an astringent and 
 
CALCIUM. 237 
 
 antacid. Locally, it is well employed as an enema against thread-worms, 
 as a mouth wash for aphthae, and as a lotion for cracked nipples, eczema- 
 tous eruptions, and many mucous and purulent discharges. For such pur- 
 poses it may be mixed with oil or glycerin, and if a few drops of carbolic 
 acid be added the efficacy of the mixture is much increased. The Lini- 
 ment is best known by the name Carron Oil, from the foundries at 
 Carron, where it is extensively used. It is one of the best applications 
 for burns and scalds, and makes a good dressing for the face in small- 
 pox, and for cases of eczema affecting a large area of the skin. The 
 vapor of slaking lime, or lime-water in the form of spray, have been use- 
 fully employed as inhalations in diphtheria. Lime-water is a good injec- 
 tion into the bladder in vesical calculus, in which its benefit is probably 
 due to its astringent and soothing effects on the inflamed vesical mucous 
 membrane, blunting its sensibility, and preventing the further growth of 
 the stone by neutralizing the free acid of the urine. 
 
 One of the curiosities of medical history is the fact that in 1739 the British Parliament 
 gave the sum of ,£5,000 to Mrs. Johanna Stephens for divulging the nature of a certain 
 lithontriptic remedy. This, she stated, consisted of calcined egg-shells and soap, with 
 various aromatic bitters, a combination which had previously been recommended by 
 Barbette for the same purpose. The nauseousness of this compound suggested to Whytt 
 the use of lime-water as a substitute, and the latter was found to be efficacious in many 
 instances. 
 
 The Syrup contains more lime in solution than lime-water does, and 
 may be used instead of the latter when a strong preparation is indicated. 
 It is one of the antidotes in poisoning by carbolic and oxalic acids, while 
 lime in any form (wall-plaster, whiting, etc.) is the best antidote for any 
 mineral acid. 
 
 Chalk is the basis of all dentifrices, and may be used as a dusting- 
 powder on ulcers, burns and excoriations of the skin. Chalk-mixture is 
 a common remedy for diarrhea, and is usually employed in combination 
 with other astringents, also with opium and aromatics. It is particularly 
 serviceable for the diarrheas of children with sour-smelling stools and 
 other symptoms of gastro-intestinal acidity. 
 
 Calcium Chloride is used with benefit as an internal remedy in the 
 various manifestations of the strumous diathesis. It often causes the 
 resolution of glandular enlargements, and the calcification of tubercular 
 deposits, aids the cicatrization of ulcerating cavities, and has proved 
 curative in eczema and lupus. It is highly praised in phthisis, also in 
 chorea, and for the colliquative diarrhea of strumous children. In 
 solution used as a fomentation it is said to hasten the maturation of 
 boils. 
 
 The therapeutics of the other salts and combinations of calcium are 
 described under the titles of their more active ingredients, Bromum, 
 Chlorum, Phosphorus and Sulphur. , 
 
238 CALENDULA — CALUMBA CAMBOGIA. 
 
 CALENDULA, Marigold, — is the florets of Calendula officinalis, the common 
 Garden Marigold, a plant of the nat. ord. Composite, frequently cultivated for ornament. 
 The tincture (20 per cent.) is also official, and is exclusively used as a local application 
 to promote the healing process in wounds, ulcers, burns and other breaches of tissue. 
 Extravagant views of its powers as a vulnerary are promulgated by the so-called "homeo- 
 pathic surgeons," and serve as one of their excuses for professing an exclusive position 
 in the art of surgery. 
 
 CALUMBA, Columbo, — is the root of Jateorhiza palmata, a plant 
 of the nat. ord. Menispermaceae, native in southeastern Africa, but culti- 
 vated in the East Indian Islands. It contains the alkaloid Berberine (see 
 under Berberis, ante, page 218), a bitter principle named Calumbin, also 
 Calumbic Acid and Starch, but no Tannin. Dose, gr. v-xxx. 
 
 Pre pa rations. 
 Extractum Calumbae Fluidum, Fluid Extract of Calumba. — Dose, TT^ v-xxx. 
 Tinctura Calumbae, Tincture of Calumba, — I in 10. Dose, gss-ij. 
 
 Calumba is the first in alphabetical order of the simple bitters, having 
 no astringency or aroma, and its action, as herein described, will apply 
 to other members of that class (Quassia, Gentian, Cornus). It stimulates 
 the nerves of taste, increases the flow of saliva, excites the flow of the 
 gastric juice and the gastric circulation, thus increasing the appetite and 
 aiding digestion, and thereby promoting the constructive metamorpho- 
 sis. As it also increases the gastric mucus, its continued use will set 
 up catarrh of the stomach and interferes with digestion, though it is one 
 of the least irritant of stomachic tonics. 
 
 As Calumba contains no tannin, it may be administered with the salts 
 of iron, and is often prescribed with the sub-carbonate. It is useful in 
 atonic dyspepsia with pain after eating, in the convalescent stage of disease 
 to promote appetite and digestion, in diarrhea and dysentery, vomiting, 
 sea-sickness, cholera morbus and cholera infantum. An Infusion of 
 Calumba with Ginger and Senna is effective in flatulence, and the same 
 preparation is a good vehicle for the administration of acids and alkalies, 
 tonics, aromatics, and mild cathartics. Having little or no irritant 
 quality, it is an excellent tonic in the hectic fever of phthisis. 
 
 CAMBOGIA, Gamboge, — is a gum-resin, obtained from Garcinia Hanburii, a 
 Siamese tree of the nat. ord. Guttiferae. It contains 73 per cent, of Gambogic Acid, a 
 resinous substance, also 25 per cent, of gum and 2 of water. It is partly soluble in 
 alcohol and ether. The only official preparation is the Pil. Catharticse Co. (described 
 under Colocynthis), each pill containing gr. ^ of Gamboge. Its dose, as a cathartic, 
 is gr. ij-v, — as a diuretic, gr. j at short intervals. 
 
 Gamboge is an irritant purgative, decidedly diuretic, and its powder is sternutatory. 
 Its catharsis is accompanied by vomiting and colic, and the stools produced are watery, 
 but not so much so as generally believed. It has no cholagogue action. Full doses are 
 liable to produce violent gastro-enteritis, and incautiously used (as in Morrison's pills) it 
 has frequently caused death. On the other hand, large doses have been given continu- 
 ously in some cases, without producing any dangerous symptoms. 
 
CAMPHORA. 239 
 
 Gamboge was formerly much used as a hydragogue cathartic and diuretic in dropsies, 
 but its irritant qualities have caused it to be superseded by other agents (elaterium, digi- 
 talis, etc. ). However, for dysentery, especially when in young subjects, very small doses 
 (gr. T ^) at short intervals, up to gr. ^ in 24 hours, have proven to be remarkably effi- 
 cacious. 
 
 CAMPHORA, Camphor, C 10 H 16 O,— is officially described as a 
 stearopten (having the nature of a ketone), obtained from Cinnamotnum 
 Camphora, a tree of the nat. ord. Laurineae, and purified by sublimation. 
 It occurs in white, translucent, waxy masses, of penetrating odor and 
 pungent taste, lighter than water, in which it is sparingly soluble (1 to 
 1300), but dissolves readily in alcohol, ether, chloroform, benzin, oils, etc. 
 The camphor-tree is indigenous to China, Japan, Formosa and other parts 
 of Eastern Asia. Borneo-camphor has the formula C 10 H 18 O, bears the same 
 relation to Japanese camphor as alcohol bears to aldehyde, and is heavier 
 than water. Dose, gr. j-xx. 
 
 Derivatives of Camphor are — Camphor- cymol, which is obtained by its 
 distillation with zinc chloride ; Camphoric and Camphretic Acids, which 
 result respectively from its lesser or greater oxidation ; and Safrol, also 
 contained in Sassafras oil, but obtained in much larger quantities from 
 Camphor oil, a waste by-product in the manufacture of crude camphor. 
 
 Official Preparations. 
 
 Aqua Camphorae, Camphor-water, — Camphor 8, Alcohol 5, Distilled Water to 1000. 
 Used externally or as a vehicle internally. Dose, gj-iv. 
 
 Spiritus Camphorae, Spirit of Camphor, — 10 per cent, in Alcohol. Dose, rr\v-xx. 
 
 Linimentum Camphorae, Camphor Liniment, — Camphor 20, Cotton-seed Oil 80. 
 
 Ceratum Camphorae, Camphor Cerate, — has of the Liniment 10, White Wax 30, 
 Lard 60. Used for itching skin- affections. 
 
 Camphora Monobromata, Monobromated Camphor, C 10 H 15 BrO, — colorless, pris- 
 matic needles or scales, of mild camphoraceous odor and taste, and neutral reaction ; 
 almost insoluble in water, slightly in glycerin, freely in alcohol, ether, oils, etc. Dose, 
 gr. j-x, in emulsion. 
 
 Camphor is also an ingredient of Linimentum Saponis, Linimentum Sinapis Compos- 
 itum, and Tinctura Opii Camphorata. 
 
 Unofficial Preparations. 
 
 Acidum Camphoricum, Camphoric Acid, C 8 H H (COOH) 2 , — is a dibasic acid, ob- 
 tained by the action of nitric acid on camphor. Occurs in white, acicular, odorless 
 crystals, of feebly acid taste ; insoluble, or nearly so, in cold water, readily soluble in 
 hot water, alcohol, ether and fatty oils. Dose, gr. x-xxx, dry on the tongue. 
 
 Rubini's Tincture of Camphor, — is a saturated solution in alcohol, ^j in 3JX> 
 of which the dose is from 4 to 10 drops. rt\vij have caused toxic symptoms in an adult. 
 
 Raspail's " Eau Sedative," — contains Aq. Ammonias Spj, Sodii Chloridum J;ij, 
 Camphorated Spirit of Wine ^iij, Water Oij. Used externally. 
 
 Camphora Carbolata is a name given to a mixture of 2^ parts of camphor with one 
 each of carbolic acid and alcohol. This preparation, mixed with olive oil, is a good 
 non-irritating and antiseptic dressing for wounds and breaches of surface. 
 
 Camphor-Chloral is a fluid obtained by triturating together equal parts of camphor 
 and chloral hydrate. It dissolves morphine sulphate readily (gr. xx in 3 i j ) , also many 
 
240 CAMPHORA. 
 
 other salts of alkaloids. It is often a serviceable application in superficial neuralgia, and 
 is said to allay spasmodic cough if painted over the larynx. 
 
 Camphora Salicylata is obtained by heating together II parts of salicylic acid and 
 14 of camphor. An ointment prepared therefrom has been used with satisfactory results 
 in the treatment of phagedena, spreading syphilitic sores, epithelioma, lupus, etc. 
 
 Oleum Camphorata, Camphorated Oil, — strength 10 per cent., is used for hypoder- 
 mic injection, in doses of TT^xv-^j. 
 
 Physiological Action. 
 
 Camphor is antispasmodic, anodyne, antiseptic, diaphoretic, a stimu- 
 lant expectorant, a cerebral excitant, a gastro-intestinal irritant, and a 
 rubefacient. It has an acrid, hot taste, and irritates the skin and mucous 
 membranes, in quantity exciting severe gastric inflammation with all the 
 effects of an irritant poison. In medicinal doses it stimulates the vaso- 
 motor system and the cardiac motor ganglia, and lessens the influence of 
 the pneumogastric, — thus increasing the circulation and raising arterial 
 tension. It also stimulates respiration and mental activity, even produc- 
 ing intoxication ; promotes diaphoresis, allays pain, and increases the 
 menstrual flow and the sexual appetite, but its continued use depresses the 
 generative function. " Camphora per nares castrat odore mares." 
 
 Large doses cause gastro-intestinal inflammation, depress the heart and 
 lower arterial tension, diminish the reflex function of the spinal cord, 
 produce coldness of the surface, insensibility, coma, convulsions and per- 
 haps death. As many as 200 grains have been taken without fatal result, 
 yet 6 or 7 grains have produced extreme drowsiness and weakness of the 
 pulse, and 20 grains laid up an Alpine guide for a day. It is eliminated 
 by the bronchial mucous membrane, skin and kidneys, and has often 
 caused dysuria. 
 
 Monobromated Camphor resembles the bromides, but its action is not 
 identical with theirs. In mammals it produces muscular weakness passing 
 into paralysis, lowered temperature and respiration, stupor and death. 
 In some cases its use by man has been followed by epileptiform convul- 
 sions. It is a nervous sedative and hypnotic, and a gastric irritant. 
 
 Antagonists, Antidotes and Incompatible s. 
 
 Arterial sedatives, coffee, cold, etc. , antagonize its action. Water precipitates it from 
 the alcoholic solution, alkalies and earthy salts precipitate even the small quantity which 
 is soluble in water. Emetics to remove as much as possible. Opium and Bromides for 
 the convulsions. 
 
 Therapeutics. 
 Camphor was much used by the older physicians as an antispasmodic, 
 and is greatly valued still in China and Japan. It has a reputation for 
 uncertainty of therapeutic action, but is usefully administered in cholera 
 and choleraic diarrhea, summer diarrhea and that of infants, vomiting, 
 gastralgia, cardiac depression, nervousness and nervous headache, nym- 
 
CANNABIS INDICA. 24 1 
 
 phomania, capillary bronchitis, typhoid and eruptive fevers, dysmenor- 
 rhea, afterpains, chordee, strangury, and catarrhal colds. Locally it is 
 effective in myalgia, lumbago, toothache, gangrene, and other conditions 
 where counter-irritation or a local anodyne is required. A solution in 
 ether has been found to be a beneficial application in erysipelas. 
 
 Subcutaneous injections of camphor dissolved in oil have been employed 
 with excellent results in the collapse of pneumonia and in other condi- 
 tions where collapse is imminent. In fibrinous pneumonia these injec- 
 tions produce a depression of about one degree in the temperature, and 
 greatly ameliorate the general condition. They are also employed with 
 benefit in the treatment of phthisis during the period of softening, ren- 
 dering the patient more comfortable and prolonging life. Camphor ad- 
 ministered in this manner is not well borne by young children, even in 
 minimum doses. 
 
 Monobromated Camphor is used as a nerve sedative and hypnotic, but 
 is not particularly efficient. It has been employed with advantage in 
 whooping-cough, neuralgia, chorea, hysteria, delirium tremens and epi- 
 lepsy, but it is taken with difficulty and is liable to irritate the stomach. 
 
 Camphoric Acid, in solutions of ]/ 2 to 6 per cent, strength, has been used with benefit 
 as a topical agent in cystitis, also in coryza, acute bronchitis and other affections of the 
 respiratory tract. Internally administered it gives good results as an intestinal disinfect- 
 ant, and has lately come into prominence as one of the most efficient agents against 
 sweating from various causes, especially the profuse night-sweats of pulmonary tubercu- 
 losis. For this purpose it is best administered dry on the tongue, in dose of 10 to 30 
 grains, not more than two hours before the time for the expected sweating to occur, as it 
 is quickly and abundantly eliminated by the urine. 
 
 CANNABIS INDICA, Indian Cannabis, Indian Hemp,— is the 
 flowering tops of the female plant of Cannabis sativa, grown in the East 
 Indies ; a coarse, pubescent, somewhat viscid annual of the nat. ord. Urti- 
 cacese. Its odor is peculiar and narcotic, its taste slightly acrid. 
 
 Cannabis Americana, American Cannabis, (Unofficial), — is the 
 same plant, Cannabis sativa, grown in the Southern States. 
 
 The two varieties are specifically identical with each other, differing 
 only in the degree of their action, that grown in India being the most 
 powerful. They contain a resin named Cannabin, and a Volatile Oil, 
 from the latter of which are obtained Cannabene, a light hydrocarbon, 
 and Cannabene Hydride, a crystalline body. Cannabis should not be 
 confounded with the so-called " Indian or Canadian Hemp," Apocynum 
 cannabinum (see ante, page 185). 
 
 Preparations. 
 
 Extractum Cannabis Indicae, Extract of Indian Cannabis. — Dose, gr. %-), if 
 active. Hering's English Extract is one of the best. 
 
 Extractum Cannabis Indicae Fluidum, Fluid Extract of Indian Cannabis, — is an 
 16 
 
242 CANNABIS INDICA. 
 
 alcoholic preparation which in mixtures must be thoroughly emulsified with Acacia, 
 otherwise the resinous drug will separate and float to the top or adhere to the sides of the 
 bottle. The Dose is put at TnJ-v or x, but the author has frequently administered ^j of 
 a good fluid extract without untoward results. Whatever may be the reason, it is a fact 
 which he has often verified, that if the precipitate, formed when the alcoholic prepara- 
 tion is added to water, be of a brownish hue, a dirty, yellow-brown, the sample will 
 prove to be almost inert ; — but if of a decided olive-green color, the preparation will be 
 active. The activity will be found to increase almost in direct proportion to the decided 
 green color of the precipitate. Samples from one manufacturer show this difference, 
 often seen between two bottles in the same shipment. The active principle seems to be 
 intimately connected with the chlorophyll or other coloring matter present, and to be 
 destroyed therewith by whatever injures the latter. 
 
 Tinctura Cannabis Indicse, Tincture of Indian Cannabis, — strength 15 per cent. 
 Dose, TT\xx-3J. The above remark on mixtures containing the fluid extract applies also 
 to those containing the tincture of this drug. 
 
 Similar preparations of Cannabis Americana are made by the manufacturers and 
 may be used in larger quantities. The dosage of all preparations of hemp is uncertain, 
 as specimens of the plant vary greatly in activity. The best rule is to begin with a 
 small dose, gradually testing the activity of the drug and the susceptibility of the patient 
 by cautiously increased doses. 
 
 Cannabin Tannate (Unofficial), — is a yellowish-brown permanent powder, insoluble 
 in water and ether, slightly soluble in alcohol, having a not unpleasant odor and a bitter- 
 ish, astringent taste. No formula has been published for it, but it is claimed to be the 
 tannate of a glucoside by Merck, of Darmstadt, who placed it on the market. Dose, 
 as a hypnotic, gr. v-x. 
 
 Preparations tised in the East. 
 
 Churrus is an impure resin, prepared by rubbing the leaves of the plant together and 
 scraping off the adhering resin. 
 
 Gunjah is the dried leaf and tops as sold in the bazaars for smoking purposes. 
 
 Hashish, Bhang or Siddhi is a confection consisting of the leaves and small stalks 
 coarsely broken and mixed with fruits and aromatics. It is employed in the preparation 
 of various electuaries and beverages, and is also smoked with or without tobacco. 
 
 Physiological Action. 
 
 Cannabis Indica is antispasmodic, analgesic, anesthetic and narcotic, 
 a cerebro-spinal stimulant and a powerful aphrodisiac. It increases intel- 
 lectual and motor activity, stimulates the vaso-motor nerves, raising arte- 
 rial tension, depresses sensation, and strengthens the energy of the 
 uterine muscular fibre, but has no power to initiate uterine contractions. 
 In large doses it causes a peculiar but generally pleasant form of intoxica- 
 tion, during which the particular traits of the individual are exaggerated, 
 and the ideas follow each other so rapidly as to produce a sense of great 
 prolongation of time, minutes seeming as if hours or even days. With 
 this occurs increased sexual desire and uterine activity, also sensations of 
 double consciousness and enormous dimensions. The sight and hearing 
 are exalted, pupils dilated, anesthesia sets in, the reflexes are lowered by- 
 stimulation of inhibition (Setschenow's centre?), and if the dose be a 
 heavy one a cataleptic state is induced. Sleep or coma follows according 
 to the size of the dose, but death has never been produced by this drug. 
 
 After-effects are dullness, heaviness, vertigo, headache, confused 
 thought, anesthesia of the skin, and marked diuresis, — but no nausea, no 
 
CANNABIS INDICA. 243 
 
 vital depression, no constipation. Repeated use of the drug causes mental 
 weakness and impotence, the result of over-stimulation. A ravenous 
 appetite is usually one of its effects. 
 
 Antagonists and Incompatibles. 
 
 Strychnine and Faradism are antagonistic. Caustic Alkalies are incompatible. In 
 poisoning by it the stomach should be evacuated, stimulants given cautiously, and respira- 
 tion maintained. The effects of a large dose last over 24 hours. Lemon-juice is said to 
 antagonize its effects. 
 
 Therapeutics. 
 
 Cannabis Indica was formerly much employed as an anodyne and hyp- 
 notic, also as an anesthetic during surgical operations. It is now some- 
 what out of fashion. In migraine it is useful to prevent recurrence of the 
 attack, and in neuralgia it is often very efficient. Uterine affections, such 
 as chronic metritis, subinvolution, menorrhagia and dysmenorrhea, are 
 greatly benefited by its anodyne quality and its power over the uterine 
 muscular fibre. It is one of the best hypnotics in delirium tremens, and 
 in traumatic tetanus and paralysis agitans large doses of this drug will 
 lower the reflex activity. Dysuria and retention of urine are often re- 
 lieved by it, while in spasm of the bladder and other painful affections of 
 that organ it will be found a most efficient remedy. It is useful in func- 
 tional impotence, especially if combined with Ergot and Nux-vomica. 
 In gonorrhea it lessens the discharge, relieves the inflammation, burning 
 pain and restlessness, and allays chordee. The tincture of Cannabis 
 Americana is the most useful in this affection, being fully as efficient as 
 copaiba or sandal oil, and much more agreeable. It should, however, 
 be prepared from the fresh plant, and be given in 3 to 5 drop doses 3 or 
 4 times daily after the subsidence of the acute symptoms. Full doses of 
 the tincture of the Indian plant are extremely efficient in many cases of 
 headache at the menopause, but should be used cautiously until the 
 activity of the sample and the susceptibility of the patient are tested. 
 
 Dr. Lees has called attention to the fact that aqueous preparations of 
 this drug, which contain but little of the resin, are much used by the 
 natives of India for intoxicating and stimulating purposes, which indi- 
 cates that the volatile oil and not the resin is the active principle. He 
 uses a strong aqueous extract, prepared without heat, which gives all the 
 beneficial effects of the alcoholic preparations without the extreme ex- 
 hilaration bordering on intoxication so often produced by even medium 
 doses of the latter. He finds that, in pulmonary affections generally, 
 this Liquor Cannabis Indices acts most favorably as an anodyne and hyp- 
 notic, while in phthisis pulmonalis it relieves the cough and aids the 
 patient by its stimulant and exhilarating qualities to a degree which no 
 other drug can accomplish. Dr. Lees has also used it in indigestion 
 with constipation, and in many affections of children in which nervous 
 
244 CANTHARIS. 
 
 symptoms are prominent it has done good service. The adult dose is 
 3ss-j. 
 
 Cannabin Tannate is considered by Fronmiiller to be a very useful 
 hypnotic, not in any degree dangerous and neither disturbing the secre- 
 tions nor leaving unpleasant after-effects. It has been used with benefit in 
 acute mania. 
 
 CANTHARIS, Cantharides, Spanish Flies, — is the dried beetle, 
 Cantharis vesicatoria, an insect of the nat. ord. Coleoptera, about an inch 
 long, of a shining green color, the powder being grayish-brown with 
 green particles, odor very disagreeable. Contains Caniharidin, C 10 H 12 O 4 , 
 the active principle ; also a greenish volatile oil and peculiar fatty bodies. 
 
 Preparations. 
 
 Tinctura Cantharidis, Tincture of Cantharides, — 5 per cent. Dose, TT\J-xx. 
 
 Ceratum Cantharidis, Cantharides Cerate, Blistering Cerate, — Cantharides 32, Yel- 
 low Wax, Resin, Lard, of each 18, Oil of Turpentine 15. 
 
 Collodium Cantharidatum, Cantharidal Collodion, Blistering Collodion, — Canthar- 
 ides 60, Flexible Collodion 85, Chloroform to 100. 
 
 Emplastrum Picis Cantharidatum, Cantharidal Pitch Plaster, Warming Plaster, 
 has of Cerate of Cantharides 8 parts, Burgundy Pitch to 100. 
 
 Physiological Action. 
 
 Cantharis applied to the skin is a rubefacient and vesicant, acting more 
 slowly than mustard but much more severely. Internally it is also irritant, 
 causing heat of stomach, gastralgia, nausea and vomiting, the circulation 
 is stimulated, temperature elevated; urine becomes scanty and irritating, 
 is voided with difficulty and pain, and often contains blood and albumin. 
 Afterwards the pulse falls, temperature and arterial tension are lowered, 
 and depression ensues. A toxic dose produces severe gastro-enteritis, 
 abdominal tenderness, tenesmus, mucous or bloody stools, pain in the 
 stomach and lungs, dysphagia, ptyalism, strangury, priapism, hematuria, 
 swollen genitals, abortion, muscular tremor, convulsions, coma and in- 
 sensibility. The post-mortem shows evidences of violent metritis, gastro- 
 enteritis and general peritonitis. Cantharis is aphrodisiac by causing 
 vascular turgescence of the genital apparatus, but only in doses which 
 produce dangerous symptoms. It is abortive only in toxic doses. In 
 small doses it is diuretic and emmenagogue. 
 
 Counter-irritation by rubefacients or blisters acts on disease probably 
 through the nervous system. Its influence is explained by the theory that 
 the peripheral extremities of the nerves supplying the skin of the part to 
 which the agent is applied undergo some molecular change, which extends 
 to the nerve centre and is thence radiated to centrifugal or trophic nerves, 
 effecting various changes in nutrition and secretion over the areas to which 
 
CANTHARIS. 245 
 
 they are distributed. In addition to this method of action, neighboring 
 parts are affected by direct extension of the inflammation produced, and 
 distant parts are also affected by absorption through the vesicated surface 
 of agents having special affinities for certain organs. 
 
 A blister acts primarily as a stimulant to the body generally as well as to 
 the organs in its vicinity, but if permitted to remain long enough to pro- 
 duce a large bleb, the result is depression proportionate to the amount of 
 serum abstracted, the serum of the bleb containing nearly as much albu- 
 min as the blood itself. 
 
 Antagonists and Antidotes. 
 
 There is no chemical antidote or physiological antagonist to Cantharis. Evacuation 
 of the stomach, mucilaginous drinks freely, Opium for the gastro-ehteritis, are the best 
 measures in poisoning by this agent. 
 
 Therapeutics. 
 
 As a counter-irritant and vesicant Cantharis is of great value in neu- 
 ralgia if applied close to the emergence of the nerve from the spinal 
 column, also in sciatica and neuritis, and in acute rheumatism around the 
 affected joints. A blister at the nape of the neck controls many head- 
 aches, and one behind the ear will modify inflammatory affections of the 
 eye. In pleuritic effusions a succession of small blisters (flying-blisters) 
 will promote absorption of the pleural contents, and a blister applied to 
 the peritoneum will often cure a rebellious gleet. Though valuable as a 
 therapeutic measure in very many conditions, blistering is going out 
 of fashion except in hospitals and among people who believe in heroic 
 treatment. It is invaluable in subacute joint affections. 
 
 As an internal remedy Cantharis must be employed in very small doses 
 (mj-iij of the tincture) in order to be efficient. When so used it is an 
 admirable agent in acute desquamative nephritis after the active inflam- 
 mation and fever have subsided to reduce the albumin and blood in the 
 urine. Drop-doses are particularly useful in irritable bladder with frequent 
 desire to micturate, so often observed in women, also in the incontinence 
 of the aged and of children; and in cystitis, gonorrhea and gleet. The 
 same dose thrice daily will generally abate chordee. In spermatorrhea, 
 prostatorrhea, scanty menstruation and menorrhagia in subjects of lax 
 fibre and general want of tone it is often very serviceable. Cutaneous 
 squamae and vesiculae are greatly improved by small doses frequently 
 administered and gradually increased, and it is one of the best remedies 
 for psoriasis. For alopecia areata it is of the utmost value as an external 
 application, and the tincture, largely diluted, is an ingredient of all the 
 hair renewers in common use. In pleurisy, after effusion has taken place, 
 it will be found admirable in 1- to 2-drop doses every 2 or 3 hours, and in 
 the after-prostration of diphtheria it proves a serviceable stimulant. One 
 of the best applications to burns or scalds is a cloth dipped in a lotion of 
 
246 CAPSICUM. 
 
 the tincture one part to thirty or forty of water. The same lotion is an 
 efficient application to vesicular erysipelas and herpes zoster. 
 
 CAPSICUM, Cayenne Pepper, African Pepper, — is the fruit of 
 Capsicum fastigiatwn , a plant of the nat. ord. Solanaceae, native in 
 tropical Africa and America. It contains Capsicin, which is a thick, red 
 liquid, and is the active principle, — also a volatile alkaloid having the 
 odor of Conii'ne. Dose of the powdered drug, gr. v-x. 
 
 Preparations. 
 
 Extractum Capsici Fluidum, Fluid Extract of Capsicum, alcoholic. Dose, TT\j-x. 
 
 Tinctura Capsici, Tincture of Capsicum, — 5 per cent, strength. Dose, n\v-xx. 
 
 Oleoresina Capsici, Oleoresin of Capsicum, — extracted by ether. Dose, TT\J-v. 
 
 Emplastrum Capsici, Capsicum Plaster, — prepared by spreading Resin Plaster on 
 muslin and then applying a thin coating of Oleoresin of Capsicum, so that each square 
 inch may contain about gr. j of the oleoresin. An excellent warming plaster. 
 
 Physiological Action and Therapeutics. 
 
 Capsicum is irritant to the skin and mucous membranes. Externally 
 used for sufficient length of time it will produce vesication, internally in 
 quantity it will excite gastritis. In medicinal doses it increases the saliva, 
 excites a sensation of warmth in the stomach, promotes appetite and 
 digestion, and produces easier and more copious alvine evacuations. It 
 stimulates the action of the heart, is diaphoretic and diuretic, also decid- 
 edly aphrodisiac. It is a general stimulant to the nervous system, but in 
 repeated doses produces a slight narcotic effect upon the brain. On the 
 vascular system it acts like ergot, powerfully constringing the vessels by 
 influencing the unstriped muscular fibre in their walls, either directly or 
 through the vaso-motor nerves. 
 
 Capsicum is an excellent stomachic tonic in atonic dyspepsia and in 
 that of chronic alcoholism with tremor and insomnia. In acute dipso- 
 mania and delirium tremens large doses are efficient in producing sleep 
 and promoting appetite. It is the best substitute for alcohol and opium 
 in attempts to cure those habits. It is well used in intermittents, chiefly 
 as an adjuvant to more active drugs, — in flatulent colic, especially when 
 occurring in hysterical women and hypochondriacs, — also in low fevers 
 and cholera as a stimulant. It gives good results in functional impotence, 
 in spermatorrhea from loss of tone, in chronic parenchymatous nephritis 
 to check the waste of albumin, and it is beneficial in chronic cystitis and 
 in prostatorrhea. The tincture internally, and a plaster externally over 
 the loins, are efficient in cases of renal congestion with habitual pain in 
 the back and a trace of albumin in the urine. Locally the tincture diluted 
 (3J to ^viij) or the powder with honey, forms an excellent gargle for relaxed 
 
CARBO. 247 
 
 throat and its accompanying cough, relaxed uvula, inflammatory sore 
 throat, and the cynanche of scarlet fever, but they must be used with 
 caution, as such applications are sometimes very irritating. 
 
 The Capsicum plaster is a mild counter-irritant, of great value in lum- 
 bago and other muscular rheumatisms as a palliative application. 
 
 CARBO, Carbon, C. — This element is widely distributed through- 
 out all the kingdoms of nature. United with oxygen in the form of 
 Carbonic Acid Gas ', C0 2 , it occurs in the air and in many mineral waters, 
 while as carbonates, such as limestone, etc., it constitutes a large portion 
 of the surface of the earth. [Compare the article entitled Acidum Car- 
 bonicum, a?ite, page 91.] Another compound with oxygen, Carbonic 
 Oxide or Carbon Monoxide, CO, is a highly poisonous gas, which is formed 
 to a certain extent during the combustion of charcoal, but does not form 
 salts. Two forms of Carbon are official, viz.: — 
 
 Carbo Animalis, Animal Charcoal, — prepared from bone, occurring 
 in dull black fragments or powder, odorless and nearly tasteless, insoluble 
 in water or alcohol. 
 
 Carbo Ligni, Charcoal, — prepared from soft wood, and very finely 
 powdered ; is black, shining, brittle, inodorous, tasteless and insoluble. 
 
 Preparations. 
 
 Carbo Animalis Purificatus, Purified Animal Charcoal, — the bone-phosphate and 
 calcium carbonate being removed by digesting with Hydrochloric Acid and washing. 
 Dose, gr. xx-£j. 
 
 Carbonei Disulphidum, Carbon Bisulphide, CS 2 , — is a clear, colorless, diffusive 
 liquid, of strong, offensive odor, aromatic taste and neutral reaction ; soluble in alcohol, 
 ether, chloroform and oils, and in 535 of water ; vaporizes at ordinary temperatures, and 
 is highly inflammable. Dose, Tr^ss-j. 
 
 Physiological Action and Therapeutics. 
 
 Charcoal is an efficient deodorant and disinfectant, as it absorbs and 
 condenses many gaseous bodies and vapors. It is evacuated unchanged 
 by the bowel and exerts no specific action on the body. 
 
 Charcoal is used in pharmacy for decolorizing vegetable principles, 
 removing alkaloids from infusions of plants, and making several prepara- 
 tions, as acidum sulphurosum, potassii iodidum, etc. 
 
 Externally, it makes an efficient disinfectant, absorbent and deodorant 
 application to cancerous discharges, foul ulcers and gangrenous wounds. 
 Having no odor it is not open to the charge of substitution of one smell 
 for another. A small quantity added to water will keep it sweet for a 
 long time. It is an excellent dentifrice if finely powdered. 
 
 Internally, it is used for the same purposes, namely, to absorb gases and 
 offending products of indigestion. In flatulent dyspepsia, gastralgia, 
 pyrosis, diarrhea, nausea of pregnancy, epidemic cholera, and constipa- 
 
248 CARDAMOMUM — CARDUUS. 
 
 tion, it has warm advocates. When used internally for any time, an 
 occasional purgative should be given to prevent its accumulation in the 
 intestines. It has been proposed as an antidote for several alkaloidal 
 poisons on theoretical grounds, but its efficacy in this respect is doubtful. 
 
 Carbon Disulphide is largely used in the arts, hence its effects are fre- 
 quently observed. Persons exposed to its fumes are affected by headache, 
 vertigo, over-excitement of the nervous system, emaciation, incoordina- 
 tion of movement, depression of all the special senses with impairment 
 of sensation and motility and perhaps insanity. Inhaled directly, it ex- 
 cites violent coughing, and produces anesthesia characterized by great 
 muscular rigidity. Being a powerful cardiac paralyzant, it is a dangerous 
 anesthetic. In 3-drop doses it produces severe nausea and vomiting, 
 with a sense of heat in the stomach and a weak and rapid action of 
 the heart. It is a good solvent for Caoutchouc and many other sub- 
 stances. 
 
 Carbon Disulphide has such a horribly offensive odor that it will 
 never be used for any purpose for which another agent can be found. It 
 relieves the pain of gastric cancer, and in ^-drop doses will alleviate 
 nausea and vomiting, also gastralgia. Locally it has been used as a 
 counter-irritant and a local anesthetic, for deafness due to want of ner- 
 vous energy, in facial neuralgia and various local pains. 
 
 CARDAMOMUM, Cardamom, — is the fruit of Elettaria repens, a plant of the 
 nat. ord. Scitamineae, cultivated in Malabar. It contains about 4^ per cent, of a Vola- 
 tile Oil, C 10 H ]6 , isomeric with Oil of Turpentine, the oil being the active principle ; also 
 a fixed oil, coloring matter, etc. It is an ingredient of Pulvis Aromaticus and of Ex- 
 tractum Aromaticum Fluidum (See under Cinnamomum), as well as of several compound 
 preparations. 
 
 Tinctura Cardamomi, Tincture of Cardamom, — 10 per cent. Dose, gj-ij. 
 
 Tinctura Cardamomi Composita, Compound Tincture of Cardamom, — has of Car- 
 damom 20, Cinnamon 20, Caraway IO, Cochineal 5, Glycerin 50, Diluted Alcohol to 
 1000 parts. Dose, 3J-ij. 
 
 Infusum Cardamomi, Infusion of Cardamom (Unofficial), — may be made in the 
 strength of 3 ij to the pint, and used in wineglassful doses. 
 
 Cardamom is aromatic, carminative and stomachic, and is used as an agreeable flavoring 
 for bitter mixtures in dyspepsia and other gastric affections. It makes the best flavoring 
 addition to saline solutions or mineral waters, and is particularly efficient to correct flatu- 
 lence and griping when combined with purgatives. 
 
 CARDUUS (Unofficial), — the seeds of Carduus marianus, or St. Mary's thistle, an 
 annual European plant of the nat. ord. Compositse. A decoction ( ^ij ad Oj) is the prep- 
 aration usually employed. It, is an old remedy revived as a hemostatic, and reported 
 as being very efficient in hemoptysis, uterine hemorrhage, melena and amenorrhea 
 connected with derangement of the portal circulation. It has proved curative in conges- 
 tion of the liver and simple jaundice, and in Germany it has long been popularly deemed 
 efficacious in gall stones and liver affections generally. Dose of the decoction, 3J - ^ ss > 
 of a tincture, TT^x-xx. 
 
 Carduus Benedictus, the "blessed thistle," also called Cnicus benedictus and Cen- 
 taurea benedicta, is another plant of the same order, formerly held in high esteem as a 
 popular "cure-all." It contains Cnicin, an amorphous bitter principle, which has been 
 
CARUM — CARYOPHYLLUS. 249 
 
 used as an antiperiodic in doses of gr. v-x, but generally produces burning sensations 
 and pharyngeal constriction, with nausea, vomiting, colic, and diarrhea. It acts chiefly 
 as a bitter tonic, resembling Calumba and Taraxacum most closely. 
 
 CARUM, Caraway, — is the fruit of Carum Carvi, a European plant of the nat. ord. 
 Umbelliferae. Its odor and taste are aromatic and agreeable. The active principle is 
 the Volatile Oil, which is also official. Caraway is an ingredient of Tinctura Carda- 
 momi Composita. 
 
 Oleum Cari, Oil of Caraway, — is the volatile oil distilled from Caraway, and is 
 resolvable into Carvene, C 10 H 16 , isomeric with Turpentine, and Carvol, C 10 H u O, isomeric 
 with Thymol. It is an ingredient of Spiritus Juniperi Compositus. Dose, TT\J-v. - 
 
 Infusum Cari, Infusion of Caraway (Unofficial), — 3J-ij ad Oss. Dose, ^ ss-ij. 
 
 The Oil of Caraway is fatal to small animals, and in one case ^j produced cerebral 
 congestion, delirium and rigors in man. The chief use of Caraway is as a flavoring 
 agent, but it is efficient in the flatulent colic of children, and to prevent griping from the 
 use of purgatives. 
 
 CARYOPHYLLUS, Cloves,— are the unexpanded flowers of 
 Eugenia aromatica, a handsome evergreen tree of the nat. ord. Myr- 
 tacese, cultivated in the East and West Indian Islands. They exude oil 
 when scratched, have an aromatic odor and a pungent, spicy taste, and 
 are contained in Tinctura Lavandulae Composita, Tinctura Rhei Aromatica 
 and Vinum Opii. They contain a heavy Volatile Oil, which is official v 
 also Eugenin, C 10 H 12 O 2 , a crystalline body; Caryophyllin, C 10 H 16 O, a 
 camphor ; Caryophyllic Acid, and tannin, gum, etc. 
 
 Preparations. 
 
 Oleum Caryophylli, Oil of Cloves, — a volatile oil distilled from cloves, soluble in 
 alcohol, and of sp. gr. 1.060. It consists of a light and a heavy oil, the latter containing 
 Eugenol, C 10 H 12 O, a phenol-like compound, and Caryophyllin, C 10 H 16 O, which yields as 
 a product of its oxidation, Caryophyllinic Acid, C 20 H 32 O 6 . Dose of the oil, rr\j-iv. 
 
 Infusum Caryophylli, Infusion of Cloves (Unofficial), may be made of strength 
 1 to 40, and used in doses of one to two fluid ounces. 
 
 Physiological Action and Therapeutics. 
 
 Cloves may be considered as a type of several agents yielding aromatic 
 oils, which as a rule consist of terpenes with camphors, resins, fatty and 
 other acids, etc., and are closely allied to phenol and benzoic acid, the 
 balsams and gum-resins. Such are Orange, Lemon, Allspice, Cajuput, 
 Caraway, Peppermint, etc. Their oils are antiseptic, locally anesthetic, 
 stimulant and irritant, antispasmodic, stomachic and carminative. In- 
 ternally they increase the circulation and temperature, promote digestion 
 and nutrition (though in quantity they may cause inflammation), relieve 
 pain and spasm, and are excreted by the kidneys, skin, liver and the 
 bronchial mucous membrane, stimulating and disinfecting their routes 
 throughout the organism. 
 
 These agents are used to flavor pharmaceutical preparations, to correct 
 the griping tendency of many purgatives, to correct flatulence, to relieve 
 
25O CASCA BARK CASTANEA. 
 
 pain in the stomach and bowels, and to promote the flow of saliva and 
 gastric juice. As external applications they are efficiently employed for 
 anesthetic and counter-irritant purposes, to relieve pain in chronic rheu- 
 matism, myalgia, lumbago, superficial neuralgia, toothache, etc. The 
 Oil of Cloves is an effective deodorizer for sponge-tents, a good applica- 
 tion to a painful tooth, and is occasionally applied over the course of an 
 aching nerve with relief to the pain. 
 
 CASCA BARK, Sassy Bark, Ordeal Bark (Unofficial),— is the bark of Erythro- 
 phloeum Guinense, an African tree, used by the negroes as an ordeal in trials for witch- 
 craft. It contains a poisonous glucoside, Erythrophlein, and when used in quantity- 
 produces nausea and vomiting, stricture across the brow, severe cephalalgia, narcosis and 
 death. It is used as a remedy for intermittent fever, dysentery, diarrhea and colic, and 
 is considered to resemble Digitalis in action and uses. A tincture is made (^ij ad Oj) 
 of which the dose is TT^x ; or a watery extract may be used in doses of gr. j. 
 
 Erythrophlcein, the active principle, is a glucoside, and is said to be a local anes- 
 thetic of extraordinary power, even surpassing Cocaine. It is found in Africa in a red 
 mass, called " Hayah," which is proven to be identical with an extract of the original 
 plant described by Oertel early in the last century, and deposited by him in the Berlin 
 Museum. It closely resembles Digitalis in action, being a cardiac tonic and a hydragogue 
 diuretic. 
 
 CASCARA AMARGA, Honduras Bark (Unofficial),— is the bark of a Mexican 
 tree of the nat. ord. Simarubaceoe, which has been used with apparent success as an 
 alterative tonic and diuretic in syphilis and various chronic skin affections. The use of 
 tobacco and alcohol seems to counteract its usefulness. It is certainly a very powerful 
 tonic and has been employed by competent observers with uniformly good results in 
 syphilis and syphilodermata, chronic liver complaints, chronic eczema, chronic nasal catarrh 
 and psoriasis. A Fluid Extract is on the market, of which the dose is ^ss-j thrice daily. 
 
 CASCARILLA, — is the bark of Croton Eluteria, a shrub or small tree of the nat. 
 ord. Euphorbiaceae, growing in the Bahamas. It contains Cascarillin, a crystalline prin- 
 ciple, two resinoid extracts, aromatic volatile oils, with tannic acid, etc. There are no 
 official preparations, but an Infusion (1 to 10) or a Tincture (i to 10) may be prepared 
 and given in doses of 3J-,^j. 
 
 Cascarilla is an aromatic bitter. It increases appetite and digestion, the mucous secre- 
 tion, the flow of saliva and gastric juice, stimulates the intestinal secretions, and acts as 
 a mild astringent by the influence of its tannin. Large doses produce nausea, vomiting 
 and diarrhea, and in medicinal doses continued it will set up gastric catarrh and conse- 
 quently indigestion. It has slight antiperiodic power. 
 
 It has been used with success in epidemic dysentery, flatulent dyspepsia, debility, 
 chronic bronchitis, intermittents, and low nervous fevers. It is difficult to dispense, as 
 the infusion decomposes quickly, and acids precipitate the resin from the tincture. 
 
 CASSIA FISTULA, Purging Cassia,— is the fruit of Cassia Fistula, a tree of the 
 nat. ord. Leguminosae, growing in tropical regions of Asia, Africa and America. No 
 active principle has been isolated as yet. The pulp is the only valuable part of the drug. 
 There are no official preparations, but it is one of the ingredients of Confectio Sennse. 
 
 Cassia-pulp is laxative in doses of ^j-ij, and purgative in large quantities, producing 
 nausea, flatulence and griping. It is rarely prescribed alone, owing to its tendency to 
 cause colic and flatulence. 
 
 CASTANEA, Chestnut, — the leaves of Castanea dentata, a stately tree of the nat. 
 ord. Cupuliferse, which should be collected while green. They contain tannic and gallic 
 acids, salts, gum, etc. 
 
 Extractum Castanea Fluidum, Fluid Extract of Castanea. — Dose, 3 ss— 3 ij. 
 
CATECHU CAULOPHYLLUM CERA. 25 I 
 
 This drug has not been studied as to its physiological action, if it has any. It is classed 
 among the vegetable astringents by reason of its containing tannin. Its only reputation 
 therapeutically is as a remedy for whooping-cough, in which it is said to be very effica- 
 cious. An infusion or a decoction of the leaves has been used, in indefinite doses. 
 
 CATECHU, — is an extract prepared from the wood of Acacia Cate- 
 chu, a tree of the nat. ord. Leguminosae, native of the East Indies. It 
 occurs in irregular masses, bark brown and brittle, nearly inodorous, but 
 of astringent and sweetish taste, soluble in alcohol, and partly so in water. 
 It contains Catechutannic Acid $0 per cent. ; also Catechuic Acid, which 
 is converted into the former by heat. Dose, gr. j-^ss. 
 
 Preparations. 
 
 Tinctura Catechu Composita, Compound Tincture of Catechu, — contains Catechu 
 10, Cinnamon 5, Diluted Alcohol q. s. ad 100 parts. Dose, TT\x- 3J. 
 
 Trochisci Catechu, Troches of Catechu, — each troche contains of Catechu nearly I 
 grain, mixed with Sugar, Tragacanth and Orange-flower Water. 
 
 Catechu is a powerful astringent, acting by virtue of its tannic acid. 
 (See ante, page 96, for action and incompatibles.) Its uses depend en- 
 tirely on its astringency. In the diarrhea of children the Tincture with 
 Chalk-mixture is very serviceable, and with Opium it is efficient in dysen- 
 tery. It is also used as a gargle and mouth-wash in relaxed conditions of 
 the pharyngeal mucous membrane, as an injection in leucorrhea, and to 
 control passive hemorrhages, to harden spongy gums, etc. 
 
 CAULOPHYLLUM, Blue Cohosh, — is the rhizome and rootlets of Caulophylhim 
 thalictroides, a plant of the nat. ord. Berberidaceae, growing in Canada and the northern 
 United States, and contains Saponin, a glucoside and two resins. Dose, gr. v-xx. There 
 are no official preparations. The eclectic preparation Caulophyllin is a resinous precipitate 
 obtained by pouring an alcoholic extract into water. 
 
 Caulophyllum is a new addition to the pharmacopoeia, and has not yet been made the 
 subject of experimental work by reliable observers. It was much used by the aborigines 
 of this country in all affections to which their women were peculiarly subject, and was 
 known among them by the name "squaw-root." It is said to produce intermittent con- 
 tractions of the gravid uterus, to have diuretic, emmenagogue, and antispasmodic powers ; 
 and is used as a remedy for deficient labor-pains, spasmodic after-pains, spasmodic pains 
 in the uterus at any time, spasmodic dysmenorrhea, and pains in other organs seemingly 
 in sympathy with uterine affections. It has somewhat of a reputation in acute rheuma- 
 tism of the hands and fingers, and as a preparative medicine for labor. 
 
 CERA, Wax, — a mixture of Myricin, Cerotic Acid and Cerolein, is 
 formed by the honey-bee, and exists in the pollen and leaves of many 
 plants, particularly in Myrica cerifera, the wax myrtle. That produced 
 by the bee is alone official. 
 
 Cera Alba, White Wax, — is yellow wax bleached. 
 
 Cera Flava, Yellow Wax, — is a concrete substance prepared by Apis 
 mellifica, the honey-bee. It is a yellowish solid, of agreeable odor and 
 faint, balsamic taste, insoluble in water or in cold alcohol, but soluble in 
 35 of ether, 11 of chloroform, in boiling alcohol, fixed and volatile oils. 
 
252 CERII OXALAS — CHELIDONIUM. 
 
 Ceratum, Cerate, — consists of White Wax 30, Lard 70. 
 Unguentum, Ointment, — consists of Yellow Wax 20, Lard 80. 
 
 Wax is also a constituent of the 5 compound Cerates, 2 of the 22 compound Ointments, 
 and 2 of the 13 Plasters. 
 
 Wax owes its value to its power of resisting decomposition and many 
 chemical agents. Its fusibility at a moderate degree of heat, and its 
 solidity at the temperature of the body, together with its unirritating 
 quality, make it a valuable ingredient of the cerates and ointments to 
 give them consistence. Ceratum and Unguentum may be used as simple 
 protective applications. They form the bases of almost all the com- 
 pound preparations so named. 
 
 CERII OXALAS, Cerium Oxalate, Ce 2 (C 2 4 ) 3 -f 9H 2 0,— is a white, slightly 
 granular powder, odorless and tasteless, insoluble in water or alcohol, but soluble in 
 diluted sulphuric or hydrochloric acid. Dose, gr. j-x, in pill or powder. 
 
 Cerium Oxalate is a gastric sedative, and is thought to possess selective action as such 
 on the motor distribution of the pneumogastric nerve. It is considered to be particularly 
 useful in vomiting of reflex origin, especially in the vomiting of pregnancy, but it often 
 fails, probably because not given in sufficient doses. To be effective, at least 4 or 5 grains 
 should be given 3 times a day to adults, and no results promised until after it has been 
 used several days. It is also recommended in the vomiting of phthisis and bronchitis, 
 cough with vomiting, chorea, and diarrhea. 
 
 CHAULMOOGRA OIL (Unofficial), — is a fixed oil expressed from the seeds of 
 Gynocardia odorata, an East Indian tree of the nat. ord. Bixaceae. It is nauseous and 
 bulky, and soluble in alcohol, ether, chloroform, etc. Its active principle, Gynocardic 
 Acid, is the best preparation for use, and may be given internally in doses of gr. ss-iij,or 
 applied as an ointment, gr. xx ad ^j of Petrolatum. Dose of theoil,gtt. v-x, in capsules. 
 
 Chaulmoogra Oil is credited with a few cures of leprosy, and several cases improved 
 by its use both internally and externally. It is recommended as an external application 
 in scaly eczema, psoriasis, syphilitic skin-diseases, chronic rheumatism, rheumatic 
 arthritis and tabes mesenterica. 
 
 CHELIDONIUM, Celandine, — is the plant Chelidonium majus, 
 nat. ord. Papaveraceae, which grows in Europe and N. America, about 
 rocky places. It contains 2 alkaloids, Chelidonine , C 19 17 N 3 3 , and Chel- 
 erythrine, the latter being identical with Sanguinarine : also Chelidoxan- 
 ihin, a yellow, crystalline substance, and Chelidonic Acid, supposed to be 
 identical with Succinic Acid. Dose of the plant, gr. v-xxx, — of the 
 fresh juice ttlv-xx. There are no official preparations. 
 
 Chelidonium used externally is irritant, internally it is a drastic purga- 
 tive but an unreliable one. It is also perhaps diuretic, diaphoretic and 
 expectorant. In overdoses it is considered poisonous. It is an old rem- 
 edy for jaundice and liver affections, but has been obsolete for some 
 time. The fresh juice is a popular application for warts and corns, and 
 a tincture in whiskey is used in Indiana as a remedy for phthisis, the 
 menstruum being probably the most useful agent. It seems to be of real 
 service in simple jaundice, whooping-cough, right-sided pneumonia with 
 hepatic involvement, and the catarrhal pneumonia of children. 
 
CHENOPODIUM CHIMAPHILA CHINOLINUM. 253 
 
 CHENOPODIUM, American Wormseed, — is the fruit of Chenopoditan amdro- 
 sioides, var. anthelminticion, a plant of the nat. ord. Chenopodiaceae, indigenous to the 
 United States. Its active principle is a Volatile Oil which is official. 
 
 Oleum Chenopodii, Oil of Chenopodiu??i, — a thin, colorless or yellowish liquid, of 
 aromatic odor and pungent, bitter taste. Dose, Tt\v-xv. 
 
 The Oil is the only preparation used and that rarely, its odor and taste being very dis- 
 agreeable. It increases the cardiac rate, and promotes the secretions of the skin, bronchi 
 and kidneys. It is an efficient anthelmintic against the round worm in doses of gtt. x 
 three times a day for two days, followed by a cathartic. It seems to possess some tonic 
 properties, and certainly is a diffusible stimulant. As such it has been used with benefit 
 in chorea, hysteria, flatulent dyspepsia, and chronic malaria. 
 
 CHIMAPHILA, Pipsissewa, — the leaves of Chimaphila timbellata, or Prince's 
 Pine, an evergreen plant of the nat. ord. Ericaceae, indigenous to all parts of the United 
 States. It contains Chi?naphilin, a yellowish crystalline principle, Arbntin, also crystal- 
 line but colorless, with tannic acid, etc. 
 
 Extractum Chimaphilae Fluidum, Fluid Extract of Chimaphila, — Dose, gss-ij. 
 
 Decoctum Chimaphilae, Decoction of Chh?iaphila (Unofficial), — I to 17. Dose, ^j-iij. 
 
 Chimaphila is a tonic, astringent diuretic, belonging to the same class as Buchu, Uva 
 Ursi, Pareira and Scoparius. It is probably the most active diuretic among this group, 
 stimulating all the excretory organs but especially the kidneys. It is an agreeable 
 tonic, excites the appetite and promotes digestion. The fresh leaves, bruised and ap- 
 plied to the skin, are rubefacient and vesicant, showing the presence of some irritant 
 principle. 
 
 Chimaphila is a good diuretic in dropsy, and is efficient in several forms of chronic 
 kidney disease with albuminuria, and in chronic catarrhal affections of the urinary pas- 
 sages, as hematuria, ischuria, dysuria and gonorrhea. It is believed to check the secre- 
 tion of uric acid, and should prove useful in gout and rheumatism. Externally, it has 
 been applied to ulcers and tumors with benefit. 
 
 CHINOLINUM, Chinolin, Leucolin, Quinolin, C 9 H 7 N (Unoffi- 
 cial), — is a constituent of coal-tar oil, but may be obtained from quinine 
 or cinchonine by their destructive distillation with potassium hydrate, 
 and is artificially prepared by heating anilin or nitro-benzol with glycerin 
 in the presence of a dehydrating agent. Chemically, it is considered to 
 be formed by a union of benzene and pyridine atoms. (Compare the 
 article Cinchona.) It is a colorless, oily liquid, strongly refractive, 
 turning dark on exposure to the air; soluble in alcohol, ether and carbon 
 disulphide, sparingly soluble in water. It combines, like an alkaloid, 
 with acids to form crystalline salts ; all of which, except the tartrate, are 
 very deliquescent. 
 
 Chinolini Tartras, Chinolin Tartrate (Unofficial), — a white crystalline powder, of 
 pungent odor, sharp taste, stable in the air and soluble in water. Dose, gr. v-xx. 
 
 Chinolin is a valuable antiseptic and antipyretic, being nearly as effec- 
 tive in this respect as quinine, which it closely resembles in chemical char- 
 acteristics and physiological action. It is one of the most powerful anti- 
 pyretics of the substances which have been discovered in the search for 
 an artificial quinine (hydroquinone, antipyrin, pyrocatechin, resorcin, 
 thallin, kairin, etc.). Chinolin itself has a very disagreeable taste and 
 
2 54 CHIRATA CHLORAL. 
 
 smell, and is irritant in action, hence the tartrate is preferred for medi- 
 cinal use. It has been extensively used as an antipyretic in pneumonia, 
 typhus, diphtheria, typhoid and other fevers, with varying success. In 
 diphtheria, a 5 per cent, solution in weak alcohol is painted on the 
 affected surface with great benefit. The tartrate has been used bene- 
 ficially in neuralgia and whooping-cough, and as an antiperiodic in inter- 
 mittents. 
 
 Quinalgen, Ortho-tzthoxy-ana-mono-benzoyl-amido-quinolin (Unofficial), — is a de- 
 rivative of Chinolin, and is a reformed and renamed Analgen (see ante, page 78), differ- 
 ing therefrom by having the benzoyl instead of the acetyl radicle. Its action is similar 
 to that of Antipyrin, except that it is claimed for this substance that no unpleasant effect 
 or after-effects are noticed after taking it. It has been used in gout, influenza, migraine, 
 sciatica, neuralgia, hay fever and rheumatic pains, with asserted benefit. Dose, gr. 
 viij-xv, not to exceed gr. xlv daily. 
 
 Chinosol, Quinosol, Potassium Oxy-chinolin-sulphonate (Unofficial), — is a lemon- 
 yellow powder, soluble in water, and said to be powerfully antiseptic, disinfectant and 
 deodorant, even in weak solutions. The powder is irritant to wounds when applied dry, 
 but not when in solution. Its advocates claim for it greater antiseptic efficacy than possessed 
 by mercuric chloride, also that it is non-toxic and does not coagulate albumin. On the 
 other hand Ahlfeld and Vahle state that its germicidal power is feeble and that it disturbs 
 the functional activity of the kidneys. It is much used as an antiseptic in gynecological 
 and obstetrical practice, generally in aqueous solution of I in 1000. 
 
 CHIRATA, Chirata, Chiretta, — is the Indian plant Swertia Chirata, nat. order 
 Gentianacese, occurring in bundles, composed of all but the coarser woody stems. It is 
 inodorous, but intensely bitter, and contains two amorphous bitter principles, named 
 Chiratin and Ophelic Acid, but no tannin. Dose of the powdered plant, gr. xv-xxx. 
 
 Extractum Chiratae Fluidum, Fluid Extract of Chirata, — made with glycerin and 
 diluted alcohol. Dose, TTLxv-xxx. 
 
 Tinctura Chiratae, Tincture of Chirata, — 10 per cent. Dose, gss-ij. 
 
 The action of this plant is that of a simple bitter, like its congener Gentian. It is an 
 excellent tonic, in this respect rivalling Cinchona, and is used in India as a substitute for 
 the latter. It is laxative and stomachic, diminishes flatulency and acidity, and is particu- 
 larly serviceable in the dyspepsia of gouty subjects. As it contains no tannin, it may be 
 administered with preparations of Iron. 
 
 CHLORAL, Chloral, Chloral Hydrate, C 2 HC1 3 + H 2 0,— is a 
 crystalline solid, composed of Trichloraldehyde (Chloral) with one mole- 
 cule of water. It occurs in colorless, transparent, rhomboidal crystals, 
 slowly volatilizing when exposed to the air ; of aromatic, penetrating and 
 slightly acrid odor, bitterish, caustic taste, and neutral reaction. It is 
 freely soluble in water, alcohol, ether, chloroform, oils, etc.; liquefies 
 when triturated with about an equal quantity of camphor, menthol, thymol 
 or carbolic acid ; melts at 136 F. and is decomposed by alkalies into 
 chloroform and a formiate of the alkaline base. Its aqueous solution 
 becomes acid, but the alcoholic solution remains neutral. 
 
 Chloral itself, (Trichloraldehyde, C 2 HC1 3 0), is an unstable, oily, color- 
 less fluid, formed by the action of chlorine upon alcohol, whence its 
 name, Chlor-al. The Hydrate is the only official preparation. 
 
CHLORAL. 
 
 O) 
 
 The Dose varies much with individual susceptibility and with the presence or absence 
 of cardiac and pulmonary disease. Death has been caused in several instances by gr. xxx, 
 in one case by gr. x, and in another gr. vijss produced alarming symptoms, all being iii 
 adults. On the other hand, recovery has occurred after the ingestion of an ounce, several 
 hundred grains having been taken at a time in more than one instance without fatal 
 results, and where tolerance has been established by habitual use 3 ij~3iij are frequently 
 taken without poisonous symptoms. An average dose for a healthy adult is gr. xx, 
 for a child gr. j tor each year of age up to gr. yj. It is best given in Syrup of Tolu, or 
 in Peppermint water. 
 
 Caution is necessary when prescribing this drug in combination with alcoholic pre- 
 parations, as the Chloral is then very apt to separate as an alcoholate, especially if the 
 Bromides of Potassium or Sodium are used in the same mixture and if the solutions are at 
 all concentrated. In this way great danger is incurred of giving a heavy overdose, as 
 the alcoholate floats on the surface of the mixture, and the entire amount of Chloral 
 contained therein may be taken at a single dose. 
 
 Unofficial Preparations. 
 
 Chloralamid, — is described under its own title. 
 
 Hypnal is a combination of Chloral and Antipyrin, occurring as tasteless and odor- 
 less rhombic crystals, soluble in' 6 of water, and credited with simultaneous action as a 
 hypnotic and an analgesic. Dose, gr. xv-xxx in aqueous mixture with some alcohol, 
 flavored with syrup of orange. It is said to cause no gastric disturbance. Although Chloral 
 and Antipyrin are incompatible with each other, they form, when heated together, the 
 above described compound, which resembles both and yet differs from each. Its 
 chemical appellation is Tri-chlaraldehyd-phenyl-diniethyl-pyrazolen. 
 
 Somnal, — is the suggestive name given to a liquid preparation formed by the union 
 of Chloral, Alcohol and Urethan, described as Ethylirtes Chloral-urethan, represented 
 by the formula C T H, 2 CL0 3 X, and claimed to be a complex body, not a simple mixture of 
 its constituents. It occurs as a colorless liquid, resembling chloroform in its behavior 
 with cold water, with which it forms globules and refuses to mix or dissolve. It is 
 soluble in hot water, in alcoholic solutions, and in alcohol, 3 parts in I. The advantage 
 claimed for Somnal is that when administered in 20-grain doses it induces within half an 
 hour a quiet sleep lasting from six to eight hours without any inconvenient results. 
 Doses of 45 and even 60 minims produced no depression of the circulation or respira- 
 tion. In doses of 3 ss its action is usually very prompt, the dose is well borne, easily 
 taken (in a little syrup of tolu or whiskey), and entirely without deleterious results. 
 The effects are much more striking and certain than those of Urethan, and far less 
 depressing than those of Chloral ; and there is no vertigo or depression, as may follow 
 the use of Sulphonal. In drachm-doses, this drug is not powerful enough to decidedly 
 control delirium tremens, maniacal delirium or severe pain. ^Dr. Gilman Thompson.) 
 
 Somnal manifests its hypnotic and sedative action to best advantage in the insomnia 
 of convalescence from acute disease, but where an adynamic condition exists it must be 
 used with caution. In whooping-cough, spasmodic laryngitis, asthma, the so-called 
 "nervous cough" and in chorea, it shows decided sedative properties. A great element 
 of safety in its use is that its action is never out of proportion to the quantity ingested, 
 nor does it act in a cumulative or other unexpected manner. It seems to have little or no 
 influence over insomnia due to acute inflammation. | Myers. | It is injurious in acute 
 mania and general paralysis, but is of great value in cases of melancholia, in which it 
 promotes sleep and produces a soothing effect on the mental condition by removing 
 depression and gloomy forebodings. It is contra-indicated when the digestion is out of 
 order. (De Montyel.j 
 
 Official Analogue of Chloral. 
 
 Paraldehydum, Paraldehyde, — is described under its own title. 
 
 V 'agues of Chloral. 
 
 Amylene Hydrate, C 5 H T2 0. Di-methyl-ethyl-carbinol, — is a tertian- alcohol, occur- 
 ring as a clear, colorless fluid, of peculiar odor, soluble in 8 of water and readily miscible 
 with alcohol. It is one of the most valuable hypnotics, in power standing between 
 chloral and paraldehyde, but being much more agreeable to the taste and safer than either 
 of those agents. Its action is exerted chiefly on the cerebrum in doses sufficient to pro- 
 
256 CHLORAL. 
 
 duce profound narcosis ; while in medicinal doses it leaves behind no unpleasant effects 
 and has no perceptible influence on the heart or respiration, these being paralyzed, how- 
 ever, by very large doses. Dose, ^j-jss. 
 
 Dormiol, Amylene-chloral, — is a mixture of one molecule each of chloral and amyl- 
 ene hydrate, forming a colorless, oily fluid. It is a prompt, reliable and safe hypnotic, 
 in doses of ^ss-j of the 10 per cent, aqueous solution, in which it is marketed. 
 
 Chloral Butylicum, Croton- Chloral, — is described under its own title. 
 
 Hypnone, C 6 H 5 (CO)(CH 3 ), Phenyl-methyl-acetone, — is a member of the Ketones, 
 occurring above 70 F. as a colorless, mobile liquid, insoluble in water or glycerin, and 
 best given in capsules. It is a hypnotic of only moderate intensity, but said to be espe- 
 cially useful in the insomnia of alcoholism. Its use is devoid of danger, and leaves behind 
 no unpleasant effects, except a disagreeable odor of the breath. In very large doses it 
 has induced coma, followed by paralysis of the heart and respiration. Dose, TT\,v-x, in 
 capsule, TT^vij or TT\,viij being usually required. 
 
 Methylal, CH 2 (OCH 3 ) 2 , Methylene-di-methyl Ether, — is one of the products of the 
 oxidation of Methylic Alcohol, occurring as a volatile, mobile liquid of pleasant, aromatic 
 odor and taste, readily soluble in water, alcohol, etc. It is a local anesthetic, and an 
 efficient hypnotic, producing a deep sleep of short duration, with more or less general 
 anesthesia and lowered reflex excitability. It is depressant to the heart, respiration and 
 body-temperature, but in medicinal doses does not cause any bad after-effects. Dose, 
 Ttyv-v, repeated thrice at short intervals. 
 
 Urethan, Ethyl Carbamate, NH 2 C0 2 C 2 H 5 , — occurs in crystals- which are readily 
 soluble in water, with scarcely any taste or odor. It is a pure hypnotic, but a mild one 
 at best, and not so reliable as paraldehyde or chloral. It does not affect the circulation, 
 nor does it depress (but rather stimulates) the respiration. It acts directly on the cerebrum, 
 causing a sleep which closely resembles the normal, and has no unpleasant after-effects. 
 In very large doses it slows the heart, lowers the temperature, and induces muscular reso- 
 lution and general anesthesia. In small animals it effectually antagonizes the action of 
 Strychnine. Dose, gr. xv-^j, an average hypnotic dose being gr. xxx ; but it is best given 
 in 5 grain doses repeated frequently, as a large dose may cause vomiting. It is a safe and 
 efficient hypnotic for children. (Squibb.) 
 
 Physiological Action. 
 
 Chloral is a powerful hypnotic, also an antispasmodic, an antiseptic, a 
 preventive of the coagulation of fibrin, indirectly an anesthetic, and es- 
 pecially a depressant of the cerebral, medullary and spinal centres and of 
 the cardiac muscle. It is more hypnotic than chloroform but less anes- 
 thetic. Applied to the skin or mucous membranes a 1 per cent, solution 
 (gr. v ad £j) is antiseptic, but strong solutions are irritant and vesicant, 
 may produce sloughing ulcers, and if taken internally may excite gastritis 
 with nausea and vomiting. 
 
 After a brief period of stimulation a medicinal dose depresses the 
 heart, dilates the peripheral vessels and lowers arterial tension, diminishes 
 oxidation and decreases the body-temperature. On the brain cells it has 
 a selective action, producing a deep sopor very like normal sleep, from 
 which the patient may be awakened, but immediately falls asleep again, 
 and which is not followed by headache or depression. This effect is con- 
 sidered by some authorities to be the result of cerebral anemia produced 
 by the drug. In some persons, instead of sleep it causes headache, in- 
 somnia and delirious excitement. It is not an anodyne, as it does not 
 affect the conductivity of the sensory nerves, and does not interrupt the 
 transmission of pain ; but by overwhelming the centres it drowns the 
 
CHLORAL. 257 
 
 consciousness of pain, and is therefore indirectly anesthetic. A toxic 
 dose produces profound narcotism, abolishment of reflexes and sensibil- 
 ity, complete muscular relaxation, and a great fall of body-temperature. 
 Death may result in the chloral sleep from paralysis of the respiratory 
 centre or the cardiac motor ganglia, or by sudden failure of the heart- 
 muscle in cases of fatty degeneration or in old drunkards. 
 
 On the blood its action is to increase the fluidity, to crenate the red cor- 
 puscles, and to destroy the leucocytes if used in large quantity. It is 
 rapidly diffused and is excreted by the kidneys partly unchanged, but 
 chiefly as urochloralic acid, producing some diuresis, — also by the skin, 
 causing various eruptions if used for any lengthened period. It has been 
 held that the blood, being an alkaline fluid, decomposes it, setting free 
 chloroform, but there are many facts against this theory. 
 
 The Chloral habit produces a state of marked anemia and muscular 
 weakness, especially of the legs; its subject presenting a weak, irritable, 
 often irregular heart, deranged hepatic functions, jaundice, bileless stools, 
 perhaps purpura and sloughing of a finger from decreased blood-supply. 
 Its votaries are on the border of insanity, excitable, uncontrollable in 
 speech and action, talking in a silly manner and very volubly, and show- 
 ing a marked loss of power of the limbs, so much so as to simulate paral- 
 ysis thereof. Many cases of insanity have their origin in chloralism. 
 
 Chloral and Atropine, though antagonistic in their action on the spinal 
 cord, both produce motor paralysis, the former by paralyzing the cord, 
 the latter by direct paralysis of the motor nerves. 
 
 Antagonists and Incompatibles. 
 
 Atropine antagonizes its cardiac, respiratory and spinal depression, and should be in- 
 jected in small doses frequently repeated, until its effects are apparent. Morphine ad- 
 ministered with Chloral antagonizes the tendency to cardiac failure, while synergistic to 
 the hypnotism. While Chloral is the antagonist to Strychnine, opposing the spinal action 
 of that drug, the reverse is true only to a very limited extent ; yet in a case described by 
 Dr. Colenso in the British Medical Journal, Nov. 3, 1 894, in which recovery occurred 
 after the ingestion of an ounce of Chloral, nine-tenths of a grain of Strychnine was em- 
 ployed by hypodermic injection in broken doses. Heat is a necessary' application, to 
 maintain the body-temperature. Artificial Respiration should be employed if required. 
 All Alkalies are incompatible with preparations containing Chloral. 
 
 • 
 
 Therapeutics. 
 Chloral Hydrate is of great value as a hypnotic and antispasmodic, 
 but must be cautiously used if at all in persons with weak or fatty heart, 
 atheromatous vessels or advanced pulmonary disease. In combination 
 with Potassium Bromide it is much used in asylum and general practice, 
 and equally abused, both drugs being active cardiac poisons. It is by far 
 the best hypnotic in acute mania and in delirium tremens, but has been 
 too incautiously employed therein. The condition of acute alcoholic 
 intoxication seems, however, to antagonize its depressant action on the 
 17 
 
258 CHLORAL. 
 
 heart to a great extent, even in old topers, for 30-grain doses, repeated 
 twice within 7 or 8 hours, are commonly used in inebriate asylums and 
 by police surgeons, for the purpose of straightening up a case of acute 
 alcoholism, with no fatal effects resulting from its direct action. Chloral 
 possesses marked power to relax spasmodically contracted unstriated 
 muscle and to dilate the peripheral vessels, properties which govern its 
 employment in many morbid conditions. Associated with Potassium 
 Iodide it is of service in bronchial asthma, and has been used in the form 
 of an enema for checking hemoptysis by the revulsion which it produces 
 in dilating the cutaneous vessels. Chloral is exceedingly efficient as a 
 gastric antiseptic and sedative in the so-called nervous dyspepsia of neu- 
 rotic persons, characterized by severe pain in the cardiac region of the 
 stomach. It is very serviceable in fevers, when high temperature exists 
 with excitement, restlessness and a sthenic condition, as it lowers tem- 
 perature and prevents the coagulation of fibrin. In the algid stage of 
 cholera and in violent cases of cholera morbus it has been injected hypo- 
 dermically in 15 -grain doses with extraordinary efficacy. In sea-sickness, 
 small doses (gr. v) two or three times a day are generally very efficient. In 
 obstetrics it is used to relieve suffering, relax the os uteri, palliate convul- 
 sions and relieve afterpains. For nocturnal epilepsy a full dose at bedtime 
 is a useful palliative. In neuralgia it maybe triturated with Camphor and 
 applied over the course of the affected nerve, and the same mixture is 
 efficiently employed as a local application for toothache and earache. 
 
 Chloral is well borne by children, and is an excellent remedy for in- 
 fantile convulsions and colic, chorea, whooping-cough, laryngismus stri- 
 dulus and the first stage of diphtheria, but it should not be used when the 
 first sound of the heart becomes dull and weak. It is highly efficient for 
 the purpose of calming children in scarlet fever. In these affections it 
 may be given with paregoric, as its combination with Opium enhances 
 its value and guards the patient against its dangers. Its hypnotic power 
 in adults is much increased by the conjoint administration of laudanum 
 or morphine, and this combination is an excellent remedy in colic, 
 cholera and cholera morbus. Tetanus is well treated by Chloral and 
 Potassium Bromide given together in full doses. In Strychnine poison- 
 ing Chloral is the antagonist. It is generally given by the mouth in very 
 dilute solution with some simple elixir, syrup of tolu, or cinnamon-water, 
 but is well absorbed by the rectum. Its hypodermic administration is 
 liable to result in great local irritation and even sloughing ulcers. 
 
 Chloral may be applied to the skin as an antipruritic in the eruptive 
 diseases, for which purpose it is well combined with Carbolic Acid, ten 
 grains of each to an ounce or two of water or oil. It is said to be the 
 best of all local applications for boils, gjss in ^iv each of glycerin and 
 water constantly applied to the boil by a tampon of cotton. For ulcers 
 
CHLORAL BUTYLICUM CHLORALAMIDUM. 259 
 
 and cancers a 25 per cent, solution is a good antiseptic and anodyne 
 application. 
 
 The chief contra-indication to the use of Chloral is the presence of 
 a cardiac affection, although it may be prescribed with much benefit in 
 neurotic palpitation of the heart and in pseudo angina pectoris. Other 
 contra-indications are rosacea, or a tendency to it, and hysteria of grave 
 character. It readily produces congestion of the face, and in hysterical 
 subjects it may excite paroxysms of delirium and hallucinations. 
 
 CHLORAL BUTYLICUM, Butyl-chloral Hydrate, Croton-chloral, C 4 H 5 C1 3 - 
 0,H 2 (Unofficial), — is formed by the action of Chlorine upon Aldehyde, adding to 
 the Butyl-chloral thus produced the necessary water. It occurs in crystalline scales, 
 insoluble in chloroform, sparingly soluble in water, (I in 100), but freely soluble in alco- 
 hol, in hot water and in glycerin, (1 in 4). Dose, gr. v-xx, in syrup or pill ; — but the 
 best method is to give 5 grains every half-hour until 20 grains have been taken or 
 until relief is afforded. 
 
 The action of Croton-chloral closely resembles that of chloral, but it is feebler as a 
 hypnotic, less depressant to the heart, and generally less poisonous, but more disagreeable 
 to the taste. It has a specific paralyzant power over the fifth nerve, and over its distribu- 
 tion causes an anesthetic condition long before it produces general anesthesia (Liebreich). 
 It has been used with benefit in various neuralgia;, especially tic-douloureux, also in 
 sciatica and dysmenorrhea. All statements concerning the action and therapeutics of 
 this drug are to be received with hesitation, as wide differences therein are reported by 
 the best authorities. 
 
 CHLORALAMIDUM, Chloralamid, Chloral Formidate, (Un- 
 official), is chemically a union of Chloral Anhydride (C 2 HC1 3 0) with 
 Formamide (CHO.NH 2 ). It is a proprietary drug, having been both 
 patented and trade-marked, wherever possible, by its proprietor and ex- 
 clusive manufacturer, Schering, of Berlin. It occurs as colorless, faintly 
 bitter, odorless crystals, which are decomposed in hot water or warm 
 solutions, and are soluble in 20 parts of cold water, or in 1^ of alcohol; 
 rapidly decomposed by caustic alkalies and slowly by alkaline carbonates. 
 
 The Dose is put at from 10 to 60 grains. The average adult hypnotic quantity is about 
 30 grains, given in a teaspoonful of whiskey or brandy, or in any alcoholic compound ; 
 for example, 30 grains in 2 drachms each of" Tinct. Cardamom. Co. and Elixir Simplex, 
 at one dose. By some observers 45 grains are considered the limit of safe dosage and 
 equal to 30 grains of Chloral Hydrate ; by others this amount is considered necessary for 
 its certain hypnotic action. Sixty grains have frequently been administered, and in one 
 case 140 grains were taken at one dose, without producing unpleasant symptoms ; — but, 
 as Dr. Steele has pointed out, the slow solubility of the drug in the watery contents of 
 the stomach must be taken into account, and when considering its effect, the action of the 
 menstruum and the condition of the gastric mucous membrane should be known. 
 
 Physiological Action and Therapeutics. 
 The action of Chloralamid is essentially hypnotic ; it has been exten- 
 sively advertised as the least depressant and most efficient sleep-producer 
 at our command, without unpleasant after-effects from ordinary doses, 
 except in 2 per cent, of the cases in which used, 1 per cent, having gastric 
 and the other 1 per cent, having cerebral symptoms ; while these were 
 
26o CHLOROFORMUM. 
 
 always slight unless the dose of 30 grains had been exceeded. The more 
 severe and unusual effects (from doses above 30 grains) are vertigo, thirst, 
 nausea, dry mouth, vomiting, anorexia, slight delirium, cardiac weakness, 
 rapid and feeble pulse, and restlessness. The drug does not seem to have 
 any cumulative action, or any tendency to provoke a habit of using it. 
 It is also credited with considerable analgesic power in certain conditions 
 (see below), as well as with anti-dyspneic and anti-hydrotic action. 
 
 The main field for the use of Chloralamid is found in the treatment of 
 insomnia, particularly the simple or idiopathic form, and when not due 
 to excitement or severe pain, but from nervousness, hysteria, chronic 
 alcoholism, and similar states ; also in that accompanying typhoid fever, 
 asthma (both cardiac and bronchial), organic heart disease, the opium 
 habit, and diabetes mellitus (Steele). It is less effective in organic 
 nervous affections and mental disorders, and is useless in these conditions 
 when the insomnia is due to excitement, hallucinations, or severe pains. 
 As an analgesic, it has lessened and checked the pains of aneurism, car- 
 cinoma of the stomach and liver, sarcoma of a rib, erysipelas, rheumatic 
 fever, gall-stone, etc.; and in dysmenorrhea it has given entire relief, 
 used just as the painful period approached, in a single dose of 30 grains. 
 It has been reported curative of chorea, in doses of 15 grains thrice daily 
 for five days, in a boy of eleven years ; and in a girl who had resisted all 
 other treatment for the same affection, it was successful in 8 days. 
 
 Compared with Sulphonal, Chloralamid is preferred for all cases in which collapse is 
 feared, by reason of its apparent freedom from depressant action on the cardiac centres or 
 the respiratory mechanism. In phthisis it has proven efficient against the most obstinate 
 night-sweats, while at the same time securing rest in cases in which the cough was not 
 very violent. To secure its best hypnotic results, the drug should be given about an 
 hour and a half before sleeping-time, in a dilute alcoholic menstruum, and on a stomach 
 containing little or no watery fluids to interfere with its solution and absorption. 
 
 CHLOROFORMUM, Chloroform, CHC1 3 (or CHC1 2 C1), Ab- 
 solute Chloroform, the Terchloride of Methyl, or the Chloride of Bichlor- 
 inaied Methyl (Di-chlor-methyl Chloride), — is formed by the substitu- 
 tion of 3 atoms of Chlorine for 3 of Hydrogen in Methyl Hydride 
 (marsh-gas, CHJ. In practice it is obtained from Ethylic Alcohol or 
 Methylated Spirit by the action of Chlorinated Lime, or from Chloral 
 by an alkaline hydrate, and is known chemically as Normal Chloroform. 
 If prepared from Methylic Alcohol (wood-spirit) it is called Methylic 
 Chloroform, and is purified with great difficulty. The object of purifica- 
 tion is to remove the chlorinated pyrogenous oil. Absolute Chloroform 
 has a sp. gr. of 1.500, and decomposes easily in sunlight or diffused day- 
 light, but when reduced to a sp. gr. of 1.485 to 1.490 by alcohol it will 
 keep well. The official form is — 
 
 Chloroformum, Chloroform, CHC1 3 , — a liquid consisting of 99 to 
 
CHLOROFORMUM. 26l 
 
 99.4 per cent, by weight, of absolute Chloroform, and 0.6 to 1 per cent, 
 of Alcohol. A heavy, clear, colorless, mobile and diffusible liquid, of 
 characteristic, ethereal odor, a burning, sweet taste, neutral reaction; 
 volatile, not inflammable ; soluble in 200 of water, freely so in alcohol 
 or ether, also in oils, benzol orbenzin. Sp. gr. not below 1.490 at 59 F., 
 or 1.473 at 77° F. Dose, internally, wlij-xx, for inhalation gss-j, re- 
 peated until the desired effect is produced. 
 
 Chloroformum Venale, Commercial Chloroforyn, (Unofficial), — is a liquid containing 
 at least 98 per cent, of Chloroform, and having a sp. gr. not lower than 1. 470. It con- 
 tains sundry Hydrocarbons, free Chlorine, Aldehyde and Hydrochloric Acid, and is used 
 only for external applications, or to make the purified article. 
 
 Preparations. 
 
 Aqua Chloroformi, Chloroform Water, — a saturated solution, prepared by agitating 
 an excess of chloroform in distilled water and pouring off the needed quantity of the 
 solution. Dose, ^ss-^ij. 
 
 Emulsum Chloroformi, Emulsion of Chloroform, — has of Chloroform 4, Expressed 
 Oil of Almond 6, Tragacanth \]/ 2 , Water to 100. Dose, 3J-^j. 
 
 Spiritus Chloroformi, Spirit of Chloroform, — has of Chloroform 6, Alcohol 94. 
 Dose, TT\x-3J, well diluted. 
 
 Linimentum Chloroformi, Chloroform Liniment, — has of Chloroform 30, Soap 
 Liniment 70. 
 
 Linimentum Chloroformi Compositum, Compound Chlorofor?n Linime?it, (Un- 
 official), — has of Chloroform 3 j, Oil of Turpentine J j, Tincture of Opium ^ ss, Tincture 
 of Aconite ^ij. 
 
 Chlorodyne, (Unofficial), — is a celebrated secret mixture, put forth by Dr. J. Collis 
 Browne, of London, and since imitated by many others. It contains Morphine, Chloro- 
 form, Ether, Cannabis Indica, Hydrocyanic Acid, Capsicum, etc., and is powerfully 
 anodyne, antispasmodic and narcotic, and therefore highly dangerous in non-professional 
 hands. Dose, TT^x-xxx, according to the quantities of Morphine and Chloroform present, 
 these being the active agents in the preparation. A tabular comparison of the principal 
 formulae which are used in imitation of Browne' s Chlorodyne, with the formula of the 
 latter preparation itself, is given in the Appendix to this book, and will show the wide 
 differences between them in Morphine strength. A list of 25 formulae for Chlorodyne 
 was published in the Therapeutic Gazette for October, 1 883. 
 
 Tinctura Chloroformi et Morphinae (B. P.), — has been made official as a substitute 
 for Browne's Chlorodyne. Each dose of 10 minims contains of Chloroform V^l%, Ether 
 TT\,^3, Alcohol WJ-yi, Morphine Hydrochlorate gr. ^L, Dilute Hydrocyanic Acid Tr^, 
 Oil of Peppermint X\^, Fluid Extract of Liquorice tr^i^, Treacle and Syrup q. s. 
 
 Tinctura Chloroformi Composita (B. P.), — has of Chloroform 2, Alcohol 8, and 
 Compound Tincture of Cardamom 10. Dose, TT\xx-3J. 
 
 Anesthetic Mixtures containing Chloroform, — see under ^Ether, ante, page 114. 
 
 Some Unofficial Chlorinated Anesthetic Compounds. 
 
 Ethylene Bichloride, Dutch Liquid, Chloj'ic Ether, C 2 H 4 C1 2 , — is a rapid and power- 
 ful anesthetic, probably safer than Chloroform and less so than Ether. It always par- 
 alyzes the respiratory centre before the heart, so that its effects may be easily watched 
 and controlled. This is the substance which Guthrie supposed he had obtained when he 
 discovered Chloroform. 
 
 Ethylidene Chloride, Chlorinated Muriatic Ether, CH 3 ,CHC1 2 , — is a mixture of 
 varying sp. gr., and is not inflammable. It closely resembles Chloroform both physically 
 and physiologically, but is less depressant to the heart, consequently safer, and recovery 
 from its effects is very prompt. 
 
 Methyl Chloride, CH 3 C1, — a colorless gas, slightly soluble in water, of sweetish odor 
 
262 CHLOROFORMUM. 
 
 and taste, inflammable, burning with a greenish flame. Cold liquefies it, and the liquid 
 boils at — 7. 6° F. It is used locally in neuralgia to produce intense cold, and with re- 
 markable success. 
 
 Methylene Bichloride, Dichloro-methane, CH 2 C1 2 ,— is an effective anesthetic which 
 it was supposed would displace Chloroform as being much safer. Dr. Richardson intro- 
 duced it and Sir Spencer Wells advocated its use, but though little used as compared with 
 other anesthetics several deaths have occurred from its employment. It kills by paralyz- 
 ing the heart. 
 
 Carbon Tetrachloride, CC1 4 , — is less irritant than Chloroform, but far more danger- 
 ous to the heart. 
 
 Physiological Action. 
 
 The action of Chloroform is similar to that of Ether (see ante, page 114) 
 with several important differences. It is more irritant to the mucous 
 membranes, and if swallowed undiluted it produces violent gastroenteri- 
 tis, which becomes apparent after the subsidence of the profound narcotism 
 which at first follows its ingestion in quantity. A dose of gj internally 
 may cause death, though recovery has taken place after the ingestion of 
 one, two and even three ounces (Wood). It clots the blood outside the 
 body, converting it into a mass resembling sealing-wax. 
 
 The inhalation of Chloroform produces sensations which are rather 
 agreeable than otherwise, and many persons acquire a liking for it. 
 After a few whiffs the patient experiences noises in the ears and flashes of 
 light before the eyes, also a feeling of weight upon the chest; the heart is 
 felt to be beating wildly and a throbbing sensation is felt in the carotid 
 arteries. In this first stage hysterical symptoms may become manifest, 
 the patient laughing, crying, screaming or swearing. The pulse is at 
 first quite rapid from nervousness, but soon falls in frequency and gains 
 in force. In a short time all sensation of discomfort passes away, the 
 patient becomes quiet, breathes easily, and is evidently comfortable. The 
 consciousness is soon affected, questions being heard but not fully under- 
 stood, and being answered hesitatingly and slowly and in an irrelevant 
 manner. After a brief period of repose there may be another spell of 
 excitement, during which the patient may struggle and endeavor to get 
 up ; but this soon passes away, and the muscles, which were contracted, 
 become flaccid, and the patient gradually assumes a condition of com- 
 plete insensibility. In this state all reflex action is abolished and pain is 
 not experienced; the pupils are contracted, and the limbs, when raised 
 and let go, fall heavily. Dangerous symptoms are: — (1) respiration be- 
 coming stertorous or shallow, (2) sudden dilatation of the pupils, (3) 
 signs of cardiac failure. 
 
 As compared with Ether the inhalation of Chloroform is less stimu- 
 lating, much more depressant to the vital functions, and much more 
 dangerous on account of its direct paralyzant action on the heart. Its 
 vapor is less irritant to the air-passages, uninflammable, more agreeable, 
 more prompt in action, produces much less subsequent vomiting, a shorter 
 
CHLOROFORMUM. 263 
 
 stage of excitement and a more profound degree of narcosis ; and should 
 be diluted with 96^ per cent, of air to produce anesthesia with safety, 
 according to the general teaching on this subject. Its mortality is much 
 greater, being about 1 in 5,600, against one in 13,000 for Ether, and fatal 
 cases continue to be reported, though none of these have occurred in 
 obstetrical practice. 
 
 The Hyderabad Chloroform Commission' s investigations, conducted under the direc- 
 tion of Dr. T. Lauder Brunton, led to the conclusion that Chloroform and Ether act in 
 the same manner upon the heart and respiration, both paralyzing the respiratory centre 
 before the heart, and Chloroform acting more quickly and powerfully than Ether in both 
 directions. Prior to this investigation it was taught that death from Chloroform is almost 
 always sudden and occurs by cardiac paralysis, while from Ether it is slow and usually 
 by paralysis of respiration. The subsequent researches of Gaskell, McWilliam and others 
 tend to sustain the latter view, and show that the verdict of the commission cannot be 
 accepted as conclusive. There is very little doubt but that Chloroform may paralyze the 
 heart without first affecting the respiration ; and it is probable that the paralysis of the 
 vaso-motor centre, and the consequent withdrawal of blood from the heart and brain to 
 the dilated splanchnic area, may be an important factor of a fatal result. Chloroform 
 undoubtedly exerts a powerful depressant action on the heart. Injected into the jugular 
 vein it instantly arrests the cardiac action, and destroys its muscular irritability. Its vapor, 
 applied to the exposed heart, paralyzes it, and even when artificial respiration is main- 
 tained the effect is very apparent. There can be no doubt but that Chloroform destroys 
 the contractile power of the cardiac muscle (Murrell). 
 
 At a certain stage of chloroform anesthesia women often exhibit marked 
 signs of sexual excitement, and on recovery it is not uncommon for them 
 to bring charges of improper conduct against some one present, with no 
 false intention but in the belief that impropriety actually occurred. It is 
 never safe to administer an anesthetic to a woman without the presence 
 of a third party (Murrell). 
 
 For the modes of dying from anesthesia see under the title ^Ether, 
 ante, page 115. 
 
 Treatment of Chloroform Poisoning. 
 
 There is no chemical antidote, and if the drug has been swallowed the stomach should 
 be evacuated and the case treated as one of irritant poisoning. Oxygen or Amyl Nitrite 
 may then be given by inhalation, and Strychnine or Atropine hypodermically to sustain 
 the heart. Artificial respiration should be used as soon as possible. 
 
 In cases of danger from Chloroform inhalation prompt measures must be taken. The 
 tongue should be pulled out with forceps and kept out. The doors and windows should 
 be thrown open so as to produce a current of fresh air, but care must be taken that the 
 body is not cooled thereby. The face and chest should be slapped with a wet towel, 
 and Artificial Respiration should be commenced at once and kept up for some time, not 
 faster than 20 to the minute. A succession of quick, sharp blows on the chest, over the 
 cardiac region, will sometimes provoke the heart to renewed action after it has apparently 
 failed. Venesection is wrongly neglected in such cases ; it relieves the right cardiac 
 engorgement, which is so constantly found at the autopsy. Galvanism may stimulate 
 the heart into action. Atropine hypodermically has rendered excellent service in several 
 cases in the author's experience. Strychnine is considered antagonistic by many authori- 
 ties, and has been used with good results. Oxygen is the best antagonist of all (Sayre). 
 
 Therapeutics. 
 Chloroform has a large field of therapeutic action besides its use as an 
 anesthetic. It is frequently employed in liniments as a rubefacient and 
 
264 CHLOROFORMUM. 
 
 anodyne application, also to promote the passage of other agents through 
 the epidermis, and to relieve itching. The vapor may be directed onto 
 the raw surface of an ulcer or a superficial burn in order to relieve pain ; 
 and that arising from a few drops placed in the hand and held close to 
 the eye will relieve photophobia. Internally it is administered with great 
 benefit in vomiting, colic, dysmenorrhea, and cholera morbus; also in 
 true cholera, in which disease it has probably been more efficient than any 
 other single remedy, and in gastric ulcer, gastralgia and other painful 
 affections of spasmodic character. In three to ten drop doses well diluted 
 it markedly improves all the functions of the stomach, and is a valuable 
 remedy for many gastric disturbances, especially acute dyspepsia. In 
 sciatica, tic-douloureux and other neuralgiae of important nerves the deep 
 injection of nr^v-xv of pure Chloroform in the vicinity of the nerve is 
 highly recommended, though it may cause dangerous local disturbance. 
 In several cases of severe supra-orbital neuralgia, the writer has injected 
 two or three minims of Chloroform into the vicinity of the supra-orbital 
 nerve just above its foramen of exit, with the most gratifying permanent 
 results, though severe local pain and considerable swelling were experi- 
 enced for several days. 
 
 The vapor of Chloroform inhaled in small quantities from warm water 
 or from a handkerchief is a very useful remedy in many neuroses, as hay- 
 fever, spasmodic asthma and reflex cough. It is one of the best pallia- 
 tives in the cough of phthisis, as was long ago pointed out by Spencer 
 Wells. It may be used with much benefit as a pulmonary antiseptic in 
 many affections of the air-passages, as acute nasal catarrh, influenza and 
 bronchitis ; and has promptly checked a severe case of catarrh extending 
 into the antrum and causing great pain. Carried to the production of 
 muscular relaxation it is often used as an aid to diagnosis, especially in 
 cases of malingering, in suspected disease of the abdominal viscera, 
 and to aid in reducing dislocations and hernise. It is used with great 
 benefit in parturition, decreasing the sensibility to pain, relaxing the 
 passages, and easing the labor, while it does not interfere with the uterine 
 contractions, or predispose to inflammation, hemorrhage or convulsions. 
 In such cases the quantity needed is very small, a few whiffs from time 
 to time being quite sufficient. In some cases, as in acute mania, a patient 
 may require to be kept under the influence of chloroform for a long time, 
 — for hours, days, or even weeks ; and this has been done in the digital 
 treatment of subclavian and other aneurisms. The writer, on one occa- 
 sion, kept an insane woman continuously under its influence for a period 
 of three weeks, except during the time necessary for taking food. 
 
 For the production of complete anesthesia the use of Chloroform is 
 steadily decreasing in favor of Ether, except for young children and in 
 obstetrical practice. Its vapor being four times denser than air, and the 
 
CHLOROFORMUM. 265 
 
 rule for its effective use requiring fully g6}4 per cent, of air with it, its 
 administration according to the orthodox fashion, requires most careful 
 management, and should never be attempted in any but the recumbent 
 posture. An ounce of Brandy and a hypodermic injection of Morphine, 
 gr. i, with Atropine, gr. yj^, given 20 minutes before commencing the 
 inhalation, are means of great utility in sustaining the heart and respira- 
 tion, as well as in rendering the anesthesia more profound. No opera- 
 tion, especially on parts supplied by the fifth nerve, should be undertaken 
 during partial chloroform anesthesia, for the reasons given on page 115. 
 For the Schleich method with a mixed anesthetic see under ^Ether, ante, 
 page 117. 
 
 Dr. Luckett, of Mt. Sinai Hospital, New York, in ten years adminis- 
 tered chloroform in 4,263 cases with but one death, and ether in 4,673 
 cases with no death. Syme administered chloroform in 5,000 cases with- 
 out a single death, and ascribed this excellent record to his adherence to 
 the following rule : " Never mind the pulse, never mind the heart, leave 
 the pupil to itself, but keep your eyes on the breathing, and if it becomes 
 embarrassed to a grave extent, pull the tongue well out with an artery 
 forceps." The Edinburgh rule is practically this: " Watch the respira- 
 tion, the heart will take care of itself"; but Professor Stewart suggests 
 that a second one should be inculcated, namely — " Watch both the 
 breathing and the pulse; and if the heart threatens to fail for want of 
 blood, fill it by raising the legs and compressing the abdomen." 
 
 The elder Sayre administered Chloroform in a manner which would startle an 
 uninitiated observer who is impressed by the orthodox rule of 96^ per cent, of air 
 with 2>Yz P er cent, of the anesthetic as the only safe proportion. Having been made 
 familiar with the practice of Dr. Sayre through observance of his methods as employed 
 by some of his pupils, the writer sought for more direct instructions from that distin- 
 guished surgeon, and received from him a letter from which the following paragraphs are 
 extracted : — 
 
 " I have employed no other method for more than twenty years, have used it in this 
 manner in some thousands of cases without the least appearance of danger, and can 
 therefore speak with confidence as to its safety. 
 
 "My plan is simply to anesthetize the patient with the smallest amount of Chloro- 
 form possible ; and as Oxygen is the Antidote to the anesthetic I exclude all air that is 
 not impregnated with the anesthetic. 
 
 "In this manner a very few inspirations will produce immediate anesthesia without 
 the muscular struggling which always follows when pure air is admitted with the chloro- 
 form. I always measure my dose with the same care as if I were administering Arsenic, 
 Strychnine, Corrosive Sublimate, or any other potent agent ; and then I know what I am 
 doing. If by accident there should be some peculiarity about the patient, making him 
 unduly susceptible, a few artificial respirations would soon remove the influence of the 
 few drops which had been inhaled, and thus all danger can be avoided. Five, ten, or 
 twenty drops of Chloroform administered in this manner is all that is requisite to pro- 
 duce immediate and profound anesthesia. I have explained my method hundreds of 
 times at my clinical lectures in Bellevue Hospital, many of which have been published 
 at different times in different medical journals by various persons who have made steno- 
 graphic reports of my lectures. In the ' Transactions of the International Medical Con- 
 gress,' held in Philadelphia in 1876, is a verbatim report of my remarks on this subject 
 made while I was performing an exsection of the hip-joint in the hospital before the 
 Congress." 
 
266 CHLORUM. 
 
 CHLORUM, Chlorine, CI, — is a greenish-yellow gas having a 
 suffocating odor, belonging to the Halogen group of elements; and 
 though not official itself, it is represented in medicine by several of its 
 compounds, as well as by several preparations which furnish it. 
 
 The so-called Halogen Elements derive their title from dAc, the sea, — because the 
 most important members of the group are obtained, directly or indirectly, from the ocean, 
 viz.: Chlorine, from sea- salt ; Bromine, from sea- water; and Iodine, from sea-weed. 
 They are all noted for their affinity for hydrogen, and consequent power as decomposers 
 of organic matter. 
 
 Chlorine Compounds, described under the titles of their respective 
 metallic bases, are — the Chlorates of Potassium and Sodium ; the Chlo- 
 rides of Ammonium, Calcium, Potassium, Sodium, Mercury, Gold, Iron, 
 Zinc, etc. ; — also Hydrochloric Acid, classed with the mineral acids (see 
 page 97), and Chloral, Croton-chloral, and Chloroform. 
 
 Preparations. 
 
 Aqua Chlori, Chlorine Water, — is an aqueous solution of Chlorine, containing at 
 least 0.4 per cent, of the gas ; and is prepared by heating together Manganese Dioxide 
 10 parts and Hydrochloric Acid 35, then saturating 400 of distilled water with the gas 
 so obtained. It is a clear, greenish-yellow liquid, of suffocating odor and disagreeable 
 taste. Dose, 3J-^ss, well diluted, as a lotion or spray; internally, npc-xx, in water. 
 Chlorine Water may be extemporaneously prepared by mixing in a mortar Chlorate of 
 Potassium 40 grains and Hydrochloric Acid ]/ 2 ounce, and adding a pint of distilled 
 water by agitation during the evolution of the vapors. If done in a closed vessel danger 
 may arise from the explosive gas, C1 2 4 , which is liberated at the same time. It should 
 be quickly bottled. 
 
 Calx Chlorata, Chlorinated Lime, Chloride of Lime, — is a compound resulting 
 from the action of Chlorine upon Calcium Hydrate, and containing at least 35 per cent, 
 of available Chlorine. It is obtained by exposing slaked Lime to the action of Chlorine 
 gas as long as the latter is absorbed, and should not be confounded with Calcium Chlo- 
 ride (see ante, page 234) . It occurs as a whitish, dry powder or in friable lumps, gradually 
 decomposing in the air, of saline, disagreeable taste, and a feeble Chlorine odor, partially 
 soluble in water and in alcohol, and when dissolved in dilute Hydrochloric acid gives off 
 Chlorine gas. Dose, gr. iij-yj in water ; for external use a I to 3 per cent, solution. 
 Liquor Calcis Chloratce, B. P. , is a solution of I pound in I gallon of water. 
 
 Liquor Sodae Chlorata, Solution of Chlorinated Soda, Labarraque' s Solution, — a 
 pale-greenish liquid, of faint chlorine odor, and alkaline taste and reaction ; prepared by 
 adding together watery solutions of Sodium Carbonate 150, and Calx Chlorata 75, each 
 in water, then adding water up to 1000. Is an aqueous solution of several chlorine- 
 compounds of sodium, containing at least 2.6 per cent., by weight, of available chlorine. 
 Dose, n\x~3J in 20 parts of water. 
 
 Physiological Action. 
 In the presence of moisture Chlorine is one of the most powerful of 
 disinfectants and deodorants, and an antiseptic and antifermentive agent 
 of the highest activity ; its power in these respects being due to its affinity 
 for hydrogen, decomposing all bodies which contain hydrogen as a molec- 
 ular constituent, forming hydrochloric acid and setting oxygen free in 
 its nascent form (ozone). Administered internally, it is converted, on 
 reaching the stomach, into hydrochloric acid and chlorides, losing all 
 action on the organism in its own character. Locally applied, it is irri- 
 
CHLORUM. 267 
 
 tant to the skin and mucous membranes, producing a sense of heat, with 
 burning sensations and even vesication. Inhaled in any quantity, it 
 causes cough, sneezing, and spasm of the glottis, also inflammation of the 
 mucous lining of the air-passages and of the lungs. 
 
 Antidotes. 
 
 Ammoniacal Vapors inhaled after Chlorine to form Ammonium Chloride. Ammonium 
 Sulphide has a similar reaction, but should be inhaled in great moderation. Albumin is 
 the antidote if Chlorine preparations have been taken into the stomach, and a little Aqua 
 Ammonias, sufficiently diluted, may also be administered with advantage. 
 
 Therapeutics. 
 
 The Chlorinated preparations are used as disinfectants and deodorizers 
 of rooms, drains and discharges from the body. They are rarely used 
 about the person or clothing of patients by reason of the irritation pro- 
 duced by them when inhaled, and their power to destroy the color of 
 fabrics. In dilute solution they are well employed as local applications 
 in aphthae, gangrene, scarlet fever and diphtheria, in which their principal 
 action is to destroy fetor. The same may be said of their use in slough- 
 ing ulcers and gangrenous wounds, foul discharges, etc. , as they are rarely- 
 employed about the person in sufficient strength to have any destructive 
 effect on disease-germs. A strong solution of Chlorinated Soda is a good 
 application to bites of serpents and insects, to wash the hands after con- 
 tact with infectious material, and to prevent infection by the syphilitic 
 poison. A combination of Potassium Chlorate and Tinctura Ferri 
 Chloridi makes a solution of Chlorine, Euchlorine, Potassium Chloride 
 and Ferric Chloride when diluted with water, and gives one of the best 
 and most innocuous solutions of antiseptics. It makes an excellent gargle 
 for sore throats, simple or diphtheritic. Glycerin should never be added 
 to it, as the resulting mixture will be liable to explode violently. These 
 preparations have been administered internally in septic diseases, low 
 fevers, etc., but without producing any marked beneficial results, except 
 in diphtheria, for which disease the internal administration of Chlorine 
 Water diluted has many advocates among practicing physicians. 
 
 Chlorine gas is a powerful local stimulant, and has been used with 
 great benefit to promote healing in old ulcers. Absorbent cotton may be 
 exposed to the gas extemporaneously prepared as directed on page 266, 
 and bandaged on the surface of the ulcer. Chlorine inhalations were 
 used forty years ago, by Sir James Simpson and others, in phthisis pul- 
 monalis, with apparent benefit. 
 
 Chlorinated Lime, freshly prepared, in solutions of varying strength, 
 from 1 in 60 to 1 in 12, is used by hypodermic injection in Australia as 
 an antidote to serpent venom. The solution is injected into several 
 points above the wound, 20 to 100 minims being inserted at each place. 
 
268 CHRYSAROBINUM CIMICIFUGA. 
 
 In some cases this procedure causes great pain, but it does not seem to 
 induce any local inflammation, and it is highly efficient for the purpose 
 for which it is used. A common method of disinfecting a sick-room is 
 to place a pound of Chlorinated Lime into a canvas bag and immerse it 
 in a mixture of common Hydrochloric Acid, \ T / 2 pint, and Water 4^ 
 pints, allowing it to remain for 24 hours. A still better method is to 
 mix common salt, Manganese Dioxide and Sulphuric Acid in a saucer. 
 The Chlorine generated is heavier than atmospheric air, so that the vessel 
 should be placed on a high shelf and not on the floor, in order that it 
 may be diffused throughout the room. 
 
 CHRYSAROBINUM, Chrysarobin, — is a mixture of proximate principles ex- 
 tracted from Goa-powder, a substance found in cavities formed by decay in the wood of 
 the trunk of Andira Araroba, a Brazilian tree of the nat. ord. Leguminosae. It is com- 
 monly misnamed " Chrysophanic Acid" (one of the constituents of Rheum) — though easily 
 converted into that substance. Occurs as an orange-yellow powder, odorless and taste- 
 less, nearly insoluble in water and in alcohol, but readily soluble in ether, solutions of 
 alkalies and sulphuric acid. Dose, gr. y%. 
 
 Unguentum Chrysarobini, Chrysarobin Ointment, — Chrysarobin 5, Benzoinated 
 Lard 95 parts. Should be diluted for average use from I to 3 times. 
 
 In 20-grain doses Chrysarobin is a gastro-intestinal irritant, producing large, watery, 
 bilious stools, with repeated vomiting but not much nausea. Locally it produces diffuse 
 dermatitis, often followed by follicular and furuncular inflammation. It stains the skin a 
 dark yellowish-brown color, which may be removed by a weak solution of chlorinated 
 lime. The use of this remedy is confined to superficial parasitic skin diseases of vege- 
 table origin, and for psoriasis, in the latter affection being the best remedy known. It 
 may be used in weak ointment locally, and internally in y% -grain doses. 
 
 CIMICIFUGA, Black Snake-root, Black Cohosh, — is the rhizome 
 and roots of Cimicifuga racemosa, a plant of the nat. ord. Ranunculaceae, 
 native in the United States. It contains a Volatile Oil when fresh, resin, 
 tannic and gallic acids, also an acrid, crystallizable, neutral principle. 
 Cimicifugin or Macrotin is an impure resin obtained by precipitation from 
 a concentrated tincture by the addition of water. The active principle 
 has not been isolated. 
 
 Preparations. 
 Extractum Cimicifugae, Extract of Cifiiicifuga .-r- Dose, gr. j-v. 
 Extractum Cimicifugae Fluidum, Fluid Extract of Cimicifuga. — Dose, TT^v-xx. 
 Tinctura Cimicifugae, Tinctzire of Cimicifuga, — 20 per cent. — Dose, Tr\x-£jj. 
 Macrotinum, Macrotin, (Unofficial). — Dose, gr. ss-ij. 
 
 Physiological Action. 
 Cimicifuga is stomachic, antispasmodic, aphrodisiac, diaphoretic, diu- 
 retic and expectorant. Its taste is bitter and nauseous, resembling that 
 of Opium. It acts on the heart and circulation similarly to Digitalis, and 
 on unstriped muscular fibre like Ergot, but is much feebler in activity 
 than either of these agents. Small doses stimulate digestion and secre- 
 tion, the generative function and the menstrual flow, and especially the 
 
CINCHONA. 269 
 
 secretions of the bronchial mucous membrane and the kidneys. Full 
 doses slow the heart while increasing its force, raise arterial tension and 
 stimulate uterine contraction. Large doses dilate the pupils and produce 
 dimness of vision, vertigo, intense headache, nausea, vomiting, and in 
 some persons soporific and anodyne effects. 
 
 Therapeutics. 
 
 Cimicifuga closely resembles Digitalis in action, but it is safer, and 
 should be more frequently used when the latter drug is indicated. In 
 cardiac diseases it is very efficient, especially in weak or fatty heart where 
 Digitalis would be dangerous. It is a good stomachic tonic, particularly 
 in the irritable dyspepsia of alcoholism. As an expectorant it is used in 
 acute and chronic bronchitis. It is a good nerve tonic in delirium tre- 
 mens, and in functional impotence it is often efficient. In rheumatoid 
 arthritis and rheumatism of the localized muscular variety, as lumbago, 
 torticollis, intercostal rheumatism, etc., it is one of the most efficacious 
 remedies, having a strong affinity for the muscular system. Neuralgias of 
 various kinds are benefited by it, particularly ovarian neuralgia. Chorea 
 about the age of puberty is one of the affections in which it is most use- 
 ful, and the same may be said of the hysterical form of this disease. 
 
 Many uterine disorders are remarkably benefited by Cimicifuga, such 
 as amenorrhea, neuralgic and congestive dysmenorrhea, subinvolution, 
 spinal irritation due to some obscure sympathetic or neuralgic affection 
 of the womb, sympathetic pains and neuralgias arising from the so-called 
 irritable womb, passive menorrhagia, etc. In obstetrics it gives excellent 
 results when used to initiate uterine contractions, to check hemorrhage, 
 and to allay afterpains and nervousness after delivery. In puerperal 
 mania and peritonitis its good effects are frequently remarkable, and in 
 puerperal hypochondriasis it is strongly recommended by very high 
 authority. 
 
 CINCHONA, Peruvian Bark.— The Cinchona tree belongs to the 
 nat. ord. Rubiaceae and is a native of the eastern slope of the Andes, but 
 has been largely planted in India, Ceylon, Java and Burmah, with the 
 result of improving the quinine-yielding value of many species by culti- 
 vation. In late years the test of appearance has given way to that of 
 assay in judging of the various barks of commerce, and only those are 
 official which yield 5 per cent, of total alkaloids of which at least 2^ per 
 cent, must be Quinine. Yellow bark contains most Quinine (as high as 
 9 per cent, having been obtained from one specimen), pale bark contains 
 most Cinchonine and least Quinine, while red bark contains these alka- 
 loids in about equal proportions. The Columbian varieties afford the 
 largest percentage of Cinchonidine. The official species are : — 
 
27O CINCHONA. 
 
 Cinchona, Cinchona, — the bark of Cinchona Calisaya, Cinchona offici- 
 nalis, and of hybrids of these and of other species of Cinchona, yielding, 
 when assayed by a prescribed process, not less than 5 per cent, of total 
 alkaloids, and at least 2^ per cent, of Quinine. 
 
 Cinchona Rubra, Red Cinchona, — is the bark of Cinchona Succi- 
 rubra, containing not less than 5 per cent, of its peculiar alkaloids. 
 From it is prepared the Compound Tincture of Cinchona. 
 
 Bark may be administered in doses of gr. x-^j, but it is never used 
 now in substance, being bulky and very disagreeable to the taste. 
 
 The principal varieties of the sub-order Cinchonese, the barks of which are found in 
 commerce and are used by manufacturers of the alkaloids, are — Cinchona Calisaya, 
 Cinchona Flava, Yellow Bark, from Peru, Bolivia and India ; C. Succirubra, Red Bark, 
 from Ecuador, Java and Ceylon ; C. Condaminea, Pale Bark, from Ecuador and Peru ; 
 C. Pitayensis, Pitaya Bark, from New Granada ; C. Micrantha, Gray Bark, from Peru 
 and Bolivia. Altogether there are some 31 species acknowledged by botanists, and the 
 list is constantly increasing, from the tendency of the different trees to hybridize. Several 
 trees formerly acknowledged as Cinchonas are now placed in the genus Cascarilla, but 
 their barks are to be found on the market. Cuprea bark is from trees of the genus Rem- 
 ijia, growing in Columbia ; it contains Quinine and a peculiar alkaloid, Cinchonamine, 
 but no Cinchonidine. 
 
 Composition of Cinchona. 
 Cinchona bark contains 21 natural alkaloids (of which 4 are official), 
 8 artificial alkaloids, 2 simple acids, 2 tannic acids, a resinoid and a color- 
 ing matter, as follows : — 
 
 Quinine, C 20 H 24 N 2 O 2 , — a strong base, fluorescent, the most valuable of all the alka- 
 loids ; heated with glycerin to 374 F., it is converted into the isomeric base, Quinicine. 
 
 Quinidine, C 20 H 24 N 6 O 2 , — isomeric with Quinine, fluorescent, probably the most 
 powerful as an antiperiodic, but existing in very small quantity. 
 
 Cinchonine, C 19 H 22 N 2 0, — the least active of the official four, having about half the 
 therapeutic power of quinine. Not fluorescent. 
 
 Cinchonidine, C 19 H 22 N 2 0, — isomeric with Cinchonine, not fluorescent, one of the 
 most powerful of the alkaloids. 
 
 The other alkaloids are of no interest medicinally. 
 
 Kinic and Kinovic Acids, — are combined in the bark with the alkaloids. The for- 
 mer is used to make a Kinate of Quinine, and the latter occurs in non-official pharmacy 
 as Kinovate of Lime, an ingredient in Deloudre's Extract, which is used in Europe and 
 India for dysentery. 
 
 Kino-tannic and Kinovo-tannic Acids, — give to bark its peculiar and powerful 
 astringent qualities. They have not been fully studied. 
 
 Kinovin, — is a bitter, amorphous resinoid, which is resolvable into Kinovic Acid and 
 sugar. It is soluble in alcohol, but not in water. 
 
 Cinchona Red, — a reddish-brown, insipid, inodorous substance. 
 
 Preparations of the Bark. 
 Extractum Cinchonse, Extract of Cinchona. — Dose, gr. j-v. 
 Extractum Cinchonse Fluidum, Fluid Extract of Cinchona. — Dose, n\x-3J. 
 Tinctura Cinchonas, Tincture of Cinchona, — has of Cinchona 20, in Alcohol 
 °7 Vz* Water 25 and Glycerin 7^. Dose, gss-ij. 
 
CINCHONA. 271 
 
 Tinctura Cinchonae Composita, Compound Tincture of Cinchona, — has of Red 
 Cinchona IO, Bitter Orange Peel 8, Serpentaria 2, in Alcohol 85, Water 7^ and 
 Glycerin 7j^ ; and is intended to replace Huxham's Tincture of Bark (see below). 
 Dose, 3J-iv. 
 
 Infusum Cinchonae, Infusion of Cinchona, — has of Cinchona 6, Aromatic Sulphuric 
 Acid I, Water to 100. Is the only official infusion containing this acid. Dose, 3J-3J. 
 
 Huxham's Tincture of Bark, 1788 (Unofficial), is still used. Red Cinchona t ^iv, 
 Orange-peel ^ iij, Serpentaria gr. lxxx, Spanish Saffron gr. clx, Cochineal gr. lxxx, 
 Brandy !§ xl, digested for 4 days, expressed and filtered. Dose, 3 ss-ij. 
 
 Quinine and its Salts. 
 
 Quinina, Quinine, C 20 H 24 N 2 O 2 -f- 3H 2 0, — a white, amorphous or minutely crystal- 
 line powder, of alkaline reaction and very bitter taste, soluble in 1670 of water and in 6 
 of alcohol at 59 F. , in 23 of ether, 5 of chloroform, and readily in dilute acids. Dose, 
 gr. j-xx, or xl in special cases. Is insoluble in saliva. 
 
 Quininae Sulphas, Quinine Sulphate, (C 20 H 24 N 2 O 2 ') 2 .H 2 SO 4 -f 7H 2 0, — very light, 
 snow-white, fragile crystals, of very bitter, persistent taste, soluble in 740 of water and 
 in 65 of alcohol at 59 F., in 30 of boiling water, 3 of boiling alcohol, also in acidulated 
 water. Dose, gr. j-xx, or even gr. xl in special cases. 
 
 Quininae Bisulphas, Quinine Bisulphate, C 20 H 24 N 2 O 2 . H 2 S0 4 -f- 7H 2 0, — clear, col- 
 orless, efflorescent crystals or small needles, of very bitter taste and strongly acid reac- 
 tion, soluble in 10 of water with blue efflorescence, and in 32 of alcohol, in 59 F. 
 Dose, gr. j-xxx, or even gr. lx in special cases. 
 
 Quininae Hydrobromas, Quinine Hydrobr ornate, C 20 H 24 N 2 O 2 HBr -J- H 2 0, — color- 
 less needles, of very bitter taste, soluble in 54 of water and in 0.6 of alcohol at 59 F., 
 very soluble in boiling water and in boiling alcohol. Dose, gr. j-xx. 
 
 Quininae Hydrochloras, Quinine Hydrochlorate, C 20 H 24 N 2 O 2 HCl 4- 2H 2 0, — white 
 needles in tufts, of very bitter taste, soluble in 34 of water and in 3 of alcohol at 59 F., 
 in I of boiling water or alcohol. Is used hypodermically. Dose, gr. j-xx. An excel- 
 lent salt which should be more generally used ; 5 to 10 gr. doses are antipyretic. 
 
 Quininae Valerianas, Quinine Valerianate, C 20 H 24 N 2 O 2 C 5 H 10 O 2 -f- H 2 0, — white, 
 pearly crystals, of valerianic odor and bitter taste, soluble in 100 of water and in 5 of 
 alcohol at 59 F. Dose, gr. j-iij. It is supposed to be the only salt of Quinine affected 
 by the constituent acid. 
 
 Quininae Hydrochloras Carbamidata, Quinine Carbatnide Hydrochlorate (Unoffi- 
 cial), — is a new compound salt of Quinine and Urea, soluble in equal parts of water and 
 therefore admirably adapted for hypodermic administration in a 50 per cent, solution. It 
 is almost unirritating to the tissues, and is given subcutaneously in doses of gr. j-iij. 
 
 Chininum Amorphum Boricum, Amorphous Quinine Borate (Unofficial), — is a 
 new preparation, soluble in an equal quantity of water, and claimed by its introducers to 
 be as satisfactory as any Quinine salt, and better borne by the stomach than any other. 
 It is said to cause little or no congestion of the membrana tympani. 
 
 Euquinine, Quinine Ethyl-carbonate (Unofficial), — the ethyl-ether of quinine-car- 
 bonic acid, is said to be as efficient as quinine in malarial fever, with the advantage of 
 being tasteless in substance, though decidedly bitter in solution. Dose, gr. v-xv. 
 
 Tinctura Pyrexialis, Tinctura Antiperiodica, Warburg's Tincture (Unofficial), — is a 
 celebrated and formerly secret preparation. The formula, published in 1875 by the 
 originator, includes 16 ingredients, one of which (Confectio Damocratis, see page 568) 
 contained many drugs which are not now attainable. The tincture contained Quinine 
 Bisulphate, 2 per cent , with Aloes, Rhubarb, Camphor and several aromatic herbs. 
 Dose, ^j (about 9^ grains of Quinine Bisulphate) in 2 doses given 3 hours apart. 
 Hager's modification of the original formula is — Quinine Sulphate I, Spt. Camphorse 2, 
 Tinct. Aloes et Myrrhse 22, Alcohol 16. Dose, as above. Some of the preparations 
 now sold under this name contain few, if any, of the original ingredients. The so-called 
 Warbu?'g 3 s Pill is a most irrational form in which to administer this complex medicine, 
 even if it contains the proper constituents. 
 
272 CINCHONA. 
 
 Other Official Alkaloids and their Preparations. 
 
 Cinchonina, Cinchonine, C 19 H 22 N 2 0, — white, lustrous prisms or needles, of bitter 
 after-taste, almost insoluble in water, readily so in dilute acids and in 1 16 of alcohol at 
 59 F. Dose, gr. j-xxx or more. 
 
 Cinchoninae Sulphas, Cinchonine Sulphate (C 19 H 22 N 2 0) 2 H 2 S0 4 -f 2H 2 0, — white, 
 shining prisms, of very bitter taste, soluble in 66 of water and in 10 of alcohol at 59 F. , 
 and readily soluble in dilute acids. Dose, gr. v-xxx or more. 
 
 Cinchonidinae Sulphas, Oinchonidine Sulphate (C 19 H 22 N 2 0) 2 H 2 S0 4 -f- 3H 2 0, — 
 white, silky crystals, of bitter taste, soluble in 70 of water and in 66 of alcohol at 59 
 F., freely soluble in acidulated water. Dose, gr. j-xx or more. 
 
 Quinidinae Sulphas, Quinidine Sulphate (C 20 H 24 N 2 O 2 ) 2 H 2 SO 4 -f- 2H 2 0, — white, 
 silky needles, of bitter taste, soluble in 100 of water and in 8 of alcohol, readily in acidu- 
 lated water, at 59 F. Dose, gr. j-xx or more. It is not so bitter as Quinine, is less 
 expensive, and is a valuable antipyretic and antiperiodic. 
 
 Unofficial Preparations. 
 
 Chinoidinum, Chinoidin, Quinoidin, — a mixture of alkaloids, mostly amorphous, 
 obtained as a by-product in the manufacture of the crystallizable alkaloids from Cinchona. 
 A black solid when cold, plastic when warmed, of bitter taste, almost insoluble in water, 
 freely soluble in alcohol and in dilute acids. It contains the 4 alkaloids in amorphous 
 condition, and has about % the therapeutic power of Quinine. Dose, gr. v-xxx or more. 
 
 Quinquinina, Quinetum, — is an Indian preparation containing the total alkaloids 
 extracted from bark by acidulated water, then precipitated by soda and dried. In India 
 it is called "febrifuge." 
 
 Cinchonidinae Salicylas, Cinchonidine Salicylate, — has anti-malarial power only 
 inferior to that of the salts of Quinine. 
 
 Substitutes for Quinine. 
 The synthetical production of Quinine has been the " philosopher's 
 stone " of the modern chemists, who have prosecuted with untiring energy 
 the search for an artificial product possessing all its properties. Though 
 in this they have as yet been unsuccessful, they have discovered several 
 organic bodies, which closely resemble each other and also quinine, both 
 in chemical constitution and physiological action. These substances 
 belong to the aromatic series of carbon compounds, all of which are de- 
 rivates of Benzene or Benzol, C 6 H 6 , the hydride of the organic radicle 
 Phenyl, C 6 H 5 . The distinctive action of the lower members of this series 
 is their antiseptic and antipyretic powers, — as that of the fatty series of 
 carbon compounds is stimulant and anesthetic (Brunton). Many of these 
 agents are obtained from coal-tar oil (petroleum) by fractional distilla- 
 tion, etc., and they are all derivatives of Benzene (Benzol), either 
 directly or from some one of the products formed therefrom by substitu- 
 tion, various radicles replacing the different constituent atoms of H and C. 
 
 Thus by the ring-arrangements of atoms peculiar to this series, there are formed from 
 Benzene (C 6 H 6 ), the following substances, viz.: — 
 
 Phenol, or Carbolic Acid, C 6 H 5 OH — by replacing H by OH (hydroxyl). 
 Pyrocatechin, or Ortho- \ CgH^OH),,. 
 
 Resorcin, or Aleta- > dioxy benzol, — by replacing 2H by 2OH. 
 
 Hydroquinone, or Para- ) C 6 H 4 (OH) 2 . 
 
CINCHONA. 273 
 
 Pyrogallol, Pyrogallic Acid, Tri-hydroxybenzene, C 6 H 3 (OH) 3 , — 3H by 3OH. 
 Amido-benzene, or Anilin, C 6 H 5 .NH 2 — by replacing H by NH 2 (amidogen). 
 Nitro- benzene, C 6 H 5 .N0 2 — by replacing H by N0 2 (nitroxyl). 
 Benzoic Acid, C 6 H 5 CO.OH— by replacing H by CO. OH (carboxyl). 
 Salicylic Acid, HC 7 H 5 3 — by replacing 2H by OH and CO.OH. 
 Naphtalin, C 10 H 8 — by uniting two Benzenes in an over-lapping ring. 
 Pyridine, C 5 H 5 N — by replacing tetrad C by triad N. 
 Chinolin, C 9 H 7 N — by uniting Benzene (C 6 H 6 ) and Pyridine (C 5 H 5 N). 
 
 Derived from Chinolin is the hypothetical base — 
 
 Chinicin or Quinicin, C 9 H 9 N 2 , — represented in Antipyrin. 
 Also Kairin, Thallin, and other compounds. 
 
 The most important of these are Antipyrin, Acetanilid, Resorcin, 
 Chinolin and Naphtalin, which are respectively described in separate 
 articles. Others of the same class are the following, viz.: — 
 
 Some Unofficial Antipyretics. 
 
 Kairinum, Kairin {Hydrochlorate of Oxy-ethyl-chinolin-hydride), C 10 H ]3 NO.HC1. 
 H 2 0, — is an artificial alkaloid prepared from Chinolin, belonging to the phenol group 
 of carbon compounds, and a powerful antipyretic in 8-grain doses hourly. It stains the 
 urine a deep green, and has not proven fatal though 220 doses have been administered 
 in one case. In some cases of typhus it has caused cyanosis and collapse. It produces 
 profuse sweating and vomiting, and the subsequent rise of temperature after its antipyretic 
 influence has worn off is generally ushered in by a severe rigor. It occurs in white 
 crystals, which are freely soluble in water, but is best given in wafer paper, or capsules. 
 Dose, gr. iij-xxx. 
 
 Kairolinum, Kairolin {Sulphate of Tetra-hydromethyl-chinolhi), — is antipyretic, but 
 much less efficient than Kairin. 
 
 Thallin, Tetra-hydro-parachinanisol, — is a synthetically prepared substance, having 
 also another chemical name, Tetra-hydro-paramethyl-oxy-chinolin. It occurs as a color- 
 less powder which is soluble in water, and enters into combination with acids, forming 
 salts, of which the tartrate and sulphate are the most eligible, especially the latter. The 
 dose of Thallin or its Sulphate ranges from gr. ij to gr. xv, a mean average dose being 
 about 5 grains, given in the form of compressed tablets. Thallin is an antipyretic of 
 very great power, doses of 5 to 1 2 grains lowering the temperature in typhoid fever 4 
 to 5 in 2 hours' time, the effect lasting nearly 3 hours. In tuberculosis similar results 
 were obtained. Large doses, however, produce very profuse sweating and a dangerous 
 degree of depression ; so that this agent is not a favorite remedy for hyperpyrexia. 
 
 ( Hydroquinone, Para-di-hydroxy-benzene, C 6 H 4 (OH) 2 , — is isomeric with Resorcin 
 (see ante, page 272). It crystallizes in rhombic, colorless prisms which are slightly sol- 
 uble in water, readily so in alcohol and in ether. It is obtained from Arbutin, a gluco- 
 side constituent of Uva Ursi and other Ericacese, by hydrolysis ; also from Anilin by 
 oxidation with chromic acid mixture and subsequent reduction of the Quinone thus 
 formed by sulphurous acid. It is an efficient antipyretic, without injurious effects so far 
 as observed, but its influence is only temporary. Dose, as an antipyretic, gr. xv-xx, best 
 given in alcohol. Gr. xl have been given without disagreeable effects. 
 
 Pyrocatechin, Catechol {Ortho-di-hydroxy-benzene), C 6 H 4 (OH) 2 , — is also isomeric 
 with Resorcin, and is one of the acid constituents of coal-tar, but is also obtained from 
 wood-tar and from kinic acid. It is a good antipyretic, but much inferior to Quinine or 
 Resorcin, and its use has been abandoned on account of its by-effects. 
 
 Physiological Action. 
 Cinchona is an astringent bitter and a stomachic tonic. At first it 
 promotes appetite, digestion, the flow of saliva and of gastric juice; long 
 continued it sets up a gastric catarrh, impeding digestion and causing 
 18 
 
274 CINCHONA. 
 
 constipation. The action of Cinchona in sufficient dose is generally that 
 of its alkaloid Quinine, except that the bark is decidedly astringent, more 
 of a gastric irritant, and its active principles are more slowly absorbed by 
 reason of its bulk. In large doses (3ij) the powdered bark has produced 
 flatulence and eructation, and in many well-authenticated instances has 
 apparently caused a well-marked febrile paroxysm, beginning with chill, 
 then fever and headache, which gradually subsided with slight perspira- 
 tion. So also, Quinine, while incapable of producing intermittent fever 
 in a healthy person, may, if taken in large doses unnecessarily, throw the 
 nervous system into high commotion, and if untimely used by a malarial 
 subject may reproduce the paroxysm with greater or less severity. 
 
 Quinine is a bitter tonic, antiseptic, antiperiodic and antipyretic, a 
 diminisher of reflex action, a protoplasmic poison and a cardiac depressant. 
 It is rapidly diffused and slowly excreted, being found in the urine in 15 
 minutes after its administration and for two or three days afterwards. 
 Occasionally it produces renal and vesical irritation. Its action on the 
 stomach is similar to that of cinchona. It arrests the movements of the 
 white blood-corpuscles though increasing their number, and prevents 
 acetification and decay of the blood. It is actively destructive of lowly 
 organized life, a solution of 1 in 500 being fatal to infusoria and fungi, 
 while one of double this strength prevents alcoholic fermentation and 
 checks putrefactive decomposition. The heart and arterial tension are 
 somewhat stimulated by small doses, but depressed by large ones (gr. 
 xl-lxxx), which slow and enfeeble the pulse by direct action on the car- 
 diac ganglia. The brain is rendered hyperemic and exhilaration is caused 
 by small or moderate doses, and large ones produce a train of congestive 
 cerebral symptoms, including a sense of fulness and constriction in the 
 head, tinnitus aurium, vertigo, staggering gait, amblyopia and deafness, 
 great headache, dilated pupils, delirium, coma, and in animals convul- 
 sions. The eyes and ears, though suffering severely, are rarely injured 
 permanently. The foregoing symptoms are collectively termed Cin- 
 chonism. 
 
 Quinine reduces the size of the spleen when enlarged, and lowers the 
 temperature of pyrexia by lessening oxidation, though it does not depress 
 the body-temperature in health. Large doses lower the reflex function 
 of the spinal cord. In some subjects it produces sexual excitement, in 
 others cutaneous eruptions sometimes followed by desquamation. It 
 lessens the excretion of uric acid but not that of urea, and is a 
 uterine stimulant in labor, but probably has no power to initiate uterine 
 contractions. 
 
 Quinidine and Cinchonidine correspond in action with Quinine both 
 qualitatively and quantitatively, the latter however producing less severe 
 head symptoms. Cinchonine also corresponds in effect, but is much the 
 
CINCHONA. 
 
 275 
 
 least active of the four alkaloids. It is said to produce greater headache 
 and much precordial pain and muscular weakness, but to have little effect 
 on sight or hearing. 
 
 Antagonists and Incompatibles. 
 
 Morphine antagonizes its cerebral action, Atropine its nervous, cardiac and antipyretic 
 powers. Free Tannic Acid is incompatible with the Infusion of Cinchona. Iodine 
 preparations, Alkalies, Alkaline Carbonates and Earths, are incompatible with solutions 
 of the alkaloids, the first-named forming insoluble compounds therewith and the latter 
 precipitating them. 
 
 Therapeutics. 
 
 Cinchona is used as a tonic, and has many applications. The Infusion 
 or Compound Tincture with a mineral acid is extremely serviceable in 
 atonic dyspepsia, gastric catarrh of alcoholics, adynamia, convalescence, 
 asthma, chronic bronchitis, and generally in weak subjects of flabby flesh 
 and freely perspiring skin. 
 
 Quinine finds its principal field of action in the malarial diseases, over 
 which its influence is specific, by reason of its power to prevent the de- 
 velopment of the plasmodium to which malaria is due. In intermittents, 
 a ten-grain dose of the sulphate should be given in the sweating stage and 
 again 5 hours before the expected time of the next paroxysm. In the 
 intervals Arsenic is better used, as quinine may cause a daily exacerba- 
 tion of temperature if long continued. In remittents from 20 to 30 
 grains are administered once or twice daily until the temperature becomes 
 normal, and in pernicious remittents doses of 30 to 60 grains are neces- 
 sary to the safety of the patient. In chronic malarial toxemia Chinoidin 
 is considered more effective than quinine. As a prophylactic against 
 malarial fevers the use of small doses of quinine, 3 to 5 grains daily, has 
 been universally approved until recently, especially in tropical countries. 
 Professor Koch considers this to be dangerous practice and to be respon- 
 sible for the increased death-rate in certain parts of West Africa during 
 late years. He holds that the indiscriminate use of quinine as a prophyl- 
 actic in malarial countries is in many cases the indirect cause of the per- 
 nicious " black-water " fever, one of the most virulent forms of malarial 
 disease ; also that this drug seriously weakens the action of the heart 
 when taken regularly in excessive doses, and will so inure the system to 
 its influence that it becomes useless as a remedy when required for that 
 purpose. 
 
 The Hypodermic Injection of Quinine is advocated by many authorities as more 
 effectual in obstinate cases than any other method of administration. It becomes neces- 
 sary in malarial fevers when vomiting is persistent and the rectum irritable, if the pa- 
 tient is insensible and cannot swallow, also when life is in imminent danger and the 
 earliest possible action of the drug is important (Manson). The best salts for hypo- 
 dermic use are the acid Hydrochlorate and the Hydrobromate, which are soluble in 
 their own weight of water ; but the Sulphate may be employed, its solution being 
 effected by adding one-half its weight of tartaric acid. Ten to fifteen grains dissolved 
 
2j6 CINCHONA. 
 
 in sterilized water would be a full hypodermic dose, which in grave cases should be 
 given three times in 24 hours, injected deeply into the substance of the gluteal or scap- 
 ular muscle. Laveran? s Formula for this purpose is — Quinine Hydrochlorate 3, Anti- 
 pyrin 2, Distilled Water 6 parts, giving a 50 per cent, solution, the injection of which is 
 painless. This solution was used extensively during a severe epidemic of malaria in 
 Algiers in 1894 and always proved satisfactory (Blum). In it is formed by chemical 
 transformation a new salt, named Chinopyrin, which is similar but not equivalent to the 
 quinine salt (Santesson). 
 
 Quinine is used as an antipyretic with good results, especially in septic 
 fevers, typhus, typhoid, variola, pneumonia and acute rheumatism. In- 
 flammations may, at their inception, be aborted by 15- or 20-grain doses, 
 combined with Morphine, which in this respect is synergistic to quinine. 
 Acute tonsillitis and acute catarrh may sometimes be aborted by a full 
 dose. In surgical fevers, pyemia and exhausting suppurative conditions, 
 also in septicemia, hectic fever, and before surgical operations, quinine 
 is much employed. Neuralgias of malarial origin are amenable to it, as 
 also neuralgia of the ophthalmic division of the fifth nerve. In eruptive 
 fevers, especially scarlet fever, erysipelas and measles, it is advantage- 
 ously administered throughout their course. In some skin diseases, par- 
 ticularly erythema nodosum, it is quite efficient, also in whooping-cough 
 and hay-fever. In the latter affection a solution of gr. vj of the neutral 
 hydrochlorate to the § is a very useful local application. Antipyresis 
 has of late received considerable attention, particularly in the German 
 hospitals. The most certain and safe of all antipyretics is undoubtedly 
 the cold bath, but it is not always the most practicable, especially in 
 private practice. Internal antipyretics are therefore of great value, and 
 of these the safest and best is Quinine, next in order being Lactophenin 
 and Phenacetin. 
 
 Warburg's Tincture has obtained a very high reputation in the hands 
 of Indian army-surgeons in the treatment of remittent and other malarial 
 fevers of the most malignant types, in malarial neuralgise, acute nervous 
 exhaustion and sudden collapse without organic disease. The most pro- 
 nounced testimony to its value is that of Dr. Maclean {Med. Times and 
 Gazette, Nov., 1875), whose authority will not be questioned by the most 
 captious. He affirms that the influence of this combination to arrest an 
 exacerbation of remittent fever is far more powerful than that of quinine 
 alone. The remedy has become much less of a favorite since its origina- 
 tor was induced to make public the secret of its composition. 
 
 The persistently bitter taste of quinine and its salts is best obviated by administering 
 them in pill form, made with glycerin as an excipient, or by using Licorice, Eriodictyon 
 or Chocolate to cover the taste if given in solution or powder. The taste is extremely 
 well covered by using as a vehicle a combination of Glycyrrhizin and Fluid Extract of 
 Eriodictyon, named " Velatine" but the Quinine must be suspended therein by the aid 
 of mucilage, for when an acid is used to dissolve it the bitter taste cannot be disguised. 
 
 For hypodermic use the best salt is the Carbamide Hydrochlorate, by reason of its 
 ready solubility and freedom from irritant quality. 
 
CINNAMOMUM COCA. 277 
 
 CINNAMOMUM, Cinnamon, — is official under the three following titles, viz. : — 
 
 Cinnamomum Cassia, Cassia Cinnamon, — is the bark of the shoots of one or more 
 undetermined species of Cinnamomum (nat. ord. Laurineae), grown in China. Is a con- 
 stituent of the compound tinctures of Cardamom, Catechu and Lavender. Cinnamo- 
 mum Saigonicum, Saigon Cinnamon, — the bark of an undetermined species of 
 Cinnamomum. Cinnamomum Zeylanicum, Ceylon Cinnamon, — the inner bark of 
 the shoots of Cinnamomum Zeylanicum. 
 
 The latter occurs in light, yellowish-brown quills, consisting of several pieces rolled 
 together, each very thin, while the Chinese variety comes in single quills of irregular 
 form and rougher texture. The taste is warm and aromatic, and the odor very fragrant. 
 The active principle is a Volatile Oil, and they also contain a resin, and tannic and cin- 
 namic acids. Dose, gr. x-xx. 
 
 Oleum Cinnamomi, Oil of Cinnamon, Oil of Cassia, — a volatile oil distilled from 
 Cassia Cinnamon. A yellowish liquid, soluble in an equal part of alcohol or of glacial 
 acetic acid. Becomes darker and thicker by age and exposure to air. Dose, gtt. j-v. 
 
 Aqua Cinnamomi, Cinnamon Water, — has of the Oil 2, triturated with Precipitated 
 Calcium Phosphate 4, and Distilled Water to 1000. Dose, indefinite. 
 
 Spiritus Cinnamomi, Spirit of Cinnamon, — has 10 per cent, of the oil in Alcohol 
 to 100. Dose, rr^v-xxx. 
 
 Tinctura Cinnamomi, Tincture of Cinnamon, — has of Ceylon Cinnamon 10, Gly- 
 cerin 5, Alcohol and Water to 100. Dose, ^ss-ij. 
 
 Pulvis Aromaticus, Aromatic Powder, — has of Ceylon Cinnamon 35, Ginger 35, 
 Cardamom 15, Nutmeg 15, triturated together to a fine powder. Dose, gr. x-xxx. 
 
 Extractum Aromaticum Fluidum, Aromatic Fluid Extract, — has of Aromatic 
 Powder 100 per cent, in Alcohol. Dose, n\x-xxx. 
 
 Cinnamon is an agreeable carminative, somewhat astringent and stimulant, also highly 
 aromatic and antiseptic. The Oil is not astringent but is a stimulant to the nervous and 
 vascular systems, and is by some believed to exercise a specific action on the uterus, par- 
 ticularly as a hemostatic. In overdoses it acts as an irritant and narcotic poison. 
 
 The various preparations are in general use as flavoring excipients, and the Aqua is a 
 pleasant vehicle for extemporaneous mixtures. The Bark and its preparations are used 
 to check diarrhea in combination with opium, chalk, or some vegetable infusion. 
 
 Cinnamon was formerly used with success in uterine hemorrhage, generally in com- 
 bination with sulphuric acid, which is itself an efficient uterine hemostatic. The Oil is a 
 good remedy for flatulence, paralysis of the tongue, cramp of the stomach, enteralgia and 
 similar complaints, and is sometimes used to check nausea and vomiting. It has an an- 
 cient reputation for healing properties, and its antiseptic powers have long been known, 
 especially on the mucous membranes, being utilized as an injection in gonorrhea. It 
 has lately been employed in France as an internal germicide, with great satisfaction; and 
 has given particularly good results in the treatment of typhoid fever, against the bacillus 
 of which disease it is believed, by its advocates, to have specific and destructive powers. 
 
 COCA, Coca, Cuca, — the leaves of Erythroxylon Coca, a small shrub 
 of the nat. ord. Linese, indigenous to the mountains of Peru and Bolivia, 
 and cultivated in those and other S. American states, also in India and 
 Java. Its odor is tea-like, its taste slightly bitter and aromatic. It con- 
 tains a crystalline alkaloid, Cocaine, C 17 H 21 N0 4 , which when heated with 
 HC1 is split up into methylic alcohol, benzoic acid and another alkaloid 
 named Ecgonine. In the Java leaves is found an alkaloid Tropacocaine, 
 which is als6 a compound of benzoic acid and a base. Other constitu- 
 ents are the alkaloids Cocamine, Isococamine, Homococ amine and Hotno- 
 isococamine, together with an aromatic oil and coca-tannic acid. The 
 leaves grown in Peru and Bolivia contain more cocaine than the others 
 and very small quantities of the other alkaloids ; those from India and 
 
2?8 COCA. 
 
 Java contain less cocain but a greater amount of the other alkaloids. 
 Coca should not be confounded with Cocoa, the seed of the chocolate- 
 tree, Theobroma Cacao. Dose of the leaves, 3j-iv. 
 
 Preparations. 
 
 Extractum Cocae Fluidum, Fluid Extract of Coca, — Dose, gss-ij. Leaves of good 
 quality are often so difficult to obtain that Dr. Squibb, the well-known pharmaceutist, 
 more than once omitted the fluid extract from his trade list, with the explanation that "it 
 is impossible to get Coca of proper quality for medical use." 
 
 Cocaina, Cocaine, C 1T H 21 N0 4 (Unofficial), — crystalline, colorless and of bitter taste, 
 soluble in 1300 of water, in 10 of alcohol, in 12 of olive oil, in 4 of oleic acid, in 4 of 
 ether and in l / z of chloroform. It has decided basic properties, combining with acids to 
 form salts. It exists in the leaves in very small quantity, — from 0.02 to 0.04 per cent. 
 Dose, gr. %-]. 
 
 Cocainae Hydrochloras, Cocaine Hydrochlorate, C 17 H 21 N0 4 HC1, also called Co- 
 caine Muriate, but is more properly Cocaine Chloride, — occurs in colorless crystals, odor- 
 less, of saline, slightly bitter taste, producing on the tongue a tingling sensation followed 
 by numbness. Soluble in 0.48 of water, and in 3^ of alcohol. Is used in aqueous 
 solutions of 2 to 10 or more per cent, hypodermically, or locally to mucous surfaces as a 
 local anesthetic. Dose, internally, gr. j^-j ; by hypodermic injection, gr. ^$-J£. 
 
 Cocainae Oleas, Oleate of Cocaine (Unofficial), — a 10 per cent, solution of the alka- 
 loid in Oleic Acid, for external use. 
 
 "Wines, Lozenges, Elixirs, Glyceroles, Pastes, etc., of Coca are being manufactured 
 and marketed in great variety. The Citrate and Salicylate of Cocaine are products of the 
 laboratory and may be obtained in the shops. 
 
 Celerina, (Unofficial), — a proprietary preparation said to contain in each fluid-drachm 
 gr. v each of Coca, Celery, Kola and Viburnum, with aromatics. Dose, gj-ij. 
 
 Tropacocaine, Tropain, Benzoyl-pseudotropeine (Unofficial), — was first obtained from 
 the Java coca leaves and was afterwards made synthetically. It is much less toxic than 
 Cocaine. The Hydrochloride is used to produce anesthesia of the eye. It produces 
 local anesthesia more rapidly than Cocaine, but for a shorter time, and causes less dilata- 
 tion of the pupil. Dose, gr. ]/%-}. 
 
 Physiological Action. 
 
 Coca is an aromatic bitter tonic, a diuretic and a cerebral and nervous 
 stimulant. Small doses improve digestion, stimulate respiration, increase 
 the heart's action after a brief depression, raise the arterial tension, and 
 increase the excitability of the sensory nerves. It stimulates the brain by 
 increasing its blood-supply, producing wakefulness, a sense of well-being, 
 and a marked diminution of the senses of fatigue, hunger and thirst. 
 Under its daily use a considerable amount of labor and loss of sleep can 
 be borne without suffering. Though diuretic, it lessens the quantity of 
 urea eliminated by checking the processes of waste. Large doses produce 
 impaired coordination, hallucinations and delirium. 
 
 Cocaine acts upon the lower animals similarly to Caffeine. It tetanizes 
 frogs, and in large doses paralyzes their sensory nerves and the posterior 
 columns of the spinal cord. It kills rabbits and dogs by paralysis of the 
 respiratory centre. In proper doses it raises arterial tension by stimulat- 
 ing the vaso-motor centres and the cardiac motor system. An effect of 
 cocaine, observed in mice, is a wide-spread destruction of the hepatic 
 
COCA. 279 
 
 cells, which become vacuolated and frequently necrosed, and the liver is 
 much enlarged and pale from fatty infiltration. 
 
 On man, in small doses Cocaine is a cerebral, cardiac, respiratory and 
 nervous stimulant and a prompt diuretic. It improves digestion, stimu- 
 lates respiration, increases the heart's action, raises the arterial tension 
 and exalts the irritability of the sensory nerves. It stimulates the brain 
 by increasing its blood-supply, producing wakefulness and marked dim- 
 inution of the senses of fatigue and hunger. Though decidedly diuretic, 
 it lessens the quantity of urea by checking the processes of waste, thus 
 acting as an indirect nutrient, and enabling the body to maintain its 
 energy on a lessened supply of food. It first decreases and then increases 
 the cutaneous circulation, flushing the surface, exciting perspiration and 
 a sense of heat, and does actually raise the body-temperature. It dilates 
 the pupil, both when locally applied and when taken systematically, and 
 stimulates intestinal peristalsis as well as the evacuation of the bladder in 
 a few minutes after its ingestion. 
 
 An overdose produces symptoms of cardiac and respiratory embarrass- 
 ment in a very short time. The pulse, at first quick and forcible, becomes 
 small, rapid and intermitting, the heart apparently standing still in 
 systole once in every 10 or 12 beats. Respiration is slow and shallow, 
 and a sense of tightness about the chest is often very marked ; the skin 
 grows cold and clammy, and the subject is seized with a sense of impend- 
 ing dissolution. Death occurs in animals by paralysis of the respiration, 
 but in man a tetanoid spasm of the cardiac muscle seems to occur, which 
 is equally dangerous to life. Maurel has shown that, as the capillaries 
 contract powerfully under the influence of cocaine, thromboses and 
 embolisms, particularly pulmonary embolisms, capable of causing fatal 
 accidents, may be produced thereby. It profoundly affects the leucocytes, 
 which become spherical and rigid, increase in size, and no longer adhere 
 to the walls of the vessels. Other symptoms are impairment of coordi- 
 nation, hallucinations and delirium. Lethal doses paralyze the intra- 
 cardiac motor ganglia, the posterior columns of the cord, the sensory 
 nerves, and the respiratory centre. 
 
 Several years ago, Satterwhite, as a result of the study of one hundred cases of 
 poisoning by this alkaloid, called attention to the dangers attending the use of even very 
 small doses, and at about the same time another author, after summarizing the records of 
 fifty cases, made a similar announcement. A case is reported by Broughton in which 
 unconsciousness, an irregular, slow respiration, and a slow pulse, followed the application 
 of three minims of a twenty per cent, solution within the cavity of a tooth. Whistler, 
 after the application of a four per cent, solution to the nasal cavity, noted vertigo and 
 threatening syncope. In a case of glossitis, Riclcet states that the patient became mori- 
 bund after the use of a similar solution. Myrtyle dropped three minims of a three per 
 cent, solution into each eye, which immediately caused a sense of numbness in the back 
 of the tongue and throat, palpitation, threatened syncope and nausea. Bettleheim records 
 that in one case the hypodermic injection of one-sixth of a grain induced alarming 
 symptoms; and in another, one-eighth of a grain similarly injected caused unconscious- 
 
280 COCA. 
 
 ness, congestion of the face, irregular breathing and trismus. Baker mentions a case in 
 which one grain injected into the gums by a dentist produced death in a few minutes, 
 and Hsenel records the case of a man in whom the injection of i l /$ grains was followed 
 by a fatal result. 
 
 As a Local Anesthetic the power of Cocaine is very great over a limited 
 area. Applied to such structures as the Schneiderian membrane, and the 
 mucous covering of the glans penis, or injected hypodermically in other 
 locations, it blanches the structures and causes a profound but temporary 
 anesthesia throughout a small space. Applied to the tongue it tempor- 
 arily destroys both taste and tactile sensibility; — to the ocular conjunctiva, 
 it produces profound anesthesia of that membrane, together with dilata- 
 tion of the pupil, partial paralysis of accommodation, enlargement of the 
 palpebral fissure, slight lachrymation, and sometimes temporary ptosis. 
 This profound degree of anesthesia is thought by some to be caused by 
 its paralyzing the terminal twigs of the sensory nerves, — by others to be 
 due to vaso-motor stimulation rendering the nerves bloodless and there- 
 fore unable to transmit sensory impressions. It produces mydriasis by 
 stimulation of the ends of the sympathetic in the iris, and does not affect 
 the third nerve or the sympathetic centre. 
 
 In general action, Cocaine resembles Atropine very closely, especially 
 in its influence upon the pulse and blood-pressure, the respiration, pupils, 
 salivary glands, sweat-glands and intestinal peristalsis. In its symptoms, 
 both from large and small doses it exactly parallels Sparteine, another 
 cardio-inhibitory depressant. 
 
 Antagonists. 
 
 Ammonia and Amy! AHtrite combat the earliest symptoms of cardiac depression, — 
 then Alcohol and Opintn as stimulants to the heart, also Artificial Respiration. The 
 most direct antagonist is Chloral, so also are Chloroform and Ether. Morphine is also 
 directly antagonistic at almost all points of its action. 
 
 The Cocaine- Habit. 
 
 Cocainism, the Cocaine-habit, is now presenting itself to observation, numerous in- 
 stances of persons addicted to its excessive use being met with. Loss of digestive power, 
 absolute insomnia, enfeeblement of the intellect, great emaciation, ascites, general maras- 
 mus, nausea, decay of the teeth, an excessively fetid breath, amblyopia, visual hallucina- 
 tions and complete anorexia, form a consensus of symptoms which rival the worst effects 
 of the opium habit. Peculiar hallucinations are characteristic of the action of cocaine. 
 One patient was always scraping his tongue to extract from it little black worms ; another 
 made his skin raw in the endeavor to draw out cholera microbes ; a third was constantly 
 looking for crystals in his skin. Two of these subjects suffered from epileptic attacks and 
 the third from cramps. (Magnan and Saury. ) Some observers report the most extraor- 
 dinary mental changes resulting from cocainism, exceeding those produced by any other 
 drug. Intense selfishness, utter disregard of all social and domestic duties, the most 
 debasing habits, complete destruction of all noble qualities, and a general condition of 
 depravity, are some of the results which are charged to this drug. The author's expe- 
 rience with a large number of such cases convinces him that a cocaine habitue who has used 
 the drug daily for a month is practically an insane individual while under the influence 
 of the drug ; but that the mind soon resumes its normal condition after withdrawal 
 thereof, which can be done, jn nearly all cases, at once, without involving any great 
 suffering. 
 
COCA. 28l 
 
 Many of the proprietary catarrh -snuffs contain cocaine, and their use may cause the 
 cocaine-habit, which, however, is in most cases acquired by morphine habitues who go 
 to cocaine in the expectation of finding help in their struggle against the tryanny of the 
 former drug. In this hope, however, they are always disappointed when the drugs are 
 in their own hands. The victim soon finds that one of these agents antagonizes the 
 other to a great extent, while, at the same time, it sets up peculiar troubles of its own ; 
 and that there is a constant need of more morphine to counteract the cocaine-symptoms, 
 and of more cocaine to antagonize the symptoms due to the increased amount of morphine. 
 The result will be that one who is using only a moderate daily amount of morphine, will, 
 if cocaine be added, soon be using a very great amount of morphine, as well as of 
 cocaine, and " the last state of that man is worse than the first." 
 
 As the stimulant effect of a single hypodermic injection passes off very quickly, within 
 about 15 or 20 minutes, the cocaine habitue is under the necessity of constantly injecting 
 the drug, so that, as one such expressed it, " I had no time to go home, — no time to do 
 anything except to prepare and take one ' shot ' after another. ' ' The effect of such re- 
 peated puncturing of the skin is very disastrous to that tissue, causing great induration 
 and numerous sloughing sores. 
 
 Therapeutics. 
 
 Coca-leaves are chewed by the Peruvians for the purpose of sustaining 
 them during arduous labors and long journeys, and are so highly esteemed 
 as to be represented on their national coat-of-arms, the people using them 
 much as we do tea, coffee or tobacco. This example was imitated by 
 Weston, the pedestrian, who is said to have been detected chewing the 
 coca-leaf during one of his protracted walks. Cocaine is a useful 
 stimulant to the brain and the nervous system in many morbid conditions, 
 particularly cerebral and spinal anemia, neurasthenia, melancholia, hys- 
 terical and hypochondriacal insanity, and in protracted mental depression 
 with suicidal tendency. It may be employed with benefit in wasting 
 diseases to retard waste and to stimulate digestion, in convalescence from 
 fevers and other acute maladies, and in migraine and neuralgia due to 
 depression of the nervous system. It is very beneficial in some cases of 
 the vomiting of pregnancy, in stomatitis and gastralgia, and in functional 
 impotence due to general atony of the spleen. 
 
 A wine of the leaves is thought by singers and speakers to relieve 
 hoarseness, to make tense the vocal cords and to improve the timbre of 
 the voice. Coca-leaves may be smoked in cigars or cigarettes to obtain 
 the exhilarating effects of the drug, and for the relief of asthma, hay-fever 
 and many irritable throat affections. The Oleate of Cocaine is an effi- 
 cient palliative application to painful hemorrhoids, fissures of the anus, 
 burns, boils, and irritable ulcers; also in pruritus pudendi et ani and skin 
 diseases attended with intolerable itching. 
 
 Cocaine Hydrochlorate has achieved celebrity as a local anesthetic, 
 and is of great value in many operations on the eye and ear, nasal pas- 
 sages, uterus and urethra. A 2 to 4 per cent, solution is brushed lightly 
 over the mucous surface or injected into the urethral canal, the applica- 
 tion being repeated within 5 or 10 minutes if profound local anesthesia 
 is required. After about fifteen minutes any superficial operation may 
 
282 COCA. 
 
 be performed without giving the slightest pain. It is used in the same 
 manner with decided benefit in congestion of the nasal passages from 
 acute catarrh and hay-fever ; and is applied to the cervix uteri to relieve 
 the first pains of labor, to the ear for tinnitus aurium, and by inhalation 
 to strengthen the vocal cords, to relieve hoarseness and cough, and to 
 improve the quality of the voice. It may be injected into the bladder 
 before lithotrity, into the urethra before the passage of sounds or cathe- 
 ters or to relieve chordee, and it is an excellent application to the gums 
 of teething infants. To be efficient it must reach the terminal filaments 
 of the sensory nerves in sufficient concentration. Rhus poisoning, by 
 either the oak or ivy, is promptly controlled by the application of a 5 
 per cent, solution or oleate, freely over the affected surface. It gives 
 instant relief from the burning and itching, and speedily reduces the 
 dermatitis. It is injected hypodermically around the prepuce to prevent 
 pain during circumcision, into the vicinity of the supra-orbital and infra- 
 orbital foramina to cut short neuralgia of those nerves, into hemorrhoids 
 previous to their ligation, and into the skin and the subcutaneous tissues 
 to produce local anesthesia in many minor operations. 
 
 The Infiltration Method of Schleich is the injection in quantity (up to 100 c.c. ) of very 
 dilute solutions (1 in 10,000, I in 1,000 and I in 500), at first superficially into the epi- 
 dermis and then deeper, by long, fine needles, so as to produce a local edema over the 
 field of operation [see page 614]. The Intraneural Method \s the injection of a 2 per 
 cent, solution into the nerve-trunk supplying the region to be anesthetized, but this has 
 produced neuritis. The Paraneural Method is the injection of the same solution in the 
 immediate vicinity of the nerve-trunk. The Subarachnoid Method of Corning, Bier, etc., 
 is the injection of 10 to 15 minims of a fresh, sterilized, 2 per cent, solution (gr. \ to \ of 
 cocaine) into the spinal canal, by a long needle inserted between the 3rd and 4th or 
 between the 2nd and 3rd lumbar vertebrae into the subarachnoid space. This produces 
 complete anesthesia below the diaphragm, beginning within 5 to 10 minutes and lasting 
 about an hour, but has no effect on consciousness. Under it many major operations" have 
 been performed painlessly on the pelvic region and the lower extremities. The method 
 is not free from danger, having a mortality of about one per cent. After-effects in many 
 cases include dizziness, headache, nausea and vomiting. 
 
 The rapid accumulation of cases in which alarming symptoms followed the injection 
 or the local application of small quantities of cocaine, together with the fact that these 
 untoward effects are due to individual idiosyncrasy and do not invariably occur immedi- 
 ately, is a positive warning to the profession that this powerful substance should not be 
 used in any case for the first time without the proper antidotes at hand and the patient 
 being kept under surveillance for at least a half" hour. 
 
 As a mydriatic for ophthalmological use, Cocaine has peculiar qualities 
 which make it one of the most serviceable of the class. The dilatation 
 produced by it is great, is quickly attained, lasts only 12 to 20 hours, is 
 promptly overcome by physostigmine, and is not accompanied by much 
 photophobia, due to the fact that the cocainized pupil is not rigidly 
 dilated (as with atropine), but reacts to light. The accommodation, 
 moreover, is greatly reduced, but not entirely paralyzed, and is quickly 
 regained. 
 
 As an antagonist Cocaine is of especial value in narcotic poisoning by 
 chloral or opiates, where depression of the cardiac and respiratory cen- 
 
COCCUS COLCHICUM. 283 
 
 tres exists. It is also indicated in chronic depressant poisoning from the 
 bromides, and in spinal paralyses. In these cases it has all the advan- 
 tages of strychnine without its poisonous character. It has no value in 
 the proper treatment of morphinism except to antagonize certain heart 
 symptoms, for which purpose it should be administered only by the phy- 
 sician in charge of the case ; but never as a regular remedy, at regular 
 intervals of time, even by him. 
 
 Unofficial Substitutes for Cocaine. 
 
 Eucaine-A, C 19 H 27 N0 4 — is an artificial alkaloid, which is much less toxic than 
 Cocaine and almost as efficient as a local anesthetic, but causes irritation and some pain. 
 The Hydrochloride is soluble in 10 of water and in 3 of alcohol. 
 
 Eucaine-B, C 15 H 21 N0 2 — is preferred to Eucaine-A for ophthalmic work, being less 
 irritant. Solutions of the Hydrochloride of I to 2 per cent, are used in the eye, of 
 2 to 5 per cent, for other mucous surfaces and for hypodermic injection. This, salt is 
 soluble in 20 of water and in 14 of alcohol, and its solutions may be sterilized by boiling 
 without undergoing decomposition. The Eucaine preparations are proprietary, being 
 manufactured by patented processes. 
 
 Orthoform, a patented product, is the methylester of amido-oxybenzoic acid, and has 
 no chemical relation to cocaine, which it resembles only in its action on the sensory nerve 
 terminations. It occurs as a white, crystalline, odorless and tasteless powder, almost 
 insoluble in water. It is non-toxic, somewhat antiseptic, and has little or no effect 
 upon the sensibility of the unbroken skin or upon healthy mucous membranes, while its 
 insolubility precludes its use by hypodermic injection. It is efficient as a local anesthetic 
 only when it is in actual contact with exposed nerve endings, and is chiefly used as a 
 dusting powder or ointment for painful surfaces, such as abrasions, ulcers or burns. In 
 doses of gr. viij-xv it has been given internally for the relief of pain in ulcer and cancer of 
 the stomach. A saturated solution in collodion may be used as a paint, and an emulsion in 
 glycerin is employed during operations within the uterus. The Hydrochloride is more 
 soluble in water and may be used for internal administration or urethral injection, but is 
 too acid for hypodermic injection or eye application. 
 
 Nirvanin, a patented coal-tar derivative of the orthoform type, is very soluble in water, 
 can be sterilized, and is antiseptic as well as anesthetic, non-irritant and only one-tenth as 
 toxic as cocaine. It is used for local anesthesia in 2 to 5 per cent, solutions. 
 
 Holocaine, — is a patented synthetic product prepared by the interaction of Phena- 
 cetin and Paraphenetidin. The Hydrochloride is soluble in 50 of water and in 6 of 
 alcohol. It is highly toxic and cannot be used hypodermically, but is employed by 
 ophthalmologists in a 1 per cent, solution. It produces complete and rapid anesthesia 
 and neither dilates the pupil nor affects the blood-vessels. 
 
 COCCUS, Cochineal, — is the dried female of Cocais cacti, an insect of the order 
 Hemiptera, which feeds on the cactus plants of Mexico and Central America. It is of 
 ovate, plano-convex form, of a purple-gray or purple-black color, yielding when crushed 
 a dark-red powder, which contains Carminic Acid, or Carmine, the red coloring-matter, 
 which is soluble in water and alcohol, but not in oils. Cochineal is an ingredient of 
 Tinctura Cardamomi Composita, and is used in pharmacy solely as a coloring material. 
 
 The only therapeutic use of Cochineal is in whooping-cough and neuralgia, in which 
 affections it is supposed to have considerable influence, especially in the former. Its dose 
 for an infant is about gr. y^ thrice daily. 
 
 COLCHICUM, Meadow Saffron,— is the corm and seed of the 
 Colchicum autumnale, a European plant of the nat. ord. Liliaceas. It 
 contains an intensely bitter, poisonous alkaloid, Colchicine, C 17 H 19 N0 5 , 
 which by the action of acetic and mineral acids is converted into Colchi- 
 
284 COLCHICUM. 
 
 c elite and a resin ; also tannic and gallic acids, resin, starch, sugar, etc. 
 It is official in two forms, namely — 
 
 Colchici Radix, Colchicum Root, — the corm, about an inch long, 
 white internally, grooved on one side, inodorous, taste sweetish, bitter 
 and acrid. Is less active than the seed. Dose, gr. ij-viij. It contains 
 of Colchicine, 0.45 part per 1000. 
 
 Colchici Semen, Colchicum Seed, — about T ^- inch thick, sub-glob- 
 ular, resembling black mustard seed but larger, very hard and tough, 
 inodorous, of bitter and acrid taste. Dose, gr. j-v. It contains of Col- 
 chicine, 3.35 parts per 1000. 
 
 Preparations. 
 
 Extractum Colchici Radicis, Extract of Colchicum Root, — made with Acetic Acid 
 35 parts to 100 of the root, and sufficient water. Dose, gr. ^-ij. 
 
 Extractum Colchici Radicis Fluidum, Fl. Extract of C. Root. Dose, TTyj-x. 
 
 Extractum Colchici Seminis Fluidum, El. Extract of C. Seed. Dose, Try-v. 
 
 Vinum Colchici Radicis, Wine of Colchicum Root, 40 per cent. Dose, Tt\v-xv. 
 
 Vinum Colchici Seminis, Wine of Colchicum Seed, 15 per cent. Dose, IT^x-xxx. 
 
 Tinctura Colchici Seminis, Tincture of C. Seed, 15 per cent. Dose, Tt^x-xxx. 
 
 Colchicina, Colchicine, C n H ]9 N0 5 (Unofficial), — a white or yellowish, amorphous 
 powder, of saffron-like odor and bitter taste, soluble in water and in alcohol. Dose, gr. 
 tto~6V I s suitable for hypodermic injection. 
 
 Laborde and Houde condemn all preparations made with acetic acid, also those made 
 from the tubers and all wines. The best preparation is Colchicine, in granules or in a 
 wine ; or a strong tincture made from fresh seed with the shell on, the latter containing 
 a very volatile but active oil. Of this seed |j j to ]/ 2 pint of highest proof alcohol, stand- 
 ing for 2 weeks. Of this gv to water q. s. ad O^, of which the dose is £ss every 4 
 hours night and day, avoiding acids, until nausea, vomiting and purging set in. 
 
 Colchicine Salicylate (Unofficial), — is marketed in capsules, each capsule containing 
 Colchicine, gr. ^io an( ^ natural Methyl Salicylate (Oil of Wintergreen), gr. iij. Dose, 
 I capsule every 2 hours, up to 10 or 15 daily. 
 
 Physiological Action. 
 Colchicum is emetic, diuretic and diaphoretic, a drastic purgative, a 
 gastro-intestinal irritant and a cardiac depressant. In small doses it 
 increases secretion, especially the urine and the sweat. In full doses its 
 action is emeto-cathartic, producing profuse watery discharges, great 
 nausea and extreme muscular feebleness. In large doses it is a powerful 
 irritant of the gastro-intestinal tract, causing severe griping, choleraic 
 discharges, lowered arterial tension and depression of the heart by reflex 
 action over the distribution of the pneumogastric, — then great prostra- 
 tion, convulsions and collapse, death occurring from exhaustion, with 
 consciousness preserved until carbonic acid narcosis sets in. The extent 
 of its influence on the excretion of uric acid and urea is very much dis- 
 puted, but it probably increases the flow of bile, and certainly unloads the 
 
 portal circulation. 
 
 Antagonists and Incompatibles. 
 
 Tannic Acid to retard absorption. Emetics and cathartics, also warm demulcent drinks 
 freely. Morphine hypodermically to antagonize the cardiac depression, also Alcohol. 
 
COLOCYNTHIS. 285 
 
 Therapeutics. 
 Colchicum is a specific palliative in gout of acute form, in which it 
 should be given with an alkali, and kept short of emeto-catharsis. It 
 does not prevent relapses, and its power in this disorder is weakened by 
 repetition. In ascites from obstructive disease of the liver it is most 
 effective, given in full doses to establish a profuse drain, with opium to 
 sustain the heart. In acute cerebral congestion and in portal congestions 
 it is well given as a drastic purgative. It is often used with marked suc- 
 cess in acute rheumatism, but frequently fails, and in no case should it be 
 continued long in this affection. It has been used with good results in 
 the treatment of gonorrhea and chordee. The alkaloid is probably the 
 best preparation for general use, and is admittedly superior to the other 
 preparations in acute gout. The preparation known as Colchicine Sali- 
 cylate is a solution of colchicine in oil of wintergreen. It should prove 
 to be a reliable remedy for gout and rheumatism, and also for many dis- 
 orders in which the rheumatic diathesis is a factor. 
 
 COLOCYNTHIS, Colocynth,— is the fruit of Citrullus Colocyn- 
 this, deprived of its rind. The plant is a native of Spain and Asiatic 
 Turkey and belongs to the nat. ord. Cucurbitaceae, the fruit being of the 
 size of a small orange, white, light, spongy, inodorous, very bitter, con- 
 taining many flat, brown seeds which should be rejected before the pulp 
 is used. Its active principle is Colocynthin, C 56 H 84 23 , an amorphous but 
 crystallizable bitter glucoside, readily soluble in water. It also contains 
 Colocynthein, a resin, and Colocynthititiy a tasteless, crystalline powder, 
 soluble in ether but not in water, and devoid of purgative action. 
 
 Preparations. 
 
 Extractum Colocynthidis, Extract of Colocynth. — Dose, gr. %-i). 
 
 Extractum Colocynthidis Compositum, Compound Extract of Colocynth, — con- 
 tains of the preceding 16 parts, Aloes 50, Cardamom 6, Resin of Scammony 14, Soap 14, 
 Alcohol 10. Dose, gr. v-xx. 
 
 Pilulae Catharticae Compositse, Compound Cathartic Pills, — have of the preceding 
 8, Calomel 6, Extract of Jalap 3, Gamboge I *^, Water to make 100 pills. Dose, j-iij. 
 
 Pilulae Catharticae Vegetabiles, Vegetable Cathartic Pills, have of Compound 
 Extract of Colocynth 6, Extract of Hyoscyamus 3, Extract of Jalap 3, Extract of Lep- 
 tandra I %, Resin of Podophyllum i]/ 2 , Oil of Peppermint 0.8, Water to make 100 pills. 
 Dose, j-iij pills. 
 
 Laville's Anti-Gout Remedy, — is a proprietary medicine prepared in France and 
 purporting to be "a mixture of prepared Kino-colocynthine." The published formula 
 is as follows : Active principle of Colocynth iy z , Quinine and Cinchonine 5, Spanish 
 Wine 800, Alcohol 100, Water to 1000 parts ; but there is good reason for believing that 
 it contains Colchicine instead of Colocynthin. 
 
 Colocynth is classed among the tonic-astringent and resin-bearing 
 purgatives. In moderate doses it increases peristalsis and the intestinal 
 
286 CONIUM. 
 
 glandular secretions, producing bilious, watery evacuations with much 
 colicky, griping pain. Its purgative action is specific, and may be ob- 
 tained by its application to the skin over the abdomen. In large doses 
 it is a violent irritant of the gastro-intestinal tract, and has frequently 
 produced fatal gastro-enteritis. It is popularly supposed to be aborti- 
 facient, but this is true only of quantities sufficient to endanger life. It 
 is an indirect diuretic. 
 
 Colocynth is too severe an agent to be administered alone for consti- 
 pation, but it makes a useful factor in compound purgatives, as the com- 
 pound cathartic pills. In cerebral congestion it may be used to produce 
 rapid derivation, and in ascites to set up a profuse drain from the intes- 
 tinal canal. In certain cases of chlorotic amenorrhea it stimulates the 
 pelvic nerves and vessels with excellent results. There seems to be abun- 
 dant evidence that in very small doses (XaVlV °^ a tincture) Colocynth 
 is an efficient remedy in colic, sciatica, ovarian and other neuralgiae, as 
 well as in the pain of glaucoma. These actions may be due to its two 
 non-purgative principles, which may prove to possess powers not hereto- 
 fore suspected, an example of which is seen in the cardiac influence of 
 Convallaria, a drug which was formerly known only as a purgative and a 
 diuretic. 
 
 CONIUM, Hemlock, — is the full-grown fruit, gathered while green, 
 of Conium maculatum, the spotted hemlock, nat. ord. Umbelliferse. It 
 contains 3 alkaloids, namely, — Coni'ine, C 8 H 15 N, liquid and volatile, 
 Methyl- confine, C 8 H U NCH 3 , and Conhydrine, C 8 H 17 NO, solid and vola- 
 tilizable ; also Coniic Acid and a volatile oil. Paraconiine is an arti- 
 ficial substance produced by the reaction between Butyric Aldehyde and 
 an alcoholic solution of Ammonia, and is isomeric with Coni'ine but not 
 identical with it. The leaves of Conium are no longer official. 
 
 Preparations. 
 
 Extractum Conii, Extract of Conium, — each grain represents a grain of the crude 
 drug. Dose, gr. ij-v up to gr. xl. 
 
 Extractum Conii Fluidum, Fluid Extract of Conium, — has the same strength as 
 the extract. Dose, TTyj-v up to TT\,xl. 
 
 Conii'na, Coni'ine, C 8 H ]5 N (Unofficial), — an oily, limpid, volatile liquid, of acrid taste, 
 alkaline reaction, and an odor comparable to that of the urine of mice. It is quickly de- 
 composed by heat, and if exposed to the air soon becomes inert. Dose, gr. -g 1 ^ — ^ , or in 
 minim doses, rt^y 1 — ij. Is too irritant for hypodermic use, unless carefully neutralized 
 by acetic acid. The Hydrobromate in watery solution of gr. viij to the ^ , of this TT^x = 
 gr. ]/(,, is a good form for subcutaneous or stomachal administration, and may be given 
 in doses of gr. T 1 ^ to gr. j, as it is not actively toxic. 
 
 All the preparations of" Conium are uncertain in action, particularly the extract, as the 
 active principle is very volatile. Any specimen must be carefully tested before deciding 
 on its dosage, and if the powerful mouse-like odor of the drug be absent, the preparation 
 is probably worthless. 
 
CONIUM. 287 
 
 Physiological Action. 
 
 The special Action of Conium and Conime is the production of motor 
 paralysis without loss of consciousness or sensation. It paralyzes the 
 motor nerves, the action commencing at the peripheral end-organs and 
 extending upwards, involving the nerve-trunks and finally the centres, 
 but the muscular irritability remains unaffected. Methyl-Coniine, on the 
 contrary, stimulates the spinal cord, and produces the convulsions often 
 seen in Conium poisoning. The sensory nerves are not affected, but the 
 general sensibility is impaired, a feeling of numbness being experienced 
 in the extremities. 
 
 Gastric irritation is usually the first sensation produced by a full dose 
 of Conium, nausea and vomiting being its symptoms. Then occur weak- 
 ness of the legs, numbness and fatigue, drooping eyelids, diplopia, slightly 
 dilated pupils, vertigo, impaired utterance, slow and labored breathing, 
 and if the dose be lethal, paralysis of the voluntary muscles occurs, those 
 of the lower limbs being first affected ; speech and vision are lost, and 
 finally death occurs from paralysis of the muscles of respiration. The 
 heart is not affected and the mind remains clear but torpid and indifferent, 
 until carbonic acid narcosis sets in. Muscular movement counteracts the 
 effects of the drug to a very great extent. 
 
 Conium is believed to have been the state poison of the Athenians, by 
 the juice of which Socrates and Phocion died. It is closely allied in its 
 physiological action to Curare. 
 
 Antagonists and Incompatibles. 
 
 Nux Vomica and its alkaloids, Picrotoxin and other tetanizers are antagonistic. 
 Tannic acid and caustic alkalies are chemically incompatible. 
 
 Therapeutics. 
 Conium is especially indicated in diseases characterized by excessive 
 motor activity. Large doses are required, as some physiological action is 
 necessary. Children bear it well, their constant activity preventing its 
 full action. In chorea and paralysis agitans it palliates, by depressing the 
 motor nervous system. In acute mania and delirium tremens, to quiet 
 motor excitement and prevent exhaustion, it is remarkably efficient, 
 especially when given conjointly with morphine. When pain and spasm 
 are present, it will prove a useful agent ; and in tetanus, blepharospasm, 
 asthma, whooping-cough, and other spasmodic affections it is frequently 
 used with very great benefit. The pain of cancer seems to be especially 
 amenable to its influence when locally applied, and Coniine vapor is an 
 admirable palliative of the tickling cough of phthisis and the irritability 
 of the air-passages in acute bronchitis. In pneumonia and pleurisy the 
 
288 CONVALLARIA. 
 
 hypodermic use of Coniine to afford the organs rest by inducing a paretic 
 state of the respiratory muscles has been followed by a marked decrease 
 in the temperature and pulse-rate. 
 
 CONVALLARIA, — is the rhizome and roots of Convallaria tna/a/is, 
 Lily of the Valley, a stemless perennial of the nat. ord. Liliacese, indig- 
 enous to Europe, Northern Asia and the Southeastern portion of the 
 United States. The preparations in the market vary in action, according 
 to the quantity of the resin present, it being emeto-cathartic. Conval- 
 laria contains two glucosides, namely — Convallamarin, on which the car- 
 diac action depends, and Convallarin, a crystalline, purgative principle, 
 insoluble in water; also an acrid Resin which probably contains the 
 latter glucoside. 
 
 Preparations. 
 
 Extractum Convallariae Fluidum, Fluid Extract of Convallaria, — is the only offi- 
 cial preparation, and probably contains Convallarin, which is not present in aqueous 
 preparations, being insoluble in water. Dose, H\rj-x. 
 
 Extractum Convallariae (Unofficial), — from the flowers and stalks with y£ of the 
 leaves and root ; is freely soluble in water and in alcohol. Dose, gr. ij-x. 
 
 Infusum Convallariae (Unofficial), — prepared from the flowers, leaves and stems 25 
 parts, in water 75. Dose, ^ss-ij. 
 
 Convallamarinum, Convallamarin, C 23 H 44 12 (Unofficial), — an amorphous, white, 
 bitter powder, freely soluble in water and in alcohol. Dose, gr. %—i}. 
 
 Physiological Action. 
 
 Convallaria has long been known as a decided cathartic and a prompt 
 and powerful diuretic, but its cardiac action has excited great atten- 
 tion, and it is now considered a close analogue of Digitalis, while free 
 from the so-called cumulative action which makes the latter drug so fre- 
 quently a dangerous remedy. Preparations of the root have a powerful 
 emeto-cathartic action, probably due to a preponderance of the resin. 
 Those freed from this ingredient correspond in action to Convallam- 
 arin, stimulate the appetite without impairing digestion, increase peri- 
 stalsis without producing catharsis, slow the heart and raise the arterial 
 tension, also slowing and deepening respiration. Lethal doses at first 
 produce irregularity of the cardiac action and spasm of the respiratory 
 muscles, high arterial tension and a very rapid pulse, — followed by low- 
 ered blood-pressure, very slow and deep breathing, and finally arrest of 
 the heart in systole. Its mode of action is by direct stimulation of the 
 pneumogastric, the motor and sensory nerves retain their irritability, the 
 muscles preserve their contractility, and the cerebral functions and the 
 pupil are unaffected. 
 
 Convallarin is a drastic purgative in 3-grain doses. Convallamarin is 
 an emetic even in small quantity, and the powdered root is sternutatory. 
 
COPAIBA. 289 
 
 Therapeutics. 
 Convallaria is a heart-tonic like Digitalis, and is indicated in the same 
 class of cases as is that drug, with the advantage that having no cumu- 
 lative action it is not dangerous to the heart in medicinal doses, and does 
 not disturb the stomach or the functions of the cerebro-spinal axis. In 
 doses of gr. xv-xxv of the extract it slows the action of the heart and 
 increases the force of its contractions, raises arterial tension, augments 
 the force and volume of the respiration, and produces prompt diuresis 
 without altering the composition of the urine. It is often a valuable 
 remedy in mitral stenosis or insufficiency with venous stasis, dilatation of 
 the heart, palpitation, vehement cardiac action or disordered rhythm, and 
 in all valvular affections accompanied by dropsy and a weak heart. It 
 has also been used with benefit in pneumonia, typhoid fever and renal 
 dropsy. Its action is maintained for several days after its administration 
 has been suspended. 
 
 COPAIBA, Copaiba, Balsam of Copaiba, — is the oleoresin of 
 Copaif era Langs dor ffii, and other species of Copaif era, a S. American tree 
 ofthenat. ord. Leguminosae, growing chiefly in the valley of the Amazon. 
 It is a translucent, viscid liquid, of yellow color, aromatic odor, acrid and 
 bitter taste, not fluorescent, soluble in alcohol and in benzol. It is not a 
 balsam as it contains no cinnamic acid. Its constituents are a Volatile 
 Oil and a Resin in about equal proportions, the latter containing nearly 
 99 per cent, of Copaibic Acid. Dose, ^x-^j. 
 
 Preparations . 
 
 Oleum Copaibse, Oil of Copaiba, C 10 H 16 , — a pale yellow liquid, of sp. gr. 0.890, 
 bitter taste and neutral reaction, soluble in 10 volumes of alcohol. Dose, n\x-xv. 
 
 Resina Copaibas, Resin of Copaiba, — is the residue left after distilling off the vola- 
 tile oil from Copaiba ; a yellowish, brittle body, of acid reaction, soluble in alcohol, 
 benzol or amylic alcohol. Consists mainly of Copaibic Acid, which is crystallizable, also 
 \y^ per cent, of a viscid resin. Dose, gr. j-v. 
 
 Massa Copaibae, Mass of Copaiba, — consists of Copaiba 94, fresh Magnesia 6, tritu- 
 rated with water and set aside to concrete into a pilular mass. Dose, TTLx-^j. 
 
 Mistura Copaibse Composita, Compound Copaiba Mixture, Lafayette Mixture 
 (Unofficial). — R . Copaibae 5J, Spiritus ^Etheris Nitrosi ^j, Liq. Potassce ^ij. Mix 
 with constant stirring, then add: Tinct. Lavandulae Co. ^j, Syrupi ^ijss, Mucil. Dex- 
 trini (N. F. ) q. s. ad ^viij. Mix the whole thoroughly by shaking. Of this each 3 
 contains rr\vijss of Copaiba {National Formulary). Dose, 3J-iv. 
 
 Physiological Action and Therapeutics. 
 Copaiba is a stimulant diuretic, diaphoretic, expectorant, and a gastro- 
 intestinal irritant. Its taste is bitter and nauseous. In the stomach it 
 causes heat, eructations, heaviness, frequently anorexia and diarrhea, and 
 if continued for any length of time gastro-intestinal catarrh and desqua- 
 19 
 
29O CORIANDRUM CORNUS — COTO. 
 
 mative nephritis may result. The oil and resin diffuse into the blood and 
 are excreted by the bronchial mucous membrane, skin and kidneys, pro- 
 ducing increased secretion at the points of elimination. The various 
 secretions have the odor of the drug, especially the urine. In medium 
 doses it increases the quantity of urine and its solid constituents, but 
 large doses will cause scanty urine, containing albumin, casts and blood, 
 with pain in the loins and other signs of renal congestion. On the skin 
 it often produces itching and several forms of eruption. 
 
 Copaiba has been largely used in gonorrhea after the acute symptoms 
 have subsided, also in chronic cystitis, acute and chronic bronchitis, and 
 in dropsies, particularly ascites. In all these affections it is a useful 
 remedy, but its nauseous taste and irritant effects on the stomach are 
 driving it out of fashion, especially in private practice. One eminent 
 surgeon declares not only that it is useless in gonorrhea but that it does 
 more harm than good, often prolonging the disease beyond its natural 
 limit. In psoriasis and urticaria, and in cutaneous affections character- 
 ized by torpid peripheral circulation, this drug has been administered 
 internally with excellent results. In long-standing cystitis in the female 
 Copaiba has been injected into the bladder with great benefit. The resin 
 is the most active ingredient, especially for diuretic purposes. 
 
 CORIANDRUM, Coriander, — is the fruit of Coriandrum sativum, a plant of the 
 nat. ord. Umbelliferse. It contains a volatile and a fixed oil. Dose, gr. x-xx. 
 
 Oleum Coriandri, Oil of Coriander, — a volatile oil distilled from Coriander. A 
 colorless liquid, of aromatic, bitter and pungent taste ; soluble in 10 volumes of alcohol, 
 forming a slightly turbid liquid neutral to litmus paper. Dose, rfUj-v. 
 
 Coriander is stimulant, aromatic and carminative. It is used almost wholly as a 
 flavoring to other remedies, or as a corrective against the griping effects of certain purga- 
 tives. Its flavor covers the taste of Senna and Rhubarb, and it is an ingredient of the 
 official Confectio Sennae. 
 
 CORNUS, Dog-wood (Unofficial), — is the bark of the root of Cornus florida, a. 
 small tree of the nat. ord. Cornacese, indigenous to the U. S. It contains a bitter prin- 
 ciple named Cornin, which is crystallizable and soluble in water and in alcohol ; also a 
 resin and tannic acid. 
 
 Cornus is a simple bitter, having stomachic and other qualities similar to those of 
 Calumba (which see). In addition it is possessed of considerable antiperiodic power, 
 and has a good deal of reputation in the Southern States as a remedy in malarial fever, 
 the physicians of that section considering it as next to quinine in efficiency. Heat de- 
 stroys its active principle, consequently a decoction is a useless preparation. A fluid 
 extract is on the market, the dose of which is tt^x-^j. 
 
 COTO, Coto Bark (Unofficial), — is the bark of some unknown tree growing in 
 Bolivia. It contains an acrid, bitter principle, of yellow color, crystalline and soluble in 
 hot water and in alcohol, named Cotoin, C 22 H 18 6 ; also Piperonylic Acid, C 8 H 6 4 , and a 
 volatile oil, resin, etc., but no tannin. Dose, gr. j-xv. 
 
 Paracoto Bark, False Coto. — Its principle, Paracotoin, C 19 H 12 6 , has a strong 
 similarity to Cotoin therapeutically, but is less active. 
 
 A fluid extract of the official strength is prepared, also a tincture (10 per cent), which 
 may be administered in doses of from TT\j-xx. Cotoin is used in doses of gr. j-iv, and 
 Paracotoin in somewhat larger quantities. 
 
CREOSOTUM. 29I 
 
 The physiological action of Coto has not been studied, all that is known about it being 
 that it is decidedly irritant to the skin and mucous membranes. After its internal admin- 
 istration the urine takes a dark-red color with Nitric Acid. Ferric Chloride blackens a 
 dilute solution of Cotoin, but has no reaction with Paracotoin. 
 
 The bark and both principles are highly recommended in diarrheas of various forms, 
 especially those of phthisis, typhoid fever, and cholera. In Asiatic cholera Paracotoin 
 has been used hypodermically in 3-grain doses with success. When there is any ten- 
 dency to acute inflammation of the gastro-intestinal tract this agent must be used with 
 caution. Small doses of the tincture (THj-v) are said to be very effective in the diarrhea 
 of children. 
 
 CREOSOTUM, Creosote, — is a mixture of phenols, chiefly Guaia- 
 col and Creosol, also Methylcreosol and Phlorol, obtained during the 
 distillation of wood-tar, preferably of that derived from the Beech. It 
 occurs as an almost colorless, or pinkish, inflammable, oily liquid, of 
 smoky odor, caustic taste, and neutral reaction ; soluble in about 150 of 
 water, and in all proportions in absolute alcohol, ether, chloroform, ben- 
 zin, carbon disulphide, acetic acid, and fixed and volatile oils. It does 
 not coagulate albumin (?) or collodion while Carbolic Acid does. It was 
 named from its remarkable preservative power over meat (creas, flesh, 
 sohzoh, preserve). Much of the commercial Creosote is an impure car- 
 bolic acid, or a heavy oil distilled from coal-tar and containing carbolic 
 and cresylic acids. Dose tt^j — iij, well diluted, in wine or whiskey. 
 Morson's beechwood creosote is the best for internal use. There is only 
 one official preparation, viz. — 
 
 Aqua Creosoti, Creosote Water, — is a I per cent, solution, containing nearly 5 minims 
 of Creosote in each fluid-ounce. Dose, 3J~oJ- 
 
 Unofficial Derivatives. 
 
 Guaiacolum, Guaiacol, Methyl Pyrocatechin, C 6 H 4 OHOCH 8 , — is the most active 
 ingredient of Creosote, of which it constitutes from 60 to 90 per cent. It occurs as a 
 colorless liquid, highly inflammable, of a powerfully aromatic odor, very slightly soluble 
 in water, readily soluble in alcohol. Dose, Tty-xv, in capsules, pills, or alcoholic solu- 
 tion. 
 
 Guaiacoli Carbonas, Guaiacol Carbonate, Duotal, — is a tasteless and odorless crys- 
 talline powder, insoluble in water. Dose, gr. iij-v or more, gradually increased to a 
 maximum of 90 grains per diem. 
 
 Creosoti Carbonas, Creosote Carbonate, Creosotal, — is a patented product, prepared 
 directiy from beechwood creosote instead of guaiacol, and is analogous to guaiacol car- 
 bonate. It occurs as a thick, brownish, inodorous oil, insoluble in water. Dose, TTyij-v 
 or more, gradually increased to a maximum of 90 grains per diem. 
 
 Benzosolum, Benzosol, Benzoyl Guaiacol, — is prepared by heating Guaiacol with 
 Benzoic Acid, and occurs in small, colorless, odorless, and almost tasteless crystals, 
 practically insoluble in water. Contains 54 per cent, of Guaiacol. Dose, gr. v-xv. 
 
 Physiological Action. 
 Creosote is expectorant, astringent, antiseptic, styptic, escharotic, an- 
 esthetic and narcotic. Its action is practically the same as that of Car- 
 bolic Acid (see ante, page 86), especially upon the heart, respiration and 
 nervous system, but differs from that of the latter, in not causing convul- 
 
292 CREOSOTUM. 
 
 sions, and in increasing the coagulability of the blood. It is eliminated 
 by the kidneys and the bronchial mucous membrane, which it stimulates, 
 being quite a good expectorant. In small doses it seems to have a selec- 
 tive sedative influence on the terminal nerve-filaments in the gastric 
 mucous membrane. In large doses it is a powerful poison, resembling 
 Carbolic Acid in its symptoms, except that its nervous effects are even 
 more marked. It explodes when combined with Oxide of Silver in pill, 
 unless previously diluted with an inert powder. 
 
 Guaiacol, locally applied, is rapidly absorbed by the skin, and appears 
 in the urine fifteen minutes after its application. Applied by painting it 
 over the skin of the thigh, abdomen or chest, in quantity of 20 to 50 
 minims, it causes a rapid reduction of body-temperature, and thereby the 
 temperature in malarial fever, typhoid fever and pneumonia falls as much 
 as 7 in the course of an hour or two, but soon rises again (Da Costa). 
 This rapid antipyretic action is not accompanied by any marked distur- 
 bance of the nervous system or any signs of collapse, not even by a very 
 profuse sweat, neither does there occur any active chill, though slight 
 chilliness is sometimes experienced. Guaiacol is said to be a powerful 
 local anesthetic, equal in this respect to cocaine and much safer, as it can 
 be injected in ten times larger doses without producing ill effects. For 
 this purpose it is used in sterilized olive oil (1 in 10 or 20) hypodermi- 
 cally, and it is claimed that thereby perfect local anesthesia is obtained 
 for the extraction of teeth, the removal of small tumors, and similar oper- 
 ations. Internally administered, the action of Guaiacol is similar to that 
 of Carbolic Acid, and overdoses may prove equally fatal. 
 
 Wyss, of Zurich, reports the case of a girl nine years of age who had been accidentally 
 given 75 drops of guaiacol. In a short time she became unconscious, the conjunctivae 
 became injected, the corneal reflexes diminished, and the pupils no longer reacted to 
 light ; there were frequent attempts at vomiting, and the saliva flowed from the mouth in 
 large quantities. The pulse became rapid and the sensibility of the skin much diminished. 
 Finally, the patient began to vomit, — the physician detecting the odor of guaiacol the 
 stomach was washed out, but she did not rally. The cyanosis gradually diminished, and 
 instead of it a deadly pallor was observed and the respiration became frequent. Three 
 and a half hours after the guaiacol had been swallowed the patient passed one hundred 
 cubic centimeters of brownish-red urine. The spleen and liver soon enlarged, the tem- 
 perature fell to 96 F., and small hemorrhages were observed upon the skin of the arms 
 and legs. The urine contained albumin, blood, and casts, and Ehrlich's carbolic-acid test 
 was positive. Jaundice soon appeared, the stupor increased, and the patient died on the 
 third day. The autopsy revealed an acute gastritis and enteritis, parenchymatous degen- 
 eration of the liver, acute hemorrhagic nephritis, parenchymatous degeneration of the 
 heart-muscle, and ecchymoses in the pleurae, peritoneum, endocardium and pericardium ; 
 the spleen was much enlarged. 
 
 Therapeutics. 
 Creosote, being a very complex substance of varying composition, has 
 been almost entirely supplanted in therapeutics by Carbolic Acid for 
 external use, and by Guaiacol for internal administration. As an astrin- 
 
CREOSOTUM. 293 
 
 gent it has been employed in intestinal hemorrhage, gonorrhea and gleet, 
 and generally in the same affections as Carbolic Acid. Externally it is 
 a good application in eczema, pruritus, ulcers and scaly skin diseases, 
 and it effectually relieves the pain of an exposed dental nerve if applied 
 thereto. It is a good agent by inhalation in chronic bronchitis and 
 gangrene of the lung, and it has been administered internally with 
 decided benefit in abnormal fermentative processes in the stomach and 
 intestines, in reflex nausea and vomiting, as from sea-sickness, pregnancy, 
 etc.; also as an aseptic expectorant in chronic basilar cavity, in which it 
 seems to have greater efficacy than any other remedy, and in bronchitis, 
 pulmonary gangrene, carcinoma of the stomach and diabetes. 
 
 In pulmonary tuberculosis, when well borne by the stomach, and con- 
 tinued over a long period of time, it has probably proved more efficient 
 than any other remedy. Its employment in this disease is based on the 
 statement of Guttmann, that tubercle bacilli are destroyed by blood 
 which contains y 2 per 1000 of Creosote, while even one-half that pro- 
 portion arrests their growth. The commencing daily dose of Creosote or 
 Guaiacol is 2 or 3 minims, largely diluted to prevent irritation, taken 
 after meals, and increased by the addition of one minim daily until a 
 maximum daily dosage of 15 to 18 minims is reached, at which rate it 
 should be continued for several months. Under this treatment cough is 
 relieved, expectoration diminished, night-sweats are stopped, the fever 
 is lowered, while body-weight and appetite are increased in most cases ; 
 and in many even the local conditions are decidedly improved, as shown 
 by the physical signs. Recent researches indicate that the good effects 
 of this treatment are due to the formation of soluble compounds between 
 the remedy and the toxic albuminous by-products of the tubercle bacillus, 
 which are then eliminated from the blood. 
 
 Creosote was advocated for phthisis by Reichenbach in 1833, and its use was revived 
 by Bouchard and Gimbert in 1877, since which time it has been tried and approved by 
 a long list of authorities, including Jaccoud, Dujardin-Beaumetz, Dieulafoy, Germain 
 See, Sommerbrodt, Von Brun, Guttmann, Douglas Powell, Burney Yeo, J. Solis-Cohen 
 and many others, who all agree as to its utility, though differing as to its mode of action, 
 its dosage, and the methods of administration. The number of cases dealt with by some 
 of these observers is so considerable that there is at least strong prima facie evidence in 
 favor of this drug and its derivatives. Bouchard reported on 93 cases at first, and on 
 more subsequently; Sommerbrodt' s report included over 5,000 cases, treated during 
 more than nine years ; and Von Brun dealt with 1,700 cases. Professor Sommerbrodt 
 contends that it is possible to administer the quantity necessary to inhibit the growth of the 
 bacilli, and believes that he did so in many cases. He had the most gratifying success 
 with this medication, and states that the more creosote the patient could bear the better 
 was the result. Of late years the tendency has been to administer Creosote or Guaiacol 
 by hypodermic injection. Lepine uses creosote dissolved in oil, and finds that a much 
 larger quantity can be used hypodermically than the stomach will tolerate. Picot injects 
 a mixture of sterilized olive oil containing I per cent, of Iodoform and 5 per cent, of 
 Guaiacol, beginning with 1 cc. of the mixture and increasing the dose to 3 cc. He states 
 that no swelling or other local reaction follows this injection. Burney Yeo has used the 
 same method with a more concentrated formula for the injection. 
 
294 CROCUS. 
 
 Guaiacol is preferred by many for internal administration instead of 
 Creosote, being the principal ingredient of the latter, and of more definite 
 chemical composition, though nearly or quite as irritant to the stomach. 
 It may be given in mixture with wine or brandy, in capsules, or hypoder- 
 mically in combination with cod-liver oil. When neither of these agents 
 agrees with the patient, useful and efficient substitutes therefor are their 
 carbonates, known by the respective trade-names Duotal and Creosotal, 
 in doses of 4 to 6 grains, gradually increased to 3jss per diem. These 
 preparations are well borne as they do not irritate the gastric mucous 
 membrane or disturb the digestion. 
 
 The antipyretic power of Guaiacol, when painted on the surface of the 
 body, has recently been utilized in the treatment of several diseases ac- 
 companied by hyperpyrexia. In typhoid fever Dr. Montagnon applied 
 10 or 15 drops with a brush whenever the temperature exceeded 102 , 
 the application being followed by a profuse perspiration, the tempera- 
 ture fell, and in a few hours a large quantity of urine was passed. The 
 action lasted about two hours, and the treatment was renewed about every 
 three or four hours with excellent results, none of the patients suffering 
 a relapse. Similar results have been obtained in the pyrexia of malarial 
 fever and pneumonia, and this employment of the drug is claimed to pro- 
 mote the absorption of pleuritic effusions in a remarkable manner. Only 
 pure guaiacol should be used, as an inferior quality produces a very grave 
 cutaneous irritation. By other clinicians it is mixed with glycerin before 
 application, in the proportion of 1 part to 8 of the latter, or even in 
 equal quantity, and it is claimed that thereby no inconvenience is expe- 
 rienced. This application of Guaiacol is also decidedly anesthetic in 
 effect, and has been utilized in orchitis, in the chest-pains of tuberculous 
 subjects and in other painful affections, especially sciatica and rheumatism. 
 
 Benzosol contains Guaiacol in the proportion of 54 percent. In the 
 intestinal canal the latter is probably set free by the action of the alkaline 
 secretions, as benzosol is excreted by the urine in the form of guaiacol 
 and benzoic acid combinations. Compared with guaiacol, this agent has 
 the advantage of being almost tasteless; hence it can be given in large 
 doses without the digestive disturbance and disagreeable eructations pro- 
 duced by the parent substance when administered in liquids, and without 
 the local irritant effect caused by the latter in capsules. In doses of 4 
 grains, gradually increased to 12 grains thrice daily, results are said to 
 have been obtained from this agent, in the treatment of phthisis, equal 
 if not superior to those produced by Creosote. 
 
 CROCUS, Saffron, — the stigmas of Crocus sativus, a plant of the nat. ord. Irideae, 
 cultivated in Europe, containing a volatile oil and coloring matter. So-called American 
 Saffron is not Crocus but the flowers of Carthai?ius tinctorius. True Saffron is expen- 
 sive, as it requires about 60,000 flowers to furnish one pound of the stigmas. Dose, 
 gr. v-xx, in infusion. 
 
CUBEBA. 295 
 
 Tinctura Croci, Tincture of Saffron, — 10 per cent. Dose, Jjj-ij. 
 
 Saffron Tea, so much used in domestic practice, is an infusion of Carthamus tine- 
 
 torius, the Sarnower. 
 
 Crocus is a stimulant aromatic, having some antispasmodic and anodyne qualities. 
 The hot infusion produces diaphoresis, probably by virtue of the hot water alone. It is 
 said to have caused death with narcotic symptoms. On the continent of Europe it is 
 employed as a stimulant and emmenagogue, but in this country its only use is as a color- 
 ing agent. The miscalled Saffron Tea noted above is used in domestic practice for 
 measles and other exanthemata. 
 
 CUBEBA, Cubeb, — is the unripe fruit of Piper Cubeba, a plant of 
 the nat. ord. Piperaceae, cultivated in Java. It contains a Volatile Oil, 
 which is official, an acrid resin composed in part of Cubebic Acid, also a 
 fatty oil, gum, and Cubebin, which is an insoluble, neutral, odorless and 
 tasteless body. The volatile oil may be separated into Cubebene a cam- 
 phor, and Cubeben a liquid portion. The active principles are the vola- 
 tile oil and cubebic acid, both of which are contained in the oleoresin. 
 Cubeb should be kept whole and not pulverized until wanted for use. 
 Dose of the powdered drug, gr. x-5ij. 
 
 Preparations . 
 
 Extractum Cubebae Fluidum, Fluid Extract of Cubeb. Dose, Tt\v-xxx. 
 
 Tinctura Cubebae, Tincture of Cubeb, — 20 per cent. Dose, TT\x-3iij. 
 
 Oleoresina Cubebae, Oleoresin of Cubeb, — extracted by ether. Dose, rr\v-xxx. 
 
 Trochisci Cubebae, Troches of Cubeb, — each contains of the Oleoresin 4, Oil of Sas- 
 safras I, Extract of Glycyrrhiza 25, Acacia 12, and Syrup of Tolu q. s. to form 100 
 troches. Dose, j-iij. 
 
 Oleum Cubebae, Oil of Cubeb, C 15 H 24 , — is the volatile oil, a colorless or pale green- 
 ish-yellow liquid, of sp. gr. 0.920, warm, aromatic taste, odor of cubeb and neutral re- 
 action. Is soluble in an equal volume of alcohol. Dose, TT^v-xx. 
 
 Cubeb belongs to the pepper family, and like black pepper is an aro- 
 matic stomachic and a stimulant diuretic in small or medium doses, but 
 large doses derange digestion and may act as a gastro-intestinal irritant. 
 Its constituents are eliminated by the bronchial mucous membrane, the 
 skin and the kidneys, stimulating and disinfecting the genito-urinary 
 passages, increasing the bronchial mucus, sweat and urine, and frequently 
 causing an urticarial or vesicular eruption. It increases the action of the 
 heart and of the vascular system, stimulates the venereal appetite, and 
 promotes the menstrual discharge. 
 
 Cubeb is particularly useful in affections of the bladder and urethra. 
 It is used in the acute stage of gonorrhea, in chronic cystitis, prostator- 
 rhea and chronic bronchitis with excellent results. The powder is a 
 good application in hay-fever, chronic nasal catarrh and follicular pharyn- 
 gitis, blown on to the mucous membrane by an insufflator. It may also 
 be smoked in cigarettes with temporary relief in cases of acute nasal 
 catarrh with " stuffed " nasal passages. In some subjects the continued 
 
296 CUPRUM. 
 
 use of cubeb produces nausea, hemorrhoids, hematuria, and severe head- 
 ache. The troches are a useful preparation in chronic irritability of the 
 fauces, pharynx and air-passages, and are much employed by singers and 
 public speakers for their tonic effect on these parts and for the relief or 
 prevention of hoarseness. 
 
 CUPRUM, Copper, Cu, — is not official, but one of its salts is, 
 namely the Sulphate. The metal itself is inert, but in combination it is 
 actively poisonous. Copper has been found in the normal human blood 
 in very minute quantity. 
 
 Salts and Preparations of Copper. 
 
 Cupri Sulphas, Copper Sulphate, CuS0 4 -f- 5H 2 0, — blue, translucent crystals, efflor- 
 escent, of nauseous, metallic taste and acid reaction, very soluble in water, insoluble in 
 alcohol. Its solution is blue by transmitted light, green by reflected light. Dose, as an 
 emetic, gr. ij-v, every 10 or 15 minutes, — as a tonic, gr. }/&-}£. 
 
 Alkaline Cupric Tartrate Volumetric Solution, Fehling's Solution, — the official 
 reagent for glucose, is prepared as follows : (l) Dissolve 34.64 grammes of pure Cupric 
 Sulphate in water, to measure exactly 500 cubic centimeters. (2) Dissolve 175 grammes 
 of Potassium and Sodium Tartrate and 125 grammes of Potassium Hydrate in water to 
 measure exactly 500 cubic centimeters. Keep the two solutions in small, rubber-stop- 
 pered bottles, separate ; and for use, mix exactly equal volumes of the two at the time 
 required. One cubic centimeter of the mixed solution is the equivalent of — 
 
 Cupric Sulphate, crystallized, CuS0 4 -)- 5H 2 0, Gramme, 0.03464 
 
 Cupric Tartrate, CuC 4 H 4 6 -f 3H 2 0, " 0.03685 
 
 Glucose, anhydrous, C 6 H 12 6 , " 0.00500 
 
 Cuprum Ammoniatum, Ammoniated Copper (Unofficial), — is made by triturating 3 
 parts of Ammonium Carbonate with 4 of Cupric Sulphate until effervescence has ceased, 
 then drying. A deep azure blue powder, of ammoniacal odor, a styptic, metallic taste, 
 and alkaline reaction, soluble in water. Dose, gr. ye-]- 
 
 Cupri Arsenis, Copper Arsenite, — is described under Arsenum, ante, page 199. 
 
 Physiological Action. 
 The salts of Copper are gastro-intestinal irritants, producing a metallic 
 taste, nausea with greenish vomited matter, purging of blood and mucus, 
 constricted fauces, depressed heart action, hurried respiration and fever. 
 Or, as with Arsenic, gastro-enteritis may not occur, but instead profound 
 nervous symptoms, as headache, defective coordination, coma and con- 
 vulsions. The symptoms of chronic poisoning are bronchial irritation 
 and catarrh, gastro-intestinal catarrh, colic with diarrhea [Lead produces 
 colic with constipation], dysentery, nausea, emaciation, anemia, saliva- 
 tion, and a green line (sulphide) along the margin of the gums in those 
 who do not clean their teeth. The nervous symptoms above mentioned 
 are also usually well marked. The liver becomes atrophied from irrita- 
 tion of its connective tissue and fatty degeneration of the hepatic cells. 
 The lungs are congested, even pneumonic consolidation may be set up, 
 the metal seeming to have affinity for the pulmonary parenchyma. These 
 
CUPRUM. 297 
 
 effects are often produced by the inhalation of cuprous fumes, and by 
 eating acid fruits cooked in a copper vessel. Brass-founding is known 
 to cause various forms of disease, as gout, chronic nephritis, progressive 
 paresis of the legs, tremor, muscular wasting, and locomotor ataxia. A 
 group of symptoms known as " brass founders' ague," has also been 
 noticed. The fit of ague is ushered in by languor and depression, then 
 follow prostration with pallor, cold sweats, and chills, which may even 
 amount to rigors, with chattering of the teeth, precordial anxiety, head- 
 ache, nausea and muscular pains. The onset of vomiting arrests the 
 symptoms and usually is followed by sleep, from which the patient awakens 
 almost well. It is not clear whether these symptoms are due to copper or 
 to zinc, both of which enter into the composition of brass. 
 
 Copper Sulphate is a simple, irritant emetic, producing prompt and 
 continued vomiting with but little nausea or depression. In small doses 
 it is a nerve-tonic, and is astringent to the gastro-intestinal tract. Exter- 
 nally applied in solution it is a useful stimulant and astringent to diseased 
 mucous surfaces, and is mildly caustic if used in substance. The Acetate 
 is possessed of the same general action as the sulphate. Its local action 
 is stimulant and escharotic. The impure acetate (verdigris) is a violently 
 irritant poison. Ammoniated Copper has no special action other than 
 that of the sulphate. 
 
 Antidotes, Antagonists and Incompatibles. 
 Potassium Ferrocyanide is the antidote in poisoning by the Copper Salts, but Albumin 
 or Magnesia may be used. Any chemical antidote should be followed by prompt evacua- 
 tion of the stomach, then Opium and demulcents for gastro-enteritis, and Potassium 
 Iodide even to saturation of the system. Alkalies and their Carbonates, Lime-water, 
 Iodides, and Mineral Salts (except the sulphates), are all incompatible. 
 
 Therapeutics. 
 
 The Sulphate is a prompt and efficient emetic, and is so used in croup 
 and narcotic poisoning. In phosphorus poisoning it forms a compara- 
 tively insoluble phosphide of copper besides producing emesis. Fifteen 
 or twenty grains may be dissolved in giv of water, and a teaspoonful or 
 more, according to age, given every ten minutes until vomiting is pro- 
 duced. In acute diarrhea and chronic dysentery it is the best metallic 
 astringent in doses of gr. -fa to ^ with Opium, and in gastro-intestinal 
 catarrh it is equally efficient. Locally, it is used with benefit in throat 
 affections, gonorrhea, granular lids and corneal ulcers, indolent granu- 
 lations and chronic inflammations of mucous membranes. In most of 
 these affections weak solutions (gr. ^ to ^ to the |) are best, but in 
 granular conjunctivitis the smooth crystal may be rubbed quickly over 
 the surface once daily. 
 
 In various nervous diseases, as epilepsy, chorea, hysteria, etc., the salts 
 of copper are sometimes beneficial, the Ammoniated Copper being con- 
 
298 CURARE. 
 
 sidered the most efficient preparation in these cases. In Germany a 
 tincture of the Acetate was formerly official, and has been used success- 
 fully in the treatment of pneumonia. Ammoniated copper has been 
 highly recommended for facial neuralgia, but requires pushing to the pro- 
 duction of some physiological action. Ointments or lotions of the Ace-* 
 tate are useful applications in eczema, herpes, tinea sycosis, mentagra and 
 herpes circinatus. 
 
 Villate' s Solution has been successfully used as a local injection for the 
 cure of caries. It is composed of Copper Sulphate, Zinc Sulphate, of 
 each 15 parts, Liquor Plumbi Subacetatis 30, Vinegar 200. The solution 
 is thoroughly injected into the sinuses leading to the carious bone. 
 
 CURARE, Woorara (Unofficial), — is a vegetable extract obtained 
 from various members of the Strychnos family, also from Paullinia curare 
 and other plants. It is used in S. America as an arrow-poison under 
 various names, as Caroval, Vao, etc. Its active principle is the crystal- 
 lizable alkaloid Curarine, which contains no oxygen. 
 
 The dose of Curare is gr. ^V - -? hypodermically, — of Curarine, gr. ^h'S'i'hu hypoder- 
 mically, or gr. y^-jV by the stomach, but as the samples vary greatly in activity they 
 should first be tried on some inferior animal before being administered to man. 
 
 Physiological Action and Therapeutics. 
 Curare is a paralyzer of the voluntary muscles, affecting them through 
 the end-organs of the motor nerves. It does not at first act upon the 
 brain or spinal cord, but if life be prolonged by artificial respiration the 
 cord, sensory nerves and even the muscular tissue become affected. 
 The heart, at first quickened, becomes depressed, the blood-pressure 
 is lowered, the eyelids droop, the eyeballs protrude, vision is disordered, 
 intestinal peristalsis and sensibility to stimuli are greatly increased, and 
 an artificial glycosuria (curare-diabetes) is set up. The limbs are para- 
 lyzed first, death occurring by paralysis of respiration. The absorption 
 of the drug by the stomach is very slow, as its active principle passes 
 with difficulty through animal membranes, and its elimination, which 
 takes place by the kidneys, being more rapid and complete than that of 
 any other agent, no marked effect may be produced when it is adminis- 
 tered internally. When hypodermically injected its action is very prompt. 
 The urine of a curarized animal will poison another, and that of the second 
 animal will paralyze a third. As compared with other motor depressants 
 Curarine and Coniine paralyze the end-organs of the motor nerves, Gel- 
 semine paralyzing the motor centres. 
 
 Antagonists and Inco?npatibles. 
 
 Strychnine, though from a member of the same family, is antagonistic as to the action 
 on the heart and respiration. So also is Atropine. Artificial Respiration is the most 
 
CUSSO DAMIANA. 299 
 
 efficient antagonist, maintaining life until elimination occurs. Evacuation of the bladder 
 repeatedly is important to prevent reabsorption. The caustic alkalies destroy Curarine 
 as they do all other alkaloids. 
 
 Curare is chiefly used for experimental purposes on the lower animals. 
 It has an historical interest from its having been the means by which 
 Bernard demonstrated the existence of muscular contractility as an essen- 
 tial endowment of that tissue. It has been used with some success in 
 spasmodic nervous affections, particularly in tetanus, both idiopathic and 
 traumatic, in hydrophobia, chorea and epilepsy. It does not promise 
 well as a therapeutic agent, but undoubted cases of hydrophobia are 
 reported by high authority as cured by this drug. 
 
 CUSSO, Kousso, Brayera, — is the female inflorescence of Hagenia abyssinica, an 
 Abyssinian tree of the nat. ord. Rosaceae. It contains tannic acid, a volatile oil, and a 
 crystalline principle named Koussin. Dose, of Cusso, ^ij-^j. 
 
 Extractum Cusso Fluidum, Fluid Extract of Kousso. — Dose, sjij-^j. 
 
 Cusso has little or no effect except the nausea, vomiting, colic and slight diarrhea pro- 
 duced by large doses. Its chief action is anthelmintic against both varieties of tape- 
 worm, but it rarely expels the head of the parasite, and is very nauseous to the taste and 
 difficult of retention by the stomach in the large doses necessary to efficiency. From g ij 
 to ^j of the flowers infused in t ^ iv of boiling water is the usual dose, which should be 
 taken on an empty stomach and followed by a castor-oil or saline purge after 3 or 4 
 hours. An emulsion of a 6 per cent, infusion with castor-oil, yolk of egg, a few drops 
 of ether and oil of anise with 10 to 20 drops of the Oleoresin of Male-fern, is more agree- 
 able and efficient than the infusion alone. 
 
 CYDONIUM, Quince Seed (Unofficial), — is the seed of Cydonia vulgaris, a tree 
 of the nat. ord. Rosaceae, native in Crete and Austria, and cultivated elsewhere. The 
 seeds placed in water swell up, forming a mucilaginous mass. The mucilage is the only 
 constituent of importance and is contained in the epithelial cells. It has been named 
 Cydonin, and is considered to be a compound of gum and cellulose. 
 
 Mucilago Cydonii, Mucilage of Cydonium (Unofficial), — is prepared by macerating 
 2 parts of Cydonium in 100 of Distilled Water. Dose, indefinite. 
 
 Cydonium is of value for its mucilage, which is used as a bland, demulcent application 
 in conjunctivitis, abrasions of the skin, and fissures of the mucous membranes, and as a 
 vehicle for injections in gonorrhea. Internally it may be used as a soothing remedy for 
 the throat, stomach, or intestines. The preparation known as Bandoline, used as a hair- 
 dressing, is identical with mucilage of Cydonium. 
 
 CYPRIPEDIUM, Ladies' Slipper,— is the rhizome and roots of Cypripedium 
 pubescens, and of C. pa)-viflorum, the Moccasin-plant, or American Valerian (nat. ord. 
 Orchideae). It contains a volatile oil, a volatile acid, resins, and tannin. 
 
 Extractum Cypripedii Fluidum, Fluid Extract of Cypripedium. — Dose, rr\x-xxx. 
 
 Cypripedin (Unofficial), — is an impure alcoholic extract. Dose, gr. ss-ij. 
 
 Cypripedium is antispasmodic, tonic, stimulant and diaphoretic, possessing the same 
 general properties as Valerian, whence one of its common names, American Valerian. 
 It is a popular remedy in some parts of the U. S. for nervous hyperesthesia unaccom- 
 panied by organic lesions, and especially in morbid sensibility of the eye. It is reported 
 to have even cured epilepsy, and is said to be highly useful in neuralgia, hysteria, nervous 
 headache and insomnia. 
 
 DAMIANA (Unofficial), — the leaves of Turnera aphrodisiaca, a plant of the nat. 
 ord. Turneraceae, growing in Mexico and Lower California. Several varieties of so-called 
 Damiana are in the market, but the true leaf is of a light-green color, small, lanceolate, 
 and dentate along the margin. It contains a volatile oil and a resin. Dose, ijj daily. 
 
300 DATURA TATULA — DIGITALIS. 
 
 Extractum Damianae, Extract of Damiana (Unofficial). — Dose, gr. ij-x. 
 
 Extractum Damianae Fluidum, Fl, Ext. of Damiana (Unof.). — Dose, TT^x-^j. 
 
 Damiana is said to be a powerful aphrodisiac in cases of sexual atony, but the pub- 
 lished reports of its use since its introduction vary greatly as to its efficacy. It is probably 
 a stimulant diuretic, a bitter tonic, and a purgative in sufficient doses. Besides its use as 
 an aphrodisiac Damiana has been administered with benefit in some forms of cerebral 
 exhaustion and general atony of the nervous system, also in sick headaches and in some 
 few cases of paralysis. It forms the chief stock in trade of the numerous charlatans who 
 fill the daily papers with advertisements of "manhood-restorers." 
 
 DATURA TATULA (Unofficial), — is an indigenous plant of the nat. ord. Solana- 
 ceoe, resembling Stramonium very closely, with which it generally agrees in its physio- 
 logical action and therapeutics. It is distinguished by its purple stem, purple flowers and 
 anthers, and the darker green of its leaves. It probably contains the alkaloid Daturine 
 (see Stramonium), — and has been smoked in asthma, in a few cases giving continued 
 relief when Stramonium had failed to render any service. 
 
 DIGITALIS, Foxglove, — Digitalis consists of the leaves, col- 
 lected from plants of the second year's growth, of Digitalis purpurea, 
 the Purple Foxglove, a plant of the nat. ord. Scrophularinese, which 
 grows wild in Europe, and is cultivated in this country, often in private 
 gardens for its beautiful spike of purple flowers, and largely by the Shakers 
 for the drug market. 
 
 The British Phar. directs that the official drug shall consist of "the dried leaf, collected 
 from the wild, indigenous plant, when about two-thirds of the flowers are expanded." 
 Much of the leaf found in our shops is of very poor quality, a large proportion being 
 inert ; but whether this is due to our Pharmacopoeia not restricting the official drug to the 
 wild plant, or to careless treatment in gathering and drying, is not definitely known. 
 When, however, the leaves are imperfectly dried, a process of decomposition sets in, 
 which destroys the active principles, and may produce new and poisonous ones. A 
 similar decomposition is said to occur whenever the tincture of Digitalis is mixed with 
 watery or syrupy solutions. Certain it is, at any rate, that Digitalis is one of the most 
 unreliable drugs, in respect to the physiological activity of any particular sample or 
 preparation. The seeds are known to contain the active principles in much greater pro- 
 portion than the leaves, but they are never used. 
 
 Constituents of Digitalis. 
 The supposed active principle of Digitalis was first designated by the 
 term Digitalinum (Digitalin), under which name a substance was official 
 in the U. S. Phar. and a process was given therein for its extraction, until 
 the revision of 1880, when it was omitted. It was an amorphous product, 
 of complex composition, and did not represent Digitalis. In 1871 Nati- 
 velle received the Orfila prize from the French Academy for the discovery 
 of a crystalline principle in Digitalis, which he named Digitaline. This 
 was supposed to be the active principle of the plant, until Roucher 
 (1872) and Schmiedeberg (1875) f° un d it to be a complex body consist- 
 ing of a mixture of Digitalin and Digitoxin. 
 
 Schmiedeberg' s latest analysis is now accepted as the most accurate determination 
 yet obtained of this vexed question. He enumerates five principles as contained in 
 Digitalis, namely — 
 
DIGITALIS. 301 
 
 (1) Digitalin, a granular glucoside, soluble in alcohol, almost insoluble in water, 
 sparingly soluble in ether or chloroform ; possesses in a high degree the medicinal action 
 of digitalis ; the active ingredient of Homolle's French Digitaline and the Digitalin of 
 the U. S. and Br. Pharmacopoeias. 
 
 (2) Digitoxin, a crystalline glucoside, soluble in alcohol, slowly in chloroform, 
 sparingly in ether, quite insoluble in water ; the most toxic of all the constituents, but 
 uncertain, cumulative and dangerous in its action ; the principal constituent of Nativelle's 
 prize Digitaline. 
 
 (3) Digitalei'n, an amorphous glucoside, soluble in both water and alcohol, insoluble 
 in ether or chloroform. Its action on the heart is non-cumulative and it causes no 
 irritation when subcutaneously injected. 
 
 (4) Digitonin, a crystallisable glucoside resembling Saponin, soluble in water, 
 insoluble in cold alcohol, ether or chloroform. It is perhaps the diuretic agent. 
 
 (5) Digitin, a crystalline body, insoluble in ether or chloroform, scarcely soluble in 
 water, more readily in alcohol. It is physiologically inert. 
 
 The first three are cardiac stimulants and are highly poisonous. Digitonin is a direct 
 depressant of the heart and antagonizes the stimulant action of the others. All five are 
 non-nitrogenous, and except Digitin are glucosides. Digitalis contains no alkaloid. 
 
 / 
 
 Official Preparations. 
 
 Digitalis, Digitalis, — the powdered leaves. Dose, gr. ss-iij. 
 
 Extractum Digitalis, Extract of Digitalis, — By maceration and percolation in Alco- 
 hol 2, Water I, distilling off the alcohol, and evaporating the residue. Dose, gr. %-). 
 
 Extractum Digitalis Fluidum, Fluid Extract of Digitalis, — By maceration and 
 percolation in Alcohol 2, Water I, and evaporation. Dose, TTLss-iij. 
 
 Tinctura Digitalis, Tincture of Digitalis, — Digitalis 15, Diluted Alcohol to 100. 
 By maceration and percolation. Dose, n\v-xx. 
 
 The Tincture and Fluid Extract, being alcoholic preparations, contain Digitalin, 
 Digitoxin and Digitale'in, which are soluble in alcohol and represent the cardiac action 
 of the drug itself. On the addition of water to these preparations, the Digitoxin is 
 precipitated. The Infusion contains Digitonin and Digitalein but practically no Digitalin 
 or Digitoxin, and is the best preparation for diuretic purpose. The Tincture is the best 
 for the cardiac action ; but to obtain the action of the plant itself the powdered leaves 
 must be used in pill or capsule. To obtain the best action of the Tincture on the heart, 
 it should be administered without admixture, or at least, with water alone, the latter 
 being added immediately before ingestion and any precipitate being also swallowed. 
 
 Infusum Digitalis, Infusion of Digitalis, — Digitalis \]/ z , Alcohol 10, Cinnamon 
 Water 15, Boiling Water 50, Water to 100. By maceration in boiling water. Dose, 
 £j-iv. Notice that the dose is in drachms, not in ounces. The British Infusion has 
 only *^ the strength of the above and is given in doses of ^ij-iv. In France a cold 
 infusion is preferred, 5 grains of the powdered drug being macerated in 4 ounces of cold 
 water for 8 to 12 hours and then filtered. The dose is 3 ss every two hours. 
 
 Unofficial Preparations. 
 
 Digitalinum, Digitalin, — is the complex product of the process formerly official 
 
 in 
 
 the U. S. and Br. Phar. Dose, gr. g'o-jV 
 
 Homolle's (or Quevenne's) Digitalin, — is much used in France in form of granules. 
 Consists chiefly of Digitalin with a little Digitoxin, and possesses the action of the 
 leaves. An amorphous, yellowish- white powder or small scales, intensely bitter, 
 inodorous, but irritant to the nostrils. Dose, gr. Jj, equal to about gr. jss of the 
 powdered leaves. 
 
 Nativelle's Digitaline, — consists largely of Digitoxin, and is cumulative in action. 
 Light, white, crystalline tufts of needles, of very bitter taste ; soluble in alcohol, insoluble 
 in water. Dose, gr. - ^ - ^ - in pill. 
 
 Digitalinum Verum, is the distinguishing name given by Kiliani to Schmiede- 
 berg's Digitalin, which he believes to be the best form in which to prescribe Digitalis. 
 Its composition is definite, it is obtainable commercially in a sufficiently pure condition, 
 
302 DIGITALIS. 
 
 it possesses all the medicinal action of Digitalis on the heart, and it is non-cumulative. 
 It is soluble in ioo of 50 per cent, alcohol and in 1 000 of water. Dose, gr. g-A^ every 2 
 or 3 hours. 
 
 Physiological Action. 
 
 Digitalis is a cardiac and vascular stimulant, a diuretic in certain con- 
 ditions, an emetic to some persons, hemostatic, anaphrodisiac, excito- 
 motor and at last a paralyzant. In over-doses it irritates the mucous 
 membranes, causing sneezing, severe gastric disturbance, nausea, vomit- 
 ing, colic and purging, the discharges being of a grass-green color. In 
 such doses it lowers temperature, probably by lessening the blood- 
 supply to the tissues, produces headache, irregularity of the heart's 
 action, vertigo and an appearance of vibratory fringes of color around 
 objects. 
 
 Digitalis slows the action of the heart but increases its force at the same 
 time. It stimulates the cardiac muscle and its inhibitory apparatus, and 
 also stimulates the vaso-motor centres, contracting the arterioles and 
 thereby greatly raising arterial tension. The continued use of full doses 
 dilates the blood-vessels, exhausts the irritability of the cardiac motor 
 ganglia, and finally paralyzes the cardiac muscle itself. The recumbent 
 posture must be maintained when Digitalis is given for its full cardiac 
 effects. Its final effect on striped muscular tissue is to lessen the con- 
 tractile power, causing great weakness and languor. Under its influence 
 the excretion of urea is at first increased, but soon decidedly diminished. 
 It lessens the sexual appetite and impairs the venereal function. Lethal 
 doses lessen the reflexes by stimulation of Setschenow's centre, and para- 
 lyze the muscles and the peripheral nerves, motor and sensory. Respira- 
 tion, at first slowed, becomes rapid and feeble ; cyanosis, coma and con- 
 vulsions follow, also death by sudden paralysis of the heart, which is 
 arrested in systole. 
 
 It has been conclusively shown that in many cases of pneumonia 
 Digitalis failed to influence the pulse, the result probably of the partial 
 paralyzant influence of high body-temperature upon the vagus centre and 
 endings in the heart, thus weakening the inhibitory apparatus to such a 
 degree that the drug awakens no responsive increase of inhibition. In 
 cases with but moderately high pyrexia the characteristic action of the 
 drug is not interfered with. 
 
 Compared with Aconite, both this drug and Digitalis slow the heart, 
 but otherwise their actions are antagonistic. Aconite at first stimulates 
 and soon relaxes inhibition and depresses the cardiac motor ganglia, — 
 Digitalis increases inhibition and stimulates the cardiac muscle. Both 
 drugs finally paralyze the heart, Aconite by direct depression of its motor 
 ganglia, Digitalis by over-stimulation of the cardiac muscle. Under 
 Aconite the heart is arrested in diastole, under Digitalis in systole. The 
 
DIGITALIS. 303 
 
 arterial tension is lowered by Aconite but is raised (at first) by Digitalis. 
 Aconite acts quickly, Digitalis very slowly, — a fact which makes the 
 latter drug of little value in poisoning by the former. 
 
 During the use of this drug for any length of time the muscle of the 
 heart is so strained by over-stimulation that on suddenly assuming the 
 erect position the cardiac energy may fail, more especially if the doses are 
 administered too close together to admit of the elimination of one before 
 the ingestion of the next. This is the explanation of the so-called cumu- 
 lative action of Digitalis, which is not now generally recognized in the 
 sense in which the term was formerly applied. Another explanation is 
 that it may stop its own excretion, by arresting the renal circulation and 
 the secretion of urine through extreme contraction of the renal vessels, 
 and thus may really accumulate in the blood. 
 
 The diuretic action of Digitalis is not yet fully understood. All authori- 
 ties agree that this action is exercised indirectly through the circulation, 
 but many differ in regard to its details. One theory is that the constit- 
 uent principle Digitalin contracts the bloodvessels all over the body, while 
 others (Digitoxin and Digitalein or perhaps Digitonin) dilate the renal arte- 
 ries. The effect of this, together with the increased force of the ventric- 
 ular contractions caused by the drug, is to greatly raise the general arterial 
 tension and consequently to increase the bloodpressure in the glomeruli ; 
 while the rapidity of the renal circulation is increased and its volume 
 augmented by the strengthening of the cardiac contractions and the dila- 
 tation of the afferent renal vessels. If this explanation be true, no other 
 drug possesses such double power, and so far as vascular action is con- 
 cerned Digitalis is the ideal diuretic. Another theory is that when a 
 small dose is given, or during the first stage of a large dose, the renal 
 arteries contract as do the other arteries of the body, but they are the first 
 to dilate under the continued influence of the drug, which then acts as a 
 diuretic. 
 
 It is generally conceded that Digitalis has some diuretic power in 
 health, but that this is slight compared with the diuresis produced by it 
 in cases of dropsy, especially when due to cardiac disease. Much un- 
 certainty exists as to its effect upon the constituents of the urine, some 
 maintaining that it increases the elimination of urea, others that this is 
 diminished, and still others that it is at first increased and afterwards 
 diminished. 
 
 Antidotes, Antagonists and Licompatibles. 
 
 Tannic Acid is the chemical antidote, but as the tannate is not inert the stomach 
 should be evacuated. Aconite is the best antagonist to the effects of large doses, Opium 
 to those of its long-continued use. Saponin and Senegin are considered to be its most 
 complete physiological antagonists. Incompatibles are Cinchona, Iron Sulphate, Tinc- 
 ture of Ferric Chloride, and Lead Acetate ; also syrupy and watery solutions, which may 
 precipitate and decompose the active principles of the plant. 
 
304 DIGITALIS. 
 
 Therapeutics. 
 
 The employment of Digitalis in disease is chiefly based on its action as 
 a cardiac tonic and a diuretic. The forms of heart disease in which it is 
 indicated are the affections of the auriculo-ventricular orifices, namely, 
 mitral and tricuspid disease, whether regurgitant or obstructive in char- 
 acter. It is contra-indicated in aortic disease, except for special symp- 
 toms, and especially in fatty degeneration of the cardiac muscle. Its 
 particular sphere of usefulness is Mitral Regurgitation, especially when 
 accompanied by venous engorgement and edema of the lungs, the right 
 heart, the liver, kidneys and subcutaneous tissues. In such cases its action 
 is shown to striking advantage, ameliorating all the symptoms by assisting 
 the flow of blood in the veins. By prolonging the diastole, it gives time 
 for the dilated auricle to empty itself through the incompetent orifice ; 
 and by strengthening the contraction of the left ventricle, it causes the 
 better approximation of the mitral flaps, consequently less regurgitation 
 occurs, less venous engorgement, and the propulsion of more blood into 
 the arterial system. If it also acts as a diuretic, as it usually does in these 
 cases, the diuresis will tend to remove the edema ; and the general im- 
 provement in the circulation produced by it will relieve the cardiac pain 
 and distress, the dyspnea and cyanosis. The less a case of mitral regurgi- 
 tation approaches the edematous type, the less good will Digitalis do as a 
 rule. 
 
 In Mitral Constriction, Digitalis is usually of great assistance, the 
 lengthened diastole giving more time for the blood to pass through the 
 narrowed orifice, and the increased force of the auricular contraction 
 helping in the same direction. 
 
 In Tricuspid Regurgitation or Constriction, Digitalis is beneficial in the 
 same manner as in disease of the mitral valve. It is particularly useful 
 in dilatation of the right side of the heart with incompetence of the tri- 
 cuspid. The rational symptoms which indicate its use are — rapid and 
 feeble cardiac action, low arterial tension, cough, dyspnea, pulsating 
 jugulars, a dusky face, scanty and high-colored urine and general dropsy. 
 
 In Aortic Regurgitation, Digitalis is generally injurious ; the prolonged 
 diastole caused by it giving more time for the blood to regurgitate through 
 the imperfectly closed orifice, and thus increasing the danger of fatal 
 syncope. It may do good if compensatory hypertrophy has not set in, if 
 the heart is feeble and its action rapid, or when there is but little blood 
 regurgitating, or when there are reasons, such as the coincident presence 
 of aortic obstruction, for wishing to strengthen and regulate the contrac- 
 tion. In any case, the dose administered should be a small one, and its 
 effects should be carefully watched. 
 
 In Aortic Constriction, Digitalis is generally contra-indicated, especially 
 
DIGITALIS. 305 
 
 when, as is usually the case, this lesion is accompanied by aortic regurgi- 
 tation. It may be of service, however, when the force of the heart-beat 
 requires strengthening ; or when, as a result of the obstruction, mitral 
 dilatation has set in, with much regurgitation and the consequent venous 
 and pulmonary engorgement. It should not be used in aortic stenosis 
 with compensatory hypertrophy, in simple hypertrophy when compen- 
 sated, in pericarditis or in fatty degeneration of the heart, except tem- 
 porarily for some special indication. 
 
 In the irritable heart of soldiers Digitalis is often curative, and palpita- 
 tion, cardiac failure and venous engorgement are well treated by it. In 
 exophthalmic goitre it has apparently benefited some cases, when used 
 over a long course of treatment; but, as a rule, this affection is not 
 amenable to its influence. 
 
 Digitalis is not a suitable diuretic in Bright's disease, though it has 
 been used with benefit in the early stage of the acute form. If its action 
 produces dilatation of the renal arteries it is questionable practice to in- 
 crease the circulation in any acutely inflamed organ ; while on the other 
 hand the arterial tension is always raised in such cases, and this drug only 
 aggravates that condition. In chronic Bright's disease it is still more 
 injurious, for the same reason, the arterial tension being already very high 
 therein. It may be of service, however, in cases of renal cirrhosis, when 
 the cardiac hypertrophy has failed to overcome the peripheral resistance, 
 and consequently there is dilatation of the left ventricle and the left 
 auriculo-ventricular orifice, with the resulting mitral regurgitation. In 
 such cases, a diuretic pill is frequently of service, consisting of Digitalis 
 leaves in powder, Calomel and Squill, a grain of each, made into pill with 
 extract of Hyoscyamus. 
 
 Digitalis is always an uncertain diuretic unless the heart is diseased ; 
 yet it has rendered good service in renal dropsy as well as in the cardiac 
 form. Its contractile power over the arteries may so predominate as to 
 arrest the renal circulation completely, and stop the secretion of urine 
 (Brunton). On this account it is well to administer at the same time an 
 agent which causes dilatation of the renal vessels, as Sodium Nitrite. Con- 
 trary to theory it has been employed with benefit in the early stage of 
 scarlet fever, and when the kidneys strike work in that disease. As a 
 hemostatic it may be used in hemorrhage from a large surface, in the 
 hemorrhagic diathesis, hemoptysis, and menorrhagia. As an antipyretic 
 it has been much used in fevers, in the first stage of pneumonia, and in 
 other inflammations, but a reaction is setting in against this employment 
 of so powerful an agent, which by over-stimulation may act as a heart- 
 depressant. In rheumatic fever it lowers the temperature, shortens the 
 duration of the disease, and is particularly indicated for any cardiac 
 complications. It was formerly much used in delirium tremens, in con- 
 20 
 
306 DIOSCOREA D1TA BARK DROSERA. 
 
 gestive headaches, acute mania and other congestive conditions of the 
 brain, but generally without much benefit. In spermatorrhea of the 
 plethoric it may be well combined with Potassium Bromide, and when 
 this affection is complicated with an atonic condition, shown by feeble 
 erections, frequent emissions, and cold feet and hands, it is a serviceable 
 anaphrodisiac. Finally, Digitalis is said by high authority to be particu- 
 larly adapted to blondes and persons of sanguine and indolent tempera- 
 ment. Sometimes the vomiting caused by it is so severe as to prevent 
 its use. 
 
 Of the four active principles contained in this plant, namely — Digita- 
 lin, Digitoxin, Digitale'in and Digitonin, the first two are soluble in alco- 
 hol and practically insoluble in water, the third is soluble in both men- 
 strua and the fourth is insoluble in alcohol but is freely soluble in water. 
 Consequently all alcoholic preparations of Digitalis contain the first 
 three principles and all aqueous ones contain the last two. In action 
 the first three are very similar, producing the characteristic effects of the 
 plant, while Digitonin is directly poisonous to the cardiac muscle, 
 decreasing its contractile power. This principle produces dilatation of the 
 arteries, generally antagonizes the action of the other constituents, and 
 perhaps irritates the renal epithelium. When, therefore, the cardiac action 
 of Digitalis is desired, the tincture should be employed, given on sugar 
 or bread, prohibiting the ingestion of any aqueous fluid within 20 min- 
 utes, either before or after swallowing it. If the diuretic action is required, 
 the proper preparation is the infusion. The latter preparation may be 
 employed hypodermically, and very small doses so administered have 
 been found efficient when larger ones given by the stomach have failed to 
 act. An infusion for this purpose is of the strength of 3 parts of the 
 leaf in 100 of water, and the hypodermic dose thereof is 15 minims 
 twice or thrice daily. 
 
 DIOSCOREA, Wild Yam, Colic-root (Unofficial), — is the rhizome of Dioscorea 
 vtY/osa, a creeping plant of the nat. ord. Dioscoraceae, indigenous to the eastern U. S. 
 It contains an acrid resin, and is reported to be expectorant and diaphoretic in action, as 
 well as stimulating to the intestinal canal, and in large doses to cause general neuralgic 
 pains with erotic excitement. It is used with great success in bilious colic ; and in the 
 cramps of cholera morbus, spasmodic hiccough, dysmenorrhea and nocturnal emissions 
 of sthenic type it is said to be very efficient. A powdered extract named Dioscorein is 
 on the market, of which the dose is gr. j-iv. A fluid extract made according to the 
 pharmacopoeial rule may be administered in doses of nptv-xxx. 
 
 DITA BARK (Unofficial), — is the bark of Alstonia scholaris, a tree of the nat. ord. 
 Apocynaceae, growing in the Philippine Islands. It contains two active alkaloids, 
 Ditaine and Ditamine, the former of which has an action identical with that of Curare. 
 The bark is considered tonic and antiperiodic, and is used in the East as a remedy for 
 intermittents. It may be given in doses of 3 j-iv, in powder or as a fluid extract. 
 
 DROSERA, Sundew (Unofficial), — A fluid extract of Drosera rotundifolia, the 
 round-leaved Sundew, is said to have been successfully used in phthisis pulmonalis. It 
 
DUB01SIA. 307 
 
 is certainly a most useful agent in whooping-cough and other spasmodic coughs ; espe- 
 cially when marked by violent paroxysms, the cough being loud and harsh, and followed 
 by bleeding from the nose or mouth, and perhaps by vomiting of the contents of the 
 stomach. The expressed juice has been applied to warts and corns, for the purpose of 
 curing them. Dose of the fluid extract, rt\v-xx. 
 
 DUBOISIA (Unofficial), — is the leaf of Duboisia myoporoidts,2XL 
 Australian tree of the order Solanaceae. It contains a poisonous alkaloid, 
 Duboisine, which is believed to be identical with Hyoscyaraine, and 
 strongly resembles Atropine. 
 
 Unofficial Preparations. 
 Extractum Duboisiae, Extract of Duboisia, — Dose, gr. Ye-%. 
 Tinctura Duboisiae, Tincture of Duboisia, — Dose, TT^v-xx. 
 Duboisinae Sulphas, Duboisine Sulphate (Langenberg's), — Dose, gr. T ^~ -£$. 
 
 Physiological Action and Therapeutics. 
 
 The actions of Duboisia are in all respects similar to those of its con- 
 gener, Belladonna, except that Duboisine is more soluble in water than 
 Atropine, is less irritating to mucous membranes, and more prompt in 
 mydriatic action, but its effects are of shorter duration. It is also less of 
 a cerebral excitant and more of a calmative and hypnotic. On man its 
 action is said by some authorities to be more powerful than that of Atro- 
 pine, but less powerful on # frogs. If administered in the intervals between 
 meals it disorders the ensuing digestion, but does not so act if given 
 while digestion is in progress. 
 
 Duboisine is highly praised for its sedative action in the mental exci- 
 tability of the insane, in the treatment of the morphine habit and in 
 paralysis agitans. In doses of gr. jfa to -f^ of the sulphate, administered 
 hypodermically twice daily, it induces quiet and refreshing sleep and is 
 not dangerous. When given in larger doses it may produce vertigo, 
 nausea or even syncope, but no fatal cases from its moderate use have 
 been reported (Massant). Its sedative effect is at the same time the most 
 persistent and also that of which the patient first acquires a tolerance. 
 Of 22 cases in which the calmative effect was at first decided, a tolerance 
 was acquired in eight. In such cases the sedative action of the drug may 
 be restored by ceasing its continuous administration and lengthening the 
 interval between the doses (De Montyel). It has been well employed in 
 puerperal mania, and may be used instead of Atropine in many conditions, 
 especially in the night-sweats of phthisis, respiratory neuroses and cardiac 
 failure. It is employed as a mild mydriatic by eye surgeons, its advan- 
 tages for them over Atropine being its more rapid action in paralyzing 
 accommodation and effecting mydriasis, the shorter duration of its effects 
 and the slight degree of conjunctival irritation produced by it. Dubois- 
 
308 DULCAMARA ELASTICA. 
 
 ine is an efficient antagonist to Morphine. Its own antagonists and 
 incompatibles are the same as for Atropine, and are given under Bella- 
 donna, ante, page 215. 
 
 DULCAMARA, Bittersweet, — the young branches of Solatium 
 Dulcamara, or Woody Night-shade, a shrub of the nat. ord. Solanaceae, 
 growing in Europe and N. America. It contains the glucoside Dulcam- 
 arin, a. peculiar principle named Picroglycion, and the alkaloid Solanine, 
 which exists in the stems of other species of Solanum, namely, S. tube- 
 rosum (potato), S. Lycopersicum (tomato), and S. nigrum (black night- 
 shade). Solanine is of bitter taste and alkaline reaction, crystallizing in 
 minute prisms which are soluble in 125 of boiling alcohol but very in- 
 soluble in water. It is a narcotic poison, but exists in very small quantity 
 in the plant. 
 
 Preparations. 
 Extractum Dulcamarae Fluidum, Fluid Extract of Dulcamara, — Dose, ^ss-jss. 
 Decoctum Dulcamarae, Decoction of Dulcamara (Unofficial), — may be made of 
 10 per cent, strength and given in doses of 3 j — ij . 
 
 Physiological Action and Therapeutics. 
 
 Dulcamara is but imperfectly understood. In overdoses it has pro- 
 duced nausea and vomiting, vertigo, convulsive muscular movements, 
 pruritus, erythematous eruptions on the skin, and languid circulation with 
 a dusky color of the face and hands. In children who have eaten the 
 berries there have been observed signs of severe enteralgia, abdominal 
 tenderness, nausea, thirst, heat in the throat and chest, great prostration, 
 rapid pulse, quick and painful respiration. In very large doses it is a nar- 
 cotic poison, causing paralysis by depression of the central nervous system, 
 with lowered activity of the heart and respiration. It is believed by 
 some authorities to be anaphrodisiac, diaphoretic and diuretic. 
 
 Dulcamara was formerly used in a variety of affections, as herpetic dis- 
 eases, chronic rheumatism, gout, jaundice, etc. It is now chiefly em- 
 ployed in obstinate scaly skin diseases, as psoriasis and pityriasis, in 
 which it is unquestionably serviceable. It is also serviceable in the diar- 
 rhea of children when produced by exposure to cold and damp, in mania 
 with strong venereal propensities, in chronic bronchitis and in whooping- 
 cough. As a diaphoretic it has been used with benefit in rheumatic and 
 venereal disorders, and is often beneficial in nasal pulmonary and vesical 
 catarrhs. It is said to be particularly useful in affections of a rheumatic 
 or catarrhal nature when caused by exposure to damp weather. 
 
 ELASTICA, India-rubber, Caoutchouc, — is the prepared milk- 
 juice of various species of Hevea (nat. ord. Euphorbiaceae), growing in 
 
ELATERINUM. 3O9 
 
 S. America, and being known in commerce as Para Rubber. It is very 
 elastic, insoluble in water, diluted acids, or diluted solutions of alkalies, 
 soluble in chloroform, carbon disulphide, oil of turpentine, benzin and 
 benzol. When pure, or nearly pure, it floats on water. 
 
 India-rubber is a hydrocarbon, and may be combined with sulphur 
 by the aid of heat (vulcanized), which process, long continued, converts 
 it into hard rubber. It is used in the fabrication of catheters, bougies, 
 pessaries, court plaster, bandages, elastic stockings, tubing, etc. An 
 analogous substance is Gutta-percha, which was official in the U. S. 
 Phar., 1880. 
 
 Gutta-percha (Unofficial), — is the concrete exudation of Isonandra gutta, a large 
 tree of the nat. ord. Sapotaceae, growing in the Malay peninsula and adjoining islands. 
 It occurs in tough but somewhat flexible pieces, of grayish or yellowish color, plastic 
 above 140 F. , soft at 212 F., insoluble in water or alcohol, soluble in chloroform, 
 oil of turpentine, carbon disulphide, benzin and benzol. It contains a hydrocarbon, 
 Gutta, C 10 H 16 (80 per cent.), two resins named Fluavil and Albau, also a volatile oil, 
 salts, fat and coloring matter. 
 
 Preparations of Gutta-percha. 
 
 Liquor Gutta-perchae, Solution of Gutta-percha (Unofficial), — Gutta-percha 9, Car- 
 bonate of Lead IO, in Chloroform 91. Used as a protective application to eruptions and 
 slight wounds, the evaporation of the menstruum leaving behind a thin adhesive and non- 
 irritating pellicle. 
 
 Traumaticin (Unofficial), — is the name given to a 10 per cent, solution of Gutta- 
 percha in Chloroform, which forms on drying a permanent, unirritating, adhesive, flexible 
 and non-contractile skin for the treatment of skin affections and slight wounds. It forms 
 an excellent basis for the application of Chrysarobin to psoriasis. 
 
 Gutta-percha has neither physiological action nor therapeutics, being used for its 
 physical qualities alone. In surgical practice it has several applications, making a good 
 material for splints, as it can be softened in hot water and adapted to any surface while 
 pliable. From it are manufactured pessaries, specula, stethoscopes and other instruments. 
 The solution may be used as a protective covering for excoriations and slight wounds, to 
 prevent pitting in small-pox, and to paint over the line of suture after post-mortem 
 examinations. 
 
 ELATERINUM, Elaterin, C 20 H 28 O 5 ,— is a neutral principle ex- 
 tracted from Elaterium, a substance deposited by the juice of the fruit of 
 Ecballium Elaterium, or Squirting Cucumber, a cultivated European 
 plant of the nat. ord. Cucurbitacese. Elaterium is no longer official by 
 reason of its variable quality. Elaterin occurs in small, colorless scales 
 or prisms, of bitter taste and neutral reaction, insoluble in water, soluble 
 in 337 of alcohol and in solutions of the alkalies. Dose, gr. ^"iV- 
 
 Preparation. 
 
 Trituratio Elaterini, Trituration of Elaterin, — Elaterin 10, Sugar of Milk 90, 
 thoroughly mixed by trituration. Dose, gr. ss-j. 
 
 Elaterin is the most powerful of the hydragogue cathartics, causing 
 profuse, watery stools, and when given in large doses great prostration 
 and gastro-intestinal irritation, nausea and vomiting. In the lower ani- 
 
310 ERGOTA. 
 
 mals it does not produce purgation, but profoundly impresses the nervous 
 system, causing irregular breathing, convulsions and death. 
 
 Its chief use is to produce free watery discharges in ascites, anasarca, 
 uremia and cerebral disorders, but while the most efficient agent we 
 possess for this purpose it must be used with great caution in the aged 
 and feeble, as its action is very depressant. 
 
 ERGOTA, Ergot, Ergot of Rye, — is the sclerotium (compact myce- 
 lium or spawn, intermediate fibrous stage) of Claviceps purpurea (class 
 Fungi), growing within the flower and replacing the grain of Rye, Secale 
 cereale (nat. ord. Gramineae). It occurs in fusiform, curved, grain-like 
 bodies, of purplish-black color, peculiar, heavy odor, and oily, disagree- 
 able taste. It should be only moderately dried, preserved in a close 
 vessel, and have a few drops of chloroform dropped upon it from time to 
 time, to prevent the development of insects. When more than one year 
 old it is unfit for use. Dose, gr. x-gj. 
 
 Composition of Ergot. 
 The composition of Ergot and the nomenclature of its supposed con- 
 stituents are subjects upon which there exist a great diversity of opinions, 
 and about which there is nothing settled. The following synopsis gives 
 the views of the different persons who have examined into the matter. 
 
 Wenzell (1864) named two alkaloids, Ecboline and Ergotine, which he claimed to be 
 the active principles, and to be combined with Ergotic Acid, a volatile body yielding 
 crystallizable salts. He also claimed the presence of Trimethylamine as a Phosphate. 
 
 Tanret (1877) isolated a crystallized alkaloid, which he named Ergotinine (dose, gr. 
 sVtV) ; also a volatile camphoraceous substance. 
 
 Dragendorf and his pupils (1875-1879) stated the active principles to be two in num- 
 ber, Sclerotic or Sclerotinic Acid, a very powerful body, yellow-brown, amorphous, taste- 
 less and well adapted for hypodermic use in doses of gr. ^ ~i , and Scleromucin, a colloid 
 substance, also quite active. Besides these they found various coloring matters (Scler- 
 erythrin, Scleroxanthin, etc.), also a non-drying Oil, a peculiar sugar (Mykose), a number 
 of alkaloids (Trimethylamine, etc.), and other inert principles. 
 
 Robert (1885) announced that Ergot contains three active principles, (i) Ergotinic 
 Acid, a glucoside, and the chief constituent of Sclerotinic Acid ; having no ecbolic action, 
 but affecting the nervous system, the heart and the respiration; — (2) Sphacelinic Acid, 
 non-nitrogenous, unstable, soluble in alcohol, insoluble in water, stimulates the vaso-motor 
 centre, and believed to be the active agent in contracting the blood-vessels and producing 
 gangrenous ergotism ; — (3) Cornutine, an alkaloid, believed to be the agent which con- 
 tracts the uterus. It produces convulsions and peristaltic contractions of the uterus, and 
 is the active agent in convulsive ergotism. 
 
 Jacobj ( 1898) finds in Sphacelinic Acid a toxic resin named Sphacelotoxin, which differs 
 from all other poisons in producing gangrene of various organs, especially in fowls and 
 pigs. It induced abortion in pregnant animals and caused ataxia and other nervous 
 symptoms in fowls. 
 
 Tanret' s Ergotinine has been proved to have no action on the uterus. The Ergotin 
 of Bonjean, Wiggers and Tanret is not a fixed compound, but a mixture. The Ecboline 
 of Wiggers is also a mixture. Sclerotinic Acid is said by many authorities to act on the 
 uterus, but this is positively denied by many others. It is probably a very uncertain 
 preparation, and is said to be really a mixture of sphacelinic acid and cornutine. Ergot 
 
ERGOTA. 311 
 
 also contains Trimethylamine ', to which its odor is due, a fixed oil, (30 per cent. ) and 
 Tannin. For the Ergotin of commerce see below. 
 
 Preparations. 
 
 Extractum Ergotae Fluidum, Fluid Extract of Ergot, — prepared with Acetic Acid 
 and Diluted Alcohol. Dose, gss-ij. 
 
 Extractum Ergotae, Extract of Ergot, commonly called Ergotin, — is prepared by 
 evaporating the fluid extract at a temperature not above 122° F., until reduced to a pilu- 
 lar consistence. Dose, gr. ij-xx. 
 
 Vinum Ergotae, Wine of Ergot, — strength 15 per cent. Dose, ^j-^j. Is now 
 made by an improved method and is more reliable than that formerly official. 
 
 Ergotin (Unofficial), — is the name of several watery extracts found on the market, and 
 varying much in action both from each other and from the parent drug. That made by 
 Squibb has about the same strength as the official extract, and represents the general 
 powers of Ergot. It may be used hypodermically in doses of gr. l /--gr. v. The Ergotin 
 of Bonjean is also an aqueous extract, but is very variable in quality and frequently inert. 
 Wiggers' Ergotin is insoluble in the ordinary menstrua, and inert on the vascular appa- 
 ratus, but causes colic and gastro-enteritis. 
 
 Physiological Action. 
 
 Ergot is a motor-excitant and a vascular contractor, also hemostatic, 
 anhidrotic, emmenagogue and oxytocic. It exalts the functional activity 
 of the spinal cord ; stimulates the vaso-motor centre, raising the blood- 
 pressure ; produces tetanic contraction of unstriped muscular fibre, dimin- 
 ishing the calibre of the arterioles; depresses the motor ganglia of the 
 heart, causing a slower and weaker pulsation ; is directly emmenagogue 
 and oxytocic, and markedly increases intestinal peristalsis. Whether the 
 admitted increase of blood-pressure is due to the action of the drug on 
 the unstriped muscle of the arterioles or is indirectly caused by stimula- 
 tion of the vaso-motor centre is a disputed question. Its action upon the 
 circulation results in the production of an artificial anemia of the arterial 
 system, and its phenomena are divided into two sets, named respectively 
 Acute and Chronic Ergotism, according as the drug is administered in large 
 doses or in small quantity for a considerable length of time. 
 
 Acute Ergotism. In large doses Ergot acts as a gastro-intestinal irri- 
 tant, causing nausea and vomiting, gastralgia, colic, thirst, difficult mictu- 
 rition and purging. It slows the heart, raises the arterial tension greatly, 
 dilates the pupils and produces pallor, vertigo and frontal headache. It 
 stimulates the contraction of unstriped muscular fibre, especially affecting 
 the sphincters and the uterus, causing continuous labor pains and tonic 
 contraction of the sphincter vesicae, making micturition difficult if not 
 impossible. It also produces cerebral and spinal anemia, coldness of the 
 surface, tetanic spasms and violent convulsions, but very large doses 
 (several ounces) are necessary to cause such results. As much as ^iij of 
 the fluid extract has been given daily for a week or more, without pro- 
 ducing any marked effect. 
 
 Chronic Ergotism occurs in two forms, the convulsive and the gan- 
 
3 I 2 ERGOTA. 
 
 grenous, — either usually excluding the other. The convulsions are 
 tetanoid spasms of the flexor muscles, the uterus, the intestinal fibres, 
 and the muscles of respiration, ending in coma and death by asphyxia. 
 The gangrenous form begins with coldness and numbness of the limbs, 
 formication of the skin all over the body, loss of sensibility and abolish- 
 ment of the special senses, bullae of blood and ichor, followed by dry or 
 moist gangrene of the lower extremities, buttocks and other parts, epi- 
 leptiform convulsions, coma and death. Autopsies show changes in the 
 posterior columns of the cord, resulting probably from spinal anemia. 
 
 Experiments with the various derivatives of Ergot show that no one 
 of its constituents represents the power of the drug itself. Those which 
 probably come nearest to it in action are the Ergotinine of Tanret and 
 Sclerotinic Acid. Cornutine stimulates the central nervous system 
 strongly and produces convulsions. 
 
 Analogues of Ergot are Ustilago (see under Zea), Gossypii Radicis 
 Cortex (Cotton-root Bark), and Caulophyllum (Blue Cohosh). They are 
 each described under their respective titles. 
 
 Antagonists and Incompatibles. 
 
 Amyl Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia antagonize its action 
 on the circulation. Caustic alkalies and metallic salts are chemically incompatible. 
 
 Therapeutics. 
 Ergot has a wide field of application. Its most familiar use is to pro- 
 mote uterine contraction in labor, but as the contractions produced by 
 it are continuous instead of the natural intermittent ones, it is highly 
 dangerous when there is any obstacle in front of the child, the probable 
 results being rupture of the uterus, paralysis of the fetal heart and severe 
 laceration of the perineum. At the end of the second stage, when the 
 head is born, is the best time for its use (if employed in labor at all) in 
 order to promote firm uterine contraction, thereby guarding against post- 
 partum hemorrhage and promoting the expulsion of the placenta. The 
 tendency, however, of obstetrical teaching, is against its employment at 
 all in labor; while in practice the teaspoonful of Ergot is almost in- 
 variably administered as soon as possible after the child is born. In 
 many uterine affections, as chronic metritis, subinvolution, congestive 
 dysmenorrhea, menorrhagia, fibroids and polypi, Ergot is well employed, 
 producing firm contraction of the womb and promoting absorption of 
 inflammatory products. It is extremely useful in amenorrhea due to 
 plethora, and in the atonic form of spermatorrhea. In conjunctivitis, 
 gonorrhea, and inflammations of mucous membranes generally, it is of 
 striking benefit, if used both locally and internally. It is also an excel- 
 lent remedy in acute and chronic dysentery, chronic diarrhea, atonic 
 
ERIGERON ERIODICTYON — EUCALYPTUS. 3 1 3 
 
 hemorrhages of arterial type, mania due to cerebral hyperemia, headache 
 and migraine of congestive form, myelitis, spinal congestion, cerebro- 
 spinal meningitis, splenic enlargement, lax sphincters of the rectum and 
 bladder, and in incontinence of urine from paralysis of the sphincter 
 vesicae. Hemorrhoids are well treated by its local application, but in 
 this affection it should not be used internally as it promotes venous con- 
 gestion. In aneurism it aids coagulation by slowing the blood current, 
 and in cardiac hypertrophy without valvular lesion it acts well by slowing 
 the heart. In diabetes insipidus full doses of Ergot are often curative, 
 and it has been used with benefit in diabetes mellitus. 
 
 Hypodermically, the aqueous extract dissolved in water and free from 
 alcohol or any other irritating substance is in many cases much more 
 prompt in action than when given internally, especially if injected near 
 the seat of the affection. This is particularly true in post-partum and 
 other hemorrhages, prolapse of the rectum, chronic metritis and subin- 
 volution of the womb, uterine fibroids, varicocele and varicose veins. 
 When so administered it will frequently contract the sphincter of the 
 bladder so as to produce retention of urine and necessitate the use of the 
 catheter. 
 
 ERIGERON, Fleabane (Unofficial), — is the flowering plant Erigeron canadense, a 
 plant of the nat. ord. Composite, growing in N. America. It contains a Volatile Oil, 
 which is official, also tannic acid and a bitter extractive. 
 
 Oleum Erigerontis, Oil of Fleabane , — a pale yellow liquid, of sp. gr. about 0.850, 
 becoming darker by age and exposure to air, of peculiar and persistent odor, pungent 
 taste and neutral reaction, readily soluble in alcohol. Dose, TTLx-^ss. 
 
 Oil of Erigeron has the same action as Oil of Turpentine but is less irritant and less 
 efficient. It has considerable reputation as a hemostatic, especially in menorrhagia and 
 intestinal hemorrhage of passive form, as in typhoid fever. It is also used with benefit 
 in diarrhea and dysentery, and in hemoptysis without fever or other evidence of irritation 
 it is a very valuable remedy. 
 
 ERIODICTYON, — the leaves of Eriodictyon glutinosum, or Yerba Santa, a Cali- 
 fornia shrub of the nat. ord. Hydrophyllaceas. They contain an acrid Resin and an 
 aromatic Volatile Oil. 
 
 Extractum Eriodictyi Fluidum, Fluid Extract of Eriodictyon, — Dose, TTLxv-gj. 
 
 Extractum Eriodictyi, Extract of Eriodictyon (Unofficial), — Dose, gr. ij-x. 
 
 Eriodictyon is expectorant, and covers the taste of Quinine in a remarkable manner, 
 for which purpose it is combined in mixture with Glycyrrhizin, under the title Velatine, a 
 proprietaiy preparation (see ante, page 276). It is used with fair success in bronchial 
 and laryngeal affections, also in asthma. Combined in syrup with Grindelia it is very 
 efficient for coughs. 
 
 EUCALYPTUS,— the leaves, collected from the older parts of the 
 tree, of Eucalyptus globulus or Blue Gum-tree (nat. ord. Myrtaceae), a 
 native of Australia, now grown in California, Italy, etc. They contain 
 tannic acid, a resin, a fatty acid and a Volatile Oil. The latter consists 
 of three different oils which distil over at various temperatures, the first 
 product being the official substance named Eucalyptol, C 10 H 18 O, which 
 
3 14 EUCALYPTUS. 
 
 by the action of phosphoric acid is converted into Eucalyptene, a sub- 
 stance allied to Cymene, and Eucalyptolen. 
 
 Preparatio7is. 
 
 Extractum Eucalypti Fluidum, Fluid Extract of Eucalyptus, — is three-fourths 
 alcohol. Dose, TTLx-^j. 
 
 Oleum Eucalypti, Oil of Eucalyptus, — the volatile oil, is distilled from the fresh 
 leaves of various species of Eucalyptus, that from E. atnygdalina being considered 
 wanting in Eucalyptol. Is soluble, in all proportions, in alcohol, carbon disulphide, or 
 glacial acetic acid. Dose, TTLv-xxx, in emulsion or capsules. 
 
 Eucalyptol, C 10 H 18 O, — is a neutral body obtained from the volatile oil ; a colorless 
 liquid, of aromatic, camphoraceous odor, and pungent, cooling taste ; soluble in all pro- 
 portions in alcohol, carbon disulphide and glacial acetic acid. Dose, Tryij-x. 
 
 Physiological Action. 
 
 The taste of Eucalyptus is warm, aromatic, bitter and camphoraceous. 
 It increases the flow of saliva, the gastric juice and the intestinal secre- 
 tions, and in small doses promotes appetite and digestion, increases the 
 heart's action and lowers arterial tension. In large doses it produces 
 eructations, indigestion, diarrhea, nausea and vomiting, lowered temper- 
 ature, great muscular weakness, and if continued will irritate and congest 
 the kidneys, and induce a feverish state with symptoms of cerebral con- 
 gestion and great constitutional disturbance. In toxic doses it is a nar- 
 cotic poison, and a fatal dose causes paralysis of respiration by direct 
 action on the respiratory centre in the medulla. 
 
 Eucalyptus is powerfully antiseptic and destructive to low forms of 
 life, a stimulating expectorant and an efficient diaphoretic. By some 
 authorities it is believed to reduce the size of an enlarged spleen and to 
 possess anti-malarial properties by absorbing noxious germs as well as by 
 draining the soil of its water, and by its aseptic emanations purifying the 
 atmosphere in its vicinity. It is largely cultivated in malarial districts 
 for these properties, and is reported to have rendered habitable a portion 
 of the deadly Roman Campagna. 
 
 Eucalyptus is eliminated by the skin, the bronchial mucous membrane 
 and the kidneys. It imparts its odor to the breath and the urine and is 
 more or less irritant at the points of its elimination. 
 
 Therapeutics. 
 Eucalyptus is an efficient stomachic in atonic dyspepsia, chronic gastric 
 and intestinal catarrh, and in conditions of the intestinal canal which 
 favor the development of worms. In chronic catarrhal conditions of the 
 genito-urinary organs, the broncho-pulmonary mucous membrane and 
 especially the bladder, it is very useful, acting as a stimulant and disinfec- 
 tant to the mucous membranes. It is equally beneficial in chronic bron- 
 chitis and bronchorrhea, in cachectic states generally and in convales- 
 
EUONYMUS EUPATORIUM EUPHRASIA. 3 I 5 
 
 cence from acute diseases. In epidemic influenza (grippe) the oil has 
 been used internally with good results, and sprinkled on blotting-paper 
 placed in offices and stores has seemed to act as a prophylactic on persons 
 employed therein. In hysteria, chorea and asthma it is beneficial, in the 
 latter affection being advantageously smoked in cigarettes with Stramo- 
 nium or Belladonna leaves. In malaria as a reconstructant it is better 
 than Quinine, and it has considerable utility in obstinate intermittents 
 where it is desirable to stop the use of Cinchona preparations. As an 
 antiseptic it is highly valuable in dilute solution for application to ulcers 
 and as a substitute for Carbolic Acid on gauze in the antiseptic treatment 
 of wounds. It is also used in dilute solution locally, as a stimulating dis- 
 infectant in stomatitis, and in the subacute stages of pharyngitis and ton- 
 sillitis. An aqueous preparation is highly recommended as a vehicle for 
 alkaloids in solution for hypodermic use, to prevent the development of 
 the penicillium which rapidly destroys the alkaloid present. 
 
 EUONYMUS, Wahoo, — is the bark of Euonymus atropurpzireus, a shrub of the 
 nat. ord. Celastrineae, growing in the U. S. It contains an amorphous, bitter principle 
 named Euonymin, also Resins, Euonic Acid, and Asparagin, fixed oil, etc. 
 
 Extractum Euonymi, Extract of Euonymus, — Dose, gr. j-v. 
 
 Euonymin (Unofficial), — the eclectic preparation, consists of the fixed oil and resin, 
 and is given in doses of gr. ss-v. 
 
 Euonymus is classed with Rhubarb, Jalap, Aloes, etc. , as a tonic-astringent and resin- 
 bearing purgative. It is said to be also diuretic and expectorant and a very efficient 
 cholagogue. Its cathartic action is similar to that of Rhubarb, but milder. It has been 
 employed with benefit in some cases of dropsy, also in habitual constipation, torpid liver, 
 and pulmonary affections. In overdoses it will set up considerable gastro-intestinal 
 irritation. 
 
 EUPATORIUM, Thorough-wort, Boneset, — the leaves and flowering tops of 
 Eupatorium perfoliatum , an American plant of the nat. ord. Composite. It contains a 
 neutral, bitter principle, named Eupatorin, tannic acid, a volatile oil, etc. 
 
 Extractum Eupatorii Fluidum, Fluid Extract of Ezipatorium, — Dose, TTLx-^j. 
 
 Eupatorium is a bitter tonic and efficient diaphoretic, also in full doses emetic and 
 aperient. It has been supposed to have antiperiodic and teniafuge powers. A warm 
 infusion (Boneset tea) is a popular diaphoretic in remittent and typhoid fevers, also at the 
 onset of an attack of acute catarrh or general cold. As a bitter tonic it may be used with 
 advantage in dyspepsia and general debility. Its common name is derived from its sup- 
 posed power to relieve the bone pains of dengue, the " break-bone fever." 
 
 Another variety of Eupatorium, E. purpureum, or Gravel-root, is reputed to have de- 
 cided power over the uric acid diathesis. 
 
 EUPHRASIA, Eye-bright (Unofficial),— is a plant of the nat. ord. Strophulari- 
 aceae, growing in Europe and the U. S., containing Euphrastic Acid, tannin, etc. It 
 was formerly of great repute in various eye-affections, and may be of utility as a mild 
 astringent in catarrhal conjunctivitis. Its chief value, however, is to abort an attack of 
 acute nasal catarrh with lachrymation, for which purpose a few drops of the tincture 
 every two hours is remarkably efficient. In hay-fever also it is of decided utility in miti- 
 gating the catarrhal symptoms, and in the acute coiyza of measles it will be found an ex- 
 cellent remedy. A tincture (i to 9) of the fresh plant should be used, and given in doses 
 of TMJ-v. 
 
3 l6 FEL BOVIS — FERRUM. 
 
 FEL BOVIS, Ox-gall, Fel Tauri, the fresh bile of Bos Taurus, is a dark-green, 
 viscid liquid, of peculiar odor, bitter taste, and neutral or faintly alkaline reaction. It 
 contains Sodium Glycocholate, Sodium Taurocholate, Cholesterin and coloring matter. 
 
 Fel Bovis Purificatum, Purified Ox-gall, — 3 of Ox-gall and I of Alcohol evaporated 
 to pilular consistence after standing 24 hours. Dose, gr. v-xv. 
 
 Bile is tonic, antiseptic and purgative. It assists in the emulsification of fats, and 
 stimulates the absorbent powers of the mucous membrane. In the stomach it neutralizes 
 the gastric juice, precipitates the pepsin, and is apt to cause nausea and vomiting. It is 
 found to act well in stimulating the resolution of hypertrophies when locally applied to the 
 part, as the mammse, tonsils, pannus, etc. It is used as a laxative in constipation when 
 the secretion of bile is deficient, but has no advantage over other purgatives. 
 
 FERRUM, Iron, Fe, — is metallic Iron in the form of fine, bright, 
 and non-elastic wire. 
 
 Ferrum Reductum, Reduced Iron,— -is metallic Iron in fine powder, 
 obtained by reducing the Sesquioxide by hydrogen at a dull red heat. It 
 is a fine, gray-black, lustreless powder, odorless, tasteless, and insoluble 
 in water or alcohol, but soluble in dilute sulphuric acid with evolution of 
 nearly odorless hydrogen gas. Dose, gr. j-v, after meals. 
 
 Salts of Iron and their Preparations. 
 
 Liquor Ferri Acetatis, Solution of Ferric Acetate, — is an aqueous solution, contain- 
 ing about 31 per cent, of the anhydrous salt, and corresponding to about 7^ per cent, of 
 metallic iron. Dose, Ttyj-x. Used chiefly in pharmacy. 
 
 Ferri Carbonas Saccharatus, Saccharated Ferrous Carbonate, — has at least 15 per 
 cent, of ferrous carbonate. A greenish-gray powder, of sweetish taste at first, changing 
 to ferruginous. Partially soluble in water, but soluble in dilute hydrochloric acid with 
 evolution of C0 2 . Action, — slightly stimulant to digestive tract. Dose, gr. ij-x. 
 
 Massa Ferri Carbonatis, Mass of Ferrous Carbonate, Vallet's Mass, — Ferrous 
 Sulphate 100, Sodium Carbonate 100, Honey 38, Sugar 25, Syrup and Distilled Water, 
 each, to make 100. Has 42 per cent, of Ferrous Carbonate. An astringent, non-irritant, 
 ferruginous tonic. Dose, gr. j-v, after food. 
 
 Pilulae Ferri Carbonatis, Pills of Carbonate of Iron, Ferruginous Pills, Chalybeate 
 Pills, Blazid's Pills, — made by mixing Ferrous Sulphate, about 2. l / z grains for each pill, 
 with Potassium Carbonate, Sugar, Tragacanth, Althaea, Glycerin and Water. Dose, j-ij. 
 
 Mistura Ferri Composita, Compound Iron Mixture, Griffith's Mixture, — has of 
 Ferrous Sulphate 6, Myrrh 18, Sugar 18, Potassium Carbonate 8, Spirit of Lavender 60, 
 Rosewater to 1000. Is really a solution of the Carbonate formed by reaction between 
 the two principal constituents. An excellent chalybeate. Dose, 3 ij-iv. 
 
 Ferri Chloridum, Ferric Chloride, Perchloride of Iron, Fe 2 Cl 6 -|- I2H 2 0, — orange- 
 yellow, deliquescent pieces, of styptic taste and acid reaction, freely soluble in water, 
 alcohol or ether. Action, — strongly astringent, hemostatic. Never used internally. 
 
 Liquor Ferri Chloridi, Solution of Ferric Chloride, — an aqueous solution of the pre- 
 ceding, containing 37.8 per cent, of the anhydrous salt, with some free HC1 acid. Action, 
 strongly astringent and styptic. Dose, lT^ij-x, well diluted. Creuse's Tasteless Solution, 
 is an agreeable preparation ; it has Liquor. Ferri Chloridi %), Acidi Citrici gr. 544, Sodii 
 Carb. gr. 1000 or q. s., Aquae Destil. ^j, Alcoholis, q. s. Dissolve the citric acid in the 
 water, heat to the boiling point, gradually adding the sodium carbonate until the acid is 
 neutralized ; mix with the iron solution and add alcohol up to a total of !| iv. Dose, 
 TT\,xx-xxx, diluted. 
 
 Tinctura Ferri Chloridi, Tincture of Ferric Chloride, — a hydro-alcoholic solution 
 of Ferric Chloride, containing about 1 3. 6 per cent, of the anhydrous salt, corresponding 
 to about 4.7 per cent, of metallic iron. Has of the preceding solution 25 in Alcohol to 
 make 100. A bright, brownish liquid, of ethereal odor, styptic taste and acid reaction. 
 
FERRUM. 317 
 
 Is used in Mistura Ferri et Ammonii Acetatis. One of the best preparations of Iron. 
 Action, — ferruginous tonic. Dose, TT\v-xx, in water, syrup or glycerin. 
 
 Ferri Citras, Ferric Citrate, Fe 2 (C 6 H 5 7 ) 2 + 6H 2 0, — garnet-red, transparent scales, 
 slowly soluble in water, not in alcohol. Action, — mildly stimulant. Dose, gr. ij-v. 
 Formed by evaporating the following : — 
 
 Liquor Ferri Citratis, Solution of Ferric Citrate, — an aqueous solution, containing 
 about 2>S l A percent, of the anhydrous salt, corresponding to about *J}4, per cent, of 
 metallic iron. Solution of Ferric Sulphate 105, Citric Acid 30, Ammonia Water 88, 
 Water q. s. evaporated to 100. A dark-brown liquid, of acid reaction. Dose, tt\y-xv. 
 
 Vinum Ferri Citratis, Wine of Ferric Citrate, — Iron and Ammonium Citrate 4, 
 Tincture of Sweet Orange Peel 15, Syrup 10, White Wine to 100. Dose, gj-ij. 
 
 Ferri Hypophosphis, Ferric Hypophosphite / Fe 2 (H 2 P0 2 ) 6 , — a white or grayish- white 
 powder, odorless, tasteless, slightly soluble in water, freely so in HC1 or in a solution 
 of sodium citrate. Action, ferruginous tonic. Dose, gr. v-x. 
 
 Ferri Iodidum Saccharatum, Saccharated Ferrous Iodide, — a yellowish-white 
 powder, very hygroscopic, odorless, of slightly acid reaction, soluble in 7 of water, 
 insoluble in alcohol. Action, — ferruginous tonic. Dose, gr. v-xxv in pill or elixir. 
 
 Pilulae Ferri Iodidi, Pills of Ferrous Iodide, — made with Reduced Iron, Iodine, 
 Licorice, Sugar, Acacia and Water, covered with a coating of Balsam of Tolu in Ether. 
 " Blancard's Pills" differ from these only in being covered with a coating of reduced 
 iron to protect the interior from oxidation, but it also protects them from the solvent action 
 of the gastric juice. Dose, 1 or 2 pills ter in die. 
 
 Syrupus Ferri Iodidi, Syrup of Ferrous Iodide, — is a syrupy liquid containing 10 
 percent, of ferrous iodide. Action, — ferruginous tonic. Dose, TTLv-xxx. 
 
 Ferri Lactas, Ferrous Lactate, Fe(C 3 H 5 O s ) 2 -f- 3H 2 0, — pale, greenish-white, crystal- 
 line grains, soluble in 40 of water, freely in solution of an alkaline citrate yielding a 
 green solution, almost insoluble in alcohol. Action that of a feeble ferruginous tonic. 
 Is a constituent of Syrupus Hypophosphitum cum Ferro. Dose, gr. j-iij, in pill or syrup. 
 
 Liquor Ferri Nitratis, Solution of Fe7-ric A T itrate, — an aqueous solution of Fe 2 - 
 (N0 3 ) 6 , containing about 6.2 per cent, of the anhydrous salt, corresponding to about 1. 4 
 per cent, of metallic iron. A transparent, amber-colored liquid, of acid, styptic taste and 
 acid reaction. Action, — medium as to irritation, astringent and hemostatic. Dose, 
 TTLv-xv, well diluted. 
 
 Ferri Oxidum Hydratum, Ferric Hydrate, Ferric Hydroxide, Hydrated Oxide of 
 Iron, Fe 2 (OH) 6 , a brown-red magma, wholly soluble in HC1 without effervescence. 
 Should be freshly prepared by mixing together Solution of Ferric Sulphate 100, Ammonia 
 Water no, and Water to 250. It is the chemical antidote for Arsenic. Dose, 3J in 
 water, frequently repeated. 
 
 Ferri Oxidum Hydratum cum Magnesia, Ferric Hydrate with Magnesia, Arsenic 
 Antidote, — is a more convenient and more efficient antidote for Arsenic than the preced- 
 ing, as the excess of the alkaline precipitant is non-irritant, and is itself an Arsenic anti- 
 dote. The two following solutions should be kept ready : (1) Solution of Ferric Sulphate 
 50 cc. in Water 100 cc. (2) Magnesia, 10 grammes rubbed up with Water 750 cc. in 
 a bottle of 1000 cc. capacity. When wanted, shake the latter to a homogeneous magma, 
 add it gradually to the former, and shake them together to a uniform, smooth mixture. 
 Should be given in large doses ( % j) and frequently repeated. 
 
 Emplastrum Ferri, Iron Plaster, Strengthening Plaster, — has of Ferric Hydrate, 
 dried, 9, Olive Oil 5, Burgundy Pitch 14, Lead Plaster 72. 
 
 Trochisci Ferri, Troches of Iron, — each troche has of Ferric Hydrate gr. v, with 
 Vanilla, Sugar and Tragacanth. Dose, j-iij troches, thrice daily. 
 
 Ferri Phosphas Solubilis, Soluble Ferric Phosphate, — bright-green, transparent 
 scales, of acidulous, saline taste, soluble in water, not in alcohol. Used as an adjuvant 
 to laxative pills to prevent the after reactionary constipation. Dose, gr. v-x. 
 
 Ferri Pyrophosphas Solubilis, Soluble Ferric Pyrophosphate, — green, transparent 
 scales, of acidulous taste, soluble in water but not in alcohol. Is almost tasteless and 
 unirritating, and non-constipative. Dose, gr. ij-v. 
 
 Ferri Sulphas, Ferrous Sulphate, FeS0 4 -j- 7H 2 0, — large, pale, bluish-green prisms, 
 
3 l8 FERRUM. 
 
 efflorescent, of saline, styptic taste, and acid reaction, soluble in 1.8 of water at 59 F., 
 insoluble in alcohol. Is chiefly used to make the Dried Sulphate and other preparations. 
 
 Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate, 2FeS0 4 -f 3H 2 0, — a grayish- 
 white powder, nearly soluble in water, consisting of the preceding salt, heated gradually 
 until it ceases to lose weight. The most astringent and irritating ferrous salt, but an 
 excellent one in small doses. Dose, gr. ss-ij, in pill. 
 
 Ferri Sulphas Granulatus, Granulated Ferrous Sulphate, — is the same salt as 
 above, precipitated by alcohol from solution in dilute sulphuric acid. Dose, gr. ss-ij. 
 
 Liquor Ferri Subsulphatis, Sohttion of Ferric Subsulphate, MonseV s Solution^ — 
 is an aqueous solution of Basic Ferric Sulphate, containing 43.7 per cent, of the salt. A 
 dark, reddish-brown, almost syrupy liquid, of very astringent but not caustic taste, and 
 acid reaction, mixing with water or alcohol in all proportions without decomposition. Is 
 but slightly irritating and powerfully astringent, chiefly used locally as an astringent and 
 hemostatic, but may be given internally in doses of rtyij-x, well diluted. 
 
 Liquor Ferri Tersulphatis, Solution of Ferric Sulphate, — is an aqueous solution of 
 Normal Ferric Sulphate, Fe 2 (S0 4 ) 3 , containing 28.7 per cent, of the salt. Has the same 
 properties as described for the preceding. Used to make other preparations of Iron. 
 
 Ferri Valerianas, Ferric Valerianate, Fe 2 (C 5 H 9 2 ) 6 , — a dark, tile-red, amorphous 
 powder, of faint, valerianic odor, and mildly styptic taste, insoluble in cold water, de- 
 composed by hot water, readily soluble in alcohol. Dose, gr. j-iij, in pill. 
 
 Compound Iron Salts and their Preparations. 
 
 Liquor Ferri et Ammonii Acetatis, Solution of Iron and Ammonium Acetate, 
 Bashaw's Mixture, — prepared from Tincture of Ferric Chloride 2, Diluted Acetic 
 Acid 3, Solution of Ammonium Acetate 20, Aromatic Elixir 10, Glycerin 12, Water to 
 100. An excellent and very pleasant preparation, having some diuretic and diaphoretic 
 powers. Dose, 3 ij-v, well diluted. 
 
 Ferri et Ammonii Citras, Iron and Ammonium Citrate, — prepared from Solution 
 of Ferric Citrate 10, Ammonia Water 4, mixed and evaporated. Transparent, garnet- 
 red scales, deliquescent, readily soluble in water, insoluble in alcohol. Dose, gr. ij-v. 
 
 Ferri et Ammonii Sulphas, Ferric Ammonium Sulphate, Ammonio-ferric Alum, — 
 pale, violet crystals, efflorescent, of styptic taste and slightly acid reaction, soluble in 3 
 of water, insoluble in alcohol. Is the least astringent of the sulphates of iron, but more 
 so than any of the salts formed by vegetable acids. Dose, gr. iij-xv. 
 
 Ferri et Ammonii Tartras, Iron atid Ammonium Tartrate, Ammonio-ferric Tar- 
 trate, — transparent, reddish-brown scales, slightly deliquescent, of sweetish and slightly 
 ferruginous taste, very soluble in water, insoluble in alcohol. Contains an equivalent of 
 about 25 per cent, of Ferric Oxide, and has but slight irritant qualities. Dose, gr. v-xx. 
 
 Ferri et Potassii Tartras, Potassio-ferric Tartrate, — transparent, garnet-red scales, 
 slightly deliquescent, of sweetish and slightly ferruginous taste, very soluble in water, 
 insoluble in alcohol. Is the least disagreeable in taste of all the iron preparations, and 
 but slightly astringent and not constipating. Dose, gr.v-x. 
 
 Ferri et Quininae Citras, Iron and Quinine Citrate, — prepared from Ferric Citrate 
 85, Quinine, dried, 12, Citric Acid 3, Aq. Destil. q. s. ad 100, mixed and evaporated. 
 Thin, transparent, yellowish-brown scales, slowly deliquescent, of bitter taste, slowly sol- 
 uble in water, slightly soluble in alcohol. Contains 1 1 y z percent, of dry quinine. Action, 
 astringent and stimulant to the digestive tract. Dose, gr. iij-v. 
 
 Ferri et Quininae Citras Solubilis, Soluble Iron and Quinine Citrate, — Ferric 
 Citrate 85, Quinine, dried, 12, Citric Acid 3, Ammonia Water, Distilled Water, to 1 00. 
 Thin, transparent scales, of greenish, golden-yellow color, rapidly soluble in cold water, 
 partially soluble in alcohol. Dose, gr. iij-v. 
 
 Vinum Ferri Amarum, Bitter Wine of Iron, — has of the preceding 5 parts, Tinct. 
 Aurantii Dulcis 15, Syrup 30, White Wine to 100. Dose, 3J-iv. 
 
 Ferri et Strychninae Citras, Iron and Strychnine Citrate, — Ferri et Ammonii Citras 
 98, Strychninae I, Ac. Citric. I, Aq. Destil. 120, mixed and evaporated. Transparent, 
 garnet-red scales, deliquescent, readily soluble in water, slightly so in alcohol. Contains 
 I per cent, of Strychnine. Action, — astringent and stimulating. Dose, gr. j-iij. 
 
FERRUM. 319 
 
 Syrupus Ferri, Quininae et Strychninse Phosphatum, Syrup of the Phosphates of 
 Iron, Quinine and Strychnine. [Described under Phosphorus.] 
 
 Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron. [De- 
 scribed under Phosphorus.] 
 
 Unofficial Preparations of Iron. 
 
 Ferratin, Acid Albuminate of Iron, — is a patented preparation, claimed to be the 
 characteristic iron compound of the liver, but this is denied by competent authority. It 
 is artificially prepared from albumin, is insoluble in -water and dilute acids, but is soluble 
 in water having a slight alkaline reaction. It causes no digestive disturbance, and has 
 given good results in anemia, chlorosis, and allied affections. Dose, gr. jss-viij. 
 
 Ferri Albuminas, Iron Albuminate, — a cinnamon-brown powder, soluble in water 
 acidulated slightly with HC1. Dose, gr. x-xxx, in simple aqueous solution, or in pill. 
 
 Ferri Arsenas, Ferrous Arsenate, Fe 3 As 2 8 , — a green, tasteless powder, insoluble in 
 water, soluble in HC1. Its activity is due to the arsenic alone. Dose, gr. ^ — \ . 
 
 Ferri Bromidum, Ferrous Bromide, FeBr 2 -f 3H 2 0, — a yellow salt, of styptic taste, 
 unstable, deliquescent and very soluble. A syrup is official in the Br. Ph. which has 
 about 4j/£ grains of the bromide in each fluid-drachm. Dose of the syrup, gss-j. 
 
 Ferrum Dialysatum, Dialyzed Iron, — composition varies from Fe 2 Cl 6 -f- i2Fe 2 3 to 
 Fe 2 Cl 6 + 95Fe 2 3 , and is a 10 per cent, solution of Ferric Oxychloride in water. Pre- 
 pared by treating a solution of Chloride of Iron with Ammonia, ferric hydrate being 
 precipitated, this being dissolved by agitation is placed in a dialyzer and suspended in 
 water, which is renewed as long as it shows a trace of HC1. A reddish-brown 
 liquid, free from astringent, styptic taste, but a very feeble chalybeate. Is used as a 
 chalybeate, and as an antidote to Arsenic, but is not considered an eligible preparation. 
 Dose, TTLx-xxx. 
 
 Ferri Malas, Ferrous Malate, — is a combination of the juice of sour apples and 
 powdered iron, much esteemed in Germany, where it is official and is given in tincture, 
 Tinctura Ferri Pomatum (Ph. Ger.), the dose of which is n\xv-xxx. 
 
 Syrupus Ferri et Manganesii Iodidi, Syrup of Iron and Manganese Iodide, — is a 
 pale, straw-colored liquid, containing a little sulphate of potassium, and in each fluid ^ 
 has 50 grains of the mixed iodides in the proportion of Iron Iodide 3 parts to I of Man- 
 ganese Iodide. Dose, TTlx-xxx-^j. 
 
 Syrupus Ferri et Manganesii Phosphatis, Syrup of Iron and Manganese Phos- 
 phate, — as used by Dr. Simpson, of Edinburgh, contains in each 3 of syrup 2 grains of 
 Iron Phosphate and I grain of Manganese Phosphate. Dose, 3J. 
 
 Mistura Ferri Aromatica, Aromatic Iroii Mixture, — Pale Bark 4, Calumba 2, 
 Cloves I, Iron Wire 2, Tr. Cardamomi Co. 12, Tr. Aurantii Cort. 2, Aq. Menth. Pip. 50. 
 Macerate the first 4 in the last one for 3 days, filter, add the tinctures and make up to 
 50 parts. Dose, 3 j — ij . 
 
 Mistura Ferri Laxans, laxative Iron Mixture, — Ferri Sulph. gr. ij, Magnesii 
 Sulph. 5J, Ac. Sulph. Dil. TTi iij, Spt. Chlorof. tt\xx, Aq. Menth. Pip. ad £j. Dose, Jj. 
 
 Mistura Ferro-salina, Ferro-saline Mixttire, — Magnesii Sulph. ^j, Potassii Bitart. 
 3J, Ferri Sulph. Exsic. gr. x, Aquae quart j. Dose, a wineglassful. 
 
 Notes on the Preparations. 
 The blandest iron preparations are those which are insoluble or but 
 sparingly soluble in water; as — metallic iron, ferrous carbonate, ferric 
 hydroxide, ferric hypophosphite and ferric valerianate. Of theaqueously 
 soluble compounds, those which are salts of the vegetable acids, and the 
 mixed salts ferric phosphate and ferric pyrophosphate, are more or 
 less bland, especially the citrate, the tartrate and the phosphate, which 
 are purely bland, the acetate and lactate comparatively so. The salts of 
 the strong mineral acids are irritant and astringent or styptic in varying 
 
320 FERRUM. 
 
 degree; the iodide and bromide being irritant but not very astringent, 
 ferrous sulphate and the ammonio-ferric sulphate being powerfully astrin- 
 gent but not styptic, and ferric chloride, ferric nitrate and both ferric 
 sulphates being powerfully astringent and styptic. In overdoses the 
 astringent salts are irritant poisons and may produce fatal results if in 
 sufficient volume and concentration of solution. The per-salts (ferric) 
 are the most actively irritant. The ferrous salts are the most readily 
 absorbed and tolerated, are less irritant and astringent than the ferric 
 salts, and are the most suitable ones for prolonged administration. 
 
 The Oxides and Carbonates possess the hematinic action of iron with 
 but slight astringency, and are therefore employed to restore the quality 
 of the blood in cases of anemia, chlorosis and amenorrhea with tendency 
 to dyspepsia and constipation. Ferrum Reductum is one of the best 
 preparations for internal use, but it causes sulphuretted or phosphoretted 
 eructations which are disagreeable. The Subcarbonate is little more than 
 the red oxide, but in the massa ferri carbonatis oxidation is prevented by 
 the sugar. The Hydrated Oxide is used only as an antidote in arsenical 
 poisoning. 
 
 The Vegetable Acid Salts are the least irritant to the stomach, but are 
 also the least efficient as chalybeates. They may be administered in 
 white wines, or with alkalies and vegetable acids in effervescent mixtures. 
 The Mineral Acid Salts are characterized by their astringent and corru- 
 gating action on the tissues, and are used locally as hemostatics, the solu- 
 tion of the subsulphate being preferred for topical use as it is powerfully 
 styptic but not corrosive. The pyrophosphate is easily assimilated, readily 
 soluble and devoid of irritant qualities. The tincture of the chloride is 
 one of the most efficient preparations for internal use, and is most agree- 
 able in the form of Creuse's tasteless solution (see ante, p. 316). Other 
 Compounds contain iron in combination with other active agents, as the 
 preparations of the iodide and bromide, those with quinine, strychnine, 
 etc. These preparations are generally used for a twofold purpose, 
 namely — to relieve anemia and to act upon the specific ailment upon 
 which the anemia depends. The Albuminate contains 5 per cent, of 
 ferric oxide and is considered by many practitioners to be the most 
 readily assimilated of all the iron preparations. 
 
 Physiological Action. 
 Metallic Iron is not inert, for in the stomach it acquires molecular 
 activity through its oxidation. It is a normal constituent of the blood 
 (1 part to 230 of red corpuscles), and is also found in the bile, lymph, 
 chyle, gastric juice, in the pigment of the eye, in the milk and in the 
 urine. Occurring in the blood, the tissues generally and many of the 
 healthy secretions, also in most of the foods upon which the body 
 
FERRUM. 321 
 
 is nourished, it may be considered a food rather than a medicine, though 
 it has many medicinal uses. Administered internally in small doses it 
 acts as a stomachic and general tonic, promotes appetite and digestion 
 and improves the quality of the blood, increasing the number of the 
 red corpuscles. 
 
 In large doses or in small ones long continued it is directly unfavorable 
 to digestion, nausea and vomiting being caused by the soluble prepara- 
 tions. Its per-salts are actively irritant, and some, as the iodide, 
 chloride, nitrate and sulphate, are active poisons, highly astringent to the 
 tissues and very injurious to the teeth. Locally the iron salts of the 
 mineral acids are more or less constringent and irritant to the mucous 
 membranes and the tissues, acting as astringents and hemostatics by 
 virtue of their power to coagulate albumin. The tincture of the chloride 
 is considered diuretic. 
 
 Absorbable iron preparations administered to a healthy person, or for 
 a long time in disease, exert but little influence, giving rise to but few 
 and slight clinical symptoms. A sense of tension and fulness of the head, 
 dull pains, discomfort, also a hard and quickened pulse, constitute usu- 
 ally the only obvious derangement. When given, however, to a person 
 suffering from anemia or chlorosis the morbid symptoms expressive of 
 deficient hemoglobin generally subside and the patient soon improves in 
 health and strength. The action of iron is to cause an increase of the 
 hemoglobin of the red blood corpuscles, either by its direct conversion 
 into an ingredient of hemoglobin, or by stimulating the functional ac- 
 tivity of the hematopoietic organs, or perhaps by both means combined. 
 This power of enriching the red blood corpuscles in hemoglobin is essen- 
 tially the whole constitutional action of iron. About 40 to 50 grains are 
 estimated to be present in the tissues of a healthy adult, but only about 
 ^ to -J of a grain is daily supplied by the ordinary dietary. This amount 
 of intake is sufficient to preserve the iron equilibrium, about the same 
 quantity being excreted daily, chiefly in the feces and to a slight extent 
 in the urine. 
 
 In the stomach all iron preparations are changed to the chloride by the 
 HC1 of the gastric juice, and in the duodenum to an alkaline albuminate. 
 The greater portion is carried on through the intestinal canal, where it is 
 converted into a sulphide, which blackens the feces ; a part, however, 
 being absorbed by the intestinal epithelium in solid form and perhaps in 
 solution. After reaching the blood by way of the lymph channels, this 
 small quantity of absorbed iron is deposited in the spleen, where it may 
 undergo some changes, is again taken up by the blood and deposited in 
 the liver and perhaps in the bone marrow. In the liver the originally 
 inorganic iron is converted into higher forms and eventually into hemo- 
 globin, ferratin being probably one step in the series. When there is no 
 21 
 
322 FERRUM. 
 
 deficiency of iron in the system the liver slowly yields its store to the 
 blood again, to be carried to the cecum and large intestine, by the epi- 
 thelium of which it is finally excreted. 
 
 The doctrine of Kletzinsky, Bunge and others, concerning the non-ab- 
 sorption of iron, though often shown to be erroneous, is occasionally 
 resuscitated by writers and teachers of medicine. Briefly stated, this doc- 
 trine is as follows : That the iron existing in food-stuffs as a constituent 
 of nucleo-albumin is the only source of iron supply to the system for the 
 formation of hemoglobin. That no iron compound administered by the 
 stomach is absorbed, but after conversion to a chloride by the gastric 
 juice the only function of iron so administered is to chemically satisfy the 
 hydrogen sulphide and other sulphur compounds in the intestinal canal, 
 thereby protecting the ingested food-iron from attack by these sulphur 
 compounds and permitting it to enter the system. Against this theory 
 have been urged the facts that no metal replaces iron in the treatment of 
 chlorosis, though others would similarly satisfy the sulphur compounds ; 
 that iron is curative in chlorosis when injected hypodermically, and that 
 the sulphide administered so as to reach the intestines unchanged acts as 
 well as other iron preparations. Furthermore, it has been shown that 
 ordinary preparations of iron given internally are absorbed ; also that 
 anemia is not necessarily accompanied by intestinal putrefaction ; while 
 it has never been demonstrated that hydrogen sulphide is invariably present 
 in the intestinal canal of chlorotic subjects. 
 
 Incompatibles. 
 
 Alkalies and their carbonates, Acids, acidulous salts, and vegetable Astringents are 
 incompatible with most preparations of Iron, the latter group being so by virtue of their 
 Tannic and Gallic Acids, which form a deep blue-black precipitate (tannate of iron) 
 with the per-salts. The Tincture of the Chloride is decomposed by alkalies, alkaline 
 earths and their carbonates, astringent vegetable infusions, and by mucilage of acacia, 
 the latter producing therewith a brown, semi-transparent jelly. 
 
 Therapeutics. 
 The chief indication for the internal administration of Iron is anemia, 
 when plethora, hemorrhage or fever exist it is contraindicated. It should 
 always be given after meals, and occasionally suspended for a time, to 
 avoid deranging the stomach. It is generally considered useless to pre- 
 scribe iron in any form until after constipation has been relieved and a 
 regular action of the bowels established. When the appetite and digestion 
 are improved by Iron it will do the greatest amount of good, many 
 authorities holding that the principal benefit derived from its use, even 
 in anemia, is due to its stimulating action upon digestion and the primary 
 assimilation. The Sulphate is one of the most efficient salts and is well 
 used in combination with Aloes when any intestinal torpor exists, espe- 
 cially as it increases the cathartic power of the latter drug, economizing 
 
FICUS FCENICULUM. 323 
 
 it, and conferring upon it a permanence of action, which alone it does 
 not possess. In chlorosis, pseudo-leucocythemia, chorea of anemic girls 
 at the age of puberty, epilepsy and neuralgia of the anemic, amenorrhea 
 and other menstrual disorders of the same class of subjects, and in acute 
 rheumatism of pale, cachectic persons, the chalybeates are generally very 
 efficient remedies, especially the Tincture of the Chloride. The same 
 preparation is extensively employed in erysipelas and diphtheria with 
 good results, and in albuminuria with chronic disease of the kidneys it is 
 a useful chalybeate diuretic. In many cardiac diseases of the anemic, 
 fatty heart, weak heart, dilatation, mitral disease, etc., ferruginous prepa- 
 rations are often of signal advantage. In the syphilitic cachexia, chan- 
 croid, and sloughing phagedena, the Iodide gives good results, particu- 
 larly when the subject is one of debilitated constitution. In the nocturnal 
 incontinence of children the Syrup of the Iodide is one of the most effi- 
 cient remedies. In all chronic affections of the respiratory organs, when 
 hemorrhage is not existing or threatened, the Iron, Quinine and Strych- 
 nine Phosphate "is used with much benefit. In passive hemorrhages, 
 especially when due to anemia, the Tincture of the Chloride is very effec- 
 tive, and in all active bleeding the Solution of the Subsulphate locally 
 used is a prompt and efficient hemostatic. A weak solution of the latter 
 preparation (3J ad ^viij), used in the form of spray, is the most serviceable 
 astringent in obstinate epistaxis, and in hematemesis the same solution 
 may be swallowed in small quantities at short intervals. In chronic 
 diarrhea and dysentery the Solution of the Nitrate is an efficient astringent, 
 and a weak solution of the Chloride is used as a rectal injection in tropical 
 dysentery and against thread-worms. The Sulphate is much employed as 
 a cheap disinfectant for sewage, its action being to precipitate the pro- 
 teids, which carry down the bacteria mechanically. The Hydrated 
 Oxide is the most effective antidote in arsenical poisoning, as it forms 
 with arsenous acid an almost insoluble compound. The solutions used 
 in its preparations should be kept on hand and mixed only when wanted 
 for use. 
 
 FICUS, Fig, — is the fleshy receptacle of Fiats Carica, bearing fruit upon its inner 
 surface. The fig-tree is a member of the nat. ord. Urticacese and a native of the shores 
 of the Levant, but is cultivated in Southern Europe and in other warm countries. Figs 
 contain about 62 per cent, of grape sugar, also gum, fat, etc., and are a constituent of the 
 official Confectio Senna. 
 
 Figs are demulcent, laxative and nutritious. They are used in their fresh state as an 
 aliment, but if eaten in quantity may produce flatulence, enteralgia and diarrhea. They 
 are chiefly used as an article of diet in habitual constipation, but may be employed as an 
 ingredient of demulcent decoctions, and locally as a poultice to gum-boils. 
 
 FCENICULUM, Fennel, — is the fruit of Faenicuhim capillaceum, a European 
 cultivated plant of the nat. ord. Umbelliferse. It contains a volatile oil, united with a 
 terpene, and is a constituent of Pulvis Glycyrrhizae Compositus. 
 
324 FORMALIN FRANGULA. 
 
 Oleum Fceniculi, Oil of Fennel, — the volatile oil, a light yellow-colored liquid, 
 having the odor of fennel, a warm taste and neutral reaction, soluble in alcohol. It is 
 an ingredient of Spiritus Juniperi Compositus. Dose, rr^ij-v. 
 
 Aqua Fceniculi, Fennel Water, — contains 2 parts of the oil in 1000 of distilled water. 
 Dose, ^ss-^j. 
 
 Fennel is an aromatic stomachic and a mild stimulant. It is chiefly used as an agree- 
 able carminative in flatulence and colic, and as a corrigent to Senna, Rhubarb, and other 
 disagreeable medicines. An infusion is often used as an enema to expel flatus in infants. 
 
 FORMALIN (Unofficial), — is the proprietary name given by its 
 patentees to a 40 per cent, aqueous solution of Formic Aldehyde or For- 
 maldehyde (see ante, page 130), which solution has heretofore been used 
 mainly as a preservative of meat and in histological work as a fixing agent. 
 It is one of the most powerful germicides, equal if not superior to corrosive 
 sublimate and practically non-toxic in the strength employed. It is also 
 a most energetic disinfectant, and sprayed over floors and walls or dropped 
 on hot plates or sheets of metal, will disinfect a room more effectually 
 than any other agent. As a deodorant it is equally efficient, completely 
 destroying the peculiar methyl-mercaptan odor of the feces, and entirely 
 deodorizing sulphuretted hydrogen. It is rapidly becoming the favorite 
 surgical antiseptic. It mixes with water in all proportions, so that any 
 dilution required can be easily prepared. To make a 1 percent, solution 
 one part of Formalin is added to forty parts of water (1 oz. to 2^ pints), 
 it being itself a 40 per cent, solution. Solutions of 1 per cent, strength 
 are sufficiently strong for most purposes, and when sprayed above the 
 patient's head by a steam-atomizer for 20 minutes thrice daily have proved 
 highly efficient in whooping-cough and chronic bronchitis. Weaker 
 solutions {j/ 2 per cent.) are used as gargles and mouthwashes and for the 
 irrigation of cavities, and stronger ones (2^ per cent.) for psoriasis, 
 lupus and other skin diseases. Solutions of 1 part in 2,000 or 3,000 
 are highly recommended by Dr. Davidson for local application in the 
 septic abrasions of the cornea ending in hypopyon ulcers, which form so 
 large a part of ophthalmological work in manufacturing communities. 
 Formalin has a tannin-like effect upon the skin, producing a leathery 
 condition which passes into that of a localized necrosis without suppu- 
 ration, leaving the surface with the appearance of a newly-healed super- 
 ficial wound. It has marked toxic properties when inhaled in quantity, 
 and the vapor is very irritating to the eyes and the throat. Amyloform, 
 Dextroform and Glutol, are compounds of Formaldehyde with starch, 
 dextrin and gelatin respectively,and have been used as antiseptic dressings. 
 
 FRANGULA, Buckthorn, — the bark, collected at least one year before being used, 
 of Rhamnus Frangula, or Alder Buckthorn, a European shrub of thenat.ord. Rhamneae. 
 It contains several principles, of which the only important one is Frangulin, or Rhamno- 
 xanthin, a lemon-yellow, odorless and tasteless glucoside, insoluble in water and but 
 sparingly so in alcohol or ether, and thought to be identical with Cathartin, the active 
 
FUCHSIN GAULTHERIA. 325 
 
 principle of Senna. Another species of the genus Rhamnus is described under the title 
 Rhamnus Purshiana. 
 
 Extractum Frangulae Fluidum, Fluid Extract of Frangula. — Dose, 3 ss— ij. 
 
 Frangula-bark when fresh is a violent irritant to the gastro-intestinal tract, producing 
 vomiting, purging, and much pain. The old dried bark is a safe purgative without irri- 
 tant qualities, and is much used in the constipation of pregnancy, and other conditions 
 requiring purgation. The fluid extract is the best form for administration. 
 
 FUCHSIN, Rose'ine, Magenta, Anilin Red (Unofficial),— is the Hydrochlorate of 
 Rosanilin, C 20 H 10 N 3 -)-HCl, occurring in brilliant, elongated crystals having a green lustre, 
 readily soluble in water and therewith making a bright red solution. Given internally it 
 has produced salivation, vomiting, and diarrhea ; and when injected intravenously it has 
 caused trembling, staggering, albuminuria and fatty degeneration of the kidneys, symptoms 
 which are thought to be possibly due to the presence of Arsenic or Anilin as impurities. 
 It imparts a magenta color to the urine, and is excreted by the kidneys, liver and salivary 
 glands. It has been found to be very efficient in reducing albuminuria, in many instances 
 having entirely arrested it. It is best administered in pill with a vegetable extract as 
 Liquorice or Gentian, and in doses of gr. ^-iv, according to age. 
 
 FUCUS VESICULOSUS, Bladder-wrack, Sea-wrack (Unofficial),— is a peren- 
 nial plant of the nat. ord. Algae, growing on the shores of the Atlantic and Pacific Oceans 
 as a sea-weed. It has a flat leaf, with a midrib throughout its length, and small spherical 
 vesicles, filled with air, in the leaf. It contains mucilage and much Soda in saline com- 
 bination, also Iodine, but less of the latter than other algae growing in deeper water. A 
 decoction of the fresh plant is the best form for administration. 
 
 Fucus Vesiculosus is one of a number of marine plants which are used in various parts 
 of the world as food for man and cattle and as manure. The species under consideration 
 is considered alterative and tonic, and has been employed in goitre, glandular and joint 
 enlargements and psoriasis, but especially to produce absorption of adipose tissue in the 
 obese. An extract is sold under the title "Anti-fat." 
 
 GALBANUM (Unofficial), — is a gum-resin obtained from Ferula galbanif.ua, an 
 Asiatic plant of the nat. ord. Umbelliferae, and probably from other allied plants. It 
 occurs in minute tears, agglutinated into a hard mass, of balsamic odor and acrid, bitter 
 taste. It contains a Volatile Oil isomeric with Turpentine, a Gum, and a mixture of 
 Resins which yield by dry distillation a blue oil and Umbelliferon, a tasteless substance 
 in satiny crystals. Dose, gr. x-xx, in pill or emulsion. 
 
 Galbanum is stimulant, expectorant and antispasmodic, acting much like Ammonia 
 and Asafetida, and usually given with either of these substances. It is used in chronic 
 bronchitis and catarrh of mucous membranes generally, in amenorrhea and chronic rheu- 
 matism. 
 
 GALLA, Nutgall, — is an excrescence on Quercus lusitanica, the Dyer's Oak, a 
 shrub of the nat. ord. Cupuliferae, growing in Western Asia, and is caused by the punc- 
 ture and deposited ova of the insect Cynips Gallce tinctorice. Galls are hard, globular 
 bodies, of blackish-gray color, tuberculated on the surface, having a central cavity and 
 an intensely astringent taste. They contain from 15 to 75 per cent, of Tannic Acid, 
 about 5 per cent, of Gallic Acid, and other unimportant constituents. Dose, gr. v-xv. 
 
 Tinctura Gallae, Tincture of Nutgall, — strength 20 per cent. Dose, ^ss-iij. 
 
 Unguentum Gallae, Ahdgall Ointment, — strength 10 per cent. 
 
 The action of Nutgalls is powerfully astringent, due to the Tannic and Gallic Acids 
 contained in them. Having no special action or use of their own, their qualities may be 
 learned by consulting the articles AciDUM TANNICUM and AciDUM Gallicum. 
 
 GAULTHERIA, Wintergreen (Unofficial), — is the leaf of Gaultheria procumbens , 
 an American evergreen plant of the nat. ord. Ericaceae. Its active principle is the Vola- 
 tile Oil, which is official. It also contains Tannic Acid, Arbutin, Ursone, Ericolin, etc. 
 
 Oleum Gaultherias, Oil of Wintergreen, — is the volatile oil, a liquid of peculiar and 
 aromatic odor, sweetish, warm taste, and a slightly acid reaction. It is readily soluble 
 
326 GELSEMIUM. 
 
 in alcohol, and consists of Methyl Salicylate 90 per cent., and Gaultherilene, a hydrocar- 
 bon, IO per cent. Dose, TT\jij-x. It is nearly identical with the Volatile Oil of Betula. 
 
 Spiritus Gaultheriae, Spirit of Gaultheria, — has of the oil 5 per cent., dissolved in 
 95 of alcohol. Used for flavoring. Dose, ^ss-ij. 
 
 Gaultheria is stimulant and slightly astringent. Its chief value is as one of the sources 
 of the oil named after it, which is also found in the sweet birch and many other plants, 
 and, containing so large a proportion of Methyl Salicylate or Methylsalicylic Acid, is 
 powerfully antiseptic and antipyretic. In large doses it is irritant to the stomach, in one 
 case ^j having caused death by violent gastritis. 
 
 Oil of Gaultheria is used successfully as a substitute for Salicylic Acid in many condi- 
 tions, especially in rheumatic and gouty disorders. The plant has been used as an 
 emmenagogue and a galactagogue, but its principal employment is in the form of the 
 spirit as an agreeable flavoring agent. 
 
 GELSEMIUM, Gelsemium, Yellow Jasmi7ie, — is the rhizome and 
 roots of Gelseinium sempervirens, a climbing plant of thenat. ord. Logani- 
 acese, with showy yellow flowers, which grows in the forests of the south- 
 ern U. S., forming festoons from one tree to another. It contains a 
 volatile oil, a resin and an alkaloid, Gelseminc, in combination with 
 Gelsemic Acid. Dose, gr. ij-xx. 
 
 Preparations. 
 
 Extractum Gelsemii Fluidum, Fluid Extract of Gelsemium. — Dose, rt^ij-xx. 
 
 Tinctura Gelsemii, Tincture of Gelsemium, — strength 15 percent. Dose, n^x-gj. 
 
 Gelsemina, Gelsemine, C n H ]9 N0 2 (Unofficial), — an amorphous, colorless, inodorous, 
 nearly insoluble solid, of intensely bitter taste, and strong basic properties, neutralizing 
 the strongest acids, and with them forming soluble salts. Dose, gr. g 1 ^— £§. 
 
 Physiological Action. 
 
 Gelsemium is a powerful motor-depressant, causing paralysis of motility 
 and depression of sensibility by central action on the spinal cord. It is 
 also antispasmodic and diaphoretic. In moderate doses it produces 
 languor, slowing of the cardiac rate, enfeebled muscular action, impaired 
 sensibility, drooped eyelids and dilated pupils, with some diaphoresis. 
 In toxic dose, as a teaspoonful of the fluid extract, it produces vertigo, 
 diplopia, drooped eyelids and dilated pupils (paralysis of 3d nerve), 
 labored respiration, slow and feeble heart, dropped jaw, staggering gait, 
 extreme muscular weakness and almost complete anesthesia, profuse dia- 
 phoresis, loss of articulation, and death by asphyxia from paralysis of the 
 muscles of respiration, consciousness being preserved until C0 2 narcosis 
 sets in. Convulsions, with backward movements, occur in animals but 
 not in man. Motion is affected before sensibility in warm-blooded ani- 
 mals, sensibility before motion in frogs. 
 
 Gelsemium is not an arterial depressant, although it lowers the heart- 
 rate, and is not irritant to the gastro-intestinal tract, but it produces a 
 decided lowering of the body-temperature. The effects of a moderate 
 dose pass off in about three hours. 
 
GENTIANA. 327 
 
 Antagonists and Incompatibles. 
 
 Morphine is the most complete antagonist, so are also Digitalis, Ammonia, Alcohol, 
 and to some extent the tincture of Xanthoxylum fraxineum. Emetics, heat, faradization 
 of the respiratory muscles and artificial respiration are measures of prime importance. 
 The caustic Alkalies and Tannic Acid are chemically incompatible. 
 
 Therapeutics. 
 
 Gelsemium is indicated in all conditions of exalted nerve function, 
 and contra-indicated whenever there is a weak heart. It is best used in 
 cerebro-spinal meningitis, mania with great motor excitement and persis- 
 tent insomnia, delirium tremens, many forms of sleeplessness, pneumonia 
 and pleurisy if the heart be strong, coughs of convulsive and spasmodic 
 character, neuralgia of the fifth nerve, remittent fever, after-pains, ovarian 
 neuralgia, dysmenorrhea, irritable bladder of women, and incontinence 
 of urine from spasm of the vesical muscular fibres. In most of these 
 affections the remedy must be pushed to the inducing of some physio- 
 logical symptoms, but its action should not be carried beyond the pro- 
 duction of drooped eyelids, diplopia and muscular debility. It has been 
 used with varying success in intercostal neuralgia, myalgia, sciatica, spas- 
 modic asthma, sick headache, eczema, pruritus and tetanus. Its especial 
 field, however, is in remittent and typho-malarial fevers and cerebro-spinal 
 meningitis. It is not suitable to low fevers and has not sufficient power 
 as a cardiac depressant to be of much use in sthenic forms. 
 
 There is much evidence for the claim, made for the alkaloid Gelsemine, 
 of singular efficiency in antagonizing the mental condition occasionally 
 manifested by an unusual degree of dread, in regard to some approaching 
 ordeal, or ordinary trial of life ; as, for example, that of a woman con- 
 cerning her impending confinement, or of a student in reference to his 
 examinations. In very many such cases, the use of Gelsemine, in small 
 doses frequently repeated (gr. yi-g- ter die), has seemed to remove the 
 state of abnormal fear entirely. 
 
 GENTIANA, Gentian, — is the root of Gentiana Zutea, the Yellow 
 Gentian, one of a numerous family of plants (nat. ord. Gentianese), 
 growing in the mountainous districts of Europe. An American species, 
 G. Catesbcei, Blue Gentian, is considered nearly equal in value to the 
 official species. It contains an active, bitter glucoside, Gentopicrin or 
 Gentianin, C 20 H 30 O 12 , which is crystalline and soluble in water, also an 
 inert, amorphous body, Gentianic or Gentesic Acid, gum, considerable 
 sugar, and a trace of volatile oil, but no tannin. 
 
 Preparations. 
 Extractum Gentianae, Extract of Gentian, — aqueous. Dose, gr. j-v. 
 Extractum Gentianae Fluidum, Fluid Extract of Gentian. Dose, 3 ss-j. 
 
328 GERANIUM — GLYCERINUM. 
 
 Tinctura Gentianae Composita, Compound Tincture of Gentian, — Gentian io, 
 Bitter Orange Peel 4, Cardamom 1, Alcohol and Water to 100. Dose, s^ss-ij. 
 
 Unofficial Preparations. 
 
 Infusum Gentianae Compositum, Compound Infusion of Gentian, — contains Gen- 
 tian 10, Bitter Orange Peel 2]/ 2 , Coriander 2^, Alcohol 40, Water to 320. Dose, 
 
 Mistura Gentianae Alkalina, Alkaline Mixture of Gentian, — Ac. Hydrocyan. Dil. 
 H\nj, Sodii Bicarb, gr. xv, Infusum Gentianae Co. to ^j. One dose. 
 
 Mistura Gentianae et Sennae, Mixture of Gentian and Senna, — Infusum Sennae 
 giij, Tr. Cardamomi Co. £j, Infusum Gentianae Co. gvj. One dose. 
 
 Physiological Action and Therapeutics. 
 Gentian is a simple bitter without astringency or aroma, its action cor- 
 responding to that of Calumba, but it is more apt to disagree with the 
 stomach. In addition, like Cornus, a member of the same class, it has 
 considerable repute as an antiperiodic and febrifuge. Gentian has been 
 considered a valuable tonic throughout Europe from the earliest historical 
 times. It is highly esteemed as a stomachic tonic in dyspepsia connected 
 with the gouty diathesis, in hysteria, jaundice, and convalescence from 
 acute diseases and from malarial fever. The compound tincture is an 
 excellent vehicle for cod-liver oil, and the infusion is a good vehicle 
 for the administration of chalybeates, mineral acids and neutral salts. 
 The discoloration which iron salts make with gentian preparations is 
 probably due to gentesic acid and not to tannin, as it contains none of 
 the latter. 
 
 GERANIUM, Cranesbill, — is the rhizome of the indigenous perennial Geranium 
 maculatutn (nat. ord. Geraniaceae). Its active constituents are tannic and gallic acids. 
 Extractum Geranii Fluidum, Fluid Extract of Geranium. — Dose, TT^v-SJ- 
 Geranium is an efficient astringent, and its action corresponds with that of Tannic 
 Acid. Having no unpleasant taste it is a useful agent for infants and others having deli- 
 cate stomachs, and is a very popular domestic remedy in many parts of the country. It 
 is especially used in diarrheas, dysentery, cholera infantum, hemorrhages, relaxed con- 
 ditions of mucous membranes, gleet and leucorrhea. 
 
 GLYCERINUM, Glycerin, — is a liquid obtained by the decom- 
 position of vegetable or animal fats or fixed oils, containing not less than 
 95 per cent, of absolute Glycerin, C 3 H 5 (HO) 3 , which is a Trihydric 
 Alcohol existing in fats and fixed oils in combination with the fatty acids. 
 
 Glycerin is a clear and colorless liquid, of syrupy consistence, hygroscopic, non-drying, 
 odorless, of warm and very sweet taste, neutral reaction, sp. gr. 1.250, soluble in water 
 and in alcohol, insoluble in ether, chloroform and fixed oils. It dissolves Tannin, 
 Gallic Acid, Carbolic Acid, Salicylic Acid, Bromine, Iodine, etc. , and with the aid of 
 heat metallic salts and oxides, alkaloids, etc. With strong Nitric Acid it forms Nitro- 
 glycerin, and it reduces Potassium Permanganate, Chromic Acid and Chlorinated Lime 
 with great violence. An impurity frequently present in it is Acrolem, formed by the use 
 of too high a degree of heat in its manufacture, and which is very acrid and poisonous. 
 Glycerin is a constituent of the 6 Glycerites, Pilulae Phosphori, Mucilago Tragacanthae, 
 Massa Hydrargyri, and several extracts and fluid extracts. Dose, gj-ij, diluted. 
 
GLYCERINUM. 329 
 
 Preparations. 
 
 Suppositoria Glycerini, Suppositories of Glycerin, — each has Sodium Carbonate 
 grains 4^, Stearic Acid grains 7^, dissolved by heat in 90 grains of Glycerin, cooled 
 in a mould, and wrapped in tin-foil. Used per rectum in chronic constipation. 
 
 Glycerites of Carbolic Acid, Tannic Acid, Starch, Boroglycerin, Hydrastis, Yolk of 
 Egg, — are described under the titles of their respective ingredients. 
 
 Glycozone (Unofficial), — is described under Oxygenium. 
 
 Physiological Action and Therapeutics. 
 Glycerin is highly antiseptic, abstracts water from tissues with which it 
 comes in contact, and unless pure is often very irritating to the skin. It 
 is freely absorbed by the cutaneous and mucous surfaces, and is decom- 
 posed in the system, passing out as formic and other acids. On the 
 stomach it has no particular action, but in large quantities it is laxative 
 and is said to cause the solution of the red blood corpuscles and hemo- 
 globinuria. The urine of persons using glycerin contains a body which 
 acts like sugar in the copper and fermentation tests, but is not sugar. 
 Glycerin is a good emollient and is considered nutritive by many authori- 
 ties. It has been used as a substitute for cod-liver oil in wasting diseases, 
 but with little benefit. It has also been tried as a remedy in diabetes, 
 but with unsatisfactory results so far as reported, except as a sweetening 
 substitute for sugar in the dietary of those afflicted with that disease. It is 
 said to be fatal to intestinal trichinae, and to be an efficient internal remedy 
 in acne and flatulence. In chronic constipation, most excellent results are 
 obtained from rectal enemata of Glycerin, or from the official supposi- 
 tories thereof. As a vehicle it is used for many drugs, and is a good 
 ingredient of solutions for hypodermic use, promoting the solubility of 
 many alkaloids and acting as an antiseptic. It is also employed to pre- 
 serve and aid the action of the digestive ferments, Pepsin and Pancreatin, 
 as well as to prevent the decomposition of vaccine lymph. Locally it is 
 valuable in many cutaneous affections as an emollient and softening 
 agent. In acute coryza it gives great relief if applied by a brush or as a 
 spray to the nasal mucous membrane. It is used on cotton to the cervix 
 uteri as a depleting agent, and mixed with an infusion of flaxseed as an 
 enema to relieve tenesmus in acute dysentery. With tincture of Benzoin 
 it is an excellent application to chapped hands or lips and fissured 
 nipples. In the external auditory canal it is usefully employed to soften 
 cerumen, diminish the secretion of pus, deplete the tissues, and keep the 
 surface moist. 
 
 Unna's Paste (Unofficial), — is a mixture of equal parts of glycerin and mucilage of 
 acacia, with which are incorporated various substances, such as zinc oxide, mercuric 
 oxide, etc. 
 
 Unna's Paint (Unofficial), — has of Glycerin 10, Gelatin 4, Zinc Oxide 4, and 
 Water 10, incorporated together to form a white mixture, which when cold resembles 
 white rubber. It is applied on gauze bandages for chronic ulcers, sprains and eczematous 
 patches with induration. The glycerin has a dehydrating effect upon edematous tissues, 
 
330 GLYCYRRHIZA. 
 
 the gelatin forms the basis of the paint and imparts elasticity to the finished dressing. 
 The zinc oxide is soothing to the skin, especially when the dressing is applied to a chronic 
 eczema. 
 
 Antiphlogistine (Unofficial), — is the trade name of a preparation very similar to 
 Unna's Paint, and stated by its manufacturers to be " composed of Glycerin, Boric Acid, 
 Salicylic Acid, Iron Carbonate, Peppermint, Gaultheria, Eucalyptus and Iodine, com- 
 bined with the base de-hydrated Oxide of the Silicate of Alumina and Magnesia ; which 
 combination results in a chemical compound possessing antiseptic, anodyne, nutrient and 
 antiphlogistic properties." It is used as a dressing or poultice applied to the surface of 
 the body for inflammatory conditions of the skin, muscles and joints, also in pneumonia, 
 pleurisy, peritonitis, acute rheumatism, etc., with the object of abstracting water from 
 the tissues and thereby relieving tension ; and in cases of deep-seated inflammation to 
 produce a superficial hyperemia and thus relieve the affected part. 
 
 GLYCYRRHIZA, Glycyrrhiza, Liquorice Root,— is the root of 
 Glycyrrhiza glabra, var. glandulifcra, a plant of the nat. ord. Legumi- 
 nosae, native in southern Europe and Asia, but largely cultivated in many 
 other parts. It contains a yellow, amorphous glucoside, Glycyrrhizin, 
 C 24 H 36 9 , also Glycyrrhizic Acid, Asparagin, sugar, resin, gum, etc. 
 Glycyrrhizin when boiled with dilute acids yields glucose and a very 
 bitter substance named Glycyrrhetin. 
 
 Preparations. 
 
 Extractum Glycyrrhizse, Extract of Glycyrrhiza, — is the commercial extract of the 
 root, occurring in glossy-black rolls, of sweet, peculiar taste. Not less than 60 per cent, 
 of it should be soluble in cold water. 
 
 Extractum Glycyrrhizae Purum, Pure Extract of Glycyrrhiza, — made with Aqua 
 Ammonise and Water, by percolation and evaporation. Dose, indefinite. 
 
 Extractum Glycyrrhizae Fluidum, Fluid Extract of Glycyrrhiza, — made with 
 Aqua Ammonias and diluted Alcohol. Dose, indefinite. 
 
 Mistura Glycyrrhizae Composita, Compound Mixture of Glycyrrhiza, Broivn 
 Mixture, — has of the Pure Extract 3 parts, Syrup 5, Acacia 3, Tr. Opii Camph. 12, 
 Vinum Antimonii 6, Spt. ^Etheris Nitrosi 3, and Water to 100. Dose, 3J-^j. 
 
 Pulvis Glycyrrhizae Compositus, Compound Liquorice Powder, — Senna 18, Glycyr- 
 rhiza 23^, Oil of Fennel 4, Washed Sulphur 8, Sugar 50 parts. Dose, 3J. 
 
 Trochisci Glycyrrhizae et Opii, Troches of Glycyrrhiza and Opium, — each has of 
 Extract of Glycyrrhiza gr. ij, Powdered Opium gr. Jg, Acacia, Sugar and Oil of Anise. 
 Dose, j-ij every hour. 
 
 Glycyrrhizinum Ammoniatum, Ammoniated Glycyrrhizin, — the sweet principle of 
 Liquorice rendered soluble by Ammonia and therefore tastable, believed to be the form 
 in which Glycyrrhizin exists in the root. Occurs in brownish-red scales, very sweet, 
 and soluble in water or in alcohol. Dose, gr. v-xv. Is a constituent of Velatine, for 
 which see page 276. 
 
 Physiological Action and Therapeutics. 
 Liquorice is demulcent and mildly laxative. It has an agreeable taste, 
 and increases the flow of saliva and mucus when slowly chewed or sucked, 
 the increased secretions acting as emollients to the throat. It is used in 
 many pharmaceutical preparations, covering the taste of senna, senega, 
 hyoscyamus, turpentine, ammonium chloride, the bitter sulphates, and to 
 some degree the bitterness of quinine. The powdered extract or root is 
 used as an excipient in pills and troches. The compound mixture is an 
 
GOSSYPIUM. 33I 
 
 efficient expectorant, much employed in acute bronchitis and catarrhal 
 laryngitis, but owing its power over cough mainly to the opium contained 
 in it. The compound powder is a gentle laxative, of which senna is the 
 most active ingredient. The troches are used for cough, but must be 
 carefully prescribed for children, as each troche contains gr. Jg. f pow- 
 dered opium. 
 
 GOSSYPIUM, Cotton,— is the hairs of the seed of Gossypium 
 herbaceum, and of other species of Gossypium (nat. ord. Malvaceae), freed 
 from adhering impurities and deprived of fatty matter. In this form it is 
 official as Gossypium Purificatum, Purified Cotton, Absorbent Cotton, 
 insoluble in ordinary solvents, but soluble in copper-ammonium-sulphate 
 solution. Cotton-fibre is familiar in appearance to every one, but when 
 examined microscopically it shows as flattened, hollow and twisted bands, 
 spirally striate, and slightly thickened at the edges. It is a modification 
 of Cellulose, C 12 H 10 O 10 , and corresponds therewith in all its ordinary 
 chemical properties. 
 
 Preparations of the Cotton Plant. 
 
 Gossypii Radicis Gortex, Cotton Root Bark, — thin bands or quilled pieces, brownish- 
 yellow exteriorly, white interiorly, of slightly acrid and astringent taste. Dose, gr. xxx- 3 j. 
 
 Extractum Gossypii Radicis Fluidum, Fluid Extract of Cotton Root Bark, — made 
 with Glycerin and Alcohol, by maceration and percolation. Dose, rTLxxx-^j. 
 
 Oleum Gossypii Seminis, Cotton-seed Oil, — the fixed oil expressed from the seeds 
 and purified. Is yellow, odorless, of bland taste and neutral reaction, soluble in ether, 
 but slightly soluble in alcohol. Is introduced into the pharmacopoeia for the reason that 
 it constitutes most of the "Olive Oil" sold in foreign-shaped bottles and under foreign- 
 appearing labels. It is used in the official Liniments of Ammonia and Camphor. 
 
 Pyroxylinum, Pyroxylin, Soluble Gun-cotton, Colloxylin, — is official for the purpose 
 of making Collodium. It is prepared by macerating Cotton in a mixture of Sulphuric 
 and Nitric Acids, washing, draining and drying. 
 
 Collodium, Collodion, — made by dissolving Pyroxylin 3, in Ether 75 and Alcohol 25. 
 
 Collodium Flexile, Flexible Collodion, — Collodion 92, Canada Turpentine 5, Castor 
 Oil 3, mixed thoroughly. 
 
 Collodium Stypticum, Styptic Collodion, — Ether 25, Alcohol 5, Tannic Acid 20, 
 Collodion to 100. 
 
 Collodium Cantharidatum, Cantharidal Collodion, Blistering Collodion, — Canthar- 
 ides 60, Flexible Collodion 85, Chloroform q. s. to 100. 
 
 Physiological Action and Therapeutics. 
 Cotton-root is believed to be an efficient emmenagogue and oxytocic 
 by Southern practitioners, also somewhat of a galactagogue, but experi- 
 ments on pregnant animals have not confirmed this view of its action. 
 The Oil of the seed is very bland and may be applied to all the purposes 
 for which olive oil is used. Cotton itself, when freed from oily matter, 
 is remarkably absorbent of water, and is a good agent for excluding air 
 from injured surfaces. Pyroxylin is highly inflammable, and explosive 
 at 300 F. Collodion is also inflammable, and rapidly dries on exposure 
 
33 2 GRANATUM. 
 
 to the atmosphere by evaporation of its ether, leaving a transparent film 
 of Pyroxylin on the surface to which it has been applied ; which film, if 
 the flexible collodion be used, does not contract on drying or readily 
 crack, making it an excellent protective application. Styptic Collodion 
 is a solution of Tannin, and is an excellent hemostatic. Cantharidal 
 Collodion is a convenient blistering agent, suitable for cases where the 
 patient is inclined to remove a blister if applied in the ordinary way. 
 
 Absorbent Cotton is a valuable agent in surgical practice, being em- 
 ployed as an application in burns and scalds, erysipelas, articular rheuma- 
 tism, etc., to exclude the atmosphere, allay pain, and when covered with 
 oiled silk or rubber cloth to keep up local perspiration. It may be car- 
 bolated, borated or salicylated, by soaking in the respective solutions, 
 and is then used as an antiseptic dressing for wounds, ulcers, etc. It is 
 employed by the pharmacist in funnels to filter oils, and for the prepara- 
 tion of the official waters. 
 
 Cotton-root bark is much employed by the negroes of the Southern 
 States in decoction as a supposed abortifacient, oxytocic and emmena- 
 gogue. It is used in the South for intensifying uterine action in normal 
 labor, also in dysmenorrhea and amenorrhea. A decoction, giv in a 
 quart of water boiled to a pint, is the favorite preparation, administered 
 in wineglassful doses. 
 
 Collodion is used as a protective covering for superficial burns, ulcers 
 and wounds, slight cuts, cracked nipples, anal fissures, and erysipelas. 
 For these affections the flexible collodion should be used, but where it is 
 desirable to produce pressure on the part the ordinary form is best, as it 
 contracts with considerable force in drying. This property makes it 
 highly useful in drawing the edges of wounds together, bringing pressure 
 on buboes, incipient boils, carbuncles, etc. Styptic Collodion has many 
 uses as a hemostatic and protective which will suggest themselves, and the 
 cantharidal form is a convenient epispastic for uneven surfaces, the thera- 
 peutics of which are detailed under Cantharis. 
 
 GRANATUM, Pomegranate, — is the bark of the stem and root 
 of Punic a Granatum, a small tree of the nat. ord. Lithrarieae, cultivated 
 in subtropical countries. It contains Tannic and Punico-tannic Acids, 
 Mannite and an active liquid alkaloid Pelktierine, C 8 H 13 NO, which is 
 soluble in water, alcohol, ether, chloroform, etc., and has strong basic 
 properties. There are no official preparations. 
 
 Unofficial Preparations. 
 Extractum Granati Fluidum, Fluid Extract of Pomegranate. — Dose, ^ss-jss. 
 Decoctum Granati, Decoction of Pomegranate, — gxvij of bark from the fresh root 
 in J xvij of boiling water, boiled down to ^ xij and strained. Dose, g iv-vj every hour, 
 
GRINDELIA. 333 
 
 preceded and followed in a few hours by a brisk cathartic. The decoction of the Br. 
 Phar. is of 1 to 10 strength and is given in doses of ^ ss-ij. 
 
 Pelletierinse Tannas, Pelletierine Tannale. — Dose, gr. v-x, taken fasting and fol- 
 lowed in 15 minutes by a sharp purgative, as Castor Oil. 
 
 Physiological Action and Therapeutics. 
 Granatum and its alkaloid are teniafuge, and very efficiently so, rarely 
 failing to bring away the whole worm. The decoction is usually em- 
 ployed, but latterly Pelletierine has been coming into fashion, a proprietary 
 form being sold as Tanref s Pelletierine in bottles containing one adult 
 dose at three dollars each. The decoction in full doses causes nausea and 
 vomiting, flatulence, purging, and sometimes cramps in the legs, giddi- 
 ness, dimness of vision, general numbness of the limbs and increase of the 
 quantity of urine. 
 
 For the expulsion of tape-worm a mixed treatment by Pomegranate-root bark, Pump- 
 kin seeds and Oleoresin of Male-fern is preferred by many practitioners. The following 
 formula has proved very efficient. R . Granati ^ij, Aquae Ojss, boiled to 3 vij ; Pep- 
 inis 3* j, deprived of outer coats and beaten to a paste with fine powdered sugar ; Oleo- 
 resinse Aspidii, gr. xxx, made into emulsion with Acacia and the above decoction of 
 Granatum, then added to the paste of Pepo, and flavored with Syrups up to ,^ix. One- 
 third of this to be taken in the morning after a light diet and a laxative on the previous 
 day. If not successful the second and third portions may be taken at intervals of 3 hours. 
 The worm should be passed sitting in a tepid sitz-bath, to prevent the expelled portion 
 tearing off the head by its weight. 
 
 GRINDELIA, — is the leaves and flowering tops of Grindelia robusta, 
 and of Grindelia squarrosa, herbaceous perennial plants of the nat. ord. 
 Compositse, indigenous to the Pacific slope of the United States and 
 Mexico, where they are common along the coast and in the mountains, 
 having yellow flowers, a balsamic odor and a pungent, aromatic and bitter 
 taste. They contain a resin, which is probably the active constituent, a 
 fixed and a volatile oil, also Robustic Acid and an alkaline principle 
 named Grindeline. There is but one official preparation. 
 
 Extractum Grindeliae Fluidum, Fluid Extract of Grindelia, — is alcoholic and con- 
 tains much resin. Dose, ff\,x-3J or more, every 3 or 4 hours, in sweetened water or 
 milk, the mixture being well stirred to prevent the resin adhering to the glass. 
 
 Physiological Action and Therapeutics. 
 Grindelia has an acrid, bitter taste, and excites the secretion of saliva 
 when chewed. Its principal action is that of an antispasmodic, but it is 
 also a motor-depressant, somewhat expectorant and decidedly diuretic. 
 Given in large doses to small animals it induces paralysis, beginning in 
 the hind extremities and affecting the sensory nerve-trunks first, then the 
 sensory side of the spinal cord, afterwards involving the motor nerve- 
 trunks, and finally the spinal motor tract. It stimulates the cardiac in- 
 hibitory apparatus and the vaso-motor centre, slowing the heart and 
 
334 GUAIACUM. 
 
 respiration, and raising the blood-pressure. In sufficient quantity it 
 causes dilatation of the pupils, reduced cutaneous sensibility and sluggish 
 reflexes, even narcotism in small animals. Its elimination occurs by the 
 bronchial mucous membrane and the kidneys, both of which it stimulates, 
 and in large doses it has produced renal irritation. 
 
 Grindelia is chiefly employed as a palliative in spasmodic asthma and 
 the dyspnea accompanying bronchitis. In several cases of recurring 
 asthma in elderly persons gss of the fluid extract has afforded almost in- 
 stantaneous relief, but has not prevented the return of the paroxysms. 
 It is an efficient remedy in chronic bronchitis, especially that of the aged, 
 also in whooping-cough and other spasmodic coughs, in hay fever and in 
 the dyspnea of various pulmonary and cardiac affections, and has been 
 employed with benefit in chronic cystitis. Locally, it is used with advan- 
 tage as a lotion for the dressing of burns and blisters, in vaginitis and 
 uterine catarrh, and to allay the pain of herpes zoster. In the proportion 
 of i part of the fluid extract to 9 of water, as a sedative lotion, it is a very 
 efficient application for the cutaneous irritation due to poison-oak or ivy, 
 also in skin diseases attended with itching and burning sensations. 
 
 GUAIACUM, Lignum Vitse, — is official in two forms, — Guaiaci 
 Lignum, the heart-wood of Guaiacum officinale and of Guaiacum sanctum, 
 and Guaiaci Resina, Guaiac, the resin of the wood of Guaiacum officinale, 
 a large West Indian tree of the nat. ord. Zygophyllese. The Resin is 
 the important constituent, and itself consists of three resins, namely, 
 Guaiaconic Acid, C 19 H 20 O 5 , 70 per cent., Guaiac Acid, C 6 H 8 3 , resem- 
 bling Benzoic Acid, and Guaiarec Acid, C 20 H 26 O 4 ; also an indifferent 
 resin. The wood also contains a yellow coloring matter, gum, etc., and 
 yields, by destructive distillation, Guaiacol (see ante, page 291). 
 
 Guaiaci Lignum, Guaiacum Wood, — generally used in the form of 
 raspings, of a greenish-brown color, resinous odor, taste slightly acrid. 
 Is a constituent of Decoctum Sarsaparillae Compositum. 
 
 Guaiaci Resina, Guaiac, — occurs in large masses of a greenish-brown 
 or reddish-brown color, fracture having a glassy lustre, insoluble in water, 
 soluble in alcohol, ether, chloroform and alkaline fluids. Dose, gr. 
 v-xxx, in wafer. Is a constituent of Pil. Antimonii Compositse. 
 
 Preparations. 
 
 Tinctura Guaiaci, Tincture of Guaiac, — 20 per cent. Dose, Tt\v-3J, in mucilage 
 or syrups, as the resin is precipitated by water. 
 
 Tinctura Guaiaci Ammoniata, Ammoniated Tincture of Guaiac, — has of Guaiac 
 20, Aromatic Spirit of Ammonia to 100. Dose, TT^x-^ss. 
 
guarana gurjun balsam. 335 
 
 Physiological Action and Therapeutics. 
 Guaiac is diaphoretic, expectorant and alterative; also laxative and 
 purgative, according to the dose administered. Its taste is acrid and 
 very disagreeable. Internally it is a local stimulant, producing salivation, 
 an acrid sensation in the throat, warmth in the epigastrium, increase of 
 the gastric and intestinal secretions and the flow of bile, and reflex stimu- 
 lation of the heart. Its continued use causes gastric catarrh, and in large 
 doses it is a gastro-intestinal irritant, causing vomiting, purging and 
 severe congestive headache. Though a colloidal body it enters the blood, 
 stimulates the liver and other excretory glands and the production of 
 bronchial mucus, and causes increased circulation and diaphoresis. 
 Sometimes it fails to act on the skin and then it is markedly diuretic. 
 
 Mineral Acids and Spirit of Nitrous Ether are chemically incompatible with Guaiac 
 preparations. 
 
 Guaiac was first used as an antisyphilitic, being employed in decoc- 
 tion and in large quantity, with a spare diet and external warmth. It 
 acquired a great reputation in that disease during the 16th century, but 
 it is now abandoned therefor except as an ingredient of the Compound 
 Decoction of Sarsaparilla. It is a very efficient remedy in tonsillitis, 
 given in 5ss doses of the tincture in emulsion with mucilage or yolk of 
 egg, to abate the inflammation and abort the disease. It has considerable 
 reputation in neuralgic dysmenorrhea, amenorrhea, chronic rheumatism, 
 gout, lumbago and sciatica. The ammoniated tincture in water makes a 
 cleanly and not very disagreeable gargle. The effectiveness of Guaiac in 
 many chronic and obscure complaints is due, partly to its purgative prop- 
 erty and partly to its nastiness, a quality which is highly appreciated by 
 many patients. 
 
 GUARANA, — is a dried paste consisting chiefly of the crushed or pounded seeds of 
 Paullinia Cupana, a climbing plant of the nat. ord. Sapindaceae, growing in Brazil. It 
 occurs in brown cakes or sticks, having an odor of chocolate, and a bitter, astringent 
 taste, partly soluble in water and in alcohol. It contains 25 per cent, of tannic acid, 
 gum, albumin, starch, and a greenish fixed oil, also an alkaloid Guaranine (5 per cent. ), 
 which is thought to be identical with Caffeine. The specimens of Guarana in the market 
 are very untrustworthy, unequal in quality and expensive, it being a secret mixture pre- 
 pared in Brazil. Hence it has been omitted from the list of Squibb' s preparations, a 
 fluid extract of green coffee being substituted in its place. 
 
 Extractum Guaranae Fluidum, Fluid Extract of Guarana, — Dose, TT\x-3ij. 
 
 Guarana has similar actions to those of Coffee, the active principles of both plants 
 being perhaps identical, both chemically and physiologically. It is chiefly employed in 
 the treatment of nervous sick-headache (migraine) administered in half-drachm doses of 
 the fluid extract when the attack is developing. It has been used in the diarrhea of 
 phthisis, in convalescence from acute diseases, and generally in conditions requiring tonic 
 treatment. 
 
 GURJUN BALSAM, Balsamum Dipterocarpi, Wood Oil (Unofficial), — is an 
 oleoresin obtained from incisions in various trees of the genus Dipterocarpus, growing in 
 
336 HCEMATOXYLON HAMAMELIS. 
 
 India. It is thick, opaque and grayish-brown by reflected light, soluble in chloroform 
 and partly so in alcohol, ether and volatile oils, odor balsamic, taste bitter. It contains 
 from 40 to 70 per cent, of a Volatile Oil, a Resin and Gurjunic Acid. Dose, n^x-^ij, 
 in emulsion, or in capsules. 
 
 The properties of this balsam are similar to those of Copaiba, but it is less disagreeable 
 and less apt to upset the stomach, also less actively diuretic. It has been used with good 
 success in leprosy, given internally in full doses and used locally at the same time. Mixed 
 with 4 parts of Lime-water it is well applied in chronic eczema, lupus and psoriasis. 
 
 H^MATOXYLON, Log-wood, — is the heart-wood of Hcematoxylon campe- 
 ckianum, a tree of the nat. ord. Leguminosse, native of tropical America, but naturalized 
 in the West Indies. It occurs in chips or powder of a dark brown-red color, often with 
 a greenish lustre, and colors the saliva a dark pink when chewed. It contains Tannic 
 Acid, and a sweet, crystalline coloring principle named Hcematoxylon, C 10 H u O 6 , which 
 is colorless when pure, but turns red on exposure to light. 
 
 Extractum Haematoxyli, Extract of Hcematoxylon. Dose, gr. v-xx. 
 
 Decoctum Haematoxyli (Unofficial), — strength 1 in 17. Dose, ^j-ij. 
 
 Logwood is mildly astringent, its properties depending on the Tannin contained in it. 
 As it is devoid of irritating qualities it is well adapted to the diarrheas and hemorrhages 
 of young children. It does not produce constipation or disorder the bowels, but colors 
 the urine and stools blood-red, and has caused phlebitis. It has been used as a hemo- 
 static in bleeding of the lungs, and in hemorrhages from the uterus and intestines, also as 
 an astringent injection in leucorrhea. 
 
 HAM AMELIS, Witch-hazel, — the leaves, collected in autumn, of 
 Hamamelis virginiana, a shrub of the nat. ord. Hamamelaceae, growing 
 in the United States. They contain about 8 per cent, of Tannic Acid, a 
 bitter principle and probably some volatile matters, but the chemistry of 
 the plant has not been fully studied. 
 
 Preparations. 
 
 Extractum Hamamelidis Fluidum, Fluid Extract of Hamamelis. Dose, Tt\j— 3 j . 
 
 It is the only official preparation, and is prepared from the leaves. 
 
 Hamamelin (Unofficial), — is an uncertain extract of very indefinite composition. 
 Dose, gr. j-ij. 
 
 Distilled Extracts, so-called, but really Waters distilled from the bark, are sold by 
 various manufacturers and are said by the vendors to contain the volatile principles of 
 the plant. Pond's Extract is such a preparation, said to be made by distilling the 
 bark with a very dilute alcohol, and is a proprietary medicine of uncertain composition. 
 
 No trustworthy experimentation has yet been made with this drug. It 
 is tonic, astringent, styptic and sedative, owing most of its properties to 
 its tannin, but appears to possess some special influence over the venous 
 circulation similar to that of Aconite on the arterial system. In full 
 doses it may produce severe throbbing pain in the head. It is used both 
 internally and locally with great benefit in hemorrhoids, particularly 
 those of the bleeding variety, varicose veins and ulcers, varicocele, venous 
 congestions and threatening local inflammations. It is highly recom- 
 mended in hemorrhages from the nose, stomach, lungs, rectum and kid- 
 neys, in threatened abortion, and externally for sprains and bruises, foul 
 ulcers, the pruritus of eczema, also in leucorrhea and gonorrhea. An 
 
HEDEOMA HELLEBORUS. 337 
 
 ointment of Witch-hazel is found in the shops, and suppositories may be 
 prepared extemporaneously by evaporating the fluid extract and incorpo- 
 rating the residue with cacao-butter. 
 
 HEDEOMA, Pennyroyal, — the leaves and tops oi Hedeoma pulegioides, a plant of 
 the nat. ord. Labiatae, common to all parts of the U. S. Its only important constituent 
 is the Volatile Oil, which is official. 
 
 Oleum Hedeomae, Oil of Pennyroyal, — is the volatile oil, readily soluble in alcohol. 
 Dose, TT\,ij-x. 
 
 Spiritus Hedeomae, Spirit of Pennyroyal (Unofficial), — contains I part of the oil in 
 9 of alcohol. Used externally or as a spray. 
 
 Hedeoma is a stimulant aromatic, also somewhat carminative and emmenagogue. Its 
 odor is extremely repulsive to insects, especially fleas and mosquitoes. In warm infusion 
 it is a popular remedy for amenorrhea and flatulent colic. It may be used as a corrective 
 with other medicines, and the spirit is well employed on the hands and face to keep away 
 mosquitoes. The writer has known death by narcosis to result from an overdose of the 
 oil self-taken to produce an abortion. 
 
 HELLEBORUS, Hellebore (Unofficial),—-the rhizome and root- 
 lets of Helleborus niger (Black Hellebore) and Hdleborus viridis (Green 
 Hellebore), plants of the nat. ord. Ranunculaceae, natives of Europe. A 
 third variety, Helleborus occidentalis, growing in Greece, is probably the 
 true Hellebore of the ancients. Its most important constituents are two 
 glucosides, Helleborin and Helleborein y both crystalline and poisonous. 
 
 Unofficial Preparations. 
 Extractum Hellebori Nigri, Extract of Black Hellebore. Dose, gr. j-x cautiously; 
 Extractum Hellebori Nigri Fluidum, Fluid Extr. of Black H. Dose, rr\jj-xv. 
 Helleborin, C 36 H 42 6 , — insoluble in water, soluble in alcohol, and in chloroform. 
 Helleborein, C 26 H u O ]5 , — crystalline, very soluble in water, slightly so in alcohol, in- 
 soluble in ether. Dose, gr. x^rV 
 
 Physiological Action and Therapeutics. 
 
 Black Hellebore is a drastic, hydragogue cathartic, and an emmen- 
 agogue. In overdoses it is a violent gastro-intestinal irritant, producing 
 vomiting, hypercatharsis, vertigo, cramps and convulsions, which may 
 result fatally. Locally applied, the fresh root is violently irritant to the 
 skin, producing inflammation and vesication. 
 
 Helleborin is an active poison, acting on the tongue like Aconite, and 
 on the nervous system as a narcotic, producing in animals paresis of 
 motion and sensation, cerebral and spinal congestion, dilated pupils and 
 death. It is less irritant than Helleborein to the mucous membranes. 
 
 Helleborein is less actively toxic to animals, but is very irritant, pro- 
 ducing conjunctivitis, sneezing, salivation, nausea, vomiting and purging. 
 It affects the heart like Digitalis, small doses frequently repeated slowing 
 its action, but large ones quicken it and then suddenly paralyze it through 
 
33^ HOANG-NAN HUMULUS. 
 
 the pneumogastric nerve. Respiration is at first accelerated, then slowed 
 and rendered laborious. Diuresis is a constant result, the kidneys and 
 uterus are congested, gradual paralysis and severe convulsions follow, and 
 death occurs by paralysis of the heart. 
 
 Black Hellebore is an old remedy, having been highly esteemed by the 
 early physicians in insanity, dropsies, worms, cutaneous affections and 
 amenorrhea. It has gone out of fashion, but might be usefully employed 
 in dropsies and as a revulsant in acute cerebral affections. Helleboreiin 
 has come into notice as a substitute for Digitalis in cardiac affections, 
 being of less bulk and more definite composition. Its action on the 
 heart is attained by doses much smaller than those necessary to produce 
 its irritant effects on the gastro-intestinal canal. Its solubility in water 
 and the freedom with which it can be used hypodermically are important 
 qualities to recommend it. 
 
 HOANG-NAN, or Hwang-Nao (Unofficial), — is the bark of Strychnos Gauthe- 
 riana, Tropical Bind-weed, a creeping vine of the nat. ord. Loganiacese, found in the 
 mountains of Tonquin. It contains the alkaloids Strychnine and Brucine, thus resem- 
 bling in composition its congeners Nux Vomica and Ignatia, but differing from them, as 
 they do from each other, in the proportional quantities in which the alkaloids are con- 
 tained, — Brucine predominating in this plant, as Strychnine does in the other two. 
 
 Like the other members of the Strychnos family, Hoang-Nan is an active tetanizer, its 
 action generally corresponding to that of Nux Vomica. It was first brought into notice 
 by the missionary fathers stationed in the French colonies in Asia, they having found its 
 employment general among the natives for leprosy and hydrophobia. Along the coast of 
 Tonquin and Cochin-China, and in Pondicherry, Trinidad, Venezuela, etc., it has an 
 established reputation in the two terrible diseases mentioned, also as a remedy for the 
 bites of venomous serpents and other reptiles, scrofulous and syphilitic ulcers, indolent 
 sores, etc. It has been used successfully for malarial fevers, in lieu of quinine, and is 
 highly spoken of by Father Brosse, as a stimulant to the intellect, without producing any 
 subsequent depression. 
 
 The dose of the powdered drug is about gr. iij-v ; of the aceto-alcoholic Extract, gr. 
 M - /^ ' an( l °f tne concentrated Tincture, rt\J-v. 
 
 HUMULUS, Hops, — the strobiles (fruit-cones) of Humulus Lupu- 
 lus, a cultivated creeping plant of the nat. ord. Urticaceae. Its constitu- 
 ents are wax, resins (50 per cent.), tannin (5 per cent.), a liquid volatile 
 alkaloid named Lupuline, a Volatile Oil (2 per cent.) which consists in 
 part of Valero I and Trimethy laming, and the crystalline, bitter principle, 
 Lupulinic Acid{\ 1 per cent.). These, except tannin, are more abundant 
 in the glandular powder of the strobiles, which is named Lupulin. 
 
 Preparations. 
 
 Tinctura Humuli, Tincture of Hops, — strength 20 per cent. Dose, 5J-ij. 
 
 Infusum Humuli, Infusion of Hops (Unofficial), — ^ss to the pint. Dose, ^j-iv. 
 
 Lupulinum, Lupulin, — is the glandular powder separated from the strobiles, of 
 bright, brownish-yellow color, aromatic and bitter taste. The Volatile Oil resides in the 
 Lupulin grains, and contains Valerol, which is changed into Valerianic Acid by long ex- 
 posure, giving a disagreeable odor to old hops. Dose, gr. v-xv. 
 
HYDRANGEA HYDRARGYRUM. 339 
 
 Extractum Lupulini Fluidum, FL Ext. of Lupulin, — alcoholic. Dose, tt\x-5J. 
 Oleoresina Lupulini, Oleoresin of Lupulin, — an ethereal extract. Dose, gr. ij-v. 
 Tinctura Lupulini, Tincture of Lupidin (Unofficial), — strength ^. Dose, gss-ij. 
 Mineral acids and metallic salts are chemically incompatible with preparations of Hops. 
 
 Humulus is a bitter tonic, and a feeble hypnotic, also somewhat dia- 
 phoretic, astringent and anaphrodisiac. It increases the cardiac action 
 and the cutaneous circulation. After slight cerebral excitement it pro- 
 duces calm and a soporific disposition, especially if the solution adminis- 
 tered be strongly alcoholic. The stomachic and tonic effects are due to 
 the bitter principle, Lupulinic Acid, and are found in bitter ale. The 
 primary stimulant and secondary sedative effects are due to the volatile 
 oil and are also possessed by ales and beer. 
 
 Hops are used as a tonic and calmative in delirium tremens, in which 
 a combination of the tincture with tincture of capsicum is very efficient 
 and is an excellent substitute for alcohol. In dyspepsia of atonic form 
 Humulus is an excellent stomachic tonic, and in nervous irritability the 
 fluid extract of Lupulin may be used as a calmative and hypnotic, or the 
 hop-pillow, which certainly exercises considerable influence, imaginary 
 or otherwise. A poultice of hops is a favorite domestic application in 
 inflammations and pain. Lupulin has been used with benefit in irritable 
 bladder and alcoholism, and as an anaphrodisiac in the treatment of 
 chordee, gonorrhea, spermatorrhea and other affections of the genito- 
 urinary organs. 
 
 HYDRANGEA (Unofficial), — is the root of Hydrangea arborescens, a plant of the 
 nat. ord. Saxifragaceae, growing in the southeastern U. S. It is a white, tough root, 
 containing gum, albumin, starch, resin, and a ferrous salt, with other salts. Dose, 
 ^ss-gij, best in fluid extract. A decoction of the root may be prepared and used in 
 doses of 3J-ij. 
 
 Hydrangea has been long used by the Cherokee Indians in calculous affections, and 
 reports of cases by competent observers show that it is of unquestionable utility in this 
 class of disorders, promoting the removal of gravel from the bladder, and relieving pain 
 during the passage of renal concretions through the ureters. Large doses produce ver- 
 tigo, oppression of the chest, and considerable cerebral disturbance. 
 
 HYDRARGYRUM, Mercury, Quicksilver, Hg,— is a shining, 
 silver-white metal, fluid and slowly volatile at ordinary temperatures, 
 solidifies at — 39 F., boils at 675 F., volatilizes without residue, in- 
 soluble in ordinary solvents, wholly soluble in nitric acid, odorless and 
 tasteless, sp. gr. 13.558 at 59 F. 
 
 Preparations of Mercury. 
 
 Hydrargyrum cum Creta, Mercury with Chalk, Gray Powder, — has of Mercury 
 38, Honey 10, Prepared Chalk 57, Water q. s., shaken and triturated together and dried 
 to 100, then reduced to a uniform gray powder. Dose, gr. ss-x. 
 
 Massa Hydrargyri, Mass of Mercury, Blue Mass, Bhie Pill, — has of Mercury 33, 
 Liquorice 5, Althaea 25, Glycerin 3, Honey of Rose 34. Each grain contains gr. ]/ z of 
 Mercury. Dose, gr. ss-x. 
 
340 HYDRARGYRUM. 
 
 Unguentum Hydrargyri, Mercurial Ointment, Blue Ointment, — Mercury 50, Lard 
 25, Suet 23, Oleate of Mercury 2, triturated together, until globules of Mercury cease to 
 be visible under a lens having a magnifying power of ten diameters. 
 
 Emplastrum Hydrargyri, Mercurial Plaster,— Mercury 30, Oleate of Mercury 1.2, 
 Lead Plaster to 100. 
 
 Emplastrum Ammoniaci cum Hydrargyro, Ammoniac Plaster with Mercury, — 
 see ante, page 144. 
 
 Chlorides and their Preparations. 
 
 Hydrargyri Chloridum Corrosivum, Corrosive Mercuric Chloride, Bichloride of 
 Mercury, Corrosive Sublimate, HgCl 2 , — heavy, colorless crystals, of acrid, metallic taste, 
 and acid reaction ; soluble in 16 of water and in 3 of alcohol, in 2 of boiling water, 1.2 
 of boiling alcohol, 4 of ether and in about 14 of glycerin. Dose, gr. ■g'g— T \r. 
 
 Hydrargyri Chloridum Mite, Mild Merairozis Chloride, Sub chloride of Mercury, 
 Calomel, Hg 2 Cl 2 , — a heavy, white, impalpable powder, odorless and tasteless ; insoluble 
 in water, alcohol or ether. Is an ingredient of Pil. Antimonii Co. and Pil. Catharticae 
 Co. Dose, gr. ^V - *- ^ ne dose depends on the effect desired. 
 
 Hydrargyrum Ammoniatum, Ammoniated Mercury, White Precipitate, Mercuric 
 Ammonium Chloride, NH 2 HgCl, — is a white, insoluble powder, odorless and tasteless. 
 Only used externally. 
 
 Unguentum Hydrargyri Ammoniati, Ointment of Ammoniated Mercury, White 
 Precipitate Ointment, — Ammoniated Mercury 10, Benzoinated Lard 90 parts. 
 
 Oxides and their Preparations. 
 
 Hydrargyri Oxidum Flavum, Yellow Mercuric Oxide, HgO, — an orange-yellow, 
 heavy, impalpable powder, odorless and tasteless, insoluble in water or alcohol, but 
 wholly soluble in nitric or hydrochloric acid. Used to prepare : — 
 
 Unguentum Hydrargyri Oxidi Flavi, Ointment of Yellow Mercuric Oxide, — 
 strength 1 to 9 of Ointment (Unguentum). 
 
 Oleatum Hydrargyri, Oleate of Mercury, — has of the Yellow Oxide 20, Oleic 
 Acid 80 parts. 
 
 Hydrargyri Oxidum Rubrum, Red Mercuric Oxide, Red Precipitate, HgO, — a 
 heavy, orange-red, crystalline powder, having the same properties as the yellow oxide, 
 from which it differs only in being crystalline, and in not so minute a state of sub- 
 division. Dose, gr. ^rV 
 
 Unguentum Hydrargyri Oxidi Rubri, Ointment of Red Mercuric Oxide,— strength 
 I to 8*4 of Unguentum and ]/ z of Castor Oil. 
 
 Iodides and their Preparations. 
 
 Hydrargyri Iodidum Rubrum, Red Merctiric Iodide, Red Iodide (Biniodide) of 
 Merctiry, Hgl 2 , — a scarlet-red, crystalline powder, almost insoluble in water, soluble in 
 130 of alcohol, in solution of Potassium Iodide or of Mercuric Chloride. Prepared by 
 double decomposition between Potassium Iodide 5, and Mercuric Chloride 4 parts. 
 Dose, gr. ^"tV 
 
 Liquor Arsenii et Hydrargyri Iodidi, Solution of Arsenic and Mercuric Iodide, 
 Donovan 's Solution, — see ante, page 199. 
 
 Hydrargyri Iodidum Flavum, Yellow Mercurous Iodide, Proliodide of Mercury, 
 Hg 2 I 2 , — a dull green or greenish-yellow powder, insoluble in alcohol or ether and almost 
 so in water. Dose, gr. 1^-3 • 
 
 Acid Combinations and their Preparations. 
 
 Liquor Hydrargyri Nitratis, Solution of Mercuric Nitrate, — a liquid containing in 
 solution about 60 *per cent, of Mercuric Nitrate, Hg(N0 3 ) 2 , with about 1 1 per cent, of 
 free Nitric Acid. Prepared from the Red Mercuric Oxide 40, by Nitric Acid 45, and 
 Distilled Water 15. Used as a caustic. 
 
 Unguentum Hydrargyri Nitratis, Ointment of Mercuric Nitrate, Citrine Oint- 
 ment, — Mercury 7 dissolved in Nitric Acid 7^, adding Lard Oil 76. 
 
HYDRARGYRUM. 34 I 
 
 Hydrargyri Subsulphas Flavus, — Yellow Mercuric Subsulphate, Basic Mercuric 
 Sulphate, Turpeth Mineral, Hg(HgO) 2 S0 4 , — a heavy, lemon-yellow powder, practically 
 insoluble in water or alcohol, soluble in nitric acid, and in io of HC1 without residue. 
 Dose, as an emetic, gr. ij-v. 
 
 Cyanide. 
 
 Hydrargyri Cyanidum, Mercuric Cyanide, Hg(CN) 2 , — colorless crystals, of metallic 
 taste, soluble in 12.8 of water and in 15 of alcohol. Dose, gr. t ^o - tV 
 
 Trihirations. 
 
 These may be prepared according to the general formula under the title Tritura- 
 tions in the Pharmacopoeia, 10 parts of the substance to 90 of Sugar of Milk. Mer- 
 cury itself or any of its salts may be so treated with excellent results, the particles being 
 much finer and therefore more easily absorbed than if rubbed up with another agent. 
 
 Un official Prep a rations . 
 
 Lotio Hydrargyri Flava, Yellow Wash, — prepared by adding Corrosive Sublimate 
 gr. xviij to Lime-water ^x, producing the yellow oxide ; a favorite application for syph- 
 ilitic sores. 
 
 Lotio Hydrargyri Nigra, Black Wash, prepared by adding Calomel gr. xxx to 
 Lime-water ^ x, producing the black oxide, and used as an application to syphilitic sores. 
 
 Unguentum Hydrargyri Nitratis Rubrum, — Red Ointment of Mercuric Nitrate, 
 Brown Citrine Ointment, — differs from the official ointment only in being made with 
 Cod-liver Oil, which gives it a brown color, and a more agreeable odor. 
 
 Physiological Action. 
 Mercury is tonic, purgative, alterative, antiphlogistic and sorbefacient, 
 and indirectly cholagogue. Some of its salts are corrosive poisons, others 
 are local caustics, all produce by long-continued administration the 
 peculiar cachexia termed Hydrargyrism. The metal itself is inert, and 
 by combination with the acids and fluids of the body it becomes active, 
 and is easily absorbed in any form, passing into the blood from the skin, 
 mucous membranes, lungs and stomach, in each case probably as an oxy- 
 albuminate of mercury. Entering the stomach in any form it is first 
 converted into a double chloride of sodium and mercury, then uniting 
 with the albuminous juices to form a complex molecule of mercury, 
 sodium, chlorine and albumin, which being soluble in an excess of sodium 
 chloride or albumin, exists in solution and is easily absorbed, then being 
 decomposed in the blood and changed to the oxyalbuminate. Entering 
 the intestines a purgative action is soon set up, of more or less severity 
 according to the preparation used, a small portion only is absorbed, the 
 rest being converted into a sulphide and excreted with the feces, unless 
 combined with Opium, which delays its progress through the intestines 
 and permits of its freer absorption. On the blood its effects in small 
 doses are tonic, but in quantity it indirectly produces impoverishment 
 thereof, impairs the ozonizing function, diminishes the red corpuscles, 
 and consequently disorders nutrition and deranges digestion. From the 
 blood it enters the tissues, where it remains for an indefinite period, exert- 
 ing a peculiar influence, termed "alterative," on all processes character- 
 
342 HYDRARGYRUM. 
 
 ized by growth of young cells, but not producing any definite anatomical 
 changes either in the viscera or the nervous tissue, though in the latter a 
 low form of inflammation arises, resulting in loss of coordination-power. 
 It stimulates most of the glands of the body to the production of patho- 
 logical secretions, especially the salivary glands and the pancreas, and is 
 excreted with comparative slowness by all the excretory organs, being 
 found in the saliva, sweat, milk, urine and bile. It tends to accumulate 
 in the liver, while stimulating its cells, and is not a direct cholagogue, 
 though stimulating the flow of bile already secreted by reflex action on 
 the bile-ducts due to its purgation of the duodenum. Its excretion is 
 hastened and completed by the use of Potassium Iodide. 
 
 In small doses administered for a short time the mercurial preparations 
 are blood-tonics, improving the general condition, increasing the number 
 of red corpuscles and the body-weight. They soon begin to promote 
 waste by stimulating the lymphatic system, and if the small doses are long 
 continued or the quantity is increased, symptoms of mercurial poisoning 
 begin to manifest themselves. 
 
 The first symptoms of Hydrargyrism are fetid breath, swollen and 
 spongy gums having a bluish line along their margins, stomatitis, sore and 
 loosened teeth, inflamed and tender salivary glands pouring out a peculiar, 
 thin saliva of foul odor in large quantity, and a metallic taste in the mouth. 
 Anorexia, diarrhea and fever follow, also ulceration and in some cases 
 even gangrene of the lips and tongue. If the use of the drug be con- 
 tinued nutrition will be greatly impaired through the extreme promotion 
 of retrograde metamorphosis, and various nervous disturbances will follow, 
 the effects being emaciation, pallor, edema, ulcerated skin, erythematous, 
 vesicular or pustular eruptions, headache, insomnia, neuralgia, tremor 
 through paresis of the muscles of the head and extremities, epilepsy, coma 
 and convulsions. In pregnant women abortion will occur by reason of 
 the impoverishment of the blood. Indeed, as Dr. Ringer said in the 
 earlier editions of his Handbook of Therapeutics, the phenomena produced 
 by mercury are singularly similar to those which will result from syphilis, 
 and the serious symptoms known as secondary and tertiary syphilis can 
 be produced both by syphilis and by mercury. The drug is a specific 
 antagonist to the syphilitic virus, probably by reason of its affecting the 
 same organs and tissues of the body on a similar line of action, both 
 poisons mutually destroying each other in the organism. It is certainly 
 capable of bringing about a radical cure of syphilis, if introduced into 
 the system in considerable quantity and its use protracted over a very long 
 time, the action of the drug in all cases being kept short of ptyalism or 
 any pronounced physiological effects. 
 
 The observations on the antiphlogistic and sorbefacient actions of 
 Mercury are clinical rather than physiological, but it is generally agreed 
 
HYDRARGYRUM. 343 
 
 that exhibited in inflammation mercurials antagonize the increase of the 
 hemic fibrin which is so constant an effect of the inflammatory process, 
 and that in chronic diseases attended by the formation of semi-organized 
 deposits, a mild mercurial course will almost insensibly remove the new- 
 formed material. 
 
 Salivation is most readily produced by blue mass, next by calomel, and 
 less easily by gray powder. Individuals differ greatly in their suscepti- 
 bility to the action of mercury, some persons having been affected after 
 a single moderate dose. Children are not easily salivated. Inhalation 
 of mercurial vapors is most apt to affect the nervous system ; the internal 
 administration and that by inunction are more likely to produce saliva- 
 tion. A not uncommon result of full doses of blue pill is an acute coryza 
 of very severe character, which the writer has frequently observed to 
 follow on neglect of the old-fashioned precaution to " work off" the mer- 
 curial by a saline cathartic. The symptoms produced are those of a severe 
 attack of influenza, — epistaxis, conjunctivitis and obstinate muco-puru- 
 lent discharge from the nasal passages being especially marked. Similar 
 effects have been observed during physiological experiments with mercury 
 on animals by Overbeck and Bennett. 
 
 Notes on the Action of the Preparations. 
 
 Metallic Mercury is not used internally except in the finely divided 
 form obtained in blue pill and gray powder, which are capable of pro- 
 ducing the effects previously described. Mercurial Ointment is the prepa- 
 ration generally used for inunction, a piece the size of a small nut being 
 daily rubbed into the soft skin at the flexures of joints. The Oleate painted 
 over the surface is a more cleanly method of making the same application. 
 Both these preparations are efficient parasiticides. 
 
 The Bichloride is the most actively toxic of the mercurial salts. It is 
 probably the most active zymoticide and parasiticide, a solution of i part 
 in 2,000 being efficiently antiseptic for use as injections or dressings, and 
 a solution of 1 in 250 being the usual strength for use against epizoa and 
 in parasitic skin affections. It is a very active gastro-intestinal irritant, in 
 toxic dose producing nausea, retching and vomiting, a metallic taste, con- 
 striction of the fauces, burning pain in the stomach, suppression of urine, 
 bloody diarrhea, collapse and death often preceded by convulsions. It 
 affects specifically the lower bowel [Calomel preferring the upper intes- 
 tine], and produces inflammation and ulceration of the rectum. It is, 
 however, one of the most manageable and efficient of the mercurials when 
 used in proper doses. 
 
 The Subchloride (Calomel) is very insoluble and unirritating, tasteless, 
 laxative in grain doses, decomposed by the alkaline contents of the intes- 
 tines, oxide of mercury being formed, and acts especially on the excre- 
 
344 HYDRARGYRUM. 
 
 mentitious glandular appendages of the upper intestine, stimulating the 
 liver by indirect reflex action as a duodenal purgative. In the presence 
 of alkaline chlorides it is converted into the bichloride, but not in 
 sufficient quantity to render it dangerous in the gastro-intestinal canal. 
 Externally applied it is sedative to the mucous membranes and the skin. 
 It is an efficient diuretic, in small doses frequently repeated. Ammoniated 
 Mercury is an Ammonio -Chloride, and a useful stimulant and parasiticide 
 when used locally in the form of ointment. 
 
 The Iodides are actively poisonous, the Red being much the most irri- 
 tant. The Cyanide is also actively poisonous. The Yellow Subsulphate is a 
 prompt and usually harmless emetic, but has occasionally produced fatal 
 results by local irritant action. The Oxides are irritant, the Red being the 
 most so, and are rarely used internally. The Acid Nitrate is a good escha- 
 rotic, the pain caused by it being transient though severe, and its caustic 
 action being comparatively superficial. The Ointment of the Nitrate 
 (Citrine Ointment) is more irritant than that of ammoniated mercury, and 
 generally needs dilution. All these preparations may produce the con- 
 stitutional effects of mercury, and the subjects of their administration 
 should be carefully watched for the first symptoms of mercurialization. 
 
 Antidotes and Incompatible*. 
 
 Albumin in some form, the white of one egg to gr. ivof the Bichloride, forms the albu- 
 minate, which must be at once evacuated by emesis or the stomach pump, as it is soluble 
 in an excess of albumin or in the alkaline contents of the intestines. 
 
 The Chlorides are incompatible with very many agents, and the Bichloride should be 
 administered in distilled water or pill by itself, being easily decomposed. Calomel is 
 decomposed by alkaline iodides or bromides. The combination of Calomel with Hydro- 
 chloric Acid or Chlorides is apt to produce corrosive sublimate. In the " mixed treat- 
 ment " of syphilis, a mercurial is combined in solution with Potassium Iodide, and the 
 Red Iodide is the preparation usually selected, as the Bichloride is decomposed by 
 potassium iodide. All trouble regarding incompatibility can be avoided by using sugar - 
 of-milk triturations according to the general official formula therefor. In this form, says 
 Piffard, "a larger proportion of the drug is utilized for specific purposes, while but a 
 small amount remains to give rise to local irritation." 
 
 Therapeutics. 
 Mercury is undoubtedly a specific in syphilis, but it is not applicable to 
 the tertiary form of that disease. It is best administered in very small 
 doses carefully watched and stopped just short of ptyalism, but renewed 
 and so continued for a long time. Fumigation by Calomel volatilized by 
 heat, or inunction by the Oleate or by Mercurial ointment may be used 
 when the stomach will not bear any mercurial. The hypodermic method 
 is also used, employing a solution of the Bichloride gr. j to gj each of 
 glycerin and distilled water, of which the dose is tr^x once daily ; or the 
 Albuminate in solution with sodium chloride ; or a cream made by mixing 
 Hydrargyrum 3J, Lanolin gij, Oil (carbolized 2 per cent.) 3J, the dose 
 of which is rr^x into the gluteal muscles once a week. The Yellow Iodide in 
 
HYDRARGYRUM. 345 
 
 doses of gr. yxr t0 i thrice daily with opium is the best preparation for 
 internal use. Accuracy of diagnosis is an absolutely necessary prelimi- 
 nary to the administration of mercury, for where there is no syphilitic 
 virus to be antagonized the constitutional effects of mercurials will become 
 manifest sooner and may do great harm in feeble subjects, besides the risk 
 of mistaking them for the results of the disease supposed to be present. 
 
 Tonsillitis, parotitis and other acute glandular inflammations of the 
 throat and neck may often be rapidly cured by Calomel gr. -^ or Gray 
 Powder gr. -|- every two hours. In irritable stomach with obstinate vom- 
 iting the same small doses of Calomel every half hour are very efficient. 
 The dysentery of adults with slimy and bloody stools is best treated by 
 small doses (gr. T -^) of the Bichloride, and in the diarrhea and dysentery 
 (ileo-colitis) of infants Gray Powder gr. £ or Calomel gr. -^ will be found 
 very effective. In gastric ulcer and in the first stage of hepatic cirrhosis, 
 the Bichloride in doses of gr. -^ to -£$ thrice daily is a good remedy. 
 Typhoid fever is treated in Germany by daily doses of Calomel, gr. x for 
 three days, as an antipyretic. Diphtheria is by many practitioners consid- 
 ered to be best antagonized by Calomel in large doses, and in this affection 
 the Cyanide has many advocates given in doses of gr. 1 ^ g0 every hour, 
 a weak solution being at the same time used as a gargle. Asiatic cholera 
 is frequently treated by small, repeated doses of Calomel with opium from 
 the start. Inflammations of sthenic character in the stage of exudation, 
 especially when affecting serous membranes, are considered by many 
 authorities to be best met by the free use of mercurials, but this treatment 
 is fast going out of favor, excepting in cases of iritis, which affection is 
 very often of syphilitic causation, and in pneumonia, which is frequently 
 treated, according to the best American authorities, with sedative doses 
 (gr. xv-xx) of Calomel. 
 
 In the general condition known as " biliousness," manifested by whitish 
 or clay-colored stools, constipation, nausea, anorexia, coated tongue, 
 slight jaundice, etc., mercurial purgatives have long been a routine 
 remedy, but mild saline purgatives are by many authorities considered 
 equally efficient. As an antiseptic to the gastro-enteric tract in many 
 forms of stomach and intestinal disorders (dyspepsia septica) the admin- 
 istration of minute doses of the Yellow Oxide will be found remarkably 
 efficient. It is best used in trituration with sugar of milk, i to 1,000, and 
 in doses of gr. q -^q. By the use of these small doses failing digestion 
 and nutrition may almost certainly be improved. 
 
 In laryngeal diphtheria (membranous croup) the Subsulphate as an 
 emetic is by many considered to have some specially beneficial influence. 
 
 Locally, an ointment of Calomel 5j to ^j of lard is an excellent anti- 
 pruritic, and ointments of the Chlorides and Iodides are much used in 
 skin diseases, particularly psoriasis, herpes, acne and pityriasis. In para- 
 
346 HYDRASTIS. 
 
 sitic affections a lotion of the Bichloride, gr. ij to 3j of distilled water, or 
 a 5 per cent. Oleate with ^th part of ether, is very efficient. The 
 Oleate is a serviceable application to syphilitic indurations, but is not 
 deemed advisable when ulceration exists. In conjunctivitis Calomel may 
 be used as a sedative application, or still better an ointment of the Yellow 
 Oxide, gr. ij-x to gj of vaselin, triturated to the utmost fineness before 
 mixing. Goitre and enlarged spleen are often speedily reduced by rub- 
 bing into the skin covering them the ointment of the Red Iodide some- 
 what diluted and applied before a hot fire or in the direct sunlight. The 
 Acid Nitrate solution is one of the best caustics for destroying chancroid 
 and syphilitic warts and vegetations. Black and Yellow Washes are used 
 as applications to syphilitic erosions and ulcerated indurations. 
 
 As an antiseptic injection or application to dressings a solution of the 
 Bichloride, gr. vijss in a quart of hot water ( ^ ), is probably the most 
 efficient that can be used, and still weaker solutions (3-0V0) are sufficiently 
 antiseptic for most purposes. 
 
 HYDRASTIS, Golden Seal,— the rhizome and roots of Hydrastis 
 canadensis, a small plant of the nat. ord. Ranunculaceae, growing in most 
 parts of the U. S. It contains an unnamed Resin and 3 alkaloids, 
 Hydrastine, C 21 H 21 N0 6 , white and crystalline, soluble in alcohol, ether, 
 etc., Berberine, C 20 H 17 NO 4 , yellow crystals soluble in hot water and in 
 alcohol, but not in ether, and Xanthopuccine, also yellow and crystalline. 
 All these alkaloids unite with acids to form salts. From Hydrastine 
 is prepared an oxidation product or artificial alkaloid, Hydrastinine, 
 C n H n N0 2 , the Hydrochlorate of which is official. 
 
 Preparations. 
 
 Extractum Hydrastis Fluidum, Fluid Extract of Hydrastis. Dose, tt\v-xxx. 
 
 Tinctura Hydrastis, Tincture of Hydrastis, — strength, 20 per cent. Dose, ^ss-ij. 
 
 Glyceritum Hydrastis, Glycerite of Hydrastis, — Hydrastis 2, in Glycerin 1, by per- 
 colation with Alcohol and Water. Used as a local application. 
 
 Hydrastininae Hydrochloras, Hvdrastinine Hydrochlorate, C n H n N0 2 HCl, — the 
 hydrochlorate of an artificial alkaloid derived from Hydrastine. Light yellow, amorphous 
 granules, deliquescent, very soluble in water, also in 3 of alcohol. Dose, gr. j in a ten 
 per cent, solution, as a hypodermic injection. 
 
 Hydrastin (Unofficial), — an impure extract precipitated by Hydrochloric Acid from 
 the alcoholic solution, consisting chiefly of Berberine Muriate. Dose, gr. ij-v. 
 
 Physiological Action. 
 Hydrastis is a simple bitter and a stomachic tonic. It promotes appe- 
 tite and digestion and increases the secretions of the gastro-intestinal tract 
 and the flow of bile, but if long used it will derange digestion and produce 
 constipation. It is possessed of antiperiodic powers, and is a protoplasmic 
 poison, arresting the movements of the white blood-corpuscles. By many 
 
HYDRASTIS. 347 
 
 observers it is also considered alterative to the mucous membranes, deob- 
 struent to the glandular system, cholagogue, diuretic and antiseptic. The 
 alkaloid Hydrastine produces effects on the nervous system somewhat 
 similar to those caused by quinine, but seems to be devoid of toxic 
 power, large doses only producing a sense of warmth in the epigastric 
 region, and noises of a rushing character in the ears. 
 
 Incompatibles. 
 
 Tannic Acid, Hydrochloric Acid and the Alkalies are chemically incompatible with 
 preparations of Hydrastis. 
 
 Therapeutics. 
 
 Hydrastis is chiefly used as a stomachic tonic, an antiperiodic, a mild 
 laxative and an antiseptic. Its alkaloid (Hydrastine) and extract (Hy- 
 drastin) are ranked high in the treatment of intermittents and chronic 
 malaria, though much less efficient than quinine. It is an excellent 
 remedy locally and internally in all forms of catarrh, especially that of 
 the stomach, duodenum, gall-ducts, bladder, uterus and vagina. Inter- 
 nally it is efficient in many glandular swellings, in chronic constipation 
 due to a sluggish state of the liver or deficiency of the other intestinal 
 secretions, in chronic dyspepsia, and as a substitute for alcohol in dipso- 
 maniacs when a catarrhal state of the stomach has been induced. In 
 gonorrhea, gleet, and chronic nasal catarrh, it is locally employed with 
 much benefit, also in syphilitic affections of the mouth, throat and nares. 
 As a local alterative and antiseptic application it is highly recommended 
 for unhealthy ulcers and sores, cancerous ulcerations, mercurial and aph- 
 thous stomatitis, rectal fissure, fistula and prolapse, internal and external 
 hemorrhoids, cracks, fissures and abrasions of the nipples, erosion and 
 ulceration of the cervix uteri, and in conjunctivitis with muco-purulent 
 discharge. In gonorrhea a very efficient injection is an infusion of 
 Hydrastis, gj of the powdered root to gviij of boiling water, or the fluid 
 extract diluted in the proportion of gss or 3J to the pint of water, but it 
 should not be used until the acute stage has subsided. 
 
 Hydrastinine has long been known as a uterine vaso-constrictof', and 
 as such has been successfully employed in metrorrhagia. It has been 
 credited with powerful qualities as an antispasmodic, and also with ac- 
 tion of decreasing the excitability of the cerebral cortex. It is considered 
 preferable to Hydrastine on account of its stimulant action on the cardiac 
 muscle, and the persistent constriction which it produces in the walls of 
 the vessels. The Hydrochlorate is employed in grain doses hypodermi- 
 cally, using a ten per cent, solution ; the injections being best made, for 
 menstrual irregularities, during a few days previous to the expected term. 
 It has been used with great benefit in uterine hemorrhage and dysmenor- 
 rhea; also in metritis, endometritis, myomata and pyo-salpingitis. It has 
 
34^ HYDROCOTYLE HYOSCYAMUS. 
 
 been employed successfully in the treatment of hydrophobia, strych- 
 nine-poisoning and epilepsy, in the latter case having been given in 
 doses of gr. %- x /2 up to gr. ij daily, and with benefit in four cases out 
 of six. 
 
 HYDROCOTYLE, Pennywort (Unofficial),— is the leaf of Hydrocotyle asiatica, 
 a small plant of the nat. ord. Umbelliferae, a native of southern Africa and India. It 
 contains a peculiar, oleaginous substance, Vellarine, which has a bitter, persistent taste, 
 and is thought to be the active principle. It has long been used in its native countries 
 as an alterative to purify the blood, and has been found of great service in eczema, lupus, 
 psoriasis, syphilitic and scrofulous sores, and in leprosy. An ounce of the dried plant or 
 leaves is given daily in infusion. It causes great itching over the whole body, ovarian 
 pain in females, and urinary irritation. In one case in which the drug was being given 
 for lupus of the hand a severe orchitis was set up without any other apparent cause. It 
 certainly exerts a markedly special influence on the genito-urinary tract. 
 
 HYOSCYAMUS, Henbane, — the leaves and flowering tops, col- 
 lected from plants of the second year's growth, of Hyoscyamus niger, 
 a biennial plant of the order Solanaceae, growing in Europe and the 
 northern U. S. It contains an alkaloid, Hyoscyamine, C 17 H 23 N0 3 , which 
 is isomeric with Atropine and identical with Daturine and Duboisine, 
 occurring as an oily liquid or in tufted crystals of silky lustre and yellow 
 color, soluble in hot water, alcohol or ether. Another substance, Hyos- 
 cine, C 17 H 21 N0 4 , is by some authorities considered a derivative of Hyos- 
 cyamine, by others a second alkaloid. It is semi-liquid, isomeric with 
 Atropine, and yields Tropic Acid and Pseudotr opine. Hyoscyamus leaves 
 also contain a fatty Oil and much Potassium Nitrate, while from their 
 destructive distillation is obtained an empyreumatic Oil which is a power- 
 ful narcotic. They are ovate, long and broad, glandular-hairy, with 
 prominent midrib, heavy, narcotic odor, taste bitter and acrid. 
 
 An allied plant is Scopolia carniolica, also of the Solanaceae, a common plant in the 
 mountains of Bavaria and Hungary, which contains in the root an alkaloid, Scopolamine 
 (or Scopoleine), C 17 H 21 N0 4 , also found in small quantities in belladonna root, stramonium 
 seeds and in duboisia. Nearly all the Hyoscine Hydrobromate supplied by manufactur- 
 ing chemists consists of Scopolamine Hydrobromate (Schmidt). The two bases may be 
 considered identical (Hesse). 
 
 Preparations. 
 
 Extractum Hyoscyami, Extract of Hyoscyamus. Dose, gr. j, when active. 
 
 Extractum Hyoscyami Fluidum, Fluid Extract of Hyoscyamus. Dose, tt\v-xx. 
 
 Tinctura Hyoscyami, Tincture of Hyoscyamus, — Strength 15 per cent. Dose, 
 ^j-iv ; as a hypnotic ^ ss-j is necessary. 
 
 All the preparations of Hyoscyamus are uncertain in strength and activity, so that the 
 effective dose of the extract formerly official ranged from 2 to 250 grains. 
 
 Hyoscyaminse Sulphas, Hyoscyamine Sulphate, (C 17 H 23 N0 3 ) 2 H 2 S0 4 , — small, yel- 
 low scales or crystals, deliquescent, of bitter taste, and very soluble in water and in alcohol. 
 It varies much in purity of the base and consequently in activity. A grain of the commer- 
 cial article, which was formerly very impure, has been given with impunity, but gr. fa 
 of the pure alkaloid has produced violent poisoning. Dose, hypodermically, should not 
 exceed gr. fa ; by the mouth gr. %-} may be given in urgent cases. 
 
HYOSCYAMUS. 349 
 
 Hyoscyaminae Hydrobromas, Hyoscyamine Hydrobromate ', C 17 H 23 N0 3 HBr, — a 
 yellowish- white, amorphous mass, or prismatic crystals, of tobacco-like odor, and acrid, 
 bitter, nauseous taste ; deliquescent, soluble in j^ of water and in 2 of alcohol. Dose, as 
 the Sulphate. Hyoscyamine of good quality is difficult to procure and is very expensive, 
 while Duboisine is easily obtained in any quantity, so that if these alkaloids prove to be 
 physiologically as well as chemically identical, the latter will be used to the exclusion of 
 the former. 
 
 Hyoscinae Hydrobromas, Hyoscine Hydrobromate, C 17 N 21 N0 4 HBr -f- 3H 2 0, — 
 colorless, transparent, rhombic crystals, odorless, of acrid, slightly bitter taste; soluble in 
 2 of water and in 13 of alcohol. Dose, gr. tfo-oV by mouth, gr. 2 * " sV hypodermi- 
 cally. Nearly all the Hyoscine Hydrobromate furnished by manufacturing chemists con- 
 sists of Scopolamine Hydrobromate. 
 
 Physiological Action. 
 
 Hyoscyamus has similar action to that of Belladonna, Duboisia and 
 Stramonium, except that it is the least powerful and irritant of the group, 
 but the most calmative and hypnotic. The delirium produced by it is 
 never furious and is without hyperemia, but is accompanied by insomnia. 
 It is more stimulant to the vaso-motor system and to the cardiac accelera- 
 tor apparatus than is Stramonium, but is less active on the pneumogastric. 
 It has decidedly laxative and carminative effects on the intestines and a 
 very marked sedative influence on the urinary passages. 
 
 Hyoscyamine corresponds in action to the plant and its congeners, 
 being considered by many authorities as almost identical with Atropine, 
 but less powerful. No death has resulted directly from it. Except in 
 very large doses it is more an anodyne or anesthetic than a narcotic or 
 soporific. It is a mydriatic, excites the cerebral functions and depresses 
 the spinal. Many observers deny that it possesses any soporific influence. 
 
 Hyoscine is a cerebral and spinal sedative, and a powerful hypnotic, 
 directly depressing the higher functions of the brain, and affecting the 
 heart but feebly. It is probably the action of this agent which prevents 
 Hyoscyamus from causing the excitation and delirium of Belladonna. After 
 the hypodermic administration of a full dose (gr. -^) } there is, in most 
 subjects, a period of semi-maniacal delirium, with flushed face and dry 
 mouth, lasting from one to two hours, and followed by the sedative action 
 of the drug, during which the pulse-rate and frequency of respiration, at 
 first quickened, are distinctly lowered. It especially affects the motor 
 tract of the spinal cord and the cerebral cortex, slightly depresses the 
 heart, but paralyzes respiration. It is free from irritant qualities and may 
 be used hypodermically. Its habitual use brings on muscular paralysis 
 and delirium of violent character. It is frequently used as a hypnotic 
 by alcoholics and nervous subjects, and will probably ere long be respon- 
 sible for many deaths. As a mydriatic its reputation is doubtful, some 
 observers claiming greater power for it in this respect than that of 
 Atropine, while others say that mydriasis may follow its use but is not 
 always produced by even large doses. Severe toxic symptoms have fol- 
 
350 HYOSCYAMUS. 
 
 lowed the application of 4 drops of a 1 per cent, solution (equal to gr. 
 2^) to the ocular conjunctivae. In large doses Hyoscine is a dangerous 
 depressant of the respiration, but it may be used without unpleasant 
 effects in medicinal doses. Whenever full doses are employed the respi- 
 ration should be watched for several hours. 
 
 Dr. Balagopal, of India, has reported a case in which a man suffering from intermit- 
 tent attacks of maniacal delirium was accidentally given gr. ^ of the hydrobromate of 
 hyoscine hypodermically. Severe toxic symptoms supervened, which were however an- 
 tagonized by Sulphuric Ether administered subcutaneously. The patient recovered, and 
 thereafter remained free from all mental or cerebral disorder. 
 
 Antagonists and Incompatibles. 
 
 These are the same as for Belladonna (see ante, page 215). Liquor Potassae though 
 incompatible is frequently prescribed in combination with Hyoscyamus. All the fixed 
 caustic alkalies decompose its alkaloid, as also those of the allied plants. 
 
 Therapeutics. 
 
 Hyoscyamus is a valuableihough feeble narcotic and is chiefly used as a 
 hypnotic and an anodyne when Opium is contraindicated, and for chil- 
 dren. It is by far the best agent to use in acute mania with great motor ex- 
 citement, obstinate insomnia and varied hallucinations. Chronic mania 
 has been more benefited by it than by any other drug, and it is very effi- 
 cient in insanity characterized by frequent delusions. In delirium tremens 
 and the delirium of fevers it is an excellent hypnotic, and the monomania 
 of hypochondriacs is alleviated and often cured by it. Whooping-cough, 
 nervous coughs, and especially a dry, tickling night-cough, are greatly 
 alleviated by full doses of Hyoscyamus. It is also efficient in colic of 
 various forms, to palliate the trembling of paralysis agitans and mercurial 
 tremor, and to relieve the pains and disordered coordination of locomotor 
 ataxia. In constipation it is a good remedy, the extract being much 
 employed in combination with other purgatives to render them more effi- 
 cient and less drastic, but the quantity generally used is too small to be 
 of any particular benefit. The tincture is an efficient remedy in irrita- 
 bility of the bladder from any cause. 
 
 Hyoscyamine may be used for the same purposes as Atropine, but 
 being liable to considerable variation in purity and activity, it is not a 
 popular agent with the profession. 
 
 Hyoscine has been frequently used in neuralgia, whooping-cough, acute 
 mania, insomnia from cerebral excitement, delirium tremens, asthma and 
 enteralgia, also in ophthalmic practice as a mydriatic. The Hydrobro- 
 mate is the salt in general use, in doses of gr. y^-g- hypodermically, gr. -^ 
 by the mouth. It efficiently, but temporarily, controls the tremor of paral- 
 ysis agitans, and is highly useful at times in the treatment of the morphine- 
 habit, especially for the extreme restlessness and insomnia resulting from 
 the final withdrawal of that drug. In such cases, however, it must be 
 
IGNATIA. 351 
 
 used only in emergencies and should not be given habitually, as it excites 
 a high degree of delirium in most subjects at first, followed after about 2 
 hours by its secondary sedative influence. Excessively or carelessly 
 employed in such cases, it is liable to seriously derange the mental facul- 
 ties in the same manner as Atropine, and is probably responsible for 
 many of the impaired intellects which emerge from the so-called " Bichlo- 
 ride of Gold Cures " for alcoholism. 
 
 Dr. Lionel Weafherly warns the uninitiated against mistaking Hyoscine for Hyos- 
 cyamine, as these two alkaloids have very different characteristics clinically. He believes 
 strongly in the power of Hyoscine as a mental alterative, and has found it to be par- 
 ticularly useful in that form of mental disturbance which renders the patient violent and 
 abusive, restless and domineering — a nuisance to every one who has anything to do with 
 him. Under the administration of repeated small doses of hyoscine such a patient 
 becomes a changed man. Violence and abusiveness give place to an amiable politeness, 
 and instead of indulging himself in the free exercise of an extensive, if somewhat shady 
 vocabulary, the patient subsides into silence. 
 
 IGNATIA, St. Ignatius' Bean (Unofficial),— is the seed oiStrych- 
 nos Ignatii, a small tree of the nat. ord. Loganiaceae, native in the Philip- 
 pine Islands, and also called Ignatia Amara. It contains the alkaloids 
 Strychnine and Brucine, about 1 per cent, of each, for a description of 
 which see under the title Nux Vomica. 
 
 Tinctura Ignatiae, Tincture of Ignatia (Unofficial), — strength 10 per cent. Dose, 
 
 Physiological Action and Therapeutics. 
 
 Ignatia closely resembles Nux Vomica in action, a poisonous dose pro- 
 ducing the same exaltation of the spinal functions, with muscular twitch- 
 ing, tetanic spasms, and death by asphyxia through tetanic fixation of the 
 respiratory muscles, but as it contains a greater quantity of Strychnine than 
 the latter it is more powerful in the same dose. It exalts the suscepti- 
 bility of the sensory nerves and the nerves of special sense for a time, but 
 an opposite condition soon succeeds, manifested by numbness and torpor 
 with great mental depression. It causes a feeling of constriction about 
 the throat and a sensation of anguish at the pit of the stomach. Its 
 antagonists and incompatibles are the same as those for nux vomica. 
 
 Ignatia is recommended in hysteria to control the general hyperes- 
 thesia, also for insomnia, clavus hystericus, mental excitement or depres- 
 sion, aphonia, perverted appetite, and convulsive crying or laughing. It 
 will often remove the intercostal neuralgia of hysterical subjects, and the 
 sensation as of a ball rising to the throat (globus hystericus). Cerebro- 
 spinal irritability is diminished by small doses though excited by large 
 ones, Ignatia being probably the most efficient controller of functional 
 phenomena of the cerebro-spinal axis. In the convulsions of children 
 from intestinal irritation without cerebral congestion, and in insomnia 
 
352 ILLICIUM — INULA — IODUM. 
 
 from nervous erethism, small doses of Ignatia are used with the happiest 
 results. It is by many practitioners preferred to nux vomica as a stom- 
 achic tonic, and is useful in the treatment of dyspepsia, hypochondriasis 
 and various nervous affections. 
 
 ILLICIUM, Star Anise, — is the fruit of Illicium verum, an Asiatic shrub of the 
 nat. ord. Magnoliaceae. It contains a Volatile Oil which is chemically and practically 
 identical with the Oil of Anise. Another species, Illicium anisatum [Illicium religiosuni), 
 is very poisonous, causing vomiting, epileptiform convulsions, dilated pupils and cyanosed 
 countenance. Its carpels are more woody, shrivelled and wrinkled, and end in a curved 
 beak. Illicium is recognized officially as a source of the Oil of Anise, and has actions 
 and uses similar to those of Anisum. (See ante, page 167.) 
 
 INULA, Elecampane, — is the root of Inula Ileleniwn, a plant of the nat. ord. 
 Compositae, growing in Europe and N. America. It contains a volatile oil, a resin, a 
 crystalline substance named Helenin, C 6 H g O, and a peculiar principle resembling starch, 
 Inulin, C 6 H 10 O 5 , which is found in Arnica, Taraxacum and other plants. Having the 
 same chemical composition as starch, Inulin differs from the latter in being colored yel- 
 low by Iodine, and depositing from its solution in hot water as the solution cools. It is 
 contained in Elecampane in large quantity, from 1 9 to 44 per cent., the latter in the 
 autumn. There are no official preparations, but a decoction ( ^ ss to Oj ) may be given 
 in doses of ^j-ij. Dose of the powdered root, gr. xx-gj. 
 
 Inula is a gentle stimulant to the secretory organs, and is said to be expectorant, dia- 
 phoretic and diuretic. In large doses it causes nausea and vomiting. It was formerly 
 supposed to be emmenagogue and was much used in amenorrhea. It is now chiefly 
 employed as a domestic remedy in chronic bronchitis and dyspepsia, and to promote the 
 eruption in exanthematous fevers. 
 
 IODUM, Iodine, I, — is a non-metallic element, existing in sea-weed, 
 sea-water, some fresh waters and fresh-water plants, also in sponge, oys- 
 ters, eggs, cod-liver oil, rock salt and several ores. It occurs in bluish- 
 black rhombic plates, of metallic lustre, peculiar odor, acrid taste and 
 neutral reaction; sparingly soluble in water (1 in 5,000), readily so in 
 ether, and in 10 of alcohol, also in a solution of potassium iodide or 
 sodium chloride. It volatilizes slowly at ordinary temperatures, and 
 produces a dark-blue color with gelatinized starch in a cold solution. 
 Internally it is generally administered in the form of an iodide or as the 
 compound solution of iodine. Dose, gr. ss-j. 
 
 Preparations of Iodine. 
 
 Tinctura Iodi, Tincture of Iodine, — strength 7 per cent. Dose, tt\J-v ; but it is gen- 
 erally used as a local application, or for injection into cavities. 
 
 Liquor Iodi Compositus, Compound Solution of Iodine, lugoP s Solution, — has of 
 Iodine 5, Potassium Iodide 10, in Distilled Water to 100. Dose, TT\J-x, well diluted. 
 
 Unguentum Iodi, Ointment of Iodine, — has of Iodine 4, Potassium Iodide 1, Water 
 2, Benzoinated Lard 93. 
 
 Iodized Phenol, Carbolated Iodine (Unofficial), — is a mixture of Iodine and crystal- 
 lized Carbolic Acid in varying proportions, generally I of the former to 4 of the latter : 
 for local use, especially in gynecology. 
 
 Iodides and their Preparations. 
 
 Ammonii Iodidum, Ammonium Iodide, NHJ, — a deliquescent, granular, white 
 salt ; soluble in I of water and in 9 of alcohol at 59 F. Dose, gr. ij-x or more. 
 
iodum. 353 
 
 Potassii Iodidum, Potassium Iodide, KI, — a colorless, deliquescent, crystalline salt, 
 of saline and bitter taste ; soluble in 0.8 of water and in 18 of alcohol. ^j of this salt 
 dissolved in ^ j of water makes nearly 3 jss of fluid, so that tt\vijss of the solution would 
 be required to obtain gr. v, a fact to be remembered in prescribing. Dose, gr. v- 5jj. 
 
 Unguentum Potassii Iodidi, Ointment of Potassium Iodide, — has of the Iodide 12, 
 Sodium Hyposulphite I, Hot Water 10, Benzoinated Lard 77. 
 
 Sodii Iodidum, Sodium Iodide, Nal, — minute, deliquescent crystals; soluble in 0.6 
 of water and in 1.8 of alcohol. Dose, gr. v-^j. 
 
 Strontii Iodidum, Strontium Iodide, SrI 2 (H 2 0) 6 , — colorless, hexagonal plates, of 
 bitter, saline taste ; very soluble in water and in alcohol. Dose, gr. v-xxx. 
 
 Iodoformum, Iodoform, Formyl Iodide, CHI 3 , — small, lemon-yellow crystals, of 
 saffron-like and penetrating odor ; very slightly soluble in water, soluble in about 52 of 
 alcohol, 12 of boiling alcohol, and in 5.2 of ether ; very soluble in chloroform, benzin 
 and fixed and volatile oils. Its solutions have neutral reaction. Dose, gr. j-v. 
 
 To remove its odor without forming a compound the best agents are Thymol (gtt. ij 
 ad 3J of Iodoform), Oil of Mirbane (gtt. vj ad gr. xv), Oil of Bitter Almonds, or Oil of 
 Rose (gtt. j ad ^j). Oil of Turpentine is particularly serviceable in removing the odor 
 from the hands, or from spatulas, mortars, etc. 
 
 Unguentum Iodoformi, Iodoform Ointment, — Iodoform, finely pulverized, 10, Ben- 
 zoinated Lard 90, thoroughly mixed by trituration. 
 
 Other Iodides and preparations thereof are — Argenti Iodidum, Arseni Iodidum, 
 Liquor Arseni et Hydrargyri Iodidum, Hydrargyri Iodidum Rubrum, Hydrargyri Iodi- 
 dum Flavum, Syrupus Ferri Iodidi, Pilulae Ferri Iodidi, Plumbi Iodidum, Sulphuris 
 Iodidum and Zinci Iodidum. As these preparations are allied in action and uses less 
 closely to Iodine than to the other elements in their composition, they are described under 
 other titles. (See Argentum Hydrargyrum, etc.) Ethyl Iodide or Hydriodic Ether is 
 described under ^Ether (see ante, page 113). 
 
 Preparation of Hydriodic Acid. 
 
 Syrupus Acidi Hydriodici, Syrup of Hydriodic Acid, — contains I percent, of abso- 
 lute Hydriodic Acid, HI. Dose, 5 j-iv, well diluted. 
 
 Physiological Action. 
 
 Iodine is irritant to the mucous membranes and to the skin. Applied 
 to the latter it stains a deep yellowish-brown color and combines with the 
 albumin of the tissue, causing considerable pain and subsequent exfolia- 
 tion of the epidermis. Vesication may be quickly produced if the quan- 
 tity used be large. Inhaled its vapor irritates the respiratory mucous 
 membrane, producing sneezing, cough, dyspnea, also pain in the chest 
 and in the frontal sinuses. In the gastro-intestinal canal it is equally 
 irritant, but is gradually converted into the iodide or iodate of sodium, 
 in which form or as an albuminate it is absorbed into the blood. Iodine 
 decomposes organic molecules, and in the presence of phosphoretted or 
 sulphuretted gases it acts like chlorine but more feebly, uniting with their 
 hydrogen and thus breaking up those noxious compounds it is disinfectant 
 and deodorant. 
 
 The Iodides of Sodium, Potassium, etc., are very diffusible and are as 
 rapidly excreted ; setting free nascent oxygen (Ozone) and Iodine at the 
 points of elimination they are remotely irritant to the mucous mem- 
 branes, causing violent coryza, with soreness of the throat, acute con- 
 junctivitis, profuse mucous discharges, headache and irritation of the 
 23 
 
354 iodum. 
 
 kidneys and the skin. Intravenous injections of these salts produce at 
 first a rapid elevation of arterial pressure with acceleration of the cardiac 
 rate ; followed by slowing of the heart, and later on lowered blood-pres- 
 sure with increased heart-rate. If used for any length of time they induce 
 great waste and rapid elimination of waste products, causing anemia, 
 emaciation and mental depression ; but these effects are credited chiefly 
 to the metallic constituent, being most severe from the potassium salt. 
 They combine with certain poisons in the system, particularly lead, 
 mercury and the products of the syphilitic disease, hastening their elimi- 
 nation. Iodism is the term applied to the general condition produced 
 by these agents, and comprises the symptoms above noted together with 
 frontal headache, ptyalism, a saline taste in the mouth, dysphagia, tem- 
 porary impotence, and an acneform eruption on the face and limbs. 
 Sometimes the eruption is furuncular or even purpuric. It is less apt to 
 result from the use of the Strontium Iodide than from that of the others. 
 The copious dilution of these preparations with water promotes their 
 excretion, and to a great extent prevents the development of unpleasant 
 results. The ptyalism occasionally produced by iodides is not a direct 
 result of their action, and occurs only in persons who have previously 
 taken mercurials. In such cases the mercury, which had been deposited in 
 the tissues as an albuminate, is set free by the iodide and coming again 
 into the circulation it produces its constitutional effects. (Murrell.) 
 
 Potassium Iodide occasionally gives rise to some peculiar symptoms in 
 certain susceptible persons. Among these are diuresis, cerebral excite- 
 ment as from alcohol, hemorrhages from the urethra and the vagina, 
 glossitis (Gross), also laryngitis and sudden edema of the glottis. The 
 latter may be of so intense a character as to require the instant perform- 
 ance of tracheotomy in order to avert death. On the circulation it pro- 
 duces marked and important effects in most cases. It causes acceleration 
 of the pulse and vascular dilatation, leading to abundant secretion from 
 several glands. It reduces the temperature a degree or more, and slows 
 the rate of the respiration. 
 
 Iodoform contains from 94 to 97 per cent, of Iodine and naturally 
 resembles the latter in action. Locally its action is anesthetic and pow- 
 erfully antiseptic. It is one of the best agents to prevent decomposition 
 and to destroy the germs of putrefaction and of disease, but must be 
 carefully employed, as when used in quantity on an extensive raw surface 
 it has often produced fatal results with symptoms of narcotic poisoning. 
 The first sign of its dangerous absorption is increase of temperature, 
 which may reach 104 or more, then headache, quick and feeble pulse, 
 marked anxiety and restlessness. Collapse and death may suddenly super- 
 vene. The quantities which have produced fatal results from local 
 absorption have varied from 525 to 4,500 grains. In small doses inter- 
 
iodum. 355 
 
 nally it is considered to be a tonic and alterative, wasting does not occur, 
 but the body-weight increases and the general condition improves. In 
 these respects its action markedly differs from that of Iodine or the 
 Iodides. In medicinal doses internally administered for any length of 
 time it may cause profuse salivation. 
 
 Ethyl Iodide (see ante, pages 113 and 116) is used by inhalation to 
 bring the system rapidly under the influence of Iodine. It is a good anti- 
 spasmodic and general stimulant and a very slow anesthetic. 
 
 Antidotes, Antagonists and Incompatibles. 
 
 Starch is the antidote to free Iodine, but the stomach must be evacuated soon as the 
 resulting iodide is active. Albumin, starch, lime-water, tannin and soap may be used in 
 poisoning by the iodides, and free emesis should be induced. In chronic iodide poison- 
 ing a free salivary flow, brought on by chewing Pyrethrum root, will hasten elimination 
 of the drug. Restoratives and vaso-motor tonics, as Quinine, Digitalis, etc., are thera- 
 peutically antagonistic. 
 
 Incompatibles with Iodine and the Iodides are the Mineral Acids, Metallic Salts, Alka- 
 loids and their salts, also Ammonia. Potassium Iodide combined in solution with Potas- 
 sium Chlorate results in a poisonous compound. As Potassium Iodide decomposes nearly 
 all the metallic salts, and is incompatible with many substances, it is best prescribed 
 alone or in some simple vehicle, a favorite one being the Compound Syrup of Sarsaparilla. 
 It may be prescribed with Tincture of Cinchona, an ounce of which dissolves 30 grains, 
 or in combination with Liquor Potassii Arsenitis, which prevents the iodic eruption to 
 some extent. In the "mixed treatment'' of syphilis it is combined with Biniodide 
 of Mercury. It is better borne when combined with Nux Vomica or Potassium Acetate, 
 or alternately with Iodide of Iron (Squire). Its efficacy is increased by uniting it with 
 Ammonium Carbonate, 2 parts to I or I ]/ z of the Iodide (Gull). 
 
 Therapeutics of Iodine. 
 The tincture and the compound solution are much employed locally as 
 counterirritants and by injection into cavities as alterative applications, 
 instances of which are their use in glandular tumors, hypertrophied ton- 
 sils, cervical and ovarian cysts, empyema, hydrocele, etc. In various 
 skin diseases, as chloasma, lentigo, lupus, the tincture or a glycerite is 
 well applied, and in many splenic and hepatic disorders of chronic type 
 the ointment or tincture is a favorite counterirritant application. In 
 sores, ulcers, and fissures, the Iodide of Starch or a mixture of Iodoform 
 and Tannin are strongly recommended, and the tincture is much used 
 locally to promote absorption of the products of acute inflammations. 
 In acute catarrh and hay-fever inhalations of Iodine-vapor or that from 
 Iodized Phenol are very serviceable, and in the vomiting of pregnancy 
 1- to 5-drop doses of the tincture every hour are often efficient. The 
 compound solution well diluted is given thrice daily in typhoid fever 
 with good results in many cases, and in malarial fevers the same prepara- 
 tion combined with Carbolic Acid has shown curative power. In strumous 
 conditions Iodine internally is generally considered to be more efficient 
 than any of the Iodides. 
 
356 iodum. 
 
 Therapeutics of the Iodides. 
 
 Potassium Iodide is the most frequently used iodide, and is the form in 
 which Iodine is generally administered internally. It is usually given in 
 simple solution or in the compound infusion or syrup of Sarsaparilla. 
 Though its mode of action has never been explained satisfactorily, it is 
 known by clinical experience to counteract many pathological conditions, 
 to promote the absorption of morbid products, and the elimination of 
 several metallic poisons. It is almost of specific rank in tertiary syphilis 
 and its results, as neuralgias, paralyses from gummata, ulcerations, syphi- 
 loma of the internal viscera, lupus, chronic rheumatism and sciatica, in 
 all of which when of syphilitic origin this iodide in large doses (50 to 150 
 grains daily) to saturation of the system will speedily cause improvement. 
 So also in mercurial poisoning and other chronic metallic toxemias, the 
 best treatment is by rapid saturation with Potassium Iodide. The products 
 left behind by pneumonia, pleurisy and pericarditis often yield to 
 moderate doses (5 grains), which if used for a prolonged period seem to 
 retard the changes of chronic nephritis. It is the best remedy for the 
 early stage of hepatic cirrhosis, and acts as a most efficient expectorant 
 in chronic bronchitis. Aneurisms are often cured by large doses (20 to 
 30 grains) of Potassium Iodide, the sac becoming solid by fibrinous 
 deposit. In acute catarrh and hay-fever, it is useful with Arsenic, the 
 Iodized Phenol being at the same time used locally in weak solution. In 
 tonsillitis and simple sore throat a weak solution (gr. ij-v to the 3) is a 
 good gargle, and in large doses it is often efficient in spasmodic asthma 
 induced by bronchial catarrh. 
 
 Ammonium Iodide in grain dose repeated frequently is an excellent 
 remedy in acute catarrh, hay-fever, duodenal catarrh and its accompany- 
 ing jaundice, in chronic and capillary bronchitis, and in catarrhal pneu- 
 monia to prevent caseation of the products. In the first stage of hepatic 
 cirrhosis and in chronic malarial poisoning it is equally efficient adminis- 
 tered in conjunction with arsenic. Being somewhat more irritating than 
 the other iodides it is usually given in smaller quantity, but being less 
 stable it is more energetic in action. 
 
 Sodium Iodide may be used instead of the potassium salt, in all affec- 
 tions in which the latter is indicated ; but requires to be administered in 
 somewhat larger doses, being less active and less toxic. Strontium 
 Iodide is still less liable to produce eruptions, and has been employed with 
 benefit in scrofulous, rheumatoid and cardiac disorders. It is said to be 
 free from causing intestinal irritation or depression of nutrition. 
 
 Hydriodic Acid is used as a substitute for iodine and the iodides. As 
 an alterative it is believed by some to possess all the powers of iodine 
 while it is much less offensive to the taste and the stomach. It has been 
 
iodum. 357 
 
 used with benefit in asthma and bronchitis. This acid is not now official, 
 as it is liable to change by the development of free iodine. 
 
 Iodoform is chiefly employed in local diseases as an antiseptic, anes- 
 thetic and alterative agent. It may be dusted in fine powder over a wound 
 or sore, or used in ethereal solution to saturate gauze or absorbent cotton. 
 It is a useful application to sloughing and phagedenic ulcers, gunshot 
 wounds, chancroids, fistulas, sinuses and painful affections of the rectum 
 or uterus. Internally it may be used as a general tonic and alterative in 
 syphilis and other cachexias, also for neuralgia, and is frequently pre- 
 scribed with Iron. Triturated with tannin it forms a good application 
 to the cervix uteri in erosions and ulcerations thereof, or an Iodo-tannin 
 may be prepared by saturating the tincture of iodine with tannic acid, 
 and applied on a cotton tent to the uterine mucous membrane in many 
 chronic affections of that organ. Tuberculosis has been successfully 
 treated by Iodoform, which checks the activity of the bacillus of that dis- 
 ease. Diabetes has been apparently cured by Iodoform, and syphilis 
 may be combated successfully thereby in lieu of potassium iodide. 
 
 Unofficial Substitutes for Iodoform. 
 
 Aristol, Dithymol Iodide, — is a combination of Iodine and Thymol, containing nearly 
 46 per cent, of the former, and is prepared by adding an alkaline solution of Thymol to 
 a solution of Potassium Iodide and Iodine. It occurs as an amorphous, odorless, unstable, 
 non-toxic powder, of a brown-red or fawn color, insoluble in water or glycerin, spar- 
 ingly soluble in alcohol, freely so in ether, chloroform, and fatty oils. As its Iodine 
 leaves it readily, no heat should be used in dispensing it, and it should not be mixed 
 with alkalies, metallic oxides, or starch. It is used locally as a substitute for Iodoform. 
 
 Aristol is highly praised by those who have used it in the local treatment of ulcers, 
 wounds, and other breaches of the tissues ; in which it is considered nearly, if not 
 quite, as efficient as Iodoform, with the great advantage of being odorless. Excellent 
 results have been obtained with it in the treatment of indolent soft ulcers, lupus, psoria- 
 sis, syphilitic ulcerative processes, eczema, severe burns, affections of the ear, nose, and 
 pharynx, as well as in the various cases in gynecological and dermatological practice in 
 which Iodoform has hitherto stood supreme. Its prolonged use may give rise to chronic 
 iodine poisoning. Aristol is best applied in powder, in solutions in Oil or Ether (5 to 10 
 per cent. ), or as ointments with a base of Lanolin or Vaselin (5 to 10 per cent.). A use- 
 ful application is a liniment, prepared by dissolving 5 grains of Aristol in g ij of a mix- 
 ture of equal parts of Ether and Alcohol, then incorporating ^j of soft Soap. 
 
 Europhen, Isobutyl-orthocresol Iodide, — is produced- by the action of Iodine upon 
 Isobutyl-orthocresol in a solution of Potassium Iodide, and contains about 27 per cent, of 
 Iodine, which it gives up to metallic oxides and mercury salts, and when brought into 
 contact with aqueous liquids. It occurs as a very fine, amorphous, yellow powder, of 
 faint aromatic odor like that of saffron ; insoluble in water and in glycerin, soluble in 
 alcohol, ether, chloroform and fatty oils ; readily decomposed by heat and by starch, 
 slowly by light. It is five times lighter and more bulky than Iodoform, and is used as a 
 substitute therefor in all local applications where a dry antiseptic is required. Like 
 Aristol, it should be kept in a dry place, and protected from the action of light. Its 
 virtues are probably due to the readiness with which it liberates free, nascent Iodine, 
 when in contact with aqueous liquids ; being fully equal in this respect to Iodoform. 
 Used externally, it is dusted on in powder, or applied as a 5 to 10 per cent, ointment 
 with Lanolin as a base. It must not be combined with metallic oxides or mercurials, 
 nor with zinc starch paste. For hypodermic use a 3 to 10 per cent, solution in Olive Oil 
 is employed. A mixture of Europhen and Aristol, equal parts of each, is highly recom- 
 mended for adhesiveness. 
 
35$ IPECACUANHA. 
 
 Bismuthi Subiodidum , Bismuth Subiodide, BiOI, — is a heavy, amorphous, brick-red 
 powder, insoluble in any reagent without decomposition. 
 
 Bismuthi Subgallas, Bismuth Subgallate [Dermatol), — is a very fine saffron-yellow- 
 odorless powder. 
 
 These are two of the very best among the agents proposed as substitutes for Iodoform 
 in local applications. They are non-irritant, powerfully bactericidal, and entirely odor- 
 less. In the author's experience the Subiodide is exceedingly efficient in stimulating the 
 growth of granulations in a large wound, such as that often necessary in the surgical 
 treatment of fistula in ano. They are described under Bismuth [ante, page 220). 
 
 Iodomuth, — is a proprietary bismuth preparation, said to contain 25 per cent, of 
 Iodine. It is described on page 219. 
 
 Iodol, Teira-iodo-pyrrol, — is obtained by treating Pyrrol, (a coal-tar product), with a 
 solution of Iodine and Potassium Iodide, usually known as Potassium Iodo-iodide solution. 
 It occurs in very long, minute, delicate, prismatic crystals, of a yellowish tint, sparingly 
 soluble in water, but readily in alcohol. When even slight decomposition is going on the 
 crystals take on a brown tinge, due to the free iodine. Its odor is very slight, it being 
 practically odorless when pure ; and, unlike Iodoform, it has no toxic properties when 
 undecomposed. It contains about 89 per cent, of Iodine. Dose, gr. ss-v, in tablet. 
 Though practically insoluble in water, Iodol dissolves readily in the gastric juice, and is 
 rapidly absorbed and as quickly diffused throughout the system. It has the same gen- 
 eral action as Iodoform, except that it is devoid of toxic power. 
 
 Iodol is a very close rival to Iodoform, and is used in almost every instance where the 
 latter agent is applicable (Squibb). It should replace Iodoform largely as a topical 
 application, on account of its freedom from unpleasant odor. Internally it is highly 
 esteemed as a remedy in chronic gastric catarrh, intestinal catarrh, and in ulceration of 
 the gastro-intestinal mucous membrane. It has been found to be highly useful in 
 bronchitis, bronchial catarrh, and in various respiratory neuroses ; and has seemed to 
 render good service in the treatment of tuberculosis and syphilis. In eczema of the ear 
 Iodol has proved very efficient. Under its use the inflammation disappears generally 
 within two weeks, but irrigation should be kept up for a short time afterwards, in order to 
 complete the treatment. (Chatellier. ) 
 
 Nosophen, Iodophen, — is a patented preparation, chemically entitled Tetra-iodo- 
 phenol-phthalein, and obtained by the action of iodine on a solution of phenol-phthalein. 
 It contains 60 per cent, of Iodine and occurs as a yellow, insoluble powder, of feebly 
 acid character, with alkalies forming soluble salts, the sodium salt being of blue color and 
 named Antinosin. Nosophen is highly germicidal and is used as an antiseptic dusting 
 powder for wounds, ulcers, etc., also internally for catarrhal inflammations of the gastro- 
 intestinal tract. Dose, gr. v-viij. 
 
 IPECACUANHA, Ipecac, — is the root of Cephaelis Ipecacuanha, 
 a small shrubby plant of the nat. ord. Rubiacese, growing in Brazil and 
 Columbia. It contains Cephaeline, C u H 19 N0 2 , which is a crystalline 
 alkaloid ; Emetine, C u H 18 (CH 3 )N0 2 , an amorphous alkaloid and a methyl 
 compound of cephaeline ; also a third alkaloid in very small quantity, a 
 glucoside named Ipecacuanhic Acid, starch, gum and a trace of a volatile 
 oil. Dose of the powdered root, as an expectorant gr. ss-ij, as an emetic 
 gr. xv-xxx. 
 
 Official Preparations. 
 
 Extractum Ipecacuanhae Fluidum, Fluid Extract of Ipecac, — Dose, tt\j-v-xx. 
 
 Syrupus Ipecacuanhae, Syrup of Ipecac, — strength 7 per cent. Dose, gj-iv. 
 
 Vinum Ipecacuanhae, Wine of Ipecac, — strength 10 per cent. Dose, Try-gj. 
 
 Pulvis Ipecacuanhae et Opii, Porvder of Ipecac and Opium, Dover 's Powder {Pulvis 
 Doveri),—ha.s of Ipecac 10, Powdered Opium 10, Sugar of Milk 80, triturated together 
 to a fine powder. Dose, gr. ij-xv or xx. 
 
IPECACUANHA. 359 
 
 Tinctura Ipecacuanhae et Opii, Tincture of Ipecac and Opium, — has of Tincture 
 of Deodorized Opium ioo evaporated to 80, Fluid Extract of Ipecac 10, Diluted Alcohol 
 to ioo. Is a fluid representative of Dover's powder. Dose, Tnjj-xx or xxx. 
 
 Trochisci Ipecacuanhae, Troches of Ipecac, — each troche contains of Ipecac about 
 gr. %. Dose, j-iij. 
 
 Trochisci Morphinae et Ipecacuanhae, Troches of Morphine and Ipecac, — each 
 troche contains about gr. -£$ of Morphine Sulphate, about gr. ^ of Ipecac, with Oil of 
 Gaultheria, Sugar, etc. Dose, j-iij. 
 
 Unofficial Preparations. 
 
 Ipecacuanha De-emetinisata, De-emetinized Ipecac, — is Ipecacuanha deprived of 
 its alkaloids, for use in dysentery. Dose, gr. v-xx. 
 
 Emetina, Emetine, — colorless, amorphous, soluble in alcohol, ether, chloroform and 
 benzin, very sparingly in water, insoluble in caustic alkalies. Its salts are readily soluble 
 in water, the Hydrochloride and Hydrobromide being those chiefly used in medicine. It 
 is powerfully toxic in large doses. Dose, as an expectorant, gr. xto™ nV> as an eme ^ c > 
 
 err 1_1 
 
 g r - 8"-¥- 
 
 Emetinae Hydrobromas, Emetine Hydrobromate, — crystalline in silky tufts of 
 needles, readily soluble in water, contains 68 per cent, of the alkaloid. Dose, gr. sV^V 
 
 Cephaelinae Hydrochloras, Cephaeline Hydrochloride, — is readily soluble in water. 
 Cephaeline is more powerfully emetic than Emetine, but does not produce depressing 
 effects in doses of gr. T ^-£ and is slow of action. 
 
 Physiological Action. 
 
 Ipecac is nauseant, emetic, expectorant, cholagogue, diaphoretic, hemo- 
 static, sternutatory, and irritant. Applied to the skin it produces red- 
 ness, itching and occasionally a pustular eruption ; injected subcutane- 
 ously it causes pain and inflammation often terminating in abscess. Used 
 as snuff it excites violent sneezing and profuse mucous secretion ; in 
 some persons the inhalation of the smallest quantity induces an asthmatic 
 paroxysm, with swelling and injection of the conjunctival and nasal 
 mucous membranes, salivation, tears, sneezing, coughing and bronchial 
 catarrh. Its action on the gastro-intestinal mucous membrane is also 
 decidedly irritant. Internally, small doses (gr. -i— J) act as a stomachic 
 and hepatic tonic and increase the gastric secretions ; larger doses (gr. 
 v-xx) are nauseant and emetic in from 20 minutes to half an hour, but 
 the emesis produced is not violent nor is it followed by much depression. 
 If these doses are repeated a tolerance of the stomach to the drug becomes 
 established and a cathartic action is produced, the stools having a peculiar 
 bilious character. The circulation is only slightly affected by Ipecac, 
 but it relaxes the skin and increases the broncho-pulmonary mucus. In 
 large doses it is decidedly irritant to the intestinal canal, but here also it 
 is capable of the same tolerance as in the stomach. In poisonous doses 
 it has frequently produced hemoptysis and other hemorrhages. Ruther- 
 ford found it to be a powerful hepatic stimulant. Woodhull believes that 
 it is a direct nervous stimulant, acting chiefly, if not entirely, upon the 
 sympathetic system. 
 
 Emetine possesses strong constringent action on the blood-vessels and 
 
360 IPECACUANHA. 
 
 is powerfully emetic and expectorant. It causes death in animals by car- 
 diac paralysis, and the autopsies show evidence of gastro-intestinal irrita- 
 tion and hyperemic lungs with patches of hepatization. 
 
 Antagonists and Incompatibles . 
 
 Narcotics generally antagonize the emetic action, so also do Bismuth, Carbolic and 
 Hydrocyanic Acids. The salts of Lead and Mercury, Vegetable Acids and astringent 
 infusions are incompatible with Ipecac. 
 
 Therapeutics. 
 
 Ipecac is much used as an emetic, being safe, efficient and non-depres- 
 sant, though slow of action. It is the best agent of the kind to relieve 
 the stomach in acute indigestion and bilious sick-headache, and an 
 ipecac-vomit is considered by many good practitioners to be very ser- 
 viceable at the commencement of eruptive, continued and periodical 
 fevers. The syrup is a favorite domestic emetic to cut short an attack of 
 spasmodic croup, and it may be used beneficially in laryngismus stridulus 
 and in capillary bronchitis. In small doses Ipecac is an excellent stimu- 
 lant of the gastric and hepatic functions, and an expectorant of great 
 value. In atonic dyspepsia, catarrhal jaundice, intestinal colic, bronchial 
 asthma, hay fever, bronchial catarrh, acute laryngitis and pharyngitis, 
 also in nervous and other coughs, it has rendered good service. In still 
 smaller doses (r^J of the wine) frequently repeated it is an efficient anti- 
 emetic in vomiting of nervous origin, and especially in the vomiting of 
 pregnancy, also in that of gastric atony as seen in chronic alcoholism ; 
 its action in this affection being due perhaps to its possessing a sedative 
 influence upon the pneumogastric in small doses. It is an excellent rem- 
 edy in hemoptysis if given in small and frequently repeated doses until 
 nausea occurs. As an antihemorrhagic it has been efficiently used in 
 epistaxis, menorrhagia and post-partum hemorrhage, in the latter affection 
 being given in combination with Ergot. In doses of a grain several times 
 a day it has given satisfaction in cases of idiopathic neuralgia, hyperi- 
 drosis, intermittent fever, erysipelas, acute and suppurative hepatitis and 
 opium narcosis, also in many of the affections which frequently compli- 
 cate the puerperal state. 
 
 In acute intestinal affections Ipecac has achieved its greatest reputation 
 as a remedy, one of its oldest titles being radix antidysenterica. Its power 
 over acute dysentery was known to Piso and Helvetius in the 17th cen- 
 tury, and was mentioned by Balmain (1797), Playfair (1813), Twining 
 (1831) and Delioux (185 1). The reports thereon by Docker (1858) 
 attracted general attention, and since the latter date it has been univer- 
 sally recognized as a specific remedy for acute tropical dysentery and that 
 of malarious districts. Under large doses, 20 to 60 grains every four 
 hours, the tormina and tenesmus disappear, the character of the stools 
 
IRIS. 361 
 
 improves and the constitutional symptoms are relieved. Such doses are 
 not necessarily emetic in all persons, especially if administered in the 
 powder, with a very small quantity of water, preceded by a full dose of 
 opium or a hypodermic injection of morphine and followed by a mustard 
 plaster applied to the epigastrium and perfect quiet in the recumbent 
 posture. De-emetinized Ipecac is said to be as efficient as the unaltered 
 drug in this disease, while nearly free from nauseant and emetic action. 
 Chronic dysentery may also be benefited by this treatment, though some 
 physicians prefer to use smaller doses for a prolonged time in this affection. 
 Diarrheas of simple but painful form, especially the summer diarrhea of 
 young children and that of teething infants, are often greatly relieved by 
 Ipecac in doses of 1 to 5 grains, the bilious character being thereby 
 restored to the discharges and a healthy stimulation of the alimentary 
 mucosae produced. Cholera morbus and cholera infantum have frequently 
 been cured by this remedy, the action of which, in these affections and 
 in dysentery, is most probably that of a sympathetic nerve stimulant, 
 restoring the nervous tone of the intestinal mucous membrane (Wood- 
 hull). After 50 years' experience in the use of Ipecac, Dr. Higginbottam 
 (1868) stated that " its main efficacy is in stimulating and restoring the 
 normal action of the capillary system." The non-emetic use of this drug, 
 so ably advocated by Woodhull, is not merely a method but a principle, 
 and means the use of the remedy, regardless of dose, so as to develop its 
 stimulant rather than its emetic power. 
 
 Ipecac is said to be destructive to the bacillus of anthrax though not to 
 its spores. As the latter are not present in malignant pustule, this drug 
 may prove efficient therein and success has followed its employment. It 
 is used locally after excision of the pustule, also internally in moderate 
 doses. 
 
 IRIS, Blue Flag, — is the rhizome and roots of Iris versicolor, an 
 indigenous plant of the nat. ord. Irideae, growing in moist meadows and 
 on the borders of swamps, having large blue flowers. It contains tannin, 
 sugar, starch, gum, an acrid resin, fixed oils and traces of an alkaloid. 
 Dose of the powdered root, gr. v-xx. 
 
 Preparations. 
 
 Extractum Iridis, Extract of Iris. — Dose, gr. j-v. 
 
 Extractum Iridis Fluidum, Fluid Extract of Iris. — Dose, TT\v-3J. 
 
 Iridin or Irisin (Unofficial), — is a so-called resinoid found in the shops, of undeter- 
 mined composition, but probably an oleoresin precipitated by water from an alcoholic 
 preparation. Dose, gr. j-v. 
 
 Iris when fresh is actively purgative, emetic and diuretic, producing 
 severe nausea and prostration.' Iridin has been the subject of experimen- 
 
362 JALAPA. 
 
 tation upon dogs, and is shown to be a powerful hepatic stimulant with 
 considerable influence on the intestinal glands, being more purgative than 
 Euonymin and less irritant than Podophyllin. In very small doses it 
 causes obstinate constipation by producing rectal inactivity. 
 
 Iris is very serviceable in duodenal catarrh with obstruction of the 
 bile-ducts and consequent jaundice, also in malarial poisoning, bilious 
 remittents, and jaundice of malarial origin. It is used in many hepatic 
 and intestinal disorders as a cholagogue and purgative of mild but effi- 
 cient action, also as a diuretic in dropsies. In small doses (n^j of a tinc- 
 ture) it is strongly recommended in a peculiar blinding headache in the 
 right supraorbital region with nausea or vomiting, supposed to be of 
 hepatic origin. 
 
 JALAPA, Jalap, — is the tuberous root of Ipomoea Jalapa, a Mexican 
 plant of the nat. ord. Convolvulaceae. It contains 15 to 20 per cent, of 
 the official Resin, which is composed of two glucosides, Jalapin, soft, 
 soluble in ether, and Convolvulin, C 31 H 50 O 16 , which is hard, insoluble in 
 ether, and the most active of the two. Dose, gr. v-xx. 
 
 Preparations. 
 
 Extractum Jalapae, Extract of Jalap. — Dose, gr. ij-x. Is an ingredient of Pil. 
 Catharticse Co., and Pil. Catharticae Vegetabiles. 
 
 Resina Jalapae, Resin of Jalap, — prepared from a tincture by precipitation by water. 
 Is insoluble in water, soluble in alcohol. Dose, gr. ij-x. 
 
 Pulvis Jalapae Compositus, Compound Powder of Jalap, (Pulvis Purgans), — has 
 of Jalap 35, Potassium Bitartrate 65, rubbed together until thoroughly mixed. Dose, 
 g r - X ~3J- 
 
 Physiological Action and Therapeutics. 
 
 Jalap is an active cathartic, producing copious and watery stools, with 
 considerable tormina and tenesmus, also sometimes nausea. It does not 
 produce hemorrhoids, but does increase the secretions of the intestinal 
 canal and the flow of bile. Its action is not due to any one of the con- 
 tained principles, but all the active constituents are found in the resin. 
 Compared with other agents of the same class its action most nearly resem- 
 bles that of Scammony. It is more drastic than Senna and less irritant 
 than Gamboge, but in overdoses may produce dangerous hypercatharsis. 
 
 Convolvulin in sufficient dose is an active irritant poison, producing 
 gastro-enteritis and narcotism. Its action as a purgative seems to be 
 wholly local, as from its intravenous injection no catharsis results, yet it 
 exerts little if any irritant action on the conjunctiva, nasal mucous mem- 
 brane or skin. It is not eliminated in the urine or the feces, and is there- 
 fore probably destroyed in the system by oxidation. 
 
 In olden bowel-moving times Jalap and Calomel were used together in 
 doses of gr. x each (" ten and ten "), as a routine purgative prescription. 
 
JAMBUL JUGLANS JUNIPERUS. 363 
 
 Less ponderous doses are now considered equally efficient, and one grain 
 of each agent with the same quantity of extract of Hyoscyamus as a cor- 
 rective may be used with advantage at the onset of fevers with inflam- 
 mations. As the compound powder it is much employed to produce free 
 watery evacuations in ascites and anasarca. Being nearly tasteless it is a 
 useful cathartic for children, and may be administered in syrup of Rhubarb 
 (gr. ij-v in gss). As a vermifuge it is efficient as an adjunct to more 
 powerful agents, and is employed with Calomel and Santonin for the 
 expulsion of lumbrici. Jalap is contraindicated in all inflammatory con- 
 ditions of the intestinal mucous membrane, but in proper doses it is one 
 of the most manageable and efficient cathartics. 
 
 JAMBUL, Jamun (Unofficial), — the seeds and bark of the Eugenia Jambolana, a 
 native tree of India, has a very varied history of successes and failures in the treatment 
 of diabetes. The British Medical Association has directed its Committee on Therapeutics 
 to investigate the claims made for and against this agent, so that some reliable informa- 
 tion may be expected concerning this very important question. One writer contends that 
 any efficient preparation should be made from the fresh seeds, discarding the pericarps, 
 and avoiding the application of heat ; also that a weak alcoholic menstruum exhausts the 
 drug and gives a stable preparation. Dose of a fluid extract, XX\v— xv. 
 
 Reports, from observers abroad and in this country, show that favorable results have 
 been obtained with Jambul in many cases of diabetes, even after the unsuccessful use of 
 all the usual remedies. In two severe cases, in which 7 and 3 per cent, respectively of 
 glucose was excreted, the urine was brought back to normal and kept therefor two years, 
 by the use of this remedy. It should be given with or after meals, in water or wine 
 sweetened with a small quantity of saccharin, and accompanied by general treatment. 
 
 JUGLANS, Butternut, — is the bark of the root, collected in autumn, of Juglans 
 cinerea, the Butternut or White Walnut, an indigenous forest tree of the nat. ord. 
 Juglandacea?. It contains an orange-yellow, crystalline and acrid substance named 
 Juglandic Acid or Ahicin, resembling Chrysophanic Acid, also some resin, volatile acid, 
 etc., but neither tannin nor any alkaloid. 
 
 Extractum Juglandis, Extract of Juglans. — Dose, gr. v-xx or more. 
 
 Juglans is a mild cathartic operating without the production of pain or irritant symp- 
 toms. It is never used in substance, but the extract is a good laxative in doses of gr. 
 v-x, and a purgative in larger doses. It has considerable reputation in dysentery and 
 chronic constipation. 
 
 JUNIPERUS, Juniper, — the source of the official Oleum Juniperi, 
 is the fruit of Juniperis communis, an evergreen shrub of the nat. ord. 
 Coniferae, growing in Europe and N. America. It contains a Volatile Oil, 
 which consists of terpenes and camphors in complex combination, also a 
 non-crystallizable principle named Juniperin, and grape sugar, resin, 
 formic, acetic and malic acids, etc. The Oil, a Spirit, and a Compound 
 Spirit are official. 
 
 Preparations. 
 
 Oleum Juniperi, Oil of Juniper, — is the volatile oil, a colorless or faintly greenish- 
 yellow liquid, sp. gr. 0.850 to 0.890 ; of terebinthinate and sweetish taste and the odor 
 of juniper ; soluble in 4 times its vol. of alcohol, and in an equal vol. of carbon disul- 
 phide. Dose, ff\v-xv. 
 
364 KAMALA KAVA-KAVA. 
 
 Spiritus Juniperi, Spirit of Juniper, — has of the Oil 5 in Alcohol 95. Dose, ^j-iv 
 or more, according to the quantity of alcohol desired. 
 
 Spiritus Juniperi Compositus, Compound Spirit of Juniper, — has of the Oil 8, Oil 
 of Caraway I, Oil of Fennel I, Alcohol 1400, Water to 2000. It approximates closely 
 a good grade of Gin. (See ante, page 131.) Dose, 3J-iv, or more, according to the 
 quantity of alcohol desired. 
 
 Oleum Cadinum, Oil of Cade, Et?ipyreumatic Oil of Juniper, — is a product of the 
 dry distillation of the wood of Jiuiiper us Oxycedrus. It is a tar-like substance, of un- 
 certain composition and purity : a dark-brown, clear, thick liquid, of tarry odor and a 
 somewhat bitter, burning taste; insoluble in water, partially soluble in alcohol, com- 
 pletely so in ether, chloroform or carbon disulphide. Used locally as a stimulant in 
 psoriasis and chronic eczema. 
 
 Infusum Juniperi, Infusion of Jtiniper (Unofficial), — has of Juniper Berries ^j in 
 Oj of boiling water. Dose, ^j-ij. 
 
 Juniper is a stomachic tonic, diaphoretic, diuretic and aphrodisiac. 
 The oil is the active principle, and is readily diffused, exciting increased 
 cardiac action, stimulating the renal functions and the action of the skin, 
 and causing a subjective sense of heat throughout the system. It is elimi- 
 nated chiefly by the kidneys, and may set up renal irritation, in large 
 doses producing strangury, priapism, hematuria, suppression of the urine 
 and uremic convulsions. It imparts a violet odor to the urine, and will 
 produce diuresis when inhaled. 
 
 The Oil of Juniper is used to flavor gin and to impart the diuretic power 
 popularly ascribed to that liquor. The medicinal use of the juniper 
 preparations (spirit and compound spirit) is restricted to their employ- 
 ment as vehicles for less irritant diuretics. The oil acts therapeutically 
 like the oil of Turpentine, and may be used in chronic pyelitis and cys- 
 titis, prostatorrhea, gleet, etc., but is contraindicated in all cases where 
 acute inflammation of the kidneys exists. 
 
 Oil of Cade is used locally in chronic skin diseases as a stimulant appli- 
 cation. It is too active for acute eruptions, but has been used with benefit 
 in chronic eczema and psoriasis. The Oil of Tar (see under Pix) is equally 
 efficient for all the purposes to which the Oil of Cade has been applied. 
 
 KAMALA, Rottlera, — the glands and hairs from the capsules of Mallotus philip- 
 pinensis, or Rottlera tinctoria, a small tree of the nat. ord. Euphorbiaceee, growing in 
 Abyssinia, Arabia, India, China, etc. It occurs as a granular, mobile, brick-red powder, 
 inodorous and nearly tasteless, partly soluble in alcohol and in ether. It contains several 
 resins, one of which is named Rottlerin, C n H 10 O 3 , also tannin, starch, gum, red coloring 
 matter, etc. There are no official preparations. Dose, 3 ss— iij. 
 
 Kamala is anthelmintic and purgative, sometimes causing nausea and colic, seldom 
 vomiting. It is used as a teniafuge and to expel the round and thread worms. One 
 or two drachms are given suspended in water, mucilage or syrup, and repeated in 4 
 hours if necessary. A tincture ( # ^ vj in % xvj of alcohol) may be used in doses of 3; j- 3j ss. 
 In India it is used locally in scabies and other skin affections and has been found of 
 especial service in herpetic ringworm. As a remedy against tapeworm it is perhaps next 
 after Male-fern in efficiency and requires no preparatory treatment. 
 
 KAVA-KAVA, Ava-Kava (Unofficial), — the root of Piper methysticiwi, a shrub 
 of the nat. ord. Piperacese, growing in South America and the South Sea Islands. It 
 contains a crystalline principle, Kavahin or Methysticin, which is analogous to Piperin, 
 
KINO KRAMERIA LACTUCARIUM. 365 
 
 an acrid, greenish-yellow resin, Kawin, which is probably the active principle, also a 
 Volatile Oil. Dose, 3ss-j, macerated in water, or the same quantity of a fluid extract. 
 Kava is intoxicant, diuretic and motor-depressant. A beverage is prepared in the 
 Hawaiian Islands by chewing the root and then infusing it in water or cocoanut milk, 
 which produces a drowsy intoxication with pleasant dreams often of erotic character, and 
 followed by severe headache. A moderate dose is tonic and stimulant, lessening the 
 sense of fatigue and sharpening the mental faculties. It is highly recommended in 
 gonorrhea and gout, also in chronic gleet and obstinate cystitis. 
 
 KINO, — is the inspissated juice of Pterocarpus Marsupium, a tall tree of the nat. ord. 
 Leguminosse, growing in India. It contains 75 per cent, of a variety of tannin named 
 Kino-tannic Acid, which gives a greenish precipitate with persalts of iron, also a crystal- 
 line, neutral substance, Kinoin, and Kino-red, gum, pectin, etc. There are several other 
 varieties of Kino in the market, brought from S. America, Africa, Australia, etc., which 
 are products of other trees than the official one. 
 
 Tinctura Kino, Tincture of Kino, — has of Kino 10, in Alcohol 65, Water 20 and 
 Glycerin 15. Dose, gss-ij. 
 
 Pulvis Kino Compositus, Compound Powder of Kino (Unofficial), — contains 5 per 
 cent, of Opium, and has of Kino 15, Opium 1, Cinnamon 4. Dose, gr. v-xx. 
 
 The action of Kino is the same as that of Tannic Acid, though less powerful, and it 
 may be used for the same purposes, both internally and locally. It is chiefly employed 
 as an astringent gargle and as a constituent of diarrhea-mixtures. The tincture, in 
 drachm doses, is one of the most efficient means of combating the atonic diarrhea which 
 results from the disuse of opium or morphine. 
 
 KRAMERIA, Rhatany, — is the root of Krameria triandra and Krameria Ixina, 
 shrubs of the nat. ord. Polygaleoe, growing in S. America, the first-named in Peru and the 
 latter in New Granada. It contains 20 to 45 per cent, of Rhatania-tannic Acid, also 
 Rhatanine, an alkaloid, and wax, gum, etc. 
 
 Extractum Krameriae, Extract of Krameria, — aqueous. Dose, gr. v-x. 
 
 Extractum Krameriae Fluidum, Fluid Extract of Krameria. — Dose, TT\v-3ss. 
 
 Tinctura Krameriae, Tincture of Krameria, — 20 per cent. Dose, Tr^v-^j. 
 
 Syrupus Krameriae, Syrup of Krameria, — has of the Fluid Extract 45 parts, with 
 Syrup 55. Dose, ^ss-^ss. 
 
 Trochisci Krameriae, Troches of Krameria, — each troche contains gr. j of the extract, 
 with Tragacanth, Sugar and Orange-Flower Water. 
 
 Krameria possesses the same astringent qualities as Tannic Acid and may be employed 
 for the same purposes, except as an antidote to Antimony. It has long had a high repu- 
 tation as an injection for fissure of the anus, as a local application to spongy gums, as a 
 tonic for debilitated subjects, in chronic diarrhea, also in passive hemorrhages and mu- 
 cous discharges, as menorrhagia and leucorrhea. 
 
 LACTUCARIUM, Lettuce, — is the concrete milk-juice of Lactuca virosa, the 
 Acrid Lettuce, a biennial European plant of the nat. ord. Compositse. It is partly solu- 
 ble in alcohol and in ether, and yields a turbid mixture when triturated with water. Lac- 
 tucarium is a mixture of several substances, the most important being Lactocin, which is 
 thought to be the active principle. It occurs in white scales, soluble in water, and used 
 as a sedative and hypnotic in doses of gr. j-v. Lactucarium also contains' three bitter 
 principles, Lactucin, Lactopict'in and Lactucic Acid ; also Lactucerin, an inert, waxy 
 substance, constituting nearly one-half of the drug. A minute quantity of a mydriatic 
 alkaloid, believed to be Hyoscyamine, has been found in the plant, but not in commercial 
 lactucarium. 
 
 Tinctura Lactucarii, Tincture of Lactucarium, — 50 per cent. Dose, TTLx-^ij, 
 according to the activity of the drug. 
 
 Syrupus Lactucarii, Syrup of Lactucarium, — has of the Tincture 10 per cent. 
 Dose > 3-klJ- 
 
 Lactucarium is feebly hypnotic, somewhat sedative and diuretic. It is supposed to 
 act similarly to Opium, but very feebly and without depressing after-symptoms. As much 
 
366 LAPPA LAVANDULA LEPTANDRA. 
 
 as half an ounce has been given to a dog without causing any special effect. Its prepa- 
 rations are very uncertain in activity, and are chiefly used as placebos, to allay cough 
 and quiet nervous irritability. The syrup is a good vehicle for expectorants and anti- 
 spasmodics. 
 
 LAPPA, Burdock, — is the root of Arctium Lappa, and of other 
 species of Arctiwn, the common Burdock, a biennial weed of the nat. 
 ord. Compositae, found in waste places and along roadsides in Europe, Asia 
 and N. America. Three varieties are recognized, formerly- known as 
 Lappa major, L. Tonientosa, and L. Minor, of which the first-named is 
 most frequently met with in this country. It contains a bitter principle, 
 traces of a volatile oil, also inulin, resin, tannin, mucilage, sugar, etc. 
 
 Extractum Lappae Fluidum, Fluid Extract of Lappa, — made with diluted alcohol. 
 Dose, gj-ij. Dr. Squibb recommended a Tincture of the seed ; lb. j of ground seed to 
 gall, j of whiskey, allowed to stand for two weeks before decanting, and used in doses of 
 £ij-iij before meals. 
 
 Lappa promotes all the secretions and is considered aperient, diuretic 
 and diaphoretic, without irritating qualities. In decoction it has been a 
 popular domestic remedy for many morbid conditions, especially rheu- 
 matism, gout, pulmonary catarrhs, and chronic cutaneous affections. By 
 several practitioners it is praised as an alterative in constitutional diseases, 
 as syphilis and scrofula, also as an external application to swellings, 
 hemorrhoids and chronic sores. A tincture of the seed has proved re- 
 markably efficient as a stomachic tonic and has cured several cases of 
 psoriasis inveterata. [See Squibb's Ephemeris, vol. i, p. 116.] 
 
 LAVANDULA, Lavender, — the source of the official Oil of Lavender Flowers, 
 is the fresh flowers of Lavandula officinalis, a small European shrub of the nat. ord. 
 Labiatae, largely cultivated in England. They have a fragrant odor, and an aromatic, 
 camphoraceous taste ; and contain resin and tannin, also a Volatile Oil. 
 
 Oleum Lavandulae Florum, Oil of Lavender Flowers, — is a volatile oil distilled 
 from fresh Lavender, and having the fragrant odor of the flowers. It is soluble in alco- 
 hol in all proportions, also in 3 times its volume of a mixture of alcohol 3 and water 1, 
 also in glacial acetic acid. Dose, TT\j-v. 
 
 Spiritus Lavandulae, Spirit of Lavender, — has of the Oil 5, in Deodorized Alcohol 
 95. A perfume and flavoring agent. Dose, ^ss-j. 
 
 Tinctura Lavandulae Composita, Compound Tincture of Lavender, — an aromatic 
 stimulant, composed of the Oil 8, Oil of Rosemary 2, Cassia Cinnamon 20, Cloves 5> 
 Nutmeg 10, Red Saunders 10, Alcohol 700, Water 250, Diluted Alcohol to 1000. Is a 
 constituent of Liquor Potassii Arsenitis. Dose, 3 ss— ij. 
 
 Lavender is aromatic, stimulant and carminative, but is rarely used alone as a medicine. 
 It is an agreeable flavoring and perfume, in the form of the official spirit, which is sold 
 under the name of " Lavender-water,' 1 '' after the addition of Oil of Bergamot and Essence 
 of Ambergris. The compound tincture, formerly called the compound spirit of Lavender, 
 is a very agreeable combination of spices, and is much used as a remedy for gastralgia, 
 nausea, flatulence, etc., and as an adjuvant or corrigent of other medicines. 
 
 LEPTANDRA, Culver's Root, — is the rhizome and rootlets of Veronica virginica, 
 an indigenous perennial plant of the nat. ord. Scrofularineas. It contains a glucoside 
 named Leptandrin , which is probably the active principle, also Saponin, resin, tannin, 
 etc. The Leptandrin of the shops is an impure alcoholic extract. 
 
LICOPERDON GIGANTEUM LIMON. 367 
 
 Extractum Leptandrae, Extract of Leptandra, — is a constituent of Pil. Catharticoe 
 Vegetabiles. Dose, gr. j-iij. 
 
 Extractum Leptandrae Fluidum, Fluid Extract of Leptandra. — Dose, TT^xx-^j. 
 
 Leptandra is tonic, laxative, and like other resin-bearing purgatives is decidedly chola- 
 gogue. The recent root is a violent cathartic, but in the dried state it is less active. It 
 is indicated in duodenal indigestion and chronic constipation with insufficiency of the 
 biliary and intestinal secretions. 
 
 LICOPERDON GIGANTEUM, Puff-Bail (Unofficial),— is a common fungus 
 of the nat. ord. Trichogastres, found in hilly and wooded districts. The dust, which 
 consists of the capillitium and spores, is a valuable hemostatic, and dusted over bleeding 
 surfaces acts promptly in arresting hemorrhage. It has been proposed as a surgical 
 dressing, but while useful in emergencies where other agents are unattainable, the fetor 
 which results from its application to wounds will prevent its use becoming general for 
 this purpose. It may prove of value as an internal hemostatic in hematemesis and the 
 hemorrhage of typhoid fever. 
 
 LIMON, Lemon, — is the fruit of Citrus Limonum, a tree of the nat. 
 ord. Rutaceae, native in Asia, but cultivated in Southern Europe and 
 many other countries. It is official in the two forms described below. 
 The Orange- {Citrus Vulgaris and C. Aurantium), the Citron {Citrus 
 medico), and the Lime {Citrus acris), all belong to the same genus. 
 
 Limonis Cortex, Lemon Peel, — is the rind of the recent fruit, and 
 contains a Volatile Oil, C 10 H 16 , which is official, and a bitter crystalline 
 glucoside, Hesperidin, chiefly contained in the white of the rind. 
 
 Limonis Succus, Lemon Juice, — is the freshly expressed juice of the 
 ripe fruit, each lemon yielding from ^ to 1 fluid ounce. It contains 
 about 7 per cent, of free Citric Acid, besides Phosphoric and Malic 
 Acids, Citrates of Potassium and of other bases, etc. Dose, ^ss-iv. 
 
 Acidum Citricum, Citric Acid, H 3 C 6 H 5 7 -f- H 2 0, — is obtained 
 from the juice of the Lemon or the Lime by adding chalk to form calcium 
 citrate, which is then decomposed by dilute sulphuric acid. It occurs 
 in colorless, rhombic crystals which are very soluble in water. A solution 
 of gr. xvij in §ss of water corresponds to gss of fresh lemon-juice, and this 
 quantity of either will neutralize of Potassium Bicarbonate gr. xxv, of 
 Sodium Bicarbonate gr. xx, and of Ammonium Carbonate gr. xivss. 
 Dose, gr. x-xxx. , 
 
 Citrates of Bismuth, Bismuth and Ammonium, Iron, Iron and Ammonium, Iron and 
 Quinine, Iron and Strychnine, Lithium, Magnesium, Potassium, nine in all, are official. 
 They are described under their respective bases, to which their medicinal qualities are due. 
 
 Preparations. 
 
 Oleum Limonis, Oil of Le??wn, C 10 H 16 , — is the volatile oil, isomeric with oil of tur- 
 pentine, and extracted from fresh lemon peel by mechanical means. It is used for flavor- 
 ing and is an ingredient of Spiritus Limonis, Spiritus Aurantii Compositus, and Spiritus 
 Ammoniae Aromaticus. Dose, rt\j-v. 
 
 Spiritus Limonis, Spirit of Lemon, Essence of Lemon, — is prepared by macerating 
 5 of the Oil and 5 of the Peel, freshly grated, in Deodorized Alcohol to 100. Used for 
 flavoring. Dose, according to the amount of alcohol desired to be given. 
 
368 LINUM. 
 
 Syrupus Acidi Citrici, Syrup of Citric Acid, — has of Citric Acid 10, Water 10, 
 Spirit of Lemon 10, Syrup to 100. Dose, indefinite. 
 
 Physiological Action and Therapeutics. 
 
 Lemon-peel is bitter and probably tonic to the stomach, but is used 
 only for flavoring purposes. Lemon-juice, on the other hand, is refrig- 
 erant and antiscorbutic, entering the blood as alkaline citrates, potassium 
 salts and phosphoric acid, the citrates being therein partly oxidized into 
 C0 2 and H 2 0, while the potassium salts and phosphoric acid probably act 
 upon the red corpuscles. Citric Acid has the same general action as Acetic 
 and the other vegetable acids. It is wholly decomposed in the blood, 
 and appears to be non-toxic in man, but used internally it may precipi- 
 tate uric acid and thus promote the formation of calculi. Lemon-juice 
 is employed largely in the treatment and prevention of scurvy, in which 
 disease it possesses powers of specific rank, but whether its action therein 
 is due to the citric acid, the phosphoric acid or the salts of potassium is 
 not known. Lime-juice is equally efficient but Citric Acid itself is not so. 
 
 As refrigerants and diuretic mixtures in fevers, Lemon-juice and Citric 
 Acid are much used, entering into the composition of lemonades, effer- 
 vescing draughts, etc., to allay thirst and subdue restlessness, and to pro- 
 mote the action of the skin and the kidneys. For acidity of the stomach 
 they are efficient if given in small doses before meals, but the mineral 
 acids are usually preferred for this purpose. Long continued they will 
 impair digestion and impoverish the blood. Atheromatous degeneration 
 of the vessels is said to be retarded by the daily use of lemon-juice, which 
 is supposed to dissolve the excess of inorganic matter and to aid its ex- 
 cretion. Obesity may be reduced by using the juice of limes or lemons in 
 large quantity, but it will be done at the expense of the digestion. Lemon- 
 juice has been found of service in acute rheumatism, probably through 
 the alkalies which it conveys into the blood. As a local application it 
 has been found efficient in pruritus scroti, sunburn, post-partum hemor- 
 rhage, and as a gargle in diphtheritic sore throat. 
 
 LINUM, Linseed, Flaxseed, — is the seed of Linum usitatissimum 
 (flax), a cultivated annual plant of the nat. ord. Lineae. It contains 
 15 per cent, of Mucilage in the epithelium, also 30 to 40 per cent, of 
 Fixed Oil in the embryo. Ground Linseed should yield not less than 
 25 per cent, of the fixed oil. 
 
 Preparations. 
 
 Oleum Lini, Linseed Oil; — the fixed oil expressed from Linseed without the use of 
 heat. A yellow, oily liquid, of slight odor, bland taste, and neutral reaction, soluble in 
 about 10 of absolute alcohol and in 1 ^ of ether. Consists chiefly of the Glyceride of 
 Linoleic Acid, C 16 H 28 4 , which having a powerful affinity for oxygen becomes resinoid 
 on exposure to the air, making it a "drying oil." Dose, ^ss-ij. 
 
LITHIUM. 369 
 
 Infusum Lini, Linseed Tea (Unofficial), Linseed Sjiij, Liquorice -root 3J, Boiling 
 Water %x, infused for four hours and strained. Dose, indefinite. 
 
 Linimentum Calcis, Lime Liniment, Carron Oil, — consists of equal volumes of 
 Linseed Oil and Lime-water, emulsified by agitation. A favorite application for burns. 
 
 Physiological Action and Therapeutics. 
 Linseed is demulcent, emollient, expectorant and diuretic. The oil is 
 laxative in a dose of §j, and in smaller doses is oxidized in the system 
 and excreted as a resinoid body by the kidneys, which it stimulates 
 slightly. The Infusion contains the mucilaginous principle and a small 
 portion of the oil, and is advantageously used in inflammations of the 
 mucous membrane of the throat, the gastro-intestinal tract and the urin- 
 ary passages. It is an excellent demulcent in coughs of various kinds, 
 and will be found very serviceable in cystitis, irritable bladder, renal 
 colic, strangury, etc. The Oil may be administered internally as a laxa- 
 tive, and has considerable reputation as a remedy for hemorrhoids in 
 doses of ^ij twice daily. For laxative purposes (especially in children) 
 it is usually administered as an enema. Externally it is a favorite appli- 
 cation to burns, when made into an emulsion with lime-water, as in the 
 official Linimentum Calcis. The ground seed (linseed or flaxseed meal), 
 is one of the best agents for making poultices, and is universally employed 
 for that purpose. [Compare the article on Poultices in Part III.] 
 
 LITHIUM, Li, — is represented in the Pharmacopoeia by five of its 
 
 salts, of which the Carbonate is but slightly soluble while the others are 
 
 readily so. The low atomic weight of this metal (7) makes its saturating 
 
 power greater than that of other alkaline metals, hence the value of its 
 
 salts in medicine. 
 
 Salts of Lithium. 
 
 Lithii Benzoas, Lithium Benzoate, LiC 7 H 5 2 , — is classed with the Benzoates and 
 described under Benzoinum. 
 
 Lithii Bromidum, Lithium Bromide, LiBr, — is classed with the Bromides and de- 
 scribed under Bromum. 
 
 Lithii Carbonas, Lithium Carbonate, Li 2 C0 3 , — a light, white powder, permanent in 
 the air, odorless, of alkaline taste and reaction, soluble in 80 of water, insoluble in 
 alcohol. Dose, gr. ij-xv. 
 
 Lithii Citras, Lithium Citrate, Li 3 C 6 H 5 7 , — a white, deliquescent powder, odorless, 
 of faintly alkaline taste and neutral reaction, soluble in 2 of water, almost insoluble in 
 alcohol. Dose, gr v— xxx. 
 
 Lithii Citras Effervescens, Effervescent Lithium Citrate, — prepared from the Car- 
 bonate 7, w T ith Sodium Bicarbonate 28, Citric Acid 37, and Sugar to 100. Dose, 3J-ij, 
 in water, as an effervescent drink. 
 
 Lithii Salicylas, Lithium Salicylate, 2LiC 7 H 5 3 , — is classed with the Salicylates and 
 described under Salix. 
 
 Physiological Action and Therapeutics. 
 The Lithium salts have strong alkaline qualities and act on the system 
 in the same manner as other alkalies (see under Potassium). The high 
 24 
 
370 LOBELIA. 
 
 saturating power of this metal makes its salts more alkaline than those of 
 potassium, sodium, or calcium, hence more efficient in alkalinizing the 
 urine. Lithium Urate is the most soluble of the alkaline urates, hence 
 the value of lithium salts in the uric acid diathesis. The Carbonate and 
 Citrate are the salts referred to in this connection, the others partaking 
 more of the qualities of their acid factors. Both these salts are antacid 
 and strongly diuretic ; the carbonate being but slightly soluble should be 
 given in carbonic acid water, and the citrate in dilute solution. The 
 latter may be extemporaneously prepared by adding citric acid to an 
 aqueous solution of the carbonate, and in the organism is decomposed, 
 the citric acid being oxidized and the carbonate formed. Many mineral 
 waters contain small quanties of the carbonate, varying from a mere 
 trace to grain o.oi in a pint, an amount so minute as to be practically 
 inert in comparison with the much greater quantities of potassium and 
 sodium salts in the same waters. 
 
 Lithium Carbonate and Citrate are extensively used in x gout and the 
 lithemic diathesis, for the purpose of holding the uric acid in solution as 
 lithium urate and preventing its deposit in the tissues as sodium urate 
 which is less soluble. Their prolonged administration is so efficient in 
 this affection that they have been credited with the power of dissolving 
 uric acid calculi and called lithontriptics. They are also highly useful in 
 the indigestion and rheumatism of obese subjects, and in irritable bladder 
 from excess of acid in the urine. Lithiated Arsenical Water has been 
 highly praised as a remedy in diabetes. 
 
 LOBELIA, Lobelia, Indian Tobacco, — the leaves and tops of 
 Lobelia i?iflata, nat. ord. Lobeliaceae, collected after a portion of the 
 capsules have become inflated. The plant is a common annual weed 
 growing on roadsides throughout the United States, having pale-green 
 alternate leaves, and small, pale-blue flowers. It contains gum, resin, 
 fixed oil, wax, lignin, salts of calcium, potassium and iron, a liquid alka- 
 loid, Lobeline, which is the narcotic principle of the plant, also Lobelic 
 Acid, and an acrid substance named Lobelacrin. 
 
 Preparations. 
 Extractum Lobeliae Fluidum, Fluid Extract of Lobelia. Dose, rr\J-x. 
 Tinctura Lobeliae, Tincture of Lobelia,— 20 per cent. Dose, TT^v-xxx. 
 Infusum Lobeliae, Infusion of Lobelia (Unofficial), — ^j to a pint. Dose, ^j- Jj. 
 Lobelinum, Lobelin (Unofficial), — an impure resinoid. Dose, gr. ss-j. 
 
 Physiological Action and Therapeutics. 
 Lobelia has an acrid, nauseous taste, and a heavy, unpleasant odor. It 
 is expectorant, diaphoretic, emetic, purgative, antispasmodic, motor-de- 
 
LYCOPODIUM. 37I 
 
 pressant and narcotic. It excites an abundant flow of saliva, much gastric 
 mucus, profuse urination and sweating, with nausea, vomiting and great 
 depression. The heart's action is enfeebled, and the blood-pressure, at 
 first increased, soon falls ; muscular debility, reduced temperature and 
 coma follow, and death occurs by paralysis of the respiratory apparatus. 
 The drug produces paralysis of the motor nerve-trunks, the peripheral 
 vagi, and probably the respiratory and vaso-motor centres also. It strongly 
 resembles tobacco in its action, and is highly dangerous in full medicinal 
 doses, having caused many deaths when administered therapeutically, the 
 most important instance of its fatal results being the case of Ezra 
 Lovett, Jr., who in 1809 was poisoned by Lobelia administered by the 
 founder of the Thomsonian sect of medical practitioners. The responsi- 
 ble party escaped conviction on the plea that he gave the drug in igno- 
 rance of its qualities. 
 
 Antidotes and Incompatibles. 
 
 Tannic Acid to form the insoluble tannate. Strychnine, Picrotoxine and Thebaine 
 antagonize its action on the nervous system ; the vaso-motor excitants, as Alcohol, 
 Digitalis, Belladonna, Ergot, etc., antagonize its effects on the circulation. Caustic 
 Alkalies are incompatible, decomposing the alkaloid. 
 
 Lobelia was a favorite remedy with the Indians at the time of the first 
 settlement of the United States, and was introduced into regular practice 
 as an anti-asthmatic, after having served as the main stock-in-trade of 
 irregular practitioners for many years. Its principal therapeutic action is 
 that of an antispasmodic, and in cautious hands it is extremely useful in 
 paroxysmal spasmodic asthma, as also in dry cough with constant tickling 
 in the throat. As an enema in cases of strangulated hernia the infusion 
 is much safer than tobacco and fully as efficient, and may overcome 
 the obstruction in intussusception, while the tincture in 2-drop doses 
 every hour will often relieve a case of impacted cecum. In constipation 
 from atony and deficient secretion a 10-minim dose of the tincture at bed- 
 time acts excellently, and in the poison-oak eczema the infusion is a good 
 local application. As an emetic it is entirely too depressant for children. 
 
 LYCOPODIUM, — is a very mobile, »pale-yellow, fine powder, consisting of the spores 
 of the Club-moss, Lycopodium clavalu??i, and of other species of Lycopodium (nat. ord. 
 Lycopodiacese), a native of Europe and the U. S. Lycopodium is odorless, tasteless, 
 floats on water, which does not wet it, and burns quickly when thrown on a flame. It 
 should be free from pine-pollen, starch, sand and other impurities, which are detected by 
 means of the microscope, the lycopodium spores being about -g-l-^ of an inch in diameter, 
 four-sided and reticulated, with short projections on the edges. They contain about 47 
 per cent, of a bland, fixed oil. 
 
 The plant was formerly considered to be diuretic and antispasmodic, and was used in 
 rheumatism and epilepsy, also in pulmonary and renal disorders. The powder is em- 
 ployed quite extensively in pharmacy to facilitate the rolling of a pill-mass and to prevent 
 adhesion of pills to each other. It makes an excellent absorbent and protective powder 
 when dusted over an excoriated surface, as between the thighs of infants. 
 
 By the homeopathic practitioners Lycopodium is elevated to the rank of an active 
 
jJ2 MAGNESIUM. 
 
 drug when triturated with sugar of milk sufficiently long to break up the seeds and liber- 
 ate their oily contents. In their first centesimal trituration ( t ^q) it is said to have pro- 
 duced symptoms of excitement of the circulation and irritation of the urinary organs, and 
 they profess to use it with benefit in affections of the mucous tracts, dyspepsia, pyrosis, 
 flatulence, constipation, ileo-colitis of infants, hepatic congestion, aneurism, chronic affec- 
 tions of the lungs and bronchi, diphtheria, lithiasis, intertrigo, porrigo capitis, plica 
 polonica and pruritus ani, in all of which as an internal remedy and in high attenuation. 
 
 MAGNESIUM, Mg. — This metal is represented by its Oxide, 
 
 Carbonate, Citrate and Sulphate, of which the last occurs native in sea- 
 water, caves, etc., the others being prepared from it. The first two are 
 almost insoluble in water or alcohol. Its salts are either white or color- 
 less, and those which are official are as follows : — 
 
 Official Salts of Magnesium. 
 
 Magnesia, Magnesia, Magnesium Oxide, MgO, — made by heating the light carbon- 
 ate in a crucible to expel nearly all the carbonic acid. A white, light and very fine 
 powder, almost insoluble in water, insoluble in alcohol, and gelatinizes with 15 of water 
 after standing y z hour, having become hydrated. Is a constituent of Pulvis Rhei Com- 
 positus, Massa Copaibae and Ferri Oxidum Hydratum cum Magnesia. Dose, gr. x-^j. 
 
 Magnesia Ponderosa, Heavy Magnesia, Magnesium Oxide, MgO, — is a white, 
 dense and very fine powder, corresponding in other properties and reactions to Mag- 
 nesia, except that it does not gelatinize with water. It is made by calcining the heavier 
 carbonate, and is much slower in action than the light magnesia. Dose, gr. X-3J. 
 
 Magnesii Carbonas, Magnesium Carbonate (MgC0 3 ) 4 Mg(HO) 2 -f- 5H 2 0, — light, 
 friable masses, or powder, odorless and tasteless, insoluble in alcohol, almost insoluble in 
 water. Dose, gr. x-gj. 
 
 Magnesii Sulphas, Magnesium Sulphate, Epsom Salt, MgS0 4 4- 7H 2 0, — colorless 
 prisms or acicular needles, slowly efflorescent, odorless, of cooling, saline taste, and 
 neutral reaction, very soluble in water, insoluble in alcohol. Is a constituent of Infusum 
 Sennae Compositum. Dose, 3J-^j. 
 
 Preparations. 
 
 Magnesii Citras Effervescens, Effervescent Magnesium Citrate, — is prepared from 
 the Carbonate 10, Citric Acid 46, Sodium Bicarbonate 34, Sugar 8, Alcohol and Distilled 
 Water, as required. A coarsely granular, white, deliquescent salt, of acid taste and 
 reaction, soluble in 2 of water, insoluble in alcohol. Dose, 3J-^j. 
 
 Liquor Magnesii Citratis, Solution of Magnesium Citrate, — prepared from the Car- 
 nate 15, Citric Acid 30, Syrup of Citric A 
 360. Dose, 3 iv-vj, repeated for catharsis. 
 
 Mistura Magnesiae et Asafaztidde, Magnesia and Asafelida Mixture, De-wees' Car- 
 minative (Unofficial), — contains of the Carbonate 5, Tincture of Asafcetida 7, Tincture 
 of Opium 1, Sugar 10, and Distilled Water to 100. Dose, gss-iv. Used for flatulent 
 colic and diarrhea in infants. 
 
 Physiological Action. 
 Magnesia and the Carbonate are mildly laxative and antacid, neutraliz- 
 ing free acids in the stomach and forming therewith laxative salts. If used 
 in large quantity for any length of time Magnesia may become hydrated 
 and produce intestinal concretions. The freshly precipitated Hydrate 
 (see above under Magnesia) is an antidote to arsenic in solution, but less 
 effective than the hydrated sesquioxide of iron, with which it is combined 
 
MAGNESIUM. 3/3 
 
 in the official Ferri Oxidum Hydratum cum Magnesia. Magnesia may 
 also be used in poisoning by acids or phosphorus. 
 
 The Citrate and Sulphate are saline cathartics, the latter being the more 
 powerful on account of its bitterness. If administered in plenty of water 
 it usually produces a prompt and free discharge from the intestines with 
 but little irritation or griping, but often accompanied by a sense of cold- 
 ness and depression. The purgative action is chiefly due to its causing a 
 greatly increased secretion of intestinal fluids, not by outward osmosis 
 from the vessels as was formerly taught, but by stimulation of the intestinal 
 glandular appendages. If the purgative action should not take place a 
 diuretic one may result, but to secure the desired catharsis the drug 
 should be administered in a considerable quantity of water. Magnesium 
 Sulphate is the principal aperient constituent of many of the popular 
 laxative mineral waters, as Friedrichshall, Piillna, Hunyadi, etc. When 
 injected into the circulation it is powerfully toxic, paralyzing first the 
 respiration and then the heart. It abolishes sensation and paralyzes the 
 sensori-motor reflex centres (Murrell). 
 
 Therapeuxjcs. 
 Magnesia and the Carbonate are used as antacids and laxatives, in acid- 
 ity, sick headache, flatulent colic, etc., and as antidotes in poisoning by 
 acids, arsenic, phosphorus, and mercuric and cupric salts. The Citrate is 
 an agreeable laxative, cooling and acceptable to the stomach. The Sulphate 
 is one of the most efficient of the saline cathartics and has a wide field of 
 application. In acute inflammatory conditions, renal and cardiac dropsy, 
 ascites from obstruction of the portal circulation, increased blood-pressure 
 within the cranium, intestinal obstruction without acute inflammation, the 
 constipation of lead poisoning, and habitual constipation from deficiency 
 of the intestinal secretions, this agent will be found to be exceedingly 
 serviceable. As it has but little influence on intestinal peristalsis it is 
 usually combined with Senna, as in the official Black Draught, which in- 
 creases its purgative action. Acute dysentery is well treated by magne- 
 sium sulphate combined with diluted sulphuric acid, and followed by 
 opium and starch enemata. Bleeding from hemorrhoids and uterine 
 hemorrhage are often relieved by the same combination when other agents 
 fail. In acne vulgaris and other obstinate eruptions due to derangement 
 of the stomach and intestinal canal, good results are often obtained by a 
 purgative dose of the sulphate daily before breakfast, or by doses of 5 
 grains in water three or four times a day. The same salt, finely triturated, 
 makes an excellent dusting powder for acne rosacea. The ferro-saline 
 mixture (see ante, page 319) is a useful laxative in the constipation of 
 anemic women. The bitter taste of this salt is best covered by coffee. 
 
374 MAGNOLIA MANACA MANGANUM. 
 
 MAGNOLIA (Unofficial), — is the bark of Magnolia glauca (Sweet Bay, Swamp 
 Sassafras), M. acuminata (Cucumber- tree), and M. tripetala (Umbrella-tree), all of which 
 belong to the nat. ord. Magnoliacese, and are indigenous to the Eastern and Southern 
 States. It contains a crystalline principle named Magnolin, which is insoluble in water, 
 but soluble in alcohol, ether, etc. Dose of the powdered bark, gss-j. 
 
 Magnolia is an aromatic bitter tonic and diaphoi-etic, usually employed in chronic 
 rheumatism, remittent and intermittent fever. In the latter affection it will arrest the 
 paroxysms if used freely. 
 
 MANACA (Unofficial), — is the root of Franciscea uniflora, a shrub of the nat. ord. 
 Scrophularineoe, indigenous to Brazil, where it is known as Mercurio- vegetal, or Vege- 
 table Mercury, a name applied by charlatans to a number of widely differing plants. 
 Very little is known about Manaca, but it has been extensively advertised as an unfailing 
 remedy for sub-acute and chronic rheumatism. It is also considered purgative, diuretic, 
 emmenagogue and antisyphilitic, being official in the Brazilian Dispensatories, and 
 noticed as follows in the Diet, de Potan. Brazileira. 
 
 "This whole plant, but especially the root, excites powerfully the lymphatic system, 
 eliminating morbid matter by the skin and kidneys. It is antisyphilitic ; the interior 
 bark is nauseating and stimulates the throat. In small doses it is resolvent ; in larger 
 purgative, diuretic and emmenagogue. In large doses it is an acrid poison." 
 
 A fluid extract is on the market, the average dose of which is TTLx. 
 
 MANGANUM, Manganese, Mn. — This metal is represented in 
 the Pharmacopoeia by three of its salts, the native Black Oxide, the Sul- 
 phate, and the Permanganate of Potassium. 
 
 Mangani Dioxidum, Manganese Dioxide, Black Oxide of Manganese, — is the 
 native, crude Dioxide of Manganese, containing at least 66 per cent, of the pure Dioxide, 
 Mn0 2 . A heavy, grayish-black powder, odorless and tasteless, insoluble in water or alco- 
 hol, giving off oxygen gas at a red heat, and if heated with hydrochloric acid it causes 
 the evolution of chlorine gas. Is used in preparing Chlorine Water. Dose, gr. ij-x. 
 
 Mangani Sulphas, Manganese Sulphate, MnS() 4 -|- 4H 2 0, — colorless prisms, of 
 slightly bitter and astringent taste and faintly acid reaction, very soluble in water, insolu- 
 ble in alcohol. Dose, gr. ij-v. 
 
 Potassii Permanganas, Potassiztm Permanganate, KMn0 4 , — deep, purple-violet 
 prisms, of sweet and astringent taste, neutral reaction, soluble in 1 6 of water with a 
 scanty, brown residue, decomposed by alcohol and by heating to 464 F. It should be 
 kept in well-stoppered bottles, and should not be triturated or combined in solution with 
 organic or readily oxidizable substances. Dose, gr. ss-ij, in pill. 
 
 Unofficial Preparations. 
 
 Syrupus Mangani Iodidi, Syrup of Manganese Iodide, — contains about £j of the 
 Iodide in each ^ . Dose, rr^x-xxx. For formula see U. S. Dispensatory. 
 
 Syrupus Ferri et Mangani Iodidi, Syrup of Iron and Manganese Iodide, — each 3 
 contains gr. 50 of the mixed iodides in the proportion of 3 of the Iodide of Iron to I of 
 that of Manganese. Dose, TTLx-xxx. For formula see U. S. Dispensatory. 
 
 Ferri et Mangani Carbonas Saccharatus, Saccharated Iron and Manganese Car- 
 bonate, — is a tasteless, reddish-brown powder. Dose, gr. v-xx. For formula see U. S. 
 Dispensatory. 
 
 Pepto-mangan, liquor Mangano-ferri Peptonatus, — a proprietary preparation, 
 advertised to contain in each half-ounce " the equivalent of 3 grains of metallic Iron and 
 I grain of metallic Manganese (as Peptonates) in organo-chemical combination." It is 
 claimed for this preparation that it does not have the astringent effect of the inorganic 
 salts of these metals upon the glands of the stomach, and that it does not affect the alka- 
 linity of the bowels. Dose, ^ ss, three to four times a day, in white wine or milk, or alone. 
 
 Condy's Red Fluid, — is a solution of Potassium Permanganate in Distilled Water, of 
 about 1 % per cent, strength, &}4 grains to the ounce, or 176 grains in 20 ounces. It is 
 
MANGANUM. 375 
 
 used as a disinfectant and deodorant for closets and bed-pans, also to wash the hands and 
 utensils, but it cannot be employed to disinfect rooms. It is not irritant, and shows by its 
 change of color when it has lost its efficacy. A one per cent, solution is official in the 
 Br. Phar. the dose of which is given as 3 ij-iv. 
 
 Physiological Action. 
 
 The salts of Manganese in small doses improve the appetite and the 
 digestion and stimulate the action of the heart. Used in larger doses and 
 for a considerable length of time they lower the heart's action, paralyze 
 the muscular system especially the muscular coat of the arteries, and cause 
 progressive wasting, paraplegia, and acute fatty degeneration of the liver. 
 They are gastro-intestinal irritants, and the Sulphate is emeto-cathartic 
 and decidedly cholagogue. Manganese is closely associated with Iron in 
 the blood, bile, etc., in the proportion of about 1 to 20. The Black 
 Oxide is an efficient emmenagogue. 
 
 Potassium Permanganate is an active oxidizer, containing as it does a 
 large proportion of oxygen which it yields very readily in the form of 
 ozone, and then becomes manganese dioxide. This property gives it the 
 qualities of an antiseptic, a disinfectant and a deodorant. It is considered 
 by some authorities to be an efficient emmenagogue. Used internally it 
 is probably not absorbed in its own state, as it must be quickly decom- 
 posed by the contents of the stomach ; at the same time it oxidizes any 
 oxidizable substance therein. 
 
 Therapeutics. 
 The salts of Manganese are used by those practitioners who affect to see 
 a manganese-anemia in cachectic subjects, but they are always combined 
 with preparations of iron. In amenorrhea, gastrodynia and pyrosis the 
 dioxide is a good remedy, and the same salt is used as an ointment in 
 many skin diseases. In jaundice of malarial origin or catarrh of the 
 biliary passages the sulphate gives good results. Manganese is becoming 
 more of an acknowledged remedy in derangements of the menstrual 
 function, as irregular or scanty menstruation, amenorrhea, menorrhagia, 
 and even metrorrhagia. By some authorities the emmenagogue power 
 of potassium permanganate is ascribed to its large proportion of oxygen, 
 which it is supposed to give up to the uterus; as potassium chlorate 
 was formerly supposed to do to the system at large. According to the 
 views of others who have studied its action, Manganese should be classed 
 with the excito-motors, increasing arterial tension, and specifically acting 
 upon the uterus. The best preparation is the Dioxide, in freshly made 
 pills of two grains each, of which 1 to 3 or 5 pills may be taken twice or 
 thrice daily. Potassium Permanganate has generally been the preparation 
 given when the effects of Manganese were desired ; but as it causes great 
 
376 MANGO. 
 
 gastric irritability, with abdominal pains and burning sensations, besides 
 other decidedly unpleasant symptoms, it is a difficult matter to get patients 
 to take it for any length of time. 
 
 Potassium Permanganate is employed as an antiseptic and oxidizing 
 agent in such affections as diphtheria, scarlatina, septicemia, erysipelas, 
 etc., in which it may be given internally and used locally at the same 
 time. It is given with apparent benefit in dyspepsia, flatulence, lithemia 
 and obesity, and has often seemed to be of service in acute rheumatism. 
 In amenorrhea it is reported to be very efficient, and has been used with 
 success as a remedy for the bites of venomous serpents and for other 
 animal poisons. For internal use it should be given in pill, as the taste 
 of a solution is very disagreeable. Locally it is frequently employed (3J 
 to the pint) to correct fetor in cancer, ulcer, caries, abscesses, ozena, etc., 
 and it will destroy the odor of a foul breath or that of the fetid perspira- 
 tion of the feet. It is used both as a test and as a corrigent for organic 
 impurities in drinking water. The stain left by it on fabrics may be re- 
 moved by sulphurous acid, but as sulphuric acid is formed in the reaction 
 the fabric should be immediately washed or rinsed in water. 
 
 Potassium Permanganate has lately come into use as an antidote against 
 morphine or opium in the stomach, for which purpose it was recom- 
 mended in 1884 by an English physician, Mr. J. Barker Smith. Little 
 attention was paid to his suggestion until it was practically tested by Dr. 
 William Moor, of New York, on himself, in 1895. After a light supper 
 he swallowed 3 grains of morphine sulphate, followed almost immediately 
 by 4 grains of potassium permanganate in water, and experienced no ill 
 effects, although being highly susceptible to the drug he would have been 
 affected if even gr. y£ of morphine had been absorbed. On another 
 occasion, two hours after breakfast, he took 5 grains of morphine sulphate 
 in water, and also 8 grains of the permanganate in 8 ounces of water soon 
 afterwards, without experiencing any symptoms of morphine action. It 
 has long been known that morphine is deoxidized and rendered in- 
 nocuous by this agent, but it was supposed that the presence of albumin 
 in the stomach would prevent their reaction. It is now shown that the 
 permanganate reduces morphine sulphate more rapidly than it does albu- 
 minous matter, and in fact exhibits a marked selective affinity for mor- 
 phine and also for physostigmine (eserine), but gives up its oxygen more 
 quickly to albuminous substances than to strychnine, oxalic acid, colchi- 
 cum or hydrocyanic acid. It exerts no oxidizing effect, in the presence 
 of albumin, on atropine, hyoscyamine, hyoscine, caffeine, cocaine, 
 aconitine, veratrine, pilocarpine, muscarine or phosphorus. (Murrell.) 
 
 MANGO (Unofficial), — is the bark of Mangifera indica, an Indian tree of the nat. 
 ord. Guttifene. It is supposed to be an astringent with special tonic action upon mucous 
 membranes. It is highly recommended by its vendors for nasal catarrh, hemorrhages 
 
MANNA MATRICARIA. 37/ 
 
 and rauco-purulent discharges from the intestines, uterus, vagina and bronchi. A fluid 
 extract is sold, which may be used in doses of H\,x - 3J- 
 
 Mango-Fruit, or Mangosteen, is the fruit of Garcinia mangostana, nat. ord. Gutti- 
 ferse, also from India. It is a powerful astringent, and is used for nasal catarrh, diarrheas, 
 dysentery, leucorrhea, etc. 
 
 MANNA, — is the concrete, saccharine exudation of Fraxinus Orniis, or Flowering 
 Ash, a tree of the nat. ord. Oleaceoe, growing in Southern Europe. Manna is produced 
 also by several other trees, and substances resembling it are exuded by many plants. It 
 contains from 40 to 90 per cent, of Mannit, C 6 H u 6 , or Manna-sugar, which does not 
 undergo vinous fermentation, and is chemically allied to the alcohols and to glycerin. 
 It also contains glucose, mucilage, some acrid resin, and a small quantity of the fluores- 
 cent glucoside Fraxin, C 16 H 18 O 10 . There are no official preparations, but Manna itself 
 may be given in doses of ^j-ij. 
 
 Manna is a mild laxative, with some tendency to produce flatulence and colic. It is 
 usually combined with other purgatives, as Senna, Rhubarb, Magnesia, etc., to disguise 
 the taste and increase the effect. It is a constituent of the official Infusum Sennae Com- 
 positum. Manna may be eaten by children if of good quality, or may be readily dissolved 
 in milk and so administered. 
 
 MARRUBIUM, Horehound, — the leaves and tops of Marrubium vulgare, a plant 
 of the nat. ord. Labiatse, native in Europe, but naturalized in America. It contains a 
 bitter principle named Marrubiin, also a volatile oil, resin, tannin, lignin, etc. There are 
 no official preparations. Dose, ^ss-j. 
 
 Horehound in large doses is laxative, diuretic and diaphoretic, and in ordinary dosage 
 it is a gentle tonic and stomachic. It is generally used in catarrhal states of the air- 
 passages, over which it seems to have a soothing effect, and is much employed in confec- 
 tionery as an ingredient of " cough drops." 
 
 MASTICHE, Mastic, — is a concrete, resinous exudation from Pistacia Lentiscus, 
 a tree of the nat. ord. Anacardiacese, growing in the island of Scio. Alcohol dissolves 
 about 90 per cent, including the resin Mastichic Acid, the remainder consisting of another 
 resin, Mastichin, which is soluble in ether and resembles copal. There are no official 
 preparations, but Mastic is an ingredient of the official Pil. Aloes et Mastiches. 
 
 Mastic was formerly used for supposed properties analogous to those of other oleo- 
 resins, but now its application is confined to dentistry, being employed as a temporary fill- 
 ing for carious teeth. A solution of ether is applied on cotton with moderate pressure, 
 and remains as a firm plug after evaporation of the solvent. 
 
 MATICO, the leaves of Pipsr angusti folium, a Peruvian shrub of the nat. ord. 
 Piperaceae. It contains a crystallizable acid Artanthic Acid, also resin, tannin, and a 
 volatile oil. Its odor is aromatic, and its taste astringent, spicy and somewhat bitter. 
 
 Extractum Matico Fluidum, Fluid Extract of Matico. Dose, gss-ij. 
 
 Tinctura Matico, Tincture of Matico, — 10 per cent. Dose, ^ss-ij. 
 
 Matico is an aromatic tonic and stimulant, also aphrodisiac, vulnerary and hemostatic. 
 It acts like cubebs on the urinary passages, and is an excellent alterative stimulant to 
 mucous membranes. It has been used with considerable success in mucous catarrhs, as 
 gonorrhea, leucorrhea, chronic cystitis, etc., also in epistaxis, hemorrhoids, menorrhagia, 
 hemoptysis, hematemesis and other hemorrhages. The under surface of the leaf is so 
 formed as to promote coagulation of blood if applied to a bleeding surface, and it is a good 
 local hemostatic for trivial cuts or wounds. 
 
 MATRICARIA, German Chamomile, — the flower-heads of Matricaria Chamo- 
 milla, a European annual plant of the nat. ord. Composite. They contain ^ per cent. 
 of a blue Volatile Oil (the color of which is due to Azulen), also a bitter extractive, 
 tannin, etc. There are no official preparations, but the flowers may be eaten or a decoc- 
 tion used almost ad libitum. 
 
3/8 MEL MELISSA MENISPERMUM. 
 
 Matricaria is a mild tonic, in large doses emetic, anthelmintic and antispasmodic. It 
 is much used in Germany, and in this country is a popular domestic remedy among Ger- 
 man people, who use it in infusions as a diaphoretic. This plant is the Chamomilla 
 of the homeopaths, who find in it remarkable power over morbid impressionability of 
 the sensory and excito-motor nerves, and administer it in pains aggravated at night and 
 by heat, clonic spasms of pregnancy, irritability of teething children, flatulent colic, etc. 
 
 MEL, Honey, — is a saccharine secretion deposited in the honey- 
 comb by Apis mettifica, the honey-bee ; occurring as a pale-yellowish, 
 syrupy liquid, gradually becoming crystalline and opaque, of peculiar and 
 heavy odor, and a very sweet, faintly acrid taste. It is a strong aqueous 
 solution of several sugars (cane and grape sugar, levulose), with wax- 
 pollen, coloring and odorous matters, etc. The sugars, which may be 
 resolved into Levulose and Dextrose, amount to 70 or 80 per cent. 
 Honey is frequently adulterated with starch and artificial glucose, which 
 may be detected by the official tests (see U. S. Phar.). Dose, indefinite. 
 
 Preparations. 
 
 Mel Despumatum, Clarified Honey, — is honey heated, skimmed and strained, with 
 Glycerin added in the proportion of 5 per cent. It is an ingredient of Confectio Rosae, 
 Mel Rosae, and Massa Ferri Carbonatis. Dose, indefinite. 
 
 Mel Rosae, Honey of Rose, — Fluid Extract of Rose 12, Clarified Honey to 100. 
 Dose, indefinite ; generally used as a local application to the throat for its astringency 
 and flavor, in combination with more active agents. 
 
 Honey is emollient, nutritive and laxative, in some persons giving rise 
 to pyrosis, flatulence and colic, and in others to an eruption of urticaria, 
 but generally constituting an agreeable article of diet. It is sometimes 
 actually poisonous from the presence of toxic agents extracted by the bee 
 from certain plants, in this country generally the Mountain Laurel {Kalmia 
 latifolid). Honey is chiefly used as an emollient in diseases of the throat, 
 to relieve dryness, pain, cough and dysphagia. A mixture of Honey 8 
 parts to 1 each of Acetic Acid and Water is official in the Br. Phar. 
 under the title Oxymel, and forms a pleasant addition to gargles or a 
 vehicle for expectorant medicines. Honey of Rose is somewhat astringent, 
 and is used in gargles or in washes, for the treatment of inflammation 
 and ulceration of the mucous membrane of the nasal passages, the mouth 
 and the throat. 
 
 MELISSA, Balm, — the leaves and tops of Melissa officinalis, a European plant of 
 the nat. ord. Labiatae, growing also in America. It contains gum, tannin, bitter extrac- 
 tive, and a fragrant essential oil in very small quantity (^ to ^ per cent.). There are 
 no official preparations. Balm has little or no action, except to flavor hot water for use 
 as a beverage or a mild diaphoretic. 
 
 MENISPERMUM, — is the rhizome and rootlets of Menispermnm canadense, the 
 Yellow Parilla, or Canadian Moonseed, a woody, climbing plant of the nat. ord. Meni- 
 spermacese, native of the eastern U.S. It contains starch, Berberine, and a white alka- 
 loid, which is soluble in alcohol and in ether. 
 
MENTHA PIPERITA. 3/9 
 
 Extractum Menispermi Fluidum, Fluid Extract of Menispermum, — is %rds 
 alcohol. Dose, rt\v-xx. 
 
 Menispermum is reputed to have tonic properties, and is used in some of the Southern 
 States in domestic practice as a substitute for Sarsaparilla in scrofulous conditions. Little 
 is known about it of a definite character. 
 
 MENTHA PIPERITA, Peppermint,— the leaves and tops of 
 Mentha piperita, a perennial herbaceous plant, of the nat. ord. Labiatse, 
 a native of Britain, but largely cultivated elsewhere. They contain i to 
 i^ per cent, of a Volatile Oil, which is official, and a little tannin. 
 
 Menthol, C 10 H 19 OH, — is a stearopten (having the character of a sec- 
 ondary alcohol), obtained from the official oil of peppermint, or from 
 Japanese or Chinese oil of peppermint (from Mentha arvensis and Men- 
 tha canadensis) ; by deposit therefrom on exposure to cold. It occurs in 
 colorless, acicular crystals, of the odor of peppermint, and a warm, 
 aromatic taste, followed by a sensation of cold when air is drawn into 
 the mouth. Soluble only slightly in water, freely in alcohol, ether, 
 chloroform, carbon disulphide or glacial acetic acid. Dose, gr. ss-iij, in 
 pill or spirituous solution, several times a day. 
 
 Preparations . 
 
 Oleum Menthae Piperitae, Oil of Peppermint, — is the volatile oil distilled from the 
 fresh herb ; a colorless or pale yellow fluid, having the odor of peppermint, and a strongly 
 aromatic taste followed by a cold sensation when air is drawn into the mouth. It consists 
 of a liquid terpene and the stearopten Menthol (see above). Dose, n\j-v. 
 
 Aqua Menthae Piperitae, Pepper?nint Water, — has of the oil 2 parts in iooo of Dis- 
 tilled Water. Dose, indefinite. 
 
 Spiritus Menthae Piperitae, Spirit of Peppermint, Essence of Peppermint, — is an 
 alcoholic solution containing io per cent, of the oil and I per cent, of the powdered 
 herb. Is an ingredient of Mistura Rhei et Sodse. Dose, TTLx-xxx. 
 
 Trochisci Menthae Piperitae, Peppermint Troches, — each troche contains I percent, 
 of the Oil, with Sugar and Mucilage of Tragacanth. Dose, indefinite. 
 
 Physiological Action and Therapeutics. 
 
 Peppermint is an aromatic stimulant, also carminative and antispas- 
 modic. The oil possesses these qualities in greater degree and is also a 
 local anodyne and anesthetic when applied locally, especially if its evap- 
 oration be prevented. The Chinese oil contains a large quantity of 
 Menthol and is particularly anodyne. Menthol is antiseptic and locally 
 anesthetic, but not corrosive, and acts also as a vascular stimulant when 
 applied to the surface. 
 
 Peppermint is used internally for the relief of nausea and colic, and to 
 expel flatus by its local stimulant and after sedative action on the bowels. 
 It is an agreeable corrigent for combination with purgatives to prevent 
 griping, and efficiently covers the taste of many nauseous substances. 
 The spirit is the best form for internal use. The oil is used locally to 
 
38O MENTHA VIRIDIS— METHYLENE BLUE. 
 
 relieve the pain of superficial neuralgia, a cloth being wet with it, laid 
 along the course of the affected nerve and covered with oiled silk to 
 restrain evaporation. It is also efficient in rheumatism as an anodyne 
 and counterirritant. 
 
 Menthol is highly praised as an external application in various neural- 
 gise, sciatica, pleurodynia, toothache, etc. For neuralgia it is used in 
 saturated alcoholic solution painted over the affected nerve. For tooth- 
 ache a crystal introduced into the carious cavity is promptly anodyne. 
 As an antiseptic it promises well as an application in parasitic skin diseases. 
 As the Chinese have used their oil of peppermint for ages as an applica- 
 tion in neuralgise, and as this oil contains a large quantity of Menthol, 
 the latter preparation will probably prove a very efficient agent in these 
 affections if the cupidity of the manufacturers will allow of its being 
 obtained pure. A spray containing 5 to 20 per cent, of Menthol is highly 
 recommended in epidemic influenza, also in tubercular laryngitis. Men- 
 thol is of marked value in almost all cases of pruritus, from whatever 
 cause. It possesses high power as an anti-emetic, having stopped nausea 
 and vomiting after the usual remedies had failed. For this purpose ten 
 drops of a 20 per cent, solution in olive oil are given on sugar. 
 
 MENTHA VIRIDIS, Spearmint, — the leaves and tops of Mentha viridis, the 
 " mint" of the kitchen garden, a plant of the nat. ord. Labiate, indigenous to England, 
 but naturalized in many countries. Its constituents and properties are identical with those 
 of peppermint, but its odor and taste differ therefrom. 
 
 Oleum Menthae Viridis, Oil of Spearmint, — is the Volatile Oil distilled from the 
 plant. Dose, rr\jj-v. 
 
 Aqua Menthae Viridis, Spearmint Water, — has 2 parts of the Oil in 1000 of Dis- 
 tilled Water. Dose, indefinite. 
 
 Spiritus Menthae Viridis, Spirit of Spearmint, Essence of Spearmint, is an alco- 
 holic solution containing 10 per cent, of the Oil and I per cent, of the powdered herb. 
 Dose, rt^x-xl. 
 
 Spearmint corresponds in action to Peppermint, but is less powerful. It is employed 
 to correct flatulence and to relieve colic, and makes an agreeable flavoring for mixtures. 
 
 METHYLENE BLUE, Tetramethyl-Thionine Chloride (Unofficial),— is an 
 anilin derivative, which when pure is seen in small, dark blue, scaly crystals, having a 
 copper bronze tinge, soluble in water. Dose, gr. j-iij, four or five times a day. 
 
 This substance imparts a blue color to nerve tissue and to the urine. From the facts 
 that it manifests a strong affinity for nerve tissue, especially for the axis cylinders of sen- 
 sory nerves, and that it is the best staining agent for the microbe found in the blood of 
 malarial subjects, this agent has been expected to possess anodyne power over neuralgic 
 and rheumatic affections and to act as an antiperiodic in malaria. It has been employed 
 by several observers as an antipyretic and internal antiseptic for rheumatism of the joints 
 and muscles, for malarial fever, diphtheria, acute nephritis and cancer, with varying 
 results. Its best action in malarial affections has been obtained in children, and being 
 tasteless it may be administered to them with greater ease than quinine, besides being free 
 from the vomiting and headache which so often result from the latter drug. In diphtheria 
 and in simple non-diphtheritic ulceration of the throat, a ten per cent, solution is used 
 locally with great benefit so far as yet reported. It has been employed successfully in 
 two cases of chronic cystitis, also in two cases of diabetes, mellitus, and has given satis- 
 faction in several very obstinate cases of rheumatoid arthritis. In a number of cases of 
 
MEZEREUM MORRHU.E OLEUM. 38 I 
 
 different forms of insanity it has been used by injection for conditions of excitement 
 with very satisfactory results (Bodonh. In the earlier stages of gonorrhea its internal 
 administration will shorten the course of the disease (Horwitz). 
 
 MEZEREUM, Mezereum, Mezereon, — is the bark of Daphne Mezereum and of 
 other species of Daphne, plants of the nat. ord. Thymelceaceoe, growing in mountainous 
 districts of Europe and Asia and cultivated as a garden shrub in Britain. It contains an 
 inert, fixed oil, an inactive glucoside, Daphnin, and an acrid Resin, which is the anhy- 
 dride of a resinous acid named Mezereinic Acid. Mezereum is an ingredient of the com- 
 pound decoction and the compound fluid extract of Sarsaparilla. Dose, gr. j-x. 
 
 Extractum Mezerei Fluidum, Fluid Extract of Mezereum , — is too acrid for inter- 
 nal use. It is an ingredient of the Linimentum Sinapis Compositum. 
 
 Mezereum is a sialogogue, and an intensely acrid, irritant poison, producing violent 
 vomiting, purging, nephritis and gastro-enteritis. In small doses it is laxative and diu- 
 retic, and has had considerable reputation as an alterative. Externally the recent bark is 
 a powerful local irritant, speedily producing vesication. 
 
 Mezereum is rarely used internally by itself, but is employed in mixtures with Sarsa- 
 parilla, etc., as an alterative in syphilis, rheumatism and some skin diseases of chronic 
 type, but with doubtful efficacy. It has been used with good effect in toothache and as a 
 masticatory in paralysis of the tongue. Its principal use is as a local irritant to keep up 
 the discharge from issues or blisters, and to stimulate indolent ulcers. 
 
 MORRHUiE OLEUM, Cod-liver Oil, Oleum Jecoris Aselli,— 
 is a fixed oil obtained from the fresh livers of Gadus Morrhua (Cod-fish) 
 or other species of Gadus. It is a colorless or pale yellow, thin, oily- 
 liquid, of slightly fishy odor and taste, and faintly acid reaction, soluble 
 in ether. It consists chiefly of Olein and Margarin, with a peculiar prin- 
 ciple named Gaduin, also Trimethy famine, free fatty Acids (oleic, palmitic, 
 stearic), traces of Iodine, Bromine, Sulphuric and Phosphoric Acids, the 
 ordinary inorganic salts of animal tissue and products, and perhaps bile 
 constituents. When saponified it does not yield glycerin, but Oxide of 
 Propyl. Three kinds or varieties are found in the market, the pale, the 
 light-brown and the dark. The pale is the official oil and the purest. 
 Dose, 3j-ij on a full stomach, increased as assimilated. 
 
 Unofficial Preparations. 
 
 Glyconin Emulsion of Cod-liver Oil, — 01. Morrhua giv, Glyceritum Vitelli t ~ix, 
 Aromatic Spirit of Ammonia gj, Sherry Wine j|ij, Diluted Phosphoric Acid ^iv, Es- 
 sence of Bitter Almond ( £ j of the Volatile Oil in Oss Alcohol) 5jij. The Cod-liver Oil 
 is to be added to the Glyconin very slowly with brisk stirring, and the other ingredients 
 added in the order named. 
 
 Hydroleine, Hydrated Oil, — is said to contain, in each dose of ^ij, Cod-liver Oil 
 ir^So, Distilled Water 1TL35, Pancreatin gr. 5, Soda gr. 1/, Salicylic Acid gr. j£. 
 
 Physiological Action. 
 The action of Cod-liver Oil is that of any other fat, except that it is 
 more easily assimilated than any member of the class. Fats in small 
 quantity are necessary for the digestion of nitrogenous food and form 
 the molecular basis of the chyle, being prepared for absorption by the 
 pancreatic juice and the bile, especially the latter. Fat is an essential con- 
 
382 MORRHtLE OLEUM. 
 
 stituent of the products of tissue formation, whether physiological or 
 pathological, and is the principal material concerned in the production 
 of force. After oxidation it is excreted as carbonic acid and water. 
 Locally applied fats reduce the body-temperature. 
 
 Cod-liver Oil is the most easily digestible of fats, penetrating animal 
 membranes with comparative ease after being emulsified by the pancreatic 
 and biliary secretions, hence entering the lacteal vessels readily and ap- 
 pearing to carry with it the oily and nitrogenous elements of the food. 
 The result is facilitation of the digestive process, increase of the red 
 blood-corpuscles and of the body-weight, and stimulation of healthy cell- 
 formation throughout the tissues. The properties of this oil have been 
 ascribed to its biliary constituent, to iodine, free oleic acid, etc., but no 
 satisfactory explanation has been offered until recently for the difference 
 between its action and that of other animal or vegetable oils. 
 
 Gautier and Mourguesof Paris have made an exhaustive series of analytical researches 
 upon Cod-liver Oil, and find that it contains — (i) Fixed Bases, Aselline and Morrhuine, 
 the latter constituting about ^ of the total alkaloids, and being probably one of the most 
 efficient principles in the oil. (2) VOLATILE Bases, Butylamine, l /z> of the total bases ; 
 A?nylamine, l /^ of the whole ; Dihydrotoluidine, J^ of the total alkaloids ; Hexylamine, 
 a small amount. (3) Acids, Morrhuic Acid \]/ z per cent., also a mixture of Formic 
 and Butyric Acids ; and a small proportion of Phosphoric Acid, derived from the phos- 
 phates, phospho-glycerates and lecithins of the extracts. As to the properties of these 
 constituents they state that Butylamine, Hexylamine, and particularly Amylamine in- 
 crease the urinary secretions. Dihydrotoluidine is a convulsivant toxic base. Aselline 
 in sufficient doses produces dyspnea, stupor, convulsive disturbances, and if continued 
 death. Morrhuine, the most important of the extractive principles, is a powerful stimu- 
 lant of the functions of nutrition and assimilation, promoting metabolic changes ; it pro- 
 duces a rapid circulation of the extractive residues of cell life towards the excretory organs, 
 where they are eliminated, provoking in their way indirectly a powerful movement of 
 assimilation correlative of the losses consequent upon the inverse movement of de-assimi- 
 lation. This is considered to be proved by the super-excitation of appetite in animals 
 brought under its influence. The physiological experiments with these substances dem- 
 onstrate that cod-liver oil is a reconstituent of the tissues through its richness in phos- 
 phates, phospho-glyceric acid, and organically combined phosphorus. Bromine and 
 iodine, which are present in small quantities, also contribute to the reparative action, but 
 chiefly to the active principles butylamine, amylamine, and especially morrhuine and mor- 
 rhuic acid does the oil owe its true medicinal value. 
 
 Therapeutics. 
 The value of Cod-liver Oil is wholly that of a nutrient, its action being 
 most marked in wasting diseases. In high febrile states or catarrhal con- 
 ditions of the gastro-intestinal tract its use is contraindicated, but in 
 phthisis a slight degree of fever will not interfere with its beneficial em- 
 ployment. It is found to be of most value in the chronic forms of phthisis, 
 in chronic bronchitis and emphysema, chronic rheumatic disorders, 
 atheroma of the arteries, strumous skin diseases and diarrhea, syphiloder- 
 mata, neuralgia, chorea and epilepsy. In many disorders referable to 
 exhaustion or debility of the nervous centres it is of great value as a nerve 
 tonic, and in convalescence from acute diseases it is of marked benefit. 
 
MOSCHUS. 383 
 
 It should always be considered as a supplementary food, and if its use 
 endangers the appetite for other food it should be abandoned. 
 
 The administration of this valuable agent is a serious matter, as many 
 patients cannot overcome their repugnance to its taste and smell. Various 
 emulsions are on the market, but they are objectionable because in no case 
 do they conceal the taste, and the efficacy of the oil is seriously impaired 
 by the processes used in their preparation. Moreover, the temptation is 
 very great to employ an inferior grade of the oil or to adulterate it with 
 other fish-oils in the manufacture of these preparations, and when the 
 commercial spirit of gain is remembered one can never be sure of the 
 quality of the oil so prepared. The oil itself is the best form for use, in 
 small doses, say a teaspoonful thrice daily for an adult, after meals, in 
 black coffee, beer or lemon-juice. The essential oil of eucalyptus in the 
 proportion of 1 part to 100 of cod-liver oil will effectually extinguish the 
 odor and taste to many persons. Alkaline stomachics given before meals, 
 the oil after, and a teaspoonful of Liquor Pancreaticus given half an hour 
 afterwards, would be a good routine in most cases, the latter agent pre- 
 venting the fishy eructations which often give so much trouble. Extem- 
 poraneous emulsions may be prepared with glyconin(see^^/<?, page 381), 
 white of egg, mucilage of tragacanth, extract of malt, or any syrup, and 
 flavored with lemon, cinnamon or bitter almond. The addition of n^iv 
 of Ether to each 3 of the oil promotes its digestion by stimulating the 
 pancreatic secretion, and enables a patient to take it with whom it had 
 previously disagreed. 
 
 Inunction by Cod-liver Oil is a method of value in the wasting diseases 
 of children. A tablespoonful may be rubbed into the skin of the abdo- 
 men twice a day, and covered with a flannel binder having oiled silk or 
 mackintosh-cloth outside. It readily passes through the skin and is 
 absorbed, producing valuable and lasting results. 
 
 MOSCHUS, Musk, — is the dried secretion from the preputial follicles of Moschus 
 moschifefus (the Musk Deer), an animal inhabiting the mountainous region of Central 
 Asia. It occurs in irregular, unctuous grains, of a reddish-brown color, peculiar and 
 penetrating odor and bitterish taste, contained in oval sacs about 2 inches in diameter, 
 membranous on one side, hairy on the other. About 10 per cent, is soluble in alcohol, 
 50 per cent, in water. Chinese Musk in the pods or sacs is the most valuable, but all 
 varieties are adulterated, the price of the drug being high. The odor is destroyed by 
 drying, but returns again on the addition of moisture. Trituration with Camphor or 
 Hydrocyanic Acid destroys it. The odorous principle has not been isolated, but is prob- 
 ably a product of decomposition which is constantly being formed. The constituents of 
 Musk are a bitter resinous substance, ammonia, fat, cholesterin, etc. Dose, gr. ij-x. 
 
 Tinctura Moschi, Tincture of Musk, — 5 per cent. Dose, Y\\xx-% jss. 
 
 Musk is a very diffusible stimulant, acting directly on the nervous and circulatory 
 systems, but without much energy. It is also an antispasmodic, and is employed with 
 benefit in general prostration of the system with nervous agitation or irregular muscular 
 action. It has been used with advantage in laryngismus stridulus, insomnia, the collapse 
 of typhoid and typhus fevers, spasmodic affections of the stomach, obstinate hiccough and 
 convulsions of children due to intestinal spasms. The pure Musk is very difficult to 
 
384 MYRCIA OLEUM — MYRISTICA. 
 
 obtain, and its high price makes it an extremely expensive medicine, so that it is seldom 
 used except as a perfume. 
 
 MYRCIiE OLEUM, Oil of Myrcia, Oil of Bay,— is a volatile oil distilled from 
 the leaves of Myrcia acris, or Bayberry, a tree of the nat. ord. Myrtacese, native of the 
 West Indian Islands. It is a yellowish-brown liquid, of aromatic odor, pungent taste, 
 slightly acid reaction, and soluble as a slightly turbid solution in an equal weight of 
 alcohol. It contains a hydrocarbon and Eugenic Acid. Used only as a perfume. 
 
 Spiritus Myrciae, Spirit of Myrcia, Bay Bum, — contains Oil of Myrcia 16, Oil of 
 Orange-peel I, Oil of Pimenta I, Alcohol 1220, Water to 2000. 
 
 The Oil of Bay is an agreeable perfume used to prepare bay-rum and in other cosmetic 
 preparations. The spirit, known as "Bay-rum," is used principally as a refreshing per- 
 fume, and is thought to relieve headache, faintness, etc., by application to the forehead 
 or to the nostrils. 
 
 MYRISTICA, Nutmeg, — is the seed of Myristica fragrans de- 
 prived of its testa. The Nutmeg-tree is cultivated extensively in the East 
 and West India Islands, belongs to the nat. ord. Myristicacese, and is a 
 native of the Banda Islands in the Malayan Archipelago. The nutmeg 
 contains 4 to 9 per cent, of the official Volatile Oil, and 30 per cent, of 
 a concrete oil, commonly called Oil of Mace, which is a compound of 
 fluid glycerides of oleic and butyric acids, and the solid glyceride of 
 Myristic Acid, some resin and volatile oil. Dose, gr. v-xx. 
 
 Macis, Mace, — is the arillode (fleshy covering) of the seed of Myris- 
 tica fragrans, the Nutmeg-tree. It occurs in narrow bands about an 
 inch long, branched and lobed, of brownish-orange color, fragrant odor, 
 warm and aromatic taste. It yields a fixed oil by pressure and a volatile 
 oil by distillation, the latter being probably identical with Oil of Nutmeg. 
 Dose, gr. v-xx. 
 
 Breparations. 
 
 Oleum Myristicae, Oil of Nutmeg, — is the volatile oil, and consists chiefly of a ter- 
 pene and an oxygenated oil, Myristicol. It is colorless or pale-yellow, of hot, spicy taste 
 and neutral reaction, and is soluble in alcohol. Dose, Try-v. 
 
 Spiritus Myristicae, Spirit [Essence) of Nutmeg, — is a 5 per cent, solution of the 
 oil in alcohol. Dose, ^j-ij. 
 
 Nutmeg is an ingredient of Acetum Opii, Pulvis Aromaticus, Tinctura Lavandulae Co., 
 Trochisci Cretae, and Trochisci Sodii Bicarbonatis. 
 
 Physiological Action and Therapeutics. 
 Nutmeg is an aromatic stomachic of agreeable flavor. In small doses 
 it stimulates the production of gastric juice and thus promotes digestion 
 and increases appetite. It also relieves intestinal spasm and flatulence. 
 In large doses it is powerfully narcotic, acting directly on the cerebrum, 
 and producing stupor and delirium. It is used chiefly for flavoring pur- 
 poses, and generally in substance grated as required, but has been 
 employed as a carminative, anodyne and astringent in diarrheas and dys- 
 entery, as well as to relieve nausea and vomiting. Strangury is efficiently 
 
MYRRH A. 385 
 
 treated by small doses of powdered nutmeg given several times a day; 
 and the same remedy is often used in the south of Germany to relieve the 
 uncomfortable feeling experienced after drinking an excessive quantity 
 of new beer. The Volatile Oil is decidedly rubefacient when used exter- 
 nally, and has narcotic powers if used internally in sufficient quantity. It 
 is occasionally employed as an external stimulant in paralysis and chronic 
 rheumatism. Mace is stimulant, carminative and aromatic. It is used 
 solely as a spice or condiment. 
 
 MYRRHA, Myrrh, — is a gum-resin obtained from Commiphora 
 Myrrha, an Arabian tree of the nat. ord. Burseraceae. It occurs in round- 
 ish tears, having a waxy fracture, a balsamic odor and a bitter taste. 
 When triturated with water it forms a brownish-yellow emulsion ; treated 
 with alcohol it yields a brownish-yellow tincture which turns purple on 
 the addition of nitric acid. It contains Gum, 60 per cent.; Myrrhin, a. 
 resin, $5 per cent.; also Myrrhol, C 10 H u O, an oxygenated ethereal oil, 2 
 per cent. Dose, gr. x-xxx. 
 
 Tinctura Myrrhae, Tincture of Myrrh, — 20 per cent. Dose, tt^x-xxx. 
 Myrrh is also contained in Mistura Ferri Co., Pil. Aloes et Myrrhae, Pil. Rhei Co., 
 and Tinctura Aloes et Myrrhae. 
 
 Locally applied Myrrh is stimulant and disinfectant to mucous mem- 
 branes and ulcerated surfaces. Administered in small doses internally 
 it acts as a gastric stimulant, but in large doses it irritates the gastrointes- 
 tinal mucous membrane, causing vomiting and purging. It quickens the 
 action of the heart, diminishes bronchial secretion, and is a uterine stimu- 
 lant and an emmenagogue. Myrrh is used in combination with other 
 drugs, as noted above, for anemia, amenorrhea and bronchial catarrh. It 
 is believed to diminish excessive secretion from the mucous surfaces of 
 the uterus, vagina, bladder and bronchi, also to have an especially bene- 
 ficial influence on chronic pharyngitis. Locally used the tincture has a 
 good tonic action on diseased mucous surfaces and is applied with benefit 
 to spongy gums, relaxed throat, aphthous patches and unhealthy ulcers, 
 and diluted with water it makes an excellent gargle for ulcerated sore 
 throat. Myrrh has long been employed as an ingredient of dentifrices. 
 
 Binz observed that the internal administration of Myrrh produced a leucocytosis in 
 which the white blood-cells were increased to four times their original number. This 
 fact has been made the basis of treatment in severe cases of diphtheria bv Stroll, who 
 reports 80 cases so treated with only one death, and has collected nearly 300 cases in 
 which the same treatment was employed with strikingly good results. His prescription 
 has of the tincture 4, glycerin 8, and distilled water to 200 parts, of which £j under 2 
 years of age, 3 ij up to 15 years, and ~ iij-iv for adults, even- half hour or hour until the 
 symptoms moderate, then every two hours, continued for 48 hours after the membrane 
 disappears. 
 
 25 
 
386 MYRTI OLEUM NAPHTALINUM. 
 
 MYRTI OLEUM, Oil of Myrtle, Myrtol (Unofficial),— is a vola- 
 tile oil distilled from the leaves of Myrtus communis, the Myrtle, nat. ord. 
 Myrtaceae, and consists of a mixture of Pinene, another hydrocarbon, 
 and Cineol ; the latter being identical with eucalyptol, and probably 
 the active medicinal ingredient. Dose, mj-iij, in capsules, several times 
 a day. 
 
 Myrtol is a very active antiseptic and parasiticide. Applied to a raw 
 surface it is sufficiently irritant to excite inflammation, but it does not so 
 affect the unbroken skin. Internally, in small doses, it excites a sense of 
 warmth in the mouth, increases the saliva, and acts as a tonic to the 
 stomach. Full doses are sedative to the nervous system, but large ones 
 act as an irritant. It is eliminated by the lungs and kidneys, acting as 
 an expectorant and as an antiseptic and stimulant to the mucous mem- 
 branes at the points of elimination. It imparts an odor like that of vio- 
 lets to the urine of the person taking it. 
 
 Administered in small doses, Myrtol aids digestion, and is an efficient 
 disinfectant and alterative in bronchorrhea, fetid bronchitis and gan- 
 grene of the lung ; and in cystitis and urethritis it acts similarly through 
 the urine on the local mucous membrane. It may be expected to give good 
 results in chronic and capillary bronchitis, whooping-cough and humid 
 asthma. It has rendered good service in hematuria not due to acute 
 congestion, and in passive hemorrhages generally. Locally it has proved 
 curative in favus, herpes, pityriasis and parasitic skin diseases; also in 
 otorrhea, ozena and other foul discharges from ulceration of the mucous 
 membranes. It has been employed successfully against both the round 
 and the thread worm. 
 
 Chekan (Unofficial), — the leaves and shoots of Myrtus Chekan, nat. ord. Myrtaceee, 
 a native of Chili. They contain a Volatile Oil resembling that of eucalyptus, also 
 Chekafiine, a volatile alkaloid, and tannin. Chekan is antiseptic, tonic, expectorant and 
 diuretic ; and is chiefly used in catarrh of the mucous membranes, especially those of the 
 bronchi and the bladder. It has been employed with benefit in cases of phthisis, and in 
 bronchitis with thick, purulent expectoration. The expressed juice diluted with water 
 makes a good lotion for conjunctivitis, and a decoction of the bark is valued as an astrin- 
 gent in dysentery. A fluid extract is marketed, the dose of which is gj-iij. 
 
 NAPHTALINUM, Naphtalin, Naphtalene, C 10 H 8 ,— is a hydro- 
 carbon product formed during the manufacture of ordinary coal gas. 
 Chemically, it is one of the benzene derivatives, being formed by the 
 union of two benzene groups in an overlapping ring (see ante, page 273). 
 When redistilled, it crystallizes in colorless, rhomboid plates, of slightly 
 tarry but strong odor, and burning, aromatic taste ; insoluble in water, 
 soluble in 15 of alcohol, very soluble in boiling alcohol, ether, chloro- 
 form, carbon disulphide, and fixed or volatile oils. It is seen frequently 
 in the form of moulded blocks, under such names as Alabastrine and 
 
NAPHTALINUM. 387 
 
 Camphylene, for preserving furs and flannels from moths, and for placing 
 in urinals for disinfectant purposes. 
 
 The dose of Naphtalin is from gr. ij to gr. viij, up to gr. Ixxx per diem 
 for adults; for children gr. j to gr. iij, every three hours. Being quite 
 insoluble in water it must be given in emulsion, or as a powder with sugar 
 in wafers or capsules. It is best flavored with oil of bergamot. 
 
 Derivatives. 
 
 Naphtol, Beta- (Iso-) naphtol, C 10 H 7 OH,— a phenol occurring in coal-tar, but usu- 
 ally prepared from Naphtalin. It is one of several naphtols, and occurs in colorless, 
 shining, crystalline laminae, or a whitish, crystalline powder, of faint, phenol-like odor, 
 and sharp taste. Soluble in 3^ of alcohol, in about 1000 of water, and in 75 of boiling 
 water ; very soluble in boiling alcohol, ether, chloroform, olive oil and petrolatum. Used 
 as ointment, 1 to 5 for adults, but for children it should be not over 2 per cent, strength. 
 
 Hydronaphtol, C 16 H 7 OH (Unofficial), — glistening, micaceous scales, sparingly solu- 
 ble in water, freely soluble in alcohol, oils, etc. Used as an antiseptic, and in ointment 
 or powder locally, diluted with oxide of zinc, 1 to 50. 
 
 Naphtolum Camphoratum, Camphorated Naphtol, Naphtol Camphor (Unofficial), — 
 is prepared by heating carefully one part of beta-naphtol with two of camphor ; the 
 product being a homogeneous, oily fluid, which is insoluble in water, and decomposes 
 readily on exposure to light and air. Used as a parenchymatous injection, the undiluted 
 fluid b^ing well borne, or in Olive oil, in doses of TT^ij-v. 
 
 Physiological Action and Therapeutics. 
 
 Naphtalin is destructive to all forms of low life, and hence is antiseptic 
 in a high degree, but must be intimately mixed with the substances upon 
 which it is to act. Internally it is a stimulant expectorant of decided 
 power, and disinfects the contents of the intestinal canal. Being so spar- 
 ingly soluble but little of it is absorbed, and hence it does no injury to 
 the organism. What is taken up by the blood is excreted by the urine, 
 partly unchanged, partly as naphtol and perhaps some as phenol. Naphtol 
 is more easily absorbed, and may induce vomiting, hematuria, convul- 
 sions and unconsciousness. An ointment containing 2 per cent, applied 
 with friction for scabies to two brothers, aged 6 and 8 years respectively, 
 caused nephritis in both and death in one, the diagnosis of nephritis 
 being verified at the autopsy. Hydronaphtol is a powerful and non- 
 irritating antiseptic, non-poisonous, non-corrosive, freely soluble in 
 alcohol, glycerin, fixed oils, etc., in cold water, 1 to 2,000 ; and in hot 
 water 1 to 100, precipitating as the water cools, but leaving a saturated 
 solution of 1 to 1,000, which is perfectly inhibitive of the germs of putre- 
 faction in all putrescible fluids. The claims made for it are that it is 12 
 times as effective as carbolic acid, 30 times as potent as salicylic acid, 60 
 times as efficient as boric acid, 600 times as antiseptic as alcohol, and 
 that it is entitled, as a true antiseptic, to stand next to mercuric chloride 
 in the comparative tables (Levis). 
 
 Naphtalin is employed as an antiseptic for the intestinal canal in typhoid 
 fever, diarrhea, both acute and chronic, tubercular diarrhea, dysentery, 
 
388 NUX VOMICA. 
 
 etc. It renders the urine aseptic and may be employed in vesical catarrh. 
 It is also used internally for humoral asthma, verminous affections, and 
 the chronic pulmonary catarrh of the aged. It has come into promi- 
 nence as an efficient, all-around anthelmintic, having been given for all 
 kinds of intestinal worms, with prompt and complete results invariably 
 obtained (Mirowicz). In pertussis the best possible results have been 
 obtained from the burning of this agent in the patient's room; giving 
 force to the belief that the well-known benefit resulting from taking 
 children to gas-works for whooping-cough is due to the naphtalin fumes 
 rather than to the gas-tar. Locally, Naphtalin has high value as an anti- 
 septic for indolent ulcers, sloughing wounds, open cancers, pus cavities, 
 etc. Painted over organic remains it effectually prevents the ravages of 
 insects. Naphtol is employed like tar for therapeutic action upon the 
 skin in hyperidrosis, scabies, eczema and local sweating, in ^ to 5 per 
 cent, alcoholic solution, or as a 10 per cent, ointment, but is a dangerous 
 application. Hydronaphtol is also highly esteemed for antiseptic pur- 
 poses generally by those who have used it, and is of benefit as an external 
 application in many skin diseases. Its non-toxic and non-irritant qi*alities 
 render it the most useful and most generally available of the three. 
 
 Camphorated Naphtol has been employed hypodermically in tuberculous adenitis, 
 with permanent improvement in nine cases, and improvement in six others, out of a series 
 of 32 cases so treated by Reboul, of Marseilles. In five cases of tuberculosis of the testis, 
 so treated by the same observer, very gratifying results were obtained ; the injection 
 appearing to be perfectly harmless, and to act beneficially, both locally and generally. It 
 has also been extensively used in the irrigation of joints, bony cavities, tendinous sheaths, 
 cold abscesses in the pleural and uterine cavities, and in tuberculosis of the bladder : all 
 which localities seem to bear the undiluted fluid well. (Squibb.) 
 
 NUX VOMICA, Nux Vomica, Poison Nut, Quaker Button,— 
 is the seed of Strychnos Nux-vomica, a tree of the nat. ord. Loganiacese, 
 growing in India, Cochin-China and the neighboring countries, all parts 
 of which are bitter and poisonous. The seeds are flattened and nearly 
 circular, about one inch in diameter, ashy-gray in color, covered with 
 short, satiny hairs, internally translucent, tough and horny, with a large 
 cavity; inodorous, but of intensely bitter taste. They contain the alka- 
 loids Strychnine and Brucine (see below), in combination with Igasuric 
 (or Strychnic) Acid, also the glucoside Loganin, a yellow coloring matter, 
 a concrete oil, gum, starch, wax, and earthy phosphates. 
 
 Preparations of Nux Vo?nica. 
 
 Extractum Nucis Vomicae, Extract of Nux Vomica, — has of total alkaloids 15 per 
 cent. Dose, gr. x /%-}i, up to a maximum in 24 rjpurs of gr. ij. 
 
 Extractum Nucis Vomicae Fluidum, Fluid Extract of Nux Vomica, — has 1)4 P er 
 cent, of total alkaloids. Dose, TT\J-v. 
 
 Tinctura Nucis Vomicae, Tincture of Nux Vomica, — has 0.3 per cent, of total 
 alkaloids. Dose, rr\v-xx. 
 
NUX VOMICA. 389 
 
 Alkaloids and their Salts. 
 
 Strychnina, Strychnine, C 21 H,.,N,0 2 , — is an alkaloid obtained from Nux Vomica, 
 Ignatia, and other plants of the order Loganiacee ; crystalline, intensely bitter even in I 
 to 700,000 solution, of alkaline reaction, soluble in 7 of chloroform, no of alcohol, 6700 
 of water, almost insoluble in ether. It is a constituent of Ferri et Strychnine Citras, and 
 of Syrupus Ferri Quinine et Strychnine Phosphatum. Dose, gr. -£$--*-§. 
 
 Strychninae Sulphas, Strychnine Sulphate (C 2] H 22 N 2 2 ) 2 H 2 S0 4 — 5H 2 0, — crystal- 
 line, efflorescent, odorless, of intensely bitter taste,, even in 1 to 700.000 solution, neutral 
 reaction, soluble in 50 of water, in 109 of alcohol, and in 2 of boiling water, but almost 
 insoluble in ether. It contains 75 per cent, of Strychnine. Dose, gr. gV'iV' but after 
 tolerance is attained much larger doses may be safely used. 
 
 Strychninae Nitras, Strychnine Nitrate (Unofficial), — forms colorless needles of a 
 silky lustre and very bitter taste, soluble in 90 parts of cold water, 3 of boiling water, in 
 70 of alcohol, and in 26 of glycerin, but insoluble in ether. It contains 84 percent, of 
 Strychnine, and is preferred to the sulphate for hypodermic use, being less irritant. Dose, 
 gr. ^L— j-V, or more after tolerance is attained. The Phar. Ger. gives the maximum single 
 dose as gr. \, the daily maximum as gr. \. 
 
 Strychninae Hydrochloras, Strychnine Hydrochlorate (Unofficial), — is used in the 
 form of Liquor Strychnine Hydrochloratis (B. P.), which is about a I per cent, solution. 
 Dose, n\v-x. 
 
 Strychninae Arsenis, Strychnine Arsenite (Unofficial), — is soluble in 35 parts of cold 
 water, in 10 of boiling water, also in alcohol, Jess so in ether. Dose, gr. ^q-^q, ^ ut as 
 it is highly toxic, the initial dose should never exceed the minimum given. 
 
 Brucina, Brucine, C 23 H 26 X 2 4 (Unofficial 1, — occurs in colorless prisms, pearly flakes 
 or masses, bitter, soluble tn 850 parts of water and in I )/ 2 of alcohol. It is separated 
 with difficulty from Strychnine, in many samples of which it occurs as an impurity. It 
 is seldom used. Dose, gr. ^ - \ . 
 
 Tests for Strychnine and Brucine. 
 
 Strychnine and its salts dissolve without color in concentrated Sulphuric Acid, but, on 
 adding to the solution some deoxidizing substance, a play of colors results, Lead Peroxide 
 producing a beautiful blue, passing into violet, then red, and finally yellow (Marchand). 
 A minute quantity of Potassium Bichromate produces similar results (Otto), while 
 Ceroso-ceric Oxide causes a blue, changing to violet and then to a permanent cherry-red. 
 If these tests are carefully applied, as minute a quantity as I part in 900,000 of the solu- 
 tion may be detected ( Wenzell). 
 
 Brucine is detected by the red color which it yields with Nitric Acid. Neither Nitric 
 nor Sulphuric Acid colors Strychnine unless Brucine is present as an impurity, a test 
 which distinguishes this alkaloid from several others. Brucine does not decompose Iodic 
 Acid, and is thereby distinguished from Morphine. 
 
 Physiological Action. 
 The action of Nux Vomica is that of its principal alkaloid Strychnine. 
 Externally, the latter is a very powerful antiseptic, but is too poisonous 
 for safe use, and in concentrated solution hypodermically it has a decided 
 irritant action on the tissues. Internally in small doses its bitter quality 
 makes it a good stomachic tonic. Increasing the vascularity of the 
 gastric mucous membrane and promoting the secretion of gastric juice, 
 also the pancreatic and biliary secretions, it aids digestion and sharpens 
 the appetite, but like all other bitter tonics it deranges digestion when 
 used excessively or for a long time. It stimulates the muscular coat of 
 ^the intestines, increasing peristalsis and thus acts as a purgative, but it 
 restrains the fecal discharges when their frequency is due to atony of the 
 
390 NUX VOMICA. 
 
 bowel. It stimulates the motor nerve-cells of the spinal cord, the cardiac 
 motor ganglia, the respiratory and vaso-motor centres in the medulla, 
 contracting the arterioles all over the body (though by full doses they are 
 relaxed), also the excitability of the sensory nerves and their terminal 
 elements. The result is that respiration is deepened and quickened, the 
 action of the heart is increased and the blood-pressure raised, the field of 
 vision is enlarged, the sight and hearing are sharpened, and the sense of 
 touch is rendered more acute, but the cerebral convolutions are not 
 affected. Excreted chiefly by the kidneys, it causes increased frequency 
 of urination, and when taken in excess produces spasm of the neck of the 
 bladder. It probably excites some degree of uterine contraction, but 
 undoubtedly promotes menstruation, disposes to sexuality, and provokes 
 erections of the penis. 
 
 The most marked feature of the action of Strychnine is the great in- 
 crease which it causes in the reflex excitability of the spinal cord and 
 other reflex centres, such as the vaso-motor and respiratory centres in the 
 medulla. When the dose is large this increase is so great as to induce 
 convulsions and cause death by asphyxia. After a full dose (gr. i l) the 
 pupils become dilated, the limbs take on jerking movements, respira- 
 tion becomes spasmodic and the lower jaw stiff, a sensation of cerebral 
 tension may be felt, and sudden shuddering and anxiety follow, the face 
 taking on an unmeaning smile, the risus sardonicus. A toxic dose 
 (gr. \ to gr. ij) produces powerful and characteristic convulsions of a 
 tetanic character. Within an hour after its administration, sometimes after 
 only a few minutes, the patient feels a sudden sense of suffocation and 
 dyspnea, the head and limbs begin to shudder and jerk, the limbs are 
 suddenly stretched out rigidly, with hands clenched and feet arched, then 
 the head is bent backwards and the whole body becomes stiffly arched 
 resting on the head and the heels, the belly tense, the chest muscles fixed 
 and the breathing all but arrested. In the height of the paroxysm the 
 face is dusky and congested, and the eyeballs project. Nearly all the 
 muscles of the body are affected, but those of the jaw are not seriously 
 implicated until near the end, and never so powerfully as in tetanus. The 
 pulse is very rapid and the body-temperature is above normal, but the 
 intellect remains unclouded and the patient often expresses a sense of 
 impending dissolution. After the paroxysm has lasted a minute or two 
 it usually relaxes for a time. In the interval the patient suffers from sore- 
 ness of the muscles, feels exhausted and sweats profusely, but soon 
 becomes aware that the spasm is returning and may cry out for some one 
 to hold him or to rub his limbs. The convulsions rapidly increase in 
 severity, a breath of wind, the slightest noise, even a bright light, being 
 sufficient to bring them on, and in one the patient may jerk himself out 
 of the bed. At last the respiration stops in the middle of a fit and the 
 
NUX VOMICA. 39I 
 
 heart soon ceases to beat. Death occurs, after two or three hours at 
 most, by exhaustion and asphyxia from tetanic fixation of the muscles of 
 respiration, consciousness being preserved until carbonic-acid narcosis 
 sets in. 
 
 Strychnine exalts all the functions of the spinal cord — reflex, motor, 
 vaso-motor, and sensory, the latter being the least affected. It has selec- 
 tive action on the large multipolar ganglia in the anterior columns, which 
 it first stimulates and finally paralyzes by over-stimulation, in this respect 
 illustrating the rule that small and large doses of an active agent act 
 antagonistically to each other. A massive dose seems to destroy the 
 spinal and medullary functions as by a single blow. The spasms of 
 Strychnine may be distinguished from those of tetanus by their intermit- 
 tency (the latter being constant), by the meaningless smile, the less marked 
 trismus, the absence of a wound, and the rapid course of the symptoms. 
 Thebaine, the tetanizing alkaloid of opium, is also a spinal exaltant, and 
 acts much the same as strychnine. 
 
 Strychnine does not directly affect the muscular tissue, the motor nerve- 
 trunks or nerve-endings, or the cerebral convolutions. Occasionally, 
 however, large medicinal doses cause a greatly heightened sensibility of 
 the optic and auditory nerves, so that brilliant lights and loud sounds pro- 
 duce painful impressions; and in a few cases there occurs a true cerebral 
 intoxication resembling a slight degree of drunkenness. It probably 
 affects all the nervous centres in some degree, the sensory, however, much 
 less than the motor and vaso-motor ones. It is to some extent oxidized 
 and destroyed in the body, the remainder being eliminated by the urinary, 
 salivary and cutaneous channels. As it contracts the renal arteries, it 
 hinders its own excretion by the kidneys, and being rapidly absorbed it 
 may accumulate in the system if even a small dose is frequently and con- 
 tinuously administered. It is much more poisonous when injected into 
 the rectum than when swallowed. 
 
 The fatal dose of Strychnine is placed by Taylor at gr. \ to gr. ij for 
 an adult, but recovery has taken place after larger doses, even 7 and 8 
 grains, cases probably of imperfect absorption, due perhaps to the pres- 
 ence of fat or tannin in the contents of the stomach. A child, aged 2^ 
 years, died in four hours from a dose of gr. Jg-. After death from this 
 poison cadaveric rigidity is marked, with opisthotonos, clenched hands, 
 and arms flexed across the chest. The muscular rigidity may persist for 
 several months after death. The face is usually pale, but sometimes livid, 
 the internal organs are gorged with dark blood, and the bladder is gener- 
 ally contracted. The cause of death is primarily asphyxia produced by 
 rigidity of the muscles of respiration, with possible factors in spasm of the 
 heart or exhaustion thereof. 
 
 On animals Strychnine acts as it does upon man, but in different de- 
 
392 NUX VOMICA. 
 
 grees. Birds, guinea-pigs and perhaps monkeys, are comparatively insus- 
 ceptible to it, while ruminants are less easily affected than other quad- 
 rupeds, and cats resist it singularly. Very minute portions in the soil 
 will destroy the life of growing plants. 
 
 Antidotes, Antagonists and Incompatibles. 
 
 The antidotes are Tannic Acid to form the very insoluble tannate, and Iodine in dilute 
 solution, or a soluble Iodide. Animal Charcoal should be given freely, also Fats and 
 Oils, to retard absorption. Potassium Permangaualehas been used successfully after the 
 ingestion of gr. }{ of strychnine without any symptom of strychnine poisoning resulting 
 (Fahr). Lard is said to be a good antidote. Evacuation of the stomach should follow 
 the administration of any antidote, and the bladder should be emptied frequently to pre- 
 vent reabsorption. The most reliable antagonist is Chloral Hydrate, of which gr. xxx 
 should be given at once, and doses of gr. xx may be repeated at hourly intervals as long 
 as reflex exaltation continues. Quiet, as perfect as possible, is an antagonistic measure 
 of great importance. Other antagonists are Hydrastinine Hydrochlorate, gr. j hypo- 
 dermically, Nicotine, Chloroform, Amyl Nitrite, Physostigma (dangerous), Veratrum 
 Viride, Oil of Chamomile, and Valerian. Potassium Bromide is antagonistic, but too 
 slow of action to be of service. Curare has been recommended, but its antagonistic value 
 is doubtful. 
 
 Incompatibles are Bromides, Iodides and Chlorides, which precipitate the strychnine 
 as a hydrobromide, etc. Strychnine salts in solution are decomposed by Alkalies and 
 their Carbonates, and by Tannic (not by gallic) Acid, but are not affected by ferric salts. 
 Oils and fats retard their absorption. 
 
 Therapeutics. 
 Nux Vomica and its chief alkaloid, Strychnine, are exceedingly useful 
 remedies, having a wide range of therapeutic efficacy. They are chiefly 
 employed as stomachic tonics, and as stimulants to the heart, the respira- 
 tory apparatus, and the muscular and nervous systems. As the quantity 
 of strychnine in nux vomica varies greatly, it is best to use the alkaloid when 
 its physiological action is desired, as more definite dosage may be thus ob- 
 tained. The tincture in 5-drop doses is excellent in atonic dyspepsia and 
 gastric catarrh, especially in drunkards, and in constipation from atony of 
 the bowels it may be given in 10-drop doses with good results, not as a 
 purgative but to increase peristalsis. The extract is much used in laxative 
 pills for habitual constipation. In the vomiting of pregnancy the tincture is 
 frequently an efficient remedy, and in the vomiting of phthisis Strychnine 
 is one of the very best agents. In the condition clinically known as that 
 of torpid liver, where the stools are of pale color and very offensive odor, 
 showing absence of bile therein, the tongue coated with a thick, perhaps 
 yellowish fur, and the patient complaining of headache, lassitude, anorexia, 
 and a bad taste in the mouth, small doses of Strychnine (gr. -gL) twice or 
 thrice daily will frequently act as well as a mercurial, restoring the bile to 
 the stools, and correcting the other symptoms. Epidemic diarrhea and 
 dysentery are often controlled by Strychnine, and in anemia and chlorosis 
 it is an invaluable remedy,- especially when combined with iron and qui- 
 nine. In intermittents, as an adjunct to quinine it is always useful, and 
 
nux vomica. 393 
 
 in neuralgia, especially of the viscera, and infraorbital and other forms 
 accompanying anemia and general debility, it is highly efficient, but in 
 these affections very small doses (gr. t ±-q) should be employed. 
 
 Headaches are often controlled by Nux Vomica, especially the sick 
 headache of gastric origin, in which minim-doses of the tincture every ten 
 or fifteen minutes frequently give marked relief, and a dose of r^x before 
 each meal will prevent frontal headache in many persons liable thereto. 
 A sense of heat and weight on top of the head, accompanied or not by 
 flatulence, and usually occurring in women at the climacteric, will often 
 yield to the tincture in doses of n^v before each meal. Its undoubted in- 
 fluence on the pneumogastric makes it a valuable remedy for many kinds 
 of cough, even those of phthisis, bronchitis, pneumonia or emphysema, but 
 it is particularly efficient in coughs of neurotic origin, such as periodical 
 cough, night cough, and the paroxysmal laryngeal cough without lung or 
 bronchial symptoms, but characterized by a persistent tickling sensation 
 in the throat. In all these drop-doses of the tincture frequently repeated 
 are more serviceable than larger doses at longer intervals. In bronchial 
 asthma and asthma of neurotic origin, in the dyspnea of pulmonary affec- 
 tions and that with cardiac palpitation in hysterical subjects, in irregular 
 action and over-action of the heart, in functional anesthesia, hypochon- 
 driasis, abdominal cramps, nervous movements accompanying pregnancy, 
 cold hands and feet due to languid capillary circulation, prolapsus ani 
 and urinary incontinence in children, and paralysis of the bladder in old 
 people, small doses of Strychnine frequently repeated are remarkably 
 beneficial. In many of these affections the therapeutic action of the drug 
 is unmistakably that of an antispasmodic, illustrating the opposite effects 
 of large and small doses of an active agent, a thoroughly established fact 
 in many cases, though not a universal one. 
 
 Nux Vomica is a most efficient remedy in impending cardiac failure 
 from almost any cause. Even with the pulse imperceptible, the extremi- 
 ties cold, and death apparently imminent, the administration of a drop of 
 the tincture every five minutes has frequently given renewed strength to 
 the cardiac contractions after five or six doses, and initiated an improve- 
 ment which resulted in eventual recovery. Local paralyses of various 
 forms are well treated by the hypodermic injection of Strychnine into the 
 substance of the affected muscles, and diphtheritic paralyses are almost 
 invariably cured by its internal administration. It may prove useful in 
 hemiplegia when degeneration has not set in, and when the paralyzed 
 muscles are completely relaxed ; but it is of no avail in recent cases or 
 when electrical contractility is lost. If used early in cerebral paralyses, 
 especially when due to hemorrhage, it may do serious harm ; and in the 
 early stage of organic spinal lesions it may be decidedly injurious, par- 
 ticularly if given in large doses. It should never be used in spinal 
 
394 NUX vomica. 
 
 paralysis when there are symptoms of congestion or inflammation of either 
 the cord or its membranes. In hysterical paralysis and that caused by 
 lead it is decidedly beneficial, and also in the form which is limited to 
 one or two groups of muscles, especially infantile paralysis of long stand- 
 ing, even when the atrophic process has gone so far as to greatly impair 
 the electrical sensibility. In multiple peripheral neuritis the hypodermic 
 injection of strychnine has proved eminently serviceable. 
 
 Strychnine is very useful in cases of nervous impairment of the sight, 
 especially in amblyopia from lead, tobacco or alcohol, from atrophy of 
 the optic nerve, and from functional disorders of the retina without ap- 
 parent lesion, also in muscular asthenopia. In these affections it may be 
 used internally, but it is usually administered by injection into the tissues 
 around the temple, beginning with gr. -fa, and gradually increasing the 
 dose up to gr. J/& or j£. Improvement may not be apparent until the 
 larger doses are reached. 
 
 In acute and chronic alcoholism, Strychnine is undoubtedly of great 
 service. In small doses it is an effective remedy for the morning vomit- 
 ing and dyspepsia of drunkards, for the tremor of chronic dipsomaniacs, 
 in the forming stage of delirium tremens, and for the depression due to 
 enforced abstinence from alcohol. The nitrate, in doses of gr. -^ to ^-, 
 hypodermically three or four times daily for a week, and less frequently 
 for two weeks longer, removes the craving for stimulants, counteracts the 
 vaso-motor paralysis to which most of the injurious effects of alcohol are 
 due, and is probably in other respects a true antagonist to the action of 
 that narcotic poison on the human organism. The published reports of 
 its efficacy in dipsomania, by Luton, Dujardin-Beaumetz, Portugaloff and 
 others, have been fully confirmed by other observers, so that Strychnine 
 is now the acknowledged remedy for inebriety, and the efficient con- 
 stituent of the numerous ''cures" therefor so widely advertised in the 
 religious and secular press. 
 
 Strychnine is a physiological antagonist to Chloral, Physostigmine and 
 Morphine, and may be used as a respiratory stimulant in poisoning by 
 these drugs, also in narcotic poisoning by any agent when the respiration 
 is failing. It has been employed in Australia as an antagonist to serpent 
 venom with great success in the hands of Mueller and others, and with 
 doubtful efficacy in the experience of many observers. From the results 
 of experiments made by Dr. Elliot, of the Indian army, it would seem 
 that its use in poisoning by cobra venom is of no service whatever and 
 may actually hasten death. 
 
 Strychnine Arsenite possesses strong antiperiodic power, and may 
 prove to be an efficient remedy for any intermittent disease which proves 
 rebellious to the influence of quinine. As it is a highly toxic agent, 
 the minimum dose (gr. -gL) should not be exceeded at its first admin- 
 
OLIV.E OLEUM. 395 
 
 istration, and its effects should be carefully watched upon repetition of 
 the dose. 
 
 Brucine was formerly supposed to have an action analogous to that of 
 strychnine though weaker. Dr. Mays has shown that pure Brucine is a 
 powerful local anesthetic in 5 to 10 per cent, solutions on mucous mem- 
 branes, and in a 20 per cent, solution on the skin. In the latter strength 
 its solutions have been employed with satisfaction for chronic pruritus, 
 and in a weaker solution (5 per cent.) for inflammations about the exter- 
 nal ear, in which Dr. Burnett claims for it more satisfactory results than 
 are obtained with cocaine. 
 
 NYMPH^EA ODORATA, Sweet-scented Water-lily (Unofficial),— is a well- 
 known American plant of the'nat. ord. Xyrnphreaceie, the root of which is very bitter and 
 highly astringent, containing much Gallic and Tannic Acids, to which its actions and 
 uses are due. A decoction of 5J to the pint may be used in doses of 5SS-J. or a fluid 
 extract in doses of ^ss-j. For the physiological actions and therapeutics of this vege- 
 table astringent see under AciDUM TANNICDM. 
 
 OLIVJE OLEUM, Olive Oil, Sweet Oil, Salad Oil— is a fixed 
 oil expressed from the ripe fruit of Oka eurofi&a, the olive tree (nat. ord. 
 Oleacese), which is cultivated in southern Europe, California and Aus- 
 tralia. It is a pale-yellow or greenish-yellow oily liquid, of nutty, oleag- 
 inous taste and neutral reaction, sparingly soluble in alcohol but readily 
 soluble in ether. Sp. gr. about 0.916. Dose, j§ss-j. 
 
 Olive Oil consists of 72 per cent, of Olein fa fluid oil) and 28 per cent, of Palmitin 
 (a solid oil or stearopten), which are compounds of the base Glyceryl, C 3 H 5 , with Oleic 
 Acid, C 19 H 34 0. 2 , and Palmitic Acid, C 1T H 31 0.,, respectively. It is frequently adulterated 
 with cheaper fixed oils, especially poppy oil, lard oil, and cotton-seed oil, quantities of 
 the latter being exported every year to Italy, whence it is returned to us as Olive Oil 
 under a French label. (See Gossypium. ) It is an ingredient of Ceratum Cetacei, Em- 
 plastrum Plumbi and Unguentum Diachylon, and is the source of the official Soap. 
 
 Physiological Action and Therapeutics. 
 Externally used Olive Oil is a good protective from the air, and ren- 
 ders the skin soft and flexible. If rubbed into the integument it is ab- 
 sorbed by the lymphatics and is directly nutritive in effect. Internally it 
 is also nutritious and mildly laxative, and in quantity acts as a protective 
 to the mucous membrane against acrid or poisonous substances. Like 
 other oils it is partly emulsified, partly saponified in the intestines, its gly- 
 cerin being. set free and its fatty acids combining with the free alkalies to 
 form soap, which with the emulsion forms the molecular basis of the chyle, 
 entering the blood through the lacteals and being finally oxidized into 
 carbonic acid and water, though an excess will appear unchanged in the 
 urine. Oils are therefore a food within certain limits, increase the fat of 
 the tissues, furnish heat and force, and lessen the waste of nitrogenous 
 tissue, but are unable of themselves to support life. 
 
396 OPIUM. 
 
 Olive Oil possesses no very marked therapeutic power over any other 
 bland oil or fat. It is a good laxative for infants administered internally, 
 and may be used as an enema followed by warm water. There is much 
 clinical evidence to prove that administered internally it is a very effi- 
 cient remedy in both nephritic and biliary colic, but how it acts therein 
 has not been explained. It is chiefly employed as a local application. 
 Applied to burns and acute inflammatory affections of the skin it is an 
 excellent protective, coating the surface and excluding the air ; and as an 
 ingredient of liniments it acts as a diluent for more active agents. It is 
 used to facilitate friction over enlarged or stiff joints, and in the desqua- 
 mative stage of scarlet fever is a very useful and grateful application. As 
 an antidote in corrosive poisoning it acts mechanically by protecting the 
 mucous membrane of the stomach and preventing absorption. In phar- 
 macy its bland, unirritating qualities have procured its common employ- 
 ment as an ingredient of liniments, plasters, ointments and cerates, but 
 the foreign article is so frequently adulterated with inferior oils that Cot- 
 ton-seed Oil is now directed in its place in many official preparations. 
 
 OPIUM, — is the concrete, milky exudation, obtained by incising the 
 unripe capsules of the White Poppy, Papaver somniferu?n i an annual herb 
 of the nat. ord. Papaveraceae, indigenous to Western Asia, but cultivated 
 extensively elsewhere. Its capsules are globular, two or three inches in 
 diameter, and are crowned by a sessile, stellate stigma, which distin- 
 guishes them from Colocynth and Bael fruits. Opium occurs in irregular 
 lumps or cakes, of dark-brown color, sharp, narcotic odor, and bitter 
 taste ; and in its normal, moist condition should yield not less than 9 per 
 cent, of Morphine when assayed by the official process. 
 
 Composition of Opium. 
 Opium contains 17 alkaloids, 2 neutral substances and 2 organic acids, 
 together with sugar, gum, resin, pectin, extractives, odorous principles, 
 water and other constituents of plants. Its most important alkaloids are 
 the following: — 
 
 Morphine, C n H 19 N0 3 , — 5 to 20 per cent., — the principal alkaloid, occurring in the 
 drug in the form of the tribasic meconate. Its properties are anodyne, hypnotic and nar- 
 cotic. From it by a process of dehydration by heat and hydrochloric acid is prepared 
 the artificial alkaloid Apomorphine, a powerful emetic and expectorant. 
 
 Codeine, C 18 H 21 N0 3 ,— 0.3 to 0.5 per cent., — is calmative and when pure a not very 
 active alkaloid, but is frequently contaminated with other alkaloids. Apomorphine may 
 be prepared also from it. 
 
 Narcotine, C 22 H 23 N0 7 , — 2 to 10 per cent., — is antiperiodic and a tetanizer, but 
 wholly devoid of narcotic properties. 
 
 Thebaine, or Paramorphine, C 19 H 21 N0 3 , — 0.15 to 0.20 per cent., — is a powerful 
 spinal exaltant and tetanizer, resembling Strychnine in its action. 
 
opium. 397 
 
 .02 per cent., — closely resembles Morphine in action, but 
 is probably more hypnotic, and is not followed by many of the disagreeable after-effects 
 of Morphine. It is extremely difficult to obtain this alkaloid pure. 
 
 Papaverine, C 21 H.,,X0 4 , — 1 per cent., — is reported inert on man by some observers, 
 a narcotic and convulsant by others. 
 
 Other Alkaloids at present acknowledged are — Cryptopine, Pseudomorphine, Protopine, 
 Hydrocotarnine, Laudanine, Codamine, Rhceadine, Meconidine, Laudanosine, Lantho- 
 pine and Gnoscopine. Many of them are probably to be regarded as derivatives of 
 Morphine. 
 
 Acids and Neutral Principles. 
 
 Acids are — Meconic Acid. C ; H 4 7 , 4 per cent., and Lactic Acid, C 3 H 6 3 , lj4 per 
 cent. , which exist in combination with the alkaloids as meconates, etc. The second acid 
 is generally called Thebolactic, but has been shown to be identical with lactic acid. 
 
 Neutral Principles are — Meconin, C ]0 H ]0 O 4 , 0.01 per cent., is white, crystalline, 
 neutral, but very acrid; Meconoiosin, C 8 H 10 O 2 , also crystalline, and Porphyroxin, which 
 is said to be a very complex combination of several opium alkaloids and not a proxi- 
 mate principle. 
 
 Official Preparations of Opium. 
 
 J" Opii Pulvis, Powdered Opium, — is Opium dried at a temperature not exceeding 185 
 F., and reduced to a very fine powder. It should contain not less than 13 nor more than 
 15 per cent, of crystallized Morphine, when assayed by the official process. Dose, gr. 
 ss— iij, an average adult dose being about I grain. 
 
 Opium Deodoratum, Deodorized Opium, Denarcotized Opium, — is powdered Opium 
 freed from the constituents thereof which are soluble in Ether, namely Narcotine and the 
 odorous principles, which are supposed to cause the unpleasant after-effects of the drug. 
 It should yield 14 per cent, of Morphine, and is a good preparation, being a purified 
 opium with a fixed morphine standard. The proprietary article named Svapnia is a 
 similar preparation. Dose, gr. ss-iij ; an average adult dose being about I grain. 
 
 ^Extractum Opii, Extract of Opium, — an aqueous extract containing 18 per cent, of 
 Moiphine, and freed from principles insoluble in water. Dose, gr. %-\). 
 
 Pilulse Opii, Pills of Opium, — each pill contains about gr. j of powdered Opium 
 incorporated with Soap. Dose, j-iij pills. 
 
 Tinctura Opii, Tincture of Opium, Laudanum, — Opium-strength 10 per cent., 
 average Morphine-strength gr. vj (equalling gr. viiss of the Sulphate) to the fl£. Has 
 about gr. xliv of Opium to the 5 . V^x] (gtt. xxij) = gr. j of Opium or gr. i/£ of Mor- 
 phine Sulphate. Sixty minims yield on the average 120 drops. Dose, TT\v-xxx, accord- 
 ing to the effect desired. 
 
 Tinctura Opii Deodorata, Tincture of Deodorized Opium, — an aqueous extract is 
 prepared and shaken with ether, which being separated the residue is dissolved in water, 
 and enough alcohol is added to preserve it. An excellent liquid preparation, being freed 
 from all the noxious and useless ingredients soluble in alcohol and ether. Opium-strength 
 10 per cent., average Morphine-strength gr. vj to the fl^. Dose, as of Tinctura Opii. 
 Drops of this preparation nearly equal minims. McMunn? s Elixir is a similar prepara- 
 tion, so also is another proprietary nostrum named Papine. 
 
 Vinum Opii, Wine of Opium, Sydenham's Laudanum, — Opium-strength 10 per 
 cent., with the aromatics Cinnamon and Cloves of each I percent., in Alcohol and White 
 Wine. A vinous tincture decreased somewhat in strength from the wine of 1870. Dose, 
 as Tinctura Opii. Drops of this preparation are larger than those of the tincture. 
 
 Acetum Opii, Vinegar of Opium. Black Drop, — Opium-strength 10 per cent., with 
 Nutmeg and Sugar in Dilute Acetic Acid. Is now l < weaker than formerly, having the 
 same strength and dose as Tinctura Opii. 
 
 Tinctura Opii Camphorata. Camphorated Tincture of Opium, Paregoric, — has of 
 Powdered Opium 4, Benzoic Acid 4, Camphor 4, Oil of Anise 4, Glycerin 40, Diluted 
 Alcohol to 1000. :|ss contains nearly one grain of powdered Opium. It is about ^th 
 the strength of Laudanum. Dose, for an infant gtt. v-xx, for an adult gj-iv. Is an 
 ingredient of Mistura Glycyrrhizie Composita. 
 
39$ ■ opium. 
 
 Emplastrum Opii, Opium Plaster,— contains of Extract of Opium 6 parts, Burgundy 
 Pitch 18, Lead Plaster 76, Water 8. 
 
 Pulvis Ipecacuanhae et Opii, Pozvder of Ipecac and Opium, Dover's Powder, — 
 has of Ipecac 10, Powdered Opium 10, Sugar of Milk 80, rubbed together into a very 
 fine powder. Dose, gr. v-xv ; ten grains equalling I grain each of Ipecac and Opium. 
 
 Tjnctura Ipecacuanhae et Opii, Tincture of Ipecac and Opium, — has of Tincture of 
 Deodorized Opium 100 evaporated to 80, Fluid Extract of Ipecac 10, Diluted Alcohol 
 to 100. Is intended to represent Dover's Powder in liquid form. Dose, TT^v-xv. 
 
 Trochisci Glycyrrhizae et Opii, Troches of Glycyrrhiza and Opium, — each troche 
 contains of powdered Opium gr. T V, with Extract of Glycyrrhiza, Acacia, Sugar and Oil 
 of Anise. Dose, j-iv troches. 
 
 [Note. — According to the U. S. Pharmacopoeia of 1890 the official dried Opium should 
 contain 13 to 15 per cent, of Morphine instead of 10 per cent, as required by the Phar- 
 macopoeia of 1870. The liquid preparations, except Paregoric, are now directed to be of 
 the uniform Opium-strength of 10 per cent., and to yield, on being assayed, 1.3 to \ l / 2 
 per cent, of crystallized morphine, making the Wine less strong by 2 per cent., the 
 Acetum fully ]^ less in strength, and the other liquid preparations stronger by y z in 
 Morphine than formerly. So that if the full anodyne dose of Tincture (1870) be taken 
 at 24 minims, equalling gr. ^ of Morphine Sulphate, the corresponding dose under the 
 present system will be 16 minims.] 
 
 Official Preparations of Morphine. 
 
 H 2 0, — white, prismatic crystals, or fine needles, 
 or a crystalline powder, odorless, of bitter taste and alkaline reaction, almost insoluble in 
 water, soluble in 300 of alcohol. Its comparative insolubility makes the salts preferable 
 for use, and as a very small proportion of acid neutralizes it, the dosage is about the same 
 for the alkaloid and its salts, viz., gr. ^-%x. j. Gr. \-\ is about equal to one grain of 
 Opium of medium Morphine-strength. [Compare Morphines Sulphas, below.] 
 
 Morphinae Acetas, Morphine Acetate, — a white, crystalline or amorphous powder of 
 faintly acetous odor, bitter taste, neutral or faintly alkaline reaction, soluble when fresh 
 in 2.y z of water and in 47.6 of alcohol at 59 F. Dose, gr. J^ — j . 
 
 Morphinae Hydrochloras, Morphine Hydrochlorate, — white, feathery crystals of 
 silky lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 62 of 
 alcohol at 59 F. Dose, gr. J^-j. 
 
 Morphinae Sulphas, Morphine Sulphate, — white, feathery, acicular crystals of silky 
 lustre, of bitter taste and neutral reaction, soluble in 21 of water and in 702 of alcohol 
 at 59 F., and in 0.75 of boiling water. Contains about 80 per cent, of Morphine. 
 Dose, gr. Jg— gr. j ; ^- y$ being a small dose for an adult, yi~ l /( a moderate one, % to % 
 a full dose, and j^-j a large one. 
 
 Pulvis Morphinae Compositus, Compound Powder of Morphine, Tally's Pow- 
 der, — has of Morphine Sulphate I part to 19 of Camphor and 20 each of Liquorice and 
 Calcium Carbonate. A similar preparation to Dover's powder minus the Ipecac. Dose, 
 gr. v-xv, ten grains containing gr. i/<3 of Morphine Sulphate. 
 
 Trochisci Morphinae et Ipecacuanhae, Troches of Morphine and Ipecac, — each 
 has gr. ? L of Morphine Sulphate with gr. yL of Ipecac, also Sugar, Oil of Gaultheria 
 and Mucilage of Tragacanth. Dose, one every hour or so ; cautiously with children. 
 
 Injectio Morphinae Hypodermica, Hypodermic Injection of Morphine (B. P.), — 
 is a solution of the Acetate, containing gr. j in each ten minims, being thrice as strong 
 asMagendie's solution. Dose, TT\j-iij. 
 
 Tinctura Chloroformi et Morphinae, Tincture of Chloroform and Morphine, (B. 
 P.), — a substitute for Chlorodyne. See ante, page 261 and also the table on Chlorodyne 
 in the Appendix. 
 
 Unofficial Preparations of Opium and Morphine. 
 
 Liquor Opii Compositus, Compound Solution of Opium (Squibb), — has the same 
 strength as the official tinctures, namely gr. vj of Morphine (equalling gr. vijss of the 
 Sulphate) to each fluidounce. TT\xyj = gr. % °f Morphine Sulphate. 
 
opium. 399 
 
 Tinctura Opii Composita, Compound Tincture of Opium, Squibb 1 s Diarrhea Mix- 
 ture, — has of Tinct. Opii, Spt. Camphorae and Tinct. Capsici !§j of each, Purified 
 Chloroform giij, Stronger Alcohol q. s. ad ^v. Each fig or teaspoonful contains 
 about ioo drops or n\xij of each of the first three ingredients and TTLivss or 1 8 drops of 
 Chloroform. Dose, for infants gtt. j-x, for children gtt. x-xxx, for adults 3 ss-j. 
 
 Liquor Morphinae Sulphatis, Solution of Morphine Sulphate, Magendie's Solu- 
 tiou, — has gr. xvj of Morphine Sulphafe in each fl^, or gr. j in TTLxxx, or gr. % in 
 TT\vijss. If made with Benzoic Acid, the solution will not spoil, and is not irritant hypo- 
 dermically. The same result is attained by adding of Carbolic Acid, mjij to the 3 . 
 
 Oleatum Morphinae, Oleate of Morphine, — Morphine-strength 10 per cent, with 
 Oleic Acid 90. For local use. 
 
 Liquor Opii Sedativus, Sedative Solution of Opium, Battlef 's Sedative, — is about 
 50 per cent, stronger than Tinct. Opii. It was formerly a favorite preparation. 
 
 Dalby's Carminative,— contains Opium, about gr. A to the ounce, also Oil of Pep- 
 permint, Nutmeg, Anise, and Magnesium Carbonate. 
 
 Godfrey's Cordial, — contains Laudanum, Sassafras and Treacle, its opium strength 
 being gr. \ to the ounce. 
 
 Nepenthe, — is a purified alcoholic solution of Morphine Meconate in sherry wine. 
 
 Chlorodyne, — (see ante, page 261, and Appendix), contains Morphine in varying 
 proportion, that of J. Collis Browne having gr. vj to the ounce. 
 
 Mrs. Winslow's Soothing Syrup, — contains Morphine, with Essence of Anise and 
 Syrup of Tola. After years of persistent denial, its proprietors have admitted that it 
 contains \ grain of Morphine in each fiuidounce (Squibb). 
 
 Derivatives of Morphine. 
 
 Apomorphinae Hydrochloras, Apomorphine Hydrochlorate, C 17 H 1T N0 2 HC1, — is 
 the hydrochlorate of an artificial alkaloid (Apomorphine) which is prepared from mor- 
 phine or codeine by the action of strong acids or zinc chloride, the morphine losing in 
 the process a molecule of water. The Hydrochlorate occurs in minute, colorless crystals, 
 odorless, of bitter taste, and neutral or faintly acid reaction ; soluble in about 45 of water 
 and in the same quantity of alcohol at 59 F., almost insoluble in ether or chloroform ; 
 decomposed by boiling water or boiling alcohol. Dose, gr. -^V to ro hypodermically, 
 gr. -^ to J by the mouth. For young children, gr. g- 1 ^ to Jq should not be exceeded. 
 Solutions should be fresh when used, and as they alter rapidly by keeping should have a 
 few drops of hydrochloric acid added to them, to prevent decomposition. 
 
 Peronine, Benzyl-morphine, (Unofficial), — is the hydrochloride of the benzyl ether 
 of morphine, and occurs as a white powder, soluble in water, insoluble in alcohol, chlo- 
 roform or ether. It produces sound sleep without previous excitement, and has been 
 useful in allaying cough, also in relieving rheumatic and neuralgic pains. It is almost 
 free from the by-effects of morphine. Dose, gr. V^-j in pill or in aqueous solution. 
 
 Heroine, Diacetyl-morphine, (Unofficial), — is an acetic ester of morphine and occurs 
 as a fine, white powder, insoluble in water but soluble in dilute acids. It resembles 
 codeine in its effects but has a stronger action on the respiratory centre. It has been very 
 efficient in coughs, pain in the chest and catarrhal affections of the respiratory tract 
 (Dreser). Dose gr. T C-l in pill or powder, or in aqueous solution with a few drops of 
 diluted acetic acid. 
 
 Dionine, (Unofficial), — is the hydrochloride of the mono-ethyl-ester of morphine, and 
 occurs as a white, crystalline powder, very soluble in water and may be used hypoder- 
 mically. It possesses some of the narcotic properties of morphine without its intensity, 
 and is recommended in the treatment of the morphine habit, since tolerance is not estab- 
 lished by its continued use. It has been employed against cough in phthisis, bronchial 
 affections and pneumonia. Dose, gr. y£- j. 
 
 Other Alkaloids and their Preparations. 
 
 Codeina, Codeine, C 18 H 2] NO s -+- H 2 0, — white or yellowish-white, rhombic prisms, 
 efflorescent in warm air, of bitter taste and alkaline reaction, soluble in 80 of water 
 and in 17 of boiling water, very soluble in alcohol, chloroform and ether. This alka- 
 
400 OPIUM. 
 
 loid is official. Dose, gr. X~') ss > hut § r - h nas caused alarming symptoms in chil- 
 dren. Much of the so-called codeine in the market consists largely of morphine. 
 
 Codeinae Phosphas, Codeine Phosphate, (Unofficial), — white crystals of slightly bit- 
 ter taste, soluble in 4 of water and in 200 of alcohol. Is the most soluble salt of codeine 
 and comparatively unirritant, hence it is well suited for hypodermic use in solution of 1 
 part in 20 of water. Dose, gr. X~J SS - 
 
 Syrupus Codeinae, Syrup of Codeine, (Unofficial), — has of Codeine Phosphate gr. 
 xxxij, dissolved in Distilled Water gijss, adding Syrup to 3XVJ. Of this %] contains gr. 
 £ of Codeine Phosphate. Dose, 3J-iv. 
 
 Narcotinae Hydrochloras, Narcotine Hydrochlorate, (Unofficial), — Dose, gr. ij-x, 
 as an antiperiodic. 
 
 Children bear Opium badly, and for them its proportionate dosage 
 should be much below that for other agents. Morphine should not be 
 given to children below 10 years of age, and never hypodermically to 
 those beneath the age of 15. Opium given to a nursing mother will affect 
 the child, being partly excreted in the milk. 
 
 Reactions and Inco?npatibles. 
 
 An aqueous or alcoholic preparation of Opium reddens litmus paper (free meconic 
 acid); gives a deep red color with Feme Chloride (meconic acid) ; forms precipitates 
 with Lead Acetate, Silver Nitrate, Zinc, Copper, and Arsenic (meconates, sulphates, and 
 coloring matter) ; forms a precipitate with tincture of Galls or astringent preparations 
 (tannates of morphine and codeine ) ; and becomes turbid with the fixed Alkalies, Car- 
 bonates, Alkaline Earths, and Ammonia (precipitated morphine and narcotine). 
 
 Tests for Alorphine. 
 
 Nitric Acid produces an orange-red color, turning yellow, then disappearing. Test- 
 solution of Ferric Chloride gives a blue color changing to green with excess of the 
 reagent, and destroyed by free acids or alcohol, but not by alkalies. Iodic Acid liberates 
 Iodine which may be tested by starch. Vaughn has shown that certain intestinal 
 ptomaines will give the same reactions with these reagents. 
 
 Physiological Action. 
 
 Opium is analgesic, hypnotic, antispasmodic, diaphoretic and narcotic. 
 It first stimulates and afterwards depresses the cerebrum, heart and respir- 
 atory apparatus, and is classed among the cerebral depressants. 
 
 In medium dose (gr. j) it arrests all the secretions except the milk and 
 sweat, the latter being increased ; producing dryness of the mouth and 
 throat, retarded digestion from decrease of the gastric juice, and decided 
 loss of appetite. The action of the heart is increased, arterial tension is 
 raised and the pupils are slightly contracted. The cerebral faculties are 
 stimulated to a pleasant activity by increased blood supply, ideas follow 
 each other rapidly through the mind, and an exhilaration bordering on 
 mild intoxication is experienced, succeeded by a calm of variable length. 
 Sleep generally follows, disturbed by dreams, and after waking, headache, 
 malaise, constipation, digestive disturbance and some depression result. 
 The conductivity of the nerves is not affected. Frequently the stage of 
 mental activity is absent, but in persons habituated to the use of Opium 
 it is usually well marked. In some subjects a lengthened period of calm 
 
OPIUM. 401 
 
 repose takes the place of sleep, in others neither calm nor sleep occurs, 
 but the stimulant action of the drug prevails, the spinal functions as well 
 as the cerebral are exalted, and great restlessness results. 
 
 In full dose (gr. iij-v) the same symptoms are produced but in greater 
 intensity; the stage of stimulation is much shorter, digestion is arrested, 
 nausea and vomiting produced, also profuse diaphoresis. The conduc- 
 tivity of the nerves is more or less impaired, the heart and circulation 
 depressed, oxidation being interfered with and the body-temperature 
 lowered. The pupils are contracted by stimulation of the motor oculi 
 through the basal ganglia, intense pruritus is produced, especially at the 
 nose, and often spasmodic retention of the urine. Profound sopor soon 
 comes on, with irregular and slow respiration, but in some subjects this is 
 replaced by coma-vigil and delirium. After-effects are nausea, depression, 
 constipation, racking headache, vertigo, anorexia, nasal pruritus, and fetid 
 pathological secretions. 
 
 A toxic dose produces cold and clammy sweat, very slow pulse, slow and 
 stertorous respiration gradually becoming feeble and irregular, cyanosed 
 face, abolished reflexes, coma gradually deepening, the pupils minutely 
 contracted but dilating as the end approaches, and finally death by par- 
 alysis of the respiratory centre due to direct action on the medulla. Post- 
 mortem examination shows only a wet brain, congested lungs, and 
 engorgement of the venous trunks and of the right heart. 
 
 The coma produced by opium-narcosis, when deep and when a history of the case 
 cannot be obtained, is almost impossible of differential diagnosis from that due to alcohol, 
 apoplexy, uremia, epilepsy, etc. [See under Alcohol, ante, page 137.] The odor of 
 the breath may point to laudanum or some other preparation of opium. The pupils are 
 very much contracted in opium poisoning (also from physostigma and chloroform), but 
 they may dilate just before death (as with chloroform), due to the irritation of the centres 
 by the excessive venous condition of the blood. In alcoholic coma they may be either 
 contracted or dilated ; and in apoplexy they are generally contracted unequally, though 
 in apoplexy of the pons varolii they may be equally and minutely contracted. The rectal 
 temperahire may be an important sign, for in most cases of apoplexy there is an initial 
 fall of temperature with a subsequent rise. A previous history of convulsions points to 
 epilepsy, and the presence of albumin in the urine, with sometimes edema of the legs, 
 indicates uremia as the cause of the coma. 
 
 The principal action of Opium is exerted upon the nervous system, first 
 affecting the cerebral convolutions, which are briefly stimulated and soon 
 depressed. Next the perceptive and sensory centres in the higher brain 
 are blunted, and the conductivity of the afferent nerves is impaired. Soon 
 the ganglia at the base of the brain are involved, evinced by the con- 
 traction of the pupils, vomiting, and slowing of respiration ; the cardiac, 
 vascular and other centres are depressed, but to a less degree than the 
 respiratory and perceptive. The gray matter of the cord, at first stimu- 
 lated, as shown by the increase of reflex excitability, is also depressed, 
 and locomotion becomes difficult, the motor nerves being paralyzed from 
 26 
 
402 OPIUM. 
 
 the centie outwards, but muscular irritability is never lost. Death occurs 
 generally by paralysis of the respiratory centre, rarely by sudden cardiac 
 failure. 
 
 Metabolism is greatly reduced in activity by Opium, the quantity of 
 urea excreted being markedly lessened, and the biliary and glycogenic 
 functions of the liver being affected, resulting in whitish stools, perhaps 
 jaundice, and certainly decided decrease of the sugar excreted by diabe- 
 tics when the drug is given to them by the stomach. 
 
 The vaso-motor centre is slightly, if at all, affected by small doses of 
 Opium, but large doses paralyze it. On the vessels of the skin the first 
 effect of the drug is to cause their dilatation, shown by turgescence of the 
 vessels of the external ear and a sense of heat therein, and often giving 
 rise to a roseolous cutaneous eruption accompanied by itching. The 
 long-continued use of opium causes a marked contraction of the capillaries 
 and arterioles throughout the body, the skin is excessively pale and the 
 subject always feels cold at the ordinary temperature of the atmosphere. 
 
 On the uterine and generative functions Opium exerts a marked influ- 
 ence, stopping menstruation if its use be continued, and in men causing 
 impotence. Both male and female functions, however, return as soon as 
 the drug is discontinued, but the female organs of generation suffer atro- 
 phy from its long-continued use. In one case, intra-uterine measurements, 
 taken during a period of two years, showed a diminution in the size of 
 the cavity from 5.1 to 1.9 inches. 
 
 The hypnotic action of Opium is now believed to be produced by a 
 double influence, (1) on the vascular system, causing anemia of the brain, 
 (2) on the cerebral cells, diminishing their activity, and consequently 
 lessening their demand for blood. Its constipating action is shown 
 experimentally to be produced by stimulation of the inhibitory nerves 
 of the intestines through the splanchnics. 
 
 Morphine was discovered by Serturner in 181 7. Its action is generally 
 similar to that of Opium, it being the principal alkaloid therein, but when 
 used by itself its influence is not complicated with the effects of the con- 
 vulsive alkaloids (thebaine, codeine and narcotine) which must influence 
 the action of opium to a considerable degree. As compared with the 
 latter, Morphine acts more quickly, and for a shorter time, has less influ- 
 ence on the intestines and skin, is less constipating, less stimulating, less 
 convulsant and less diaphoretic, but more sedative, more anodyne and 
 hypnotic and produces more intense pruritus. Its elimination commences 
 quickly but may not be completed for as much as 48 hours, and is effected 
 by the intestines, the urine, and the salivary glands. It is also eliminated 
 by the gastric mucous membrane, and constantly reappears in the stomach 
 until finally excreted. When injected hypodermically more than one-half 
 the amount administered may be recovered by repeatedly washing out 
 
OPIUM. 4O3 
 
 the stomach. It is probably retained in the organism to a great extent 
 when the action of the kidneys is defective, and when given continuously 
 in renal disease may accumulate with fatal result. 
 
 Apomorphine in dose of gr. -^ given hypodermically is a systemic 
 emetic, acting directly on the vomiting centre, and is the quickest, most 
 certain and least irritating of all emetics, acting in from five to twenty 
 minutes with but moderate nausea. In large dose it is very depressant to 
 the heart, gr. J- having caused death in a weak adult by cardiac failure, 
 and produces paralysis of the motor and sensory nerves, delirium, convul- 
 sions, and depression of respiratory power. Small doses (gr. 3L-) given 
 by the mouth are expectorant, and the same quantity, administered hypo- 
 dermically, is said to have a hypnotic effect lasting from one to two 
 hours. Morphine in solution kept for a long time may become changed 
 into Apomorphine. 
 
 Codeine differs chemically from Morphine in having the radicle methyl 
 (CH 3 ) replacing an atom of hydrogen, and may be considered a methyl- 
 morphine. Like all methyl compounds it possesses motor-paralyzant 
 power, like that of Curare. On man it has some hypnotic action, but 
 far less than that of morphine. It exalts the spinal cord more than mor- 
 phine does, producing muscular tremor in excess of its sedative action. 
 It has a special sedative influence on the pneumogastric nerve, contracts 
 the pupils, and is remarkably analgesic to the nerves of the abdominal 
 and pelvic viscera. When administered for several consecutive days it 
 lessens the irritability of the digestive tract to such an extent that arsenic 
 produces neither vomiting nor purging (Murrell). It markedly reduces 
 the amount of sugar excreted by diabetics, but has no advantage over 
 morphine in that respect. 
 
 Narcotine should be named Anarcotine, as it has little or no narcotic 
 power. It is a convulsant in animals and an antiperiodic in man. 
 
 Narceine is said by some observers to be remarkably hypnotic, and 
 free from convulsant action — by others equally deserving of credit it is 
 considered almost inert. This alkaloid is difficult to obtain pure, hence 
 the samples heretofore used have probably been contaminated with other 
 alkaloids. It is said to possess laxative properties. 
 
 Thebaine is a powerful convulsant, exalting the spinal cord almost like 
 Strychnine and Brucine. It is not used medicinally. 
 
 Cryptopine is said to dilate the pupils, a remarkable property if true. 
 
 Fatal Doses. 
 
 In a child one day old TT\J of Laudanum caused death. A medicinal dose given to a 
 nursing mother proved fatal to the infant. A few drops of Paregoric have killed a child 
 of nine months. In the adult gr. y^ of Morphine in one case, and gr. iv of crude Opium 
 in another, have proved fatal. 
 
404 opium. 
 
 Antidotes, Antagonists and Treatment of Poisoning. 
 
 Potassium Permanganate is the best antidote to Opium or Morphine in the stomach, 
 given in dose about one-half greater than the quantity of morphine present, and repeated 
 in less quantity from time to time in cases where the poison has been administered hypo- 
 dermically so as to neutralize the morphine excreted by the gastric mucous membrane. 
 If an Opium preparation has been taken, or the alkaloid Morphine itself, Vinegar should 
 be added to the permanganate solution in order to convert the alkaloid into a soluble salt. 
 [For other antidotes see Part III.] Atropine antagonizes the cerebral action of 
 Morphine, also its action on the pupils, respiration, heart and arterial tension, but if given 
 too freely will endanger the case by substituting Belladonna-narcosis for Opium-narcosis ; 
 gr. T i ff hypodermically every fifteen minutes for three doses, is generally sufficient. It is 
 unsafe to be guided in this respect by the pupils. Caffeine is also physiologically antago- 
 nistic, and is generally used in the form of strong black coffee frequently administered. 
 
 The Chief Indications in opium or morphine poisoning are — to antidote any of the 
 poison in the stomach, and to wash out that viscus repeatedly at short intervals, to main- 
 tain respiration and keep up the circulation. [See the article on Poisoning in Part III.] 
 Strychnine is an efficient antagonist to the respiratory paralysis, and may be used in lieu 
 of Atropine, or in connection therewith. Amyl Nitrite should also be used when the 
 heart shows signs of failure. Capsicum, the tincture, ^ ss-j by injection into the rectum, 
 is said to give almost instantaneous results in antagonizing the stupor of opium poisoning. 
 
 Therapeutics. 
 The chief indications for the use of Opium are — (i) to relieve pain from 
 any cause except acute inflammation of the brain ; (2) to produce sleep, 
 particularly in the insomnia of low fevers with delirium, in which the 
 combination of Morphine and Chloral is very efficient ; (3) to allay irri- 
 tation in the various forms of acute nervous erethism ; (4) to check ex- 
 cessive secretion, as in diarrheas, dysentery, diabetes, ptyalism, etc. ; 
 (5) to support the system in low fevers and other adynamic conditions, 
 when sufficient food cannot be retained ; (6) as a sudorific, to produce 
 sweating in coryza, etc. It is considered of especial value in any irrita- 
 tion of the stomach, bladder or bronchi, in severe vomiting, both forms 
 of diabetes, gastralgia, colic and muscular spasm. In diabetes mellitus 
 Morphine by the mouth reduces the sugar promptly, but when used hypo- 
 dermically it has little or no effect thereon, even in the same case. In 
 peritonitis and inflammation of other serous membranes, used freely even 
 to narcotism it has often saved life. In cerebro-spinal meningitis it is the 
 one remedy if given early, before exudation has set in. Cholera morbus 
 and dysentery are efficiently treated by Morphine and Atropine hypoder- 
 mically (gr. 1 with gr. y^-) after the ingesta have been removed by purg- 
 ing. In acute uremia its use in large doses is recommended by Loomis 
 to control convulsions and promote diuresis, but here it is a dangerous 
 agent. In muscular rheumatism and acute colds Dover's powder as a 
 diaphoretic, conjoined with hot drinks and foot-baths, is old but excel- 
 lent treatment. In chronic mania and melancholia, nervous prostration 
 and the delirium of fevers, Opium is one of the best hypnotics. In 
 acute mania it does not act so well as Hyoscine, and in delirium tremens 
 it should be used only in cases which show great prostration, and then 
 
OPIUM. 405 
 
 for temporary effects alone, as a stimulant. In chronic melancholia 
 small doses of Opium three times a day give better results than any other 
 treatment. Severe pain from any cause (except cerebritis) is relieved by 
 Opium with an efficiency possessed by no other drug, as the pain of sci- 
 atica, neuralgia, lumbago, cancer, renal and hepatic colic from calculi, 
 etc. Cough of harassing and frequent character with but little secretion 
 is best treated by Opium, but when there is profuse expectoration it 
 should not be used, as the lowering of excitability of the respiratory cen- 
 tre which it produces would be dangerous in such a case. In nearly all 
 acute inflammations it is valuable, especially when it becomes advisable 
 to lock up the bowels. Its tranquilizing power over the circulation 
 makes it invaluable in the various forms of hemorrhage, while in that 
 from uterine fibroids and cancer the implanting of the opium-habit is 
 deserving of consideration as a beneficial measure, as it checks and 
 even stops the bleeding, as soon as established. Dyspnea from any 
 cause is relieved by Morphine, especially that of cardiac disease. " It 
 gives the power to breathe" (Huchard). In cardiac disease, especially 
 aortic stenosis or insufficiency, with dyspnea, paroxysms of angina pec- 
 toris, or signs of cerebral anemia, — Morphine hypodermically presents 
 the greatest advantages. 
 
 Apomorphine, though a derivative of Morphine, is not narcotic in 
 any degree. Administered by the mouth in small doses, gr. 3 1 - 2 1 o ? it is 
 a valuable expectorant and given hypodermically in doses of gr. -^ it is 
 a powerful emetic. Its therapeutic value depends chiefly on these two 
 properties and has many applications in practice. As an emetic it is of 
 much service in poisoning, especially when swallowing is difficult, and it 
 may be used with advantage in narcotic poisoning before narcosis has 
 blunted the vagus centre. It is a very valuable agent in any case of pois- 
 oning where time is of great importance. As an expectorant it is one of 
 the most efficient and useful agents at our command. In catarrh of the 
 bronchi gr. -^ by the mouth every three or four hours is very beneficial, 
 but the drug must be used in all cases with caution, especially in young 
 children, who bear it very badly. In hacking coughs without expectora- 
 tion it will prove very serviceable, if given in very minute doses, not 
 exceeding gr. -^ in the entire 24 hours. In phthisis it may be given in 
 combination with morphine with great advantage, especially in cases 
 where there are dyspnea, continual and harassing cough, and thick, tena- 
 cious expectoration. The two agents do not destroy each other's action, 
 but from the combination we get increased secretion from the mucous 
 membrane, with diminished irritability of the respiratory centre and con- 
 sequently lessened cough (Brunton). Apomorphine has been used success- 
 fully, by hypodermic injection, as an antidote to strychnine in dogs ; and 
 in one case, in which it was given in mistake for morphine, it entirely 
 
406 opium. 
 
 dissipated an acute and severe attack of sciatica. In small doses, gr. -fa 
 hypodermically, it has been used as a hypnotic, and is said to produce a 
 sleep lasting from one to two hours (Douglas). 
 
 Codeine is much employed as a palliative for cough, especially the 
 irritable, hacking cough of phthisis unaccompanied by much expectora- 
 tion. It seems to have a special influence on the nerves of the larynx, 
 and will relieve a tickling cough better than any other form of opium, if 
 given in one dose of gr. ^ an hour before bed-time. In vomiting from 
 almost any cause, doses of gr. fy, repeated two or three times at hourly 
 intervals, are usually very efficient. In the milder forms of diarrhea, 
 gr. y 2 to gr. j will generally check the disorder without inducing any 
 unpleasant after-effects. In diabetes Codeine lessens the amount of sugar 
 in the urine and often removes it entirely, but it must be given in large 
 doses, beginning with gr. ij-iv, and rapidly increasing to gr. xv or xx. 
 It is highly efficient in abdominal and pelvic pain, especially when ovarian 
 in origin. 
 
 Applications of the Various Preparations. 
 
 Superficial pain is often alleviated by the plaster or by extemporaneous 
 liniments containing laudanum or some other fluid preparation. It is, 
 however, very doubtful whether such applications are of direct value, as 
 morphine is not absorbed by the unbroken integument; but the oleate 
 is said to be very penetrating. Intense pain, as from the passage of cal- 
 culi, is best met by the hypodermic injection of morphine sulphate in 
 full doses (gr. %-%) with atropine sulphate (gr. y-J-g-). Either the solu- 
 tion of morphine or the liquid preparations of opium may be given 
 by the mouth in corresponding doses for the same purpose. Severe pain 
 enables the system to resist the action of opium, which in such cases 
 should be repeated at short intervals for effect, regardless of dosage. 
 
 Sedative action is obtained by different preparations for various organs. 
 The stomach is best affected by the solution of morphine in effervescing 
 mixtures, the extract in a small pill, or morphine given hypodermically 
 over the epigastrium. The intestines may be influenced by laudanum 
 in an enema of starch, or internally by Dover's powder, pulvis opii, or 
 pil. opii, especially the latter with or without calomel, as an astringent 
 when the bowel must be quieted, as in peritonitis, hernia, intussuscep- 
 tion, etc. The rectum and other pelvic organs are promptly affected by 
 a suppository of the extract of opium, gr. ^(, with gr. -^ of the extract 
 of belladonna. The ovaries and the abdominal and pelvic organs gener- 
 ally are markedly susceptible to the analgesic action of codeine in doses 
 of gr. j to gr. ij for an adult in severe pain. 
 
 To produce sleep the most efficient preparations are the tinctures, the 
 solution of morphine, pil. opii and Dover's powder, in doses correspond- 
 ing to the degree of insomnia and restlessness present. 
 
ORIGANUM. 407 
 
 Cough is relieved by the two trochisci, the tinctures, and by the solu- 
 tion of morphine in small doses with syrup of wild cherry or syrup of 
 tolu ; also by codeine in the last-named syrup. Diaphoresis is obtained 
 by the use of Dover's powder in either of its forms. 
 
 Ad?ninistration. 
 
 Probably no drug in the materia medica is so useful as Opium or has 
 so wide a range of application. At the same time no other drug requires 
 such careful handling, by reason of the many influences which modify 
 its action and uses. As before pointed out, children are extremely sus- 
 ceptible to its narcotic action, and women are more easily affected by it 
 than men. Many persons are found with idiosyncrasies in respect to 
 opium, some being easily narcotized, others being remarkably insusceptible 
 to its action, and many suffer from a decided shock after its hypodermic 
 administration, which may even produce alarming symptoms of collapse. 
 In subjects of kidney disease it may accumulate and act more powerfully 
 than expected, and generally it may be said to be contraindicated ox to be 
 used with great care in alcoholism, congestion of the brain, and advanced 
 disease of the respiratory organs, heart and kidneys. 
 
 The conjoint administration with opiates, of the spiritus aetheris, spir- 
 itus getheris compositus, or spiritus aetheris nitrosi, an equal part with 
 tinctura opii deodorati, will prevent the nausea often excited by the latter, 
 and correct the drying-up effects of opium, due to its checking secretion. 
 Some of its cerebral effects, as vertigo and mental confusion, are removed 
 by a full dose of potassium bromide, others are antagonized by quinine, 
 and the general intra-cranial effects of the drug are to some extent 
 opposed by digitalis and tartar emetic. 
 
 Morphine and Atropine are sufficiently antagonistic to each other to 
 make their combination extremely valuable as a therapeutic measure, and 
 their use as mutual antidotes in poisoning by either a most efficient pro- 
 cedure if employed with due precautions. When morphine is given as a 
 hypnotic or an anodyne, atropine should always be administered at the 
 same time in the proportion of gr. T yt~~tq~o °^ t ^ ie ^ atter t0 g r - }i °f tne 
 former. By this means the anodyne and hypnotic qualities of morphine 
 are increased, while the nausea and depression with the subsequent dys- 
 pepsia and constipation due to it are avoided. Moreover, as in the doses 
 above mentioned atropine is a cardiac and respiratory stimulant, it will 
 counteract the depressing tendency of morphine on the heart and respi- 
 ration in subjects who have undue susceptibility to its action. 
 
 ORIGANUM, Wild Marjoram (Unofficial), — is the plant Origanum vulgare, 
 a perennial herb of the nat. ord. Labiatae, native of Europe and America. It contains a 
 Volatile Oil, some tannin, resin, and a bitter principle. The oil was formerly much used 
 
408 OXYGENIUM. 
 
 and was official, but it is now superseded by the Oil of Thyme. Origanum is an ingre- 
 dient of Vinum Aromaticum. Dose, 3J-ij, in infusion. 
 
 Origanum is gently tonic, also carminative, stimulant, and emmenagogue. It was 
 formerly much employed as a diaphoretic, etc., but is now rarely administered. 
 
 OXYGENIUM, Oxygen, O. This element is not official though 
 it is extensively used in medicine. Its two combinations with Hydrogen, 
 Water H 2 0, and Hydrogen Dioxide H 2 2 , are official, as are also nine 
 other Oxides, namely — those of Antimony, Barium, Ethyl, Iron, Lead, 
 Manganese, Mercury, Silver and Zinc. It enters into the composition of 
 most of the acids and their salts, many of the organic bases, and all the 
 alkaloids except a few. 
 
 Oxygen is the most universally diffused element in nature, forming about one-fifth of 
 the atmosphers, one-third of water, and a great part of the earth and of the tissues of 
 plants and animals. It is a colorless, odorless, and tasteless gas, of sp. gr. 1. 1057, and 
 can be liquefied by subjection to extreme cold and pressure combined. It was discovered 
 by Priestley in 1 774, and given its name, Oxygen (acid producer) by Lavoisier in 1778. 
 It may be obtained pure from many of its combinations, but is usually prepared by heat- 
 ing Manganese Dioxide or Potassium Chlorate, or preferably both together. It is 
 furnished by manufacturing chemists in all large cities, compressed in iron cylinders 
 furnished with a rubber bag and mouth-piece by which to administer it. 
 
 Ozone, 3 (Unofficial), — is an allotropic form or condensed condition 
 of Oxygen, three atoms of which are contained in a molecule of the 
 former, instead of two as in the molecule of oxygen. Ozone exists in 
 the atmosphere in the general proportion of 1 part in 10,000, but it is 
 more abundant in the open country and on the ocean than in the air of 
 cities. It is formed when an electric spark is passed through air, being 
 then manifested by its peculiar odor. In the sick-room it may be pro- 
 duced by dissolving in water a mixture of Manganese Dioxide, Potassium 
 Permanganate and Oxalic Acid. 
 
 Official Preparations. 
 
 Aqua Hydrogenii Dioxidi, Solution of Hydrogen Dioxide, Solution of Hydrogen 
 Peroxide, commercially known as "Peroxide of Hydrogen," — consists of water to which 
 nascent Oxygen has been presented, whereby an additional atom thereof has entered 
 into combination with the hydrogen, producing H 2 2 . It is officially described as a slightly 
 acid, aqueous solution of Hydrogen Dioxide, containing when freshly prepared about 
 3 per cent, of the pure dioxide, corresponding to about 10 volumes of available oxygen ; 
 and is directed to be prepared by agitating Barium Dioxide in cold distilled water, add- 
 ing Phosphoric and Dilute Sulphuric Acids, filtering and diluting to the required strength. 
 The commercial article is said to contain about 15 volumes of available oxygen, and to 
 be permanent at ordinary temperatures ; but it undergoes decomposition in time, especially 
 if agitated. It occurs as a colorless liquid, without odor, slightly acidulous, producing a 
 peculiar sensation and soapy froth in the mouth, and liable to deteriorate by age, heat or 
 protracted agitation. Dose, ^j-iij, diluted with 3 to 4 parts of water. 
 
 Aqua, Water, H 2 0, — is described under its own title. 
 
 Oxides of Antimony, Ethyl, Iron, Lead, Mercury, Silver and Zinc, and the Dioxides 
 of Barium and Manganese, are described under the titles of their metallic bases. 
 
 Unofficial Preparations. 
 
 Glycozone is claimed to be a stable compound resulting from the reaction between 
 chemically pure glycerin and 1 5 times its volume of ozone ; and not a mixture of hydro- 
 
OXYGENIUM. 4O9 
 
 gen dioxide with glycerin. It is very hydroscopic, and must be kept tightly corked, to 
 prevent deterioration. It is said to act upon diseased tissue in the same manner as 
 Hydrogen Dioxide (which see), but more slowly, and may be used in full strength as 
 an application to wounds or suppurating surfaces, to stimulate healthy granulations, and 
 generally as an antiseptic surgical dressing. It is mixed with water (1 to 10) as a rectal 
 injection ; and may be administered internally, in doses of ^j-ij in a wineglassful of 
 water, in gastric affections, as dyspepsia, pyrosis, ulcer and catarrh of the stomach. 
 
 Pyrozone is the name given by a well-known manufacturer to a concentrated solution 
 of Hydrogen Dioxide in Ether. It is said to contain about 50 per cent, of the dioxide 
 and is a very potent and efficient oxidizer, intended for external use only. It has abun- 
 dant applications in the practice of surgeons. ( Squibb. ) 
 
 Sanitas is a proprietary solution for disinfecting purposes, containing Hydrogen Diox- 
 ide, and described under Terebinthina. 
 
 Physiological Action. 
 
 Oxygen is essential to respiration, blood-formation, nutrition and tissue- 
 change, in fact to life itself, and to fully describe its physiological action 
 would involve a complete description of these processes, which would 
 be a treatise on physiology. Applied to the unbroken skin it has no ap- 
 parent effect, but when applied to a wounded tissue it increases the circu- 
 lation therein and acts as a stimulant. Inhaled in the pure state (not as 
 air) it causes very little constitutional disturbance. A slight sense of heat 
 is felt in the mouth and may extend along the larynx, trachea and bron- 
 chi. The pulse is usually quickened, but it may be lessened in frequency, 
 the appetite is increased, the temperature is slightly raised and the car- 
 diac action is stimulated ; a sense of mental exhilaration and a disposition 
 to greater bodily activity are produced, but no constant influence on the 
 excretions has been noticed. In some persons it seems to cause nervous 
 symptoms similar to those produced by nitrous oxide gas (Brunton). 
 
 Ozone is a powerful oxidizing and destructive agent. It attacks 
 metals, destroys organic substances and the coagulability of albumin and 
 decomposes blood. It is highly irritant to the tissues, and sets up an 
 acute catarrh of the respiratory mucous membrane if inhaled in quantity. 
 When present in small quantity in the air it is breathed without unpleasant 
 effects and is decidedly soporific (Binz). It is poisonous to low organ- 
 isms, and is therefore an energetic antiseptic and disinfectant. In animals 
 it sometimes quickens and often slows respiration, and produces excite- 
 ment followed by exhaustion, sometimes by convulsions and death. 
 
 Hydrogen Dioxide, in fresh solution, is one of the most powerful oxi- 
 dizing agents known, by reason of the facility with which it parts with 
 oxygen to oxidizable substances brought in contact with it. It is conse- 
 quently a powerful yet non-toxic antiseptic, destroying morbid products 
 and organized ferments to which it is applied. In contact with a suppu- 
 rating surface it generates a white foam, as the result of its action on the 
 pus. This soon subsides, leaving the subjacent tissue cleansed of all 
 morbid secretions. One part added to 1000 of water containing sewage 
 
410 OXYGENIUM. 
 
 or infectious microbes is sufficient to destroy the various organisms if 
 allowed to act thereon for 24 hours. 
 
 Therapeutics. 
 
 Oxygen is efficient as an application to the surface in atonic, scrofulous 
 and syphilitic ulcers, also in cases of senile and other forms of gangrene. 
 Its application to the scalp, by means of a rubber cap fitted to the head, 
 has restored the hair in a case in which it was lost by reason of alopecia 
 areata. Its principal use has been in cases of disease of the respiratory 
 apparatus characterized by dyspnea, as emphysema, bronchial dilatation,, 
 phthisis and gangrene of the lungs, also spasmodic asthma, and asphyxia 
 from the inhalation of toxic gases or due to opium and chloroform nar- 
 cosis. It has been employed with benefit in uremic coma, and in the 
 dyspnea of cardiac disease and that of anemia from loss of blood or 
 from protracted suppuration. It has given good results in diseases char- 
 acterized by defective oxidation, as gout and diabetes ; in the latter affec- 
 tion the sugar sometimes disappears entirely from the urine during its in- 
 halation. It has been used in the treatment of epilepsy and spasm, and 
 is recommended in cholera. 
 
 Ozone has been recommended in cases similar to those for which oxy- 
 gen is used ; also in infectious diseases, as diphtheria, in which it is ex- 
 pected to destroy the pathogenic microbes exposed to its influence. 
 
 Hydrogen Dioxide in solution has long been employed as a bleaching 
 agent for delicate fabrics, and on the human hair for the production of 
 the " bleached blonde" hue so fashionable lately in certain circles of 
 society. As a cleansing agent for foul wounds, ulcers, sores, and the like, 
 it is highly efficient ; and has been used with great benefit as a gargle or 
 spray to the throat and nasal passages, in quinsy, croup, diphtheria, scar- 
 let fever, ozena, and other morbid conditions of these parts. As a diag- 
 nostic agent in determining the presence of pus, it is injected into the 
 part in which suppuration is suspected, and indicates its contact with pus 
 by causing an almost immediate swelling up of the part. If such a spot 
 is cut into at once, pain is not felt. In this manner a number of suppu- 
 rating buboes have been treated with great success. As a disinfectant of 
 drinking water suspected of pollution it is highly recommended, as it does 
 not impair the taste or other potable qualities of the water in the small 
 quantity (1 to 1000 parts) needed for its efficient action. Used internally 
 it imparts oxygen to the blood, improves digestion, and relieves spasm of 
 the respiratory apparatus, — aborting the paroxysms of whooping-cough. 
 It gives great relief in chronic bronchitis with dyspnea, and operates well 
 in phthisis by promoting digestion, palliating cough, and giving increased 
 activity to chalybeate remedies. 
 
PARALDEHYDUM PAREIRA. 4 1 I 
 
 PARALDEHYDUM, Paraldehyde, C 6 H 12 3 , a polymeric modi- 
 fication of Ethylic Aldehyde C 2 H 4 0, — is a colorless liquid at ordinary 
 temperatures and is obtained by treating Aldehyde with dilute sulphuric 
 or nitric acid ; aldehyde being the oxidation product of alcohol just pre- 
 ceding the formation of acetic acid. Paraldehyde is soluble in %y 2 of 
 water, and miscible, in all proportions, with alcohol, ether, and fixed or 
 volatile oils. 
 
 The dose of Paraldehyde may be placed at gss-gijss, but the latter quantity has fre- 
 quently been exceeded without any ill effects, with no digestive or cerebral disturbances 
 following, nor any unpleasant symptoms resulting other than a disagreeable odor of the 
 breath. Very few cases of poisoning therefrom, acute or chronic, are recorded. One 
 case, under treatment by Dr. Mackenzie, of Douglas, in the Isle of Man, recovered from 
 a dose of 3^ ounces after 34 hours of sleep, furnishing " a striking testimony to the 
 safety of Paraldehyde as a hypnotic." The average hypnotic dose for an adult is about 
 3Jss, given in ^j of simple elixir. 
 
 Physiological Action and Therapeutics. 
 
 Paraldehyde is a reliable hypnotic, almost equal in this respect to 
 Chloral, though its hypnotic action is not so persistent as that of the latter 
 drug, and it requires more frequent repetition to produce sustained sleep. 
 It is also antispasmodic and diuretic but "not diaphoretic, and is unques- 
 tionably safer than chloral, strengthening and slowing the heart's action, 
 instead of weakening it. Its administration is followed by a well-marked 
 stage of excitement, after which it produces a sound sleep which is de- 
 scribed as refreshing. It does not interfere with the appetite or digestion, 
 but occasionally causes an erythematous eruption ; and may give rise to 
 cerebral congestion and vaso-motor paralysis if used for any long period 
 of time. A toxic dose paralyzes the medulla and the respiratory centre 
 therein. 
 
 Paraldehyde is used as a hypnotic in fevers, rheumatism, acute mania, 
 hysteria and insomnia from various causes, also as an antispasmodic in 
 asthma. Several cases of tetanus have been treated successfully with it, 
 and it has been found useful as a diuretic and hypnotic in a case of senile 
 arterial degeneration with double aortic and mitral regurgitant murmurs, 
 mental depression and very marked insomnia and restlessness. 
 
 Cases of Paraldehyde habit are occasionally seen, and exhibit a train of symptoms 
 similar to those observed in delirium tremens. There is great emaciation and anemia, 
 weak and irregular action of the heart, a soft and intermittent pulse, general muscular 
 weakness, tremulousness and restlessness, the gait feeble and unsteady, mental anxiety, 
 agitation and confusion, temporary loss of memory and incoherent speech, also hallucina- 
 tions of sight and hearing and delusions, all of an unpleasant kind. There is marked 
 gastric derangement, but an abnormally large appetite, excessive flatulence and consti- 
 pation. The treatment of such a case generally takes about three months, and should be 
 conducted in an inebriate asylum. 
 
 PAREIRA, Pareira, Pareira Brava, — is the root of Chondodendroii 
 tomentosum, a climbing, woody vine of the nat. ord. Menispermaceae, 
 
412 PASSIFLORA INCARNATA PEPSINUM. 
 
 with very large leaves and a grape-like fruit, inhabiting Peru and Brazil. 
 It contains Pelosine or Cissampeline, an alkaloid identical with the Ber- 
 berine of Nectandra and the Buxine of Buxus sej?ipervirens (Boxwood). 
 Several other Pareiras are on the market, that from the West Indies QCis- 
 sampelos Pareira) being the plant formerly official in the Br. Phar. 
 
 Extraction Pareirae Fluidum, Fluid Extract of Pareira. — Dose, ^ss-^j. 
 Infusum Pareirae, Infusion of Pareira (Unofficial), — I in 17. Dose, ^j-ij. 
 
 Pareira is diuretic and laxative, stimulating peristalsis and the action 
 of the kidneys. It is eliminated by the kidneys, and passing over the 
 mucous membrane of the genito-urinary tract it acts thereon in a tonic 
 and soothing manner, especially on the bladder. It is particularly useful 
 in chronic cystitis, suppurative kidney diseases, gonorrhea and gleet, but 
 must be used internally, as when injected locally for these affections it 
 has not proved successful. Formerly Pareira was considered an efficient 
 lithontriptic, and in Brazil it is used as a cure for the bites of poisonous 
 serpents, being employed both internally and locally. 
 
 PASSIFLORA INCARNATA, Passion-flower (Unofficial),— is an indigenous 
 plant which is highly esteemed by many American physicians as a calmative, analgesic 
 and hypnotic remedy. It has been administered with satisfactory results in neuralgia, 
 chorea, spasmodic asthma, pertussis, hysteria, dysmenorrhea, insomnia, infantile and 
 puerperal convulsions and the opium-habit. A concentrated tincture is prepared from the 
 whole plant, the dose of which is 3 ss-j every 2 or 3 hours. 
 
 PEPO, Pumpkin-seed, — is the seed of Cucurbita Pepo, or common Pumpkin (nat. 
 ord. Cucurbitaceoe). The active principle is a resin contained in the endopleuron or en- 
 velope immediately surrounding the embryo. It also contains an alkaloid Cucurbitine, a 
 fixed oil, starch, sugar, etc. There are no official preparations. Dose, of the resin, gr. 
 xv ; of the seeds, ^j-ij, beaten up into an emulsion with sugar and water. 
 
 Pumpkin-seed is an efficient agent for the removal of tapeworm, and its use is not 
 followed by unpleasant symptoms. The outer coat of the seed should be removed, and 
 an emulsion then made by trituration with sugar and water. This, if taken on an empty 
 stomach and followed by a brisk cathartic, will generally prove effective. Dr. Squibb 
 maintains that the seeds should not be decorticated, but that husks and all should be 
 swallowed. According to some observers the expressed oil is equally efficient in doses 
 of 3 ss repeated two or three times and followed by a cathartic. 
 
 PEPSINUM, Pepsin, — is the name for the hypothetical digestive 
 principle of the gastric juice. As a definite body it is unknown, the 
 various preparations, official and unofficial, being mere approximations 
 and varying much from each other. It is officially described as a proteo- 
 lytic ferment or enzyme, obtained from the glandular layer of fresh 
 stomachs from healthy pigs, and capable of digesting not less than 3000 
 times its own weight of freshly coagulated and disintegrated egg albu- 
 min, when tested by the official process. 
 
 Pepsin is a fine, white, or yellowish-white, amorphous powder, or thin, pale-yellow, 
 translucent grains or scales, free from any offensive odor ; soluble in about 100 of water, 
 more soluble in water acidulated with HC1, insoluble in alcohol, ether or chloroform. It 
 
PEPSINUM. 413 
 
 usually has a slightly acid reaction, and may be neutral, but should never be alkaline. 
 Commercial Pepsin is usually obtained from a solution prepared by digesting the mucous 
 membrane scraped from the rennet-bags of sheep or the stomach of the pig in acidu- 
 lated water for several days. It is then precipitated by sodium chloride (Scheffer), lead 
 acetate (Boudatilt), or by drying the peptones on glass plates (Beale). It may also be 
 precipitated by alcohol. By Scheffer's process it occurs as a tough, gray, leathery sub- 
 stance, partly soluble in water, one grain dissolving 3000 grains of albumin in a few 
 days. Jensen's Crystal Pepsin, probably prepared after Beale's method, is in yellowish, 
 translucent scales, soluble in water, and reputed to be many times stronger than any 
 other preparation yet obtained. 
 
 Preparations. 
 
 Pepsinum Saccharatum, Saccharated Pepsin, — is Pepsin 1, triturated with 9 of 
 Sugar of Milk. One part should digest at least 300 parts of egg-albumin, when tested 
 by the official process. Dose, gr. v-^j, shortly after meals. 
 
 Liquor Pepsini, Liquid Pepsin (Unofficial), contains of Saccharated Pepsin 40 
 parts, Hydrochloric Acid 12, Glycerin 400, Waterq. s. ad 1 000 parts. Dose, gij-iv. 
 
 Every manufacturer of Pepsin has his own preparation and his peculiar name there- 
 for, such as Liquid Pancreopepsine, Lacto-peptine, Gluco-pepsine, Golden Scale Pep- 
 sin, Peptogenic Milk Powder, etc. They vary considerably in their properties, but all 
 have the power in some degree of digesting albumin and fibrin. 
 
 Lactopeptine (Unofficial), — is claimed to contain Pepsin, Diastase or Ptyalin, Pan- 
 creatin, Lactic and Hydrochloric Acids, and that 3J will digest ^ viij-x or albumin, 
 fibrin, casein, or gelatin, will emulsionize ^xvj of cod-liver oil, and convert 31V of 
 starch into glucose. A proprietary preparation. Dose, gr. v-xv. 
 
 Peptenzyme (Unofficial), — is prepared from the peptic, pancreatic, salivary, Lieber- 
 kuhn's and Brunner's glands and the ferment extract of the spleen and liver, slightly 
 benzoated and mixed with sugar of milk and citric acid. It is claimed for it that it con- 
 tains the active ferments and undeveloped ("mother") enzymes of all the digestive 
 organs or glands, in the same physiological condition as that in which they exist in 
 nature ; that it digests food in an acid, an alkaline or a neutral menstruum ; and that it 
 will digest all kinds of food. It is best administered before meals. 
 
 Analogous Products. 
 
 Pancreatinum, Pancreatin, — is officially described as a mixture of 
 
 the enzymes naturally existing in the pancreas of warm-blooded animals, 
 
 usually obtained from the fresh pancreas of the hog (Sus scrofd). It 
 
 occurs as a yellowish-white or grayish, amorphous powder, of faint odor, 
 
 and meat-like taste ; slowly soluble in water, insoluble in alcohol. It 
 
 consists of four ferments, viz. : (1) Trypsin, the proteolytic ferment, (2) 
 
 Pancreatic Diastase, the amylolytic ferment, (3) a fat-emulsifying, and 
 
 (4) a milk-curdling ferment. Besides the official form it is sold in 
 
 various preparations, as Pancreatic Emulsion and the following — 
 
 Liquor Pancreaticus, Pancreatic Solution (Unofficial), — prepared by digesting a 
 finely-chopped pig's pancreas with 4 times its weight of dilute alcohol. It is a nearly 
 clear alcoholic solution, with little taste or smell. Dose, ^j-^ss. 
 
 Ingluvinum, Ingluvin (Unofficial), — is obtained from the gizzard of 
 the domestic fowl, and owes its activity to a peculiar bitter principle, 
 and not to any ferment corresponding with pepsin. Dose, gr. x-xxx. 
 
 Unofficial Vegetable Digestives. 
 
 Papain, Papaiva, Papayotin, — is a vegetable ferment obtained from the milky juice 
 of Carica Papaya, a. S. American fruit-tree of the nat. ord. Papayaceoe. It is soluble in 
 
414 PEPSINUM. 
 
 water but not in alcohol, and has active digestive powers. It is composed essentially of 
 a mixture of vegetable globulin, albumoses and peptone, with which are associated the 
 ferments characteristic of the preparation. It is marketed under the name Papoid. 
 Dose, gr. j-iij. Papaw Milk is the milky juice of the fruit, coagulating into two parts, 
 a pulpy mass and a liquid serum. When mixed with alcohol an amorphous powder is 
 precipitated, which when dried forms Papain. 
 
 Bromelin, — is an active digestive ferment contained in the fresh juice of Ananassa 
 Sativa, the Pineapple. It is more nearly related to trypsin than to pepsin, and is de- 
 cidedly active in the presence of either acids or alkaline carbonates, but is most energetic 
 in neutral solutions, and is a very constant and powerful digestant of vegetable and 
 animal proteids. Dose of the fresh pineapple juice, 3 ss-j. 
 
 Physiological Action and Therapeutics. 
 
 Pepsin is not a solvent but a ferment, and is a normal constituent of 
 the gastric juice, converting albuminoids (casein, albumin, fibrin, etc.) 
 into peptones for assimilation, with the aid of the lactic and hydro- 
 chloric acids associated with it. This it will do out of the body or in 
 cavities as the rectum, if warmth, acidity and moisture are present. Pan- 
 creatin, on the other hand, is destroyed by acids and requires an alkaline 
 medium in which to exercise its powers. As the food passes out of the 
 stomach in 2 or 3 hours, Pepsin should be administered within and Pan- 
 creatin after that period, to be effective. Alcohol destroys the activity 
 of pepsin, alkalies and many mineral salts precipitate it. 
 
 Dyspepsia in its various forms is the malady for which Pepsin is chiefly 
 employed, but it is also extremely useful in the apepsia of infants, gas- 
 tralgia, anemia, chlorosis, gastric ulcer and cancer, the diarrhea of in- 
 fants and the vomiting of pregnancy. It is added to nutritive enemata, 
 the rectum not being a digestive organ, and is injected into the substance 
 of morbid growths which are homologous to the tissues, particularly fatty 
 tumors, for the purpose of arresting their growth and promoting their 
 absorption. It has been injected into the bladder to break down a blood- 
 clot, and has been suggested as an atomized inhalation in diphtheria and 
 croup to digest the membrane without injuring the living tissues. 
 
 Pancreatin digests albuminoids and converts starch into sugar and 
 proteids into peptones, also emulsifies fats in the presence of an alkaline 
 solution (Pepsin requiring an acid one). Prolonged contact with mineral 
 acids renders it inert. It is digested by pepsin, and hence probably 
 never passes into the duodenum in its own character. Pancreatin is used 
 to partially digest (peptonize) milk, gruel, soups, and other foods, before 
 their administration in cases of great digestive debility. These peptonized 
 foods may be administered by the stomach or the rectum, and are valua- 
 ble in intestinal dyspepsia, wasting diseases, and convalescence from acute 
 affections. A teaspoonful of Pancreatin solution taken after the adminis- 
 tration of cod-liver oil will prevent the disagreeable eructations which 
 are so offensive to some patients, and will aid in the digestion of the oil. 
 
PETROLATUM. 415 
 
 Trypsin, unlike Pepsin, will dissolve mucin, and like pepsin it is inert towards nuclein, 
 horny tissues, and amyloid matter. Used as a spray on diphtheritic membrane it has 
 proved a very efficient solvent. It affects albuminoids even in a slightly acid solution. 
 
 Ingluvin is particularly useful against vomiting and has been found exceptionally 
 efficient in the vomiting of pregnancy, given in 20-grain doses before meals. 
 
 Papain, Papoid, has the power of digesting to a greater or less extent all forms of 
 proteid or albuminous matter, both coagulated and uncoagulated. It is peculiar in that 
 its digestive power is exercised in either acid, alkaline or neutral media, in which respect 
 it differs greatly from the other digestive ferments. It acts more rapidly than pepsin and 
 at higher temperatures. It is a rapid solvent of false membranes and intestinal worms ; 
 and has been injected into neoplasmic tumors, dissolving their tissues in its immediate 
 vicinity, but with much pain and considerable febrile reaction. Papoid has been used as 
 a paste locally in diphtheria, to destroy and remove the false membrane ; internally, in 
 gastric and gastro-intestinal catarrh, the diarrhea of infancy and various dyspeptic con- 
 ditions, with very great success. Its power over both gastric and intestinal indigestion 
 renders it much more useful than either pepsin or pancreatin in cases of doubtful diag- 
 nosis, in which it is difficult to decide as to the location of the trouble. 
 
 Papoid may be obtained in powder or tablets, either alone or in combination with 
 sodium bicarbonate, boracic acid, and nux vomica ; also as a glycerole which is said to be 
 a permanent liquid preparation. The dose of papoid is from I to 3 grains, but 5 grains 
 or more may be given in special cases. 
 
 Pineapple Juice is one of the most efficient digestive aids at our command, and has 
 the advantage of being pleasant to the patient. The author directs the fruit to be cut 
 into slices as required, and the juice to be squeezed out immediately before administra- 
 tion. It has long been used by the natives of South Africa as a remedy for diphtheria, 
 and diphtheritic sore throats with unusual success, according to the testimony of com- 
 petent observers ; and has been employed by Dr. Chambers of Calcutta in this disease 
 with marked benefit. He had the patient sip the juice all day at short intervals, or else 
 masticate slices of the fruit and swallow the juice ; but as he employed Papaya fruit in 
 the same cases it is impossible to give all the credit of his success to the pine-apple. 
 
 PETROLATUM, — is a mixture of hydrocarbons, chiefly of the 
 marsh-gas series, obtained from Petroleum, by distilling off the lighter 
 portions and purifying the residue. It is colorless or yellowish, and in 
 the latter case is more or less fluorescent ; amorphous, odorless and taste- 
 less, of neutral reaction, insoluble in water or alcohol, soluble in ether, 
 chloroform, benzin, fixed and volatile oils, etc. Commercially it is 
 known as Cosmoline, Vaselin, Petroleum Ointment, etc., and is largely- 
 prepared from residuums or sediments deposited in tanks containing 
 crude petroleum. It is official in the following three forms, all of which, 
 when heated, give off a faint odor of petroleum, viz.: — 
 
 Petrolatum Liquidum, Liquid Petrolatum, — an oily, transparent fluid, of sp. gr. 
 0.875 t0 °-945- 
 
 Petrolatum Molle, Soft Petrolatu?)i, — a fat-like mass, of the consistence of an oint- 
 ment, sp. gr. about 0.820 to 0.840, melting-point between 104 and 113° F. 
 
 Petrolatum Spissum, Hard Petrolatum, — a fat-like mass, of about the consistence 
 of a cerate, sp. gr. 0.820 to 0.850, melting-point between 113 and 125 F. 
 
 Petrolatum is a valuable protective dressing, and an excellent basis for 
 ointments, having no acridity and no liability to become rancid. It is 
 readily miscible with many active agents, as the alkaloids, phenol com- 
 pounds, etc., but it does not penetrate the skin so readily as animal fats 
 
4l6 PHENACETINUM. 
 
 and fixed oils. Uncombined, it forms an excellent bland application in 
 all irritated conditions and injuries of the skin. 
 
 Albolene and Glymol are two of the numerous proprietary products of petroleum. 
 They are odorless, do not become rancid, and are employed as bases for ointments and 
 as lubricants. Liquid Albolene is readily diffused in the form of a spray and is a good 
 solvent for drugs intended for application to the naso-pharyngeal mucous membrane. 
 
 PHENACETINUM, Phenacetin, Oxy-ethyl-acetanilid, Para- 
 acet phenetidin, C 10 H 13 NO 2 , (Unofficial), — is a crystalline substance, closely 
 allied in composition to Acetanilid, and produced by the action of glacial 
 acetic acid on para-phenetidin, a body obtained from phenol. 
 
 Phenacetin occurs in colorless, tasteless, inodorous, scaly crystals, sparingly soluble 
 in cold water, more freely in boiling water, also in about 1 6 of alcohol. Dose, gr. ij- 
 xx ; — as an antipyretic, gr. viij-x hourly or every two hours, in powder or tablets ; 
 against neuralgia and rheumatism, gr. xv, repeated if necessary up to ^jss in 24 hours. 
 
 Physiological Action and Therapeutics. 
 
 The physiological action of Phenacetin is similar to that of Acetanilid. 
 It is probably the safest of the new synthetical antipyretics, yet in suffi- 
 ciently large doses it is as poisonous as any of its analogues. Cerna 
 reports a case in which a baby, five days old, received seven 2-grain doses 
 of phenacetin in three days, by mistake for bismuth, and was deeply 
 cyanosed for three days and less so for nearly a month, notwithstanding 
 the repeated employment of oxygen inhalations. There was also marked 
 jaundice, with grave anemia, and pronounced loss of weight. 
 
 Phenacetin reduces pyrexia gradually and causes perspiration without 
 producing collapse. It is also analgesic and hypnotic in action, relieving 
 pain and inducing sleep. It has been administered with benefit, in 2- 
 grain doses with T / 2 grain of citrated caffeine at short intervals, for mi- 
 graine ; also in epidemic influenza, both as a prophylactic and as a 
 remedy. As an antipyretic it is extensively employed in phthisis, peri- 
 tonitis, polyarthritis, endocarditis, typhus and typhoid fevers; and as an 
 analgesic in vaso-motor neuroses, for the lancinating pains of locomotor 
 ataxia, also in neuralgia and hemicrania. It is highly praised in whoop- 
 ing-cough, rheumatic and other fevers, and though slower in action than 
 Antipyrin or Acetanilid it is deemed fully as efficient in reducing pyrexia, 
 while usually free from the depressant after-effects of the latter agents. 
 
 Lactophenin, Lactyl-para-phenetidin (Unofficial), — is another phenetidin derivative, 
 containing a lactic acid constituent instead of the acetic acid one of phenacetin. Its 
 action is antipyretic, analgesic and hypnotic, and it has been recommended as a substi- 
 tute for phenacetin on account of its greater solubility. It has been used with especial 
 benefit in abdominal typhus (Jaksch) ; also in acute rheumatism, chorea and locomotor 
 ataxia (Von Roth). Dose, gr. viij-xv or more, up to ^jss daily, in wafers. 
 
 Methacetin, Oxy-methyl-acetanilid (Unofficial), — derives its name from its analogy 
 to Phenacetin, from which it differs only in containing a methyl group in place of an 
 
• PHOSPHORUS. 417 
 
 ethyl one. From Acetanilid it differs in the substitution of the oxy-methyl group for a 
 hydrogen atom. It occurs as lustrous, scaly, colorless, odorless crystals ; soluble in 12 of 
 hot water, in alcohol, chloroform, glycerin and fatty oils ; scarcely soluble in cold water, 
 Methacetin was introduced as an antipyretic for children and feeble persons, and prom- 
 ised at one time to supersede phenacetin. It is well borne, and no malaise, tinnitus, 
 cardiac weakness or exanthem follow its ingestion ; but it often gives rise to a violent and 
 exhausting perspiration. It has been used successfully in typhoid fever, all forms of 
 rheumatism, neuralgias, pneumonia and in most forms of pyrexia, but has not as yet 
 equaled the results obtained by either phenacetin or antipyrin. Its employment in phthisis 
 was not favorable, chiefly by reason of the profuse sweating induced by it. Its advan- 
 tages, over all the other antipyretics of its class, are its lack of toxic properties and its 
 comparatively ready solubility in water, being five times more soluble than its rival, phen- 
 acetin. Dose, gr. iij-v, or more. 
 
 Malakin, Salicyl-para-phenetidin, — is described under Salicinum. 
 
 Phenocoll Hydrochloride (Unofficial), — is another synthetical antipyretic, closely 
 allied to Phenacetin, both chemically and medicinally, and distinguished by its com- 
 paratively free solubility. It is produced by the interaction of Phenetidin and Glycocoll 
 (amido-acetic acid), and occurs as a white, micro-crystalline powder, soluble in about 16 
 of water, therein forming a neutral solution. The pure base, Phenocoll, is precipitated 
 from the solution by ammonia, the fixed alkalies and their carbonates. 
 
 Phenocoll Hydrochloride may be looked upon as a soluble Phenacetin, 15 grains dis- 
 solving readily in ^j of water. With decided antipyretic, antirheumatic and analgesic 
 powers, it possesses a marked advantage over the other members of its class in that it 
 has no injurious effect upon the blood corpuscles, even when in direct contact with them. 
 It is promptly absorbed, readily excreted, and reduces the hyperpyrexia of fever without 
 producing very profuse sweating or other unpleasant by-effects. The fall in temperature 
 is very decided and occurs within an hour after the administration of the drug, being 
 due to great diminution of heat-production, without any alteration of heat-dissipation. In 
 ordinary doses it has no effect on the circulation, but large doses diminish the blood- 
 pressure and reduce the pulse-rate, by stimulating the cardio-inhibitory centres. This 
 drug has been employed with marked success as an antipyretic in hectic, malarial, 
 typhoid and other fevers ; also in acute rheumatism, neuralgia, epidemic influenza, and 
 for the neuralgic pains of the latter affection. In combination with Piperazin, 15 grains 
 of each daily, in a pint or more of carbonated water, it has rendered excellent service in 
 gouty and rheumatic affections, especially when accompanied with pain and fever. The 
 same combination has proven of service in a case of obstinate gastric irritability with 
 uncontrollable vomiting, which had resisted every known remedy. The dose is gr. v-xxx, 
 an average dose being about 12 grains, three or four times a day. 
 
 PHOSPHORUS, PHOSPHITES and PHOSPHATES,— 
 
 are best studied together, as the supplying of the element Phosphorus to 
 the body is the aim of the administration of these agents. 
 
 Phosphorus, P, — is a non-metallic element obtained from bones, and 
 occurs as a translucent, nearly colorless solid, of waxy lustre, and usually 
 the consistence of beeswax, insoluble in water, to which, however, it 
 imparts its characteristic odor and taste. It is soluble in 50 parts of any 
 fatty oil, in 80 of absolute ether, 350 of absolute alcohol, and freely in 
 chloroform and in carbon disulphide. It has a disagreeable odor and 
 taste, melts at in° F., and in the air it emits white fumes which are 
 luminous in the dark. On longer exposure to the air it ignites, and 
 should be kept under water in a cool place, protected from light. It 
 usually contains Arsenic and sometimes Sulphur, the limits of which 
 are fixed by the official pharmacopceial tests. Dose, gr. x \ ^, thrice 
 daily. 
 
 27 
 
41 8 . PHOSPHORUS. 
 
 Preparations of Phosphorus. 
 
 Pilulae Phosphori, Pills of Phosphorus,— each contains gr. yi^ of Phosphorus, dis- 
 solved in Chloroform, mixed with Althaea and Acacia in Glycerin and Water, and coated 
 by shaking with a solution of Balsam of Tolu in Ether. Dose, j-v. 
 
 Oleum Phosphoratum, Phosphorated Oil, — has of Phosphorus I part, Ether and 
 Expressed Oil of Almond to ioo. Dose, tt\J-v thrice daily. 
 
 Acidum Phosphoricum, Phosphoric Acid, and Acidum Phosphoricum Dilutum, 
 are described on page 104. 
 
 Acidum Hypophosphorosum Dilutum, Diluted Hypophosphorous Acid, — a liquid 
 composed of about 10 per cent, of the absolute acid (HPH 2 2 ), and about 90 per cent, 
 of water. Used in the preparation of Syrupus Hypophosphitum. 
 
 Spiritus Phosphori, Spirit of Phosphorus, Tincture of Phosphorus, — has of Phos- 
 phorus 1.2, dissolved in Absolute Alcohol 1000. 
 
 Elixir Phosphori, Elixir of Phosphorus, — has of the preceding 210, Oil of Anise 2, 
 Glycerin 550, Aromatic Elixir to 1000. Each cubic cm. represents about }( milligramme 
 of Phosphorus (each 3 contains about gr. -fa). Dose, gss-^ss. 
 
 Tinctura Phosphori ( Thompson'' s), Unofficial, — Phosphorus gr. j, Absolute Alco- 
 hol gv, Glycerin ,^jss, Alcohol £ij, Spt. Mentha; Piperita; rr^xl. Of this gj contains 
 gr. i/j of Phosphorus. Dose, ^ss-^jss. 
 
 Tinctura Phosphori (Pellevue Hospital), Unofficial, — Phosphorus gr. xxxij, Abso- 
 lute Alcohol, ^xlvj, Essence of Vanilla 3J, Oil of Orange giij, Alcohol q.s. ad 3 xlviij. 
 Of this s;j contains gr. j 1 ^ of Phosphorus. Dose, .^ss-j. 
 
 Zinci Phosphidum, Zinc Phosphide, Zn 3 P 2 , — crystalline fragments or a gray-black 
 powder, insoluble in water or alcohol, but completely soluble in hydrochloric or sulphuric 
 acids with evolution of hydrogen phosphide. Is very irritant. Dose, gr. 5V-2V 
 
 Preparations of Phosphites. 
 
 Calcii Hypophosphis, Calcium Hypophosphite, Ca (PH 2 2 ) 2 , — colorless prisms, or 
 thin, pearly scales, of nauseous taste, soluble in 6.8 of water, insoluble in alcohol. Is an 
 ingredient of the Syrupus Hypophosphitum. Dose, gr. x-xxx. 
 
 Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 ) 6 , — a white or grayish- white 
 powder, odorless and tasteless, slightly soluble in water, freely so in hydrochloric acid or 
 a solution of sodium nitrate. Dose, gr. v-x. A ferruginous tonic. 
 
 Potassii Hypophosphis, Potassium Hypophosphite, KH 2 P0 2 , — white masses, or a 
 white, granular powder, deliquescent, odorless, of saline taste and neutral reaction. 
 Soluble in 0.6 of water and in 7.3 of alcohol at 59 F. Dose, gr. v-x. 
 
 Sodii Hypophosphis, Sodium Hypophosphite, — NaPH 2 2 + H 2 0, — small plates, or 
 a white, granular powder, deliquescent, odorless, of sweetish, salineutaste, and neutral re- 
 action. Soluble in I of water and in 30 of alcohol at 59 F. Dose, gr. v-x. 
 
 Syrupus Hypophosphitum, Syrup of Hypophosphites, — has of Calcium Hypophos- 
 phite ^y z , of Potassium and Sodium Hypophosphites ij^ each, per cent. Dose, 3J- J ss. 
 
 Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron, — has 
 of Ferrous Lactate 1, Potassium Citrate 1, in Syrup of Hypophosphites to 100 parts. 
 Dose > 3J-3 SS - 
 
 Preparations of Phosphates. 
 
 Calcii Phosphas Praecipitatus, Precipitated Calcium Phosphate, Ca 3 (P0 4 ) 2 , — a 
 light, white, amorphous powder, insoluble in water or in alcohol. Dose, gr. ij-x. 
 
 Syrupus Calcii Lactophosphatis, Syrup of Calcium Lactophosphate, — has of the 
 preceding 2^ per cent. The Calcium Phosphate is dissolved by Lactic and Phosphoric 
 Acids, but does not form the chemical combination suggested by the title. Dose, 
 
 3J-5 SS - 
 
 Sodii Phosphas, Sodium Phosphate, Na 2 HP0 4 + I2H 2 0, — large, colorless, mono- 
 clinic prisms, efflorescent, of saline taste and alkaline reaction ; soluble in 6 of water, 
 in 1 Yz of boiling water, insoluble in alcohol. Dose, 3J- Jj. 
 
PHOSPHORUS. 4I9 
 
 Sodii Pyrophosphas, Sodium Pyrophosphate, Na 4 P 2 7 -\- ioH 2 0. — colorless, mono- 
 clinic prisms, of saline taste and alkaline reaction ; soluble in 12 of water, insoluble in 
 alcohol. Dose, gss-^ss. 
 
 Syrupus Ferri, Quininae et Strychninae Phosphatum, Syrup of the Phosphates 
 of Iron, Quinine and Strychnine, — has of Soluble Ferric Phosphate 2, Quinine Sul- 
 phate 3, Strychnine -^L, Phosphoric Acid 4.8, Glycerin 10, Water 5, Syrup to 100. A 
 powerful tonic. Dose, 3J-iij. 
 
 Syrupus Phosphatum Compositus, Compound Syncp of Phosphates, Parrish's 
 Chemical Food, (Unofficial), — has in each 3, of Ferric Phosphate gr. 2J^, Calcium 
 Phosphate gr. j. Dose, 3 j — iij. 
 
 Melachol (Unofficial), — is a proprietary preparation, advertised to contain in each {3 
 eighty-five grains of Sodium Phosphate with Citric Acid and Sodium Nitrate. Dose, 
 gss-^|j, in water. 
 
 Ferri Phosphas Solubilis, Soluble Ferric Phosphate, and Ferri Pyrophosphas 
 Solubilis, — are described under Ferrum, ante, page 317. 
 
 Physiological Action. 
 
 Phosphorus in small doses stimulates the brain and circulation, the 
 functions of the stomach and the genital organs, and the growth of bones. 
 It aids digestion by irritating the end-organs of the gastric nerves, but 
 produces eructations of hydrogen phosphide. Its fumes cause necrosis 
 of the upper or lower maxillae especially in those whose teeth are decayed, 
 but this may be prevented by the inhalation of the fumes from old acid 
 turpentine. In poisonous doses it is a powerful irritant of the gastro- 
 intestinal tract, causing vomiting and purging with great depression of 
 the vital forces. Reaching the blood as Phosphorus, it is partly oxidized 
 at the expense of the oxygen of the red corpuscles, causes acute hemor- 
 rhages by producing fatty degeneration of the arterial walls ; also rapid 
 steatosis of the stomach, liver and heart, accompanied by deep jaundice ; 
 then delirium, convulsions, coma and death, the latter usually from 
 gradual failure of the respiration and circulation. Acute yellow atrophy 
 of the liver resembles phosphorus poisoning so much that it is generally 
 impossible to distinguish between them. The effect of Phosphorus on 
 metabolism is to Increase the nitrogenous products, to diminish the ex- 
 cretion of carbonic acid, to reduce the glycogen of the liver to almost 
 nothing, and to raise the temperature. While generally increasing meta- 
 bolism it so influences that process as to arrest it at the stage of the con- 
 version of proteids into urea and oil, instead of allowing it to proceed 
 to the final oxidation of oil into carbonic acid and water, and hence it 
 induces fatty degeneration of epithelial, glandular and muscular proto- 
 plasm throughout the body. 
 
 Calcium Phosphate is an essential ingredient of all the tissues and 
 fluids of the body, and forms more than 50 per cent, of the bones. Lac- 
 tic and hydrochloric acids dissolve it in small quantities. It increases 
 the alkalinity of the blood as well as its power of holding carbonic acid, 
 and diminishes the excretion of urea. 
 
420 PHOSPHORUS. 
 
 Sodium Phosphate acts on the blood and on the excretion of urea sim- 
 ilarly to the calcium salt. It increases secretion generally, especially that 
 of the bile, being an excellent cholagogue and thereby aiding in the 
 digestion of fats. In half-ounce doses it is laxative. It is a normal con- 
 stituent of the blood, and possesses the property of increasing the capa- 
 city of any fluid to hold carbonic acid in solution. 
 
 The Hypophosphites are generally tonic in action, and are supposed 
 to constitute a safer form in which to administer Phosphorus than in the 
 unoxidized state. They are probably converted into phosphates in the 
 stomach. 
 
 Antidotes and Antagonists to Phosphorus. 
 
 Antidotes are Hydrated Magnesia, Lime-water, powdered Charcoal, Copper Sulphate 
 and old acid Turpentine. Hydrated Magnesia as a quickly acting purgative, Lime-water 
 or Charcoal to prevent the action of the poison on the tissues. Potassium Permangan- 
 ate may have antidotal action. No Oils or Fats should be used, as they dissolve phos- 
 phorus and promote its absorption. Opium to antagonize the depression of the heart 
 and system. Transfusion has proved efficient when the blood is seriously affected as 
 a result of phosphorus poisoning. Copper Sulphate, as an emetic and to form the com- 
 paratively insoluble phosphide of copper, also Crude French Acid Turpentine, given 
 rapidly in an emulsion of gum, are generally placed among the antidotes, but are both 
 practically useless. The first has caused death more rapidly than the phosphorus, and 
 the second is generally unobtainable, and has proved useless when employed. 
 
 Therapeutics. 
 
 Phosphorus is chiefly used to promote the nutrition of osseous and 
 nervous tissue. It is useful in chronic nervous exhaustion when the nerve 
 centres are implicated, also in osteomalacia, rachitis and progressive 
 locomotor ataxia. In threatened cerebral softening it affects the nerve 
 centres as no other drug does, and in paraplegia of myelitic origin from 
 excessive venery it is often very efficient. Progressive pernicious anemia 
 has sometimes been arrested by Phosphorus in very small doses, while in 
 impotence of functional character there is no remedy so effective. In 
 wakefulness of the aged and that due to cerebral anemia small doses of 
 the pill or tincture are sometimes remarkably beneficial. In certain skin 
 diseases (acne, psoriasis, lupus), it is an excellent substitute for arsenic. 
 Neuralgia is often cured by Phosphorus, but large doses are necessary, at 
 least gr. y 1 ^ every four hours. A solution in P.etinol is very stable, 
 and is strongly recommended for the external and internal use of the 
 drug. 
 
 Calcium Phosphate and the Hypophosphites are used with benefit in all 
 diseases of mal-nutrition, and where the repair or development of the 
 bones is required. They are particularly useful in protracted suppuration, 
 osteomalacia, rachitis, caries, scrofulosis, chronic phthisis, and in the 
 anemia and bone-softening of lactation. The Hypophosphites are much 
 employed in nervous and general debility and in chronic lung diseases, 
 
PHYSOSTIGMA. 421 
 
 and are supposed to act in the same manner as free phosphorus, but without 
 irritation. They are probably converted into phosphates in the stomach, 
 and hence may be expected to promote the growth and healing of bones, 
 to stimulate the hepatic and intestinal secretions, and to affect the lymph- 
 atic glands and adenoid tissue. The Compound Syrup of the Hypophos- 
 phites is an excellent remedy in acne indurata. 
 
 Sodium Phosphate in doses of 3j-ij thrice daily for adults (gr. x-xxx 
 for children) is extremely useful as a laxative in conditions depending on 
 catarrh of the bile-ducts and duodenum, as headache, jaundice, chalky 
 stools, etc. Gall-stones may be prevented from forming by scruple or 
 drachm doses before meals for months at a time. It is also an efficient 
 agent in obesity, hepatic diabetes, incipient hepatic sclerosis, chronic in- 
 fantile diarrhea, cerebral debility, bilious sick-headache, and the pasty, 
 white stools of ill-conditioned children. Vichy-water contains this salt 
 in the proportion of gr. ^ to the pint, and is considered a valuable water 
 in hepatic colic and kindred conditions. Hypodermic injections of So- 
 dium Phosphate have been used with highly beneficial results in syringo- 
 myelias and in unilateral astasia-abasia. Drs. Crocq and Luton of 
 Rheims advocate the hypodermic use of this salt as a substitute for the 
 organic extracts, and maintain that it is equally efficient in all cases in 
 which these extracts have proved to be of value. [Compare the article 
 on Animal Extracts, page 157.] 
 
 Crocq' s solution contains Sodium Phosphate I part, Alcohol 5, Glycerin 20, Distilled 
 Water 25 ; the dose of which is 3 cc. (about 45 minims) hypodermically, with aseptic 
 precautions, once daily or on alternate days. Luton uses a solution of the crystallized 
 Sodium Phosphate and Sodium Sulphate. 
 
 Glycero-phosphates (Unofficial), — have been used during the last few years, espe- 
 cially in France. Glycero-phosphoric Acid is prepared by mixing Phosphoric Acid I part, 
 with Glycerin I ]/ 2 , and gradually heating to 374 F. When pure, it is a yellow, odorless 
 liquid, of syrupy consistence and acid taste, soluble in water and in alcohol. Dose, 
 TttJ-v, three times daily. The salts in general use are — the Glycerophosphate of Cal- 
 cium, dose, gr. ij-v ; of Iron, dose, gr. j-ij ; of Lithium, dose, gr. iij-xv ; and of Sodium 
 (in 50 per cent, solution), dose, gr. ij-ivin sodium chloride solution by hypodermic injec- 
 tion. 
 
 This acid and its salts are said to accelerate metabolism and the nitrogenous exchanges, 
 to promote the assimilation of albuminoids, and to increase the excretion of nitrogen, the 
 oxidation of broken-up sulphur compounds and the elimination of sodium chloride. 
 They may also favor the assimilation of the phosphates of the food and so protect the 
 combined phosphorus of the nervous system from waste (Robin). The acid is highly 
 valued as a nervine remedy and has been used with benefit in neurasthenia, locomotor 
 ataxia, phosphaturia, lithemia and muscular atrophy. The Iron salt is praised in anemia 
 and chlorosis. 
 
 PHYSOSTIGMA, Calabar Bean,— is the seed of Physosiigma 
 venenosum, nat. ord. Leguminosae, a woody creeper of Calabar, West 
 Africa, where it is used by the natives as an ordeal for witches, etc., 
 vomiting after its ingestion being held to establish the innocence of the 
 accused. It contains two alkaloids, Physostigmine (Eserine), C 15 H 21 - 
 
422 PHYSOSTIGMA. 
 
 N 3 2 , and Calabarine, which is antagonistic to the former and is allied 
 to strychnine in its action, while Physostigmine resembles gelsemium. 
 
 Preparations. 
 
 Extractum Physostigmatis, Extract of Physostigma, — an alcoholic extract, of 
 which the usual dose is from gr. T X g to \, but gr. j-iv are used in tetanus. 
 
 Tinctura Physostigmatis, Tincture of Physostigma, — 15 per cent. Dose, tt\v-xx. 
 
 Physostigminae Salicylas, Physostigmine Salicylate, Eserine Salicylate, — colorless, 
 columnar crystals, of bitter taste and neutral reaction, soluble in 150 of water and in 12 
 of alcohol. Dose, gr. 1 ^ ■ 6 1 . 
 
 Physostigminae Sulphas, Physostigmine Sulphate, Eserine Sulphate, — a white, 
 micro-crystalline powder, of bitter taste, very deliquescent in moist air, very soluble in 
 water and in alcohol. Dose, gr. xlrff^V 
 
 Physiological Action. 
 
 Physostigma is a direct spinal paralyzer, producing complete general 
 paralysis and abolished reflexes, but not affecting muscular irritability or 
 the cerebral functions. It stimulates secretion, excites nausea and vom- 
 iting, salivation and diaphoresis, and is laxative by stimulating the mus- 
 cular coat of the intestines to increased peristalsis as well as by increasing 
 the intestinal secretions. It first lowers then raises arterial tension, in- 
 creases the frequency of the heart-beat, but depresses the power of the 
 cardiac muscle though not destroying it. It produces dyspnea by a 
 tetanic action on the respiratory muscles, causing carbonic acid narcosis 
 and death by paralysis of respiration. It contracts the pupil (how, is 
 disputed), also the ciliary muscle, producing marked myosis. It is elim- 
 inated chiefly by the kidneys, the urine of the animal affected poisoning 
 another. 
 
 The alkaloids of Physostigma have opposite actions, and different or 
 even contradictory results may be obtained from the drug according to 
 the proportion of each in the preparation employed. Physostigmine 
 represents the action of the bean, paralyzing the nervous centres and 
 stimulating muscular fibre, while Calabarine causes convulsions like 
 strychnine (Brunton). Physostigmine, in its action on the cord is allied 
 to gelsemium and antagonistic to strychnine and to picrotoxin, but Cal- 
 abarine is allied to both (Murrell). 
 
 Antagonists and Incompatibles. 
 
 Atropine is antagonistic as to the effects on the respiration, heart and pupils. Chloral 
 is also antagonistic, and over a greater field of action, but to be effective must be admin- 
 istered before the ingestion of the Physostigma. Tannic Acid, the vegetable astringents 
 and the caustic alkalies are chemically incompatible. 
 
 Therapeutics. 
 
 The applications of Physostigma are not many. It is efficient in con- 
 stipation due to torpor of the bowels, in which condition it is usually 
 
PHYTOLACCA. 423 
 
 combined with belladonna and nux vomica. In tetanus it has been used 
 with advantage to diminish reflex excitability, but large doses (2 to 4 
 grains) must be given, and its effects must be carefully watched. In small 
 doses it is a useful remedy in many nervous affections, such as locomotor 
 ataxia, writers' cramp and the paraplegia due to myelitis, also in pro- 
 gressive paralysis of the insane which is apparently retarded by it. The 
 extract should be given in these diseases, in doses of gr. -^ in pill every 
 three hours ; and if the treatment is kept up for six months or longer the 
 results will prove very satisfactory, though the improvement will be slow 
 (Murrell). While theoretically antagonistic in poisoning by atropine or 
 strychnine, practically it is not of much value therein. 
 
 Physostigmine (Eserine) is used locally by ophthalmologists for many 
 purposes in affections of the eye. In a solution of gr. ij to the g of 
 water dropped into the eye it is efficient in breaking up or preventing 
 adhesions of the iris, diminishes intraocular tension, prevents suppuration 
 after operations, contracts the pupil, diminishing the entrance of light in 
 photophobia, etc., and empties the vessels of the eye. It is very useful 
 in keratitis, glaucoma, strumous ophthalmia, and neuralgia of the eye- 
 ball. The salts of Physostigmine in neutral solution may be used for 
 these purposes, as well as to counteract the effects of atropine on the 
 pupil. Gelatin disks medicated therewith may be obtained in the shops, 
 and are a convenient form in which to use the drug for ophthalmic pur- 
 poses. In dose of gr. t -J-q hypodermically it has proved remarkably 
 efficient as an occasional substitute for morphine, after the final with- 
 drawal of that drug in the treatment of its habitues. 
 
 PHYTOLACCA, Poke,— is official under two forms, the fruit and 
 the root of Phytolacca decandra, a plant of the nat. ord. Phytolaccacese, 
 found in all parts of the United States. It contains a neutral principle 
 Phytolaccin, and an acid Phytolaccic Acid, also tannin, starch, fixed oil, 
 etc. The official titles are — 
 
 Phytolaccse Fructus, Phytolacca Fruit, Poke Berry, — a depressed- 
 globular, dark purple, compound berry, about yj, inch in diameter, 
 inodorous, taste sweet, slightly acrid. Dose, gr. x-xxx. 
 
 Phytolaccae Radix, Phytolacca Root, Poke Root, — large, conical, 
 branched, fracture fibrous, inodorous, sweetish and acrid. Dose, as an 
 emetic, gr. x-xxx ; as an alterative, gr. j-v. 
 
 Preparations. 
 s Fluidum, . 
 
 Tinctura Phytolaccae, Tincture of Phytolacca (Unofficial). — Dose, rr\x-3J. 
 
 Extractum Phytolaccae Radicis Fluidum, Fluid Extract of Phytolacca Root. 
 Dose, rry-xxx. 
 
424 PICHI PICROTOXINUM. 
 
 Physiological Action and Therapeutics. 
 
 Phytolacca is an emeto-cathartic, acting slowly but persistently, with 
 great nausea and considerable depression. It lowers the rate of respira- 
 tion and of cardiac action, and is a motor depressant, paralyzing the 
 spinal cord and the medulla, death occurring from paralysis of respira- 
 tion preceded by tetanic convulsions. Several cases of poisoning by 
 this plant have occurred. Its action is antagonized by Alcohol, Ether, 
 Opium, Digitalis, and other motor-excitants. 
 
 Alterative powers have been ascribed to Phytolacca, and competent 
 observers have reported curative results from its use in malignant tumors, 
 varicose and other ulcers, obstinate eczema, sycosis, favus and other 
 skin affections, employing it both internally and externally. It is a very 
 serviceable remedy in chronic rheumatism, and given internally has 
 undoubtedly cured cases of granular conjunctivitis. Mastitis is some- 
 times aborted and suppuration of the breasts prevented by the use of the 
 fluid extract internally while a solid extract is locally applied to the seat 
 of the impending inflammation. In tonsillitis and diphtheritic sore throat, 
 also in chronic follicular pharyngitis, it has been much used with good 
 results, especially when there is high fever and pains in the head, back 
 and limbs. In true adynamic diphtheria it will do little good. 
 
 Phytolacca has long been known to promote the absorption of adipose 
 tissue, and was suggested as a remedy for obesity as early as 1858. A 
 resinoid preparation of the berries is on the market as an "anti-fat" 
 remedy, under the name Phytoline, the dose of which is n^x six times a 
 day, before and after each meal. 
 
 PICHI, Pichi (Unofficial), — is the shrub Fabiana imbricata, a member of the nat. 
 ord. Solanaceas, and a native of S. America. Among the Chilians it has been much 
 prized as a remedy in cystitis with calculi and gravel, and in chronic catarrh of the 
 bladder. It seems to have considerable power over the hematuria and pain of renal 
 calculus. It is also highly praised in dyspeptic disorders. Its medicinal virtues reside 
 in oleoresinous constituents which are insoluble in water. An extract is prepared from 
 the leaves, of which the dose is gr. v-x in capsules. Dose of the fluid extract, 3 j, but 
 it should not be added to water. 
 
 PICROTOXINUM, Picrotoxin, Picrotoxic Acid, C 30 H 34 O 13 ,— is 
 a poisonous, neutral principle obtained from the seeds contained in the 
 berries {Cocculus Indicus, Fish-berries), of Anamirta paniculata (Anam- 
 irta Cocculus, Menispermum Cocculus), a climbing shrub of the nat. ord. 
 Menispermacese, a native of the East Indies. The berries contain, be- 
 sides Picrotoxin, a large quantity of fixed oil and other substances of 
 less interest. In the shell are found Menispermin an alkaline principle, 
 Paramenispermin which is neutral and crystalline, and Hypopicrotoxic 
 Acid. There are no official preparations. 
 
PICROTOXINUM. 425 
 
 Picrotoxin occurs in colorless, flexible crystals, of bitter taste and neutral reaction, 
 soluble in 240 of water and in 9 of alcohol, also in acids and in alkaline solutions. Dose 
 by the stomach gr. Q — ^ f cautiously. For hypodermic use a solution in water of gr. ij 
 
 Unofficial Preparations of Coccidus. 
 Tinctura Cocculi, Tincture of Coccidus, — I in 8. Dose, mjj-xv. 
 Extractum Cocculi Fluidum, Fluid Extract of Coccidus. — Dose, TT\j-iij. 
 Planat's Tincture of Cocculus, — 1 in 4. Dose, rr\j-v. 
 
 Physiological Action. 
 
 Picrotoxin is a cerebro-spinal exaltant, affecting especially the centres 
 in the medulla oblongata, and in its action representing the combined 
 action of belladonna and mix vomica. It stimulates all the secretions, 
 especially the cutaneous, the salivary and the intestinal, produces nausea 
 and vomiting, and slows the heart and the respiration after transiently 
 accelerating both. It causes muscular twitching, incoordination, stupor, 
 delirium, epileptiform convulsions, tonic spasms of the flexor muscles 
 alternating with clonic ones, exalted reflexes and trembling, — then coma, 
 insensibility and death by paralysis of the heart, which is arrested in 
 diastole. The action of the drug is on the spasm and vagus centres in 
 the medulla and on Setchenow's inhibitory centre, as well as on the cere- 
 bellum and spinal cord, paralyzing the first-named centres and stimulating 
 the reflex centres in the cord. It is eliminated by all the excretory chan- 
 nels, chiefly by the kidneys. The spasms caused by Picrotoxin are choreic 
 and chiefly affect the flexor muscles, — those from Strychnine are tetanic, 
 affecting principally the extensors. The order, succession and character 
 of the phenomena produced by Picrotoxin resemble in marked degree 
 those of the epileptic paroxysm. 
 
 Cocculus berries are used to stupefy fish, being thrown into ponds con- 
 taining them. They are also employed'to adulterate beer and porter in 
 order to make these drinks more intoxicating. 
 
 Antagonists. 
 
 Chloral is antagonistic to its cerebral and spinal actions, but synergistic to its depressant 
 power over the heart and the respiration. Acetic Acid gives relief in overdosing, and may 
 have some antidotal power. Anesthetics antagonize its spasm-producing action. 
 
 Therapeutics. 
 Picrotoxin is used chiefly in nervous diseases. Epilepsy is amenable to 
 it, especially when the attacks are nocturnal, and in anemic cases and 
 those attributable to onanism. Paralyses of several forms have been 
 greatly benefited by it, especially paralysis of the sphincters, hemiplegia 
 from cold, glosso-labio-laryngeal paralysis and paralysis agitans. Chorea 
 is well treated by it but requires full doses. It is remarkably efficient in 
 
426 PILOCARPUS. 
 
 controlling the night sweats of phthisis and in flatulent colic, also in dys- 
 pepsia with flatulence and severe epigastric pain, and in vomiting with 
 giddiness, headache and intolerance of light and sound. Dysmenorrhea 
 is often benefited by Cocculus administered for two days before the 
 period ; and leucorrhea, when the discharge is sero-purulent with lumbar 
 pains, is frequently controlled by it. Parasitic skin diseases are well 
 treated by an ointment of Picrotoxin (gr. x to the 3) which will also kill 
 pediculi, but it must be used cautiously and with special care to avoid 
 an abraded surface. The tincture of Cocculus may be used undiluted as 
 a wash to kill body-lice. 
 
 PILOCARPUS, Jaborandi, — the leaflets of Pilocarpus Selloanus 
 and of Pilocarpus Jaborandi, Brazilian plants of the nat. ord. Rutaceae. 
 The word Jaborandi is applied in Brazil to any tree or shrub which pos- 
 sesses the power of inducing sweating, and a number of plants are so 
 designated, but the true leaves are known by their numerous pellucid 
 dots, easily recognized when the leaf is held between the eye and a light. 
 They contain the four alkaloids Pilocarpine, C u H 16 N 2 2 , a syrupy fluid, 
 slightly soluble in water, and forming salts ; Jaborine, isomeric with 
 pilocarpine, but antagonistic thereto in action, and does not form crys- 
 tallizable salts ; Pilocarpidine, which acts like pilocarpine ; and Jabori- 
 dine, which is analogous in action to jaborine. 
 
 Preparations. 
 
 Extractum Pilocarpi Fluidum, Fluid Extract of Pilocarpus. — Dose, TT\v~3J. 
 
 Pilocarpine Hydrochloras, Pilocarpine Hydrochlorate, C n H 16 N 2 2 HCl, — small, 
 white, deliquescent crystals, odorless, of faintly bitter taste ; very soluble in water and 
 in alcohol, almost insoluble in ether or chloroform. Dose, gr. ^-^. 
 
 Physiological Action. 
 Pilocarpus is a paralyzer of the vaso-motor system, and a stimulant of 
 the peripheral terminations of nerves supplying glands and involuntary 
 muscular fibre, subsequently paralyzing the latter. It is therefore a 
 powerful diaphoretic and sialogogue, a cardiac depressant by stimulation 
 of the vagus ends, also myotic, emetic, and under some circumstances 
 abortifacient. Its taste is hot and pungent. It causes prompt and pro- 
 fuse perspiration (gix-xv in quantity) and salivation (gx-xxvij) after a 
 preliminary flushing of the skin. The nasal, bronchial and lachrymal 
 secretions are much increased, sometimes watery diarrhea occurs; the 
 action of the heart at first increased is afterwards lowered, the arterial 
 tension is reduced, and the temperature falls from i° to 4 . Drowsiness, 
 pallor, chilliness and debility succeed, and last several hours; the pupils 
 are contracted and accommodation is impaired. The elimination of urea 
 is greatly increased, but not the quantity of urine. The respiratory power 
 
PILOCARPUS. 427 
 
 is lowered, and apnea may occur from increase of the bronchial mucus. 
 Pilocarpus is rapidly diffused and is eliminated by the skin and the 
 salivary glands. Its effects pass off usually in from three to six hours. 
 Children are less affected than adults by proportionate doses. It causes 
 contraction of the bladder, uterus and spleen, in the latter case whether 
 the organ is enlarged or of normal size. The desire to urinate, which is 
 experienced after a full dose, is due to the drug causing contraction of 
 the bladder. Pilocarpus is not a diuretic but tends rather to diminish 
 the quantity of urine as a result of its powerful diaphoretic action. 
 
 Pilocarpine is the principle to which the foregoing actions are due, but 
 Jaborine, though chemically identical, is perfectly antagonistic thereto in 
 its effects on the heart, pupils, lungs and salivary glands, acting precisely 
 like atropinj on these organs. The difference is probably due to a dif- 
 ferent molecular arrangement in these agents. 
 
 Antagonists and Incompatibles. 
 
 Atropine is the antagonist to Pilocarpine, in dose of grain T ^ for gr. A of the latter. 
 The antagonism between these two alkaloids extends over the whole range of their action, 
 and is the most complete known to physiological experimentation. Conversely Pilocar- 
 pine is exactly antagonistic to Atropine, but Jaborine acts similarly to the latter drug. 
 Morphine controls the nausea and vomiting. Caustic alkalies, the persalts of Iron and 
 salts of the metals generally, are chemically incompatible. 
 
 Therapeutics. 
 
 Pilocarpus is used with great benefit in dropsies, especially the renal 
 form, also in eclampsia of renal origin, in uremia, pleuritis, meningitis 
 and other inflammations of serous membranes, but is contraindicated when 
 from any cause there is a weak heart. In diabetes insipidus it reduces 
 the quantity of urine remarkably, relieving the kidneys by throwing the 
 work, on the skin. In the acute and chronic forms of Bright's disease it 
 has been used with advantage, but being very depressant it must be em- 
 ployed with great caution in this disorder. For alopecia it is the most 
 efficient remedy known, stimulating the skin and improving the color and 
 condition of the hair. In agalactia it stimulates the secretion of the 
 milk, and it often gives prompt relief in parotitis. Ptyalism is frequently 
 relieved by minute doses of Pilocarpine (gr. Jg-), which, acting specifi- 
 cally on the same gland, may correct its morbid action, and similar doses 
 used thrice daily will check profuse perspiration. The hypodermic use 
 of Pilocarpine will arrest a paroxysm of spasmodic asthma and is equally 
 efficient in hiccough. Atropine-poisoning is best combated by the use 
 of Pilocarpine hypodermically. . 
 
 Diphtheria has been treated with Pilocarpine successfully, Guttmann 
 having reported eighty-one cases without a single death ; but other 
 clinicians have not found it so efficient, and Lashkewitz and Jacobi con- 
 demn it absolutely. In children above the age of five years, in whom 
 
428 PIMENTA PIPER. 
 
 the condition of the heart does not contraindicate it, this drug often 
 gives pronounced satisfaction in detaching the false membrane and pre- 
 venting its reformation ; but care must be taken to give full support by 
 food and alcohol throughout its use, and to avoid it altogether in cases 
 which manifest cardiac weakness or great depression. In erysipelas it 
 is often highly efficient, and for the purpose of breaking up a common 
 cold it is one of the best agents at our command. For the latter purpose 
 the fluid extract of Pilocarpus may be used in doses of v^x-^} according 
 to age, given at bed-time and repeated once or twice during the night if 
 necessary. Children bear it well in all its physiological actions. 
 
 Ophthalmologists employ Pilocarpine with most excellent results in the 
 amblyopia of alcoholism and that from the abuse of tobacco, in detach- 
 ment of the retina, chronic iritis, keratitis, glaucoma, hemorrhage into 
 the vitreous, atrophic choroiditis, white atrophy, to promote resolution 
 and absorption in inflammatory conditions with exudation, and instead 
 of physostigmine as a myotic. 
 
 Pilocarpine is highly efficient as an aid to sorbifacient remedies in 
 removing inflammatory exudations and promoting the absorption of effu- 
 sions. When iodides and mercurials are being used for these purposes 
 their action is greatly aided by this drug administered occasionally for a 
 few days at a time. It has been suggested by Waldstein as a remedy in 
 phthisis for the purpose of inducing leucocytosis and stimulating glandu- 
 lar activity, and is one of the ingredients in a new " cure " for consump- 
 tion named Aseptolin. (See ante, page 85.) 
 
 PIMENTA, Allspice, — is the nearly ripe fruit of Pimento, officinalis, a West 
 Indian tree of the nat. ord. Myrtaceoe. The berries contain a Volatile Oil which is 
 official, a green fixed oil, fat, tannin, gum, resin, etc. Dose, gr. x-xl. 
 
 Oleum Pimentae, Oil of Pimento,, — the volatile oil, colorless or pale yellow, of aro- 
 matic odor, pungent taste and slightly acid reaction. Is a constituent of Bay Rum (Spt. 
 Myrcice). Dose, TTLij-vj. 
 
 Allspice is a warm, aromatic stimulant, very useful as a condiment, improving diges- 
 tion by increasing the vascularity of the gastric mucous membrane and by stimulating 
 the salivary secretion. The oil is an agreeable remedy for flatulence, nausea, and in- 
 testinal colic, and is used to prevent the griping of purgatives and to cover the taste of 
 nauseous medicines. 
 
 PIPER, Pepper, Black Pepper, — is the unripe fruit of Piper nigrum, or Pepper- 
 vine, a perennial plant of the nat. ord. Piperacese, growing in India, Siam, Java, Borneo, 
 etc. It contains a principle, Piperin, which is official, also a green, acrid, concrete oil, 
 a balsamic volatile oil, starch, lignin, gum, extractive, etc. Dose, gr. v-xx. 
 
 Oleoresina Piperis, Oleoresin of Pepper, — contains almost all the volatile oil and 
 acrid resin extracted by ether, with but little of the Piperin. Dose, rr\^-j. 
 
 Piperinum, Piperin, C 17 H 19 N0 3 , — a neutral' principle prepared from Pepper, and 
 occurring also in other plants of the natural order Piperacese. Occurs in colorless or 
 pale-yellowish prisms, of neutral reaction, almost insoluble in water, slightly so in ether, 
 but soluble in 30 of alcohol. Dose, gr. j-x. 
 
 Piperidinum, Piperidin (Unofficial), — is produced by the hydrolysis of Piperin, or 
 synthetically by reducing pyridine by nascent hydrogen. It occurs as a colorless, limpid 
 
PIPERAZINUM. 429 
 
 liquid, and is a powerful base. The Acid Tartrate is a white, crystalline powder, readily- 
 soluble in water, the dose of which is gr. x-xv. 
 
 Pepper when applied to the skin acts as an irritant ; internally its effects are similar to 
 those of other aromatics, being a warm carminative and stimulant, increasing slightly the 
 action of the heart, stimulating the kidneys somewhat, and toning up the mucous mem- 
 brane of the urinary and intestinal passages, by which channels it is eliminated. It has 
 been thought to possess antiperiodic power, and was formerly much employed in inter- 
 mittents. Its chief medicinal use is to correct flatulence, and to excite action of the 
 stomach, being very commonly taken as a condiment with food. It is occasionally em- 
 ployed in gleet, but more extensively in hemorrhoids and other diseases of the rectum. 
 Its active constituents are the concrete oil or resin and the volatile oil, Piperin having 
 very slight action on the system except as an antiperiodic and antipyretic, qualities which 
 it certainly possesses. 
 
 Piperidin Tartrate increases the solvent power of serum for sodium biurate to a much 
 greater extent than Piperazin, Lysidin or Urotropin, and has been introduced as a solvent 
 for gouty deposits, uric acid gravel and calculi. 
 
 PIPERAZINUM, Piperazin, C 4 H 10 N 2 (Unofficial),— is a syntheti- 
 cal basic compound formed by the action of Ammonia upon Ethylene 
 Bromide or Chloride ; and occurs as a white, crystalline powder, soluble 
 in water and liquefying when exposed to the air, from which it absorbs 
 water and carbon dioxide. Dose of the base or its hydrochloride, gr. v- 
 xv. It may be injected hypodermically in 3 to 5 per cent, solution. 
 
 Piperazin possesses the valuable property of forming with uric acid a 
 very soluble compound, piperazin urate being seven times more soluble 
 in water than is lithium urate, the former requiring but 50 parts and the 
 latter 368 parts of water for solution. It is non-toxic, and devoid of 
 powerful physiological effects, being well borne without ill results, even 
 when administered for prolonged periods. It is non-irritant to mucous 
 membranes, is readily absorbed from the stomach, and circulates in the 
 blood unchanged, reaching the parts affected by gouty deposits in a con- 
 dition in which it neutralizes and dissolves the latter, thus facilitating 
 their removal from the body. 
 
 The administration of Piperazin in gout promptly reduces the redness 
 and swelling of the affected joints, and is frequently followed by a dis- 
 charge of gravel. The minimum daily dosage for this purpose is about 
 15 grains, which should be dissolved in half a pint of water, and the solu- 
 tion should be added to a pint or more of any convenient carbonated 
 water, and be taken in divided doses through the day. When there is 
 much pain and fever present, an equal quantity of Phenocoll Hydro- 
 chloride may be added, — but in preparing them, each agent should be 
 dissolved separately and then mixed together, otherwise a precipitate will 
 form in the solution. It gives marked relief in the pruritus of the uric 
 acid diathesis due to the irritation of imperfect nitrogenous elimination. 
 In solution it may be introduced into the bladder in order to dissolve 
 vesical calculi of the uric character, and in gout it may be locally em- 
 ployed by hypodermic injection. A one per cent, solution, applied 
 locally to open gouty sores, relieves the pain and reduces the inflamma- 
 
430 PISCIDIA PIX, 
 
 tion. It should be tried in rheumatic arthritis of difficult diagnostic 
 differentiation. As a solvent for uric acid and urate concretions Piperazin 
 has been highly praised by many observers and its efficacy disputed by 
 many others. It is patented, which fact, together with its extremely high 
 price, prevents its general use. It is supplied in vials containing 10 
 grammes (150 grains), which is sufficient for ten days' dosage and may 
 be prescribed in Bviij of water, of which solution the daily dose would 
 be %) (equal to 18^ grains), taken in a quart or more of any carbonated 
 water during the day in broken doses. 
 
 Lysidin (Unofficial), — is a base obtained by the action of sodium acetate upon 
 ethylene-diamine hydrochlorate, and said to possess a solvent power on uric acid five 
 times greater than that of Piperazin. It has been tried in cases of chronic gout with ex- 
 cellent results. The stiffness of the joints was lessened, and a conspicuous reduction 
 occurred in the tophi around the joints, and on the epiglottis in one case. The dose is 
 3SS-3 ijss of the 50 per cent, alkaline solution in a glassful of carbonated water. 
 
 Lycetol, Dimethyl-piperazin Tartrate (Unofficial), — is a new uric acid solvent, which 
 is said to combine the solvent properties of Piperazin with the alkalinizing and diuretic 
 effects of a tartrate. The dose is gr. xv-xxx daily, administered in carbonated water or in 
 the form of a lemonade. 
 
 Urotropin (Unofficial), — is prepared by the action of ammonia on formic aldehyde, 
 and occurs as a white, crystalline powder readily soluble in water. It is used as a genito- 
 urinary antiseptic in cystitis and phosphaturia and as a solvent for uric acid. Dose, gr. 
 viij, dissolved in water or carbonated water. 
 
 Piperidin Tartrate (Unofficial), — is another powerful solvent of sodium biurate. 
 It is described under the title Piper, on page 429. 
 
 PISCIDIA, Jamaica Dogwood (Unofficial), — is the bark of the root of Piscidia 
 erythrina, a tree of the nat. ord. Leguminosae, growing in the West Indies. It occurs 
 as a tough, fibrous bark, of heavy, narcotic odor, and contains a yellowish, resinoid sub- 
 stance named Piscidin. Its active principle has not been isolated. A fluid extract is 
 on the market, of which the dose is ^ss-j, carefully increased. 
 
 Piscidia has a narcotic effect on many animals, and has been used in Jamaica for many 
 years to stupefy fish, that they may be easily taken. It produces muscular relaxation, 
 incoordination of movement, lowered sensibility, increased action of the heart and increase 
 of the arterial tension by stimulation of the vaso-motor centre. Soon however the 
 heart is weakened, vascular tension falls, and a tetanoid state results from stimulation of 
 the spinal cord, with reduced reflex action. On the brain its effects resemble those of 
 Opium, but it causes deep sleep without any unpleasant after-results. It relieves pain 
 in less degree however than Opium does, but its hypnotic action is greater. It also re- 
 lieves cough and spasm, produces diaphoresis and salivation and dilates the pupil. From 
 toxic doses death occurs by asphyxia in animals. In man its action is probably the same, 
 but in decidedly less marked degree. 
 
 Piscidia is used chiefly as a general nervous sedative. Its hypnotic and anodyne 
 powers are somewhat uncertain, but have in many cases been very decided. It is useful 
 in whooping-cough and spasm, and has proved almost specific in many cases of neuralgia, 
 while in others it has caused great gastric distress without the least anodyne effect. 
 
 PIX, Pitch, — is a resinous exudation from the stem of certain trees 
 of the genera Pinus (Pines) and Abies (Firs and Spruces), and may also 
 be obtained by the evaporation of wood-tar. [See Pix Liquida, p. 431.] 
 The first two of the following varieties are official. 
 
 Pix Burgundica, Burgundy Pitch, — the prepared resinous exudation 
 of Abies excelsa or Norway Spruce (nat. ord. Coniferae), a native of 
 
pix. 431 
 
 Europe and Northern Asia. It occurs in hard, brittle, opaque or trans- 
 lucent mass, with a shining, conchoidal fracture, almost entirely soluble 
 in glacial acetic acid. It is very fusible, and at the body-heat it softens 
 and becomes adhesive. It is used for plasters. 
 
 Pix Liquida, Tar, — is an empyreumatic oleo-resin obtained by the 
 destructive distillation of the wood of Pinus palustris and other species 
 of Pinus (nat. order Coniferae). It is thick, viscid, semi-fluid, blackish- 
 brown, of acid reaction, terebinthinate odor, and sharp, empyreumatic 
 taste ; slightly soluble in water, soluble in alcohol, in oils and in a solu- 
 tion of potassa or of soda. 
 
 By distillation Tar yields an acid liquor named Pyroligneous Acid and an empyreu- 
 matic oil called Oil of Tar, (see Oleum Picis Liquids, below), the residue being pitch. 
 Its granular appearance is due to crystals of Pyrocatechin, which occur either in the 
 Pyroligneous Acid or in the tarry mixture. Dose, gj-ij daily, in ten-grain doses. 
 
 Pix Canadensis, Canada or Hemlock Pitch (Unofficial), — is the pre- 
 pared resinous exudation of Abies canadensis (nat. ord. Coniferae), the 
 Hemlock Spruce of the U. S. and Canada. Its properties are much the 
 same as those of Burgundy Pitch. 
 
 Preparations. 
 
 Emplastrum Picis Burgundicae, Burgundy Pitch Plaster, — has of Burgundy Pitch 
 80, Olive Oil 5, Yellow Wax 15. 
 
 Emplastrum Picis Cantharidatum, Cantharidal Pitch Plaster, Warming Plaster, 
 has of Cerate of Cantharides 8, Burgundy Pitch to 100. 
 
 Oleum Picis Liquidae, Oil of Tar, — a volatile oil distilled from Tar. Dark, red- 
 dish-brown (almost colorless when fresh), of tarry odor and taste and acid reaction, 
 readily soluble in alcohol. Contains a great variety of compounds, including Hydro- 
 carbons, Phenols, Paraffin, etc., among the phenols being Creosote and Carbolic Acid. 
 
 Syrupus Picis Liquidae, Syrup of Tar, — has of Tar 7^ per cent.; and is a sweet- 
 ened Tar- water. Dose, 3 ij- ^ ss. 
 
 Unguentum Picis Liquidae, Tar Oint?nent, — contains of Tar 50 parts, Yellow 
 Wax 12^, Lard 37 %. Is irritating unless mixed with finely levigated chalk. 
 
 Infusum Picis Liquidae, Tar Water (Unofficial), — made by shaking Tar 1 with 
 Water 4 frequently during 24 hours, decanting and filtering. Dose, Oj-ij daily. 
 
 Vinum Picis Liquidae, Wine of Tar (Unofficial), — Tar jfxvj, Glycerin, White 
 Wine, Honey, aa^viij, Acetic Acid ff), Boiling Water Oyj, shaken together and di- 
 gested in a closed vessel for two hours at 150 to 160 F., then macerated for a few days, 
 frequently shaken, strained and filtered. 
 
 Oleum Pini Sylvestris, Oil of Scotch Fir (Unofficial), — a colorless, fragrant oil, 
 distilled from the leaves of Times Sylvestris, resembling Turpentine in action. Used by 
 inhalation ( ^ss to Oj of boiling water), or locally. 
 
 Retinol, Resinol (Unofficial), — obtained by the distillation of Burgundy pitch, occurs 
 as a yellowish, oily liquid, boiling at temperatures above 536 F. Used as a solvent for 
 a number of the newer remedies, as Cocaine, Aristol, lodol ; also for Carbolic Acid, 
 Creosote, Phosphorus and many alkaloids. 
 
 Concentrated Extract of Pinus Canadensis (Unofficial"), — is an aqueous, non- 
 irritant astringent, prepared from the Abies Canadensis or Hemlock Spruce. It is said 
 to have a specific tonic action upon mucous membranes. Two kinds are sold, one being 
 called the White Extract, in reality a golden yellow, — and the other the Dark Extract, 
 the former intended for use when it is desirable to avoid staining the linen. This prep- 
 
432 PLANTAGO. 
 
 aration received the endorsement of Dr. J. Marion Sims, and has been extensively 
 employed, both locally and internally, as a topical application in uterine and vaginal 
 catarrhs, and as a systemic remedy in catarrhal inflammation of the gastro-intestinal and 
 broncho-pulmonary mucous membranes. 
 
 Physiological Action and Therapeutics. 
 
 Pitch is a gentle rubefacient when applied to the skin, but in some 
 constitutions the Burgundy variety causes a vesicular and pustular inflam- 
 mation if used extensively. It is generally employed as a basis for plas- 
 ters, and is of benefit in lumbago, rheumatism, chronic pleurisy, painful 
 joints, superficial neuralgiae, etc., protecting the part from variations of 
 temperature, and perhaps by the gentle pressure exercised stimulating the 
 lymphatics and promoting absorption. It is supposed to have a special 
 influence on the rectum, and in pill with Tar has been employed as a 
 remedy for hemorrhoids. In applying adhesive plasters the hair should 
 first be shaved off, and when about to be removed the plaster should be 
 warmed, and a little oil of turpentine inserted between its edge and the 
 skin. Canada Pitch is too soft for plasters, but is employed for the same 
 purposes as the preceding. A volatile oil obtained from the same tree 
 and named Oil of Spruce or Oil of Hemlock, has been used for abortifa- 
 cient purposes, endangering the life of the subject. 
 
 Tar is a complex mixture of resins and hydrocarbons, containing creo- 
 sote and carbolic acid, which give to it irritant qualities. Internally it 
 is expectorant, and produces gastro-intestinal irritation, sometimes severe 
 headache, giddiness and febrile phenomena. It is eliminated chiefly by 
 the kidneys, which it stimulates, and may cause their congestion also in- 
 creased diuresis. Externally it is a decided stimulant to the skin, often 
 giving rise to considerable irritation and pain. It is antiseptic and in 
 most of its effects it resembles the turpentines. Tar is used as a local 
 application in chronic scaly skin diseases, especially psoriasis and chronic 
 eczema. As an atomized inhalation it is of decided benefit in bronchitis, 
 pharyngitis, laryngitis and winter cough. Internally it may be employed 
 with advantage in these affections, also in hemorrhoids, bronchial catarrh, 
 and phthisis. The best preparation for internal administration is the 
 syrup, which is a sweetened tar-water, the sugar forming with the Tar a 
 soluble compound. 
 
 PLANTAGO, Plantain (Unofficial), — is the leaf of Plantago major and Plantctgo 
 lanceolata (nat. ord. Plantaginaceae), the common Ribbed Grass. The pounded leaves 
 applied as a paste, or the dry leaf powdered, are actively hemostatic, stopping hemor- 
 rhages speedily. Among the ancients it had a good reputation as a remedy for toothache 
 and earache, which still adheres to it in Switzerland and other parts of Europe. In 
 many other painful affections it is extremely efficient, especially in mastitis, rhus-poison- 
 ing, erysipelas, burns, scalds, wounds and bruises. A poultice of the leaves may be 
 applied to the affected part, and an infusion administered internally. A fluid extract is 
 sold in the shops, of which the dose is TT\v-xv. 
 
PLUMBUM. 433 
 
 PLUMBUM, Lead, Pb, — is not official, but several of its salts are, 
 namely — the Acetate, Carbonate, Iodide, Nitrate and Oxide: of which 
 the Acetate is the only one administered internally, the solutions of the 
 Subacetaie are the only liquid preparations, the Oxide (Litharge) is used 
 as Emplastrum Plumbi, the Nitrate is used as a local stimulant or escha- 
 rotic, the Iodide as an ointment for absorbent purposes, and the Carbonate 
 as an astringent locally to inflamed surfaces. The metal occurs in nature 
 chiefly as a Sulphide named Galena, also as an Oxide rarely, and in 
 .various other combinations (salts). 
 
 Official Salts of Lead. 
 
 Plumbi Acetas, Lead Acetate, Sugar of Lead, — Pb (C 2 H 3 2 ) 2 -f- 3H 2 0, — colorless, 
 shining, prismatic crystals or scales, efflorescent, of faintly acetous odor and acid reaction, 
 and a sweetish, astringent and metallic taste. Soluble in 2.3 of water and in 21 of alco- 
 hol at 59 F., in 0.5 of boiling water and in I of boiling alcohol. Dose, gr. ss-v. 
 
 Plumbi Carbonas, Lead Carbonate, White Lead, (PbC0 3 ) 2 Pb(HO) 2 , — a heavy, 
 white, opaque powder, odorless and tasteless ; insoluble in water or alcohol, but soluble 
 with effervescence in acetic or in diluted nitric acid. Used locally only. 
 
 Plumbi Iodidum, Lead Lodide, Pbl 2 , — a heavy, bright citron-yellow powder, odor- 
 less and tasteless, fusible and volatilizable by heat ; soluble in about 2000 of water at 59 
 F., and in about 200 of boiling water. Used externally as an ointment. May be given 
 internally in doses of gr. A twice daily. 
 
 Plumbi Nitras, Lead A'itrale, Pb(X0 3 ) 2 , — colorless, opaque, octahedral crystals, 
 odorless, of sweetish, astringent and metallic taste and acid reaction ; soluble in 2 of water 
 at 59 F., almost insoluble in alcohol. Used locally as an astringent and deodorizer in 
 solutions up to I per cent., also as an escharotic and a disinfectant. 
 
 Plumbi Oxidum, Lead Oxide, Litharge, PbO, — a heavy, yellowish, or reddish- 
 yellow powder, odorless and tasteless ; insoluble in water or alcohol, but almost wholly 
 soluble with slight effervescence in dilute nitric acid. When heated in contact with char- 
 coal it is reduced to metallic lead. Used as Lead-Plaster and sometimes with oil as an 
 external application. 
 
 Preparations. 
 
 Liquor Plumbi Subacetatis, Solution of Lead Subacetate, Goulard'' s Extract, — 
 an aqueous solution containing about 25 per cent, of the salt, prepared from Acetate of 
 Lead 170, Oxide of Lead 100, and Distilled Water to 1000. It is a clear, colorless liquid, 
 of sweetish, astringent taste and alkaline reaction, of sp. gr. 1.195, and when added to a 
 solution of acacia it produces a dense, white precipitate. Used locally as an astringent 
 and cooling lotion, diluted usually with an equal quantity of water. 
 
 Liquor Plumbi Subacetatis Dilutus, Diluted Solution of Lead Subacetate, Lead 
 Water, — has of the preceding 3, in Distilled Water to 100. Used locally as a mildly 
 astringent and cooling lotion. 
 
 Ceratum Plumbi Subacetatis, Cerate of Lead Subacetate, Goulard 's Cerate, — has 
 of the same solution 20 parts with 80 of Camphor Cerate, freshly prepared as it becomes 
 rancid easily. Used as an astringent and protective application. 
 
 Emplastrum Plumbi, Lead Plaster, Diachylon Plaster, — Oxide of Lead 32, Olive 
 Oil 60, rubbed together and boiled with 10 parts of water. Is white, pliable and tena- 
 cious, free from greasiness or stickiness, and entirely soluble in warm Oil of Turpentine. 
 A protective in abrasions and bed-sores, and the basis of many other plasters. 
 
 Unguentum Diachylon, Diachylon Ointment, — has of Lead Plaster 50, Olive Oil 
 49, Oil of Lavender Flowers I. Used locally in Eczema and other cutaneous disorders. 
 
 Unguentum Plumbi Carbonatis, Ointment of Lead Carbonate, — has of the Carbon- 
 ate in very fine powder 10, Benzoinated Lard 90. Used as a dressing for burns. 
 28 
 
434 PLUMBUM, 
 
 Unguentum Plumbi Iodidi, Ointment of Lead Iodide, — has of the Iodide in very 
 fine powder io, Benzoinated Lard 90. Used locally to promote absorption = 
 
 Oleatum Plumbi, Oleate of Lead (Unofficial), — a 20 per cent, solution of Oxide o£ 
 Lead in Oleic Acid. A soft, yellowish ointment, for local use. 
 
 Physiological Action. 
 
 Lead salts are all more or less poisonous, but metallic Lead is inert until 
 converted into a soluble salt by the acids of the stomach. The Acetate 
 in large doses- is emetic, so that acute lead-poisoning therefrom is rare. 
 Its chief phenomena are intense gastro-intestinal irritation, vomiting, 
 paralysis, coma and collapse. Chronic lead-poisoning, Plumbisni, has its 
 principal sources in pure water conveyed by leaden pipes, the use of hair 
 dyes, handling of printing-type, working in the smelting of lead ores, etc. 
 It produces loss of appetite, emaciation, pallor and constipation, fol- 
 lowed by slowing of the heart's action, and accompanied by violent colic, 
 muscular impairment evinced by paralysis of the extensor muscles of the 
 forearm (drop-wrist), impaired sensibility and albuminuria. Occasion- 
 ally aphonia, vertigo, gastralgia, headache, stupor and convulsions are 
 manifested. Rheumatism without fever or tenderness in the joints, 
 which however are red and swollen, is a frequent symptom. A blue line 
 (sulphide) is seen along the margins of the gums in those who do not 
 clean their teeth. Neuralgic troubles may arise and amblyopia often 
 occurs from impairment of the optic nerve. The metal becomes depos- 
 ited in the affected muscles and other tissues, and probably acts by 
 impairing the isolating power of the nerve-fibres, thus enfeebling the 
 nerve-currents. It also produces contraction of the smaller vessels, and 
 may affect any muscles of the body, also the brain, producing delirium, 
 coma, and convulsions. Abortion is a frequent result, either through an 
 influence on the muscular tissue of the uterus, or from a toxic action on 
 the fetus. Death may occur from extension of the paresis to the muscles 
 of respiration, from gradual impairment of nutrition, or from convulsions 
 and coma, a form of disease known as Lead-encephalopathy. 
 
 Astringency is the chief quality of the lead salts ; they lessen secre- 
 tion, contract muscular tissue and then destroy its contractile power, slow 
 both the heart and the respiration, and in time destroy the red blood- 
 corpuscles. Lead enters the blood as an albuminate, in which form also 
 it is retained by the tissues. It is slowly excreted by the liver, kidneys, 
 skin and mammary glands. That which escapes by the bile is reabsorbed 
 by the bowel, and is again excreted by the intestinal glands, escaping 
 with the feces as a sulphide. It lessens the excretion of uric acid. 
 
 Antidotes, Antagonists and Incompatibles. 
 
 In acute poisoning by lead salts, as by the Acetate, the antidotes are Sodium or Mag- 
 nesium Sulphate and Sodium Phosphate. The stomach should be evacuated, and albu- 
 
PLUMBUM. 435 
 
 minous drinks and Opium given to allay irritation. Chronic poisoning is best treated by 
 Atropine and Iodides, the latter to saturation of the system. Sulphurated Potassa Baths 
 ( 5jj or more in 'water) are also very useful. Incompatibles are Mineral Acids and their 
 salts, vegetable acids, alkalies, vegetable astringents, Potassium Iodide, albuminous solu- 
 tions, Opium, and all waters containing Lime, Sulphates, Carbonates, and C0 2 . 
 
 Therapeutics. 
 
 Lead salts are chiefly used as astringents and hemostatics. The solu- 
 tion of the Subacetate diluted with 4 parts of glycerin and water is locally 
 employed in many skin-diseases, especially in eczema, lichen, impetigo, 
 and erythema ; also in catarrhal discharges of muco-purulent character 
 from the ear, vagina, and urethra, particularly gonorrhea and leucorrhea. 
 Inflammations of external parts are constantly treated by the lotion of 
 "Leadwater and Laudanum" (liquor plumbi subacetatis dilutus 7 parts 
 to 1 of tinctura opii). Though the constituents of this lotion are chem- 
 ically incompatible it is a valuable sedative and astringent. The acetate, 
 in 5-grain doses every three hours, is an efficient internal styptic in various 
 hemorrhages, particularly in hemoptysis, hematemesis, and gastric ulcer, 
 lowering the action of the heart and constringing the vessels. Its astrin- 
 gent action is well manifested in bronchorrhea and other pulmonary 
 affections with excessive secretion. It is well used in diarrheas, gr. ij 
 with gr. j of pulverized opium in choleraic diarrhea, and smaller doses 
 for the summer complaint of children. In caseous pneumonia the 
 Acetate is highly recommended as the best remedial agent, combined 
 with opium and digitalis; and in cardiac hypertrophy it may be used to 
 lower the action of the heart. It is also serviceable in whooping-cough 
 with profuse bronchial secretion and in humid asthma. 
 
 The Carbonate is only used externally to protect irritated surfaces, as 
 erythema, erysipelas, intertrigo, etc., in which it may be dusted over the 
 surface if unbroken. The official ointment, or white paint mixed with 
 linseed oil, is an excellent application to burns or scalds, but if applied 
 on the broken cuticle it may prove rapidly poisonous. The Iodide is 
 employed externally as an ointment to enlarged lymphatic glands and 
 enlarged spleen, also for chronic eczema and psoriasis. It has been used 
 internally to reduce a malarial spleen. 
 
 The Nitrate is an efficient application to fissured nipples, gr. x to ^j of 
 glycerin. In powder, dusted over unhealthy granulations, and sanious 
 ulcers resulting from onychia, it gives prompt relief after a brief period 
 of pain. It is said to have cured cases of epithelioma when used in the 
 same manner. In solution (gr. x to the |) it is a most efficient deodor- 
 izer against the fetor from gangrenous sores, ozena and other offensive 
 discharges. Pharmaceutically it is used in the preparation of the Iodide. 
 The Oxide is used in the manufacture of plasters and most of the other 
 salts of lead. It may be used as an external application mixed with sweet 
 
43^ PODOPHYLLUM POLYGONUM. 
 
 oil in superficial burns, but care should be taken that it is applied only to 
 the unbroken skin. It is not employed internally. 
 
 PODOPHYLLUM, May Apple,— is the rhizome and rootlets of 
 Podophyllum pe Itatum, the Mandrake, an herbaceous perennial of the nat. 
 ord. Berberidaceae, growing in the woodlands of Canada and the U. S., 
 having a pale-green stem, with a single white flower at its summit. Its 
 active principle is a Resin which is official and is a compound of several 
 resins. It probably contains the alkaloid Berberine, which is also found 
 in Berberis, Hydrastis and other plants. Dose, gr. v-xx. 
 
 Preparations. 
 
 Extractum Podophylli, Extract of Podophyllum. — Dose, gr. v-x. 
 
 Extractum Podophylli Fluidum, Fluid Ext. of Podophyllum. — Dose, mj-xxx. 
 
 Resina Podophylli, Resin of Podophyllum, Podophyllin, — is precipitated from a 
 concentrated tincture by acidulated water. Soluble in alkaline liquids and partly so in 
 ether. Contains Podophyllotoxin and Picropodophyllin, also Podophyllinic and Proto- 
 catechuic Acids. Dose, gr. )/%-}, in pill. Is an ingredient of Pilulse Catharticse Vegetabiles. 
 
 Podophyllum is a tonic-astringent and resin-bearing purgative, having 
 action similar to that of jalap but slower, like calomel' taking 6 to 10 
 hours to produce its cathartic effect. It increases the intestinal secretions 
 and the flow of bile, causing copious watery stools, with considerable 
 griping pain and some nausea. The powder is irritant to the respiratory 
 passages and to the skin. The Resin is an excellent purgative in cases 
 of habitual constipation or portal congestion and a useful cholagogue. 
 Laxative effects are produced by small doses (gr. }i-%), but grain- 
 doses are necessary for its full action. It should be combined with 
 hyoscyamus, belladonna or cannabis indica, in order to counteract its 
 griping tendency. It is an efficient derivative in cases of catarrhal or 
 malarial jaundice, and is recommended in very small doses for prolapse 
 of the rectum, remittent fevers of children, dyspepsia, hepatic derange- 
 ment, bilious vomiting and headache, and in the vomiting and diarrhea 
 of gastro-enteritis. 
 
 POLYGONUM, Smart-weed, Water-pepper (Unofficial), — is the plant Polygonum 
 Hydropiperoides, nat. ord. Polygonacege, indigenous to the U. S., having narrow, lance- 
 olated leaves and slender spikes of whitish flowers. It contains Tannin and an active 
 principle, Polygonic Acid, which is green, crystallizable, insoluble in water, but soluble 
 in alcohol, ether, and chloroform. 
 
 Extractum Polygoni Fluidum, El. Ext. of P. (Unofficial). — Dose, TT\x-3J. 
 
 Extractum Polygoni, Extract of Polygonum (Unofficial). — Dose, gr. j-v. 
 
 Smart-weed has a pungent, acrid taste, producing a sensation of heat in the stomach, 
 and a peculiar tingling throughout the system. It stimulates the action of the heart, 
 raises the arterial tension, increases the warmth of the surface, promotes the cutaneous, 
 bronchial and renal secretions and the menstrual flow. It is an efficient diuretic, 
 emmenagogue and aphrodisiac. The juice applied to the skin excites inflammation and 
 vesication. 
 
PONGAMIA POTASSIUM. 437 
 
 Amenorrhea from functional inactivity of the uterine system is remarkably benefited 
 by this remedy in 3 ss doses of the fluid extract four times daily for a week before the 
 expected period. It has considerable influence over functional impotence, but produces 
 aching pains in the hips and loins, and a sense of weight and fullness within the pelvis. 
 It has been used with benefit in diarrhea, dysentery and gravel, also locally in mercurial 
 salivation and the sore mouth of nursing women. 
 
 PONGAMIA, Kurung Oil (Unofficial), — is a yellow oil expressed from the seeds 
 of Pongamia glabra, an Indian tree of the nat. ord. L eguminosx. It has been used for 
 many years in India for skin affections, and in professional hands has proven an excellent 
 application in pityriasis versicolor, rubbed in twice daily. It promises to be a valuable 
 remedy in parasitic diseases of the skin, is not irritating and does not discolor the surface 
 to which it is applied. 
 
 POTASSIUM, Kalium, K, — is represented by a number of official 
 salts, which are colorless or white, sometimes anhydrous, and generally 
 readily soluble in water. The metal itself is not official. The chief 
 source of its salts is the ash remaining after the combustion of plants or 
 trees, which contains the Carbonate, from which most of the other salts 
 are prepared. There are also two subsidiary sources, — the Nitrate 
 which is found native, and the Bitartrate, which under the name of 
 Crude Tartar or Argol is deposited during the fermentation of wine. 
 It is distinguished from all other bases (except magnesium, sodium and 
 ammonium) by not being precipitated by Ammonium Sulphide or Am- 
 monium Carbonate. It is positively known by the violet color it imparts 
 to flame, by its very sparing solubility when converted into the Bitartrate, 
 and by its precipitation by Platinum Perchloride. 
 
 Potassium Salts and their Preparations. 
 
 Potassa, Potassium Hydrate, Caustic Potash, KOH, — a very deliquescent, white, 
 hard and dry solid, of very acrid and caustic taste and strongly alkaline reaction, soluble 
 in 0.5 of water and in 2 of alcohol. It is a powerful and deeply-acting escharotic, and 
 should be kept in well-stoppered bottles made of hard glass. 
 
 Potassa cum Calce, Potassa with Lime, Vienna Paste, — a grayish-white, deliques- 
 cent powder, consisting of equal parts of Potassa and Lime rubbed together. A milder 
 and more manageable caustic than the preceding. 
 
 Liquor Potassae, Solution of Potassa, — contains about 5 per cent, of Potassium Hy- 
 drate, and is prepared by dissolving Potassium Bicarbonate 85, in 400 of Distilled Water, 
 40 of Lime in the same quantity of Distilled Water, boiling, mixing the solutions gradu- 
 ally, again boiling, and when cold adding Water up to 1000 parts, straining, settling, and 
 decanting the clear solution. Or, by dissolving 56 of Potassa in 944 of Distilled Water. 
 Is a clear, colorless, odorless liquid, of acrid and caustic taste, and strongly alkaline 
 reaction. Dose, TJLv-^ss, well diluted with water. 
 
 Potassii Acetas, Potassium Acetate, KC 2 H 3 2 , — a white, satiny, crystalline mass, 
 very deliquescent, odorless, of pungent, saline taste, and a neutral or faintly alkaline 
 reaction, soluble in 0.4 of water and in 1.9 of alcohol at 59 F. Dose, gr. v-gj. 
 
 Potassii Carbonas, Potassium Carbonate, K 2 C0 8 , — a white, crystalline or granular 
 powder, very deliquescent, odorless, of alkaline taste and reaction, soluble in 1.1 of 
 water at 59 F. , insoluble in alcohol. Dose, gr. ij-xx. 
 
 Potassii Bicarbonas, Potassium Bicarbonate, — KHC0 3 . — colorless prisms of saline 
 and alkaline taste and alkaline reaction, soluble in 3.2 of water at 59 F. , decomposed 
 by boiling water, almost insoluble in alcohol. Dose, gr. v-xxx. 
 
438 POTASSIUM. 
 
 Potassii Chloras, Potassium Chlorate, KC10 3 , — colorless prisms or plates, of pearly- 
 lustre, of cooling, saline taste and neutral reaction, soluble in 16.7 of water at 59 F. and 
 in 1.7 of boiling water; slightly soluble in mixtures of alcohol and water, insoluble in 
 absolute alcohol. Dose, gr. v-xx. 
 
 Potassium Chlorate should be kept in glass-stoppered bottles, and great caution should 
 be observed in handling the salt, as dangerous explosions are liable to occur when it is 
 mixed with organic matters (cork, tannic acid, sugar, etc.), or with sulphur, antimonium 
 sulphide, phosphorus, or other easily oxidizable substances, and either heated directly or 
 subjected to trituration or concussion. It should not be mixed with glycerin in the 
 presence of a free acid. [For the combination of this salt with the tincture of the 
 chloride of iron, see ante, page 267.] 
 
 Gargarysma Potassii Chloratis, Potassium Chlorate Gargle (Unofficial), — has of 
 the salt 3J, in Glycerin giv and Water to 3jvj. 
 
 Trochisci Potassii Chloratis, Troches of Potassium Chlorate, — each troche contains 
 about 4^ grains of the salt, with sugar, tragacanth, and spirit of lemon. Dose, j-iij, 
 slowly dissolved in the mouth. 
 
 Potassii Citras, Potassium Citrate, K 3 C 6 H 5 0~ -f- H 2 0, — transparent, prismatic crys- 
 tals, odorless, of cooling, saline taste, and neutral reaction, soluble in 0.6 of water, very 
 soluble in boiling water, sparingly soluble in alcohol. Dose, gr. x-xxx. 
 
 Potassii Citras Effervescens, Effervescent Potassium Citrate, — consists of Pot. 
 Bicarb. 90, Citric Acid 63, Sugar 47, powdered, mixed to a paste, dried and again pow- 
 dered. Dose, 3J-ij, in a glass of water, as an effervescent drink. 
 
 Liquor Potassii Citratis, Solution of Potassium Citrate, Mistura Potassii Citratis, — 
 contains about 9 per cent, of the anhydrous salt, together with small amounts of citric 
 and carbonic acids. Prepared by dissolving Citric Acid 6, and Pot. Bicarb. 8, each in 
 water 40, filtering the solutions separately, and adding in each case enough water to bring 
 to 50 parts, then mixing the two together. Dose, ^ss-^j or more. 
 
 Potassii Nitras, Potassium Nitrate, Saltpetre, Nitre, KN0 3 , — colorless, transparent 
 prisms or a crystalline powder, of pungent, cooling and saline taste and neutral reaction ; 
 soluble in 4 of water at 59 F. and in 0.4 of boiling water ; almost insoluble in alcohol. 
 Is a constituent of Argenti Nitras Dilutus. Dose, gr. v-xx, well diluted. 
 
 Charta Potassii Nitratis, Potassium Nitrate Paper, — is unsized paper immersed in 
 a solution of 20 parts of the salt in 80 of distilled water, and dried. Used for inhalation, 
 the fumes from the burning paper being inhaled in asthma. 
 
 Potassii Sulphas, Potassium Sulphate, K 2 S0 4 ,— colorless, hard, rhombic prisms, of 
 sharp, saline and bitter taste and neutral reaction, soluble in about 9.5 of water at 59 
 F. , and in 4 of boiling water, insoluble in alcohol. Dose, gr. xx- ^ ss, well diluted. 
 
 Potassii Bitartras, Potassium Bitartrate, Acid Tartrate of Potash, Cream of 
 Tartar, KHC 4 H 4 6 ,— colorless rhombic crystals, or a white, gritty powder, of acidulous 
 taste and acid reaction ; soluble in about 201 of water at 59 F., and in about 1 6. 7 of 
 boiling water, very slightly soluble in alcohol. Is a constituent of Pulvis Jalapoe Com- 
 positus. Dose, gr. xx-^j (diuretic and refrigerant), ^ss-j (purgative). 
 
 Potassii et Sodii Tartras, Potassium and Sodium l^artrate, Rochelle Salt, 
 KNaC 4 H 4 6 -j- 4H 2 0, — colorless, rhombic crystals, or a white powder, of cooling and 
 slightly saline and bitter taste, and neutral reaction ; soluble in 1.4 of water at 59 F., 
 very soluble in boiling water, almost insoluble in alcohol. Is a constituent of the follow- 
 ing preparation. Dose, 3 ss-j. 
 
 Pulvis Effervescens Compositus, Compound Effervescing Potvder, Seidlitz Pow- 
 der, — each powder has of the preceding salt 120 grains, of Sodium Bicarbonate 40 grains, 
 mixed in one paper ; and of Tartaric Acid 35 grains in another paper. Dose, I to 2 pair, 
 dissolved separately in water and the solutions poured together. 
 
 Potassii Silicas, Potassium Silicate, Soluble Glass, K 2 SiO s (Unofficial), — is used in 
 solution of a syrupy consistence for the preparation of immovable dressings for fractured 
 limbs, etc. [See under Silicates.] 
 
 The Arsenite is described under Arsenum, — the Bromide under Bromum, — the 
 Bichromate under Acidum Chromicum, — the Iodide under Iodum, — the Cyanide 
 and Ferrocyanide under Acidum HydrocyAnicum, — the Hypophosphite under 
 Phosphorus, — the Permanganate under Manganum, — the Nitrite under Amyl 
 Nitris, — and Sulphurated Potassa under Sulphur. 
 
potassium. 439 
 
 Physiological Action. 
 
 Caustic potash, like other caustic alkalies, destroys the tissues by com- 
 bining with their water, dissolving the albumin and saponifying the fats, 
 and converting the tissue to which it is applied into a moist, gray slough, 
 with considerable surrounding inflammation. Internally it acts as a 
 powerful corrosive poison, destroying the mucous membrane of the parts 
 with which it comes in contact, and giving rise to intense pain, diarrhea, 
 convulsions and delirium. Unless speedily rejected or neutralized it 
 causes death from inflammation of the larynx, from the gastro-intestinal 
 lesions, or after some time from stricture of the esophagus. Liquor 
 Potassae, containing over 5 per cent, of the pure Potash, possesses in a 
 degree the same caustic properties, and should never be administered 
 undiluted. It neutralizes the acids in the stomach, and in the blood exists 
 chiefly as the carbonate, being eliminated with the urine which it renders 
 alkaline. If its use be continued too long it impairs the blood, and 
 renders the subject anemic. 
 
 Potassium Salts in large doses are cardiac poisons, muscular paralyzers, 
 poisonous to protoplasm especially nerve tissue, and destructive to the 
 ozonizing function of the blood. They increase the saliva, promote 
 oxidation and stimulate retrograde metamorphosis, and are therefore 
 waste-producers. In small doses on an empty stomach they promote the 
 formation of acid gastric juice by favoring the outward osmosis of its 
 constituents from the blood ; in larger doses they act chemically on the 
 stomach contents, neutralizing its free acids, and disordering digestion. 
 The Bicarbonate, given on an empty stomach, enters the blood unchanged, 
 meets the neutral phosphate of sodium and is decomposed, acid phosphate 
 of sodium being formed which renders the urine more acid. On a full 
 stomach it is decomposed by the acids of the gastric juice, increases the 
 alkalinity of the blood and makes the urine less acid. The salts of 
 potassium with vegetable acids (Acetate, Citrate, Tartrate, etc.) enter the 
 blood in their own form, are there decomposed, forming free C0 2 , and 
 are converted into alkaline carbonates in which form they are eliminated, 
 alkalinizing the blood and the urine. They are diuretics also, increasing 
 the urinary water and solids, but decreasing the uric acid by causing in- 
 creased oxidation. The mineral salts (Nitrate, Chlorate, etc.) are not 
 decomposed in the blood, but are eliminated in their own form, the Ni- 
 trate being a most active diuretic, the Chlorate irritating the kidneys, 
 depressing the heart, causing albuminuria, and impairing the ozonizing 
 function of the blood. In large doses these salts decompose the red 
 blood-corpuscles and paralyze the motor ganglia of the heart. The Chlo- 
 rate does not part with its oxygen in the system, as generally believed. 
 
440 POTASSIUM. 
 
 The Sulphate is chiefly purgative in its action, but acts harshly, and in 
 overdoses has caused death. 
 
 The action of the remaining Potassium salts is described under the 
 titles of their acid and other constituents, to which their effects are chiefly 
 referable. 
 
 Antidotes and Incompatibles. 
 
 Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, 
 lemon-juice ; — then demulcent drinks and oils to protect the mucous membrane, and the 
 usual measures to support vitality. The Alkalies and their Carbonates are incompatible 
 with the acids and also with metallic salts, and the Caustic Alkalies decompose most of 
 the alkaloids. 
 
 Therapeutics. 
 
 Caustic Potash is used locally to destroy morbid or cicatricial tissue, to 
 cauterize the wounds resulting from bites of animals or stings of insects, 
 to form issues or to open deep-seated abscesses, or to destroy chancres, 
 malignant pustules, nevi, warts, etc. Its action is deep and severe, and 
 it is best employed in the form of Potassa cum Calce, which is a far more 
 manageable preparation. 
 
 Liquor Potassse is used internally as a free alkali to neutralize excess 
 of acid in the stomach, blood and secretions, and as an antilithic in the 
 uric acid diathesis, also for acne, boils, and obesity. Locally it is em- 
 ployed to soften the nail in in-growing toe-nail, and diluted to relieve 
 pruritus and to remove scales in various skin-diseases. In small doses 
 with a vegetable bitter tonic before meals it acts well in atonic dyspepsia, 
 increasing the flow of the gastric juice by direct stimulation of the gas- 
 tric mucous membrane. If given after meals in acid dyspepsia large 
 doses are necessary for temporary alleviation by neutralizing the food 
 acids. These remarks concerning acidity and dyspepsia apply equally 
 well to the Bicarbonate, which is used for the same purpose, and while 
 possessing all the virtues of the potassium salts is without any corrosive 
 or irritant action. It is also useful in simple gastralgia or cardialgia ; and 
 in cystitis, gonorrhea, etc., where there is acid urine, it renders the urine 
 less irritating and soothes the inflamed surfaces. Acute and chronic 
 rheumatism and rheumatoid arthritis are much benefited by an alkaline 
 treatment in patients of sufficient bodily vigor to stand its lowering 
 effects. The Bicarbonate is also used to alkalinize the blood and secre- 
 tions in lithemia, jaundice, many cutaneous eruptions, and in diabetes ; 
 also locally as a lotion for fetid perspiration of the feet and axillae, acne, 
 and acute eczema. The Carbonate is diuretic, antacid and antilithic, 
 but is seldom used internally being too irritant, and the Bicarbonate hav- 
 ing all its virtues without its objectionable qualities. Locally a solution 
 (3J to the §) is said to be effectual as a remedy for pruritus vulvae, and 
 one of half the above strength is used in freckles, sunburn and tan of the 
 epidermis, in moist eczema and the itching of urticaria. 
 
POTASSIUM. 441 
 
 The Acetate and Citrate are good purgatives in doses of 5ij to giv, 
 and in smaller doses are employed as alkalinizers of the blood and urine 
 and as diuretics. Of the vegetable potassium salts the Acetate is the 
 most certain diuretic, the Bitartrate is the most active cathartic, while 
 the Citrate is the most reliable diaphoretic and the best to alkalinize the 
 urine, it having the least injurious effect on the blood and on the diges- 
 tion. In lithemia the first and last of these salts are given to promote 
 oxidation, and by keeping the urine alkaline they may reduce small cal- 
 culi of the uric acid variety. In acute rheumatism and fevers they act 
 as antacids in the blood, as febrifuges by promoting diaphoresis, and as 
 sedatives to the general nervous system. As an agreeable laxative no 
 preparation surpasses the Bitartrate in 2 to 4 drachm doses made into a 
 paste with orange marmalade or any other conserve. It is also used as a 
 diuretic in general cardiac dropsy and in acute desquamative nephritis. 
 In cases of acute dysentery with scorbutic symptoms, as seen among 
 miners, sailors, etc., a full purgative dose of this salt (^ss or more) has 
 acted most beneficially as a preliminary to other treatment, and in many 
 cases has proven to be the only remedy required. In the acute diarrhea 
 of soldiers it is usually promptly curative. Being an acid salt its internal 
 administration will in many cases acidify an alkaline urine. 
 
 Potassium Chlorate is employed locally in solution (^ss to the g) as a 
 deodorant and detergent wash in inflamed, ulcerated and aphthous con- 
 ditions of the mouth. On unhealthy mucous membranes it exercises 
 an alterative action for the better, but if long used it will keep up a state 
 of chronic irritation. In mercurial salivation it is of great benefit, and 
 in dilute solution (gr. x to the J) it is an efficient application to un- 
 healthy sores and ulcers, as a wash for foul sinuses or cavities, and as an 
 injection in chronic affections of the bladder. The powdered salt may 
 be applied to aphthae, and dusted over epithelioma will alter the action, 
 diminish the pain, check the growth and promote cicatrization. In- 
 ternally this salt has been administered in the idea that it parts with 
 its oxygen in the system, but it is now acknowledged that it is excreted 
 unchanged. Setting up congestion and irritation of the kidneys it is 
 highly dangerous in large doses or if used for any length of time, but is 
 constantly administered in diphtheria, chronic bronchitis, purpura, hem- 
 aturia, ovarian tumor, pseudo-membranous laryngitis, scarlatina, typhoid 
 fever and chronic cystitis. When used internally it should be given 
 in small doses (gr. xx in 24 hours for an infant, gr. xxx in 24 hours for a 
 child of 2 to 4 years, and 3iss for an adult in the same time), and the ac- 
 tion of the heart and the kidneys should be carefully watched. It should 
 never be prescribed with potassium iodide lest the poisonous Iodate be 
 formed, nor with the syrup of the iodide of iron, lest it liberate the 
 Iodine, and cause severe gastritis. Strong acids and acid sulphates de- 
 
442 PRINOS PRUNUS VIRGINIANA. 
 
 compose it, and it forms explosive compounds with easily oxidizable sub- 
 stances, as sugar, sulphur, tannin, sodium or potassium hypophosphites, 
 catechu, glycerin, etc. For the combination of Potassium Chlorate with 
 the tincture of the chloride of iron, as a gargle, see under Chlorum. 
 
 The Nitrate has been much employed as a refrigerant diaphoretic and 
 diuretic in febrile and inflammatory affections, especially in inflammation 
 of the trachea and bronchi, pneumonia and rheumatism, but its action is 
 uncertain, and it is now giving place in these disorders to more efficient 
 agents. The fumes of burning nitre paper (Charta Potassii Nitratis) are 
 a useful inhalation in some forms of spasmodic asthma. The Sulphate 
 is used in teaspoonful doses in water as an hepatic stimulant and a mild 
 cathartic, increasing the secretions of the intestinal glandular apparatus. 
 Its action is sometimes harsh, and death has resulted from overdoses. 
 Potassium and Sodium Tartrate, Rochelle Salt, is the chief aperient 
 agent in Seidlitz Powders. In doses of §ss-j it is a gentle and cooling 
 laxative, and in drachm doses frequently repeated it is used to render the 
 urine alkaline and as an antilithic. 
 
 The therapeutics of the other Potassium Salts are described under the 
 respective titles of their more active bases. 
 
 PRINOS, Black Alder (Unofficial), — is the bark of Prinos verticillatus,oxWva.\sx- 
 berry, a shrub of the nat. ord. Aquifoliaceoe, indigenous to Canada and the U. S., having 
 small, white flowers, and a globose, six-seeded, bright-red berry, which grows in clusters 
 and is persistent all winter. It contains an amorphous, yellow and bitter principle, also 
 tannin, sugar, starch, wax, resin, etc. The bark may be given in substance in doses of 
 g ss, or a decoction ( 3 ij in Oiij boiled to a quart) in doses of 3 j-ij. 
 
 Black Alder is astringent and tonic, and has been used in intermittent fever, diarrhea, 
 and chronic cutaneous diseases. In the latter class of disorders it may be applied locally. 
 
 PRUNUM, Prune, — is the fruit oi Primus domestica, the Plum tree (nat. ord. Rosa- 
 cea), indigenous to Western Asia, but cultivated in most countries of temperate climate. 
 Prunes contain sugar, pectin, albumin, malic acid and salts. They are a constituent of 
 Confectio Sennse. The root-bark contains a glucoside Phloridzin, which causes glyco- 
 suria in animals (see below, under Prunus Virginiana). 
 
 Prunes are laxative and nutritious, and are freely used as a food and sweetmeat, but in 
 excess may give rise to flatulent colic from the indigestibility of their skins. Stewed 
 prunes is an excellent dish for constipation in children, and may be made more effective 
 by the addition of a little Senna. 
 
 PRUNUS VIRGINIANA, Wild Cherry,— is the bark of Pru- 
 nus serotina, the Wild Cherry, a large forest tree of the nat. ord. Rosacea^ 
 growing in Canada and the U. S. On maceration in water it develops a 
 distinct odor of bitter almonds. It contains tannin, gallic acid, resin, 
 starch, etc., also Amygdalin and Emulsin, which by their mutual reaction 
 in the presence of water, produce Hydrocyanic Acid and a Volatile Oil 
 resembling that of Bitter Almond. [See ante, pages 99 and 148.] The 
 root-bark contains a glucoside, Phloridzin, also found in the same part of 
 the apple, pear and plum trees, which causes glycosuria in animals and 
 
PULSATILLA. 443 
 
 man when given by the mouth, intravenously or hypodermically. Dose 
 of the powdered bark, gss-j. 
 
 Preparations. 
 Extractum Pruni Virginianae Fluidum, Fl. Extr. of Wild Cherry. — Dose, gss-j. 
 Infusum Pruni Virginianae, Infusion of Wild Cherry, — 4 per cent. Dose, 3SS-J. 
 Should be made with cold water. 
 
 Syrupus Pruni Virginianae, Syrup of Wild Cherry, — 15 per cent. Dose, 5 j-iv. 
 
 Physiological Action and Therapeutics. 
 
 Wild Cherry is an aromatic bitter tonic, increasing appetite, aiding 
 digestion, and thus promoting the constructive metamorphosis. The 
 presence of a volatile oil gives it a local stimulating action on the alimen- 
 tary canal in common with serpentaria, cascarilla and other members of 
 the same class. Hydrocyanic Acid being yielded by it in the presence 
 of cold water, imparts a sedative action to its preparations, calming irri- 
 tation and diminishing nervous excitability. Very large doses reduce 
 the action of the heart. The glycosuria previously mentioned as caused 
 by Phloridzin, the glucoside found in the root-bark, differs from that of 
 true diabetes in the fact that the sugar of the blood is not increased in 
 amount ; hence it is not due to any change in the general metabolism 
 of the body, but to some alteration of the renal epithelium, by which the 
 blood sugar escapes into the urine instead of being retained in the body 
 and used as a source of energy (Cushny). 
 
 The preparations of Wild Cherry are used in catarrhal conditions of 
 the bronchial mucous membrane, also in the hectic of phthisis and scrof- 
 ula, with palpitation of the heart and a debilitated stomach ; a collection 
 of symptoms often observed in consumptive subjects, for whom it is a very 
 useful palliative. Cough is supposed to be especially amenable to its in- 
 fluence, and hence it has become a matter of daily routine to prescribe 
 the syrup as an ingredient of cough-mixtures. The infusion is an excel- 
 lent stomachic tonic, and may be administered with great benefit in dys- 
 pepsia and in convalescence from acute disease. 
 
 PULSATILLA, — is the herb, collected soon after flowering, of Ane- 
 mone Pulsatilla and Anemone firate?isis (Pulsatilla nigricans), the Pasque- 
 flower or Meadow Anemone, small herbal plants of the Ranunculaceae, to 
 which order Aconite also belongs. They inhabit Europe and Siberia, and 
 have large, purple flowers, which are inodorous and very acrid. Pulsatilla 
 contains an acrid yellow oil, which in the presence of water is gradually 
 changed into Anemonin, C 15 H 12 6 , or Pulsatilla camphor, the active prin- 
 ciple, and Anemonic Acid, C 15 H u 7 , a white, crystalline, tasteless and 
 apparently inert substance, which may also be formed by the action of 
 
444 PULSATILLA. 
 
 alkalies on Anemonin. The herb should be carefully preserved and not 
 kept longer than one year. Dose, gr. j-v. 
 
 Anemone patens or Pulsatilla nuttaliana, is an inhabitant of the United States, some- 
 times has whitish-colored flowers, and was formerly one of the official sources of the drug. 
 
 Preparations. 
 
 The herb alone is official, but a tincture may be prepared according to the pharma- 
 copceial directions for Tincturse Herbarum Recentium (i part in 2 of alcohol), the 
 dose of which is Tr^y— Y(\x, several times a day. The imported German homeopathic 
 tincture contains equal parts of the expressed juice and alcohol, and is an efficient 
 preparation ; but tinctures or fluid extracts made from the imported dried plant are not 
 trustworthy. 
 
 Anemoninum, Anemonin (Unofficial), — a volatile, unstable, camphoraceous princi- 
 ple, crystallizable, soluble in chloroform and in hot alcohol, almost insoluble in water 
 and in ether. Dose, gr. \-\ in pill ; but much larger doses may be taken without in- 
 convenience, as much as two grains having produced no physiological symptoms in man 
 (Schroff). 
 
 Physiological Action. 
 
 Pulsatilla is an active irritant when locally used ; the oil vesicates the 
 skin, and the fresh juice produces tingling and burning sensations in a part 
 to which it is applied. It may excite a violent dermatitis, with a vesicular 
 or pustular eruption, and inflammation and even gangrene of the entire 
 limb has followed the application of the bruised root to the calf of the leg 
 for rheumatism. Inhalation of its dust has produced itching of the eyes, 
 colic, vomiting and diarrhea ; and swallowing the fresh herb may cause 
 severe irritation of the gastro-intestinal mucous membrane. The fresh 
 juice applied to the tongue gives rise to tingling and burning sensations 
 followed by numbness, symptoms very like those caused by Aconite. 
 Internally administered Pulsatilla is diuretic, diaphoretic and emmena- 
 gogue, and also acts as a cardiac and vascular sedative, lowering the action 
 of the heart, the arterial tension and the body-temperature. In overdoses 
 it strongly affects the mucous membranes, and produces nausea and vom- 
 iting, slimy diarrhea, bloody urine, profuse and offensive sweats, coryza 
 and cough ; also vesicular and pustular eruptions on the skin, peculiar 
 pains in the eyes and dimness of vision. Its primary action is that of a 
 spinal irritant, secondarily it produces exhaustion and paralysis of both 
 motion and sensation. Stupor, coma and convulsions may be caused by 
 a toxic dose, also paralysis of the cord and medulla. Most of these 
 effects have been observed on rabbits, and the pharmacology of the drug 
 is not yet accurately worked out. The homeopathic writers credit it with 
 specific influence on the synovial membranes, the veins, the ears, and the 
 generative apparatus of both sexes. 
 
 Anemonin was discovered in 1771 by Storck, and its effects have been 
 studied to some extent on animals. When applied to the conjunctiva 
 it caused slight inflammation thereof, and placed on the human tongue it 
 
PULSATILLA. 445 
 
 left a slight burning sensation. When melted, its vapor produced intense 
 inflammation of the eyes and pricking sensations in the tongue followed 
 by numbness and white patches. The symptoms following its internal ad- 
 ministration in fatal doses were a slow and feeble pulse, slow respiration, 
 lowered body-temperature, frequent diarrhea, paralysis of first the hind- 
 and then the fore-legs, dyspnea, mydriasis followed by myosis, stupor and 
 death without convulsions. The absence of the latter is thought to be 
 due to a paralyzing action of this principle on the cerebral motor cen- 
 tres, as in poisoning by extract of Pulsatilla convulsions are always pres- 
 ent. The autopsies showed congestion and edema of the lungs, also 
 marked hyperemia of the cerebral and spinal membranes, especially in 
 the vicinity of the medulla. The heart walls were, relaxed, and its cavi- 
 ties and the great vessels filled with dark and clotted blood, while the 
 blood elsewhere was fluid. The liver, spleen, kidneys and abdominal 
 viscera were found to be healthy. 
 
 Antagonists and Incompatibles. 
 
 Alcohol, Opium and Digitalis are its physiological antagonists. Tannic Acid, the 
 caustic alkalies and the metallic salts are chemically incompatible with preparations con- 
 taining Pulsatilla or Anemonin. » 
 
 Therapeutics. 
 The ancient writers credited different species of Anemone with many 
 medicinal virtues, but the modern use of this drug dates from the time of 
 Baron Storck and his contemporaries (i 770-1800) who highly praised the 
 Pulsatilla nigricans as a remedy for corneal opacities, cataract, paralysis, 
 rheumatism, amenorrhea, melancholia, secondary syphilis, old ulcers and 
 scaly skin diseases. Later therapeutists differ widely as to the medicinal 
 value of this drug, some giving it extravagant praise and others finding 
 no efficacy in it. It is quite possible that no effects whatever would be 
 obtained if an old preparation or even a fresh one from the dried herb 
 were employed. It has proved very efficient in acute catarrhal affections 
 of the mucous membranes, especially rhinitis and conjunctivitis, in the 
 early stage of the purulent ophthalmia of children and in gonorrheal 
 ophthalmia, also in subacute and chronic bronchitis of delicate persons 
 accompanied with profuse mucous expectoration, and in chronic catarrh 
 of the bladder. It is used with benefit in chronic nasal catarrh with a 
 thick though bland discharge, also in acute and subacute inflammation of 
 the middle ear and the lining of the external auditory canal so often seen 
 in children, where the membrane is red and swollen, with severe pain, 
 and later on a thin, acrid discharge, which is often bloody and soon be- 
 comes puriform. In-these affections medium doses (rr^v) of the tincture 
 may be given internally every four hours to adults, and a lotion composed 
 of 3J-1J in %v] of warm water may be applied to accessible parts. A similar 
 
446 PULSATILLA. 
 
 use of this agent has been of decided benefit in many cutaneous affections, 
 especially eczematous eruptions, syphilides, and indolent ulcers. 
 
 In acute and chronic dyspepsia, characterized by gastric catarrh or 
 subacute gastritis with a white-coated tongue, no taste or a greasy sensa- 
 tion in the mouth, nausea, flatulence, heart-burn, sick headache, anorexia, 
 depression, diarrhea, etc., Pulsatilla is a very efficient remedy, given in 
 medium doses, n^v of the tincture every four hours. It does good service 
 in intestinal catarrhs, shown by passive, mucous diarrhea with little pain, 
 which are frequently seen in the febrile affections of childhood, especially 
 measles, mumps, chicken-pox and remittent fever. 
 
 Pulsatilla is generally credited with specific therapeutical action on the 
 generative organs of both sexes. Epididymitis and orchitis have been 
 often controlled and entirely dissipated by its administration in very 
 small doses, a few drops of the tincture in a glass of water, of which gj 
 is given every two hours (Piffard, Sturgis). In more than 24 cases of 
 acute uncomplicated epididymitis, doses of two drops of the tincture 
 every two hours gave immediate relief, the patients wearing a suspensory 
 bandage but not being confined to bed (Borcherin). Doses of five drops 
 aggravated this disorder, while those of rri -^ every three hours proved 
 curative (Piffard). In functional amenorrhea, in scanty or delayed 
 menstruation, and in suppression thereof from fright or cold, in ovaritis 
 and in simple leucorrhea with back-pains and nervous depression, it has 
 been found an excellent remedy. Dysmenorrhea has been removed 
 in several cases by two-drop doses of the tincture given thrice daily for 
 several days before the menstrual epoch (Piffard). Extravagant opinions 
 as to its virtues in the puerperal state, and during parturition are promul- 
 gated by the homeopathists, and their authorities on materia medica 
 credit this drug with power to rectify false presentations during labor 
 by causing version of the child. 
 
 Besides the catarrhal affections of the ocular mucous membrane already 
 mentioned, Pulsatilla has remedial power in certain affections of the eye- 
 lids. Its internal administration is said to effectually blight a stye if 
 given early, but will not prevent its recurrence. It is an efficient remedy 
 in recent blepharophthalmia, with profuse lachrymation and meibomian 
 secretion ; and it is said to stop twitching of the lids accompanied by 
 photophobia. It has been used with decided benefit in the earache of 
 children and in recent catarrhal deafness, also in acute cerebral and spinal 
 meningitis, eclampsia from various causes, asthma, subacute rheumatism 
 of the small joints, acute rheumatic gout, left-sided clavus, hemicrania 
 and infra-mammary pain. Denian used this drug with benefit in several 
 nervous affections, and concludes that it is a direct sedative of nervous 
 irritability, but only indirectly a sedative to the circulation. Tucker 
 found it especially serviceable in the nervous headache produced by over- 
 
PYRETHRUM — QUASSIA. 447 
 
 taxing the mind. An extract of the root has proved to be an efficient 
 teniafuge. Coughs which are loose by day, but dry and tickling in char- 
 acter on lying down at night, are greatly benefited by small doses of the 
 tincture frequently repeated ; and Anemonin, in doses of gr. ss-j, has 
 been extremely useful in whooping-cough and coughs of irritative char- 
 acter. 
 
 PYRETHRUM, Pellitory, — is the root of Anacychis Pyrethrwn, a plant of the 
 nat. ord. Conipositce, native of Northern Africa, but cultivated in Europe. It contains an 
 alkaloid Pyrethrine, also inulin, tannin, mucilage, etc., with a brown Resin and two 
 fixed oils. Dose, as a masticatory, 3 ss-j. 
 
 Pyrethrum Roseum, Persian Pellitory (Unofficial), — is indigenous to Western Asia, 
 and resembles Chamomile in appearance. The flower-heads are used in powder to kill 
 insects, 4 grains killing a fly in a vial in 2 or 3 minutes. 
 
 Tinctura Pyrethri, Tincture of Pyrethrwn, — 20 per cent. Xot used internally. 
 
 Pellitory is an irritant sialogogue. When chewed it causes a pricking sensation in the 
 tongue and fauces, with heat, acridity, pungency and a copious flow of saliva and buccal 
 mucus. Large doses may cause bloody diarrhea, tetanoid spasms, accelerated pulse, and 
 profound stupor. Applied to the skin it acts as a rubefacient, the powder inhaled as a 
 sternutatory. It stimulates the local nerves and vessels of the mouth and salivary glands 
 by direct irritant action, but soon depresses the nerves and blunts their sensibility. 
 
 Pellitory is chewed as a masticatory and sialogogue in paralysis of the tongue, rheu- 
 matic and neuralgic affections of the head and face, and pain from carious teeth. Its 
 powder has been recommended as a sternutatory in chronic catarrh of the frontal sinuses. 
 As a gargle or lotion ( giij toOj) it is very useful for relaxed uvula and as a mouth-wash. 
 When used for toothache a few drops of the tincture should be inserted into the cavity on 
 cotton or wool. Used as a sialogogue it is an efficient agent to secure the rapid elimina- 
 tion of Iodine from the system in chronic poisoning thereby. 
 
 QUASSIA, — is the wood of Picrcena excelsa, a tree of the nat. ord. 
 Simarubeae, indigenous to Jamaica and other West Indian islands. 
 Surinam Quassia, used in Europe, is the wood of Quassia amara. Both 
 varieties, as met with in the shops, occur as chips or raspings, of a yel- 
 lowish-white color, inodorous but intensely bitter. The wood is turned 
 into cups, which are sold under the name of quassia- or bitter-cups. It 
 contains a bitter principle, Quassin, C 31 H 42 9 , which is crystalline, solu- 
 ble in hot alcohol and in chloroform, slowly in cold water, faster in alka- 
 line or acidulated water. Dose of the powdered wood, gr. xx-xxx. 
 
 Preparations. 
 
 Extractum Quassiae, Extract of Quassia,— aqueous. Dose, gr. j-iij. 
 
 Extractum Quassiae Fluidum, Fluid Extract of Quassia. — Dose, 3 ss-j. 
 
 Tinctura Quassiae, Tincture of Quassia, — strength 10 per cent. Dose, TTiv-^}. 
 
 Infusum Quassiae, Infusion of Quassia (Unofficial), — made with cold water gx, 
 Quassia chips gj, macerated for }4 hour and strained. Or water poured into a quassia- 
 cup and left standing will give a good infusion. Dose, ^ j-iij. 
 
 Physiological Action and Therapeutics. 
 Quassia is a simple bitter, having no flavor, but is intensely bitter and 
 less agreeable than either Gentian or Chiretta. It is fatal to flies and fish, 
 
44-8 QUERCUS ALBA QUILLAJA. 
 
 and makes an excellent anthelmintic enema against the thread-worm. A 
 concentrated preparation is poisonous to rabbits and dogs, and has pro- 
 duced very alarming narcotic symptoms in a four-years-old child. Its 
 action is that of a bitter stomachic tonic, as described under Calumba. 
 
 The preparations of Quassia contain no tannin and hence may be pre- 
 scribed with salts of Iron. It is chiefly employed in atonic dyspepsia with 
 pain after eating, and vomiting or regurgitation of food, also in atonic 
 diarrhea depending on indigestion or an irritable condition of the intes- 
 tinal mucous membrane. It is useful in convalescence to promote the 
 appetite and digestion, and with sodium bicarbonate in gastric vertigo. 
 It has been used as a feeble antiperiodic, and in hysteria its repulsive- 
 ness is an aid to its medicinal action. The strong infusion used as an 
 enema is an effective remedy against the thread-worm (oxyuris vermicu- 
 laris). 
 
 QUERCUS ALBA, White Oak,— is the bark of Quercus alba, 
 the White-oak tree (nat. ord. Cupuliferse). It contains a variety of 
 tannin named Quercitannic Acid, C 28 H 24 12 , also Pectin and a bitter 
 principle named Quercin, but no gallic acid. There are no official prep- 
 arations, but a decoction (3J ad Oj) may be used in doses of §ss-j. 
 
 Quercus Tinctoria, Black Oak Bark, — formerly official, contains a yellow coloring 
 principle named Quercitrin, also Quercitannic Acid, etc. 
 
 Quercus Lusitanica is the source of Galls (see under Galla). 
 
 Oak-bark is astringent and tonic, but is seldom used internally. Its 
 actions and uses are those of Tannic Acid. The decoction is much used 
 in country practice as a cheap astringent application for injection in 
 leucorrhea, prolapsus ani, hemorrhoids, etc., and as a gargle in faucial 
 inflammation and prolapsed uvula. It has also been used as an injection 
 into dropsical cysts, and as a lotion for flabby ulcers and suppurating 
 wounds. The powdered bark as a poultice has proved an excellent appli- 
 cation in gangrene, and in finely pulverized state it is a useful ingredient 
 of tooth-powders. A concentrated fluid extract is used in the Heaton- 
 Warren operation for the radical cure of hernia, by injection into the 
 tissues around the margin of the ring, with the object of exciting inflam- 
 mation and occlusion of the opening. 
 
 QUILLAJA, Soap Bark, — is the inner bark of Quillaja Saponaria, a tree of the 
 nat. ord. Rosacea?, indigenous to Peru and Chili. It contains calcium sulphate crystals, 
 also starch and the glucoside Saponin, C 32 H 54 18 , a white, amorphous, sternutatory 
 powder, soluble in water and in dilute alcohol. The Infusion of Quillaja foams like 
 soap- water. The only official preparation is the tincture. 
 
 Tinctura Quillaja, Tincture of Quillaja, — 20 per cent. Dose, rr\v-xxx. 
 
 Quillaja in powder is sternutatory and causes the water in which it is macerated to 
 froth, making emulsions of oil, and being used instead of soap for washing purposes in 
 various affections of the skin, also to stimulate the growth of the hair in alopecia. Its 
 
RESIXA RESORCIXUM. 449 
 
 properties are due to the glucoside Saponin, which is found also in Senega and in a 
 number of other plants, and is a violent irritant of the respiratory passages, a local anes- 
 thetic, an antipyretic, a powerful paralyzant of the heart and respiration, and a poison 
 to the voluntary muscles. It has not been made use of in practical medicine. 
 
 A decoction of the bark (5 to 200^ has been employed in doses of 3 j — ij according to 
 age, as a substitute for Senega in the treatment of diseases of the respiratory organs 
 where a pleasant expectorant is indicated. Its expectorant properties are well estab- 
 lished, and children take it readily. It does not provoke diarrhea or vomiting, and has 
 a sweetish, agreeable taste. 
 
 RESINA, Resin, Colophony, C w H 6 ,0 4 , — is the residue left after 
 distilling off the volatile oil from Turpentine. It is a transparent, amber- 
 colored substance, hard and brittle, with a glossy and shallow conchoidal 
 fracture and a faintly terebinthinate odor and taste ; soluble in alcohol, 
 ether, fixed or volatile oils, and in its own weight of oil of turpentine. 
 Chemically it is considered as the Anhydride of Abietic Acid, C^H^Ch, 
 •into which acid it is converted by agitation with warm diluted alcohol. 
 Silvic, Pinic, and Pahnaric Acids are decomposition products, not con- 
 stituents of resin as was formerly taught. 
 
 For the definition of a Resin see ante page 25, also the title Resins in Part II. 
 Other official resins are Resina Copaibae, Resina Jalapse, Resina Podophylli and Resina 
 Scammonii, which are severally described under the titles of the plants forming their 
 respective sources. 
 
 Preparations. 
 
 Ceratum Resinse, Resin Cerate, Basilicon Ointment, — consists of Resin 35, Yellow 
 Wax 15, and Lard 50 parts. It forms 65 per cent, of Turpentine Liniment. 
 
 Emplastrum Resinae, Resin Plaster, Adhesive Plaster, consists of Resin 14, Lead 
 Plaster 80, Yellow Wax 6 parts. Is the common adhesive plaster of surgery, and an 
 ingredient of the official Arnica, Belladonna and Capsicum Plasters. 
 
 Resin itself is an ingredient of Cantharides Cerate. 
 
 Resin gives consistence and adhesiveness to plasters and cerates, and 
 generally acts as a mild local stimulant, but the writer has seen persons 
 with so susceptible a skin that the ordinary adhesive plaster would pro- 
 duce on them a high degree of cutaneous irritation. It is never employed 
 internally, but in chronic bronchial catarrh the fumes from boiling resin 
 are inhaled with considerable advantage. Resin Cerate is one of the 
 most commonly used applications to promote the healing of indolent 
 ulcers, also to blistered surfaces, burns, scalds and chilblains. 
 
 RESORCINUM, Resorcin, Metadioxybenzol, C 6 H 4 (OH) 2 ,— is a 
 diatomic phenol, isomeric with Pyrocatechi?i and Hydroquinone, obtained 
 by fusing certain resins with a caustic alkali, but best prepared by 
 fusing potassium benzol-disulphonate with caustic potassa, the salt 
 being decomposed into potassium sulphite and resorcin. It crystallizes in 
 colorless, rhombic prisms or plates of neutral reaction, odorless, and of 
 sweetish, acrid taste, very soluble in water, also in alcohol, ether, etc. 
 29 
 
45° RESORCINUM. 
 
 Dose, gr. v-xv ; — as an antipyretic ^ss-j not repeated for several hours, 
 or gr. v every 2 hours. 
 
 Physiological Action. 
 Resorcin is closely allied to Carbolic Acid, but possesses an advantage 
 over the latter in that it is odorless, more soluble and almost non-irritant. 
 It is equally powerful as an antiseptic and antiferment, arresting decom- 
 position and destroying low organisms. Injected beneath the integument 
 in solution it produces very little irritation and never causes inflammation 
 or abscess. Vesication results from its application to the mucous mem- 
 brane. Internally a 30- to 60-grain dose causes a sense of heat, discom- 
 fort and oppression, followed by profuse perspiration and languor; if 
 fever be present the temperature of the body is lowered several degrees 
 but rises again after a rigor in from 2 to 4 hours. Larger doses (150 
 grains) have produced deafness, dizziness, salivation, confused vision, 
 vertigo, unconsciousness, general clonic convulsions and tetanic rigidity 
 of the muscles of the neck, with no decline of temperature in feverless 
 subjects. Toxic doses (gr. xv to each 35 ozs. of weight) cause in animals 
 trembling succeeded by epileptiform convulsions, which increase in 
 severity and then decline ; the respiration is quickened and enfeebled, 
 the heart's action becomes rapid, weak, and irregular, and death results 
 from paralysis of respiration, the drug paralyzing the motor tracts in the 
 spinal cord but not affecting the general sensibility. It is eliminated 
 chiefly by the urine which it colors a bluish-violet hue, and with great 
 rapidity, about one hour serving for its excretion. The best test of its 
 presence is the solution of the perchloride of iron, which produces with 
 resorcin a dark-violet, almost black color. 
 
 Antagonists. 
 
 Atropine and other cardiac and respiratory stimulants, cerebral excitants, and agents 
 which raise the arterial tension, are physiologically antagonistic. 
 
 Therapeutics. 
 Resorcin is employed as an antipyretic and antiseptic, being preferred 
 to carbolic acid for internal and subcutaneous use. A 3 per cent, solu- 
 tion gives good results in stomach complaints, as gastralgia, gastric 
 catarrh, gastritis, gastric ulcer, gastric cancer and fermentative indiges- 
 tion. In ulcer of the stomach its analgesic property is so marked that 
 the stomach is enabled to tolerate food. It has given very great satisfac- 
 tion in the treatment of diarrhea of children ; and it is highly recom- 
 mended by some observers in intermittent fevers and malarial diseases 
 generally, while others have been much disappointed with its action in 
 these affections. As an antipyretic it has been used in erysipelas, puer- 
 
RHAMNUS PURSHIANA — RHEUM. 45 I 
 
 peral fever, septicemia, and diphtheria, and in the latter disease it has 
 been locally employed in crystals with decided benefit. As a local ap- 
 plication to tuberculous and other ulcerations of the larynx, in diphtheria, 
 tonsillitis, pharyngitis, chronic rhinitis, etc., strong even supersaturated 
 solutions are employed with increasing satisfaction, being highly efficient 
 and quite painless. Applied to the peri-laryngeal mucous membrane, 
 it has proved very useful in the treatment and prophylaxis of pertussis. A 
 2 per cent, solution has given satisfaction as a local antiseptic application 
 to wounds, parasitic skin diseases, cystitis, gonorrhea, anthrax, and 
 syphilitic sores of unhealthy character. As a spray a similar solution is well 
 applied to catarrhal or ulcerative affections of the respiratory passages. 
 As a caustic it may be applied in undiluted form to chancres, papillomata 
 and carbuncles. A saturated ethereal solution is a good application 
 where the caustic action of the drug is required. 
 
 A paste consisting of equal parts of Resorcin and Zinc Oxide has been 
 applied to the face to promote peeling of the skin in the treatment of acne 
 rosacea. In three or four days the skin becomes like parchment, when 
 the application must be stopped, in order to avoid the cracking of the 
 skin which begins at that stage. A dressing of gelatin, glycerin, zinc 
 oxide and hot water is then applied, covered with cotton wool. In a few 
 more days the dressing comes off, bringing the epidermis with it. Some 
 few dangerous and unfavorable results have followed this method, but a 
 number of very satisfactory cases are reported. Freckles and other super- 
 ficial spots on the skin may be removed by the same treatment. 
 
 RHAMNUS PURSHIANA, Cascara Sagrada, Chittem Bark, Sacred Bark,— 
 is the bark of Rhainmis Purshia7ia, the California Buckthorn, a small tree of the nat. ord. 
 Rhamnese. growing on the Pacific Coast of the United States. It contains a Volatile Oil, 
 a neutral crystalline substance, several Resins, with tannic, malic and oxalic acids. It 
 has been found very serviceable in the treatment of chronic gout and chronic constipation, 
 given in gradually diminished doses. It produces large, soft and painless evacuations, 
 and the bowels are said to act naturally and regularly after its disuse. 
 
 Another species of the same order, RhajJinus Frangula, is official under the title 
 Frangula, which see. 
 
 Extractum Rhamni Purshianae Fluidum. Fluid Extract of Cascara Sagrada, — 
 is made with diluted alcohol. Dose, £ss-jss, two or three times a day. 
 
 Cascara Cordial is a trade preparation, intended as a remedy for constipation, dys- 
 pepsia and hemorrhoids, and as a pleasant excipient for nauseous and bitter drugs. A 
 similar preparation may be made by combining the fluid extract with the official Elixir 
 Aromaticum in the proportion of 3 j to 5 ij, of which the dose is £ j or more. 
 
 RHEUM, Rhubarb, — is the root of Rheum officinale, a perennial 
 plant of the nat. ord. Polygonacese, a native of Thibet. There are many 
 other undetermined species of Rheum, several of which are cultivated in 
 Europe and America, their leaf-stalks being used as a fruit. The com- 
 monly accepted medicinal Rhubarb is the Chinese variety, and is imported 
 from Shanghai and Canton. It imparts its virtues to water and alcohol, 
 
45 2 RHEUM. 
 
 and contains several substances of greater or less activity, the least im- 
 portant being Phceoretin, the rhubarb-resin, Erythroretin, and Chrysophan, 
 the latter of which is split by acids into sugar and chrysophanic acid. 
 (See Chrysarobinum.) It also contains Rheo-ta7inic Acid, C 52 H 52 28 , 
 Rheumic Acid, C 40 H 32 O 18 , and probably a principle which is identical with 
 Cathartic Acid (see Senna), on which its purgative activity may depend. 
 Dose of Rhubarb as a stomachic, gr. j-v ; as a purgative, gr. x-xxx. 
 
 Preparations. 
 
 Extractum Rhei, Extract of Rhubarb. — Dose, gr. j-x. 
 
 Extractum Rhei Fluidum, Fluid Extract of Rhubarb. — Dose, TtLx-^j. 
 
 Pilulae Rhei, Pills of Rhubarb, — are composed of Rhubarb 60, Soap 6, Water to 
 100 ; each pill containing about 3 grains of powdered Rhubarb. Dose, j-v pills. 
 
 Pilulae Rhei Compositae, Compound Pills of Rhubarb, — each pill contains of Rhu- 
 barb about 2 grains, Aloes 1*4, Myrrh I, Oil of Peppermint T L grain. Dose, ij-v pills. 
 
 Tinctura Rhei, Tincture of RJmbarb, — has of Rhubarb 10, Cardamom 2, Glycerin 
 10, Alcohol and Water to 100. Dose; ^j-iv. 
 
 Tinctura Rhei Aromatica, Aromatic Tincture of Rhubarb, — has of Rhubarb 20, 
 Cinnamon 4, Cloves 4, Nutmeg 2, Glycerin 10, Alcohol, Water and Diluted Alcohol to 
 100. Dose, ^j-iv. 
 
 Tinctura Rhei Dulcis, Sweet Tincture of Rhubarb, — has of Rhubarb 10, Glycyr- 
 rhiza 4, Anise 4, Cardamom I, Glycerin 10, Alcohol, Water and Diluted Alcohol to 100. 
 Dose, ^ss-ij. 
 
 Syrupus Rhei, Syrup of Rhubarb, — has of the Fluid Extract 10, Spirit of Cinnamon 
 0.4, Potassium Carbonate 1, Glycerin 5, Water 5, Syrup to 100. Dose, for an infant, gj ; 
 for older children, ^ij-iv. 
 
 Syrupus Rhei Aromaticus, Aromatic Syrup of Rhubarb, — has of the Aromatic 
 Tincture 15, Syrup 85. Dose, as the Syrup. 
 
 Pulvis Rhei Compositus, Compound Pozuder of Rhubarb, — has of Rhubarb 25, 
 Magnesia 65, Ginger 10. Dose, a teaspoonful. 
 
 Mistura Rhei et Sodae, Mixture of Rhubarb and Soda, — has of Sodium Bicarb. 
 3%, Fluid Extract of Rhubarb 1}^, Fluid Extract of Ipecac 3/3, Glycerin 35, Spirit of 
 Peppermint 3^, Water to 100. Dose, gij-^ij. 
 
 Physiological Action and Therapeutics. 
 Rhubarb is classed among the tonic-astringent and resin-bearing pur- 
 gatives, agents which increase the circulation of the glandular appendages 
 of the intestinal canal and stimulate the muscular layer of the bowel. In 
 small doses (gr. j-v) its action is that of a gastric tonic and an intestinal 
 astringent, the influence of the bitter principle and the rheo-tannic acid 
 probably predominating. In larger doses (gr. xxx-lx) its cathartic action 
 prevails, producing in 6 to 8 hours copious yellow, pultaceous stools, with 
 some griping and considerable hepatic stimulation. After the cathartic 
 principle is expelled, the astringent quality of its tannin asserts itself and 
 constipation is likely to result. The yellow color of the stools is partly 
 due to the rhubarb pigment and partly to excess of bile, the drug having 
 marked cholagogue properties, probably due to its resin, Phaeoretin. Its 
 pigment stains the milk, urine and sweat, the milk acquiring a bitter 
 taste and purgative properties. The cathartic action of Rhubarb may 
 
RHINACANTHUS RHUS. 453 
 
 be obtained from its application locally to ulcers, by being rubbed into 
 the moist skin, or applied to the abdomen as a poultice. 
 
 Rhubarb is highly esteemed as a cathartic for children, from the mild- 
 ness of its action ; though occasionally producing quite severe griping, 
 it never inflames the gastro-enteric mucous membrane. The tonic and 
 astringent action following its catharsis makes it a valuable agent in diar- 
 rheas due to the presence of irritating matter in the bowel, and to correct 
 atonic indigestion accompanied by diarrhea. For hemorrhoids with 
 constipation its gentle action makes it peculiarly suitable, its astringent 
 after-effect being entirely overcome by 2- to 4-drachm doses of olive oil 
 nightly. It may be combined with a mercurial or with sodium bicar- 
 bonate, the latter being supposed to overcome its astringent action and 
 to disguise its taste in some degree. In small doses the tincture is a very 
 efficient stomachic tonic, improving appetite, increasing the flow of the 
 gastric juice, assisting digestion, and promoting the action of the liver 
 without producing any cathartic results. The preparations most in use 
 for children are the Aromatic Syrup and the Mistura Rhei et Sodae. 
 
 RHINACANTHUS (Unofficial), — the leaves and root of Rhinacanthus communis, 
 a shrub of the nat. ord. Acanthacese, indigenous to India and China. The root contains 
 a quinone-like body named Rhinacanthin, C u H 18 4 , which forms with alkalies intensely 
 red compounds which are decomposed by benzin. It is known in China as Hong-Pang- 
 Ckong, and is employed as a local remedy for ringworm and parasitic skin diseases, the 
 leaves being bruised and mixed with lime-juice. Used internally a tincture of the root 
 has some reputation as a feeble tonic and antiperiodic. The same preparation is applied 
 locally in chronic eczema, tinea, and psoriasis. 
 
 RHUS AROMATICA, Sweet Sumach (Unofficial),— is an indigenous shrub of 
 the nat. ord. Terebinthacese, growing about 5 feet high, and having yellow flowers in 
 spikes. The root-bark contains a volatile oil, several resins, fat, tannin, etc. A fluid 
 extract is prepared from the bark of the root according to the general pharmacopceial rule, 
 and may be given in doses of TT^x-xxx, every 2 or 3 hours. 
 
 Rhus Aromatica has astringent properties, and seems to possess a selective action upon 
 the urinary tract. Its action is not yet clearly made out. Therapeutically it has been 
 used with advantage in cystitis, night-sweats, hematuria, monorrhagia, diabetes insip- 
 idus, diarrhea and dysentery. As a remedy for incontinence of urine in children it has 
 attracted considerable attention, having been extremely efficient in doses of n\xv of a 
 good fluid extract four times daily, administered in glycerin and water, or any other suit- 
 able excipient. It is reported to be equally effective in hysterical enuresis of adults, but 
 larger doses (TT^xx-xxx several times a day) are required. Diabetes insipidus is remark- 
 ably benefited by its continued use, and even in diabetes mellitus its employment has 
 occasionally seemed to have been followed by curative results. 
 
 RHUS GLABRA, Smooth Sumach, — is the fruit of Rhus glabra, an indigenous 
 shrub of the nat. ord. Anacardiacecz, growing in rocky and barren soil to a height of 8 to 
 12 feet. The leaves and bark have an astringent and bitter taste, and are also used 
 medicinally. It contains tannin, coloring matter, also potassium and calcium malates. 
 
 Extractum Rhoi's Glabrae Fluidum, Fluid Extract of Rhus Glabra. — Dose, gj-ij. 
 
 Sumach-berries form a useful acidulous and astringent drink or gargle in catarrhal 
 pharyngitis, stomatitis, aphthae, etc. An infusion ( ^ j to the pint) or the official fluid ex- 
 tract may be used as a wash and dressing for ulcers and wounds. Internally they are 
 useful remedies for mild catarrhal affections of the stomach and bowels. 
 
454 RH US TOXICODENDRON. 
 
 RHUS TOXICODENDRON, Poison Ivy,— is the fresh leaves 
 of Rhus radicans, a plant of the nat. ord. Anacardiacece, indigenous to 
 Canada and the greater part of the eastern United States. This climbing 
 plant is not by itself a distinct species, but a variety of the erect shrub, 
 Rhus Toxicodendron, the Poison Oak, formerly official as a source of the 
 drug ; both of which when wounded exuding a poisonous, acrid, milky 
 juice which turns dark on exposure. The poisonous principle of the plant 
 is Toxicodendric Acid, which is volatile, and also exists in Rhus venenata 
 or Swamp Sumach, Rhus pumila, and Rhus diversiloba, the first of which 
 is probably the most poisonous of the four. The dose of the leaves is 
 generally placed at gr. j-iv, but if old and dry they will generally prove 
 to be inert. There are no official preparations. 
 
 Tinctura Rhois Toxicodendri, Tincture of Rhus Toxicodendron (Unofficial), — may 
 be prepared according to the formula of the Pharmacopoeia for Tincturce Herbarum 
 Recentium (Tinctures of Fresh Herbs), one part of the fresh leaves to two of Alcohol. 
 Dose, rr^L-rrLij. 
 
 Extractum Rhois Toxicodendri, Extract of Rhits Toxicodendron (Unofficial), — 
 has been used 'in France in large doses. It is probably inert. 
 
 Physiological Action. 
 The effects of Rhus Toxicodendron upon the skin are familiar to all 
 who have suffered from contact with poison-oak or ivy. Some persons 
 are so susceptible to this poison that the exhalations from the plant will 
 produce on them its characteristic action. Others are apparently insus- 
 ceptible to its influence, and can with impunity rub the juice into their 
 skin, or even chew its leaves. The action of the plant when locally 
 applied is that of a cutaneous irritant, causing redness and swelling of 
 the affected parts, with a vesicular eruption and intolerable itching, 
 which may spread rapidly over the surface of the body and extend to the 
 mucous membranes, producing conjunctivitis, redness and tumefaction of 
 the mouth and throat, thirst, cough, nausea and vomiting, vertigo and 
 stupefaction. Colicky pains are experienced in the abdomen, are worse 
 at night and are aggravated by food and drink. Diarrhea may occur, 
 with tenesmus and bloody stools, also diuresis, bloody urine, or even 
 complete retention. Fever with delirium is frequently present, and may 
 be typhoid in character, or intermittent with profuse perspiration. 
 Pains of rheumatoid type are experienced throughout the body, but par- 
 ticularly in the joints and lumbar region, apparently intensified by rest 
 and heat. The fibrous structures are evidently the seat of its selective 
 action, and a sensation of numbness in the lower extremities is frequently 
 experienced. Similar phenomena attend its internal administration, but 
 fatal results have not followed in any case of poisoning recorded. The 
 effects of the poison usually last from ten to fifteen days, and are then 
 followed by desquamation of the epidermis. 
 
RICINI OLEUM. 455 
 
 Antidotes and Antagonists. 
 
 Cocaine Hydrochlorate, in 4 to 8 per cent, solution, is the best lotion to relieve the 
 intolerable itching and burning. Grindelia Robusta makes one of the best local appli- 
 cations, and a solution of Mercuric Chloride is also a very serviceable lotion ; also Lime- 
 water with Linseed-oil, solution of Plumbum Acetate, solution of Chlorinated Soda, and 
 Alum-curd are all useful. Rest, low diet and laxatives are appropriate, and Opium or 
 strong black coffee to relieve the irritability of the nervous system. 
 
 Therapeutics. 
 Rhus Toxicodendron was used medicinally by Dufresnoy in France and 
 by Alderson in England about the close of the eighteenth century. The 
 attention of the former was attracted to it by the accidental poisoning of 
 a student who was afflicted with chronic eczema, which disappeared on 
 the subsidence of the Rhus symptoms. It is a favorite remedy with the 
 so-called homeopathists, who ascribe to it extraordinary virtues in acute 
 cutaneous affections of vesicular type, subacute and chronic rheumatism, 
 vesicular erysipelas and typhoid fever. Among regular authorities it 
 meets with very little favor as a remedial agent, but Phillips recommends 
 it strongly in rheumatic affections of the fibrous tissues, erythema and 
 erysipelas, eczema, herpes zoster and pemphigus. Piffard corroborates 
 these opinions of its therapeutical value, and states that when rheumatic 
 pain is worse at night prompt relief may be expected from Rhus. It was 
 used by Dufresnoy in paralyses with some success, and Eberle reports a 
 case of paralysis in which it proved curative. It is admitted by many ob- 
 servers to be a useful remedy in paralytic affections of the lower extremities 
 depending on a rheumatic diathesis, or resulting from exposure to cold and 
 wet. As an external application it is efficacious in sprains and other affec- 
 tions of ligaments and tendons, also to extensive but superficial burns, 
 stings of insects and chilblains. For these affections a lotion of about gss 
 of the tincture to a pint of water is usually employed. 
 
 RICINI OLEUM, Castor Oil,— is a fixed oil expressed from the 
 seeds of Ricinus communis, a tree of the nat. ord. Euphorbiacese, indigen- 
 ous to India, but extensively cultivated in the United States. The oil is 
 an almost colorless, transparent, viscid liquid, of faint odor, bland or 
 slightly acrid taste, neutral reaction, soluble in an equal weight of 
 alcohol. It consists mainly of Ricinolein the glyceride of ricinoleic acid, 
 also palmitin, stearin and myristin in small quantities, and an acrid prin- 
 ciple. The seeds contain a highly toxic ferment or phytalbumose named 
 Ricin, and an alkaloid, Ricinine* which seems to be inert. 
 
 Castor Oil is an ingredient of Collodium Flexile in the proportion of 3 per cent., also 
 of Linimentum Sinapis Compositum, 15 per cent., and of Pilulse Antimonii Composite. 
 
456 RICINI OLEUM. 
 
 Physiological Action and Therapeutics. 
 Used externally pure Castor Oil is perfectly bland. Internally admin- 
 istered it is non-irritant until it reaches the duodenum, where it is decom- 
 posed by the pancreatic juice setting free the Ricinoleic Acid, which 
 produces purgation by a mildly irritant action on the bowel, stimulating 
 the intestinal glands and muscular coat, but not the liver. It is a simple 
 purgative, acting in four to six hours, producing one or more liquid stools 
 without pain or tenesmus, and followed by a sedative effect on the intes- 
 tines. The leaves are believed to possess galactagogue properties when 
 locally applied as a poultice to the breasts. Ricinoleic Acid enters the 
 blood and the tissues, and is excreted with the various secretions of the 
 body, imparting its purgative qualities to the milk of the nursing mother. 
 Ricin, given either hypodermically or by the mouth, produces violent 
 gastro-enteritis, nephritis and cystitis, also inflammation of the mucous 
 lining of the biliary duct. To it is ascribed the jaundice and anuria 
 observed in some cases of poisoning by castor-oil seeds. 
 
 Castor Oil is one of the best of the simple purgatives, and is used 
 when a free evacuation of the bowels is alone indicated, or when only a 
 laxative action is desired, as in the constipation of typhoid fever, in 
 pregnancy and post-partum conditions, diarrhea from the presence of 
 irritating matter in the bowels, and after operations on the abdominal or 
 pelvic organs. It is often used as a purgative for children, also for the 
 aged and infirm. Infants bear a larger relative dose than adults, prob- 
 ably from their ability to digest a greater quantity of what is taken. It is 
 employed with great benefit as a laxative in irritation or inflammation of 
 the bowels, in hemorrhoids, inflammatory or spasmodic affections of the 
 genito-urinary organs, nephritis or cystitis, gonorrhea, calculi, and 
 stricture of the urethra and rectum. In cases of dysentery 10 to 20 drops 
 of laudanum may be added to each dose to counteract the pain, tenesmus 
 and exhaustion resulting from the frequency of the passages. If much 
 depression exists, as shown by lowered arterial tension and a dry, glazed 
 tongue, 5 drops of oil of turpentine should also be added. 
 
 Castor Oil is much used in the puerperal state and greatly abused. 
 There is considerable evidence in support of the charge that it induces 
 hemorrhoids by congesting the rectal vessels. Its purgative action is 
 milder in proportion to the purity of the sample employed. Externally, 
 the pure oil is employed as a local sedative and protective, as in neutral- 
 izing the effects of lime upon the conjunctiva. The leaves of the castor- 
 oil plant are used to promote the secretion of milk. They may be applied 
 to the breast in poultice, and a decoction or fluid extract given internally 
 at the same time. 
 
rosa. 457 
 
 A dm in ist ration . 
 
 The nauseous smell is best concealed by the Essential Oil of Bitter Almonds. Emul- 
 sions are not a success. Capsules containing the requisite dose are easily obtained. In 
 the absence of these the best way to administer a dose of oil is to smear the sides of a 
 clean wineglass with very thick cream, then to pour in the oil, covering it with a little 
 more cream. A teaspoonful of cream being then taken into the patient's mouth, he is 
 directed to bolt the dose at one gulp. Some prefer it floated on orange-juice, strong 
 coffee, gruel or wine. One of the best vehicles for it is foaming beer. Glycerin increases 
 its purgative power, when given conjointly. If the mouth be chilled by broken ice im- 
 mediately before taking the oil, the taste of the latter will be imperceptible. 
 
 ROSA, Rose, — is represented in pharmacy by the petals of two 
 species and the volatile oil from a third. 
 
 Rosa Centifolia, Pale Rose, — is the petals of Rosa centifolia, the 
 Cabbage Rose, a well-known cultivated shrub of the nat. order Rosa- 
 ceae. The odor is due to a minute quantity of a volatile oil, besides 
 which the petals contain tannin, fat, resin, sugar, etc. If it is desired to 
 keep Pale Rose fresh for any length of time, it should be mixed with 
 one-half its weight of sodium chloride and pressed into a jar, which 
 should be kept in a cool place, well closed. 
 
 Rosa Damascena, Da??iask Rose, — is the source of the official Oil 
 of Rose, which is distilled from the fresh flowers. This variety of the 
 nat. order Rosacese is largely cultivated in Roumelia, on the southern 
 slope of the Balkan mountains, from which section comes nearly all of 
 the oil supplied to commerce. 
 
 Rosa Gallica, Red Rose, — is the petals of Rosa gallica, collected 
 before expanding. They contain an aromatic oil, tannic and gallic 
 acids, Quercitrin, coloring matter, salts, etc. 
 
 Preparations of Rosa Damascena. 
 
 Oleum Rosae, Oil of Rose, Attar of Rose, — is a volatile oil distilled from the fresh 
 flowers of Rosa damascena. It is a pale-yellowish, transparent liquid, having a strong 
 odor of rose, a sweetish taste and a slightly acid reaction, but slightly soluble in alcohol. 
 It consists of an aromatic oxygenated elaeopten and an odorless solid stearopten (rose- 
 camphor). Being very expensive it is much adulterated with other volatile oils. It is 
 used chiefly for perfuming cosmetic preparations, ointments and lotions, and as the basis 
 of the following : 
 
 Aqua Rosae Fortior, Stronger Rose Water, Triple Rose Water, — is water saturated 
 with the volatile oil of Rose petals, obtained as a by-product in the distillation of Oil of 
 Rose. An agreeable excipient and flavoring agent. Dose, .^ss-j. 
 
 Aqua Rosae, Rose Water, — consists of equal volumes of the preceding and distilled 
 water, mixed together immediately before use. It is an ingredient of Mistura Ferri Com- 
 posita. Dose, gj-ij. 
 
 Unguentum Aquas Rosae, Ointment of Rose Water, Cold Cream, — has of Stronger 
 Rose Water 19, Expressed Oil of Almond 60, Spermaceti 12^, White Wax 12, and 
 Sodium Borate ]/ 2 . For local use. 
 
 Preparations of Rosa Gallica. 
 
 Extractum Rosae Fluidum, Fluid Extract of Rose, — prepared with glycerin and 
 diluted alcohol. Dose, ttV~oJ- 
 
45 8 ROSMARINUS — RUBIDIUM. 
 
 Confectio Rosae, Confection of Rose, — has of Red Rose 8, Sugar 64, Honey 12, 
 Stronger Rose Water 16, beaten together into a mass. Dose, gr. x-^j. 
 
 Mel Rosae, Honey of Rose, — has of the Fluid Extract 12, and Clarified Honey 
 to 100. Dose, gj-ij. 
 
 Syrupus Rosae, Syrup of Rose, — has of the Fluid Extract 12^, with Syrup 87^. 
 Dose, 3J-ij, for flavoring. 
 
 Red Rose is an ingredient of Pil. Aloes et Mastiches. 
 
 Pale Rose petals are used only for odoriferous purposes. Rose Water has 
 no strictly medicinal properties, but is an agreeable excipient for lotions, 
 collyria and urethral injections. The ointment, commonly termed cold 
 cream, is a pleasant emollient and protective agent, generally used for 
 chapped hands and other superficial skin affections. Red Rose is classed 
 among the astringents, as it contains an appreciable amount of tannic 
 and gallic acids. A compound infusion, containing sugar and dilute 
 sulphuric acid, was formerly official, and is used as an agreeable gargle 
 for the throat and mouth in inflamed and ulcerated conditions. The 
 chief uses of the rose preparations are as vehicles for other agents, or to 
 impart flavor and odor to extemporaneous prescriptions. 
 
 ROSMARINUS, Rosemary, — the source of the official Oil of Rosemary, is the 
 leaves of Rosmarinus officinalis, a shrub of the nat. ord. Labiatae, cultivated for the sake 
 of its large, pale-blue flowers. They are pungently aromatic and somewhat camphor- 
 aceous, and contain the volatile oil, a little tannin, some resin and a bitter principle. 
 
 Oleum Rosmarini, Oil of Rosemary, — is the volatile oil distilled from Rosemary, a 
 colorless or yellowish liquid, having the characteristic odor of the plant and a camphor- 
 aceous taste; readily soluble in alcohol. It consists of a terpene, isomeric with Turpen- 
 tine, C 10 H 16 , and a body allied to camphor. It is an ingredient of Linim. Saponis, Spir- 
 itus Odoratus and Tinct. Lavandulae Comp. Dose, rr\J-v. 
 
 Rosemary was formerly considered emmenagogue, galactagogue and 'diuretic, but is 
 now never employed in substance. Its oil is somewhat stimulant and carminative, and 
 in excessive quantity has caused death. It is chiefly used as an external stimulant in 
 liniments and lotions, especially to the scalp in alopecia, where it is supposed to increase 
 the blood-supply to the hair bulbs and is usually combined with cantharides. Inhaled it 
 reduces the body- temperature and gives the urine a violaceous odor. 
 
 RUBIDIUM, Rubidium, Rb, (Unofficial), — is one of the rarer metals, belonging 
 to the group of alkaline metals of which potassium and sodium are typical. It has a 
 molecular weight of 85, that of Potassium being 39, and that of Sodium 23. Its salts are 
 supposed to act more promptly and efficiently than those of the latter, upon the theory 
 that the physiological action of salts is as much a periodic function of the atomic weights 
 of their elements as are their physical and chemical characteristics. Its principal salt is — 
 
 Rubidii Iodidum, Rubidium Iodide, Rb I, (Unofficial), — occurs in white, non- 
 efflorescent crystals, odorless, of milder taste and greater solubility in water than Potas- 
 sium Iodide. Dose, gr. v-xxx or more. 
 
 Rubidium Iodide has generally the same physiological and therapeutical action as 
 Potassium Iodide, but has a far less toxic action upon the cardiac muscle. It is well 
 borne by the stomach, does not disturb the appetite or give rise to digestive derangements, 
 and does not affect the circulation. It rarely produces iodism, and even when the iodo- 
 derma and catarrh were present as the result of the administration of potassium iodide, 
 the change to the rubidium salt has resulted in decrease of these symptoms. It has been 
 employed in lieu of the potassium salt, with greater efficiency and less disturbance, in most 
 of the affections for which the iodides are indicated. In eye affections requiring an 
 absorptive treatment it is employed internally and externally as a 5 per cent, vaselin oint- 
 ment or in the form of 5 per cent, drops ( 3 j to ^ ijss). 
 
RUBUS RUMEX RUTA. 459 
 
 RUBUS, Blackberry-Bark, — is the bark of the root of Rubus villosus the common 
 Blackberry, Rubus canadensis the Dewberry, and Rubus trivialis the Bush Blackberry 
 of the Southern States, all of the nat. ord. Rosacese. It contains over 10 per cent, of 
 tannin. Dose, gr. xv-xxx. 
 
 Extractum Rubi Fluidum, Fluid Extract of Rub us. — Dose, rr\,x-^j. 
 
 Syrupus Rubi, Syrup of Rubus, — has of the Fl. Extr. 25, Syrup 75. Dose, 3J-3J. 
 
 Syrupus Rubi Aromaticus, Aromatic Syrup of Rubus (Unofficial), — contains Rubus, 
 Cinnamon, Cloves and Mace. Each £3 has 30 grains of the drug. Dose, 3J-^j. 
 
 Blackberry-bark derives its virtues from its tannin. It is strongly astringent, and may 
 be used in decoction, wine or the above-named preparations. It is highly esteemed in 
 summer and infantile diarrheas. 
 
 RUBUS IDi^EUS, Raspberry, — is the fruit of Rubus idceus the Raspberry bush, 
 nat. ord. Rosaceae. It contains sugar, malic and citric acids, proteids, pectin, etc., also 
 a Volatile Oil consisting of compound ethers, to which the odor is due. Its sole use in 
 medicine is to prepare a pleasantly flavored syrup. The closely allied, light-red fruit of 
 Rubus strigosus the wild Red Raspberry, and the purplish-black fruit of Rubus Occident- 
 alls the Thimble-berry, may be employed in place of the raspberry. 
 
 Syrupus Rubi Idaei, Raspberry Syrup, — has of Raspberries and Sugar any convenient 
 quantity, boiled (but not in tinned vessels) and strained. Dose, ad libitum. It has a 
 bright-red color, a fruity, agreeable odor, a pleasant, acidulous taste and an acid reaction. 
 It has no special medicinal virtues, but forms an agreeable flavoring for mixtures, and 
 mixed with water a pleasant drink in febrile conditions. 
 
 The leaves of the wild Red Raspberry [Rubus strigosus) are considerably astringent, 
 and in infusion, ^j to the pint, are a popular domestic remedy for diarrheas. 
 
 RUMEX, Yellow Dock, — is the root of Rumex crispus, and of some other species of 
 Rumex, plants of the nat. ord. Polygonaceae, growing as common weeds along roadsides. 
 Several species of Rumex have sour leaves, and are popularly called Sorrel to distinguish 
 them from the others which are called Dock. The official root contains tannin, mucilage, 
 starch, calcium oxalate, and two principles named Rumicin and Lapathin, which are 
 shown to be identical with Chrysophanic Acid. Its constituents are nearly identical with 
 those of Rhubarb. Dose, gr. xv-^j. 
 
 Extractum Rumicis Fluidum, Fluid Extract of Rumex. — Dose, Tr^xv-^j. 
 
 Decoctum Rumicis, Decoction of Rumex (Unofficial), — ^ij of the fresh root of 5J 
 of the dry root to Oj of water. Dose, Jj-ij. 
 
 Rumex is astringent, tonic and laxative. It has also been considered alterative and 
 anti-scorbutic. It is employed in chronic cutaneous disorders, glandular swellings, and 
 other symptoms of the strumous diathesis. It seems to possess a selective action on the 
 mucous membrane of the larynx, and in man)' cases of laryngeal irritation with catarrhal 
 symptoms, dry, violent cough, and a sense of soreness behind the sternum, it will give 
 relief. The Rumex Acetosa has a popular reputation as a local application for cancer. 
 
 RUTA, Rue (Unofficial), — the leaves of Ruta graveolens, an herba- 
 ceous perennial of the nat. ord. Rutaceae, growing wild throughout 
 Southern Europe, and frequently cultivated in gardens for its yellowish 
 flowers. The fresh leaves only should be used, and as drying impairs 
 their qualities the oil is generally employed in medicine. 
 
 Oleum Rutae, Oil of Rue (Unofficial), — the volatile oil distilled from Ruta graveo- 
 lens ; a colorless, or greenish-yellow liquid, of disagreeable but aromatic odor, pungent 
 acrid taste and neutral reaction, soluble in an equal weight of alcohol. Dose, n\j-v. 
 
 Physiological Action and Therapeutics. 
 Rue is an active irritant, the oil applied locally producing heat, inflam- 
 mation and vesication. Administered in full medicinal dose it causes a 
 
46O SABINA. 
 
 sensation of heat in the stomach and skin, increases the action of the 
 heart, and stimulates the bronchial, cutaneous and renal secretions. The 
 odor of the oil is distinctly perceptible in the breath, sweat and urine. 
 After a toxic dose of the oil violent gastro-enteritis results, with extreme 
 prostration, convulsions, strangury and suppression of the urine, and the 
 symptoms of a narcotic poison ensue if the dose is large enough. Abor- 
 tion may be produced by large doses, but with great danger to life. Rue 
 is an efficient emmenagogue, and in men aphrodisiac ; it is also considered 
 antispasmodic and carminative. 
 
 The Oil of Rue is employed internally in amenorrhea, menorrhagia, and 
 metrorrhagia, hysteria, convulsions and flatulence. As an emmenagogue 
 it is very efficient when the condition is one of functional inactivity of 
 the uterus and ovaries. In small doses it has been well used in metror- 
 rhagia from debility and after abortion. A decoction of the fresh leaves 
 is often employed by injection against thread-worms, and internally to 
 remove lumbricoid worms. Externally the same preparation has been 
 applied to the chest in chronic bronchitis, also in various scaly eruptions 
 and glandular enlargements. Used as an abortifacient it has frequently 
 caused death, preceded by symptoms of irritant and narcotic poisoning. 
 Even in poisonous doses its abortifacient action is very uncertain, so that 
 only the most ignorant criminals employ it with such purpose. It was 
 formerly official but has been dismissed from the pharmacopoeia. 
 
 SABINA, Savine, — the tops of Juniperus Sabina, a small evergreen 
 shrub of the nat. ord. Coniferse, growing in Northern Europe, Asia and 
 America. It closely resembles Red Cedar {Juniperus virginiand), but is 
 distinguished from the latter by its smaller size and by its larger fruit. 
 It contains a Volatile Oil (which is official), also tannin, resin, extractive 
 matters, chlorophyll, etc. Dose, gr. v-x. 
 
 Preparations. 
 
 Extractum Sabinse Fluidum, Fluid Extract of Savine. — Dose, TT\,v-xv. 
 
 Ceratum Sabinae, Savine Cerate (Unofficial), — may be prepared by incorporating 
 the Fluid Extract 25 in Resin Cerate 90, melted and cooled. Formerly official. 
 
 Oleum Sabinae, Oil of Savine, — a volatile oil distilled from Savine, existing in the 
 fresh tops in the proportion of 2% per cent., and in the berries 10 per cent. It is a 
 colorless or yellowish liquid, isomeric with oil of turpentine, C 10 H 16 , having a peculiar, 
 terebinthinate odor, a pungent camphoraceous taste and neutral reaction ; soluble in an 
 equal volume of alcohol. Dose, Tt\J-v. 
 
 Physiological Action and Therapeutics. 
 
 Externally the action of Savine resembles that of Turpentine, except 
 
 that it is more irritant, the oil producing vesication if applied sufficiently 
 
 long. Internally a full medicinal dose causes heat sensations, nauseous 
 
 eructations, flatulence, increased cardiac action, stimulation of the cuta- 
 
SACCHARINUM. 461 
 
 neous, bronchial and renal secretions, irritation of the kidneys, hyper- 
 emia of the ovaries and uterus and increased menstrual activity. In large 
 doses it produces hematuria, dysuria, and intense gastro-enteritis, with 
 violent vomiting and purging. Toxic doses produce the symptoms of an 
 irritant and narcotic poison. It may originate uterine contractions in 
 the pregnant female, but its abortifacient effect can only be produced by 
 a quantity sufficient to endanger life. The oil diffuses into the blood 
 and is excreted by the various excretory channels. 
 
 As an emmenagogue Savine is highly esteemed by many authorities, 
 Phillips considering it "one of the most certain and powerful" agents 
 of this class, "with the additional advantage that it can be given with 
 perfect freedom from risk of doing harm. ' ' So irritant an agent, however, 
 requires the exercise of great caution in its use. It has been found ex- 
 tremely efficient in dysmenorrhea when not due to mechanical causes; 
 also in menorrhagia and hemorrhage after abortion. In chronic gout 
 and the joint affections of chronic rheumatism, it was formerly much em- 
 ployed. Externally the Cerate is used to prolong the discharge from 
 blisters, setons or issues, and to stimulate the healing of indolent ulcers. 
 For these purposes it is considered safer than cantharides, as its prolonged 
 employment does not bring on strangury or vesical irritation. As a 
 caustic it is efficient for the destruction of warts and other excrescences, 
 and the moistened powder is used as a paste on venereal condylomata, in 
 combination with burnt alum or cupfic subacetate. The Oil is the most 
 efficient preparation for internal administration. 
 
 SACCHARINUM, Saccharin (Unofficial), — is a sweet imide de- 
 rivable from a coal-tar product, Toluene, from which it is prepared by a 
 complicated process. It has the chemical title Benzoyl-sulphonic-imide, 
 and the formula C 6 H 4 (CO)(S0 2 )NH. It occurs as a white, amorphous 
 powder, with a very sweet taste, a faint flavor of bitter almonds, and is 
 official in the Br. Phar. under the title Glusidum, Gluside (Glucus- 
 imide). The pure product is a white, crystalline powder, about 500 
 times sweeter than sugar and giving a distinct flavor to 70,000 times its 
 weight of water, but the commercial article is standardized to about 300 
 times the sweetening power of sugar. Dose, gr. ss-ij. 
 
 Saccharin is soluble in 400 of water, 28 of boiling water, 30 of alcohol, 48 of glyc- 
 erin, 500 of chloroform and in 100 of ether. [Sugar is not soluble in ether.] It is 
 very soluble in a dilute solution of ammonia, also in solution of sodium bicarbonate 
 where it acts the part of an acid, displacing C0 2 . 
 
 Prepa?-ations. 
 
 Saccha'rinum Solubile, Soluble Saccharin (Unofficial), — is prepared by neutralizing 
 a solution of sodium bicarbonate with saccharin. It is a soluble sodium saccharuiate, 
 containing about 90 per cent, of Saccharin, and is soluble in 15 of water. 
 
462 SACCHARUM. 
 
 t 
 Elixir Saccharini, Elixir of Saccharin (Unofficial), — has of Saccharin 3J, Sodium 
 Bicarbonate S| ss, Alcohol ^ijss, Distilled Water to 3XX. Each drachm contains 
 gr iij of Saccharin. 
 
 Saccharin is from 300 to 500 times sweeter than sugar and is also an 
 efficient antiseptic. It is not a food and has no injurious action on man. 
 It is eliminated in the urine and the saliva without change. It is used as 
 a substitute for sugar in the food of diabetics and subjects of hepatic 
 disease and corpulence ; also to cover the taste of nauseous drugs and as 
 an internal antiseptic in cases of cystitis with decomposing urine. A 
 grain of Saccharin sweetens 6 to 8 fluidounces of liquid. It may be used 
 to a maximum quantity of 30 grains per diem. It is rendered soluble by 
 mixing with it two-thirds its quantity of sodium bicarbonate. 
 
 Dulcin, Sucrol, Para-phenetol-carbaniide . (Unofficial), — is a urea derivative of phene- 
 tidin and occurs in colorless crystals which are soluble in 800 of water, 55 of boiling 
 water, 25 of alcohol, also in ether. Its sweetening power is about 200 times that of 
 sugar. In reasonable doses it is harmless, does not cause any decomposition of the blood, 
 or give rise to the great disgust engendered by Saccharin on prolonged use. Its great 
 insolubility is its chief disadvantage. Dose, gr. ss-ij, up to a daily maximum of 30 
 grains. 
 
 Saxin, — is a similar product of English manufacture, said to be 600 times sweeter 
 than sugar. 
 
 SACCHARUM, Sugar, Cane sugar, C 12 H 22 O n ,— is the refined 
 sugar obtained from Saccharum officinarum, the Sugar-cane, a perennial 
 plant of the nat. order Gramineae, indigenous to India and adjoining 
 countries but cultivated in tropical regions throughout the world. It is 
 also obtained from various species or varieties of Sorghum (nat. order 
 Gramineae), and from one or more varieties of Beta vulgaris, the Sugar- 
 beet (nat. ord. Chenopodiaceae). It is present in several other grasses, 
 as Zea Mays, Maize, also in the juice of various trees (maple, birch, 
 palm, etc.), and in many roots. 
 
 Cane-sugar occurs in white, dry, hard crystalline granules, permanent in the air, odor- 
 less, of purely sweet taste and neutral reaction, soluble in 0.5 of water and in 175 of 
 alcohol, in 0.2 of boiling water and in 28 of boiling alcohol, insoluble in ether. The 
 saturated aqueous solution has the sp. gr. 1.345, and is miscible with alcohol in all pro- 
 portions. Its freedom from Grape-sugar (glucose ) and from more than a slight quantity 
 of Inverted Sugar (glucose plus levulose) is ascertained by dissolving I gramme in 10 
 cc. of boiling water, then mixing with the solution 4 or 5 drops of test-solution of Silver 
 Nitrate and about 2 cc. of Aqua Ammonia, and quickly heating to boiling, when not 
 more than a slight coloration, but no black precipitate, should appear after standing at 
 rest for 5 minutes. 
 
 Other Sugars. 
 
 Saccharum Lactis, Sugar of Milk, Lactose, C 12 H 22 O n -f H 2 0, — see next page. 
 
 Glucose, Dextrose, Grape-sugar, Starch-sugar, C 6 H 12 6 (Unofficial), also known as 
 liver-sugar, diabetic sugar, — forms yellowish nodules or crystals, very soluble in water 
 and in alcohol, has a sweet taste less marked than that of cane-sugar, may be obtained 
 artificially from cane-sugar or from starch, by boiling with a dilute mineral acid, or by 
 the action of diastase, a vegetable ferment formed during the germination of grain. Boil- 
 ing solutions of the alkalies convert it into a brown substance (melassic acid). 
 
SACCHARUM LACTIS. 463 
 
 Levulose, Fruit-sugar, C 6 H 12 6 (Unofficial), — frequently found with grape-sugar in 
 fruits, also in honey. See also Diabetin, below. 
 
 Inosit, Phaseo-mannit, C 6 H 12 6 -j- 2H 2 (Unofficial), — exists in the juice of some 
 meats, in asparagus, etc. Is very sweet, but does not undergo alcoholic fermentation. 
 
 Allied Substances. 
 
 Theriaca, Treacle, Sugar-house Molasses (Unofficial), — is the uncrystallizable residue 
 of the process for refining sugar, a thick, brown, fermentable syrup, very sweet and of 
 sp. gr. about 1.40. It is official in the Br. Ph., and is used in making up some of the 
 official pills of that pharmacopoeia. 
 
 Amylum, Starch, C 6 H ]0 O 5 , — when boiled with dilute mineral acids or when sub- 
 jected to the action of diastase, ptyalin, or pancreatin, it is converted into glucose. (See 
 ante, article Amylum.) 
 
 Preparations. 
 
 Sugar is an ingredient of Pil. Ferri Carbonatis, Pil. Ferri Iodidi, Ferri Carbonas Sac- 
 charatus, Mistura Ferri Composita, Pulvis Crete Compositus, Pulvis Glycyrrhizae Com- 
 positus, also the Troches, Syrups, Compound Syrups, etc. 
 
 Physiological Action and Therapeutics. 
 Sugar is employed in pharmacy and therapeutics chiefly as a vehicle, a 
 corrigent, a preservative and an antiseptic. Syrups protect the active 
 ingredients against putrefaction, but not always against fermentation. 
 They also protect certain ferruginous preparations against oxidation. As 
 an ingredient in troches, powders and extemporaneous mixtures sugar is 
 used to cover the taste or to make insoluble substances more easily mis- 
 cible with water. It increases the solubility of Lime in water. As a food 
 it possesses well-known properties, being a nutrient to adipose tissue and 
 a respiratory fuel, and is decidedly diuretic in its action upon healthy 
 kidneys. Sugar and sugar-forming food constitute more than one-half of 
 the nourishment needed by a healthy person, and when withheld or 
 diverted as in diabetes, the patient is actually starved and undergoes pro- 
 gressive and rapid emaciation. Levulose is found to be more easily con- 
 sumed in the system than cane-sugar, and in the treatment of diabetic 
 patients may be used with benefit for some time. Heretofore its cost has 
 been very great, but it is now being manufactured in large quantities and 
 sold at a reasonable price, under the trade-name Diabetin. 
 
 SACCHARUM LACTIS, Sugar of Milk, Lactose, C 12 H 22 ?1 -f H 2 0,— is one 
 
 of the constituents of the milk of mammals, and is officially described as a peculiar 
 crystalline sugar obtained from the whey of cow's milk by evaporation and purified 
 by re-crystallization. Occurs in white, hard, crystalline masses, yielding a gritty, white 
 powder, odorless, permanent in the air, of faintly sweet taste and neutral reaction, solu- 
 ble in about 6 of water and in I of boiling water, insoluble in alcohol, ether or chloro- 
 form. On adding to a solution of sugar of milk in an equal weight of boiling water 
 some solution of soda, the liquid turns brownish, and on further addition of test-solution 
 of cupric sulphate a brick-red precipitate separates. 
 
 Sugar of Milk is the least soluble of all sugars in water and is soluble in alcohol. It 
 enters into alcoholic fermentation with difficulty. In the presence of decomposing albu- 
 minous matter and under certain other influences, it undergoes the lactic fermentation, 
 
464 SALICINUM. 
 
 which results in the formation of Lactic Acid, Carbon Dioxide and Alcohol. It readily 
 reacts with the reduction tests. 
 
 Lactose has been shown to act as a powerful diuretic, especially in cardiac dropsy, in 
 which See considers it "the best and most certain diuretic we possess, the excretion 
 of urine caused by it being greater than that due to any other drug." He found that it 
 acts similarly to Caffeine though more powerfully, while possessing none of the disad- 
 vantages of the latter. Its diuretic action is but very slight in cases where extensive renal 
 disease exists, and it has no power over dyspnea. 
 
 Sugar of Milk is used in the triturations, also in Dover's powder, deodorized opium, 
 etc., as a diluent. Being much harder than cane-sugar it is considered a valuable ex- 
 cipient for powders requiring the minute subdivision of their medicinal constituent. It is 
 less sweet than cane-sugar, and being less apt to ferment in the stomach and bowels is 
 better than the latter for use with infants' food. 
 
 SALICINUM, Salicin, C 13 H 18 7 ,— is a glucoside obtained from 
 several species of Salix, the Willow, and Populus, the Poplar, trees of the 
 nat. ord. Salicaceae. It is found also in Gaultheria procumbens, the Win- 
 tergreen (nat. ord. Ericaceae,), and in Betula lenta, the Sweet Birch (nat. 
 ord. Betulacese), the volatile oils of which, distilled from the leaves Of 
 the former and from the bark of the latter, consist almost entirely of 
 methyl salicylate (see next page). 
 
 Salix Nigra, the Pussy Willow, grows along streams in the Southern 
 States. A fluid extract is on the market, and may be used in doses of gss 
 thrice daily, as a sexual sedative. 
 
 Salicin occurs in colorless or white and silky, shining crystalline needles, or a crystal- 
 line powder, odorless, of very bitter taste, permanent in the air, of neutral reaction ; 
 soluble in 28 of water and in 30 of alcohol, in 0.7 of boiling water and in 2 of boiling 
 alcohol ; almost insoluble in ether or chloroform. Dose, gr. x-3 j. 
 
 Acidum Salicylicum, Salicylic Acid, HC 7 H 5 3 , — is an organic acid, 
 existing naturally in combination in various plants, but most largely pre- 
 pared synthetically from carbolic acid. It occurs in light, fine, white, 
 prismatic needles, or a crystalline powder, odorless, of sweetish, after- 
 wards acrid taste and acid reaction, permanent in the air ; soluble in 
 about 450 of water, but readily soluble in water containing 8 per cent, of 
 Borax or 10 per cent, of Sodium Phosphate. It is soluble in 2^ of alco- 
 hol, in 14 of boiling water, in 2 of ether, in 80 of chloroform, and is very 
 soluble in boiling alcohol. Dose, gr. V-3J. 
 
 Salicylic Acid is a derivative of Salicin, probably by double oxidation ; but may also 
 be considered as a substitution-derivative of Benzene, formed by replacing 2 atoms of its 
 hydrogen, the one by hydroxyl, and the other by carboxyl. It is obtained therefore 
 either synthetically by combining the elements of Carbolic Acid with those of Carbonic 
 Acid, and subsequent purification, — or from natural Salicylates as the Oil of Wintergreen 
 and Sweet-Birch, — or from Salicin, by heating with caustic potash and treating with 
 hydrochloric acid. The acid prepared from natural sources is purer and more efficient 
 than that prepared artificially, and will often be tolerated by a patient who cannot bear 
 the latter. 
 
 Official Preparations. 
 
 Salol, Salol, Phenyl Salicylate, C 6 H 5 C 7 H 5 3 , — is the salicylic ether of phenol, now 
 obtained from salicylic acid by heating at from 320 to 464 ° F. excluding the air; by 
 
SALICINUM. 465 
 
 which process the acid is converted into Salol, Water and CO,. It is a white, crystalline 
 powder, odorless and almost tasteless, nearly insoluble in water, soluble in 10 of alcohol, 
 and very soluble in ether, chloroform and oils. On being warmed with an alkali it splits 
 up into Salicylic Acid 60, and Carbolic Acid 40. Dose, gr. v-xv, frequently repeated, in 
 compressed tablets or in cachets, or suspended by mucilage of acacia or of tragacanth. 
 
 Lithii Salicylas, Lithium Salicylate, LiC T H 5 3 , — a white or grayish-white powder, 
 odorless, sweetish, deliquescent, very soluble in water and in alcohol. Dose, gr. v-gj. 
 
 Sodii Salicylas, Sodium Salicylate, XaC-H 5 3 , — a white, amorphous powder, soluble 
 in ^ of water and in 6 of alcohol, also in glycerin. Dose, gr. v-gj. 
 
 Physostigminae Salicylas, Pkysostigmine [Bserine) Salicylate, — is described under 
 Physostigma. Dose, gr. 1 ^ - 6 I . 
 
 Methyl Salicylas, Methyl Salicylate, Artificial {Synthetic) Oil of Wintergreen, CH,- 
 C 7 H 5 3 , — is a colorless liquid, having the characteristic odor and taste of Oil of Gaulthe- 
 ria, with the essential constituent of which it is identical. It is wholly identical with 
 Oleum Betulie Volatile, and is soluble in all proportions in alcohol, carbon disulphide, or 
 glacial acetic acid. Dose, n\v— xv, suspended in water or in sugared water. 
 
 Oleum Betulae Volatile, Volatile Oil of Betula, Oil of Sweet Birch, — is a volatile 
 oil distilled from the bark of Betula lent a, the Sweet Birch. It is identical with Methyl 
 Salicylate (see above), and nearly identical with Oil of Gaultheria. Russia leather 
 derives its odor from this oil. Dose, Ttly-xv. 
 
 Oleum Gaultheriae, Oil of Gaultheria, Oil of Wintergreen, — consists almost en- 
 tirely of Methyl Salicylate, and is nearly identical with the preceding. It is described 
 under the title Gaultheria. 
 
 Unofficial Preparations. 
 
 Salophen, Para-amidophenol Salicylate, — contains the equivalent of nearly 51 per 
 cent, of Salicylic Acid, and occurs as minute, white, crystalline scales, odorless and 
 tasteless, insoluble in water, soluble in alcohol ; decomposed by alkalies into salicylic 
 acid and acetyl-para-amidophenol ; also decomposed by the organisms as demonstrated 
 in the urine. Dose, gr. v-xv, up to :jj or jss in the 24 hours. 
 
 Salipyrin, Antipyrin Salicylate, C 1S H ]8 X 2 4 , — is produced by the combination of 
 Salicylic Acid 57.7, and Antipyrin 42.3 parts. It is a white, crystalline, odorless powder, 
 very soluble in alcohol, insoluble in water. Its claims to preference are based upon its 
 comparative harmlessness (^ijss having been taken within 3 or 4 hours without the 
 slightest ill effect) ; also its freedom from unpleasant after-effects. Dose, gr. x-xxx 
 eveiy hour or 2 hours until % ij have been taken. It is best administered in wafers, as a 
 powder, or in mixture, rubbed up with glycerin and flavored with raspberry syrup. 
 
 Malakin, Salicyl-para-phenefidin, — is a condensation product of salicylic aldehyde 
 and p-phenetidin, occurring in bright yellow needles, almost insoluble in water or alco- 
 hol, and decomposed by dilute mineral acids. Its action is that of salicylic acid, but its 
 effects are very mild, — hence its name (from malakos, mild). It has proved valuable 
 in acute rheumatism and other febrile affections, as an antipyretic and analgesic. As it 
 may be given for a long time without causing any disturbance, it is of especial service 
 in habitual headache. Dose, gr. viij-xv, repeated about six times in 24 hours. 
 
 Physiological Action. 
 Willow-bark is highly astringent, antiperiodic and feebly tonic, but is 
 never employed medicinally owing to its bulk. Salicin is a bitter tonic, 
 also antifermentive, antiseptic and highly destructive to low organisms. 
 It has slight antiperiodic power and is feebly antipyretic. It prevents 
 the reaction between amygdalin and emulsin, also that of ptyalin, etc., 
 on starch. It seems to be devoid of toxic power on man, and is mainly 
 excreted as salicylic, salicyluric and salicylous acids, being first changed 
 in the bowel into saligenin and glucose. Salicin is well borne by the 
 stomach. 
 
466 SALICINUM. 
 
 Salicylic Acid has properties similar to Salicin, but it is much more 
 energetic in its action, being a powerful antipyretic and antiseptic. It is 
 also anhydrotic, checking local perspiration when locally applied. Inhaled 
 it causes irritation of the respiratory passages, producing sneezing and 
 cough. In small doses it stimulates the stomach, heart and respiration, 
 but moderate quantities derange the stomach, causing nausea and vomit- 
 ing; while large doses depress the heart's action and the respiration after 
 a primary excitation of both, lower the arterial tension, relax the vessels, 
 produce free perspiration, and reduce the temperature in fever. It causes 
 vertigo, dilated pupils, tinnitus aurium, a sensation of tension in the 
 frontal cerebrum, delirium, and may produce bed-sores from depression 
 of the circulation, but does not affect the peripheral nerves as to either 
 motion or sensation. In the blood it is first changed to sodium salicylate, 
 but a portion is again set free and uniting with glycocoll forms salicyluric 
 acid, coloring the urine green. It is slowly excreted with the secretions 
 generally, especially in the urine, sweat, saliva, and bile. It stimulates 
 the kidneys, at the same time disinfecting them and increasing the acidity 
 of the urine, but may so irritate the kidneys as to produce albuminuria 
 and hematuria. 
 
 Salicylic acid is destructive to the torula and prevents alcoholic fermenta- 
 tion, also that caused by the organic ferments (pepsin, ptyalin, etc.). In 
 solutions containing bacteria it will prevent their development if in the 
 proportion of 1 per cent., and in that of 1 in 60 it will destroy them. 
 
 Sodium Salicylate is remarkably antipyretic in doses of gr. xv, given 
 4 or 5 times in 24 hours. It is a powerful diaphoretic, and an efficient 
 cholagogue, and is supposed to possess the curious property of increasing 
 the fluidity of the bile, at the same time that it promotes its secretion, — 
 other cholagogues increasing the proportion of solids therein. (Brunton.) 
 It has no antiseptic power, unless in association with a strong mineral 
 acid which will liberate the salicylic acid. 
 
 Salol is antiseptic, antipyretic, and germicide, in a higher degree than 
 either of its constituents. As an antipyretic in fever it stands next after 
 antipyrin, and it acts with force sufficient to depress the temperature a 
 dsgree or two below normal. It is sedative to the cerebrospinal system 
 and somewhat analgesic. It causes profuse sweating, and in a few cases 
 depression has accompanied its antipyretic employment, but it is not 
 toxic, and may be used freely in its proper dosage, which ranges from 5 
 to 60 grains, up to 2 or 3 drachms in the 24 hours. In large doses it is 
 liable to induce the symptoms of carbolic acid poisoning. 
 
 Therapeutics. 
 Salicin and its derivatives are chiefly used in acute rheumatism, to 
 lower temperature, relieve pain, and reduce articular swelling. They 
 
SALICINUM. 467 
 
 are most suitable to strong, vigorous patients, and if not promptly effi- 
 cient they should be abandoned. The acid is much used as an antipy- 
 retic in fevers, especially those of septicemic character. It is a useful 
 local application in gangrenous wounds, eczema of the hands or feet, 
 cancer, burns, and in fetid perspirations, in the last affection being used 
 in solution with borax. 
 
 Sodium Salicylate is more soluble than the acid and less irritant to the 
 stomach, while in doses about 50 per cent, larger it is equally efficient. 
 It is employed in 3- to 5-grain doses internally after meals, to arrest gas- 
 tric fermentation and to prevent acidity and flatulence. It is used instead 
 of the acid in acute and chronic rheumatism, to relieve headaches, and 
 for phlegmasia alba, in which it is considered very efficient. It is con- 
 sidered an effective remedy to cut short an attack of tonsillitis, a " bad 
 cold" and other acute affections of the respiratory mucous membrane, 
 also in urticaria, diabetes, gout and cases having a tendency to the for- 
 mation of gall-stones it has many advocates. Lithium Salicylate is not 
 irritant and is supposed to act towards uric acid in the same manner as 
 the other salts of this metal. It is said to be of especial value in acute 
 rheumatism and rheumatic gout. 
 
 Salol is one of the most efficient remedies for duodenal catarrh, catarrh 
 of the bile-ducts and catarrhal jaundice ; also in the bilious form of sick- 
 headache, and in some forms of neuralgia. Its therapeutic value depends 
 chiefly upon its property of splitting up in the alkaline fluids of the in- 
 testine into Salicylic Acid and Phenol compounds, whereby it effects the 
 thorough antisepsis of the intestinal tract and performs the work of its 
 constituent elements upon the organism. In all affections associated with 
 micro-organisms in the intestines, as acute diarrhea, cholera, dysentery, 
 etc., it has done most excellent service, even in Asiatic cholera. It is 
 highly praised in epidemic influenza (grippe), having proved itself re- 
 markably efficient in recent epidemics of that affection. 
 
 Salol is a remedy of very great value in typhoid fever ; disinfecting the 
 ulcerated intestine it promotes the healing process therein, and hinders 
 reinfection. It is highly recommended in dysentery, in cholera, and in 
 infantile diarrhea. Given in the latter affection, a dark staining of the 
 child's diapers is often noticed, which is due to the development of car- 
 bolic acid from the remedy. Its greatest power is manifested over acute 
 rheumatism, in which disease many clinicians maintain that it has no 
 superior, if given in 15- to 30-grain doses, up to 2 drachms in the 24 
 hours, and continued for some time after the acute symptoms have 
 subsided. In large doses, however, it is liable to induce symptoms of 
 carbolic acid poisoning, which may be met by administering sodium 
 sulphate or any other sulphate. It proves to be an efficient disinfectant 
 in catarrh of the bladder, its constituents being excreted with the urine, 
 
468 SALVIA — SAMBUCUS. 
 
 and coming in contact with the vesical mucous membrane for a consider- 
 able length of time. It is much quicker in its action upon the urine than 
 ammonium benzoate, as in a day or two ordinarily the urine loses its 
 foul odor and alkalinity and becomes clear. Dissolved in Retinol, it is 
 considered especially useful in subacute cystitis, having conquered cases 
 in which other remedies have proven ineffectual. 
 
 Externally, Salol is employed as an antiseptic and deodorant powder 
 against impetigo, eczema, sycosis and other skin diseases; and has done 
 good service as an insufflation in the treatment of ozena. In spirituous 
 solutions (5 per cent.) it is used with various flavoring agents in the prepa- 
 ration of mouth-washes and dentifrices, and it enters into the composition 
 of soaps, face powders, and other toilet articles. A mixture of equal parts 
 of Camphor and Salol, heated together, has given good results in the 
 treatment of suppuration of the middle ear, giving no pain and setting 
 up no inflammation of the part. 
 
 Salophen is considered non-toxic in its action upon the organism, while affording all 
 the medicinal qualities of Salol. It has been employed with success, in dosage of 3 j to 
 £jss daily, in the treatment of acute rheumatism, acute rheumatic arthritis, typhoid fever, 
 cholera and allied conditions ; also in neuralgia and sciatica, gastro-enteritis, pyelitis, and 
 cystitis. In intestinal dyspepsia with flatulence and in gastrectasis it has been used with 
 decided benefit, in the latter affection chiefly for the relief of the fermentive disturbances 
 to which the dilated stomach is liable. «., 
 
 Salipyrin has been employed with excellent results in acute and chronic rheumatism, 
 rheumatic sciatica, neuralgia and influenza. In rheumatic fever 15-grain doses are given 
 at short intervals { l / z hour to I hour), until about ^ ij have been taken, continuing with 
 smaller doses for a long time after convalescence to prevent relapses. A dose of 8 grains 
 is often sufficient against neuralgia. It was extensively used during the epidemic of in- 
 fluenza in 1891, and highly extolled for efficiency therein, as well as for its freedom from 
 cardiac action. It has proved highly efficient in the -treatment of metrorrhagia, especially 
 in that following labor or abortion. Orthmann employed it with most excellent results in 
 50 cases of metrorrhagia from various causes, giving gr. xv thrice daily up to a total of 
 ^ ijss in some cases. In no instance were unpleasant effects observed. 
 
 As it is not obtainable in this country, by reason of a legal conflict between its paten- 
 tees and those of Antipyrin, and as it is a very loose combination' at best, Dr. Squibb sug- 
 gests that there is no reason whatever why just as good results should not be obtained 
 from the administration of its constituents in conjunction, in proper doses to suit each in- 
 dividual case, and in the proportion of about 3 df Salicylic Acid to 2 of Antipyrin. 
 
 SALVIA, Sage, — the leaves of Salvia officinalis, the common garden Sage, a peren- 
 nial plant of the nat. ord. Labiate, native in Southern Europe but cultivated in our gar- 
 dens for its- strong, fragrant odor. They contain tannin, resin, etc., and a volatile oil 
 which consists of Salviol (C 10 H 16 O), camphor and terpenes. There are no official prep- 
 arations. Dose of the powdered leaves, gr. xx-xxx, in infusion. 
 
 Sage is aromatic, stimulant, tonic, astringent and a vulnerary. It was highly esteemed 
 in ancient times, and even, yet is popular as a domestic cure-all with many people. In 
 infusion it may be used as a beverage in febrile conditions and to check sweating, also for 
 the night-sweats of phthisis. Like other members of the same class it has a slight influ- 
 ence over enteralgia and flatulence. It makes a good astringent and stimulating gargle. 
 
 SAMBUCUS, Elder, — the flowers of Sambncus canadensis, the common Elder, a 
 shrub of the nat. ord. Caprifoliacese. The plant contains a small quantity of a volatile oil, 
 also a resin and valerianic acid. The common Elder of Europe (S. nigra) is more of a 
 
SANGUINARIA. 469 
 
 tree, and is official in the Br. Phar. There are no official preparations. Dose, gr. xxx- 
 
 o 
 
 Elder-flowers are stimulant and diaphoretic, also diuretic in some degree. The berries 
 are diaphoretic and laxative, while the inner bark is a hydragogue cathartic and in large 
 doses emetic. Formerly the inspissated juice of the berries was employed as an altera- 
 tive in rheumatism and syphilis, but the flowers are now used only for flavoring purposes. 
 Elder-flower Water (Aqua Sambuci, B. P.) is an excellent vehicle for collyria and lotions. 
 
 SANGUINARIA, Blood-root,— is the rhizome, collected in 
 autumn, of Sanguinaria canadensis, a perennial plant of the nat. ord. 
 Papaveraceae, which grows abundantly throughout the U. S., being one 
 of the earliest and most beautiful of the spring flowers. It has a single 
 white flower on an erect stalk, the petals often tinged with rose or purple. 
 It contains 3 alkaloids, — Sanguinarine, C 17 H 15 N0 4 , which is probably 
 identical with Chelerythrine (see Chelidonium), Porphyroxine and Puc- 
 cine, combined with Chelidonic and Sanguinarinic acids ; also resin, gum, 
 albumin, sugar, etc. The salts of its alkaloids are of brilliant red, and 
 orange colors and areal} soluble in water. Dose of the powdered root as 
 an expectorant, gr. j-v ; as an emetic, gr. x-xxx ; best given in pill. 
 
 Preparations. 
 
 Extractum Sanguinariae Fluidum, Fluid Extract of Sanguinaria. — Dose, frvj-v 
 as an expectorant and stimulant ; Tr^x-lx as an emetic, cautiously. * 
 
 Tinctura Sanguinariae, Tincture of Sangzdnai'ia, — strength 15 percent. Dose, as 
 an expectorant, Tr^v-^j, as an emetic gj-hj. 
 
 Sanguinarina, Sanguinarine, G 17 H 15 N0 4 (Unofficial), — is the chief alkaloid and 
 probably the active principle of the plant. Dose, as an 'expectorant, gr. ^-\ ; as an 
 emetic gr. y z repeated in 10 minutes will produce vomiting after the second or third dose. 
 
 ■* ( - 
 
 Physiological Action. 
 Sanguinaria is sternutatory, sialagogue, expectorant and emmenagogue, 
 a systemic emetic, a cardiac paralyzer, a violent irritant, an acro-narcotic 
 poison and an alterative. Its taste is bjtter and acrid. It causes violent 
 sneezing when inhaled, increases secretion by irritating the secretory 
 organs as it is eliminated, and in full doses produces salivation, catharsis 
 and vomiting with great depression. Overdoses are violently irritant, the 
 heart's action being at first increased, together with the arterial tension, 
 then markedly depressed, and finally paralyzed by stimulation of its in- 
 hibition. The reflexes are lowered by paralysis of the spinal centres, 
 muscular contractility is impaired, the pupils are dilated, the temperature 
 is lowered, cold sweats, great thirst and collapse supervene, and death 
 occurs by paralysis of the cardiac and respiratory centres, often preceded 
 by convulsions. Locally used, Sanguinaria is a feeble escharotic. 
 
 Antagonists and Incompatibles. 
 
 Aviyl Nitrite, Opium, Atropine, etc., to antagonize the depression of the circulation 
 and the local irritant action. Incompatibles are alkalies, Tannin, and most of the metal- 
 lic salts. 
 
470 SANTALUM ALBUM. 
 
 Therapeutics. 
 
 As a tonic to the stomach and a stimulant to the liver Sanguinaria or 
 its active principle is well employed in small doses (gtt. iij of the tincture 
 or gr. Y2" °f tne alkaloid) for atonic dyspepsia, duodenal catarrh and 
 catarrh of the biliary ducts with jaundice. Respiratory affections are 
 often remarkably amenable to its influence, particularly chronic nasal 
 catarrh, asthma and acute bronchitis. In these affections expectorant 
 doses are the best, namely gtt. x of the tincture, and in the former the 
 powder locally as a sternutatory. A decoction is a very efficient gargle 
 in the sore-throat of scarlet fever. Sanguinaria is a very serviceable 
 remedy in chronic bronchitis and in amenorrhea of functional character, 
 also in functional impotence from irritability of the organs, with daily 
 seminal losses and relaxation of the genitalia. By many practitioners it 
 is considered a specific emetic in croup, but others look upon it with dis- 
 favor as too uncertain and harsh in its action. It has been thought to 
 have alterative properties, and hence is frequently used with Stillingiaand 
 other plants in the treatment of strumous and syphilitic affections. In 
 pneumonia of typhoid type and in pleuro-pneumonia it has undoubtedly 
 been of great service in many cases. 
 
 Locally, the powdered root is well employed as an application to foul 
 ulcers and fungous granulations, also by insufflation to nasal polypi, and 
 for chronic hypertrophy of the nasal mucous membrane. 
 
 Sanguinarine has been used with good results in pneumonia, bronchitis 
 and atonic dyspepsia. Doses of gr. -^ to -J- are expectorant without irri- 
 tating the stomach, and still smaller doses (gr. -^ to j 1 ^-) are stimulating 
 to the gastric and intestinal secretions. 
 
 SANTALUM ALBUM, White Sandalwood,— the source of 
 
 the official Oil of Santal, is not itself official. It is a tree of the nat. 
 ord. Santalacese, having its habitat in India but now nearly exterminated 
 there. Santalum citrinum, the yellow Sandalwood, from the Hawaiian 
 and Fiji Islands, is more commonly met with in commerce. 
 
 Oleum Santali, Oil of Santal, Oil of Sandalwood, — a volatile oil distilled from the 
 wood of Santalum album ; a pale-yellow liquid, soluble in alcohol, of peculiar and aro- 
 matic odor, pungent taste and acid reaction. Dose, TT^x-xxx, in emulsion or capsules. 
 
 Extractum Santali Fluidum, Fl. Extr. of Santal (Unofficial). — Dose, ^ j — iij. 
 
 Sandalwood is a very agreeable perfume. The Oil is astringent to 
 mucous membranes, producing dryness of the fauces, thirst, colic, and a 
 sense of fulness in the renal regions. In concentrated form it is a local 
 irritant, but the effects of large doses have not been studied. It is exten- 
 sively used in chronic bronchitis and in gonorrhea, forming the contents 
 
SANTALUM RUBRUM — SANTONICA. 47 I 
 
 of proprietary capsules which are sold for the cure of the latter disease in 
 all drug stores. As found in the shops it is extensively adulterated with 
 oil of cedar and is a very unreliable remedy. 
 
 SANTALUM RUBRUM, Red Saunders, — is the wood of Pterocarptts santalinus, 
 a tree of the nat. ord. Leguminoste, native in India. It comes in chips or as a coarse 
 powder, nearly inodorous and tasteless, not imparting any red color to water when mac- 
 erated in it, but coloring alcohol, ether and alkaline solutions a bright red. The wood 
 has no medicinal properties and is employed solely for the purpose of coloring alcoholic 
 preparations. It is a constituent of Tinctura Lavandulae Compositus. 
 
 SANTONICA, Levant Wormseed, — is the unexpanded flower- 
 heads of Artemisia fiauciflora, a small, perennial plant of the nat. ord. 
 Composite, which grows in Asia Minor, and contains a volatile oil and 
 the peculiar, crystalline principle Santonin. Dose, gr. x-lx. 
 
 Santoninum, Santonin, C 15 H 18 3 , — the neutral principle obtained 
 from Santonica. Occurs in colorless, prismatic crystals, turning yellow 
 on exposure to light, odorless, of bitter after-taste, and neutral reaction, 
 nearly insoluble in cold water, but soluble in 250 of boiling water, in 40 
 of alcohol, 3 of boiling alcohol, 140 of ether, 4 of chloroform, also in 
 solutions of the caustic alkalies. Dose, gr. y^-) for a child, gr. j-v for 
 an adult, not repeated soon as the action of the drug is slow. 
 
 Trochisci Santonini, Troches of Santonin, — each troche contains about l / z grain of 
 Santonin, with Sugar, Tragacanth, and Stronger Orange Flower Water. Dose, j-v. 
 
 Santonin and its preparation are sensitive to light and should be kept in amber-col- 
 ored bottles tightly corked. 
 
 Physiological Action and Therapeutics. 
 
 Santonin is anthelmintic to the round-worm (Ascaris lumbricoides), 
 also but in less degree to the thread-worm (Oxyuris vermicularis). It is 
 taken into the blood as Sodium Santoninate, and affects the cerebral 
 faculties and the vision ; objects appearing at first blue, green, or red, then 
 yellow (chromatopsia), often succeeded by blindness for a week or more. 
 Toxic doses disturb the consciousness of the patient, produce a sort of 
 intoxication, tremors, weakness, with enfeebled respiration and slowing 
 of the pulse, coldness of the surface, vomiting, sweating, mydriasis, con- 
 vulsions, and death from failure of respiration. A dose of 2 grains is 
 said to have proved fatal to a feeble child five years old. It is ex- 
 creted by the kidneys, coloring the urine if acid a greenish-yellow, if 
 alkaline a reddish-purple, and it produces considerable enuresis. 
 
 As an anthelmintic Santonin is the most certain agent against the round- 
 worm, and is best administered in powder with calomel at bedtime after 
 a day of fasting, a senna-draught or a dose of castor oil being used the 
 following morning. It also acts fairly well in suppository against the 
 thread-worm, but is inoperative against tape- worm. Some observers 
 
472 SAPO. 
 
 consider it more promptly efficient when given in castor oil, and that the 
 oil lessens the risk of evil after-effects. It has also been prescribed with 
 great benefit for nocturnal incontinence of urine, and for certain eye 
 affections, particularly amblyopia from atrophic or inflammatory changes 
 in the retina and optic nerve. It should never be given to children 
 during a fever, nor when the bowels are constipated, for fear of toxic 
 results. 
 
 SAPO, Soap, White Castile Soap, — is Soap prepared from soda and 
 olive oil ; a whitish solid, hard, yet easily cut when fresh, of faint, peculiar 
 odor, free from rancidity, a disagreeable alkaline taste and alkaline re- 
 action; easily soluble in water and in alcohol. It is an ingredient of 
 several of the official pills. 
 
 Sapo Mollis, Soft Soap, Green Soap, — is Soap prepared from potassa 
 and linseed oil ; a soft, unctuous mass, of a yellowish-brown color, solu- 
 ble in about 5 of hot water and in 2 of hot alcohol. The name Green 
 Soap is a misnomer, as it is not green in color. 
 
 Insoluble Soaps are combinations of the oily acids with earths and 
 metallic oxides. Two are official, — the Soap of the Monoxide of Lead 
 (Emplastrum Plumbi) and the Soap of Lime (Linimentum Calcis). 
 
 Saponification is a process of double decomposition between a fat (stearate, palmitate 
 or oleate of glyceryl) and an alkali, in which glycerin and the metallic salt of the fatty 
 acid are formed. The glycerin, not being saponifiable, is set free, but the fatty acid 
 (stearic, palmitic or oleic) unites with the salifiable base to form soaps, which are therefore 
 mixed stearates, oleates and palmitates of various bases. Nearly all soaps are oleates or 
 palmitates (or both) of sodium or potassium (or both). Hard soaps are soda soaps, soft 
 soaps are potassium soaps. [Compare the articles entitled Olivce Oleum, Adeps, Acidum 
 Oleicum, Glycerinum.] 
 
 Unofficial Soaps. 
 
 Sapo Animalis, Curd Soap, — official in the Br. Phar. , — is made with Soda and a 
 purified animal fat, and consists chiefly of Stearin. Used in pills and suppositories. 
 
 Sapo Medicatus, — official in the Fr. Codex, — is a Soda soap prepared from expressed 
 Almond Oil. 
 
 Preparations. 
 
 Emplastrum Saponis, Soap Plaster, — has of Soap 10, Lead Plaster 90, Water q. s. 
 
 Linimentum Saponis, Soap Liniment, — has of Soap 7, Camphor 4^, Oil of Rose- 
 mary I, Alcohol 75, Water to 100. Opodeldoc is a similar preparation. Soap Lini- 
 ment is an ingredient of Chloroform Liniment. 
 
 Linimentum Saponis Mollis, Liniment of Soft Soap, Tincture of Green Soap, — 
 has of Soft Soap 65, Oil of Lavender 2, Alcohol 30, Water to 100. 
 
 Physiological Action and Therapeutics. 
 Soap is laxative, antacid and antilithic ; externally it is a stimulating 
 discutient, and is used for cleansing the skin, removing fatty substances 
 and softening the epidermis, but if too long applied it may prove de- 
 cidedly irritant. It is a good antidote in poisoning by acids, and should 
 
SARSAPARILLA. 473 
 
 be administered freely in such cases until more energetic alkalies can be 
 obtained. In aqueous solution it makes a useful enema for constipation, 
 or a plug of soap may be inserted into the rectum. 
 
 Soft Soap is a powerful detergent stimulant and is much employed in 
 skin diseases, especially eczema rubrum, in which the tincture is rubbed 
 on, the diseased skin well washed and then covered with a bland oint- 
 ment. The tincture is the most elegant form for use, and may be diluted 
 with three parts of alcohol for shampooing the scalp. 
 
 The Liniment is used with friction in sprains, bruises and stiff joints, 
 being a little more stimulating than camphor-liniment. It makes a good 
 basis for extemporaneous liniment prescriptions. 
 
 SARSAPARILLA, — is the root of Smilax officinalis, Smilax med- 
 ica, and of other undetermined species of Smilax, plants of the nat. ord. 
 Liliaceae, growing in Mexico, Brazil, etc. There are six commercial 
 varieties on the market, which are put up in differently formed bundles. 
 It contains starch, resin, calcium oxalate, an essential oil, and an acrid 
 neutral principle named Parillin or Smilacin, which when acted on by 
 dilute sulphuric acid affords another principle, Parigenin. 
 
 Preparations. 
 
 Extractum Sarsaparillae Fluidum, Fluid Extract of Sarsaparilla. — Dose, gss-j. 
 
 Extractum Sarsaparillae Fluidum Compositum, Compound Fluid Extract of 
 Sarsaparilla, — has of Sarsaparilla 75, Glycyrrhiza 12, Sassafras 10, Mezereum 3, Glycerin 
 10, Water and Alcohol to 100. Dose, ^ss-j. 
 
 Syrupus Sarsaparillae Compositus, Compound Syrup of Sarsaparilla, — has of 
 the Fluid Extract 20, Fl. Ext. of Glycyrrhiza i l / 2 , Fl. Ext. of Senna l^|, Sugar 65, Oils 
 of Sassafras, Anise and Gaultheria, each 0.01, Water to 100. Dose, ^ j— 3 j. 
 
 Decoctum Sarsaparillae Compositum, Compound Decoction of Sarsaparilla , — 
 has of Sarsaparilla 10, Sassafras 2, Guaiacum Wood 2, Glycyrrhiza 2, Mezereum I, 
 Water to 100. Dose, ^ j— iv. 
 
 Syrup of Sarsaparilla (Unofficial), — much used in flavoring soda-water, is a mixture 
 of the oils of sassafras and gaultheria in syrup. 
 
 Physiological Action and Therapeutics. 
 Those who believe that Sarsaparilla has any action ascribe to it prop- 
 erties as a diuretic, diaphoretic, tonic and alterative. Careful physiolog- 
 ical experiments with the drug and its principle have so far given negative 
 results. It has been used as a so-called "blood-purifier" in scrofula, 
 chronic abscesses, necrosis, old ulcers, many cutaneous diseases, etc., but 
 is generally combined with other agents of undoubted activity. The 
 compound decoction is considered a good agent in tertiary syphilis, 
 especially in debilitated subjects ; while the other preparations are com- 
 monly employed as vehicles for potassium iodide and mercuric chloride 
 in syphilis of any form. Whenever used, the compound decoction will 
 
474 SASSAFRAS — SCAMMONIUM. 
 
 give the best results, the hot water and its other constituents having 
 medicinal value if the principal ingredient has none. 
 
 SASSAFRAS, — is the root-bark of Sassafras variifolium, an indigenous tree of the 
 nat. ord. Laurinese. The volatile oil is official, and contains as its principal constituent 
 Safrol, which is largely used to disguise the odor of the fatty bases in soap manufacturing. 
 
 Sassafras Medulla, Sassafras Pith, — is the pith of the above-mentioned tree. 
 Macerated in water it forms a mucilaginous liquid which does not give a precipitate on 
 the addition of alcohol. 
 
 Mucilago Sassafras Medullae, Mucilage of Sassafras Pith, — has of the pith 2, in 
 water ioo. Dose, indefinite. 
 
 Oleum Sassafras, Oil of Sassafras, — a volatile oil distilled from Sassafras, — a color- 
 less or yellowish liquid, having the odor of Sassafras, a warm, aromatic taste and a 
 neutral reaction, readily soluble in alcohol. Treated with cold nitric acid it becomes of 
 a dark red color, and is finally converted into a red resin. Dose, H\j-iv. 
 
 Infusum Sassafras, Infusion of Sassafras (Unofficial), — is a popular "tea" which 
 may be taken ad libitum. When made from the bark, and taken internally as well as 
 applied locally, it is almost a specific for the rash produced by poison oak (Hinton). 
 
 Sassafras is a constituent of the three compound Sarsaparilla preparations. It acts aj 
 a stimulant diaphoretic when used in quantity of the hot infusion. It enjoys a popular 
 reputation as a "blood-purifier," and has a destructive influence on infusoria. It is 
 employed chiefly in combination with Sarsaparilla and Guaiacum in cutaneous disorders 
 and rheumatic and syphilitic affections. The mucilage of the pith is an excellent demul- 
 cent drink in acute gastritis and enteritis, or in poisoning by irritant and corrosive agents. 
 It may also be used in extemporaneous prescriptions to hold insoluble substances in sus- 
 pension and for flavoring purposes. The oil is chiefly used for flavoring in mixtures and 
 confectionery. The syrup popularly known as "Sarsaparilla" is composed of Oil of 
 Sassafras and Oil of Gaultheria, in syrup. 
 
 Dr. J. Bartlett, of Chicago, in a paper on the toxic properties of Sassafras, published 
 in the Pharmaceutical fournal, says that it appears to have some resemblance to three 
 familiar drugs — opium, strychnine, and ergot ; for it has a narcotic and sudorific action ; 
 a property of inducing tetanic and clonic spasms followed by paralysis, and a probable 
 stimulant effect on the uterus. 
 
 SCAMMONIUM, Scammony, — is a resinous exudation from the 
 root of Convolvulus Scammonia, a plant of the nat. ord. Convolvulaceae, 
 growing chiefly in Syria and Asia Minor. It contains about 80 per cent, 
 of Resin, with gum, sugar, starch, etc. The active principle, Jalapin, is 
 probably identical with the Convolvulin of Jalap, and is contained in the 
 root, the resin, etc. Dose, gr. v-x. 
 
 Resina Scammonii, Resin of Scammony, — soluble in ether. Dose, gr. iij-viij. 
 Extractum Colocynthidis Compositum, — (see ante, page 285) contains 14 per 
 cent, of Resin of Scammony, and is an ingredient of the Compound Cathartic Pill. 
 
 Scammcny is an active cathartic, stimulating the liver and the intes- 
 tinal glands, and causing free purgation in a few hours with considerable 
 griping. Its solution in the bile is necessary to its action, and it com- 
 bines with the soda in that secretion. Though quite drastic in action it 
 is somewhat uncertain as a purgative and is generally employed in com- 
 bination with similarly acting agents. It is anthelmintic against the 
 tapeworm, and in overdoses produces a high degree of irritation. It is 
 used as a drastic purgative for children with calomel or potassium sulphate, 
 
scilla. 475 
 
 when an active cathartic is indicated. In the same way it is the appro- 
 priate agent on the principle of derivation in dropsies and cerebral affec- 
 tions, also in torpid states of the intestines with much slimy intestinal 
 mucus; but it is contraindicated in cases attended by irritability of the 
 stomach and bowels. 
 
 SCILLA, Squill, — is the sliced bulb of Urginea mariti??ia, a. peren- 
 nial plant of the nat. ord. Liliaceae, growing on the shores of the Medi- 
 terranean. Its active principle has not yet been definitely isolated, but 
 it is probably the acrid, bitter glucoside Scillitoxin. Other principles 
 have been obtained and are named Scillipicrin, Scillitin and Scil/in, also 
 a peculiar carbo-hydrate or mucilage named Sinistrin and the usual con- 
 stituents of plants. Dose, in powder, gr. j-iij. 
 
 Preparations . 
 
 Extractum Scillae Fluidum, Fluid Extract of Squill. — Dose, rr\j-v. 
 
 Tinctura Scillae, Tincture of Squill, — 15 per cent. Dose, rr\v-xxx. 
 
 Acetum Scillae, Vinegar of Squill, — 10 per cent. Dose, TT^x-^j. 
 
 Syrupus Scillae, Syrup of Squill, — has of the Acetum 45 parts, with Sugar 80 and 
 Water to 100. Dose, gss-ij. 
 
 Syrupus Scillae Compositus, Compound Syrup of Squill, — has of the fluid ex- 
 tracts of Squill and Senega, each 8, Tartar Emetic 0.2, Calcium Phosphate I, Sugar 75, 
 Water to 100. Is known popularly as Coxe" 1 s Hive Mixture, and contains less than one 
 grain of Tartar Emetic to the fluid ounce (15 grains in 17 fl. ozs.). Dose, for children, 
 rr\v _ 3Jj the latter being an emetic dose ; for adults, as an expectorant, TT^xx-xxx. 
 
 Physiological Action and Therapeutics. 
 
 In small doses Squill is expectorant, in larger doses emetic and diuretic, 
 and in overdoses it is a violent irritant poison, producing nausea, vomit- 
 ing, purging, gastro-enteritis, strangury, bloody urine, perhaps suppression 
 of urine, paralysis and convulsions, with death by paralysis of the heart 
 in systole. Medicinal doses slow the heart, making the pulse stronger 
 and slower, raising the arterial tension, and increasing the flow of urine 
 (like Digitalis). Its active constituents diffuse into the blood, and its 
 systemic effects follow on its application to the skin and seem to be ex- 
 erted upon the mucous membrane of the secretory organs, especially affect- 
 ing the bronchial, gastro-intestinal and genito-urinary. 
 
 Squill is employed in medicine for its expectorant and diuretic effects. 
 It is especially applicable in cardiac dropsy, combined with digitalis or 
 the saline diuretics, and in chronic bronchitis, in which it may be asso- 
 ciated with ipecac or ammonia, asafetida, benzoin, etc. It is also used 
 in croup, but is usually combined in this affection with some other 
 emetic, as tartar emetic in the compound syrup, a mixture which may 
 produce very depressing effects and should be used with caution. In 
 
476 SCOPARIUS. 
 
 whooping-cough and other irritant coughs with tickling sensations in the 
 throat the Syrup or Vinegar of Squill is often of great service. 
 
 The action and uses of Squill should be studied in connection with 
 those of Digitalis and Ipecacuanha. 
 
 SCOPARIUS, Broom, — the tops of Cytisus Scoparius, the Broom- 
 plant, a common garden shrub of the nat. ord. Leguminosae, having 
 small, downy leaves and numerous large golden-yellow flowers. It con- 
 tains Scoparin, C 21 H 22 O 10 , a neutral, crystallizable principle; also Spar- 
 teine, C 15 H 26 N 2 , a volatile, liquid alkaloid, which contains no oxygen, 
 but possesses very decided basic qualities and is highly poisonous. 
 
 Preparations. 
 
 Extractum Scoparii Fluidum, Fluid Extract of Scoparius, — made with diluted 
 alcohol. Dose, ^ss-ij. 
 
 Decoctum Scoparii, Decoction of Broom-tops (Unofficial), — ^j to the pint. Dose, 
 3J every three hours until a diuretic effect is produced. 
 
 Sparteinse Sulphas, Sparteine Sttlphate, — white, prismatic crystals, or a granular 
 powder, of slightly saline and bitter taste, very soluble in water and in alcohol. Dose, 
 gr. YE~h hypodermically, gr. %,-'\) by the mouth. Small doses, gr. T ^— i, every five 
 hours, for cardiac action; larger, gr. j-ij, for diuresis (Clarke). Larger doses are nec- 
 essary, say gr. iss-iij, ter die (Prior). 
 
 Physiological Action. 
 
 Broom-tops are diuretic and laxative, also emetic and cathartic in large 
 doses. In the form of decoction they have long been a favorite diuretic 
 and vehicle for other diuretics in the treatment of dropsies, both cardiac 
 and renal, but are considered most reliable in dropsy of renal origin. 
 
 Sparteine has been thought to resemble Coniine in its action, paralyz- 
 ing the end-organs of the motor nerves and vagi, lowering the reflex 
 excitability of the cord, and causing death by paralyzing the respiratory 
 centre in the medulla. Later observations, however, place it in the 
 Digitalis group, and in the front rank thereof. In small doses it slows 
 and strengthens the heart-beats and raises the arterial tension, at the same 
 time increasing the cutaneous and renal circulation, so that the surface 
 becomes flushed and moist, and in some cases marked diuresis and dia- 
 phoresis occur. The respiration, at first quickened, is soon slowed and 
 deepened, the patient experiencing a sense of increased warmth and well- 
 being, and if suffering from irregular cardiac action, precordial distress 
 and dyspnea, these symptoms are promptly relieved. If the pulse has 
 been abnormally slow Sparteine will quicken it, though its general action 
 is to slow the cardiac rate. An overdose brings on marked palpitation, a 
 small and rapid pulse of high tension, precordial pain and a sense of 
 " tightness " about the chest, with anxiety, and a feeling of great debility, 
 
scoparius. 477 
 
 perhaps even muscular tremor. Death occurs by asphyxia from depres- 
 sion of both the centre and the muscles of respiration. 
 
 Sparteine acts directly on the cardiac muscle as well as upon the inhib- 
 itory apparatus, giving greater force to the cardiac contractions and 
 regulating (generally slowing) the pulse-rate. It also stimulates the vaso- 
 motor centre to contract the vessels throughout the splanchnic area, thus 
 increasing the circulation in the skin and kidneys and raising arterial 
 tension generally. Its diuretic power on healthy persons is denied by 
 some observers and affirmed by others, though all acknowledge it in dis- 
 ease. It is accompanied by increased excretion of urea, is due to the 
 increase of blood-pressure both behind and in front of the renal circula- 
 tion, and is produced only by large doses, gr. j^j-gr. ij. 
 
 The action of Sparteine upon the circulation is manifested quickly as 
 compared with that of other similarly acting drugs. In y 2 hour after its 
 ingestion the pulse is markedly slower, in another ^ hour the arterial 
 tension rises, and both effects last from 5 to 6 hours. When taken regu- 
 larly for several days or weeks its influence remains for nearly a week after 
 its discontinuance. There is no danger of cumulative action. Though 
 the dosage employed has varied from gr. T J g- every 4 hours to gr. xij in 
 24 hours, no toxic action was observed, nor was there any evidence of 
 accumulation, even when given continuously for 3 to 4 months. (Clarke.) 
 Only from a dose of gr. xxxj were evil effects observed. (Prior.) 
 
 Therapeutics. 
 
 Broom-tops are a favorite remedy for dropsy of cardiac origin and for 
 the anasarca of chronic kidney disease, but are inadmissible in acute 
 renal affections or where pulmonary congestion or inflammation exists. 
 
 Sparteine has been employed with very great benefit in cardiac affec- 
 tions requiring stimulation of the heart's action with the smallest possible 
 increase of arterial tension, also the relief of dyspnea, precordial pain, 
 palpitation and edema. In such cases small doses, gr. Jg- to \, are best, 
 and as the influence of the drug is remarkably sustained they need not be 
 repeated oftener than once in 5 or 6 hours. It has given the most 
 marked satisfaction in mitral regurgitation, in which it relieves all the 
 symptoms; also in mitral stenosis, when the pulse is small, weak and 
 irregular. In aortic regurgitation, it quiets the excited action of the heart 
 without unduly prolonging the systole, and is of great value. Used in 
 chronic Bright's disease, with hypertrophy and high arterial tension, it 
 stimulates the heart without increasing the tension. In exophthalmos it 
 gives remarkable relief to all the symptoms. For cardiac palpitation and 
 arrhythmia, small doses are of great service. In asthma it is of signal 
 benefit, cutting short the paroxysms and rendering their recurrence much 
 less frequent. In the opium-habit it is used at periods of depression 
 
47 S SCUTELLARIA SENEGA. 
 
 during the treatment, to overcome the plateau shown in the sphygmo- 
 graphic trace by stimulating the cardiac action. (Jennings.) For this pur- 
 pose, doses of gr. iss-iij three or four times daily are necessary. (Prior.) 
 
 SCUTELLARIA, Skull-cap, — is the plant Scutellaria lateriflora, an indigenous, 
 perennial herb of the nat. ord. Labiatae, growing in moist places and along ditches. It 
 contains a little volatile oil, traces of a bitter principle, besides fat, tannin and sugar. 
 
 Extractum Scutellariae Fluidum, Fluid Extract of Scutellaria. — Dose, gss-ij. 
 
 Scutellaria produces no very obvious effects when taken internally. By some practi- 
 tioners it is said to have tonic, nervine and antispasmodic powers, and it has been used 
 in domestic practice to calm the nervous system in diseases characterized by restlessness, 
 tremors, spasms, twitching of the muscles, hyperesthesia, etc., as chorea, delirium tremens, 
 nervous exhaustion from fatigue or over-excitement, hydrophobia, hysteria and epilepsy. 
 The Scutellarin of the eclectics is not a proximate principle, but an extract precipitated 
 by alum from a concentrated aqueous tincture. It is given in dose of gr. j-iv. 
 
 SENEGA, — is the root of Polygala Senega, an indigenous, perennial 
 plant of the nat. ord. Polygaleae, having small, white flowers in a close 
 spike at the summit of the stem. Its principal constituent is the glucoside 
 Senegin, C 32 H 54 Oi 8 5 which is identical with Saponin, and closely allied to 
 Digitonin. It is a white, amorphous powder, readily soluble in alcohol 
 and hot water, forming a soapy emulsion when mixed with boiling water, 
 and decomposed by HC1 into sugar and Sapogenin, C u H 22 2 . 
 
 Preparations. 
 
 Extractum Senegae Fluidum, Fluid Extract of Senega. — Dose, rr^x-xx. 
 
 Syrupus Senegae, Syrup of Senega, has of the fluid extract 20, Aqua Ammonias y 2y 
 Sugar 70, Water to 100. Dose, 3J-ij. 
 
 Syrupus Scillae Compositus, Coj>ipound Syrup of Squill, — contains 8 per cent, of 
 Senega. (See under Scilla, page 475.) 
 
 Physiological Action and Therapeutics. 
 
 Senega is a stimulating expectorant, a diuretic and a diaphoretic. It 
 causes irritation of the throat, with some salivation and gastro-intestinal 
 irritation, an inclination to cough, increased bronchial secretion, and 
 perhaps some diuresis and diaphoresis. Inhaled as a snuff it is very irri- 
 tant to the mucous membrane of the nose, causing cough, sneezing and 
 nasal catarrh. Senegin is violently irritant and a powerful depressant of 
 the heart, and of the vascular, nervous and muscular systems. It is ex- 
 creted by the bronchial mucous membrane, the kidneys and the skin, 
 all of which it stimulates and in large quantity irritates. 
 
 The use of Senega is chiefly that of a stimulating expectorant in chronic 
 bronchitis, the second stage of acute bronchitis, typhoid pneumonia, 
 asthma and croup, also as a diuretic in dropsy due to renal disease. It 
 removes the tightness and oppression experienced in the subacute chest 
 affections, relieves cough and rapidly promotes expectoration. When the 
 mucus is tough and scanty this remedy is of no value. It has been used 
 
SENNA. 479 
 
 with benefit in amenorrhea, given in saturated decoction for two weeks 
 before the expected period. In chronic rheumatism and in rheumatic 
 paralysis its stimulating and diaphoretic powers have been of great value. 
 Senegin has been successfully used in 2-grain doses as a remedy for uterine 
 hemorrhage. 
 
 SENNA, — the leaflets of Cassia acutifolia (Alexandria Senna), and of 
 Cassia a?igustifolia (India Senna), shrubs of the nat. ord. Leguminosae, 
 growing in Egypt and India. They contain an amorphous glucoside, 
 Cathartic Acid, C 180 H 192 N 2 SO 82 , which forms salts with bases and may be 
 decomposed into glucose and Cathartogenic Acid. Other constituents 
 are Sennapicrin and Sennacrol, both glucosides ; Catharto-mannite, a 
 peculiar, unfermentable sugar; also a coloring matter allied to Chrysa- 
 robin, and various vegetable salts. 
 
 Preparations. 
 
 Extractum Sennae Fluidum, Fluid Extract of Senna, — an excellent preparation. 
 Dose, 3 ss- % ss. 
 
 Syrupus Sennae, Syrup of Senna, — has of Alexandria Senna 25, Oil of Coriander 
 y 2 , Alcohol 15, Sugar 70, Water to 100. Dose, 3J-3J. 
 
 Confectio Sennae, Confection of Senna, — has of Senna 10, Cassia Fistula 16, Tama- 
 rind 10, Prune 7, Fig 12, Sugar 55 ]/ 2 , Oil of Coriander l / 2 , Water to 100. Is sold under 
 the trade names Tamar-Indien, Tropical Fruit Laxative, etc. Dose, ^j-ij. 
 
 Infusum Sennae Compositum, Compound Infusion of Senna, Black Draught,- — 
 has of Senna 6, Manna 12, Magnesium Sulphate 12, Fennel 2, Boiling Water 80, Cold 
 Water to 100. Dose, Jj-iij. 
 
 Pulvis Glycyrrhizae Compositus, Compound Liquorice Powder (See under Gly- 
 CYRRHIZA), — contains 18 per cent, of Senna. Dose, ^ss-^jss. 
 
 Syrupus Sarsaparillae Compositus, Co??ipound Syrup of Sarsaparilla (See under 
 Sarsaparilla), — contains i]A percent, of the fluid extract of Senna. Dose, ^j-^j- 
 
 Physiological Action and Therapeutics. 
 Senna is a very efficient and safe cathartic, producing copious yellow 
 stools in about 4 hours, with considerable griping and flatulence, which 
 may, however, be lessened by combining it with carminatives. Its action 
 is chiefly expended on the small intestine, and it increases both peristalsis 
 and secretion. It has no irritant quality in ordinary doses, and does not 
 produce hypercatharsis, or leave constipation as an after-result. Its in- 
 fusion injected into the veins causes both vomiting and purging; and in 
 large doses by the mouth it produces nausea, vomiting, flatulence, excited 
 pulse and drastic purgation with severe tenesmus, but its effects are never 
 poisonous. It may cause hemorrhoids and increase the menstrual flow in 
 women. Given to a nursing mother her milk will acquire purgative 
 powers. In some very susceptible persons the odor of the leaves or of 
 the infusion will cause an evacuation of the bowels. Its odor and taste 
 are particularly disagreeable, especially when administered in infusion. 
 
480 SERPENTARIA. 
 
 Senna would probably take rank as our best and safest cathartic but for 
 the nauseousness of its smell and taste. It is a favorite laxative in England 
 for children, and is used with great benefit in habitual constipation or 
 where prompt evacuation of the bowels is required. In hemorrhoids and 
 anal fissure it is employed to produce soft and easy motions ; but if a 
 tendency to hemorrhoids exists, the use of this drug in cathartic doses 
 will cause irritation of the part and induce an acute attack. For the same 
 reason it is contraindicated in hemorrhage or inflammation of the intes- 
 tinal mucous membrane, menorrhagia, and abortion. The least disa- 
 greeable of its preparations are the Confection of Senna and the Com- 
 pound Liquorice Powder. 
 
 SERPENTARIA, Virginia Snake-Root,— is the rhizome and 
 roots of Aristolochia Se?-pe?itaria and of Aristolochia reticulata, indigen- 
 ous herbaceous plants of the nat. ord. Aristolochiacege, growing in rich, 
 shady woods, with purple flowers arising from joints near the root. It 
 contains a volatile oil, a camphor-resin and a bitter principle named 
 Aristolochine, which is soluble in both alcohol and water. All its prepa- 
 rations should be made from the fresh root, as it deteriorates by keeping. 
 
 Preparations. 
 Extractum Serpentariae Fluidum, Fluid Extract of Sei'pentaria. — Dose, Ti\x-xxx. 
 Tinctura Serpentariae, Tincture of Serpentaria, — 10 per cent. Dose, ^ss-ij. 
 Tinctura Cinchonae Composita, Compound Tincture of Cinchona, — has two parts 
 of Serpentaria in 100. (See ante, under Cinchona.) Dose, 3J-ij. 
 
 Physiological Action and Therapeutics. 
 
 Serpentaria is a stimulant expectorant and tonic, a cardiac stimulant, 
 a diaphoretic, diuretic, emmenagogue, aphrodisiac, and somewhat of an 
 antiperiodic. Its taste is warm and pungent, its odor is characteristic. 
 Small doses promote appetite and digestion, increase the bronchial and 
 intestinal secretions, the action of the heart, the cutaneous circulation 
 and the surface temperature, and produce mental exhilaration. Large 
 doses are irritant, causing nausea and vomiting, vertigo and headache, 
 colic, borborygmi, rectal tenesmus, flatulent distention and frequent but 
 not watery stools. The irritant action seems to produce gas rather than 
 fluid. Pruritus ani and hemorrhoids are occasionally caused by its use. 
 
 Serpentaria is chiefly employed as a vehicle for other stimulant drugs, 
 but has many uses of its own. In bronchial affections it is extremely 
 valuable as a stimulating expectorant. In typhoid pneumonia it is a 
 good vehicle for ammonium carbonate, and in the exanthemata it is use- 
 ful when much depression exists. It is indicated in typhoid conditions 
 generally, and in the amenorrhea of anemia and chlorosis it is an efficient 
 
SESAMI OLEUM SILICATES — SINAPIS. 45 1 
 
 emmenagogue in many cases. It will often restore the waning sexual 
 power in functional impotence, while in bilious vomiting it frequently 
 checks the nausea and settles the stomach. It is used as a vehicle for cin- 
 chona in remittent fever. In diphtheria, scarlatina, etc., an infusion 
 forms an excellent gargle. Its diaphoretic and diuretic properties, though 
 slight, are sometimes of avail in chronic rheumatism. 
 
 SESAMI OLEUM, Oil of Sesamum, Teel Oil, Benne Oil,— is a fixed oil ex- 
 pressed from the seeds of Sesamum indicum, or Benne plant (nat. ord. Pedaliaceae), 
 which is a native of India, but is cultivated in the southern portion of the U. S. It is a 
 yellowish or yellow, -oily liquid, inodorous or nearly so, having a bland, nut-like taste 
 and a neutral reaction. It is a bland fixed oil, very similar in its properties to olive oil, 
 and may be used for the same purposes. It is rich in Olein (76 per cent.) and keeps 
 better than olive oil. It is chiefly employed as a hair-oil. 
 
 SILICATES of Sodium (Na 2 Si0 3 ), of Potassium (K 2 Si0 3 ), and of 
 Magnesium (2Mg03Si0 2 ) are used in medicine and surgery, a solution 
 of the Sodium Silicate being official. 
 
 Liquor Sodii Silicatis, Solution of Sodium Silicate, Soluble Glass 
 Solution, — is a semi-transparent, colorless or yellowish, viscid liquid, 
 odorless, of sharp saline and alkaline taste and alkaline reaction. A 
 small quantity should not produce any caustic effect when applied to the 
 skin. It usually contains about 20 per cent, of Silica and 10 per cent, of 
 Soda, and is used on bandages to make immovable dressings, being lighter 
 than plaster-of-Paris and stronger than starch. 
 
 Liquor Potassii Silicatis, Solution of Potassium Silicate (Unofficial), — also known 
 as Soluble Glass Solution, — is used for immovable dressings in the same manner as the 
 preceding. A mixture of 2 parts of this solution with one of the soda salt solution is said 
 to set more quickly and firmly than either solution separately. Diluted (I to 4) the 
 solution of Potassium Silicate has been applied locally in erysipelas, gonorrhea, cystitis, 
 vaginitis, etc., as an antiseptic with good results. 
 
 Magnesii Silicas Hydratus, Hydrated Magnesium Silicate, Meerschaum* 2MgO,- 
 3Si0 2 -\- 2H,0 (Unofficial), — a mineral used for the manufacture of smoking-pipes, and 
 employed in France as a substitute for Bismuth Subnitrate in obstinate choleraic diarrhea, 
 to protect the intestinal mucous membrane or as an absorbent. It is given in fine powder 
 and in doses of 3J-iv per diem. 
 
 SINAPIS, Mustard, — is official under the two following titles, but 
 the pharmacopceial preparations are directed to be made from Black 
 Mustard only. 
 
 Sinapis Alba, White Musta?-d, — the seed of Brassica alba, an annual 
 plant of the nat. ord. Cruciferae, cultivated in our gardens. It has yellow 
 flowers in racemes, and ribbed pods with a long, ensiform beak. 
 
 White Mustard contains Myrosin, a ferment, and Sinalbin, a crystalline substance, 
 which reacting on each other in the presence of water produce Sulpho-cyanate ofAcrinyl, 
 a rubefacient principle allied to the volatile oil of black mustard. It also contains Sin- 
 opine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil, all three of which are 
 contained also in black mustard. 
 
4^2 SINAPIS. 
 
 Sinapis Nigra, Black Mustard, — is the seed of Brassica nigra, an 
 annual plant of the nat. ord. Cruciferae, native of Europe, but natural- 
 ized in the U. S. It has small, yellow flowers on peduncles at the end 
 of the branches, also smooth, erect pods with a short beak. 
 
 Black Mustard contains Myrosin, a ferment, and Sinigrin (potassium myronate), 
 which reacting on each other in the presence of water produce the Sulp/w-cyanide of 
 Allyl, or Volatile Oil of Mustard. It also contains Sinapine, an alkaloid, Erucic or 
 Brassic Acid, and a bland, fixed oil ; all three of which are contained also in white 
 mustard. 
 
 Commercial Flour of Mustard (Unofficial), — is a mixture of white and 
 black mustard seeds ground to a fine powder. It may be employed in 
 lieu of either variety. Dose, as an emetic, oij-iv. 
 
 Preparations. 
 
 Oleum Sinapis Volatile, Volatile Oil of Mustard, Sulpho-cyanide of Allyl, C 4 H 5 - 
 NS, — a colorless or pale yellow liquid, of pungent, acrid odor and taste and neutral re- 
 action, almost insoluble in water but freely soluble in alcohol and ether. Dose, Tr^-^. 
 
 Charta Sinapis, Mustard Paper, — Consists of Black Mustard, the fixed oil removed 
 by percolation with Benzin, mixed with Solution of Gutta-Percha and spread on paper. 
 Each square inch should contain about gr. vj of Mustard. For local use. 
 
 Linimentum Sinapis Compositum, Compound Liniment of Mustard, — has of the 
 Volatile Oil 3, Fl. Ext. of Mezereum 20, Camphor 6, Castor Oil 15, Alcohol to 100. 
 
 Physiological Action and Therapeutics. 
 
 Locally used, Mustard is rubefacient, counter-irritant, and a nervous 
 stimulant, causing heat, redness and severe burning pain. Its prolonged 
 application produces vesication by inducing local inflammation. Inter- 
 nally it is a local emetic in full doses, in smaller doses a condiment and 
 carminative. Its irritant effect on the gastric mucous membrane is much 
 less powerful than on the skin. 
 
 Mustard is commonly used as a local application to relieve local pain, 
 to stimulate the viscera, and to produce counter-irritation. These ob- 
 jects find their application in muscular rheumatism, neuralgia, colic, 
 gastralgia, inflammation of the throat, larynx, bronchi, lungs, pleurae and 
 pericardium ; also as a derivative in headache, cerebral congestion, and 
 suppressed menstruation. It may be used as a stimulant to the heart, 
 vascular system and respiratory apparatus. When action of a mild char- 
 acter is desired it may be diluted with flaxseed or flour. Internally it 
 maybe employed as an emetic in indigestion or narcotic poisoning. Its 
 use as a condiment is familiar, acting by stimulation of the gastric mu- 
 cous membrane. In overdoses it may excite severe gastritis. White 
 Mustard seed, unground, has been used as a laxative, as it produces no 
 irritation. The Oil is one of the most irritant of the volatile oils, pro- 
 ducing severe gastro-enteritis. It is used chiefly as an ingredient of 
 stimulating liniments, but may be employed internally in small doses. 
 
SODIUM. 483 
 
 SODIUM, Natrium, Na. — This metal is represented by a number 
 of official salts, which are generally colorless or white, and with very few 
 exceptions are readily soluble in water. Some of them are found native, 
 as the Chloride (in sea-water, salt lakes, salt mines), the Nitrate (in 
 Peruvian deserts), and the Borate (in lakes of Persia, California, etc.). 
 The Carbonate is found in the ashes of marine plants. From the Chlo- 
 ride is prepared the Sulphate, from this the Carbonate, and from the latter 
 most of the other salts are prepared. All sodium salts impart a yellow 
 color to flame, which should not appear more than transiently red when 
 observed through a blue glass. The latter cuts off the yellow rays but 
 allows the violet ones of potassium to be seen. 
 
 Sodium Compounds and their Preparations. 
 
 Soda, Sodium Hydrate, Caustic Soda, XaOH, — a white, hard, opaque solid, deliques- 
 cent in moist air, efflorescent in dry air, odorless, of intensely acrid and caustic taste and 
 strongly alkaline reaction, soluble in 1.7 of water at 59 F., and in 0.8 of boiling water, 
 very soluble in alcohol. Is a powerful caustic, but milder than Potassa, and should be 
 kept in well-stoppered bottles made of hard' glass. 
 
 Liquor Sodas, Solution of Soda, — contains about 5 per cent, of the hydrate, and may 
 be prepared by dissolving 56 of Soda in 944 of Distilled Water. It is a clear, colorless 
 liquid, odorless, of acrid and caustic taste and strongly alkaline. Dose, TT\v- 3 ss, well 
 diluted with water. 
 
 Sodii Acetas, Sodium Acetate, NaC 2 H 3 9 + 3H 2 0, — large, transparent prisms, efflo- 
 rescent in dry air, odorless, of saline, bitter taste and a neutral or faintly alkaline reaction, 
 soluble in 1. 4 of water and in 30 of alcohol at 59 F. , in ]/ z of boiling water and in 2 of 
 boiling alcohol. Dose, gr. xx-^j. 
 
 Sodii Carbonas, Sodium Carbonate, Xa 2 C0 3 -f- ioH 2 0, — large, colorless crystals, 
 rapidly efflorescent, with a harsh alkaline taste and strongly alkaline reaction ; very solu- 
 ble in water, insoluble in alcohol. Of it 20 grains will neutralize 9.7 grains of Citric 
 Acid, or ioj^ grains of Tartaric Acid. Dose, gr. v-xxx. 
 
 Sodii Carbonas Exsiccatus, Dried Sodium Carbonate, — is the Carbonate 200 parts 
 dried at a heat of 113 F., until it is converted into a white powder weighing 100 parts. 
 Is chiefly used for pharmaceutical purposes. 
 
 Sodii Bicarbonas, Sodium Bicarbonate, XaHC0 3 , — an opaque, white powder, per- 
 manent in the air, odorless, of cooling, saline taste, and a slightly alkaline reaction ; solu- 
 ble in 1 1.3 of water, insoluble in alcohol, decomposed by hot water and converted into 
 normal Carbonate. Of it 20 grains neutralize 16.7 grains of Citric Acid, or 17.8 grains 
 of Tartaric Acid. It is a constituent of Mistura Rhei et Sodae and of Pulvis Effervescens 
 Compositus. Dose, gr. x-^j. 
 
 Trochisci Sodii Bicarbonatis, Troches of Sodium Bicarbonate,— each troche con- 
 tains of the Bicarbonate about 3 grains, with Sugar, Nutmeg and Mucilage of Tragacanth. 
 
 Sodii Chloras, Sodium Chlorate, NaC10 3 , — colorless, transparent tetrahedrons, per- 
 manent in dry air, odorless, of cooling, saline taste and neutral reaction ; soluble in 1. 1 
 of water and in about 100 of alcohol, also in 0.5 of boiling water and in about 40 of boil- 
 ing alcohol. Should be kept in well-stoppered bottles, and should not be mixed or 
 heated or triturated with readily oxidizable or combustible substances. Dose, gr. v-xx. 
 
 Sodii Chloridum, Sodium Chloride, Common Salt, NaCl, — white, hard, cubical 
 crystals or a crystalline powder, permanent in the air, odorless, of a purely saline taste 
 and neutral reaction ; soluble in 2.8 of water at 59 F., and in 2.5 of boiling water. 
 Almost insoluble in alcohol. Dose, gr. x-^j. 
 
 Sodii Nitras, Sodium Xitrate, Chili Nitre, Chili Saltpetre, NaN0 3 , — colorless, trans- 
 parent crystals, slightly deliquescent, odorless, of cooling, saline and bitter taste, and neu- 
 tral reaction ; soluble in 1.3 of water at 59 F., in 0.6 of boiling water, scarcely soluble 
 in cold alcohol. Dose, 3 j — ij . 
 
484 SODIUM. 
 
 Sodii Sulphas, Sodium Sulphate, Glauber 1 s Salt, Na 2 S0 4 -|- loH 2 0, — large, color- 
 less, transparent, monoclinic prisms, rapidly efflorescent in air ; of cooling, saline taste 
 and neutral reaction ; soluble in 2.8 of water at 59 F., in 0.25 of water at 93. 2° F., 
 and in 0.47 of boiling water, insoluble in alcohol. Dose, gr. v-xx ; as a purgative 3 ss-j. 
 
 Sodii Ethylas, Sodium Ethylate, Caustic Alcohol, C 2 H 5 NaO (Unofficial),— is a 
 white powder, often having a brownish tinge, dissolving in water with a hissing sound. 
 Upon contact with the smallest quantity of water or moist living tissue it splits into alco- 
 hol and caustic soda. An alcoholic solution is made by dissolving sodium in absolute 
 alcohol, and is used as a caustic. Chforoform decomposes it at once into ether and 
 sodium chloride. It should be kept in a cool place as it is liable to explode. 
 
 The Arsenate is described under Arsenum ; — the Benzoate under Benzoinum ; — 
 the Borate under Acidum Boricum ;— the Bromide under Bromum ; — the Solution 
 of Chlorinated Soda under Chlorum ; — the Iodide under Iodum ; — the Hypophos- 
 phite, Phosphate and Pyrophosphate under Phosphorus ; — the Nitrite under 
 Amyl Nitris ; — the Salicylate under Salicin ; — the Sulphite, Bisulphite and 
 Hyposulphite under Acidum Sulphurosum ; — and the Sulpho-carboiate under 
 Acidum Carbolicum. 
 
 Physiological Action. 
 
 The action of the Sodium salts is similar to that of Potassium salts, 
 except that the former are feebler as alkalies, are not so depressant, and 
 are not so poisonous to the cardiac muscle or the nerves. They are dif- 
 fused more slowly, are neither absorbed nor excreted so readily, and have 
 not so marked a diuretic action. Locally applied in large doses to mus- 
 cular and nervous tissues they are paralyzant, but not so powerfully as 
 potassium salts. Sodium Urate is not soluble like the urates of lithium 
 and potassium, and is therefore much less readily excreted, forming the 
 masses called chalk-stones in gouty subjects. Soda is a less active eschar- 
 otic than potash, having less affinity for water. Liquor Sodse renders 
 the blood and secretions more alkaline, but does not alter nutrition to 
 the extent that liquor potassse does. The Acetate is converted into the 
 Carbonate in the blood, and is a less active diuretic than the correspond- 
 ing potassium salts. The Carbonate is chiefly used in the preparation of 
 the other salts. The Bicarbonate is slightly irritant, stimulates the secre- 
 tion of gastric juice, acts as an antacid and will increase the alkalinity of 
 the blood. The Nitrate is a mild cathartic and in solution is a solvent 
 of false membranes. The Ethylate is an antiseptic and a powerful but 
 almost painless caustic. 
 
 Sodium Chloride (common salt) is one of the most important and 
 abundant of the saline constituents of the animal organism, existing nor- 
 mally in the blood, where it keeps the fibrin and albumin in solution ; 
 hence in inflammation, being thus needed, it accumulates at the seat of 
 the morbid action disappearing temporarily from the urine ; its reap- 
 pearance therein being considered one of the surest signs of the patient's 
 improvement. In very dilute solution it enables water to dissolve both 
 albumins and globulins, and renders water non-irritant to the animal 
 tissues and harmless to the red blood-corpuscles. For these purposes the 
 solution employed is one of 0.65 per cent., known in experimental physi- 
 
SODIUM. 485 
 
 ology as the normal salt solution. In substance however or in concen- 
 trated solution, the salt is very irritant to cut surfaces, mucous mem- 
 branes, muscle and nerve tissues. Taken into the stomach in quantity it 
 irritates that organ and induces vomiting. When absorbed in excess of 
 the normal requirements of the body it causes the peculiar nervous irri- 
 tation expressed by the sense of thirst ; which is relieved only by the 
 ingestion of water in sufficient quantity to enable the excess to be dis- 
 solved and excreted by the kidneys. It is rapidly absorbed, and rapidly 
 excreted ; and when consumed in excess it increases tissue-change and 
 consequently the excretion of urea and potassium salts. On the other 
 hand, the excessive ingestion of potassium salts (as in the cases of herbi- 
 vorous animals and vegetarian cranks) increases the excretion of sodium 
 chloride by a double decomposition between these salts in the blood, 
 forming potassium chloride and sodium phosphate, which being foreign 
 to the blood are constantly excreted. In this way, by a continuous vege- 
 table diet the normal amount of sodium chloride in the organism may be 
 greatly reduced, and the animal will feel the want of it and will travel 
 hundreds of miles to visit a salt-lick. Besides being emetic when given 
 internally, Sodium Chloride also acts as a hemostatic, decreases the 
 secretion of mucus, is a vermifuge against thread-worms, promotes the 
 absorption of pleuritic serous exudations and of dropsies, and has con- 
 siderable power as an antiperiodic and an antiseptic. 
 
 Sodium Sulphate, administered by the mouth in dilute solution, excites 
 active secretion in the intestines, especially in the small intestine, partly 
 by its bitterness but also by its irritant quality and its specific property 
 of stimulating the activity of the intestinal glands. The action is not an 
 osmotic one, as was formerly taught. The stimulation caused by this 
 salt extends to the liver and the pancreas, especially the former. The 
 absorption of the secretions is impeded by the low diffusibility of the 
 salt, so that the result is a large accumulation of fluid in the intestinal 
 canal, which finds its way to the rectum and produces purgation. The 
 more dilute the solution employed the more prompt will be the effect, 
 but this salt will not produce catharsis if administered in concentrated 
 form. When injected into the blood it excites no intestinal secretion, 
 does not act as a purgative, and produces no toxic effect. [Magnesium 
 Sulphate is toxic when so administered.] The quantity of Sodium Sul- 
 phate to the pint of Carlsbad water (Sprudel) is 20 grains, in Friedrichs- 
 thal 46^ grains, and in Hunyadi Janosfrom 122 to 173 grains; the latter 
 being the most active hepatic stimulant of the three. A mixture of the 
 Sulphate and the Bicarbonate is sold as the natural salt obtained by 
 evaporation of Carlsbad water. 
 
 The action of the other Sodium salts is described under the titles of 
 the respective constituents to which their effects are mainly referable. 
 
486 SOLANUM CAROLINENSE. 
 
 Antidotes and Incompatibles. 
 
 Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, 
 lemon-juice ; then demulcent drinks and oils to protect the mucous membrane, and the 
 usual vital supporters. The alkalies and their carbonates are incompatible with the acids 
 and also with metallic salts, and the caustic alkalies decompose most alkaloids. 
 
 Therapeutics. 
 
 The Sodium salts mentioned in the first paragraph treating of their 
 action are not much used internally, the corresponding Potassium salts 
 being preferred, especially when it is desired to alkalinize the urine or to 
 promote oxidation. In the alkaline treatment of stomach affections the 
 Sodium salts are the most efficient, especially the Bicarbonate, in small 
 doses before meals or on an empty stomach to increase the gastric juice. 
 The same salt is used in diabetes to lessen the amount of sugar, in frontal 
 headache with constipation, the pain being seated at the junction of the 
 forehead with the hairy scalp, also as a wash (gr. ij ad gj) in itching skin 
 affections and as a lotion in burns and eczema. The Chloride is used 
 internally as an antidote in poisoning by silver nitrate and as an emetic, 
 and will often relieve hemoptysis and migraine. In bilious diarrhea it 
 is employed in doses of gr. x-gj, thrice daily. Locally in baths it is a 
 good stimulant to the skin, and in solution {j/ 2 to i per cent.) to wash 
 wounds, to cleanse the nasal cavities, or to destroy thread-worms, in 
 which case it is given by enema of the strength of two tablespoonfuls to 
 the pint. The Carbonate may be used in dilute solution locally to pre- 
 vent itching, but is chiefly employed in the preparation of the other salts. 
 The Sulphate is a good purgative and hepatic stimulant, and is given 
 either alone or with the Bicarbonate in imitation of Carlsbad salts, for 
 bilious disorders, gouty affections, chronic constipation, obesity and dia- 
 betes mellitus. The Chlorate has uses similar to those of Potassium 
 Chlorate, and being more soluble can be used in stronger solutions, but 
 this is of doubtful benefit for internal use, as it has all the irritating 
 power on the kidneys and destructive action on the blood possessed by 
 the other salt. The Nitrate is employed as a mild cathartic, and in solu- 
 tion by atomization to destroy the false membrane in diphtheria. The 
 Ethylate has been of service as a caustic in cancer, lupus and nevus, for 
 the latter affection being painted over the growth with a glass rod. 
 Caustic Soda is a better escharotic than caustic potassa, as it has less 
 affinity for water, and hence does not destroy the tissues so deeply, nor 
 has it the same tendency to run over adjacent parts. 
 
 The therapeutics of. the other sodium salts are described under the titles 
 of the constituents to which their uses are chiefly referable. 
 
 SOLANUM CAROLINENSE, Horse-nettle, Sand-brier (Unofficial),— is a 
 weed belonging to the nat. ord. Solanaceae, a native of Florida and Carolina. In epilepsy 
 
SPIGELIA STAPHISAGRIA STILLINGIA. 487 
 
 a 20 per cent, tincture of the berries is highly recommended, in doses of 3 ss-j thrice 
 daily. It has also been used with benefit in convulsions due to the albuminuria of 
 pregnancy and in other convulsive affections. 
 
 SPIGELIA, Pink-root, — is the rhizome and roots of Spigelia ma- 
 rilandica, the Carolina Pink, an herbaceous perennial of the nat. ord. 
 Loganiaceae, native of the Southern States; having large, showy flowers, 
 scarlet or crimson externally, yellow within. It contains a bitter prin- 
 ciple and a volatile oil, also tannin, wax, resin, lignin and salts. Dose, 
 3J-ij for an adult, gr. x-xx for a child of 3 years. 
 
 Extractum Spigeliae Fluidum, Fluid Extract of Spigelia. — Dose for an adult, gj-ij ; 
 for a child of 3 years, TT^x-xx. 
 
 Infusum Spigeliae Compositum, Compound Infusum of Spigelia, Worm Tea (Un- 
 official), — has Spigelia 15, Senna 10, Fennel 10, Manna 30, Water 500. Dose, ^iss-v. 
 
 Spigelia is anthelmintic against the round-worm (ascaris lumbricoides), 
 and is in popular use as a vermifuge, administered with senna. In large 
 doses it is an uncertain cathartic, and may produce serious symptoms, as 
 vertigo, dimness of vision, dilated pupils, spasms and convulsions. These 
 effects are most apt to occur when the drug fails to produce purgation, 
 hence it is usually administered with an active cathartic. 
 
 Spigelia Anthelmia, Demarara Pink-root, Worm-grass (Unofficial), — produces 
 vomiting, dilated pupils, dyspnea, convulsions and death. If eaten by cattle they perish 
 in great agony. It has been used with real benefit in cardiac affections of rheumatic 
 origin, also in rheumatic fever and in cardiac palpitation with dyspnea, due to mitral and 
 aortic disease. A tincture \i to 8) may be used in doses of TTjv-xx. 
 
 STAPHISAGRIA, Stavesacre, — is the seed of Delphinium Staphisagria, an an- 
 nual or biennial plant of the nat. ord. Ranunculaceae, a native of Europe, having bluish 
 or purple flowers in terminal racemes, and seeds in straight, oblong capsules. The seeds 
 contain an alkaloid Delphinine, probably three other alkaloids, a bitter principle, a 
 volatile oil and a fixed oil, etc. There are no official preparations. 
 
 Unguentum Staphisagriae, Ointment of Staphisagria (Unofficial), — contains of the 
 powdered seeds I part with 2 each of olive oil and lard. 
 
 Delphinina, Delphinine, C 22 H 35 N0 6 (Unofficial), — is the active alkaloid, and exists 
 in the fatty oil which is extracted by ether. Dose, gr. T V-J. 
 
 Stavesacre is a violent emetic and cathartic, also parasiticide. The alkaloid is irritant 
 to the skin if locally used, producing tingling, burning and inflammation. Internally, it 
 lowers the activity of the heart and respiration and produces a most profound adynamia, 
 and may prove fatal from paralysis of the spinal cord and asphyxia. In many respects 
 its alkaloid resembles Aconitine and Veratrine. The ointment is often employed as a 
 parasiticide against pediculi and the acarus scabiei. The fixed oil is probably equally 
 effective. Delphinine has been used internally in asthma, rheumatism and neuralgia, and 
 in the latter affection is well employed as an ointment (gr. xx to 5J), applied over the 
 course of painful superficial nerves. It has been suggested as an antipyretic and for 
 dropsy. A tincture or fluid extract is a very efficient application against pediculi. 
 
 STILLINGIA, Queen's Root, — is the root of Stillingia sylvatica, 
 or Queen's Delight, an indigenous, perennial plant of the nat. ord. 
 Euphorbiacese. It contains a resin and a volatile oil, but its active prin- 
 ciple has not yet been isolated. The fresh root should be used in making 
 
488 STRAMONIUM. 
 
 the preparations, as those from the dried root are almost inactive. Dose 
 of the powdered root, gr. X-3J. 
 
 Preparations. 
 
 Extractum Stillingiae Fluidum, Fluid Extract of Stillingia. — Dose, TT^x-gj. 
 
 Tinctura Stillingiae, Tincture of Stillingia (Unofficial). — Dose, ^ss-ij. 
 
 Decoctum Stillingiae, Decoction of Stillingia (Unofficial). — ^j adOj. Dose, 3J-ij. 
 
 Syrupus Stillingiae Compositus, Compound Syrup of Stillingia (Unofficial), — is 
 composed of Stillingia, Corydalis, Iris, Chimaphila, Coriander, Xanthoxylum, Sam- 
 bucus, Sugar, Water and Alcohol. For the formula, see U. S. Dispensatory, 17th 
 edition. 
 
 Physiological Action and Therapeutics. 
 
 Stillingia in large doses is emetic and cathartic, in smaller doses it is 
 expectorant, diaphoretic, diuretic, sialagogue and cholagogue, possessing 
 the various properties which are considered "alterative." Its taste is 
 acrid and pungent and it increases the action of the heart, skin, kidneys, 
 and bronchial mucous membrane, also the gastric, hepatic, intestinal and 
 salivary excretions. Full doses often excite epigastric pain, nausea and 
 vomiting. 
 
 Stillingia is much employed with Sarsaparilla and similarly acting drugs 
 as an alterative in syphilitic affections, particularly in chronic cases of 
 the tertiary form, in which the system is greatly reduced by the abuse of 
 mercurials and iodides. In these cases it possesses considerable power 
 and frequently cures. It is highly esteemed in strumous affections, in 
 ascites due to hepatic changes, in portal changes with jaundice following 
 malaria, also in habitual constipation, hemorrhoids from hepatic obstruc- 
 tion, and intermittents. In the latter affection the fluid extract with 
 quinine or arsenic is a very useful combination. A strong decoction is 
 used to ward off an impending paroxysm of ague. The compound syrup, 
 notwithstanding its reputation as a model of polypharmaceutical skill, is 
 still largely used in the West and South. 
 
 STRAMONIUM, Thornapple.— The plant Datura Stramonium, 
 the Jamestown Weed or Thornapple (nat. ord. Solanacese), is official in 
 two forms, the leaves and the seed. It is an annual, of rank and vigor- 
 ous growth, having a green stem with large white flowers. It grows wild 
 in Southern Russia and the middle United States, and contains an alka- 
 loid, Daturine (see next page), which is generally considered identical 
 with Atropine both physiologically and chemically, — also malic acid, 
 albumin, gum, resin, etc. 
 
 Stramonii Folia, Stramonium Leaves, — the leaves of Datura Stra- 
 monium, of bitter and nauseous taste. Dose, gr. ij-xx. 
 
 Stramonii Semen, Stramoniu?n Seed, — the seed of Datura Stra- 
 
STRAMONIUM. 489 
 
 monium, of unpleasant odor when bruised and an oily, bitter taste. 
 Dose, gr. j. The official preparations are all made from the seed. 
 
 Preparations. 
 
 Extractum Stramonii Seminis, Extract of Stramonium Seed. — Dose, gr. Ye-}^. 
 
 Extractum Stramonii Seminis Fluidum, Fl. Ext. of St. Seed. — Dose, Tt\j-v. 
 
 Tinctura Stramonii Seminis, Tinct. of St. Seed, — 15 per cent. Dose, n\v-xxx. 
 
 Unguentum Stramonii, Stramonium Ointment, — has of the Extract 10, Diluted 
 Alcohol 5, Benzoinated Lard 85. 
 
 Daturina, Daturine, C 17 H 23 N0 3 (Unofficial), — is the alkaloid found in all parts of 
 the plant, also in Datura Tatula. It is a Tropate of Tropin, isomeric and identical with 
 Atropine. Dose, gr. t |o-<jV 
 
 Physiological Action. 
 
 The action of Stramonium is similar to that of Belladonna in almost 
 every particular, except that Stramonium is more powerful and chiefly 
 influences the sympathetic nervous system, not affecting the motor or sen- 
 sory nerves. It excites a greater degree of cardiac irregularity and a more 
 furious delirium, and seems to have a special affinity for the generative 
 apparatus, being decidedly aphrodisiac in full doses. 
 
 As previously stated the alkaloids Atropine, Daturine, Hyoscyamine 
 and Duboisine are chemically alike and almost identical physiologically. 
 They all produce dilatation of the pupil, increase the cardiac action, the 
 pulse and respiration rate and cause delirium. Poisoning by one of them 
 is indistinguishable from that by another. 
 
 Antidotes, Antagonists, and Inconipatibles. 
 
 These are the same as for Belladonna. t Poisoning by Stramonium is not uncommon, 
 as children may eat the seeds, which should be evacuated by an emetic. If physiolog- 
 ical symptoms follow Opium must be exhibited as the antagonist, but cautiously, lest 
 opium-narcosis be substituted. 
 
 Therapeutics. 
 Stramonium is chiefly used as an antispasmodic and to relieve pain. In 
 asthma the leaves are smoked with advantage at the commencement of a 
 paroxysm, the smoke being drawn into the lungs. In other spasmodic 
 affections, as hepatic colic, laryngeal cough, chorea and stammering, it 
 is very beneficial. In dysmenorrhea and neuralgia it is used in combina- 
 tion with opium and hyoscyamus, and in tic douloureux and sciatica it 
 is often very efficient. In nymphomania with great mental depression it 
 is frequently effective, and in mania of furious character, particularly the 
 puerperal form with suicidal tendency, it is highly serviceable in 10 to 20 
 minim doses of the tincture every 3 or 4 hours. The ointment is much 
 used in irritable ulcers, and as an anodyne application in painful hemor- 
 rhoids and certain cutaneous diseases. 
 
49° STRONTIUM. 
 
 STRONTIUM, Sr.— The metal Strontium is represented in the 
 pharmacopoeia by three of its salts, viz. — 
 
 Strontii Bromidum, Strontium Bromide, SrBr 2 -f- 6H 2 0, — colorless, transparent, 
 hexagonal crystals, very deliquescent, of bitter, saline taste ; very soluble in water and 
 in alcohol, insoluble in ether. Dose, gr. v-xxx. 
 
 Strontii Iodidum, Strontium Iodide, Srl 2 -j- 6H 2 0, — hexagonal plates, colorless, 
 transparent, of bitter, saline taste ; very soluble in water, also in alcohol and slightly so 
 in ether. Dose, gr. v-xxx. 
 
 Strontii Lactas, Strontium Lactate, Sr(C 3 H 5 3 ), -f- 3H 2 0, — a white, granular pow- 
 der, or crystalline nodules, of slightly bitter and saline taste ; soluble in 4 of water, in 
 less than y z of boiling water, also in alcohol. Dose. gr. v-xxx. 
 
 Strontii Salicylas, Strontium Salicylate (Unofficial), — is highly recommended by 
 Dr. H. C. Wood. Dose, gr. v-xxx. 
 
 Physiological Action and Therapeutics. 
 
 The Strontium salts are among the recent additions to the materia 
 medica. Their marked anti-putrescent and antiseptic properties were 
 first noticed in 1891 by Germain See, on patients suffering from gastric 
 dilatation. He found that in such cases the Bromide prevented the acetic 
 and lactic fermentations and the formation of the gases of decomposi- 
 tion. The toxic action, hitherto attributed to the salts of strontium, has 
 been ascertained to be due to barium, which was present in the commer- 
 cial products used. When pure, they may be safely employed in the 
 same doses, and in the same cases, as the corresponding preparations of 
 potassium and sodium ; while they are much less liable to cause eruptions 
 and are more rapidly and completely eliminated by the kidneys. 
 
 The Iodide is analogous in action to potassium iodide, its intravenous 
 injection producing at first a rapid elevation of arterial pressure with 
 acceleration of the cardiac rate, followed by slowing of the heart, and later 
 on by lowered blood-pressure with increased heart-rate. It has been 
 used, with good results, in the treatment of scrofulous, rheumatoid and 
 cardiac disorders, especially scrofuloderma, scrofulous otorrhea, and 
 enlarged lymphatic glands ; also in lupus vulgaris and ozena. 
 
 The Lactate has been successfully employed in diabetes and in albu- 
 minuria. It diminishes the amount of albumin in Bright's disease, in 
 the parenchymatous nephritis of rheumatic and scrofulous subjects, and 
 in the albuminuria of pregnancy ; for which purpose it should be given in 
 full doses (gr. xxx) thrice daily. It is contraindicated when there is 
 scanty urine or symptoms of uremia. Da Costa held that while the stron- 
 tium salts are admirable as diuretics in renal affections, they accomplish 
 more in the acute than in the chronic forms of nephritis. 
 
 The Salicylate, in doses of gr. v, is one of the best intestinal antiseptics, 
 yielding better results than salol, naphtalin and similar agents. In doses 
 of gr. x-xv it acts very decidedly as a salicylate in gouty and chronic 
 rheumatic conditions, without producing gastric disturbance. In chronic 
 
STROPHANTHUS. 491 
 
 gouty conditions and in lithemia with intestinal indigestion, it is one of 
 the most valuable drugs we have. (H. C. Wood.) 
 
 The uses of Strontium Bromide are mentioned with those of the other 
 Bromides under the title Bromum. 
 
 STROPHANTHUS,— is the seed, deprived of its long awn, of 
 Strophanthus hispidus, an African climbing plant (nat. ord. Apocynaceae), 
 from which the natives extract a toxic preparation known as the Kombe 
 arrow-poison. It contains a crystalline glucoside, named Stropha?ithin, 
 the active principle, which is bitter, slightly acid, soluble in water and 
 in alcohol, but almost insoluble in ether, chloroform, benzin, etc. It is 
 very plentiful in the seeds (8 to 10 per cent.), and is an agent of great 
 energy, the frog being killed by a solution of i in 10,000,000. 
 
 Preparations. 
 
 Tinctura Strophanthi, Tincture of Strophanthus, (1 in 20). — Dose, Tt\v-x, or 
 Wl/^-ij frequently repeated. A stronger tincture (1 in 8) is on the market. 
 
 Strophanthinum, Strophanthin (Unofficial). — Dose, gr. jIq—^q hypodermically : gr. 
 ■gfi has been used, the influence of one such injection upon the circulation having lasted 
 at least eight days. 
 
 Physiological Action. 
 
 Strophanthus acts primarily upon muscular tissue by direct contact 
 through the blood and with great energy. It increases the contractile 
 power of all striped muscle, and in poisonous quantity it fixes the muscu- 
 lar contraction into a condition of tetanic permanence, the muscle being 
 unable to resume its normal condition of partial flexibility. As the heart 
 receives much more blood in a given time than any other muscle in the 
 body, it is quickly and markedly affected by the strophanthus-charged 
 fluid, and by regulating the dosage the cardiac muscle may be affected by 
 a quantity which will not influence the other muscles. 
 
 Small doses stimulate the cardiac contractions, increasing the force of 
 the ventricular systole and lowering the rate of the heart-beats. At the 
 same time the general blood-pressure is raised and diuresis is produced, 
 both being due to the vis a tergo — the direct stimulation of the circulation 
 from behind. Large doses paralyze the heart in systole and leave the 
 cardiac muscle in a state of contraction resembling cadaveric rigidity. It 
 does not act through the nervous system, but paralyzes the muscular tis- 
 sue, striated and non-striated, by direct contact ; and when contractility 
 has been once destroyed thereby no stimulus will re-excite it. It does 
 not affect the vascular system directly. 
 
 Compared with Digitalis, Strophanthus is a powerful cardiac stimulant, 
 differing from digitalis in not producing vaso-motor constriction of the 
 arterioles. It reduces the pulse, lowers body-temperature somewhat, is 
 not cumulative in action, and does not cause any gastro-intestinal dis- 
 
492 STYRAX. 
 
 turbance. It is diuretic by direct stimulation of the renal circulation ; 
 and has power over rigors by its rapid cardiac action, stopping them 
 and preventing their recurrence. 
 
 Therapeutics. 
 Strophanthus is undoubtedly a valuable cardiac stimulant, from the 
 rapidity and permanence of its action, as well as its non-interference 
 with the calibre of the peripheral vessels. It promptly relieves cardiac 
 dyspnea, often modifies the pulse-rate in less than an hour, while the in- 
 fluence of a single dose upon the circulation persists for a long time. It 
 may well replace digitalis in the treatment of chronic Bright's disease 
 and valvular lesions of the heart, when it is important that the work of 
 the heart should not be increased by any additional resistance in the 
 arterial system. It has been reported as exceedingly useful in the treat- 
 ment of Bright's disease for the dyspnea, orthopnea, dropsy and uremia; 
 also in mitral insufficiency with great anasarca and dyspnea, in palpita- 
 tion, exaggerated cardiac action, in weak heart, and for exophthalmos 
 with tumultuous action of the heart ; also in pulmonary edema due to 
 valvular lesions or to pneumonia. It is useful in endocarditis, also in 
 atheroma of the arteries, in reflex palpitation of neurasthenia, hysteria 
 and chlorosis, and for rigors due to catheterization or operations on the 
 urethra. These high claims, made by enthusiastic therapeutists, have not 
 been maintained by the experience of the general profession, so that this 
 drug is gradually falling into disuse though but recently added to the 
 official pharmacopoeia. 
 
 Ouabain, C 30 H 46 O 12 (Unofficial), — is a glucoside obtained from the root and wood of 
 Acocanthera Ouabaio, an apocynaceous tree of the Somali coast ; also from the seeds of 
 Strophanthus glabrus, a climbing plant from Gaboon. The former furnishes an arrow 
 poison used by the African natives. Ouabain occurs in white, odorless crystals, of 
 feebly bitter taste ; soluble in hot water and in spirit, slightly in cold water, insoluble in 
 absolute alcohol, chloroform and ether. Dose, gr. iqW ever y three hours, in children. 
 
 Ouabain is an extremely active poison, paralyzing the cardiac muscle by direct action. 
 It is a powerful emetic, especially when given hypodermically ; also a potent local anes- 
 thetic, being considered by many observers as superior to Cocaine in this respect. In 
 therapeutic doses it does not seem to affect the body-temperature, but increases urination, 
 either by stimulating the blood-pressure or by paralyzing the sphincter vesicae. It also 
 promotes defecation, probably by stimulating peristalsis. Veiy small doses give some 
 evidence of action similar to that of Digitalis. It has been used with striking benefit in 
 all stages of pertussis ; and to some extent as a local anesthetic for the eye. 
 
 STYRAX, Storax, — is a balsam prepared from the inner bark of Liquidambor 
 orientalis, the Oriental Sweet-gum, a tree of thenat. ord. Hamamelaceae, growing in Asia 
 Minor. It is semi-liquid, sticky, opaque and gray-colored, of agreeable odor and bal- 
 samic taste, completely soluble (except accidental impurities) in an equal weight of warm 
 alcohol. It consists of a volatile oil named Stryot, C 8 H 8 ; a crystalline solid Styracin, 
 which is a cinnamate of cinnamic ether ; two peculiar resins, one hard, the other soft ; 
 and Cinnamic Acid, C 9 H 9 2 , a colorless, odorless, crystalline body, closely allied to 
 Benzoic Acid, excreted in the urine partly as Hippuric Acid, and occurring also in the 
 Balsams of Peru and Tolu. Dose of Storax, gr. v-xx. 
 
SUCCINUM SULPHONAL. 493 
 
 Tinctura Benzoini Composita, Compound Tincture of Benzoin, Friar's Balsam, 
 contains 8 per cent, of Storax. Dose, ^ss-ij. 
 
 Storax is a stimulant expectorant, an antiseptic and a disinfectant, acting both locally 
 and remotely, like benzoin and the balsams. It is used with benefit in chronic bronchitis 
 and other affections of the respiratory organs, also in chronic catarrhs of the genito- 
 urinary passages, in gonorrhea and in amenorrhea. Externally it is employed in oint- 
 ment as a detergent for foul ulcers, and as a parasiticide for scabies and phthiriasis. 
 
 SUCCINUM, Amber (Unofficial), — the source of Oil of Amber, is a fossil resin, 
 occurring in alluvial deposits, chiefly in Prussia, Bohemia, and Courland. It is usually 
 associated with lignite, sometimes encloses insects and parts of vegetables, and consists 
 of a volatile oil, a yellow resin, another resin, succinic acid and a bituminous principle. 
 Its source is thought to be an extinct coniferous tree, the Pinites succinifer, of which 
 amber represents the exudation. The Kauri Gum from New Zealand is a similar sub- 
 stance. 
 
 Oleum Succini, Oil of Amber (Unofficial), — is a volatile oil obtained by the destruc- 
 tive distillation of Amber, and purified by subsequent rectification ; a pale yellow, thin 
 liquid, of sp. gr. about 0.920, of empyreumatic and balsamic odor, warm, acrid taste, 
 and neutral or faintly acid reaction, readily soluble in alcohol. Dose, gtt. v-x. 
 
 Oil of Amber is stimulant, antispasmodic and diuretic when used internally. Exter- 
 nally it is irritant and- rubefacient. It has been employed with benefit in epilepsy, hys- 
 teria, convulsions, amenorrhea, whooping-cough, etc. As a liniment it is often used in 
 chronic rheumatism, and has been applied along the spine in infantile convulsions, mixed 
 with an equal part of laudanum and diluted with olive oil or brandy. 
 
 SULPHONAL, Sulphonal, Diethylsulphon- dimethyl -methane, 
 C 7 H 16 S 2 4 (Unofficial), — is a synthetical hypnotic which has recently been 
 admitted to an official place in the pharmacopoeias of several countries, 
 though unofficial as yet in the United States. It is produced by the in- 
 teraction of anhydrous Mercaptan (ethyl hydrosulphide) and anhydrous 
 Acetone, in the presence of a stream of dry HC1. The resulting Mercap- 
 tol is separated, washed and oxidized by potassium permanganate; yield- 
 ing Sulphonal in colorless, prismatic crystals, soluble in 15 of boiling 
 water, in about 450 of cold water, and in about 50 of cold alcohol; very 
 soluble in boiling alcohol and in ether. Sulphonal is a very stable body, 
 being unaffected by concentrated acids, alkalies or oxidizing agents, cold 
 or warm. Dose, gr. xv-xxx. 
 
 Physiological Action and Therapeutics. 
 Sulphonal was introduced several years ago as a harmless hypnotic, 
 producing sound and quiet sleep without unpleasant after-effects, without 
 intoxicant or narcotic action, and having no unfavorable effects on the 
 heart or circulation even in full doses. It rapidly came into general use 
 as a hypnotic in mental diseases, in nervous insomnia and in sleeplessness 
 from various causes. Recently a number of competent observers have 
 recorded instances of toxic action following its use, and opinions are now 
 greatly divided as to its therapeutical value. If it were not for the very 
 evident advantage of the drug when used with care and under medical 
 supervision, it would stand a very fair chance of being either excluded 
 
494 SULPHONAL. 
 
 from practice or restricted by legislative authority (Squibb). In many 
 cases of serious poisoning thereby death has followed ; and its prolonged 
 use may give rise to such minor toxic effects as noises in the ears, headache, 
 vertigo, weakness and incapacity for mental or physical exertion. The 
 patient may next pass into a condition of drowsiness or stupor, or may 
 surfer from difficulty of speech ; and ptosis, edema of the eyelids and 
 cyanosis may be experienced. The stopping of the drug in subjects of 
 sulphonism is followed by vertigo, motor disturbances, general weakness, 
 digestive troubles, etc., a condition resembling that in morphinism when 
 the morphine is suddenly cut off (Lepine). In one reported case, a dose 
 of 20 grains nightly for 15 months was accompanied by complete cessa- 
 tion of menstruation. It has produced persistent skin eruptions in some 
 cases and severe functional disturbances in others. The chief character- 
 istics of chronic poisoning by this drug are as follows : — disturbances of 
 digestion, shown by vomiting and diarrhea or constipation ; disturbances 
 of the nervous system, as ataxy and feebleness of the limbs, ptosis and 
 ascending paralysis; also ischuria and oliguria, sometimes albuminuria 
 or the presence of hematoporphyrin (Kast). Recovery rapidly follows 
 if the entire alimentary tract be thoroughly purged ; and as long as this 
 is kept free and the kidneys act efficiently and normally, the drug may 
 be considered harmless (Fuerst). In order to secure elimination and to 
 guard against cumulative action and consequent toxicity, its administra- 
 tion should be interrupted from time to time. Anorexia, vomiting, or 
 pains in the stomach may be regarded as indications for immediate dis- 
 continuance (Kast). In acute poisoning by Sulphonal the treatment is 
 by alkalies freely administered. 
 
 As a hypnotic Sulphonal acts admirably in many instances, if admin- 
 istered in hot fluids and about two hours before its action is required ; but 
 its efficacy decreases with use, and it is of no value whatever against 
 insomnia due to pain. The average hypnotic dose is about 20 grains for 
 a woman and 30 grains for a man. The dose is to be administered only 
 once daily, and should be discontinued at the first sign of toxic action. 
 In no case should its administration be continued over any great length 
 of time. In cases of insomnia due to neuralgia and nervous excitement, 
 the dose of sulphonal may be advantageously combined with a small 
 dose of morphine, in proportion to suit individual cases, the mixture 
 forming a safe and efficient hypnotic (Gonzales). An excellent hypnotic 
 combination is made by mixing together 10 or 15 grains each of sul- 
 phonal and trional, to be taken in some hot liquid at bed-time. The 
 trional producing early sleep and the sulphonal effects being manifested 
 later, the patient will usually obtain a more prolonged result from the 
 small dose of each agent administered together than from a larger dose of 
 either alone. 
 
sulphur. 495 
 
 Trional, Diethylsulpkon-methyl-ethyl-methane, — differs from Sulphonal only in the 
 substitution of an ethyl for a methyl group. It occurs in lustrous, bitter, tabular crystals, 
 soluble in 320 of cold water, readily soluble in hot water, in alcohol and in ether. It is 
 an efficient hypnotic, prompter in action and less liable to produce ill effects than Sul- 
 phonal, but must be given in doses fully as large, gr. xv-xxx. It is said to be peculiarly 
 valuable in cases of slight psychical excitement accompanied by obstinate insomnia, and 
 to act promptly and usefully in many forms of delirium. When pain is present it may be 
 administered in conjunction with phenacetin or acetanilid. A potent objection to its use 
 is the fact that it is patented in this country, which is also true of the following agent. 
 
 Tetronal, Diethyhulphon-diethyl-methane, — contains 4 ethyl groups to 3 in Trional 
 and but 2 in Sulphonal. Dr. Lauder Brunton holds of the physiological action of the 
 disulphones, to which group these three substances belong, that only those containing 
 ethyl groups are active and that the hypnotic activity is increased with the number of 
 such groups. This, if substantiated in practice, would make Tetronal the most powerful 
 hypnotic of the three. Trional is found to be generally more active however in this 
 respect, and to be freer from unpleasant by-effects, Tetronal producing vomiting and other 
 digestive disturbances in many cases. Neither of them has any value against insomnia 
 due to pain. Dose, gr. xv-xxx, twice or thrice daily. 
 
 SULPHUR, and SULPHIDES.— The non-metallic element Sul- 
 phur, S, is a brittle solid of a pale yellow color, permanent in the air, of 
 crystalline texture and susceptible of several allotropic states, which are 
 for the most part induced by heat. It is obtained native in several vol- 
 canic districts, or from the native Sulphides of Iron and Copper (iron and 
 copper pyrites) by roasting, as it sublimes at about 238 F. It is official 
 in three forms, viz. — 
 
 Sulphur Sublimatum, Sublimed Sulphur, S, — is prepared from crude 
 Sulphur by sublimation and condensation. It is a fine citron-yellow 
 powder, of faintly acid taste and acid reaction, insoluble in water or 
 alcohol. Ignited it burns with a blue flame, forming sulphurous acid gas, 
 and leaving no residue or only a trace. Dose, gr. x-xx-lx. 
 
 Sulphur Lotum, Washed Sulphur, S, — prepared by digesting sub- 
 limed Sulphur with dilute Water of Ammonia, thoroughly washing with 
 water and passing through a sieve. In this process the Ammonia dis- 
 solves out any sulphide of arsenic which may be present and neutralizes 
 any sulphurous or sulphuric acid. [For its solubility and dose see Sul- 
 phur Pr^ecipitatum below.] 
 
 Sulphur Prsecipitatum, Precipitated Sulphur, Lac Sulphuris, Milk 
 of Sulphur, S, — is prepared by boiling sublimed Sulphur with slaked lime 
 and water, forming the sulphide and hyposulphite of calcium, which are 
 then decomposed by HC1, and Sulphur is precipitated as a very fine 
 powder which is next washed until the washings are tasteless and dried 
 with a gentle heat. The result is a very fine, yellowish-white, amorphous 
 powder, odorless and almost tasteless, insoluble in water or alcohol, but 
 completely soluble in carbon disulphide or in a boiling solution of soda. 
 By heat it is completely volatilized. Dose, gr. x-^j. 
 
496 SULPHUR. 
 
 Preparations of Sulphur. 
 
 Unguentum Sulphuris, Sulphur Ointment, — has of Sublimed Sulphur 30, Benzoin- 
 ated Lard 70, rubbed together until thoroughly mixed. 
 
 Pulvis Glycyrrhizae Compositus, Compound Liquorice Powder (see under Gly- 
 CYRRHIZA), — contains 8 per cent, of Washed Sulphur. 
 
 Sulphurous Acid and the Sulphites are described under Acidum Sulphurosum ; 
 the Sulphates under the titles of their respective bases. For Sulphuric Acid see 
 Acidum Sulphuricum. 
 
 Sulphides. 
 
 Calx Sulphurata, Sulphurated Lime, Crude Calcium Sulphide, — is a mixture of CaS, 
 CaS0 4 and Carbon, in varying proportions, containing at least 60 per cent, of the first. 
 A pale, gray powder, of offensive taste and smell, and alkaline reaction, insoluble in 
 alcohol, very slightly soluble in water. Dose, gr. y 1 — £• 
 
 Calcii Sulphidum, Calcium Sulphide, CaS (Unofficial), — a constituent of the preced- 
 ing, is named Hepar Sulphuris, Liver of Sulphur, by the homeopathists, who prepare it 
 by mixing equal parts of powdered oyster-shell and sublimed sulphur, and heating at a 
 white heat in a crucible hermetically sealed. Dose, gr. -^-\. 
 
 Potassa Sulphurata, Sulphurated Potassa, Liver of Sulphur, — is a mixture of 
 Potassium Trisulphide with small quantities of Potassium Hyposulphite and Potassium 
 Sulphate; prepared by heating together Sublimed Sulphur I, Potassium Carbonate 2, in 
 a covered crucible until melted. Occurs in irregular pieces of liver-brown color, of dis- 
 agreeable odor, alkaline reaction and repulsive taste. Soluble in 2 of water, except a 
 small residue. Alcohol dissolves only the potassium sulphide, leaving the other con- 
 stituents undissolved. Dose, gr. ij-x, in pill or solution. 
 
 Sulphuris Iodidum, Sulphur Iodide, Iodine Disulphide, I 2 S 2 , — is prepared by fusing 
 together Washed Sulphur I part and Iodine 4. It is a grayish-black crystalline solid, 
 having the odor of iodine, an acrid taste and a faintly acid reaction, insoluble in water, 
 but very soluble in disulphide of carbon and in about 60 of glycerin. Alcohol and ether 
 dissolve out the iodine, leaving the sulphur. Used only as ointment, gr. xxx to the 3 . 
 
 Hydrogenii Sulphidum, Hydrogen Sulphide, Sulphuretted Hydrogen, H 2 S, — is used 
 only for test purposes ; a saturated, aqueous solution being one of the official reagents. 
 It is a colorless gas, having the odor of rotten eggs, prepared by the action of dilute 
 sulphuric acid on iron sulphide ; the gas being passed into water a solution is obtained. 
 It precipitates most of the metals from acid solutions as sulphides ; that with Arsenic 
 being yellow ; with Antimony, orange ; with Cadmium, yellow ; with Copper, Lead, 
 Mercury and Silver, black ; with Bismuth, brown ; with Gold and Platinum, brownish- 
 black. 
 
 Carbon Disulphide is described under Carbo ; Antimony Sulphide and Sulphu- 
 rated Antimony under Antimonium. 
 
 Unofficial Allied Compounds. 
 
 Ichthyolum, Ichthyol, Ammonium Sulpho-ichthyolate, C 2S H., 6 S 3 6 (NH 4 ) 2 , — is pre- 
 pared from the product of the distillation of bituminous rocks from the Tyrol which 
 contain fossil fishes. It occurs as a viscous, reddish-brown mass, of tarry odor and ap- 
 pearance and feebly alkaline reaction ; soluble in water and in a mixture of alcohol and 
 ether ; mixes in all proportions with glycerin, fats and oils. It contains a large propor- 
 tion of Sulphur, about 10 per cent. Dose, internally, gr. v-xxx. 
 
 Sulpho-ichthyolates of Lithium, Sodium and Zinc are also prepared, and are on the 
 market. 
 
 Thiolum, Thiol — is prepared by the sulphuration of certain non-saturated hydro- 
 carbons, and is a product very similar to Ichthyol. It occurs in both dry and liquid 
 form, the former, Thiolum siccum, as dark-brown lamellae or powder, of bituminous 
 odor and bitter, astringent taste ; soluble in water and in chloroform, sparingly in alco- 
 hol, insoluble in ether and in benzin. The liquid form, Thiolum liquidum, is a dark- 
 colored, syrupy fluid, miscible in all proportions with water. Dose, internally, gr. v-xxx. 
 
 Tumenolum, Tumenol, — is obtained by treating the unsaturated hydrocarbons of 
 mineral oils with concentrated sulphuric acid. It occurs in several forms, solid and 
 
sulphur. 497 
 
 fluid, that known as Commercial Tumenol being considered the most generally useful. 
 It is a dark-brown fluid, which can be employed in ointment and in tincture, externally. 
 
 Physiological Action. 
 
 Sulphur is a mild laxative and a diaphoretic. In contact with living 
 protoplasm it enters into combination and produces either sulphuretted 
 hydrogen or sulphurous acid ; taken into the intestinal canal a large por- 
 tion passes out unchanged, some of it being converted by the alkaline 
 bile into sulphuretted hydrogen and sulphides. The former is excreted 
 by the lungs, giving to the breath the smell of rotten eggs, also by the 
 skin, discoloring silver articles carried about the person by forming a 
 sulphide of silver. The Sulphides are partly absorbed into the blood and 
 are excreted in the urine, chiefly as sulphates, and in the feces, which 
 they blacken and render soft. Given in full doses they are irritant to the 
 stomach and intestines, extremely nauseous to the taste and smell, increase 
 the secretions of the intestinal glands, promote peristaltic action, and if 
 used for any length of time they impair the blood, causing anemia, 
 emaciation, tremor and great debility. 
 
 Sulphuretted Hydrogen is very destructive to plant life. In animals it 
 destroys the tissue functions, decomposing the blood and paralyzing the 
 nervous and muscular systems. The symptoms of poisoning are those of 
 asphyxia; muscular tremors occur and are followed by convulsions and 
 death. This gas is often found in cesspools in large quantities, but in 
 one case poisoning occurred from its excessive formation in the intestines 
 and subsequent absorption into the blood. 
 
 Calx Sulphurata and Potassa Sulphurata act like the sulphides as local 
 irritants and in large doses as irritant poisons, producing narcotic symp- 
 toms and convulsions. In small doses they act like sulphur, and are 
 supposed by many observers to have a special influence on suppuration, 
 limiting or preventing it if given in small doses frequently repeated. 
 
 The Iodide is believed to possess some of the properties of both its 
 elements. It is doubtful whether it is a distinct chemical compound or 
 merely a physical mixture. As a parasiticide it is very efficient, and has 
 been found remarkably alterative in many local affections of chronic 
 character, but may prove very irritant to the skin if improperly prepared. 
 
 The actions of Sulphuric Acid, of Sulphurous Acid and of the Sulphites 
 are respectively described under the titles Acidum Sulphuricum and 
 
 ACIDUM SULPHUROSUM. 
 
 Incompatibles and Antidotes. 
 
 Solutions of the Sulphides are decomposed by the mineral acids and by solutions of 
 metallic salts. Antidotes are Chlorine-water, Chlorides of Sodium and Potassium, Sul- 
 phate of Iron, etc. Poisoning by Sulphuretted Hydrogen is best treated by artificial 
 respiration. 
 
 32 
 
498 SULPHUR. 
 
 Therapeutics. 
 
 Sulphur is chiefly used as a laxative when pultaceous rather than liquid 
 stools are required, as in hemorrhoids and anal fissure, also in constipa- 
 tion. Scabies has long been treated by its local and internal use, but 
 sulphur alone does not kill the itch insect. The older sulphur ointments 
 were made with sublimed sulphur, and probably contained a consider- 
 able amount of sulphurous acid on which their parasiticide property de- 
 pended. The later ointments, made with purified sulphur, all contain 
 an alkaline ingredient and develop sulphides, which are powerful insect 
 poisons. Sulphur fumigations are practically applications of volatile 
 sulphurous acid, while most of the sulphur baths and sulphurous mineral 
 waters are solutions of sulphuretted hydrogen or of the alkaline sulphides. 
 They are of value in lead poisoning to favor the elimination of that metal, 
 in chronic constipation, chronic rheumatism and sciatica and many skin 
 diseases, especially chronic psoriasis, eczema, pityriasis and prurigo. 
 The Ointment and the Alkaline Ointment are both used in scabies. 
 
 The Iodide has been used internally in scrofula, glanders and cutaneous 
 disorders, but it is chiefly employed as an ointment in lupus and parasitic 
 skin diseases, especially herpes circinatus. Calx Sulphurata is extremely 
 efficient as an internal remedy in crops of boils, scrofulous sores, glan- 
 dular enlargements, acne, etc., and will prevent or limit suppuration. 
 For these purposes it must be used in small doses (gr. -^) frequently re- 
 peated. Potassa Sulphurata is only used externally as baths or ointment 
 in skin diseases and mucous discharges, also in chronic rheumatism. 
 
 Ichthyol was introduced several years ago, by Dr. Unna, the cele- 
 brated dermatologist, as a promptly efficient remedy in certain chronic 
 skin diseases, particularly eczema and psoriasis. It mixes with vaselin, 
 lard and oils, is soluble in a mixture of ether and alcohol, and is not 
 irritant locally, even if covered with oiled silk. 
 
 In one case of eczema infantile, an ointment was applied containing I part of Ichthyol 
 to 5 of Vaselin, resulting in the child sinking into a stupor which lasted for 12 hours. A 
 fatal case of poisoning thereby is reported by Bergerio, of Turin, in a woman whose 
 uterus had been curetted the day previous. After the washing out of the uterine cavity 
 with a solution of Ichthyol 33 to Glycerin 66, she complained of a putrid fish taste in her 
 mouth, her pulse became like that in tachycardia and symptoms of general depression 
 rapidly supervened, ending in death after about 12 hours. These instances show that 
 this agent is not devoid of danger, and that care must be exercised in its employment. 
 
 The particular value of Ichthyol, as a local remedy, is due to its non- 
 irritant quality and to the large proportion of sulphur contained therein; 
 which in any pharmaceutical combination would excite a dermatitis. 
 Its application in medicine depends chiefly upon its reducing property, 
 its antiseptic power and its contractile action upon the vascular system. 
 Most of the affections for which it has been recommended are caused by 
 
SUMBUL TABACUM. 499 
 
 anomalous circulation and especially capillary dilatation. Used inter- 
 nally, it retards the disintegration of albumins and favors their formation 
 and accumulation. Upon exudations it has a remarkable effect, given in- 
 ternally at the same time as applied externally, promoting their reabsorp- 
 tion and promptly alleviating pain. For these purposes it has been 
 highly praised in gynecology and even in pleurisy. For chronic rheu- 
 matism a 50 per cent, ointment is used locally and the remedy is also 
 given internally. It has done excellent service in erysipelas and in ulcers 
 of the leg, locally applied in ointment form with Lanolin or pure ; and 
 internally in various affections of the digestive and intestinal tract, also 
 in phthisis, syphilis and leprosy. In gynecology it is combined with 
 glycerin (1 in 10) ; it is used with turpentine as a liniment for rheumatism, 
 or with an equal weight of a mixture of lanolin and olive oil and 30 per 
 cent, of chloroform ; and against erysipelas as a 10 to 20 per cent, collo- 
 dion, with or without castor oil. 
 
 Thiol, the German artificial Ichthyol, is largely used in place of Ichthyol by gyne- 
 cologists and dermatologists. It causes no pain, burning, or other irritation, and no 
 bleeding from eroded surfaces ; promotes rapid absorption of effusions, and has many 
 advantages over the natural Ichthyol, among which is the ease with which the stains it 
 produces on linen may be removed. The dry form, used as a dusting powder, is of 
 especial service in erysipelas and is employed with benefit in eczema, erythema, inter- 
 trigo, impetigo, pemphigus and other cutaneous affections ; especially in acute, moist 
 inflammations of the skin and subjacent tissues, in chilblains, periphlebitis, contusions, 
 subcutaneous hemorrhages and syphilitic ulcers. It is also an efficient application in 
 pelvic exudations and endometritis. It may be applied as a powder or collodion, also in 
 aqueous or glycerin solutions, as ointment, soap, plaster, etc. Internally, it is given in 
 wine or chocolate (I to 2 per cent.), also in pills containing a grain each. Mixed with 
 Talc, in the proportion of 10 to 20 per cent., it makes an excellent dusting powder for 
 use on babies' skin. 
 
 Tumenol is said to owe its therapeutic action to its powerful reducing property rather 
 than to the sulphur in its composition. The tincture has been almost universally success- 
 ful in all forms of pruritus. Moist eczema is especially benefited by it, and it generally 
 gives good results when employed in erosions, excoriations and superficial ulcerations. 
 It is not anti-parasitic in action and is of no service in erysipelas. 
 
 SUMBUL, — is the root of Ferula Sumbul, a very large plant of the nat. ord. Umbel- 
 liferse, which grows to the height of 8 feet in Northern Asia. The root contains Angelic 
 Acid, C 5 H 8 2 , Valerianic Acid, C 5 H, O 2 , also a volatile oil, two balsamic resins, a bitter 
 substance, etc. Dose, gr. xxx-gj or more, in infusion or decoction. 
 
 Tinctura Sumbul, Tincture of Sumbul, — 10 per cent. Dose, gj-iv. 
 
 Sumbul is an efficient nerve tonic, having qualities closely resembling musk and vale- 
 rian. It is used by the Russian physicians in very many morbid conditions and seems 
 to be a favorite remedy in that country for almost any. disease. It is probably of some 
 value in hysteria and other nervous derangements of delicate females, and may be used 
 as a substitute for musk in typhoid conditions and fevers, asthma, delirium tremens and 
 perhaps in epilepsy. 
 
 TABACUM, Tobacco, — is the commercial dried leaf of Nicotiana 
 Tabacum, an annual plant of the nat. ord. Solanaceae, native of tropical 
 America, but cultivated in several parts of the world, especially in Cuba 
 and Virginia. The leaves contain a very poisonous, oily fluid alkaloid 
 
500 TABACUM. 
 
 named Nicotine, C 10 H 14 N 2 , which occurs as a malate and in quantity- 
 varies greatly in different specimens. Tobacco contains also a volatilizable, 
 camphoraceous principle named Nicotianin, the existence of which is de- 
 nied by some analysts, besides potassium and calcium salts (nitrates and 
 phosphates), silica, gum, resin and other substances. There are no 
 official preparations. 
 
 Nicotina, Nicotine, C 10 H U N 2 (Unofficial), — the alkaloid and active 
 principle; a colorless, oily fluid, having the odor of tobacco and an 
 acrid taste ; readily soluble in water, and forming soluble salts with acids. 
 Dose, tTL^-yV' U P to ^J ^ n tw0 nours > in tetanus and in strychnine 
 poisoning. [Other Liquid Alkaloids besides Nicotine are — Coni'ine, 
 Lobeline, Lupuline, Muscarine, Piperidine, Pyridine, Sparteine and the 
 alkaloidal compound Trimethylamine.] 
 
 The proportion of Nicotine in tobacco is stated at 6 in 10,000 parts (0.06 per cent.) 
 by Posselt and Reimann, but other analysts have found 2 per cent, in Havana tobacco 
 and more than 8 per cent, in French tobacco. Turkish tobacco is said to contain little 
 or none. The effect of curing undoubtedly produces chemical changes, but chemists 
 differ as to whether the proportion of nicotine is greater or less after that process. 
 
 According to Zeise (1843) and Vohl and Eulenberg (1872), tobacco-smoke contains 
 no nicotine, but does contain a series of empyreumatic products, the result probably of its 
 decomposition, viz. — pyridine, collidine, picoline, parvoline, etc. Of these, Pyridine, 
 C 5 H 5 N, predominates when tobacco is smoked in a pipe, but Collidine, C 8 H U N, which 
 is far less active, predominates when there is free access of air as in smoking cigars. 
 Tobacco-smoke also contains Carbon Dioxide, C0 2 , of which Krause determines the 
 average proportion to be 9.3 per cent, and to which he credits much of the injurious 
 effects of smoking in young subjects. It also contains creosote, hydrogen cyanide and 
 sulphide gases, also several acids, including acetic, carbolic and valerianic. 
 
 Unofficial Preparations and Salts, etc. 
 
 Enema Tabaci, Enema of Tobacco (B. P. 1867), — gr. xx of the leaf infused in ^viij 
 of boiling water for an hour, strained, and the whole administered as one enema. 
 
 Oleum Tabaci, Oil of Tobacco, — is an empyreumatic product and a most virulent 
 poison, obtained by distillation at a temperature above that of boiling water. 
 
 Vinum Tabaci, Wine of Tobacco, — 3J to the pint. Dose, TT^v-^j. 
 
 Pyridina, Pyridine, C 5 H 5 N, — a colorless, liquid alkaloid, of powerful odor, evapor- 
 ating when exposed to air and mixing with water in all proportions. Dose, ^j-.^jss, 
 allowed to evaporate in an open dish in a small room, in which the patient is exposed 
 for 20 to 30 minutes thrice daily for the relief of asthma (See). 
 
 Nicotinae Bitartras, A'icotine Bitartrate, — occurs in fine, white crystals, having a 
 tendency to aggregate, readily soluble in water. This salt is stable and keeps well, even 
 in solution. It is recommended as the most suitable form of administering nicotine in 
 tetanus, strychnine poisoning, etc. Dose, gr. aV" iV> u P to a max hnum of gr. ij in 2 hours. 
 
 Physiological Action. 
 Tobacco is a very depressant nauseant, an emetic by irritant as well as 
 by systemic action and an antispasmodic ; also sternutatory, diuretic, dia- 
 phoretic, cathartic, sedative and narcotic. It first stimulates and after- 
 wards paralyzes the motor nerves of involuntary muscles and the secreting 
 nerves of the glands, also the spinal cord and the vagus ; at first stimulating 
 
TABACUM. 501 
 
 both the vagus-roots and its ends in the heart (slowing the pulse-rate), but 
 afterwards paralyzing the latter (causing high pulse-rate). It increases 
 the salivary and intestinal secretions and produces diuresis, tremor, clonic 
 spasms and a tetanic stage followed by paresis. It contracts the pupils, 
 slows and depresses the heart, lowers arterial tension at first and after- 
 wards raises it, reduces the body-temperature and causes profuse sweating, 
 cold and clammy skin, collapse and death usually by paralysis of respi- 
 ration, sometimes by paralysis of the heart. It does not impair the 
 muscular irritability, nor does it act upon the cerebrum directly. Its 
 empyreumatic products act similarly but less powerfully. Fatal results 
 have followed the inhalation of its vapor into the lungs. 
 
 The continued use of Tobacco, by smoking or chewing it to excess, 
 produces granular inflammation of the fauces and pharynx, atrophy of 
 the retina, dyspepsia, lowered sexual power, sudden faints, nervous de- 
 pression, cardiac irritability and occasionally angina pectoris. Used by 
 the young it hinders the development of the higher nerve centres and 
 impairs the nutrition of the body by interfering with the processes of 
 digestion and assimilation. It has been credited with causing cancer of 
 the lips and tongue, blunting of the moral sense, mental aberration and 
 even insanity. The so-called " tobacco heart " includes many forms of 
 nervous, painful or oppressed cardiac action, depending on the age of 
 the subject, the quantity consumed and other circumstances. In mild 
 cases an occasional palpitation or flutter is complained of; in more severe 
 ones there is considerable cardiac irregularity and rapidity, and more or 
 less distress experienced ; in some there is actual cardiac pain, decided 
 irregularity and occasional intermittence of action, and the symptoms 
 may simulate those of a case of angina pectoris. There are no pnysical 
 signs as a rule, so that the diagnosis is made by exclusion. The pathology 
 is unknown, but probably involves some lesion of the vagus. In the 
 young, excessive indulgence in tobacco may lead to cardiac hypertrophy, 
 dilatation and even valvular lesions (Osier). 
 
 Nicotine, in even minute doses (gr. 1), causes symptoms of intense gas- 
 tric irritation with an extreme degree of collapse. It abolishes the func- 
 tion of the motor nerves and paralyzes respiration. Its general action is 
 that of tobacco, but it is one of the most powerful and rapidly-acting 
 poisons known, death having occurred within three minutes after its in- 
 gestion, the patient dropping instantly to the floor insensible, with no 
 symptoms except a wild stare and a deep sigh. The -JU of a grain has 
 caused death in a human being, and g 1 ^- is fatal to cats and dogs. 
 
 Antidotes and Antagonists. 
 
 Strychnine is the true physiological antagonist to Nicotine for Tobacco) and vice versa. 
 Alcohol, Ammonia, Ergot, Digitalis, Belladonna, etc., antagonize its action on the circu- 
 lation. In poisoning by Tobacco the means resorted to are evacuation of the stomach, 
 
502 TAMARINDUS TANACETUM. 
 
 Tannin, Iodides, and artificial respiration. A curious synergism has been observed by 
 the author between Opium and Tobacco. If a person habituated to the use of the latter, 
 either by smoking or chewing, begins to use Morphine, the smallest quantity of Tobacco 
 will make him sick, the symptoms being those experienced by a novice in its use. For 
 the depression due to excessive smoking, the best agent is Spiritus ^Etheris Compositus 
 (Hoffman's Anodyne). 
 
 Therapeutics. 
 Tobacco is now but little used in medicine, the dangers attending its 
 employment either internally or externally having caused it to be super- 
 seded by less violently acting agents. The principal objects for which it 
 is employed are to relax spasm of the intestines and to relieve local pain 
 therein. Intestinal affections, like impaction of the cecum, intussuscep- 
 tion and strangulated hernia, may be overcome by a tobacco-enema to 
 relax spasm, but it is a dangerous expedient. In dropsy, especially the 
 renal form, it makes a very efficient diuretic. In tetanus there is no 
 more effective remedy than minim doses of the alkaloid every two hours 
 by the stomach, or Tr^ij by the rectum, or better still the wine in 10 minim 
 doses repeated for effect. Strychnine-poisoning is best met by minute 
 doses of Nicotine, gr. -£% hypodermically, as a physiological antagonist. 
 It may be employed with advantage in habitual constipation, for the 
 dyspnea of spasmodic asthma and emphysema, also in nymphomania and 
 chordee. In all forms of asthma the inhalation of the fumes of Pyridine is 
 beneficial, as it has a powerfully sedative action on the respiratory centre. 
 The use of Tobacco in moderation, when under excessive exertion, aids 
 in supporting the system and lessening the sense of fatigue. Smokers 
 rarely suffer from constipation, but generally experience an immediate 
 laxative result from their morning cigar. 
 
 TAMARINDUS, Tamarind, — is the preserved pulp of the fruit of Tamarindus 
 indica, a large tree of the nat. ord. Leguminosae, native in the East and West Indies. 
 It contains citric, tartaric and malic acids, sugar, gum, potassium bitartrate, etc. 
 
 Confectio Sennae, Confection of Senna, — contains Tamarind to the amount of I o per 
 cent. Dose, gj-ij. (See under Senna.) 
 
 Tamarind is a laxative and refrigerant fruit. In infusion it may be used by convales- 
 cents as a pleasant acidulous drink, or the pulp may be boiled with milk as a whey for 
 the same purpose. As a laxative it is usually prescribed in connection with other agents 
 having the same action. 
 
 TANACETUM, Tansy, — the leaves and tops of Tanacetum vulgare, a perennial, 
 herbaceous plant of the nat. ord. Compositse, indigenous in Europe but cultivated in our 
 gardens and growing wild in old fields. It contains a volatile oil, a bitter principle Tan- 
 acetin, a tannic acid, etc. There are no official preparations, but a fluid extract may be 
 prepared according to the general rule and administered in doses of TTLx-^j. The dose 
 of the volatile oil (Oleum Tanaceti) is I to 3 drops. An infusion (Tansy Tea) may be 
 made in the proportion of 5J to the pint, and used in doses of ^j-ij. 
 
 Tansy is emmenagogue, diuretic and anthelmintic, an aromatic bitter and an irritant 
 narcotic poison. Fatal results have followed upon overdoses of the oil ( ^ss-j) or strong 
 decoctions, preceded by clonic spasms, disturbed respiration and cessation of the heart's 
 action. It is a useful remedy in amenorrhea, but is in popular repute as an abortifacient, 
 a virtue which it does not possess except in quantity dangerous to life. 
 
TARAXACUM TEREBINTH INA. 503 
 
 TARAXACUM, Dandelion, — is the root of Taraxacum officinale, a plant of the 
 nat. ord. Composite. All parts of the plant contain a bitter, milky juice, exuding from 
 any break or wound. Its constituents are a bitter amorphous principle named Tarax- 
 acin, a crystalline principle Taraxacerin, with potassium and calcium salts, Inulin, and 
 resinoid bodies, etc. The French name for the plant is " Pissenlit. " 
 
 Extractum Taraxaci, Extract of Taraxacum. — Dose, gr. v-xxx. 
 
 Extractum Taraxaci Fluidum, Fluid Extract of Taraxacum. — Dose, 3J-5J. 
 
 Taraxacum is a bitter tonic, a diuretic and an aperient. It has been supposed to act 
 especially on the liver and is chiefly used in dyspepsia with hepatic torpor. As found in 
 the shops it is usually inert. The extract is of value as an excipient for pills. 
 
 TEREBINTHINA, Turpentine.— A Turpentine means a vege- 
 table exudation, liquid or concrete, consisting of resin combined with a 
 peculiar essential oil named Oil of Turpentine (C 10 H 16 ), and generally 
 procured from various species of the nat. ord. Coniferae (cone-bearers). 
 Of the many turpentines two only are official, viz. — 
 
 Terebinthina, Turpentine, — a concrete oleoresin from Pinus palustris 
 the Yellow Pine and other species of Pinus, nat. ord. Coniferae. Occurs 
 in tough, yellowish masses, brittle when cold, crummy-crystalline inte- 
 riorly, of terebinthinate odor and taste. Dose, gr. v-xxx as a stimulant, 
 antispasmodic or diuretic ; 5ij~iv as an anthelmintic. 
 
 Terebinthina Canadensis, Canada Turpentine, Balsam of Fir, — a 
 liquid oleoresin obtained from Abies balsamea, the Silver Fir or Balm of 
 Gilead, nat. ord. Coniferae. A yellowish, transparent, viscid liquid, of 
 agreeable, terebinthinate odor and a bitterish and slightly acrid taste, 
 slowly drying on exposure, forming a transparent mass; completely solu- 
 ble in ether, chloroform or benzol. Dose, gr. x-xxx. 
 
 Pitch and its preparations are described under the title Pix. 
 
 Unofficial Turpentines. 
 
 Chian Turpentine, — from the Pistacea Terebinthus, a small larch 
 tree growing in the islands of Chio and Cyprus ; a thick, tenacious, 
 greenish-yellow liquid, concreting on exposure to the air into a translu- 
 cent solid. Dose, gr. iij-v in emulsion. 
 
 Venice Turpentine, — procured in Switzerland from the Larix 
 Europoza or European Larch ; a viscid liquid of the consistence of honey, 
 does not concrete on exposure, and is entirely soluble in alcohol. The 
 Venice Turpentine of commerce is usually prepared by dissolving resin 
 in oil of turpentine. 
 
 Thus Americanum, Common Frankincense (B. P.), — the concrete 
 turpentine scraped off the trunks of Pinus australis and Pinus Tceda. 
 An ingredient of the Emplastrum Picis of the Br. Phar. 
 
 Official Preparations of Turpentine. 
 
 Oleum Terebinthinae, Oil of Turpentine, commonly called Spirit or Spirits of Tur- 
 pentine, — is a volatile oil distilled from Turpentine. A thin, colorless liquid, of charac- 
 
504 TEREBINTHINA. 
 
 teristic odor and taste ; soluble in 3 times its volume of alcohol, mixes with other volatile 
 and fixed oils, and dissolves resins, wax, sulphur, phosphorus and iodine. Bromine and 
 powdered Iodine act violently on it, and when brought into contact with a mixture of 
 Nitric and Sulphuric Acids it takes fire. It is isomeric with a number of volatile oils, 
 has the formula C 10 H 16 — but constantly absorbs oxygen from the air when exposed, be- 
 coming thicker and less active from formation of resin. It is a mixture of several hydro- 
 carbons, each having the same formula as itself, viz., C 10 H 16 . 
 
 Oleum Terebinthinae Rectificatum, Rectified Oil of Turpentine, — prepared by 
 shaking Oil of Turpentine with 6 times its volume of Lime Water, distilling three- fourths, 
 and separating. This preparation should always be dispensed when Oil of Turpentine is 
 required for internal use. Dose, as a stimulant or diuretic, Tf^v-xv in emulsion 3 to 6 
 times daily ; — as a cathartic or anthelmintic J ss or more, combined with other cathartics. 
 A little glycerin and oil of gaultheria will disguise the taste. 
 
 Linimentum Terebinthinae, Turpentine Liniment, — has 35 parts of the Oil of Tur- 
 pentine with 65 of Resin Cerate. 
 
 Linimentum Terebinthinae Aceticum, Liniment of Terpentine and Acetic Acid 
 (Br. Ph.), — has of the Oil of Turpentine 4, Glacial Acetic Acid I, Liniment of Camphor 4. 
 An imitation of St. John Long's celebrated liniment. 
 
 Derivatives of Turpentine. 
 
 Resina, Resin, Colophony, — is the residue left after distilling off the volatile oil from 
 turpentine ; the portion of turpentine which is fixed by oxidation, consisting in greater 
 part of Abietic anhydride (C 44 H 62 4 ). See ante, under its own title. 
 
 Terebenum, Terebene, C 10 H ]6 , — is a hydrocarbon obtained by the oxidation of Oil of 
 Turpentine by strong Sulphuric Acid, and occurs as a colorless, or light yellow liquid, 
 with the pleasant odor of newly cut pine wood ; practically insoluble in water, soluble in 
 an equal volume of alcohol. It consists chiefly of Pinene, and should contain not more 
 than very small proportions of Terpinene and Dipentene (U. S. P. ) ; [consists of Cam- 
 phene, Cymene, Borneol and Terpilene (Squibb)]. Dose, TT\v-xx on sugar, or sus- 
 pended in £ ss of water by the aid of gr. xx of light magnesium carbonate. 
 
 Terpini Hydras, Terpi7i Hydrate, C ]0 H 18 (OH) 2 .H 2 O, — is the hydrate of the diatomic 
 alcohol Terpin (Terebinthene), obtained by distilling oil of Turpentine with an alkali. 
 Colorless, lustrous, rhombic prisms, nearly odorless, of slightly aromatic and somewhat 
 bitter taste ; soluble in 10 of alcohol and in about 250 of water at 59 F., in 32 of boil- 
 ing water and in 2 of boiling alcohol. Dose, gr. j-x. 
 
 Terpinol (Unofficial), — an oily body obtained from the preceding by the action of 
 an acid thereon. Dose, gr. ij-v. 
 
 Sanitas Disinfecting Fluid (Unofficial), — is an aqueous solution of turpentine 
 which has been oxidized by exposure to the air. It contains Hydrogen Dioxide, Thymol, 
 Camphor and Camphoric Acid, the latter in such small proportion, however, that its 
 action cannot be expected. This proprietary preparation has many advantages. It is a 
 good oxidizing agent and antiseptic, is not poisonous and does not stain the linen ; 
 qualities which recommend it as a disinfectant and for use in surgical operations. 
 
 Official Analogues of Turpentine. 
 
 These include Juniperus Juniper, Sabina Savine, PlX Pitch, and PlX LlQUIDA 
 Tar, which are described under their respective titles. 
 
 Unofficial Analogues of Turpentine. 
 
 Oleum Succini, Oil of Amber, — a volatile oil obtained by the destructive distillation 
 of Amber (Succinum), a fossil resin thought to be the exudation of Pinites succinifer, an 
 extinct coniferous tree. Dose, gtt. v-x. See ante, under Succinum. 
 
 Oleum Thujas, Oil of Thuja, — a volatile oil which is given in doses of tt\j-v. A 
 saturated tincture may be used in drachm doses. Obtained from Thtija occidentalis, the 
 Arbor Vitae, a coniferous tree. See under Thuja. 
 
 Oleum Pini Sylvestris, Oil of Scotch Fir (B. P.), — a colorless liquid, obtained by 
 distilling the fresh leaves of Pinus sylvestris, used externally and by inhalation. [See 
 page 431.] 
 
terebinthina. 505 
 
 Physiological Action. 
 
 Turpentines are stimulant, diuretic, anthelmintic, and hemostatic; in 
 large doses laxative and irritant, and externally used are rubefacient and 
 antiseptic. Their virtues depend entirely on the volatile oil. 
 
 Oil of Turpentine in small doses causes a sense of heat at the epigas- 
 trium, burning in the mouth and salivation by reflex action. In mod- 
 erate doses it at first stimulates the vaso-motor nervous system, after- 
 wards paralyzing these centres, thus causing a rise and then a fall of the 
 arterial tension. It lowers the functions of the brain, spinal cord and 
 medulla in the order stated, causing diminution of voluntary movement 
 and reflex action, dilatation of the vessels, lowered blood-pressure and 
 slowed respiration, the latter often becoming spasmodic. The pulse is 
 sometimes slowed, sometimes quickened. Large doses produce gastro- 
 enteritis, with vomiting and diarrhea, suppression of urine, pain in the 
 lumbar regions, burning in the urethra, hematuria and strangury. The 
 muscular power is diminished, coordination impaired and a state of in- 
 toxication induced. In toxic dose it acts as a narcotic poison and causes 
 complete muscular relaxation, profound insensibility with abolished re- 
 flexes, dilated pupils, cyanosed face, labored and stertorous breathing 
 and death by paralysis of respiration. It is excreted by the various or- 
 gans of excretion, all of which are highly irritated, the kidneys suffer- 
 ing particularly. Its vapor inhaled produces nasal and renal irritation, 
 frontal headache, also frequently strangury and hematuria. Locally to 
 the skin it is rubefacient and even vesicant if applied for any length of 
 time or if evaporation be prevented. 
 
 The- Oil, when exposed to the air, readily absorbs oxygen in the form 
 of ozone, which it retains tenaciously. This ozonized oil of turpentine 
 is an antidote to phosphorus, preventing the formation of phosphoric 
 acid and converting the phosphorus into an insoluble substance resem- 
 bling spermaceti. Worn about the neck in an open vial it is believed to 
 prevent necrosis of the jaw and steatosis of the organs in workmen ex- 
 posed to phosphorus-fumes. It is supposed to dissolve gall-stones. 
 
 Antidotes and Antagonists. 
 
 In cases of poisoning the stomach should be emptied, anodynes and demulcents admin- 
 istered, elimination favored, and special symptoms met as they arise. 
 
 Therapeutics. 
 
 The Oil of Turpentine is employed externally as a rubefacient and 
 
 counter-irritant in many conditions producing pain and inflammation. 
 
 Cloths wrung out of hot water and then sprinkled with the oil (turpentine 
 
 stupes) are useful applications in sciatica and other neuralgia, lumbago, 
 
506 THEOBROMATIS OLEUM. 
 
 chronic rheumatism, chronic bronchitis, peritonitis with tympanites, 
 pleurisy, renal colic, etc. It is one of the most efficient agents in hospital 
 gangrene, applied in full strength to the part affected. The liniment is 
 in constant use for sprains, neuralgia and other slight local affections. 
 
 Internally it is best employed in ulceration and hemorrhage of the 
 intestines and in passive hemorrhages from other organs. Active bleed- 
 ing with a plethoric condition and hematuria are states in which it is 
 contraindicated. It is often used with ether (i to 3) in biliary and flatu- 
 lent colic as an anodyne and antispasmodic. As a vermifuge against 
 tape-worm it must be employed in large doses (sss-ij) with castor oil to 
 promote its rapid passage through the intestinal canal. The French acid 
 oil, which is old and contains ozone, is used in phosphorus poisoning. 
 It is well employed as a stimulant to the heart and vaso-motor system in 
 puerperal fever, yellow fever, traumatic erysipelas, pneumonia, capillary 
 bronchitis, etc. It is also useful in chronic bronchial catarrh, chronic 
 cystitis, subacute gonorrhea and similar affections of the mucous surfaces 
 generally. Inhalations of the vapor or atomized oil are beneficial in 
 chronic affections of the larynx and bronchi. The pure vapor is too irri- 
 tant for inhalation but it may be diluted with steam from an atomizer. 
 Chian Turpentine is one of the remedies which have been used for cancer. 
 
 Terebene has been extensively used by Murrell, with excellent results, 
 as a remedy for obstinate winter-cough and emphysema of the lungs, in 
 flatulence and flatulent dyspepsia, in cystitis and gleet, and as a spray in 
 phthisis and post-nasal catarrh, also with cocaine with solution as a spray 
 for coryza and hay-fever. Other observers, of several years' experience 
 with this remedy, praise it highly as an inhalant remedy in phthisis, 
 bronchiectasis, chronic bronchitis and other pulmonary affections char- 
 acterized by profuse, purulent expectoration. Rieu employs it exten- 
 sively in bronchitis and bronchorrhea, in doses internally of gr. xv-xxx 
 per diem, but says that it does not affect the muco-purulent expectora- 
 tion of phthisis. It probably has no superior efficacy to creosote, Venice 
 turpentine, etc., except that it is without much odor and has no taste. 
 
 Terpin Hydrate is praised very highly in chronic and recurrent bron- 
 chitis, night-cough from habit, catarrhs and kindred affections. In fact, 
 all acute and many chronic affections of the respiratory passages form the 
 proper field for the therapeutical action of this preparation. 
 
 THEOBROMATIS OLEUM, Oil of Theobroma, Cacao-butter,— -is a fixed 
 oil expressed from the seed of Theobroma Cacao, the Chocolate-tree, nat. ord. Stercu- 
 liacese, growing in Mexico, the West Indies and South America. The oil is a yellowish- 
 white solid, of faint odor, bland taste and neutral reaction. The seeds are oval, about 
 the size of almonds, and consist of shells and kernels, in both of which is found the 
 alkaloid Theobromine, C 7 H 8 N 4 2 , which closely resembles Caffeine, the latter being its 
 methyl derivative. Chocolate is prepared by roasting the seeds, removing the shells, then 
 crushing or grinding the kernels to a smooth paste, which is cast in molds. 
 
THUJA THYMI OLEUM. 507 
 
 Oil of Theobroma consists chiefly of Stearin with a little Olein. Its action is demul- 
 cent, and it does not become rancid on exposure to the air. Its chief use is as a basis 
 for making suppositories. A Cerate is prepared by melting together Cacao-butter 35, 
 White "Wax 35, Oil of Almond 30, adding a drop of Oil of Rose and coloring with a 
 minute quantity of Carmine previously triturated with a drop of Water of Ammonia. 
 This is known as Red Lip-salve. 
 
 Theobromine has the same action and uses as Caffeine. [See under Caffea, for this 
 principle and for Diuretin.] 
 
 THUJA, Arbor Vitse (Unofficial), — the fresh tops of Thuja occi- 
 dentalism a tree of the nat. ord. Coniferae, commonly though incorrectly 
 called White Cedar, growing in swampy ground in Canada and in the 
 northern U. S. They contain a volatile oil, tannin, wax, resin, etc.; also 
 Pinipicrin a bitter principle, and Thujin a yellow, astringent and crys- 
 tallizable coloring principle, which is separable into glucose and Thujetin. 
 
 The dose of a saturated, fresh tincture or fluid extract is 3 j, 3 to 6 times daily. The 
 Volatile Oil may be given in doses of TT\J-v. 
 
 Physiological Action and Therapeutics. 
 
 Thuja resembles Savine in action very closely. It is stimulant, irritant 
 and astringent, also aromatic, diuretic and emmenagogue. The oil is a 
 gastro-intestinal irritant and produces epileptiform convulsions in warm- 
 blooded animals but paralysis in cold-blooded ones. It causes rhythmi- 
 cal contraction and dilatation of the vessels, lowers the temperature and 
 is anthelmintic. Thuja is indirectly an abortifacient when given in doses 
 sufficient to cause violent gastro-enteritis. It is reported to have produced 
 an acute urethritis resembling gonorrhea. 
 
 Thuja in decoction has been usefully employed in coughs, rheumatic 
 and arthritic pains, dropsy and amenorrhea. It has been given with 
 benefit in intermittent fever and as an alterative blennorrhetic in chronic 
 catarrh and bronchorrhea. It is highly praised by Phillips for the cure 
 of warts with narrow base and pendulous body, a strong tincture being 
 applied locally and given internally at the same time in 5-minim doses 
 twice daily. Piffard speaks strongly in its favor as a valuable agent for 
 non-syphilitic warts (condylomata acuminata) of the penis and vulva, for 
 papillomatous growths in general and for gleet dependent on granular 
 urethritis. It has been used in chronic gonorrhea and prostatitis with 
 asserted success, and is said to have cured epithelioma. The oil has been 
 employed as a vermifuge. 
 
 THYMI OLEUM, Oil of Thyme,— is a volatile oil distilled from 
 Thymus vulgaris, the Garden Thyme, a common shrub of the nat. ord. 
 Labiatse, indigenous to France but cultivated in our gardens. This oil is 
 a pale yellow or colorless, thin liquid, having a strong odor of thyme, a 
 warm, pungent and afterwards cooling taste and a neutral reaction ; 
 
508 THYMI OLEUM. 
 
 readily soluble in alcohol. It consists of two portions, the more volatile 
 being a mixture of the hydrocarbons Cymene and Thymene, the less vola- 
 tile being chiefly Thymol, which is official. 
 
 Thymol, C 10 H u O, — is a phenol contained in Oil of Thyme and in 
 the volatile oils of several other plants. It occurs in large, colorless, 
 hexagonal crystals, of aromatic odor, pungent taste and neutral reaction ; 
 soluble in 1200 of water, in 900 of boiling water, in 1 of alcohol, freely 
 in fats and oils, solutions of chloral and alkalies, ether, chloroform, etc. 
 It liquefies when triturated with about equal quantities of camphor, 
 menthol or chloral. Dose, gr. ss-ij. 
 
 Unofficial Prepai'ations. 
 
 Thymol Solution, — for antiseptic spray, I part in 1000. 
 
 Thymol Ointments, — vary in strength from 5 to 30 grains to the ^ . 
 
 Thymol Inhalation, — Thymol gr. xx, Alcohol giij, Magnesium Carbonate gr. x, 
 Water to ^iij. A teaspoonful to a pint of water at 150 F. for each inhalation. 
 
 Volkmann's Antiseptic Fluid, — has of Thymol I, Alcohol 10, Glycerin 20 and 
 Water 100 parts. 
 
 Physiological Action and Therapeutics. 
 
 Oil of Thyme has the same properties as the oils of other mints, and 
 containing a large quantity of Thymol it is similar to the latter in action. 
 
 Thymol in its action stands between carbolic acid and oil of turpen- 
 tine. Like the former it is a powerful antiseptic and disinfectant, also 
 a local irritant and anesthetic to the skin and mucous membranes, para- 
 lyzing the end-organs of the sensory nerves. When absorbed it paralyzes 
 the nerve-centres in the spinal cord and in the medulla, lessening reflex 
 action, slowing respiration, lowering the temperature and the arterial 
 tension, and in poisonous doses causing weakness, coma and death. 
 Internally administered in doses of 20 to 30 grains per diem it produces a 
 sensation of epigastric heat, sweating, singing in the ears, deafness, a sense 
 of constriction in the forehead and increase of the urinary discharge, 
 which assumes a dark greenish hue. It is eliminated by the respiratory 
 and urinary organs, which it irritates considerably during the process of 
 its excretion. As an antiseptic it is much more powerful and permanent 
 than carbolic acid, and much less poisonous. 
 
 Thymol is chiefly employed in lieu of carbolic acid as an antiseptic 
 for dressing wounds ; as a gargle, spray or inhalation in laryngitis and 
 diphtheria ; as an ointment in ringworm, eczema and psoriasis, and as an 
 injection in ozena. A solution of 1 part in 1000 is the strength usually 
 employed. Internally it has been used with success in diphtheria, typhoid 
 fever and other intestinal affections, diabetes, phthisis and vesical catarrh. 
 Its fragrant odor renders it a very agreeable antiseptic application for 
 ulcerated conditions of the mouth and fauces, but makes it very attractive 
 
TIGLII OLEUM. 5O9 
 
 to flies, which fact together with its high price will prevent it becoming 
 a favorite in hospital practice. A solution, used as a mouth-wash, is very 
 efficient in removing the odor of tobacco from the breath. Thymol is 
 almost specific against the intestinal parasite ankylostomum duodenale, for 
 which it is given in three or four doses of 10 to 30 grains, well triturated, 
 in capsules ; care being taken that no alcoholic drink is ingested after- 
 wards, in order to avoid its absorption and the consequent poisoning 
 thereby. 
 
 TIGLII OLEUM, Croton Oil,— is a fixed oil expressed from the 
 seed of Croton Tiglium, a small tree of the nat. ord. Euphorbiaceae, a 
 native of India. The oil is of a pale or brownish-yellow color, somewhat 
 viscid and slightly fluorescent, of fatty odor, acrid taste and slightly acid 
 reaction ; soluble in 60 of alcohol, freely in ether, chloroform, or carbon 
 disulphide. Its composition is very complex and has not been thor- 
 oughly made out, but it is known to contain the glycerides of several fatty 
 acids, also a peculiar acid named Tiglinic Acid, C 5 H s 2 , which is iso- 
 meric with Angelic Acid. Dose, nt^-ij, in P^> emulsion or tincture. 
 
 Physiological Action and Therapeutics. 
 
 Externally Croton Oil is highly irritant, producing a pustular eruption 
 which heals by scabbing and may leave unsightly cicatrices. Internally 
 it is a powerful drastic cathartic, producing in one or two hours copious 
 watery stools, in overdoses causing great congestion of the intestinal canal 
 and perhaps death from gastro-enteritis. Vomiting usually occurs after 
 large doses, so that the irritant hyper-catharsis is not always observed. It 
 is absorbed into the blood, and produces glandular hyperemia as well as 
 direct inflammation of the intestinal mucous membrane, together with in- 
 creased peristaltic action. Its cathartic power is increased by the addi- 
 tion of an alkali, and is manifested, though in less degree, when applied 
 to the integument. 
 
 Croton Oil is used as a hydragogue cathartic when a speedy and com- 
 plete evacuation of the bowels, diminution of arterial pressure and prompt 
 derivative action are desired, as in apoplexy, impaction of the intestines, 
 dropsy, lead constipation, paralysis, etc. It is contraindicated when 
 either debility, organic obstruction or inflammatory conditions of the 
 stomach and bowels exist. The smallness of the dose makes it a very easily 
 administered and manageable purgative. An inconsiderable fraction of 
 a drop, absorbed by a pellet of sugar or bread, may be given in repeated 
 doses until the desired effect is obtained. It has been used as a vermi- 
 fuge against tapeworm. Externally it is employed as a counter-irritant 
 in ovaritis, bronchitis, pleurisy, rheumatism, neuralgia, glandular swell- 
 ings and in laryngeal and pulmonary diseases. The Linimentum Crotonis 
 
510 TONGA — TOXINS. 
 
 of the Br. Phar. contains i part of the oil in $% each of alcohol and oil 
 of cajuput, and is a useful pustulant preparation, being more manageable 
 then the oil itself. 
 
 TONGA (Unofficial), — is a mixed drug said to be obtained from the Fiji Islands, 
 consisting of thin barks, root-fibres and leaves, tied into long bundles. The fibrous 
 material is believed to be derived from Rhaphidophora vitiensis, a creeping plant of the 
 nat. ord. Araceae, containing starch, potassium chloride, and a volatile alkaloid Tongine. 
 The barky portion is referred to Premna tatiensis, a shrub or tree of the nat. order Ver- 
 benacese, and contains a little volatile oil, sugar, pectin, etc. A fluid extract is on the 
 market, which may be given in doses of TTLxxx-gj thrice daily. 
 
 Tonga was introduced by Ringer and Murrell as a remedy for neuralgia in 1880, stat- 
 ing that they had used it with gratifying results. Since then reports have differed con- 
 siderably in regard to its efficacy, and from the fact that Dr. Ringer does not mention it 
 in the later editions of his Handbook of Therapeutics, it may be inferred that his further 
 experience with it has not borne out the claims first made. 
 
 TOXINS (Unofficial). — The toxins are specific poisons produced 
 by bacterial metabolism in suitable media, and when circulating in the 
 animal organism are the immediate causes of the acute infectious diseases. 
 Many of their active principles are of albuminous nature, the so-called 
 Toxalbumins. Toxins have been obtained from ripe cultures of the bac- 
 teria of tetanus, diphtheria, tuberculosis, cholera, typhoid fever, anthrax, 
 pneumonia, glanders and swine-plague, also from cultures of streptococ- 
 cus erysipelatis, bacillus prodigiosus, etc. The treatment of diseases due 
 to pathogenic microbes by the toxic products of their own particular 
 bacteria is based upon the theory that these germs produce substances in 
 their culture media which are inimical to their own life. The treatment 
 of tuberculosis by Koch's tuberculin and the inoculations of HafTkine 
 against cholera are examples of true toxin treatment. The vaccinations 
 of Jenner for variola and Pasteur for rabies are of the same nature when 
 employed as remedial methods, the material being obtained from a mor- 
 bid product of the disease in the one case and from the diseased tissue 
 itself in the other, the culture medium in both being the blood and tissues 
 of the infected animal organism. 
 
 It has been frequently observed that patients afflicted with malignant 
 disease have been greatly benefited by an intercurrent attack of erysipelas, 
 in consequence of which the tumors seemed to undergo retrogressive 
 changes. This has suggested the employment of the toxins of streptococ- 
 cus erysipelatis and bacillus prodigiosus in inoperable cancer, and may 
 lead to the treatment of other diseases by the toxins of bacteria hitherto 
 unassociated with them. 
 
 The injection of a toxin, in gradually increasing doses at proper inter- 
 vals, will confer immunity in many cases upon the animal so treated 
 against the corresponding disease and its particular bacteria. This im- 
 munity may be transferred to another animal by injecting into its cellular 
 tissue the blood-serum of the immunized one, and this serum will also 
 
TOXINS. 511 
 
 act remedially on a subject of the disease if administered early in its 
 course (Behring). The immunizing and curative action of the serum is 
 believed to be due to the existence of an antitoxin in the blood of the 
 inoculated animal, elaborated by the living cells of its tissues as a defence 
 against the action of the toxin. These facts and hypothesis form the 
 basis of the treatment of certain diseases by antitoxic serum (described 
 under the title Antitoxins, ante, page 174 et seq.), which now promises 
 better results than any other system of bacterio-therapy. 
 
 The toxin produced by any particular bacteria varies greatly in power 
 through very slight circumstances. It may be weakened or increased in 
 virulence be the cultivation of its bacteria on different culture media or 
 on the same media with different surroundings as to oxygen, temperature, 
 etc.; also by passing successive generations of these organisms through a 
 definite series of animals, chosen for their natural insusceptibility or sus- 
 ceptibility thereto. The pathogenic microbes of several diseases are now 
 cultivated in test-tubes, forced to acquire an increased or lessened degree 
 of virulence or toxin-producing power as required, are separated from the 
 poisonous products of their metabolic life-work, and by the inoculation 
 of either their progeny or their chemical products (toxins) the cor- 
 responding diseases are reproduced upon healthy animals in almost any 
 desired degree of intensity. 
 
 Repeated efforts have been made in some cases to separate from these 
 bacterial products a germicidal ingredient without its toxic associates, 
 which might prove curative for the corresponding disease. The Tuber- 
 culocidin and Antiphthisin of Klebs are claimed to be such substances, and 
 are described in the following pages. 
 
 Tuberculin, or Koch' s Lymph, announced as a secret and specific 
 remedy for tuberculosis by Professor R. Koch, of Berlin, ten years ago, 
 was subsequently stated by him to be an extract of the products of pure 
 cultures of the tubercle bacillus, made with glycerin and water. In Koch' s 
 preliminary statement to the Berlin meeting of the International Medical 
 Congress in 1890, the chief point made was that guinea-pigs could be 
 rendered immune to inoculated tuberculosis by means of this agent, but 
 even this has been denied by other observers. In his extended paper 
 published in November, 1890, he stated that the remedy would not di- 
 rectly kill the bacilli, but that it acted powerfully and specifically upon 
 the living tuberculous tissue, caused a necrotic condition thereof and 
 hastened its disintegration ; also that it might be expected to increase 
 the resistant power of healthy tissue and thereby starve the bacilli, check 
 their increase, and lead in many cases to the cure of the disease. The 
 actual result, however, as Virchow and others soon pointed out, was to 
 soften and disintegrate quiescent deposits and to disseminate the bacilli 
 throughout the body, forming new foci of active infection in other situa- 
 
512 TOXINS. 
 
 tions. The severe reactions, which followed the injections of the lymph 
 in many instances, proved that serious risk must attend its general use; 
 and that, like most remedies for phthisis, it could do good only in a few 
 carefully selected cases. A sense of profound disappointment followed 
 the enthusiasm at first excited, with the result that the remedial action of 
 tuberculin became thoroughly discredited and its use was almost universally 
 abandoned. It has lately become of interest again by reason of the per- 
 sistent efforts to extract from it a germicidal constituent free from toxins 
 (see infra), as also by the results obtained in tuberculosis with the blood 
 serum of animals immunized by its repeated inoculation. (See the article 
 on Tuberculosis Antitoxin, ante, page 180.) 
 
 The violent action of tuberculin, together with its source, prove it to 
 be a true bacterial toxin. Taken by the mouth it is inert, being probably 
 digested in the stomach. In small dose (one milligramme of the original 
 lymph) injected hypodermically upon healthy subjects, it gives rise to 
 slight pains in the limbs and a transient sense of fatigue ; but the same 
 quantity injected upon tuberculous subjects produces a very powerful re- 
 action both locally and generally, the constitutional effects being similar 
 to those accompanying an acute exacerbation of the disease. About three 
 hours after the injection a decided rigor occurs, which is followed by a 
 rapid rise of temperature and pulse-rate ; also pains in the limbs, a sense 
 of great fatigue, drowsiness, nausea and loss of appetite, these effects 
 lasting from 12 to 15 hours. In cases of advanced phthisis with cavities, 
 after the injection of tuberculin the temperature has risen to 105. 8° F., 
 which falling suddenly collapse has occurred and the patients have died. 
 If the case presents a local tuberculous lesion, this swells and becomes 
 tender to the touch and the skin over it is inflamed. In pulmonary cases 
 the reaction is greater than from the same dose in those having surgical 
 tuberculous lesions; the cough increases, there is great distress and 
 dyspnea, the patient feels decidedly worse and occasionally suffers a slight 
 collapse. When the reaction has subsided the patient feels comparatively 
 well and generally better than before. In cases of lupus the effects of the 
 injection are very marked. Within three hours there arises a feeling of 
 tightness with heat and burning over the face and nose, and an eczematous 
 exudation sets in, which continues about 48 hours and dries into crusts 
 on the surface of the lesion. After two days these symptoms begin to 
 subside, and after nine days the crusts have fallen off and the affected 
 tissue appears shrunken, red and shiny, like the surface of a lupus patch 
 which has been scraped with a Volkmann's spoon. 
 
 The principal lessons taught by the history of Koch's tuberculin are 
 pathological rather than therapeutical, and cannot be set forth here. 
 An important one is that any treatment in tuberculosis which promotes 
 destructive changes instead of conservative ones, shown in this case by 
 
TOXINS. 513 
 
 the breaking down of the lung tissue and its appearance on a large scale 
 in the sputum, cannot be other than detrimental to the patient, as the 
 area of infection, instead of being limited as it was, is thereby considerably 
 widened. As a diagnostic agent it is certainly of value in showing the 
 presence or absence of latent tuberculosis, but for this purpose it should 
 only be used in veterinary practice, for the ordinary means of diagnosis 
 are already so reliable that so dangerous a procedure is not justifiable 
 on human subjects. 
 
 Professor Koch has acknowledged that tuberculin is only serviceable in 
 the initial stage of phthisis and in cases of simple infection, also that 
 when the case is complicated by the presence of other microbes it is of 
 no service and often does harm. Professor Ewald has stated that so far 
 as clinical and experimental testimony had gone it possesses no specific 
 curative action, and that its use must finally be abandoned on account 
 of the dangers attending its administration. The physicians of the 
 Hospital for Consumption and Diseases of the Chest at Brompton, Eng- 
 land, reported on its systematic employment in 30 cases of pulmonary 
 tuberculosis and lupus, with the following conclusions : " That the tuber- 
 culin did not favorably influence the course of the disease in the majority 
 of cases; that in some the effects were detrimental; and that even in the 
 stationary and improved cases it was difficult to ascribe any distinct im- 
 provement to the injections which might not have been equally attained 
 under the treatment ordinarily employed in the hospital." 
 
 Koch's Tuberculin was distributed in the form of a brown solution, which by evapora- 
 tion and filtration had been concentrated to one-tenth the volume of the ripe culture fluid. 
 One part of this original lymph, added to nine parts of distilled water containing y z to I 
 per cent, of carbolic acid, made tbe so-called " mother solution," in which form, though 
 too powerful for use, it will keep a long time, being still further diluted as required. One 
 part of this 10 per cent, solution added to nine parts of distilled water makes the dilute 
 1 per cent, solution used for injection. If, as Koch estimated, the original lymph con- 
 tains but one per cent, of the dry, active substance, its proportion in the injection solution 
 would be only one in ten thousand. The dose of the latter solution ranged from o. 1 cc. 
 to I.o cc. , corresponding to 0.001 cc. and 0.01 cc. of the original lymph ; and was admin- 
 istered by a sterilized hypodermic syringe of special form, under strict aseptic precautions, 
 beneath the skin of the back between the scapuloe. In early lung cases a period of about 
 four to six weeks completes the course of treatment. Koch's syringe contains 1.0 cc. 
 and is graduated in tenths, each division representing one minimum dose (o. 1 cc. ) of the 
 I per cent, solution. When large doses are reached the stronger 10 per cent, solution 
 may be used in appropriate quantity. For cases of lupus much heavier doses were 
 employed at first, even ten times the quantities mentioned above, but necessarily at much 
 longer intervals. These large doses, however, give rise to most formidable and danger- 
 ous symptoms, and caused fatal results in some cases. Dr. Whitla believes that better 
 results would have been obtained by the use of much smaller doses. 
 
 Tuberculin-R. Professor Koch has produced three new tuberculins, named Tuber- 
 culin-A, Tuberculin-O and Tuberculin-R. The last-named is the only one of thera- 
 peutic value, and is prepared by extraction of pure cultures of tubercle bacillus with 40 
 to 50 per cent, glycerin and repeated precipitation by alcohol. The result is a snow-white 
 mass which turns a light gray color upon drying. It is soluble in water, but the aqueous 
 solution is unstable ; a solution in 50 per cent, glycerin remains unchanged. It is 
 administered subcutaneously in the muscles of the back between the shoulder-blades. 
 
 33 
 
5 H TOXINS. 
 
 After injection the point is covered with iodoform collodion and bandaged with iodoform 
 gauze. This preparation proved decidedly active in immunizing against the tubercle 
 bacilli. Decided benefit was obtained from it in every case of lupus treated, also in the 
 early stage of pulmonary tuberculosis. Maragliano states that there is no real difference 
 between the new tuberculin and the old one, and that the latter is the best of the two. 
 Experience with it in Erb's and von Leyden's clinics did not show any striking results, 
 Kernig warns against its use, and Bouchard terms it "an impure, bacteria-infected 
 product, entirely unsuited to scientific investigations." Dose, gr. 2io"6T > ¥ to l m S- 
 
 Tuberculocidin. After Koch's tuberculin became discredited, its 
 composition became the subject of analytical research with the view of 
 separating out its toxic constituents and obtaining a remedial agent from 
 it. These investigations were made principally by W. Hunter, Watson 
 Cheyne and E. Klebs of Zurich. The latter treated the crude tuberculin 
 with platinum chloride, which precipitates the alkaloidal constituents or 
 toxins, leaving a solution which he named Tuberculocidin, on account of 
 its supposed antagonism to the tubercle bacillus. With this solution he 
 treated 75 cases of phthisis, and reported 14 as cured, 45 improved, 14 
 unimproved, and 2 died. During experiments on animals with it he 
 claims to have observed the complete regression of an apparently advanced 
 tuberculosis. Langermann used it in four cases of pulmonary tuberculosis 
 with varied results. He admits that it does not cause either serious con- 
 stitutional effects as tuberculin does or irritation at the site of injection, 
 but as to its curative action he has great doubt. Klebs has apparently 
 abandoned this agent in favor of Antiphthisin, his more recent but 
 similar product. 
 
 Antiphthisin is the latest result of Klebs' long-continued efforts to 
 extract a non-toxic and curative substance from tuberculin, which, accord- 
 ing to his most recent analysis, contains (1) tox-albumins, precipitated by 
 sodic iodide of bismuth, (2) alkaloids, (3) an albuminoid derived from 
 the bodies of the dead bacilli, (4) a soz-albumin, precipitated by absolute 
 alcohol after the removal of the toxic ingredients. It is claimed by 
 Klebs that an aqueous solution of this soz-albumin, prepared by him and 
 named Antiphthisin, possesses the germicidal and curative properties of 
 tuberculin without any of its toxic effects. With this product he claims 
 to have caused the complete cure of tuberculosis in guinea-pigs, and to 
 have obtained 90 per cent, of good results (whatever that may mean) 
 for all stages of phthisis in the human subject. He states however that 
 it will produce its fullest benefits in the very early stages of the disease, 
 for which stages alone it is recommended as a specific remedy ; and that 
 in advanced and complicated cases the prospects for its successful use are 
 less certain. In asking physicians to give it a trial he requests that they 
 will not try the remedy except in cases of pure tuberculosis, excluding 
 for the present cases of mixed infection, septic cases, and all such as have 
 amyloid degeneration or are so far reduced that they must die of the 
 complications or exhaustion present. These requirements may be good 
 
TOXINS. 515 
 
 for the reputation of the remedy, but are most difficult to observe in 
 practice, as they confine it to a class of cases which seldom come to the 
 physician in that stage and which are not easily diagnosed with accuracy 
 when seen. Von Ruck, who is associated with Klebs, reports as his 
 experience of nearly 100 cases of phthisis treated with this remedy, that 
 it has an unmistakable influence over the fever, that under its use percus- 
 sion dulness becomes perceptibly less, bronchial and harsh breathing give 
 place to puerile and then vesicular respiration, the lung-capacity increases, 
 the cough diminishes, the sputum loses its purulent character and lessens 
 in quantity, while the bacilli therein diminish in number and show 
 marked signs of degeneration. Denison, of Denver, reports that most 
 of the cases treated by him with antiphthisin gave evidence of its germi- 
 cidal and healing effects, " in the lessening of the number of germs to 
 the field found, and their degenerative or incomplete forms thrown off 
 when good sized doses were reached, as well as in the clearing up of con- 
 solidated or infiltrated tubercular lung tissue." 
 
 Antiphthisin is prepared by Professor Klebs, who explains the process of manufacture 
 as follows : "We take the ripe culture of the tubercle bacillus and reduce it to one-tenth 
 of the original amount by evaporation in a vacuum and filter. This really is the tuber- 
 culin as prepared by Professor Koch. To the filtrate we now apply an acid solution 
 of sodic iodide of bismuth and obtain a precipitate which is filtered out. This precipi- 
 tate represents the toxic properties of tuberculin, as proved both in the animal experiment 
 and in its application to the human being for diagnostic purposes. . . . After the 
 tox-albumins are filtered out, we precipitate further by the addition of absolute alcohol 
 an organic substance resembling in its chemic reaction a peptone, and this organic sub- 
 stance redissolved in distilled water is antiphthisin. In the animal experiment we find 
 that this alcoholic precipitate does not produce fever or toxic symptoms of any kind. 
 Antiphthisin cannot be given by the mouth, being an albuminoid substance it would be 
 digested in the stomach. The remedy has no diagnostic properties, there is no reaction 
 to its use. I think my remarks will make it plain, that the diagnostic value lies in the 
 toxins, and the curative substance separated from the toxins is antiphthisin." (From 
 Klebs' remarks in German, before the Section on Diseases of Children at the Baltimore 
 meeting of the American Medical Association, May, 1895, translated by Von Ruck.) 
 
 The daily dose for an adult is o. 1 cc. at first, increased daily or every other day until 
 0.5 cc. is reached. This dose may be repeated daily for a week, and is then gradually 
 increased to 1.0 cc, which latter dose is again continued for a time, before being again 
 increased. It is seldom necessary to go beyond 2.0 cc, though a dose of 10 cc. has been 
 given. The administration may be intermitted for a time after 50.0 cc have been used. 
 If, under a certain dose, the improvement is rapid and satisfactory, there is no reason 
 to increase the quantity given ; and physical examination should constantly accompany 
 and control the future course. The remedy may be administered hypodermically under 
 aseptic precautions, or by rectal injection. It is put up in vials containing 15, 30, and 
 50 cc, and is sold at the rate of fifty cents per cubic centimeter. 
 
 Erysipelas and Prodigiosus Toxins. Malignant tumors have 
 occasionally been observed to disappear after the patient had suffered from 
 an intercurrent attack of erysipelas. When the discovery was made that 
 artificial erysipelas could be produced by the inoculation of pure cultures 
 of the streptococcus erysipelatis, this inoculation was practised upon sub- 
 jects of cancer as a remedial measure. The results,- though favorable, 
 were not so complete as in the cases acted upon by accidental erysipelas, 
 
5 16 TOXINS. 
 
 and the inoculated disease often proved fatal to the patient. Coley then 
 employed the toxin of the streptococcus instead of the culture itself, 
 and reported a number of apparent cures of malignant disease thereby. 
 Later it was found by Roger that the bacillus prodigiosus has the power 
 of intensifying the virulence of the streptococcus erysipelatis, and by 
 using a mixture of the toxins of both these germs, Coley obtained a 
 more beneficial effect than from the erysipelas toxin alone. The remedial 
 action is much more efficient in sarcoma than in carcinoma, though some 
 cases of the latter disease are reported as apparently cured by this treat- 
 ment. Including all the cases of sarcoma in which these mixed toxins 
 have been employed by Coley, there are 43 such reported of which n 
 were apparently cured. Professor Senn of Chicago has found negative 
 results in his own experience of this treatment, and states that in all 
 his cases these injections failed to effect even temporary improvement. 
 Coley prepares these toxins in the usual manner, and avoids the danger 
 of inoculating erysipelas itself by subjecting the cultures to a temperature 
 (136. 4 F.) sufficient to destroy, the germs. The commencing dose is 1 
 or 2 minims, injected once daily into the tumor or subcutaneously in its 
 vicinity and gradually increased. This method should be employed only 
 in cases which are manifestly unfit for operative interference. 
 
 Richet and Hericourt injected a serum obtained from animals inoculated with the fil- 
 tered emulsion of an osteo-sarcoma into a recurrent sarcoma of the chest-wall and also 
 into a supposed carcinoma of the stomach. The tumors were thereby reduced in size 
 and general improvement followed, but in neither case was there any microscopical 
 examination made, hence the diagnoses are uncertain. 
 
 Emmerich and Scholl claim that excellent results were obtained by them in the treat- 
 ment of both sarcoma and carcinoma by injecting into the growth an antitoxic serum 
 obtained from sheep inoculated with the toxins of virulent erysipelas streptococci. Other 
 experimenters, including Bruns and Angerer, do not confirm their statements in this 
 respect ; and as their observations were limited to a few weeks, it is impossible to regard 
 their cases as presenting evidence of cure. 
 
 Cholera Toxin. An extended series of inoculations against cholera 
 was carried out in India by Dr. Haffkine, whose procedure comprises 
 the preparatory use of a weak virus followed by a second inoculation with 
 a stronger one. He obtained the weak virus by passing air and oxygen 
 over a culture of the comma bacillus on agar at a high temperature, which 
 so modified the microbes that when injected they produced only slight 
 local puffiness, followed by a mild reaction. The second inoculation 
 was made five days after the first, and with a virus of such intensity that 
 it killed a guinea-pig in eight hours. The virus, used on the human 
 subject subsequent to the preparatory inoculation, caused only slight 
 local and constitutional disturbance, thereby proving that the first inocu- 
 lation had conferred a certain degree of immunity against its effects. 
 The symptoms subside in another five days, and not until then can it be 
 said that the operation of preventive inoculation against cholera is com- 
 
TOXINS. 517 
 
 plete. Dr. Haffkine made 42,445 such inoculations, without a single 
 instance of mishap or injury to health resulting therefrom. The results 
 obtained were highly favorable, the statistics demonstrating for this pro- 
 cedure a remarkably protective power against cholera in a country where 
 that disease is endemic. The figures are furnished, not by Dr. Haffkine, 
 but by responsible British medical officers assigned to the duty of 'veri- 
 fying the result in each case. 
 
 Rabies Toxin. Although no microbe has yet been found associated 
 with rabies, there is abundant evidence to prove that the specific virus of 
 this disease is a micro-organism, inasmuch as it behaves exactly like one. 
 Pasteur found that the virus is most abundant in the spinal cord of the 
 rabid animal and showed that its inoculation upon a healthy animal will 
 produce the characteristic symptoms of the disease, also that the virus 
 may be attenuated in virulence by drying the spinal cord containing it. 
 He also found that by inoculating on each successive day the virus from 
 a cord dried during a shorter period than that used on the previous day, 
 the animal so treated may be gradually made almost certainly secure 
 against rabies, either from the bite of a rabid animal or from any method 
 of subcutaneous inoculation. Upon these facts he founded his preven- 
 tive treatment of this disease commenced by him in Paris in 1885, which 
 consists in the daily inoculation of the bitten person with emulsions of 
 gradually increasing virulence, made from the dried spinal cords of rab- 
 bits that have died from inoculated rabies. By this procedure chemical 
 substances (toxins), produced during the life of some specific organism 
 and known to be inhibitory of its growth, are introduced into the system 
 of the patient (V. Horsley). 
 
 During the eight years from 1886 to 1893 inclusive there were treated 
 by this method at the Pasteur Institute in Paris 14,430 bitten persons 
 from many countries with 72 deaths resulting, a mortality rate of y 2 of 
 1 percent, for the entire number; tHe mortality for each year having 
 steadily decreased from 0.94 per cent, in 1886 to 0.25 per cent, in 1891, 
 0.22 percent, in 1892, and 0.24 per cent, in 1893. During the four 
 years from 1892 to 1895 inclusive, there were treated at the Pasteur 
 Institute in New York 424 bitten persons from all parts of the United 
 States and Canada, among whom only 2 deaths occurred. 
 
 The patient bitten by an animal supposed to be rabid should be sent 
 at once for treatment to one of the Pasteur Institutes, and should be 
 accompanied if possible by a piece of the medulla oblongata of the 
 biter animal, in order to determine by experimental methods whether 
 the animal was rabid or not. The specimen should be removed with an 
 aseptic knife and placed in a mixture of equal parts of pure glycerin 
 and water, previously sterilized by boiling. The period of treatment is 
 usually 15 days, during which from 2 to 6 inoculations are administered 
 
5 l8 TRAGACANTHA. 
 
 daily with viruses of gradually increasing intensity ; the number depend- 
 ing on the time which has elapsed between the infliction of the bite and 
 the commencement of the treatment. 
 
 The Hydrophobia Committee, appointed by the British Parliament in 1887 to investi- 
 gate Pasteur's treatment of rabies, consisted of Sir James Paget, chairman, Sir Joseph 
 Lister, Dr. Lauder Brunton, Sir Richard Quain, Dr. Geo. Fleming, Sir Henry Roscoe 
 and Dr. Burdon Sanderson, with Professor Victor Horsley as secretary. Their report 
 to parliament, made after an extended investigation in Paris and much experimental 
 research, states as follows : "It may hence be deemed certain that M. Pasteur has dis- 
 covered a method of protection from rabies comparable with that which vaccination 
 affords against infection from small-pox. It would be difficult to overestimate the impor- 
 tance of the discovery, whether for its practical utility or for its application in general 
 pathology. . . . From the evidence of all these facts we think it certain that the 
 inoculations practiced by M. Pasteur on persons bitten by rabid animals have prevented 
 the occurrence of hydrophobia in the large proportion of those who, if they had not been 
 so inoculated, would have died of that disease." Professor Victor Horsley, the secretary 
 of the committee, said three years afterwards in Fowler' 's Dictionary of Medicine, that 
 "its adoption has reduced the mortality among those bitten by indubitably rabid dogs 
 from 15 per cent, to 1.3 per cent." 
 
 Tizzoni and Cantani have published reports of experiments on the cure of rabies after 
 its actual outbreak. They found that an alcoholic precipitate from the serum of highly 
 immunized animals not only caused protection against rabies but also cured it, even after 
 the first symptoms of the disease had made their appearance. It has also been announced 
 that at Bologna a cure of rabies in the advanced stage was effected by a special mode of 
 the Pasteur treatment. A man bitten by a rabid dog, who had subjected himself to the 
 inoculations, was seized with the phenomena of paralytic rabies. Paralysis having pro- 
 gressed from the lumbar region over the whole organism, bladder and rectum included, 
 intravenous injections of the fixed virus were administered, whereupon the painful symp- 
 toms diminished and finally a perfect cure was accomplished. 
 
 Mallein is an extract in glycerin of the products of cultures of the 
 bacillus mallei, the microbe associated with glanders. This toxin, when 
 injected into animals affected with glanders, produces a strongly marked 
 febrile reaction, similar to that caused by tuberculin in tuberculous sub- 
 jects. It is extensively employed in veterinary practice for the purpose 
 of testing horses suspected of being infected with the disease. However, 
 a case occurred in London in which ten horses in one stable showed the 
 typical reaction after the use of mallein, but subsequently developed none 
 of the symptoms of glanders. 
 
 TRAGACANTHA, Tragacanth, — is a gummy exudation from Astragalus gum- 
 mifer and from other species of Astragalus, shrubs of the nat. ord. Leguminosae, growing 
 chiefly in Asia Minor and Persia. It occurs in shell-like, curved or contorted bands, 
 swelling with water to a gelatinous mass, which is tinged blue by test-solution of iodine, 
 and consists of a mixture of Arabiu, or gum-arabic, which is soluble in water, and 
 Bassorin, a gum which is insoluble in water but swells up in it, also a little starch. 
 
 Mucilago Tragacanthae, Mucilage of Tragacanth, — Tragacanth 6, Glycerin 18, 
 Water to 100. Dose, !|j or more. 
 
 Tragacanth is demulcent, but in large quantities may cause indigestion. It is chiefly 
 employed to suspend resins and heavy powders in emulsion. The mucilage may be used 
 as a vehicle for active agents in gargles for pharyngitis, and to cause cohesion in the prepa- 
 ration of pills, troches, etc. It is a constituent of 12 of the 15 official troches, and is a 
 better agent than acacia for making emulsions of cod-liver oil. 
 
TRITICUM ULMUS — UVA UKSI. 5 19 
 
 TRITICUM, Couch-grass, — is the rhizome, gathered in the spring and deprived 
 of its roots, of Agropyn'um repens, the Couch-grass, a perennial plant of the nat. ord. 
 Graminece, abounding in meadows and cultivated grounds, where it ranks as a weed 
 though of the same genus as wheat. It contains much sugar and a gum-like principle, 
 Triticin. Dose, 3J-,^ j, in infusion or decoction. 
 
 Extractum Tritici Fluidum, Fluid Extract of Triticum. — Dose, 3J-5J, well 
 diluted. 
 
 Couch-grass is demulcent, emollient and a feeble diuretic. It is chiefly used in cystitis 
 and irritable bladder. The infusion is a popular fever-drink in Europe, and has had of 
 old a considerable reputation in dysuria. 
 
 ULMUS, Elm, Slippery Elm, — is the inner bark of Ulmus fulva, an indigenous 
 tree of the nat. ord. Urticaceae. It contains a large quantity of mucilage which it readily 
 parts with to water. 
 
 Mucilago Ulmi, Mucilage of Elm, — Elm 6, Water to 100, digested for an hour and 
 strained. Dose, ad libitum. Should be freshly made when wanted. 
 
 Slippery-elm Bark is demulcent, slightly astringent and somewhat tonic. It is used 
 internally in diarrhea, dysentery and affections of the urinary passages, and externally in 
 the form of poultice as an emollient application in cases of inflammation. It is also 
 employed in the dilatation of fistulse, strictures and the os uteri. 
 
 UVA URSI, Bearberry, — the leaves of Arctostaphylos Uva-ursi, 
 a low, evergreen shrub of the nat. ord. Ericaceae, inhabiting the northern 
 latitudes and high mountains of Europe, Asia and America. They con- 
 tain tannic and gallic acids and 3 principles, viz., Arbutin, a bitter glu- 
 coside, neutral, crystalline, soluble in warm water and resolvable into 
 glucose and Hydroquinone ; Ericolin, bitter and amorphous; Ursone, 
 resinous, neutral, crystalline and tasteless. The Californian Manzanita 
 {Arctostaphylos glauca) is an allied plant and also contains arbutin and 
 tannin. Dose of the powdered leaves, gr. x-^j in infusion or decoction. 
 
 Preparations . 
 Extractum Uvae Ursi, Extract of Uva Ursi. — Dose, gr. ij-x. 
 Extractum Uvae Ursi Fluidum, Fluid Extract of Uva Ursi. — Dose, TT\x-3J. 
 Infusum Uvas Ursi, Infusion of Uva Ursi (Unofficial), — 3J to Oj. Dose, ^j-ij. 
 Arbutinum, Arbutin, C 24 H 32 O u (Unofficial). — Dose, gr. iij-v. 
 
 Uva Ursi is astringent, tonic and feebly diuretic. Used in large quan- 
 tity it produces vomiting and purging and is alleged to have oxytocic 
 power. Arbutin is an efficient diuretic, and is decomposed in the body 
 yielding hydroquinone, excreted by the kidneys as hydroquinone-sul- 
 phuric acid, which is non-toxic and imparts a brown color with antiseptic 
 and slightly irritant qualities to the urine. 
 
 Bearberry was formerly used in all calculous affections and chronic dis- 
 orders of the urinary passages. It has some reputation as an antilithic, 
 and is useful in gravel, chronic nephritis, cystitis and urethritis. It 
 relieves incontinence of urine, dysuria and strangury, and has proved 
 serviceable even in uterine hemorrhages. Arbutin has been successfully 
 employed in cardiac dropsy as a diuretic, also in urethritis. 
 
520 VALERIANA. 
 
 VALERIANA, Valerian, — is the rhizome and roots of Valeriana 
 officinalis, a large, herbaceous plant of the nat. ord. Valerianeas, having 
 small, white, or rose-colored flowers. The plant is a native of Europe, 
 but is cultivated in Vermont and New York. It contains a Volatile Oil, 
 from which are developed by oxidation Valerene, C 10 H 16 a terpene, 
 Valerol or Baldrian Camphor, C 12 H 20 O, and Valerianic Acid, C 5 H 10 O 2 , 
 which occurs also in many other plants and in cod-liver oil. The Vale- 
 rianic Acid of pharmacy is obtained as a product of the oxidation of 
 amylic alcohol, and from it are formed the various valerianates. It is not 
 identical with the natural acid. Dose of the powdered root, gr. x-xxx. 
 
 Preparations of Valerian. 
 
 Extractum Valerianae Fluidum, Fluid Extract of Valerian. — Dose, V\x-%]. 
 
 Tinctura Valerianae, Tincture of Valerian, — strength 20 per cent. Dose, 3 ss-ij. 
 
 Tinctura Valerianae Ammoniata, Ammoniated Tincture of Valerian, — has of 
 Valerian 20, Aromatic Spirit of Ammonia to 100. Dose, g ss-ij. 
 
 Oleum Valerianae, Oil of Valerian (Unofficial), — the volatile oil, sp. gr. about 0.950, 
 a greenish or yellowish, thin liquid, having the odor of Valerian, an aromatic taste and a 
 slightly acid reaction, readily soluble in alcohol. Dose, rryj-v. 
 
 The Oil is by far the best preparation for use, as the tinctures are extremely nauseous 
 and the fluid extract is too bulky. The taste is best covered by Cinnamon. 
 
 Preparations of Valerianic Acid. 
 
 Valerianates of Ammonium, Ferrum, Quinine and Zinc are official and are described 
 under the titles of their respective bases. They are made with the artificial valerianic 
 acid and do not represent the action of the plant but rather that of the bases from which 
 they are prepared. 
 
 Physiological Action and Therapeutics. 
 
 Valerian is antispasmodic and a gentle stimulant to the nervous and 
 circulatory systems. It is sedative to reflex excitability, antagonizing the 
 action of strychnine, brucine, thebaine, etc., and is laxative, diaphoretic 
 and anthelmintic. Its taste and odor are very disagreeable but cats are 
 extravagantly fond of it. In these animals it greatly excites the sexual 
 appetite, probably from a resemblance between its odor and theirs when 
 under venereal excitement. After a time it produces in them violent 
 spasms and convulsions. In full doses it increases the action of the heart 
 and raises the temperature, in most persons producing exhilaration (in 
 some, slight mental disturbance), with formication of the hands and feet. 
 Long used it induces a condition of melancholia. Large doses cause 
 hiccough, diarrhea, nausea and vomiting, frequent micturition with 
 tenesmus of the bladder and lithates in the urine, mental disturbance 
 even to delirium, reduced motility and sensibility and lessened reflex 
 excitability. The Oil in large doses is paralyzant to the brain and the 
 spinal cord, lowers the blood-pressure and slows the pulse. 
 
 The Valerianates follow their bases in general action but are supposed 
 to possess some of the sedative qualities of their acid constituent. 
 
VANILLA VERATRUM VIRIDE. 52 I 
 
 Valerian was formerly employed in epilepsy but was probably useful 
 only in the hysterical form of that disease (hystero-epilepsy). It is a 
 valuable remedy in all forms of hysteria, especially in young and delicate 
 women. It is useful in the flatulence of infants and in that of hypo- 
 chondriacal and hysterical subjects, also for coughs of nervous type, 
 whooping-cough, diabetes insipidus, convulsions due to worms and in 
 delirium with vital depression. In the coma of typhus fever the oil 
 proved remarkably efficient in a series of 135 cases out of 172 cases 
 treated by it. Ammonium Valerianate is used in the same class of dis- 
 orders as is Valerian. It is often a good remedy for nervous headache, 
 administered in 10-grain doses in an elixir. Zinc Valerianate has been 
 supposed to combine the antispasmodic power of valerian with the nerve- 
 tonic effect of a zinc salt. It has been used in cholera, epilepsy and 
 neuralgia, frequently with considerable success. The Ferric and Quinine 
 Valerianates are used as are the other salts of their respective bases. 
 
 VANILLA, — is the fruit of Vanilla planifolia, a perennial climbing plant of the 
 nat. ord. Orchideae, native of the West Indies and tropical America, but cultivated in 
 Java, etc. Its characteristic odorous principle is Vanillin, the methyl-ether of protocate- 
 chuic aldehyd, which oxidizes slowly in damp air to Vanillic Acid, and may be resolved 
 into methyl chloride and protocatechuic acid. Vanillin may be made synthetically from 
 Coniferin or from Eugenol. Dose, indefinite. 
 
 Tinctura Vanillae, Tincture of Vanilla, — 10 per cent. Dose, a few drops, accord- 
 ing to the strength of flavor desired. 
 
 Trochisci Ferri, Troches of Ii-on, — contain about jL- per cent, of A'anilla. 
 
 Vanilla is an aromatic stimulant, with considerable influence on the nervous system. 
 It is chiefly employed as a perfume and for flavoring purposes but has been used with 
 benefit in hysteria and low fevers. 
 
 VERATRUM VIRIDE, American Hellebore,— is the rhizome 
 and roots of Veratrum viride, the Indian Poke (Poke-root, Swamp Helle- 
 bore), an indigenous plant of the nat. ord. Liliaceae. It contains the 
 alkaloids Veratrine (Cevadine) C 32 H 49 X0 9 , Jervine, Pseudojervine and 
 Rubijervine, also resin, gallic acid, sugar, etc. 
 
 Allied Plants. 
 
 Veratrum Album, White Hellebore, — is a native of the mountainous 
 regions of continental Europe, and so closely resembles V. Viride in 
 appearance and characteristics that it may be considered a variety of the 
 same plant. The rhizome was official in the U. S. P. 1870. It contains 
 the alkaloids Protoveratrine C 32 H 51 NO n , Jerome, Pseudojervine, Rubi- 
 jervine, Protoveratridi?ie and others. 
 
 Veratrum Sabadilla, Cevadilla (Asagrcea officinalis), — is a bulbous 
 plant of the nat. ord. Liliaceae, indigenous to Mexico and Central 
 America. It contains the alkaloids Veratrine (Cevadine), Cevadilline, 
 Sabadine, Sabadinine and another base known as Wright's Veratrine. 
 
522 VERATRUM VIRIDE. 
 
 This plant is the source of the official mixture of alkaloids called Vera- 
 trine (see below). 
 
 Veratrine can be decomposed into Angelic Acid and Cevine, a base allied to aconine ; 
 Protoveratrine is probably a combination of Isobutyric Acid and a similar base. Vera- 
 trine and Protoveratrine are powerful alkaloids, the latter almost rivalling aconitine in 
 toxicity. Jervine, Sabadine and Sabadinine possess some action on the organism. Cev- 
 adilline has not been examined ; the others are said to be inert. 
 
 The nomenclature of the various veratrise alkaloids is confusing, having undergone 
 considerable modification. That given above is the most recent, but many authors follow 
 Bullock, who gave the names Jervine and Veratroidine to the chief constituents of vera- 
 trum viride and Veratralbine to the principal alkaloid of veratrum album. The sub- 
 stance officially termed Veratrine is not the alkaloid so named but is a mixture of 
 alkaloids. 
 
 Preparations. 
 
 Extractum Veratri Viridis Fluidum, Ft. Ext. of Veratrum Viride. — Dose, Try-iv. 
 
 Tinctura Veratri Viridis, Tinct. of Veratrum Viride, — 40 per cent. Dose, Tt\,ij-x. 
 
 Norwood's Tincture of Veratrum Viride (Unofficial), — has a very high reputation 
 for efficiency, — Dose, TT\v, increased by n\J every 3 hours, until pulse is down to 65, 
 when the original dose will hold it there. Larger doses in puerperal convulsions. 
 
 Veratrina, Veratrine, — is a mixture of alkaloids prepared from the seeds of Asagraa 
 officinalis (see p. 521). A white, or grayish- white, amorphous powder, highly irritant 
 to the nostrils, of very acrid taste, producing tingling and numbness of the tongue and 
 constriction of the fauces ; slightly soluble in cold water, soluble in 3 of alcohol, in 6 
 of ether, in 2 of chloroform, in 96 of glycerin and in 56 of olive oil. Dose, gr. -5— To- 
 
 Unguentum Veratrinae, Veratrine Ointment, — Veratrine 4, Olive Oil 6, Benzoinated 
 Lard 90. For local use. 
 
 Oleatum Veratrinae, Oleate of Veratrine, — Veratrine 2, Oleic Acid 98. Local use. 
 
 Physiological Action. 
 
 Veratrum Viride is closely allied to Aconite in action, being a powerful 
 cardiac depressant and spinal paralyzant. It differs from Aconite in affect- 
 ing the respiration to a much less degree, in being a systemic emeto- 
 cathartic, in paralyzing the motor system centrally, impairing the reflexes 
 but leaving sensation unimpaired, and in having little or no diaphoretic 
 or diuretic action in ordinary medicinal doses. It causes great muscular 
 depression but is seldom fatal ; when death does result from its use it 
 occurs by paralysis of the respiration. In small doses Veratrum reduces 
 the force of the pulse, but does not at first affect its rate. If continued 
 for some time, the pulse becomes very slow, soft and compressible ; rising 
 on the least exertion to be very rapid and feeble. At the same time there 
 is great muscular weakness, and frequently nausea and vomiting. Large 
 doses increase these symptoms very much, the pulse becoming very rapid 
 and so small as to be almost imperceptible ; the skin is cold and clammy, 
 and constant vomiting, extreme debility, giddiness, impaired vision, and 
 partial unconsciousness ensue. 
 
 Veratrum Album contains the powerful alkaloid Protoveratrine. Its 
 general action is similar to that of its congener, but it is much more 
 irritant to the gastro-intestinal mucous membrane, causing violent 
 vomiting and purging, intense abdominal and esophageal pain, greatly 
 
VERATRUM VIRIDE. 523 
 
 reduced temperature and pulse, collapse and death from cardiac and 
 respiratory paralysis. 
 
 The official Veratrine is an acrid and intensely irritant powder, con- 
 sisting of a mixture of alkaloids. It causes violent sneezing, a burning 
 sensation, and free salivation. It affects the heart and circulation simi- 
 larly to the other Veratriae and in addition seems to be a direct poison 
 to muscular tissue and to cause violent convulsions before the muscular 
 paralysis sets in. 
 
 The action of the alkaloid Veratrine on the central nervous system 
 and sensory nerve terminations resembles that of Aconitine very closely. 
 Locally applied it causes the same prickling, warm sensation, followed 
 after a time by a feeling of numbness and cold in the part. In con- 
 tact with the mucous membrane of the nose and throat it gives rise to 
 violent sneezing and coughing. Internally administered the character- 
 istic prickling, burning sensation is soon felt in the mouth and throat, 
 followed by a sense of heat in the stomach, salivation, nausea and vom- 
 iting. The prickling sensation spreads to the skin all over the body and 
 profuse perspiration often occurs. The pulse becomes slow and irregular, 
 the respiration slow and labored. In veratrine poisoning the bowels are 
 more affected than with aconitine, severe colic and violent catharsis 
 being usually experienced. Fibrillary contractions of the muscles and 
 convulsions are commonly observed, and collapse occurs, followed by 
 coma and finally by failure of the respiration. 
 
 Veratrine stimulates the central nervous system and the sensory nerve 
 terminations, but by large doses this stimulation gives way to paralysis. 
 Applied directly in solution to the peripheral nerves it abolishes their 
 irritability. It increases the catabolic changes in striated muscular tissue, 
 producing prolongation of the period of contraction and causing an 
 increase in the height and absolute strength of the contractions. The 
 result is that the muscles remain shortened for a time after contraction 
 and resist the action of their opposing muscles, so that the animal cannot 
 extend a limb immediately after flexing it and its locomotion is greatly 
 impaired. 
 
 Protoveratrine is much more poisonous than veratrine and acts on the 
 same general lines as aconitine. It does not paralyze the motor nerve 
 terminations even when applied to them in quantity. It shortens the 
 contraction period of muscular tissue instead of prolonging it as vera- 
 trine does, and it increases the muscular force temporarily but induces 
 its early exhaustion. Jervine, Sabadilline and Sabadinine have the same 
 action as veratrine but are much less poisonous. 
 
 Antagonists and Incompatibles. 
 Opium, Alcohol, Belladonna and Ammonia counteract the cardiac depression. Mor- 
 phine and Atropine should be administered hypodermically, or Laudanum internally with 
 
524 VERBASCUM. 
 
 alcoholic stimulants ; the recumbent position should be enforced, and dry heat applied to 
 the body. Caustic alkalies are incompatible, as they decompose the alkaloids. 
 
 Therapeutics. 
 
 Veratrum Viride is inferior to Aconite in most of the fevers and inflam- 
 mation, by reason of its lacking power over excretion. It renders good 
 service in the early stages of many parenchymatous and serous inflamma- 
 tions when occurring in sthenic subjects, especially pneumonia. It is 
 highly esteemed in puerperal fever and in simple hypertrophy, irritable 
 heart and other cardiac disorders. It has been used with remarkably 
 good results in acute mania and puerperal convulsions, and it is of service 
 in aneurism to depress the circulation to the lowest point, but in this case 
 the recumbent position must be strictly observed in order to secure 
 safety. It should always be administered in small doses and its effects 
 carefully watched. In puerperal eclampsia large doses have been admin- 
 istered without danger and with decided benefit, as much as 20 drops of 
 Norwood's tincture every hour for 5 consecutive days and nights in one 
 case, the patient making a good recovery. The same preparation may 
 be given hypodermically, in doses of TTLij-iv. 
 
 Veratrum Album is the Hellebore of the ancient physicians, and was 
 employed by them as a derivative in insanity. It is rarely used at present 
 except by the homeopathists, who give it in the cold stage of cholera, in 
 colic, in the vomiting and purging of summer diarrhea, in whooping- 
 cough and in asthma. 
 
 Veratrine is chiefly used externally. The ointment or oleate is applied 
 with benefit in many cases of superficial neuralgia, myalgia and head- 
 aches, a small quantity being rubbed in over the seat of the pain. It 
 may be absorbed through an abrasion of the cuticle and give rise to 
 dangerous symptoms. Internally it has been employed as a cardiac seda- 
 tive in fevers and inflammation, also in acute articular rheumatism, 
 dropsies, dysmenorrhea and various nervous affections, but its uncertainty 
 of action and the dangerous depression which it may produce have caused 
 it to lose favor as an internal remedy. 
 
 VERBASCUM, Mullein (Unofficial),— the leaves of Verbascum Thaspus, the 
 Mullein- weed, a plant of the nat. ord. Scrophulariaceae, having large woolly leaves and 
 yellow flowers in dense spikes. Its chief constituent is mucilage, but the flowers contain 
 an oil in very small quantity. An infusion of ^ iv of fresh leaves to the pint of milk is 
 the form in which it has generally been given ; a pint to be taken thrice daily. 
 
 Mullein is emollient and demulcent, perhaps also slightly anodyne. It has long been 
 a popular Irish remedy in pulmonary affections. Under its use the weight steadily in- 
 creases in phthisis and other wasting disorders, while expectoration is rendered more 
 easy, cough is palliated and the general condition improved. It is recommended in 
 cystitis, irritable bladder, and diarrhea, and is employed as an enema in dysentery and 
 as a poultice for hemorrhoids. The dried leaves may be smoked with benefit in aphonia 
 from laryngeal irritation. 
 
VIBURNUM OPULUS XANTHOXYLUM. 525 
 
 VIBURNUM OPULUS, Cramp Bark,— is the bark of Viburnum Opulus, a 
 shrub of the nat. ord. Caprifoliacese. 
 
 Extractum Viburni Opuli Fluidum, Fl. Extr. of Viburnum Opulus. Dose, ^ss-ij. 
 
 Viburnum Opulus is highly valued by many practitioners as a remedy for uterine and 
 abdominal pains. The so-called Viburnum Compound of Dr. Hayden is stated by its 
 manufacturers to consist of " the active principles of the Viburnum Opulus, Dioscorea 
 Villosa, Scutellaria Lateriflora, and a combination of aromatics, prepared by a process 
 peculiar to ourselves." This they call publishing the formula of the preparation. 
 
 VIBURNUM PRUNIFOLIUM, Black Haw,- is the bark of Viburnum pru- 
 nifolium, an indigenous shrub of the nat. ord. Caprifoliacea?. It contains tannic, oxalic, 
 citric and malic acids, sulphates and chlorides ; also two resins, one named Viburnin, 
 and Vibumic Acid which is identical with Valerianic Acid. 
 
 Extractum Viburni Prunifolii Fluidum, Fl. Extr. of Vib. Prun. Dose, gss-ij. 
 
 Viburnum Prunifolium is considered to possess nervine, antispasmodic, astringent, 
 diuretic and tonic properties, and to be especially useful in preventing abortion, in the 
 nervous diseases of pregnancy, and in spasmodic dysmenorrhea. It may be administered 
 with cannabis indica, morphine, nerve-sedatives or simple aromatics. No exact observa- 
 tions have been made regarding its action, and its therapeutical claims are denied by 
 many who have used it. It often excites nausea and vomiting. 
 
 VIOLA TRICOLOR, Pansy (Unofficial), — is the wild-grown, flowering herb of 
 Viola tricolor, the Heart' s-ease Pansy, a plant of the nat. ord. Violaceas, native in 
 Europe, but naturalized in the southern U. S. It contains an active alkaloid, Violine, 
 allied in many respects to Emetine, and poisonous. Dose, gr. x-gj, in decoction. 
 
 Viola is mucilaginous, emollient, expectorant and slightly laxative. Its active prin- 
 ciple is emeto-cathartic, but exists in very small quantity. A decoction of the fresh herb 
 in milk, with a poultice of the same, was formerly recommended highly in crusta lactea 
 and impetigo. It is used with benefit in some forms of eczema, especially in that of the 
 head and face, and has had some reputation in bronchitis and constitutional syphilis. 
 
 Viola Cucullata, the common Violet, is used in Pennsylvania with success as an in- 
 ternal antidote against rattlesnake venom. The leaves are eaten, and a poultice of salt 
 and indigo is applied to the wound. 
 
 VISCUM, Mistletoe (Unofficial), — occurs in two species, (1) Viscum album, the 
 European Mistletoe, a small, parasitic, evergreen shrub, of the nat. ord. Loranthacese, 
 growing chiefly on deciduous-leaved trees, and (2) Visciftn flavescens, the American 
 species, growing on oaks, elms, etc. They contain mucilage, starch, fixed oil, resin, 
 salts, etc., and Viscin, or Bird-lime, which occurs also in Ilex aquifolium, Gentiana lutea 
 and other plants. Dose, gr. x-^j in decoction, or TTLv-xxx of a ten per cent, tincture. 
 
 The berries of the mistletoes have produced emeto-catharsis, with great thirst, tenes- 
 mus, bloody stools, convulsions and even death in young children. The leaves and twigs 
 have been used in epilepsy, hysteria, chorea, asthma and other nervous affections. The 
 American plant is asserted to possess qualities similar to those of Digitalis and to incite 
 uterine contractions. It has been used in cardiac affections, dropsies, uterine hemor- 
 rhages and amenorrhea, also as an abortifacient. 
 
 XANTHOXYLUM, Prickly Ash,— is the bark of Xanthoxylum 
 americanum the northern species, and of Xanthoxylum Clava-Herculis 
 the southern species, of an indigenous shrub of the nat. ord. Rutaceae. 
 It contains a volatile oil, a fixed oil, resin, gum, coloring matter and the 
 alkaloid Xanthoxyline, which is identical with Berberinc. Dose, of the 
 powdered bark, gr. x-xxx. 
 
526 ZEA MAYS. 
 
 Preparations . 
 Extractum Xanthoxyli Fluidum, Fluid Extract of Xanthoxylum. — Dose, ^ss-j. 
 Decoctum Xanthoxyli, Decoction of Xanthoxylum (Unofficial), — ^j to the quart. 
 Dose, a pint during 24 hours in divided doses. 
 
 Physiological Action and Therapeutics. 
 
 Xanthoxylum is a stimulant and aromatic bitter, a local and systemic 
 sialagogue, also diaphoretic, diuretic and emmenagogue. Its taste is 
 aromatic, soon becoming acrid and bitter, causing profuse salivation, 
 tingling in the tongue and increased secretion from the stomach, intestines, 
 liver and pancreas. It increases the cardiac action and raises the arterial 
 tension, and is classed among the vegetable alteratives with mezereum, 
 guaiac, stillingia, etc. 
 
 Xanthoxylum has a high reputation in chronic rheumatism, myalgia, 
 lumbago and similar disorders, also in jaundice from catarrh of the bile- 
 ducts, 111 dropsies, chronic pharyngitis and constitutional syphilis. In 
 old cases of pharyngitis, the mucous membrane being glazed and dry, the 
 decoction should be used as a gargle and ttlx-xxx of the fluid extract 
 taken internally thrice daily. The bark, used as a masticatory, is a popu- 
 lar remedy for toothache and has been frequently successful in paralysis 
 of the tongue. 
 
 ZEA MAYS, Maize, Indian Corn. — This well-known species of 
 the nat. ord. Gramineae, though itself unofficial, is the source of the offi- 
 cial Starch (see Amylum), and of two drugs, one official, viz. — 
 
 Zea, Corn-Silk, Stigmata Maydis, — the styles and stigmas of Zea 
 Mays, gathered when the tassels have shed their pollen. Its active 
 principle is thought to be Maizenic Acid. There are no official prepara- 
 tions. 
 
 Extractum Zeae Fluidum, Fluid Extract of Zea (Unofficial), — is made by the 
 general rule for fluid extracts. Dose, 3J-ij- 
 
 Ustilago, Corn Smut (Unofficial), — is Ustilago Maydis, nat. ord. 
 Fungi, a smut grown upon the stems, the pistils and the male inflorescence 
 (tassel) of Zea Mays. Its odor and taste are unpleasant, and it contains 
 fixed oil, resin, pectin, gluten, sugar, an acid resembling the sclerotic 
 acid of ergot, and a volatile principle called Secaline, which is supposed 
 to be identical with trimethylamine. 
 
 Extractum Ustilaginis Fluidum, Fluid Extract of Ustilago (Unofficial), — maybe 
 prepared by the general rule for fluid extracts. Dose, TTix-^j. 
 
 Physiological Action and Therapeutics. 
 Zea is a certain but mild diuretic when given in full doses at short 
 intervals. It is by some observers considered demulcent and anodyne, 
 
ZINCUM. r 527 
 
 and is generally believed to have a specific or alterative influence over 
 many disorders of the genito-urinary passages and the urinary bladder. 
 It has been used with success for incontinence of urine, uric and phos- 
 phatic gravel, gout, rheumatism, urethritis, pyelitis, acute and chronic 
 cystitis, cardiac dropsy and obstructive valvular disease of the heart. 
 
 The properties of Ustilago, so far as examined, resemble those of ergot 
 and nux vomica combined. It is a spinal excitant and exalts sensibility 
 and reflex action, producing tonic convulsions on the least irritation of 
 the skin. It slows the heart by stimulation of the pneumogastric, dilates 
 the pupils, causes muscular paresis and death by tetanus of the respiratory 
 muscles or by exhaustion. Experiments on its reputed oxytocic action 
 have not substantiated the claims made for it in this respect, though it is 
 said to have produced abortion in cows after they had eaten the diseased 
 grain. As a therapeutic agent Ustilago has been very little used, but 
 when employed it has been as a substitute for ergot. 
 
 ZINCUM, Zinc, Zn, — is metallic Zinc, in the form of thin sheets 
 or irregular, granulated pieces, and is a bluish-white metal, having the 
 sp. gr. 6.9. It occurs native as a sulphide {Blende), as a Carbonate and a 
 Silicate (Calamine), as a Red Oxide (Zincite), and as a mixture of Zinc 
 Oxide with Oxide of Iron and Manganese (Franklinite). Zinc is soluble 
 in the weakest acids and therefore should never be used for culinary ves- 
 sels. Its salts are all more or less actively poisonous. Metallic Zinc is 
 official but is not employed as a medicine. 
 
 Zinc Salts and their Preparations. 
 
 Zinci Acetas, Zinc Acetate, Zn(C 2 H 3 2 ) 2 -f 2H 2 0, — soft, white, micaceous or pearly, 
 six-sided tablets or scales, somewhat efflorescent in dry air, of faintly acetous odor, sharp 
 metallic taste and a slightly acid reaction ; soluble in 3 of water and in 36 of alcohol at 
 59° F., in \y z of boiling water and in 3 of boiling alcohol. Used locally as an astringent 
 in solution of gr. j or ij to the 3 , or internally in doses of gr. ^-ij. 
 
 Zinci Carbonas Praecipitatus, Precipitated Zinc Carbonate, — a white, impalpable 
 powder, permanent in the air, odorless and tasteless, insoluble in water or alcohol, but 
 soluble in acids with copious effervescence. Used locally as a protective. 
 
 Zinci Chloridum, Zinc Chloride, ZnCl 2 , — a white, granular powder, or porcelain-like 
 masses, odorless, of intensely caustic properties ; very soluble in water and in alcohol ; 
 very deliquescent. Is tonic and escharotic. For internal use a solution in Spirit of Ether 
 is the most convenient form, strength ^j to the ^ , of which four to eight minims may 
 be given twice daily in water. Strength of injections and collyria, gr. j-ij to the J. 
 
 Liquor Zinci Chloridi, Solution of Zinc Chloride, — is an aqueous solution, contain- 
 ing about 50 per cent, of the salt. A clear, colorless, odorless liquid, of a very astringent, 
 sweetish taste and an acid reaction. A powerful disinfectant for sinks, drains, etc. Used 
 also as an injection in gonorrhea, leucorrhea, etc., in dilute solution, ^ to I per cent. 
 Burnett's Disinfecting Fluid 'is similar to the above but slightly stronger. 
 
 Zinci Iodidum, Zinc Iodide, Znl 2 , — a white, granular powder, very deliquescent, of 
 sharp, saline and metallic taste and acid reaction ; very soluble in water and in alcohol. 
 Dose, gr. ss-ij in syrup. 
 
 Zinci Oxidum, Zinc Oxide, ZnO, — an amorphous, white powder, odorless and taste- 
 less ; insoluble in water or alcohol ; soluble without effervescence in dilute acids, also in 
 ammonia water. Dose, gr. j-x, in pill. 
 
528 ZINCUM. 
 
 Unguentum Zinci Oxidi, Ointment of Zinc Oxide,— has of Zinc Oxide 20, Ben- 
 zoinated Lard 80. 
 
 Oleatum Zinci, Oleate of Zinc, — has of Zinc Oxide 5, in Oleic Acid 95. For ex- 
 ternal use. 
 
 Zinci Stearas, Zinc Stearate, Zn(C 18 H 35 2 ) 2 (Unofficial), — a white, insoluble pow- 
 der. Not used internally. 
 
 Zinci Sulphas, Zinc Sulphate, ZnS0 4 -f- 7H 2 0, — small colorless prisms or acicular 
 needles, efflorescent in dry air, odorless, of sharp, saline, and metallic taste and acid 
 reaction ; soluble in 0.6 of water, insoluble in alcohol. Dose, as an emetic gr. x-xxx ; 
 as a tonic and astringent gr. t T q— ij , in pill. For Vi Hate's Solution, see p. 298. 
 
 Zinci Valerianas, Zinc Valerianate, Zn (C 5 H 9 2 ) 2 -f 2H 2 0, — white, pearly scales, 
 having the odor of valerianic acid, a sweetish and styptic taste and acid reaction ; soluble 
 in about 100 of water and in 40 of alcohol. Dose, gr. J^— ij, in pill. 
 
 The Bromide is described under Bromum, and the Phosphide under Phosphorus. 
 
 Physiological Action. 
 
 Zinc Salts are astringents, but milder ones than the salts of lead. Its 
 soluble compounds (the Chloride, Iodide, Sulphate and Acetate) are cor- 
 rosive poisons, causing violent gastro-enteritis and in some cases profound 
 nervous depression. The Chloride is a powerful and painful escharotic 
 or rather mummifier of the tissues, having great affinity for water, coagu- 
 lating albumin and shrivelling the vessels. It is a very active disinfectant. 
 The Sulphate is also an escharotic and a specific emetic, acting promptly 
 by direct irritation of the stomach, without much depression or after- 
 nausea. In small doses it is tonic and astringent, in larger ones it would 
 be a severe irritant but for its causing prompt emesis. The Acetate re- 
 sembles the sulphate in action. The Oxide used externally is a mild, 
 soothing astringent; used internally it enters the blood as a lactate or 
 chloride, acting as a mild astringent and as a nervous sedative. Being 
 almost insoluble in the stomach, it has but feeble diffusive power and 
 consequently but slight activity. The Carbonate resembles the oxide in 
 action. The Iodide locally is a powerful escharotic and has been sup- 
 posed to possess some alterative power when given internally, in addition 
 to its astringent qualities as a zinc salt. The Stearate is feebly antiseptic 
 but strongly astringent. The Valerianate acts as a nervous sedative, but 
 its properties are in all probability due to its zinc base and not to the acid 
 combined with it. 
 
 The continued use of Zinc salts produces symptoms similar to those of 
 chronic lead-poisoning, but of much less gravity. These salts manifest 
 less tendency to accumulate in the system than other metallic salts and 
 are excreted much more rapidly. Elimination takes place chiefly by the 
 liver and intestinal glands. 
 
 The actions of the Bromide and Phosphide are described respectively 
 under the titles Bromum and Phosphorus. 
 
ZINCUM. 529 
 
 Antidotes and Incompatibles. 
 
 Lime-water, mucilaginous drinks, soap, Tannic Acid, milk, Potassium and Sodium 
 Carbonates, if given early, are the antidotes in poisoning by the salts of zinc. Incom- 
 patibles are — Lime-water, Alkalies and their carbonates, Silver Nitrate and vegetable 
 astringents. Lead Acetate produces double decomposition with zinc salts, but it is often 
 used in solution with the Sulphate as an injection. 
 
 Therapeutics. 
 Zinc salts are chiefly employed in weak solution as mild astringent 
 applications in catarrhs of mucous membranes, as conjunctivitis, gonor- 
 rhea, etc., also as unguents and lotions in skin diseases, particularly 
 eczema, impetigo, herpes and erythema. The Chloride is made into a 
 paste with flour and glycerin for the destruction of lupus, epithelioma and 
 other morbid growths, also for opening abscesses in locations where punc- 
 ture or incision might be dangerous. The cuticle, if unbroken, should 
 be removed by strong water of ammonia before the paste is applied, as it 
 will not act through the epidermic tissue. It is a commonly used disin- 
 fectant and deodorant, and in weak solution (rrLiij-v of the liquor to §j 
 of water) makes a good lotion for putrid ulcers, and still weaker (gr. j-ij 
 to the pint) is an excellent injection for gonorrhea. The Iodide is not em- 
 ployed as an escharotic, nor has it ever been a favorite remedy for internal 
 use. It is chiefly employed in solution as an application to enlarged tonsils, 
 and as an ointment (1 part to 8 of lard) for the reduction of glandular 
 enlargements. The Sulphate is used locally as an astringent to mucous 
 surfaces generally, internally as an emetic in narcotic poisoning and 
 croup, and in small doses as a tonic and antispasmodic in convulsive 
 diseases, as chorea, hysteria, epilepsy, angina pectoris, asthma, etc. In 
 diarrheas and dysentery it is a good astringent and is frequently com- 
 bined with opium and ipecac. The Acetate is used for the same pur- 
 poses as the sulphate, but is usually preferred for collyria. The Oxide 
 may be employed as a dusting powder in intertrigo, also as an ointment 
 in eczema and excoriated surfaces generally. In combination with bis- 
 muth and pepsin it is an excellent remedy for the summer diarrhea of 
 children, and with aromatic powder and morphine it is very efficient in 
 gastralgia. It is a good remedy in 3-grain doses for the night-sweats of 
 phthisis, and has been successfully employed in epilepsy and neuralgia, 
 in whooping-cough, hysteria and nervous headache, and in bronchorrhea 
 to check the profuse secretion. It is much employed as an ingredient of 
 cosmetics. The Carbonate is by some preferred to the oxide for local use 
 in skin diseases. Calamine Ointment, which is a mixture of the impure 
 carbonate (calamine) with the oxide and an unguent basis, was until 
 recently a favorite application as a soothing protective to abrasions and 
 inflammations of the integument. The Valerianate has been used in 
 such as the nervous headache of hysterical women, nervous coughs and 
 34 
 
530 ZINGIBER. 
 
 aphonia due to uterine and ovarian irritation. The Stearate is an 
 excellent dusting and insufflating powder, much used in rhinological 
 practice and in the treatment of gonorrhea. It may be mixed with boric 
 acid, europhen menthol, chrysarobin, salicylic acid, and other antisep- 
 tics, for use in intertrigo, burns, eczema, coryza, hay fever and many 
 other local affections. 
 
 The Bromide and Phosphide are employed for the effects of their 
 respective non-metallic bases, under which titles their uses are described. 
 
 ZINGIBER, Ginger, — is the rhizome of Zingiber officinale, a plant 
 of the nat. ord. Scitaminese, having dingy-yellow flowers on a leafless 
 flower-stalk and long, lanceolate leaves on a separate stem. The plant 
 is a native of Hindostan, but is cultivated in Jamaica, Sierra Leone, etc. 
 It contains an aromatic volatile oil, and a resin. 
 
 Preparations. 
 
 Extractum Zingiberis Fluidum, Fl. Ext. of Ginger, — alcoholic. Dose, TT\,x- 3 ss. 
 
 Tinctura Zingiberis, Tincture of Ginger, — 20 per cent. Dose, rr^xx-^ij. 
 
 Syrupus Zingiberis, Syrup of Ginger, — has of the Fluid Extract 3 per cent, in sugar 
 and water. Dose, 3 ss— ij . 
 
 Trochisci Zingiberis, Troches of Ginger, — each troche contains of the Tincture 2 
 minims, with Tragacanth, Sugar and Syrup of Ginger. 
 
 Oleoresina Zingiberis, Oleoresin of Ginger, — is extracted by ether and contains all 
 the virtues of the root. Dose, TT^ss-j, well diluted. 
 
 Ginger is also a constituent of Pulvis Aromaticus and Pulvis Rhei Compositus. 
 
 Ginger is sialagogue when chewed, sternutatory when inhaled and ex- 
 ternally a rubefacient. Internally it is a grateful stimulant and carmina- 
 tive, produces a sensation of warmth at the epigastrium and promotes the 
 expulsion of flatus. It is employed as a carminative in colic, as a mastic- 
 atory to increase the secretion of saliva and in relaxed conditions of the 
 throat, also internally in atonic dyspepsia, to relieve flatulence, and as an 
 adjunct to purgative agents to correct their griping properties. The 
 syrup is in common use as a flavoring adjuvant in prescriptions. 
 
 Ginger Beer is a favorite temperance beverage, but most of the preparations sold 
 under its name are simply carbonated water flavored with ginger. The following recipe 
 is furnished by Dr. William Hardman, of Blackpool, in whose family it has been used for 
 over fifty years, and the excellence of which he guarantees : 
 
 Take \]/ z oz. of the best ginger well bruised, I oz. of cream of tartar, and i l / 2 lb- °f 
 cane loaf sugar. Put all the ingredients into an earthen vessel and pour on a gallon of 
 boiling water ; when nearly cold add a gill of yeast, cover over with a blanket and let it 
 stand in a warm place until next morning. Then skim it and run it through a filtering 
 bag, bottle it, cork well with good corks and tie down the corks with string. In three 
 days it will be fit for use. The bottles must be clean and sweet. A little lemon juice is 
 considered an improvement by some. [Lancet.) 
 
PART II. 
 
 PHARMACY AND PRESCRIPTION WRITING. 
 
 Pharmacy (<pdp/iaxov, a drug or medicament), — may be defined as the 
 art of selecting and preserving medicines, and preparing them for ad- 
 ministration. It may be divided into — 
 
 Official or Galenical Pharmacy, — dealing with the processes and prep- 
 arations of the Pharmacopoeia ; and — 
 
 Extemporaneous or Magistral Pharmacy, — which includes the opera- 
 tions of compounding and dispensing remedies as directed by the ex- 
 temporaneous prescriptions of physicians. 
 
 Pharmacopoeias and Dispensatories. 
 
 A Pharmacopoeia is an official list of the drugs and their prepara- 
 tions recognized by the medical profession of a certain country. In 
 foreign countries the Pharmacopoeias are published under government 
 auspices and have the force of a legal standard ; in the United States its 
 publication is left to the medical and pharmaceutical professions and it is 
 revised every ten years by a convention called for that purpose. The 
 official Pharmacopoeias in the English languages, with the dates of their 
 latest revision or additions, are as follows, viz. — 
 
 The Pharmacopoeia of the United States of America, 7th Decennial 
 Revision, 1890; official from January 1, 1894. 
 
 The British Pharmacopoeia, 1898. 
 
 Besides the above there are — The Pharmacopoea Germanica, 1890, supplement, 1895 ; 
 the Pharmacopee Francaise (Codex Medicamentarius), 1884, supp. 1895 ; the Austrian, 
 Pharmacopoea Austriaca, 1889 ; Russian, Ph. Rossica, 1891 ; the Swedish, Ph. Suecica, 
 1879; the Norwegian, Ph. Norvegica, 1895 ; the Danish, Ph. Danica, 1893; the Belgian, 
 Ph. Belgica, 1885 ; the Swiss, Ph. Helvetica, 1893 ; the Spanish, Farmacopea Espanola, 
 1884; the Portuguese, Ph. Portugueza, 1876 ; the Indian, Ph. of India, 1868 ; the 
 Hungarian, Ph. Hungarica, 1888; the Netherlands', Ph. Neerlandica, 1889; the Rou- 
 manian, Ph. Romana, 1874 ; the Finnish, Ph. Finnica, 1885 ; the Chilian, Farmaco- 
 pea Chilena, 1886 ; the Greek, Ph. Hellenica, 1868 ; the Japanese, Ph. Japonica, 1891 ; 
 the Mexican, Neuva Farmacopea Mexicana, 1896 ; the Croatia- Slavonian, Ph. Croatico- 
 Slavonica, 1888 ; and the Italian, Farmacopea Italiana, 1892. 
 
 531 
 
532 WEIGHTS AND MEASURES. 
 
 A Dispensatory is a commentary on one or more pharmacopoeias, 
 giving in extenso the physical and medicinal history of drugs and prepara- 
 tions, with their doses, physiological action and therapeutics, and includes 
 similar information about many drugs which are not official in any phar- 
 macopoeia but are of occasional use or general interest. A dispensatory 
 is a private publication, of authority according to the reputation of its 
 author. The principal dispensatories are American publications, and are 
 veritable drug-encyclopaedias, so elaborately do they deal with every 
 subject embraced therein. Those of acknowledged value are — 
 
 The Dispensatory of the United States of America, by Dr. Geo. B. Wood and 
 Dr. Franklin Bache. 1 8th edition, revised and largely rewritten, by Professors H. C. 
 Wood, J. P. Remington, and S. P. Sadtler. Philadelphia, J. B. Lippincott & Co. 1899. 
 
 The National Dispensatory. 5th edition, revised by Professors Stille, Maisch and 
 Caspari. Philadelphia, Lea Bros. & Co. 1896. 
 
 The American Dispensatory, by King & Lloyd, Cincinnati, is the recognized 
 authority of the "eclectic " practitioners. 1 8th edition, 1899. 
 
 A Companion to the U. S. Pharmacopoeia, by Drs. Oldberg and Wall ; New 
 York, Wm. Wood & Co. — is an excellent book, but not so exhaustive as the others in its 
 method of treating the subjects embraced in it. 
 
 A Companion to the British Pharmacopoeia, by Peter Squire; 17th edition, 
 London, 1899; is the nearest English approach to the American dispensatories, and is 
 the standard text-book on the general materia medica in Great Britain. Although a 
 very good book it does not compare as a work of reference with either of the two great 
 American Dispensatories first above named. 
 
 WEIGHTS AND MEASURES. 
 
 The working formulae of the U. S. Pharmacopoeia of 1880 were con- 
 structed on the system of parts by weight for all articles, whether solids 
 or fluids, except in the case of fluid extracts, for which the metric weights 
 and measures were employed. On this system it really made no differ- 
 ence what unit of weight was adopted in official pharmacy. The phar- 
 macopoeia of 1890 has, however, in most cases employed definite weights 
 for solids, and measures for liquids, in terms of the metric system. In 
 certain cases, where weighing is decidedly more convenient or where the 
 product is adjusted to a percentage by weight which would be rendered 
 uncertain if the ingredients were taken by measure, liquids are ordered 
 to be weighed. In some cases (Aqua Destillata, Aqua Aurantii Florum, 
 etc.) the quantities are directed simply by volume. In most cases, there- 
 fore, solids are officially directed to be weighed by grammes, and liquids 
 to be measured by cubic centimeters. At the same time, however, the weights 
 and measures generally used by physicians in prescribing and by phar- 
 
WEIGHTS AND MEASURES. 
 
 533 
 
 macists in dispensing medicines, are and will doubtless continue to be, 
 in the United States those of the Apothecaries' or Troy System of 
 weights, (having 480 grains to the ounce and 5 760 grains to the pound) ; 
 and the Wine Measure. The drachm (60 grains) and the scruple (20 
 grains), are intermediate units of weight which are still used but are 
 becoming obsolete. 
 
 The units of the Wine Measure are the minim (rr^), which in water at 
 its maximum density equals gr. 0.95 ; the fluidrachm (60 minims) and 
 the fluidounce (8 fluidrachms or 480 minims). The signs used to denote 
 these units are r^ minim, 9 scruple, 3 drachm, § ounce, and in the case 
 of liquids an f to denote fluid is often placed before the sign, thus fg for 
 fluidrachm, fg for fluidounce. The relations between these units of 
 
 weight and measure are as follows : — 
 
 Measure. Weight. Weight 
 
 ffij, One minim = 0.95 grains. grain j 
 
 f^j, One fluidrachm = 56.96 " 3j 
 
 f^j, One fluidounce =455.69 " ^j 
 
 Measure. 
 I.05 minims. 
 63.20 " 
 505.60 " 
 
 Pound. 
 Libra. 
 
 . rb 
 
 Table of Troy or Apothecaries' Weight. 
 
 Drachm. Scruple. 
 
 Drachma. Scrupulum. 
 
 96 = 288 
 
 Ounce. 
 Uncia. 
 
 I 
 12 
 
 I 
 
 24 
 
 3 
 
 Grain. 
 
 Granum. 
 
 gr- 
 
 5760 
 
 480 
 
 60 
 
 20 
 
 Gallon. 
 Congius. 
 
 Table of Apothecaries' or Wine Measure. 
 
 Pint. Fluidounce. Fluidrachm. 
 
 Octarius. Fluiduncia. Fluidrachma. 
 
 o. fg iz 
 
 - 8 = 128 = 1024 = 
 
 1 = 16 =• 128 = 
 
 1 = 8 
 
 Minim. 
 
 Minimum. 
 
 "I 
 
 61440 
 
 7680 
 
 480 
 
 60 
 
 The British Pharmacopoeia recognizes only the Imperial Standard 
 (avoirdupois) weights, having 487^ grains to the ounce, 16 ounces to the 
 pound (instead of 12), and 7000 grains to the pound; and the Imperial 
 Measure, having 20 ounces to the pint (instead of 16, as with us). 
 
 Table of British Pharmacopceial Weight. 
 
 Troy grain, Avoirdupois ounce and pound 
 
 Pound. 
 Libra. 
 
 lb 
 
 
 Ounce. 
 
 Uncia. 
 oz. 
 
 
 Grain. 
 
 Granum. 
 
 g r - 
 
 1 
 
 — 
 
 16 
 
 — 
 
 7000 
 437'A 
 
 The Troy ounce contains 42^ grains more than the avoirdupois ounce, but the Troy- 
 
 pound contains 1 240 grains less than the avoirdupois pound, 
 common to both. 
 
 The grain is the only unit 
 
534 
 
 WEIGHTS AND MEASURES. 
 
 Table of British Imperial or Pharmacopceial Measure. 
 
 Gallon. 
 
 Pint. 
 
 Fluidounce. 
 
 Fluidrachm. 
 
 
 Minim. 
 
 Congius. 
 
 Octarius. 
 
 Fluiduncia. 
 
 Fluidrachma. 
 
 
 Minimum. 
 
 c. 
 
 0. 
 
 floz. 
 
 fldr. 
 
 
 min. 
 
 I 
 
 8 
 
 160 
 
 = 1280 
 
 — 
 
 76800 
 
 
 i = 
 
 = 20 : 
 
 = 160 
 
 — 
 
 9600 
 
 
 
 I i 
 
 8 
 
 = 
 
 480 
 60 
 
 The Metric, or Decimal System of Weights and Measures, is now 
 the official system in the United States, having been adopted throughout 
 the last revision of the U. S. Pharmacopoeia. It is in general use on the 
 continent of Europe and is employed by French and German physicians 
 in this country. Its three standard units are as follows, — 
 
 A Meter, the standard unit of linear measure and also of the whole system, is the ten- 
 millionth part of the quadrant of the earth, i. e., the forty-millionth part of the earth's 
 circumference around the poles. One-tenth of the Meter is the Decimeter, one-hundredth 
 is the Centimeter, and one-thousandth is the Millimeter. 
 
 A Liter, the unit of measure of capacity, is the volume of one kilogramme of pure 
 water at the temperature of its maximum density, in vacuo. Theoretically, the Liter is 
 equal to one cubic decimeter, or 1 000 cubic centimeters. Per contra one- thousandth of 
 a Liter is the Milliliter (or Cubic Centimeter), which measure of pure water at its maxi- 
 mum density weighs one Gramme. 
 
 A Gramme, the unit of weight, is the weight of the one-thousandth part of a liter of 
 water at its maximum density. Its tenth is the Decigramme, its hundredth is the Centi- 
 gramme, and its thousandth part is the Milligramme. 
 
 The original and French spelling is metre, litre, gramme ; the Anglicized form is 
 meter, liter, gram. The U. S. Ph. of 1890 sanctions a combination of both, thus — 
 meter, liter, gramme. 
 
 The metric terms used in pharmacy are few, and are generally confined 
 to the Gramme, the Cubic Centimeter (or fluid-gramme) and the Milli- 
 gramme ; but the system embraces many other terms of increase and de- 
 crease, which are set forth in the following table, viz. — 
 
 
 
 1 0000. 
 
 Myrialiter. 
 
 
 
 1 0000. 
 
 Myriameter. 
 
 1000. 
 
 Kiloliter. 
 
 
 
 1000. 
 
 Kilometer. 
 
 100. 
 
 Hectoliter. 
 
 
 
 100. 
 
 Hectometer. 
 
 10. 
 
 Dekaliter. 
 
 1 0000. 
 
 Myriagramme. 
 
 10. 
 
 Dekameter. 
 
 1. 
 
 Liter. 
 
 1000. 
 
 Kilogramme. 
 
 1. 
 
 Meter. 
 
 .1 
 
 Deciliter. 
 
 100. 
 
 Hectogramme. 
 
 .1 
 
 Decimeter. 
 
 .01 
 
 Centiliter. 
 
 10. 
 
 Dekagramme. 
 
 .01 
 
 Centimeter. 
 
 .001 
 
 Milliliter (Cubic 
 
 1. 
 
 Gramme. 
 
 .001 
 
 Millimeter. 
 
 
 Centimeter). 
 
 .1 
 
 .01 
 
 .001 
 
 Decigramme. 
 Centigramme. 
 Milligramme. 
 
 The relations between the Metric Weights and Measures and the 
 Apothecaries' are as follows, — 
 
 I meter = 39.370432 inches. I grain = 0.06479895 gramme. 
 
 I liter == 2.113433 pints. • I minim = 0.061613 cubic centimeter. 
 
 I gramme = 15.43234874 grains. 
 
 The Metric System is making way but slowly in this country although 
 its progress is aided by every process of forcing which scientific bodies 
 
WEIGHTS AND MEASURES. 
 
 535 
 
 can bring into action, and it remains to be seen how much its adoption 
 in the last edition of the U. S. Pharmacopoeia will influence the medical 
 profession in its behalf. With all the influence brought to bear in its 
 favor it certainly has not yet been adopted by any considerable propor- 
 tion of native-born and home-educated physicians and pharmaceutists. 
 One of its greatest difficulties for the physician is the absence of any 
 correspondence or relation between the unit of weight'(gramme) and the 
 unit of measure (liter), and the consequent want of fluid denominations 
 below the cubic centimeter, corresponding with the decigramme, centi- 
 gramme and milligramme of the weight scale. Its chief disadvantage is 
 one which is inherent to any decimal system, — that the number ten 
 cannot be divided more than once without producing a fraction. This 
 is partly compensated for by the practice of dividing five into the three 
 parts 2, 2 and i, and on this principle metric weights are usually con- 
 structed. 
 
 Approximate or Domestic Measures become necessary in appor- 
 tioning doses for a patient, when liquid medicines are used. Of these 
 the measure most commonly employed is the teaspoonful, which is gen- 
 erally taken as equivalent to a fluidrachm, though in most cases as now 
 manufactured the teaspoon contains about 75 minims, or 25 per cent, 
 more than the theoretical quantity. The dessertspoonful is about equal 
 to two teaspoonsful, and the tablespoonful to about 4 teaspoonsful or 
 f^ss, while the wineglass is supposed to contain about f^ij. The use of 
 graduated medicine glasses is strongly recommended instead of these 
 approximate measures. They may be obtained at a trifling cost in any 
 well-stocked drug store. 
 
 Drops (Guttae) are very variable in size, though popularly supposed 
 to equal minims ; the variations in their relative dimensions being due to 
 the viscidity of the liquid, the shape and surface of the orifice from which 
 they escape and sundry other circumstances. The Syrups and Mucilages 
 produce large- drops, while Bromine, Chloroform and other heavy mobile 
 liquids produce very small ones. These differences are well illustrated in 
 the following table, which gives the number of drops in a fluidrachm of 
 several liquids of certain classes. [See the Appendix for a fuller table.] 
 
 Syrupus Acacise, 44. 
 
 Syrupus Scillae, 75. 
 
 Aqua, 60. 
 
 Liquor Potassse, 62. 
 
 Liquor Hydrargyri Nitratis, 13] 
 
 Acetum Opii, 90. 
 
 Vinum Opii, 100. 
 
 Tinctura Opii Deodorati, no. 
 
 Tinctura Opii Camph., no. 
 
 Oleum Ricini, 77. 
 Oleum Copaibae, 123. 
 Oleum Juniperi, 148. 
 Spiritus Camphorae, 143. • 
 Spiritus Chloroformi, 150. 
 Ext. Digitalis Fluid, 134. 
 Ext. Ipecac. Fluid., 120. 
 Ext. Cinchouse Fluid., 138. 
 Ext. Zingiberis Fluid., 142. 
 
536 PRESCRIPTIONS. 
 
 Tinctura Opii, 130. Ext. Buchu Fluid., 150. 
 
 Tinctura Iodi, 148. Ext. Hyoscyami Fluid., 160. 
 
 Tinctura Aconiti, 146. ^Ether, 176. 
 
 Alcohol Dilutum, 137. Bromum, 250. 
 
 Alcohol, 146. Chloroformum, 250. 
 
 Specific Gravity is the relative weight of equal bulks of different 
 bodies. The specific gravity of water at a certain temperature (generally 
 59 F.) is taken as 1, and that of all other substances is expressed in terms 
 of this unit. The Pharmacopoeia gives very complete tables of percent- 
 ages and specific gravities of Alcohol, Ammonia Water, Acetic, Hydro- 
 bromic, Hydrochloric, Nitric, Sulphuric and Phosphoric Acids, and aque- 
 ous solutions of Potassa and Soda. The specific gravity of any substance 
 is expressed by the quotient obtained by dividing the weight of a given 
 measure of the substance by the weight of an equal measure of water. In 
 pharmacy the specific gravity of solids is not of any importance, but that 
 of liquids is a matter of constant value, and is determined in most cases 
 by means of a specific gravity bottle or by a hydrometer, instruments 
 which are described in any standard work on chemistry or physics. 
 Modifications of the hydrometer with scales adapted to particular work 
 are the urinometer, saccharometer, lactometer, etc. 
 
 Specific Volume is the relative bulks of equal weights of different 
 bodies. In pharmacy it means the volume of the weight of a liquid com- 
 pared with the volume of an equal weight of water at 59 F. The specific 
 volume of a body is therefore inversely as its specific gravity, and is ex- 
 pressed by the quotient obtained by dividing unity by the specific gravity. 
 s^HF: = S P- v °l- an d therefore sp. gr. X sp. vol. = 1. 
 
 A table of the specific gravity and specific volume of several liquids 
 will be found in the Appendix. 
 
 PRESCRIPTIONS. 
 
 Extemporaneous Prescriptions are formulae written on the instant 
 {ex tempore) to meet the requirements of individual cases. 
 
 A prescription should begin with the name of the person for whom it 
 is designed and the date on which it is written. Then follows the Latin 
 wordJZecifle, usually abbreviated to the sign R, and signifying "Take; " 
 next, the names and quantities of the ingredients to be used, which are 
 also expressed in Latin ; then the directions to the compounder, followed 
 
PRESCRIPTIONS. 537 
 
 by the directions to the patient, the last being now usually expressed in 
 English ; and finally the signature and address of the prescriber. 
 A prescription then has four component parts, as follows : the — 
 
 Superscription, — consisting of the name of the party for whom it is designed, the date 
 
 and the sign 1J signifying " Take thou." 
 Inscription, — the body of the prescription, consisting of one or more of the following 
 subdivisions : the — 
 
 Basis, — or chief, active ingredient. 
 Adjuvant, — to assist the action of the basis. 
 
 Corrective, — to correct some injurious quality of the other ingredients. 
 Vehicle or Excipient, — giving the prescription a suitable form. 
 Subscription, — the directions for the compounder, usually expressed in contracted Latin. 
 Signature, — the instructions for the guidance of the one administering the medicine, 
 expressed in English, followed by the signature of the prescriber. 
 
 A prescription may, however, contain the base alone, or the base with 
 the adjuvant, or the base with a simple vehicle or diluent. A single 
 ingredient may serve a double or a triple office, as the Syrupus Rhei 
 Aromaticus with Quinine, in which case the syrup serves as an adjuvant 
 to increase the action of the quinine, as an excipient to cover the taste, 
 and as a vehicle to facilitate the administration of the dose directed. 
 Again, the basis may need no aid in doing its work and may require no 
 corrective of its action nor any special vehicle. On the other hand, 
 there is no limit to the number of ingredients which may be used, pro- 
 vided that the prescriber has a clear idea of something to be accomplished 
 by each one, and if there is no chemical or medicinal incompatibility 
 between them. In olden times prescriptions were very complex and 
 contained a great many curious and incongruous ingredients. As Dr. 
 Piffard well says, " the tendency of the present age is toward mono- 
 rather than poly-pharmacy, and prescriptions with the orthodox adjuvans 
 and corrigens are less frequently seen than formerly." There is danger, 
 however, in carrying this simplicity too far, for there is no doubt but 
 that proper combinations of medicines will often produce effects for 
 the patient's good which could not be obtained from the use of any one 
 remedy. 
 
 Procedure in Writing a Prescription. 
 In writing an extemporaneous prescription, the first step is to write the 
 patient's name and address, the date and the sign R. Then the title of 
 each ingredient should be written in Latin and in the genitive case, except 
 that when a certain number only of an ingredient is ordered the name 
 of the ingredient should be in the accusative case, for example, " Vitel- 
 lumunum, — one yolk-of-egg." Next, the quantity of each ingredient 
 sufficient for one dose should be mentally determined and multiplied by 
 the number of doses which the mixture is to contain, and the result set 
 
538 PRESCRIPTIONS. 
 
 down in signs and Roman numerals. The directions to the pharmacist 
 and patient being added and the prescriber's name or initials affixed, 
 the prescription is completed ; but when very active agents are used, it 
 is a good plan to go over the calculations a second time before letting 
 them leave the hands of the person most responsible for the result. For 
 pills or powders the same process should be employed, slightly varied 
 according to the requirements of each case. Frequently the ingredients 
 and quantities for but one pill, powder or suppository are named, with 
 instructions to make a certain number after the formula. When an un- 
 usually large dose of any poisonous drug is prescribed, it is customary to 
 underline the quantity, so as to call the attention of the compounder to 
 the fact that the prescriber is aware that the dose is above the average. 
 
 An Example will perhaps make the foregoing more comprehensible, 
 and at the same time serve to indicate the style of writing usually em- 
 ployed. The following formula is that ordered in the U. S. Pharma- 
 copoeia for the preparation known as Black Draught, but officially styled 
 the Compound Infusion of Senna ; approximate weights and measures 
 being substituted for the pharmacopceial metric weights. 
 
 For Mrs. Gray. July 7 lh, ,S 9 S. 1 SuPEESCRIPTION . 
 
 Recipe, Take, — I 
 
 f Senna semiunciam, 
 
 (x> • \ \ Of Senna, half an ounce, 
 ^ ' ' 1 Magnesii Sulp/iatis, 
 
 Of Magnesium Sulphate, 
 
 , . ,. . x f Manna, ana uncia?n unam, 
 
 (Adjuvant.) < 
 
 Inscription. 
 
 Of Manna, of each an ounce, 
 
 , r^ ,. -, f Fceniculi, drachmam unam. 
 
 (Corrective.) | Qf Fe ^ Qne drachm> ' 
 
 (V V 1 \ I Aqua Bullientis, Jluiduncias octo, 
 (Vehicle.) j Qf Boi]ing Water> eight fluid-ounces. 
 
 Macera per horam in vase clauso, deinde cola. 1 Subscription 
 
 Macerate for an hour in a closed vessel, then strain. J 
 
 Signetur, Let it be entitled, — A wineglassful every four hours \ 
 
 until it operates. \ SIGNATURE. 
 
 /. F. Wood, M.D. J 
 
 Abbreviated in the style usual among physicians, the above prescription 
 
 would read as follows, — 
 
 For Mrs. Gray. July jth, 1898. 
 
 $ . Sennce, ^ ss. 
 
 Magnesii Sulphat., 
 
 Manna, aa ^j- 
 
 Fceniculi, 3J. 
 
 Aqua Bull., f ^ viij. 
 
 Mac. per hor. in vase clauso, deinde cola. 
 Sig. — A wineglassful every four hours, until it operates. 
 
 Wood. 
 
 As the result of the above is nearly identical with the official prepara- 
 tion, we might write the same prescription more simply, as follows, — 
 
 R. Infusi Senna Compos., ^ viij. 
 
PRESCRIPTIONS. 539 
 
 with the proper superscription and signature ; this being the manner of 
 prescribing the official preparations. 
 
 It will be noticed that in the above analysis the term basis covers two 
 ingredients; but it is obvious that either of them might be considered 
 the principal agent, and the other one classed as an adjuvant. 
 
 " These four parts of a formula are intended to accomplish the object 
 of Asclepiades, curare cito, tute et jucunde ; in other words, to enable the 
 basis to cure quickly, safely and pleasantly." (Pareira.) 
 
 Another Example will illustrate the mental operations which should 
 always be followed by a prescriber • for no matter how good a memory 
 he may have, he will surely make a grievous mistake some day if he fol- 
 lows the practice of writing prescriptions from memory. Furthermore, 
 the unscientific character of the latter habit will, when appreciated, pre- 
 vent any educated physician from indulging in it. Every prescription 
 should be written with a definite purpose in view, consequently the mind 
 of the prescriber should weigh each step carefully and should avoid all 
 slavish subjection to ready-made formulae. 
 
 Suppose, then, that we wish to order for Miss Graham an emulsion of 
 Castor Oil, flavored and sweetened so as to make it less disagreeable 
 to the taste than it naturally is. If the ingredients were simply mixed 
 together, as in the previous example, the result would be an unsightly 
 preparation, consisting of sweetened and flavored water with the oil float- 
 ing on top. So we require that the process of emulsification be first 
 accomplished, by which the oil is minutely subdivided and suspended in 
 the water by the aid of the emulsifier, which may be any viscid excipient, 
 as gum, soap, or yolk-of-egg. Taking the last-named for the emulsifying 
 agent, we would begin by writing down in order the following terms, as 
 stated below in italics, viz. : — 
 
 For Miss Graham. June ioth, 1898. 
 
 & . (Take thou—) 
 
 Olei Ricini, (of Oil of Castor), 
 Vitellum, (Yolk-of-egg), 
 Tere bene simul ; dein adde — (Rub well together ; then add — ) 
 
 Having gone so far, we begin to think of an agreeable vehicle, and 
 
 choosing from the many Syrups at our disposal that of Ginger, and from 
 
 the flavored Waters that of Cinnamon, we write further for these as the 
 
 ingredients to be added, thus — 
 
 Syrupi Ziugiberis, (of Syrup of Ginger), 
 Aquce Cinnamo?7ii, (of Cinnamon Water). 
 
 The ingredients are now all entered upon the prescription, but their 
 respective quantities have not yet been decided upon. We proceed then 
 by first taking into consideration the total quantity of the medicament 
 required, — which, in this case, as the preparation is intended to purge 
 
54-0 PRESCRIPTIONS. 
 
 the patient, need not embrace more than one or two doses. As it is well 
 to provide for a repetition of the dose, in case the medicine should not 
 act sufficiently, we will decide upon two doses in all. Now, the average 
 adult dose of Castor-oil is about a tablespoonful or half-an-ounce, and as 
 we want two such doses we insert the sign and numerals fg, or simply ^j, 
 opposite the title of the oil which is written in the genitive case. But 
 to emulsify it properly we need about one-half as much of the emulsify- 
 ing agent, and we may express this by writing for half-an-ounce of yolk- 
 of-egg, or for the yolk of one egg, or for one yolk-of-egg, which weighs 
 about half-an-ounce. This would be expressed in Latin by either of the 
 following methods, — 
 
 Vitelli semi-unciam, (^ss). One-half-ounce of Yolk-of-egg. 
 Vitellwn oviunius, (j). The Yolk of one egg. 
 Vitellum unum, (j). One Yolk-of-egg. 
 
 As the word Vitellus means Yolk-of-egg, we may omit the word Ovi, 
 and accepting the latter as the best style, insert the numeral j opposite 
 the word Vitellum, which is properly in the accusative case. The whole 
 quantity so far specified is one ounce and a half, and if we add two and 
 a half ounces of diluent we shall have a four-once mixture, or the full 
 of a regular-sized bottle as found in the shops. There being consider- 
 able viscidity already present in the emulsion we do not need much 
 syrup, so we assign to the Syrup of Ginger the odd half-ounce, leaving 
 two ounces of the Water to make up the total bulk of four fluid-ounces. 
 
 The prescription now only requires for its completion that the subscrip- 
 tion and signature be added. We proceed to admonish the dispenser by 
 telling him to mix the ingredients together, writing therefore the word 
 Misce or the abbreviation M commonly used therefor ; and to further 
 point out the nature of the preparation we add, Let be made an emulsion, 
 or in Latin, Fiat emulsum, — the passive verb taking as predicate-nomina- 
 tive the thing into which the making is to be. The final direction Label 
 or Write thus, is expressed by the term Signetur, Let it be entitled, fol- 
 lowed by the instructions for the patient or the person who is to admin- 
 ister the medicine, which should be in English though they may be 
 written in Latin. Our completed prescription will stand thus, — 
 
 For Miss Graham. June 10th, 1898. 
 
 R. Olei Kicini, j§j. 
 
 Vitellum, j. 
 
 Tere bene simul, dein adde — 
 
 Syrtipi Zingibei'is, . . . . , Jj ss » 
 
 Aquce Cinnamomi, 3 ij. 
 
 M. Fiat emulsum. 
 
 Sig. — " One-half at once, to be repeated next day if re- 
 quired.'''' Potter. 
 
 The last entry of the inscription might be written — Aquoz Cinnamomi, 
 quantum sufficiat ad %\w, meaning "of Cinnamon-Water as much as may 
 
PRESCRIPTIONS. 541 
 
 be necessary to [bring the whole quantity to] four ounces," usually 
 expressed in contracted style, thus — 
 
 Aq. Cinna?nomi, q. s. ad 5|iv. 
 
 This style is preferred when any of the quantities are approximations, 
 and the final item cannot be exactly stated to secure a certain total. In 
 the foregoing case, the one yolk-of-egg might measure a little more than 
 the half-ounce assigned to it ; but by using the q. s. ad style at the end, 
 we make sure of getting a total of exactly four fluid-ounces. 
 
 The 'Use of Latin in Prescriptions. 
 
 The use of the Latin language in writing prescriptions is a sore point 
 with a certain class of patients who like to know what they are taking, or 
 wish to exercise their critical judgment upon the prescription of a phy- 
 sician in whose learning, skill and judgment they professed to have con- 
 fidence when they consulted him. This feeling crops out frequently in 
 our State legislatures, where bills are periodically introduced making it a 
 crime for a physician to write a prescription in any other than the ver- 
 nacular language. It is well for the student to know the reasons for 
 maintaining the use of a dead language in the ordinary affairs of life. 
 These reasons are as follows : — 
 
 The names of plants vary in every modern language, and even in the 
 same language several different plants not infrequently receive the same 
 common name. For example, — the name " Starwort " is given to Aletris 
 farinosa and Helonias dioica ; ' ' Colic-root ' ' is one of the names of Aletris 
 farinosa, also of Dioscorea villosa and Liatris spicata ; " Mandrake " is 
 applied to Podophyllum and Mandr agora ; " Winter-green ' ' to Chimaphila 
 and Gaultheria; and " Snake-root " to five different plants, — As arum t 
 Cimicifuga, Eryngium, Senega and Serpentaria. There are many other 
 instances of this diverse nomenclature in English, and as each plant has 
 a different name in French, another in German, and still another in 
 Italian, Spanish, Dutch, etc., the confusion, in so polyglot a country 
 as this, would cause innumerable errors if any but a generally understood 
 language were used in prescriptions. Latin is such a language, it is the 
 accepted language of science throughout the world, the Latin names of 
 plants are definite and cannot be confounded, and a prescription written 
 in Latin by a physician of any nationality, in any part of the civilized 
 world, can be readily understood and correctly compounded by a phar- 
 macist in any other civilized country. 
 
 Another reason, formerly more potent than at present, is the protection 
 to the patient which the secrecy of a Latin prescription affords. A pre- 
 scription ordering mercury and potassium iodide in plain language would 
 be an awkward thing to send by one's child or servant to be put up, or 
 
542 PRESCRIPTIONS. 
 
 to have ordered by telephone to be sent to Mrs. C. B. of a certain number 
 and street. Again, there exists in many cases a strong prejudice against 
 certain names of drugs, usually borne of ignorance but none the less 
 potent, and in such it becomes necessary for the patient's good to con- 
 ceal from. him the name of the medicine he is taking. In this age of free 
 education in all branches and the consequent smattering of everything 
 possessed by almost everybody, the use of Latin does not afford the neces- 
 sary secrecy, and the physician who does not dispense his medicines is often 
 compelled to resort to private formulae deposited by him with a certain 
 druggist. In France it is a criminal offense to make known or expose 
 the contents or nature of a prescription to any person other than the 
 party for whom it was written, the law recognizing the fact that prescrip- 
 tions may betray secrets which should be carefully guarded. 
 
 Opium, Morphine, Cocaine, and other agents likely to cause drug- 
 habits, should never be ordered on written prescriptions for neurotic or 
 hysterical subjects. The physician should keep such drugs in his own 
 hands and thereby retain the absolute control of their administration in 
 every case in which he finds it necessary to use them. He should protect 
 his patient from such a result as drug-slavery by every means in his power. 
 Many of the worst cases of the cocaine-habit, known to the author, were 
 acquired by the use of cocaine in nasal sprays prescribed by physicians ; 
 and similar methods are responsible for many of the wrecks made by 
 indulgence in opium and morphine. 
 
 There is no royal road to prescription-writing ; practice, care and knowl- 
 edge of the whole subject are necessary to enable one to turn out habitu- 
 ally those elegant prescriptions which are properly termed "magistral," 
 being the work of a magister or master of his business. A fair knowledge 
 of the Latin language is a sine qua non to every professional man but 
 especially to the physician. It is pitiable to see a Doctor write ignorantly 
 of even the genitive-case endings of the drug-names which he uses. The 
 teaching of Latin is not within the scope of this work, and this part of 
 the subject will be concluded with the advice to the physician who is 
 ignorant of that language to write his prescriptions wholly in English if 
 he cannot write them in decent Latin. A very full table of the Latin 
 words, phrases and contractions used in prescription-writing, also a table 
 of genitive case endings, will be found in the Appendix ; but for a com- 
 plete treatment of the subject the reader should consult Pareira's Selecta 
 e Prizscriptis, in which every detail of prescription-writing is explained. 
 
 Principles of Combination. 
 The principles of combination are so well laid down by Dr. H. C. 
 Wood, that his words are appended verbatim, as follows: — 
 
 The art of combining medicines is not a difficult one ; but in practice 
 
PRESCRIPTIONS. 543 
 
 certain principles should not be lost sight of. Chief of these are, to pre- 
 scribe as few remedies as possible, and to use no powerful drug without a 
 very distinct idea of what it is intended to do. Whenever it is desired 
 to give a powerful remedy in increasing doses until its physiological effect 
 is produced, it should always be given by itself. Thus, it may be neces- 
 sary to give Arsenic so as to impress the system, at the same time that 
 Iron is indicated; but the two remedies should be given separately, so 
 that the dose of either can be increased or diminished independently of 
 the other. The principles of combination formulated below were long 
 ago enunciated by Dr. Paris, but are to-day as imperative as ever. 
 Medicines are combined — 
 
 First. To augment, correct, or modify the action of a medicine. 
 Thus, purgatives act much more kindly when a number of them are 
 united together. The chief reason of this probably is, that as different 
 remedies affect different portions of the gut, the whole intestine is best 
 reached by a union of the diverse substances. It may take an intense 
 irritation of the mucous membrane to purge as actively as does a mild 
 irritation of both the mucous membrane and the muscular coat. 
 
 There are powerful medicines which act similarly upon some parts of the organism 
 but dissimilarly upon other parts. By combining such remedies powerful effects can be 
 obtained at the points where the two lines of action cross each other, without influencing 
 to a great extent other portions of the system. Thus, Chloral produces sleep by its action 
 upon the brain, and also has a distinct influence upon the heart but none upon the intes- 
 tinal tract. Morphine acts upon the brain and does not influence the heart, but has a 
 powerful effect upon the intestinal tract. By combining Chloral and Morphine we get 
 an overwhelming conjoined influence upon the brain in producing sleep with the least 
 possible disturbance of the heart and of the intestinal tract. 
 
 Secondly. To obtain the joint action of two or more diverse remedies. 
 Thus, in a cough mixture Morphine may be included to quiet the cough, 
 whilst Ipecacuanha and Squill (in accordance with the first principle) are 
 added to affect the mucous membrane. The application of this principle 
 requires caution, or the practitioner will be led into that chief abomina- 
 tion — polypharmacy. It is worse than futile to attempt to prescribe for 
 every symptom. The underlying cause of the disorder or the understratum 
 of bodily condition must be sought out and prescribed for simply. 
 
 Thirdly. To obtain a special combination, which is really a new remedy, 
 or which experience has shown acts almost as a new remedy. Thus, when 
 to Iodide of Potassium in solution Corrosive Sublimate is added, a new 
 chemical compound is formed, which experience has shown to be of great 
 value in syphilitic diseases. Griffith's antihectic mixture is another in- 
 stance of the use of chemical changes, the Proto-carbonate of Iron being 
 formed out of the Sulphate of the metal and the Carbonate of Potassium. 
 In the famous Dover's powder no chemical change occurs, but the ordi- 
 nary action of Opium upon the skin is so enhanced that the combination 
 may be looked upon almost as a new remedy. 
 
544 PRESCRIPTIONS. 
 
 Fourthly. To afford a suitable form. Thus, Acacia is added to make 
 an emulsion or Confection of Rose to make a pill. In the choice of 
 excipients care should be exercised to select a substance free from medical 
 properties, having no chemical incompatibility with the medicinal agent, 
 and of suitable physical character. Bread crumbs often make a good 
 basis for pills, but with Nitrate of Silver they are chemically incompati- 
 ble, on account of the chlorides in them. 
 
 When writing a prescription, the utmost care should be taken to use such excipients 
 that the combination should not only be attractive to the eye, but also as little repulsive 
 to the palate as may be. Whenever possible, the pill-form should be employed with 
 bitter or disagreeable medicines. The pill may be readily coated with silver-foil ; tonic 
 pills may be coated with Iron by shaking or rolling them in Ferri Pulvis while soft and 
 sticky. Sugai"-coated pills and " compressed pills " are apt to get so hard and insoluble 
 that their use requires caution. In regard to mixtures, flavoring oils should be freely 
 used, and the power of Glycerin to conceal the disagreeable taste of many substances 
 should be remembered. (IVooa's Therapeutics, nth edition, page 68, et seq.) 
 
 Metric Prescriptions. 
 
 Metric prescriptions are written or compounded with sufficient accu- 
 racy by considering a Milligramme as equal to the -J-g-th of a Troy grain, 
 a Gra7?ime as equivalent to 15 Troy grains, and a Cubic Cejitimeter (fluid 
 gramme, millimeter) as equal to 15 minims or ^th of a flui drachm. All 
 other metric terms, units and prefixes may be wholly ignored by the phy- 
 sician and the pharmacist. In fact the terms centigram?ne and decigramme 
 are rarely used at all, the former being generally expressed by 10 milli- 
 grammes and the latter by 100 milligrammes. The term Gramme when 
 abbreviated is printed and written Gm., the term Milligramme, Mg., and 
 the term Cubic Centimeter, Cc. In expressing quantities by metric weight 
 or measure in writing the common or Arabic numerals are used, and are 
 always placed before the term or abbreviation designating the unit, thus — 
 2.50 gm., 30 cc. When apothecaries' weight is employed the numerals 
 are placed after the sign or symbol designating the unit, and in Roman 
 characters, thus — gr. x, 9ij, ^jss, gvj. The decimal point after the figure 
 representing the number of grammes or cubic centimeters should be 
 replaced by a line, in order to avoid such errors as might arise from the 
 misplacement of a point, the dropping of ink, or the intrusion of a fly- 
 speck, which might cause serious results in many cases. The simplest 
 rule for writing a prescription in metric terms by one who is not prac- 
 ticed in the use of the system, is the following, — 
 
 Write as though prescribing but one dose of each ingredient in grains or 
 minims and deci??ials thereof; then substitute the term "grammes" or 
 ' ' cubic centiineters ' ' for grains or minims, and the prescription is correct 
 for 15 doses in metric terms. 
 
 Of course, when writing for a mixture or solution, the proper quantity 
 
PRESCRIPTIONS. 545 
 
 of vehicle must be added to complete the one dose, and must also be 
 expressed first in grains or minims. For example, — 
 
 One dose. 15 doses metric. 
 
 &. Quininae Sulphatis, gr. j, I 
 
 Strychninae Sulph., gr. ^ T or 0.016, 
 
 Ext. Glycyrrhizae FL, TT\,iv, 4 
 
 Syrupi, ffU*, 60 
 
 This gives a two-ounce mixture approximately, of which the dose would be a tea- 
 spoonful. 
 
 One dose. 15 doses metric. 
 
 R . Quininae Sulphatis, gr. j 1 
 
 Massae Ferri Carb. , gr. ij, 2 
 
 Ext. Nucis Vomicae, gr. % or 0.25, 25 
 
 Ft. pil. no. xv. Sig. — One pill thrice daily after meals. 
 
 The above rule will answer for all liquids except those which are very 
 heavy, as Syrups and Chloroform, or very light, as Ether. Measures may 
 be entirely discarded, and all fluid quantities expressed in grammes. The 
 average drop of water may be considered equivalent to 0.05 cubic-centi- 
 meter (or gramme), the average teaspoonful to 5 cc, the tablespoonful 
 to 20 cc, the Troy § to 30 grammes, the fluidounce to 30 cc, and 8 
 fluidounces to 250 cc. 
 
 In prescribing Syrups or Chloroform, each Troy fluidounce should be 
 reckoned at something more than 30 grammes — say 40; and if this be 
 done, the difficulty of converting one scale into the other will be obviated. 
 As to Syrups, Chloroform, etc., the following table shows the actual 
 weight in grammes of each fluidounce of the substances named : — 
 
 Fluid oz. 
 
 3!: 
 
 311. = 
 
 J viii. = 
 
 A table of equivalents between Apothecaries' and Metric Weights and 
 Measures will be found in the Appendix. 
 
 Abbreviations. 
 Abbreviations, though very commonly used by physicians in prescrib- 
 ing, are a source of much annoyance to the compounder, and frequently- 
 one of great danger to the patient. Physicians who never knew anything 
 of the Latin grammar, or those who have forgotten its rules, are very apt 
 to use abbreviations to conceal their ignorance of case-endings. Many 
 others use them through sheer laziness and some from force of habit. The 
 educated and conscientious man will take pride in turning out a full and 
 clear prescription, free from cabalistic letters and all elements of uncer- 
 tainty. In the Appendix will be found a list of the Latin terms used in 
 35 
 
 Water. 
 (Grammes.) 
 
 Tinctures. 
 (Grammes) 
 
 Syrup. 
 
 (Grammes.) 
 
 Chloroform. 
 (Grammes.) 
 
 Ether. 
 (Grammes.) 
 
 29.52 
 
 5904 
 
 118.08 
 
 28.00 
 
 56.OO 
 
 II2.0O 
 
 38.OO 
 
 76.OO 
 
 152.OO 
 
 43-70 
 
 84.40 
 
 174.80 
 
 22.14 
 44.28 
 88.56 
 
 236.16 
 
 224.OO 
 
 304.OO 
 
 349 60 
 
 177.12 
 
546 
 
 PRESCRIPTIONS. 
 
 prescriptions, with the abbreviations in vogue and the English meanings. 
 Ambiguous contractions may result fatally to the patient, as is readily 
 seen by studying the following list, which gives a few examples of the 
 dangers of careless abbreviation : — 
 
 Acid. Hydroc. — may mean 
 
 Aconit. . . . 
 
 j Aconitine. 
 \ Aconitum. 
 
 
 j Ammonia. 
 
 \ Ammoniacum. 
 
 Amnion. . . 
 
 Aq. Chlor. . . 
 
 j Aqua Chlori. 
 
 \ Aqua Chloroformi. 
 
 Aq. Fontis. 
 
 j Might easily be read 
 \ Aqua Fortis. 
 
 
 f Chlorine. 
 
 Chlor. . . . 
 
 . 1 Chloral. 
 
 
 ( Chloroform. 
 
 
 f Calomel. 
 
 Hyd. Chlor. . 
 
 . < Corrosive Sublimate. 
 
 
 ( Hydrate of Chloral. 
 
 Acidum Hydrochloricum. 
 Acidum Hydrocyanicum. 
 
 f Hydrargyrum. 
 
 Hydr. 
 
 Sod. Sulph. 
 
 Stilph . 
 
 Zinci Phos. 
 
 Hydras. 
 Hydriodas. 
 Hydrochloras. 
 [ Hydrocyanas. 
 
 [Sodium Sulphate. 
 Sodium Sulphite. 
 Sodium Sulphide. 
 {Sulphur. 
 Sulphide. 
 Sulphate. 
 Sulphite, 
 f Zinc Phosphate. 
 ^ Zinc Phosphide. 
 
 Renewals of Prescriptions. 
 
 It would be advisable for physicians to always write the words Non 
 Repetatur, or some similar direction, on all prescriptions which should 
 not be repeated without their sanction. By so doing they would doubt- 
 less cut off a good many renewal charges from the receipts of druggists 
 who would fear the legal consequences of disobeying the mandate. This 
 inconvenience to the drug-seller would be more than compensated for in 
 the advantage resulting to the drug-taker, who too frequently carries in 
 his pocket-book a stock of receipts for his various complaints; and in 
 protection to the physician, who by giving up the dispensing of his own 
 medicines has placed it in the power of the druggist to connive at a direct 
 robbery of the just reward of professional skill and knowledge. 
 
 It is doubtless a fact familiar to every observer, that the old-time con- 
 fidential relations between the professions of physician and pharmacist 
 have almost passed into oblivion. In fact, the tendency of pharmacy 
 now-a-days is towards the position of a mere money-making trade, instead 
 of in the exalted direction of a profession. The indiscriminate renewing 
 of prescriptions, the open sale of quack nostrums and homeopathic pel- 
 lets, the readiness with which counter-prescribing is indulged in, the in- 
 sinuations too frequently made over the drug-counter in reflection on 
 physicians, and many other similar practices, have caused the non-com- 
 batant profession to regard the average druggist with suspicion. If phy- 
 sicians boldly took the dispensing of medicines more into their own hands 
 many of these evils would soon eliminate themselves from the drug-stores. 
 Right here it may be said that there is nothing unprofessional or deroga- 
 tory in the dispensing of his own medicines by the physician. In England 
 
PRESCRIPTIONS. 547 
 
 it has been the universal practice for centuries in all places except the 
 largest cities, and it has been given up by a part of the medical profession 
 only as a matter of convenience to themselves, not as a right belonging 
 to the pharmacist. The homeopaths fought for the reclamation of this 
 practice as a right belonging to the medical profession, and succeeded in 
 securing its legality, but not from a worthy motive. They dispense 
 their own medicines in order to cover up the many frauds of which they 
 are daily guilty, and to give them the power of administering full doses 
 of powerful drugs in a form which is apparently "homeopathic," with 
 no tell-tale prescription on file in a drug-store to give mute but danger- 
 ous evidence against their honesty. In this way they administer several 
 grains of calomel or eighth-grain doses of morphine, or correspondingly 
 large quantities of active alkaloids, triturated with sugar of milk, or dis- 
 solved as many of the latter may be in alcohol. Chemistry, by isolating 
 the active principles of plants, and furnishing them to commerce in the 
 form of soluble salts, has enabled the homeopath to practice this fraudu- 
 lent method of dispensing drugs, which the innocent and ignorant patient, 
 who believes in the power of the minimum dose, supposes to be infinites- 
 imal in amount. But the physician of the regular profession is too apt 
 to think that if he uses a practice which charlatans have appropriated to 
 themselves, he may be classed with them by his professional competitors. 
 Hence, many regular physicians are absolutely afraid to use such drugs as 
 Aconite, Belladonna, Gelsemium, Arnica, Rhus, etc., all of which are 
 official, and most of which are older in medicine than homeopathy; and 
 avoid pocket-cases, drachm-vials and triturations, as badges of charlatan- 
 ism. It is high time that we asserted our independence in all these mat- 
 ters, and made use freely of those means which} are recommended by our 
 individual judgments as promotive of the best results to our patients and 
 to ourselves. With a small stock of reliable fluid extracts, and an equally 
 moderate supply of gelatin-coated pills and compressed tablet-triturates 
 from the best houses, physicians could check-mate the unscrupulous prac- 
 tices of many druggists to a great extent, save their patients many dol- 
 lars, and retain many a dollar for their own pockets which under the 
 present system goes to their enemies. The homeopaths understand the 
 money part of the argument well. When their patients' medicine is 
 exhausted, the doctor must be seen for a fresh supply, meaning of course 
 another consultation about symptoms, a change perhaps from Mercurius 
 Dulcis to Mercurius Vivus, and another fee. The expense is nothing, 
 sugar of milk being cheap, and there is no prescription in the patient's 
 pocket-book, to be renewed scores of times (paying toll however every 
 time to the druggist), and finally to be copied by aunts, mothers, and 
 friends, as a " sovereign remedy " for a cough, or a "really wonderful 
 receipt " for a case of croup. 
 
54-8 incompatibility. 
 
 Prescription Blanks. 
 
 After many years' experience in prescribing on blanks furnished by 
 druggists, the writer has come to the conclusion that it is much better, 
 for many reasons, for the physician to have his own blanks, without the 
 address of any drug-store thereon. These blanks should be furnished 
 with stubs on which to write the prescription at first in rough, afterwards 
 copying it out cleanly on the main blank. A careful prescriber always 
 writes a formula twice before letting it go out of his hands. If he does 
 the first writing on the stub of a book of blanks he will always have a 
 copy of the prescription in his possession, for which he may afterwards 
 be thankful. The blank used by the writer measures 4^ inches by 3^, 
 joined by a perforated edge to a stub 3^ inches by 2^ inches. On the 
 main blank the physician's name and address are printed, together with 
 his office-hours, and a place for number and date, also the sign R., and 
 a line for signature. On the stub there are printed the words, " Copy of 
 Prescription No For " 
 
 These blanks are bound up in books of 100 each, with a flexible morocco 
 cover, from which the book of stubs may be slipped and a fresh book 
 inserted as required. The size is ample for all ordinary requirements, 
 and permits of the book being carried in the breast-pocket. 
 
 INCOMPATIBILITY. 
 
 Incompatibility may be Chemical, Pharmaceutical or Therapeutical, 
 according as the prescribed combination results in chemical decomposi- 
 tion, physical disassociation or antagonistic action. In the first case the 
 incompatibility may be unintentional or intentional on the part of the 
 prescriber, for in many cases the result of the chemical action affords the 
 substance desired. 
 
 Instances of intentional incompatibility are the mixtures of Calomel or Corrosive Sub- 
 limate with Limewater, producing the Black and Yellow Oxides of Mercury respectively 
 and commonly known as Black Wash and Yellow Wash. Such a combination should 
 not be filtered (as a novice might suppose), but should be dispensed with a Shake-label, 
 in order that the precipitate may be uniformly distributed before using. 
 
 Chemical Incompatibility generally results from neglect on the part 
 of the prescriber of the most common chemical reactions, such as that — 
 
 1. Acids tend to combine with bases and to form salts. 
 
 2. Weak acids or bases are displaced from their combinations by 
 
INCOMPATIBILITY. 549 
 
 stronger ones, so that salts in solution when brought together generally 
 exchange their radicles, especially if by doing so an insoluble compound 
 can be formed. 
 
 3. A salt in solution is easily decomposed by a strong alkali if the salt 
 is one having a weak or volatile base. 
 
 4. A substance in solution may be decomposed by another without 
 precipitation, the product being soluble in the solution. 
 
 5. Alkaloidal salts are precipitated from their solutions by the addition 
 of fixed alkalies, their salts, or salts which produce insoluble compounds. 
 Oxides of the fixed alkalies decompose salts of the metals proper and 
 those of the alkaloids, precipitating their bases ; but the base may be 
 soluble in an excess of the alkali. 
 
 6. Tannic and Gallic Acids and vegetable substances containing them 
 precipitate albumin, alkaloids and most of the metallic oxides, and form 
 inky solutions when brought into contact with the persalts of Iron. 
 Tannic Acid precipitates gelatin. 
 
 7. Glucosides are incompatible with free Acids or Emulsin. 
 
 Examples of the neglect of these principles are seen in the prescribing of Quinine Sul- 
 phate in mixture with Potassium Acetate, resulting in a voluminous precipitate of Quinine 
 Acetate which cannot be poured from the bottle ; — Vinegars or Syrups containing Acetic 
 Acid (Syr. Allii, Syr. Scillse) added to a solution of alkaline carbonates, causing decom- 
 position of the latter with evolution of C0 2 ; — the addition of Liquor Potassae to a solu- 
 tion of Ammonia-alum, setting free gaseous ammonia ; the mixing of Strychnine Sul- 
 phate and Potassium Bromide in solution, causing the decomposition of the alkaloid sul- 
 phate and precipitation of strychnine ; — prepaiations of Cinchona with salts of Iron, 
 forming an inky tannate of iron ; — Elixir of Chloral with Alkalies, causing the elimination 
 of chloroform and its subsequent evaporation. 
 
 Insoluble Salts. — The following more or less Insoluble Salts will be 
 formed whenever the materials of which they are composed are brought 
 together in solutions: — the Hydrates, Carbonates, Phosphates, Borates, 
 Arsenates and Tannates of most earthy and heavy metals and alkaloids, 
 and the metallic Sulphides; the Sulphates of Calcium and of Lead, and 
 the subsalts of Mercury ; the Chlorides, Iodides, and Bromides of Bis- 
 muth, Silver, Lead, and subsalts of Mercury; the Iodides of Quinine, of 
 Morphine, and of most alkaloids. 
 
 Instances are — Limewater or Aromatic Spirit of Ammonia with Tincture of Chloride 
 of Iron, or solutions of Mercury salts, or neutral solutions of Quinine or Morphine salts. 
 
 Ammonium, Potassium, and Sodium Carbonates or Bicarbonates with Limewater. 
 
 Solutions of Magnesium Sulphate, Alum, Zinc Acetate or Sulphate, with solutions of 
 salts of Iron, Manganese, Bismuth, Antimony, Lead, and most alkaloids. 
 
 Ammonium or Sodium Phosphates with solutions of Iron Salts, with Limewater, solu- 
 tion of Magnesium Sulphate, of Alum, etc. 
 
 Liquor Potassii Arsenitis with Limewater, with solutions of basic salts of Iron, and with 
 solutions of neutral salts of Quinine and Morphine, etc. 
 
 Solutions, Decoctions, Tinctures, and Extracts containing Tannic Acid with solutions 
 of salts of Iron, Mercury, Antimony, Lead, also with solutions containing albuminous 
 substances and Gelatin. 
 
55o 
 
 INCOMPATIBILITY. 
 
 Limewater with solutions of Quinine or Morphine Sulphates. 
 
 Solutions of Lead Acetate with Zinc Sulphate or Alum. 
 
 Sodium Chloride with Silver Nitrate. 
 
 Morphine Hydrochlorate with Lead Acetate. 
 
 Alkaline Iodides or Bromides with Bismuth Carbonate or Subnitrate, with Lead Ace- 
 tate, with Subchloride of Mercury, or with neutral solutions of Quinine, Morphine and 
 Strychnine salts. 
 
 Table of Precipitant Solutions. 
 The following table shows the most important instances of solutions which mutually 
 precipitate each other, the letter P meaning " forms a precipitate with ' ' — 
 
 Solutions of— 
 
 _o 
 "o — 
 
 ._ <u 
 O bC 
 
 < 
 
 c 
 
 CO ni 
 a c 
 
 5 be 
 
 <y 
 _) 
 
 O </i 
 
 J (A 
 
 3 
 O 
 
 CO 
 
 u 
 > 
 CO 
 
 "S3 
 
 wis 
 jo, 
 
 ts 
 "0 
 
 co 
 
 S 
 
 u . 
 
 <2lo 
 _S 
 
 "o 
 to 
 
 0) 
 
 So 
 
 cd • 
 £2 
 „_, rt 
 
 oco 
 
 * 
 
 CO 
 
 s 
 
 
 .0 
 
 < 
 
 c 
 .0 
 
 *o 
 
 c 
 
 rt 
 
 13 
 O 
 
 "o 
 
 w 
 
 3 
 
 "3 
 to 
 
 
 P 
 P 
 P 
 
 p 
 p 
 p 
 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 P 
 
 P 
 
 P 
 
 
 
 
 P 
 
 P 
 
 Carbonic Acid and Carbonates, 
 
 P 
 P 
 P 
 
 P 
 
 
 
 Phosphoric Acid and Phosphates, .... 
 
 P 
 P 
 
 p 
 p 
 
 P 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Hydriodic Acid and Iodides, 
 
 Sulphides, 
 
 P 
 
 ' p ' 
 p 
 p 
 
 
 
 
 
 
 
 
 
 
 
 Albumin, 
 
 
 
 
 
 
 
 
 
 
 
 
 Explosive Compounds result from the admixture of powerful oxid- 
 izing agents with substances which are readily oxidizable. The most 
 important members of these two classes are as follows : — 
 
 Oxidizers. 
 Chlorine and its Oxides. 
 Free Hydrochloric Acid. 
 Nitro-hydrochloric Acid. 
 Chlorates. Hypochlorites. 
 Chromates. Chromic Acid. 
 Permanganates. 
 Nitric Acid. Nitrates. 
 Bromine. Bromates. 
 Iodine. Iodates. 
 Silver Oxide. 
 Peroxides (Dioxides). 
 
 Oxidizable or Combustible. 
 Phosphorus. Hypophosphites. 
 Sulphur. Sulphides. 
 Glycerin. Sugar. Alcohols. 
 Oils. Ethers. Tannin. 
 Cork. CharcoaL Creosote. 
 Dry Organic Substances. 
 Powdered Iron and Zinc. 
 Arsenous Acid. 
 Cyanides. 
 Oxalates. 
 Ferrous, Mercurous and Stannous salts. 
 
 Explosions have resulted from mixing Fluid Extract of Uva Ursi with certain sam- 
 ples of Spirit of Nitre, Chromic Acid with Glycerin, Potassium Permanganate with 
 Glycerin, Nitric Acid with Glycerin, Silver Nitrate with Creosote, Silver Oxide in pill 
 with Extract of Gentian, Potassium Chlorate with Glycerin and Tincture of Ferric Chlo- 
 ride. Calcium Chloride triturated with Sulphur in a mortar has exploded, so also has 
 Calcium or Sodium Hypophosphite when triturated alone. Tincture of Iodine with 
 Ammonia forms the Iodide of Nitrogen, which is highly explosive, especially if triturated 
 in the presence of water. Catechu and Potassium Chlorate in a dentifrice have exploded 
 in the mouth from the friction produced by a dry tooth-brush. Lozenges of Potassium 
 Chlorate, carried in the pocket with a box of safety matches, have exploded by rubbing 
 on the composition on the outside of the box, causing an extensive burn of the thigh. 
 
INCOMPATIBILITY. 5 5 I 
 
 Hydrogen Peroxide (Dioxide) is peculiar in that it acts both as an oxidizer and as an 
 oxidizable agent. It reduces oxidizing agents and is itself reduced at the same time, 
 hence it is incompatible with all the substances mentioned above. Nitrites may act in 
 the same way under favorable circumstances. 
 
 Poisonous Compounds may be formed by the admixture of many 
 substances in solution, such as — 
 
 Potassium Chlorate with Potassium Iodide, in solution together do not 
 react at ordinary temperatures, but in the system they evolve a poisonous 
 agent, probably Potassium Iodate. 
 
 Potassium Chlorate with Syrup of Ferrous Iodide, liberates Iodine from 
 the Iodide in the warm stomach, causing severe gastric irritation, perhaps 
 gastritis of dangerous degree. 
 
 Dilute Hydrocyanic Acid or Potassium Cyanide with Calomel, forms 
 the Bichloride and Bicyanide of Mercury, both virulent poisons; — with 
 metallic hydrates, carbonates, sub-nitrates or sub-chlorides, cyanides of 
 the metals are formed which are even more poisonous than the acid itself 
 in its usual diluted form. 
 
 Pharmaceutical Incompatibility differs from chemical incompati- 
 bility in the absence of chemical action, and is generally produced by 
 adding one substance to another which, through differences in solubility, 
 causes a precipitation of solid matter or a separation of part of the liquid. 
 The separated constituents may be active and hence important, or inert 
 and therefore unimportant. 
 
 Instances of this are — the addition of an acid to a Quinine and Liquorice mixture, 
 resulting in precipitation of the Glycyrrhizin (relied on to cover the taste of the Quinine) 
 by the acid ; or the use of Quinine, Tincture of Ferric Chloride and Liquorice together ; 
 — or the prescribing of solutions of Chloral and Potassium Bromide with an alcoholic 
 preparation, the Chloral separating to the top as an alcoholate, and therefore dangerously 
 in excess for the first few doses ; — or the neglect to prescribe Acacia or some other emul- 
 sifier in mixtures of an alcoholic fluid extract of a resinous body with an aqueous prepara- 
 tion, which would result in the separation of the resin to the surface and an overdose 
 with the first teaspoonful. 
 
 When a fluid extract is diluted with a liquid differing in composition 
 from those used in the fluid extracts, the gum, albumin, resin and mucil- 
 age are often separated. In such a case as Fluid Extract of Cannabis 
 Indica the active resin would be thrown out of its alcoholic solution and 
 floating on top might cause serious symptoms ; but in many other in- 
 stances the precipitate would be inert and filtration would be in order. 
 Water is the solvent for albuminous, gelatinous, gummy and saccharine 
 bodies and for a large number of inorganic salts; while Alcohol is the 
 solvent for volatile oils and resins, gum-resins, resinoids, balsams and all 
 drugs containing these as their active principles. The solvent power of 
 either Alcohol or Water for their particular substances decreases in pro- 
 portion to the amount of the other added. 
 
552 INCOMPATIBILITY. 
 
 Instances of Pharmaceutical Incompatibility. 
 
 Resinous Tinctures or Fluid Extracts with aqueous solutions. 
 Tincture of Guaiac with Spirit of Nitrous Ether. 
 Compound Infusion of Gentian with Infusion of Wild Cherry. 
 Compound Infusion of Cinchona with Compound Infusion of Gentian. 
 Essential Oils with aqueous liquids in quantities exceeding I drop to % j. 
 Fixed Oils and Copaiba with aqueous liquids (except excipients). 
 Tinctures made with Alcohol with those made with Diluted Alcohol. 
 Alcoholic Tinctures and Fluid Extracts with aqueous preparations. 
 Spirit of Nitrous Ether, with strong mucilages. 
 Infusions generally with metallic salts. 
 
 Therapeutical Incompatibility arises when two agents are admin- 
 istered together which oppose each other in their action on the human 
 system, — as for instance Belladonna in any form with Physostigma. But 
 in many cases physiological antagonists are designedly prescribed together, 
 one as a guard against the action of the other, as in the hypodermic 
 administration of Morphine guarded by Atropine. The antagonists to 
 each of the active medicinal agents may be found in the section on 
 Materia Medica under their various titles, and also in Part III, under the 
 title Poisoning. They are summarized in the table, of antagonistic 
 poisons on page 35. 
 
 The Dangers of Incompatibility may in great measure be avoided 
 by the use of the utmost simplicity in prescribing. The subject can only 
 be glanced at within these pages, but the following simple rules may help 
 the burdened memory of the student and the practitioner. 
 
 Never use more than one remedy at a time, if one will serve the purpose 
 for which you are prescribing. 
 
 Never use Strong Mineral Acids with other agents, unless you know 
 exactly what reaction will ensue. They decompose salts of the weaker 
 acids, and form ethers when combined with alcohol. Never combine 
 Free Acids with hydrates or carbonates. 
 
 Select the simplest solvent, diluent or excipient you know of, remem- 
 bering that the solvent power of alcohol and of water for their respective 
 substances decreases in proportion to the quantity of the other added. 
 
 Generally do not combine two or more soluble salts ; for such salts in 
 solution, when brought together, usually exchange their radicles thereby 
 forming an insoluble compound. [See ante, page 549.] 
 
 Never prescribe a drug with any of its Tests or Antidotes. 
 
 Never prescribe a Glucoside (as Santonin, Colocynthin, etc.) in com- 
 bination with Free Acids or with a substance containing Emulsin, as these 
 agents will decompose it. 
 
 Aconite should be ordered in water alone, Corrosive Mercuric Chloride 
 by itself in water or in simple syrup. The latter drug is incompatible 
 with almost everything, even the Compound Syrup of Sarsaparilla being 
 said to decompose it. 
 
INCOMPATIBILITY. 553 
 
 Potassium Iodide decomposes most of the metallic salts, and is one of 
 the drugs which are best administered alone. 
 
 The following-named substances are incompatible with so many others 
 that it is best to always prescribe them alone ; they are best given in 
 simple solution : — 
 
 Alum. Morphine Acetate. 
 
 Dilute Hydrocyanic Acid. Morphine Hydrochlorate. 
 
 Dilute Nitro-hydrochloric Acid. Quinine Sulphate. 
 
 Sulphuric Acid. Liquor Calcis. 
 
 Mercuric Chloride (Corr. Sub.). Liquor Potassae. 
 
 Iodine and Iodides. Liquor Potassii Arsenitis. 
 
 Syrup of Ferrous Iodide. Liquor Ferri Nitratis. 
 
 Potassium Permanganate. Tinct. Ferri Chloridi. 
 
 Potassium Acetate. Zinc Acetate. 
 
 Potassium Bromide. Iron and Quinine Citrate. 
 
 Tartar Emetic. • Free Chlorine in solution. 
 
 Tincture of Guaiac. Tannic and Gallic Acids. 
 
 Silver Nitrate and Lead Acetate and Subacetate, though incompatible 
 with almost everything, may be combined with Opium, the latter forming 
 therewith a compound which though insoluble is therapeutically active as 
 an astringent and anodyne lotion. Silver Nitrate with Creosote forms an 
 explosive compound. 
 
 Tannic and Gallic Acids, and substances containing them (as the 
 astringent bitters), precipitate albumin, alkaloids and most soluble 
 metallic salts. They may be prescribed with the proto-salts of Iron, 
 but not with its per-salts. Calumba is the best vegetable tonic to use 
 with ferric salts, as it contains neither tannic nor gallic acid. Tannic 
 Acid precipitates gelatin. 
 
 Iodine and the soluble Iodides are incompatible with the alkaloids and 
 substances containing them, also with most metallic salts. 
 
 Alkalies neutralize free acids, and precipitate the alkaloids and the 
 soluble non-alkaline metallic salts. Oxides of the Alkalies decompose 
 salts of the metals proper and salts of the alkaloids, precipitating their 
 bases; but the base may be soluble in an excess of the alkali. 
 
 Resinous Tinctures or Fluid Extracts, {e. g., Tinct. Cannabis Indicae), 
 when combined with aqueous solutions should always have Acacia or 
 some other emulsifying agent added, to prevent the separation of the 
 resin, which otherwise will be deposited on the sides of the bottle or will 
 float on top of the mixture. 
 
 Ti?icture of Digitalis should not be mixed with aqueous or syrupy solu- 
 tions, for in such cases precipitation or decomposition of the active 
 principles may occur. This tincture is injured by admixture and is best 
 administered on sugar or dropped on a piece of bread. 
 
554 EXTEMPORANEOUS PHARMACY. 
 
 EXTEMPORANEOUS PHARMACY. 
 
 This is the most important division of the whole subject of Pharmacy, 
 embracing as it does the preparation and dispensing of those medicines 
 which are designed for immediate use and are compounded on the pre- 
 scriptions of physicians. Hence it comprises the chief portion of the 
 daily work of the pharmacist, and can be learned only at the dispensing 
 counter under the personal supervision of a competent master. In the 
 following pages are given the most important of the general directions 
 pertaining to this subject, with the object so far as the limits of the book 
 will admit of enabling the young medical practitioner to familiarize him- 
 self with the compounding and dispensing of drugs. The drug-store of 
 the present day has degenerated so much from its legitimate business that 
 ere long physicians will be compelled in self-defense to dispense their 
 own medicines, thereby protecting themselves and their patients from the 
 patent-medicine vending, the counter-prescribing, and the many other 
 nefarious methods which have degraded the pharmacist from his old pro- 
 fessional position to that of a mere trader in drugs and nostrums. The 
 first outfit of every young doctor should include a few pharmaceutical in- 
 struments and a small stock of drugs. By the daily handling of these, 
 the tools of his profession, he will insensibly become familiar with the 
 technique of the art, and even if he does not continue to dispense his 
 medicines in after years he will never regret possessing the practical 
 knowledge which such a course will give him. 
 
 Compounding means the mixing or preparing of the drugs ordered 
 in a prescription, and comprises all the operations of official pharmacy 
 together with many other manipulations which will be described in their 
 appropriate places. 
 
 Dispensing is the operation of putting up and issuing the drugs or- 
 dered in a prescription, and may apply to the already compounded prepa- 
 rations of official pharmacy as well as to those prepared extemporaneously. 
 
 Filling a Prescription means a combination of operations which 
 requires great care, undivided attention, and a special practical appren- 
 ticeship at the dispensing desk. In the following discussion of extem- 
 poraneous preparations such hints are incorporated as are particularly 
 applicable to the compounding of each article under consideration ; and 
 they may be prefaced by a few general suggestions which will serve to 
 point out the most approved method of dealing with this important part 
 of the druggist's work. 
 
EXTEMPORANEOUS PHARMACY. 555 
 
 The prescription should first be slowly read over in a critical spirit, but 
 no word or action of unfavorable criticism should reach the ears or eyes 
 of the messenger. To shrug the shoulders when scanning the items, to 
 laugh or even smile at the phraseology, to question the person offering it 
 as to whom it is for, or what complaint it is given for, are instances of 
 such flagrant treason to the prescriber as would justify the most complete 
 professional ostracism of the offender. The compounder has no business 
 whatever with the propriety of the prescription for its purpose. It might 
 have been given as a placebo for reasons eminently wise and judicious; or 
 if not so constituted it has at least been ordered by one who is in posses- 
 sion of facts about which the druggist knows nothing, even if by educa- 
 tion and experience the latter were competent to judge in the matter, 
 which he seldom is. His criticism should be directed only to the dosage 
 and the pharmaceutical compatibility of the ingredients. Even in the lat- 
 ter case he must remember that incompatibles are often prescribed with the 
 view of forming another agent from the chemical reaction produced. If 
 he thinks that there is any mistake, or that the quantities ordered are in 
 any degree poisonous, it is his duty to make an excuse for delay to the 
 messenger and at once communicate with the physician. This course, in 
 these days of telephones, is nearly always practicable. 
 
 After reading the prescription, it is well to first number it and then 
 write the label. This gives time for the label to dry, and avoids the use of 
 blotting paper, which often mars the writing and renders the directions 
 all but illegible. 
 
 A clearly denned method should next be decided on by which to com- 
 pound the prescription. Directions for such plans of procedure will be 
 found in the succeeding pages under the titles of the various preparations. 
 Next, the ingredients should be carefully weighed or measured out, each 
 one being checked off so as to avoid the danger of its being duplicated. 
 In many cases the excipient is not specified, its choice being left to the 
 druggist ; but in all such a note should be made on the prescription to 
 show the article used, in order that in the event of a renewal being ordered 
 there may be no difference perceptible. No alteration or addition should 
 be made which would in any degree affect the medicinal action of the 
 prescription or interfere with the intention of the prescriber. 
 
 The labelling of the package and the numbering and filing of the pre- 
 scription are matters of mechanical detail which are best learned at the 
 counter. Various devices for simplifying these operations are in vogue 
 and may be seen in any well-appointed drug-store. Poisonous articles 
 sold by druggists should always be labelled Poison, and the transaction 
 entered in a book usually required by law to be kept for that purpose; 
 but in the case of prescriptions the word "Poison " should not appear on 
 the package or label unless so directed by the prescriber. 
 
556 OFFICIAL PHARMACY. 
 
 Stock Solutions of the salts most frequently prescribed are kept in 
 many establishments for convenience in dispensing. Those most gener- 
 ally used are the following : — 
 
 Alum, — oiJ ss m a q uart °f distilled water. Of this solution each fiuidounce repre- 
 sents 3 ss of the salt. 
 
 Potassium Bicarbonate, — ^j in f^iv of distilled water ; of which 3 ss contains 
 3J of the salt. 
 
 Potassium Chlorate, — 1 in 24 of distilled water, will not crystallize as the tempera- 
 ture changes. 
 
 Potassium Bromide, — 1 in 3 of distilled water, makes a very convenient solution 
 for dispensing purposes. 
 
 Chloral Hydrate, — 1 in 1 of distilled water, of which each minim contains one grain 
 of Chloral Hydrate ; or I in 6 of distilled water, of which each 3 contains 10 grains. 
 
 Morphine Sulphate, — gr. xvj in 3J of distilled water, with a grain of Salicylic Acid 
 or 3 drops of Carbolic Acid to prevent change. Of this solution, known as Magendie' s, 
 each minim contains gr. 3L of the salt, and tt\x contain gr. y^. A safer solution, as it 
 requires less mental calculation, is one of one-half the above strength, viz. — gr. viij in 
 3J, of which each fluid-drachm contains gr. j of Morphine Sulphate. 
 
 Carbolic Acid, — ^j in f^iv of glycerin, makes a convenient solution which will 
 mix with water in all proportions. TT\,ivss represent gr. j of Carbolic Acid. 
 
 Tannic Acid, — 3J in f ^iv of glycerin, dissolved by the aid of a gentle heat. TTijvss 
 represent gr. j of Tannic Acid. 
 
 Rules for the Pharmaceutical Student. The following rules are 
 quoted from the Chemist' s and Druggist's Diary, and are well worth re- 
 membering by the student : — 
 
 Read through a prescription, rapidly and in a manner suggesting no suspicion or doubt. 
 
 Write directions invariably before dispensing. Avoid thus the use of blotting paper ; 
 a good dispenser uses almost none. 
 
 If a mixture contains readily soluble ingredients, never use a mortar. 
 
 Avoid effecting solution by heat, for fear of recrystallization. 
 
 With syrups and also ingredients not water, arrange in dispensing to rinse out the 
 measure and leave it clean ; a skilled dispenser shows very little traces of his work. 
 
 Carefully clean and put away weights and scales after each operation. 
 
 Hold the scales firmly by the left hand, never lift them high above the counter, and 
 judge of the weight as much by the indicator as by the position of the scale. 
 
 Select glass pans for scales, preferably of heavy make, and discard flimsy brass 
 material, which corrodes speedily and becomes inaccurate. 
 
 Learn to judge of the quantity to be weighed with tolerable accuracy ; train the eye 
 as well as the hand. 
 
 If in doubt, always begin with that about which you have no doubt. 
 
 Be rapid in manipulation. Finish wrapping, tying, or sealing quickly. Slow dispens- 
 ing is bad dispensing, and arises either from deficient practice or want of knowledge. 
 
 Never, when in a shadow of doubt, hesitate to ask advice from a fear of compromising 
 your own dignity. 
 
 OFFICIAL PHARMACY. 
 
 Official Operations are those processes which are directed in the 
 pharmacopoeia to be used in the preparation of medicines. Many of them 
 are processes which are common to both chemistry and pharmacy, as 
 precipitation and crystallization, — while others are peculiar to pharmacy, 
 
PHARMACEUTICAL OPERATIONS. 557 
 
 as percolation, trituration, etc. The most important of the pharmaceuti- 
 cal operations are briefly described below; for full details of the various 
 apparatus used the student is referred to the more exhaustive treatises on 
 Pharmacy. 
 
 PHARMACEUTICAL OPERATIONS. 
 Carbonization is the heating of organic substances without exposure 
 to the air until the volatile constituents are driven off, and the residue 
 assumes the characteristic appearance of carbon. 
 
 Clarification is the separation from liquids of solid matter which 
 prevents their being transparent, without using filters or strainers. It may 
 be effected by heat (as in the case of Mel Despumatum), by adding a 
 lighter liquid, by adding albumin, gelatin, milk, or paper-pulp, by fer- 
 mentation, or by the subsidence of the particles in the form of a sediment 
 through long standing. 
 
 Colation or Straining is usually a very simple operation, so familiar 
 to every one of ordinary experience as to be scarcely worth describing. 
 The strainers are made of cotton flannel, fine muslin, gauze, woolen felt 
 and other fabrics. 
 
 Comminution is the process by which the aggregation of the particles 
 of a solid body is overcome, and the body is reduced to pieces of varying 
 sizes. Its object is to increase the area of the surface exposed to the 
 action of solvents, and it includes the operations of cutting, rasping, 
 grating, crushing, stamping, grinding, pulverizing, triturating, levigating, 
 elutriating, granulating, etc. Apparatus of various kinds, as cutters, 
 mortars and pestles, mills, etc., are used for the comminution, while 
 spatulas are employed to loosen the particles, and sieves to sift the coarser 
 from the finer. These last-named contrivances are of five sizes, desig- 
 nated by the number of their meshes to the inch, 80, 60, 50, 40, and 
 20, respectively permitting the passage of powders termed very fine, fine, 
 moderately fine, moderately coarse and coarse. 
 
 Crystallization is the process which bodies undergo in passing from 
 the liquid or the gaseous state to the geometrical forms called crystals. 
 Six systems of crystals are recognized by crystallography, which has 
 assumed the dignity of a separate science. Bodies which are not capable 
 of crystallization are termed a??iorphous. Every crystallizable body 
 assumes its own peculiar form, or some other form derived from or re- 
 lated to it. The process of crystallization is effected (1) by fusion and 
 partial cooling, as in the cases of some metals and Sulphur ; (2) by sub- 
 limation, as Benzoic Acid, Mercuric Chloride, etc. ; (3) by deposition 
 from hot saturated solutions while cooling; (4) by deposition from a 
 
55§ PHARMACEUTICAL OPERATIONS. 
 
 solution during evaporation ; (5) by deposition caused by passing a gal- 
 vanic current through the solution; (6) by precipitation as in the case 
 of Mercuric Iodide; (7) by the addition to the solution of a substance 
 having a strong affinity for water, as the adding of Calcium Chloride to 
 an aqueous solution of Sodium Chloride, or Alcohol to a solution of 
 Potassium Nitrate or to an aqueous syrup. In a few cases amorphous 
 solids may crystallize without undergoing liquefaction, as Sulphur, Barley- 
 sugar and Iron wire. The methods most frequently employed are those 
 by deposition from supersaturated solutions, and by deposition during 
 evaporation. The more slowly the process is carried on the larger and 
 more regular will be the crystals. The process is facilitated by use of 
 foreign bodies as nuclei around which the crystals are deposited ; a familiar 
 instance being the thread in the centre of a mass of rock-candy. 
 
 The Water of Crystallization is the H 2 with which most substances combine in 
 the act of crystallization, and the number of molecules thereof differs for each body and 
 for the same body frequently under different conditions. Exsiccation is the removal of 
 this combined water by heat, the crystals assuming thereby the form of a dry powder. 
 Efflorescence is a similar process occurring spontaneously on exposure of the crystals to 
 the air, the effloresced portion appearing as a dry powder on the surface of the crystals. 
 Deliquescence, on the other hand, is the act of absorbing water from the atmosphere, a 
 property possessed by some substances which are therefore said to be hygroscopic. 
 
 Decantation is the pouring or drawing off a supernatant liquid into 
 another vessel. If done by pouring, a guiding-rod for the liquid to run 
 on is an effective adjuvant ; if by drawing, the siphon in some form is 
 usually employed. 
 
 Decoloration, or the removal of coloring-matter from liquids or from 
 solids in solution, is effected by the use of animal charcoal, which in small 
 operations may be arranged in a funnel or a percolator, and the liquid 
 placed thereon. It should not be forgotten that charcoal absorbs many 
 other principles besides coloring-matter, especially alkaloids, bitters and 
 astringents, so that the process of decoloration may be one of serious 
 injury to the efficiency of the preparation. 
 
 Deflagration is the heating of an inorganic substance with another 
 which yields oxygen (usually a nitrate or a chlorate), the result being 
 the decomposition of the body with violent and sudden combustion. 
 
 Desiccation is the process of removing moisture from solids, and has 
 for its object either the preservation of the substance, the reduction of 
 its bulk or the facilitation of its comminution. The operation should be 
 conducted at as low a temperature as possible. Roots, leaves and seeds 
 are generally dried by being placed in trays of wire network and exposed 
 to a uniform temperature in a room heated by steam. A better method 
 is to suspend organic substances from the ceiling of an attic during warm 
 
PHARMACEUTICAL OPERATIONS. 559 
 
 weather; a slow process, but one which does not result in much loss of 
 the active volatile principles. Crystals and precipitates require a higher 
 temperature and are usually dried on a water-bath. When the water of 
 crystallization is to be expelled, as in desiccating Alum and Ferrous Sul- 
 phate, a temperature of about 400 F. is required. In absorbing water 
 from alcohol Potassium Carbonate and slaked Lime heated are employed, 
 and in several instances Sulphuric Acid is the desiccator used. 
 
 Dialysis is a process by which crystallizable substances are separated 
 from non -crystallizable ones, by suspending a solution containing both 
 upon a porous diaphragm having its under surface in contact with water. 
 The crystalloids pass through the diaphragm, while the non-crystalline 
 remain above it, and are termed colloids. Examples of the latter class 
 are gelatin, gum, glue, starch, dextrin, albumin and extractive matters, 
 which are generally the inert and valueless constituents of vegetable 
 drugs. Parchment-paper and bladders are used for the diaphragm ; the 
 whole apparatus being termed the dialyzer, while the water into which the 
 crystalloids pass is called the diffusate. 
 
 The unofficial preparation known as Dialyzed Iron [Ferrum Dialysatuni) is a colloidal 
 substance obtained by treating Ferric Chloride in solution with Ammonia, whereby Ferric 
 Hydrate is precipitated and then dissolved by agitation. The mixture being placed on a 
 dialyzer, the crystalloids formed (Ammonium Chloride and Ferric Chloride), together 
 with any free acid present, pass into the diffusate, leaving the neutral colloidal liquid 
 (solution of Ferric Oxychloride) above on the septum. 
 
 Distillation consists of two processes, (i) the evaporation of a liquid, 
 (2) the condensation of the vapor into a liquid in a separate vessel. The 
 agent used in the first part of the operation is heat, in the second part 
 cold. Its object is to separate mixed volatile and fixed substances, or to 
 combine volatile substances which cannot otherwise be mixed, as in the 
 preparation of some of the Waters. The apparatus used is of great variety, 
 from the simple retort and receiver to the elaborate and costly stills. 
 
 Destructive or Dry Distillation is a process of decomposing an organic substance 
 by heat into volatile products, which are collected in a separate vessel, the residue being 
 said to be carbonized. It is employed only by large manufacturers, for the preparation 
 of Acetic and Succinic Acids, Oil of Amber, Wood Tar, etc. 
 
 Fractional Distillation is the separation by distillation of substances which are 
 volatile at different temperatures, each being separately driven over and received in a 
 vessel by itself. Different degrees of heat are successively employed in accordance with 
 the volatilizing points of the substances to be obtained. 
 
 Expression is the forcible separation of liquids from solids, by sub- 
 jecting them to pressure. Hand-pressure through straining-cloths may be 
 employed, but mechanical presses are more efficient and are coming into 
 general use. Oils obtained in this manner are called expressed or fixed 
 oils, to distinguish them from the volatile oils obtained by distillation. 
 
560 PHARMACEUTICAL OPERATIONS. 
 
 Exsiccation or Calcination is the process of depriving a solid of its 
 moisture or other volatile constituents by the application of heat without 
 fusion. The term Exsiccation is usually applied to the vaporization of 
 the water of crystallization from a crystalline body ; Calcination to such 
 operations as the expulsion of carbonic acid and water from carbonates, 
 as in the manufacture of Lime, Magnesia, etc. 
 
 Filtration is a process of straining through a medium so fine as to 
 deliver the filtrate in transparent condition. The filters are made of paper 
 usually, though charcoal, asbestos, sand and other articles are sometimes 
 employed, and are supported in a funnel of glass or other material held by 
 the ring of a retort-stand. The best filtering-paper is made in Sweden by 
 Munktell, and is white; but a good paper for ordinary use is the Prat 
 Dumas White, which should always be employed for filtering alkaline 
 or alkaloidal solutions. The gray French papers answer well enough for 
 fluid extracts, tinctures or colored liquids, but should never be used for 
 solutions containing free alkali. 
 
 Filtering-paper is folded by doubling a sheet upon itself, and then folding it again 
 directly in the middle. When opened four distinct sections appear, one of which is 
 separated from the other three, and the filter thus formed is placed in a funnel. This 
 arrangement is known as a plain filter, which by repeated creasing is converted into the 
 plaited filter ; the latter being the form generally used in pharmaceutical operations of 
 small extent. In large laboratories special processes of filtration are employed with 
 apparatus of more or less complexity for hot filtration, rapid filtration, etc. 
 
 Fusion is the process of liquefying solids by the application of high 
 heat without the use of a solvent. It is employed in making ointments, 
 plasters, etc., in purifying resins, and for the purpose of decomposition. 
 The degree of heat required varies from a temperature of 90 F., sufficient 
 to melt lard in an open vessel, to one of 8oo° F., employed in fusing Zinc 
 in an earthen crucible; and may be regulated by the aid of the water-, 
 steam- or sand-bath. The two former appliances limit the degree of heat 
 applied, while the sand-bath prevents sudden changes in the temperature. 
 Oil-baths and glycerin-baths are employed in fractional distillation. 
 
 Granulation is a process of reducing a coarsely crystalline substance 
 to a granular powder, by dissolving it in water and evaporating the solu- 
 tion with constant stirring until the product becomes perfectly dry. Many 
 salts are thus treated for convenience in dispensing, as the Bromide, the 
 Iodide, the Carbonate and the Citrate of Potassium. Ferrous Sulphate, 
 though generally dispensed in the exsiccated powder, may be granulated 
 into minute crystals by filtering an aqueous solution of it into alcohol. 
 
 Ignition in pharmacy means the process of strongly heating solids or 
 semi-solid substances, the residue left being the product desired. It is 
 
PHARMACEUTICAL OPERATIONS. 56 1 
 
 used in the official quantitative tests for Phosphoric Acid, Ammonium 
 Phosphate and purified Antimony Sulphide. 
 
 Incineration is the heating of organic substances with access of air 
 until the carbon is consumed, the ashes being the product desired. 
 
 Maceration is one of the processes of extracting the soluble princi- 
 ples from drugs, and consists in steeping the comminuted substance in a 
 suitable liquid called the menstruum, generally alcohol, for a period vary- 
 ing from 2 to 14 days, during which it is occasionally agitated. The 
 liquid is then poured off, the residue is expressed, and the mixed liquors 
 are filtered. Several of the official tinctures are prepared by this method, 
 and many others by maceration first and percolation afterwards. A few 
 active principles may be extracted by water alone (e. g. morphine), and 
 in some cases the addition of acids or alkalies to the water will effect the 
 chemical solution of many ingredients which are insoluble in plain water. 
 As a rule however Alcohol is the most generally applicable of all simple 
 solvents, but from its hardening the cell-membranes instead of softening 
 them it prevents the osmosis of their contents. Drugs subjected to alco- 
 holic or other menstrua should have their cells thoroughly broken or torn, 
 so that the solvent maybe brought into actual contact with the principles 
 contained in them. The degree of disintegration required depends upon 
 the size of the cells, ducts, tubes, intercellular spaces, etc., in which the 
 active principles are enclosed. A very finely powdered state is open to 
 objection from the packing of the particles together into an almost im- 
 penetrable mass when treated by the solvent. The average size of vege- 
 table cells is about -%fa of an inch, while resin cells and other cavities are 
 larger, averaging about ^-1^ inch. The Pharmacopoeia prescribes in each 
 instance the degree of fineness of the powdered drug employed in making 
 Certain of its preparations, or its bruising, slicing, etc., when such opera- 
 tions will answer. [Compare the article on Comminution on p. 557.] 
 
 Percolation or Displacement is a process of obtaining the soluble 
 constituents of a powdered substance by the descent of a solvent through 
 it. Though an ancient process for the making of lye from wood-ashes 
 (lixiviation), it has only within the last forty years been adopted as an 
 official process in pharmacy, but it is gradually taking the place of macera- 
 tion as a means of extracting the soluble principles of drugs. The vessel 
 used to hold the powdered drug is called the percolator, of which there 
 are many forms employed by the manufacturers. The liquid used as a 
 solvent is called the menstruinn, and when coming from the 'percolator it 
 is termed the percolate. The U. S. Pharmacopoeia gives very full direc- 
 tions concerning this process. 
 36 
 
562 PHARMACEUTICAL OPERATIONS. 
 
 Precipitation is the process of separating solids from their solutions, 
 and is usually effected by chemical reaction, though it may be accom- 
 plished by other methods, as by adding a second liquid in which the 
 substance is insoluble, by heating albuminous solutions, or by exposing 
 solutions of silver salts to the action of light. The most familiar example 
 of chemical precipitation is the addition of a solution of Mercuric Chloride 
 to one of Potassium Iodide, the result being a double decomposition of 
 the salts and the formation of Mercuric Iodide, which falls to the bottom 
 of the vessel as a brilliant, red, insoluble and crystalline powder. The 
 Precipitate is the separated substance, which is usually thrown down, but 
 it remains suspended in some cases, and in others it rises to the top. The 
 Precipitant is the substance which is added to produce the precipitation. 
 A Magma is a thick, tenacious precipitant remaining behind after the 
 supernatant liquid is removed by decantation or otherwise. Precipitates 
 are termed flocculent, gelatinous, curdy, granular, crystalline, etc., accord- 
 ing to the forms assumed. In small operations they are usually collected 
 on plain filters, and washed by the repeated addition of water. 
 
 Separation of liquids which do not mix with each other is a simple 
 mechanical process performed with pipettes of various forms, or with 
 funnels having stop-cocks in their necks. Special forms of receivers are 
 used for the separation of volatile oils from the water which may accom- 
 pany them during distillation. 
 
 Solution is the dissolving of a solid or a gaseous substance in a liquid, 
 and may be Simple when the substance undergoes no alteration, being 
 recovered unchanged on evaporation; or Chemical when the dissolved 
 body is chemically altered by the solvent or some other substance present, 
 and cannot be recovered on evaporation. Simple Syrup is an instance of 
 simple solution, the Syrup of Lime one of chemical solution. The liquid 
 employed is termed a Solvent before the substance is added to it, after 
 the operation is completed the combined preparation is called a Solution. 
 If fully charged with the dissolved^ substance so that it will retain no 
 more, it is known as a Saturated Solution. One liquid may be dissolved 
 in another, or a gas may be dissolved in a liquid. The solution of solids 
 is greatly facilitated by pulverization and by stirring the menstruum.. 
 Heat generally aids solution, most substances being more soluble in 
 hot liquids than in cold ones. A saturated solution of one substance 
 may still be capable of dissolving others. Rapid solution of solids 
 without chemical change causes reduction of temperature, while chemi- 
 cal solution produces elevated temperature. Circulatory Solution is 
 performed by suspending the substance to be dissolved near the surface 
 of the solvent in a gauze bag or on a porous shelf. The portion first 
 
PHARMACEUTICAL OPERATIONS. 563 
 
 acted on descends and produces a circulatory movement in the fluid, 
 facilitating the solution of the whole. 
 
 Solvents employed are chiefly Water, Alcohol, Glycerin, Acids and Oils. Others 
 less frequently used are Ether, Chloroform, Benzin and Carbon Disulphide. 
 
 Sublimation is the distillation of a volatile solid, the product being 
 termed a Sublimate. Its objects are to purify volatile solids from 
 impurities and to collect such as result from chemical action at high 
 temperatures. The operation is carried on in iron, glass or stoneware 
 retorts, and results in Cake Sublimates or Powder Sublimates according 
 as the temperature of the condensing surface is high or low. 
 
 Testing and Assay are directed by the Pharmacopoeia in certain 
 cases, for the purpose of determining the identity and purity of its drugs 
 and their preparations. In the main portion of the book such Tests are 
 frequently directed, according to a specified method in each case ; but 
 processes of Assay are confined to Cinchona, Nux Vomica, Opium and 
 such of their preparations as are considered to require it. The Pharma- 
 copoeia contains also a very complete section on Reagents, in which 
 full directions are given for the preparation and use of Test solutions and 
 Volumetric solutions; also instructions for Gasometric estimations, and 
 for the determination of the Optical Rotation of organic substances. 
 
 Pharmacopceial testing and the volumetric method of determination 
 are necessary to the work of the practical pharmacist, and as the appar- 
 atus used is simple and the operations are those in the line of his daily 
 work, he should be familiar therewith. On the other hand the proxi- 
 mate analysis of organic substances for their principles, and the ultimate 
 analysis of the same bodies for their elements, require a high degree of 
 skill and long experience, and should be left to the professional chemist. 
 
 The apparatus used in testing consists of graduated flasks and jars, 
 burettes, pipettes, funnels, beakers, test-tubes, capsules, crucibles, re- 
 agent-bottles, etc. The metric system is directed for all work, and the 
 apparatus employed should be graduated accordingly. 
 
 Torrefaction or Roasting is the application of heat, in a less 
 degree than for carbonization, to an organic substance for the purpose 
 of modifyingsome of its constituents, as in the roasting of coffee and of 
 rhubarb. The latter substance, when subjected to this process, loses its 
 cathartic properties, but retains its astringency, and is known as Torrefied 
 Rhubarb. 
 
 Trituration is the comminution of a solid to an extremely fine powder 
 by continued rubbing in a wedgewood mortar with an inert and gritty 
 powder, Sugar of Milk being the substance directed to be used. The 
 
564 PHARMACEUTICAL OPERATIONS. 
 
 product is called a Trituration (see that title under Official Prepara- 
 tions). The surfaces of the mortar and pestle-head should coincide closely, 
 and the thorough comminution of the trituration is best accomplished by 
 a circular motion of the pestle in gradually increasing circles, until the 
 side of the mortar is reached, then reversing the motion and gradually 
 lessening the circles until the pestle reaches the centre again. The pro- 
 cess is greatly facilitated by having the pestle attached to a long handle 
 playing in an opening made in a piece of wood which is nailed at a con- 
 venient height. A weight may be fixed on top of the handle if a greater 
 degree of friction is desired. 
 
 Pulverization by Intervention is only another name for trituration when performed 
 in a mortar and with solid bodies, the foreign substance used being subsequently removed. 
 Potassium Sulphate may be employed as the medium for the pulverization of Gold, and 
 is then dissolved out with water. Alcohol or Chloroform may be added to Camphor to 
 aid its pulverization, and then removed by evaporation. Phosphorus may be pulverized 
 by placing it in water, gently heating the latter until the phosphorus is melted, and agi- 
 tating the whole while cooling. 
 
 Levigation is trituration of a substance made into paste with water or some other 
 liquid, and resembles the old process of grinding oil paints by hand on a slab of stone. 
 The process is used for coarse materials, as chalk, etc., where the refuse is rejected, or for 
 such substances as Red Mercuric Oxide, Zinc Oxide, etc. When performed with a por- 
 phyry slab and muller it is termed Porphyrization. 
 
 Elutriation is a water-sifting process for separating the coarser particles of insoluble 
 substances from the finer. The substance is mixed with water and after the larger par- 
 ticles have fallen to the bottom, the liquid is decanted into another vessel, in which the 
 light and powdery particles are collected. 
 
 Vaporization includes the various operations by which volatile matters 
 are separated from fixed substances or from other matters which are less 
 volatile, heat at varying temperatures being the agent used. The opera- 
 tions under this head are — Evaporation, Distillation, Desiccation, and 
 Sublimation, of which the last three have been described. 
 
 Evaporation in pharmacy is the process by which the more volatile 
 constituents of a liquid are driven off by heat for the purpose of reducing 
 its volume or of purifying it, as in the preparation of extracts and fluid 
 extracts, the crystallization of salts, etc. The vessels used should be shal- 
 low so as to expose a large surface of the liquid to the atmosphere. The 
 heat used may be regulated by a water-bath, a steam-bath or a sand-bath, 
 and ordinarily should be kept below but near to the boiling point of the 
 liquid treated. As organic substances are usually injured by long heating, 
 small portions only of vegetable preparations should be subjected to this 
 process, and the liquid should be frequently stirred in order to hasten the 
 operation. In large laboratories vacuum pans are employed to remove 
 the atmospheric pressure, enabling the evaporation to be accomplished at 
 a much lower degree of heat than if the liquid were exposed to the air. 
 Ebullition or Boiling is a form of evaporation. 
 
 Spontaneous Evaporation is the evaporation of a liquid without the direct applica- 
 tion of strong heat, but at the temperature of the room or closet used for the purpose. It 
 
PHARMACEUTICAL PREPARATIONS. 565 
 
 is especially applicable to cases in which the residue is liable to injury or loss from much 
 heat, or in order to secure finer crystals than can be obtained by the quick evaporation 
 of their solution. 
 
 Washing is a simple mechanical process for separating soluble from 
 insoluble matter, by pouring upon it a liquid which will dissolve the solu- 
 ble portion. Various methods of doing this are in vogue and are often 
 dignified with very high-sounding terms, as Lotion, Affusion, Ablution, 
 etc. An ordinary wash-bottle, with the two glass tubes perforating the 
 cork, is a convenient implement for directing a continuous stream upon 
 a precipitate, while for continuous washing a combination of bottles with 
 a funnel may be used. 
 
 PREPARATIONS. 
 
 The Official Preparations may be presented under various methods 
 of classification, one of the simplest being that which divides them into 
 liquids and solids, the former being subdivided into groups named after 
 their principal bases, viz.: — 
 
 Liquid Preparations. 
 
 Aqueous, — Waters, Solutions, Infusions, Decoctions, Syrups, Honeys, Mucilages, 
 Emulsions, Mixtures ; the last five containing sweet or viscid substances. 
 Alcoholic, — Fluid Extracts, Tinctures, Wines, Spirits, Elixirs. 
 Ethereal, — Oleoresins, Collodions. 
 Oleaginous, — Liniments, Oleates. 
 Acetous, — Vinegars. Glycerines, — Glycerites. 
 
 Solid Preparations. 
 
 Extracts. 
 
 Pills. 
 
 Powders. 
 
 Ointments. 
 
 Resins. 
 
 Troches. 
 
 Triturations. 
 
 Cerates. 
 
 Masses. 
 
 Confections. 
 
 Suppositories. 
 
 Plasters. 
 Papers. 
 
 In the following descriptions of the pharmaceutical groups the com- 
 position and dosage of the various preparations are omitted, as they are 
 fully detailed in the section on Materia Medica, under the title in each 
 case of the principal constituent. 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 The Pharmaceutical Preparations include the pharmacopceial (official) 
 as also those of extemporaneous pharmacy (unofficial). Both classes are 
 described together in alphabetical order, for the sake of easy reference. 
 
 Aceta, Vinegars, — are solutions of the active principles of certain 
 drugs in Diluted Acetic Acid. They are made by percolation and each 
 
566 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 contains the soluble principles from 10 per cent, of drug. Acidulous 
 menstrua form soluble salts with the alkaloids and possess antiseptic 
 qualities. The official Vinegars number 2, viz.: — 
 
 Acetum Opii. 
 
 Acetum Scillae. 
 
 Aquae, Waters, — are aqueous solutions of volatile substances, which 
 may be solids, liquids or gases, dissolved by solution in cold or hot 
 water, by filtration through an absorbent powder, by percolation through 
 cotton saturated with the substance, or by distillation. The official waters 
 number 19, including two forms of Aqua itself, viz.: — 
 
 Aqua. 
 
 Aqua Destillata. 
 
 Aqua Ammonia. 
 
 Aqua Ammonite Fortior. 
 
 Aqua Amygdalae Amarae. 
 
 Aqua Anisi. 
 
 Aqua Aurantii Florum. 
 
 Aqua Aurantii Florum Fortior. 
 
 Aqua Camphorae. 
 
 Aqua Chlori. 
 
 Aqua Chloroformi. 
 
 Aqua Cinnamomi. 
 
 Aqua Creosoti. 
 
 Aqua Foeniculi. 
 
 Aqua Hydrogenii Dioxidi. 
 
 Aqua Menthae Piperitae. 
 
 Aqua Menthae Viridis. 
 
 Aqua Rosae. 
 
 Aqua Rosas Fortior. 
 
 Of the above 5 are prepared by simple solution, 4 by passing gases through water, 3 
 by distillation, and 6 by trituration of the medicament with precipitated calcium phos- 
 phate, addition of water and filtration. 
 
 All waters deteriorate when long kept, microscopic plants being propa- 
 gated in them from spores derived from the atmosphere. They should 
 be prepared only in such quantities as are needed for immediate use. 
 
 Balnea, Baths (Unofficial). Baths are often medicated, and then 
 become medicinal preparations. The ingredients only are ordered in a 
 prescription, as per the following examples, each of which is intended for 
 a bath of 20 to 30 gallons : — 
 
 Balneum Acidi Nitrohydrochlorici. 
 
 R . Acidi Nitrici, 
 
 Acidi Hydrochlorici, . aa^j. 
 M. Sig. — Use with 30 gallons of hot 
 water, as a bath. 
 
 Balneum Sulphuris Compositum. 
 
 R. Sulphuris Praecip., . . . 5ij. 
 Sodii Hyposulphitis, . . 5j. 
 Acidi Sulphurici Dil., . Jss. 
 Aquae, ... Oj. 
 
 M. Sig. — For a 30-gallon bath. 
 
 Capsulae, Capsules, (Unofficial). Gelatin Capsules of various sizes 
 from o to 10 are to be obtained from the drug-stores. They are a conve- 
 nient means of administering oils or nauseous solids, and when filled may 
 be swallowed as easily as a large pill. By some of the manufacturers 
 Soluble Elastic Capsules are prepared, each containing an ordinary dose 
 of such medicines as Castor Oil, Cod-liver Oil, etc. The largest of these 
 capsules makes a bolus which may be swallowed with a little effort, as it 
 is quite compressible and changes its shape to suit the calibre of the pas- 
 
PHARMACEUTICAL PREPARATIONS. 567 
 
 sage. The ordinary capsules are easily filled by the aid of a paper funnel, 
 and the end of a pen-holder as a packer; but simple devices (capsule- 
 fillers) for facilitating the operation may be purchased. 
 
 & . Pulv. Opii, gr. x. 
 
 Pulv. Camphorae, . . gr. xx. 
 Sacch. Alb., q. s. 
 Triturat., et fiant capsular x. 
 
 R . " Copaiba, ^iss. 
 
 Oleoresinae Cubebae, . sj ss. 
 M., et fiant capsular xij. 
 Sig. — Two capsules to be taken three 
 
 Sig. — One at bedtime for chordee ; re- i times daily, soon after meals, for gonor- 
 peat in two hours if necessary. | rhea. 
 
 Cataplasmata, Poultices, — are usually prepared at the residence of 
 the patient, the ingredients only being ordered from the druggist. They 
 are generally employed as a means of applying heat and moisture to a 
 certain portion of the body, but are sometimes medicated with anodyne, 
 counter-irritant or disinfectant agents. Poultices are not official in the 
 U. S. Pharmacopoeia, but are in the British, the following list including 
 all so recognized : — 
 
 Cataplasma Carbonis, Charcoal Poultice, — Wood Charcoal I, Crumb of Bread 4, 
 Linseed Meal 3, Boiling Water 20 parts. 
 
 Cataplasma Conii, Hemlock Poultice, — Hemlock -juice I, evaporated to half its vol- 
 ume, Linseed Meal 4, Boiling Water 10 parts. 
 
 Cataplasma Fermenti, Yeast Poultice, — Beer Yeast 3, Wheaten Flour 7, Water at 
 ioo° F., 3 parts. 
 
 Cataplasma Lini, Linseed Poultice, — Linseed Meal 2, Boiling Water 5 parts, mixed 
 with constant stirring. / 
 
 Cataplasma Sinapis, Mustard Poultice, — Mustard, Linseed Meal, Boiling Water 
 and Water, of each a sufficiency. 
 
 Cataplasma Sodae Chlorinatae, Chlorine Poultice, — Solution of Chlorinated Soda 1, 
 Linseed Meal 2, Boiling Water 4 parts. 
 
 Cerata, Cerates, are unctuous preparations similar to ointments, but 
 of a much firmer consistence. They all contain Wax (Cera), and do not 
 melt at temperatures below 104 F. They are intended for external use, 
 and are generally spread on lint before being applied. There are 6 official 
 Cerates, including Ceratum itself, which is made by fusing together 30 of 
 White Wax and 70 of Lard. The composition of the others maybe found 
 in the section on Materia Medica under the appropriate titles, but the 
 figures in parentheses below give the percentage of drug to basis in each. 
 
 Ceratum. Ceratum Cetacei (10). 
 
 Ceratum Camphorae (2). Ceratum Plumbi Subacetatis (5). 
 
 Ceratum Cantharidis (32). Ceratum Resinae (35). 
 
 Chartse, Papers, — consist of strips of paper medicated by impregna- 
 tion of its fibers with medicinal substances or by being coated therewith. 
 Of the 2 official Papers 1 is made with sized paper, and intended for 
 external application as a vesicant or counter-irritant; the other (Charta 
 Potassii Xitratis) is unsized paper impregnated with Nitre and intended 
 for the inhalation of its fumes while burning. The official papers are — 
 Charta Potassii Xitratis. Charta Sinapis. 
 
568 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 Collodia, Collodions, — are liquid preparations having for their base a 
 solution of Pyroxylin in a mixture of Ether and Alcohol. They are in- 
 tended for external use, being applied to the skin by means of a brush, 
 producing a film on the surface after the evaporation of the menstruum. 
 There are 4 official Collodions, viz.: — 
 
 Collodium. 
 
 Collodium Cantharidatum. 
 
 Collodium Flexile. 
 Collodium Stypticum. 
 
 The Flexible Collodion contains 5 per cent, of Canada Turpentine, and 3 per cent, of 
 Castor Oil. Styptic Collodion contains 20 per cent, of Tannic Acid. 
 
 Confectiones, Confections, — consist of medicinal substances formed 
 into a mass with Sugar, Honey, Water, etc., with the object of rendering 
 them palatable and preserving them from change. Electuaries are 
 similar preparations, but this term is now obsolete. There are only two 
 official Confections, viz.: — 
 
 Confectio Rosse. Confectio Sennae. 
 
 Confections and Electuaries are very seldom prescribed, and therefore 
 can have but little place in extemporaneous pharmacy. A few old for- 
 mulae for such preparations are given below as pharmaceutical curios. 
 The first is a meritorious prescription, the second is said to have been 
 purchased by Lord Anson for the sum of ^300. 
 
 Electuary for Piles. 
 R . Potassii Bitartratis, 
 Potassii Nitratis, 
 Pulv. Jalapse, .... aaj^ss. 
 Confectionis Sennse, . . ^j. 
 Syrupi Zingiberis, q. s. 
 M. Fiat electuarium. 
 Sig. — A piece the size of a marble to be 
 taken thrice daily. 
 
 The Chelsea Pensioner* 
 
 & . Sulphuris Loti, ^ ij. 
 
 Potassii Bitart., ^j. 
 
 Pulv. Rhei, 3 ij. 
 
 Guaiaci Resinae, ^j. 
 
 Mellis Despum., . . . . Ibj. 
 Myristicam Pulv., . . . . j. 
 M. Fiat electuarium. 
 Sig. — A dessertspoonful twice daily, as 
 a laxative in chronic rheumatism. 
 
 Confectio Damocratis. 
 [An ingredient of Warburg's Tincture.] 
 This preparation was official in the London Pharmacopoeia of 1745. It contained I 
 grain of Opium in ^ ss, and consisted of 45 ingredients, as follows, viz. : Cinnamon, 14 
 parts; Myrrh, 1 1 parts; — White Agaric, Spikenard, Ginger, Spanish Saffron, Treacle, 
 Mustard Seed, Frankincense and Chian Turpentine, of each 10 parts; — Camel's Hay, 
 Costus Arabacus, Zedoary, Indian leaf, Mace, French Lavender, Long Pepper, Seeds 
 of Harwort, Juice of ripe Cistus, strained Storax, Opponex, strained Galbanum, Balsam 
 of Gilead, Oil of Nutmeg, Russian Castor, of each 8 parts;— Water Germunder, Balsam- 
 tree Fruit, Cubeb, White Pepper, Seeds of Cretian Carrot, Poley Mont, strained Bdellium, 
 of each 7 parts ; — Gentian-root, Celtic Hard, Leaves of Dittany of Crete, Red Rose, 
 Seeds of Macedonium, Parsley, Sweet Fennel Seeds, Seeds of Lesser Cardamom, Gum 
 Arabic, Opium, of each 5 parts ; — Sweet Flag, Wild Valerian, Anise-seed, Sagapenum, 
 of each 3 parts; — Spigrul, St. John's Wort, Juice of Acacia, Catechu, Dried Bellies of 
 Skunk, of each 2 y 2 parts ; — the roots finely powdered and the whole mixed thoroughly 
 into a paste with Clarified Honey. 
 
 Decocta, Decoctions, — are made by boiling vegetable substances with 
 water. As very few drugs contain active ingredients which are not in- 
 
PHARMACEUTICAL PREPARATIONS. 569 
 
 jured by heat, these preparations have never obtained favor with scientific 
 physicians. There are only 2 official Decoctions, viz.: — 
 
 Decoctum Cetrariae. Decoctum Sarsaparillse Compositum. 
 
 The official general formula for Decoctions prescribes that when the strength is not 
 directed by the physician, nor specified by the Pharmacopoeia, they shall be prepared in 
 the proportion of 5 grammes of the substance with 100 cc. of water ; but that the strength 
 of decoctions of energetic or powerful substances should be specially prescribed by the 
 physician. Decoctum Cetrariae has the aforesaid official strength, while Decoctum Sar- 
 saparillae Compositum has the strength of 10 per cent, as regards its principal ingredient. 
 
 Elixiria, Elixirs, — are sweetened, aromatic, and spirituous prepara- 
 tions, containing active medicinal substances in small quantities. There 
 are but 2 official Elixirs, viz.: — 
 
 Elixir Aromaticum. Elixir Phosphori. 
 
 The first-named is intended to represent a type of the large class of 
 unofficial elixirs employed in manufacturing and extemporaneous phar- 
 macy. It is practically an alcoholized syrup, flavored with Orange, and 
 is designed for use as an excipient for extracts, tinctures, salts, etc. The 
 Elixir of Phosphorus has about ^ milligramme of Phosphorus to each cubic 
 centimeter. The manufacturers have put on the market a great variety 
 of elixirs, and most druggists keep a stock of them on hand prepared in the 
 shop ; but they may be ordered by prescription just as any other mixture 
 would be. The substances generally used in this form are as follows : — 
 
 Arsenic. Guarana. 
 
 Bismuth. Iron, Tincture of the Chloride. 
 
 Ammonium Bromide. Iron, Phosphate. 
 
 Lithium Bromide. Iron, Pyrophosphate. 
 
 Potassium Bromide. Liquorice. 
 
 Calisaya Bark. Pepsin. 
 
 Chloral Hydrate. Quinine. 
 
 Coca. Strychnine. 
 
 Gentian. Taraxacum. 
 Ammonium Valerianate. 
 
 Many of these agents may be combined with one another, as in the Elixir of Bismuth 
 and Strychnine ; Elixir of Calisaya, Iron and Strychnine ; Elixir of Gentian with Tincture 
 of Chloride of Iron ; Elixir of Iron, Quinine and Strychnine, etc., etc. 
 
 Emplastra, Plasters, — are solid compounds, insoluble in water, of a 
 tenacious but pliable consistence and intended for external application to 
 limited areas of the body surface. They are prepared by incorporating 
 medicinal substances with certain bases, which are usually Lead Plaster 
 (Oleate of Lead), a Gum-resin, or Burgundy Pitch. The heat employed 
 should be low so as to avoid decomposing the active agents, and should 
 not be continued long enough to drive off any volatile constituents. The 
 plaster mass is then spread evenly on chamois skin, kid skin or muslin. 
 
57o 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 The constituents of the following named 13 official Plasters may be found 
 in the section on Materia Medica, under their appropriate headings. 
 
 Emp. Ammoniaci cum Hydrargyro. 
 Emplastrum Arnicae. 
 Emplastrum Belladonnas. 
 Emplastrum Capsici. 
 Emplastrum Ferri. 
 Emplastrum Hydrargyri. 
 
 Emplastrum Ichthyocollae. 
 Emplastrum Opii. 
 Emp. Picis Burgundicae. 
 Emp. Picis Cantharidatum. 
 Emplastrum Plumbi. 
 Emplastrum Resinae. 
 Emplastrum Saponis. 
 
 Of the foregoing only two are directed to be spread, viz. — Emp. Capsici upon muslin, 
 and Emp. Ichthyocollae upon taffeta, the others having no pharmacopceial prescription for 
 the material to be used. Plasters after being spread should remain soft, pliable and ad- 
 hesive, without melting at the heat of the body. To soften the surface, if old, it should 
 be brushed with a small quantity of Tincture of Camphor. 
 
 Plasters are rarely prepared extemporaneously, the official and many 
 others being produced on a large scale by the manufacturers, and are 
 kept in stock by all druggists. As a consequence the compounding and 
 spreading of a plaster by the pharmaceutist has become a lost art. The 
 official plasters may be ordered by prescription in the manner illustrated 
 below. Blisters may be produced by the application of any preparation 
 of Cantharides sufficiently strong for the purpose. The official Cerate of 
 Cantharides may be spread on Adhesive Plaster (Emplastrum Resinae), 
 making a blistering plaster, or Cantharidal Collodion may be painted 
 over the surface. Plasters are usually ordered by the square inch, but a 
 diagram of the shape and size may be drawn on paper, and the plaster 
 be directed to conform thereto, as in the first following prescription. 
 
 Emplastrum Vesicatorium. 
 R . Cerati Cantharidis, q. s. 
 
 Extende supra Emplastrum Resinae hujus 
 formae et magnitudinis. 
 
 Sig. — Blistering Plaster, to be applied 
 over the region of the heart. 
 
 Counter-irritant and Anodyne. 
 R . Chartae Sinapis, 
 
 Emplas. Belladonnas, aa 3 // x 6 r/ . 
 Sig. — Apply the mustard paper first, to 
 be followed by the plaster when the surface 
 has been well reddened. 
 
 Emulsa, Emulsio?is, — are aqueous, liquid preparations containing an 
 insoluble medicinal substance (as an oil or a resin) in a state of minute 
 subdivision and suspended by the aid of some viscid excipient, as gum, 
 which may be contained in the medicinal ingredient itself (Ammoniac, 
 Asafcetida), or may be added by the pharmaceutist. The official Emul- 
 sions are 4 in number, all of which were classed as Mixtures in the phar- 
 macopoeia of 1880, viz. — 
 
 Emulsum Ammoniaci. 
 Emulsum Amygdalae. 
 
 Emulsum Asafcetidae. 
 Emulsum Chloroformi. 
 
 Natural Emulsions comprise two classes of substances, — (1) those emul- 
 sions which exist ready formed in nature, as milk, yolk of egg, the milky 
 
PHARMACEUTICAL PREPARATIONS. 57 I 
 
 juices of plants, etc., and (2) the mixtures formed by rubbing up gum- 
 resins (as Ammoniacum, Myrrh, Asafcetida) with water. Each of these 
 substances contains, together with its resin, enough gum to make a per- 
 fect emulsion when triturated with water. The manufactured emulsions 
 are simply imitations of the natural ones, sufficient gum being added in 
 case of a resinous substance to cause its suspension in the aqueous diluent. 
 
 Emulsification consists in the division of the oily or resinous substance 
 into very minute globules, and the surrounding of each globule with a 
 thin envelope of the excipient. If properly done the globules will remain 
 mechanically suspended in the water, without any tendency towards re- 
 combination. Milk is the best illustration of a natural emulsion, its butter 
 existing in the aqueous portion as very minute globules, each surrounded 
 by a thin film of casein. Yolk of Egg is a dense emulsion, consisting 
 of oil suspended in water by means of albumin. 
 
 The Excipients which may be used for emulsification are the following, 
 arranged in the order of their most frequent employment, viz. — 
 
 Mucilage of Acacia, — used for oils and resins. Powdered Acacia is even better, 
 being made into a mucilage by the process of emulsification ; such a mucilage having the 
 advantage of being perfectly fresh when incorporated with the other ingredients. To 
 give good results the following proportions in parts by weight should be used, — 
 
 Gum Acacia. Water. 
 
 I part of Fixed Oil or Copaiba requires, y 2 ^ 
 
 I " " Balsam of Peru " 2 1^ 
 
 I " " Oil of Turpentine " I I 
 
 Mucilage of Tragacanth, — may also be used for oils and resins, but it has not 
 proved so satisfactory as the preceding. The same may be said of powdered Tragacanth. 
 
 Vitellus, Yolk of Egg, — is an excellent agent for emulsifying oils, but mixtures 
 made with it must be used within a few days, as they will not keep long. One yolk will 
 emulsionize an ounce of fixed oil, and is about equal to half an ounce of Acacia. It is 
 best suited to emulsions of cod-liver oil intended for immediate administration. The 
 official Emulsum Chloroformi is an emulsion made with yolk of egg. Glyceritum Vitelli 
 or Glyconin is an official preparation consisting of glycerin and yolk of egg. One ounce 
 of it will emulsify three ounces of fixed oil. 
 
 Liquor Potassa?, — may be used for oils, the resulting compound being however a 
 soap rather than an emulsion. Copaiba is usually emulsified by using both a gum and an 
 alkali ; a similar process being employed for many of the fixed oils. 
 
 Tincture of Senega, — will emulsify fats and oils very efficiently, even in very small 
 quantities, rr^x emulsifying an ounce of fixed oil. 
 
 Tincture of Quillaja (Soap-bark), — is a good emulsifier of oils, and is much used 
 in Europe for this purpose. 
 
 Milk, — is used to emulsify Scammony in the Mistura Scammonii, which is official in 
 the British Pharmacopoeia. 
 
 Syrups, Confections and Extracts, — may be used in making emulsions, but are 
 rarely so employed. 
 
 Soap, — is occasionally used for emulsifying Oil of Turpentine. 
 
 The method of preparing an emulsion which experience has shown to 
 be the best is as follows : — Add the oil, resin, etc., to a proper quantity 
 
572 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 of the excipient and mix both thoroughly in a mortar. Then add 
 enough water to equal one-half the weight of the previous mixture, and 
 triturate the whole rapidly and unceasingly until the emulsion is homo- 
 geneous and of a whitish color. Next, add the remainder of the water 
 slowly, with continual stirring ; finally incorporating the other ingredients, 
 if any. 
 
 Emulsions are sometimes flavored and at the same time colored with 
 such a preparation as the Compound Tincture of Cardamom, but they 
 present a better appearance when perfectly white. Alcoholic preparations 
 should not be added in large quantity to emulsions made wjth Acacia or 
 Yolk of Egg, as alcohol will precipitate the emulsifying agent. Volatile 
 Oils require admixture with a fixed oil before being made into an emul- 
 sion. Soluble salts should never be prescribed with emulsions of oils. 
 Acids are incompatible with mixtures which have been emulsified by an 
 alkali. Mucilage used for emulsions should always be freshly prepared. 
 
 The following examples of prescriptions for emulsions will represent 
 those generally met with : — 
 
 Cod-Liver Oil Emulsion 
 . Olei Morrhuae, 
 
 Vini Albi, 
 
 Acidi Phosphorici Dil. 
 
 Syrupi, 
 
 Vitellum, ... 
 
 Aq. Amygd. Amar. , q 
 Misce, et fiat emulsum. 
 
 Sig. — Tablespoonful doses 
 
 • 3 l h 
 . g iss. 
 
 • giij- 
 . 3 v. 
 
 J- 
 
 ad^ viij. 
 
 Alkaline Emulsion of Copaiba. 
 R . Copaibse, 
 
 Liq. Potassse, aa. 3 ij . 
 
 Misce, et adde — 
 Pulv. Acacise, 
 
 Pulv. Sacchari, a^gij. 
 
 Aq. Menth. Viridis, q. s. 
 
 ad ^iv 
 
 Misce, et fiat emulsum. 
 
 Sig. — Tablespoonful doses. 
 
 Extracta, Extracts, — are solid or semi-solid preparations obtained by 
 evaporating solutions of vegetable principles. The drug is first powdered, 
 then percolated with the appropriate menstruum to exhaustion. The first 
 third of the percolate is reserved, the remainder is evaporated at a tem- 
 perature not above 122 F., until its weight is ten per cent, of that of the 
 drug used, then mixed with the reserved portion, and both are evaporated 
 to a pilular consistence. The above is the general rule, but in several 
 instances maceration is directed for i to 4 days before percolation ; and 
 in other cases, instead of reserving a portion of the percolate, the whole 
 quantity is distilled until the alcohol is removed and the residue is evapo- 
 rated to a pilular consistence. The menstrua used are, — in 6 cases Alco- 
 hol, in 13 cases Diluted Alcohol of varying strength, in 7 Water, in 1 
 Water with Aqua Ammoniae, in 1 a diluted Acetic Acid, and in 2 Acetic 
 Acid and Diluted Alcohol. One extract is an inspissated juice (Ext. 
 Taraxaci) ; one is made by evaporating a fluid extract (Ext. Ergotae), one 
 by mixing an extract with other ingredients (Ext. Colocynthidis Comp.), 
 and one (Ext. Glycyrrhizse) is an ordinary commercial product. 
 
PHARMACEUTICAL PREPARATIONS. 573 
 
 The official Extracts number 33, and are named as follows, the letters 
 in parentheses indicating the ingredients of the menstruum used in ex- 
 traction in each case, viz. — 
 
 Extractum Aconiti (A). Ext. Glycyrrhizae Purum (W). 
 
 Ext. Aloes (W). Ext. Haematoxyli (W). 
 
 Ext. Arnicae Radicis (DA). Ext. Hyoscyami (AgWj). 
 
 Ext. Belladonnas Foliorum Alcohol- Ext. Iridis (A). 
 
 icum(A 2 W 1 ). Ext. Jalapae (A). 
 
 Ext. Cannabis Indicae (A). Ext. Juglandis (DA). 
 
 Ext. Cimicifugae (A). Ext. Krameriae (W). 
 
 Ext. Cinchonae (AgWj). Ext. Leptandrae (AgWj). 
 
 Ext. Colchici Radicis (WAc). Ext. Nucis Vomicae (AgWJ. 
 
 Ext. Colocynthidis (DA). Ext. Opii (W). 
 
 Ext. Colocynthidis Compositum. Ext. Physostigmatis (A). 
 
 Ext. Conii (DA, Ac). Ext. Podophylli (A 4 W X ). 
 
 Ext. Digitalis (AjW^. Ext, Quassiae (W). 
 
 Ext. Ergotae (DA,Ac). Ext. Rhei (A f W t ). 
 
 Ext. Euonymi (A 2 Wj). Ext. Stramonii Seminis (DA). 
 
 Ext. Gentianae (W). Ext. Taraxaci (W). 
 
 Ext. Glycyrrhizae. Ext. Uvae Ursi (A 2 W 5 ). 
 
 The Proximate Principles generally present in extracts, besides the 
 peculiar principles of plants, are Sugar, Tannin, Extractive, Chlorophyll, 
 Coloring-matter and Salts. When an alcoholic solvent is used there are 
 also present Resins, Fats and often a Volatile Oil, and when the men- 
 struum is not purely alcoholic there is more or less of gum and starch. 
 One of these ingredients, named Extractive or Apotheme, is a deposit, 
 soluble in water and alcohol, which has the singular property of passing 
 into an insoluble substance under the influence of the atmospheric air 
 with heat. It also has a tendency, when precipitated from solutions, to 
 unite with other principles carrying them down with it. It is frequently 
 present in extracts, hence its name. 
 
 Extracta Fluida, Fluid Extracts, — are permanent and concentrated 
 solutions of vegetable drugs, of uniformly definite strength if the crude 
 drugs are so, a cubic centimeter (11^16.23) in each case representing the 
 medicinal powers of one gramme (gr. 15.43) of the drug, or approxi- 
 mately a minim of the finished preparation representing the active con- 
 stituents of a grain of the drug. They are officially directed to be pre- 
 pared by percolation and partial evaporation, the menstrua employed 
 being usually Alcohol, diluted Alcohol, or Alcohol and Water in various 
 proportions, though a few are percolated with water, the alcohol being 
 afterward added. In several instances Glycerin in different proportions 
 is added to the first menstruum ; and in the menstrua used for the fluid 
 extracts of Conium, Ergot, Nux Vomica and Sanguinaria, Acetic Acid is 
 an ingredient. In the preparation of the fluid extract of Primus Virgin- 
 iana, the extraction is preceded by maceration with water and glycerin, 
 in order to permit of the formation of Hydrocyanic Acid by the reaction 
 
574 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 of the amygdalin and emulsin of the bark upon each other, which takes 
 place only in the presence of water. The glycerin aids to keep the dis- 
 solved matters in perfect solution, and also to better retain the acid and 
 volatile oil formed during the process. The fluid extract of Glycyirhiza 
 is prepared by maceration for 48 hours in a menstruum containing Am- 
 monia-water, then by percolation, using a mixture of alcohol and water. 
 The menstruum directed to be used in each case is intended to be that 
 which will thoroughly extract all the active constituents of the drug and 
 at the same time leave the inert soluble matters behind in the rejected 
 portion, known as the marc. In manufacturing fluid extracts on a large 
 scale modifications of the official processes are necessary, the methods 
 used being generally percolation and maceration with hydraulic pressure, 
 vacuum maceration followed by percolation, percolation with incomplete 
 exhaustion, or repercolation. 
 
 The official Fluid Extracts number SS, and are named in the following 
 list; the letters and figures following in parentheses showing the ingre- 
 dients of their respective menstrua, by the initials of Alcohol, Diluted 
 Alcohol, Water, Glycerin and Ammonia-water. The interrogation sign 
 (?) signifies that the several proportions cannot be represented by figures. 
 
 Extractum Aconiti Fl. (AgWj). Ext. 
 
 Ext. Apocyni Fl. (A 65 W 25 G ]0 ). Ext. 
 
 Ext. Arnicae Radicis Fl. (AgWJ. Ext. 
 
 Ext. Aromaticum Fluidum (A). Ext. 
 
 Ext. Asclepiadis Fluidum (DA). Ext. 
 Ext. Aspidospermatis Fl. (A 6 W 3 G 1 ). Ext. 
 
 Ext. Aurantii Amari Fl. (AgWj. Ext. 
 Ext. Belladonnse Radicis Fl. (A 4 Wj). Ext. 
 
 Ext. Buchu Fluidum (A). Ext. 
 
 Ext. Calami Fluidum (A). Ext. 
 
 Ext. Calumbae Fluidum (A 3 Wj). Ext. 
 
 Ext. Cannabis Indicae Fl. (A). Ext. 
 
 Ext. Capsici Fl. (A). Ext. 
 
 Ext. Castaneae Fl. (A 4 W 5 G X ). Ext. 
 
 Ext. Chimaphilae Fl. (DA). Ext. 
 
 Ext. ChirataeFl. (A 2 W,). Ext. 
 
 Ext. Cimicifugae Fl. (A). Ext. 
 
 Ext. Cinchona Fl. (AWG ?). Ext. 
 
 Ext. Cocae Fluidum (DA). Ext. 
 
 Ext. Colchici Radicis Fl. (AjWj). Ext. 
 
 Ext. Colchici Seminis Fl. (A 2 W X ). Ext. 
 
 Ext. Conii Fl. (DA). Ext. 
 
 Ext. Convallarias Fl. (DA). Ext. 
 
 Ext. Cubebae Fluidum (A). Ext. 
 
 Ext. Cusso Fluidum (A). Ext. 
 
 Ext. Cvpripedii Fluidum (DA). Ext. 
 
 Ext. Digitalis Fluidum (A 2 W X ). Ext. 
 
 Ext. Dulcamarae Fluidum (DA). Ext. 
 
 Ext. Ergotae Fluidum (DA). Ext. 
 
 Ext. Eriodictyi Fluidum (A^j). Ext. 
 
 Ext. Eucalypti Fluidum (AgWj). Ext. 
 
 Ext. Eupatorii Fluidum (DA). Ext. 
 
 Ext. Frangulae Fluidum (A 5 W 8 ). Ext. 
 
 Gelsemii Fluidum (A). 
 Gentianae Fluidum (DA). 
 Geranii Fluidum (DA 9 Gj). 
 Glycyrrhizae Fl. (A 30 W 65 Am 5 ). 
 
 Gossypii Radicis Fl. (AgGjJ. 
 Grindeliae Fluidum (A). 
 Guaranae Fluidum (AgWj). 
 Hamamelidis Fl. (A^GJ. 
 Hydrastis Fluidum (AgWgG^. 
 Hyoscyami Fluidum (A 2 Wj). 
 Ipecacuanhae Fluidum (AgWj). 
 Iridis Fluidum (A). 
 Krameriae Fluidum (DA 9 Gj). 
 Lappae Fluidum (DA). 
 Leptandrse Fluidum (AgW^). 
 Lobeliae Fluidum (DA). 
 Lupulini Fluidum (A). 
 Matico Fluidum (AgWj). 
 Menispermi Fluidum (A 2 Wj). 
 Mezerei Fluidum (A). 
 Nucis Vomicae Fluidum (AgWj). 
 Pareirae Fluidum (AWG?). 
 Phytolacca: Radicis Fl. (AjWj). 
 Pilocarpi Fluidum (DA). 
 Podophylli Fluidum (A 4 Wj). 
 Pruni Virginianse Fl. (AWG?). 
 Quassiae Fluidum (A X W 2 ). 
 Rhamni Purshianae Fluidum (DA). 
 Rhei Fluidum (A 4 W X ). 
 Rhois Glabrae Fluidum (DA 9 G X ). 
 Rosae Fluidum (DAgG^. 
 Rubi Fluidum (A 6 W 3 G,). 
 Rumicis Fluidum (DA). 
 
PHARMACEUTICAL PREPARATIONS. 575 
 
 Ext. Sabinse Fluidum (A). Ext. Stillingiae Fluidum (DA). 
 
 Ext. Sanguinariae Fluidum (AjWj). Ext. Stramonii Seminis Fl. (AgWj. 
 
 Ext. Sarsaparilloe Fluidum (A^V^. Ext. Taraxaci Fluidum (DA). 
 
 Ext. Sarsaparilk-e Fl. Co. (A 3 \V 6 G 1 ). Ext. Tritici Fluidum (AjWg). 
 
 Ext. Scillae Fluidum (A3WJ. Ext. Uvae Ursi Fluidum (A,W 5 G S ). 
 
 Ext. Scoparii Fluidum (DA). Ext. Valerianae Fluidum (AgWj). 
 
 Ext. Scutellariae Fluidum (DA). Ext. Veratri Viridis Fluidum (A). 
 
 Ext. Senegze Fluidum (A 75 W 20 Am 5 ). Ext. Viburni Opuli Fluidum (A 3 W,). 
 
 Ext. Sennse Fluidum (DA). Ext. Viburni Prunifolii Fl. (AjWj). 
 
 Ext. Serpentarias Fluidum (A 4 Wj). Ext. Xanthoxyli Fluidum (A). 
 
 Ext. Spigelise Fluidum (DA). Ext. Zingiberis Fluidum (A). 
 
 In 14 instances only does the Pharmacopoeia direct the making of 
 other preparations from corresponding fluid extracts, these being the 
 Syrups of Ipecac, Krameria, Rhubarb, Rose, Rubus, Senega, and Ginger, 
 the Compound Syrups of Sarsaparilla and Squill, the Tincture of Ipecac 
 and Opium, the Wine of Ipecac, the Extract of Ergot, the Liniment of 
 Belladonna and the Mixture of Rhubarb and Soda. Notwithstanding 
 this fact it is a common practice for dispensing pharmaceutists to make 
 tinctures, syrups, infusions, etc., from fluid extracts; and some manufac- 
 turers put labels on the bottles containing their fluid extracts, giving the 
 formulae for so preparing other preparations. This practice is illegitimate 
 and tends still further to degrade the profession of pharmacy into a mere 
 trade, so far as dispensing is concerned. 
 
 A large number of unofficial fluid extracts are manufactured and for sale, one firm 
 alone carrying over 400 such on its catalogue. Normal Liquids are a class of superior 
 fluid extracts introduced by Parke, Davis & Co., which are claimed to be adjusted to a 
 maximum strength by accurate assays for alkaloidal strength made at each stage of their 
 manipulation, irrespective of the amount of material required, which in the case of official 
 fluid extracts is prescribed by the Pharmacopoeia, regardless of the varying quality of dings 
 in the market. This firm prepares Normal Liquids of Aconite, Veratrum Viride, Bella- 
 donna (root or leaves), Cannabis Indica, Cinchona, Calisaya, Cinchona Rubra, Colchicum 
 (root or seed), Conium, Ergot, Digitalis, Gelsemium, Hyoscyamus, Ipecacuanha, Podo- 
 phyllum, Nux Vomica. Rhubarb, and Stramonium (seed or leaves). Of these prepara- 
 tions one cubic centimeter is equivalent to one gramme of the corresponding drug of 
 standard alkaloidal strength. A fluid extract of Belladonna leaves may contain 0.25 or 
 0.45 per cent, of Atropine, according to the quality of the drug employed ; a Normal 
 Liquid will contain invariably 0.4 per cent, of the alkaloid, so that in a given dose it may 
 be relied upon to produce a certain effect. 
 
 Gargarisma, A Gargle (Unofficial), — is a mixture or solution for 
 application to the pharynx or to the mouth (mouth-wash). It should not 
 contain any very active drug, which would produce dangerous symptoms 
 if swallowed, or any agent which would injure the teeth or the mucous 
 membrane. Gargles are ordered and compounded in the same manner 
 as mixtures. They usually contain astringent or disinfecting salts (Alum, 
 Borax, Potassium Chlorate, Zinc Sulphate), with a vegetable astringent 
 and often honey. The following formulae will illustrate prescriptions of 
 this class : — 
 
576 PHARMACEUTICAL PREPARATIONS. 
 
 JJ . Tr. Guaiaci Ammoniatae, l R • Aluminis, z ij. 
 
 Tr. Cinchonae Comp., aa ^ss. Granati Corticis, . . . Ziv. 
 
 Mellis Despumat., . . Jjss. Petal. Rosae Rubr., . . 'zj 
 
 Bene simul agita, et adde 
 
 Potassii Chloratis, . . . 3 ijss 
 Aquae, q. s., ad . . . . % viij 
 
 Fiat gargarisma. Sig. — Gargle. 
 
 Mellis Despumat, . . . !^j. 
 Aquae Bullientis, . . . ^ vj. 
 M. Sig. — Gargle. 
 
 ( Goddard.) 
 
 Glycerita, Glycerites, — are mixtures of medicinal substances with 
 Gh r cerin, in which some of them are dissolved. They are very useful 
 preparations for dispensing purposes, as they can be readily diluted with 
 water or alcohol without precipitation. There are 6 official Glycerites, 
 the figures following their names in the list below indicating the percent- 
 age of drug in each. The Glycerite of Starch contains 10 per cent, of 
 water, and that of Hydrastis has for its menstruum a mixture of glycerin, 
 alcohol and water. 
 
 Glyceritum Aeidi Carbolici, 20. Glyceritum Boroglycerini, 31. 
 
 Glyceritum Acidi Tannici, 20. Glyceritum Hydrastis, 100. 
 
 Glyceritum Amyli, 10. Glyceritum Vitelli, 45. 
 
 Haustus, A Draught (Unofficial), — is an extemporaneous mixture 
 consisting of a single dose, and usually ordered in a vial containing from 
 one to two fluidounces. 
 
 Effervescing Draught is one of the best known. It is prepared by neutralizing a 
 watery solution of Potassium Bicarbonate with Lemon-juice or Citric Acid, and may be 
 drank during effervescence. When the C0 2 has escaped it is a solution of Potassium 
 Citrate in water, and corresponds to the official Liquor Potassii Citratis. 
 
 Black Draught is another well-known preparation of this class. It is official as 
 Infusum Sennae Compositum. 
 
 Infusa, Infusions, — are prepared by treating vegetable substances with 
 hot or cold water without boiling. Cold water is preferred when the 
 drug contains a desirable volatile principle, or when its active ingredient 
 is injured by heat. The drug should be coarsely comminuted, sliced or 
 bruised, and treated by maceration or percolation with the proper quan- 
 tity of water, which in the absence of specific directions to the contrary 
 should be 5 parts by weight of the drug to 100 of water, or 5 grammes in 
 100 cc. Infusions should be freshly made as required for they are very 
 prone to decomposition. Those official number 4 and are named in the 
 following list, the figure after each representing the percentage of drug 
 to menstruum, viz. — 
 
 Infusum Cinchonae, 6. Infusum Pruni Virginianae, 4. 
 
 Infusum Digitalis, \ l / 2 . Infusum Sennae Compositum, 6. 
 
 The last-named infusion contains also 12 per cent, each of Manna and Magnesium 
 Sulphate and 2 of Fennel. The infusion of Cinchona has of Aromatic Sulphuric Acid 
 I per cent. Alcohol, in the proportion of 10 per cent, is an ingredient of the Infusion 
 of Digitalis to prevent decomposition. 
 
PHARMACEUTICAL PREPARATIONS. 
 
 577 
 
 Many dispensing pharmaceutists are in the habit of making infusions 
 from concentrated alcoholic tinctures or from fluid extracts. It is a very- 
 reprehensible practice, especially in those cases where the active ingre- 
 dients are of a resinous nature and therefore precipitate when the alco- 
 holic solution is added to water. 
 
 Inhalationes, Inhalations, and Vapores, Vapors (both Unofficial), 
 are medicines in the form of a vapor, a gas or an atomized spray, to be 
 inhaled by the patient for their local action on ihe respiratory tract. 
 The well-known steam-atomizer is the agent by which most of these 
 preparations are administered, though many substances may be inhaled 
 from the surface of hot water, from a sponge in a bottle surrounded by a 
 hot cloth, or from a heated shovel. They are prescribed in the usual 
 manner, as follows: — 
 
 Stimulant Inhalation. 
 
 E. 
 
 Olei Cubebae, . . . ^ij. 
 
 Magnesii Carbonat., . . gj. 
 
 Aquae, giij. 
 
 M. big. — A teaspoonful in a pint of 
 water at 150 F., for each inhalation. 
 
 Oil of Pine. 
 
 R . 01. Pini Sylvestris, . 
 
 Magnesii Carb., . . . 
 
 Aquae, 511J. 
 
 M. Sig. — A teaspoonful on a pint of 
 hot water for each inhalation. 
 
 si- 
 
 Carbolized Inhalation. 
 
 R. 
 
 Acidi Carbolici, .... TTLxlviij. 
 Aquae, q. s. ad . . . . :§ij. 
 M. Sig. — Use one-half in the cup of 
 steam-atornizer for each inhalation. 
 
 Tar and Turpentine. 
 
 B 
 
 01. Picis Liquidae, 
 
 01. Terebinth., . . aagij. 
 M. Sig. — Pour slowly on a hot shovel 
 in the sick-room, keeping the vapor con- 
 fined therein. 
 
 The official Charta Potassii Nitratis (Nitre-paper), is a preparation intended for use as 
 an inhalation, its vapors while burning being taken into the lungs. 
 
 Injectiones, Iijections (Unofficial), — are liquid preparations in- 
 tended for introduction into the cavities of the body by means of a 
 syringe. When thrown into the rectum they are termed Enemata (Ene- 
 mas or Clysters), and are usually prepared at the bedside. Enemata 
 may be demulcent, laxative, nutritive, stimulant or vermifuge in charac- 
 ter; and always have warm or tepid water as their diluent, with which 
 are incorporated such medicaments as may be desired. They may con- 
 sist simply of water to act as a wash for the cleansing of the bowel. In- 
 jections are termed vaginal, urethral, vesical, nasal, hypodermic, etc., 
 according to the locality in which they are employed. A special form of 
 syringe is employed in each case, the discussion of which belongs rather 
 to the domain of surgery than to that of medicine. Those used for the 
 nasal cavities are often arranged with small holes or an atomizing attach- 
 ment, so as to deliver the injection in the form of a fine spray. A Col- 
 lunarium is a nasal douche or wash. In the Appendix will be found a 
 37 
 
578 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 list of formulae for hypodermic injections ; a few prescriptions for other 
 forms are appended below. 
 
 Enema for Stricture of the Rectum. 
 R . Bismuthi Subcarb., . ^j. 
 Extracti Opii, . . . . . gr. ij. 
 Glycerini, Aquae, . . aa^ij. 
 M. Fiat enema. Sig. — Two table- 
 spoonfuls to be injected thrice weekly. 
 
 R. 
 
 Demulcent Enema. 
 Tincturae Opii, ... TT\xx. 
 Decocti Amyli, .... ^iv-vj. 
 M. Fiat enema. 
 
 Vermifuge Enema. 
 R. Extr. Quassiae Fl., . . ,^jss. 
 
 Aquae, 3 ijss. 
 
 M. Sig. — A tablespoonful with an equal 
 quantity of warm water, as an enema, to 
 be retained as long as possible. 
 
 A T asaI Injection (Dooell's). 
 R. Acidi Carbolici, .... ^jss. 
 Sodii Bicarb., 
 Sodii Boratis, . . . . aa 3 iv. 
 
 Glycerini, ^xivss. 
 
 Aquae, q. s. ad 3 viij. 
 
 M. Sig. — A tablespoonful diluted with 
 an equal quantity of tepid water to be used 
 thrice daily with a nasal sprayer. 
 
 Injection for Gonorrhea. 
 (Injection Brou.) 
 
 Zinci Sulphatis, . . . 
 
 • gr- viij. 
 
 Plumbi Acetatis, . . 
 
 . gr. xv. 
 
 Tinctune Opii, . . . 
 
 • gij- 
 
 Tinct. Catechu, . . . 
 
 
 Aquae Rosas, q. s. ad . 
 
 • § v j- 
 
 M. Fiat injectio. Sig.- 
 
 — Use with 
 
 ethral syringe. 
 
 
 Injection for Chronic Urethritis. 
 R. Hydrarg. Chi. Corrosivi, gr. %. 
 
 Zinci Chloridi gr. ss. 
 
 Aquae Destillatae, . . 3 viij. 
 M. Sig — A tablespoonful to be injected 
 well down into the urethra thrice daily, 
 through a gum catheter. 
 
 I r aginal Injections for Leucorrhea. 
 
 R. Aluminis, 3J. 
 
 Zinci Sulphatis, . . . . ^ss. 
 Sodii Boratis, . . gr. iv. 
 
 M. Sig. — Dissolve in half-a-pint of 
 warm water, and use with a vaginal sy- 
 ringe. 
 R. Acidi Tannici, .... ^j. 
 
 Glycerini, ^iv. 
 
 M. Sig. — One-half with an equal 
 quantity of water to be injected twice 
 daily. 
 
 Linimenta, Liniments, — are very thin ointments for external applica- 
 tion, intended to be applied with friction to the skin. They are solutions 
 of various substances in oily liquids or in alcoholic liquids containing 
 fatty oils. Of the following 9 official Liniments 2 have as their basis 
 Cotton-seed Oil, 1 Linseed Oil, 1 Oil of Turpentine, 1 Alcohol, and 
 3 Alcohol and Water. 
 
 Linimentum Ammoniae. 
 Linimentum Belladonnae. 
 Linimentum Calcis. 
 Linimentum Camphorae. 
 
 Linimentum Chloroformi. 
 Linimentum Saponis. 
 Linimentum Saponis Mollis. 
 Linimentum Sinapis Compositum. 
 Linimentum Terebinthinae. 
 
 Besides the above, (except Lin. Saponis Mollis), the Br. Phar. contains Lin. Aconiti, 
 Lin. Camphorae Comp., Lin. Crotonis, Lin. Hydrargyri, Lin. Iodi, Lin. Opii, Lin. 
 Potassii Iodidi cum Sapone, and Lin. Terebinthinae Aceticum. 
 
 Extemporaneous Liniments may correspond to the official ones or they 
 may be simple mixtures of fluids without either fat or soap. A prescrip- 
 tion for each kind is appended. The official Linimentum Saponis (Soap 
 Liniment) is a good basis for extemporaneous preparations of this class. 
 
PHARMACEUTICAL 
 
 Compound Chloroform Liniment. 
 R. Ext. Belladon. Rad. Fl., . Jss. 
 Ext. Aconiti Fl., 
 Chloroformi Venalis, 
 Spiritus Camphorae, 
 Alcoholis Diluti, q. s. 
 M. Fiat linimentum. 
 Sig. — Poison. To be rubbed on the 
 painful part. 
 
 M 
 
 Anodyne Liniment. 
 
 Tinct. Aconiti, gij. 
 
 Tinct. Opii, giv. 
 
 Tinct. Arnicae, ^j. 
 
 Chloroformi, gij. 
 
 Linim. Saponis, q. s. ad . ^ iv. 
 Fiat linimentum. 
 
 Sisf. — Poison. Liniment. 
 
 PREPARATIONS. 579 
 
 Stokes 1 Liniment. 
 R. Olei Terebinthinae, .... % ^iij. 
 
 Acidi Acetici, ^ ss. 
 
 Olei Limonis, gj. 
 
 Vitellum, j. 
 
 Aquae Rosae, J n j- 
 
 M. Fiat linimentum. 
 Sig. — Liniment. 
 
 Army Medical Wagon Liniment. 
 
 Liq. Ammoniae, 
 
 Ol. Terebinthinae, 
 
 01. Olivae, 
 
 aa, partes aequales. 
 M. Fiat linimentum. 
 Sig. — Liniment. 
 
 An Embrocation is a similar preparation, but of thinner consistence, 
 almost obsolete. 
 
 The term is 
 
 Liquores, Solutions, — comprise all aqueous solutions of non-volatile 
 substances, except the syrups, infusions and decoctions, which naturally 
 form distinctive classes. There are 24 official solutions, 7 of which are 
 simple aqueous solutions of the medicament, the rest being chemical 
 aqueous solutions, in which the dissolved substances are altered by 
 chemical action and new ones formed. They are named as follows : — 
 
 Liquor Acidi ArsenosH -- ^ 
 
 Liquor Iodi Compositus. 
 
 Liquor Ammonii Acetatis. 
 
 Liquor Magnesii Citratis. 
 
 Liquor Arseni et Hydrargyri Iodidi. 
 
 Liquor Plumbi Subacetatis. 
 
 Liquor Calcis. 
 
 Liquor Plumbi Subacetatis Dilutus 
 
 Liquor Ferri Acetatis. 
 
 Liquor Potassae. 
 
 Liquor Ferri Chloridi. 
 
 Liquor Potassii Arsenitis. 
 
 Liquor Ferri Citratis. 
 
 Liquor Potassii Citratis. 
 
 Liquor Ferri et Ammonii Acetatis. 
 
 Liquor Sodae. 
 
 Liquor Ferri Nitratis. 
 
 Liquor Sodae Chloratae. 
 
 Liquor Ferri Subsulphatis. 
 
 Liquor Sodii Arsenatis. 
 
 Liquor Ferri Tersulphatis. 
 
 Liquor Sodii Silicatis. 
 
 Liquor Hydrargyri Nitratis. 
 
 Liquor Zinci Chloridi. 
 
 Lotio, A Lotion or Wash (Unofficial), — is a solution or mixture of 
 medicinal agents, intended for external application ; usually consisting 
 of some soluble, astringent salt, dissolved in water, with perhaps some 
 glycerin or alcohol. A Fomentation {Fotus) is a similar preparation 
 used hot. A Collyrium is an eye-wash, and generally contains a soluble 
 astringent salt dissolved in rose-water or distilled water, in the proportion 
 of gr. j-iv to the g. The only official preparation suitable for a lotion is 
 the Liquor Plumbi Subacetatis Dilutus (Lead- water). A well-known 
 anodyne, refrigerant and astringent lotion is that represented by the 
 upper two of the following prescriptions. 
 
58o 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 R. 
 
 Lead-water and Laudanum. 
 Liq. Plumbi Subacetatis, . 5jj. 
 
 Tinct. Opii, %]. 
 
 Aquae, q. s. ad 3 v iij- 
 
 M. Fiat lotio. Sig. — Lotion. 
 
 ( Gross. ] 
 
 g r - 
 
 Collyrium. 
 
 R • Sodii Boratis, .... 
 
 Aquae Camphorae, . . 
 
 Mucil. Cydonii, 
 
 Aquae Destil. , aa 3 ss. 
 
 M. Fiat collyrium. Sig. — Eye-water ; 
 a few drops to be put into the eye three or 
 four times daily. 
 
 Lead and Opium Wash. 
 R . Liq. Plumbi Subacetatis, 
 
 Tinct. Opii, .... aa ^j. 
 
 Aquae, q. s. ad J viij. 
 
 M. Fiat lotio. Sig. — Lotion. 
 
 ( Sturgis. ) 
 
 Collyrium of Four Sulphates. 
 R . Zinci Sulphatis, 
 Ferri Sulphatis, 
 Cupri Sulphatis, 
 
 Aluminis, aa gr. j. 
 
 Aqua? Destillatae, . . . . ^j. 
 M. Fiat collyrium. Sig. — For use with 
 brush to palpebral conjunctivae, and to be 
 washed off with clean water. 
 
 Massse, Masses, — are Pill-masses prepared as described under the 
 subtitle Pjlul^. The official Masses number 2, viz. — 
 
 Massa Copaibae. 
 
 Massa Ferri Carbonatis. 
 
 Massa Hydrargyri. 
 
 Mellita, Honeys, — differ from syrups merely in their being prepared 
 with honey as a base. The Oxymel and Oxymel Scillaz of the B. P. are 
 similar preparations, containing also Acetic Acid. There are 3 official 
 Honeys, including two forms of honey itself, viz. — 
 
 Mel. 
 
 Mel Despumatum. 
 
 Mel Rosae. 
 
 Misturse, Mixtures, — in official pharmacy are aqueous preparations 
 of insoluble substances held in suspension by a suitable vehicle. In ex- 
 temporaneous pharmacy the term mixture has a wider signification, as 
 explained below. Mixtures are generally prepared extemporaneously 
 upon prescriptions, as few of them are of the stability necessary to insure 
 their preservation beyond a few days. The official mixtures are 4 in 
 number, and are named as follows, — 
 
 Mistura Cretae. 
 
 Mistura Ferri Composita. 
 
 Mistura Glycyrrhizae Composita. 
 Mistura Rhei et Sodae. 
 
 In extemporaneous pharmacy the term Mixture is applied to every fluid 
 compound intended for internal use, except a few which bear distinctive 
 titles, such as Emulsions, Draughts, Enemas, Elixirs and Drinks. The 
 simplest form of mixture in this extended sense is that in which two or 
 more liquids are mixed together ; but a great variety of substances may 
 be prescribed in this form, chief among which are most of the soluble 
 salts, light insoluble powders, salts which may be diffused by agitation, 
 extracts, gum-resins, and the fixed essential oils. They are generally 
 ordered in 2, 3, 4, 6, 8, 10 and 12-ounce vials. 
 
 Substances suitable to the mixture-form, properly so called, are those 
 which, though more or less insoluble in water, will mix therewith by 
 
PHARMACEUTICAL PREPARATIONS. 
 
 58 
 
 means of agitation, trituration, etc. 
 as follows : — 
 
 Diffused by Agitation : — 
 
 Calcii Phosphas Praecipitatus. 
 Cinchona (powdered). 
 Ipecacuanha (powdered). 
 Magnesia. 
 Quininae Sulphas. 
 Sulphur Praecipitatum. 
 
 Suspended by Viscid Excipients : — 
 Essential Oils. 
 Oleum Amygdalae. 
 Oleum Morrhuae. 
 Oleum Olivae. 
 Oleum Ricini. 
 Copaiba. 
 Ferri Carbonas Saccharatus. 
 
 Those most frequently ordered are 
 
 Miscible only by Trituration : — 
 Ammoniacum. 
 Asafcetida. 
 Confectio Rosae. 
 Confectio Sennae. 
 Extractum Aconiti. 
 Ext. Belladonnae Fol. Alcohol. 
 Ext. Conii. 
 Ext. Hyoscyami. 
 Ext. Stramonii. 
 Ext. Glycyrrhizae. 
 Ext. Kramerise. 
 Ext. Taraxaci. 
 Guaiacum. 
 Scammonium. 
 Myrrha. 
 
 Best Suspended by the aid of a Fixed Oil or Yolk of Egg : — 
 Ext. Cannabis Indicae. Oleum Terebinthinae. 
 
 Camphora. Chloroformum. 
 
 Solutions intended for internal administration are classed as Mixtures 
 in extemporaneous pharmacy, for the reasons already stated. The follow- 
 ing list of acids and salts comprises most of the solids which are best 
 adapted for use in liquid form, by reason of their solubility in water. 
 
 Acidum Citricum. 
 Acidum Tannicum. 
 Acidum Tartaricum. 
 Alumen. 
 
 Ammonii Chloridum. 
 Antim. et Potass. Tartras. 
 Barii Chloridum. 
 Calcii Chloridum. 
 Calcii Hypophosphis. 
 Ferri Pyrophosphas. 
 Ferri Sulphas. 
 Ferri et Ammonii Citras. 
 
 Ferri et Potassii Tartras. 
 Fern et Quininae Citras. 
 Magnesii Sulphas. 
 Mangani Sulphas. 
 Potassii Acetas. 
 Potassii Bicarbonas. 
 Potassii Bromidum. 
 Potassii Carbonas. 
 Potassii Citras. 
 Potassii Chloras. 
 Potassii Hypophosphis. 
 Potassii Iodidum. 
 
 Potassii Tartras. 
 Potassii et Sodii Tartras. 
 Morphinae Acetas. 
 Moi-phinae Hydrochloras. 
 Morphinae Sulphas. 
 Sodii Bicarbonas. 
 Sodii Boras. 
 Sodii Carbonas. 
 Sodii Chloridum. 
 Sodii Hypophosphis. 
 Sodii Phosphas. 
 Sodii Sulphas. 
 
 A few require the use of viscid substances as vehicles or correctives. 
 They are as follows : — 
 
 Ammonii Carbonas. 
 Plumbi Acetas. 
 
 Hvdrar^vri Chloridum Corrosivum. 
 
 Potassa. 
 
 Potassii Cyanidum. 
 
 Certain salts are best ordered by prescribing such agents as will when 
 in solution together react upon each other and produce the desired salt. 
 Instances of this may be found in the pharmacopceial processes for most 
 of the official Liquores, some salts so produced being the following : — 
 
 Ammonii Acetas. 
 Magnesii Citras. 
 Potassii Citras. 
 Ferri Citras. 
 
 Fern Acetas. 
 Ferri Chloridum. 
 Ferri Nitras. 
 Hydrargyri Nitras. 
 
 Potassii Arsenis. 
 Potassii Hydras. 
 Sodii Hydras. 
 Zinci Chloridum. 
 
582 PHARMACEUTICAL PREPARATIONS. 
 
 Certain other substances require the addition of other agents in order 
 to form eligible solutions. Such are the following : — 
 
 Quininse Sulphas, — requires acidulated water for its solution, the acid used being 
 generally Diluted Sulphuric, or the Aromatic Sulphuric. This method of prescribing 
 the salt develops its bitter taste to the utmost, and is often avoided by ordering the drug 
 to be suspended in a viscid liquid, such as Pulv. Acaciae in Syrup of Ginger. In such a 
 case an officious dispenser anxious to show his smartness by adding some dilute Sul- 
 phuric Acid to dissolve the Quinine would thereby defeat the object of the prescriber. 
 
 Quinine Sulphate may be prescribed with Aromatic Spirit of Ammonia, Spirit of 
 Nitrous Ether, Tinctures or other alcoholic preparations together with Glycerin or Syrup 
 and Water. In such cases the salt should be first dissolved in the alcoholic portion of 
 the prescription, then the glycerin or syrup and finally the aqueous portions should be 
 added gradually. It may also be ordered with Diluted Sulphuric Acid and some vege- 
 table infusion containing Tannin, in which case a precipitate of Quinine Tannate will be 
 produced. This of course should not be filtered, but should* be dispensed with a 
 "Shake-label." 
 
 For the use of Velatine as a vehicle for the administration of Quinine Salts, see under 
 the title Cinchona, in Part I. 
 
 Chinoidin, Cinchonine Sulphate and Quinidine Sulphate, — also require the 
 addition of a dilute mineral acid for their solution in aqueous mixtures. 
 
 Iodine, — requires the addition of Potassium Iodide for its solution in a convenient 
 quantity of water, as in the case of the official Liquor Iodi Compositus. 
 
 Hydrargyri Iodidum Rubrum, Red Mercuric Iodide, — requires the addition of 
 Potassium Iodide or Mercuric Chloride for its aqueous solution. 
 
 Potassii Bitartras, Cream of Tartar, — requires the addition of Borax or Boric Acid 
 for its solution in water. 
 
 Benzoic Acid, — requires the addition of Borax to aid its solubility in water, an equal 
 part of the latter making it 5 times more soluble than when alone. 
 
 Lime, — is more soluble in sweetened water than in plain water, the sugar aiding its 
 solution. 
 
 Excipients are substances which give form and consistence to prescrip- 
 tions, and serve as vehicles for the exhibition of the other ingredients. 
 Some of the excipients are Diluents, or agents which effect the dilution or 
 division of the active ingredients ; while others act in the double capacity 
 of diluents and Flavoring agents. The Excipients most generally used in 
 mixtures may be tabulated as follows, — 
 
 Diluents. True Excipients. 
 
 Water (Aqua). Acacia (in powder or mucilage). 
 
 Medicated Waters (Aquae). Tragacanth (in powder or mucilage). 
 
 Syrups. Confections. Sugars. 
 
 Mel Rosae. Some Extracts. 
 
 Elixir Aromaticum. Yolk of Egg (Vitellus). 
 
 Flavoring Agents. 
 
 Oleum Amygd. Amarae. Tinct. Cardamomi Comp. Spiritus Limonis. 
 
 Oleum Cari. Tinct. Cinnamomi. Spiritus Myristicse. 
 
 Oleum Caryophylli. Tinct. Gentianas Comp. Spiritus Menthae Piperitae. 
 
 Oleum Cinnamomi. Tinct. Tolutana. Spiritus Menthae Viridis. 
 
 Oleum Gaultheriae. Tinct. Vanillae. Syrupus Limonis. 
 
 Oleum Sassafras. Tinct. Zingiberis. Syrupus Tolutanus. 
 
 Tinct. Aurantii Dulcis. Spiritus Anisi. Syrupus Zingiberis. 
 
 Tinct. Cardamomi. Spiritus Lavandulae. 
 
PHARMACEUTICAL PREPARATIONS. 583 
 
 Compounding the Mixture is a matter of no slight importance, and one 
 which is best learned at the dispensing counter, though a few directions 
 may not be out of place. In the case of the simplest form of mixture, 
 where two or more fluid preparations are prescribed together, the only- 
 operations required are the measuring of the several ingredients and 
 pouring them into, the designed vial. In doing this the compounder 
 should pursue a regular and definite order of procedure. Taking in 
 his left hand a graduate of sufficient capacity to hold the whole quantity 
 prescribed, he should walk alongside the shelves, and with the right hand 
 pour from the stock-bottles the requisite quantity of each ingredient in 
 the order in which they are entered on the prescription. A skillful 
 druggist will hold the graduate between the thumb and first finger, the 
 prescription between the second and third fingers, and the stopper of the 
 stock-bottle between the little finger and the hand, leaving his right hand 
 free for the manipulation of the bottles containing the ingredients. 
 
 When an actively poisonous agent is ordered it should always be the 
 last thing put into the mixture. Attention to this rule will prevent the 
 danger of the toxic substance being put in twice. 
 
 The order in which the ingredients are put together is not of so much 
 importance in compounding a simple mixture as in the case of an emul- 
 sion, and the order of the prescription can usually be followed, with the 
 exception noted in the preceding paragraph. Still, when several alcoholic 
 preparations, syrups and waters are ordered together, it is good practice 
 first to mix the alcoholic fluids, then to add the syrups and finally the 
 water, so as to avoid the precipitation of resinous principles which would 
 occur if the alcoholic solutions were added to the water. Distilled water 
 should always be used, in order to insure uniformity in taste and appear- 
 ance, and also as a matter of purity and cleanliness. All mixtures should 
 be well shaken before being labelled. 
 
 Solids which are comparatively insoluble or only slowly soluble require 
 to be rubbed up in a mortar with one or more of the fluid ingredients. 
 Glass mortars are much employed for this purpose, and many compound- 
 ers mix all the ingredients in such a mortar before transferring them to 
 the vial. Vegetable powders (as Rhubarb, Ipecac, etc.), or finely pul- 
 verized inorganic substances, are often ordered in intimate mixture with 
 water, thickened with mucilage or syrup. In such cases the mixture 
 should be made in a porcelain or wedgewood mortar, enough mucilage or 
 syrup being added at first to make a thick paste, and after this is rubbed 
 smooth the water may be gradually added during the continued process 
 of mixing. This process will answer for all inorganic substances in 
 powder, except Magnesia, which is best mixed by being thrown on the 
 surface of the water; after it has sunk to the bottom as a uniform sedi- 
 ment the other ingredients may be added and the whole well shaken. 
 
5 §4 PHARMACEUTICAL PREPARATIONS. 
 
 Froth upon the surface of the liquid, which often arises after agitation 
 and may prevent the corking of the bottle, will quickly subside on the 
 addition of a few drops of alcohol. 
 
 The following are specimens of prescriptions for medicines to be admin- 
 istered in mixture form: — 
 
 Bismuth Mixture for Children. Quinine Mixture for Children. 
 
 R. Bismuthi Subcarbonatis, . . ^ij. ' R. Quininae Sulphatis (pulv.), . 3 ss. 
 Syrupi Acaciae, Acaciae (pulv.), g ss. 
 
 Aquae Cinnamomi, 
 Misce. Signa. — A teaspoonful every 
 hour in choleraic diarrhea. 
 
 Syrupi Zingiberis, ^ iv. 
 
 Fiat mistura. Signa. — A teaspoonful 
 thrice daily. 
 
 Mucilagines, Mucilages, — are thick, viscid liquids prepared by dis- 
 solving gum in water, or by extracting with water the mucilaginous prin- 
 ciples from certain plants. They are easily spoiled and should be kept 
 only in small quantities. The official Mucilages number 4, as follows, 
 the first two being prepared without heat, the last two with heat, — 
 
 Mucilago Acaciae. Mucilago Tragacanthae. 
 
 Mucilago Sassafras Medullae. Mucilago Ulmi. 
 
 Oleata, Oleates, — are liquid solutions of metallic salts or alkaloids in 
 Oleic Acid, intended for external administration. They are not definite 
 chemical compounds, though the term is also employed in trade to desig- 
 nate certain solid preparations which are claimed to be chemical com- 
 pounds of the same acid with various bases. [See under Acidum Olei- 
 CUM, ante, page 103.] There are three official Oleates, as follows, — 
 
 Oleatum Hydrargyri (20 per cent.). Oleatum Veratrinae (2 per cent.). 
 
 Oleatum Zinci (5 per cent.). 
 
 Oleoresinse, Oleoresins, — are liquid preparations consisting princi- 
 pally of natural oils and resins extracted from vegetable substances by 
 percolation with Ether. They differ from fluid extracts in not bearing 
 any uniform relation of cc. to the gramme of drug, in containing prin- 
 ciples which though soluble in ether are not so in alcohol, and in some 
 instances b'eing devoid of principles which are insoluble in ether but 
 soluble in alcohol. They are the most concentrated liquid preparations 
 of drugs which can be produced, and are prepared by percolating the 
 powdered drug with Ether until exhausted, recovering the greater part of 
 the ether by distillation, and exposing the residue in a capsule to spon- 
 taneous evaporation until the remaining ether has evaporated. There 
 are 6 official Oleoresins, viz. — 
 
 Oleoresina Aspidii (10-15). Oleoresina Lupulini (50). 
 
 Oleoresina Capsici (5). " Oleoresina Piperis (5). 
 
 Oleoresina Cubebae (18-25). Oleoresina Zingiberis (6-8). 
 
 The figures in parentheses show the percentage of oleoresin yielded by each drug. 
 
PHARMACEUTICAL PREPARATIONS. 
 
 58s 
 
 Pigmenta, Paints, (Unofficial), — are preparations for external use, 
 which cannot be classed with the preceding. They are generally pre- 
 scribed in skin diseases, for use over inflamed joints, or for application to 
 the throat with a camel' s-hair brush. 
 
 R. Tinct. Iodi, gj. 
 
 ^Etheris, ^iij. 
 
 Tinct. Aconiti, . . . . 3 ss. 
 
 Ext. Belladon. Rad. FL, . '^iv. 
 
 Morphinae Sulph., . . . . gr. ij. 
 
 Iodi, 3Jss. 
 
 Sig. — Paint 4 or 5 coats freely over the 
 inflamed and painful parts. 
 
 rjt . Alcoholis, Saponis Viridis, 
 
 Olei Cadini, . . . aa 3J. 
 
 Sig. — Paint over the part. 
 
 R 
 
 . Olei Tiglii, 5jj. 
 
 .Etheris, gij. 
 
 Tinct. Iodi, 3 v. 
 
 M. Sig. — Paint on once in 3 days. 
 
 Pilulse, Pills, — are spherical masses composed of medicinal agents 
 and intended to be swallowed whole. The Mass consists of the active 
 ingredients and the Excipient, the latter being the substance which gives 
 to the mass its adhesive and plastic qualities. In official pharmacy the 
 excipients are specified both as to composition and quantity in each case, 
 and those directed to be used in the preparation of the 3 official Masses 
 and the 15 official Pills are as follows, — 
 
 5 are made with Soap and Water, — Pil. Aloes, Pil. Aloes et Asafcetidae, Pil. Asafce- 
 tidae, Pil. Opii, Pil. Rhei. 
 
 4 are made with Water alone, — Pil. Aloes et Mastiches, Pil. Catharticae Comp., Pil. 
 Cathartics Vegetabiles, Pil. Rhei Comp. 
 
 I with Syrup, — Pil. Aloes et Myrrhae. 
 
 I with Mucilage of Tragacanth, — Pil. Antimonii Comp. 
 
 1 with Acacia and Water, — Pil. Ferri Iodidi. 
 
 2 with Glycerin and Water, — Pilulae Phosphori, Pil. Ferri Carbonatis. 
 I with Confection of Rose, — Pilulae Aloes et Ferri. 
 
 I with Honey, Syrup and Water, — Massa Ferri Carbonatis. 
 
 I with Glycerin and Honey of Rose, — Massa Hydrargyri. 
 
 I has no excipient, — Massa Copaibae, being a resin left after distillation. 
 
 The pharmacopceial directions for the formation of the pill-mass vary 
 in each case, but in general they prescribe that the ingredients shall be 
 mixed intimately, then beaten with the excipient to form a mass and 
 divided into a certain number of pills. Two of the official pills are 
 directed to be coated with an ethereal solution of the Balsam of Tolu, 
 — Pilulse Ferri Iodidi and Pilulae Phosphori. Full descriptions of the 
 various details of pill-making are given on the next page. 
 
 The number of official pills is 15, for the composition of which the 
 student is referred to their several titles in the section on Materia Medica. 
 Thev are named as follows, — 
 
 Pilulse Aloes. 
 
 Pilulae Aloes et Asafcetidae. 
 Pilulae Aloes et Ferri. 
 Pilulae Aloes et Mastiches. 
 Pilulae Aloes et Myrrhae. 
 Pilulae Antimonii Compositae. 
 Pilulae Asafoetidae. 
 
 Pilulae Catharticae Compositae. 
 Pilulae Catharticae Vegetabiles. 
 Pilulae Ferri Carbonatis. 
 Pilulae Ferri Iodidi. 
 Pilulae Opii. 
 Pilulae Phosphori. 
 Pilulae Rhei. 
 
 Pilulae Rhei Compositae. 
 
586 PHARMACEUTICAL PREPARATIONS. 
 
 Pills constitute a form of medicine very much used in extemporaneous 
 pharmacy, and one with the preparation of which the compounder should 
 be perfectly familiar, for it will constitute fully one-third of his work at 
 the dispensing counter. Pills should not exceed 5 grains in weight, 
 unless the ingredients are very heavy, as Bismuth, Calomel, Hydrargyrum 
 cum Creta, etc., of which 6, 8, or 10 grains may be made into a pill 
 which may be readily swallowed. A Bolus is a similar mass, but larger 
 than a pill, while the names Granule and Parvule are given to masses 
 smaller than the average pill. 
 
 The Process of Pill-making. 
 The Process of Pill-making is briefly as follows : The ingredients 
 ordered in the prescription are separately weighed out in the order of 
 their bulk, commencing with that one of which the smallest quantity is 
 to be used. If any require pulverization they should be placed first in 
 the mortar and reduced to powder, the other dry ingredients added, next 
 the soft extracts and the excipient selected ; the whole being worked up 
 into a mass, the Pill-mass, by the aid of the mortar and pestle. The 
 perfect pill-mass should be uniform throughout, should not show any 
 particles of any one ingredient, should have such a consistence that the 
 pills made from it will retain their shape, should not be too hard, nor too 
 dry, nor should it stick to the fingers. The mortar should be large and 
 shallow, of unpolished wedgewood ware ; having a thick, smooth and 
 well-formed bottom and a pestle which fits it. The operation of working 
 up the mass is one of kneading it between the end of the pestle and the 
 side of the mortar, and if proper ingredients and excipient are used and 
 the work is well done, the mass will eventually loosen itself from both 
 mortar and pestle. If it does not do so it should be removed with a 
 spatula when sufficiently worked, and may be kneaded for a few minutes 
 between the fingers. It should then be placed upon the tile or slab pre- 
 viously dusted with a little Lycopodium or Starch in fine powder, and 
 rolled into a long cylinder by the aid of a broad-bladed spatula, until the 
 mass is of a length corresponding to the divisions on the tile-scale which 
 represent the number of pills to be made. The mass should then be 
 placed along the scale, and a cut made through it with the spatula at each 
 division, the pieces being at once rounded separately into pills by the 
 thumb and two fingers of each hand. A pill-machine is often employed, 
 consisting of two metal plates having semi-cylindrical grooves on one 
 side, set into wooden boards, the whole forming a convenient apparatus 
 for rolling the mass and then cutting it into the required number of pills 
 by one movement. The pills are then left to dry upon the slab while the 
 label is being written, after which they are placed in a pill-box, or in a 
 wide-mouthed bottle if they contain volatile ingredients, and surrounded 
 
PHARMACEUTICAL PREPARATIONS. 587 
 
 by a Conspergative powder (Lycopodium, powdered Chalk, dusted Talc), 
 to prevent their adhering together or losing their shape. 
 
 Excipients used in pill-making are seldom mentioned in the prescrip- 
 tion, but are usually left to the choice of the compounder. Some sub- 
 stances need no excipient, but may be made at once into pills; such 
 being the softer Extracts and some Gum-resins, the former if too hard 
 only needing a little water, and the latter a few drops of spirit to soften 
 them to the required degree of plasticity. Every druggist has his favorite 
 pill-excipient, many using a paste made of powdered Tragacanth 1, Gly- 
 cerin 3^ and Water 1 part, while others use Extract of Malt or a mixture 
 of Syrup and powdered Acacia for general use. Powdered Tragacanth to 
 give tenacity, Glycerin to keep the mass soft, and Water to develop the 
 adhesive qualities of many ingredients, will answer for fully nine-tenths 
 of all the cases which occur in practice. These three excipients should 
 stand on the dispensing counter ready for use, and all ready-made pastes 
 or mixtures should be discarded as being slovenly, dirty and liable to 
 change. The excipients described below are those in general use and 
 are arranged in the order of their comparative importance. 
 
 Liquid Excipients. 
 
 Glycerin, — is a very valuable excipient, as it continually attracts moisture from the 
 atmosphere, and pills made from it do not get hard. It should always be used for 
 Quinine pills. Glycerites of Starch or Tragacanth are generally useful excipients. The 
 former is official, the latter is made in the proportion of 3 ss to the ^ . 
 
 Glucose, — is a good excipient, being colorless, adhesive, and not readily volatilized 
 at ordinary temperatures. Since its introduction by Mr. Lascheid for this purpose it has 
 steadily grown in favor. 
 
 Honey, — may be used for dark-colored substances. It should be evaporated to one- 
 half its bulk, and then if mixed with a little Tragacanth it makes an excellent excipient 
 for insoluble powders. 
 
 Extract of Malt, — is a pretty fair excipient, but has the disadvantage of its dark color. 
 
 Syrup, — is a fair excipient for powders, but it should not be used for metallic salts, 
 especially Calomel, which it reduces in a short time. Syrttp of Acacia is good where 
 there is little room left for the excipient, but pills made with it become very hard and 
 insoluble if they are kept long. 
 
 Mucilage of Acacia, — is very adhesive, but not a good excipient for the same reason 
 as given for the syrup. 
 
 Water, — is only used alone as an excipient when the ingredients possess sufficient ad- 
 hesiveness to be developed by the water. Such are the following powders : Aloes, Rhu- 
 barb, Kino, Tannic Acid, Opium, Squill, Asafcetida, — also Ferric Citrate, Berberine Sul- 
 phate, and some other salts. 
 
 Alcohol, — is used to soften Camphor, Compound Extract of Colocynth, Guaiac, res- 
 inous extracts, gums, etc. 
 
 Solid Excipients. 
 
 Tragacanth, — is an excellent excipient, especially for substances which are too soft, 
 giving them body and elasticity. 
 
 Acacia, — is added to give more adhesiveness than can be obtained from viscid liquids 
 alone. Pills made with it are generally very hard. It is used for Silver Nitrate, which 
 may explode if mixed with vegetable extracts or glucose. 
 
588 PHARMACEUTICAL PREPARATIONS. 
 
 Soap, — is the best for resinous and fatty substances, increasing the solubility of the 
 former. It is oftener employed in the official pills than any other excipient, but should 
 not be used for substances which are decomposed by an alkali, nor for Tartar Emetic. 
 
 Bread-crumb (Mica Pants), — is an excellent excipient for Croton Oil, or other 
 powerful liquid substances, as volatile oils. 
 
 Confection of Rose, — is too bulky for general use, but is a good excipient for very 
 active agents like Strychnine, which are used in small quantity. 
 
 Althaea, — is good for absorbing and adhesive purposes, but is too bulky for general use. 
 
 Petrolatum, Cacao Butter, and Resin Cerate, — are used for oxidizable substances, 
 as Potassium Permanganate. 
 
 Kaolin, — is well adapted as an excipient for Silver Nitrate and other substances which 
 are easily decomposed. 
 
 Liquorice, — is an old excipient, but not much employed now. In powder it may 
 be used for oils. 
 
 Conspergatives are absorbent powders which are dusted upon the 
 finished pills and put around them in the box or vial in which they are 
 dispensed, to keep them from sticking together and losing their shape. 
 Powdered Liquorice was formerly much used for this purpose, but the best 
 conspergatives are Lycopodium, Talc, Althaea and Rice Flour, the latter 
 especially for white pills. 
 
 Substances suitable for the pilular form of medicine are — 
 Those acting in small doses. Heavy, insoluble substances. 
 
 Those intended to act slowly. Fetid substances. 
 
 Those to act on the lower bowel. Vegetable extracts. 
 Gums-resins, Balsams, Turpentine. 
 
 When the basis is an unadhesive substance, one of the other ingredients 
 should be an extract or a vegetable powder which will form a mass by 
 moisture alone. Attention to this rule in prescribing pills will often pre- 
 vent the increase of their size by the use of inert excipients. 
 
 Substances difficult to combine, except by peculiar treatment, are met 
 with frequently. The following notes will cover most such cases : — 
 
 Aloes, — is best treated on a heated slab with alcohol in very small quantity. Soap is 
 the excipient in the official Pilulse Aloes. 
 
 Butyl Chloral Hydrate, — should be treated with a little Confection of Rose and 
 thick mucilage. 
 
 Calcium Sulphide, — should be well triturated with an equal quantity of Sugar of 
 Milk, and then worked up with a little powdered Liquorice -root and Tragacanth 
 Mucilage. 
 
 Camphor, — should be powdered with a little alcohol, and may be worked into a pill- 
 mass with Glycerite of Tragacanth after the evaporation of the alcohol. 
 
 Carbolic Acid, — requires nearly an equal part of wheaten flour or bread-crumb, with 
 a very minute quantity of Glycerite of Tragacanth. Creosote may be made into a mass 
 by the addition of Powdered Liquorice with a very little bees' wax. If made into a pill 
 with Silver Oxide it will explode unless the silver salt be first diluted by trituration with 
 Liquorice, Gentian, or some other inert powder. 
 
 Iron and Quinine Citrate, — is very deliquescent with most excipients. Canada 
 Balsam is the best for it. 
 
PHARMACEUTICAL PREPARATIONS. 
 
 589 
 
 Copaiba, — may be made into a pill-mass by the addition of a little Magnesium Car- 
 bonate or Wax. 
 
 Croton Oil, — is best worked up with bread-crumb, though powdered Liquorice and 
 mucilage of Acacia may be used. 
 
 Ferrous Iodide, — in pill form requires special manipulation and protection to remain 
 unoxidized. The official Pil. Ferri Iodidi is prepared with Iodine and Reduced Iron, 
 has Liquorice, Sugar, and Acacia as excipients, and is protected by a coating of Balsam 
 of Tolu. In other formulae, Acacia, Althaea, Cacao-butter, Elm bark, and Liquorice are 
 used as excipients. 
 
 Ferrous Sulphate, — is used in Blaud's Pill and in the official Pil. Ferri Compositae, 
 with Potassium Carbonate, to form by mutual decomposition Ferrous Carbonate, which 
 quickly passes into the ferric salt by exposure. Myrrh in powder and syrup is the ex- 
 cipient used for the official pill. 
 
 Gallic Acid, — makes a good pill with a very small quantity of Glycerin. Tannic 
 Acid requires about one-fifth its weight of Glycerin and one-tenth of Mucilage. 
 
 Phosphorus, — presents the problem of combining it in pill without letting it oxidize. 
 This is believed to be accomplished by the pharmacopoeial directions for the Pil. Phos- 
 phori, according to which the Phosphorus is dissolved in Chloroform in a test-tube, then 
 quickly worked into a mass with Althaea, Acacia, Glycerin and Water, and finally the 
 pills are coated by shaking with an Ethereal solution of Balsam of Tolu. Carbon Disul- 
 phide is a better solvent, but when it is used the pill-mass retains its disgusting odor. 
 
 Potassium Acetate, — requires Canada Balsam to secure its stability in pill form. 
 Potassium Iodide is best manipulated by rubbing it into a smooth paste with a very 
 little water, then adding a small quantity of Liquorice powder. Potassium Perman- 
 ganate should be worked up with Kaolin and a very little water. Resin Cerate, Soft 
 and Hard Paraffin and Cacao-butter are also used as excipients. 
 
 Quinine, — requires very clean hands and tools, and a colorless excipient, as Glycerin 
 or Glucose, to make a nice-looking pill. If one part of Tartaric Acid is added to four of 
 the Quinine salt, the mass will be less likely to crumble and will be of less bulk. Qui- 
 nine Sulphate may be made into small and soluble pills by simply triturating it with 
 Aromatic Sulphuric Acid TC\j\] to each 5 grains of the salt. The moulding into pills 
 should be done at the moment when the mass has begun to dry. A drop of syrup or 
 honey, added at this time, will prevent the too rapid hardening of the mass. 
 
 Rhubarb, — in powder makes a good mass with one-fifth of its weight of Glycerin ; 
 but Soap is the excipient ordered for the official Pilulae Rhei. 
 
 Substances unsuited to the pilular form are — 
 Those requiring large doses, and those which are volatile. 
 Emetics, and other agents administered for immediate effect. 
 Essential Oils in quantity exceeding half a drop to each pill. 
 Oils and other bodies which require much solid matter to make a mass; 
 
 except those prescribed in very small dose, as Croton Oil. 
 Deliquescent Salts, unless intended to be used immediately. 
 Efflorescent Salts, unless deprived of their water of crystallization. 
 
 Deliquescent Salts. 
 
 Ammonii Iodidum. 
 
 Nitras. 
 
 Valerianas. 
 
 Auri Chloridum. 
 
 Calcii Chloridum. 
 
 Chinolin Salts, except the Tartrate, which 
 
 is stable. 
 Lithii Citras. 
 
 Bromidum. 
 
 Salicylas. 
 
 Efflorescent Salts. 
 
 Alumen (slightly). 
 Ammonii Carbonas. 
 
 Phosphas. 
 
 Antim. et Potassii Tartras (slightly). 
 Cupri Acetas. 
 
 ■ Sulphas. 
 
 Magnesii Sulphas (slightly). 
 Potassii et Sodii Tartras (slightly). 
 
 Ferrocyanidum (slightly). 
 
 Quininae Bisulphas. 
 
59Q 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 Deliquescent Salts. 
 
 Magnesii Citras. 
 Potassa. 
 
 cum Calce. 
 
 Potassii Acetas. 
 Carbonas. 
 
 Citras. 
 
 Cyanidum. 
 
 Hypophosphis. 
 
 Sulphis. 
 
 Tartras. 
 
 Sodii Hypophosphis. 
 
 Iodidum. 
 
 Zinci Bromidum. 
 Chloridum. 
 
 Iodidum. 
 
 Efflorescent Salts. 
 
 Quininae Sulphas (after a time). 
 
 Soda. 
 
 Sodii Acetas. 
 
 Arsenas (slightly). 
 
 Benzoas. 
 
 Boras (slightly). 
 
 Carbonas. 
 
 Hyposulphis. 
 
 Phosphas. 
 
 Santoninas (slightly). 
 
 Sulphas. 
 
 Sulphis. 
 
 Strychninse Sulphas. 
 Zinci Acetas. 
 Sulphas. 
 
 Coated Pills are manufactured upon a large scale by the great drug 
 houses, extensive machinery being employed for the purpose. The coat- 
 ing material used is either Sugar or Gelatin. The U. S. Pharmacopoeia 
 directs that two of the official pills shall be coated by being shaken with 
 a solution of Balsam of Tolu in Ether, — Pil. Ferri Iodidi and Pil. Phos- 
 phori. In extemporaneous pharmacy it is rarely practicable to coat pills 
 with anything except gold or silver leaf, and this is sometimes directed 
 by the prescriber, the word li Deaur enter — let them be gilded" being 
 used in the subscription. To do this neatly the pills should have no trace 
 of powder on them, but should be first coated with a trifle of fresh muci- 
 lage by rolling between the mucilage-moistened fingers, each pill being 
 then dropped directly on to a sheet of gold or silver leaf, until a dozen or 
 more are so deposited. The leaf and its pills are then allowed to slide into 
 a globular boxwood shaker, or the leaf may be first placed in the shaker 
 and the pills dropped on it there. A cautious circular movement being 
 given to the shaker the pills are caused to travel around its walls, and 
 when the cover is removed they will be found to have each received an 
 even coating of the metal used. Gold leaf should always be employed 
 for pills of Blue Mass or Asafoetida, as silver is amalgamated with the 
 former and turned black by the latter. 
 
 Albumin may be used for coating small numbers of pills, which should be of very firm 
 consistence before the coating is applied. Each pill is rolled between two fingers with a 
 little white of egg, and then revolved in a warm pan. Another method of finishing them 
 is, after coating with albumin, to rotate them in a tray with powdered French chalk until 
 their surfaces become smooth and shiny. This process gives a very nice finish. 
 
 The following prescriptions represent the composition of a few unoffi- 
 cial pills in general use. A complete pill formulary is easily obtained, 
 being published annually by the principal manufacturers. 
 
 Anaphrodisiac and Sedative. 
 
 R . Camphorse, gr. xxx. 
 
 Lupulini, ... gr. xx. 
 
 Fiat massa et div. in pil. xx. 
 Sig. — One thrice daily. 
 
 Astringent Pill. 
 
 R . Argenti Nitratis, . . . 
 
 Pulv. Cretse (Gallicse), . 
 
 Petrolati, q. s. 
 
 Fiat massa et div. in pil. xl. 
 
 xx. 
 
 lxxx. 
 
PHARMACEUTICAL PREPARATIONS. 
 
 591 
 
 Pills of Iron. 
 
 R . Ferri Reducti, gr. 1. 
 
 Mannae, gr. xv. 
 
 Glucosi, q. s. 
 Fiat massa et div. in pil. xxv. 
 Sig. — One after each meal. 
 
 Emmenagogue Pill 
 
 {Otto). 
 
 R. Ferri Sulph. Exsic, 
 
 . . gr. xlviij. 
 
 Pulv. Aloes, . . . 
 
 . • gr. xij. 
 
 Terebinthinae, . . . 
 
 . . gr. xxvij. 
 
 01. Terebinth., . . 
 
 . . TT\x. 
 
 Fiat massa et div. in pil. 
 
 xxx. 
 
 Sig. — Two, three times 
 
 a day. 
 
 Hoope? J s Female 
 
 Pills. 
 
 R . Pulv. Aloes Socot., . 
 
 . . gr. xlviij. 
 
 Ferri Sulph. Exsic., 
 
 . . gr. xxiv. 
 
 Ext. Hellebori Nig., 
 
 
 Pulv. Myrrhae, 
 
 
 Saponis, 
 
 . aagr. xij. 
 
 Pulv. Canellas Alb., 
 
 
 Pulv. Zingiberis, 
 
 . aa gr. yj. 
 
 Aquce vel Syrupi, q. s 
 
 
 Fiat massa et div. in pil. 
 
 , quisque pondo 
 
 gr. ijss. 
 
 
 Sig. — One to three at a 
 
 dose. 
 
 Astringent Pill. 
 . Plumbi Acetatis, . . . . gr. xvj. 
 
 Pulv. Camphorae, . . . gr. xij. 
 
 Pulv. Opii, gr. iij . 
 
 Bismuthi Subcarb., . . . gr. xij. 
 
 Ext. Gentianae, q. s. 
 Fiat massa et div. in pil. xij. 
 Sig. — One thrice daily. 
 
 Cholagogue Pills [Squibb). 
 . Resinae Podophylli, . . . gr. vj. 
 
 Ext. Belladon. Alcohol., gr. iij. 
 
 Pulv. Capsici, 
 
 Pulv. Sacch. Lactis, . aa gr. xxiv. 
 
 Pulv. Acaciae, gr. vj. 
 
 Glycerini, Syrupi, aa q.s. 
 Fiat massa et div. in pil. xxiv. 
 Sig. — One or two as required. 
 
 R. 
 
 Aperient Pills. 
 
 Pul. Aloes Socot., . . 
 
 Pulv. Rhei, ... 
 
 Hydrarg. Chlor. Mitis.. 
 
 Antim. et Potas. Tart., 
 Fiat massa et div. in pil. xxiv 
 Siff. — One or two as needed, 
 
 gr. xxiv. 
 gr. xlviij. 
 gr. iv. 
 . gr. ij. 
 
 Tonic Pill for Women 
 R. Strychninae Sulph., 
 Acidi Arsenosi, . 
 Ext. Belladonna?, 
 Quininae Sulph., . 
 Massae Ferri Carb., 
 Fiat massa et div. in pil. xxxv 
 Sig. — One three times daily 
 
 aagr. 
 
 • g r - 
 
 • gr- 
 g r - 
 
 v. 
 xxxv, 
 
 Anti- Bilious Pills. 
 Pulv. Scammonii, 
 Pulv. Aloes Socot., 
 Pulv. Gambogiae, 
 Hydrarg. Chlor. Mitis, 
 Potassii Bitart., . . . aa gr. xx. 
 Ext. Taraxaci, q. s. 
 Fiat massa et div. in pil. xx. 
 
 Potus, A Drink (Unofficial), — is a solution or a mixture intended to 
 be used ad libitum, and generally consists of a Potassium or Sodium salt 
 or a mineral acid, in dilute solution, sweetened and flavored. 
 
 The Imperial Drink. R. Potassii Bitartratis, ^ij; Olei Limonis, n\v ; Aquae 
 Bullientis, q. s. ad £xx. M. Fiat potus. Sig. — Use as a drink. 
 
 Pulveres, Powders, — are usually prepared extemporaneously, but a 
 few compound ones have been made official, the ingredients being 
 directed to be rubbed together until reduced to a fine powder and thor- 
 oughly mixed. Special directions are given for the preparation of two 
 — the Compound Effervescing Powder and the Compound Powder of 
 Morphine. There are 9 official powders, named as follows, — 
 
 Pulvis Antimonialis. Pulvis Glycyrrhizae Compositus. 
 
 Pul vis Aromaticus. Pulvis Ipecacuanhae et Opii. 
 
 Pulvis Cretae Compositus. Pulvis Jalapae Compositus. 
 
 Pulvis Effervescens Compositus. Pulvis Morphinae Compositus. 
 
 Pulvis Rhei Compositus. 
 
59 2 PHARMACEUTICAL PREPARATIONS. 
 
 The composition of each of these preparations will be found in the section on Materia 
 Medica and under the title from which its name is derived, except that of the Compound 
 Effervescing Powder, which is placed under the title Potassium. Pulvis Ipecacuanha 
 et Opii is really a trituration, its ingredients being rubbed together with sugar of milk 
 into a very fine powder. 
 
 As prepared extemporaneously Powders are generally compound and 
 maybe mixed on a slab with a spatula, but a much better method of 
 mixing them is by trituration in a mortar. The latter should always be 
 employed except in the case of substances which may explode if so 
 treated, as Potassium Chlorate with oxidizable substances. (See ante, 
 page 550.) The diluent best employed in powders is Sugar of Milk, on 
 account of its hardness, its density and its comparative insolubility. A 
 coloring agent, as Carmine in minute quantity, is a useful ingredient, 
 enabling the eye to judge of the degree of mixing and subdivision ob- 
 tained. Powders containing soluble salts, extracts, volatile oils, camphor, 
 or any other hygroscopic or volatile substances, should be dispensed in 
 waxed paper. For ordinary powders the plain white paper of the drug- 
 stores will answer, but a better paper for small powders is a very thin 
 one having a high surface finish, as the white glazed French demy. 
 Powders are often ordered in Wafers {Cachets), to be swallowed without 
 unfolding. The division of powders into the number of Papers (C/mr- 
 tutce) ordered and folding them neatly, require a considerable amount 
 of practice. A small machine is used, over which the ends of the papers 
 are bent, in order to have them of the proper size for the box in which 
 they are dispensed. If they are to be put into an envelope, less exact- 
 ness of folding is required, and the mechanical contrivance may be dis- 
 pensed with. 
 
 Substances suitable to administration in the form of powders are those 
 which are insoluble, those which would be chemically incompatible in 
 fluid form, and certain pulverizable extracts. Those which are unsuited 
 to this form are such as have a very nauseous taste or odor, substances of 
 which the dose is large, those which are deliquescent, efflorescent or 
 very volatile, and those which liquefy on mixing. A list of deliquescent 
 and efflorescent salts is found on page 589, while the following-named, 
 though dry alone, become moist when triturated together, viz. — 
 
 Sodium Sulphate and Potassium Carbonate. 
 Zinc Sulphate and Lead Acetate. 
 Camphor and Chloral Hydrate. 
 
 Many substances cannot be powdered without the intervention of 
 another body: thus Opium requires a hard substance like sugar of milk 
 or potassium sulphate, Camphor requires a minute quantity of alcohol, 
 Myrrh needs sugar or gum, etc. Substances, as the alkaloids and their 
 salts, which are very active and are used in very small doses, require some 
 inert substance to give them bulk enough for division and handling. 
 
PHARMACEUTICAL PREPARATIONS. 
 
 593 
 
 Sugar of Milk will be found the best agent for this purpose. Prescrip- 
 tions may order the ingredients for a single powder, with directions to 
 dispense a certain number of the same composition ; or they may give 
 the quantities for the whole number of powders ordered, with instructions 
 to divide into a certain number. The dispenser should carefully scan the 
 prescription in order to avoid the multiplication of quantities where divi- 
 sion is intended. The official powders are named on p. 591, and the 
 following formulae will serve to illustrate those generally prescribed : — 
 
 Astringent Powder for Infants. 
 
 U . Plumbi Acetatis, . . . . gr. ij. 
 
 Pulveris Opii, gr. ss. 
 
 Camphorae, . . . . gr. j. 
 
 Sacchari Lactis, . . g r - hj- 
 
 Trit. et div. in chartulas xij. 
 Sig. — One every 2 or 3 hours in diar- 
 rhea of infants. For an adult the above 
 represents one dose. 
 
 Gastric Sedative. 
 
 Bismuth i Subnitratis, . . £j. 
 
 Pulveris Rhei, 
 
 Pulveris Aromat., . . aa^ss. 
 M. et div. in chartulas vj. 
 Sig. — One before each meal. 
 
 Laxative Powder. 
 
 Hydrarg. Chlor. Mitis, . gr. x. 
 
 Sacchari Lactis, . . . gr. xx. 
 M. et fiant pulv. x. 
 Sig. — One powder twice daily. 
 
 Bismuth and Soda. 
 
 R . Bismuthi Subnitratis, 
 
 Sodii Bicarb., . . . . aa^ij. 
 
 Pulv. Zingiberis, .... gr. xl. 
 M. et div. in chartulas xij. 
 Sig. — One after each meal. 
 Corrective in dyspepsia, acne and eczema. 
 
 R 
 
 Antipruritic Powder. 
 
 Pulveris Camphorse, . . . £j. 
 
 Zinci Oxidi, z iv. 
 
 Pulv. Amyli, ^j. 
 
 M. et fiat pulvis. 
 
 Sig. — Use locally as a dusting powder to 
 relieve itching. 
 
 Catarrh Po7uder. 
 
 R: . Bismuthi Subnitratis, . . 3 iij. 
 
 Pulv. Acacia?, £j. 
 
 Pulv. Talci, sjij. 
 
 Morphinae Hydrochlor. , . gr. j. 
 M. Sig. — Use by insufflation. 
 
 Compressed tablets are really powders which have been compressed into 
 tablet shape by machinery. A little pressure from the blade of a spatula 
 will restore them to the powder form. 
 
 Resinae, Resins. — Pharmaceutical resins are solid preparations ob- 
 tained by precipitating the resinous principles of plants from their alco- 
 holic solution by the agency of water. They differ from alcoholic ex- 
 tracts in containing only those principles which are soluble in alcohol 
 and insoluble in water, while the extracts contain all principles which are 
 soluble in alcohol. Besides Resina itself, which is the residue left after 
 distilling off the volatile oil from Turpentine, there are 4 official Resins, 
 three of which correspond to the above description, and one (Resin of 
 Copaiba) is the residue left after distilling off the volatile oil from Copaiba. 
 They are named : — 
 
 Resina Copaibae. 
 Resina Jalapa?. 
 True Resins are defined on page 25. 
 38 
 
 Resina Podophylli. 
 Resina Scammonii. 
 
594 PHARMACEUTICAL PREPARATIONS. 
 
 Spiritus, Spirits, — are alcoholic solutions of volatile substances, which 
 may be solids, liquids or gases. They are officially prepared either by 
 simple solution, by solution with maceration, by gaseous solution, by 
 chemical reaction or by distillation. The menstruum is Alcohol or 
 Deodorized Alcohol in nearly all instances, 4 having Water in addition, 
 and 2 being alcoholic liquors of a specified alcoholic strength (Whiskey, 
 Brandy). The official spirits are 25 in number, as follows, — 
 
 Spiritus Athens, 32^. Spiritus Fmmenti, 44-50. 
 
 Spiritus zEtheris Compositus, 32^. Spiritus Gaultheriae, 5. 
 
 Spiritus ^Etheris Nitrosi, 4. Spiritus Glonoini. 1. 
 
 Spiritus Ammoniae, 10. Spiritus Juniperi, 5. 
 
 Spiritus Ammoniae Aromaticus, 9. Spiritus Juniperi Compositus, 63^. 
 
 Spiritus Amygdalae Amarae, I. Spiritus Lavandulae, 5. 
 
 Spiritus Anisi, 10. Spiritus Limonis, 5. 
 
 Spiritus Aurantii, 5. Spiritus Menthae Piperitae, 10. 
 
 Spiritus Aurantii Compositus, 20. Spiritus Menthae Viridis, 10. 
 
 Spiritus Camphorae, 10. Spiritus Myrciae, 55. 
 
 Spiritus Chloroformi, 6. Spiritus Myristicae, 5. 
 
 Spiritus Cinnamomi, 10. Spiritus Phosphori, 0.12. 
 Spiritus Vini Gallici, 39-47. 
 
 The figures placed after Spiritus Frumenti, Spiritus Juniperi Comp., Spiritus Myrciae, 
 and Spiritus Vini Gallici, represent the percentage of absolute Alcohol by weight in 
 each ; those placed after the others indicate the quantity of the principal ingredient in 
 grammes to each 100 cubic centimeters of the preparation. Absolute Alcohol is the 
 menstruum directed for Spiritus Phosphori. 
 
 Suppositoria, Suppositories, — are solid bodies containing medicinal 
 substances, and intended for introduction into the vagina, rectum or 
 urethra. The Pharmacopoeia prescribes a general formula for their prepa- 
 ration, according to which the medicinal portion should be incorporated 
 with Oil of Theobroma by rubbing together at a temperature of 95 F. 
 The mixture should be poured into suitable moulds and cooled on ice or 
 in ice-cold water. Unless otherwise specified they should have the fol- 
 lowing shapes and weights, corresponding to their several uses : — 
 
 Rectal Suppositories, — cone-shaped, about I gramme (15 grains) each. 
 Urethral Suppositories, — pencil-shaped, about 1 gramme (15 grains) each. 
 Vaginal Suppositories, — globular, about 3 grammes (45 grains) each. 
 
 The only official Suppositories are those of Glycerin, (Suppositoria 
 Glycerini), in which Stearic Acid is employed to give the requisite con- 
 sistence. 
 
 In extemporaneous pharmacy Suppositories are usually prepared with 
 Cacao-butter as a basis, but for those intended for the uterus or urethra a 
 mixture of Gelatin and Glycerin is considered the best excipient, being 
 firmer and more plastic than cacao-butter, and more easily handled. 
 Hollow cones of cacao-butter, or some composition resembling it, are 
 kept in the shops, and will be used by the average druggist in filling pre- 
 scriptions for rectal suppositories unless prohibited, as they save him con- 
 
PHARMACEUTICAL PREPARATIONS. 595 
 
 siderable labor; the active drug being simply placed in the centre of the 
 cone, which is then sealed by a plug fitting into its base. These contriv- 
 ances are by no means so efficient as the regular suppository, in which 
 the medicinal agent is thoroughly incorporated with the excipient, for the 
 former smear the rectum with a quantity of melted grease before the active 
 ingredient is permitted to come into contact with its walls. The agents 
 used in suppositories are chiefly extracts and alkaloids, some few powders 
 and a few metallic salts are occasionally employed. Those for the adult 
 rectum should contain about 15 grains of the excipient, for the vagina a 
 drachm of cacao-butter is the average quantity. Those for the uterus and 
 urethra are made of cylindrical instead of conical form, and about the 
 diameter of a no. 9 catheter. 
 
 The methods of compounding suppositories are two — that by the use of 
 moulds (the official method), and that by hand. The former process is 
 described above, but many prefer the hand method which is as follows: 
 The medicament is mixed with finely shaved Cacao-butter by the aid of a 
 spatula, on a board or tile lightly dusted with Lycopodium or Starch. 
 After a smooth and uniform mixture is thus obtained, the mass may be 
 rolled into cylindrical form, cut into the required sizes and with the 
 spatula given the required shape. When dispensed, they should be placed 
 in a powder-box between layers of cotton. 
 
 Bougies or Pencils, as urethral and uterine suppositories are often 
 termed, may be prepared by melting together White Gelatin 3, Glycerin 
 1, and Distilled Water 1 part by weight, then adding the medicament 
 and drawing the mass into a glass tube previously oiled inside. When 
 cold the bougie may be pushed out and cut into suitable lengths. 
 
 Suppositories and bougies may be prescribed in the manner illustrated 
 by the following formulae : — 
 
 Anodyne Suppository. Wade'' s Bougies. 
 
 H- Ext. Opii, gr. vj. R. Iodoformi, 
 
 Ext. Belladonnse Fol. Al- Bismuthi Subnitrat., . . aagj. 
 
 coholici, gr. ss. Chloralis Hydratis, . . . . gr. viij. 
 
 Ext. Hyoscyami, . . . . gr. ij. Morphinae Sulphat, . . . gr. iij. 
 Olei Theobromae, q. s. 01. Rosas, TTLx. 
 
 M. Fiant suppositoria vj. Gelatini et Glycerini, q. s. 
 
 Sig. — One into the rectum morning and ! M. Fiant bougia xij. 
 night. 
 
 Anthelmintic. 
 
 rj« . Santonini, gr. xij. 
 
 Olei Theobromae, • 3J- 
 
 M. Fiant suppositoria vj. 
 Sig. — One into the rectum as directed 
 
 Sig. — One into urethra thrice daily. 
 
 Botigie for Gleet. 
 R . Zinci Sulphatis, . . . . gr. vj. 
 Ac. Carbolici, . . . tt\jij. 
 Pulv. Hydrastis, . . . gr. xij. 
 Ext. Belladonnse Fol. Al- 
 
 coholici, gr. xij. 
 
 Qumine Suppository. Gelatini et Glycerini, q. s. 
 
 . Quininae Sulphatis, . . gr. v. M. Fiant bougia xij. 
 
 Olei Theobromae, . . . gr. x. Sig. — One into the urethra night and 
 
 Fiat suppositorium unum, mitte tales sex. j morning. 
 
59^ PHARMACEUTICAL PREPARATIONS. 
 
 In the British Pharmacopoeia the following 7 suppositories are official, viz. — 
 
 Suppositoria Acidi Carbolici, Phenol Suppositories, — Phenol, 12 grains; White 
 Beeswax, 24 grains; Oil of Theobroma, q. s. for 12 suppositories, each containing 1 
 grain of Phenol. 
 
 Suppositoria Acidi Tannici, Tannic Acid Suppositories, — Tannic Acid, 36 grains ; 
 Oil of Theobroma, q. s. for 12 suppositories, each containing 3 grains of Tannic Acid. 
 
 Suppositoria Belladonnae, Belladonna Suppositories, — Alcoholic Extract of Bella- 
 donna, 18 grains; Oil of Theobroma, q. s. for 12 suppositories, each containing 1)4. 
 grains of the extract or approximately ^ grain of the alkaloids of belladonna root. 
 
 Suppositoria Glycerini, Glycerin Suppositories, — Gelatin, cut small, y z ; Glycerin, 
 by weight, 2^ ; Distilled Water, a sufficiency to make as many suppositories as desired, 
 according to size, each containing 70 per cent, by weight of Glycerin. 
 
 Suppositoria Iodoformi, Iodoform Suppositories, — Iodoform, 36 grains; Oil of 
 Theobroma, q. s. for 12 suppositories, each containing 3 grains of Iodoform. 
 
 Suppositoria Morphinae, Morphine Suppositories, — Morphine Hydrochloride, 3 
 grains ; Oil of Theobroma, q. s. for 12 suppositories, each containing % grain of the 
 Morphine salt. 
 
 Suppositoria Plumbi Composita, Compound Lead Suppositories, — Acetate of 
 Lead, 36 grains ; Opium, in powder, 12 grains ; Oil of Theobroma, q. s. for 12 suppos- 
 itories, each containing 3 grains of Lead Acetate and 1 grain of Opium. 
 
 Syrupi, Syrups, — are concentrated solutions of Sugar in water or in 
 aqueous liquids. They sometimes contain Acetic Acid, and occasionally 
 Alcohol ; and are termed simple, medicated or flavored, according as they 
 are simple solutions of sugar in water alone, or contain soluble medicinal 
 substances or flavoring ingredients. The sugar used should be very dry, 
 and its official description corresponds with the granulated sugar of com- 
 merce. The permanency of these preparations chiefly depends on their 
 possessing the proper relative proportions of sugar and water. They are 
 prepared either by solution with heat, by agitation without heat, by add- 
 ing a medicated liquid to simple syrup, by digestion or maceration, or by 
 cold percolation; these processes being all officially directed except the 
 last. They are best preserved by being poured while hot into pint bottles, 
 which should be corked securely while full, and the tops dipped into 
 melted sealing-wax. Fermented syrups are useless for dispensing pur- 
 poses. The number of official syrups is 32, as follows, — 
 
 Syrupus. Syrupus Ipecacuanhae. 
 
 Syrupus Acaciae. Syrupus Krameriae. 
 
 Syrupus Acidi Citrici. Syrupus Lactucarii. 
 
 Syrupus Acidi Hydriodici. Syrupus Picis Liquidae. 
 
 Syrupus Allii. Syrupus Pruni Virginianae. 
 
 Syrupus Althaea?. Syrupus Rhei. 
 
 Syrupus Amygdalae. Syrupus Rhei Aromaticus. 
 
 Syrupus Aurantii. Syrupus Rosae. 
 
 Syrupus Aurantii Florum. Syrupus Rubi. 
 
 Syrupus Calcii Lactophosphatis. Syrupus Rubi Idaei. 
 
 Syrupus Calcis. Syrupus Sarsaparillae Compositus. 
 
 Syrupus Ferri Iodidi. Syrupus Scillae. 
 
 Syrupus Ferri, Quininae et Strychninae Syrupus Scillae Compositus. 
 
 Phosphatum. Syrupus Senegae. 
 
 Syrupus Hypophosphitum. Syrupus Sennae. 
 
 Syrupus Hypophosphitum cum Ferro. Syrupus Tolutanus. 
 Syrupus Zingiberis. 
 
PHARMACEUTICAL PREPARATIONS. 
 
 597 
 
 Tabellse, Tablets (Unofficial), — are largely manufactured by several 
 reliable firms, and consist of various medicinal powders pressed into tab- 
 let shape by machinery. They are extremely convenient preparations 
 for the physician's use, as quite a variety can be carried in a pocket-case, 
 and as slight pressure is sufficient to reduce them to powder they can 
 be dispensed with facility and accuracy of dosage. The following list 
 includes the most important of these preparations, the figures represent- 
 ing the number of grains in a tablet in each case : — 
 
 , 4, 5- 
 4, 5- 
 
 i _i_ i 
 
 £0> 30' 20* 
 
 Benzoic, 5. 
 
 Gallic, 5. 
 
 Salicylic, 2j£, 5. 
 
 Salicylic, 2 l / 2 , and Morphine, y 1 ^. 
 
 Tannic, 2, 5. 
 
 Aconitina, ^L. 
 
 Aloes, 2. Aloes et Ferri (U. S. P.). 
 
 Aloes, 2, et Myrrh, 1. 
 
 Aloes, %, et Rhei, 1^, et Gentian, %. 
 
 Aloin, \, %, y 2 . _ 
 
 Ammonium Bromide, 5> IO. 
 
 Ammonium Chloride, 3, 5, 10. 
 
 Antiseptic, Hydr. Chlor. Corros., 7^. 
 
 Atropine, fo. 
 
 Bismuth Subcarb. , 5. 
 
 Subnitrate, 5, IO. 
 
 Borax, 5. 
 
 Caffeine Citrate, I. 
 
 Calcium Sulphide, J^, y, ^, I. 
 
 Calomel, y, y 2 , 1, 2, 3, 5. 
 
 Calomel, 2, Opium, 1. 
 
 Camphor Monobromated, 2, 3, 5« 
 
 Carbo Animalis, IO. 
 
 Cathartic, Compound (U. S. P.). 
 
 Vegetable (U. S. P.). 
 
 Cerium Oxalate, 2. 
 Chloramine Pastilles (Spencer). 
 Cinchona Alkaloids (Mixed). 
 Cinchonine Sulphate, 2, 3, 4, 5. 
 Cinchonidine Sulphate, 2, 3, 4, 5- 
 Cocaine Hydrochlorate, y. 
 Codeine, ){. 
 Digitalin, gL 
 
 Extract of Cannabis Indica, y. 
 Extract of Ignatia Amara, */{, y 2 . 
 Extract of Nux Vomica, y,y. 
 Fehling's Test for grape-sugar in urine. 
 Ferrum (Quevenne's), I, 2. 
 Arsenate, %, y. 
 
 Proto-carbonate, 3, 5. 
 
 Lactate, I. 
 
 The terms Tabloid and Soloid are proprietary designations of compressed tablets 
 manufactured by a particular firm, Messrs. Burroughs, Wellcome and Co., of London, 
 
 England. 
 
 Ferrum Pyrophosphate, 2. 
 
 and Quinine Citrate, 2, 3, 5. 
 
 Hydrargyrum, I, 3, 5. 
 
 Chloridum Coi 
 
 Iodidum Rub., 
 
 Iodidum Flavum, j 1 ^-, y, 1 
 
 Oxidum Flavum, 2 ^. 
 
 Ipecac, et Opii, 2, 3, 5. 
 Morphine Sulphate, ^, y, y 6 , 
 Opium, Deodorized, I. 
 Opium, l / z , and Lead Acetate, I 
 Pepsin, Saccharated, 2, 5. 
 Podophyllin, y L, y, %, y, I, : 
 Potassium Bromide, 5, IO. 
 Chlorate, 5. 
 
 and Borax, aa 2j^. 
 
 Iodide, 5. 
 
 Nitrate, 5. 
 
 Permanganate, y, I, 2. 
 
 Quinine Bisulphate, ^, I, 2, 3, 
 
 Salicylate, 2. 
 
 Quinine Sulphate, y, I, 2, 3, 
 
 Quinquinine, 2, 3. 
 
 Rhubarb, 3. Rhei Co. (U. S. 
 
 Rhubarb, 2, and Magnesia, 2. 
 
 Salicin, 2^, 5. 
 
 Santonin, I. 
 
 Santonin, I, and Calomel, I. 
 
 Sodium Bicarbonate, 5. 
 
 Salicylate, 3, 5. 
 
 Strychnine, jfa, ^, up to ^. 
 Zinc Phosphide, ^ up to y. 
 
 Hypodermic Tablets. 
 
 Morphine Sulphate, T ^ to \. 
 Morph. Sulph. and Atropine Sulph. 
 Atropine Sulphate, ^\-^-^- 
 Strychnine Sulphate, yi^. 
 Apomorphine Hydrochlorate, ^b-xV 
 Pilocarpine Hydrochlorate, -£q-\. 
 (And several others.) 
 
 P.). 
 
 Tincturae, Tinctures, — are alcoholic solutions of medicinal substances, 
 and with one official exception (Tincture of Iodine) are made from non- 
 
59 8 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 volatile bodies. They are prepared by percolation, maceration, solution 
 or dilution ; the menstrua employed being chiefly Alcohol, Diluted Alco- 
 hol, and Alcohol and Water in various proportions. In one case (Tinc- 
 ture of Sanguinaria) Acetic Acid is an ingredient of the menstruum, in 
 two the Aromatic Spirit of Ammonia, and in several Glycerin. 
 
 For Tinctures of Fresh Herbs [Tinctura Herbarum Recentiuni), the Pharmaco- 
 poeia prescribes a general formula, according to which, when not otherwise directed, they 
 are to be prepared by macerating 50 grammes of the fresh herb, bruised or crushed, in 
 100 cubic centimeters of alcohol, for 14 days, then expressing the liquid and filtering. 
 
 The official Tinctures number 71, and are named in the following list, 
 the figures placed after each name giving the number of grammes of the 
 drug in each 100 cubic centimeters of the tincture : — 
 
 Tinctura Aconiti, 35. 
 
 Tinctura Humuli, 20. 
 
 Tinctura Aloe's, 10. 
 
 Tinctura Hydrastis, 20. 
 
 Tinctura Aloes et Myrrhas, 10. 
 
 Tinctura Hyoscyami, 15. 
 
 Tinctura Arnicse Florum, 20. 
 
 Tinctura Iodi, 7. 
 
 Tinctura Arnicse Radicis, 10. 
 
 Tinctura Ipecacuanhas et Opii, IO. 
 
 Tinctura Asafcetidas, 20. 
 
 Tinctura Kino, IO. 
 
 Tinctura Aurantii Amari, 20. 
 
 Tinctura Kramerias, 20. 
 
 Tinctura Aurantii Dulcis, 20. 
 
 Tinctura Lactucarii, 50. 
 
 Tinctura Belladonnas Foliorum, 15. 
 
 Tinctura Lavandulas Composita, o.S 
 
 Tinctura Benzoini, 20. 
 
 Tinctura Lobelias, 20. 
 
 Tinctura Benzoini Composita, 12. 
 
 Tinctura Matico, 10. 
 
 Tinctura Bryonias, 10. 
 
 Tinctura Moschi, 5. 
 
 Tinctura Calendulas, 20. 
 
 Tinctura Myrrhas, 20. 
 
 Tinctura Calumbae, 10. 
 
 Tinctura Nucis Vomicas, 20. 
 
 Tinctura Cannabis Indicas, 15. 
 
 Tinctura Opii, 10. 
 
 Tinctura Cantharidis, 5. 
 
 Tinctura Opii Camphorata, 0.4. 
 
 Tinctura Capsici, 5. 
 
 Tinctura Opii Deodorati, 10. 
 
 Tinctura Cardamomi, 10. 
 
 Tinctura Physostigmatis, 15. 
 
 Tinctura Cardamomi Composita, 2. 
 
 Tinctura Pyrethri, 20. 
 
 Tinctura Catechu Composita, 10. 
 
 Tinctura Quassias, 10. 
 
 Tinctura Chiratae, 10. 
 
 Tinctura Quillajas, 20. 
 
 Tinctura Cimicifugae, 20. 
 
 Tinctura Rhei, 10. 
 
 Tinctura Cinchonas, 20. 
 
 Tinctura Rhei Aromatica, 20. 
 
 Tinctura Cinchonas Composita, IO. 
 
 Tinctura Rhei Dulcis, 10. 
 
 Tinctura Cinnamomi, 10. 
 
 Tinctura Sanguinarias, 15. 
 
 Tinctura Colchici Seminis, 15. 
 
 Tinctura Scillas, 15. 
 
 Tinctura Croci 10. 
 
 Tinctura Serpentarias, 10. 
 
 Tinctura Cubebas, 20. 
 
 Tinctura Stramonii Seminis, 1 5. 
 
 Tinctura Digitalis, 15. 
 
 Tinctura Strophanthi, 5. 
 
 Tinctura Ferri Chloridi, 1 3. 6. 
 
 Tinctura Sumbul, 10. 
 
 Tinctura Gallas, 20. 
 
 Tinctura Tolutana, 10. 
 
 Tinctura Gelsemii, 15. 
 
 Tinctura Valerianae, 20. 
 
 Tinctura Gentianas Composita, IO. 
 
 Tinctura Valerianae Ammoniata, 20. 
 
 Tinctura Guaiaci, 20. 
 
 Tinctura Vanillas, 10. 
 
 Tinctura Guaiaci Ammoniata, 20. 
 
 Tinctura Veratri Viridis, 40. 
 
 Tinctura 
 
 Zingiberis, 20. 
 
 Triturationes, Triturations, — form a class of powders having for 
 their diluent Sugar of Milk, and possessing a definite relation between the 
 active ingredient and the diluent. The Pharmacopoeia prescribes a gen- 
 eral formula for these preparations, according to which 10 grammes of the 
 
PHARMACEUTICAL PREPARATIONS. 599 
 
 Substance and 90 of Sugar of Milk are to be well mixed by a spatula, the 
 latter being added in successive quantities, and both triturated in a mortar 
 until the substance is intimately mixed with the diluent and finely com- 
 minuted. There is but one official trituration (Trituratio Elaterini), 
 though the Pulvis Ipecacuanha et Opii practically belongs to this class, 
 except in respect to the proportions prescribed. Sugar of Milk is em- 
 ployed as the diluent because of its hardness and its comparative insolu- 
 bility. The first of these qualities secures the fine comminution of the 
 active ingredient, whereby the action of the medicine is increased and 
 better distributed. Its insolubility makes it the best diluent for powders 
 or triturations administered from a spoon or glass with fluid, as is so often 
 done, for unlike cane sugar it is not readily dissolved and does not leave 
 the active substance behind on the surface of the utensil. Triturations 
 are excellent forms for the administration of powerful alkaloids, which 
 may thus be divided with great accuracy into the minute quantities re- 
 quired. Mercury and its salts are especially adapted to this method of 
 preparation, being more uniformly divided and hence more active than 
 when administered in any other form. Triturations of mercury with sugar 
 were commonly used in England a hundred years ago, and triturations of 
 many substances were employed by the Arabian physicians of the 13th 
 century; but the subsequent adoption of these preparations by the home- 
 opathists produced such a prejudice against them in the ranks of the regu- 
 lar profession, that until recently any one using them stood in danger 
 of being stigmatized as a homeopath. Their recognition by the U. S. 
 Pharmacopoeia under their proper title does away with any such implica- 
 tion, though it is much to be regretted that the compilers of the last two 
 revisions of the British Pharmacopoeia should have shown their fear of a 
 name by continuing the title Pulvis Elaterini Compositus to designate 
 a preparation which in every respect is a trituration. The preparations 
 of Pepsin daily prescribed by physicians all over the country are really 
 sugar-of-milk triturations of that ferment, and not pure pepsin as many 
 suppose. Professor H. G. PifTard, Med. Dept. Univ. of the City of New 
 York, in his treatise on the Materia Medica and Therapeutics of the Skin 
 (N. Y., 1881), after detailing several microscopical examinations of pills 
 and triturations, uses the following language : — 
 
 "It is to be expected, therefore, that the protoiodide trituration will prove, ceteris 
 paribus, more active than the pill, and such we have. found it. Since we have 
 
 used the triturations, however, in preference to the ordinary pills, patients more rarely 
 complain of disagreeable sensations. We have been enabled to materially reduce the 
 size of the dose in order to obtain the desired effect. In other words, a larger proportion 
 of the drug is utilized for specific purposes, while but a small amount remains to give rise 
 
 to local irritation I have nothing to add to this, except that I continue to 
 
 use triturations of Mercury and other substances with increasing satisfaction. Beside 
 those mentioned I employ Calomel, Cyanide of Mercury, Black Oxide of Mercury and 
 Corrosive Sublimate in this form." ' 
 
6oo 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 The following examples will illustrate the mode in which Triturations 
 may be prescribed : — 
 
 R. Hydrarg. Oxidi Flavi, . gr. ss. 
 Sacchari Lactis, . . . . gr. 1. 
 Trit. et div. in chartulas xxiv. 
 Sig. — One twice daily. 
 
 R. Hydrarg. Chlor. Mitis, 
 Sacchari Lactis, q. s. 
 Trit. et div. in chartulas x. 
 Sig. — One powder daily. 
 
 gr. x. 
 
 R. Morphinae Sulph., . . . gr. 
 
 j- . 
 
 Sacchari Lactis, . . . . gr. 
 
 xvj 
 
 Trit. et div. in chartulas viij. 
 
 
 Sig. — One every six hours. 
 
 
 R . Acidi Arsenosi, . . . . gr. 
 
 ss. 
 
 Sacch. Lactis, gr. 
 
 xl. 
 
 Trit. et div. in chartulas xx. 
 
 
 Sig. — One powder thrice daily. 
 
 
 Trochisci, Troches, also called Pastilles or Lozenges, — are small 
 flattened cakes of medicinal substances, prepared from a mass made with 
 a basis of Sugar, some having Mucilage of Tragacanth, others Orange- 
 flower Water, Syrup of Tolu, etc., as excipients. They are especially 
 useful when the active ingredients are intended to come into contact with 
 the mucous surface of the throat. There are 15 official Troches, named 
 as follows : — 
 
 Trochisci Acidi Tannici. 
 
 Trochisci Ammonii Chloridi. 
 
 Trochisci Catechu. 
 
 Trochisci Cretae. 
 
 Trochisci Cubebae. 
 
 Trochisci Ferri. 
 
 Trochisci Glycyrrhizae et Opii. 
 
 Trochisci Ipecacuanha?. 
 Trochisci Krameriae. 
 Trochisci Menthse Piperitae. 
 Trochisci Morphinae et Ipecacuanhae. 
 Trochisci Potassii Chloratis. 
 Trochisci Santonini. 
 Trochisci Sodii Bicarbonatis. 
 
 Trochisci Zingiberis. 
 
 Troches are not readily compounded at the dispensing counter, but 
 may be obtained in all first-class shops, being prepared in great variety 
 by the manufacturers. Besides the official Troches, those named in the 
 following list are generally for sale : — 
 
 Alum, gr. ij. 
 
 Alum, gr. \}<z, Catechu, gr. ij. 
 
 Ammonium Chloride, gr. ij, and Cubeb, 
 
 gr. j- 
 Ammon. Chlor., gr. ij, Liquorice, gr. viij. 
 Benzoic Acid, gr. l / z . 
 Borax, gr. iij. 
 
 Bismuth, gr. ij, and Charcoal, gr. v. 
 Bronchial, — Oleores. Cubebae, gr. \, Tolu, 
 
 gr. i, 01. Sassafras, gr. -j 1 ^, and Ext. of 
 
 Liquorice, gr. vij. 
 Brown Mixture. 
 Carbolic Acid, gr. j. 
 
 Ginger and Sodium Bicarbonate. 
 
 Guaiac, gr. ij. 
 
 Kino, gr. ij. 
 
 Lettuce, gr. j. 
 
 Lime-juice. 
 
 Logwood, gr. ij. 
 
 Magnesia, gr. iij. 
 
 Pellitory, gr. j. 
 
 Pepsin, gr. iij, Charcoal, gr. iij, Magnesia, 
 
 gr. ij, and Ginger, gr. j. 
 Potassium Bitartrate, gr. iij. 
 Potassium Citrate, gr. iij. 
 Santonin, gr. )/ z , and Calomel, gr. y 2 . 
 
 Unguenta, Ointments, — are soft, fatty mixtures of medicinal agents 
 with a basis of lard, petrolatum, or fixed oils with a solid fat such as wax 
 or spermaceti. They are intended for application to the skin by inunc- 
 tion, and have a melting point which is below the ordinary temperature 
 
PHARMACEUTICAL PREPARATIONS. 6oi 
 
 of the human body. Of the 23 official Ointments 1 is prepared by chem- 
 ical reaction (Unguentum Hydrargyri Nitratisj, 3 by fusion and 17 by 
 incorporation of the ingredients with each other, they being mixed to- 
 gether by trituration or through the agency of a spatula and a porcelain 
 slab. Unguentum itself is prepared by fusing together 80 of Lard and 20 
 of yellow Wax, and is the basis of 3 other ointments, while 14 have Benzo- 
 inated Lard as their basis. The official Ointments are — 
 
 Unguentum. Ung. Hydrargyri Oxidi Flavi (10). 
 
 Unguentum Acidi Carbolici (5). Ung. Hydrargyri Oxidi Rubri (10). 
 
 Unguentum Acidi Tannici (20). Unguentum Iodi (4). 
 
 Unguentum Aquae Rosae. Unguentum Iodoformi fio). 
 
 Unguentum Belladonnae (10). Unguentum Picis Liquidse (50). 
 
 Unguentum Chrysarobini (5). Ung. Plumbi Carbonatis (10). 
 
 Unguentum Diachylon. Ung. Plumbi Iodidi (10). 
 
 Unguentum Gallae (20). Ung. Potassii Iodidi (12). 
 
 Unguentum Hydrargyri (50). Unguentum Stramonii (10). 
 
 Ung. Hydrargyri Ammoniati (10). Unguentum Sulphuris (30). 
 
 Ung. Hydrargyri Nitratis (7). Unguentum Veratrinae (4). 
 Unguentum Zinci Oxidi (20). 
 
 The figures in parentheses show the percentage of the extract or other active ingredi- 
 ent in the ointment. The composition of each may be found in the section on Materia 
 Medica under the title from which the preparation is named, except Unguentum, which 
 will be found under the title Adeps, and Unguentum Diachylon under Plumbum. 
 
 Ointments and Cerates are frequently ordered on extemporaneous for- 
 mulae, though the numerous official preparations of these classes would 
 seem to give the physician a sufficiently wide field for selection. The 
 basis is usually either the official Ceratum or Unguentum, but Petrolatum, 
 Lard, Lead Plaster with a fixed oil, etc., may be employed. Lard is 
 probably the best basis for all ointments, as it softens the skin better than 
 any other similar substance. Its disadvantage is that it soon becomes 
 rancid, so that preparations made with it must be quickly used. Cerates 
 only differ from ointments in their firmer consistence, melting at tem- 
 peratures above 104 F., while the latter melt below the ordinary tem- 
 perature of the body. Oleates are described fully on page 103. 
 
 The process of compounding an ointment or a cerate is sufficiently sim- 
 ple, being generally a mere matter of triturating the ingredients together 
 in a mortar, or of their incorporation on a slab by means of a spatula. 
 Rarely will melting be required in the compounding of extemporaneous 
 ointments. When extracts, powders or gritty substances are ordered, the 
 ingredients should be first pulverized into a fine powder, then triturated 
 with a small quantity of the basis into a smooth, impalpable paste, the 
 remainder of the basis being added gradually, until the whole is thor- 
 oughly incorporated. A warm mortar may be required for hard extracts. 
 Soluble salts should be triturated with a little water before adding the 
 excipient. Camphor needs a little alcohol to enable it to be pulverized. 
 Iodine should be rubbed to a fine powder, then a little alcohol added 
 
602 
 
 PHARMACEUTICAL PREPARATIONS. 
 
 and finally the excipient by degrees. Sulphur Iodide requires persevering 
 work with a small portion of olive oil. Borax should be triturated with 
 glycerin and Red Mercuric Oxide with distilled water. A bone or horn 
 spatula should be used for all ointments, as steel or iron blades will injure 
 many substances, particularly alkaloids, free acids, tannin, iodine and 
 several of the mercurial salts. Volatile substances are added last and 
 quickly worked in, so that their evaporation may be as slight as possible. 
 Ointments are dispensed usually in amber-colored glass pots with wooden 
 or metallic covers, or in porcelain jars called Gallipots. In hospital and 
 dispensary practice the common chip pill-box is used, but soon becomes 
 exceedingly dirty and disagreeable to handle. 
 
 Unguentum lodoforini Compositum. 
 
 R. Iodoformi, gj. 
 
 Ol. Anisi, rr\xx. 
 
 Ol. Rosae, 
 
 Ol. Ylang-ylang, . . aaTTLv. 
 
 Ung. Aquae Rosae, . . . ^j. 
 M. Fiat unguentum. 
 Sig. — Ointment. 
 
 Unguentum Anti-pruritictan. 
 
 R . Camphorae, 
 
 Chloralis Hydrat., . aagj. 
 Tere una ad liquorem, dein 
 adde cum tritu — 
 
 Unguenti Aquae Rosae, . ^j. 
 M. Fiat unguentum. 
 Sig. — Ointment for itching. 
 
 Vina, Wi?ies, — when medicated are practically the same as tinctures. 
 The menstruum directed to be used is the official White Wine (Vinum 
 Album), which should contain from 10 to 14 per cent, by weight of abso- 
 lute alcohol. It is however reinforced by the addition of alcohol to the 
 amount of 15 per cent, in all the medicated wines except that of Ipecac, 
 which has 10 per cent. In the two Ferric Wines the alcoholic reinforce- 
 ment is in the shape of the tincture of sweet orange peel. The official 
 Wines are 10 in number, 2 of which are not medicated and stand first 
 in the following list; 4 are prepared by solution or admixture, 2 by 
 percolation and 2 by maceration during seven days. They are — 
 
 Vinum Album, IO-14. 
 Vinum Rubrum, 10-14. 
 Vinum Antimonii, 0.4. 
 Vinum Colchici Radicis, 40. 
 Vinum Colchici Seminis, 15. 
 
 Vinum Ergotae, 15. 
 Vinum Ferri Amarum, 5. 
 Vinum Ferri Citratis, 4. 
 Vinum Ipecacuanhas, 10. 
 Vinum Opii, 10. 
 
 The figures placed after the first two show the percentage of absolute alcohol by weight 
 required in each ; those placed after the others indicate the quantity of the principal in- 
 gredient in grammes to each ioo cubic centimeters of the preparation. 
 
PART III. 
 
 SPECIAL THERAPEUTICS. 
 
 Authorities. The principal authorities to whom references are made, 
 with their initials, are included in the following list. When a statement 
 is not followed by any reference by name or initial, it is to be understood 
 as coming from the writer of this book. 
 
 References and Bibliography. 
 
 (A) Aitken. — The Science and Practice of Medicine, by Wm. Aitken. 
 
 (Ag) Agnew. — The Principles and Practice of Surgery, by D. Hayes Agnew. 
 
 (B) Bartholow. — Materia Medica and Therapeutics; also On the Antagonism between 
 
 Medicines and between Remedies and Diseases, by Roberts Bartholow. 
 (Br) Brunt on. — Pharmacology, Therapeutics and Materia Medica, by T. Lauder Brunton. 
 
 (C) Carter. — A Practical Treatise on Diseases of the Eye, edited by Green. 
 (CI) Clarke. — A Manual of the Practice of Surgery, by W. Fairlie Clarke. 
 
 (Da C) Da Costa. — Notes of Clinical Lectures, delivered by Professor J. B. Da Costa at 
 the Pennsylvania and Jefferson Hospitals. 
 
 (D) Druitt. — A Manual of Modern Surgery, by Robert Druitt. 
 
 (E) Emmet. — Principles and Practice of Gynecology, by Thos. Addis Emmet. 
 (El) Ellis. — A Practical Manual of Diseases of Children, by Edward Ellis. 
 
 (F) Fothergill. — The Practitioner's Handbook of Treatment, by J. M. Fothergill. 
 
 (G) Goodell. — Lessons in Gynecology, by William Goodell. 
 
 (H) Hamilton. — Nervous Diseases, etc., by Allan McLane Hamilton. 
 
 (L) Leishman. — A System of Midwifery, by William Leishman. 
 
 (M) Murrell. — A Manual of Pharmacology and Therapeutics, by Wm. Murrell. 
 
 (Mn) Manson. — Tropical Diseases, by Patrick Manson. 
 
 (M & P) Meigs and Pepper. — Diseases of Children, by J. F. Meigs and Wm. Pepper. 
 
 (N) Niemeyer. — A Text-book of Practical Medicine, by Felix von Niemeyer. 
 
 (O) Osier. — The Principles and Practice of Medicine, by Wm. Osier. 
 
 (P) Phillips. — Materia Medica and Therapeutics, by Chas. D. F. Phillips. 
 
 (Pf) Piffard. — Materia Medica and Therapeutics of the Skin, by H. G. Piffard. 
 
 (R) Ringer. — A Handbook of Therapeutics, by Sidney Ringer. 
 
 (Ros) Rosenthal. — Diseases of the Nervous System, by M. Rosenthal. 
 
 (S) Stille. — Therapeutics and Materia Medica, by Alfred Stille. 
 
 (St) Sturgis. — The Student's Manual of Venereal Diseases, by F. R. Sturgis. 
 
 (T) Tanner. — An Index of Diseases and their Treatment, by Thos. H. Tanner. 
 
 (Tr) Trousseau and Pidoux. — On Therapeutics, by Trousseau, Pidoux and Paul. 
 
 (Tt) Tail. — Diseases of Women, by Lawson Tait. 
 
 (Ty) Tyson. — The Practice of Medicine, by James Tyson. 
 
 (W) Wood. — Therapeutics, its Principles and Practice, by H. C. Wood. 
 
 (Wa) Waring. — Practical Therapeutics, edited by Buxton. 
 
 (Y) Yeo. — A Manual of Medical Treatment, by I. Burney Yeo. 
 
 Besides the above-named, occasional references are made to other works by the same 
 authors. References will also be found, with names in full, to Anstie, Brown-Sequard, 
 Clymer, Cohen, Flint, Fordyce-Barker, Gross, Hammond, Hilton, Lister, Loomis, Mitch- 
 ell, Nelaton, Noyes, Nussbaum, Ricord, Roosa, Simpson, A. A. Smith, Thomas, several 
 authors in Allbutf s System of Medicine, and many writers in current medical literature. 
 
 603 
 
604 
 
 ABASIA ABDOMINAL PLETHORA ABORTION. 
 
 Applied Therapeutics may be studied either with the various thera- 
 peutic agents as the objects of chief consideration, as in the first part of 
 this work ; or with the different diseases and morbid conditions forming 
 the objects of study in respect to their modification and treatment by 
 medicines. In the following pages the latter method is followed, the 
 therapeutics of each affection being exhibited in the form of an Analyti- 
 cal Index to the recognized text-books of the day. Every indication for 
 the use of a drug, or statement regarding its value, is followed by the 
 name or initial (in parenthesis) of its author: these references enabling 
 the book to be used as an Index to the Authorities, for more strict differ- 
 entiation between indicated remedies, — while the brief analyses given 
 include sufficient material to make each section a synopsis of the most 
 advanced therapeutics of the disease named in its title. ' 
 
 Abasia and Astasia. 
 
 Sodium Phosphate, by hypodermic injection, once a day for 25 days, cured 
 a case of unilateral abasia-astasia (Charcot's " neurasthenie dimidiee"), in the 
 municipal hospital at Jerusalem. The patient should be taught to walk as one 
 teaches an infant, and compression of the posterior region of the trunk may 
 be made with an appropriate bandage (Roux). [Compare Hysteria.] 
 
 Abdominal Plethora. 
 
 Cathartics, saline and hydragogue cathartics are of value in congestion of 
 the portal circulation (B). Saline Mineral Waters, especially the purgative 
 saline waters, as Vichy and Saratoga, in plethora of the abdominal viscera (B). 
 Grape-cure has helped many cases, particularly those of hepatic engorgement 
 and sluggish portal circulation ; is best used after a preliminary course of 
 powerful mineral waters (P). Aliment is very important ; a dry diet is particu- 
 larly indicated in cases of dyspepsia and hepatic enlargement due to excessive 
 beer-drinking. Avoid much bread, also salted or twice-cooked meats, rich 
 sauces, solid vegetables, especially cucumbers, soups and fruits. Biscuits, 
 fresh meat, lemons, fish, fowl and game, may be used. [Compare Hepatic 
 Congestion, Obesity.] 
 
 R . Potassii Bicarbonatis, 
 
 Sodii Sulphatis, . . . .aagiv. 
 Solve in Ojss Aquae, et adde — 
 
 Acidi Tartarici (cryst.), . Sjij. 
 Cork quickly and firmly. ^d to be 
 taken thrice daily. 
 
 R. Resinse Podophylli, . . gr. vj. 
 Ext. ColocynthidisCo., . gr. xij. 
 Ext. Belladonna Fol. 
 
 Alcoh., gr. iij. 
 
 Fiatmassa, et div. inpil. no. xij. 
 Sig. — One pill every night. 
 
 Abortion. 
 
 Opium, cautiously in threatened abortion, is often very valuable (Wa); the 
 tincture, tt\xx-xxx by rectum (Parvin) ; Opium to check uterine action and 
 Ergot to restrain hemorrhage (B). Ergot, small tonic doses give excellent 
 results in threatened abortion (P). Tannin, combined with Opium and Ipecac 
 (W). Cimicifuga, to prevent miscarriage when uterus is irritable and pro- 
 lapsed (R). Savine, the dried powder of the leaves, gr. xv-xx, thrice daily, 
 one of the most powerful remedies against the hemorrhage indicative of ap- 
 proaching abortion (Wa) ; the tincture in doses of 5 to 10 drops, every % to 3 
 
ABSCESS. 
 
 605 
 
 hours, useful against the hemorrhage (P). Viburnum Prunifolium, in threat- 
 ened and habitual abortion, has a very high reputation. Aurum Chloride, to 
 avert the tendency to habitual abortion (B). Iron, with Potassium Chlorate, 
 throughout the pregnancy, when fatty degeneration the cause of habitual abor- 
 tion (McLane). Asafcetida, is highly efficient in habitual abortion ; given in 
 pills of gr. jss each, 2 daily, gradually increased to 10 daily, as soon as a new 
 pregnancy occurs, and continued until the labor is over (Turazzo). Tampon- 
 ade, of the cervix uteri, with cotton or sponge, dipped in vinegar or glycerin, 
 when abortion is inevitable and it is desirable to hasten it and restrain hemor- 
 rhage. Empty the uterus thoroughly with the finger, placenta-forceps liable 
 to do harm (Barker). Abortifacients (see page 58); Quinine and Ergotin, 
 of each gr. ij in pill every 3 hours, the routine abortifacient of many irregular 
 practitioners. Only by the production of such violent irritation of the ab- 
 dominal and pelvic organs as generally endangers life, can the pregnant 
 uterus be stimulated to expel its contents (P). The abortifacient effect of 
 Savine and other drugs cannot be obtained unless by the administration of a 
 quantity sufficient to endanger life (B). 
 
 R. Ext. Ergotse Fluidi, . . . 5 v. 
 Tinct. Opii Deodorat., . . 7, iij. 
 
 Syrupi Limonis, ^j. 
 
 M. Sig. — A teaspoonful thrice daily. 
 
 R. Acidi Tannici, gr. xv. 
 
 Pulv. Ipecacuanhse, . . . gr. xij. 
 
 Extracti Opii, gr. iij. 
 
 Ft. pil. xij. Sig. — One every six hours. 
 
 Abscess. 
 
 Poultices to check or to assist in maturation ; may be smeared with Bella- 
 donna or Opium (R). Belladonna, as plaster to subdue (B) ; painted around 
 areola (Wa) ; internally often successful in aborting abscesses (R). Calcium 
 Sulphide, half-grain doses frequently repeated, to abort abscess or to hasten 
 formation of pus (B) ; gr. ^ every hour or two, giving striking results in healing 
 large abscesses (R). Calcium Phosphate, in large abscesses (R). Mercury 
 and Morphine, the Oleate locally, diminishes induration due to old abscesses 
 and prevents the formation of new ones(R). Carbolic Acid, a weak solution 
 as injection after evacuation, also as a dressing (Lister). Silver Nitrate, a 
 strong solution in Nitrous Ether if applied early to adjacent surface will check 
 inflammation (B). Blisters or Iodine, as counterirritants around or adjacent 
 to seat of disease (R). Potassium Permanganate, Z) to the pint of water, to 
 correct fetor (B). Iodine, the tincture injected after opening large abscesses 
 (R) ; especially in scrofulous abscess (Wa). Salicylic or Boracic Acid, as 
 dressings (B). Sarsaparilla, a very useful remedy in chronic abscess with pro- 
 fuse discharge (P). Cod-liver Oil, improves and lessens discharge from scrof- 
 ulous abscesses (Wa). Surgical. Opening necessary in all deep abscesses, 
 or when on face, near anus, mammary, or if danger of its opening into an in- 
 ternal cavity. Open with grooved director and forceps ; never open a deep 
 abscess with a plunge (Hilton). Drainage-tube may be required, also irriga- 
 tion of the cavity and pressure (Agnew). Weaning of child necessary in 
 chronic mammary abscess (Gross). Psoas abscess may result from strain or 
 laceration of muscle, as by heavy lifting, effort to recover balance when skat- 
 ing, etc., as well as from spinal disease; the symptoms are often obscure, sim- 
 ulating those of chronic malaria. Early opening by lumbar incision neces- 
 sary ; then tonics, good food, and daily irrigation of the cavity with an 
 antiseptic solution. [Compare Suppuration, Carbuncle.] 
 
 R 
 
 Quininae Sulph., . . . 
 
 • sj. 
 
 Ferri Pyrophosphatis, . 
 
 • Eh 
 
 Strychnince Sulph., . . 
 
 ■ g r - J- 
 
 Ac. Phosphor. Dil., . 
 
 • 3ij. 
 
 Syrupi Zingiberis, . . . t ^ij. 
 
 Aquae, q. s. ad ^iv. 
 
 M. Fiat mistura. Sig. — A teaspoonful 
 thrice daily. 
 
6o6 
 
 ACIDITY ACNE. 
 
 Acidity. 
 
 Acids, Hydrochloric or Phosphoric before meals ; acid wine, a genuine 
 Rhine wine best ; Sulphurous Acid rr^v-xxx well diluted, for acid fermentation 
 of starchy foods (R) ; acids after meals for alkaline pyrosis (R). Tannic Acid, 
 useful in pill, gr. iv with rr\J of Glycerin (B). Carbolic Acid, often arrests 
 eructations (B). Alkalies, after meals, for immediate relief, effects only tem- 
 porary, Bicarbonates best (R) ; frequent use of alkalies enhances the mischief 
 (B). Nux Vomica, nUj-iij of tincture before meals ; is excellent in small doses 
 (B) ; especially in acidity of pregnancy (R). Pulsatilla, n^v of tincture every, 
 4 hours in acid dyspepsia (P). Silver Oxide, extremely useful (B). Man- 
 ganese Oxide, gr. x-xx of the purified black oxide relieves (B). Kino, a favorite 
 remedy (B). Ipecacuanha, in acidity of pregnancy (R). • Mercury, gr. ss of 
 gray powder thrice daily, when acidity with clayey stools (R). Atropine, the 
 sulphate, thrice daily by mouth, gave excellent results in a case of gastric hy- 
 persecretion of acid ; after the third day pain had stopped and vomiting 
 ceased. Bismuth, gives excellent results, combined with Opium or Morphine, 
 sometimes with Magnesia (R). Diet, use lemon-juice, aerated or old bread, 
 plain biscuits ; avoid new bread, pastry, and vegetables. 
 
 R. 
 
 Bismuthi Subnitrat., . 
 
 • 3 "J- 
 
 
 
 Acidi Carbolici, . . . 
 
 gtt. ij- 
 
 -v. 
 
 
 Mucil. Acaciae, . . . 
 
 
 
 
 Aquae Menth. Pip., 
 
 §"j. 
 
 
 M 
 
 . Sig. — A tablespoonful 
 
 3 or 4 
 
 times 
 
 dail} 
 
 for adults. 
 
 
 
 R. Sodii Bicarbonatis, . . 
 Spt. Amrnoniae Aromat., 
 Tinct. Zingiberis, . . . 
 Infus. Gentianse Co. (U. 
 S. P., 1870), q. s. ad 
 
 3»J- 
 3 viij. 
 
 M. Sig. — A tablespoonful or two. 
 
 Acne. 
 
 Alkalies, internally, yield the best results in a number of cases (Bulkley) ; 
 alkaline lotions for cases with seborrhea (B). Borax, a weak solution in rose- 
 water (Sj-^viij), of great benefit locally in acne simplex (Wa). Potassium 
 Bromide, in moderate doses, has proved curative in some obstinate cases (R). 
 Sulphur, internally and as a lotion ; in severe forms an ointment of the Iodide 
 or Hypochlorite, £ij ad ^j (R). Belladonna, locally, is of some service, 
 checking the abundant secretion from the sebaceous follicles (R). Arsenic, in 
 old cases, especially in acne indurata, but often disappoints; given with Brom- 
 ides it prevents the bromic acne (R) ; Arsenic Bromide is adapted to most cases 
 of acne vulgaris (Pf). Phosphorus, is an excellent substitute for arsenic (B) ; 
 the compound syrup of the Hypophosphites in acne indurata (R). Mercury, 
 in lotion, is much employed (B); a weak lotion of the Bichloride to the face two 
 or three times daily (R); the Iodo-chloride (gr. v-xv ad ^) as irritant applica- 
 tion (Fox); or ointments containing the Bichloride of Biniodide may be 
 employed instead of the green soap application (Pf). Glycerin, internally, has 
 been used with success (B). Berberis, tt\,v of a fresh tincture thrice daily for 
 the acne of girls at puberty. Calcium Sulphide is indicated in cases character- 
 ized by a tendency to pustulation (Pf). Bismuth, locally, as a cosmetic (B). 
 Magnesium Sulphate, as a purgative daily before breakfast, in cases of acne 
 vulgaris depending on derangement of the stomach and bowels (Duhring) ; the 
 salt, finely triturated, is an excellent dusting-powder and in five-grain doses 
 internally, 3 or 4 times a day, is often very efficient in acne vulgaris and other 
 obstinate eruptions due to derangement of the gastro-intestinal tract. Ergot, 
 is well used in various forms of acne (See Acne Rosacea). Sapo Mollis, as an 
 active irritant in subacute cases, applied every night as long as bearable, then 
 emollients until irritation subsides, when the soap should be removed (Pf). 
 Water, hot sponging for 15 or 20 minutes several times a day, followed by Gly- 
 cerite of Starch to allay irritation (R) ; the local use of very hot water is of the 
 greatest benefit in all inflammatory forms of acne (Bulkley). Puncturing each 
 
ACNE ROSACEA ACTINOMYCOSIS. 
 
 607 
 
 papule with a lancet point, followed by very hot water, and ointments of Sul- 
 phur Iodide, Ammoniated Mercury, etc., diluted (Pf). Diet and Hygiene, 
 require careful attention (B) ; powerful tonics are often required (Bulkley). 
 [Compare Acne Rosacea, Seborrhea.] 
 
 3U 
 
 R . Potassii Acetatis, . 
 
 Tinct. Nucis Vora., 
 
 Infusi Quassiae, vel 
 
 Tinct. Cinchonae Co., ad 5 iv. 
 M. Sig. — Teaspoonful in water 
 meals, as an antacid tonic. 
 
 ™-l'y 
 
 after 
 
 R. 
 
 Magnesii Sulphatis, . . ^jss. 
 Ferri Sulphatis, . . . . gr. xvj. 
 Acidi Sulphurici, . . . 5jij. 
 Aquae, .... q. s. ad %v\\). 
 M. Sig. — A tablespoonful in a glass of 
 water before breakfast. 
 
 R . Sulphuris, ^j. 
 
 Glycerini, 3|j. 
 
 Aquae Rosae, 3 vl j- 
 
 M. Sig. — Lotion. 
 
 R. 
 
 Bismuthi Subnit., £j. 
 
 Ung. Hydr. Ammoniat., ^ij 
 Ung. Aq. Rosae, . . ad^]. 
 M. et fiat unguentum. 
 
 R. 
 
 Hydrarg. Iodo chlor., . gr. v-xv. 
 
 Adipis, Eh 
 
 Fiat unguentum. An irritating applica- 
 tion, requiring care. 
 
 Acne Rosacea. 
 
 Resorcin, as paste with equal part of Zinc Oxide, applied to the affected 
 part several times a day, to promote peeling of the skin in the treatment of 
 acne rosacea ; in 3 or 4 days the skin becomes like parchment, when the appli- 
 cation must be stopped to avoid cracking of the skin, and a dressing of gelatin, 
 glycerin, zinc oxide, and hot water is applied, covered with cotton wool ; in a 
 few days the dressing will come off, bringing the skin with it. Some few dan- 
 gerous results have followed this practice, but there have been a number of 
 very satisfactory cases (Unna). Ergot is well used in acne rosacea and other 
 forms of acne; a good fluid extract with glycerin and water, giving £ss inter- 
 nally per diem (B). Magnesium Sulphate, finely triturated, is an excellent 
 dusting-powder for cases of acne rosacea ; also in 5-grain doses thrice daily 
 internally (See Acne). Bismuth, the Oleate as an ointment, and the greased 
 surface powdered over with a mixture of Oleate of Zinc, Bismuth Subcarbonate 
 and Starch (Shoemaker). Antipyrin, with Coca, often gives marked relief, when 
 abnormal irritability of the gastric nerve endings leads to vaso-motor disturb- 
 ances of the nose and face (Whitla). Bromides, with Arsenic, for women, 
 when acne rosacea due to cessation of menstruation (Id). Electricity, the gal- 
 vanic current, 5 to 8 elements of an ordinary battery, both poles applied to the 
 nose and continually moved about, or the anode on the zygoma and the nose 
 gently stroked with the cathode ; these applications repeated once in 2 or 3 
 days, for at least 10 to 15 sittings, have proved uniformly successful in 31 cases 
 (Helbing). Chloral will aggravate rosacea. 
 
 R. Antipyrini, 3Jss. 
 
 Extr. Cocae Fluidi , . . ^ ij. 
 
 Tinct. Aurantii, 
 
 Glycerini, aa ^j. 
 
 M. Sig. — 3J thrice daily between 
 meals. {Whitla.) 
 
 R . Potassii Iodidi, .... 
 Potassii Bromidi, . 
 Liq. Acid. Arsenosi, . . 
 Tinct. Sumbul, .... 
 Aquae Camphorae, . ad 
 
 gr. xl. 
 
 3Jss. 
 
 Zxij. 
 
 M. Sig. — ^ ss in water after meals 
 
 Actinomycosis. 
 
 Sodium Salicylate, produces amelioration of symptoms (Netter). Potassium 
 Iodide, in full doses, 80 grains daily at first, diminished as its, physiological 
 effect is produced, is promptly curative, acting probably by augmenting tissue 
 resistance. This drug has cured six human cases in Holland, and one in 
 France; also 71 out of 185 oxen so treated in Chicago (Netter). 
 
6o8 
 
 ADDISON S DISEASE ADYNAMIA. 
 
 Addison's Disease. 
 
 Arsenic, with cod-liver oil, gives the best results (Da C). Iron and other 
 tonics are useful, especially a combination of the chloride, glycerin and chloro- 
 form (Greenhow). Phosphorus, has seemed to exert a beneficial influence 
 (Wilks). Adrenal Extract has been employed in a few cases with some benefit 
 while used. (See page 165.) Treatment must be symptomatic, and is of little 
 use, the disease being always fatal (H). 
 
 R. Tinct. Ferri Chloridi, 
 
 Spt. Chloroformi, . . . aa^j. 
 Glycerini, ^ vj. 
 
 M. Sig.- 
 thrice daily. 
 
 ■A dessertspoonful in water 
 ( Greenhow. ) 
 
 Adynamia. 
 
 Cinchona, or Quinine, with Arsenic, for pale, badly-fed town-dwellers (R) ; 
 as a general tonic when flesh flabby, skin perspiring (P). Arsenic, for swelled 
 feet of old or weakly persons, and breathlessness from weak heart (R) ; as a 
 tonic in continued doses of gr. -^ to ^ (Wa). Nux Vomica, in adynamia of 
 drunkards ; Tinct. Capsici 3vj ; Tinct. Nucis Vom. gij ; gtt. xx in water every 
 four hours (B). Calcium Phosphate, when from prolonged town-life or over- 
 work ; gr. j with grain j each of Iron Phosphate and Calcium Carbonate as a 
 dose (R) ; Hypophosphites of Lime or Soda, in nervous or general debility 
 (R). Iron, promotes appetite and digestion ; gr. j-iij of the Sulphate, or the 
 official Iron and Aloes pill, or with Manganese (B) ; anemic subjects (R). 
 Hydrastine, as substitute for Quinine, to promote appetite and digestion and 
 improve assimilation (B). Digitalis or Eucalyptus, in debility with weak heart 
 action (B). Bitters, especially Calumba and Gentian, are useful for a short 
 time (B). Sanguinaria, when stomach needs stimulation (P). Sarsaparilla, in 
 broken-down, syphilitic constitutions (P). Orchitic Extract. [See page 163]. 
 Alcohol is of great value, but has been abused ; hurtful when it increases tem- 
 perature and pulse, dryness of tongue, etc. (B) ; a wine with much ether in 
 debility of old age, especially where sleeplessness, indigestion and stomach 
 cramps (R). Aliment, sugar and saccharine fruits, vegetables, oil, milk, cod- 
 liver oil, wine of good body and strength (B) ; Porter or Rum-and-milk for 
 town-living women (R). Sea-bathing is useful in chronic illness, with much 
 debility (R). Turkish Baths, when debility is caused by the tropics, but cau- 
 tion necessary ; when town-dwellers become stout and flabby, are easily tired, 
 suffer from a lack of energy and from mental depression, a course of baths is 
 beneficial (R). [Compare Anemia, Convalescence, Neurasthenia.] 
 
 Tonic Prescriptions. 
 
 R- . Liq. Potas. Arsenitis, . . . n^x. 
 
 Ext. Nucis Vom. Fluidi, . ir^xx. 
 
 Tinct. Gentianae Compos., 
 
 Tinct. Cinchonas, 
 
 Tinct. Calumbae, 
 
 Vini Kolse, . . . . . . aa 3 iv. 
 
 M. Sig. — A wineglassful after each 
 meal. 
 
 R. Tinct. Nucis Vom. , . . . %'\]. 
 Tinct. Cinchonae, . . . ad%\v. 
 M. Sig. — A teaspoonful after each 
 meal. 
 
 R. Acidi Arsenosi, gr. j. 
 
 QuininaeSulphat, .... 3J. 
 
 Ferri et Potass. Tart., . . gij. 
 M. Ft. pil. no. xxx. Sig. — One 
 after each meal. 
 
 pill 
 
 R . Quininae Sulph., . . 
 
 . £i. 
 
 Strychnin as Sulph., . 
 Tr. Ferri Chloridi, 
 Ac. Phosph. Dil., . 
 Syr. Limonis, . . . . 
 M. Sig. — A teaspoonful 
 daily, in nervous debility. 
 
 ad%v). 
 in water thrice 
 
AFTER-PAINS AGALACTIA ALCOHOLISM. 609 
 
 After-pains. 
 
 Opium, more certain in action than any other remedy (Wa) ; Morphine and 
 Atropine (gr. % and gr. -^q), combined (B), hypodermically (Wa). Bella- 
 donna, as ointment, much used in France (L). Camphor, gr. x with gr. y& of 
 Morphine, an effective remedy (B) ; Jj in ^vj of mucilage, tablespoonful doses 
 every hour or two (Wa). Chloral, will stop the pains, but large doses (gr. xx- 
 xl) are necessary (R). Chloroform, the Linimentum Chloroformi, ^j with 
 Linim. Saponis Jvj, applied on flannel to the abdomen (Barker). Quinine, gr. 
 v-x night and morning, with the above chloroform liniment locally, in neural- 
 gic after-pains which do not yield to opiates, the uterus being tender on pres- 
 sure (Barker). Gelsemium, suspends them, large doses (ttLxx) necessary (B). 
 Cimicifuga, relieves the pains, and allays general nervous excitement (P). 
 Ergot, is better than Cimicifuga (R). Poultices, warm, over the hypogastrium, 
 with soothing injections into the vagina (L). 
 
 Agalactia. 
 
 Ricinus, gr. v. of extract, or 3j-ij of strong decoction, daily in water; also 
 the leaves, or an infusion, locally to mammae (T). Gossypium, an emulsion 
 of the seeds has repute in India as a galactagogue ; a wineglassful of the de- 
 coction every 20 to 30 minutes (P). Pilocarpus, remarkably increases the se- 
 cretions (B) ; Pilocarpine is a galactagogue, and probably the only example of 
 this class we possess, it distinctly increasing the secretion of milk in nursing 
 women (M). Tea, a good black tea is thought to promote the milk supply. 
 [Compare Lactation.] 
 
 Albuminuria. 
 
 Aconite, in incipient albuminuria with high body-temperature (R). Lead, 
 diminishes the albumin (R). Turpentine, gtt. ss-j, every 2 to 4 hours, or one 
 to two drop doses night and morning, of great value in chronic albuminuria 
 without other marked symptoms of Bright's disease (P). Gallic Acid, the most 
 efficient agent in the acute form to restrain loss of albumin (P). [See Aitken's 
 formula below.] Cannabis Indica is indicated when bloody urine (R). Chim- 
 aphila, has unquestioned power over albuminuria (P). Cantharis, tt\J of the 
 tincture every 3 hours, after the subsidence of acute symptoms, especially 
 when bloody urine (R). Fuchsin, in doses of gr. j-iij, completely arrested al- 
 buminuria with edema in many cases (Bouchut). Alkalies, the citrates and 
 acetates as diuretics (R); the Buffalo Lithia Water of Virginia is highly recom- 
 mended. Strontium Lactate, has been used with benefit, but should not be 
 given when scanty urine or symptoms of uremia are present. Nitro-glycerin, 
 vr\j of a one per cent, solution to dilate the peripheral vessels, relieving the 
 heart and lessening the renal congestion (B). Turkish Baths, benefit by re- 
 lieving the kidneys of work (R). Milk-cure, with buttermilk, has proved very 
 efficient in many cases (B). Chalybeate Waters, especially those having pur- 
 gative qualities, are beneficial (B). [Compare Bright's Disease.] 
 
 R . Acidi Gallici, 3*HJ- 
 
 Ac. Sulphurici Dil., . . . 3 ss. 
 Tinct. Lupuli, . , pjj. 
 
 Infusi Lupuli, . q. s. ad ^yj. 
 Sig. — Tablesp. thrice daily. — [Aitken.) 
 
 R . Liq. Ferri et Ammonii 
 
 Acetatis(U. S. P.), . . gvj. 
 Sig. — Teasp. to a tablesp. according to 
 age, well diluted, thrice daily. 
 
 (Basham.) 
 
 Alcoholism. 
 
 Arsenic, for distressing vomiting, one drop of Liquor Arsenicalis (Fowler's 
 solution), before breakfast (R). Capsicum, in dyspepsia of chronic alcoholism, 
 and to induce sleep; also as a substitute for the alcohol; with Bromides or 
 39 
 
6io 
 
 ALCOHOLISM. 
 
 Arsenic and bitters to assist in overcoming habit, by removing the distress at 
 pit of the stomach ; the tincture in io-minim doses should be taken shortly 
 before meals, or whenever there is a depression or craving for alcohol ; it obvi- 
 ates the morning vomiting, and promotes appetite and digestion (R). Ammo- 
 nia, a full dose (3ss) of the spirit will often sober a drunkard speedily (R); 
 a few drops of Liquor Ammonias, diluted, have prompt action (S) ; 3j of the 
 aromatic spirit with Capsicum (see formula below). Ammonium Chloride, is 
 remarkably efficient in straightening up a subject of acute alcoholism ; 3ss in 
 ]/z pint of water, swallowed at one draught, by a patient on the verge of deli- 
 rium tremens, is said to quickly restore the faculties. Ammonium Acetate, 
 the solution, in full doses, is one of the most efficient agents for quickly straight- 
 ening up a drunkard. Hydrastine, the sulphate in doses of gr. -^ increased to 
 gr. ■£$, hypodermically four times a day, is one of the " cures,'' and has been 
 used for this purpose in Canada for many years. Aurum and Arsenic Bromide, 
 the solution (Barclay's), is an excellent tonic remedy for alcoholism, and may 
 be used by hypodermic injection, in doses of n\,x four times daily. Kola is a 
 good general tonic for cases of chronic alcoholism. Cinchona, especially Cin- 
 chona Rubra, for gastric catarrh of drunkards (B) ; Quinine, gr. ij-vj daily to 
 raise the nervous tone (P). Nux Vomica, for after stomachal disorders (B) ; 
 in the tremor of chronic alcoholism is of much value (P); the tincture in 5-minim 
 doses with 15 of Tinct. Capsici, in water every 4 hours, is exceedingly effective 
 in diminishing the craving for spirits and sustaining the nervous system. 
 Strychnine, the Nitrate, gr. ^"tV hypodermically thrice daily for ten days, is 
 an absolute cure for dipsomania (Luton) ; a very valuable remedy for chronic 
 alcoholism and dipsomania, not merely curing the attacks, but abolishing the 
 desire for drink, the patients abstaining from spirits of their own accord (Pom- 
 brak). Glycozone, is one of the very best remedies for the chronic gastric 
 catarrh of chronic alcoholism (Edson). Potassium Bromide, Z] every 4 to 6 
 hours in the " horrors " (B). Phosphorus, in chronic alcoholism, recommended 
 by Anstie (R). Opium, cautiously, if at all (B) ; Morphine with tonics before 
 meals for pain, nausea, and want of appetite (R). Cocaine has been pro- 
 nounced of great benefit, restoring appetite, inducing sleep and promoting 
 digestion, while it soothes the brain and induces a feeling of contentment and 
 calm (R). Cimicifuga, is said to be useful in the treatment of the drunkard's 
 stomach (R). Chloral is very successful, but must be cautiously used with old 
 worn-out drunkards with weak hearts (B). Picrotoxin, small doses for the 
 tremor, gr. ^ repeated (B). Lupulin, is the best substitute for alcohol, and is 
 extremely serviceable in delirium tremens (B). Zinc Oxide, is very useful in 
 chronic alcoholism, to diminish the craving, to relieve the gastric catarrh and 
 lessen the tremor (B). Keeley Injection contains Strychnine and Atropine, 
 also Codeine and Cocaine for subjects of the opium-habit. {N. Y. Med. 
 Record.) [See under Patent Medicines.] Acute Alcoholic Poisoning [see 
 page 137] requires an emetic or the stomach-pump, cold douche to the head 
 and breast, warmth to the feet and limbs. Artificial respiration may be re- 
 quired. Milk, mucilaginous drinks, and black coffee, are the principal reme- 
 dies. A milk diet often creates a disgust for alcohol. [Compare Delirium 
 Tremens, Vomiting, and Neuritis.] 
 
 R- . Tinct. Capsici, t ^ss. 
 
 Potass. Bromidi, . . . . J ss. 
 
 J^/Liq. Potass. Arsenit., ml. 
 
 Vel Tinct. Nucis Vom. , 3 ij. 
 
 Spt. Ammonise Aromat., ^iij. 
 
 Syr. Tolutani, . q. s. ad ^yj. 
 M. Fiat mistura. Sig. — A dessertspoon- 
 ful in water four or five times daily. 
 
 R-. Zinci Oxidi, ....... ^j. 
 
 Piperini, gr. xx. 
 
 M. Fiant pil. no. xx. Sig. — One pill 
 thrice daily. 
 
 R. Tinct. Gentianse Co., 
 
 • • j|ij. 
 
 Tinct. Calumbse Co., 
 
 • • |ij- 
 
 Tinct. Nucis Vom., . 
 
 . . -mJxxx. 
 
 M. Sig. — A dessertsp. 
 
 before each 
 
 meal, for rum-stomachs. 
 
 (Loomis.) 
 
ALOPECIA AMAUROSIS. 
 
 6ll 
 
 R. Tinct. Nucis Vom., . . 5jj. 
 
 Tinct. Gentians Co., . . giij. 
 
 Spt. Limonis, ^Vi- 
 
 Spt. Chloroformi, . . . gj. 
 
 Aquae, . . . . q. s. ad ^vj. 
 M. Sig. — One-sixth to be taken 3 
 times daily, for insomnia. 
 
 or 4 
 
 R. Ext. Lupulini Fl., . . gj. 
 Ext. Aromatici Fl., ^ 
 Tinct. Capsici, . . >aa sjvj. 
 Mucil. Acaciae, . . J 
 Aquae Menth.Viridis, ad ^iv. 
 Fiat emulsum. Sig. — A teaspoonful or 
 
 two as required. 
 
 Alopecia. 
 
 Cantharides, the tincture, 1 part to 8 of castor oil, well rubbed into roots of 
 hair, night and morning (Wa). Arsenic, n\v of Liq. Arsenicalis ter die, exer- 
 cises a more or less powerful influence (Wa). Nitric Acid, with olive oil, makes 
 a serviceable liniment (Wa). Pilocarpine, has a decided influence on the growth 
 of the hair (B). Glycerin in combination with the above remedies (Wa). Sul- 
 phur Iodide, has been found very effectual, used internally and externally 
 (Wa). Thyroid Extract, [see page 158]. Oxygen, applied under a rubber cap 
 fitted to the head, into which oxygen was pumped, with entire satisfaction, in 
 the case of a girl who had lost nearly all her hair in consequence of alopecia 
 areata (Stoker). Frequent Shaving may often save the hair in alopecia after 
 illness. Use clean brushes with long bristles, and brush against the natural 
 lay of the hair. [Compare Tinea.] 
 
 R. 01. Amygdalae Expres., 
 
 Aq. Ammoniae, . . . . aa Jj. 
 
 01. Rosmarini, gij. 
 
 Alcoholis, , ^ij. 
 
 Aq. Destillat, Sij. 
 
 Mellis Despumat., . q. s. ad % viij. 
 Sig. — Lotion for the hair. ( Wilson.) 
 
 R. Tinct. Macis, 2>j ss - 
 
 Olei Olivae, . . q. s. ad §ij. 
 Sig. — Lotion for baldness. (Hebra.) 
 
 R 
 
 M 
 
 Tinct. Cantharidis, . . . S^jss. 
 Tinct. Capsici, ..... TT^xx. 
 
 Glycerini/ 3 SS - 
 
 Spt. Odorat., .... ad£v]. 
 Sig. — Hair tonic. (Gross.) 
 
 R. Pilocarpin. Hydrochlorat. , gr. j. 
 Aquae Destillat., . . . %]. 
 M. Sig. — Ten to thirty drops twice 
 daily, according to age, to improve the 
 growth of the hair. (Bartholow.) 
 
 Amaurosis and Amblyopia. 
 
 Arnica, has long been a popular remedy for amaurosis in Germany ; Man- 
 noir employed it with much success (P, Wa). Rue, in minim doses night and 
 morning, for dimness of vision from functional amaurotic condition ; Elgajaki 
 says it produces dimness of vision, and in smaller doses improves the eyesight 
 (P). Strychnine will cure amblyopia from lead, tobacco, and alcohol (B) ; gr. 
 -^ hypodermically (Nagel) ; hypodermically in tobacco and traumatic ambly- 
 opia, and in progressive nerve atrophy not dependent on intercranial disease 
 (R). Guaiac, is advised for cases of amaurosis occurring in persons of rheu- 
 matic diathesis (Wa). Santonin, has given very satisfactory results in amau- 
 rosis (Wa). Veratrine, as lotion brushed over eyelids, brows and temples once 
 a day, is often useful, but should not be permitted to touch the conjunctiva, or 
 great pain will result (Wa) ; [see formula below]. Potassium Iodide, in 
 amblyopia from lead-poisoning (Wa). Opium with champagne, has caused 
 recovery from tobacco amaurosis without the abandonment of the habit of 
 smoking (Hutchinson). Seton, a small seton in the temple kept open for a 
 long period, has been found effectual when other remedies failed (Wa). 
 Amaurosis and Amblyopia are names formerly used to denote the various 
 forms of blindness, before ocular diagnosis became as exact as it now is. 
 Amblyopia is still used to designate certain impairments of vision not accounted 
 for by any organic changes visible (Roosa). 
 
612 
 
 AMENORRHEA. 
 
 R . Veratringe, gr. x. 
 
 ^theris, gij. 
 
 Alcoholis, ^j. 
 
 M. Sig. — Use with a brush once a day 
 over eyelids, eyebrows and temples. 
 
 R. Strychninae Sulphatis, . . gr. j. 
 
 Alcoholis, jjj. 
 
 Aquae Destillatae, q. s. ad !§iv. 
 Sig. — A teaspoonful thrice daily before 
 meals, when not used hypodermically. 
 
 Amenorrhea. 
 
 Aconite, in sudden suppression from cold or wet feet (R, P). Pulsatilla, in 
 sudden suppression (B) ; often of the greatest value in the functional form (P). 
 Iron, when from anemia, the most frequent cause ; small doses preferred. 
 Solution of Acetate, or Ferri et Ammonii Citras (gr. ij), or Ferri et Strychninse 
 Citras (gr. j), also chalybeate waters; make a careful diagnosis before giving 
 iron (B). Aloes, when dependent on anemia (B) ; at the periods, with hot 
 pediluvia, friction, etc. (R, P). Potassium Permanganate, gr. j thrice daily in-' 
 creased to gr. ij , is the best of all remedies for bringing back the menses, having 
 specific action on the uterine tissue (R) ; excellent in amenorrhea from. cold 
 feet, and is by far the best emmenagogue ; in pill it may explode, best in cap- 
 sule with powdered elm or licorice (Parvin). Manganese Binoxide,, in pill, 
 gr. ij thrice daily, is a very efficient emmenagogue. Mercury, the Biniodide is 
 a certain and safe emmenagogue, gr. y% in pill, four times daily. Oxalic Acid, 
 is highly praised, gr. >£-^ in mixture, every hour (Poulet). Apiol, when from 
 functional inactivity ; first give Iron for the blood ; next aloetic purgatives, 
 then apiol (gr. xv) just preceding the period; or a daily dose for a week or 
 several days before (B) ; the best emmenagogue next to Potass. Permang. 
 (Parvin). Senega, a saturated decoction of the root, to extent of a pint in 24 
 hours, during the preceding two weeks, advantageous (P). Polygonum, has 
 given excellent results when used in 3ss doses four times daily for a week (B). 
 Cimicifuga, has been recommended (R) ; is of very great value (P). Arsenic, 
 combined with Iron, when from functional inactivity of ovaries (B). Aurum 
 Salts, in amenorrhea from torpor of ovaries (B). Ignatia, in suppression of 
 hysteria (P). Cinnamon, causes a flow of blood to the womb (Goodell). Indigo, 
 is considered very efficient in doses of from 3j to Z'w ; larger doses produce 
 nausea and vomiting. Nux Vomica, small doses of the extract, of benefit in 
 some obstinate cases (Wa). Silver Nitrate, in substance, applied lightly to the 
 os uteri, at time of the expected discharge (Wa). Colocynth, in chlorotic 
 amenorrhea (P). Ergot, has cured when due to plethora (B) ; when anemia 
 after use of iron (R) ; in chlorotic (P) ; n\j every }4, hour for 5 or 6 hours the 
 day before and that of the expected flow, is very efficient when the cessation is 
 not due to anemia (A. A. Smith). Senecio Aureus, will provoke menstruation 
 in cases of functional amenorrhea but will not do so when there is anemia or 
 advanced phthisis (M). Rue, in functional form, TT\j-v of the oil (B, P). San- 
 guinaria, is indicated for functional amenorrhea in the absence of plethora (B, 
 P). Savine, general atony ; tr^v-x of the fluid extract (B, R, P). Serpentaria, 
 with anemia or chlorosis (B). Ammonium Chloride, for headache (R). Sitz- 
 baths, hot, for six days before period ; mustard may be added at period ; often 
 effectual in sudden suppression (B). Spinal Ice-bag, to lower dorsal and lum- 
 bar vertebrae, or cold sponging ; useful (R). Electricity, in atony of uterus and 
 ovaries (B). [Compare Anemia, Chlorosis.] 
 
 R . Olei Sabinae, 
 
 Olei Rutae, aa.^j. ' 
 
 Tinct. Polygon. Hydropip., Jjj. 
 
 Ol. Amygdalae Expres., 
 
 Mucil. Acacias, 
 
 Aquae Menthae Pip. , . . aa % ij . 
 Fiat mistura. Sig. — A teaspoonful two 
 or three times daily. (Bartholow.) 
 
 R. Tinct. Ferri Chloridi, . . . ^iij. 
 Tinct. Cantharidis, . . . . gj. 
 Tinct. Guaiaci Ammon., . t ^iss. 
 
 Tinct. Aloes, J ss. 
 
 Syrupi, . . . . q. s. ad % vj. 
 Fiat mistura. Sig. — A tablespoonful 
 thrice daily, in simple atonic amenorrhea. 
 (H. C. Wood. Dezvees.) 
 
ANEMIA. 
 
 613 
 
 R. Ext. Aloes, 3J. 
 
 Ferri Sulph. Exsic, . . . 3 ij. 
 
 Asafcetidae, £iv. 
 
 Fiant pilulae 100. Sig. — One pill after 
 each meal, gradually increased to three. 
 ( Goodell. ) 
 
 R. Quininae Sulphat., .... giss. 
 
 Extr. Nucis Vom., . . . gr. xij. 
 
 Olei Sabinae, gss. 
 
 Aloes Socotrinae, . . . . gr. viij. 
 
 Cantharidis, gr. xxiv. 
 
 Fiant pilulae xlviij. Sig. — One pill thrice 
 daily. 
 
 Anemia. 
 
 Nux Vomica, stimulates the blood-making organs, and is used as an adjunct 
 to restorative remedies (B). Iron, its chief value is to improve digestion, also 
 to furnish hematin to the blood ; the astringent preparations are the best and 
 they should be given after meals ; chalybeate waters are also useful (B). Some 
 persons require bland preparations, especially when the gastric mucous mem- 
 brane is irritable ; a pale and flabby tongue indicates large doses of the chloride 
 or sulphate (R). Arsenic, as an adjunct to Iron, and when iron cannot be borne 
 or fails (B). Aurum Arsenate, is highly beneficial ; the solution of Aurum and 
 Arsenic Bromide renders excellent service in anemia. Orchitic Extract, has 
 seemed serviceable. Adrenal and Thymus Extracts have been used with bene- 
 fit. Nuclein, has rendered good service. Bone Marrow, is highly efficient in 
 pernicious anemia. [See page 160.] Cerebrinin, has been used with good results. 
 [See page 164.J Quinine, for badly-fed town dwellers (R). Hypophosphites, 
 are useful, but should not be given with iron, cod-liver oil, or stimulants (R). 
 Calcium Phosphate, in anemia of growing persons, and of women weakened by 
 rapid child-bearing or excessive menstruation (R). Calcium Lacto-phosphate, 
 for nursing mothers, or in waste from suppuration (B). Acids, added to purga- 
 tive salts as tonics to the mucous membrane (R). Pepsin, is recommended by 
 Hollmann. Manganese, alone not of much use ; is best combined with Iron 
 (B) ; is not, like iron, found in the feces, nor does it cause constipation (Wa). 
 Pepto-mangan, is highly esteemed by many competent clinicians. Gal- 
 vanization, as an aid to remedies (B). Cold Sponging, needs great caution, as 
 it may lower the tone by minute degrees (R). Diet and Hygiene, of prime 
 importance. Nourishing, digestible food, in as large quantities as can be as- 
 similated — milk, eggs, animal broths ; afterward fish, poultry, game, mutton, 
 etc. Moderate daily out-of-door exercise, in pure air, is indispensable. Bath- 
 ing, especially sea-bathing, aids restoration. Wines, often useful. Red wines 
 are the best. [Compare Adynamia, Chlorosis, Convalescence, Leucocy- 
 
 THEMIA, LYMPHADENOMA.] 
 
 Tonic Prescriptions. 
 
 R 
 
 Tinct. Ferri Chloridi, . g iv. 
 
 Ac. Phosphorici Dil., . £vj. 
 
 Spt. Limonis, £ij. 
 
 Syrupi, . . . q. s. ad Jvj. 
 Misce. Sig. — A dessertspoonful in water 
 after meals. To the above may be added 
 3 ij of the Liquor Strychninae Hydrochlo- 
 ratisofthe B. P. {Goodell.) 
 
 R. Hydrarg. Chlor. Corr., . 
 
 Liq. Acidi Arsenosi, . . 
 
 Tinct. Ferri Chlor., 
 
 Ac. Hydrochlor. Dil. , aa 
 
 Syrupi, 
 
 Aquae, . . . . q. s. ad 
 Misce. Sig. — A dessertspoonful in a 
 wineglassful of water after each meal, as 
 an alterative tonic. (A. H. Smith.') 
 
 gr. J- 
 
 |»j- 
 
 V J- 
 
 R. Ferri Sulph. Exsiccat., 
 
 Potass. Carbonatis, . aa ^ij. 
 
 Syrupi, q. s. 
 
 Fiant pilulae no. xlviij. Sig. — One pill 
 after each meal, gradually increased to 
 three. (Blaud.) 
 
 R . Quininae Sulphatis, . 
 Ferri Sulph. Exsic, 
 Strychninae Sulph., 
 Fiant pilulae xx. Sig.- 
 
 daily. 
 
 . . gr. xx. 
 . . gr. xl. 
 . . gr. ss. 
 -One pill thrice 
 (Bart/iolozv.) 
 
 R. Massae Ferri Carbonat., 3J. 
 Acidi Arsenosi, .... gr. j. 
 Quininae Sulphatis, . . gr. xl. 
 Fiat massa et div. in pilulas no. xl. 
 Sig. — One or two pills thrice daily. 
 
614 
 
 ANESTHESIA. 
 
 Anesthesia, General. 
 
 Morphine, subcutaneously before the inhalation, diminishes danger, and les- 
 sens the after-pain if operation is performed (Nussbaum) ; Morphine gr. -^ and 
 Atropine gr. y^, hypodermically, after emergence from anesthesia, will re- 
 lieve the nausea and vomiting ; a preliminary injection of Morphine lessens 
 the stage of rigidity and spasm, enables a smaller quantity of the anesthetic 
 to be used with full effect, prolongs the stage of insensibility, prevents shock, 
 and antagonizes the cardiac and respiratory depression (B). Chloral, as an 
 aid to Chloroform in surgery and obstetrics, 10 to 15 grains given 20 minutes 
 before the anesthetic, seems to intensify the effect and enable a less quantity 
 to be used, also tiding the patient over the excited stage (Brodnax); in children 
 a full dose of chloral before anesthesia enables the latter to be obtained during 
 sleep without using force (Id). Atropine, is decidedly the best antagonist to 
 the respiratory paralysis of Ether, and should be given hypodermically (gr. -£$) 
 as soon as alarming symptoms manifest themselves (Amidon) ; the writer of 
 this book has saved at least four subjects of chloroform-narcosis by the hypo- 
 dermic use of Atropine after both heart and respiration had apparently failed. 
 Alcohol, ^j-ij of whiskey or brandy before inhalation, to sustain the heart 
 and prolong narcosis (B). [Compare page 115 for the general subject of 
 Anesthesia.] 
 
 Anesthesia, Local. 
 
 Ether, as spray, projected upon the skin in a continuous stream, produces 
 cold and local anesthesia by its rapid evaporation, and may be used for any 
 minor operation. Rhigolene, a volatile petroleum product, freezes the part when 
 sprayed thereon from a hand atomizer and produces local anesthesia. Guaiacol 
 in sterilized olive oil, 1 part in 10 or 20, hypodermically, is a powerful local an- 
 esthetic [see page 292]. Cocaine, in 1 to 4 per cent, aqueous solutions injected 
 hypodermically or applied to mucous membranes, produces profound local an- 
 esthesia [see page 278]; injected into the spinal canal between the 2d and 3d lum- 
 bar vertebrae, produces anesthesia of the lower limbs and the scrotum (Corning). 
 Eucaine, is equally effective and less dangerous than Cocaine [see page 283]. 
 Holocaine, is too toxic for hypodermic use, but in a 1 percent, solution instilled 
 on the eye it causes complete, rapid and painless anesthesia [see page 283]. 
 Tropacocaine, is less toxic than cocaine and equally anesthetic on the eye [see 
 page 280]. Orthoform, is too insoluble for hypodermic use, but is efficiently 
 employed as a dusting powder or ointment for painful surfaces where it comes 
 into contact with exposed nerve endings [see page 283]. Infiltration Method 
 is based on the theory that fluid infiltration of the tissues is the cause of the 
 anesthesia produced by local injection of anesthetic solutions ; distilled water 
 being too painful, weak anodyne solutions are used for injection, as follows : 
 No. 1, Strong, — Cocaine Hydrochloride gr. iij, Morphine Hydrochlorate gr. ss, 
 Sodium Chloride gr. iij, Distilled Water, sterilized, ^iij ^iij, of which gvj may 
 be used during one operation. No. 2, Normal, — Cocaine, Hydroch. gr. jss, 
 Morph. Hydroch. gr. ss, Sod. Chlor. gr. iij, Distilled Water, sterilized, ^iij 3'\\], 
 of which ^iijss maybe used at one operation. No. J, Weak, — Cocaine Hy- 
 droch. gr. \, Morph. Hydroch. gr. ss, Sod. Chlor.gr. iij, Distilled Water, steril- 
 ized, ^iij 3iij» of which a pint may be used at one operation (Schleich). [Com- 
 pare the List of Local Anesthetics and Anodynes on page 32.] 
 
 R . Chloroformi, partes xij . 
 
 Camphorse, partes ij. 
 
 Tinct. Aconiti, .... partes xij. 
 Tinct. Capsici, .... partes iv. 
 Tinct. Pyrethri, .... partes ij. 
 01. Caryophylli, .... partes ij. 
 
 Dissolve camphor in chloroform, add 
 the oil of cloves and then the tinctures. 
 This is credited with almost magical local 
 anesthetic effect. 
 
 [Parson'' s Local Anesthetic.) 
 
ANEURISM — ANGINA PECTORIS. 615 
 
 Aneurism. 
 Potassium Iodide, in large doses (gr. xv-£ss), 3 or 4 times a day, gives great 
 relief and has cured (B) ; combined with recumbent position and restricted 
 diet (R). Veratrum Viride aids surgical expedients; also in large internal 
 aneurisms, with absolute recumbence and a little Opium to relieve pain, vom- 
 iting to be avoided (B). Ergot, with recumbent position ; favors coagulation 
 of the blood in sac (B) ; Ergotin (P). Gallic Acid and Iron, internally, have 
 cured cases of aortic aneurism (Speer). Chloroform inhalation for great dysp- 
 nea (R). Lead Acetate, a valuable auxiliary to the more important items of 
 rest, diet and mechanical appliances, gr. iij-v ter die (Wa) ; its use limited to 
 the sacculated form (S). Electrolysis, galvano-puncture in deep aneurisms; 
 not very successful (B). The object sought is the coagulation of blood within 
 the aneurismal sac ; cures have not been attained by this treatment, but in 
 many it has produced great amelioration of the most distressing symptoms 
 (Petit). Glycerin, by subcutaneous injection, to increase the coagulability of the 
 blood [see page 127]. Aliment, milk regimen, for denutrition (B) ; a low diet, 
 with absolute rest ; Ergotin and Potassium Iodide for deep aneurisms beyond 
 reach of surgical treatment (B). Rest, in recumbent posture, and light, un- 
 stimulating diet, are primary and essential elements in the treatment of 
 aneurisms. Surgical Treatment includes ligation of the vessels, also pressure 
 by a tourniquet or bags of shot, the operator's fingers, etc., applied to the main 
 artery above the tumor, and the introduction of fine wire into the sac to favor 
 coagulation. 
 
 R. Potassii Iodidi, ..... 3J. 
 
 Tinct. Veratri Viridis, . ,"jss. 
 
 Tr. Cinchonae Co., . . . Sjj. 
 
 Tr. Cardamomi Co., . . 5Jss. 
 
 Tr. Gentianae Co., ... ^ ss. 
 
 Syrupi Simplicis, 
 
 Alcoholis, aa t ^iv. 
 
 Aquae, q. s. ad ^xvj. 
 
 Misce. Sig. — ^ss thrice daily. Each 
 dose has gr. xv of Potassium Iodide. 
 
 R. Acidi Gallici, . . . . gj. 
 
 Ext. Ergotae, 
 
 Digitalis, . . . aa gr. 
 Fiat massa et div. in pil. xx. 
 Sig. — One every two hours. 
 
 R. Plumbi Ace*atis, . . . gr. xxxvj. 
 Extracti Opii, .... gr. iv. 
 Confectionis Rosae, . . q. s. 
 Ft. pil. xij. One every four hours. 
 
 Angina Pectoris. 
 Aconite, believed by Gubler to be appropriate, and by Fleming to have been 
 curative in many severe cases resisting other remedies (P). Arsenic, lessens 
 or prevents paroxysms, if used in the intervals (Anstie). Amyl Nitrite, as in- 
 halation, affords signal relief (R) ; unsafe in advanced degeneration of cerebral 
 vessels and fatty degeneration of heart (B) ; gives great relief during par- 
 oxysms (Br). Sodium Nitrite, is less rapid in action than Amyl Nitrite, but is 
 more efficient in preventing return of symptoms (Br). Strychnine, in the milder 
 forms ; very small doses, gr. y^-to -^ (P). Glonoin, doses of rr^ yi^ have been 
 used with success (Pf, R). Chamomile, in pseudo-spasms of hysterical persons 
 (P). Ether, aborts a mild attack (B); Sulphuric Ether in the nervous form, a 
 spoonful immediately on commencement of attack will greatly mitigate it 
 (Anstie). Phosphorus, often serviceable (R). Morphine, hypodermically, 
 especially when cardiac dyspnea; strengthens the heart (R). Turpentine ap- 
 plications, hot over chest, to mitigate severity of the paroxysms, especially in 
 the aged ( Wa). Quinine, when intermittent (Wa) ; or when any malarial taint 
 present (Br). Brandy, in frequent small doses, with hot "bran poultice over 
 heart and warmth to extremities. Cocaine, in doses of gr. y^ to % thrice daily 
 for two days, proved curative in four very severe cases (Laskevitch). Cactine 
 is efficient in pseudo-angina pectoris. Chloral, may be well prescribed in 
 pseudo-agina pectoris (De Holstein). Crataegus Oxyacantha, the English 
 hawthorn, a fluid extract of the berries, used in 40 cases of true angina with re- 
 markably good results (Jennings). 
 
6i6 
 
 ANTHRAX ANTRUM DISEASE ANUS. 
 
 Anthrax. 
 
 Nitric Acid strong, applied steadily, after thorough cleansing and drying, to 
 destroy the diseased mass (D). Bromine, to saturate the surface (D). Nitric 
 Acid fuming, is the preferable caustic (Greenfield). Quinine and Carbolic Acid, 
 internally, are indicated in all forms, also stimulants, as Ammonia, Ether, and 
 Alcohol (Greenfield). Eschar should be promptly destroyed, to avoid con- 
 tagion (R). Excision and Cauterization demanded, when from direct inocula- 
 tion ; the two most successful measures (Greenfield). Carbolic Acid, a 2 or 3 
 per cent, solution injected subcutaneously around the pustule thrice daily, and 
 applied on compresses soaked in the solution (Jarnvosky) ; of 24 cases so treated 
 17 recovered (Matveieff). 
 
 Antrum Disease. 
 
 Hydrogen Dioxide, the solution, 1 to 12 of water, injected through the ostium 
 for diagnosis ot empyema of the antrum ; if pus be present it is driven out, and 
 fills the nose as a white foam (Brown). Chloroform, by inhalation, small 
 quantities frequently, for treatment of acute catarrh extending to the antrum, 
 extremely efficient, both as a remedy therefor and as a preventive of suppura- 
 tion therein (Potter). Operative Measures, that in most favor is to enter the 
 antrum through the alveolus of the second molar tooth (Garretson); to give 
 free drainage and enable medication of the diseased mucous membrane it is 
 best to enter the antrum in its most dependent portion, through the upper part 
 of the alveolus or immediately above it, between the roots of the 2d bicuspid 
 and 1st molar ; a gold tube then fitted to the opening, so as to project beyond 
 the mucous membrane, will give free drainage, without sacrificing a sound or 
 even diseased tooth (Brown). Boric Acid, in saturated solution, as wash to 
 cavity twice a day, the after-treatment ; occasionally injecting Iodine, Zinc Sul- 
 phate or Bismuth Subnitrate (Id). 
 
 Anus, Fissured. 
 
 Hydrastis, locally, promotes healing (B). Rhatany, as injection, night and 
 morning, after enema in the morning to move the bowels (Pf, Tr). Iodoform, 
 improves and relieves pain (B). Iodo-tannin, well applied, effective (B). 
 Belladonna, locally of great service for painful spasms of sphincter (P). 
 Opium, with gall-ointment for fissures of anus; mild purgatives should be 
 simultaneously employed (R). Sulphur, as a mild purgative, to cause soft 
 motions (R). Tannin, 3j in Glycerin ^ij, introduced on a tent, night and 
 morning, with great advantage (Wa). Collodion, as protective covering (P). 
 Potassium Bromide, with 5 parts of Glycerin, as local application (R). Silver 
 Nitrate, in solution, to the ulcer after careful cleansing and applying a 4 per 
 cent, solution of Cocaine, which prevents the pain due to the silver solution ; 
 followed by Iodoform oint. gr. xxx to the ^ ; this is most efficient (Adler). 
 Castor Oil, as a mild purgative (R) ; to keep motions soft (Br). Surgical 
 Means, the most efficient ; forcible dilatation of sphincter or partial division 
 in severe cases, through the mucous membrane and a few fibres of sphincter. 
 Anal fissure, when uncomplicated with some other rectal affection, is curable 
 in many cases by non-operative methods of treatment (Adler). Mercury, an 
 ointment of the Oxide, 30 grains to the %, has cured many cases (Id). 
 
 R. Tinct. Krameriae, .... ^j. 
 
 Ext. Krameriae, jjij. 
 
 Aquae, ad £ viij. 
 
 M. Sig. — One-fourth as injection, night 
 and morning, after using enema. 
 
 R. Sulphuris, ; ^j. 
 
 Pulveris Aromat., 
 
 Confec. Rosae, aa^ij. 
 
 Misce. Sig. — One-third to be taken at 
 bedtime as a laxative. 
 
APHONIA APHTHA. 
 
 617 
 
 M 
 
 Hydrarg. Chlor. Mitis, . . gr. iv. 
 Ext. Belladonnae, 
 
 Pulv. Opii, aa gr. ij. 
 
 Ung. Sambuci, ^j. 
 
 Sig. — To be applied frequently 
 
 anal fissure. 
 
 (Allingham. ) 
 
 M. 
 
 Plumbi Acetatis, 
 
 Zinci Oxidi, aa gr. x. 
 
 Pulv. Calaminae, gr. xx. 
 
 Adipis Benzoinat., . . . . % iv. 
 Siff. — Ointment for use in anal 
 
 fissure. 
 
 {Allingham.) 
 
 Aphonia. 
 
 Ignatia, in aphonia of hysterical women (P). Atropine, in hysterical apho- 
 nia and for fatigue of vocal cords, gr. T ^ to ■£§, morning and evening (B). 
 Ethyl Bromide, for rapid anesthesia, during which it was suggested to the pa- 
 tients to shout out loudly their names, count numbers, etc. ; this successful in 5 
 cases of hysterical aphonia in women (Arslan). Nitric Acid, rr^v-x of the di- 
 lute acid, for hoarseness of singers, in fatigue of vocal cords, and when apho- 
 nia is stomachal (B). Benzoin, the tincture by inhalation in laryngeal catarrh 
 (Br). Oil of Rue, as inhalation in chronic catarrh (Br). Uranium Nitrate, as 
 spray in very chronic catarrh (Br). Alum, gr. X-3J aquae, as spray, in chronic 
 coughs and hoarseness (R). Borax, a piece the size of a pea allowed to dissolve 
 in the mouth (R). Glycerite of Tannin, locally in chronic inflammation of the 
 throat (R). Sulphurous Acid, by inhalation, spray, or fumigation, in clergyman's 
 aphonia (R). Ipecacuanha wine, as spray, when congestion of vocal cords 
 (R) ; in laryngeal catarrh (Br). Ammonium Chloride, as vapor inhaled, of 
 great value in catarrhal aphonia (Wa). Turkish Bath, at commencement of a 
 feverish cold (R) ; in acute laryngeal catarrh (Br). Galvanism, localized, the 
 best treatment for hysterical aphonia. 
 
 R. Acidi Nitrici Dil., . . . . sjij. 
 Tinct. Calumbse, .... Sj. 
 
 Aquae, ad £iv. 
 
 M. Sig. — A dessertsp. in a winegl. 
 water thrice daily. 
 
 of 
 
 R . Liq. Ammoniae, 
 
 Aquae, . . . . aa ^j. 
 
 M. Sig. — A teaspoonful in a pint of 
 hot water for each inhalation. 
 
 Aphthae. 
 
 Potassium Chlorate, the best remedy ; a solution of gr. x to the f as wash, 
 alone or with borax (Br) ; and gr. x to xx by the stomach (B). Borax, with 
 honey, or as glycerite of borax, frequently used (R) ; crystals allowed to dis- 
 solve in the mouth (W). Sulphurous Acid, as solution, strong or diluted, locally 
 (R), diluted as spray (B). Mineral Acids, formerly much used (B). Mercury, 
 Hydr. cum Creta in small doses to remove the indigestion on which aphthae 
 often depend (B) ; Borax being used locally when aphthae exist in the mouth 
 (Wa). Copper Sulphate, a weak solution painted over mucous membrane (R). 
 Potassium Iodide, gr. j-v in ^j aquae, locally (B). Salicylic Acid, one part 
 dissolved in alcohol to 250 of water (R). Quinine, gr. j every 2 or 3 hours, in 
 infants (B), especially when consequent on diarrhea (Br). Coptis, the infu- 
 sion has repute in New England (B). Bismuth, freely to the parts (B) ; as a 
 local application (Br). Glycerin, will sometimes cure (R). Rhubarb, the com- 
 pound powder to remove indigestion (Br) ; is highly useful in small doses 
 (Wa). Limewater, as a mouth-wash, is much used. 
 
 R. Acidi Sulphurosi, . . . . ,^ij. 
 
 Aquae, q. s. ad Jij. 
 
 M. Sig. — Mouth-wash, or may be used 
 as a spray. 
 
 &. Pulv. Rhei Co., . . .' . . 31J. 
 
 Sacch. Lactis, q. s. 
 
 Triturat. et div. in pulv. xij. Sig. 
 One powder thrice daily. 
 
6i8 
 
 APOPLEXY APPETITE ARTH PvITIS. 
 
 Apoplexy. 
 
 Aconite, when full, strong pulse, hot, dry skin, plethoric cases, is the best 
 remedy (P) ; to lower blood-pressure and prevent further hemorrhage, where 
 the pulse is strong and arterial tension high (Br). Elaterium, as a purgative; 
 a large dose (gr. ij) in suppository with soap; or as an injection into the large 
 bowel (P). Croton Oil, as purgative, a drop may be put on the back of the 
 tongue (Br) ; tt\J^ or l X each hour (R). Colocynth, as a derivative purgative 
 (Br) ; appears to act well (P). Cold Water, often harmful, though frequently 
 used ; is injurious when face pale, surface cool, circulation depressed (B). 
 Electricity, very mild galvanic currents to promote absorption ; caution neces- 
 sary, especially if much headache and vertigo (B). Diet and Hygiene, of great 
 importance in patients subject to apoplexy ; avoid stimulating food and drink, 
 especially beer, over-eating, excitement, haste, exposure to hot sun, heated 
 rooms, etc. At no subsequent period should a full animal diet or the use of 
 undiluted wines be indulged in (A). Diagnosis. Should be carefully differ- 
 entiated from alcoholism, with which it is often confounded. [Compare Cere- 
 bral Congestion, also page 137.] 
 
 Be . Tinct. Aconiti, TT^x. 
 
 Aquse Cinnamomi,q. s. ad ^\]. 
 M. Sig. — A teasp. every % hour for 2 
 hours, then every half-hour. 
 
 R • Ext. Colocynthidis Co., gr. xx. 
 Olei Tiglii, . ... ni ij. 
 Fiat massa et div. in pil. iv. Sig. — 
 One pill as required, until free purgation. 
 
 Appetite. 
 
 Ignatia, will correct diseased appetite (P) ; especially in hysterical subjects 
 (Br). Anthemis, will stimulate the appetite. Cannabis Indica, produces a 
 ravenous appetite. Bitters, to stimulate the appetite (R). Food should be 
 savory and well cooked. Habits require examining into, when lost appetite 
 complained of. Fluoride of Sodium or Potassium will produce almost total 
 anorexia, and may be employed with advantage in bulimia (Da C). [Compare 
 Dyspepsia.] 
 
 &. Gentianse, Quassise, 
 
 Cinnamomi, . . . . aa gij. 
 Sig. — Put into a pint of boiling water, 
 and when cold strain ; take a winegl. thrice 
 daily as an appetizer. 
 
 R . Anthemidis, 
 
 Quassioe, aa gj. 
 
 Sig. — Put in a pint of boiling water, and 
 when cold strain ; take a winegl. thrice 
 daily before meals as an appetizer. 
 
 Arthritis, Rheumatoid. 
 
 Aconite, highly spoken of as liniment, conjoined with internal use (Wa). 
 Cimicifuga, when joints enlarged and much stiffened, and when traceable to 
 uterine derangement, is very useful (R) ; when pains worse at night (Wa). 
 Viburnum Prunifolium, the fluid extract with that of Cimicifuga, 20 drops of 
 each thrice daily, gradually increased to 30, produced steady improvement in 
 a well-marked case of eight years' standing, involving nearly all the articula- 
 tions. Iodine, the tincture internally, said to be better than potassium iodide 
 (R). Iodoform, 10 parts to 20 of Ether and 20 of Alcohol, as liniment to the 
 joint, applied by a pencil, and covered with oiled silk (Gubler). Iodides, often 
 signally benefit, especially when due to syphilitic, mercurial, or mineral poison- 
 ing (B) ; large doses of Potassium Iodide sometimes required (R) ; combined 
 with Guaiac, or Corrosive Sublimate, often curative in cases resisting these 
 remedies given separately (Wa) ; Potassium Iodide should always be fairly 
 tried (Da C). Guaiac, the ammoniated tincture, in doses of 3 j-ij in milk, often 
 gives excellent results (Da C). Colchicum, with alkalies, extremely useful (B). 
 [See Gout, for formulae.] Arsenic, when referable to nervous affections (B) ; 
 as a bath containing ^iv washing soda and gr. xx of Sodium Arsenate ; in 
 
ASCITES. 
 
 619 
 
 large doses continued, sometimes of great benefit but action is capricious (R) ; 
 in small doses is of great benefit (Da C). Aurum, the Bromide of Gold and 
 Arsenic has proved curative in arthritis deformans, characterized by great pain, 
 stiffness and swelling of the joints (E. A. Wood). Lithium Salicylate, very effi- 
 cient in acute and progressive subacute articular rheumatism, and has some 
 effect also in chronic cases where some of the joints are deformed, swollen and 
 painful ; 3j may be given daily, in doses of gr. vij to x, in water (Vulpian). 
 Lithium Bromide, of great value in acute and chronic (B). Phenocoll, with 
 Piperazin, 15 grains of each daily, in a pint or more of carbonated water, has 
 rendered good service in gouty and rheumatic affections. Piperazin, should be 
 used in all cases of difficult diagnostic differentiation for its remarkable power 
 over uric acid and urate concretions. Potassium Bromide sometimes allays 
 the severe pain (R). Arnica, the tincture and infusion are said to be of great 
 value (P). Cod-liver Oil, internally and locally, of much value (R). Baths, 
 Turkish or sulphur ; the cold douche, which may be slightly warmed in winter, 
 use for one or two minutes and rub dry (R). Dry Heat, by the Tallerman appa- 
 ratus, has been used in many cases with great benefit ; in my experience it has 
 very little value in this affection (W). Adhesions, may be broken up under 
 anesthetics (Da C). Massage may be used to ameliorate the condition in 
 chronic cases where a cure cannot be obtained (Da C). Counterirritation, by 
 the actual cautery or flying blisters to the affected articulations, passive move- 
 ments of the joints, sulphurous baths, in conjunction with Potassium Iodide 
 internally in doses of 7j^ to 30 grains in the 24 hours (Letulie). 
 
 $ . Vini Colchici Seminis, . ^iij. 
 Spt. Ammon. Aromat., ^xiij. 
 M. Sig. — A teasp. every 3 hours, until 
 some physiological effect is produced. (B.) 
 
 R. Lithii Bromidi, .... ajiij. 
 
 Syr. Zingiberis, . . . . Jss. 
 
 Aquae, ^j ss - 
 
 M. Sig. — A teasp. thrice daily, 
 jointly with a lotion of the same. 
 
 Ascites. 
 
 Digitalis, when ascites is part of a general dropsy due to cardiac or renal 
 diseases ; is of the greatest service, except where aortic regurgitation and car- 
 diac hypertrophy (P) ; a fresh infusion the best preparation (R) ; its action 
 increased by combination with Squill and Mercury (Br). [See formula below.] 
 Jalap, the most generally approved hydragogue purgative is the compound 
 powder of Jalap with Podophyllum (B) ; with Potassium Bitartrate, combined 
 in form of electuary, may be persevered with daily, though apt in some cases 
 to cause gastric derangement (Saundby). Stillingia, in ascites due to hepatic 
 changes (B). Elaterium, as hydragogue cathartic, gr. l /(>, with a grain of Ext. 
 Hyoscyami, and a drop of some aromatic oil, is the most efficient of its class in 
 ascites but its action is very exhausting (W) ; cautiously in debilitated subjects, 
 and is contraindicated where gastro-intestinal irritation or inflammation present 
 (B). Arsenic, when ascites is due to feeble heart, and in that of old age (B) ; 
 did excellent service after tapping in a woman aged 82, from whom the writer 
 removed 6% gallons of ascitic fluid at one tapping, when almost moribund, 
 with the result that she lived ten years longer (Potter). Diuretin, is often of 
 very marked benefit, especially in cases of cardiac and renal origin. [See 
 under Dropsy.] Aurum, has an ancient reputation ; is efficient in ascites due 
 to chronic hepatic disease (Gcetzner), or induration of the abdominal organs 
 (Schroff). Diuretics, are of little use when the accumulation is excessive, the 
 venous pressure seems to be too great for them to act (Saundby). Copaiba is 
 an excellent remedy in hepatic dropsy (Br); the resin in doses of 10 to 15 grains 
 often serviceable in cases of moderate effusion (Saundby). Milk-diet is an 
 ancient remedy for ascites, and often successful, causing profuse alvine and 
 urinary discharges (B) ; is. sometimes very serviceable when the renal action 
 is inadequate (Br). Surgical, paracentesis abdominis should be done in all 
 cases where excessive effusion ; laparotomy and washing out of the peritoneal 
 
620 
 
 ASPHYXIA AND APNEA. 
 
 cavity, in cases of tubercular peritonitis with effusion, which has recently been 
 treated successfully thereby (Saundby). [Compare Dropsy.] 
 
 R. Potassii Bitart. , . . . . ^ ss. 
 
 Mellis, §j. 
 
 Sig. — A teasp. every 2 hours until bowels 
 are freely moved. 
 
 R. Resinse Copaibse, . . . ^iij. 
 
 Alcoholis, ^v. 
 
 Spt. Chloroformi, . . . ^j. 
 Mucil. Acaciae, . . . . % ij. 
 Aquae, . . . . q. s. ad J xij. 
 M. Sig. — A tablesp. thrice daily. 
 
 R . Potassii Bitart. , . . . • ^ ss. 
 
 Pulv. Jalapae, 3J SS - 
 
 Mellis, §j. 
 
 Sig. — A teasp. every 2 hours 
 
 bowels are freely moved. 
 
 R. 
 
 V J- 
 
 ttil 
 
 Hydrarg. Chlor. Mitis, 
 
 Pulv. Digitalis, 
 
 Pulv. Scillse, . . . aa gr. 
 Fiat massa et div. in pil. vj. 
 Sig. — One pill thrice daily, in ascites 
 from hepatic changes. 
 
 Asphyxia and Apnea. 
 
 Of the New-Born. — Clean the mucus out of nostrils and throat ; catheterize 
 the trachea, and suck up the mucus. Marshall Hall's method, — by placing 
 child on abdomen, then bringing into lateral posture, repeating slowly and 
 deliberately. Schultze's method, — by placing the thumbs upon the anterior 
 surface of thorax, the indices in the axillae, and the other fingers along the 
 back, the face of the child being from you ; rotate the child, by swinging 
 upward, so that the inferior extremities turn over toward you. In a moment 
 re-rotate to the original position. Do not support head or legs in the forward 
 rotation ; their bending upon or toward the abdomen gives a forced expiration. 
 
 From Foreign Bodies in Air Passages. — If the foreign bodies are round and 
 smooth, invert the patient head downwards and strike upon the back. The 
 bristle-probang is a good instrument for the removal of fish-bones, coins, etc., 
 from the gullet ; or a pair of curved forceps will often render good service. 
 The writer removed a gold plate with three teeth attached, from the esophagus 
 of an insane woman, by passing down a curved piece of stout wire, having the 
 end bent upon itself to form a hook. After the hook was passed to one side of 
 and below the obstruction, the wire was half rotated, so as to engage the plate, 
 which came up on the second trial of the improvised instrument. Tracheot- 
 omy or Laryngotomy may be necessary, as a final resort. 
 
 From Drowning. — Remove the person from the water as rapidly and gently 
 as possible, turn the face downwards for a moment and depress the tongue, in 
 order that water, mucus, etc., may be removed from immediately over the 
 entrance of the windpipe. Give the patient plenty of fresh air, fully exposing 
 neck and chest to the breeze, unless that be inclement. Turn gently on the 
 face, one forearm being under the forehead, and raise the body up that the 
 water may have free discharge from the mouth. Place the patient upon the 
 side and apply stimulants (Ammonia, etc.) near to the nostrils ; or the cold 
 douche to the face and chest in order to excite respiration. 
 
 The above measures being ineffectual, convey the body to the nearest con- 
 venient spot, strip it carefully and dry it, and place it on a warm bed, with 
 head and shoulders slightly raised, and at once employ one of the following 
 methods : — 
 
 Silvester's Method. — Pull the tongue forward, to prevent obstruction to en- 
 trance of air into the windpipe ; produce expansion of the chest by drawing 
 the arms from the sides of the body and upwards until they almost meet over 
 the head. Then bring the arms down to the sides again, causing the elbows 
 almost to meet over the pit of the stomach, thus producing contraction of 
 the chest. This imitation of the act of respiration should be continued at the 
 rate of fifteen or sixteen times a minute, as in health. 
 
 Marshall Hall's Method. — The person should be placed flat on the face, 
 
ASTHENOPIA. 621 
 
 gentle intermittent pressure being made with the hands on the back, the body- 
 turned on the side, or a little beyond, then on the face, and the same pressure, 
 etc., continued as at first. The whole body must be worked simultaneously. 
 The same number and frequency of these artificial processes of respiration 
 should be employed as in the other method. 
 
 The Michigan Method. — Lay the body face down, the head upon the arm, 
 and stand astride it ; grasp it then about the shoulders and armpits, and raise 
 the chest as high as you can without lifting the head quite off the arm, and 
 hold it about three seconds ; then replace the body upon the ground, and press 
 the lower limbs downward and upward, with slowly-increasing force, for ten 
 seconds ; then suddenly let go, to perform the lifting process again. 
 
 Whichever process be employed, the effort to restore the temperature of the 
 body must be maintained, the body being well rubbed in an upward direction 
 with the hands, with warm flannels, etc. ; bottles of hot water, hot bricks, etc., 
 being applied to the stomach, the axillae, the soles of the feet, etc., stimulants 
 and beef tea being judiciously administered when restoration is about taking 
 place. The attempts at resuscitation must be persevered in for several hours, 
 if necessary. In artificial inflation, always press the larynx and trachea against 
 the vertebral column, so as to close the esophagus and thus prevent the air 
 entering the stomach. Laryngotomy or Tracheotomy, with or without cathe- 
 terization, or forced insufflations of air or oxygen, have proved successful, as 
 also has electro-puncture (Garratt). 
 
 After Long Submersion is Recovery Possible ? — According to Harley, dogs 
 kept under the water \]/ z minutes always died, if water had entered the lungs. 
 If it had not, the trachea being plugged, they survived a submersion of 4 min- 
 utes. When persons rise after sinking they usually get some air, and less 
 speedily come into a state from which recovery is impossible. The greatest 
 period between the last inspiration and the stoppage of the heart is 4 minutes. 
 Some think that no recovery has been made after complete cessation of the 
 heart's action. We infer that after complete submersion for 5 minutes recovery 
 is improbable, unless the person had been previously choked or in a fainting 
 state, so that no water entered the lungs. But in Anderson's case, the patient 
 had been under water at least 15 minutes, and in Garratt's the time was vari- 
 ously estimated at from 15 to 60 minutes. 
 
 When is a Case Hopeless ? — Harley says, "If the eyes are open, the pupils 
 dilated, the conjunctiva insensible, the countenance placid, the skin cold, 
 frothy mucus round the nostrils and mouth, no attempt at respiration, and the 
 heart's action inaudible (when the ear is applied to the chest), the case is 
 hopeless." 
 
 Signs of Death. — The following have been suggested as methods of decid- 
 ing whether death has occurred : Tie a string firmly about the finger ; if the 
 end of the finger becomes swollen and red, life is not extinct. Insert a bright 
 steel needle into the flesh ; if it tarnishes by oxidation in the course of half an 
 hour, life may be considered not extinct. Inject a few drops of Liquor Am- 
 monise under the skin ; during life a deep red or purple spot is formed. Moisten 
 the eye with Atropine ; during life the pupil will dilate. Look at a bright 
 light or at the sun, through the fingers held closely side by side ; during life 
 the color is pink ; after death a dead white. After death a dark spot is said 
 to form gradually on the outer side of the white of the eye, from drying of the 
 sclerotic, so that the dark choroid shows through. Putrefaction is an absolute 
 sign of death ; better delay for it than run any risk of burying alive. 
 
 Asthenopia. 
 
 The proper glasses ; cold douche ; rest of eyes. Atropine, systematically 
 instilled, to prevent strain, and control spasm of the accommodation (C) ; cau- 
 tiously in persons over 35 or 40 years old. [Compare Eye Diseases, Myopia.] 
 
622 ASTHMA. 
 
 Asthma. 
 
 Potassium Iodide, when from acute bronchial catarrh, gr. xv-xx each 2, 3, 
 or 4 hours (R) ; the best medicament to suppress the asthmatic attack, in bron- 
 chial asthma, is Potassium Iodide and Chloral (Lazarus) ; is the specific in 
 asthma, if any drug can be so called ; should be given with Lactucarium (See). 
 Chloral, is highly efficient in spasmodic asthma ; may arrest a paroxysm (R). 
 Paraldehyde, ffLxlv-3j, used in 30 cases of asthma with rapid and complete 
 relief in most and lessening of distress in the others (Hearder). Nux Vomica, 
 in nervous subjects (B) ; often of great benefit in spasmodic asthma (P) ; the 
 tincture, in drop doses every five minutes has rendered extraordinary results 
 in both cardiac and bronchial asthma, and in asthma of peripheral reflex 
 origin, as from phimosis (Macfarlan). Antipyrin, is successfully employed in 
 bronchial asthma. Aconite, in spasmodic (P) ; often averts the attack, if given 
 at commencement ; useful also in the asthma following coryza and sneezing in 
 children (R). Ipecacuanha, the wine as spray to the fauces, sometimes useful 
 in severe bronchial asthma, but not of much service in genuine asthma (R) ; 
 nauseant and emetic doses in the spasmodic form (B). Lobelia, gtt. x of the 
 tincture every % hour during paroxysm ; n^x ter die, with additional doses at 
 night, in bronchitic asthma when worse at night ; cautiously if heart disease 
 (R) ; often gives permanent relief (B). Pilocarpine Hydrochlorate, gr. £ in 
 water, at bedtime, promptly and effectively relieves, in cases of bronchitic 
 asthma with hypertrophic rhinitis ; in some of nine years' standing it appar- 
 ently gave permanent relief (Wyss). Grindelia, gives relief in spasmodic form 
 (B) ; three grains of extract thrice daily, to prevent attacks, or l^xx-xxx of 
 fluid extract every half-hour or hourly from onset of paroxysm (R). Arsenic, 
 as cigarettes, as well as by internal administration (B) ; TT\J of liquor arseni- 
 calis ter die, in attacks from bronchitis, local irritation, etc., allied to hay 
 fever (R). Belladonna, relieves paroxysm when expectoration abundant, skin 
 cool and moist (B) ; internally in large doses, also in cigarettes (Br). Atro- 
 pine, hypodermically is more efficient, gr. -£$ at bedtime to abort morning par- 
 oxysm (B) ; large doses required, but very satisfactory (R) ; very much valued 
 by Salter and See (P). Duboisine, may be used instead of Atropine. Stra- 
 monium, twenty grains of the dried leaves or ten of the powdered root may 
 be smoked ; Datura is sometimes better ; Stramonium preparations are often 
 of bad quality, asthmatics advised to grow the drug themselves (R). Cocaine, 
 hypodermically, is used with the best results, even where other remedies failed 
 to relieve (Mosler) ; the leaves of the coca-plant make the best cigarettes 
 for asthma (Nachtigal). Chloroform, inhaled from warm water; anesthetics 
 relieve, but increasing doses required, leading to habit (R). Ether, in full dose, 
 may avert a mild attack (B). Amyl Nitrite, inhaled, quickly checks spasmodic 
 asthma (R). Ethyl Iodide, very valuable in spasmodic form, and lessens lia- 
 bility to subsequent attacks ; rr\,v-xx thrice daily by inhalation (B). Cannabis 
 Indica, has been useful (R). Sulphurous Acid, by inhalation, spray, or fumi- 
 gation (R). Morphine, hypodermically, quickly cuts short a paroxysm (B) ; in 
 some cases morphine will induce a paroxysm (R). Oxy-camphor, acts like 
 morphine on the respiratory centre, and is very efficient in many forms of 
 dyspnea [see page 683]. Adrenal Extract, is very useful in bronchial asthma 
 (Solis-Cohen). Apomorphine, gr. ^hypodermically, has been found effective; 
 or gr. T ^ every 3 or 4 hours in camphor water, with or without Morphine or 
 Ipecacuanha. Hyoscine, the Hydrobromate, gr. ^^q, with Morphine Sulphate 
 gr. %-\ and Strychnine Sulphate gr. 6 X Q £ , the best combination for the par- 
 oxysm (S. Solis-Cohen). 
 
 Euphorbia Pulifera, 3ss-j of the fluid extract thrice daily, used with excel- 
 lent results in asthma and asthmatic bronchitis (Dujardin-Beaumetz). Bro- 
 mides, relieve but soon lose effect (R). Eucalyptus, smoked with Stramonium, 
 Belladonna, Tobacco (B). Quinine, after acute symptoms subside, as antipy- 
 retic to succeeding fever and restorative tonic (B). Potassium Nitrate, the in- 
 
ASTIGMATISM. 
 
 623 
 
 halation of fumes of burnt nitre paper will sometimes avert a paroxysm ; differ- 
 ent methods of preparation useful for different cases (R). Silver Nitrate, some- 
 times injected into trachea (R). Chamomile Oil, has been found very service- 
 able (P). Sanguinaria, is very useful in humid asthma, and occasionally so in 
 the spasmodic form (R). Antimony, in an affection of children like asthma, 
 dissolve a grain of Tartar Emetic in half a pint of water, and give a teaspoon- 
 ful of this every % hour for the first hour, then hourly; if vomiting induced, 
 lessen the dose (R). Coffee, a small cup of very strong coffee often useful in a 
 paroxysm (R) ; asthmatics should not use it as a beverage (P). Tobacco, 
 smoking, sometimes relieves (R). Pyridine, the fumes are highly efficient 
 (See). Asafcetida, has been recommended (R) ; palliative only (P). Colchi- 
 cum, in gouty subjects (R). Oxygen inhalations are serviceable, but should 
 not be used if heart disease is present (R). Carbonic Acid, in 5 to jo per cent, 
 solution, by inhalation, is well borne and renders good service (P). Carburetted 
 Hydrogen, the inhalation of ordinary illuminating gas for 3 minutes never 
 failed to abort a paroxysm in a lady who had sought professional assistance in 
 vain (White). Galvanism, of pneumogastric often relieves, -\- pole beneath 
 mastoid process, — pole to epigastrium. Faradism of no use (B). Prophylaxis, 
 avoidance of exciting causes, especially indigestible food, wet, damp, and sud- 
 den changes of temperature. Attention to the stomach will do most for many 
 asthmatic patients. An important point is to take the heaviest meal early in the 
 day, and very little solid food after 2 P. M. Shower-bath and out-of-door ex- 
 ercise, not however to a fatiguing extent (R). In special cases of reflex origin 
 from exposed nerve-filaments, operative treatment of the nose and naso-pharynx, 
 by galvanic cautery or otherwise is required (Lazarus). [Compare Dyspnea.] 
 
 $ . Ammonii Bromidi, . . 
 Ammonii Chloridi, . . 
 Tinct. Lobeliae, .... 
 Spt. Athens Comp., . . 
 Syrupi Acaciae, q. s. ad 
 M. Sig. — A dessertspoonful in water, 
 every hour or two, for the paroxysm. 
 
 {Pepper.) 
 
 R 
 
 M 
 
 Ext. Grindelise Fluidi, 3 ss. 
 Ext. Lobeliae FL, . . . gij. 
 Ext. Belladonna; Fl., . gj. 
 Potassii Iodidi, .... Sjiij. 
 
 Glycerini, ,^ n J- 
 
 Sig. — A dessertspoonful as required. 
 
 R. 
 
 Ft 
 
 Ext. Stramonii, 
 Potassii Iodidi, . 
 Ammonii Carbonatis, 
 Tinct. Lobelia;, 
 Aqua; Chloroformi, 
 
 q. s. ad ^viij. 
 mistura. Sig. — A tablespoonful 
 
 gr. ij. 
 
 3J SS - 
 
 3Jss. 
 
 every four to six hours. 
 
 Arsenical Cigarettes. 
 
 R . Sodii Arsenatis, .... ^ss-j. 
 Aqua; Destillatae, . . . 25 j. 
 Moisten unsized white paper, and roll 
 into cigarettes, each containing gr. % to 
 
 gr. j of the salt. Two or 
 
 three of these to 
 
 be inhaled daily. 
 
 (Bartholozu. ) 
 
 R . Belladonna; Fol. , . 
 
 • • 3'i- 
 
 Stramonii Fol., 
 
 
 Hyoscyami, . . . 
 
 aa 3 ss. 
 
 Extracti Opii, . . . 
 
 . . gr. iij. 
 
 Aquae Laurocerasi, 
 
 . q. s. 
 
 Dissolve the opium in 
 
 the water, and 
 
 moisten the leaves therew 
 
 th. When dry, 
 
 roll into twelve cigarettes. 
 
 Smoke two to 
 
 four daily. 
 
 ( Trousseau. ) 
 
 R. Spt. vEtheris Compos. , 
 Liq. Morph. Sulph., 
 
 (g r - J ad |j), . . aa %]. 
 M. Sig. — A teaspoonful every half-hour 
 or hour during the paroxysm. 
 
 Astigmatism. 
 
 Atropine, a weak solution to aid examination of the eye by dilating pupil and 
 paralyzing accommodation (B). Duboisine, as substitute for atropine, has more 
 rapid action, with shorter duration of effects and less conjunctival irritation. 
 Glasses, of suitable form, cylindrical in simple astigmatism, bi-cylindrical in 
 mixed astigmatism. Pray's Test Letters, to determine degree and direction of 
 the defect (C). [Compare Eye Diseases, Myopia.] 
 
624 ATHEROMA BERIBERI. 
 
 Atheroma. 
 
 Phosphorus, in minute doses, with cod-liver oil (B). Arsenic, often of great 
 value in atheroma, especially where imperfect action of kidneys (Br) ; indicated 
 when there are puffy eyes, drowsiness, intellectual torpor (B). Lemon-juice, 
 daily used, is said to retard atheromatous degeneration of the vessels. Aurum 
 and Arsenic Bromide is very efficient in atheroma and calcareous degeneration 
 of the arteries (Barclay). Quinine, gr. iij-x daily, in atheroma, is used with 
 advantage (B). Ammonium Bromide, to promote absorption of deposit (Wa). 
 Digitalis, may be useful in general capillary atheroma ; cautiously ! (W). 
 Cod-liver Oil, with Phosphates, Hypophosphites, or Calcium Lactophosphate, 
 in combination (B). [Compare Aneurism.] 
 
 Atrophy. 
 
 Cod-liver Oil, has proved beneficial (Wa). Olive Oil, by inunction, every 
 12, 6, or 4 hours, successfully employed (Wa). Arsenic, has had remarkable 
 success in muscular atrophy (Tr). Electricity, in progressive muscular atrophy, 
 the induced current very strong at first, then weaker as improvement ; inter- 
 rupted currents from vertebral column and plexuses to nerves of affected mus- 
 cles ; in more extended forms, the constant current to the nerves, the induced 
 to the muscles (Ros). Massage, removes the waste products and restores the 
 muscular power (Br). [Compare Emaciation, Locomotor Ataxia.] 
 
 Balanitis. 
 
 Mercury, Hydr. Chlor. Corr. gr. j to ^jss Aquae Calcis, as lotion, if not much 
 inflammation (Br). Oil, on linen, to inflamed part beneath foreskin, which 
 must be again drawn forward ; strict cleanliness. Astringent Lotions, of Alum 
 or Zinc Sulphate, with warm water injections (Br). Lime-water, the best lotion 
 if much inflammation (D). Tannin, in alcohol, equal parts, as dressing after 
 washing with a weak solution of common salt. Carbolic Acid, a 5 per cent, 
 solution, on cotton rag after washing, thrice daily, is generally sufficient. 
 [Compare Phimosis, Gonorrhea.] 
 
 Bed-sores. 
 
 Alcohol, Brandy, or Eau-de-Cologne, to harden skin of parts exposed to 
 pressure (R) ; as wash to parts threatened (B). Glycerin, or glycerin cream, 
 rubbed over the parts exposed to pressure, after washing, morning and even- 
 ing, is one of the best preventives (R). Alum, ^ss, whites of four eggs, Tinct. 
 Camphorae jfij, an excellent application (B). Charcoal, sprinkled over the 
 black slough, which then should be covered with a poultice (R). Galvanic 
 Couplet, of zinc and silver, connected by a copper wire; one element on sore, 
 the other on the adjacent part (B). Silver Nitrate, a solution (gr. xx ad gj) to be 
 painted on the threatened but unbroken skin, as soon as it becomes red, will 
 prevent sores ; if Nitrous Ether solution be used, gr. v to the % is enough (R). 
 Iodoform, dusted over sores (R). Linen, air-dried better than that which is 
 ironed or mangled, by reason of its greater softness. Aristol, is an excellent 
 application. 
 
 Beriberi. 
 
 Methylene Blue, caused rapid amelioration of all the symptoms in eleven 
 cases (Thur). Digitalis or Strophanthus, small doses seem to do good in the 
 cardiac cases (Mn). Nitroglycerin, full doses, r»Liij— v of the one per cent, solu- 
 tion every % or % hour, when signs of acute cardiac distress appear (Simon). 
 Amyl Nitrite, by inhalation in sudden cardiac attacks, pending the action of 
 nitroglycerin (Mn). Bleeding from the arm or external jugular, 8 or 10 ounces, 
 if signs of cardiac distress or failure persist and increase, in spite of the above- 
 
BILIOUSNESS. 
 
 625 
 
 mentioned drugs (Id). Oxygen inhalations, are worth trying in cardiac cases. 
 Magnesium or Sodium Sulphate, in small and repeated doses from the outset, 
 to counteract constipation and drain the tissues of fluid (Mn). Potassium 
 Bromide and Aconite, with anodyne liniments, for cramps and excessive mus- 
 cular hyperesthesia (Id). Strychnine, Arsenic and Silver Nitrate, as tonics for 
 the nervous and muscular complications. Medication should be purely symp- 
 tomatic, no drug known has any specific influence on the disease (Mn) ; the 
 symptoms are treated as in other forms of neuritis (Ty). Faradization and 
 Massage, are of great service for the muscular atrophy and cutaneous anes- 
 thesia; but should not be employed until the muscular hyperesthesia has sub- 
 sided (Mn). Diet, should be nutritious but not bulky, animal food in reasonable 
 amount, milk, eggs, wheaten flour, oatmeal, beans, are all indicated. Rice is 
 a bad food for beriberics, being too bulky (Mn) ; withdraw suspected food or 
 drinking water (Ty). Rest in bed for the worst cases, especially those showing 
 cardiac complications ; the milder cases should be up and out in the open air. 
 Removal from the infected house or district (Ty), is essential to recovery ; a 
 dry locality best, the room sunny, thoroughly ventilated and in an upper story 
 (Mn). A sea-voyage has often a marvelously restorative effect (Id). 
 
 Biliousness. 
 
 Podophyllum acts as a cathartic (B) ; corrects deficient secretion of bile, espe- 
 cially in children and infants ; gr. ^ t0 tV> every six hours, to correct white or 
 clayey stools ; also in general hepatic derangement (P). Aconite, in occasional 
 doses, improves the effect of Podophyllum (R). Mercurial Cathartics, act only 
 as purgatives ; Calomel gr. j-x, or Pil. Hydrarg. gr. v-x ; Mercury as purga- 
 tive restricted to cases where there is excess or deficiency of bile (B) ; frequent 
 small doses of gray powder for deficiency (R) ; Calomel, gr. iij, followed by 
 3ij each of Rochelle and Epsom Salts, when the tongue is heavily coated and 
 furred (Gross). Mercury, Yellow Oxide, in doses of gr. ^j- to ■£$, in trituration 
 with sugar of milk, exceedingly efficient in many disordered conditions of the 
 alimentary canal and its appendages (Schaffer). Bryonia, is worthy of com- 
 mendation in the ordinary bilious headache with vomiting, and in the general 
 hepatic derangement known as sluggish liver (P). Hydrastis, gtt. v-xv of 
 fluid extract dailv before meals, for biliousness with chronic gastric catarrh and 
 dyspepsia (B). Mineral Acids, before meals, Hydrochloric Acid and Pepsin 
 after meals, in atonic dyspepsia (B). Stillingia, when deficient biliary secre- 
 tion (B) ; may be used in place of Mercury (Br). Ammonium Iodide, gr. j-iij 
 in water each 2, 3 or 4 hours, for catarrh of duodenum and biliary ducts (B). 
 Ammonium Chloride, is much employed in Germany for hepatic derangements, 
 and with success. Euonymus, is considered a very efficient remedy by many 
 practitioners in cases of hepatic dyspepsia, or "bilious attacks," so called. Man- 
 ganese, for gouty subjects. Rhubarb, as a cholagogue. Aloes, in biliousness 
 with constipation. Angostura, is suitable in the worst forms of bilious fevers 
 (P). Calumba, is of benefit in many forms (P). Alkalies, and their laxative 
 salts, in the bilious state, with uric acid diathesis (B). Milk-cure, in obstinate 
 cases; buttermilk or skimmed milk often agrees best (B). [Compare Dys- 
 pepsia, Hepatic Congestion, Duodenal Catarrh.] 
 
 R. Ext. Stillingia Fl., . . 3 v. 
 
 Tinct. Aloes, ^ij. 
 
 Tinct. Nucis Vom., . . ^j. 
 M. Sig. — Twenty drops in water thrice 
 daily. (B.) 
 
 R. Ext. Euonymi, 
 Ext. Hyoscyami, 
 Ext. Gentianae, . . 
 Fiat massa et div. in 
 One pill every other day. 
 40 
 
 pil. 
 
 3ss. 
 gr. xv 
 
 g r 
 
 Xlj. 
 
 R . Hydrarg. Oxidi Flavi, . gr. j. 
 Sacch. Lactis, q. s. 
 
 Triturat. et div. in chart, xlviij. 
 
 Sig. - One powder dry on the tongue 
 twice daily. 
 
 Sig. 
 
 R. Massse Hydrargyri, 
 
 Ext. Colocynthidis Co., aa gr. iij. 
 
 M. et div.* in pil. ij. 
 
 Sig. — Take at once, and follow it in 
 few hours wiih a saline cathartic. 
 
626 
 
 BLADDER BLEPHARITIS BOILS. 
 
 Bladder, Irritable. 
 
 Belladonna, in nocturnal incontinence, due to relaxation of sphincter, or 
 irritable mucous membrane (B) ; gtt. v-xx of tincture every 3 or 4 hours 
 give gradual but sure relief (P). Cantharis, in women, without acute inflam- 
 mation (B); incontinence on coughing (R). Benzoic Acid, when from en- 
 larged prostate, removes fetor of urine ; also renders phosphatic or alkaline 
 urine acid (P). Ammonium Benzoate, may be used instead of Benzoic Acid 
 (Br). Gelsemium, the best remedy for irritable bladder of women of hysterical 
 type, with constant desire to urinate (B). Cubeb, is often successful in women, 
 but Cantharis generally better (B) ; is of especial value when vesical catarrh 
 present (P). Aquapuncture, strange to say, has been used with considerable 
 success (B). Cannabis Indica, in spasm of the bladder and in irritable condi- 
 tions of that organ, is generally useful. Eucalyptol, is often very efficient, but 
 frequently fails, mjj on sugar two or three times a day. Carbonic Acid, by in- 
 jection through a catheter, after washing out the bladder, may be employed in 
 almost all forms of irritability of the bladder, unless acute inflammation be 
 present (P). Antipyrin, 20 grains in solution, by rectal or vesical injection, 
 powerfully lessens irritability of the bladder (Chastelet). [Compare Cystitis, 
 Dysuria,' Enuresis, Lithiasis, Calculi, Urinary Disorders.] 
 
 R . Tinct. Gelsemii, 3 ss. 
 
 Sodii Bromidi, Z iij. Sig. — A teaspoonful in water every four 
 
 Ext. Triciti Fluidi, .... 5 iss. hours, for irritable bladder. 
 
 Bladder, Paralysis of. 
 
 Cannabis Indica, in retention from spinal disease (R). Ergot, in paralytic 
 dysuria, especially when sensation of bladder being only partially emptied 
 (P); when incontinence from paralytic sphincter, and in paralysis from over- 
 distention (Wa). Arnica, has proved curative (P). Strychnine, gr. ^ to ■£$, is 
 useful (B). Cantharis, often given with excellent effect, when bladder atonic 
 (Wa). Galvanism, may greatly benefit (B) ; electro-magnetic current from the 
 bladder to the spine, of great use (Wa). % 
 
 Blepharitis. 
 
 Pulsatilla, internally and externally (P). Mercury, after detaching crusts, 
 rub in brown citrine ointment (B) ; should be diluted with vaselin or simple 
 ointment (Br). Tannin, powdered, or tannic acid solution, gr. j-x to the ^ 
 (B). Alum, after acute symptoms subside (B) ; a solution, gr. viij to ^j aquae, 
 every % ox % hour, an excellent application (R). Hydrastis, as lotion, very 
 serviceable (P). Bismuth, equal parts of the Subnitrate and Glycerin, to the 
 inflamed surface, in ciliary and glandular blepharitis (Wa). Ergot, the fluid 
 extract locally, gives excellent results (B). 
 
 R . Aluminis, gr. x. 
 
 Aquae Rosae, ^ij. 
 
 M. Sig. — Lotion for the eyelids. (B.) 
 
 R . Unguent. Hydrarg. Nitrat. , g j. 
 
 Petrolati Molli, 3 iij. 
 
 Sig. — Ointment for margins of lids. 
 
 Boils. 
 
 Chloral Hydrate, is probably the best local application ; the boil should be 
 kept covered with a tampon of cotton soaked in a solution of Chloral Hydrate 
 gijss in Glycerin and Water, aa 3v (Spehn). Salicylic Acid, locally, to destroy 
 the staphylococcus pyogenes [see formula below] ; a 2 per cent, solution in 
 alcohol, washed over small boils, or in plaster of 50 per cent, strength, changed 
 4 or 5 times daily, to hasten the necrotic process in a well-formed boil ; a 2% 
 
BONE DISEASES BREATH. 62? 
 
 per cent, ointment in vaselin rubbed over daily after bathing the part with warm 
 water, in general furunculosis (Philipson). Calcium Chloride, in solution, ex- 
 ternally as a fomentation, will hasten maturation ; or Lime-water on compress 
 covered with oiled silk, promotes suppuration more quickly than ordinary 
 poultices (P). Sulphides, in small doses (gr. xg-to ^ of Calx Sulphurata) every 
 hour or two, or Sulphurous Mineral Waters, will abort or mature, and aid to 
 expel pus (R) ; of no use in the boils of diabetes (R). Belladonna, as plaster, 
 to subdue inflammation, or lint wetted with Atropine, gr. iv, Rose-water, ^j 
 (B); with Glycerin locally, to allay pain ; internally often successful (R, Wa). 
 Aromatic Sulphuric Acid, for the tendency, gtt. x-xv, in plenty of water thrice 
 daily. Silver Nitrate, gr. v-xx to |jj of Nitrous Ether, painted over adjacent 
 part, to abort ; specific if used early (R). Boric Acid, gr. xij daily, in 2 wafers; 
 also a 4 per cent, aqueous solution warm, externally by gentle friction, 4 or 5 
 times a day, and on compresses to the parts — will abort furuncles yet in the 
 commencement of development, rapidly cure those matured, and prevent new 
 ones (Alison). Arsenic, long-continued for succession of boils (B) ; to lessen 
 tendency to recurrence (Br). Opium, a thick extract locally (R). Alcohol, 
 pure, or containing 5 per cent, of tincture of Benzoin, applied thrice daily to 
 arrest minute boils (Philipson) ; Camphorated Alcohol, smeared over boils in 
 early stage, then when the skin is dry smear with camphorated oil, to abort 
 them (R). Sodium Phosphate, the best remedy for the systemic condition 
 which produces boils (R). Carbolic Acid, undiluted, on a thread passed through 
 center of boil while recent, will abort it ; a Carbolic Acid solution (5 per cent.) 
 on dressings after opening a boil, will prevent a second crop, due as is often 
 the case to the migration of cocci into the skin from the original boil. Counter- 
 irritation, by blisters or Iodine around the boil (R). Collodion, at papular or 
 pustular stage (R). Hydrarg. Biniodide, the ointment locally, with Calcium 
 Sulphide, gr.j daily in divided doses internally, leaves little to be desired so far 
 as treatment is concerned. Corrosive Sublimate, the B. P. solution, 1 in 875, 
 dropped into the ear twice daily, in furunculosis of the ear, also on cotton wool 
 in the canal, gives satisfactory results and prevents return ; as lotion, 1 in 1000, 
 to frequently cleanse the part, then powder with Boric Acid and Starch, and 
 cover with a clean and dry antiseptic dressing (Mn). Iodine, the tincture, lo- 
 cally to the initial papule, may often abort a threatening boil (Id). Aluminum 
 Acetate, a solution in water (1 to 4) causes the speedy abortion of boils in the 
 external auditory canal (Grosch). Poultices to assist maturation and allay 
 pain, may be smeared over with Belladonna or Opium (R) ; should never be 
 used, except in exceptional cases, as they sodden the adjacent area and are 
 prone to be followed by more boils therein (Mn). Mangos are frequently 
 blamed for boils in tropical countries. [Compare Acne, Carbuncle.] 
 
 R. Calcis Sulphurat., . . . gr. iij. [ R. Acidi Salicylici, .... £ij. 
 Sacch. Lactis, . . . . q. s. Emplast. Saponat., . . 5ij. 
 
 Triturat. et div. in chartas xxx. Emplast. Diachyl., . . gj. 
 
 Sig. — One powder every 2 hours. Sig. — Ointment for boils. (Heitzmann.) 
 
 Bone Diseases. 
 
 Iodine, in scrofulous affections of bones, should be used locally, with Fer- 
 rous Iodide or Cod-liver Oil internally, nutritious diet, wine, out-door exercise 
 (Wa). Cod-liver Oil, in scrofulous affections, maybe relied on if perseveringly 
 used and accompanied by good hygienic conditions (Wa). [Compare Caries, 
 Exostosis, Nodes, Periostitis, Rachitis, Spina Bifida, etc.] 
 
 Breath, Fetid. 
 
 Potassium Permang., gr. j to ^j aquae rosae, as a wash for the mouth (B). 
 Chlorine, as solution of chlorinated lime to remove fetor (B). Carbolic Acid, 
 a dilute solution, as wash for mouth (W). Camphor, is used as a corrective(R). 
 
628 
 
 BRIGHT S DISEASE. 
 
 Thymol, in solution, as a mouth-wash is very efficient in removing the odor of 
 tobacco from the breath. Look for bad teeth, disordered digestion, and in very 
 offensive cases for gangrenous lungs ; cleanliness of teeth is essential. 
 
 R 
 
 3 i5 J- 
 
 Calcis Chlorat., 
 Aquae destillatae, 
 
 Alcoholis, aa gij. 
 
 Olei Rosas, W^iv. 
 
 M. Sig. — A teaspoonful in a glassful of 
 water as a lotion for the mouth. (B.) 
 
 R. Acidi Salicylici, . . . 5jj. 
 
 Liq. Ammonii Acetatis, z iij. 
 
 Glycerini, ^j. 
 
 Aquae, . . . q. s. ad gvj. 
 M. Sig. — A tablespoonful every six 
 hours. {Robinson.) 
 
 Bright's Disease, Acute. 
 
 Aconite, should be given immediately on the appearance of the nephritis in 
 scarlatina (R) ; as a diuretic, advocated (P). Strontium Lactate, is highly 
 efficient and is much more useful in acute nephritis than in chronic (Da C). 
 Pilocarpus, is much used (Da C) ; large doses very depressant to the heart, but 
 n\v-x of the fluid extract every half-hour or hour will produce sweating ; may 
 be combined with tincture of Digitalis (Smith) ; or Pilocarpine Nitrate, to excite 
 skin when symptoms urgent, gr. ^ to £ for adult (B) ; the dose should be small 
 at first ; it is not a suitable drug for children (Y) ; I have latterly resumed its use, 
 often with benefit (O). Turpentine, in drop or half-drop doses every 2 to 4 
 hours, controls the dropsy in a remarkable manner (P) ; hot turpentine epithems 
 are serviceable but may increase the action of the kidneys (Wa). Belladonna, 
 has often proved useful (P) ; may be used with benefit (Wa). Hyoscyamus, 
 may be used instead of Belladonna (Wa) ; is useful in irritable kidneys (P). 
 Cantharis, after subsidence of the acute stage, one-minim dose every 3 hours 
 will stop the hematuria (R). Digitalis, (infusion ^ss) the best remedy in renal 
 dropsy from acute desquamative nephritis (B) ; is diuretic only as long as dropsy 
 lasts (R). Cannabis Indica, as diuretic ; is especially useful when bloody urine 
 (R). Eucalyptus, sometimes effective ; cautiously, or it will aggravate symp- 
 toms (B). Jalap, the compound powder is the most generally useful purgative, 
 used in the early morning to produce free watery evacuations when uremic 
 symptoms supervene (B). Gallic Acid, checks albuminuria (B). [See Albu- 
 minuria, for formula.] Juniper, as diuretic; often aggravates (P). Diuretics, 
 the stimulating ones, which act on the secreting cells of the kidneys, are con- 
 traindicated ; but this is not the case with those which simply favor the flow of 
 water through the kidneys, and of such diuretics Water is the best (Y). Alkaline 
 Salts, as Potassium Citrate, Sodium Benzoate, or Sodium Bicarbonate, may be 
 usefully added to the water (O). Diluents, as milk, and Potassium Bitartrate 
 in solution, should be used freely to relieve the congestion and remove obstruc- 
 tions from the tubules (B). Iron, after the acute symptoms have subsided, as a 
 tonic, the most suitable preparation being Basham's mixture (the now official 
 Liquor Ferri et Ammonii Acetatis) in ^ss doses thrice daily (Da C). Poultices, 
 large, of linseed meal, made light and soft as possible, beneficial (Wa). Cup- 
 ping, in lumbar region, ameliorates acute desquamative nephritis, and con- 
 gestion of the kidney (B) ; cupping or leeches over the loins, with opiates freely, 
 diluents, and demulcents, with rest and antiphlogistic regimen, often suffice 
 (Wa). A Vapor-bath or Warm Pack, to increase the action of the skin. [Com- 
 pare Albuminuria, Hematuria, Scarlet Fever, Uremia.] 
 
 R. Ext. Pilocarpi Fl., . . . ^ss. 
 
 Vini Ipecac, 3J SS « 
 
 Mucil. Acaciae, .... gj. 
 Aq. Cinnamomi, . . ad ^ij. 
 M. Sig. — A teasp. every four 
 
 until free diaphoresis. 
 
 hours 
 
 5 IV. 
 
 R. Pulv. Jalapae Comp., 
 Div. in chartulas no. iv. 
 Sisr. — One in water before breakfast. 
 
 R. Potassii Acetatis, . . . ^ijss. 
 
 Infusi Digitalis, .... 3 iij. 
 
 Infusi Juniperi, . q. s. ad £vj. 
 M. Sig. — A tablesp. every 2 to 4 hours 
 as a diuretic. 
 
 R. 
 
 Liq. Ferri et Ammonii 
 
 Acetatis (U. S. P.), . 5 viij. 
 Sig. — A tablesp. thrice daily, as soon as 
 hematuria disappears. 
 
BRIGHT'S DISEASE BRONCHIECTASIS. 629 
 
 Bright's Disease, Chronic. 
 
 Lead, diminishes the albumin (R). Gallic Acid, to lessen albuminuria (A). 
 [See under Albuminuria for formula.] Hydrastis, lessens excretion of albu- 
 min (B). Potassium Bitartrate, to prevent dangerous accumulations in cellu- 
 lar tissue or important cavities, also to draw off effete matters ; care must be 
 used, as it is a brisk purgative and is weakening (R) ; in form of cream-of-tartar 
 lemonade an agreeable diuretic (B). Jalap, the compound powder occasion- 
 ally as derivative cathartic, to relieve the kidneys (Da C). Nitroglycerin, 
 rrtrw to dilate peripheral vessels, relieves the heart and the renal congestion 
 and diminishes albumin (B). Fuchsin, in doses of gr. vij-xv daily, used with 
 considerable success in different stages of the disorder, and was well borne 
 (Riess). Oleum Erigerontis, lessens albumin, lowers vascular tension, im- 
 proves general condition, and favorably influences the headache, nausea, and 
 other uremic symptoms (B). Cod-liver Oil, is very useful (R). Cannabis In- 
 dica, as diuretic when bloody urine (R). Turpentine, sometimes given in very 
 small doses as a diuretic, and to check hematuria (R) ; half-drop or drop doses 
 every 2 to 4 hours very successful in dropsy with albuminous urine depending 
 on non-desquamative disease of the kidneys. Jaborandi, is very satisfactory 
 in uremia (B) ; large doses very depressant to the heart (Smith); n^xx of the 
 fluid extract ter in die if the urine decreases much (Da C). Iron, to improve 
 digestion and correct anemia ; the tincture of the Chloride or Tinct. Ferri Ace- 
 tatis preferred (B) ; in chronic tubular nephritis with cardiac hypertrophy the 
 Liq. Ferri et Ammonii Acetatis, ^ss ter in die, with an occasional vapor-bath 
 (Da C). Chimaphila, has power over various forms of nephritic disease, espe- 
 cially when albuminuria present (P). Eucalyptus, in chronic desquamative 
 nephritis, cautiously used, will improve (B). Elaterium, for the dropsy, as a 
 derivative cathartic ; must be cautiously used (R). Bromides, are useful in the 
 convulsions (R). [See under Uremia.] Potassium Iodide, has improved some 
 cases, which were possibly due to syphilis (R). Aurum, the Chloride in pill 
 gr. 3^ to ■£$ ter in die, persistently, in chronic interstitial nephritis, to arrest 
 hyperplasia of the connective tissue; may be combined with Arsenic, which 
 has a similar influence (B). Mercuric Chloride, acts in the same manner, 
 gr. -^ bis die (Da C). Milk-cure, has been very successful ; skim-milk alone 
 for some time, then gradual addition of other diet (B). Water, in large draughts 
 as diuretic, when excretion of solids is deficient (Br) ; hot fomentations to lum- 
 bar region (B). Baths, warm and Turkish, when uremic symptoms and 
 dropsy; discretion needful, as baths may weaken (R). Mineral Waters, espe- 
 cially the Buffalo Lithia Water, of Virginia, which has many advocates. Food 
 should be nourishing ; milk, eggs, and rare beef are particularly suitable (Da C). 
 Peanuts are an excellent article of food for subjects of kidney disease, by whom 
 foods rich in animal albumin are to be avoided (Furbringer). [Compare 
 Dropsy, Uremia.] 
 
 R- . Strychninse Sulphatis, . . gr. %. 
 Tinct. Ferri Chloridi, . . % ss. 
 
 Acidi Acetici, 3J SS - 
 
 Curacose, ,^j« 
 
 Liq. Ammonii Acetat. , ad ^vj. 
 M. Sig. — A tablesp. every 6 hours, fol- 
 lowed by a glass of water. For the anemia. 
 
 R. Tinct. Nitro-glycerini, 1 percent. 
 
 Sig. — One drop, gradually increased to 
 five, four times daily, on sugar. (B.) 
 
 R- . Auri et Sodii Chloridi, . gr. jss. 
 Aquae Destillatae, . . . . ,^iv. 
 Solve. Sig. — A teasp. ter in die. 
 
 Bronchiectasis. 
 
 Quinine, the most useful remedy as a tonic (B). Phosphates, are undoubt- 
 edly useful, so also are the Hypophosphites (B). Chlorine, in solution as a 
 stimulant and deodorizer, or as inhalation to lessen fetor (Br). Palliation of 
 the cough and expectoration, with care of the general health of the patient, is 
 all that can be accomplished. [Compare Emphysema.] 
 
630 
 
 BRONCHITIS. 
 
 Bronchitis, Acute. 
 
 Acetanilid, in dose of gr. iv every two hours, has often arrested the attack 
 within 24 hours. Aconite, gtt. ss-j every hour (B) ; in catarrh and bronchitis 
 of measles (R). Tartar Emetic, in the first stage, gr. -^ to y 1 ^, especially if 
 cough is violent (B) ; gr. j to a quart of water, a teasp. of this every hour for 
 the wheezing and cough of slight bronchitis in children (Smith) ; gr. %. to l / z 
 every 2 or 3 hours (R). Ipecacuanha, as wine, when expectoration profuse and 
 difficult to expel (R) ; in dry stage (P) ; Ipecac, when secretion is scanty and 
 dry, but use Squill when the secretion, though copious, is difficult to expel 
 (Br). Lobelia, as expectorant (B) ; for paroxysmal dyspnea (R). Camphor, 
 in oil by hypodermic injection in bronchitis from cold ; the first injection acts 
 like an expectorant, and after the fourth the expectoration ceases completely, 
 even in the most serious cases (Alexander); has but slight value in the bron- 
 chitis of the emphysematous. Sanguinaria, after subsidence of acute symp- 
 toms, as expectorant (B) ; very successful (P). Quinine, to reduce temperature 
 (R). Adrenal Extract, has given good results [see page 165]. Colchicum, useful 
 when gouty diathesis (P). Opium, Morphine and Quinine combined, or Dover's 
 powder, to abort an attack ; also with expectorants to allay cough (B) ; in fre- 
 quent and violent coughs, without obstructed oxidation ; also to check excessive 
 secretion (R) ; as sudorific, gr. x of Dover's powder very useful (P). Carbolic 
 Acid, as spray, a 5 per cent, solution with steam atomizer, prompt and efficient. 
 Apomorphine, the Hydrochlorate internally in doses ofgr. ^ every three hours, 
 the best of all expectorants. Cimicifuga, an excellent expectorant, and useful 
 when acute symptoms have subsided (B). Nitric Acid, ripe of the dilute acid 
 relieves (B). Asafcetida or Ammoniacum, the last best, in bronchitis with 
 wheezing of old people (R). Asafcetida, is an excellent stimulant of respiration, 
 especially when the capillaries have become clogged with the products of in- 
 flammation, and suffocation seems imminent ; here also the Cold Bath is a 
 means of enabling the patient to expel the mucus, the equal of which has not 
 been yet advanced ; it may be used for even very young infants, and should be 
 but momentary for them (W). Ammonium Carbonate, when the expectoration 
 is profuse, and the condition low (R). Ammonium Acetate, from its sudorific 
 action, is always indicated, especially in children (Dessau). [See formula 
 below.] Cubeb, very useful, especially when secretion copious and system 
 relaxed (P). Copaiba, after subsidence of the fever, the most serviceable ex- 
 pectorant, but nauseous (B). Counterirritants, mustard as large poultice, with 
 linseed or oatmeal, or both, very useful (R). Iron, Lead, Zinc Oxide, to check 
 profuse secretion (R). Heat to chest by linseed poultices, of great service. 
 Diet, should be light and in liquid form. Temperature of atmosphere in room 
 should be about 8o° F., and the air moistened by steam. [Compare Cough.]. 
 
 R 
 
 M. 
 hours 
 
 Antim. et Potassii Tart., gr. ij. 
 Liq. Ammonii Acetatis, t ^ iv. 
 Spt. Athens Nitrosi, . ^j. 
 Tinct. Aconiti, . . . . ^ss. 
 Syr. Simplicis, . q. s. ad J vj. 
 
 Sig. — A teaspoonful every 2 or 3 
 . In first stage. 
 
 R. Liq. Ammon. Acetatis, giv. 
 
 Spt. Athens Nitrosi, 
 
 Syr. Ipecac., .... aa^jss. 
 
 Syr. Senegae, 33. 
 
 Syr. Limonis, Jj. 
 
 M. Sig. — A teaspoonful every 3 hours 
 for children. [Dessau.) 
 
 R 
 
 . Tinct. Sanguinariae, 
 
 Tinct. Lobeliae, . . . aa^j. 
 Vini Ipecac, . . . . Jjij. 
 Syrupi Tolutani, q. s. ad ^ iv. 
 
 M. Sig. — A teaspoonful every 3 hours. 
 
 (B.) 
 
 R„ Apomorph. Hydrochlor. , gr. %. 
 
 Ac. Hydrochlor. Dil., . rr\jij. 
 
 Syrupi Senegae, . . . . 5 v. 
 
 Aquae Destillat., . . . . ^j. 
 M. Sig. — A teaspoonful every 2 hours, 
 for a child of 3 years as expectorant. 
 Should be put up in a blue bottle. 
 
BRONCHITIS. 
 
 63I 
 
 B 
 
 M 
 
 Ext. Cimicifugae Fl., . . ^ss. 
 Tinct. Opii Deodorat., . 3). 
 Syr. Tolutani, . q. s. ad ^ij. 
 Sig. — A teaspoonful every 4 hours. 
 (B.) 
 
 R. Tinct. Aconiti, TT^viij. 
 
 Aquae Cinnamomi, . . . ^j. 
 M. Sig. — A teaspoonful every y^ hour 
 
 for 2 hours, then every hour, 
 fiammatory form. 
 
 In acute in- 
 
 R. Vini Ipecac, ^ij. 
 
 Liq. Potassii Citratis, . . £iv. 
 Tinct. Opii Camphorat., 
 Syr. Acaciae, . . . . aa t ^j. 
 M. Sig. — Tablesp. terdie. In first stage 
 
 of ordinary acute bronchitis. (Da Costa.) 
 
 R 
 
 . Ext. Eriodyctii FL, . . gvj. 
 
 Ext. Senegae FL, . . . . 3 iv. 
 
 Syr. Pruni Virginianae, . 3jij. 
 
 Aquae, . . . . q. s. ad ^iv. 
 M. Sig. — Teaspoonful every 3 hours. 
 
 Bronchitis, Capillary. 
 
 Ipecacuanha, as emetic, preferred to tartar emetic in capillary bronchitis of 
 very young or very old (B) ; as wine, when expectoration profuse and difficult 
 to expel (R) ; in very young infants should be used in place of antimony 
 (M & P). Squill, as expectorant, may be used with benefit (Wa). Antimony 
 Sulphurated gr. -^ in combination with Dover's powder, every 2 or 3 hours, 
 when the temperature very high, and pulse full and strong; must be stopped 
 as soon as nausea and vomiting begin (M & P). Lobelia, for paroxysmal dysp- 
 nea (R). Ammonium Carbonate, when expectoration profuse and strength 
 diminishing ; in severe bronchitis or broncho-pneumonia of children, especially 
 when prostrate and livid (R) ; has probably a specific action on the diseased 
 tissue and its products (Clymer). Ammonium Iodide, in small, rapid doses, 
 often gives great relief to the catarrhal process (Da C) ; often gives the most 
 astonishing relief (B). Ammonium Muriate, gr. ij every 2 hours, either alone 
 or with Potassium Chlorate (Clymer). Serpentaria, in capillary bronchitis of 
 children gives excellent results (B). Turpentine, one of the best stimulants when 
 vital powers are depressed and peripheral circulation feeble (B). Camphor, to 
 allay cough and promote expectoration (B). Hydrocyanic Acid, for cough and 
 tendency to spasm. Hydrargyrum Subsulphate, is effective as emetic (B). 
 Mustard, as poultice or bath, useful (R) ; the most important part of the treat- 
 ment (M & P). Poultices, to encircle the whole chest in children (R) ; fol- 
 lowed by a jacket of cotton wool around the chest. Steam, by inhalation, 
 may be impregnated with sedatives, or with Carbolic Acid ; is of great impor- 
 tance (M & P). Quinine, in that form of capillary bronchitis occurring in trop- 
 ical climates, and where marked debility (M & P). Stimulants, are often 
 necessary, especially in the suffocative form, and where marked prostration 
 (M & P). Emetics are necessary when suffocative symptoms become prom- 
 inent. [Compare Cough.] 
 
 R. Ammonii Iodidi, .... gj-ij. 
 Ammonii Carbonat., . . £ij-iij. 
 Syr. Glycyrrhizae, 
 Syr. Tolutani, . . . . aa^ij. 
 M. Sig. — A teasp. every 2 or 3 hours. 
 
 R. Quininae Sulphatis, . . . gr. vj. 
 
 Ac. Sulphurici DiL, . . TTLxij. 
 
 Syr. Simplicis, ^ ss. 
 
 Aquae, ^ ijss. 
 
 M. Sig. — A teasp. every 2 hours to 
 child of 2 or 3 years ; older children re- 
 quire more quinine. (M. & P.) 
 
 R. Liq. Ammonii Acet.. 
 
 Syr. Ipecac, . . . 
 
 Morphinae Sulph., . 
 
 Syr. Acaciae, . . . 
 
 Aquae, 
 
 M. Sig. — A teasp. every 2 hours for a 
 child 2 years old. When surface pale and 
 expression languid, skin cool. (M. & P. ) 
 
 gss. 
 
 g r - tV 
 fj- 
 
 ;jss. 
 
 R. Ext. Serpentariae FL, . . 3SS. 
 Ammonii Carbonat., . . .^ij. 
 
 Syr. Tolutani, oJ ss - 
 
 A teasp. every 2, 3, or 4 hours. 
 
632 BRONCHITIS. 
 
 Bronchitis, Chronic. 
 
 Antimony, when expectoration copious and difficult to expel (R). Arsenic, 
 in cigarettes, when emphysema (B). [See Asthma, for formula.] Sulphur, 
 gr. v-x, in severe cases, with abundant discharge, especially where constitu- 
 tional debility (R). Sulphurous Acid Gas, inhalations, or the acid in form of 
 spray, sometimes beneficial (R). Hydrogen Dioxide, the solution internally, 
 doses of 3j-iij, diluted with 3 to 4 of water, gives great relief in chronic bron- 
 chitis with dyspnea. Lobelia, for paroxysmal dyspnea (R). Ammonium 
 Chloride, combined with stimulating expectorants, such as Serpentaria, Sangui- 
 naria or Eucalyptus (B) ; when secretion is thick and abundant the salt may be 
 applied by an atomizer (R). Carbolic Acid, as inhalation of spray, 1 part to 100 
 of water ; may be combined with tincture of Iodine (R) ; a 5 per cent, solution 
 in steam atomizer as inhalation. Hydrastis, fluid extract, locally and internally 
 (B) ; of great value internally and externally in chronic coryza (P). Senega, 
 especially in the aged (R). Iodine, by inhalation, sometimes used (R) ; the 
 Iodides, especially Ammonium Iodide, are very serviceable in combination 
 with expectorants (B). Colchicum, in gouty subjects (R). Balsam of Peru and 
 of Tolu, when copious secretion of pus (R). Ammonia, as inhalation, to lessen 
 expectoration (R). Oleum Anthemidis, in pulmonary catarrh with excessive 
 secretion and difficult expectoration, a very useful remedy, Tt\jj-iv (P). Am- 
 moniacum, the mistura, with Ammonium Chloride or Carbonate, efficient in 
 the bronchitis of old people, with wheezing and abundant secretion (R). 
 Benzoin, Z) of the compound tincture on boiling water, as inhalation ; eases 
 cough and lessens expectoration (R) ; is sometimes used by atomization (B). 
 Phosphates, for the resulting cachexia (B) ; the Calcium Phosphate (R). Ser- 
 pentaria, as stimulant. Alum, powdered, dusted over surface (B). Silver 
 Nitrate, locally in solution, gr. v-xx to the ^, on sponge probang (B). Cam- 
 phor, to allay cough and promote expectoration (B). Sumbul has decided 
 efficacy (P). Opium, with expectorants, to allay cough (B) ; when cough 
 frequent and violent without any signs of obstructed oxidation, also to check 
 excessive secretion (R). Codeine, gr. Ye every 3 to 6 hours, when other opiates 
 are not well borne (P). Morphine, gr. £ with 5 grains of Dover's powder at 
 bed-time, followed by whiskey on the next morning, used in more than 200 
 cases of bronchitis with excellent results (English). Euphorbia Pulifera, is very 
 successful in asthmatic, chronic and advanced or subacute bronchitis (Dujar- 
 din-Beaumetz) ; 3ss-j of the fluid extract thrice daily. Ethyl Iodide, by in- 
 halation, is very valuable by reason of its local influence, n\,v-xx thrice daily 
 (B). Grindelia, an excellent expectorant, especially when cough is troublesome 
 (B). Strychnine, as a respiratory stimulant and to check the reflex vomiting 
 (B) ; the Syrup of the Phosphates of Iron, Quinine, and Strychnine. Squill, 
 in chronic forms with tenacious sputa, but not when fever or acute inflamma- 
 tion (R). Adrenal Extract, has given good results [see page 165]. Tar, dimin- 
 ishes the secretion and allays the cough (P) ; gr. ij in pill every 3 or 4 hours in 
 chronic paroxysmal winter cough (R). Digitalis, when interstitial pneumonia 
 and general anasarca (B). Eucalyptus, valuable in chronic cases of broncho- 
 pulmonary catarrh (B). Apomorphine, by the mouth, as an expectorant, alone 
 or along with morphine (Br). Chekan, a fluid extract of the leaves is said to 
 be highly efficient (M). Carbonic Acid, diluted, may be inhaled with benefit 
 (P). Formalin, in dilute solution administered as spray. Nuclein, has been 
 administered with benefit, as a general tonic. Gallic Acid, is useful in some 
 forms of chronic broncho-pulmonary catarrh (B). Iron, with free expectoration, 
 Mistura Ferri Composita ; or better, the Phosphate of Iron, Quinine, and 
 Strychnine (B) ; to check profuse bronchial secretion (R). Myrtol, in fetid 
 bronchitis, of great value (Gubler). Copaiba, when purulent secretion (R) ; 
 for profuse secretion the best of all expectorants, but nauseous (B). Cubeb, 
 when profuse expectoration, has similar remedial influence (B). [See Bron- 
 chorrhea, for formula.] Terpin Hydrate, gave immediate and curative re- 
 
BRONCHORRHEA. 
 
 633 
 
 suits in cases of long-standing and obstinate bronchitis, which had resisted 
 all other treatment; gr. xlviij.in Glycerin, q. s. ut. ft. solutio, Syr. Lactucarii, 
 q. s. ad %\], of which a teasp. every three hours (Boyland). Terebene, is 
 proving very valuable ; requires an equal weight of light magnesium carbonate 
 to suspend it. Koomiss-cure, possesses great value (B). Cod-liver Oil, a tea- 
 spoonful ter die, after meals, of great service, if continued (B) ; to control 
 expectoration (R). Poultices, made large, of hot linseed meal to cover the 
 chest, when congestion of lungs. Olive Oil, inunctions to chest, has soothing 
 and strengthening effects. Diet, nutritious, and stimulants necessary when 
 great prostration ; Koomiss is an excellent article of diet. [Compare Cough, 
 Emphysema.] 
 
 R. Ext. Eucalypti Fl., . . gj. 
 Ammonii Chloridi, . . gj. 
 Ext. Glycyrrhizae, . . gij. 
 Syrupi Tolutani, . . . ^iij. 
 M. Sig. — A teasp. 4 to 6 times daily. 
 
 ; . Tinct. Sanguinariae, 
 Ammonii Chloridi, 
 Syrupi Tolutani, . 
 Spt. ^Etheris Nitrosi 
 Aquae, 
 
 M. Sig. — Tablesp. p. r. n. 
 
 Zh 
 ZY 
 Z l h 
 
 ^ss. 
 
 511JSS. 
 
 R 
 
 M 
 
 Syrupi Scillae, ^ss. 
 
 Tinct. Opii Camph., . . £ij. 
 
 Ammoniaci, 3 ss. 
 
 Syrupi Tolutani, . . . . ^x. 
 Sig. — A teasp. p. r. n. 
 
 Ammonii Chloridi, . . . !?iij. 
 
 Syrupi Picis Liquidae, . . ^yj. 
 
 M. Sig. — A tablesp. 4 times daily. 
 
 R 
 
 Ammonii Carbonat., . . 
 
 Infusi Serpentariae, . . . 
 
 M. Sig. — A tablesp. every 3 
 
 gr. xl. 
 
 hours. 
 
 Bronchorrhea. 
 
 Ammonium Iodide, often improves the condition, especially if used with 
 Arsenic (B). Eucalyptus, the oil of great utility (B) ; rr\,ij ter die on sugar, or 
 see formula above. Sulphurous Acid Gas, as inhalations, or in solution as 
 spray, sometimes improves (B). Lead Acetate, as astringent to restrain secre- 
 tion (B) ; gr. j-ij every 2 hours. Petroleum, crude, in capsules, has been ad- 
 ministered with rapid amelioration as the result (Blache). Grindelia, an 
 efficient remedy (B). Iodine, as liniment, over front and back of chest (R). 
 Spinal Ice-bag, to restrain excessive secretion (R). Quinine, and the Phos- 
 phates, also Cod-liver Oil, as restoratives (Wa). Copaiba, the most serviceable 
 expectorant, but nauseous (B) ; when copious secretion of pus (R). Cubeb, 
 has remedial effect in chronic bronchial affections with profuse expectoration 
 (B). Asafcetida, is of great benefit (B). Turpentine, an excellent remedy when 
 fetid expectoration ; may be used internally or by inhalation from atomizer. 
 Terpin Hydrate, seems to be even more efficient than turpentine, in doses of 
 gr. x-xx daily. Carbolic Acid, internally (n^i), and by spray (gr.v ad ^j aquse), 
 often of great utility (Da C). Benzoin, by inhalation, for its local influence. 
 Myrtol, is largely eliminated by the lungs, and is a most valuable agent in 
 bronchorrhea and fetid bronchitis, acting as a stimulant and antiseptic (Gubler) ; 
 dose, rr\jj in capsules (Br). [Compare Cough.] 
 
 R . Copaibae, 
 
 Syrupi Tolutani, . . . aa ^ ss. 
 Spt. ^Etheris Nitrosi, . . 5j. 
 Aquas Menth. Pip., . . 51J. 
 M. Sig. — A teasp. every 4 hours. 
 
 ». 
 
 M. 
 
 Copaibae, 
 Bals. Tolutan., 
 
 Pulv. Acaciae, . . . . aa^ss. 
 Ac. Sulph. Aromat., . . 7, ss. 
 Aquae Destillat., . . . . ^vj. 
 Sig. — Tablesp. bis vel ter in die. 
 
 R. Ammonii Chloridi,. . . gj. 
 Emulsi Asafoetidae, . . ^ iv. 
 Misce. Sig. — Tablesp. as required. 
 
 R. 
 
 Potassii Iodidi, 
 Ac. Nitrici Dil., . 
 
 
 Zh 
 
 Z n h 
 
 3>J- 
 
 Z)- 
 
 ater 3 
 
 
 
 Tinct. Belladonnae, 
 Ac. Salirvlici. . . 
 
 
 
 Aquae Camphorae, q.s. ad 
 
 M. Sig. — Dessertsp. in w 
 
 times daily, for fetid bronchitis 
 
 or 4 
 
634 BRUISES BURNS AND SCALDS. 
 
 Bruises. 
 
 Arnica, the infusion very useful as an external application for bruises and 
 cuts ; also an excellent internal remedy for internal bruises, shake, falls, blows, 
 or shock ; TT\,v-x every 2 or 3 hours (P) ; in bruises, sprains, etc. (Wa). Aconite, 
 the liniment locally to painful sprains and bruises (Wa). Capsicum, a strong 
 tincture applied with gum, said to act like a charm on discolored bruises (R). 
 Sulphurous Acid, a solution constantly applied (R). Oil of Bay, as stimulating 
 liniment (P). Opium, the tincture gj with Linimentum Saponis ^j diligently 
 rubbed in two or three times a day, affords great relief (Wa). 
 
 Bubo. 
 
 Mercury, necessary in the indurated buboes diagnostic of syphilis (Ricord) ; 
 Calomel locally applied for indolent buboes refusing to heal after opening (H). 
 Nitric Acid, indolent and broken bubo (R). Sulphides, are less useful in ma- 
 turating buboes than in the case of ordinary boils or abscesses (R) ; to check 
 suppuration (St). Iodoform, locally, has proved useful (Wa). Iodine, applied 
 to produce vesication around a bubo, relieves inflammation (R) ; freely every 
 day, with rest and compression, to cause absorption (St). Silver Nitrate, lightly 
 to surface, to stimulate indolent buboes (Wa). Potassio-tartrate of Iron, 30 
 parts to 250 aquae destil., three tablesp. daily, also as lotion to sore (Ricord) ; 
 in phagedena (St). Tartar Emetic, gr. j every two hours, reduces inflamma- 
 tion in many cases (Wa). Ice, greatly relieves (B). Surgical, open freely with 
 a bistoury when suppurating; if the pus is virulent the open bubo is a chan- 
 croid and must be treated as such (Keyes). Pressure, by compressed sponge 
 under a spica bandage or a shot bag, the best local treatment for indolent bubo 
 (Keyes) ; in all cases cleanliness, rest in recumbent posture, emollient poul- 
 tices. Diet, should be generous with cod-liver oil in phagedenic bubo. Treat- 
 ment of syphilitic bubo is that of general syphilis, local measures are useless 
 and no treatment is called for until the general eruption appears (Keyes). 
 [Compare Chancroid, Syphilis.] 
 
 Bunion. 
 
 Iodine, as paint, or Emplastrum Hydrargyri, for indolent form, thick but not 
 tender (D). Rest, fomentations and anti-arthritic remedies for thickened 
 bunion ; burst it by pressure if recent and sac thin (D). [Compare Bursitis.] 
 
 Burns and Scalds. 
 
 Carbolic Acid, 1 part to 30 of Linim. Calcis, or 1 part to 6 of Olive Oil ; the 
 latter speedily relieves pain, and promotes healing without suppuration (Wa) ; 
 1 part to 10 of Olive Oil, applied on layers of cotton batting, the best applica- 
 tion for burns of all degrees. Boracic Acid, a saturated watery solution, used 
 with great success (Lister). Lead Carbonate, as white lead paint, an excellent 
 application to burns of small extent (B). Salicylic Acid, Z) to ^viij 01. Olivse, 
 is an efficient local application (B). Collodion, flexible, to burns of first degree 
 (R). Phytolacca, relieves pain (B). Lime, as Lime-water and Oil, equal parts 
 (R) ; or Lime-water with Linseed Oil, the celebrated Carron Oil, or better still 
 with Olive Oil, a favorite and efficient application (P). Picric Acid, a saturated 
 solution, Picric Acid 5, dissolved in Alcohol 80, then add Distilled Water 1000, 
 applied on strips of sterilized gauze, gives better results than any other treat- 
 ment (Power). Normal Salt Solution, applied on cotton, gives great satisfaction 
 (Keen). Aristol j, Olive Oil, sterilized ij, Vaselin viij, as ointment for extensive 
 burns (Walton). Acetanilid, powdered and dusted over the surface, is an ex- 
 cellent application. Rhus Toxicodendron, the tincture externally, 3j to the pint 
 of water, in superficial but extensive burns (P). Cantharis, the tincture diluted 
 
BURSITIS CACHEXIA. 
 
 635 
 
 with 40 of water and applied on rags, is a most excellent application. Sodium 
 Carbonate in solution as lotion, immediately relieves pain and promotes rapid 
 healing. Turpentine, in dangerous cases, where great constitutional depression 
 (P) ; as wash to severe burns, then locally Basilicon Ointment mixed with Tur- 
 pentine (B). Cotton-wool, to allay pain and exclude air (P). Warm Bath, 
 immerse for some days (R) ; exclusion of air the main indication (H). Pinus 
 Canadensis, the concentrated extract, painted on freely, relieves the pain 
 effectually. 
 
 Lime and Linseed. 
 
 R. Olei Lini, .^ y ij- 
 
 Aquae Calcis, ^ viij. 
 
 M. Sig. — Apply on sheet lint, 
 cover with oiled silk. 
 
 and 
 
 R. Sodii Carbonatis, . . . . ^yj. 
 
 Aquae, Oiij. 
 
 M. Sig. — Apply freely for 3 days 
 old cloths or lint. 
 
 R . Iodoformi, ^j. 
 
 Cetacei, £}. 
 
 Ext. Conii Alcohol., . . gr. xl. 
 
 Acidi Carbolici, .... gtt. x. 
 M. Sig. — Spread on lint and cover the 
 parts therewith. 
 
 R. Pulv. Carbonis Ligni, . . 3; viij. 
 
 Sig. — To be dusted thickly over the 
 burned parts. 
 
 Bursitis. 
 
 Iodine, painted on outside, after removal of fluid from aspirator (D) ; after 
 blistering (Wa). Blisters, in rheumatic enlargement of bursae, are almost 
 indispensable for a rapid cure (Wa). Fomentations, with rest, to relieve pain 
 and swelling ; if unavailing, a crucial incision into the bursa, care being taken 
 not to open the capsule of the knee (D). Excision, when chronic, tumor hard, 
 resisting other measures (C). 
 
 Cachexiae. 
 
 Calcium Phosphate, in scrofulous affections and anemia (Wa) ; in phthisis 
 and affections marked by mal-nutrition (B). Iron, in splenic, syphilitic and 
 strumous, and especially in all apemic states ; also in the malarial and phthis- 
 ical ; chalybeate waters (B) ; the Ammonio-citrate is the best tonic in the 
 cachexia of gastric ulcers, especially in chlorotic females (Wa). Arsenic, a 
 prompt remedy in the malarial cachexia ; also of real value in the cancerous 
 (Wa). Hydrastine, in paludal and splenic cachexiae, stands in high esteem 
 (B). Nitric Acid, is adapted to the cachexia following acute diseases or intem- 
 perance ; also as alterative after a long course of Mercury (Wa). Potassium 
 Iodide, in constitutional syphilis and resulting affections of bones and skin 
 (Wa). Mercury, in the syphilitic, but its utility much questioned (Wa). Aurum, 
 in cancerous, mercurial, and syphilitic cachexiae, especially when bones, 
 glands, and oculo-nasal mucous membrane affected. Phosphates, in bone 
 diseases, wasting, bronchitic, leucorrheic cachexiae, etc. (B). Arnica, in very 
 developed cachexiae, has excitant action on the nervous system (Wa). Euca- 
 lyptus, a serviceable tonic and stimulant in cachectic states generally (B). 
 Manganese, the Syrup of Ferrous and Manganese Iodide, in anemic, syphilitic, 
 strumous, malarial, cancerous cachexias, etc. (B). Grape-cure, often modifies 
 most happily many conditions (P). Air, in good condition, an important 
 element (B). Water, the Turkish bath and wet pack as aids to remedial 
 action, in plumbic, mercurial and paludal cachexiae (B). Oils and Fats, to 
 promote constructive metamorphosis in many cachexias, especially cod-liver 
 oil (B) ; the latter a most valuable remedy in scrofula, phthisis, atrophy, 
 tubercular and jail cachexias, anemia, etc. (Wa). Massage, has been produc- 
 tive of remarkable results in many forms of cachexia (B). Aliment, of prime 
 importance (B). [Compare the titles Anemia, Scrofula, Syphilis, etc., and 
 the Formulae for Tonics under Adynamia and Anemia.] 
 
6$6 CALCULI. 
 
 Calculi, Biliary. 
 
 Chloroform, in 20- to 60-drop doses every 3 or 4 hours, is by some supposed 
 to act as a solvent of gall-stones ; it cannot so act but undoubtedly affords some 
 relief (B) ; as an inhalation it may be used to relieve the pain of the paroxysm 
 (Br). Ether and Turpentine, equal parts of each, 5j once daily for a year, is 
 Durande's solvent remedy ; is not solvent, and as an anodyne is inferior to 
 morphine or chloral (B). Morphine, gr. % with Atropine, gr. t ^q, hypodermic- 
 ally, the best anodyne for the pain and vomiting during the paroxysm (Br). 
 Chloral sometimes relieves the pain (R). Counter-irritants, as mustard poul- 
 tices to relieve the pain during the paroxysm (Br). Olive Oil, 3 i j at night, 
 followed next morning by 3 or 4 seidlitz powders an hour apart, efficient in 
 facilitating the expulsion of accumulated gall-stones ; this treatment is based on 
 rational principles, as gall-stones placed in Olive Oil undergo solution, losing 
 nearly 70 per cent, of their weight in 10 days (Brockbank) ; ^iv-viij per diem 
 between the attacks the best prophylactic (Id). Sapo Animalis, of the Br. Ph., 
 is still more efficient for their solution and breaking up (Id). Nitro-muriatic 
 Acid, as bath, found useful in India to relieve the pain and promote expulsion 
 of the calculus, ^iij of the acid to a gallon of water (Scott). Glycerin, is a good 
 remedy for biliary lithiasis (Ferrand). Sodium Phosphate, in 3 -dose before 
 each meal for several months, to prevent recurrence (B); should be given in 
 plenty of water (B). Sodium Salicylate, increases the secretion of bile and 
 renders it more watery ; it is therefore indicated in cases where there is a 
 tendency to the formation of gall-stones (Br). Succinate of the Peroxide of 
 Iron, hydrated, contains a large proportion of nascent oxygen, and is given in 
 teaspoonful doses after meals for several months, and resumed at intervals 
 afterwards to prevent reformation of the calculi (Buckler). Diet, is important ; 
 withhold all starches, sugars, and fats, also malt liquors and spirits ; moderate 
 exercise out of doors, lean meats, eggs, fish, fruits and succulent vegetables 
 to be used freely. Mineral Waters, the alkaline are useful, especially Vichy, 
 which is deemed of great benefit. [Compare Colic, Jaundice.] 
 
 R. Spt. .-EtherisComp., . . gij. 
 Liq. Magendie, .... TT^xxx. 
 
 R . Ferri Peroxidi Succinat. 
 
 Hydrat. , % iss. 
 
 Aquae, 3 vjss. 
 
 M. Sig. — Teasp. after each meal for 
 
 several months. 
 
 Syr. Zingiberis, q. s. ad %]. 
 M. Sig. — Teasp. doses, an hour apart, 
 until pain is relieved. 
 
 Calculi, Renal and Vesical. 
 
 Alkalies, especially Potassium salts, if long continued, will effect solution of 
 uric acid calculi (R) ; Sodium salts should not be used (B). Calcium Carbon- 
 ate, an old and efficient remedy, also Lime-water has been used with benefit, 
 and may be injected into the bladder (P). Potassium Citrate, in large doses 
 for bloody urine containing uric acid crystals (R) ; the Citrate and Carbonate 
 are the most desirable solvents for uric acid gravel (Sir H. Thompson). Potas- 
 sium Tartra-borate, if long used, is very efficient as a solvent for uric acid cal- 
 culi (B). Potassium Salts, are much more efficient than those of Lithium as 
 solvents for uric acid (Rogers). Alkaline Mineral Waters, those rich in Potas- 
 sium preferred, especially Vichy (B). Ammonium Benzoate, long continued, 
 will dissolve phosphatic calculi (B). Ammonium Biborate, will prevent attacks 
 of colic where uric acid calculi, in 20-grain doses every two hours until free 
 urination, then gr. xv thrice daily in a glass of flaxseed tea. Magnesium Boro- 
 citrate is a good solvent of uric acid calculi (Madsen). Lithium Citrate, to 
 promote oxidation (Da C). Piperazin, as a solvent for uric acid and urate con- 
 cretions, is far superior to other agents. Olive Oil, internally, is of excellent 
 service in renal as well as in hepatic calculi, controlling the crises of the disor- 
 der with undoubted effect (Aussilloux). Hydrangea, in decoction, used by the 
 Cherokees in all calculous affections with uniform success (Butler). Lead 
 
CANCER. 
 
 637 
 
 Acetate, gr. ^ to the J of distilled water, injected into the bladder to prevent 
 formation of phosphatic calculi, or a solution of Dilute HC1 Acid, rr^ij-iij to 
 the ^ (Sir H. Thompson). Nitric Acid, very dilute, as injection for phosphatic 
 calculi (R) ; gtt. j to the ^, as injection into the bladder in chronic cystitis and 
 phosphatic deposits (B). Cotton-root, in decoction, as a demulcent for strang- 
 ury and gravel (P). Castor Oil, of value as a purgative (P). Calumba, to 
 relieve the vomiting (P). Counter-irritants, as mustard-poultices, or turpentine 
 stupes, to relieve the pain of the paroxysm (R). Anesthetics, for the same 
 purpose (B). Antipyrin gr. xxiv, Laudanum gtt. x, Water ^iij, injected into 
 the rectum ^ hour before beginning lithotrity, rendered the crushing and 
 evacuation of the stone absolutely painless, the bladder seeming non-sensitive 
 to touch or tension (Chastelet). Morphine, hypodermically, as an anodyne and 
 to relieve the vomiting (B). Hot Fomentations, to alleviate spasm and pain 
 while calculus is passing. Diet. Restrict the use of sugar in any form or com- 
 bination, also fats and alcoholic beverages. Fresh, green vegetables may be 
 used freely, also skimmed milk or buttermilk. Mineral waters, preferably 
 Vichy, Friedrichshall and Carlsbad. Frequent abstinence from animal food. 
 Lemon-juice and soft water in large draughts, are useful. Surgical Measures. 
 Lithotomy or Lithotrity for removal of a stone from the bladder. Solvents are 
 of no use except for a very small calculus, and even then a considerable time 
 must be occupied in the process. No operation in surgery more certainly safe, 
 rapid, and successful than lithotrity (Sir H. Thompson). [Compare Colic, 
 
 LlTHIASIS, OXALURIA, etc.] 
 
 Magnesium Boro-citrate. 
 
 U . Magnesii Carbonat., . 3J. 
 
 Sodii Biborat., 
 
 Acidi Citrici, . . . aa 3 ij. 
 
 Aquas Bullientis, . 3 viij. 
 
 M. Sig. — Tablespoonful 3 or 4 times 
 daily. (B.j 
 
 Potassium Tartra-borate. 
 
 R 
 
 Potassii Bitartratis, . . . partes iv. 
 
 Ac. Borici, partem j. 
 
 Aquae, partes x. 
 
 By heating the above together, the salt is 
 obtained as a powder, of which gr. xx in a 
 large draught of water 3 or 4 times daily. 
 
 Cancer. 
 
 Opium, stands first on the list of palliatives, allaying pain and quieting irri- 
 tation (Wa) ; as powder applied to cancerous sores ; also Morphine, dissolved 
 in glycerin, and spread on lint, very useful where there is much pain ; Opium 
 is also used in cancer of the stomach (R). Codeine, gr. -^ to ^, a good hyp- 
 notic (P). Arsenic, in cancer of the stomach, diminishes pain and checks 
 vomiting; also in scirrhus of stomach and epithelioma. Arsenous Acid, pure 
 or with starch, as a caustic ; enough should be used to set up active inflam- 
 mation (R) ; may cause arsenical poisoning by absorption. Belladonna, 
 locally and internally, tt^v-x, of great benefit as palliative in severe pains of 
 cancer (P). Conium, as poultice, and internally to relieve pain (R) ; is par- 
 ticularly applicable to pain of cancer (P) ; as palliative (Wa). Hydrastis, has 
 a renewed interest (Pf). Carbolic Acid, undiluted, to sore, and injected be- 
 neath it, limits and retards (B); pure, as anesthetic, before applying caustics ; 
 with glycerin as application to fetid cancers (R). Mercuric Chloride, in small 
 doses, long continued, will retard the growth of gastric cancer (Da C). Citric 
 Acid, 3j to ^ viij aquas, useful in allaying pain of cancerous ulcerations (Wa). 
 Acetic Acid, 1 to 3 aquae, rr^xxx injected into the tumor, has been used with 
 varying success (Wa). Chloral, in 10-grain doses, 3 times a day, has relieved 
 the most severe pain of cancer (R). Chloroform, as vapor to raw surface (R). 
 Pyoctanin (Methyl Violet) in solution, by injection into the neoplasm, to bring 
 about the shrivelling up and final disappearance of carcinoma (Mosetig). Hy- 
 oscyamus, bruised leaves, locally (P). Bismuth, relieves pain and vomiting 
 of gastric cancer (B). Aurum, the Arsenate was extensively employed internally 
 by Massart with benefit (see page 209). Iodoform, applied to diseased surface, 
 relieves pain and removes fetid odor (P). Resorcin, 15 parts to 20 of Vaselin 
 
638 CANCRUM ORIS — CARBUNCLE. 
 
 as an ointment twice daily after washing with a solution of Pot. Permanganate, 
 has successfully stopped epithelioma (Antonio). Potassium Chlorate, in im- 
 palpable powder, dusted on epithelioma, said to be curative (B). Pepsin, in- 
 jections into tumor (B). Salicylic Acid, pure, applied in powder (B). Zinc 
 Chloride, the most efficient and safe escharotic ; parts j-ij to v of flour, as 
 " caustic arrows " inserted at base of tumor (B). Potassa Fusa, as escharotic 
 (B). Zinc Sulphate, dusted over, dry, an excellent caustic ; remove the eschar 
 by poultice (B). Bromine, for destruction of uterine cancer, is preferred by 
 some (B). Chromic Acid, a powerful escharotic (B). Calcium Carbonate, as 
 calcined oyster-shell, very efficient in arresting growth of cancerous tumors, 
 and in alleviating the pain thereof (Hood). Rumex Acetosa, an excellent 
 local application ; has a popular reputation. Iron and Manganese, the Syrup 
 of the Iodide, for resulting cachectic state (B). Toxins, the erysipelas and 
 prodigiosus toxins have proved more efficient in sarcoma than in carcinoma 
 (Coley). Ozone, locally applied as an antiseptic and anodyne agent in cancer 
 of the tongue and throat, is highly efficient; was used on Sir John Millais with 
 great benefit during the last three months of his life and kept him comfortable 
 without narcotics. Poultices, of starch, applied cold (R) ; or poultices of bread, 
 sprinkled with charcoal or freshly ground coffee, as deodorizers to open can- 
 cers. Water Enemata, to relieve pain and straining in intestinal cancer (R). 
 Electrolysis, has been of great service in many cases, relieving the pain and 
 diminishing the tumor. In a case of sarcoma of the thigh, in which amputa- 
 tion was the only possible resource, after one application of the needles by Mr. 
 Annandale, the pain was relieved and the tumor diminished (Duncan). It 
 seems proved that there is a less frequent return of cancerous growths removed 
 by electrolysis than by the ordinary procedures ; the evidence in its favor has 
 recently accumulated (Tibbits). In any case in which operative interference 
 is necessary, electrolysis is the preferable method, and in others is advisable 
 (Butler). In 18 cases of epithelioma treated by electrolysis, 13 were cured, 2 
 improved, in 2 there were no results, and 1 ended fatally (Groh). [Compare 
 Uterine Cancer.] 
 
 Cancrum Oris. 
 
 Arsenic, in medicinal doses (R). Nitric Acid, to surface (R); strong Nitric 
 Acid the best caustic for worst forms of the disease (Wa). Potassium Chlorate, 
 gr. xx-xl in 24 hours, has been strongly recommended (D). Quinine, made 
 into a syrup, or as enema, to support the strength (Wa). [Compare Aphthae, 
 Stomatitis.] 
 
 Carbuncle. 
 
 Boric Acid, administered internally and externally as for Boils (which see) ; 
 equally efficacious in carbuncle, diminishing pain, redness and hardness ; nu- 
 merous apertures rapidly form for the elimination of the core ; the fever falls, 
 excitation and insomnia abate, and the carbuncle heals, in the majority of 
 cases without surgical interference (Alison). Mercury, Corrosive Sublimate, 
 injected into tumor at several points, in doses of 2 drachms of a ^ per cent, 
 solution dividedly, has produced good results; these injections were often 
 repeated, in broken doses likewise, on the following days (Casson). Bella- 
 donna, with Glycerin, as local application to relieve pain (P). Ammonium 
 Acetate, to support the system (Cezard). Carbolic Acid, on lint, with Glycerin 
 or Oil, into discharging sinuses (R) ; or hypodermically into the sloughing 
 tissues. Iodine, to produce vesication around carbuncle ; reduces inflammation 
 (R) ; part j of the tincture to iij aquae locally, has most striking effect (Wa) ; 
 may be used with benefit internally or hypodermically (Cezard). Calcium Sul- 
 phide, gr. ■£$ hourly or every two hours, of great service (R). Opium, a thick 
 extract, locally (R). Potassium Chlorate, highly recommended, also Quinine 
 and Iron freely, to support the system and counteract the carbuncular poison. 
 
CARIES CATALEPSY. 
 
 639 
 
 Poultices, the inflamed surface having been previously smeared with Belladonna 
 and Glycerin (R) ; long-continued poulticing is thought to create a tendency 
 to a fresh crop. Strapping, with plaster, concentrically from border inwards, 
 leaving the centre free, will sometimes arrest extension (R). Collodion, as 
 protective covering (P) ; as zone around base, leaving the centre exposed (Wa) ; 
 Collodium cum Cantharide in a broad zone painted around the carbuncle, to 
 relieve the tension (Ag). Ice, or Ice-bags or iced water on cloths in early 
 stage, changing to warm fomentations as soon as suppuration has begun (He- 
 bra). Galbanum and Opium, as plaster to relieve pain, the separation of the 
 core then proceeding painlessly (Hill). Crucial Incisions are not so frequently 
 made now as formerly ; they relieve tension but often give rise to severe hem- 
 orrhage. Diet should be very supporting, and stimulants may be used freely 
 when the patient is debilitated ; Saline purges occasionally (Hill). Cauteriza- 
 tion, with fuming Nitric or Carbolic Acid, on top of a free crucial incision, fol- 
 lowed by dressing with Carbolized Oil, is the course to pursue in malignant 
 pustule. Caustic Potash, applied before an opening occurs, or small pieces 
 inserted into openings made by scalpel, to cause the rapid separation of the 
 slough. The resulting ulcer should be treated on general principles. [Com- 
 pare Anthrax, Boils.] 
 
 R. Calcis Sulphurat. , . . . gr. iij. 
 Sacchari Lactis, . . . q. s. 
 
 Triturat. et div. in chart, xxx. 
 
 Sig. — One powder every 2 hours, to be 
 taken dry on the tongue. 
 
 R. Tinct. Ferri Chloridi, ^j. 
 
 Potass. Chlorat., . . . 3 iij. 
 
 Liq. Ammonii Acetat., . 3 iij. 
 
 Syrupi et Aquae, q. s. ad ^viij. 
 
 M. Sig. — Dessertsp. every 2 hours. 
 
 Caries. 
 
 Aurum, in syphiloma of bones (B). Calcium Chloride, where strumous 
 cachexia (B). Phosphoric Acid, with 8 parts water, locally applied, has been 
 of benefit (Wa). Phosphates, the best is Syrup of Calcium Lacto-phosphate, 
 or Parrish's phosphates (R). Villate's Solution, injected through the sinuses 
 to dissolve the carious bone, has cured many cases (B). [See formula below.] 
 Sarsaparilla, a very useful medicine (P). Iodine, locally, with Iron or Cod- 
 liver Oil internally (Wa). [See Bone.] Potassium Iodide, in syphilitic caries, 
 holds the first place (Wa). Cod-liver Oil, to promote constructive metamor- 
 phosis (R). Mechanical Contrivances, are necessary in most cases; Sayre's 
 plaster jacket, Agnew's jacket of leather and steel, Taylor's apparatus, etc., 
 are used in spinal caries to separate the diseased bones, and extend the spinal 
 column. [Compare Necrosis.] 
 
 R . Cupri Sulphat. , 
 
 Zinci Sulphat. , . . aa partes xv. 
 Liq. Plumbi Subacetat., p. xxx. 
 Aceti, p. cc. 
 
 ( Vitiate 1 ' s Solution.') 
 
 R . Syrupi Calcii Lacto-phos- 
 
 phatis (U. S. P.), . . ^viij. 
 Sig.— A dessertsp. to a tablespoonful 3 
 or 4 times daily. 
 
 Catalepsy. 
 
 Turpentine, in enemas, and embrocations along the spine, affords the best 
 chance of stopping the paroxysms (Wa). Treatment must be essentially tonic 
 and restorative (H) ; no constant line can be stated (A) ; external stimulation 
 to arouse consciousness, by Ammonia, cold douches, Faradism, etc. Apomor- 
 phine, gr. £$ to ^, in the paroxysm ; with the onset of nausea, consciousness 
 returns and spasm ceases ; in the intervals between the attacks the treatment 
 should be that of hysteria (Gowers). 
 
64O CATARACT CATARRH. 
 
 Cataract. 
 
 Galvanism, has been successfully employed in the incipient stage (Wa). 
 Mydriatics, Atropine, Duboisine, etc., to secure full dilatation of pupil, as a means 
 of ascertaining when the operation should be made, which is when the cata- 
 ract is mature and there is no vision even with dilated pupil (Wa). Diet and 
 Regimen, may do much to retard degeneration of the lens in cases due to dia- 
 betes, or to malassimilation in gouty or rheumatic persons (C). Iridectomy, 
 made early and effectually may postpone the progress of lenticular opacity, if 
 due to increased intraocular tension (C) ; in partial cataracts which have 
 become stationary, iridectomy for artificial pupil may be done to expose the 
 clear portion of the lens (Roosa). Medicine, accomplishes nothing except to 
 improve the general health and so delay the progress of the opacity. Removal 
 may be performed by one of several operations (Roosa). Phosphorus, with 
 Oil, by frictions to the forehead, and instillation of the same into the eye, may 
 cause absorption of the lens or capsule (Wa). Codeine, in diabetic cases 
 (Br). Sodium Sulphate, a solution suggested as injection into anterior cham- 
 ber, in hope to dissolve the nebula (Wa). 
 
 Catarrh, Acute Nasal. 
 
 Menthol, 1 or 2 parts dissolved in 20 of chloroform, of which a few drops 
 in the hollow of the hand, the hands then rubbed together and placed before 
 the face, the remedy being inhaled alternately through the nose and the 
 mouth, will arrest the progress of a cold in its initial stages (Wunsche). Chlo- 
 roform, by inhalation in small quantities, is an excellent nasal antiseptic, and 
 is of great value in acute nasal catarrh. Sodium Salicylate, to abort a cold, 
 gr. x bis die. Aconite, in severe coryza with much chilliness, aching limbs, 
 hot and dry skin, and quick pulse ; also in catarrhs of children and that 
 accompanying measles (R) ; in acute coryza (P) ; with Belladonna in ordinary 
 colds with sore throat and high fever (B) ; in doses of ir^ every % hour very 
 useful for a commencing cold in the head (Smith). Belladonna, in acute 
 nasal catarrh with profuse watery secretion, X(\y of tincture, then rt\j each 
 hour (B). Nux Vomica, has great effect upon a dry cold in the head (P). 
 Euphrasia, is of decided utility in coryza (P). Pulsatilla, a warm lotion, 3j-ij 
 in ^iv aquae, syringed into the nasal passages in subacute coryza with muco- 
 purulent secretion (P) ; acts similarly to Aconite, but is contraindicated if 
 much gastric or intestinal irritation exists (B). Iodine, by inhalation in daily 
 attacks with itching nose (R); gij of the tincture with 3j of Carbolic Acid 
 inhaled from sponge in the bottom of a wide-mouthed bottle placed in hot 
 water (B). Iodides, are unquestionably serviceable, their action being local 
 and substitutive ; Ammonium Iodide, gr. j every two hours, the best mode of 
 using them (B). Sodium Iodide, gr. x ter die, with Pil. Ferri Iodidiin catarrhs 
 of specific origin (B). Potassium Iodide, gr. x at bedtime at the onset, to cut 
 short an acute cold in the head ; also useful in chronic colds (R). Arsenic 
 Iodide is very efficient as a remedy for an acute cold, coryza, and similar 
 affections, especially when accompanied by a sore throat resembling that of 
 diphtheria ; gr. iij triturated with gr. xx of sugar of milk, one-half of which 
 may be dissolved in ^iv of water, and a teasp. given every hour or so. Ar- 
 senic, when sneezing, itching of nostrils and frontal headache (R) ; as cigar- 
 ettes (B). [See under Asthma, for formula.] Veratrum Viride, if Arsenic 
 fails (R). Potassium Bichromate, in small doses, gr. yi^ in trituration, is very 
 efficient, especially when the nasal discharge is thick, stringy, and glutinous. 
 Potassium Chlorate, in doses of eight or ten lozenges a day, will abort many 
 a cold (R) ; a very good remedy in ordinary catarrh (P). Quinine, gr. x, with 
 Morphine, gr. l /e, at incipiency, will often abort an acute coryza (B). Opium, 
 at night, if taken early in the case, will often abort an attack of coryza ; a glass 
 of hot grog assists its action (R) ; Dover's powder in a full dose at the onset may 
 
CATARRH. 
 
 64I 
 
 abort (B). Codeine, is useful in common colds, as a palliative (B). Ammonia, 
 may be inhaled in the early stage (R). Camphor, as inhalation, the spirit in 
 form of vapor (R) ; with Opium and Ammonium Carbonate as powder (see 
 formula below), to break up or modify a cold (Beard). Tartar Emetic, gr. 
 -fa to y 1 ^ in the first stage (B) ; in acute catarrh of children often accompanied 
 by vomiting and diarrhea (R). Ipecacuanha, for acute nasal and bronchial 
 catarrh, and ordinary colds in children (B). Cimicifuga, when headache, stiff 
 muscles, dull aches, bone-pains, etc. (R) ; an excellent expectorant (B) ; rheu- 
 matic colds; neuralgic pains in jaw (P). Jaborandi, the fluid extract in doses 
 of u\x to xxx, every half hour until profuse diaphoresis sets in, is one of the 
 best modes of aborting a cold ; or Pilocarpine Hydrochlorate, gr. yi in water at 
 bed-time, will give prompt relief and cure in a few days (Wyss). Cocaine, a 4 
 or 5 per cent, solution locally as spray, to empty the engorged venous sinuses 
 of the nasal mucous membrane by their contraction, which it induces ; the fluid 
 extract of Coca diluted with water is equally efficient if enough be used 
 (Cohen). Resorcin, the best of all applications. [See Catarrh, Chronic] 
 Chloral, 20 grains in %j of Castor Oil, applied with a soft mop, when the 
 Schneiderian membrane is very irritable, checks the secretion of mucus and 
 lulls the irritation and the head pains (Brodnax). Ammonium Chloride or 
 Cubeb, in the dry, congestive stage of a cold in the head ; Cubeb cigarettes 
 may be smoked as a temporary palliative with great relief. Sulphurous Acid, 
 in coryza, by inhalation, spray, or fumigation, is very efficient (R). Oil 
 Inunctions, daily to the whole body, in cases of undue susceptibility to taking 
 cold, will prevent the frequency of the attack (B). Baths, a warm foot-bath 
 before going to bed ; Turkish bath, at onset in coryza, may prove abortive, 
 also useful later on ; cold sponge-bath in cases of extreme susceptibility, sup- 
 plemented by occasional Turkish baths (R). [Compare Cough, Hay-Fever, 
 Influenza.] 
 
 R. Quininae Sulphatis, . . gr. xviij. 
 Liq. Arsenicalis (B. P.),TT\xij. 
 Liq. Atropinse(B. P.), . try. 
 Ext. Gentianae, . . . . gr. xx. 
 Pulv. Acaciae, . . . . q. s. 
 Ft. pil. no. xij. Sig. — One every 3, 4, 
 
 or 6 hours, for acute colds. 
 
 ( Whalen. 
 
 R. Camphorae, gr. 1. 
 
 yEtheris, q. s. 
 
 Dissolve to creamy consistence, 
 then add — 
 
 Ammonii Carbonat, . . gr. xl. 
 
 Pulv. Opii, gr. x. 
 
 Divide into thirty papers. 
 One or two powders, according to age, 
 twice or thrice daily. [Beard.) 
 
 R. Tinct. Aconiti, .... TT^x. 
 Tinct. Belladonnas, . . t ^ss. 
 Syrupi Zingiberis, . ad Jij. 
 M. Sig. — Half to one teasp. according 
 to age, every hour. 
 
 R. Acidi Carbolici, . . . gr. lxxx. 
 
 Alcoholis, ^ss. 
 
 Aq. Ammonias, . . . rr^lxxx. 
 
 Aquae, 3 ijss. 
 
 M. Sig. — A few drops as an inhalation 
 from a cone of blotting paper. {Brand.) 
 
 R 
 
 Morph. Acetatis, . . . gr. iv. 
 
 Bism. Subnitrat., 
 
 Pulv. Talci, .... aagj. 
 Ft. chartulas no. xxx. 
 Sig. — Use as snuff in acute rhinitis. 
 
 [Sajous. ) 
 
 R 
 
 g r - "■ 
 
 Codeinae, .... 
 Syrupi Tolutani, 
 Syr. Scillae Comp., . aa ^j. 
 M. Sig. — Teaspoonful occasionally for 
 a common cold. (B.) 
 
 R. Morph. Hydrochlor., . gr. ij. 
 
 Bismuthi Subnit., . . . gvj. 
 
 Pulv. Acaciae, , . . . 3 ij. 
 M. Sig.— Use as snuff, % to yi the 
 above in 24 hours. (Ferrier' s Snuff. ) 
 
 Catarrh, Chronic Nasal. 
 
 Sanguinaria, the tincture in 10-drop doses thrice daily or gr. ^ of the alka- 
 loid internally, and the powder in small quantity locally to the mucous mem- 
 brane, is successful treatment for chronic nasal catarrh (B). Glycozone, fre- 
 
 41 
 
642 
 
 CATARRH. 
 
 quently applied, is of benefit (Edson). Hydrastis, is of value in chronic coryza, 
 also in ulceration of the septum or any other part of the nasal fossae, gtt. v of 
 the tincture thrice daily internally, and 3j to gviij of water locally by syringe 
 (P). Pulsatilla, is excellent in subacute inflammation of nasal passages, with 
 offensive muco-purulent discharge, 3j-ij to giv of water, as wash (P). Potas- 
 sium Bichromate, is an excellent local application in a solution of gr. j-x to ^iv 
 water (B) ; small doses, gr. -^ in trituration internally, a most efficient remedy, 
 especially when the discharge is tough and stringy, and the nose tender. 
 Cocaine, is much used, but is only of temporary benefit; danger of inducing 
 the cocaine habit. Resorcin, the best of all applications ; after cleansing the 
 nose with Dobell's solution, use a 2 to 10 per cent, ointment in vaseline, also a 
 spray every other day, of a 2 to 4 percent, solution : it gives the same results as 
 cocaine, but is slower in action and more lasting, and does not suppress the 
 normal function of the mucous membrane, as the latter does. Zinc Stearate, 
 makes an excellent insufflating powder, especially when mixed with boric acid, 
 europhen, etc. [See page 530.] Eucalyptus, has been employed with benefit 
 (Wa). Bismuth, in powder with acacia, as in Ferrier's snuff (see previous page), 
 or with tannin, calomel, etc., used by insufflation daily (Robinson). Iodoform 
 and Tannin, 1 of the former to 2 or 3 of the latter, carefully triturated and ap- 
 plied by an insufflator every other day only, is the very best of all applications 
 (B). Sodium Chloride or Phosphate, a teasp. to the pint of warm water as 
 cleansing solution, or the Bicarbonate, in the same proportion ; a sea-water 
 gargle in the naso-pharyngeal space, has been used with success (Mosler) ; 
 Wei de Meyer's Catarrh Cure is simple Sodium Bicarbonate and a little pink 
 coloring matter (Robinson). Potassium Permanganate, gr. j-x to the pint of 
 warm water, as a deodorant solution when necessary. Ammonia, by inhalation, 
 when painful inflammation of nasal mucous membrane and frontal bones (R). 
 Carbolic Acid, a 1 per cent, solution as spray, or inhalations of the vapor with 
 that of Iodine from a bottle in hot water, or vaporized by the warmth of the 
 hand (B). Salicylic Acid, in weak solution, 1 to 500 of water, as a disinfectant 
 and astringent injection, used with a retropharyngeal syringe, and followed by 
 applications of powdered Calomel through a speculum upon the ulcerated parts 
 of the mucous membrane (Massei). Cubeb, finely powdered and blown into 
 the nares by an insufflator (B) ; may be smoked, and administered internally in 
 teasp. doses (Wa) ; in freshly ground powder as a confection, in follicular disease 
 of the naso-pharyngeal space (Robinson). Ammoniacum, in the same condition, 
 small doses, gr. j-iij, with Ipecac or Ammonium Carbonate, will lessen the 
 amount of secretion (Robinson). Aurum Chloride, in mercurialized and syphi- 
 litic subjects, with offensive discharge, depressed spirits, and soreness of the 
 nasal bones. Iodides, of Iron and Sodium, in catarrh of specific origin (B). 
 Silver Nitrate, in powder, as alterative application, gr. x-xv to the ^ of men- 
 struum, is often a useful adjunct to treatment, used once every 4 or 5 days 
 (Robinson). Cod-liver Oil should be used in strumous subjects (R). Alum, 
 in powder, dusted over the affected surface, is a useful application (B). Bromine, 
 the vapor may greatly benefit, but must be used with caution (B). Senega, has 
 been found serviceable (Wa). Douche is dangerous, being likely to cause ex- 
 tension of the catarrh to the Eustachian tube and the middle ear; it has been 
 very generally abandoned. Sprays by hand-ball atomizers, or compressed air 
 apparatus, of warm watery solutions, Vaselin, etc., are used with considerable 
 success (Cohen) ; the Hank's atomizing tubes, with a 2-ball rubber syringe, are 
 very serviceable for office use, and for the application of Rumbold's hot Vaselin 
 spray. [See formula below.] Sulphur Waters, internally, of great benefit in 
 follicular disease (Robinson). [Compare Ozena.] 
 
 R . Acidi Carbolici, .... rr\x. 
 
 Glycerini, gvj. 
 
 Vaselini, ^ij. 
 
 M. Sig. — Warm and use as a spray 
 every 4 hours. {Rumbold. ) 
 
 R. Pulv. Argenti Nitrat., . gr. vij. 
 
 Pulv. Acacise, . . . . £j. 
 
 Bismuthi Subnitrat., . . giij. 
 Triturat. Sig. — Apply with insufflator 
 once in 4 or 5 days. {Robinson.) 
 
CEREBRAL ANEMIA CEREBRAL CONGESTION. 
 
 643 
 
 R. Acidi Carbolici, .... n^xl. 
 Sodii Boratis, 
 
 Sodii Bicarbonat., . aa spj. 
 Glycerini, gvij. 
 
 Aquae, . . . q. s. ad ^viij. 
 M. Sig. — Use daily as spray. 
 
 iD obeli.) 
 
 R. Bismuthi Subcarb., 
 
 Pulv. Acaciae, ... aa 3 ss. 
 Zinci Sulphat., . . . . gr. x. 
 Morph. Sulphat., . . . gr. ij. 
 M. Sig. — Snuff, to be used thrice daily. 
 (Sajous.) 
 
 R . Bismuthi Subcarb. , 
 Morph. Muriatis, 
 Pulv. Amyli, . . 
 Triturat. [Burness' 
 
 Ferrier's Snuff.) 
 
 ■ • 3 V J- 
 
 . . gr. ij. 
 modification of 
 
 R. Ext. Pini Canaden., . . Tlpcx. 
 
 Glycerini, TTLxxx. 
 
 Aquae, . . . . q. s. ad Oj. 
 
 M. Sig. — Use with post-nasal syringe. 
 
 R. Sodii Boro-benzoatis, 
 Ext. Hydrastis Fl., 
 Glycerini, .... 
 Ac. Carbolici, . . 
 Aquae Camphorae, . 
 Aquae, .... q. s. 
 M. Sig.— Use 
 
 thrice daily. 
 
 3J- 
 
 ad 3 xij. 
 ith syringe or atomizer 
 ( Ch a m berla in . ) 
 
 R . Acidi Carbolici, .... gtt. x 
 
 Extr. Hydrastis FL, . . 3J. 
 
 Sodii Bicarb., 
 
 Sodii Biborat., . . . aa %). 
 
 Glycerini, zj. 
 
 Aquae Camphorae, q. s. ad §viij. 
 M. Sig. — Use with posterior 
 sprayer. 
 
 £• 
 
 nasal 
 
 Sodii Salicylatis, , . . gij. 
 
 Sodii Boratis, ^iij. 
 
 Glycerini, ^ss. 
 
 Aquae, . . . . q. s. ad ^vj. 
 M. Sig. — A dessertspoonful into a pint 
 of warm water ; snuff it from the hollow 
 of the hand thrice daily. (Sajous.) 
 
 Cerebral Anemia. 
 
 Iron, the tincture of the Chloride, or mild chalybeate waters, in chronic 
 cases from general anemia (B). Amyl Nitrite, in vaso-motor spasm ; affords 
 relief in sudden attacks (B). Chloral, in small doses with stimulants and warm 
 baths (Ros). Camphor, or other cerebral excitants, as Asafcetida, Valerian, 
 Serpentaria (B) ; the Mono-bromide in one- to five-grain doses (Hammond). 
 Glonoinum, vnj of a 1 per cent, solution (P). Phosphorus, supplies the needed 
 material for healthy brain action (B). Strychnine, stimulates the circulation 
 generally ; with Iron preparations as a tonic. Galvanism, a mild current 
 transversely through the head, gives excellent results in the confusion of mind, 
 vertigo, etc., due to imperfect nutrition of the brain from atheroma of the cere- 
 bral vessels (B). Arsenic, is highly efficient in some hypochondriacal cases 
 (B). Aurum, is of great utility in vertigo, melancholia, etc., when due to or 
 accompanied by cerebral anemia (B). [Compare Insomnia.] 
 
 Cerebral Concussion. 
 
 Arnica, when concussion is due to a fall, cannot be too highly spoken of (P). 
 Warmth, to extremities, rest, expectant treatment, will suffice in mild cases 
 (Ag). The indications are : (1) to recover from insensibility and collapse ; (2) to 
 prevent inflammation ; (3) to restore impaired faculties (D). Stimulants or 
 Venesection, cannot be too strongly reprobated (Ag). 
 
 Cerebral Congestion. 
 
 Aconite, in the active form, renders important service (B) ; is much the best 
 remedy in this condition (P). Belladonna, one of the best remedies in all 
 hyperemic conditions of the brain or spinal cord (P). Gelsemium, n^v of the 
 fluid extract every two hours, very useful (B). Bromides, are very useful (B) ; 
 must be used in full doses. Colocynth, as a counter-irritant, appears to act well 
 (P). Cathartics, lessen blood-pressure (B). Colchicum, in plethoric subjects 
 
644 CEREBRAL SOFTENING — CHANCROID. 
 
 (P), Galvanism, of the brain and cervical sympathetic (B). Chloral, when 
 temperature high (B). Arsenic, sluggish venous circulation, torpor (B). Hy- 
 drocyanic Acid, n\,ij-v of Scheele's dilute acid (B). Venesection, will prevent 
 injury to brain ; not to be adopted as a matter of course; is contraindicated 
 when anemia, aortic valvular disease, or in cases commencing with syncope 
 (A). Water, cold douche to head, feet in warm water; ice and hot water 
 alternately to head and nape of neck, often more effective than ice alone (B) ; 
 hot water to head on flannels, mustard and hot water packing for 20 to 30 
 minutes around legs, when active congestion ; protect bowels well (R). Diet, 
 should be low, but not too low, until all fear of relapse is past ; full animal 
 diet should be avoided, also undiluted wines (A). [Compare Apoplexy, 
 Coma.] 
 
 Cerebral Softening. 
 
 Venesection, and antiphlogistic treatment generally, are most beneficial in 
 red softening the result of inflammation ; require wise discretion, and should 
 be used early ; not to be thought of in the yellow form, arising from want of 
 nutrition, wherein restoratives and food are needed, perhaps wine (A). Phos- 
 phorus, in threatened softening of the brain ; is the only drug which affects the 
 nerve centers (W). 
 
 Chancre. 
 
 Mercury, small doses steadily, but ptyalism must not be induced ; Black- 
 wash (Calomel gr. viij, Aq. Calcis ^j), or yellow-wash (Hydr. Chlor. Corr. gr. j, 
 Aq. Calcis gj) on lint, to erosions and ulcerated indurations (B); Calomel 
 alone as dry dressing : the internal use of Mercury is best postponed until sec- 
 ondary symptoms appear (St). Carbolic Acid, as wet dressing, gr. ij of crys- 
 tals in ^iv of water applied thrice daily (St). Iodoform, heads the list of dry 
 dressings ; with Lycopodium, equal parts, or 1 to 2 of Zinc Oxide ; 2 to 1 of 
 Calomel (St). Hydrogen Dioxide, said to destroy the specific character ; wash 
 lesions thrice daily, and apply lint soaked in it (R). Caustics, should never be 
 used unless chancre is attacked by phagedena (St). Caustic Alkalies, to hard 
 edges (R). Bromine, Chromic Acid, are the best escharotics (B). Dressings, 
 are effective as far as the local trouble is concerned in the majority of cases, 
 sometimes a piece of lint on the erosion will suffice; never cauterize an initial 
 lesion unless it is attacked by phagedena (St). Cleanliness, of great impor- 
 tance ; tepid water locally frequently suffices for the local treatment of infecting 
 chancre. [Compare Chancroid, Syphilis.] 
 
 Chancroid. 
 
 Mercury, the Acid Nitrate one of the best caustics ; apply with a glass rod 
 (B). Nitric Acid, fuming, as caustic (R) ; Z] to ^viij aquae is an excellent 
 dressing (St). Carbolic Acid, injected into sore (B) ; 3ij-vtoOj aquae locally 
 in phagedena (St). Ferri et Potassii Tartras, the born enemy of phagedena 
 (Ricord); %) to Jjvj aquae, internally, teasp. doses thrice daily; also locally 
 (St). Ferrous Iodide, in sloughing phagedena, or simple chancroid in debili- 
 tated constitutions (B). Iodoform, powdered and dusted over the sore, allays 
 pain, changes morbid action, and is antiseptic (R) ; 1 part to 2 of Lycopodium, 
 or one of Tannic Acid ; as stimulant and alterative (St) ; does no good except 
 to relieve pain (Gross). Potassium Chlorate, in impalpable powder, is better 
 than Iodoform (B). Chloral, gr. iij ad gj aquae, the best local application to 
 relieve pain (Gross). Caustics, in severe cases, the white-hot iron, strong Sul- 
 phuric Acid, pure Nitric Acid, pure Carbolic Acid, are effective in the order 
 named (St). [Compare Bubo, Chancre.] 
 
CHAPPED HANDS AND LIPS — CHLOROSIS. 645 
 
 Chapped Hands and Lips. 
 
 Sulphurous Acid, as solution or by fumigation, will speedily cure (R). 
 Glycerin, diluted, or better still, Glycerite of Starch, or with y 2 the quantity of 
 Eau de Cologne (R). Benzoin, the comp. tinct. 1 part to 4 of Glycerin ; an 
 admirable application (P). Hydrastis, on compress as lotion (P). Collodion 
 is usefully employed (P). Carbolic Acid, 1 to 2 of Glycerin, locally; one appli- 
 cation is generally sufficient. Unguentum Aquae Rosae alone, is often efficient; 
 may be combined with Zinc Oxide. Menthol, with Salol, etc. (see below), is 
 said to alleviate the pain of chapped hands on the first application. 
 
 R . Mentholi, gr. xv. 
 
 Saloli, gr. xxx. 
 
 01. Olivae, 3 ss. 
 
 Lanolini, ^ jss. 
 
 M. Ft. unguentum. 
 
 R . Cetacei, £j. 
 
 Glycerini, ^ij. 
 
 Cerae Albae, gr. xv. 
 
 01. Amygd. Amarse, . . TT\,iij. 
 M. Ft. unguentum. 
 
 Chest-pains. 
 
 Belladonna, as ointment, when tenderness is in the skin (R). Iodine, as 
 oint. when pain is in muscles (myalgia) of chest, they being tender on pressure, 
 while the skin may be pinched without pain (R). Strychnine, affords relief in 
 functional irritability of the nervous system, manifested by wandering neuralgic 
 pains (B). Arnica, internally for a stitch in the side. Bryonia, when painful 
 catching of breath. Cimicifuga, for intercostal rheumatism and pains under the 
 breasts in women. [Compare Myalgia, Neuralgia, Pleuritis, Pleuro- 
 dynia, Pneumonia.] 
 
 Chilblains. 
 
 Digitalis, internally and locally, to improve the circulation, and combat the 
 arterial hypo-tension and peripheral vaso-dilatation which are always present in 
 those subject to chilblains (Pilatte). Caffeine and Kola may sometimes be sub- 
 stituted for Digitalis. Iodine, as ointment, the best application (R) ; the tincture 
 lightly painted over the surface every 3 or 4 days, is particularly serviceable 
 for the itching. Arnica, is a useful application (Wa). Carbolic Acid, with 
 Iodine, as ointment, is a very efficient application for chilblains. Benzoin, the 
 tincture in Glycerin, applied after thorough washing in soap and water and 
 drying, the best application. Sulphurous Acid, an efficient application ; 3j to 
 3iij each of water and glycerin (B) ; as solution or fumigation (D). Balsam of 
 Peru, in ointment for broken chilblains (R). Capsicum, the tincture painted 
 over unbroken chilblains (R). Cajuput Oil, applied locally (R). Turpentine, 
 as wash, then apply Basilicon Ointment mixed with Turpentine (B). Ichthyol, 
 as oint. has been of service. Thiol, the dry form, as a dusting powder, is 
 used efficiently. Alcohol, as Eau de Cologne, or camphorated, with friction, 
 after careful drying of the hands and feet. Vaselin and other fatty substances 
 should never be applied (Pilatte). 
 
 R. 
 
 . Tinct. Digitalis, .... 3 jss. 
 Thymoli (cryst.), . . . gr. xlv. 
 Alcoholis (70 C), 
 
 R. Acidi Carbolici, . . . . 
 Tinctura Iodi, . . . . 
 Acidi Tannici, . . . . 
 
 3?J- 
 
 Glycerini, . . . . aa £xv. 
 M. Sig.— For local use. {Pilatte.) 
 
 Cerati Simplicis, . . . 
 Misce bene, ft. unguentum. 
 
 3 i v - 
 {Morrow. 
 
 Chlo 
 
 rosis. 
 
 
 Iron, combined with Arsenic or Strychnine, also occasional purgation and 
 active exercise (R) ; the Iodide, when much torpor of the system, is often 
 speedily efficacious (Wa) ; Iron is not a specific in chlorosis, and acts best in 
 
646 
 
 CHOKING CHOLERA ASIATICA. 
 
 the purest types (Tr). Manganese, the saccharated carbonate of iron and 
 manganese (B) ; Pepto-mangan is a good preparation. Arsenic, if Iron fails 
 or disagrees (B). Aurum Arsenate, has rendered good service. Ergot, in 
 chlorotic amenorrhea (P). Nux Vomica, stimulates the blood-making organs, 
 and may be combined with Iron ; a very generally useful preparation is the 
 syrup or elixir of Iron, Quinine, and Strychnine (B). Cocculus Indicus, when 
 amenorrhea and exhausting leucorrhea (P). Hypophosphites, of Calcium or 
 Sodium (R). Benzoin, has been used with advantage (P). Pepsin, benefits, 
 especially where digestive derangement (B). Sulphur, of great benefit in cases 
 where Iron is of no effect ; also to prepare the system for benefit from Iron 
 (Schulz). Bone Marrow, has been used with benefit. Thymus Extract, has 
 apparently been of service. Nuclein, is employed with success in some cases. 
 Purgation, is very important, to prevent auto-infection from putrid intestinal 
 decomposition, which is the true cause of this disease (Duclos) ; absorption of 
 such products tending to impoverish the blood, and produce a " fecal anemia " 
 (Sir A. Clark). Oils and Fats, as inunctions, after baths, of great benefit (B). 
 Galvanization, central, will aid the action of the remedies (B). [Compare 
 Anemia, Amenorrhea.] 
 
 R. Ferri Arsenatis, . . . . gr. ij. 
 Extracti Cinchonae, . . gr. xij. 
 Fiant pil. xij. Sig. — One pill after each 
 meal. (B.) 
 
 R . Ferri Sulph. Exsiccat. , . gr. xl. 
 Quininae Sulphatis, . . gr. xx. 
 Strychninae Sulphat., . gr. ss. 
 Ft. pil. xx. Sig. — One thrice daily. 
 
 R. Pulv. Aloes Socot., . . gr. v. 
 
 Ferri Sulph. Exsiccat., . gr. xv. 
 
 01. Tanaceti, vel 
 
 01. Sabinae, gtt. xxx. 
 
 Croci, 
 
 Myrrhae, 
 
 Cantharidis, . . . . aa gr. xxx. 
 Ft. pil. lx. Sig. — Two thrice daily, 
 gradually increased to four. ( Wallace.) 
 
 Choking. 
 
 Potassium Bromide, benefits a curious affection, sometimes found in children 
 who from their birth can swallow solids with ease, but choke at drinks (B). Oil 
 of Cajuput, in one case of persistent choking sensation in the throat, a few doses 
 removed the symptom which had lasted several weeks (Hale). 
 
 Cholera Asiatica. 
 
 Camphor, a drop or two of the saturated tincture, or gtt. v-x of the spirit with 
 a little Opium every half-hour (B) ; gtt. iv-vj of strong spirit every ten minutes 
 until symptoms abate, then hourly (R); the combination of camphor, opium, 
 etc., known as Squibb' s Cholera Mixture (see next page for formula) is an effi- 
 cient remedy at the inception. Morphine, gr. y% to y hypodermically in the 
 preliminary diarrhea (P); y to % gr. of the greatest value even in collapse 
 (R); dangerous if kidney complications exist (P): Morphine is the principal 
 ingredient in Chlorodyne (see page 261), a remedy commonly used in India. 
 Chloroform, a few drops frequently repeated, or 10 to 30 drops of chlorodyne, 
 of great value (B). Chloral, with Morphine, by hypodermic injection, is the 
 most effective treatment (see next page for formula); it causes pain and in- 
 duration but not suppuration (B). Arsenic, in epidemic cholera ; some cases 
 of arsenic poisoning are not distinguishable from cholera (B) ; for the vomiting 
 and in collapse (R). Copper salts have been given (R). Turpentine, tt\,x-xx 
 every two hours, promises to be a remedy of value (Wa). Lead, the Acetate 
 in early stages (R). Carbolic Acid, with Iodine, has given good results (B). 
 Salol, has done excellent service. Sulphuric Acid, the aromatic, with Opium, 
 is very effective (B) ; two parts of the former with one of Laudanum, of this 5 
 to 30 drops as per age, is one of the best prophylactics (McClellan). Strych- 
 nine, as prophylactic during the preliminary diarrhea, and in epidemic form 
 
CHOLERA INFANTUM. 
 
 647 
 
 when nearing collapse (B). Alcohol, small doses of iced brandy for vomiting 
 (B). Spinal Ice-bag, for cramps (R). Saline Injections, into the veins, have 
 been successful in tne collapse (B) ; Sodium Chloride, Sodium Carbonate, aa 
 3j, Boiled Water quart j, makes a suitable injection, of which one to three 
 quarts at ioo° F. may be slowly injected into a vein by gravitation, the effect 
 being carefully watched (Mn). Milk, by transfusion, in the collapse (B). Irri- 
 gation of the intestines with hot water and soap, using 1 to 3 gallons at a time 
 twice daily, also Hydrogen Peroxide with hot water to cleanse the stomach; 
 the method used by me in Russia and at Hamburg, during the epidemic of 
 1892 (Elmer Lee). Treatment, the only treatment of any proved value is the 
 purely symptomatic and expectant one (Mn). Absolute Rest, recumbent pos- 
 ture, no food, ice ad libitum ; enemata of warm milk ; fresh air, friction, and 
 heat to abdomen, legs and feet ; stimulants are worse than useless. Cholera 
 Toxin, as inoculated by Dr. Haff kine, has been highly efficient as a prophyl- 
 actic in India. 
 
 R 
 
 M 
 
 Chloroformi, 5jj. 
 
 Tinct. Opii, 
 Spt. Camphoras, 
 Tinct. Capsici, . . . aa giij. 
 Alcoholis, . . q. s. ad ^ij. 
 Sig. — 30 to 60 drops in water. 
 
 (Sgztibb's Cholera Mixture. 
 
 gr. viij. 
 
 R . Acidi Carbolici, . . 
 
 Bismuthi Subnit. , . 
 
 Mucil. Acacias, 
 
 Aquas Laurocerasi, aa 3;j. 
 M. Sig. — Teasp. every hour or two, 
 for vomiting and diarrhea. 
 
 ft. 
 
 M 
 
 01. Menthse Piperita, . partem j. 
 
 Tinct. Opii, partes iv. 
 
 Ac. Hydrochlor. Dil., . partes ij. 
 Quininae Hydrochlor. , . partes iv. 
 Tinct. Cinchonas Comp., 
 Spt. ^Etheris Comp. , aa partes xv. 
 . Sig. — 15 drops every 2 hours. 
 
 {Botkiri's Cholera Drops. ) 
 
 R. Chloralis Hydrat., . . sjiij. 
 
 Morphinas Sulph., . . gr. iv. 
 
 Aquas Laurocerasi, . . %'). 
 M. Sig. — Fifteen to twenty drops as 
 injection hypodermically. 
 
 Cholera Infantum. 
 
 Bismuth Subnitrate, in hourly doses of 3 to 6 grains, is regarded by many as 
 almost a specific. Ipecacuanha, greenish stools with mucus and often blood 
 (B). Arsenic, for vomiting and collapse (R). Mercury, gr. yi of gray powder 
 hourly of great service in infantile cholera with incessant sickness, profuse, 
 almost continuous diarrhea, offensive and nearly colorless stools ; a Starch in- 
 jection, with a minute quantity of Laudanum, assists the gray powder, and 
 should be given in urgent cases (R). Zinc Oxide, with Bismuth and Pepsin, is 
 very useful (B). Camphor, £>j of the spirit in ^iv of milk, very serviceable (B) ; 
 an admirable remedy for summer and choleraic diarrhea (R). Opium is gen- 
 erally necessary ; enemata of Starch and Laudanum [see above under Mer- 
 cury]. Morphine, hypodermically, in doses of gr. ^^ to ^ according to age, 
 the latter dose for a child of one year, with 5 or 6 drops of Ether, to be repeated 
 in an hour, the most efficient treatment (E. Smith). Copper Sulphate is often very 
 successful (B). Carbolic Acid, with Bismuth, may arrest the disorder promptly 
 (Br). Lead Acetate, is one of the most useful astringents in this complaint (Br). 
 Potassium Bromide, when due to nervous irritation or cerebral congestion 
 (B). Silver Nitrate, is beneficial after the acute symptoms have passed (B). 
 Caffeine, when due to nervous irritation (R). Coto Bark, the tinct. gtt. j-iij, 
 is highly recommended by Rohrer for choleraic diarrhea in children. Alco- 
 hol, in grave cases, with tendency to collapse, gtt. x-xx of brandy with milk 
 every 30 to 60 minutes. Diet, farinaceous food a common cause ; cow's milk 
 0|^ with sacch. lactis £j to O^ aquae-bul., or cold milk with Lime-water (R); 
 milk, animal broths ; no starches or fats (B). Drinks, as water, weak tea, etc., 
 freely, to keep vessels filled and prevent paralysis of the heart (Meinert). Spice 
 Poultice, to abdomen, composed of Cloves, Ginger and Cinnamon, mixed with 
 
648 
 
 CHOLERA SIMPLEX — CHORDEE. 
 
 brandy or whiskey. Mustard Bath, in stage of collapse, with mustard over 
 the heart, and Ether hypodermically (Smith). Lactic Acid, a 2 per cent, solu- 
 tion in drachm doses, 5 to 8 times in 24 hours, in epidemic diarrhea of infants 
 with green discharges, also local antisepsis as to linen and diapers, on the 
 theory of a baciliary origin for the disease (Hayem). Peptenzyme, is excellent 
 in cholera infantum and the summer diarrhea of children. 
 
 R . Cupri Suiphat., . . . . gr. j. 
 
 Tinct. Opii Deod., . . gtt. viij. 
 
 Aquae Destil., . . . . % iv. 
 M. Sig. — Teasp. every 2, 3, or 4 hours 
 for a child of one or two years. (B.) 
 
 R. 
 
 Acidi Carbolici, . 
 Spt. Vini Gallici, 
 Aquae Menth. Pip, 
 Mucil. Acaciae, . 
 Syr. Papaveris, . 
 Tinct. Opii Deod, 
 
 gr. xxiv. 
 gtt. xxiv. 
 f jss. 
 3 V J- 
 
 gtt. x. 
 
 M. Sig. — A teasp. every 2 hours. 
 
 R. Hydrarg. Chlor. Mitis, . gr. -j^. 
 Bismuthi Subnitrat., . . gr. ij-v. 
 In powder every half hour for the vom- 
 iting and purging. 
 
 R . Acidi Carbolici, . . . gr. iv. 
 Bismuthi Subnit., . . . zij. 
 Mucil. Acaciae, . . . §j. 
 Aquae Menth. Pip., . . ^iij. 
 Sig. — Teasp. every 2, 3, or 4 hours. 
 (B.) 
 
 M 
 
 R . Plumbi Acetat. , . . , 
 Pulv. Opii, .... 
 Pulv. Camphorae, . , 
 Sacch. Lactis, . . 
 Triturat. et div. in chart. 
 
 Sig. — One powder every hour. 
 
 . gr. xx 
 . gr. xij. 
 . gss. 
 . q. s. 
 xij. 
 
 (B.) 
 
 R . Hydrarg. Chlor. Mitis, . gr. |. 
 
 Plumb. Acetatis, . . . gr. ^. 
 
 Pulv. Opii, gr. T L-i. 
 
 Ft. pulv. no. j. Repeat every half-hour 
 or hour for the acute gastric symptoms. 
 
 Cholera Simplex. 
 
 Camphor, an admirable remedy (R). Salol, is highly efficient. Salophen, 
 is equally so. Veratrum Album, for the vomiting (R). Copper Salts, have 
 been given (R). Arsenic, for vomiting ; also for collapse in latter stages (R). 
 Chloral, hypodermically with Morphine, is the most efficient treatment (B). 
 [See C. Asiatica for formula] ; for the cramps Chloral %} in Linim. Saponis 
 §iv to vj, applied to the abdomen with friction (Da C). Opium, gr. l /e to yi 
 every 2, 4, or 6 hours, in the early stage (P). Morphine, gr. y£ to y 2 hypoder- 
 mically, is very useful (B). Carbolic Acid, with Bismuth (see under Cholera 
 Infantum for formula) is very effective (B). Lead, the Acetate in the early 
 stages (R). Calumba, as anti-emetic, of great value (P). Ipecacuanha, has 
 been used with much advantage (Wa). Sumbul, said to have proved success- 
 ful (P). Mustard, as an emetic in collapse, to stimulate a failing heart (P). 
 Cajuput Oil, much used in India for choleraic affections (P). Alcohol, as 
 iced brandy in small doses for vomiting (B) ; the value of stimulants is justly 
 doubted ; if given, should be largely diluted (Wa). [Compare Cholera 
 Asiatica and Infantum.] 
 
 Chordee. 
 
 Aconite, gtt. j of the tincture hourly, will relieve chordee (R). Belladonna, 
 combined with Camphor or Opium, gives the best results of remedies adminis- 
 tered internally (St). Camphor, 3j doses of the spirit will relieve (R). Can- 
 tharis, gtt. j of tinct. ter die, will prevent (R). Cannabis Indica or Cannabis 
 Sativa (P). Lupulin, valuable (P) ; said to prevent (B). Morphine, hypoder- 
 mically, the one sure remedy; should be injected into the perineum at bed- 
 time (St). Cocaine, a few drops of a 4 per cent, solution, locally to the 
 glans ; or injected into the urethra, promptly relieves chordee. Diet, should 
 be plain, even low, no stimulants ; copious draughts of barley-water, or lin- 
 seed tea. 
 
CHOREA. 
 
 649 
 
 R . Liq. Morph. Magendie, 3 iv. 
 
 Atropinae Sulphat., . . gr. j. 
 
 Acidi Acetici, . . . . q. s. 
 
 Aquas Destillat., q. s. ad ?]. 
 M. Sig. — TT^v-viij hypodermically at 
 bedtime. (Sturgis.) 
 
 R . Pulv. Opii, .... 
 
 Pulv. Camphorae, . 
 
 Sacch. Alb., . . . 
 
 Fiant capsulae xij. 
 
 Sig. — One at bedtime, to be repeated in 
 
 2 hours if required. [Sturgis.) 
 
 gr. xij. 
 gr. xxiv. 
 
 q. s. 
 
 Chorea. 
 
 Antipyrin, is the only medicine from which cures may confidently be antici- 
 pated (McCall Anderson) ; is successfully used to combat excitability of the 
 motor nerve centres (W) ; may be given in 2 grain doses every 3 hours to very 
 young children (Whitla). Acetanilid has been used with benefit, in both mild 
 and grave forms of chorea (Id). Exalgin, with Citrate of Iron and Quinine 
 after meals (Dana) ; is believed by many to have specific power over chorea, 
 given in doses of 2 grains thrice daily and gradually increased to 3 grains five 
 times a day. Arsenic, is one of the most certain remedies, but large doses are 
 required and are well borne (B) ; rt\jij of Fowler's solution thrice daily for a 
 child of 7 years, gradually increased to n\,x thrice daily, and may be continued 
 for several weeks (Whitla); is very successful in uncomplicated cases (R). 
 Zinc Sulphate, in doses of 2 or 3 grains gradually increased to 8 grains, is next 
 in value to arsenic (Whitla); in large and increasing doses is very useful (R) ; 
 has action similar to that of Arsenic, but is inferior (B). Hyoscyamine, -g-jro 
 grain thrice daily, gradually increased, has cured cases which resisted all other 
 remedies (Da C). Duboisine is equally efficient ; the Solanaceas are very suit- 
 able for nervous, delicate children. Hyoscyamus may be tried. Quinine, as 
 a stimulant to the inhibitory centre which controls motor discharge from the 
 spinal cells, and which is weakened in chorea to a greater degree than the dis- 
 charge power (W). Aurum Bromide, in daily doses of gr. \ to ^, continued 
 until its characteristic headache is produced (Goubert) : the Bromides in full 
 doses have proved useful. Chloral, contributes to cure by inducing quiet sleep 
 (R) ; in gradually increasing doses is of the greatest service, as it has an almost 
 absolute power to suspend or control spasm during its deep hypnotic action 
 (Gairdner). Chloralamid, may be pushed with greater safety, and excellent 
 results have followed its use (Whitla); [see p. 260]. Physostigma, is recom- 
 mended (R) ; is of doubtful benefit (B) ; cures the disease in 5 or 6 days with 
 doses of -^Q grain of Physostigmine twice daily hypodermically (Reiss). Calcium 
 Chloride, has done good in strumous subjects (B). Cocaine, is of the highest 
 value, and has cured cases repeatedly in which all the ordinary remedies had 
 been used in vain (B) ; the whole amount given daily has rarely exceeded }4 
 grain (Id). Cimicifuga, is a very valuable remedy in cases due to menstrual 
 derangement (P) ; when there is a rheumatic history (R). Strychnine, in doses 
 gradually increasing to the toxic (Tr) ; minute doses, gr. -fa to ^, have been 
 highly useful when chorea is due to fright or commencing puberty (B). Cuprum 
 Ammoniatum, has been used successfully (B). Iron, large doses of the Subcar- 
 bonate in anemic cases, about the time of puberty (B). Chalybeate waters often 
 relieve or cure. Arsenic generally better, unless anemia coexists (R). Vera- 
 trum Viride, has been employed (R). Cocculus, or Picrotoxin, large doses (P). 
 Conium, in large doses, to quiet muscular agitation (B) ; is only palliative (R) ; 
 evidence contradictory as to its value (P). Valerian, said to restrain the move- 
 ments (R); useful when from worms (P). Chloroform, inhalations often of 
 great service in severe cases (R). Morphine, with Chloral, hypodermically in 
 large doses for severe cases (Tr); when the movements prevent sleep (R). 
 Musk, has been given (R). Cod-liver Oil, when nutrition is low (R). Water, 
 by cold affusion to head and spine, and cold baths are important (B) ; tepid 
 water first, cold should not be used if rheumatism or fever or pain in the joints 
 (R). Electricity, static, is useful in some forms (B) ; the constant current used 
 in 20 cases, all recovering (Benedict) ; a galvanic chain around the neck and 
 down the back, is reported serviceable. 
 
650 
 
 CHOROIDITIS CLIMACTERIC DISORDERS. 
 
 R . Chloralis Hydratis, 
 
 Tinct. Hyoscyami, 
 
 Syr. Limonis, . . , 
 
 Aquae Cinnamomi, 
 
 M. Sig. — A teasp. 3 
 
 according to age. 
 
 or 4 
 
 R. 
 
 llj-Vj, 
 
 lxxv. 
 
 Zinci Oxidi, .... 
 
 Sacchari Albi, . . . 
 M. et div. in pulv. no. vj. 
 Sig. — One powder thrice daily. 
 
 (Bamberger. 
 
 R. Tinct. Ferri Chloridi, . |jj. 
 Liq. Acidi Arsenosi, . . gij. 
 
 Syr. Limonis, ^j ss - 
 
 Aquae, . . . . q. s. ad ^ viij. 
 M. Sig. — A teasp. thrice daily after 
 
 meals, gradually increased and effects 
 
 watched. 
 
 R. 
 
 Acidi Arsenosi, . . . . gr. ■£$—£$. 
 Ferri Reducti, . . . . gr. j-iij. 
 Quininae Sulph., . . . gr. ij-v. 
 In pill or capsule, thrice daily. 
 
 {Sacks.) 
 
 Choroiditis. 
 
 Mercury, as in iritis ; cannot be borne to the same extent as in the latter dis- 
 ease (A). Opiates, necessary externally and internally to overcome pain (A). 
 Treatment, is generally the same as in corresponding forms of iritis, but when 
 atrophic spots appear on the choroid, no treatment can repair the damage 
 (A) ; rest of eyes and protection from light by blue glasses ; in suppurative 
 form (panophthalmitis) use Atropine, in strong solution, with ice compresses 
 and leeches in early stage ; Paracentesis repeatedly to relieve tension and 
 give exit to pus ; Canthoplasty of outer canthus to relieve the pressure of the 
 lids (Roosa). 
 
 Chyluria. 
 
 Thymol, in doses of 1 grain, gradually increased to 5 grains, cured two cases 
 of chyluria due to filariae in the blood (Laurie). Hypophosphites, the syrup in 
 emulsion with Cod-liver Oil, caused the entire disappearance of chyluria in a 
 woman who had been a life-long sufferer therefrom (Barnes). Sodium Benzo- 
 ate, in doses of Z) thrice daily, gave promising results, but the after-history of 
 the cases was not obtained (Mackenzie). Potassium Iodide, in large doses, 
 has checked the discharge for a time in several cases (Lewis). Gallic Acid, in 
 doses of 3j-iji always affords some benefit (Id). Ferric Chloride, large doses 
 of the tincture do some good (Id). Treatment, is unsatisfactory ; no remedy 
 appears to possess any constant effect (Whitla) ; drugs have no influence what- 
 ever in stopping the lymphorrhagia, the best results are obtained by absolute 
 rest in bed, elevating the pelvis, restricting the amount of food and fluid — espe- 
 cially fatty food, and gentle purgation (Mn). 
 
 Climacteric Disorders. 
 
 Aconite, for nervous palpitations, and restlessness or " fidgets " ; gtt. j hourly 
 (R). Cimicifuga, for distressing headache (R). Amyl Nitrite, in small doses 
 when the "heats" predominate, followed by cold, clammy, pale skin (R). 
 Ergot, for the flooding, gr. ij of Squibb's extract in fresh pill every hour until 
 relieved ; Cannabis Indica may be well combined with it. Cannabis Indica, is 
 used in the headaches of the menopause, with uniformly good results. [See 
 Headache, for formula.] Iron, for flutterings of the heart, with fullness of 
 head, heat and weight on the vertex, frequent flushings, and hot and cold per- 
 spirations ; large doses of the Chloride thrice daily (R). Nux Vomica, Opium 
 and Belladonna, when the symptoms described above under Iron are limited 
 to the head and face (R). Ammonia, Raspail's sedative lotion to painful part 
 of the head in climacteric headaches (R). Potassium Bromide, for the 
 despondency, with sleeplessness and irritability, often also with heats, flush- 
 ings, perspirations (R). Physostigma, the extract gr. -^ every %, hour for 7 
 or 8 doses, for flatulence and a sensation of fluttering at the pit of the stomach 
 
COCCYGODYNIA — COLIC. 
 
 651 
 
 (Smith). Camphor, for drowsiness and headache ; Eau-de-cologne, saturated 
 with Camphor, rubbed on the head (R). Zinc Valerianate, hysterical symptoms 
 (R). Change of air and scene, when other treatment only partially successful 
 (R). Warm Bath, to promote free perspiration ; at 90 to 95 F. for an hour, 
 once a week, will correct many of the symptoms (R). [Compare Metror- 
 rhagia.] 
 
 Coccygodynia. 
 
 Chloroform, injected as deeply as possible about the seat of greatest pain (B). 
 Electricity, has cured one severe case of 12 years' standing, and helped others. 
 Surgical treatment the only resource in rebellious and painful cases (Ros). 
 Nott extirpated the coccyx ; Simpson performed subcutaneous section of mus- 
 cles and ligaments ; Goodell removed the bone, after first treating the case as 
 the local expression of a general neurosis. 
 
 Coldness. 
 
 Strychnine, for cold hands and feet (R). Cold Baths, with friction to the 
 skin, nightly for cold feet (R). Chloral, in small doses daily, will counteract 
 the coldness of the feet and hands in certain cases of anemia, hysteria, etc. 
 (Cherchevsky). Spinal Ice-bag, is often efficiently employed in general cold- 
 ness of the surface, and persistent coldness of the hands and feet (R). Co- 
 caine or Atropine, will raise the body-temperature. (See page 38.) 
 
 Colic, Intestinal. 
 
 Nux Vomica, quickly subdues abdominal cramps and spasms (P). Bella- 
 donna, especially in children (R). Chamomile Oil, TTyv-vj, in colicky attacks 
 of hysterical women (P). Cocculus, of great value, especially during preg- 
 nancy (P). Chloral, sometimes relieves (R). Chloroform, effective in flatu- 
 lent colic ; also useful in hepatic and saturnine (B); often used combined with 
 Opium (D). Potassium Bromide, in a peculiar form of colic in young children 
 (R) ; given in Anise- or Peppermint-water is of greater efficacy for the colic 
 of infants than the opium preparations in general use, and perfectly safe (B). 
 Asafcetida, no better remedy in flatulent colic of infants ; teasp. doses of the 
 Emulsum Asafcetida (B). Dioscorea, is used successfully in so-called bilious 
 colic, TTLxv-xxx of the fluid extract. Morphine, gr. yi-% hypodermically, 
 repeated in 15 minutes, gives more relief than any other remedy in all forms 
 of colic (B) ; frequent small doses (P). Arsenic, will cure in a surprising 
 manner when enteralgia is idiopathic (B). Essential Oils, especially those of 
 Cloves and Cinnamon (R) ; of Anise, Cardamom, etc.; Oil of Rue in flatulent 
 colic of children (P). Magnesium, the Carbonate with Opium and Asafcetida, 
 as in Dewees's Carminative (see page 202), the dose being ir^xx for an infant 
 2 to 4 weeks old. Tobacco, as enema, is dangerous ! (B) ; as clyster, or by 
 stomach (R). Ammonia, in spasm of intestinal canal and in colic of children 
 or infants from bad feeding (R). Lime Water, for young children who eject 
 milk in lumpy masses, with colic and flatulence (R). Water, hot fomentations 
 to ease pain (R) ; a copious enema of warm water often gives immediate 
 relief. 
 
 R . Spiritus Chloroformi, 
 
 Tinct.Cardamomi Co., aa 3jij. 
 
 M. Sig. — Teasp. in water every 
 
 hour. (B.)' 
 
 R. 
 
 Atropinae Sulphatis, 
 Zinci Sulphatis, . . 
 Aquae De?til., 
 
 M. Sig. 
 times daily. 
 
 gr- J- 
 gr. xxx. 
 
 to 5 drops two or three 
 
 R. Ext. Gentianse, 
 
 Pulv. Rhei, . . . . aa srj. 
 Ft. pil. xx. Sig. — One or two 
 thrice daily for tendency to colic. 
 
 pills 
 
 R 
 
 Pulv. Camphorae, 
 Pulv. Capsici, 
 
 Pulv. Zingiberis, . . . aa gr. ij. 
 Ft. pil. xij. Sig. — One pill as required. 
 
652 
 
 COLIC COLLAPSE. 
 
 Colic, Lead. 
 
 Alum, singularly, is the best remedy (B) ; gr. x hourly (R) ; converts the 
 poisonous salt of lead in the system into a comparatively innocuous sulphate ; 
 3jss-iv daily with nrxl-1 Tinct. Opii, and an occasional dose of Castor or 
 Croton Oil to procure one or two motions daily (Wa). Opium, gives more 
 relief than any other remedy, gr. yi to % of Morphine hypodermically (B) ; 
 gr. ij-iv of Opium, with a moderate dose of Castor Oil (P). Sulphuric Acid, 
 diluted well, as a prophylactic, and is useful in the treatment of the disease (B) ; 
 considered remarkably efficient when used in association with repeated Sulphur 
 baths (Wa). Calomel, a full dose, with or without Opium, followed in a few 
 hours by Castor Oil and a Turpentine enema, often affords speedy and marked 
 relief (Wa). Tobacco, may control, but is dangerous (B). Croton Oil, in half-, 
 drop doses, with sufficient Opium to relieve the pain, repeated every 3 or 4 hours 
 until free evacuations are produced; proves effectual when other remedies fail 
 (Wa). Magnesium Sulphate, for the constipation, and to remove the poison 
 from the system ; should be combined with Potassium Iodide, 3j of the former 
 thrice daily and about two hours after having given gr. v-x of the Iodide ; 
 this treatment dissolves the lead in the tissues, causes its elimination by the 
 intestinal mucus, renders it insoluble after it has entered the intestinal canal, 
 and quickly removes it from the body (Br). Atropine, gr. y^, with Potassium 
 Iodide, gr. v, gives excellent results in the treatment of lead-poisoning, the 
 former relieving the colic and pain in the head in the most rapid manner, 
 keeping the bowels open freely, assisting in the return of the bodily powers, 
 and aiding in the removal of the lead by the Iodide (Humphreys). [Compare 
 Poisoning by Lead.] 
 
 R. Aluminis, ^ij. 
 
 Ac. Sulphurici Dil., . . zj- 
 Syr. Limonis, . . . . 3J. 
 
 Aquae, ifiij. 
 
 M. Sig. — Tablesp. every hour or two 
 
 for lead colic. 
 
 (B.) 
 
 R. Magnesii Sulphatis, . . ^j. 
 
 Ac. Sulphurici Dil., . . gj. 
 
 Aquas, . ^ iv. 
 
 M. Sig. — Tablesp. every 3 hours (B) ; 
 or thrice daily, each time preceded by a 5- 
 to io-grain dose of Potassium Iodide. (Br.) 
 
 Colic, Renal and Hepatic. 
 
 Ether, inhaled in paroxysms of hepatic colic (R). Chloroform, by inhalation 
 in renal and biliary colic, inferior only to Morphine injection, superior to 
 Opium, warm baths, etc. ; two or three administrations will be required (R). 
 [See also Colic, Intestinal.] Counter-irritation, flying blisters for renal 
 colic (R). Opium, small doses with Spt. Chloroformi every five or ten minutes 
 until the pain gives way, or Morphine hypodermically (R). Turpentine, has 
 been given with benefit in biliary colic (R). Olive Oil, in full dose during an 
 attack of colic, frequently gives relief (Brockbank) ; stops the spasm of the 
 ureters, and acts in nephritic colic precisely as it does in hepatic colic (Aussil- 
 loux). Glycerin, in doses of £v-vij in hepatic colic brings the attacks to an 
 end ; doses of 3j-iv daily, in a little alkaline water, prevented recurrences 
 (Ferrand). Water, warm baths to ease the pain (R). Aliment, withhold 
 all starches and fats; Alkaline mineral waters are useful (B).' [Compare 
 Calculi.] 
 
 Collapse. 
 
 Camphor, Z] of a 10 per cent, solution in oil, hypodermically into each fore- 
 arm, in the collapse of pneumonia (Schilling) ; hypodermic injections of cam- 
 phor are used for purposes of excitation in collapse. Ether, by mouth, inhala- 
 tion, or hypodermically, is of great service. Ammonia, the liquor diluted, by 
 intravenous injection, in cases of fracture and laceration accompanied with 
 
COMA CONJUNCTIVITIS. 653 
 
 collapse (P) ; in desperate cases when the hypodermic method is the only avail- 
 able route (Whitla). Brandy, or other alcoholic stimulant, by mouth if the 
 patient can swallow, if not then by the bowel or hypodermically (Id). Digitalis, 
 the tincture as a cardiac stimulant, but being slow of action it should be pre- 
 ceded by Ammonia or Alcohol. Strychnine, or Nux Vomica, for impending 
 cardiac failure, is very efficient. [Compare the articles on Heart Affections 
 and Syncope.] Electricity to the phrenic nerve, or an interrupted current 
 through the upper extremities (Whitla). Beef Extract, Liebig's in large doses 
 with hot water, is a rapidly acting stimulant (Id). Transfusion, or a warm 
 saline solution by subcutaneous injection, when collapse is associated with 
 extensive hemorrhage ; or an Esmarch bandage to the limbs, or the tourniquet 
 to the femoral artery, to keep the blood out of the lower extremities (Id). Heat 
 to the surface and over the cardiac region. Counter-irritation, by mustard to 
 the spine, nape of the neck, and calves of the legs. Affusion, of cold water 
 alternating with hot (P). [Compare Exhaustion, Shock, Syncope.J 
 
 Coma. 
 
 Croton Oil, as a purgative, tt\,X or y^ every hour, mixed with a little butter 
 or lard and conveyed to the back of the tongue (R). Oxygen, by inhalation, 
 is generally applicable in coma. Potassium Bitartrate, free purging therewith, 
 often removes coma, convulsions, and other symptoms due to poisoned blood 
 (R). Blisters, in the comatose condition, large blisters or mustard poultices 
 should be applied in quick succession to different parts of the body — chest, 
 abdomen, thighs, and calves ; often very valuable in the critical condition near 
 the end of an acute illness (R). Cold Douche, for stupor of drunkenness or of 
 opium poisoning ; may have to be repeated if relapses occur ; it should be kept 
 up for a long time if pulse and breathing improve or are no worse (R). Mus- 
 tard, as poultice to the feet and ankles in the coma of narcotic poisoning (P). 
 Exercise, in coma from poisoning the patient should be persistently walked 
 about. [Compare Cerebral Congestion, Uremia, and Poisoning by Nar- 
 cotics.] 
 
 Condylomata. 
 
 Nitric Acid, ^j in Oj aquas, as wash, frequently used (R). Thuja, locally a 
 strong tincture, also Ti^v internally, night and morning, for warts with narrow 
 base and pendulous body ; warts about anus or pudenda of either sex, whether 
 syphilitic or not, are often rapidly cured by Thuja (P) ; in non-syphilitic warts 
 of penis or vulva, I have employed it with satisfaction (Pf). Mercury, Calomel 
 dusted over, after washing with a solution of Chlorinated Soda (Ricord) ; the 
 Nitrate locally, or a 20 per cent, oleate (R). Zinc, the Chloride, Iodide or 
 Nitrate as local applications (R). Arsenous Acid, as a caustic (R). Carbolic 
 Acid, as a mild escharotic (B). Chromic Acid, gr. c in ^j aquae dest. ; a good 
 local application (B). [Compare Syphilis, Warts.] 
 
 Conjunctivitis, Catarrhal. 
 
 Zinc, a weak solution of the sulphate or acetate as astringent collyrium (B) ; 
 gr. j-ij in ^j aquas destil. as mild astringent lotion every few hours, with ice 
 locally in the earlier stage (Roosa). Sodium Borate, gr. v in ^j aquas dest. a 
 good and mild astringent for ordinary cases. Boric Acid, gr. vj in ^j each of 
 aquas camph. and aq. destil., as collyrium (Fox). Boro-glyceride, in dilute 
 solution, ^ss to the ^, is an efficient application. Mercury, Calomel finely levi- 
 gated and dusted from a camel's-hair brush over the palpebral conjunctiva in 
 severe cases (B) ; is a most efficient application in the conjunctivitis of children 
 showing minute ulcers ; the Oleate of Mercury and Morphine applied to the 
 
654 
 
 CONJUNCTIVITIS. 
 
 outside of the lids in palpebral conjunctivitis (R); the Red Oxide as ointment, 
 10 grains to the £ of Vaselin (Bader) ; the Yellow Oxide, 8 to 10 grains to the 
 3 of Vaselin (Seely) ; yi grain in 3ij of Vaselin is strong enough. Carbolic 
 Acid, a 5 per cent, solution applied every two hours by spray of steam atomizer, 
 which dilutes it one-half, an extremely efficient application, relieving the pain 
 and contracting the vessels. Cocaine, the Hydrochlorate, in 3 to 5 per cent, 
 solution or oleate, applied to the palpebral conjunctiva, is a very efficient pal- 
 liative, especially where much pain and photophobia (Koller). Alum, Potassa 
 Alum after acute symptoms subside (Br) ; gr. iij-v ad ^ij aq. destil. brushed 
 over the conjunctiva twice daily. Pulsatilla, 3j-ij of tincture to ^iv aquae, as 
 wash several times daily, also mj-x internally every 3 or 4 hours (P). Opium, 
 the wine dropped into the eye relieves pain and improves the condition of the 
 conjunctiva (R) ; Morphine, gr. j-ij ad ^j, is often used in collyria with Zinc 
 Salts or Alum, but is irritant. Cadmium, as collyrium, gr. ij of the sulphate to 
 §j aquae rosae (B). Tannin, in Glycerin, Z) ad ^j, every second day in chronic 
 catarrhal conjunctivitis, presenting diffused injection of vessels with edema 
 (Hansell). Silver Nitrate, solutions of gr. j-iv to the §, applied by physician 
 to conjunctiva (R) ; should not be given to patient ; Zinc and Copper Salts are 
 preferred (B). Copper, the Sulphate crystal in chronic cases where great swell- 
 ing or hypertrophy of the papillary layer ; is too irritating to be entrusted to 
 the patient. Lead salts should never be used lest deposits occur in slight abra- 
 sions or ulcerations of the cornea. Sulphates, of Zinc, Copper, and Iron, with 
 Alum aa, gr. j to jfj of aq. destil. as collyria, extremely efficient ; in severe 
 cases may be used in saturated solution by the physician (Holmes). Castor 
 Oil, a drop placed in the eye often allays the pain and photophobia caused by 
 an irritant (R). Belladonna, locally and internally (B). Atropine in strong 
 solution, gr. iv to the ^, is one of the best local applications where mydriasis 
 is not objectionable. Euphrasia, as a mild astringent (P). Blisters, behind 
 the ears in bad cases (R). Ergot, the fluid extract locally gives excellent re- 
 sults in acute conjunctivitis (B). Staphisagria, especially in tarsal ophthalmia 
 (P). Colchicum, when gouty diathesis (A). Spigelia, in rheumatic form (P). 
 
 R 
 
 M 
 
 Zinci Sulphatis, 
 
 Morphinae Sulph. , . aa . gr. j. 
 
 Atropinae Sulph., . . . gr. ss. 
 
 Aquae Rosae, ^j. 
 
 Sig. — Eye- water . 
 
 R 
 
 Liq. Plumbi Subacetat., ^j. 
 
 Aquae Destillatae, . . . giij. 
 M. Sig. — For local use. To be brushed 
 over conjunctiva of everted lids by the sur- 
 geon and washed off with water. [Stiller.) 
 
 R. Hydrarg. Oxidi Rub., . gr. x. 
 
 Atropinae Sulph., . . . gr. j. 
 
 Vaselini, ^j. 
 
 M. Sig. — A minute portion as an oint- 
 ment for the eye. [Bader.) 
 
 R. Ung. Hydrarg. Nitrat., . gr. xx. 
 
 Cocainae Hydrochlorat., gr. v. 
 
 Vaselini Albi, gij. 
 
 Use a fresh ointment, triturate thor- 
 oughly, and label " Ointment for the eye. " 
 
 Conjunctivitis, Diphtheritic. 
 
 Zinc Chloride, gr. ij-iv to the j§, as collyrium, has succeeded admirably (Wa). 
 Atropine, locally throughout the disease ; not very effectual (Roosa) ; is, for 
 severe cases, powerless ; cornea sure to be attacked and liable to slough 
 (Noyes). Boric Acid, a 4 per cent, solution, as antiseptic, the best application, 
 with Quinine internally in full doses (Noyes). Iron, the Pyrophosphate for 
 children, 3j in ^iij of simple syrup, of which a teasp. thrice daily after meals, 
 with Quinine in 1- to 3-grain doses thrice daily and good food (Derby). Cold 
 by compresses as in purulent ophthalmia, in early stages. Silver Nitrate, in 
 10 grains to the ^ solution locally, or the mitigated stick in the second stage. 
 Tannin, gr. xx to the J of Glycerin, later on, applied every day, with hot water 
 lotions if corneal complications are present. 
 
CONJUNCTIVITIS. 6$ 5 
 
 Conjunctivitis, Gonorrheal. 
 
 Zinc Chloride, gr. j-ij ad ^j aquae, as collyrium, used with marked benefit 
 (Wa). Silver Nitrate, a 2-grain to the £ solution, after syringing out the eye 
 with warm water, followed by ice compresses, in hope to abort the attack, if seen 
 early (Roosa). Cold, by ice or wet compresses, essential in the early stages 
 (C). Atropine, may be used from the beginning, as corneal complications 
 begin very early. Treatment, is generally the same as for Purulent Conjunc- 
 tivitis; isolation and cleanliness are of prime importance. 
 
 Conjunctivitis, Granular. 
 
 Silver Nitrate, the diluted stick applied lightly and quickly (C) ; strong solu- 
 tions to granular lids, gr. xx to the 3 cautiously when corneal ulcers exist (B) ; 
 mild solutions better, gr. v to the § daily in the papillary form ; in miliary tra- 
 choma it should not be stronger than gr. ij to the 3 (Noyes) ; applications lose 
 their effect after a time, and should be changed (Roosa). Copper Sulphate, 
 the solid crystal lightly touched to the membrane once a day, the favorite 
 astringent and caustic in all forms of trachoma (Roosa) ; when the membrane 
 is torpid to other stimulation and when lymphoid substance is predominant ; as 
 ointment gr. v-x to the ^ of Vaselin, when for use by patient (Noyes). Alum, 
 a smooth crystal is a useful daily application (Noyes). Tannin, gr. x-xxx to the 
 £ of Glycerin, an application to change to from others (Roosa). Bismuth is one 
 of the numerous applications in chronic conjunctivitis and granular lids (B). 
 Phytolacca internally, is undoubtedly efficient in granular conjunctivitis (W). 
 Jequirity, to excite substitutive inflammation (see page 75). Atropine, gr. ij to 
 the 5, thrice daily, is often advisable, when moderate irritation and haziness 
 of the cornea (Noyes). Hygienic Measures, are of great value ; protection by 
 blue or smoked glasses ; rest of eyes, best secured by using Atropine collyria ; 
 hot or cold water as local bath frequently. Tobacco, must be avoided, also all 
 locations contaminated by impure air. Canthoplasty, of outer commissure 
 when the lids press on the globe. 
 
 Conjunctivitis, Phlyctenular. 
 
 Mercury, Calomel finely levigated and dusted from a camel's-hair pencil 
 over the membrane in phlyctenular ophthalmia, an excellent application, but 
 should never be used when Iodine is being taken ; in more obstinate cases a 
 small bit the size of a pin-head of Pagenstecker's ointment (Hydrarg. Oxidi 
 Flav. gr. j-iij, Vaselini gj), placed between the lids (Noyes). Ergot, the fluid 
 extract applied undiluted gives excellent results in the phlyctenular ophthalmia 
 of children (B). Antimony, Tartar Emetic gr. ¥ X g to -£% 3 or 4 times daily in 
 strumous ophthalmia, with sharp purgation at the outset (R). Belladonna, or 
 Atropine, locally in strumous ophthalmia, of great service in relieving pain ; 
 constitutional treatment also required (Wa). Arsenic, invaluable in inveterate 
 cases of strumous ophthalmia, especially when complicated with cutaneous 
 eruptions (Wa). Tannin, finely powdered and dusted over the everted lid, 
 gives remarkably good results in this and other forms of conjunctivitis, causing 
 very little pain and no inflammatory reaction (B). Carbonic Acid Gas, applied 
 to the eye is said to relieve the pain and photophobia of strumous ophthalmia 
 (R). Hydrastis, as lotion, is serviceable when Meibomian follicles are impli- 
 cated, causing adhesion of lids in the morning (P). Physostigmine, locally, 
 to reduce the pupil and shut out the light (P). Iodine, is employed locally in 
 strumous ophthalmia, for its alterative stimulation (W). Zinc Chloride, gr. 
 ij-ivio the ^, as collyrium, has succeeded admirably in pustular ophthalmia 
 (Wa). Zinc Sulphate, gr. j-iv to the ^, is very serviceable; the addition of 
 Liquor Plumbi improves its efficacy (Wa). Rhubarb, the Mistura Rhei et Sodae 
 
656 
 
 CONJUNCTIVITIS CONSTIPATION. 
 
 when much disturbance of digestion 'present. Tonics, may be given later, as 
 preparations of Cinchona and Iron. Cod-liver Oil, in strumous subjects, tends 
 to remove the manifestations of the disease (R). 
 
 Conjunctivitis, Purulent. 
 
 Alum, gr. ij ad ^j aquas, a sufficient astringent application in ophthalmia 
 neonatorum (Roosa) ; gr. viij ad ^j aquas, applied every % or */ 2 hour in the 
 purulent ophthalmia of children, its success depending on the frequency of the 
 application (R). Copper Sulphate, gr. j ad %] aquas camph. as collyrium in 
 purulent ophthalmia of infants (Wa). Silver Nitrate, gr. iij-x ad gj aquas 
 destil., rarely so strong as gr. x to the ^, applied by brush once daily to 
 everted lids in purulent ophthalmia of infants (Noyes) ; solution gr. j£ to the ^ 
 twice daily under lids (Meigs) ; by many considered needless and injurious 
 (Roosa). Boric Acid, a 4 per cent, solution, as antiseptic, is all that is neces- 
 sary in mild cases ; in others it is the proper fluid for cleansing the eye 
 (Noyes). Atropine, when the cornea becomes invaded and shows haziness, a 
 solution gr. ij to the ^ must be instilled every 3 hours (R). Cold, by ice or wet 
 compresses, essential in the early stages of acute purulent ophthalmia (C). 
 Cleanliness, of great importance ; as the discharge is infectious the patient 
 should be isolated and care taken to prevent inoculation of the other eye. 
 
 R. Sodii Boratis, gr. xij. 
 
 Zinci Sulphatis, . . . . gr. j. 
 
 Aquae Camph., .... ¥.]. 
 
 Aquae Destillat., . . . . 3J. 
 M. Sig. — Apply to lids 2 or 3 times 
 daily in ophthalmia neonatorum, with solu- 
 tion of Silver Nitrate, gr. 3^ to the ^ in- 
 jected under lids twice daily. [Meigs.) 
 
 R- . Sodii Boratis, gr. iij. 
 
 Aquae Rosae, Aquae, aa % > ). 
 M. Sig. — Apply beneath lids three or 
 four times daily after cleansing. 
 
 K 
 
 . Atropinae Sulph., . . . gr. j. 
 
 Glycerini, ^ss. Aquae, ^ij. 
 M. Sig. — Two drops into the eye. 
 
 Constipation. 
 
 Nux Vomica, gtt. j-ij of tincture, twice or thrice daily (R) ; gtt. v-x in a glass 
 of cold water before breakfast and dinner, often overcomes the most obstinate 
 constipation (P) ; especially useful when great fecal accumulations from torpor 
 of bowel (B). Sulphur, gr. x with Confectio Sennas, often succeeds after other 
 remedies fail (R) ; sulphurous mineral waters (B) ; or Sulphates in purgative 
 waters; frequent small doses (R). Podophyllum, the most generally used 
 cathartic when secretion deficient (B) ; gr. T x j to £ night and morning when 
 constipation with nervous and bilious headaches (P). Senna, as in the Pulvis 
 Glycyrrhizas Compos., which may be taken in doses of a teasp. to a tablesp. as 
 required, and kept up for months (Goodell). Mercury, Calomel or gray pow- 
 der as a cathartic (R). Hydrastis, very valuable when constipation is refer- 
 able to a sluggish liver (P). Magnesium, the Bicarbonate, a useful and mild 
 aperient (R). Alum, a cheap and serviceable laxative (B). Aloes, in minute 
 doses, in pill with Ferrous Sulphate, as the official Pil. Aloes et Ferri, is one of 
 the best agents in the management of chronic cases ; purgation should not be 
 aimed at. Chloral, is an efficient laxative in rebellious chronic constipation, 
 particularly that of neuropathic cases (De Holstein). Ipecacuanha, gr. j every 
 morning, fasting, when great torpor of bowel (R). Cocculus, flatus, hard 
 lumpy motions (P). Turpentine, in purely atonic constipation, with gaseous 
 distention of colon, has triumphed when all other remedies failed (P). Physos- 
 tigma, very effective in intestinal torpor (B). Stillingia, TT\,x of fluid extract 
 in habitual constipation (B). Castor Oil, a mild efficient cathartic (B). Am- 
 monium Chloride, in the so-called bilious state with constipation (B). Arsenic, 
 mjj of Fowler's solution often overcome constipation (R). Belladonna, gr. y 2 
 of the extract at night, in habitual constipation (B) ; gr. yi-% once a day, espe- 
 
CONVALESCENCE. 
 
 657 
 
 daily when dyspepsia (R) ; acts directly on the bowels as a stimulant (P). 
 Croton Oil, the most efficient cathartic, when simple impaction without inflam- 
 mation ; gtt.j-ij (B) ; whenevacuationsofblackenedfeces(R). Cascara Sagrada, 
 the fluid extract in doses of 3j, produces large, soft evacuations without grip- 
 ing, and leaves behind it a laxative influence. Frangula, in similar doses, is 
 equally efficient, but if from a fresh bark may produce griping. Cathartics, 
 especially Confectio Sennas, Pil. Rhei Compos., Pil. Aloes, the Comp. Cathar- 
 tic Pill, as well as those above (B) ; purgation as usually practiced was de- 
 nounced by the editor of the Lancet, October 1, 1870. Saline Waters, are use- 
 ful (B) ; Pullna, Friedrichschall, or Hunyadi,the first two with milk, are good 
 for children (R). Enemata, of soap-suds and salt, or a pint of cold water (B) ; 
 or Turpentine, Castor Oil, aa ^ss to Oss-j of gruel (P) ; the habitual use of 
 warm enemata increases topor of the bowels (R). Tamar-Indien, a favorite 
 mild aperient, is proprietary, and supposed to contain Cocculus, Glauber's salt, 
 etc. Aliment, important in habitual constipation ; corn bread, cracked wheat, 
 oatmeal, bread of unbolted flower, fruits, green corn, tomatoes and celery ; ]/ 2 
 dozen each of almonds and raisins daily. Water, a glass of cold water before 
 breakfast may overcome habitual constipation (B) ; drinking largely of water 
 is a most beneficial measure in cases of chronic constipation. Smoking a 
 cigar or a pipe after breakfast (R) ; tobacco smokers rarely suffer from consti- 
 pation. [Compare Intestinal Obstruction.] 
 
 R. Ext. Colocynth Co., . . gr. xij. 
 Ext. Belladonnae, . . . gr. ij. 
 Ext. Gentianae, .... gr. vj. 
 
 Olei Cari, gtt. iij. 
 
 Ft. pil. vj. Sig. — One pill at bedtime. 
 
 R. Podophylli Resinae, 
 
 Quininae Sulphatis, 
 
 Ext. Aloes, . . . 
 
 Fellis Bovini, . . 
 
 Ft. pil. no. xvj. Sig. 
 
 bedtime 
 
 . . gr. ij. 
 
 aa gr. viij. 
 • gr- xvj. 
 -One or two at 
 (Goodell.) 
 
 R . Ext. Rhamn. Pursh., FL, ^j. 
 
 Ext. Belladonnae FL, . gj. 
 
 Tinct. NucisVom., . . £ij. 
 
 Syrupi et Aquae, . aa ad ^ iv. 
 M. Sig. — Teasp. thrice daily in obsti- 
 nate constipation. {Clarke.} 
 
 Castor Oil Emulsion. 
 
 M. 
 
 R. 
 
 01. Ricini, 
 
 
 Glycerini, .... 
 Tinct. Aurantii, . . 
 
 aa 5J. 
 
 Tinct. Senegae, . . 
 Aq. Cinnamomi, q. s. 
 ft. emulsum. Sig.- 
 
 . . rtvv. 
 
 ad t ^ss. 
 —One dose, to 
 
 icen in the morning. 
 
 
 Artificial Hunyadi 
 
 Water. 
 
 Magnesii Sulphatis, 
 Sodii Sulphatis, 
 
 aa ^ ss. 
 
 Potas. Sulphatis, . 
 Sodii Bicarbonatis, 
 
 • g r - ij- 
 . gr. viij. 
 
 Sodii Chloridi, . . 
 
 . gr. xx. 
 
 Aquae, . . . q. s 
 
 ad^ viij. 
 
 M. Sig. — A winegl. before breakfast. 
 
 Convalescence. 
 
 Lime, as Lime-water, or the Carbonate, in convalescence from serious dis- 
 ease (R). Quinine or Hydrastine, to promote digestion and appetite (B). 
 Fats, especially Cod-liver Oil (R). Alcohol, before or during meals (R). 
 Koumiss, possesses great value (B). Bitters, especially Gentian and Calumba 
 (B) ; the latter especially when stomach weak (R). Eucalyptus, a serviceable 
 tonic (B). Coca, 3 ss— ij of the fluid extract at a dose (B). Guarana, gr. xv-^j 
 may be given (B). Opium, as Laudanum injected per rectum, for insomnia of 
 convalescents (R). Sea-baths, valuable in many cases (R). Nuclein, is used 
 with benefit. Orchitic Extract, has been employed with good results. Bone 
 Marrow, gives great satisfaction in anemic cases. Diet, requires the most 
 careful attention ; the prevalent error of giving food difficult of digestion too 
 early must be guarded against, especially in intestinal and gastric disorders ; 
 the strictest moderation should be enjoined. The symptoms must be watched 
 closely, and combated by appropriate medication. [Compare Adynamia for 
 Tonic Prescriptions, also Anemia.] 
 42 
 
658 
 
 CONVULSIONS CORNEAL OPACITIES. 
 
 Convulsions. 
 
 General Directions. — In all cases a horizontal posture, fresh air, clothing 
 loose ; a plug of soft wood or a cork between the teeth, to prevent biting the 
 tongue ; sprinkle the face and chest with cold water. Epileptic. — The general 
 directions above will usually suffice. Hysterical. — The diagnostic peculiarities 
 are : pupils not dilated but are sensitive to light, no wounding of tongue, 
 face not livid, pulse usually normal. Infantile. — Administer some anti- 
 spasmodic as Ether, alone or combined with Musk or Belladonna; then search 
 for any mechanical cause, as a pin in a dress, etc. ; lance the gums if dentition 
 the cause (A). Solanum Carolinense, has a good reputation in the southern 
 states for epilepsy and other convulsive affections, and has rendered excellent 
 service in my hands (Napier) ; a tincture is prepared by bruising the berries 
 and steeping them in whiskey, of which the dose is 3j, repeated until drowsi- 
 ness is produced. [Compare Albuminuria, Epilepsy, Hysteria, Puerperal 
 Convulsions, Uremia.] 
 
 Convulsions, Infantile. 
 
 Belladonna is of the highest value in certain congestive forms, as in fits due 
 to the irritation of teething, or those referable to whooping-cough (P). Ignatia, 
 is efficient in convulsions of children from intestinal irritation, no cerebral con- 
 gestion being present (P). Valerian, has been successfully used in convulsions 
 from the worms to which it is fatal (P). Potassium Bromide, in all forms of 
 convulsions in children (R) ; children bear it in large doses, gr. v thrice daily 
 or oftener for a child a year old, in convulsions from teething (Br). Chloral, 
 in large doses, gr. v, by mouth or rectum (Br) ; best used as a suppository rather 
 than by liquid injection, and is often very useful (R); it gives better results 
 than any other agent. Chloroform inhalations are of great service (R); useful 
 in all forms (B) ; should be used to arrest the convulsion and prevent recurrence 
 (Smith). Alcohol, has remarkable power in arresting convulsions of dentition ; 
 small doses of wine or brandy (W). Asafcetida, in the convulsions of teething, 
 a small portion in an enema, appears to mitigate them (Wa). Opium, efficient 
 but dangerous in young children. Veratrum Viride has been employed suc- 
 cessfully (R). Amyl Nitrite, gtt. v, with gr. % of Morphine, was used in one 
 case as a last resort after five hours' convulsions in a child of 18 months, 
 and resulted in producing quiet sleep (Engel). Hot Baths, are important, 
 with cold affusions or ice to the head (B). Spinal Ice-bag, may be very 
 efficient (R). 
 
 R. Chloralis Hydratis, . . gr. v. 
 Lactis, ....... |j. 
 
 M. Sig. — As rectal injection. Or the 
 dose may be made into a suppository 
 with cacao-butter and inserted well up into 
 the rectum. 
 
 R- . Sodii Bromidi, 
 
 Chloralis Hydratis, 
 
 Sodii Bicarb., . . . . aa gr. viij. 
 
 Aquae, ij- 
 
 M. Sig. — A teaspoonful every hour to 
 a child under four months old. 
 
 Corneal Opacities. 
 
 Cadmium, is said to promote their absorption ; gr. ij of the Sulphate to £j of 
 rose-water, as collyrium (R, Wa). Mercury, Calomel by insufflation, or the red 
 Iodide gr. ij, Cerate gr. xl, Olive Oil gtt. xx, as ointment, successfully used 
 (Wa) ; weak solutions of the Bichloride, or ointments of the Oxides, gr. % to 
 the %, as remedies among others to hasten absorption in recent cases (Arlt). 
 Oils, Eel-liver and Cod-liver Oils, Ox-gall, Juniper Oil, Oil of Turpentine com- 
 bined with Olive Oil, and others, dropped into the eye once or twice daily for 
 the same purpose (Arlt). Opium, the wine at first, then insufflations of Calomel 
 
CORNS — COUGH. 
 
 659 
 
 and Red Precipitate or Yellow Oxide ointment, frequently used in recent cases 
 (Arlt). Potassium Iodide, as ointment with Potassium Carbonate after Cod- 
 liver Oil or Oil of Turpentine with Olive Oil, in cases of longer standing (Arlt). 
 Silver Nitrate, gr. v-x ad ^j aquae, as lotion (C). Iodine, internally and as 
 collyria, has been efficacious, especially in strumous cases (Wa). Sodium 
 Chloride, gr. x ad ^j aquae destil., of which tt\,v-x injected subconjunctivally, 
 to hasten disappearance of turbidity (C). Operative Measures, only in case of 
 incrustations (as of lead and lime) situated superficially, by removal of epithe- 
 lium and anterior elastic layer ; deeper interference may lead to suppurative 
 keratitis. Excision of opaque cornea and transplanting of one from an ani- 
 mal's or a recently enucleated human eye (keratoplasty), has always failed. 
 Artificial pupil by iridectomy, for central opacities which are unremovable. 
 Tattooing to relieve deformity of disfiguring leucomata (Arlt). Pannus and 
 leucoma are best let alone (D). Stenopaic Spectacles, for semi-transparent 
 opacities in pupillary region (Donders). [Compare Keratitis.] 
 
 Corns. 
 
 Salicylic Acid, in strong solution, removes excess of epidermis, warts and 
 corns ; is the essential ingredient of all corn-cures. Silver Nitrate, solid, after 
 soaking and paring (Wa) ; the best application for soft corns and very irritable 
 ones (D). Acetic Acid, strong, to remove corns (Wa). Mercury, Corrosive 
 Sublimate in alcoholic solution locally to remove corns (Wa). Iodine, gr. xl ad 
 ^j Alcoholis, locally (Wa). Poultices, are useful ; or a plaster of soft material 
 with hole in centre (D). Water, hot and cold, alternately applied to inflamed 
 corns. Keep a corn thin by frequent washing and paring ; in performing the 
 latter the knife should work downwards to the apex of the corn, so as to remove 
 the central pressure on the subjacent tissue. 
 
 R. Acidi Salicylici, . . . gr. xv. 
 Extr. Cannabis Ind., . gr. vijss. 
 Alcoholis, 90 , .... rr^xv. 
 Athens, 62 ° TTLxxxvij. 
 
 Collodii Flexilis, . . . TT^lxxv. 
 Mix, and keep in closely-corked vial. 
 Paint the corn every other day for a week, 
 then it can be easily squeezed out. 
 
 ( Vigier.) 
 
 Cough. 
 
 Opium, in some form, is much used in cough-mixtures ; Morphine and Gly- 
 cerin applied to fauces (B) ; moderate doses are useful in irritative affections 
 of the air-passages to allay irritation and hypersecretion, but it may do even 
 fatal mischief in cases where secretion is copious and expulsory power feeble 
 (P) ; opiates inadmissible when with copious expectoration there is any indica- 
 tion of bronchial congestion (Wa); very useful in violent and frequent cough 
 with little rhonchus and no signs of obstructed oxidation ; also, when cough is 
 due to red, inflamed and ulcerated throat; Opium or Morphine given so as to 
 cling for some time in contact with the pharyngeal structures (R). Codeine, is 
 often efficient in cough (Br); of particular value in %-gr. doses; is slightly 
 expectorant, also laxative, does not nauseate or cause vomiting, or affect the 
 appetite; is by far the best agent for the cough of phthisis when morphine is not 
 well borne (Kobler). Peronine is intermediate in its effects between morphine 
 and codeine, and has a very quieting action on the paroxysmal cough of 
 phthisis (Schroder) ; gr. yi~H thrice daily, the latter dose giving a quiet night's 
 sleep, even in cases where morphine and codeine were ineffective (Munk). 
 Heroine and Dionine, are very useful [see page 399.] Nux Vomica, in laryn- 
 geal cough of neurotic origin, drop doses of the tincture every five minutes ; 
 is promptly efficient (Macfarlan) ; has specific action on the pneumogastric, 
 and is one of the most efficient remedies in cough of any kind, whether from 
 bronchitis, pneumonia, phthisis or emphysema, but especially in nervous 
 coughs and periodic coughs which come on in the evening and stay all night 
 
660 COUGH. 
 
 {Jour, de Med.). Pulsatilla, as Anemonine, % gr. and gr. doses, very useful 
 in irritative cough, asthma, whooping-cough (P). Iodine, by inhalation 
 for children in hoarse, hollow cough, wheezing (R) ; the tincture, 5-10 drops, 
 inhaled from boiling water for five minutes at bedtime, often gives most signal 
 relief in the irritating cough of phthisis. Apomorphine Hydrochlorate, very 
 valuable in cough where there is persistent hacking without expectoration, or 
 with difficult expectoration ; the dose is only gr. ^ to T X F in the 24 hours ; 
 solution rapidly alters unless a few drops of Hydrochloric Acid are added 
 (Stocquardt). Terpin Hydrate, in bronchial cough, and night-cough from 
 habit, is very efficient in a 2-grain dose at bedtime, repeated early in the 
 morning (Boyland). [See under Bronchitis, Chronic, for formula.] Aconite, 
 irritable, tickling throat-cough ; short, dry cough of asthmatics, with anxious 
 look and full, strong pulse (P). Belladonna, often useful ; no indications (R) ; 
 internally and externally as plaster to the chest, very serviceable in spasmodic 
 and nervous coughs (Wa). Hyoscyamus, very useful in spasmodic tickling 
 night coughs (P). 
 
 Hydrocyanic Acid, for nervous, irritable cough and cough of phthisis, also 
 mother's sympathetic cough (B); no more certain palliative for simple, ner- 
 vous cough due to irritable state of the system (S) ; a valuable adjunct to ordi- 
 nary remedies in cough of phthisis (Wa). Potassium Cyanide, is equally 
 useful, gr. iij with ^j each of Ext. Grindeliae Fl., Syr. Scillae and Syr. Tolutan., 
 makes a good non-opiate cough mixture, of which the dose is 3j every 4 hours 
 (Waugh). Prunus Virginiana, has some influence, due to its Hydrocyanic 
 Acid ; is much used in cough mixtures (P). Laurocerasus, used as a substi- 
 tute for Hydrocyanic Acid in spasmodic coughs (B). Conium, supposed. to be 
 useful (R) ; is very useful in spasmodic cough (Wa). Ipecacuanha, the fid. 
 extr. for troublesome night-cough (B) ; in obstinate winter-cough, with wheez- 
 ing, the wine as spray to fauces, efficacious (R) ; in coughs of childhood Ipecac 
 is one of the most generally serviceable expectorants we can use (Wa). 
 Lobelia, dry cough, continued tickling sensation, even in sleep (P). San- 
 guinaria, combined with Hyoscyamus, in nervous, spasmodic cough (P). 
 Senega, as a stimulant expectorant in the cough of chronic bronchitis and 
 subacute chest affections. Gelsemium, excessive irritability of the respiratory 
 centre (R) ; often remarkably relieves convulsive or spasmodic, reflex and ner- 
 vous coughs (B). Alum, internally in spasmodic cough ; gr. x to ^j aquae as 
 spray, in chronic cough also (R). Drosera, the fluid extr. in y z teasp. dose to 
 an adult every 2 or 3 hours, of high value when spasm predominates. [See 
 page 306.] Potassium Bromide, serviceable in various reflex coughs (uterine, 
 renal, etc.). and in cough of phthisis it is occasionally ameliorative as a gargle 
 (B). Cubeb, 3ss-j of the tinct. in half-glass of Linseed tea thrice daily, often 
 cures like a charm the coughs of chronic catarrh, of emphysema, or acute 
 catarrh, or following an attack of influenza (R). Asafcetida, its value due to 
 the sulphur in it (Garrod) ; very serviceable in after-cough from habit, and in 
 mother's sympathetic whooping-cough (B). Carbolic Acid, as spray, a 5 per 
 cent, solution in a steam atomizer will often prevent as well as cure a cough from 
 cold. Valerian, in asthmatical and hysterical coughs (P). Chloroform, with 
 Morphine and molasses in paroxysmal dry cough; may be painted on throat 
 also (R) ; in irritable reflex cough, the vapor of a teaspoonful of the spirit may 
 be inhaled from the surface of hot water, and repeated every five minutes for 
 four or five times (B) ; the inhalation of small quantities of chloroform gives 
 the greatest possible relief in the irritable cough of phthisis (Spencer Wells). 
 Chloral, in convulsive coughs, ameliorates symptoms after hypnotic effect 
 (Wa). Camphor, equal parts of Camphor and Chloral triturated together are 
 said to allay spasmodic cough when painted over larynx (B). Glycerite of 
 Tannin, applied to throat when chronically inflamed and so producing cough ; 
 often the case with children (R). Grindelia, used in cough of habit and spas- 
 modic cough (B). Squill, in catarrhal cough, should not be employed until 
 active inflammation has subsided (Wa); the syrup or vinegar of Squill is the 
 best preparation for cough with tickling in the throat (P). Cod liver Oil, in 
 
COXALGIA CROUP, CATARRHAL. 
 
 66 1 
 
 chronic coughs (R). Lactucarium, the syrup as vehicle in cough-mixtures (B). 
 Chamomile Oil, gtt. ij-viij, in coughs due to heightened reflex irritability, 
 especially in hysterical women (P). Pix, Tar-water in winter cough, especially 
 when paroxysmal (R) ; allays the cough of bronchitis and phthisis (P) ; the 
 Plaster as rubefacient and counter-irritant in chronic coughs (Wa). The fre- 
 quency and violence of nervous coughs may be controlled by a determined 
 effort of the patient's will. [Compare Bronchitis, Pertussis, Phthisis.] 
 
 Prescriptions for Cough Mixtures. 
 
 R. Spiritus ^Etheris Nitrosi, zij. 
 
 Vini Ipecac, 3 ss. 
 
 Tinct. Opii Deodorat., . %]. 
 
 Syrupi Tolutani, q. s. ad j ij. 
 M. Sig. — A teaspoonful twice or thrice 
 daily . (Bowditch . ) 
 
 R. 
 
 Liq. Morph. Magendie, 
 
 Spt. Limonis, . . aa gj. 
 
 Syr. Ipecac, 
 
 Spt. Lavand. Comp., aa giv. 
 
 Syr. Scillae Comp., 
 
 Syr. Tolutani, . . aa ^j. 
 
 Syr.Pruni Virgin. ,q.s. ad |jvj. 
 M. Sig. — A teasp. as required. 
 Each dose has of Morph. Sulph. gr. 2V 
 
 R . Codeinae, gr. v. 
 
 Alcoholis, . . q. s. ad solv. 
 
 Potassi Cyanidi, . . . gr. v. 
 
 Syr. Scillae, Ij. 
 
 Aquae, . . . q. s. ad Jiv. 
 M. Sig. — A teasp. every 2 or 3 hours 
 for irritable cough. {Potter.) 
 
 R. Mist. Glycyrrh. Co., . . Jij. 
 Syr. Pruni Virginianae, 
 Syr. Tolutani, . . aa 3jj. 
 M. Sig. — Half teaspoonful 3 or 4 times 
 daily for infants, teaspoonful doses at I to 
 2 years, larger doses for older children. 
 
 R . Tinct. Opii Deodorat., 
 
 Vini Antimonii, . aa ^ss. 
 
 Ext. Valerianae Fl., 
 
 Syr. Simplicis, . . aa j^ij. 
 
 Aquae, '|jss. 
 
 M. Sig. — A teaspoonful every hour or 
 two until cough controlled. For those of 4 
 years and upwards. {Meigs & Pepper.) 
 
 R . Tinct. Sanguinariae, 
 
 Tinct. Lobelias, . . aa gjss. 
 
 Vini Ipecac, ^ iij . 
 
 Tinct. Opii Camphorat., 
 
 Syr. Scillae, . . . . aa Sjjss. 
 
 Aquae Cinnamomi, . ad £ vj. 
 M. Sig. — 3J every three hours in the 
 cough of bronchitis. (Potter.) 
 
 Coxalgia. 
 
 Barium Chloride, in considerable doses (gr. j-ij) persevered in for a month, 
 is thought to be most valuable in scrofulous diseases of the joints (Wa). Sul- 
 phuric Acid, Z] ad ^j Adipis, as ointment, persevered in, has resulted in great 
 benefit ; a powerful irritant (Wa). Counter irritation, by blisters around the 
 hip, with perfect rest in the straight posture, Cod-liver Oil, etc. (D). Ferrous 
 Iodide, in scrofulous diseases of the joints, with Cod-liver Oil and nutritious 
 diet (Wa). Iodoform, very successfully used by many continental practition- 
 ers in scrofulous diseases of the joints (Wa). Cod-liver Oil, the remedy on 
 which most reliance is to be placed (R). [Compare Abscess, Caries, Suppu- 
 ration, Synovitis.] 
 
 Croup, Catarrhal. 
 
 Aconite, valuable (R) ; has been employed with the best results (P) ; gtt. % 
 to j every half hour, until an impression is made on the fever movement, 
 then every hour or two (B). Hot Water, applications beneath the chin and 
 along the whole course of the larynx (Wa). Hot fomentations or turpentine 
 stupe to throat (El) ; hot bath (95°-io2°) in the paroxysm, a good method 
 (M & P). Potassium Bromide, locally, a solution by atomization, has proved 
 highly efficient in spasmodic croup (Wa). Lobelia, has been used with occa- 
 sional success (P). Ipecacuanha, the syrup or fluid extract as an emetic at the 
 
662 
 
 CROUP, MEMBRANOUS. 
 
 outset (El) ; is a slower emetic than Tartar Emetic (P) ; the syrup to vomiting 
 during the paroxysm, and tt\,v-x every 2 or 3 hours next day (M & P). [Com- 
 pare Laryngismus Stridulus.] 
 
 U . Potassii Citratis, 
 
 S'h 
 
 Syr. Ipecac, ^ij. 
 
 Tr. Opii Deodorat. , . . gtt. xij. 
 
 Syr. Simplicis, . . . . ^ij. 
 
 Aquae, vU ss * 
 
 M. Sig. — Teaspoonful every two hours 
 at 2 years of age. In severe form of spas- 
 modic laryngitis. (M. 6° P. ) 
 
 R. Tinct. Belladon., . 
 
 Tinct. Opii Camph. 
 
 Pulv. Aluminis, . . 
 
 Syr. Acaciae, . . . 
 
 Aquae, 
 
 M. Sig. — Teaspoonful every 2 or 3 
 hours at 6 months old when cough fre- 
 quent and harassing. [M. 6° P. ) 
 
 gtt. iv. 
 gtt. 1. 
 gr- vj. 
 Sss. 
 ;jss. 
 
 Croup, Membranous — Laryngeal Diphtheria. 
 
 Mercury, a remedy of established value, gr. ss-j of Calomel, with gr. yi-% 
 of Ipecac, according to age every 2 hours, with local and other general meas- 
 ures, especially the use of a hot {7o°-y$°) and moist atmosphere (Wa) ; the 
 Sub-sulphate, given early, is the best emetic, gr. iij-v ; Calomel is strongly 
 urged as a laryngeal sedative and aplastic agent, allaying laryngeal spasm and 
 preventing formation of membrane (B). Alum, one of the best emetics in this 
 disease, a teasp. in honey or syrup, repeated every ten or fifteen minutes until 
 it operates (M & P) ; a very useful and non-depressant emetic (B). Sanguinaria, 
 by many considered specific, is undoubtedly the best emetic for this disease 
 (P) ; is too harsh and too uncertain in action (B). Tartar Emetic, as an 
 emetic, has established value in croup (W) ; is injurious, too depressant (B). 
 Potassium Chlorate, as alkali, after emetics, the most reliable internal remedy, 
 gr. ij-iij every 2 hours to a child of 4 years (M & P). Ferric Chloride, may be 
 combined with the preceding, in doses of 3-5 drops of the tincture at the 
 same age (M & P). Emetics, besides the above, are : Copper Sulphate, in 
 small frequent do'ses (R) ; Ipecacuanha, inferior to Mercury (B) ; in severe 
 cases vomiting should be caused 2 or 3 times a day, and should be commenced 
 early (R) ; Apomorphine, effective, but highly dangerous (B). Senega, is con- 
 sidered a valuable auxiliary (P) ; has been employed (R). Quinine, in full doses 
 is highly useful (B). Sulphurous Acid, as spray, hourly or more frequently 
 (R). Tannin, a 5 per cent, spray, several times a day for 15 or 20 minutes 
 at a time (R). Hydrogen Dioxide, the solution, 1 in 4 of water, copiously 
 sprayed over the nose, throat, mouth, etc., to destroy the membranes and pre- 
 vent their reproduction ; then Glycozone, a teasp. in a winegl. of water thrice 
 daily internally, prevents any disturbance of the stomach and regulates the 
 bowels (Edson). Lactic Acid, as solvent of membrane (B). Iodine, the tinc- 
 ture externally, affords great relief and tends to prevent formation of false 
 membrane (Wa). Water, warm bath, hot fomentations or compresses to the 
 throat ; watery vapor in room. Steam inhalations, with a few drops of Iodine 
 or Bromine. Diet, water only in small quantities during attack ; supporting 
 diet may be required afterward. Lime-water, by vaporization, or inhalations 
 of the vapor of slaking lime for a few minutes in every hour, or some other 
 alkaline solution during the whole treatment (M & P). Tracheotomy, fully 
 justifiable, 21^ per cent, recovered out of 1024 operations; should be done 
 when paroxysms become very frequent, and dyspnea is rather persistent than 
 paroxysmal (M & P). [Compare Laryngitis, Diphtheria.] 
 
 R. Pulv. Sanguinarias, . . gr. xx. 
 
 Pulv. Ipecac, . . . . gr. v. 
 
 Syr. Ipecac, ^ij. 
 
 M. Sig. — A teasp. every % hour until 
 emesis, then y 2 teasp. every hour. (P.) 
 
 R. Acidi Lactici, giijss. 
 
 Aq. Destillat., . . . . §x. 
 M. Sig. — To be used as a spray, or ap- 
 plied by a mop. 
 
 [London Throat Hospital.} 
 
CYANOSIS — CYSTITIS. 
 
 66 3 
 
 Cyanosis. 
 
 Amyl Nitrite, by inhalation, often gives marked relief (P). Quebracho, in 
 that from asthmatic attacks of consumptives, lessened the cyanosis or entirely 
 relieved it (Rohrer). Oxygen, by inhalation in the cyanosis of asphyxia from 
 toxic gases or due to opium and chloroform narcosis. Leeching is of service, 
 in a manner not easily understood (P). Treatment must depend on the nature 
 of the lesion or disease giving rise to the cyanotic condition (A). [Compare 
 Asphyxia, Asthma, Dyspnea, Heart Affections.] 
 
 Cystitis, Acute. 
 
 Belladonna, is a good remedy in almost every form of vesical irritation (G) ; 
 very useful in recent catarrh from chill, with pain (P). Cantharis, in large 
 doses causes inflammation of the urinary tract, but gtt. j of the tincture every 
 hour will often relieve vesical catarrh (Smith) ; in small doses continued very 
 efficient (B) ; gtt. j-v of the tincture thrice daily, when bladder is irritable, its 
 sphincter weak, and pain along the urethra (P) ; may be employed in cystitis 
 with benefit (R) ; in small doses the best remedy for acute cystitis. Aconite, for 
 febrile symptoms (P). Quinine, often useful for acute symptoms (B). Iodoform, 
 in suppository for painful cystitis (R). Opium, a rectal injection of Starch and 
 Laudanum will subdue pain and prevent the frequent micturition (R) ; danger- 
 ous if the kidneys are diseased (P). Alkalies, the Citrates and Bicarbonates if 
 urine is highly acid ; stop when it becomes alkaline (R); Liquor Potassae in 
 barley-water or in a decoction of Triticum repens, preferred to all other alka- 
 lies ; urine must be maintained at a neutral or very slightly acid reaction 
 (Thompson). Urotropin, an excellent urinary antiseptic. [See page 430.] 
 Cannabis Indica, an excellent anodyne in all bladder cases, having specific 
 effect on that organ. Rest in horizontal posture, mucilaginous drinks, hot 
 fomentations and hip-baths, laxatives for the bowels, light food. Milk-diet often 
 necessary, especially in children. [Compare Bladder Irritable, Calculus, 
 Dysuria, Enuresis, Hematuria.] 
 
 R . Atropinse Sulphatis, . . gr. j. R . Pulv. Opii, gr. xij. 
 
 Acidi Acetici, .... gtt. xx. Camphorse, gr. xxx. 
 
 Alcoholis, Ext. Belladonnas, . . . gr. iij. 
 
 Aquae, aa ^ss. 01. Theobrom., . . . . q. s. 
 
 M. Sig. — Four drops in a winegl. of M. et div. in supposit. no. vj. 
 
 water before each meal. (G.) Sig. — One to be used at bed-time. 
 
 Cystitis, Chronic. 
 
 Benzoic Acid, and the Benzoates, in chronic cystitis from any cause, when 
 urine is alkaline (B) ; has some balsamic character, and is useful in some cases 
 of chronic cystitis ; gr. xxiv in the day at least, in pills made with Glycerin 
 (Thompson). Sodii Benzoas, 3j in Tinct. Gelsemii 3 ij — iij , and water to ^vj, 
 makes an excellent wash for painful cystitis of old men with enlarged prostate ; 
 a fluidounce should be warmed and injected and retained 20 to 30 minutes 
 (Copeland). Alkalies, when urine is acid ; the Liquor Potassae, with Hyoscya- 
 mus as an anodyne, preferred notwithstanding its chemical incompatibility, to 
 control painful and frequent micturition (Thompson) ; Bicarbonates or Citrates 
 better, as the strong reaction of liq. potassae unfits it to be given in doses suffi- 
 ciently large to affect in any great degree the reaction of the urine (R). 
 Triticum, is very efficient as an internal remedy, §ij-iv of the rhizome boiled 
 in a quart of water until reduced to a pint, this strained to be taken in four doses 
 in the 24 hours (Thompson) ; a very useful remedy (Pancoast). Buchu, is 
 probably the most efficient of the urino-genital remedies, the fluid extract in 
 doses of Tr\,x-3j (B) ; the best drug in chronic cystitis, especially when the 
 
664 
 
 CYSTITIS, CHRONIC. 
 
 catarrh implicates the ureters or the kidneys themselves, producing considera- 
 ble muco-purulent discharge (P). Uva Ursi, is decidedly effective (P) ; is less 
 so than Buchu (B). Stigmata Maydis, an infusion, 31J to the pint, a wine- 
 glassful every 3 or 4 hours, has been used internally with considerable success 
 (Dessein). Pareira, considered superior to Uva Ursi (Brodie) ; often very suc- 
 cessful (P). Chimaphila, is often very efficient, but is more actively diuretic 
 than the above-named remedies (B) ; by many practitioners it is considered 
 the best remedy for chronic cystitis. Copaiba, is very useful by virtue of its 
 local action on the mucous membrane, but objectionable for its nauseous taste 
 and resulting gastric disturbance (B). Cubeb, is often useful from its stimu- 
 lating effect (P). Turpentine, has been useful in many cases (R) ; when cys- 
 titis is due to urethral inflammation or prostatic disease (B). Juniper, the oil 
 is indicated under the same conditions as is Turpentine (B). Eucalyptus, there 
 is no moreefficient remedy in chronic cystitis than this (B) ; the oxygenated oil 
 of Merck is best, in doses of 3 drops on sugar every 6 or 8 hours. Myrtol, has 
 been used with excellent results in the Paris Hospital. Salicylic Acid, in large 
 doses, either internally or by injection into the bladder, is most efficient (B); 
 the acid or Salicylates often useful to prevent decomposition (P). Salol, proves 
 an efficient disinfectant, as its constituents are excreted with the urine ; solu- 
 tions of 5 to 10 per cent, in Retinol gave gratifying results in subacute cases 
 of obstinate character, where other agents were of no avail ; this solution 
 remains in the bladder, in diminishing quantity of course, after 6 or 8 urina- 
 tions (Desnos). Camphoric Acid, in % to 3 per cent, solution in hot water, as 
 injection, has cured several cases. Carbolic Acid and Sulpho-carbolates, to 
 preserve the urine sweet (R). Sulphites will accomplish the same object (B) ; 
 Silver Nitrate, by intra-vesical injection, gr. j in giv to begin with, increased 
 gradually to gr. % to the ^ at most (Thompson) ; stronger solutions are advo- 
 cated by Professor Richardson of New Orleans, and Professor Gardiner of 
 McGill College, Montreal; in the writer's experience a solution of gr. v to the 
 ^ used as a vesical wash, has been promptly efficient in curing many cases 
 which resisted other treatment for months, — it sometimes produces serious 
 symptoms, and it is therefore well to have a neutralizing solution of Sodium 
 Chloride on hand for use if required. Other Injections, which may be used to 
 wash out the bladder are — Lead Acetate, gr. j to Jiv of warm water, once 
 daily ; Nitric Acid, dilute, Tty-ij to ^j of water. Tannic Acid, gr. j to ^j ; 
 Borax, ^j to ^ij of glycerin and J;ij of water, of which ^ss in Sjiv of warm 
 water for one injection ; Quinine, gr. j-ij to ^j of water, with a drop of 
 Acetic Acid. All injections must be used with great care, not more than ,^ij 
 forced in at once and that very slowly ; use flexible catheter, warm solutions, 
 and a rubber injecting-bottle with a long nozzle and stop-cock (Thompson); 
 washing the bladder is of great value (R). Evacuation of the urine, some of 
 which is often retained in the bladder, is a matter of great importance. Ergotin, 
 hypodermically, increases the contractile power of the bladder, and enables 
 it to empty itself more perfectly (Langenbeck). Pichi, the fluid extract, rrvxx 
 to xxx four times daily, gave excellent results in bad cases of long standing, 
 urine being alkaline, ammoniacal, ropy and purulent (Delamere). [Compare 
 Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.] 
 
 R. Uvse Ursi Fol., 
 
 Pareirae Radicis, . . aa^j-ij. 
 Sig. — Boil in 3 pints of water until re- 
 duced to a quart, then strain, and take I 
 or 2 wineglassfuls 3 or 4 times daily. 
 
 (Thompson.) 
 
 R. Ext. Tritici Repentis Fluidi, 
 Syr. Amygdalae, . . . aa^ij. 
 M. Sig. — A dessertsp. in water 5 or 6 
 times daily. [Pancoast.) 
 
 R . Quininas Sulphatis, . . 3 ss. 
 
 Acacias, sjij. 
 
 Morphinse Sulphatis, . gr. jss. 
 
 Aquae, . . . q. s. ad Jiij. 
 M. Sig. — A tablesp. to 3^ ounces of 
 warm water, which inject in 3 parts, daily. 
 
 R . Sodii Boratis, Jj. 
 
 Glycerini, 
 
 Aquae, aa^ij. 
 
 M. Sig. — Tablesp. in four ounces of 
 warm water as an injection. 
 
CYSTS DEAFNESS DELIRIUM. 665 
 
 &. Argenti Xitratis, . . . gr. vij. R. 01. Terebinth., . . . . ^ss. 
 
 Aquae Destillat., . . . Jiijss. • I Carnphone, gr. xv. 
 
 M. Sig. — Injection every third or Extr. Hyoscyami, . . gr. ss. 
 
 fourth day after washing the bladder out \ Fiat massa. Sig. — Take a piece the size 
 with warm water. {Ricord.} of a cherry-stone morning and evening. 
 
 ( Chauvel. ) 
 
 Cysts. 
 
 Iodine, by injection very effective in cysts of the neck, and sometimes in 
 unilocular ovarian cysts (B) ; after tapping (R). Silver Nitrate, gtt. v-x of a 
 strong solution (gr. xx ad 3ij), as injection into cystic tumors (wens), after 
 allowing the contents to escape, will cure by setting up adhesive inflammation 
 (B). Galvano-puncture will permanently occlude cysts of the neck (B). Aurum 
 Chloride, may sometimes cure ovarian dropsy (B). Remedies, internally, have 
 all proved worthless (E). [Compare Ovaritis.] 
 
 Deafness. 
 
 Quinine, cures some forms, and often causes deafness (Brown-Sequard). 
 Gycerin, for dryness of meatus ; also to form a film to ruptured tympanum 
 (R) ; either alone or in combination with Olive Oil (P) ; effects are temporary 
 (\Va). Tannin, the glycerite as application for throat deafness (R). Gelse- 
 mium, the tincture, TT^xv-xx, repeated 2 or 3 times a day, is often useful in the 
 treatment of nervous deafness, and seems to have an influence on the organ 
 of hearing similar to that of Nux Vomica on the organ of sight. Colchicum, 
 when from gout in ear (A). Cantharides, as ointment; gr. xxx ad |jj Adipis, 
 below and behind the ear bis die, with alterative mercurial treatment, in deaf- 
 ness from thickened tympanum (Wa). Collodion, contractile, applied to the 
 membrana tympani, in deafness from relaxation of the membrane, has exerted 
 a permanently beneficial influence, even in cases of long standing (Wa). 
 Turpentine, gtt. xl in J;ss Glycerin, a few drops into the meatus in deafness 
 depending on deficient secretion of cerumen, results in much benefit (Wa). 
 Morphine, gr. ss, sprinkled on surface behind the ear denuded by a small blis- 
 ter, has proved curative in chronic deafness, after all other remedies had failed 
 (Wa). Gargles, in throat-deafness are of great value ; of Potassium Nitrate, 
 Borax, etc., in sthenic cases ; tincture of Capsicum added in nervous forms ; 
 of Hydrargyrum Bichloride when from secondary syphilis (Wa). Water, 
 washing in warm water, in deafness from general debility (Toynbee). Faradi- 
 zation of the ear in nervous deafness, in which slight results only to be expected 
 from the treatment (R); demands the utmost caution (Wa). Inflation, by the 
 Politzer bag, or Eustachian catheter, in throat deafness. Remove wax from the 
 external canal. 
 
 Delirium. 
 
 Belladonna, in delirium of typhus and other fevers (R) ; in severe forms of 
 delirium (P). Hyoscyamus, in delirium of typhus ; for the mild, less inflamma- 
 tory form, with hallucinations, nervous excitement, little cerebral congestion 
 (P). Stramonium, in wild and furious delirium of puerperal mania, with gen- 
 eral restlessness and suicidal or destructive tendency (Wa) ; no drug deserv- 
 ing of more confidence in the greater number of maniacal cases (Cullen). 
 Opium, in traumatic delirium, as a rectal injection, combined with Tartar 
 Emetic in fevers ; or better still Morphine hypodermically ; Laudanum in low, 
 muttering delirium (R) ; is regarded with suspicion (P). Cannabis Indica, the 
 extract in doses of gr. Y,- l A in nocturnal delirium occurring in softening of the 
 brain (Wa). Potassium Bromide, in delirium resembling delirium tremens 
 (R). Camphor Monobromide, useful in rambling delirium (Wa). Camphor, in 
 
666 DELIRIUM TREMENS. 
 
 20 grain doses, every 2 or 3 hours, especially in low muttering delirium (R). 
 Chloral, in violent delirium of fevers (R). Antimony, in delirium of fevers (R). 
 [See Fever.] Water, the cold douche in maniacal delirium ; place patient 
 in warm bath during application (R). [Compare Cerebral Congestion, 
 Fever, Mania.] 
 
 Delirium Tremens. 
 
 Chloral, at outset (R) ; very successful, but dangerous to old drunkards or 
 when heart disease exists (B) ; the experience of inebriate asylum physicians 
 does not bear out the teaching that chloral is dangerous to old alcoholic 
 cases, being by them commonly given in 30-grain doses every 3 or 4 hours 
 until sleep is induced, without apparent danger. Belladonna, of proven effi- 
 cacy when congestion of the brain (P) ; useful for the insomnia when coma 
 vigil, cold surface, cyanosis (B). Stramonium can do all that Belladonna can 
 do, and is more powerful (Tr). Hyoscyamus, in some forms admirable (P). 
 Hyoscine, is a useful drug in delirium tremens, and in other affections in which 
 tremor is a marked symptom (Weatherly). Duboisine, is even more sedative 
 and hypnotic than Hyoscine. Opium, cautiously, if at all (B); as rectal injection, 
 hypodermically or with spirits ; if patient strong, delirium boisterous, and pulse 
 full, add Tartar Emetic or Aconite (R). Bromides in the " horrors " preceding 
 the delirium, 3j every 4 to 6 hours ; are of less value in the delirium, and in 
 subsequent attacks (R) ; Ammonium Bromide has been used with very good 
 results (Wa). Chloroform, inhalations to procure sleep (R); anesthetics are 
 dangerous (B). Cannabis Indica, gr. ss-j of extract, one of the least dangerous 
 and most useful hypnotics (P). Tartar Emetic, as hypnotic (B) ; combined 
 with Opium to control mania and insomnia (R). Capsicum, to induce sleep in 
 early stages, gr. xx-xxx in a bolus with honey, repeated after three hours (R); 
 in 20-30 gr. doses has remarkable success (P) ; the tincture in 3ss doses every 
 three hours of great benefit (Wa). Nux Vomica, or Strychnine, should be 
 more freely used than it is in alcoholism, and in delirium tremens may be 
 used hypodermically almost to the commencement of tetanic action (Luton). 
 Arnica, the tincture is exceptionally serviceable in cases where there is depres- 
 sion (B). Coffee, often exceedingly useful (P). Digitalis, 3ss of tincture re- 
 peated in 4 to 6 hours (R) ; a tablesp. of the infusion every 4 hours in pale 
 subjects, where anemia of brain, with effusion, and edema (B) ; has cured 
 many cases promptly without producing any unfavorable symptoms ; its safety 
 and efficacy are alike questionable (Wa). Cimicifuga, an excellent tonic for 
 the nervous system, is very successful (P). Quinine, with a mineral acid to 
 restore digestion, in the "horrors," and in adynamic states (B); gr. j two or 
 three times daily as a tonic, the best agent to produce nervous tranquillity 
 (Anstie). Sumbul, very efficient for insomnia (P). Zinc Phosphide, gr. jss 
 daily, in divided doses, for many weeks, is used with decided benefit. Zinc 
 Oxide, is of essential benefit as a nerve tonic and sedative, gr. ij-viij, twice 
 d,aily, gradually increased to the higher dose named (Wa). Lupulin, the tinc- 
 ture or oleo-resin; useful in mild cases as stomachic tonic and cerebral sedative 
 (B). Ammonium Carbonate, when anemia of brain and feeble heart-action 
 (B). Conium, combined with Opium, is useful (P). Alcohol, of undoubted use 
 where failure of stomach to appropriate food (B) ; is best omitted entirely from 
 the treatment, the experience in inebriate asylums showing that cases recover 
 more rapidly and surely without alcohol. Water, about 6o° with ice to head, to 
 reduce temperature in the hyperpyrexia (R). Treatment, should tend to nour- 
 ishment and establishing of digestion ; concentrated liquid food with moderate 
 use of stimulants (H). Diet and Hygiene, the immediate source of danger is 
 exhaustion, hence animalized and nutritious, digestible diet should be used in 
 fluid form, small quantities frequently repeated; beef tea, soups, yolk of eggs, 
 warm milk, cocoa, cayenne pepper or stimulants in soups ; coffee to still ner- 
 vous excitement ; hot baths and wet pack to eliminate the poison ; a quiet, 
 
DEMENTIA PARALYTICA — DENGUE — DENTITION. 
 
 667 
 
 darkroom ; sleep a necessity, often induced by Belladonna. [Compare Alco- 
 holism ; also page 138, for Treatment of Delirium Tremens.] 
 
 R . Tinct. Capsici, 
 
 Ext. Lupulini Fl., . . aa.%). 
 
 Mucil. Acaciae, . . . . 3 ss. 
 
 Aquae Cinnamomi, . . ^jss. 
 M. Sig. — Dessertsp. as required for the 
 wakefulness and excitement which pre- 
 cede an attack of delirium tremens. 
 
 R . Chloralis Hydratis, . . 3 vj. 
 Ext. Conii FL, . . . . ^iij. 
 Ext. Hyoscyami FL, . giv. 
 Mucil. Acaciae, . . . . ^ij. 
 Aquae Menth. Virid., ad Jij. 
 M. Sig. — Teaspoonful in water 
 
 after 
 
 each meal, to prevent delirium tremens. 
 
 Dementia Paralytica. 
 
 Physostigma, has seemed to retard the progress of the disease in some few 
 cases (B). Paraldehyde, in one or two drachm doses as a calmative and hyp- 
 notic, is as efficient as Chloral and without danger (B). Tonics, may be used, 
 though treatment is only palliative ; Calcium Lactophosphate, Cod-liver Oil, 
 etc.; no remedies have hitherto been of any avail. 
 
 Dengue. 
 
 Emetics and Purgatives are indicated at the outset, also free diaphoresis. 
 Quinine, in five-grain doses every four or five hours for the fever (Da C) ; 
 should be given more for its tonic than for its antiperiodic effect (Fayrer). 
 Opium, in some form for the pains and nocturnal restlessness. Salicylic Acid 
 or Salicylates, for the pains in joints and muscles. Carbolic Acid, as lotion, a 
 4 percent, solution for the itching, or Camphorated Oil. Belladonna, confers 
 great relief, ttlx-xv of the tincture may be given every hour for two or three 
 doses (Fayrer). Aconite, with salines and Nitrous Ether, during the pyrexia, 
 which may be so high that cold sponging or the cold bath may be required. 
 Bitter Tonics, as Gentian or Calumba, with Quinine and a mineral acid or 
 Strychnine during convalescence. Treatment, is entirely symptomatic. 
 
 Dentition. 
 
 Belladonna, in convulsions of dentition, rarely fails to relieve (P). Hyoscy- 
 amus, to alleviate pain and subdue irritation ; better than Opium for children 
 (P). Chamomilla, try of the tincture every % hour, an excellent sedative for 
 children (A. A. Smith). Potassium Bromide, for irritability and convulsions 
 in teething (R). Dulcamara, the infusion, in the diarrhea of dentition, quickly 
 checks symptoms (P). Calumba, excellent for the accompanying vomiting and 
 diarrhea (P) Hypophosphites, of Calcium or Sodium, as a general tonic, are 
 highly recommended (R). Rhubarb, with Soda, internally for the aphthae, 
 with perfect cleanliness of the mouth and a wash of Borax or Potassium Chlo- 
 rate in Glycerin, gr. x to the § (E.Smith). Castor Oil, for the diarrhea of den- 
 tition to clear out the bowels, then a mixture of Chalk and Catechu, or Zinc 
 Oxide gr. j to the dose, with gtt. j of Laudanum if required to reduce peristalsis 
 (Id). Lancing the Gums to relieve tension when gum is actually swollen ; 
 should not be indulged in indiscriminately. 
 
 R . Potassii Bromidi, . . . gj. 
 
 Olei Anisi, mjj. 
 
 Mucil. Acaciae, 
 
 Aq. Menth. Pip., . . aa^j. 
 M. Sig. — Teasp. every half-hour until 
 the child is relieved. (B.) 
 
 R . Sodii Bromidi, Sodii Bicarb., 
 
 Chloralis, aa gr. xx. 
 
 Aq. Menth. Viridis, . . jjss. 
 Syr. Zingiberis, . . . . 3 ss. 
 M. Sig. — Half-teasp. to a dessertsp., 
 
 according to age. 
 
668 
 
 DHOBIE ITCH DIABETES INSIPIDUS. 
 
 Dhobie Itch. 
 
 Chrysarobin, gr. xx to the J of vaselin, rubbed in twice daily, is almost inva- 
 riably successful ; stains the clothing, must not be applied to the face, and 
 should be stopped when it causes an erythematous ring at the edge of the dis- 
 eased patch (Mn). Silver Nitrate, a 4 per cent, solution in alcohol, painted 
 over the surface daily, has given satisfaction in many cases. Salicylic Acid, 
 in collodion, has many advocates [see formula below]. Calcium Sulphide, as 
 in Vleminck's Solution [see formula below], applied every night 3 or 4 times, 
 after a thorough use of soap and water, generally brings about a rapid cure 
 (Mn). Cassia Alata, a tincture of the leaves painted on, or the crushed leaves 
 themselves well rubbed in, are successful (Id). Iodine, the liniment freely 
 applied and of double strength, is the best remedy for the ringworms of the 
 thick-skinned natives (Id). Zinc Oxide, with Boric Acid and Starch, equal 
 parts of each, as a dusting powder to the crutch and axillae after the daily 
 bath, to prevent infection of the skin (Id). Dhobie Itch is a term used in the 
 far East for any itching, ringworm-like affection of any part of the skin, but 
 most commonly refers to some form of epiphytic disease of the crutch or 
 axilla. The chief parasites attacking these localities are — (1) the trichophytons 
 or ordinary body ringworms, (2) microsporon minutissimum of erythrasma, and 
 (3) the diplococcus of pemphigus contagiosus (Mn). 
 
 R. Quick-lime, ^j. 
 
 Precipitated Sulphur, . % ij. 
 Water, J xv. 
 
 Boil in an earthenware vessel until re- 
 duced to 3 x ; after subsidence decant the 
 sherry-colored fluid. 
 
 [Vleminck'' s Solution.') 
 
 R. Ac. Salicylici, 
 
 Chrysarobin i, . 
 
 Traumaticini, . 
 
 M. Sig. — Apply 
 
 affected area. 
 
 . gr. xx. 
 . gr. xxx. 
 
 paint to the 
 {Morrow.} 
 
 Diabetes Insipidus. 
 
 Opium, large doses necessary, gr. yj-xij a day (B) ; combined with Gallic 
 Acid, the most generally useful remedy (W). Ergot has cured many cases, 
 the fluid extract in doses of 3 ss-j thrice daily (Da C) ; one of the most efficient 
 remedies (B) ; is the most useful remedy (R) ; but if used in large doses or 
 long continued symptoms of ergotism appear and the drug has to be stopped 
 (Ralfe). Adrenal Extract, has given good results [see page 165]. Nitro- 
 glycerin, has been employed with good results (Id). Arsenic, improves the 
 general condition and given with other special remedies it greatly increases 
 their power (Id). Iron and Strychnine are very useful for tonic effects (Da C). 
 Valerian, in large, increasing doses (R) ; restrains the flow of urine but does 
 not cure (B). Sodium Salicylate, in small doses, very effective in some cases. 
 Muscarine has been used with apparent success (R). Potassium Iodide is cura- 
 tive in many cases of syphilitic origin (B). Alum has produced good results 
 (B). Jaborandi, is used successfully to reduce the quantity of urine (B). 
 Krameria lessens the quantity of urine (P). Galvanism, the constant current 
 over the upper part of the spinal cord ; or one pole to the loin and the other to 
 the hypochondrium on the same side for a few minutes, then on the opposite 
 side ; or the anode to the nape of the neck and the cathode first to the loins 
 and then to the epigastrium (Kulz). Diet, a dry diet beneficial (B), but is very 
 difficult to carry out. 
 
 Diabetes Mellitus. 
 
 Phosphoric Acid, largely diluted, assuages the inordinate thirst ; in one case 
 it seemed to act as a curative agent (Wa). Arsenic, when from fatty assimi- 
 lation, in diabetes of hepatic origin, and in thin subjects (B) ; the Bromide is 
 
DIABETES MELLITUS. 669 
 
 credited with several cures [see Aurum below] : the Lithiated Arsenical Water 
 was used in 70 cases, with cure of 96 per cent. (Martineau); [see infra for 
 formula.] Morphine, is very efficient in reducing sugar when used by mouth, 
 but is ot no value when employed subcutaneously, even in the same case 
 (Bruce). Opium in large doses, gr. vj-xij a day, ameliorative. Codeine, is 
 especially serviceable (B) ; abates thirst and controls appetite (R) ; its value 
 much disputed (P) ; is of great value in many cases (W) ; is one of the best 
 remedies in doses of gr. %-% (Da C). Jambul, has given favorable results 
 after abandoning all the usual remedies (Lawrence) ; in 2 severe cases, in 
 which 7 and 3 per cent, of glucose were excreted, the urine was brought back 
 to normal by preparations of the bark, and kept so for two years (Vix) ; should 
 be given after meals, in water or wine sweetened with Saccharin. Sodium 
 Salicylate has cured when all other drugs have failed (R) ; gr. x-xv in com- 
 pound spirit of Lavender and water, thrice daily, is my favorite remedy (Da C). 
 — Caution! the urine of patients taking Salicylic Acid gives the reaction of 
 sugar with Trommer's test (R). 
 
 Ergot, is one of the useful drugs ( Da C) ; decreases the quantity of sugar and 
 the volume of urine. Potassium Bromide, gr. xx ter die, cured two cases in six 
 weeks (Begbie) ; useless (Da C). Krameria lessens the quantity of urine (P). 
 Phosphates, to avert failure of nutrition (B). Aurum, the Chloride is one of the 
 promising remedies (B) ; the Bromide of Gold and Arsenic caused so much im- 
 provement in one case that he was accepted as a good risk by one of the fore- 
 most life insurance companies (E. A. Wood). Iodoform, in doses of gr. j-ij, 
 rapidly reduced the sugar and caused its disappearance in 4 or 5 days in five 
 cases, without any change in diet being made (Moleschott); the amount of testi- 
 mony for its value in this disease is quite considerable (B). Iodol, can be ad- 
 vantageously substituted for Iodoform in all the diseases to which the latter is 
 applicable (B). Uranium Nitrate, gr. i-iij, thrice daily has caused decided im- 
 provement in several cases (Hughes). Aloin, for the accompanying constipa- 
 tion (Da C). Nux Vomica, or Strychnine, is generally beneficial. Calcium 
 Lactophosphate benefits the thin, nervous type of diabetic remarkably (B). 
 Antipyrin, affects secretion, and has been used with benefit. Methylene Blue, 
 has given satisfaction in two cases (Estay). Orchitic and Adrenal Extracts 
 have been given with reported success. Alkalies are used on theoretical 
 grounds, but have not produced much benefit; one case apparently cured by 
 the diligent use of Ammonium Carbonate (B) ; are serviceable (Da C) ; alka- 
 line mineral waters for diabetes of hepatic origin and in obese subjects, are 
 extremely useful; tepid drinks for the intense thirst (B). Salines, a warm 
 solution of the Phosphate and Chloride of Sodium, by intravenous injection in 
 diabetic coma, produced astonishing results in one case (B). Oxygen as oxy- 
 genated water, instead of carbonated water, has been successfully used (Le 
 Blond). Glycerin has produced good results (B); used in place of sugar (W T ). 
 Diet and Hygiene are of the utmost importance; avoid amylaceous food and 
 everything containing sugar, especially ordinary bread ; use fresh, nutritious 
 animal food, with bread of bran or almonds ; warm baths, warm climate, flan- 
 nel underclothing. Professor Lupo of Naples maintains that some cases may 
 be cured by an exclusive vegetable diet, including all sorts of vegetables, and 
 gives two cases in which this treatment proved successful. Professor Saundby 
 permits the ingestion of the maximum amount of carbohydrates which the 
 patient can assimilate. Peanuts, are an excellent article of food for diabetics, 
 being rich in albumin, of which they contain 47 per cent., together with 19 
 per cent, of fat and non-nitrogenous extractive matters (Furbringer). Milk- 
 cure, by skimmed milk, very successful, 6 to 10 pints daily ; give no other 
 food for six weeks, then animal food (R). Saccharin, as a substitute for 
 sugar, does well for sweetening purposes, but is not a nutrient and has no 
 influence on the disease. Dulcin, is sweeter than saccharin, and is harmless 
 in reasonable doses, up to 24 grains in the day (Kobert). Levulose, is a sac- 
 charine food which can be taken freely and without any injury by diabetic 
 patients ; it most nearly approaches the ideal carbohydrate food indicated in 
 
670 
 
 DIARRHEA. 
 
 diabetes (Kebra) ; it is assimilated well and nearly all oxidized by diabetics, 
 who are able to partake freely of it in comparatively large quantity (Ebstein) ; 
 sugar and sugar-forming food constitute more than half the nourishment needed 
 by a healthy person, and it is the imperative duty of the physician to furnish 
 a diabetic with a moderate amount thereof, to prevent death from inanition, 
 and to lessen the danger of diabetic coma which is induced by a diet of meat 
 alone (Leyden) ; Levulose, formerly very high in price, is now sold at a reason- 
 able rate under the name Diabelin. 
 
 R. Liq. Potassii Arsenitis, . 3Jss. 
 Tinct. Opii Deodorati, . 3 v. 
 Syrupi Zingiberis, . . . ^j. 
 Aquae Cinnaraomi, . ad % iv. 
 M. Sig. — Teasp. thrice daily. 
 
 R. Codeinae, gr. viij. 
 
 Alcoholis, q. s. ad solv. 
 
 Syrupi, 5ij. 
 
 Aquas, . . . . q. s. ad %'w. 
 M. Sig. — A teasp. twice daily, the 
 dose to be gradually increased up to a 
 tablesp. (Pavy.) 
 
 R . Lithii Carbonatis, . . . gr. xl. 
 
 Sodii Arsenatis, , . . . gr. j. 
 
 Ext. Gentianae, . . . . gr. xx. 
 Ft. pil. no. xxv. Sig. — One night and 
 morning until sugar disappears. ( Vigier.) 
 
 R . Sodii Arsenatis, . . . . gr. iij. 
 
 Aquae, Oj. 
 
 A tablesp. of this with Lithii Carbonat. 
 gr. iij, into a quart siphon filled with car- 
 bonated water, which is to be taken freely, 
 as daily beverage. (Martineau.) 
 
 Diarrhea. 
 
 Mercury, in diarrhea of children with bad digestion, flatulent distention and 
 clay-colored, pasty, stinking motions, gr. j of the Bichloride to ^viij of water 
 in doses of Z) every hour ; or still better Hydrarg. cum Creta, gr. y$ every hour 
 or two, will restore the natural bilious color and limit the number of the stools (R); 
 Calomel in minute doses, gr. -fa to T ^ every half hour, is useful in the diarrhea 
 and dysentery (ileo-colitis) of children, when there is much irritability of the 
 stomach (B) ; in the acute or chronic diarrhea of children, characterized by 
 slimy stools mixed with blood and accompanied by pain and straining, gr. j of 
 the Bichloride to %x of water, in doses of 3j. is very efficient, curing with re- 
 markable speed and certainty (R) ; in mucous diarrhea, gr. j of the Bichloride 
 to a quart of water, in doses of 3>j every hour (A. A. Smith). Antipyrin, in 
 doses of gr. }4 to !}£, has rendered signal service in the diarrhea of infants and 
 children. Aconite, in diarrhea from chill, with high fever and cutting pains in 
 the abdomen (P). Camphor, in summer diarrhea and the preliminary diar- 
 rhea of Asiatic cholera (B) ; when from effluvia of drains or exposure to cold 
 (R) ; useful in many forms (P). Opium, is commonly used, but is best when 
 evacuations are very watery, combined with mineral Acids or with Lead Acetate 
 (B) ; with Starch as an injection in severe cases (R). Codeine, gr. ss-j answers 
 most satisfactorily in the milder forms of diarrhea and leaves no unpleasant 
 after-effects (Braithwaite). Ipecacuanha, in summer diarrhea and dysentery 
 of children with greenish stools (B); hourly drop-doses of the wine, especially 
 if vomiting (R); when from nervous irritation, especially in young children 
 (P). Dulcamara, in diarrhea of children from damp or with dentition (P). 
 Pulsatilla, dyspeptic diarrhea, mucous discharges, active piles (P). Quinine, 
 in periodic diarrhea, with dysentery and jaundice (B). Veratrum Album, in 
 the vomiting and purging of summer diarrhea (R). Podophyllum, in chronic, 
 with high-colored motions and cutting pains, also in morning diarrhea (R) ; 
 gr. -£$ to ^, with occasional doses of Aconite, for vomiting and diarrhea of 
 gastro-enteritis and prolapse of rectum (P). Chamomile, an infusion in sum- 
 mer diarrhea of adults, or in that of dentition (R) ; the Oil in diarrhea of chil- 
 dren, especially from worms (P). Arsenic, for evacuation of undigested food 
 
DIARRHEA. 6jl 
 
 (B) ; gtt. j of Liq. Arsenicalis before meals when diarrhea excited by food ; also 
 in chronic and membranous forms (R). Nux Vomica, a very useful adjunct 
 to other remedies (B) ; often of much service in epidemic diarrhea (P). Sul- 
 phuric Acid, in summer and choleraic diarrhea ; small doses in the chronic 
 form and in the straining diarrhea of children (R). Magnesium Sulphate, a 
 teaspoonful in a wineglassful of water every 3 hours when intestinal inflam- 
 mation (B) ; very efficient in acute diarrhea of soldiers. Peptenzyme, is excel- 
 lent in cholera infantum and the summer diarrhea of children. Balsam of 
 Peru, is excellent in diarrhea, with or without tenesmus (Tr). Kola, is useful 
 in atonic diarrhea. Zinc Salts, are very efficient in the summer diarrhea of 
 children (B). Haematoxylon, is devoid of irritating qualitiesand is well adapted 
 to the diarrheas of young children. Calumba, in diarrhea due to relaxation 
 of the mucous membrane and not dependent on inflammation (B). Catechu, 
 in atonic diarrhea and in that following withdrawal of morphine or opium from 
 habitues, also in the diarrhea of children ; in the latter the tincture with Chalk- 
 mixture is very serviceable. Kino, in atonic diarrhea ; the tincture in doses of 
 3j for the diarrhea resulting from the disuse of opium or morphine. Goto, the 
 fluid extract, or Cotoin, is one of the new remedies for atonic diarrhea. Tan- 
 nic Acid, is very useful in profuse and chronic diarrhea (B) ; with milk diet in 
 chronic diarrhea and dysentery (S). Potassium Bichromate, in doses of gr. ss 
 in trituration, for chronic diarrhea due to intestinal ulceration. 
 
 Castor Oil, in cathartic dose for diarrhea due to irritating material in the 
 intestinal canal, as undigested food or irritant secretions, no remedy more 
 useful (B) ; makes a good preparatory treatment for other medication. Bis- 
 muth Subgallate, gr. xx-xxx every 2 or 3 hours, does good service. Bismuth 
 Subnitrate, is effective, requires large doses, gr. xxx-lx every 3 or 4 hours ; is 
 especially indicated when desire for stool is felt immediately after eating (B) ; 
 gr. j hourly with milk, sometimes with gr. ^ of gray powder in various forms of 
 infantile diarrhea (R). Bismuth and Ammonium Citrate, in diarrhea without 
 irritation but rather relaxation of the intestinal mucous membrane. Bismuth 
 Salicylate, is highly praised in the diarrhea of phthisis and in that of typhoid. 
 Salol, is very efficient in acute diarrhea due to action of microbes. Resorcin, 
 gives very marked satisfaction in the diarrhea of children. Thymol, gr. xx to 
 3ij in 24 hours in divided doses for adults, is a very efficient internal antiseptic 
 in all cases of diarrhea, especially that of phthisis, teething children, chronic 
 diarrhea, etc. (Martini) ; avoid alcohol in any form with or after thymol, lest 
 poisoning result. Carbolic Acid, very useful in fermentative diarrhea, espe- 
 cially combined with Bismuth in cholera nostras and cholera infantum (B). 
 Mineral Acids, in painless, watery stools, light color and alkaline (B). Alkalies, 
 Mistura Cretae in sour-smelling stools (B) ; Sodium, Potassium or Magnesium 
 Bicarbonates when acid canal (R). Calcium Carbonate, as Chalk-mixture, in 
 the later stages, also in the diarrhea of typhoid or phthisis (R) ; may be com- 
 bined with Opium and with vegetable astringents. Lead Acetate, with Opium 
 as an injection (R) ; is excellent in all forms (B). Rhubarb, in early stages, to 
 get rid of irritant, afterward to check the diarrhea (R) ; when torrefied it has no 
 purgative power, but its astringency is retained. Rumex, in morning diarrhea 
 (R). Arnica, checks exhausting diarrhea with great certainty (P). Silver 
 Nitrate, in diarrhea of children, with white, pasty, and offensive stools ; com- 
 bined with Opium the most effective remedy for that of phthisis and typhoid 
 (B). Copper Sulphate, the most effective astringent in chronic diarrhea and 
 that of phthisis (B). Ergot, in persistent, chronic diarrhea (B). Iodine, one 
 or two drops of tincture in diarrhea from atony of mucous membrane (B). 
 Diet, should be cool or cold, light bland food; gruel, rice, arrowroot, whey, 
 barley-water, in recent cases ; in chronic cases the most digestible but nutri- 
 tious food, as fresh fish, game, raw eggs, rice, mucilaginous drinks ; Milk and 
 Lime-water or Soda-water very useful ; also raw meat pulp ; avoid beef, pork, 
 veal, and much starchy food. In most forms of diarrhea in children it is wise 
 to cut off milk and substitute some artificial food (R). [Compare Dysentery, 
 Cholera.] 
 
672 
 
 DIPHTHERIA. 
 
 R. Bismuthi Subnit., , . . ^j-ij. 
 Pepsini Saccharat., . . gss. 
 
 Zinci Oxidi, gr. vj-xij. 
 
 Trit. et div. in chartulas xij. 
 Sig. — One every four hours in summer 
 diarrhea of children. 
 
 B 
 
 5*J- 
 
 aa J5J. 
 
 Ac. Nitrici Diluti, 
 
 Tinct. Camphorse, 
 
 Tinct. Opii, . .• 
 
 Syr. Zingiberis, . 
 
 Aq. Menthse P\p.,q.s.ad ^vj. 
 M. Sig. — Tablesp. doses to be used 
 after a cathartic. (Hope's Mixture as modi- 
 fied by Thompson. ) 
 
 R . Tinct. Opii Deodorat., . rt^x. 
 
 Bismuthi Subcarb., . . gjss. 
 
 Syrupi Zingiberis, . . . ^vj. 
 
 Mist. Cretse, . . q.s. ad ^iv. 
 M. et fiat emulsum. Sig. — A teaspoon - 
 ful every 2 or 3 hours, for a child of one 
 year old, when the stools are acid and 
 green. ( Goodhart. ) 
 
 R. 
 
 . Plumbi Acetat., . . . 
 
 . gr. xx. 
 
 Pulv. Opii, 
 
 • gr- x. 
 
 Fiat massa, et div. in pil. 
 
 X. 
 
 Sig. — One twice daily. 
 
 
 R. Spiritus Athens Co., 
 
 Tinct. Opii Camph., . aalj. 
 Syr. Simplicis, . . . . gij. 
 M. Sig. — A dessertspoonful after each 
 
 movement. 
 
 R . Zinci Sulphatis, 
 
 Pulv. Opii, 
 
 Pulv. Ipecac, . . . aa gr. xij. 
 M. Fiant pil. no. xij. Sig. — One 3 or 
 4 times daily in chronic diarrhea of adults. 
 
 R. Tinct. Opii Camph., 
 
 Tinct. Catechu, . . aa ^iij. 
 
 Mist. Cretse, 3 x. 
 
 M. Sig. — A teaspoonful four or five 
 
 times daily for children. 
 
 R. Tinct. Opii Deodorati, . zj. 
 Tinct. Calumbae, q. s. ad 3 i j . 
 M. Sig. — Teasp. in winegl. of water 
 before meals. 
 
 R 
 
 Zinci Oxidi, .... 
 
 Sodii Bicarb., . . . 
 M. et div. in chartulas iv. 
 Sig. — One every 6 hours. 
 
 gr. xvij. 
 gr. viij. 
 
 3" ss - 
 
 R . Sodii Bromidi, . . 
 
 Mucil. Acaciae, 
 
 Aquae Purse, . aa q. s. ad ^ ij. 
 M. Sig. — Teaspoonful every three 
 hours in the diarrhea of dentition, for child 
 less than a year old. (A. A. Smith.) 
 
 R 
 
 Tinct. Opii Camph., 
 Syr. Rhei Aromat., . aa Jjss. 
 Aquae Calcis, . q. s. ad §ij. 
 M. Sig. — A teasp. for children. 
 
 Diphtheria. 
 
 Antitoxin is eminently successful, particularly when the treatment is com- 
 menced early in the case. (See page 177.) Mercury, the Corrosive Chloride 
 internally, with Ichthyol rubbed into the glands of the neck, employed with 
 marvellous success (Davison) ; doses for 24 hours are gr. % in ^iv of water for 
 young children, gr. ]/ 2 in ^vj for children of 6 or 7 years, gr. ^ in ^ viij for 
 adults, with Ichthyol (as above) and Antipyrin by enema if much fever (Dale) ; 
 the Bichloride has given me most success, with a gargle of Thymol or Boric 
 Acid (Da C); gr. jss in ^iv of glycerin and water, of which 3j every yi hour 
 for 6 doses, then every hour night and day, to a child of 4 years (Grant-Bey) ; 
 locally very efficient, gr. ij to Oj of water, applied on a cotton swab, which 
 should be burned after one using ; this hourly night and day (Oatman). 
 Hydrargyrum Cyanide, in solution of gr. ^ to the %, of which a teasp. every 
 Yi hour day and night to older children and adults, with a gargle of the same 
 solution (Sellden) ; gr. ^V~iV» according to age, every hour or two (Erichsen) ; 
 gr. \ in ^iv of water, of which Z) to iv as per age every hour (Schultz) ; used 
 by homeopaths in Berlin almost entirely, sometimes alternated with Apis, but 
 most efficacious alone ; table of 484 cases so treated, with 28 deaths. {Brit. 
 Jour. Homoeop., 1884, p. 382.) Calomel is next in importance to Quinine and 
 Iron, has proved successful in cases where other means failed, gr. l /%-%. every 
 
DIPHTHERIA. 673 
 
 3 hours, with a little Dover s powder (Da C) ; checks plastic exudation, its use 
 limited to children of good constitution with sthenic symptoms ; gr. ]/ 2 to j every 
 2 or 3 hours, with or without Dover's powder (gr. j) or Ipecac (gr. j) till bowels 
 become relaxed with greenish stools (Wa) ; gr. v repeated boldly every hour up 
 to 3iv, for a child of 3 years, until the stools appear like polyps in water-troughs, 
 gelatinous and of a bright, dark-green hue, — then a dose of Castor Oil if sali- 
 vation is feared (Reiter) ; the safest and most efficient germicide with which we 
 can saturate the system ; nothing like it in diphtheria, gr. yi-yi every hour, 
 even gr. j every 2 hours has no bad effects, no salivation (Fowler). 
 
 Belladonna, an excellent remedy ; if given early will abort the exudation and 
 later is useful to sustain the heart (B) ; especially when throat and tonsils 
 acutely inflamed and much swollen (R). Pilocarpine, used in 80 cases without 
 a single death ; produces free salivary discharge, but it is depressant to the heart 
 (Guttmann) ; many opinions for and against it; is decidedly injurious in ady- 
 namic cases (B). Quinine, in tonic doses recommended from my experience 
 (Da C) ; when headache with high temperature, vomiting, and symptoms of 
 septic poisoning, then in full doses (Wa) ; is most useful after serious symptoms 
 have abated, then with Iron and a mineral acid (Mackenzie). Arsenic, in 
 medicinal doses for malignant cases, or when sloughing of throat (R) ; the 
 Iodide, in doses of gr. -fa every hour or so, (see under Throat, Sore), an ex- 
 cellent remedy for the so-called diphtheritic sore throat. Calcium Chlorate, in 
 solution locally as lotion for the mouth ; considered almost specific by some ; 
 its chief utility is in removing fetor ; may influence germs (R). Potassium 
 Chlorate, grain-doses every ]/ z hour (Smith) ; is more largely used than any 
 remedy, both internally and locally (B) ; in full doses with Liq. Cinchonae, 
 seems to be of service in some cases (Wa). Carbolic Acid, as a spray, a 5 per 
 cent, solution in the atomizer cup; locally to the fauces, to remove fetor and 
 destroy disease-germs (B) ; the strong acid in Glycerine as caustic on a mop or 
 brush (W) ; with Iodine internally to prevent systemic infection (B). Sodium 
 Sulpho-carbolate, internally, has been found useful in lieu of Carbolic Acid 
 (Wa). Salicylic Acid, locally, and internally gr. x, has produced good re- 
 sults (B). Sulphurous Acid, the gas recommended by a royal commission in 
 Victoria, as a means of arresting the disease ; crude sulphur burned in the 
 room, all apertures being closed (R) ; the official acid in full and frequent doses, 
 causes rapid disappearance of the exudation, and improvement in the general 
 condition ; Z) every % hour to an adult in severe cases, in ordinary ones every 
 two hours; an 8-ounce mixture should have 2 or 3 ounces of syrup and 
 be given in milk to young children (Snow). Sodium Sulphite, £j to ^j aquse, 
 locally, an easily managed application (B) ; an injection for nares in nasal 
 diphtheria (Da C). [See formula below.] Sodium Hyposulphite, in solution 
 of 3j to ^ij of water, of which hourly doses of 3j> to be retained in throat 
 several minutes before being swallowed, an excellent local and constitutional 
 remedy, which may also be used by a brush or spray to the throat, and by a 
 syringe to the nares (Fruitnight). Sodium Benzoate, is highly efficient, 75 to 
 100 grains daily, according to age, also used locally (B). Myrrh, the tincture 
 
 4 parts, Glycerin 8 and Distilled Water to 200, of which Z) to giv as per age 
 every hour or half-hour, used in nearly 300 cases with strikingly good success 
 (Stroll). [See under Myrrha, a«/^, page 385.] Strychnine, hypodermically, 
 for the subsequent paralyses, which may be any form of motor paralysis. 
 
 Lime-water, dissolves false membrane ; the vapor of slaking lime inhaled ; 
 or, better, Lime-water by atomizer to back of fauces, while patient inspires 
 deeply (W). Ferric Chloride, as solution painted on or applied by spray to 
 the throat (R) ; of no advantage locally, internally may serve by supporting 
 the organism (B) ; the tincture, gtt. xx every 2 or 3 hours ; or better the Per- 
 chloride, gr. % to j everv 2 hours in syrup and water, is easier to take and 
 doesn't hurt the throat (Da C) ; the solution is an ingredient of Loeffler 's Solu- 
 tion (see formula below) for local use. Thymol, 3j in Glycerin !§j and Water 
 ^iij, is the best agent for use as a gargle (Da C). Toluene, with Menthol, 
 Creolin, etc., as in Loeffler s Solution, which is applied on a swab of cotton 
 
 43 
 
674 DIPHTHERIA, 
 
 every 3 hours for 4 or 5 days, after cleansing the surface ; is highly efficient for 
 destroying the bacilli and preventing absorption of toxin (LoefHer). Hydrogen 
 Dioxide, the solution, as spray or gargle, is a very useful application, and may 
 be diluted with 3 or 4 parts of water ; is much more powerful against young 
 bacilli of diphtheria than against those of two days old, and hence its 
 value is especially available at the very outset of the disease, and as a 
 prophylactic during epidemics thereof (Traugott). Glycozone internally, a 
 tablesp. in a winegl. of water every 3 hours, has an excellent effect (Edson). 
 Tartaric Acid locally, converts membrane into a gelatinous mass, easily ex- 
 pelled (Vidal). Chloral, a dilute solution in glycerin and water makes an excel- 
 lent local application for the throat ; internally may be used as a symptomatic 
 remedy in the early stages, but not when the heart is weak. Papain, by atom- 
 ized inhalation, is used to destroy the membrane. Pineapple Juice and Papaya 
 Juice, used by sipping and swallowing the juice after chewing the pulp, highly 
 efficient in India (Chambers) ; see page 415. Boracic Acid, in solution as gargle, 
 ranks next best after Thymol (Da C). Sulphur and Alum, equal parts, pow- 
 dered and blown into the throat at the moment of deep inspiration, as often as 
 asphyxia is threatened, are efficient (Jones) ; Sulphur is a very old and efficient 
 local remedy in diphtheria, the flowers (sublimed sulphur) rubbed up with water 
 as a gargle, or blown upon the throat through a quill, was the method of Dr. 
 Field, who had a great reputation in England a few years ago for curing this 
 disease. {Lancet). Trypsin, is a good solvent of the false membrane ; of all 
 remedies used with the spray-atomizer it has given me the largest percentage 
 of recoveries (Fruitnight). Chinolin, a 5 per cent, solution painted over the 
 affected parts with great advantage (Seifert) ; the tartrate in 10-grain doses in- 
 ternally (B). Bromine, the vapor by inhalation, is useful (Wa) ; a j^j solution 
 in distilled water, of which gtt. j-iij every ]/z hour in a teasp. of sweetened 
 water, using a glass spoon ; and a saucer full of Bromine Water in the room, 
 renewed every 12 hours, has seemed to be extremely efficient in a number of 
 cases. Iodine as inhalation frequently ; with use the solution may be increased 
 to ^ss at each inhalation (R). Potassium Permanganate, gr. ]/ z in distilled 
 water internally and also used locally, is of undoubted benefit (B) ; is credited 
 with brilliant results even in malignant cases. Sanguinaria, the best emetic, 
 and by many is considered specific in this disease (P). Lactic Acid, ^iijss to 
 ^x of distilled water, as gargle, on mop or by spray, to dissolve membrane (B). 
 Tannin, a 5 per cent, solution as spray (R). Cubeb, very efficient in the catar- 
 rhal forms of diphtheria (Robinson) ; the freshly ground berries in large doses 
 in early stages of the disease, a very successful treatment (Trideau). Turpen- 
 tine, Z) of the oil thrice daily, with tnjv of Spiritus yEtheris as a corrective, at 
 the same time using ice-bags and a gargle of Potassium Chlorate solution, and 
 internally ^-ounce doses every 2 hours of a 2 per cent, solution of Sodium 
 Salicylate (Roesse, Baruch). Tar and Turpentine vapor, made bv burning in 
 the room Coal-tar 7 parts to Oleum Terebinthinae 3 (Delthil). Methylene Blue, 
 was used with success after losing cases by other treatment ; even in simple 
 non-diphtheritic ulceration of the throat, patients would, after one or two appli- 
 cations of the solution, express themselves with delight as being cured (Rose). 
 Chlorine-water, tablesp. doses internally and as a gargle, highly efficient ; a 
 mixture of Chlorine-water 2 parts and Distilled Water 1, of which 3j internally 
 every 2 or 3 hours, is by far the best treatment of this disease ; no water should 
 be given after the mixture (Schubert) ; as a prophylactic the same may be 
 given 2 or 3 times daily (Id). Nuclein, has been used with benefit (see page 
 161). Alcohol, is probably as good a local antiseptic as any ; diluted with 
 equal parts of water, by hand-ball atomizer every % hour ; is the prince of 
 antiseptics, and the most perfect and reliable medicine in diphtheria of which 
 we have any knowledge (Hills). Stimulation, freely, the essential part of the 
 treatment ; infants are not injuriously affected by teasp. doses of whiskey every 
 Yz hour ; stimulate for effect and not by dose ; those cases do best which are 
 stimulated freely and early (Da C) ; there is more danger from giving too little 
 alcohol than from too much ; a three-year-old child can comfortably take %}- 
 
DROPSY. 
 
 675 
 
 Jv of Cognac, or gr. xv of Musk or Camphor, or gr. xv-£j of Ammonium 
 Carbonate in 24 hours ; in the septic form especially, the intoxicating action of 
 Alcohol is not experienced, and young children with general sepsis began to 
 improve when their ^iv of brandy were increased to ^xvj daily (Jacobi). 
 Water, as ice in the mouth and the wet pack to the throat, is extremely ser- 
 viceable (B) ; Ice sucked, especially at commencement, and continued until 
 the disease declines (R) ; Ice packed in bladders or thin india-rubber bags, to 
 the throat (W). Aliment, good foods, wines or brandy, necessary from the 
 start to maintain the patient's strength (R) ; a teasp. of glycerin every 3 or 4 
 hours, plenty of good soup and wine, nutritive enemata, are necessary to sus- 
 tain the system. Moist inhalations. Temp, of room 68° Fah. Removal from 
 the house wherein attacked is advisable. Tracheotomy, only in extremis (R) ; 
 is not successful in diphtheria, though very much so in membranous croup 
 (Da C). Intubation of the Larynx, as an alternative to tracheotomy, is enthu- 
 siastically advocated by many operators. [Compare Croup membranous.] 
 
 R. Hydrarg. Chlor. Corros., gr. jss. 
 
 Glycerini, t ^j. 
 
 Aquae Destillatae, . . . ^iij. 
 M. Sig. — A teasp. every ^ hour for 6 
 doses, then every hour night and day to a 
 child of four years. Also, — 
 
 R. Ung. Iodoformi (1 in 10), rubbed in 
 over swollen glands every 3 hours. 
 
 ( G?-ant-Bey.) 
 
 R 
 
 . Sodii Sulphitis, . . . . Sjiij. 
 
 Glycerini, £ij. 
 
 Aquae, . . . . q. s. ad ^ iv. 
 M. Sig. — Nasal injection. {Da Costa.) 
 
 l\> 
 
 R . Tinct. Ferri Chloridi, 
 Syrupi Tolutani, 
 Liq. PotassiiCitratis, . aa^ijss. 
 M. Sig. — Teasp. to dessertsp. accord- 
 ing to age, every 3 hours ; 3J=rr\x of 
 the tincture. {Anderson.) 
 
 R . Hydrarg. Chlor. Corros. , gr. j, may 
 be added to the above formula, which 
 should then be given in teasp. doses. 
 
 R . Mentholi, 10 Gm. 
 
 Toluene, . , q. s. ad 36 Cc. 
 Dein adde — 
 
 Creolin, 2 Cc. 
 
 Liq. Ferri Chloridi, . . 4 Cc. 
 Alcoholis, . . q. s. ad 100 Cc. 
 Sig. — To be applied by cotton swab 
 every 3 hours for 4 or 5 days. 
 
 {Loeffler 1 s Solution.) 
 
 R 
 
 . Ac. Tartarici, f ) ). 
 
 Glycerini, 3 jss. 
 
 Aquae Menth. Pip.,q.s.a</ ^iv. 
 M. Sig. — Gargle frequently. {Vidal.) 
 
 R. Tinct. Ferri Chloridi, . ^j. 
 Potassii Chloratis, . . . J ss. 
 Misce et adde — 
 
 Aquae, . . . . q. s. ad ^viij. 
 Sig. — Gargle. {Jacobi. ) 
 
 For the chemistry of this combination 
 see under Chlorum, ante, page 267. Gly- 
 cerin should not be added, as in Dr. Ja- 
 cobi' s original R, which makes a mixture 
 that may explode. 
 
 Dropsy. 
 
 Arsenic, in dropsy from feebleness of heart, and in old age (B) ; swelled feet 
 from debility (R). Aurum, has an ancient reputation in several forms of 
 dropsy (see page 209). Digitalis, one of the best remedies, especially in renal 
 dropsy from acute desquamative nephritis ; the infusion in doses of 3jss (B) ; 
 the fresh infusion best for that of heart disease, especially when tricuspid re- 
 gurgitation (R) ; induces striking effects in cardiac dropsy, when scanty urine 
 and venous engorgement; has high rank as a diuretic (P). Apocynum Can- 
 nabinum, actively diuretic (P). Diuretin has been employed with marked 
 benefit in both cardiac and renal dropsy, in hepatic cirrhosis, and in various 
 diseases of the heart and kidneys accompanied by edema ; gr. xv several 
 times daily, in aqueous solution, avoiding acids or acid vegetable juices. 
 Caffeine, the Citrate in 5-grain doses is eminently diuretic ; for objections to its 
 use see page 232. Cactus, has long had a high reputation in dropsy among 
 the natives of its habitat; is probably of service in cardiac dropsy. Hydrargy- 
 rum, a classical pill in dropsy with dyspnea from cardiac disease is the combi- 
 
676 
 
 DROPSY 
 
 nation of Dr. Baillie, containing Mercury, Digitalis, and Squill (see formula 
 below) ; Calomel in doses of gr. ss-ij is eminently diuretic, especially in car- 
 diac dropsy, but by many it is thought to act by aiding the action of other 
 diuretics. Bryonia, as a drastic purgative and diuretic ; care necessary, as it 
 depresses the heart; the infusion best (P). Hellebore, the tincture, in doses of 
 gtt. v-xv, every 2 or 3 hours, very successful in dropsical effusions, especially 
 in general anasarca after scarlatina (P). Senega, as a diuretic when dropsy is 
 dependent on kidney disease ; has been praised (P). Chimaphila, is useful as 
 a diuretic in renal dropsy especially when loss of appetite and debility (P) ; 
 may be substituted for Scoparius (B). Juniper, largely used as a diuretic in 
 cardiac and renal dropsy (B) ; esteemed in post-scarlatinal dropsy (R). Iron, 
 purgative chalybeate waters (B) : the Liquor Ferri et Ammonii Acetatis (Ba- 
 sham's Mixture), in anemic dropsy (Da C). Pilocarpus, very valuable in renal 
 dropsy when secretion of urine is much reduced or suppressed (B). Jalap, the 
 compound Jalap powder, gr. xv-xx, with 3 iij of Potas. Bitart. and a little Ginger, 
 early in the morning, 2 or 3 times a week , no hydragogue superior in dropsy 
 from Bright's disease (Wa). Turpentine, controls dropsy with albuminous 
 urine, from non-desquamative renal disease ; gtt. ss every 2 to 4 hours (P). 
 Colchicum, as a hydragogue in hepatic and cardiac dropsy when patient is 
 vigorous, also in post-scarlatinal dropsy (B). Scoparius, esteemed by English 
 physicians (B) ; is most useful in cardiac dropsy ; Cullen found it the most cer- 
 tain diuretic: diluents should be freely used with it (P). Squill, in cardiac 
 dropsy; cautiously if from kidney disease; if anemic add Iron (R). Taraxa- 
 cum, is occasionally used as a diuretic, with limited utility (B). Copaiba, gives 
 good results, especially in ascites, which see for formula (B). Potassium Bitar- 
 trate and Acetate, are very certain as diuretics when largely diluted with water, 
 as cream-of-tartar lemonade; indicated in desquamative nephritis, and in 
 general dropsy from valvular disease of the heart (R). Elaterium, of unques- 
 tionable value as a derivative in many passive forms of dropsy, though many 
 fear it (P). Acupuncture, or better still, incisions from % to an inch long, one 
 over each external malleolus generally sufficient; a hot sponge, moistened 
 with weak carbolic acid solution kept to incisions (R). Aliment, dry diet is of 
 advantage in dropsy of serous cavities (B); should be light in acute dropsies; 
 nourishing in chronic. Water not injurious but beneficial as drink. Warm 
 baths, Holland gin in small doses, tapping for alleviation in incurable cases. 
 A moderately warm, dry atmosphere. Skim-milk diet said to be of great value 
 in renal dropsy. [Compare Ascites, Hydrocele, Hydrocephalus, Hydro- 
 thorax, etc.] 
 
 R . Pulv. Scillse, 
 
 Pulv. Digitalis, . . . aa^ss. 
 Potassii Nitratis, . . . 3J. 
 M. Fiat massa et div. in pil. xxx. 
 Sig. — One pill thrice daily. 
 
 R 
 
 . Potassii Acetatis, ... 3 vss. 
 
 Spt. ^Etheris Nitrosi, . . £ij. 
 
 Aquse, . . . . q. s. ad^vW). 
 M. Sig. — Tablesp. every 3 or 4 hours. 
 
 R. Potassii Bitartrat. , . . . ^j. 
 
 Ext. Taraxaci, . . . . £ss. 
 
 Decocti Taxaraci, . . . Jviij. 
 M. Sig. — ]/ 2 wineglassful twice or 
 thrice daily. 
 
 R . Aceti Scillae, ^ ss. 
 
 Infusi Digitalis, q. s. ad 5 iv. 
 M. Sig. — A tablesp. 2 or 3 times daily. 
 
 R . Pulv. Digitalis, . . . . gr 
 
 Pulv. Scillse, gr 
 
 Hydrarg. cum Creta vel 
 Pil. Hydrargyri, . . . gr. 
 
 Ft. pil. no. j. Mitte tales xxiv. 
 
 Sig. — One pill thrice daily 
 
 J-jSS. 
 
 j- 
 
 j-nj. 
 
 R . Liq. Ferri et Ammonii 
 
 Acetatis (U. S. P.), . 25 vj. 
 Sig. — Dessertsp. or two, three or four 
 times daily. (Bas/iam's Mixture.) 
 
 R. Eiaterini, gr. j. 
 
 Spt. ^Etheris Nitrosi, . % ij . 
 
 Tinct. Scillse, 
 
 Tinct. Colchici, . . . aa^ss. 
 
 Syr. Simplicis, . . ■ . %]. 
 M. Sig. — A teaspoonful 3 or 4 times 
 daily, for hepatic and cardiac dropsy in 
 sthenic subjects. 
 
DUODENAL CATARRH DYSENTERY. 677 
 
 Duodenal Catarrh. 
 
 Salol, is the most efficient remedy. Sodium Phosphate, Z] four times daily, 
 extremely efficient in catarrhal conditions of the duodenum and bile-ducts, 
 resulting in jaundice, hepatic colic, etc. (B). Vichy Water, in similar condi- 
 tions, probably owes its efficacy to the Sodium Phosphate contained in it (B). 
 Potassium Bichromate, in doses of gr. yu~^, two or three times a day, is an 
 excellent remedy in so-called duodenal dyspepsia, manifested by a bitter taste, 
 coated tongue, pale stools, vomiting of glairy fluid and dull pain in right hypo- 
 chondrium. Arsenic, has been used with success in jaundice from catarrh of 
 bile-ducts after duodenal catarrh (B). Aurum salts will often remove duodenal 
 catarrh and that of the bile-ducts, also the jaundice therefrom (B). Podophyl- 
 lum, in catarrhal and malarial duodenitis. Nitro-muriatic Acid, internally in 
 mucous duodenitis; also as bath to right hypochondrium (3iij to gal. j), temp, 
 of bath 96 (B). Aliment, no starches or fats ; milk, eggs, oysters, beef-broth, 
 broiled or raw beefsteak, white-fish (B) ; the diet should be exclusively animal, 
 in order to let the stomach deal with it. [Compare Jaundice, Biliousness.] 
 
 Dysentery. 
 
 Ipecacuanha, is the remedy for acute dysentery of the ordinary type ; large 
 doses; gr. xxv-xxx (P); gr. xv in milk (B) ; valuable in acute or epidemic 
 forms, also in summer dysentery of children, with greenish stools, mucus and 
 blood, gr. ij-v every 2 hours in milk (B) ; in dysenteric diarrhea of children, 
 especially with vomiting, which will often yield to hourly drop doses of Ipecac 
 wine (R). [See page 360 for the method of administration.] Castor Oil, as a 
 mild cathartic, is very valuable in appropriate cases (Wa) ; gtt. v every hour, 
 in water with sugar and gum, is excellent for dysenteric diarrhea of children 
 (Smith) : ^j of the oil, guarded by 10 to 20 drops of laudanum, the best pre- 
 liminary treatment for all cases of catarrhal dysentery. Magnesium Sulphate, 
 drachm doses of a saturated solution with rr\,x of dilute sulphuric acid, every 
 hour, gives striking results in acute tropical dysentery (Thorpe) ; £>iv of a sat. 
 sol. with rt\,xv of ac. sulph. dil. every 2 hours, and a milk diet, acted like magic 
 in all my cases of tropical dysentery (Wiglesworth) ; produced complete and 
 permanent cure in a bad case from India, in which many other remedies had 
 no effect (Alexander) ; the best remedy for acute dysentery, especially when 
 fever, pain, tenesmus, and stools containing mucus and blood (B). Sulphuric 
 Acid, dilute, with saline purgatives (B) ; a remedy much used in India contains 
 Ac. Sulph. Dil. j ; Vin. Ipecac, j ; Tinct. Opii, j ; Ol. Ricini, v; well shaken 
 and given in doses of 5 to 12 drops frequently, the smaller dose as often 
 as half-hourly. Opium, as enema, with starch and milk, after canal is 
 emptied by salines ; indispensable in chronic dysentery (B) ; for the purging 
 (R) ; a remedy of great value, and applicable to every stage and every form 
 of the disease, allaying pain and vascular excitement, moderating peristalsis, 
 promoting the cutaneous secretion ; is inferior to Ipecac in acute dysentery, 
 and is most valuable in the chronic form (Wa). Silver Nitrate, in pill, 
 gr. %-), with Opium, in acute dysentery after subsidence of acute symptoms ; 
 also an enema beyond the sigmoid flexure (gr. x-xx ad Oj aquae) using from 3 
 to 6 pints (O) : also as escharotic through speculum to ulcer of rectum (B) ; a 
 solution of 1 in 1000 as antiseptic wash daily, up to 60 washes in series, entirely 
 successful in many cases of the recurrent form of tropical dysentery, having 
 lasted from 1 to 5 years (Gallay, Surgeon-Major for French Colonies). Potas- 
 sium Bitartrate, in acute dysentery with scorbutic symptoms, as seen in miners, 
 sailors, etc. ; a full cathartic dose, ^ss or more, has acted most beneficially as 
 a preliminary to other treatment, and in many cases has proven to be the only 
 remedy required. Bismuth Subnitrate, in doses of gr. xv-xx every hour or so, 
 is highly efficient ; may also be used in suspension with Starch or Chalk- 
 
6yS 
 
 DYSENTERY. 
 
 mixture, as a rectal injection. Bismuth Subgallate, may be used instead of 
 the subnitrate and in the same doses, or 30 grains may be given at longer 
 intervals. Bismuth Salicylate, gr. xv in milk or cachet 4 times daily ; gr. 
 xx twice daily with gr. ij of Ammonium Carbonate to prevent flatulence 
 (Tirard). Quinine, when periodic (B) ; in malarial subjects is as successful as 
 Ipecacuanha in dysentery of the ordinary type (P) ; in warm solutions, 1 in 
 1000 to 1 in 5000, as rectal injections for amebic dysentery, the amebae being 
 rapidly destroyed thereby (Ty). Ailanthus Glandulosa, as infusion, sometimes 
 succeeds where other measures have failed, and seems to be especially service- 
 able when the case has become subacute or chronic (Mn). Monsonia Ovata, 
 a tincture gave wonderful results in chronic cases and in acute ones which had 
 resisted the ordinary remedies (Maberly). Methylene Blue, may be of use in 
 amebic dysentery, on account of its being partially excreted by the feces (Arm- 
 strong). Mercury, in minute doses for the ileo-colitis of children ; gr. -fa to ^ 
 of Calomel or Hydrargyrum cum Creta every half hour (B) ; gr. y^ of the Bi- 
 chloride hourly or every 2 hours, in acute or chronic dysentery if stools are 
 slimy or bloody (R) ; Calomel in fractional doses every hour, is most in vogue in 
 Germany, and is best suited to the croupous form(Mn). Zinc Sulpho-carbolate, 
 gr. ij-iij in pill 4 or 5 times a day as an intestinal antiseptic. Salol, is highly 
 efficient as an intestinal antiseptic. Tannic Acid, in solution, 3j to the pint, by 
 rectal irrigation, as an intestinal antiseptic. Cinnamon, sometimes does good in 
 chronic dysentery, may be combined with Ailanthus (Mn). Iron,weak solutions of 
 the tincture of the Chloride for irrigation of the bowel have been used in bad cases 
 with great benefit; the Pernitrate for the anemia in chronic dysentery (Mac- 
 lean) ; sometimes useful in the chronic army form (B). Balsam of Peru, 3 grains, 
 with alcohol 3j . syrup of lemons £iv and water ^iij , excellent for dysentery (Tr). 
 Arnica, is highly extolled as an internal remedy for cases where the vital 
 powers are depressed (Wa). Gamboge, gr. % internally in the 24 hours, ex- 
 ceedingly valuable in young persons (P). Matico, the infusion by mouth and 
 rectum was found serviceable in the malignant hemorrhagic dysentery occur- 
 ring in Trinidad. Glycerin, with infusion of Linseed, 1 to 4, to allay tenesmus 
 (B). Lead Acetate, as enemata, in acute and chronic dysentery to allay 
 tenesmus (B) ; with Ipecac and Opium in pill, for acute form (Da C). Hama- 
 melis, when the discharges contain much blood (R). Aconite, when fever and 
 cutting pains (P). Nux Vomica, in epidemic dysentery (P) ; prune-juice 
 stools, much gas, vital depression (B). Arsenic, Fowler's solution gtt. ij with 
 gtt. v of Opium often benefits (B). Copper Sulphate, useful in acute dysentery ; 
 in chronic the most valuable astringent (B) ; gr. x-xx ad Oj aquae (R). Ergot, 
 in chronic after acute, and also in the acute form (R). Grape-cure, is used 
 successfully in the chronic form (P). Calumba, is of great value in chronic 
 dysentery with ulceration of colon (P). Chekan, is used with benefit. Injec- 
 tions of mucilaginous enemata (as Linseed) are of great value (R). Diet is of 
 prime importance (B) ; avoid animal food and stimulants, liquid foods best, all 
 to be cold (R) ; milk diet alone during exacerbations. Boiled and peptonized 
 milk, light animal broths and beef-juice, not beef teas ; barley or rice may be 
 added to such broths, but should be thoroughly cooked (Ty). Colostomy was 
 done on an old and bad case of amebic dysentery, the colon then irrigated 
 daily with a weak solution of hydrogen peroxide, resulting in immediate relief 
 from pain and finally complete cure(Barbat). [Compare Diarrhea, Enter- 
 itis, Sprue.] 
 
 R. Morphinae Sulph., . . . . gr. ij. 
 
 Strychninse Sulph., . . . gr. ^. 
 
 Ac. Sulphurici Dil., . . . jfss. 
 
 Aquae Camphorse, .... ^ iijss. 
 M. Sig. — A teasp. well diluted every 
 hour or two. In epidemic dysentery with 
 prune-juice stools and marked depression. 
 
 R . Plumbi Acetatis, . . . . gr. xxiv. 
 
 Ipecacuanhse, 
 
 Pulv. Opii, aa gr. iij. 
 
 Fiant pil. no. xij. Sig. — One pill every 
 2 hours until blood ceases, then at longer 
 intervals. {Da Costa. ) 
 
DYSMENORRHEA. 
 
 6/9 
 
 R. Magnesii Sulphatis, . . . .^viij. 
 
 Ac. Sulphurici Dil., . . . 5ss. 
 
 Aquae, 3 v "j- 
 
 M. Sig. — Tablesp. in a winegl. of water 
 every hour or two until it operates. (B.) 
 
 R. 
 
 Ext. Ergotae Fl., .... 5iijss. 
 Tinct. Opii Deodorati, . . gss. 
 M. Sig. — A teasp. thrice daily. 
 
 {Andrew.) 
 
 R . Plumbi Acetatis, . . . . gr. iv. 
 Morph. Acetatis, . . . . gr. ss. 
 
 Aquae Fervid., ^j. 
 
 M. Sig. — Enema to allay tenesmus. 
 
 R . Ferri Sulphatis, gr. xl. 
 
 Pulv. Opii, gr. xx. 
 
 Fiant pil. no. xx. Sig. — One pill thrice 
 daily, in chronic dysentery. 
 
 Dysmenorrhea. 
 
 Ammonia, the Aromatic Spirit in doses of 5j every 4 hours or oftener, a 
 thoroughly trustworthy remedy, and should be used in place of the alcoholic 
 stimulants generally prescribed (Illingworth). Ammonium Acetate, has re- 
 markable power over many forms of dysmenorrhea ; the Liq. Ammonii 
 Acetatis, in ^ss doses, with gr. y^ of Ipecac, every 2 or 3 hours, to keep up the 
 action of the skin until the flow is well established (E). Antipyrin, as an anal- 
 gesic, is efficient. Acetanilid, is equally efficient for the pain. Cimicifuga, 
 relieves pain in the congestive variety and is decidedly useful (P) ; is said to 
 be very efficient (R) ; is valuable (Wa). Opium, necessary when pain is very 
 severe ; one hypodermic of Morphine at each period is often sufficient (Wa). 
 Codeine, when Morphine is not well borne, has given very complete satisfaction 
 in several cases; gr. % to }i morning and evening (Oliver). Gelsemium, 
 relieves pain in the neuralgic form, rr\,v-x of the fluid extract every 2 hours (B). 
 Chloroform, as the liniment on a flannel wrung out of hot water, or by inhala- 
 tion as an anesthetic when pains very severe; sometimes exerts a permanent 
 influence (Wa). Ergot, given when the molimen begins, is useful in the con- 
 gestive form (B). Amyl Nitrite, may be inhaled with benefit in the neuralgic 
 variety, especially in chlorotic girls (Wa). Sodium Borate, in the membranous 
 form, has been used with great benefit combined with Ext. Belladonnas (Wa). 
 Camphor, is my favorite remedy, gr. x in mucilage and Cinnamon-water; 
 repeat the dose in an hour or two if necessary (Dewees). Guaiacum, is very 
 useful (P); drachm doses of the ammoniated tincture in the neuralgic or rheu- 
 matic forms (B). Caulophyllum, is by many considered the best curative 
 remedy for spasmodic dysmenorrhea, if given in the intervals. Viburnum 
 Opulus, the fluid extract, in half-drachm doses, has considerable reputation in 
 some sections for uterine pains of various kinds, and is useful in the spasmodic 
 variety of this affection ; may be used in combination with Cannabis Indica 
 (Thomas). Arsenic, gtt. iij-x of Fowler's sol. with gtt. x of Tinct. Digitalis, ter 
 die between the periods, gives excellent results (Athill) ; indicated when copious 
 membranous discharge from bowels and uterus (R). Cannabis Indica, is very 
 useful as a palliative in painful menstruation (B) ; gr. ss-j thrice daily to relieve 
 the pain (R). Nux Vomica, in neuralgic form ; Syrup or Elixir of Iron, Qui- 
 nine and Strychnine (B). Apiol, neuralgic form (B) ; as emmenagogue, night 
 and morning, for several days near the period (Wa). Pulsatilla, in the func- 
 tional form ; is of much benefit when discharge is scanty or profuse, black and 
 clotted ; should be persevered in for two months or more (P) ; gtt. ij every hour 
 is most effective when the affection is not of membranous, obstructive, or 
 neuralgic character (Smith). Hydrastinine, has been used with benefit. [See 
 under Menorrhagia.] Chloralamid, in one dose of gr. xxx, to prevent an 
 impending attack, has been of service. Belladonna, in neuralgic or spasmodic 
 forms, dark and fetid discharge, crampy pains, and cold chills; a suppository 
 or mild injection together with internal administration, will relieve (P) ; in 
 neuralgic dysmenorrhea it will permanently relieve (B). Aconite, a valuable 
 remedy when commenced early (P); for the congestive form in plethoric sub- 
 jects (B). Aletris, is advertised as a highly efficient agent. Carbonic Acid, 
 injected into the vagina (see page 93). Electricity: in neuralgic, a galvanic 
 current ; in congestive, the inverse current (B). Croton-chloral, in neuralgic 
 
68o 
 
 DYSPEPSIA. 
 
 form (R). Iron, if depending on anemia (B). [See Amenorrhea for formula.] 
 Cajuput Oil, said to relieve the pains (R). Rue and Sumbul, are reported use- 
 ful (P). Emetic of Ipecac, with warm covering in bed, feet in hot water, hot 
 ginger tea, Liquor Ammonii Acetatis ; if pain very severe, a suppository of 
 Morphine and Belladonna per rectum ; best to avoid anodynes (E). Acces- 
 sories, spinal ice-bag, when scanty discharge ; when menorrhagic, hot water 
 spinal-bag ; sitz-baths, either hot or cold, or cold alone, during intervals. 
 
 R. Ext. Cimicifugae Fl., . . . £iv. 
 
 Ext. Pulsatilla Fl., . . . 3Jss. 
 
 Ext. Eriodyctii FL, . . . sjj. 
 
 Syr. Aurantii, . . q. s. ad ^ iv. 
 M. Sig. — One or two teasp. every two 
 hours, for six doses. 
 
 R. 
 
 gr. iv. 
 
 Ext. Belladonnae, . . 
 Ext. Stramonii, 
 Ext. Hyoscyami, . . . aa gr. v. 
 Quininae Sulphatis, . . . . gr. xl. 
 Fiant pil. no. xx. Sig. — One pill thrice 
 daily, in neuralgic dysmenorrhea. 
 
 R 
 
 Fl. 
 
 Ext. Viburni Prunifol. 
 
 Ext. Senec. Aurei, . 
 
 Tinct. Guaiaci Volat., 
 M. Sig. — A teasp. in new milk, 
 daily, between attacks, gj every hour dur- 
 ing attack, and a hot sitz-bath. 
 
 R. Ext. Ergotse FL, ... ^vij. 
 
 Tinct. Gelsemii, .... ^j. 
 
 Tinct. Aconiti, .... TTLxvj. 
 M. Sig. — Teasp. every 2, 3, or 4 hours. 
 In congestive dysmenorrhea. 
 
 gr. v. 
 
 R. Ext. Opii, .... 
 
 Ext. Cannabis Ind., 
 
 Ext. Hyoscyami, . . aa gr. x. 
 
 Camphorae, gr. xxv. 
 
 M. Fiant pil. no. x. Sig. — One pill 
 two or three times daily. (McLane.) 
 
 R 
 
 Ext. Cannabis Ind. FL, . gjss. 
 Ext. Viburni Op. FL, . £vj. 
 Mucil. Acacise, . . . . giij. 
 Aq. Cinnamomi, q. s. ad £ iv. 
 M. Sig. — Dessertsp. every 4 to 6 hours. 
 
 Dyspepsia. 
 
 Pepsin, is very beneficial ; Scheffer's or Beale's saccharated pepsin with 
 diluted HC1 acid (B) : is especially adapted to gastric indigestion. Pancreatin, 
 for intestinal indigestion ; Liquor Pancreaticus to peptonize milk, gruel, soups, 
 etc., before administration; in cases of great digestive debility. Peptenzyme, 
 is said to be very efficient. Papain (Papoid), acts equally well in gastric and 
 intestinal indigestion, and hence is particularly indicated in cases of difficult 
 diagnosis as to the location of the trouble ; is used in the various forms of dys- 
 pepsia and indigestion with most excellent results ; has marked proteolytic 
 action in acid, alkaline and neutral solutions, and in the presence of many 
 chemicals, antiseptics and therapeutic agents (Chittenden). Ingluvin, also 
 promotes digestion (B). Pineapple Juice has the power of digesting proteids 
 (Marcano) ; the fresh juice is a very constant and powerful digestant of albu- 
 minous matters, its ferment being decidedly active in the presence of either 
 acids or alkaline carbonates, but most energetic in neutral solution and be- 
 tween 122 and 140 F. (Chittenden). Mineral Acids, Hydrochloric or Lactic 
 with Pepsin after meals in atonic dyspepsia ; Hydrochloric after meals for acid 
 pyrosis ; Nitro-muriatic for dyspepsia with mental despondency, oxalates in 
 urine, offensive gas, sallow complexion (R) ; Phosphoric, dilute, very efficient 
 before meals (Da C). Sulphurous Acid, tt\,v-3j, well diluted, for acid pyrosis 
 (B). Alkaline Mineral Waters, before meals in atonic dyspepsia, and highly 
 useful in the dyspepsia of obese subjects (B). Alkalies, shortly before a meal 
 increase the gastric juice, and are usually better than acids in atonic dyspepsia ; 
 Sodium Bicarbonate is the best (R) ; a full dose (gr. xl-lx) in dyspeptic attacks, 
 with flatulence, etc., usually affords speedy relief (Wa) ; Lime-water is often 
 efficient. Chloroform, gtt. xv-xx in sweetened water, when rapid fermentation 
 of food and evolution of gas soon after eating ; is promptly efficient in giving 
 relief (Willis) ; a highly efficient remedy in acute dyspepsia. Chloral, is a very 
 good remedy in doses of 5 to 10 grains in ^j of cinnamon water ; acts as a 
 
DYSPEPSIA. 68 1 
 
 gastric antiseptic and sedative, and is efficient in the nervous dyspepsia of 
 neurotic subjects, with severe gastric pain. Arsenic, drop doses of Fowler's 
 solution before meals in irritative dyspepsia (B) ; also when diarrhea is excited 
 by food (R). Bryonia, in dyspepsia of liver origin, and bilious headache with 
 vomiting (P). Charcoal, when flatulence; Nux Vomica in 5 rr^ doses before 
 meals, better (R). Mercury, Gray powder, gr. j 3 or 4 times a day, when 
 dyspepsia during chronic disease or convalescence ; if constipated, Calomel, 
 gr. ss, with Ext. Hyoscyami, gr. iij, in pill for 3 nights (R) ; the Yellow Oxide, 
 in doses of gr. ^V~Tjy» f° r dyspepsia septica and kindred disorders of the ali- 
 mentary canal ; remarkably efficient in Austrian navy (Schaffer). Ipecacuanha, 
 ttVv-x of the wine most valuable in atonic and chronic catarrhal dyspepsia 
 (P) ; constipation, depression, food like a heavy weight (R). Hydrastis, gtt. v- 
 xv of the tincture before meals, a good stomachic tonic (B) ; in chronic dys- 
 pepsia, sluggish liver (P). Pulsatilla, a good remedy when depression with 
 fear of death, white-coated tongue, little or greasy taste, nausea, flatulency, 
 heartburn ; gtt. v in water every 4 hours (P). Cannabis Indica, often renders 
 good service in indigestion. 
 
 Nux Vomica, gtt. v-x ter in die before meals as stomachic tonic (B) ; when 
 flatulence, weight on head, and heartburn (R) ; often of the highest possible 
 value in simple atonic form, or in the dyspepsia of drunkards (P). Cinchona, 
 with mineral acids in atonic dyspepsia (P). Quinine, especially for town- 
 dwellers and elderly people ; checks excessive fermentation in alimentary 
 canal (R). Chamomile, rr\jj of oil, very useful in atonic dyspepsia (P). Igna- 
 tia, useful in nervous dyspepsia (P). Taraxacum, certainly does good in sim- 
 ple atonic dyspepsia (P). Belladonna, gr. }4 to % of the extract, once a day 
 when there is constipation (R). Bismuth, mixed with vegetable Charcoal in 
 flatulent dyspepsia (R) ; gr. x with same quantity of Calcined Magnesia, in 
 chronic gastric catarrh where diet cannot be regulated (Rose) ; the Subgallate 
 (Dermatol) is said to be an efficient remedy. Aurum, the Chloride is useful in 
 nervous dyspepsia (see page 209) Manganese, gr. x-xv of the Black Oxide 
 in gastrodynia and pyrosis (B). Sanguinaria, gtt. ij-v of tincture or gr. T ^- of 
 alkaloid, in atonic dyspepsia promotes secretion and increases the appetite 
 (B). Silver Oxide, %. -grain doses with same quantity of Ext. Hyoscyami be- 
 fore meals in nervous dyspepsia (B). Xanthoxylum, as stomachic tonic, 3j of 
 the fl. ext. in atonic dyspepsia (B). Simple Bitters, Calumba is the best ; 
 Quassia or Gentian or infusions of them as vehicles for acids and alkalies (B) ; 
 Calumba is easily tolerated when the stomach is weak (R) ; Gentian as sto- 
 machic and tonic, very useful in atonic dyspepsia and that of gouty subjects ; the 
 tinct. in some aromatic water, or in combination with alkalies and sedatives 
 (Wa) ; Chirata is particularly serviceable in the dyspepsia of gouty subjects. 
 Rhamnus Purshiana, in all cases of dyspepsia associated with a torpid liver 
 and constipation ; small doses at first, gradually increased (Wa). Salophen, 
 is used with decided benefit in intestinal dyspepsia with flatulence. Strontium 
 Bromide, is excellent in dyspepsia, also in acetic and lactic fermentations. 
 Glycozone, is an excellent remedy for atonic and acid dyspepsias, in which it 
 gives very gratifying results (Edson). Aloes, combined with other agents, 
 where habitual constipation accompanies dyspepsia (R) ; especially indicated 
 in duodenal dyspepsia, gr. ij-iv with Ipecac gr. j-ij two or three times a week 
 (Wa). Water, a dry diet will entirely relieve the ice-water dyspepsia, or that 
 due to excessive beer-drinking (B) ; half a tumbler of cold water yi hour be- 
 fore breakfast acts to some people as a purgative and removes many dyspeptic 
 symptoms, but flatulent dyspepsia is often traceable to excessive water drink- 
 ing at meals, especially that of iced beverages (R). Hot Water, x / 2 a pint to a 
 pint at no°-i5o° F. an hour before each meal and %. an hour before going to 
 bed, each draught sipped slowly during 15-30 minutes; as a cure for dyspep- 
 sia this is an old and efficient practice (Wa). Milk-cure, has succeeded ad- 
 mirably (B) ; fresh Buttermilk a most excellent article for dyspeptics, as also is 
 Kumyss. Alcohol, in any form, especially good wines, is useful in the atonic 
 dyspepsia of sedentary livers (B) ; when loss of appetite and of digestive power 
 
682 
 
 DYSPHAGIA. 
 
 from fatigue, a glass of wine or brandy-and-water before eating is very appro- 
 priate ; useful also in indigestion of town-dwellers, or during convalescence 
 from acute disease (R). Diet, avoid tea and hot beverages, over-cooked food, 
 over-feeding and iced-water ; masticate all food well, eat slowly, small quan- 
 tities and frequently. Active out-of-door habits should be cultivated, and all 
 articles of food known to disagree should be strictly avoided. [Compare 
 Acidity, Biliousness, Flatulence, Gastralgia, Pyrosis.] 
 
 R. AcidiHydrochlor.Diluti, . £jss. 
 
 Glycerini, ]|ij. 
 
 Syr. Rubi Idaei, <> J ss - 
 
 Liq. Pepsini (Fairchild), . *iij. 
 Spt. Chloroformi, . . . . ?ss. 
 Vini AlbizWXericijq. s. ad gxij. 
 Sig. — ^ ss thrice daily after meals. 
 
 3J- 
 
 R. Ac. Hydrochlorici Dil., 
 
 Tinct. Capsici, .... 
 
 Tinct. Calumbae, .... 5jss. 
 
 Vini Pepsini, . . q. s. ad giv. 
 
 M. Sig. — Desser-tsp. after meals. 
 
 atonic dyspepsia. [Pancoast.] 
 
 In 
 
 R. Tinct. Capsici, H\,xvj. 
 
 Tinct. Nucis Vom., . . . zij. 
 
 Tinct. Gentianae Co.,<\.s.ad ^ij. 
 M. Sig. — A teasp. in water thrice daily, 
 with gr. ^ of Aloin at bedtime, avoiding 
 a starchy diet. For aggravated dyspepsia 
 with constipation. {Da Costa.) 
 
 R. Chloralis Hydratis, . . . ^ss-j. 
 
 Sodii Hyposulphitis, . . . 3J. 
 
 Aquae Menthae Pip., . ad ^iij. 
 M. Sig. — A teaspoonful in water after 
 meals in nervous dyspepsia with severe 
 gastric pain. 
 
 R. Creosoti, TT^viij. 
 
 Bismuthi Subcarb., . . . gij. 
 
 Glycerini, 
 
 Aq. Menth. Pip., . . . aa ^j. 
 M. Sig. — To be well shaken. A teasp. 
 every 3, 4 or 6 hours, for pain in stomach 
 and wind. (B.) 
 
 R. Tinct. Nucis Vom., . . , 
 Ac. Hydrochlorici Dil., , 
 Glycerini, ....... 
 
 Aquae Lauro-cerasi, . . , 
 M. Sig. — Dessertsp. before 
 
 improve appetite and digestion. 
 
 R. 
 
 M 
 
 Sodii Bicarb., gij. 
 
 Spt. Ammon. Aromat., . . ^ij. 
 
 Tinct. Zingib., 5j. 
 
 Infusi Gentianae Co. , . ad g viij. 
 Sig. — Teasp. or two thrice daily. 
 
 For acid dyspepsia. 
 
 R . Rhei, Gentianae, et Carda- 
 
 momi, contus. , . . . aa ^ij. 
 Spt. Vini Gallici, . . . . % ij. 
 
 Aquae, sjvj. 
 
 Macera per horas 48, cola et adde — 
 Tinct. Nucis Vomicae, 
 Potassii Carbonatis, . . aa gj. 
 M. Sig. — Tablesp. in water thrice daily, 
 before meals. 
 
 Dysphagia. 
 
 Cocaine, the Hydrochlorate in solution, 20 per cent., as spray or by swab, re- 
 lieves the dysphagia of phthisical laryngitis (P). Cajuput Oil, in nervous dys- 
 phagia, used in India with considerable success (P). Potassium Bromide, for 
 congenital dysphagia of liquids in children, when no diphtheria or malforma- 
 tion (R) ; in hysterical dysphagia (Wa) ; benefits a curious affection sometimes 
 seen in children, who from their birth can swallow solids with ease but choke at 
 liquids (R). Sprays of Ammonium Bromide, Chlorine-water, or other sedative 
 agents in warm solution, for the dysphagia depending on specific disease of the 
 larynx (Muirhead). Galvanism, in the vicinity of the esophagus will speedily 
 remove hysterical dysphagia (Muirhead). Tonics, as Strychnine, Iron and 
 Quinine, for post-diphtheritic dysphagia. Iced Fluids, slowly swallowed, will 
 often remove spasmodic dysphagia (Wa). 
 
DYSPNEA DYSURIA. 
 
 68 3 
 
 Dyspnea. 
 
 Morphine, hypodermically, the most efficient agent in relieving dyspnea 
 from cardiac disease, or any other form ; but if albumin in the urine it must be 
 withheld (Allbutt) ; controls dyspnea from any cause, more energetically than 
 any other agent, giving the very power to breathe (Huchard). Oxy-camphor, 
 in doses of gr. xv several times daily, is sedative to the respiratory centre like 
 morphine without producing the injurious effects of the latter agent, and is an 
 excellent remedy for many forms of severe dyspnea. Grindelia, of great 
 service in dyspnea with cough, occurring in emphysema (W). Cimicifuga, 
 has often relieved most distressing cases from cardiac disease (P). Spigelia 
 Anthelmia, produces and often relieves it when with palpitations (P). Valerian 
 has proved useful when nervous (P). Prunus Virginiana, has proved very 
 efficacious in cardiac dyspnea (P). Amyl Nitrite, serviceable in cardiac 
 dyspnea and other forms (Wa). Asafcetida, in combination with other anti- 
 spasmodics, often very beneficial in dyspnea of chronic bronchitis (Wa). 
 Strychnine, is a stimulant of the respiratory centre, and in small doses is use- 
 ful for the dyspnea of pulmonary affections and that with cardiac palpitation 
 in hysterical subjects. Arsenic, is efficient in the dyspnea of weak heart and 
 in that of chronic bronchitis. Ether, in 3-doses internally, for uremic dyspnea 
 (Whitla) ; seems to be of service only where there is much pulmonary en- 
 gorgement [see under Uremia]. Chloroform, a few whiffs give great relief in 
 the cough and dyspnea of phthisis and bronchitis (Wa). Ethyl Iodide, by 
 inhalation, is very serviceable in many forms (See). Terpin Hydrate, of espe- 
 cial value in asthmatic dyspnea, gr. ij every % hour until gr. x are taken 
 (Boyland). Terebene, for the dyspnea of chronic emphysema of the lungs ; 
 efficient in combating this symptom of various pulmonary affections. Bleed- 
 ing, in a plethoric subject of pneumonia, with firm and incompressible pulse, 
 suffering from dyspnea, or much pulmonary embarrassment and lividity, may 
 be relied on to turn the scale in the patient's favor (Whitla). Oxygen inhala- 
 tions, relieve the dyspnea of advanced phthisis and also the cardiac dyspnea 
 connected with mitral disease (P). Dyspnea is a symptom, and may be due 
 to cardiac, pulmonary, pharyngeal, laryngeal or tracheal disease (T). [Com- 
 pare Angina Pectoris, Asthma, Bronchitis, Croup, Emphysema, Phthisis, 
 etc.] 
 
 R. Potassii Iodidi, .... gj. 
 
 Tinct. Lobeliae, . . . . Zrv 
 
 Syr. Sanguinariae, . . . ^j. 
 
 M. Sig. — A teasp. every hour. 
 
 R . Liq. Morph. (Magendie), 3 j. 
 Spt. ^Etheris Compos. , . zij. 
 Syr. et Aquae, aa q. s. ad 3 iv 
 M. Sig. — 5 j-ij thrice daily. 
 
 Dysuria. 
 
 Cantharis, gtt. j (sometimes v) of tincture ter die, for frequent micturition with 
 pain (R) ; for irritable bladder, vesical tenesmus (B). Cannabis Indica, relieves 
 dysuria (R) ; when bloody urine (P) ; an excellent anodyne in painful affections 
 of the bladder, having specific action on that organ. Belladonna and Hyos- 
 cyamus, have similar sedative effects in vesical and urethral irritation (P). 
 Linseed, as infusion, is often a valuable adjunct (P). Opium, in suppository, 
 gr. ij combined with Hyoscyamus, gr. x, an excellent palliative (P) ; an enema 
 of Laudanum or Morphine hypodermically to relieve the strangury caused 
 by blisters (B). Camphor, is said to relieve strangury (R). Chimaphila, has 
 undoubted power (P). Squill, often produces the best effects, especially a com- 
 bination of the Acetum with Spt. ^theris Nitrosi equal parts, of which 3ss in 
 3 i j of Anise-water, every hour or oftener (Wa). Gelsemium, a useful remedy 
 
684 EAR AFFECTIONS ECTROPION. 
 
 (B). Ergot, in paralytic dysuria, with sensation of bladder being imperfectly 
 emptied (P). Alkalies, the Citrates, when dysuria from uric acid crystals in 
 young male children (R). Nitrous Ether, Spt. ^Etheris Nitrosi, 3j-j ss in any 
 convenient vehicle, a popular and efficacious remedy (Wa). Diluent Drinks, 
 freely, especially a decoction of Uva Ursi or of Cotton-root (P). [Compare 
 Vesical Sedatives, Bladder Irritable, and Cystitis.] 
 
 Ear Affections. 
 
 Boric Acid, dry by insufflation, to destroy aspergillus in the external meatus ; 
 used after weak astringent injections, leeches, fomentations, etc., in general 
 inflammatory conditions of the external ear (Whitla). Sodium Bromide, in 
 large doses, gr. xxx ter die, gives some slight benefit in tinnitus aurium (Id). 
 Cocaine, by instillation, sometimes gives considerable relief in tinnitus aurium, 
 from its influence on arterial pressure (Id). Water, warm, by syringe, to re- 
 move wax and foreign bodies. Olive Oil, poured into the canal, to drive out 
 insects or their larvae. Iodol, renders good service in eczema of the ear ; in 
 moist, confluent eczema of the pinna, extending within the auditory canal, the 
 surfaces should be thoroughly cleansed and the powder insufflated into the 
 canal ; in dry, external eczema it is best applied in the form of a Lanolin oint- 
 ment. The inflammation disappears completely under this treatment in about 
 2 weeks, but irrigation should be kept up for a short time afterwards to com- 
 plete the cure (Chatellier). [Compare Boils, Deafness, Otalgia, Otitis, 
 Otorrhea, Vertigo.] 
 
 Ecchymosis. 
 
 Arnica, rapidly disperses, if administered shortly after injury, tt\,v-x in water 
 every two or three hours (P). Alcohol, diluted more or less, according to the 
 amount of irritation present, is a good lotion (P). Hamamelis, the tincture 
 diluted with 5 to 8 parts of water, as lotion, when much discoloration. Ammo- 
 nium Chloride, in solution, as lotion on lint, or with bread or Linseed to form a 
 poultice, in ecchymosis of the eyelids (Wa). Capsicum, the tincture or a strong 
 infusion mixed with an equal bulk of mucilage or gum arabic and a few drops 
 of glycerin added, painted on over the bruised surface, a second or third coat- 
 ing being applied as soon as the first is dry ; there is nothing to compare with 
 this treatment for a black eye. [Compare Bruises, Purpura.] 
 
 Ecthyma. 
 
 Quinine, cures, though in many subjects will cause it (B) ; when due to mal- 
 nutrition (R). Lead, the Liquor Plumbi Subacet., 3j ad Oj aquas, a soothing 
 application (Wa). Zinc Oxide, the Glycerite with a little Camphor, an excellent 
 application (Wa). Cod-liver Oil, internally and locally (B). Grape-cure, often 
 happily modifies (P). Borax, a solution in rose or elder flower water (Wa). 
 Chlorinated Lime, a solution as a lotion (Wilson). Chrysarobin, internally, 
 half-grain doses, in wafer or pill, given with good results (Stocquart). 
 
 Ectropion and Entropion. 
 
 Silver Nitrate, freely to the exposed surface, in ectropion of lower lid due to 
 hypertrophy of conjunctiva after inflammation (C). Collodion, successfully 
 used in entropion to restore position of the lid by its contraction ; should be 
 concentrated (Wa). Faradization, in paralytic ectropion (C). Operative 
 Measures, of great variety, are in use, Arlt's being the best for bad cases of 
 the upper lid (Roosa). Epilation of lashes gives temporary relief in entropion. 
 
ECZEMA. 685 
 
 Eczema. 
 
 Arsenic, tt^v of Fowler's solution thrice daily on a full stomach, gradually 
 diminishing the dose, in the chronic type (B) ; especially in eczema of vulva, 
 anus and scrotum (R) ; small doses for acute, full doses for chronic form ; the 
 urine to be closely watched and the drug discontinued on the least sign of 
 renal irritation (Pf). Sodium Arsenate, hypodermically into an eczematous 
 patch, to change the indolent form into an active one (Pf ) : Arsenic rarely does 
 any good and often irritates (Hutchinson). Tar, internally, the Pix Liquida 
 in doses of gr. ij-v thrice daily, when Arsenic fails to relieve or is contraindi- 
 cated; locally in third stage when redness, drying and scaling; Oleum Ca- 
 dini when genuine is the best form of tar, mixed with simple ointment, Sss-j 
 to the ^ : 01. Rusci or Pix Liquida may be used (Pf ) : Tar is the chief local 
 remedy for eczema and is specific for all forms, next in order of value being 
 Lead and Mercury ; it should be employed in weaker solutions than are usual, 
 the best being the alcoholic solution of coal tar named Liquor Carbonis De- 
 tergens, 3j to the pint of water, used freely (Jonathan Hutchinson) : Tar should 
 never be used in the moist stage, but only after the acute inflammatory symp- 
 toms have subsided, and then cautiously; a useful combination, and one less 
 likely than tar ointments to cause irritation, is Ol. Cadini, Sj-iij, 01. Amygd. 
 Dulc, q. s. ad 25J, brushed lightly over the diseased surface. Lead, soluble 
 salts as lotions when much inflammation and discharge (R) ; also in early vesi- 
 cular and pustular conditions ; Diachylon ointment comes next in efficiency 
 to mercurial ointments (Pf ). Zinc, the Oxide and Carbonate as dusting pow- 
 ders (R) ; the Sulphate with Alum, Glycerin and Rose-water, an excellent lo- 
 tion (B) ; the Oxide is not curative, but as a protective is the best ointment, 
 when freshly and well made, for use over a large surface (Pf ). Lime-water, 
 as sedative application and to check discharge ; after inflammation is subdued, 
 Lime-water and Glycerin (R) ; mixed with Carron Oil a very good application 
 in acute eczema. Mercury, as black and yellow washes in early vesicular and 
 pustular conditions ; mercurial ointments are the most efficient of the local 
 applications, especially those of White Precipitate, Nitrate, mild Chloride, 
 and Black Oxide; ointments of the Biniodide or Bichloride as irritating appli- 
 cation in chronic indolent form (Pf); Brown Citrine Ointment nightly in ec- 
 zema of the margin of the eyelids after detaching scales (B); very useful when 
 eczema on hairy parts of face ; often is best mixed with a tar ointment (R). 
 Carbolic Acid, externally and internally in chronic forms (B) ; is analogous to 
 Tar, and suitable to the same types of the affection as the latter is (Pf ). Phy- 
 tolacca has cured obstinate cases (B). Graphite, in ointment, 1 to 10, or with 
 some inert powder, as Lycopodium or precipitated Calcium Phosphate, in 
 fissured eczema, especially that of the hands and behind the ears (Pf ). Bis- 
 muth, the Subnitrate or Subcarbonate locally (R) ; the Subgallate (Dermatol) 
 has proven very useful in the treatment of moist eczema. Zinc Salts, the 
 Oxide and Carbonate as dusting powder, or the Sulphate, etc., in astringent 
 ointments (Bulkley). Buckwheat Flour, one of the best dressings ; a limb 
 may be enveloped in a bag filled with the flour (Bulkley). Salicylic Acid, 
 locally, in eczema of hands and feet has been very successful (B) ; in plaster 
 is of very great value, and becoming more recognized (Unna, Pick) ; the best 
 form is a salicylated soap-plaster (formula on next page). Salol, as an anti- 
 septic powder, has done good service. Belladonna, gr. % of extract with gr. 
 iij of Quinine Sulphate thrice daily in eczema of the hand, with Bismuth Sub- 
 carbonate as a dusting powder (B). Aristol, is an excellent application. 
 
 Conium, the tincture may be added to one of the ointments for the pru- 
 ritus, which is usually very obstinate ; so also Stramonium or crude Petro- 
 leum (Pf ). Hamamelis, locally as antipruritic, and in chronic eczema marked 
 by decided venous retardation (Pf). Benzoin, to allay itching, the compound 
 tincture painted on the skin (R). Ichthyol, a promptly efficient remedy. 
 Thiol, may well replace Ichthyol ; the dry form as a dusting powder has been 
 
686 
 
 ECZEMA. 
 
 used with remarkable benefit. Anacardium Orientale (Oil of Cashew), as oint- 
 ment in patches of indolent chronic eczema (Pf). Iris Versicolor, in chronic 
 eczema of gouty patients invaluable as a hepatic stimulant, tt^v-x of tincture 
 from the fresh root twice daily (P). Rhus Tox., externally and internally, 
 when burning and itching, quickly subdues in some cases (P) ; in chronic 
 form with rheumatism, worse at night-time ; also in acute cases if given at the 
 very beginning, ^Ihts of a good tincture is dose enough to begin with (Pf). 
 Phosphorus, of undoubted service in eczema of long standing, probably acts 
 as a hepatic stimulant, gr. y^-g- to ^ in oil or reliable pill (Pf). Viola Tricolor, 
 an infusion the best form, with purgative doses of Senna for a few days then 
 alone, in eczema of the head and face ; gives prompt results (good or bad) ; 
 often aggravates, which though good in chronic forms must be avoided in 
 acute types (Pf ). Calcium Sulphide, gr. y^ to ^ in acute and chronic cases 
 of pustular character, the impetigo of old writers ; small doses in acute form, 
 larger ones in chronic cases (Pf ). Sulphur, internally and Sulphides as baths, 
 but not in the acute stage (R) ; solution of Potassium Sulphide in water locally 
 (B). Liquor Potassse, or a stronger solution of Potash, to infiltrated patch of 
 chronic eczema, before attempting to heal it (Pf ). Croton Tiglium, the seeds 
 bruised in alcohol, as liniment (Wa) ; the Oil as basis of stimulating appli- 
 cations in the chronic form (Pf ). Glycerite of Tannin, locally (R). Potassium 
 Iodide,- is often efficient where a syphilitic history or inheritance can be traced. 
 Glycerin, locally at night when caustic lotions have been used (R). Electricity 
 has cured obstinate cases (B). Thyroid Extract, has been used with bene- 
 fit (see page 158). Water, locally is injurious, unless its sp. gr. approaches 
 that of the blood serum ; Rose-water with a little Glycerin and Sodium Chlor- 
 ide when ablution necessary in second stage, that of exudation and crusting 
 (Pf ). Soaps, Petroleum, Cade or Carbolic (R) ; Sapo Viridis, to soften up in- 
 filtrated patches of chronic form, instead of the potash solutions mentioned 
 above (Pf ). Chaulmoogra Oil, in old cases is often of great benefit, as an 
 ointment (Wa). Oil of Cajuput, put up by mistake of druggist for Oil of Cade, 
 made a remarkable cure in a case which had resisted treatment for some time 
 (Claiborne). Diet should be largely vegetable, especially vegetables which are 
 eaten raw ; Cod-liver oil as a supplemental article of diet. Milk diet when 
 acid indigestion present (B). 
 
 R. Violse Tricolor, %]. 
 
 Sennae, *^ss. 
 
 M. Fiant chartulae no. iv. 
 Sig. — Make an infusion with hot water 
 from each paper, and take every night. 
 
 (Piffard.) 
 
 R. 
 
 oJ ss - 
 
 Vini Ferri Amari, . . . 
 Syrupi Tolutani, .... 311J. 
 Liq. Potass. Arsenit., . . 55 j. 
 Aquae Anethi, . . . . Jij. 
 M. Sig. — A teasp. to a dessertsp. thrice 
 daily. ( Wilson. ) 
 
 R. Potassii Citratis, gij. 
 
 Liq. Potassii Arsenit., . . 3 j — ij. 
 
 Tinct. Nucis Vom., . . . ^ ij. 
 
 Tinct. Cinchon. Comp., ad ^ iv. 
 M. Sig. — A teasp. in water, after meals, 
 as a tonic and alterative. {Bulkley.) 
 
 R . Emplas. Diachyli Simplicis, 
 
 Emplas. Saponat. , . . aa p. xl. 
 
 Petrolati, p. xv. 
 
 Acidi Salicylici, . . . . p. v. 
 Sig. — Emplas. Salicyl. Compos. [Pick.) 
 
 R-. Acidi Salicylici, 3J. 
 
 Zinci Oxidi, 3 iij. 
 
 Pulveris Amyli, ziv. 
 
 Adipis Lanae Hydrosi, . . 3J. 
 M. Fiat unguentum. Sig. — Apply daily 
 as a paste for eczema. [Practitioner.) 
 
 R 
 
 Hydrarg. Ammoniat. 
 Glyceriti Amyli, 
 M. Fiat unguentum. 
 
 gr. xv. 
 
 {Miiller. 
 
 R . Olei Cadini, 
 
 Zinci Oxidi, . . 
 Ung. Aquae Rosae, 
 M. Sig. — Ointment. 
 
 mildly astringent. 
 
 Antipruritic and 
 {Bulkley.) 
 
EMACIATION EMPHYSEMA. 
 
 687 
 
 R. Picis Liquids, 
 
 Pulv. Sem. Anisi, 
 Magnesise Calcin. 
 M. Ft. pil. no. c. 
 
 pills daily. 
 
 . . . aa 3 ijss. 
 
 . . q. s. 
 Sig. — Two to ten 
 (Miguet.) 
 
 R. 01. Cadini, ^ss. 
 
 Glycerini, sj. 
 
 Ung. Diachyli, J ijss. 
 
 M. Ft. unguentum. In squamous ec- 
 zema with thickened skin. {Fox. ) 
 
 Emaciation. 
 
 Calcium Phosphate, is especially useful in chronic wasting disease (R). 
 Arsenic, is used by cattle-breeders to fatten oxen, etc., quickly (Tr). Iodine, 
 improves the appetite and digestion, and gives strength and plumpness to the 
 body ( Wa). Cinchona, in small doses improves the appetite and the general 
 tone (Wa). Iron Salts, cause marked gain in flesh and color (Wa) ; remark- 
 ably promote the appetite and digestion (B). Cod-liver Oil, internally and 
 externally with friction, often very effective in the malnutrition and marasmus 
 of children (P). Olive Oil, by friction daily; inunctions are of value in many 
 wasting diseases (P). Pepsin, to promote digestion of food (P). [Compare 
 Appetite, Atrophy, Phthisis, Tabes Mesenterica.] 
 
 Emissions and Erections. 
 
 Hyoscine, the Hydrobromate in pill, gr. yJq to -^ at bed-time, will always 
 check seminal emissions (W). Belladonna, when emissions, genitalia relaxed, 
 atonic state (B) ; in gradually increasing doses produces good results, even in 
 extreme cases of emissions (Wa). Camphor, fails as often as it succeeds (P). 
 Potassium Bromide, exercises special influence as a sedative in irritable states 
 of the genito-urinary organs (Wa). Cimicifuga, as tonic to the nervous system, 
 removes irritation and melancholy, produces sound and refreshing sleep (Wa). 
 Lupulin, useful to check emissions (P) ; gr. v-x or xv to keep penis at rest 
 (Wa). Ruta, in small doses to limit discharge (P). Chloral, at bed-time, re- 
 peated every night until the habit is broken off (Wa). Iron, the tincture of 
 the Chloride in 3 doses at bed-time, sometimes conquers nocturnal emissions 
 (Wa). Cocaine, a few drops of a 4 per cent, solution upon the glans penis, 
 promptly controls an erection. [Compare Chordee, Spermatorrhea, and 
 the List of Anaphrodisiacs on page 31.] 
 
 Emphysema of the Lungs. 
 
 Morphine, gr. l /e, and Atropine, gr. T |^, hypodermically for the asthmatic at- 
 tacks ; no remedy so efficient ; the disease being incurable treatment must be 
 chiefly palliative (B). Potassium Iodide, in full doses alone or combined with 
 the Bromide, affords most relief next to Morphine (B). Strychnine, is a valu- 
 able respiratory stimulant ; useful where there is constant dyspnea with pro- 
 longed expiration (Wa). Stramonium, the leaves smoked for the asthma and 
 dyspnea before retiring, will often give a good night's rest (Wa). Ammonium 
 Iodide, with Arsenic for the bronchitis, with Copaiba, Turpentine or Eucalyp- 
 tol, continued for some time (B). Digitalis, or hydragogue cathartics as Pulvis 
 Jalapas Comp., for the dropsy (Da C). Arsenic, when emphysema is con- 
 nected with recession of a rash, is useful (R); long continued it ameliorates 
 (B). Terebene, gives good results on the dyspnea. Lobelia, allays the dysp- 
 nea which accompanies capillary bronchitis in emphysema (R). Senega, 
 often acts beneficially (P). Cod-liver Oil, continued for a long time (R). 
 Hypophosphites, are useful (B). Chalybeates, the Phosphate of Iron, Quinine 
 and Strychnine (B). Grindelia, for asthmatic breathing and bronchitis (B) ; 
 of great service (Wa). Chloral, for the short breath of such patients brought 
 on bv catching cold ; if obstructed circulation caution required (R). Bleeding 
 and Purging, have been used with great success in many emphysematous con- 
 ditions (R). Breathing into Rarefied Air, the only scientific remedy yet brought 
 
688 
 
 EMPYEMA ENDOMETRITIS. 
 
 forward for this affection, affording much relief which is sometimes permanent. 
 The Waldenberg-Schlitzner apparatus is the best for this purpose. When there 
 is co-existing bronchial catarrh it is necessary to precede the expiration into 
 rarefied air by inspiration of compressed air, else irritative cough is excited 
 (Y). [Compare Asthma, Bronchitis, Dyspnea,] 
 
 R. Potassii Iodidi, giij. 
 
 Strychninae Sulph., . . . gr. j. 
 
 Liq. Potassii Arsenit. , . . Z ijss. 
 
 Aquae Laurocerasi, q. s. ad 3 iv. 
 M. Sig. — Teasp. 4 times daily. For 
 relief of dyspnea, toning the cardiac ac- 
 tion, removing the bronchial catarrh, and 
 preventing the progress. [Hughes.) 
 
 R. Potassii Chlorat., 
 
 Tinct. Belladon., . . . aa^jss. 
 Ext. Pruni Virgin. Fluidi, 
 Tinct. Cinchonse Comp., aa^ij. 
 M. Sig. — A dessertsp. 4 times a day, 
 when chronic bronchitis and anorexia. 
 Dry cups also to chest night and morning. 
 (Da Costa.) 
 
 Empyema. 
 
 Carbolic Acid, a weak solution to be injected after evacuating the pus (R) ; 
 Carbolate of Iodine has been injected with benefit (B). Iodine, in solution to 
 be injected after tapping (R) ; the undiluted tincture may be thrown in without 
 risk and with great benefit ; or the compound solution Jj to |xv aquae, as wash 
 for the cavity to prevent re-formation of pus (B). Chlorine Water, or a solution 
 of Quinine, to wash out the cavity (R). Salicylic Acid, in solution, answers 
 well for the same purpose (P). Ammonium Acetate, the official Liquor Ferri 
 et Ammonii Acetatis, with Quinine and stimulants, if the affection shows a ten- 
 dency to linger (Da C). 
 
 Endocarditis. 
 
 Aconite, should be given early in all inflammations of serous membranes 
 (Wa) ; gtt. y 2 or less, frequently (R) ; it is rare to meet with permanent organic 
 heart disease as a result of rheumatic fever when the disorder is treated with 
 Aconite from its commencement (P). Spigelia Anthelmia, is very useful in 
 rheumatic endocarditis (P). Opium, in inflammation of serous membranes 
 (B). Digitalis, to control the circulation, especially where irregular heart 
 action (Da C). Veratrum Viride, has been used with remarkable effect on the 
 pulse (Wa). Alkalies, as Potassium or Ammonium Carbonate, freely until 
 urine is alkaline, to prevent permanent changes about the valves or orifices 
 (Da C). Potassium Iodide, to promote absorption of the exuded lymph. 
 Quinine, at the onset, may check the inflammation (B). Salicylic Acid, is use- 
 ful in the rheumatic form (P). Iron, the tincture of the Chloride with alkalies, 
 if pyemic symptoms are manifested (Da C). Rest for some days after active 
 signs have abated, with agents to lower the blood-pressure within the heartand 
 vessels (Fothergill). Leeching, in the stage of acute inflammation is to be 
 recommended if done early, later is useless ; use cups if no leeches are at hand 
 (Da C). Poultices, give great relief and are of decided benefit (Id). Stimulants, 
 as Ammonium Carbonate, etc., freely, if signs of oppressed circulation appear 
 (Id). [Compare Pericarditis.] 
 
 Endometritis. 
 
 Carbolic Acid, undiluted, on cotton-wrapped probe ; no better method of 
 treating uterine catarrh (B). Iodine, the most valuable of all local remedies 
 (E) ; Churchill's tincture (Iod. gr. 75, Pot. Iod. gr. 90, Alcohol gj), one of the 
 most useful applications to the endometrium (Munde). Iodized Phenol (Iodine j, 
 Ac. Carbol. iv), on cotton-wound probes, applied to the uterine cavity, has 
 given the best results of any agent used for years past (Battey). Chromic 
 
ENEMATA ENTERITIS. 
 
 689 
 
 Acid, as caustic, when slough is required ; should only be used after dilatation 
 of cervical canal, and at the patient's home (Munde) ; a solution of gr. xv to 
 3j of hot water applied with success to the uterine cavity for catarrh (Wooster). 
 Nitric Acid, fuming, to uterine cavity through intra-uterine speculum (Atthill) ; 
 is considered by many the one agent for all forms of intra-uterine medication ; 
 is efficient and comparatively safe but produces too much cicatricial tissue 
 (Munde). Iodoform, as suppository in rectum (B) ; in pencils to uterine canal. 
 Iodo-tannin, locally in chronic cases (B). Ergot, or better Ergotin, gr. j, sub- 
 cutaneously, for the train of uterine disorders depending on passive congestion 
 of the organ (P). [See Hysteria for formula.] Glycerin, as a local application, 
 introduced by Sims, is of great value ; especially as vehicle for impure Carbolic 
 Acid or Iodine, on cotton or oakum (E). Hot Water injections in large 
 quantity about the os uteri, are of great value (E) ; as usually made are of no 
 value ; must be applied by special syringe, in the dorsal recumbent posture 
 with elevated hips, at a temperature of ioo° to 120 F. twice daily for at least 20 
 minutes each time, and persevered in for months and years (Munde). [Com- 
 pare Uterine Congestion and Hypertrophy.] 
 
 R . Potassii Iodidi, 
 
 Potassii Bromidi, . . . aagr. xx. 
 
 Tinct. Iodi, . . . . . . gss. 
 
 Aquae, ^ij. 
 
 M. For hypodermic injection into cer- 
 vix, in chronic cervical metritis. [Bennett.) 
 
 R . Ergotini, gr. xx. 
 
 Tinct. Iodi, gj. 
 
 Glycerini, .... q.s. ad%). 
 M. Sig. — Apply twice daily with cam- 
 el's-hair brush, in cervical metritis. 
 
 {Dabney. ) 
 
 Enemata. 
 
 Enemata, for an infant, ^ss-j ; child of 2 to 5 years, Jij-vj ; 5 to 15 years, 
 § vj-Oj ; adult, Oj-quart j. A simple domestic enema consists of soapsuds with 
 a little common salt, or a pint of cold water (B). Simple warm water or gruel 
 sometimes ; or to one or the other of these add Soap, Turpentine or Castor 
 Oil, with soap or gruel to suspend the two latter. Very cold water may be 
 used without inconvenience. Starch, boiled or raw, of cream consistence, tem- 
 perature 100 , with a few drops of Tinct. Opii, in extreme cases of choleraic 
 diarrhea, or that of phthisis or typhoid fever (R). Nutrient Enemata, should 
 contain materials for artificial digestion, as the rectum is not an organ of diges- 
 tion, and to secure rapid osmosis should have an acid reaction. A suitable 
 formula is appended below. Inject slowly and not frequently ; five times in 
 twenty-four hours should be the maximum. Defibrinated blood has also been 
 used as a rectal injection with good results, being completely absorbed (B). 
 Enemata should not exceed three or four ounces of bland material, injected 
 slowly, after ascertaining that the rectum is not filled with feces (R). [Compare 
 the subtitle Injectiones, ante, page 577.] 
 
 Nutrient Enema. 
 R. Infusi Carnis (Beef-tea), . ^iv. 
 Acidi Hydrochloric:, . . . TT^x. 
 Glyceriti Pepsini (Scheffer), 3 ij. 
 If rectum irritable add 10 to 20 drops of 
 Laudanum. ■ 
 
 Enema Ricini et Terebinthince. 
 
 01. Ricini, 3J SS - 
 
 01. Terebinth. , 3 ss. 
 
 Ovum, j. 
 
 Decocti Hordei, vel 
 
 Aq. Fervid., ^ x i y - 
 
 Enteritis. 
 
 Opium, to the point of tolerance, is the remedy, the deodorized tincture in 
 10-drop doses every second or third hour, according to age (Da C) ; of great 
 value to control inflammation and quiet the intestines (B) ; proves of signal 
 use (Wa). Aconite, of great utility in acute inflammation with high tempera- 
 
 44 
 
690 
 
 ENURESIS EPIDIDYMITIS. 
 
 ture, sthenic condition, resisting pulse (R). Arsenic, surprisingly curative ; 
 small doses with Opium (B). Podophyllum, with occasional doses of Aconite, 
 will often allay the vomiting and diarrhea (P). Ricinus Communis, is employed 
 with great advantage (P). Lime-water, in mucous enteritis. Turpentine 
 stupes, hot, over seat of disease, are of advantage (Wa). Skim-milk, is of the 
 highest value as sole diet in acute inflammation of digestive organs (B). 
 Poultices, Linseed, large and hot (Wa) ; may be used or not, as the patient 
 feels benefit from them or otherwise (Da C). Water, hot fomentations, followed 
 by a wet compress ; cold and hot, principally cold, or ice, of unquestionable 
 advantage (B). Ice or cold water freely swallowed. Perfect quiet in bed. 
 Diet, no food until inflammation subsides, then beef-tea, milk, gum-water, etc., 
 the very mildest and most bland diet for four or five days (Da C). [Compare 
 Cholera, Diarrhea, Dysentery, Peritonitis, Typhlitis.] 
 
 Enuresis. 
 
 Belladonna, no single remedy so uniformly successful ; children require large 
 doses ; small doses are useless (P) ; a solution of Atropine best, gr. T |^ to ^ 
 (B) ; the best remedy for children, gtt. x-xx of the tinct. three times a day ; if 
 unsuccessful and no worms or other irritation exist, try Strychnine, Cantharides, 
 Turpentine, Santonin or Galvanism (R). Santonin, in over-doses produces 
 incontinence of urine in children, but curiously will sometimes stay the habit, 
 even when not dependent on worms and in cases where Belladonna fails (R) ; 
 in the enuresis from worms (P). Cantharides, one or two drops of the tinct. 
 three or four times a day in middle-aged women or the aged, even when due 
 to paralysis ; sometimes also in children, but for them Belladonna is generally 
 better (R). Chloral Hydrate, enuresis in children (R) ; three-grain doses thrice 
 daily for infantile incontinence (Da C). Strychnine, may succeed when the 
 above remedies fail (B) ; sometimes useful for old people with paralysis of 
 bladder, also for children (R). Quinine, in full doses, does good service in 
 cases where chorea exists (Potts). Buchu, often successful in chronic enuresis 
 (P). Turpentine, small doses sometimes remove the trouble (B). Lupulin, 
 said to be useful ; Herzfelder used it with advantage. Rhus Aromatica, has 
 proven curative in 75 per cent, of cases treated with it and of great benefit in 
 the other 25 per cent.; the fluid extract, tt\,x-xv four times daily in glycerin and 
 water (Stein). Scutellaria, remarkably efficient in many instances, 3j of the 
 fluid extract thrice daily for a child 12 years old. Potassium Nitrate, has been 
 recommended for children (R). Potassium Bromide, succeeds in some cases 
 (Wa). Collodion, painted to form a cap over end of prepuce (R). Ergot, 
 when from paralytic state of sphincter (B) ; said to be useful (R). Iron Iodide, 
 the syrup rr^xv-xx, well diluted with water, ter die, in pale, delicate, strumous 
 children (B) ; sometimes useful even when no worms (R). Habits, children 
 to be taught to retain water as long as possible during the day, little salt to be 
 eaten, abstinence from fluids not necessary, bland fluids diminish acridity of 
 the urine. Removing meat from the diet has cured several cases permanently, 
 after all remedies had been tried without success. 
 
 R. Strychninse Sulph., . . gr. j. 
 
 Pulv. Cantharidis, . . . gr. ij. 
 
 Morphinse Sulph. , . . . gr. jss. 
 
 Ferri Reducti, . . . . gr. xx. 
 Ft. pil. no. xl. Sig. — One thrice daily 
 for a child of 10 years. (Gross.) 
 
 R. Tinct. Ferri Chloridi, . . srij. 
 
 Ext. Ergotae Fluidi, . . 3 v. 
 
 Spt. Chloroformi, . . . zij. 
 
 Tinct. Quassiae, q. s. ad Jjiv. 
 M. Sig. — A teasp. in a winegl. of water 
 thrice daily for children 
 
 Epididymitis. 
 
 Aconite, alternately with Pulsatilla, the latter in very small doses, a few 
 drops of tinct. in a glass of water, a teasp. every 2 or 3 hours, produces the 
 happiest effects (Pf, St). Belladonna, the extract, 3j-ij ad jfj of glycerin and 
 
EPILEPSY. 69I 
 
 water, on lint, applied to the inflamed testicle (Bumstead). Tobacco, with Lin- 
 seed meal, as poultice, cautiously ! (P). Mercury and Morphine, locally, a 20 
 per cent, oleate by inunction, in cases of syphilitic origin (R). Silver Nitrate, 
 gr. lxxx ad ^iv aquae destil. freely applied to the scrotum will sometimes abort 
 an epididymitis (Wa). Strapping and suspensory bandage to support the testicle, 
 also rest in the recumbent posture from the beginning, with a saline cathartic 
 to clear the bowels, are all measures of great importance (Bumstead). [Com- 
 pare Orchitis.] 
 
 Epilepsy. 
 
 Bromides, should be first employed in all cases, there being no remedy equal 
 to large doses of Bromine salts, which should be persistently continued for 
 many months, and with short periods of rest may be kept up for years; the 
 combination mixture of Bromides has been taken by patients for 8 to 10 years 
 without harm (Brown-Sequard) ; Bromides taken for long periods without a 
 physician's supervision have caused profound muscular depression, mental 
 alienation and death (Hammond). Potassium Bromide, gr. xl ter die before 
 meals, double dose at bedtime, for two or more years after all epileptic indications 
 have ceased; is generally useful, especially in daytime seizures a.r\& grand mal 
 of sexual origin; also for infantile convulsions (B); especially in convulsive 
 form, but often powerless (R). Sodium Bromide, gr. xx ter die, will arrest epi- 
 lepsy without producing the cerebral symptoms of bromism (Clymer). Lithium 
 Bromide, 3ss daily, acts in some cases after Pot. Brom. has failed, and is gen- 
 erally efficient in about one-half the dose of the latter salt (Weir Mitchell). 
 Nickel Bromide, gr. v thrice daily is remarkably efficient in the epilepsy oc- 
 curring at the menstrual epoch, and cases which have withstood the action of 
 the other bromides (Da C). Ferrum Bromide, will often cure cases in weak and 
 anemic subjects; also with Potassium Bromide to combat the anemia and 
 depression produced by the latter (B). Ammonium Bromide, preferred in 
 petit mal by many authorities ; combined with other bromides, as in Brown- 
 Sequard's mixture (see formula on p. 693), before meals, with Strychnine 
 or Arsenic and a vegetable bitter after meals ; in combination with Antipyrin 
 (see next page) is efficient (W). Zinc Bromide, gr. v in water and glycerin 
 four times daily ; may be combined with the other bromides. Strontium 
 Bromide, in doses of gr. xx thrice daily, gradually increased ; has been bene- 
 ficially used as an alternate, being much less liable than the others to produce 
 bromism (See) ; should be given in 30-grain doses, and combined with a 
 dose of Physostigmine, when its effect on epilepsy is very marked (Stanley) ; 
 both the Strontium and Calcium Bromides may be used with benefit (Fere). 
 Aurum Bromide, is highly efficient in doses of gr. ]/% to ]/ 2 (see page 209); 
 Aurum and Arsenic Bromide, the solution in 5-minim doses thrice daily, in- 
 creased to 10 minims, gave very satisfactory results in a severe case in a boy 
 aged lYz years (Barclay). 
 
 Opium, a valuable adjunct to the Bromide treatment, a prolonged treatment 
 by opium rendering the organism extremely susceptible to the action of bro- 
 mides ; for 6 weeks ascending doses beginning with 1 grain, up to a daily 
 dosage of 15 grains or more; then suddenly stopped and replaced by 30 grain 
 doses of Potassium Bromide four times daily, produced instantaneous effect on 
 cases in which all other medication for several years had failed (Flechsig). 
 Digitalis, Belladonna or Physostigma, in combination with bromides give better 
 results than the latter alone (Poulet) ; Digitalis is valuable in petit mal and in 
 nocturnal epilepsy (Da C), a good addition to the bromides when there is 
 cardiac weakness (Huchard) ; 10-minim doses of the tincture with 20 grains of 
 Potassium Bromide thrice daily, in cases complicated with cardiac dilatation 
 (Gowers). Belladonna, for petit mal and nocturnal epilepsy, in pale and anemic 
 subjects, should be given for a year or more ; extract and leaves, gr. \ of each 
 in pill, every day at same hour, one additional pill every month (Tr) ; useful, 
 especially when from fright (P). Atropine better, drop-doses of a 1 per cent. 
 
6g: 
 
 EPILEPSY. 
 
 solution of the neutral sulphate in white brandy (Tr). Arsenic, in epileptiform 
 vertigo from stomach disorder (B) ; sometimes useful (R) ; the Bromide of 
 Gold and Arsenic (see ante). Sodium Borate, in doses of gr. xx 3 or 4 times 
 a day, has produced very good results in nocturnal epilepsy ; is of real value 
 and better than Bromides in symptomatic epilepsy, may also be found useful 
 in nervous forms after the bromides have failed (Mairet) ; if begun with 
 small doses may be gradually increased to 90 grains a day ; when dose exceeds 
 60 grains daily it is advisable to add glycerin to the water and syrup used as 
 excipients (Dijoud) ; excellent results obtained from a combination of Borax 
 with Bromides, especially Sodium Bromide (Alexander) ; in most cases the 
 disadvantages of this drug more than counterbalance the slight benefits result- 
 ing therefrom (Fere) ; for cases in which Borax acts best, and for the results 
 of Borism see page 82. Physostigma used in 12 cases, of which 6 were im- 
 proved, and in the others a notable increase took place in the number of the 
 paroxysms (Williams). Chloral, a valuable auxiliary in troublesome cases with 
 tendency to insomnia, violent convulsions or maniacal excitement ; should be 
 given in the evening, combined with bromides and used with caution when 
 cardiac debility (Y) ; in full doses at night the most suitable remedy for the 
 nocturnal variety (B). Antipyrin in combination with Ammonium Bromide 
 (gr. vj with gr. xx) has proved very efficient, alleviating some quite hopeless 
 cases (W) ; is a real gain in the management of epilepsy (Y) ; Potts has pub- 
 lished a report of 43 cases treated with this combination. Acetanilid, of great 
 value where bromides fail, in four such cases it produced definite cures in doses 
 of iVz grains in cachets thrice daily (Dujardin-Beaumetz) ; of very uncertain 
 action (Y) ; is most useful in the diurnal form and in cases of full habit, active 
 circulation, red face, and injected eyes (B). 
 
 Amyl Nitrite, inhaled at the beginning of the aura will prevent an attack 
 (B) ; or TTLij-v in mucilage, when fits are very frequent (R). Nitro-glycerin, 
 V^TWU' slower in action than Amyl Nitrite, but more enduring (Pf ). Chloro- 
 form, by inhalation during paroxysm and also in intervals (Wa) ; is of high 
 value especially in cases of an hysterical character (Brown-Sequard) ; Anes- 
 thetics are rarely called for (W). Amylene Hydrate, in 10 per cent, solution, 
 of which a tablesp. or two (gr. 30 to 90) a day, of value in petit mat and noc- 
 turnal epilepsy, also when bromides have failed, and where the attacks are not 
 only very frequent but severe (Nache). Hydrastinine, has been used with 
 benefit, in doses of gr. % to gr. y 2 of the Hydrochlorate, up to gr. ij daily. 
 Picrotoxin, anemic subjects, attacks occurring at night, ^j to -fa of a grain 
 hypodermically, or -fa to -^ by stomach (B); benefits cases resulting from 
 onanism (P). Cannabis Indica, has given good results; is suitable for petit 
 mal, the nocturnal variety, and with Strychnine, Belladonna, or Picrotoxin 
 for cases characterized by anemia and depression (B). Quinine, when of 
 malarial origin (P) ; often useful in intermittent epilepsy (Ros). Ignatia, in 
 convulsions unattended with cerebral congestion (P) ; is par excellence the 
 controller of functional phenomena of the cerebro-spinal axis (Pf ). Strychnine, 
 is useful in idiopathic epilepsy, but injurious in symptomatic form ; benefits when 
 Potassium Bromide fails ; when cerebral anemia, nocturnal attacks (S, Pf ) ; if 
 bromides fail and case is anemic, give Strychnine, gr. -^ ter die, and push it 
 (B). Silver Nitrate, is not without efficacy, and was formerly much used, but 
 the danger of staining the skin has caused its disuse, especially as better agents 
 have been found (Wa). Copper Salts, may be useful in cases originating from 
 the stomach ; were formerly much used (B) ; the Nitrate or Oxide often given 
 with benefit (R) ; the Ammonio-sulphate, gr. % in pill, thrice daily to begin 
 with ; should not be continued beyond 3 or 4 months at a time (Brown- 
 Sequard). Zinc Salts, have been much used in place of silver and copper 
 salts, not having the serious drawbacks attending the latter agents ; the Oxide 
 is probably useful only in cases originating from the stomach ; much said for 
 and against it (R) ; the Citrate and the Lactate are preferred by many, as less 
 likely to cause stomach derangement (Y). Orchitic Extract, also Spermine, have 
 been used with benefit (see pages 163, 164). Turpentine, has long been used, 
 
EPISTAXIS. 
 
 693 
 
 when due to reflex impression of intestinal parasites (B). Conium, not equal to 
 the bromides (B) ; not of much value (P). Valerian, has been used with some 
 advantage (R). Bryonia, has an ancient reputation (P). Rue, may benefit 
 when seminal emissions (P). Solanum Carolinense (the Horse-nettle), in tinc- 
 ture of the berries, made by bruising them and steeping in whiskey, has quite 
 a reputation among the negroes for epilepsy and other convulsive affections, 
 and has rendered good service in my hands (Napier). Fats and Oils, espe- 
 cially cod-liver oil when faulty assimilation exists (B). Galvanism, only in 
 idiopathic epilepsy (B). Meat Diet, in many cases must be prohibited entirely. 
 Trephining the skull, has given good results in several cases where a distinct 
 impression from injury existed; in others where apparently indicated it has 
 been of no service. [Compare Convulsions.] 
 
 R 
 
 B 
 
 . Potassii Bromidi, . . . . ]§j. 
 
 Ferri Bromidi, gr. iv. 
 
 Aquae, 5ij. 
 
 Syrupi Simplicis, . . . . §vj. 
 M. Sig. — A tablesp. twice daily. 
 
 Strychninae Sulphatis, . . gr. j. 
 Acidi Sulphurici Dil., . . ttlx. 
 Aquae Desril., .... ^iv. 
 M. Sig. — A teasp. gradually increased 
 to a dessertsp. after each meal. 
 
 R. Potassii Bromidi, 
 
 Sodii Bromidi, . . . . aa Jss. 
 
 Liq. Potas. Arsenitis, . . £ss. 
 
 Ext. Conii Fl., n\L 
 
 Aquae Cinnamomi, . . . ^ij. 
 
 Infus. Gentian. Co., q.s. ad ^viij. 
 M. Sig. — One tablesp. two hours after 
 each meal. 
 
 R . Potassii Bromidi, 
 
 Sodii Bromidi, 
 
 Ammonii Bromidi, . . aa^iij. 
 
 Potassii Iodidi, 
 
 Ammonii Iodidi, . . . aagjss. 
 
 Ammonii Carbonat., . . £j. 
 
 Tinct. Calumbae, .... Jjss. 
 
 Aquae, .... q. s. ad ^viij. 
 M. Sig. — A teasp. and a half before 
 each meal, and three teasp. at bed-time. 
 [Brown- Sequard. ) 
 
 & . Potassii Bromidi, 
 
 Ammonii Brom., . . . aa j§ij. 
 
 Ext. Ergotae FL, . . . . |j. 
 
 Aq. Cinnamomi, . q. s. ad Jviij. 
 M. Sig. — A dessertsp. in water thrice 
 daily. When maniacal excitement and 
 danger of cerebral hemorrhage. {Smith.) 
 
 Epistaxis. 
 Aconite, has been used with the best results (P) ; small frequent doses 
 quickly check epistaxis in children and plethoric people (R). Antipyrin, has 
 been highly efficient; in 5 to 15 per cent, solution as a local hemostatic, it 
 will arrest almost any nasal hemorrhage (Huchard). Adrenal Extract, used 
 both locally and internally, is very efficient [see page 165]. Gelatin, 5 parts 
 dissolved in 95 of normal salt solution and sterilized by boiling at a temperature 
 not above 239 F., is a promptly styptic application (Carnot). Arnica, internally, 
 is of great service in epistaxis from mechanical violence (P). Belladonna, 
 when the bleeding is of congestive origin (P). Ipecacuanha, has been highly 
 praised (R) ; acts upon the vessels (B) ; gr. j-ij every quarter hour until nausea 
 is felt, but vomiting need not be excited (Wa), Hamamelis, venous hemorrhage 
 (Pf). Ergot, £>ss-3j of fresh powdered Ergot, or 3j— 3ij of flu. ext. every half hour 
 or hour, necessary in urgent cases (B). Alum, injected or snuffed up in powder 
 (R). Iron Spray, in obstinate cases Liq. Ferri Subsulph., £j to ^viij aquae by 
 spray or injection ; the tinct. of the Chloride also useful (B) ; diluted Z'\) in 5yj 
 injected into the nostrils is often effectual (Wa). Tannin, finely powdered, blown 
 into the nostrils through a quill (Wa); a strong solution, Z'\) ad 31V, by nasal 
 syringe (B). Turpentine, may be given internally with advantage (Wa) ; espe- 
 cially in debilitated conditions (B). Lead Acetate, gr. ij-iv with Opium gr. ss-j, 
 proves signally useful ( Wa). Vinegar, on lint introduced into the nostrils, some- 
 times highly efficient (Wa). Digitalis, is of undoubted benefit (B) ; the infusion 
 best (R). Transfusion, when death from exhaustion is apparently imminent (B). 
 Facial Artery, compression of (R). Keep head elevated and cool, warm the 
 feet and hands by plunging into hot water, apply ice over the nose, resort at 
 once to the tampon if bleeding becomes alarming. Cauterize with electric 
 cautery any ulcers in anterior nares. [Compare Hemorrhage for formulae.] 
 
694 ERUPTIONS ERYSIPELAS. 
 
 Eruptions Produced by Drugs, etc. 
 
 Aconite, vesicular exanthemata. Antimony (locally), papules, vesicles, pus- 
 tules, similar to the eruption of small-pox. Antipyrin, erythema and urticaria, 
 chiefly on thighs and abdomen, with much itching and dyspnea. Antitoxin 
 (Diphtheritic), erythema, with pain in the joints. Arsenic, erythema, eczema, 
 papules, vesicles, pustules. Atropine, erythema, like the rash of a scarlet fever. 
 Belladonna, as Atropine. Borax, papules, scarlatiniform. Bromides, acne, 
 chiefly on the face and back ; pustules, deep tubercles with ecchymoses, ulcers, 
 pemphigus. Castor Oil, urticaria. Cinchona, as Quinine. Carbolic Acid, 
 erythema. Chloral Hydrate, erythema, on face and neck, itching, desquama- 
 tion, eczema, petechias, purpura. Codeine, as Opium. Copaiba, also Cubeb, 
 urticaria, erythema, eczema, pemphigus ; the Copaiba rash has a preference for 
 the ankles and wrists. Cod-liver Oil, acne. Croton Oil (locally), papules, pus- 
 tules. Digitalis, erythema, after long usage. Enemata, of the simplest form, 
 as soap and water, may cause a bright scarlet rash and other symptoms of a 
 mild septic toxemia (Burford). Iodides, acne, papules, vesicles, pustules, 
 eczema, ecthyma, ecchymoses and purpura ; the Iodide rash prefers the face 
 and back of neck and shoulders. Mercury, erythema, eczema. Opium and 
 Morphine, erythema, papular eruption with marked desquamation and itching. 
 Phosphorus, purpura. Quinine, erythema, scarlatina, papular erythema, 
 hemorrhagic purpura, pemphigus and prurigo ; the prevailing type of the 
 Quinine eruption is erythema, or exceptionally eczema or purpura, and is 
 essentially ephemeral ; it is of a bright vivid hue, disappearing on pressure, 
 and resembles the scarlatinal rash, first appearing on face and neck, and thence 
 spreads over the body : in some instances it comes in distinct spots and 
 resembles measles ; in others it is an urticaria, with some edema, and distress- 
 ing burning, tingling, and itching; five cases of purpura are authentically 
 reported. Rhus Toxicodendron (and other varieties of Sumac), vesicles perhaps 
 pustules, with redness, swelling and intolerable itching. Salicylic Acid, urti- 
 caria, purpura, pemphigus, vesicular angina. Santonin, pemphigus, vesicles. 
 Stramonium, as Atropine. Strychnine, as Quinine. Sulphur (locally), ery- 
 thema, eczema. Tar, acne. Tartar Emetic (locally), as Antimony ; in some 
 cases of poisoning by tartar emetic a rash of the above description appeared 
 all over the body. Turpentine, as Copaiba. 
 
 Articles of Food producing eruptions are : Acid Fruits, may cause acute 
 eczema. Strawberries, urticaria. Apples, acneform efflorescence about the 
 mouth. Walnuts, inflammation of buccal mucous membrane. Shell-fish, 
 urticaria. Roast Turkey, in one case caused great urticaria. Lager Beer, 
 acne in some. Alcohol, aggravates cutaneous inflammations. Butter, Oat- 
 meal, Buckwheat, Fish, are popularly credited with causing eruptions, but 
 there is no evidence therefor. Mangos, pemphigus and other eruptions, in 
 persons who are not accustomed to this fruit. 
 
 Erysipelas. 
 
 Antitoxin (Streptococcus), see page 182. Pilocarpine, to abort the disease, 
 very efficient if used early, gr. ]/$ hypodermically, or fluid extract of Jaborandi 
 internally ; when free diaphoresis occurs, the temperature and pulse fall to 
 normal and the disease is checked ; not suitable to debilitated cases or those 
 with a weak heart (Da C). Aconite, a favorite remedy with Liston, if used at 
 beginning when fever high (Wa) ; no more useful agent in idiopathic erysipe- 
 las especially facial, and cases of sthenic type (B) ; at onset often cuts the 
 attack short ; is very useful in the erysipelas following vaccination (R) ; very 
 valuable in sthenic cases (P) ; especially so in traumatic erysipelas (Tr). 
 Belladonna, rr\,v of tincture in water every hour for five or six doses, also 
 locally ; has astonishing power in superficial and non-vesicular forms, also 
 
ERYSIPELAS. 695 
 
 when erysipelas attacks the brain and in the phlegmonous type (P) ; for simi- 
 lar indications as noted under Aconite, also when adynamia; if much fever 
 combine it with Digitalis or Aconite, when much depression give it with 
 Quinine ; gr. % of the extract with gr. ij of Quininae Sulph. every 3 or 4 hours 
 (B) ; the extract with Glycerin, equal parts, spread thickly over the surface 
 (Quain) ; should be used both internally and externally and may be combined 
 with Aconite (R). Iron, Tincture of the Chloride, the nearest to a specific yet 
 discovered ; the remedy of most service, any man being decidedly to blame 
 who neglects its use; requires decided doses, gtt. xl every 4 hours (Da C) ; 
 treatment by it very general but questionable (B) ; should be given with 
 shorter intervals than 4 hours (R) ; is very successful in this disease (P) ; ten- 
 drop doses every hour, or TTLxl every 4 hours (Quain) ; is also used locally with 
 much success, being painted over the surface in full strength. Quinine, may 
 be given with the Iron, also alone if thoracic complications, wherein Iron 
 might be contra-indicated (Da C) ; if pulse soft and tremulous, or very rapid 
 with low muttering delirium (D) ; a combination of Quinine and Tincture of 
 the Chloride of Iron offers special advantages (Wa) ; in the more severe cases 
 to sustain the vital powers and prevent cerebral embolism ; but large doses, 
 gr. xv-xx every 4 hours, are alone of any use (B). Ammonium Carbonate, 
 when feeble circulation, cyanosis and delirium, also when any signs of embol- 
 ism appear (B) ; highly useful in debilitated subjects (Wa) ; after free purgation 
 the continued use of this salt is all that is needed in most cases (Watson). 
 Potassium Iodide, with agents to secure free action of the bowels, skin and 
 kidneys, the most efficient treatment in erysipelas ambulans, in which Iron 
 and Quinine are useless (Da C). Antipyrin, is particularly efficient when 
 hyperpyrexia (Ernst). Rhus Tox., a very useful remedy in the vesicular form 
 (P). Tartar Emetic, in doses of gr. ^ frequently repeated, renders incontest- 
 able service (B). Calomel and Jalap, as purgative at onset, followed in 4 or 5 
 hours by Magnesium Sulphate ^ss (Da C). Chloral, is an admirable adjunct 
 to give sleep at night (Id). Turpentine, as a stimulant in traumatic erysipelas, 
 more generally serviceable than alcohol (B). 
 
 Local Applications. Silver Nitrate, by Higginbotham's method in traumatic 
 form ; gr. Ixxx of the brittle stick dissolved in £iv of water and painted 2 or 3 
 times over inflamed surface and beyond, after careful washing and drying 
 (R); no agent more useful in subduing external inflammation. Iodine, 
 painted over affected and neighboring surfaces, to prevent spreading (R). 
 Ichthyosis very efficient as a 10 to 25 percent, collodion ; Ichthyol and Ether, 
 of each 5, Collodion 10 parts, with or without the addition of Castor Oil ; has 
 almost specific properties in this disease (Radcliffe). Thiol, dry, as a dusting 
 powder, has given excellent results. Iodized Collodion, is very successful as a 
 local application. [See formula on next page.] Collodion, a thick coat relieves 
 (B). Digitalis, an infusion is of much service, applied as a lotion (R). Sulph- 
 urous Acid and Glycerin, equal parts, or a solution of Sodium Bisulphite 
 (Dewar). Zinc, Benzoated, as ointment, or the Unguentum Zinci Oxidi, any- 
 thing to exclude the air, and whichever one is most agreeable to the patient 
 (Da C). Bismuth, the Ointment of the Oleate, a very certain application to 
 allay itching and burning, lessen pain, etc. (Shoemaker). Oil, by inunction, is, 
 very grateful in simple erysipelas (B). Oil of Turpentine, painted over surface 
 is said to be remarkably efficient. Vaselin, Lard or Mercurial Ointment 
 diluted, 3) to ^j of Vaselin ; the simplest applications are the best (B). Car- 
 bolic Acid, one part, with 8 to 14 parts of Oleic Acid, locally by inunction for 3 
 or 4 minutes every % hour, all around the edge of the diseased part until it 
 ceases to spread (Jacobi). Cotton Wool, sprinkled with flour or a mixture of 
 Starch and Zinc Oxide, is a good application (B). Earth, clean yellow clay, 
 free from grit or sand and powdered, applied directly to the skin in the form 
 of a smooth paste, made by mixing it with water, the best of all applications, 
 having properties of antiseptic, antiphlogistic, antipyretic, and antimorbific 
 nature (Hewson). 
 
 Tracheotomy, promptly if edema of glottis occurs, the operation giving time 
 
6 9 6 
 
 ERYTHEMA ESOPHAGEAL AFFECTIONS. 
 
 for inflammation to subside (Da C). Incisions, maybe necessary in traumatic 
 erysipelas when limb is greatly swollen and inflamed ; also in the phlegmonous 
 variety (Id). Diet, a milk-diet is generally suitable ; should be light but nutri- 
 tious (R) ; feed the patient well (Da C). [Compare Phlegmon.] 
 
 R. Quininae Sulphatis, . . . ^j. 
 
 Ac. Sulphurici Dil., . . . q. s. 
 
 Aquae, % ij. 
 
 Tincturae Ferri Chlor., . . ^ss. 
 
 Spt. Chloroformi, . . . . gvj. 
 
 Glycerini, . . . q. s. ad giv. 
 M. Sig. — A teasp. in water every two 
 hours. {Loomis.) 
 
 B . Tinct. Ferri Chloridi, 
 
 Syrupi Tolutani, . . . aa ^j. 
 
 Liq. Potassii Citratis, . . ^ iv. 
 
 M. Sig. — Teasp. to tablesp. according 
 
 to age, every 3 hours, ^j has Vf\x, ^ij 
 
 has V(\xx, ^sshasTTLxl. {Anderson.) 
 
 R. Pyroxylini, £j. 
 
 Athens, 
 
 Alcoholis, aajjv. 
 
 Solve, et adde — 
 
 Ammonii Iod., gr. xl. 
 
 Cadmii Iod. , 
 
 Cadmii Brom., . . . . aa gr. xx. 
 
 M. Sig. — For local use with a camel's 
 
 hair pencil. If the cadmium salts are not 
 
 to be had use 3 j Ammon. Iod., and gr. xx 
 
 of Pot. or Amm. Bromide. {Humphreys.) 
 
 R . Plumbi Acetatis, 
 
 Ammonii Carb., . . . aa^j. 
 
 Aquae Rosae, ^ v "j« 
 
 Ft. lotio. Sig. — Apply on lint, to allay 
 irritation. {Peart.) 
 
 Erythema. 
 
 Antipyrin, internally for the itching, is efficient. Belladonna, useful in 
 cases resisting ordinary treatment (B). Quinine, the most valued remedy 
 in erythema nodosum (B). Rhus Toxicodendron, a valuable remedy (P). 
 Zinc Sulphate, as lotion, with Alum and Glycerin [see Eczema, for formula] ; 
 or the Acetate, in ointment (see below). Bismuth Subcarbonate, dusted over 
 erythema about genitals of infants soothes pain and promotes healing (B). 
 Mineral Acids, Nitric and Nitro-hydrochloric, have been advantageously used 
 in erythema from imperfect digestion (B). Dusting Powders, of Starch, Lyco- 
 podium or Buckwheat flour are very useful. Thiol, the dry form, as a dusting 
 powder. 
 
 R. Plumbi Carbonatis, 
 
 Bismuthi Subnit., . . . aa^j. 
 Sodii Bicarbonat., . . . . % ss. 
 Ung. Zinci Oxidi Benz., . ^ij. 
 Ft. unguentum. Sig. — Local use. 
 
 . Zinci Acetatis, . . . 
 
 . . gr. ij 
 
 Aquae Rosae, . . . . 
 Ung. Aquae Rosae, . . 
 M. Sig. — Ointment. 
 
 
 Esophageal Affections. 
 
 Belladonna, the liniment with frictions to the sternum, often very useful as a 
 palliative in stricture of the esophagus (Wa). Conium, in spasmodic contrac- 
 tions, with crampy pains of stomach, flatulence, and globus hystericus, has 
 proved very serviceable (Wa). Hyoscyamus, or Conium, in stricture of esoph- 
 agus, if much irritability ; with occasional leeching to relieve exacerbations 
 of pain or spasm (D). Silver Nitrate, in stricture of the esophagus, a weak 
 solution on sponge probang (D). Anesthetics, should be used only to meet 
 temporary indications (W). Nutrient Enemata, in stricture of the esophagus, 
 when swallowing impossible (R) ; may, in some cases, even preserve life (Wa). 
 [See Enemata.] Dilatation, by bougies, in non-spasmodic (structural) strict- 
 ure, the only appropriate treatment (H). [Compare Choking, Dysphagia.] 
 
EXHAUSTION EXOPHTHALMOS EXOSTOSIS. 697 
 
 Exhaustion. 
 
 Acetanilid, for the "tired feeling," a pinch put into the mouth, mixed with 
 saliva and swallowed, rests one up in a few minutes and makes one as fresh as 
 before (Brodnax). Arnica, a few drops internally for aching of the muscles 
 (R); in nerve prostration with general aching from over-fatigue (P). Phos- 
 phorus, for physical or mental exhaustion ; also in depression from overwork 
 (R). Calcium Phosphate, combined with Calcium Carbonate and Ferric Phos- 
 phate, gr. j of each for a dose (R). Potassium Bromide, when insomnia, bad 
 dreams and irritability (R). Opium, gtt. j of Laudanum with 2 or 3 of the 
 Tinctura Nucis Vomicae, 3 or 4 times a day, for symptoms of exhaustion with 
 headaches, flushing and dyspepsia (R). Ammonia, internally ; its influence is 
 but brief (R). Coffee or Tea, in hot or cold climates (R). Castor, is service- 
 able but seldom used (P). Musk, benefits all forms of nerve-exhaustion (P). 
 Cimicifuga, for headache from overstudy or excessive fatigue (R). Alcohol, 
 of value in all conditions of fatigue (P). Coca, lessens the sense of fatigue 
 under exertion, relieves thirst, and obviates the effects of a too rarefied atmo- 
 sphere ; is suitable for weakly subjects easily fatigued and convalescents (P). 
 Cocaine, has been used successfully in exhaustion from sunstroke, loss of blood 
 and diarrhea (P). Wet Sheet, dripping, cold, as a restorative and to prevent 
 aching of muscles (R). Sea Bathing, is also valuable (R). Habits, change of 
 occupation better than absolute rest. [Compare Adynamia, Convalescence, 
 Insomnia, Myalgia, Neurasthenia.] 
 
 Exophthalmos. 
 
 Exalgin, has been used with some success in the treatment of exophthalmic 
 goitre (Churton). Belladonna, tt\,v of tincture hourly, of great service (R) ; 
 results recorded from its use are very remarkable, but Digitalis will usually 
 answer better (P). Duboisine, gr. T ^ n of the sulphate 2 or 3 times daily, has 
 produced remarkable results in one case (Hunt). Opium, may be of use in 
 some cases (P). Iron, with Digitalis, seems to do more good than any other 
 medicine (Da C). Chalybeate Waters, are beneficial (B). Aurum Bromide, 
 in daily doses of gr. %l /% to l /e, continued until its characteristic headache is 
 produced (Goubert). Bromides, with Iron, of very great value in the milder 
 forms associated with anemia in young women (Y). Digitalis, to raise arterial 
 tension and slow the heart, is decidedly ameliorative in young subjects (B); 
 in some cases beneficial, but in others it increases the cardiac excitement and 
 makes matters worse, while its tendency to cause gastric irritation is more 
 manifest in this disease than in any other (Y). Strophanthus, quiets the cardiac 
 action and is of real service in this malady ; 5 minims may be given thrice 
 daily (Y). Convallaria, ameliorates the painful palpitation (Wa). Arsenic, 
 gr. ^2 twice daily, increased with intermissions up to gr. -^ daily, is my favorite 
 remedy (Jaccoud). Zinc Valerianate, gr. j thrice daily, is valuable to allay the 
 nervous symptoms and the insomnia (Y). Thyroid Extract, has proved bene- 
 ficial [see page 159]. Splenic Extract' has given excellent results (W) ; [see 
 page 166]. Pancreatin, in full doses successfully used (Liegeois). Galvanism, 
 of the cervical sympathetic and pneumogastric, also of the eyes and thyroid 
 gland, is decidedly curative in uncomplicated cases (B). 
 
 Exostosis. 
 
 Potassium Iodide, may promote absorption when recent ; also use friction 
 with an ointment of Mercury or Iodine (D). Aconite, was used by Storck (P). 
 Mercury, a moderate course of mercurials may be effectual, when exostoses are 
 due to a blow or from syphilis (D). Excision, if required (MacCormac). Ex- 
 ostoses of the clavicles in children almost always disappear of themselves (D). 
 
698 EYE DISEASES EYELIDS. 
 
 Eye Diseases. 
 
 Belladonna, locally and internally in iritis, conjunctivitis and other inflam- 
 mations. Atropine, in iritis, locally ; hypodermically in glaucoma (R) ; the 
 best application generally in inflammatory conditions of the eye ; the indis- 
 criminate instillation of Atropine in persons over 35 or 40 years of age by 
 general practitioners is to be condemned, being liable to light up an incipient 
 or latent glaucoma. Pilocarpus, is used with great benefit in many eye- 
 affections, particularly amblyopia from alcohol and tobacco, detachment of the 
 retina, chronic iritis, keratitis, hemorrhage into the vitreous, glaucoma, muscas, 
 atrophic choroiditis, hemorrhages of the retina, white atrophy of the optic 
 nerve, and inflammatory affections with effusion and exudation, to promote 
 resolution and absorption (Wecker). Strychnine, hypodermically in muscular 
 asthenopia, amblyopia, amaurosis, and in progressive nerve-atrophy not de- 
 pendent on intercranial disease (R) ; increases the sensibility of the eye, the 
 field of vision becoming extended, and the vision more acute (Br). Ergot, is 
 useful in many eye affections, especially disturbances of accommodation, acute 
 and chronic inflammations, and the blepharitis and pustular conjunctivitis of 
 children (Wa) : is a myotic. Acetanilid, is exceedingly effective in optic neuritis 
 with pain, not only to remove the latter but also to arrest the inflammatory 
 process (Dujardin-Beaumetz). Cocaine, as a local anesthetic in ophthalmic 
 surgery, a 4 per cent, solution, by instillation, sometimes injection required, as 
 into the muscles for squint operation; is mydriatic, and in some cases panoph- 
 thalmitis has resulted after operations under it (R). Chloroform, vapor, close 
 to a photophobic eye, relieves (R). Oleate of Mercury and Morphine, outside 
 the eye in palpebral conjunctivitis and stye ; also in syphilitic iritis (R). Silver 
 Nitrate, Copper and Zinc Salts, are much used in weak solutions for conjunc- 
 tivitis, etc. Euphrasia, had an extended reputation in Germanv, is a mild 
 astringent, and of service in catarrhal conjunctivitis (P). Pulsatilla, as lotion 
 in inflammations and ophthalmic cases (P). Santonin, gives good results in 
 inflammatory and atrophic conditions of the retina and optic nerve, and in the 
 stage of effusion of many other inflammations (Wa). Ruta, minim doses, night 
 and morning, in dimness of vision depending on functional amaurotic con- 
 dition, produces good results (P). Physostigmine, topically, to contract pupils ; 
 to reduce excessive atropinization ; stimulates the third nerve (P). [Compare 
 Amaurosis and Amblyopia, Asthenopia, Cataract, Conjunctivitis, Cor- 
 neal Opacities, Glaucoma, Iritis, Keratitis, Myopia, Ophthalmia, 
 Photophobia, Retina, Strabismus, etc., also the lists of Mydriatics, Myotics 
 and other Agents acting in the Eye, on pages 57 and 58. J 
 
 Eyelids. 
 
 Calomel, locally, or Brown Citrine Ointment, as an application in many dis- 
 eases of the lids (B). Mercury and Morphine, the 20 per cent, ointment with 
 Lard, applied outside the lid, for stye (R). Pulsatilla, internally, and exter- 
 nally as wash, in ophthalmic cases and inflammations ; the so-called stye may 
 often be aborted by this treatment (P). Cadmium, much esteemed as colly- 
 rium, gr. ij of sulphate to ^j aquae rosas (R). Zinc and Copper Sulphates, are 
 esteemed applications (B). [See Conjunctivitis for formulas.] Ergot, an 
 aqueous infusion as a collyrium, in ptosis and paralysis of the eyelids (Wa). 
 Tannin, a strong solution (1 to 3 aquse) locally ; or a weaker solution (1 to 20, 
 30 or 50 aquas), is much employed; also used in pomade, or as fine powder 
 (Wa). Veratrine, in solution, brushed over lids once daily in painful spasmodic 
 contraction of the orbicularis (Wa). Ammonium Chloride, in solution as lotion, 
 forecchymosis of eyelids, vulgarly known as black eye. Capsicum, the tincture 
 or infusion for a black eye (see under Ecchymosis). [Compare Blepharitis, 
 Conjunctivitis, Ecchymosis, Ectropion, Ptosis, etc.] 
 
FACE FALSE PAINS FEET FEVER. 
 
 699 
 
 Face. 
 
 Amyl Nitrite, Nixs to ^6, in 30 times its volume of spirits, for flushing of face, 
 or sensation of flushing, with cold feet and hands and great prostration, occur- 
 ring in women at change of life (R). Curare, effective in facial spasm, when 
 other remedies failed (P). Blisters, behind the ear, in facial palsy, followed 
 by warm covering to the part (H). Strychnine, has improved some cases of 
 facial palsy (P). [Compare Acne, Freckles, Neuralgia, Odontalgia, 
 Parotitis, Tic-douloureux.] 
 
 False Pains. 
 
 Tartar Emetic, with small doses of Opium and external fomentations, where 
 evidence of congestion (L). Opiates, to allay uterine irritation, after rectifying 
 any derangement of bowels (L). Opium, is valuable, having specific action 
 on uterine muscular fibres, relaxing some, stimulating others (Wa). Acetanilid 
 may be given with benefit. 
 
 Feet. 
 
 Arsenic, swelled feet of old or weak persons (R) ; edema of feet and ankles 
 in the old, from feebleness of the heart (B). Lead, as ointment, equal parts 
 of Emplastrum Plumbi and Linseed Oil spread on linen and wrapped round 
 sweating feet, to be renewed every third day for nine days (R). Potassium 
 Permanganate, solution gr. j to the ^ as a wash, will remove fetor of feet (B); 
 temporarily discolors the skin. Boracic Acid, in strong solution, is used with 
 good results. Chloral, 1 in 50 of water as bath, efficient against fetor. Sodium 
 Bicarbonate, a solution freely applied will remove fetor (B). Belladonna, will 
 check fetid secretions (R). Salicylic Acid, in solution with Borax, the most 
 agreeable and efficient deodorant for fetid perspirations (B); 3jss-iij with ^iij 
 of dried Alum in powder, applied freely to feet after washing and drying ; Acid 
 Salicylic 3, Magnesium Silicate 87, is the composition of the powder used in 
 the German army for sweating of the feet. Iron, the Chloride, mixed with x / z 
 its weight of glycerin, as paint to the soles and interdigital spaces, in severe 
 cases of sweating feet ; should be exposed to the air while drying ; repeat after 
 48 hours at first, subsequently at longer intervals, during which the feet should 
 be washed in vinegar and water night and morning and powdered with sali- 
 cylated talc or starch and tannin (Vignol). Alum, powdered, locally, the most 
 satisfactory application for bromidrosis (Baylor). Sodium Chloride, 3 table- 
 spoonfuls to % a pint of water, as antiseptic lotion for tender feet, answers per- 
 fectly in most cases. Ice, to the spine, or heat and cold alternately, to equalize 
 the circulation, has been strongly advocated (Wa). Stockings, should be 
 changed every day, and dipped in a strong solution of Boric Acid and dried, to 
 effectually check fetid perspirations. Cold Footbath, and drying with friction, 
 for cold feet (R). [Compare Chilblains.] 
 
 R . Ac. Salicylici, . . . . gr. xv. R. Ac. Borici (pulv.), . . ^jss. 
 
 Amyli, gr. cl. Vaselini, ^j. 
 
 Talci, J|iij. M. Sig. — Ointment for bromidrosis. 
 
 INI. et trit. Sig. — Locally. {Koknhorn.) (Cha??ipionniere.) 
 
 Fever. 
 
 [See also the titles of the Fevers, in their alphabetical order.] 
 
 Guaiacol, applied to the surface, as antipyretic (see page 294). Aconite, has 
 the highest value in the eruptive fevers, also in all hyperpyrexias (B) ; always 
 indicated in early stage of simple inflammatory fevers, pneumonia, and in 
 most acute congestions (P) ; has marvellous power over sthenic fevers ; the 
 
JOO FEVER. 
 
 thermometer should go hand in hand with Aconite (R). Veratrum Viride, has 
 considerable power as an antipyretic ; useful in rheumatism and pneumonia 
 (P) ; in delirium ferox of fevers it is of value (B) ; strongly recommended in 
 both sthenic and asthenic fevers (R). Belladonna, in the eruptive fevers, espe- 
 cially scarlatina (B); in typhus, with delirium, insomnia, painful sensitiveness 
 to light and sound, and in all hyperemic states of brain and spinal cord (P) ; is 
 prophylactic often against scarlet fever (Pf) ; in delirium of fevers, also excellent 
 in typhus (R). Gelsemium, in remittent and typho-malarial, of real benefit; is 
 antipyretic (B) ; in bilious remittent, of value (Pf). Arsenic, in prostrating 
 acute fevers to strengthen pulse and invigorate patient ; except quinine no drug 
 subdues intermittents so well (R) ; in malarial, especially typho-malarial, it is of 
 great value (B). Quinine, in the eruptive fevers and all malarial, remittent and 
 intermittent; as apyretic less effective and more dangerous than cold baths; 
 useless in typhus and typhoid, except for hyperpyrexia (B) ; it is antimiasmatic, 
 antiseptic, and antiphlogistic, and of great value in intermittent, septicemic, 
 and hectic fevers (P) : large doses at night to reduce temperature in typhoid 
 and other fevers, are strongly urged in Germany. Cinchonine is better than 
 quinine as prophylactic against ague (R). Antipyrin, the type, also the best, 
 of the new series of synthetical antipyretics, which includes Acetanilid, 
 Kairin, Phenacetin, Chinolin, Thallin, etc. ; is antipyretic and diaphoretic, 
 moderates the intensity of the febrile movement, and is especially indicated 
 in self-limited diseases with persistent hyperpyrexia, especially pneumonia, 
 typhoid, etc. Phenacetin, the favorite antipyretic among the new synthetical 
 compounds ; is efficient and safe. Kairin, is an efficient antipyretic, but 
 profusely diaphoretic, also a cardiac and nerve depressant of great power, 
 and highly dangerous in pneumonia and other fevers where the heart is 
 weak; it often produces nausea and vomiting with headache and tinnitus 
 aurium (P). Resorcin, has been given in acute rheumatism, typhoid, typhus, 
 pneumonia, erysipelas, etc., as an antipyretic; like Kairin, however, its action 
 in lowering temperature is transient as compared with Quinine or Salicylic 
 Acid (P) ; may be used hypodermically as it is not irritant (B). Salicylic 
 Acid, or Sodium Salicylate, nearly equal to Quinine as an antipyretic ; very f 
 useful in all forms with high temperature and in intermittents, especially in sep- 
 ticemia, pyemia, erysipelas and surgical fevers (R). Digitalis, the German 
 antipyretic; very useful in scarlet fever, rheumatic and pneumonia (B); espe- 
 cially in typhoid (R). Cimicifuga, as substitute for Digitalis, but less effective ; 
 good in hectic fever (B). Hydrastine, intermittents, typhoid with copious sweats 
 (P). Arnica, is antipyretic, full doses in sthenic cases, small (rr^v of tincture) 
 in asthenic ; large and small doses produce different results (B) ; in rheumatic 
 fever and typhoid it is highly extolled (P). Camphor, subdues reflex excita- 
 bility ; is praised as stimulant in adynamic fevers (P) ; in adynamic fevers and 
 where there is delirium (R). Mercury, large doses of Calomel, the German 
 specific treatment of typhoid (B); small doses in typhoid at commencement; 
 has marked effect on tonsils in scarlatina (R). Rhus Tox., in rheumatic fever 
 after Aconite, and in scarlatina with typhoid symptoms, is invaluable (P). 
 Opium, much less used than formerly ; useful in delirium and with Quinine in 
 remittents and intermittents (B); fevers characterized by prostration, insomnia 
 and delirium, noisy or muttering, with picking of bed-clothes and twitching of 
 the muscles, — in such cases Opium, judiciously given, may save an almost hope- 
 less case (R) : Morphine, hypodermically, the best form in febrile diseases, 
 being less disturbing to the stomach and digestive power (B). Turpentine, in 
 typhoid, puerperal, and yellow (l^x-xxx) as a stimulant to vaso-motor nervous 
 system (B) ; as enema (3ss-j in starch mucilage with rr\,x of Tinct. Opii if 
 pain) invaluable when in typhoid hemorrhage occurs with tympanites (R). 
 Tartar Emetic, minute doses (gr. y 1 ^) frequently repeated and with Opium, are 
 of great value in many acute febrile diseases (B) ; as a diaphoretic; in ague; 
 in large doses to abort specific fevers (B). Muriatic Acid, very useful in all 
 forms, especially in typhoid and the exanthemata ; relieving dryness of the 
 mouth and fauces, increases digestion and restrains the diarrhea (B). Acid 
 
FEVER, SIMPLE, TROPICAL. ^OI 
 
 Drinks, such as raspberry vinegar, citric acid, etc., very grateful and useful 
 (R, B) ; two sliced limes or lemons, with gij of sugar in Oj of boiling water, 
 cooled and strained, makes an agreeable refrigerant beverage (Wa). Baptisia, 
 useful in common continued fever, or in the first stage of typhoid ; drop-doses of 
 a fresh tincture every hour. Eucalyptus, has given varied results in malarial 
 fevers, some observers praising it very highly (P). Valerian, has done much 
 good in fevers of a nervous character (P). Sumbul, is used in Russia for low 
 fevers of typhoid type (P). Cocculus, for tympanites of typhoid (P). Ammo- 
 nium Acetate, as a diaphoretic and in simple forms, as catarrhal ; the Carbonate 
 in scarlet fever and measles (R). Purgation, by Castor Oil, Magnesium Sul- 
 phate, etc., before exhaustion (R). Mustard Bath, on recession of rash in 
 eruptive fevers (R). Aliment, milk and beef-tea alternately, every 3 hours ; 
 milk in fevers and in inflammations of the digestive tract (B). Alcohol, in 
 low conditions is useful when it causes improvement in symptoms, which may 
 become worse (R) ; Coffee better than alcohol (P). Water, especially car- 
 bonated water as a drink, is a valuable adjunct to remedies in the treatment of 
 fevers ; warm baths, the wet pack, hot and cold compresses, fomentations, 
 moist inhalations, etc., have great value (see the various fever titles) : a most 
 important agent: cold baths or cold wet pack to reduce temperature (B) ; cold 
 affusion, baths, packing, ice and ice-bag, hot affusion and sponging, all of 
 great value in every form (R). [Compare Fevers, Tropical.] 
 
 R. Tinct. Aconiti, .... 3 ss-j. 
 Spt. yEtheris Nitrosi, . ^ij. 
 Glycerini, . . q. s. ad 1| ij. 
 Sig. — A teasp. hourly to an adult. 
 
 R . Phenacetini, . . . . % ss-j. 
 Aquae Cinnamomi, . . J iv. 
 M. Sig. — A teasp. every 2 hours for 
 children, to control pyrexia. 
 
 Fever, Simple. 
 
 Aconite, in small repeated doses, the best remedy for febricula (B) ; in ordi- 
 nary febrile conditions, if given early, will abate fever and induce free per- 
 spiration ; may be administered in conjunction with any other remedy indi- 
 cated (R). Veratrum Viride, in small doses, as antipyretic (P). Hyoscyamus 
 or Belladonna, very useful in febricula, especially for head symptoms and con- 
 stipation (P). Gelsemium, when remittent or bilious symptoms (P). Arsenic, 
 if typho-malarial symptoms (B). Phenacetin, in hourly doses of gr. ij or less, 
 in the simple continued fever of children, as antipyretic. Hydrochloric Acid, 
 in the continued fever of childhood, has a beneficial influence (West). Valer- 
 ian, when nervous excitability (P). Lemon-juice, as lemonade or with Potas- 
 sium Bicarbonate, as a mild diaphoretic and diuretic (P). Pomegranate-juice 
 is very grateful if mixed with sugar or honey (P). Bromides, gr. ss-j every 
 quarter-hour are excellent for the febrile disturbances of children (Smith). 
 Baths, warm, in simple fevers of children (R). Aliment, milk and beef-tea 
 alternately every 3 hours, the most useful (B). 
 
 R. Ac. Hydrochlor. Dil., . ^ss. 
 
 Spt. yEtheris Co., . . . ^jss. 
 
 Syr. Rosae, % ss. 
 
 Aquae Camph., q. s. ad £ iv. 
 M. Sig. — Teasp. to tablesp., according 
 to age, every 6 hours. 
 
 {Modified from West.) \ cording to age. 
 
 Fevers, Tropical. 
 
 R. Potassii Acetatis, . . . ^ij. 
 Spt. ^Etheris Nitrosi, . 3 iv. 
 Syr. Simplicis, .... 3;j. 
 Liq. Ammonii Acetatis, 2;ij. 
 Aquae Camphorae, q. s. ad£ viij. 
 M. Sig. — Teasp. to tablesp. doses, 
 
 Unclassed fevers of the tropics include a simple continued fever, a low 
 fever and a non-malarial remittent (Crombie) ; also a double continued fever 
 (Mn). Calomel and Quinine Bisulphate, aa gr. iv, with Rhubarb and Jalap, 
 aa gr. vj, as in Dr. Livingstone s 'liver rousers," has given excellent satisfac- 
 
702 
 
 FISTULA — FLATULENCE. 
 
 tion at the commencement of such cases, especially when symptoms of hepatic 
 congestion exist (Potter) ; purgation should not be actively continued, but each 
 case should be treated on its own merits and on general principles (Mn). 
 Quinine must not be continued if it has been tried without benefit (Id). Anti- 
 pyrin, or some similar drug, for the headache, if no contra-indication exists 
 (Id). Medication should be confined to some simple fever mixture, there being 
 no specific treatment for any of these affections (Id). Diet, bland, unstimu- 
 lating and fluid. Sea-voyage, is especially serviceable in low fever, which is 
 unrelieved by quinine or arsenic (Mn). 
 
 Fistula. 
 
 Piper Nigrum, the confection, as a gentle stimulant in anal fistula (P). 
 Iodine, by injection, sometimes curative, but generally fails (Wa). Sangui- 
 naria, as injection, has cured (P). Capsicum, the weak infusion, a useful 
 stimulant in fistulous ulcerations (P). Glycozone, 3j in ^j of lukewarm water, 
 as enema once or twice daily, soon produces good effects in cases of fistula in 
 ano (Edson). Bismuth Subiodide, after operation, dusted over the surface of 
 the wound after washing, to stimulate granulations when the healing process is 
 indolent, is remarkably efficient. Surgical, division of sphincter in anal 
 fistula by knife or ligature, the best treatment (D) ; in fistula lachrymalis dila- 
 tation of passage by probing the canaliculus or slitting the canaliculus up (D) ; 
 in vesico-vaginal or recto-vaginal, surgical methods best. Diet, should be 
 nourishing and digestible ; fresh air and good general hygienic conditions are 
 necessary (R). 
 
 Flatulence. 
 
 Nux Vomica, will remove flatulence and intestinal indigestion (B) ; when 
 constipation, heartburn, weight on head (R). Charcoal, gr. v or x, soon 
 after or just before meals (R) ; mixed with Bismuth (R). Chloroform, pure, 
 in drop doses, benefits (R) ; by far the best agent in flatulent dyspepsia to 
 prevent flatulence, always given well diluted (Huchard). Carbolic Acid, 
 when no acidity present (R). Turpentine, gtt. iij-v on sugar, will quickly 
 relieve (B). Strontium Bromide, is excellent in flatulence from decomposition. 
 Asafcetida or Valerian, quickly relieves the flatulence of hypochondriasis (P). 
 Asaf. 3j of tinct. to 0% water, dose Z) ', useful for children (R). Sodium 
 Sulpho-carbolate, gr. xxx after eating, will be found very serviceable (R). 
 Phosphoric Acid, dilute, is often promptly alleviative. Anise, the Oil, also 
 Ether, or any other member of the carminative group (see page 41), will 
 promote the expulsion of gas from the stomach and intestines. Mercury, in 
 flatulence with clayey stools (R). Calumba, an effective remedy for flatulent 
 disposition is an infusion of §ss of Calumba and Ginger, Z) of Senna, hot 
 water Oj, a wineglassful ter die (P). Potassium Permanganate, in flatulence 
 attendant on obesity (B). Physostigma, flatulence of women at climacteric 
 (B). Sulphurous Acid, in 5 to 10 minim doses, when flatulence due to fer- 
 mentation (R). Diet, abstain from sugar, starchy food and tea — especially 
 sugar ; eat little, slowly and regularly ; as a general rule abstain from alcoholic 
 drinks and from vegetables, especially cabbage. Pepsin or Ingluvin after 
 meals, to promote digestion (R). [Compare Colic, Dyspepsia.] 
 
 rj . Tinct. Illicii Anisati, 
 
 Tinct. Gentianse, 
 
 Tinct. Nucis Vomicae, aa gj. 
 
 Chloroformi, TT^xv-xxx. 
 
 M. Sig. — 8 to 10 drops in a winegl. of 
 water, before meals. 
 
 R . Bismuthi Salicylatis, 
 
 Magnes. Calcinat., . aagiv. 
 Pulv. Carb. Ligni, . . gvj. 
 
 Olei Anisi, 3 ij. 
 
 Ft. pulv. Sig. — A teaspoonful before 
 
 each meal. [Huchard.) 
 
FLUSHING-HEATS — FRECKLES. 703 
 
 Flushing-heats. 
 
 Nux Vomica, n\,ij of the tinct. with tt\j of Laudanum in hysterical flushings 
 of the middle-aged, with flatulence, weight on head and perspirations (R). 
 Amyl Nitrite, ^yu to l A m thirty times its volume of rectified spirits, is effec- 
 tive for flushing of face, or sensation of flushing, followed by coldness, with 
 cold feet and hands and great prostration occurring at climacteric chiefly (R). 
 Potassium Bromide, at climacteric, with mental depression (R). Zinc Vale- 
 rianate, or Valerian, flushings at the climacteric (R). Eucalyptol, for the 
 flushings, palpitations and flatulence incident to the change of life (R). 
 [Compare Climacteric Disorders.] 
 
 Foreign Bodies. 
 
 In the Eye, remove by bathing, or wiping towards the lower inner corner 
 with a soft, moistened handkerchief or a bent bristle, the two ends being held 
 in the fingers ; use tepid solution of Vinegar (3ss to the ^) for removing lime, 
 tepid water for powder ; then apply a weak Zinc or Alum collyrium, or instil a 
 solution of Atropine (gr. ij to the ^), or of Cocaine 4 per cent. In the Ear, 
 examine carefully with speculum before removal ; first syringe with warm 
 water, or instil a drop of sweet oil to drive out insects, before using the forceps ; 
 apply equal parts of Laudanum and Olive Oil, a few drops on cotton, if much 
 pain. In the Nose, a current of tepid salt water, forced up one nostril, may 
 force down the body through the other, if the mouth be held open. In the 
 Larynx or Pharynx, if water can be swallowed the obstruction is in the 
 trachea. Never push a body down ; remove by curved forceps or blunt hook. 
 If passed into the stomach use solid diet to inbed the article. If all fail and the 
 case be urgent, resort to catheterism or tracheotomy. In the Flesh, remove at 
 once by forceps, or sponge and water. [Compare Asphyxia.] 
 
 Fractures and Dislocations. 
 
 Arnica, internally is excellent to neutralize the ill effects of mechanical inju- 
 ries, ti^v-x in a wineglassful of water every 2 or 4 hours ; when used after 
 amputations it certainly has the power of promoting the rapid union of the 
 surfaces ; the infusion is better than an alcoholic preparation for external use 
 (F). Aconite, quickly and repeatedly, if feverish symptoms ensue (P). Iodine, 
 internally and by friction, occasionally useful in ununited fractures (Wa). 
 Calcium Phosphate, promotes formation of callus (Wa). Opium, useless in 
 surgical fever and may do harm (CI); for nervousness or muscular spasms 
 after dressing, gr. % of Morphine hypodermically as anodyne (Ag). Benzoin, 
 the tincture on lint as a dressing for compound fractures and other severe 
 injuries, leads to rapid and satisfactory healing (Bryant). Carbolic Acid, 1 to 
 20 or 1 to 40 solutions, for irrigation and dressings in compound fractures, 
 obviates pyemia and most of the other preventable causes of death (P). Lead- 
 water and Laudanum, on lint, or a Calendula lotion to the part, after reduction 
 of the injury, with morphine hypodermically and perfect quiescence. Diet, 
 should be very simple for a week or ten days. [Compare Wounds.] 
 
 Freckles. 
 
 Resorcin, as paste with Zinc Oxide, applied to the face, to promote peeling 
 of the skin and removal of freckles and other superficial spots (Unna). [See 
 under Acne]. Iodine, the tincture or glycerite, locally (B). Liquor Potassse, 
 3j in 31J aquae rosse, as a lotion (Todd). Benzoin, the compound tincture with 
 water, as cosmetic to remove freckles (P). Sodium Borate, a saturated solution 
 
704 
 
 GANGRENE GASTRALGIA, GASTRODYNIA. 
 
 of Borax is a safe and often efficient lotion to remove freckles (B). Lime- 
 water, and Olive Oil, equal parts, with a little Liq. Ammoniac, as liniment 
 (Wa). Potassium Carbonate, makes a good lotion for freckles, sunburn and 
 tan (B). Mercury, the Bichloride, with Alcohol and Glycerin, as a lotion, has 
 been found effective : Donovan's solution, rr^lxxx to ^viij of water, of which 
 ^j every three hours, has been highly successful (Wa). 
 
 &. Potassii Carbonatis, . 
 
 Sodii Chloridi, . . . 
 
 Aquae Aurantii Flor. , 
 
 Aquae Rosae, . . . . 
 
 M. Sig. — Face-wash. 
 
 R. Hydrarg. Chlor. Corr., . gr. vj. 
 Ac. Hydrochlor. Dil., . . gj. 
 Alcoholis, Aq. Rosae, . aa^ij. 
 Glycerini, ^j, Aquae, ad $vii). 
 Apply at night, wash off in morning. 
 
 Gangrene. 
 
 Salicylic Acid, pure, in powder locally, to destroy fetor and change the 
 character of the morbid action (B). Carbolic Acid, acts in the same way 
 (B) ; a i per cent, solution as lotion in gangrenous ulcers (Wa). Sodium 
 Sulphate, in solution, i to 5 or 10 of water, as lotion or applied on compresses, 
 to destroy odor, soothe pain and restore healthy action (Wa). Ammonium 
 Chloride, in solution as baths and fomentations, very successful in one case of 
 senile gangrene (Wa). Cinchona, or better, Quinine, has often proved of value 
 (P) ; generally decoction of Cinchona is best (Wa). Turpentine, locally, after 
 removal of gangrenous part, a most efficient application (B); by stomach and 
 inhalation from hot water in gangrene of lungs ; the oil locally in dry and 
 chronic gangrene (P). Sanguinaria, has been recommended (P). Oxygen, as 
 gaseous bath in senile gangrene (R). Charcoal, as poultice, value doubtful (R). 
 Citric Acid, Lemon-juice dropped into wound, which is then covered with lint 
 steeped in a solution of Chlorine ; very effective for hospital gangrene in 
 Parisian hospitals {Lancet). Ferric Chloride, locally, is considered superior to 
 the mineral acids (Wa). Nitric Acid, strong, applied carefully, until the ulcer 
 is converted into a firm, dry mass (Wa) ; is probably the best escharotic, next 
 to Bromine, for destruction of gangrenous tissue (B). Bromine, is the best 
 escharotic fof hospital gangrene (B). Chromic Acid, is a very efficient caustic, 
 penetrating deeply with but little pain (B). Opium, to soothe the pain, and 
 diminish restlessness and irritability (Wa). Myrtol, 1 or 2 drops, in capsules, 
 internally, for gangrene of the lungs. 
 
 Gastralgia, Gastrodynia. 
 
 Resorcin, internally, acts exceedingly well. Opium, in some form necessary 
 to relieve the pain in severe cases (Da C). Morphine, is of great value (P) ; 
 subcutaneously in epigastrium very efficient, or in small doses with Bismuth and 
 milk before meals (R). Belladonna, is useful in painful affections of the stomach 
 (R). Atropine, often relieves promptly, and is excellent in neuralgic pain of 
 the abdominal viscera (P). Nux Vomica, an excellent stomachic, gtt. v-x of 
 tincture before meals (B) ; gtt. j-ij every 2 hours in many forms of gastric de- 
 rangement (R). Strychnine, hypodermically for gastralgia and gastrodynia 
 (R) ; in very small doses, gr. 1 ^ -- 3 ^- two or three times daily, a very successful 
 remedy (P). Arsenic, sometimes dissipates the pain surprisingly (B) ; a drop 
 of Liquor Arsenicalis before food in irritative dyspepsia and gastralgia with 
 heartburn (R). Bismuth Subnitrate, when gastralgia due to irritation of mucous 
 membrane, acts well alone, but is most efficient when given with aromatic pow- 
 der and a little Morphine (R) ; or a combination of Bismuth and Arsenic in 
 more chronic cases (B) ; the Subcarbonate is especially adapted to gastralgia 
 with laborious digestion and putrid or acid eructations (Wa). Manganese, the 
 Black Oxide in gastrodynia and pyrosis (R). Zinc Oxide, an excellent remedy 
 
GASTRIC DILATATION. 
 
 705 
 
 when gastralgia occurs after food, gr. v-x with aromatic powder and Morphine 
 before meals (B). Silver Nitrate, in solution to check the pain of many stom- 
 achal disorders (R) ; a pill of gr. ss, with Extr. Hyoscyami gr. ij-iv (Wa). Hydro- 
 cyanic Acid, often cures rapidly when gastralgia from nervous derangement (B); 
 may check vomiting as well as relieve pain (R) ; Cherry-laurel water a useful 
 form (P). Nitro-hydrochloric Acid, gtt. ij-iij of the dilute acid, is serviceable 
 (Da C). Ether, a few drops or the compound spirit n\x-xx, often relieves 
 quickly (B). Chloroform, TT\,ij-v on sugar, often relieves (B). Chloral, some- 
 times relieves pain in gastralgia (R). Pulsatilla, is efficient in many cases of 
 painful dyspepsia, with coated tongue, headache and nervous depression (P). 
 Pepsin, when gastrodynia from indigestion (P). Creosote, checks pain after 
 food (R). Cocaine, in doses of nrv of a 4 per cent, solution every hour, given 
 by the mouth for its local action, is an efficient gastric sedative and anodyne. 
 Alum, often affords relief (B). Ergot, of value in visceral neuralgias (P). 
 Alkalies, for pain in stomach, Liquor Potassae generally employed (R). 
 Quinine, in cases showing periodicity and those of neuralgic type (P). Sodium 
 Salicylate, for gastralgia with fermentation (R). Nitroglycerin allays the pain 
 speedily (B). Carbonic Acid Water, in painful and irritable conditions ; may 
 be mixed with milk (R). Milk-cure, very efficacious in obstinate cases (B). 
 Galvanism of the pneumogastric, and locally to the organ itself (B). Aqua- 
 puncture has given extraordinary relief (B). Diet is of the greatest importance ; 
 food should be digestible, varied and plainly cooked ; persons of sedentary life 
 should refrain from much animal food ; meals regular and frequent, eating 
 little at a time and that very slowly. Alcoholic beverages do harm as a rule, 
 but may benefit particular cases. Eating should be done in as agreeable a 
 frame of mind as possible and the patient should rest for a time after a meal. 
 [Compare Acidity, Dyspepsia, Neuralgia.] 
 
 R. Morphinse Sulph., . . . . gr. j. 
 
 Ac. Carbolici, ^ss. 
 
 Aq. Menth. Pip., . q. s. ad J iv. 
 M. Sig. — Teasp. thrice daily. 
 
 {Da Costa. 
 
 R. Bismuthi Subnit., . . . . gij. 
 Ac. Hydrocy. Dil., . . . gss. 
 Mucil. Acaeiae, 
 
 Aq. Menth. Pip., . . . aagij. 
 M. Sig. — Tablesp. thrice daily. 
 
 R. Atropinse Sulph., . . . . gr. j. 
 
 Zinci Sulph., 3 ss. 
 
 Aquae Destil., 3jj. 
 
 M. Sig. — 3 to 5 drops two or three 
 times daily. (B.) 
 
 R. Bismuthi Subnit., 
 
 Magnesii Carb., . . . aa gr. xvj. 
 
 Ac. Hydrocy. Dil., . . . l\x. 
 
 Aquae, ^iv. 
 
 M. Sig. — Dessertsp. for a child of 3 
 years in flatulent gastrodynia and gastralgia. 
 
 R 
 
 . Ac. Hydrocy. Dil., . . . £ij. 
 Aq. Laurocerasi, . q. s. ad £ iv. 
 M. Sig. — Teasp. every 4 hours. 
 
 R. Pepsini, gj. 
 
 Ac. Hydrochlor. Dil., . . gss. 
 
 Glycerini, .^j ss « 
 
 Aq. Cinnamomi, ... ^ ijss. 
 M. et filtra. Sig. — Tablespoonful doses 
 
 for slow and feeble digestion. 
 
 Gastric Dilatation. 
 
 Carbolic Acid, internally to allay fermentation, with an occasional washing 
 by the stomach-pump (Da C). Strychnine, hypodermically or by the mouth, 
 or Nux Vomica, the best remedy, conjointly with washing of the stomach and 
 strict diet (Da C). Bismuth Subnitrate, with Magnesia or Soda, or Lime-water 
 frequently, for the acidity, which is one of the most distressing symptoms (Fen- 
 wick). Bismuth Salicylate, as an internal antiseptic, is highly praised. Salo- 
 phen, relieves the fermentative disturbances. Diet, should be free from all 
 starch and sugar and from vegetables of any kind (Fenwick) ; milk not advis- 
 able as much fluid will further dilate the organ ; solids better, as small quanti- 
 ties of dry, stale bread or gluten bread and underdone meat (Da C). 
 
 45 
 
yo6 
 
 GASTRIC ULCER GASTRITIS. 
 
 Gastric Ulcer. 
 
 Arsenic, Fowler's solution in drop doses lessens the pain and relieves the 
 vomiting remarkably (B) ; has given relief when commonly-used remedies 
 failed (B) ; gives good results when used in very small doses (Da C). Bismuth 
 Subnitrate, relieves pain and vomiting and contributes to the cure (B) ; see 
 under Gastralgia for formulas. Chloroform I, with Bismuth Subnitrate 3 and 
 Water 1 50, of which 3j-ij hourly, or without the bismuth, which is not necessary, 
 gives marked improvement in recent ulcer as well as in long-standing cases 
 (Stepp). Silver Nitrate, in solution, to check pain and relieve the vomiting 
 (R) ; is next in value to Bismuth, promoting cicatrization and easing the pain 
 (B). Silver Oxide is equally efficient, and is not liable to produce staining 
 (Da C). Atropine, often happily relieves the pain and vomiting even when 
 given in very small quantity (B). Morphine, for the pain and vomiting (R) ; 
 in full doses if perforation occurs, to localize peritonitis until adhesions take 
 place (Da C). Ergotin, 1 part to 10 of water, of which gtt. xv hypodermically 
 several times a day for the hemorrhage. Gallic Acid, in 5-grain pill every hour 
 for hemorrhage. Lead Acetate, is sedative and hemostatic ; gr. ss-ij in pill 
 with Opium, very useful to check hemorrhage and allay pain (R). Turpentine, 
 5 to 10 drops frequently repeated in hemorrhage (R). Resorcin, acts very well ; 
 its analgesic property herein is so marked that the stomach is enabled to tolerate 
 food (Pope). Glycozone, is the best of all known agents for the treatment of 
 gastric ulcer (Edson) ; should be given on an empty stomach, one or two teasp. 
 in a wineglassful of water. Charcoal is said to ease the pain by preventing 
 formation of acid products (R). Mercury, Corrosive Sublimate an effective 
 remedy, gr. ^V" F5 thrice daily before meals (B). Pepsin, by facilitating diges- 
 tion is useful (B). Iron, for the anemia ; the Lactate or Ammonio-citrate if 
 stomach irritable (Da C). Ice-bag, to the epigastrium, for pain and vomiting 
 (R). Nutrient Enemata, to rest the stomach ; (see under Enemata for formu- 
 la) ; Brandy may de added, also Laudanum gtt. x-xx, if the rectum is 
 irritable (B). Milk-cure, has succeeded admirably (B) ; a strictly skimmed 
 milk diet with Lime-water, 2 parts of milk to 1 of Aqua Calcis (Da C). Diet, 
 should be of non-irritating character, with cold or hot compresses to the epi- 
 gastrium, leaves little room for medicine : in bad cases nourish per rectum so 
 as to give the stomach complete rest; in any case use such food as is chiefly 
 digested in the small intestine, farinaceous vegetables, rice, arrowroot, etc. 
 A nice change from milk diet is a warmed pancreas, chopped up with rare meat, 
 being nutritious and well relished (Da C). Rest, in bed for several months is 
 imperative (Da C). Defibrinated Blood, by injection into rectum, in doses of 
 ^iij-vj (A. H. Smith). [Compare Hematemesis.] 
 
 R . Argenti Oxidi, 
 
 Ext. Hyoscyami, . . aagr. x. 
 Ft. pil. no. xx. Sig. — One pill thrice 
 daily before meals. 
 
 R. Bismuthi Subcarb., . . ^iij. 
 
 Morphinae Sulph., . . . gr. j-ij. 
 
 Pulv. Aromat., .... sjj. 
 Ft. pulv. no. xij. Sig. — One powder in 
 milk before each meal. 
 
 R . Argenti Nitratis, . 
 Ext. Opii, .... 
 Ft. pil. no. xx. Sig. 
 daily, after meals. 
 
 , • gr. v. 
 . gr. iij. 
 -One pill thrice 
 
 R . Argenti Oxidi, . . . . gr. v. 
 
 vel Zinci Oxidi, . . . . 5 ss. 
 
 Morphinae Sulph. , . . . gr. j-ij. 
 Ft. pil. no. x. Sig. — One pill thrice 
 daily, before meals. 
 
 Gastritis, Acute. 
 
 Mercury, Calomel in broken doses with ice, frequently swallowed, for the 
 idiopathic form, which is occasionally seen and cannot be distinguished from 
 that due to irritant poisons (Da C). Bismuth, the Subnitrate or Subcarbonate 
 in full doses after the acute symptoms have abated (Da C). Morphine, hypo- 
 dermically for pain (B). Ice, internally and externally gives great relief (R). 
 
GASTRITIS. 707 
 
 Aliment should be given per rectum ; no food, except milk and Lime-water, 
 being admitted to the stomach for some time (Da C). Antidotes, in cases of 
 irritant poisoning, as Alkalies to neutralize acids, Dialyzed Iron or the Hy- 
 drated Sesquioxide for arsenic, Turpentine for phosphorus, etc. (see Poison- 
 ing) : then Oil, Albumin or milk, to protect the mucous membrane ; stimulants, 
 Opium, Ammonia, etc., to antagonize depression of the vital powers. 
 
 Gastritis, Chronic. 
 
 Arsenic, sometimes surprisingly curative; for the vomiting gtt. j-ij of Fow- 
 ler's solution before meals (B). Pulsatilla, in subacute gastritis of phlegmatic 
 temperaments, white tongue, heartburn, nausea, flatulence, little or no taste 
 (P). Hydrastis, gtt. v-xv of tincture or fluid extract, daily before meals, espe- 
 cially for gastric catarrh of acute alcoholism (B). Nux Vomica, gtt. j of tinc- 
 ture every 5 to 10 minutes for 8 or 10 doses, in acute gastric catarrh, with head- 
 ache or sick-headache ; also drop or 2-drop doses every 2 hours or oftener, 
 when chronic gastric catarrh occurs in the course of chronic disease (R). Cin- 
 chona, to promote healthy state of mucous membrane, the infusion with min- 
 eral acids, or Quinine ; the Red Bark in gastric catarrh of drunkards (B). Alka- 
 lies, either shortly before meals to stimulate production of gastric juice, or some 
 hours after to neutralize the acids of decomposition (Da C). Pepsin, gr. v 
 immediately after a meal, to assist digestion (Da C). Podophyllum, in small 
 doses at night, to act on upper bowel; purgation as a method of treatment 
 stands at the head (Da C). Ipecac, in small doses may prove useful, rr\,v-x of 
 the wine (P) ; for the nausea and vomiting (R). Tannic Acid, in 4-grain doses 
 with a drop of glycerin to make a pill (B). Bismuth Subnitrate, is very useful 
 in chronic gastritis, especially that of drunkards, and the chronic gastric catarrh 
 of children with vomiting (R) ; invaluable for its sedative, alterative and as- 
 tringent action ; 10-15 grain doses several hours after meals (Da C) ; the Sub- 
 gallate (Dermatol) is being advertised as a remedy for chronic gastritis. Bis- 
 muth Salicylate, as an internal antiseptic, is praised in chronic gastric affec- 
 tions. Strontium Bromide, gave successful results in 32 cases of gastric catarrh 
 (See). Resorcin, acts exceedingly well. Glycozone, is one of the best reme- 
 dies for the chronic gastric catarrh of alcoholism, and that from other causes 
 (Edson). Hydrocyanic Acid, is much used (R) ; in subacute gastritis it often 
 proves useful given in an ordinary effervescing draught (Wa). Silver Nitrate, 
 in % or ]/ z -grain doses with Opium if pain, or preferably Belladonna, is ex- 
 tremely useful (Da C) ; to check pain and vomiting (R). Silver Oxide, is nearly 
 as good as the nitrate, and not liable to produce staining (Da C). Opium, or 
 Morphine, to quell pain in chronic gastritis from alcoholic excess (R). Eucal- 
 yptus, a useful stomachic, not to be used in inflammatory states (B) ; is used 
 with benefit (R). Mercury, the Yellow Oxide, in doses of gr. g 1 - 3 1 o > in chronic 
 form (see under Dyspepsia). Calumba, and other bitters are useful (B). 
 Ammonium Chloride, in high repute in Germany (B). Caffeine, especially 
 when associated with migraine (B). Lead Acetate, in chronic gastritis with 
 gastralgia and pyrosis, may be combined with Morphine beneficially (B). 
 Alum, when vomiting of glairy mucus (B). Aliment, such as will be digested 
 in the small intestine ; requires careful attention ; the milk-cure has been very 
 effective in bad cases ; malt liquors are harmful (B) ; mineral waters of purga- 
 tive type, to keep the portal system drained : exercise is not beneficial, better 
 live quietly and occasionally spend a day or two in bed (Da C) : Kumyss 
 agreeable and tolerant to stomach ; the milk-cure and buttermilk have been 
 efficient; the farinaceous vegetables, rice, tapioca, arrowroot, aerated bread. 
 [Compare Dyspepsia, Gastralgia.] 
 
 R. Sodii Bicarbonat., . . . ^jss. 
 
 Tinct. Aurantii Cort. , . 3 ss. 
 
 Infusi Calumbae, q. s. ad % viij. 
 M. Sig. — Two tablesp. before each 
 meal. In chronic gastric catarrh. 
 
 rj . Magnesii Sulphatis, . . gj-ij. 
 
 Sodii et Potassii Tart., . £ss-j. 
 
 Ac. Tartarici, . . . . gr. xx. 
 Sig. — Dissolve in a glass of water and 
 drink, an hour before breakfast. 
 
708 
 
 GLANDERS AND FARCY GLANDULAR AFFECTIONS. 
 
 U . Aluminis, . . . 
 Ext. Gentianae, . 
 M. Ft. pil. no. xxx. 
 twice daily. 
 
 R . Argenti Oxidi, . . 
 
 Ext. Belladonna, . 
 
 Olei Caryophylli, . 
 M. Ft. pil. no. xxiv. 
 twice daily. 
 
 . . 31J. 
 . . 3ss. 
 Sig. — Two pills 
 
 . . gr. xij. 
 
 • • gr. Hj. 
 . . gtt. xx. 
 Sig. — One pill 
 {Da Costa.) 
 
 R . Sodii Bicarbonat. , . . . gr. lxxx. 
 
 Spt. Chloroformi, . . . gjss. 
 
 Tinct. Gentianse, . . . % ss. 
 
 Infusi Rhei, J iv. 
 
 Aq. Menth. Pip., q. s. ad ^viij. 
 M. Sig. — A tablesp. or two before each 
 meal. In chronic gastric catarrh with flat- 
 ulence. 
 
 Glanders and Farcy. 
 
 Ammonium Carbonate, in water hourly, as concentrated as can be swallowed, 
 followed by an opiate and preceded by an emetic of Ipecac, and an incision 
 into each of Wharton's ducts ; proved successfully in a case of acute glanders 
 (Wa). Carbolic Acid, and the Sulphites, as Sodium Sulphite, are most worthy 
 of trial. Creosote, or Carbolic Acid, in Glycerin, locally (Wa) ; or dilute 
 Chlorinated Soda and Lime-water. Escharotics, to destroy the affected spot, 
 if inoculation occurs. Iodine, internally, also Arsenic and Strychnine, have 
 been recommended. Quinine, in large doses and Ferric Chloride, may be 
 useful. Potassium Iodide, gr. 150 daily, with baths in Hot Springs of Arkan- 
 sas, conquered the disease in me, probably the only man who ever survived 
 it. (Dr. Paul Paquin, Univ. Mo.) No drug yet tried has any marked specific effect 
 on the disease (Durham). Mallein, for diagnostic purposes (see page 518). 
 
 Glandular Affections. 
 
 Iodine and Iodides, no remedy more efficient, when simple hypertrophy ; 
 useless (with all other medicines) when caseation or suppuration has set in ; 
 Iodine injected into cystic and glandular growths of neck ; Syrup of Ferrous 
 Iodide occupies an important place (B) ; Potassium Iodide for mammae and 
 testicles, but especially for thyroid (R). Iodoform is equal, if not superior to 
 Iodine, in enlarged scrofulous glands and other glandular swellings (Wa). 
 Lead Iodide, as an ointment. Ung. Hydrarg. Iodidi Rubri, produces very 
 striking effects in goitre, enlarged spleen, etc. (B). Sulphides, especially the 
 Blue Lick water, are said to abort or to mature suppuration in glands (R). 
 Calcium Sulphide, for hard, swollen glands behind the angle of the jaw, with 
 deep-seated suppuration (R). Calcium Chloride, highly useful in strumous 
 inflammation and suppuration (B). Pilocarpus, is curative in acute affections 
 of parotid and submaxillary glands (B). Mercury, useful in acute inflamma- 
 tory states, tonsillitis, parotitis, etc. ; Hydr. Chlor. Corr. gr. fa or Hydr. cum 
 Creta, gr. \, every two hours (B) ; the Oleate of Mercury and Morphine in 
 obstinate and painful tonsillitis and inflammation of lymphatic glands (R). 
 Aurum Salts, have cured enlarged and indurated cervical glands. Aurum and 
 Arsenic Bromide, the solution is highly efficient in cervical adenitis (Barclay); 
 rendered good service in a case of adenitis with enormous enlargement of the 
 left side of the neck (E. A. Wood). Belladonna, especially in tonsillitis (P). 
 Valerian, with Guaiacum, in strumous enlargement (P). Hydrastis, frequently 
 controls (P). Carbolic Acid, a 2 per cent, solution injected into substance of 
 gland (B). Electrolysis, used by me to remove a number of swollen and pain- 
 ful lymphatic glands in the neck (Remak) ; by the use of strong and often 
 interrupted faradic currents multiple indurated lymphatic tumors have been 
 removed or diminished (Meyer); enlarged glands have been repeatedly cured 
 by electrolysis (B). [Compare Bubo, Goitre, Parotitis, Tabes Mesenterica, 
 Tonsillitis, Wen, etc.] 
 
GLAUCOMA — GLEET. 
 
 709 
 
 Glaucoma. 
 
 Atropine, gr. -fa hypodermically is beneficial (Anstie) ; imprudently used has 
 caused the disease (Graefe, Wells) ; should not be indiscriminately instilled 
 into the eyes of persons over 35 or 40 years of age, in whom it may light up a 
 latent or incipient glaucoma. Physostigmine, lowers intra-ocular tension, and 
 with Quinine is indicated in all cases of threatened glaucoma, to preserve the 
 eye from the risk of consecutive glaucoma, and after iridectomy or sclerotomy 
 (de Wecker). Iridectomy, the only remedy for the disease, medicine being worse 
 than useless ; the operation should be performed as soon as a state exists which 
 can be called glaucomatous ; even when vision is lost the operation will best 
 relieve the pain (C) : almost a certain cure in early stages, in later nearly 
 always palliative and often curative. Drainage of Eye, by gold wire or catgut, 
 has proved successful (de Wecker). 
 
 Gleet. 
 
 Cantharis, in drop doses, when frequent desire and pain in region of pros- 
 tate (R) ; of benefit in subjects of relaxed fibre and feeble circulation (B). 
 Blisters, to the perineum, of undoubted benefit (R). Piper Methysticum, has 
 cured obstinate gleet (Switzer). Bismuth, 1, glycerin 1, water 6 parts, as an 
 injection, often useful in gleet (R). Eucalyptol, is used with benefit in chronic 
 catarrh of the genito-urinary tract (R). Iron, the tincture of the Chloride, 3ss 
 in Oss of water with 3] of Laudanum, makes a good injection for gleet (R) ; 
 internally for anemic subjects (St). Mercury, y 2 grain of Corrosive Sublimate 
 in gvj of water, is a good injection in gleet, used every 2, 3 or 4 hours (R) ; 
 Donovan's Solution in doses of 10 minims thrice daily, so uniformly successful 
 in controlling chronic urethral discharge as to be almost a specific for gleet. 
 Zinc Salts, the Sulphate or Chloride, gr. ij of the latter to a pint of water, as 
 injection every hour (R). Bougies, of gelatin, medicated with astringents, are 
 extremely efficient. Turpentine, in moderate doses, when due to relaxed con- 
 dition (R). Copper Sulphate, a solution as injection (R) ; astringent injections 
 may be used with benefit (Wa). Copaiba, smeared on a bougie and introduced 
 into the urethra, will sometimes cause gleet to yield (Wa). Sandalwood Oil, 
 TT^xv ter die (R). Glycerite of Tannin, with equal quantity of Olive Oil or 
 mucilage, as injection, Z\] enough ; persevere 8 or 10 days after discharge 
 ceases and do not use at bedtime (R). Balsams of Peru and Tolu, Buchu, 
 Canada Balsam, Copaiba, Mastic, and Tannin, are used with advantage (P, R). 
 Gleet is often kept up by over-treatment, will some time or other come to an 
 end (St). Diet and Habits important; stimulants, both solid and liquid, 
 should be rigidly avoided, also coffee ; frequent ablutions, fresh air, good nour- 
 ishment. [Compare Gonorrhea.] 
 
 R. Tinct. Ferri Chlor., . , . sjvj. 
 Tinct. Cantharidis, . . . 3 ij. 
 M. Sig. — 15 drops in water three times 
 daily. 
 
 R. Zinci Sulphatis, gr. iij. 
 
 Ac. Carbolici, rtyj. 
 
 Ext. Hydrastis, 
 
 Ext. Belladonnse, . . . aagr. vj. 
 
 Gelatini, q. s. 
 
 M. Ft. bougia no. vj. Sig. — One in 
 urethra at bedtime. 
 
 R. Pulv. Cantharidis, . . . . gr. iij. 
 
 01. Terebinth., gj. 
 
 M. Ft. pil. no. xij. Sig. — One thrice 
 daily in obstinate gleet. If strangury 
 occur, stop for a day or two. 
 
 R. Ac. Tannici, gr. x. 
 
 Bismuthi Subnit., . . . . gij. 
 
 Aq. Rosae, ^vj. 
 
 M. Sig. — Shake and use as an injection 
 thrice daily. (Maury.) 
 
7io 
 
 GLOSSITIS — GLOTTIS — GOITRE. 
 
 Glossitis. 
 
 Bismuth, gr. xx of Subnitrate with ^j of glycerin and ^vij of water, as lotion 
 for erythematous inflammation of the tongue (A). Purgatives, with gargles, 
 leeches, antiphlogistic regimen generally (D). Quinine and Iron, should be 
 given internally, with dilute acid washes, and free purgation (CI). Alum, dry, 
 powdered, may be dusted on tongue (CI). Leeches, applied beneath the jaw, 
 if symptoms are urgent (CI). Abscess, should be opened, if any form. In- 
 cisions, along superior surface, followed by vapor of hot water, may instantly 
 relieve congestion (A). Tracheotomy or Laryngotomy, if suffocation is appa- 
 rently imminent (A). 
 
 Glottis, Edema of. 
 
 Emetics, when edema slight (A). Inhalations, of steam with Benzoin or 
 Conium of great service (A); or of Tannin, grain viij or to ^j of water; or 
 Alum, gr. x to the % t or a saturated solution of Potassium Chlorate, all as spray 
 (Walker). Ethyl Iodide, by inhalation, proved curative in one case in which 
 it was repeated twelve times (See). Scarification, by laryngeal lancet, of par- 
 amount value (A). Tracheotomy, if the above fail (A). O'Dwyer's laryngeal 
 tubation promises well. [Compare Croup, Laryngitis.] 
 
 Goitre. 
 
 Iodine, is curative in simple hypertrophy (ordinary goitre) used both inter- 
 nally and externally : deep injection of the tincture is very successful in cystic 
 degeneration of the gland (B); also in the fibrous and fibro-cystic varieties, 
 if injection be made into the tumor; dangerous, if into a vein or into the 
 surrounding areolar tissue (Wa). Mercuric Iodide, as oint. assisted by the 
 sun's rays ; a piece the size of a large pea rubbed in daily, very successfully 
 used in India for simple hypertrophy (R) ; the official Unguent. Hydrarg. 
 Iodidi Rubri, I in 10, daily (B) ; is too strong (Gross) ; gr. xv to the ^ strong 
 enough for the worst cases (Wa). Potassium Iodide, internally, also exter- 
 nally as ointment, in simple hypertrophy of the gland (R). Strychnine, 
 gr. y 1 ^ thrice daily, has been successful in several cases (Holmes). Ferric 
 Chloride, injections of the solution used in thirty-eight cases with curative 
 results (Mackenzie). Ergotin, injected with benefit into the parenchyma of 
 the goitre (P) ; also used hypodermically with good results (Wa). Ammon- 
 ium Chloride, as an internal remedy has proved curative (Stevens). Thyroid 
 Gland, 3j to ij, once a week, cured 4 children completely, and cured or relieved 
 9 out of 12 cases so treated (Bruns) ; Thyroid Extract is used with benefit (see 
 page 159). Electrolysis, has sometimes cured in cases of simple hypertrophy 
 and cystic gland (B) ; 6 out of 14 test cases of goitre were absolutely cured by 
 electrolysis (Duncan). Spongia Usta, was formerly considered a sovereign 
 remedy (Wa). Seton, has cured. Fluoric Acid, in doses of tt\,xv to 3j thrice 
 daily, largely diluted, cured seventeen cases out of twenty (Woakes). Excision, 
 is a very difficult operation, only to be considered in extreme cases ; it has been 
 performed successfully by Desault, Harris, Lane, Hedenus, Billroth and Greene. 
 [Compare Exophthalmos.] 
 
 R . Ammonii Chloridi, . . . 3 vss. 
 Syrupi Simplicis, . . . . x, ss. 
 Aq. Cinnamomi, . . . . ^iv. 
 M. Sig. — Teasp. thrice daily. 
 
 R . Unguenti Hydrargyri Iodidi 
 
 Rubri, 3j. 
 
 Vaselini, 3 V U- 
 
 M. Sig. — Use as directed. {Gross.) 
 
GONORRHEA. J\ I 
 
 Gonorrhea. 
 
 Aconite, a drop of tinct. each hour in the acute stage (R) ; when inflamma- 
 tion (Pf, St). Gelsemium, serviceable, acute stage (Pf ). Methylene Blue, in 
 doses of gr. ij thrice daily, given in the earlier stages, will shorten the course 
 of the disease (Horwitz). Cannabis Sativa, after acute symptoms subside, a 
 few drops 3 or 4 times a day, is fully as effectual as Copaiba or Sandal and 
 infinitely more pleasant to take (Pf). Cannabis Indica, relieves pain, 
 diminishes discharge (P); occasionally useful (R). Colchicum, the wine of the 
 seed has frequently cured gonorrhea, and was used in thirty-minim doses 
 nightly for the relief of chordee by Brodie (B). Ferric Chloride, when acute 
 stage has passed and the discharge is degenerating into gleet, few remedies are 
 more useful than this tincture in doses of n^xv-xx thrice daily (Wa). [See 
 Erysipelas for formula.] Alkalies, Citrates or Bicarbonates to render the 
 urine alkaline (R) ; Lithium Carbonate in five-grain doses thrice daily, for the 
 same purpose : Alkalies are the chief factor in Otis's treatment ; Potassium 
 Bicarb., gr. x in a tumbler of water or in Flaxseed tea, or Infusion of Triticum 
 with gr. xv of Potass. Bromide if great pain present ; Vichy Water (Celestin) 
 freely (Otis). Turpentine, in chronic stage when parts are relaxed, moderate 
 doses are of great benefit (B). Cantharis, drop-doses may be used(R) ; in the 
 chronic stage (B). Pulsatilla, in subacute and gonorrheal ophthalmia (P). 
 Copaiba, especially adapted to gonorrhea (B) ; pour it upon half a winegl. of 
 water to which add some bitter tincture (Chapman); if given too early in the 
 disease it will aggravate the symptoms (P) ; should not be used until pain in 
 urinating is nearly gone, chordee ceased and the discharge diminishing and of 
 yellow color (Wa) ; does no good but is injurious, and prolongs the disease 
 (Otis). Saw Palmetto, the fluid extract of the berries of this palm, has been 
 used with good results in doses of 3j (Porter). Santal Oil, is valuable in sub- 
 acute gonorrhea (P) ; a good quality difficult to obtain (Pf ) ; the best internal 
 remedy, Copaiba next (St). Cubeb, unlike Copaiba, is given with good effect 
 in acute stage ; best results from a mixture of both as in electuary (see formula 
 p. 713) ; is not irritating to the stomach, and agrees with some patients better 
 than Copaiba (Wa). Balsams of Peru and Tolu, also Buchu, Uva Ursi, 
 Chimaphila, Pareira, etc., are among the numerous remedies used for gonor- 
 rhea (R). 
 
 Injections, of Tannin, Copper Sulphate, Iron, Cadmium, Port-wine, Brandy- 
 and-water and 1000 other agents (R); injections are very bad, especially in 
 the acute stage ; should never be used until the 5th week and then only if the 
 case is not progressing (Otis) ; true gonorrhea is never cured in less than four 
 weeks (Van Buren and Keyes) ; urethritis is a different disease entirely (Otis). 
 Silver Nitrate, a weak solution, gr. j-v to the ^, as injection ; in vaginal gon- 
 orrhea a strong solution, Z) to the ^, through speculum to every part of the 
 canal (B); as abortive injection is useless and dangerous (St). Argonin (Sil- 
 ver Casein), is less irritant than silver nitrate and less efficient (Kopp) ; up to 
 4 per cent, strength of solution it usually does not irritate. Largin (Silver Prot- 
 albin), irritates about as much as the nitrate and possesses no marked superi- 
 ority over the latter salt (Kopp). Argentamin, is markedly irritant even in 1 
 to 4000 solution ; no cures resulted from its sole use (Id). Protargol (Silver Pro- 
 tein), a few drops of a 20 per cent, solution in glycerin instilled into the fossa 
 navicularis after a suspected coitus, will secure almost perfect immunity from in- 
 fection (Kopp); in gonorrhea a 1 per cent, solution injected every 30 minutes 
 during the day (Neisser) ; causes but little irritation and a rather speedy check- 
 ing of the gonorrheal discharge; on the whole it presents no decided advantage 
 over silver nitrate (Kopp). Itrol (Silver Citrate), is strongly advocated by Crede, 
 and seems to possess real merit, its disadvantages are the difficulty of prepar- 
 ing aqueous solutions and the rapidity with which they decompose (Id). Zinc 
 Salts, a weak injection of the Chloride, gr. j to ^vj or viij of Rose-water ; or of 
 
712 
 
 GONORRHEA. 
 
 the Sulphate, gr. j to the %, frequently repeated, is probably the best treatment 
 (B) ; the best injections are those of the Sulphate or Acetate, gr. vj-xij to ^iv 
 aquae, after the acute inflammation subsides (St). Bismuth, the oleate, smeared 
 on a sound, and inserted for 5 minutes (Shoemaker) ; with mucilage as an in- 
 jection, excellent in chronic gonorrhea (Hill). Lead Acetate, the dilute solution 
 of the Subacetate, as injection, may be employed at any stage (B). Chloral, a 
 weak solution, gr. j-iv to the ^, a very good injection (Hill). Resorcin, a 1 
 per cent, solution makes a useful injection (Wa). Antipyrin 100 parts, Corro- 
 sive Sublimate 1, Distilled Water 10,000, used as injection four times daily 
 and retained as long as possible (Vatier). Boric Acid 3iss, Tinct. Iodine 3ij, 
 Glycerin ^ij, Distilled Water q. s. ad ^iv, as injection morning and night, has 
 given excellent results in both acute and chronic cases when other treatment 
 proved inefficient (James). Potassium Permanganate, a solution of 1 to 1000, 
 one or two quarts at each sitting, washing out the bladder as well as the urethra 
 several times daily, is highly efficient ; a solution of 1 or 2 per cent, as injection 
 in chronic gonorrhea (Keyes) ; a hot solution of 1 in 2000, gradually increased 
 to 1 in 1000, injected into the bladder, in chronic gonorrhea, especially poste- 
 rior urethritis (Ultzmann) ; has proved disappointing, both as an abortive agent 
 and for acute gonorrhea (Kopp). Alumnol, 1 to 3 per cent, solutions as injec- 
 tions ; is reported to be efficient. Mercury, excellent results from Corrosive 
 Sublimate (Pf); gr. ]i-yi to ^viij aquas destill. in subacute and chronic stages, 
 as injection thrice daily ; may have gr. ss-j of Zinc Chloride added with bene- 
 fit ; is often effectual (Wa) ; the Oxycyanide, in solutions of 1 to 3000 or 1 to 
 1000, is well tolerated by the urethral mucous membrane; resembles Protargol 
 in action and has no specific power in gonorrhea (Kopp). Gallobromol, a 1 or 
 2 per cent, solution [see page 97]. Hydrastis, the infusion best for injection, 
 3j of root to ^viij aquae (Pf) ; the fluid extract is one of the best injections, 
 properly diluted ; or the Muriate of Berberine (Hydrastin) 3j to ^iv mucil. 
 acaciae (B). Soluble Bougies made of Iodoform, Eucalyptus and Cacao-butter, 
 are highly recommended to cut the disease short (Wa) ; a series of similar 
 preparations, having a basis of gelatin and glycerin, medicated with the usual 
 astringent and sedative drugs, is manufactured by C. L. Mitchell, of Philadel- 
 phia and may be obtained of the drug trade. Wrappings of several folds of 
 cotton are heating and uncomfortable, also dirty and productive of balanitis, 
 etc. ; pin a false front to the shirt for covering (St). Rest, in bed is an absolute 
 desideratum, especially during the inflammatory stage. Hot water, ioo° F., to 
 the penis during urination, extreme cleanliness, milk diet; water freely as a 
 beverage, flavored with a few drops of Oil of Gaultheria ; or Flaxseed tea, or 
 Infusion of Triticum with Potassium Bicarbonate. Sexual thoughts to be 
 entirely avoided (Otis). Alcohol, or any other stimulant, must be avoided 
 entirely (R). [Compare Chordee, Gleet, Orchitis, Rheumatism Gonor- 
 rheal, Urethritis, Urethral Stricture, Vaginitis.] 
 
 For Internal Use. 
 
 R. Potassii Citratis, .... ^5 ss-j. 
 
 Spt. Limonis, % ss. 
 
 Syr. Simplicis, 5ij. 
 
 Aquae, gj. 
 
 M. Sig. — Dessertsp. largely diluted, 3 
 or 4 times daily. As alkali for the increas- 
 ing stage. {Otis.) 
 
 R- . Oleoresinae Cubebae, . . . 55 iv. 
 Potassii Bromidi, . . . . ^j. 
 
 Olei Sassafras, n\x. 
 
 Syr. Acacias, ..... ^ ij. 
 Aquae, . . . . q. s. ad ^ vj. 
 M. Sig. — Dessertsp. 3 or 4 times daily. 
 (/. Wm. White.) 
 
 R 
 
 For Local Use. 
 
 Resorcini, 3J. 
 
 Ac. Borici, gr. xx. 
 
 Zinci Acetatis, g r -X - / 
 
 Aquae Destil., 25 iv. 
 
 M. Sig. — Dessertsp. as injection. 
 
 R. Zinci Sulphatis, gr. viij. 
 
 Liq. Plumbi Subacet. Dil., ^iv. 
 M. Sig. — Use as an injection. 
 
 R. Zinci Chloridi, gr. j. 
 
 Aquae Rosae, ^ vj— viij. 
 
 M. Sig. — Use as an injection. 
 
GOUT. 
 
 713 
 
 The Black Paste. 
 
 R. 
 
 Pulv. Cubebse, SEiij. 
 
 Copaibas, ^j ss - 
 
 Aluminis, ....... 3 ij. 
 
 Sacchari Albi, 3J. 
 
 Magnesiae, 3J SS - 
 
 Olei Cubebse, gj. 
 
 Olei Gaultheriae, .... gj. 
 M. fiat electuarium. Sig. — A piece the 
 size of a walnut after each meal. [Otis.) 
 
 [For Emulsion of Copaiba see page 572.] 
 
 R. Zinci Sulphatis, gr. vj. 
 
 Plumbi Acetatis, . . . . gr. viij. 
 Ammonii Chloridi, . . . gr. iv. 
 
 Aluminis, gr. v. 
 
 Aquas Rosas, 
 
 M. Sig. — Injection to be 
 acute symptoms subside. 
 
 • 5J- 
 used 
 
 aft« 
 
 R 
 
 . Pulv. Iodoformi, . . . . ^ss. 
 
 Ac. Carbolici, 5jij. 
 
 Glycerini, t ^ij. 
 
 Aquae Destil., . q. s. ad ^ viij. 
 M. Sig. — Teasp. as injection. 
 
 [For Injection Brou, see page 578.] 
 
 Gout. 
 
 Piperazin, the best solvent for uric acid ; promptly reduces the redness and 
 swelling of the joints in acute gout, remarkably relieves the paroxysm and 
 promotes elimination of uric acid and urates; should be given in doses of 15 
 grains daily, dissolved in a pint or more of carbonated water. Lysidin, is still 
 more powerfully solvent on uric acid [see page 430] ; tried in cases of chronic 
 gout with exacerbations with excellent results (Grawitz). Lycetol, is beneficial 
 [see page 430]. Phenocoll, when much pain and fever; combined with Piper- 
 azin, gr. xv of each daily in a pint or more of carbonated water, is very 
 efficient treatment. Morphine, hypodermically, as close to the affected joint 
 as possible outside of the red areolar, is miraculous in giving immediate relief. 
 Antipyrin, remarkably efficient for relieving the pain as well as prophylactic 
 against future attacks (Marshall). Aconite, may certainly relieve pain (P). 
 Belladonna, the best remedy effectually and speedily to soothe the pain, also in 
 gout of the stomach ; 5-rri^ doses efficacious (P). Potassium Iodide, especially 
 when pain is worse at night (R). Colchicum is merely palliative ; Z) of the 
 wine often removes the severest pain in an hour or two, and soon after the 
 swelling and heat subside (R) ; it is especially useful in acute and rheumatic 
 gout (B) ; is not specific, nor a lasting or final remedy for gout, but acts very 
 directly on the pain and inflammation of acute attacks (P); is useful in the 
 bronchitis, asthma, dyspepsia, urticaria, etc., of gouty subjects (R). Colchi- 
 cine Salicylate, is highly efficient in chronic gout [see page 285]. Strontium 
 Salicylate, in chronic gouty conditions, appears to be the most valuable drug 
 that we have (W). Sodium Salicylate, 10 grains every 2 hours internally, 
 also 3ij in ^vij of warm water as lotion on lint covered with oiled silk, in 
 acute gout is very efficient treatment. Salicylates do not cure gout, they simply 
 aid in keeping down the diathesis (W). Ammonium Salicylate is much better 
 than the sodium salt, which is the worst of all the salicylates ; the Strontium 
 salt acts slowly and does not derange the digestion like the others (W). Cas- 
 cara Sagrada, is said to promote the elimination of uric acid to a remarkable 
 extent. Coffee, a tincture of green coffee promotes elimination of the poison 
 of gout from the system. Veratrine, as ointment to painful joints (R). Arsenic, 
 a standard remedy in chronic gout. Chimaphila, should prove useful [see 
 page 253]. Chirata, in the dyspepsia of gouty subjects [see page 254]. Cod- 
 liver Oil, in chronic gout (R). Sulphides, as baths in chronic gout, or 
 fumigation with Sulphurous Acid, and bed-clothes exposed to its strong 
 fumes (R) ; Sulphur waters certainly benefit (B). Iodine, painted around joints 
 in chronic gout (R). Strychnine, hypodermically for later stage of gout 
 paralysis (R). Lithium, the Bromide internally and a strong solution of 
 Lithia to the joints (B) ; the Bromide is the most efficient agent in combating 
 the disease (Aulde) ; the Carbonate, in solution, gr. v to the ^, on lint 
 around gouty enlargements, joints, etc. (R). Guaiacum, has long had high 
 
714 
 
 GUMS. 
 
 repute, and may be given for a long time without injury (Wa). Rhubarb with 
 an alkali, regularly during intervals, very serviceable (Halford). Manganese, 
 Syrup. Ferri et Mang. Iodidi, Tt^x-^ss, for the cachectic state (B). Alkalies, to 
 relieve indigestion, especially Lithium Salts; alkaline mineral waters have long 
 had a deserved reputation (B) ; Magnesia and its Carbonates often of great 
 service ; the latter dissolved in excess of CO2 an elegant form of administra- 
 tion (Wa). Alkaline Poultice, Linseed meal 9 parts to one of Sodium Bicarb, 
 is a useful application (R). Turkish Baths, are useful in chronic gout (R). 
 Carbonated Water freely, has an exceedingly beneficial influence. Oxygen, 
 is used with benefit in cases of deficient oxidation (Br). Aliment, farinaceous 
 vegetables and acid fruits; avoid animal or saccharine food, and vegetable 
 proteids as well as animal proteids (Luff). Abstinence from the use of common 
 salt has benefited several cases. A milk diet has improved cases and appar- 
 ently removed the diathesis (B) ; entire abstinence from alcoholic beverages ; 
 the most injurious wines are port, sherry and madeira. Local Measures, the 
 affected limb should be raised, and surrounded by hot, moist flannels; wrap 
 the hands in flannel dripping with water and cover with water-proof bag, to 
 dissolve gouty deposits. Baths, are useful, especially hot, steam and Turkish 
 baths, but they do not cure the disease (W). Exercise, if there be any cure 
 for gout it is exercise (W). [Compare Arthritis, Lithemia.] 
 
 Scudamore 1 s Mixture {Modified). 
 R- . Vini Colchici Radicis, 
 
 Magnesii Sulphatis, . aa!|j. 
 Magnesise Optimae, . . 3 ij. 
 Aquae Menth. Pip., . . ^ x. 
 M. Sig. — Tablesp. every hour until it 
 operates on the bowels. 
 
 ft. Colchicinae, gr. j. 
 
 Ext. Colocynthidis Co., % ss. 
 
 Quininae Sulphat., . . 3 iij. 
 Ft. pil. no. lx. Sig. — One pill every four 
 hours. (B.) 
 
 R- . Vini Colchici Seminis, . % ss. 
 
 Tinct. Digitalis, . . . gij. 
 
 Liq. Potassii Citratis, . 5 ijss. 
 M. Sig. — A teasp. in water every six 
 hours. 
 
 R. 
 
 M 
 
 Lalleviand" 1 s Specific. 
 Ext. Colchici Acet. (B. P.), 
 Ext. Opii Aquosi, . . aa gr. xr. 
 Potass. Iodidi, . . . . % iv. 
 Potass. Acetatis, . . . gij. 
 Aquae Destill. , .... ^iijss. 
 
 Vini Albi, 3 ss. 
 
 Sig. — 20 drops thrice daily. 
 
 Gums. 
 
 Myrrh, the tincture for spongy and ulcerated gums (P) ; gij-iv in %iv of 
 water or Infusion of Cinchona, is highly serviceable as a gargle or mouth-wash 
 (Wa). Alum, for spongy and ill-conditioned gums, tending to recede from the 
 teeth, whether of mercurial or scorbutic origin (Wa). Catechu, a piece dis- 
 solved slowly in the mouth is often of service in similar conditions (Wa). 
 Rhatany, the powder as a dentifrice, keeps gums in good order (B). Potassium 
 Chlorate, gr. ij every four hours for a child of one year, for inflammation of 
 gums in teething (Wa). Carbolic Acid, gr. iij ad ^j aquae, as lotion in diseases 
 of the gums (Hilditch). Pomegranate, the bark an excellent basis for gargles 
 in relaxed gums (P). Potassium Iodide, gr. x thrice daily, for periostitis of 
 alveolar processes, marked by looseness of teeth, pain and swelling of gums 
 (Graves). Sodium Salicylate, in doses of gr. xv every 4 hours, is highly efficient 
 for the same condition, especially in combination with rr^xv of tincture of Bella- 
 donna (Coley). Iodine, gr. j ad gj aquas, applied by a brush after each meal 
 to the margin of the gums, for retraction thereof with loosening of the teeth (S) ; 
 the tincture is a good application in many morbid conditions of the gums. Zinc 
 Chloride, a saturated solution applied by cotton to the margins, an excellent 
 astringent tonic. Tannin, the glycerite, for spongy and bleeding gums (B). 
 Carbolate of Iodine, when fetor (B). Benzoin, the tincture a good application 
 (B). [Compare Odontalgia, Scurvy, Teeth.] 
 
HAIR HAY-FEVER. 
 
 715 
 
 R. Aluminis, gss. 
 
 Tinct. Myrrhae, ^j. 
 
 Tinct. Cinchonas, . . . . 3 iv. 
 
 Mel. Rosae, %). 
 
 Vini Albi, § viij. 
 
 M. Sig. — Mouth-wash. 
 
 R. Tinct. Orris, 
 Spt. Rosae, 
 
 Alcoholis, aa £ iv. 
 
 01. Amygd. Amar., . . . gtt. ij. 
 M. Sig. — Violet Mouth-wash. 
 
 (Piesse.) 
 
 Hair. 
 
 Rosemary, encourages the growth of hair, mitigates baldness, and is supposed 
 to prevent uncurling in a damp atmosphere (P). Hydrogen Dioxide and 
 other preparations of oxygen, are used to " blonde " the hair, for purposes of 
 fashion (Wilson). Hair-dyes, comprise Potassium Permanganate, Pyrogallic 
 Acid, Black Oxide of Lead, which are temporary, and the Black Oxide of Silver, 
 which is permanent in its action (Wilson). Depilatories usually consist of 
 powders containing Quicklime 3 parts, Sodium Sulphide 1, and Starch 4 : a 
 powerful depilatory is Barium Sulphide made into a thin paste with Starch 
 (Wilson) : another contains Yellow Sulphide of Arsenic, gr. xx, Quicklime, ^ss, 
 Starch, 3'\) : a very effective one is Barium Sulphide and Zinc Oxide (B). 
 Sarsaparilla is stated by Teste to possess the curious property of changing red 
 hair to a light flaxen color, when taken internally for three months. [Compare 
 Alopecia, Syphilis, Tinea Tonsurans, etc.] 
 
 R • Sodii Boratis, 3 iv. 
 
 Aq. Ammonias, ^j. 
 
 Spt. Myrciae, %\). 
 
 Aq. Rosae, ^ x iij- 
 
 M. Sig. — Shampoo Hair Wash. 
 
 R 
 
 Ac. Salicylici, . . . 
 Tinct. Benzoini, 
 Alcoholis, Glycerini, 
 M. Sig.— Hair Wash. 
 
 gr. xl. 
 3ss. 
 
 Rn — 01, Ricini, ^jss- 
 
 01. Bergamottae, 3J SS - 
 
 01. Cinnamomi, 
 — 01. Caryophylli, .... aaTTLvij. 
 
 01. Lavandulae, Tr\,xl. 
 
 Tinct. Cantharidis, . . . . gj. 
 
 Aq. Ammoniae, sjij. 
 
 Alcoholis, ... q. s. ad Oj. 
 M. Sig. — Hair Tonic. 
 
 Hay-Fever. 
 
 Arsenic, especially valuable when disease is more of catarrhal than of asth- 
 matic type, 3-minim doses of Liquor Arsenicalis (Mackenzie) ; as cigarettes, 2 
 or 3 daily. [See Asthma for formula.] Belladonna, when nasal secretion is 
 very profuse (B). Euphrasia, of decided benefit for the catarrhal symptoms 
 (Pf). Quinine, very useful after the more acute symptoms have subsided (R) ; 
 injected into the nares checks catarrhal discharge and spasmodic symptoms 
 (P) ; a solution of the Hydrochlorate, gr. iv-viij ad ^j aquae, applied locally to 
 nasal mucous membrane by a spray-producer or a brush, will arrest the disease 
 if confined to the nares and fauces (B). Ipecacuanha, in hay-asthma (R); 
 is of great value, though the smallest doses cause similar effects (P). Aconite 
 is better than Arsenic in true hay-fever (R) ; has been used with the best results 
 (P). Grindelia benefits cases of asthmatic type (B). Iodides are very ser- 
 viceable, locally and internally; large doses until some iodism observed ; may 
 be combined with Arsenic (B). Opium, especially as Morphine, of great value 
 in any stage, but great danger of the opium-habit (B) ; the tincture in doses of 
 ttUJ-iij every 2 hours for three doses, then ff\j every 2 hours until the discharge 
 abates, has given excellent results (Wa). Black Coffee is highly recommended 
 (P). Cocaine, a 5 to 20 per cent, solution of the Hydrochlorate, brushed over 
 the nasal mucous membrane after drying it as far as possible, is the most effi- 
 cient palliative yet obtained (R) ; a 4 per cent, solution dropped from a medi- 
 cine-dropper well into the anterior nares the head being thrown well backward, 
 or sprayed up the nostrils from a small atomizer; gives immediate relief, and 
 
7 i6 
 
 HEADACHE. 
 
 though not curative it prevents so much suffering and distress that in no case 
 should it be left untried (Da C). Ignatia, the tincture has seemed to benefit 
 some cases, and to influence favorably the course of the disorder (Da C). 
 Lobelia, has been found an efficient remedy (Wa). Adrenal Extract, has 
 proved very efficient [see page 165]. Tobacco, smoking helps some and 
 aggravates the symptoms in other instances ; internally ad nauseam it helps, 
 but there are better and safer remedies (Wa). Removal to the sea-coast or a 
 barren, mountainous district, gives the only relief to some subjects; though 
 many of the worst cases, hitherto unaffected by medicine, are now relieved by 
 the local application of Cocaine. [Compare Asthma, Catarrh, Conjunc- 
 tivitis, Influenza.] 
 
 R 
 
 M 
 
 For Internal Use. 
 
 Potassii Iodidi, ^j. 
 
 Liq. Potass. Arsenit., . . zj. 
 
 Aquae Cinnam., . . . Jiv. 
 
 Sig. — Teasp. every 4 hours. 
 
 R 
 
 M, 
 
 relieved. 
 
 R 
 
 Ext. Hyoscyami, . . . . gr. xij. 
 
 Potassii Iodidi, zj. 
 
 Potassii Bicarb., 3 Ij. 
 
 Ext. Glycyrrhizae Pur., . . z,iv. 
 
 Aquae Anisi, ^ ivss. 
 
 Sig. — Dessertsp. every 4 hours until 
 
 {Weber.) 
 
 Liq. Potassii Arsenit., . . ^j. 
 Tinct. Belladonnae, . . . 55 ij. 
 M. Sig. — 5 to 10 drops after meals, as 
 a prophylactic. 
 
 R. Tinct. Euphrasiae, .... Zjss. 
 
 Aq. Camphorae, . q. s. ad Jij. 
 
 M. Sig. — Teasp. four times daily, for 
 the catarrh. 
 
 For Local Use. 
 
 r 
 
 Tinct. Iodi, zj. 
 
 Ac. Carbol., gtt. x. 
 
 Aq. Destill., J iv. 
 
 M. Sig. — For local use with atomizer 
 or post-nasal syringe. 
 
 R. Mentholi, zj. 
 
 Ac. Carbol., ^ss. 
 
 Zinci Oxidi, zj. 
 
 01. Amygd. Dulcis, . . . Jjss. 
 
 Cerati Simplicis, . . . . 3 ij. 
 M. Sig. — Apply thoroughly to the nos- 
 trils every few hours. 
 
 R . Quininae Bisulph. , . . . . Z, iij. 
 
 Aquae, 3 iv. 
 
 M. Sig. — Irrigate the nares, after 
 cleansing with a weak alkaline solution. 
 
 R. Cocainae Hydrochlor., . . gr. vj. 
 
 Aquae Destill., 3 i j . 
 
 M. Sig. — 5 per cent, solution. A few 
 drops to be instilled into nares while head 
 is lowered. {Da Costa.) 
 
 Headache, Bilious-sick. 
 
 Antipyrin, the most valuable single remedy for headaches ; an 8-grain dose 
 for dyspeptic headache, in a little water, at commencement of attack, the patient 
 lying down in a dark room ; a second dose one hour after is.generally enough, 
 but a third or fourth may be required : sleep generally follows, and there are 
 no unpleasant after-effects. Acetanilid, in 4-grain dose, equally effective. Nux 
 Vomica, gtt. j of tinct. frequently, when acute gastric catarrh, with headache 
 and nausea (R) ; gtt. j every 10 minutes, soon after meals, often gives marked 
 relief in sick-headache not of neurotic origin (Smith) ; drop doses every 10 min- 
 utes for an hour cure sick-headache, especially when accompanied by bilious- 
 ness (M). Strychnine, with Aloin and Belladonna, in minute granules, for 
 bilious headache trom obstinate constipation, effective if given several times a 
 day for a week or ten days (Roy). Belladonna, the extract in doses of gr. ^V"to» 
 in similar form. Iris, blinding headache in right supraorbital region, with 
 nausea and vomiting, usually the result of hepatic derangement; Try every half- 
 hour for three doses, usually relieves promptly (Pf). Bryonia, ordinary bilious 
 sick-headache with vomiting (P). Picrotoxin, gr. ^ by stomach, in periodical 
 form (B). Chamomile, a popular remedy (R). Salol, is one of the most effi- 
 cient remedies. Podophyllum, in sick headache, with dark bilious diarrhea, 
 or when constipation with dark evacuations (R). Sanguinaria, when due to 
 
HEADACHE. 
 
 717 
 
 stomach derangement, a few doses relieve (P). Hydrastis, from constipated 
 bowels (P). Mercury, as Blue Pill, to prevent or mitigate; or small doses, gr. 
 t 1q, of the Bichloride when headache with light-colored diarrhea (R). Ammo- 
 nium Chloride is an efficient remedy in most forms (Wa). Sodium Phosphate, 
 a useful laxative in so-called bilious sick-headache (B). Potassium Bromide, a 
 large dose in ordinary or sick headaches (R). Ginger, in paste, as counter- 
 irritant (P). Water, as cold or hot affusion, or ice-bag to head ; hot sometimes 
 best ; the purgative waters (as Friedrichshall) before breakfast in a cup of hot 
 water (R); a brisk saline purgative, or small doses of Epsom salts thrice 
 daily, very effectual for frontal headache with constipation (Br). Nitro-muri- 
 atic Acid, 10 drops of the dilute acid in a winegl. of water before each meal, 
 often an effectual remedy (Br). Charcoal, two teaspoonsful stirred in half-glass 
 of water, as a draught, is an efficient remedy for sick-headache with sour stom- 
 ach and flatulence, etc. [Compare Hemicrania.] 
 
 R. Ammonii Chloridi, . 
 
 • • 3"j. 
 
 Morphinse Acetatis, . 
 
 • • g r - J- 
 
 Caffeinae Citratis, . . 
 
 . . 3ss. 
 
 Spt. Ammonii Aromat. 
 
 • 3J- 
 
 Elix. Guaranae, 
 
 
 Aquae Rosae, .... 
 
 . aa 5 iv. 
 
 M. Sig. — Dessertsp. every quarter-hour 
 
 until relieved. 
 
 ( Carpenter. ) 
 
 R. Podophylli Resinae, . . . gr. ij. 
 Tinct. Zingiberis, . . . . £ij. 
 Alcoholis, . . . q. s. ad 3J. 
 M. Sig. — Teasp. in a winegl. of water 
 every night at bedtime, or every second, 
 third or fourth night as required. 
 
 {DobelL) 
 
 Headache, Congestive. 
 
 Antipyrin or Acetanilid (see preceding article). Aconite, to reduce the cir- 
 culation (R). Veratrum Viride, at menstrual periods (R). Belladonna, relieves 
 cerebral congestion, and distress from light and sound (P) ; pain over brows 
 and in eyeballs, often due to stomach or uterine derangements, especially in 
 young women ; rr^iij of tinct. every three hours (R). Potassium Bromide, gr. 
 xv-xx, in ordinary or sick headaches (R) ; Bromides are useful when nervous 
 system has been irritated, but when exhausted they do harm (Hammond). 
 Calomel, gr. -g 1 ^, every hour for ten or twelve doses, will relieve the headache 
 of syphilis occurring at night (Tr). Cannabis Indica is given with uniformly 
 good results in the headache of the climacteric. Potassium Iodide, throbbing, 
 intolerance of light, pain passing from back of neck over vertex to brow, noc- 
 turnal, tender scalp, almost unbearable ; ten-grain doses ter die will cure (R). 
 Hydrastis, when constipated bowels (P). Amyl Nitrate, for headaches with 
 severe flushing heats at menstruation or climacteric, v^-go a sufficient dose (R). 
 Mustard, in hot foot-bath, or as poultice to nape of neck in various forms of 
 headache (R). Water, cold water poured gently over forehead, sometimes 
 warm water better (R) ; a very hot foot-bath often effectually relieves (Wa). 
 Purgatives are often beneficial, especially when congestive headache arises 
 from suppression of hemorrhoidal discharge, or in persons of phlegmatic habit ; 
 Aloes best(Wa); or Colocynth, as derivative, when cerebral hyperemia (Da C). 
 
 R. Ext. Colocynthidis Co., . gr. xij. 
 
 Pulv. Capsici, gr. iv. 
 
 Ext. Gentianae, gr. xxiv. 
 
 Ft. pil. no. xij. Sig. — One pill thrice 
 daily ; also a 25-grain dose of Sodium Bro- 
 mide nightly, at bedtime. [_Da Costa.) 
 
 R . Spt. Ammoniae, ^j. 
 
 Spt. Camphorae, ^ ss. 
 
 M. Sig. — For a quart of water, in which 
 a handful of common salt has been dis- 
 solved. Cork tightly and use locally on 
 lint as an evaporating lotion. 
 
 Headache, Nervous. 
 
 Antipyrin, is efficient [see under Headache, Bilious-Sick]. Acetanilid, 
 is very efficient in headache from fatigue (Brodnax) ; as routine remedies for 
 the relief of headache these agents are much more valuable than bromides 
 
7i» 
 
 HEADACHE. 
 
 and caffeine (Whitla). Phenacetin, is used with much success (M). Cannabis 
 Indica, ten-minim doses of the tincture thrice daily in the intervals, often 
 curative in bad cases of neuralgic headache ; or X to ^ -grain doses of the 
 extract (P). [See under Hemicrania.] Belladonna, rr\jij of tinct. every 3 
 hours, when pain over brows and in eyeballs, especially when at menstrual 
 periods ; also when from over-study or fatigue (R). Nux Vomica, if with 
 gastric symptoms (R) ; is better than Strychnine, and should be given in 
 quarter-grain doses of the extract after meals, combined with Iron and Quinine 
 if patient is chlorotic (Hammond). Bromides, are useful when the nervous 
 system has been irritated, but harmful when it is exhausted (Hammond). 
 Silver Nitrate, half-grain doses with minute doses of Pil. Coloc. Comp., in- 
 valuable in headaches of hysterical women and especially stomach headaches 
 of delicate and literary men (Wa). Ignatia, removes clavus hystericus (Pf ). 
 Ammonia, the Aromatic Spirit (3ss-3ij) or the Carbonate (gr. v-x) in nervous 
 headache (B); the Hydrochlorate (gr. x-xx) in bilious and hysterical head- 
 aches, especially in hard-worked and delicate young women (Wa). Amyl 
 Nitrite, inhaled, when extreme pallor of face (B). Arsenic, throbbing supra- 
 orbital headache (R) ; as a nerve tonic stands next in value to Zinc (Hammond). 
 Cimicifuga, in nervous or hysterical women, especially at menstrual periods 
 (R) ; in rheumatic and menstrual headaches (P). Coffee and Tea, when from 
 nervousness or exhaustion (R) ; Coffee especially useful (P). Caffeine Citrate, 
 one to two-grain doses in capsule every half-hour, a very effectual remedy for 
 nervous and sick-headache, but causes insomnia if used in the evening. 
 Guarana, a very effective palliative, gr. xx every half-hour for three doses (P) ; 
 ff\,xv of the fluid extract every quarter-hour increased to TT^xl will often relieve 
 periodical headaches not of malarial origin (Smith). Sodium Salicylate, in 
 small doses, gr. ij-iij every quarter-hour, is very efficient in neuralgic headache 
 (Br). Phosphorus, as dilute Phosphoric Acid, in doses of n\,xxx well diluted, 
 thrice daily; or Zinc Phosphide, gr. -fa in pill, ter die, very useful in most 
 forms of nervous headache (Hammond). Cajuput Oil, well rubbed in twice 
 daily (P). Menthol, locally to forehead in frontal headache (Wa). Potassium 
 Cyanide, locally in reflex headaches, as gastric, cardiac, pulmonary, menstrual 
 (B). Valerian is of great value in excitable persons (P). Camphor, a satu- 
 rated solution in Eau-de-Cologne rubbed on head, when headache of uterine 
 origin (R) ; in hysterical females, internally, with Magnesium Carbonate (P). 
 Podophyllum, purgative doses often give relief when near menstrual periods, 
 with constipation and dark stools (R). Zinc Oxide, two- to five-gr. doses useful 
 (R) ; a remedy of great value (Hammond). Bismuth, the Subcarbonate, in 
 two-grain doses after each meal, often better than Zinc, especially where 
 gastric disturbance (Hammond). Ether Spray, for frontal headache, after 
 acute illness or fatigue (R). Chloroform, rr^xv-xxx of the spirit internally, often 
 effective (Wa). Galvanism, sometimes valuable ; the constant current always, 
 avoiding too great intensity lest amaurosis ensue (Hammond). [Compare 
 Hemicrania, Neuralgia.] 
 
 R • Potassii Cyanidi, . . . gr. x-xx. 
 Aquae Laurocerasi, . . ^ iv. 
 M. Sig. — Apply locally on a compress 
 for ^ to % an hour. (B.) 
 
 R 
 
 . Zinci Phosphidi, . . . gr. iij. 
 
 Ext. Nucis Vom., . . . gr. x. 
 
 Confect. Rosae, . . . . q. s. 
 M, et div. in pil. no. xxx. 
 Sig. — One pill after each meal. 
 
 (Fordyce Barker. 
 
 R. Extracti Nucis Vom., . gr. iij. 
 
 Ferri Reducti, . . . . gr. xij. 
 
 Quininae Sulphatis, . . gr. vj. 
 Ft. pil. no. xij. Sig. — One after each 
 meal. [Hammond.) 
 
 R 
 
 M 
 
 Ext. Cannabis Ind. Fl., giv. 
 Pulv. Acaciae, . . . . 3 v. 
 Syr. Aurantii Covt., . . ,:§ ij. 
 Aquae, . . . . q. s. ad ^vj. 
 Sig. — Teasp. every 3 hours. 
 
HEART AFFECTIONS. 7 1 9 
 
 Heart Affections. 
 
 Potassium Iodide, the true remedy for the heart ; especially applicable in 
 non-compensatory mitral or myocardial diseases, and where there is cardiac 
 debility ; restoring energy and vascular tension at first ; then by dilating, later 
 on, all the arterioles, it frees the heart from resistance, and enables it to re- 
 cover its contractile power ; also dilating the coronary arteries it furnishes 
 nutrition to the heart itself (See). Strychnine, in medicinal doses, is said to 
 strengthen the heart-beats (R). Nux Vomica, gave speedy relief in several 
 cases of heart-failure in which death was imminent ; small doses every y 2 hour 
 for four successive doses, then every hour (Bowie) ; in a case of cardiac hyper- 
 trophy and mitral insufficiency, in which death was imminent from heart- 
 failure, one drop of the tincture in a teasp. of water every 5 minutes for 10 
 doses, then every 10 minutes for 3 doses, continuing at longer intervals, com- 
 pletely restored the cardiac force, and dispelled the accompanying cardiac 
 asthma (Macfarlan). Digitalis, acts as a stimulant tonic (P) ; small doses for 
 sedative action ; tonic or physiological doses to create hypertrophy in dilata- 
 tion (Tr) ; irregularity of pulse its best indication (R) ; irritable heart (Da C) ; 
 the tincture, given without water, is the best preparation ; especially indicated 
 in weak heart acting rapidly because of its weakness, and in valvular disease 
 (Wa). Cimicifuga, safer than Digitalis in fatty heart (B) ; its action is strongly 
 stimulating and tonic ; it relieves excessive dyspnea when weak heart (P). 
 Convallaria Majalis, will usually succeed in all cases in which Digitalis is use- 
 ful, acting similarly to that drug, but with less reliability ; is useful in aortic 
 disease and in others where Digitalis cannot be used (Wa). Helleborein, as a 
 substitute for Digitalis [see page 338]. Adrenal Extract, is a powerful cardiac 
 stimulant, slowing and strengthening the heart [see page 165]. Cactus, is 
 highly praised in functional cardiac affections. Chloral, is generally contra- 
 indicated in heart affections, but may be used with benefit in neurotic palpita- 
 tion and in pseudo-angina pectoris. Morphine, next to Digitalis, is in general 
 the most indispensable remedy in the treatment of severe heart disease, being 
 by far the most efficient agent for the dyspnea (Striimpell); hypodermically is 
 employed in many cardiac disorders with marked advantage, especially 
 in dyspnea and angina with diseased coronary arteries, mitral regurgitation 
 with its dyspnea and insomnia, aortic disease, etc. Caffeine, an excellent car- 
 diac stimulant, and diuretic, gr. ij-v of the Citrate every three hours (Da C). 
 Arsenic, for dyspnea from weak heart (R); in all cardiac neuroses it is 
 especially valuable when combined with Iron and Strychnine, and is re- 
 garded as indispensable in all forms of weak heart accompanied by pain 
 (Wa). Aconite, in the highest degree serviceable to diminish excitement 
 or irritability ; is more a remedy for functional derangement than for organic 
 disease (Wa) ; in pericarditis (R) ; in nervous palpitations and hypertrophy 
 (P) ; the heart seldom affected in rheumatic fever if Aconite be used from 
 the start (P). Veratrum Viride, as cardiac depressant (B) ; in chronic car- 
 diac diseases where excessive hypertrophy, i. e. when Digitalis is contra- 
 indicated (W). Iron, useful in various forms, especially anemic disorders and 
 palpitation ; also in dilatation and fatty heart, and mitral regurgitation (B). 
 Hyoscyamus, in functional derangement from emotion, is specially indicated; 
 requires large doses, tt\,xl-lx of tinct., or gr. ^g- of Hyoscyamine Sulphate 
 hypodermically (Wa). Amyl Nitrite, relieves heart-pains resisting all other 
 treatment (W). Blisters, flying blisters over the precordial region, to stimu- 
 late action in extreme weakness (R). Alcohol, as Brandy when heart sud- 
 denly enfeebled by fright, loss of blood, etc. (R). Ether, Tr\,xx hypodermic- 
 ally and repeated soon, is a very promptly-acting stimulant in sudden heart- 
 failure ; the compound spirit in 3j doses for less urgent cases. Schott Cure, as 
 practised at Nauheim, is a combination of saline baths containing C0 2 in solu- 
 tion, and a series of graduated gentle exercises ; the best results therefrom 
 are obtained in cases of cardiac dilatation due to overwork or worry, but it is 
 
720 
 
 HEART AFFECTIONS. 
 
 also useful in fatty infiltration of the heart (not fatty degeneration) accompany- 
 ing general obesity (M). [Compare Angina Pectoris, Dropsy, Endocar- 
 ditis, Pericarditis, Syncope, and the five following articles.] 
 
 R. Ext. Ergotse Fl., .... giijss. 
 
 Tinct. Digitalis, 25 ss. 
 
 M. Sig. — Teasp. thrice daily in en- 
 larged heart without valvular lesion. 
 
 R . Spt. ^Etheris Comp., 
 
 Liq. Morphinae Sulphatis, 
 
 (U. S. P., 1870), aa gj. 
 Teasp. as required for dyspnea. 
 
 Heart, Dilated. 
 
 Digitalis, where much dilatation and hypertrophy of left ventricle without 
 valvular disease ; is not contraindicated when aortic disease (R) ; use in physio- 
 logical doses (Tr) ; in simple dilatation gives most favorable results ( Wa) ; very 
 useful in mitral disease, when dilatation of the left ventricle (P) ; gives miracu- 
 lous relief, is not sufficiently appreciated, but requires skilful administration ; 
 use the infusion in preference to other preparations, a tablespoonful thrice daily, 
 watching its effects (Da C). Scoparius, the infusion (Broom-tea), to maintain 
 the kidney action if Digitalis is not sufficient (Da C). Purgation, brisk, free, 
 watery stools, next to Digitalis is the best treatment (Da C). Morphine, hypo- 
 dermically, gr. yi-ye two or three times a week in dilated heart with dyspnea (B). 
 Amyl Nitrite, dyspnea from dilatation (R) ; is useful when great dyspnea, the 
 cardiac asthma (P). Ether, the Compound Spirit an excellent remedy for the 
 dyspnea (Da C). Mercury, a classical pill and a very efficient one as a diuretic 
 in dropsy from cardiac disease is the combination of gr. j each of Pulv. Digitalis, 
 Pulv. Scillae, and Hydrarg. cum Creta (Foster). Schott Cure, in dilatation due 
 to overwork or worry (see preceding page). 
 
 Heart, Fatty. 
 
 Strychnine, often the first remedy to do good ; unduly pushed will produce 
 nervous worry and be injurious (P) ; is the remedy with Iron, nourishing but 
 not fat-making diet, and wine to keep up the tone of the blood (Da C). Ergot, 
 in occasional doses has been given with apparent benefit (Wa). Iron, the 
 tincture of the Chloride in small doses for a long time, has been of remarkable 
 benefit (Wa). Cimicifuga, safer than Digitalis (B) ; the latter should not be 
 used (Wa). Digitalis, of no value except for very temporary use and for some 
 special indication (Da C). Chloral, must be entirely debarred (Id). Ether, the 
 compound spirit for sudden attacks of pain or dyspnea (Id). Amyl Nitrite, 
 for the same indications (Id). Stimulants, freely used, in an acute attack of 
 any kind, afford the only chance (Id). Schott Cure, useful in fatty infiltration 
 (not fatty degeneration) accompanying general obesity (M). 
 
 Heart, Hypertrophied. 
 
 Aconite, often better than Digitalis (R) ; dangerous in hypertrophy of left 
 side with diseased valves, but useful in simple hypertrophy (P) ; for over- 
 action with hypertrophy (B) ; the one remedy which can be depended on ; 
 small doses for months, say gtt. j of a good tincture ter die, to lower the heart 
 gradually and keep it low (Da C). Digitalis, very useful in pure hypertrophy due 
 to valvular disease or excessive muscular exertion (R) ; the primary action 
 (small doses) required, as it creates hypertrophy when given in physiological 
 or tonic doses (Tr). Veratrum Viride, as a cardiac depressant, gtt. v ter die, 
 will relieve in simple hypertrophy, and irritable heart from abuse of tobacco, 
 inadmissible when valvular lesions exist (B) ; gives the best results next after 
 Aconite (Da C). Lead Acetate, for violent palpitations, in some instances effi- 
 cient (Wa). Amyl Nitrite, for dyspnea, syncope (R). Ergot, in enlarged heart 
 
HEART AFFECTIONS. 
 
 721 
 
 without valvular lesion ; may be combined with digitalis (B). Potassium 
 Iodide, small doses long continued benefit some cases (Wa). Camphor, in 
 doses of gr. iij-xij daily for tumultuous palpitations and dyspnea of hyper- 
 trophy with dilatation (Wa). Iron is necessary where anemia exists (Da C). 
 Quiet Life of great importance, no stair-climbing, no long walks ; rest in bed 
 for days at a time often of service, moderate diet, avoiding fattening foods, 
 meat and stimulants (Da C). 
 
 Heart, Palpitation of. 
 
 Aconite, for the fluttering heart of nervous persons and nervous palpitations 
 (R) ; for over-action with hypertrophy (B) ; for palpitation with simple hyper- 
 trophy (P). Hydrocyanic Acid, when from dyspepsia (P). Iron, when palpitation 
 due to anemia, a very frequent cause; other causes are tobacco, coffee, tea, etc. 
 to excess, dyspepsia, venery, excessive exercise (Da C). Spigelia Anthelmia, 
 when due to mitral and aortic disease, with much dyspnea (P). Digitalis, in 
 small doses as sedative (Tr) ; combined with Iron in palpitation with valvular 
 disease, or given alone in very r severe cases (Wa) ; suits a large number of 
 cases, especially for temporary purposes (Da C) ; the only remedy of positive 
 service for the actual palpitation (Richardson). Camphor, recommended in 
 nervous palpitations (R). Veratrine, as ointment to chest, when rapid, irregular 
 pulse, hurried breathing, dropsy and lividity, palpitation, inability to lie down 
 (R). Nux Vomica, of great value in nervous palpitation. Bromides, in flut- 
 tering heart (B) ; are useful when tolerated by the stomach (Da C). Hyos- 
 cyamus, in nervous, and violent palpitations from excited state of the brain (P) ; 
 in large doses, for functional disturbance arising from emotion (Wa). Bella- 
 donna, in small doses, when irregularity of rhythm ; may also be applied exter- 
 nally (Da C). Valerian, nervous palpitation, with dyspnea (P). Eucalyptus, 
 palpitation and weak heart (B). Galvanization, of cervical sympathetic and 
 pneumogastric (B). Hot Foot-bath, relieves palpitations (R). Milk-cure, has 
 been beneficial in irregular action (B). Ice, to the cardiac region, has benefited 
 many cases ; is of chief value when patient can be kept in bed, which some- 
 times becomes necessary (Da C). 
 
 R . Pulv. Digitalis, gr. xx. 
 
 Pulv. Colchici Sem., . . . gr. xl. 
 
 Sodii Bicarb., gr. lx. 
 
 M. et div. in chart, no. xl. Sig. — One 
 powder at first 3 or 4 times daily, gradually 
 reduced to one at bedtime. For irregular 
 cardiac action. (Bowditch.) 
 
 R. Tinct. Digitalis, . . . . ^ij. 
 
 Sp. iEtheris Nitrosi, . . . gj. 
 
 Liq. Ammonii Acet. , q. s. ad"£ iv. 
 M. Sig. — A dessertsp. every 4 hours. 
 If prolonged insomnia with palpitation add 
 
 of Morph. Sulph. gi 
 
 to each dose. 
 
 {Richardson.) 
 
 Heart, Valvular Disease. 
 
 Nux Vomica, the tincture in one-drop doses every 5 minutes remarkably 
 efficient in heart-failure, even with death impending (Bowie) ; also for the 
 asthma (Macfarlan). [See under Heart Affections.] Digitalis, in aortic 
 regurgitation (R) ; most effective in mitral insufficiency (P) ; in rapid action 
 with low arterial tension, in mitral disease ; infusion best, tablesp. doses 
 twice daily (B) ; mj of tinct. every %, hour or hour, often gives more relief than 
 larger doses (Smith) ; when heart is weak and struggling (Da C). Cactus, is 
 especially recommended in complicated aortic regurgitation, as it does not 
 prolong the diastole like Digitalis, but stimulates the cardiac action. Morphine, 
 hypodermically for the dyspnea, is better in mitral than in aortic disease (R) ; 
 the agent above all others in aortic insufficiency, combating the two great 
 symptoms therein, the cerebral anemia and the dyspnea ; is to aortic regur- 
 gitation what Digitalis is to mitral (Dujardin-Beaumetz). Aconite, useful for 
 the palpitation, but dangerous in hypertrophy of left side with diseased valves 
 46 
 
722 HEAT-STROKE. 
 
 (P) ; for cases presenting excessive growth and strong action, diminishes the 
 blood-pressure in the arterial system, and gives great relief (Da C). Veratrum 
 Viride, has similar applicability, but is more apt to nauseate ; an admirable 
 sedative, and one which does not sicken, is a mixture of Tinct. Aconiti, Try, 
 Tinct. Veratri Vir., rrijij, Tinct. Zingiberis, n\,vij (Da C). Strophantus, is a 
 cardiac tonic like Digitalis, but does not contract the vessels nearly so much 
 (Br). Nitroglycerin, is the best of all remedies when actual cardiac pain ; it 
 lessens blood-pressure and diminishes the resistance the heart has to overcome 
 (Da C). Adrenal Extract, is a powerful cardiac stimulant and may be used 
 cautiously [see page 165]. Caffeine, as a tonic and diuretic, of especial value 
 in cases where urine is scanty, with cardiac pains, headache and dyspnea, and 
 weak heart ; gr. ij of the Citrate every three hours (Id). Adonidine, in doses of 
 gr. tV t0 i thrice daily, acts excellently as a cardiac regulator (Id). Barium 
 Chloride, gr. ■£$ in pill three or four times daily, is diuretic, lessens cardiac pain, 
 increases tone in the vessels, and is a good general and cardiac tonic (Id). 
 Purging, with Jalap, etc., in engorgement of right side of heart (R) ; occasionally 
 useful (Da C). Treatment is directed chiefly to the dilatation or hypertrophy 
 resulting from the valvular disease ; the simplest rule is to use one's best judg- 
 ment as to when the heart needs strengthening by the use of Digitalis or reduc- 
 ing by the administration of Aconite or Veratrum Viride (Da C). [Compare 
 Endocarditis.] 
 
 Heat-stroke. 
 
 Quinine, in all fulminating fevers, including siriasis, occurring in warm cli- 
 mates, if malaria be suspected and especially if its plasmodium is discovered in 
 the blood ; gr. vij of the Hydrochlorate hypodermically at once and repeated 
 3 or 4 times at intervals of 4 hours (Mn). Morphine to control the convulsions 
 (Bevan). Chloroform, by inhalation cautiously, for the convulsions (Mn). 
 Strychnine, must be avoided in heat-stroke, there being a tendency to convul- 
 sions in this affection (Chandler). Digitalis, fl^xl of the tincture hypodermic- 
 ally as soon as possible in siriasis, preceded by a small bleeding in plethoric 
 cases showing high arterial tension (Chandler). Bromides, for restlessness 
 and insomnia (Mn) ; courses of the Bromides and Iodides, with repeated blis- 
 tering of the neck and scalp, also careful dieting and general hygiene, for per- 
 sistent headache and other signs of chronic meningitis (Id). Antipyrin and 
 other antipyretic drugs are to be avoided in all serious cases of siriasis, as they 
 are dangerous by their depressant action on the heart (Id). Alcohol in every 
 form, must be strictly forbidden in any case of heat-stroke in which the cerebral 
 symptoms suggest meningeal congestion or inflammation (Id). Stimulation is 
 indicated in the syncopal form, generally called " heat-exhaustion " ; Ammonia 
 held to the nostrils and a stimulant given by the mouth or rectum or hypoder- 
 mically (Id); external stimulation in asphyxial cases to the precordium by, 
 mustard, also to the feet by hot bottles, and hypodermics of nitro-glycerin, 
 atropine, brandy, camphor or ether (Anders). Cold by ice-bag applied to the 
 shaven scalp for a time in heat-stroke, the bowels kept free, the food light and 
 non-stimulant (Mn) ; Ice packed around the head and body, iced water 
 dripped on the body from an elevation of 5 to 10 feet for 30 or 40 minutes, a 
 fine iced spray on the forehead for only 1 or 2 minutes ; a thermometer in the 
 rectum and the cold application to be discontinued in hyperpyrexial cases 
 when the rectal temperature reaches 104 F., and in cases of simple thermic 
 fever when it has fallen to 102 F., as dangerous collapse may ensue from 
 a longer application ; then wrap the patient in a blanket and apply hot 
 bottles to the limbs and trunk (Chandler). Artificial Respiration, when the 
 breathing threatens to become suspended, has given marvellous results in some 
 cases (Id). Climate should be changed ; as soon as the subject of heat-stroke 
 is able to be moved he should go to a cold climate and should not return to the 
 tropics while the slightest evidence of cerebral trouble remains (Mn). [Com- 
 pare Cerebral Congestion, Meningitis cerebral.] 
 
HECTIC FEVER HEMATEMESIS HEMATOCELE. 723 
 
 Hectic Fever. 
 
 Quinine, in large doses, gr. xv-xx daily, if stomach and intestines do not 
 rebel (P) ; given before the paroxysm, to limit it (Roberts). Antipyrin, is better 
 than Quinine, but must be used in much smaller dosage than ordinarily em- 
 ployed, say gr. iv or v about y 2 hour before fever rises, then doses of gr. ij 
 hourly as long as temp, remains above 100. 5 ; this daily, will give excellent 
 results in the hectic of phthisis (Pibram). Phenacetin, is safer and equally 
 efficient. Phenocoll, as an antipyretic, is used with marked success. Aconite, 
 in small doses, a remedy of much value in the irritative fever of phthisis (Da C). 
 Morphine and other anodynes, are of especial value, given in full doses toward 
 bed-time (Gross). Prunus Virginiana, the bark has been found useful, espe- 
 cially when irritable cough (P). Calcium Phosphate, is especially useful (R). 
 Calumba, excellent for tonic effects (P). Digitalis, the tincture, combined with 
 Tinct. Ferri Chloridi, abates the temperature and diminishes the sweats (B). 
 Iron, the Mistura Ferri Composita has obtained great celebrity, especially when 
 much debility and anemia (Wa) ; the Sulphate and Tincture of the Chloride 
 are of especial value in the treatment of hectic (Gross). Ipecacuanha, a few 
 grains of Dover's powder at bed-time, will stop the profuse perspirations (Wa). 
 Salicin, for profuse perspirations (Wa) ; as antipyretic. [Compare Perspira- 
 tion, Phthisis.] 
 
 & . Quininse Sulph., . . . Zj'ss. 
 
 Elix. Taraxaci, . . . . ^ iv. 
 
 M. Sig. — Teaspoonful every hour for 
 six hours. 
 
 R. Tinct. Digitalis, . . . . giij. 
 Tinct. Ferri Chloridi, . 3 v. 
 M. Sig. — 15 drops 3 or 4 times a day. 
 
 (B.) 
 
 Hematemesis. 
 
 Ipecacuanha, is decidedly effective in small doses, also when hematemesis 
 is vicarious of menstruation (P, Wa). Hamamelis, TT\j-ij of tinct. every 2 or 3 
 hours (R) ; effective from its Tannin (B). Alum, serviceable in passive hemor- 
 rhage ; Iron be'tter (B). Turpentine, especially in passive hemorrhage with 
 debility (R) ; and in hemorrhagic transudations on the free mucous surfaces, 
 hematemesis, etc. (B). Ergot, has often cured when other means failed (P) ; 
 most valuable ; in urgent cases Ergotin in 2 to 5 gr. doses hypodermically 
 (R). Iron, the Subsulphate (Monsel's solution) or Pernitrate, the best remedies ; 
 gtt. j-ij frequently, diluted with ice-water (B) ; the Chloride, in a mixture with 
 glycerin and pounded ice, a teasp. every hour, gave excellent results in two 
 cases of very severe hematemesis (St. George Reid). Lead Acetate, especially 
 when gastric ulcer, gr. ss-v (B). Tannic Acid, gr. x-xx, when hematemesis 
 from gastric ulcer or obstructive disease of the liver (B). Gallic Acid, an ex- 
 tremely useful agent ; is best used in combination with dilute Sulphuric Acid 
 (Wa). Ice, in small pieces swallowed, a most useful agent, with perfect rest 
 for stomach ; when hematemesis from that organ, nutrient enemata must be 
 employed ; iced champagne to arrest faintness, if persistent ; when moderate 
 the bleeding need not give cause for alarm. 
 
 JJ . Olei Terebinth giij. 
 
 Ext. Digitalis Fluid., . . zj. 
 
 Mucil. Acaciae, 5 ss - 
 
 Aq. Menth. Pip., .... ^j. 
 M. Sig. — Teasp. every 3 hours. 
 
 R. Ac. Gallici, Zj. 
 
 Ext. Ergotae Aquosi, 
 
 Digitalis, aa gr. xx. 
 
 M. et div. in pil. no. xx. Sig. — One 
 every 4 hours. 
 
 Hematocele, Pelvic. 
 
 Opium, or Morphine, if needed for pain, with absolute rest in bed, and a 
 moderately tight abdominal bandage (E). Hemostatics, as Gallic Acid, Lead, 
 Turpentine, etc., to arrest the hemorrhage, if it be still going on, combined with 
 opiates, and the use of ice-bags or cold lotions to the abdomen or per vaginam. 
 Tonics, as Iron and Quinine, while resolution of the extravasation is going on. 
 
724 
 
 HEMATURIA HEMERALOPIA AND NYCTALOPIA. 
 
 Bromides and Iodides, to quiet the action of the ovaries, if the hemorrhage 
 recurs at different periods. Potassium Iodide, as an absorbent, may be given 
 with Quinine (Braxton Hicks). Iodized Cotton, an excellent application to the 
 cervix uteri in cases of hematocele (Wa). Leeches, should be applied early 
 in cases of peri-uterine hematocele; later, except to check inflammation, they 
 are inadmissible (Wa). Mercury, gr. ^ of the Bichloride thrice daily, with 
 Iron and Ergot, conjoined with vaginal injections of hot water morning and 
 evening ; later in lieu of the mercurial the Syrup of Ferrous Iodide in 20-drop 
 doses thrice daily, was thoroughly efficient treatment in one very bad case of 
 retro-uterine hematocele (Hengst). Surgical interference has many advocates, 
 but is criminal in a large majority of the cases (E). If the case does not end 
 in resolution it will terminate in pelvic abscess. 
 
 R. Iodi, 5j. Mix and saturate 8 oz. of cotton with 
 
 Potassii Iodidi, Jij. the mixture ; then carefully dry, and label 
 
 Glycerini, ii vn J. " Iodized Cotton. " [See above.] 
 
 Hematuria. 
 
 Turpentine, when with constitutional debility (B) ; in very small doses (R) ; 
 is often very efficacious (P). [See under Hematemesis, for formula.] Hama- 
 melis, has arrested severe cases (R). Chimaphila, controls hematuria (P). 
 Gallic Acid, the most uniformly successful remedy (B) ; gr. x-xx every hour or 
 two (Da C). Sulphuric Acid, alone or with Gallic Acid, is an efficient remedy 
 (Da C). Acetic Acid, in a case of alarming hemorrhage from the bladder, 
 which occurred after an operation for vesico-vaginal fistula, and resisted all 
 other means, an injection of apple-vinegar and ice-water, equal parts, suc- 
 ceeded in arresting it (Ghent). Quinine, large doses necessary; cures when 
 intermittent or from malarial infection (B) ; useful in some cases of intermittent 
 hematuria (R). Myrtol, has been used with success in hematuria not due to 
 acute congestion (B). Iron, the tincture of the Chloride, n\,x-xx several times 
 daily ; in this affection the best form of Iron for internal use (Wa). Ipecacu- 
 anha, exercises a powerful influence (Wa). [See under Hematemesis. J Ergot, 
 by stomach or subcutaneously ; may be combined with Ipecac, Krameria, or 
 other astringents (B). Ergotin, hypodermically, is far superior for efficacy and 
 rapidity of operation (Wa). Matico, the infusion, in doses of ^ij every 2 or 3 
 hours, is fully equal to Gallic Acid, Lead, etc. (Thompson). Ammonium Ben- 
 zoate, in 5-gr. doses every 2 hours for the albuminuria and hematuria of scarla- 
 tina (Hillier). Cannabis Indica, is especially indicated in dysuria and strangury 
 when there is bloody urine (R). Camphor, in 2 to 5 grain doses is said to 
 promptly remove the renal hyperemia with bloody, coagulable urine, caused 
 by Cantharis, Turpentine, Oil of Mustard, Copaiba, etc. (R). Ice in rectum or 
 to perineum, for vesical hemorrhage (Thompson). Endemic hematuria, due to 
 the bilharzia parasite, can only be palliated ; as yet we know of no means by 
 which the bilharzia can be destroyed (Mn). 
 
 R. Acidi Gallici, gss. 
 
 Acidi Sulphurici Dil., 
 
 Tinct. Opii Deodor., . aa £j. 
 
 Infusi Digitalis, ^ iv. 
 
 M. Sig. — Tablesp. every 4 hours or R . Ext. Ergotae (Squibb), . . t ^j. 
 
 oftener. In hematuria, raenorrhagia, pur- Aquae, %}. 
 
 pura hemorrhagica, and the hemorrhagic M. Sig. — For hypodermic use 
 
 diathesis. (D.) contain gr. j. 
 
 R . Ext. Ergotae Fluidi, 
 
 Tinct. Kramerise, . . . aa ^j. 
 M. Sig. — A teasp. every hour or two. 
 
 tt\x 
 
 Hemeralopia and Nyctalopia. 
 
 Strychnine, for night-blindness; small doses gradually increased, of service 
 (Wa). Mercury, Hydrarg. Chlor. Corr. gr. ij ad §j aquae, dropped into the eye 
 twice daily, with blister on each temple, and mild aperients, has cured hemera- 
 
HEMICRANIA. 725 
 
 lopia (Smith). Quinine, in as large doses as can be borne, after cathartic and 
 emetic, for night- and day-blindness (Howard). Blisters, small, \}i inches in 
 diameter, close to external canthus of the eye (Bampfield). Electricity, occa- 
 sionally useful (Wa). Rest, protection of eyes from bright light, constitutional 
 remedies as indicated by state of the general health, and change of climate, 
 speedily cure hemeralopia. It is sometimes merely a symptom of pigmentary 
 degeneration of the retina, or a feature of scurvy. 
 
 Hemicrania. 
 
 Antipyrin, the most valuable single remedy for headache, especially in 
 migraine and those cases for which Ergot and Amyl Nitrite are indicated ; 5 
 grains at beginning of the attack often sufficient (Birdsall) ; of great value in 
 true migraine, employed in twenty cases with unfailing benefit ; less useful in 
 the malarial or dyspeptic forms, and useless in uremic (Thompson) ; one dose 
 of gr. xx, or 2 doses of gr. x each, % hour apart, given in the prodromal 
 period, or at the very beginning of a paroxysm, will invariably cut it short 
 within an hour (Sprimon, Ungar, etc.). Acetanilid and Antipyrin, the striking 
 powers of these two agents are best demonstrated in severe migraine (Whitla). 
 Phenacetin, has been given with great benefit, in doses of 2 grains with }i 
 grain of Caffeine Citrate, for migraine. Belladonna, when due to vaso-motor 
 spasm, the face being pallid (B) ; the tincture in small and repeated doses if 
 the disease be of reflex character (H). Iris, in blinding form, from hepatic 
 trouble, right supra-orbital region ; n\J every half-hour for 3 doses, usually 
 relieves promptly (Pf). Cannabis Indica, one of the most valuable remedies 
 for megrim or sick headache, apparently acting on the nervous centre whence 
 the disorder springs ; is most useful in the intervals to prevent the attacks, and 
 especially when the paroxysms are becoming more frequent ; it may be com- 
 bined in pill with either Iron or Aloes (K) ; of especial value in the con- 
 gestive form, the tincture in repeated doses until some physiological action 
 is induced (H) ; gr. y^ of the extract before each meal, increased gradu- 
 ally to l /2 or z / z grain, in the intervals, kept up for 3 months (Seguin); gr. yi 
 of the solid extract night and morning, very efficient in migraine, if used con- 
 tinuously for a long time (Hare). Camphor, gr. iij-v, with a 20- or 30-grain 
 dose of Magnesium Carbonate, is very useful, especially in hysterical females 
 (P). Croton-chloral, in milder forms without severe vomiting, headache 
 being predominant; the Bromides are useful after it (R) ; rarely of any use, 
 but if given it should be in 20-grain doses twice daily (H); Guarana, is useful 
 (B), a very effective palliative ; gr. xx every % hour for three hours (P) ; its 
 efficacy diminishes by degrees, attacks usually becoming longer (Tr) ; >>ij of 
 fluid extract in course of an hour or two, to anticipate the attack when expected 
 (Seguin). Caffeine, in typical migraine ; gr. j hypodermically (P) ; is espe- 
 cially adapted when chronic gastric catarrh, gr. j every half-hour (B) ; the 
 Citrate in grain doses every hour for some time before a paroxysm (Wa) ; gr. j 
 every half-hour often gives marked relief (Smith). Valerian, of especial value 
 when hemicrania in excitable temperaments, and after profuse or painful 
 menstruation (P). Ammonium Chloride, is exceptionally serviceable ; seldom 
 failing to cut short an attack (Austin) ; 10- to 15-gr. doses (R); as a diffusible 
 stimulant is very efficient, gr. xx up to 3j every hour during the attack (H). 
 Sodium Chloride, in small doses, proved very efficient in six positive cases 
 attended by gastric distress (Rabon). Podophyllin or Mercury, when of bilious 
 origin (R). Bromides, for true migraine ; Raspail's Eau Sedative locally, gives 
 great relief (B) ; when due to uterine disorder (R). Potassium Bromide, very 
 serviceable in the paroxysm, also in the continuous form (R). Eucalyptus, 
 in cerebral anemia (B). Digitalin, gr. -^ bis die in granules for congestive 
 hemicrania (B). Ergot, if due to miliary aneurisms of intercranial arterioles; 
 also in congestive migraine and in nearly all kinds (B). Menthol, locally in 
 frontal headache due to migraine, is said to be very efficient (Wa). [See for- 
 mula on next page.] Piscidia, recommended (Wa) ; efficient in doses of £ij 
 
726 
 
 HEMIOPIA — HEMOGLOBINURIC FEVER. 
 
 of the fluid extract (Ford). Arsenic, for cerebral congestion and hemicrania 
 (B) ; for throbbing pain in one brow (R) ; often has the best effect : Watson 
 believed that gtt. iv-vj of Liq. Arsenicalis, 3 or 4 times a day, with due attention 
 to the bowels, would cure 9 out of every 10 cases (Wa). Aconitine or Vera- 
 trine, ointment over brow (R) ; Aconitine internally is of great service (Seguin). 
 Phosphorus, is strongly recommended (R). Amyl Nitrite, by inhalation, in 
 migraine with pallor of face (R). Sanguinaria, a few doses very successful, 
 when migraine is due to gastric derangement (P). Ignatia, removes clavus 
 hystericus (Pf). Nux Vomica, when of gastric origin (R). Cimicifuga, is 
 strongly recommended (P). Rubber Bandage, applied tightly from eyes up, 
 protecting the temporal arteries by pads, or a dry muslin bandage wetted after 
 being put on (Weir Mitchell). Acupuncture, the needle run down to the cra- 
 nium will give relief in clavus hystericus, when nothing else will do so (Pan- 
 coast). [Compare Headache, Bilious Sick and Nervous.] 
 
 R 
 
 Quininae Sulphatis, . . . sjss. 
 
 Pulv. Belladonnae, . . . gr. x. 
 
 Ext. Digitalis, gr. xv. 
 
 Ext. Valerianae, 3 ss. 
 
 Mellis, q. s. 
 
 Ft. pil. no. xl. Sig. — 2 to 10 pills daily, 
 gradually increased, during three or four 
 days before the expected attack. 
 
 R. 
 
 
 Mentholi, 
 
 Alcoholis, 
 
 01. Caryophylli, 
 01. Cinnamomi, . . . aa TT^xx. 
 M. Sig. — Apply with finger over seat 
 of pain. 
 
 R- . Ammonii Chloridi, 
 
 Ammonii Bromidi, 
 
 Spt. Athens Nitrosi, 
 
 Syr. Pruni Virgin., 
 
 Aquae, . . . . q. 
 M. Sig. — Dessertsp. 3 or 4 times daily, 
 conjoined with the use of RaspaiPs Eau 
 Sedative (see page 145), locally. 
 
 . . 3vj. 
 • • 7> ly - 
 
 . . liij. 
 
 ad % vj. 
 
 R. 
 
 M 
 
 Aconitinae (Duquesnel), . gr. j 1 ^. 
 Alcoholis, 
 
 Glycerini, aa gj. 
 
 Aq. Menth. Pip., q. s. ad ^ij. 
 Sig. — Teasp. thrice daily. 
 
 [Seguin.') 
 
 Hemiopia. 
 
 When established, hemiopia offers little hope of cure, though it has no ten- 
 dency to progress. In hemiopia scintillans, Potassium Bromide, gr. xl-lx 
 daily, or a band of such metal as idiosyncrasy of the patient may decide, with 
 stimulants to ward off the aura ; Quinine, Iron, Hydropathy, when Potassium 
 Bromide fails (De Wecker). 
 
 Hemiplegia. 
 
 Strychnine, is most useful when the muscles are relaxed ; hypodermically, 
 when paralysis incomplete and the muscles flaccid but not wasted (B). [See 
 Paralysis for formula.] Potassium Iodide, gr. x-xviij daily, occasionally 
 proves effectual (Wa). Galvanism, constant current to the brain or cord, 
 faradic to the muscles opposite those contracted (Hammond). Physostigma, 
 prevents muscle wasting, and hence is given with benefit to hemiplegics ; gr. 
 ■^j-rij °f the extract repeated frequently (R). Massage, in hemiplegia and 
 other forms of paralysis due to intercranial lesions, when cold and blue skin, 
 wasting and contracted muscles, ulcerations, etc. (B). Cocculus, in hysterical, 
 epileptic and choreic hemiplegia, acts well ; also in hemiplegia from cold (P). 
 [Compare Paralysis Facial.] 
 
 Hemoglobinuria Fever. 
 
 Antipyrin, Phenacetin, and similar antipyretics, are dangerous (Mn). Qui- 
 nine, is less efficient in this than in any other form of malaria (Mn) ; as it con- 
 duces to hemoglobinuria its use is deprecated (Plehn) ; should be given in this 
 affection if the malarial parasites are found in the blood, but not if they are 
 absent (Bastianelli). Calomel, in large doses, 20 to 30 grains, is the favorite 
 
HEMOPTYSIS. 
 
 727 
 
 remedy in Africa (Mn) ; Calomel and Jalap, separately or combined, to keep 
 the bowels well open (Copeman). Chloroform, in small doses internally ; 
 Chloroform 3j, Pulv. Acacise q. s., Sweetened Water, ad ^viij, of which ^ss 
 every ten minutes until a certain degree of chloroform intoxication is produced, 
 the effect to be kept up by enemata of Chloral ; of 22 cases so treated none died 
 (Quennec). Chloral, with perhaps small doses of Jaborandi, if uremic convul- 
 sions or coma supervene (Copeman). Tannic Acid, gr. xv well diluted, every 
 2 hours for 4 or 5 times, repeated on the third and sixth days to the extent of 
 two doses each day (Mn). Transfusion of blood has been successfully prac- 
 tised in high degrees of anemia in some of these cases (Id). Hot Water, in 
 bottles in the bed, if the temperature should fall below normal (Copeman). 
 Diuretics must not be given if urine suppressed, but hot fomentations to the 
 loins, diaphoretics and plenty of bland diluents internally (Mn). Milk Diet 
 exclusively until all albumin has disappeared from the urine (Id). Care neces- 
 sary at all times to avoid getting wet or chilled or over-fatigued, for those who 
 have suffered once from this affection (Id). [Compare Malaria, Intermit- 
 tent Fever, Remittent Fever.] 
 
 Hemoptysis. 
 
 Atropine, gr. -j-j^ hypodermically, is remarkably efficient in stopping the 
 bleeding in phthisical hemoptysis (Squibb). Gallic Acid, exceedingly effective 
 (P) ; may be combined with Ergotin and Digitalis. [See Hematemesis and 
 Hematuria for formulas.] Lead Acetate, with Opium (B) ; proves signally 
 useful (Wa). Ergot, the fluid extract in 30 to 40 minim doses, every 3 or 4 
 hours, or hourly in severe cases ; or Ergotin hypodermically for urgent cases, 
 in 2 to 3 grain doses (R). Opium, should be freely used for the attendant 
 excitement (W). Chloral, is used with benefit, its vaso-dilator power probably 
 acting as a derivative, and its sedative influence allaying excitement. Ipecac- 
 uanha, has been highly praised (R) ; in emetic doses arrests hemoptysis (Tr), 
 though in poisonous doses produces it (P) ; a well-founded case is recorded 
 where Ergot and Gallic Acid utterly failed, and Ipecac was effectual; but it 
 must be pushed to the nauseating point, in order to effect the control (Squibb). 
 Turpentine, in drachm doses every 3 hours, may cause unpleasant symptoms 
 which soon disappear on its discontinuance (R) ; has proved very efficient (P) ; 
 after other hemostatics fail it is worthy of trial (Wa). Alum is serviceable in 
 purely atonic hemorrhages (Wa) ; in 10 grain doses every 2 hours (B). Oil of 
 Erigeron, is very efficient when no fever or other signs of constitutional irrita- 
 tion (Wa). Hamamelis, Tr\J— ij of tincture every 2 or 3 hours (R) ; Wlij-x of 
 fresh tincture several times a day (Pf). Ferric Acetate, a little added to water 
 so as to taste, this constantly sipped (R) : Iron spray will often arrest (B). 
 Digitalis, has undoubted power over hemoptysis (B) ; small doses daily (P) : 
 infusion in large doses (R). Arnica, of great service, if from violence (P). 
 Aconite, employed with best results (P). Sodium Chloride, half a teaspoonful 
 of common salt, taken dry, repeated till nausea (R). Sulphuric Acid, the dilute 
 acid a useful adjunct to other treatment (Wa). Spinal Hot-water Bag, to cer- 
 vical or upper dorsal vertebras (R). Auxiliaries, Cold externally, acidulated 
 drinks, perfect rest, and antiphlogistic diet (Wa). 
 
 R. Ext. Ergotse Fl., . . . . gjss. 
 Ext. Ipecac. FL, 
 Tinct. Opii Deod., . . aa^ij. 
 M. Sig. — Teasp. every y z hour. 
 
 R. Plumbi Acetat., gr. xx. 
 
 Pulv. Digitalis, gr. x. 
 
 Pulv. Opii, gr. v. 
 
 M. ft. pil. no. x. Sig. — One every 4 
 hours. (B.) 
 
 R. Aluminis, ....... gj. 
 
 Sacch. Alb., gss. 
 
 Pulv. Ipecac. Comp., . . gr. xx. 
 M. ft. pulv. no. vj. Sig. — One powder 
 every 2 hours. {Skoda. ) 
 
 R. Liq. Ferri Subsulph., . . n\xx. 
 
 Aquae, §ij. 
 
 M. Sig. — Use as spray by inhalation for 
 5 minutes every hour. 
 
728 HEMORRHAGE. 
 
 Hemorrhage, Hemorrhagic Diathesis. 
 
 Iron, when hemorrhagic diathesis due to anemia; the tincture of the Chloride 
 preferred (B) ; this tincture as a styptic (Wa) ; 1 or 2 teaspoonfuls of the con- 
 centrated solution in a glass of water an excellent hemostatic (Tr) ; the Acetate, 
 just enough to make water taste, in hemorrhage of lungs and kidneys (R). 
 Ergot, in uterine hemorrhage of any kind, and many forms of hemorrhage, 
 Ergot or Ergotin of great value (P) ; not to be relied on alone (B). Antipyrin, 
 is a most efficient hemostatic; a 4 per cent, solution checks general oozing 
 from a bleeding surface ; as a styptic it constricts the small vessels without 
 causing an external clot to break down (Park). Gelatin, as a styptic [see page 
 127]. Adrenal Extract, externally and internally [see page 165]. Alum, is 
 sanctioned by high authority (B) ; dusted on in slight cases (R) ; in uterine and 
 traumatic hemorrhage, when small vessels open (Tr). Hamamelis, wij-ij of 
 tincture every 2 or 3 hours, effective in many forms (R). Ipecacuanha, pro- 
 duces hemorrhage in poisonous doses, yet has great energy in arresting it (P) ; 
 exercises a powerful influence on internal hemorrhage generally, and in ex- 
 haustion therefrom ; gr. j-ij every %. hour (Wa) ; in emetic doses serviceable 
 (Tr). Turpentine, few agents more useful in the passive forms (B); small 
 doses in hematuria (R) ; for serious hemoptysis, and hemorrhage of typhoid 
 (P). Belladonna, hemorrhage from rectal ulcers (P). Digitalis, in uterine, 
 and many other forms, of great value (P); with restoratives has undoubted 
 power in the hemorrhagic diathesis (B). [See Hemoptysis.] Bone-marrow, 
 in hemophilia due to anemia (see page 160). Gallic and Tannic Acids, in all 
 passive hemorrhages, especially in that of the bladder (P); Tannic Acid for 
 local use, Gallic for systemic effects upon remote parts: when hemorrhage 
 occurs in relaxed and debilitated constitutions, Gallic Acid may be combined 
 with Ergot and Digitalis (B). Matico, proves useful in many cases, especially 
 monorrhagia, hematuria and hemoptysis (Wa). Nux Vomica, in hemorrhagic 
 diathesis, especially when occurring in anemic subjects; also the Syrup of 
 Iron, Quinine and Strychnine Phosphates; no prescription more generally 
 useful (B). Aconite, to reduce the circulation, in epistaxis, hemoptysis, etc. 
 (P). Cinchona, internally very efficient in some forms of hemorrhage (Tr). 
 Copper Sulphate, in stick, solution or ointment, to arrest hemorrhage from 
 small vessels (R). Arnica, in ecchymoses from mechanical violence (P). 
 Rhatany, the extract, one of the most powerful hemostatics (Tr). Hematoxy- 
 lon, is devoid of irritant qualities and is therefore well adapted to check the 
 diarrheas and hemorrhages of young children. Sulphuric Acid, the dilute 
 acid an excellent internal hemostatic, sometimes very effective in uterine 
 hemorrhage (B). Dilute Vinegar to leech-bites, piles, cuts, etc. (R). Apple- 
 vinegar as injection for vesical hemorrhage. [See under Hematuria.] 
 Grape-cure, as tonic for convalescents (P). Alcohol, in hemorrhagic diathesis, 
 to elevate the arterial tension (B) ; Brandy, Wine, when heart suddenly enfee- 
 bled by hemorrhage (R). Venesection, will promptly arrest pulmonary hem- 
 orrhage (B). Styptics, are either needless or inefficient, hence practically use- 
 less in general surgery ; hemorrhage should be controlled by either pressure or 
 ligation (Roberts). Hot Water, sponged over a bleeding surface, is the best 
 agent to stop hemorrhage (Gross). Transfusion, when death imminent (B). 
 Ice, internally in wounds or hemorrhage of lungs, or from stomach ; small 
 pieces frequently (R). Rest, perfect rest is often indispensable, especially in 
 hematemesis, in which nutrient enemata may be required. [Compare Dysen- 
 tery, Ecchymosis, Epistaxis, Hematemesis, Hemoptysis, Hemorrhoids, 
 Hematuria, Hemorrhage Post-partum and Intestinal, Menorrhagia, 
 Metrorrhagia, Purpura, Wounds, etc.] 
 
 R . Infusi Digitalis, ^ ij. 
 
 Ext. Ergotse Fluidi, 
 
 Tinct. Kramerige, . . aa^j. 
 M. Sig. — A tablesp. as required in 
 hemorrhagic conditions generally. (B.) 
 
 $. Potassii Carbonat., . . . £ij. 
 
 Saponis, 3J~~ij- 
 
 Alcoholis, ^iij. 
 
 Mix and use as a styptic especially for 
 
 operations about the face. {Jos. Pancoast. ) 
 
HEMORRHAGE. 729 
 
 R . Tinct. Benzoini, ^ viij. 
 
 Aluminis, lb. j. 
 
 Aquae, lb. x. 
 
 Boil 6 hours in a glazed earthenware ves- 
 sel, adding hot water in lieu of that vapor- 
 ized, and keeping well stirred ; filter, and 
 put up in stoppered bottles. PagliarV s 
 Styptic. 
 
 R. Ext. Ipecac. Fl., . . . . gij. 
 
 Ext. ErgotaeFJ., . . . . ^iv. 
 
 Ext. Digitalis Fl. 3 i j . 
 
 M. Sig. — Half teasp. to a teasp. at a 
 dose, repeated as required. An excellent 
 anti-hemorrhagic combination. (B.) 
 
 Hemorrhage, Intestinal. 
 
 Turpentine, should be used (B) ; especially in that of typhoid (P). [See Hema- 
 temesis, for formula.] Belladonna, for irritable and bleeding rectal ulcers (P). 
 Iodine, in passive form, gtt. j-ij of tinct. frequently repeated, of great service 
 (B). Sulphuric Acid, is serviceable (B). Lead Acetate, often of great service, 
 especially when used as an enema (Jenner). Tannin, one of the most service- 
 able remedies for the intestinal hemorrhage of typhoid fever (B). Hamamelis, 
 very effective in intestinal hemorrhage, owing to its large proportion of Tannin 
 (B). Ergot, is most valuable ; may be given hypodermically in urgent cases 
 (R). Gallic Acid, gr. xv with gtt. iij-iv of Laudanum, in a winegl. of iced water 
 every 2 or 3 hours in the hemorrhage of typhoid (Jenner). Opium, a valuable 
 adjunct to astringents, allaying the nervous excitement (Wa) ; most useful (Da 
 C). [Compare Dysentery, Hemorrhoids, Typhoid Fever.] 
 
 Hemorrhage, Post-partum. 
 
 Atropine, hypodermically, is remarkably efficient. [See under Abortion.] 
 Hamamelis, for persistent oozing (R). Ipecacuanha, in flooding after delivery 
 (R). Iron, Monsel's solution, j to iij of water, strong enough and safe as 
 injection (B) ; the Perchloride diluted (R). Amyl Nitrite, ff\,v by inhalation, 
 has stopped a hemorrhage promptly and permanently (Kerr). Ergot, a full 
 dose of the fluid extract as soon as birth is completed, as a prophylactic (Play- 
 fair); hypodermically in urgent cases, gr. ij of Bonjean's Ergotin deeply into 
 the tissues of the arm (Wa) ; £ss doses of the fluid extract every 2 to 4 hours 
 in secondary hemorrhage. Cimicifuga, will check post-partum hemorrhage, 
 especially when tediously prolonged (P). Digitalis, the infusion best; a 
 tablesp. bis die, or in urgent cases every half hour for 4 doses (B). Nux 
 Vomica, the tinct. gtt. xx ; Ext. Ergotae Fl. gtt. xxx ; each hour for 2 or 3 doses 
 (B). Opium, the tincture Z) with Brandy, in profuse flooding (R). Vinegar, a 
 handkerchief soaked in vinegar and carried into the uterus, will often check 
 a severe hemorrhage (Landis) ; is antiseptic, astringent and sufficiently irrita- 
 ting to produce contraction, yet not so irritating as to cause subsequent mis- 
 chief, and always acts promptly (Penrose). Tamponade by absorbent cotton, 
 plugs of linen, etc., is indicated in hemorrhage from abortion or placenta 
 praevia (Parvin) ; never tampon after delivery ! you might as well hang the 
 woman by the neck (Wallace). Auxiliary Measures of importance are firm 
 pressure on the uterus, compression of the abdominal aorta, the plug, and if 
 necessary intra-uterine injections (Wa). Hot Water, no to 122 F., injected 
 into uterus, extremely successful in checking post-partum hemorrhage (Att- 
 hill) ; the most prompt and certain method, and the least unpleasant to the 
 patient (Parrish). [See also Dr. Cameron in Canada Med. and Surg. Jour., 
 March, 1878, with record of 16 cases so treated.] Ice, to abdomen or within 
 the womb (B) ; into womb or rectum (R) ; as a prophylactic against hem- 
 orrhage and to secure firm contraction of the uterus, a good method is to 
 grasp the womb through the abdominal parietes with a hand kept cold by 
 frequent immersion in a pan of broken ice, while waiting for the expulsion of 
 the placenta ; while one hand is kept on the uterus the other maybe immersed 
 in the ice. Transfusion of milk into veins may be necessary in cases of col- 
 lapse (Thomas). 
 
730 
 
 HEMORRHOIDS. 
 
 Hemorrhoids. 
 
 Galls, as ointment, very useful ; the official Unguentum Gallae, or Galls com- 
 bined with Lead and Opium (R). [Formula on next page.] Iron, a solution of 
 the subsulphate as wash to bleeding piles, which should then be well oiled (B) ; 
 or an ointment of the same (Basic Ferric Sulphate) gr. xv to the £, locally night 
 and morning, with gr. j of the salt thrice daily by mouth ; gives excellent 
 results. Hamamelis, by mouth, also as lotion or injection in bleeding piles (R) ; 
 is employed with satisfaction ; u\,ij-x of tincture several times a day ; also as 
 enema or suppository (Pf ). Nux Vomica, emphatically beneficial (P). Sul- 
 phur, gr. v-x, with 3j Confec. Sennas, as laxative (R) ; exercises a most soothing 
 influence (Wa). Sulphides, especially Blue Lick water (B). Podophyllum, as 
 cathartic, for hemorrhoids of recent formation, bleeding from stasis in portal 
 circulation (B). Aloes, causes congestion of pelvic viscera, yet Fordyce Barker 
 shows it to be curative in piles, especially in recent ones, as after delivery (B) ; 
 to greatly relieve bowels (R) ; cures by removing constipation (P). Hydrastis, 
 as lotion or ointment to external piles, of great value; vt\y of tincture ter die 
 internally at same time (P). Ergot, with or without Nux Vomica, in dilated 
 hemorrhoidal veins without new tissue, given by the stomach and used locally 
 will often cure (B). [See Diarrhea for formula.] Stillingia, will remove per- 
 manently when due to constipation, and temporarily when from hepatic obstruc- 
 tion (B). Senna, to procure soft and easy evacuations use the Confectio Sennae 
 at bedtime, gr. cxx in a bolus (B). Iodoform, the ointment, and in suppository 
 (B). Nitric Acid, as caustic, followed by free use of Olive Oil (B); ^ss-^j ad 
 Oss aquae as lotion for bleeding piles (R). Hyoscyamus or Stramonium, leaves 
 bruised or ointment, locally for pain (P). Linseed Oil, boiled, in doses of ^ij 
 twice daily, has quite a reputation as a remedy for piles (W). Alum, to painful 
 bleeding piles, a crystal trimmed and passed into rectum, or as an ointment 
 (B). Ice, to painful, bleeding piles, or cold water injected daily (B) ; locally 
 for pain after operation (R). Leeches, directly to swollen, irreducible, and 
 painful piles (B). Alkaline Mineral Waters, excellent (B). Carbolic Acid, 3 
 parts to 1 of Olive Oil, a few drops injected into the tumor; a favorite and suc- 
 cessful treatment by itinerants (Andrews); uncertain in all cases and in many 
 fraught with danger (Gross) : a good procedure : use 4 drops each of pure Car- 
 bolic Acid and Glycerin, and inject one tumor at a time (Hunt). Grape-cure, is 
 used with success (B). Saline Purgatives, notably Epsom salts, combined with 
 Sulphuric Acid, will often stop the hemorrhage (B). [See Dysentery for 
 formula.] Diet, etc., avoid stimulants, indigestible food and over-eating; 
 during an attack use little animal food. Petroleum soap when piles protrude, 
 with cold or tepid water ablutions. Injections, Oj of cold or tepid water, are 
 very useful. Stool should be at night. Surgical Methods are: the ligature 
 for internal hemorrhoids, excision for external ones. Ligation, is the proper 
 treatment for the former, all other methods of operating radically being now 
 discarded as unsurgical and dangerous to life (Gross). Thermo- Cautery is used 
 by Smith of London and many other surgeons, but is apt to leave behind fissures 
 and ulcers, which are with difficulty healed. Prevention, soft seats favor the 
 production of piles, as also of uterine disorders, by pressure on the arteries as 
 they emerge from the pelvis, tending to drive the blood into the interior of that 
 cavity (Holden). 
 
 R. Iodoformi, 3J. 
 
 Balsam. Peruv. , . . . . 5jij. 
 
 Magnes. Calcin., . . . . £j. 
 
 Cetacei, ^ss. 
 
 Ol. Theobromse, . . . . q. s. 
 M. et fiant suppositoria xij. Sig. — One 
 twice daily. {Potter.) 
 
 R. Ext. Colocynth. Co., . . . gr. xxx. 
 
 Ext. Nucis Vom., . . . . gr. vj. 
 Hydr. Chlor. Mitis, 
 
 Ext. Hyoscyami, . . aa gr. xij. 
 M. et div. in pil. no. xij. 
 Sig. — One pill as required for sluggish 
 bowels. {Barker.) 
 
HEPATALGIA HEPATIC CONGESTION. 
 
 731 
 
 R . Pulv. Gallse, gr. xx. 
 
 Pulv. Opii, gr. x. 
 
 Ung. Plumbi Subacet. , . gr. xl. 
 
 Ung. Simplicis, ^j. 
 
 M. et ft. unguentum. Sig. — Ointment 
 (CEsterlen.) 
 
 for pile 
 
 R . Pulv. Gallse, 
 
 Pulv. Opii, 
 
 Plumbi Acetat., . . . aa gr. xx. 
 
 Ung. Picis Liquids, 
 
 Cerati Simplicis, . . aa ^ ss. 
 M. etft. unguentum. Sig. — Apply night 
 and morning after bathing parts with cold 
 water. 
 
 a. 
 
 M 
 
 Ext. Opii, gr. x. 
 
 Pulv. Stramonii, .... £jj. 
 
 Pulv. Tabaci, 3 ss. 
 
 Ung. Simplicis, ^ss. 
 
 Sig. — Ointment for piles. 
 
 [Shoemaker. 
 
 R. Ac. Carbolici, gij. 
 
 Ac. Tannici, 3J. 
 
 Alcoholis, ^iv. 
 
 Glycerini, Jjij. 
 
 M. Hypodermic injection for piles. 
 
 ( Girard. ) 
 
 Hepatalgia. 
 
 Ammonium Chloride, 20 to 30 grains every 4 hours, is highly efficacious 
 (Anstie). Bryonia, worthy of commendation in many liver affections (P). Nux 
 Vomica, has been found of much benefit ; dose should be small, gr. T ^ to -£% 
 two or three times a day (P). Quinine, would naturally be thought of for 
 malarial subjects, but does not afford any relief (Anstie). 
 
 Hepatic Cirrhosis. 
 
 Diuretin, for the dropsy. [See under Dropsy.] Nitric Acid, in long-stand- 
 ing diseases, as this will augment flow of bile after liver has struck work from 
 mercury (R); the mineral acids do not benefit (B). Arsenic, small doses 
 perseveringly, give good results in improving the nutrition of the organ (B). 
 Aurum, the Bromide of Gold and Arsenic has been used with benefit (Barclay) ; 
 the Chloride of Gold and Sodium, in doses of gr. -£$, as an hepatic alterative, 
 may be used conjointly with Sodium Phosphate (B). Sodium Phosphate is said 
 to produce good results (Da C) ; has power to retard the sclerosis, and may 
 possibly arrest the changes and restore a state of comparatively normal func- 
 tion (B). Iodides, are the best remedies for the first stage (B) ; Potassium 
 Iodide is highly recommended by some authorities (Da C) ; the great measures 
 in the treatment of this affection are Potassium Iodide, hydrotherapy, and a 
 milk diet(Lancereaux). Stillingia and Alkaline Mineral Waters, are important 
 in the first stage (B) ; Alkalies early, especially Carlsbad water, with total ab- 
 stinence from alcoholic beverages (Legg). Mercury, Corrosive Sublimate in 
 small doses, gr. ^ thrice daily, for a long time, does benefit the condition and 
 has possibly cured a few cases (Da C). Tapping becomes necessary for the 
 dropsy, though purgation and diuresis may help to lessen it (Id). Diet, should 
 be of easy digestibility, especially milk, avoiding starches and fats and quitting 
 alcohol (Id). [Compare Ascites.] 
 
 Hepatic Congestion. 
 
 Nitric Acid, in chronic congestion, will augment flow of bile after liver has 
 struck work from excessive use of mercury (R). Nitro-Muriatic Acid, is found 
 useful in India, with the nitric acid bath, ^iij ad gall, j, tohypochondrium (B); 
 formerly held high rank but is superseded by Ammonium Chloride ; the acid 
 baths being now rarely employed (Fayrer). [See page 566 for formula.] Sul- 
 phates, in natural purgative waters, small doses often repeated (R) ; in the shape 
 of some bitter water or of Carlsbad salts, generally give prompt relief (Mn) ; a 
 good substitute for Carlsbad salts \s Sodium Sulphate 2, Sodium Bicarbonate 1, 
 Sodium Chloride 1 (Id) ; Potassium Sulphate is occasionally poisonous (R). 
 Chelidonium, as deobstruent (S) ; energetically affects the liver (Pf ). Iodine, 
 
732 
 
 HEPATIC CONGESTION. 
 
 tincture and ointment locally for hepatic engorgement after malarial attack ; 
 also Ammonium Iodide in moderate frequent doses, for functional derange- 
 ment from malarial disease (B). Sodium Phosphate, 3j-ij. 3 or 4 times daily, in 
 plenty of water, as a purgative (B). Ammonium Chloride, in passive conges- 
 tion, and chronic torpidity, is well worthy of attention ; gr. xx every 4 hours 
 (Wa) ; an excellent remedy (Da C). Turpentine, epithems, hot, often found 
 very beneficial (Wa). Quinine, gr. xv-xx with Morphine, gr. %-%, in the 
 acute congestion due to climatic or malarial causes, no remedy so efficient (B). 
 Bryonia, is worthy of commendation in liver affections of various kinds (P). 
 Iris, really serviceable when stools clay-colored and skin jaundiced (B) ; is one 
 of the best aperients in hepatic derangement (P). Mercury, valuable only as 
 a purgative ; its use restricted to cases where there is deficiency or excess of 
 bile (B) ; a full Calomel purgative is of utility in cases of congestion (Wa). 
 Podophyllum, the resin in congestion of the portal circulation, is especially 
 useful (B); gr. l /e-% every six hours will speedily relieve symptoms (P). San- 
 guinaria, is useful in hepatic engorgement without organic disease (P). Col- 
 chicum, in hepatic congestion and dropsy ; an active remedy in congestion of 
 the liver (B). Resin-bearing Purgatives, as Rhubarb, Podophyllum, Iris, 
 Euonymus, etc., are all actively cholagogue. [See list on page 53.] Ipecacu- 
 anha, decidedly stimulant to the flow of bile (B) ; is the Indian treatment now 
 for the local liver, given in large doses for a week or two (Da C). Taraxacum, 
 has had a reputation, but I cannot recommend it (Id). Aliment, no starches or 
 fats; give milk, eggs, oysters, beef-broth, whitefish, etc. (B) ; in chronic hepatic 
 congestion (tropical liver), alcohol must be forbidden in every shape, animal 
 food used very sparingly, especially beef and mutton, fruit and farinaceous 
 substances may be more freely taken, but over-eating in every form must be 
 avoided (Mn). Exercise should be taken twice daily, and should provoke 
 perspiration (Id). Cold Water Belt around the abdomen, covered with oiled 
 silk, gives great comfort in chronic cases (Da C). [Compare Biliousness, 
 Jaundice, etc.] 
 
 R. Hydrarg. Chlor. Mitis, . . gr. vj. 
 
 Pulv. Ipecac, gr. j. 
 
 Sodii Bicarb., gr. x. 
 
 Div. in pulv. no. ij. Sig. — One at bed- 
 time, followed by the following: — 
 R. Ac. Nitro-hydrochlor. Dil., 3 iij. 
 Elix. Taraxaci Co., ad ^yj. 
 M. Sig. — Dessertspoonful before meals, 
 and a milk diet. 
 
 gr. Ixxij. 
 gr. xxiv. 
 
 R. Ext. Taraxaci, . . . 
 
 Ext. Aloes, .... 
 
 Ext. Colchici Rad., 
 
 Pulv. Ipecac, . . . . aagr. 
 
 M. et div. in pil. no. xxiv. 
 
 Sig. — 2 nightly in chronic enlargement 
 
 and torpidity of the liver. {Martin.) 
 
 xij. 
 
 R . Sanguinariae, gr. viij. 
 
 Podophyllini, gr. iij. 
 
 Ext. Hyoscyami, . . . . gr. iij. 
 
 Saponis, gr. viij. 
 
 M. et div. in pil. no. xx. 
 Sig. — 2 to 4 pills daily. In hepatic tor- 
 por without organic disease. {Phillips.) 
 
 R. Cinchonidinae Sulph., 
 
 Euonymini, 
 
 Leptandrini, 
 
 Juglandini, 
 
 Irisini, 
 
 Podophyllini, 
 
 Ext. Belladonnae, 
 
 Ext. Hyoscyami, . . , 
 M. et div. in pil. no. Ix. 
 Sig. — One pill thrice daily 
 hepatic torpor. 
 
 aa 3J. 
 
 aa gr. x. 
 
 . In obstinate 
 {Blackwood.) 
 
 R 
 
 . gr. xij. 
 . gr. vj. 
 
 Euonymini, . . . 
 Ext. Hyoscyami, . 
 M. et div. in pil. no. vj. 
 Sig. — One at bedtime, followed next 
 morning by a full dose of an aperient min- 
 eral water. 
 
 R. Potass. Bicarb., 
 
 Potass. Citratis, . . . . aa ^j. 
 
 Syrupi Simplicis, . . . . ^vj. 
 M. Sig. — A teaspoonful to a tablesp. 
 with a similar quantity of lemon-juice, in 
 y z glass of water ; the whole to be drank 
 
 while effervescing. 
 
 ( Wood.) 
 
HEPATIC DISEASES HEPATITIS. 733 
 
 Hepatic Diseases. 
 
 Ammonium Chloride is highly serviceable in all cases of liver disease, 
 whether due to organic changes or to functional derangement ; especially indi- 
 cated after the more acute symptoms have abated (Wa). Nitro-hydrochloric 
 Acid, formerly held high rank, but is now superseded by Ammonium Chloride 
 (Wa) ; even the acid baths, so long considered of great importance, are now 
 but little, if ever, used in India (Fayrer). Nitric Acid acts in some way bene- 
 ficially on long-standing liver-diseases, as in chronic congestion and cirrhosis 
 (R) ; with vegetable bitters, long continued, useful in waxy liver (Wa). 
 Podophyllum has a high reputation in a variety of liver diseases (P) ; is actively 
 cholagogue (R). Mercury, mercurial purgatives are used for both deficiency 
 and excess of bile ; harmful in many acute forms of hepatic disease, and gen- 
 erally are of doubtful propriety in liver affections (B) ; in hepatic congestion a 
 full Calomel purge is of great benefit (Wa). Red Mercuric Iodide, as oint- 
 ment, gr. j to £v, gives best results in malarial enlargement of the liver (W). 
 Calomel is used in inflammatory disorders of the liver, but is less suited to par- 
 enchymatous than to serous inflammations (Da C). Ipecacuanha promotes the 
 flow of bile (B) ; may be used in small doses with great advantage in func- 
 tional derangement of the organ (Wa). Resinous Purgatives, as Leptandra, 
 Iris, Euonymus, Rheum, etc., are decidedly cholagogue (B). Euonymin is of 
 great value in torpid liver and its accompanying headache (W). Bryonia is 
 worthy of commendation in liver affections of various kinds (P). Chelidonium 
 powerfully affects the liver (Pf). Taraxacum is highly recommended in all 
 chronic affections of the liver, especially in indolent enlargement and incipient 
 scirrhus (Watson). Sodium Phosphate is cholagogue, and extremely useful in 
 liver affections, especially the jaundice of children and hepatic calculi (Thudi- 
 cum). Phosphorus specifically affects the liver, and used early in acute yellow 
 atrophy may have an action of antagonism upon the disease (B). Potassium 
 Salts, as depuratives, are of decided value, especially the Citrate, in hepatic 
 torpor and other affections (W). Sulphur, the sulphurous mineral waters, pro- 
 longed, give excellent results in liver disorders (B). Alkaline Waters are very 
 serviceable (B) ; especially the sulphur waters; Glauber's salt in their place 
 (Da C). Chlorine Water has been employed with benefit in chronic hepatic 
 affections, in doses of 3ss-ij i n ^iij or j v f water (W). Iron preparations, 
 long continued, in amyloid degeneration (Da C). Gentian, and other bitter 
 tonics, in functional disorder; also Nux Vomica occasionally, but use Mer- 
 curials and Podophyllum sparingly (Da C). Iodine and Iodides in waxy en- 
 largement, simple hypertrophy and chronic congestion, of great value (Wa) ; 
 Potassium Iodide alternately with Ferrous Iodide in waxy liver (Frerichs); a 
 few drops injected into hydatids (B). Sanguinaria is of great value in hysteria 
 from chronic hepatitis, and in hepatic engorgement without organic disease (P). 
 Stillingia for torpid liver and jaundice following ague, in the first stage of cir- 
 rhosis, and in ascites from hepatic changes (B). Malt Liquors are harmful in 
 all chronic affections, especially in fatty liver (B). Galvano-puncture for hy- 
 datids, the negative needle into the hydatid (B). [Compare Lists of Agents 
 acting on the Liver, page 53 ; also, the articles in this section entitled Bilious- 
 ness, Calculi, Cancer, Hepatalgia, Hepatic Congestion, Hepatic Cir- 
 rhosis, Hepatitis, Jaundice.] 
 
 Hepatitis and Hepatic Abscess. 
 
 Ammonium Chloride, is almost a specific in hepatitis and abscess of the liver 
 (Stewart) ; often preventing the latter disorder, and in many instances curing 
 it (Wa) ; 20-grain doses thrice daily, are usually prescribed (Mn). Ipecacuanha, 
 in full doses, repeated once or twice daily for 2 or 3 days, if dysentery be 
 present (Id). Quinine, in large doses for the acute parenchymatous inflam- 
 mation (Da C) ; in medium doses persistently for a long time has done excel- 
 
734 HERNIA HERPES. 
 
 lent service in chronic suppurative hepatitis without abscess, but with frequent 
 exacerbations. Tartar Emetic, gr. %- l /z, every two or three hours, with 
 Opium or Calomel as indicated by symptoms ; of especial value early in the 
 acute attack (Wa). Leeches to margin of the anus in the acute type (B) ; to 
 unload the portal system (Wa). Mercury is used, but is better suited to serous 
 inflammations than to parenchymatous ones (W). Chelidonium has been used 
 with benefit in both acute and chronic hepatitis (P). Alkalies and Colchicum, 
 when the affection is of a gouty nature (Wa). Sulphites are recommended in 
 chronic forms (Da C). Sinapisms and Linseed poultices over the hepatic 
 region in acute hepatitis (Wa). Saline Purgatives, as the Sulphate of Sodium 
 or Magnesium, to increase the watery exudation from the mucous membrane 
 of the intestines, in acute hepatitis (Wa) ; free purging by the Sulphates, 
 massive hot poultices, low diet and rest in bed, the treatment for hepatitis 
 which has not proceeded to abscess formation (Mn). Nitro-hydrochloric Acid, 
 for some time, in the chronic form tending to abscess (Da C). Aspiration, when 
 pus forms ; early operation the rule of practice ; has induced many recoveries 
 (Id). [Compare Jaundice.] 
 
 Hernia. 
 
 Opium, or Morphine hypodermically to narcotism, often obviates the neces- 
 sity of an operation in strangulated hernia (Wa). Chloroform, of evident bene- 
 fit (Wa) ; inhaled to assist reduction (R) ; has superseded the use of Tobacco 
 and Lobelia in strangulated hernia (P). Coffee, large doses, has certainly a 
 remarkable influence in aiding or causing reduction of strangulated hernia 
 (Wa). Thyroid Extract, causes herniae to vanish in a few weeks or months 
 when due to accumulation of myxedematous or fatty material in the abdominal 
 cavity, and should be tried in hernial protrusions from any part of the abdomen 
 before resorting to surgical means (Parker). Oak Bark extract, as injection 
 into the tissues, for a radical cure by stimulating the occlusion of the rings 
 (Heaton's radical cure) : a similar operation was patented by Dr. Gage in 1840, 
 the Oil of Cloves being the injection used ; Professor Pancoast injected tincture 
 of Iodine for the same purpose. Ice Poultice is of use if no strangulation of 
 gut or omentum (Wa). Sternutatory, as snuff or Ipecac, to cause sneezing 
 while patient lies on his shoulders with elevated hips and legs over the back 
 of a chair, frequently successful after taxis has failed to effect reduction ; in 
 this position the action of gravity, aided by the sudden action of the dia- 
 phragm, tends to draw inwards the posterior portion of the escaped gut, which 
 is the part most difficult to manage by taxis. Cold Douche, with taxis properly 
 performed and the position above described, will reduce 90 per cent, of the 
 cases of strangulated hernia within a few minutes (Raiford). Truss, properly 
 adjusted, is the best remedy for a reducible hernia, often curing the disease by 
 the pressure of its block (Gross). Surgical, Bassini's operation for the radical 
 cure, or some modification thereof, produces very satisfactory results. 
 
 Herpes. 
 
 Ferrum Arsenate, in* doses of gr. ^ daily, will effect the cure of a herpetic 
 affection in the adult, however extensive or long established (Duparc). Mer- 
 cury, Calomel ointment, 3] to the ^, is one of the best mercurial preparations 
 (Pereira). Potassium Carbonate, as lotion, gr. xxx to Oj, to allay irritation 
 (Wa); or as ointment, gr. xx to ^j, smeared over eruption at night, and 
 washed off in the morning with a solution, gr. xxx to Oj (Neligan). Myrtol, 
 is curative of herpes (B). Glycerin, diluted, is a serviceable application in 
 herpes labialis (Wa). Ergot, the Oil prepared by the action of Benzin upon 
 Ergot, which, upon evaporation of the solvent, makes a valuable application 
 in herpes genitalium and other skin affections (Shoemaker). Alum, in herpes 
 praeputialis, a solution of %] to ^j ; aquae, applied on lint to the glans penis, is 
 generally effectual (Wa). Collodion, the flexible form, is applicable to various 
 
HERPES ZOSTER HICCOUGH. 
 
 735 
 
 kinds of herpes (Wa). Magnesium Citrate, as a cooling laxative, with soothing 
 and protective lotions and ointments, and the Liquor Picis Alkalinus, diluted 
 10 to 20 times, for the itching (Bulkley). Astringent Lotions, of Tannin or 
 Zinc Sulphate, in herpes praeputialis, to render the parts less sensitive (Da C). 
 [For Herpes Circinatus see Tinea Circinata.] 
 
 R . Tragacanthae, g ij-iv. 
 
 Liq. Calcis, 3 iv. 
 
 Glycerini, ^j. 
 
 Aquae Rosae, Jjiij. 
 
 M. Sig. — Ointment. 
 
 R. Acidi Carbolici, .... gtt. v- 
 Pulv. Calaminae Praep., 
 Zinci Oxidi, .... aa^ss-j. 
 Ung. Aq. Rosae, . . . ^j. 
 M. et ft. unguentum. 
 
 Herpes Zoster. 
 
 Rhus Toxicodendron, very readily subdues, especially when burning or itch- 
 ing (P). Aconite and Opium, locally for pain (Wa). Morphine, the oleate ex- 
 ternally without friction (R) ; hypodermically to mitigate the pain (Anstie). 
 Celandine has been recommended (P). Dulcamara, has an old reputation (P). 
 Silver Nitrate, painted on the warning patch of erythema, before or as soon as 
 vesicles begin to form (R) ; as a local application is reported on favorably (Wa). 
 Veratrine, as ointment, gr. xx-xl to the §, in neuralgia following shingles (R). 
 Zinc Phosphide, gr. % every 3 hours, is said to control the pain and abort 
 the eruption (Hughes). Grindelia, is reputed to relieve the pain (Stille). Mer- 
 cury, the Ung. Hydrarg. Ammoniat. is said to relieve the pain and irritation 
 remarkably (Wa). Blisters, for subsequent neuralgia (R). Hot Fomentations 
 will often disperse (R). Baths daily, exercise out of doors, abundant nutritious 
 food. Flexible Collodion, constantly reapplied to exclude air (Anstie). Gal- 
 vanization of the affected intercostal nerves, the positive pole over their points 
 of emergence, the negative brushed over the terminal filaments of the skin (B). 
 Starch, dusted over the eruption, and on a muslin band sewed tightly around 
 the body to protect it from the friction of the clothes, gives the greatest relief 
 (Bulkley). Rest, absolute, when eruption is extensive (Fournier). 
 
 R 
 
 Zinci Phosphidi, 
 Ext. Nucis Vomicae, . aa gr. x. 
 M. et div. in pil. xxx. Sig. — One every 
 2 to 4 hours, as a nerve tonic. {Bulkley.) 
 
 R. 
 
 Liq. Sodii Hypochlorit. , 5 iv. 
 Aquae, ....... 'J ij. 
 
 M. Sig. — Wash for ulcerated vesicles. 
 
 R. Bismuthi Subnitratis, . ^iv. 
 Hydr. Chlor. Mitis, 
 Zinci Oxidi, .... aa^j. 
 M. ft. pulvis. Sig. — To be dusted on 
 cotton-wool, and applied to the ulcerated 
 vesicles, after washing with the solution of 
 Sodium Hypochlorite. (Fotirnier.) 
 
 Hiccough. 
 
 Morphine, hypodermically, often arrests hiccough (R) ; an injection of Mor- 
 phine and Atropine together has stopped a most violent hiccough in which 
 morphine alone and other agents had proved unavailing. Nux Vomica, in 5 
 or 10 minim doses of the tincture, with rr\,xv of dilute Nitric Acid ; a short 
 course frequently curative (P). Chloroform, combined with Opium (R). Pepper, 
 gr. ij-x, to stop hiccough (P). Laurel-water, a useful remedy, n^v (P). Cam- 
 phor, has been recommended (R). Mustard, 3j infused in %'iv of hot water has 
 cured most obstinate cases (R). Pilocarpine, gr. ■£$ of the Muriate, has cured 
 bad cases which resisted all other means (Ortille). Ether, as spray to the epi- 
 gastrium for ten minutes, then to the site of the phrenic in the neck (Regoni) ; 
 or the spirit, tr^xx-xxx in some aromatic water, given internally, will often 
 arrest the spasm immediately (Wa). Zinc Valerianate, gr. ^, with a small 
 portion of Ext. Belladonnas, cured a severe case of fifteen days' duration 
 (Danet). Nitro-glycerin, sometimes arrests (R). In mild cases deep inspira- 
 tions, holding breath as long as possible, or a firm belt around epigastrium (T). 
 
736 HYDROCELE HYDROPHOBIA HYDROTHORAX. 
 
 Hydrocele. 
 Iodine, injection of the tincture 1, water 2, into the sac to excite obliterative 
 inflammation, the usual procedure for radical cure after tapping the sac (Wa) ; 
 may be used full strength, or with equal part of water ; the latter the safest 
 method in ordinary cases, but relapses are not infrequent (Gross). Carbolic 
 Acid, gss, w ith a minute quantity of water or glycerin to render it fluid, injected 
 into sac and manipulated to bring all portions under its action, after which 
 rest in bed and support to scrotum (Levis) ; a very efficient method for radical 
 cure, but may cause erosion of vessels and hemorrhage into sac (Gross). Am- 
 monium Chloride, as discutient lotion to the scrotum in hydrocele of children 
 (Wa). Galvano-puncture, a current of 20 to 40 elements, by two needle elec- 
 trodes, will invariably cure (B). Operations for radical cure include that by 
 iron-wire sutures to excite adhesive inflammation (Simpson), and the incision 
 of the hydrocele under antiseptic precautions (Volkman) ; the same end may 
 be obtained by the simpler methods of injection noted above (Gross). [Com- 
 pare Dropsy, Orchitis.] 
 
 Hydrocephalus, Chronic. 
 
 Mercury, holds a high place in the opinion of many ; Calomel gr. ]i~Yz 
 twice daily, with mercurial inunction to the shaved head, or the latter alone ; 
 child to wear a woolen cap ; this treatment for 30 or 40 days (Wa). Ferrous 
 Iodide, with Cod-liver Oil, always gives good results among the poor (Wa). 
 Iodine, as lotions. [See Meningitis, Tubercular.] Potassium Iodide, may 
 arrest progress (Wa) ; is of value certainly ; appears to have power of promot- 
 ing absorption (Wa). Cod-liver Oil, sometimes improves the condition, espe- 
 cially in scrofulous children (Wa). [Compare Dropsy.] 
 
 Hydrophobia. 
 
 Belladonna, in all hyperemic states of the brain and spinal cord, is one of 
 the very best remedies (P). Stramonium, is used by Brahmins in India with 
 apparent success. Glonoin, may be of benefit (Wa). Nicotine, rightly used, 
 will probably prove to be our best remedy (B). Amyl Nitrite, should be fairly 
 tried (B). Hydrastinine, is used with benefit, in grain doses of the Hydro- 
 chlorate, hypodermically. Curare, is encouraging, gr. */j injected, 7 doses in 
 5>4 hours, dispelled the symptoms, but replaced them by paralysis of the limbs 
 continuing for over 2 months (Ros) ; has seemed to antagonize the convulsive 
 phenomena (B). Morphine, chiefly palliative; for deep injection into the teta- 
 nized muscles (B). [See Tetanus.] Coniine, is indicated ; has not succeeded 
 (B). Cauterization, with hot iron or Caustic Potash after cleansing wound, 
 which should be kept open by Unguentum Basilicon for 5-6 weeks (Ros) ; with 
 Silver Nitrate sharpened to a point, and applied freely to every sinuosity of the 
 wound as preventive (Wa). Excision, the safer practice (Wa). Baths, warm 
 and hot, produce calm (Ros). Rabies Toxin, the Pasteur inoculation with a 
 modified virus, protects the bitten person from the disease. [See page 517.] 
 
 Hydrothorax. 
 
 Diuretin, has been employed with benefit. [See under Dropsy.] Digitalis, 
 in the purely dropsical form, also in passive pleuritic effusions ; used as a diuretic, 
 3j-ij of infusion bis die or oftener, of great value (R). Elaterium, unques- 
 tionably of value as a derivative, though many fear it (P). Jaborandi, pro- 
 duces good results (B). Iodine, Z) of tincture injected in returning hydro- 
 thorax (B). Sanguinaria, has been used with the best effects (Wa). Blisters, 
 when effusion has taken place, certainly seem to stimulate the absorbents to 
 action (Wa). Dry Cupping, over the chest, gives relief (Da C). Thoracentesis, 
 if much distress. [Compare Dropsy.] 
 
HYPOCHONDRIASIS HYSTERIA. 737 
 
 Hypochondriasis. 
 
 Arsenic, in the aged, gives great comfort, especially when combined with 
 Opium (B). Ignatia, is useful, the tincture best (P). Cimicifuga, of singular 
 value in puerperal hypochondriasis, and that accompanying spermatorrhea, 
 etc. (P). Aurum, the Chloride, gr. -fa to -fa ter die gives excellent results, when 
 depression, vertigo, cerebral anemia (B) ; Gold is an efficient remedy in hypo- 
 chondriasis accompanying hepatic or testicular disease. Valerian, quickly re- 
 lieves the flatulence of hypochondriacs (B). Asafcetida, especially indicated in 
 cases marked by flatulence and gloom (B). Potassium Bromide, especially 
 among female town-dwellers, but also in male (R) ; effects are variable ; re- 
 lieves some, not others (Wa). Hyoscyamus, when syphiliphobia (P). Opium, 
 stimulant doses of the tincture are of great importance (B). Caffeine, the 
 Citrate, gr. j-v, has been used as a cerebral stimulant with advantage (B). 
 Alcohol, gives temporary relief in hypochondriasis ; should never be given for 
 its narcotic or stimulant effects in these cases (W). Cocaine, especially useful 
 in cases marked by debility and nervousness, and in mental affections accom- 
 panied by depression ; the fluid extract of Coca may be used, either alone or 
 in wine (Br). Turkish Baths, are useful for town-dwellers, with soft, flabby 
 tissues and mental depression (R). [Compare Melancholia.] 
 
 Hysteria. 
 
 Antipyrin, for the painful affections of hysteria. Aurum, the Bromide is of 
 decided benefit, in doses of gr. X to y 2 (Rosenbach). Arsenic, lessens mobility 
 of the nervous system and improves nutrition (B). Opium, gtt. j of Laudanum 
 with gtt. ij of the tincture of Nux Vomica, 3 or 4 times a day, for the flushes, 
 weight on the head, depression, etc. (R) ; Opium is a useful agent if its identity 
 be concealed from the patient, otherwise the opium habit is sure to follow. 
 Ignatia, useful in many forms of hysteria, with feeling of suffocation, sensation 
 as of a ball rising to the throat, convulsive crying, flatulence, etc. (P). Cam- 
 phor, in hysterical excitement (P). Musk, for many anomalous and distressing 
 symptoms (R). Chamomile Oil, in the spasmodic and pseudo-neuralgic 
 affections of hysterical women, a very excellent remedy (P). Cimicifuga, in 
 hysterical chorea, is rapidly curative (P) ; for the headache (R). Asafcetida, 
 in hysterical convulsive affections, with flatulence and cough (P) ; arrests 
 paroxysm, valuable for flatulence (B) ; removes headache, peculiar sensations 
 in head, and flatulence (R). Valerian, has great value, 3»ss doses of fluid ex- 
 tract (B) ; useful in most cases, especially those of hysterical dyspepsia (P). 
 Zinc Valerianate, especially at the climacteric age, for hysterical symptoms 
 which can be traced to no particular cause (R). Ergot, with Iron and tonics 
 (formula on next page), in cases depending on sub-involution of the uterus, 
 with indigestion and anemia (B). Nux Vomica, of great use in middle- 
 aged subjects, when flatulence, weight on head, flushing and perspirations (R). 
 Atropine, for hysterical aphonia, gr. ^q to -fa morning and evening (B). Ether, 
 for the flatulence, and for the hysterical paroxysm in sudden seizures (B). 
 Ammonia, the aromatic spirit for the acidity and eructations (B) ; the fetid spirit 
 for flatulent colic, etc., may be given with great advantage in doses of 3ss-j 
 (Wa). Potassium Bromide, gives control and prevents paroxysms ; when 
 verging on'nymphomania large doses required (R). Iron, a course often use- 
 ful, especially when anemia or uterine obstructions (R). Phosphorus, in 
 hysterical paralysis (R). Orchitic Extract, is used with benefit. Cerebrinin, is 
 employed with good results (Paul). Ovarian Compression, has in many cases 
 relieved recent hysterical contractions, and many other similar phenomena 
 (Bourneville). Electricity, for aphonia, paralysis and anesthesia, and to 
 educate the nervous control ; is the sworn enemy of hysteria. Accessory 
 Measures, occupation of mind and body ; removal from influence of friends ; 
 complete abandonment of the use of alcohol ; the shower-bath or cold-bath, as 
 47 
 
738 
 
 ICHTHYOSIS IMPETIGO IMPOTENCE. 
 
 an educator of the will as well as to invigorate the body ; excitement to be 
 avoided. The word Hysteria should never be applied to the case in the 
 patient's hearing. Disorders of vision are often found at the bottom of hysteria ; 
 look for hypermetropia and astigmatism. 
 
 R. Ext. Ergotae, gj. 
 
 Ferri Sulphatis, 3 ss. 
 
 Ext. Nucis Vomicae, . . . gr. viij. 
 
 Hydr. Chlor. Corros. , . . gr. ss. 
 Fiant pil. no. xxx. Sig. — One pill 
 thrice daily. For the indigestion and ane- 
 mia of hysterical subjects. (B.) 
 
 R. Tinct. Asafcetidae, 
 
 Tinct. Valerianae Ammon., 
 Tinct. Castorei, . . . aa spj. 
 
 Aquae Camph., 3 v ij- 
 
 M. Sig. — A tablespoonful or two every 
 
 hour. 
 
 Ichthyosis. 
 
 Zinc, the ointment or glycerite of the Oxide, especially the latter with a little 
 Camphor added to it, is a most useful application (Wa) ; an ointment of the 
 Sulphate, Z] to ^j, found very efficient (Wilson). Sodium Bicarbonate, as 
 ointment, gr. xv-xxx to the ^, or lotion, 3ij-nj to the pint (Devergie). Copper 
 Sulphate, gr. x ad ^j of Unguentum Sambuci, a useful application (Wilson). 
 Ulmus, in decoction, used internally, has cured the disease (Wa). Cod-liver 
 Oil, applied locally with friction, has proved promptly curative. Warm Baths, 
 may generally be employed with benefit (R) ; alkaline and vapor baths, with 
 Sapo Mollis ; and inunctions of oil or simple ointment to prevent Assuring of 
 the new skin (Duhring) ; frequent alkaline baths, with internal and external 
 use of oily preparations, as Linseed and Cod-liver oils, yield the best results 
 (Bulkley). Thyroid Extract, has been given with benefit. 
 
 Impetigo. 
 
 Salol, locally, as an antiseptic and deodorant powder. Arsenic, is very use- 
 ful (see under Eczema) ; the Iodide in doses of gr. ■£$ has been employed with 
 great success; or Donovan's Solution, tt\,v-x (Wa). Nitric Acid, internally, 
 frequently benefits (Wa). Glycerite of Tannin, an excellent application (B); 
 during the day, with poultices at night to remove scabs (R). Quinine, and 
 Mineral Acids, when from imperfect digestion (R). Zinc, the ointment of the 
 Oxide, after subsidence of inflammation (R). Sulphur, internally, serviceable 
 (R). Calcium Chloride, gr. xv-xxx, daily in some vegetable infusion, is well 
 spoken of (Wa). Mercury, Citrine Ointment diluted, locally, is an excellent 
 application (Wa) ; a very weak White Precipitate Ointment answers best in im- 
 petigo contagiosa, with a little Carbolic Acid lotion, 1 in 20, if it does not yield 
 (Bulkley); Calomel to cover the floor of the pustules, after opening, evacuating 
 and washing them out (Da C). Laurel-water, relieves the itching (P). Grape- 
 cure, has proved excellent (P). Flexible Collodion, or Liquor Guttae-perchae, 
 to cover the pustules, if located where they are liable to irritation (Da C). 
 [Compare Eczema.] 
 
 Impotence. 
 
 Phosphorus, no remedy more efficient ; the pill of Zinc Phosphide the most 
 convenient form (B) ; gr. -£$ thrice daily. Phosphoric Acid, full doses, with gr. 
 ss of Pulvis Cantharidis, an effective combination, especially in impotence of 
 old age (B). Aurum Chloride, prevents decline of sexual power (B); Gold 
 salts are highly praised by several authorities for decline of sexual power in 
 men. Kola, as a general tonic. Cantharis, with Iron is beneficial (B) ; in 
 large doses, gtt. xx-xxx, with Iron and Phosphoric Acid or Nux Vomica (R) ; 
 of doubtful efficacy (Wa). Cubeb, removes functional trouble (B). Nux 
 Vomica, drop doses of tincture in atonic impotence (B) ; in large doses when 
 spermatorrhea (R). Sanguinaria, has decided aphrodisiac properties, but is 
 useful only in the functional form (B). Serpentaria, in relaxation and feeble 
 
INFLAMMATION. 
 
 739 
 
 erections, will often restore power ; 3ss doses of tincture twice daily (B). 
 Ergotin, hypodermically about the dorsal vein of penis, when its enlargement 
 and too rapid emptying is the cause of impotence (B). Cannabis Indica, is a 
 useful remedy ; the best combination for functional impotence would be one of 
 Cannabis, Nux Vomica and Ergot (B). Polygonum Hydropiperoides, is a 
 useful remedy in the functional form, erections feeble, semen watery and testes 
 soft (B). Ferrum Arsenate, acts as a tonic to the organs, and in full doses often 
 benefits cases of functional form (B). Damiana, has been brought forward 
 as a genital stimulant and a remedy for impotence, but there is probably no 
 ground for any confidence in such claims (Stille). [Compare Emissions, Sper- 
 matorrhea, also the List of Aphrodisiacs, ante, page 40.] 
 
 R . Ferri Arsenatis, gr. v. 
 
 Ext. Ergotae, gr . xxx. 
 
 Ft. pil. no. xxx. Sig. — One twice daily. 
 
 R . Ext. Cannabis Indicae, . . gr. x. 
 
 Ext. Ergotae, gr. xl. 
 
 Ext. Nucis Vom. , . . . . gr. x. 
 Ft. pil. no. xx. Sig. — One pill night 
 and morning. 
 
 R . Quininse Sulph., . 
 
 Strych. Sulph., . 
 
 Ext. Ergotae, . . 
 
 Mas. Ferri Carb., 
 M. Ft. pil. no. xxx. 
 or 3 times daily. 
 
 . . . . gr. xxx. 
 . . . . gr. ss. 
 . . . . gr. xv. 
 . . . . gr. xlv. 
 Sig. — One pill 2 
 
 R . Sanguinariae, . . 
 Ext. Ergotae, . . 
 M. Ft. pil. no. xx. 
 thrice daily. 
 
 • • • gr. ij. 
 . . . gr. xx. 
 Sig. — One pill 
 
 R. Tinct. Sanguinariae, . . . giij. 
 Ext. Stillingiae FL, . . . . gv. 
 M. Sig. — 15 to 20 drops in water, thrice 
 daily. 
 
 R. Phosphori, gr. ss. 
 
 Ext. Nucis Vom., . . . . gr. vj. 
 
 Mas. Ferri Carbonat., . . gr. xl. 
 
 Ext. Gentianae, gr. xxx. 
 
 M. Ft. pil. no. xxv. Sig. — One pill 2 
 or 3 times daily. 
 
 Inflammation. 
 
 Aconite, is especially indicated in inflammation of the respiratory organs, in 
 the eruptive fevers, and all inflammatory states of high temperature and sthenic 
 reaction ; not in adynamic states, or continued fevers, except for hyperpyrexia ; 
 may be advantageously combined with Opium (B); gives most brilliant results 
 in many forms (R) : always indicated in early stages of simple inflammatory 
 fevers, in all inflammation of serous membranes, pneumonia, tonsillitis, acute 
 rheumatism, erysipelas, etc. ; is especially adapted to the uses for which bleed- 
 ing was formerly employed (P). Arnica, is antipyretic, large doses, ^ss of tinct., 
 in sthenic, small doses, rn^x, in asthenic inflammation (B) ; in inflammation of 
 serous membranes it has given good results (P). Belladonna, in many forms 
 no remedy more useful, notably scarlet fever, erysipelas, low fevers ; for inflam- 
 mation of the eyes, boils, carbuncles, etc., Atropine externally, Belladonna in- 
 ternally; when much fever, may be combined with Aconite (B) ; both locally 
 and internally in inflammation of the eye; is effectual in inflammation which 
 threatens to end in abscess (R) ; in erysipelas, inflammatory sore throat, 
 encephalitis, gouty and rheumatic inflammation, cystitis, pneumonia, etc. (P). 
 Gelsemium, especially for inflammation of lungs and pleurae, and in pneumonia, 
 ttlv-x of fl. ext. every two hours (B) ; in acute stage of gonorrhea is valuable 
 (P). Bryonia, exceedingly valuable in pleurisy and other serous inflamma- 
 tions, especially pericarditis ; after the aconite stage (P). Veratrum Viride, 
 when much delirium and arterial excitement, useful at beginning only (B) ; in 
 pneumonia, Veratrine is most valuable, also in acute rheumatism and generally 
 as an antipyretic (P). Tartar Emetic in frequent minute doses, gr. ^, renders 
 incontestable service (B); in pneumonia, tonsillitis, pleurisy, bronchitis, and 
 other inflammatory affections (R) ; gr. Ye, frequently repeated, has the power 
 of completely dissipating early local inflammations (Spender) ; quite as useful 
 in arresting local inflammations as Quinine is in malarial fever (Lawrie). Pul- 
 satilla, in acute and subacute inflammations with muco-purulent discharges, 
 
740 INFLAMMATION. 
 
 especially of eyes, ears, and nasal passages (P) ; also with Aconite in epididy- 
 mitis (Pf ). Mercury, in acute glandular inflammation of throat and neck, in 
 ileo-colitis, iritis, syphilitic inflammations of serous membranes, laryngitis (R). 
 Silver Nitrate, locally in strong solution, gr. clx to %) of distilled water, painted 
 over surface and beyond, after thorough cleansing and drying; no agent so 
 safe, powerful or efficacious in subduing external inflammation (Higginbotham) ; 
 a strong solution in Nitrous Ether is a most efficient application to check in- 
 flammation in superficial parts, as boils, felons, orchitis, synovitis, erysipelas, 
 erythema, eczema, etc. (B). Iodine, as liniment in vicinity of local inflamma- 
 tion to produce vesication (R). Sulphides, especially that of Calcium, gr. -^g-, 
 appear often to arrest suppuration ; after formation of pus they hasten matura- 
 tion and circumscribe inflammation ; in boils, abscesses, and deep-seated sup- 
 puration, they improve the condition and promote healing (R). Antipyrin, 
 Kairin, and other antipyretics (see under the title Fever). Alkalies, espe- 
 cially Ammonium and Potassium salts, are very valuable in the stage of exuda- 
 tion (B). Astringents, locally in inflammations of mucous membranes (R). 
 Lead, the Liquor Plumbi Subacetatis Dilutus as a soothing and astringent 
 application to inflamed and erysipelatous surfaces (Wa) ; to eczema and other 
 inflammatory diseases of the skin (Pf ). Digitalis, the German antipyretic, is 
 especially useful in pneumonia, bronchitis, rheumatic fever, and scarlet fever 
 (B) ; aconite safer and better (R) ; locally and internally Digitalis is useful in in- 
 flammations, especially those of the joints, of breast, erysipelatous and varicose; 
 a fomentation of a teasp. of the dried leaves in half a pint of boiling water, or 
 Z) of tincture to the same quantity of water, applied by flannels to the part, 
 will quickly subdue (Fairbank). Quinine, in peritonitis (Tr) ; is indicated in 
 most acute forms, unless objections occur (P) ; has power to arrest inflamma- 
 tion in formative stage ; with Morphine and in full doses, gr. xv-xx, may sup- 
 press many forms (B). Chloral, excellent when temperature is high, much 
 delirium ; gr. v every 3 hours (B). Opium, is important in most inflammations, 
 but especially those of serous membranes ; a full dose, gr. \i of Morphine, at 
 first, smaller doses after ; is especially curative in inflammation of intestines 
 and peritoneum, and in cerebro-spinal meningitis, arachnitis, etc. (R). Saline 
 Purgatives, valuable as part of the denutrition treatment, and to diminish 
 arterial tension (B). Salicylic Acid is antipyretic, especially in septicemic in- 
 flammation, and in acute rheumatism, erysipelas, pneumonia (B) ; Sodium 
 Salicylate more soluble (R). Colchicum, often exercises a happy influence 
 over certain acute inflammations, as bronchitis, conjunctivitis, etc., especially 
 if occurring in gouty subjects (P). Cocaine, locally in commencing inflamma- 
 tions of mucous surfaces, to constrict the blood-vessels of the part (R). Pilo- 
 carpus, gives good results in the exudative stage of pleuritis, iritis, keratitis, etc. 
 (B). Cold, by Ice in bags, or cold water, a very useful agent. Ice, in small 
 pieces in a bladder, applied to inflamed part (R). Water, cold and hot baths 
 and packing very useful in all inflammations (B). Alcohol, is constantly pre- 
 scribed, and is of value in low states, if symptoms after its administration are 
 ameliorated (B). [See under Fever.] Poultices, useful in many inflamma- 
 tory states, but often abused (B); to check formation of pus and assist in mat- 
 uration (R). Glycerin, as in Unna's Paste or Antiphlogistine, a very efficient 
 application in many forms of inflammation. Heat, by hot water, fomenta- 
 tions, etc., often much better than cold applications. Dry Heat, applied by 
 the Tallerman apparatus, of great value in tendinous inflammations, traumatic 
 synovitis, subacute rheumatism, etc. (W). Venesection, when the pulse is 
 hard, strong, full and frequent, a plethoric state of the system and great 
 intensity of morbid action ; if required, the earlier it is done the better 
 (Gross) ; Leeches very useful in many forms where sthenic reaction and ple- 
 thora ; value of bloodletting probably due to derivative and counter-irritant 
 effects (B) ; a remedy of great power for good or evil, now much neglected 
 (Wa) ; local bleeding by leeches, cups, scarification, etc., should generally be 
 preceded by some form of general depletion (Gross). Aliment, when no 
 inflammation of the digestive tract use milk and beef-tea alternately every 3 
 
INFLUENZA. 
 
 741 
 
 hours ; nt starches or fats ; in intestinal inflammation milk, eggs, animal 
 broths, oysters, fish, but all food must be used with great caution ; skim-milk 
 treatment (B) ; Cod-liver oil in many chronic inflammations, as of heart, lungs, 
 kidneys, etc. (R). [Compare the various titles, as Bronchitis, Pleuritis, 
 etc., also the list of Antiphlogistics on page 37.] 
 
 [See pages 578 and 580 for Liniment and Lotion formulae.] 
 
 R. Tinct. Aconiti, gj. 
 
 Tinct. Belladon., . . . . grj. 
 M. Sig. — Three or four drops in water 
 every hour. (B.) 
 
 R. Ammonii Chloridi, . . . . 5 v. 
 
 Acidi Acetici, 
 
 Alcoholis, aa £x. 
 
 Aquae, q. s. ad \ x. 
 
 M. et fiat lotio. Evaporating and dis- 
 cutient lotion. 
 
 R. 
 
 Antim. et Pot. Tart., . 
 Magnesii Sulph., . . . 
 Morphinae Sulph., . . 
 Ac. Sulph. Aromat., . 
 Tinct. Verat. Virid., . 
 Syr. Zingiberis, . . . 
 Aquae Destill., .... 
 M. Sig. — Tablesp. every 2, 4, or 6 
 hours. Antimonial and Saline Mixture. 
 
 (Gross.) 
 
 gr. ijss. 
 3ss. 
 
 5i. ss - 
 5 x. 
 
 Influenza. 
 
 Menthol, dissolved in Chloroform, as inhalation, to abort an attack of influ- 
 enza (see under Catarrh, Acute Nasal), is highly efficient as a prophylactic 
 (Wunsche) ; Menthol in 5 to 10 per cent, spray, is highly praised. Cocaine, a 
 4 per cent, solution snuffed up the nostrils or sprayed into them, is very efficient 
 in the early stage (R). Eucalyptus, the Oil, sprinkled on blotting-paper placed 
 around a large room, was considered an efficient prophylactic during the Lon- 
 don epidemic of 1891, and was much used in offices, shops, etc. Salol, and 
 Salipyrin, as internal remedies, were highly extolled during the epidemic of 
 1 891. Phenacetin, is used with great benefit, both as a prophylactic and a 
 remedy. Phenocoll, the Hydrochloride has been used with marked success in 
 epidemic influenza and for the neuralgic pains thereof. Acetanilid, 2, with Sali- 
 cylic Acid and Ammonium Bromide, each one part, forming the mixture called 
 Antinervin, was used with much success during the recent epidemic in Scotland. 
 Quinine, the Hydrochlorate, gr. viij daily as prophylactic, has specific action, 
 as shown by experience with hussars at Bonn during the epidemic of 1889-90 
 (Graeser) ; the Hydrobromate in 8 to 16 grain doses, if the fever is high (Huch- 
 ard) ; Quinine is used with benefit throughout the disease, and especially for 
 the neuralgic pains following the acute stage (Wa). Potassium Bicarbonate, 
 is more nearly specific than any other remedy ; gr. xxx with TTLxx of Glycerin 
 and Liquor Ammonii Acetatis ^ss, every three hours ; it prevents complications 
 when given in time and also prevents sequelae (Calvert). Sodium Salicylate 
 in doses of gr. v every half hour for six or eight doses, then every hour until all 
 pain has vanished, then every two hours for a day or two, is very efficient 
 (Parker). Ammonium Salicylate, is even better than the sodium salt ; add 
 Liquor Ammoniae Fort., 3j to Ac. Salicylic, gr. lxxx, to make an 8 ounce mix- 
 ture for tablespoonful doses (Id). Strychnine, for the underlying weakness and 
 depression, the real enemy to fight against in the grippe, Strychnine is the best 
 remedy we have (Huchard). Digitalin, crystallized, in dose of gr. ^, in grip- 
 pal pneumonia, in which, though the disease is in the lungs, the danger is to 
 the heart (Id). Sodium Benzoate, with Quinine and Caffeine (formula on next 
 page) in the simple form of grippe (Id). Ammonium, the Liquor of Ammonii 
 Acetatis, combined with Nitric or Chloric Ether, is often of great service (Wa). 
 Sanguinaria, is used with much benefit (Wa). Cimicifuga has been given with 
 much success (R). Camphor, in solution, hypodermically (formula on next 
 page), 2 to 4 times daily, with 3 to 6 of Caffeine and 2 or 3 of Ether, for grippal 
 pneumonia (Huchard). Camphoric Acid, in one dose of gr. xx-xxx, dry on the 
 tongue, not over 2 hours before the expected time for sweating, is remarkably 
 
742 
 
 INSANITY AND DEMENTIA. 
 
 efficient to prevent it. Agaricic Acid, gr. ^-/i by mouth, is efficient against 
 the sweating of influenza. Bismuth Salicylate, or Naphtol, Betol, Salol, or 
 Benzo-naphtol, as intestinal antiseptics, when such are required (Huchard). 
 Sulphurous Acid, by fumigation or inhalation, a few drops on boiling water, or 
 as a spray, often controls influenz^ (R). Benzol vapor, is a reliable pulmonary 
 antiseptic, and has been employed with very favorable results (Robertson). 
 Benzoin, the compound tincture, 3ss-j, inhaled from a pint of hot water fre- 
 quently (Da C). Tartar Emetic has been recommended strongly, but is too 
 depressant (Wa) ; has extraordinary power of aborting local inflammations, 
 especially those of the respiratory apparatus. [See under Inflammation.] 
 Spiritus Athens Nitrosi, in doses of 3j-jss, in any convenient vehicle, is a popu- 
 lar and efficacious remedy (Wa). Cubeb, gss or 3j doses of the tincture in l / z 
 glass of Linseed-tea thrice daily, for the subsequent cough, often curing like a 
 charm (R). Opium, best avoided in early stage, but later for the cough, with 
 Ipecac, gives great ease; Dover's powder, with Nitre and Lobelia, is a good 
 form (Wa). Potassium Nitrate, largely diluted as lemonade, 3j-ij in the course 
 of the day, proves highly useful (Wa). Boric Acid, as gargle, also borated 
 ointment or vaselin to the nasal cavities, and great care taken to maintain 
 a clean mouth ; antisepsis of the nose, mouth and pharynx is very important 
 and does much to prevent complications and perhaps broncho-pneumonia 
 (Plicque). Coca and Kola, the tinctures, a mixture of equal parts of each, for 
 the nervous depression (Id). Hot Fomentations, for the headache (R). Turk- 
 ish Baths, have been used with marked advantage (Wa). 
 
 R 
 
 R 
 
 . Quininae Hydrobromat., 
 
 Sodii Benzoat., 
 
 Caffeinse, aa gr. xxx. 
 
 M. et ft. pil. no. xxx. 
 
 Sig. — One pill thrice daily. {Huchard. 
 
 Ammonii Chloridi, . . . £jss. 
 
 Morphinae Sulph., . . . gr. ij. 
 
 Tinct. Sanguinariae, 
 
 Syr. Ipecac, . . . . aa^iv. 
 
 Mist. Glycyrrh. Co., 
 
 Aquae, aa^jss. 
 
 M. Sig. — Teasp. as required for the- 
 cough. Each dose has of Morphine Sul- 
 phate gr. T \. 
 
 R . Ext. Cimicifugae Fl. , . . J§ ss. 
 Tinct. Opii Deodorati, . 3]. 
 
 Syr. Tolutani, 5 x j- 
 
 M. Sig. — Teasp. every four hours. 
 
 R . Camphorae, g ijss. 
 
 01. Olivae (steriliz.), . . ^iij. 
 M. Sig. — 3 ss hypodermically twice or 
 thrice daily. (Huchard.) 
 
 R. Ext. Ipecac. Fl., . . . . gij. 
 
 Tinct. Opii Deodorati, . 3 iv. 
 
 Tinct. Aconiti, . . . . ^j. 
 M. Sig. — Five to ten drops every two 
 hours, for the bronchitis. 
 
 Insanity and Dementia. 
 
 Hyoscine, has strong power as a mental alterative ; is particularly useful in 
 that form of mental disturbance which renders the patient violent and abusive, 
 restless and domineering, a nuisance to every one who has anything to do with 
 him (Weatherly). Duboisine, gr. y^ to y 1 ^ hypodermically twice daily, is 
 highly efficient in the treatment of the mental excitability of the insane, induc- 
 ing quiet and refreshing sleep, and is not dangerous (Massant). Atropine, pro- 
 duced a permanent cure after bromides failed, in a case of periodic insanity 
 with delusions of persecution (Hitzig). Opium, especially Morphine, is injur 
 rious in mania, but is useful in melancholia and for climacteric and senile 
 cases. Chloral, does as much harm as good, is best suited to wildly maniacal 
 and erotic patients. Potassium Bromide, is almost discarded, except for epi- 
 leptic cases. Conium, is useful, sparingly, for noisy patients. Colchicum, for 
 gouty cases, which are numerous ; cure the gout, and you may cure the insanity. 
 Shower-bath, suitable for cases due to self-abuse ; the wet pack in the mania 
 of hystero-epilepsy. Stimulants rank high, next to quiet and absence from 
 home. Thyroid Extract, has been used with apparent benefit. Tonics and 
 Hypnotics, should be employed in cases requiring them. Food of good quality 
 
INSOMNIA. 743 
 
 is essential to the treatment. Kumyss, is an excellent food in hysterical dys- 
 pepsia and anorexia simulating that of insanity. Moral Treatment, is now suc- 
 cessfully carried out in many asylums, but is expensive, requiring a large staff 
 of trained attendants. With correct management from the start, nearly all 
 cases of insanity unattended by paralysis or physical decay may be cured 
 (Savage) ; this can be best administered in a well-conducted asylum or hospital 
 for the insane, where security and the prospect of recovery will be better than 
 in the best home ; the total abolition of any one plan of treatment in favor of 
 another would be a great mistake ; more than half of first attacks of insanity 
 are recovered from under good management, which is best attained under 
 the direction of persons trained in this specialty (H). Recently, efforts have 
 been made at the improvement of the condition of the insane by requiring 
 them to attend school daily, with remarkably good results. [Compare Deli- 
 rium, Hypochondriasis, Mania, Melancholia.] 
 
 Insomnia. 
 
 Chloral, is quite unrivaled, being the most direct and generally useful hypnotic 
 (B) ; acts best in cases of purely nervous type (Wa) ; in doses of 20 to 30 grains 
 is by far the best hypnotic for many forms of insomnia (R) ; is dangerous in 
 old drunkards, in whom the heart and vascular system have undergone fatty 
 and calcareous degeneration (B) ; in combination with Opium or Morphine it 
 acts splendidly in small dose, each ingredient intensifying the hypnotic action 
 of the other (Brodnax) ; children bear it well, especially when given with Pare- 
 goric. Chloralamid, 30 grains in Z] of whiskey or brandy, in simple or idio- 
 pathic insomnia, or that from nervousness, hysteria, chronic alcoholism, but 
 not when due to excitement or severe pain. Croton-chloral, is feebler than 
 Chloral and less toxic ; as a hypnotic Z) may be given (R). Dormiol, is a 
 mixture of Chloral and Amylene [see page 256]. Somnal, is a combination 
 of Chloral, Alcohol and Urethan, and strikingly efficient in the insomnia of 
 convalescence from acute disease (Myers). Paraldehyde, in doses of 5j-3ij, 
 one of the most efficient and safe hypnotics, being free from depressant action 
 on the heart and other unpleasant by-effects. Sulphonal, 1 5 to 30 grains in milk, 
 2 hours before effect is desired ; an admirable hypnotic in many cases, but its 
 efficacy decreases with use, and it is of no value in insomnia due to pain. Trional, 
 is markedly hypnotic and sedative, acts surely and promptly in the insomnia of 
 neurasthenia and organic brain affections ; is better than Sulphonal or Chloral in 
 many respects (Schultze). A mixture of Sulphonal and Trional, gr. x-xv of each, 
 is an admirable hypnotic, the latter producing early sleep and the former later 
 sleep. Tetronal, is somewhat less hypnotic than Trional, but more of a sedative; 
 the sleep from either lasts 6 to 8 hours, and is generally dreamless ; neither is 
 of any use when insomnia is due to pain. Potassium Bromide, when from 
 cerebral over-action, gr. xv before each meal, and gr. xxx on retiring ; has cumu- 
 lative effect (B). Opium, 15 to 20 minims of the tincture, or ]/$ to ^ grain of 
 Morphine, the most effective hypnotic when insomnia is due to pain ; in combi- 
 nation with Chloral (see above) smaller doses of each are efficient. Opiates 
 should be given so as to act at the natural time for sleeping (R). Codeine and 
 Narceine are hypnotic in proper doses. Apomorphine, gr. -^ hypodermically is 
 the average hypnotic dose, should be given when the patient is ready for bed ; 
 its action lasts from one to two hours, but it often starts the patient to a good 
 night's sleep (Douglas). Hyoscyamus, an effective substitute for Opium in 
 children, 3ij-^j of tinct. necessary, and without danger (B); when Opium dis- 
 agrees (R). Hyoscine, produces sleep after a brief period of excitement ; gr. -^ 
 of the hydrobromate hypodermically is excellent for the insomnia of the insane. 
 Duboisine, is even more calmative and hypnotic than Hyoscine, and is espe- 
 cially useful when high mental excitement exists ; gr. -^ to -fa or -fa hypoder- 
 mically, may be combined with gr. % to % of Morphine. Belladonna or 
 
744 
 
 INTERMITTENT FEVER. 
 
 Atropine, is hypnotic in some conditions, especially when prostration, low 
 arterial tension and contracted pupils. Ignatia, for sleeplessness from nervous 
 erethism, better than Morphine (Pf ). Gelsemium, in simple wakefulness (B) ; 
 and in that of drunkards, mania and over-excitement (R). Coffee, insomnia 
 from lowering of nervous power, and from chronic alcoholism (P). Sumbul, 
 30 to 40 minims of the tincture, with a little Chloric Ether, is very efficient in 
 the insomnia of chronic alcoholism (P). Tartar Emetic, with Opium, is effec- 
 tive when insomnia is due to cerebral congestion and when Opium stimulates 
 (B). Hypnal is credited with simultaneous hypnotic and analgesic action. 
 Methylal is an efficient hypnotic. Hypnone is of moderate hypnotic power, 
 but is said to be especially useful in the insomnia of acute alcoholism. 
 Urethan, a pure but mild and safe hypnotic, especially useful for children. 
 Pellotine, the alkaloid of Anhalonium Lewini, a Mexican cactus, is hypnotic 
 in doses of gr. ^ hypodermically (Jolly) ; gr. \ of the Hydrochlorate produced 
 dangerous collapse in one case (Langstein). Digitalis, is of great use as a 
 soporific in sleeplessness at night when drowsiness during the day, both symp- 
 toms depending on want of tone in the vessels (Br). Resorcin, produces 
 quiet sleep in general nervous excitability, and in the insomnia of typhus fever 
 and pulmonary tuberculosis. Ether or Chloroform, in full dose (R) ; may be 
 used by inhalation when other means of producing sleep have proved unsuc- 
 cessful. Phosphorus, when nutrition is inactive, and in the insomnia of the 
 aged (B). Humulus, a hop-pillow is said to be effective in many cases (P) ; 
 the tincture of Lupulin, 3ss-^ss, as a cerebral sedative. Cocaine has been 
 used with some success (Wa). Chamomilla, rr\j of the tinct. every quarter- 
 hour, an excellent sedative for children (Smith). Cannabin Tannate, in 8-grain 
 doses, a good hypnotic (Fronmiiller) ; very inefficient (W). Cannabis is very 
 uncertain in its action (R). Alcohol, if from cerebral anemia, a full dose of 
 whiskey or brandy ; in some a glass of ale or beer answers better (B). Water, 
 a tepid bath just before retiring often effective ; when head is hot apply cold 
 to it, and a tepid bath to the body (B). [Compare Nervousness ; also the 
 title Hypnotics, on page 54, and the sub-title Unofficial Analogues of Chloral 
 on page 255.] 
 
 R. Paraldehyde ,^ij ss - 
 
 Alcoholis (99 per cent.), . §jss. 
 
 Tinct. Vanillas, 3 ss. 
 
 Aquse^ - gj. 
 
 Syr. Simplicis, . q. s. ad % iv. 
 M. Sig. — A teasp. or two every hour 
 until sleep is obtained. 
 
 ( Yvoii's Hypnotic Elixir.} 
 
 R. Potassii Bromidi, . . . . ^iv. 
 
 Chloralis Hydratis, . . . giij. 
 
 Tinct. Asafcetidae, . . . . 3 iv. 
 
 Syrupi, gvj. 
 
 Aquae, . . . q. s. ad £vj. 
 
 M. Sig. — Tablesp. every 2 hours until 
 sleep is induced. In the insomnia of hys- 
 teria. 
 
 Intermittent Fever. 
 
 Quinine, as prophylactic, gr. v-x each morning in black coffee ; begin with 
 gr. v, add gr. j each week (R) ; in ordinary intermittents give 6 or 10 grain doses 
 up to 20 or 30 grains, so as to have it all in 4 or 5 hours before the expected 
 paroxysm ; give the Sulphate and in solution to get its full action (Da C) ; for 
 acute ague, gr. x in sweating stage, and the same dose 5 hours before next 
 paroxysm, also gr. x-xv at the septenary periods, until the third has passed ; 
 in pernicious form, gr. xx-xl are required, by stomach, rectum or skin, to 
 secure safety of patient ; best in combination with Morphine, and with con- 
 tinuous administration of Arsenic during intermissions ; may be given in solu- 
 tion by rectum, or hypodermically (R) ; is almost specific in intermittents when 
 uncomplicated and of recent origin (Wa) ; a fever fit, once begun, cannot be 
 cut short by quinine, and to give it during the early stages aggravates the 
 headache and general distress ; gr. x, preferably in solution, should be admin- 
 istered at the commencement of sweating, and thereafter gr. v every 6 or 8 
 hours for the next 2 or 3 days (Mn). Chinoidine may be used as a substitute 
 
INTERMITTENT FEVER. 745 
 
 for Quinine in doses twice as large (B). Cinchonine, Cinchonidine, Quinidine, 
 the Sulphates of these alkaloids are scarcely, if at all, inferior to Quinine as 
 therapeutical agents (Report of the Madras Commission). Cinchonidine Sali- 
 cylate, promises well as an antiperiodic (B). 
 
 Arsenic, the best remedy next to Quinine, especially useful in long-standing 
 agues"of quartan type (R); useful as adjunct to Quinine daily to prevent re- 
 lapse; with Iron, most important in chronic ague; also as prophylactic small 
 doses of Fowler's solution (B). Hydrastine, stands next after Arsenic ; indica- 
 tions same as for Quinine (B) ; in doses of gr. ij-ix is strongly recommended 
 (P). Tannic Acid, enjoys a certain reputation in malarial fevers which have 
 resisted quinine, and especially in hemoglobinuric fever (M) ; [see under 
 Hemoglobinuric Fever.] Pilocarpine, gr. }£ of the Muriate, in the cold stage, 
 is strongly recommended by high authority to excite profuse perspiration and 
 thus lessen the attack (Da C). Apiol, when prejudice exists against Quinine ; 
 gtt. xv during an hour, in divided doses, 4 hours before paroxysm (B) ; is one of 
 the minor remedies which often prove successful in mild cases (Wa). Salicin, as 
 substitute for Quinine, but inferior (B) ; grs. x-xl, in mild cases (P). Opium, as 
 Morphine, gr. l /6-% hypodermically, not only lessens the chill, but aids the 
 action of the antiperiodic ; is to be strongly urged (Da C) ; is useful in the perni- 
 cious variety in combination with Quinine (B). Capsicum, the resins of black 
 and red pepper, as adjuvants chiefly (B) ; promotes action of Quinine (Pf ). Nux 
 Vomica, has been used with success, but is now used as adjunct to Quinine 
 (B) ; good in convalescence (P) ; has antiperiodic value not inferior to that of 
 Quinine ; gr. ^ of Strychnine equals gr. j of Quinine Sulphate (Wa). Strych- 
 nine Arsenite, is an efficient remedy (see page 394). Methylene Blue, is effi- 
 cient, and has many advantages over Quinine, especially for very young chil- 
 dren (Ferreira). Chloroform, to prevent an impending paroxysm ; 3j-3ij of 
 the spirit before the chill, or by inhalation (B). Narcotine, gr. ij-v ter die, is 
 eminently antiperiodic ; no other drug, except Quinine, cures intermittents so 
 rapidly and surely, or with more freedom from disagreeable effects ( Wa) ; said 
 to be superior to Quinine (R). Nitric Acid, full doses every 4-6 hours (B). 
 Sodium Chloride, in large doses during the apyrexia, ^viij-xij, may occasion- 
 ally prove efficacious (Wa). Eucalyptus, during convalescence (B) ; has been 
 successfully used in treatment of ague, 3j-ij of a tincture (Wa). Carbolic Acid, 
 in 4-grain doses with Infusion of Ginger, cured a series of 8 cases which had 
 resisted Quinine (Wa) ; its value established ; ff\,ss-ij in mint-water or gr. % in 
 Tt^xx of water, hypodermically (Tessier) ; combined with Iodine is of great value 
 (B). Mercury, uncalled for in ordinary cases ; but Hydrarg. cum Creta, Qui- 
 nine and Rhubarb are of service in the obstinate intermittents of children in 
 tropical regions (Wa). Sodium Hyposulphite, gr. xv-xx every two hours, is 
 said to cure (R). Cascarilla, Chamomile, Quassia, are used (R). Gentian, is 
 valued chiefly as a vehicle (P). Ammonium Picrate, has proved wonderfully 
 effective in India, where 10,000 cases were treated therewith (Clark). Lemon, 
 in decoction, exceedingly efficient in preventing recurrence of the paroxysms 
 after they have been broken up by the use of Quinine (Crudeli). Emetics, 
 may cure many cases ; one each morning will assist the action of Quinine ; 
 Ipecacuanha preferred (R) ; only at commencement, inadmissible if gastric 
 irritation (Wa). Antimony, at the onset and continuously in mild, uncompli- 
 cated cases ; Tartar Emetic, gr. yi- l /e every 2 hours, has been followed by 
 complete cures (Moore). Guaiacol, locally to skin, as an antipyretic (see page 
 294). Antipyrin, is useless (Falkenheim). Resorcin, and similar agents, have 
 no specific action, merely controlling the pyrexia (Wa). Warburg's Tincture, 
 is a remedy of great power, but produces such severe diaphoresis as to be 
 dangerous to dynamic subjects (Maclean). Purgatives, in the intermission, 
 before using the antiperiodic, is good practice; Podophyllum, Colocynth or 
 Jalap (Da C). Iron, is valuable in chronic cases; the system should be thor- 
 oughly saturated with it (Da C). Ergot, for the enlarged spleen (Da C). 
 [Compare Hemoglobinuric Fever, Malaria ; also the List of Antiperiodics 
 on page 37.] 
 
746 
 
 INTERTRIGO INTESTINAL OBSTRUCTION. 
 
 R. Acidi Carbolici, gj. 
 
 Tinct. Iodi Comp., . . , giij. 
 
 M. Sig. — 4 drops every 4 hours in 
 sufficient water. (B.) 
 
 gr. xxxij. 
 
 R. Quininae Sulphatis, 
 
 Mucil. Acaciae, . . . 
 
 Syr. Eriodyctii Aromat. 
 (Parke, Davis & Co.), vel 
 
 Mist. Glycyrrhizse Co., vel 
 
 Velatine, . . . . q. s. ad ^ij. 
 M. Fiat emulsum. Sig. — A teasp. 
 contains gr. ij of Quin. Sulph. Suspension 
 of the Quinine without dissolving it makes 
 the bitter taste less perceptible (Squire), 
 and the syrup of Eriodictyon covers the 
 taste well. {Potter. ) 
 
 B 
 
 xl. 
 
 Quininae Sulphatis, . . . . gr. 
 Ferri Sulph. Exsiccat., . . gr. xx. 
 
 Acidi Arsenosi, gr. j. 
 
 M. Ft. pil. no. xx. Sig. — One pill 
 thrice daily. (B. ) 
 
 R . Quininae Sulphatis, 
 Capsici, .... 
 Opii Pulveris, . . 
 M. Ft. pil. no. xx. 
 
 pills as required. 
 
 Sig. 
 
 . gr. xxx. 
 
 . gr. xv. 
 • gr. iij. 
 -One to five 
 (Piffard.) 
 
 R. Massae Ferri Carb., . . . ^j. 
 
 Acidi Arsenosi, gr. j. 
 
 M. Ft. pil. no. xx. Sig. — One pill 
 thrice daily in chronic ague. (B.) 
 
 R. 
 
 Quininae Sulphatis, 
 Ac. Hydrobrom. Dil., 
 Aquae, 
 
 3J- 
 3 x1V. 
 
 M. Sig. — A teasp. contains gr. iij^ of 
 Quin. Sulph. The acid directed prevents 
 the unpleasant cerebral action. (B.) 
 
 R. Quininae Sulphatis, 
 
 Pulv. Acaciae, aagss. 
 
 Syr. Zingiberis,; giv. 
 
 M. Sig. — A teasp. contains one grain of 
 Quin. Sulph. A good formula for children, 
 the quinine being suspended, not dissolved. 
 
 R . Quininae Sulphatis, . . . gr. lxxx. 
 
 Ac. Sulphurici Diluti, . . q. s. 
 
 Spt. ^Etheris Nitrosi, . . . 55 iv. 
 
 Syr. Tolu, Aquae, q. s. ad ^ij. 
 M. Sig. — A teasp. contains gr. v. of 
 Quin. Sulph. {Da Costa.) 
 
 Intertrigo. 
 
 Acetanilid and Boric Acid, equal parts, dusted thickly over the surface, in 
 the intertrigo of infants or adults, separating the surfaces which rub by ab- 
 sorbent cotton (Brodnax). Bismuth, the Nitrate or Carbonate, as dusting pow- 
 der (R). Tannin, the glycerite, is excellent (P). Camphor, added to dusting 
 powders, to allay heat and itching (R). Lime-water, to obviate results of irri- 
 tating urine (R). Soap, with free ablution when intertrigo caused by acid se- 
 cretions ; use greasy applications afterwards (R). Boracic Acid, as ointment, 
 3jss to ^j of vaselin, a very useful application (Wa). Glycerin, with Traga- 
 canth, etc. [See under Herpes for formula.] Calomel, as ointment, Z] to ^j, 
 is especially useful (Wa). Zinc Carbonate, as Calamine, a good dusting pow- 
 der ; so also is the Oxide, or Fuller's Earth. 
 
 Intestinal Obstruction. 
 
 Opium, even ^ -grain doses every 4 hours, for 2 to 4 days, arrests dangerous 
 symptoms, and brings a painless purgation (Brinton, P). Morphine, endermi- 
 cally (Wa). Belladonna, often successfully employed (P) ; gr. %-}i every 
 few hours, when from want of tone and partial spasm (Tr). Strychnine, occa- 
 sionally beneficial ; cautiously in acute cases (Wa). Mercury, a full dose of 
 Calomel, followed in a few hours by Castor Oil and a Turpentine enema, af- 
 fords relief (Wa). Caffeine acts upon the muscular tissue and often proves of 
 the utmost value (Wa). Senna, the infusion, in doses of ^j-iij, is an efficient 
 purgative (Wa). Purgation to be refrained from (Brinton). Enemata, insuffla- 
 tion and surgical measures are often necessary. [Compare Constipation, 
 Intussusception, Hernia.] 
 
INTUSSUSCEPTION IRRITABILITY. 74/ 
 
 Intussusception. 
 
 Belladonna, gr. iv of the extract in enema, has been successfully used (Wa). 
 Opium, in full doses carried to narcotism, has been successful in many cases 
 (Wa) ; must be used freely to prevent inflammation (Macleod). Effervescent 
 Enemata, have been employed with success (B). Tobacco Enema, may over- 
 come, and has proved exceedingly effective, but is dangerous ; produces most 
 depressing nausea ; not safe to use more than ^iv of an infusion of 3j in Oj 
 (B). Inflation, of intestines with air (Hippocrates), seems a most reasonable 
 mechanical remedy. Irrigation, by hydrostatic pressure, is resorted to with 
 success ; requires care and gentleness (B) ; hot water (Wa) ; ox-gall, gr. x-xxx 
 in the solution used, is especially efficient in cases arising from partial paresis 
 of the bowels (Hawkins) ; the knee-chest position is the best during irrigation 
 or inflation. [Compare Hernia, Typhlitis.] 
 
 Iritis. 
 
 Belladonna, locally and internally (R) ; ir^v every 3 hours, also as lotion, 3j 
 of extract to ^iv aquae, is of great value (P). Atropine, solution, gr. iv to the 
 ^, has a wide field of utility as a mydriatic (B) ; should never be omitted (C) ; 
 is essential in the treatment of every form, should be applied early in the case 
 and persevered in throughout its continuance (Lawson). Mercury, when of 
 syphilitic origin, as it usually is (B) ; the Bichloride is of great service (R) ; in 
 plastic iritis of original severity, or in cases aggravated by improper treatment, 
 Mercury is imperative, gr. ij of Blue Pill twice a day, until blue line appears on 
 gums(C). Aurum, the Bromide of Gold, Arsenic and Mercury has been admin- 
 istered with evident advantage (E. A. Wood). Duboisine, as substitute for 
 Atropine, is more rapid for effecting dilatation, less irritating to the conjunctiva, 
 and has less permanent after-effects (B). Turpentine, in so-called rheumatic 
 iritis is very successfully used ; small repeated doses (P). Opium, when 
 much pain, an indispensable adjuvant, or Morphine hypodermically (C). 
 Copaiba, gij in mucilage, thrice daily, gives excellent results in iritis and 
 sclerotitis, diminishing pain in 24 to 48 hours and restoring sight (Hall). Quinine 
 and Iron, when the patient is feeble or anemic. Irritants or astringents 
 should never be employed (C). Surgical, paracentesis when increased ten- 
 sion, corelysis when only one or two adjacent adhesions; iridectomy; com- 
 plete functional rest to the eyes, by Atropine and a bandage with compression 
 pad, an absolute necessity during the whole period of treatment (C). [Com- 
 pare Syphilis.] 
 
 R. Hydrarg. Chlor. Corr., . gr. j. 
 
 Potassii Iodidi, 5jj. 
 
 Tinct. Calumbae, . . . . ,^ij. 
 Aquae Destil., . q. s. ad ^vj. 
 M. Sig. — A dessertspoonful, in a wine- 
 glass of water, 2 or 3 times daily. 
 
 {Lawson.} 
 
 R. 01. Terebinth., giij. 
 
 Syr. Acaciae, ,^j ss « 
 
 Aquae Cinnamomi, . • ifss. 
 M. Sig. — Teasp. 4 times daily. 
 
 R . Extracti Belladon., . . . gj. 
 Ung. Hydrargyri, . . . . ^vj. 
 M. Sig. — For inunction to brow. 
 
 Irritability. 
 
 Ignatia, in small doses diminishes, in large doses excites irritability of cere- 
 brospinal axis; the remedy^?' excellence (Pf). Chloral, gr. v, 2 or 3 times a 
 day, in irritability with nervousness and restlessness (R). Chamomilla, is an 
 excellent sedative for children, in doses of rr\J of the tincture every % hour 
 (Smith). Opium, gives calm to the nervous system if used in medium doses. 
 Strychnine, in functional irritability of the nervous system. [Compare Insom- 
 nia, Nervousness. I 
 
74-8 JAUNDICE — JOINT AFFECTIONS. 
 
 Jaundice. 
 
 Salol, is one of the most efficient remedies in catarrhal jaundice. Mercury, 
 in attacks with depression, sickness and coated tongue, gr. l /6-yi of Gray Pow- 
 der taken at onset, and repeated three or four times a day, very valuable (R) ; 
 as purgative in jaundice from both deficiency and excess of bile, singularly 
 enough (B) ; Gray Powder with Ipecac, followed next morning by Castor Oil, 
 is well adapted to the jaundice of infancy and childhood (Wa) ; Mercurials 
 and Podophyllum are better avoided, especially in obstructive jaundice, unless 
 very marked indications for them exist (Da C). Celandine, was formerly 
 employed as a deobstruent (P) ; energetically affects the liver (Pf). Hydrastis, 
 useful if continued for some time, in jaundice from catarrh of ducts (B). 
 Arsenic, used with success in jaundice from catarrh of bile ducts after catarrh 
 of duodenum ; better for jaundice of malarial origin (B). Nitro-Hydrochloric 
 Acid, internally, and acid bath to right hypochondrium ; temperature of bath 
 96 , Jiij to gall, j (B); when jaundice depends on torpor of the liver, oris 
 catarrhal in origin (W) ; during convalescence, rr\,v-x of the dilute acid in Z] 
 of a compound elixir of Taraxacum before each meal (Da C). Quinine, when 
 due to malaria, or when periodic (B). Euonymin, an hepatic stimulant of 
 especial power (B). Podophyllum, in catarrhal and malarial jaundice (B); 
 when stools exhibit no trace of bile, one dose has cured (Wa) ; is best 
 avoided, unless markedly indicated (Da C). Sodium Phosphate, no remedy 
 superior in jaundice from catarrh of gall ducts ; 3j doses every four hours for 
 adults ; gr. x-xx for children (B). Manganese, in jaundice from malarial origin 
 or catarrh of biliary passages (B). Aloes, for simple jaundice of an atonic 
 kind(B); when hypochondriasis (P). Rhubarb, for the above maladies in 
 children, white or clay-colored pasty stools, skin jaundiced (B). Saline Pur- 
 gatives, as Rochelle salt, to depurate the upper bowel ; with alkaline baths, 
 diaphoretics and diuretics (Da C). Ammonium Iodide, gr. j-iij in water every 
 2 or 3 hours in catarh of bile ducts and jaundice; also Ammonium Chloride, 
 with fluid extract of Taraxacum (B) ; in 20-grain doses every 4 hours, pro- 
 duces a decided change (Wa). Stillingia, relieves jaundice and torpid liver 
 following intermittent fever (B). Dulcamara, employed with advantage (P). 
 Iris, in malarial jaundice and that from duodenal catarrh (B). Alkaline Min- 
 eral Waters, especially in catarrh of duodenum or bile-ducts (B). Potassium 
 Salts, the Chlorate in chronic or asthenic jaundice; the Sulphate the most 
 useful saline purgative in jaundice (Wa). Aliment, no starches or fats ; use 
 milk, eggs, oysters, beef broth, broiled or raw beefsteak, or whitensh (B) : plenty 
 of green vegetables at each meal ; use cold water freely, avoid high seasoning 
 in food and all liquors. [Compare Calculi, Hepatic Cirrhosis, Hepatic 
 Diseases.] 
 
 Joint Affections. 
 
 Phenacetin, for the pyrexia of polyarthritis ; is efficiently antipyretic and safe. 
 Aconite, for pains in inflamed joints (R) ; the liniment locally in chronic arth- 
 ritic swellings (Wa). Mercury, the oleate in chronic inflammation of the knee 
 (R) : Ung. Hydrarg. Ammoniat., diluted, 1 to 4 at first, then 1 to 8, by gentle 
 friction 2 or 3 times daily, in chronic articular inflammations, by far the best 
 application (P). Rhus Toxicodendron, internally and as lotion, is invaluable 
 for subacute stiffness and aching of joints after acute rheumatic fever (P). 
 Iodine, 3iij-yj ad Glycerini ^iij, Aq. destil. ^iv, in numerous obstinate cases 
 of joint affections consequent on rheumatism (Wa). Ferrous Iodide, with 
 Iodine, locally, in scrofulous affections of the bones and joints (Wa). Iodoform 
 has been used with satisfactory results, in scrofulous affections of the joints and 
 bones, by many continental authorities (Wa). Salicylic Acid, 3) with 3'iv of 
 Lanolin, and Ol. Olivas, q. s. to make a paste, applied locally and covered with 
 cotton, or rubbed in once daily for 3 or 4 days, then omitted for a week, and 
 
KERATITIS LABOR. 
 
 749 
 
 again renewed, is of proven value in many obstinate cases of stiff knees, pains 
 from so-called rheumatism, painful ankle and wrist joints, etc. (Aulde). 
 Arsenic, often serviceable in rheumatoid arthritis and nodosities of joints ; large 
 doses continued are necessary (R). Alcohol, and water, equal parts, an excel- 
 lent evaporating lotion (B). Silver Nitrate, a strong solution in Nitrous Ether is 
 the most efficient application to check inflammation in small joints if applied 
 early to adjacent vascular parts (B). Cod-liver Oil, in strumous subjects (R) ; 
 the remedy on which most reliance may be placed in scrofulous joint affections 
 (Wa). Cold Douche, Galvanism, Turkish Baths, for stiff joints (R). Digitalis, 
 as fomentation, 3j of tincture to 0% boiling water, applied on flannel, has 
 proved very efficient in acute inflammations of joints (Fairbank). Turpentine, 
 the liniment a serviceable application in chronic enlargement of the joints 
 (Wa). Sulphuric Acid, as irritant ointment, 3j of acid to ^j of lard, very bene- 
 ficial in chronic diseases of joints (Wa). [Compare Arthritis, Bursitis, 
 Coxalgia, Gout, Rheumatism, Synovitis.] 
 
 Keratitis. 
 
 Atropine, renders great service by contracting the vessels (B) ; by instillation, 
 with enforced disuse, and a protective bandage, should be regarded as meas- 
 ures of course (C). Mercuric and Ferric Chlorides, with Cod-liver Oil, will 
 accomplish all that medicine can do for interstitial keratitis in syphilitic sub- 
 jects (C). Calcium Sulphide, proves most useful in doses of gr. -^ to % , thrice 
 daily, in sugar-of-milk trituration (Snell). Arnica, Potassium Iodide or Bro- 
 mide, Iron, Quinine, for their constitutional effects in vascular keratitis ; also 
 counter-irritation by Iodine painted on the temples until soreness (C). Ferric 
 Chloride, successfully employed in panniform keratitis ; a large drop of the 
 solution dropped from a quill every second or third day (Wa). Physostigmine, 
 lowers intra-ocular tension (B). Astringents or Irritants, as Alcohol in any 
 form, Zinc Sulphate, Silver Nitrate, etc., are entirely inadmissible (C). Iridec- 
 tomy, is often beneficial in severe vascular keratitis (C). Pressure-Bandage, 
 in severe suppurative forms, limits extent. Water, cold when inflammatory 
 symptoms marked ; hot, 90°-ioo° F., in non-inflammatory form, to excite in- 
 flammatory reaction ; should be discontinued when marked injection occurs. 
 [Compare Corneal Opacities.] 
 
 R . Hydrarg. Chlor. Corros. 
 
 Ammonii Chloridi, . . 
 
 Tinct. Belladonnse, . . 
 
 Aquae Destillatse, . . . 
 
 M. et fiat collyrium. 
 
 gr. J- 
 gr-.vj. 
 
 % viij. 
 
 Sig. — A teasp. in a winegl. of tepid 
 water, to be applied frequently with a 
 pledget of lint on the closed lids. In 
 phlyctenular keratitis of children. 
 
 ( TurtibulL ) 
 
 Labor. 
 
 Ergot, only when uterine inertia, and after the first stage has passed ; is 
 dangerous if any obstacle in front ; dangerous to child by paralysis of fetal 
 heart (B) ; is best given when the head has passed the brim of pelvis (Wa). 
 Anesthetics, in protracted and painful labor ; cautiously with primiparse (B) ; 
 increase the risk of post-partum hemorrhage (W). Chloroform, not to com- 
 plete anesthesia, lest uterine action be interrupted; usually begin its inhalation 
 when os is dilated (Simpson). Chloral, of great value to relieve pain ; does 
 not interfere with the exhibition of chloroform; should be given in 15-grain 
 doses every ^-hour till effect produced (Wa) ; the best of all remedies for rigid, 
 undilatable cervix, gr. xv every 20 minutes for 3 doses, perhaps a 4th after an 
 hour's interval (Playfair). Ethyl Bromide, a rapid, sure and safe anesthetic, 
 particularly suited to labor cases (Levis). Opium, facilitates dilatation, pro- 
 motes expulsive power of uterus, lessens hemorrhage, stimulates longitudinal 
 and oblique fibres of the os (Wa) ; a full dose of Morphine, gr. % , in tedious 
 
750 LACTATION. 
 
 labors, with severe pains, will aid patient greatly and promote progress of the 
 child ; no bad results ensue ; for relief of pains and after-pains, or painful com- 
 plications (Wa) ; hypodermically in rigid os and cervix (R). Cimicifuga, exercises 
 special action, similar to that of Ergot; is less dangerous to life of child and 
 soft parts of mother (Wa) ; for mental disturbance and suppressed lochia (R) ; 
 as partus accelerator in lieu of Ergot, also to allay nervous excitement after 
 labor, and to check post-partum hemorrhage (P). Belladonna, topically to 
 uterus of great service in long-protracted labors from rigidity of os and cervix 
 (H). Gelsemium, quiets the nagging pains of the first stage ; requires physio- 
 logical doses (B) ; relaxes spasm in rigidity of the os (Wa). Acetanilid, eases 
 pain and brings on profuse sweat which helps to relax muscular rigidity (Brod- 
 nax). Quinine, to strengthen uterine contractions ; used by many in place of 
 Ergot (R). Cannabis Indica, the tincture gtt. xxx, as stimulant to uterine con- 
 tractions, more prompt, less lasting, than Ergot (Wa). Ipecacuanha, after de- 
 livery ; to promote natural functions (R). Cotton-root, as excitant of uterine 
 contractions, may be more energetic than Ergot (P). Althaea, the decoction, 
 as vaginal injection in difficult labor (P). Sodium Borate, excites activity of 
 the uterus, and is well employed in tedious labor, where there is deficiency of 
 uterine action (Rigby). Amyl Nitrite, has acted admirably in a case of hour- 
 glass contraction of the uterus; seems to antagonize the action of Ergot 
 (Barnes). Oil of Eucalyptus is very valuable in effecting antiseptic midwifery 
 (Wa). Mercury, the Bichloride, gr. vijss to a quart of hot water gives a -^o^ 
 solution ; probably the worst of all antiseptics for this purpose ; is too danger- 
 ous for obstetrical use (Fleischman). [Compare Abortion, After-Pains, 
 False Pains, Hemorrhage Post-Partum, Lactation, Puerperal Con- 
 vulsions, — Mania, — Fever, — Disorders.] 
 
 Lactation. 
 
 Pilocarpine, as a galactagogue, gr. l /% in brandy on retiring, the patient to be 
 covered well in bed ; is efficient in direct proportion to its diaphoretic and sialo- 
 gogue effects, these being evanescent, but its galactagogue power remains 
 for weeks, an occasional dose only being required to spur up the secretion 
 when flagging (Minges) : is a galactagogue, and probably the only example of 
 this class we possess (M). Antipyrin, is an anti-galactagogue, 4-grain doses 
 every 2 hours have proven highly efficient. Belladonna, internally or 
 externally or both, in excessive lactation (R); Atropine gr. iv to ^j Aquae 
 Rosae on lint around the breast to arrest secretion of milk ; remove when 
 fauces become dry and pupils dilated (B). Camphor, locally to arrest the 
 secretion; a saturated solution in Olive Oil or Glycerin, is more efficient than 
 Belladonna (Wa). Potassium Iodide, in 25 to 30 grain doses internally, for 
 the same purpose, is very effectual (Rousset). Calcium Phosphate and Hypo- 
 phosphite, in debility from over-lactation (R, Wa). Ammonium Chloride, for 
 the intercostal neuralgia of nursing women ; gr. x-xx, every 3 or 4 hours (Wa). 
 Quinine, Tannin, are used to arrest the secretion (R). Alcohol, as beer or 
 porter, often useful for women weakened by suckling — not always (R). [Com- 
 pare Abscess, Agalactia, Mastitis, Nipples, also the List of Galactagogues 
 on page 52.] 
 
 Excreted in the Milk, when taken by the nursing women are : the Oils of 
 Anise, Cumin, Dill, Wormwood and Garlic, Turpentine, Copaiba, the active 
 principles of Rhubarb, Senna, Scammony and Castor-oil, Opium, Iodine, 
 Indigo, Antimony, Arsenic, Bismuth, Iron, Lead, Mercury and Zinc. Acids 
 given to the mother cause griping in the child. Natural salts, as a rule, and 
 the purgative agents above-named, act as purgatives to the child, and Potas- 
 sium salts as diuretics. Turpentine, Copaiba and Potassium Iodide given to 
 the mother, can be detected in the urine of the child. Opium given to the 
 mother may narcotize the child, and Mercurials in the same manner may sali- 
 
LARYNGISMUS STRIDULUS LARYNGITIS. 
 
 751 
 
 vate it (Br). Atropine, Hyoscyamine, the Salicylates and Potassium Sulphide, 
 have been found in the milk after their ingestion by the woman. 
 
 R. Tinct. Aconiti, TT^xx. 
 
 Antim. et Potass. Tart., . gr. ij. 
 Spt. yEtheris Nitrosi, 
 Syr. Simplicis, .... aa^j. 
 Aquae Aurantii Flor. , . . % ij. 
 
 Misce. Sig. — A teaspoonful in a wine- 
 glassful of sweetened water, every two 
 hours, for milk fever. {Fordyce Barker.) 
 
 Laryngismus Stridulus. 
 
 Aconite, checks the spasm and relieves the croupous breathing (R). Anti- 
 pyrin, has proven very serviceable. Belladonna, promises to be of value (Wa); 
 Atropine, gr. jfo in a goblet of water (60 doses), of which a teasp. every hour 
 or ^-hour will give prompt relief (Smith). Bromides, when uncomplicated 
 except with convulsions (R) ; full doses will suspend an attack, and moder- 
 ate doses steadily continued will prevent recurrence (B). Ipecacuanha, an 
 emetic dose to cut short an attack (B). Lobelia, has been employed (R). 
 Chloroform, quickly cures the paroxysm, a few drops on a handkerchief suffi- 
 cient (B) ; may often be used with advantage (W). Nitroglycerin, will speedily 
 allay the spasm (B). Chloral, gr. v-xv to prevent or arrest (B). Quinine, 
 given between attacks to prevent (B) ; a most valuable remedy, in small, 
 repeated doses (P). Emetics, Tartar Emetic ; Mercuric Sulphate, gr. iij-v, safer 
 and better (R). Conium, is valuable, carried to a point of physiological effect 
 (B). Water, wet pack to neck (B) ; cold sponging twice or thrice daily more 
 successful than anything else, with out-of-door exercise ; cautiously if hoarse 
 voice indicates laryngitis (R). [Compare Croup, Laryngitis.] 
 
 Laryngitis, Acute Catarrhal. 
 
 Aconite, very valuable (R) ; especially indicated in inflammatory states of 
 respiratory parts ; gtt. ss-j every half-hour till an impression is made on the 
 fever, then every hour or two (B). Antimony, Tartar Emetic, gr. Jjj, a very 
 excellent remedy internally ; larger doses in edematous laryngitis, gr. T ^ with 
 gr. iij of Dover's powder every 2 or 3 hours (Da C). Iodine, inhaled, also as 
 counter-irritant painted over neck (B). Morphine, small doses to allay cough 
 (A). Sulphurous Acid as spray is vaunted (Wa). Leeches to throat are valu- 
 able auxiliaries to general treatment in sthenic cases ; or cupping at the nape 
 of the neck (Wa). Rumex, has selective action on the laryngeal mucous 
 membrane (see page 459). Zinc or Copper Sulphates, as emetics, in large 
 quantities of warm water, where edema slight (A) ; a solution of Zinc Sulphate, 
 gr. xx to the ^ on sponge to larynx with aid of the laryngoscope if possible to 
 use it (Da C). Scarification, by Mackenzie's laryngeal lancet, of great service 
 in the edematous form (Da C). A Purgative and Diaphoretic, with mucilagi- 
 nous drinks, if given at the start may be sufficient (Da C). Iron, Monsel's 
 solution, 1 part to 2 or 3 of water and glycerin, an excellent local application 
 (Da C). Heat, by poultices or fomentations (A) ; hot-water stupes may suc- 
 ceed (Wa). Inhalations of hot steam, with Benzoin, the comp. tinct. gtt. x-xv 
 to the %, with gtt. x Tinct. Opii, or Hops, or Conium, of great service (Da C). 
 Tracheotomy ought not to be delayed, if inhalations, leeches, and fomenta- 
 tions fail (Wa) ; is especially indicated in sudden attacks of edematous 
 laryngitis, as those occurring in Bright's disease (Da C). Ice, steadily applied 
 in bags over the larynx, if tracheotomy refused, has succeeded in bad cases ; 
 small pieces may be slowly swallowed (Da C). [For Croupous Laryngitis, 
 see Croup membranous; for Spasmodic Laryngitis, see Croup catarrhal; 
 for Edematous Laryngitis, see Glottis edema of. Compare also Laryngis- 
 mus stridulus, Pharyngitis.] 
 
752 LARYNGITIS. 
 
 Laryngitis, Chronic. 
 
 Iodine, painted over neck as a counter-irritant, and inhalation of its vapor 
 (B). Sulphur, as Sulphurous Acid by spray in syphilitic laryngitis, or a 
 solution of Sodium Sulphite, Z] to the j§ of water (B) ; by inhalation, spray, 
 or fumigation (R). Carbolic Acid, where long-standing hyperemia with 
 diminished secretion, 3j-ij to the ^ of glycerin is a most successful application 
 (Mackenzie). Silver Nitrate, powdered or in solution to chronically inflamed 
 larynx (R) ; a solution of gr. x or xx to the ^, applied with a brush by the 
 aid of the laryngoscopic mirror (W) ; formerly much used, but is objectionable 
 (B) ; should be used with great caution, and only when a particular point can 
 be seen for it with the laryngoscope (Da C). Ferric Chloride, a solution of 3j- 
 ij in the % of glycerin, as a local application (A). Zinc Chloride, gr. xx-xxx 
 to the 3j of glycerin ; alternation of topical remedies is of great value (A). 
 Copper Sulphate, gr. xx to the ^ of water, locally twice a week (Da C). Bis- 
 muth Subnitrate, by insufflation, is highly recommended in the worst forms of 
 laryngitis (Tr). Guaiacum, as lozenges, is useful in mucous laryngitis (A). 
 Althaea, as pectoral lozenzes to relieve laryngeal irritation (P). Cubeb, the 
 berries chewed are very efficient in relaxation of the larynx following a cold or 
 prolonged speaking (Wa). Cocaine, a 20 per cent, solution by spray, mop, or 
 brush, is efficient in many laryngeal affections (James). Benzoin, in strum- 
 ous laryngitis (Wa) ; in chronic, Benzoin on hot coals, or inhaled from boiling 
 water, is of great service (Tr). Tannin, in chronic catarrh and ulcerations, a 
 solution, gr. x-xx to ^iv, applied by hand-ball or steam atomizer (A). Inhala- 
 tions, or spray, of the best agents, very grateful (B) ; air loaded with vapors of 
 Ammonium Muriate by inhaler, said to be used successfully (W) ; vapors from 
 boiling Tar, Turpentine, etc., placed on hot water, or better by steam atomizer 
 (Da C) ; Chloroform, Hops, Benzoin, etc., by atomization (Walker). Insuffla- 
 tion, substances to be in small quantity, mixed with some bland powder (B). 
 Functional Rest of the voice often requisite, especially in phthisical and syphilitic 
 laryngeal ulceration (A). Chronic Laryngitis, includes many disorders of the 
 larynx, which of late years have been differentiated as thickened vocal cords 
 (chronic laryngitis proper), laryngeal ulcers, polypi, cysts, cauliflower growths, 
 tubercular and syphilitic laryngitis, etc., in all the voice being similarly affected. 
 Dysphagia, as a concomitant symptom is indicative of tubercular laryngitis 
 (Da C). [Compare Cough, Dysphagia, Syphilis.] 
 
 Laryngitis, Tubercular. 
 
 Cocaine, as pastilles or by insufflation, to relieve pain and dysphagia, espe- 
 cially when much ulceration or perichondritis present ; in the later stages its 
 use prolongs life. Resorcin, a strong solution locally, is very beneficial in 
 tuberculous and other ulcerations of the larynx (Tymowski). Zinc Sulphate, 
 in solution mixed with a 1 or 2 per cent, solution of Cocaine, in the early catarrhal 
 stage (Neumann). Silver Nitrate, in powder or solution locally (R). Bismuth 
 Subnitrate, by insufflation is highly efficient (Tr). Iodoform, in large insuffla- 
 tions has surprising anodyne effect when extensive tubercular ulceration exists 
 (Neumann). lodol, and Boric Acid, equal parts, by insufflation, in less severe 
 cases (Id). Antitoxin, Paquin's serum has produced good results (Loeb). 
 Menthol, is of great value, relieves pain and is claimed to destroy the local de- 
 posits ; a solution of 1 in 10 of pure olive oil brushed freely over the part daily, 
 a solution of 1 in 5 being used after the first week. Lactic Acid, is reported by 
 many authorities as highly successful, even curative ; a solution of 30 per cent., 
 gradually increased to 75 per cent., brushed over the affected surface after 
 swabbing with Cocaine, or a few drops injected into the larynx by a laryngeal 
 syringe ; is excellent, lasting good results having been obtained thereby 
 (Whitla). Scraping the ulcerated spots before applying lactic acid, done by me 
 
LARYNGOTOM Y LEPROSY. 753 
 
 in 200 cases with 28 cures (Ehring). Tracheotomy, where deep and extensive ul- 
 cerations exist beyond the reach of local treatment. Diet, thick liquids are more 
 easily swallowed than thin ones, and if the patient lies on a couch or bed with 
 his head hanging down over the side while swallowing, this is rendered easier 
 (Wolfenden) ; feeding should be done by the soft rubber tube when much dys- 
 phagia exists which does not yield to cocaine. Dysphagia, as a constant symp- 
 tom of chronic laryngitis is indicative of the tubercular form (Da C). 
 
 Laryngotomy. 
 
 Laryngotomy is more quickly and easily performed on the adult than trache- 
 otomy, being further from the lungs and less dangerous. It is usually directed 
 to be performed by cutting longitudinally through the skin, then horizontally 
 through the crico-thyroid membrane, which may be felt as a soft depression, 
 an inch below the pomum Adami. In urgent cases, however, Professor Wood 
 recommends a narrow-bladed knife to be passed horizontally through both 
 skin and membrane at once, and then to enlarge the opening laterally to the 
 required extent. The advantage of having a horizontal incision in the skin is 
 the greater openness of the wound when the patient throws up his head under 
 a sense of dyspnea (D). In Laryngo-Tracheotomy, the deep incision is 
 carried downwards from the crico-thyroid membrane, through the cricoid carti- 
 lage and one or two upper rings of the trachea (CI). 
 
 Leprosy. 
 
 Anacardium Orientale, Oil of Cashew, has been much lauded ; investiga- 
 tion established that much of its success was due to hygienic measures and 
 use of fresh meat as food (P). Arsenic, with 5 or 6 times the quantity of black 
 pepper, in esteem in India (Wa). Sarsaparilla, as tonic and alterative is valu- 
 able (P). Gurjun Balsam, Wood Oil, as ointment and emulsion, has been 
 used with success in alleviating the disease, by Dr. Dougall, Port Blair, Anda- 
 man Islands ; the ulcers of 24 lepers healed thereby. Ferri Arsenas, gr. £ 
 daily, is used with success (Wa). Mercury, the Oint. of the Red Iodide, diluted 
 1 to 10, or gr. j of the salt to £v of unguentum, gives very good results (Wa). 
 Europhen, 5 per cent, in oil, cured a case some years ago on the Island of 
 Madeira (Goldschmidt). Chaulmoogra Oil [see page 252], is credited with a 
 few cures and many cases improved ; the oil is mixed with Psoralea corylifolia 
 as a liniment, and is also used internally (Wa). Hoang Nan, is considered of 
 utility by a number of writers on leprosy, and is given in combination with 
 Alum 1, Realgar 2 or 1, and the drug 2 parts, the whole being made into 3- 
 grain pills, one pill daily being given at first and gradually increased (Pf). 
 Argenti Nitras, is said to act as a tonic and alterative, and to control leprosy 
 for a limited period (Pf). Ichthyol, used internally in increasing doses, with 
 vigorous rubbing of the arms and legs twice daily with a 10 per cent, oint- 
 ment of Pyrogallic Acid in Lanolin, and the cheeks and trunk with Chrysaro- 
 bin, 10 per cent, in Lanolin, also applying to the forehead and chin a plaster 
 of Chrysarobin, Salicylic Acid and Creosote, changed every day. This treat- 
 ment, continued for a month, and followed by a course of warm baths before 
 being resumed, has cured several cases (Unna). Sodium Salicylate, in doses 
 of gr. xv four times a day, gradually increased for six months or a year, 
 if commenced early in the disease, sometimes effects a cure (Danielssen). 
 Thyroidin, caused marvelous improvement in a case of nerve leprosy during 
 3 years of its use (Mn). Goto Treatment, consists in bathing daily in hot 
 water in which are placed bags containing hichiyon bark, taifunshi, sulphur and 
 yoku yaku ; internally are given seiketsuren pills, tincture of the chloride of 
 iron, quinine, strychnine, potassium iodide, gentian, columbo, carbonate of 
 soda and potash, and Epsom salts (Alvarez) ; but proof is lacking that cure has 
 48 
 
754 LEUCOCYTHEMIA LEUCORRHEA. 
 
 been obtained in any case (Emerson). Toxins and Antitoxins, are being tried 
 in various payts of the world, but are not trustworthy, as the bacillus has never 
 been cultivated and animals are quite refractory thereto (Goldschmidt). Diet, 
 nutritious food, with frequent baths and great cleanliness, will do much to pre- 
 vent the manifestations of the disease (R). 
 
 Leucocythemia — Leukemia. 
 
 Arsenic, in as full doses as can be borne, may be of service, though hitherto 
 ineffectual (Gowers) ; produced rapid improvement in a severe case, conjoined 
 with Oxygen inhalations, 5 minims of Liquor Arsenicalis being given thrice 
 daily, increased by 2 minims every 4 or 5 days until the dose reached 45 
 minims (Fred'k Taylor) ; is of the greatest value and great improvement has 
 resulted from its use in many cases (Muir). Oxygen, 30 litres by inhalation 
 daily with the conjoined use of Arsenic, has been successful in the early stages 
 in some cases, but in many it has failed (Muir) ; 4 litres daily for 2 months 
 cured one case, the spleen being of normal size after the treatment (Koster). 
 
 Alkaline Hypophosphites, have been used with more or less benefit (Wa). 
 Digitalis, in young subjects (B). Nitro-muriatic Baths, should not be neglected, 
 with tonics and nutrients (A). Iron, is of little value (B) ; large doses may do 
 good in the early stage, with careful diet, and Ergot to contract the spleen (Da 
 C). Phosphorus, gr. ^ increased to gr. ^, has proved successful in several 
 cases (Wa) : good results have been reported in one or two cases, but the gen- 
 eral experience is that it is of no value (Muir). Quinine, in large doses, is 
 considered of value by some, but it is distinctly inferior to Arsenic (Id). 
 Thymus Extract, has been used with benefit. Bone-marrow is worth a fair 
 trial. Galvanization of the spleen, is curative in uncomplicated cases (B); 
 causes improvement of the blood, increasing the number of its red corpuscles 
 (Gowers). Splenectomy has been performed in a number of cases, almost 
 invariably with fatal result; is absolutely unjustifiable and is also useless 
 (Muir). [Compare Anemia, Lymphadenoma.] 
 
 Leucorrhea. 
 
 Hydrastis, the fluid extract undiluted, applied topically, quickly improves in 
 uterine and vaginal leucorrhea (B). Pulsatilla, 5-drop doses ter die for a few 
 weeks ; also a teasp. of the tinct. in a pint of cold or tepid water, as vaginal en- 
 ema daily, when pain in the loins, depression of spirits, loss of appetite, etc. (P). 
 Silver Nitrate, in solution locally, also tampon saturated with 3j each of Alum 
 and Bismuth, when leucorrhea due to granular vaginitis (Parvin). Balsams 
 of Peru and Tolu, internally (P). Glycerin, is largely employed for vaginal 
 leucorrhea, and for erosions and ulcerations of the cervix uteri (B) ; the best 
 vehicle for other agents (E). Glycozone, applied on small rolls of lint or 
 absorbent cotton, after thorough washing of the vagina with solution of Hy 
 drogen Dioxide, I to 4 of water, and repeated twice daily (Edson). Borax, %] 
 to Oj of water, as vaginal wash for the leucorrhea of pregnancy (Parvin) 
 Cimicifuga, is said to be useful (P). Copaiba, has been used with success (P) 
 Cocculus Indicus when sero-purulent discharge, pain in lumbar region (P) 
 Carbolic Acid, diluted, as injection (B) ; for vaginal leucorrhea (R). Bismuth, 
 with mucilage, as injection ; or with cacao-butter as suppository (B). Copper 
 Sulphate, in solution, as injection (R). Tannic Acid, in chronic cases service- 
 able as injection, £ss j n ^viij of claret wine (B) ; if os ulcerated, a suppository 
 of tannin and cacao-butter to mouth of uterus (R). Iodo-Tannin, is an excel- 
 lent application, 3} of iodine to ^j of tannic acid, a sufficient quantity to be 
 packed dry around the cervix (B). Alum and Borax, make a useful injection 
 in vaginal leucorrhea (R). Belladonna, with Tannin as bolus when neuralgia 
 or ulceration of the os ; when disease due to over-secretion of mucous glands 
 
LICHEN PLANUS LITHEMIA. 
 
 755 
 
 about the os and much pain present inject Sodii Bicarbonat., Z] \ Tincturae 
 Belladonnas, ,^ij ; Aquae, Oj (R). Potassium or Sodium Bicarbonate, 3j in 
 Oj aquas as injection, especially when discharge alkaline and copious (R). 
 Pareira, Uva Ursi, are successfully used (P). Sumbul, recommended in 
 atonic form (P). Myrrh, with Iron or Aloes, beneficial (P). Ergot, said to be 
 useful in some cases (R). Potassium Permanganate, has no special advan- 
 tage ; is used in solution, gr. ij to the % (B). Potassium Chlorate, 3j to Oj of 
 water as injection in simple cases (Parvin). Iron, the Iodide, internally and 
 externally has proven serviceable; the Mistura Ferri Composita, when anemia 
 and general debility (Wa); the styptic preparations locally (R). Phosphates, 
 for the cachexia (B) ; Calcium Phosphate, gr. j-ij several times daily, of great 
 value in checking profuse discharge (Wa). Injections, water at 6o° F. to 
 prevent recurrence (R) ; hot water injections are the best tonic for the pelvic 
 vessels to relieve venous congestion ; use with elevated hips (E). [Compare 
 Endometritis, Uterine Ulceration, Vaginitis.] 
 
 Bt . Aluminis, gj. 
 
 Zinci Sulph., 3 ss. 
 
 Sodii Boratis, gr. iv. 
 
 Aq. Rosse, ! v hj« 
 
 M. Sig. — Injection. (B.) 
 
 R. Liq. Plumbi Subacet., . . .^jss. 
 Ac. Carbolici, . . . . j|ss. 
 M. Sig. — One-fourth to be added to 
 pint of water and used as an injection. 
 
 Lichen Planus. 
 
 Arsenic, is the only remedy which exercises anything like a specific effect, 
 and it not infrequently fails (Brooke). Antipyrin, internally for the itching, is 
 efficient. Aconite, sometimes useful (R). Mercury, Calomel and Mercuric 
 Nitrate Oint. mixed, also Tar Oint. may be added, in patches of obstinate 
 lichen (R). Silver Nitrate, the Nitrous Ether solution painted over the patch 
 every day or two (R). Quinine, with Belladonna and Ergot, as in urticaria 
 (Brocq) ; large doses in an effervescing mixture (Crocker). Potassium Chlorate, 
 gr. xv before meals, also dilute Nitric Acid, n\x after meals, thrice daily, has 
 given very good results (Bulkley). Lead-water as lotion, thickened with zinc and 
 starch powder or calamine, with the addition of a few drops of Carbolic Acid 
 or Liquor Picis Carbonis, has a very sedative effect in very acute cases 
 (Brooke). Mercury, as in Unna's ointment, composed of Hydrarg. Chlor. 
 Corr. gr. iij-v-xx, Ac. Carbol. gr. xx, Ung. Zinci ^j ; the smallest quantity of 
 the mercurial for extensive cases, the larger for local caustic effects in stubborn 
 patches. If used early and efficiently this ointment alone will remove the 
 threatening general symptoms of lichen neuroticus (Unna). Excision may be 
 required to remove the horny accumulations of lichen corneus (Brooke). 
 Cautery for the same purpose, even superficially applied it sometimes removes 
 the itching permanently (Van Dort). Formerly used to denote many spreading 
 papular eruptions, the term Lichen is now restricted to one specific form of 
 disease, that described by Erasmus Wilson as Lichen Planus, of which Hebra's 
 Lichen Ruber is a rare and aberrant acute manifestation (Brooke). [Compare 
 Eczema, Strophulus.] 
 
 Lithemia. 
 
 Piperazin, by far the best agent to promote the elimination of uric acid and 
 urates, with which it forms one of the most soluble of uric acid compounds : 
 relieves the pruritus of the uric diathesis. Lithium Salts, especially the Citrate, 
 gr. xx thrice daily, is very efficient (Da C) ; the Carbonate invaluable (Wa); 
 the Bromide, in solution of Potassium Citrate given after stomach digestion is 
 completed, one of the very best agents (Aulde). Strontium Salicylate, in 
 chronic gouty conditions and in lithemia with intestinal indigestion, the most 
 valuable drug that we have (W). Salicylic Acid, or its salts, are most powerful 
 solvents and excretents of uric acid (Haig). Lysidin, is still more solvent of 
 
756 
 
 LOCOMOTOR ATAXIA. 
 
 uric acid than is Piperazin [see page 430]. Cascara Sagrada, is believed to 
 promote the excretion of uric acid. Colchicum, 15 minim doses of the wine 
 twice or thrice daily, are very useful (Wa) ; the combination of Colchicine with 
 Oil of Wintergreen in capsules [see page 284] is a useful remedy. Coffee, a 
 tincture of green coffee is anti-lithic. Pichi, of great value in lithemia with 
 cystitis (Wyman). Arsenic, in small doses, is also useful (Da C). Nitric Acid, 
 10 mimim doses of the dilute acid in half-glass of water thrice daily, with an 
 occasional dose of Pil. Rhei Compos, at bedtime, is the most efficient treatment 
 for patients who will not diet themselves (Hughes). Purgatives, especially alka- 
 line mineral waters, to clear the portal system (Da C). Sodium Phosphate, in 
 laxative doses, Z] thrice daily, gives good results. Alkalies, in biliousness ; 
 also the continued use of alkaline waters rich in potassium salts, for solution 
 of calculi (B). Acids, Hydrochloric often of great service; also Lactic, when 
 faulty digestion and assimilation (Br). Potassium Permanganate, prevents 
 calculi by converting uric acid into urea (B). Buchu, combined with an alkali, 
 has been beneficial (P). Chimaphila is believed to check the secretion of uric 
 acid (P). Aliment, farinaceous vegetables and acid fruits are suitable (B) ; 
 Alcohol in any form is poison to a lithemic (Da C) ; succulent vegetables and 
 fruits, occasional abstinence from animal food ; milk diet, and frequent draughts 
 of pure water are recommended ; removal to a locality where pure soft water 
 can be procured, is often curative ; high living, alcoholic liquors, and sedentary 
 habits are injurious. [Compare Calculi, Dyspepsia, Gout.] 
 
 R. Lithii Bromidi, ,l ss- j- 
 
 Liq. Potassii Citrat. , . . ^ iv. 
 Syrupi Simplicis, . . . . ^ij. 
 M. Sig. — A teasp. in a wineglassful or 
 
 more of water, 2 hours after each meal. 
 
 Reduce the dose after a week. 
 
 R 
 
 . Potassii Nitratis, . . 
 
 Ext. Pichi Fl., . . . 
 
 Elixir Simpl., ^iij. 
 
 M. Sig. — A teasp. every 2 hours. 
 
 3J- 
 3J- 
 
 JR. Tinct. Belladonnse, . 
 
 Vini Colchici Rad., . 
 
 Liq. Potass. Citrat. , q. 
 M. Sig. — A dessertsp. 
 every 3 hours. 
 
 . . TTLxviij. 
 
 s. ad $iv. 
 well diluted, 
 
 R 
 
 . Vini Colchici Rad., . . . ^ij. 
 
 Ext. Phytolacca? FL, . . gj. 
 
 Potassii Acetatis, .... ^iij. 
 
 Aquae, q. s. ad 3 vj. 
 
 M. Sig. — A tablesp. four times daily. 
 
 Locomotor Ataxia. 
 
 Antipyrin or Phenacetin for the lancinating pains ; the former relieves them 
 remarkably ; the use of Morphine for the pains should be avoided as long as 
 possible (Osier). Acetanilid, is admirable for relief of the pains (B). Bella- 
 donna and Ergot are highly efficient (Brown-Sequard). Silver Nitrate, when 
 motor disturbances are very marked ; improved 1 case in 20 (R) ; gives the 
 best results in doses of gr. % to gr. % thrice daily, withholding it after a few 
 weeks to prevent argyria (Da C) ; the only remedy which has done good in 
 progressive locomotor ataxia ; gr. -j 3 ^-^ two or three times daily, with Sodium 
 Hypophosphite, both to be discontinued when blue line appears on gums 
 (Althaus). Silver Oxide, may be used instead of the nitrate, in half-grain 
 doses (Da C). Aurum, is especially curative in all forms of sclerosis ; the 
 Bromide of Gold and Arsenic has been of special service in this form (E. A. 
 Wood). Potassium Iodide, Corrosive Sublimate, or Gold and Sodium Chloride, 
 all in full doses, often retard the progress of the disease (Da C). Physostigma 
 has proved beneficial (R). Phosphorus, useful, but may not cure (B). Hyos- 
 cyamine, ameliorative, gr. -^ gradually increased to gr. ^ (B). Electricity, 
 the galvanic current relieves pain ; faradic stops wasting of muscles (B) ; in 
 the stage of irritation the constant current (ascending) through spinal column 
 (R). Water, one of the most efficient agents; friction with a cloth dipped in 
 water of 60-6 5 F., a cold compress to head ; 4-8 minute bath of 70-7 5 
 gradually lowered to 6o°, then shower-bath and frictions (R). Rest, as com-' 
 plete as possible, must be insisted on ; with good, nutritious diet, milk being 
 
LUMBAGO. 
 
 757 
 
 desirable (Da C). Pilocarpine, produces general improvement if given in the 
 incipiency, gr. j to If j of water, of which TtLxxx thrice daily (B). Strychnine, 
 gr. -^ in 5j of Syr. Hypophosphitum, thrice daily, when the system is saturated 
 with silver (Da C). Suspension daily, by head, has seemed to give relief to 
 pain and improve condition: is known as Charcot's treatment, but originated 
 with Matchoukowsky of Odessa, and was carried out systematically by Hessing 
 of Pesth, before Charcot took it up: is now abandoned. Morphine, sooner or 
 later becomes necessary for the lancinating pains ; in one case, personally 
 known to the author, which had been treated ineffectually by every known 
 method, including suspension by Charcot himself, and was rapidly progres- 
 sive, the abandonment of the hypodermic syringe for Morphine by mouth, gr. 
 xv daily in divided doses, has seemed to result in complete cessation of pro- 
 gress, which has now lasted over six years ; the patient is free from pain, 
 eats and sleeps well, and attends to business, getting around by aid of a stick 
 and some slight assistance from friends when crossing a crowded street. 
 Orchitic Extract, also Spermine, have been used with some success. Cere- 
 brinin, is reported beneficial [see page 164]. 
 
 Lumbago. 
 
 Cimicifuga, is said to be more effectual than any other remedy (R) ; has some- 
 times wonderful success ; no indications can be given for it ; 3ss-ij of fluid 
 extract (B) ; is curative (P). Rhus Toxicodendron, in subacute muscular or ten- 
 dinous rheumatism, worse at night; completely relieves some cases (Pf). 
 Veratrum Viride, the tincture useful (R). Aconite, in % rr^ doses of tincture 
 every two hours, with Linim. Aconiti locally (Wa). Iodides, if referable to 
 syphilis, mercury, copper, tin, or lead poisoning (B). Ammonium Muriate, is 
 very efficient in myalgic lumbago, gr. xx thrice daily for 2 days or until signs 
 of congestion of the nasal mucous membrane appear, then to be replaced by 
 Quinine, gr. v, thrice daily for a week (Waugh). Antipyrin, gr. vij, hypo- 
 dermically, completely banished it in a very bad case at the Hotel Dieu, Paris. 
 Morphine, hypodermically, to relieve pain (R) ; gr. l /e with Atropine gr. ■£$, 
 hypodermically, will frequently cure lumbago in two or three hours (Da C). 
 Capsicum, a strong infusion applied on lint, and covered with oiled silk, very 
 efficient in recent lumbago (R) ; a Capsicum plaster is a very efficient applica- 
 tion. Potassium Nitrate, in ten-grain doses hourly or every two hours, when 
 urine scanty and high-colored (R). Belladonna, as plaster, very valuable for 
 persistent lumbago remaining in a small spot (R). Turpentine, in doses of 
 ttLxx-xxx, carefully lest strangury and nephritis, of greatest value when the 
 bowels are regular and urine clear and abundant (Wa). Ether Spray, externally 
 as freezing mixture (R). Guarana, in 20 to 40 grain doses, removed severe 
 chronic lumbago (Rawson). Chloroform Liniment, affords relief (Wa). Canada 
 Balsam, gr. v-xx, is useful, or Burgundy Pitch, as plaster (P). Acupuncture, 
 occasionally gives instant relief (B); not when high fever (R). Aquapuncture, 
 has been employed with extraordinary success (B). Heat, by hot douche to 
 seat of pain (B) ; or by very hot poultices for three hours, then the skin covered 
 with flannel and oiled silk ; or a hot flat-iron (R). Galvanism, the constant cur- 
 rent (B) ; is highly useful ; faradization almost as successful as acupuncture (R). 
 Strapping from the thigh upwards with layers of adhesive plaster which overlap 
 each other; nothing is so instantaneously beneficial. Diet, should be gener- 
 ous and nutritive ; Lemon-juice as a beverage. Absolute rest is of great im- 
 portance. [Compare Lithemia, Myalgia, Rheumatism.] 
 
 U . Collodii, 
 
 Tinct. Iodi., 
 
 Spt. Ammonise, . . aa part. aeq. 
 Sig. — Paint over the part with a camel's- 
 hair brush. {Burggracve.) 
 
 R . Ammonii Chloridi, . . . £). 
 Ext. Cimicifugae Fl., 
 Syr. Simplicis, . . . . aajf j. 
 Aq. Laurocerasi, q. s. ad "^v). 
 M. Sig. — Adessertsp. every four hours. 
 
75§ LUNG DISEASES— LUPUS. 
 
 Lung Diseases. 
 
 Aconite, is indicated in most acute congestions (P) ; is especially indicated 
 for inflammatory states of the respiratory organs (R); Belladonna, in doses of 
 rry of the tincture frequently, is of great benefit in pulmonary edema, to retard 
 exudation of serum and to counteract the failure of the heart (Smith). Tere- 
 bene, is very valuable in many conditions. Terpin Hydrate, is still more effi- 
 cient and more easily administered. [See under Bronchitis.] Ammonium 
 Acetate, serviceable not only in bronchitis, but in the whole range of acute 
 pulmonary complaints occurring in children (Dessau). [See under Bron- 
 chitis, for formula.] Veratrum Viride renders important service in acute 
 parenchymatous congestions (B) ; gr. ]/e of resin in pill when temperature and 
 pulse are high ; it tends to induce prostration, collapse, etc. (A). Blisters, fly- 
 ing blisters to chest, and perhaps along the pneumogastric in hypostatic con- 
 gestion (R). Copaiba, exercises a powerful influence over the pulmonary 
 mucous membrane, and is beneficial in lung diseases generally, when attended 
 with excessive secretion (Wa). Jaborandi, is serviceable for the attacks of 
 breathlessness attendant on lung affections, but must be watched lest collapse 
 ensue (Berkart). Liquor Potassae, in doses of ffVx-xv added to an ordinary 
 expectorant mixture, is often attended with good results in congestions of 
 bronchi and lungs, chronic bronchitis, plastic bronchitis, etc.(Walshe). Cimi- 
 cifuga, is a useful sedative in many irritative affections of the lungs and bron- 
 chial tubes, relieving cough, improving appetite, and ameliorating the general 
 condition (Wood). Croton Oil, as liniment, is a highly useful counter-irritant 
 in many chronic lung diseases, and even in the bronchitis of infancy (Park). 
 Cubeb, in small and oft-repeated doses, is efficient in chronic bronchitis and 
 other lung affections of old persons, checking the excessive secretion and 
 gently stimulating the system (Wa). [Compare Bronchitis, Emphysema, 
 Hemoptysis, Phthisis, Pleuritis, Pleurodynia, Pneumonia.] 
 
 Lungs, Gangrene of. 
 
 Creosote, by inhalation, to obviate the fetor (R). Carbolic Acid inhalations, 
 are used with marked benefit (Wa). Mineral Acids, especially Nitro-hydro- 
 chloric, with Quinine, the main reliances in chronic pulmonary gangrene (A). 
 Stimulants, as malt liquors, with general tonic treatment, are necessary (A). 
 Ammonium Carbonate, one of the most reliable remedies ; is best given in 
 decoction of Cinchona (Wa). Eucalyptus, the Oil with Alcohol, equal parts of 
 each, of which Z] as inhalation by steam atomization, is useful (Wa). Turpen- 
 tine, the spirit on boiling water inhaled for fifteen minutes every two hours, 
 successfully employed (Skoda). [Compare Pneumonia, Phthisis.] 
 
 Lupus. 
 
 Arsenic, in chronic cases not of syphilitic origin. Fowler's solution long 
 continued exerts a curative influence, also Arsenous Acid locally (B) ; the best 
 remedy in lupus of the head and face (Wa) ; the Oleate in ulcerating forms, 
 constantly applied, will destroy cell infiltration in a mild and comparatively 
 painless manner ; it is also well employed in the tubercular variety (Id). 
 Phosphorus, as an internal remedy, may be used as a substitute for arsenic (B). 
 Aurum Arsenate, internally, is said to be serviceable. Aurum salts, locally 
 and internally, have proved curative ; the Chloride has been used as a caustic 
 (P). Iodine is useful in lupus, whether syphilitic or scrofulous, the tincture or 
 a glycerin solution locally (Hebra) ; the tincture or liniment applied to the 
 edges and around them (R) ; it may also be employed internally. Aristol, has 
 given excellent results locally as a dressing (EichofT). Strontium Iodide, has 
 
LUPUS. 
 
 759 
 
 been used in lupus vulgaris with varied results. Calcium Chloride internally, 
 has proved curative, but must be taken for a long time. Mercury, in small 
 doses, is one of the constitutional remedies which should receive a fair trial 
 (Whitla) ; as ointment in lupus erythematosus, and in form of Calomel oint- 
 ment in scrofulous and tubercular lupus of children (R) ; internally Calomel in 
 doses of i to 2 grains increased to 4 grains, will quickly check it (Wa) ; the 
 Emplastrum Hydrargyri is very efficient in lupus erythematosus and allied 
 affections (Kohn). Salicylic Acid, is the most typical member of the group of 
 agents which have selective action on the new growth and destroy it with the 
 least amount of injury to healthy tissue (Whitla) ; used as a paste, made by 
 rubbing it with an equal part of Creosote, applied daily after using a strong 
 solution, 10 to 20 per cent, of Cocaine over the part; or Unna's plaster mulls, 
 containing these two ingredients, may be used (Id) ; as dressing, Salicylic Acid 
 5, Creosote 5, Glycerinum Saponatum 90, after destruction of the growth, has 
 given good results where no scraping nor any other operation was performed 
 (Hebra). Lactic Acid, seeks out the diseased tissue, as a dog does game, 
 surely finds it and effectually destroys it (Hortmann) ; the concentrated acid 
 should be used, either alone or as a paste made with Kaolin. Lead, the Liquor 
 Plumbi, with 1 or 2 of glycerin, in the milder forms, applied warm after the 
 removal of the crusts (R). Jequirity, is a good application to destroy the dis- 
 eased tissue by setting up the jequirity inflammation (Shoemaker). Sodium 
 Ethylate, on absorbent cotton, is the best of the caustics, followed by Bismuth 
 Oleo-palmitate as a soothing and astringent application (Id). Carbolic Acid, 
 the crystals melted by heat, as a mild escharotic (B) ; its action is very superfi- 
 cial. Zinc Sulphate, dried, freely dusted over the surface as a caustic, followed 
 by a poultice to remove the slough (B). Silver Nitrate, a weak solution grad- 
 ually strengthened, may be used in superficial forms (R). Chromic Acid, in 
 solution, 100 grains to the ^ of distilled water, is an efficient escharotic (B). 
 Thyroid Extract, has been used as a stimulant of the cutaneous functional 
 activity with most satisfactory results. Tuberculin, in this disease has excited 
 great interest, but the best authorities deny that its use has produced a single 
 absolute cure ; yet combined with surgical methods it will give good results 
 (Whitla). Scraping off the diseased tissue with Volkmann's spoon under 
 anesthesia, is the most radical and satisfactory of the mechanical procedures 
 (Id) ; the Paquelin cautery is better than the spoon for removing the morbid 
 tissue (Unna). Electrolysis, has given good results in Jackson's hands, who 
 reports that the electrolytic action of the current seems to expend itself only on 
 the diseased tissue. Cauterization, with the actual cautery at white heat, after 
 scraping out as much as possible of the diseased tissue, so as to destroy the 
 lupus cell. Seek to replace the lesion by a cicatrix, to prevent relapse in situ, 
 and the development of the disease elsewhere. Internal remedies are only 
 useful for the general health, and have no specific action on the disease. 
 Phototherapy, by bringing the concentrated chemical rays of solar or electric 
 light upon the lupus patch, thereby destroying the tubercle bacilli (Finsen) ; 
 has given striking results in some cases, but is uncertain, slow and very ex- 
 pensive (Anderson). 
 
 B 
 
 . Iodi, 
 
 Potassii Iodidi, . . . . aa ^ ss. 
 
 Glycerini, . . ...... gj. 
 
 M. Sig. — Locally in lupus. 
 
 {McCall Anderson. 
 
 R. Ung. Arseni Oleat., . . . gij. 
 
 Ung. Simplicis, gj. 
 
 M. ft. unguentum. Sig. — Use constantly 
 over the affected surface. If pain sets in 
 Opium maybe added. {Shoemaker.} 
 
 R. Hydrargyri Bromidi, . . gjss. 
 Adipis, 3 v. 
 
 M. ft. unguentum. Sig. — To cover the 
 part affected, using Cod-liver Oil freely, 
 and the following solution internally. In 
 tubercular lupus of the face. {Hardy.) 
 
 R. Potassii Iodidi, 
 
 Sodii Chloridi, 
 
 Aq. Destil., . 
 
 M. Sig. — Teasp. 
 
 and morning. 
 
 gr. lxxv. 
 
 §ss. 
 
 Jviijss. 
 
 before meals, night 
 {Hardy.) 
 
760 LYMPHADENOMA — MALARIA, 
 
 Lymphadenoma — Hodgkin's Disease. 
 
 Arsenic is by far the most successful remedy, both in acute and chronic 
 cases, several having been recorded in which the glandular swellings have 
 disappeared and the patients have recovered under its influence (Murray); 
 large doses, rr^xv-xx of Fowler's solution, arrived at by gradual increase, should 
 be maintained until some physiological effect is produced (Ty) ; injected into 
 the lymphoid masses has given good results, especially when not well borne by 
 the stomach (Id). Phosphorus, has had good effects in a few cases, and should 
 be used if arsenic is not well borne (Gowers), Iodine and Potassium Iodide, 
 have been used but with little benefit ; the latter may be distinctly harmful 
 (Murray). Quinine, Iron and Cod-liver Oil, as tonics; every means must be 
 employed to support the patient's strength (O). Organic Extracts, of spleen, 
 thymus and other glands, are being tried but with no very decisive results as 
 yet (Murray). Bone-marrow is perhaps worthy of trial, Jj of fresh ox marrow 
 thrice daily for an adult (Id). Local Treatment, by applications to or injections 
 into the diseased glands, has reduced their size but has no influence on the 
 progress of the disease (Id) ; is of doubtful benefit (O). Extirpation of the dis- 
 eased glands, in suitable cases, especially where the enlargement is confined 
 to one group, when the spleen is not greatly enlarged and when there is neither 
 fever nor marked anemia, may arrest the disease and is the proper treatment 
 (Murray) ; if the number of red corpuscles is below 60 per cent, removal should 
 not be attempted (Gowers). [Compare Anemia, Leucocythemia.] 
 
 Lymphangitis. 
 
 Belladonna, the extract softened with glycerin and freely applied, is of great 
 service ; when pain is severe a poultice may be applied over the extract for a 
 few hours only (Wa). Lead, Liq. Plumbi Subacet. Dilutus, as an external ap- 
 plication, constantly applied, to soothe and restrain the inflammation (Wa). 
 Iodine, in strong tincture, applied around the glands, to prevent suppuration 
 (Roberts). Quinine, or Salicin, with alcoholic stimulants freely, in septic cases 
 (Id). [Compare Bubo.] 
 
 Malaria, Chronic. 
 
 Arsenic plays an important role in chronic malarial disease (B) ; diminishes 
 splenic engorgement, and combined with Iron is rapidly curative of many af- 
 fections due to malaria (Boudin) ; is a powerful prophylactic against malaria, 
 and in chronic malarial poisoning, with frequent return of fever and neuralgia, 
 its continued use is of great benefit (Fayrer). Quinine, is less curative than 
 when the infection is recent, but in periodical affections depending on the 
 malarial cachexia it is of specific value, large doses being required (B) ; the in- 
 discriminate use of quinine as a prophylactic in malarial countries is attended 
 with great danger, seriously weakening the action of the heart and so inuring the 
 subject to its action that it has no longer any value of importance as a remedy 
 (Koch). Salicylates, of Quinine and Cinchonidine are especially effective in 
 chronic malarial disease (B). Iron, the Sulphate has decided antiperiodic 
 power, and is particularly successful in anemic subjects and in those with en- 
 largement of the spleen (Wa) ; it improves the anemia of chronic malaria, and 
 should generally be combined with Arsenic (B). Iron and Manganese Iodide, 
 the syrup in doses of rr^xx-xxx, is a successful remedy for chronic malaria (B). 
 Manganese Sulphate, gives excellent results in jaundice of malarial origin 
 (B). Cornus, Calumba, and other bitters are highly efficient, especially the 
 first named, in chronic malarial poisoning and in convalescence after malarial 
 fever (B). Carbolic Acid and Iodine combined, are of great value in chronic 
 
MANIA. 
 
 76l 
 
 malarial infection ; both are highly antiperiodic, and the latter is the best sub- 
 stitute for Quinine and the most active reducer of splenic enlargement (Gim- 
 well). Eucalyptus, is of high utility to reconstruct damages in the organs of 
 assimilation (B). Nuclein, has been used with benefit (Vaughn). Baths, the 
 vapor-bath and Turkish baths are efficient aids to medicinal treatment in break- 
 ing up chronic cases, and may of themselves cure such by inducing profuse 
 perspiration (Da C). [Compare Hemoglobinuric Fever, Intermittent 
 Fever, Remittent Fever.] 
 
 R-. Cinchonidinse Salicylat., . ^ij. 
 
 Acidi Arsenosi, gr. j. 
 
 Ferri Sulph. Exsiccat., . . gr. xx. 
 M. ft. pulv. no. xx. Sig. — One powder 
 in wafer thrice daily. 
 
 J& . Cornus, 
 
 Calumbse, 
 
 Liriodendri, 
 
 Pruni Virginians, . . aa^vj. 
 
 Eupatorii, 
 
 Capsici, aa^iv. 
 
 Pulv. et misce. Sig. — A teasp. in cold 
 or warm water, three or four times daily. 
 A good tonic tincture may be made from 
 the above combination. (B.) 
 
 R. Quinine Sulph., .... gr. xl. 
 
 Ferri Sulph. Exsic, . . . gr. xx. 
 
 Acidi Arsenosi, gr. j. 
 
 M. ft. pil. no. xx. Sig. — One pill thrice 
 daily. 
 
 Be. Tinct. Iodi, gij. 
 
 Acidi Carbolici, .... £j. 
 M. Sig. — Two or three drops three or 
 four times a day, in water. 
 
 rjL . Acidi Arsenosi, gr. j. 
 
 Mass. Ferri Carbonatis, . gj. 
 M. ft. pil. no. xx. Sig. — One pill thrice 
 daily. 
 
 Mania. 
 
 Stramonium, of value ; allays irritation and induces tranquil sleep ; in wild 
 and furious but intermittent delirium, also in nymphomania (P) ; many facts 
 seem to confirm its reported value (Tr). Daturine, gr. iQQ -gV hypodermically 
 in acute mania, but is less useful than Atropine or Hyoscyamine (Wa). Duboi- 
 sine, gr. -£% hypodermically in acute mania (Gubler) ; is more sedative and 
 hypnotic than the other alkaloids of the group and acts well in doses of gr. 
 y^o at first, gradually increased to gr. ^. Belladonna is useful, especially in 
 monomania with fixed hallucinations, though a large dose causes a temporary 
 insanity (Tr) ; one of the very best remedies in all hyperemic conditions of the 
 brain (P). Hyoscyamus, in violent intermittent forms, to procure sleep and 
 calm violent delirium (R) ; delirium with hallucinations but not congestion ; in 
 milder and less inflammatory forms, also in hypochondriacal monomania (P). 
 Hyoscine, finds its greatest and most useful application in the treatment of 
 maniacal violence and noisiness, and is a drug for emergencies of this kind 
 (Weatherly). [See under Insanity.] Veratrum Viride, successfully combats 
 the excitement in acute mania (B). Camphor, has been used successfully ; its 
 action is uncertain (P). Opium with Tartar Emetic is satisfactory for many 
 cases ; also Morphine hypodermically to induce sleep (R) ; its narcotic effect is 
 of doubtful utility, better in insanity with depression (P) ; will not produce nar- 
 cotism in many such cases, even in 2-grain doses. Bromides are used in 
 puerperal mania, that of pregnancy, nymphomania and other forms (R) ; the 
 combined use of Potassium Bromide and Tinct. of Cannabis Indica, equal 
 parts, 3j of each thrice daily for weeks and months, has proved very efficient 
 in acute and periodical mania, senile mania, and other forms (Clouston). 
 Chloral, as calmative and hypnotic, has induced mental improvement (B). 
 Paraldehyde, as a hypnotic, in doses of 3ss-j, is often decidedly useful (R) ; 
 larger doses are necessary, an average one is 3iss. Conii'ne, most suitable to 
 acute mania, quiets muscular action ; doses of TT^ss-iij, or hypodermically, 
 beginning with gr. yV ; with Morphine conjointly injected, is very successful 
 (R). Digitalis, ^ss-Sj of tinct. valuable in acute and chronic mania, espe- 
 
762 MASTITIS — MASTODYNIA. 
 
 cially when complicated with general paresis and epilepsy (Maudsley) ; caution I 
 watch the pulse for any marked intermittence (B) ; a very valuable palliative 
 in acute mania (Van der Kolk). Ergot, large doses, 3ss-j of fluid extract, to 
 reduce excitement, shorten attacks, widen intervals between them, and prevent 
 exhaustion, hence is very useful in recurrent and epileptic forms, and in chronic 
 mania with lucid intervals (Crichton Browne). Iron, as a restorative, is fre- 
 quently used in chronic mania with benefit, the tincture of the Chloride in 5- 
 10 minim doses (B). Gelsemium, is useful in mania with great motor excite- 
 ment and wakefulness ; large doses required, TT\,xv-xx of tincture. Croton Oil, 
 as a purgative, NL/^ - K every hour, as revulsive in mania from cerebral con- 
 gestion (R). Cimicifuga, is often efficiently used in cases of mania occurring 
 during the puerperal or pregnant condition (R). Chloroform, may be neces- 
 sary to control very violent cases temporarily ; its inhalation need not be carried 
 to complete anesthesia. Galvanism, of the head and cervical sympathetic, has 
 produced distinct improvement (B). Cold Douche, in maniacal delirium, the 
 patient being in a warm bath during the application of the douche to the head 
 (R). Removal from home, from sympathetic friends, and from surroundings 
 connected with the origin of the malady, is a prime necessity to a cure. [Com- 
 pare Delirium, Insanity, Puerperal Mania.] 
 
 Mastitis. 
 
 Belladonna, Atropine locally [see Lactation], or combined with Morphine 
 and Chloral, when much pain (B) ; especially as liniment to check secretion of 
 milk when inflammation is imminent (R) ; or when breasts are distended by 
 milk (P) ; when inflammation has set in, continuous application of Belladonna 
 for 24 hours often arrests it ; also useful when abscess has formed ; fomenta- 
 tions in addition, but skin must be dried well before the Belladonna is rubbed 
 in (R) ; rr^v-x of tinct. internally as well (P). Camphor, a saturated solution 
 in glycerin locally, in mammary congestion threatening abscess (Wa). Phy- 
 tolacca, has power to arrest inflammation of the mammae and to prevent sup- 
 puration ; the fluid extract in 10-minim doses internally, and the solid extract 
 to the inflamed breast (B). Conium, the extract in small doses several times 
 a day, of striking benefit in mastitis and impending abscess of breast (Wa). 
 Calcium Sulphide, internally in mammary abscess ; occasionally increases pain 
 (R). Hyoscyamus, as plaster, to relieve painful distention from milk (P). 
 Stramonium, fresh leaves as cataplasm to discuss indurated milk (P). Iodine, 
 tinct. and ointment to remove indurations of breasts after inflammation (B). 
 Mercury and Morphine, the Oleate locally in mammary abscess (R). Tobacco 
 leaves, as poultice in abscess (R). Digitalis, the infusion locally as fomenta- 
 tion in severe inflammation of the breasts, causes it to yield speedily (Fairbank). 
 Ammonium Chloride, 3j in Spt. Rosmarini Oj, as lotion on linen cloths, 
 constantly applied, especially in induration after the abscess has suppurated 
 (Wa). Tartar Emetic, in small and frequent doses, given early, is beneficial 
 (Wa). Oil frictions in first stage of inflammation of breasts, from circumfer- 
 ence towards the nipple (L). Rest, by supporting mammas with strips of plaster, 
 and bandaging the arm to the side, to prevent motion (T). Alcohol, over 
 proof, applied by sponging until part is cold ; renew if high heat returns. Heat, 
 applied by a basin lined with flannel saturated with hot water, to relieve pain 
 and prevent suppuration. [Compare Abscess, Lactation.] 
 
 Mastodynia. 
 
 Conium, has specific anodyne action on the mammae and generative organs. 
 Cimicifuga, relieves infra-mammary pains of uterine origin in spinsters. Olive 
 Oil, 2 parts, to 1 of Tinctura Opii, may be used by gentle friction to painful 
 breasts after parturition (Parvin). Non-interference is best in simple cases of 
 
MEASLES MELANCHOLIA. 
 
 763 
 
 enlargement and tenderness, which will spontaneously subside if let alone ; 
 in severe cases support by strips or bandage, if breast pendulous ; Belladonna 
 ointment or liniments ; amputation of the breast has been necessary (T). 
 
 Measles. 
 
 Aconite, for febrile symptoms, and especially to arrest the catarrhal pneu- 
 monia (R) ; a valuable remedy (P) ; the best drug when fever is very high, 
 J^-drop doses of the tincture every 2 hours (Da C). Jaborandi, with a hot 
 bath, as a diaphoretic in cases of delayed eruption (Da C). Asclepias, an 
 infusion or decoction freely as a diaphoretic to promote the eruption (W). 
 Veratrum Viride, has been employed (R). Pulsatilla, for the catarrhal oph- 
 thalmia, nasal and intestinal catarrh ; 3j-ij of tincture to ^iv water as wash 
 (P). Ammonium Carbonate, dissolved in a solution of the Acetate, is much 
 vaunted ; when feeble circulation, cyanosis, delirium, gr. v-x to ^ss-gj Liq. 
 Ammonii Acetatis (B); gr. iij-vj or vij, every hour or two, in Cinnamon-water 
 or milk; one of the reliable remedies (W). Camphor, the water with Liq. 
 Ammon. Acetatis, excellent when cough and catarrh the most urgent symp- 
 toms (A). Ipecacuanha, for cough and catarrh, gr. j-ij every 4 or 6 hours (A). 
 Antimony, preferred to Ipecac by some (A). Quinine, in small doses, gr. j- 
 iij, for the adynamia, or large, gr. xv, for hyperpyrexia and catarrhal pneumo- 
 nia (B). Carbolic Acid, has been employed in several hundred cases with 
 decided advantage ; most useful at early stage (Wa). Cod-liver Oil and Iron, 
 to scrofulous children, a long course of such medication after convalescence 
 (Da C). Purgatives, must be given with caution (R) ; the milder purging salts, 
 as Magnesium Sulphate, to be preferred (A). Mustard, as bath on sudden retro- 
 cession of rash (R) ; often increases the fever without benefiting the pneumonia 
 or other complications (A). Water, cold affusion at commencement ; packing, 
 especially when retrocedent (R) ; hot foot-baths for convulsions (A) ; tepid 
 bath with cold douche to head, if cerebral symptoms are severe (Da C). Oil 
 Inunctions, Cacao-butter is very grateful and reduces temperature ; also in the 
 roseola (B) ; hands and feet to be rubbed with a firm fat to remove heat and 
 tightness produced by rash (R). Aliment, low diet and slops ; no animal food 
 during the whole course (A). Hygiene, dark room, complete disuse of eyes, 
 strict cleanliness (A). [For Sequelae see Bronchitis, Cough, Ophthalmia, 
 Otorrhea, Pneumonia, etc.] 
 
 R . Acidi Carbolici, 
 
 Acidi Acetici, . . . . aa 3 j— ^ jss. 
 
 Tinct. Opii Deodorati, - 
 
 Spt. Chloroformi, . . . aa gj. 
 
 Aquae, q. s. ad §viij. 
 
 M. Sig. — A tablespoonful every 4 
 hours, until fever abates. {Keith.) 
 
 R- . Tinct. Tolutanae, . . . . 3 ij. 
 
 Syr. Senegae, 5|ss. 
 
 Acidi Acetici, <fj ss - 
 
 Syr. Pruni Virg., q. s. ad % iv. 
 M. Sig. — A teaspoonful as required for 
 
 cough after convalescence. 
 
 Melancholia. 
 
 Aurum, gives excellent results, gr. ^ to ^y of the Chloride thrice daily, 
 especially when cerebral anemia coexists (B) ; the Bromide of Gold and 
 Arsenic has rendered good service in many cases, rr^x hypodermically thrice 
 daily : Gold is highly recommended in suicidal melancholia. Bromides, 
 sometimes afford relief which no other agent will ; no indications (B) ; Potas- 
 sium Bromide for townspeople, especially women with unendurable despon- 
 dency (R). Arsenic, gives great comfort in the melancholia of aged persons, 
 is best when combined with small doses of opium, thus — Liq. Potas. Arsenit. 
 TTLij, Tinct. Opii, ntiij-v ter die (B). Opium, in stimulant doses of tincture, 
 gives good effects (B) ; especially when paroxysms of acute anguish and 
 
764 MENINGITIS, CEREBROSPINAL. 
 
 despair, or when suicidal impulse (Wa) ; Morphine hypodermically is of great 
 benefit in some persons who have a peculiar idiosyncrasy therefor (R). Cam- 
 phor has been highly recommended (R). Musk and Castoreum are employed 
 in melancholia with benefit (R). Cannabis Indica, sometimes relieves (B). 
 Phosphorus, depression from overwork (R). Chloral, as hypnotic, has been 
 followed by marked amelioration and cure (Wa). Valerian, in hysterical or 
 suicidal melancholia, is often beneficial (Wa). Caffeine has been useful (B). 
 Iron, as restorative, the tincture of the Chloride (B). Cocaine, a useful tonic 
 and especially beneficial in nervous affections accompanied by depression (Br). 
 Cimicifuga, in puerperal or uterine despondency, of singular value (P). Ignatia, 
 has soothing effect in great mental depression (P). Orchitic Extract, has been 
 used with benefit. Water-cure, shower-bath for 15-20 seconds, or warm-bath, 
 95 F. for 30 minutes ; the shower or cold douche may be usefully employed 
 in cases where reaction takes place after it (W). [Compare Hypochondriasis, 
 Hysteria, Insanity. 
 
 Meningitis, Cerebral. 
 
 Aconite, is as serviceable in this as in the other acute inflammations ; during 
 the stage of excitation, the tincture, gtt. ij with gtt. v of the tincture of Opium, 
 every 2 hours, gives admirable results (B). Belladonna, in all hyperemic 
 conditions of brain and spinal cord one of the very best remedies, especially 
 during the period of excitement (P). Hyoscyamus, valuable in subacute form 
 (P) ; for nervous irritability during convalescence (A). Gelsemium, extremely 
 useful ; tt\,v of fluid extract every 2 hours (B). Mercury, as ointment gives 
 good results in children (A) ; Calomel in small, frequent doses, so as to bring 
 the system under it quickly, a most valuable remedy apart from its purgative 
 effects (W) ; the Unguentum Hydrargyri rubbed for 30 minutes into the skin 
 on the front of the abdomen, groins and arm-pits, repeated after 12 hours if 
 no evidences of improvement or salivation ; such unmistakable benefits follow 
 the free use of mercury that to withhold this remedy in desperate or apparently 
 hopeless cases is unjustifiable (Whitla). Potassium Iodide in large doses 
 where vomiting and gastric derangement are absent, and in the later stages 
 of syphilitic meningitis may be very valuable (Id) ; has cured (Niemeyer). 
 Ergot, the fluid extract in £ss doses with an equal quantity of Potassium Bro- 
 mide, every four hours, to diminish the vascular excitement (B). Potassium 
 Bromide, in the convulsions following simple meningitis (R). Opium, in small 
 doses ; by clinical evidence proved to be the best remedy, especially for acute 
 stage before exudation, or during the stage of excitation (B) : when collapse, 
 it may sustain the vital powers ; with Tartar Emetic has proved most benefi- 
 cial, but should be used with caution, as it may do great harm (Wa). Bryonia, 
 exceedingly valuable for serous inflammations in stage of effusion (P). Pulsa- 
 tilla, valuable in the acute form (B). Purgatives, as soon as possible, unless 
 exhaustion ; Calomel and Jalap the most active and searching (A); Croton Oil 
 as a derivative and revulsive, also locally to the shaven scalp is productive of 
 the best results (Wa). Venesection, or arteriotomy (temporal artery) gives 
 good results (B) ; when high cerebral excitement and vascular action (A). 
 Blisters, on nape of neck if coma, after active symptoms are subdued (A) : 
 useless, and cause needless suffering (O). Water, cold water for hyperpy- 
 rexia (C) ; pounded ice in bag or bladder, as a cap to the head (R). There are 
 no remedies which in any way control the course of acute meningitis (O). [Com- 
 pare Meningitis, tubercular.] 
 
 Meningitis, Cerebro-Spinal. 
 
 Opium, in small doses is the most effective remedy ; its utility ends when 
 effusion occurs and stupor and coma ensue (R) ; large doses (Valleix) ; gr. j 
 every hour in very severe cases (S) ; has been used in France and Germany 
 
MENINGITIS, SPINAL. 
 
 765 
 
 with much success (Tr) ; is the best remedy of all, gr. j every hour for 4 days, 
 even such doses will not narcotize (Da C). Antipyrin, has rendered good ser- 
 vice. Aconite, is useful combined with Opium (B) ; affects the cranio-spinal 
 axis from 3d nerve to phrenics, the region where this disease is most manifest 
 (Harley). Gelsemium, extremely valuable, tt\,v of fluid extract every 2 hours, 
 to maintain constant physiological effect (B) ; is efficient for the delirium. Bel- 
 ladonna, in all hyperemic conditions of brain and spinal cord, especially dur- 
 ing stage of excitement (P). Iron, the tincture of the Chloride, in 20-30 minim 
 doses, every two hours, suggested by the similarity of the disease to erysipelas, 
 has made many successful cures without leaving any sequelae (Klapp). Bro- 
 mides, to guard the Opium and enable the latter to be pushed, 20-grain doses 
 every 4 hours (Da C). Hydrocyanic Acid, dilute, TT\J — i j , with gr. iij-v of Sodium 
 Bicarbonate, every 3 or 4 hours for severe vomiting (Delafield). Quinine, in 
 large doses at the commencement (B); has been exhaustively tried in this dis- 
 ease and failed (Da C). Potassium Iodide for the sequelae, a long course of 
 Iodides during convalescence is the best treatment (Da C). Cold to the spine, 
 the most satisfactory treatment (Radcliffe); to head and upper spine for 5 
 minutes only at a time, for the headache and tetanic symptoms (Da C). Vene- 
 section, or arteriotomy (temporal artery), probably of service, but cautiously 
 (B) ; leeches at back of neck and on temples, to relieve the terrible headache, 
 if patient is strong and vigorous (Da C). Digitalis, in early stage (Rummel). 
 Ergot, one of the best remedies (B). Turpentine, enema, as derivative (B). 
 Stimulants, in small quantities (A). Counter-irritation, by actual cautery freely 
 applied to back, alleviates pain (A). Water, cold baths or wet pack for hyper- 
 pyrexia (B) ; hot-water bottles or sand-bags to trunk and extremities to keep up 
 warmth ; bath of 102-106 for short time only, then wrap in blankets (A). 
 Heat to the body, except the head and neck (Da C). Aliment, nutritious and 
 suitable food at short intervals, day and night (A) ; tonics with fresh air and 
 good diet during convalescence (A). Ventilation, of dwellings, the best sanitary 
 precaution when the disease is epidemic (Simon). 
 
 R. 
 
 M 
 boy 
 
 Morphinse Sulph., . . . gr. ss. 
 Ac. Sulphurici Aromat, gj. 
 Tinct. Cinchonse Co., ad ^ vj. 
 
 Sig. — Tablesp. every 2 hours, for a 
 [2 years old. {Meigs (5r> Pepper.} 
 
 R. Potass. Iodidi, giv. 
 
 Tinct. Gentian. Comp., 
 Syr. Sarsaparillse Co., . aa^ij. 
 M. Sig. — Teasp. thrice daily, to pro- 
 mote absorption during convalescence. 
 
 Meningitis, Spinal. 
 
 Aconite, is very useful (B) ; with an Ergot and Opium impression to reduce 
 the amount of blood in the vessels of the cord (Da C). Potassium Iodide, in 
 the chronic form, with the Bichloride of Mercury when a specific history present 
 (Hammond). Belladonna, strongly to be relied on, even when brought on by 
 external violence (P). Bryonia, in serous inflammations when effusion, is 
 extremely valuable (P). Purging, by Magnesium Sulphate, combined with 
 Tinct. Hyoscyami (A). Quinine, when paralysis occurs, in 3-grain doses 
 thrice daily, with ^-grain doses of Ext. Belladonnae, or 20-30-grain doses of 
 Potassium Iodide, and flying blisters along the spine (Da C). Opium, in some 
 form, must be used for pain (Bastian). Mercury, gr. T ^ of the Bichloride, with 
 increasing doses of Potassium Iodide, to promote absorption of inflammatory 
 products, if the inflammation subsides (Bastian) ; a mercurial impression often 
 benefits the paralysis (Da C). Mercury is the only drug which has any influ- 
 ence on the acute process ; it is best given by inunction (Risien Russell). 
 Cold, by ice to spine is deemed necessary, and no doubt alleviates the pain, 
 though heat would be a more rational application for the inflammation 
 (Bastian). 
 
766 MENINGITIS, TUBERCULAR MENORRHAGIA. 
 
 Meningitis, Tubercular. 
 
 Potassium Iodide, is the routine remedy, to be administered in ordinary typi- 
 cal cases, full and frequently repeated doses are necessary, gr. j every 2 hours 
 for a child of 2 years (Whitla). Iodine, lotions to scalp, or inunction of Iodine 
 ointment together with Ferrous Iodide and Cod-liver Oil internally, offer the 
 best chance of success, although most remedies often fail (Wa). Potassium 
 Bromide, combined with the Iodide in double the dose of the latter, is advan- 
 tageous (Whitla). Tartar Emetic, the oint. as counter-irritant to scalp in tuber- 
 cular meningitis (R) ; in large doses internally was formerly employed (Wa). 
 Croton Oil, is said to have removed the excess of fluid from the ventricles (R) ; 
 as a derivative and revulsive, also locally to the shaven scalp, is productive of 
 the best results (Wa). Mercury, Hydrarg. Chlor. Corr., in doses of gr. ■£$ to ^, 
 has proved successful (Wa). Mercury by inunction should be used heroically 
 as long as there is any reason to doubt the diagnosis, in the hope that the case 
 may be one of simple meningitis (Whitla). Magnesium Carbonate, Sj-ij sat- 
 urated with Lemon-juice, every 2 or 3 hours, a useful purgative in hydrocephalus 
 (Wa). Turpentine, in doses of Ttiv-x with Tr^xx-xl of Castor Oil, or terebin- 
 thinate enemata, in incipient hydrocephalus (Wa). Purgatives, in small doses, 
 every 4 or 6 hours after having overcome the constipation, to maintain action 
 for some days; a single dose of Calomel, followed up by Magnesium Sulphate 
 at short intervals ; their value can hardly be overrated (Wa). Leeches, on crown 
 of head rather than on temples, when much febrile action ; inadmissible if patient 
 is much debilitated ; sometimes serviceable (Wa). Cases of recovery have 
 been reported by reliable authorities, but they are extremely rare, and there is 
 always a reasonable doubt as to the correctness of the diagnosis. I have 
 never seen a case recover which I regarded as tuberculous (O). 
 
 Menorrhagia. 
 
 Opium, has specific action in reducing the uterine circulation and should be 
 pushed, even to inducing habit, in severe cases (Lutaud). Ipecacuanha, in full 
 emetic doses (Wa) ; is excellent (B) ; Ergot is better (P). Savine, enlarged, 
 relaxed, and passively congested uterus (B) ; in 5-10 drop doses of tinct. in 
 water every half-hour to three hours, has proved useful (P) ; when menorrhagia 
 due to want of tone in uterus (R). Ergot, large spongy uterus; Bromides bet- 
 ter (B); Ergotin, gr. j or ij in glycerin and water, undoubtedly efficacious as 
 hypodermic injection (P) ; in all forms (R); minim doses of the fluid extract 
 are very beneficial (Smith). Hydrastinine, a powerful uterine vaso-constrictor ; 
 successfully used in grain doses of the Hydrochlorate in 10 per cent, solution 
 hypodermically, for a few days before the expected term. Hamamelis, has 
 decided influence on venous system ; of high repute (Pf ). Arsenic and Iron, 
 when from anemia (B). Cannabis Indica, often successful (R); gtt. v-x of 
 tinct., thrice daily, productive of extraordinary success (Wa) ; has a stimulant 
 action on the uterine muscular fibre, and may be given in combination with 
 Ergot (B). Iron, when dependent on anemia (B). Rue, low vascular tonus ; 
 should never be used in the pregnant state (B). Erigeron, the Oil, in 10-drop 
 doses, is efficient (Wa). Gossypium, a favorite uterine hemostatic in many 
 hospitals, 30-minim doses of the fluid extract every four hours (Parvin). 
 Quinine, has been recommended (R) ; after Ergot it is the best agent, in 6-grain 
 doses every 3 hours (Parvin). Digitalis, very useful, especially when from 
 heart disease, in plethoric subjects (R); ^j-jss of infusion will arrest menor- 
 rhagia when unconnected with disease (P, R). Aloes, with Iron in debilitated 
 and relaxed subjects (B). Cimicifuga, passive, coagulated and dark (P); for 
 accompanying headache (R). Gallic Acid, is very efficient (R). Potassium 
 Chlorate or Bromide, in doses of gr. xv thrice daily, combined with Ergot, has 
 an almost infallible influence over uterine hemorrhage, unless caused by cancer, 
 
METRITIS, ACUTE. y6y 
 
 polypi, adherent placenta, or other similar affections (Tait). Bromides, usually 
 arrest promptly (B); that of Potassium most useful in young women if loss 
 occurs at period only ; commence the Bromide a week before and discontinue 
 when discharge ceases till a week before the next term ; if loss occurs every 
 two or three weeks give Bromides continuously in io-grain doses, but more 
 when organic changes in womb (R, Wa). Ammonium Chloride, for headaches 
 (R). Calcium Phosphate, in anemia from excessive menstruation (R). Mag- 
 nesium Sulphate, very small doses with a little dilute Sulphuric Acid and syrup, 
 is exceedingly useful (Wa). Cinnamon, the Oil, in drachm doses (R). Mam- 
 mary Extract, gave signal satisfaction as an internal remedy in two cases of 
 menorrhagia with dysmenorrhea and enlarged uterus (Bell). Water, hot water 
 bag to lower dorsal and lumbar vertebrae (R) ; cold sitz-bath, feet in warm 
 water, especially valuable ; 6o°-65° F., for 5—1 5 minutes, patient then quickly 
 dried and put to bed. [Compare Metrorrhagia.] 
 
 R. Ext. Ipecac. Fl., £ij. 
 
 Ext. Ergotse FL, ^iv. 
 
 Ext. Digitalis Fl. , . . . . ^ij. 
 M. Sig. — A half teasp. to a teasp. as 
 
 R-. Ext. Ergotae (Squibb), . . gr. xij. 
 
 Ext. Opii, gr. vj. 
 
 M. et div. in pil. no. xij. 
 
 Sig. — One pill every hour, in profuse 
 
 required until emesis occurs. (B.) | menstruation of atonic type 
 
 Menstrual Disorders. 
 
 Aconite, gtt. j of tinct. every half-hour or hourly promptly restores the dis- 
 charge when suddenly suppressed from chill (P, B, R, Wa) ; as emmenagogue 
 (Tr). Pulsatilla, often of the greatest value when menses scanty or delayed, or 
 suppressed by fright or chill (P, B). Ignatia, in the suppression of hysteria (P). 
 Savine, a powerful uterine tonic ; as emmenagogue certain, powerful, safe (P). 
 Ferrum, in anemic subjects (B). Aloes, as emmenagogue [see Amenorrhea]. 
 Cocculus Indicus, for irregular menstruation with colicky pains and scanty dis- 
 charge ; should be given for a few days prior to and during period (P) ; ttUj-iij 
 of a saturated tincture thrice daily. Opium, in suppression from violent mental 
 emotions, a valuable remedy (Wa) ; in many menstrual disorders it proves 
 invaluable, but must be cautiously administered lest the habit be formed. 
 Cimicifuga, relieves heat and pains in the head, flushings of the face, pains in 
 back and limbs, etc., when occurring as the result of menstrual perversion 
 (Wa). [Compare Amenorrhea, Dysmenorrhea, Menorrhagia, Climac- 
 teric Disorders.] 
 
 Mentagra. 
 
 Mercury, the Oleate, or the Bichloride, gr. ij to ^j of water, applied as lotion 
 after each epilation (R) ; Citrine oint. extensively employed (Wa). Sulphu- 
 rous Acid, with an equal part of glycerin, an efficient application (Jenner). 
 Arsenic, has powerful influence, used internally in doses of TTLv of Liquor 
 Arsenicalis thrice daily (Wa) ; the Oleate of Arsenic is an efficient local applica- 
 tion. Sulphur Iodide, as ointment, Z) to ^jss, is efficient, with Donovan's solu- 
 tion internally (Sir E. Wilson). Copper Sulphate, as lotion, Z] to ^xvj of water, 
 with ^ss of Zinc Sulphate, and §jss of Aqua Laurocerasi (B). 
 
 Metritis, Acute. 
 
 Opium, by suppositories or enema is more effectual than if administered 
 internally (VVa). Aconite, is invaluable in early stage of simple inflammatory 
 fevers (P). [Compare Puerperal Fever.] Heat, to the feet, and by large 
 poultice to the abdomen ; also hot water vaginal injection literally for hours if 
 possible, repeated at short intervals ; the only means of aborting an attack of 
 cellulitis (E), which is the condition generally present in cases which are 
 
768 
 
 METRORRHAGIA MILIARIA. 
 
 usually supposed to be ones of acute metritis (Playfair). Turpentine, as hot 
 epithems ; few measures are more generally serviceable (Wa). Linseed Poul- 
 tices, produce great relief to pain and favorably affect the course of the disease 
 (Duncan). Leeches, to the hypogastric region, may be required in patients of 
 full habit. [Compare Puerperal Fever, Puerperal Metritis.] 
 
 Metrorrhagia. 
 
 Opium, has specific action on the uterine circulation [see page 402], and 
 should be given freely in intractable cases of metrorrhagia from uterine fibroids 
 or cancer, in which the establishment of the opium-habit is often advisable 
 (Lutaud). Hydrastinine, a powerful uterine vaso-constrictor ; successfully em- 
 ployed in grain doses of the Hydrochlorate in 10 per cent, solution hypodermi- 
 cally. Atropine, gr. y^ to J^ hypodermically, in profuse metrorrhagia after 
 abortion or of obscure origin ; may require as many as four injections to cause 
 cessation of the flow (Squibb). Salipyrin, in doses of gr. xv thrice daily, em- 
 ployed in fifty cases of metrorrhagia from various causes, with best results in 
 cases following labor or abortion (Orthmann). Ipecacuanha, possesses con- 
 siderable energy in arresting flooding (P) ; in full emetic doses, gr. xx in even- 
 ing, followed by an acidulated draught in the morning (Wa). Hamamelis, 
 when persistent oozing (R). Ergot, the most valuable remedy in full doses 
 repeated every hour or so (R, P). [See Menorrhagia for formula.] Savine, 
 5 to 10-drop doses of tincture in cold water every y 2 hour to 3 hours (P). Iron, 
 styptic preparations as injections (B). [See Hemorrhage, Post-partum.] 
 Cannabis Indica, often arrests metrorrhagia especially when at climacteric ; 
 tincture gtt. v-xx ter die (P) ; has had extraordinary success in number and 
 rapidity of cures (Wa). Sulphuric Acid, sometimes very effective, especially 
 when due to fibroid or polypus ; Ac. Sulphurici Dil., gtt. v-xx, well diluted (B) ; 
 long and extensively prescribed (Wa). Cinnamon, is used with good effect 
 (P) ; has specific action on the uterus (T). Digitalis, in plethoric subjects; the 
 infusion best, a tablesp. bis die (P) ; the effect is prompt and decided (Wa). 
 Magnesium Sulphate, often succeeds (B). Senegin, in 2-grain doses, is suc- 
 cessfully employed (P). [Compare Amenorrhea.] Ice, to abdomen, or within 
 the uterus (B) ; Ice in every way the first thing to try (Wa). Rest, absolutely 
 necessary. Dry Cupping, over the sacrum, is found useful (R). [Compare 
 Menorrhagia, Uterine Tumors.] 
 
 R. Ext. Ergotae Fl., . . . . ^ss. 
 Ext. Senec. Aur. FL, 
 Ext. Viburn. Prunif. Fl. , aa 3 j. 
 01. Myristicae, TT^xx. 
 
 Syr. Simplicis, 
 
 ad 1 
 
 *]« 
 
 hour 
 
 until relieved, then reduce the dose. Keep 
 the head low, and apply cold over the hypo- 
 gastrium. 
 
 Miliaria — Prickly Heat. 
 
 Carbolic Acid, a 4 or 5 per cent, solution in water, adding a little glycerin, 
 is the best local application for the itching and prickly sensations. Baths, 
 warm or containing Sulphides (R) ; sponge-baths with alkaline lotions, diluted 
 lead-water, fluid extract of Grindelia well diluted, or a solution of Copper Sul- 
 phate gr. x to the ^, with dusting powders of Lycopodium, Zinc Oxide or Starch, 
 singly or combined (Hughes) ; fine rice powder makes an excellent application. 
 Diet in severe cases should be simple, nutritious but not stimulating, alcohol is 
 most deleterious (Pringle) ; it is most important to avoid all causes of perspira- 
 tion, as the copious consumption of fluids, excessive exercise, close rooms and 
 warm clothing (Mn). Prickly heat is a form of miliaria, not of lichen, and is 
 due to the excessive sweating incident to the heat of tropical climates (Id). 
 Inunction of the body after the morning bath, with vaselin or some fatty ma- 
 terial, is prophylactic in persons who are subject to the affection (Pringle). 
 
MILIARY FEVER MUSCLE MYALGIA MYELITIS. 769 
 
 Miliary Fever. 
 
 Aconite, for the hyperpyrexia (R, P). Cooling Drinks, purgatives and anti- 
 phlogistics, in mild cases ; malignant ones sometimes occur, and are dangerous 
 (A). Lime-water applied by sponging, is very useful ; or a lotion of Zinc Oxide 
 suspended in Lime-water, gr. xl to jfj, painted on the affected parts of the skin, 
 and permitted to dry thereon (E. Wilson). 
 
 Muscae Volitantes. 
 
 Potassium Iodide, very effectual in curing muscse depending upon hepatic 
 derangement (Wa), Valerian, often found curative (Wa). Muscse Volitantes 
 are due to shadows cast on the retina by fibrillae floating in the vitreous body, 
 and are most visible to myopic persons ; they do not merit attention unless very 
 abundant, or steadily increasing (C). Rest of the eye necessary. Neutral-tint 
 glasses may be worn to render the muscae less visible, if troublesome. 
 
 Myalgia. 
 
 Arnica, the best agent for contused muscular fibre ; also for shake, concus- 
 sion, shock ; TTlv-x every 2 or 3 hours in water (P) ; a few drops of tincture in- 
 ternally, removes stiffness, after packing with cold, wet sheet (R). Cimicifuga, 
 often succeeds wonderfully, as often fails; no indications for its use(B) ; general 
 bruised sensation (R). Ammonium Chloride, in 10- to 20-grain doses, the most 
 efficient remedy (Anstie) ; is effective (R). Veratrine, the ointment externally 
 may control (B). Belladonna, as liniment, is often successful (R). Gelsemium, 
 frequently cures, but large doses are necessary, tt\v-xx of the fluid extract every 
 3 hours (B). Coca, to relieve the sense of fatigue (P). Opium, by frictions or 
 poultices (R). Iodine, ointment for pain and tender muscles of the chest, when 
 skin may be pinched without pain (R). Xanthoxylum, externally and. inter- 
 nally, has a deserved reputation (B). Chloroform Liniment, with friction, often 
 affords great relief (Wa). Firing, sometimes very beneficial (B). Packing, 
 with dripping wet sheet (R). Counter-irritation, by firing, aquapuncture, acu- 
 puncture (B). Electricity, the constant current (B). Baths, Turkish, in aching 
 muscles, from over-exertion (R). Poultices, very hot, followed by applications 
 of lint and oilskin (R). Rest, is the remedy, of course (Wa) ; rest and support 
 to weak muscles are important until they regain tone; especially in painful 
 muscular affections following prolonged or excessive exertion, or in the sore- 
 ness or stiffness which occur during convalescence from any long illness, or 
 accompanying general debility, and generally better after repose, but increased 
 with fatigue. [Compare Lumbago, Pleurodynia.] 
 
 Myelitis. 
 
 Belladonna, is decidedly effective, especially when disease is brought on by 
 external violence (P). Ergot, most successful : large doses are necessary (B). 
 Electricity, in chronic, not in recent form (B). Silver Nitrate, in chronic inflam- 
 mations of the cord, one of the few remedies which are ever of service ; gr. 
 X~K (W). Silver Phosphate, of special value in myelitis with disturbance of 
 bladder and rectum (Wa). Sodium Phosphate, hypodermically, was employed 
 with great benefit in a case of syringo-myelitis [see page 421]. Phosphorus, of 
 marked benefit in myelitic paraplegia from excessive venery (W). Water-cure, 
 Ice-bag to spine, feet in hot water; or better, hot douche to spine (B). Cold, 
 externally, by ice-bags along the spine, with cupping or leeching if much 
 localized pain or tenderness ; spoon feeding and a sparing amount of stimulants, 
 also copious warm enemata to relieve the bowels and act as derivatives. Little, 
 49 
 
yyO MYOPIA MYXEDEMA NAILS — NASAL AFFECTIONS. 
 
 if anything, is to be done with drugs. Posture should be prone, or on side ; 
 absolute rest (Bastian). [Compare Meningitis spinal, Paralysis.] 
 
 Myopia. 
 
 Atropine, by daily instillation, systemically, for the purpose of sacrificing 
 either the convergence or the accommodation, in cases where failure of the 
 internal recti occurs, the disability assuming the form of muscular asthenopia 
 (C). Glasses, properly adjusted, should be worn from the commencement. 
 Extraction of the Lens, produces the happiest results in extreme myopia, 
 especially when progressive, since by removal of the crystalline lens the refrac- 
 tion of a very myopic eye is brought back nearly to emmetropia (Valude). 
 
 Myxedema. 
 
 Thyroid Extract, or the thyroid gland itself, fed to the patient daily, is now 
 the recognized treatment, and produces the best results (see page 157). Tonics, 
 as Iron, Arsenic and the Hypophosphites, with diaphoretic drugs, as Jaborandi, 
 and daily baths, formed the early treatment of this affection (Ord). Exposure to 
 Cold, aggravates all the symptoms and causes great weakness and depression, 
 even though the patient is not conscious of any discomfort from the impact of 
 cold air, by reason of the thickened and insensible condition of the skin. Even 
 while reaping so great a benefit from the use of the thyroid, we are still bound 
 to shield our patients from exposure to cold (Ord). 
 
 Nails, Ingrowing. 
 
 Liquor Potassae, a solution, ^ij to ^j, on cotton-wool, applied to margin of 
 nail at ulcerated surface, to soften the nail in ingrowing toenail (B). Glycerin, 
 or Silver Nitrate, on a fold of lint, to the ulcerate.d surface (C). Lead Carbo- 
 nate, a piece softened between the fingers, and applied as plaster beneath the 
 fungous cushion, cures in a few days (Tr). Paring the nail, after softening in 
 warm water, and cutting a V-shaped incision in centre of nail ; the ingrowing 
 portion should not be cut. 
 
 Nasal Affections. 
 
 Ammonia, by inhalation, in pain and inflammations of nose and frontal 
 bones (R). Potassium Iodide, large doses, gr. xxx-lxxv daily, valuable in 
 syphilitic affections of the nose (Wa). Glycerite of Tannin, to excoriations of 
 inside of nose, after measles, scarlatina, etc., also for impetiginous eruptions of 
 inside ; epilation sometimes needful ; also in discharge of greenish, black, 
 stinking mucus (R). Glycerite of Starch, or Zinc Ointment, applied often, a 
 good supplementary application (R). Hydrastis, in chronic catarrhal condi- 
 tions and nasal ulcers, used internally and externally with great benefit (P). 
 Pulsatilla, may be employed both internally and externally in nasal inflamma- 
 tions (P), and in acute inflammation of nose (B). Cod-liver Oil for chronic 
 discharge (R). Adrenal Extract, locally, has many valuable uses in conges- 
 tions of the nasal passages, also as a styptic after operations [see page 165]. 
 Injections, by nasal douche, are used with benefit in catarrhal states (Wa). 
 Zinc Chloride, gr. ij to the Jj, or the Sulpho-carbolate, gr. v to the ^, as solu- 
 tions locally by cotton-wrapped probe to diminish sensibility of the nasal mu- 
 cous membrane (Sajous). Cocaine, has many applications in treatment of 
 nasal affections ; a 4 per cent, solution by mop or spray will empty the en- 
 gorged venous sinuses, and is very useful in acute catarrh, hay fever, etc., also 
 for posterior and anterior rhinoscopy (R). [Compare Acne, Catarrh, Epis- 
 taxis, Hay Fever, Influenza, Ozena, Polypus, Sneezing.] 
 
NAUSEA — NECROSIS — NERVOUS AFFECTIONS. 77 1 
 
 Nausea. 
 
 Carbolic Acid, or Creosote, is very useful in reflex nausea. Hydrocyanic 
 Acid, rt^i-iv of the dilute acid in £j of water, is useful (Beale). Ammonia, 
 rryij-iv of Liq. Ammoniae in a winegl. of water when the feeling of nausea is 
 most troublesome, may cure the ailment (Id). Hydrargyrum, a small dose of 
 Blue Pill or Calomel will sometimes cure very obstinate nausea, although many 
 other remedies have failed (Id). Cocaine, a 2 per cent, solution sprayed high 
 into the nasal passages, so as to reach the terminal filaments of the olfactory 
 branches, is specific against nausea, its influence lasting several hours (Ingra- 
 ham). Chloroform, ttUj-v on sugar, will relieve some kinds of nausea (B). 
 
 Ipecacuanha, has no rival in sickness of pregnancy, scarcely less useful in 
 that of chronic alcoholism ; very small doses, gr. -£% of powder or rr\j of wine 
 (P). Pulsatilla, in dyspeptic nausea, with coated tongue, flatulence, sick head- 
 ache (P). Cocculus Indicus, in cephalic nausea, violent but ineffectual efforts 
 at vomiting (P). Calumba, in nausea of languid stomach with flatulence, has 
 considerable reputation (P). Cinnamon or Cloves, will check nausea (P). 
 Nutmeg, the simple powder in wine (P). Pimenta, Pepper, Peppermint, re- 
 lieve nausea (P). Tartaric Acid, as effervescing draught, with a tew drops of 
 Tinct. Opii, Tinct. Calumbae, or Dilute Hydrocyanic Acid added, when from 
 morbid gastric irritation (Wa). Bismuth Subnitrate, or the Liquor Bismuthi, 
 when the salt in substance disagrees, is a remedy of established value in nausea 
 and vomiting arising from gastric disorders ; may be combined with Hydro- 
 cyanic Acid (Wa). Counter-irritation, by a mustard poultice applied over 
 the region of the stomach and liver for 20 minutes every 3 or 4 days (Beale). 
 Heat, hot water on spongio-piline, worn for an hour or two, will frequently. 
 be found efficacious (Id). Cold, by a compress or ice-bag, over the stomach, 
 is often very useful. [Compare Dyspepsia, Headache bilious-sick, Sea- 
 sickness, Vomiting of Pregnancy.] 
 
 Necrosis. 
 
 Sarsaparilla, a very useful medicine in diseases of the bones (P). Rest, in 
 a Salter's swing, with poultices, water-dressings or stimulating lotions, to aid the 
 work of repair (CI, Hilton). Tonics, nutritious food, baths, good hygiene, all 
 are necessary adjuncts to local treatment (Andrews). Acid Solutions, of no 
 use as solvents, may be employed with benefit for detergent and alterative 
 effects to expedite the sloughing and restorative processes (Gross). Operation 
 to remove sequestrum is generally necessary ; or resection of the devitalized 
 bone, the latter in young subjects greatly exhausted, where delay would 
 endanger life (Gross). Potassa cum Calce introduced into fistulae, to convert 
 them into large openings, permitting the removal of diseased bone (Kirk- 
 patrick). [Compare Caries, Bone Diseases, Syphilis, Scrofulosis.] 
 
 Nervous Affections. 
 
 Nux Vomica, in one-drop doses of the tincture every 5 minutes, is promptly 
 efficient in relieving many affections of reflex neurotic origin, as cough, 
 dyspnea, syncope, palpitation, flatulent dyspepsia, eructations, etc., especially 
 when occurring in hysterical subjects (Macfarlan). Arsenic, of especial value 
 in nervous affections resulting from malaria, in which large doses are required ; 
 Tt^x of Liq. Arsenicalis, increased to rr^xxx thrice daily (Wa). Asafcetida, is a 
 remedy of much value in nervous affections connected with uterine derange- 
 ment, also in dyspeptic hypochondriasis and other nervous affections ; may be 
 combined with bitter tonics and mild aperients (Wa). Potassium Bromide, 
 takes precedence in epilepsy, epileptiform convulsions, hysterical convulsions 
 
7/2 NERVOUSNESS. 
 
 and spasms, tetanus, etc. ; is of great value in chorea, insanity, acute mania, 
 insomnia, delirium tremens, some forms of neuralgia, and the numerous 
 symptoms of vaso-motor disturbance, such as numbness, coldness, deadness, 
 pricking sensations, indefinable but distressing sensations in abdomen, hypo- 
 gastrium or epigastrium ; feelings similar to rigors, with anxiety, palpitation or 
 fluttering of the heart — all due to interference with the local circulation (Rey- 
 nolds). Valerian and Valerianates, are thought to exercise some special 
 influence over nervous affections, especially Zinc Valerianate, in half-grain to 
 grain doses in pill, or the Ammoniated Tincture of Valerian, from which every 
 good that can be expected from the valerianates will be more certainly 
 obtained (W). Sumbul, acts as a nervous stimulant, and is especially effi- 
 cacious in neurotic migraine, also in hysteria and the obscure paralytic affec- 
 tions associated therewith (Wa). Caffeine, is of signal value in neuralgia, 
 hemicrania and other nervous affections (Shaffer) ; grain-doses in solution 
 hypodermically afford great relief in dorso-intercostal neuralgia attending 
 shingles, insomnia, etc. (Anstie). Cocaine is a powerful nerve stimulant, 
 destroying the sense of fatigue, and often evincing marked analgesic power in 
 neuralgias ; is effective in melancholia, hypochondriasis, etc., as well as locally 
 in nerve pain over a limited area ; it acts as an excitant upon the central 
 nervous system (R). Opium, is a remedy of marked value in insanity, melan- 
 cholia, mania, and all nervous affections accompanied by pain ( W) ; gives 
 general repose to both body and mind, is of decided value in diabetes, and pro- 
 duces marked improvement in melancholia and despondency (R). Lupulin, 
 is peculiarly useful in nervous affections when Opium cannot be tolerated, 
 especially in chronic hysteria attended with morbid vigilance, io-grain doses 
 every 6 hours afford great relief, without causing any unpleasant symptoms 
 .(Eberle). Santonin, in convulsions, epileptiform seizures, and affections 
 regarded as choreic, etc., the result of reflex irritation from worms (Wa). 
 Phosphorus, of occasional utility in affections of the nervous system induced 
 by mental exertion or over-excitement; the danger from its use is its liability 
 to produce fatty degeneration of the internal organs (Wa). Sodium Phos- 
 phate, hypodermically, employed with great benefit in a case of syringo- 
 myelitis, also in one of unilateral astasia-abasia : is considered by Luton to be 
 possessed of reconstructive power equal to that of the animal extracts. Orchitic 
 Extract, has been used with benefit in several affections of the nervous system 
 [see page 162]. Physostigma, given for six months or longer, in small doses, 
 gr. tq of the extract every 3 hours, is useful in many nervous affections, as 
 locomotor ataxia, writer's cramp, and paraplegia due to myelitis (Murrell). 
 Silver Phosphate, is of special value in sclerosis of the nervous substance and 
 in myelitis (Wa). Shower Baths, cold, are often beneficial in nervous affec- 
 tions unconnected with disease of the brain. [Compare Diabetes, Hemi- 
 crania, Headache nervous, Hemiplegia, Hysteria, Insomnia, Loco- 
 motor ataxia, Mania, Melancholia, Myelitis, Neuralgia, Neuras- 
 thenia, Neuritis, Nervousness, Paralysis, Paralysis agitans, Spinal 
 paralysis, etc.] 
 
 Nervousness. 
 
 Opium, calms the nervous system and gives general repose to both body and 
 mind (R) ; small doses, identity of drug to be carefully concealed lest the opium- 
 habit be formed. Antipyrin, is efficient for nervous irritation. Ignatia, in small 
 doses better than Morphine for mental excitement and nervous erethism (P) ; 
 for the nervous exaltation of cinchonism (Pf). Strychnine, affords relief in 
 functional irritability of the nervous system, manifested by restlessness and 
 wandering neuralgic pains (B) : especially useful as a tonic in nervousness 
 from over-use of tobacco (H). Potassium Bromide, especially for women who 
 are despondent, irritable, and sleepless, from overwork, grief, worry, etc.; often 
 connected with migraine (R) ; gr. ss-j of any Bromide everv % hour, is very 
 efficient for the nervous disturbances of children (Smith). Valerian, extremely 
 
NEURALGIA. 
 
 773 
 
 useful as a sedative to reflex excitability, calms nervousness, does much good 
 in fevers where restlessness, fidgets, anxiety, etc. (P). Aconite, gtt. j of tinct. 
 at bedtime, repeated if needful, for restlessness and " fidgets " of men as well 
 as women (R). Caffeine, for restlessness due to great lowering of nervous 
 power (P). Chamomile, lowers reflex excitability (P) ; minim doses of the 
 tincture every 15 minutes an excellent sedative for children (Smith). Resorcin, 
 produces quiet sleep in general nervous excitability. Conium, where a great 
 deal of motor agitation, especially in the typhoid-like condition with insomnia, 
 exaggerated nervousness and delirium, often resulting from mental overwork, 
 acts charmingly in securing sleep, by removing the motor agitation ; rr\,x of a 
 fluid extract of the unripe fruit, every y 2 hour, carefully watched (Madigan). 
 Musk, serviceable in nervous affections when due to uterine derangement (Wa). 
 Sumbul, often invaluable in restlessness of pregnancy; npcxx-xl of tinct. with 
 a little Chloric Ether as a draught (P). Camphor, a powerful subduer of reflex 
 excitability (P). Chloral, where restlessness, debility (R). Chloroform, the 
 Spirit internally (R). Hop, the hop-pillow is deserving of trial. Lupulin is 
 peculiarly useful when Opium cannot be tolerated (Wa). Water, warm spong- 
 ing to induce sleep and calm restlessness in convalescence; also, cold spong- 
 ing (R). [Compare Insomnia, Irritability.] 
 
 R . Strychninae Sulphatis, . gr. j. 
 Quininse Sulphatis, . . ^j. 
 Tinct. Ferri Chloridi, . 3 v. 
 Ac. Phosphor. Dil., 
 Syrupi Limonis, . . . aa^ij. 
 M. Sig. — A teasp. in water thrice daily. 
 
 R. Potassii Bromidi, . . . t ^j. 
 
 Ext. Guaranse Fl., . . . ^jss. 
 
 Syr. Tolutani, . . . . ^iij. 
 
 Aquse, .... q. s. ad ^vj. 
 M. Sig. — Teasp. to a dessertsp. three or 
 four times daily. To relieve nervousness. 
 
 Neuralgia. 
 
 Antipyrin, is prescribed in all forms of neuralgia (M) ; is highly efficient in 
 neuralgia of the 5th nerve associated with neuritis (B). Acetanilid, is used with 
 success in facial and intercostal neuralgias (M) ; is highly useful against pain 
 due to inflammation of nerves (B). Phenacetin, is especially useful in the 
 fugacious and variable neuralgias so common in the hysterical and neurotaxic 
 (M) : of the three drugs named Phenacetin is probably the safest and most effi- 
 cient in doses of 8-10 grains. Salipyrin has been employed with excellent 
 results ; a dose of gr. viij being often sufficient. Phenocoll, is used successfully, 
 especially for the neuralgic pains of epidemic influenza (grippe). Salol, is 
 very efficient in some forms. Salicylates, in large doses, cured a case of tic 
 douloureux of 12 years' standing (Dercum). Opium, internally, or Morphine 
 hypodermically, in the vicinity of the affected nerve, the best treatment ; cau- 
 tion ! morphine-habit (B) ; gr. -^ to X often relieves and frequently cures after 
 a few repetitions (P) ; no remedy promises more speedy and permanent relief 
 than Morphine by subcutaneous injection in sciatica, lumbago, tic douloureux 
 and other neuralgic affections (Wa). Aconite, when arterial excitement (B) ; 
 in congestive neuralgias, and acrodynic of extremities ; has important role (P); 
 as ointment or liniment, especially when fifth nerve affected ; also in neuralgic 
 headache (R) ; a remedy of great value (Wa); a perfect physiological remedy 
 against neuralgia, especially those forms which are based on congestive or sub- 
 inflammatory affections ; but its action is often slow, so that Morphine must be 
 given with it as a palliative. Aconitine, with Veratrine as an ointment locally, 
 a good application (Da C) ; internally the best agent of all in essential neu- 
 ralgia ; should be combined with Quinine in intermittent forms and those which 
 resist quinine alone. [See formula, p. 776.) Belladonna, must be persisted 
 with in full doses ; gr. -^ of Atropine internally, or gr. ^ to -£§ hypodermically 
 in vicinity of nerve, has special utility in tic douloureux and sciatica; also in 
 peri-uterine and dysmenorrheal neuralgias (B) ; rr\j of solution of gr. j in 3ij 
 of water hypodermically (P) ; for spinal irritation, intercostal neuralgia; the 
 
774 NEURALGIA. 
 
 Liniment or Ointment of Atropine in facial (R) ; gr. ijss of the extract every 
 hour till giddiness, then lessen the dose and continue for several days (Tr). 
 Veratrum Viride, tincture, said to be very useful (R) ; Veratrine Ointment for 
 facial neuralgia and sciatica (R) ; the Oint., gr. viij to j§j, frequently of much 
 benefit (P). Quinine, large doses, gr. v-xx in sherry, just before the attack in 
 periodical neuralgia, whether malarial or not ; useful also, in small, frequently 
 repeated doses, in other types, especially of supra-orbital nerve (P) ; has selec- 
 tive action upon supra-orbital form (Spender). Arsenic, cures by its influence 
 on bodily nutrition ; directly so in neuralgia of malarial origin, though inferior 
 to Quinine (B) ; in various neuralgias, also in angina pectoris (R) ; the Bromide 
 of Gold and Arsenic rendered good service in an obstinate case of trifacial 
 neuralgia diagnosed as due to syphilis, after other treatment besides anti- 
 syphilitic had failed (E. A. Wood). 
 
 Nux Vomica, is most useful in visceral neuralgiae, as gastralgia, hepatalgia, 
 etc., the tincture with carminatives in the former affection ; or Strychnine, gr. 
 TU7 to T2" tw i ce or thrice daily : in all forms of neuralgia this remedy should be 
 used in small doses (P). Ignatia, in hysterical and intercostal neuralgia with 
 nervous erethism, is valuable (P). Phosphorus, gr. T ^ every few hours, has 
 made very effective cures (B) ; gr. y^ to T ^ every 3 hours ; very useful in all 
 forms, especially when uncomplicated (R) ; always a good remedy, except for 
 cases due to cold or inflammation, and those not depending on depraved nutri- 
 tion (H). Ammoniated Copper, in neuralgia of the 5th, used with remarkable 
 success; ^-grain doses pushed (Fereol). Physostigmine, very efficient in neu- 
 ralgia of the eyeball, a solution of gr. ij to the ^ by instillation. Cannabis In- 
 dica, %-Yz gr. doses of extract 2 or 3 times a day; especially for neuralgic 
 headache (P) ; found useful (R). Cod-liver Oil, when low nutrition, faulty 
 assimilation (W). Iron, when from anemia ; tincture of the Chloride ttLxxx-xl 
 ter die, also chalybeate waters (B) ; only moderate doses required (R); in 
 chlorotic subjects, of whom nearly all will have neuralgia (Tr). Iodides, for 
 neuralgia of fifth, dependent on syphiloma of the nervous system, pain, noc- 
 turnal chiefly (B). Bromides, benefit some kinds, especially ovarian (B) ; 
 Potassium Bromide occasionally relieves (R). Ammonium Chloride, half- 
 drachm doses in facial and other neuralgias, is much used (R) ; a very efficient 
 and diffusible stimulant, gr. xx-£j at first, repeated every hour during the 
 attack (H). Chloroform, as anesthetic to relieve pain, is occasionally useful 
 locally, also as spray for uterine neuralgia (R) ; rr^v-xv of pure Chloroform by 
 deep injection into vicinity of affected nerve, a very efficient method of dealing 
 with long-standing cases (B) ; used in one case it caused symptoms so severe as 
 to imperil the life of the patient (W). Theine, hypodermically, is promptly anal- 
 gesic, and has prolonged influence, but must be aided by remedies to improve 
 the nutritive state of the affected nerves, or agents which are capable of remov- 
 ing the diathesis upon which the neuralgiae depend (Mays). [See formula, 
 p. 776.] Caffeine, hypodermically has been found useful, especially in cervico- 
 brachial neuralgia (P). Cocaine, as a hypodermic injection, a 4 or 5 per cent, 
 solution is very effective if administered in the vicinity of the aching nerve 
 (R); also by instillation in neuralgia of the eyeball, and whenever it can be 
 applied to the mucous surface in the vicinity of the pain. Croton Chloral, very 
 effective, especially in tic douloureux and sciatica, gr. ij-v every hour till gr. 
 xv are taken (B) ; in facial, that from carious teeth, that of neck and back of 
 the head, tic douloureux, etc. (R) ; gr. j every ^-hour is a very efficient dose 
 (Smith) ; rarely of any value, but when used it is best given in 20-grain doses 
 twice daily (H). Chloral and Camphor, equal parts, triturated together, and 
 painted over surface (R) ; also with Morphine (B). Amyl Nitrite, inhaled in 
 dysmenorrheal neuralgia (B) ; and when of 5th nerve (R). Nitro-glycerin, 
 has often afforded great relief (Wa). 
 
 Sumbul, for certain types, of more value than any other remedy ; facial, 
 sciatic, or ovarian neuralgias, in women of nervous constitution, often yield to 
 it at once (P). Cimicifuga, in neuralgia of the 5th from cold, and in ovarian 
 (B). Gelsemium, successful in neuralgia of 5th (B) ; especially dental branches 
 
NEURALGIA. 
 
 775 
 
 (R) ; of value in trigeminal, ovarian, etc. (W) ; in suitable cases small doses 
 answer as well if not better than large ones (Pf ) ; TT^iij of the tincture every ]/ z 
 hour often succeed miraculously with no ill results in neuralgiae about the head 
 and face (Smith); no better remedy in tic douloureux, but must be given in 
 large doses, TTLx-xv of a strong tincture or fluid extract (H). Zinc Valerianate, 
 extremely beneficial in neuralgia from reflex irritation of female pelvic organs 
 (B). Spigelia Anthelmia, is useful in the facial form (P). Ammonium Valeri- 
 anate, or Zinc Valerianate in neuralgia of face or head (R) ; the latter in ner- 
 vous cases, and uterine (Wa). Chamomile, in neuralgia of the 5th nerve (R). 
 Staphisagria, internally and externally often curative in obstinate facial and 
 cervical neuralgia (P). Ergot, much employed in visceral forms, especially 
 gastralgia (P) ; is said to be useful (R). Digitalis, is strongly recommended in 
 sciatica, also locally in earache (P). Valerian, serviceable in facial neuralgia 
 of hysterical type (P). Bibiru Bark, in intermittent forms (P). Pyrethrum, 
 the root is chewed with benefit in facial neuralgia (P). Capsicum, a strong infu- 
 sion on lint covered with gutta-percha (R). Coccus Cacti, has been very suc- 
 cessful in 20-30 minim doses of a 1 to 8 tincture twice daily, the larger doses 
 in the paroxysms (W). Peppermint, the Oil, painted over the part in facial 
 neuralgia (R) ; especially the Chinese oil, which contains a large excess of 
 Menthol, a very useful application in superficial neuralgiae (W). Turpentine, 
 has cured tic douloureux and sciatica (B) ; often of wonderful service (P). 
 Potassium Chlorate, for facial neuralgia (B). Alcohol, containing much volatile 
 ether ; care must be taken in prescribing it (R). Piscidia, almost specific in 
 many forms, useless in many cases (W). Tonga, is efficient in facial neural- 
 gia, n\x-xx every two hours (H). Osmic Acid, a one per cent, aqueous solu- 
 tion with glycerin to prevent change, of which 5 to 10 drops hypodermically, 
 has made striking cures of inveterate neuralgiae, with no ill effects resulting 
 (Shapiro). Carbonic Acid Gas, injected into vagina for neuralgia of uterus. 
 Aquapuncture, strangely relieves pain in a superficial nerve, so much so, that 
 some hold the curative effects of morphine injections to be due to the water alone 
 (B). Counter-irritation, Mustard poultices in neuralgic pains (P) ; blisters to a 
 posterior branch of the spinal nerve-trunk from which the painful nerve issues 
 (Anstie). Wet Pack, is of great benefit, especially in sciatica. Intense Cold, 
 produced by a spray of Methyl Chloride, or concentrated Carbonic Acid gas, 
 directed along the nerve from special apparatus, immediately relieves the pain, 
 and usually cures ( Jacoby). Compressed Air, by insufflation into the middle 
 ear, in cases of persistent and paroxysmal temporo-occipital neuralgia, due to 
 chronic follicular pharyngitis and inflammation of middle ear ; if these insuf- 
 flations result in diminution of the pain, treatment should be directed to the 
 naso-pharynx and Eustachian tubes (Masucci). Galvanism of the affected 
 nerve, one of the most important curative measures ; a continuous current of 
 4 to 8 cells down the nerve generally answers best, though some cases are 
 helped more by a rapidly interrupted faradic current: Electricity is of no value 
 in cases dependent upon organic lesions, and in any individual case is purely 
 experimental (W). Diet, animal fats necessary, as cod-liver oil, butter, cream, 
 etc., in as large quantity as can be digested. Rest often needed, with protec- 
 tion from cold and damp, also flannel clothing, bathing and shampooing. 
 [Compare Gastralgia, Hemicrania, Hepatalgia, Otalgia, Ovarian Neu- 
 ralgia, Sciatica, Tic Douloureux, etc.] 
 
 For Internal Use. 
 
 R. Quininae Sulphatis, 
 
 Ferri Pyrophosphatis, aa ^j. 
 
 Strychnine Sulphat., . gr. ss. 
 
 Ac. Phosphor. Diluti, . .^ij. 
 
 Syr. Zingiberis, . . . . 25 ij. 
 Aquae, . . . . q. s. ad £ iv. 
 
 M. Sig. — A tablespoonful twice daily. 
 
 For Local Use. 
 
 R. Aconitinae (Duquesnel), gr. v. 
 
 Veratrinae, gr. xv. 
 
 Glycerini, 5pj. 
 
 Cerati, 3 v 'i- 
 
 M. Sig. — To be rubbed over the part, 
 carefully avoiding any abraded surface. 
 
 {Da Costa.) 
 
776 
 
 NEURASTHENIA. 
 
 R 
 
 M. 
 
 For Internal Use. 
 
 Phosphori, gr. ss-jss. 
 
 Alcoholis, q. s. ad solv. 
 Spt. Menthae Piperitae, . q. s. 
 Glycerini, . . . q. s. ad % iv. 
 Sig. — A teasp. after each meal. 
 
 (H.) 
 
 R 
 
 Cupri Ammonio-sulphat.,gr. j-iv. 
 Syr. Aurantii Fior., . . zj. 
 Aquae Destil., . . . . ^iij. 
 M. Sig. — One-third as a dose, thrice 
 daily. [Pro/. Ftreol.) 
 
 R. 
 
 Aconitinae Crystal., . . gr. -g^. 
 
 Quininae Hydrobrom., . gr. xx. 
 M. ft. massa, et div. in pil. no. xij. 
 Sig. — One every 4 or 5 hours. [Potter. 
 
 R. Tinct. Aconiti, 
 
 Tinct. Colchici Sem., 
 
 Tinct. Cimicifugae, 
 
 Tinct. Belladonnae, . aa part. aeq. 
 M. Sig. — 6 drops every hour until re- 
 lieved. {Metcalf.) 
 
 For Local Use. 
 
 R . Chloroformi, 
 
 Tinct. Aconiti, . . . aa ^ ss. 
 
 Linim. Saponis, . . . . ^j. 
 M. Sig. — Apply on flannel and cover 
 with oiled silk. For superficial neuralgia. 
 
 R. 
 
 Mentholi, gr. xlv. 
 
 Cocainae Hydrochlor. , . gr. xv. 
 Chloralis Hydratis, . . gr. x. 
 
 Vaselini, 5 v. 
 
 M. ft. ung. Sig. — For local use. 
 
 {Potter.) 
 
 R 
 
 . Veratrinae, 
 
 Adipis, vel Unguenti, 
 M. Sig. — Local use. 
 
 gr. xl. 
 [Da Costa.) 
 
 R. 
 
 Theinae, 
 
 Sodii Benzoatis, . . . aa^j. 
 
 Sodii Chloridi, . . . . gr. x. 
 
 Aquae Destil. , ^j. 
 
 M. Sig. — 3 to 20 drops hypodermically 
 at central seat of disturbance. ff\,yj = gr. ss 
 of Theine. [Mays.) 
 
 Neurasthenia. 
 
 Ammonia, the Aromatic Spirit has proved very serviceable ; ^ss-j in water 
 thrice daily (Wa). Hypophosphites of Lime or Sodium, or Iron, are actively 
 tonic in cases of nervous depression and torpor, with occasional shooting pains 
 (Wa) ; the Syrup of the Hypophosphites with Strychnine is of service as a 
 general tonic, in connection with other remedies. Arsenic, is often very 
 serviceable; Fowler's or Pearson's solution, in doses of nuij-v, in water, after 
 each meal. Aurum, the Bromide of Gold and Arsenic (Barclay), gave excel- 
 lent results in 3 out of 4 cases of marked neurasthenia, in doses of tr^v of the 
 solution 4 times daily (Love). Strychnine Acetate, a remedy of great promise, 
 when combined with a rigid system of diet, mental discipline, etc. (Marshall 
 Hall). Zinc Oxide, often excellent as a tonic and sedative, in nervous irrita- 
 bility and depression from anxiety, over-study, etc. (Wa). Phosphorus, of 
 occasional utility in nervous breakdown from over-study, etc. (Wa). Caffeine, 
 gr. j or more in a cup of coffee, to relieve brain weariness and nervous 
 exhaustion (Wa). Cocaine, in J^-grain doses proves serviceable in nervous 
 exhaustion (R): danger of cocaine-habit if identity known to the patient. 
 Coca, as a stimulant has been used with benefit, but only for a short time, 
 and acts deleteriously unless given in small doses (W). Kola-nut is used in 
 France, contains Caffeine, is subject to the same remarks as Coca, above. 
 Musk, is a valuable remedy in such cases, being stimulant and antispasmodic ; 
 it stimulates the nervous centres when exhausted, without producing any very 
 pronounced symptoms (W). Orchitic Extract, has been used with benefit. 
 Nuclein, is useful in many cases (Vaughn). Cerebrinin, has been used 
 with advantage (Paul). Artificial Serum, in cases of lowered arterial tension 
 (lessening of first sound, tachycardia embryocardia), an injection hypo- 
 dermically of n\xv of the solution formulated on next page, 2 to 4 times a day 
 {La France Med.). Diet should be chosen from the most readily assimilable 
 food, calling for a minimum amount of digestive work. As a rule, neurasthenics 
 eat too much and drink too little ; plenty of water, at least a liter and a half 
 
NEURITIS — NEVUS. 
 
 777 
 
 per day, is the best drink; it maintains the arterial tension, irrigates the tissues 
 and assists the excretion of debris. Milk should be prohibited, also vegetable 
 soups, peptones and extracts of meat. The albuminoid element of the food 
 should not exceed one-fifth of the total (Vigoreaux). Counterirritation, the 
 actual cautery along the spine has rendered excellent service in several cases 
 of neurasthenia accompanied by neuralgia of the superficial branches of the 
 spinal nerves ; its action is doubtless often a mental one, and it renders the 
 carrying out of the rest-cure more thorough than when attempted without some- 
 thing to enforce quiet. Rest-cure, with forced alimentation and systematic 
 massage to keep up the muscles while holding the nervous system as inactive 
 as possible, will do more than medicine in these cases. Many such will recover 
 under the discipline and quiet of a. hospital or sanitarium alone ; while others 
 are greatly benefited by removal from home influences and cares, and from 
 association with certain persons who irritate them. [Compare Adynamia, Ex- 
 haustion, Gout, Hysteria, Spinal Irritation.] 
 
 Artificial Serum. 
 R . Sodii Phosphatis Pur. , . 
 Sodii Sulphatis Pur., . . 
 Sodii Chloridi Pur., . . 
 Ac. Carbol. Cryst., . . . 
 Aq. Destil. Bullient., 
 Dose, TT^xv hypodermically 
 
 • 3"J- 
 , . gr. lxxx. 
 
 . gr. xxx. 
 
 . gr. v. 
 ad £ iv. 
 
 R. 
 
 Strychninae Acetatis, . . . gr. j. 
 
 Ac. Acetici Diluti, .... rr^xx. 
 
 Alcoholis, ^ij. 
 
 Aquae Destill., . . . . ^vj. 
 Sig. — Ten drops thrice daily. [Hall.) 
 
 Tonic and Stimulant. 
 
 R. Tinct. Kolae, ^j ss - 
 
 Ac. Citrici, gr. xx. 
 
 Sodii Arseniat. , gr. j. 
 
 Tinct. Cocae, . . . q. s. ad Hjiv. 
 Dose, 5J at each meal. 
 
 R. 
 
 M. 
 
 Ac. Phosphorici Dil., . . . 5j. 
 Elixir Calisayae (U. S. Disp.),3vj. 
 Elix. Ammonii Valerian., . . Jij. 
 
 Glycerini, ^i'j* 
 
 Vini Xerici, . . . q. s. ad Oj. 
 Sig. — ^j thrice daily. 
 
 Neuritis. 
 
 Strychnine, internally, is of value, and may be given in increasing doses (O) ; 
 hypodermically, in multiple peripheral neuritis, is of great advantage ; no case 
 remembered in which it failed to cause improvement (Walker). Acetanilid, 
 is so effective that it seems to have specific action (B). Antipyrin and Salicy- 
 lates, are recommended in the acute cases with fever (O). Arsenic may be 
 employed (O) ; the Bromide of Gold and Arsenic cured a case of neuritis with 
 partial hemiplegia lasting five years, with inability to walk and considerable 
 pain along the spine and in right arm and leg (Barclay). Potassium Iodide 
 and Mercury, if there is a history of syphilis (O). Massage is probably the 
 most reliable means at our command in the later stages, when the atrophy is 
 marked and the pains have lessened. Contractures may be gradually over- 
 come by passive movements and extension. The interrupted current is useful 
 when the acute stage has passed (O). [Compare Alcoholism, Neuralgia, 
 Spinal Irritation.] 
 
 Nevus. 
 
 Ferrum Chloride, injected, is effectual ; but dangerous when applied thus to 
 nevi about the head (Wa). Creosote, pencilled over twice a day, may remove 
 nevi (Wa). Chromic Acid, as escharotic, or local application, gr. c ad ^j aquae 
 destil. (B). Electrolysis, or galvano-cautery, to remove nevi (B) ; 40 cases so 
 treated ; the process is certain and safe, leaving a faint cicatrix and no after- 
 pain (Knott) ; in my hands has answered well during ten years' use in these 
 cases (Marshall). Nitric Acid, strong, as escharotic for small superficial nevi, 
 followed by Oleum Olivae (B). Zinc Chloride, Iodide and Nitrate, locally, 
 especially the first named (R). Setons, threads passed across the growth in 
 
77 s 
 
 NIGHTMARE NIPPLES NODES NYMPHOMANIA. 
 
 various directions, to produce suppuration ; when pus appears the threads 
 should be removed. Sodium Ethylate, prepared by adding the metal Sodium, 
 piece by piece, to absolute alcohol in a wide-mouthed bottle; the crystalline 
 substance found deposited after effervescence ceases is an excellent caustic for 
 nevi ; painted over them it rapidly causes an eschar, and usually gives but little 
 pain (Richardson). Mercury, the Acid Nitrate, an excellent caustic for remov- 
 ing moles from the face (Thomas). 
 
 Nightmare. 
 
 Potassium Bromide, in nightmare of adults, and children's attacks of night- 
 screaming often associated with squinting : the digestive organs may also 
 require attention (R). Camphor-water, a teaspoonful or two the most suitable 
 medicine (H). Sleep, in abundance, may prevent nightmare (H). Diet, light; 
 avoid late meals and indigestible food. 
 
 Nipples, Sore, Fissured. 
 
 Benzoin, an admirable local application (P) ; the tincture locally for slight 
 erosions (Parvin). Silver Nitrate, touched lightly, is effectual (Wa). Sulphur- 
 ous Acid, solution neat or diluted, constantly applied, or with equal quantity of 
 glycerin as lotion (R). Collodion, sometimes used (R) ; useful for protection 
 (P); better applications are Arnica cerate, the glycerite of Starch, or 2 parts of 
 eau-de-Cologne to 1 of glycerin (R). Lime-water, is a useful application for 
 cracked nipples. Alcohol, Brandy and water as a lotion before delivery and 
 after each suckling to prevent cracking (R). Borax, saturated solution, bene- 
 ficial (W). Iron, the solution of the Subsulphate diluted with 3 parts of glyc- 
 erin, and applied with a camel's-hair brush, an effective application for fissured 
 nipples (B). Tannin, the Glycerite, one of the best applications to fissured 
 nipples (B). Lead Nitrate, in glycerin, or ointment 3j to ^j, for fissured nip- 
 ples (B). Zinc Shield, constantly worn (R). Balsam of Peru or Tolu, valuable 
 as an application, with Oil of Almond, gum arabic, and rose-water (P). Rhat- 
 any, as wash or cerate, has had great success in fissure (Tr) ; 1 part of extract 
 to 15 of cacao-butter (Wa). Nipple-shield, to give the nipple rest while the 
 child sucks, gives great comfort. [Compare Lactation, Mastitis.] 
 
 R. Balsam. Peruvian., . . . ^ij. 
 
 Olei Amygdalae, .... ^jss. 
 
 Mucil. Acaciae, gij. 
 
 Aquae Rosae, q. s. 
 
 M. Sig. — Apply to the nipples after 
 each nursing. {Phillips.) 
 
 R. Liq. Plumbi Subacet. Dil., ^ ss. 
 
 Ext. Opii, £j. 
 
 Aquae Rosae, J iijss. 
 
 M. Sig. — Lotion to be used after a 
 bread- and-milk poultice, for inflamed nip- 
 ples. (F. Barker.) 
 
 Nodes. 
 
 Mercury, the Oleate of Mercury and Morphine externally, is very valuable 
 (R). Potassium Iodide, as ointment in conjunction with internal use, in syph- 
 ilitic nodes of children ; also in non-syphilitic periosteal thickenings (R) : in 
 syphilitic nodes it holds the first place, especially when pains are worse at night 
 and increased by heat of bed (Wa). Stramonium leaves, locally, relieve (Wa). 
 [Compare Exostosis, Periostitis.] 
 
 Nymphomania. 
 
 Potassium Bromide, when from plethora; not useful when relaxation, or 
 from cerebral lesion (B) ; large doses required, at least gr. xx ter die (R) ; an 
 abundance of evidence testifies to its value (W). Tobacco, to nausea, effect- 
 
OBESITY ODONTALGIA. 779 
 
 ually cures, but is horribly depressing (B). Camphor, in considerable doses 
 said to control inordinate sexual desire (R) ; at present not much relied on 
 (Wa). Lupulin, seems worthy of fair trial (Wa). Sulphur, or dilute Sulphuric 
 Acid internally, when arising from hemorrhoidal congestion, not an infrequent 
 cause (Wa). Orchitic Extract, has given satisfaction. Cerebrinin, has been 
 used with benefit (Paul). 
 
 Obesity. 
 
 Iodoform is highly efficient, but causes wasting and anemia, the latter by 
 injuring the red blood corpuscles (B). Iodol, in 2-grain doses thrice daily, is 
 equally effective (B). Alkalies, as solutions of Oxides or Bicarbonates (R) ; 
 alkaline mineral waters, with exercise and dietary (B) ; serviceable (Wa) ; 
 Liquor Potassae ^ss in milk, thrice daily, of established value (Wa) ; generally 
 fails (R). Ammonium Bromide, sets up gastric catarrh (B) ; but lessens 
 corpulency (Wa). Sulphurous Waters, especially Blue Lick, ^iv before each 
 meal (B). Potassium Permanganate, for attendant dyspepsia and flatulence ; 
 also useful for the obesity; gr. %-] ter die, in distilled water (B). Vinegar, 
 only successful at expense of serious injury to the body (R). Fucus Vesic- 
 ulosus, Jias power to reduce adipose tissue; an extract is sold under the title 
 Antifat as a proprietary medicine (W). Phytolacca, has been long known as 
 a reducer of adipose tissue; a resinoid preparation, named Phytoline, is on 
 the market as an " anti-fat," the dose of which is n\x, six times daily, before 
 and after each meal. Thyroid Extract, has been employed in several cases 
 with uniformly good results [see page 159]. 
 
 Banting Dietary is alone sufficient to improve the condition ; its chief feature 
 is the exclusion of the two elements, starch and sugar, from the food ; there- 
 fore bread (except toast, or the crust of a common loaf), potatoes, sweet roots, 
 butter, sugar, cream, beer, porter, and champagne, should be avoided. In one 
 year, on this diet, Mr. Banting reduced his weight 46 pounds, and his girth 
 about 12 inches; at the same time, his numerous corporeal infirmities were 
 greatly mitigated or altogether removed ; but it cannot be recommended indis- 
 criminately. This was the method of Hippocrates, avoiding all fats, starches, 
 and sugars; in fact, all roots or vegetables which grow underground (B). Meat 
 Diet, very successful in 42 cases, the diet being confined to rump-steak, hot 
 water and codfish, for 14 days, absolutely excluding everything else (Smith). 
 The Schweninger or Oertel method is similar, using chiefly albuminous food, 
 excluding fat and carbohydrates, limiting the fluids drank, especially at meals, 
 and enforcing exercise. Peanuts, are an excellent article of food for the cor- 
 pulent (Furbringer). [See under Diabetes Mellitus.] Exercise, daily, in the 
 open air, is necessary, and if carried on systematically is the most efficient and 
 least injurious method of reducing an excess of adipose tissue. 
 
 Odontalgia. 
 
 Aconite, as ointment or liniment for facial neuralgia due to diseased teeth, 
 will succeed quickly if at all (R, Wa). Arsenic, gr. ^, as escharotic to destroy 
 pulp ; when used for pain may be mixed with Opium ; it sometimes at first 
 aggravates pain (R, W). Staphisagria, the alcoholic solution dropped into the 
 cavity (P). Alum, a solution in Nitric Ether, 3U to 3 vij, is said to be an effect- 
 ual application (B) ; Alum and salt powdered and placed in the cavity, excellent 
 when nerve exposed. Chloral, rubbed up with an equal weight of Camphor, 
 and placed in the cavity (R) ; these two, with Glycerin and Carbolic Acid, equal 
 parts of each ingredient, applied on a little cotton after cleaning the cavity, will 
 relieve the pain, and makes an excellent mixture for " toothache drops " (Brod- 
 nax). Chloroform or Croton- Chloral, equal parts of the former and Creosote, a 
 good application (R). Tannin, a solution in Ether is a good application to a 
 carious tooth (B). Creosote, with Tannin or Opium or Chloroform, placed in 
 
78o 
 
 ONYCHIA AND PARONYCHIA. 
 
 the cavity of a decayed tooth, often gives relief (R). Sodium Salicylate, gr. xv 
 every 4 hours, is highly efficient for toothache started by taking cold, also for 
 the periostitis in which the tooth becomes loosened and projects so as to be ex- 
 quisitely tender when eating (Coley). Cocaine, a 5 per cent, solution on cotton 
 applied to a cavity will often bring instant relief. Coniine, a solution in alco- 
 hol placed into a hollow painful tooth (R). Collodion and Carbolic Acid, equal 
 parts, as jelly for filling carious teeth (R). Opium, mixed with Tannin or 
 Creosote inserted in cavity of painful tooth (R). Morphine, hypodermically 
 for severe toothache (R). Oil of Cloves, inserted into cavity (P). Camphor, 
 with Morphine and Flaxseed, as a cataplasm to the cheek (B). Xanthoxylum, 
 a domestic remedy (B). Capsicum, a strong infusion on lint (R). Gelsemium, 
 useful in some forms (R). Zinc Chloride, to destroy exposed painful pulp (R). 
 Ginger, Mezereon, Pyrethrum, are useful masticatories in toothache (P). [Com- 
 pare Gums ] . 
 
 R. Linim. Aconiti (B. P.), 
 
 Chloroformi, .... aa^iij. 
 Tinct. Capsici, .... 3J. 
 Tinct. Pyrethri, 
 Olei Caryophylli, 
 Pulv. Camphorae, . . aa^ss. 
 M. Sig. — A few drops to be placed on 
 a pellet of cotton and applied to the cavity. 
 
 {Mason.) 
 
 R- . Acidi Tannici, . . . . gr. xx. 
 
 Mastiches, gr. x. 
 
 Athens, ^ss. 
 
 M. Sig. — On cotton to cavity. (D.) 
 
 R. 
 
 Creosoti, .... 
 01. Caryophylli, 
 01. Menth. Piperit 
 Camphorse, . . 
 Alcoholis . . . q 
 
 . % iv. 
 
 • 3'J SS - 
 adO]. 
 
 M. Sig. — Toothache Drops. 
 
 R. Morphinse Sulph., . . . gr. iv. 
 
 Atropinse Sulph., . . . gr. j. 
 
 Aquae Destill., .... ^j. 
 M. Sig. — A few drops on cotton, placed 
 in the cavity. (B.) 
 
 Onychia and Paronychia. 
 
 Silver Nitrate, a strong solution in Nitrous Ether, painted over the adjacent 
 tissue, will abort if applied early (B); frequently causes resolution of the 
 inflammation (Wa). Lead Nitrate, dusted over night and morning (R); 
 relieves pain and hastens healing process (B). Turpentine, applied on a piece 
 of lint or other absorbent material, stops the pain at once, and seems to abort the 
 felon. Mercury, as ointment, for 10 minutes in every hour ; poultices in interim 
 (R). Arsenic, gr. ij ad ,^j Adipis, as ointment, almost specific in onychia 
 maligna (Wa). Tartar Emetic, will shorten course and render it milder (R). 
 Iodoform, oint. or powder dusted on (B); or 1 part to 9 of Ether applied by a 
 dropper, in syphilitic onychia (Fox). Iodine, a strong alcoholic solution locally 
 will often subdue the disorder (Wa). Chloral, a solution locally, as antiseptic 
 and to promote healing (B). Sodium Chloride, common salt roasted until the 
 chlorine is driven off, equal parts of this, Castile Soap and Venice Turpentine, 
 as a poultice, is a very efficient application. Carbolic Acid, to benumb surface 
 during incision (R) ; which should be carried down to the bone, especially in 
 tendinous whitlow (D). Cocaine, hypodermically, will accomplish the local 
 anesthesia more thoroughly, if delivered deeply into the tissue. Morphine, 
 powdered, as local application to relieve pain. Heat, by poultices, is a very 
 beneficial application. In Opening a felon avoid the lines of the arteries on 
 the sides of the fingers, and that of the flexor tendons, which is the median line 
 on the palmar surface ; the incision should be made midway between these lines. 
 If the sheath of the tendon be opened the tendon may slough, and the finger 
 be rendered useless (Ashhurst). Removal of the nail may be necessary in ob- 
 stinate cases of onychia, the raw matrix being dressed with powdered Lead 
 Nitrate. 
 
OPHTHALMIA OPIUM HABIT. 78 1 
 
 Ophthalmia. 
 
 Silver Nitrate, a strong solution, gr. xx to the 3, in granular lids ; cautiously 
 when corneal ulcers exist (B) ; a solution, gr. ij-x to the %, painted over the 
 everted lids, which should be washed with a solution of common salt, and then 
 with water before being replaced (C) ; in solution, gr. v to ^j aquae destillatae, 
 locally once a day in purulent ophthalmia of the new-born, washed off with a 
 weak solution of common salt (Noyes) ; in solution, gr. iij to the §, to abort 
 the discharge in catarrhal ophthalmia (Fox). Boroglyceride, in many catarrhal 
 affections, especially ophthalmia neonatorum, is a most efficacious application, 
 the solutions used being of 10, 25 and 50 per cent, strength (Fox). Alum, gr. 
 viij to ^j aquae, applied every %X.oYz hour in purulent ophthalmia of children ; 
 success depends on the frequency of the application (R) ; a crayon formed of 
 a crystal of alum, a mild and occasionally useful application (C). Mercury, 
 Calomel dusted over membrane in phlyctenular ophthalmia ; or after detach- 
 ing scales rub in Brown Citrine Ointment every night, for eczema of margin of 
 lids (B). Pulsatilla, as a lotion to conjunctiva 8 or 10 times in 24 hours, also 
 internally (P) ; much used by homeopaths (B). Spigelia, useful in rheumatic 
 ophthalmia (P). Antimony, as Tartar Emetic, gr. -fe to -^g-, three or four times 
 a day in strumous ophthalmia, with sharp purgation at commencement (R). 
 Belladonna or Atropine locally, of great service in strumous ophthalmia to 
 relieve pain ; constitutional treatment also required (Wa) ; Atropine, gr. ij of 
 the neutral sulphate to the § of aqua destillata, twice or thrice daily, as soothing 
 application (C). Arsenic, invaluable in inveterate cases of strumous ophthal- 
 mia, especially when complicated with cutaneous eruptions (Wa). Copper 
 Sulphate, gr. j to gj aquae camphorae as collyrium in purulent ophthalmia of 
 infants; in substance to inner part of lids in granular conjunctivitis (Wa). 
 Tannin, powdered or in solution, gr. j-x to the § , produces remarkable results (B). 
 Lead Acetate.gr. j ad ^j aquae destillatae, applied by camel's-hair pencil to sur- 
 faces of everted lids, washed away before the lid is replaced ; or the Tannate 
 of Lead 1 ]/ z to 3 parts fine Oil and 1 of fresh Lard, a very small piece as ointment 
 to lid (C). Carbonic Acid Gas, said to relieve the pain and photophobia of stru- 
 mous ophthalmia, when locally used (R). Physostigmine, locally, to reduce pu- 
 pil and shut out the light (P). Iodine, is employed locally in scrofulous ophthal- 
 mia for its alterative stimulation (W). Iodoform, in gonorrheal ophthalmia, and 
 purulent conjunctivitis, of very great value locally, but should be pulverized 
 very finely (Grossmann) ; does not bear out the claims made for it (Keyser). 
 Zinc Chloride, gr. j ad ^j aquae, as collyrium in gonorrheal ophthalmia is used 
 with marked benefit; also a stronger solution, gr. ij-iv to the %, effectually 
 arrests the muco-purulent discharge remaining after subsidence of purulent 
 ophthalmia, and has succeeded admirably in diphtheritic conjunctivitis and 
 pustular ophthalmia (Wa). Zinc Sulphate, as collyrium, gr. j-iv to the ^, is 
 very serviceable in ophthalmia of infants or adults ; Liquor Plumbi added 
 improves it (Wa). Staphisagria, especially in tarsal ophthalmia (P). Colchi- 
 cum, when gouty diathesis (P). Cod-liver Oil, in strumous subjects, tends to 
 remove the manifestations of the disease (R). Cold Wet Compresses, or iced, 
 are held to be essential in the early stage of acute purulent and gonorrheal 
 ophthalmia (C). [Compare Blepharitis, Conjunctivitis, Keratitis.] 
 
 Opium Habit. 
 
 Sodium Bromide, in large and increasing doses, Z) twice daily, increased 
 by 20 grains each day, to a maximum of 100 to 120 grains twice in twenty-four 
 hours, with simultaneous gradual reduction of the opiate dose, so that from the 
 8th to the 10th day it is entirely abandoned ; each dose of the salt should be 
 given in 6 or 8 fluid ounces of cold water ; this drug, with Codeine and Trional, 
 form a combination of unrivalled efficacy, if properly used in proper cases, and 
 
782 OPIUM HABIT. 
 
 combined with minor aids make a method far in advance of any yet presented, 
 to secure the minimum duration of treatment and maximum freedom from pain 
 (Mattison) : a combination of Bromides [formula on next page], commencing 
 with 40 grains, increasing to 100 grains twice daily, at 10 a.m. and 4 p.m., 
 freely diluted with water, does not depress vitality, or produce the injurious re- 
 sults of the bromides as commonly administered; this, with Z) of Warburg's 
 Tincture before breakfast each morning, Spt. Athens Nitrosi to eliminate the 
 bromides rapidly, electricity, a mixture of Iron and Strychnine, and an occa- 
 sional hypodermic of 5 or 10 minims of a 4 per cent, solution of Cocaine for 
 nervous restlessness, is the general line of my treatment (Mann) : by acute 
 bromidism it is possible to obliterate quickly and permanently the desire for 
 morphine without the usual suffering, but requires careful nursing (Macleod). 
 Bromides may do great harm, if recklessly administered, paralyzing the mus- 
 cular system and causing prolonged delirium. Cocaine, or the fluid extract of 
 Coca, has been used to relieve the depression caused by the withdrawal of the 
 drug (B); has been, by many careful observers, pronounced of great benefit, 
 restoring appetite, inducing sleep, promoting digestion, while soothing the brain 
 and inducing a feeling of contentment and calm (R) : should never be entrusted 
 to the patient, lest he jump out of the frying-pan into the fire. In the treat- 
 ment of the combined morphine and cocaine habit, the latter drug may be 
 withdrawn entirely at once without any suffering, and the former may be re- 
 duced one-half at the same time. Codeine, in doses of a grain or more, is very 
 useful in combating the nervous agitation which succeeds to the final with- 
 drawal of the opium. [See under Sodium Bromide above.] Trional, in dose 
 of 30 to 40 grains as a hypnotic, is of special value in these cases. Paralde- 
 hyde, in dose of 3jss-ij, a s a hypnotic, is efficient, but its sleep is of briefer 
 duration than that produced by Trional or Sulphonal. Gelsemium, subdues 
 the restlessness and motor excitement; proved of great value in one case where 
 30 grains of morphine were used daily ; rr\j of tincture every )/ z hour (Pennoyer). 
 Conium, in 10-drop doses of a good fluid extract, to check motor activity and 
 relieve the wandering pains. Sparteine, in doses of gr. l / z to % hypodermi- 
 cally, at moment of systolic cardiac depression which answers to the period of 
 craving, and corresponds to the truncated curve of the sphygmographic trace, 
 characteristic of the period when the stimulant effect of morphine has passed 
 (Jennings). Nitroglycerin acts in the same manner, but its effect is more rapid 
 and ephemeral (Id). Atropine, used with great benefit in one severe case, re- 
 pressing the copious exudation from the air-passages, bowels and skin, and 
 moderating the distressing symptoms due to the withdrawal of the morphine 
 (W. Koch). Physostigmine, gr. y^ acts remarkably well at the crisis as a 
 substitute for the drug. Duboisine, injected daily succeeded in destroying the 
 craving for morphine in a case of long standing (Birnabee) ; is an excellent 
 calmative and hypnotic at the crisis. Hyoscyamine, Merck's amorphous, use- 
 ful as a hypnotic, and is perfectly safe in patients of good general condition, 
 in whom the disuse of opium produces unusual insomnia and motor activity 
 (M). Hyoscine, the Hydrobromate, in doses of gr. y^ to ^.hypodermically, 
 is very efficient for the same purpose, but must be used sparingly, as it excites 
 high delirium in most subjects for a time. Cannabis Indica, may be required 
 in full doses, for restlessness after withdrawal of the opiate, 3-doses of Squibb's 
 fluid extract, repeated every hour or two, as required (M); or increasing doses 
 of Hering's solid extract, beginning with one or two grains. Chloral, as a hyp- 
 notic, fails in the first few days of abstinence; later in full doses, 45 grains at 
 once, rather than three 15-grain doses, alone or with a Bromide, it can be re- 
 lied on (M). Galvanism, is very efficient for the neuralgic pains in various 
 parts ; a strong faradic current sometimes acting better (M). Baths, if hot, 
 105 to 112 F., are of great value to relieve disquiet; warm baths are worth- 
 less (M). Lavage of the stomach with a solution of Sodium Bicarbonate, or the 
 drinking of such a solution to neutralize the hyperacidity of the stomach, which 
 is the cause of most of the distress (Erlenmeyer). 
 
 Strychnine, is invaluable, especially when the cure is nearly completed (Barr). 
 
ORCHITIS. 
 
 783 
 
 Aurum, the Bromide of Gold and Arsenic, m^x hypodermically, as a tonic, 
 thrice daily, to complete the cure. Capsicum, is serviceable as a stimulant to 
 the stomach and a cerebral sedative ; removes the sinking sensation at the epi- 
 gastrium, and tones up the intestines. Catechu, the tincture in Z doses, for the 
 diarrhea. Ergot, in full doses, for the headache. Lupulin, with Phosphoric 
 Acid [see formula below], helps to sustain the patient, lessens the force of his 
 suffering, and shortens its duration (Fleming). Zinc and Iron, as blood tonics, 
 administered for a month at least, are valuable restoratives, and are best 
 given on alternate days (Fleming). Piscidia Erythrina, has been proposed as 
 a substitute, and highly recommended, but is worthless, as are also Avena 
 Sativa and many other falsely termed substitutes (M) ; there is no specific for 
 the opium habit (Da C). Zinc Oxide, for the vomiting and diarrhea, begin- 
 ning with gr. j once daily and increasing to tolerance (Da C). Withdrawal of 
 the drug suddenly and completely, is the method of Levinstein and other Ger- 
 mans, and is preferred when we can have absolute control and surveillance of 
 the patient (Da C); entails horrible suffering, and is utterly inexcusable (M) ; 
 a more gradual reduction is the method usually employed, taking off one-third 
 the first day, one-fourth the second day, and then gradually reducing the 
 amount until the sixth or seventh day, when it may be withdrawn entirely. No 
 agent is of any value unless strengthened by moral courage and perseverance 
 on the part of the patient (Squibb). Useless to try to cure a patient while he 
 is pursuing his ordinary avocations ; failure will result unless there is complete 
 seclusion and entire giving up to the treatment (Mann). It is very important 
 to keep the patient in total ignorance of the rate of reduction. 
 
 R . Ammonii Bromidi, 
 
 Sodii Bromidi, . . . . aa^ss. 
 
 Potassii Bromidi, . . . . J|j. 
 
 Liq. Potass. Arsenit., . . «?j. 
 
 Syr. Tolutan., ..... %]. 
 
 Aquae Menthse Piper., . . 5 jss. 
 
 Syr. Hypophos Comp., . 3 iij. 
 M. Sig. — 3J to gij in water thrice 
 daily. Has of total Bromides, gr. 21^ in 
 each 3 . [Mann.) 
 
 Bi . Tinct. Capsici, 
 
 Potassii Bromidi, . . . aa^iv. 
 
 Spt. Ammoniae Aromat, . 3" iij. 
 
 Aquae Camphorae, . q. s. ad Hj vj. 
 M. Sig. — A dessertsp. several times 
 daily, in the depression of alcoholism and 
 the opium-habit. Instead of the bromide, 
 Fowler's solution, mj, may be added ; or 
 Tinct. Nucis Vomicae 3 Ij, or Tinct. Aur- 
 antii Amari 3 v. [Ringer.) 
 
 R . Codeinae, gr. xvj. 
 
 Alcoholis, . . . . q. s. ad%o\v. 
 
 Cocainae Ffydrochlor., . . gr. xvj. 
 
 Elixir Simplicis, . q. s. adgi]. 
 M. Sig. — gj in water, occasionally, 
 when great restlessness. Formula never 
 to be given to the patient. [Potter.) 
 
 R. Tinct. Cannabis Ind., . . T^xl-lx. 
 
 Spt. Athens, £j. 
 
 Aquae, . . q. s. ad£). 
 
 M. Sig. — One dose, if insomnia is very 
 protracted. [Fleming.) 
 
 R . Tinct. Nucis Vomicae, . . 3 iij. 
 
 Ac. Phosphor. Diluti, . . 3 v. 
 
 Syr. Pruni Virg., . . . . ,^ij. 
 
 Aque, . q. s. ad^iv. 
 
 M. Sig. — £ij twice daily as a nerve 
 tonic. [Potter.) 
 
 Orchitis. 
 
 Pulsatilla, mj or less of the tincture every hour, relieves the pain rapidly, 
 though not the edema (St). Belladonna, int., and as oint.; extract j ad iij 
 Adipis, when inflammation has subsided (Wa). Sodium Salicylate, in gonor- 
 rheal orchitis, subdues the pain in a few hours. Iodine, tinct. locally to remove 
 swelling after the acute stage has passed (B). Iodoform, 1 part in 10 of vaselin, 
 as ointment to reduce enlargement, a very efficient application. Mercury, the 
 Oleate locally (B) ; Calomel gr. iij with Ipecac gr. x, at once, followed by a saline 
 next morning, and smaller doses of Calomel and Ipecac every 6 hours, with 
 Morphine gr. % hypodermically into cellular tissue of scrotum (McElroy). 
 Ammonium Chloride, makes a good evaporating lotion in solution with alcohol 
 
;8 4 
 
 OTALGIA OTITIS OTORRHEA. 
 
 and water (R). Silver Nitrate, a strong solution to the scrotum, with gentle 
 pressure (Wa). Tartar Emetic, in acute orchitis (R). Digitalis, locally, is 
 found most useful (P). Guaiacol, pure, as a local application for the pain. 
 Alcohol, with equal quantity of water, as evaporating lotion (B). Ice, bene- 
 fits the inflammation and relieves pain (B). [Compare Epididymitis.] 
 
 R . Ammonii Chloridi, . 
 Alcoholis, Aquae, . 
 M. Sig. — Lotion, to 
 thin cloths to the part. 
 
 . . . gr. xl. 
 . . aagij. 
 
 be applied on 
 
 R. Hydrarg. Ammoniat., . . 5{j. 
 
 Cerati Simplicis, ^j. 
 
 M. ft. unguent. Sig. — Apply locally, 
 with gentle friction. 
 
 Otalgia. 
 
 Aconite and Opium, equal parts of the tinctures, a few drops well down the 
 external meatus, will usually subdue the pain. Blistering Fluid, or Croton Oil 
 Liniment behind the ear, often relieves earache (R). Glycerin, for dryness of 
 meatus (R); or Olive Oil for accumulation of wax in external meatus, dropped 
 in every night, gentle syringing in the morning with warm water (CI). Opium, 
 Morphine in solution, gr. iv to the ^, with gr. j-ij of Atropine, is an excellent 
 application (B). Atropine, gr. ■£$ in 3*x of water, a teasp. every three hours 
 for a child in the acute otitis media of children from coryza, very successfully 
 used to abort the otitis and relieve the earache (Miot) ; a solution locally is 
 especially applicable in the earache of children from whatever cause, gr. j to 
 the %, of which gtt. iv dropped into ear to remain for 10 or 15 minutes. Pul- 
 satilla, internally and externally, is often used with advantage (P). Cocaine, 
 a 4 per cent, solution sprayed over the tympanic membrane through the exter- 
 nal meatus, and forced into the Eustachian tubes by inhaling the spray and 
 then expanding the tubes by Valsalva's method ; this repeated every three 
 minutes is a very sure method of curing otalgia (R). Olive Oil, often used 
 warm as a local application, but it is of no service and may do harm by under- 
 going decomposition and becoming favorable soil for the growth of aspergillus 
 or other vegetable fungi. [Compare Otitis.] 
 
 R. Chloralis Hydratis, 
 Camphoroe, 
 
 Acidi Carbolici, . . . . aagr. xx. 
 Olei Ricini, ^j. 
 
 Sig. — Pour into the ear (after warming) 
 enough to fill it ; cover with cotton wet 
 with warm water, and a cloth wrung out 
 of hot water. (Brodnax.) 
 
 Otitis. 
 
 Pulsatilla, in inflammation of external auditory canal ; in otitis, as lotion 
 warmed and applied by syringe, three or four times a day (P). Aconite, 
 quickly relieves the pain (R) ; should be used internally and locally. Carbolic 
 Acid, a 20 per cent, solution instilled into ear in moderate otitis, relieves the 
 pain at once and checks progress ; a solution in glycerin is best (Rohrer). 
 Atropine, in the acute otitis media of children, is very efficient. [See Otalgia, 
 above.] Blisters, behind ears, either kept discharging or repeated, are often 
 very useful (Wa). Leeches, behind the ear, afterwards a small blister upon 
 the same place, when the leech-bites have healed (H). Warm Douche fre- 
 quently to the ear, to secure cleanliness, then dry the part thoroughly (Roosa). 
 [Compare Otalgia.] 
 
 Otorrhea. 
 
 Salol and Camphor, equal parts, heated together, have given good results in 
 suppuration of the middle ear ; the application causes neither pain nor inflam- 
 mation (Pegon). Bismuth Subgallate, on cotton tampon, introduced after 
 thorough syringing with a 3 per cent, solution of Boric Acid, and careful dry- 
 
OVARIAN NEURALGIA OVARITIS. 785 
 
 ing with absorbent cotton, the best means of combating an acute or chronic 
 otorrhea, outside surgical measures (Chaniavsky). Boric Acid, finely pulver- 
 ized, as astringent and disinfectant application ; may be mixed with pulv. 
 Alum, and just enough powdered Lycopodium to keep it dry; this packed 
 carefully through speculum, after washing with a weak and tepid alkaline solu- 
 tion. Absorbent Cotton, on holder, may be used every few hours by the patient 
 to keep pus removed from the canal. Syringing with warm salt water, once daily, 
 as absolute cleanliness is essential in the treatment. Politzer Bag, inflation 
 is a useful adjunct in keeping secretions out of tympanum and breaking up ad- 
 hesions (Roosa). Mercury, in chronic cases, the Brown Citrine Ointment (B). 
 Lead lotions are much employed (B). [See Gonorrhea, for formula.] Potas- 
 sium Permanganate, as injection or spray, gr. j to ^j aq. destil. (B). Silver 
 Nitrate, locally, a solution of gr. iv to the ^ (B) ; gr. x to the ^ (Roosa). Cop- 
 per Sulphate, gr. j-v to the § (Roosa). Tannin, the Glycerite, locally, is suc- 
 cessful (B) ; especially in children (Wa). Zinc Sulphate, locally, in solutions 
 of gr. ij-viij to the ^ (B) ; gr. j-v to the 5 (Roosa). Cadmium, gr. ij to ^j 
 rose-water (B). Liquor Sodae Chloratae, rr^xv-xxx ad ^j aquae when discharge 
 fetid ; is highly useful as injection (Wa). Quinine, with Sulphuric Acid, advis- 
 able in otorrhea after scarlatina (Wa). [Compare Otitis.] 
 
 Ovarian Neuralgia. 
 
 Codeine, has especial value against ovarian pain (Freund), whether of inflam- 
 matory or neuralgic origin, in doses of gr. ^ at least. Opium, often the cause; 
 if use stopped entirely improvement may ensue (E) ; one of the best remedies 
 in ovarian pain of non-inflammatory character (Graily Hewitt). Atropine, 
 subcutaneously, the best remedy for pain in the pelvic viscera (Wa). Am- 
 monium Chloride, gr. xxx with gtt. ij-v Tinct. Aconiti, repeated in J^-hour if 
 necessary, to relieve pain (W). Camphor, with Cannabis Indica, of great ser- 
 vice in relieving ovarian pain, especially when spasmodic in character (W). 
 Conium, or, better still, its alkaloid, used as a vaginal pessary, in all cases of 
 ovarian pain, whether neuralgic or inflammatory, is quite a specific (Meadows). 
 Ether, the compound spirit, in doses of ttlxxx-xI as a palliative (Anstie). 
 Gelsemium, deserves a trial ; its power is great but not certain (Wa). Hot 
 Water, as vaginal injections night and morning ; sunlight baths, fresh air (E). 
 Leeches over the groin, or inside the thigh, when ovarian pain persistent, or 
 tenderness and aching (Wa). Surgical, Battey's operation as a last resort (E). 
 [Compare Dysmenorrhea, Ovaritis.] 
 
 Ovaritis. 
 
 Tartar Emetic, as ointment for counter-irritation over seat of disease, in sub- 
 acute ovaritis ; at the same time a pill of Opium, Hemp and Camphor (Hewitt). 
 [Formula on next page.] Opium, in suppository or enema, more effectual than 
 internally (Tilt). Mercurial Ointment, combined with Camphor and Bella- 
 donna, over the seat of the disease by friction (West). Blisters, in subacute 
 ovaritis are often of great service, placed over the region or to the cervix uteri 
 (Wa). Enemata, of warm water, simple or medicated, in subacute ovaritis, 
 are warmly recommended; they should be retained as long as possible (Wa). 
 Salix Nigra, the " pussy willow," in doses of rr\,xxx of the fluid extract thrice 
 daily, of decided benefit in ovarian hyperesthesia, etc., of highly nervous 
 women. Ergot, is valuable in chronic ovaritis, with rest and Potassium Bro- 
 mide (Tait). Aurum salts, have been found beneficial in dropsy of the ovaries 
 (Martini). Ovarian Extract, has been used in ovarian disease [see page 166]. 
 Parotid Extract, used as an internal remedy in six cases of enlarged and tender 
 ovary with menorrhagia, etc., with signal success (Bell). Turpentine, hot tur- 
 pentine epithems applied over the seat of the disease (Wa). Ice, in bag, over 
 5o 
 
786 
 
 OXALURIA — OZENA. 
 
 seat of pain, when intolerable, and patient too much reduced to bear leeches ; 
 is often of benefit (Wa). Poultices of Linseed meal, as light as possible, often 
 produce great benefit in ovarian inflammation. 
 
 R. Ext. Opii, gr. iij. 
 
 Ext. Cannabis Ind., 
 
 Camphorae, aa gr. vj. 
 
 M. ft. pil. no. vj. Sig. — One pill twice 
 daily. (Graily Heivitt.) 
 
 R. Ung. Hydrargyri, 
 
 Camphorse, . . . 
 
 Ext. Belladonnae, 
 
 M. ft. unguent. Sig. 
 
 twice daily. 
 
 . . . 3yj. 
 
 . . . gr. xl. 
 
 • • • 3ij. 
 
 -To be rubbed in 
 (West.) 
 
 Oxaluria. 
 
 Mineral Acids, when eructations of sulphuretted hydrogen (R). Nitro- 
 muriatic Acid, renders important service (B) ; especially in the condition show- 
 ing general malaise, weakness, and depression of spirits, with oxalate crystals 
 in the urine (W) ; also in sciatica and other forms of neuralgic rheumatism 
 accompanied with oxaluria, full doses, n\vj-x, of this acid, with an occasional 
 brisk purgative, and cold douche followed by friction (Wa). Zinc Sulphate, 
 often very serviceable in irritability of the nervous system, associated with dys- 
 pepsia and oxaluria (Bird). Lactic Acid, aids imperfect digestion (B). [Com- 
 pare Dyspepsia.] 
 
 Ozena. 
 
 Aurum Salts, are very serviceable in syphilitic ozena (B). Mercury, 
 the Ointment of the Nitrate in syphilitic form ; the White or Red Precipitate 
 with 58 times its weight of sugar, snuffed after clearing the nose, in non-syph- 
 ilitic forms (R). Potassium Permanganate, solution 3j to Oj as an injection or 
 spray (B). Hydrastis, the fluid extract locally (B) ; solution 3} to ^viij as 
 lotion with rr^v of the tincture internally thrice daily (P). Bromine, as inhala- 
 tion [see formula below] ; or Iodine with Carbolic Acid, or the latter in one 
 per cent, solution, as inhalations (B). Carbolic Acid, a 1 per cent, solution in- 
 haled from atomizer (B). Silver Nitrate, applied behind veil of palate ; gr. v-xx 
 ad £j (B). Alum, solution, 3j to Oj, for irrigation (R). Glycerite of Tannin, by 
 irrigation (R). Salicylic Acid, in very weak solution, 1 to 500, as cleansing, as- 
 tringent, and disinfectant wash, used by retro-pharyngeal syringe, and followed 
 by applications of Calomel, in powder, to the ulcerated portions of the mucous 
 membrane (Massei). Hydrogen Dioxide, the solution as spray, is a most excel- 
 lent application. Salol, has done good service, as insufflation. Strontium 
 Iodide, has been used in scrofulous ozena, with varied results. Cubeb, the 
 Oleo-resin, gtt. xv-xxon sugar after each meal, to restrain the secretion and 
 perhaps modify its character (Cohen). Calcium Chloride, gr. xxx-lx with ^j 
 Decocti Kramerise ; of which 3ij-iij, diluted with an equal quantity of water, 
 should be injected twice daily after cleansing with salt and water (Cohen). 
 [Compare Catarrh, chronic nasal.] 
 
 R. Tinct. Iodi, 
 
 Acidi Carbolici, .... 
 M. Sig. — Use on sponge 
 mouthed bottle as inhalation, 
 porized by heat of hand. 
 
 Z 1V - 
 
 in a wide- 
 To be va- 
 
 ( Potter.) 
 
 R 
 
 Bromi, 3 SS - 
 
 Alcoholis, ^ss. 
 
 M. Sig. — Use by inhalation when va- 
 porized by heat of the hand. 
 
 R. Sodii Carbonatis, 
 
 Sodii Boratis, . . . . aagij. 
 
 Liq. Sodae Chloratae, . . 3ss-gij. 
 
 Glycerini, f ) ]. 
 
 Aquae, . . . . q. s. ad ^vj. 
 M. Sig. — Apply by means of a hand- 
 spray apparatus. {Thornton.) 
 
 R. 
 
 Acidi Carbolici, .... TT\,xx. 
 
 Aquae Calcis, Oj. 
 
 M. Sig. — Use as wash or spray. 
 
PAIN. 787 
 
 Pain. 
 
 Opium, is the most efficient of all analgesics and is universally used to relieve 
 pain [see page 406] ; the Liniment applied with friction relieves pleurodynia, 
 superficial neuralgia, etc., and poultices containing the Tincture are useful ap- 
 plications in the pain of inflammation. Opiates soon lose their power in any 
 particular dose, and require increasing dosage to sustain their analgesic influ- 
 ence, hence in chronic cases all other means should be exhausted before re- 
 sorting to them (R). Morphine, is the most analgesic alkaloid of opium ; 
 hypodermically in the vicinity of the nerve is curative when not so by the 
 stomach (B) ; the Sulphate, gr. ye to y 2 with Atropine Sulphate gr. y^ to yj^, 
 is very efficient, but the morphine-habit must be kept in mind ; a single injec- 
 tion thereof is sometimes curative in sciatica and other neuralgias; the con- 
 joined administration of Morphine and Antipyrin is much more efficient in 
 pain than the use of either agent alone. Codeine, has a special influence 
 over abdominal pain and that of the ovaries, and is not liable to give rise to a 
 drug habit. Antipyrin, is a most efficient analgesic in doses of 10 to 15 grains, 
 being especially adapted to neuralgia, migraine and the pains of gouty and 
 rheumatic origin, but is of no value in pain due to a local inflammation ; it 
 may be used hypodermically. [See under Morphine, above; also page 172.] 
 Acetanilid, is highly efficient in doses of 4 to 7 grains for the pains of locomotor 
 ataxia and those of rheumatic origin; also locally as a dry dressing for painful 
 wounds, ulcers, etc.; it is the active ingredient in a host of recent proprietary 
 remedies against pain [see page 77J. Phenacetin, is efficient in 10 to 15 grain 
 doses, for neuralgia, hemicrania, etc. Phenocoll Hydrochloride, in doses of 12 
 to 15 grains, is a good analgesic in the neuralgic pains of influenza, and in 
 gouty and rheumatic pain. Lactophenin, is analgesic and non-toxic ; a feeling 
 of comfort follows its use (Clevenger). Belladonna, is the best remedy for every 
 kind of pain in the pelvic viscera (Anstie). Atropine, hypodermically in local 
 pain, neuralgia, sciatica, glaucoma, etc.; when it succeeds, has more lasting effect 
 than morphine (R); for sciatica, tic douloureux, etc. (B). Iodides, are magical 
 in syphilitic nocturnal pains of head (B); the Ammonium Iodide, gr. iij ad Sjj 
 01. Olivae, with friction; causes the disappearance of nocturnal syphilitic pains 
 (W). Cimicifuga, relieves many kinds of pain, as neuralgia of 5th, rheumatic 
 headache, ovarian neuralgia, dysmenorrhea; inferior to Ergot in labor-pains 
 or after-pains; 3] doses (B). Conium, in cancer, rheumatism, neuralgia, 
 ovarian pain, etc. (R); also for the fulgurant pains of locomotor ataxia, chronic 
 alcoholism, sciatica, phthisis, etc., doses of tt\,x of a fluid extr. of the unripe 
 fruit every ]4. hour, well watched (Madigan). Iron, with Belladonna, for the 
 wandering pains of anemia, in which morphine is dangerous and bromides 
 are useless (Waugh). Aconitine, locally over seat of pain ; one of the most 
 certain and powerful palliatives in neuralgic, rheumatic, and gouty affections 
 (Wa) ; especially serviceable in neuralgia of 5th nerve (B). Carbolic Acid, as 
 local anesthetic (R). Cocaine, as a local anesthetic to mucous surfaces, or 
 hypodermically for minor operations involving a small area, as circumcision, 
 eye operations, etc., has no equal; a 4 per cent, solution is generally employed 
 (R); has many applications, as in odontalgia, otalgia, neuralgia of superficial 
 nerves, etc. Eucaine, is fully as efficient as Cocaine in causing anesthesia of 
 the mucous membranes, and is much less poisonous (Schleich) ; is absolutely 
 harmless in medicinal doses, and does not affect the heart (Reichert). Theine, 
 of very great value for neuralgic pain ; affects the nerve outwardly along its 
 course from the site of the injection (Mays). Chloroform, locally, inferior to 
 other local anesthetics, two or three drops on cotton into the ear for faceache 
 or toothache ; the vapor on raw surface of cancers, for neuralgia of uterus, 
 photophobic eye, etc. ; by inhalation in renal and biliary colic, and to produce 
 general anesthesia [which see] (R). Ether, spray for local anesthesia ; in- 
 haled for general anesthesia (R). Guaiacol, locally or by hypodermic injec- 
 tion, 1 part in 10 of olive oil, or mixed with equal part of glycerin for painting 
 
788 PARALYSIS AND PARESIS. 
 
 on the surface, is an efficient local anesthetic, and is used successfully in or- 
 chitis, in neuralgic pains of tuberculous subjects, also in sciatica and rheuma- 
 tism (Moissy). Chloral, has no direct pain-relieving power, except in dangerous 
 doses; to relieve pain and promote sleep the best agent is a combination of 
 Chloral and Morphine; cautiously, if heart trouble, or in old drunkards; gr. 
 xv-xxx with gr. ^ (B) : sometimes relieves neuralgia, also pain of chronic 
 rheumatism, gall-stones, colic, gastralgia, and even of cancer (R). Iodoform, 
 as suppository in painful diseases of the rectum or bladder (R). Stramonium, 
 is used as ointment (R). Duboisine, used instead of Atropine (B). Rhatany, 
 relieves the pain of ulcerative disease of mucous membranes, pain of burns, 
 ulcers, and especially of blisters (Tr). Cannabis Indica, formerly used (B). 
 Aquapuncture (B). [See under Neuralgia.] Galvanism, of an affected 
 nerve gives certain relief; the positive pole on point of emergence, negative 
 over superior ganglion of cervical sympathetic (B). Heat, if pain is without 
 fever or inflammation (B) ; warm injections soothe the pain of cystitis, prosta- 
 titis and abdominal pains generally (B). Hot Water, as bath, relieves pain 
 most wonderfully : Napoleon, at St. Helena, suffering from cancer of the 
 stomach, appreciated highly the pain-relieving power of the hot bath ; often 
 staying half and even whole days therein. Cold, when pain is inflamma- 
 tory (B). [Compare the Lists of Analgesics, Anesthetics and Narcotics, on 
 pages 31, 32, 58, ante ; also in this part the articles entitled After-pains, 
 Anesthesia, Boils, Chest-pains, Colic, Gastralgia, Headache, Hepa- 
 talgia, Inflammation, Lumbago, Myalgia, Neuralgia, Neuritis, Odon- 
 talgia, Otalgia, Ovarian Neuralgia, Rheumatism, etc.] 
 
 R. Antipyrini, gr. xv. 
 
 Cocain?e Hydrochlor. , . gr. ss. 
 
 Aquae Destil., .... TTlxv. 
 M. Sig. — One-half as hypodermic in- 
 jection, or the whole when rapid action de- 
 sired. (See.) 
 
 R. Liquoris Magendie, . . ^j. 
 Aquae, . . . q. s. ad % lj. 
 M. Sig. — A teasp. to a dessertsp. every 
 six or eight hours, for pain. Each drachm 
 contains ^ grain of Morphine Sulphate. 
 
 (Potter.) 
 
 Paralysis and Paresis. 
 
 Nux Vomica, in hysterical paralysis and in that from lead-poisoning ; only 
 in chronic cases (P) ; in paraplegia due to softening and wasting of the cord 
 (Brown-Sequard). Ignatia, in paralysis of the lower extremities (P). Strych- 
 nine, hypodermically into the affected muscles, for hemiplegia, paraplegia, 
 local, mercurial, paludal, rheumatismal, facial, infantile and diphtheritic 
 paralyses ; in that of the spinal muscles, of the bladder and all local forms (B) ; 
 in hysterical paralyses (P); in all forms except cerebral and spinal paralyses 
 (Barwell) ; internally in doses of gr. ^ to y\ (R). Phosphorus, with Cod-liver 
 Oil in the paralysis of white softening of the brain (B) ; in hysterical paralysis 
 (R) ; in myelitic paraplegia from excessive venery ; the only drug which really 
 affects the nerve-centres (W). Belladonna, when depending on chronic in- 
 flammation of the cord (R) ; externally as ointment along spine, with Ergot 
 internally (Brown-Sequard). Physostigmine, into the eye in ocular paralyses 
 (B) ; Physostigma in general paralysis of the insane, also in progressive muscu- 
 lar atrophy without much mental disorder, long-standing hemiplegia, para- 
 plegia, locomotor ataxia (R). Ergot, in paralysis of bladder from over-distention 
 (B) ; paralytic dysuria, sensation of but partial emptying of bladder (P); said 
 to be useful in paraplegia (R) ; in paraplegia complicated with menstrual irregu- 
 larity and forms of paralysis arising from spinal congestion (Wa); has cured 
 cases of constipation of the paralytic when all the most powerful cathartics 
 failed (Curran). Cocculus Indicus, valuable in hemiplegia, paraplegia, and 
 paralytic stiffness ( P). Picrotoxin has greatly benefited several forms, especially 
 paralysis of the sphincters, hemiplegia from cold, and glosso-labio-laryngeal 
 paralysis. Cannabis Indica, for retention of urine in spinal paralysis (R). 
 Rhus Toxicodendron, is certainly efficacious in paralysis depending on rheu- 
 matism (P). Ammonium Iodide and Carbonate, to aid in absorption of thrombi, 
 
PARALYSIS AGITANS PAROTITIS. 
 
 789 
 
 thus promoting cerebral nutrition in cases of incipient hemiplegia, due to end- 
 arteritis deformans reducing the lumen of the vessels in the brain (B). [See 
 formula below.] Arnica, in paralysis of the bladder, and many forms (P). 
 Orchitic Extract, has been thought to be beneficial in general paralysis [see page 
 162J. Capsicum, in x /z to 2-grain doses every 4 hours as general stimulant (P). 
 Colocynth, in cerebral paralyses, sometimes seems to act favorably upon prin- 
 ciples of revulsion or counter-irritation (P). Mustard, as an emetic to stimulate 
 failing heart in certain forms of paralysis (P). Senega, in rheumatic paralysis, 
 is a powerful help (P). Nutmeg, the Oil as external stimulant (P). Oil of Bay, 
 has been given ; is obsolete (P). Cajuput Oil, efficacious in palsy (P). Coun- 
 ter-irritation by blistering fluid, in peripheral paralysis of the 7th nerve (R). 
 Cod-liver Oil, when low nutrition and faulty assimilation (Anstie). Galvanism, 
 in hemiplegia and many forms (B). Electricity, faradization of the muscles 
 affected ; localized electricity probably of more importance in confirmed spinal 
 paralysis than medicinal treatment. Massage, in infantile paralysis, given 
 with Calcium Lactophosphate and Cod-liver Oil, and Strychnine injected into 
 the muscles (B). [Compare Hemiplegia, Locomotor Ataxia, Paralysis 
 Agitans, Tongue.] 
 
 R. Strychninae Sulph., . . . gr. iij. 
 Aquae Destillatae (fervid.), ^x. 
 M. Sig. — For hypodermic administra- 
 tion : TT\x=gr. gV °f Strychnine Sulphate. 
 
 R . Ammonii Iodidi, .... gj. 
 Ammonii Carbonatis, . . . Zij. 
 Liq. Ammonii Acetatis, . Jvj. 
 M. Sig. — A tablesp. thrice daily. (B.) 
 
 Paralysis Agitans. 
 
 Hyoscyamus, full doses of the tincture will palliate the trembling ; or Hyos- 
 cy amine, gr. ■£% gradually increased to gr. T ^ (B). Hyoscine, gr. y^ or less, 
 efficiently but temporarily controls the tremor of paralysis agitans (Weatherly). 
 Duboisine, acts very well in most cases. Conium, has benefited some cases 
 (Harley). Gelsemium, in full doses, to quiet the nervous irritation (Lavers) ; 
 a combination of Conium, Hyoscyamus and Gelsemium [see under Tremor]. 
 Potassium Iodide, to promote absorption (Lavers). Cocaine, influences paraly- 
 sis agitans more favorably than any other remedy, large doses and frequent 
 administration are unnecessary (B). Cannabis Indica, in large doses, lowers 
 reflex activity. Picrotoxin, has greatly benefited some cases. Opium, Arsenic 
 and Hyoscyamine may be tried, but the disease is incurable, and nothing can 
 be done except to attend to the physical comfort of the patient ; there is no 
 treatment which can be recommended as satisfactory in any respect (O). 
 Sodium Borate, gr. xv-xlv daily, in 3 or 4 doses, produced most striking 
 improvement in a case of paralysis agitans which developed after a fall upon 
 the shoulder (Sacaze). Phosphorus, in small doses, with Cod-liver Oil, is very 
 useful (R). Hypophosphites, the Syrup ought to be of service, if taken 
 steadily for a long time. Cod-liver Oil, long continued, is more constantly 
 useful than any other medicine (Anstie). Orchitic Extract, has been used 
 with benefit [see page 162]. Sulphur Baths, are certainly of great value in 
 this disease (Lavers). Electricity, the constant current, anode over the spine, 
 cathode drawn along the course of the nerves from where they leave the verte- 
 bral column to the periphery (Id). [Compare Chorea, Tremor.] 
 
 Parotitis. 
 
 Aconite, in febrile conditions (R). Mercury, % grain of Gray Powder, 3 or 
 4 times a day, is very useful, relieving pain and swelling (R). Poultice of 
 Flaxseed meal, is a good local application for the gland. Leeching, often 
 gives speedy relief, when pain is great and resists hot fomentations (Wa). 
 Care to avoid chilling, important. Incision, when suppuration occurs. Stimu- 
 lants and Tonics internally are very necessary in symptomatic parotitis, occur- 
 ring as a complication or sequel of other diseases, with adynamic symptoms. 
 
79° 
 
 PEDICULI PEMPHIGUS — PERICARDITIS. 
 
 Pediculi. 
 
 Mercury, as Citrine Ointment or a wash of Corrosive Sublimate solution, for 
 lice on all parts of the body ; the Oleate destroys lice immediately, and also 
 kills the ova (R) ; for crab-lice the ordinary Blue Oint. is very disagreeable, and 
 often toxic in its effect on the patient ; a better preparation is Calomel in 5 per 
 cent, oint., or the Bichloride, a 1 per cent, solution in alcohol, of which a teasp. 
 to a pint of water, as a bath to parts twice daily. Cocculus Indicus, destroys 
 pediculi (P) ; the tincture undiluted as a wash. Staphisagria, as Oil or an oint- 
 ment of the powdered drug (R) ; " lice-bane " (P) ; the tincture a very efficient 
 application, and much more cleanly than an oil or an ointment. Acetum, 
 Vinegar will kill the nits, as it softens the adhesive chitin by which the ova are 
 glued to the hairs. Benzol, is a very efficient, convenient and cleanly applica- 
 tion for destroying pediculi capitis or pubis, if fire or light be carefully avoided : 
 a single application is usually sufficient. Ether, washed over the parts, effectu- 
 ally destroys crab-lice. Tobacco, a decoction of the leaf is an efficient appli- 
 cation, but requires care, especially if the surface is abraded (Wa). Essential 
 Oils, will kill pediculi, as Rosemary, Anise (P) ; or powdered Pyrethrum (R). 
 Cleanliness, cannot be dispensed with, and in many cases may alone be suffi- 
 cient. Boil the underclothing. Isolation of person, and of brushes, towels, 
 etc., to prevent infection. In Vienna the following prescriptions are used: — 
 
 R . Bals. Peruvian., 
 
 Petrolei, aa part. xv. 
 
 Olei Pichuri, .... part. j. 
 To be applied and washed off after 3 
 hours. 
 
 R. Acidi Salicylici, .... part, ij-iij. 
 
 Aceti, part. xxv. 
 
 Alcoholis (80 per cent.), part. lxxv. 
 To be rubbed on with a bit of flannel. 
 One application is often enough. 
 
 Pemphigus. 
 
 Antipyrin, internally, for the itching, is efficient. Arsenic, is curative, espe- 
 cially when chronic (B) ; largest dose, tr^y of Liquor Arsenicalis 3 times a day 
 on full stomach (R) ; exercises a powerful influence (Wa). Mercury, as Citrine 
 Ointment is largely used (Wa). Potassium Iodide, improves the condition in 
 pemphigus (Wa) ; with good, simple diet; Quinine, Cod-liver Oil, etc. Silver 
 Nitrate, gr. ij ad ^j aquae locally in pemphigus, after the bullae have burst and 
 excoriations remain (Wa). Water Dressings, on lint, covered with oiled silk, 
 applied constantly, in pemphigus and rupia (Wa). Cod-liver Oil, with nutritious 
 diet, is a powerful auxiliary to treatment (Wa). Puncturing the blebs and 
 evacuation of their contents are necessary as soon as formed; cleanliness, the 
 frequent use of a 1 in 1000 corrosive sublimate lotion, a dusting powder of 
 equal parts of boric acid, zinc oxide and starch, are speedily effective (Mn) ; or 
 buckwheat flour, lotion of Liquor Plumbi Subacetatus Dilutus, or painting 
 with a 4 per cent, solution of Silver Nitrate in alcohol, after cutting off the tops 
 of the blebs and cleaning the bases. The affection is highly contagious. 
 
 Pericarditis. 
 
 Aconite, when violent throbbing and extreme pain (R) ; of great value, if 
 given early (P) ; proves in the highest degree serviceable, when object is to 
 diminish vascular excitement or irritability (Wa). Spigelia Anthelmia, useful 
 in rheumatic pericarditis (P). Digitalis, when rapid and feeble heart, cyanosis 
 and dropsy (P, N) ; in second stage when heart flags, a tablespoonful of the 
 infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in second 
 stage, that of exudation ; fully equals any remedy in pericarditis (P). Opium, 
 regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial (Wa). 
 Veratrum Viride, extract made by inspissating the juice of the root, of which 
 
PERIOSTITIS PERITONITIS. 79 1 
 
 gr. ij with gr. j of Calomel every 2 hours, valuable (Waring-Curran). Quinine, 
 gr. xv-xx may suppress an acute attack, if given at critical moment (B) ; may 
 be used as an antipyretic. Counter-irritation, has been much abused ; useful 
 at commencement, but not in acute inflammatory stage (B) ; by Iodine painted 
 over the cardiac region, or flying blisters in the second stage. Iron, the tinc- 
 ture in full doses may be required in the second stage. Poultices, large, hot, 
 often renewed (R). Ice may be used instead of poultices in the early stage. 
 Paracentesis, by aspiration, may be required in the second stage. [Compare 
 Endocarditis.] 
 
 Periostitis. 
 
 Mezereon, in the rheumatic and scrofulous form (P). Mercury and Mor- 
 phine, the Oleate externally (R). Potassium Iodide, in syphilitic children, also 
 in non-syphilitic periosteal thickening (R) ; holds the first place for syphilitic 
 affections of the bones (Wa). Ammonium Iodide, cures periostitis most readily 
 when syphilitic (Wa). Staphisagria, when the long bones are affected (P). 
 Iodine, the tincture, or blisters locally, of great service in chronic form (R) ; 
 under the external use of Iodine periostitis often rapidly improves (Wa). 
 Poultices, after an early and free incision, when suppuration takes place (C). 
 Incisions, carried deeply, should be made without waiting for fluctuation, when 
 great tension exists and there is a tendency to suppuration ; the sides of the 
 abscess should then be brought together with compresses and a bandage 
 (Gross). Tonics and Stimulants, as milk-punch, Quinine, Iron, and Opium, in 
 full and sustained doses, are imperatively demanded in many cases (Gross). 
 [Compare Nodes, Onychia.] 
 
 Peritonitis. 
 
 Phenacetin, as an antipyretic ; is efficient and safe. Aconite, of great utility 
 when sthenic reaction ; [see Opium below] ; should be given early in all 
 inflammations of serous membranes (P). Bryonia, exceedingly valuable in 
 second stage, when exudation (P). Mercury, when tendency to fibrinous 
 exudation, is employed with good effect (W). Opium, to quiet intestinal move- 
 ments (R) ; by far the best agent (P) ; Morphine, gr. ^ hypodermically, will 
 often abort, if given early ; Aconite and Opium, the tinctures, gtt. ij of the 
 former with gtt. vj of the latter, in water every hour or two ; a larger dose of 
 opium if pain is severe (B) ; large doses of opium are easily borne in this affec- 
 tion (Wa). Cocculus Indicus, for tympanites; a few doses will often remove 
 the pain and relieve distention (P). Quinine, strongly urged by Trousseau; is 
 naturally indicated in most inflammations (P). Turpentine, for tympanites 
 (P) ; turpentine stupes, v-xv drops of Turpentine on flannel wrung out of hot 
 water during acute stage, then blisters for a short time (B). Leeches, to abdo- 
 men, if patient plethoric and of sthenic reaction, relieve pain (B). Purga- 
 tives, are inadmissible when from perityphlitis or inflammation of appendix 
 vermiformis (B). Poultices, large, hot, and frequently renewed; should be 
 thin, and covered with cotton-wool (R). Ice, to abdomen (B) ; cold relieves 
 (W). Hot Water, as fomentations to relieve pain, sometimes cold compress 
 better. Ice, sucked or swallowed, to assuage the vomiting ; sips of cold water. 
 Diet, after acuteness of the attack has passed ; should be mild and unstimuiat- 
 ing. [Compare Puerperal Peritonitis.] 
 
 Peritonitis, Tubercular. 
 
 Quinine, in the acute form to reduce fever, as in acute tuberculosis, together 
 with rest, poultices or warm fomentations, liquid diet, Opium, etc. (Whitla). 
 Cod-liver Oil, by inunction with friction, also its continuous administration by 
 the binder and mackintosh, is of great value in the chronic form of this disease 
 (Id). Arsenic, children affected with tuberculosis involving the intestines and 
 
792 
 
 PERSPIRATION. 
 
 peritoneum have steadily and slowly improved and finally recovered under the 
 Arsenic treatment (R). Laparotomy, has been done with uniform success and 
 with complete cure of the disease in 80 per cent, of all cases of tubercular 
 peritonitis in which the abdomen was opened, cleaned and drained (Tait) : in 
 131 cases so treated 84 were cured and 23 greatly improved ; only in 3 per 
 cent, could death be ascribed to the operation (Konig) ; of 38 cases treated by 
 simple laparotomy in 1896-97, 21 cases or 55 per cent, were completely cured 
 (Chrobak). Treatment by medicine is useless, tapping is at best only of tem- 
 porary service, incision and evacuation of the abdominal contents afford by far 
 the best chances of recovery (Id). 
 
 Perspiration. 
 
 Belladonna, as liniment locally, also the tincture internally, especially in 
 weakly children who sweat profusely (R). Atropine, gr. ^-^ to j^j hypoder- 
 mically, or in exceptional cases even gr. ■£■$ in pill, in sweating of phthisis and 
 exhausting diseases (R) ; gr. ^ at bedtime for sweats of phthisis (B). Duboi- 
 sine, may be used instead of atropine. Pilocarpine, gr. ^ thrice daily, checks 
 profuse perspiration (R, Pf ). Naphtol, in a 5 per cent, ointment or alcoholic 
 solution, is a very efficient application for local sweating (Kaposi). Potentilla 
 Sarmentosa, the Cinquefoil, an infusion of the vine, leaves, and root, may be 
 drunk ad libitum, and is a very efficient remedy for night-sweats, having 
 stopped them when Atropine failed to relieve (Pope). Salvia, the ordinary 
 Sage-tea is very efficient, used internally and locally by sponging the body; 
 the infusion for night-sweats of phthisis (Da C). Quinine, in that of exhaust- 
 ing diseases; in many cases a night-draught of Quinine, Zinc Sulphate and 
 Sulphuric Acid is useful (R). Opium, as Dover's powder, may succeed in 
 profuse colliquative sweating (R) ; a fact, though it is hard to account for it 
 (Wa). Agaricine, is used successfully [see formula below]. Agaricic Acid, 
 in dose ot gr. ^ to \, not hypodermically, one of the most efficient agents 
 against sweating from various causes, especially that after influenza; in over 
 two years' use, it only failed me in one case (Richards). Camphoric Acid, gr. 
 x-xxx, dry on the tongue, not over 2 hours before the expected sweating, is 
 remarkably efficient against sweating from various causes, especially that of 
 phthisis even when very profuse (Jas. Wood). Aromatic Sulphuric Acid, 
 to check sweats of phthisis ; bad for digestion (B). Muscarine, has been used 
 with great success in the sweats of phthisis and of other morbid states (R). 
 Zinc Oleate, rapidly controls excessive and offensive sweating in the axillae 
 and groins on slight exertion, also the night-sweats of phthisis (Murrell). 
 Zinc Oxide, gr. iij, with gr. ss of Ext. Belladonnae, in a pill at bedtime for the 
 sweats of phthisis (R). Gallic Acid, is very useful for the same condition, and 
 may be combined with extract of Belladonna (B). Tannic Acid, may be used 
 with benefit. Aluminum, the Oleate, checks hyperidrosis and antisepticizes 
 the sweat, thus forming a useful application to the axillae and groins of children 
 (Wa). Potassium Permanganate, gr. j in ^j of water, for fetid perspirations 
 of axillae, feet, etc. (B). Salicin, profuse sweats of hectic fever (Wa). Salicylic 
 Acid, in solution with Borax, the most agreeable and efficient deodorant for 
 fetid perspirations (B). Carbolic Acid, 2 parts, to 3 of glycerin and water, twice 
 daily for fetid sweat (Wa). Oils, rubbed into the whole skin to prevent sweat- 
 ing accompanying exhausting diseases, as phthisis ; but sponging with a weak 
 acid wash better (R). Ergot, said to arrest sweating (R). Sponging, with 
 acidulated water, or very hot sponging in phthisis (R). [Compare Feet.] 
 
 . Acidi Tannici, gr. xxx. 
 
 Pulv. Digitalis, . . . . gr. xv. 
 
 Ext. Cinchonae, . . . . q. s. 
 Ft. pil. xx. Sig. — One pill at bedtime. 
 
 R. Agaricinae (Merck), . . . gr. x. 
 
 Atropinae Sulphatis, . . . gr. j. 
 
 Acidi Sulph. Aromat., . . ^ijss. 
 Solve et filtra. Dose, rr^x in syrup or 
 simple elixir, 5 or 6 hours before retiring. 
 
pertussis. 793 
 
 Pertussis. 
 
 Antipyrin, is successfully employed. Phenacetin, is highly praised. Aconite, 
 in all acute congestions (P) ; as a preventive or abortive remedy is very efficient 
 when associated with Ipecac and cherry-laurel water (Dervieux). Amyl 
 Nitrite, with Carbolic Acid, in steam atomizer, has proved a very efficient in- 
 halation (Bayliss). Ipecacuanha, useful in many cases (R) ; tt\j for 5 years of 
 age, every hour or two, gives the greatest relief (P) ; when bronchitic or pneu- 
 monic complications, combined with Ammonium Bromide (Wa). Bromides, 
 relieve spasmodic element (B) ; that of Ammonium will readily cure many 
 cases ; gr. ij or iij ter die for infants (Wa). Lobelia, in spasmodic stages ; well 
 tolerated by children ; Ttpc of tinct. every hour for child 2 years old ; also ad- 
 ditional dose when cough is imminent (R, P). Alum, when acute stage is over 
 and no complication exists, gr. ij— vj every three hours or less every hour, in 
 glycerin or honey (R). Bromoform, in daily dosage of 5 to 20 minims, in gly- 
 cerin and alcohol, very efficient for relief of paroxysms, and to reduce their 
 number, but has little other influence on the course of the disease ; must be pure, 
 hence colorless ; increasing doses should not be pushed very far, for fear of 
 toxic symptoms (Bedford) ; is almost a specific, acting as a local anesthetic on 
 the mucous membrane of the pharynx and larynx, given in doses of 1 to 5 
 drops 3 or 4 times daily (Carpenter) ; it may be used by inhalation instead of 
 chloroform or ether, to lessen severity of tho paroxysms. Hydrogen Dioxide, 
 the solution, in drachm doses diluted with 2 or 3 of water, internally, cuts short 
 the paroxysms and lessens the duration of the disease. Benzol, is a reliable 
 pulmonary antiseptic, and has been used for many years in this affection with 
 unvarying success (Robertson) ; the vapor may be diffused throughout the 
 room, carefully avoiding a light or fire. Ouabain, in doses of gr. ywuis every 
 three hours, is highly efficient in all stages of this affection (Gemmell). 
 Resorcin in solution, applied to the perilaryngeal mucous membrane, has 
 aborted an attack at the outset in 24 hours, has cured well-marked cases in 
 from 9 to 14 days, and is a perfect method of prophylaxis for children living 
 with those suffering from the affection (Moncorvo). Naphtalin, burned in the 
 patient's room, is of high value, both as a palliative and a curative agent 
 (Chavernac). Belladonna, obviously of value in febrile stage, is of special use 
 when dentition is in progress ; relieves the congestion of air-passages and also 
 the determination of blood to the head (P) ; good when profuse bronchial secre- 
 tion ; best in spasmodic stage ; children bear this drug well, rt\,x of tinct. may 
 be given hourly to a child 3 years old (R). [Formula on next page.] Sodium 
 Benzoate is highly efficient. Conium, or the Hydrobromate of Coni'ine, in 
 doses of gr. -^ to gr. ^ according to age, an efficient remedy (W). Drosera, 
 small doses are effective (Murrell). Chamomile Oil, a very useful remedy (P). 
 Coccus Cacti (Cochineal), in doses of gr. ]/$ thrice daily for infants has been 
 highly recommended (W) ; proves effective in most cases. Hydrocyanic Acid, 
 is serviceable in cough from habit after cessation of whooping-cough proper, 
 or in the nervous sympathetic cough of the mother (P). Myrtol, may be ex- 
 pected to afford a large measure of relief (B). Formalin, as spray, is quite effi- 
 cient. Opium, in the convulsive stage, to produce and maintain slight heaviness 
 (R). Cocaine, a 5 per cent, solution, painted on tonsils, fauces, back of tongue, 
 and if possible on larynx, is very efficient (Labrie). Chloral, gr. v-x in spas- 
 modic stage, relieves quickly (B) ; gr. iij-viij every 4 hours (Porter). Carbolic 
 Acid, as vapor, with steam atomizer ; found to be very beneficial (J. L. Smith). 
 Castanea, a decoction of chestnut leaves has been used with much success; 
 dose ad libitum (B) ; the fluid extract, in 3-doses, exercises a remarkable in- 
 fluence over the cough (W). Valerian, said to control the paroxysms (R). 
 Nitric Acid, well diluted in sweetened water, after the subsidence of the catarrhal 
 stage (B). Gelsemium, in spasmodic stage (B). Camphor Monobromide, gr. 
 v in mucilage and Syrup of Tolu 3 or 4 times a day, has been serviceable (B). 
 Zinc Sulphate, gr. % -j with Ext. Belladon., gr. yk-yi, has varying degree of 
 
794 
 
 PHARYNGITIS. 
 
 success (B). [See formula below.] Lactucarium, the syrup as vehicle for 
 cough mixtures (B). Quinine, in solution, locally to fauces (Dawson) ; the Tan- 
 nate with Sodii Bicarb, of each 5, and Pulv. Acaciae 100 parts, used with an 
 insufflator (Pollack). Petroleum, on rags around head of the bed, is recom- 
 mended highly by Hildebrandt. Silver Nitrate, when acute stage passed (Tr) ; 
 probably inferior to Alum (Wa). [Compare Cough.] 
 
 3J- 
 39- 
 
 R . Chloralis Hydratis, . 
 
 Potassii Bromidi, . . 
 
 Syr. Pruni Virgin., 
 
 Aquae, aa 3J. 
 
 M. Sig. — A teasp. thrice daily for in- 
 fants in the convulsive stage. [Dessau.) 
 
 ft. 
 
 Olei Morrhuae, 
 Mellis Despumat., 
 
 Succi Limonis, . . . aa partes aeq. 
 
 M. Sig. — A teasp. or two as required. 
 
 {Sir Wm. Gull.) 
 
 ft. Amyli Nitritis, ^ss. 
 
 Acidi Carbolici, rr^x. 
 
 Glycerini, 
 
 Alcoholis, aa ^ss. 
 
 M. Sig. — Use by inhalation with steam 
 atomizer. (Eayliss.) 
 
 ft . Bromoformi, TT\^xvj. 
 
 Glycerini, ^j ss - 
 
 Tinct. Cardamom. Co., 
 
 Alcoholi 
 
 «J- 
 
 M. Sig. — A teaspoonful at commence- 
 ment of the paroxysm. {Bedford.) 
 
 ft . Bromoformi, TT^xlviij. 
 
 Alcoholis, 3i v - 
 
 Tinct. Cardamom. Co., . . ^iij. 
 M. Sig. — A teaspoonful in water three 
 
 or four times daily. (Carpenter.) 
 
 ft. Zinci Sulphatis, gr. iv. 
 
 Tinct. Belladonnas, . . . TT\xlviij. 
 
 Aq. Anisi, . . . . q. s. ad 31J. 
 M. Sig. — 20 to 60 drops, according to 
 age of child, every three hours. 
 
 Pharyngitis. 
 
 Aconite and Belladonna, for acute attacks (B) ; when high temperature (R). 
 Belladonna, is very useful, relaxes the pharyngeal muscles (W). Capsicum, 
 3j of the tincture to 0)4 of water, as gargle in the very early stage only (R). 
 Alum, gargles, in chronic throat inflammations (R). Silver Nitrate, gr. v-xx 
 to the %, on sponge probang, successful if systematically applied (B); in early 
 stage of inflammation ; also on brush, or as spray in the chronic form (R) : the 
 solid stick to each diseased follicle, after scraping (A). Ammonium Chloride, 
 gr. ij with rr\,xv of Tinctura Cubebae, every half hour, often controls acute 
 pharyngitis ; when a gouty diathesis exists add n\x of the Ammoniated Tinct- 
 ure of Guaiac, and give every hour (Smith). Xanthoxylum, a decoction of the 
 bark locally to throat, and tt\,x-xxx of the fluid extract thrice daily, a very 
 successful remedy for chronic pharyngitis (B). Tannin, by insufflation to 
 affected surface (B). Cubeb, powdered, locally, useful (B). Glycerin, pure, 
 locally, with Tannic Acid, very serviceable (B) ; in chronic inflammation of 
 the throat (R). Glycozone, frequently applied, is of benefit in follicular pha- 
 ryngitis (Edson). Hydrastis, the fluid extract locally, also tt^v-x internally 
 (B). Alcohol, diluted, as gargle in relaxed throat (R). Cimicifuga, when 
 pharynx dry and spotted over with inspissated mucus (R). Ipecacuanha, the 
 wine as spray in non-inflammatory sore throat, with hoarseness from con- 
 gestion of vocal cords (R). Pomegranate Bark, as gargle (P). Resorcin, in 
 strong solution, a very efficient application (Tymowski). Potassium Chlorate, 
 as lozenge to stimulate the follicular secretions to a healthy condition (A). 
 Iron, Quinine, and Strychnine, as tonics, are indicated (A). Zinc Sulphate, as 
 gargle, occasionally employed in relaxed throat (R). Inhalation of vapors, or 
 of pulverized fluids, by the atomizer, found very beneficial (Wa). Food, of 
 piquant kind, spices, pepper, mustard, etc., should be strictly prohibited ; all 
 fluids should be used at a moderate temperature (A). . Water, by throat com- 
 press, relieves ; also in daytime, in obstinate cases. Rest, to voice and cultiva- 
 
PH I MOSIS PHLEBITIS PHLEGMASIA. 
 
 795 
 
 tion of beard, are useful aids. [Compare Throat, sore, Tonsillitis, and 
 Formulae for Gargles on page 576.] 
 
 R. Tinct. Aconiti, R . Aluminis, 3 ss -ij- 
 
 Sodii Boratis, .... sjjss. 
 Glycerini, 
 
 Tinct. Myrrhse, . . . aazij. 
 Aquae, . . . q. s. ad 3 iv. 
 M. Sig. — Use as an astringent gargle, 
 4 or 5 times a day 
 
 Tinct. Aconiti, 
 
 Tinct. Belladonnas, . . aagss. 
 
 Tinct. Guaiaci Ammon., . g v. 
 
 Syr. Limonis, 5ss. 
 
 Aquae Cinnamomi, q. s. ad J iv. 
 
 M. Sig. — A teasp. 
 acute pharyngitis. 
 
 every 3 hours for 
 
 R 
 
 Tinct. Aconiti, 3 SS - 
 
 Ac. Hydrocyan. Dil. , . . ttlxl. 
 
 Liquor Ammonii Acetat. ,ad£ iv. 
 
 M. Sig. — Teasp. every 2 or 3 hours 
 
 according to the severity of the case. In 
 
 acute and subacute pharyngitis. 
 
 R- . Acidi Tannici, . . . . gr. Ix. 
 
 Alcoholis, "ttlxxx. 
 
 Aquae Camphorse, q. s. ad% iv. 
 M. Sig. — An astringent gargle, to be 
 used several times a day. 
 
 Phimosis. 
 
 Belladonna, as ointment, the extract 7 to 20 parts of Lard, has proven effect- 
 ual (Wa). Lupulin, 5 to 15 grain doses, of advantage after operation, to keep 
 the penis at rest (Wa). Surgical, division of the prepuce by bistoury and 
 director ; circumcision (D). Cocaine, a 4 per cent, solution injected at several 
 points around the edge of prepuce, as local anesthetic during the operation of 
 circumcision. Chloroform, or Ether, as an anesthetic in paraphimosis, before 
 attempting reduction (Wa). 
 
 Phlebitis. 
 
 Hamamelis, has as decided an influence on the venous system as Aconite 
 has on the arterial (Pf ). Mercury, in frequent and liberal doses, to early and 
 decisive constitutional impression ; the best form being Calomel or Blue Mass 
 (Gross). Rest, fomentations, poultices, early incision of abscesses, aperients, 
 Opium to relieve pain and insure quiet of mind and body (D). Blisters, over 
 the course of an inflamed superficial vein (R). Diet, nutritious, also wine, 
 especially if great loss of blood (D). Stimulants, as Quinine and Iron, espe- 
 cially the tincture of the Chloride, also milk-punch, are needed to combat the 
 depression which is sure to arise: the disease is always dangerous and often 
 fatal (Gross). Incisions, must be freely made if abscesses form, and the inter- 
 nal organs watched for multiple abscess. Ulceration, if it occur, must be 
 watched for hemorrhage, which should be arrested by compression and styptics 
 (Gross). [Compare Phlegmasia, Varicosis.] 
 
 Phlegmasia Alba Dolens. 
 
 Belladonna, and Mercury, equal parts, as ointment, often of much benefit 
 (Wa). Hamamelis, has specific action on the venous system (P) ; extolled by 
 Dr. Preston (R). Blisters, in early stage ; are extremely useful if judiciously em- 
 ployed (L). Ammonium Carbonate, often valuable where great prostration ; 
 full doses (Wa). Hydrochloric Acid, 3j of dilute acid in Oij of Barley-water, 
 with ^ss of Potassium Chlorate, to be taken daily (Mackenzie). Opium, large 
 doses internally, with leeches and anodyne ointments (Wa); Laudanum, 
 sprinkled on hot fomentations, if pain severe (L). Leeches, of great service 
 during the acute inflammatory stage (Wa). Bandaging, when the more acute 
 symptoms subside; at first with flannel, afterwards with ordinary roller band- 
 age (L). Regimen, should be tonic (L). Water, by compresses in active 
 stage ; hot and cold douches, in chronic form. 
 
yg6 PHLEGMON PHOTOPHOBIA PHTHISIS. 
 
 Phlegmon. 
 
 Aconite, or Belladonna are certainly efficacious ; Aconite best (R). Sulph- 
 ides, to abort, or when inevitable, to promote ; gr. ss-j of Potassa Sulphurata 
 every hour or two (B). Silver Nitrate, a strong solution may check if applied 
 early in the vicinity (B). Carbolic Acid, injections; a 2 per cent, solution 
 (B) ; used with great success (W). Iodine Injections, after evacuation (B). 
 [Compare Erysipelas.] 
 
 Photophobia. 
 
 Atropine, a neutral solution of the Sulphate, gr. j to the ^, for adults, 
 dropped into the eye every four hours (C) ; if much lachrymation, so as to di- 
 lute the solution, it may be applied more frequently ; in some cases it irritates 
 and has to be abandoned (Wa). Conium, in scrofulous photophobia, gr. ss of 
 Coniine in 3j of Ol. Amygdalae, locally twice or thrice daily ; or the vapor of 
 Coniine (Wa). Mercury, Calomel by insufflation (C). Canthoplasty, for the 
 spasm of the orbicularis in severe photophobia (C). Glasses, of cobalt blue, 
 the best color (R). Arsenic, in the condition described by old writers as stru- 
 mous ophthalmia, with its attendant photophobia, is very valuable as an internal 
 remedy (C). Chloroform, the eye exposed to the vapor of a few drops, in severe 
 photophobia will be speedily relieved (Jones). Croton- Chloral, gr. v-x, in 
 young people and those suffering from syphilitic corneo-iritis (Bader). Potas- 
 sium Chlorate, internally, is most useful in some cases (Vernon). Cocaine, in 
 2 to 4 per cent, solution, a few drops upon the conjunctiva, will be found 
 promptly efficient in most cases of severe photophobia. 
 
 Phthisis. 
 
 Creosote, gives excellent results (Bouchard) ; is directly curative, at least in 
 the initial stage of the disease (Frantzel) ; promotes the sclerotic change by 
 means of which recovery is found to occur (Jaccoud) ; Morson's beechwood 
 Creosote should be used, in doses of try in whiskey and glycerin, every 3 or 4 
 hours ; should be largely diluted to prevent irritation, and continued for many 
 months [see page 293]; relieves cough, diminishes expectoration, stops night- 
 sweats, increases weight, decreases fever, promotes appetite, and in many cases 
 improves the local condition, as shown by the physical signs (Robinson): 
 the Carbonate {Creosolal), the Valerianate {Eosole), and the Phosphate, have 
 each given good results. Guaiacol, the chief ingredient of creosote and 
 equally efficient; the Carbonate {Duotal), in doses of gr. vj to viij, up to 3jss 
 daily, is better borne and an efficient substitute [see page 294] ; gr. iv four 
 times a day increased to gr. vj six times a day, also inunctions of Europhen in 
 Olive Oil, 3] in ^ijss, has given excellent results in many cases. Benzosol, 
 contains 54 per cent, of Guaiacol, which it yields up in the intestines : in doses 
 of 4 grains, gradually increased to 12 grains, thrice daily, it has given results 
 in phthisis, equal if not superior to those from creosote (Walzer). Iodine, 
 should be more used than it is ; the compound solution, gtt. j-iij thrice daily, 
 or when anemia and not much fever use Ferrous Iodide, ty\,xv of the syrup 
 pushed to Z] ter die (Da C) ; as inhalation in chronic phthisis ; to lessen 
 expectoration and cough ; also as liniment painted under clavicles, to allay 
 harassing cough, and to check secretion (R) ; extremely useful ; also as intra-- 
 pulmonary injection, a solution of the compound tincture of Iodine, 1 to 4 of 
 distilled water, of which ttlx-xx injected once every 4 or 5 days, through the 
 1st, 2d, or 3d intercostal spaces, anteriorly, or in the axillary region, avoiding 
 the pericardium and great vessels (Robinson): Iodine or Iodoform, with 
 Creosote, Carbolic Acid, Eucalyptus, Chloroform and Alcohol or Ether, as a 
 combination for an antiseptic inhalation (Br) ; a compound solution hypoder- 
 mically, each g-dose containing Iodine gr. ss, Bromine gr. ^, Phosphorus gr. 
 
phthisis. 797 
 
 yitf, Thymol and Menthol of each gr. 2 /,, used in 35 cases with excellent results 
 (lngraham). Europhen by inunction, with Creosote internally, has given cura- 
 tive results even in the breaking-down stage, and almost always cures incip- 
 ient cases (Flick); [see formula p. 799]. Iodoform internally, has proved 
 extremely effective in all forms, as witnessed by numerous observers in various 
 countries (S. Smith) ; though not one of the most active germicides, it is 
 very destructive to the bacillus tuberculosis (B). Iodol, may be advanta- 
 geously substituted for Iodoform (B). Ichthyol, is far superior to creosote 
 or cod-liver oil, and is very useful in pulmonary tuberculosis (Cohn) ; a 
 mixture of equal parts of Ichthyol and water, of which 4 drops are taken 
 thrice daily, the dose being increased by one drop daily until the maximum 
 of 40 drops three times daily is reached (Id). Cod-liver Oil, holds first rank 
 as a remedy and food in the chronic forms ; a teasp. after meals ter die is 
 enough ; when not well borne may be combined with Aqua Caicis, Comp. 
 Tinct. of Gentian ; or with Ether when not digested (B, R) ; is of great utility 
 by improving nutrition, and by affecting the tubercle ; give ^ss thrice daily one 
 hour after meals, with TT\,v-xv of Ether, or an equal quantity of malt or whiskey ; 
 do not give it in hot weather (Da C). Alcohol, an important remedy ; may be 
 given with Cod-liver Oil ; or Spt. Frumenti, ^j-^ij with some bitter, immedi- 
 ately after meals; if it disagrees, it harms: curiously, it induces an intractable 
 form of phthisis (B). Sulphurous Acid, by inhalation, spray or fumigation, in 
 chronic phthisis (R). Formalin 3j, Glycerin giv, Distilled Water 3 V, as spray 
 for 10 or 15 minutes 4 times in 24 hours in the early stage (Green). Aurum, 
 the Bromide of Gold and Arsenic internally, with inhalations of Papoid as 
 glycerole by the atomizer, gave astonishing improvement in two cases of 
 fibroid phthisis with cavities, due to neglected pneumonitis ; also in a case of 
 grinders' consumption (E. A. Wood) ; the Chloride has rendered excellent 
 service in the hands of Gibbes and Shurly. [See infra, under Chlorine.] 
 Arsenic, valuable in chronic forms as no other remedy; but not in caseous 
 phthisis or where much hectic ; may be given by stomach or fumigation (B) ; 
 as cigarettes, useful in the diarrhea, probably diminishes temperature, caution 
 required ! (R) ; of great value in early stage, in later stages it is of no use ; 
 Arsenous Acid, gr. -£$, or Fowler's solution rr\jij thrice daily (Da C). An organic 
 compound of Arsenic, named CacodyU, is attracting much attention in France 
 as a cure for phthisis; used hypodermically in doses of 5 to 10 centigrams 
 daily, it is free from unpleasant results (Gautier) ; under it certain forms, with 
 excavations or with softening of the tubercles, are greatly improved (Letulle). 
 
 Aconite, in small doses for the irritative fever, is a remedy of much value (Da 
 C). Antipyrin, in a 2j^-grain dose hourly for 3 doses daily, for the hectic fever. 
 Phenacetin is better borne and is efficiently antipyretic; extensively employed 
 in the hectic of phthisis. Cinchona, for the hectic and sweats, Quinine, gr. xv-xx 
 (B) ; if small doses fail, a dose of 6 or 8 grains at once, or in portions repeated 
 hourly (R). Ipecacuanha, the wine as spray to throat when bronchial asthma 
 and emphysema combined with fibroid phthisis (R). Opium, or Morphine, 
 in a viscid vehicle for cough, or as lozenges when cough due to inflamed 
 throat (R) ; must in time be given for the cough, which is an irritative one. 
 Codeine, gr. ^ to ^ in simple elixir, is useful and does not constipate (Da C). 
 Apomorphine, with Morphine, makes a good combination for many symptoms, 
 especially for dyspnea, continual cough and thick tenacious mucus (Br). 
 Cannabis Indica, an aqueous solution [see page 243] relieves the cough and 
 aids the patient in many ways (Lees). Hydrogen Dioxide, the solution inter- 
 nally, in doses of gj to iij diluted with 3 parts of water, renders good service 
 by promoting digestion, palliating cough, and increasing the activity of chaly- 
 beate remedies. Terebene, with Thymol and Carbolic Acid, equal parts of 
 each, of which £ss to a pint of hot water as an inhalation ; is extremely useful 
 for the dyspnea (Camman). Verbascum, the Mullein-plant, has long been a 
 popular remedy in phthisis; it facilitates expectoration, improves the general 
 condition, and palliates the cough. Calcium Phosphate, in the diarrhea, and in 
 chronic forms of phthisis with little or no fever (R). Cimicifuga, useless in 
 
ygS phthisis. 
 
 tuberculosis, but in phthisis it relieves cough, improves appetite, lessens inter- 
 current bronchitis, and so improves the patient's general condition (Wa). 
 Cocaine, locally for the throat symptoms, to be applied just before meals are 
 eaten (Da C). Sanguinaria, helps expectoration, and revives the enfeebled 
 stomach (P). Camphorated Naphtol, undiluted, or tr^i] in olive oil hypoder- 
 mically, used with very good results in 15 out of 32 cases so treated (Reboul). 
 Chloroform, with glycerin or honey, for the cough in fibroid phthisis (R); by 
 inhalation in small quantities for the cough and dyspnea, gave extraordinary 
 relief to a noble patient of mine during the last 8 months of his life (Spencer 
 Wells) ; by continuous inhalation, kept short of full anesthesia, may be effective 
 as a germicide in phthisis (Potter, in Pacific Med. Jour., Oct., 1890) : TTLxv-gj 
 or 3ij, by inhalation twice daily, continued for a long period of time, will give 
 better results than any other known remedy (Flick): Creosote, with Chloro- 
 form as a vehicle, may be taken into the lungs from a globe nebulizer, pro- 
 ducing the most happy results (Id). Chlorine gas, by inhalation, also the 
 hypodermic use of Iodine and Chloride of Gold and Sodium, extensively 
 employed in pulmonary consumption with good results (Gibbes and Shurly). 
 Ferrum, often prescribed ; has no especial influence on deposit (B) ; is pre- 
 scribed in tuberculosis (Tr) ; the Liquor Ferri Perchloridi, 3j ad 3J aquae, the 
 most serviceable local application in laryngeal phthisis, diminishing irritability 
 of the mucous membrane, and quieting cough (Mackenzie). Mercury, gr. T ^$ 
 of Corrosive Sublimate every two or three hours, for the diarrhea (R). Benzoin, 
 as inhalation, to lessen cough and expectoration (R). Mineral Acids, for the 
 indigestion ; especially the dilute Hydrochloric (B). Prunus Virginiana, has a 
 domestic reputation, probably due to its influence over cough ; the syrup is 
 much used as a vehicle for cough-mixtures (B). Hypophosphites, are very use- 
 ful in chronic cases (B); have no special effect (Da C). Digitalis, as an anti- 
 pyretic ; deranges intestinal canal, therefore injurious in phthisis (B). Copper 
 Phosphate, in nascent form soluble in an alkaline body, is held to be specific 
 by Prof. Luton of Rheims ; his formula contains Neutral Acetate of Copper 0.15, 
 Cryst. Phosphate of Sodium 0.75, Glycerin and Pulv. Liquorice, aa q. s. for one 
 pill. Copper Sulphate, gr. ■£%> or Silver Nitrate, gr. % , or Bismuth, gr. xx, for 
 the diarrhea (Da C). Camphor, in oil, as subcutaneous injections during the 
 period of softening [see page 241]. Amick Chemical Cure consists in the use 
 of Calomel, Iodoform. Guaiacol, etc., as described by Dr. N.B. Shade in various 
 journals (Waugh). [See under Patent Medicines in Appendix.] Aseptolin, 
 lately put on the market by Edson, is described on page 89. Tuberculin, 
 (Koch's lymph) described on page 511 ; a deceptive bubble which for a short 
 time commanded the attention and admiration of the whole world, but which 
 has been ruthlessly pricked by the critical scalpel in the hands of the father of 
 modern pathology (Senn). Tuberculocidin, a derivative of Tuberculin (Klebs) ; 
 is described on page 514. Antiphthisin, is Dr. Klebs* latest remedy, and is fully 
 described on page 514. Antitoxin, advocated by Maragliano and Paquin, is 
 described fully on page 180. Nuclein, has been employed with encouraging 
 results by Vaughn [see page 161]. Baths, sea-bathing, if chronic, little or no 
 fever, without active deposition of tubercle, or scrofulous pneumonia; Turkish 
 baths for the cough (R). Grape-cure, is serviceable (B). Aliment, should be 
 nutritious and digestible, malt liquors better than wine or spirits : extract of 
 malt, cod-liver oil, plenty of meat, and alcohol in moderation (Da C) ; warm 
 clothing, bathing and friction of skin, moderate exercise, and a suitable climate. 
 Forced Alimentation, when anorexia appears, and superalimentation at all 
 times, necessary to successful treatment; washing out the stomach daily by 
 syphon-tube, with warm water alkalinized with Borax, and then feeding through 
 the tube (Robinson). Climate, the best by far is that of Egypt or Algeria ; 
 next coming New Mexico, Southern California, especially in the desert along 
 the Colorado River, South Carolina and portions of Georgia and Florida; the 
 latter being especially suitable for cases having a co-existing bronchitis ; for 
 some cases Colorado is very good, and the Adirondack region for early cases 
 in which there is no tendency to hemorrhage (Da C). [Compare Cough, 
 
PITYRIASIS. 
 
 799 
 
 Hectic Fever, Hemoptysis, Laryngitis tubercular, Meningitis tuber- 
 cular, Peritonitis tubercular, Perspiration, Tuberculosis acute, 
 Tuberculous Affections. 1 
 
 R . Quininse Sulphatis, . . gr. xviij. 
 
 Pulv. Digitalis, . . . . gr. vj. 
 
 Pulv. Opii, gr. iij. 
 
 M. ft. pil. no. xij. Sig. — One pill thrice 
 daily, for the irritative fever. [Niemeyer.) 
 
 R. Iodoformi, 3J SS - 
 
 Creosoti, rtl^xv. 
 
 01. Eucalypti, .... rt\,xxx. 
 
 Chloroformi, giij. 
 
 Alcoholis, 
 
 iEtheris, . . aaq. s. ad ^ij. 
 M. Sig. — io to 20 drops on the sponge 
 of a perforated zinc inhaler, to be worn 20 
 minutes thrice daily. (Bruuton.) 
 
 R . Europhen, gj. 
 
 01. Rosse, Try. 
 
 01. Anisi, £j. 
 
 01. Olivse, gijss. 
 
 M. Sig. — ^ss by inunction at bed- 
 time; wash off with bay rum or whiskey 
 in the morning. [Flick.) 
 
 R 
 
 . Iodoformi, 
 
 Creosoti, 
 
 Pulv. Benzoini, 
 
 Bals. Tolu., . . . . aa gr. j. 
 In pill, of such 2 to 4 daily. {Huchard.) 
 
 R. Tinct. Belladonnae, . . gij. 
 
 Syr. Scillae, ^ij. 
 
 Morphinae Sulph., . . . gr. j. 
 
 Syr. Tolutani, . q. s. ad £ iv. 
 M. Sig. — Tablespoonful at bedtime, for 
 cough and restlessness; to be repeated if 
 necessary. 
 
 R . Codeinse, gr. xv-xx. 
 
 Alcoholis, . . . q. s. ad solv. 
 
 Potassii Cyanidi, . . . gr. xij. 
 
 Syr. Pruni Virgin., . . t ^iv. 
 
 Aquce, . . . . q. s. ad Jvj. 
 M. Sig. — A teasp. 4 to 6 times daily, 
 for the cough. [Potter.') 
 
 R 
 
 M 
 
 Arseni Iodidi, 
 Strychninse Sulph., 
 Hydrarg. Chlor. Corr. 
 Quininae Sulph., 
 
 Iodoformi, aa 3 i j . 
 
 ft. pil. no. xl. Sig. — One thrice daily 
 
 aa gr. j. 
 
 as a tonic in tubercular cases. 
 
 {Mann.) 
 
 R. 
 
 Creosoti (beech-wood), . n\vj. 
 
 Glycerini, %}. 
 
 Spt. Frumenti, . . . . ^ij. 
 M. Sig. — For one day's use, as directed 
 in ^ ss doses. [Robinson.) 
 
 [For a Cod-liver Oil Emulsion see formula on page 572.] 
 
 Pityriasis. 
 
 Alkaline and Tonic Remedies generally control mild cases, together with 
 baths and emollients ; the more severe ones requiring constant envelopment 
 in linseed oil or cod-liver oil (Bulkley). Mercury, in obstinate cases, Donovan's 
 solution, is highly successful (Wa) ; the yellow Iodide, gr. x to ^j of lard, or a 
 5 per cent, solution of the Oleate of Mercury in Oleic Acid with one-eighth part 
 of Ether, applied by a camel's-hair brush (B) ; Citrine ointment, especially 
 when the hairy parts of the face are affected (R) ; an ointment of Ammoniated 
 Mercury and Calomel is very useful in ordinary cases of dandruff or pityriasis 
 simplex (Bronson). Sulphur, Z) to ^j of vaselin applied every morning to the 
 scalp, with sweet almond oil anointing at night (Jackson). Soap, the liniment 
 of soft soap as shampoo every morning for cleanliness, or Borax and water, or 
 the yolks of three eggs beaten up in a pint of Limewater with ^ss of Alcohol, 
 all of which make good shampooing mixtures (Jackson). Borax, to cleanse 
 the scalp, a saturated solution; or the Glycerite of Borax (R). Lead, the Liq- 
 uor Plumbi, with glycerin, equal parts of each, and two of water, as lotion for 
 cases where there are high inflammation and abundant weeping (R). Carbolic 
 Acid, 2 parts to 3 of glycerin and water, twice daily, with the daily use of a 
 carbolized soap, is often effectual (Wa). Sulphides, ^ss of Potassa Sulphurata 
 to Oj of Lime-water, as a lotion, or the Bareges Pomade [see formula on next 
 page]. Thyroid Extract, as a stimulant of the cutaneous circulation, has been 
 
8oo 
 
 PLAGUE — PLETHORA — PLEURITIS. 
 
 used with satisfactory results [see page 158]. Myrtol, is curative (B). Baths, 
 frequently, and hard rubbing after shampooing the scalp ; avoid stimulating 
 food in bad cases, as well as the use of a fine-toothed comb on children's 
 heads. [Compare Seborrhea, and for Pityriasis versicolor see Tinea 
 versicolor.] 
 
 R . Sodse Sulphuratse, 
 
 Sodii Carbonatis, . . . aa £ij. 
 
 Axungiae, % ijss. 
 
 M. Sig. — Pomade de Bareges. 
 
 R. Hydrarg. Ammoniat., . . gr. xx. 
 Hydrarg. Chlor. Mitis, . . gr. x. 
 
 Petrolati, gj. 
 
 M. ft. unguent. Sig. — Local use. 
 
 Plague, Bubonic. 
 
 Strychnine, should be used as a routine treatment and commenced early in 
 the disease ; also with or without Ammonium Carbonate in the later stages 
 when the pulse begins to fail (Lowson). Morphine, is by far the best hypnotic 
 if given with judgment, gr. l /i-}i hypodermically at the onset to relieve suffer- 
 ing and induce sleep, later on gr. yb suffices (Id). Hyoscine, gr. ^hj~T5> or 
 Chloral gr. xx with Potassium Bromide gr. xxx, are of service for the same pur- 
 pose (Id). Salol, gr. x every 4 hours, as an intestinal antiseptic for the diar- 
 rhea, if urgent (Mn). Belladonna with glycerin, applied to the buboes in their 
 early stage; if red and inflamed they must be poulticed and when softening 
 occurs they should be incised and treated with Iodoform (Mn). Mercuric 
 Chloride and Carbolic Acid solutions, were injected into the glands with tem- 
 porary benefit, during the Hong-Kong epidemic (Payne) ; good results followed 
 the injection of Mercuric Chloride and Potassium Iodide (Cantlie). Iodine, as 
 liniment for indolent bubonic swellings (Mn). Calomel in full dose, followed 
 by a saline, usually relieves the vomiting (Lowson). Hydrocyanic Acid and 
 Morphine, in effervescing mixture, also ice pellets, for the vomiting, if calomel 
 does not succeed (Id). Cold, by ice-bags to the head and neck, when head- 
 ache and high fever (Mn). Water, sponging the body with warm water every 
 hour to reduce hyperpyrexia, is safer than antipyretic drugs (Id). Antitoxin, 
 Yersin's serum, from an immunized horse, was used in 26 cases in China with 
 24 reported recoveries, but further experience in India has not confirmed its 
 value (Id). Vaccination by Haffkine's protective inoculation of healthy per- 
 sons, causes severe reaction ; the results, though encouraging, are not conclu- 
 sive as to its value (Id). Treatment is very unsatisfactory, no specific or anti- 
 dotal drug has ever been discovered. As in other asthenic fevers, give the 
 patient an abundant supply of fresh air, avoid over-crowding, use cold affu- 
 sions or baths at the height of the fever, also such cooling drinks as may pro- 
 mote his comfort. Alcoholic stimulation appears to be of less value than in 
 typhus (Payne). Diet, would seem to be of minor importance in a malady of 
 such short duration (Payne in Allbutt's System). 
 
 Plethora. 
 
 Aconite, is useful for affections of plethoric subjects, and is decidedly the 
 best remedy for apoplexy in the plethoric (P). Arsenic, is used with advantage 
 when there is determination of blood to the head (Wa). Sulphur, as a mild 
 purgative for plethora from cessation of the menses (Wa). [Compare Abdom- 
 inal Plethora.] 
 
 Pleuritis. 
 
 Aconite, no remedy more effective prior to the stage of effusion (R) ; [see 
 under Inflammation] ; the tincture in doses of %. drop every 3 hours to a child 
 3 years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride, gtt. viij of tinc- 
 ture every 3 hours, with a drop added to each dose until the pulse is reduced or 
 nausea occurs (Wa) ; opinions differ as to whether it should be used in sthenic 
 
PLEURODYNIA. 
 
 So i 
 
 or asthenic forms (R). Bryonia, exceedingly valuable in second stage ; should 
 follow Aconite (P). Tartar Emetic, in early stages and young plethoric sub- 
 jects, when much febrile action, small doses, gr. ^ to % , may be useful (Wa) : 
 [see under Inflammation.] Digitalis, as antipyretic (R) ; deranges intestinal 
 canal (B) ; Aconite preferred (P) ; the tincture in doses of one drop every 3 
 hours to a child 2 years old (J. Lewis Smith). Quinine, has abortive power, 
 increased by combination with Morphine, gr. xv -|- gr. ss ; also as restorative 
 tonic in low-type cases (B). Opium, cannot be too highly extolled (P) ; is 
 especially beneficial ; gr. ss of Morphine hypodermically at the beginning will 
 often cut short an attack ; during the disease its effects are very beneficial ; a 
 slight physiological effect should be maintained (B) ; Morphine for severe pain 
 (R). Antipyrin, is found effective in promoting the absorption of pleuritic 
 effusions [see page 173]. Diuretin, has caused a large pleuritic effusion to 
 disappear [see page 233]. Guaiacol, locally to promote absorption of effusion 
 [see page 294]. Potassium Iodide, to promote absorption of effusions, steadily 
 for a long time (R) ; also chest painted with tincture of Iodine, one day on each 
 wall alternately ; may be washed off with Potassium Iodide, Alcohol or Ether 
 (B) ; as a diuretic to remove effusion (Clark). Iodine, as injections, with great 
 benefit and without risk, in empyema and hydrothorax (P). Burgundy Pitch, 
 the plaster externally as a mechanical support (P). Asclepias, the popular 
 pleurisy-root, is a favorite remedy in the South (W). Pilocarpus, in subacute 
 cases to remove fluids (Caro); or Pilocarpine Nitrate, gr. ^-bis die, for children 
 (Vigier); is too depressing and therefore unsafe (Smith). Sodium Chloride, 
 3ss in ^j of water, flavored with Licorice, in tablesp. doses every 3 hours, 
 often very useful in causing absorption of pleuritic serous exudations ; but is 
 contraindicated when exudation is purulent (Br). Bloodletting, by cups or 
 leeches, useful by reason of counter-irritation produced, and to relieve pain, 
 only in robust sthenic cases (B). Blisters, often greatly abused ; are harmful 
 during inflammatory stage (B). Poultices, large, hot, and frequently renewed 
 (R). Water, cold wet-pack to chest probably better than a hot one, pinned 
 tightly to limit movement of chest-walls (B). Thoracentesis, by aspiration, if 
 the quantity of fluid seriously embarrasses the respiration. [For Chronic 
 Pleurisy see Empyema, also compare Hydrothorax, Pleuro-pneumonia.] 
 
 Be . Potassii Acetat., .... 3]. 
 Infusi Digitalis, q. s. ad ^iv. 
 M. Sig. — Teasp. every 3 hours to a 
 child of 4 or 6 years, in the second stage. 
 
 R. Morph. Sulphat., . . . gr.j. 
 Tinct. Aconiti, .... rr^xxiv. 
 Liq. Potassii Citratis, . ^ij. 
 M. Sig. — A teasp. every 3 hours. 
 
 Pleurodynia. 
 
 Cimicifuga, curative when rheumatic and valuable in sympathetic cases from 
 irritability of uterus (P) ; or uterine derangements (R, Wa). Croton Oil, in 
 obstinate pleurodynia especially when blackened feces (R). Belladonna, the 
 plaster or liniment ; the latter generally best (R). Chloral, made liquid with an 
 equal weight of Camphor and rubbed in gently, often affords instant relief in 
 severe pleurisy (R). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful 
 in most cases (Hughes). Ether, as spray, sometimes immediately and perma- 
 nently removes the pain (R). Opium, as liniment rubbed in after warm 
 fomentations (Wa) ; or a hypodermic injection of Morphine (R). Iodine, as 
 liniment painted on the chest, often relieves where mustard fails (R). Blister- 
 ing, often successful when other means fail ; sometimes strong vesication is 
 necessary (R). Rest, is important and may be obtained by strapping the 
 affected side with strips of adhesive plaster. Poultices, very hot, followed by 
 application of lint and oilskin; Belladonna Liniment generally better (R). 
 Mustard, as a poultice, is generally efficient, and can be renewed when the 
 pain returns (R). [Compare Myalgia, Neuralgia.] 
 
 5i 
 
802 PLEURO-PNEUMONIA PNEUMONIA. 
 
 Pleuro-pneumonia. 
 
 Bryonia, is often of great service ; limits effusion and assists absorption (P). 
 Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice 
 a day, has had remarkable success (B). Sanguinaria, as a contra-stimulant 
 (P). Turpentine, as a fomentation (P). Arnica, the tincture in doses of tt^x 
 every 3 or 4 hours, very useful in controlling the heart's action (Wa). Pilo- 
 carpine, gr. ss, or 3ij of the tincture of Jaborandi, benefits cases of pleuro- 
 pneumonia (Wa). [Compare Pneumonia.] 
 
 Pneumonia. 
 
 Aconite, gives good results in catarrhal and fibrinous forms (B) ; has marked 
 effect (R) ; very valuable in first stage (P) ; in several cases it apparently cut 
 short the attack (Wa) ; to reduce circulation either Aconite or Veratrum Viride, 
 until the pulse is impressed (Da C). Veratrum Viride, valuable (P) ; in the very 
 incipiency (B) ; opinions differ as to whether it should be used in sthenic or 
 asthenic cases (R). Guaiacol Carbonate, gr. xx in emulsion every 2 hours, 
 gave excellent results in a case of double pneumonia (Thomson) ; in 13 cases 
 successfully treated it was practically the only remedy used (Cassonte) ; is 
 almost specific in this disease (A. H. Smith) ; preferred to the salicylates after 
 the stage of congestion, in feeble cases and when cardiac lesions exist (Bridges). 
 Sodium Salicylate, in large doses, not less than 3ij daily, proved curative in 
 72 consecutive cases (Liegel) ; has antibacterial power in pneumonia (A. H. 
 Smith). Strychnine Sulphate, in addition to guaiacol or the salicylate, to 
 obviate cardiac depression, also for its action on the nervous system (Bridges) ; 
 in a full dose hypodermically, repeated if necessary, for impending cardiac 
 failure ; is more useful in 1 or 2 full doses than in smaller doses more 
 frequently (Pye-Smith) ; gr. -^ every 3 or 4 hours with free use of alcohol, 
 the uniform treatment in the U. S. Navy, and to it the Surgeon-General attrib- 
 utes the unusually low percentage of mortality for 1896-97 in his service 
 from this disease. Quinine or Salicylic Acid, to reduce temperature (R) ; 
 Quinine as a tonic in cases which are asthenic from the first (P) ; in conjunc- 
 tion with Aconite and Veratrum, gr. viij-xij daily at start, is beneficial (Da C). 
 Antipyrin, to reduce pyrexia; is decidedly more serviceable in pneumonia 
 than Quinine (Wa) ; gr. xv several times a day, or 3 hourly doses each of 
 gr. xxx, then stopping until temperature rises again (R) ; such doses are too 
 high and are dangerous [see page 170] ; with Camphor internally, successful 
 in all of 22 cases of croupous pneumonia so treated at the Lorn Hospital, in 
 1894, Antipyrin gr. viij, Camphor gr. ij, Morphine Hydrochlorate gr. y 1 ^, in 
 powder every one or two hours (Ivanoff). Camphor, in olive oil, in doses of 
 from gr. j to gr. ij three or four times a day, hypodermically, in adynamic 
 cases, used simultaneously with the above antipyrin and camphor powder 
 (Id) ; in fibrinous pneumonia these injections lower the temperature about a 
 degree and ameliorate the general condition. Ammonium Carbonate, at 
 crisis for depression; in infusion of Senega (B) [or the formula on next page] ; 
 is useful late in disease when lung tissue breaks down (Da C). Ammonia, the 
 Aromatic Spirit as a substitute for the Carbonate, in doses of gss in simple 
 elixir (Da C). Turpentine, as stimulant at crisis (B). Serpentaria, with Am- 
 monium Carbonate in low types, as a stimulant about the crisis. Digitalis, of 
 doubtful value; may be useful for high temperature, ischemia, and low tension 
 of vessels (B) ; as case goes on and circulation is to be further controlled, 
 Digitalis is indicated (Da C) ; the best agent to slow the heart in infantile 
 pneumonia, with Belladonna as an adjuvant (Brown). Bryonia, when pleu- 
 ral complications (P). Phosphorus, especially when typhoid symptoms ; ap- 
 proved by Fleischmann (R). Belladonna is useful in the first stage (P) ; 
 Harley esteemed it highly in pneumonia (Wa) ; as an adjuvant to Digitalis in 
 infantile pneumonia, to soothe the irritable nervous system and curtail super- 
 
POISONING. 
 
 803 
 
 abundant secretion (Brown). Tartar Emetic, formerly given in large doses ; 
 now abandoned ; small doses may be useful, but should be used with care lest 
 depression ensue (B) ; at commencement with alcoholic stimulants, if patient 
 weak (R) ; may benefit young, robust subjects (Wa). [See under Pleuritis.] 
 Sanguinaria, as a contra-stimulant, when fever has abated, and graver symp- 
 toms have amended (P). Iodides, no remedy more efficient ; Ammonium 
 Iodide with Arsenic, to prevent caseation of inflammatory products (R) ; Ethyl 
 Iodide, gtt. v-xx ter die by inhalation, very valuable in catarrhal form (B) ; 
 Sodium Iodide is useful in catarrhal pneumonia (Da C). Ipecacuanha, the 
 wine in infantile pneumonia, should never be dispensed with, as it promotes 
 expectoration, controls hemorrhage and regulates secretion (Brown). Senega, 
 in advanced stages as expectorant, when cough is dry, irritating and painful, 
 tightness and oppression of chest (P). Opium, or Morphine by injection, 
 sometimes needed for severe pain (R) ; Opium is very desirable in many cases, 
 relieves the symptoms and arrests delirium (Wa). Copper Acetate, Kissel re- 
 gards it curative; under it the mortality was only 4 T % per cent. Stimulants, in 
 asthenic cases, those of malignant type, and those occurring in aged people 
 (Wa). Blisters, useful at very beginning only, or at crisis of disease, harmful 
 in inflammatory stage (B) ; to lessen the pain, but should be used in modera- 
 tion (R). Wet-pack, hot, tightly pinned to limit motion of chest-walls (B). 
 Poultices, encircling the whole chest in children (R). Glycerin, in the form of 
 Unna s Paste (see page 329), or in the application called Antiphlogistine, makes 
 an excellent poultice and fulfils many indications in pneumonia. Diet, farina- 
 ceous, mucilaginous drinks, and rest in warm room (R). [Compare Pleuro- 
 pneumonia.] 
 
 R. 
 
 Tinct. Veratri Viridis, . TT^xl. 
 Spt. yEtheris Nitrosi, . . ^vj. 
 Liq. Potassii Citratis, . 3 ivss. 
 Syr. Zingiberis, q. s. ad % vj. 
 M. Sig. — A tablesp. every 3 hours, in 
 the early stage. [Da Costa.) 
 
 R- . Ammonii Carbonat. , . . gr. xl. 
 Infusi Serpentariae, . . . ^iv. 
 M. Sig. — A teasp. every 3 hours, as a 
 stimulant about the crisis. [B.) 
 
 R. Sodii Iodidi, Sjiij. 
 
 Morphinae Sulph., . . . gr. j. 
 Elixir Simplicis, . . . . jfiv. 
 M. Sig. — A teasp. ter die, also blisters 
 over the apex. In catarrhal pneumonia. 
 
 {Da C.) 
 
 R- . Ammonii Iodidi, . . . gr. xl. 
 
 Spt. Ammoniae Aromat. , £ij. 
 
 Elix. Simp, et Aquae, ad 3 viij. 
 M. Sig. — Two tablesp. thrice daily. In 
 syphilitic lobar pneumonia. {Da C.) 
 
 Poisoning. 
 
 A Poison, in the medical and toxicological sense, is any substance of inher- 
 ent deleterious character and incapable of self-reproduction, which, acting 
 chemically or physiologically upon the tissues or fluids of the body, will se- 
 riously injure the health or destroy life. 
 
 The most energetic poisons are Hydrocyanic Acid, Potassium Cyanide, 
 Nicotine, Strychnine, Carbolic Acid and some reptile venoms. The poisons 
 usually selected by poisoners for criminal purposes on others are those which 
 produce effects resembling the symptoms of natural disease, as Arsenic, Col- 
 chicine, Tartar Emetic, Strychnine, Morphine and Aconite. Those generally 
 chosen for suicidal purposes are such as may be most readily obtained by the 
 laity, namely — Carbolic Acid, Morphine, Illuminating gas, Charcoal gas and 
 Potassium Cyanide ; the first being easily purchased for disinfecting purposes, 
 while the last is commonly used in the arts. In 2,097 cases of death from 
 poison in England and Wales, from 1863 to 1867, there were 628 due to Opium 
 and its preparations, 151 to Hydrocyanic Acid and Potassium Cyanide, 83 to 
 Arsenic, yy to Mineral Acids, 66 to Oxalic Acid, 61 to Strychnine, 58 to Mercu- 
 rial compounds, 15 to Phosphorus and 11 to Ammonia. 
 
 General Principles of Treatment. The following Rules are laid down by 
 
804 POISONING. 
 
 high authority : (i) Lose no time. (2) Use the best remedy obtainable at 
 once. (3) Get rid of the poison. (4) Stop its action. (5) Remedy the mis- 
 chief already done. (6) Fight against the tendency to death (Tanner). In 
 the treatment of poisoning, whether by mineral or vegetable substances, if the 
 poison is known the first indication is to administer the proper chemical 
 Antidote, so as to render it harmless or comparatively so. Next, the stomach 
 should be emptied and washed out, lest the newly-formed compound be ab- 
 sorbed after a time, also to remove any poison which may have escaped the 
 action of the antidote. Next, the appropriate Antagonist should be adminis- 
 tered, to counteract the effects of such portion of the poison as may have been 
 absorbed. Lastly, such Antagonistic Measures should be employed as may sus- 
 tain the action of any organic function showing signs of failure. In most 
 cases of alkaloidal poisoning absorption has proceeded so far before profes- 
 sional assistance is obtained that antidotes are of no value, hence reliance can 
 be placed only upon the physiological antagonist and such supporting meas- 
 ures as will tend to maintain vitality until the poison can be eliminated by 
 the natural channels. 
 
 Antidotes affect a poison, either physically or chemically or both, so as to 
 remove it from the body or alter its character before absorption, and thereby 
 prevent its toxic action upon the organism. They do their work in the ali- 
 mentary canal or in the respiratory passages, and are applicable to vegetable 
 as well as mineral poisons, but they are not available against poisons adminis- 
 tered hypodermically. [See page 36.] Among them are Emetics, Cathartics, 
 Washes, Injections, Ligatures, Poultices, the use of the Stomach-pump, of tour- 
 niquets, etc., which are termed Mechanical Antidotes ; and the Chemical or 
 True Antidotes, which include Albumin, Milk, Charcoal, Soap, Starch, Oils, 
 Tannin, Turpentine, Acids, Alkalies, Potassium Permanganate, Carbonates, 
 Hydrates, Sulphates, Sodium Chloride, Iodine, Iron preparations, etc. 
 
 Antagonists are agents which oppose each other in their physiological 
 action, and may be employed against each other as counterpoisons, to neu- 
 tralize their effects upon the organism. They do their work in the blood and 
 tissues, after absorption, and are especially available against poisons adminis- 
 tered hypodermically, in which cases antidotes are useless. Substances so 
 employed are generally the active principles of plants, a few being chemicals, 
 as Oxygen and Chloral. Antagonistic Measures include such proceedings as 
 tend to neutralize the remote effects of poisons, as artificial respiration, faradism 
 of the respiratory muscles, hot and cold applications, douching, constant 
 motion or absolute repose, etc. (See page 33.) 
 
 Emetics, when employed, should be used without delay. They are often 
 rendered needless by vomiting induced by the poison itself, or by the free use 
 of diluent drinks ; and are contraindicated when there is severe corrosion of 
 the alimentary canal or when abdominal inflammation exists. The best emetics 
 are : Zinc Sulphate, for stomachal administration, being non nauseating, 20 
 to 30 grains in water, 5 grains for children. Apomorphine, gr. T V~/^> hypoder- 
 mically, when narcosis prevents the use of emetics by the mouth. It should 
 be administered hypodermically, as it is very uncertain in action when given 
 otherwise. The following may be used : — Copper Sulphate, 1 to 5 grains in 
 water ; Ipecac, in powder ; Emetine, gr. T \ to -| ; Tartar Emetic, i}4. grains, acts 
 slowly and is depressant ; Turpeth Mineral; Cadmium Sulphate; Sodium 
 Chloride (common salt), 2 teaspoonfuls in a pint of water; Mustard, 2 tea- 
 spoonfuls in a cup of warm water ; also Olive Oil, Soap-suds, Snuff, melted 
 Fats, and tickling the fauces with the finger or a feather. Sodium Chloride, as 
 an emetic, is contraindicated in poisoning by tartar emetic or corrosive 
 sublimate, and so also are Oils and Fats and substances containing them, in 
 poisoning by phosphorus, cantharis, carbolic acid or copper salts. 
 
 Cathartics are generally employed after the use of a chemical antidote, to 
 remove the compounds formed thereby from the intestinal canal. The best 
 are Castor Oil, Croton Oil, Senna, and Magnesium Sulphate (Epsom salt). 
 
POISONING. 805 
 
 Castor Oil protects the mucous membrane and obstructs absorption, but is 
 contraindicated in poisoning by phosphorus, carbolic acid, copper salts, or 
 cantharis, the absorption of which is aided by oils and fats. Croton Oil is rapid 
 and powerful in the dose of from 1 to 5 minims, in a bread pill. Magnesium 
 Sulphate, in the dose of 1 to 4 oz., well diluted, is of special service in chronic 
 lead poisoning and to remove antidotal compounds from the intestines. 
 Senna, Gamboge, and other drastics are the best catharticsin narcotic poisoning. 
 
 The Stomach Pump and Stomach Siphon are efficient, and do not weaken 
 the patient as emetics do, but are not always available, and cannot be used 
 when there is corrosion of the stomach or esophagus, for fear of perforation. 
 The continuous or occasional washing of the stomach is a measure of great 
 importance in the case of soluble poisons, some of which are excreted into the 
 stomach [see infra under Opium]. These appliances are almost useless when 
 the poison is in solid form and in large pieces (as meat, sausage, fish, cheese, 
 etc.). 
 
 Albumin is an ideal chemical antidote, being harmless, easily procured, and 
 forming compounds (which are more or less insoluble) with most of the metallic 
 salts, corrosive alkalies and mineral acids, as also with Iodine, Bromine, Chlor- 
 ine, Creosote, Anilin, and alcoholic solutions of most of the Alkaloids. It is 
 especially suitable against inorganic poisons, and was recommended by Orfila 
 for invariable use, even on the mere suspicion of poisoning. It should be well 
 diluted, the whites of four eggs to a quart of lukewarm water; and should be 
 followed by emetics and cathartics, as many of its compounds are soluble in 
 an excess of itself. 
 
 Milk is a good substitute for Albumin, its antidotal action being nearly the 
 same in range and due to its casein, albumin and free alkali. It is particularly 
 valuable against metallic salts, corrosive acids and alkalies (especially Am- 
 monia) and the alkaline earths, but it is contraindicated when fatty antidotes 
 are to be avoided, by reason of its richness in fat. 
 
 Gelatin is of especial value against Iodine, Bromine and the Alums, but 
 requires too much time for its preparation, as it should be broken up, soaked in 
 water for half an hour and reduced to the consistency of honey. 
 
 Gluten is of value against Corrosive Sublimate, but is less so than albumin 
 and is not easily obtained. 
 
 Tannin (Tannic Acid), precipitates the Alkaloids and their salts, with which 
 it forms compounds (tannates), which, though comparatively insoluble are not 
 entirely inactive, and should be removed at once from the alimentary canal 
 by emetics and drastic purgatives. It acts well against many metallic salts, 
 though inferior to albumin for these, except against Tartar Emetic, which 
 albumin does not affect, but tannin renders harmless. It is given in doses of 
 gr. xv to xlv, in a 2 per cent, solution, every ]i hour; and if combined with 
 about 10 per cent, of its weight of Iodine its antidotal effect on vegetable poi- 
 sons is greatly increased. If not itself obtainable, decoctions or infusions of 
 substances containing it may be used, as tea and coffee, nut-galls, kino, rhatany , 
 catechu, and the barks of oak, willow and cinchona. 
 
 Oils and Fats are efficient against the corrosive acids and alkalies, the 
 metallic oxides and salts ; but are contraindicated in poisoning by Phosphorus, 
 Cantharis, Carbolic Acid, or Copper salts, the absorption of which they pro- 
 mote. With the caustic alkalies they unite to form soaps, liberating glycerin ; 
 they are inferior to albumin against the metallic salts, and as their action is 
 slow they are less efficient than acids against alkalies. Those used are olive, 
 cotton-seed, linseed and almond oils, also melted butter and lard. 
 
 Starch, in paste, 1 to 15 of water, is the antidote for Iodine and Bromine, 
 with which it forms compounds which are almost harmless. It has some 
 value against Corrosive Acids, Corrosive Sublimate, and Zinc and Copper 
 
806 POISONING. 
 
 Sulphates, but it is not so efficient as Albumin, which is preferred for these 
 poisons as well as for Iodine, since it has a greater affinity than starch has 
 therefor. 
 
 Soap, as Castile Soap, dissolved in 4 times its bulk of hot water, to make 
 "suds," and given by the cupful, is one of the most efficient antidotes against 
 corrosive acids and metallic salts, especially Corrosive Sublimate, Potassium 
 Bichromate, and Salts of Tin and Zinc. It is inferior to albumin against 
 these, but is preferred to caustic alkalies against acids, as of itself it has no 
 corrosive action. It should not be used against alkalies. 
 
 Gum Arabic, in the form of mucilage, is chiefly used as a protective against 
 corrosive poisons, and has been recommended in copious draughts against 
 poisoning with the Bismuth salts. 
 
 Charcoal has some antidotal value against many alkaloids, the metallic salts, 
 and Phosphorus, slowing their toxic action and postponing their effects, prob- 
 ably by a protective action upon the gastric walls. It has the valuable prop- 
 erty of absorbing gases, but enters into no fixed compound with any mineral 
 or vegetable poison. Fresh animal charcoal is the best, though wood charcoal 
 is efficient, but in less degree. 
 
 Oil of Turpentine, after long exposure to the air, therefore containing much 
 oxygen, is one of the antidotes against Phosphorus. It should be admin- 
 istered immediately after the ingestion of that poison, alone or in hot water, 
 and in quantity 100 times that of the phosphorus supposed to be present. 
 
 Organic Acids, such as Acetic (vinegar), Citric (lemon-juice), and Tartaric 
 are employed against the Alkalies and alkaline Carbonates. 
 
 Inorganic Acids. — Diluted Sulphuric Acid, in water, is used against the solu- 
 ble salts of Barium and Lead, with which it forms insoluble sulphates ; also as 
 a prophylactic against the colic of lead poisoning. 
 
 Ammonia, diluted, used by inhalation, is an efficient antidote against the 
 vapors of corrosive acids and Nitrobenzol, also against Chlorine, Bromine, 
 and Hydrocyanic Acid. 
 
 Magnesium Hydrate and Carbonate are the most efficient antidotes against 
 Acids and the acid salts, also against Oxalic Acid and the acid oxalates, 
 in the absence of the calcium antidotes therefor. They are also valuable 
 against Arsenic, Phosphorus, Mercury, Corrosive Sublimate and other 
 metallic salts, forming with arsenic compounds which are almost insoluble, and 
 with metallic salts in solution precipitating the corresponding oxides or basic 
 salts. 
 
 Magnesia is a compound of the Hydrate and Carbonate of Magnesium with 
 water, or a basic Magnesium Carbonate. When heated at alow temperature it 
 becomes calcined, losing C0 2 and H 2 0; then mixed with 25 times its weight 
 of warm water it becomes gelatinized, in which condition it is best for antidotal 
 purposes, in doses of from ij^ to 2 oz., at short intervals for a few doses, then 
 at longer intervals. An excess does no harm, but rather benefits the patient by 
 its cathartic action. 
 
 Carbonates and Bicarbonates of Sodium and Potassium are employed against 
 most of the poisonous metallic salts, especially those of Zinc, which they imme- 
 diately decompose, forming insoluble basic compounds ; also against Iodine, 
 Bromine, and Potassium Bichromate, forming the neutral chromate with the 
 latter and harmless salts with the former. They are useful in dilute solution 
 against Acids, but are less easily tolerated than magnesium sulphate. They 
 are contraindicated in poisoning by Oxalic Acid, with which they form danger- 
 ous compounds. 
 
 Calcium Hydrate and Carbonate, in the form of lime-water, chalk, eggshells 
 or powdered oyster-shells, are used against Acids, both mineral and organic, 
 
POISONING. 807 
 
 and especially against Oxalic Acid and the acid oxalates, which they neutral- 
 ize and convert into the insoluble calcium oxalate. 
 
 Sulphates of Magnesium and Sodium (Epsom and Glauber's salts), the solu- 
 ble sulphates, are particularly efficient against Carbolic Acid and the salts of 
 Barium and Lead. 
 
 Sodium Chloride (Common Salt), in dilute solution, is the best antidote 
 against the Silver salts, converting them into the insoluble chloride of silver. 
 It may be given with albumin, which is also a very efficient antidote in this 
 form of poisoning. 
 
 Potassium Ferrocyanide, given in doses of 30 to 60 grains in water, is of 
 special value against the Copper salts, but albumin is equally efficient and 
 more easily obtained. 
 
 Potassium Permanganate, is the best antidote against all organic poisons, if 
 used promptly, before absorption has taken place, as it rapidly destroys them 
 by oxidation. It has been used successfully against Morphine and Strychnine 
 salts and Phosphorus in the stomach, and locally for snake-poison. 
 
 Iron. — The Hydrated Sesquioxide is the best antidote to Arsenic in solution 
 or in a soluble form, as it combines with the latter to form a ferrous arsenate, and 
 also protects the gastro-intestinal mucous membrane against the local action 
 of the poison. In the proportion of 10 parts to one of arsenic the union is very 
 complete, but its union with the salts of arsenic is limited even when it is in 
 great excess, though much more effectual if there is added to it a small amount 
 of ammonia or other caustic alkali, or if the basic ferric acetate is mixed with 
 it. For the preparation of the official arsenic antidote see Ferrum Oxidum 
 Hydratum cum Magnesia, under the title Ferrum in Part I. Dialyzed Iron, 
 Saccharated Iron, and the basic Ferric Acetate have all been used with more 
 or less success in arsenic poisoning. 
 
 Copper Carbonate, in dose of 3 to 6 grains, with sugar and water, preceded 
 and followed by an emetic, is recommended in phosphorus poisoning, being 
 supposed to coat the particles of Phosphorus first with a layer of copper phos- 
 phide and then with one of copper itself, thus preventing their solution in the 
 fluids of the stomach. 
 
 Sodium Hyposulphite, in doses of 15 grains, in very dilute solution and fre- 
 quently repeated, is a valuable antidote against Bleaching Powder (Calcium 
 Hypochlorite), Labarraque's solution (Sodium Hypochlorite), and Javelle 
 Water (Potassium Hypochlorite), which it reduces to chlorides, itself under- 
 going oxidation to the sulphate. 
 
 Chlorine, in the form of Chlorine Water, Labarraque's solution, or Javelle 
 Water (see above), is employed externally as an antidotal wash for snake-bites 
 and other poisoned wounds ; also, well diluted, internally against alkaloids and 
 other vegetable and animal poisons ; and as a spray for antidotal inhalation 
 against coal gas (Carbonic Oxide), Ammonia, Phosphoretted and Sulphuretted 
 Hydrogen, also Hydrocyanic Acid. 
 
 Iodine, in very dilute solution, is used as an antidote against alkaloids and 
 their salts, other vegetable poisons and snake-venom. All its compounds are 
 more or less soluble and toxic, and must therefore be removed from the system 
 as soon as possible. Bouchardaf s Antidote for vegetable poisons consists of 3 
 grains of Iodine, 30 grains of Potassium Iodide, and 11 oz. of distilled water. 
 The dose, which is from iyi to 3 oz., should be repeated frequently. 
 
 Ammonium Carbonate, in dose of 5 grains, administered hypodermically in 
 the vicinity of wounds caused by poisoned arrows, was repeatedly used by Dr. 
 Parke, the surgeon of Stanley's last expedition in Africa, with entire success in 
 saving life when it was employed immediately after the injury. Persons so 
 wounded, if they were at too great a distance to receive this treatment, invari- 
 ably died within a short time. 
 
808 POISONING. 
 
 Antidote Bag, designed by Martindale, of London, contains the following- 
 named articles, labeled with directions for use, viz. — 
 
 Dialyzed Iron. Spt. Ammonige Aromat. Amyl Nitrite. 
 
 Syrup of Chloral. Oil of Turpentine. Zinc Sulphate. 
 
 Chloroform. Acetic Acid. Ipecacuanha. 
 
 Spt. Chloroformi. Tincture of Digitalis. Potassium Bromide. 
 
 Calcined Magnesia. Tannic Acid. Potassium Permanganate. 
 
 Also a Hypodermic Syringe and Solutions or Pellets therefor of — 
 
 Morphine Sulphate. Apomorphine Hydro- Pilocarpine Nitrate. 
 
 Atropine Sulphate. chlorate. Strychnine Nitrate. 
 
 General Antidotes have been devised for use when the nature of a poison is 
 unknown, with the object of a " shot-gun prescription," intended to hit some- 
 thing. One of the best is JeauneVs, composed as follows, — Liquor Ferri Sul- 
 phatis (sp. gr. 1.45) ^ijss, Magnesia Calcinat. ^ij, Carbo Animalis ^j, Aqua 
 ^xx. These ingredients should be kept separate — the solution of the sulphate 
 in one vessel, the others together. When needed, the former should be added 
 to the latter and violently agitated. Dose, ^jss to ^iij. This is a perfect anti- 
 dote for Arsenic, Zinc, Digitalin, etc. It delays the action of the salts of Cop- 
 per, Morphine and Strychnine, and slightly influences compounds of Mercury. 
 It is valueless for Cyanide of Mercury, Tartar Emetic, Hydrocyanic Acid, 
 Phosphorus, or the caustic Alkalies. Bouchardafs Antidote is described on 
 the previous page, under Iodine. Bellini considers the Iodide of Starch 
 a valuable antidote to alkaline Sulphides, earthy Sulphides, vegetable and 
 caustic Alkalies, and Ammonia. In the first two cases he considers it superior 
 to all other antidotes. 
 
 A fresh mixture of the Sulphides of Iron and Sodium with Magnesia, is said 
 to be a perfect antidote for Copper salts, Corrosive Sublimate and Mercuric 
 Cyanide. If the nature of the poison is entirely unknown, a harmless yet 
 effectual antidote in most cases is one composed of equal parts of Magnesia, 
 Wood Charcoal, and the Hydrated Ferric Oxide, given freely in plenty of 
 water. 
 
 Poisoning by 
 
 Acetanilid. Antagonists, — Belladonna or Atropine, to maintain the blood- 
 pressure; Strychnine, for the respiration; Oxygen inhalations, to overcome 
 cyanosis ; Heat, externally applied. Stimulants and supporting measures. 
 
 Acids. Antidotes, — Alkalies for the least irritant acids, Magnesia, Mag- 
 nesium Oxide, slaked Lime, Chalk ; plaster from wall with water, milk, oil, 
 white of egg, bland mucilaginous drinks and poultices (R). Antagonists, — 
 See under Acids, Mineral, on the next page. 
 
 Acid, Acetic. Antidotes, — Magnesia or Magnesium Carbonate, freely ; Soap 
 and water, Lime-water, Chalk, White-wash ; also milk, oils and thick gruel 
 may be given. Antagonists, — Morphine, gr. % , to ward off shock. 
 
 Acid, Carbolic. ' Antidotes, — Any soluble Sulphate to form a sulpho-car- 
 bolate, as Magnesium or Sodium Sulphate (Epsom or Glauber's salts). In 
 a case where ]/ z oz. of 95 per cent, carbolic acid had been taken, nearly 3 
 ozs. of Magnesium Sulphate were used, resulting in full recovery from an 
 apparently hopeless condition. Alcohol, is a perfect antidote to the corrosive 
 effects of carbolic acid (Phelps). The routine practice in one emergency 
 hospital is to wash out the stomach with alcohol and water, equal parts of 
 each, and then to leave in the stomach about ^viij or ^x of the same mixture. 
 This treatment has proved very efficient in a number of cases. Liquor 
 Calcis Saccharatus, or the official Syrupus Calcis, given freely. Soap, 
 in strong watery mixture (suds), is said to be almost a perfect antidote. 
 Cider Vinegar may prove antidotal, as it removes the effects of the strong 
 
POISONING. 809 
 
 carbolic acid applied locally. Vegetable Demulcents (but no oils or glycerin), 
 to protect the mucous surface. Sodium Carbonate, in strong solution locally, 
 for the effects of its local use in excess ; this also as a wash for the mouth, if 
 necessary. Antagonists. — Atropine is a very complete antagonist to the 
 systemic symptoms, maintaining the heart and respiration until elimination 
 occurs: gr. -^ hypodermically. Amyl Nitrite, by inhalation, Alcoholic 
 stimulants freely. Heat to the extremities, also Faradism and friction thereof. 
 Venesection in desperate cases (Murrell). 
 
 Acid, Carbonic (Carbon Dioxide). See ante, page 92, also under Illumi- 
 nating Gas, below, for the treatment of poisoning by Carbonic Acid and Car- 
 bonic Oxide gases. 
 
 Acid, Hydrocyanic (Prussic). Forty minims of the official diluted acid have 
 proved a fatal dose. Antidotes, — if time to do anything, Cobaltous Nitrate 
 has proved a perfect antidote in over 40 cases (Antal). Ammonia, diluted, by 
 inhalation, or Chlorine Water by spray, for the vapor. Per- and Proto-salts of 
 Iron with Magnesia. Calcium or Sodium Chloride, gr. xxx-xl, in water. 
 Sodium Thiosulphate. Use emetics or the stomach-pump. Antagonists, — 
 Stimulants, as Brandy, Chloric Ether, Ammonia, ad libitum. Alternate hot 
 and cold Douche, from a height. Artificial Respiration, the faradic current 
 (mild) to chest walls and over cardiac region. Atropine has antagonistic 
 action, but is too slowly diffused to be of any value. Ammonia by inhalation, 
 by the stomach, and by intra-venous injection, with cold affusion to the spine, 
 and artificial respiration, are the measures most likely to avail in cases where 
 there is time to do anything. 
 
 Acids, Mineral. Antidotes, — Alkalies, as Sodium Carbonate or Bicar- 
 bonate, Magnesia, or Chalk, Soap, Whiting, Wall-plaster, in water. Albumin, 
 Flour, Milk, Starch, Olive Oil, to protect the mucous membrane. Avoid water 
 in Sulphuric Acid cases. Antagonists, — Opium, Ammonia (intra-venously), 
 Alcohol, as stimulants, to combat the depression of the vital powers. 
 
 Acid, Oxalic, also the Acid Oxalates, as Potassium Oxalate, known as " Salts 
 of Lemon," or of " Sorrel," used for removing ink-stains. Antidotes, — Cal- 
 cium Carbo7iate or Hydrate (as lime-water, chalk, whiting, wall-plaster, in 
 water), or Magnesia. Avoid Potassium and Sodium Carbonates and Bicarbon- 
 ates. Bland mucilaginous drinks and poultices to the abdomen. 
 
 Aconite. Antidotes, — Tannic Acid, or Animal Charcoal, powdered, in 
 water. Emetics or the stomach-pump. Castor Oil, or other purgatives. Bland 
 fluids, and poultices for abdominal irritation. Antagonists, — Atropine, Caffeine, 
 Morphine, Ether, Ammonia, Amyl Nitrite, antagonize its effects on the heart 
 and respiration. Digitalis antagonizes its action on the heart and its relax- 
 ation of cardiac inhibition (Fothergill). In Aconite-poisoning the stomach 
 should be evacuated, warmth applied to the extremities, stimulants adminis- 
 tered, artificial respiration if necessary, and the recumbent posture strictly 
 maintained. Caffeine may be administered hypodermically, and strong Coffee 
 by the mouth. 
 
 Alcohol. Antidotes, — Emetics or the stomach-pump, if much alcohol re- 
 cently swallowed. Antagonists, — Ammonia by inhalation cautiously. Cold 
 affusion to the head. Warmth to the extremities. Faradism of the muscles of 
 respiration. Artificial Respiration. Chloral, gr. xx-xxx every 4 hours to secure 
 sleep. Bromides for the same purpose, or Capsicum in doses of gr. xx-xxx. 
 Ammonium Chloride, about £ss \ n h a if a pint of water at one draught, has a 
 marvelous effect in generally straightening up the victim, antagonizing- stupor 
 and restoring faculties. Hyosclne or Dubolslne, as hvpnotic, gr. !oo ~F7 hypo- 
 dermically. [Compare the titles Alcoholism and Delirium Tremens in Part 
 III, also pages 137, 138, ante.'] 
 
 Alkalies. Antidotes, — Acids, diluted, especially the vegetable acids, as 
 Vinegar, Lemon-juice, etc. Albumin, Milk, Gelatin. Oils to protect the mucous 
 
8lO POISONING, 
 
 surfaces. [Compare Ammonia below.] Antagonists, — Opium for the shock 
 and vital depression, also Caffeine, Alcohol, and other stimulants. 
 
 Alkaloids. Antidotes, — Tannin holds high rank, forming tannates, which 
 are comparatively insoluble. Potassiuin Per7nanganate (see ante, page 376). 
 Albumin. Iodine. Charcoal. Emetics and cathartics afterwards. Antago- 
 nists, — differ for each. [See their several titles in this section.] 
 
 Alum. Antidotes, — Carbonates of Ammonium, Potassium, etc. Other 
 treatment as for corrosive salts. [See Metallic Salts, page 814.] 
 
 Ammonia. Sources of Danger, the use of Smelling Salts or Spirit of Harts- 
 horn in excess, and the strong solution of Ammonia kept by housekeepers 
 for laundry purposes. Antidotes, — Vinegar, Lemon- or Orange-juice, any 
 Vegetable Acid, followed by demulcents to protect the mucous surfaces. When 
 inhaled, give vapor of Acetic or Hydrochloric Acids or Chlorine-water by in- 
 halation, the two latter forming the chloride. Antagonists, — Aconite, Vera- 
 trum, Digitalis, as cardiac sedatives. 
 
 Amyl Nitrite. Antagonists, — Ergotin, Atropine, Strychnine, also Brucine, 
 Digitalis, Picrotoxin, and all other agents which increase the functional activity 
 of the spinal cord and sympathetic, are antagonistic, though not always avail- 
 able by reason of their slower rate of diffusion. Stimulants, artificial respira- 
 tion, the alternate cold and hot douche, with cold to the head, and Ergotin or 
 Atropine hypodermically, are the best measures to be used in cases of poison- 
 ing by the Nitrites. 
 
 Anesthetics (Ether, Chloroform, etc., by inhalation). Antagonists, — Atro- 
 pine, hypodermically, is of great value in combating the cardiac and respira- 
 tory failure of ether (Amidon) ; and is equally efficient in chloroform poison- 
 ing, as I have found by experience (Potter). Strychnine, hypodermically, has 
 done good service in chloroform narcosis and has many advocates. Amyl 
 Nitrite, by inhalation. Oxygen, by inhalation. Venesection, to relieve the 
 engorged right heart, supplemented by Galvanism to stimulate the cardiac 
 action (Spooner). Artificial Respiration, Fresh Air, Coffee. Faradism of the 
 respiratory muscles. Heat applied to the body and limbs. Ice in the rectum, 
 Ammonia, 10 minims of the Liquor in 40 of water, intravenously, — unsuccess- 
 ful (Bartholow). Invert the patient, draw the tongue well forward with forceps, 
 compress and relax the chest, maintain the inverted position until the pulse and 
 respiration are good (Nelaton). 
 
 Antimony (as Tartar Emetic, etc.). Antidotes, — Tannin, or any substance 
 containing it, is the antidote, forming the insoluble tannate. Albumin or Milk. 
 Carbonates of Magnesium and Sodium. Magnesia, in milk, especially for the 
 chloride of antimony. Alkalies and Salts of Lead decompose tartar emetic. 
 Emesis by tickling the fauces. Demulcent drinks freely, to protect the mucous 
 membranes. Water, warm, in large draughts; or lavage of the stomach with 
 water first, then with a solution of Tannin. Antagonists, — Opium, Alcohol, 
 Ether, and other antispasmodics. 
 
 Antipyrin, See ante, under Acetanilid, for the treatment of poisoning by 
 Antipyrin, Phenacetin, Kairin, and similar compounds. 
 
 Arsenic (Arsenous Acid). Two grains have been fatal. Common Sources of 
 Danger: arsenical wall-papers, Arsenic mistaken for "salts" or for "magnesia," 
 adulterated confectionary, also Paris Green (Cupric Aceto-Arsenite) taken with 
 suicidal intent. Antidotes, — -Hydrated Ferric Oxide, freshly prepared by 
 precipitating a solution of Ferric Chloride with Sodium Carbonate or Ammo- 
 nia, — or as the official Ferri Oxidum Hydratum cum Magnesia (see ante, page 
 317), in the proportion of gr. viij for each grain of the poison ingested. Dia- 
 lyzed Iron, is quite efficient as an antidote, is more easily obtained than the 
 hydrated oxide, and has rendered good service in many cases of poisoning 
 from inhaling arsenical fumes. Ferri Subcarbonas is equally good, ^ij followed 
 
POISONING. 8 II 
 
 by Castor Oil (Leale) ; or Hydrated Magnesia, or Magnesia and Sugar (Carl). 
 Magnesium Bicarbonate or other alkalies (R). Charcoal, £ss or more (R). 
 Saccharated Ferric Oxide. Basic Ferric Acetate. Apoinorphine, hypoder- 
 mically, or Zinc Sulphate, as an emetic (avoid Tartar Emetic). Emesis by 
 feather- tickling. Oil and Lime-water mixed, before and after emesis (Tavlor). 
 Milk or other bland fluids to wash stomach. Castor Oil after emesis. Mag- 
 nesia and Linseed tea. Poultices and fomentations over abdomen. Potassium 
 Iodide afterwards to promote elimination. Antagonists, — None. 
 
 Barium Salts. Antidotes, — Sulphates of Magnesium and Sodium (Epsom 
 and Glauber's salts), of Calcium or Potassium. Diluted Sulphuric Acid. 
 
 Bee and Insect Venom. Antidotes, — Aqua Ammonia , Sodium Bicarbonate 
 or Chloride, or Carbolic Acid, applied to the wound ; or TT\,xv of a 2 per cent, 
 solution of the first hypodermically, with Liquor Ammonii Acetatis internally. 
 [Compare the article on Stings in Part III.] 
 
 Belladonna and Atropine. Antidotes, — Tannin, Zinc Sulphate or Apo- 
 morphine, as emetics, or the Stomach-pump. Purgation. Magnesium Bicar- 
 bonate, and other alkalies (R). Charcoal, ^ss or more is necessary (R). An- 
 tagonists, — Morphine is the physiological antagonist to the effects of Atropine 
 on the cerebrum, pupils, heart, respiration, arterial tension and kidneys; 
 Aconite, Physostigmine, Pilocarpine and Quinine are each antagonistic to some 
 of its effects, Muscarine to most of them. Brandy or strong Coffee. Capsicum. 
 Faradism of respiratory muscles. Flagellation. Cold to the head. Ammonia, 
 the vapor inhaled into air-passages (R). 
 
 Bromides. Antidotes, — Nitrous Ether is incompatible with Ammonium 
 Bromide, Acids and Metallic Salts are so with all the bromides. Poisoning 
 thereby is always chronic, never acute, hence no antidotes can be employed. 
 Antagonists, — Morphine is the most efficient, especially for the mental symp- 
 toms. Digitalis, Ergot, Belladonna, and other vaso-motor stimulants, antag- 
 onize many of the effects of the bromides. Cocaifie is useful in chronic depres- 
 sant poisoning thereby, and Alcohol with Opium as a nervous stimulant. 
 
 Bromine. Antidotes, — Albumin, Starch, Gelatin, Sodium and Potassium 
 Carbonates and Bicarbonates. Against the irritant vapor, Ani7nonia vapor by 
 inhalation, or steam inhalations. Antagonists, — Opium and Alcohol as stimu- 
 lants, if much depression ensues. 
 
 Calcium Chloride. Antidotes, — Albumin, Mucilaginous drinks, or Oils, 
 Milk, Flour and water. Avoid acids. Antagonists, — Opium, Alcohol, for 
 vital depression. 
 
 Camphor. Antidotes, — Water to precipitate it from the alcoholic solution. 
 Alkalies and earthy salts precipitate even the small quantity which is soluble 
 in water. Emetics to remove as much as possible. Antagonists, — Aconite 
 and other arterial sedatives. Coffee. Cold. Alcoholic stimulants. Opium 
 and Bromides for the convulsions. 
 
 Cannabis Indica. Antidotes, — Emetics to remove as much as possible. 
 Antagonists, — Alcohol, as stimulant. Strychnine as respiratory stimulant. 
 Faradism of muscles of respiration. Lemon-juice is said to antagonize its 
 effects, which last over 24 hours from a large dose. 
 
 Cantharis. Avoid Oils, also fats and milk, which promote its absorption. 
 Antidotes, — Emetics. Demulcents (as linseed tea, gruel, barley-water), 
 freely. Water in large quantities, to flush the kidneys. Oleaginous injections 
 into the bladder to allay irritation. There is no chemical antidote. Antag- 
 onists, — None, but Opium may be given for the gastro-enteritis. 
 
 Carbonic Oxide. See page 813, under Illuminating-gas, for the treatment of 
 poisoning by Carbonic Oxide and Carbonic Acid gases. 
 
 Chloral Hydrate. Antidotes, — Liquor Potassa?, in hourly doses of £ij well 
 diluted, which amount will decompose 20 grains of chloral each time in the 
 blood (Dougall). Emetics, or the stomach-pump, if patient is seen shortly 
 
8l2 POISONING. 
 
 after ingestion of a toxic dose. Reliance must generally be placed on the 
 antagonism of the following. Antagonists, — Strychnine, but only to a limited 
 extent ; though Chloral is the most perfect antagonist to strychnine, opposing 
 its spinal action (but see page 257). Heat to the body and limbs, by hot 
 blankets, hot water bottles, etc., is the most efficient antagonist. Atropine 
 antagonizes its cardiac, respiratory and spinal depression, and should be used 
 hypodermically, in small doses (gr. -^jj), frequently repeated, until its effects 
 are apparent. Morphine administered with chloral antagonizes its tendency 
 to produce cardiac failure, while synergistic to the hypnotic action of the drug. 
 Cocaine is of value for the cardiac and respiratory depression. Alcoholic 
 stimulation. Amyl Nitrite by inhalation. Frictions. Coffee, black, a pint 
 injected into the rectum, as for narcotic poisoning. Artificial respiration. 
 
 Chlorine. Antidotes, — Albumin for chlorine preparations in the stomach, 
 also Aqua Ammonias in small quantity, well diluted. Ammonia vapor inhaled 
 against chlorine inhalations, forming ammonium chloride. Ammonium 
 Sulphide has similar reaction, but should be used in great moderation. Fresh 
 air. Steam inhalations. Emesis with warm water, then white of egg or milk, 
 flour, or lime-water. Antagonists, — Chloroform by inhalation, to ease the 
 cough. 
 
 Chloroform (swallowed). Recovery has occurred after the ingestion of one, 
 two and even three ounces of chloroform (H. C. Wood). Antidotes, — Sodium 
 Carbonate in plenty of water. Emetics. Treatment as for irritant poisoning. 
 Antagonists, — Atropine or Strychnine, hypodermically. Amyl Nitrite, by 
 inhalation. Coffee, black, a pint into the rectum. Heat to the body and 
 especially to the cardiac region. Rouse by slapping with wet towel. Mustard 
 to calves of legs and over the heart. Relapse may occur, hence the patient 
 should not be left for some time after apparent restoration. 
 
 Cocaine. Antidotes, — See under Alkaloids, above. Antagonists, — 
 Chloral is the most direct antagonist, so also are Chloroform and Ether. 
 Morphine is directly antagonistic at almost all points of action. Amyl Nitrite 
 combats the earliest symptoms of cardiac depression, then Alcohol and Opium 
 as cardiac stimulants. Artificial Respiration may be required. 
 
 Colchicum. Antidotes, — Tannic or Gallic Acid, followed by emetics and 
 cathartics. Demulcent drinks, warm. Antagonists, — Alcoholic stimulants. 
 Morphine, hypodermically for the cardiac depression. Treatment is the same 
 as that for Aconite poisoning. 
 
 Conium. Antidotes, — Tannic or Gallic Acid, followed by emetics and 
 cathartics. Antagonists, — Nux Vomica and its alkaloids, also Picrotoxin and 
 other tetanizers. Alcohol. Muscular Movement. Heat applied externally, as 
 soon as the stomach has been evacuated. 
 
 Copper Salts. Antidotes, — Albumin, Soap, Gluten, Milk, Sugar, Mag- 
 nesia. Potassium Ferrocyanide, is the most efficient chemical antidote, but 
 Magnesia or Albumin may be used. In the absence of eggs, give a thin paste 
 of flour and water. Any antidote should be followed by prompt evacuation of 
 the stomach, and Potassium Iodide to saturation of the system. Antagonists, 
 — Opium and Demulcents for the gastro-enteritis. 
 
 Corrosive Sublimate (Corrosive Mercuric Chloride). Antidotes, — Albumin, 
 Gluten, Magnesia, Milk, Lime-water. Albumin, in some form, is the most 
 efficient ; the white of one egg to each 4 grains of the poison, forms the albu- 
 minate, which must be at once evacuated by emesis or the stomach-pump, it 
 being soluble in an excess of albumin, also in the alkaline contents of the 
 intestines. Potassium Iodide for after-treatment, converts the poison into solu- 
 ble combinations and promotes their elimination. Charcoal, !|ss or more neces- 
 sary (R). Hydrated Protosulphide of Iron, if given within 20 minutes, is said 
 to be an efficient antidote. Antagonists, — See under Mercury, page 814. 
 Fatal Dose, — gr. iij have proved fatal. 
 
POISONING. 813 
 
 Creosote. Antidotes, — Mucilage, Oils, are the most easily obtained. An- 
 tagonists, — Ammonia, for depression. Treatment is the same as for Acid, 
 Carbolic, which see. 
 
 Curare. Antidotes, — Ligate above the wound, if any ; incise the part freely 
 and suck it strongly. Evacuation of the bladder repeatedly, to prevent reab- 
 sorption. Caustic Alkalies destroy the poison. Antagonists, — Artificial 
 Respiration is the most efficient antagonist, maintaining life until elimination 
 occurs. Strychnine, though from a member of the same family of plants, is an- 
 tagonistic as to its action upon the heart and respiration. So also is Atropine. 
 
 Cyanide of Potassium. Antidote, — Ferrous Sulphate to form Prussian Blue 
 (Ferric Ferrocyanide), followed by evacuation of the stomach. Ferrous Sul- 
 phate is a theoretical antidote, but is said to be practically worthless. Cobaltous 
 Nitrate, is a perfect antidote (Antal). Sodium Thiosulphate. Antagonists, — 
 Ammonia, intravenously. Digitalin, Strychnine, Alcohol. Artificial Respira- 
 tion, general friction and galvanism. [Compare Acid, Hydrocyanic, page 809.] 
 
 Digitalis. Antidote, — Tannic Acid, to form the tannate, which, however, 
 is not inert, so that the stomach should be immediately evacuated. Antag- 
 onists, — Aconite for the effects of large doses, Opium for those due to its con- 
 tinued use. Saponin and Senegin are its most complete physiological antag- 
 onists. Alcohol, Galvanism, Horizontal posture. The treatment is similar to 
 that for Aconite. 
 
 Ergot. Antidote, — Tannic Acid, followed by an emetic. Antagonists, — 
 Amyl Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia, antagonize its 
 action on the circulation. 
 
 Fish-poison. Antidotes, — Emetics and Cathartics. Antagonists, — Potas- 
 sium Chlorate freely, Liquor Ammonii Acetatis, Opium, Capsicum, Chloroform. 
 
 Fungi, Poisonous. Antagonist, — Atropine, is practically specific as an 
 antagonist in many cases of fungi poisoning. [Compare Muscarine, page 815.] 
 
 Gamboge. Antidotes, — Potassium or Sodium Carbonates. Magnesia in 
 milk. Emetics. Mucilaginous drinks. Antagonists, — Opium for the depres- 
 sion. Alcoholic stimulants. 
 
 Gases and Vapors. See Ammonia, Acid Hydrocyanic, Chlorine, Illumin- 
 ating-gas, Nitrous Oxide Gas, Sulphur. 
 
 Gelsemium. Antidote, — Tannic Acid, followed by an emetic or the 
 stomach-pump, if recent. Antagonists, — Morphine, is the most complete. 
 Digitalis, Ammonia, Alcohol, Atropine, and to some extent the tincture of 
 Xanthoxylum, are also antagonistic. Heat externally, Faradization of the 
 respiratory muscles, and Artificial Respiration are measures of prime import- 
 ance. Brandy and Capsicum are useful. 
 
 Glass (coarse or powdered). Antidotes, — Bread-crumbs freely to envelop 
 it, then emetics. 
 
 Gold Salts. Antidotes, — Ferrous Sulphate. Albumin, as eggs or flour. 
 Mucilage. Emetics. Treatment as for Corrosive Sublimate. 
 
 Hyoscyamus. See Belladonna, page 811. 
 
 Hypochlorites, as Javelle Water (Potassium Hypochlorite), Labarraque's 
 Solution (Sodium Hypochlorite), and Bleaching Powder (Calcium Hypo- 
 chlorite). Antidote, — Sodium Hyposulphite, in dose of gr. xv, well diluted 
 and frequently repeated, reducing them to chlorides, itself undergoing oxidation 
 to the sulphate. 
 
 Illuminating-gas. Antidotes, — Chlorine -water as spray, inhaled. Antag- 
 onists, — Oxygen by inhalation, 4 or 5 quarts. Ammonia vapor inhaled. Gal- 
 vanism, by interrupted current to extremities. Artificial Respiration, to be 
 
8 14 POISONING. 
 
 maintained steadily for hours. Rhythmic traction of the tongue. Fresh air, 
 in plenty ; open all doors and windows. Coffee, black, a pint as enema. Vene- 
 section may be of service. Douche, alternately cold and warm, to head and 
 chest. Horizontal position, clothing removed. Alcohol moderately by mouth 
 or rectum. Catheter may be required in prolonged cases. Subsequently, a 
 warm bed, heat applied to the body and limbs, open windows, perfect quiet, 
 Condy's fluid about the room, stimulants sparingly, cold acid drinks freely. 
 
 Iodine. Antidotes, — Starch, Albumin, IFlour, Gelatin, Sodium and 
 Potassium Carbonates and Bicarbonates. Starch is the antidote to free Iodine, 
 but the stomach must be evacuated, as the Iodide of Starch is not inactive. 
 In chronic poisoning by the Iodides, a free salivary flow induced by chewing 
 Pyrethrum-root will hasten elimination of the drug. Antagonists, — Quinine, 
 Digitalis, and other restorative agents and vaso-motor tonics. Amyl Nitrite. 
 Morphine, for pain. 
 
 Ipecacuanha. Antidotes, — Vegetable Acids and Astringents are incom- 
 patible with Ipecac, and may be used as antidotes. Antagonists, — Bismuth, 
 Carbolic and Hydrocyanic Acids, also Narcotics, antagonize the emetic action. 
 
 Iron. Antidotes, — Ammonium and Sodium Carbonates, Magnesia, Mucil- 
 aginous drinks. 
 
 Lead Salts. Antidotes, — Sodium or Magnesium Sulphate, Sodium Phos- 
 phate, Diluted Sulphuric Acid, Magnesium Bicarbonate, Ferrous Sulphate, 
 freshly precipitated. Albumin, Milk. Emetics or the stomach-pump. Potas- 
 sium Iodide, gr. xv-xxx, 3 or 4 times daily, in cases of chronic poisoning, as 
 eliminative (R). The cachexia is much relieved by a combination of Quinine 
 Sulphate, Ferrous Sulphate and Diluted Sulphuric Acid (B). Baths of Potassa 
 Suiphurata (^j or more in the necessary water), are also very useful in chronic 
 poisoning by lead (R). Antagonists, — Opium, to allay irritation. Belladonna, 
 the extract, gr. }£, with Pulv. Rhei, gr. ij, in pill twice daily, for the great pain 
 at defecation (Da C). Alum, is the most efficient remedy for the colic ; to a 
 pint of boiling milk add 90 grains of powdered Alum, separate the curd and 
 sweeten with sugar ; give a wineglassful every hour or two (B). Strychnine, 
 for the paralysis, gives good results ; also Atropine, gr. -j-j^, with Potassium 
 Iodide, gr. v. Electricity, a slowly interrupted current until it causes reaction, 
 for the paralysis of extensors (dropped wrist) ; cure to be completed by the 
 faradic current (B). Marked Diagnostic Signs of chronic poisoning by 
 Lead are — the dropped wrist, due to paralysis of extensor muscles and a dark, 
 blue line around the margin of gums. 
 
 Lime. See Alkalies, page 809. 
 
 Lobelia. Antidotes, — Tannic Acid, to form the insoluble tannate. Char- 
 coal, powdered in water, [see under Aconite, page 809]. Antagonists, — Alco- 
 hol, Digitalis, Belladonna, Ergot, the vaso-motor excitants, antagonize its effects 
 on the circulation ; Strychnine, Picrotoxin, and Thebaine, those on the nervous 
 system. 
 
 Mercury. [See Corrosive Sublimate, page 812, also Metallic Salts below.] 
 Antidotes, — Albumin, Gluten, Flour, Milk. Vegetable astringents. Hy- 
 drated Protosulphide of Iron. Charcoal. Alkalies, especially Magnesium Bi- 
 carbonate (R). Potassium Iodide, to saturation of the system, as after-treat- 
 ment; converts the metal into soluble combinations (B). Baths, simple or 
 sulphurous (R). Antagonists, — Bismuth, Tannin, Sodium Sulphite, Diluted 
 Nitric Acid in water, as gargles and mouth-washes for salivation. Belladonna, 
 n\,v-x of tincture every 4 to 6 hours, to lessen secretion in ptyalism (B). Hyos- 
 cya7nine, for the tremor, gr. -gL gradually increased to gr. ^ (Oulmont). 
 
 Metallic Salts. Antidotes, — Albumin, Milk, Magnesia, Starch, Soap. 
 Oils and other demulcents. Sodium or Potassium Carbonate or Bicarbonate. 
 Lavage of stomach. Emetics and cathartics. Antagonists, — Opium, Alcohol, 
 Cocaine and other stimulants, for shock and vital depression. 
 
POISONING. 815 
 
 Mezereum. Antidotes, — Albumin, Milk, Oils and Fats, Mucilaginous 
 drinks. Antagonists, — Opium, as stimulant against shock and depression. 
 Poultices, cool, to abdomen. 
 
 Morphine. See Opium, on the next page. 
 
 Muscarine. Antidotes, — [see Alkaloids, page 810.] Antagonists, — Atro- 
 pine exactly opposes Muscarine, and vice versa. Digitalis is antagonistic to 
 some extent, so also is Physostigmine. There is no example of physiological 
 antagonism so complete in all particulars as that between Atropine and Mus- 
 carine. [See ante, page 119-] 
 
 Mushrooms. Antidotes, — Emetics, if poisoning very recent ; Cathartics, 
 especially Castor Oil, if some time has elapsed. Tannic Acid, has been recom- 
 mended. Antagonists, — Atropine. Alcoholic Stimulants. Poultices, warm, 
 to abdomen. [Compare Muscarine, above.] 
 
 Narcotics. See Alkaloids, page 810, also Opium, Belladonna, Alcohol, Chlo- 
 ral Hydrate, Cannabis Indica, Carbolic Acid, Chloroform, Illuminating-gas, 
 Hydrocyanic Acid, etc. Vegetable Acids antagonize their after-effects to some 
 extent. 
 
 Nitrobenzol. Antidotes, — Ammonia, diluted, by inhalation. Emetics. 
 Antagonists, — Alcohol, Liq. Ammoniae (£ss in water), or Chloric Ether (£j in 
 water), frequently repeated, as stimulants, given internally, by enema or hypo- 
 dermically (brandy). Atropine. Artificial Respiration. Galvanic current, in- 
 terrupted, to chest-walls, and over cardiac region. Fatal Dose, — Death has 
 resulted from merely tasting it. 
 
 Nitroglycerin. See Amyl Nitrite, page 810. 
 
 Nitrous Oxide Gas. Antagonists, — Artificial Respiration, to be commenced 
 at once and kept up for two hours if necessary, not faster than 18 per minute. 
 Fresh air, open all doors and windows, and fan the patient. Oxygen by in- 
 halation, 3 or 4 pints. Douche to chest, alternately hot and cold. The tongue 
 should be pulled well forward, and the mouth cleared of any obstruction to 
 respiration, as artificial teeth. In apparently hopeless cases, two or three 
 violent blows on the chest, delivered in quick succession, may restore the 
 cardiac action (Murrell). 
 
 Nux Vomica and Strychnine. Antidotes, — Tannic Acid, forms the very 
 insoluble tannate. Iodine in dilute solution, or a soluble salt thereof. Animal 
 Charcoal, largely. Potassium Permanganate, has been taken in large dose by 
 Dr. Fahr, of Milford, N. J., after having ingested gr. % of Strychnine, resulting 
 in the entire absence of any symptoms of strychnine poisoning. Lard, is the 
 antidote, as shown by numerous experiments on dogs and other animals (Tur- 
 ner). Eucalyptus, a decoction as a wash for the stomach ; has a true anti- 
 dotal action in frogs (Masmeci). Emetics or the stomach-pump should follow 
 the administration of any antidote. The bladder must be frequently evac- 
 uated to prevent reabsorption. Antagonists, — Quiet, as perfect as possible, 
 is very important. Chloral is the antagonist, gr. xxx as soon as possible, 
 repeated in 20-grain doses at hourly intervals, as long as reflex exaltation 
 continues. Butyl-chloral Hydrate, is a very energetic antagonist (Grigo- 
 rescu). Potassium Bromide, is almost too slow of action to be of much prac- 
 tical service. Chloroform or Ether inhalation, to procure muscular relaxation. 
 Physostigma, is antagonistic (R). Chamomile Oil, remarkably subdues reflex 
 excitability in frogs after poisoning by strychnine or brucine (P). Amyl Nitrite, 
 by inhalation (R). Veratrtim Viride, cured a bad case ; Z] was given at once, 
 then gtt. ij every ten minutes (R). Urethan. Methyl and Ethyl compounds 
 of Strychnine, Brucine, and Thebaine. Monobromated Camphor. Ice to spine. 
 Tobacco, by enema. Valerian mitigates the spasms (P). Curare, gr. % hypo- 
 dermically; is warmly recommended, but its claims are doubtful (P). Apo~ 
 morphine, hypodermically, is very effective in dogs (Wills). Nicotine, many 
 
8l6 POISONING. 
 
 cases prove its curative power (P). Hydrastinine Hydrochlorate, in doses of 
 gr. j hypodermically, has been successfully employed. Artificial Respiration, 
 if possible. Fatal Dose of Strychnine, — gr. \ for an adult, gr. ^ for a child. 
 
 Opium and Morphine. Antidotes, — Tannic Acid, or vegetable astringents, 
 followed by evacuation of the stomach, if the poison has been taken by the 
 mouth. Charcoal, ^ss or more (R). Apomorphine , as emetic, gr. ^ to T ^ hy- 
 podermically ; must be administered before narcosis sets in (B). Stomach- 
 pump better than emetics, which by the mouth are generally useless in these 
 cases. Potassium Permanganate, an efficient antidote if given soon after inges- 
 tion of the poison [see pages 376, 404]. Compound Tincture of Iodine. An- 
 tagonists, — Atropine, hypodermically, gr. T ^ every 15 minutes for three doses 
 (B) ; antagonizes the cerebral action, also that on the respiration, heart, and 
 arterial tension ; but, if given too freely, will endanger the case by deepening 
 the narcosis [see page 404] ; no one is warranted in omitting it (P). Caffeine, 
 is antagonistic, and may be given hypodermically, though generally used in the 
 form of strong coffee, frequently administered by mouth or rectum. Cocaine, 
 is of especial value against the cardiac and respiratory depression. Strychnine, 
 efficiently antagonizes the respiratory paralysis, and may be used in lieu of 
 Atropine, or in conjunction therewith. Amy I Nitrite, by inhalation, or Ammonia 
 by intravenous injection, when the heart shows signs of failure; the former 
 proved eminently successful in a case wherein Atropine proved useless to 
 restore the patient. Capsicum, the tincture, ^ss-j by rectal injection, is said to 
 antagonize the stupor almost instantaneously. Vegetable Acids, as Vinegar and 
 water, Lemon-juice, Cream of Tartar in water, etc., every 10 minutes (R); to 
 antagonize the narcotism. Douche, alternately cold and hot, or hot water and 
 ice alternately to nape of neck, for the narcosis. Artificial Respiration, should 
 be kept up for at least two hours (Murrell). Oxygen, by inhalation, is of great 
 value (Macalister). Venesection, has proved effective after all other measures 
 failed ; is especially beneficial when death is impending from failure of respira- 
 tory action due to distention of the right heart with backward pressure ( Marshall). 
 Potassium Bromide removes some of the cerebral effects of Opium, as the vertigo 
 and mental confusion ; others are antagonized by Quinine, and the general 
 intracranial effects of the drug are to some extent opposed by Digitalis and 
 Tartar Emetic. The Important Measures indicated in Opium or Morphine 
 poisoning are — (1) the removal of the poison, (2) the maintenance of respira- 
 tion, (3) the keeping up of the circulation. The stomach should be evacuated 
 at once, and then washed out repeatedly at short intervals, in order to recover 
 the morphine which is constantly excreted into that viscus. Faradization of 
 the chest muscles, cold affusion and artificial respiration are of great value, and 
 evacuation of the bladder frequently is important, to prevent reabsorption. 
 Flagellation is a very dangerous procedure, from the exhaustion which may be 
 thereby induced, — strong faradic currents are much more efficient. The anode 
 should be placed over the lowest conjoined root of the phrenic nerve, the 
 cathode three inches below the ensiform cartilage and a little to the left of the 
 median line. Common Sources of Danger, — Overdosing with cough mix- 
 tures, or Paregoric, or the Soothing Syrups so much used for quieting children, 
 all of which contain Opium [see page 399]. The American Journal of Pharm- 
 acy estimates the loss of life from the latter cause at 150,000 yearly. Fatal 
 Doses, — see page 403. 
 
 Phenacetin. See page 808 under Acetanilid, for the treatment of poisoning 
 by Phenacetin, Antipyrin and similar compounds. 
 
 Phosphorus. Antidotes, — Potassium Permanganate, is probably the most 
 reliable. Copper Sulphate, as an emetic and a chemical antidote, doses of 3 
 grains in dilute solution every 5 minutes, until emesis occurs ; is recommended 
 by authority, but does more harm than good. Turpentine, old and acid, con- 
 taining oxygen, given rapidly in a gum emulsion, is said by some to be the best 
 antidote ; it is generally unattainable and has proved useless in many cases. 
 Lime-water or Charcoal, to prevent action on the tissues. Hydrated Magnesia, 
 
POISONING. 817 
 
 as a quickly acting purgative ; may be given in Linseed tea. Copper Carbon- 
 ate, with sugar and water. Avoid Oils, Fats and Milk, as they dissolve the 
 poison and promote its absorption. Antagonists, — Opium, to counteract the 
 cardiac and systemic depression. Transfusion, to repair the blood. 
 
 Physostigma. Antidotes, — Emetics or the stomach-pump. Tannic Acid 
 or vegetable astringents. Antagonists, — Atropine, as to the effects on the 
 respiration, heart and pupil ; gr. -£$ to ^ hypodermically, repeated until effects 
 are evident. The one nine-thousandth of a grain of Atropine, injected 5 minutes 
 before giving a minimum fatal dose of Physostigma, prevents its fatal result 
 (R). Chloral, is also antagonistic, and over a greater field of action, but to be 
 effective must be administered very early in the case (R) ; gr. x by mouth or 
 rectum every y 2 hour. Strychnine, gr. -^ of the sulphate or gr. -^ of the nitrate, 
 hypodermically; or the tincture of Nux Vomica, tt^xx by mouth or rectum, in 
 very bad cases (Murrell). Stimulants, freely. Artificial Respiration. Fatal 
 Dose, — gr. 1^ is given as the minimum fatal dose. 
 
 Picrotoxin. Antidotes, — Emetics or the stomach-pump. Acetic Acid gives 
 relief in overdosing, and may have some antidotal power. Antagonists, — 
 Chloral, is antagonistic to its cerebral and spinal action, but synergistic to its 
 depressant power over the heart and respiration. Anesthetics, against its 
 spasm-producing action. Potassium Bromide, in addition to Chloral, if tetanus 
 (Murrell). 
 
 Pilocarpine (Jaborandi). Antidotes, — Persalts of Iron and salts of the 
 metals generally, are chemically incompatible. Antagonists, — Atropine, gr. 
 y^ for gr. \ of the poison, is a complete antagonist, the most so known to 
 physiological experimentation. Conversely, Pilocarpine is exactly antagonistic 
 to Atropine, but Jaborine acts similarly to the latter. Morphine controls the 
 nausea and vomiting. 
 
 Potash. See Alkalies, on page 809. 
 
 Potassium Bichromate. Antidotes, — Sodium and Potassium Carbonates 
 and Bicarbonates. Soap. Antagonists, — Opium or Alcohol, for the nervous 
 and muscular depression. 
 
 Potassium Cyanide. See Cyanide of Potassium. 
 
 Potassium Nitrate (Saltpetre). Antidotes, — No chemical antidote. Emetics 
 or stomach-pump. Demulcent drinks and emollient enemata. Milk. An- 
 tagonists, — Opium, for the subsequent depression. Aromatics. Brandy. 
 
 Pulsatilla. Antidotes, — Tannic Acid, followed by emetics. Antagonists, — 
 Alcohol, Opium, Digitalis. 
 
 Quinine. Antidotes, — Emetics and cathartics, also diuretics and sudorifics 
 to promote elimination. Antagonists, — Alcohol, Opium, Coffee. Morphine 
 antagonizes its cerebral action. Atropine that on the nervous system and heart, 
 also its antipyretic power. 
 
 Rat-pastes, — contain Phosphorus or Arsenic. Ratsbane is Arsenous Acid 
 (Arsenic). Rough-on-Rats contains Arsenic (which see). 
 
 Resorcin. Antidotes, — Albumin. Soda or Saccharated Lime, in plenty of 
 tepid water, as wash for stomach. Emetics or the stomach-pump. Antago- 
 nists, — Stimulants freely. Heat to the extremities. Amy I Nitrite, inhaled. 
 Atropine and other cardiac and respiratory stimulants, cerebral excitants, and 
 agents which raise the arterial tension, are physiologically antagonistic. Fric- 
 tion with warm hand. Galvanism, the interrupted current. Fatal Dose, — 
 3ij nearly proved fatal (Murrell). 
 
 Rhus (Poison Oak or Ivy). Antagonists, — Cocaine, a 5 per cent, aqueous 
 solution, or a 10 per cent, oleate, locally, is by far the most efficient application, 
 promptly relieving the burning and itching. Grindelia Robusta, the fluid ex- 
 tract, 1 to 10 of water, or undiluted, is a very serviceable lotion. Other appli- 
 cations found useful are : — Carbolic Acid, 5 per cent, solution ; Lobelia, as infu- 
 sion, 5J to the pint ; solutions of Corrosive Sublimate, Lead Acetate, Chlorin- 
 52 
 
515 POISONING. 
 
 ated Soda, Lime-water with Linseed Oil, Alum-curd. R. Plumbi Acetatis, 3ij ; 
 Ammonii Chloridi (crude), ^ss; Aquae, ^viij ; as lotion on cloths constantly- 
 wetted therewith, is used with uniform success (Burns). Soap-suds and Hot 
 Water, frequent washing therewith the surest, speediest and best treatment 
 (Couch). Aristol, freely dusted over the part, gives magical relief (Levick). 
 Hydrogen Dioxide, a solution washed over the face and hands, as a preventive 
 (Behringer). Sassafras, an infusion of the bark, taken internally and applied 
 locally, is almost specific for the rash (Hinton). Sodium Sulphite, granular, 
 Z) ; Glycerin, gss ; Camphor-water, q. s.ad ^iv, is preferred as a topical appli- 
 cation (Behringer). Opium or Coffee, to relieve the nervous irritability. Rest, 
 low diet, and laxatives are appropriate measures. 
 
 Sanguinaria. Antidotes, — Tannin, Alkalies, and most of the metallic salts 
 are incompatible. Antagonists, — Opium, Atropine, Amyl Nitrite, etc., to an- 
 tagonize the depression of the circulation and the local irritant action. 
 
 Savine. Antidotes, — Epsom salt. Demulcents. Emetics and purgatives, 
 especially Castor Oil. Antagonists, — Morphine, gr. % hypodermically. Poul- 
 tices of linseed meal to abdomen. 
 
 Serpent-venom. Antidotes, — Potassium Permanganate, hypodermically 
 into the vicinity of the wound, after ligating the part above it (Weir Mitchell). 
 Chloride of Lime (Chlorinated Lime) in solution, I in 60, injected in doses of 
 20 minims, produced recovery (Hodgson) ; after ligature applied above the 
 wound, a solution, 1 in 12, was injected in doses of 30 minims, 25 injections in 
 all in different parts of the body, brought about recovery after severe symptoms 
 from the bite of a tiger snake (Mackenzie). Hypochlorites of Lime or Sodium, 
 Chloride of Lime, and Gold Chloride, are absolute antidotes against serpent- 
 venom (Calmette). Antivenene [seepage 183]. Carbolic Acid, strong, or a 
 Mineral Acid, as caustic, after forcible sucking of wound by a person with 
 perfect mucous surface of lips and mouth, and thorough cleansing. Ammonia, 
 rr^xij of Liq. Ammoniae, diluted with 3 volumes of water, hypodermically into 
 the radial vein, for snake-poison (Halford) ; is shown to be unavailing by 
 Brunton and Fayrer (B). Antagonists, — Strychnine, hypodermically, has 
 proved eminently efficient in numerous cases (Baron von Miiller). Alcohol, 
 as brandy or whiskey freely. Arsenic, for the rapid prostration (B). Potassium 
 Iodide, R. Potassii Iodidi, gr. iv ; Hydrarg. Chlor. Corr., gr. ij ; Bromi, 3 V ', 
 Aquae, 3j ; of which gtt. x in 3ij of Brandy, repeated if necessary (Hammond). 
 Viola Cucullata, the common Violet, is used in Pennsylvania against rattlesnake 
 venom. [See page 525.] Agave Virginica, is known in South Carolina by 
 the name of "rattlesnake's master." 
 
 Silver Salts. Antidotes, — Sodium Chloride (common salt), dissolved in 
 water, largely diluted and freely used ; precipitates the silver as the insoluble 
 and harmless chloride, and acts as an emetic (R) ; vomiting should be induced 
 at once, as silver chloride is soluble in a solution of sodium chloride and in 
 the digestive fluids. Large draughts of salt and water should be taken and 
 vomited, this being repeated until no silver remains. The stomach should 
 then be filled with milk and the bowels moved by castor oil. Alkalies, espe- 
 cially Magnesium Bicarbonate (R). Albumin. Antagonists, — Milk, to allay 
 the resulting irritation ; it may serve as food until the stomach is restored. 
 Opium, against results of irritation. [See Metallic Salts, page 814.] For the 
 treatment of chronic poisoning, and regulation of a course of silver medica- 
 tion, see page 192. 
 
 Soda and Sodium Salts. See Alkalies and Potassium Nitrate, also Metallic 
 Salts. 
 
 Stramonium. See Belladonna. 
 Strychnine. See Nux Vomica. 
 
 Sulphonal. Antidote, — Alkalies, freely administered. Antagonists,— 
 Stimulants. Diuretics. 
 
POLYPUS. 819 
 
 Sulphur and Sulphides. Antidotes, — Chlorine-water. Sodium Chloride 
 (common salt). Potassium Chloride. Ferrous Sulphate. Chlorine Gas or Cal- 
 cium Hypochlorite, for Sulphuretted Hydrogen ; the former should be well 
 diluted with common air. Antagonists. — Artificial Respiration is the best 
 treatment for poisoning by Sulphuretted Hydrogen. 
 
 Tartar Emetic. See Antimony. 
 
 Tin. Antidotes, — Albumin, Ammonium and Sodium Carbonates, Milk. 
 [See also Metallic Salts.] 
 
 Tobacco. Antidotes, — Tannin, followed by emetics, or the stomach-pump. 
 Iodides. Antagonists, — Strychnine is the true physiological antagonist to 
 Nicotine (or Tobacco) and vice versa. Alcohol, Ammonia, Ergot, Digitalis, 
 Belladonna, antagonize its action on the circulation ; Brandy is efficient, also 
 strong Coffee. Warmth applied to the surface, also friction. Artificial Respi- 
 ration. Recumbent position should be strictly maintained. 
 
 Turpentine. Antidotes, — Magnesium Sulphate (Epsom salt), 3J in water. 
 E?netics or the stomach-pump. Demulcent drinks, as milk, barley-water, etc. 
 Antagonists, — Opium or Morphine, if much pain, and for shock. 
 
 Tyrotoxicon (in milk, cheese, ice-cream, etc.). Antidotes, — Emetics, if 
 vomiting is not free ; also the stomach-pump or siphon to rinse out the stomach 
 with water. Thymol, Salol, Naphtalin, or other antiseptics. Antagonists, — 
 Opium, or other sedatives, to allay irritation. Stimulants, when prostration. 
 
 Veratrum and Veratrine. Antidotes, — Emetics or the stomach-pump. An- 
 tagonists, — Alcohol, Opium, Ammonia, Digitalis, and Belladonna counteract 
 the cardiac depression. Morphine with Atropine hypodermically, or Lauda- 
 num internally, with alcoholic stimulants. Heat, dry, applied to the body. 
 Recumbent posture strictly maintained. Coffee, strong, as enema. [See also 
 Aconite.] 
 
 Wounds, Poisoned. Antidotes, — Ammonium Carbonate, gr. v hypodermi- 
 cally in the vicinity of wounds caused by poisoned arrows, was repeatedly used 
 with entire success by Parke, the surgeon to Stanley's last African expedition. 
 [See page 147 ; also Serpent-venom on page 818, and the article on Wounds, in 
 Part in.] 
 
 Zinc Salts. Antidotes, — Sodium or Potassium Carbonate dissolved in warm 
 water, largely diluted, used freely. Albumin, as eggs and milk, with tepid 
 water, freely. Tannic Acid, or vegetable astringents, or strong tea. Lime- 
 water. Soap-suds freely. Mucilaginous drinks. Antagonists, — Opium, or 
 Morphine hypodermically. Linseed-meal as poultices to abdomen. Enemata 
 of gruel or starch-and-water, if much abdominal pain. 
 
 Polypus. 
 
 Sanguinaria, has been employed as snuff for nasal polypi (P) ; with doubtful 
 benefit (W). Tannin, finely powdered, as snuff blown daily into nostrils 
 through a quill, is especially adapted to the soft and gelatinous varieties ; while 
 it has apparently no effect on the healthy mucous membrane it causes the 
 complete withering of the polypus (Wa). Zinc Chloride, has been injected 
 interstitially with success in a case of naso-pharyngeal polypus (Barthelemy). 
 Iron, a solution of the Chloride is advised as an interstitial application (Auger). 
 Acetic Acid, glacial, injection into the body of the tumor, will cause it to shrink 
 up and to drop off in a few days. Alum, in powder, applied to point of origin 
 to prevent recurrence (D). Surgical, — a nasal polypus should be seized with 
 polypus forceps and twisted off at the neck; it may be removed through the 
 mouth or the nostril ; in a few cases the nostril must be dilated with a specu- 
 lum, or the ala slit to give access to the root of the tumor (D). 
 
820 POULTICES PREGNANCY. 
 
 Poultices. 
 
 Poultices and Fomentations are simply local baths utilizing warmth and 
 moisture, relaxing the tissues and relieving pain. If applied early they will 
 check inflammation, or assist the evacuation of pus when suppuration has set 
 in. Poultices should be applied thick (thin in peritonitis), as hot as possible, 
 covered with cotton-wool, and frequently changed ; large at onset, very small 
 after maturation. Belladonna and Glycerin, equal parts, smeared over tissues 
 under a poultice, aid the latter greatly, also Tinctura Opii, especially when the 
 skin is broken. Linseed-meal or Oatmeal, Starch, Bread, Bran, are best in the 
 order mentioned ; add the meal to boiling water, stir and spread quickly on 
 warm linen. Charcoal under the poultice, when foul sores are being treated. 
 
 An excellent method of preparing poultices is to make several bags of 
 various sizes, of either of the fabrics known as Swiss and Cheese-cloth, filling 
 each bag half full with the linseed meal or other agent used, then sewing up 
 the open end. When wanted for use one of these bags is submerged in boiling 
 water for a few minutes, and on taking it out the meal is found to have swelled 
 so as to fill the bag, which should then be squeezed to rid it of the superfluous 
 water, laid on the part and covered with oiled silk and a bandage. If too hot 
 it will scald the skin. (Potter.) The ordinary filthy poultice of flaxseed, slip- 
 pery elm, bread and milk, has no place among the resources of the aseptic 
 surgeon. The common poultice is a hot-bed for bacteria, and as such, it should 
 be discarded. In the treatment of an ordinary furuncle with poultices, almost 
 every surgeon must have seen occasionally the development of innumerable 
 minute daughter-furuncles in the surface covered by the poultice. In phleg- 
 monous inflammation of the fingers or hand, the prolonged use of the poultice 
 is followed by maceration of the skin, extensive edema of the superficial struc- 
 tures, a flabby condition of the granulation — in fact all the evidences which 
 point to the poultice as a means of favoring the extension of the infectious pro- 
 cess (Senn). 
 
 Fomentations, — Flannel may be wrung very dry out of boiling water, applied 
 and covered with oiled silk. Spongio-piline, a fabric composed of sponge and 
 wool, coated with india-rubber, is an excellent vehicle for the application of 
 warmth and moisture. The inner surface is moistened with hot water; and its 
 utility may be increased by sprinkling the moistened surface with charcoal or 
 yeast, or by saturating it with any desired lotion or liniment. 
 
 Pregnancy, Disorders of. 
 
 Mercury, a few grains of blue pill to correct clay-colored stools (L). Iodine, 
 the tincture internally for cardialgia (Wa). Aloes, has cured piles in preg- 
 nancy, by removing constipation ; cautiously ! (P). Alum, Tannin or Catechu, 
 in medicated pessaries for vaginal leucorrhea (L). Castor Oil, an excellent 
 laxative (P) ; to clear out the bowels in diarrhea (L). Cocculus Indicus, when 
 intestines much distended with flatus, and frequent desire to urinate from 
 flatulent pressure on bladder (P). Bismuth, Calumba and Antispasmodics, 
 with minute doses of Opium, for gastrodynia and pyrosis (L). Potassium Bro- 
 mide, with Chloroform, as an antispasmodic in dyspnea (L). Sumbul, is invalu- 
 able in the restlessness ; rr\,xxx-xl of the tincture with a little Chloric Ether, 
 giving quiet nights for a long time (P). Galla, Unguentum Gallae cum Opio, 
 the best local application to hemorrhoids, also fomentations with sponges 
 wrung out in very hot water, to relieve pain (L). Digitalis, in infusion, very 
 beneficial in the albuminuria (L). Potassium Acetate, with Basham's mixture 
 (Liq. Ferri et Ammonii Acetatis), when albuminuria with anemia. Calcium 
 Phosphate, believed to exert an influence on the fetus if administered during 
 pregnancy, so that mothers who have borne only rachitic or scrofulous children 
 will bear healthy ones (Wa). Berberine, found very useful in the periodical 
 
PROLAPSUS ANI PROSTATITIS. 821 
 
 neuralgias of pregnancy, even in cases in which Quinine had previously failed 
 (Maclagan). Camphor Liniment, for lumbar pains (Wa). Senna, the confec- 
 tion proves a mild and efficient purgative in the constipation of pregnancy 
 (Wa). Milk-diet, the best remedy for albuminuria of pregnancy, if strictly 
 carried out (Parvin). Injections, must be used carefully, even tepid water often 
 induces uterine contractions (L). [Compare Albuminuria, Nephritis, Ner- 
 vousness, Ptyalism, Vomiting of Pregnancy.] 
 
 Prolapsus Ani. 
 
 Nux Vomica, or Strychnine, especially when in children, with constipation ; 
 in the latter event add Nux Vomica to a purgative, as tincture of Rhubarb 
 (R, P) ; Strychnine hypodermically, gr. -^ for an adult every 48 hours, }£ inch 
 from anus and parallel to rectum, into the cellular tissue; generally requires 
 4 to 8 injections (Weber). Piper, the Confectio Piperis in doses of gr. lx to 
 cxx, persevered in for 3 or 4 months, in chronic, weak subjects (Wa). Sulphur, 
 has a beneficial effect in addition to its laxative value (R). Alum, in solution, 
 gr. vj to the ^ (R). Ice, locally, when parts inflamed (R). Ergot, the fluid 
 extract injected into the perineum, is followed by immediate relief (Vidal). 
 Ferrous Sulphate, 3j to ^viij aquas, of which one-third by enema twice daily. 
 Podophyllin, in small doses for rectal prolapse in children (P). Tannin, by 
 injection to restrain the prolapsus (R). Hydrastis, by enema, or as a lotion (P). 
 
 Prolapsus Uteri. 
 
 Cimicifuga, to prevent miscarriage in prolapsus uteri (R) ; has a remarkable 
 effect upon the uterus (P). Astringents, as Decoctum Quercus, Decoctum 
 Galias (Wa) ; or Pomegranate bark (P). Tannin, as Catechu, Kino, Rhatany. 
 Alum, a solution, gr. vj to the ^ (R) : lb. j ad C j aquas, as hip-bath ; should also 
 be passed well up vagina (Wa). Ice, locally when parts inflamed (R) ; ap- 
 plied to the spine (Wa). Pessaries, in any form, are of but temporary benefit, 
 and in the end positively detrimental (E) ; but many cases cannot be treated 
 without mechanical support of some kind. 
 
 Prostate, Hypertrophied. 
 
 Alkalies, for the cystic irritation with acid urine ; great benefit from Liquor 
 Potassas, or the Citrate and Acetate of Potassium (B). Triticum Repens, bene- 
 fit follows its use in the prostatic enlargement of old men (Sir H. Thompson). 
 Ammonium Benzoate, for the cystitis, urine alkaline (B). Ammonium Chloride, 
 is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa). Iodine Injections, 
 through rectal walls (B) ; a weak ointment applied by rectum (Wa). Iodine, 
 has been tried in all forms, but is of no value (Thompson). Iodoform, as sup- 
 pository in the rectum, has proven of great value (B). Colchicum, in persons 
 of a gouty diathesis (Wa). Medicine is not likely to have any control over this 
 condition, which is a simple hypertrophy ; castration was suggested by J. Wm. 
 White, and has been performed with successful results in three cases by 
 Haynes, also by other operators. [Compare Cystitis.] 
 
 Prostatitis. 
 
 Cantharides, a drop of the tincture, 5 may be required, 3 or 4 times a day 
 (R). Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino- 
 Genitals, especially Turpentine, Cubeb, Juniper, Cantharis (B) ; Cubeb, in doses 
 of gr. xx daily, is found of much benefit (Wa) ; Buchu relieves (P). Silver 
 Nitrate, a solution, gr. v-x to the %, applied to the prostatic urethra in chronic 
 
822 PROSTATORRHEA — PRURIGO PRURITUS. 
 
 prostatitis, may be useful (Wa). Blisters, in chronic prostatitis, a small blister 
 on each side of the raphe of the perineum, kept open 4 to 6 weeks, has given 
 the best results (Wa). Tonic medicines and regimen should be prescribed 
 (Wa). Hot Injections, to relieve pain (R). [Compare Prostatorrhea.] 
 
 Prostatorrhea. 
 
 Iron, the Tincture of the Chloride, when there is much debility (B) ; chaly- 
 beate tonics with Quinine and Strychnine (Gross). Atropine, indicated in all 
 cases, with Potassium Bromide (Gross). Potassium Bromide, when irritability 
 and excitement (B) ; indicated in all cases (Gross). Lead, injections of Gou- 
 lard's Extract, 3>j to ^x of water, night and morning, for 10 minutes at a time 
 (Gross). Ergot, when relaxation exists (B). Bougie, methodically intro- 
 duced, is one of the best local measures (Gross). Hydrastis, locally applied, 
 a useful medicine (B). [Compare Prostatitis.] 
 
 Prurigo. 
 
 Antipyrin, as a symptomatic remedy, is efficient in true prurigo. Alkaline 
 Baths, followed by a carbolized ointment, and Carbolic Acid internally, are of 
 value in the papular eruption known as prurigo (Bulkley). Sulphides, Potassa 
 Sulphurata, with Tar and Benzoinated Lard, as ointment in genuine prurigo 
 (R). Arsenic, in doses of Tr^v of Liquor Arsenicalis thrice daily and gradually 
 increased, has exercised a more or less powerful influence (Wa) ; has only a 
 moderate effect (Bulkley). Belladonna, controls cases which have resisted 
 ordinary treatment (B). Carbolic Acid, locally and internally, is especially 
 serviceable in prurigo senilis (B). Mercury, the Bichloride gr. xx with Ammo- 
 nium Chloride gr. xxx, in Oj of pure water, as lotion in prurigo contagiosa, the 
 so-called army-itch ; nothing equal to it (White). Borax, a saturated solution 
 in rose-water locally (R) ; gr. v-xto^j of hot water for pruriginous eruptions on 
 mucous membrane of vulva and vagina (R). Galvanism, when prurigo is 
 referable to alterations in the cutaneous nerves (B). Tonics, are required, 
 nerve-tonics as well as general ones, Cod-liver Oil, Quinine, Strychnine and 
 Phosphorus (E. Wilson). Quinine, in large doses, gr. v-x, will control violent 
 exacerbations (Wilson). Baths, the Turkish, frequently repeated, with inunc- 
 tion of the skin, may be regarded as curative in most cases (Wilson). [Com- 
 pare Pruritus.] 
 
 Pruritus. 
 
 Cocaine, in 5 per cent, solution or oleate, is by far the most efficient of all 
 antipruritics; relieves the itching of scrotal eczema, pruritus ani et pudendi, 
 and especially in lesions of the epidermis where the oleate or solution can 
 penetrate at once to the true skin. Resorcin, in solution locally, gives marked 
 relief, lasting for several hours, in the majority of cases. Carbolic Acid, is the 
 opium of the skin (Unna), and the most useful antipruritic agent; in combina- 
 tion with glycerin, as lotion to the itching surface, gives great relief (Bulkley) ; 
 internally and locally in pruritus senilis (B) ; a one per cent, solution as lotion 
 in pruritus ani (R). Chloral, with Carbolic Acid, locally [see page 258J. 
 Camphor and Chloral, rubbed together, make a liquid which, added to vaselin, 
 gives an ointment which is powerfully antipruritic (Bulkley) ; added to dusting 
 powders, allays heat and itching of eczema and intertrigo (R). Tumenol, as 
 tincture, is used locally with almost universal success (Neisser). Menthol, seems 
 to be of marked value in almost all cases of pruritus, from whatever cause 
 (Squibb). Antipyrin, internally as a symptomatic remedy against itching, is 
 promptly efficient in nervous pruritus, true prurigo, urticaria, erythema, pern- 
 
PRURITUS. 
 
 823 
 
 phigus vulgaris and lichen ruber. Alkaline Baths, locally, followed by the 
 application of carbolized ointment, give great comfort in all forms of pruritus 
 (Bulkley); Sodium or Potassium Carbonate preferred (Tr) ; in solution locally, 
 3iij ad £iv (B). Brucine, in 20 per cent, solution, has been employed with 
 satisfaction in chronic pruritus, as a local application (Mays). Mercury, strong 
 solutions of the Bichloride, Black or Yellow Wash or Mercurial Ointment, in 
 the itching of skin affections (R) ; Yellow Wash is one of the most efficient 
 applications for pruritus ani : solutions of the Bichloride are very useful 
 applications in pruritus vulvae et ani (Tr) ; for pruritus vulvas a lotion of the 
 Bichloride 1 to 2500 parts of water, with Alum and Starch, is recommended 
 (B) : Calomel Z) to ^j of Lard, as ointment, is the best application, except in 
 the pruritus of urticaria ; very useful in pruritus ani, less so in pruritus pudendi 
 (R): the Oleate, a 5 per cent, solution in Oleic Acid with one-eighth part of 
 Ether, applied by a camel's-hair brush, in pruritus ani et pudendi (Marshall). 
 Alum, a strong solution is very useful for pruritus vulvae (Tr). Hydrocyanic 
 Acid, diluted as lotion, often very serviceable; may be prescribed in solution 
 with Borax (B) ; or Laurel-water as lotion, especially in pruritus senilis (P). 
 Potassium Cyanide, Z) to Oj of water, as lotion, for pruritus of various kinds 
 when the skin is unbroken (R) ; as ointment or solution, if strong enough, 
 relieves greatly, but must be used with caution (B); or Tr^xxx of the dilute Hey 
 Acid of the Br. Ph. in ^j of water or glycerin, may be used instead (R). Silver 
 Nitrate, a solution, gr. xx to the ^, painted over the affected parts in pruritus 
 vulvae, is very effective (B). Tobacco, is an effective but dangerous applica- 
 tion (B). Iodoform, as ointment, 3j ad ^j Adipis (R). Iodine, for itching of 
 the nose or inner canthus, sneezing, etc., its inhalation has a marked effect (R). 
 Arsenic, for itching of the nose accompanying asthmatic symptoms (R). 
 Benzoin, the compound tincture painted on the skin, for the itching of 
 eczema, urticaria, etc. (R). Boracic Acid makes an excellent lotion in pruritus 
 pudendi, a teasp. to the pint of hot water (R). Borax, gr. v-x to the % of hot 
 water (R). [See Prurigo.] Balsam of Peru, is a very good application in 
 pruritus ani, scabies, and many other forms of itching (Auerbach). Zinc 
 Sulphate and Alum, equal parts of each, are almost a specific in pruritus ani 
 (Agnew). Chloroform, as ointment to allay itching of skin diseases. Gelsemium, 
 ttlxv of the tincture every half hour, up to 3} m all, for itching which is out of 
 proportion to the cutaneous lesion (Pelcher). Lead Lotions, to ease the itching 
 of urticaria, pruritus .pudendi, etc., especially when the mucous membrane is 
 red and excoriated (R). Piperazin, gives immediate relief in the pruritus of 
 the uric acid diathesis. Salicylic Acid, as ointment, in pruritus ani et vulvae 
 (R). Sodium Salicylate, in 15-grain doses by mouth every four hours, will 
 greatly relieve pruritus vulvae, when due to diabetes (G). Tar, as ointment, is 
 strongly recommended (Tr); for general pruritus, if no cause can be found, the 
 two best remedies are Tar and Sulphur, as lotion or bath (Sparks) ; ointments 
 containing Tar give relief in many instances (Bulkley). Sulphur, may be em- 
 ployed as a bath, Potassa Sulphurata, ^ij ad C xv of hot water (Sparks) ; or the 
 alkaline sulphites locally (Wa) ; the Iodide of Sulphur externally and inter- 
 nally, in pruritus senilis (Wa). Chlorine, the Liquor Sodae Chloratae, diluted, a 
 useful application in pruritus ani (Wa). [Compare Eczema, Erythema, 
 Lice, Pediculi, Prurigo, Scabies, Urticaria.] 
 
 R . Hydrarg. Chlor. Corr. , 
 Pulv. Aluminis, . . 
 
 Amyli, 
 
 Aquae, 
 
 M. Sig. — Apply locally. 
 
 gr.J- 
 
 gr. xx. 
 3Jss. 
 
 3 V J- 
 (Goodell.) 
 
 R. Acidi Hydrocyan. Dil., gij. 
 
 Sodii Boratis, . . . . gj. 
 
 Aquae Rosae, J vn j- 
 
 M. Sig. — Lotion. [Fox.) 
 
 Acidi Hydrocyanici Dil., ^ss-j. 
 Infusi Althaeae, .... ^ v-viij. 
 M. Sig. — Lotion. [Fox.) \ 
 
 Potassii Cyanidi, 
 Pulv. Cocci, . . 
 Ung. Aquae Rosae, 
 M. Sig. — Ointment. 
 
 gr. V J- 
 gr. j. 
 
 {Anderson.} 
 
824 
 
 PSORIASIS PTERYGIUM — PTOSIS. 
 
 . Potassii Cyanidi, . 
 Aquae Laurocerasi, 
 M. Sig. — Lotion. 
 
 gr. xv. 
 
 E viij. 
 (Anderson.) 
 
 R . Acidi Benzoici, . . . . gr. ex. 
 Olei Caryophylli, . . . gtt. xl. 
 
 Alcoholis, 3'j ss - 
 
 Solve et adde — 
 
 Cerati Simplicis, . . . ^ viij. 
 Balsami Peruviani, . . ,^j. 
 M. ft. unguentum. Especially good for 
 scabies, but may be used for any pruritus. 
 
 JJ . Gummi Camphorae, 
 
 Chloral is Hydratis, . . aagj-ij. 
 Rub together until liquefied, 
 then add slowly, with friction, — 
 Unguenti Aquae Rosse, . . gj. 
 Sig. — Ointment for itching. 
 
 (Bulkley.) 
 
 R. 
 
 Acidi Carbolici, .... 3 
 
 Glycerini, | 
 
 Aquae Rosae, . . q. s. ad | 
 M. Sig. — Lotion for pruritus. 
 
 Psoriasis. 
 
 Chrysarobin, has the most decided effect on psoriasis, 3ss-ij ad gj of ung. 
 aquae rosae ; often irritates, and should be employed at first with caution 
 (Bulkley) ; gr. x-xxx to the ^ of Petrolatum, applied to each spot twice daily, 
 invariably successful (Hughes). Thyroid Extract, several cases of psoriasis 
 treated with this remedy alone recovered completely in the course of a few 
 weeks (Bramwell). [See page 158.] Aurum, is useful in the squamous skin 
 diseases. Ichthyol, is a very efficient application. Thiol, is probably a better 
 remedy than Ichthyol ; the dry form, used as a dusting powder, is remarkably 
 efficient (Squibb). Aristol, is an excellent application. Arsenic, at first appar- 
 ently aggravates, but soon cures the disease (R); must be persistently used 
 for a long time (B) ; exercises a powerful influence (Wa) ; maximum dose of 
 Liquor Arsenicalis n\v ter die, never on empty stomach (R). Mercury, in patches 
 of obstinate psoriasis, especially of hands, even when not syphilitic; Calomel 
 and Mercuric Nitrate ointment may be mixed and Tar ointment added (R). 
 Lappa Major, a tincture of the seeds in whiskey, used by tablespoonful doses, 
 cured several cases of long standing (Reiter). Carbolic Acid, 1 to 4 of lard, as 
 ointment (Wa). Mezereon, a useful adjunct (Wa). Sulphur, internally (R) ; 
 a solution of Potassa Sulphurata in water, is excellent in chronic psoriasis (B) ; 
 not in acute (R). Sulphur Iodide, externally and internally, in doses of gr. j-vj 
 used with great advantage (Wa). Silver Nitrate, occasionally in psoriasis 
 of tongue and buccal mucous membrane ; if syphilitic, mercurials best (R). 
 Nitric and Nitro- Hydrochloric Acids, when symptomatic of imperfect digestion 
 and assimilation (B). Phosphorus, as substitute for Arsenic (B). Coptis, has 
 reputation in New England (B). Copper Sulphate, applied solid to spots (R). 
 Lead, the ointment of the Iodide (B). Tar, painted on, in obstinate cases (R). 
 Oils, Cod-liver Oil internally and locally, is the sheet-anchor, especially when 
 of strumous origin (B) ; oils and fats to lubricate skin, also warm baths (R). 
 Diet and Hygiene, nourishing diet, frequent small quantities of raw vegetables, 
 Cod-liver Oil for growing persons, especially when stale fish the cause. Rest 
 and change for overworked subjects. Open-air exercise is most useful. Warm 
 or tepid soft-water baths at night, with use of pure soap ; daily baths or cold 
 sponge-baths. 
 
 Pterygium. 
 
 Silver Nitrate, locally, especially when pterygium with catarrhal conjunc- 
 tivitis (Wa). Treatment is unavailing, and benefit is seldom derived from any 
 operation (C). Arlt's Operation, the most satisfactory ; cut away as little tissue 
 as possible, dissect cleanly, close with suture (Green). 
 
 Ptosis. 
 
 Veratrine, gr. x in Z'\) of Sulphuric Ether and ^j of Alcohol, brushed over 
 the eyelids, brows and temples every morning, till a slight burning sensation 
 
PTYALISM PUERPERAL CONVULSIONS. 
 
 825 
 
 is produced; conjointly with the use of electricity (W). Ergot, aqueous infu- 
 sion as collyrium (Wa). Electricity, the constant current may often relieve 
 recent cases (C). Operation for shortening the lid, by removing an elliptical 
 piece of skin and subjacent muscle (C) ; is not advisable unless the ptosis is 
 nearly or quite complete, and of great inconvenience. 
 
 Ptyalism. 
 
 Acids, as astringents, small medicinal doses (R). Sulphuric Acid, internally 
 and with Decoctum Cinchonae as a gargle, of great benefit in mercurial ptyal- 
 ism (Wa). Potassium Chlorate, in simple or mercurial ptyalism (R) ; in the 
 latter form 3j ad ^vj aquae as mouth-wash, and internally in teasp. doses, 4 or 
 5 times daily (St). Belladonna, very effective in mercurial ptyalism, and that of 
 pregnancy ; gtt. v-x, or Atropine, gr. ^^j to ^^ every 4 to 6 hours (B) ; is good 
 treatment when ptyalism is the result of some reflex action, but not so when it 
 is an effort of nature to eliminate some drug-poison, as mercury, iodine, etc., from 
 the system (Whitla). Pellitory, to stimulate the salivary flow in the latter case, 
 unless the gums are swollen and ulcerated (Id). Hyoscine or Opium, may 
 be used instead of Atropine (Id). Astringents, in ptyalism from excessive 
 mercurialism when the gums are swollen and ulcerated ; Alum 1 in 40, Zinc 
 Chloride 2 grains to the ^, Tannic Acid 1 in 40, or other vegetable astringents 
 (Id). Tannic Acid, in mercurial ptyalism is an excellent gargle, 3j of Tannin 
 to Jij of Mel Rosas, and ^vj of water (B). Alcohol, diluted, as a gargle (R). 
 Potassium Iodide, is sometimes beneficial in mercurial ptyalism, but often 
 aggravates it (R). Iodine, the tincture £ij in ^viij of water, as a gargle (R) ; 
 is worthy of trial (Wa). Borax, the glycerite is an efficient local application, 
 but must be used almost continuously (Whitla). Potassium Bromide, has 
 proved useful in the salivation of pregnancy ; it may be combined with small 
 doses of Belladonna or Hyoscyamus (Id). Chlorinated Lime or Soda, in weak 
 solution, for the fetor (Id). Stimulants, may be needed in severe cases. Diet, 
 liquid food when swallowing is difficult. [Compare the Lists of Sialogogues and 
 Antisialics on page 62.] 
 
 R. Acidi Sulphurici, . . . gss. 
 
 Tinct. Myrrhse, . . . . 7,'y 
 
 Aquae, . . . . q. s. ad ^vj. 
 M. Sisr. — Mouth-wash. 
 
 R . Sodii Boratis, gij. 
 
 Pulv. Myrrhae, . . . . 7,]. 
 
 Aquae, sj vj . 
 
 M. Sig. — Mouth-wash or gargle. 
 
 Puerperal Convulsions. 
 
 Chloroform, by inhalation to narcosis (R) ; its utility unquestionable when 
 convulsions are not due to cerebral hemorrhage (B) ; the combined chloroform 
 and chloral treatment results in a death-rate of only 7.6 per cent. (Winckel). 
 Chloral, after the chloroform, given with Bromides by the rectum to keep up the 
 effect ; full doses, 20 to 30 grains every 2 hours (B) ; a remedy of the greatest 
 value, in full dose before proceeding to one of the bromides (Playfair, Barnes). 
 Bromides, in large doses by enema, are distinctly indicated (P) ; Potassium 
 Bromide, 3j-ij by the rectum, after venesection if convulsions return (Whitla). 
 Veratrum Viride, in gss doses of fluid extract every 15 minutes, to nausea, 
 invaluable (R) ; the fl. ext., in doses of tt\,viij-x hypodermically, may be re- 
 peated in half-hour with Morphine, or rr^x by enema, promptly efficient in the 
 worst cases (Elmer) ; a very bad case cured by 20-minim doses every hour for 
 5 days (Dunn) ; the worst case seen in my 30 years' experience, after 14 seiz- 
 ures was promptly cured by a hypodermic injection of rr\,iv of Norwood's 
 tincture in a little water (Etheridge). Pilocarpine Nitrate, gr. ^ hypodermically 
 every 2 hours, very successfully used in several cases (Finniss) ; is dangerous, 
 being liable to cause edema of the lungs (P). Aconite, one of the best agents 
 (P); gtt. j-ij of tinct. every 10 or 15 minutes for the first hour, then at longer 
 
826 PUERPERAL DISORDERS FEVER. 
 
 intervals (B). Belladonna, the tinct. internally with Atropine hypodermically, 
 of verified utility (P). Potassium Bitartrate, administered for a month prior to 
 confinement, in quantity sufficient to bring about free action of kidneys and 
 bowels, will certainly prevent puerperal convulsions (Anderson). Opium is 
 apt to induce eclampsia, unless its use be preceded by free purgation or vene- 
 section (Id) ; as Morphine hypodermically, the most important agent for 
 cure of uremic convulsions (B) ; with the lancet, sometimes required (P) ; 
 Morphine is combined with the chloral treatment by many authorities. Amyl 
 Nitrite, by inhalation (B) ; may cause alarming hemorrhage (W). Ice, to 
 the head (R); and mustard poultices at same time to the feet (Wa). Vene- 
 section, by far the most efficient measure (Wallace); when great cerebral 
 congestion and vascular tension, shown by a livid face, a full and bounding 
 pulse, and strong pulsation in the carotids (Play fair) : remove 15-20 ounces of 
 blood, and follow by enemata of Potassium Bromide, 3j-ij ( if convulsions re- 
 turn ; Chloroform should be very cautiously used, if at all, after blood-letting 
 (Whitla). Compression of the Carotids, Trousseau's method, often stops or 
 materially modifies the attack, and may be used in most cases to gain time 
 until chloroform narcosis is established (Id). Saline Purgatives, the best 
 being Magnesium Sulphate, or the compound Jalap powder, with free use of 
 the wet pack to act upon the skin, for the rapid elimination of the retained 
 excrementitious products, urea, leucin, tyrosin, etc. (Id). 
 
 Puerperal Disorders. 
 
 Cimicifuga, in puerperal hypochondriasis, and depression (Wa, P). Opium, 
 either alone or with alteratives, highly serviceable in puerperal intestinal irrita- 
 tion; a few drops of the tincture effectually arrests the diarrhea (Wa) ; when 
 shock and marked exhaustion, a moderate dose is of benefit (L). Castor Oil, 
 undoubtedly the best laxative (L) ; purgatives generally are not required, 
 castor oil the very worst (Fordyce Barker) ; action uncertain (Parry). Rhu- 
 barb, or enemata, best means of stimulating bowels after fourth day (L) ; gr. 
 xx-xxx in some aromatic water a good aperient (Wa). Aliment, in puerperal 
 state should be easy of digestion and sustaining (L). Catheter, necessary often 
 for several days when bladder paralyzed, if warm water lavements fail (L). 
 Water, tepid sponging of external parts, vaginal washings daily with warm 
 water, with t £q part Carbolic Acid (L). [See After-pains, Hemorrhage, 
 Labor, Lactation, Mastitis, Nipples, Phlegmasia Alba Dolens, etc.] 
 
 Puerperal Fever. 
 
 Aconite, drop doses every one or two hours steadily, with an occasional dose 
 of Castor Oil, and repeated hot poultices or Laudanum fomentations, the most 
 successful treatment, even in the worst cases, but useless if not promptly effi- 
 cient (P). Veratrum Viride, is used with great benefit in most cases (Barker). 
 Opium, for wakefulness and delirium (B) ; a yery valuable remedy, tending to 
 allay pain, and reduce excitement of the nervous and vascular systems (Wa). 
 Alkaline Sulphites, especially valuable in early stages, internally and locally ; 
 gr. xv-xxx of Magnesium or Calcium Sulphite every 2 or 3 hours, with injec- 
 tions every day (Wa). Stramonium, when cerebral excitement (P). Potassium 
 Permanganate, gr. %-] ter die, has been given with benefit (B). Alcohol, 
 freely used, until all evidence of sepsis subsided, caused recovery in one of the 
 most desperate cases of puerperal septicemia of three weeks' standing, with 
 temp, falling to 95 and rising to 107° (Hills). Calumba, preferable to Cinchona 
 (P). Quinine, only large doses are useful ; gr. v-xx every 4 hours (B) ; reduces 
 the temperature (P). Warburg's Tincture, is more efficient than the largest 
 doses of Quinine in cases of puerperal malarial fever, ^ss every four hours 
 until fever abates, then in diminishing doses to 3j-ij, until convalescence is 
 established (Fordyce Barker). Turpentine, when depression of the vaso-motor 
 
PUERPERAL MANIA PULSE PURPURA. 827 
 
 nervous system, cardiac weakness and tympanitic distention of abdomen (P). 
 Resorcin, is much used in Vienna by Braun ; gr. xl repeated p. r. n. Strepto- 
 coccus Antitoxin, has been used with success by several authorities [see page 
 182]. Rest and quiet but attentive nursing, frequent liquid food. Water, hot 
 fomentations frequently to the parts, valuable as preventive. Antiseptic Injec- 
 tions into the uterus are used, but are strenuously opposed by many of the most 
 prominent and experienced clinicians. [Compare Puerperal Peritonitis, 
 Septicemia.] 
 
 Puerperal Mania and Melancholia. 
 
 Stramonium, will allay cerebral excitement and soothe the nervous system; 
 when delirium mild and furious, but intermittent ; tendency to suicide or to 
 destroy the child ; rt\,x-xx of tinct. every 3-4 hours (P). Hyoscyamus, in the 
 milder cases; when nervous system is greatly excited (P). Duboisine, as 
 calmative and hypnotic, acts efficiently for a time in puerperal mania. Aconite, 
 in puerperal mania with high fever and restlessness ; speedy and marked suc- 
 cess follows if given soon after the chill (P). Cimicifuga, has cured (B) ; "its 
 effects are truly remarkable in the mania and hypochondriasis of the puer- 
 peral state (P). Chloral, often alleviates symptoms (B) ; to produce sleep 
 (Wa). Potassium Bromide, in sthenic cases (R); its effects are very variable 
 (Wa). Anesthetics, Chloroform or Ether inhaled in violent paroxysms of 
 mania (B). Tartar Emetic, in frequently repeated doses (Wa). Quinine, when 
 much weakness ; skin cold and sweating (B). Chalybeates, Tinct. Ferri 
 Chloridi, n\,v-xx, in the anemic form (B). Opium, cautiously (B) ; gives the 
 best results in such doses as may be necessary to allay irritation and procure 
 sleep (Wa). Poultices, hot fomentations, enemata, or gentle laxatives; nutri- 
 tious and stimulating diet. Lochia, should be watched (P). Weaning, 
 imperative in melancholia ; not so in acute mania. 
 
 Puerperal Peritonitis. 
 
 Aconite, has cured cases of the usual type (P). [See under Puerperal 
 Fever.] Cimicifuga, especially in rheumatic form, has remarkable effects (P). 
 Opium, its curative power in this, one of the best established facts in therapeu- 
 tics (B) ; is good, but Aconite often better (P) ; especially valuable in adynamic 
 cases (Wa) ; the drug of all others to be relied on (Godson). Turpentine, as 
 stimulant, Ti^x frequently repeated, better than Alcohol (B) ; by enema, also 
 hot turpentine epithems may be used with advantage (Wa). Quinine, in con- 
 siderable doses, with or without Opium (B) ; gr. x-xx twice daily as an antipy- 
 retic (Wa). Antimony, as Tartar Emetic, gr. T \y to ^ every hour to shorten 
 attack and render it more mild (R). Cathartics, advised by many, prohibited 
 by as many ; evidence is in favor of mild aperients combined with Dover's 
 powder or Hyoscyamus ( Wa). Poultices, hot, of very great value (B). Water, 
 Ice in mouth or swallowed, hot fomentations to abdomen ; in some cases cold 
 compresses best. [Compare Puerperal Fever.] 
 
 Pulse. 
 
 Aconite, for a quick, resisting pulse (P) ; a moderate dose, while it makes the 
 pulse less frequent, renders it fuller, stronger and less compressible (R). 
 Veratrum Viride, reduces febrile heat with abnormal rapidity of pulse (P). 
 Veratrine, pulse at first quick and strong, then slowed ; afterward quick, weak 
 and irregular (R). Digitalis, for weak, quick pulse. [Compare Heart Dis- 
 eases, Fever, etc., also the Lists of Vascular Contractors and Dilators, on 
 pages 65, 66.] 
 
 Purpura. 
 
 Sulphuric Acid, often acts happily (B). Ergot, has been strongly urged 
 (R) ; is most useful in removing purpura (P) ; many cases are recorded as 
 
828 PYROSIS RACHITIS RECTUM. 
 
 cured by hypodermic injections of Ergotin (Wa). Turpentine, has been used 
 (R) ; with invariable benefit (Wa). [See Hematemesis.] Nux Vomica, no 
 prescription more generally useful than the Syrup of Iron, Quinine, and Strych- 
 nine (B). Iron, when due to anemia ; the tincture of the Chloride (B) ; is 
 preeminently the curative remedy for purpura haemorrhagica, arresting the 
 hemorrhagic tendency in 24 to 48 hours (Pize). Vinegar, and water, is an 
 excellent application by sponging over the body (E. Wilson). Quinine, or Hux- 
 ham's Tincture of Bark, are much used (H). Potassium Nitrate, gr. x thrice 
 daily in purpura simplex, used successfully (Wa). Styptics, as the Ammonio- 
 ferric Alum, tincture of Ferric Chloride (Tr) ; Tannic and Gallic Acids, used 
 in some cases (H). Alum, and brandy or whiskey and water at such tem- 
 perature as is not chilling, applied by sponging the body, is the best local 
 measure (H). Wines are generally indicated (B). [Compare Hemorrhage, 
 Scurvy.] 
 
 Pyrosis and Cardialgia. 
 
 Capsicum, in atonic dyspepsia, with heartburn and diarrhea (P). Nux 
 Vomica, of the highest possible value in atonic dyspepsia with heartburn, hic- 
 cough, regurgitation, etc. ; an excellent combination is tr^v-x of the tincture 
 with rr^xv of dilute Nitric Acid for one dose (P). Pulsatilla, a good medicine in 
 the heartburn of dyspepsia in phlegmatic subjects (P). Podophyllin, gr. ^ 
 night and morning in obstinate heartburn, with liver derangement (P). Almonds, 
 blanched, six or eight are said to relieve heartburn (P). Rhubarb, and other pur- 
 gatives are often useful ; also Magnesia, Bismuth, and Ginger (Beale). Opium 
 in small doses has been advocated for water-brash (Id). Catechu and Kino, 
 also other astringents, sometimes do good, and bitter infusions, especially that 
 of Calumba, have been given with advantage in water-brash (Id). Diet, lemon- 
 juice, aerated bread, plain biscuit, etc. ; but avoid new bread, much vegetable 
 food, and pastry. [Compare Acidity, Dyspepsia.] 
 
 Rachitis. 
 
 Lime, as Lime-water, or the Carbonate, or the Syrupus Calcii Lacto-phos- 
 phatis (B) ; in small doses (R) ; the Phosphate may be advantageously com- 
 bined with Cod-liver Oil (Wa). Iron, the Syrup of the Iodide preferred; 
 Calcium and Ferric Phosphates excellent in combination (B) ; must be con- 
 tinued a long time (R). Nitro-hydrochloric Acid, as baths, gives excellent 
 results (Wa). Quinine, often very valuable (P). Thymus Extract, is suggested 
 as probably useful [see page 160]. Aliment, food rich in Calcium Phosphate 
 and other phosphatic salts; oatmeal, Graham bread, etc. (B) : Cod-liver Oil, 
 the best constructive agent (B) ; a full animal diet (Wa) ; cold sponging (R). 
 
 Rectum, Diseases of. 
 
 Podophyllum, in doses of gr. -£$ to -^ night and morning, for a child, may 
 relieve prolapsus of the rectum (P). Belladonna, the extract locally in fissure 
 (R) ; and irritable ulcers (P) ; internally and locally to remove ulcers, also ex- 
 cellent for burning pain following defecation ; or with mercurial ointment, equal 
 parts of each, for fissures and ulcers (P). Acetanilid, in fine powder, is an 
 excellent application to ulcers of the rectum. Phosphorus, in chronic inflam- 
 mation of the rectum, has been highly recommended (R). Cocaine, gr. xl to 
 25J of glycerite of starch, applied by Seeley's Pile-pipe, very efficient in control- 
 ling spasm of the rectum. Potassium Bromide, in 5 parts of glycerin, locally, 
 for fissures and painful growths (R). Iodoform, as suppository in painful 
 diseases, relieves greatly (R). Pepper, the confection, as gentle stimulant in 
 fistula, ulcers, hemorrhoids (P). Castor Oil, in fissure and hemorrhoids, is 
 commonly used as purgative (R, P). Sulphur, with Confectio Sennse, in irrit- 
 
RECTUM REMITTENT FEVER. 
 
 829 
 
 able rectum, is very soothing (Wa). Stramonium, an ointment of the fresh 
 leaves to alleviate pain (P). Conium, the extract in doses of gr. x to allay 
 pain and irritability in rectal cancer (Wa). Spigelia Anthelmia, an enema of 
 the juice, also a decoction internally, are used by the Venezuelan natives with 
 success in the epidemic gangrenous proctitis of that country (Ackers). Lemon, 
 roasted, and one of the quarters introduced into the rectum once or twice 
 daily, is used with very satisfactory results in the same affection (Id). Purga- 
 tives, are best for proctalgia (D). Surgical, an incision through mucous mem- 
 brane, and in severe cases to divide part of the sphincter, in ulcer or fissure ; 
 a flake of cotton should be laid in the wound, so that it may heal by granula- 
 tion (D). [Compare Anus, Diarrhea, Dysentery, Hemorrhage intes- 
 tinal, Hemorrhoids, Prolapsus, Rectum ulceration of, Sprue.] 
 
 Rectum, Ulceration of. 
 
 Mercury, the Red Oxide, Z\ to the ^j of Unguentum, as ointment in flat 
 ulcers of rectum existing just within the anus (Coulson). Belladonna, the 
 extract locally for rectal ulcers, is very efficient (P). Carbonic Acid, per anum, 
 is strongly advised (Wa). Chloroform, as ointment, in irritable ulcer of rectum 
 (Curling). Iodoform, in suppository, extremely useful in painful ulceration 
 (R) ; used in many cases with satisfactory results, but in some instances 
 poisoning occurs ; hence it should be used with caution (Wa). Phosphorus, 
 as an internal remedy, is highly recommended in chronic inflammation of the 
 rectum (R). Copper Sulphate, with Opium, may often be used internally with 
 advantage, and a weak solution of the same, or of Silver Nitrate, locally (Curl- 
 ing) ; the writer had a case resisting treatment for three years, in which a cure 
 was effected by the persevering use of a pill of Cuprum Sulphate, Extract of 
 Opium, and Quinine Sulphate [see below]. Silver Nitrate, gr. %.-) combined 
 in pill with Opium, gr. ss ; and a solution, gr. x-xx to the pint, by enema (B). 
 Glycozone, ^j in ^xij of lukewarm water, mixed immediately before using, and 
 given by enema once daily, in ulceration and chronic inflammation of the 
 rectum and lower gut (Edson). [Compare Dysentery.] 
 
 R. Cupri Sulphat., 
 
 Morphinae Sulphat., . aa gr. ij. 
 
 Quininae Sulphat., . . . gr. xxiv. 
 
 M. ft. pil. no. xxiv. Sig. — One pill 
 thrice daily. {Potter.) 
 
 R . Chloroformi, 3 j — ij. 
 
 Zinci Oxidi, 3 ss. 
 
 Olei Olivse, gj. 
 
 Cerati Cetacei, . . . . giv. 
 
 M. ft. unguentum. [Curling.') 
 
 Relapsing Fever. 
 
 Cathartic, a mild one at beginning (H) ; if jaundice or other hepatic derange- 
 ment, a Calomel purgative, cautiously lest irritation (Wa). Potassium Citrate, 
 as cooling diaphoretic. Quinine, in moderate doses after the crisis, at least 
 until the relapse, which will not be prevented by any amount of Quinine (Wa). 
 Leeches or Cupping, best for headache (A). Alcohol, required by some pa- 
 tients. Diet, supporting, especially in third week, beef-tea, etc. Urine, should 
 be watched carefully (A). [Compare Typhus Fever.] 
 
 Remittent Fever. 
 
 Antipyrin or Phenacetin, in full dose during pyrexia, to lower the temp., is 
 very efficient treatment, especially if conjoined with Quinine during the remis- 
 sion ; the latter drug being too slow of action to be of immediate service in the 
 pyrexia. Aconite, in the hot stage, if any febrifuge is required, frequently re- 
 peated doses (B) ; is next in value to Quinine for high fever and headache, gtt. 
 j of a good tincture every hour (Da C). Quinine, 20 to 30 grains in single dose 
 
83O RETINA RHEUMATISM. 
 
 once or twice daily until the temperature is reduced, with other appropriate 
 remedies (B) ; 1 5 to 20 grains at most (Maclean) ; 30 to 50 or 60 grains in severe 
 cases of pernicious remittents several times a day without regard to exacerba- 
 tion (P, B) ; 10 or 15 grains should be administered at once in bilious remittent 
 and other severe forms of malarial fever, without waiting for the remission or 
 sweating ; an aperient may be given at the same time, 5 or 10 grains of Calo- 
 mel is the best (Mn) ; when vomiting is severe the rectum should be cleared 
 out with an injection of warm water and then an enema of Quinine gr. xxx in 
 Water ifiij, with a few drops of acid to aid solution, and 5 or 10 grains of Cal- 
 omel may be given at the same time by the mouth (Id). Warburg's Tincture, 
 has achieved a very high reputation, but must be used in less dosage than 
 directed, and supporting treatment given when its sudorific action commences 
 (Wa). Gelsemium, exercises a really beneficial influence; depresses the tem- 
 perature (B) ; valuable in bilious remittents of the South (Pf ). Morphine, gr. 
 % hypodermically to abort pernicious remittent fever (B). Purgation, by Cal- 
 omel with Jalap or salines afterwards, is very necessary during the course of the 
 disease (Da C). Quassia, an excellent tonic in the convalescence, combined 
 with mineral acids (Wa). Packing, by the wet sheet, is resorted to with advan- 
 tage, except when hepatic or splenic congestion exists (Wa). [Compare 
 Fevers tropical, Hemoglobinuric Fever, Intermittent Fever, Mala- 
 ria.] 
 
 Retina, Affections of. 
 
 Mercury, in syphilitic retinitis, is of great value ; Calomel gr. j-ij with Opium 
 gr. )i-Yz every 4 or 6 hours; also mercurial inunction till the gums are affected 
 or the disease yields (Wa). Potassium Iodide and Bromide, in combination, 
 in retinal hemorrhage, to promote absorption of the effused blood and to benefit 
 the congestion (C). Physostigmine, locally, to contract the pupil, and diminish 
 the amount of light admitted to the eye (Wa). Iron, in full doses, generally the 
 tincture of the Chloride, in pigmentary retinitis; seems to have a tendency to 
 arrest the malady (C). Leeches, to the temple better than general bloodletting 
 (Wa); when much local congestion present, depletion by artificial leech is 
 almost always indicated (C). Pilocarpus, in detached retina and optic neuritis; 
 has been found a very useful remedy in retinal affections generally. [Compare 
 Amaurosis.] 
 
 Rheumatism, Acute. 
 
 Plans of Treatment, may be resolved into three, viz., — (1) that by Salicylic 
 Acid, (2) that by Alkalies, (3) that by Iron. Salicylic Acid or the Salicylates, in 
 20-grain doses, to not less than £ij in 24 hours, in solution with excess of 
 alkali, is especially suited to vigorous, sthenic subjects, whose stomachs will 
 bear it, in whom it often effects a cure in 3 or 4 days. Salicin, gr. x-xxx every 
 2, 3, or 4 hours ; gr. xv every 3 hours in powder mixed with water (Maclagan), 
 or same dose of Salicylic Acid, is of great benefit ; good effect generally 
 experienced within 48 hours (R); the Acid is better than the Salicylates, but 
 must be abandoned if not effective after 3 or 4 days (Da C). Oil of Gaultheria, 
 as a substitute for Salicylic Acid, used very successfully in form of emulsion 
 (B). Alkalies, for flabby, fat subjects ; alkaline carbonates, as Potassium Car- 
 bonate ^jss every 24 hours, alone or with a vegetable acid, until the urine 
 becomes neutral or alkaline, when it may be reduced one-half, and so main- 
 tained for some days, when Quinine or Iron may be used ; if successful, this 
 treatment brings about a cure in two weeks: the alkaline treatment is now 
 seriously questioned; an injurious dyscrasia results from their use (B) ; Potas- 
 sium Bicarbonate, gr. xxx every 4 hours, in a dilute solution, until joint-symp- 
 toms and fever disappear (Wa) : cardiac complications require Ammonium 
 Carbonate, in 5-grain doses frequently, also Infusion of Digitalis with hypo- 
 dermics of Morphine, and a blister over the precordium, followed by Iron 
 
RHEUMATISM, ACUTE. 83 I 
 
 and Quinine after the acute symptoms have subsided (B). Tincture of the 
 Chloride of Iron, for feeble, anemic and nervous subjects, rr\,xxx every 4 
 hours, with an occasional saline laxative, blisters around joints, and Atropine, 
 as an anodyne rather than Opium, used hypodermically in the vicinity of the 
 affected joint (B) ; very serviceable in pale, delicate subjects, rr^xx-xxx every 4 
 hours ; also as prophylactic where tendency (Anstie) ; harmful to the plethoric 
 and overfed (B). Iron and Salicylic Acid in combination, should be most 
 valuable, but as heretofore prescribed has always made an insoluble pre- 
 cipitate ; this is overcome by Dr. Peabody in the formula given on the next 
 page, which makes a ruby-red mixture, and has advantage of preventing the 
 anemia which results from the Acid given alone. 
 
 Aconite, very serviceable when much heat and dry skin (B) ; subdues pain 
 in inflamed joints and perhaps shortens the fever (R) ; in small doses fre- 
 quently repeated is of the greatest value, and if used from the start prevents 
 organic cardiac disease (P) ; not reliable as a curative agent, but is a valuable 
 adjunct to other remedies (Wa). Veratrum Viride, said to be useful (R) ; small 
 doses as antipyretic, may be combined with Opium (P). Salipyrin, has been 
 employed with excellent results, in 15-grain doses every }i hour or hour, until 
 about 3ij have been taken, continuing with smaller doses for a long time after 
 convalescence, to prevent relapses. Salol, the great remedy, none superior 
 (B) ; given in doses of 15 to 30 grains, up to -j>ij in 24 hours, and continued for 
 some time after acute symptoms have subsided ; may prove toxic in large doses, 
 with symptoms of carbolic acid poisoning. Salophen, is said to be equally 
 efficient and non-toxic, Sj-o'jss daily. Antipyrin, has held a high place for 
 several years [see page 172]. Phenacetin, is an efficient and safe antipyretic. 
 Phenocoll, for the pyrexia, is used with marked success. Rhus Toxicodendron, 
 positively invaluable in after-stage, also in subacute forms, muscular or ten- 
 dinous, worse at night (P, Pf). Hydriodic Acid, the Syrup, in dessertsp. doses 
 every 2 or 3 hours, the best remedy for acute and subacute rheumatism, reliev- 
 ing pain and swelling in 18 to 24 hours (Craig). Cimicifuga, has excellent 
 reports (B) ; much used, and is said to quell the pain speedily (R) ; found very 
 serviceable (P). Dulcamara, recommended especially for persons who are 
 subject to catarrhal affections in cold and damp weather (P). Ammonium 
 Bromide, an excellent treatment, followed by Quinine ; gives a very low pro- 
 portion of cardiac complications ; gr. xv-xx every 4 hours (Da C) ; is dis- 
 agreeable but strongly recommended (B). Arnica, lowers pulse and tempera- 
 ture, relieves articular pain and swelling, diminishes urea (P). Trimethyl- 
 amine, Tr^iv-viij in Peppermint-water, often has remarkable power in acute 
 rheumatism and gout (B). Bryonia, after the swollen joints have been reduced 
 by other means, is extremely efficient for the pain and stiffness (P). Spigelia 
 Anthelmia, for rheumatic pericarditis and endocarditis; rheumatic fever with 
 pain shifting from joint to joint (P) ; seems to fix the disease in certain joints, 
 and prevent its shifting around (P). Sulphurous Acid, by fumigation, the 
 patient covered with blankets and exposed to strong fumes, produces perspira- 
 tion, sleep and relief (R). Colchicum, alleviates the symptoms, and shortens 
 their duration (Wa). Laville's Mixture, is said to be a tincture of Quinine and 
 Colocynthine, but it is more than probable that Colchicine is the active agent 
 therein. Quinine, as antipyretic ; not so useful as wet pack or cold bath ; gr. 
 ij-v after the more acute symptoms have subsided (B) ; is best for the head 
 symptoms (Da C). Opium, strongly recommended as anti-rheumatic ; gr. j 
 every 2 or 3 hours, increased to gr. xij in 24 hours ; tolerance remarkable in 
 this disease ; in rheumatic carditis indispensable (Wa) ; a very good remedy 
 in moderate doses (Da C). Lithium Bromide, equally good in all forms, 
 especially for insomnia, delirium (B). Digitalis, in powder, gr. ij every 4 
 hours, usually effective after 2 to 7 days ; especially useful in cardiac complica- 
 tions with cyanosis and edema. Lime-juice, ^viij daily, Lemon-juice inferior 
 (R). Blisters, are a very effective method ; a number of small blisters applied 
 to vesication around a joint (B) ; large flying blisters around a joint (R). 
 Water, cold baths for the hyperpyrexia (Da C) ; the wet pack efficacious in 
 
S32 
 
 RHEUMATISM, CHRONIC. 
 
 rheumatism, also a vinegar vapor bath (B) ; the wet pack, 20 or 30 minutes, 
 and tepid (70 ) shallow bath 1 or 2 minutes. Cold applications only when skin 
 hot and dry, and temperature high. Warm baths, or hot compresses very use- 
 ful. Spongiopiline an excellent substance for applications. Diet, low during 
 the fever, water, barley-water, milk-and-water, gruel ; use liquid food through- 
 out, avoid malt liquors, port wine and sugar. Lemon-juice may be used freely. 
 Blankets, instead of sheets to sleep in, and flannel underclothing, are useful 
 adjuncts. Pack the joints with cotton covered with rubber cloth or oiled silk. 
 Dry Heat, applied by the Tallerman apparatus is of great value in tendinous 
 inflammations, also in subacute rheumatism through its sweating and local in- 
 fluence (W). 
 
 R. Olei Gaultheriae, . . . ^j. 
 
 Acidi Salicylici, . . . gr. lxxx. 
 Sodii Boratis, . , . . £j. 
 Syr. Picis Liquidae, 
 Aquse Anisi, . . . aa^ij. 
 M. Sig. — Adessertsp. every two hours. 
 
 R. 
 
 3iJ- 
 
 Potassii Iodidi, . . 
 Vini Colchici Sem., 
 Syr. Simplicis, . . . aa Z iv. 
 Aquae Menthae Pip. , . . 3V. 
 M. Sig. — Tablesp. every 4 hours. 
 
 (New Orleans Charity Hosp.) 
 
 R. Propylamine Chlorid., . gr. xxiv. 
 Aquse Menthae Pip., . . ,:§ vj. 
 M. Sig. — A tablesp. every two or three 
 hours. {Tyson.) 
 
 R . Acidi Salicylici, . . . . 3 ij. 
 Ferri Pyrophosphat. , . . 3J. 
 Sodii Phosphatis, . . . gr. xij. 
 
 Aquae, ^vj. 
 
 M. Sig. — A tablesp. every two hours. 
 ( Peabody. ) 
 
 R . Ammonii Phosphatis, . £ jss. 
 
 Tinct. Colchici Seminis, 5J. 
 
 Tinct. Aconiti, . . . . 31J. 
 
 Syr. Simplicis, .... J iij. 
 M. Sig. — A teasp. every three or four 
 hours. (Corson.) 
 
 R. Sodii Salicylatis, . . . ^ss. 
 
 Tinct. Lavand. Co., . . g iij. 
 
 Glycerini, 3 v. 
 
 Aquae, . . . . q. s. ad t ^vj. 
 M. Sig. — A tablesp. every three hours, 
 well diluted. 
 
 Rheumatism, Chronic. 
 
 Arsenic, is very good in most cases, given in small doses steadily (Da C) ; is 
 more efficient than Sulphur and should be used instead of the latter in the Chel- 
 sea Pensioner [see page 568], an old remedy for chronic rheumatism (Fother- 
 gill). Sulphur waters are undoubtedly efficient (Da C) ; Sulphur locally, also the 
 Sulphides as baths (R) ; is certainly of benefit (B). Guaiac is another ingredient 
 of the Chelsea Pensioner ; is used with varying success (B) ; the ammoniated 
 tincture in milk often gives excellent results (Da C) ; is vile to the taste. 
 Potassium Iodide, especially when pains are worse at night, or of syphilitic 
 origin (R) ; should always be fairly tried in chronic rheumatism (Da C) ; was 
 Sir Astley Cooper's remedy ; Iodides often prove very satisfactory, especially in 
 strumous or syphilitic subjects (B). Rhus Toxicodendron, a very powerful 
 agent in subacute muscular or tendinous rheumatism worse at night (Pf ) ; the 
 tendons, ligaments, and fasciae are most benefited; externally, as lotion on 
 compresses; also internally, small doses every two hours (P). Aconite, the 
 extract as plaster to joints is unquestionably very useful (P) ; is more useful in 
 chronic than acute rheumatism (Wa) ; the liniment of the B. P. locally over the 
 sciatic nerve when affected (Fothergill). Ichthyol, is invaluable given inter- 
 nally in pill, gr. x-xxx thrice daily ; also as ointment with Lanolin 50 percent. 
 (Illinsky) ; or as a liniment with Turpentine or an equal weight of a mixture of 
 Lanolin and Olive Oil, with 30 per cent, of Chloroform. Cimicifuga, some- 
 times has wonderful success, yet often fails ; no indications (B) ; in rheumatic 
 neuralgias and headaches, and rheumatism of uterus (P) ; signally beneficial 
 in many forms (R). Lithium Bromide, gives excellent results, when smaller 
 joints are swollen and tender (B). Lithium Salicylate, in 15- to 20-grain doses 
 every four hours, gives good results in lingering, subacute cases after acute 
 
RHEUMATISM, GONORRHEAL. 
 
 833 
 
 attacks (Da C). Colchicum, is of decided advantage in the neuralgia of 
 chronic rheumatism (B). Cdlchicine Salicylate, is used with satisfaction [see 
 page 285]. Bryonia, is a useful remedy, especially for painful and stiff joints 
 (P). Mercury, the oleate of Mercury and Morphine locally (R). Mezereon is 
 strongly recommended (P). Phytolacca, has proved useful (B). Dulcamara, 
 has been used with benefit (P). Iodine, locally, for pain around joints (R). 
 Quinine, in rheumatism with debility, shown by night sweats or sweats during 
 sleep and only then (Wa). Arnica, the tincture and infusion are useful (P). 
 Cajuput Oil, internally and externally in muscular rheumatism (P). Turpentine, 
 benefits and relieves the pains ; internally and externally as liniment (P). 
 Aletris, is extensively advertised as an efficient remedy. Nuclein, has been 
 used with decided advantage (Vaughn). Eucalyptus, the leaves wrapped 
 around the affected part, renewing them daily for a week or more, often very 
 efficient as a local stimulant, but will produce vesication if too long continued 
 (Gibbons). Xanthoxylum, has long had deserved reputation, Ttlxv-^ij of fluid 
 extract (B). Thuja Occidentalis, is useful for rheumatic pains (P). Manganese 
 Sulphate, is one of the remedies (B). Belladonna, the extract locally very 
 valuable for pains (P). Cod-liver Oil, internally and externally, exercises 
 some influence (B). Chimaphila, may prove useful, especially when lithiasis 
 (P). Lupulin, as an anodyne (P). Burgundy Pitch, as plaster locally (P). 
 Aliment, avoid spirits and malt liquors, coffee, also starchy, animal and sac- 
 charine food; the farinaceous vegetables and acid fruits suitable (B) ; Alkaline 
 mineral waters have deserved reputation (B). Turkish Baths, in chronic mus- 
 cular rheumatism (B) ; steam bath daily of great benefit, may be obtained at 
 home by pouring water on hot bricks in a tub, the patient sitting on a board or 
 chair above, enveloped in a blanket (Brick). Carbonic Acid Baths are some- 
 times beneficial [see page 93] . Red Flannel next skin, very popular, but white 
 better, as the red often gives rise to eruptions (Da C). [Compare Arthritis, 
 Lumbago, Myalgia, Pleurodynia, Sciatica.] 
 
 R • Pulv. Resin. Guaiaci, 
 
 Potassii Iodidi, . . . aa'^j. 
 
 Tinct. Colchici Seminis, . 3 iij . 
 
 Aquae Cinnamomi, 
 
 Syrupi, . . aa q. s. ad % vj. 
 
 M. Sig. — A dessertsp. to a tablesp. 
 thrice daily. . [Pepper.) 
 
 R . Tinct. Guaiaci yEther., . 
 
 Tinct. Colchici Esther., . 
 
 Tinct. Cann. Ind. ^Ether. 
 M. Sig. — 25 to 30 drops on sugar, every 
 4 hours, for rheumatic and neuralgic symp- 
 toms. {Atlee.) 
 
 Si- 
 
 3*j- 
 
 R. Acidi Arsenosi, .... gr. iij. 
 
 Pulv. Guaiaci, £>iij- 
 
 Pulv. Capsici, ^ss. 
 
 Pil. Aloes et Myrrhse, 5 iij. 
 Ft. pil. no. cxx. Sig. — One thrice daily. 
 The modified Chelsea Pensioner. 
 
 (Fothergill.) 
 
 R. 
 
 P. 
 
 Linim. Aconiti (B. 
 
 Linim. Belladon., . . aa^ij. 
 
 Glycerini, Jij. 
 
 M. Sig. — Apply locally over the seat of 
 pain. [Fothergill.) 
 
 R 
 
 Olei Sinapis, % ss. 
 
 Olei Terebinth., . . . 3 iij. 
 
 Camphorae, giv. 
 
 Liq. Amraon, Port., . . £iij. 
 Tinct. Capsici, . . . . % iv. 
 Alcoholis, . . q. s. ad ^vj. 
 M. Sig. — Russian Spirit, a liniment for 
 rheumatism. 
 
 R 
 
 3 SS - 
 
 M 
 
 Potassii Iodidi, . . 
 Potassii Nitratis, . 
 Ext. Cimicif. Fl., 
 Glycerini, . . . aa^ss. 
 Vini Colchici Sem., q.s. ad ^ ij. 
 . Sig. — A teasp. after each meal. 
 
 (Potter.) 
 
 Rheumatism, Gonorrheal. 
 
 Opium, as Dover's powder, full doses in the acute stage (Wa). Potassium 
 Iodide, with tonics and stimulants, after the acute stage has passed, followed by 
 friction, shampooing, and passive movements of the joints (Wa). Ammonium 
 Chloride, in free doses, especially when the muscles are affected (Fuller). 
 Potassium Chlorate, internally, and as urethral injection, until urethral dis- 
 
 53 
 
834 RHEUMATISM, MUSCULAR — SCABIES. 
 
 charge is entirely stopped, then tt\,xx of Tinct. Ferri Chlor. 4 times daily, with 
 gr. x. of Quinine daily, and good food (Da C). Aspirate, when pus is discov- 
 ered around the joints; the case will be one of pyemic rheumatism, and may 
 involve more joints than one (Da C). 
 
 Rheumatism, Muscular. 
 
 Diaphoretics, as Dover's powder, with Potassium Nitrate, or Ammonium 
 salts, also dry heat to the part involved and rest in bed (Da C). Morphine 
 gr. % and Atropine, gr. ^, together hypodermically, are of great service in 
 most forms (R). Lithium Bromide, is almost specific (B) ; Lithium and its 
 salts where there is a uric acid diathesis. Colchicine, a ^ solution in 5-minim 
 doses hypodermically thrice daily into the affected muscles, very effective in 
 cases resisting other treatment. Colchicine Salicylate, is used with benefit [see 
 page 285]. Aurum, the Bromide of Gold and Arsenic is employed successfully 
 (Barclay). Jaborandi, or Pilocarpine hypodermically, to get the skin acting 
 freely, a great desideratum (Da C). Potassium Iodide and Colchicum, or Qui- 
 nine, gr. xij-xvj in 24 hours, if the case lingers over a week (Da C). Capsicum, 
 powdered, with Lard, 3ij to the jf , rubbed over the part, night and morning, 
 with a gloved hand, is very efficient (Macdonald). Cimicifuga, is often very 
 efficient in lumbago, myalgia, pleurodynia, and similar conditions (Wa). Xan- 
 thoxylum, gives relief in some cases of muscular rheumatism (B). Liniments 
 are of little use except to amuse the patient, but Chloral ^j in ^vj of Linim. 
 Saponis, makes a good one (Da C). Electricity, the constant current daily 
 renders good service. [Compare Lumbago, Myalgia, Neuritis, Pleuro- 
 dynia, Rheumatism chronic, Torticollis.] 
 
 Roseola. 
 
 Scarcely any treatment called for; no local application needed, as the rash 
 is but slightly irritating. Aconite or Belladonna, according to the symptoms, 
 or Ammonium Carbonate answers all the indications. [Compare Measles.] 
 
 Sarcinae. 
 
 Sulphites and Hyposulphites, have been employed to destroy sarcinae and 
 torulae in the stomach (R); or Sulphurous Acid, diluted, before each meal 
 (Wa). The treatment of these microscopic fungi is that of the primary gastric 
 affection. [Compare Cancer, Dyspepsia, Gastric Dilatation.] 
 
 Scabies. 
 
 Sulphur, a solution ot Potassa Sulphurata 3ss in ^j, as local application ; an 
 extemporaneous Sulphide may be made by boiling one part of quicklime and 
 two of sulphur in ten of water (B) ; Sulphurous Acid, as gaseous bath, the 
 quickest method ; Hebra's mixture of Sulphur, Chalk, Tar, Soap and Lard, less 
 irritating and equally sure (R). Calcium Sulphide, as a bath (W). Sulphuric 
 Acid, internally, has cured when other remedies failed (Wa). Storax, equally 
 serviceable and not irritating as is Sulphur, one part to two of Olive Oil, 
 with a warm bath (R). Mercury, the Bichloride is very efficient, if used 
 strong enough, but caution is required in its employment (B). [Formula on 
 next page.] Staphisagria, a certain remedy; 3 to 5 of Lard, boiled for 24 
 hours, when cooled, after straining add a little essence; friction with this 
 4 times daily (Wa). Balsam of Peru, the best of all applications, killing the 
 acarus, relieving the itching and dermatitis, and disinfecting the parts; rub in 
 Z) over the body after a warm bath (Bruce) ; is fatal to the itch-mite (Oldberg). 
 Manganese, the Oxide, 3'j to Jj Adipis as ointment (B). Copper Sulphate, as 
 lotion, Jj to Oj, has been used with great success, after crusts are thoroughly 
 
SCARLET FEVER. 
 
 83s 
 
 removed with soap-and-water (B). Alkalies, as soaps or ointments to remove 
 cuticle and break up burrows (R). Carbolic Acid, locally (B). [See under Tinea 
 for formula.] Cocculus Indicus, as ointment, useful (P). Tar Ointment, re- 
 lieves itching quickly and cures disease in 10 to 12 days (P). Anise or Ka- 
 mala, as ointments, efficient (P). Benzoic Acid, gr. x-xx ad Oy 2 aquae, as 
 lotion, effectual for the pruritus (R). [See formula under Pruritus.] Beta- 
 Napthol, in 3 to 5 per cent, alcoholic solution or as a 10 per cent, ointment, is 
 by far the best application (Shoemaker) ; a 2 per cent, ointment applied by 
 friction has caused acute nephritis in two brothers aged 6 and 8 years, one of 
 whom died therefrom (Baatz). Linen, should be immersed in boiling water, 
 other garments should be baked in an oven or well fumigated with Sulphur 
 vapor, to destroy the acari and their ova (R). 
 
 B 
 
 . Styracis Liquidis, . . . . g ij. 
 
 Ung. Sulphuris, . . . . 3 iv. 
 
 Ung. Petrolei, . q. s. ad % > ). 
 M. Sig. — Apply after washing. 
 
 R. Hydrarg. Chlor. Corr., . . gr. iv. 
 
 Alcoholis, ^vj. 
 
 Ammonii Chloridi, . . . 7, ss. 
 
 Aqua? Rosse, . . q. s. ad ^vj. 
 M. Sig. — Lotion for scabies, phthiriasis, 
 and tinea versicolor. (Fox.) 
 
 R 
 
 R 
 
 . Sulph. Sublimat., . . 
 
 Balsam. Peruv. , . . 
 
 Adipis, 
 
 M. Sig. — For children. 
 
 Eh 
 
 (Dukring.) 
 
 Sulph. Sublimat., 
 Olei Cadini, .... . aa^ij. 
 Cretse Preparatse, .... 3 ijss. 
 Saponis Viridis, 
 
 Adipis, aa %]. 
 
 M. ft. unguentum. (Bulkley.) 
 
 Scarlet Fever. 
 
 Aconite, of the highest value for all marked increase of temperature (R) ; 
 helps development of the eruption when due (P) ; in the early stage, when 
 patient is not decidedly adynamic, is very useful (W). Belladonna, during the 
 eruptive stage, when depression exists, and rash is imperfectly evolved (B); as 
 prophylactic has been recommended (R) ; is often efficacious as prophylactic 
 (P) ; the preponderance of evidence is certainly in favor of such use of the drug 
 (Pf ) ; this virtue is claimed by imposing authorities ; when so given its dose is 
 gr. \ several times a day (Tr). Mercury, gr. \ of Gray Powder every hour has 
 marked effect on inflamed tonsils (R). Ammonium Carbonate, feeble circula- 
 tion, cyanosis, delirium (B) ; in all forms, especially if given early (R); one of 
 the most reliable remedies ; gr. iij-vij, according to age, in milk or Cinnamon- 
 water, every hour or two (Wa). Potassium Iodide, in full doses, a very satis- 
 factory remedy (Mitchell). Mineral Acids, Muriatic internally and as gargle; 
 Nitric locally to sloughs in the throat (R). Salicylic Acid, given in 125 malig- 
 nant cases, with mortality of only 3^ per cent. (Shakowaki). Salol, in doses 
 of 7 to 30 grains daily, according to age, internally, with gargles of a solution 
 of Carbolic Acid, used in several cases with recovery in all and without albu- 
 minuria or other complications (Ouioc). Carbolic Acid, internally and asgargle, 
 successfully used [see Measles, for formula] ; seems to exercise some influence 
 as prophylactic (Wa) ; is good for the vomiting and for its general effect on the 
 disease ; Tr^ss, every 2 or 3 hours (Da C). Sodium Sulpho-carbolate, as a 
 means of introducing Carbolic Acid into the system ; has been successfully 
 employed (Wa). Chloral with Paregoric, is highly efficient for calming the 
 patient [see page 258]. Potassium Chlorate, in grain-doses every }i hour, will 
 not injure the kidneys, and will give results equal to those of larger doses on 
 the throat inflammation (Smith). Asclepias, to promote the eruption (W). 
 Zinc Sulphate, gr. -^ every 3 hours, believed to have specific influence on the 
 disease (Hoyt). Sodium Benzoate, is highly efficient, having slower but more 
 permanent effects on the fever than Quinine or the Salicylates (Klebs). Boric 
 Acid, makes an excellent gargle (Da C). Juniper, as diuretic when dropsy 
 (R). Magnesium Sulphate, as purgative, to prevent sore throat and other 
 
8 3 6 
 
 SCIATICA. 
 
 sequelae (R). Veratrum Viride, in convulsions (R). Rhus Toxicodendron, of 
 great service, if typhoid or rheumatic symptoms (P). Digitalis, very useful ; 
 lowers temperature and maintains kidney action (B) ; the best antipyretic and 
 diuretic, the infusion with dry cups for the renal dropsy in its inception ; later 
 on a milk diet and Basham's Mixture (Da C). Potassium Permanganate, 
 locally to throat, and internally, gr. %-} ter die, has undoubted benefit (B). 
 Sulphurous Acid, by inhalation, spray, or fumigation, in malignant sore throat 
 (R). Chlorine Water, in sloughing of throat (R) ; seemingly prophylactic 
 (Wa). Quinine, small doses in adynamic states, large in hyperpyrexia (B) ; 
 very successful when used systematically from the start (Wa). Ferric Chloride, 
 the tincture in doses of rt\,x-xv, according to age. in advanced stage ; when 
 albuminuria and hematuria, is very valuable (Wa). Mustard Bath, on reces- 
 sion of rash, to bring it back (R). Oil Inunctions, very grateful, especially use- 
 ful in desquamative stage ; Cacao-butter the most elegant (B). Ice, sucked, for 
 the sore throat (R). Water, cold baths with oil inunctions are all that are 
 needed in mild cases ; when temperature above 104 , urine scanty and rash 
 retroceding, the cold-wet pack renders signal service (R) ; cold wet compress 
 to neck, through the whole course, renewed every 3 hours (R). Diet, fruit, if 
 ripe, in season, toast, gruel, etc., in simple cases ; in malignant, extract of beef, 
 stimulants as per pulse. Milk the most suitable aliment, both as nutrient and 
 as diuretic ; a strict milk diet was enforced during the illness in all the cases 
 mentioned above under Salol (Quioc). [Compare Albuminuria, Bright's 
 Disease, Uremia.] 
 
 aa^ij. 
 
 R. Acidi Borici, £ss. 
 
 Potassii Chloratis, 
 
 Tinct. Ferri Chloridi, 
 
 Syrupi, 
 
 Aquae, . aa^ij. 
 
 M. Sig. — Tablesp. every 2 hours, to a 
 child of five years. {Smith. ) 
 
 R 
 
 Acidi Carbolici, . . . £ss-j. 
 
 Vaselini, ^ iv. 
 
 M. Sig. — By inunction to the entire 
 surface. 
 
 R . Acidi Salicylici, . . 
 Tinct. Aconiti, . . . 
 Infusi Digitalis, . . . 
 Spt. Ammon. Aromat., 
 Syr. Aurantii Cort., . 
 
 A q u3e > §j. 
 
 M. Sig. — Teasp. every 3 hours, for 
 child of five years. {Brown. 
 
 3*j- 
 
 gtt. X1J. 
 
 3jss. 
 5fss. 
 
 R . Acidi Borici, 3 iij. 
 
 Glycerini, ^ iv. 
 
 M. Sig. — For a pint of water, to be 
 used as a gargle. {Da Costa.) 
 
 Sciatica. 
 
 Opium, internally and externally (Wa). Morphine, hypodermically, is espe- 
 cially curative in sciatica (B) ; 3 or 4 injections of gr. l /e each may almost be 
 regarded as a specific (Wa) ; a single injection sometimes cures long standing 
 cases permanently ; if not it may be repeated every second day or so (R) ; 
 should be injected' deeply into the adjacent muscular structure (Pepper). Apo- 
 morphine, gr. -^ hypodermically, given by accident instead of morphine, caused 
 immediate disappearance of the pain in a very severe and intractable case, 
 not returning again for 12 months, and then only a slight attack which pro- 
 gressed favorably under Potassium Iodide and Gelsemium (Owen). Antipyrin 
 or Acetanilid, efficiently analgesic. Salipyrin, has been employed with excel- 
 lent results in rheumatic sciatica. Salicylic Acid, as paste locally, 5j with giv 
 of Lanolin and Ol. Olivae, q. s., also Rhus. Tox., gtt. j of a 1 per cent, solution 
 of the fluid extract internally every 4 hours, cured one very obstinate case 
 (Aulde). Salol, gr. vij in evening and gr. xv more at midnight, completely 
 cured me after 3 weeks' suffering in bed, unrelieved by other remedies (Aschen- 
 berg). Ether, as spray, is generally of temporary value (R). Guaiacol, 
 painted over the nerve as a local anesthetic. Aurum, the Bromide of Gold 
 and Arsenic has rendered good service in chronic cases. Chloroform, applied 
 on flannel along the course of the nerve, and covered with oiled silk (Wa) ; 
 Tt\,xv of the official spirit, or TT\,v-xv of pure chloroform, by deep hypodermic 
 
SCLERODERMA — SCLEROSIS. 
 
 837 
 
 injection into the vicinity of the affected nerve, gives the best results in old 
 cases (B). Cocaine, a 4 per cent, solution, hypodermically along the course 
 of the nerve, affords instant relief (Wa). Gelsemium, has been used with vary- 
 ing success. Nux Vomica, is often successful in chronic sciatica (Wa). 
 Belladonna, has afforded relief (R); Atropine, hypodermically, is curative, gr. 
 so t0 "Jo m tne vicinity °f the nerve (B). Stramonium, gr. % to }4, every 3 or 
 4 hours for 4 or 5 doses, often affords decided relief, but should be stopped 
 when the slightest symptoms of narcotism appear (P). Duboisine, is a good 
 substitute for Atropine, and equally effective. Veratrine, in strong ointment 
 or oleate locally ; the tincture of Veratrum Vinde internally is also recom- 
 mended (R). Aconite, locally (P) ; as ointment controls sciatica in somecases 
 (R) ; valuable in many obstinate cases (Wa). Ammonium Chloride, in 
 mild forms (R) ; in cases occurring in the young (Anstie). Iodides, in syph- 
 ilitic or metal poisoned subjects (B); often fails (R) ; Potassium Iodide in daily 
 doses of 3j dissolved in Decoction of Sarsapanlla, most efficacious in sub- 
 acute or chronic (Wa). Turpentine, causes an exquisite sensibility along the 
 track of the great nerves (Tr) ; occasionally of great value in sciatica, yet not 
 a specific, nor have we scientific indications for its use (P) ; ^ss doses for 4 to 
 8 successive nights (R). Sulphur, locally, believed to relieve the pain ; effect 
 probably due to the flannel surrounding it (R) ; is worthy of trial after active 
 symptoms are subdued (Wa). Phosphorus, in neuralgic form ; less satisfac- 
 tory in sciatica than in other neuralgias (R). Rhus Toxicodendron, a very 
 powerful therapeutic agent in various rheumatic affections of the fibrous tissues 
 (P). Cimicifuga, is highly extolled (R). Nitroglycerin, in doses of Try thrice 
 daily, gradually increased to TTVv, of a one per cent, solution, promptly curative 
 in a long-standing and severe case (Lawrence) ; its powerful anti-neuralgic 
 properties were well exhibited in 3 cases which would not respond to other 
 agents, two being cured and one remarkably improved thereby (Mikhalkme). 
 [See formula below.] Cold of intense degree, produced by refrigeration of 
 limb by Methyl Chloride, extremely efficient (Jacoby) ; has been found effectual 
 when applied to the sound limb. Cantharides, as counter-irritant, to free vesi- 
 cation (R). Aquapuncture, has had extraordinary success (B). [See under 
 Neuralgia.] Acupuncture, occasionally affords instant relief (B); often 
 cures cases of long standing (R). Nerve-stretching, by forcibly flexing the 
 thigh on the abdomen (Lange). Poultices, applied very hot (R). Turkish- 
 Baths, are often very useful (R). Electricity, produces excellent results (B) ; 
 does great good, but often aggravates ; the continuous current best, when stage 
 of acute inflammation past (W) ; galvanism often quickly relieves the pain 
 (Pepper). Cod-liver Oil, should always be tried in obstinate cases (W). [ Com- 
 pare Neuralgia, Rheumatism chronic] 
 
 R. Tinct. Colchici Seminis, R. Tinct. Trinitrini (1 p. c), . £jss. 
 
 Tinct. Belladonnae, Tinct. Capsici, £ij. 
 
 Tinct. Aconiti, . . . . aagj. Aquae Menthae Piper., . . ^iv. 
 
 M. Sig. — TT^vj every 6 hours. Remark- M. Sig. — 5 to 10 drops to be taken 
 
 ably efficient. {Metcalf.) three times a day. (Mikhalkine.) 
 
 Scleroderma. 
 
 Cod-liver Oil, our sheet-anchor, used internally and locally (B). Electricity, 
 is used successfully (B) ; with stimulating inunctions offers the best prospect of 
 improvement (Bulkley). Strontium Iodide, has been used, with varied results. 
 
 Sclerosis. 
 
 Aurum, the preparations of Gold are among the remedies which are believed 
 by some writers to retard the progress ; others being Arsenic in full doses, 
 Silver Nitrate in % grain doses, Physostigma and Ergot (Osier) : Gold is a 
 
838 SCROFULOSIS SCURVY. 
 
 specially curative agent in all forms of sclerosis, including cirrhosis of the 
 liver, interstitial nephritis, cirrhosis of the lungs, etc. ; and Dr. Barclay's 
 Liquor Auri et Arseni Bromidi is very efficient in these affections, and much 
 superior to the Chloride of Gold and Sodium (E. A. Wood). [Compare the 
 titles mentioned in this article, also Atheroma, Locomotor Ataxia, 
 Paralysis Agitans.] 
 
 Scrofulosis. 
 
 Ammonium Iodide, when glandular enlargement (Wa) ; Ferrous Iodide, 
 when debility and emaciation, a powerful and efficacious remedy; also in 
 anemia of scrofula, the syrup r^xx-^j ter die (Wa) ; useful in simple gland- 
 ular hypertrophy, but disappointing in scrofulous (B). Strontium Iodide has 
 been used with varied results in scrofulous otorrhea. Iodine, tinct. or oint. 
 applied over scrofulous glands — take care not to increase inflammation (R) : 
 Iodine and Iron the best remedies, but all medicines utterly useless without 
 strict hygiene (A). Aurum, the Bromide of Gold and Arsenic has rendered 
 good service in a case of adenitis with enormous enlargement of the neck (E. 
 A. Wood). Calcium Salts, the Chloride in doses of gr. x-xx in milk after food, 
 when glandular enlargement of neck and chronic diarrhea; the Phosphate of 
 great use for sores (R) ; is of eminent service as a palliative (Wa). [See Sul- 
 phides below.] Spongia Usta, formerly held in high repute ; has fallen into 
 perhaps unmerited neglect; contains Sodium Iodide, Magnesium Bromide, 
 Calcium Phosphate and Ferric Protoxide, all in small quantities (Wa). Iron, 
 Ferrum and Calcium Phosphates combined give good results, also chalybeate 
 waters (B) ; must be long continued (R). Sulphides, for sores, abscesses, sup- 
 purating glands; gr. fa or fa of Calcium Sulphide every hour or two (R). 
 Coniine, gr. y 2 to 3j of Almond Oil applied two or three times a day to con- 
 junctivae in scrofulous photophobia; has proved very successful (P). Cod- 
 liver Oil, the best remedy to promote assimilation (B) ; of great service in the 
 various manifestations of this disease (R). Stillingia, a domestic remedy, used 
 with much success (B). Capsicum, in scrofulous and fistulous ulcerations, a 
 weak infusion becomes a useful stimulant (P). Mezereum, strongly recom- 
 mended (P). Sarsaparilla, useful by reason of its tonic and alterative proper- 
 ties (P). Hyoscyamus, the bruised leaves as cataplasm for scrofulous ulcers 
 (P). Prunus Virginiana, is found very useful in the hectic (P). Chimaphila, 
 holds a certain amount of reputation as a useful remedy (P). Tussilago, was 
 employed by Cullen (P). Gentian, is valued; the infusion a useful vehicle for 
 chalybeates, etc.(P). Blisters, for scrofulous glands (R). Grape-cure, renders 
 much service (B). Alcohol, no doubt as to its great value; with Cod-liver Oil, 
 or in small amounts at meals (Wa). Phosphorus, eminently serviceable in 
 scrofuloderma, gr. x in Ol. Olivas ^j, doses of rr^v-x, thrice daily after meals 
 (Broadbent). Phosphates, see above, under Calcium and Iron. Aliment, 
 raw or broiled meat, the latter for children. Abundance of fresh air and sun- 
 shine. Sea-air, sunlight, moderate exercise, and light digestible food are nec- 
 essary. [Compare Cachexia, Coxalgia, Glands, Ophthalmia.] 
 
 Scurvy. 
 
 Citric Acid, used with great advantage, though inferior to Lemon-juice (Wa). 
 Lemon- or Lime-juice, of the utmost value, both as preventive and a curative 
 agent ; its efficacy believed to be due to its Potassium salts ; Oranges are highly 
 useful (Wa). Acids, especially Vinegar, to prevent scurvy, in the absence of 
 lime-juice or fresh vegetables (R) ; dilute Muriatic Acid, gtt. v, thrice daily 
 with juice of three lemons daily, vegetables and fresh meat (Da C). Potas- 
 sium Chlorate, is probably a remedy of some value (Wa) ; is not (W). 
 Cinchona, a decoction, or the dilute tincture with Myrrh or the Chlorates, a very 
 useful gargle. Quinine, internally when much prostration, combined with 
 mineral acids (Wa). Alcohol, diluted, as gargle (R). Atropine, hypodermic- 
 
SEA-SICKNESS SEBORRHEA SEPTICEMIA. 839 
 
 ally for salivation (R). Alum, a solution in water with Tinct. Myrrhas sjss, 
 several times daily as lotion for ulceration of the gums (W). Liquor Sodae 
 Chloratae, gvj ad ^xij aquae, as a mild application to gums (Wa). Dietetic 
 Treatment, alone required ; Lemon-juice plays no essential part in the treat- 
 ment ; the full diet of an hospital, comprising fresh meat, vegetables, and milk, 
 is generally sufficient. [Compare Cancrum Oris, Purpura.] 
 
 Sea-sickness. 
 
 Antipyrin, is successfully employed. Chloral, the most effective remedy ; 
 gr. xv-xxx every four hours (R). Staphisagria, has given relief (P). Creo- 
 sote, checks the vomiting (R). Chloroform, drop doses pure (R) ; n\,ij-v on 
 sugar (B). Atropine, hypodermically, gr. yi^ in epigastrium, will relieve (B) ; 
 S r - W(j to izwo given with Strychnine, gr. -f~ to -^ hypodermically, is really 
 specific in most cases, and in some if given before sailing, will prevent for the 
 whole voyage, though but one dose be administered. Bromides, in full doses 
 (Beard) ; the Sodium Bromide preferred, in doses of 30 grains thrice daily for 
 3 days before sailing and continued for the first 3 or 4 days of the voyage, is 
 by far the most effective treatment and never produces evil effects (Rockwell). 
 Cocaine, is quite efficient : the Hydrochlorate 1 in water 100, of which nyv-v 
 on a bit of ice thrice daily (Otto) ; a 2 per cent, solution, as spray high up into 
 nasal passages, is specific against nausea. [See under Nausea.] Morphine, 
 gr. ■£% to ^ hypodermically, will often relieve severe cases (B) ; often fails (Wa). 
 Amyl Nitrite, by inhalation (B) ; is strongly recommended, but must be cau- 
 tiously used. Champagne, iced ; tablespoonful doses every quarter-hour (B). 
 Calumba, a few drops of the tincture will sometimes relieve (B). Spinal Ice- 
 bag, often successful (R). [Compare Nausea, Vomiting.] 
 
 Seborrhea. 
 
 Glycerin, especially useful ; with Lead Acetate, Borax or Zinc, diminishing 
 secretion ; also acts efficiently when there is a want of sebaceous secretion 
 (Wa). Zinc Oxide, 5j, Plumbi Carbonat. £j, Cetacei gj, Ol. Olivae q. s. Ft. 
 unguent. (B). Oleate of Arsenic, is of benefit (Wa). Mercury, an ointment 
 of the White Precipitate is serviceable on the scalp, with an occasional sham- 
 poo with tar soap or soft soap in solution, followed later by mildly stimulating 
 lotions (Bulkley). [Compare Acne, Pityriasis.] 
 
 Septicemia and Pyemia. 
 
 Quinine, only large doses, gr. xv-xx, are useful (B) ; supposed to diminish 
 the temperature (R) ; to cinchonism, in childhood the best remedy (Wa) ; is 
 probably the most useful medicine, given in full and frequently repeated doses 
 (Haward). Salicin, to reduce the temperature in septicemia and to relieve the 
 cerebral symptoms (R). Salicylic Acid, has decided value (B). Potassium 
 Permanganate, is given with advantage, gr. %-gr.) thrice daily in distilled water 
 (B). Boracic Acid, a saturated solution to wounds, ulcers, etc. ; also Chlorine 
 as disinfectant (B). Oleum Caryophylli, locally, also Oleum Gaultherias, Thymi, 
 etc. (B) ; as antiseptics. Sulphites, may do some good in chronic cases, but 
 the use of Sulphurous Acid has not given the results in man which Polli ob- 
 tained from its use on animals (Haward). Streptococcus Antitoxin, has been 
 used successfully [see page 182]. Antistreptococcic serum, 20 cc. in puerperal 
 septicemia (Mapleton) ; also in acute hemorrhagic septicemia 3^ cc. every 4 
 hours, increased to 7 cc. after eight injections (Balance). Saline Injections of 
 a quart of normal salt solution, ^ per cent., into the subcutaneous cellular 
 tissue, has given excellent results in acute septicemia (Lanphear) ; hypodermic 
 injection fully as effectual as intravenous, used in 12 cases of which 10 recov- 
 ered (Duret). Water, hot water as dressing for wounds, to avert pyemia, 
 
84O SHOCK — SICK-ROOM. 
 
 Hamilton's immersion plan (B) ; stumps to be immersed in warm bath (R); 
 every wound, however slight, should be immersed in Bichloride solution, 1 to 
 10,000, as prophylactic, then dried with a sterile cloth and coated with collo- 
 dion (Wyeth). Aliment, plentiful, with wine and good ventilation, are not to 
 be neglected (Wa) ; concentrated food, milk and alcohol (Currier). Stimu- 
 lants are necessary, brandy the best (Wa) ; Turpentine is a better stimulant 
 than alcohol (B). Abscesses must be opened early, especially when in joints, 
 to prevent pyemia. 
 
 Shock, Surgical. 
 
 Codeine, in large dose, gr. j, hypodermically, immediately after laparotomy, 
 quiets pain, prevents intestinal contraction, and relaxes the tonic spasm of the 
 vessels which forms the first stage of shock, shown by the small and rapid 
 pulse, before the second stage, that of paresis of the vaso-motor system, sets 
 in, as shown by the soft, compressible pulse ; Morphine is the ideal relaxer of 
 spasm, but has many objectionable qualities which Codeine is free from (Boise). 
 Amyl Nitrite and Glonoin, relax arterial spasm, and are indicated in the first 
 stage of shock. Strychnine hypodermically, is the best medicinal agent in the 
 second or paretic stage of shock, when the vessels are relaxed and the pulse 
 is soft and compressible; a full dose, gr. ^, is necessary, and may be repeated 
 in y z hour (W). Digitalin, hypodermically, may also be of great service in 
 the second stage. Alcohol, as Brandy or Whiskey, hypodermically or by 
 enema, is commonly used; is harmful, being a vaso-motor paralyzer, encour- 
 ages hemorrhage, increases restlessness and in large doses weakens the heart 
 — Strychnine is far better (Estes). Ether as a stimulant is open to the same 
 objections as alcohol (Id). Heat, is a potent preventive of shock; the room 
 should be warmed to at least 72 F., exposed limbs should be wrapped in cotton 
 batting, and hot water bottles wrapped in towels should surround the patient's 
 body both during and after operation. Hot Water, as clyster, a pint injected 
 into colon, and repeated as required, after laparotomy, in which operation the 
 handling of the intestines sets up irritation of the sympathetic system, and is a 
 potent cause of shock ; this acts as a sedative thereto, and restores fluid to the 
 blood, allaying thirst and supporting patient. Normal Salt Solution, consisting 
 of Yj, of one per cent, of Sodium Chloride in sterilized water, intravenously or 
 subcutaneously to raise the volume of the pulse, stimulate the heart and restore 
 volume to the blood, renders good service in the second stage of shock. Saline 
 intravenous injections are inferior to saline rectal injections, the effects of the 
 former being evanescent, but the latter are frequently used with most satisfactory 
 results (Estes). The best fluid for injection into the cellular tissue is — Calcium 
 Chloride 0.1, Potassium Chloride 0.75, Normal Salt Solution, 0.75 per cent, 
 strength, 1 (Edes). Absorption from the cellular tissue is very rapid and the 
 injection is not dangerous as is intravenous injection. 
 
 Sick-room. 
 
 Every home of any pretensions should contain a room especially arranged 
 and kept ready for the use of sick members of the family. Such a room should 
 be on the upper floor, and preferably in the south-east corner, so as to have 
 the best sunny exposure; or still better, should be itself the upper floor of a 
 two-story annex, separate from the main building, but joined thereto by a 
 light, latticed bridge. It should have no upholstered furniture, a bare but 
 painted floor, and rough-plastered and painted walls and ceiling, without pic- 
 tures or paper, curtains or hangings. It should contain no sink, wash-basin, 
 water-closet or any other convenience which connects with the sewers, but 
 should communicate with the kitchen by a dumb-waiter, or have connected 
 with it a smaller room, furnished with a gas-stove and the other requirements 
 of a diet-kitchen. It should contain everything requisite for nursing a case of 
 typhoid fever, scarlatina, diphtheria, measles or small-pox ; and all its arrange- 
 
SNEEZING — SPERMATORRHEA. 84 1 
 
 merits should be supervised by the family physician. The possession of such 
 an appendage to the home would enable the owner to defy the mandate of a 
 Health Officer, in regard to removing an inmate thereof to a public pest-house, 
 as it could be shown to the satisfaction of any reasonable court, that a case of 
 infectious disease could be better isolated and more humanely treated in such 
 a room than in any " pest hospital" yet erected by our political administrators 
 of health laws (Potter). 
 
 Sneezing. 
 
 Arsenic, a drop of Liquor Arsenicalis three times a day in paroxysmal sneez- 
 ing, allied to asthma (R). Potassium Iodide, gr. x, several times a day (R). 
 Iodine inhalations, in paroxysmal sneezing with itching of nose (R). Camphor, 
 in incessant sneezing, with profuse running from eyes and nose ; the powder 
 should be snuffed, or the alcoholic solution inhaled (R). [Compare Catarrh, 
 Hay-fever, Influenza.] 
 
 Somnambulism. 
 
 Potassium Bromide, will give decided relief in the somnambulism of children 
 allied to epilepsy, often with squinting, which may become permanent, generally 
 the result of deranged digestion ; the nightmare of adults will usually yield to 
 the same drug (R). [Compare Nightmare.] 
 
 Spasmodic Affections. 
 
 Aconite, externally and internally, for spasms not of a severe type (P). Aconi- 
 tine, as ointment in the most severe, as well as in the milder local spasmodic 
 affections ; in angina pectoris, spasmodic asthma, cough, etc.(P) ; in spasmodic 
 laryngitis has good effect (R). Camphor is said to relieve in many forms, as 
 strangury, etc. (R). Hyoscine, is used with advantage in various spasms (Erb). 
 Belladonna, of value for spasms of sphincter muscles, especially those of pel- 
 vic organs (P) ; Atropine hypodermically in local spasm (R). Strychnine, of 
 great value in spasmodic asthma (P) ; also in tetanus, chorea, and epilepsy 
 (Pf, S). Veratrine, as solution, brushed over lids once a day in painful spas- 
 modic contraction of the orbicularis (Wa). Opium, very useful as an anti- 
 spasmodic, especially if given with a stimulant, as Alcohol, Ether, or Chloro- 
 form (R). Ipecacuanha, in spasms of respiratory organs, of great value (P). 
 Chamomile Oil, in spasms of hysterical persons, in 4 to 6 minim doses a very 
 excellent remedy ; also useful in pseudo angina pectoris (P). Lobelia, a valu- 
 able antispasmodic in cautious hands (P). Lupulin, in gouty spasms (P). 
 Tobacco, in spasmodic asthma, and for relaxation of muscular spasms (P). 
 Sumbul, is of use in gastric spasms (P). Cardamom, is usefully employed in 
 gastric spasms (P). Ammonia, useful in children's colic (R). Chloroform, in- 
 haled for intestinal spasm (P). Sulpho-carbolates, in flatulent spasm of 
 women, usually a neuralgia of the abdominal nerves, the pain being excited 
 by flatulence ; act by preventing the formation of wind, — sometimes Phos- 
 phorus better (R). Mustard Poultice, an excellent counter-irritant in spas- 
 modic affections (P). [Compare list of Antispasmodics on page 39, and in 
 this section the titles Angina Pectoris, Asthma, Chorea, Colic, Convul- 
 sions, Cough, Croup, Dysuria, Epilepsy, Gastrodynia, Hydrophobia, 
 Hysteria, Laryngismus, Pertussis, Stammering, Tetanus, Torticollis, 
 Trismus.] 
 
 Spermatorrhea. 
 
 Potassium Bromide, when due to plethora, erections normal, but persistent 
 and teasing ; is harmful in debilitated states, or daily losses (B) ; combined 
 with cold sponging and the use of a hard bed (R). Digitalis, 3j or ij of the 
 infusion twice or thrice daily ; few remedies are more successful in arresting 
 spermatorrhea (R, P) ; when feeble erections, frequent emissions, cold hands 
 
842 
 
 SPINA BIFIDA — SPINAL CONGESTION. 
 
 and feet (B). Cantharis deficient tone of seminal vesicles, erections feeble, 
 sexual feeling torpid ; the tincture, gtt. ij-iij ter du ( R) ; with Iron internally in 
 emissions (R). Phosphorus, for the induced ph) 'cal and mental debility; 
 also, Hypophosphites of Lime and Soda (R). Gelsemium, as anaphrodisiac, 
 may be combined with Belladonna or Cimicifuga (B). Nux Vomica, for relaxa- 
 tion and atony (B). Strychnine, in large doses, especially when impotence (R). 
 Quinine, has been recommended (R). Belladonna, gr. }( °f extract with gr. 
 jss of Zinc Sulphate, three or four times a day, often successful in nocturnal 
 emissions (R). Atropine, relaxed genitalia, no dream or orgasm (B). Camphor 
 Bromide, has been useful (W). Lupulin, is a good anaphrodisiac ; with 
 Camphor, when a genital sedative is required (B). Iron, the Iodide, is useful in 
 anemic cases (B). Ergot, beneficial in relaxed state (B). Hydrastis, is a use- 
 ful injection, gtt. x of the fluid extract through a urethral tube to the prostatic 
 portion of the urethro (B). Cimicifuga, useful in weak, relaxed conditions (B); 
 when hypochondriasis exists it is very beneficial (P). Hyoscine, is a most use- 
 ful remedy through its influence on the spinal centres (W). Silver Nitrate, a 
 vesicating solution applied to perineum generally useful, and without danger 
 (B); in solution, gr. xxx to the ^, applied by urethral syringe to the prostatic 
 portion of the urethra, is Lallemand's treatment, and still finds favor with many 
 surgeons (Whitla). Arsenic, when from weak and relaxed seminal vesicles. 
 Kind Advice, frequently the best treatment, as this affection is often due to the 
 phantasms of a morbid imagination. Bladder, should be emptied after the 
 first sleep. [Compare Emissions, Hypochondriasis, Impotence, also the 
 List of Anaphrodisiacs on page 31.] 
 
 R. Potassii Bromidi, . . . £j. 
 
 Sodii Bicarbonat., . . . gr. xv. 
 
 Infusi Digitalis, . . . . ^ss. 
 
 Atropinse Sulphat., . . gr. -^. 
 M. Sig. — One dose, to be taken at bed- 
 time. ( Gross. ) 
 
 R. 
 
 Tinct. Gelsemii, . . . ^j. 
 Tinct. Belladonnse, . . 3 ij. 
 M. Sig. — 15 drops thrice daily. 
 
 (B. 
 
 R . Lupulini, gr. x. 
 
 Pulv. Camphorse, . . . gr. vj 
 Ext. Belladonnse, . . . gr. ij. 
 M. ft. pil. no. xij. Sig. — One pill 
 daily. 
 
 R 
 
 thrice 
 (B.) 
 
 Tinct. Cantharidis, . . 3 ij. 
 
 Tinct. Ferri Chloridi, . ^vj. 
 M. Sig. — 20 drops in water thrice daily. 
 In impotence with spermatorrhea, of great 
 utility. (H. C. Wood.) 
 
 Spina Bifida. 
 
 Iodine, injected into the sac, £ss of tincture, or gr. ss, with Potassium Iodide 
 gr. v, aquae 3j, has cured numerous cases (B) ; Iodi gr. %, Pot. Iod. gr. % ad 
 aquae 3j (Wa). Collodion, as a means of compression (B). Bayer's Operation, 
 treats the tumor as if it were a hernia ; he dissects out two lateral flaps from 
 the skin covering it and removes the sac, leaving only two lateral flaps of the 
 dura, which he sews together, afterwards bringing the skin and muscles together 
 separately. 
 
 Spinal Concussion. 
 
 Lead-water and Opium, as lotion over the seat of injury (A). Leeches, if 
 pain persistent (A). During the early stage the treatment of shock must be 
 instituted, stimulants and restoratives being freely administered ; traumatic 
 neurosis may be treated with electricity, massage, hydropathy and the rest- 
 cure ; inflammatory symptoms require the treatment for acute or chronic 
 myelitis (Lyman). [Compare Myelitis.] 
 
 Spinal Congestion. 
 
 Ergot, gives excellent results (Brown-Sequard). Turpentine, as hotepithems, 
 useful (Wa). Antiphlogistic measures, with rest and absolute diet ; wet cups 
 
SPINAL IRRITATION — SPRUE. 843 
 
 or leeches to the column ; cool affusions or ice-bags to the spine while patient 
 is in a warm half-bath (Ros). [Compare Meningitis, Myelitis.] 
 
 Spinal Irritation. 
 
 Aconite, as ointment locally (R). Belladonna preparations, locally, gen- 
 erally are better than Aconite (B). Ignatia, in small doses diminishes irrit- 
 ability of cerebro-spinal axis (Pf). Strychnine, persistently, will ameliorate 
 wandering neuralgic pains due to irritability of nervous system (B). Ergot, 
 large doses for congestion (Hammond). Conium, in functional derangement 
 of the cord, with excessive irritability of the reflex function (Wa). Firing, 
 sometimes very beneficial (B). Electricity, the inverse galvanic current gives 
 much relief (Hammond). Blisters, with hot-water bag to spine, large doses 
 of Strychnine, Phosphorus, Phosphoric Acid and Opium, are the methods 
 based upon the anemic theory of the disease ; out of 156 cases so treated 133 
 were thoroughly cured (Hammond). [Compare Meningitis, Myelitis, Neu- 
 ritis, Neurasthenia.] 
 
 Spinal Paralysis and Softening. 
 
 Ergot, to starve the inflammation by occluding the spinal arteries (Ham- 
 mond). Electricity, best ; galvanic current from spine to nerves and muscles 
 (Ros). Mercury and Potassium Iodide, a thorough course, in spastic para- 
 plegia when syphilis is suspected (O). Massage, with forcible flexion and ex- 
 tension and proper apparatus, to overcome rigidity and contracture in infantile 
 spastic paraplegia, have often enabled a patient to get around comfortably (O). 
 Baths, warm, of every description, are useful in spastic spinal paralysis (Ly- 
 man). Suspension, has been tried with some degree of success (Id). In 
 softening the treatment must be palliative and supporting only (H). [Com- 
 pare Locomotor Ataxia, Myelitis.] 
 
 Splenic Affections. 
 
 Mercury Biniodide, gr. j to Z] of ointment, rubbed in before a hot fire, has 
 given excellent results in chronic malarial enlargement of the spleen (Wa). 
 Quinine, in simple malarial enlargement (B) ; gr. xv or xx or more daily, one 
 of the most effectual remedies (Wa). Ergot, the most effectual remedy for 
 enlarged spleen (Da C). Ammonium Iodide, effective in chronic splenitis, with 
 Unguent. Hydrarg. Iod. Rubn externally; also small doses frequently repeated 
 in all splenic derangements from malaria (B). Iodine, locally in chronic forms 
 (B). [Compare Leucocythemia.] 
 
 Sprains. 
 
 Arnica, is very useful ; the infusion internally and externally (P) ; the tinc- 
 ture diluted as lotion is very effectual (Wa). Aconite, the liniment to painful 
 sprains, often affords relief (Wa). Turpentine, as a liniment (P). Ammonium 
 Chloride, in solution, as lotion, or with bread as poultice, to remove discolora- 
 tion due to sprains (W). Rhus Toxicodendron, the tincture £ss to Oj of water 
 is a good application to sprains. Oil of Bay, as a stimulating liniment (P). 
 Cold Douche, salt may be added ; the force must be regulated by the condition 
 of the tissues (R). Heat, by fomentations alternated with cold affusions (D). 
 Rest, is the most essential measure and should be perfect ; a roller bandage 
 with splints may be required to secure the rest of the part. 
 
 Sprue. 
 
 Simaruba, the Ailanthus glandulosa, in large doses of a stronger decoction 
 than usually prepared, has given satisfaction in some cases of dysenteric origin 
 
844 STAINS STAMMERING STERILITY. 
 
 (Mn). Santonin, the yellow form, gr. v in Z] of olive oil, once or twice daily 
 for a week, has given good results (Begg) ; tried without benefit (Mn). Calcium 
 Carbonate, as powdered cuttle-fish bone or powdered crabs' eyes, two teaspoons- 
 ful at a time, after purgation by castor oil, also an aromatic tincture containing 
 probably Simaruba and Opium; the method of a successful but irregular 
 " sprue doctor " of Shanghai, who said that the object of his treatment was to 
 remove the slime which coats the bowel (Mn). Castor Oil, as an aperient 
 before commencing the milk-cure (Id). Rhubarb, the compound powder as an 
 aperient occasionally, when relapses of diarrhea, sore mouth and flatulent 
 dyspepsia (Id). Silver Nitrate, in solution by enema, for cases of dysenteric 
 origin (Id). Cocaine, in solution, gr. v to the ^, brushed over the painful 
 mouth before taking food, relieves suffering (Id). Borax, a weak solution as 
 mouth-wash after taking milk (Id). Fruit-cure, has given good results in Java; 
 the diet must consist entirely of such fruits as are pulpy and free from coarse 
 seeds, fibres, and excessive acidity, except pine-apple, which is interdicted (Van 
 der Burg). Milk-cure, is by far the most successful treatment ; at first not more 
 than 60 ounces in the 24 hours, sipped through a glass tube in small quantities 
 hourly. A ]/ z pint may be added daily after a few days, until 100 ounces are 
 reached, and after 10 days more this may be increased gradually to a daily 
 maximum of 6 or 7 pints. For 6 weeks after the stools become solid, and the 
 mouth free from irritation, no other food should be permitted (Mn). Kumyss, 
 sometimes agrees for a time when milk fails to give satisfaction (Id). Diet, 
 after the above-mentioned six weeks, may be varied by a raw egg added to the 
 milk; later, some artificial malted food, arrowroot or other digestible starch; 
 still later, fish or chicken (Mn). Meat -juice, obtained by squeezing a pound 
 of good beef-steak, cleared of fat and underdone, every 2 hours for 7 or 8 days 
 daily, in those cases where milk does not agree (Macleod). Hygiene, the 
 patient must never feel cold, and hence must dress warmly. He should not 
 return to the tropics (Mn). [Compare Dysentery.] 
 
 Stains. 
 
 Silver Nitrate Stains may be removed by washing with Potassium Cyanide 
 3ijss, Iodine, gr. xv, Water, ^iij ; or, after moistening the spots, drop on them 
 a few drops of Tinct. Iodine, and wash out with a solution of Sodium Hyposul- 
 phite, 3ss to ^j (B). Blood-stains, if on dark-colored materials are best seen 
 by an artificial light. After a few hours they become of a rusty, reddish-brown 
 color, which they maintain for years. The microscope shows the characteristic 
 corpuscles. These stains when on Iron are difficult to distinguish from rust; 
 the latter is not soluble in water, while blood is extremely so. Heat applied to 
 the metal will cause the blood to peel off, unless the stain has been exposed 
 long enough to have rust mingled with the blood. A solution of blood in water, 
 heated, forms a coagulum which is soluble in hot caustic potash, the solution 
 thus formed is green by transmitted light, and red by reflected light. Menstrual 
 blood cannot be distinguished from that resulting from a wound (Husband). 
 
 Stammering. 
 
 Vocal Training, the rhythmical method, the most successful, the chief end in 
 view being to regulate the precipitate, irregular form of respiration ; but long 
 continuance necessary, six months, a year, or more, in special institutions 
 (Ros). The patient must be taught the use of language anew, treated with 
 especial kindness, and never subjected to mockery or punishment. [See Potter 
 on Speech audits Defects, Lea Prize Essay, Philadelphia, 1882.] 
 
 Sterility. 
 
 Aurum, cures sterility when dependent on chronic metritis or amenorrhea, 
 or coldness, more certainly than any other remedy ; the Chloride, gr. 3^ (B). 
 
STINGS AND BITES — STOMATITIS. 
 
 845 
 
 Potassium Iodide, when due to syphilis (R). Dilatation of os and cervix care- 
 fully when sterility depending on obstruction, with dysmenorrhea (H). Ster- 
 ility is frequently associated with uterine displacement (Meadows); less often 
 with atresia. In persons of good health it may be caused by an acid discharge 
 from the uterus, which kills the spermatozoa ; for this Vichy water internally 
 and per vaginam, also alkaline baths (Charrier). Is due to aspermatism of the 
 husband in more cases than generally believed (Gross). Many cases are due 
 to blocking of the cervical canal with a morbid discharge from the cervical 
 glands, and such may be relieved simply by repeated cleansing of the canal 
 with a cotton-wrapped probe or forceps. 
 
 Stings and Bites. 
 
 Quassia, a strong infusion used as a wash in Java on the mat-covered floors 
 infested with fleas, the swarms vanishing as by magic (Neale). Ammonia or 
 Alkalies, a weak solution, in stings of insects, to neutralize the formic acid (R) ; 
 Ammonia, as nervine stimulant in snake-bites, more useful than brandy or any 
 other stimulant ; rr\,x-xx of Liquor Ammoniae in water or wine, every half hour 
 or oftener ; also externally or hypodermically, 1 in 2 of water into a vein 
 (Wa). Ammonium Carbonate, gr. v hypodermically, as used for wounds by 
 poisoned arrows. [See under Wounds.] Carbolic Acid, a weak solution 
 sponged over the body, to keep off mosquitoes (R). Salicylic Acid, 1 to 19 of 
 flexible collodion, locally for bites of insects; allays pain at once, and only in 
 rare cases is the neighboring tissue swollen. Mercury, the Bichloride, 1 to 1000 
 of flexible collodion, is equally effective. Potassium Permanganate, in strong 
 solution, 1 to 6 locally, is promptly efficient for all reptile-bites and insect- 
 stings ; if wound is small, make incision to enlarge it, and insert lint soaked in 
 the solution ; if a rattlesnake-bite, inject the solution hypodermically above the 
 wound (Dupon). Viola Cucullata, the common violet, is used as an internal 
 remedy in Pennsylvania for rattlesnake-bite, and is successful in a remarkable 
 degree ; the leaves are eaten, and a poultice of Indigo and salt is at the same 
 time applied to the wound. Arsenic, 1 part to 5 of black pepper, is the Tan- 
 jore pill, highly esteemed in India for bites of venomous snakes (Wa). Cal- 
 cium Chloride, a filtered solution injected into wound from snake-bite, success- 
 ful in seventeen cases (Binz). Silver Nitrate, the sharpened stick applied to 
 every sinuosity of the wound ; excision safer (Wa). Sugar, applied to stings 
 of wasps, said to relieve almost instantly (Wa). Ipecacuanha, as poultice or 
 paste, allays pain or irritation ; is regarded by some as almost specific (Wa). 
 Antivenene [see page 183], is an effective antitoxin against the venom of 
 several serpent species (Fraser). Stimulants, in snake-bites, freely, are most 
 important; Liquor Ammoniae the best (Wa) ; stimulants are indicated in 
 snake-bites, but there is no remedy of any value therefor (Gross). Sting, 
 should always be removed if left in the wound ; pressing upon it with the bar- 
 rel of a small key will expose it. [Compare Wounds.] 
 
 R. 01. Picis Liquids, 01. Oliva?, 
 
 01. Hedeomae, .... aa^j. 
 
 Spt. Camphorse, 
 
 Glycerini, . . . . aa^ss. 
 
 Acidi Carbolici, . . . . 31J. 
 M. Sig. — Shake well. Lotion against 
 mosquitoes, for fishermen and hunters. 
 
 R 
 
 . Carbonis Vegetab., . . 
 
 . fib j. 
 
 
 
 Potassii Nitratis, . . . 
 
 • ■| i J- 
 
 
 
 Acidi Carbolici, .... 
 
 • 3J SS - 
 
 
 
 Persian Insect Powder, . 
 
 • 3 vii i- 
 
 
 
 Mucil. Tragacanth., . . 
 
 . q. s. 
 
 
 
 To make fumigating pastilles for 
 
 use 
 
 ^g 
 
 ainst mosquitoes. 
 
 
 
 Stomatitis. 
 
 Potassium Chlorate, locally and internally ; large doses necessary, gr. x-xx ; 
 in ulcerative stomatitis of nursing women and aphthae, of no value in mercu- 
 rial form (R). Hydrastis, the fluid extract locally in mercurial and aphthous 
 stomatitis (B). Glycozone, frequently applied, is of benefit in ulcerative 
 
846 STRABISMUS — SUPPURATION. 
 
 stomatitis (Edson). Carbolic Acid, a concentrated solution in glycerin care- 
 fully, as a mild caustic in aphthous stomatitis (Wa). Alcohol, Brandy-and- 
 water an excellent lotion (B). Mineral Acids, pure Hydrochloric applied on 
 pine wood to ulcers (B). Eucalyptus, a decoction of the leaves, locally (B). 
 Glycerite of Tannin, in ulcerative stomatitis (R). Copper Sulphate, solution 
 painted over edges of gums in ulcerative stomatitis; generally dry Alum 
 better (R). Alum, in ulcerative form, applied dry with the finger several 
 times a day, especially when disease affects one-half the jaw (R). Salicylic 
 Acid, to ease the pain of catarrhal stomatitis ; one part, dissolved in sufficient 
 Alcohol, to 250 parts of water (R). [Compare Aphtha, Cancrum Oris, 
 Sprue.] 
 
 Strabismus. 
 
 Belladonna, for the strabismus of encephalitis (P). Atropine, with strong 
 convex glasses, to suspend accommodation for months, or years if necessary; 
 may cure convergent strabismus in its earlier stages, in children of 3 years of 
 age and younger (Green in C). Operation, required in most cases, especially 
 when of congenital origin. Glasses, properly adjusted to sight, serve to 
 strengthen the weak muscles in children, and to pull the axes right (Gould). 
 
 Strophulus. 
 
 Nitric Acid, Ac. Nitrici Dil. 3ss-j, Bismuthi Subnit. £ss, Tinct. Digitalis 3j, 
 Glycerini ^ss, Aquae Rosas ^vij, applied to the affected parts frequently (Wa). 
 Zinc Oxide, dusted freely over the part. Magnesia, or some other mild alkali, 
 with improved feeding and aperients, to which measures this affection gener- 
 ally yields in infants. Lancing the gums is proper (H). [Compare Lichen.] 
 
 Sunstroke. 
 
 Veratrum Viride, and Gelsemium, as sedatives, instead of stimulants, when 
 the pulse is full and strong (Ely). Water, as cold affusion when the patient is 
 stricken down unconscious (R) ; absolute rest and quiet, free air, loose clothes. 
 Potassium Bromide, in cold water by enema. Stimulants when the pulse is 
 frequent and feeble. Chloroform, if convulsions. Leeching, in the stage of 
 reaction (Wa). [Compare Heat-stroke.] 
 
 Suppuration. 
 
 Sulphides, small doses, gr. ss-j, frequently repeated, are very serviceable 
 (B). Calcium Sulphide, when ichor secreted instead of pus ; also arrests sup- 
 puration, or if that is impossible will hasten maturation (R). Quinine, recom- 
 mended in profuse suppuration (R) ; to sustain system when suppuration pro- 
 longed (B). Sarsaparilla, is very useful (P). Phosphates, Parrish's syrup to 
 repair waste from suppuration (B). Iron and Manganese Iodide, the syrup in 
 cachectic states resulting from suppuration (B). Hydrogen Dioxide, is a most 
 energetic pus-destroyer ; the solution may be applied in lull strength, or diluted 
 with an equal part of water. Glycozone, acts similarly but more slowly ; after 
 cleansing by Hydrogen Dioxide solution, the application of Glycozone stimu- 
 lates healthy action and hastens the cure ; for which purpose it has no superior 
 in the entire range of therapeutics (Edson). Bismuth Subiodide, dusted over 
 a suppurating surface after cleansing, is highly efficient as an antiseptic and a 
 stimulant of healthy granulation. Acetanilid, is effective for 2 or 3 days, but 
 ultimately fails to prfevent suppuration (Foote) ; the following combination, 
 used as a dressing, absolutely inhibits suppuration where it can reach the 
 wound surface, and checks and quickly abolishes suppuration if that be 
 already present, — Acetanilid, powdered, 48 ; Boric Acid, powdered, 1 5 ; Starch, 
 
SURGICAL FEVER SYNOVITIS. 847 
 
 powdered and finely sifted, 35 ; Carbolic Acid, liquid, 2. It should be changed 
 twice daily as long as there is discharge to moisten it, when the wound becomes 
 dry the dressing may be left on for days (Fallas). Nuclein, has been used 
 successfully in suppurative disorders (Vaughn). [Compare Abscess, Boils, 
 Carbuncle, Septicemia.] 
 
 Surgical Fever. 
 
 Aconite, quickly and repeatedly administered in early stages, during chill or 
 soon after, the safest treatment (P). Salicylic Acid, or Sodium Salicylate, espe- 
 cially useful as an antipyretic (B). Chloral, gr. xv-xxx every 2 hours ; there 
 is no better treatment (Wa). 
 
 Sycosis. 
 
 Nitric Acid, 3J to Oj aquae, as wash, used frequently (R). Boracic Acid, 
 3jss finely powdered and incorporated with gj of Vaselin, is found most use- 
 ful (Wa). Salol, as an antiseptic powder, has done good service. Mercury, 
 Citrine Ointment has been extensively employed, also the Oleate of Mercury, 
 both with good results (Wa). Arsenic, the Oleate, is found beneficial, and the 
 Solution of Arsenic and Mercury, Donovan's solution, internally is highly 
 useful. Mercurial Ointments, are extensively employed (Wa). Sodium Sul- 
 phite 3j» Glycerin ^j, Water giij, locally, when of parasitic origin (Wa). 
 [Compare Condylomata, Mentagra.] 
 
 Syncope. 
 
 Nux Vomica, in drop doses of the tincture every 5 minutes, to restore the 
 cardiac action in extreme cases of syncope approaching heart-failure, especially 
 when of neurotic origin ; is promptly efficient (Macfarlan). Cinnamon, the Oil, 
 as a powerful stimulant, is sometimes employed (P). Alcohol, as brandy or 
 wine, when heart suddenly enfeebled from fright, etc. (R). Amyl Nitrite, in 
 some forms, especially in anemic subjects, its inhalation speedily restores con- 
 sciousness (O'Neill). Atropine, gr. x^— ±V subcutaneously, the best means of 
 resuscitation, there being no medicine which so promptly exalts the force and 
 rapidity of the heart's action (Harley). Duboisine, may be used instead of 
 Atropine. Ammonia, internally, or breathed into the air-passages (R) ; the 
 Carbonate as smelling salts (Wa). Lavandula, the compound tincture (Wa). 
 Chloroform, internally, for hysterical people, as cardiac stimulant (R). Posi- 
 tion, leaning forward, with head as low as possible (R). Galvanization, of the 
 pneumogastric (B). Cold Water over the face, and volatile substances to the 
 nose (B) : cold affusion always (Wa). [Compare Heart Affections.] 
 
 Synovitis. 
 
 Potassium Iodide, with Iron and Quinine, in syphilitic patients with consti- 
 tution broken down (D). Iodine, in chronic synovitis, painted around joint; 
 the solution injected into white swelling (R). Quinine, and free stimulation in 
 all cases of pyemic synovitis, such as occurs in acute rheumatism of gonor- 
 rheal causation, occasionally in typhoid fever, and may result from a trifling 
 injury in strumous subjects. Mercury, and Morphine, the Oleate locally (R) ; 
 an elegant and efficient application (B) ; in syphilitic cases Mercury internally 
 when acute symptoms have subsided (D). Aconite, for pains in inflamed 
 joints (R). Silver Nitrate, locally to vesication almost, often very beneficial 
 (Wa). Carbolic Acid, injected into joint (B). Alcohol, and water, equal parts, 
 an excellent evaporating lotion (B). Blisters, a flying blister every night in 
 chronic synovitis (R). Cod-liver Oil, in strumous cases (B). Surgical Treat- 
 ment, splints to keep the limb motionless in all cases arising from injury ; during 
 acute stage splint should be fastened at some distance above and below the 
 
848 SYPHILIS. 
 
 joint, not touching the joint itself; straight position, leeches to the joint, or 
 cupping near it ; ice, evaporating lotions or hot fomentations ; blisters inapplic- 
 able until the acute stage subsides (D) : if suppuration occurs the joint must 
 be dealt with as any other abscess cavity (MacCormac). Heat, as fomentations 
 or poultices in the acute form. The results of dry heat, applied by the Taller- 
 man apparatus seem almost marvelous in traumatic synovitis, whether in base- 
 ball men or other persons (W). Bandage, or Strapping, to cause absorption of 
 fluid ; bandage with cold water after alternate bathing with hot and cold water, 
 in chronic synovitis. [Compare Coxalgia, Joint Affections.] 
 
 Syphilis. 
 
 Mercury, the mainstay in the earlier and later stages ; the Protiodide in pills 
 of gr. Ye each, one after each meal increased by one every third day, until teeth 
 get sore or bowels disordered, then drop two pills from each dose (Keyes) ; 
 the best remedy for primary and secondary forms, not in tertiary ; small doses 
 are best, stopping short of ptyalism (B) ; Blackwash, Calomel, or Citrine Oint. 
 very useful in mucous sores, tubercles, and elevated indurations ; in syphilitic 
 ozena, psoriasis, rashes, condylomata, etc., the Bichloride, gr. ij-v in ^j of Al- 
 cohol, painted over syphilitic mouth lesions daily (Keyes) ; Mercury is believed 
 to be a true vital antidote against the virus (R) ; used for at least two years can 
 eradicate it (Keyes): internal administration best because most practicable ; the 
 two great preparations are the Bichloride and Protiodide (Fournier): by intra- 
 muscular injection, which method offers many advantages in army practice [see 
 page 344 for formula], and has given me the very best results (Lambkin). Nitric 
 Acid, in secondary forms (R) ; holds a high place as an internal remedy (Wa); 
 when sponginess of gums excessive, 3\v to %\j aquas, teasp. 4 times daily ; 
 also use locally (St) ; as cautery for the initial lesion, the fuming acid, if used 
 at all, should be applied early and thoroughly, followed by Blackwash locally 
 on lint (Bulkley). Potassium Iodide, is approached by no remedy in constitu- 
 tional syphilis ; also for mercurial cachexia, syphiloma of nervous system, and 
 many disorders of syphilitic origin ; will certainly arrest ulceration of nares, 
 palate, etc., if given in large doses, gr. xx-£j every 4 hours (R) ; is of little 
 value in early stages ; in the later should be combined with Mercury (St). 
 Rubidium Iodide, is more pleasant than Potassium Iodide, having a milder 
 taste, and is born far better, especially by the stomach and in regard to the 
 production of iodism and cardiac difficulties (Neisser) ; is indicated in patients 
 in a low state, with weak cardiac activity (Mering) ; in doses of ^jssto Jjiij of 
 a 5 per cent, solution daily, gave the best possible results without troublesome 
 disturbances (Bunge). Iodine, as gargle for ptyalism ; the tincture applied to 
 syphilitic sores of the throat (R); or ^ss of tincture to ^iv Syr. Fusci., a tea- 
 spoonful well diluted ter die, after meals, when Potassium Iodide can not be 
 borne (St). Iodoform, powdered and dusted over ulcers (B). 
 
 Aurum, after Mercury and the Iodides, in old cases of secondary and ter- 
 tiary, ulceration of the throat, ozena, phthisis, syphilitic bone-diseases (B) ; its 
 beneficial action incontestable (Tr) ; the Bromide of Gold and Arsenic has 
 rendered good service in trifacial neuralgia diagnosed as due to syphilis (E. A. 
 Wood) ; Gold is unquestionably useful in the later stages, its best effects being 
 obtained with very small doses (Pf ) : the Bromide of Gold, Arsenic and Mer- 
 cury (Mercauro) is highly praised in the late manifestations of syphilis, espe- 
 cially in those affecting the nervous system. Stillingia, with Nitric Acid in 
 chronic cases of broken-down constitutions from abuse of Mercury and Iodides 
 has been most satisfactory (B). Cascara Amarga, is said to have remarkable 
 powers as an alterative in syphilis, but to be useless if alcohol and tobacco are 
 used at the same time. Sanguinaria, in secondary and tertiary forms is held 
 to be very useful (P). Sarsaparilla, a most important remedy, as adjunct to, 
 and in abuse of Mercury (P) ; with Guaiac and Mezereon, as the Compound 
 Decoction of Sarsaparilla, in tertiary form (B). [See Guaiac, below.] Bella- 
 
TABES MESENTERICA. 
 
 donna, with Mercurial Ointment, for secondary ulcerations of rectum (P) ; the 
 tincture 3iv ad ^ij aquas, a teaspoonful 4 times a day in water, instead of mer- 
 curials (St). Iron, the Iodide in constitutional syphilis, to promote constructive 
 metamorphosis (B) ; where anemia exists (R) ; the Potassio-Tartrate, gr. xv-xx, 
 every 4 hours, especially in the gangrenous form (Otis). Guaiacum, in tertiary 
 syphilis only, or as vehicle for Potassium Iodide and Mercuric Chloride (B). 
 Carbolic and Salicylic Acids, locally to syphilitic abscesses, Carbolic best (B). 
 Zinc Chloride, Iodide, Nitrate, locally to syphilitic ulcers (R). Syphilis Anti- 
 toxin, has been used with encouraging results [see page 183]. Denutrition, the 
 Arabic "hunger-cure" efficient, but unpopular (B). Turkish Baths, or wet 
 packing, ameliorate and aid the cure of constitutional syphilis (B). Hygiene, 
 is of the greatest importance in syphilis (Bulkley). Cod-liver Oil, remarkably 
 improves condition resulting from prolonged use of Mercury and Iodides, the 
 syphilodermata, and squamae ; internally and by inunction (R). [Compare 
 Chancre, Condylomata, Ptyalism, Ulcers.] 
 
 gr. in. 
 
 R . Hydrarg. Iodidi Rubri, 
 
 Potassii Iodidi, . . . 
 
 Tinct. Aurantii Cort, 
 
 Syrup. Aurantii Cort., aa !|j. 
 
 Aquae, . . . . q. s., ad£\n]. 
 M. Sig. — A teasp. thrice daily after 
 meals. ( Otis, for the Mixed Treatment. ) 
 
 R . Hydrarg. Bichloridi, . . gr. iv. 
 
 Tinct. Benzoini, . . . . 5ss. 
 
 Aquae Cologniensi, . . . gj. 
 
 Aquae Rosae, ^ivss. 
 
 M. Sig. — Apply locally with sponge to 
 skin for 20 minutes. For squamous syphil- 
 ides. (S. W. Gross.) 
 
 R. Massae Hydrargyri, . 
 Ferri Sulph. Exsiccat. 
 
 Extr. Opii, 
 
 In pill, thrice daily. 
 
 g r - J- 
 
 g r - X- 
 {Otis.) 
 
 R . Hydrargyri Bichloridi, 
 
 Ammonii Chloridi, . . aagr. iij. 
 Tinct. Cinchonae Comp. , 
 
 Aquae, aa^iij. 
 
 M. Sig. — A teasp. thrice daily. Each 
 
 3 contains gr. -^ of Corrosive Sublimate. 
 
 (Bumstead.) 
 
 R. Hydrarg. Iodidi Rubri, . gr. ij. 
 
 Ammonii Carbonatis, . . gr. xx. 
 
 Potassii Iodidi, . . . . 3 iij. 
 
 Tinct. Gent. Co., q. s., ad^iv. 
 M. Sig. — A teasp. in water after each 
 meal. {Fox , for the Mixed Treatment.) 
 
 R. Hydrarg. Chlor. Mitis, 
 
 Lycopodii, aa^ij. 
 
 M. Sig. — Use as snuff thrice daily, in 
 lesions of the nostrils. {Diday. ) 
 
 The Three Eights. 
 
 R. 
 
 Hydrarg. Chlor. Corr., . gr. viij. 
 Potassii Iodidi, .... g viij. 
 Syr. Sarsaparillae Co., . ,f viij. 
 M. Sig. — A teasp. thrice daily. 
 
 R 
 
 M. 
 
 Potassii Iodidi, . . . . 3 i j . 
 Ammonii Carb., . . . . 3 ss. 
 Tinct. Cinchonae Comp.,^iv. 
 
 Glycerini, j^j. 
 
 Syr. Aurantii Cort., . . 3Jss. 
 Sig. — A teasp. in plenty of water 
 
 after each meal. 
 
 {Keyes.) 
 
 Tabes Mesenterica. 
 
 Calcium, the Chloride and Phosphate (R) ; the former is a powerful remedy 
 if kept up (Wa). [See under Scrofulosis.] Iodine, with Cod-liver Oil by in- 
 unction (El) ; locally over glands ; carefully, lest inflammation be increased (R). 
 Potassium Iodide in small repeated doses, valuable (Wa). Mercury, Corro- 
 sive Sublimate with bark ; gr. j ad £ij Tinct. Cinchonae, after meals, for chronic 
 glandular disease (D). Phosphates, for malnutrition (B) ; the Hypophosphites 
 act slowly but surely (Wa). Iron and Iodine, in various forms are the most 
 useful remedies in scrofulosis, but medicine is powerless without strict hygienic 
 measures (A) ; the Iodide or Phosphate of Iron and Cod-liver Oil, as for tuber- 
 cle elsewhere (El). Fel Bovinum, is worthy of trial, though at best a palliative 
 (Wa). Cod-liver Oil, is the best remedy to promote assimilation (B) ; of great 
 54 
 
85O TASTE — TEETH — TEMPERATURE. 
 
 service (R). Chaulmoogra Oil, is of benefit, used by inunction (Wa). Aliment, 
 raw meat, cream, chocolate, and cocoa, are valuable nutriments in these cases 
 (El) ; peptonized foods are of inestimable value (Wa). Hygiene, change of air, 
 especially to sea-air, is all-important (El). [Compare Scrofulosis.] 
 
 Taste, Disordered. 
 
 Mercury or Podophyllin, as purgative for cankery taste unconnected with 
 alcoholism ; or half-glass of pure cold water daily half an hour before break- 
 fast (R) ; y$ gr. of Gray Powder 3 or 4 times a day will generally remove the 
 disagreeable taste in the mouth due to dyspepsia, in the course of chronic dis- 
 ease or in early convalescence from acute illness (R). Electricity, faradization 
 as a stimulant of the nerves in the tongue, may aid the recovery of function 
 when loss of taste is due to nerve disease (Gowers). 
 
 Teeth. 
 
 Potassium Iodide, in doses of gr. x, thrice daily, often cures looseness of 
 teeth from periostitis of alveolar processes (Wa) ; Iodine, the tincture painted 
 over gums close to the teeth when the gums begin to recede ; also to remove 
 tartar (R). Cinchona, powdered bark often used in tooth-powders (R). Col- 
 lodion, on cotton, as filling for carious teeth (P). Liquor Sodae Chloratae, 
 3yj and ^xij aquas, a highly useful application in fetid discharges from carious 
 teeth (Wa). [Compare Dentition, Gums, Odontalgia.] 
 
 Temperature in Disease. 
 
 Average Normal Temperature, of adults, 98. 6° F. ; of children, 99 ; of the 
 aged, 98. 8°. Diurnal variation i° to 1.5° F., highest from 9 a.m. to 2 p.m. 
 Above 108 F. is a fatal sign, which issue may be averted by cold baths, reduced 
 by ice from 96 to about 6o° F. (A). The clinical thermometer placed in the 
 mouth, axilla or rectum, and retained in situ for five minutes, should go hand 
 in hand with Aconite in the treatment of inflammations (R). [For Antipyretics 
 see the articles on Fever and Inflammation, also the list of these agents 
 on pages 37 and 38.] 
 
 Clinical Thermometry is one of the principal means of positive diagnosis. 
 The thermometer should be self-registering, certified, and accurately marked 
 according to the Fahrenheit scale. The most reliable temperature is that in 
 the rectum or vagina ; less so in the axilla and folds of skin, and still less re- 
 liable in the mouth. A correct reading of the thermometer cannot be obtained 
 in less time than five to seven minutes (Da Costa). 
 
 The Average Normal Temperature of the body is 98. 6°, which, like the pulse, 
 will vary somewhat in individual cases ; as a general practical result it is agreed 
 that in temperate regions the normal temperature at completely sheltered parts 
 of the surface of the human body amounts to 98.4 Fahr., or a few tenths more 
 or less ; and a rising above 99. 5 , or a depression below 97. 3 F., is a sure indi- 
 cation of some kind of disease, if the increase or depression is persistent. 
 The temperature is increased at the prime of life, is raised and depressed 
 temporarily by the influence of diet, stimulants, exercise, etc. The minimum 
 diurnal temperature is observed at 2 a.m., the maximum at 4 to 6 p.m. The 
 greatest recorded range of temperature in disease is 50.4 ; the minimum is 
 7 1. 6° in a case of sclerema neonatorum (Quain's Diet.), the maximum 122 . 
 In severe and fatal cases it rarely exceeds 107 , and rarely falls below 92 , even 
 in fatal collapse. It may rise 3 to 4 after death, as observed in a case of typhoid 
 fever in which death occurred with a temperature of 107 , which increased 
 shortly afterwards to 110.5 . A temperature of 107 indicates malignancy, and 
 
TEMPERATURE. 85 1 
 
 when met with for two consecutive days in typhus, scarlatina, measles, pneu- 
 monia, pyemia, meningitis or rheumatism, death may be expected shortly. 
 In relapsing, remittent and intermittent fevers, and in the initial chill of an 
 abortion, the temperature may reach 107 without indicating great danger. 
 During the last hours of life in many diseases, the temperature rises to 109 - 
 iii° ; for example, in tetanus, sunstroke, typhus, etc. With a temperature of 
 96 collapse is imminent. 
 
 Abnormally High Temperatures reported in the British Medical Journal, by 
 Dr. Donkin, include those of eight cases, all but one in females, and none 
 proved fatal. Pain was a prominent symptom in all. (1) 111.6 ; convalescing 
 from enteric fever. (2) 108 ; no organic lesions; ovarian pain. (3) 115.8 ; 
 great abdominal pain and excitement. (4) in°; convalescing from enteric 
 fever. (5) 113°; enteric fever and double pneumonia. (6) 11 2°; synovitis; 
 this was the only male. (7) 112 ; painful stump, with necrosis. (8) 117 ; 
 pyonephrosis. Dr. Jacobi of New York reported a case of injury in which the 
 temperature taken in the mouth, axillae, rectum and urethra, before many wit- 
 nesses and with many thermometers, was 148 F. and yet the patient did not 
 die. Dr. Welch mentioned as a well-known case, one Galbraith of Omaha, in 
 whom the temperature went to 17 1° F. for some hours. 
 
 High Average Temperature (above 104 ), is found in severe pneumonia, 
 scarlatina, remittent, typhus, typhoid and relapsing fevers, pyemia, etc. Mod- 
 erate High Temperature (102 and above), is seen in peritonitis, acute rheu- 
 matism, pericarditis, pleurisy, dysentery, cerebro-spinal meningitis, catarrhs, 
 etc. A temperature of ioo° and above is found in chronic affections, incipient 
 inflammations and mild fevers. When, in effervescence, the heat increases 
 rapidly, it will in defervescence decline proportionately fast and vice versa. 
 Look for a grave affection when high temperature is of continuous type. A 
 distinct interval between the morning and evening temperature is a favorable 
 sign. A slow and gradual increase indicates typhoid fever; in rheumatism 
 and anomalous fevers the increase is more rapid, and still more so in acute 
 inflammatory disease, as pneumonia, pleurisy, typhus, scarlatina, rubeola, 
 etc. The rise is usually rapid in intermittent fever, febricula, and ephemeral 
 fevers. A rapid effervescence and slow defervescence indicates some com- 
 plication of disease ; the reverse order indicates great danger. When the 
 temperature begins to fall from the evening to the morning, it is an indication 
 of improvement ; while a rise of temperature from the evening to the morn- 
 ing is a sure indication that the patient is worse. Stability of temperature 
 from morning to evening is a good sign, but from evening to the morning is 
 unfavorable. 
 
 Decrease of Temperature below the normal point is rare. It occurs some- 
 times transitorily, announcing a favorable crisis, by preceding the return to 
 the normal temperature. It is also met with occasionally during the morning 
 remission of remittent fever ; also during the apyrexia of intermittents ; in acute 
 collapse, preceded or not by fever ; in chronic wasting diseases, and some- 
 times also on the approach of death, especially in typhus fever. 
 
 In Phthisis, the temperature is higher in the evening than in the morning ; 
 later, higher at early bedtime than at noon, and high again at dusk. This is a 
 valuable and delicate test of the progress of tuberculization. 
 
 In Typhoid Fever, the accession is by a rise of one degree each day, with the 
 diurnal variation. If the evening temperature does not exceed 103. 5 , the dis- 
 ease will probably be mild ; but a temperature of 105 in the evening indicates 
 a severe type and much danger. A sudden reduction to 95 in the third week 
 denotes intestinal hemorrhage; a lingering temperature of ioi°-io2° in the 
 fourth and fifth weeks indicates non-cicatrization of the intestinal ulceration. 
 
 In Scarlatina, the rise of temperature is rapid, 104. 7 may be reached in a few 
 hours and 105 by the second day. It seldom rises above 105 and almost 
 never above 106 ; is continuous until the eruption begins to fade, when remis- 
 sions take place unless complications arise. 
 
852 TESTICLES TETANUS. 
 
 In Measles, 103 is the usual temperature, with daily variations, increasing 
 with the eruption and catarrhal symptoms. A high temperature lasting beyond 
 the tenth day denotes complications. 
 
 In Diphtheria, the temperature by the end of the third day will, in uncom- 
 plicated cases, not exceed io3°-io4°. It falls temporarily when the exudation 
 appears. Defervescence occurs in the severe but favorable cases, from the 
 twelfth to the fourteenth day; in the milder cases not before the sixth. In 
 some fatal cases it occurs early, from the third to the fourth day. In asthenic 
 cases the temperature of the surface falls, while that of the interior remains 
 high, ioo° in the axilla and 103 in the rectum. During convalescence, the 
 temperature is low and readily depressed, but may be raised by intercurrent 
 maladies. Any increase after the first five days, or a continuous high tem- 
 perature after the first ten days, is unfavorable. A sudden rise may indicate 
 complications. 
 
 Co-Relation of Pulse and Temperature. — As a general rule the co-relation 
 of pulse and temperature may be stated as follows, namely : — an increase of 
 temperature of one degree above 98 F. corresponds with an increase of ten 
 beats of the pulse per minute. 
 
 Testicles. 
 
 Mercury, the ointment, locally in indurations and enlargements of testes 
 (Wa) ; Corrosive Sublimate, with Cinchona or Sarsaparilla in sarcocele (D). 
 Camphorated Naphtol, used hypodermically in tuberculosis of the testis with 
 very gratifying results (Reboul). Aurum, is highly recommended in hypochon- 
 driasis accompanying testicular disease, and as a tonic for low-spirited, pining 
 boys with undeveloped testes. Water, cold applications in neuralgia of testes 
 with tonics and neuralgic treatment generally (D). Suspensory Bandage, with 
 rest, in many affections of the testes (D). [Compare Hydrocele, Orchitis, 
 Varicocele.] 
 
 Tetanus. 
 
 Potassium Bromide, not less than ,^ss during the day, with Chloral at night 
 as a hypnotic ; out of 21 cases so treated but 3 died; its physiological action 
 indicates it to be the best remedy known (W) ; in very large doses, 3j every 3 
 or 4 hours, has given better results than any other remedy (B). Chloral, in 
 full doses, gr. xx, no remedy more effectual (B) ; has sometimes cured (R) ; 
 best used in combination with Potassium Bromide (W). Chloroform, in small 
 and frequently repeated inhalations, also by friction, has been useful in many 
 instances (Wa) ; anesthetics give temporary relief (B) ; four cases of acute tet- 
 anus treated successfully by chloroform inhalations, the daily dose varying from 
 3ij to iv (Preobrajensky). Paraldehyde, promises well, in full doses, ^ij-ijss; 
 does not depress the heart, as chloral and the bromides do (B). Strych- 
 nine, of decided service (P) ; cured 8 cases of traumatic form in doses of gr. 
 tV t0 MS) ; the evidence as to its curative power is of doubtful credence, but 
 it is most successful in spontaneous and chronic cases rather than in the 
 traumatic form (B). Aconite, has benefited many cases (P) ; its success war- 
 rants further trial (W). Belladonna, successfully used in many cases ; the ex- 
 tract internally, and locally to wound (Wa) ; Atropine, gr. T | 7 injected into 
 muscle (B); bleeding, vapor-baths, and large doses of Belladonna have cured 
 tetanus (Tr). Nicotine, by rectum or hypodermically, appears to be useful in 
 many cases (R) ; much evidence for it as the best remedy (P) ; effective but 
 dangerous (B) ; Physostigma better (Wa). Physostigma, has been used with 
 excellent results (P) ; the fluid extract by mouth if possible, at the very begin- 
 ning, and must be pushed until just short of arresting breathing (B) ; evidence 
 is discrepant (W). Apomorphine, may prove antagonistic (P). Curare, hypo- 
 dermically, has much evidence for its power (P). Cannabis Indica, used with 
 marked success in traumatic form (P) ; it is difficult to obtain an active extract 
 
THIRST THROAT. 853 
 
 (W). Cocaine, and morphine, of each a 5 per cent, solution, 3 syringesful 
 hypodermically, immediately relieved and finally cured a bad case of idiopathic 
 tetanus unrelieved for 3 days by chloral, morphine, etc. (Lopez). Gelsemium, 
 has cured several cases (P) ; its spinal action is opposed to that of tetanus (B). 
 Hyoscyamine, or Duboisine, gr. ■£% gradually increased to gr. ^$, is very efficient 
 (Oulmont). Antipyrin, antagonizes excitability of the motor nerve centres, 
 and has been used with benefit. Amyl Nitrite, used in 3 cases with marked 
 benefit as spinal sedative (W) ; has been used with success (R). Morphine, 
 hypodermically, deeply into tetanized muscles, and if possible to the point of 
 entrance of the nerves, used with successful results (Demarquay) ; as ordinarily 
 used is of no value (Wa). Tetanus Antitoxin, is unquestionably the most effi- 
 cient remedy known for this disease [see page 180]. Conium, is indicated, 
 but has not been successful (B). Water, as warm baths, and cold, or ice, af- 
 fords only temporary amelioration (B). Spinal Ice Bag, extremely useful (R). 
 Division, or stretching of any nerve-trunk connecting the wound with the spinal 
 cord. [Compare Spasmodic Affections.] 
 
 Thirst. 
 
 Acid Drinks, allay thirst by promoting the secretion of the alkaline saliva ; 
 but excessively used will derange the stomach (R). Bitters, in drinks with 
 acids slake thirst most effectually (R) ; a weak infusion of Cascarillaor Orange- 
 peel, acidulated slightly with HC1 acid, an efficient thirst-quelling drink for 
 fever patients (Graves). Ice, sucked, is very grateful, and allays thirst in fevers 
 (R). Tepid Drinks, are useful in the thirst of diabetes (Prout). Fruit Juices, 
 or these made into drinks, but the most harmless agents must be used in mod- 
 eration, and their consumption has to be checked, otherwise patients will take 
 them to excess and may thus do themselves considerable injury (Fenwick). 
 
 Throat, Sore. 
 
 Aconite, when temperature high, half-drop doses of the tincture, every ^ hour 
 for 2 hours, then every hour, will almost certainly prove efficacious (R) ; valu- 
 able in ordinary sore throat (P). Belladonna, is very admirably adapted to the 
 treatment of ordinary sore throat ; when much fever combine with Aconite 
 (R, P). [See under Catarrh, Acute.] Nitre, dissolved in mouth, to abort a 
 sore throat (Wa). Tannic Acid, as powder, gargle, spray (P) ; the Glycerite of 
 Tannin, after acute inflammation ; in ulceration of aphthous sore throat daily 
 when tendency to catarrh (R). Ipecacuanha, the wine as spray, in non-inflam- 
 matory sore throats and hoarseness from congestion of vocal cords (R). Capsi- 
 cum, 5j of tincture to 0%, aquae as gargle, in some sore and malignant sore 
 throats (R, P). Potassium Chlorate, in grain doses every half-hour (Smith). 
 Alum, dry, or in solution (R). Myrrh, as gargle in ulcerated sore throat (P). 
 Guaiac, the compound guaiac gargle [see page 576] is often very efficient in sim- 
 ple sore throat and commencing tonsillitis. Chloral, internally and locally, is an 
 excellent remedy for ulcerated sore throat (Brodnax) Cimicifuga, in simple sore 
 throat (P) ; also in malignant forms when the mucous membrane is dry and 
 spotted with inspissated mucus (R). Mercury, in acute tonsillitis, which see (R) ; 
 the Bichloride as a gargle [formula on next page], in ulcerated forms of syphi- 
 litic sore throat (Sir Chas. Bell). Rhus Glabra, a decoction, ^j toOj boiled to 0% , 
 with Potassium Chlorate ^ss, is a very efficient gargle(W). Arsenic, in medic- 
 inal doses, for sloughing of throat or malignant sores (R): the Iodide is an 
 excellent remedy for the so-called diphtheritic sore throat, gr. iij triturated with 
 gr. xx of sugar of milk, one-half of which is dissolved in %'iv of water, and a 
 teasp. given every hour or so. Methylene Blue, in simple, non-diphtheritic 
 ulceration of the throat, patients would express themselves with delight as 
 being cured, after one or two applications of the solution (Rose). Iodine, the 
 tincture, locally to sores, whether syphilitic or not (R). Nitric Acid, undiluted, 
 
854 
 
 TIC DOULOUREUX TINEA CIRCINATA. 
 
 to sloughs (R). Silver Nitrate, locally, in early stage of inflammation, may 
 cut it short (R). Sulphurous Acid, by inhalation, spray, or fumigations for 
 malignant sore throat, scarlatinal or otherwise (R). Water, cold compress 
 nightly, to harden the throat Avhen tendency to catarrh (R). Ice, constantly 
 sucked (R). [Compare Diphtheria, Pharyngitis, Tonsillitis ; also the 
 formulae for Gargles on page 576. J 
 
 $. Tinct. Guaiaci Amnion., 
 
 Liq. Potassse, . , . . aagiij. 
 
 Tinct. Opii, % ij. 
 
 Aq. Cinnamomi, q. s. ad Jviij. 
 M. ft. gargarisma. 
 
 Sig. — To be used as a gargle, every hour, 
 in clergyman's sore throat. [Garner.) 
 
 R . Hydrarg. Bichlor. , . . . gr. iv. 
 
 Alcoholis, ^ij. 
 
 Solve, et adde — 
 
 Decocti Cinchona?, Mellis Rosa?, 
 Tinct. Myrrhae, . . . aa Sjij. 
 M. ft. gargarisma. Sig. — Gargle, to be 
 diluted if too severe. [Sir C/ias. Bell.) 
 
 Tic Douloureux. 
 
 Croton-Chloral, has special effect on the 5th nerve (B) ; is palliative in doses 
 of gr. v every x / z hour till gr. xxx are taken (W). Salicylates, in large doses, 
 cured a case of 12 years' standing. Stramonium, gr. % to yi of the extract 
 every 3 or 4 hours for 4 or 5 doses, often affords decided relief; stop if narcotic 
 symptoms appear (P). Arsenic, cures by influencing nutrition (B). Phosphorus, 
 is useful in doses of gr. T ^y to gr. -£$ every 3 hours (R). Morphine, with Atro- 
 pine, hypodermically, gives relief (B). Aconitine, has lately been given with 
 good results (B). Antipyrin, and Acetanilid, are sufficiently analgesic to relieve 
 the pain in many cases. Iodides, are promptly curative when tic is due to 
 syphiloma of the nervous system, the pain being nocturnal chiefly (B). Cimi- 
 cifuga, is frequently very effective (B). Turpentine, when rheumatic in origin 
 or produced by fecal accumulations (B). Quinine, holds a foremost place in 
 the list of remedies (Wa). Ammonium Chloride, in doses of 30 grains 4 times 
 daily, is of great service in numerous cases, especially when the pain partakes 
 more of a rheumatic than of a neuralgic character (Sir Thos. Watson). Can- 
 nabis Indica, gr. % to ]/ 2 rarely gr. j, of a good extract, is very effective and 
 ranks in value next to morphine and atropine (Reynolds). Physostigma, a 
 few drops of a solution of the extract, 1 in 30, or one or more gelatine discs of 
 Physostigmine introduced within the eyelids of the affected side, effectively 
 relieved or cured several cases (Munro). Chloroform, the liniment applied with 
 friction is sometimes serviceable (Wa); a few drops by deep injection in the 
 vicinity of the nerve trunk (B). Galvanization of the fifth nerve, gives decided 
 relief to the pain, and frequently results in permanent cures in cases which be- 
 long to the category of the so-called essential neuralgias (B). [Compare Hemi- 
 crania, Neuralgia, Neuritis, Odontalgia.] 
 
 Tinea Circinata — Ringworm of the Body. 
 
 Mercury, the Bichloride, 1 part in 250 of water, as parasiticide application, 
 after depilation (A); Calomel, as ointment, 3j to the ^, is useful (B) ; strong 
 Citrine ointment rubbed in twice daily is often effectual (Wa) ; the ointment of 
 the Red Oxide often cures ringworm on the body or limbs when other reme- 
 dies fail (Wa). Carbolic Acid, Z) to the 5 of glycerin, or equal parts of each, 
 is a very efficient application (B). Boric Acid, is an excellent topical applica- 
 tion, especially in that form affecting the scrotum and inner side of the thigh 
 (Watson). Copper Acetate, in ointment, gr. x to the ^, is a very effective 
 application (B). Sulphites, are used in parasitic skin diseases to destroy the 
 parasites (B). Sulphurous Acid, is better than Carbolic and safer (A); must 
 be fresh to be of use (Bulkley). Cocculus Indicus, the decoction locally, after 
 washing the skin well (P). Oil of Cade, the best depilatory known (A). 
 Arsenic will not cure, but may do service as a nerve tonic or an improver of 
 
TINEA DECALVANS — TINEA IMBRICATA. 855 
 
 nutrition, in connection with other remedies (Bulkley). Iodine, as liniment 
 once applied (R) ; with Oil of Tar, 1 to 4, is excellent (Wa). Kamala, used 
 locally by the Hindoos (P). Tar Ointment, is used with good effect (P). 
 Acetic Acid, strong, applied to ringworm of any part of the body except the 
 scalp ; no treatment is easier, more speedy or certain in its action (R). 
 Sodium Chloride, common salt in ointment is a very effective remedy [see under 
 Tinea Tonsurans]. Cod-liver Oil, is a powerful auxiliary in weakly and 
 cachectic subjects (Wa). Diet and Hygiene, are important; the food should 
 be nutritive and abundant, especially animal fats ; daily baths, out-of-door 
 exercise. Fungus, is the Trichophyton tonsurans (A). 
 
 Tinea Decalvans — Alopecia Areata. 
 
 Parasiticide Lotions, must be used after epilation and washing of head daily 
 with soft or black soap. Collodion, with Cantharidal Ether, equal parts, as a 
 stimulant after the fungus is destroyed (A). Oxygen, locally applied to the 
 scalp by a close-fitting rubber bag, to restore the hair [see under Alopecia]. 
 Tonics, are necessary, especially for the nervous system (Bulkley). Fungus — 
 the Microsporon Audouini (A) ; but I have never seen it, though having made 
 repeated and thorough searches (Bulkley). 
 
 Tinea Favosa — Favus. 
 
 Mercury, is efficient when used early ; the Bichloride, gr. xx to ^j of simple 
 cerate (B) ; or gr. ij to the § of water applied after each epilation (R). Myrtol, 
 is curative of favus (B). Carbolic Acid, in glycerin or cod-liver oil, as a local 
 application (B). Sulphurous Acid, as a parasiticide ; Acidi Sulphurosi Dil. ^ss, 
 Sodii Hyposulphitis §iij, Aquae q. s. ad ^xvj (Startin) ; is useful in favus, but 
 when cases are unusually obstinate its action should be assisted by epilation (R). 
 Simple Oils, to soften and facilitate the removal of scabs (R). Poultices, are 
 useful preparatory to epilation (R). Iron, the tincture of the Chloride, internally 
 in doses of n^x thrice daily for a child ten years old ; combined with cod-liver 
 oil if the disease is associated with scrofula (Sir E. Wilson). Sulphur Iodide, 
 in weak ointment, gr. xx to the ^, well rubbed in after removal of crusts, is the 
 most reliable preparation of its class (Whitla). Epilation, must be resorted to 
 and carried out with care and patience (Id). All the remedies useful for ring- 
 worm of the scalp may be used against favus, and success depends rather upon 
 the judicious way in which these agents are used one after the other than on 
 the persistent use of any one of them (Id). It is clearly demonstrated that the 
 disease is conveyed from the mouse to the cat and then to the children who 
 play with the affected cat (Id). Fungus — the Achorion Schonleinii (A) ; a 
 very rare affection in this country (Bulkley). 
 
 Tinea Imbricata — Tokelau Ringworm. 
 
 Iodine, the double strength liniment, freely applied, is the best treatment for 
 natives (Mn). Chrysarobin, as ointment, gr. xx to the J of vaselin, for limited 
 patches (Id); [see under Dhobie Itch]. Cassia Alata, the bruised leaves well 
 rubbed in over the affected area (Id). Sulphur, as fumes or ointment, acts very 
 slowly and unsatisfactorily (Id). Oiling the Body, is believed to be a prevent- 
 ive (Daniels). Cleanliness of the skin and boiling or destruction of the clothing 
 worn next it, to prevent recurrence (Mn). The disease is a form of body ring- 
 worm peculiar to certain eastern tropical climates, is produced by a trichophyton, 
 and is characterized by a concentric arrangement of closely set rings of scaling 
 epidermis (Mn). 
 
856 TINEA — TONGUE. 
 
 Tinea Tonsurans — Ringworm of the Scalp. 
 
 Mercury, the Bichloride, gr. xx to the ^ of simple ointment, is an effective 
 aDplication when used early (B) ; must be used with caution. Carbolic Acid, 
 3j to the ^ of glycerin (B). Sulphurous Acid, the acid of the B. P. with an 
 equal part of glycerin, is useful ; must be assisted by epilation when the affec- 
 tion is obstinate (R) : or Startin's formula [see ante under Tinea Favosa]. 
 Potassium Sulpho-cyanide, ^ss in glycerin ^j and water ^vij, as lotion applied 
 on lint covered with oiled silk, after washing the patches twice daily with warm 
 water and soap and drying (Gee). Sodium Chloride, in ointment, equal parts 
 of common salt finely powdered and vaselin, thoroughly mixed, and well 
 rubbed in night and morning after shaving the part, until the skin becomes 
 very sore; is most efficient even in apparently intractable cases (Perkins). 
 Iodine, Z\) to the j§ of the oil of wood tar, is an efficient application, producing 
 no pain and preventing the extension of the disease (R). Arsenic Iodide, is 
 the best constitutional remedy ; gr. ^ increased to gr. \ for an adult, gr. -^ to 
 3^ for children, with alkaline lotions locally (Wa). Viola Tricolor, the leaves 
 are employed in Italy for tinea capitis (P). Cocculus Indicus, a decoction lo- 
 cally applied after washing the part well, is efficient (P). Quinine, dissolved in 
 glycerin, or a mild mercurial pomade, as grease to the hair of the patient and 
 uncontaminated members of the family, to prevent the sporules reaching un- 
 affected parts (R). Oils, may be used to facilitate the removal of the scabs (R). 
 Cleanliness, and free use of soap and water, is a sine qua non, and in some 
 cases of tinea may be alone sufficient to produce curative results. Isolation of 
 person, and brushes, towels, etc., necessary to prevent infection. Fungus — 
 the Trichophyton tonsurans (A). 
 
 Tinea Versicolor. 
 
 Iodine locally, preceded by washing with soft soap and warm water (Morris). 
 Sulphurous Acid, diluted to one-fourth with water, or a strong solution of 
 Sodium Hyposulphite, as local applications (Id). Benzol and lavender water, 
 equal parts of each (Id). Chrysarobin and Salicylic Acid, dissolved in Trau- 
 maticin or Collodion (Morrow) ; [see under Dhobie Itch for formula]. Fungus 
 — the Micro sporon furfur . 
 
 Tongue. 
 
 Potassium Chlorate, gr. v internally and 3j-ij ad Oj aquas locally ; in ulcers 
 of tongue (Wa) ; also for rawness of tongue in advanced phthisis. Potassium 
 Iodide, in syphilitic ulcers of tongue (D) ; and in hypertrophy (A). Potassium 
 Bromide, 5j to ^vj water as wash, may soothe morbid sensibility of the tongue 
 (A). Borax, Sodii Boratis gr. xl, Glycerini jfj, Aquae Jiv, as application in 
 cracked tongue (Wa). Iodine, the tincture locally by a fine brush, or as a 
 gargle with 7 or 10 parts of water and some honey, has given uniform success 
 in malignant ulcers (Wa). Aurum, internally and locally, has cured hyper- 
 trophy of the tongue with induration thereof in scrofulous subjects, also stru- 
 mous ulceration of the tongue. Conium, is thought to act specifically with 
 benefit in ulcer of the tongue (Wa). Cinnamon, the oil as a powerful stimulant 
 in paralysis of tongue (P). Ginger, Cochlearia, Pyrethrum, as gargles. Cloves, 
 Mezereon, Pepper, as masticatories, in paralysis (P). Frenum, should be di- 
 vided in tongue-tie ; use blunt-pointed scissors, directing the points down close 
 to the jaw, so as to avoid wounding the ranine artery (D) ; better to cut as little 
 as possible, and directly backwards, as the artery of the frenum may proceed 
 from the sublingual (Holmes). [Compare Glossitis, Ranula.] 
 
TONSILLITIS — TONSILS. 
 
 857 
 
 Tonsillitis. 
 
 Aconite, when high fever and elevated arterial tension, relieves greatly, gtt. 
 ss-j of tincture every J^-hour or hour(B); every % -hour for 2 hours, then every 
 hour, will almost certainly prove efficacious (R). Belladonna, of surprising 
 efficacy, gtt. v of tinct. every 3 hours in ^ss aquse (P). Mercury, often speedily 
 removes ; Calomel, gr. ■£$, or Hydr. cum Creta, gr. ^ every 2 hours ; not in 
 chronic forms (B); gr. y$ of Gray Powder every hour when tonsils almost meet, 
 has marked effect ; the Oleate of Mercury and Morphine in obstinate and pain- 
 ful tonsillitis (R). Silver Nitrate, locally may abort, if applied early (R) ; the 
 solid stick, once thoroughly applied in the first stage, rarely fails to prevent 
 suppuration (Howard). Guaiac, disagreeable, but very effective (P) ; ^ss doses 
 of tincture every 4 hours has remarkable power; should be given in emulsion 
 with mucilage or yolk of an egg (B) ; makes an excellent gargle, [see page 576 
 for formula] : the tincture of Guaiac and glycerin, equal parts, in 3 doses every 
 hour or two, gives excellent results in acute tonsillitis. Opium, gr. v-x of Dover's 
 powder at bedtime, is in many cases curative (Shoemaker). Cocaine, in 10 per 
 cent, solution, locally, at intervals of 15 minutes, removes pain at once and 
 promotes resolution ; a very efficient application in 5 or 10 per cent, solution, 
 but causes temporary paralysis of palatal muscles, so that liquids regurgitate 
 through the nose (Boeckel): a strong solution painted freely over the affected 
 tonsil in cases which commence on one side of the fauces, will cut short the 
 attack in most cases and prevent suppuration. Emetics, at the very onset of 
 the disorder, will sometimes succeed in cutting it short (Sir Thomas Watson). 
 Alum, dry or in solution (R). Potassium Iodide, locally, gr. j-v to the ^, is 
 useful (B). Potassium Chlorate, in grain doses every half-hour, very efficient 
 (Smith). Capsicum, the dilute tincture in a gargle, or in powder applied on a 
 swab, is useful in severe tonsillitis, especially in that accompanying scarlatina 
 (W). Quinine, gr. x-xv will sometimes abort (B). Tannic Acid, is useful (P) ; 
 as gargle, [see page 795]. Ice and wet pack, extremely grateful (B). Hydrogen 
 Dioxide, the solution as gargle, is used with great benefit. Cold Wet Compress, 
 around neck, covered with oiled silk and a dry bandage, applied nightly, is 
 very useful. Sodium Bicarbonate, locally by wetted finger to surface of tonsils 
 every five minutes for ^-hour, then every hour during the same day, will pre- 
 vent necessity for lancing (Lyon Medical). Incision of the tonsils gives imme- 
 diate and marked relief in all cases especially those which are not amenable to 
 ordinary treatment. 
 
 R. Tinct. Aconiti, gss. 
 
 Tinct. Guaiaci, 
 
 Syr. Zingiberis, . . . . aa 3 ss. 
 
 Syr. Simplicis, % ij . 
 
 M. Sig. — 3 ss-ij every 2 hours, accord- 
 ing to age. In severe cases, with high 
 fever, bounding pulse, severe headache. 
 
 {Shoemaker.') 
 
 Tonsils, Enlarged. 
 
 Ammonium Iodide, gss in ^j of glycerin, applied every night by a camel's- 
 hair brush, very efficacious (Wa). Barium Iodide, in hypertrophy of the tonsils, 
 effects a rapid diminution in their size, even when indurated for years (Hale). 
 Liquor Ferri Chloridi, diluted, 3j-ij to the ^, painted over tonsils twice daily, is 
 one of the most effective astringents (Mackenzie). Aluminum Sulphate, a 
 saturated solution applied daily by a brush, as a mild caustic (W). Ergot or 
 Ergotin, by injections into tonsils (Meigs). Zinc Chloride, as caustic, the most 
 efficient and least annoying method; a saturated solution applied on a wire 
 cotton-holder to each crypt and held there a few seconds; a few applications 
 will shrink the gland in a week. Tannin, a strong solution touched daily to 
 tonsils (H) ; a few sips of a saturated solution, ^ss in ^iij aquse, slowly sipped, 
 will stop bleeding, if profuse (A); gr. xx to §j aquse, hypodermically, as in 
 
858 TONSILS TORTICOLLIS — TOXEMIA TREMOR. 
 
 nasal polypus. Silver Nitrate, touched daily to tonsils, will sometimes make 
 them shrink (H). Catechu, a serviceable astringent gargle ; the infusion ^vj 
 with tincture of Kino 3ij, as gargle (Wa). Oxgall, locally, is praised (Wa) ; is 
 of real utility (Wa). Citric Acid, rubbed daily to tonsils, is highly praised in en- 
 largement thereof. Excision of a part of the tonsil (H) : Mackenzie's double 
 guillotine removes both tonsils at once; hemorrhage seldom happens, ice will 
 generally check it (A). Surgical measures should receive unprejudiced con- 
 sideration, as the medical treatment is tedious in the extreme. 
 
 Tonsils, Ulcerated. 
 
 Coptis, the infusion as a gargle (B). Sulphurous Acid, dilute, locally by 
 spray, or a solution of Sodium Sulphite Z] in. water 3J (B). Potassium Iodide, 
 will arrest syphilitic ulcerations at once (B). Carbolic Acid, a 5 per cent, wash 
 with tincture of Myrrh, a good application by sponge to throat (Wa). Cimi- 
 cifuga, a decoction of the root as a gargle (Wa). 
 
 Torticollis. 
 
 Cimicifuga, has curative efficacy (P). Capsicum, a handful of the crushed 
 pods infused for 36 hours in a pint of hot or cold water, and applied on lint 
 covered with gutta-percha (R) ; gives striking results (Wa). Opium, as lini- 
 ment with friction, or an opium plaster, is often serviceable (Wa). Potassium 
 Bromide, in large doses with Arsenic, may always be tried in the spasmodic 
 form, which is sometimes one of the most obstinate complaints (Whitla). 
 Gelsemium, some cases have been reported as cured by its hypodermic 
 administration after tenotomy or myotomy had failed (Id); very large doses, 
 rr\jij of Wyeth's fluid extract thrice daily, increased until eight times this 
 amount is taken, so as to produce very pronounced physiological symptoms, 
 in spasmodic torticollis (Weir Mitchell). Surgical Treatment, by stretching or 
 resection of a portion of the spinal accessory nerve, has succeeded sometimes 
 in spasmodic torticollis, but it has also failed, and being so unsatisfactory 
 should not be tried except as a last resort (Whitla). Electricity, galvanization 
 of the affected muscles and faradization of the opposed ones, quickly relieves 
 (B) ; has given excellent results in spasmodic torticollis, and if resorted to 
 early may succeed, but must be persisted in for some time (Whitla). 
 
 Toxemia. 
 
 Saline Injections, beneath the skin and into the veins, successfully used in 
 various forms of toxemia, as diabetic coma and the anemia and collapse fol- 
 lowing intestinal hemorrhage in cases of typhoid fever. The apparatus em- 
 ployed is uncomplicated and the technic simple. Care must be taken to avoid 
 air-embolism and the introduction of foreign bodies. If the patient is robust 
 and his condition sthenic, with venous infusion on one side may be conjoined 
 venesection upon the other. The object is to hasten the dilution and elimina- 
 tion of the poison, both directly and through the skin and the kidneys particu- 
 larly. The results are good in a certain proportion of cases and sometimes ex- 
 traordinary, while the procedure is practically harmless (Hare). Deci-normal 
 salt solution injected into a vein and filling the rectum with a saturated solution 
 of Magnesium Sulphate (McKeown). [Compare Septicemia, Shock, Uremia.] 
 
 Tremor. 
 
 Hyoscyamus, the tincture in full doses will palliate mercurial tremor ; or 
 Hyoscyamine, gr. -fa gradually increased to T V(B). Hyoscine, is a useful drug 
 in diseases having tremor as a marked symptom, as disseminated sclerosis, 
 
TRICHURIASIS TUBERCULOSIS. 859 
 
 delirium tremens, etc., and is usually quite safe (Weatherly). Coniine, will con- 
 trol excessive tremor in many instances. Gelsemium, in full doses may palli- 
 ate excessive tremor ; a combination of Hyoscyamus, Conium and Gelsemium, 
 the first to keep the brain quiet, the latter to quiet the nervous irritation at both 
 the central and peripheral extremities (Lavers). Cocaine, influences alcoholic 
 and senile tremor more favorably than any other remedy ; large doses and fre- 
 quent administration are unnecessary (B). Veratrine, has been used success- 
 fully in alcoholic tremor and that of disseminated sclerosis, also in the trembling 
 weakness of typhoid fever (Ferris). Calcium Salts, were given by me in one 
 case of tremor at the beginning of general paralysis, resulting in its cessation 
 for several months (Br). Arsenic, ^ij-iij of Fowler's solution, diluted with two 
 parts of water and given hypodermically, was successful in several cases 
 (Eulenberg). Phosphorus, in alcoholic and mercurial tremor (De Mussy). 
 Silver Nitrate, gr. ys-iij daily, used in six cases of mercurial palsy with fairly 
 rapid recovery (Sementini). Zinc Phosphide, is effective in the tremor of 
 mercurial and arsenical poisoning (De Mussy) ; not so in the tremor of 
 sclerosis (P). [Compare Chorea, Delirium tremens, Paralysis agitans ; 
 also Bruntori s Pharmacology, 3rd edition, page 133, for the Pathology of 
 Tremor.] 
 
 Trichiniasis. 
 
 Benzol, in doses of rr\,x, every hour or two, up to 3jss daily, followed by a 
 brisk laxative, has been very successful in 27 cases, treated simultaneously 
 (Putter). Purgatives, as Rhubarb and Senna, or an occasional dose of Calo- 
 mel, to thoroughly evacuate the gastro-intestinal canal. Glycerin, in large 
 doses, to destroy the worm by its hygroscopic qualities, has been recommended. 
 The indications, in the stage of invasion, are to relieve the pains, to secure 
 sleep, to combat the fever, and to support the patient's strength ; there are no 
 medicines which have any influence upon the embryos in their migration 
 through the muscles (O). 
 
 Trismus. 
 
 Aconite (A), Atropine (R), hypodermically. Cannabis Indica, has been 
 used successfully in trismus neonatorum (B). Opium, til y% doses of Laudanum, 
 with Castor Oil and warm bath, in trismus infantum. Ether, Chloral, Gelsem- 
 ium, Physostigma (B). Treatment of any kind is seldom effectual (D) ; is 
 never effective (El). Trismus neonatorum, lock-jaw of the new-born infant, 
 may be due to many causes ; one of which is bathing in very hot water. A 
 certain midwife, whose hands could not distinguish the differences in tem- 
 perature of the bath, sent me over 100 cases (Weber). 
 
 Tuberculosis, Acute. 
 
 Quinine, to subdue the fever, also Salicylic Acid for the same purpose, with 
 repeated blistering over different parts of the chest and many dry cuppings of 
 the lower limbs and the trunk morning and evening ; this, with wine and alco- 
 hol, broths, jellies, milk and peptonized foods, is my plan of treatment for 
 acute miliary tuberculosis, by which one case was absolutely cured (Jaccoud). 
 Arsenic, appears to reduce the temperature gradually and is useful in many 
 ways (R). Cold, to the surface of the abdomen, with ice sucked freely, the 
 body sponged with iced vinegar and water, food and drinks to be iced, and 
 even iced enemata sometimes; with Quinine, gr. x-xxx once in 48 hours, or 
 the pill of Quinine gr. j, Digitalis gr. ss, and Opium gr. %, every 4 hours, fluid 
 food every hour or half hour day and night, in acute miliary tuberculosis, may 
 bring about a cure if energetically followed from the beginning (McCall 
 Anderson). [Compare Phthisis.] 
 
860 TUBERCULOUS AFFECTIONS — TUMORS. 
 
 Tuberculous Affections. 
 
 Arsenic, children affected with tuberculosis involving the lungs, intestines 
 and peritoneum, have steadily and slowly improved and finally recovered 
 under Arsenic treatment (R). Salicylic Acid, Unna's strongest plaster, applied 
 repeatedly for several days, to remove the horny covering in tuberculosis 
 verrucosa cutis ; this will remove much, and the rest is destroyed by the 
 fuming Acid Mercuric Nitrate, applied to a small portion of the growth at a 
 time, as it is painful (Crocker). Camphorated Naphtol, hypodermically in 
 tuberculosis adenitis, tuberculosis of the testis and of the bladder, etc. [see 
 page 388]. Potassium Cantharidinate, gr. ^y to gr. -g^ hypodermically, 
 produces an exudation of serum throughout the body, and may cause a con- 
 centration at an affected spot of efficacious substances which would not ordin- 
 arily find their way there, but it should not be employed when kidney disease 
 exists (Liebrich). Hydrargyrum Thymol aceticum, in solution injected into 
 the glutei muscles every eight days, followed after a few injections by Potassium 
 Iodide, gr. iij thrice daily by the mouth, as a cure for tuberculosis (Tranjen, 
 Ewald). Zinc Chloride, in dilute solution, deeply injected into the tissues sur- 
 rounding tubercular deposits, in order to induce a condition of sclerosis fatal to 
 the growth or existence of the bacilli; in tuberculosis of the epididymis and in 
 spina ventosa a 1 in 20 solution ; for tuberculous disease of the joints, ribs and 
 glands a 1 in 10 solution, of which 20 drops to be injected in a number of places 
 around the periphery of the diseased part (Lannelongue). Iodoform, a 10 per 
 cent, emulsion filled into the cavity after free opening and scraping, the cavity 
 being then sewn up, gives excellent results in tuberculous abscesses (Billroth) ; 
 a sterilized 10 per cent, emulsion made with glycerin or olive oil, injected every 
 14 days or oftener into tuberculous joints and abscesses after thorough aspira- 
 tion, also in tubercular empyema (Bruns) ; this may be well employed for all 
 forms of local tuberculosis of soft parts, as the glands, testes and lungs (Tren- 
 delenburg). Cod-liver Oil, is the remedy from which we can expect the most 
 good in the tuberculous diathesis (Wa). Antitoxin, Paquin's serum has given 
 good results in knee-joint tuberculosis (Cale) ; also in other forms [see page 
 181]. Antiphthisin, is doing good service in cases of pure tuberculosis [see 
 page 514]. Tuberculin, as a diagnostic agent for latent tuberculosis [see page 
 513]. [Compare Laryngitis tubercular, Lupus, Meningitis tubercular, 
 Peritonitis tubercular, Phthisis, Scrofulosis, Tabes mesenterica.] 
 
 Tumors. 
 
 Mercuric Bromide, in yi grain doses, has benefited abdominal tumors (Wa). 
 Chloroform, to aid in diagnosis of abdominal tumors when deep-seated, and 
 when walls of the belly are hard and rigid ; also in phantom tumors (R). Pep- 
 sin, hypodermically, to dissolve them. Hyoscyamus, the leaves as cataplasm 
 or fomentations to painful tumors, afford great relief (Wa). Iron, the Liquor 
 Ferri Chloridi is found to be valuable as a curative application to fungous or 
 hemorrhoidal tumors (Wa). Galbanum, as plaster to indolent, non-malignant 
 tumors, to diminish or cause their absorption (Wa). Electrolysis, is employed 
 with more or less benefit in sebaceous tumors, lipoma, bronchocele, enlarged 
 glands, etc. (Wa) : Apostoli's method for the dispersion of fibroid tumors ; it 
 will dissipate pain, improve nutrition, and diminish their size without danger to 
 life (Bigelow) ; the treatment of fibroid tumors by the galvanic current has of 
 late been universally recognized by the profession (Massey) ; solid tumors, as 
 goitre, enlarged glands and similar growths have been repeatedly cured by 
 electrolysis (B). [Compare Cancer, Cysts, Glandular enlargement, 
 Goitre, Polypus, Uterine tumors, Wen. J 
 
TYMPANITES TYPHOID FEVER. 86 1 
 
 Tympanites. 
 
 Turpentine, often greatly benefits (P, Wa) ; $] every 6 hours in tympanites of 
 typhoid, with prostration but without diarrhea (R). Asafcetida, in hysterical 
 tympanites, internally or as enema, beneficial (P) ; also in that of fever (Wa). 
 Capsicum, gr. ss-ij, every 4 hours (P). Cocculus Indicus, a few doses of the 
 tincture will often succeed in the tympanites of peritonitis and enteric fever 
 (P). Ginger, with drastic purgatives (P). Posture, relieves many bad cases 
 promptly ; inversion or partial inversion of the patient, as in the knee-chest 
 position, for 10 or 15 minutes, to cause the gravitation of the bowels upwards, 
 thus straightening out the rectum ; or if this is not practicable, place the patient 
 on one side and elevate the foot of the bed two or three feet (Sweetnam). 
 Surgical Measures, by celiotomy and incision of the gut, should be done 
 promptly, when cathartics, posture, enemata and the use of the rectal tube have 
 failed to give relief (Porter). Puncture or Aspiration only in extreme cases and 
 as a last resort, and then only in such cases which present no other cause for 
 celiotomy than the tympany itself, as typhoid fever without perforation, pneu- 
 monia, etc. (Id). [Compare Peritonitis, Typhoid Fever.] 
 
 Typhlitis. 
 
 Opium, of undoubted curative power (B). Purgatives, are inadmissible ; 
 Epsom salt may be used, but no drastics (B). Leeches, should never be 
 omitted when tenderness and fever begin (B). Ice-bag, over the swelling (B) ; 
 has conquered many cases which the surgeons would operate on 'for appendi- 
 citis. 
 
 Typhoid Fever. 
 
 Guaiacol Carbonate, in two daily doses of 25 to 30 grains, is highly efficient, 
 sixty cases treated thereby with no deaths ; is non-poisonous, but does not affect 
 the temperature, hence antipyretics may be required (Hoelscher) ; is the princi- 
 pal ingredient in the Woodbridge abortive treatment [see formulae on page 
 863] ; aims at aborting the disease by intestinal antisepsis and elimination. 
 Guaiacol, 10 to 15 drops of pure Guaiacol painted over the skin of parts where 
 it is readily absorbed is very efficient in reducing temperature when exceeding 
 102 (Montagnon). Carbolic Acid, Z] with tincture of Iodine 3ij> of which mix- 
 ture 1 to 3 drops every two or three hours, is a very good plan of treatment 
 (Da C) ; all his cases during an entire year were treated with a mixture of 
 Carbolic Acid and Chloroform, without the loss of a single case, by Dr. Quill 
 of the Indian army [see page 90]. Chloroform, the spirit in mixture of Car- 
 bolic Acid, as above; a y z percent, solution of Chloroform will kill the bacillus 
 of enteric fever (Werner). Copper Arsenite, in divided daily doses of gr. y^-, 
 commenced early and continuously used, will maintain a moderately low tem- 
 perature, a good pulse rate, comparative freedom from great abdominal pain 
 and tympanites, and will lessen materially the number of stools, while it greatly 
 improves their character and consistence (Aulde) ; used in 90 cases with but 
 one death ; leaves an excellent condition of the alimentary tract after the fever 
 is over (Thomas). Salol is of great value as an intestinal disinfectant, promot- 
 ing healing and preventing reinfection ; given in 5 to 10 grain doses, according 
 to age, every 4 hours until the urine is tinged, then reducing the amount and 
 frequency, but maintaining a faint coloration of the urine, has for ten years 
 afforded me the most gratifying results (Bramwell) : it should not be given in 
 the compressed tablet form for many reasons. Salophen has proved equally 
 efficient. 
 
 Nitro-hydrochloric Acid, is to be preferred over all other plans of treatment, 
 20-drop doses in simple elixir, also Sulphuric acid for intestinal hemorrhage 
 
862 TYPHOID FEVER. 
 
 (Da C). Mineral Acids, are very useful generally, especially HC1 (Wa). 
 Thymol may also be employed, in doses of gr. ss-ij in solution (Da C). 
 Sulphurous Acid, is highly praised by Dewar, and has real antidotal power ; 
 tt\,ijss-xx every 4 hours according to age, continued for a weak or ten days, 
 until the patient's complaints show him to be saturated; if diarrhea be present 
 add Sulphuric Acid and Opium (Wilks). [Formulae on next page.] Cinnamon, 
 the Oil is efficiently used to abort the disease [see page 277]. Potassium 
 Bromide, is as much a specific for typhoid fever as Quinine Sulphate is for 
 ague, aborting the fever in 8 or 10 days (Hawkins). Arnica is highly extolled ; 
 its " picture " shows definite powers in this disease (P) ; small doses in asthenic 
 conditions (B) ; when vital powers are greatly depressed (Wa). Baptisia is 
 very useful in the early stage (W). Turpentine, invaluable when hemorrhage 
 and extreme tympanites(P, R) ; rr^xxx-lx in Starch mucilage and rr^x of Tinct. 
 Opii (P) ; Tt\,v-x frequently for hemorrhage or rt^x every 2 hours in advanced 
 stage, with dry tongue (R) ; when coma, stupor, it often arouses the vital 
 powers (Wa) ; rr^vij with gr. ^ of Morphine ; of especial value when marked 
 fever and congested lungs, as well as for the tympany (Da C). Chloral, is the 
 best drug for nervous symptoms, but must not be used when the heart is weak 
 (Da C). Opium, small doses at night, for insomnia with delirium ; also as in- 
 jection for the diarrhea (R) ; in one case when vital powers seemed hopelessly 
 depressed, gr. */> caused improvement (Wa); for spreading tenderness (peri- 
 tonitis), give 10-minim doses of the deodorized tincture, also gr.j in suppository 
 every four hours (Da C). Belladonna, when contracted pupils, low, muttering 
 delirium (B) ; is thought to counteract the poison of typhoid (Wa). Mercury, 
 Corrosive Sublimate gr. y^ every 2 or 3 hours for the diarrhea ; Calomel in 
 small doses at onset (R),gr. x in one dose the first day, gr. iij per diem for 3 
 or 4 days, the German "specific treatment" (B). Bismuth, gr. x-xxv of the 
 Subnitrate with gr. yi-] of Opium every 3 hours for the severe diarrhea (Da C). 
 Ergot, for intestinal hemorrhage, hypodermically if the symptoms are urgent 
 (R) ; Ergotin, gr. ij-vj hypodermically, or Z) of the fluid extract of Ergot, for 
 intestinal hemorrhage (Da C). Tartar Emetic, with Opium, when wakefulness 
 and delirium ; minute doses gr. y 1 ^ frequently, are of great service (B) ; Anti- 
 mony cuts the disease short with such certainty that it is almost doubtful 
 whether the lesion of typhoid is specific or is not rather incidental or ad- 
 ventitious (Lawrie) ; should be given with cardiac tonics. Digitalis, of value 
 in many cases as a sustainer of heart power, but may be dangerous in the later 
 stages (Anstie, Murrell) ; used by the Germans when there is no cardiac weak- 
 ness ; gr. x-xx as antipyretic, over a period of 36 hours (P). Quinine, may 
 have efficacy in typho-malarial fever, is less effective as the typhoid element 
 predominates, useless in purely continued fevers (B) ;■ is justly abandoned, but 
 may be used to maintain the circulation, in tonic doses, gr. vj-x in the 24 hours 
 (Da C). Medicines should not be given in tablet or pill form, which are liable 
 to cause irritation of the intestinal lesions. 
 
 Antipyrin, Phenacetin, Acetanilid, are extensively used as antipyretics ; for 
 the dangers depending on the extensive employment of the latter drug see 
 page 79. Phenocoll Hydrochloride as an antipyretic, is used with marked 
 success. Veratrum Viride, to reduce temperature (R) ; for delirium ferox (B) ; 
 strongly recommended (Wa) ; its efficacy difficult to believe (S). Serpentaria, 
 useful when much depression exists, cautiously if intestines at all irritable 
 (B). Hydrastine, when copious sweats (P). Lead Acetate, with Opium, for 
 the purging (R) ; also Alum (R). Lime-water, as an astringent and antacid, 
 is efficient. Sodium Chloride, should not be withdrawn from the food (Wa). 
 Aromatic Spirit of Ammonia, for great accumulation of mucus in the throat 
 (Da C). Copper Sulphate, gr. J%, with Opium, gr. %, for the diarrhea (Da C). 
 Strychnine, is the remedy for the functional palsies (Da C). Purgatives, only 
 the very mildest, and they with the greatest caution (Wa). Medicine, will 
 never abort a case of true typhoid, its natural duration is from 28 to 30 days 
 (Sir Wm. Jenner). Typhoid Antitoxin, has been used in a few cases, apparently 
 with good results [see page 184]. Cold Baths, when the temperature rises 
 
TYPHUS FEVER. 
 
 863 
 
 above 102 , a most important agent (B) ; in mild cases, cold wet compresses or 
 wet sheets, or washing with cold water; in severe cases, affusion, shower, or 
 general cold bath, 50 to 55 F., or better 95 cooled gradually to 6o° (R) ; this, 
 the Brand (more justly Currie's) method, increases the flow of urine and its 
 toxicity, restoring the latter to normal and sometimes to double the normal, 
 thereby clearing the system of a large quantity of toxins (Ausset). Stimulants, 
 freely, with Quinine, for pyemic cases, showing joint complications [see under 
 Synovitis]. Aliment, by Milk alone, or alcohol with milk, eggs, broth (B) ; 
 Coffee, a better stimulant than alcohol (P) ; Alcohol is needed to sustain the 
 heart's action (Da C) ; Milk must be used with great caution ; if the curd be un- 
 digested great evils arise; give essence of meat alone (Sir Wm, Jenner) ; 
 avoid the extremes; an absolute milk diet required if intestinal symptoms are 
 grave ; no solid food until health is restored fully ; a scalded-milk diet exclu- 
 sively may be depended on. Adjuvants, water, especially the abdominal 
 compress, cleanliness, ventilation, absolute rest and quiet. Discharges should 
 be received in vessels containing Carbolic Acid or a solution of Corrosive 
 Sublimate, and buried instantly. [Compare Hemorrhage intestinal, Rec- 
 tal ULCERATION, TYMPANITES.] 
 
 R. 
 
 Resin. Podophylli, . . . 
 Hydrarg. Chloridi Mitis, 
 Guaiacoli Carbonatis, 
 
 gr- 
 
 Eucalyptoli, . . q. s. 
 
 Ft. tabella no. j. Sig. — One or more of 
 
 these tablets every ]/^ hour during the first 
 
 3 days, to secure 5 or 6 free evacuations 
 
 daily {Woodbridge No. 1.) 
 
 R. 
 
 gr- slo- 
 
 Resin. Podophylli, . . . 
 
 Hydrarg. Chloridi Mitis, 
 
 Mentholi, 
 
 Thymoli aa gr. jL. 
 
 Guaiacoli Carbonat., . . gr. j£. 
 
 Eucalyptoli, . . . . q. s. 
 Ft. tabella no. j. Sig. — One tablet every 
 hour or two, after third or fourth day, re- 
 duced so as to gradually lessen frequency 
 of evacuations, until the temperature re- 
 turns to normal. ( Woodbridge No. 2.) 
 
 R . Mentholi, gr. ss. 
 
 Thymoli, gr. j. 
 
 Eucalyptoli, VC[v. 
 
 Guaiacoli Carbonat., . . gr. iij. 
 Ft. capsula no. j. Sig. — One capsule 
 every 3 or 4 hours, alternating with the 
 tablets, after the fourth or fifth day of treat- 
 ment. All the medicines to be washed 
 down with large draughts of distilled or 
 sterilized water. ( Woodbridge No. 3.) 
 
 R . Tinct. Iodi, 
 
 Acidi Carbolici, . . . . aa p. aeq. 
 M. Sig. — gtt. j-ij every 4 or 6 hours. 
 In typho-malarial fever, and in typhoid. 
 
 R . Acidi Sulphurosi, 
 
 Acidi Sulphurici Dil., . aa^ij. 
 
 Tinct. Opii Deodor., . . rr^xx. 
 
 Syr. Aurantii, 3 iij. 
 
 Aquae, q. s. adj^ vj. 
 
 M. Sig. — One-sixth to be taken every 
 4 hours. ( Wilks. ) 
 
 R 
 
 Acidi Sulphurosi, .... TT^xv. 
 Syr. Aurantii, .... 3 iij. 
 
 Aquae, 
 M. Sig.- 
 four hours. 
 
 R 
 
 q- 
 
 s. ad'. 
 
 -For infants, one-sixth every 
 {Wilks.) 
 
 Ant. et Potassii Tartrat., 
 Morphinae Sulphat., . . - 
 Aquae Laurocerasi, . . . 
 M. Sig. — A teasp. every 
 or four hours. 
 
 gr- J-'J- 
 gr. ss. 
 
 two, three 
 
 R 
 
 Quininae Sulphatis, . . . gr. x. 
 
 Acidi Hydroohlor. Dil., 
 
 Vel Ac. Sulphurici Dil., . # ^ss. 
 
 Syr. Aurantii, £]. 
 
 Aquae Cari, . . . q. s. ad£ vj. 
 M. Sig. — A tablesp. in an equal quan- 
 tity of water, every three or four hours. 
 
 [Mure his on.) 
 
 Typhus Fever. 
 
 Phenacetin, is extensively used for the pyrexia. Baptisia, is said to have 
 proved very useful (W). Belladonna, to cleanse and moisten the tongue ; 
 controls the delirium, slows and strengthens the pulse, reduces the tempera- 
 ture, shortens course of disease (R, P) ; in the early stages, relieves severity 
 of symptoms (P) ; give when contracted pupils (Wa). Arnica, very highly ex- 
 
864 ULCERS AND SORES. 
 
 tolled (P, Wa). Hyoscyamus, for mild brain symptoms (P). Opium, fulfils 
 many important indications ; never give when pupils are contracted (Wa). 
 Mineral Acids, their use recommended in all countries (Wa). Tartar Emetic, 
 with Opium in the delirium with insomnia (R). [See under Typhoid.] Chloral, 
 to produce sleep and allay violent delirium (R, Wa) ; its use has often been 
 followed by amelioration of the symptoms (Wa). Antipyrin or Quinine, as 
 antipyretics, it being more necessary than in typhoid to keep the temperature 
 within safe limits (B). Podophyllin, gr. l /e~% as mild laxative at onset, when 
 constipation, congestive headache, biliary derangement (P). Digitalis, in 
 large doses, a favorite remedy in Germany (P). Rhatany, as tonic, in ad- 
 vanced stages (P). Serpentaria, in low stage, delirium, watchfulness, tongue 
 dry and brown, or black ; combine with Ammonium Sesquicarbonate (P); is 
 given occasionally to excite diaphoresis and support the vital powers (Wa). 
 Camphor, a remedy of considerable value, but contraindicated when flesh-red 
 tongue, tender abdomen, diarrhea (Wa). Purgatives [see under Typhoid 
 Fever]. Coffee, better than alcohol for the adynamia (P). Stimulants, are not 
 needed under the use of mineral acids and a supporting diet in many cases 
 (Wa) ; are needed sooner than in typhoid, as the adynamia is more profound 
 and appears sooner (B). Diet, nutritious persistently, beef-tea, egg-nog, nutri- 
 ent enemata. Isolation, imperative, as the disease is eminently contagious 
 (B). [Compare Delirium, Typhoid Fever.] 
 
 Ulcers and Sores. 
 
 Arsenic, improves rodent ulcer (B). Belladonna, has a remarkable influ- 
 ence over various ulcerative processes (P). Chloral, as lotion for sluggish sores, 
 5 to 20 grains to the ^ of water (Keyes) ; is highly efficient in ulcerated sore 
 throat or ulceration from any cause (Brodnax). Mercury, Calomel finely levi- 
 gated and dusted on, is highly efficient in ulcer of the conjunctiva ; Calomel 
 Ointment or Black Wash in scrofulous or tuberculous lupus, and in open scrof- 
 ulous sores (R) ; Corrosive Sublimate, in 1 per cent, solution, as application to 
 syphilitic ulcers (Fox) ; the Ung. Hydrarg. Nitratis, for serpiginous ulcerations 
 diluted one-half, or the Iodide, gr. xx-xl to the ^ of vaselin, in syphilitic ulcer- 
 ations (Keyes). Lime, as the Carbonate or Lime-water to check discharge ; the 
 Sulphide when thin ichorous discharge ; the Phosphate has influence on scrofu- 
 lous sores (R). Phytolacca, as a local application (B). Hamamelis, employed 
 with satisfaction in varicose ulcers (Pf ). Opium or Morphine, with glycerin, 
 as an application to relieve pain (R) ; gr. j-ij, daily, also locally, has a decid- 
 edly curative value in phagedenic and indolent ulcers ; not so useful in so- 
 called irritable ulcers (Pf, P). Ichthyol, pure as oint. or with Lanolin, has done 
 excellent service in ulcers of the leg. Thiol, the dry form, as dusting powder, 
 has been of great benefit. Piperazin, in 1 per cent, solution, locally to gouty 
 sores, relieves the pain and reduces the inflammation. Resorcin, in strong or 
 supersaturated solution, locally applied to tuberculous and other ulcerations of 
 the larynx, is efficient and painless (Tymowski). Tannin, or Glycerite of Tan- 
 nin, to coat over wounds or discharging sores (R). Potassium Chlorate, in so- 
 lution as a wash to clean and stimulate foul ulcers (R) ; in impalpable powder, 
 a better application than Iodoform (B). Cinchona, powdered Bark dusted over 
 foul, indolent, sloughing and gangrenous ulcers, promotes healing (R). Conium, 
 locally, by means of a poultice, will ease pain and improve the sore (R). 
 Chlorine, in solution as a wash for sloughing and indolent sores (R) ; the gas 
 as a local stimulant to promote healing in old ulcers, is highly efficient ; [for the 
 method of application see page 267]. Iodide of Starch, cold, as a poultice (R). 
 Acetanilid, in fine powder, dusted on, is an excellent application to ulcers and 
 sores, mucous patches and ulcers of the rectum [see page 79]. Lead, the solu- 
 ble salts of lead as lotions to unhealthy over-secreting sores (R). Pyrogallic 
 Acid, is an excellent application to venereal ulcers (Vidal). Nitric Acid, as 
 escharotic, applied with a glass rod, Oil to protect the surrounding tissues, 
 
ULCERS AND SORES. 
 
 865 
 
 arrest by alkaline wash ; Sjj to Oj is a good acid lotion for washing (B) ; the 
 lotion for indolent and painful ulcers (R). Hydrastis, internally and externally, 
 employed with excellent results in rodent ulcer, and ulcers of legs, rectum, and 
 uterus (R). Sanguinaria, locally, to repress fungous granulations of indolent 
 ulcers, 1 part to 80 of Glycerin (P). Carbolic Acid, and Salicylic, locally (B) ; 
 the Glycerite of Carbolic Acid a good application to fetid sores (R) ; Carbolic 
 Acid, pure, freely applied under chloroform anesthesia, as a powerful and 
 penetrating caustic to destroy the diseased surface, in tropical sloughing 
 phagedena (Mn). Balsams of Peru and Tolu, excellent (P). Camphor, dusted 
 over indolent sores (R). Charcoal, locally to sloughing sores (R). Alcohol, 
 locally to cover sores with thin protecting layer of coagulated albumin (R). 
 Alum, dry or in solution, applied to relaxed and abundantly-secreting sores 
 (R). Turpentine, internally for ulceration of bowels (P). Collodion, as pro- 
 tective covering (P). Capsicum, a weak solution useful as a stimulant in 
 scrofulous or fistulous sores (P). Savine, as acrid (not chemical) caustic (P). 
 Potassa Fusa, or the milder Vienna paste, as escharotic ; to arrest its action use 
 a dilute acid (B). Zinc Chloride, the most efficient escharotic consistent with 
 safety (B). Zinc Sulphate, dried, dusted over sores (R). Iodoform, dusted 
 over surface (B) ; prevents granulation in all ulcers, and does no good except 
 to relieve pain (Gross). Aristol, is highly praised ; an excellent substitute for 
 Iodoform, being quite as efficient, and odorless ; has given excellent results in 
 treatment of indolent soft ulcers, syphilitic ulcerative processes, etc. Silver 
 Nitrate, as caustic, quickly rubbed over surface (B) ; applied to unhealthy 
 ulcers, also ulcers of the mouth (R). Copper Sulphate, to indolent ulcers : 
 touch with a crystal, or frequently apply a solution, gr. ij-x to the ^ (R). Cop- 
 tis, the infusion has high reputation (B). Chimaphila, Copaiba, Catechu, 
 Myrrh, Rhatany, Rhubarb, Storax, Benzoin, Tar-water, locally, are useful (P). 
 Oxygen, to atonic, painful ulcers (R) ; locally applied to ulcers [see page 410] 
 is highly efficient (Stoker). Nuclein, locally applied, cured an ulcer of 20 years' 
 standing in 4 months (Vaughn). Aurum, locally and internally, is highly 
 recommended in scrofulous ulceration. Galvanic Couplet [see under Bed- 
 sores]. Yeast, as a poultice (R) ; its action probably due to the Nuclein con- 
 tained in it. Section of exposed nerve-filament, in irritable ulcer, by bistoury 
 passed beneath the sore (Hilton). Cod-liver Oil, especially for ulcerations of 
 the glands, or indolent ulcers with excoriated edges, lupus, etc. Water, is suf- 
 ficient as dressing in the majority of cases. Hot Water, applied by the con- 
 tinuous immersion therein of the affected limb, is perhaps the most efficient 
 treatment of indolent ulcers of the leg or foot, resisting other applications ; 
 proved very successful in my Philippine experience for tropical ulcer and gan- 
 grenous sores of the leg, fissures and sores of the feet, and similar affections. 
 Rest and support of great value ; cleanliness, bandaging and recumbent posi- 
 tion in ulcer of legs, facilitate recovery ; also daily washing to restore the lost 
 vitality of parts ; elastic stockings, and the Esmarch bandage in chronic cases. 
 [Compare Chancre, Chancroid, Bedsores, Throat ; Gastric, Intestinal 
 and Uterine Ulceration ; Syphilis.] 
 
 R . Iodoformi, gi], 
 
 Mucil. Acaciae, rr^xv. 
 
 01. Menthse Pip., .... rr\jj. 
 
 Glycerini, r^xx. 
 
 M. Sig. — For unhealthy ulcers. 
 
 (Bronson.) 
 
 R. Emplas. Plumbi, . . . . ^ij. 
 Ung. Hydrargyri, . . . . ^ ss. 
 
 OleiCadini, ^ij. 
 
 M. Sig. — Spread on linen, and apply to 
 inflamed patches on palms from syphilis. 
 
 (Bumstead and Taylor?) 
 
 55 
 
 R. Hydrarg. Chlor. Cor., . . gr. xv. 
 
 Acidi Carbolici, ir^xx. 
 
 Aquce, q. s. ad ^ iv. 
 
 M. Sig. — For syphilitic ulcers, pack on 
 cotton, and renew daily. (Box.) 
 
 R. Ung. Petrolei, . . . . . ^ij. 
 Ung. Hydrargyri, . . . . £iv. 
 
 Olei Cadini, ^ij. 
 
 M. Sig. — Apply after removing scales 
 to chronic palmar and plantar lesions. 
 
 (Bumstead and Taylor?) 
 
866 UREMIA URETHRAL STRICTURE. 
 
 Uremia. 
 
 Pilocarpine, as an active diaphoretic, on the first appearance of uremic 
 symptoms, as headache, drowsiness, convulsions ; also free purgation by salines 
 or Elaterium (Y) ; a weak or fatty heart is a positive contraindication for this 
 drug (B); it must not be used if edema of the lungs exists, as further edema 
 and death will result (Whitla). Digitalis, the infusion internally, or a poultice 
 of the leaves to the back and abdomen, to procure free action of the kidneys 
 (B). Morphine, hypodermically, is most efficient (Loomis, Scanzoni); in acute 
 not in chronic uremia (Pf) ; is of remarkable value in uremic convulsions (B). 
 Oxygen, by inhalation, 10 litres thrice daily, is used with success (Jaccoud) ; is 
 as useful in practice as it is rational in theory (Carter) ; used with remarkable 
 success in a very bad case of uremic coma (Macalister). Sodium Benzoate, 
 15 grains 4 times daily, has been found very serviceable in threatening uremia 
 (Whitla). Sodium Bromide with Chloral, in full doses, by the bowel, for 
 uremic convulsions (Id). Potassium Salts given in Bright's Disease increase 
 the danger of uremia, hence Sodium salts are preferred (Id). Naphtalin, also 
 Iodoform and Charcoal, as intestinal disinfectants, as much of the toxic material 
 in the blood has been reabsorbed from the bowel (Bouchard). Amyl Nitrite or 
 Nitroglycerin, and brisk purgation, to relieve the dyspnea. Ether, in doses of 
 3ij by the mouth or 3ss hypodermically deep into the muscles (painful), for 
 uremic dyspnea ; must be pushed to ^ij or iij in 24 hours before good results 
 can be expected (Gallois) ; being rapidly eliminated it can be given in fairly 
 large doses without causing intoxication. Colchicum, is an excellent deriva- 
 tive in these cases and acts best when combined with other purgatives (B). 
 Elaterium, gr. -^g- to £, to procure free watery evacuations — cautiously ! (B) ; 
 the compound powder of Elaterin, gr. \ to iij, may be thrown on the tongue 
 and washed down with a teaspoonful or two of water (Y). Saline or Hydra- 
 gogue Cathartics, are of great importance to secure elimination by the intes- 
 tinal canal and to relieve the blood-pressure (B) ; purgation by salines on the 
 first appearance of uremic symptoms (Y). Transfusion, in uremic convulsions 
 (B). Hot Saline Injections, into the cellular tissue [see under Shock for for- 
 mula], gave excellent results in a case of chronic nephritis with uremia 
 (Hare) ; used in 2 cases with good recoveries, the patients having been bled 
 before administering the injections (Richardiere) ; is worthy of a wide trial and 
 seems to offer a chance of recovery in many cases which otherwise would 
 prove fatal. Hot Pack or vapor-bath, to induce powerful diaphoresis (B) ; the 
 hot wet-pack or hot air bath, may be given daily or oftener when uremia is 
 threatening. Milk is the only admissible food. Venesection, 10 to 20 ounces 
 of blood from the arm gives striking relief in acute forms of uremia in the 
 robust (Y) ; leeches to the temples for the headache (Id). [Compare Coma, 
 Convulsions, Bright's Disease, Dyspnea, Scarlet Fever, and the Lists of 
 Diaphoretics and Diuretics on pages 45 and 47.] 
 
 Urethral Stricture. 
 
 Aconite, is of great service in spasmodic stricture (P). Cocaine, locally, by 
 catheter (Smith). Buchu, in irritable urethra, spasmodic stricture, and gleet 
 (P). Opium, in full dose or an opiate suppository, with fomentations and a 
 warm bath, will often suffice in spasmodic stricture (CI). Catheterization, under 
 an anesthetic in spasmodic stricture if other measures fail to relieve ; also for 
 gradual dilatation in organic stricture, the safest and most generally applicable 
 treatment (CI). Oil, injected before dilatation (Wa). Thorough Division, by a 
 dilating urethrotome, the best operation for a radical cure ; 600 cases thus 
 treated without a death or permanent disability (Otis). Electricity, a weak 
 galvanic current, with negative pole to the stricture, will destroy it in 2 or 3 
 sittings by electrolysis, and if carefully done, is the most efficient and least 
 painful method of treatment for radical cure. 
 
URETHRITIS — URINARY DISORDERS. 86? 
 
 Urethritis. 
 
 Aconite, is used to advantage in urethral fever ; also for prevention of chill 
 after passage of sound (Pf, W). Strophantus, efficient in preventing rigors 
 after instrumentation on the urethra, the tincture in doses of 5 minims (Fen- 
 wick). Silver Nitrate, locally, very efficient in chronic urethritis in females 
 (W). Tannin, on bougies, once a week for 15 minutes, most efficient for ure- 
 thritis in the female (Wa). Zinc Sulphate, cast in sticks, for introduction into 
 the urethra (Wa). Myrtol, internally, in chronic inflammation of the bladder 
 and urethra (Br). Potassium Bicarbonate, with Potassium Acetate, aa gr. x in a 
 large cup of flaxseed tea or a glass of Vichy water, every 4 to 6 hours ; with 
 absolute rest in bed, a calomel purge, and urination under hot water, sufficient 
 for most cases of urethritis, which may arise from lithiasis, leucorrhea in fe- 
 males, etc. ; many cases of so-called aborted gonorrhea were really simple 
 urethritis (Otis). [Compare Gonorrhea.] 
 
 Urinary Disorders. 
 
 Aconite, of great service in sub-inflammatory retention from chill (P). Tur- 
 pentine, in hematuria and chronic catarrh of the bladder, incontinence from 
 atony, etc. (B). Strychnine, sometimes employed with marked benefit in reten- 
 tion or incontinence of the old (P). Cantharis, frequent or involuntary mictu- 
 rition, especially when coughing, in women from weakness of sphincter; one 
 or two drop doses (R). Cannabis Indica, in retention from spinal diseases (R) ; 
 Diuretin, a remarkably efficient diuretic in cardiac and renal dropsy, 15 grains 
 several times daily will increase the urine three and fourfold. Digitalis, holds 
 high rank as a diuretic, 3j °r ij of the infusion night and morning, or oftener 
 if necessary ; in sudden depression from cold or damp, or after scarlatina if 
 danger threatens (P). Benzoic Acid, or Sodium Benzoate, in 10 to 15-grain 
 doses, to render alkaline urine acid, and check the formation of phosphates 
 (B) ; this acid and its salts are among the very few agents by which morbid 
 alkalinity of the urine can be neutralized. Salol, is quicker in this respect than 
 the benzoates [see page 64], Salicylic Acid, to acidify an alkaline urine. 
 Potassium Bitartrate, in full doses, will acidify an alkaline urine. Urotropin, 
 in ammoniacal fermentation of the urine, is very efficient ; renders the urine 
 acid and is a valuable urinary antiseptic, useful also in phosphaturia. Nitro- 
 hydrochloric Acid, dilute, gtt. x-xv thrice daily in water, forphosphatic deposits 
 (Mears). Ammonium Carbonate, in 6-grain doses, 3 or 4 times a day, to ren- 
 der acid urine alkaline. Triticum, in pint doses daily of its infusion or decoc- 
 tion, for strangury, cystitis, and many other complaints connected with the 
 urinary apparatus. Alkalies, to neutralize acid urine, and control chronic 
 cystitis ; the Liquor Potassae preferable to the bicarbonates, and citrates, which 
 have diuretic action and increase frequency of micturition ; Liquor Potassas 
 mixed with the tincture of Hyoscyamus or Belladonna, may undergo chemical 
 changes, but the combination materially controls painful and frequent mictu- 
 rition in bladder troubles (Thompson). Buchu, renders more help than any 
 drug known in incontinence or retention from catarrh of bladder implicating 
 the ureters and even the kidneys (P). Water, copious injections are beneficial 
 in some cases of suppression (R). Diet, a vegetable diet has a powerful influ- 
 ence to alkalinize an acid urine ; also fruit, milk and fish [see page 64]. Com- 
 pare the Lists of Diuretics and other agents acting upon the urine, on pages 46 
 and 64 ; also the articles entitled Bladder irritable, Bladder paralysis 
 of, Chyluria, Cystitis, Diabetes insipidus, Dysuria, Dropsy, Enuresis, 
 Hematuria, Lithiasis, Nephritis, Oxaluria, Uremia, Urethral Stric- 
 ture. 
 
868 
 
 URINE, CLINICAL EXAMINATION. 
 
 R. Pulv. Scillse, 
 Pulv. Digitalis, 
 
 Hydrarg. Chlor. Mitis, aa gr. xij. 
 M. ft. pil. no. xij. Sig. — One pill as a 
 diuretic twice daily. [Sir A. Clark.') 
 
 R. Potassii Citratis, .... ^j. 
 Sodii Bicarbonat., . . . Zv, 
 
 Syr. Limonis, 3J. 
 
 Aquas, q. s. ad^iv. 
 
 M. Sig. — A teasp. every 2 hours, to 
 
 render the urine alkaline. {Roberts.} 
 
 R. Tinct. Digitalis, 3 ss -j- 
 
 Spt. ^Etheris Nitrosi, . . ^iij. 
 Liq. Ammon. Acetat., . . 5ss. 
 
 Aquae, q. s. ad\v). 
 
 M. Sig. — One-sixth every 3 hours, to 
 
 re-establish the renal secretion. ( Goodeve. ) 
 
 R . Potassii Bicarb. , .... 5 iijss. 
 
 Acidi Acetici, gvj. 
 
 Aquae, Jiij. 
 
 M. Sig. — Teasp. doses as required, as 
 a diuretic. Each dose contains about gr. 
 x of Potassium Acetate. 
 
 Urine, Clinical Examination. 
 
 Urine for Examination should be that passed in the morning, or a sample of 
 all passed during the 24 hours. 
 
 Quantity. Normal quantity is about 50 fl. oz. in 24 hours, from which there 
 may be considerable variation either way, according to the quantity of sweat, 
 the fluidity of food used, etc. 
 
 Specific Gravity. If possible, take the mixed urine. Normal sp. gr. is about 
 1. 018, i. e., 18 grains of solids in each fl. oz. If sp. gr. is high, suspect sugar; 
 if low, suspect albumin. 
 
 Color and Specific Gravity. Urine pale and copious, of sp. gr. 1.030 and 
 above, indicates the presence of sugar. Pale and copious, sp. gr. below 1.018, 
 is seen in hysteria, convulsions, nervous diseases. Color high, urine scanty, 
 sp. gr. above normal, — in fevers and the uric acid diathesis. Color high, urine 
 scanty, sp. gr. below normal, — in Bright's disease. Urine is colored very yel- 
 low or greenish-yellow, by Bile and by Rhubarb: dark, with odor of violets, 
 by Turpentine : dark, muddy, smoky, by blood and strong coffee : black, by 
 disintegrated blood, putridity of the urine, Tar, Creosote : olive-green or smoky, 
 by Carbolic Acid and Salol : brown, by Arbutin : green, by Indigo and Salicylic 
 Acid : dark-green, by Karin and Thymol : dark-blue, by Methylene Blue : bluish- 
 violet, by Resorcin: violet, by Juniper: greenish-yellow, reaction acid, by San- 
 tonin : reddish-purple, reaction alkaline, by Santonin : blood-red, by Hema- 
 toxylon : mage7ita, by Fuchsin : reddish-brown, by Sulphonai. 
 
 Smell, — fragrant, indicates Cystine or Sugar: a fetid smell indicates alka- 
 linity : the smell of violets indicates Turpentine. 
 
 Reaction, — of 24 hours' urine in health is always acid, but it may be alkaline 
 shortly after a meal. It is often alkaline from medicine or disease. If exces- 
 sively acid, examine for crystals of uric acid. If alkaline, let the test-paper dry, 
 so as to ascertain whether the alkali be fixed or volatile. 
 
 Albumin by Heat and Nitric Acid. With Acetic Acid, or dilute Ammonia, 
 make the urine slightly acid, if alkaline or neutral. If a precipitate appear on 
 boiling, it may be Albumin or Phosphates. Add a drop or two of nitric acid ; 
 if the precipitate dissolve, it is phosphates ; if not, it is albumin. If a deposit 
 or turbidity disappears on heating, it consists of urates ; if not, add a drop of 
 nitric acid; if now dissolved, we have phosphates; if not, cystine. Other 
 Tests are the Potassio-Mercuric Iodide, Sodium Tungstate, Potassium Ferro-cy- 
 anide, Acetic Acid, and Picric Acid ; but the above described one, if carefully 
 done, will give as good results as any. 
 
 Tests for Albumin are interfered with by the presence in the urine of alka- 
 loids, analgen, antipyrin, benzoic acid ( contained in benzoin, benzoates, 
 balsams of Peru and Tolu, cranberries, plums, styrax), benzosol, chloroform, 
 copaiba, hypnone, oil of santal, piperazin. 
 
URINE, CLINICAL EXAMINATION. 869 
 
 Bile Pigment and Bile Acids. Vogel's color-table. MarechaVs Test, as 
 follows : Put Z] of urine in a test-tube, and permit one or two drops of Tinct. 
 Iodi to trickle down along the side of the tube, held horizontally nearly, so 
 that the two fluids may touch, but not mix. If bile pigment be present, a fine 
 green color will at once be developed below the red Iodine layer. Noel's 
 Test, Pettenkofer's Test, Nitric Acid Test, Oxide of Silver Test. 
 
 Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a pre- 
 cipitate ceases to form. Thus estimate the amount of chlorides. 
 
 Sugar. Urine containing sugar is usually light-colored, froths readily when 
 poured from one vessel to another, and has a high specific gravity. Fehlings 
 Test, as follows: Add to the boiling urine a few drops of freshly- prepared 
 alkaline cupric tartrate volumetric solution (Fehling's solution). If sugar be 
 present, a yellow, orange or red precipitate of cuprous oxide will form, 10 cc. 
 of the solution being reduced by gramme 0.05 of diabetic sugar (anhydrous 
 glucose). For the preparation of Fehling's solution, see page 296. Much 
 more convenient is Dr. Piffard's cupro-potassic paste, or Dr. Pavy's cupric 
 test pellets (see Tyson on Urine, page 57), or Wyeth's compressed tablets for 
 preparing Fehling's solution; a box of the latter costing only 50 cents, and ob- 
 tainable in any good drug-store. The writer has used these tablets for several 
 years with great satisfaction. 
 
 Pavy's Solution is a modification of Fehling's ; is equally good for qualitative 
 and volumetric testing, and is intended for those who prefer the apothecaries' 
 weights and measures to the metric system. It is made in the same manner 
 as Fehling's, 100 minims corresponding to yi grain of diabetic sugar, and con- 
 sists of Copper Sulphate, gr. 320; Potassium Tartrate (neutral), gr. 640; Caus- 
 tic Potash, gr. 1280; and distilled Water, f^ 20. Other Tests for sugar are 
 Bottcher's Bismuth Test, the Fermentation Test, Moore's, Trommer's, Haines', 
 the Picric Acid and the Indigo-Carmine. They are all useful, but will not be 
 detailed here, as one good method is all that the average practitioner wants. 
 
 Tests for Sugar are interfered with by the presence in the urine of acetani- 
 lid, antipyrin, ammonium salts, arbutin (contained in epigea, kalmia, uva 
 ursi, etc.), benzoates, betol, bromides, camphor, some carbohydrates (e. g. 
 animal gum), chloral, chloroform, copaiba, creatinine, cubeb, glycerin, glyco- 
 suric acid, iodides, morphine, phenacetin, pyrocatechin, rhubarb, rumex, sali- 
 cylic acid (contained in salicylates, oil of wintergreen, oil of betula and salol), 
 senna, serum-globulin, sulphonal, turpentine, urethan, uric acid and urates. 
 Of the foregoing, those which actually reduce the Fehling's solution are acet- 
 anilid, antipyrin, chloral, chloroform, copaiba, glycerin, morphine, rhubarb 
 and salicylic acid. 
 
 Te7?iporary Glycosuria may be produced by poisoning with alcohol, amyl 
 nitrite, carbonic oxide, chloral, hydrocyanic acid, morphine, sulphuric acid. 
 
 Acetone. Add to the urine a drop of an aqueous solution of Magenta 
 decolorized by sulphurous acid. If Acetone is present a violet color is pro- 
 duced, the intensity of which is proportional to the amount of acetone. In 
 dilute solutions the coloration does not appear until after four or five minutes. 
 If the amount of acetone be very minute the urine may be distilled, the first 
 portion coming over being examined. In this way a very minute proportion 
 of acetone may be detected (Chautard). 
 
 Urea. Place a drop of urine on platinum-foil, add a drop of Nitric Acid, 
 and leave undisturbed in a cool place for a minute or two. If the urea is in 
 excess, crystals of uric nitrate form immediately. To ascertain the percentage 
 of urea, use the ureameter of Doremus, or that of Mayhew, manufactured 
 by Mayer and Meltzer of London, or the ureometer sold by Parke, Davis & 
 Co. If the latter is used the Sodium Hypobromite solution should be em- 
 ployed rather than the chlorinated soda solution, as the former gives the best 
 results. These instruments are simple and accurate enough for clinical pur- 
 poses. Bartley's ureometer is probably the most accurate. 
 
Syo 
 
 URTICARIA. 
 
 Mucus and Pus resemble each other so closely under the microscope, that it 
 is almost impossible for any one, except an expert, to distinguish between them 
 thereby. Mucus is more cloudy and flocculent to the naked eye than pus, 
 which is generally of a stringy consistence and thickish yellow appearance at 
 the bottom of the vessel. The supernatant liquid being poured off, and an 
 equal bulk of Liquor Potassae added, the deposit, if containing much pus, be- 
 comes gelatinized, and so tough that it cannot be poured out. If mucus, Acetic 
 Acid added coagulates it, forming delicate molecular fibres. 
 
 Other Deposits are best examined with the microscope, and compared with 
 good plates, rather than with printed descriptions. The plates in Hoffmann 
 and Ultzmann on Analysis of the Urine, will answer the wants of most general 
 practitioners, but the text follows the metric system. The urinary deposits 
 may be classified thus : — 
 
 In Alkaline Urine 
 
 only. 
 
 In Alkaline or Acid 
 Urine. 
 
 Organized Deposits. 
 
 Calcium Phosphate 
 Ammonium Urate 
 Ammoniaco- 
 magnesian, or 
 Triple Phosphates. 
 
 Uric Acid 
 
 Urates 
 
 Phosphates 
 
 Oxalates 
 
 Cystine. 
 
 Mucus Torulce 
 Pus Sarcinse 
 Blood Vibriones 
 Tube-casts Bacteria 
 Spermatozoa, etc. 
 
 Necessary Apparatus. A dozen Test-tubes. Alcohol lamp. A small porce- 
 lain dish. 2 watch-glasses. A sheet of platinum foil, % inch square. 3 pipettes 
 of different sizes, to be used only for urine. A 2 oz. graduate. Urinometer 
 (Squibb's). Ureameter (one of the 4 named on p. 869). Litmus-paper, blue 
 and red. The reagents mentioned above. A little Grape-sugar, for use in 
 testing the Fehling's solution. A Physician s Pocket Reagent Case, intended for 
 urinalysis at the bedside, is put up by Parke, Davis & Co., and sold at the low 
 price of $1.50. It contains a set of Dr. Oliver's Test Papers or Pellets (pre- 
 ferably the latter), a color scale, specific gravity beads, two test-tubes, a pipette, 
 and full directions for the use of the reagents. 
 
 The foregoing directions comprise all that the average practitioner will usu- 
 ally perform in the matter of urinary analysis. For fuller instructions the 
 reader is referred to one of the numerous manuals on the subject, among 
 which may be mentioned Da Costa on Medical Diagnosis, Chapter vn, — 
 Tyson on the Practical Examination of Urine, — and Sir Henry Thompson's 
 Clinical Lectures on Diseases of the Urinary Organs, Lecture xxiv. 
 
 Urticaria. 
 
 Antipyrin, internally, is promptly efficient in urticaria, also in the urticaria- 
 like eruptions of children. Chloroform, as ointment to allay itching (R). 
 Potassium Cyanide, or Hydrocyanic Acid (R). [See under Prurigo.] Nitric 
 Acid, as dilute wash, controls itching and prevents wheals (R). Benzoin, the 
 compound tincture painted on the skin for itching (R). Benzoic Acid, gr. viij 
 in 3iv aquae, as a lotion (Squire). Sodium Phosphate, in doses of 60 to 80 
 grains every 3 hours, is a valuable agent in this affection (Wolff). Zinc Car- 
 bonate and Zinc Oxide, aa. 3jss, Carbolic Acid 3ss, Lime-water ^ij, Rose-water 
 to make ^iv, as a lotion applied freely and frequently for the itching (Id). 
 Sodium Salicylate, gr. ij every % hour, is remarkably efficient (Smith) ; gr. xx 
 thrice daily is effective. Copaiba, in full doses will produce urticaria, but drop- 
 doses every l / z hour will sometimes control it (Smith). Strychnine, with emetics 
 and purgatives, when the affection is chronic (Guibout). Colchicum, in gouty 
 persons (R). Lead, in lotions to ease itching (R). Alkalies (R). [See under 
 PRURIGO.] Warm Baths, may be employed with benefit. 
 
UTERINE CONGESTION AND HYPERTROPHY. 87 1 
 
 Uterine Affections. 
 
 Cimicifuga, to prevent miscarriage in irritable uterus and prolapsus (R) ; 
 promises to be a valuable remedy in uterine affections (Wa) ; is remarkably- 
 efficient in neuralgia and sympathetic pains arising from an irritable uterus, no 
 matter what their precise character (P). Belladonna, with Tannin, as supposi- 
 tory in uterine neuralgia (R) ; as vaginal or rectal injections, in neuralgic or 
 inflammatory pains (Tr). Arsenic, in irritable ulcers, of decided benefit ; gr. 
 2^ ter die, after meals (Wa). Carbonic Acid, injected up the vagina for neu- 
 ralgia of the uterus (R). Opium, with Starch as injection into the rectum, will 
 subdue the pain of uterine diseases (R) ; gives more speedy relief than any 
 other remedy in irritable uterus, but long-continued is one of the worst (Wa). 
 Iodized Phenol, has proved the most generally efficient agent for intra-uterine 
 use during eight years' experience, applied by hard rubber probes wound with 
 cotton-wool ; it removes cervical mucus, gives freedom from pain, softens and 
 dilates the cervix, heals abrasions, removes induration and villosities, regulates 
 the menses, improves appetite and digestion, acts as a general alterative, over- 
 comes barrenness, etc., if used long enough, but rapid results are not attainable 
 by any method of treatment (Battey). Lead, as plaster, for pain in the back 
 due to uterine disease (R). Chloroform, spray, in uterine neuralgia (R). Aqua- 
 puncture, has had extraordinary success in uterine colic (B). Baths of warm 
 salt water remarkably useful in nervous or inflammatory hysteralgia (Tr). [See 
 Abortion, Amenorrhea, Climacteric, Dysmenorrhea, Endometritis, 
 Hemorrhage post-partum, Leucorrhea, Menorrhagia, Menstrual Dis- 
 orders, Metritis, Metrorrhagia, Prolapsus uteri, etc.] 
 
 Uterine Cancer. 
 
 Conium, useful as a palliative, ^iij— iv ad Oj aquae, as injection for the ex- 
 treme pain of uterine cancer (Wa). Arsenic, small doses for a long time, with 
 a strong solution of Iodine and Glycerin locally (Atlee) ; is believed to retard 
 the growth of uterine cancer (Br). Carbonic Acid, injected vaginally, to relieve 
 the pain (R). Opium, stands first in the list of palliatives, quieting irritation, 
 allaying pain (Wa). Morphine, the specific action thereof upon the uterine 
 circulation should be utilized in hopeless cases of this disease (Lutaud). [See 
 page 405.] Carbolic Acid, a weak solution as injection, an excellent cleanser, 
 healer, disinfector, and allayer of pain (R). Bromine, the best escharotic for 
 destruction of the mass (E). Glycerite of Tannin, checks discharge and stench ; 
 is still better if mixed with glycerite of Carbolic Acid (R). Iodoform, with 
 cocoa-fat as bolus inserted into excavation produced by cancer (R) ; gr. v-xin 
 each bolus (W). Iodine, the saturated tincture thoroughly applied to the 
 entire surface of the mass, is frequently of great use in checking hemorrhage, 
 and seems to temporarily check the extension of the disease (E). Chloral, as 
 anodyne, will agree with most persons (E) ; relieves the pains (W). Chloro- 
 form Spray, for some minutes (R). Cannabis Indica, to allay the pain (W). 
 Thyroid Extract, used internally with apparent curative results in three cases 
 of carcinoma of the cervix (Bell). Surgical Measures, are to be advised, as 
 medicines can only serve as palliatives. 
 
 Uterine Congestion and Hypertrophy. 
 
 Aurum Salts, often beneficial in chronic metritis with scanty menstruation 
 (B). Ergotin, long continued, successful in chronic metritis; lessens con- 
 gestion (B) ; long continued has produced remarkable results in fibroids and 
 polypi and chronic metritis, large, spongy, subinvoluted uterus (P) ; by inter- 
 stitial injection into the cervix, has been of great benefit (G). Carbolic Acid, 
 undiluted, on cotton-wrapped probe, no better treatment for uterine catarrh (B). 
 Iodine, has proved the most valuable of all remedies as a local stimulant and 
 
8;2 
 
 UTERINE DISPLACEMENTS — TUMORS. 
 
 a reliable alterative and excitant of uterine contraction ; use a saturated tinc- 
 ture to any part not exposed to the air (E) ; may be injected into cervix (G). 
 Iodo-tannin, or Iodoformi 3j. Ac. Tannici ^j, a serviceable application in many 
 inflammatory and hypertrophic conditions ; Iodoform suppositories in chronic 
 metritis (P). Potassium Bromide, our main stand-by in uterine troubles ; 
 aside from its soothing properties it seems to divert the blood from the womb, 
 and to lessen uterine congestion (G) ; a specific cure for simple subinvolution, 
 the benefit being derived from the potash (Tait). Digitalis, in subinvolution 
 (B). Glycerin, on cotton tampon to cervix as a local hydragogue (Thomas). 
 Glycozone, as an application in tumefied conditions of the cervix and uterus, 
 is far superior to pure glycerin (Edson). Potassa, Caustic Potassa and Potassa 
 cum Cake, are said to be effective in chronic metritis ; must be used cautiously 
 (B). Chromic Acid, a strong solution to interior of uterus, a very useful appli- 
 cation. Ipecacuanha, in subacute metritis of the puerperal state (Tr). Iron, 
 locally in uterine catarrh (R) ; as a tonic, Iron and other restoratives, a cardinal 
 rule in the treatment of all uterine disorders ; with Ergot, Quinine, Arsenic or 
 Potassium Bromide, whenever the womb as a whole is congested or hyper- 
 trophied ; Syr. Ferri Iodidi, with Cod-liver Oil, wins half the battle (G). Zinc 
 Valerianate, in 2- to 4-grain doses thrice daily, is one of the best nervines in 
 these cases (G). Mammary and Parotid Extracts, used with signal benefit as 
 internal remedies in several cases of subinvolution and menorrhagia (Bell). 
 Scarification, after dry cupping, in chronic metritis (Thomas). Electricity, in 
 chronic congestive enlargement, a galvanic current of moderate intensity, slowly 
 interrupted (B). Water, hot injections or douche, also cold alternately, one of the 
 most effective measures, a gallon very hot ter die (R) ; especially valuable in con- 
 gestion, which is generally venous ; elevated hips a necessary part of treatment 
 (E) ; cold water is often better than hot (G). Rest, to the patient and the 
 organ, is of prime importance, abdominal bandage, skirt-supporters, pessary 
 if anteversion or retroversion, abstinence from sexual intercourse (Thomas). 
 
 B 
 
 n 
 
 Ext. Hurauli, .... 
 Elix. Ammon. Valerianae 
 Syr. Lactucarii, . . . . aa £ ss. 
 M. Sig. — A dessertsp. at bedtime, or 
 during the day when needed, as an anti- 
 spasmodic. ( Goodell. ) 
 
 R . Iodi, 
 
 Potass. Bromidi, . . aa gr. xx. 
 
 Tinct. Iodi, gj. 
 
 AqureDestillat., q. s. ad giv. 
 M. Sig. — TT^xxx to be injected into the 
 cervix by 3 to 5 punctures. [Goodell.) 
 
 Uterine Displacements. 
 
 Anteversion, without prolapsus, is not a malposition (F). Ice, locally when 
 parts inflamed (R). Hot-water injections, to give tone to the vessels, essential ; 
 also valuable after reduction of malpositions (E). Mechanical Means, only 
 reliable or safe in retroversion and prolapse ; the sound, as a means to restore 
 a retroverted uterus to position, cannot be regarded as free from risk, even in 
 skillful hands (E). Pessaries, harmful unless expertly fitted ; should be adjusted 
 so as to restore the uterus to the normal line, where the circulation will be least 
 obstructed, not too high ; should never be employed where cellulitis exists (E). 
 Cotton Roll, as a substitute for the orthodox pessary, is far superior ; use 
 Borated Cotton in flat sheets, rolling it into a roll 2 inches long by 1 inch 
 diameter, and saturating in Boroglyceridi 5J, Alumini Acetatis Jjj, Glycerini 
 Pur. q. s. ad Oj ; if an astringent is required, the Acetate may be replaced by 
 Alumini Sulphas (Wylie). [Compare Prolapsus Uteri.] 
 
 Uterine Tumors. 
 
 Mercury, the Bichloride in small doses, long continued, of undoubted value 
 in treatment of fibrous or polypoid growths ; gr. -^ every 6 hours, sometimes 
 restrains the hemorrhage when other remedies fail (Wa). Calcium Chloride, 
 
UTERINE ULCERATION — UVULA — VACCINATION. 873 
 
 in 30-grain doses thrice daily, has by prolonged use cured uterine fibroids 
 (Hewitt) ; calcifies uterine arteries, also those of the body generally, and is 
 dangerous (Tilt, Wells). Ergotm, hypodermically for fibrous tumor (R) ; 
 gr. ij-vj on alternate days, give excellent results (B) ; nine cases of fibroid 
 treated thus by Hildebrandt with good results (P) ; this method often causes 
 great pain and severe local inflammation (W); one grain each of Ergotin 
 and Ferri Sulphas Exsiccat., in pill thrice daily, persistently, for uterine 
 fibroids, using for the hemorrhages a tampon saturated with tincture of Iodine 
 or Monsel's solution (Parvin). Opium, has specific action upon the uterine 
 circulation, and in bleeding from hopeless cases of cancer or fibroid tumors 
 should be used freely, regardless of the opium habit (Editorial, N. Y. Medical 
 Record Dec io, 1887). Mammary Extract, used as an internal remedy with 
 signal benefit in two cases of uterine fibroid (Bell). Ammonium Chloride, in 
 fibrous tumors, gives more benefit than any other remedy, gr. x, twice or thrice 
 daily, for weeks and months consecutively (Atlee). Ferrous Subsulphate, in- 
 jected to restrain bleeding, cautiously ! (B). Saline Mineral Waters, especially 
 those at St. Catherine's, Canada, are useful (B). Aliment, carefully regulated, 
 chiefly animal food, with recumbent posture while flowing, and long-continued 
 use of Ergot in small doses, may accomplish something (E). 
 
 Uterine Ulceration. 
 
 Hydrastis, quickly improves ; the fluid extract undiluted as a topical appli- 
 cation in uterine and vaginal leucorrhea, ulcerations and erosion of cervix (B). 
 Carbolic Acid, pure, over the surface twice a week in simple ulceration (R). 
 Silver Nitrate, a serviceable application, but is often abused (B) ; the solid stick 
 applied to surface, after cleansing and drying with cotton-wool (Wa). Alum, 
 as hip-bath, lb j ad Cj, and vaginal injection, is of great utility in ulcerations 
 of the os uteri, or of the uterine cavity (Recamier). Glycerin 25, Alcohol \7.%, 
 and pure Creosote 1 part, an excellent application to ulcers of the neck. Gly- 
 cozone, as an application to ulcerated cervix, is far superior to pure glycerin 
 (Edson). [See under Leucorrhea, for manner of application.] Bismuth 
 Subnitrate, with enough glycerin to make a thick cream, is the best of all appli- 
 cations for ulceration of the os and cervix uteri (Suesserott). Vegetable 
 Astringents, infusions or decoctions of Galls, Oak-bark, Hamamelis, Geran- 
 ium, Alum-root, etc.; the Glycerite of Tannin, or Iodoform and Tannin, 
 packed around the cervix (B). 
 
 Uvula. 
 
 Tannin, Rhatany or Zinc, as astringent lozenges, for relaxed uvula (A). 
 Cocaine combined with extract of Krameria, in a pastille, is often very effectual 
 as a local astringent for elongated uvula (Hall) ; a 20 per cent, solution applied 
 by the spray or brush, will often suffice to give relief in acute uvulitis (Id). 
 Ammonium Bromide, gr. xx ad gj aquae, as gargle, is one of the best applica- 
 tions, being as soothing as it is astringent (Muirhead). Amputation of the 
 elongated part (A) ; after applying a 20 per cent, solution of cocaine, by 
 Mackenzie's uvulatome, or the uvula may be seized with forceps and a portion 
 cut off with scissors (Hall) ; the hemorrhage may be severe and may recur 
 some hours after the operation, but will be arrested by slowly sipping a mixture 
 of Tannin 3vj, Gallic Acid 3ij and Water Sjj (Mackenzie). 
 
 Vaccination. 
 
 Aconite, internally with Belladonna Ointment locally twice daily for erysipe- 
 latous redness after vaccination (R). Zinc Oxide, dusted over, to allay the 
 subsequent local irritation (W) ; with Pulv. Amyli, equal parts, over the surface. 
 Lead Acetate, Z) to Oj water, as lotion for irritable pock (Foster). Carbolic 
 Acid, 3j to Oj water, as lotion for excessive redness, with burning and itching. 
 
874 VAGINISMUS VARICOSIS. 
 
 Vaginismus. 
 
 Ether, by inhalation as anesthetic, to ascertain cause, usually a displace- 
 ment, fissure, or cellulitis (E). Thiol j and Glycerol ij, in which soak a tampon 
 and apply for vaginal irritation (Bloom). Iodoform, in suppository when red- 
 ness and excoriation ; but Belladonna, the extract I part with 8 or 9 of fresh lard, 
 when pain alone (Gallard). Tents, to gradually dilate the vagina, may be im- 
 pregnated with various sedatives (Id). Hygiene, sun-baths, hot-water injections, 
 fresh air, removal from husband, etc. (E). Operation, Sims', removal of hymen 
 with scissors and insertion of glass plug till parts are healed, when the cicatrix 
 is to be divided, etc. (E) : Atthill removed a narrow strip of mucous membrane 
 on each side of the vaginal orifice with marked success in a very severe case. 
 Cocaine, in ointment with Morphine and Conium, smeared over the painful 
 spot with the finger ; or in a pessary with Iodoform and extract of Belladonna, 
 may give speedy relief (Whitla). 
 
 Vaginitis. 
 
 Silver Nitrate, in solution, gr. xl to the ^, applied within the cervical canal 
 and over the vaginal mucous lining (E). Pinus Canadensis, the concentrated, 
 colorless extract, locally, has a very soothing effect in acute vaginitis. Tannin, 
 the glycerite in chronic vaginitis of children (R). Emollients, with Opium, as 
 injections (Goodell). [Compare Gonorrhea, Leucorrhea.] 
 
 Varicella. 
 
 Ammonium Acetate, in diaphoretic and antifebrile mixture. [See under Fe- 
 ver, Simple, for formula.] Inunction, with Camphorated Oil, or thin starch, 
 to relieve itching and allay inflammation (P). Aconite, is of great value (B). 
 Water, hot and cold baths and packs are of great utility ; cold, if hyperpyrexia ; 
 cold compress if sore throat ; hot or warm pack when free diaphoresis required 
 (B). Diet, no animal food, milk best, with careful attention to the bowels, 
 patient to be kept cool with light covering, and use of a mattress rather than 
 a feather bed, is all the treatment required (A). Saline Mixture, if high fever. 
 Quinine, during convalescence. Complications are to be treated symptom- 
 atically. 
 
 Varicocele. 
 
 Hamamelis, appears to have permanently cured one case (R). Ergot, gr. 
 ij-vj of Ergotin hypodermically, the needle to be inserted among the affected 
 veins, care being taken not to puncture a vein, is effective ; severe pain follows 
 for a few hours (R). Water, cold douche to the perineum and buttocks, with 
 suspension of testicles in cold water (R). Radical Cure, consists in obliterating 
 the veins by wire ligatures, etc. (CI). 
 
 Varicosis. 
 
 Hamamelis, is employed with satisfaction in varicose veins and ulcers (Pf ). 
 Digitalis, by fomentation, in acute inflammation from varicose ulcers (R). 
 Ergotin, injected alongside of vein, but not within it, has cured (B). Bandage, 
 or elastic stocking; with cold sponging and rubbing upwards, as palliatives 
 (CI). [Compare Hemorrhoids, Ulcers.] 
 
VARIOLA VERTIGO. 875 
 
 Variola. 
 
 Treatment, in no way differs from that of the other eruptive fevers. Stokes' 
 three indications for treatment are accepted by other authorities and are : (1) 
 exclusion of air, (2) keeping the parts in a permanently moist state so as to pre- 
 vent hardening of the scabs, (3) lessening of local irritation (Whitla). Quinine, 
 small doses in adynamic states, larger doses when hyperpyrexia (B). Iron and 
 Quinine, in large doses by the mouth, also Ergotin by deep parenchymatous 
 injection, and Turpentine by the bowel, in the hemorrhagic form of the disease 
 (Whitla) ; these two drugs are the most valuable antiseptics in variola (Moore). 
 Opium, low, muttering delirium ; not so much used now as formerly (B) ; Mor- 
 phine in the insomnia of the advanced stage, once or twice only, but not when 
 copious salivation or mucous expectoration (Wa). Vaccinia Antitoxin, has been 
 used in a few cases with much success by Beclere [see page 184]. Cimicifuga, 
 is given internally by some, who assert that it prevents pitting (R). Mercury, 
 in ointment or plaster, to prevent pitting in semi-confluent, or barely confluent 
 cases (Wa) ; formerly used (R). Camphor, is said to restore the eruption, if 
 retrocedent; in confluent malignant smallpox, camphor alone, or with Opium, 
 may be used for great depression of the vital powers (Wa). Belladonna, suc- 
 cessfully used both as prophylactic and curative agent (Erasmus Wilson); 
 gr. yi-) every 3, 4, or 6 hours, to dilatation of pupil and some stupor, found 
 effectual (Wa). Carbolic Acid, is used with decided advantage (Wa) ; [see 
 under Measles] ; has been much used on theoretical grounds, but not with 
 success (B). Ammonium Carbonate, has had cheering success (Wa) ; [see 
 under Scarlet Fever]. Chloral, temperature high, much delirium and rest- 
 lessness (B). 
 
 External Applications, as powdered starch, flour, or Zinc Carbonate, 3 parts 
 to 1 of Zinc Oxide with Olive Oil ; cold or tepid water with vinegar, sponged 
 over body twice or thrice daily (Wa). Diet, tea and dry toast, raw eggs beaten 
 in cold milk, beef-tea, grapes, roasted apples, ripe fruits in season ; cold water 
 may be drank freely. Fats, bacon fat smeared over the face, to allay itching 
 and prevent pitting. Silver Nitrate, on a sharp-pointed stick, inserted into 
 each vesicle after rupture, to prevent pitting (B) ; or simply paint skin with a 
 solution of gr. xx to the J (R). Iodine, the tincture to prevent pitting, is painted 
 ten times over face if on first day of eruption, 12 if on the second day, 12-16 
 times if on third day (B). Collodion, or solutions of India-rubber or Gutta- 
 percha in Chloroform, to prevent pitting ; or cotton-wool dipped into Lime lini- 
 ment, applied to face or neck (R). Carron Oil [see page 235], makes a good 
 dressing for the face. Salicylic Acid, Z] in a quart of hot water, applied by 
 sponging to the skin and by gargle to the throat every 4hours, also used internally 
 if much diarrhea, is my treatment and I have not lost a case of variola since 
 adopting it (Pope). Eucalyptus, the Oil as inunction from the very commence- 
 ment of the disease, is to be strongly recommended as an antiseptic application 
 to the skin (Whitla). Water, as cold baths and cold pack, of great utility (B) ; 
 packing especially on retrocession of rash (R). [Compare Vaccination.] 
 
 Vertigo. 
 
 Digitalis, in small doses, alternately with tincture of Larch, and a long 
 course of Iron Citrate and Strychnine, in essential vertigo, without any other 
 head symptoms, and with general depraved nutrition, the most effectual treat- 
 ment (Wa). Potassium Bromide, oftens controls paroxysmal vertigo, without 
 coexistent spasm, or organic brain-disease (Wa). Ammonium Bromide, in 
 an effervescing form with Cascarilla, for vertigo from overwork, when there 
 are usually restlessness, insomnia, depression of spirits, with a sense of impend- 
 ing evil (Wa). Alkalies and Bitter Tonics, give the best results in vertigo 
 
876 VOMITING. 
 
 of gastric origin. Sodium Bicarbonate, after meals, tonics before meals. 
 Strychnine, with Iron, thrice daily, gives good results. Corrosive Sublimate, 
 in small doses, with attention to the bowels and diet. Cod-liver Oil, for giddiness 
 of the aged, when no serious brain-disease (R). Aurum, in vertigo and ver- 
 tiginous sensations connected with gastric disorders or due to cerebral anemia, 
 which are often removed by a course of the salts of gold (B). Quinine, in 
 aural vertigo, Meniere's disease, 10 to 15 grains daily, continued with intervals 
 for several weeks (Charcot). Electricity, the constant current daily, anode 
 over cervical vertebrae, cathode over the ear, the current strength being gradu- 
 ally increased to toleration and continued from 3 to 5 minutes at a sitting, is 
 of great benefit in aural vertigo, ameliorating the condition in most cases. 
 Nitro-glycerin, gives good results in epileptic vertigo (Br). Vertigo, is usually 
 symptomatic of disorder of the stomach, or of the liver (cholemia), sometimes 
 of general debility, rarely of disease of the brain (H). 
 
 Vomiting. 
 
 Arsenic, in many forms of gastric vomiting, especially that of alcoholism 
 and chronic ulcer (B), and in the vomiting of cholera (R) ; gtt. ss of Fowler's 
 solution, every y 2 hour for 6 or 8 doses, often relieves vomiting after a debauch, 
 the morning vomiting of drunkards, and that of pregnancy (Smith). Nux 
 Vomica, stands next to Arsenic, is useful in many ways (B) ; may be given 
 with Ipecac, especially when tongue coated (R). Ipecacuanha, in small doses, 
 will arrest certain kinds — a curious fact ; especially useful in certain forms, 
 Try of Vinum Ipecac, every y 2 hour or more (B, R, P) ; in sick stomach of 
 nervous origin, minute doses are of undoubted value (W). Cocaine, in doses 
 of gr. % thrice daily, controlled the vomiting of gastric carcinoma, after all 
 other means failed (Meigs) ; 10-minim doses of a 4 per cent, solution every 
 hour, of inestimable value in the vomiting of yellow fever (Jennings) ; in 2 
 per cent, solution sprayed high up the nasal passages [see under Nausea]. 
 Potassium Nitrate, one of the surest remedies against vomiting and nausea, 
 gr. % m S ss °f c °ld water every 4 or 5 minutes until relieved, in all cases 
 except reflex ones and those due to irritant poisons (Moore). Mercury, gr. y z 
 of Gray Powder every two hours, especially in children with clayey stools (R) ; 
 Calomel, gr. j to Oj aquae, first dissolved in ^j of Lime-water, a teasp. every 
 ten minutes for the regurgitation of food in nursing children (Smith). Opium, 
 will arrest many kinds, best in that of biliary or renal calculi, dysmenorrhea, 
 sea-sickness, pregnancy ; Morphine, hypoder. gr. y 1 ^ to \ (P). Codeine, in 
 doses of gr. %, usually answers exceedingly well in vomiting from almost 
 any cause (Braithwaite). Bryonia, for bilious vomiting and headache (P). 
 Veratrum Album, in vomiting and purging of summer diarrhea (R). Hydrocy- 
 anic Acid, often very serviceable in nervous vomiting, acts promptly if at all 
 (R). Hydrobromic Acid, £ss in %] of water, four times daily, useful for the 
 vomiting due to gastric ulcer. Chloroform, truj-v, on sugar, for noninflam- 
 matory vomiting (R) ; [see under Yellow Fever for formula]. Bromides, 
 in cerebral vomiting only ; not in the gastric form (B) ; Potassium Bromide in 
 that of uterine disease (W) ; Strontium Bromide is excellent in vomiting due 
 to various causes ; gr. x-xv twice daily with meals. Phenocoll, with Piperazin, 
 in a case of uncontrollable vomiting which had resisted every known remedy. 
 Menthol, has successfully checked persistent vomiting after all the usual 
 remedies had failed in the hands of many well-known observers; TTT.X of a 20 
 per cent, solution in Olive Oil, dropped on powdered sugar, each dose being 
 about 1 grain (Weil). Sulphurous Acid, tt\,v-3j, well diluted, or less effec- 
 tively Sodium Sulphite ; Sulphites often curative in vomiting of sarcinae and 
 acid matter, due to acid fermentation of starchy elements (B). Cocculus 
 Indicus, efficient in cephalic vomiting (P). Iris, in vomiting with blinding 
 right supraorbital pain, liver deranged (P). Bismuth, in many forms of vomit- 
 
VOMITING OF PREGNANCY. 
 
 8 77 
 
 ing in children, especially when from gastric catarrh (R). Carbolic Acid, 
 with or without Bismuth (B) ; in nervous vomiting (W). Creosote, in the 
 vomiting of cancer, gastric ulcer, etc. (R) ; gtt. j-ij (W). Cinnamon or Cloves, 
 will check vomiting (P). Calumba, in vomiting from kidney disease and renal 
 calculi; frequently allays that of pregnancy and dentition (P). Serpentana, 
 for bilious vomiting (P). Cerium Oxalate, in that of pregnancy and from 
 cancer (B) ; gr. j every three hours (R). Ammonium Carbonate, may relieve 
 vomiting when the ejected matter is acid (B). Peptenzyme, is highly efficient. 
 Pepsin, for vomiting of food after meals, gr. x-xv before or during meals. 
 Lime-water, is a favorite remedy for vomiting, especially in children : Mjlk 
 and Lime-water often relieve when other methods fail (B). Sodium Bicar- 
 bonate, £ss-j to a pint of milk, for infants, especially if constipated (R) ; the 
 effervescing soda powders in the vomiting of acute diseases and the exanthe- 
 mata (B) ; the severe vomiting of acute disease is often controlled by 3 doses 
 in plenty of hot water. Kumyss, proves effective when no other food will be 
 retained. Carbonated Water, is an efficient remedy. Ice, sucked, with hori- 
 zontal posture, also absolute rest and quiet (Wa) ; iced champagne, ^ss every l /- 
 hour (B). Alcohol, iced brandy or champagne in spoonful doses every ]4. hour 
 in vomiting of cholera, pregnancy, and delirium tremens (B). Counter- 
 Irritation, at epigastrium (R). Nutrient Enemata, [see under Enemata]. 
 [Compare the list of Anti-emetics, on page 49, also the articles entitled 
 Cholera, Hematemesis, Nausea, Sea-sickness, Vomiting of Pregnancy.] 
 
 R. Ac. Hydrocyan. Dil., . . %]. 
 
 Aquse Laurocerasi, . . . :§ij. 
 
 M. Sig. — A teasp. every 2 hours, for 
 nervous vomiting. 
 
 R. Ac. Hydrobromici Diluti, ^ ij. 
 
 Sig. — Half a teasp. in a wineglassful 
 of water, 4 times daily. 
 
 Vomiting of Pregnancy. 
 
 Ipecacuanha or Nux Vomica, either will generally succeed where the other 
 fails (R) ; no other remedy of equal value to Ipecac (P) ; [see under Vomiting] . 
 Nux Vomica, is useful but often fails, gtt. ss-j every hour or two in water (R) ; in 
 very minute doses (S) ; gtt. ij-iij of the tincture every two or three hours, or 
 gtt. x before each meal, with very hot water as a drink, is the best treatment 
 (Parvin). Arsenic, fowler's solution, gtt. j before each meal, will often relieve, 
 when vomiting of food, retching and straining, with blood and pain (B). Creo- 
 sote, checks the vomiting (R). Carbolic Acid, drop-doses of crystals, liquefied 
 by heat, in mucilage ter die (Wa). Staphisagria, has subdued when other 
 remedies failed (P). Cerium Oxalate, gr. j every three hours (R) ; ordinary 
 doses far too small, give as high as 10 grains (B). Morphine, hypodermically, 
 in severe vomiting (R). Pepsin, has been used with success. Ingluvin, seems 
 almost specific (B). Potassium Bromide, is often efficacious (W) ; 3ss doses 
 thrice daily, exceedingly effective in the combined diarrhea and vomiting of 
 pregnancy ; the first dose should be given an hour before rising. Strontium 
 Bromide, proved entirely successful in severe cases ;■ gr. xv in water with 
 meals, twice daily, for a month. Hydrocyanic Acid, often the best remedy (P) ; 
 [see under Vomiting]. Copper Sulphate, sometimes effective, not more than 
 gr. 2V ter die (B). Iodine, rr^v of the tincture in ^ss of sweetened water 
 repeated in ]/ z hour, of magical effect in a bad case which had resisted every 
 other treatment ; is often useful (B). Menthol, has proven very successful 
 in obstinate cases [formula on next page]. Cocaine, locally to cervix, 
 cured a most intractable case of several months' duration, though it failed 
 when used internally (Boys) ; has given excellent results when used internally 
 in triturates of -^ grain each [or see formula on next page] : a 2 per cent, solu- 
 tion sprayed high up the nasal passages [see under Nausea]. Calumba, as 
 tincture often useful, drop-doses every hour or two (B). Bismuth, and Car- 
 bolic Acid are effective (B). Atropine, frequently effective (R) ; never failed 
 
878 
 
 VULVA AND VULVITIS — WARTS. 
 
 to give relief in many years of using it (Boys). Ether, sprayed over the epi- 
 gastric region and the corresponding part of the spinal column, for 3 to 5 
 minutes every 3 hours, gives immediate relief (Lubelsky). Pop-corn, is a god- 
 send to this complaint, having acted marvelously in several cases in which I 
 have used it (Sweringen). Peptenzyme, is said to be very efficient. Aconite, 
 in full doses, is often very successful (W). Dilatation, of the cervical canal, 
 by the index finger, is regarded as extremely efficient, and reasonably safe ; it 
 may bring on abortion, if too extensive, but from records of several cases 
 since 1875, li may be said that it is a safe and sure remedy (Copman). Ice- 
 bag to spine, an efficient measure (R). Vesication, a single blister over the 4th 
 and 5th dorsal vertebras, never failed for many years to put an end at once to 
 the sickness of pregnancy for the whole remaining period of gestation (Harkin). 
 
 R . Atropinae Sulphatis, . . . gr. j. 
 
 Morphinae Sulphatis, . . . gr. iv. 
 
 Acidi Sulphurici Aromat., ^iij. 
 
 Aquoe, . 3 v. 
 
 M. Sig. — Ten to twenty drops, thrice 
 daily. [Boys.) 
 
 R. Bismuthi Subnitrat., . . . gr. clx. 
 
 Cerii Oxalatis, gr. xl. 
 
 Morphinae Sulphatis, . . gr. jss. 
 
 Syrupi, et Acacise, q. s. ad ^ ij. 
 M. ft. emulsura. Sig. — A teasp. every 
 hour until vomiting ceases. ( Van Valzah.) 
 
 R . Mentholi, 
 
 gr. xx. 
 
 % vjss. 
 
 Alcoholis, . t 
 
 Syr. Simplicis, . q. s. ad Jij. 
 M. Sig. — 3J every hour. {Potter.) 
 
 R . Cerii Oxalatis, . . . 
 
 Ipecacuanhse, . . . 
 
 Creosoti, 
 
 M. Ft. pil. no. xij. Sig.- 
 hour. 
 
 . . gr. xij. 
 . . gr. xv. 
 . . gr. xxiv. 
 —One pill every 
 (Goodell.) 
 
 R . Cerii Oxalatis, . . . 
 Ext. Hyoscyami, . . 
 M. Ft. pil. no. xij. Sig.- 
 daily. 
 
 . . gr. xxiv. 
 . . gr. xxxvj. 
 —One pill twice 
 (Goodell.) 
 
 Ro Cocainse Hydrochlor. , . . gr. xv. 
 
 Acidi Carbolici, Tr^x. 
 
 Aq. Cinnamomi, . . . . ^ ss. 
 
 Syr. Zingib., . . q. s. ad ^j. 
 M. Sig — IO drops gradually increased 
 to 20, in a little water every hour until re- 
 lieved, then every 2 or 3 hours. [Potter.) 
 
 Vulva and Vulvitis. 
 
 Sodium Hyposulphite, an unfailing remedy in lotion for aphthae of the vulva 
 (R). Arsenic, much used for eczema (T). Lead Acetate, a concentrated solu- 
 tion in glycerin locally for eczema of vulva (T). Alum, as lotion in vulvitis of 
 children ; gr. lx to Oj aquae, or less strong if found to increase discharge (R). 
 Lead, solutions of the Acetate as wash, after the acute stage has subsided. 
 Lime-water, as wash (R). [Compare Pruritus, Prurigo, Vaginitis.] 
 
 Warts. 
 
 Chrysarobin, a 10 per cent, solution in ether or liquor gutta-perchae, after 
 having pared the wart down with fine glass-paper ; is a specific application 
 (Fitz). Thuja, is highly effective for the cure of warts having a narrow base 
 and a pendulous body ; the strong tincture applied locally thrice daily, also TT\,v 
 in a wineglassful of water internally night and morning (P). Iron, the tincture 
 of the Chloride and dilute HC1 Acid, equal parts applied night and morning, 
 very effective (Bulkley). Nitric Acid, 3 j — ij of the dilute acid to a pint of water, 
 as wash to keep small syphilitic warts constantly moist (R). Sabina, as caustic 
 (P) ; 1 part to 2 of Alum (Wa). Rue, the Oil, with honey, locally (P). Arsenous 
 Acid, as a caustic ; enough to be used to excite active inflammation ; or Liq. 
 Arsenicalis painted over warts (R) ; may be taken internally (B). Mercurial 
 Ointment, containing 5 per cent, of Arsenic, or a plaster having in each 8 
 square inches 1 54 grains of Arsenic and 77 grains of Mercury (Unna). Tannin, 
 and Burnt Alum, equal parts, powdered over warts twice daily, gives good 
 results. Chromic Acid, gr. c to ^j aquae, with a glass rod, to saturate diseased 
 
WEN WORMS. 879 
 
 growth ; remove any superfluous acid, dress with dry lint (R, Wa). Mercuric 
 Nitrate, locally (R). Silver Nitrate, as caustic, but is usually too superficial (R). 
 Dermal Curette, is much used in Vienna to remove warts by enucleation. 
 Strangulation by tying a string tightly around the base, will cause them to 
 drop off in a few days. Heat, is a most thorough measure for their radical 
 removal ; it may be best applied by touching the wart 3 or 4 times daily with 
 the hot end of a cigar ; the first few applications only give pain. Caustic 
 Alkalies, locally (R) ; a saturated solution of Potassa Fusa, carefully applied 
 by a brush or sponge fastened to the end of a stick, is to be preferred (Wilson). 
 [Compare Condylomata.] 
 
 Wen. 
 
 Extirpation, the least troublesome and most speedily effective method. Run 
 a scalpel through it, seize the cut edge of the cyst, and gently tear it out with a 
 touch or two from the knife. Dressing of lint and Carbolic Oil to cause suppu- 
 ration and contraction (D). 
 
 Worms. 
 
 Santonin, the best anthelmintic, a laxative in the morning, fast all day, a dose 
 of Santonin, gr. ss-v, and Calomel, or Troches of Santonin, j-x, at bedtime, 
 a Senna draught next morning, for ascarides (P) ; for round and thread-worms, 
 give in Castor Oil by mouth, or as injection (R). Iron, the syrup of the Iodide 
 internally and a solution of the tincture locally, for ascarides (B) ; the Tinct. 
 Ferri Chlor. ^ss ad Oj aquae, a good injection for thread-worms, coagulating 
 their albumin (R). Quassia, the infusion an effectual injection, conjoined 
 with simple bitters internally, for ascarides (R). Lime-water, as injection for 
 thread-worms (R) ; Jiij-iv repeated, for ascarides (Wa). Sodium Chloride, in 
 3ss doses on empty stomach, expels ascarides and prevents reproduction (Wa). 
 Quinine, as a tonic, also cold sponging, out-door exercise and judicious diet ; 
 useful probably by preventing the production of the abundant mucus which 
 favors the growth of worms (R) ; especially useful for ascarides, also as injec- 
 tion for thread-worms and teniae (Wa). Ignatia, for convulsive symptoms (P). 
 Eucalyptus, as injection, for ascarides (B). Aloes, are efficacious for ascarides 
 (P). Scammony, for thread-worms in rectum (R) ; with Calomel, effective 
 (Wa). Tannin, as Catechu, Kino, Red-gum, Rhatany, Hematoxylon in injec- 
 tions, to destroy thread-worms (R). Alum, as solution for injection (R). Am- 
 monium Chloride, to prevent formation of thick mucus which serves as nidus 
 for worms (R). Valerian, especially when convulsions (R). Myrtol, is efficient 
 against ascarides and round worms (B). Thymol, is almost specific against 
 the ankylostomum duodenale, given in doses of gr. x-xxx, well triturated and 
 in capsules, repeated 3 or 4 times ; but no alcoholic drink afterwards lest the 
 drug be absorbed and poisoning ensue (Mn). Filix Mas, to be taken on an 
 empty stomach for tape-worm, and followed by a purge (P). Pepo, 3 ij as 
 emulsion, taken fasting, one of the most efficient remedies against teniae (B). 
 Pelletierine, the alkaloid of Granatum, is by far the best vermifuge for a tape- 
 worm, repeated after a week for a second worm, as many as 3 having been 
 found in one patient (Da C) ; gr. xv-xx of the Tannate, followed in a few 
 hours by Castor Oil (R). Chloroform, a very efficient teniafuge, Z] in ^j of 
 mucilage, after 20 hours' fast, followed one hour later by ^j of Castor Oil, this 
 is an adult dose, 3j should never be exceeded (Wilde). Kamala (Rottlera), 
 excellent for teniae, requires no purge (P) ; gr. cl-clxxx for an adult (Wa). 
 Cusso, the fluid extract in dose of 3'j to ^j, or the same quantity of the flowers 
 infused in £iv of boiling water, for both varieties of the tape-worm [see page 
 299]. Naphtalin, an excellent all-round anthelmintic, of high value for as- 
 carides and teniae, thoroughly reliable for all kinds of intestinal worms, giving 
 prompt and complete results invariably, wkh entire absence of all unpleasant 
 symptoms; a single dose of gr. xv removed tape-worms entire (Mirowicz) ; 
 
88o 
 
 WOUNDS. 
 
 for adults a dose of Castor Oil should follow, but for children it is preferable 
 to give both together (see page 387). Potassium Iodide, gr. xxxvj, Iodine, gr. 
 xij, Water ^j, ten drops thrice daily in water, caused the expulsion of a tape- 
 worm 11 yards long, of which there were no previous symptoms, and proved 
 successful in other cases (Newington). Ailanthus, a decoction of the fresh 
 bark, for teniae (B). Turpentine, as poison for tape- and thread-worms (R) ; for 
 teniae (Wa). Tonics, as Iron, Cod-liver Oil, etc., to restore the intestinal canal 
 to a healthy condition (R). [Compare Chyluria, also the List of Anthel- 
 mintics on page 36.] 
 
 R . Chloroformi, 
 
 Ext. Filicis Maris, . . aa^j. 
 Emulsi Ol. Ricini (50 per 
 
 cent.), £iij. 
 
 Sig. — One dose after 24 hours' fast- 
 Acts just as well if the Male Fern be 
 
 M 
 ing. 
 omitted. 
 
 {Smith. 
 
 R. Ext. Spigelian Fl., . . . . |j. 
 Ext. Sennas Fl. , . . . . . 3jss. 
 M. Sig. — A teasp. to a child of 3 to 5 
 years. {Smith.) 
 
 R. Ext. Spigeliaeet Sennas Fl.,^j. 
 
 Santonini, gr. viij. 
 
 M. Sig. — A teasp. to a child of 5 years. 
 {Smith.) 
 
 R. Granati Corticis, . . . ^ij. 
 
 Ft. infusum. Sig. — To be taken before 
 11 A. m. , and followed after 2 hours by — 
 
 R. 01. Ricini, gfrj. 
 
 Ol. Terebinth., . _. . . 5jj. 
 
 3h 
 
 Ext. Filicis Maris ^Ether. 
 M. ft. haustus. 
 Fasting unnecessary. 
 
 Wilde.) 
 
 R . Magnesii Sulphat. , . . % ij. 
 Sodii Chloridi, . . . . J ss. 
 M. Sig. — An ounce in half a glass of 
 water, with gtt. v of Carbolic Acid, night 
 and morning, for ascarides. Persevere. 
 
 {Barkley. ) 
 
 'Wounds. 
 
 Arnica, is very useful for external bruises and cuts, also for internal injuries ; 
 unites surfaces very rapidly after amputations ; the infusion or decoction best 
 (P) ; very effectual (Wa). Aconite, valuable in surgical fever (P). Bismuth 
 Subiodide, dusted into a wound one of the most efficient antiseptics, non-irri- 
 tant, and a prompt stimulant of granulation ; an excellent dressing for wounds 
 after approximation of the edges, the powder to be dusted thickly over the 
 edges and thoroughly covered with flexible collodion. Dermatol (Bismuth 
 Subgallate), is an excellent non-irritant vulnerary, having great stability and 
 valuable drying and bactericidal qualities. Europhen, is an ideal application 
 to sores and wounds, also for the many protective requirements of minor 
 surgery ; is used as a dusting powder, or as a 5 to 10 per cent, ointment, with 
 Lanolin as a base. Aristol, is very efficient, or a mixture of Aristol and 
 Europhen, equal parts of each ; Aristol is an excellent substitute for Iodoform, 
 and odorless. Acetanilid, in fine powder dusted over the surface of wounds 
 and other breaches of tissue [see page 79.] Alumnol, a powerful astringent, 
 desiccant and antiseptic, reaches the deep recesses of wounds [see page 144]. 
 Iodoform, powdered and dusted over sloughing wounds, irritable and ill-con- 
 ditioned ulcers and sores (B) ; Iodoform 1, Collodion 9 parts, painted on a 
 superficial wound while edges are held together (Gross) ; may be painted over 
 edges when stitched together ; gives excellent results. Mercury, the Bichloride, 
 gr. vijss to quart j of hot water, stirred with a stick, makes a solution of 1 to 
 2000; the best of all antiseptics for washing a wound or cavity, and for 
 saturating the dressings. Carbolic Acid solutions [see page 84] check suppu- 
 ration and correct fetor (B) ; its employment as an antiseptic has become 
 much restricted and most surgeons have abandoned it. Boric Acid, in lotion 
 or ointment successfully used as dressings for wounds, a solution of I in 133 
 arresting the activity of bacteria ; is applicable for the same purposes as car- 
 bolic acid (B). Boro-glyceride, in aqueous solution, 1 to 40, as a lotion for 
 wounds. Sulphurous Acid, in solution, diluted or not, constantly applied (R) ; 
 in solution or by fumigation, is regarded by some as superior in efficacy to car- 
 
YELLOW FEVER. 88 I 
 
 bolic acid, and less irritant (Wa). Salicylic Acid, Thiersch prefers it to car- 
 bolic ; may be applied pure in powder to gangrenous and sloughing wounds 
 (B). Formalin, is now the favorite surgical antiseptic [see page 324] ; but 
 cannot replace the Bichloride of Mercury. Aloes, pulverized fine, is an 
 efficient dressing for wounds, closing them and favoring cicatrization, also 
 relieving the pain at once, requires removal only at long intervals (Millet), 
 Nitric Acid, as escharotic for gangrene (B). Turpentine, one of the most 
 efficient applications in hospital gangrene (B). Balsam of Peru, excellent for 
 closing recent wounds (P). Benzoin, the basis of all the healing balsams (P). 
 Aloes, topically as a slight stimulant; often purges (R). Gum Tragacanth, 
 a thick aqueous solution to granulating surfaces, to protect them from the air 
 (Wa). Opium, internally to quiet intestinal movements in wounds of the 
 abdomen (R); forwards the reparative processes (P). Tannin, or Glycerite of 
 Tannin, to coat over wounds (R). Collodion or Liquor Gutta-perchae, to secure 
 primary union of incised wounds (B); as protective covering (P). Ammonium 
 Carbonate, gr. v hypodermically in the vicinity of wounds caused by poisoned 
 arrows, repeatedly used with success in saving life by Dr. Parke, the surgeon of 
 Stanley's last expedition in Africa. Galvanic Couplet, to wounds *of indolent 
 form (B). Alcohol, an excellent antiseptic dressing when suppuration ; favors 
 cicatrization of open wounds (B). Poultices, are often abused ; of Yeast or 
 Charcoal best for foul wounds (B). Water, in universal use as dressing ; cold 
 water often abused, hot-water dressing as advocated by Hamilton, promises 
 better results (B). Turkish Baths, for pain in the seat of old wounds (R). 
 Ice and Salt, applied to wounds prevent inflammation (R). [Compare Bed- 
 sores, Gangrene, Hemorrhage, Inflammation, Septicemia, Surgical 
 Fever, Ulcers.] 
 
 R. AcidiTannici, . . . . ^ij. 
 Alcoholis Absolut., . . Jss. 
 
 vEtheris, 3 ijss. 
 
 Collodii, 3 x ij- 
 
 ft. Collodii, ....... I). 
 
 Olei Ricini, 
 
 Acidi Carbolici, . . . aa ^ ss. 
 M. Sig. — Carbolized Collodion, for use 
 
 M. Sig. — Styptic Collodion. ' on wounds 
 
 Yellow Fever. 
 
 Treatment must all be done at the beginning, no time to be lost ; cold 
 sponging early and frequently repeated, Calomel, Quinine and Salines at the 
 start, Potassium Acetate for the kidneys, Morphine for gastric irritation, the 
 feet to be in mustard water (Da C). Diaphoretics and Diuretics, also Laxa- 
 tives, are very important throughout the disease (Da C). Pilocarpine, in dose 
 of gr. % hypodermically, in the first stage, carried to the induction of emesis and 
 catharsis, as well as that of diaphoresis, the most efficient treatment known, 
 absolutely jugulating the paroxysm (Habersmith). Mercury, a Calomel purga- 
 tive, gr. ss, 2 or 3 times on the first day, followed by a warm-water enema, is 
 good treatment (B) ; has many advocates, and many opponents (Wa) ; should 
 generally be abstained from (S). Duboisine, gr. J^, subcutaneously, the most 
 efficient hypnotic and calmative (B). Turpentine, when cardiac weakness, 
 depression of vaso-motor system, dissolved state of the blood, TrLx-gss . sm all 
 doses, with Tinctura Ferri Chloridi, in the hemorrhagic form (B). Quinine, has 
 some strong evidence in its favor as an abortive agent, one large dose, gr. 
 xxx-xl, with Opium at outset (Wa) ; is not a specific ; may hasten recovery in 
 mild cases (S); gr. xx per rectum, to reduce temperature (B). Lime-water, 
 with milk, has been found efficient for the vomiting (Wa). Capsicum, to obvi- 
 ate the black vomit, is highly spoken of (Wa). Cocaine, for the vomiting, 
 nothing equals it in efficiency, it also acting as a diuretic, 10-minim doses of a 
 4 per cent, solution, by mouth, every hour for 2 or 3 doses, acts like a charm 
 (Jennings). Chloroform, for the vomiting, a few drops to prepare the stomach 
 for reception and retention of food; its effects transitory, has to be repeated 
 56 . 
 
882 
 
 YELLOW FEVER. 
 
 before each meal (Wa) ; the Ammoniated Chloroform in zymotic pyrexia, its 
 action is sedative, analgesic and antipyretic (Richardson). Carbolic Acid, by 
 stomach and hypodermically, remarkably efficacious, even after the ominous 
 " coffee-grounds" vomit (Lecaille). Chlorodyne, is excellent for restlessness, 
 insomnia, irritability of stomach (A). Veratrum Viride, gtt. j-x hourly accord- 
 ing to age, till pulse and temperature are subdued ; successfully used in con- 
 nection with Mercury, etc. (White and Ford). Alkalies, to counteract the 
 hyperacidity of the gastric and intestinal contents ; Sodium Bicarbonate gr. 
 cl, Hydrargyrum Chlor. Corr. gr. }{, in a quart of water, of which ^jss is 
 given every hour; of 301 white cases so treated only 7.3 per cent, died, and 
 of 72 blacks all recovered (Sternberg) ; this plan of treatment promises well 
 (Mn). Morphine, is dangerous and must be avoided (Id). Stimulants, only 
 in the typhus form (B); in third stage must be bold, prompt, and continued 
 (Da C). Diet, of the blandest description (A) ; Milk and Lime-water, half 
 and half, in small quantities, is the best aliment; in convalescence, the utmost 
 care is necessary in giving aliments (B). Rest is very important (Da C). Iced 
 Champagne, in tablespoonful doses every % hour, for the vomiting (B). Pur- 
 gation, throughout the disease (Da C) ; is beneficial at the very onset, but 
 must not be repeated nor given at all after the second day of the disease (Mn). 
 [Compare Remittent Fever.] 
 
 R. Potassii Carbon at., . . . gr. xx. 
 
 Tinct. Opii Camphorat. , . 7,). 
 
 Aquae, J viij. 
 
 M. Sig. — ^j every hour or two, as a 
 diaphoretic. {Dickson.) 
 
 R . Chloroformi, 
 
 Tinct. Camphorse, . . aa ^ ss. 
 M. Sig. — Two drops as required for 
 the vomiting. 
 
APPENDIX 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES USED IN 
 WRITING PRESCRIPTIONS, WITH THE CORRESPONDING 
 ENGLISH EQUIVALENTS. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 aa. 
 
 Ana 
 
 Of each. 
 
 Abd. 
 
 Abdomen, gen. inis 
 
 The belly. 
 
 Abs. feb. 
 
 Absente febre 
 
 Fever being absent. 
 
 Ace. 
 
 Accurate 
 
 Accurately. 
 
 Acerb. 
 
 Acerbus, a, um 
 
 Sharp, sour, harsh (to the taste). 
 
 Acerbit. 
 
 Acerbitas, £•<?«. atis 
 
 Sourness. 
 
 Ad 
 
 Ad ( prep. gov. ace. ) 
 
 To, up to. 
 
 Ad concil. gust. 
 
 Ad conciliandum gustum 
 
 To suit the taste. 
 
 Ad 2 vie. 
 
 Ad duas vices 
 
 At twice taking. 
 
 Ad sec. vie. 
 
 Ad secundum vicem 
 
 For the second time. 
 
 Ad 3 tiam vie. 
 
 Ad tertiam vicem 
 
 For the third time. 
 
 Add. 
 
 Adde, Addantur 
 
 Add, Let them be added. 
 
 Add. 
 
 Addendus, Addendo 
 
 To be added, By adding. 
 
 Add. c. trit. 
 
 Adde cum tritu 
 
 Add with trituration. 
 
 Ad def. an. 
 
 Ad defectionem animi 
 
 To fainting. 
 
 Ad grat. acid. 
 
 Ad gratam aciditatem 
 
 To an agreeable sourness. 
 
 Ad grat. gust. 
 
 Ad gratum gustum 
 
 To an agreeable taste. 
 
 Adhib. 
 
 Adhibendus 
 
 To be administered. 
 
 Adjac. 
 
 Adjacens 
 
 Adjacent. 
 
 Ad lib. 
 
 Ad libitum 
 
 At pleasure. 
 
 Admov. 
 
 Admove, Admoveatur 
 
 Apply, Let it be applied. 
 
 Ad part, dolent. 
 
 Ad partes dolentes 
 
 To the painful (aching) parts. 
 
 Ad sat. 
 
 Ad saturandum 
 
 To saturation. 
 
 Adst. feb. 
 
 Adstante febre 
 
 The fever being on. 
 
 Adv. 
 
 Adversum 
 
 Against. 
 
 JEg. 
 
 .-Eger 
 
 The sick one, the patient. 
 
 Aggr. feb. 
 
 Aggrediente febre 
 
 While the fever is coming on. 
 
 Agit. 
 
 Agita 
 
 Shake, stir. 
 
 Agit. 
 
 Agitetur 
 
 Let it be shaken or stirred. 
 
 Agit. ante sum. 
 
 Agita ante sumendum 
 
 Shake before taking. 
 
 Agit. vas. 
 
 Agitato vase 
 
 The vial being shaken. 
 
 Alb. 
 
 Albus, a, um 
 
 White. 
 
 Aliq. 
 
 Aliquot 
 
 Some. 
 
 Alt. 
 
 Alter 
 
 The other. 
 
 Alt. hor. 
 
 Alternis horis 
 
 Every other hour. 
 
 Alut. 
 
 Aluta 
 
 Leather. 
 
 Alv. 
 
 Alvus 
 
 The belly, the bowels. 
 
 Alv. adst. 
 
 Alvo adstricta 
 
 The bowels being confined. 
 
 Amp. 
 
 Amplus 
 
 Large. 
 
 Ampul. 
 
 Ampulla 
 
 A large bottle. 
 
 App. 
 
 Appone, Applica 
 
 Apply, Lay or put on. 
 
 Aq. 
 
 Aqua, gen. x 
 
 Water. 
 
 883 
 
884 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Aq. astr. 
 
 Aqua astricta 
 
 Frozen water. 
 
 Aq. bull. 
 
 Aqua bulliens 
 
 Boiling water. 
 
 Aq. com. 
 
 Aqua communis 
 
 Common water. 
 
 Aq. ferv. vel calid. 
 
 Aqua fervens vel calida 
 
 Hot water. 
 
 Aq. fluv. 
 
 Aqua fluviatilis 
 
 River water. 
 
 Aq. font. 
 
 Aqua fontana vel fontis 
 
 Spring water. 
 
 Aq. gelid. 
 
 Aqua gelidus 
 
 Cold water. 
 
 Aq. mar. 
 
 Aqua marina 
 
 Sea water. 
 
 Aq. niv. 
 
 Aqua nivialis vel nivalis 
 
 Snow water. 
 
 Aq. phag. 
 
 Aqua phagedaenica 
 
 Yellow wash. 
 
 Aq. pluv. 
 
 Aqua pluvialis 
 
 Rain water. 
 
 Aq. pot. 
 
 Aqua potabilis 
 
 Drinkable water. 
 
 Aq. satur. 
 
 Aqua saturni 
 
 Lead-water. 
 
 Aq. urb. 
 
 Aqua urbis 
 
 City water. 
 
 Aqual. 
 
 Aqualis 
 
 Pertaining to water. 
 
 Aquil. alb. 
 
 Aquila alba 
 
 Calomel. 
 
 Aut 
 
 Aut 
 
 Or. 
 
 B. A. vel Bal. ar. 
 
 Balneum arenas 
 
 Sand-bath. 
 
 B. M. vel Bal. mar. 
 
 Balneum maris 
 
 Salt-water bath. 
 
 B. V. vel Bal. vap. 
 
 Balneum vaporis 
 
 Vapor-bath. 
 
 Bals. 
 
 Balsamum 
 
 Balsam. 
 
 B. B. 
 
 Barbadensis 
 
 Barbadoes. 
 
 Bene 
 
 Bene 
 
 Well, good. 
 
 Bib. 
 
 Bibe vel Bibatur 
 
 Drink (thou), Let it be drank. 
 
 Bid. 
 
 Biduum 
 
 Two days. 
 
 Bis 
 
 Bis 
 
 Twice. 
 
 Bis die 
 
 Bis in die ^<?/dies 
 
 Twice a day. 
 
 Bol. 
 
 Bolus 
 
 A large pill. 
 
 Bon. 
 
 Bonus 
 
 Good. 
 
 Brach. 
 
 Brachium 
 
 The arm. 
 
 Brev. 
 
 Brevis 
 
 Short. 
 
 Bui. 
 
 Bulliatw/Bulliant 
 
 Let it (or them) boil. 
 
 But. 
 
 Butyrum 
 
 Butter. 
 
 C. 
 
 Cum 
 
 With. 
 
 Coerul. 
 
 Caeruleus, gen. i 
 
 Blue. 
 
 Calef. 
 
 Calefactus, gen. i 
 
 Warmed. 
 
 Calom. 
 
 Calomel vel Calomelas 
 
 Mild Chloride of Mercury, Calomel, 
 
 Calor. 
 
 Calor, gen. oris 
 
 Heat, warmth. 
 
 Cap. 
 
 Cape, Capiat 
 
 Take (thou), Let him take. 
 
 Cap. quant, vis 
 
 Capiat quantum vis 
 
 Let him take as much as he will. 
 
 Capil. 
 
 Capillus, gen. i 
 
 A hair. 
 
 Capsul. 
 
 Capsula, gen. ae 
 
 A capsule. 
 
 Caput 
 
 Caput, gen. Capitis 
 
 The head, Of the head. 
 
 Carbas. 
 
 Carbasus, gen. i 
 
 Linen, lint. 
 
 Caute 
 
 Caute 
 
 Cautiously. 
 
 Cc. 
 
 Centimeter cubicum 
 
 Cubic centimeter. 
 
 Ccu. 
 
 Cucurbita 
 
 A cupping-glass. 
 
 Celer. 
 
 Celeriter 
 
 Quickly, immediately. 
 
 Cena. 
 
 Cena vel Ccena 
 
 Supper. 
 
 Chart. 
 
 Charta 
 
 Paper. 
 
 Chart, cerat. 
 
 Charta cerata 
 
 Waxed paper. 
 
 Chartul. 
 
 Chartula 
 
 A small paper. 
 
 Chin. 
 
 Chininum 
 
 Quinine. 
 
 Cib. 
 
 Cibus, gen. i 
 
 Food, victuals. 
 
 Circit. 
 
 Circitu 
 
 Near, around, about. 
 
 Cit. 
 
 Cito 
 
 Quickly. 
 
 Cito disp. 
 
 Cito dispensetur 
 
 Let it be dispensed quickly. 
 
 Clar. 
 
 Clarus, a, um 
 
 Bright, clear. 
 
 Claus. 
 
 Clausus, a, um 
 
 Closed, inclosed. 
 
LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 885 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Coch., Cochleat. 
 
 Cochleare, Cochleatim 
 
 A spoonful, By spoonfuls (3J). 
 
 Coch. amp. 
 
 Cochleare amplum 
 
 A dessertspoonful ( 3 ij). 
 
 Coch. mag. 
 
 Cochleare magnum 
 
 A tablespoonful ( § ss). 
 
 Coch. med. 
 
 Cochleare medium 
 
 A dessertspoonful (31J). 
 
 Coch. parv. 
 
 Cochleare parvum 
 
 A teaspoonful (gj). 
 
 Coct. 
 
 Coctio 
 
 Boiling. 
 
 Cog. 
 
 Cogantur 
 
 Let them be combined. 
 
 Col. 
 
 Cola 
 
 Strain. 
 
 Colatur. 
 
 Colaturae 
 
 Of the strained liquor. 
 
 Colat. 
 
 Colatus 
 
 Strained. 
 
 Colent. 
 
 Colentur 
 
 Let them be strained. 
 
 Colet. 
 
 Coletur 
 
 Let it be strained. 
 
 Coll. 
 
 Collum, gen. i 
 
 The neck. 
 
 Collun. 
 
 Collunarium, gen. i 
 
 A nasal wash. 
 
 Collut. 
 
 Collutorium 
 
 A mouth-wash. 
 
 Collyr. 
 
 Collyrium 
 
 An eye-wash. 
 
 Coloret. 
 
 Coloretur 
 
 Let it be colored. 
 
 Commis. 
 
 Commisce 
 
 Mix together. 
 
 Commod. 
 
 Commode 
 
 Rightly, properly, suitably. 
 
 Comp. 
 
 Compositus 
 
 Compound, compounded. 
 
 Con., Concis. 
 
 Concisus 
 
 Cut. 
 
 Concus. 
 
 Concuscus, gen. i 
 
 Shaken. 
 
 Concut. 
 
 Concuti, Concutiatur 
 
 Shake, Let it be shaken. 
 
 Conf. 
 
 Confectio 
 
 Confection. 
 
 Cong. 
 
 Congius 
 
 A gallon. 
 
 Conquas. 
 
 Conquassando 
 
 By vigorous shaking. 
 
 Cons. 
 
 Conserva, Conserve 
 
 A converse ; Keep, preserve. 
 
 Consperg. 
 
 Consperge 
 
 Dust, sprinkle. 
 
 Contere 
 
 Contere 
 
 Rub together. 
 
 Cont. rem. 
 
 Continuentur remedia 
 
 Let the medicines be continued. 
 
 Contus. 
 
 Contusus 
 
 Bruised. 
 
 Coq. 
 
 Coque, Coquantur 
 
 Boil, Let them be boiled. 
 
 Coq. ad med. con- 
 
 Coque ad medietatis con- 
 
 Boil to the consumption of half. 
 
 sump. 
 
 sumptionem 
 
 
 Coq. S. A. 
 
 Coque secundum artem 
 
 Boil according to art. 
 
 Coq. in S. A. 
 
 Coque in sufficiente aquae 
 
 Boil in sufficient water. 
 
 Coq. simul 
 
 Coquentur simul 
 
 Boil them together. 
 
 Cor 
 
 Cor, gen. cordis 
 
 The heart, Of the heart. 
 
 Cort. 
 
 Cortex, gen. corticis 
 
 The bark, Of the bark. 
 
 Cot. 
 
 Cotula 
 
 A measure. 
 
 Cox. 
 
 Coxa 
 
 The hip. 
 
 Cras 
 
 Cras 
 
 To-morrow. 
 
 Cras mane sumend. 
 
 Cras mane sumendus 
 
 To be taken to-morrow morning. 
 
 Cras nocte 
 
 Cras nocte 
 
 To-morrow night. 
 
 Cras vesp. 
 
 Cras vespere 
 
 To-morrow evening. 
 
 Crast. 
 
 Crastinus 
 
 For to-morrow, early. 
 
 Cru. 
 
 Cru or 
 
 Blood, gore. 
 
 Cucur. 
 
 Cucurbitula 
 
 A cupping-glass. 
 
 Cuj. 
 
 Cujus, Cujus-libet 
 
 Of which, Of any. 
 
 Cum 
 
 Cum 
 
 With. 
 
 Curs. hod. 
 
 Cursu hodie 
 
 During the day. 
 
 Cyath., C. vinar. 
 
 Cyathus, vet C. vinarius 
 
 A wine-glass ( ^j-ij). 
 
 Cyath. these 
 
 Cyatho theae 
 
 In a cup of tea. 
 
 D. 
 
 Dies, Dosis 
 
 A day, A dose. 
 
 Da, Det. 
 
 Da, Detur 
 
 Give, Let it be given. 
 
 De 
 
 De {prep. gov. ablative) 
 
 From, down. 
 
 Deaur. pil. 
 
 Deaurentur pilulae 
 
 Let the pills be gilded. 
 
 Deb. spiss. 
 
 Debita spissitudo 
 
 To a proper consistence. 
 
 Deb. 
 
 Debitus, a, um 
 
 Due, proper. 
 
886 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Dec. 
 
 Decanta 
 
 Pour off. 
 
 Decern 
 
 Decern, decimus 
 
 Ten, The Tenth. 
 
 Decoct. 
 
 Decoctum 
 
 A decoction. 
 
 Decoq. 
 
 Decoque 
 
 Boil down. 
 
 i Decub. 
 
 Decubitus 
 
 Lying down. 
 
 De d. in d. 
 
 De die in diem 
 
 From day to day. 
 
 Dein 
 
 Dein vel Deinde 
 
 Thereupon ; afterward, then. 
 
 Deglut. 
 
 Deglutiatur 
 
 Let be swallowed. 
 
 Dej. alv. 
 
 Dejectiones alvi 
 
 Stools. 
 
 Dejic. 
 
 Dejiciatur 
 
 Let be purged. 
 
 Dent. 
 
 Dentes ; Dentur 
 
 The teeth ; Let them be given. 
 
 Det. in. dup. 
 
 Detur in duplo 
 
 Let twice as much be given. 
 
 Dext. 
 
 Dexter, Dextra 
 
 The right. 
 
 Dieb. alt. 
 
 Diebus alternis 
 
 Every other day. 
 
 Dieb. tert. 
 
 Diebus tertiis 
 
 Every third day. 
 
 Dies vel D. 
 
 Dies, gen. diei 
 
 A day. 
 
 Dig. 
 
 Digere, Digeretur 
 
 Digest, Let it be digested. 
 
 Diluc. 
 
 Diluculo 
 
 At break of day. 
 
 Dil. 
 
 Dilue, Dilutus, a, um 
 
 Dilute (thou), Diluted. 
 
 Dim. 
 
 Dimidius, a, um 
 
 One-half. 
 
 D. P. vel Dir. prop. 
 
 Directione propria 
 
 With a proper direction. 
 
 Disp. 
 
 Dispensa, Dispensetur 
 
 Dispense, Let it be dispensed. 
 
 Div. in p. aeq. 
 
 Dividatur in partes 
 aequales 
 
 Let it be divided into equal parts. 
 
 Divid. 
 
 Dividendus, a, um 
 
 To be divided. 
 
 Dol. 
 
 Dolor, Dolore 
 
 Pain, In pain. 
 
 Don. 
 
 Donee 
 
 Until. 
 
 Don. alv. dejec. 
 
 Donee alvus dejecerit 
 
 Until the bowels move. 
 
 Don. alv. sol. ft. 
 
 Donee alvus soluta fuerit 
 
 Until the bowels shall be opened. 
 
 Don. dolor neph. 
 
 Donee dolor nephriticus 
 
 Until the nephritic pain is removed. 
 
 exulav. 
 
 exulaverit 
 
 
 Don. hab. colat. 
 
 Donee habeas colaturae 
 
 Until you have of strained liquor. 
 
 Don. len. dol. 
 
 Donee leniatur dolor 
 
 Until the pain is relieved. 
 
 Don. sintres. 
 
 Donee sint residuse 
 
 Until there is ... of residue. 
 
 Dos. 
 
 Dosis 
 
 A dose. 
 
 Dr., 3 
 
 Drachma 
 
 A drachm (6o grains). 
 
 Dulc. 
 
 Dulcis, Dulcitas 
 
 Sweet, Sweetness. 
 
 Dup. 
 
 Duplico 
 
 In duplicate. 
 
 Dur. dolor. 
 
 Durante dolore 
 
 While the pain lasts. 
 
 Ead. 
 
 Eadem (fem.) 
 
 The same. 
 
 Eburn. 
 
 Eburneus 
 
 Made of ivory. 
 
 Ejusd. 
 
 Ejusdem 
 
 Of the same. 
 
 Elect. 
 
 Electuarium 
 
 An electuary. 
 
 Em. 
 
 Emesis 
 
 Vomiting. 
 
 En., Enem. 
 
 Enema, Enemata 
 
 A clyster or enema, Enemas. 
 
 Epistom. 
 
 Epistomium 
 
 A stopper, bung. 
 
 Et 
 
 Et 
 
 And. 
 
 Etiam 
 
 Etiam 
 
 Also, besides. 
 
 Evan. 
 
 Evanuerit 
 
 Shall have disappeared. 
 
 Ex 
 
 Ex {gov. ablative) 
 
 From, out of. 
 
 Ex quib. sum. 
 
 Ex quibus sumatur 
 
 From which are given. 
 
 Ex mod. p. 
 
 Ex modo praescripto 
 
 After the manner prescribed. 
 
 Ex paul. aq. 
 
 Ex paululo aquae 
 
 From (In) a very little water. 
 
 Ex parte 
 
 Ex parte 
 
 Partly. 
 
 Exhib. 
 
 Exhibeatur 
 
 Let it be exhibited. 
 
 Exper. 
 
 Experime 
 
 Try (thou). 
 
 Ext. 
 
 Extende, Extendatur 
 
 Spread, Let it be spread. 
 
 Ext. sup. alut. 
 
 Extende super alutem 
 
 Spread upon leather. 
 
 Ext., Extr. 
 
 Extractum, gen. i 
 
 An extract. 
 
 \ 
 
LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 887 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Extr. 
 
 Extrahe, Extrahatur 
 
 Extract (thou), Let it be extracted. 
 
 F. 
 
 Fac 
 
 Make (thou). 
 
 F. L. A. 
 
 Fiat lege artis 
 
 Let it be made by the rules of art. 
 
 F. pil. xij 
 
 Fac pilulas duodecim 
 
 Make 12 pills. 
 
 Far. 
 
 Farina 
 
 Flour. 
 
 Fas. lint. 
 
 Fascia lintea 
 
 A linen bandage. 
 
 Fascic. 
 
 Fasciculus 
 
 A small bundle. 
 
 Febr. 
 
 Febris 
 
 Fever. 
 
 Febr. dur. 
 
 Febre durante 
 
 During the fever. 
 
 Fem. intern. 
 
 Femori interno 
 
 To the inner thigh. 
 
 Ferv. 
 
 Fervens, gen. entis 
 
 Hot. 
 
 Fict. 
 
 Fictilis, e 
 
 Earthen, An earthen vessel. 
 
 Fil. 
 
 Filtra 
 
 Filter (thou). 
 
 Filt. 
 
 Filtrum, gen. i 
 
 A filter. 
 
 Fistul. arm. 
 
 Fistula armata 
 
 A syringe ready for use. 
 
 Flav. 
 
 Flavus, a, um 
 
 Yellow. 
 
 Flor. 
 
 Flores {pi.) 
 
 Flowers. 
 
 Fluid, vel Fl . 
 
 Fluidus 
 
 Liquid. 
 
 Fol. 
 
 Folia, gen. orum 
 
 Leaves. 
 
 Form. 
 
 Formula, Formentur 
 
 A prescription, Let them be formed. 
 
 Frig. 
 
 Frigor, gen. oris 
 
 Cold. 
 
 Frust. 
 
 Frustillatim 
 
 In small pieces. 
 
 Ft. 
 
 Fiat, Fiant {pi.) 
 
 Let it {or them) be made. 
 
 Ft. cerat. 
 
 Fiat ceratum 
 
 Let a cerate be made. 
 
 Ft. chart, xij 
 
 Fiant chartulse duodecim 
 
 Let 12 powders be made. 
 
 Ft. collyr. 
 
 Fiat collyrium 
 
 Let an eye-wash be made. 
 
 Ft. emuls. 
 
 Fiat emulsum 
 
 Let an emulsion be made. 
 
 Ft. en. 
 
 Fiat enema 
 
 Let an enema be made. 
 
 Ft. inject. 
 
 Fiat injectio 
 
 Let an injection be made. 
 
 Ft. pil. xij 
 
 Fiant pilulse duodecim 
 
 Let 12 pills be made. 
 
 Ft. pulv. 
 
 Fiat pulvis 
 
 Let a powder be made. 
 
 Ft. pulv. xij 
 
 Fiant pulveres duodecim 
 
 Let 12 powders be made. 
 
 Ft. sol. 
 
 Fiat solutio 
 
 Let a solution be made. 
 
 Ft. suppos. viij 
 
 Fiant suppositoria octo 
 
 Let 8 suppositories be made. 
 
 Ft. troch. xx 
 
 Fiant trochisci viginti 
 
 Let 20 troches be made. 
 
 Ft. ung. 
 
 Fiat unguentum 
 
 Let an ointment be made. 
 
 Ft. venesec. 
 
 Fiat venesectio 
 
 Let a bleeding be done. 
 
 Fuerit 
 
 Fuerit 
 
 Shall have been. 
 
 Fus. 
 
 Fuscus, a, um 
 
 Brown, dark. 
 
 Garg. 
 
 Gargarisma 
 
 A gargle. 
 
 Gelat. quav. 
 
 Gelatina quavis 
 
 In any kind of jelly. 
 
 Ging. incid. 
 
 Gingivas incide 
 
 Lance (or cut) the gums. 
 
 Gm. 
 
 Gramma 
 
 A gramme. 
 
 g r - 
 
 Granum, Grana 
 
 A grain, Grains. 
 
 gr. vj pond. 
 
 Grana sex pondere 
 
 Six grains by weight. 
 
 Grad. 
 
 Gradatim 
 
 By degrees, gradually. 
 
 Grat. 
 
 Gratus 
 
 Pleasant. 
 
 Gros. 
 
 Grossus, a, um 
 
 Large, coarse. 
 
 Grum. 
 
 Grumus 
 
 A clot (of blood). 
 
 Gtt. 
 
 Gutta, Guttae, Guttas 
 
 A drop, Drops. 
 
 Guttat. 
 
 Guttatim 
 
 By drops. 
 
 Gtt. quibusd. 
 
 Guttis quibusdam 
 
 With a few drops. 
 
 H. 
 
 Hora 
 
 An hour. 
 
 Har. pil. 
 
 Harum pilularum 
 
 Of these pills. 
 
 Haust. 
 
 Haustus, geh. i 
 
 A draught. 
 
 H. p. n. 
 
 Haustus purgans noster 
 
 My own purgative draught. 
 
 Hebdom. 
 
 Hebdomada, Hebdomas 
 
 A week. 
 
 Herb. 
 
 Herba, gen. ae 
 
 An herb. 
 
 Herb, recent. 
 
 Herbarum recentium 
 
 Of fresh herbs. 
 
888 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Heri 
 
 Heri 
 
 Yesterday. 
 
 Hie, Haec, Hoc 
 
 Hie, Haec, Hoc 
 
 This. 
 
 Hirudo 
 
 Hirudo, gen. inis 
 
 A leech. 
 
 Hirud. app. 
 
 Hirudines appone 
 
 Apply leeches. 
 
 Hor. 
 
 Hora, gen. ae 
 
 An hour. 
 
 Hor. decub. 
 
 Horse decubitus 
 
 At bedtime. 
 
 Hor. j spat. 
 
 Hone unius spatio 
 
 After one hour. 
 
 Hor. interna. 
 
 Horis intermediis 
 
 In the intermediate hours. 
 
 Hor. som. 
 
 Hora somni 
 
 At the hour of sleep. 
 
 Hor. xj matut. 
 
 Hora. undecima. matutina 
 
 At the eleventh hour of the morning. 
 
 Id. 
 
 Idem 
 
 The same. 
 
 Iden. 
 
 Identidem 
 
 Repeatedly, often. 
 
 Idon. 
 
 Idoneus, a, um 
 
 Suitable, proper, convenient. 
 
 Idon. vehic. 
 
 Idoneo vehiculo 
 
 In a suitable vehicle. 
 
 111. 
 
 Illico 
 
 Then, immediately. 
 
 Immit. 
 
 Immitatur 
 
 Let it be placed in. 
 
 Imp. 
 
 Impone 
 
 Lay on, apply. 
 
 Impr. 
 
 Imprimis 
 
 First, chiefly. 
 
 In 
 
 In 
 
 In, within, upon, not. 
 
 Inc. 
 
 Incide, Incisus 
 
 Cut (thou), Being cut. 
 
 Ind. 
 
 In dies 
 
 Daily, or From day to day. 
 
 Inde 
 
 Inde 
 
 Therefrom. 
 
 Infun. 
 
 Infunde 
 
 Pour in. 
 
 Infus. 
 
 Infusum 
 
 An infusion. 
 
 Ing. 
 
 Ingere, Ingerendus 
 
 Put into, Putting into. 
 
 Injec. 
 
 Injectio 
 
 An injection. 
 
 Injic. enem. 
 
 Injiciatur enema 
 
 Let a clyster be injected. 
 
 In lag. bene obt. 
 
 In lagena bene obturator 
 
 In a well-stoppered bottle. 
 
 In loco frig. 
 
 In loco frigido 
 
 In a cold place. 
 
 In mass. cog. 
 
 In massam cogantur 
 
 Let them be combined in a mass. 
 
 In pulm. 
 
 In pulmento 
 
 In gruel. 
 
 In star 
 
 Instar 
 
 As big as, the size of. 
 
 Int. 
 
 Internus, a, um 
 
 Inner, internal, between. 
 
 Inter 
 
 Inter 
 
 Between. 
 
 Intus 
 
 Intus 
 
 Inwardly. 
 
 Invol. gelat. 
 
 Involve gelatina 
 
 Coat [or cover) with gelatin. 
 
 Invor. 
 
 Invoruntur 
 
 Let them be moistened. 
 
 Ita 
 
 Ita 
 
 In such manner. 
 
 Iter. 
 
 Iteretur, Iterentur 
 
 Let it (them) be repeated. 
 
 Jam 
 
 Jam 
 
 Now. 
 
 Jentac. 
 
 Jentaculum, gen. i 
 
 Breakfast. 
 
 Jucund. 
 
 Jucunde 
 
 Pleasantly. 
 
 Jul. 
 
 Julepum 
 
 A julep. 
 
 Juscel. 
 
 Tuscellum 
 
 A broth. 
 
 Juscul. 
 
 Jusculum 
 
 Soup. 
 
 Jux. 
 
 Juxta, Juxtim 
 
 Near to, Close by. 
 
 K. 
 
 Kali, Kalium 
 
 Potassa, Potassium. 
 
 Kal. ppt. 
 
 Kali praeparata 
 
 Potassium carbonate. 
 
 Lac. 
 
 Lac, gen. Lactis 
 
 Milk, Of milk. 
 
 Lag. 
 
 Lagena, gen. se 
 
 A flask, or bottle. 
 
 Lam. 
 
 Lamella 
 
 Plate, leaf, layer, scale. 
 
 Lan. 
 
 Lana, gen. se 
 
 Flannel, wool. 
 
 Lang. 
 
 Languor, gen. oris 
 
 Faintness. 
 
 Lapid. 
 
 Lapideus, a, um 
 
 Stony, made of stone. 
 
 Larg. 
 
 Largus, a, um 
 
 Abundant, plentiful. 
 
 Larid. 
 
 Laridum, gen. i 
 
 Lard. 
 
 Lat. 
 
 Latus, a, um 
 
 Broad, wide. 
 
 Lat. 
 
 Latus, gen. eris 
 
 The side. 
 
 Lat. admov. 
 
 Latere admoveatur 
 
 Let it be applied to the side. 
 
LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 889 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Lat. dol. 
 
 Lateri dolenti 
 
 To the painful side. 
 
 Lax. 
 
 Laxus, a, urn 
 
 Loose, open. 
 
 Lb., lb 
 
 Libra 
 
 A pound. 
 
 Lect. 
 
 Lectus, gen. i 
 
 Abed. 
 
 Len. 
 
 Leniter 
 
 Easily, gently. 
 
 Len. ter. 
 
 Leniter terendo 
 
 By rubbing gently. 
 
 Lev. 
 
 Leviter 
 
 Lightly . 
 
 Lig. 
 
 Ligatura 
 
 A ligature. 
 
 Linct. 
 
 Linctus, gen. i 
 
 A linctus, (taken by licking). 
 
 Linim. 
 
 Linimentum, gen. i 
 
 A liniment. 
 
 Lint. 
 
 Linteum, gen. i 
 
 Lint, linen. 
 
 Liq. 
 
 Liquor, gen. oris 
 
 A solution. 
 
 Lot. 
 
 Lotio 
 
 A lotion. 
 
 Lut. 
 
 Luteus, a, um 
 
 Yellow, golden yellow. 
 
 M.,nt 
 
 Minimum, gen. i 
 
 A minim. 
 
 M. 
 
 Misce 
 
 Mix (thou). 
 
 M. 
 
 Manipulus, gen. i 
 
 A handful. 
 
 Macer. 
 
 Macera 
 
 Macerate (thou). 
 
 Mag. 
 
 Magnus, a, um 
 
 Large. 
 
 Man. 
 
 Manipulus, gen. i 
 
 A handful. 
 
 Mane 
 
 Mane (indecl.) 
 
 Morning, in the morning. 
 
 Mane primo 
 
 Mane primo 
 
 Early in the morning. 
 
 Manus 
 
 Manus, gen. i 
 
 The hand. 
 
 Mass. 
 
 Massa, gen. se 
 
 , A mass, a pill-mass. 
 
 Mat. 
 
 Matula, gen. se 
 
 A vessel, a chamber-pot. 
 
 Matut. 
 
 Matutinus 
 
 In the morning. 
 
 Med. 
 
 Medius, a, um 
 
 Middle. 
 
 Mens. 
 
 Mensura 
 
 By measure. 
 
 Mic. pan. 
 
 Mica panis 
 
 A crumb of bread. 
 
 Min. 
 
 Minimum 
 
 A minim. 
 
 Mi nut. 
 
 Minutum * 
 
 A minute. 
 
 Mis. 
 
 Misce, Miscetur 
 
 Mix (thou), Let it be mixed. 
 
 Mis. bene 
 
 Misce bene 
 
 Mix well. 
 
 Mis. caut. 
 
 Misce caute 
 
 Mix cautiously. 
 
 Mist. 
 
 Mistura 
 
 A mixture. 
 
 Mit. 
 
 Mitte, Mittatur, Mittantur 
 
 Send (thou), Let it be sent, Let 
 them be sent. 
 
 Mit. sang, ad uncias 
 
 Mitte sanguinem ad uncias 
 
 Take away blood to 12 ounces at 
 
 xij salt. 
 
 duodecim saltern 
 
 least. 
 
 Mit. tal. 
 
 Mitte tales 
 
 Send of such. 
 
 Mod. diet. 
 
 Modo dictu 
 
 As directed. 
 
 Mod. pr. 
 
 Modo pnescripto 
 
 In the manner prescribed. 
 
 Modic. 
 
 Modicus, a, um 
 
 Moderate-sized, middling. 
 
 Mol. 
 
 Mollis, Molle 
 
 Soft. 
 
 Mor. 
 
 Mora, gen. 3d 
 
 Delay. 
 
 Mor. diet. 
 
 More dictu 
 
 In the manner directed. 
 
 Mor. sol. 
 
 More solito 
 
 In the usual manner. 
 
 Mort. 
 
 Mortarium, gen. i 
 
 A mortar. 
 
 Natr. 
 
 Natrium, gen. i 
 
 Sodium. 
 
 Ne tr. s. num. 
 
 Ne trades sine nummo 
 
 Do not deliver without the money. 
 
 Necn. 
 
 Necnon 
 
 And also, and yet. 
 
 Nig. 
 
 Niger, nigra, nigrum 
 
 Black. 
 
 Nisi 
 
 Nisi 
 
 Unless. 
 
 No. 
 
 Numero, Numerus 
 
 In number, A number. 
 
 Noct. 
 
 Noctis 
 
 Of the night. 
 
 Noct. maneq. 
 
 Nocte maneque 
 
 At night and in the morning. 
 
 Non 
 
 Non 
 
 Not. 
 
 *This is medical Latin, or 
 gesima pars horcz. 
 
 bog-Latin." The proper Latin for a minute of time is Sexa- 
 
890 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Non repetat. 
 
 Non repetatur 
 
 Let it not be repeated. 
 
 Noxa 
 
 Noxa, gen. ae 
 
 An injury. 
 
 Nucha 
 
 Nucha 
 
 The nape of the neck. 
 
 Nunc 
 
 Nunc 
 
 Now. 
 
 Nut. 
 
 Nutricius, a, um 
 
 Nutritious. 
 
 Nutrit. 
 
 Nutritus, gen. us 
 
 Nutriment. 
 
 Nux 
 
 Nux, gen. nucis 
 
 A nut. 
 
 Nux mosch. 
 
 Nux moschata 
 
 A nutmeg. 
 
 O. 
 
 Octarius 
 
 Apint(5xvj). 
 
 Obd. 
 
 Obduce 
 
 Cover, conceal, coat. 
 
 Obduct. 
 
 Obductus, a, um 
 
 Covered, coated. 
 
 Obtrit. 
 
 Obtritus, a, um 
 
 Crushed. 
 
 Occlus. 
 
 Occlusus, a, um 
 
 Enclosed. 
 
 Oct. 
 
 Octo, Octavus 
 
 Eight, Eighth. 
 
 Octup. 
 
 Octuplus 
 
 Eight-fold. 
 
 Ocul. 
 
 Oculus, gen. i 
 
 The eye. 
 
 Odor. 
 
 Odora, Odoretur 
 
 Perfume, Let it be perfumed. 
 
 Odorat. 
 
 Odoratus, a, um 
 
 Perfumed, odorous. 
 
 01. lini sine ig. 
 
 Oleum lini sine igne 
 
 Cold-drawn linseed oil. 
 
 01. O. Opt. 
 
 Oleum oli^se optimum 
 
 Best olive oil. 
 
 011a 
 
 011a, gen. x 
 
 A pot, a jar. 
 
 Ollic. 
 
 Ollicula, gen. x 
 
 A little pot. 
 
 Omn. hor. 
 
 Omni hora. 
 
 Every hour. 
 
 Omn. bih. 
 
 Omni bihorio 
 
 Every two hours. 
 
 Omn. quadr. hor. 
 
 Omni quadrante hone 
 
 Every ^ hour. 
 
 Omn. mane 
 
 Omni mane 
 
 Every morning. 
 
 Omn. noct. 
 
 Omni nocte 
 
 Every night. 
 
 Op. 
 
 Opus 
 
 Need, occasion. 
 
 Opt. 
 
 Optimus, a, um 
 
 Best. 
 
 Oryza 
 
 Oryza, gen. x 
 
 Rice. 
 
 Os 
 
 Os, gen. oris 
 
 The mouth. 
 
 Ov. 
 
 Ovum, gen. ovi 
 
 An egg. 
 
 P. 
 
 Pondere 
 
 By weight. 
 
 P. P. A. 
 
 Phiala prius agitata 
 
 The bottle having been first shaken. 
 
 P. r. n. 
 
 Pro re nata 
 
 Occasionally, as needed. 
 
 Pab. 
 
 Pabulum, gen. i 
 
 Food. 
 
 Pallid. 
 
 Pallidus, a, um 
 
 Pale. 
 
 Pan. 
 
 Panis, Pannus 
 
 Bread, A cloth or rag. 
 
 Par. , Pt. 
 
 Pars, gen. Partis 
 
 A part, Of a part. 
 
 Para, Parat. 
 
 Para, Paratus 
 
 Prepare, Prepared. 
 
 Pt. aeq. 
 
 Partes aequales 
 
 Equal parts. 
 
 Pt. affect. 
 
 Parte affecta 
 
 On the affected part. 
 
 Part. vie. 
 
 Partitis vicibus 
 
 In divided doses. 
 
 Parv. 
 
 Parvus, a, um 
 
 Little. 
 
 Parvul. 
 
 Parvulus, a, um 
 
 An infant, a parvul e. 
 
 Pastil. 
 
 Pastillus, Pastillum 
 
 A pastille, a lozenge. 
 
 Pauc. 
 
 Paucus, a, um 
 
 Little, few. 
 
 Paul. 
 
 Paulatim 
 
 Little by little, gradually. 
 
 Pect. 
 
 Pectus, gen. oris 
 
 The breast. 
 
 Pediluv. 
 
 Pediluvium 
 
 A foot-bath. 
 
 Penicil. cam. 
 
 Penicillum camelinum 
 
 A camel' s-hair pencil or brush. 
 
 Per 
 
 Per {prep. gov. accus.) 
 
 Through, by means of, very. 
 
 Peract. operat. emet. 
 
 Peracta. operatio emetici 
 
 When the emesis is finished. 
 
 Percalef. 
 
 Percalefactus, a, um 
 
 Thoroughly heated. 
 
 Percol. 
 
 Percola 
 
 Strain through, percolate. 
 
 Per deliq. 
 
 Per deliquium 
 
 By deliquescence. 
 
 Per fistul. vit. 
 
 Per fistulam vitream 
 
 Through a glass tube. 
 
 Perg. 
 
 Perge, Pergetur 
 
 Proceed, Let be continued. 
 
 Perind. 
 
 Perinde 
 
 Just as. 
 
LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 89I 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Permit, vir. 
 
 Permittentibus viribus 
 
 The strength permitting. 
 
 Perpur. 
 
 Perpurus, a, urn 
 
 Very clean. 
 
 Pervesp. 
 
 Pervesperi 
 
 Very late in the evening. 
 
 Pes 
 
 Pes, gen. pedis 
 
 The foot. 
 
 Pess. 
 
 Pessarium, Pessulum 
 
 A pessary. 
 
 Ph. 
 
 Phiala, gen. se 
 
 A vial, a bottle. 
 
 Pil. 
 
 Pilula, gen. ae 
 
 A pill. 
 
 Pil. 
 
 Pilus, gen. i 
 
 The hair. 
 
 Ping. 
 
 Pinguis, gen. is 
 
 Fat, grease. 
 
 Pist. 
 
 Pistillum, gen. i 
 
 A pestle. 
 
 Plac. 
 
 Placebo 
 
 I will satisfy (please). 
 
 Plas. 
 
 Plasma, Plasmetur 
 
 Mould, Let it be moulded. 
 
 Plen. 
 
 Plenus, a, um 
 
 Filled. - 
 
 Poc. 
 
 Poculum, Pocillum 
 
 A cup, A little cup. 
 
 Pon., P. 
 
 Pondere 
 
 By weight. 
 
 Pon. civ. 
 
 Pondus civile 
 
 Civil weight (avoirdupois). 
 
 Pon. med. 
 
 Pondus medicinale 
 
 Medicinal (apothecaries' ) weight. 
 
 Pone aur. 
 
 Pone aurem 
 
 Behind the ear. 
 
 Post cib. 
 
 Post cibos 
 
 After meals. 
 
 Post sing. sed. liq. 
 
 Post singulas sedes liquidas 
 
 After every loose stool. 
 
 Postrid. 
 
 Postridie 
 
 On the next day. 
 
 Pot. 
 
 Potus, gen. us 
 
 A drink. 
 
 Pne 
 
 Prae {prep. gov. abl.) 
 
 Before, very. 
 
 Prcep. 
 
 Praeparatus, a, um 
 
 Prepared. 
 
 Prand. 
 
 Prandium, gen. i 
 
 Dinner. 
 
 Prid. 
 
 Pridie 
 
 On the previous day. 
 
 Prim. man. 
 
 Primo mane 
 
 Very early in the morning. 
 
 Primus 
 
 Primus, a, um 
 
 The first. 
 
 Pro 
 
 Pro {adv. and prep. gov. 
 abl.) 
 
 For, before, according to. 
 
 Prop. 
 
 Proprius, a, um 
 
 Special, particular. 
 
 Pro rat. aet. 
 
 Pro ratione aetatis 
 
 According to the age of the patient. 
 
 Pro r. n. 
 
 Pro re nata 
 
 Occasionally, as needed. 
 
 Prox. 
 
 Proximo 
 
 Nearest. 
 
 Pug. 
 
 Pugillus 
 
 A pinch. 
 
 Pulm. 
 
 Pulmentum, gen. i 
 
 Gruel. 
 
 Pulv. 
 
 Pulvis, gen. ens 
 
 A powder. 
 
 Pulv. gros. 
 
 Pulvis grossus 
 
 A coarse powder. 
 
 Pulv. subtil. 
 
 Pulvis subtilis 
 
 A smooth powder. 
 
 Pulv. ten. 
 
 Pulvis tenuis 
 
 A fine powder. 
 
 Pulvz. 
 
 Pulverizatus, a, um 
 
 Powdered. 
 
 Pur. 
 
 Purus, a, um 
 
 Pure, clean. 
 
 Purg. 
 
 Purgativus, gen. i 
 
 A purgative, a purging. 
 
 Pyx. 
 
 Pyxis, gen. idis 
 
 A small box, a pill-box. 
 
 Q- 
 
 Quadrans, gen. tis 
 
 A fourth part, a quart. 
 
 Q. lib. 
 
 Quantum libet 
 
 As much as you please. 
 
 Q. p. 
 
 Quantum placet 
 
 << << (« a a 
 
 Q. q. 
 
 Quoque 
 
 Also. 
 
 Qq. 
 
 Quisque, Quaque 
 
 Each, or Every. 
 
 Qq. hor. 
 
 Quaqua. hora. 
 
 Every hour. 
 
 Q. s. 
 
 Quantum sufficiat 
 
 As much as is sufficient. 
 
 Q. s. 
 
 Quantum satis 
 
 <« (( an a 
 
 Q. v. 
 
 Quantum vis 
 
 As much as you please. 
 
 Q. vol. 
 
 Quantum volueris 
 
 a a (i a a 
 
 Quad. 
 
 Quadruplo 
 
 Quadruple, in fourfold. 
 
 Quam 
 
 Quam 
 
 As much as. 
 
 Quart. 
 
 Quartus, gen. i 
 
 Fourth. 
 
 Quat., Quater 
 
 Quatuor, Quater 
 
 Four, Four times. 
 
 Quibus 
 
 Quibus 
 
 From which. 
 
892 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Quinq. 
 
 Quinque 
 
 Five. 
 
 Quint. 
 
 Quintus 
 
 The fifth. 
 
 Quoq. 
 
 Quoque 
 
 Also. 
 
 Quor. 
 
 Quorum 
 
 Of which. 
 
 Quotid. 
 
 Quotidie 
 
 Daily. 
 
 Quoties req. 
 
 Quoties requiritur 
 
 As often as is required. 
 
 r£ 
 
 Recipe 
 
 Take (thou). 
 
 Rar. 
 
 Rarus, a, um 
 
 Loose, thin, rare. 
 
 Rat. 
 
 Ratio, gen. onis 
 
 Relation, proportion. 
 
 Rec. 
 
 Recens, gen. ends 
 
 Fresh, recent, newly. 
 
 Red. in pulv. 
 
 Redactus in pulverem 
 
 Reduced to powder. 
 
 Redig. in pulv. 
 
 Redigatur in pulverem 
 
 Let it be reduced to powder. 
 
 Reg. umbil. 
 
 Regro umbilici 
 
 The umbilical region. 
 
 Rel. 
 
 Relectus, a, um 
 
 Opened, loosened. 
 
 Reliq. 
 
 Reliquus, gen. i 
 
 Remaining, the remainder. 
 
 Renov. 
 
 Renova, Renovetur 
 
 Renew, Let it be renewed. 
 
 Renov. semel 
 
 Renovetur semel 
 
 Let it be renewed once only. 
 
 Rept. 
 
 Repetatur, Repetantur 
 
 Let it (them) be repeated. 
 
 Res 
 
 Res, gen. rei 
 
 A substance, thing, affair. 
 
 Resid. 
 
 Residuus, a, um 
 
 Residual, remaining. 
 
 Respon. 
 
 Responde 
 
 Answer (thou). 
 
 Retin. 
 
 Retinetur 
 
 Let it be withheld. 
 
 Rict. 
 
 Rictus, gen. us 
 
 A wide (distended) opening. 
 
 Rig. 
 
 Rigidus, a, um 
 
 Rigid, hard, inflexible. 
 
 Rub. 
 
 Ruber, Rubra, Rubrum 
 
 Red, ruddy. 
 
 Rudic. 
 
 Rudicula, gen. se 
 
 A spatula. 
 
 Rudis 
 
 Rudis, gen. is 
 
 A stirring-rod. 
 
 Rum. 
 
 Rumen, gen. inis 
 
 The throat. 
 
 S. expr. 
 
 Sine expressione 
 
 Without expression. 
 
 S. A. 
 
 Secundum artem 
 
 According to art. 
 
 S. L. 
 
 Secundum legem 
 
 According to law. 
 
 S.N. 
 
 Secundum naturam 
 
 According to nature. 
 
 s. s. s. 
 
 Stratum superstratum 
 
 Layer upon layer. 
 
 S. V. R. 
 
 Spiritus vini rectificatus 
 
 Alcohol. 
 
 S. V. T. 
 
 Spiritus vini tenuis 
 
 Proof spirit. 
 
 Sac. lac. 
 
 Saccharum lactis 
 
 Sugar of milk. 
 
 Sac. sat. 
 
 Saccharum saturni 
 
 Sugar of lead. 
 
 Saep. 
 
 Saepe 
 
 Frequently. 
 
 Sal 
 
 Sal, gen. salis 
 
 Salt. 
 
 Sal am. 
 
 Sal amarum 
 
 Magnesium sulphate. 
 
 Sal mir. 
 
 Sal mirabile 
 
 Sodium sulphate. 
 
 Sal vol. 
 
 Sal volatile 
 
 Ammonium carbonate. 
 
 Saltern 
 
 Saltern 
 
 At least. 
 
 Saltim 
 
 Saltim 
 
 By leaps. 
 
 Sang. 
 
 Sanguis, Sanguineus 
 
 Blood, Bloody. 
 
 Sap. 
 
 Sapor, gen. oris 
 
 A flavor, delicacy. 
 
 Sat. 
 
 Satis 
 
 Enough, sufficient. 
 
 Saturat. 
 
 Saturatus, a, um 
 
 Saturated. 
 
 Scarif. 
 
 Scarifica 
 
 Scarify (thou). 
 
 Scarif. expl. 
 
 Scarificatione explicata 
 
 Scarification having been effected. 
 
 Scat. 
 
 Scatula, gen. se 
 
 A box. 
 
 Scil. 
 
 Scilicet 
 
 Namely. 
 
 Scrup., 9 
 
 Scrupulum, gen. i 
 
 A scruple (20 grains). 
 
 Scut. pect. 
 
 Scuto pectori 
 
 For protection to the breast. 
 
 Sec. 
 
 Secundo, Secundum 
 
 Secondly, According to. 
 
 Secund. 
 
 Secundus 
 
 Second. 
 
 Sed. 
 
 Sedes, gen. is 
 
 The fundament, the feces. 
 
 Semel 
 
 Semel 
 
 Once. 
 
 Semidr. 
 
 Semi -drachma 
 
 Half a drachm. 
 
LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 893 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Semih. 
 
 Semi-hora 
 
 Half an hour. 
 
 Sensim 
 
 Sensim 
 
 Gently, gradually, slowly. 
 
 Separ. 
 
 Separatim 
 
 Separately. 
 
 Sept. 
 
 Septem 
 
 Seven. 
 
 Septim. 
 
 Septimana 
 
 A week. 
 
 Sero 
 
 Sero 
 
 Late, at a late hour. 
 
 Sesq. 
 
 Sesqui 
 
 One and a half. 
 
 Sesqh. 
 
 Sesquihora 
 
 An hour and a half. 
 
 Sesunc. 
 
 Sesuncia 
 
 An ounce and a half. 
 
 Sev. 
 
 Sevum, gen. i 
 
 Suet, tallow. 
 
 Sex, Sext. 
 
 Sex, Sextus 
 
 Six, Sixth. 
 
 Si 
 
 Si 
 
 If. 
 
 Sic! 
 
 Sic! 
 
 So, thus. 
 
 Sic. 
 
 Sicca, Siccetur 
 
 Dry (thou), Let it be dried. 
 
 Sic. 
 
 Siccus 
 
 Dry, Dried. 
 
 Sig. 
 
 Signa, Signetur 
 
 Write (thou), Let it be marked. 
 
 Sig. nom. prop. 
 
 Signatur nomine proprio 
 
 Let it be written upon (marked) with 
 its proper name. 
 
 Sign. 
 
 Signanter 
 
 Clearly, distinctly. 
 
 Sile hujus ! 
 
 Sile hujus ! 
 
 Keep silence concerning this. 
 
 Simp. 
 
 Simplex, gen. simplicis 
 
 Simple, unmixed. 
 
 Simul 
 
 Simul 
 
 Together. 
 
 Sin. 
 
 Sine 
 
 Without. 
 
 Sing. 
 
 Singulorum 
 
 Of each. 
 
 Si non val. 
 
 Si non valeat 
 
 If it does not answer. 
 
 Si op. sit 
 
 Si opus sit 
 
 If necessary. 
 
 Si vir. perm. 
 
 Si vires permittebant 
 
 If the strength will permit. 
 
 Sit 
 
 Sit 
 
 Let it be. 
 
 Sit in promp. 
 
 Sit in promptu 
 
 Let it be in readiness. 
 
 Sitis, Siti 
 
 Sitis, Siti 
 
 Thirst, For thirst. 
 
 Sol. 
 
 Solus 
 
 Alone, only. 
 
 Solat. 
 
 Solatium,^;?, ii 
 
 A soothing, assuaging. 
 
 Solit. 
 
 Solitus, a, um 
 
 Accustomed, ordinary. 
 
 Solut. 
 
 Solutus, a, um 
 
 Dissolved. 
 
 Solut. 
 
 Solutio, gen. onis 
 
 A solution. 
 
 Solv. 
 
 Solve, Solvetur 
 
 Dissolve, Let it be dissolved. 
 
 Solv. c. calor. 
 
 Solve cum calore 
 
 Dissolve with heat. 
 
 Som. 
 
 Somnus, gen. i 
 
 Sleep. 
 
 Spiss. 
 
 Spissus, a, um 
 
 Dense, hard. 
 
 Spt. 
 
 Spiritus, gen. us 
 
 Spirit. 
 
 Spt. vin. rect. 
 
 Spiritus vini rectificatus 
 
 Rectified spirit of wine (Alcohol). 
 
 Spt. vin. ten. 
 
 Spiritus vini tenuis 
 
 Proof spirit. 
 
 Spt. vinos. 
 
 Spiritus vinosus 
 
 Ardent spirit (of any strength). 
 
 ss. 
 
 Semis, Semissis, Semi- 
 
 A half. 
 
 St. 
 
 Stet, Stent 
 
 Let it (or them) stand. 
 
 Stat. 
 
 Statim 
 
 Immediately. 
 
 Stib. 
 
 Stibium, gen. ii 
 
 Antimony. 
 
 Stillat. 
 
 Stillatim 
 
 By drops, drop by drop. 
 
 Stom. 
 
 Stomachus, gen. i 
 
 The stomach. 
 
 Strat. 
 
 Stratum, gen. i 
 
 Layer, stratum. 
 
 Strat. superst. 
 
 Stratum, superstratum 
 
 Layer upon layer. 
 
 Suav. 
 
 Suavis 
 
 Pleasant, agreeable. 
 
 Sub 
 
 Sub 
 
 Under, somewhat. 
 
 Subact. 
 
 Subactus 
 
 Subdued, sinking. 
 
 Sub fin. coct. 
 
 Sub finem coctionis 
 
 When the boiling is nearly done. 
 
 Subind. 
 
 Subinde 
 
 Frequently. 
 
 Subtil. 
 
 Subtilis 
 
 Fine, smooth, nice. 
 
 Sue. 
 
 Succus, gen. i 
 
 Juice, sap. 
 
 Suggil. 
 
 Sugillationi 
 
 To the bruise. 
 
8 9 4 
 
 LIST OF CONTRACTIONS AND LATIN PHRASES. 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Sum. 
 
 Sume, Sumat 
 
 Take (thou), Let him take. 
 
 Sum. 
 
 Sumatur, Sumantur 
 
 Let it (them) be taken. 
 
 Sum. tal. 
 
 Sumat talem 
 
 Let him take one like this. 
 
 Sumend. 
 
 Sumendus 
 
 To be taken. 
 
 Summit. 
 
 Summitates 
 
 The highest points, summits. 
 
 Sum. mane sum. 
 
 Summo mane sumendus 
 
 To be taken very early in the morning. 
 
 Summ. 
 
 Summus, a, urn 
 
 Highest, summit. 
 
 Sup. 
 
 Super, Supra 
 
 Above, upon, over. 
 
 Sup. bib. haust. 
 
 Superbibendo haustum 
 
 Drinking afterwards this draught. 
 
 Suppos. 
 
 Suppositoria, gen. se 
 
 A suppository. 
 
 Suppos. rect. 
 
 Suppositories rectales 
 
 Rectal suppositories. 
 
 Suppos. ureth. 
 
 Suppositorise urethrales 
 
 Urethral suppositories. 
 
 Syr. 
 
 Syrupus, gen. i 
 
 Syrup. 
 
 T. d., velT. i. d. 
 
 Ter die, vel Ter in die 
 
 Thrice daily. 
 
 Tab. 
 
 Tabella, gen. se 
 
 A lozenge, tablet. 
 
 Tal. 
 
 Talis, gen. is 
 
 Of such, like this. 
 
 Tam 
 
 Tam 
 
 So far, in so far. 
 
 Tan. 
 
 Tandem 
 
 At last, finally. 
 
 Tant. 
 
 Tan turn, gen. i 
 
 So much, so many. 
 
 Teg. 
 
 Tegmen, gen. inis 
 
 A cover. 
 
 Temp. 
 
 Tempus, gen. oris 
 
 Time, temple. 
 
 Temp. dext. 
 
 Tempori dextro 
 
 To the right temple. 
 
 Ten. 
 
 Tenuis 
 
 Fine, weak, thin. 
 
 Tep. 
 
 Tepidus, a, um 
 
 Tepid, lukewarm. 
 
 Ter 
 
 Ter 
 
 Thrice, three times. 
 
 Tere, Teret. 
 
 Tere, Teretur 
 
 Rub (thou), Let it be rubbed. 
 
 Tere sim. 
 
 Tere simul 
 
 Rub (thou) together. 
 
 Teres 
 
 Teres, gen. etis 
 
 Rubbed, smooth, polished. 
 
 Tert. 
 
 Tertius 
 
 Third. 
 
 Test. ov. 
 
 Testa ovi 
 
 An egg-shell. 
 
 Thion. 
 
 Thionas, gen. atis 
 
 Sulphur, sulphate. 
 
 Tinct., velTx. 
 
 Tinctura, gen. se 
 
 Tincture. 
 
 Tinct. herb, recent. 
 
 Tincturae herbarum recen- 
 tium 
 
 Tinctures of fresh herbs. 
 
 Tinct. theb. 
 
 Tinctura thebaica 
 
 Laudanum. 
 
 Tr. 
 
 Tres, Tria 
 
 Three. 
 
 Trid. 
 
 Triduum, gen. ui 
 
 The space of three days. 
 
 Trit. 
 
 Tritura, Trituretur 
 
 Triturate, Let it be triturated. 
 
 Troch. 
 
 Trochiscus, Trochisci 
 
 A lozenge, or troche, Lozenges. 
 
 Turn 
 
 Turn 
 
 Then, next, furthermore. 
 
 Turb. 
 
 Turbidus, a, um 
 
 Turbid, muddy. 
 
 Tus. 
 
 Tussis, gen. is 
 
 A cough. 
 
 Tuto 
 
 Tuto 
 
 Safely. 
 
 Ubi 
 
 Ubi 
 
 Where, wherever, whenever. 
 
 Uln. 
 
 Ulna, gen. se 
 
 The arm, elbow. 
 
 Ult. 
 
 Ultime, Ultima 
 
 Lastly, at the last. 
 
 Ult. prsesc. 
 
 Ultimo prsescriptus 
 
 The last ordered. 
 
 Una 
 
 Una 
 
 Together. 
 
 Una, I 
 
 Uncia, gen. se 
 
 An ounce. 
 
 Unct. 
 
 Unctus, a, um 
 
 Anointed, besmeared. 
 
 Unctul. 
 
 Unctulus, a, um 
 
 «' " 
 
 Ung. 
 
 Unguentum, gen. i 
 
 An ointment, unguent. 
 
 Unguil. 
 
 Unguilla, gen. se 
 
 An ointment-box. 
 
 Urg. 
 
 Urgens, gen. entis 
 
 Pressing, urgent. 
 
 Ust. 
 
 Ustus, a, um 
 
 Burnt. 
 
 Ut 
 
 Ut, Uti 
 
 That, so that, in order that. 
 
 Ut diet. 
 
 Ut dictum 
 
 As directed. 
 
 Utend. more sol. 
 
 Utendus more soli to 
 
 To be used in the usual manner. 
 
 Utere 
 
 Utere 
 
 Use (thou), make use of. 
 
NUMERALS. 
 
 8 95 
 
 Contraction. 
 
 Word or Phrase. 
 
 English Equivalent. 
 
 Vas 
 
 Vas, gen. vasis 
 
 A vessel, utensil, bottle. 
 
 
 Vas vit. 
 
 Vas vitreum 
 
 A glass vessel. 
 
 
 Vehic. 
 
 Vehiculum, gen. i 
 
 A vehicle, menstruum. 
 
 
 Vel 
 
 Vel (or Ve as a.sttffix) 
 
 Or. 
 
 
 Venaesec. brach. 
 
 Vensesectio brachii 
 
 Bleeding in the arm. 
 
 
 Venen. 
 
 Venenum, Venenosus 
 
 A poison, Poisonous. 
 
 
 Ver. 
 
 Verus, a, um 
 
 True, real, genuine. 
 
 
 Vesp. 
 
 Vesper, gen. eris 
 
 The evening. 
 
 
 Vesper. 
 
 Vesperma, gen. ae 
 
 Supper. 
 
 
 Vic. 
 
 Vicis, Vices 
 
 Change, changes. 
 
 
 Vin. 
 
 Vinum, gen. i 
 
 Wine. 
 
 
 Vir. 
 
 Vires (pi. of Vis) 
 
 Strength, vigor, life. 
 
 
 Virid. 
 
 Viridis, Viride 
 
 Green. 
 
 
 Vis 
 
 Vis, gen. viris 
 
 Strength, vigor, life. 
 
 
 Vitel. 
 
 Vitellus, gen. i 
 
 Yolk. 
 
 
 Vitel. ovi 
 
 Vitellus ovi 
 
 Yolk of egg. 
 
 
 Vitel. ovi sol. 
 
 Vitello ovi solutus 
 
 Dissolved in the yolk of an 
 
 e gg- 
 
 Vitr. 
 
 Vitrum, Vitreus 
 
 Glass, Of glass, glazed. 
 
 
 Vol. 
 
 Volatilis, Volatile 
 
 Volatile. 
 
 
 Vom. urg. 
 
 Vomitione urgente 
 
 Vomiting being severe. 
 
 
 For Dangerous Abbreviations, see ante, page 546, under the title Prescriptions. 
 
 NUMERALS. 
 
 Cardi 
 
 NALS. 
 
 Ordinals. 
 
 Unus 
 
 One. 
 
 Primus 
 
 First. 
 
 Duo 
 
 Two. 
 
 Secundus 
 
 Second. 
 
 Tres 
 
 Three. 
 
 Tertius 
 
 Third. 
 
 Quatuor 
 
 Four. 
 
 Quartus 
 
 Fourth. 
 
 Quinque 
 
 Five. 
 
 Quintus 
 
 Fifth. 
 
 Sex 
 
 Six. 
 
 Sextus 
 
 Sixth. 
 
 Septem 
 
 Seven. 
 
 Septimus 
 
 Seventh. 
 
 Octo 
 
 Eight. 
 
 Octavus 
 
 Eighth. 
 
 Novem 
 
 Nine. 
 
 Nonus 
 
 Ninth. 
 
 Decern 
 
 Ten. 
 
 Decimus 
 
 Tenth. 
 
 Undecim 
 
 Eleven. 
 
 Undecimus 
 
 Eleventh. 
 
 Duodecim 
 
 Twelve. 
 
 Duodecimus 
 
 Twelfth. 
 
 Tredecim 
 
 Thirteen. 
 
 Tertius decimus 
 
 Thirteenth. 
 
 Quatuordecim 
 
 Fourteen. 
 
 Quartus decimus 
 
 Fourteenth. 
 
 Quindecim 
 
 Fifteen. 
 
 Quintus decimus 
 
 Fifteenth. 
 
 Sexdecim 
 
 Sixteen. 
 
 Sextus decimus 
 
 Sixteenth. 
 
 Septemdecim 
 
 Seventeen. 
 
 Septimus decimus 
 
 Seventeenth. 
 
 Octodecim 
 
 Eighteen. 
 
 Octavus decimus 
 
 Eighteenth. 
 
 Novemdecim 
 
 Nineteen. 
 
 Nonus decimus 
 
 Nineteenth. 
 
 Viginti 
 
 Twenty. 
 
 Vicesimus 
 
 Twentieth. 
 
 Viginti unus, vel "1 
 Unus et viginti J 
 
 Twenty-one. 
 
 Vicesimus primus 
 
 Twenty-first. 
 
 Vicesimus secundus 
 
 Twenty-second. 
 
 Triginta 
 
 Thirty. 
 
 Tricesimus 
 
 Thirtieth. 
 
 Quadraginta 
 
 Forty. 
 
 Quadragesimus 
 
 Fortieth. 
 
 Quinquaginta 
 
 Fifty. 
 
 Quinquagesimus 
 
 Fiftieth. 
 
 Sexaginta 
 
 Sixty. 
 
 Sexagesimus 
 
 Sixtieth. 
 
 Septuaginta 
 
 Seventy. 
 
 Septuagesimus 
 
 Seventieth. 
 
 Octoginta 
 
 Eighty. 
 
 Octogesimus 
 
 Eightieth. 
 
 Nonaginta 
 
 Ninety. 
 
 Nonagesimus 
 
 Ninetieth. 
 
 Centum 
 
 ,One hundred. 
 
 Centesimus. 
 
 Hundredth. 
 
8g6 
 
 GENITIVE CASE-ENDINGS — VERBS. 
 
 GENITIVE CASE-ENDINGS. 
 
 Nom. 
 
 Gen. 
 
 Exceptions. 
 
 a 
 
 ae 
 
 .Cataplasma, Enema, Physostigma, Aspidosperma and Gargarisma, all have 
 the genitive in -atis. Coca is unchanged, though the genitive Cocas is 
 written by some authorities. Folia is plural, gen. Foliorum. 
 
 us 
 urn 
 
 OS 
 
 on 
 
 i 
 
 Rhus, Rhois ; Flos, Floris ; Bos, Bovis ; Limon, Limonis ; Erigeron, -ontis. 
 Fructus, Cornus, Quercus, Spiritus, Haustus Potus, do not change, being 
 of the 4th declension. 
 
 as 
 
 atis 
 
 Asclepias, -adis; Mas, Maris. 
 
 is 
 
 idis 
 
 Pulvis, -eris ; Arsenis, -itis ; Phosphis, -itis ; Sulphis, -itis, and all salts 
 ending in -is, have the genitive in -itis. 
 
 o 
 
 onis 
 
 Mucilago, -inis ; Ustilago, -inis ; Solidago, -inis. 
 
 1 
 
 lis 
 
 Fel, Fellis ; Mell, Mellis ; Sumbul, Sumbuli. 
 
 en 
 ps 
 rs 
 
 r 
 
 X 
 
 inis 
 pis 
 rtis 
 
 ris 
 cis 
 
 Words which do not change in the Genitive. 
 
 *Amyl. *Coca. Haustus. Quercus. 
 Azedarach. Condurango. Hydrastis. Sago. 
 Berberis. Cornus. Jaborandi. Sassafras. 
 Buchu. Curare. Kino. Sinapis. 
 Cannabis. Digitalis. Matico. Spiritus. 
 Catechu. Fructus. Potus. 
 
 * But some authorities give Amylis, Cocae. 
 
 Pronunciation. 
 
 Attention is particularly directed to the accentuation of words commonly mispronounced ; 
 as, for example, acetas, angina, atropa, chimaphila {kimaphild), chloridum, codeia, co- 
 nium, enema, iodidum, radicis, ricinus, sinapis, syrupus, eczema, umbilicus, abdomen, 
 bromidum, paresis. 
 
 Verbs. 
 
 The Verbs used in prescription writing are nearly all in the imperative mood, giving 
 directions to the compounder, and having their objects in the accusative case. Such are — 
 
 Adde, add. Fac, make . Recipe, take. 
 
 Cola, strain. Filtra, filter. Signa, write. 
 
 Divide, divide. Macera, macerate. Solve, dissolve. 
 
 Extende, spread. Misce, mix. Tere, rub. 
 
 A few verbs are found in the subjunctive mood, taking their subject or predicate in the 
 nominative case. The most usual are — 
 
 Fiat, let be made. 
 Coletur, let be strained. 
 Color etur, let be colored. 
 
 Bulliat, let boil. 
 Capiat, let take. 
 Deter, let be given. 
 
 Dividatur, let be divided. 
 Sit, let it be. 
 Sumatur, let be taken. 
 
 Participles. 
 
 Participles or Verbal Adjectives are occasionally used, and should agree with their 
 respective nouns in gender, number, and case. Such are — 
 
 Adhibendus, a, um, to be administered. Dividendus, a, um, to be divided. 
 
 Sumendus, a, um, tobe taken. 
 
HYPODERMIC FORMULAE. 
 
 8 97 
 
 Prepositions. 
 Those in the first column require the noun following to be in the accusative case, — 
 those in the second column require the ablative case. 
 
 Ad, to, up to. Cum, with. 
 
 In, into. Pro, for. 
 
 Supra, upon. Sine, without. 
 
 Ana, of each, — governs the genitive case. 
 
 Sundry 
 
 Bene, well. 
 Bis, twice. 
 Dein, thereupon. 
 Et, and. 
 
 Gradatitn, gradually. 
 Guttatim, by drops. 
 In dies, daily. 
 Da, give. 
 
 Words and Phrases, 
 Non, not. 
 Numerus, number. 
 Octarius, a pint. 
 Semel, once. 
 Simul, together. 
 Statim, at once. 
 Ter, thrice. 
 Quater, four times. 
 
 IN MOST FREQUENT USE. 
 
 Ad saturandum, to saturation. 
 Nutnero, to the number of. 
 Quantum sufficiat, as much as necessary. 
 Pro re natd, according to need. 
 In partes cequales, into equal parts. 
 Redactus in pulverem, let be pulverized. 
 Secundum artem, according to art. 
 Non repetatur, let it not be repeated. 
 
 Apomorphine. 
 
 R. Apomorphinse Hydrochlor., gr. j. 
 
 Div. in pulv. xvj. One to four in lr^xx 
 of water as required. 
 
 HYPODERMIC FORMULA. 
 
 Coniine. 
 R. 
 
 a. 
 
 Atropine. 
 
 Atropine Sulphatis, . . . gr. j. 
 Aquae Destillatae, . . . . 25 j. 
 Solve. Sig. — For hypodermic use, rrLyj 
 gr- -sV> m> = § r - Tiff- 
 
 Caffeine. 
 
 R . Caffeinae Citratis, . . . . gr. 
 Aquae Destillatae, . . . . ^j. 
 Solve. Sig. — TT^xx contain gr. j. 
 
 Carbolic Acid. 
 
 R. Ac. Carbol. Purif., . . . gr. x. 
 
 Aquae Destil., ^j. 
 
 M. Sig. — tt^viij contain gr. ys of the 
 acid, which may be given up togr. ij or iij. 
 
 Chloral. 
 
 R . Chloralis Hydratis, . . . 5J iv. 
 
 Aquae Destil., ^j. 
 
 M. Sig. — rrpcxx contain gr. xv of 
 Chloral Hydrate. 
 
 Chloroform. 
 
 R . Chloroformi Purif. , . . . 3; ss. 
 
 Sig. — TT^v-xv can be used as one deep 
 injection. (See page 264. ) The spirit is 
 safer, in somewhat larger doses. 
 
 57 
 
 Coniinae Hydrobromat. , . gr. j. 
 Aquae Destillat., . . . . l§j. 
 M. Sig. — rr^x contain gr. -fa. 
 
 Cocaine. 
 
 R. Cocainae Hydrochlorat., . gr. v. 
 Aquae Destillatae, . . . .. 3 ij. 
 Solve. Sig. — Tr\xij contain gr. ss. 
 
 Curare. 
 
 R. Curare (Merck), . . . . gr. j. 
 
 Acidi Acetici, tr\\. 
 
 Aquae Destillatae, q. s. ad X(\c. 
 M. et filtra. Sig. — tr\x contain gr. -j- 1 ^. 
 
 R . Curarinae Sulphat. 
 Aquae Destillat., 
 M. 
 
 gr- J- 
 gss. 
 
 Daturine. 
 
 R . Daturinae, gr. ss. 
 
 Aquae Destil., ^j. 
 
 Solve. Sig. — X(\\v contain gr. ^io- 
 Dose, TTLiv-x. 
 
 Digitalin. 
 
 gr- 
 
 R . Digitalini, 
 
 Alcoholis, 
 
 Aquae Destil., . . . . aa ^ij. 
 Solve. Sig. — rnjx contain gr. T \-§. 
 Dose, rtyv-viij. 
 
898 
 
 HYPODERMIC FORMULAE. 
 
 Duboisine. 
 
 R. Duboisinae Sulphat., . . . gr. j. 
 
 Aquae Destil., £]. 
 
 M. Sig. — TT^iv contain gr. 
 
 200- 
 
 Ergot and Ergotin. 
 
 R. Extr. Ergotae Fluid., . . . Jss. 
 Filtra. Sig. — Dose, n\x. 
 
 R. Extracti Ergotae (Squibb), zj. 
 Aquae Destillat., . . . . ^j. 
 Solve et filtra. Sig. — Tl^x contain gr. j. 
 Dose, Tt^x-xx. 
 
 R. 
 
 Hyoscine, Hyoscyamine. 
 
 Hyoscinae Hydrobrom., vel 
 Hyoscyaminae Hydrobrom., gr. j. 
 Aquae Destillatae, . . . . Jj. 
 M. Sig. — TT^v contain gr. ^. 
 
 Mercury. 
 
 R. Hydrarg. Chlor. Corr., . gr. j. 
 Aqua; Destillat., . . . . %'). 
 M. Sig. — rr\x contain gr. ^. 
 
 R. 
 
 Hydrarg. Chlor. Corrosivi, 
 Ammonii Chloridi, . . aa gr. iij. 
 
 Misce et solve in — 
 
 Aquae Destillatae, .... 3Jss. 
 
 Dein adde — 
 
 Albuminis Ovi, 3J SS - 
 
 Aquae Destillatae, . . . .3 V. 
 
 Filtra, et adde — 
 
 Aquae Destil., . . q. s. ad 3X. 
 
 Sig.— TMJ contains gr. ^. Dose, rryij-x. 
 
 R 
 
 Hydrarg. et Sodii Iodidi, . gr. iij. 
 Aquae Destillatae, .... ^iijss. 
 Solve. Sig. — ir^x contain gr. *^. Dose, 
 Tl\x every second day. 
 
 Morphine. 
 
 R. Morphinae Sulphatis, . . . gr. xvj. 
 
 Acidi Carbolici, rryij. 
 
 Aquae Destillat ^j. 
 
 Solve et filtra. Sig. — TT\vijss contain 
 
 R 
 
 Morphine and Atropine. 
 
 Morphinae Sulphatis, . . . gr. xvj. 
 
 Atropinae Sulphatis, . . . gr. ss. 
 
 Acidi Carbolici, ..... TT\nj. 
 
 Aquae Destillat., . . . . ^j. 
 Solve et filtra. Sig. — rt\vijss contain gr. 
 j^ of Morphine Sulph., and gr. ^±_ of 
 Atropine Sulphate. 
 
 R . Morphinae Sulphatis, . . . gr. xxiv. 
 
 Atropinae Sulphatis, . . . gr. j. 
 
 Ol. Amygdalae Amar., . . gtt. j. 
 
 Aquae Destillat., . . . . ^ij. 
 Solve. Sig. — rt\,x contain gr. ^ of 
 Morphine Sulphate, and gr. -^ of Atropine 
 Sulphate. (Didama's Solution.) 
 
 R. 
 
 Physostigmine (Eserine). 
 
 Physostigminae Sulph., . . gr. j. 
 Aquae Destillatae, .... ^j. 
 
 Solve. Sig. 
 
 Pilocarpine. 
 
 R. Pilocarpinae Hydrochlor., . gr. xvj. 
 Aquae Destillat., . . . . \y 
 M. Sig. — n^v contain gr. */$ . 
 
 Potassium Iodide. 
 
 R. Potassii Iodidi, 3J. 
 
 Aquae Destillatae, . . . . £iv. 
 Solve. Sig. — Dose, rr\vj-xx. 
 
 R 
 
 Quinine. 
 
 Quininae Disulph., . . , 
 Ac. Sulph urici Dil., . . 
 
 Ac. Carbolici, 
 
 Aquae Destillatae, . . . 
 Solve. Sig. — 3 j contains gr. 
 Is irritant (B). 
 
 gr- 1 (5o). 
 TT^c (100). 
 
 "iv (5). 
 vj. (Lente.) 
 
 R. Quininae Hydrobrom., . . gr. xlviij. 
 Aquae Destillat., . . . . ^iv. 
 Solve. Sig. — TT\xx contain gr. iv. 
 
 R. 
 
 Quininae Bimur. Carbamidat. , 
 Aquae Destillatae, . . . aa Sjiv. 
 Solve. Sig. — TT\x contain gr. v. 
 
 R 
 
 Strychnine. 
 
 . Strychninae Sulphat. , . . . gr. j. 
 
 Aquae Destillatae, . . . . ^j. 
 Solve sine alcohol. Sig.— tt\x contain 
 
 g r - 
 
 R. Strychnirfte Nitratis, . . . gr. iij. 
 
 Aquae Fervid. , 3 x. 
 
 Solve. Sig.— Y(\x contain gr. ¥ V 
 
 (Portugalojf. ) 
 
PATENT MEDICINES. 
 
 8 99 
 
 PATENT MEDICINES. 
 
 These formulae have been published from time to time in various journals and formu- 
 laries, and are supposed to represent the preparations designated. The name of the 
 author is appended in each case when known. 
 
 Alcoholic Strength of Quack Bitters. 
 
 Hostetter, 43. 20 
 
 Drake Plantation, 3°- 2 4 
 
 Rush, 34-20 
 
 Peruvian, 22.40 
 
 Hoofland, 20.85 
 
 Oxygenated, !9- 2 3 
 
 California Wine Bitters, 18.20 
 
 Walker's Vinegar Bitters, .... 7.20 
 
 Amick's Consumption Cure. 
 
 The Amick advertisements appeared 
 shortly after the publication of Dr. N. B. 
 Shade's paper in this and other journals. 
 Amick copied Shade's language, speaking 
 of the ' ' chemical ' ' cure, etc. , and, I believe, 
 adopted Shade's methods of treatment. 
 These were fully described by Shade, and 
 consist in the use of Calomel, Iodoform, 
 Guaiacol, etc. 
 
 {Dr. Waugk, in Times and Register^) 
 
 Ayer's Ague Cure. 
 
 This, according to Churchill's analysis, is 
 alleged to consist of a syrupy tincture of 
 Peruvian Bark with Aromatics, each bottle 
 holding six fluid ounces, and each fluid 
 ounce containing 3.2 grains of amorphous 
 Cinchona alkaloids, 3 grains Cinchonine, 
 0.7 grain Cinchonidine, 0.8 grain Quinine, 
 and one grain of Quinidine. 
 
 Ayer's Cherry Pectoral. 
 
 Morphinae Acetat., . . . . gr. iij. 
 Vini Antim. et Potass. Tartrat., 
 Vini Ipecacuanhse, . . .aa^iij. 
 Tinct. Sanguinariae, . . . zij. 
 Syr. Pruni Virginian. , . . . 3 iij. 
 
 Ayer's Pills. 
 
 Consist of Colocynth, Gamboge and 
 Aloes, coated with Starch and Sugar. 
 
 Ayer's Sarsaparilla. 
 
 Alcohol, 
 
 Fl. Extr. of Sarsaparilla, 
 
 Fl. Extr. of Stillingia, . aa ^ iij. 
 
 Fl. Extr. of Yellow Dock, 
 
 Fl. Extr. of Podophyllum, aa 5ij. 
 
 Sugar, §j. 
 
 Potassium Iodide, .... gjss. 
 
 Iodide of Iron, gr. x. 
 
 Mix. 
 
 Brandreth's Pills. 
 
 Podophylli Radicis, . . 
 Extracti Podophylli, . . 
 Extr. Phytolaccae Baccae, 
 Pulv. Caryophylli, . . . 
 
 Cambogiae, 
 
 Ol. Menthae Piperitae, 
 
 Croci, 
 
 Misce, fiat massa, et div. in pil. xxiv. 
 
 (Hager.) 
 
 gr. x. 
 gr. x. 
 gr. xxx. 
 gr. x. 
 gr. ij-v. 
 tttfij. 
 
 Castoria. 
 
 Senna, av. oz. 2. 
 
 Pumpkin seed, dr. 6. 
 
 Rochelle salts, dr. 4. 
 
 Wormseed, Levant, . . . dr. 3. 
 
 Sodium Bicarbonate, . . .dr. 2. 
 
 Anise Seed, dr. 1. 
 
 Oil of Gaultheria, . . . . dr. y z . 
 
 Oil of Peppermint, . . . . dr. %. 
 
 Sugar, av. oz. 8. 
 
 Water, enough to make . . fl. oz. 16. 
 
 Exhaust the vegetable drugs by boiling 
 
 with water, evaporate to the proper volume, 
 
 and dissolve the sugarand other ingredients.. 
 
 ( Western Druggist. ) 
 
 Chlorodyne, Collis Browne's. 
 
 Morphine Hydrochlorate, . gr. 6. 
 
 Chloroform, dr. 6. 
 
 Cannabis Indica, . . . . gr. 6. 
 
 Prussic Acid (Scheele's), . IT^ 6. 
 
 Treacle, to make, . . . . oz. I. 
 
 Dose. — 10 to 30 minims. {Hygiene.} 
 
900 PATENT MEDICINES. 
 
 Clarke's Blood Mixture. Holloway's Ointment. 
 
 Potassium Iodide, . . . . gr. 48. 
 
 Chloric Ether, dr. 4. 
 
 Liquor Potassae, TT\, 30. 
 
 Water, colored with Burnt 
 
 Sugar, oz. 7^. 
 
 Dose. — One tablespoonful four times a 
 day. {Hygiene. ) 
 
 Ely's Cream Balm 
 
 consists of Vaselin, I ounce ; Thymol, 3 
 grains ; Bismuth Carb., 15 grains; Oil Win- 
 tergreen, 2 minims. The directions are to 
 dip the little finger into the balm and insert 
 up the nostrils, giving two or three full 
 inhalations. [Medical Record.) 
 
 Garfield Tea 
 
 consists chiefly of Senna leaves and Couch- 
 grass (Triticum), with aromatics. 
 
 {Prof. Leng field.) 
 
 Hamburg Tea. 
 
 Sennae Foliorum, . . . . pt. viij. 
 
 Mannae, pt. iv. 
 
 Coriandri, pt. j. 
 
 Hamlin's Wizard Oil. 
 
 
 Spt. Camphorae, . 
 Spt. Ammoniae, 
 
 
 l'y 
 
 Olei Sassafras, . . 
 
 . . aa 
 
 ^ss. 
 
 Olei Caryophylli, 
 Chloroformi, 
 
 
 3 l h 
 
 Olei Terebinthinae, 
 
 . v aa 
 
 ^ss. 
 
 Alcoholis, .... 
 
 q. s. ad 
 
 3v. 
 
 Helmbold's Buchu. 
 
 Said to resemble the genuine. 
 
 Short Buchu, oz. 9. 
 
 Uva Ursi, oz. 4^. 
 
 Liquorice root, dr. 10. 
 
 Macerate in 9 pints of boiling water, 
 strain and add — 
 
 Caramel, oz. 2. 
 
 Molasses, oz. 8. 
 
 Mix well and add — 
 
 Cubeb (fluid extract), . . . oz. 5. 
 
 Alcohol, pints 2. 
 
 Peppermint Oil, oz. 1. 
 
 "Water, sufficient to make, . pints 12. 
 (Lillard's Prac. Hints and Formula.) 
 
 Has in 159 parts — 
 
 Olive Oil, 62| parts. 
 
 Lard, 50 
 
 Resin, 25 
 
 White Wax, 12^ 
 
 Yellow Wax, 3 
 
 Turpentine, 3 
 
 Spermaceti, 3 
 
 Holloway's Pills. 
 
 Have in 144 pills — 
 
 Aloes, 
 
 Rhubarb, . . . . 
 Saffron, . . . . 
 Glauber's Salt, . 
 Pepper, . . . . 
 
 . gr. 62. 
 . gr. 27. 
 
 • gr. 3« 
 
 • gr. 3- 
 
 • gr- 7- 
 {Dorvalt.) 
 
 Hostetter's Bitters. 
 
 Sacchari Albi, 
 Aurantii Corticis, 
 Calami, 
 Cinchonae, 
 
 Gentianse, aa lb j. 
 
 Rhei Pulv., ^iv. 
 
 Cinnamomi, t ^ij. 
 
 Caryophylli, ^j. 
 
 Alcoholis Diluti, . . . . Cij. 
 
 {Med. Bulletin, 1884.) 
 
 The Keeley Gold Cure. 
 
 The hypodermic injection, administered 
 4 times daily for 3 weeks, contains Strych- 
 nine (or Brucine) and Atropine (or Hyos- 
 cine), with Codeine and Cocaine for the 
 opium cases. The whiskey supplied to the 
 victims contains about gr. -^ of Apomor- 
 phine to each average drink. The "cross- 
 shot " is an injection of Apomorphine. The 
 "tonic" contains — 
 
 Ammonium Chloride, . . gr. j. 
 
 Aloin, gr. ij. 
 
 Tinct. Cinchonas Comp., . 5iij. 
 
 Water, to make, £iv. 
 
 {N. Y. Med. Record.) 
 
 Laville's Gout Mixture. 
 
 Calcium Chloride, Chinoi- 
 
 din, of each, . . grm. 5. 
 
 Extract of Colocynth, .grm. 2.5. 
 
 Water, grm. 85. 
 
 Alcohol, grm. 100. 
 
 Spanish Wine, .... grm. 800. 
 Made into a solution. A pill of very 
 complicated composition is used in connec- 
 tion with the gout remedy. {Hager. ) 
 [See also page 285, ante.~\ 
 
PATENT MEDICINES. 
 
 901 
 
 Morrison's Pills. 
 
 Powdered Colocynth, . . . gr. 3. 
 
 Powdered Gamboge, . . . gr. 6. 
 
 Powdered Aloes, . . . . gr. 9. 
 
 Cream of Tartar, . . . . gr. 12. 
 Also syrup enough for 12 pills. Serious 
 results are often produced by large doses of 
 these pills. 
 
 Orange Blossom. 
 Zinc Sulphate, gr. 
 
 60. 
 
 Alum, gr. 15. 
 
 Expr. Oil of Almond, . . gr. 90. 
 
 Extract of Hyoscyamus, . gr. I. 
 
 White Wax, gr. 30. 
 
 Oil of Theobroma, . . . . gr. 180. 
 Made into oblong suppositories, one inch 
 long, one and a half wide and half an inch 
 thick, weighing 32 grains each. 
 
 Perry Davis's Pain Killer. 
 
 Tinct. Capsici, ;f j. 
 
 Spt. Camphorae, ^ij. 
 
 Guaiaci Resinae, 3 ss. 
 
 Alcoholis, % 11 )- 
 
 Tinct. Myrrhse, q. s. ut coloretur. 
 
 Pierce's Favorite Prescription. 
 
 Sabinse, Cinchonae, 
 
 Agarici Albi, .... aa ^ij. 
 
 Cinnamomi, gr. xv. 
 
 Coq. in aq. suff. etft. decoct. ^ viij. 
 Deinde cola, et adde — 
 
 Sacchari Albi, ^ ss. 
 
 Acaciae, ^j. 
 
 Solve, et addantur — 
 
 Tinct. Opii Deodorat., 
 
 Tinct. Digitalis, . . . . aa £ss. 
 
 01. Anisi, gtt. viij, in Alco- 
 holis, . ,:§jss. 
 
 Misce. {Hager. ) 
 
 Pierce's Golden Discovery. 
 
 Ext. Lactuci, ^j. 
 
 Mellis, gj. 
 
 Tinct. Opii Deodorat., . . ^ss. 
 Alcoholis Diluti, 
 
 Aquae, aa ^iij. 
 
 {Hager. 
 
 Radam's " Microbe-Killer." 
 
 Oil of Vitriol (impure), . . dr. 4. 
 Muriatic Acid (impure), .dr. 1. 
 
 Red Wine, oz. 1. 
 
 Water, gall. I. 
 
 {Eckels. 
 
 Radway's Ready Relief. 
 
 Tinct. Capsici, 
 Aquae Ammoniae, 
 
 Alcoholis, aa !f j. 
 
 Linimenti Saponis, . . . . ^ iij. 
 
 {Hager.) 
 
 Radway's Resolvent. 
 Vini Zingiberis, 
 Vini Cardamomi, . . . aa ^iij. 
 
 Sacchari Albi, q. s. 
 
 {Hager.) 
 
 Recamier Balm. 
 
 Zinc Oxide, lbs. 5. 
 
 Glycerin, dr. 2. 
 
 Alcohol, oz. 2. 
 
 Mercuric Chloride, . . . . oz. 4. 
 
 Distilled Water, qts. 64. 
 
 {Boston Herald.) 
 
 Recamier Cream. 
 
 
 Rice Flour, . . 
 
 
 . oz. 
 
 48. 
 
 Zinc Oxide, 
 
 . . . 
 
 . oz. 
 
 60. 
 
 Glycerin, . . 
 
 . . . 
 
 . oz. 
 
 640. 
 
 Cacao Butter, . 
 
 . . . 
 
 . oz. 
 
 48. 
 
 Lard, .... 
 
 
 . oz. 
 
 48. 
 
 Mercuric Chloride 
 
 
 . oz. 
 
 4. 
 
 ake 32 pints. 
 
 {Boston Herald. 
 
 Revalenta Arabica Food. 
 
 Consists solely of Lentils ground up into 
 a fine powder. {Stokes in "Hygiene.") 
 
 Sage's Catarrh Remedy. 
 
 Salis Culinaris(Sodii Chlor. ), partes xx. 
 Pulv. Camphorae, .... part. j. 
 
 Acidi Carbolici, part. j. 
 
 M. — To be dissolved in water and either 
 injected or sniffed up the nose. 
 
 Pulv. Hydrastis Canadensis, partes v. 
 
 Pulv. Indigo, part. ss. 
 
 Pulv. Camphorae, 
 
 Acidi Carbolici, . . . . aa partes ij. 
 
 Sodii Chloridi, partes 1. 
 
 {New Remedies.) 
 
 Sanford's Catarrh Cure. 
 According to an analysis made by Prof. 
 A. B. Lyons for the New Idea, this prepa- 
 ration is composed of distilled extract of 
 Witch-hazel, containing a little Alcohol and 
 Glycerin and some Morphine. The pro- 
 portions of the constituents were not de- 
 termined. {Nat. Druggist.) 
 
 Seigel's (Mother) Syrup. 
 Contains Aloes, gr. 30 to the oz. Also 
 Borax, Capsicum, Liquorice, and Treacle. 
 {Stokes in "Hygiene.") 
 
902 
 
 PATENT MEDICINES. 
 
 Sequah's Oil. 
 A mixture of % Turpentine and y$ Fish 
 Oil, scented with a few drops of Oil of 
 Camphor. {Stokes in "Hygiene.") 
 
 Sequah's Prairie Flower. 
 
 Has to the ounce — 
 
 Aloes, gr. 52^. 
 
 Carbonate of Soda, . . . gr. 17^. 
 
 Water, gr. 362^. 
 
 and a few drops of the Tinctures of Capsi- 
 cum and Myrrh. [Stokes in "Hygiene.") 
 
 St. Jacob's Oil. 
 
 Gum Camphor, 
 
 Chloral Hydrate, > 
 
 Chloroform, 
 
 Sulphuric Ether, . of each, oz. I. 
 
 Tinct. of Opium, 
 
 Oil of Origanum, 
 
 Oil of Sassafras, . of each, oz. %. 
 
 Alcohol, gal. y z . 
 
 Dissolve the Gum Camphor in the Oils 
 
 and Alcohol, then add the other ingredients. 
 
 Squibb says that it is a weak Aconite 
 
 Liniment, also containing Ether, Alcohol, 
 
 Turpentines, red coloring matter,and water. 
 
 [Ephe?neris, p. 1 14. ) 
 
 Swift's Specific, "S.S.S." 
 Fluid Extr. of Smilax Sarsaparilla, 16 parts. 
 Fluid Extr. of Stillingia Sylvatica, 1 6 parts. 
 Fluid Extr. of Lappa Minor, . .16 parts. 
 Fluid Extr. of Phytolacca, . , . 16 parts. 
 Tinct. of Xanthoxylum, .... 8 parts. 
 [Registered Pharmacist. ) 
 Stearns' New Idea gives the following : 
 Stillingia, Pokeroot, and Sarsaparilla, with 
 Nitrate of Potash and a small quantity of 
 Iron, and enough Alcohol to preserve it. 
 
 Tamar Indien. 
 
 According to the Report de Pharmacie, 
 the formula for this preparation is as fol- 
 lows : — 
 
 Tamarind (pulp), 450; powd. Sugar, 
 40 ; powd. Sugar-of-milk, 60 ; pure Gly- 
 cerin, 50 (all parts). Mix and evaporate 
 to the consistence of a soft extract, then 
 add powd. Anise, 10 ; Ess. Lemon, 3 ; Tar- 
 taric Acid," 3 (all parts). Mix and divide 
 into 100 boluses. Roll in the following 
 mixture : Cream of Tartar, 5 ; White Sugar, 
 35 ; Sugar-of-milk, 35 ; Tragacanth, 2 ; 
 Tartaric Acid, 2 ; powd. Red Sandal, 25 
 (all parts). Dry and put up in tin foil. 
 
 [American Druggist. ) 
 
 Thompson's Eye- Water. 
 Copper Sulphate, . . . . gr. 10. 
 
 Zinc Sulphate, gr. 40. 
 
 Rose-water, .... . nints 2. 
 
 Tincture of Saffron, . 
 Tincture of Camphor, 
 Mix and filter. 
 
 - drm. 4. 
 . drm. 4. 
 
 Van Buskirk's Sozodont. 
 
 Saponis Albi, £ss. 
 
 Alcoholis, gj. 
 
 Aquae, _ ^vj. 
 
 Glycerini, 3 ij. 
 
 Olei Gaultheriae, 
 Olei Caryophylli, 
 Olei Menthae Piperitae, 
 
 aaq. s. ad saporem grat. 
 Cocci Cacti, q. s. ut coloretur. 
 
 Calcis Praecipitat., 
 Magnesii Carbonatis, 
 Iridis Florent. Radicis, . aa p. aeq. 
 M. et triturat. [Hoffmann.) 
 
 Vita Nuova. 
 Cocaine, gr. 8. 
 
 Pepsin (golden scale), . . gr. 48. 
 
 Port Wine, gall. 1. 
 
 [Boston Herald.) 
 
 Walker's Vegetable Vinegar Bitters. 
 
 Aloes Socotrin, ^ij. 
 
 Guaiaci Resinae, 3 iv. 
 
 Sassafras Mucil., . . . - %]• 
 
 Aceti, gij. 
 
 Aquae, q. s. 
 
 Coque, et ft. decoctum, ad ^ xix, 
 deinde cola, et addantur — 
 
 Sodii Sulphatis, 3jj. 
 
 Acaciae, 3 ij. 
 
 Spt. Anisi, 10 p. c, . . . 3 i j . 
 
 Alcoholis, %). 
 
 M. Dose, 3 ij. [Eberbach.) 
 
 Warner's Safe Kidney and Liver Cure. 
 
 In Germany each maker of patent medi- 
 cines must furnish the government with 
 the formula for the patent he makes. This 
 is the one furnished by Warner for "Safe 
 Kidney and Liver Cure." Each bottle 
 contains : — 
 
 Extr. Lycopus Virginiana, 
 
 Extr. Hepatica (herb), 
 
 Extr. Gaultheria, . . 
 
 Potassium Nitrate, . . 
 
 Alcohol (90%), . . . 
 
 Glycerin, 
 
 Water sufficient to make one pint. 
 [Formulary and Druggists' Magazine.) 
 
 h 
 
 • gr- 
 
 308. 
 
 
 gr- 
 
 322. 
 
 
 g r - 
 
 7/ 2 - 
 
 
 gr. 
 
 39- 
 
 
 oz. 
 
 2>/ 2 . 
 
 
 dr. 
 
 10. 
 
DIFFERENTIAL DIAGNOSIS. 
 
 903 
 
 TABLES OF DIFFERENTIAL DIAGNOSIS. 
 
 Forms of Bright's Disease. 
 
 Compared with Acute Nephritis and with each other. 
 
 Note. — The signs 4- and — in the line entitled Sp. Gr., respectively denote a specific gravity 
 
 nr 1p«;<; than t mS. 
 
 greater than 1.024, or less than 1.018. 
 
9°4 
 
 DIFFERENTIAL DIAGNOSIS. 
 
 Cancer. 
 
 Cancerous [Malignant) Tumors. 
 
 Are of constitutional origin. 
 
 Have no cyst, but invade and convert the 
 
 surrounding tissues. 
 Cancer material is short-lived from rapid 
 
 deterioration, but is rapidly reproduced. 
 Severe increasing pain. 
 Extend to remote parts, reappearing chiefly 
 
 in lymphatic glands. 
 Cancerous cachexia of general health. 
 Recur after extirpation, fatal in end. 
 
 Non-malignant Tumors. 
 
 Origin, some local error of growth. 
 Limited by a cyst ; may compress, but do 
 
 not invade adjacent tissues. 
 Have uncertain period of increase, after 
 
 which may remain stationary. 
 Usually no pain. 
 Are local, have no disposition to spread. 
 
 Impair functions of part pressed on. 
 Do not recur. 
 
 Scirrhus. 
 
 Is hard. 
 
 Appears mostly on female breast. 
 
 Hard kernel, movable under skin. 
 
 Becomes fixed to adjoining structures, 
 
 which it puckers. 
 Single and grows slowly. 
 Course slow — 2 to 4 years. 
 Never in the young. 
 
 Encephaloma. 
 
 Is soft and brain-like. 
 
 Most frequently on the limbs. 
 
 At first deeply seated, hard to recognize. 
 
 Spreads through loose textures, which it 
 
 pushes aside and distends. 
 Has numerous tumors, grows rapidly. 
 Generally fatal in I to 2 years. 
 Often in the young, even at birth. 
 
 Carditis, Endo- and Peri-. 
 
 Endocarditis. Pericarditis. 
 
 Blowing sound. Excited heart action. 
 Slight if any increase of percussion dullness. 
 Impulse strong. 
 
 Sounds normal or more distinct except at 
 site, where a murmur is heard. 
 
 Friction sound. Excited heart action. 
 Marked increase in effusion stage. 
 Wavy and feeble. 
 Feeble and muffled ; no blowing sounds. 
 
 Cerebral. 
 
 Concussion. 
 
 Patient can be roused ; pupils react. 
 Breathing seldom stertorous. 
 Urinary action normal. 
 Symptoms appear soon after accident. 
 
 Compression. 
 
 Complete insensibility ; motionless pupils. 
 Breathing usually stertorous. 
 May be either retention or incontinence. 
 Frequently do not. 
 
 Chancre and Chancroid. 
 
 Chancre. 
 Commences about 3d week after coitus. 
 First as a papule, abrasion, or crack. 
 
 Generally indurated (rarely not). 
 
 Develops slowly. 
 
 Discharge slight, unless irritated. 
 
 Is soon limited and seldom phagedenic. 
 
 Edges sloping, not undermined. 
 
 Scanty serous secretion. 
 
 Sore remains solitary, and cannot be multi- 
 plied. 
 
 Followed by numerous buboes, rarely sup- 
 purating, never furnish inoculable pus. 
 
 Chancroid. 
 
 In 24 hours to 3 days. 
 
 First as a red spot, then a pustule, then a 
 suppurating sore. 
 
 Not on an indurated base. 
 
 Develops rapidly. 
 
 Suppurates profusely. 
 
 Tends to invade surrounding tissues, or be- 
 come phagedenic. 
 
 Edges undermined. 
 
 Discharge is purulent and copious. 
 
 May be transplanted at will, and is seldom 
 single. 
 
 A single bubo may appear and .suppurate. 
 
DIFFERENTIAL DIAGNOSIS. 
 
 905 
 
 Cholera. 
 
 Asiatic. 
 Preceded by painless diarrhea. 
 Not directly from error in diet. 
 First pain shooting down thighs. 
 Prostration rapid and overwhelming, and 
 
 out of ratio to evacuations. 
 Rapid reduction of surface temperature ; 
 
 high temperature in cavities. 
 Evacuations like rice-water from the first. 
 
 Cramps commence in extremities. 
 Veins congested ; tongue, lips and extremi- 
 ties livid purple. 
 Urine albuminous. 
 
 Simple. 
 Seizure sudden. 
 Generally is from error in diet. 
 First pain is abdominal (colic). 
 Prostration gradual, less marked than the 
 
 vomiting and purging. 
 Gradual reduction of surface temperature ; 
 
 internal temperature normal. 
 Discharges bilious, causing burning and 
 
 smarting pain ; colorless only at very last. 
 Cramps commence in abdomen. 
 Not so. 
 
 Not so. 
 
 Croup and Diphtheria. 
 
 Croup. 
 
 Premonitory hoarse, metallic cough, with- 
 out illness. 
 
 A child's disease. 
 
 Tenacious mucus covering the swollen 
 membcane. 
 
 A local disease. 
 
 Diphtheria. 
 
 Premonitory illness, marked by chills, fever 
 and sore throat, without cough. 
 
 Attacks adults as well. 
 
 Distinguished by a false membrane, and 
 the Klebs-Loejffler bacillus. 
 
 A blood poison ; great general depression. 
 
 Epilepsy and Hysteria. 
 
 Epilepsy. 
 
 Loss of consciousness is sudden, complete. 
 
 Livid face, frothy saliva escapes, eyelids 
 half open, eyeballs rolling, teeth grind- 
 ing, tongue biting ; more or less insensi- 
 bility of pupils to light. 
 
 Countenance is distorted. 
 
 Patient shows no feeling. 
 
 Aura epileptica may precede attack. 
 
 Short paroxysm, followed by heavy coma- 
 tose sleep and dull intellect. 
 
 Frequently occurs at night. 
 
 Not necessarily of uterine connection, 
 though a paroxysm often occurs at the 
 menstrual period. 
 
 Hysteria. 
 
 Gradual and partial or apparent. 
 
 Face flushed, or complexion unaltered, no 
 froth on lips, eyelids closed, eyeballs 
 fixed, no grinding of teeth, or biting of 
 tongue ; pupils react readily. 
 
 Is not. 
 
 Sighs, or laughs, or sobs. 
 
 Globus hystericus. 
 
 Longer paroxysm ; patient not sleepy, usu- 
 ally wakeful and depressed in spirits. 
 
 Rarely occurs at night. 
 
 Often connected with uterine or menstrual 
 disorders. 
 
 Gout and Rheumatism. 
 
 Gout. 
 
 Affects chiefly the small joints, especially 
 
 the metatarsal joint of the great toe. 
 Occurs from 35-50 years of age ; rarely 
 
 before puberty. 
 Most frequent in men, and often the result 
 
 of idle, intemperate and luxurious life. 
 Is strongly hereditary. 
 Chalk-stones (sodium urate) in external 
 
 ear, on tips of fingers, or elsewhere. 
 Uric Acid in the blood, absent from urine. 
 A fit often affords temporary relief. 
 Bronchitis common. 
 Is confined to the temperate zone. 
 
 Rheumatis77i. 
 Large joints chiefly implicated. 
 
 Occurs generally in young adults. 
 
 Affects both sexes equally, and equally the 
 
 poor and the rich. 
 But slightly so. 
 Not so. 
 
 Lactic Acid in the blood. 
 
 Quite the contrary. 
 
 Not so. 
 
 Is ubiquitous — prevails in all climates. 
 
go6 
 
 DIFFERENTIAL DIAGNOSIS. 
 
 Pleurisy and 
 
 Pleurisy. 
 
 Sharp pain, friction sound, dry cough, im- 
 paired chest motion. 
 
 In stage of effusion, obliteration of inter- 
 costal spaces, enlargement of the side, 
 viscera displaced. 
 
 Dullness, with enfeebled or absent respira- 
 tion, voice, and fremitus. 
 
 Sputa frothy, rarely any rales. 
 Febrile symptoms slight usually. 
 Temperature irregular, rarely high. 
 
 Pneumonia. 
 
 Pneumonia. 
 
 Dull pain, crepitant rale, cough followed 
 
 by expectoration. 
 In stage of hepatization none of these signs 
 
 are present. 
 
 Dullness, with marked bronchial respira- 
 tion, distinct thoracic voice, increased 
 vocal fremitus. 
 
 Sputa rusty color, rales common. 
 
 Febrile symptoms severe. 
 
 Sudden elevations and falls, high tempera- 
 ture not uncommon. 
 
 Scarlet 
 
 Scarlet Fever. 
 Incubation, I day to weeks. 
 
 Fever, great heat of skin, 
 and frequent pulse, un- 
 abated during eruption. 
 
 Brilliant stare. 
 Sore throat, rarely coryza 
 or bronchitis. 
 
 "Raspberry" tongue, red. 
 
 Temperature maybe 105 °- 
 106 to iothday, subsides 
 gradually, falls on 5th, 
 10th, and 15th days. 
 
 No secondary fever. 
 
 Eruption on second day, not 
 rough, first on neck and 
 chest, spreads rapidly, 
 white streak on pressure 
 with nail. 
 
 Eruption uniform, or in 
 large patches, inter- 
 spersed raised spots and 
 some vesicles ; rash scar- 
 let, on its seventh day 
 very complete desquama- 
 tion in large patches. 
 
 Cerebral symptoms are fre- 
 quent and grave. 
 
 Pneumonia rare, pleurisy 
 more frequent. 
 
 Sequelae : Bright' s disease, 
 dropsy, deafness, conjunc- 
 tivitis, phthisis, chronic 
 diarrhea ; glandular en- 
 largements. 
 
 Fever, Measles and 
 
 Measles. 
 Incubation, 7 to 14 days. 
 
 Same fever rather increased 
 by eruption. 
 
 Liquid, watery eye. 
 Coryza and bronchitis very 
 
 constant, sore throat 
 
 rarely. 
 Tongue coated, may be red 
 
 at edges. 
 io3°-io6° before eruption, 
 
 remains high for 1 to 2 
 
 days thereafter, then falls 
 
 suddenly. 
 No secondary fever. 
 
 Eruption on fourth day, on 
 face, rough, spreads grad- 
 ually, the streak lasts 
 only a short time. 
 
 Eruption in crescentic 
 patches, lasts about 5 
 days, then partial des- 
 quamation, scales very 
 fine. 
 
 Not so. 
 
 Pneumonia a frequent com- 
 plication. 
 
 Sequelae : chronic bronchi- 
 tis, phthisis, conjunctivi- 
 tis. 
 
 Smallpox. 
 
 Smallpox. 
 
 Incubation, 6 to 20 days, 
 average, 10. 
 
 Fever often violent, bound- 
 ing pulse, pain in loins ; 
 all are greatly relieved by 
 eruption. 
 
 Eyes injected, face red. 
 
 Sore throat often, also a dry 
 cough. 
 
 Tongue coated,and swollen, 
 may be red at edges. 
 
 Before eruption often 106 , 
 then rapidly sinks to ioo 
 in 36 hours ; rises during 
 the secondary fever. 
 
 Secondary fever always. 
 
 Eruption usually on third 
 day, at first on lips, fore- 
 head and hands, spreads 
 rapidly. 
 
 Eruption is first papular, 
 then vesicular, finally 
 pustular ; pustules matur- 
 ate on 8th day of erup- 
 tion. 
 
 Cerebral symptoms are fre- 
 quently seen. 
 
 Pneumonia not a very fre- 
 quent complication. 
 
 Sequelae : chronic diarrhea, 
 glandular enlargements, 
 various eve diseases. 
 
DIFFERENTIAL DIAGNOSIS. 
 
 907 
 
 Typhus and Typhoid. 
 
 Typhus Fever. 
 Attacks quickly, incubation 9 days. 
 
 Occurs at any age. 
 
 Rare among the higher classes, except 
 
 those exposed. 
 Mulberry Eruption on 4th and 5th day, on 
 
 extremities, lasts until the close. 
 
 Brain chiefly affected ; bowels often but 
 little so ; abdomen natural, evacuations 
 dark, but never bloody (these are occa- 
 sionally reversed). 
 
 Contracted pupils, dusky face. 
 
 Pulse and temperature rise to 120 and 105 
 until 3d day, high for 6 days, then fall. 
 
 Lasts 2 to 3 weeks. 
 Relapses rare. 
 
 Death from coma or congestion of the 
 lungs, in 1st or 2d week. 
 
 Arises from destitution, over- crowding, 
 bad ventilation, is highly contagious and 
 generally epidemic. No microbe deter- 
 mined. 
 
 Post-mortem : changes not constant, the 
 most frequent are dark blood, enlarged 
 spleen, soft heart. 
 
 Typhoid (Enteric) Fever. 
 Commences slowly, incubation about 13 
 
 days. 
 Most common in youth and childhood, 
 
 rare after the age of 40. 
 As common among the rich as the poor. 
 
 Rose Eruption on 7th to 10th day, isolated, 
 flattened papules, few, on abdomen and 
 back, in successive crops which fade 
 and disappear. 
 
 Bowels chiefly affected, evacuations ochre- 
 color and watery, sometimes hemorrhage 
 or even ulceration, abdomen tumid. 
 
 Dilated pupils, cheeks flushed. 
 
 Pulse and temperature rise and fall inde- 
 pendently, and without uniformity, but 
 both are usually high to the 15th day. 
 
 Lasts 4 to 6 or more weeks. 
 
 Relapses frequent. 
 
 Death from asthenia, pneumonia, hemor- 
 rhage or perforation of intestine, in or 
 after 3d week. 
 
 From poisoned drinking water, putrid ani- 
 mal matter, bad drainage ; is not conta- 
 gious, often sporadic. E berth's bacillus 
 present in the intestinal lesions, the 
 spleen, liver, blood, etc. 
 
 Post-mortem : morbid Peyer' s patches, en- 
 larged mesenteric glands, ulcerated mu- 
 cous coat of intestines ; enlarged and 
 soft spleen, ulcerated pharynx. 
 
 Vomiting. 
 
 Cerebral. 
 Little or no nausea, vomiting continues 
 
 after stomach is emptied. 
 No tenderness on pressure over the liver or 
 
 stomach. 
 Pulse infrequent and hard. 
 Tongue clean, breath sweet, conjunctivae 
 
 normal or injected, headache primary. 
 
 Constipation generally obstinate. 
 No salivation. 
 
 Gastric or Hepatic. 
 
 Nausea relieved by vomiting, returns when 
 food is taken. 
 
 Liver and stomach are tender, pressure pro- 
 duces inclination to vomit. 
 
 Pulse frequent and weak. 
 
 Tongue furred, breath offensive, conjunc- 
 tivae often yellowish, headache secon- 
 dary as to time. 
 
 Griping abdominal pain, diarrhea and 
 clay-colored stools. 
 
 Increased salivation. 
 
 Yellow and Bilious Remittent Fevers. 
 
 Bilious Re?nittent. 
 Lasts 9 days or more. 
 Incubation may extend to months. 
 A disease of several paroxysms, with inter- 
 vening remissions. 
 
 Yellow Fever. 
 Duration short, ends in 3 to 7 days. 
 Incubation 5 to 9 days. 
 A disease of one paroxysm, terminating in 
 recovery or collapse. 
 
908 
 
 SPECIFIC GRAVITIES AND VOLUMES. 
 
 Yellow Fever. 
 Very severe nausea and vomiting, early 
 
 epigastric tenderness. 
 Black vomit, due to gastric hemorrhage. 
 Hemorrhages from various parts. 
 Tongue clean, or slightly coated. 
 Pulse variable, slow at end. 
 Eye injected and humid. 
 Supra-orbital pain, pain in back and in 
 
 calves of legs. 
 Rarely delirious, mind clear generally. 
 Urine albuminous, usually suppressed. 
 Convalescence rapid, no sequelae. 
 Muscular prostration slight. 
 Mortality high, disease epidemic. 
 Treatment unsatisfactory. 
 Autopsy : inflamed or congested stomach, 
 
 enlarged yellow liver, filled with oil 
 
 globules, muscular fibres of heart are 
 
 often disintegrated. 
 
 Bilious Remittent. 
 
 These symptoms are not so severe, nor do 
 they occur so early. 
 
 Bilious vomiting. 
 
 No hemorrhagic tendency. 
 
 Tongue heavily coated. 
 
 Pulse quick until convalescence. 
 
 Eye natural. 
 
 Headache, sense of fullness in head, often 
 no loin or leg pains. 
 
 Delirium frequent, mind dull. 
 
 Not so. 
 
 Convalescence slow, tedious sequelae. 
 
 Muscular prostration greater. 
 
 Mortality slight, disease endemic. 
 
 Very amenable to treatment. 
 
 Autopsy : stomach congested, rarely in- 
 flamed, liver olive or bronze hue, not 
 fatty. 
 
 TABLE OF SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. 
 
 (Temperature at 59 F., except when otherwise stated. Where the sp. gr. is variable, 
 the mean specific gravity is stated.) 
 
 Liquid. 
 
 Acid, Acetic, 
 
 Acid, Acetic, Dil., . . . 
 
 Acid, Hydrobromic (34 
 
 percent.), ...... 
 
 Ac. Hydrobrom. Dil., . . 
 Ac. Hydrochloric, . . . 
 Ac. Hydrochlor. Dil., . . 
 
 Acid, Lactic, 
 
 Acid, Nitric, 
 
 Acid, Nitric, Dil., . . . . 
 
 Acid, Oleic, 
 
 Acid, Phosphoric, . . . 
 Acid, Phosphoric, Dil., . 
 Acid, Sulphuric, . . . . 
 Ac. Sulphuric, Dil., . . . 
 
 ^Ether, 
 
 Alcohol, at 6o° F., ... 
 Alcohol, at 77° F., ... 
 Alcohol, Dil., at 6o° F., . 
 Alcohol, Dil., at 77 F., . 
 Aqua Destil., at 59 F., . 
 
 Aq. Ammoniae, 
 
 Aq. Ammon. Fort., . . . 
 
 Benzin, 
 
 Carbon Disulphide, . . 
 
 Chloroform, 
 
 Chloroformum Venale, . 
 
 Glycerin 
 
 Liq. Ferri Acet., . . . . 
 Liq. Ferri Chlor., . . . . 
 
 Specific 
 
 Specific 
 
 Gravity. 
 
 Volume. 
 
 1.048 
 
 •954 
 
 1.008 
 
 .992 
 
 1-303 
 
 .767 
 
 1.077 
 
 .928 
 
 1-163 
 
 .860 
 
 1-059 
 
 •952 
 
 1.213 
 
 .824 
 
 1. 414 
 
 •709 
 
 1-057 
 
 .946 
 
 .900 
 
 1. in 
 
 1. 710 
 
 .584 
 
 1-057 
 
 .946 
 
 1-835 
 
 •545 
 
 1.070 
 
 •934 
 
 •725 
 
 1-379 
 
 .820 
 
 1. 219 
 
 .812 
 
 1-231 
 
 •937 
 
 1.066 
 
 •930 
 
 1 -075 
 
 1. 000 
 
 1. 000 
 
 .960 
 
 1.042 
 
 .901 
 
 1. 109 
 
 .670 
 
 1-493 
 
 1.268 
 
 .788 
 
 1.490 
 
 .671 
 
 1.470 
 
 .680 
 
 1.250 
 
 .800 
 
 1. 160 
 
 .862 
 
 r-387 
 
 .721 
 
 Liquid. 
 
 Liq. Ferri Tersulph., 
 Liq. Potassae, . . 
 Liq. Sodae, . . . 
 Mel (Honey), . 
 Oleum Adipis, . 
 Ol. Amyg. Expres 
 Ol. Aurant. Cort., 
 Ol. Bergamottae, 
 Ol. Caryophylli, 
 Ol. Copaibae, . . 
 Ol. Cubebae, . . 
 Ol. Eucalypti, . 
 Ol. Gaultheriae, . , 
 Ol. Gossyp. Sem., 
 Ol. Lavandulae, . 
 Ol. Limonis, . . 
 Ol. Lini, .... 
 Ol. Menthae Pip., 
 Ol. Morrhuae, . . 
 Ol. Olivae, . . . 
 Ol. Ricini, . . . 
 Ol. Rosmarini, . 
 Ol. Sassafras, . . 
 Ol. Sesami, ... 
 Ol. Terebinthinae, 
 Spt. yEtheris Nitros 
 Spt. Frumenti, . . 
 Spt. Vini Gallici, . 
 
 Syrupus, 
 
 Vinum Album, . . 
 
 Specific 
 Gravity. 
 
 1.320 
 
 1.036 
 
 1-059 
 
 1-375 
 
 •9i5 
 
 .917 
 
 .850 
 
 .883 
 
 1.065 
 
 .900 
 
 .920 
 
 .920 
 
 1. 180 
 
 •925 
 
 •936 
 .910 
 
 •923 
 
 .916 
 
 .960 
 
 •905 
 
 1.080 
 
 .921 
 
 .862 
 
 •839 
 
 .920 
 
 •933 
 
 I-3I7 
 
 1. 000 
 
 Specific 
 Volume. 
 
 838 
 081 
 128 
 165 
 068 
 oq8 
 083 
 092 
 042 
 104 
 
 925 
 
 194 
 
 160 
 191 
 086 
 071 
 759 
 000 
 
CHLORODYNE. 
 
 9O9 
 
 CHLORODYNE. 
 
 A Comparison of Ten Formula therefor, the Quantities being calculated 
 for each to a Four- Ounce Mixture, or n^ 1920. 
 
 
 
 Quantity of each article in a 3iv mixture, as per the formula of 
 
 Articles. 
 
 * 
 
 a,' 
 
 V 
 
 u 
 
 '5 
 a 1 
 
 i 
 
 -0 
 W 
 
 £ 
 
 u 
 
 JU 
 
 c 
 U 
 
 d 
 Q 
 c/i 
 D 
 
 d 
 5 
 
 ■* 
 6 
 O 
 
 Q 
 
 Ph' 
 
 
 i 
 
 
 
 
 Cu, 
 
 pq 
 
 «\5 
 
 6 
 
 p 
 M 
 .22 
 
 "3 
 u 
 
 Morphine Hydro- 
 chlorate, . . . 
 
 Chloroform, . . . 
 
 Ether, 
 
 Cannabis Indica, 
 Tincture, . . . 
 
 Cannabis Indica, 
 Extract, . . . 
 
 Hydrocyanic Acid, 
 2 p. c, . . 
 
 01. Mentha Piper- 
 ita, .... 
 
 Capsicum, Fluid 
 Extract, . . . 
 
 Capsicum, Tinc- 
 ture, 
 
 Capsicum, Oleo- 
 resin, .... 
 
 Alcohol, .... 
 
 Hydrochloric 
 Acid, .... 
 
 Sugar, Burnt, . . 
 
 Glycyrrhiza, Ex- 
 tract, 
 
 Acacia, Mixture, . 
 
 Tragacanth, Mucil- 
 age, . . 
 
 Theriaca, or Syr. 
 Fusci, .... 
 
 Syrup, 
 
 Glycerin, .... 
 
 Water, 
 
 "I 
 "I 
 
 "I 
 
 gr- 
 
 *l 
 
 "I 
 
 *l 
 
 "I 
 
 "I 
 
 *l 
 
 "I 
 gr- 
 
 gr- 
 "I 
 
 "I 
 
 "I 
 *l 
 *l 
 "I 
 
 I 
 236 
 
 59 
 
 118 
 2 
 
 236 
 
 147 
 
 236 
 1033 
 
 16 
 192 
 
 96 
 192 
 
 6 
 290 
 
 384 
 
 760 
 
 760 
 
 16 
 240 
 
 32 
 
 16 
 4 
 
 810 
 818 
 
 32 
 372 
 
 248 
 
 50 
 IO 
 
 4 
 904 
 
 126 
 
 i26 
 
 33^ 
 375 
 
 250 
 
 5o 
 8 
 
 37 
 
 1010 
 62 
 
 128 
 
 14 
 207 
 
 207 
 
 42 
 7 
 
 7 
 690 
 
 760 
 
 16 
 24O 
 
 I20 
 
 20 
 90 
 
 7 
 120 
 
 30 
 20 
 
 903 
 150 
 
 240 
 
 247 
 62 
 
 123 
 
 2 
 
 247 
 
 154 
 
 247 
 992 
 
 4 
 
 240 
 
 60 
 
 120 
 2 
 
 240 
 24O 
 
 24O 
 
 q. s. 
 
 24 
 240 
 
 24 
 48 
 
 1632 
 
 Morphine Hydro- 
 chlor. in tt\xv, . 
 
 gr- 
 
 1 
 
 128 
 
 % 
 
 % 
 
 X 
 
 X 
 
 A 
 
 % 
 
 1 
 T28 
 
 1 
 
 32 
 
 1 
 
 Note.— See ante, page 261, for remarks on this preparation, and the number of formulas repre- 
 senting it. 
 ♦Author of " A Companion to the Br. Pharmacopoeia." 
 fSee Hartshorne's " Essentials," 5th ed., p. ** Parke, Davis & Co., Detroit. 
 
 625. frTinct. Chloroformi et Morphinae, B. P. 
 
 tMade by Eli Lilly & Co., Indianapolis. g As given by Stokes and Blyth in " Hygiene." 
 
 f 2d ed., page 430. 
 
9io 
 
 DROPS IN A FLUIDRACHM. 
 
 TABLE SHOWING THE 
 NUMBER OF DROPS IN A FLUIDRACHM 
 
 OF VARIOUS LIQUIDS, ALSO THE WEIGHT OF ONE FLUIDRACHM IN GRAINS. 
 
 (Compare page 535.) 
 
 Liquid. 
 
 Acetum Opii, . . 
 Acetum Scillae, . 
 Acid, Acetic, . . 
 Ac. Acetic, Dil., . 
 Acid, Carbolic, . 
 Ac. Hydrochloric, 
 Ac. Hydrocyanic, 
 Acid, Lactic, . . 
 Acid, Nitric, . . 
 Ac. Nitro-hydrochloric 
 Ac. Phosphoric Dil., 
 Ac. Sulphuric, . . 
 Ac. Sulph. Aromat., 
 Ac. Sulph. Dil., . . 
 Ac. Sulphurosum, . 
 
 ^Ether, 
 
 Alcohol, 
 
 Aqua, 
 
 Aqua Destillata, . . 
 Balsam of Peru, . . 
 
 Bromine, 
 
 Chloroform, .... 
 
 Copaiba, 
 
 Creosote, 
 
 Ext. Belladon. Fl., 
 Ext. Buchu FL, 
 Ext. Digitalis Fl., . 
 Ext. Ergotae FL, . 
 Ext. Ipecac. FL, . . 
 Ext. Rhei FL, . . . 
 Ext. Senegae FL, . 
 Ext. Valerianae Fl., 
 Ext. Zingib. FL, . . 
 
 Glycerin 
 
 Hydrargyrum, . . 
 Liq. Acidi Arsenosi, 
 Liq. Ferri Chloridi, 
 
 Drops 
 in f5j. 
 ("llx.) 
 
 90 
 68 
 
 108 
 68 
 
 in 
 70 
 60 
 
 111 
 
 102 
 76 
 
 59 
 128 
 146 
 
 60 
 
 59 
 
 176 
 146 
 60 
 60 
 101 
 250 
 250 
 no 
 
 122 
 
 156 
 ISO 
 134 
 133 
 I20 
 158 
 137 
 150 
 142 
 67 
 I50 
 
 57 
 
 Weight 
 of f5j in 
 grains. 
 
 61 
 57 
 58 
 55 
 59 
 65 
 54 
 66 
 
 57 
 101 
 53 
 58^ 
 55 
 39 
 44 
 
 55 i/ 
 53^ 
 60 
 
 165 
 80 
 
 5i 
 56^ 
 
 57 i/ 
 47^ 
 62 
 60 
 60 
 61 
 62 
 49 
 48 
 68 
 760 
 
 55 
 72 
 
 Liquid. 
 
 Liq. Iodi Compos., . 
 Liq. Potassae, . . . 
 Liq. Zinci Chloridi, 
 Oleores. Aspidii, . . 
 Oleores. Capsici, . . 
 Oleores. Cubebae, . 
 Oleum Anisi, . . . 
 Oleum Bergamottae, 
 Oleum Cari, .... 
 Oleum Juniperi, . . 
 Oleum Limonis, . . 
 Oleum Ricini, . . . 
 Oleum Rosas, . . . 
 Oleum Terebinthinae 
 Oleum Tiglii, . . . 
 Spt. ^EtherisComp., 
 Spt. yEtheris Nitrosi 
 Spt. Camphorae, . . 
 
 Syrupus, .* 
 
 Syrupus Acaciae, 
 Syrupus Ferri Iodidi 
 Syrupus Scillae, . . 
 Syr. Scillae Comp., . 
 Syrupus Senegae, . 
 Tinctura Aconiti, . 
 Tinct. Belladonnas, 
 Tinct.Benzoini Comp 
 Tinct. Cantharidis, 
 Tinct. Digitalis, - . 
 Tinct. Ferri Chlor., 
 Tinct. Iodi, .... 
 Tinct. Opii, .... 
 Tinct. Opii Camph., 
 Tinct. Opii Deodor. 
 Vin. Colchici Rad., 
 Vin. Colchici Sem., 
 VinumOpii, .... 
 
 Drops 
 in f5j. 
 
 onix.) 
 
 63 
 
 62 
 
 89 
 
 130 
 
 120 
 
 123 
 119 
 130 
 132 
 
 148 
 129 
 77 
 132 
 136 
 104 
 148 
 146 
 143 
 65 
 44 
 65 
 75 
 102 
 106 
 146 
 137 
 148 
 
 131 
 
 128 
 150 
 148 
 130 
 130 
 no 
 107 
 in 
 100 
 
 Weight 
 of f5j in 
 grains. 
 
 59 
 
 58 
 88 
 52 
 5i 
 52 
 54 
 46 
 50 
 49 
 
 47 i/ 
 45^ 
 
 50 
 45 
 47 
 47 
 72 
 73 
 77 
 74 
 70 
 70 
 46 
 58 
 48 
 5i 
 53 
 53 
 47 
 53 
 52 
 54 
 55 
 54 
 55 
 
 WEIGHTS AND MEASURES. 
 
 APOTHECARIES' or troy weight. 
 
 Pound. Ounces. Drachms. Scruples. Grains. 
 
 ft S 5 9 gr. 
 
 I = 12 = 96 = 288 = 5760 
 
 i = 8 = 24 = 480 
 
 1 = 3 = 60 
 
 1 = 20 
 
 METRIC WEIGHTS. 
 
 i Milligramme, . . . o.ooi = gr. ^ 
 
 1 Centigramme, . . . o.oi = gr. £ 
 
 1 Decigramme, ... 0.1= gr. i£ 
 
 1 Gramme, 1. = gr. 15.432 
 
 1 Kilogramme, . . . 1000. = 
 
 f ft 2.7 Troy. 
 ( ft 2.2 Av. 
 
 APOTHECARIES' OR WINE MEASURE. 
 
 Gallon. Pints. FV ounces. FV dr'ms. Minims. 
 C. O. fS f5 m 
 
 1 = 8 = 128 = 1024 = 61440 
 
 1 = 16 = 128 = 7680 
 
 1 = 8 = 480 
 
 1 = 60 
 
 APPROXIMATE EQUIVALENTS. 
 
 TTIjorgr.j, . . 
 f 5j or 5j , ... 
 fSj, ...... 
 
 o) 
 
 fsj of Glycerin, 
 fSj of Syrups, 
 
 = .0 
 
 6 gramme. 
 
 = 4- 
 
 grammes 
 
 = 30. 
 
 " 
 
 = 3i- 
 
 
 = 37- 
 = 40. 
 
 it 
 
METRIC CONVERSIONS. 
 
 9 II 
 
 TABLE FOR CONVERTING 
 APOTHECARIES' WEIGHTS AND MEASURES INTO METRIC. 
 
 (Adapted from Maisch.) 
 
 [Multiply all grains, or fractions of a grain, by 6479 ( or 648) for the metric equivalent 
 
 in milligrammes. — Potter.] 
 
 Troy Weight. 
 
 Metric. 
 
 Apothecaries' 
 Measure. 
 
 Fluid Grammes or Cubic Centimeters. 
 
 
 
 Liquids 
 
 Liquids of 
 
 Specific 
 Gravity of 
 
 Water.f 
 
 Liquids 
 
 Grains. 
 
 Grammes. 
 
 
 Lighter than 
 Water.* 
 
 Heavier than 
 Water. J 
 
 
 Milligramme. 
 
 "1 I 
 
 •055 
 
 .06 
 
 .08 
 
 1 
 
 .OOI 
 
 2 
 
 .IO 
 
 .12 
 
 •15 
 
 & 
 
 .0015 
 
 3 
 
 .16 
 
 .18 
 
 .24 
 
 3*0 
 
 .C02 
 
 4 
 
 .22 
 
 .24 
 
 -32 
 
 A 
 
 .OO3 
 
 5 
 
 .28 
 
 •3° 
 
 .40 
 
 1 
 T6 
 
 .OO4 
 
 6 
 
 .32 
 
 •36 
 
 .48 
 
 ¥ 
 
 .OO5 
 
 7 
 
 .38 
 
 .42 
 
 •55 
 
 1 
 
 .006 
 
 8 
 
 •45 
 
 •50 
 
 .65 
 
 1 
 
 8 
 
 .008 
 
 9 
 
 •50 
 
 •55 
 
 •73 
 
 1 
 
 Centigramme 
 .OI 
 .Ol6 
 .02 
 
 10 
 
 •55 
 
 .60 
 
 .80 
 
 6 
 
 1 
 
 12 
 15 
 
 .65 
 .80 
 
 .72 
 .90 
 
 .96 
 1.20 
 
 3 
 1 
 
 
 16 
 
 .90 
 
 1. 00 
 
 1.32 
 
 2 
 3 
 
 •°3 
 •05 
 .065 
 
 Decigramme. 
 
 20 
 
 1. 12 
 
 1-25 
 
 1.60 
 
 I 
 
 25 
 
 1.40 
 
 i-55 
 
 2.00 
 
 
 30 
 
 1.70 
 
 1.90 
 
 2.50 
 
 2 
 
 • l 3 
 
 35 
 
 2.00 
 
 2.20 
 
 2.90 
 
 3 
 
 .20 
 
 40 
 
 2.25 
 
 2.50 
 
 3 3o 
 
 4 
 
 .26 
 
 48 
 
 2.70 
 
 3.00 
 
 4.00 
 
 5 
 
 •3 2 
 
 50 
 
 2.80 
 
 3.12 
 
 4.15 
 
 6 
 
 •39 
 
 6o(f 3 j) 
 
 3-40 
 
 3-75 
 
 5.00 
 
 7 
 
 •45 
 
 65 
 
 3.60 
 
 4.00 
 
 5-3o 
 
 8 
 
 .52 
 
 72 
 
 4.00 
 
 4-5o 
 
 6.00 
 
 9 
 
 •59 
 
 80 
 
 4-5o 
 
 5.00 
 
 6.65 
 
 10 
 
 •65 
 
 9o(f3Jss) 
 
 5.10 
 
 5.60 
 
 7-5o 
 
 
 Gramme. 
 
 96 
 
 5 -4o 
 
 6.00 
 
 8.00 
 
 15 
 
 I. OO 
 
 100 
 
 5.60 
 
 6.25 
 
 8.30 
 
 20 Oj) 
 
 I.30 
 
 I20(f3ij) 
 
 6-75 
 
 7.50 
 
 10.00 
 
 24 
 
 I.50 
 
 i5o(f3ijss) 
 
 8.50 
 
 9-5o 
 
 12.50 
 
 26 
 
 1.62 
 
 160 
 
 9.00 
 
 10.00 
 
 13-30 
 
 30 ( 3 ss) 
 
 i-95 
 
 i8o(f 3 iij) 
 
 10.10 
 
 n.25 
 
 15.00 
 
 40 
 
 2.60 
 
 2io(f3iijss) 
 
 11.80 
 
 13.00 
 
 i7-5o 
 
 5o 
 
 3.20 
 
 2 4 o(f3iv) 
 
 i3-5o 
 
 15.00 
 
 20.00 
 
 6o(3J) 
 
 3-9o 
 
 300 (f 3 v) 
 
 16.90 
 
 18.75 
 
 25.00 
 
 100 
 
 6.48 
 
 330 (f 3 vss) 
 
 18.60 
 
 20.75 
 
 27.50 
 
 I20(3ij) 
 
 7.80 
 
 36o(f3YJ) 
 
 20.25 
 
 22.50 
 
 30.00 
 
 180 
 
 11.65 
 
 42o(fgvij) 
 
 23.60 
 
 26.25 
 
 35-oo 
 
 240 ( I ss) 
 
 i5-5o 
 
 480 (f 2 j) 
 
 27.00 
 
 30.00 
 
 40.00 
 
 300 
 
 19.40 
 
 54o(f3ix) 
 
 30.40 
 
 33-75 
 
 45-00 
 
 360 
 
 23- 50 
 
 600 (f 3 x) 
 
 33-75 
 
 37-5Q 
 
 50.00 
 
 420 
 
 27.20 
 
 72o(f3xij) 
 
 40.50 
 
 45.00 
 
 60.00 
 
 480 (gj) 
 
 31.10 
 
 840 (f ^xiv) 
 
 47.25 
 
 52.50 
 
 70.00 
 
 96o(|ij) 
 
 62.20 
 
 9 6o(fjij) 
 
 54.00 
 
 60.00 
 
 80.00 
 
 1000 
 
 64.79 
 
 1000 
 
 56.00 
 
 62.50 
 
 83.00 
 
 ♦Lighter than water are tinctures, spirits, compound spirit of ether, sweet spirit of nitre, 
 fixed and volatile oils. ^Ether, f 5 j = grammes 2.80. 
 
 fSame as water are waters, liquids, decoctions, infusions, most fluid extracts, and tinctures 
 made with dilute alcohol. 
 
 t Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the latter 
 f 5 j = grammes 5.50. 
 
NDEX. 
 
 The salts of the metals are usually described in the text under the titles of their metal- 
 lic constituents; some few (as the Arsenates, Phosphates, etc.), also the salts of the 
 alkaloids and those of active elementary substances (as the Bromides, Iodides, etc.) are 
 placed under the titles of their most active constituents. Salts are therefore not men- 
 tioned individually in the Index except when their places in the text are exceptional and 
 do not come within either of the above rules. 
 
 Abasia and Astasia, 604 
 Abbreviations, their use, 545 
 
 Table of, 546, 883 
 Abdominal Plethora, 604 
 Abies, 430 
 
 balsamea, 503 
 
 canadensis, 431 
 
 excelsa, 430 
 Abietic Anhydride, 449, 504 
 Abortion, 604 
 Abrin, 75, 175 
 Abrus, 75 
 Abscess, 605 
 
 of the Liver, 733 
 
 Mammary, 605 
 Absinthe, 76 
 Absinthium, 76 
 
 Absorption by various channels, 67 
 Acacia, 76 
 
 Catechu, 251 
 Accommodation of the Eye, 29 
 Aceta, 565 
 Acetanilid, 76 
 
 Ammoniated, 77 
 
 Antidotes and Antagonists, 808 
 
 Compound, 77 
 Acetates, — See the titles of their basic 
 
 stituents. 
 Acetone, 493 
 
 in Urine, Test for, 869 
 Acetous Preparations, 565 
 Acetum, 80 
 Acid, Abietic, 449 
 
 Abric, 75 
 
 Acetic, 80, 129 
 
 Antidotes, etc., 808 
 
 Aconitic, 106, ill 
 
 Agaricic, 1 18 
 
 Aloeti'c, 141 
 
 Anemonic, 443 
 
 Angelic, 499, 509, C22 
 
 Arabic, 76 
 
 Arsenous, 198 
 
 Antidotes and Antagonists, 8 
 
 58 
 
 HO 
 
 Acid, Artanthic, 377 
 Benzoic, 216, 273 
 Boracic, 81 
 Boric, 81 
 Brassic, 481 
 Butyric, 382 
 Caffeic, 227 
 Calumbic, 238 
 Camphoric, 239, 241 
 Camphretic, 239 
 Capronic, 196 
 Caprylic, 196 
 Carbazotic, 104 
 Carbolic, 83, 272, 291 
 
 Antidotes and Antagonists, 808 
 
 Gauze, 84 
 
 Solution, 84 
 Carbonic, 91, 247 
 
 Antidotes and Antagonists, 809 
 Carminic, 25, 283 
 Caryophyllic, 249 
 Caryophyllinic, 249 
 Catechuic, 251 
 Catechu-tannic, 251 
 Cathartic, 479 
 Cathartogenic^ 479 
 Cerotic, 251 
 Cetraric, 152 
 Chelidonic, 252, 469 
 Chromic, 93 
 Chrysammic, 141 
 Chrysophanic, 268, 459 
 Cinnamic, 21 1, 216, 492 
 Citric, 367 
 Coca-tannic, 277 
 Copaibic, 289 
 Cresylic, 83, 291 
 Cubebic, 295 
 Dibromogallic, 97 
 Digallic, 95 
 Ergotic, 310 
 Ergotinic, 310 
 Erucic, 481 
 Eugenic, 384 
 
 9 X 3 
 
9H 
 
 INDEX. 
 
 Acid, Euonic, 315 
 Euphrastic, 315 
 Filicic, 203 
 Fluoric, 95 
 Formic, 382 
 Gallic, 95 
 Gallotannic, 95 
 Gambogic, 238 
 Gelsemic, 326 
 Gentesic, 327 
 Gentianic, 327 
 Glycyrrhizic, 330 
 Guaiac, 334 
 Guaiaconic, 334 
 Guaiarec, 334 
 Gurjunic, 336 
 Gynocardic, 252 
 Hydriodic, 353 
 Hydrobromic, 221 
 Hydrochloric, 97 
 Hydrocyanic, 99, IOI, 442 
 
 Antidotes and Antagonists, 809 
 Hypophosphorous, 418 
 Hypopicrotoxic, 424 
 Igasuric, 368 
 Ipecacuanhic, 358 
 Isobutyric, 522 
 Juglandic, 363 
 Kinic, 270 
 Kinotannic, 270, 365 
 Kinovic, 270 
 Kinovo-tannic, 270 
 Lactic, 101, 397 
 Lactucic, 365 
 Laricic, 118 
 Linoleic, 368 
 Lobelic, 370 
 Lupulinic, 338 
 Maizenic, 526 
 Malic, 213 
 Mastichic,~ 377 
 Meconic, 397 
 Melassic, 462 
 Methyl-salicylic, 326 
 Mezereinic, 381 
 Mineral, 97 
 
 Antidotes and Antagonists, 809 
 Morrhuic, 382 
 Muriatic, 97 
 Myristic, 384 
 Nitric, 102 
 
 Nitrohydrochloric, 102 
 Nitromuriatic, 102 
 Nucleinic, 160 
 Oleic, 103, 395 
 Ophelic, 254 
 
 Ortho-phenol-sulphonic, 84 
 Orthophosphoric, 1 04 
 Oxalic, 50, 612 
 
 Antidotes and Antagonists, 809 
 Palmaric, 449 
 Palmitic, 395 
 Phenic, 83 
 
 Acid, Phosphoric, 104, 382 
 
 Phytolaccic, 423 
 
 Picric, 104 
 
 Picrotoxic, 424 
 
 Pinic, 449 
 
 Piperonylic, 290 
 
 Podophyllinic, 436 
 
 Polygonic, 436 
 
 Protocatechuic, 436, 521 
 
 Prussic, 99 
 
 Punico-tannic, 332 
 
 Pyrogallic, 97, 273 
 
 Pyroligneous, 431 
 
 Quercitannic, 96, 448 
 
 Rhatania-tannic, 96, 365 
 
 Rheotannic, 452 
 
 Rheumic, 452 
 
 Ricinoleic, 455 
 
 Robustic, ^^ 
 
 Rosolic, 84 
 
 Salicylic, 273, 464 
 
 Salicylous, 465 
 
 Salicyluric, 465 
 
 Sanguinarinic, 469 
 
 Scheele's, 99 
 
 Sclerotic, 310 
 
 Sclerotinic, 310 
 
 Silvic, 449 
 
 Sozolic, 84 
 
 Sphacelinic, 310 
 
 Stearic, ill 
 
 Strychnic, 388 
 
 Succinic, 143 
 
 Sulphuric, 104 
 
 Aromatic, 104 
 
 Sulphurous, 105 
 
 Tannic, 95, 325 
 
 as an Antidote, 805 
 
 Tartaric, 106 
 
 Thebolactic, 397 
 
 Tiglinic, 509 
 
 Toxicodendric, 454 
 
 Tropic, 213, 348 
 
 Valerianic, 130, 338, 499, 520 
 
 Vanillic, 521 
 
 Vegetable, 80 
 
 Viburnic, 525 
 
 Xylic, 83 
 Acidifiers, Urinary, 64 
 Acidity, 606 
 Acids, — their action, 29, 80, 97 
 
 as Antidotes, 806 
 
 Antidotes and Antagonists, 808 
 
 Mineral, 97 
 
 Organic, 25 
 Acne, 606 
 
 Rosacea, 607 
 Acocanthera Ouabaio, 492 
 Aconine, 106 
 Aconite, 106 
 
 Antidotes and Antagonists, 809 
 Aconitine, 107 
 Aconitum, 106 
 
INDEX. 
 
 915 
 
 Acorin, 233 
 
 Acorus Calamus, 233 
 
 Acrinyl, Sulpho-cyanate, 481 
 
 Acrolein, 328 
 
 Actinomycosis, 607 
 
 Actol, 195 
 
 Addison's disease, 608 
 
 Adenitis, — See Glandular Affections, 708 
 
 Adeps, no 
 
 Benzoinatus, no 
 
 Lanae Hydrosus, III 
 Administration of Medicines, 67 
 Adonidin, 112 
 Adonis, III 
 Adrenal Extract, 1 65 
 Adynamia, 608 
 .Ether, 112 
 
 Acetic, 113 
 After-pains, 609 
 Agalactia, 609 
 Agaric, 1 18 
 Agaricin, 118 
 Agaricus, 1 18 
 Agathin, 77 
 Agave Americana, 141 
 Agents acting on each other, 33 
 Agropyrum repens, 519 
 Ague, — See Intermittent Fever, 744 
 Ailanthus, 120 
 Airol, 219 
 Alabastrine, 386 
 Albau, 309 
 Albolene, 416 
 Albumen, 120 
 Albumin, 120 
 
 as an Antidote, 805 
 
 in Urine, Test for, 868 
 
 Ovi, 121, 127 
 
 Phosphorized, 163 
 Albuminates, 28 
 Albuminoids, 28, 1 20 
 Albuminuria, 609 
 Albumoses, 127 
 Alcohol, 128 
 
 Amyl, 130 
 
 Antidotes and Antagonists, 809 
 
 Caustic, 484 
 
 Ethyl, 128 
 
 Methyl, 130 
 
 Phenyl, 83, 129 
 Alcoholic Preparations, 565 
 
 strength of Bitters, 899 
 Alcoholism, 135, 138, 609, 809 
 Aldehyde, 129 
 
 Acetic, 129 
 
 Ethyl, 129, 411 
 
 Formic, 130, 324 
 
 Protocatechuic, 52 1 
 Alder Bark, 96, 141 
 
 Black, 442 
 
 Buckthorn, 324 
 Ale, 131 
 Aletris, 140 
 
 Alexins, 175 
 
 Alkalies, their action, 30 
 
 Antidotes and Antagonists, 809 
 Alkaline Mineral Waters, 186 
 Alkalinizers, Urinary, 64 
 Alkaloids, 22 
 
 Antidotes and Antagonists, 810 
 
 Liquid, 22, 500 
 Allium, 140 
 Allspice, 428 
 Allyl Sulphide, 140, 202 
 
 Sulpho-cyanide, 482 
 Almond, 99, 148 
 Alnus, 96, 141 
 Aloe Socotrina, 141 
 Aloes, 141 
 Aloin, 141 
 Alopecia, 611 
 
 Areata, 855 
 Alstonia scholaris, 306 
 Alteratives, 30 
 
 Uterine, 65 
 Althaea, 142 
 Alum, 143 
 
 Ammonio- ferric, 318 
 
 Antidotes and Antagonists, 810 
 
 Curd, 127 
 Alumen, 143 
 
 Exsiccatum, 143 
 Aluminum, 143 
 Alumnol, 144 
 Alum-root, 96 
 Amanita Muscaria, 1 18 
 Amaroids, 24 
 Amaurosis, 61 1 
 Amber, 493 
 Amblyopia, 31, 611 
 Amenorrhea, 612 
 Amick's Consumption-cure, 899 
 Amido-benzene, 273 
 Ammonia, 144 
 
 as an Antidote, 806 
 
 Antidotes and Antagonists, 8lO 
 Ammonia-alum, 143 
 Ammoniacum, 144 
 Ammoniated Copper, 296 
 
 Glycyrrhizin, 330 
 
 Mercury, 340 
 Ammonio-ferric Alum, 318 
 
 Tartrate, 318 
 Ammonium, 144 
 
 Benzoate, 216 
 
 Carbonate, as an Antidote, 807 
 
 Picrate, 104 
 
 Sulpho-ichthyolate, 496 
 Ammonol, 77 
 Amorphous Bodies, 557 
 Amygdala, 99, 148 
 Amygdalin, 99, 148, 442 
 Amyl Alcohol, 130 
 
 Chloride, 116 
 
 Hydrate, 130 
 
 Hydride, 116 
 
9 i6 
 
 INDEX. 
 
 Amyl Nitrite, 149 
 
 Antidotes and Antagonists, 810 
 Amylamine, 382 
 Amylene, 1 16 
 
 Hydrate, 255 
 Amyloform, 324 
 Amyloid Substances, 28 
 Amylum, 152, 463 
 
 Iodatum, as Antidote, 808 
 Anacyclus Pyrethrum, 447 
 Analgen, 77 
 Analgesics, 31 
 Analgesine, 77 
 Anamirta paniculata, 424 
 Ananassa Sativa, 414 
 Anaphrodisiacs, 31 
 Anarcotine, 403 
 Anasarca, — See Dropsy, 675 
 Andira Araroba, 268 
 Anemia, 613 
 
 Cerebral, 643 
 Anemone, 443 
 Anemonin, 443, 444 
 Anesthesia, 1 14, 262, 614 
 
 Hewitt's Method, 117 
 
 Local, 32, 280, 282, 292, 614 
 
 Sayre's Method, 265 
 
 Schleich's Method, 117, 282, 614 
 
 Therapeutics of, 614 
 Anesthetics, 32, 116, 261 
 
 Antidotes and Antagonists, 810 
 
 Local, 32, 280, 292, 614 
 
 Mixtures, 1 14 
 
 Modes of using, 265 
 Anethol, 167 
 Aneurism, 615 
 Angelate of Butyl, 167 
 Angina, — See Croup, Laryngitis, Pharyn- 
 gitis, Throat, Tonsillitis, etc. 
 Angina Pectoris, 615 
 Anhalonium, 226 
 Anhidroses, 32 
 Anilin, 273 
 
 Red, 325 
 Animal Extracts, 156 
 Anise, 167 
 
 Star, 352 
 Anisum, 167 
 Anodynes, 31, 32, 595 
 
 Dental, 44 
 
 Local, 32 
 Ant- acids, 30 
 Antagonism of Drugs, 33 
 
 Toxicological, 34 
 Antagonists, 33, 804 
 
 List of, 35 
 
 Table of, 35 
 Anthelmintics, 36, 595 
 Anthemis, 167 
 Anthrax, 616 
 Antiabrin, 175 
 Antibilious Pills, 591 
 Antidote, Arsenic, 317 
 
 Antidote, Bouchardat' s, 808 
 
 JeaunePs, 808 
 Antidote-bag, 808 
 Antidotes, 36, 804 
 
 General, 808 
 Anti-emetics, 49 
 Anti-fat, 325, 424 
 Antifebrin, 76 
 
 Antigalactagogues, — See Galactophyga, 52 
 Antikamnia, 77 
 Antikol, 77 
 Antilithics, 56 
 Antilupin, 77 
 Antimonial Powder, 168 
 Antimony, 167 
 
 Antidotes and Antagonists, 810 
 
 Sulphurated, 168 
 Antinervin, 77, 79 
 Antinosin, 358 
 Antiperiodics, 37 
 Antiphlogistics, 37 
 Antiphlogistine, 330 
 Antiphthisic Serum, 182 
 Antiphthisin, 514 
 Antipyretics, 37, 294 
 Antipyrin, 170 
 
 Antidotes and Antagonists, 810 
 
 Salicylate, 171, 465 
 Antiricin, 175 
 Antiseptic Fluid, 508 
 
 Injection, 346 
 
 Solutions, 84, 346 
 Antiseptics, 38, 508 
 Antisialics, 62 
 Antispasmodics, ^8 
 Antitoxin, 174 
 
 Diphtheria, 176 
 
 Plague, 184 
 
 Streptococcus, 182 
 
 Syphilis, 183 
 
 Tetanus, 179 
 
 Tuberculosis, 180 
 
 Typhoid, 184 
 
 Vaccinia, 184 
 Antitoxins, 174, 184 
 Antivenene, 183 
 Antizymotics, 39 
 Antrum, Disease of, 616 
 Anus, Fissured, 616 
 
 Prolapse of, 821 
 Aperients, 41, 591 
 Aphonia, 617 
 Aphrodisiacs, 39 
 Aphthae, 617 
 Apiin, 184 
 Apiol, 184 
 
 Apis mellifica, 251, 378 
 Apnea, 620 
 Apocynin, 185 
 Apocynum, 185 
 Apomorphine, 399, 403, 405 
 Apoplexy, 618 
 Apotheme, 573 
 
INDEX. 
 
 917 
 
 Apparatus for testing urine, 870 
 
 Appetite, 618 
 
 Approximate Measures, 535, 910 
 
 Weights, 910 
 Aqua, 185 
 
 Carbonata, 91 
 
 Regia, 102 
 Aquae, 566 
 Arabin, 76, 518 
 Arbor Vitae, 504, 507 
 Arbutin, 253, 325, 519 
 Arctium Lappa, 366 
 Arctostaphylos glauca, 519 
 
 Uva-ursi, 519 
 Argentamin, 195 
 Argentol, 195 
 Argentum, 190 
 
 Antidotes and Antagonists, 818 
 
 Compounds, 195 
 Argol, 437 
 Argonin, 195 
 Argyria, 191 
 Aristol, 357 
 Aristolochia, 480 
 Aristolochine, 480 
 Arnica, 196 
 Arnicin, 196 
 Aromatic Fluid Extract, 277 
 
 Powder, 277 
 
 Sulphuric Acid, 104 
 
 Wine, 131 
 Arrow-root, 154 
 Arsenate, Iron, 319 
 
 Sodium, 198 
 Arsenates and Arsenites, 198 
 Arsenauro, 206, 210 
 Arsenic, 198 
 
 Antidote, 317 
 
 Antidotes and Antagonists, 810 
 Arsenite, Copper, 199 
 
 Potassium, 198 
 
 Strychnine, 389, 394 
 Arsenum, 198 
 Artemisia Absinthium, 76 
 
 pauciflora, 471 
 Arterial Transfusion, 69 
 Arthritis, Rheumatoid, 618 
 Asafcetida, 201 
 Asagrsea officinalis, 521 
 Ascarides, — See Worms, 36, 333, 879 
 Ascites, 619 
 Asclepias, 203 
 Aselline, 382 
 Aseptol, 84 
 Aseptolin, 85, 89 
 Ash, Flowering, 377 
 
 Prickly, 525 
 Asparagin, 143, 315, 330 
 Asphyxia, 92, 620 
 Aspidium, 203 
 Aspidosperma, 203 
 Aspidospermine, 203 
 Assay, 563 
 
 Astasia, 604 
 
 Asthenia, — See Adynamia, Convalescence. 
 
 Asthenopia, 621 
 
 Asthma, 622 
 
 Astigmatism, 623 
 
 Astragalus gummifer, 518 
 
 Astringents, 40, 64 
 
 Intestinal, 55 
 
 Pill, 591 
 
 Powder, 593 
 
 Urinary, 64 
 
 Vegetable, 96 
 Atheroma, 624 
 Atropa Belladonna, 212 
 Atrophy, 624 
 Atropine, 213 
 
 and Morphine, 407, 898 
 
 Antidotes and Antagonists, 811 
 Atrosin, 213 
 Aurantiin, 204 
 Aurantium, 204 
 Aurin, 84 
 Aurum, 205 
 
 Authorities, List of, 603 
 Ava-kava, 364 
 Avena Sativa, 210 
 Ayer's Ague Cure, 899 
 
 Cherry Pectoral, 899 
 
 Pills, 899 
 
 Recamier Balm, 901 
 Cream, 901 
 
 Sarsaparilla, 899 
 
 Vita Nuova, 902 
 Azedarach, 21 1 
 
 Azoturia, — See Urinary Disorders, 867 
 Azulen, 377 
 
 Balanitis, 624 
 
 Baldness, — See Alopecia, 611, 855 
 
 Balm,^ 378 
 
 Cream, 900 
 
 of Gilead, 503 
 
 Recamier, 901 
 Balnea, 566 
 Balsam of Copaiba, 289 
 
 of Fir, 503 
 
 Friar's, 21 5 
 
 Gurjun, 335 
 
 of Peru, 211 
 
 of Tolu, 211 
 Balsamum Dipterocarpi, 335 
 
 Peruvianum, 211 
 
 Tolutanum, 211 
 Bandoline, 299 
 Banting Dietary, 779 
 Baptisia, 212 
 Baptisin, 212 
 Barbaloin, 141 
 Barberry, 218 
 Barium Dioxide, 212 
 
 Salts, Antidotes, etc., 811 
 Bark, Blackberry, 459 
 
918 
 
 INDEX. 
 
 Bark, Casca, 250 
 
 Chittem, 451 
 
 Cramp, 525 
 
 Cuprea, 270 
 
 Elm, 519 
 
 Honduras, 250 
 
 Huxham's Tincture of, 271 
 
 Oak, 96, 448 
 
 Ordeal, 250 
 
 Peruvian, 269 
 
 Pitaya, 270 
 
 Sacred, 451 
 
 Sassy, 250 
 
 Soap, 448 
 
 Willow, 465 
 Barley, 152, 154 
 Barosma, 226 
 Barosmin, 226 
 Basham's Mixture, 318, 676 
 Basilicon Ointment, 449 
 Bassorin, 518 
 Baths, 566 
 
 Formulae, 566 
 Battley's Sedative, 399 
 Bay-berry, 384 
 Bay Rum, 384 
 
 Sweet, 374 
 Beans, 1 54 
 Bear-berry, 519 
 Bed-sores, 624 
 
 Bee-venom, Antidotes, etc., 811 
 Beef, 122 
 
 Peptonoids, 122 
 
 -tea, 127 
 Beer, 131 
 
 Ginger, 530 
 Beet, Sugar, 462 
 Behring's Law, 174 
 Belladonna, 212 
 
 Antidotes and Antagonists, 81 1 
 Belladonnine, 213 
 Benne Oil, 481 
 Benzene, 1 16, 217, 272 
 Benzin, 216 
 Benzoates, 216 
 Benzoin, 216 
 
 Benzoinated Lard, no, 2l6 
 Benzol, 116, 217, 272 
 Benzosol, 291, 294 
 Benzoyl Guaiacol, 291 
 
 Morphine, 399 
 
 Pseudotropeine, 278 
 
 Sulphonic-imide, 461 
 Benzyl Cinnamate, 211 
 Berberine, 218, 238, 346, 378, 412, 436, 525 
 Berberis, 218 
 Bergamot, Oil of, 218 
 Bergaptene, 218 
 Beriberi, 624 
 Beta-naphtol, 387 
 Beta vulgaris, 462 
 Betula lenta, 464, 465 
 Bhang, 242 
 
 Bibliography and References, 603 
 Bichlorinated Methyl Chloride, 260 
 Bichromate of Potassium, 94 
 
 Antidotes and Antagonists, 817 
 Bile, 316 
 
 Agents affecting, 42, 53 
 
 Pigment in Urine, Test, 869 
 Biliary Solvents, 56 
 Biliousness, 345, 625 
 Bilious Remittent Fever, 907 
 Bind-weed, 338 
 Birch, Sweet, 464, 465 
 Bird-lime, 525 
 Bismuth, 218 
 
 Mixture for Children, 584 
 
 Subgallate, 219, 358 
 
 Subiodide, 219, 358 
 Bitartrate, Nicotine, 500 
 
 Potassium, 438 
 Bites and Stings, 845 
 Bitters, Action of, 238 
 
 Alcoholic Strength of, 899 
 
 Hostetter's", 900 
 
 Vinegar, 902 
 Bittersweet, 308 
 Blackberry, 96, 459 • 
 
 Black Draught, 479 
 
 Drop, 397 
 
 Haw, 525 
 
 Paste, 713 
 Bladder, Inflammation of, 663 
 
 Irritable, 626 
 
 Paralysis of, 626 
 Bladder-wrack, 325 
 Blancard's Pills, 317 
 Blaud's Pills, 316 
 Bleaching Powder, Antidotes, 813 
 Blende, 527 
 Blepharitis, 626 
 Blistering Cerate, 244 
 
 Collodion, 244 
 Blisters, 55 
 Blood as Food, 127 
 Blood-root, 469 
 Blood-stains, 844 
 Blue Cohosh, 251 
 
 Flag, 361 
 
 Mass, 339 
 
 Methylene, 380 
 
 Ointment, 340 
 
 Pi", 339 
 Boiling, 564 
 Boils, 626 
 Boldine, 221 
 Boldo, 221 
 Boldus, 221 
 Bolus, 586 
 Bone Diseases, 627 
 
 Marrow Extract, 1 60 
 Boneset, 315 
 Borax, 81 
 Borine, 81 
 Borism, 82 
 
INDEX. 
 
 919 
 
 Borneol, 27, 504 
 Boroglyceride, 81, 83 
 Boroglycerin, 81 
 Borolyptol, 81 
 Bos Taurus, 316 
 Botkin's Cholera Drops, 647 
 Bots, 211 
 
 Bouchardat's Antidote, 807 
 Bougies, 595 
 Bovinine, 122 
 Bovril, 122 
 Boxwood, 412 
 
 Brain Disorders, — See Cerebral Anemia, 
 Cerebral Concussion, etc. 
 
 Extract, 164 
 
 Fever, — See Meningitis, Cerebro- 
 spinal Meningitis, Typhoid Fever, 
 Typhus Fever. 
 Brandre th's Pills, 899 
 Brandy, 130 
 Brassica, 481 
 Bray era, 299 
 Breasts, — See Abscess, Lactation, Mastitis, 
 
 Nipples. 
 Breath, Fetid, 627 
 Bright' s Disease, Acute, 628 
 Chronic, 629 
 Diagnosis, 903 
 Bromelin, 414 
 Bromides, 221 
 
 Antidotes and Antagonists, 81 1 
 
 Formulae for, 693, 783 
 Bromidrosis, — See Feet, 699 
 Bromine and Bromides, 221 
 
 Antidotes and Antagonists, 81 1 
 Bromism, 222 
 Bromoform, 221, 224 
 Bronchiectasis, 629 
 Bronchitis, Acute, 630 
 
 Capillary, 631 
 
 Chronic, 632 
 Bronchocele, — See Goitre, 710 
 Bronchorrhea, 633 
 Broom, 476 
 Brown Mixture, 330 
 Brucine, 338, 351, 389, 395 
 Bruises, 634 
 Bryonia, 225 
 Bryonin, 225 
 Bubo, 634 
 Buchu, 226 
 
 Helmbold's, 900 
 Buckthorn, 324, 451 
 Bulimia, 618 
 Bunion, 634 
 Burdock, 366 
 
 Burnett's Disinfectant, 46, 527 
 Burns, 634 
 Bursitis, 635 
 Buttermilk, 123, 128 
 Butternut, 363 
 Butyl Angel ate, 167 
 
 Chloral Hydrate, 259 
 
 Butyl Chloride, 116 
 Hydride, 1 16 
 Valerianate, 167 
 
 Butylamine, 382 
 
 Buxine, 412 
 
 Buxus sempervirens, 412 
 
 Cacao-butter, 230, 506 
 Cachets, 592 
 Cachexiae, 635 
 Cacodyle, 797 
 Cactine, 226 
 Cactus Grandiflora, 226 
 Cadmium, 226 
 Caffacemon, 77 
 Caffea, 227 
 Caffeine, 227 
 
 Citrated, 228 
 Caffenol, 77 
 Caffeol, 227 
 Caffeone, 227 
 Cajuput, Oil of, 233 
 Cajuputene Bihydrate, 233 
 Cajuputol, 233 
 Calabar Bean, 421 
 Calabarine, 422 
 Calamine, 527 
 
 Ointment, 529 
 Calamus, 233 
 Calcauro, 206 
 Calcination, 560 
 Calcium, 234 
 
 Chloride, Antidotes, etc., 81 1 
 
 Hydrate, as an Antidote, 806 
 
 Sulphide, 496 
 Calculi, Biliary, 636 
 
 Renal, 636 
 
 Solvents of, 56 
 
 Vesical, 636 
 Calendula, 238 
 Calomel, 340 
 Calumba, 238 
 Calumbin, 238 
 Calx, 234 
 
 Chlorata, 266 
 
 Sulphurata, 496 
 Cambogia, 238 
 
 Camp Fever, — See Typhus, 863 
 Camphene, 504 
 Camphor, 239 
 
 Antidotes and Antagonists, 81 1 
 
 Baldrian, 520 
 
 Bergamot, 218 
 
 Carbolated, 239 
 
 -chloral, 239 
 
 -cymol, 239 
 
 Monobromated, 239 
 
 Naphtol, 387 
 
 Peppermint, — See Menthol, 379 
 
 Pulsatilla, 443 
 
 Salicylated, 240 
 Camphors, 27 
 
920 
 
 INDEX. 
 
 Camphylene, 387 
 Canadian Hemp, 185 
 
 Moonseed, 378 
 Cancer, 637 
 
 Diagnosis of, 904 
 
 of Uterus, 871 
 Cancrum Oris, 638 
 Cannabene, 241 
 Cannabin, 241 
 Cannabis Indica, 241 
 
 Antidotes and Antagonists, 81 1 
 Cantharides, 244 
 Cantharidin, 244 
 Cantharis, 244 
 
 Antidotes and Antagonists, 811 
 Caoutchouc, 308 
 Capsicin, 246 
 Capsicum, 246 
 Capsules, 566 
 Caraway, 249 
 Carbinol, 130 
 Carbo, 247 
 
 Animalis, 247 
 
 Ligni, 247 
 Carbohydrates, 21, 153 
 Carbon, 247 
 
 Acids, 25 
 
 Dioxide, 91, 116, 500 
 
 Antidotes and Antagonists, 811 
 
 Disulphide, 116, 247 
 
 Monoxide, 1 16, 247 
 
 Tetrachloride, 1 1 6, 262 
 Carbonated Mineral Waters, 91, 93, 187 
 Carbonates, as Antidotes, 806 
 Carbonei Disulphidum, 1 1 6, 247 
 Carbonization, 557 
 Carbuncle, 638 
 
 Carcinoma, — See Cancer, 637 
 Cardamom, 248 
 Cardiac Disorders, — See Heart, 719 
 
 Sedatives, 40 
 
 Stimulants, 40 
 
 Tonics, 41 
 Cardialgia, — See Pyrosis, 828 
 Cardine, 164 
 
 Carditis, Diagnosis of, 904 
 Carduus, 248 
 Carica Papaya, 413 
 Caries, 639 
 Carminative, Dalby's, 399 
 
 Dewees', 202, 372 
 Carminatives, 41 
 Carmine, 283 
 Carnogen, 160 
 Caroval, 298 
 Carragheen, 1 21 
 Carron Oil, 235, 237, 369 
 Carthamus tinctorius, 294 
 Carvene, 249 
 Carum, 249 
 Carvol, 249 
 Caryophyllin, 249 
 Caryophyllus, 249 
 
 Casca Bark, 250 
 Cascara Amarga, 250 
 
 Sagrada, 451 
 Cascarilla, 250 
 Cascarillin, 250 
 Casein, 120, 122 
 Cassia acutifolia, 479 
 
 angustifolia, 479 
 
 Cinnamon, 277 
 
 Fistula, 250 
 
 Purging, 250 
 Castanea, 96, 250 
 Castor Oil, 455 
 
 Emulsion ; Formula, 657 
 Castoria, 899 
 Catalepsy, 639 
 Cataplasmata, 567 
 Cataract, 640 
 Catarrh, Acute Nasal r 640 
 
 Broncho-pulmonary, — See Bronchitis, 
 Bronchorrhea. 
 
 Chronic Nasal, 641 
 
 Duodenal, 677 
 
 Epidemic, — See Influenza, 741 
 
 Gastric, — See Gastritis, Chronic, 707 
 
 Genito-urinary, — See Bladder, Catarrh 
 of, Cystitis, Endometritis, Gonor- 
 rhea, Leucorrhea, etc. 
 
 Intestinal, — See Dysentery, Jaundice. 
 
 Sage's Remedy, 901 
 
 Sanford's Cure, 901 
 
 Summer, — See Hay Fever, 715 
 Catechol, 273 
 Catechu, 96, 251 
 Cathartics, 41 
 
 in Poisoning, 804 
 Catharto-mannite, 479 
 Caulophyllin, 251 
 Caulophyllum, 251 
 Caustic, Lunar, 190 
 
 Mitigated, 190 
 
 Potash, 437 
 
 Soda, 483 
 Caustics, 50 
 Cedar, Oil of, 471 
 
 Red, 460 
 
 White, 507 
 Celandine, 252 
 Celerina, 278 
 Cellulose, 153, 331 
 Centaurea benedicta, 248 
 Century-plant, 14 1 
 Cepbaeline, 358 
 Cephaelis Ipecacuanhae, 358 
 Cephalalgia, — See Headache, 7 10 
 Cera, 251 
 Cerata, 567 
 Cerate, 252 
 
 Blistering, 244 
 
 Cantharides, 244 
 
 Cetaceum, in 
 
 Goulard's, 433 
 
 Lead, Subacetate, 433 
 
INDEX. 
 
 921 
 
 Cerate, Resin, 449 
 
 Savine, 460 
 
 Spermaceti, ill 
 
 Theobroma, 507 
 Cerates, 567, 601 
 
 Compounding of, 601 
 Ceratum, 252 
 
 Cerebellum, Agents affecting, 43 
 Cerebral Anemia, 643 
 
 Compression, Diagnosis, 904 
 
 Concussion, 643 
 Diagnosis, 904 
 
 Congestion, 643 
 
 Depressants, 43 
 
 Excitants, 43 
 
 Softening, 644 
 
 Vomiting, — Diagnosis, 907 
 Cerebrine, 164 
 Cerebrinin, 164 
 Cerebro- spinal Fever, 764 
 Cereus, Night-blooming, 226 
 Cerium Oxalate, 252 
 Cerolein, 251 
 Cetaceum, ill 
 Cetin, in 
 Cetraria, 152, 156 
 Cetyl Palmitate, ill 
 Cevadilla, 521 
 Cevadilline, 521 
 Cevadine, 521 
 Cevine, 522 
 Chalk, 234 
 
 Chalybeate Waters, 186 
 Chamomile, 167 
 
 German, 377 
 Chamomilla, 167, 378 
 Chancre, 644 
 
 Diagnosis of, 904 
 Chancroid, 644 
 
 Diagnosis of, 904 
 Change of Life, — See Climacteric, 650 
 Chapped Hands and Lips, 645 
 Charcoal, 247 
 
 as an Antidote, 806 
 Chartae (Papers), 567 
 Chartulse, 592 
 Chaulmoogra Oil, 252 
 Cheese, 123 
 Chekan, 386 
 Chekanine, 386 
 Chelerythrine, 252 
 Chelidonine, 252 
 Chelidonium, 252 
 Chelidoxandiin, 252 
 Chelsea Pensioner, 568, 833 
 Chemical Incompatibility, 548 
 Chenopodium, 253 
 Cherry-laurel, 99, IOI 
 Cherry Pectoral, 899 
 
 Wild, 442 
 Chestnut, 96, 250 
 Chest-pains, 645 
 Chian Turpentine, 503 
 
 Chicken-pox, — See Varicella, 874 
 
 Chilblains, 645 
 
 Children, Dosage for, 72, 400 
 
 Chimaphila, 253 
 
 Chimaphilin, 253 
 
 China, Pride of, 211 
 
 Chinicin, 273 
 
 Chminum Amorphum Boricum, 271 
 
 Chinoidin, 272 
 
 Chinolin, 253, 273 
 
 Chinopyrin, 276 
 
 Chinosol, 254 
 
 Chirata, 254 
 
 Chiratin, 254 
 
 Chiretta, 254 
 
 Chittem Bark, 45 1 
 
 Chloral, 254 
 
 Analogues, 255 
 
 Antidotes and Antagonists, 81 1 
 
 Butylic, 259 
 
 Formidate, 259 
 
 Hydrate, 254 
 Chloralamid, 259 
 Chloral-habit, 257 
 Chlorates, — See the titles of their metallic 
 
 constituents. 
 Chlorides, — See the titles of their metallic 
 constituents. 
 
 in Urine, Test, 869 
 Chlorinated Waters, 187 
 Chlorine, 266 
 
 as an Antidote, 807 
 
 Antidotes and Antagonists, 81 2 
 Chlorine-water, 266 
 Chlorodyne, 261, 399 
 
 Collis Browne's, 899 
 
 Formulas for, compared, 909 
 Chloroform, 1 16, 260 
 
 Antidotes and Antagonists, 81 2 
 
 Sayre' s method of using, 265 
 Chlorosis, 645 
 Chlorum, 266 
 Chocolate, 230, 506 
 Choking, 646 
 Cholagogues, 42, 53 
 
 Pills, 591 
 
 Purgatives, 42 
 Cholera Asiatica, 646 
 
 Diagnosis of, 905 
 
 Infantum, 647 
 
 Mixture (Squibb), 399, 647 
 
 Simplex, 648 
 
 Toxin, 516 
 Cholesterin, 121 
 
 Chondodendron tomentosum, 41 1 
 Chondrus, 121 
 Chordee, 648 
 Chorea, 649 
 Choroiditis, 650 
 Chromic Anhydride, 93 
 
 Trioxide, 93 
 Chrysarobin, 268 
 Chrysophan, 452 
 
922 
 
 INDEX. 
 
 Churrus, 242 
 
 Chyluria, 650 
 
 Cigarettes, Formulae for, 623 
 
 Ciliary Excitants, 43 
 
 Cimicifuga, 268 
 
 Cimicifugin, 268 
 
 Cinchona, 269 
 
 Red, 270 
 
 Rubra, 270 
 Cinchonamine, 270 
 Cinchonidine, 270, 272 
 Cinchonine, 270, 272 
 Cinchonism, 274 
 Cineol, 386 
 Cinnamein, 211 
 Cinnamomum, 277 
 
 Camphora, 239 
 Cinnamon, 277 
 Cinquefoil, 792 
 
 Circulation, Agents affecting, 40, 66 
 Cissampeline, 412 
 Cissampelos Pareira, 412 
 Citrates, 367, — See also the titles of their 
 
 basic constituents. 
 Citrine Ointment, 340, 341 
 Citron, 367 
 
 Citrullus Colocynthis, 285 
 Citrus acris, 367 
 
 Aurantium, 204 
 
 Bergamia, 21 8 
 
 Limonum, 367 
 
 medica, 367 
 
 vulgaris, 204 
 Clarification, 557 
 Clarke's Blood Mixture, 900 
 Classification of Medicines, 29 
 Claviceps purpurea, 310 
 Clavus, — See Headache, 717 
 Clemens' Solution, 199 
 Climacteric Disorders, 650 
 Cloves, 249 
 Club-moss, 371 
 Clysters, 577 
 Cnicin, 248 
 
 Cnicus benedictus, 248 
 Coagulated Proteid, 28 
 Coal-gas, Antidotes and Antagonists, 
 
 813 
 
 Coca, 230, 277 
 Cocaine, 230, 278 
 
 Antidotes and Antagonists, 812 
 Cocaine-habit, 280 
 Cocamine, 277 
 Cocculus Indicus, 424 
 Coccus, 283 
 Coccygodynia, 651 
 Cochineal, 283 
 Cocoa, 230 
 Codamine, 397 
 Codeine, 396, 399, 403, 406 
 Codfish, 381 
 Cod-liver Oil, 381 
 
 Emulsion, 381, 572 
 
 Coffea, 227 
 Coffee, 227 
 Cohosh, Black, 268 
 
 Blue, 251 
 Cola acuminata, 230 
 Colation, 557 
 Colchiceine, 283 
 Colchicine, 284 
 
 Salicylate, 288 
 Colchicum, 283 
 
 Antidotes and Antagonists, 812 
 Cold Cream, ill 
 Coldness, 651 
 Colic, Hepatic, 652 
 
 Intestinal, 651 
 
 Lead, 652 
 
 Renal, 652 
 Colic-root, 140, 306 
 Collagen, 121 
 
 Coliagenes and Mucilaginous Bodies, 28 
 Collapse, 652, — See also Exhaustion, 
 
 Shock, Syncope. 
 Collidine, 500 
 Collodia, 568 
 Collodion, 331 
 
 Blistering, 244, 331 
 
 Cantharidal, 244, 331 
 
 Carbolized, 881 
 
 Flexible, 331 
 
 Styptic, 95, 331, 881 
 Colloids, 559 
 Colloxylin, 33 1 
 Collunarium, 577 
 Collyrium, 579 
 
 Formulae for, 580 
 Colocynth, 285 
 Colocynthein, 285 
 Colocynthin, 285 
 Colocynthis, 285 
 Colocynthitin, 285 
 Cologne- water, 131 
 Colophony, 449, 504 
 Coloring Matters, 25 
 Columbo, 238 
 Coma, 653 
 
 Alcoholic, 137 
 
 Opium, 401 
 Combination, Principles of, 542 
 Combustibles, 55° 
 Comminution, 557 
 Commiphora Myrrha, 385 
 Compounding Medicines, 554 
 
 a Mixture, 583 
 
 an Ointment, 601 
 Compounds, Explosive, 550 
 
 Miscellaneous, 28 
 
 Poisonous, 551 
 Condylomata, 653 
 Condy's Fluid, 46, 374 
 Confectio Damocratis, 568 
 Confections, 568 
 
 Formulae for, 568 
 Conhydrine, 286 
 
INDEX. 
 
 923 
 
 Coniine, 286 
 Conium, 286 
 
 Antidotes and Antagonists, 812 
 Conjunctivitis, Catarrhal, 653 
 
 Diphtheritic, 654 
 
 Gonorrheal, 655 
 
 Granular, 655 
 
 Phlyctenular, 655 
 
 Purulent, 656 
 Conspergatives, 588 
 Constipation, 656 
 Constituents of Organic Drugs, 21 
 Contractions, List of, 546, 883 
 Contractors, Vascular, 65 
 Convalescence, 657 
 Convallamarin, 288 
 Convallaria, 288 
 Convallarin, 288 
 Convolvulin, 362, 474 
 Convolvulus Scammonia, 474 
 Convulsions, 658 
 
 Infantile, 658 
 
 Puerperal, 825 
 Copaiba, 289 
 
 Emulsion, 289, 572 
 
 Mixture, 289 
 Copaifera LangsdorfHi, 289 
 Copper, 296 
 
 Carbonate, as Antidote, 807 
 
 Salts, Antidotes, etc., 812 
 Coral, 235 
 Cordial, Aletris, 140 
 
 Cascara, 451 
 
 Godfrey's, 399 
 Coriander, 290 
 Coriandrum, 290 
 Corn, Indian, 152, 526 
 Corn-silk, 526 
 Corn-smut, 526 
 Corneal Opacities, 658 
 Corneitis, — See Keratitis, 749 
 Cornin, 290 
 Corns, 659 
 Cornus, 290 
 Cornutine, 310 
 
 Corpulence, — See Obesity, 779 
 Corrosive Sublimate, 340 
 
 Antidotes and Antagonists, 812 
 Coryza, — See Catarrh, Acute, 640 
 Cosmoline, 415 
 Coto Bark, 290 
 Cotoin, 290 
 Cotton, 331 
 
 Gun, 153 
 
 Iodized, Formulae for, 724 
 Cotton-seed Oil, 331 
 Couch-grass, 519 
 Cough, 659, 793 
 
 Mixtures, Formulae for, 661, 763, 794, 
 
 799 
 Counter-irritants, 55 
 Counter-irritation, 244 
 Court Plaster, 121, 128 
 
 Coxalgia, 661 
 
 Coxe's Hive Mixture, 168, 475 
 
 Crab Lice, — See Pediculi, 790 
 
 Crabs' -eyes, 235 
 
 Cramp Bark, 525 
 
 Cramps, — See Colic, Spasmodic Affections, 
 
 Trismus. 
 Cranesbill, 96, 328 
 Crataegus Oxyacantha, 615 
 Cream, Cold, III, 457 
 
 Recamier, 901 
 
 of Tartar, 438 
 Creolin, 85, 90 
 Creosol, 291 
 Creosotal, 291 
 Creosote, 85, 291 
 
 Antidotes and Antagonists, 813 
 Cresol, 8^ 
 Creta, 234 
 
 Creuse's Iron Solution, 316 
 Crocq's Solution, 421 
 Crocus, 294 
 Croton-chloral, 259 
 Croton Eleuteria, 250 
 
 Oil, 509 
 
 Tiglium, 509 
 Croup, Catarrhal, 661 
 
 Membranous, 662 
 Diagnosis, 905 
 Cryptopine, 397, 403 
 Crystallization, 557 
 Cubeb, 295 
 Cubeben, 295 
 Cubebene, 295 
 Cubebin, 295 
 Cuca, 230, 277 
 Cucumber, Squirting, 309 
 
 Tree, 374 
 Cucurbita Pepo, 412 
 Cucurbitine, 412 
 Culvers Root, 366 
 Cuprea Bark, 270 
 Cuprum, 296 
 
 Ammoniatum, 296 
 Curare, 298 
 
 Antidotes and Antagonists, 813 
 Curarine, 298 
 
 Cure, Keeley's Gold, 210, 900 
 Cures, — See Patent Medicines, 899 
 Cusso, 299 
 
 Cutaneous Irritants, 55 
 Cuttle-fish Bone, 235 
 Cyanides, — See the titles of their metallic 
 
 constituents. 
 Cyanosis, 663 
 Cydonin, 299 
 Cydonium, 299 
 Cymene, 504, 508 
 Cynips Gallae tinctoriae, 325 
 Cypripedin, 299 
 Cypripedium, 299 
 Cystitis, Acute, 663 
 
 Chronic, 663 
 
924 
 
 INDEX. 
 
 Cysts, 665 
 
 Cytisus Scoparius, 476 
 
 Dalby's Carminative, 399 
 
 Damiana, 299 
 
 Dandelion, 503 
 
 Dandruff, — See Pityriasis, 799 
 
 Dangers of Incompatibility, 552 
 
 Daphne Mezereum, 381 
 
 Daphnin, 381 
 
 Datura Stramonium, 488 
 
 Tatula, 300 
 Daturine, 300, 489 
 Deafness, 665 
 
 Death, Signs of, — See Asphyxia, 621 
 Debility, — See Adynamia, Anemia, Con- 
 valescence. 
 Decantation, 558 
 Decimal Weights, etc., 534 
 Decocta (Decoctions), 568 
 Decoloration, 558 
 Deer, Musk, 383 
 Deflagration, 558 
 Deliquescence, 558 
 Deliquescent Salts, List of, 589 
 Deliriants, 43 
 Delirium, 665 
 
 Tremens, 135, 138, 666 
 Delphinine, 487 
 Delphinium Staphisagria, 487 
 Dementia, 742 
 
 Paralytica, 667 
 Demulcents, 44 
 Dengue, 667 
 Dental Anodynes, 44 
 Dentifrices, 44 
 Dentition, 667 
 Deodorants, 44 
 Deposits in Urine, 870 
 Depressants, Cerebral, 43 
 
 Hepatic, 52 
 
 Motor, 56 
 
 Renal, 48 
 
 Respiratory, 60 
 
 Uterine, 65 
 Dermatol, 219, 220, 358 
 Desiccation, 558 
 Destructive Metamorphosis, 45 
 Dew-berry, 459 
 
 Dewees' Carminative, 202, 372 
 Dextrin, 152 
 Dextroform, 324 
 Dextrose, 378, 462 
 Dhobie Itch, 668 
 Diabetes Insipidus, 668 
 
 Mellitus, 668 
 Diabetin, 463, 670 
 Diacetyl-morphine, 399 
 Diacetyl-tannin, 97 
 Diachylon Ointment, 433 
 
 Plaster, 433 
 Diagnosis, Differential, 903 
 
 Dialysis, 559 
 Dialyzed Iron, 319, 559 
 Diaphoretics, 45 
 Diarrhea, 670 
 Diastase, 152 
 
 Pancreatic, 413 
 Dichlor-methyl Chloride, 260 
 Dichloro-methane, 262 
 Didama's Solution, 898 
 Didymin, 162 
 
 Diet, — See Albumin and Amylum. 
 Diethylsulphon-diethyl-methane, 495 
 Diethylsulphon -dimethyl-methane, 493 
 Diethylsulphon-methyl-ethyl-methane, 495 
 Diffusate, 559 
 
 Digestive System, Agents affecting, 30 
 Digitalei'n, 301 
 Digitalin, 300 
 Digitalis, 300 
 
 Antidotes and Antagonists, 813 
 Digitin, 301 
 Digitonin, 301 
 Digitoxin, 301 
 Dihydro-toluidine, 382 
 Dilators, Vascular, 66 
 Diluents, 45, 582 
 Dimethyl-amido-antipyrin, 1 71 
 Dimethyl-ethyl-carbinol, 255 
 Dimethyl -piperazin Tartrate, 430 
 Dimethyl-xanthin, 230 
 Di-oleyl-lecithin, 163 
 Dionine, 399 
 Dioscorea, 306 
 Dioscorein, 306 
 Diospyros, 96 
 Dipentene, 504 
 Diphtheria, 177, 672 
 
 Antitoxin, 176 
 
 Diagnosis of, 905 
 
 Laryngeal, 662 
 
 Temperature in, 852 
 Dipsomania, — See Alcoholism, Delirium 
 
 Tremens. 
 Discutients, 45 
 Disinfectants, 46 
 
 Burnett's, 46 
 
 Condy's, 46 
 
 Labarraque' s, 46 
 Disinfecting Fluid, 527 
 Disinfection Oil, 85 
 Dislocations, 703 
 Dispensatories, 532 
 Dispensing, 554 
 
 by Physicians, 554 
 Displacement, 561 
 Distillation, 559 
 Dita Bark, 306 
 Ditaine, 306 
 Ditamine, 306 
 Dithymol-Iodide, 357 
 Diuretics, 46 
 
 Formulae for, 676, 868 
 
 List of, 47 
 
INDEX. 
 
 925 
 
 Diuretics, Refrigerant, 46 
 
 Stimulant, 47 
 Diuretin, 233 
 
 Dizziness, — See Vertigo, 875 
 DobelPs Xasal Wash, 578, 643 
 Dock, Yellow, 459 
 Dog-wood, 290 
 
 Jamaica, 430 
 Domestic Measures, 535 
 Donovan's Solution, 199 
 Dorema Ammoniacum, 144 
 Dormiol, 256 
 Dosage of Medicines, 72 
 
 of Official Preparations, 73 
 Doses, Average, 73 
 
 Table of, — See inside of cover. 
 Dover's Powder, 358, 398 
 Drastic Purgatives, 42 
 Draught, 576 
 
 Black, 479, 576 
 
 Effervescing, 576 
 Drink, 591 
 
 Imperial, Formula, 591 
 Drops, 535 
 
 Botkin's Cholera, 647 
 
 Table of Drops to a Drachm, 535, 
 910 
 Dropsy, 675 
 Drosera, 306 
 
 Drowning, — See Asphyxia, 620 
 Drug-eruptions, 694 
 Drug-experimentation, 19 
 Drugs, 17 
 
 Active principles, 21 
 
 Antagonism of, 33 
 
 Constituents of, 21 
 
 Inorganic, 21 
 
 Neutral principles, 24 
 
 Organic, 21 
 Dryopteris Filix-mas, 203 
 
 Marginalis, 203 
 Duboisia, 307 
 Duboisine, 307 
 Dulcamara, 308 
 Dulcamarin, 308 
 Dulcin, 462 
 Duodenal Catarrh, 677 
 Duotal, 291 
 Dutch Liquid, 261 
 Dyscrasiae, — See Cachexise, 635 
 Dysentery, 677 
 Dysmenorrhea, 679 
 Dyspepsia, 680 
 Dysphagia, 682 
 Dyspnea, 683 
 Dysuria, 683 
 
 Ear Affections, 684 
 
 Agents affecting, 52 
 Earache, — See Otalgia, 784 
 Eau Sedative, 145, 239 
 Ebullition, 564 
 
 Ecballium Elaterium, 309 
 
 Ecbolics, 58 
 
 Ecboline, 310 
 
 Ecchymosis, 684 
 
 Ecgonine, 277 
 
 Eclampsia, — See Puerp. Convulsions, 825 
 
 Ecthyma, 684 
 
 Ectropion, 684 
 
 Eczema, 685 
 
 Efflorescence, 558 
 
 Efflorescent Salts, List of, 589 
 
 Egg-albumen, 121 
 
 Egg-shell, 235 
 
 Egg, Yolk of, 121 
 
 Eggs as Food, 127 
 
 Eights, The Three, 849 
 
 Elastica, 308 
 
 Elaterin, 309 
 
 Elaterium, 309 
 
 Elder, 468 
 
 Elecampane, 352 
 
 Electuaries, 568 
 
 Electuary for Piles, 568 
 
 Elettaria repens, 248 
 
 Elixir, Aromatic, 205 
 
 McMunn's, 397 
 
 Simple, 205 
 
 of Vitriol, 104 
 
 Yvon's Hypnotic, 744 
 Elixiria, 569 
 Elm, Slippery, 519 
 Elutriation, 564 
 Ely's Cream Balm, 900 
 Emaciation, 687 
 Embrocation, 579 
 Emetics, 48 
 
 in Poisoning, 804 
 Emetine, 358 
 Emissions, 687 
 Emmenagogues, 49 
 
 Formulae for, 612 
 
 Pills, 591 
 Emollients, 50 
 Emphysema of Lungs, 687 
 Emplastra, 569 
 Empyema, 688 
 Emulsa, 570 
 Emulsification, 571 
 Emulsin, 99, 148, 442 
 Emulsions, 570 
 Encephaloma, — See Cancer, 637 
 
 Diagnosis of, 904 
 Endarteritis, — See Atheroma, 624 
 Endermic Method, 71 
 Endocarditis, 688 
 
 Diagnosis of, 904 
 Endometritis, 688 
 Enemata, 577, 689 
 
 Formulae for, 578, 689 
 Enepidermic Method, 72 
 Enteralgia,— -See Colic, Intestinal, 651 
 Enteric Fever, — See Typhoid, 861, 907 
 Enteritis, 689 
 
926 
 
 INDEX. 
 
 Entropion, 684 
 
 Enuresis, 690 
 
 Enzymes, 39 
 
 Eosote, 796 
 
 Epidermic Method, 72 
 
 Epididymitis, 690 
 
 Epilation, — See Tinea Circinata, 854 
 
 Epilepsy, 691 
 
 Diagnosis of, 905 
 Epispastics, 55 
 Epistaxis, 693 
 Epsom Salt, 372 
 Epulis, — See Teeth, 850 
 Equinia, — See Glanders, 708 
 Erections, 687 
 Ergot of Rye, 310 
 
 Antidotes and Antagonists, 813 
 
 of Corn, — See Ustilago, 526 
 Ergota, 310 
 Ergotin, 310 
 Ergotine, 310 
 Ergotinine, 310 
 Ergotism, 311 
 Ericolin, 325, 519 
 Erigeron, 313 
 Eriodictyon, 313 
 Errhines, 50 
 Eructations, 681, 702 
 Eruptions caused by Drugs, etc., 694 
 Erysipelas, 694 
 
 Toxin, 515 
 Erythema, 696 
 Erythrophloein, 250 
 Erythrophloeum Guinense, 250 
 Erythroretin, 452 
 Erythroxylon Coca, 230, 277 
 Escharotics, 50 
 Eserine, 421, 422 
 Esophageal Affections, 696 
 Essential Oils, 27 
 Ethene, 116 
 
 Chloride, 1 16 
 
 Dichloride, Il6 
 Ether, 112 
 
 Acetic, 113, 116 
 
 Chloric, 261 
 
 Chlorinated Muriatic, 261 
 
 Hydriodic, 1 1 3, 116 
 
 Hydrobromic, II 3, II 6, 117 
 
 Methylene-di-methyl, 256 
 
 Methylic. 1 16 
 
 Nitrous, 113, 116, 117 
 
 Petroleum, 216 
 Ethereal Oil, 113 
 
 Preparations, 565 
 Ethyl Acetate, 1 13 
 
 Alcohol, 112, 128 
 
 Aldehyde, 129, 411 
 
 Bromide, 1 1 3, 1 16 
 
 Carbamate, 256 
 
 Chloride, 116 
 
 Hydrate, 112, 1 28 
 
 Hydride, 116 
 
 Ethyl Hydrosulphide, 493 
 
 Iodide, 113 
 
 Nitrite, 113, 150 
 
 Oxide, 112 
 Ethylate of Sodium, 484 
 Ethylene Bichloride, 261 
 Ethylidene Chloride, 261 
 
 Oxide, 129 
 Ethylirtes Chloral-urethan, 255 
 Eucaine, 283 
 Eucalyptene, 314 
 Eucalyptol, 313 
 Eucalyptolen, 314 
 Eucalyptus, 313 
 Euchlorine, 267 
 Eudoxin, 219 
 Eugenia aromatica, 249 
 
 Jambolana, 363 
 Eugenin, 249 
 Eugenol, 249 
 Euonymin, 315 
 Euonymus, 315 
 Eupatorin, 315 
 Eupatorium, 315 
 Euphormol, 81 
 Euphrasia, 315 
 Euquinine, 271 
 Europhen, 357 
 Euthymol, 81 
 Evaporation, 564 
 
 Spontaneous, 564 
 Exalgin, 77, 80 
 
 Exanthemata, Diagnosis of, 906 
 Excipients, 571, 582, 587 
 Excitants, Cerebral, 43 
 
 Ciliary, 43 
 
 Motor, 57 
 Excoriation, — See Intertrigo, 746 
 Excretion, Agents affecting, 32, 45, 46, 59, 
 
 61, 63, 64 
 Exhaustion, 697 
 Exodyne, 77 
 Exophthalmos, 697 
 Exostosis, 697 
 Expectorants, 5 1 
 Explosive Compounds, 550 
 Expression, 559 
 Exsiccation, 558, 560 
 Extemporaneous Pharmacy, 554 
 Extract, Adrenal, 165 
 
 Bone Marrow, 160 
 
 Brain, 164 
 
 Goulard's, 433 
 
 Lymphatic, 166 
 
 Mammary Gland, 1 67 
 
 Meat, 122 
 
 Orchitic, 162 
 
 Ovarian, 166 
 
 Pancreatic, 166 
 
 Parotid, 166 
 
 Pineal, 164 
 
 Pituitary, 164 
 
 Pond's, 336 
 
INDEX. 
 
 927 
 
 Extract, Splenic, 166 
 
 Supra-renal, 165 
 
 Testicular, 156, 162 
 
 Thymus, 160 
 
 Thyroid, 157 
 
 Uterine, 167 
 Extracta, 572 
 
 Fluida, 573 
 Extractive, 573 
 Extracts, 572 
 
 Animal, 156 
 
 Distilled, 336 
 Eye, Agents affecting, 29, 31, 57, 58 
 
 Diseases, 698 
 
 Ointments, Formulae for, 654 
 
 Sensibility, Agents affecting, 31 
 
 Water, Formulae for, 654, 902 
 Eye -bright, 315 
 Eyelids, 698 
 
 Fabiana imbricata, 424 
 Face, 699 
 
 Face-ache, — See Neuralgia, 773, Tic Dou- 
 loureux, 854 
 Fainting, — See Syncope, 847 
 False Pains, 699 
 Farcy, 708 
 Fat, — See Obesity, 779 
 
 Hog, no 
 
 Wool, in 
 Fatigue, — See Exhaustion, 697 
 Fats and Oils, 26 
 
 as Antidotes, 805 
 Favus, — See Tinea Favosa, 855 
 Febricula, — See Fever, Simple, 701 
 Febrifuge, 272 
 Febrinol, 78 
 Feet, 699 
 
 Fehling's Solution, 296, 869 
 Fel Bovis, 316 
 
 Tauri, 316 
 Felon, — See Onychia, 780 
 Fennel, 323 
 Fermentation, 39 
 
 Lactic, 463 
 Ferments, 28, 39 
 
 Agents affecting, 39 
 Fern, Male, 203 
 
 Marginal Shield, 203 
 Ferratin, 319 
 
 Ferrier's Snuff, Formula, 641, 643 
 Ferrocyanide of Potassium, 99, 101 
 
 as an Antidote, 807 
 Ferrum, 316 
 
 Dialysatum, 319, 559 
 
 Reductum, 316 
 Ferula fcetida, 201 
 
 Galbaniflua, 325 
 
 Sumbul, 499 
 Fever, 699 
 
 Bilious Remittent, Diagnosis, 907 
 
 Cerebro-spinal, 764 
 
 Fever, Enteric, — See Typhoid, 861, 907 
 
 Hay, 715 
 
 Hectic, 723 
 
 Hemoglobinuria 726 
 
 Intermittent, 744 
 
 Miliary, 769 
 
 Milk, — See Lactation, 750 
 
 Pernicious, — See Intermittent Fever, 
 Remittent Fever. 
 
 Puerperal, 826 
 
 Relapsing, 829 
 
 Remittent, 829 
 
 Diagnosis of, 907 
 
 Rheumatic, 830 
 
 Scarlet, 835 
 
 Diagnosis of, 906 
 
 Simple, 701 
 
 Spotted, — See Typhus Fever ; also 
 Meningitis, Cerebro-spinal. 
 
 Surgical, 847 
 
 Traumatic, — See Surgical Fever, 847 
 
 Tropical, 701 
 
 Typhoid, 861 
 
 Diagnosis of, 907 
 
 Typho-malarial, — See Typhoid, 861 
 
 Typhus, 863 
 
 Diagnosis of, 907 
 
 Yellow, 881 
 
 Diagnosis of, 907 
 Fibrin, 28, 120, 122 
 Ficus (Fig), 323 
 Filix Mas, 203 
 Filtering paper, 560 
 Filtration, 560 
 Fir, Balsam of, 503 
 
 Scotch, 431, 504 
 
 Silver, 503 
 Firs, 430 
 Fish-berries, 424 
 Fish-poison, Antidotes, etc., 813 
 Fistula, 702 
 
 Fits, — See Apoplexy, Convulsions, Epi- 
 lepsy, Hysteria, Syncope. 
 Fixed Oils and Fats, 26 
 Flatulence, 702 
 Flavoring Agents, 582 
 Flaxseed, 368 
 Flea-bane, 313 
 
 Fleming's Tincture of Aconite, 107 
 Flooding, — See Hemorrhage Post-partum, 
 
 Menorrhagia, Metrorrhagia. 
 Fluavil, 309 
 Fluid, Antiseptic, 508 
 
 Condy's, 374 
 
 Disinfecting, 527 
 
 Extract, Aromatic, 277 
 
 Extracts, 573 
 Flushing-heats, 703 
 Fly-agaric, 1 18 
 Fceniculum, 323 
 Fomentation, 579, 820 
 Food, Horlick's, 153 
 
 Mellin's, 153 
 
928 
 
 INDEX. 
 
 Food, Parrish's, 419 
 
 Foods, 61, 124, — also Albumin, Amylum. 
 
 Producing Eruptions, 694 
 Foreign Bodies, 620, 703 
 Formaldehyde, 1 30, 324 
 Formalin, 130, 324 
 Formamide, 259 
 Formulae, Hypodermic, 897 
 Formyl Iodide, 353 
 Fotus, 579 
 
 Fowler's Solution, 198 
 Fox-glove, 300 
 Fractures, 703 
 Franciscea uniflora 374 
 Frangula, 324 
 Frangulin, 324 
 Frankincense, 503 
 Franklinite, 527 
 Fraxin, 377 
 Fraxinus Ornus, 377 
 Freckles, 703 
 Friar's Balsam, 216 
 Fuchsin, 325 
 Fucus Vesiculosus, 325 
 Fungi, Antidotes, etc., 813 
 Furuncle, — See Boils, 626 
 Fusel Oil, 130 
 Fusion, 560 
 
 Gaduin, 381 
 
 Gadus Morrhua, 381 
 
 Galactagogues, 51 
 
 Galactophyga, 52 
 
 Galbanum, 325 
 
 Galena, 433 
 
 Galla, 95, 325 
 
 Gallipots, 602 
 
 Gallobromol, 97 
 
 Gall-stones, — See Calculi, Biliary, 636 
 
 Gallus Bankiva, 12 1 
 
 Gamboge, 238 
 
 Antidotes and Antagonists, 813 
 Gangrene, 704 
 
 of Lungs, 758 
 Garcinia Hanburii, 238 
 
 mangostana, 377 
 Garfield Tea, 900 
 Gargarisma, 575 
 Gargles, Formulas for, 576, 675, 795, 
 
 854 
 Garlic, 140 
 
 Gas, Illuminating, — Antidotes, etc., 813 
 Gaseous Preparations, 577 
 Gases, Agents affecting, 41, 44 
 
 Antidotes and Antagonists, 813 
 Gastralgia, 704 
 Gastric Dilatation, 705 
 
 Fever, — See Fever Simple, Gastritis, 
 Remittent Fever, Typhoid Fever. 
 
 Pain, 61, 704 
 
 Sedatives, 49, 61 
 
 Tonics, 63 
 
 Gastric Ulcer, 707 
 
 Vomiting, Diagnosis, 907 
 Gastritis, 706 
 Gastrodynia, 704 
 Gaultheria, 325, 464 
 Gaultherilene, 326 
 Gauze of Carbolic Acid, 84 
 Gelatin, 121, 126 
 
 as an Antidote, 805 
 
 Capsules, 566 
 Gelsemine, 326 
 Gelsemium, 326 
 
 Antidotes and Antagonists, 813 
 Generative System, Agents affecting, 31, 
 
 39, 58 
 Genitive Case-endings, 896 
 Gentian, 327 
 Gentianin, 327 
 Gentopicrin, 327 
 Geranium, 96, 328 
 Gigartina, 121 
 Gin, 131 
 Ginger, 530 
 Glanders, 708 
 
 Toxin, 518 
 Glandular Affections, 708 
 
 Extracts, 156 
 Glass, Antidotes for, 813 
 
 Soluble, 438, 481 
 Glauber's Salt, 484 
 Glaucoma, 709 
 Gleet, 709 
 Globulins, 28 
 Glonoin, 150 
 Glossitis, 710 
 Glottis, Edema of, 710 
 Gluco-pepsine, 413 
 Glucose, 462 
 Glucosides, 23 
 Glucusimide, 461 
 Glusidum, 461 
 Gluten, 28, 122 
 
 as an Antidote, 805 
 Glutol, 324 
 Glycerin, 328 
 
 Preparations, 565 
 Glycerites, 121, 329, 576 
 Glycero- phosphates, 421 
 Glyceryl, 395 
 
 Borate, 81 
 
 Trinitrate, 1 50 
 Glycocholate, Sodium, 316 
 Glycocoll, 417 
 Glycogen, 153 
 
 Agents affecting its production, 53, 54 
 Glyconin, 121 
 
 Emulsion, 381 
 Glycosuria, Temporary, 869 
 Glycozone, 408 
 Glycyrrhetin, 330 
 Glycyrrhiza, 330 
 Glycyrrhizin, 330 
 Glycyrrhizinum Ammoniatum, 330 
 
INDEX. 
 
 929 
 
 Glymol, 416 
 Gnoscopine, 397 
 Goa-powder, 268 
 Godfrey's Cordial, 399 
 Goitre, 710 
 Gold, 205 
 
 Antidotes and Antagonists, 813 
 
 " Bichloride," 2IO 
 
 Bromide, 206 
 
 Chloride, 206 
 
 Cure, Keeley's, 138, 210, 900 
 Golden Discovery, Pierce's, 901 
 
 Seal, 346 
 Gonorrhea, 71 1 
 Gossypii Radicis Cortex, 331 
 Gossypium, 331 
 Goulard's Cerate, 433 
 
 Extract, 433 
 Gout, 713 
 
 Diagnosis of, 905 
 Granatum, 96, 332 
 
 Granular Lids, — See Conjunctivitis, Oph- 
 thalmia. 
 Granulation, 560 
 Granule, 586 
 Grape, Oregon, 218 
 Grass, Ribbed, 432 
 
 Worm, 487 
 Gravel -root, 315 
 
 Graves' Disease, — See Exophthalmos, 697 
 Gray Powder, 339 
 Griffith's Mixture, 316 
 Grindelia, ^^^ 
 Grindeline, 333 
 Grippe, — See Influenza, 741 
 Guaiac, 334 
 Guaiacol, 29 1, 294 
 Guarana, 229, 335 
 Guaranine, 229, 231, 335 
 Gum Arabic, 76, 518 
 
 as an Antidote, 806 
 
 Kauri, 493 
 
 Sweet, 492 
 Gumboil, — See Gums, 714 
 Gum-resins, 26 
 Gums, 22, 714 
 Gum-tree, Blue, 313 
 Gun-cotton, 153, 331 
 Gunjah, 242 
 Gurjun Balsam, 335 
 Gutta, 309 
 Guttae (Drops), 535 
 Gutta-percha, 309 
 Gynocardia odorata, 252 
 Gypsum, 234 
 
 Hematoxylin, 336 
 Haematoxylon, 96, 336 
 Hagenia abyssinica, 299 
 Hager's Tincture, 271 
 Hair, 611, 715 
 
 Washes, Formulae, 611, 715 
 59 
 
 Hair-tonic, 611, 715 
 
 Haller's Dictum, 19 
 
 Halogen Elements, 266 
 
 Hamamelin, 336 
 
 Hamamelis, 96, 336 
 
 Hamburg Tea, 900 
 
 Hamlin's Wizard Oil, 900 
 
 Hands, — See Chapped Hands, 645 
 
 Hashish, 242 
 
 Haustus, 576 
 
 Haw, Black, 525 
 
 Hawthorn, 615 
 
 Hayah, 250 
 
 Hayden's Viburnum Compound, 525 
 
 Hay-fever, 715 
 
 Head-ache, Bilious Sick, 716 
 
 Congestive, 717 
 
 Nervous, 717 
 Hearing, 52 
 Heart Affections, 719 
 
 Dilated, 720 
 
 Fatty, 720 
 
 Hypertrophied, 720 
 
 Palpitation, 721 
 
 Valvular Disease, 721 
 Heartburn, — See Pyrosis, 828 
 Heart' s-ease, 525 
 Heat-stroke, 722 
 Hectic Fever, 723 
 Hedeoma, 337 
 Helenin, 352 
 Hellebore, 337, 521 
 
 American, 521 
 
 False, in 
 
 Swamp, 521 
 Helleborei'n, 337 
 Helleborin, 337 
 Helleborus, 337 
 Helmbold's Buchu, 900 
 Hematemesis, 723 
 Hematics, 61 
 Hematocele, Pelvic, 723 
 Hematuria, 724 
 Hemeralopia, 724 
 Hemicrania, 725 
 Hemiopia, 726 
 Hemiplegia, 726 
 Hemlock, 286 
 
 Spruce, 431 
 Hemoglobinuric Fever, 726 
 Hemoptysis, 727 
 Hemorrhage, 728 
 
 Intestinal, 729 
 
 Post-partum, 729 
 Hemorrhagic Diathesis, 728 
 Hemorrhoids, 730 
 Hemostatics, 63 
 Hemp, 241 
 
 Canadian, 185, 241 
 
 Indian, 241 
 Henbane. 348 
 Hepar Sulphuris, 496 
 Hepatalgia, 731 
 
930 
 
 INDEX. 
 
 Hepatic Abscess, 733 
 
 Cirrhosis, 731 
 
 Congestion, 731 
 
 Depressants, 52 
 
 Diseases, 733 
 
 Stimulants, 53 
 
 Vomiting, Diagnosis, 907 
 Hepatitis, 733 
 Hernia, 734 
 Heroine, 399 
 Herpes, 734 
 
 Zoster, 735 
 Hesperidin, 204, 367 v 
 
 Heuchera, 96 
 Hevea, 308 
 
 Hewitt's Method of Anesthesia, 1 17 
 Hexylamine, 382 
 Hiccough, 735 
 
 Hip-joint Disease, — See Coxalgia, 661 
 Hive Mixture, 168, 475 
 
 Syrup, 168 
 Hives, — See Urticaria, 870 
 Hoang Nan, 338 
 Hoarseness, — See Aphonia, 617 
 Hodgkin's Disease, 760 
 Hoffmann's Anodyne, 113, 118 
 Hoff's Malt Extract, 153 
 Hog, 413 
 Holloway's Ointment, 900 
 
 Pills, 900 
 Holocaine, 283 
 Homatropine, 213 
 Homeopathic Practices, 547 
 Homococamine, 277 
 Homoisococamine, 277 
 Honduras Bark, 250 
 Honey, 378 
 Honeys (Mellita), 580 
 Hong-Pang Chong, 453 
 Hooper's Female Pills, 591 
 Hope's Mixture, 672 
 Hops, 338 
 
 Hordeolum, — See Eyelids, 698 
 Hordeum distichum, 152 ■ 
 Horehound, 377 
 Horlick's Food, 153 
 Horse-nettle, 486 
 Hostetter's Bitters, 900 
 Housemaid's Knee, — See Bursitis, 635 
 Humulus, 338 
 
 Hunger, — See Appetite, 618 
 Hunyadi Water, 657 
 Huxham's Tincture of Bark, 27 1 
 Hwang-Nao, 338 
 Jiydragogue Diuretics, 46 
 
 Purgatives, 42 
 Hydrangea, 339 
 Hydrargyrism, 342 
 Hydrargyrum, 339 
 
 Ammoniatum, 340 
 
 Antidotes and Antagonists, 81 2 
 
 cum Creta, 339 
 Hydrastin, 218, 346 
 
 Hydrastine, 346 
 
 Hydrastinine, 346 
 
 Hydrastis, 346 
 
 Hydrates, — See the titles of their metallic 
 
 constituents. 
 Hydrides, — See the titles of their metallic 
 
 constituents. 
 Hydrobromates, — See the titles of their 
 
 basic constituents. 
 Hydrocele, 736 
 Hydrocephalus, 736 
 
 Acute, — See Meningitis Tubercular. 
 Hydrochlorates, — See the titles of their 
 
 basic constituents. 
 Hydrocotarnine, 397 
 Hydrocotyle, 348 
 Hydrogen Carbonate, 91 
 
 Dioxide, 408 
 
 Peroxide, 408 
 
 Sulphide, 496 
 
 Sulphuretted, 496 
 Hydroleine, 381 
 Hydronaphtol, 387 
 Hydrophobia, 736 
 
 Toxin, 517 
 Hydroquinone, 272, 273, 519 
 Hydroscopic Substances, 558 
 Hydrothorax, 736 
 Hydroxy methane, 130 
 Hygroscopic Bodies, 558 
 Hyoscine, 348 
 Hyoscyamine, 348 
 Hyoscyamus, 348 
 
 Antidotes and Antagonists, 813 
 Hyperidrosis, — See Perspiration, 792 
 Hypnal, 171, 255 
 Hypnone, 1 30, 256 
 Hypnotics, 54, 256, 744 
 Hypochlorites, Antidotes, etc., 813 
 Hypochondriasis, 737 
 Hypodermic Formulae, 897 - 
 
 Injections, 69 
 
 Method, 69 
 
 Solutions, 71, 897 
 
 Tablets, 71 
 Hypophosphites, 418, — See also the titles 
 
 of their basic constituents. 
 Hyposulphites, 105, — See also the titles of 
 their basic constituents. 
 
 as Antidotes, 807 
 Hysteria, 737 
 
 Diagnosis of, 905 
 
 Ice, 188 
 
 Iceland Moss, 121, 152 
 
 Ichthyocolla, 121 
 
 Ichthyol, 496, 498 
 
 Ichthyosis, 738 
 
 Icterus, — See Jaundice, 748 
 
 Ignatia, 351 
 
 Ignition, 560 
 
INDEX. 
 
 931 
 
 Ileus, — See Intestinal Obstruction, 746 
 
 Ilex Paraguayensis, 229 
 
 Illicium, 352 
 
 Impetigo, 738 
 
 Impotence, 738 
 
 Incineration, 561 
 
 Incompatibility, 548 
 
 Chemical, 548 
 
 Dangers of, 552 
 
 Pharmaceutical, 55 J 
 
 Rules for avoiding, 552 
 
 Therapeutical, 55 2 
 Incompatible Substances, 553 
 India-rubber, 308 
 Indian Corn, 152, 526 
 
 Hemp, 241 
 
 Poke, 521 
 
 Tobacco, 370 
 Indigestion, — See Dyspepsia, 680 
 Indigo, Wild, 212 
 Inflammation, 739 
 Influenza, 741 
 Infusa (Infusions), 576 
 Ingluvin, 413 
 Inhalations, 577 
 Injection Brou, 578 
 Injections, 577 
 
 Antiseptic, 346 
 
 Formulae, 578, 712 
 
 Hypodermic, 69, 897 
 
 Parenchymatous, 71 
 
 Urethral, 578, 712 
 
 Vaginal, 578 
 Injuries, — See Bruises, Burns, Ecchymosis, 
 
 Fractures, Sprains, Wounds. 
 Inoculation, 72 
 Inosit, 463 
 Insanity, 742 
 Insolation, — See Heatstroke, 722 ; also 
 
 Sunstroke, 846 
 Insoluble Salts, 549 
 Insomnia, 743 
 
 Integument, Absorption by, 71 
 Intemperance, — See Alcoholism, Delirium 
 
 Tremens, Opium Habit. 
 Intermittent Fever, 744 
 Intertrigo, 746 
 Intestinal Astringents, 55 
 
 Diseases, — See Colic, Constipation, 
 Diarrhea, Duodenitis, Dysentery, 
 Enteritis, Hemorrhoids, Hernia, 
 Intestinal Obstruction, Intussus- 
 ception, Typhlitis, Tabes Mesen- 
 terica, Worms. 
 
 Obstruction, 746 
 
 Parasites, — See Worms, 879 
 Intussusception, 747 
 Inula, 352 
 Inulin, 196, 352 
 Inunction, 72 
 Iodides, 352 
 Iodine, 352 
 
 as an Antidote, 807 
 
 Iodine, Antidotes and Antagonists, 814 
 
 Carbolated, 352 
 
 Disulphide, 496 
 Iodism, 354 
 Iodized Cotton, 724 
 
 Phenol, 352 
 Iodoform, 353 
 Iodol, 358 
 Iodomuth, 219, 358 
 Iodophen, 358 
 Iodothyrin, 159 
 Iodum, 352 
 Ipecacuanha, 358 
 
 Antidotes and Antagonists, 814 
 Ipomcea Jalapa, 362 
 Iridin, 361 
 Iris, 361 
 Irish Moss, 1 21 
 Irisin, 361 
 Iritis, 747 
 Iron, 316 
 
 as an Antidote, 807 
 
 Antidotes for, 814 
 
 Dialyzed, 319, 559 
 
 and Manganese, 374 
 
 Pills, 591 
 Irritability, 747 
 Irritants, Cutaneous, 55 
 Ischuria, — See Urinary Disorders, 867 
 Isinglass, 1 21 
 
 Isobutyl-orthocresol Iodide, 357 
 Isococamine, 277 
 Isonandra Gutta, 309 
 Iso-naphtol, 387 
 Itch, — See Scabies, 834 
 Itching, — See Lichen, Prurigo, Pruritus, 
 
 Pediculi, Scabies, Urticaria, etc. 
 Itrol, 196 
 Ivy, Poison, 454 
 
 Jaborandi, 426 
 
 Jaboridine, 426 
 
 Jaborine, 426 
 
 Jalap, 362 
 
 Jalapin, 362, 474 
 
 Jambul, 363 
 
 James' Powder, 168 
 
 Jamestown Weed, 488 
 
 Jamun, 363 
 
 Japaconitine, 106 
 
 jasmine, Yellow, 326 
 
 Jateorhiza palmata, 238 
 
 Jaundice, 748 
 
 Javelle Water, Antidotes, etc., 813 
 
 Jeaunel's Antidote, 808 
 
 Jequirity, 75 
 
 Jervine, 521 
 
 Joint Affections, 748 
 
 Juglans, 363 
 
 Juniper, 363 
 
 Juniperin, 363 
 
 Juniperus communis, 363 
 
932 
 
 INDEX. 
 
 Juniperus Oxycedrus, 364 
 Sabina, 460 
 Virginiana, 460 
 
 Kairin, 273 
 
 Kairolin, 273 
 
 Kalium, 437 
 
 Kalmia latifolia, 378 
 
 Kamala, 364 
 
 Kaputin, 78 
 
 Kavahin, 364 
 
 Kava-kava, 364 
 
 Kawin, 365 
 
 Keeley Gold Cure, 610, 900 
 
 Kefir, 124 
 
 Keratitis, 749 
 
 Kermes Mineral, 168 
 
 Ketone, 130 
 
 Kidneys, Diseases of, — See Albuminuria, 
 Bright' s Disease, Calculi, Colic Renal, 
 Diabetes, Dropsy, Gout, Hematuria. 
 
 Kino, 96, 365 
 
 Kinoin, 365 
 
 Kino-red, 365 
 
 Kinovin, 270 
 
 Koch s Lymph, 511 
 
 Kola, 230 
 
 Kolanin, 230 
 
 Kombe arrow-poison, 491 
 
 Koomiss, 123 
 
 Koussin, 299 
 
 Kousso, 299 
 
 Krameria, 96, 365 
 
 Kumysgen, 123 
 
 Kumyss, 123, 131 
 
 Kurung Oil, 437 
 
 Labarraque's Solution, 46, 266 
 
 Antidotes, etc., 813 
 Labor, 749 
 Lac Sulphuris, 495 
 Lactation, 750 
 Lactocin, 365 
 Lactopeptine, 413 
 Lactophenin, 416 
 Lactopicrin, 365 
 Lactose, 463 
 Lactuca virosa, 365 
 Lactucarium, 365 
 Lactucerin, 365 
 Lactucin, 365 
 
 Lactyl-para-phenetidin, 416 
 Ladies' Slipper, 299 
 Lady Webster's Pill, 142 
 La Fayette's Mixture, 289 
 Lallemand's Specific, 714 
 Lanolin, ill 
 Lanthopine, 397 
 Lapathin, 459 
 Lappa, 366 
 Larch, 1 18, 503 
 Lard, no 
 
 Lard, Benzoinated, no, 216 
 
 Oil, no 
 Largin, 196 
 Larix Europsea, 503 
 Laryngismus Stridulus, 751 
 Laryngitis, 751 
 Laryngotomy, 753 
 Latin in Prescriptions, 541 
 
 Genitive Case-endings, 896 
 
 Numerals, 895 
 
 Participles, 896 
 
 Phrases and Terms, 541, 883, 897 
 Table of, 883 
 
 Prepositions, 897 
 
 Pronunciation, 896 
 
 Verbs, 896 
 Laudanine, 397 
 Laudanosine, 397 
 Laudanum, 397 
 Laurel, Cherry, 99 
 
 Mountain, 378 
 Laurocerasus, 99 
 Lavandula, 366 
 Lavender, 366 
 Laveran's Formula, 276 
 Laville*s Gout Mixture, 285, 900 
 Laxatives, 41, 593 
 Lead, 433 
 
 Colic, 652 
 
 Plaster, 433 
 
 Salts, — Antidotes, etc., 814 
 
 Sugar of, 433 
 
 Water, 433 
 
 and Laudanum, 435 
 
 White, 433 
 Lecithin, 121, 163 
 Leek, 140 
 Lemon, 367 
 
 Lentigo, — See Freckles, 703 
 Leopard's Bane, 196 
 Leprosy, 753 
 Leptandra, 366 
 Leptandrin, 366 
 Lettuce, 365 
 Leucocythemia, 754 
 Leucolin, 253 
 
 Leucoma, — See Corneal Opacities, 658 
 Leucomaines, 23 
 Leucorrhea, 754 
 Leukemia, 754 
 Levigation, 564 
 Levulose, 378, 463 
 Lice, — See Pediculi, 790 
 Lichen, 755 
 Lichenin, 152 
 Licoperdon giganteum, 367 
 Lignum Vitee, 334 
 Lily-of-the-Valley, 288 
 Lily, Water, 395 
 
 Pond, 96 
 Lime, 234, 367 
 
 Antidotes and Antagonists, 814 
 
 Chlorinated, 266 
 
INDEX. 
 
 933 
 
 Lime, Kinovate, 270 
 
 Sulphurated, 496 
 
 Water, 235 
 Limon, 367 
 Linimenta, 578 
 
 Liniments, Formulae, 235, 369, 579 
 Linseed, 368 
 Lint, Boracic, 81 
 Linum, 368 
 
 Lips, — See Chapped Lips, 645 
 Lip-salve, Red, 507 
 Liquid-ambar orientalis, 492 
 Liquids, Normal, 575 
 Liquores, 579 
 Liquorice Root, 330 
 
 Wild, 75 
 Listerine, 82 
 Litharge, 433 
 Lithemia, 755 
 Lithium, 369 
 
 Benzoate, 216 
 Lithontriptics, 56, 237 
 Liver, — See Hepatalgia, etc., 731 
 Liver of Sulphur, 496 
 Lixiviation, 561 
 Lobelacrin, 370 
 Lobelia, 370 
 
 Antidotes and Antagonists, 814 
 Lobelin, 370 
 Lobeline, 370 
 Lochia, — See Labor, 749 
 Lock-jaw, — See Tetanus, 179, 852 
 Locomotor Ataxia, 756 
 Loeffler's Solution, 675 
 Loganin, 388 
 Logwood, 96, 336 
 Lotion, 579 
 
 Black, of Mercury, 341 
 
 Boracic, 81 
 
 Evaporating, 741 
 
 Yellow, of Mercury, 341 
 Loxopterygium Lorentzii, 204 
 Lozenges, 600 
 Lugol's Solution, 352 
 Lumbago, 757 
 
 Lumbrici, — See Worms, 36, 333, 879 
 Lung Diseases, 758 
 
 Gangrene of, 758 
 Lupulin, 338 
 Lupuline, 338 
 Lupus, 758 
 Lycetol, 430 
 Lycopodium, 371 
 Lyctonine, 106 
 Lymphadenoma, 760 
 Lymphangitis, 760 
 Lymphatic Extract, 166 
 Lysidin, 430 
 Lysol, 85, 90 
 
 Mace, 384 
 Maceration, 561 
 Macis, 384 
 
 Macrotin, 268 
 
 Magendie's Solution, 399, 898 
 
 Magenta, 325 
 
 Magma. 562 
 
 Magnesia, 372 
 
 as an Antidote, 806 
 Magnesium, 372 
 
 Borocitrate, 82, 637 
 
 Silicate, 481 
 Magnolia, 374 
 Magnolin, 374 
 Maize, 152, 154, 462, 526 
 Malakin, 78, 465 
 Malaria, 760 
 Male Fern, 203 
 Mallein, 518 
 
 Mallotus philippinensis, 364 
 Malt, 152 
 
 Extract, 152, 155 
 Hoff s, 153 
 Maltum, 152 
 Mammary Abscess, 605 
 
 Gland Extract, 167 
 Manaca, 374 
 Mandrake, 436 
 Manganauro, 206 
 Manganese, 374 
 Mangano-ferri Peptonatus, 374 
 Manganum, 374 
 Mangifera indica, 376 
 Mango, 376 
 Mango-fruit, 377 
 Mangosteen, 377 
 Mania, 761 
 
 Puerperal, 827 
 Manna, 377 
 Mannit, 377 
 Mannite, 332 
 Manzanita, 519 
 Marasmus, — See Atrophy, Emaciation, 
 
 Tabes Mesenterica. 
 Marc, 574 
 Margarin, no, 381 
 Marginal Shield Fern, 203 
 Marigold, 238 
 Marjoram, Wild, 407 
 Marrubiin, 377 
 Marrubium, 377 
 Marsh-mallow, 142 
 Marsh Rosemary, 96 
 Mass, Blue, 339 
 
 of Copaiba, 289 
 
 of Ferrous Carbonate, 316 
 
 of Mercury, 339 
 
 Vallet's, 316 
 Massae, 580 
 Mastic, 377 
 Mastiche, 377 
 Mastichin, 377 
 Mastitis, 762 
 Mastodynia, 762 
 
 Masturbation, — See Emissions, 687 ; Sper- 
 matorrhea, 841 
 
934 
 
 INDEX. 
 
 Mate, 229 
 
 Materia Medica, 17, 75 
 
 Matico, 377 
 
 Matricaria, 377 
 
 May Apple, 436 
 
 McMunn's Elixir of Opium, 397 
 
 Meadow Anemone, 443 
 
 Meadow Saffron, 283 
 
 Measles, 763 
 
 Diagnosis of, 906 
 
 False, — See Roseola, 834 
 
 Temperature in, 852 
 Measures, Antagonistic, ^ 
 
 Antidotal, 36 
 
 Apothecaries', 533 
 
 Approximate, 535 
 
 British Imperial, 534 
 
 Domestic, 535 
 
 Metric, 534 
 
 and Weights, 532, 910 
 
 Wine, 533 
 Meat Diet, 125 
 
 Extracts, 122 
 
 -juices, 122 
 Meconidine, 397 
 Meconin, 397 
 Meconoiosin, 397 
 Medicines, Administration of, 67 
 
 Classification of, 29 
 
 Dosage of, 72 
 
 Patent, 899 
 Medulline, 164 
 Meerschaum, 481 
 Mel, 378 
 Melachol, 419 
 
 Melaleuca Leucadendron, 233 
 Melancholia, 763 
 
 Puerperal, 827 
 Melia Azedarach, 211 
 Melissa, 378 
 Mellin's Food, 153 
 Mellita, 580 
 
 Meniere's Disease, — See Vertigo, 875 
 Meningitis, Cerebral, 764 
 
 Cerebro-spinal, 764 
 
 Spinal, 765 
 
 Tubercular, 766 
 Menispermin, 424 
 Menispermum, 378 
 
 Cocculus, 424 
 Menopause, — See Climacteric, 650 
 Menorrhagia, 766 
 Menstrual Disorders, 767 
 Menstruum, 561 
 Mentagra, 767 
 Mentha arvensis, 379 
 
 canadensis, 379 
 
 piperita, 379 
 
 viridis, 380 
 Menthol, 27, 379 
 Mercaptan, 493 
 Mercaptol, 493 
 Mercauro, 206, 2IO 
 
 Mercurio- vegetal, 374 
 Mercury, 339 
 
 Antidotes and Antagonists, 812, 814 
 
 Vegetable, 374 
 Mesenteric Disease, — See Tabes Mesen- 
 
 terica, 849 
 Metabolism, Agents affecting, 30 
 Metadioxybenzol, 449 
 Metallic Salts, Antidotes, etc., 814 
 Metamorphosis, Destructive, 45 
 Methacetin, 416 
 Methane, 1 16 
 Methene Chloride, 1 16 
 Methol, 130 
 Methyl-acetanilid, 77 
 Methyl Alcohol, 116, 130 
 
 Bromide, 116 
 
 Chloride, 1 16, 261 
 
 Bichlorinated, 260 
 
 Coniine, 286 
 
 Creosol, 291 
 
 Ether, 116 
 
 Ether of Protocatechuic Aldehyde, 
 521 
 
 Hydrate, 130 
 
 Pyrocatechin, 291 
 
 Salicylate, 326, 465 
 
 Terchloride, 260 
 Methylal, 116, 256 
 Methylated Spirit, 130 
 Methylene Bichloride, 262 
 
 Blue, 380 
 Methylene-dimethyl Ether, 256 
 Methysticin, 364 
 Metric Prescriptions, 544 
 
 System of Weights, etc., 534 
 
 Table for Conversions, 91 1 
 Metritis, Acute, 767 
 Metrorrhagia, 768 
 Mezcaline, 226 
 Mezereon, 381 
 Mezereum, 381 
 
 Antidotes and Antagonists, 815 
 Mica Panis, 588 
 Microbe-killer, 901 
 Microbes, Agents affecting, 38, 46 
 
 in Water, 188 
 Migraine, — See Hemicrania, 725 
 Migranin, 78, 171 
 Miliaria, 768 
 Miliary Fever, 769 
 Milk as an antidote, 805 
 
 as a food, 123, 128; See also Aga- 
 lactia, 609, and Lactation, 750 
 
 of Asafetida, 202 
 
 Condensed, 123 
 
 Desiccated, 123 
 
 Papaw, 414 
 
 Peptonized, 123 
 
 Sugar of, 463 
 
 of Sulphur, 495 
 
 Substances excreted in, 75° 
 Milk-fever, — See Lactation, 750 
 
INDEX. 
 
 935 
 
 Mindererus, Spirit of, 145 
 Mineral Green, 199 
 
 Waters, 91, 185 
 Mint, 380 
 
 Miscarriage, — See Abortion, 604 
 Mistletoe, 525 
 Misturae, 580 
 Mixture, A. C. E., 114 
 
 Antimonial and Saline, 741 
 
 Basham's, 318, 676 
 
 Bismuth, for Children, 584 
 
 Brown, 330 
 
 Chalk, 235 
 
 Clarke's, 900 
 
 Copaiba, Compound, 289 
 
 Cough, Formulae, 661, 763, 794, 
 
 799 
 
 Coxe's Hive, 168, 475 
 
 Diarrhea, 399 
 
 Ferro-saline, 319 
 
 Griffith's, 316 
 
 Hope's, 672 
 
 Iron, Aromatic, 319 
 Compound, 316 
 Laxative, 319 
 
 Lafayette's, 289 
 
 Laville's, 285, 900 
 
 Liquorice, Compound, 330 
 
 Magnesia and Asafetida, 202, 372 
 
 Nussbaum's, 1 14 
 
 Potassium Citrate, 438 
 
 Quinine, 584, 746 
 
 Rhubarb and Soda, 452 
 
 Saline, 741 
 
 Schleich's, 114 
 
 Scudamore's, 714 
 
 Squibb' s, 399 
 
 Vienna, 1 14 
 Mixtures, 580 
 
 Anesthetic, 1 14 
 
 Compounding of, 583 
 
 Substances suitable to, 580 
 Moccasin-plant, 299 
 Molasses, 463 
 Mole, — See Nevus, 777 
 Mollities Ossium, — See Bone Diseases, 
 
 627, Rachitis, 828 
 Monk's-hood, 106 
 Monsel's Solution, 318 
 Moonseed, Canadian, 378 
 Morbilli, — See Measles, 763 
 Morphine, 396, 398, 402 
 
 and Atropine, 407, 898 
 
 Antidotes and Antagonists, 815 
 
 Habit, 781 
 
 Tests for, 400 
 Morrhuae Oleum, 38 1 
 Morrhuine, 382 
 Morrison's Pills, 238, 901 
 Moschus, 383 
 Mosquitoes, 845 
 Motor Depressants, 56 
 
 Excitants, 57 
 
 Mouth, Absorption by, 67 
 
 Diseases, — See Aphthae, Cancrum 
 Oris, Gums, Parotitis, Ptyalism, 
 Stomatitis, Toothache, Tongue. 
 
 Washes, Formulae, 715 
 Mucilages, 584 
 Mucilagines, 584 
 Mucilaginous Bodies, 28 
 Mucus in Urine, Test for, 870 
 Mullein, 524 
 
 Mumps, — See Parotitis, 789 
 Muscae Volitantes, 769 
 Muscarine, 119 
 
 Antidotes and Antagonists, 815 
 Muscular Disorders, — See Atrophy, Chorea, 
 Hydrophobia, Laryngismus, Lumbago, 
 Myalgia, Pleurodynia, Rheumatism, 
 Tetanus, Torticollis. 
 Mushrooms, Antidotes, etc., 815 
 Musk, 383 
 Mustard, 481 
 Myalgia, 769 
 Mydriasis, 57, 214 
 Mydriatics, 57 
 Myelitis, 769 
 Mykose, 310 
 Myopia, 770 
 Myotics, 58 
 Myrcia, 384 
 Myrica, 96 
 
 cerifera, 251 
 Myricin, 251 
 Myristica, 384 
 Myristicol, 384 
 Myronate, Potassium, 482 
 Myrosin, 481 
 Myrrh, 385 
 Myrrhin, 385 
 Myrrhol, 385 
 Myrtle, 96, 251, 386 
 Myrtol, 386 
 Myrtus communis, 386 
 
 Chekan, 386 
 Myxedema, 770 
 
 Nails, Ingrowing, 770 
 Napelline, 106, 107 
 Naphtalene, 386 
 Naphtalin, 273, 386 
 Naphtol, 387 
 
 Camphorated, 387, 388 
 Narceine, 397, 403 
 Narco-hypnotics, 54 
 Narcosis, 401 
 Narcotics, 58 
 
 Antidotes and Antagonists 815 
 Narcotine, 396, 400, 403 
 Nasal Affections, 770 
 Natrium, 483 
 Nausea, 771 
 Necrosis, 771 
 
936 
 
 INDEX. 
 
 Nectandra, 412 
 
 Nepenthe, 399 
 
 Nephritis, Acute, 903, — See also Bright' s 
 Disease, 628 
 
 Nervous Affections 771 
 
 Exhaustion, — See Neurasthenia, 776 
 System, Agents affecting, 31, 32, 38, 
 
 39, 43, 56, 57, 58 
 Nervousness, 772 
 Neuralgia, 773 
 
 Ovarian, 785 
 Neurasthenia, 776 
 Neuritis, 777 
 Neurodin, 78 
 Nevus, 777 
 
 Nicotiana Tabacum, 499 
 Nicotianin, 500 
 Nicotine, 500 
 
 Antidotes and Antagonists, 819 
 
 Bitartrate, 500 
 Niemeyer's Pill, 799 
 Nightmare, 778 
 Nightshade, Black, 308 
 
 Deadly, 212 
 
 Woody, 308 
 Night Sweats, — See Hectic Fever, Per- 
 spiration, Phthisis. 
 Nipples, Sore, Fissured, 778 
 Nirvanin, 283 
 
 Nitrates, — See the titles of their metallic 
 constituents. 
 
 Antidotes and Antagonists, 817 
 Nitre, 438, 483 
 
 Chili, 483 
 
 Sweet Spirit of, 1 13 
 Nitrites, 150, — See also the titles of their 
 
 metallic constituents. 
 Nitro-benzene, 273 
 
 -benzol, 149 
 
 Antidotes, etc., 815 
 
 -glycerin, 150 
 
 Antidotes, etc., 815 
 Nitrous Ether, 113, 116 
 
 Oxide, 116 
 
 Antidotes, etc., 815 
 Nodes, 778 
 Normal Liquids, 575 
 
 Salt Solution, 485, 840 
 Norway Spruce, 430 
 Norwood's Tincture, 522 
 Nose-bleed, — See Epistaxis, 693 
 Nosophen, 358 
 Nucin, 363 
 Nuclein, 160 
 Numerals, Latin, 895 
 Nutgall, 96, 325 
 Nutmeg, 384 
 Nux Vomica, 388 
 
 Antidotes and Antagonists, 815 
 Nyctalopia, 724 
 Nymphaea, 96 
 
 Odorata, 395 
 Nymphomania, 778 
 
 Oak-bark, 96, 448 
 Oak, Dyer's, 325 
 
 Poison, 454 
 
 White, 448 
 Oat, 154, 210 
 Obesity, 779 
 Odontalgia, 779 
 Official Operations,, 556 
 
 Preparations, 565 
 Oil of Allspice, 428 
 
 of Almond, Bitter, 148 
 Expressed, 149 
 
 of Amber, 493, 504 
 
 of Anise, 167 
 
 of Anlhemis, 167 
 
 of Aurantium Cortex, 205 
 Flores, 205 
 
 of Bay, 384 
 
 Benne, 481 
 
 of Bergamot, 218 
 
 of Betula, 27, 465 
 
 of Birch, 465 
 
 of Cade, 364 
 
 of Cadinum, 364 
 
 of Cajuput, 233 
 
 Camphor, 239 
 
 Camphorated, 240 
 
 of Caraway, 249 
 
 Carron, 235, 237, 369 
 
 of Carum, 249 
 
 of Cassia, 277 
 
 Castor, 455 
 
 of Caryophyllus, 249 
 
 of Cedar, 471 
 
 Chamomile, 167 
 
 Chaulmoogra, 252 
 
 of Chenopodium, 253 
 
 of Cinnamon, 277 
 
 of Cloves, 249 
 
 Cod-liver, 381 
 
 of Copaiba, 289 
 
 of Coriander, 290 
 
 of Cotton-seed, 331 
 
 Croton, 509 
 
 of Cubeb, 295 
 
 Disinfection, 85 
 
 of Erigeron, 313 
 
 Essential, 27 
 
 Ethereal, 113 
 
 of Eucalyptus, 44, 314 
 
 of Fennel, 324 
 
 of Fleabane, 313 
 
 Fusel, 130 
 
 of Gaultheria, 325, 465 
 
 of Gossypium-seed, 331 
 
 Hamlin's Wizard, 900 
 
 of Hedeoma, 337 
 
 of Hemlock, 432 
 
 Hydrated, 381 
 
 Jecoris Aselli, 381 
 
 of Juniper, 363 
 
 Kurung, 437 
 
 Lard, no 
 
INDEX. 
 
 937 
 
 Oil of Lavender-flowers, 366 
 of Lemon, 367 
 of Linseed, 368 
 of Linum, 368 
 of Mace, 384 
 of Mentha Piperita, 379 
 of Mentha Viride, 380 
 of Mirbane, 149 
 of Morrhua, 381 
 of Mustard, Volatile, 482 
 of Myrcia, 384 
 of Myristica, 384 
 of Myrtle, 386 
 of Neroli, 205 
 of Nutmeg, 384 
 Olive, 395 
 
 of Orange flowers, 205 
 of Orange-peel, 205 
 of Origanum, 407 
 of Pennyroyal, 337 
 of Peppermint, 379 
 Phosphorated, 418 
 of Pimenta, 428 
 of Pinus Silvestris, 43 1 , 504 
 of Pix Liquida, 431 
 of Pongamia, 437 
 of Ricinus, 455 
 of Rose, 457 
 of Rosemary, 458 
 of Rue, 459 
 of Ruta, 459 
 of Sabina, 460 
 Salad, 395 
 of Sandalwood, 470 
 of Santal, 470 
 of Sassafras, 474 
 of Savine, 460 
 of Scotch Fir, 43 1, 504 
 Sequah's, 902 
 of Sesamum, 481 
 of Sinapis, Volatile, 482 
 of Spearmint, 380 
 of Spruce, 432 
 St. Jacob's, 107, 902 
 Sweet, 395 
 
 of Succinum, 493, 504 
 of Tabacum, 500 
 of Tanacetum, 502 
 of Tansy, 502 
 of Tar, 431 
 Teel, 481 
 
 of Terebinthina, 503 
 of Theobroma, 230, 506 
 of Thuja, 504, 507 
 of Thyme, 507 
 of Tiglium, 509 
 of Tobacco, 500 
 of Turpentine, 503 
 
 as an Antidote, 806 
 of Valerian, 520 
 Volatile, 27 
 
 of Wintergreen, 325, 465 
 Wizard, 900 
 
 Oil, Wood, 335 
 
 Oils, as Antidotes, 805 
 
 and Fats, 26 
 
 Essential, 27 
 
 Expressed, 559 
 
 Fixed, 26 
 
 Hydrocarbon, 27 
 
 Nitrogenous, 27 
 
 Oxygenated, 27 
 
 Sulphuretted, 27 
 
 Volatile, 27 
 Ointment, 252 
 
 Antipruritic, 602 
 
 Basilicon, 449 
 
 Blue, 340 
 
 Boracic, 81 
 
 Calamine, 529 
 
 of Carbolic Acid, 84 
 
 Citrine, 340, 341 
 
 Diachylon, 433 
 
 Hollo way's, 900 
 
 Pagenstecher' s, 655 
 
 of Rose Water, 1 1 1 
 
 Spermaceti, ill 
 
 of Tannic Acid, 95 
 
 Tar, 431 
 
 V\hite Precipitate, 340 
 Ointments, 600 
 
 Compounding, 601 
 
 Formulae for, 602 
 Olea Europaea, 395 
 Oleaginous Preparations, 565 
 Oleata, 584 
 Oleates, 103, 584 
 Olein, no, 381, 395 
 Oleoresina, 584 
 Oleo-resins, 26, 584 
 Olive, 395 
 Onion, 140 
 Onychia, 780 
 
 Operations, Pharmaceutical, 557 
 Ophthalmia, 781 
 
 Opisthotonos, — See Tetanus, 852 
 Opium, 396 
 
 Antidotes and Antagonists, 816 
 
 Denarcotized, 397 
 
 Deodorized, 397 
 
 Habit, 781 
 Opodeldoc, 472 
 Orange, 204, 367 
 
 Blossom, 901 
 Orchitic Extract, 162 
 Orchitis, 783 
 Ordeal Bark, 250 
 Oregon Grape, 218 
 Organic Acids, 25 
 Origanum, 407 
 Orphol, 219 
 
 Ortho-dihydroxy-benzene, 273 
 Orthoform, 283 
 Oryza sativa, 152 
 Ossein, 121 
 Otalgia, 784 
 
938 
 
 INDEX. 
 
 Otitis, 784 
 Otorrhea, 784 
 Ouabain, 492 
 Ovarian Extract, 166 
 
 Neuralgia, 785 
 
 Tumors, — See Cysts, 665 
 Ovaritis, 785 
 Ovis Aries, 1 1 1 
 Oxaluria, 786 
 Ox-gall, 316 
 Oxides, 408, — See also the titles of their 
 
 metallic constituents. 
 Oxidizers, 550 
 Oxy-camphor, 683 
 Oxyethyl-acetanilid, 416 
 
 -chinolin, 273 
 Oxygen, 408 
 Oxymel, 378, 580 
 Oxymethyl-acetanilid, 416 
 Oxytocics, 58 
 Oxyuris Vermicularis, 36 
 Oyster-shell, 235 
 Ozena, 786 
 Ozone, 408 
 
 Pagliari's Styptic, 728 
 Pain, 406, 787 
 
 Gastric, 63 
 
 Remedies relieving, 31 
 Pain-killer, Perry Davis', 901 
 Pains, After-, 609 
 
 Chest, 645 
 
 False, 699 
 Paint, Unna's, 329 
 Paints, 585 
 
 Palmitate of Cetyl, III 
 Palmitin, 395 
 
 Pancreas, Agents affecting, 59 
 Pancreatic Extract, 166 
 Pancreatin, 413 
 Pancreatine, 164 
 Pancreopepsine, 413 
 Pannus, — See Corneal Opacities, 658 
 Panopepton, 122 
 Pansy, 525 
 Papain, 413, 415 
 Papaiva, 413 
 Papaver somniferum, 396 
 Papaverine, 397 
 Papaw Milk, 414 
 Papayotin, 413 
 Paper, Filtering, 560 
 Papers (Chartae), 567, 592 
 Papine, 397 
 Papoid, 414, 415 
 Para Rubber, 309 
 Paraconiine, 286 
 Paracoto Bark, 290 
 Paracotoin, 290 
 Paraldehyde, 130, 41 1 
 Paralysis, 788, 843 
 
 Agitans, 789 
 
 Paralysis of the Bladder, 626 
 
 Para-acetphenetidin, 416 
 
 Para-amidophenol, 465 
 
 Para-dihydroxy-benzene, 273 
 
 Paramenispermin, 424 
 
 Paramorphine, 396 
 
 Paraphenetol Carbamide, 462 
 
 Paraphimosis, — See Phimosis, 795 
 
 Paraplegia, — See Paralysis, 788, 843 
 
 Parasiticides, 59 
 
 Paregoric, 397 ' 
 
 Pareira, 411 
 
 Parenchymatous Injection, 71 
 
 Paresis, — See Paralysis, 788, 843 
 
 Parigenin, 473 
 
 Parilla, Yellow, 378 
 
 Parillin, 473 
 
 Paris Green, 199 
 
 Paronychia, 780 
 
 Parotid Extract, 166 
 
 Parotitis, 789 
 
 Parrish's Chemical Food, 419 
 
 Parsley, 184 
 
 Participles, Latin, 896 
 
 Parvoline, 500 
 
 Parvule, 586 
 
 Pasque-flower, 443 
 
 Passiflora Incarnata, 412 
 
 Passion-flower, 412 
 
 Paste, Black, 713 
 
 Unna's, 329 
 
 Vienna, 437 
 Pasteur's Inoculation, 517 
 Pastilles, 600 
 Patent Medicines, 899 
 Paullinia Cupana, 229, 335 
 
 curare, 298 
 Pavy's Solution, 869 
 Pearson's Solution, 198 
 Peas, 154 
 Pectin, 448 
 Pediculi, 790 
 Pelletierine, 332 
 Pellitory, 447 
 Pellotine, 226 
 Pelosine, 412 
 Pemphigus, 790 
 Pencils, 595 
 Penis, — See Chancre, Chancroid, Chordee, 
 
 Gleet, Gonorrhea, Phimosis, Urethra. 
 Pennyroyal, 337 
 Pennywort, 348 
 Pental, 118 
 Pepo, 412 
 Pepper, African, 246 
 
 Black, 428 
 
 Cayenne, 246 
 
 Water, 436 
 Peppermint, 379 
 Pepper-vine, 428 
 Pepsin, 412 
 Pepsinum, 412 
 Peptenzyme, 413 
 
INDEX. 
 
 939 
 
 Peptogenic Milk Powder, 413 
 Pepto-mangan, 374 
 Peptones, 28, 124 
 Peptonoids, 122 
 Perchloride of Iron, 316 
 Percolation, 561 
 Pericarditis, 790 
 
 Diagnosis of, 904 
 Periostitis, 791 
 Peritonitis, 791 
 
 Puerperal, 827 
 
 Tubercular, 791 
 Permanganate of Potassium, 374 
 
 as an Antidote, 376, 807 
 Pernicious Fever, — See Intermittent Fever, 
 
 Remittent Fever. 
 Peronine, 399 
 Peroxide, Barium, 212 
 
 Hydrogen, 408 
 Perry Davis' Pain-Killer, 901 
 Persimmon, 96 
 Perspiration, 792 
 Pertussis, 793 
 Peruvian Bark, 269 
 Petrolatum, 415 
 Petroleum Ether, 216 
 
 Ointment, 415 
 Petroselinum sativum, 184 
 Peumus Boldo, 221 
 Phaeoretin, 452 
 Phagedena, — See Chancre, Chancroid, 
 
 Gangrene, Ulcers. 
 Pharmaceutical Incompatibility, 551 
 
 Operations, 557 
 
 Preparations, 565 
 
 Rules, 556 
 Pharmaceutists, — Their objectionable prac- 
 tices, 546, 554, 577 
 Pharmacodynamics, 1 7 
 Pharmacology, 17 
 Pharmacopoeias, List of, 531 
 Pharmacy, 17, 531 
 
 Extemporaneous, 554 
 
 Official, 556 
 
 Rules for neophytes, 556 
 Pharyngitis, 794 
 Phaseo-mannit, 463 
 Pheasant's Eye, ill 
 Phenacetin, 416 
 
 Antidotes and Antagonists, 816 
 Phenatol, 78 
 Phenazone, 170 
 Phenocoll Hydrochloride, 417 
 Phenol, 83, 272 
 
 Camphor, 84 
 
 Iodized, 84, 352 
 
 Sodique, 84 
 Phenolid, 78 
 Phenols, 84 
 Phenopyrin, 17 1 
 Pheno-resorcin, 84 
 Phenosalyl, 84, 9 1 
 Phenyl, 272 
 
 Phenyl Alcohol, 83, 129 
 
 Hydride, 217 
 
 Salicylate, 464 
 Phenyl-acetamide, 76 
 
 Ammoniated, 77 
 Phenyl-dimethyl-pyrazolon, 1 70 
 Phenyl-methyl-acetone, 130, 256 
 Phimosis, 795 
 Phlebitis, 795 
 
 Phlegmasia Alba Dolens, 795 
 Phlegmon, 796 
 Phloridzin, 442 
 Phlorol, 291 
 Phosphates, 418 
 Phosphide, Zinc, 418 
 Phosphites, 418 
 Phospho-albumen, 163 
 Phosphorus, 417 
 
 Antidotes and Antagonists, 816 
 Photophobia, 796 
 Phthisis, 796 
 
 Temperature in, 851 
 Physiological Antagonism, 34 
 Physostigma, 421 
 
 Antidotes and Antagonists, 817 
 Physostigmine, 421 
 Phytolacca, 423 
 Phytolaccin, 423 
 Phytoline, 424 
 Pichi, 424 
 Picoline, 500 
 Picraena excelsa, 447 
 Picrates, 104 
 Picroglycion, 308 
 Picropodophyllin, 436 
 Picrotoxin, 424 
 
 Antidotes and Antagonists, 817 
 Pierce's Favorite Prescription, 901 
 
 Golden Discovery, 901 
 Pigmenta, 585 
 Piles, 568, 730 
 Pill, Anaphrodisiac, 590 
 
 Anti-bilious, 591 
 
 Aperient, 591 
 
 Astringent, 590 
 
 Ayer's, 899 
 
 Blancard's, 317 
 
 Blaud's, 316 
 
 Blue, 339 
 
 Brandreth's, 899 
 
 Cathartic, Compound, 285 
 Vegetable, 285 
 
 Chalybeate, 316 
 
 Cholagogue, 591 
 
 Emmenagogue, 591 
 
 Ferruginous, 316, 591 
 
 Holloway's, 900 
 
 Hooper's, 591 
 
 Iron, 591 
 
 Lady Webster's, 142 
 
 Lapactic, 142 
 
 Morrison's, 238, 901 
 
 Niemeyer' s, 799 
 
940 
 
 INDEX. 
 
 Pill, Plummer's, 168, 170 
 
 Tanjore, 845 
 
 Tonic, 591 
 Pill-making, 586 
 Pill-mass, 580, 586 
 Pills, 585 
 
 Coated, 590 
 
 Excipients for, 587 
 
 Formulae for, 590 
 
 Official, 585 
 
 Process of making, 586 
 
 Substances suitable for, 588 
 Pilocarpidine, 426 
 Pilocarpine, 426 
 
 Antidotes and Antagonists, 817 
 Pilocarpine-phenyl-hydroxide, 85 
 Pilocarpus, 426 
 Pilulae, 585 
 Pimenta, 428 
 Pimpinella Anisum, 167 
 Pimples, — See Acne, 606 
 Pine, Prince's, 253 
 
 Yellow, 503 
 Pineal Extract, 164 
 Pineapple, 414, 415 
 Pinene, 386, 504 
 Pines, 430 
 Pinipicrin, 507 
 Pinites succinifer, 493 
 Pink, Carolina, 487 
 Pink-root, 487 
 
 Demarara, 487 
 Pinus, 430 
 
 austral is, 503 
 
 Canadensis, 431 
 
 palustris, 431, 503 
 
 sylvestris, 504 
 
 Taeda, 503 
 Piper, 428 
 
 angustifolium, 377 
 
 cubeba, 295 
 
 methysticum, 364 
 
 nigrum, 428 
 Piperazin, 429 
 Piperidin, 428 
 Piperin, 428 
 Pipsissewa, 253 
 Pisf idia, 430 
 Piscidin, 430 
 Pissenlit, 503 
 Pistacia Lentiscus, 377 
 
 Terebinthus, 503 
 Pitaya Bark, 270 ' 
 Pitch, 430 
 
 Pituitary Extract, 164 
 Pityriasis, 799 
 Pix, 430 
 
 Liquida, 413 
 Plague, Bubonic, 800 
 Planat's Tincture, 425 
 Plantago, 432 
 Plantain, 432 
 Plaster, Adhesive, 449 
 
 Plaster, Anodyne, 570 
 
 Cantharidal, 244 
 
 Capsicum, 246 
 
 Counterirritant, 570 
 
 Court, 121 
 
 Diachylon, 433 
 
 Isinglass, 121 
 
 Pitch, 431 
 
 Resin, 449 
 
 Strengthening, 317 
 
 Vesicating, 570 
 
 Warming, 244, 431 
 Plasters, 569 
 
 Formulae for, 57° 
 Plethora, 800 
 
 Abdominal, 604 
 Pleurisy, 800 
 
 Diagnosis of, 906 
 Pleurisy-root, 203 
 Pleuritis, 800 
 Pleurodynia, 801 
 Pleuro-pneumonia, 802 
 Plum, 442 
 Plumbism, 434 
 Plumbum, 433 
 Plummer's Pills, 168, 170 
 Pneumonia, 802 
 
 Diagnosis of, 906 
 Podophyllin, 436 
 Podophyllitoxin, 436 
 Podophyllum, 436 
 Poison Ivy, 454 
 
 Nut, 388 
 
 Oak, 454 
 
 Antidotes and Antagonists, 817 
 
 Sumach, 454 
 Poisoning, ^^^ 803, — See also the several 
 poisons under their titles in Part I. 
 
 Antidotes and Antagonists, ^^, 804 
 
 Treatment of, — Indications for, 33 
 General Principles of, 803 
 Poisonous Compounds, 551 
 Poisons, Energetic, 803 
 Poke-berry, 423 
 Poke, Indian, 521 
 Poke-root, 423 
 Polygala Senega, 478 
 Polygonum, 436 
 Polyporus fomentarius, 1 18 
 
 officinalis, 118 
 Polypus, 819 
 
 Polyuria, — See Diabetes Insipidus, 668 
 Pomade de Bareges, 800 
 Pomegranate, 96, 332 
 Pond Lily, 96 
 Pond's Extract, 336 
 Pongamia, 437 
 Poplar, 464 
 Poppy, White, 396 
 Populus, 464 
 Porphyrization, 564 
 Porphyroxin, 397, 469 
 Porrigo Capitis, — Tinea Tonsurans, 856 
 
INDEX. 
 
 941 
 
 Porter, 131 
 Port Wine, 1 31 
 Potash, 437 
 
 Antidotes, etc., 817 
 Potassa, 437 
 
 cum Calce, 437 
 
 Sulphurata, 496 
 Potassio- ferric Tartrate, 318 
 Potassium, 437 
 
 Alum, 143 
 
 Bichromate, 94, 817 
 
 Cyanide, 99, 101, 813 
 
 Ferrocyanide, 99, 101, 807 
 
 Myronate, 482 
 
 Nitrate, 438, 817 
 
 Nitrite, 150 
 
 Permanganate, 374, 376, 807 
 
 Silicate, 438, 481 
 
 Tartraborate, 82, 637 
 Potato, 154, 308 
 
 Spirit, 130 
 Potentilla Sarmentosa, ''92 
 Potus, 591 
 Poultices, 567, 820 
 
 List of Br. Official, 567 
 Powder, Antimonial, 168 
 
 Aromatic, 277 
 
 Bleaching, Antidotes, 813 
 
 Dover's, 358, 398 
 
 Effervescing, 438 
 
 Gray, 339 
 
 James', 168 
 
 Liquorice, 330, 479 
 
 Purgative, 362 
 
 Seidlitz, 438 
 
 Tally's, 398 
 Powders, 591 
 
 Formulae for, 593 
 
 Substances suitable to, 592 
 Prairie Flower, 902 
 Precipitant Solutions, Table of, 550 
 Precipitate, White, 340 
 
 Red, 340 
 Precipitation, 562 
 Pregnancy, Disorders of, 820 
 
 Vomiting of, 877 
 Premna tatiensis, 510 
 Preparations, 5°5 
 
 Official, 73, 565 
 Prepositions, Latin, 896 
 Prescription, Pierce's Favorite, 901 
 
 Writing, 537 
 
 Latin Phrases used, 541, 883, 897 
 Prescriptions, 536 
 
 Abbreviations in, 545 
 
 Analysis of, 538 
 
 Blanks for, 548 
 
 Contractions, 545, 883 
 
 Filling of, 554 
 
 Latin Phrases used, 541, 883, 897 
 
 Metric, 544 
 
 Renewals, 546 
 
 Table of Doses, — See cover. 
 
 Prescriptions, Tonic, 608, 613, 777 
 
 Use of Latin in, 541 
 Prickly Heat,— See Miliaria, 768 
 Pride of China, 211 
 Prince's Pine, 253 
 Principles in Drugs, 21 
 
 Bitter, 24 
 
 in Extracts, 573 
 
 Neutral, 24 
 Prinos, 442 
 
 Proctitis,— See Rectum, 828 
 Prodigiosus Toxin, 515 
 Prolapsus Ani, 821 
 
 Uteri, 821 
 Pronunciation, 896 
 Propyl Oxide, 381 
 Propylamine, 197 
 Prosopalgia, — See Neuralgia, Odontalgi; 
 
 Tic Douloureux. 
 Prostate, Hypertrophied, 821 
 Prostatitis, 821 
 Prostatorrhea, 822 
 Protargol, 196 
 Protectives, 59 
 Proteid, Coagulated, 28 
 Protein, 120 
 
 Bodies, 28 
 Protonuclein, 161 
 Protopine, 397 
 Protoveratridine, 521 
 Protoveratrine, 521 
 Prune, 442 
 Prunum, 442 
 Prunus Amygdalus, 148 
 
 domestica, 442 
 
 Laurocerasus, 99 
 
 Serotina, 442 
 
 Virginiana, 99, 442 
 Prurigo, 822 
 Pruritus, 822 
 Pseudaconitine, 106 
 Pseudo-jervine, 521 
 Pseudo-morphine, 397 
 Pseudotropine, 348 
 Psoriasis, 824 
 Pterocarpus marsupium, 365 
 
 santalinus, 471 
 Pterygium, 824 
 Ptomaines, 23 
 Ptosis, 824 
 
 Ptyalism, 61, 343, 825 
 Puccine, 469 
 Puerperal Convulsions, 825 
 
 Disorders, 826 
 
 Fever, 826 
 
 Mania, 827 
 
 Melancholia, 827 
 
 Peritonitis, 827 
 Puff-ball, 367 
 Pulmonary Sedatives, 59 
 Pulsatilla, 443 
 
 Antidotes and Antagonists, 817 
 Pulse, 827 
 
94: 
 
 INDEX. 
 
 Pulse and Temperature, 852 
 Pulveres, 591 
 Pulverization, 564 
 Pulvis Doveri, 358 
 
 Purgans, 362 
 Pumpkin-seed, 412 
 Punica Granatum, 332 
 Purgatives, 41 
 Purging Agaric, 1 18 
 
 Cassia, 250 
 Purpura, 827 
 
 Pus in Urine, Test for, 870 
 Pustule, Malignant, — See Anthrax, 616 
 Pustules, — See Anthrax, Ecthyma, Erup- 
 tions, Impetigo, Variola. 
 Pustulants, 55 
 Pyemia, 839 
 Pyramidon, 17 1 
 Pyrethrine, 447 
 Pyrethrum, 447 
 Pyretine, 78 
 Pyridine, 273, 500 
 Pyrocatechin, 272, 273, 431 
 Pyrogallol, 97, 273 
 Pyrrol, 358 
 Pyrosis, 828 
 
 Pyroxylin, 153, 331, 568 
 Pyrozone, 408 
 
 Quaker Button, 388 
 
 Quantities, Prescription, Table of, — See 
 
 Cover. 
 Quassia, 447 
 Quassin, 447 
 Quebrachine, 203 
 Quebracho, 203 
 Queen's Delight, 487 
 
 Root 487 
 Quercin, 448 
 Quercitrin, 448, 457 
 Quercus Alba, 96, 448 
 
 Lusitanica, 325, 448 
 
 Tinctoria, 448 
 Quicksilver, 339 
 Quillaja, 448 
 Quinalgen, 78, 254 
 Quince-seed, 299 
 Quinetum, 272 
 Quinicine, 270, 273 
 Quinidine, 270, 272 
 Quinine, 270, 271 
 
 Antidotes and Antagonists, 817 
 
 Hypodermically, 275 
 
 Mixtures, 584, 746 
 
 Solutions of, 582 
 
 Substitutes for, 272 
 Quinoidin, 272 
 Quinolin, 253 
 Quinone, 273 
 Quinosol, 254 
 Quinquinina, 272 
 Quinsy, — See Tonsillitis, 857 
 
 Rabies, — See Hydrophobia, 736 
 
 Toxin, 517 
 Rachitis, 828 
 
 Radam's Microbe-killer, 901 
 Radway's Ready Relief, 901 
 
 Resolvent, 901 
 Raspail's Eau Sedative, 145, 239 
 Raspberry, 459 
 
 Rat-pastes, Antidotes, etc., 817 
 Ratsbane, 817 
 Raw Beef, 127 
 Recamier Balm, etc., 901 
 Rectum, Absorption by, 68 
 
 Diseases of, 828 
 
 Prolapse of, 821 
 
 Ulceration of, 829 
 Red Gum, — See Strophulus, 846 
 
 Rose, 96, 457 
 References and Bibliography, 603 
 Refrigerants, 60 
 Relapsing Fever, 829 
 Remittent Fever, 829 
 
 Diagnosis of, 907 
 Renal Depressants, 48 
 Renewals of Prescriptions, 546 
 Resin, 25, 449, 504 
 
 Cerate, 449 
 
 Plaster, 449 
 Resina, 449, 504 
 Resince, 593 
 Resinol, 431 
 Resins, 25, 593 
 
 Pharmaceutical, 26 
 
 True, 26 
 Resorcin, 85, 272, 449 
 
 Antidotes and Antagonists, 817 
 Respiration, — See Bronchitis, Croup, 
 Dyspnea, Emphysema, Pneumo- 
 nia. 
 
 Agents affecting, 50, 59, 60 
 
 Artificial, 620 
 Respiratory Depressants, 60 
 
 Stimulants, 60 
 
 Tract, Absorption by, 68 
 Restoratives, 61 
 Retina, Affections of, 830 
 Retinol, 431 
 Revalenta Arabica, 901 
 Rhamnoxanthin, 324 
 Rhamnus Frangula, 324 
 
 Purshiana, 451 
 Rhaphidophora vitiensis, 510 
 Rhatanine, 365 
 Rhatany, 96, 365 
 Rheum, 451 
 Rheumatism, Acute, 830 
 
 Chronic, 832 
 
 Diagnosis of, 905 
 
 Gonorrheal, 833 
 
 Muscular, 834 
 Rheumatoid Arthritis, 618 
 Rhinacanthin, 453 
 Rhinacanthus, 453 
 
INDEX. 
 
 943 
 
 Rhinitis, — See Catarrh Acute Nasal, In- 
 fluenza, Nasal Affections. 
 Rhceadine, 397 
 Rhubarb, 45 1 
 Rhus, 453, 454 
 
 Antidotes and Antagonists, 817 
 Rice, 152, 154 
 Ricin, 175, 455 
 Ricinine, 455 
 Ricinolein, 455 
 Ricinus communis, 455 
 Rickets, — See Rachitis, 828 
 Rigors, — See under Fever, 699 
 Ring- worm, — See Dhobie Itch, 668: 
 
 Tinea, 854 
 Risus sardonicus, 390 
 Roasting, 563 
 Rochelle Salt, 438 
 Rosa, 96, 457 
 Rosanilin, 325 
 Rose, 96, 457 
 
 Attar of, 457 
 
 Honey of, 378, 458 
 Roseme, 325 
 Rosemary, 96, 458 
 Roseola, 834 
 Rosmarinus, 458 
 Rottlera, 364 
 Rottlerin, 364 
 Rough-on-rats, 817 
 Rubber, India, 308 
 Rubefacients, 55 
 Rubeola, — See Measles, 763 
 Rubidium, 458 
 Rubijervine, 521 
 Rubini's Tincture, 239 
 Rubus, 96, 459 
 Rue, 459 
 Rules for Incompatibility, 553 
 
 for Pharmaceutists, 556 
 Rum, 131 
 
 Bay, 38+ 
 Rumex, 459 
 Rumicin, 459 
 
 Rupia, — See Pemphigus, 790 
 Russian Spirit, 833 
 Ruta, 459 
 Rye, 154, 310 
 
 Sabadine, 521 
 Sabadinine, 521 
 Sabina, 460 
 
 Antidotes and Antagonists, 818 
 Saccharin, 461 
 Saccharum, 462 
 
 Lactis, 463 
 Sacred Bark, 451 
 Safflower, 295 
 Saffron, 294 
 
 American, 294 
 
 Meadow, 283 
 Saffron-tea, 295 
 
 Safrol, 239, 474 
 
 Sage, 468 
 
 Sage's Catarrh Remedy, 901 
 
 Sago, 154 
 
 Sal-ammoniac, 145 
 
 Salbromalide, 77 
 
 Salfene, 78 
 
 Salicin, 464 
 
 Salicylate, Para-amidol, 465 
 
 Physostigmine, 422 
 
 Sodio-Theobromine, 233 
 Salicylates, 465 
 Salicyl-bromalide, 77 
 Salicyl-para-phenetidin, 465 
 Saligenin, 465 
 Saline Mineral Waters, 186 
 
 Purgatives, 42 
 Salipyrin, 171, 465, 468 
 Saliva, Agents affecting, 6 1 
 Salivation, 61, 343, 825 
 Salix, 464 
 
 Nigra, 464 
 Salol, 464, 467 
 Salophen, 465, 468 
 Salt, common, 483 
 
 as an Antidote, 807 
 
 Epsom, 372 
 
 Glauber's, 484 
 
 Rochelle, 438 
 Saltpetre, 438 
 
 Antidotes and Antagonists, 817 
 
 Chili, 483 
 Salt-rheum, — See Eczema, 685 
 Salts, Deliquescent, List of, 589 
 
 Efflorescent, List of, 589 
 
 Insoluble, 549 
 
 Metallic, Antidotes, etc., 814 
 Salve, Red Lip, 507 
 Salvia, 468 
 Salviol, 468 
 Sambucus, 468 
 Sandal-wood, 470 
 
 Oil, 470 
 Sand-brier, 486 
 Sanford's Catarrh Cure, 901 
 Sanguinaria, 469 
 
 Antidotes and Antagonists, 818 
 Sanguinarine, 469 
 Sanitas, 46, 504 
 Sanose, 122 
 Santalum Album, 470 
 
 Citrinum, 470 
 
 Rubrum, 471 
 Santonica, 471 
 Santonin, 471 
 Sapo, 472 
 .Sapogenin, 478 
 Saponification, 472 
 Saponin, 251, 448, 478 
 Saprol, 85 
 Sarcinse, 834 
 
 Sarcocele, — See under Cancer, Testicles. 
 Sarsaparilla, 473 
 
944 
 
 INDEX. 
 
 Sarsaparilla, Ayer's, 899 
 Sassafras, 474 
 
 Swamp, 374 
 Sassy Bark, 250 
 Saunders, Red, 471 
 Savine, 460 
 
 Antidotes and Antagonists, 818 
 Saxin, 462 
 
 Sayre's Method for Chloroform, 265 
 Scabies, 834 
 
 Scald-head, — See Eczema, Tinea. 
 Scalds, 634 
 Scammonium, 474 
 Scam mo ny, 474 
 Scarlet Fever, 835 
 
 Diagnosis of, 906 
 Temperature in, 851 
 Scheele's Acid, 99 
 
 Green, 199 
 Schleich's Method of Anesthesia, 1 17 
 
 Solutions, 114, 614 
 Sciatica, 836 
 Scilla, 475 
 Scillin, 475 
 Scillipicrin, 475 
 Scillitin, 475 
 Scillitoxin, 475 
 Scirrhus, — See Cancer, 637 
 
 Diagnosis of, 904 
 Sclererythrin, 310 
 Scleroderma, 837 
 Scleromucin, 310 
 Sclerosis, 837 
 Scleroxanthin, 310 
 Scoparin, 476 
 Scoparius, 476 
 Scopolamine, 348 
 
 Scopoleine, 348 ( 
 
 Scopolia carniolica, 348 
 Scorbutus, — See Scurvy, 838 
 Screaming, — See Nightmare, 778 
 Scrofulosis, 838 
 Scudamore's Mixture, 714 
 Scurvy, 838 
 Scutellaria, 478 
 Scutellarin, 478 
 Sea-sickness, 839 
 Sea-wrack, 325 
 Seborrhea, 839 
 Secale cereale, 310 
 Secaline, 526 
 Sedative, Battley's, 399 
 Sedatives, 61 
 
 Cardiac, 40 
 
 Gastric, 49, 593 
 
 General, 49 
 
 Pulmonary, 59 
 
 Urinary, 64 
 
 Uterine, 65 
 
 Vascular, 65 
 
 Vesical, 66 
 Seidlitz Powder, 438 
 Seigel's Syrup, 901 
 
 Senega, 478 
 
 Senegin, 478 
 
 Senna, 479 
 
 Sennacrol, 479 
 
 Sennapicrin, 479 
 
 Separation, 562 
 
 Septicemia, 839 
 
 Sequah's Oil, 902 
 
 Prairie Flower, 902 
 
 Serpentaria, 480 
 
 Serpent-venom, Antidotes,, etc., 818 
 
 Serum, Antiphthisic, 182 
 Antitoxic, 175 
 Artificial, 777 
 
 Serum-therapy, 1 76 
 
 Sesamum, 481 
 
 Sevum, III 
 
 Shampoo Mixtures, 715 
 
 Sheep, in 
 
 Shells, 230 
 
 Sherry Wine, 131 
 
 Shingles, — See Herpes Zoster, 735 
 
 Shock, Surgical, 840 
 
 Sialagogues, 61 
 
 Sickness at Stomach, — See Nausea, Sea- 
 sickness, Vomiting. 
 
 Sick-room, 840 
 
 Siddhi, 242 
 
 Silicates, 481 
 
 Silicious Mineral Waters, 187 
 
 Silver, 190 
 
 Antidotes and Antagonists, 818 
 Compounds, 195 
 
 Sinalbin, 481 
 
 Sinapine, 481 
 
 Sinapis, 481 
 
 Singultus, — See Hiccough, 735 
 
 Sinigrin, 482 
 
 Sinistrin, 475 
 
 Skin, Agents affecting, 32, 40, 44, 50, 55, 
 59, 63 
 as an Absorbent, 71 
 
 Skin Diseases, — See Acne, Anthrax, Bed- 
 sores, Boils, Burns, Carbuncle, Chapped 
 Hands and Lips, Chilblains, Condylo- 
 mata, Dhobie Itch, Ecchymosis, Ecthy- 
 ma, Eczema, Eruptions, Erysipelas, Ery- 
 thema, Freckles, Herpes, Herpes Zoster, 
 Ichthyosis, Impetigo, Intertrigo, Lep- 
 rosy, Lichen, Lupus, Mentagra, Miliaria, 
 Nevus, Onychia, Pemphigus, Perspira- 
 tion, Phlegmon, Pityriasis, Prurigo, Pru- 
 ritus, Psoriasis, Roseola, Scabies, Sclero- 
 derma, Seborrhea, Strophulus, Sycosis, 
 Syphilis, Tinea, Ulcers, Urticaria, Warts, 
 Wen. 
 
 Skull-cap, 478 
 
 Sleep, Abnormal, — See Delirium, Insom-' 
 nia, Nightmare, Somnambulism. 
 
 Slippery Elm Bark, 519 
 
 Smallpox, — See Variola, 875 
 Diagnosis of, 906 
 
 Smart-weed, 436 
 
INDEX. 
 
 945 
 
 Smell, Agents affecting, 62 
 Smilacin, 473 
 Smilax, 473 
 Snake-root, Black, 268 
 
 Virginia, 480 
 Sneezing, 841 
 
 Agents producing, 51. — See also Ca- 
 tarrh, Hay Fever, Influenza. 
 Soaloin, 141 
 Soap, 472 
 
 as an Antidote, 806 
 
 Bark, 448 
 Soda, 483 
 
 Antidotes and Antagonists, 818 
 
 Caustic, 483 
 
 Chlorata (Chlorinated), 266 
 
 Water, 91, 93 
 Sodio-Theobromine Salicylate, 233 
 Sodium, 483 
 
 Benzoate, 216 
 
 Bisulphite, 105 
 
 Borate, 81 
 
 Hyposulphite, 105 
 
 as an Antidote, 807 
 
 Nitrite, 150 
 
 Phosphate, 157, 418, 421 
 
 Silicate, 481 
 
 Sulphite, 105 
 
 Sulpho-carbolate, 84 
 
 Taurocholate, 316 
 
 Tetraborate, 82 
 Solanine, 308 
 Solanum Carolinense, 486 
 
 Dulcamara, 308 
 Solid Preparations, 565 
 Soloid, 597 
 
 Soluble Substances, 581 
 Solution, 562 
 
 Aids to, 582 
 
 Alkaline Cupric Tartrate, 296 
 
 Antiseptic, 84, 346 
 
 Circulatory, 562 
 
 Clemens', 199 
 
 Creuse's, 316 
 
 Crocq's, 421 
 
 Didama's, 898 
 
 Donovan's, 199 
 
 Fehling's, 296 
 
 Fowler's, 198 
 
 Glass, 481 
 
 Labarraque' s, 46, 266 
 
 Loemer's, 675 
 
 Lugol's, 352 
 
 Magendie's, 399, 898 
 
 Monsel's, 318 
 
 Normal Salt, 485, 840 
 
 Pavy's, 869 
 
 Pearson's, 198 
 
 Quinine, 582 
 
 Saturated, 562 
 
 Villate's, 298, 639 
 
 Vleminck's, 668 
 Solutions (Liquores), 579 
 60 
 
 Solutions, Hypodermic, 71, 897 
 
 Precipitant, Table of, 550 
 
 Schleich's, 144, 614 
 
 Stock, 556 
 Solutol, 85 
 Solvents, 563 
 Solved, 85 
 Somatose, 123 
 Somnal, 255 
 Somnambulism, 841 
 Sorbefacients, 45 
 Sores, 864 
 
 Bed, 624 
 Sorghum, 462 
 Sorrel, 459 
 Soz-albumin, 514 
 Sozodont, 902 
 Spanish Flies, 244 
 Sparteine, 476 
 Spasmodic Affections, 841 
 Spearmint, 380 
 Specific Gravity and Volume, 536 
 
 Table of, 908 
 Spermaceti, ill 
 Spermatorrhea, 841 
 Spermine, 164 
 Sphacelotoxin, 310 
 Spigelia, 487 
 Spina Bifida, 842 
 Spinal Concussion, 842 
 
 Congestion, 842 
 
 Inflammation, — See Meningitis, Mye- 
 litis, etc. 
 
 Irritation, 843 
 
 Paralysis, 843 
 
 Softening, 843 
 Spirit of Mindererus, 145 
 
 Methylated, 130 
 
 Perfumed, 13 1 
 
 Potato, 130 
 
 Proof, 130 
 
 Rectified, 130 
 
 Russian, 833 
 
 Wood, 130 
 Spirits (Spiritus), 594 
 Splenic Affections, 843 
 
 Extract, 166 
 Spongia Usta, 838 
 Spongio-piline, 820 
 
 Spotted Fever, — See Typhus Fever, Men- 
 ingitis Cerebro-spinal. 
 Sprains, 843 
 Spruces, 430 
 Sprue, 843 
 Spunk, 118 
 
 Squamce, — See Ichthyosis, Pityriasis, Pso- 
 riasis, etc. 
 Squaw-root, 251 
 Squibb 's Mixture, 399, 647 
 Squill, 475 
 
 St. Ignatius' Bean, 351 
 St. Jacob's Oil, 107, 902 
 St. Mary's Thistle, 248 
 
946 
 
 INDEX. 
 
 St. Vitus' Dance, — See Chorea, 649 
 Stains, 844 
 Stammering, 844 
 Staphisagria, 487 
 Starch, 152, 463 
 
 as an Antidote, 805, 808 
 Star-wort, 140 
 Statice, 96 
 Stavesacre, 487 
 Stearin, 1 10 
 Sterility, 844 
 Sternutatories, 50 
 Stigmata Maydis, 526 
 Stillingia, 487 
 Stimulants, 62 
 
 Cardiac, 40 
 
 Diffusible, 62 
 
 Hepatic, 53 
 
 Local, 63 
 
 Pancreatic, 59 
 
 Respiratory, 60 
 
 Vascular, 06 
 Stings, 845 
 Stock Solutions, 556 
 Stokes' Liniment, 579 
 Stomach, Absorption by, 67 
 
 Diseases, — See Dyspepsia, Gastralgia, 
 Gastric Ulcer, Gastritis, etc. 
 Stomachics, 63 
 Stomatitis, 845 
 Stone, — See Calculi, 56, 636 
 Storax, 492 
 Strabismus, 846 
 Straining, 557 
 Stramonium, 488 
 
 Antidotes and Antagonists, 818 
 Strangury, — See Cystitis, Dysuria. 
 Stricture, — See Rectum, 828 
 
 Urethral, 866 
 Strontium Salts, 490 
 Strophanthin, 491 
 Strophanthus glabrus, 492 
 
 hispidus, 491 
 Strophulus, 846 
 Strychnine, 338, 351, 389 
 
 Antidotes and Antagonists, 815 
 Strychnos Ignatii, 351 
 
 Gautheriana, 338 
 
 Nux Vomica, 388 
 Sturgeon, 121 
 Stye, — See Eyelids, 698 
 Styptic Collodion, 95, 331, 881 
 Styptics, 63, 728 
 Styracin, 492 
 Styrax, 492 
 
 Benzoin, 216 
 Styrol, 492 
 Sublimation, 563 
 Substances, Amyloid, 28 
 
 best given alone, 553 
 
 difficult to combine in pill, 588 
 
 suitable for mixtures, 581 
 
 suitable for pills, 588 
 
 Substances suitable for powders, 592 
 
 unsuited to pill-form, 589 
 Succinum, 493 
 Sucrol, 462 
 Sudorifics, 45 
 Suet, in 
 Sugar, 462 
 
 of Lead, 433 
 
 of Milk, 463 
 
 in Urine, — See Diabetes Mellitus, 668 
 Tests for, 869 
 Sulphates, — See the titles of their basic 
 constituents. 
 
 as Antidotes, 807 
 Sulphides, 495 
 Sulphites, 105 
 Sulpho-carbolates, 84, 90 
 Sulpho-cyanate, Acrinyl, 481 
 Sulpho-cyanide, Allyl, 482 
 Sulpho-ichthyolates, 496 
 Sulphonal, 493 
 
 Antidotes, etc., 818 
 Sulphur, 495 
 
 Antidotes and Antagonists, 819 
 Sulphurated Antimony, 168 
 
 Lime, 496 
 
 Potassa, 496 
 Sulphuretted Hydrogen, 496 
 Sulphurous Mineral Waters, 186 
 Sumach, 453 
 Sumbul, 499 
 Sun-dew, 306 
 
 Sunstroke, 846, — see also Heat-stroke, 722 
 Suppositoria, 594 
 Suppositories, Formulce, 595 
 
 Official in Br. Phar., 596 
 Suppuration, 846 
 Surgeon's Agaric, 1 18 
 Surgical Fever, 847 
 Sus scrofa, 413 
 Svapnia, 397 
 Swallowing, — See Dysphagia, Esophageal 
 
 Affections. 
 Swamp Sassafras, 374 
 Sweet Bay, 374 
 
 Flag, 233 
 
 Gum, 492 
 Swertia Chirata, 254 
 Swift's Specific, S. S. S., 902 
 Sycosis, 847 
 
 Sydenham's Laudanum, 397 
 Syncope, 847 
 Synovitis, 847 
 Syntonin, 124 
 Syphilis, 848 
 
 Diagnosis, — See Chancre, 904 
 Syrup, Siegel's, 901 
 
 Mrs. Winslow's Soothing, 399 
 Syrupi (Syrups), 596 
 
 Tabacum, 499 
 Tabellae, 597 
 
INDEX. 
 
 947 
 
 Tabes Mesenterica, 849 
 
 Table of Antagonistic Drugs, 35 
 
 Drops in a Drachm, etc., 535, 910 
 
 Latin Words, Phrases, etc. , 883 
 
 Metric Conversion, 91 1 and cover. 
 
 Precipitant Solutions, 550 
 
 Prescription Doses and Quantities, — 
 See cover. 
 
 Specific Gravities and Volumes, 908 
 Tables of Differential Diagnosis, 903 
 
 of Weights and Measures, 533, 910 
 Tablets, 597 
 
 Compressed, List of, 597 
 
 Hypodermic, List of, 71, 597 
 
 of Nitroglycerin, 150 
 Tabloid, 597 
 Tag Alder, 141 
 Tamarind, 502 
 Tamar-Indien, 479, 902 
 Tamarindus, 502 
 Tanacetin, 502 
 Tanacetum, 502 
 Tannigen, 97 
 Tannin, 95 
 
 as an Antidote, 805 
 Tansy, 502 
 
 Tapeworms, 36, 203, 333, 879 
 Tapioca, 154 
 Tar, 431 
 Tar- water, 431 
 Taraxacerin, 503 
 Taraxacin, 503 
 Taraxacum, 503 
 Tartar, Cream of, 438 
 
 Crude, 437 
 
 Emetic, 168 
 
 Antidotes and Antagonists, 819 
 Tartraborate of Potassium, 82, 637 
 Tartrate, Ammonio-ferric, 318 
 
 Antimony and Potassium, 168 
 
 Potassio- ferric, 318 
 
 Potassium and Sodium, 438 
 Tartrates, 106 
 Taste, Agents affecting, 64 
 
 Disordered, 850 
 Taurocholate of Sodium, 316 
 Tea, 229 
 
 Boneset, 315 
 
 Flaxseed, 369 
 
 Garfield, 900 
 
 German Breast, 143 
 
 Hamburg, 900 
 
 Linseed, 369 
 
 Saffron, 295 
 
 Tansy, 502 
 
 Worm, 487 
 Teel Oil, 481 
 Teeth, 850 
 
 Agents affecting, 44 
 Teething, — See Dentition, 667 
 Temperature in Disease, 850 
 
 Drugs affecting, 37 
 Tenesmus, — See Dysentery, 677 
 
 Teniae, 36, 203, 333, 879 
 Teniafuges, 36 
 Terebene, 504 
 Terebinthene, 504 
 Terebinthina, 503 
 Terpenes, 27 
 Terpilene, 504 
 Terpin, 504 
 Terpinene, 504 
 Terpinol, 504 
 Testa Praeparata, 235 
 Testicles, 852 
 Testicular Juice, 1 56, 162 
 Testing, 563 
 Tests for Morphine, 400 
 
 for Urinary Constituents, 868 
 Tetanus, 179, 852 
 Tetraborate, Sodium, 82 
 Tetrachloride, Carbon, 1 16, 262 
 Tetra-hydromethyl-chinolin, 273 
 Tetra-hydro-parachinanisol, 273 
 Tetra-hydroparamethyl-oxychinolin, 273 
 Tetra-iodo-pyrrol, 358 
 Tetra-methyl-Thionine Chloride, 380 
 Tetronal, 495 
 
 Tetter, — See Herpes, Pityriasis, Psoriasis. 
 Thallin, 273 
 Thea sinensis, 227 
 Thebaine, 396, 403 
 Theine, 227, 231 
 Theism. 229 
 
 Theobroma Cacao, 230, 506 
 Theobromine, 229, 231, 506 
 Therapeutical Incompatibility, 552 
 Therapeutics. 17 
 
 Applied, 18, 604 
 
 Empirical, 18 
 
 Natural, 18 
 
 Rational, 19 
 
 Special, 603 
 Theriaca, 463 
 Thermodin, 78 
 Thermometer, Clinical, 850 
 Thimble-berry, 459 
 Thiol, 496, 499 
 Thirst, 853 
 
 Agents allaying, 60 
 Thistle, Blessed. 248 
 
 St. Mary's, 248 
 Thompson's Eye- water, 902 
 
 Tincture, 418 
 Thorn-apple, 488 
 Thorough- wort, 315 
 
 Throat, — See Aphonia, Croup, Diphthe- 
 ria, Laryngitis, Pharyngitis, Scarlet 
 Fever, Tonsillitis, etc. 
 
 Sore, 853 
 Thrush, — See Aphthae, 617 
 Thuja, 507 
 Thujetin, 507 
 Thujin, 507 
 
 Thus Americanum, 503 
 Thyme, Garden, 507 
 
94 8 
 
 INDEX. 
 
 Thymene, 508 
 
 Thymol, 508 
 
 Thymus (gland) Extract, 160 
 
 vulgaris, 507 
 Thyreoantitoxin, 159 
 Thyreoidin, 159 
 Thyroid Extract, 157 
 Tic Douloureux, 854 
 Tiglii Oleum, 509 
 
 Tin, Antidotes and Antagonists, 819 
 Tinctura Antiperiodica, 271 
 
 Pyrexialis, 271, 276 
 Tincturae (Tinctures), 597 
 Tincture, Fleming's, 107 
 
 Hager's, 271 
 
 Huxham's, 271 
 
 Norwood's, 522 
 
 Planat's, 425 
 
 Rubini's, 239 
 
 Thompson's, 418 
 
 Warburg's, 271, 276 
 Tinea Circinata, 854 
 
 Decalvans, 855 
 
 Favosa, 855 
 
 Imbricata, 855 
 
 Sycosis, — See Mentagra, 767 
 
 Tonsurans, 856 
 
 Versicolor, 856 
 Tinnitus Aurium, — See Ear, 684 
 Tobacco, 499 
 
 Antidotes and Antagonists, 819 
 
 Indian, 370 
 
 Symptoms, — See Amaurosis, Ner- 
 vousness. • 
 Toe-nails, — See Nails, Ingrowing. 
 Tokelau Ringworm, 855 
 Tolene, 211 
 Toluene, 461 
 Toluifera Pereirse, 21 1 
 
 Balsamum, 211 
 Tomato, 308 
 Tonga, 510 
 Tongine, 510 
 Tongue, 856 
 
 Absorption by, 67 
 Tonics, 61 
 
 Cardiac, 41 
 
 Formulae, 608, 613, 777 
 
 Gastric, 63 
 
 Hair, 715 
 
 Nerve, 773, 777, 783 
 
 Pill for Women, 591 
 
 Uterine, 65 
 
 Vascular, 65 
 
 Vesical, 66 
 Tonsillitis, 857 
 Tonsils, Enlarged, 857 
 
 Ulcerated, 858 
 Toothache, — See Odontalgia, 779 
 Toothrash, — See Strophulus, 846 
 Torrefaction, 563 
 Torticollis, 858 
 Torulae, — See Sarcinae, 834 
 
 Toxalbumins, 510, 514 
 Toxemia, 858 
 
 Toxicological Antagonism, 34 
 Toxicology, 17, 33, 803 
 Toxin, Cholera, 516 
 
 Erysipelas, 515 
 
 Prodigiosus, 515 
 
 Rabies, 517 
 
 Tuberculosis, 511 
 Toxins, 510 
 
 Tracheitis, — See Croup, 661 
 Trachoma, — See Conjunctivitis, Granular, 
 
 655; Ophthalmia, 781 
 Tragacantha, 518 
 Transfusion, 69 
 
 Traumatic Fever, — See Surgical Fever. 
 Traumaticin, 309 
 Treacle, 463 
 Tree of Heaven, 120 
 Tremor, 858 
 Tri-bromo-methane, 221 
 Trichiniasis, 859 
 Trichloraldehyde, 254 
 Trichophytosis capitis, — See Tinea, 854 
 Trihydroxy-benzene, 97, 273 
 Trikresol, 85, 90 
 
 Trimethylamine, 197, 198, 310, 338, 381 
 Trimethyl- ethylene, 1 18 
 
 -xanthin, 227 
 Trinitrin, 150 
 Trinitrophenol, 104 
 Trional, 495 
 Trismus, 859 
 Triticin, 519 
 Triticum, 152, 519 
 Trituration, 563 
 Triturationes, 598 
 Triturations, their advantages, 599 
 
 of Elaterin, 309 
 
 Formulae, 600 
 
 of Mercury, 341, 599 
 Troches, 600 
 Trochisci, 600 
 Tropacocaine, 277, 278 
 Tropaiin, 278 
 Tropeius, 213 
 
 Tropical Fruit- Laxative, 479 
 Tropin, 213 
 Trypsin, 413 
 Tubercular Laryngitis, 752 
 
 Meningitis, 766 
 
 Peritonitis, 791 
 Tuberculin, 511 
 Tuberculin-R, 513 
 Tuberculocidin, 514 
 
 Tuberculosis, 859, — See also Tubercular 
 Laryngitis, etc., above ; also Lupus, 
 Phthisis, Scrofulosis, Tuberculous 
 Affections. 
 
 Acute, 859 
 
 Antitoxin, 180 
 Tuberculous Affections, 860 
 Tully's Powder, 398 
 
INDEX. 
 
 949 
 
 Tumenol, 496, 499 
 Tumors, 860 
 
 Diagnosis of, 904 
 
 Uterine, 872 
 Turnera aphrodisiaca, 299 
 Turpentine, 116, 503 
 
 as an Antidote, 806 
 
 Antidotes and Antagonists, 819 
 Turpeth Mineral, 341 
 Tympanites, 861 
 Typhlitis, 861 
 Typhoid Fever, 861 
 
 Diagnosis of, 907 
 
 Temperature in, 851 
 Typho-malarial Fever, — See Typhoid. 
 Typhus Fever, 863 
 
 Diagnosis of, 907 
 Tyrotoxicon, Antidotes, etc., 819 
 
 Ulcers and Sores, 864 
 
 of Rectum, 829 
 
 of Stomach, 707 
 
 of Tonsils, 858 
 
 of Uterus, 873 
 Ulmus, 519 
 Umbelliferon, 325 
 Umbrella-tree, 374 
 Unguenta, 600 
 Unguentum, 252 
 Urea, Agents affecting, 53, 54 
 
 in Urine, Test for, 869 
 Uremia, 866 
 Ureometers, 869 
 Urethan, 256 
 Urethral Stricture, 866 
 
 Injections, 578, 712 
 Urethritis, 867 
 Urginea maritima, 475 
 Uric Acid Diathesis, — See Lithemia, 755 
 Urinary Acidifiers, 64 
 
 Alkalinizers, 64 
 
 Astringents, 64 
 
 Disorders, 867 
 
 Sedatives, 64 
 Urine, Articles coloring, 868 
 
 Deposits in, 870 
 
 Examination of, 868 
 Urotropin, 430 
 Ursone, 325, 519 
 Urticaria, 870 
 Ustilago, 526 
 Uterine Affections, 871 
 
 Alteratives, 65 
 
 Cancer, 871 
 
 Congestion, 871 
 
 Depressants, 65 
 
 Displacements, 872 
 
 Extract, 167 
 
 Hypertrophy, 871 
 
 Prolapse, 821 
 
 Tonics, 65 
 
 Tumors, 872 
 
 Uterine Ulceration, Sj^ 
 Uva Ursi, 519 
 Uvula, 873 
 
 Vaccination, 873 
 
 Vaginismus, 874 
 
 Vaginitis, 874 
 
 Valerene, 520 
 
 Valerian, 299, 520 
 
 Valerianate, Butyl, 167 
 
 Valerianates, 520 
 
 Valerol, 338, 520 
 
 Vallet's Mass, 316 
 
 Van Buskirk's Sozodont, 902 
 
 Vanilla, 521 
 
 Vao, 298 
 
 Vapores (Vapors), 577 
 
 Vaporization, 564 
 
 Varicella, 874 
 
 Varicocele, 874 
 
 Varicosis, 874 
 
 Variola, 875 
 
 Diagnosis of, 906 
 Vascular Contractors, 65 
 
 Dilators, 66 
 
 Sedatives, 66 
 
 Stimulants, 66 
 
 Tonics, 65 
 Vaselin, 415 
 
 Vegetable Drugs, their Constituents, 17 
 Veins, — See Phlebitis, Phlegmasia, Vari- 
 cosis. 
 
 Transfusion by, 69 
 Velatine, 276 
 Vellarine, 348 
 Venice Turpentine, 503 
 Venom, Insect, Antidotes, 81 1 
 
 Serpent, Antidotes, etc., 818 
 Venous Medication, 69 
 Veratralbine, 522 
 Veratrine, 522 
 Veratroidine, 522 
 Veratrum Album, 521 
 
 Sabadilla, 521 
 
 Viride, 521 
 
 Antidotes and Antagonists, 819 
 Verbascum, 524 
 Verbs, Latin, 896 
 Verdigris, 297 
 Vermicides, 36 
 Vermifuges, 36, ^, 879 
 Veronica Virginica, 366 
 Verruca, — See Warts, 878 
 Vertigo, 875 
 
 Vesical Tonics and Sedatives, 66 
 Vesicants, 55 
 Viburnin, 525 
 Viburnum, 525 
 Vienna Paste, 437 
 Villate's Solution, 298, 639 
 Vina (Wines), 131, 602 
 Vinegar, 80 
 
950 
 
 INDEX. 
 
 Vinegar Bitters, 902 
 Vinegars (Aceta), 565 
 Vinum, 130 
 Viola Cucullata, 525 
 
 Tricolor, 525 
 Violet, 525 
 Violine, 525 
 Viscum, 525 
 
 Visions, Agents producing, 66 
 Vita Nuova, 902 
 Vitellus, 121 
 Vitriol, Elixir of, 104 
 Vleminck's Solution, 668 
 Volatile or Essential Oils, 27 
 Volkmann's Antiseptic Fluid, 508 
 Vomiting, 876 
 
 of Pregnancy, 877 
 
 Diagnosis of, 907 
 Vulva, 878 
 Vulvitis, 878 
 
 Wade's Bougies, 595 
 Wafers, 592 
 Wahoo, 315 
 
 Walker's Vinegar Bitters, 902 
 Walnut, White, 363 
 Warburg's Tincture, 271, 276 
 Warming-plaster, 244, 431 
 Warner's Safe Cure, 902 
 Warts, 878 
 Wash, 579 
 
 Black, 341 
 
 Hair, 611, 715 
 
 Lead and Opium, 580 
 
 Mouth, 715 
 
 Nasal, 578, 643 
 
 Yellow, 341 
 Washing, 565 
 
 Waste, Agents promoting, 45 
 Wasting, — See Atrophy, Emaciation. 
 Water, 45, 185 
 
 of Carbolic Acid, 84 
 
 Carbonated, 91, 93 
 
 Cherry-laurel, 99, 101 
 
 Cologne, 131 
 
 of Crystallization, 558 
 
 Distilled, 185 
 
 Eye, Thompson's, 902 
 
 Hunyadi, 657 
 
 Javelle, Antidotes, etc., 813 
 
 Lavender, 366 
 
 Lead, 433, 435 
 
 Lime, 235 
 
 Oxygenated, 408 
 
 Sedative, 145, 239 
 
 Soda, 91, 93, 185 
 
 Tar, 431 
 Water-brash, — See Pyrosis, 828 
 
 -lily, 395 
 -pepper, 436 
 Waters (Aquae), 566 
 
 Waters, Mineral, 91, 185 
 
 Nomenclature, 185 
 Wax, 251 
 
 Myrtle, 96, 251 
 Waxes, 26 
 
 Weakness, — See Adynamia, Exhaustion. 
 Weight of a Drachm in Grains, 910 
 Weights and Measures, 532, 910 
 
 Apothecaries', 533? 9 JO 
 
 British Pharmacopceial, 533 
 
 Metric, 534, 910 
 
 Table for Converting, 91 1 
 Wen, 879 
 Wheat, 152, 154 
 Whiskey, 130 
 White of Egg, 127 
 White-leg, — See Phlegmasia, 795 
 White-swelling, — See Joints, Synovitis. 
 Whitlow, — See Onychia, 780 
 Whooping-cough, — See Pertussis, 793 
 Willow, 464 
 Wine, 130 
 
 Wines (Vina), 131, 602 
 Winslow's (Mrs.) Soothing Syrup, 399 
 Winterberry, 442 
 Wintergreen, 325, 464 
 Witch-hazel, 96, 336 
 Wolf's-bane, 106 
 Wolff's Formula, 1 23 
 Wood Oil, 335 
 
 Spirit, 130 
 Wool-fat, III 
 Woorara, 298 
 
 Words and Phrases, Latin, 883, 897 
 Worm-grass, 487 
 Worms, 36, 333, 879 
 Wormseed, 253 
 
 Levant, 471 
 Worm Tea, 487 
 Wormwood, 76 
 Wounds, 880 
 
 Poisoned, Antidotes, etc., 819 
 Writers' Cramp, — See Spasmodic Affec- 
 tions, 841 
 Wry-neck, — See Torticollis, 858 
 
 Xantho-puccine, 346 
 Xanthoxyline, 525 
 Xanthoxylum, 525 
 Xeroderma, — See Ichthyosis, 738 
 Xeroform, 219 
 
 Yam, Wild, 306 
 Yellow Fever, 881 
 
 Diagnosis of, 907 
 Yerba Santa, 313 
 Yolk of Egg, 121, 127 
 Yvon's Hypnotic Elixir, 744 
 
INDEX. 
 
 951 
 
 Zea, 526 
 
 Mays, 152, 462, 526 
 Zinc, 527 
 
 Phosphide, 418 
 
 Salts, Antidotes, etc., 819 
 
 Zincite, 527 
 
 Zincum, 527 
 
 Zingiber, 530 
 
 Zona, — See Herpes Zoster, 735 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 13 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 15 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 17 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 19 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 29 
 
 The Physician's Visiting List. 
 
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 only. 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 31 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 33 
 
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MEDICAL AND SCIENTIFIC PUBLICATIONS. 35 
 
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 41 
 
O NE VOLUME 
 
 A Cyclopedia of Practical 
 Medicine and Surgery 
 
 A CONCISE REFERENCE BOOK, ALPHABETICALLY 
 
 ARRANGED 
 
 OF 
 
 medicine, surgery, obstetrics, materia medica, therapeutics, 
 
 and the various specialties, with particular 
 
 reference to diagnosis and treatment 
 
 COMPILED UNDER THE EDITORIAL SUPERVISION OF 
 
 GEORGE M. GOULD, MIX AND WALTER L* PYLE, M.D. 
 
 Author of "An Illustrated Dictionary of Medicine;" Assistant Surgeon Wills Eye Hospital j formerly 
 
 Editor " American Medicine/' etc. Editor ** International Medical Magazine," etc- 
 
 WITH SEVENTY-TWO SPECIAL CONTRIBUTORS 
 
 WITH MANY ILLUSTRATIONS 
 
 LARGE SQUARE OCTAVO. TO CORRESPOND WITH GOULD'S " ILLUSTRATED 
 DICTIONARY." FULL SHEEP OR HALF DARK-GREEN LEATHER, $10.00? 
 WITH THUMB INDEX, $11.00? HALF RUSSIA, THUMB INDEX, $12.00, NET 
 
 The great success of Dr. Gould's " Illustrated Dictionary of Medicine " suggested 
 the preparation of this companion volume, which should be to the physician the same 
 trustworthy handbook in the broad field of general information that the Dictionary is 
 in the more special one of the explanation of words and the statement of facts. The 
 aim has been to provide in a one-volume book all the material usually contained in 
 the large systems and much which they do not contain. Instead of long discursive 
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 arranged, giving the latest methods of diagnosis, treatment, and operating — a working 
 book in which the editors and their collaborators have condensed all that is essential 
 from a vast amount of literature and personal experience. 
 
 The illustrations have been selected with care, only those having been used that are 
 of practical value ; no effort has been made to overload the book with useless pictures. 
 
 The seventy-two special contributors — the names of whom are given on the 
 following page — have been selected from all parts of the country in accordance 
 with their fitness for treating special subjects about which they may be considered 
 expert authorities. They are all men of prominence, teachers, investigators, and 
 writers of experience, who give to the book a character unequaled by any other work 
 of the kind. 
 
 V LARGE DESCRIPTIVE CIRCULAR UPON APPLICATION 
 
 42 
 
GOULD AND PYLES 
 
 CYCLOPEDIA OF MEDICINE 
 
 LIST OF CONTRIBUTORS 
 
 Samuel W. Abbott, A.M., M.D., Boston. 
 
 James M. Anders, M.D., LL.D., Phila. 
 
 Joseph D. Bryant, M.D., New York. 
 
 James B. Bullitt, M.D., Louisville. 
 
 Charles H. Burnett, A.M., M.D., Phila. 
 
 J. Abbott Cantrell, M.D., Philadelphia. 
 
 Archibald Church, M.D., Chicago. 
 
 L/ Pierce Clark, M.D., Sonyea, N. Y. 
 
 Solomon Solis-Cohen, M.D., Philadelphia. 
 
 Nathan S. Davis, Jr., M.D., Chicago. 
 
 Theodore Diller, M.D., Pittsburg. 
 
 Augustus A. Eshner, M.D., Philadelphia. 
 
 J. T. Eskridge, M.D., Denver, Col. 
 
 J. McFadden Gaston, A. B., M.D., Atlanta, 
 Ga. 
 
 J. McFadden Gaston, Jr., A.M., M.D., At- 
 lanta, Ga. 
 
 Virgil P. Gibney, M.D., New York. 
 
 George M. Gould, A.M., M.D., Phila. 
 
 W. A. Hardaway, A.M., M.D., St. Louis. 
 
 John C. Hemmeter, M.B., M.D., Baltimore. 
 
 Barton Cooke Hirst, M.D., Philadelphia. 
 
 Bayard Holmes, M.D., Chicago. 
 
 Orville Horwitz, B.S., M.D., Philadelphia. 
 
 Daniel E. Hughes, M.D., Philadelphia. 
 
 James Nevins Hyde, A.M., M.D., Chicago. 
 
 E. Fletcher Ingals, A.M., M.D., Chicago. 
 
 Abraham Jacobi, M.D., New York. 
 
 William W. Johnston, M.D., Washington, 
 D. C. 
 
 Wyatt Johnston, M.D., Montreal. 
 
 Allen A.Jones, M.D., Buffalo. 
 
 William W. Keen, M.D., LL.D., Phila. 
 
 Howard S. Kinne, M.D., Philadelphia. 
 
 Ernest Laplace, M.D., Philadelphia. 
 
 Benjamin Lee, M.D., Philadelphia. 
 
 Charles L. Leonard, M.D., Philadelphia. 
 
 James Hendrie Lloyd, A.M., M.D., Phila. 
 
 J. W. MacDonald, M.D. (Edin.), F.R.C.S. 
 Ed., Minneapolis. 
 
 L. S. McMurtry, M.D., Louisville. 
 
 G. Hudson Makuen, Philadelphia. 
 
 43 
 
 Matthew D. Mann, M.D., Buffalo. 
 
 Henry O. Marcy, A.M., M.D., LL.D., 
 
 Boston. 
 Rudolph Matas, M.D., New Orleans. 
 Joseph M. Mathews, M.D., Louisville. 
 John K. Mitchell, M.D., Philadelphia. 
 Harold N. Moyer, M.D., Chicago. 
 John H. Musser, M.D., Philadelphia. 
 A. G. Nicholls, M.D., Montreal. 
 
 A. H. Ohmann-Dusmesnil, M.D., St. 
 Louis. 
 
 William Osier, M.D., Baltimore. 
 
 Samuel O. L. Potter, A.M., M.D., M.R. 
 
 C.P. (London), San Francisco. 
 Walter L. Pyle, A.M., M.D., Philadelphia. 
 
 B. Alexander Randall, A.M., M.D., Phila. 
 Joseph Ransohoff, M.D., F.R.C.S. (Eng.), 
 
 Cincinnati. 
 Jay F. Schamberg, A.M., M.D., Phila. 
 Nicholas Senn, M.D., LL.D., Chicago. 
 Richard Slee, M.D., Swiftwater, Pa. 
 S. E. Solly, M.D., M.R.C.S., Colorado 
 
 Springs, Col. 
 Edmond Souchon, M.D., New Orleans. 
 Ward F. Sprenkel, M.D., Philadelphia. 
 Charles G. Stockton, M.D., Buffalo. 
 John Madison Taylor, A.M., M.D., Phila. 
 William S. Thayer, M.D., Baltimore. 
 James Thorington, A.M., M.D., Phila. 
 Martin B. Tinker, M.D., Philadelphia. 
 James Tyson, M.D., Philadelphia. 
 J. Hilton Waterman, M.D., New York. 
 H. A. West, M.D., Galveston, Texas. 
 J. William White, M.D., PH.D., Phila. 
 Reynold W. Wilcox, M.A., M.D., LL.D., 
 
 New York. 
 George Wilkins, M.D., Montreal. 
 DeForest Willard, M.D., Philadelphia. 
 Alfred C. Wood, M.D., Philadelphia. 
 Horatio C. Wood, M.D., LL.D., Phila. 
 Albert Woldert, PH.G., M.D., Phila. 
 James K. Young, M.D., Philadelphia. 
 
Deaver's Surgical Anatomy 
 
 A Treatise on Human Anatomy 
 in its Application to the Practice 
 of Medicine and Surgery J> & 
 
 By JOHN B. DEAVER, M.D. 
 
 Surgeon-in- Chief to the Ger7nan Hospital, Philadelphia ; Surgeon to the Children's Hospital; 
 
 Consulting Surgeon to St. Agnes' ' , St. Timothy' s , and Germantown 
 
 Hospitals; formerly Assistant Professor of Applied 
 
 Anatomy, University of Pennsylvania, etc. 
 
 In Three Royal Octavo Volumes, containing about Four Hundred and Fifty Full-page Plates, 
 nearly all from dissections made for the purpose 
 
 Handsome Cloth, $21.00 ; Full Sheep, $24.00 ; Half Green Morocco, 
 Marbled Edges, $24.00 ; Half Russia, Gilt, Marbled Edges, $27.00 net. 
 
 SYNOPSIS OF CONTENTS 
 
 VOLUME L— Upper Extremity— Back of Neck, Shoulder, and Trunk— Cranium— Scalp- 
 Face ♦ 
 
 VOLUME IL— Neck— Mouth, Pharynx, Larynx, Nose— Orbit— Eyeball— Organ of Hearing- 
 Brain — Female Perineum — Male Perineum ♦ 
 
 VOLUME EL— Abdominal Wall— Abdominal Cavity— Pelvic Cavity— Chest— Lower Ex- 
 tremity. 
 
 The book is designed to aid the general practitioner and surgeon in his 
 everyday work. The text is excellently clear, succinct, and systematically arranged, 
 and contains a wealth of illustrations far in advance of the usual text-book. It is not 
 intended merely for the surgeon — though to him it will prove invaluable — but for the 
 general physician, who, while called upon to cope with innumerable emergencies and 
 special cases, has not the means or the hospital facilities by which he can readily 
 acquaint himself with every phase of anatomy — superficial and deep — as applied to 
 disease and the most modern methods of treatment of injuries. 
 
 To the specialist it will prove of great value. The anatomy of the head and 
 neck, the spinal cord, the organs of sense, and the throat appeals directly to the 
 ophthalmologist, aurist, rhinologist, laryngologist, and neurologist, while those sections 
 devoted to the abdomen and pelvic cavity will give the gynecologist and specialist 
 on diseases of the urinary organs, rectum, etc., material regarding the relations of the 
 parts and the operations thereon, unique in many ways, and in a manner never before 
 so exactly and concisely stated. To those devoted to these specialties it will prove a 
 supplement to other text-books that omit special anatomy, and which do not attempt 
 to show the applied anatomy* 
 
 44 
 
Deaver's Surgical Anatomy 
 
 The illltstf ations, which at the first glance appear as the prominent feature of 
 the book-— but which in reality do not overshadow the text — consist of a series of 
 pictures absolutely unique and fresh. They will bear comparison from an artistic point 
 of view with any other work, while from a practical point of view there is no other 
 volume or series of volumes to which they can be compared. When originally an- 
 nounced, the book was to contain two hundred illustrations. As the work of prepara- 
 tion progressed, this number gradually increased until it is estimated that there will now 
 be more than four hundred full-page plates, many of which contain more than one 
 figure. With the exception of a few minor pictures made from preparations in the 
 possession of the author, they have all been drawn by special artists from dissections 
 made for the purpose in the dissecting-rooms of the University of Pennsylvania. Their 
 accuracy cannot be questioned, as each drawing has been submitted to the most careful 
 scrutiny. 
 
 From The Medical Record, New York. 
 
 * The reader is not only taken by easy and natural stages from the more superficial to the 
 deeper regions, but the various important regional landmarks are also indicated by schematic 
 tracing upon the limbs. Thus the courses of arteries, veins, and nerves are indicated in a way that 
 makes the lesson strikingly impressive and easily learned. No expense, evidently, has been 
 spared in the preparation of the work, judging from the number of full-page plates it contains, not 
 counting the smaller drawings. Most of these have been ' drawn bv special artists from dissections 
 made for the purpose in the dissecting-rooms of the University of Pennsylvania.' In summing up 
 the general excellences of this remarkable work, we can accord our unqualified praise for the 
 accurate, exhaustive, and systematic manner in which the author has carried out his plan, and we 
 can commend it as a model of its kind, which must be possessed to be appreciated." 
 
 From The Philadelphia Medical Journal. 
 
 " Many members of the profession to whom Dr. Deaver is well known either personally or by 
 reputation as a surgeon, writer, teacher, and practical anatomist, have awaited the appearance of 
 his Surgical Anatomy with the expectation of finding in it a guide in this difficult branch of medi- 
 cine of much more than ordinary practical value, and their expectations will not be disappointed/' 
 
 From The Journal of the American Medical Association. 
 
 " In order to show its thoroughness, it is only necessary to mention that no less than twelve 
 full-page plates are reproduced in order to accurately portray the surgical anatomy of the hand, 
 and it is doubtful whether any better description exists in any work in the English language." 
 
 From The Southern California Practitioner. 
 
 " Aside from the merit of this great work, it will be a delight to the lover of books. Its gen 
 eral make-up shows the highest development of the book-making art. The bibliophile, when 
 holding one of these volumes in his hands, would be as careful with it as though he were handling 
 an infant, and to drop it would cause him the keenest pain. The illustrations, the print, and the 
 paper and binding are each and all delightful in themselves, and yet the text is concise and clear, 
 and taken with the illustrations make a remarkably good substitute for the dissecting-room. To 
 have these three volumes on his library shelves will be a source of pride and joy and profit to 
 every practitioner. Dr. Deaver has in these volumes conferred a boon upon the medical profession 
 which has, at least, never been surpassed by any one." 
 
 From The New Orleans Medical and Surgical Journal. 
 
 " While the needs of the undergraduate have been fully kept in view, it has been the aim of 
 the author to provide a work which would be sufficient for reference for use in actual practice. We 
 believe the book fulfils both requirements. The arrangement is systematic and the discussion of 
 surgical relations thorough." 
 
 jggg~ Large Descriptive Circular will be sent upon application 
 
 45 
 
COHEN 
 
 Physiologic Therapeutics 
 
 ANNOUNCEMENT 
 
 The term ** Physiologic Therapeutics " comprises that great variety of remedial measures 
 other than the use of drugs, by which the natural or physiologic powers of the human body 
 may be stimulated, controlled, or supplemented in the fight against disease. They 
 represent the internal and environmental forces, through whose action and reaction 
 the evolution of the human body and mind has progressed, the powers of resistance 
 have developed, and the tendency to recovery has become organized. They are there- 
 fore among the most potent aids of the physician. The title ' ' Physiologic Therapeutics ' ' 
 has been adopted for the present series of volumes to emphasize the fact that the 
 measures described are in largest degree elaborations and adaptations of processes 
 normal to the human body — physiologic, therefore — but requiring to be exaggerated, 
 systematized, specialized, and often localized for therapeutic purposes. 
 
 These therapeutic methods, which include not only the use of rest, exercise and 
 special manipulations of the body, light, heat and electricity, air, water and food, 
 climate and mineral springs, bacterial products, and the sera secretions and organs of 
 normal and artificially immunized animals, but also the legitimate powers of the mind 
 over mind and body, have never been entirely neglected. Until recently, however, 
 they have not been systematically presented in lectures, and even now they are too 
 much neglected by practitioners. It is not only in typhoid fever that water has therapeu- 
 tic application ; it is not only in hysteria that rest and massage and psychic influence 
 are curative ; it is not only in pulmonary tuberculosis that the use of air at modified 
 pressures or special climatic factors are to be availed of. These agencies and the other 
 resources of physiologic therapeutics have varied and extensive usefulness, and when 
 indicated cannot be substituted by the most skillful drugging. Their knowledge is im- 
 peratively demanded of the progressive physician. 
 
 While there have been monographs upon many of these subjects, this is the first 
 systematic collection of volumes including all these topics into an organized whole, dom- 
 inated by one mind, and so planned and arranged that the entire field should be 
 covered by experts under the guidance and assistance of one who has devoted his pro- 
 fessional work in large part to the study, use, and advocacy of the measures compre- 
 hended ; each volume, moreover, being especially written with reference to other 
 volumes of the System, and to the requirements of the System as a whole. In each 
 volume and each article sufficient attention has been paid to the theory of the subject 
 to make clear the principles upon which are based the specific recommendations for 
 the applications of special measures to individual cases of disease ; but the largest space 
 has been devoted to practical detailed directions, explanations of technic, manipulation, 
 indications and counterindications. 
 
 See Pages g and 10 of this Catalogue. 
 
 *** An elaborate descriptive circular with sample pages and detailed information concern- 
 ing plan of publication, prices, etc., will be sent upon application. 
 
 46 
 
JUST READY 
 
 DISEASES of the INTESTINES 
 
 THEIR SPECIAL PATHOLOGY, 
 DIAGNOSIS, AND TREATMENT 
 
 WITH 
 
 Sections on Anatomy and Physiology ; Microscopic and Chemic 
 Examination of the Intestinal Contents, Secretions, Feces and 
 Urine, Intestinal Bacteria and Parasites; Surgery of the Intes- 
 tines ; Dietetics ; Diseases of the Rectum, etc* 
 
 By JOHN C HEMMETER, MIX, PHILOS*D* 
 
 Author of "A Treatise on Diseases of the Stomach"; Professor in the Medical Department of the 
 
 University of Maryland ; Consultant to the University Hospital and 
 
 Director of the Clinical Laboratory 
 
 IN TWO OCTAVO VOLUMES 
 With Many Original Illustrations, Several in Colors 
 
 The Section on Anatomy has been prepared by Dr. J. Holmes Smith, Associate Pro- 
 fessor and Demonstrator of Anatom;-, and Lecturer on Clinical Surgery, University 
 of Maryland, Baltimore. 
 
 The Section on Bacteria of the Intestines has been prepared by Dr. Wm. Royal Stokes, 
 Associate Professor of Pathology and Bacteriology, and Visiting Pathologist to the 
 University Hospital, University of Maryland, Baltimore. 
 
 The Section on Diseases of the Rectum has been prepared by Dr. Thomas C. Martin, 
 Professor of Proctology, Cleveland College of Physicians and Surgeons. 
 
 The Section on Examination of Urine and Feces has been prepared by Dr. Harry 
 Adler, Demonstrator of Clinical Pathology, University of Maryland, Baltimore. 
 
 VoL I— 742 Pages; 2 Plates in Colors; 35 Full-Page Plates 
 and other Illustrations* Cloth, $5*00; Sheep, $6*00 net 
 
 VoL II.— 679 Pages; \ 3 Full-Page Plates and Many Other 
 Illustrations* Cloth, $5*00 ; Sheep, $6*00 net* 
 
 This work, together with the author's book on " Diseases of the Stomach," forms a complete 
 treatise on Diseases of the Intestines. The subject is covered thoroughly and systematically by an 
 author of well-known reputation and ability. The results of recent investigation, by which so 
 much progress has been made in the Pathology, Diagnosis, and Medical and Surgical Treatment of 
 disorders of the intestinal tract, make its issue at this time of special importance. 
 
 The illustrations form a most useful and practical series of pictures ; nearly all have been repro- 
 duced from pathological preparations and original drawings made especially for this work. 
 
 *** Circular with List of Contents will be sent upon application 
 
 47 
 
PRACTICAL GYNECOLOGY 
 
 A Modern Comprehensive Text-Book 
 By E. E. MONTGOMERY, M.D. 
 
 Professor of Gynecology, Jefferson Medical College; Gynecologist to the Jefferson Medical 
 
 College and St. Joseph's Hospitals; Consulting Gynecologist to 
 
 the Philadelphia Lying-in Charity 
 
 * 
 
 WITH FIVE HUNDRED AND TWENTY-SEVEN 
 ILLUSTRATIONS 
 
 Nearly all of which have been Drawn and Engraved Specially for this 
 "Work, for the most part from Original Sources 
 
 OCTAVO. 819 PAGES. CLOTH, $5.00 j LEATHER, $6.00 
 
 From THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 
 
 " Fashion in medical book-making seems to be running to the composite, which 
 may be advantageous and the means of producing a better book than one written by 
 an individual. It may be the old-fashioned notions of the reviewer, but he belives in 
 the old idea of one book, one author, and he should have all the responsibility, all the 
 criticism, and all the glory that attach to it. The composite is likely to be written 
 under a ' rush ' order — so much space, in so much time, for so much money. The work 
 before us is the work of one individual, and the personality of that individual is evident 
 through the whole book. ♦ ♦ . The result shows painstaking effort in every detail, 
 in conciseness of statements, in arrangement of subjects, and in the systematic order 
 and completeness in which each is considered. . . . The author is neither too 
 radical nor too conservative in his consideration of the conditions that may need radical 
 operations. In the introduction he tells us that the true gynecologist must be ' so con 
 servative that he will sacrifice no organ whose physiologic integrity is capable of being 
 restored ; so bold and courageous that his patient shall not forfeit her opportunity for 
 life or restored health through his failure to assume the responsibility of any operative 
 procedure necessary to secure the object.' This is the basal idea that permeates the 
 book : the ultra-radical operator will find no endorsement, and the * tinkering ' gynecologist- 
 he who treats all diseases of women by means of a pledget of cotton and a speculum — 
 no encouragement in its pages. 
 
 "The book is one that can be recommended to the student, to the general practi- 
 tioner — who must sometimes be a gynecologist to a certain extent whether he will or not 
 — and to the specialist, as an ideal and in every way complete work on the gynecology of 
 to-day — a practical work for practical workers." 
 
00T -0 /o/,/ 
 

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 Explanation. — In Writing a Prescription look for the dose of the ingredient (say gr. 
 the column headed by the size of your mixture ( % vi) ; then on that line in the left marginal column is 
 the quantity (gr. ijss) you must put into the entire mixture to get your close in each drachm thereof. 
 In Reading a Prescription finrl the quantity of any ingredient called for in the left marginal column 
 (say gr. %), and on the same line in the column headed by the number of ounces in the mixture ( 5 IIj) 
 you will find the quantity ( gr. T : j) in each drachm dose. Of course when the dose is more or less than 
 51 the result must be proportionately multiplied or divided accordingly. 
 
 Copyrighted, 1894, by P. Blakiston, Son & Co. 
 
mnmmw 
 
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 LIBRARY OF CONGRESS 
 
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