/Aateria^e.dica LIBRA! )NGRESS. Ciiapl ^ ' Copyright No. Shelf. :.Jk± 597 UNITED STATES OF AMERICA. TEXT-BOOK OF MATERIA MEDICA FOR NURSES COMPILED BY LAVINIA L. DOCK GRADUATE OF BELLEVUE TRAINING SCHOOL FOR NURSES THIRD EDITION, REVISED AND ENLARGED ELEVENTH THOUSAND G. P. PUTNAM'S SONS NEW YORK LONDON 27 WEST TWENTY-THIRD STREET 24 BEDFORD STREET, STRAND Vyt guxickerbockw IpHSS 1897 a:. TWO C9Hf:S RECEIVED Copyright 1890 BY LAVINIA L. DOCK Copyright 1897 BY G. P. PUTNAM'S SONS Ube Iknfcfcerbocfcetr press, mew lorfc CONTENTS PAGE Part I. — The Inorganic Materia Medica : The Alkalies and Alkaline Earths ..... I The Metals . . ' 18 Non-Metallic Elements ,49 Inorganic Acids ........ 63 Organic Acids . . . . . . . .68 The Carbon Compounds ....... 76 Part II. — The Organic Materia Medica : The Vegetable Kingdom . . . . . . .113 The Animal Kingdom . . . . . . 204 New Drugs Arranged Alphabetically .... 211 Appendix. 223 Index 227 PREFACE- The study of materia medica is made, to some ex- tent, a part of the course in all our training schools for nurses ; bat, so far, no text-book has been prepared along the special lines followed in class recitations. Those special lines are well defined, and are limited. They begin and end with medicines, and do not run into therapeutics. The application of medicine to dis- ease is no part of a nurse's study, and there are there- fore some inconveniences met with in using — as text- books — works on materia medica which are written solely for the use of the medical profession. Large works, containing all the points which a nurse needs to know, contain also an immense amount of mat- ter with which she has nothing to do, and are very ex- pensive ; while those which are more concise usually presuppose a large amount of information, and are, in- deed, not intended to be used at the beginning of a course of study, but rather at the end. It is in the hope of filling this middle place that this text-book has been compiled, and the attempt made to collect from all available sources the scattered points which concern a nurse, and to give them simply and directly. The outlines followed are those of the classes in materia medica as taught in most of our Training Schools for nurses, and include something of the source and composition of drugs ; their physiological actions ; signs indicating their favorable or unfavorable results ; the symptoms of poisons with their antidotes ; and prac- tical points on administration. For material I am indebted to the following works : " Materia Medica and Therapeutics," by Dr. H. C. Wood ; VI PREFACE. " Quiz Compend of Materia Medica," by Dr. S. 0. Potter ; " Materia Medica and Therapeutics," by Dr. R. Bartho- low ; " Lectures on Materia Medica and Therapeutics," by Dr. Thomson, edited by Dr. Le Fevre ; " Manual of Pharmacology, Therapeutics, and Materia Medica," by Dr. T. Lauder Brunton ; " Materia Medica and Therapeutics," by Dr. J. Mitchell Bruce ; and Dr. Farquharson's " Guide to Therapeutics and Materia Medica," edited by Dr. Woodbury. I gratefully acknowledge the kind permission accorded by the authors and publishers of the first five works to make extracts from them. For the use of the two lat- ter I am indebted to the courtesy of Messrs. Lea Brothers. Sincere thanks are due also to Dr. Charles Rice for much kindness in giving assistance and information, and in contributing a table of comparison between minims and drops ; and to Dr. George Dock for revi- sion and corrections and for many practical suggestions. The classification follows that used by Dr. Brunton and Dr. Bruce. The doses are taken from Dr. Wood's " Materia Medica and Therapeutics." PREFACE TO THE THIRD EDITION. In response to various suggestions I have added a number of drugs, both old'and new, and have given the metric system of dosage in addition to the old measure- ments. For all of the work on the preliminary chapter descrip- tive of the metric system, the classification of drugs ac- cording to their physiological effects, and the table of poisons and antidotes, I am indebted to Miss Mary Cloud Bean of the Johns Hopkins Training School for Nurses. INTRODUCTION. The broad meaning of medicine {Medicina) is " the science and art of healing and curing the sick " (Gould) ; but aside from this meaning the word is used in a re- stricted sense, to signify a drug used for the cure or re- lief of disease. The word drug means " a substance, simple or compound, natural or prepared, single or mixed with other substances, used as a medicine " (Gould); and " Materia Medica " covers the entire list of such sub- stances, with their whole history. On beginning the study of Materia Medica a general knowledge should be acquired of the classification of drugs considered from three standpoints : I. Their source or derivation. II. Their physiological actions. III. Their ultimate forms and appearance as prepared in the pharmacy by definite, standard formulae, for ad- ministration. I. Both the organic and inorganic worlds furnish ma- terial useful for medicine, and in the former both the animal and vegetable kingdoms are represented. The class of inorganic drugs is large, and comprises alkalies, alkaline earths, acids, metals and non-metals, and com- plex chemical compounds, as the carbon compounds. Among them all are many familiar elements, as lead, iron, etc. The animal kingdom furnishes but a small quota. The drugs of vegetable origin are by far the most numerous, and are obtained from green and flowering plants, both fresh and dry, fungi, and lichens. The whole plant may be represented or a part only, as the flowers, seeds, fruit, X INTRODUCTION. stems, or roots. The constituents of vegetable drugs are many and varied in character, some of them being of great potency. They are extracted from the plant and isolated in a pure form by elaborate chemical processes, and by means of especially constructed appliances. The principal ones are as follows : Aromatic, odorous, and bitter principles, albuminous bodies, starches and sugars, glucosides, oils, gums, resins and oleo-resins, and alkaloids. Gums are exudations from the stems of plants. Resins are solid, brittle, non-volatile substances, insoluble in water ; and oleo-resins may be broken up into resins and volatile oils. The alkaloids are the most important, forming as they do a class of poisons of marked characteristics and great intensity. They are nitrogenous compounds, many of them of deadly power, and are spoken of as the " active principles " of those drugs in which they are found, and to which they lend their own distinctive properties. The name alkaloid is given to them from their similarity in many ways to alkalies. The other constituents of vegetable drugs are relatively unimportant. II. In considering drugs in reference to the second division we find them grouped according to the effect they have on the human organism in disease. This mode of classification must be grasped broadly, not by rule. It is impossible to assign fixed and definite places to all medicines from this standpoint, or to draw sharp lines of division. Remembering the complex nature of plants, and that one drug may contain more than one active alka- loid, and a number of the less important substances just named, it is evident that one medicine may have several actions ; and practically it is found that their effects arc as scales of varying gradation, and run insensibly into one another. The same drug that in small doses acts as a beneficent agent, may in large ones be an overwhelming poison. One given to quiet the nervous system may also constipate ; another given for purgation may seriously reduce the strength of the heart ; another given to strengthen the heart may also increase the flow of urine, IN TROD UCTION. XI so that classification may well be sometimes a little puzzling. It will dispel bewilderment to remember that the most important and prominent characteristic of a drug is usu- ally taken -as its representative quality, the others being for the time ignored. Individual peculiarities have much to do in modifying the physiological actions of drugs. The more highly strung nervous organizations respond more quickly, as a rule, to the actions of drugs than do those of coarser fibre, and more quickly show evidence of over-dosing and mild poisoning. Among these temperaments are found many examples of what is called " idiosyncrasy " — that is, an increased susceptibility to the effects of a drug which en- tirely forbids its use, and for which no reason can be discovered. Custom makes a decided difference, and the action of a medicine is more energetic with one unused to it. With frequent repetition comes "toleration," when the, system accommodates itself to the drug, and larger doses can be taken with relatively less effect. Beyond this point comes "habit," when the system not only tolerates but craves the drug in ever increasing quantities, and with the result of a progressive degradation of the will power, as is most strikingly shown in the ascendency of alcohol and opium over the individual. " Accumulation " and " cumulative action " of drugs are expressions often met and are self-explanatory up to a certain point. While it might be difficult to explain the exact processes in the body tissues by which drugs are stored up or accumulate in them, it is, fortunately, sufficient for practical purposes to know that a number of drugs do become apparently fixed in the tissues, and that many others accumulate by being given more rapidly than they can be excreted. Age is an important factor to consider. Strong drugs, and especially those that act on the brain, are given with much care to children and to the aged. The condition of the stomach is another point to consider. Medicines act more rapidly on an empty stomach, and any irritating Xll INTRODUCTION. properties they may have are then more marked. Given with or soon after food the action is more gentle and slow. The kinds of food taken are to be thought of, and any which might neutralize the medicine should be put off for a safe interval. In giving medicines to produce sleep, all conditions favorable to sleep must first be secured. The good effect of many a hypnotic is lost through the failure to provide darkness, warmth, and quiet before giving it. In general the effects of medicines are classed as pri- mary and secondary, immediate or remote. By the primary or immediate action is meant the first definite result of the drug, and subsequent changes which are brought about by this first result are termed the secondary or re- mote effects, viz., if a diuretic is administered to a drop- sical patient a copious flow of urine soon occurs as the primary effect. As a result of increased urination fluid is largely abstracted from the body tissues, and the con- sequent diminution of the dropsy is the secondary effect. The classes of medicine according to their physiological actions are arranged alphabetically as follows : Antispasmodics. — Those which relieve convulsions and spasmodic pains (Gould): Anaesthetics. — Those which produce a state of in- sensibility to pain. They may be (a) general, as ether ; or {b) local, as cocaine. v Astringents. — Those which tend to contract the tissues, thus checking secretions. Alteratives. — A rather vague term, not universally approved, applied to certain drugs which have an unex- plainable power over the nutritive processes. Anodynes, Analgesics. — Those which give relief from pain. Antiperiodics. — Those which break up the rhythmical character of some manifestations of disease, as chills in ague. Antipyretics. — Those which reduce fever. Antacids. — Those which counteract acidity. Anthelmintics. — Those used to expel (vermifuge) or kill (vermicide) intestinal parasites. Absorbents. — Those which produce absorption and exudation of diseased tissue (Gould). INTRODUCTION. xill Analeptics. — Restorative medicines, or food. Antiarthritics. — Medicines which relieve gout. Antihydropics. — Those which relieve dropsical con- ditions. Antilithics. — Those which dissolve calculi. Antiseptics. — Medicines which prevent putrefaction. Antizymotics. — Those which have power to kill disease germs. Aromatics. — Medicines characterized by a spiciness of odor and taste, stimulant to the gastro-intestinal mu- cous membrane. Bitters— Simple. — Medicines which have a bitter taste and power of stimulating the gastro-intestinal tract without affecting the general system. Bitters — aromatic. — Those which unite the proper- ties of the aromatics and the bitters. Carminatives are slightly stimulant, and expel gas from the stomach and intestines. Cardiac Stimulants. — Those which strengthen the heart's action. Cardiac Depressants. — Those which weaken the heart's action. Cathartics, Purgatives.— Those which produce evacuation of the bowels. They are subdivided as fol- lows : laxatives, or aperients, those of gentle actiom among which are fruits and some vegetables ; drastic cathartics, those of severe action causing griping ; hydra- gogue cathartics, those which remove water freely from the intestines. Some of the drastics belong to this class, and all salines. Saline cathartics produce a copious flow of serum from the intestinal walls into the canal. The blood serum being of one degree of alkalinity and the salts a much stronger solution, an active exchange takes place until the two are equalized. It was formerly taught that salts should be given in a large quantity of water, but Dr. Hay teaches giving them in saturated solution, and states that it is not the amount of water in the canal, but in the tissues that is of importance, and that purgation may be prevented by withholding water from the diet for a day or two. XIV ' INTRODUCTION. Calefacients. — Those used to produce a sense of warmth. Caustics. — Drugs which have the power of destroy- ing living tissue. CholagOgues. — Those which cause a flow of bile. ConvulsantS — Those which cause convulsions. Correctives. — Medicines used to correct or render more pleasant the action of other remedies, especially purgatives. Diluents. — Those which dilute the secretions of or- gans. Diaphoretics. — Those which increase the action of the skin and produce perspiration. Diuretics. — Those which increase the flow of urine. Depresso-Motors. — Those which lessen the activity of the spinal cord and motor centres (Gould). Demulcents. — Mucilaginous principles which are used in solution to soothe and protect irritated mucous membranes or other tissues. Deodorants. — Substances which destroy or hide foul odors. Depilatories.— Those used to remove hair. Depurants. — Medicines which stimulate excretions and so purify the system. Detergents. — Those which cleanse wounds, ulcers, etc. Disinfectants. — Those which have the power of destroying disease germs or noxious properties of or- ganic matter. Excito-Motors. — Those which increase the activity of the spinal cord and motor centres (Gould). Emetics. — Those which produce emesis or vomiting : (a) local emetics, those that act directly on the nerves of the mucous membrane of the stomach, and (fi) systemic emetics, those that act on the vomiting centres in the medulla. Expectorants. — Those which increase bronchial secretions. Emmenagogues. — Those which stimulate the men- strual flow. IN TROD UCTION. XV Ecbolics. — Those which produce abortion. Emollients. — Substances used to soften and protect tissue. Errhines. — Medicines which increase the nasal se- cretion. Evacuants. — A term applied to purgatives. Epispastics, Escharotics. — Those which produce blisters and sloughing. Febrifuges. — Medicines which dissipate fever. GalactagOgues. — Those which increase the secretion of milk. v Hypnotics. — Those which produce sleep, but have no power over pain. All anodynes are also hypnotics, but all hypnotics are not anodynes. Haemostatics. — Such as arrest hemorrhage. Mydriatics. — Drugs which cause mydriasis or dilata- tion of the pupil. Myotics. — Those which cause myosis or contraction of the pupil. Narcotics. — Those which have intensified ano- dyne and hypnotic power, producing a condition of stupor. Neurotics. — Those which act on the nervous sys- tem. Nutriants. — Drugs which modify nutritive pro- cesses. Nutrients. — Substances which nourish. Oxytocics. — Medicines which stimulate uterine con- tractions. Prophylactics. — Medicines which prevent the taking or development of a disease. Refrigerants. — Those which lessen the body tem- perature. Revulsants. — Those which, by causing irritation, serve to draw the blood from a distant diseased part. Counter-irritants. Rubefacients. — Those which redden the skin by distending the capillaries. Rubefacients, epispastics, and escharotics must be classified loosely, as many drugs have all three actions, according to the length of time and xvi INTRODUCTION. seventy of application. Nitrate of silver is an eschar- otic which does not belong to the other two classes. Sedatives. — Those which have a soothing effect by lowering functional activity (Gould). Stomachics. — Stimulants exciting the functional activity of the stomach. Sialagogues. — Those which produce an increased flow of saliva. Sorbefacients. — Medicines which cause absorp- tion. Sudorifics. — Those which produce sweating. Somnifacients and Soporifics. — Those which cause sleep. Specifics. — Those which have direct curative influ- ence on certain individual diseases. Stimulants. — Those which increase functional ac- tivity. Styptics. — The same as haemostatics. Taeniacides. — Drugs which kill tape-worms. Tonics. — Those which promote nutrition and give tone to the system. Vesicatories. — Blisters. III. The preparation of medicines from the crude drug is carried on in drug mills and pharmacies by many processes of great nicety and by exact formulae which place them, when completed, in distinct classes, each class differing from all others in one -or more particulars. To standardize the preparation of drugs, each country has its Pharmacopeia, or authorized publi- cation containing the list of such drugs and their prep- arations as are declared official for that country. Abroad the national Pharmacopeias are established by law. In this country, representatives of the medical and pharmaceutical professions together formulate the U. S. P., and appoint a committee to revise it every ten years. Dispensatories are private unofficial publications — com- mentaries on the Pharmacopeia, treating with much detail not only those official drugs contained in it, but unofficial ones, and their preparations also. The Dispensatory gives INTRODUCTION. XV11 doses, but the Pharmacopeia does not. The classes of preparations of the U. S. P. are as follows, a few being omitted as unimportant : LIQUID PREPARATIONS. Decoctions, Decocta. Infusions, Infusa. Solutions, Liquores. Waters, Aquce. Tinctures, Tincturce. Fluid extracts, Extracta Jluida. Spirits, Spiritus. Wines, Vina. Mixtures, Misturce. Vinegars, Aceta. Oleates, Oleata. Oleo-resins, Oleoresince. Glycerites, Glycerita. Syrups, Syrupi. Mucilages, Mucilagines. Liniments, Linimenta. SOLID PREPARATIONS. Extracts, Extracta. Resins, Eesina. Cerates, Cerata. Confections, Confectiones. Pills, Pilulce. Powders, Pulveres. Papers, Charta. Ointments, Unguenta. Plasters, Emplastra. Lozenges, Trochisci. Suppositories, Suppositoria. LIQUID PREPARATIONS. Decoctions.— Made by boiling the drug in water. A method used for hard fibrous or wood plants. There are but two official decoctions. They are made in a strength of 5 ^ unless otherwise directed. Infusions. — Made by treating a vegetable drug with either hot or cold water without boiling. Four official. The strength is the same as that of decoctions. Solutions. — Preparations of non-volatile drugs dis- solved in water. Twenty-four official. Waters. — Solutions of volatile principles dissolved in water. Tinctures. — Preparations of non-volatile substances (except one, iodine) dissolved in alcohol. In the revis- ion of the Phar ma copeia of 1890, the proportion of drug to the finished tincture has been made, wherever practi- cable, either 5, 10, 15, or 20 taken after meals in pill form. It may be given to children in candy or lozenges. Pilulae Ferri Iodidi. Pills of Ferrous Iodide. Contain reduced iron, iodine, glycyrrhiza, acacia, and balsam of tolu. {Antidotes to Arsenic.) Ferri Oxidum Hydratum. Ferric Hydrate. Hydrated Oxide of Iron. As an antidote to arsenic this preparation of iron must be fresh, and may be quickly prepared by adding to several ounces of the tr. ferri chlor. enough ammonia water or sodium carbonate to form a precipitate, which will appear almost instantly. Continue adding the alkali until no more of the precipitate falls ; then turn it into a piece of muslin or a fine strainer and wash it well by letting cold water run freely through it, until all traces of the soda or ammonia are removed. Stir up a tablespoonful of the precipitate in milk or water, and give it, repeating as often as necessary. It is harmless ; THE METALS. 35 and about 8 grains of it are required to neutralize i grain of the poison. Ferri Oxidum Hydratum cum Magnesia. Ferric Hydrate with Magnesia. Made by combining the solution of the ferric sulphate with magnesia. It is said to be the best antidote for arsenic. Dialyzed Iron. An antidote to arsenic ; also given medicinally. It is said that it does not blacken the teeth nor constipate. Dose, from 20 to 40 drops. It should always be given alone. Manganesium (Manganese). Manganese is found native in the form of the black oxide. Physiological Actions. Manganese is found in the human body associated with iron. They are found together in the blood, hair, and bile, the proportion in the blood being 1 part of manganese to 20 of iron. The preparations of manga- nese are gastro-intestinal irritants. In small doses they aid digestion and promote appetite. They enter the blood probably as albuminates. Used in excess they lower the heart action, diminish the pulse rate, and cause loss of muscular power and paralysis. The action of manganese on the tissues, blood, and excretory organs is not clearly defined. It is supposed that the salts are decomposed before being absorbed, ex- cept when in poisonous doses. 36 MATERIA MEDIC A EOR NURSES. Preparations of Manganese. Potassii Permanganas. Potassium Permanganate. Made from the black oxide of manganese, potassium chlorate, and a solution of caustic potash, by a very elaborate chemical process. It has the form of dark- purple slender prisms, inodorous, with an astringent sweet taste ; soluble in 16 parts of water. It should be kept in the dark. Potassium permanganate in the pure state is irritant and caustic. In solution it is stimulating and heal- ing. In the latter form it gives out oxygen in the form of ozone, and changes into hydrated peroxide of man- ganese, losing its purple color and becoming brown. This change does not occur with the crystals. This oxidizing power gives it special attributes as an antiseptic, disinfectant, and deodorant, but practi- cally it is not useful in disinfecting excreta, as the amount required to be effectual would make it enor- mously expensive. It is oftenest and most satisfactorily used as a deodor- izer, in the one-per-cent solution, as a wash, douche, spray, or gargle, for foul, carious, or gangrenous dis- charges. It is also used in skin disinfection, in a super- saturated solution. The stains made upon linen by this salt may be removed with oxalic acid (lemon juiced, or water with muriatic acid. Given internally, the dose, gr. ss.-ii., is freely diluted with distilled water ; or, if given in pellets, boiled or filtered water should be given with it to dilute it after being swallowed. It should be given on an empty stomach. Mangani Sulphas. Manganese Sulphate. In full doses an emetic and cathartic, with action on the liver, a we ll diluted and given after meals. (0.0013-0.006 gm.) Liquor Acidi Arsenosi. Solution of Arsenous Acid. Contains arsenous acid 1 part in 100, and hydrochloric acid 1 part in 200. Dose, TT[ ii.-x. (v\ x. = gtt. x.), well diluted and given after meals. (0.1-0.65 g m -) Liquor Potassii Arsenitis. Solution of Potassium Arsenite. Fowler's Solution of Arsenic. Contain tr. of lavender and arsenous acid and bi- carbonate of potassium, 1 part of each in 100. Five minims represent gr. £±. Dose, TTl ii.-x. (tt[ x. = gtt. x.), well diluted and given soon after meals. (0.1-0.65 g m Arseni lodidum. Iodide of Arsenic. Dose, gr. io~\. Liquor Arseni et Hydrargyri Iodidi. Solution of Arsenic and Mercuric Iodide. Donovan's Solution. A very powerful alterative, containing 1 each of 46 MATERIA MEDICA FOR NURSES. iodide of arsenic and red iodide of mercury. It is cap- able of acting as a corrosive poison, and may salivate. Locally it is a violent irritant. Dose, 3-10 mm., well diluted. (0.008-0.65 gm.) Cupri Arsenis. Paris Green. Is not used medicinally, but is often taken as a means of suicide. It may be repeated in conclusion that all preparations of arsenic should be given well diluted, and soon after meals, to avoid the local irritant action on the stomach ; and that it is necessary to keep close watch for the con- stitutional symptoms, which may at first be so unobtru- sive as to escape notice. Antimonium (Antimony). The metal itself (stibium) is not official, all prepara- tions being derived from black antimony, which is ob- tained from siliceous matter, purified and powdered. Antimonii et Potassii Tartras. Antimony and Potassium Tartrate. Tartar Emetic. Made by boiling cream of tartar and water with oxide of antimony. Tartar emetic, applied to the skin, is a strong counter^ irritant, and excites an eruption closely resembling that of smallpox, viz., small papules, becoming vesicular and finally pustular. It is now but little used in this way. Internally it is irritant, and, as an emetic, its action is partly direct— that is, acting immediately on the walls of the stomach, and partly indirect, or acting on the nerve- centre in the medulla which controls vomiting. Tartar emetic causes nausea and depression both before and after the act of vomiting, and is therefore not well suited to cases where rapid action with as little depres- sion as possible is required, as in poisoning. THE METALS. 47 In small continued doses the local action of tartar emetic is apt to produce loss of appetite, nausea, diar- rhoea, and pain. In the tissues antimony has an alter- ative action, the special results being an increase of the waste products of the body, with a lessening of oxygena- tion, and fatty degeneration of the organs. Tartar emetic depresses the circulation even in small doses, the first effect visible after a therapeutic dose being a diminution of the pulse and increase of perspiration. With a continuance of the medicine the pulse becomes weakened, soft, and compressible, infrequent and irreg- ular, and fainting may occur. Respiration is weakened, inspiration being shortened, and expiration lengthened. The nervous system is depressed, a feeling of languor, sleepiness, and lassitude being produced by a moderate dose. It affects the muscular system so powerfully that before chloroform came into use tartar emetic was em- ployed to produce muscular relaxation in the reduction of dislocations, etc., and the depressed state so brought about lasted for six or eight days in spite of heart stimulants. Emetic doses cause great muscular weakness, tremors, and aching of the muscles, loss of power to stand, with free perspiration and an increase of saliva. Antimony is excreted by all the mucous surfaces, the liver, kidneys, and skin. Its excretion by the bile shows it to be a hepatic Stimulant ; in passing through the kidneys it acts as a diuretic, and through the skin as a diaphoretic. The characteristic pustular eruption is sometimes caused by its internal use. Symptoms of Poisoning. The symptoms of poisoning are very like those of the collapse of cholera, viz. : shrunken features, cold surface and breath ; great epigastric pain, vomiting, and purging ; small, rapid, soft, and irregular pulse ; cyanosis ; syn- cope ; cramps of the lower extremities ; insensibility to stimulants ; intense prostration ; delirium ; tetanic spasms in some cases, or aphonia. The quantity of tartar emetic which will destroy life is 48 MATERIA MED1CA FOR NURSES. not definitely known. The smallest fatal dose recorded is f of a grain in the case of a child ; gr. ii. has caused death in an adult, while doses have been recovered from, ranging from gr. xx. to § i. It is probable that, under ordinary circumstances favoring the action of the poison, gr. x. or xv. would destroy life, if taken at once, or a smaller quantity, if divided. The symptoms come on rapidly, and death may occur in a few hours, or days, or may be delayed for several weeks. Treatment of Poisoning. The antidote is tannic acid ; or substances containing it, as strong tea. Opium, and alcoholic stimulants, with demulcent drinks, are given. Dose of tartar emetic, gr. yg-i., diluted. (0.005- 0.06 gm.) Vinum Antimonii. Wine of Antimony. Contains of tartar emetic gr. ii. to § i. This preparation decomposes on being kept, and a fungoid growth takes place in it which unfits it for use. Dose, TT[ v. (fT[ x. = gtt. xii.)-3 ss. (0.3-2. gm.) Pilulae Antimonii Compositae. Compound Pills of Antimony. Plummer's Pills. Contain sulphurated antimony, mild mercuric chloride, guiac, and castor oil. Syrupus Scillae Compositus. Compound Syrup of Squill. Contains squill, senega, phosphate of lime, and dilute alcohol, with tartar emetic, about gr. f to § i. Syrup of squill is sometimes used as a domestic remedy for chil- dren, without a physician's order, and as tartar emetic is not a safe medicine for children, its unauthorized use has sometimes had fatal effects, and should always be strongly discouraged. Bismuthum (Bismuth). A crystalline metal, impure in its crude state, and con- taining arsenic as one of the impurities. It goes through various chemical processes by way of purification. NON-METALLIC ELEMENTS. 49 Physiological Actions. Externally and internally bismuth acts as a mild seda- tive and astringent. It is useful as a dry application in the first stages of bed-sores, as a dressing for burns and blisters, and may be satisfactorily used on small fresh wounds. It is given internally as an astringent, and in large quantities colors the faeces black or dark-gray. Bismuthi Subnitras. Subnitrate of Bismuth. A heavy white powder, odorless and almost tasteless, insoluble in water. The easiest way to give it is mixed in a little glycerine and diluted with milk or water ; or it may be given in wine, or placed dry on the tongue. Dose, gr. v.- 3 i. (0.3-4. gm.) NON-METALLIC ELEMENTS. Phosphorus (Phosphorus). A non-metallic element made from bones, by treating bone-ash with sulphuric acid and water. It is a semi- transparent, almost colorless, wax-like solid, with a peculiar garlic odor : it is luminous in the dark, is in- soluble in water, and soluble in ether and in oils. Phosphorus is a constituent of the most important tissues of the body, especially of the nervous system, where it exists as phosphorized fats. In the bones it is present as phosphate of calcium, magnesium, and sodium. It is contained in various articles of food, especially in fish and vegetables. Physiological Actions. In small doses phosphorus acts as a tonic and alter- ative, and stimulates the nutritive processes, especially in the case of the nervous and bony tissues. Given for a considerable length of time in small doses it affects the structure of bone, and makes the spongy portion firm and compact. The heart is stimulated by medicinal doses of phosphorus, and the temperature slightly raised. 4 50 MATERIA MEDIC A FOR NURSES. Full doses given for a long time disturb the stomach, producing eructations of gas (phosphide of hydrogen), and depress the heart. Perspiration and urine are in- creased by phosphorus, and the latter becomes reddish and has the odor of violets. Symptoms of Poisoning. Phosphorus is an irritant poison, and the symptoms vary somewhat according to the state in which it is taken, appearing more quickly after taking a solution in oil, or the paste used as a vermin killer, than after match heads or ordinary phosphorus have been used. In the latter case the symptoms do not come on at once ; some hours usually — sometimes one or two days — intervening before they show themselves. Then epigastric pain and burning begin, with a burning sensation in the throat, a taste of garlic in the mouth, and an odor of garlic to the breath ; great thirst, nausea, and vomiting. During the first eight or ten hours the vomited matters have a garlic odor and are luminous in the dark, and if purging occurs, the faecal matters are sometimes luminous, as is also the urine. Vomiting sometimes continues through the whole of the attack, but usually stops about the second or third day. Jaundice is a characteristic but not an invariable symp- tom. It appears from the third to the fifth day, and with it vomiting may reappear, exuded blood giving a peculiar appearance which is described as "coffee- ground." There is great prostration, with a small, frequent, almost imperceptible pulse, and cold skin. The mind may remain clear, or there may be noisy delirium,, Sometimes convulsions occur, or paralysis. Death may take place suddenly from collapse and paralysis of the heart, but more commonly the patient dies comatose from gradual failure of respiration and circulation. The time at which death occurs varies from a few hours to several weeks, the average time being several days or a week. The fatal dose is stated to be between gr. f and ii., though it may vary according to circumstances, and large quantities have been recovered from. NON-ME TALLIC ELEMENTS. 5 [ Treatment of Poisoning. The chemical antidote is the crude French acid turpentine, which is given in doses of 3 ss. every fifteen minutes. After the poison has entered the blood there is no known antidote, and therefore, emetics and pur- gatives are of the greatest importance. Sulphate of cop- per is the emetic used, and forms an insoluble compound, phosphide of copper. It is given in dilute solution, gr. ii. at a time, every five minutes until vomiting is caused? and after that in small doses, gr. J, every twenty minutes as long as ordered. Hydrated magnesia may be used as a purgative. Mucilaginous and albuminous drinks are given, and all oils and fats carefully avoided, both in medicine and nourishment, as they dissolve phosphorus and hasten its absorption. Chronic phosphorus poisoning is found among art- isans who are exposed to the fumes, and is especially characterized by necrosis of the jaw. This form of poisoning is not as common now, since improved ways of making matches have been introduced, as it once was. Preparations of Phosphorus. Oleum Phosphoratum. Phosphorated Oil. Contains stronger ether, oil of almond, with phospho- rus in a strength of 1 in 100. One minim equals gr. y^ of phosphorus. Dose, TU i.-iii. (TT[ x. = gtt. xv.). (0.06-0.02 gm.) Pilulae Phosphori. Pills of Phosphorus. Each contains gr. y-J-g- of phosphorus. (0.0006 gm.) 52 MATERIA MEDIC A FOR NURSES, Calcii \ Fern \ Hypophosphis. Potassii I Sodii ) Dose, gr. x.- 3 ss. (0.65-2. gm.) Syrupus Hypophosphitum. Syrup of Hypophosphites. Contains hypophosphite of lime, about gr. iii. to 3 i. y and of soda and potash each about gr. i. to 3 i-, with citric acid, spirits of lemon, and sugar. Dose, 3 i.- 3 ii., diluted. (4.-8. gm.) Chlorum (Chlorine). Chlorine is a greenish-yellow gas, belonging to the halogen group of elements. The title " halogen " is derived from the Greek word meaning sea, and is so given because the most important members of the group are obtained directly or indirectly from the ocean — viz. : chlorine, obtained from sea-salt ; bromine, from sea- water ; and iodine, from sea-weed. Chlorine itself is not official, but is represented in medicine by several of its compounds ; also by hydro- chloric acid and chlorinated lime, by which it is fur- nished. Chlorine is irrespirable, and of strong penetrating odor. It is soluble in water, in the proportion of two parts gas to one part water. If inhaled in any quantity it irritates the lining of the air-passages, causes spasm of the glottis, and narcotizes the brain. It is a most powerful disinfectant, antiseptic, and deodorant, its great activity in these respects being due to its affinity for hydrogen, by which it decomposes com- pounds containing hydrogen, and sets oxygen free in its most active state, as ozone. It is not used in disinfect- ing clothing, as it destroys the color and texture of fabrics, nor the person, as it cannot be breathed in a strength sufficient to destroy germs. For disinfecting rooms it may be prepared as follows : Mix equal parts NON-METALLIC ELEMENTS. 53 of common salt and black oxide of manganese. To a tablespoonful of this powder, in a saucer, add a table- spoonful ( 1 ss.) of strong sulphuric acid diluted one third with water. In cold weather the saucer should be heated. This will produce enough chlorine to disinfect a room thirty-two feet square. Calx Chlorata. Chlorinated Lime. Made by the action of chlorine on slaked lime, con- taining 35 per cent, chlorine. Its action as a disinfect- ant is that of chlorine, and when so used it should be perfectly fresh or it is valueless. To test it, dissolve a little in water ; if the solution is clear, it is good, but if it has lost its chlorine the solution will be turbid and milky. This preparation is sometimes improperly called chloride of lime. Liquor Sodae Chloratae. Solution of Chlorinated Soda. Labarraque's Solution. Contains sodium carbonate and chlorinated lime. A greenish-yellow liquid, with sharp salty taste and very slight odor of chlorine. It is a good preparation for cleansing purposes in sick-rooms, wards, etc., in weak solution. In full strength it removes stains from glass. Medicine droppers, douche nozzles, and other small articles which are hard to clean may be soaked in it until the stains come away. It is sometimes given internally, in half a tumblerful of sweetened milk or water. The antidote, in case of poisoning by any of the chlorine compounds, is albumin ; white of egg, milk, and flour. Dose, 3 ss.— ii. (2.-8. gm.) Bromum (Bromine). A liquid element obtained from sea-water and from certain mineral springs. A dark, brownish-red, very 54 MATERIA MEDIC A FOR NURSES. volatile liquid, of strong and suffocating odor. When brought into contact with organic matter it oxidizes and destroys it with great rapidity. Its local action is, there* fore, powerfully irritant and escharotic. It is also a deodorant and antiseptic. It is never given inter- nally, alone, but has been used as a caustic, and the vapor has been used medicinally. Preparations of Bromine. Potassii Bromidum. Potassium Bromide. Prepared by adding a solution of pure carbonate of potash to a solution of bromide of iron, filtering, and evaporating. Colorless crystals, soluble in i T 6 -g- parts water. Physiological Actions. Potassium bromide lessens cerebral activity, and the tendency to " emotionalism " ; diminishes the sensibility and irritability of the mind in various nervous states ; such, for instance, as result from excessive mental strain, anxiety, or intellectual work ; and produces a condition of ansemia of the brain such as is found in natural sleep. It is thus an indirect hypnotic, not acting like opium, or chloral, but inducing sleep by bringing about a physio- logical condition favorable to its advent. Bromide of potash is depressing to the heart and respirations, both being slowed and weakened by its action. The spinal centres, spinal nerves, and the muscles are all depressed, and the temperature somewhat lowered, though not to any marked extent. Bromide of potassium contains 66 per cent, of bromine. Dose, gr. x.-lx. (0.65-2.6 gm.) Ammonii Bromidum. Ammonium Bromide. Prepared by precipitating the freshly made solution of bromide of iron with ammonia water. The salt remain- NON-METALLIC ELEMENTS. 55 ing in solution is crystallized and powdered. It is soluble in i \ parts of water. The effects and uses of bromide of ammonia are very like those of the bromide of potash, and it is said to be, in addition, slightly stimulating. It is not much used. Dose, gr. x.-lx. (0.65-2.6 gm.) Sodii Bromidum. Sodium Bromide. Colorless crystals, soluble in iy 2 ^ parts of water, and containing 78 per cent, of bromine. It resembles potas- sium bromide, and has very much the same qualities. It is considered less depressing, and the least toxic of all the bromide preparations. There is a variety of opinions as to its hypnotic power compared with that of potassium bromide. Dose, 3 ss.-ii. (2.-8. gm.) Lithii Bromidum. Lithium Bromide. A granular, very soluble salt, containing 92 per cent, of bromine. In addition to the hypnotic power of the bromides in general it is said to have some tonic and diuretic action. Dose, gr. v.-xx. (0.3-1.3 gm.) Incidental Effects, In giving a course of the bromides it is very essential that the state of the digestion and of the bowels be care- fully watched, and the latter strictly regulated, for the accumulation of an excess of bromine in the system causes a series of symptoms known as " bromism." The first is usually a salty taste in the mouth, with salivation and fetid breath. Next come drowsiness, heaviness, and sluggishness of intellect, loss of memory, partial aphasia, depressed spirits, a staggering gait, dull, listless expres- sion, sluggish pupils, and sometimes an infrequency of winking. 56 MATERIA ME DIC A FOR NURSES. One of the marked features of bromism is the appear- ance of eruptions of the skin, in great variety, and of varying severity. All manner of skin lesions have been described, as resulting from the use of bromine, even to one resembling that of smallpox. The most common is a simple acne or eruption of pimples. It sometimes occurs early, or after the use of small doses, yet is not always among the first symptoms. The bromides are excreted by the kidneys chiefly, ^Iso by the salivary and mammary glands, the skin, and all mucous surfaces. They are rapidly diffused, appear- ing in the secretions a few moments after being taken. Iodum (Iodine). Iodine is a non-metallic element of bluish color, de- rived chiefly from the ashes of sea-weeds ; not readily soluble in water ; soluble in ether, alcohol, and glycerine. It is never given internally in crude form. Physiological Actions. Applied externally iodine is an irritant and vesicant, and stains the skin yellow, or, in repeated applications, deep brown. It causes some pain, with a feeling of warmth, and desquamation may follow its use. It is absorbed into the blood partly through the skin and partly in the form of vapor. The vapor of iodine, like that of chlorine but in a feebler degree, decomposes sulphuretted and phosphu- retted compounds, and is, therefore, antiseptic and disinfectant. Internally iodine excites a sensation of heat and burning in the stomach. In sufficient quantity it is an irritant poison, causing inflammation of the lining of the stomach, severe pain in the abdomen, vomiting, and purging. The matters vomited have a yellow color, except when farinaceous food has been taken ; in this case they are blue or purplish. The amount of iodine necessary to produce toxic symptoms varies with consti- tutional peculiarities and with the kind and amount of food in the stomach. Death has been caused in twenty* NON-METALLIC ELEMENTS. 5? four hours by 3 i. The antidote is starch or flour stirred up in water, and emetics should be given afterwards. Iodine is rapidly excreted, appearing in the urine, the perspiration, saliva, bile, milk, and mucous secretions, especially of the air-passages. Preparations of Iodine. Potassii Iodidum. Potassium Iodide. Made by dissolving iodine in liquor potassse, evapora- ting, and treating the residue with wood charcoal. Potassium iodide is extremely diffusible and enters the blood with great rapidity. It acts in a general way as a tonic and stimulant to nutrition, accelerates tissue- changes, and increases the excretion of waste products. It has some slight diuretic action, and has the power of dislodging from the tissues various poisonous metallic substances, notably lead and mercury. The lymphatic glands are reduced in size by iodide of potash, and, like mercury, it has over some forms of dis- ease a marked and positive influence, not thoroughly explainable. Its action in these cases is called " specific " or " alterative." Incidental Effects. In giving any of the iodides, and especially the iodide of potash, the peculiar set of symptoms known as " iodism " must be carefully watched for. There is first an inflammation of the mucous membrane of the head resembling acute coryza, or catarrh ; running at the eyes and nose, salivation, swelling of the eyelids, sneezing, and frontal headache ; sore-throat, hoarseness, and trou- ble in swallowing, with a feeling of general wretchedness, and rise in temperature. There are also several varieties of eruptions which may appear, said to be more likely to occur in the case of patients with diseased kidneys. The most common is an $8 MATERIA ME D1C A FOR NURSE a. eruption of acne on the face, shoulders, and thighs, and eczema is also frequent. Debility and pains in the joints are sometimes noticed, and in some cases digestive disturbances result, with nausea and diarrhoea. The solution of i in i (Tit i. = gr. i.), is best given in milk ; or it may be given in cinnamon water, or the compound syrup of sarsaparilla, to disguise the unpleas- ant taste. It is often ordered with bichloride of mercury, and they may be given together, but if it is not ordered in combination it should never be added to any other medicine, but given alone. By largely diluting it and giving it on an empty stom- ach, symptoms of iodism are in a measure avoided. Dose, gr. v.- 3 i. (0.3-4. gm.) Liquor Iodi Compositus. Lugol's Compound Solution of Iodine. Composed of iodine and potassium iodide. Twenty minims contain gr. i. of iodine. Dose, Tit v.-xv. (TJ[ x. = gtt. x.), well diluted. (0.3-1. gm.) Tinctura Iodi. Tincture of Iodine. Contains 8 parts iodine and 92 parts alcohol. It is used externally as a counter-irritant ; applied with a camel's-hair brush, and in one or more coats as ordered. Each coat must dry separately. It cannot be diluted with water, as the iodine precipitates in water. If ex- treme burning follows the application, and it is desirable to wash it off, alcohol, or ether, or a solution of iodide of potash will remove it, or, still better, a weak solution of aqua ammonia. Unguentum Iodi. Iodine Ointment. Contains 4 parts in 100 of iodine, with one part of potassium iodide and benzoinated lard to make up the rest. NON-METALLIC ELEMENTS. 59 Iodoformum. Iodoform. Iodide of Formyl. Iodoform is made by heating iodine with potassium carbonate, alcohol, and water, and allowing the crystal- line deposit to settle. It consists of small, bright-yellow, lustrous crystalline scales, with a very strong and clinging odor, and sweetish taste. It contains about 97 per cent, ©f iodine, and is freely soluble in oils, ether, and chloroform. It is slightly volatile at ordinary temperatures, and at a temperature above 239 F. emits vapors of iodine. In making sterilized iodoform gauze this iodine vapor will condense and turn the gauze brown unless free evapora- tion is allowed from the mouth of the jar or sterilizer. Iodoform was discovered in 1822, but was not used for some years. At various times since then its qualities have been referred to in medical articles, and within the last few years it has become very popular as an an- tiseptic in surgical dressings, — so much so that its use has been carried to excess and its reputation greatly exaggerated. Various cases of poisoning had the effect of checking its too lavish use, and its limitations as well as its powers are now more clearly known. It is no longer considered one of the most active germicides, as was claimed for a time, yet it has proper- ties sufficient to give it a secure place in surgery. It prevents or arrests decomposition, promotes union and cicatrization in wounds, and is a deodorizer. It is not irritating, but acts rather as a local anodyne. In a wound treated with iodoform the secretion is lessened, and is serous rather than purulent in character. In cases of poisoning by absorption through a wounded surface, the following symptoms may occur : Rise of temperature as high as 104 F., or higher. This may be the only symptom ; or with it there may be headache, a rapid and compressible pulse, and loss of appetite, the symptoms going off as soon as the iodoform is discontinued. Iodine is found in the urine in iodo- form poisoning. More serious effects are : a grave de- pression of the system, and anxious melancholia ; a 60 MATERIA MEDIC A FOR NURSES. restless mental condition, with very weak and rapid pulse, perhaps reaching 180 ; drowsiness, delirium, and collapse. Death sometimes occurs quickly, even though the application be stopped. The amount capable of causing fatal poisoning has been recorded as varying from 500 grains upwards. In using iodoform the extent of exposed surface through which absorption may take place is of more importance than the actual amount ap- plied, which may not all be absorbed. Iodoform is sometimes given internally, in pill or capsule. Dose, gr. i.-ii. (0.06-0.13 gm.) Unguentum Iodoformi. Iodoform Ointment. Iodoform 10 parts, and benzoinated lard 90 parts. Iodol. Iodol is a new substance which has been chemically produced in the attempt to make an equivalent for iodoform, which should have its qualities without the unpleasant odor. It is obtained by the action of iodine on certain constituents of mineral oil, and contains about 85 per cent, iodine. It is a yellowish-brown powder, which darkens on exposure to light. It is odorless, soluble in alcohol, ether, and chloroform ; iusoluble in water. It is said to be as efficiently antiseptic and disinfectant as iodoform, having the same deodorant and anaesthetic properties, but it is not much used. Other derivations of iodoform are : Aristol. Antiseptin. Europhen. Losophane. Antiseptol. Sozoiodol. Sozal. Sulphaminol. Thiophene. Sulphur (Brimstone). Sulphur is found native in volcanic districts as crude sulphur, and in combination with metals, as sulphides. NON-METALLIC ELEMENTS. 6 1 Physiological Actions. Sulphur is used externally for its action on the skin. It has no local action of its own, but by contact with the products of the skin it changes into sulphuretted hydro- gen and sulphides, which are active substances. In this form it is a vascular stimulant, a nerve sedative, a stimulant to the skin, and a diaphoretic. Taken internally it acts as a laxative, increasing peri- stalsis, and it has also probably some power of influencing nutrition. If taken for a long time it impairs the blood and causes emaciation, anaemia, trembling, and debility. It forms sulphuretted hydrogen in the intestines, giving an un- pleasant odor to the faeces, and the same disagreeable odor is imparted to the perspiration, by the excretion of sulphur through the skin. Silver jewelry worn by a pa- tient taking sulphur becomes discolored by the excretions of the skin. Preparations of Sulphur. Sulphur Sublimatum. Sublimed Sulphur. Flowers of Sulphur. Prepared from crude sulphur (which compressed into molds forms the roll sulphur used in fumigating) by sub- liming. A yellow powder, tasteless, and odorless until heated, and insoluble in water. It always contains a little sulphuric acid, and is only used in making other preparations. Sulphur Lotum. Washed Sulphur. Sublimed sulphur washed with ammonia water and freed from acid. The action is laxative. It is given in powder mixed with simple syrup or molasses. Dose, 3 i.-iii., given at night. (4.-12. gm.) Potassa Sulphurata. Liver of Sulphur. 62 MATERIA MEDIC A FOR NURSES. Made by fusing sublimed sulphur with carbonate of potash. Solid greenish pieces, alkaline, and of very acrid taste ; soluble in water, making an orange-colored solu- tion. Locally applied, sulphurated potassa is an irritant, and taken internally is a violent corrosive poison. It is used in ointments and in giving sulphur baths ; in the latter case in a strength of from % i.-vi., to 30 gal- lons of water. The bath may last from twenty minutes to two hours, and has a generally stimulating effect. A papular eruption and eczema sometimes follow the use of sulphur. Unguentum Sulphuris. Sulphur in strength of 3 parts in 10, with benzoinated lard. Ichthyol. A preparation obtained from a bitumen ' found in the Tyrol, and supposed to be the residue of extinct fishes. It contains 10 per cent, of sulphur and is not irritating to the skin. It is used externally in an ointment of 10-20 per cent, strength. Carbo (Carbon). Charcoal. Charcoal is obtained from the combustion of bones, — carbo animalis, animal charcoal, or bone black — and of wood — carbo ligni, wood charcoal. Charcoal absorbs and condenses many gases and vapors, coloring matters, alkaloids, and other substances in quan- tities many times greater than its own bulk ; and when exposed to the air it thus increases rapidly in weight. For this reason, when intended for medicinal purposes it must be kept carefully covered in well-stopped bottles. Externally it is used as an absorbent and deodorant, and internally as a carminative. It may be given be- tween two slices of bread and butter, or mixed with wine. Charcoal does not enter the system, but is entirely ex- pelled by the bowels. Dose, 3 i.- ? i (4.-32. gm.) 1 An inflammable mineral substance. INORGANIC ACIDS. 6$ Aqua Hydrogenii Dioxidi. Solution of Hydrogen Dioxide. Peroxide of Hydrogen. A slightly acid watery solution of hydrogen dioxide, containing, when fresh, about 3 per cent., by weight, of the pure dioxide, corresponding to about ten volumes of oxygen. It is used in the treatment of ulcers, fetid suppura- tion, diphtheritic membranes, etc. Its virtues depend on its readiness to yield oxygen to all oxidizable substances. As it soon loses strength, it should be kept in small quantities, in a cool place, not exposed to the light, and *s it is an expensive article, should be carefully used. INORGANIC ACIDS. Acidum Sulphuricum (Sulphuric Acid). Oil of Vitriol. Sulphuric acid is made from the gas which is produced by the combustion of sulphur, by hydration on the action of steam. It is a colorless, oily-looking, intensely acid liquid, containing 2 per cent, water. On exposure to the air it absorbs moisture and becomes less dense. Physiological Actions. Sulphuric acid is a powerful corrosive, and abstracts water from animal and vegetable tissue, leaving carbon. It thus blackens organic matter while destroying its texture. Concentrated and mixed in a paste with charcoal, sul- phuric acid has been used as an escharotic. Diluted, its special action both externally and internally is that of an astringent. Symptoms of Poisoning. When swallowed in concentrated form it corrodes the alimentary canal, causing acute pain of the mouth, throat, and epigastrium. The tongue and lining of the mouth are whitened, like parchment, afterwards turning brown, while brown or blackened spots appear on the lips. 64 MATERIA MEDICA FOR NURSES. There are : violent vomiting, of tarry matters often, cold extremities, and clammy skin ; profuse and bloody salivation, suppressed voice, and feeble pulse. The face expresses great suffering and anxiety. The mind is clear. The matters at first vomited are acid, and, if they fall on colored articles of dress the color is taken out, and the texture destroyed ; while on black material brown spots are produced, with an edge of red. There is sometimes perforation of the stomach or intestines. The symptoms come on immediately after the act of swallowing, and death may result in a few hours, but usually delays for from 18 to 24 hours ; oc- curring, finally, very suddenly. The smallest fatal dose recorded is 3 i. Usually f i. or more has been taken. Antidotes. The antidotes are chalk, magnesia, whitewash, or soap. They should be mixed in milk or water and given freely. Preparations. Acidum Sulphuricum Dilutum. Dilute Sulphuric Acid. Has a strength of 10 per cent, of the acid. Dose, Til x.-xxx. (Tlj, x. = gtt. x.) (0.65-2. gm.) Acidum Sulphuricum Aromaticum. Aromatic Sulphuric Acid. Contains alcohol and aromatics, and acid in a strength of 20 per cent. Both these preparations should be given well diluted, and through a glass tube, to save the teeth from injury. Dose, TTj, x.-xx. (TTJ, x. gtt. xxiv.). (0.65-1.3 gm.) Acidum Nitricum (Nitric Acid). Aqua Fortis. Nitric acid is prepared from nitre by distillation with water and sulphuric acid. A colorless, intensely acid, fuming liquid, containing 70 per cent, acid, the rest water. r INORGANIC ACIDS. 65 Physiological Actions. It is a very powerful caustic, and if used in this way the sound tissues should be protected by a coating of oil or soap, or sheet-lint wet in a solution of bicarbonate of soda, and the spot cauterized be washed with warm soap- suds after sufficient effect has been obtained. Taken internally in medicinal doses it has stimulant and astringent properties. Poisoning and Antidotes. In concentrated form nitric acid is an exceedingly corrosive poison, even more violent than sulphuric acid. Like the latter, it destroys the membrane lining the mouth, oesophagus, and stomach. The symptoms are the same, except that nitric acid stains the tissues yellow instead of black. They come on with the same severity, and immediately. The antidotes are the same, and death occurs on an average in half a day, or a day. Preparations. Acidum Nitricum Dilutum. Dilute Nitric Acid. Has a strength of 1 part to 6. It must be well diluted and given through a glass tube. Dose, TT[ x. (Til x. = gtt. x.). (0.65 gm.) Acidum Hydrochloricum. Hydrochloric or Muriatic Acid. Hydrochloric acid is obtained by the action of sul- phuric acid on chloride of sodium, and solution of the fumes in water until it has a strength of about 30 per cent. An almost colorless, very acid liquid, with pun- gent odor. It is one of the natural acids of the stomach, and acts as a tonic on the glands of the alimentary canal, increasing the normal secretions. Its astringent properties are not marked. In concentrated form it is a corrosive poison, not as powerful as nitric or sulphuric acids. The symptoms and treatment are like the two others. 5 66 MATERIA MEDIC A EOR NURSES. Acidum Hydrochloricum Dilutum. Diluted Hydrochloric Acid. Has a strength of g iv. of the acid to one pint. Dose, TTt x.-xxx. (TT[ x. = gtt. x.), well diluted and given after meals. (0.65-2. gm.) Acidum Nitro-Hydrochloricum. Nitro-Hydrochloric Acid. Made by mixing three parts of nitric with five parts of hydrochloric acid. An orange-colored liquid, changing color in time, and more rapidly on exposure to light, to a light yellow. In medicinal doses the physiological effects are : stimulation of the liver specially, and also of the other glands of the alimentary canal. Besides being given internally, it is used in local applications to the liver, and in baths. In the former case, for stupes, the strength is 3 i.-iii. to O. i. of water ; and in the latter, \ i. to C. i. In poisonous doses the effects are the same as the other mineral acids. The stains it produces are yellow. The same antidotes are used as given before. In giving any of the mineral acids, the first symptoms of intolerance are : griping pains and diarrhoea, with strongly acid urine. These points are to be remembered, as well as the necessity for protecting the teeth. Acidum Nitro-Hydrochloricum Dilutum. Dose, TTj, v.-xx. (TT[ x. = gtt. x.), well diluted and given through a glass tube. (0.3- [.3 gm.) Acidum Phosphoricum. Phosphoric Acid. A colorless, odorless liquid, made by boiling phos- phorus with nitric acid and water, and having a strength of 66 per cent. It is very acid, but does not corrode the tissues. Its physiological effects are unimportant — mildly tonic and astringent. INORGANIC ACIDS. 6? Acidum Phosphoricum Dilutum. Diluted Phosphoric Acid. Dose, TTi xv - 3 ss. (tt[ x. = gtt. x.), well diluted. (-1.-2. gm.) Acidum Sulphurosum (Sulphurous Acid). Made by heating sulphuric acid with charcoal. Sul- phurous-acid gas results, and is dissolved in water, con- stituting 5 per cent, of the solution. A colorless liquid with pungent sulphurous odor. Sulphurous-acid gas is obtained by the combustion of roll sulphur, and is used in disinfecting rooms. Before the day of microscopical study this disinfection was believed to be complete ; but it is now known to have very little value where patho- genic bacteria are concerned. To be at all efficient it must be combined with steam. In Germany, sulphur fumigation after contagious diseases has been entirely discarded. It is, however, of real value in ridding a room or ward of bed-bugs, if these pests have lodged in the walls or woodwork, and for this purpose steam is not necessary. Acidum Boricum. Boric or Boracic Acid. Made by the action of sulphuric acid on borax, or by purification of native boric acid, which is a compound of the element boron with oxygen, and is obtained from certain mineral springs in Italy. White, pearly, glistening crystals, soluble in 25 parts of cold and 3 parts of hot water. The saturated solution has a strength of 4 per cent. Physiological Actions. Boric acid is antiseptic, disinfectant, and deodor- ant, destroying low organisms, and stopping fermenta- tion and putrefactive changes. It is not irritating externally, but rather the reverse, and when applied to wounds prevents suppuration. In- ternally, in large doses, it is a gastro-intestinal irri- tant, and poisoning has been caused by washing out 6$ MATERIA MEDICA FOR NURSES. internal cavities with a 5 per cent, solution. The symp- toms were : nausea, vomiting, hiccough, disturbed respirations, rapid, feeble pulse, erythema and ecchy- mosis, subnormal temperature, and collapse. As a wash for babies' eyes and mouths, the saturated solution is diluted one half with water. It is used as the basis of a variety of mouth washes for the sick. It constitutes the largest part of Thiersch powder, used in making an antiseptic solution. (See salicylic acid.) Unguentum Acidi Borici. Contains white wax, paraffin, almond oil, and boric acid. THE ORGANIC ACIDS. Acidum Aceticum (Acetic Acid). Prepared from wood by destructive distillation and purification. A colorless liquid, with pungent odor and strong acid taste ; strength 33 per cent. ; the rest water. Glacial acetic acid has 99 parts acetic acid to 1 of water, and crystallizes at a temperature below 6o°. It is not officinal. Acidum Aceticum Dilutum. Diluted Acetic Acid. Has a strength of 1 part acid to 7 parts water. Acetum. Vinegar. An organic liquid containing acetic acid. It corre- sponds nearly in strength with the dilute acid. Vinegar is obtained from various vegetables and fruits by a process of fermentation known as the acetous or sour, as dis- tinguished from the vinous fermentation and others. Acetous fermentation may be induced in all liquids capable of undergoing vinous fermentation. The best vinegar is made from cider. It is often adulterated with sulphuric acid. THE ORGANIC ACIDS. 69 Locally used acetic acid is a caustic. It is best applied with a glass rod, or a splinter of wood and needs to be applied with care to avoid injuring the surrounding parts. Diluted and applied to the skin, it is stimulant, as- tringent, and refrigerant, and in the form of vinegar is sometimes added to baths for the reduction of tem- perature. Internally it has a stimulating effect on the appetite and digestion ; increases the secretion from the intestines, and the flow of urine. It does not neutralize the alka- linity of the blood, but decomposes there, and combines with part of the alkali of the plasma, forming a car- bonate, and in this form passes out of the body, unless given in excess, when the excess escapes unchanged from the kidneys. In the alimentary canal the acid acts directly on its contents, and is given in the form of vinegar as an antidote for poisoning by alkalies. In concentrated doses acetic acid is a corrosive poison, and has caused death in one case known. The symptoms are like those of the mineral acids, and the treatment is the same, consisting in giving alkalies and their carbonates ; warm soapsuds, and milk. Acidum Citricum (Citric Acid). Citric acid is obtained from the juice of the lemon, citrus limonum, or of the lime, citrus bergamia, by neutralizing the boiling juice with chalk, and putting it through various processes. It is very soluble in water, and gr. xx. in 3 ss. of water makes a solution resembling lemon juice in strength and acidity. Citric acid, like the other free acids, acts directly on the contents of the alimentary canal, neutralizing alkalies. It is stimulant ; relieves thirst and promotes ap- petite ; increases the flow of the saliva and of the gastric juice ; and, indirectly, the action of the kidneys and skin ; hot lemonade especially being a diaphoretic. It is slightly laxative, and counteracts a tendency to torpidity of the liver. The juice of half a lemon, mixed /O MATERIA MEDIC A FOR NURSES. with that of an orange, is a satisfactory laxative drink in many cases. It is best taken before breakfast. In malarial countries lemon-juice is freely used as an article of food, and among sailors and soldiers it is used as a prophylactic against scurvy. Citric acid has no action on the sound skin ; it is but slightly irritating in large quantities internally, and is not poisonous. It may not be out of place here to refer to a popular error regarding a point of diet : that is, that a nursing woman may not drink lemonade because it will " sour the milk," and "give the baby colic." A nurse will probably often be appealed to on this subject. Her knowledge of the chemical facts : that citric acid is de- composed in the blood, forming a neutral salt ; that it does not reach the tissues as an acid, but passes out of the body as a carbonate, will at once decide the question. Acidum Tartaricum (Tartaric Acid). Tartaric acid is the acid of the grape, and is made from acid tartrate of potassium by a process similar to that used with citric acid. Its local action upon abraded surfaces, mucous mem- branes, or even the unbroken skin, is that of a decided irritant. Taken internally it is diuretic and slightly laxative, and somewhat depressing to the heart. Tartaric acid does not enter the tissues as an acid, but is decomposed in the blood, and passes out of the body as a carbonate. Poisoning and Antidotes. In large doses it is an irritant poison, causing burning pain of the oesophagus and stomach, vomiting, and gastro-intestinal inflammation, which may prove fatal. A dose of | i. has caused death in nine days. The alka- lies, magnesia, lime, soapsuds, or the alkaline carbonates are antidotes. Dose, gr. x.-xx., freely diluted. (0.65-1.3 gm.) THE ORGANIC ACIDS. 7 1 Acidum Tannicum (Tannic Acid). There are two kinds of tannic acid, of which the official one is the gallo-tannic, and is obtained by treat- ing powdered galls with washed ether. (Galls are growths of plant tissue caused by parasitic fungi or insects, whose excretions stimulate the plant cells to an abnormal de- velopment. There are many hundred varieties ; that from which tannic acid is made being formed on an oak tree, Quercus lusitanica, by the action of the fly Cynips gallse tinctorise.) Tannic acid is a light, feathery, yellow- white, non-crystalline powder, of faint odor and slightly bitter taste. Physiological Actions. Locally applied it is an active astringent, contracting the tissues ; and in the case of mucous membranes, caus- ing great dryness. It coagulates albumen readily. It has much greater strength than gallic acid. It is used to overcome relaxed conditions, and to check excessive se- cretions of the skin and mucous membranes. Parts ex- posed to friction, as tender feet or sore nipples, may be successfully hardened by the use of tannic acid. It is also a haemostatic. It is the best chemical antidote for the poisonous alka- loids, but its administration should be followed by emet- ics and purgatives, as the compounds formed are capable of being dissolved and absorbed in the alimentary canal. When meant to act on the stomach it is usually given in powder ; on the bowels, in pill form ; and locally, as an ointment or lotion. Tannic or gallic acid in some form is contained in and gives character to nearly all of the vegetable astrin- gents, such as castanea or chestnut, catechu, geranium, pomegranate, logwood, hamamelis or witch hazel, kino, coto bark, alder, diospyros or persimmon, mango, pinus Canadensis, and others. Preparations. Glyceritum Acidi Tannici. Glycerite of Tannic Acid. Strength, 20 $. 72 MATERIA MEDICA FOR NURSES. Unguentum Acidi Tannici. Tannic Acid Ointment. Strength, 20 . Trochisci Acidi Tannici. Tannic Acid Troches. 1 gr. each. Acidum Gallicum (Gallic Acid). Gallic acid is also made from galls, and is an astrin- gent similar to but milder than tannic acid. It does not coagulate albumen. It is given in powder and pill, in doses of from 10-30 gr. (0.65-2. gm.) Acidum Lacticum (Lactic Acid). Lactic acid is found in sour milk. It is also produced by the action of a special ferment on sugar, and is one of the normal constituents of the gastric juice. It is a pale-yellow, syrupy, inodorous liquid, with acid taste. Lactic acid aids digestion and promotes appetite. It is credited with the power of dissolving fibrinous exu- dations, but its use as an application is very painful. Flatulence and epigastric pain result from its too free administration. It enters the blood as alkaline lactates, is decomposed, and excreted by the urine as carbonic acid. Acidum Lacticum Dilutum. Dilute Lactic Acid. Consists of 15 parts acid to 85 parts water. Dose, \ ss.-ii , well diluted. Acidum Hydrocyanicum. Hydrocyanic or Prussic Acid. The pure anhydrous 1 acid is a colorless, transparent, volatile, and inflammable liquid, so poisonous that its fumes alone will cause death. 1 Without water. THE ORGANIC ACIDS. 73 Its discoverer, Scheele, is supposed to have died from inhaling it. It is not official, and is only kept in laboratories. It is found in nature in a number of vege- table substances, viz., peach kernels, bitter almonds, wild cherry, cherry laurel, etc. Acidum Hydrocyanicum Dilutum. Diluted Hydrocyanic Acid. Made by distilling aqueous solutions of ferro-cyanide of potassium and sulphuric acid, and diluting the product with the water to the required strength. A colorless, watery liquid, containing 2 parts of the pure acid to 98 parts of alcohol and water. Its reaction is faintly acid ; the taste and odor like those of peach kernels and bitter almonds. Under the influence of light it has a tendency to decompose, and should be kept in dark-colored, well-stopped bottles. Physiological Actions. Applied to the skin the acid depresses the sensory nerves and causes numbness. It is therefore used for various local purposes, largely diluted, but should nevei be applied to an abraded surface, as, being readily absorbed, poisoning might result. It enters .the blood very rapidly, especially through the lungs, enters the tissues promptly, and acts chiefly on the nervous structures as a sedative and depres- sant. The respiratory centre is especially affected, the respirations weakened and slowed. The vaso-motor centre is stimulated temporarily, and then quickly de- pressed. The cardiac centre is also depressed, though it is the last to be affected. The sedative action of the drug is not confined altogether to the nerve-centres, but is shown also on the muscular structure of the hearr. The motor nerves and muscles are weakened by hydro- cyanic acid, the enfeebling action extending downward. It is very rapidly eliminated from the system, prob- ably by the lungs. This is not, however, a settled point. When taken in medicinal doses hydrocyanic acid causes a feeling of sleepiness. The first peculiar effects are : a bitter taste, an increased flow of saliva, and a feeling 74 MATERIA MEDIC A FOR NURSES. of irritation and constriction of the throat. These effects pass off in half an hour or, at most, an hour. When the dose is rather larger than medicinal, viz., about TT[ xxx. of the weak acid, there may be noticed : nausea, transient giddiness, faintness, a feeble pulse, and general muscular weakness. Sometimes there is vomiting, or foaming and frothing at the mouth, with a suffused or bloated appearance of the face and prominent eyes. Symptoms of Poisoning. The inhalation of the vapor, short of a fatal quantity, causes giddiness, faintness, embarrassed breathing, a weak, small pulse, and even coma and insensibility, followed by recovery. If death results from small doses, there are commonly present tetanic spasms, lockjaw, and involuntary evacua- tions. Prussic acid is one of the most powerful poisons known, and after a toxic dose the symptoms come on instantly, and death may result in a few moments. Among its most marked effects are the insensibility and loss of muscular power, which are produced much more rapidly than by any other poison. There is usually loss of consciousness in a few sec- onds ; the eyes are protruding and shining, the pupils dilated and irresponsive to light ; the limbs relaxed and covered with clammy sweat ; the pulse imperceptible \ respiration very slow and convulsive, sometimes ster- torous, sometimes gasping, or sobbing, the act of expira- tion being long and forced, with a pause afterwards during which the patient seems dead. There is usually an odor of the acid on the breath. When the poisonous dose is small, yet still fatal, there are often convulsions, spasmodic clinching of the fingers, and contraction of the toes. The smallest fatal dose recorded was an amount equivalent to gr. yV of pure acid. This caused death in twenty minutes. Probably the average fatal dose is about gr. i. of pure acid, and the average time of death from two to ten minutes. It is not an accumulative poison. THE ORGANIC ACIDS. 75 Treatment of Poiso?iing. There is no chemical antidote which acts quickly enough to. be of any service. Cold-water affusions to the head and spine, and artificial respirations, are of more service than anything else, and should be perse- vered in, especially the latter, as long as there is any sign of breathing ; as, if the tendency to death from apncea be combated until the influence of the poison begins to pass off, life may be saved. The stomach may be emptied by emetics or the stomach-pump ; inhalations of ammonia and chlorine water given ; and injections hypodermically of ammonia, ether, and alcoholic stimulants. Dose of dilute acid, TT[, i-iii. (TTL i. = gtt. i.). (0.06- 0.2 gm.) Acidum Oxalicum (Oxalic Acid). Oxalic acid is never used in medicine, but, as a poison, it has caused accidental death so often that it will be included here. There are two forms of oxalic acid : one, the simple acid, which is found in sorrel and several other vegetable substances ; the other, the article known as essential salt of lemon, one of the most violent of the corrosive poisons, and often mistaken for Epsom salt. Symptoms of Poisoning. A hot, acrid taste, and burning in the throat and stomach ; intense abdominal pain, and vomiting of greenish, brown or bloody mucus of very acid reaction ; livid, cold skin ; small, irregular pulse ; unconscious- ness, stupor, and collapse. In some cases the gastric symptoms predominate, in others the nervous symptoms, as convulsions, numbness, paralysis, and stupor. The smallest fatal dose known is 3 i. An ounce usually proves fatal, and the symptoms appear immediately. Death may occur within a few minutes, or may be de- layed more than a week, and then take place from starva- tion resulting from the injuries to the intestinal canal. Treatment of Poisoning. The immediate administration of an antidote is of the greatest importance. Neither potash nor soda can be used, as their oxalates are poisonous ; but lime and chalk y6 MATERIA MEDIC A FOR NURSES. are perfect antidotes, and can be given as precipitated chalk or saccharated solution of lime, or they may be scraped off the wall, whitewashed fences, or ceilings, stirred up in milk, and freely administered. Emetics, followed by the soothing and demulcent drinks usual in the after-treatment of irritant poisons, are employed, and stimulants, with external warmth. THE CARBON COMPOUNDS. Alcohol. Alcohol is a product which results from a process of fermentation in substances containing grape-sugar — called the vinous fermentation in distinction from the acetous or vinegar-forming process. At a temperature of 8o° F., the presence and growth of the fermenting body (a low vegetable organism called the yeast-plant) converts a solution of grape-sugar into alcohol and carbonic acid. Starchy substances yield alcohol, starch being convertible into grape-sugar. From these vinous or fermented liquors alcohol is obtained by repeated distillation. It is also made syn- thetically, 1 by shaking olefiant gas (a gas composed of carbon and hydrogen, which is generally present in coal gas, oil gas, and other gaseous mixtures produced by the action of heat on organic substances) with strong sulphuric acid, diluting and distilling. Alcohol is a colorless, volatile liquid, of strong pungent odor and burning taste ; it is inflammable, burning without smoke and with a blue flame, evaporates on exposure to the air, is vaporized by heat, and unites readily with water in all proportions. There are three important alcohols or varieties of alcohol, viz. : i. Alcohol Ethylicum, Ethyl Hydrate, Grain Spirit. This is the alcohol of common language. 2. Alcohol Amylicum, Amyl Hydrate, Potato Spirit, called fusel oil, and obtained also as an impurity in the production of ethylic alcohol by continuing the distillation after the pure spirit has ceased to come away. Amylic alcohol is not inflammable. 1 By uniting elements into a compound. THE CARBON COMPOUNDS. J*] 3. Alcohol Methylicum, Methyl Hydrate, Wood Spirit. Wood spirit is inflammable, and is cheaper than alcohol. Physiological Actions. Alcohol is locally antiseptic and disinfectant, cooling, and astringent. Internally, in medicinal doses it is pre-eminently a heart stimulant, and, in a lesser degree, a diuretic, diaphoretic, and anti- pyretic. Under certain conditions, it is a food ; under still others, a poison. When rubbed into the skin, as for the prevention of bed-sores, it disinfects and hardens it, checks the activity of the sweat glands, and irritates the cutaneous nerves, causing redness, heat, and local anaesthesia. Applied and allowed to evaporate, as in sponge baths, it has a cooling action. Coming in contact with an abraded surface it is very painful. It is absorbed by the un- broken skin. In the stomach it produces a sense of warmth, and, in moderate amount, stimulates the mucous membrane and dilates the small vessels, with the result that the blood supply is increased and the gastric secre- tions correspondingly abundant. When used in doses sufficient to give this result simply, alcohol is evidently favorable to digestion, but in larger quantities it has another and unfavorable action, namely, that of precipitating the pepsin of the stomach. Overdoses produce this result ; a small quantity, di- luted as it is by the gastric fluids, has not sufficient power to act on the pepsin to any marked degree. If alcohol is constantly used to excess, an abnormal secre- tion of mucus — gastric catarrh — results, with various evidences of dyspepsia, viz. : loss of appetite, acidity of stomach, heartburn and pyrosis, nausea, and morning vomiting. Other evidences of the alcohol habit are : constipa- tion ; pain on pressure over the stomach ; brown, dry tongue with red tip ; chronic pharyngitis ; fat, flabby, soft hands. 78 MATERIA MEDICA FOR NURSES. Sleep, for the first part of the night, is sound, but is disturbed in the early morning, after which wakefulness remains, or broken sleep with bad dreams. Confirmed drinkers age fast. The skin becomes dry, and feels waxy, soft, and unhealthy. The mind becomes sluggish and weak, and cirrhosis of the liver and kid- neys, phthisis, epilepsy, paraplegia, insanity, and other disorders are among the sequels of alcoholism. Symptoms of Poisoning. A steady course of alcohol in excess, without taking food, will result in delirium tremens. Acute alcoholic poisoning presents the following symptoms : a short period of excitement, followed by coma ; respirations irregular, sometimes sighing but usually stertorous ; pupils either dilated or contracted, usually the former ; face flushed ; pulse hard, rapid, and strong. Acute alcoholic poisoning may be mistaken for opium poisoning, apoplexy, and compression of the brain. Death results from paralysis of the heart and respira- tions. The time at which death may occur varies from a few minutes to several days. The smallest known fatal dose was between § iii.-iv. of brandy swallowed by a child of seven years. Treatment of Poisoning. The treatment consists in emptying the stomach ; the application of heat to the extremities and cold affusions to the head ; the inhalation of ammonia, and the use of electricity applied to the respiratory muscles. Physiological Actions (Continued). Alcohol enters the blood unchanged or as aldehyde, 1 and reaches the tissues and organs, a small portion being changed into acetic and carbonic acids. In its passage through the tissues it is oxydized, if given in moderate amount, and changed into carbonic acid and water, like other carbo-hydrates, — thus becoming a food or source of heat and force. i Alcohol deprived of a certain proportion of its hydrogen. THE CARBON COMPOUNDS. ?Q In a healthy adult, § iss. of absolute alcohol can be thus oxydized in twenty-four hours, and supplies to the organism as much heat and energy as is contained in the same amount of cod-liver oil or in about § ix. of beef. Beyond this, in health, it becomes injurious, and is eliminated by the kidneys, skin, and lungs ; though in different morbid states large — even excessive — quanti- ties can be safely taken. Children and old people bear alcohol well. Although alcohol is itself oxydized, it interferes with the oxidation of other substances, thus saving the tissues from wear and retarding the process of waste. This, joined to its stimulating action on the circulation and on the nervous system, gives it the power of sustain- ing life for a time, under the strain of acute exhausting disease, or during a period of temporary inability to take sufficient food. Its stimulant effect is shown on the heart by an in- crease in the strength of the contraction or systole. The pulse becomes strong and regular, full, and compressible. If it had, before, been rapid and weak, it will, under the favorable influence of alcohol, become reduced in fre- quency to near the normal ; but, if over-stimulated, this shortening of the period of rest will in time exhaust the heart. In giving alcohol as a medicine, it is important to be able to recognize the first evidences of over-stimulation as given by the pulse. The " whiskey pulse " as it is called, is unnaturally strong, full, frequent, and bounding. On the brain and nervous system alcohol acts as a stimulant, up to a certain point ; beyond that, as a de- pressant and narcotic. On the circulation and bodily heat its action would, at first sight, seem to be contradictory. The sense of warmth given by a dose of alcohol seems incompatible with the well-proved facts that the bodily heat is, on the whole, lowered by alcohol, and that the power of resist- ance to cold is weakened by its use. The physiological explanation is, that the blood-vessels 80 MATERIA ME DIC A FOR NURSES. are dilated by the stimulus of alcohol, — the blood rushes to the surface to fill the superficial vessels, and a feeling of warmth results, which, in a warm or moderately cool atmosphere, remains, and promotes the general comfort ; but, in a cold atmosphere, the supply of blood to the sur- face being so much larger than ordinary, and perspira- tion being also increased, while active tissue-changes are checked, heat is abstracted from the body by evaporation at a rate which soon affects the vital powers seriously. In giving stimulants there are various points to notice by which to judge whether it is doing good or not. The pulse has been mentioned ; the tongue gives another indication. If a dry tongue becomes moist un- der the influence of alcohol, it is acting well ; if the dry- ness of the tongue be increased, it is not, and the same rule applies to the skin. If nervousness is quieted, sleep induced, delirium and subsultus lessened by alcohol, it is acting favorably ; if restlessness and uneasiness follow, or increased delirium, or sleeplessness, — unfavorably. In cases of sudden heart failure alcoholic stimulants are given hot and concentrated. Preparations of Alcohol. Spiritus Rectificatus. Rectified Spirit. Contains 85 per cent, of pure ethyl alcohol with 15 of water. Absolute Alcohol. Made from the rectified spirit by a lengthy chemical process. It consists of 99 parts pure alcohol with 1 of water, and is not kept for sale but used only for pharma- ceutical purposes. Spiritus Tenuior. Proof Spirit. Equal parts of alcohol and water, or, strictly speakings 49 per cent, alcohol. THE CARBON COMPOUNDS. 8 1 Alcohol Dilutum. Dilute Alcohol. Equal parts of alcohol and water. Alcohol. Contains of absolute alcohol 94 parts by volume (91 parts by weight). Alcoholic Beverages. Spiritus Frumenti. Whiskey. Made in the United States from rye and corn, in Scotland from barley, and in Ireland from potatoes. It has from 44 to 50 per cent, by weight of ethyl alco- hol (by volume 50 to 56 per cent.), and contains ethers which are developed in the course of its fermentation ; and, even in the best varieties, some traces of fusel oil. Whiskey should be at least two years old before it is used. It is sometimes necessary or convenient to use alcohol instead of whiskey. The ordinary dose of § ss. whiskey is represented by a little over 3 ii. of alcohol, or by J ss. of dilute alcohol. Spiritus Vini Gallici. Brandy. Brandy should be distilled from grapes, but it is also made artificially. It has about the same percentage of alcohol as whiskey. It may be* either pale or dark ; in the former case it is colored by the cask, in the latter it contains caramel. It should be at least four years old. Brandy has a more sedative action on the stomach than whiskey, and is preferable where there is any tendency to diarrhoea, as it is slightly constipating, containing a little tannin. Both brandy and whiskey are more easily taken, as medicines, if poured over a small glassful of cracked ice ; or they may be diluted with carbonated or seltzer water more acceptably than with plain water. Giving them in milk very often causes patients to take a dislike to the milk. They are both used hypodermically, and foi this purpose should always be filtered. 82 MATERIA MEDIC A FOR NURSES. Rum, Made by the distillation of fermented molasses. Gin. Distilled from rye or barley, and flavored with juniper berries. If it is pure, it is an efficient diuretic, owing to the oil of juniper, but it is rarely pure. Wines. Official wines are white wine, vinum album, and stronger white wine, vinum album fortius. They are used in medicinal preparations. White wine contains about jo per cent, of alcohol, and is made from grape juice without skins, stems, or seeds. All wines contain various acids and traces of mineral substances. Those which are free from sugar are called " dry " wines. The red wines — claret, port, etc., are made from col- ored grapes with the skins, and have considerable alco- holic strength. Port wine, vinum portense, contains from 30 to 40 per cent, of alcohol, but is rarely pure. As stimulants and in narcotic power these wines stand next to brandy and whiskey. They contain some tannic acid and are astringent, causing constipation and disordering the stomach. They also tend to raise the temperature. Vinum Xericum, or sherry, belongs to the dry spiritu- ous wines. It contains 17 per cent, of alcohol, and is usually made artificially. It assists digestion if taken during meals. Sparkling wines, of which champagne is the most im- portant, are bottled before fermentation is complete, and are effervescent, being charged with carbonic acid. They are more intoxicating" than others in proportion to their strength, are less stimulating to the heart, and liable to leave headache and sour stomach as after-effects when freely taken. In small doses they are gastric seda- tives, champagne especially being so. Given ice-cold and in teaspoonful doses, at short intervals, it may be THE CARBON COMPOUNDS. 83 retained by an irritable stomach which rejects every thing else. In giving champagne in this way care is necessary to prevent escape of the gas and flattening of the wine. A champagne tap is used, and the bottle held head downward. In the intervals it is kept on ice in the same position. Sweet wines, including Burgundy and Madeira, are rather trying to the digestion. They disorder the stom- ach and cause headache. They contain 6 or 7 per cent, of alcohol. Dry acid wines, — the German and some of the French wines, are stimulant, and do not cause acid fermentation. They contain from 5 to 7 per cent, of alcohol. Beer, Ale, Porter, Stout, Contain from 2 to 6 per cent, of alcohol ; also extract of malt, lactic acid, salts of potash and of soda, and aromatics. Chloroformum (Chloroform). Chloroform is made by the action of chlorine on alcohol. Physiological Actions. Externally applied and allowed to evaporate, chloro- form causes a sense of coldness and depresses the termi- nations of the sensory nerves, acting as an anodyne and producing insensibility to pain. If evaporation is pre- vented it irritates, reddens, and blisters the skin. These effects are followed by anaesthesia of the part. Given by mouth, chloroform has a hot, sweet taste, and in the stomach produces a feeling of warmth. In large quanti- ties or undiluted it causes violent gastro-enteritis. Me- dicinally it is given as an antispasmodic, anodyne, and carminative. It enters the circulation through the lungs, stomach, and unbroken skin. It reaches the tis- sues very rapidly, and exerts its greatest power on the central nervous system. It is excreted partly as chloro- form by the kidneys, lungs, mammary glands, and skin, and part is lost in the system. 84 MATERIA MEDIC A FOR NURSES. Symptoms of Poisoning. In poisoning by chloroform taken internally the symp- toms are stupor ; cold skin covered with perspiration ; pulse slow, thready, sometimes almost imperceptible ; res- pirations at first stertorous, afterwards becoming shallow, irregular, and infrequent. The symptoms come on almost immediately after it has been swallowed, and death may result in a few hours, or may result after a longer time from gastro-enteritis or from inflammation of the trachea. Treatment of Poisoning. There is no antidote for chloroform, on account of its extremely rapid diffusibility through the system. The stomach must be emptied, washed out, if necessary, and cold-water affusions applied to the head, and plenty of fresh air admitted. Artificial respiration should be prac- tised steadily and unremittingly. The smallest fatal dose recorded is 3 ii. Dose of chloroform, TT], xv.-xxx. (TT[ x. = gtt. lx.). (1.-2. gm.) Spiritus Chloroformi. Strength, 10 . Dose, 3 ss.-i., well diluted. (2.-4. gm.) Emulsum Chloroformi. Chloroform, 8 wdered Ipecac Dose, gr. xx. (1.3 gm.) Pulvis Ipecacuanhae. Powdered Ipecac. THE VEGETABLE KINGDOM. I $7 Syrupus Ipecacuanhae. Strength, 5 parts fluid ext. to 100. Dose for infant, 3 ss.-ii. - (2.-8. gm.) Vinum Ipecacuanhae. Strength, 1 part fluid ext. to 7 white wine. Dose, 3 ss.-ii. Extractum Ipecacuanhas Fluidum. Emetic dose for adult, TT[ xxx. (TT1 x. = gtt. xx.). (2. gm.) Emetine. Dose, gr. f-J. (0.01-0.03 gm.) All these preparations are best given with plenty of warm water, in cases of poisoning ; with croupy children, however, swallowing being difficult, it is best not to di- lute the dose, or but very little. Catechu. An extract from the wood of Acacia Catechu, from the East Indies. It contains kino-tannic and catechinic acids, and is a strong astringent. Tinctura Catechu Compositus. Dose, 3 i.-iii. (4.-12. gm.) Coffea Arabica (Coffee Plant). The seeds of the coffee plant, grown m Arabia, yield the alkaloid caffeine (which is also obtained from plants belonging to different families, viz., Paullinia sorbilis, guarana). The coffee seeds also contain sugar, tannic acid, caffeic acid, a volatile oil, etc. The qualities of coffee as a beverage are too familiar to need mention. In moderation, and when well made, it aids digestion and has laxative effect. In excess, or when improperly made and allowed to boil, it causes dyspepsia by the astringent action of its tannic acid. 158 MATERIA MEDICA FOR NURSES. Caffeine. Caffeine is distinguished by containing more nitrogen than almost any other vegetable principle. It is absorbed unchanged into the circulation, and is a stimulant to the brain and heart, producing wakefulness, with a clear, vigorous state of the intellect, and strengthening the contraction of the heart. It resembles digitalis in its action as a cardiac stimu- lant, but acts more promptly and is more transitory in its effects. It has no decided cumulative tendency, and does not disagree with the stomach. It acts as a diuretic by stimulating the cells of the kidneys, as well as by its action on the heart and circulation. It has been known to cause, after doses of moderate size, nervous wakefulness and restlessness, tremulousness, frequent pulse, confused thought, and visions passing in a constant train. These symptoms have lasted for several hours. In large doses it has caused poisonous though never fatal symptoms, such as muscular tremor, a burning feeling in the throat, • palpitations with rapid, violent pulse and short, quick respirations ; giddiness, nausea, disordered vision, and marked diuresis. Dose of caffeine, gr. v.-xx. (0.3-1.3 gm.) Nat. Ord. Ternstromiacece. Camellia Thea (Tea Plant). The leaves of the tea plant, grown in China, contain theine, the active principle ; tannic acid, and a volatile oil. Theine was formerly considered to be identical with caffeine, but investigators have recently pronounced them to be different. Tea is stimulating" and refreshing. Used to excess it weakens the digestive system and causes constipation, depresses the heart and vaso-motor nerves, producing neuralgic pains. In cases of poisoning, when tannin is needed, it may sometimes be most quickly procured in THE VEGETABLE KINGDOM. 1 59 the form of strong, rank tea. By boiling it hard and squeezing dry the leaves, the tannin is extracted as thoroughly as possible, and the tea is given, without sugar or milk, in large quantities. Nat. Ord. Valerianacetz. Valeriana (Valerian). The dried rhizome and roots of Valeriana officinalis. The active principles are a volatile oil and valerianic acid. The latter is found in many other plants, in cod- liver oil, and may be derived from amylic alcohol. Valerian is a carminative, circulatory stimulant, and anti-spasmodic. In nervous cases it sometimes acts successfully as an hypnotic. Large doses ( 3 ii.-iv.) may cause nausea, vomiting, and colic, a quickened pulse, and a feeling of formication in hands and feet. Preparations. Tinctura Valerianae. Strength, I ii. to Oj. Dose, 3i.-iiL (4.-12. gm.) Extractum Valerianae Fluidum. Dose, 3 i. (4. g m -) Tinctura Valerianae Ammoniata. Ammoniated Tincture. Strength, § ii. to Oj. Dose, 3 i.-iii. (4.-12. gm.) Nat. Ord. Composite. Santonica (Levant Wormseed). The dried flower-heads of Artemisia pauciflora, of Asia Minor. The active principle is santonin, and there is also a compound volatile oil resembling camphor in its action. 160 MATERIA MEDIC A EOR NURSES. Santonin is an anthelmintic, acting especially on the ascaris lumbricoides, or round worm. In overdoses it produces disturbances of vision and of consciousness. Objects appear at first to be blue, then yellow. There are tremors, aphasia, and sometimes convulsions. The respirations become feeble, and the pulse is reduced. It is necessary, in giving it, to watch its action, that these symptoms may be avoided. It is excreted by the bowels and by the kidneys, and discolors the urine, making it saffron or reddish. There have been numerous cases of fatal poisoning among children from santonin. Alarming symptoms have been caused by gr. ii in a child eight years old, and a dose of gr. ii. to a child of five years caused death. Dose, gr. J-v. (0.015-0.3 gm.) Eupatorium (Thoroughwort). The herbal parts of a coarse plant yield this drug, whose chief action is as a sudorific. The infusion is given very hot, in doses of one-half or one tumbler full, the patient being warmly covered in bed, and free dia- phoresis results. The taste is very unpleasant. Taraxacum (Dandelion). The root of the dandelion is a simple bitter and mild laxative. Extractum Taraxaci Fluidum. Dose, 3 i.-ii., after meals. (4.-8. gm.) Tanacetum (Tansy). The common tansy contains a volatile oil, its active principle. It is a stimulant emmenagogue and is capable of producing abortion. It is a dangerous drug, one teaspoonful of the oil having produced severe symp- toms of poisoning, such as abdominal pain, unconscious- ness, convulsions, and in one instance death. Dose of the oil, Oleum Tanaceti, TT[ i.-iii. (0.06-0.2 gm.) THE VEGETABLE KINGDOM. l6l Arnicae Flores ; Arnicae Radix. The Arnica montana, or leopard's bane, grows in Northern Europe and Asia and in the Northwestern United States. The root and flowers contain two alka- loids and the ammonia compound, trimethylamine, which is found in cod-liver oil and in ergot, and may also be obtained from various decomposing albuminous substances. Externally arnica is Stimulating and irritant, in- creasing the circulation of the skin. It sometimes causes excessive redness and eczema, and must be used with care. The diluted tincture promotes the absorption of blood which has effused into the tissues, as after a blow, and prevents swelling. Internally, in small doses, arnica is slightly stimulating to the heart, the skin, and kidneys. In larger doses it is a cardiac depressant, and in doses equal to f i. of the tincture it has caused the pois- onous symptoms of gastro-intestinal irritation ; cold dry skin ; feeble fluttering pulse, lowered sometimes to 60 ; and occasionally vomiting and purging, with final col- lapse. It should never be applied to an open wound. Preparations. Tinctura Arnicae Flores. Tincture of Arnica Flowers. Strength, 20 %. Tinctura Arnicae Radix. Tincture of Arnica Root. Strength, 10 . Dose, 3 ss.-i. (2.-4. gm.) Tinctura Benzoini Composita. Friar's Balsam. For external use ; it contains benzoin, aloes, styrax, balsam of tolu, and alcohol. 164 MATERIA MEDIC A FOR NURSES. Ammonii \ Lithii v Benzoas. Sodii ) Dose, gr. v.-xxx. (0.3-2. gm.) Nat. Ord. Oleacece. Oleum Olivae (Olive Oil). The oil expressed from the fruit of Olea Europaea. Olive oil is composed of a fluid oil, olein ; a solid oil, palmitin ; with oleic and palmitic acids. Used externally by inunction, it is absorbed by the lymphatics, and has some nutritive value. As a mechanical application it is used both externally and internally in the treatment of burns and corrosive poisons. It acts as a laxative, and is used for this pur- pose in enemata, tending to soften the faecal mass and assist in its expulsion. Oils in general are changed into carbonic acid and water in the system, and so excreted, but an excess will appear unchanged in the urine. Nat. Ord. Loganiacece. Spigelia (Pink-Root). Spigelia is an anthelmintic and purgative, and acts on the round worm. Extractum Spigeliae Fluidum. Dose, TTJ, x - 3 ii. (0.65-8. gm.) Gelsemium (Yellow Jessamine). The root of Gelsemium sempervirens, of the Southern United States. The alkaloid gelsemium and gelseminic acid are the important constituents. THE VEGETABLE KINGDOM. 1 65 Physiological Actions. Gelsemium is a motor depressant and anti- spasmodic, acting by direct influence on the spinal cord. In medicinal doses it is sedative and dia- phoretic. The smallest active quantity (TTJ, v.-xv.) causes a languid feeling, with slight reduction of the strength and frequency of the pulse. If the amount be increased, pain over the eyes, some disturbance of vision, and diz- ziness result, with increased perspiration It has a peculiar nervous effect on some people, making them cry without knowing why. Symptoms of Poisoning. Poisonous doses ( 3 i. of the fluid extract) produce, in addition to these symptoms, great muscular weakness, affecting especially the flexors of the arms. The gait also is affected, and becomes staggering. The jaw drops, and articulation fails. There is marked effect on the sight : double vision, partial or complete blindness may develop ; sometimes a squint is produced; the eyelid droops ; the pupil dilates. There is profuse perspiration, cold surface and sub- normal temperature, and a condition of general anaesthe- sia. The pulse is thready and feeble, and death finally results from paralysis of the respiratory muscles. Con- sciousness remains until carbonic-acid narcosis begins as the result of asphyxia. Gelsemium is rapidly diffused, and the effects appear within half an hour, and, after medicinal doses, disap- pear within two or three hours. Death, when it occurs, may do so in a few hours, and has been known to result from taking one sixth of a grain. Treatment of Poisoning. Poisonous symptoms are treated by emetics, alcoholic stimulants, external heat, electricity, and artificial respi- ration, if necessary. 1 66 MATERIA MEDIC A FOR NURSES. Preparations. Extractum Gelsemii Fluidum. Dose, TT[ v. (TT1 x. = gtt. xxv.). (0.3 gm.) Tinctura Gelsemii. Strength, 1 to 6.6. Dose, TT], x.-xxx. (0.65-2. gm.) Nux Vomica (Poison Nut ; Quaker Buttons). The seeds of Strychnos Nux-vomica, an East Indian tree. The active principle is the alkaloid, strychnine, an important poison. Two other important principles are brucine and igasuric acid. Brucine is of half the strength of strychnine. Physiological Actions. Nux vomica in medicinal doses is tonic, with the qualities of bitter stomachics ; it increases appetite, aids digestion, and promotes peristalsis. It also stimu- lates respiration, the heart, and vaso-motor centres. These actions are largely due to the presence and in- fluence of strychnine. Strychnine enters the system rapidly, especially the nervous tissues, on which its pre- eminent action, that of a motor excitant, is shown. It is excreted very slowly, not disappearing from the tissues for several days, and therefore accumulates in the system when given in continuous doses, even small ones. The power of strychnine in regard to the nervous sys- tem is exerted on the motor centres of the spinal cord and all the important nerve centres in the medulla. The first constitutional symptoms are a feeling of restlessness, with slight trembling of the extremities. After a full dose (gr. yV), there are noticeable muscular twitching and jerking of the limbs, slight stiffness of the jaw, a tense feeling about the head, stricture of the throat and chest, shuddering, and a feeling of anxiety. Symptoms of Poisoning. After poisonous doses (gr. \ for an adult) violent symptoms come on very suddenly, probably within THE VEGETABLE KINGDOM. 1 67 fifteen minutes, with tonic convulsions resembling the spasm of tetanus. The legs are rigid, extended, and the feet everted, or the body may be bent backward until the head and heels meet (opisthotonos). The arms are bent, and hands clinched ; the eyes open and staring. The corners of the mouth are drawn up by the muscles in a mechanical grin, the " risus sardonicus," which gives a ghastly unmeaning expression, and the face — at first pale — presently becomes livid from asphyxia. Between the paroxysms there is a period of relaxation and quiet, but the slightest sound, or touch, or breath of air brings on the spasms again instantly by reflex action, owing to the condition of intense irritability. In cases which terminate fatally the spasms succeed each other quickly, and death takes place in two or three hours from paralysis of the respiratory muscles. The mind usually remains clear up to the last. Sometimes asphyxia produces insensibility just before death. Strychnine convulsions resemble tetanic and hysterical convulsions in some particulars. The special points of difference are as follows : Strychnine. The convulsions begin with a restless, excited state ; the special senses are sharpened. Muscular symptoms come on very rapidly, either beginning in the extremities or appearing simultaneously over the body. The jaw is the last part affected and the first relaxed. The eyes are open, and the muscles are relaxed between the con- vulsions. Tetanus. The symptoms come on gradually, with pain and stiff- ness of the back of the neck and occasional slight mus- cular twitchings. The jaw is the first part affected, and is rigid (trismus, or lock-jaw). There is a permanent state of general muscular rigidity. Hysteria. Begins with weakness and blindness. The muscular symptoms begin with stiffness of the neck. The extrem- 1 68 MATERIA MEDIC A FOR NURSES. ities are affected last. The jaw is set before a convul- sion and remains fixed between them. The eyes are closed Treatment of Poisoning. In treating strychnine poisoning, tannic acid or a soluble iodine salt is given as an antidote, followed quickly by emetics, as the compounds thus formed are not permanent. The bladder must be emptied to prevent re-absorption ; then absolute quiet is of the greatest importance. Inhalations of chloroform are used, with full doses of chloral and bromide of potassium given internally. Precautions. In giving strychnine, the possibility of its cumulative action must always be kept in mind as a grave feature. It is more likely to develop if the medicine is in pill form than if in solution. With the liquid preparation of iron, strychnine, and quinine, the danger exists also, as the strychnine is apt to precipitate. It must always therefore be well shaken. Strychnine is more effective with old people. The first constitutional symptoms are to be looked for with care : twitching, trembling, starting, or stiffness of the muscles. It is of great importance to know exactly when they begin, especially when, as is often the case, the orders received are to push the medicine to the utmost limit. Preparations of Nux Vomica. Abstractum Nucis Vomicae. Abstract of Nux Vomica. Dose, gr. i.-ii. (0.06-0.12 gm.) " Tinctura Nucis Vomicae. Tincture of Nux Vomica. Strength, 20 per cent. Five minims of the tincture represent 2 -J-g- grain of strychnine. Dose, TT[ x.-xxv. (fTj, x. = gtt. xxv.). (0.65-1.6 gm.) THE VEGETABLE KINGDOM. 1 69 Extractum Nucis Vomicae Fluidum. Fl. Ext. of Nux Vomica. Dose, Til ii.-iii. (TIj, x. = gtt. xxv.). (0.13-0.2 gm.) Extractum Nucis Vomicae, in pill. Dose, gr. J- J. (0.015-0.03 gm.) All preparations of nux vomica are given before meals. Preparations of Strychnine. Strychninae Sulphas. Strychnine Sulphate. Dose, gr. -gVsV (^ x - = gtt. x.). (0.001-0.003 gm.) Ferri et Strychninae Citras. Iron and Strychnine Citrate. Dose, gr. i.-iii. (0.06-2. gm.) Syrupus Ferri, Quininae, et Strychninae Phosphatum. Syrup of the Phosphate of Iron, Quinine, and Strychnine. One part strychnine to 2,500. Dose, 3 i.-ii. (4.-8. gm.) Nat. Ord. Gentianacece. Gentiana (Gentian). The root of Gentiana lutea, the yellow gentian of the Alps, furnishes an efficient simple bitter and stom- achic tonic. Preparations. Tinctura Gentianae Composita. Compound Tincture of Gentian Strength, 10 $. Dose, 3i.-3iv. (4.-16. gm.) Extractum Gentianae Fluidum. Fluid Extract of Gentian. Dose, HI x.-xxx. (0.65-2. gm.) Mistura Gentianae Alkalina. Alkaline Mixture of Gentian. Contains soda bicarb., dilute hydrocyanic acid, and gentian. 170 MATERIA MEDIC A FOR NURSES. Nat. Ord. Convolvulacece. Scammonium (Scammony). The root of Convolvulus scammonia yields an exudate from which is obtained a resin, having properties as a drastic purgative. The chief ingredient of the resin is called jalapin, and is probably the same as the con- volvulin of jalap. The dose of the resin of scammony is gr. ii.-x. (0.13 -0.65 gm.) Jalapa (Jalap). Obtained from the tuber of Ipomsea jalapa, a vine growing in Mexico. The active principle is a double resin, or one separable into two, called jalapin and con- volvulin, the latter being the most important. Jalap is a hydragogue cathartic, and creates a feeling of nausea. In overdoses it causes severe vomiting and purging. The stools produced by its action are large and watery. It is seldom used alone, but is often combined with calomel. The compound powder, Pulvis Jalapse Compositus, contains jalap and cream of tartar. Nat. Ord. Afiocynacecz. Strophanthus (Arrow-Poison). The seeds of Strophanthus hispidus, of Africa. The active principle is a glucoside named strophanthin. It exists in the seeds in a strength of 8 or 10 . Dose, TU 10-30. Emplastrum Capsici. Capsicum Plaster. Tabacum (Tobacco). The leaves of Nicotiana Tabacum, a native of tropical countries cultivated in the North. They contain an exceedingly powerful alkaloid, nico- tine ; a volatile oil, nicotiana ; and, in slight propor- tions, the following alkaloids, some of which are familiar 178 MATERIA MEDIC A FOR NURSES. as being found in other plants : lupuline, coniine, lobe- line, piperidine, pyridine, muscarine, and sparteine ; also the alkaloidal compound trimethylamine. Tobacco smoke contains but little nicotine, if any, and a large proportion of pyridine. Nicotine is one of the most violent poisons known, acting almost as rapidly as prussic acid. Death has followed a toxic dose in three minutes. Emetics, tannin, and artificial respiration are to be em- ployed in treating the poisoning. Tobacco is no longer used in medicine, being seriously depressing in its effects. Nat. Ord. Scrophnlariaceoz. Digitalis (Purple Foxglove). The leaves of the second year's growth of Digitalis purpurea, native of Great Britain, and cultivated in this country. The active principle, digitalin, occurs in two forms, one amorphous and the other crystalline, and is com- posed of four glucosides. Digitalin is no longer offi- cinal, the preparations made from the whole leaf being considered more trustworthy. Physiological Actions. The most important action of digitalis is as a heart stimulant and tonic, and is shown in the slowing and strengthening of the pulse. This is partly brought about by a direct action on the heart-muscle, by which the circulation in the organ itself is more efficiently carried on ; partly by a strengthening of the inhibitory apparatus, which tends to slow the heart ; and partly by a stimulant action on the vaso-motor system, by which the arteries are more strongly contracted, and, by offering some resistance to the force of the heart, excite it to greater effort. The result of all this is, that the diastole is lengthened, and the systole becomes more energetic. Thus the ventricles are better filled and more thoroughly emptied, and the beats, reduced in number, gain in firmness and strength. THE VEGETABLE KINGDOM. Ijg When an excessive amount is taken, signs of over- stimulation appear, marked by intermittency of the pulse or by a fall below normal ; it may be to 40 or 50 in a minute. In this condition any sudden exertion, such as sitting upright, may bring to a climax the grow- ing exhaustion of the heart, and the pulse may run up to 150 or more, becoming small, weak, and irregular. For this reason patients taking digitalis continuously must be kept quietly in bed and not allowed to sit up or to make any sudden exertion. In taking it only occasionally or for a short time there is not the same danger. Digitalis is also a diuretic, acting through an influ- ence on the renal as well as on the general circulation, and for this purpose it is also used locally in the form, of poultices applied over the kidneys, and made from the leaves or with the fluid preparations. Digitalis is elimi- nated by the urine, and much more slowly than it is absorbed into the system. For this reason, if doses are given close together, part of the influence of one may be added to that of the next, and the action is intensified by so much. But except conditionally in this way, a cumulative action of the drug is not acknowledged by all authorities. Symptoms of Poisoning. In cases of poisoning the symptoms begin with violent and repeated vomiting of mucus and bile. There is a feeling of vertigo, pain, and heat in the head, and dis- turbance of vision, fringes of color with a vibratory motion being sometimes seen around objects. The face is pale, the eyes staring and prominent, with dilated pupils and a blue color of the sclerotics. There is sometimes salivation, and usually diarrhoea. The un'ne may be suppressed. The vomiting continues, and great prostration follows. The pulse is irregular, small, and weak, yet the beat of the heart may be hard and strong. The respirations become rapid and feeble. Pains in the limbs and back may be present, There are, usually before the end, delirium and stupor, or convul- l8o MATERIA ME D1C A FOR NURSES, sions. Death occurs from general failure of the circula- tion with final paralysis of the heart, and has taken place as soon as three quarters of an hour after taking the poison. The average time, however, is one or two days. Digitalis poisoning of an acute form is not com- mon, and in the majority of cases the patient recovers. The smallest fatal dose is not known. Twenty grains of the extract are known to have caused death in ten days. Treatment of Poisoning. Emetics and cathartics must be given, and tannin in large quantities. Alcoholic stimulants are used, but with great care, and the most perfect rest and quiet, with a perfectly horizontal position, maintained. Incidental Effects. Digitalis is very bitter, nauseating, and irritant to the stomach, and is apt to interfere with digestion, and to cause vomiting, with occasional diarrhoea, marked by green discharges. These two latter symptoms may also be produced by hypodermic administration of the drug. Headache and vertigo, fainting, sneezing, and buzzing in the ears, are caused by overdoses ; also sparks before the eyes and other disturbances of sight ; sleeplessness ; fall of temperature ; and irregularity or threadiness of the pulse. Preparations of Digitalis. Infusum Digitalis. Infusion of Digitalis. Strength, i to 66.6. Dose, 3 i.- § ss. More diuretic than stimulant. To be largely diluted. (4.-16. gm.) Tinctura Digitalis. Tincture of Digitalis. Strength, t to 6.66. Dose, TTj, v.-xx. (0.3-1.3 gm.) THE VEGETABLE KINGDOM. l8l Extractum Digitalis Fluidum. Fluid Extract of Digitalis. Dose, TT[ i.-ii. (Til i. — gtt. ii.). The tincture and fluid extract are more stimulant than diuretic, and are only slightly diluted when given. (0.06-0.13 gm.) Digitaline. Dose, gr. -£$. It has been used hypodermically, but is irritating and much more liable to cause abscesses than either the tincture or the fluid extract given in the same way. (0.0013 gm.) Nat. Ord. Labialce. Oleum Lavandulae Florum (Oil of Lavender Flowers). An oil obtained from the flowers of Lavandula offici- nalis. Tinctura Lavandulae. Tincture of Lavender. May be pleasantly used, in small quantity, added to water for bathing. Spiritus Lavandulae Compositus. Compound Spirits of Lavender. A stomachic and cordial. Dose, 3 ss -ii. (2- 8. gm.) Oleum Menthae Piperita (Oil of Peppermint). The oil of the fresh flowering Peppermint. Aqua Menthae Piperitae. Used as a carminative. Dose, TT[ x -xx., in water (TT[ x. = gtt. x.). (0.65-1.3 gm.) Menthol. Peppermint Camphor. A stearoptene obtained from peppermint oil. Used as a local anaesthetic in headache, in the form of a pencil. 1 82 MATERIA MEDIC A FOR NURSES. Thymol. A stearoptene from the volatile oils of thymus vulgaris and other herbs. It is an antiseptic and germicide, resembling carbolic acid and oil of turpentine in action. Nat. Ord. Polygonacecz. Rheum (Rhubarb). The root of Rheum officinale, from China. Rhubarb contains cathartic acid, a peculiar tannic acid, a yellow coloring matter, etc. Rhubarb acts entirely on the alimentary canal. In small doses it is Stomachic, strengthening appetite and digestion. In large doses it is a cathartic, with as- tringent after-effects. In its purgative action the liver is stimulated as well as the intestinal glands, and evacuation takes place in six or eight hours, accompanied by some griping pain. Preparations of Rhubarb. Extractum Rhei Fluidum. Fluid Extract of Rhubarb. Dose, TT[ xv.-xxx. (fU x. = gtt. xx.) (1.-2. gm.) Syrupus Rhei. Syrup of Rhubarb. Dose, for infants, 3 i. (4. gm.) Tinctura Rhei. Tincture of Rhubarb. Dose, 3 i-ii. (4.-8. gm.) Nat. Ord. Lauracece. Camphora (Camphor). A stearoptene obtained from the wood of Cinnamomum Camphora, of China and other Eastern countries. THE VEGETABLE KINGDOM. 1 83 Camphor is one of the most widely diffused of all vegetable substances. It is found in pennyroyal, hemp- tops, and numbers of other plants. Physiological Actions. Externally applied, camphor is irritant, stimulating the local circulation. It has feeble antiseptic power, and is sedative to the nerves after first stimulating them. Internally, it acts as a carminative and anti-spas- modic, gives increased force and fulness to the pulse, and stimulates the cerebro-spinal nerves. When large doses (gr. xx.-xxx.) are given, the pulse falls, and a feel- ing of lassitude and giddiness is produced. Symptoms of Poisoning. After poisonous doses (gr. xxx.-lx.) there are faintness and headache, vertigo, confused ideas, burning pain in the stomach, delirium, convulsions, and insensibility. The pulse is small, sometimes slow, again accelerated. The skin is pale, cold, and covered with perspiration. No death of an adult has occurred with camphor. Preparations. Aqua Camphorae. Strength, 1 to 125. Dose, § ss.-ii. (16.-64. g m -) Spiritus Camphorae. Strength, 1 to 10. Dose, 3 ss.-i. (2.-4. gm.) Linimentum Camphorae. Olive oil, 6 parts ; camphor, 1 part. Linimentum Saponis. Soap Liniment. Soap, 10 parts ; camphor, 5 ; alcohol, 70 ; oil of rose- mary and water to 100 parts. Oleum Camphorae. More stimulating than the other preparations. Dose, TTL v.-x. (TTL x. = gtt. xx.). (0.3-0.65 gm.) 1 84 MATERIA MEDIC A FOR NURSES. Cinnamomum (Cinnamon). The bark of different varieties of the genus cinnamon. It contains tannic acid and a yellowish volatile oil, oleum cinnamomi. This has a fragrant and pleasant taste, and is used to mitigate that of disagreeable drugs. The preparations of cinnamon are used as carminatives. Pulvis Aromaticus. Aromatic Powder. Is composed of cinnamon, ginger, cardamom, and nut- meg. It is given in doses of gr. x.-xx. (0.65-1.3 gm.) Nat. Ord. Aristolochice. Serpentaria (Snakeroot). The dried rhizome and rootlets of two or three varieties of Aristolochise, found in North America. The taste and odor resemble camphor. It contains a resin, a volatile oil, bitter principle, etc., and is a Stimulant tonic. Preparations. Tinctura Serpentarise. Strength, 10 of Burgundy pitch. Cantharidal Pitch Plaster has 8 parts of cerate of can- tharides to 92 of Burgundy pitch. Pix Liquida (Tar). Tar is an oleoresin distilled from the wood of several varieties of pine. It contains pyroligneous acid, methy- lic alcohol, acetic acid, creosote, and several hydrocar- bons, one of which is called toluene, also oil of tar, with other oily bodies, and pyrocatechin. The oil of tar, oleum picis liquidse, is used locally and by inhalation. It contains a large number of compounds, among which are creosote and carbolic acid. Tar ointment has 50 . For external use. Colchici Semen (Colchicum Seed). Colchici Radix (Colchicum Root). Meadow Saffron. The dried ripe seeds and corm * of Colchicum autum- nale, found in Europe. The active principle is called colchicine. Physiological Actions. Colchicum is a sedative to the central nervous sys- tem ; a diuretic ; and an irritant cathartic. It stim- ulates the liver, and excites the action of the skin. The urine, urea, and uric acid are increased in amount by moderate doses of colchicum. The pulse is slightly re- duced in frequency — about 12 beats less to the minute being noticed while the impression lasts. Symptoms of Poisoning. Colchicum in poisonous doses is an acro-narcotic, 2 producing a combination of nervous and gastro-intestinal symptoms. Nausea, violent and persistent vomiting and retching appear first, with purging of serous, mucous, and bloody matters, attended with griping pain. 1 A part of the stem which is underground, yet not the actual root — a bulb. 2 A poison which is irritant, and which also acts on the brain and spinal cord. THE VEGETABLE KINGDOM. 201 Tenderness and burning are felt in the abdomen and stomach ; the urine may be diminished or suppressed, while in some cases it is increased, and in others the kidneys seem unaffected almost to the last. Spasms occur frequently, and there may be fatal con- vulsions. The circulation fails, the pulse becomes rapid and grows feeble and thready, the skin is cold, livid, and covered with perspiration. Consciousness remains, and death results from col- lapse. The fatal dose is small, death having been caused by 3 ii.-ss. of the wine. Treatment of Poisoning. The only chemical antidote is tannin, though it is not always sure in its action. Emetics, with plenty of warm water, and castor oil must be given ; albuminous drinks — milk, white of egg, etc. — and demulcents freely given, and stimulation used as the need arises. Incidental Effects. Colchicum, even in small doses, may produce un- pleasant secondary symptoms : dizziness, fulness and pain in the head ; pains over the body ; numbness, red- ness, prickling or smarting sensations ; sneezing ; running at the eyes ; irritated fauces ; coated tongue ; loss of appetite or nausea ; abdominal uneasiness or pain ; flatulence or borborygmi ; or rectal tenesmus may be observed. Preparations of Colchicum. Tinctura Colchici Seminis. Tincture of Colchicum Seeds. Strength, seeds, 15 parts in 100. Dose, 3 ss.-iss. (2-6. gm.) 202 MATERIA MEDICA FOR NURSES. Vinum Colchici Seminis. Wine of Colchicum Seeds. Same strength. Dose, 3 ss.-iss. (2.-6. gm.) Extractum Colchici Seminis Fluidum. Fluid Extract Colchicum Seeds. Dose, TT[ ii.-vi. (t\[ x. = gtt. xxv.). (0.1-0.35 g m -) Vinum Colchici Radicis. Wine of Colchicum Root. Strength, 40 f . Dose, TT|, x.-xv. (TT[ x. = gtt. xx.). (0.6-0.1 gm.) Purgative dose, 3 ss. Extractum Colchici Radicis Fluidum. Fluid Extract of Colchicum Root. Dose, Tli ii.-iv. (fT[ i. = gtt. ii.). (0.1-0.3 g m -) Nat. Ord. Graminacece. Ergota (Ergot). Ergot is a parasite which developes in rye, taking the place of the grain, and having the appearance of a black- ish fungus. It is a complex substance, containing various alkaloids and acids ; a fixed oil, etc. Three of the alkaloids are named ecboline, ergotine, and ergotinum ; and the watery extract ergotin contains all the important constituents, and may be considered to represent the active principles of ergot. Physiological actions. Ergot is specially known as an oxytocic, exciting or increasing uterine contractions ; and as a haemostatic. In the latter capacity it acts by contracting the small vessels, thus promoting coagulation. The frequency of the pulse is lessened by ergot, and very large doses THE VEGETABLE KINGDOM. 203 depress the heart and vaso-motor centres and lower arterial pressure. It is not an active poison, and an ounce of the fluid extract has been given without producing serious symp- toms. Symptoms of Poisoning. In cases where poisoning has occurred the symptoms were thirst ; gastric irritation and diarrhoea ; a small pulse ; burning pain in the feet ; and sometimes tingling and cramps, dizziness, dilated pupils, and a feeling of cold. Before death there are convulsions. In Euro- pean countries, where the poorer classes live largely on rye bread, chronic ergot-poisoning is familiar, and has at times prevailed as a scourge. There are two varieties of this chronic poisoning — the gangrenous and the spas- modic, — but it is unknown in this country, and need not be described here. Incidental Effects. The urine, perspiration, and milk are reduced in quan- tity by ergot. After taking medicinal doses, one or more of the following symptoms may be observed : an un- pleasant taste in the mouth ; tickling in the throat ; nausea ; burning pain in the stomach or abdomen, with eructations of gas or diarrhoea ; headache ; lassitude ; giddiness ; specks before the eyes ; unsteady gait ; irregular pulse ; chilly feelings. Extractum Ergotae Fluidum. Fluid Extract of Ergot. Dose, 3 i.-ii. (4.-8. gm.) Ergotin. Bonjean's preparation of ergotin is about ten or twelve times as strong as ergot — gr. v. or vi. representing 3 i. of the drug. It is used hypodermically. It is irritant to the tissues and may produce abscesses, even when deeply given. Preparations of ergot lose their strength if kept for any length of time. 204 MATERIA MEDICA FOR NURSES. Nat. Ord. Filices. Aspidium ; Filix Mas (Male Fern). The root-stock of Aspidium filix mas, an European fern. The medicinal principle of fern is an oleo-resin of a bitter, nauseous taste. It is an anthelmintic, specially destructive to the tape-worm. Although less irritating than some others of its class, it may, in overdoses, produce severe intesti- nal irritation, and death has been caused in an adult by taking six ounces. Nat. Ord Fungi. Agaricus. A fungus, called polyporus officinalis, white or purging agaric, which grows on the larch. In small doses it checks perspiration, the secretions of the bronchial tubes, the mammary glands, and the bowels. In large doses it is purgative. Agaricin. Dose, gr. -£-£, in pill. (0.01-0.03 gm.) Nat. Ord. Lycopodiacece. Lycopodium. The dust, or sporules, which fills the spikes of a European moss. Collected in Switzerland and Ger- many, and used as a dusting powder for infants especially; also for bed-sores, etc., either alone or mixed with bis- muth. Locopodium is inflammable, and is sometimes called vegetable sulphur. It is a very soft, fine powder, and is used in rolling and packing pills and suppositories. THE ANIMAL KINGDOM. Lanolin. A combination of fats obtained from sheep's wool. It does not become rancid, nor form soaps, and is rapidly absorbed by the skin. It is used as a simple emollient, and as a means of introducing medicine into the system. THE ANIMAL KINGDOM. 20$ Saccharum Lactis (Sugar of Milk). A crystallized sugar obtained by evaporation from the whey of milk, and specially suitable for use in preparing baby foods. It is soluble in one part boiling and seven parts cold water. Pepsin. Pepsin is one of the normal constituents of the gastric juice, and, with the aid of hydrochloric acid, changes albumins into peptones, in which form they are readily diffusible and capable of being absorbed into the blood. Pepsin, as used in medicine, is a preparation made from the mucous membrane which lines the stomach of the calf, sheep, or pig. It is made by cleaning the mucous lining, scraping it, drying the pulp at a temperature of ioo° F., and pulver- izing it. The powder is a light yellow-brown, almost insoluble in water, and of slightly salty taste. It may be taken dry on the tongue or given in milk. Dose, gr. ii.-v., with meals or immediately after. (0.13-0.3 gm.) Pancreatin. A preparation made from the pancreas of the pig. Pancreatic extract digests starchy and proteid sub- stances, and pancreatin, while not given alone as a medicine, is very largely used in preparing artificially digested foods, viz. : pancreatized milk, eggs, oysters, soups, broths, etc. The principle followed in making pancreatized food is that by subjecting it to the action of pancreatin in the presence of moderate heat, the process of digestion takes place, and may be made complete or only partly so, according to the length of time during which they are in contact. 206 MATERIA MEDIC A FOR NURSES. The digestive process is stopped by heat at the boiling point, or by extreme cold. For this reason artificially digested foods, having reached the point desired, are either brought quickly to a boil or else are put on ice. Milk, if thoroughly digested, has a slightly bitter taste, which is not noticeable if the process has been short of complete. Adeps Praeparatus (Prepared Lard). Lard consists of a fluid oil, olein, with stearin and palmitin, which are solid oils. It is used as the basis of various officinal ointments. Benzoinated Lard. One part of benzoin to fifty parts of lard. Cetaceum Spermaceti. A fatty substance obtained from the head of the sperm whale, and resembling white wax. It is used as an emollient. Oleum Morrhuse (Cod-Liver Oil). The oil obtained from the liver of gadus morrhua, and other species of cod fish. An exceedingly complex sub- stance, containing glycerine, acetic acid, and several fatty acids, iodine, chlorine, and traces of bromine, phosphorus and phosphoric acid, and various other con- stituents. There are three varieties : the pale yellow, light brown, and dark. The pale oil is the purest, being prepared by forcing steam at high pressure through the livers, and is less nauseous than the dark oil. Physiological Actions. Cod-liver oil is an alterative to the general nutrition in various diseased conditions, and is more truly a food THE ANIMAL KINGDOM. 207 than a medicine, as it supplies the need of the tissues for fat. Fat produces force, and is utilized by every part of the body in quantities directly proportioned to the activity of the different tissues. The nervous system needs the largest amount ; the muscular, the next largest. Having been elaborated by the liver of the fish, cod-liver oil is more easily digested than other fats. The smell of cod-liver oil is unpleasant and sometimes causes nausea. This may be avoided by taking some peppermint into the mouth just before taking the oil, and by avoiding bringing it into direct line with the nose. All patients do not know how to take oil ; by tossing it into the mouth and not allowing the lips to touch it, it is less disagreeable. It is best to mix no other medicines with cod-liver oil, except hypophosphites. If other medicines come at the same time they should be given separately. It may be given in any of the ways in which castor oil is given ; it is almost always well taken if floated in a little brandy or wine, or lemon juice. These precautions about giving it do not necessarily apply to" the various emulsions of oil, which are usually not at all hard to take. The proper time to administer cod-liver oil is when digestion is at its height. In overdoses, or when first taken, it may disorder the stomach, or cause temporary relaxation of the bowels. It sometimes causes an eczema. Emulsions of cod-liver oil spoil in a short time, and patients should not be encouraged to buy the ready- made preparations in the shops. In giving cod-liver oil the faeces must be watched, to see if any is carried away undigested. Dose, 3 i.- 1 ss., from three quarters of an hour to an hour after meals. (4.-16. gm.) Cantharis (Cantharides ; Spanish Flies). The dried and powdered bodies of the cantharis vesi- catoria, a beetle of Southern Europe. The powder is grayish-brown and specked with minute greenish span- 2o8 MATERIA MEDIC A FOR NURSES. gles from the wing-cases of heads. It has a strong unpleasant odor. The active principle is cantharidin, an active irritant, besides which it contains a volatile oil and fatty substances. Physiological Actions. Externally cantharides is vesicant. When applied to the skin a feeling of heat and burning is felt in a few hours, and small vesicles form which unite in one large blister. The average time required for this result is about eight hours. The action of cantharides is attended with less injury to the skin than that of any other vesicant. No pus is formed during the healing process, and no scar is left by the blister. Internally cantharides is irritant to mucous mem- brane, and if given medicinally must be largely diluted. It enters the blood from the stomach and also from blistered surfaces, and is slowly excreted by the kidneys. In small doses it causes diuresis with some irritation of the urinary organs, and larger doses produce strangury. Symptoms of Poisoning. When a poisonous dose of cantharides is taken the first symptoms are burning in the oesophagus and stom- ach, a constricted feeling about the throat, gastric and abdominal pain, with vomiting and in most cases diarrhoea. If the powder has been taken the small green specks may be seen in the matter vomited, which is at first mucous, then bilious, and finally serous. The discharges from the bowels have the same characteristics and are scanty, frequent, and accompanied by tenesmus. There is frequently salivation with swelling of the salivary glands. The pulse is weak and rapid, and death usually occurs quickly from collapse caused by the gastrointes- tinal inflammation, but if it is delayed for a few hours the symptoms of irritation of the urinary apparatus appear, THE ANIMAL KINGDOM. 20Q beginning with pains in the back, and ending in stran- gury, with scanty, albuminous, or bloody urine, and tenesmus of the bladder. Treatment of Poisoning. There is no antidote to cantharides, and the stomach must be at once emptied, and as thoroughly as possible washed out ; large quantities of albuminous and mucila- ginous drinks given ; warm baths to relieve the strangury, and stimulant? 'f necessary. No oils or glycerine must be given, as they aid in the absorption of the poison. It is to be remembered that constitutional effects are sometimes produced by even a moderate blister, and if necessary, the blister must be removed and the part washed with soap and water. Cautions. Before applying a blister the spot should be washed with soap and water ; dried ; washed again with alcohol or ether, and briskly rubbed for a moment or two. Absorption then takes place more quickly. A blister should never be applied over a bony prominence, as sloughing may follow, the circulation in such parts being sluggish. On tender skins vesication is soon produced and the blister must be carefully watched lest the action be too severe. On coarse skins, or in places where it is thick, as on the scalp or at the knee-joint, more time is needed. Hairs must be cut away, or shaved. A blister should not be left on a child's skin long enough to rise, but should be rejnoved when redness appears, and poultices be applied to finish the process. MISCELLANEOUS LIST OF NEW DRUGS ARRANGED ALPHABETICALLY. Acetal. A derivative of alcohol, employed as a sedative and hypnotic. It is usually given as an emulsion. Dose, gr. 75-150. (5.-10. gm.) Agathin. Agathin is obtained from the salicylates, and is used as an anti-neuralgic and anti-rheumatic. Dose, gr. ii.-viii. (0.12-0.5 S m «) Analgen. A remedy used as an anti-neuralgic, antipyretic, and analgesic, and considered efficient. Dose, gr. x.-xv. (0.65-1. gm.), repeated in three hours. Antinervin. This drug contains ammonium bromide, salicylic acid, and acetanilid. It is used as an anodyne and anti- neuralgic. Dose, gr. xv. (1. gm.) Antisepsin. This is also called asepsin. It is produced from bro- mine and acetanilid. It is soluble in alcohol and ether. 212 MATERIA MEDIC A FOR NURSES. but insoluble in water. It is used as an antipyretic, analgesic, and antiseptic. Unpleasant symptoms that may be caused by it are cyanosis, a depressed pulse, and tremors. Dose, gr. \-\. (0.03-0.06 gm.) Antiseptol. Antiseptol is a reddish-brown powder made from iodine and cinchonine, and used as a substitute for iodoform. Antispasmin. A combination of narcein, sodium, and salicylate of sodium. It is a whitish powder, and absorbs water from the air. It is soluble in water. It is used as a sedative and hypnotic, and given usually in syrup. Dose, gr. \- \\. (0.01-0.10 gm.) Apolysin. Apolysin resembles phenacetine in its actions, lowering fever, and diminishing pain and hyperesthesia. It is used as an anti-neuralgic. It is readily absorbed and acts quickly. It is not poisonous, and there are usually no unpleasant after-effects. It should not be given on an empty stomach. Dose, gr. v.-xxx. (0.3-2. gm.) Aristol (Annidalin). The essential constituent of aristol is iodine, of which it contains about 45 $., other substances entering into its composition being thymol and sodium. It is odorless, and is used as a substitute for iodoform. As an antisep- tic it is not strong and has no poisonous qualities. It is used in dusting powders, ointments, and solutions in oil, ether, or collodion, usually in a strength of from 5-10 of iodine, and used as a substitute for iodoform. It is soluble in alcohol, ether, chloroform, and oil. As a dusting powder it is used in a strength of from 5-10 $, and hypodermically solutions in olive oil are used in from 3-10 aphtalin . 104 Magendies Solution of Mor- ]S "aphthalinum 104 phine 128 IS aphtol 104 Magnesia . 17 A Hcotine . 177 " Citras Effervescent ; 18 IS itrate of Silver 24 " Sulphas 17 > itric Acid 64 Magnesium Sulphate . 17 is itroglycerin 95 Male Fern . 204 IS itrohydrochloric Acid 66 Mandrake . 116 A Tor wood' s Tincture . 199 Manganese Sulphate . 36 > ux Vomica 166 Manganesium 35 Mangani Sulphas 36 C il of Camphor . 183 Massa Hydrargyri 41 ' " Eucalyptus 145 May Apple 116 1 " Garlic 150 McMunn s Elixir 126 ' 4 " Gaultheria 1S8 Meadow Saffron . 200 ' " Juniper . 193 Menthol 181 ' " Lavender Flowers . 181 Mercurial Ointment 41 ' " Peppermint 181 Mercuric Cyanide 40 ' " Savine 194 Mercury 37 ' " Sweet Birch 188 " with Chalk . 41 ' " Tansy 160 Metachloral 9 1 1 '.' Tar . 191 Methyl Hydrate . 77 ' " Theobroma , 135 " Salicylate 188 ' " Turpentine 191 Mild Mercurous Chloride . 40 ' " Vitriol . 63 Milk of Lime 16 intment of Boric Acid 68 INDEX. 235 PAGE PAGE Ointment of Mercury . 41 Phenolid . . I07 " Nitrate 4 1 Phenol . 96 " " Red Oxide o: Pheno Resorcin . . 108 Mercury 41 Phenyl Salicylate . I02 " " Yellow Oxide Phosphorated Oil • 51 of Mercury . 41 Phosphoric Acid . 66 " " Veratrine 199 Phosphorus . 49 Oleate of Veratrum Viride . 200 Physostigma . 141 Oleic Acid . no Physostigmine . 142 Oleum Betulae Volatile 188 Phytolacca . . 197 " Ca??iphorce 183 Pi cro toxin . . 120 " Eucalypti 145 Picrotoxinum . 120 " Gaultheriae 188 Pills of Ferrous Carbonate . 34 Juniperi . 193 " " " Iodide • 34 " Lavandulae Florum . 181 " " Phosphorus • 51 " Menthae Piperitae 181 Pilocarpinae Hydrochloras . 137 " Morrhuae 206 Pilocarpine Hydrochlorate . 137 " Olivae 164 Pilocarpus . . 136 " Phosphoratum 51 Pilulae Aloes et Mastiches . 196 " Picis Liquidae . 191 " AntimoniiCompositae 48 " Ricini 186 " Asafcetidae • 151 " Sabinae . 194 " Catharticae Compositae 147 " Tanaceti 160 " Vegetabiles 147 " Terebinthinae . 191 " Ferri Carbonatis . 34 Theobromatis . 135 " Opii . 126 Tiglii 185 " Phosphori • 51 Olive Oil . 164 Pink Root . . 164 Opium . 120 Pix Burgundica . . 191 Oxalic Acid 75 " Liquida . 191 Oxide of Zinc 27 Plumbi Acetas . 21 Plumbum . . 18 Pancreatin . 205 Plummer's Pills . • 48 Paraldehyde 91 Podophyllum . 116 Paraldehydum . 9i Porter • 83 Paregoric . 126 Port Wine . . 82 Parillin . *95 Poison Nut . 166 Paris Green 46 Poke .... . 197 Pasque Flower . 116 Pomegranate Rind • 145 Pelletierine .... 145 Potassa .* 2 Pepo . 148 ' ' Sulphurata . 61 Peppermint Camphor . 181 Potassii Acetas . • 5 Pepsin . 205 " Bicarhonas • 3 Peroxide of Hydrogen 63 " Bitartras • 7 Peruvian Bark . 152 " Bromidum • 54 Petrolatum no ' ' Carbonas • 3 Phenacetine 108 " Chloras . . 5 Phenocoll Hydrochloride 109 | " Citras . 5 236 INDEX. PAGE Potassii Cyanidum 7 Quinine " et Sodii Tartras 8 Quinine Sulphate " Hypophosphis 52 " Iodium . 57 Raspail 's Sedative Water . " Nitras . 8 Rectified Spirit . " Permanganas . 36 Red Iodide of Mercury Potassium Acetate 5 Reduced Iron " and Sodium Tart Resin Plaster rate 8 Resina Podophylli " Bicarbonate 3 Resorcin " Bitartrate . 7 Rincinoleic Acid " Bromide 54 Rheum " Carbonate . 3 Rhubarb " Citrate 5 Rhus Toxicodendron " Cyanide 7 Rochelle Salt 11 Hypophosphite 52 Rubus '* Iodide 57 Rue . " Nitrate 8 Pum . " Permanganate 36 Ruta Graveolens . Potato Spirit 76 Prepared Chalk . 17 Sabina . - . " Lard . 206 Saccharin . Proof Spirit 80 Saccharum Lactis Propeny I Alcohol in Sacred Bark Prot iodide of Mercury 40 Saleratus . Prunus Virginiana 144 Salicin 103 Prussic Acid 72 Salicinum . Pulsatilla . 116 Salicylic Acid Pulvis Aromaticus 184 Salol . . • . " Effervescens Compos Salt. . itus 11 Saltpetre . ' ' Ipecacuanha 156 Sanitas " " et Opii 127 Santonica . Jalapae Composi- Santonin tiis 170 Saponin " Morphinae " 128 Saprol Pumpkin Seeds . 148 Sarsaparilla Purple Foxglove 178 Sarsaponin . Pyridine 109 Savin e Pyroxylinum 134 Scammonium Scammony . Quaker Buttons . 166 Scilla .... Quassia 137 Scoparius . Quevenne's Iron . 34 Sea Onion . Quicksilver 37 Seidlitz Powder . Quinina 153 Senega Quininae Sulphas 155 Senna INDEX. 237 PAGE PAGE Serpentaria I84 Spigelia I64 Sherry 82 Spirit of Camphor 183 Silver 23 44 44 Ether . 87 Nitrate . 23 44 4< Mindererus . 15 Sinapis 129 14 4l Nitrous Ether 87 Snake Root I84 Spiritus Athens 87 Soap Liniment , 183 44 Compositu. J 87 44 Plaster 22 Nitrosi 87 Soda .... 9 " Ammonise Aromati Sodii Bicarbonas II cus 14 " Boras 12 " Cam phone 183 44 Bromidum . 55 Chloroformi . 84 44 Carbonas . 10 44 Frumenti 8l 44 Chloridum . 9 44 Glonoini 95 Hypophosphis . 52 44 Lavandula Compos 44 Salicylas 102 itus 181 Sodio Theobromine Salicy 4 ' Rectificatus 80 late 103 44 Tenuior 80 Sodium Bicarbonate . 11 44 Vini Gallici . 81 44 Borate . 12 Spotted Hemlock 149 44 Bromide 55 Squib V s Mixture 127 4 ' Carbonate 10 Squill 194 4 4 Chloride 9 Squirting Cucumber . 147 ' ' Hypophosphite 52 Staphisagria 116 44 Salicylate 102 Staves Acre 116 Solution of Ammonium Ace St. Jacob's Oil . 116 tate 15 Stout .... 83 44 ' 4 Arsenic and Mer Stramonii Folia . 175 curie Iodide 45 Stramonium Leaves . 175 44 44 Arsenous Acid 45 Strophanthin 171 44 44 Chlorinated Sods 1 53 Strophanthus 170 44 44 Ferric Acetate 33 Strychnine . 167 44 44 44 Subsulphate - 33 Sulphate . 169 44 44 Hydrogen Diox Styptic Collodion 135 ide 63 Styracol 100 44 44 Iron and Ammo Sublimated Sulphur . 61 nium Acetate 33 Subnitrate of Bismuth 49 44 <4 Lead Subacetate 22 Sugar of Lead 21 44 44 Magnesium Cit 44 " Milk ' . 205 rate 18 Sulfonal .... 92 44 ' 4 Potassa 4 Sulphaminol 60 44 44 Porassium Ar Sulphur 60 senite 45 Lotum . 61 Sozal .... 60 44 Sublimatum . 61 Spanish Flies 207 Sulphuric Acid . 63 Sparteine Sulphate 139 Sulphurous Acid 67 Spermaceti . 206 Sweet Spirit of Nitre . 87 2 3 8 INDEX. Syrup of Ferrous Iodide • 33 Tinctura Aloes . . 196 " Ipecac . 157 " et Myrrhae . 196 " " Hypophosphites • 52 " Arnicae Flores . 161 " " Iron, Quinine, and ' ' Radix . 161 Strychnia Phos " Asafcetidae • 151 phate . 169 " Belladonnas Folio " " Lime . . 16 rum . t/4 " " Rhubarb . 182 " Benzoini . 163 " " Sarsaparilla, Com " Composita 163 pound . 195 ' ' Bryoniae 148 " " Senega • 131 '" Calumbae . 120 " " Senna . • 143 " Cannabis Indicas . 190 " '* Squill . • 195 " Capsici . 177 " " Tar . 191 " Catechu Composita 157 Syrupus Calcis . 16 " Chloroformi et " Ferri Iodidi . 33 Morphines , 128 " Ferri - Quininae e t " Cinicifugae . 118 Strychninae Phos ' ' Cinchonae 153 phatum 169 Compos " Hypophosphitum 52 ita . 153 " Ipecacuanhas 157 " Colchici Seminis 201 " Rhei 182 " Digitalis 180 " Sarsaparillae Com " Ferri Chloridi 32 posit us 195 " Gelsemii 166 " Scillae . J 95 " Gentianae Compos " Compositus 195 ita . 169 " Humuli 191 Tabacum . 177 Hydrastis 119 7a??iar Jndien 143 " Hyoscyami . 176 Tamarinds . 142 Iodi . 58 Tanacetum 160 " Ipecacuanhas et Tannic Acid 7i Opii . 127 " " Ointment 72 " Lavandulce . 181 " " Troches 72 " Lobeliae 163 Tansy 160 Opii . 126 'Jar . 191 " Camphorata 126 " Ointment 191 ' ' C omposita 127 Taraxacum 160 " Deodorata 126 Tartar Emetic . 46 " Physostigmatis 142 Tartaric Acid 70 " Quassias 138 Tea Plant . 158 " Rhei 1S2 Thiersch Powder 103 Scillae . 194 Thiophene . 60 " Serpentarias . 184 Thorn Apple 175 " Stramonii Seminis 176 Thorough wort 160 " Strophanthi . 171 Thymol 182 " Valerianae 159 Tinctura Aconiti 116 " Veratrum Viridis . 199 INDEX. 239 PAGE PAGE Tinctura Zingiberis 189 Trinitrin 95 Tincture of Aconite . Il6 Trituratio Elaterini . I48 " ' Aloes I96 Trochisci Acidi Tannici 72 " ' " and Myrrl 1 I96 Tropical Fruit Laxative 143 " ' Arnica Flowers l6l Tully's Powder . 128 " Root l6l Turpene 144 " ' Asafcetida • 151 " ' Belladonna Unguentum Acidi Borici 68 Leaves . 174 " " Tannici 72 " ' Benzoin . I63 " Diachylon 22 " ' Bryonia 148 " Hydrargyri 41 41 1 Calumba . T20 " " Nitratis 41 " ' Cannabis Indict I I9O * < " Oxidi " ' Capsicum . 177 Flav 1 41 " ' Chlo7-oform anc i " " Oxidi Morphine 128 Rubr i 41 " ' Cimicifuga Il8 " Iodi 58 " ' Cinchona . 153 " Iodoforrai 60 " ' Colchicum Seec L 201 " Sulphuris 62 " ' Digitalis . 180 " Veratrinae 199 " ' Ferric Chloride ; 32 " Zinci Oxidi 27 " ' Gelsemium 166 Urethan 93 " ' Ginger 189 " ' Hops 191 Valerian J 59 " ' Hydrastis . 119 Valerianic Acid . x 59 " ' Hyoscyamus 176 Valero I 190 " ' Iodine 58 Vaseline no < i ' Ipecac and Veratrina 199 Opium . 127 Veratrum Viride . 197 " ' Lavender . 181 Vesicating Collodion . 135 " • ' Lobelia 163 Viburnum Opulus 151 " ' Opium 126 " Prunifolium 151 " ' Physostigma 142 Vinegar 68 " ' Quassia 138 Vinum Album 82 " ' Rhubarb . 182 " Antimonii 48 " ' Serpentaria 184 " Colchici Radix 202 " ' Squill 194 " " Seminis 202 " 1 Stramonium " Ipecacuanhse . 157 Seed 176 " Porlense . 82 " ' Strophanthus 171 " Xe 'icum . 82 1 ' ' Valerian . 159 •« ' Veratrum Viride 199 Warburg r Tincture . 155 Tobacco 177 Washed Sulphur 61 Toluene 191 Whiskey 81 Tragacanl h' '. '. 139 White Arsenic 42 Tragacan ha 139 Whitewash 16 Trimethy 1 amine , 161 White Wine 82 240 INDEX. PAGE PAGE Wild Cherry M4 Yellow Wash 42 Wine of Antimony 48 " " Colchicum Root 202 Zinc .... 25 " Seed 202 " Chloride 26 " Ipecac . 157 " Ointment . 27 Wines 82 " Sulphate 26 Wolfsbane . 113 Zi.nci Chloridum 26 Wood Spirit 77 " Oxidum 27 " Sulphas 26 Yellow Jessamine 164 Zincum 24 " Mercuric Oxide 40 Zingiber 189 NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. NOTES ON NEW DRUGS. LIBRARY OF CONGRESS DDDEblODHlO