*• w /\ *°o > v ^ ■ .o T .•• % ^ ^ *. . " ^ J> ' ^W/k\ ^ t £" ^ *«- 8 *T SfcXy ^\/ f^B^V lie <*.£>&" "> u \ ^°* ' V :*S^ V - A- V -'III: K ■O v o°"«* *o ^ 4* *\ V ./ 4 l* -y '♦ ^ V • 1 * •- *v ... «fe «. ^ •yaK&r. ^ a* * V • ' * ° ^ t\ "^ >*' ♦•«■&*. ^ A * ' .: r,* ^ ^ *^ ^^ J 7v« ; .a f: ^^ V ^7^T»*\y °q - ."*?*^* A o° <> .,' ^ v % f ,o^ \.'-^f>^' %^.^-y V 5 ^'*/ V---V V**.r.» -<* ♦^J!8&i*- ^ : ^bv* ^ vtf *- Dunglison's Medical Library. NEW EEMEDIES: THE METHOD OF PREPARING AND ADMINISTERING THEM THEIR EFFECTS ON THE HEALTHY AND DISEASED ECONOMY, j. Et post clarificat. limpid, admisce Mucil. gum. arab. (seu sem. cydon.) ^ij. Applied by means of linen rags in cases of burns. Trusen. 5<. Calcis chlorid. jij. ad jiij. Aquae, ffii. Solve. To be applied by means of rags kept constantly wet, in cases of hospital gangrene ; the mixture being shaken. Rust and Kluge. The disinfecting liquor of Labarraque, Liqueur desinfectante de Labarraque, is made by adding ten parts of water, to one part of the chloride of lime divided in a mortar; suffering the solution to settle, and then filtering. Colly rium Calcis Chloridi. Collyrium of Chloride of Lime. g<. Calcis chlorid. gr. Iv. ad vj. Laudan. liquid. Sydenham. 9ss. Mucilag. gum. arab. .^iss. Aq. rosar. Jij. M. et filtra. To be dropped in the eye in cases of catarrhal and scrofulous ophthalmia. ( Farvagnie. 92 dunglison's new remedies. Cataplasma Calcis Chloridi. Cataplasm of Chloride of Lime. 5<. Calcis chlorid. Sodse muriat. aa. 5*ss. Aquae distill. Ibss. Farinse sem. lin. q. s. ut fiat cataplasma. Used in cases of scrofulous swelling of the joints. Graefe. Unguentum Calcis Chloridi. Ointment of Chloride of Lime. &. Calcis chlorid. 3j. Axungiae, 3J. M. fiat unguentum. To be rubbed in, in cases of scrofulous swellings. Cima. £. Calcis chlorid. gss. Axung. porcin. 3j. M. F. unguent. Used in goitre. Werneck. 3c. Axung. 5j. Boracis venet. Calcis chlorid. aa. £j. M. exactissime. In cases of chilblains. Trusen. B<. Flor. sulphuris, S*iss. Calcis chlorid. bene tritur. 5*ij. Axungiae, 3*x. M. In itch, morning and evening. Hospital. Linimentum Calcis Ckloridum. Liniment of Chloride of Lime. fy. Calcis chlorid. 3ss. Tere in mortario vitreo et sensim aliunde Aq. rosar. (seu fontanas,) §j. Et post, limpid, clarificat. admisce 01. amygd. dulc. 3J. To be applied by means of a pencil in cases of tinea capitis. Trusen. CALENDULA OFFICINALIS. Synonymes. Calendula Sativa, Caltha Sativa, Verrucaria, Crysanthemum, Sponsa Solis, Single Marigold, Garden Marigold. French. Souci, S. Ordinaire. German. Ringelblume. This plant belongs to the family Synanthereae, and in the Linnsean system to Syngenesia necessaria. It is much cultivated in the gardens of southern Europe more especially, and grows wild there. The whole plant has a feeble aromatic smell, which is not, CALENDULA OFFICINALIS. 93 however, unpleasant. The taste is bitter and somewhat pungent. It was examined chemically by Geiger and Stoltze, 1 who found in it a peculiar glutinous matter, readily soluble in spirit of wine; insoluble in ether, and in ethereal or volatile oils, and but little soluble in water ; to this they gave the name calenduline. EFFECTS ON THE ECONOMY. The term officinalis indicates, that the calendula was formerly- received into the lists of the Materia Medica as an "officinal ;" but it had become entirely obsolete, when Westring, 2 a Swedish physi- cian, in 1817, recalled attention to it. He recommended it particu- larly in cases of cancer of the breast and uterus, having noticed its good effects by accident. Visiting an aged female, who had suffered, for a long time, under an extremely painful induration of one mamma, he found she was able to allay the burning pain by the application of the fresh plant. This induced him to try it in several cases of cancer, and from the results he was led to infer, that it is perhaps the best agent that can be employed in that frightful malady. He never, however, employed the calendula alone, but associated with it other active remedies, so that but little attention was paid to his recommenda- tion : — a great portion of the efficacy of the agents employed, being — it was thought probable — ascribable to the associated articles. Some time after Westring's publication, the remedy was used by others, and his observations were confirmed. Rudolph 3 employed it with advantage internally, in a case of induration of the mammae in a young female ; but the acetate of iron was at the same time applied externally in solution. Fehr 4 found it highly useful not only in incipient, but in advanced, scirrhus. Stein praises it in cancer of the integuments (hautkrebs). He forms the expressed juice of the young plant and flowers into an ointment with fresh butter, and applies it once or twice a day by means of lint, having previously washed the ulcers with a decoction of the plant. Inter- nally, the calendula is prescribed in the form of decoction, made with milk or water, or of a rnellago prepared from the fresh juice, dissolved in an aromatic water; or made into pills. When the salve is applied, a sense of burning arises, which soon becomes absolute pain. This soon, however, abates ; and almost wholly disappears, — if too violent, more butter may be added ; the ichorous discharge becomes improved ; the offensive odour corrected, and 1 Berlin. Jahrb. d. Pharmac. B. xxi. S. 282. 2 Erfahrung uber die Heilung der Krebsgeschwure, u. s. w. Translated from the Swedish into German by K. Sprengel. Hal. 1817. 8 llufeland und Osann's Jour, der prakt. Heilk. B. lviii. St. 1. S. 119. 4 Verhandlungen der verein. ftrztlich. Gesellschafl. der Schweiz. .Tahrg. 1831, and Dierbach, in Heidelberger Annalen, B. x. H. 4. S. 501. Heidel- berg, 1834. 94 dunglison's new remedies. in from fourteen to twenty-one days, the ulcer is converted into one of a benign and readily cicatrisable character. Rust also frequently administered the extractuni calendula? in cancerous ulcers and as a discutient in chronic indurations, in combination, however, with other efficacious agents. Schneider affirms, that he prescribed the extract of calendula with the best effects in induration of the stomach, and in tumefaction and decided induration of the glands and uterus. A decoction of the flowers and plant, he employed in cancer of the uterus, and found it an excellent soothing, and discutient agent. Muhrbeck 1 used the extract with eminent success in chronic vomiting; Carter 2 in extremely obstinate vomiting ; and De Camp in a case of cardialgia, where the excitability of the stomach was so great, that every remedial agent was rejected before it had opportunity to act. Fehr also extols it as an emmenagogue, for which property it was cele- brated with the older physicians. As Riecke 3 has remarked, the amount of experience with the calendula is yet small — too small for us to pronounce whether it merits a fixed place in the lists of the materia medica. METHOD OF ADMINISTERING. The extractuni calendula? is contained in the Hannoverian and Saxon pharmacopoeias ; in the latter it is directed to be prepared in the following manner : Take of the calendula officinalis, 1 part. Water, 8 parts. Macerate for twenty-four hours; then boil for a quarter of an hour, and strain forcibly ; boil the remainder with four parts of water ; mix the two liquors, and, after twenty-four hours' rest, evaporate to the proper consistence. 4 The dose of the extract is different according to different obser- vers. Muhrbeck gave four grains, five times a day. Fehr allows, 3ij. to 3vj. Phoebus directs the dose of the extract, prepared according to the Prussian Pharmacopoeia, to be eight to sixteen grains, gradually increasing it to 3ss. and more, from two to four times a day. It may be given either in the form of pill or mixture. Externally, the extract is used in solution, to moisten the dressings of ulcers, and to form ointments. The dose of the decoction of the fresh plant is §j. to |ij. The Sardinian Pharmacopoeia has a conserva jlorum calendula, made by beating together one part of the flowers and two parts of 1 Hufeland's Journal der prakt. Heilk. B. lxii. St, 5, S. 128. Rust's Magazin. der gesammt. Heilk. B. xi. S. 350. 2 London Med. Rep. April, 1826, p. 347. See, also, Link and Osann, in art. Calendula in Encyc. Wurterb. u. s. w. B. vi. S. 520. Berl. 1831. 3 Op. cit. S. 101. 4 Pharmacopee Universelle, &c. par Jourdan, ii. 536. CARBO ANIMALIS. 95 powdered sugar. It has, also, an acetum Jiorum calendula, made of one part of the petals digested in four parts of vinegar ; and the Wirtemberg Pharmacopoeia has an unguenlum jiorum calendula, made of four ounces of the petals boiled in a pound of fresh butter, until the mixture is entirely evaporated. This is used as an emol- lient and resolvent. Pilula Calendula. Pills of Calendula. & Ferri oxydat. fuse. Herb, calend. pulv. Extract, calend. aa. 3j. Mucilag. gum. arab. q. s. ut fiant pilulae xc. Dose. — Five to eight three times a day, as a soothing agent in cancerous ulcers. Rust. B< Hydrarg. submuriat. £)ss. Sulphur, aur. antim. 9j. Extr. calendul. conii rnacul. aa. 9ij. M. f. pil. pond. gr. ij. Dose. — Five pills, three times a day, as a discutient in chronic indurations. Rust. Lotto Extracti Calendula. Lotion of the Extract of Calendula. B< Extract, calend. cham. vulg. aa. £>ij. Solve in Aq. lauroceras. §ij. Adde Tinct. opii. simpl. 3j. As a wash (Verbandwasser) in cancerous ulcerations. Rust. It is obvious that the precise agency of the calendula cannot be tested in any of these formulae, the substances associated with it being themselves active agents. In this country, we do not believe it is ever used. CARBO ANIMALIS. Synonymf.s. — Carbo Carnis, Animal Charcoal. French. — Charbon animal. German. — Thierische Kohle ; Fleischkohle, Thierkohle. Animal charcoal is an ancient remedy, which has been revived amongst us. The older physicians used several kinds, and recom- mended them in various diseases, but without having any fixed 96 DUNGLISON 's NEW REMEDIES. principle ; the circumstances, indeed, that suggested their exhibition in many cases, are entirely unintelligible to us of the present day. In the old Wirtemberg Pharmacopeia, we find the Erinacens com- bustus, or " burnt hedgehog," as an antihydropic ; the Sericum tos- tum, or "burnt silk," and the Hi.rundines combnstce, or "burnt swallows," as antiepileptics; the Lepus combustns, or "burnt hare," as an antilithic ; the Regidi usti, or " burnt wrens," advised in nephritis and in calculous affections ; and the Talpce combnstce^ or " burnt moles," at one time much extolled in erratic gout, lepra, scrofula, ulcers and fistulas ! All have properly fallen, however, into oblivion with the profession, although there may yet be some, who cling with pertinacity to these relics of ancient ignorance and superstition. The cancer remedy of Cosme, into the composition of which burnt shoe soles entered, appears to have kept up the em- ployment of animal charcoal ; as well as the "burnt sponge," Sjiongia usta, in which, however, the charcoal is of but little efficacy com- pared with the iodine it contains. These were perhaps the only forms in which animal charcoal was used at the time when Weise, a German physician, revived its employment ; and many physicians soon came forward to attest favourably in regard to it. METHOD OF PREPARING. Weise gives the following method of preparing it. Cut ribs of veal, with the flesh attached, into small pieces, and put them in a drum for roasting coffee : turning the drum constantly whilst it is placed over the fire. When inflammable air begins to pass off, which is distinguished by the flame playing around the drum, the combustion must still be kept up a quarter of an hour longer. If it be continued so long as any inflammable air is disengaged, the preparation is inefficacious. The substance, most commonly met with under the name of Animal Charcoal, is obtained by burning bones. The residue, when reduced to powder, is the well known substance bone black or ivory black. 1 This generally contains more or less phosphate of lime according to the kind of bone from which it has been procured. This is directed in the London Phar- macopoeia to be purified by digestion in dilute hydrochloric acid as follows : Take of animal charcoal, a pound ; hydrochloric acid and water, each twelve fluid ounces. Mix the hydrochloric acid with the water, and gradually pour it upon the charcoal ; then digest for two days in a gentle heat, occasionally agitating. Set aside, and pour off the supernatant liquor; then wash the charcoal with repeated portions of water, till no traces of acid are perceptible ; lastly, dry it. 2 Charcoal, prepared in this way, should be a com- 1 See Art. Carbo Animalis, by Dr. F. Bache, in Wood and Bache's Dis- pensatory, 3d edition, p. 161. * Brande, Dictionary of Materia Medica, p. 151. London, 1839. CARB0 ANIMALIS. 97 bination of carbon, carbonate and phosphate of lime, hydrogen, and azote. From an analysis, which Meurer made of animal charcoal, prepared according to Weise's formula, it contains also muriate and a little carbonate of soda, as well as a portion of iron. EFFECTS ON THE ECONOMY. In the case of a young man of scrofulous diathesis, Weise saw a tumour, of the size of a hazelnut, and very painful, situate under the nipple, disappear under the use of animal charcoal. According to him, its efficacy is strongly exerted on the uterus and mammas. Rothamel and Hohnbaum extol it in dyspepsia and gastricism, as well as in cases of diarrhoea. In obstinate chronic glandular indurations, especially of the mammary glands, Weise affirms it to be a certain remedy ; he, at the same time, however, considers a regulated diet to be indispensable. Scirrhus of the lips, he says, also disappears under its use, and even scirrhous goitre when the charcoal is associated with burnt sponge. On cartilaginous polypi, it is said to have exerted a beneficial agency, and to have diminished the tendency of mucous polypi to return after operation. Even open cancer, it is asserted, has been healed by it. 1 On these recommendations of Weise, animal charcoal has been used by several German physicians, especially by Wagner, Kopp, Pitschaft, Radius, Rothamel, Hesselbach, Gumpert, Hohn- baum, Fricke, Michaelsen, and Siebenhaar; and as a general re- sult of their observations it would seem not to be devoid of thera- peutical agency ; although many of the experimenters failed in noticing any sanative effect from it. Fricke, for example, did not observe the least benefit in the very cases mentioned by Weise. He gave it also in the way of experiment, in several other cases, but without detecting the slightest influence on the organism. Other physicians saw advantages from its use in open cancer, but these were only transient. On the other hand, the experience of Wagner, Kopp, Michaelsen, and Rothamel would seem to show, that it was effectual in removing incipient scirrhus of the mammas. Kopp employed it successfully in scirrhous goitre, and Pitschaft in a case of what he terms struma varicosa. Radius dispersed under its use a considerable swelling of the submaxillary glands. In scrofulous affections, especially in scrofulous indurations of the glands, it proved useful in the hands of Kopp, Rothamel and Speranza. Pitschaft, in a delicate, strumous woman, who was suffering constantly under ozcena, found it of eminent service after other remedies had failed. Radius thought it aided the absorption of a disintegrated cataract, and Siebenhaar saw good effects from it in induration of the pancreas. Riecke 3 suggests, that further trials might show that it might be 1 Riecke, Die neuern Arzneimictel, u. s. w. S. 104. 2 Op. cit. 7 — c dungl 7 98 dunglison's new remedies. used in the place of iodine, which it appears to resemble in its action on the economy, whilst it affects the organism less in- juriously. It is extremely doubtful, however, whether the proper- ties of the two substances can be regarded as at all analogous, and whether the charcoal is possessed of any other properties than those usually ascribed to the prepared charcoal. MODE OF ADMINISTERING. The carbo animalis is given in doses of from half a grain to three grains twice a day, commonly in the form of powder with sugar, or with powdered liquorice root. Weise advises it to be sprinkled on the hard edges of cancerous ulcers, and Speranza extols an ointment made of charcoal and oil or simple cerate as a discutient in scrofulous swellings. Pulvls Carbonis Animalis. Powder of Animal Charcoal. £. Carbon, animal, gr. ij. Pulv. rad. glycyrr. gr. v. F. pulvis. A powder to be given morning and evening. 5<. Carbon, animal, gr. vi. Spong. marin. ust. gr. xij. Pulv. rad. glycyrrhiz. gss. M. F. pulv. in partes vi sequales dividendus. A powder to be taken night and morning in scirrhous goitre. RlECKE. B<. Pulv. carbonis animal, gr. iv. Pulv. rad. glycyrrh. 9iv. M. et divide in part. viij. One of these to be taken dry, morning and evening, a little water being drunk afterwards, in cases of scirrhous indurations of the mammae. After the eight powders have been taken, the dose may be increased gradually by half a grain, until it ultimately attains four grains. At the same time, abirritating, and spare diet should be inculcated. Boli Carbonis Animalis. Boluses of Animal Charcoal. $. Pulv. carbon, animal, gr. iij. Ammon. muriat. pulv. 9j. Ext. conii macul. gr. ij. glycyrrhiz. q. s. ut fiat bolus. One of these to be given three times a day ; — in cases of swell- ing and scirrhus of the prostate, and of the mucous membrane of the urethra. Magendie. CARBONIS SESQ.TJI-IODIDUM — CETRARINA. 99 CARBONIS SESaUI-IOUIDUM. Synonymes. Carbonis Sesqui-ioduretum, Sesqui-iodide, or Sesqui-ioduret of Carbon. This preparation is made by mixing concentrated alcoholic solu- tions of iodine and potassa until the former loses its colour. A solution is obtained, from which the addition of water will throw down a yellow precipitate — the sesqui-iodide of carbon. This substance is soluble in alcohol and ether, but insoluble in water. The ethereal solution yields large yellow crystals by slow evaporation. It has a sweet taste, and a strong saffron-like odour. Mitscherlich 1 considers the taste very disagreeable. Fifty grains given by Dr. Cogswell, 2 to a strongly made terrier dog, proved fatal ; and, on dissection, the large vessels were found congested; the inner membrane was closely corrugated, and the apices of the rugae were of a rose red colour. EFFECTS ON THE ECONOMY IN DISEASE. Dr. Litchfield 3 used it with advantage in five cases of enlarged, glands; in two of lepra, and three of porrigo, in the form of oint- ment composed of 3ss of the powder to 3vj of simple cerate. CETRARINA. Synonymes. Cetraria, Cetrarine. French. — Cetrarin. This substance has been extracted, of late, from the lichen islandicus or cetraria islandica, by M. Herberger, a pharmacien at Kaiserslautern. 4 METHOD OF PREPARING. The coarse powder of the lichen is boiled for half an hour in four times its weight of alcohol at .883; it is left at rest until vapours cease to be given off. to avoid the loss of the alcohol ; it is then strained and pressed. Three drains of hydrochloric acid pre- viously diluted with water are now added to each pound of the lichen ; this is mixed with from four times and a quarter to four times and a half its bulic of water, and the mixture is left at rest for ' Traite de Chimie, traduit par Valerius. 2 K.say on Iodine, p. 122. Edinb. 1837. 3 Lend. Med. Gaz. Aug. 1836. 4 Buclmer's Repertorium, B. viii. H. 1. 1S37. 100 dunglison's new remedies. a night in a closed flask. The next day, the deep yellow fluid, which swims ahove the copious deposite obtained, is poured off: this deposite is the impure cetrarine, the colour of which is more or less greenish. It is now collected on a filter (chausse), left to drain as little as possible and subjected to pressure. To purify it, it must be divided into small fragments, and washed whilst still moist with alcohol or ether, which deprives it of colour ; it is then treated with two hundred times its weight of boiling alcohol, in which the inorganic matter, which has hitherto accompanied it, is scarcely soluble. The greater part of the cetrarine is gradually precipitated on the cooling of the alcoholic solution. The portion which still remains in solution, may be separated by the evapora- tion of the alcohol. Pure cetrarine is at times in the state of a white powder, resem- bling magnesia; at others in small globules united in the form of arborisations, which do not present — even under the microscope — any crystalline texture. When gently compressed, it has a slight silky splendour. It is light, unalterable in the air, inodorous, and has a very intense bitter taste, especially in the alcoholic solution. Its best solvent is absolute alcohol, one hundred parts dissolving 1.70 of it at the boiling temperature, but only 0.28 at 14° centig. (58° Fahr.) Alcohol, at^O.830 dissolves 0.44 when boiling, 0.28 at 25° cent. (77° Fahr.) and only 0.04 at 14° cent. (58° Fahr.) It i* still less soluble in boiling and in cold water, the essential oils, creosote, &c. It is somewhat more soluble in ether, but insoluble in the fixed oils. 1 EFFECTS ON THE ECONOMY IN DISEASE. M. Miiller, a physician of Kaiserslautern, 2 details two cases in which he has administered the cetrarine. One of these was a quartan, the other a tertian intermittent. The effects appeared to be exerted more slowly than those of quinine, but it seemed to him not to affect the stomach as much.[?] Its price must be much less, as M. Herberger succeeded in obtaining from a pound of lichen 135 grains of very pure cetrarine. It has not been given, so far as we know, in this country. METHOD OF ADMINISTERING. Miiller gave it in the form of powder according to the following prescription : — £. Cetrarin. Gummi arabic. aa. gr. ij. Sacchar. alb. 9ss. M. et fiat pulvis. Dose. — One of these every two hours during the apyrexia. 1 Journal de Pharmacie, xxiii, 505, Paris, 1837, and Bulletin General de Therapeutique, No. 18, Sep. 30, 1S37. 8 H. Bruck, in Bulletin General de Therapeutique, No. 17. Sep. 15, 1837. CHIMAPHILA. 101 H. Bruck, 1 suggests, that if dissolved in spirit of wine, its action may be incomparably more potent, and that it may more speedily arrest the paroxysms of an intermittent than when given in powder. CHIMAPHILA (FOLTA.) Synonymes. Chimaphilas vel Chimopbilae Umbellatae Folia ; Pyrolae Um- bellatse Folia, WiDter Green, Pipsissewa. French. — Heibe a pisser, Pyrole en Ombelle. German. — Die Blatter des holdenbluhtigen Wintergruns. This plant is not new to us; but numerous trials have been made with it recently in Europe. It is admitted into the Pharma- copoeia of the United States, is a beautiful evergreen, and is indi- genous in the northern parts of Europe. Asia, and America. It belongs to the natural family of heaths, Ericese ; and, in the Lin- nasan System, to Decandria Monogynia. A good description of it is given by Barton. 2 The leaves have a bitter-sweetish taste, with some degree of astringency. The taste of the stems and roots is, in addition, con- siderably pungent. Boiling water and alcohol extract the virtues of the plant. The constituents, so far as ascertained, are bitter ex- tractive, tannin, resin, gum, liguin and saline matters. EFFECTS ON THE ECONOMY IN DISEASE. The leaves of the Chimaphila were long used by the Indians of this continent, and from them the American physician was induced to employ them. The first regular treatise respecting the plant is said to have been a thesis of Dr. Mitchell, published in the year 1803. s In Canada it is said to have been long used in diseases of the urinary passages, especially in calculus, dropsy, and in chronic gout and rheumatism; its effects appearing to resemble — but not to exceed — those of the uva ursi. Somerville 4 and Barton extol it as an excellent diuretic in different forms of dysuria, and in drop- sies, especially such as succeed to acute diseases ; in nephralgia as a palliative, especially when the paroxysms are occasioned by gravel which has accumulated in the kidney; and even in vesical calculus. During its use the appetite improved, and the digestive powers augmented ; the patients often experiencing — immediately 1 Op. cit. * Medical Botany, i. 17; see, also, Art. Chimaphila, in Wood & Bache's Dispensatory, 3d edit. p. 193. 3 Barton's Collection, ii, 2. * Medico-chirurgical Transactions, v, 340. 102 dunglison's new remedies. after it was taken — an agreeable sensation in the stomach, and in the region of the kidneys. Radius' found it especially serviceable in dropsy, gout and rheu- matism ; and in inordinate activity of the secretory function of the mucous membranes — chronic catarrh, phthisis pituitosa, &c. Ac- cording to him, it is conlraindicated when there is much fever, disposition to diarrhoea, gastricism, and great debility of the stomach. Heyfelder affirms, that the chimaphila appears to be advantageous in the debility of the digestive organs attendant upon dropsy, but its diuretic effect is not considerable or enduring, so that it requires to be associated with other more powerful agents. Experiments, which have been made recently in the Burgerhos- pital at Pesth, and which have been collected by St. Rochus and published by Windisch, the director of the hospital, are extremely favourable to the chimaphila. Within two years, nearly two hun- dred dropsical cases are said to have been radically cured by it. Windisch recommends it most strongly to the attention of his col- leagues ; he asserts it to be one of the best diuretics we possess ; that it does not impair digestion ; moderately accelerates the circu- lation ; gently encourages the action of the bowels, and powerfully augments the urinary secretion ; that the patients willingly take it, and that it induces no nausea. It was administered with advantage in dropsies unaccompanied by fever, and not dependent upon or- ganic mischief, upon "corruption of the humours or paralysis of the lymphatic textures." In febrile conditions and inflammatory diatheses, it is said to have been always injurious, as well as when it was administered prior to the resolution of obstructions remaining after long protracted intermittents ; but when these are removed, and no excitement exists, more, according to Windisch, is to be expected from it than from any other agent, and he strongly ad- vises, that careful trials should be made with it in the proper cases. He advises, also, that its use should be persevered in, in order that good effects may be derived from it. We have frequently administered the chimaphila in public and private practice, and have found it serviceable, where a tonico- diuretic was indicated. MODE OF ADMINISTERING. The chimaphila is given either in infusion, or, what is preferable, in decoction ; the dose in the day being from half an ounce to an ounce. Where it does not act sufficiently on the bowels, Radius advises, that a few senna leaves should be added. In affections of the chest, he found the addition of the sweet spirit of nitre advan- tageous. Generally, however, he gave the chimaphila alone. Windisch found a combination of it with tartar emetic, liver of sul- 1 Auserlesene Heilformeln zura Gebrauche fur praktische Aerzle und Wunclarzte, u. s. w. Leipz. 1836. CHLORINUM. 103 phur, sal ammoniac, squill, and, in very great weakness, cinchona and preparations of iron, serviceable. Radius often administered also the aqueous or spirituous extract. Decoctum Chimaphilce. Decoction of Chimaphila. £. Chiraaphil. umbellat. §j. Macera per horas xij. in aquffi font. Bij. (ffiiss Ph. Lond.) Coque ad colatur. Bj. To be used daily in dropsy. Somerville. 5<. Chiraaphil. umbellat. ^ss ad § j. Coque cum aquae font. §xij, ad reman, ^vj. Coctione finita adde Spiritus frumenti. (gin, malt spirit or whisky) §ij. Digere frigide per horas vj, et cola. Dose — Two spoonfuls to be taken four times a day in dropsy and gout. Radius. &. Chimaphil. umbellat. gvj. Coque cum aq. font, ^xij ad reman, ^vj. Sub fluem coctionis adde Fol. senna? £ij, et cola. Dose — A spoonful to be taken every two hours. Radius., CHLORINUM. Synonymes. Chlorum, Chlorine, Murigene, Acidum Muriaticum Oxygena- tum, Acidum Marinum Dephlogisticatum, Spiritus Salis Marini Dephlo- gisticatus. French. — Chlore. German. — Chlor, Chlorgas. Uncombined chlorine is employed medicinally not only in the gaseous but liquid state. Of each of these we shall treat in suc- cession. The forms for evolving it in the gaseous state, as well as the gaseous chlorine itself, have had various names assigned them ex- pressive of their chemical or medical properties. They have been termed, respectively, Acidum muriaticum oxygenatum ad contagia ; Fumigatio muriatico-oxygenata ; Pulvis ad fumigationes muriati- cus ; Species pro vaporibus superoxydi niuriatici; Suffitus oxymu- riaticus; S. chlorini ; Alexiterium Chloricum, Fumigation de chlor, P. de Guyton, F. Guytonienne, F. Hygienique, &c. 104 dunglison's new remedies. mode of preparing. Chlorine is obtained from muriatic or hydrochloric acid. For this purpose, one part of well pulverised peroxide of manganese with five or six parts of concentrated muriatic acid is put into a retort, to which heat is applied and the gas received over water. Or, it may be obtained from a mixture of one part of manganese, four parts of kitchen salt, two parts of concentrated sulphuric acid, and four parts of water. Chlorine is a greenish yellow gas ; of a peculiar, strong, disa- greeable, stifling odour. The flame of a lighted taper introduced into it becomes at first pale, afterwards red, and is ultimately ex- tinguished. It remains unchanged in the highest temperatures. It has a great affinity for hydrogen, so that it abstracts this gas from every substance that contains it, and forms with it muriatic acid. Hence it decomposes all the gases that contain hydrogen, and all organic colouring matters, as well as — it is conceived by many — miasmata and contagious matters. EFFECTS ON THE ECONOMY. Chlorine when diluted, and received into the lungs, occasions coughing, and symptoms of suffocation, to which a protracted catarrh often succeeds ; not frequently,, too, we observe in those, who are compelled to be exposed to the gas, bronchitis and pneu- monia. Animals soon die when they are immersed in it. 1 In Mr. Broughton's experiments, mice exposed to it fell dead in less than thirty seconds. On opening them, the heart was found palpitating ; the peristaltic motion of the intestinal canal con- tinued, and could be kept up by irritating it with a probe. Tha vessels of the brain were collapsed. The lungs were tinged with the yellow colour of the gas, and the peculiar odour of chlorine was perceptible throughout their structure. Coagulation of the blood took place as under ordinary circumstances. A rabbit, two or three weeks old, was immersed in chlorine, and died in less than half a minute. On opening the thorax, the heart was found acting freely and on puncturing the aorta, the blood jetted out forcibly to a considerable distance. The peristaltic motion of the bowels was also going on. The vessels of the brain were in a collapsed state. The lungs were very much distended, tinged yellow, and when removed from the chest to a distance, emitted the odour of chlorine. The right ventricle of the heart was distended with dark blood. The eyes were much glazed in each experiment. " It has been generally thought," adds Mr. Broughton, " that chlorine is incapable of passing the epiglottis" (the glottis), but from the above observations it is evident that this gas enters tfie bronchial tubes in the act of inspiration. A portion of it probably circulates 1 See Christison oa Poisons, 3d edit. p. 736. Edinb. 1836. CHLORINUM. 105 through the brain, suspending the cerebral functions without di- rectly destroying the action of the involuntary organs, — contrac- tility remaining long after the destruction of animal life, as is evinced by the activity of the heart and of the intestinal canal." 1 These very facts, however, seem to show that but little of the gas enters the lungs; probably no more than what passes imme- diately preceding the closure of the glottis by the forcible contrac- tion of the arytenoidei muscles. When inhaled in a dilute state, it is absorbed, and. according to Mr. Wallace, the urine acquires bleaching properties. It would appear also, that, in manufactories, the chief consequences, resulting from exposure to an atmosphere of chlorine, are acidity and other stomach complaints, which the men generally remove by taking chalk: 2 this fact is confirmatory of the view, that acidity of the stomach is usually, if not always, dependent upon excess in the secretion of the gastric acids, the most important of which is the hydrochloric. Where chlorine is inhaled, it is reasonable to suppose that more of the hydrochloric acid may be secreted in the stomach. METHOD OF EMPLOYING. 1. By inhalation. — In the way of inhalation, chlorine gas is never administered in a state of purity, but always diluted with atmospheric air ; often, too, it is united with watery vapour. Gannal affirms that the workmen in a bleaching establishment, who suffered under diseases of the chest, were visibly improved, and ascribed the amelioration to the inhalation of air containing chlorine. He, therefore, instituted various experiments on con- sumptive individuals, from which good results, he conceived, fol- lowed. Sir James Murray 3 also mentions that a friend of his had observed similar effects among his workmen exposed to the inhala- tion of watery vapour strongly impregnated with chlorine. The experiments, however, which were instituted at La Charite, in Paris, on this mode of treating phthisfs, were by no means en- couraging; and the same may be said of those at the Hotel Dieu of that city, instituted by Rullier. 4 In many cases, indeed, the disease appeared to be aggravated. Bayle likewise thought the inhalation of chlorine generally un- favourable, although he asserts that he cured a case of tubercular phthisis thereby. Recently, it has been again recommended by Cottereau. Professor Albers, 5 of Bonn, who administered it repeatedly, and 1 Journal of the Royal Institution, from Jan. to June, 1830. 1 Pereira, Elements of Materia Medica, pt. i. p. 107. Lond. 1839. 3 A Dissertation on the Influence of Heat, &c, Lond. 1829; cited in the Dublin Journal of Medical Science for March, 1839, p. 96. * See, also, Pereira, Elements of the Materia Medica, pt. i. p. 108. Lond. 1839. 1 Hannoversche Annalen, 1836, and Br. and For. Rev. for July, 1837, p. 215. 106 dunglison's new remedies. carefully watched its effects, conceives that it acts as a stimulant when applied to the membrane, but that, when it gets into the blood, its effects are antiphlogistic ; and he is of opinion that, when there is no haemoptysis, or violent local irritation present, chlorine inhalations may be used in diseases of the lungs and air passages. Its stimulant effect gradually diminishes, and, after a time, the mucous surfaces of the lung become less sensible to its exciting influence. In tubercles of the lung, in chronic catarrh, in chronic inflammation and ulceration of the bronchial mucous membrane, and in dilatation of the bronchi, he found it of no service, and, in most cases, it could not be borne in consequence of the irritation it induced ; but its operation was very salutary in pure ulceration of the lungs or vomica. It had always, however, to be administered cautiously and experimentally. Dr. Stokes always found chlorine inhalations prejudicial in phthisis, producing, in every case, increase of bronchial irritation, dyspepsia, and arrest of the pulmonary secretion. In his trials of the remedy in gangrene of the lungs, 1 he found it decidedly bene- ficial, correcting the fcetor of the breath and expectoration, and, therefore, calculated to obviate not only the local but the constitu- tional symptoms. Sir James Clark 2 is of opinion that the inhalation of chlorine has only produced relief in persons whose lungs have been dis- eased to a very limited extent. Dr. Pancoast informs the author, that a case of aphonia, occur- ring in a young lady, in which there was but little voluntary power over the diaphragm, was cured by the inhalation of chlorine, after the galvanic plates and the electro-magnetic apparatus had been used in vain. The chlorine may be inhaled from a common dish or inhaling apparatus, by dropping any of the acids on a mixture of chloride of lime, so that the acid may be disengaged slowly, but the best method of inhaling it, as well as iodine, is that recently recom- mended by Dr. Corrigan. 3 He properly remarks that, in order that inhalation may have a fair trial, it is requisite, first. That the apparatus should be simple in its construction, and easily kept in order. Secondly. That it should be capable of keeping up a sup- ply of vapour for any length of time, and that the evolution of the vapour should be steady and easily regulated. Thirdly. That it should also furnish a sufficient supply of aqueous vapour to prevent any irritation of the larynx, or lining membrane of the air tubes ; and, fourthly, and most important of all, that its employment should entail neither trouble nor fatigue on the invalid. To fulfil these objects, Dr. Corrigan advises the apparatus re- 1 Dublin Hospital Reports, vul. v. 2 Treatise on Tubercular Phthisis, p. 84, Lond. 1S34; also, Araer. edit. Phiiad. 1835. 8 Dublin Journal of Medical Science, March, 1839, p. 94. CHLORINUM. 107 presented in the margin. It consists of a light open iron-wire frame, about eighteen inches high, at the bottom of which is a spirit lamp, A : at the proper height above it is an evaporating por- celain dish, about six inches in diameter, B: above this is a glass globe, C, with its neck downwards. In the neck of the globe is a cork, D, bored, and through the opening is drawn, moderately tight, a short plug of cotton wick, such as is used in a spirit lamp: in the glass globe at E, opposite the neck, is drilled a pin-hole, to allow air to pass in, according as the fluid within drops out through the neck. To use it, the porcelain dish is filled with hot water, the spirit lamp is lighted, and as soon as the water in the dish has begun to boil, the glass globe containing the chlo- rine, (if this be the substance used,) is placed as shown in the mar- ginal illustration. The rate, at which the fluid in the globe shall percolate the cotton wick and drop into the hot water beneath, is easily regulated. If it do not drop with sufficient rapidity, one or two of the threads of the cotton may be removed. If it drop too rapidly, this is corrected by pressing in the cork more tightly, or introducing one or two additional threads of wick. In employing the chlorine, eight ounces of saturated solution of chloride of lime may be poured into the glass globe ; and into the water of the porcelain dish, two ounces of the dilute sulphuric acid of the pharmacopoeia. As the solution of the chloride drops, the aaid seizes on the lime, and the chlorine is evolved in connection with the aqueous vapour. 1 Chlorine is but little used in this form, and can only be adapted for cases in which the pathological condition of the bronchial mucous membrane, or neighbouring parts, requires the exhibition of an ex- citant. 2 In this way, it may be occasionally serviceable in chronic bronchitis ; but its administration requires great caution. 3 In cases of poisoning by the hydrocyanic, acid, as well as by sulphuretted hydrogen, chlorine is a most efficacious agent. The chloride of lime may be used for this purpose. 1 Lond. Med. Gazette, April 6, 1839, p. 49. 2 Toulmouche, in Revue Medicale, Avril, 1834. 8 Archives Generales, Avril, 1834 J and a recent communication on the excellent effects of chlorine vapour incatatrh, in Gazette Medicale de Paris, June, 1838. 108 uunglison's new remedies. 2. By Fumigation. — Fumigations of chlorine have been parti- cularly re com mended by Wallace, of Dublin. 1 They appear to resemble, in their action, the nitrous and nitro-muriatic acid baths, and have been especially employed in liver diseases, unaccom- panied by inflammation, but in which there is disturbance of the biliary secretion. According to Wallace, fumigations of chlorine are more certain than ablutions and baths of nitro-muriatic acid, and they have the advantage, that their application subjects the pa- tient to less inconvenience. The good effects of chlorine, in such cases, have likewise been tested by Zeise, 2 in his bathing establish- ment at Altona. When the chlorine is, in this way, brought into contact with the skin, it soon occasions a pricking sensation ; in- crease of transpiration ; great afflux of fluids to the surface of the body, and sometimes a pustular eruption : increased secretion of saliva, urine, and bile; slight inflammation of the mouth and fauces, and impeded respiration and circulation. Wallace found chlorine fumigations serviceable not only in hepatic diseases with disordered secretion of the liver, but in several other morbid conditions, as hypochondriasis, cachexia, and in all affections in which a prolonged excitation of the skin, and a resto- ration of its suppressed or impaired functions could be esteemed serviceable, — hence, in old cases of syphilis, scrofula, chronic ca- tarrh, and rheumatism : generally, cathartics were combined with the fumigations, and the evacuations were constantly observed to present a highly bilious character. In chronic cutaneous affections, as in lepra, psoriasis, and sca- bies, these fumigations have been found useful ; but, generally, fumigations of sulphurous acid are employed by preference, in con- sequence of the greater facility with which they can be prepared. 3 Injections of chlorine gas have been employed for the radical cure of hydrocele by M. Deblois, of Tournay, and M. Deconde. 4 The chlorine gas is contained in a bladder, to which is attached a pipe and stopcock adapted to the canula of the trocar, into which it is fixed after the fluid is evacuated: the stopcock is then turned, and the bladder pressed so as to force the gas into the tunic*, vagi- nalis. When this is distended, the pipe and bladder are removed, and the thumb is placed over the mouth of the trocar, so as to pre- vent the issue of the gas for the space of two minutes : it is then allowed to escape, and two or three repetitions of the injection are made, which are sufficient for the cure. It would appear, that risk must be incurred from the injection of such an acrid substance, but M. Deconde says not. Fumigations of chlorine, with the view of destroying the matter 1 Researches respecting the Medical Powers of Chlorine, &c. Lond. 1S22. 2 Nye Hygea udgived af C. Otto, 1825, and Hufeland und Osann's Journ. der prakt. Heilkund. B. lxiii. St. 1. 3 Green on Diseases of the Skin. American Library edit., Philada. 1838. * Bulletin Medical Belse, Janvier, 1S36. CHLORINUM. 109 of contagion, and of preventing the spread of contagious disease?, have long been used. 1 As long ago as the year 1773, they were proposed by Guyton de Morveau, and hence they have been called the "Guytonian," or the (i Guyton Morveau fumigations." They are the best agents for the purpose that we possess. In fumigating the extensive general penitentiary at Milbank, Westminster, Dr. Faraday adopted the following method. One part of common salt was intimately mixed with one part of the black oxide of manganese ; the mixture was placed in a shallow earthen pan, and two parts of oil of vitriol, previously diluted with two parts by measure of water, were poured upon it, — the whole being stirred with a stick. Chlorine was liberated for four days. The quantities of the ingredients employed were 700 pounds of common salt, the same quantity of the oxide of manganese, and 1400 pounds of sulphuric acid. 2 When chlorine is evolved in the manner described, it is liable, like all the acid gases, to the objection that it is extremely irritating when respired. It cannot, therefore, be used in the sleeping apart- ments of the sick, although it may be employed beneficially after they have been withdrawn, and the object is to disinfect the cham- ber. It ruins all polished surfaces, but this can be effectually ob- viated by painting them over with a compost of starch. The chlo- rides are not liable to the same objection, as they exhale the chlorine slowly. 3 CHLORINI AQUA. Synonymes. Aqua Chlorinii, Liquor Chlori, Aqua Chlori, Aqua Oxymu- riaiica, Liquor Acitli Muriatici Oxygenati, Aqua Oxygenata Muriatica, Aqua Oxygeno-Muriatica, Liquor Alexitereus Oxygenatus, Solutio Alexi- teria Oxygenata, Solution of Chlorine, Liquid Oxymuriatic Acid. French.— Colore Liquide, Eau de Chlore. German. — Chlorwasser. This preparation is contained in many of the pharmacopoeias. It is in those of Austria and Anvers; and in the Batavian, Bavarian, Belgian, Danish, Dublin, Parisian, Finnish, Hannoverian, Polish, Prussian, and Swedish. 4 It has been more extensively adminis- tered on the continent of Europe than in this country, or in Great Britain. METHOD OF PREPARING. The Prussian Pharmacopoeia directs chlorine gas, made after the manner before described, to be passed into the bottles of a Woulfe's apparatus filled with distilled water, until two-thirds of the water 1 Link, Art. Chlor, in Eneyclopad. Worterb. der medicin. Wissenschaft. B. vii. S. 575. Berlin, 1831. 2 Pereira, Op. cit. p. 107. 8 See the author's General Therapeutics, p. 509. Philad. 1836. 4 Pharmacopee Uuiverselle, i. 405. Paris, 1828. 110 dunglison's new remedies. are displaced ; the bottles are corked under water, and the water is agitated until it takes up the gas. . The liquid is then drawn off into small bottles, which are well filled, and kept in a dark place. In this way, liquid chlorine may be kept for a long time undecomposed. In its preparation, some little muriatic acid is formed, so that it has at times to be purified by treating it with a solution of nitrate of silver. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made by Orfila 1 on dogs, it appears that con- siderable doses of a moderately concentrated solution of chlorine prove fatal, by exciting sooner or later inflammation of the stomach, accompanied with great languor; and when death takes place very rapidly, signs of organic alteration are met with in the stomach. In its action on the economy, chlorine is closely allied to the acids, and especially to the muriatic. Introduced into the stomach in moderate doses, the solution of chlorine excites an agreeable feeling of warmth, which soon spreads over the whole of the body: in strong doses, according to L. W. Sachs, a kind of intoxicating stupor is induced by it, soon succeeded by prostration. It has been conceived to act equably as a moderate excitant on the nervous system, and thereby to moderate inordinate action in any part, and is, to a certain extent, antiphlogistic, without possessing any of the debilitating qualities of the antiphlogistics proper. In the opinion of some of the German pathologists, it exerts a powerful stimula- tion on the organic actions, especially on the lymphatic and glan- dular systems, moderating inordinate secretion. Its antiseptic pro- perties are likewise considerable. It would appear, however, that the number of observations has not been sufficiently great— al- though they have been by no means few — to allow of any com- prehensive appreciation of its exact modus operandi on the human organism. 2 EFFECTS ON THE ECONOMY IN DISEASE. Although the solution of chlorine is properly no new remedy, it is only of late years, that it has been frequently administered. At the present day in some countries, it is in common use. It is not long since Meurer maintained, that it is impossible to administer chlorine internally, and that in every case in which it was believed to have been given, the article really taken was the hydrochloric or muriatic acid ; for, owing to the affinity of chlorine for hydrogen, whenever any union takes place between it and organic matters, the chlorine he affirmed disappears, and muriatic acid alone exists, as he had proved by repeated experiments. In this assertion, how- ever, he was opposed by many observers. Herzog and Barman n 1 Toxicolojie Generale, i. 141. * Riecke, Die neuern Arzneimittel, u. s. w. S. 30. Stuttgart, 1S37. CHLORINUM. Ill came forward with experiments to show that Meurer had gone too far in his deductions ; and from all the experiments, it would ap- pear, that in prescribing the aqua chlorini many mistakes had been, and — we may add — -still are, committed. From Barwald's experi- ments it would appear, that if water which has rested on aromatic or other vegetable substances be chosen for the dilution of the aqua chlorini instead of distilled water, a difference is produced in the rapidity of the decomposition. In a mixture of aqua chlorini, distilled water, and simple syrup, the decomposition takes place tardily ; but if in the place of the syrup, a mucilaginous juice be substituted — for example, thesyrupus althseae — acids are speedily formed ; as well as when a decoction of althaea is substituted for distilled water ; whereas a mixture of the decoction of salep (gr. v to water §j), syrup, and the aqua chlorini in well stopped bottles remained undecomposed above twenty four hours. In these experiments, however, the persistence of the smell and taste of the chlorine ex- hibited, that the whole of the chlorine had not been converted into muriatic acid. In the same manner as in the case of the decoction of marshmallows, the addition of the infusum sennas and infusum Valeriana?, as well as of solutions of extracts, and especially of liquorice, destroyed the smell of the aqua chlorini instantaneously, even when the taste of chlorine could still be detected. When the solution was combined with remedial agents, that contain much colouring matter, the decompostion took place with great rapidity. From the results of these experiments, Barwald advises the aqua chlorini to be given in admixture with distilled water and simple syrup, as in this way only can we be sure, that the patient has taken the chlorine undecomposed. Herzog lays it down as a rule, that the solution of chlorine should only be mixed with colourless transparent substances — water, simple syrup, gum arabic or the decoction of salep. In respect to' its administration in disease, we shall speak first of its internal use, which in several morbid conditions seems to have rendered good, and in some cases eminent, service. The following are the diseases in which it has been chiefly recommended. 1. Irritative fever, as in the violent irritative fever that occurs during the period of dentition ; in which it has been administered with great success by Kopp, Mehlhausen, Goden, Trusen, and Riecke. 1 Dangerous determinations to the head, have been, in this way obviated, along with the unpleasant complications which are apt to he occasioned thereby. Toel 2 exhibited it in convulsions, during dentition, which were accompanied by too great activity of vessels, and he affirms, that he has prescribed no-remedy, which, in all respects, answered so well. 2. Nervous fever, especially when tending to the putrid charac- ter. In the plague, according to Wagner, it is of no avail ; but in 1 Op. cit. S. 30. a Archiv. d. med. Erfahrung, Marz uod April, 1S25. 112 dunglison's new remedies. putrid fever, according to Kopp, it is highly useful. Spangerberg observed good effects from it in an epidemic typhus with hepatic derangement. It is likewise extolled in typhus by Wolf, Braun, Hufeland, and others ; and by Sacco in the fever called petechial, itself a typhus. Of late, it has been much used in Germany in the typhus abdominalis, which corresponds to our typhoid fever, to oppose the origin and development of the intestinal ulcerations; but when the disease is farther advanced it has been found useless. It is especially recommended in this disease by Clemens, but he commonly premises the use of an emetic. Trusen considers the emetic unnecessary. He first applies leeches to the epigastrium, and then prescribes immediately the aqua oxymuriatica in con- siderable doses ; — in lighter cases, a dram every two hours ; and if the disorder of the head be already great, the tongue chapped (rissiir), and the peculiar expression of countenance present, he gives two drams every two hours. Bartels is less satisfied with the action of chlorine in abdominal typhus. It raises, he says, the sinking powers very speedily, but often excites the sanguiferous system, and not unfrequently increases the abdominal symptoms so palpably, that the physician is compelled to have recourse to other agents. Riecke 1 thinks, however, that it may be of essential ser- vice in this disease, which so frequently mocks the best directed efforts of the practitioner ; and he suggests, that farther experi- ments are highly desirable, especially as those instituted by Trusen and others are not free from objections, by reason of their having combined with the chlorine substances that quickly decompose it. 3. Carbuncidus raa/^?ms (Milzbrandkarbunkel). — In the variety of malignant anthrax caused by handling the skins of cattle, the internal and external use of chlorine has been found of essential service by Ettmuller, Herbst, Stumpf, and Hoffmann. 4. Scarlatina.— Pfeufer. Wendt, Kopp, and Trusen extol it highly in this disease, for which, on theoretical grounds, it would seem to be appropriate, by reason of the great turmoil in the san- guiferous system, as indicated by rapidity of pulse and inordinate secretion of heat, bearing but little direct ratio to the degree of vital energy. Braith waite, who, it is asserted, was one of the earliest, if not the earliest, who advised chlorine in scarlatina, supposed that it acted as specifically as the bark in intermittent, or mercury in syphilis ; and Trusen asserts that it may be advantageously used in cases where other remedies have been found ineffectual. It is espe- cially recommended by Braun and Spiritus in malignant scarlatina. 5. In other febrile exanthemata, small-pox, measles, rubeola, &c, it has been prescribed with advantage. In putrid dysentery, (faulige Ruhr,) it is extolled by Nysten and Kopp; and in inter- mittent, by Kopp and Kretschmar. Trusen recommends it in the irregular, and especially in the anticipating forms, where there is danger of their becoming continued. Under its use, 1 Op. cit. S. 33. CHLORINUM. 113 he found the paroxysms became regular, with perfect apyrexiae, so that the ordinary febrifuges could be advantageously given. In gastric fever, Trusen trusted to it solely for the removal of the dis- ease: he found that it corrected the morbid secretions from the mucous membrane of the digestive tube. Other physicians have also derived equally favourable results from its administration in that disease. 6. In gastromalacia, it has been prescribed by Rhades, Blasius, and Winter, but as Riecke, 1 from whom this detail of the experi- ence of the German practitioners has been chiefly taken, properly observes, farther observation is necessary before we can decide as to its efficacy in such cases. 7. In erysipelas, especially of children, it has been recommended by Kopp. 8. In inflammation of the liver, favourable results were obtained from it in the Children's Hospital of St. Petersburg; and it exhibited, in these cases, the analogy to calomel in its action, which has been pointed out by many observers. 9. In hydrophobia, it has been used both internally and exter- nally as a preventive, especially by the Italian physicians Brera, Previtali, 2 Ghisaldoni, Agliati, Arrigoni,Narcisi, and Anelli, whose experience is in its favour. Wendelstadt and Ruppius have like- wise published favourably regarding it. It is obvious, however, that much fallacy may arise as to the precise agency of reputed preventives. Every one, for example, who may be bitten by a mad dog is not attacked with hydrophobia; and, unless great caution be used, any article may be regarded as a preventive. This is the main reason why we have so many preventives of hydrophobia and other diseases. 10. Again : — the solution of chlorine has been advised by Rup- pius and Mertzdorf in dropsy, especially such as supervenes on the acute exanthemata. 11. In the diathesis phthisica. it has been recommended by Gbden, and has been affirmed to moderate the hectic in phthisis, and to make the remissions more marked. In these cases, it re- quires to be given in large doses, and to be exhibited for a consi- derable time. 12. In many cases of chronic cutaneous affections, with dimi- nished plastic energy, it has been used with success by Kopp. 13. Lastly: in noma, orcancrum oris, and in fcetorof the mouth, it has been recommended internally as well as topically; and, ac- cording to the experiments of Persoz, Nonat, and others, it renders eminent service in cases of poisoning by the hydrocyanic acid. Externally, it is used either pure, diluted with water, or in com- bination with oil. Godier affirms that he cured strumous swellings 1 Op. cit. S. 34. 2 Pratiche Osservazioni suit Idrofobia, &c. Milan, 1820. 7— d dungl 114 dunglison's new remedies. of the glands by a cerate of chlorine. Eisenmann, Cnllerier, and Biache recommend it at times pure, at others diluted, in the way of injection, in gonorrhoea and leucorrhoea. It is employed, also, in flabby, putrid, and offensive ulcers, in the carbunculus malignus, in chronic cutaneous affections, as tinea capitis, itch, (Deimann,) herpes, (Alibert,) cancrum oris, asthenic aphthae, (fee. Lastly: ablution with a solution of chlorine, or of the chlorides, has been advised as a preventive of venereal infection. In can- cerous ulcers, it corrects the unpleasant odour, and excites a new action in the part ; causing the secretion of a better pus : farther than this, we cannot expect much from it. Baths of chlorine are recommended by Wagner as an excellent means for preventing the plague. Schonlein advises that, in scarlatina, the whole surface of the body should be washed with a mixture of aqua chlorini and water, which he prefers to ablution with cold water. Finally; — the aqua chlorini is occasionally sprinkled in the sick chamber to purify the atmosphere during the prevalency of conta- gious or other diseases. MODE OF ADMINISTERING. As already remarked, whenever the aqua chlorini is prescribed, its facility of decomposition must be borne in mind. It is, for this reason, best to prescribe it with water only, or at most with the addition of simple syrup, for internal administration. For external use, water alone should be associated with it. As to the precise mode in which chlorine is affected by fatty substances, we have as yet no accurate knowledge; it may be calculated, however, that a part undergoes decomposition. Such combinations have, notwith- standing, been found very useful. The solution should never be prescribed in quantity larger than is necessary for twenty-four hours, as by frequently opening the vessel in which it is contained, decomposition readily ensues. The vessel should be put into a dark place, and be surrounded by black paper. The average dose for an adult, in the twenty-four hours, may be fixed at an ounce, although much larger doses may be given with- out inconvenience. It is scarcely necessary to say that the precise dose must vary with the degree of concentration. Unguentum Oxygenatum ex tempore parandiim. Ointment of Chlorine. Jy. Aquae chlorin. p. j. Adipis, p. viij. M. Used in the itch. Pharmacopeia of Austria. CINCHONINA. 115 Linimentum Aqua, Chlorini. Liniment of Chlorine. 5<. Aquas chlorin. 3j. Olei olivar. ^j. M. Externally in obstinate itch, tinea capitis, and herpes. Deimann. 5<. Cerae albae, ^ij. , Leni calor. liquef. adde 01. amygdal. q. s. Ut fiat linimentum cui refrig. adde Aq. chlorin. giss. M. Used externally in cases of ulcers. Ltjdwig. Gargarisma Aqua Chlorini. Gargle of Chlorine. £. Pulv. tragac. gr. xij. Aquae %iv. Aquas chlorin. Syrup, aa. gss. M. To be used as a gargle in ulceration and chronic inflammation,' of the mouth and fauces. Ratier. 1 CINCHONINA. Synonymes. Cinchonia, Cinchoninum, Cinchonin, Cinchonine. Although Duncan, of Edinburgh, Reuss, of Moscow, and Gomez, 2 of Lisbon, had endeavoured to separate the active prin- ciple of the cinchonas, and had given the term cinchonine to a resinous extract obtained in their investigations ; the honour of discovering both cinchonine and quinine and of applying them to practical purposes belongs to the French chemists — Pelletier and Caventou. 3 Cinchonine is commonly obtained from the gray or pale varieties of cinchona; the yellow furnishing the quinine, and the red both cinchonine and quinine. It is an alkaloid strikingly analogous to the quinine in its chemical and medical relations, but is not as much used. 1 Formulaire pratique des h6pitaux civils de Paris, 3me. edition. Paris, 1827. 8 Richter's Specielle Therapie, B. x. S. 325. Berlin, 1828, and Magen- die's Formulaire. 3 Anuales de Chimie et de Physique, xv. 289 and 337. 116 dunglison's new remedies. METHOD OF PREPARING. Cinchonine is obtained by boiling the bark in alcohol, until it loses all its bitterness ; the alcoholic solution is then evaporated to dryness in a water bath ; the extract, thus obtained, is dissolved in boiling water, strongly acidulated with muriatic acid; an excess of calcined magnesia is added, which, after a few minutes' boiling, will fix all the red colouring matter, and render the liquid clear. When cold, the liquid is filtered, and the magnesian precipitate washed with cold water; it is then dried in a stove ; and all the bitterness separated by repeated digestions in boiling alcohol ; the alcoholic liquors are mixed, and the cinchonine crystallises as the fluid cools. The cinchonine, thus obtained, still contains a green fatty matter, which may be separated by solution in a very weak acid. If the acid be too strong, it will dissolve a part of the fatty matter, and the intended object will be thus defeated. 1 Cinchonine may also be obtained by treating pulverised pale cinchona by weak sulphuric acid, precipitating the solution by means of lime in excess; collecting the precipitate on a filter, washing it, and treating it, after drying, with boiling alcohol. 2 Cinchonine is white, translucent, crystallising in needles; re- quiring, for its solution, 700 parts of cold water, according to Magendie; according to others, 2500 parts of boiling water. On account of its very sparing solubility in water it has but a slightly bitter taste. In alcohol, it is readily soluble, and the solution is extremely bitter, as well as the salts formed by its union with acids, which resemble the salts of quinine. It does not dissolve readily in fixed or volatile oils, or in ether. At a certain tempera- ture, it volatilises ; a great part, indeed, is destroyed by the opera- tion, yet a sensible portion escapes the decomposing power of the caloric. In medicine, pure cinchonine, as well as the sulphate and acetate, are prescribed. The sulphate is soluble in 54 parts of water, and in 6.5 parts of alcohol, (s. g. 0.815) ; it is not soluble in ether. It forms crystals and tastes bitter. The acetate, on the other hand, does not crystallise ; and is less soluble in water than the sulphate ; but an excess of acid facilitates the solution. EFFECTS ON THE ECONOMY. It is not necessary to say much on the application of cinchonine and its preparations to disease, as they have been almost wholly superseded by the quinine and its salts. It is a weaker article, and therefore requires to be given in larger doses ; Magendie and Gittermann assert, that it has been found ineffective as a iebrifuge. 1 Magendie, Formulaire, &c. * Pharmacopee Universelle, i. 414. Paris, 182S. CINCHONINA. 117 Bally, 1 Chomel, 2 Mariani, 3 Wutzer, 4 and others, however, have exhibited it successfully. 5 Dufresne 6 frequently prescribed it, and he assigns it this claim to preference, that it is almost tasteless, or at least that the bitter taste is but tardily developed ; and that it needs not to be given in combination with acids, as the acid con- tained in the gastric secretions will render it soluble. 7 He gave it in intermittents during the apyrexia in the quantity of from six to twenty grains, and he found it, moreover, of marked use in the cases of gastralgia with formation of acid, which are so often met with in young females, and are not unfrequently associated with leucorrhoea, hypochondriasis, melancholy, &c. MODE OF ADMINISTERING. The following formulae have been recommended, but, as was before remarked, they are rarely used, the preparations of quinine being now almost universally prescribed. Syrupus Cinchonince. Syrup of Cinchonine. 5=. Sulphat. cinchonin. gr. xlviii. Syrup, simpl. Bbj. Used in the same cases as the syrupus quininee, a tablespoon- ftll for a dose. Mag end ie. Vinam Cinchonince. Wine of Cinchonine. It. Sulnhat. cinchonin. gr. xviij. Vini Maderens. ffiij. Tinclura Cinchonince,. Magendie. 5<. Sulphat. cinchoninae, gr. ix. Alcohol (34° or s. g. .847.) gj. M. Magendie. Magendie recommends that this tincture should be used for preparing, extemporaneously, the wine of cinchonine, by adding two ounces of the tincture to a pint of the Madeira wine. 1 Nouv. Biblioth. Medicale, ix. 189. 2 Nouv. Journ. de Medecine, Mars, 1821. 8 Osservaz. sulla Pratica del solfato de Cinconina, &c. 4 Rust und Caspei's Krit. Repert. B. xxi. Bulletin des Sciences Medic. Sept. 1827. 6 Art. Cinchonine, in Merat and De Lens, Diet, de Mat. Med. • Bibliotheque Universale, Mai, 1831, p. 89. 7 See, also, Ganz, in Bulletino delle Scienze Mediche di Bologna, Agosto et Settembre, 1836, p. 12). 118 DUNGLISON'jS new remedies. Boli Antifebriles} Febrifuge Boluses. 5*. Sulphat. cinchonin. gr. iij. Micae panis, Mellis, Glycyrrhiz. aa. q. s. ut fiat bolus. Dose, — one of these to be repeated every two hours. Brera. Mlstura Cinchonince. Mixture of Cinchonine. Soh Sulphat. cinchonin. gr. vi to xlviij. Potassae acetat. Sacchar. alb. aa. 3ss. Aquae chamsem. ^vj. Dose — A table-spoonful every two hours, in intermittents. Sundelin. CODEINA. Synonymes. Codeinum, Codeia, Codeine. German.— Kodein. Although opium had been repeatedly examined by the chemists, and certain of its active constituents separated from it, it was not until within the last k\v years, that the article, whose name is at the head of this paragraph, had been obtained from it. It was disco- vered by Robiquet in 1832, 2 and as it has been exhibited as a thera- peutical agent, it requires notice. METHOD OF PREPARING. According 1 to Winkler, 3 this new alkaloid may be prepared in the following manner. The morphine is first thrown down from a solution of opium made in the cold by means of ammonia; the meconic acid is precipitated by the muriate of lime; for the removal of the colouring matter, the fluid is then treated with the extract or subacetate of lead ; and the extract of lead, contained in the fluid poured off from the precipitates, is afterwards decomposed by sul- phuric acid ; the fluid, separated from the sulphate of lead, is now 1 Ricettario Clinico di Brera. Padov. 1825. 2 Journal de Pharmacie, xix. 91 and 162. Paris, 1833. 5 Buckner's Report, xlv, p. 459, cited in Journal de Pharmacie, xxi, 251. Paris, 1835. CODEINA. 119 treated with an excess of caustic alkali; the mixture is exposed to the air until the excess of free alkali has attracted carbonic acid from it; it is then agitated and digested with ether, and left to evaporate spontaneously, after which a yellowish, highly transpa- rent, but not crystalline compound remains, which forms with mu- riatic acid a crystalline salt, and resembles exactly the codeine of Robiquet. Merck 1 procures the codeine in a very simple manner. He treats morphine precipitated by soda with cold alcohol; the spiri- tuous tincture is carefully saturated with sulphuric acid; the alcohol drawn off, and the residue treated with cold water as long as it is turbid ; it is then filtered, and the filtered liquid evaporated until it has the consistence of syrup: on cooling, ether is poured over it in a large flask; caustic alkali is added in excess, and the whole strongly agitated. The sethereal mixture is then so saturated that the codeine crystallises from it in a few hours. By evaporating the ether, and treating the residue with alcohol, the codeine is obtained by degrees wholly pure, and separated from an oily matter, which is a great obstacle to crystallisation. Codeine, according to Pelletier consists of 31 parts of carbon ; 40 parts of hydrogen ; 5 parts of oxygen, and 2 of azote. It is an alkaloid, soluble in water, alcohol and ether; but not so in alkaline solutions. It unites readily with acids, and with the muriatic acid especially forms a salt, which crystallises with great facility. When the crystals of codeine are heated on a plate of platina, they burn with a flame without leaving any residue. Heated in a tube, they melt at about 150° centigrade; and, if allowed to cool immediately, they form a crystalline mass ; if, how- ever, the heat be continued, the oleaginous fluid rises along the sides of the tube, appearing to shun the heat; but it does not vola- tilise. When dissolved in water, codeine communicates to it deci- dedly alkaline properties. 1000 parts of water at 60° Fahrenheit, dissolve 12.6 parts of codeine ; the same quantity at 100°, 37 parts, and at 21.2°, 58.8 parts. If more codeine be added to boiling water than can be taken up, the surplus melts, and forms, like the meco- nine, an oleaginous layer on the bottom of the vessel. This aqueous solution, by careful refrigeration, affords a translucent and uncom- monly well defined metal. The tincture of galls forms a copious precipitate with a solution of codeine, in which respect, the latter differs essentially from morphine, as it does in many other of its properties. EFFECTS ON THE ECONOMY. As morphine does not represent the whole of the activity of opium, Robiquet concluded, that other substances might concur thereto, and he conjectured that codeine might be one of those. 1 Journal de Pharmacie, cited in Amer. Journal of Pharmacy, new series, i, 171. Philad. 1835. 120 dunglison's new remedies. Under this idea, Kunkel 1 instituted experiments with it on rabbits and dogs, from which he obtained the following results. First. Codeine differs from morphine in this, that it does not, like the latter, paralyse the lower extremities. Secondly, Codeine appears to exert a powerfully excitant action. It occasions convul- sions of the limbs, and of the muscles of the neck, and when it pro- duces death, this seems to be owing to its action on the cerebellum and medulla oblongata ; twice he noticed symptoms of backward progression under Its use, and those parts after death were found turgid with blood. To judge from the condition of the heart and lungs it affects likewise the circulatory organs. It occasions in- flammation of the tissues, with which it comes into immediate con- tact. Its action is more energetic, when introduced into the cellular membrane, than into the stomach. It seems, also, to exhibit a special action on the urinary organs, for animals to which it is given never evacuate their bladder as long as they are under its influence. Thirdly. The action of codeine differs from that of the watery extract of opium, in not paralysing the hinder extremi- ties ; but it approximates it in this, that it acts, as has been said, more powerfully when introduced into the cellular membrane than into the stomach, and accelerates the respiration and circulation. Kunkel, however, remarks upon the results of his experiments, that they demand repeated trials for confirmation, as he was only able to experiment with a very small quantity of the substance. Robiquet observes that Kunkel's experiments have led to the in- ference, that when codeine is combined with acids, it loses much of its efficacy — the very opposite, by the way, to the inferences of Magendie. Barbier 2 has taken considerable pains to fix the value of codeine as a remedial agent. He prescribed it in the dose of one or two grains in a syrup, prepared with the aqueous solution of the alka- loid, of such strength, that a table-spoonful or half an ounce con- tained one grain of codeine. In his opinion, it exerts a peculiar agency on the nerves of the ganglionic system, whilst it appears to possess but little influence on the hemispheres of the brain, and to make no impression upon the spinal marrow. In the epigastric region, he remarks, the agency of codeine is powerfully manifested ; and here in the centre of the ganglionic system, its effects may be investigated, and their extent and magnitude appreciated. If a spoonful, or, at an interval of from one to two hours, two spoonfuls of the syrup of codeine be administered to one affected with the symptoms to be described immediately, we shall find, that it ex- hibits a considerable and remarkable effect upon the economy. If the person complains of pain in the epigastric region, beneath the lower extremity of the sternum, and stretching to the sides and back ; and if, with these symptoms, there is combined a feeling of 1 Journal de Chimie Medicale, ix, 223. * Gazette Medicale, Mars 8, 1834. CODEINA. 121 heat, indescribable anxiety, marked debility, paleness, decided alteration of the features; a sense of painfnl traction sometimes on one side, at others in the other side of the epigastric region, with tendency to syncope, frequent sighing, despondency, and more or less sensibility to pressure in the epigastric region, &c. Barbier considers the seat of the disease to be the epigastric nervous plexus; and in such cases, he says, he has found no remedy supe- rior to the syrup of codeine. He has observed it afford decided relief where the coats of the stomach were manifestly in a state of degene- ration. Adbmmon effect of the codeine is sleep; which is never accompanied by heaviness of the head, or by determination of blood to the brain. When the persons awake from the sleep pro- duced by codeine, the countenance is bright and lively, and there is a tendency to laughter. Barbier was led to believe, that it does not affect the nervous cords connected with the vertebral portions of the centre of the nervous system. In his observations at the hospital of Amiens, he often noticed the neuralgic affection of the abdomen above mentioned to be accompanied by pains in the head, loins, and limbs, and whilst the codeine relieved the abdominal un- easiness, it left the others untouched — a singular circumstance if true, but requiring fresh observation before we can esteem it to be established. He remarks farther, that almost all the patients that were benefited by the codeine had used laudanum unsuccessfully. Codeine, he adds, occasions no manifest change in the circulation and respiration ; it does not disturb the digestive function ; seems merely to diminish the feeling of hunger, and occasions no con- stipation. During its use, itching of the surface is frequently ex- perienced. When applied to the skin, it induces no striking phenomena. When applied, in the dose of two grains, to a surface abraded by a blister, it excites a painful sensation of burning, without any other change appearing to supervene ; the neuralgic pains, for the removal of which it may have been thus employed, not appearing to be modified by it. Mr. Gregory made experiments upon himself and some of his pupils with the nitrate of codeine. None of them experienced any effect from a dose of three grains and under; from four to six grains, however, occasioned striking symptoms — quickness of the pulse, sense of heat in the head and face, remarkable excitement, like that following the use of intoxicating liquors; agreeable, and apparently permanent, stimulation, accompanied by considerable itching, which began at the head and extended over the whole body. To this succeeded, in the course of a few hours, a disagree- able sense of relaxation, with nausea, and often vomiting. None of the experimenters felt the slightest inclination to sleep, until after the supervention of the feeling of relaxation. Riecke 1 thinks, that these experiments confirm Kunkel's obser- 1 Die neuern Arzneimiltel, u. s. w. S. 140. Stuttgart, 1837. 122 dunglison's new remedies. vations, that the codeine loses its efficacy when combined with acids. In the year 1834, M. Martin Solon, at one of the sittings of the Academie Royale de Medecine, when the experiments of Barbier with codeine were the subject of discussion, confirmed his views regarding its soporific property. It appeared to him to allay the cough of the consumptive. He remarked, however, that he had not observed the effects on the ganglionic nervous system, which Barbier had witnessed. Magendie 2 took a grain of codeine, dissolved it in a* little water, and injected it into the jugular vein of a middle sized dog, which was immediately thrown into a profound sleep — readily broken, however, by any strong noise made in the vicinity of the ani- mal ; but the interruption was of brief duration, — sleep soon recurring. This condition persisted for several hours without being accompanied by any unpleasant symptoms. The effect was not the same with the muriate of codeine ; a single grain of this salt introduced in the same manner into the organism suddenly induced deep sleep, but after the animal had slept five or six hours, it died. Several similar experiments afforded a like result. Ma- gendie administered the codeine in the Hotel Dieu to different patients. He found that one grain, given once or twice, succeeded, in many cases, in inducing a quiet and soft sleep, to which no con- fusion succeeded the next day, as is commonly the case with mor- phine. As respects intensity of action, he compares one grain of codeine to half a grain of morphine. Two grains often excited nausea, and even vomiting. Magendie found the muriate to be decidedly stronger than the pure codeine. Two grains commonly induced, besides sleep, vertigo, nausea and even vomiting; but this dose succeeded like a charm, in cases of neuralgia faciei and in sciatica, which had resisted the most valued agents. 2 Dr. Miranda, of the Havana, has published 3 the results of his ex- perience with codeine in what he calls powerful nervous irritations of the mucous membrane of the stomach, and he affirms, that he cured eleven cases by the syrup of codeine alone. He began with a dram of the syrup night and morning, and gradually increased the quantity to an ounce in the twenty-four hours. His success was so striking that he is induced to " regard the discovery of codeine as fortunate for humanity, especially for climates like that of the Havana, in which gastrites are so multi- plied." The syrup of codeine, syrupus codeince, is directed by M. Cap 4 to be prepared iu the following manner : — 1 Forraulaire pour la preparation et l'emploi de pleusieurs nouveaux medi- camens. Edit. 9me. Paris, 1836. 2 Gully's Translation of the 8th edit, of Magendie's Formulaire. Lond. 1835. 3 Journal de Pharmacie, xxiv, 145- Paris, 1838. * Ibid, xxiii, 418. Paris, 1837. COLCHICUM AUTUMNALE. 123 5«. Codein. gr. xxiv. Aqua? distillat. %'w. Sacchar. puriflcat. ^viij. Reduce the codeine to an impalpable powder in a glass or porce- lain mortar. Triturate with one third of the water, allow it to settle and decant. Treat the residuum with another third of the water, and again with the remainder. Put the whole into a small rnattrass, covering the opening with a piece of moistened parch- ment perforated with a pinhole. Heat in a water bath until the codeine has entirely disappeared. Remove the mattrass from the fire to add the sugar ; cover the opening again ; agitate, and put the vessel again in the bath, until the sugar is completely dissolved. Each ounce of the syrup contains two grains of codeine. The muriate has been used in this city, but it has not been found to possess any virtues which the salts of morphine do not ; whilst its price is enormous — as much, we are informed, as four dollars the dram. COLCHICUM AUTUMNALE. Synonymes.— Colchicum, Meadow Saffron. French.— Colchique, Tue-Chien, Mort aux Chiens, Safran des Pres, Safran Batard, Vieillotte. Gei*man. — Herbslzeitlose, Zeitlose, Wiesensafran. Herbstblume. The meadow saffron is a well-known plant in the temperate parts of Europe, where it grows wild in moist meadows. It be- longs to the family Colchicacese ; and, in the Linnean system, to the class Hexandria, order Trigynia. The plant is avoided by cattle ; and its active poisonous properties have been long known ; fatal cases, indeed, still occur every now and then from its employment, not only in animals, but in consequence of its too free use in the treatment of gout. A case is given of a man who took, by mistake, an ounce and a half of the tincture, and died in forty-eight hours, after much suffering from vomiting, acute pain in the stomach, colic, purging, and delirium. 1 The cases of two children are also on record, who were poisoned by a handful of the seeds, and who died in the course of the day, death being preceded by violent vomiting and purging. In the bodies of these children, considerable redness of the mucous coat of the stomach and small intestines was found ; in other cases, no morbid appearance has been detected. 2 Colchicum is not of modern introduction. It is, indeed, the Her- modactyl of the ancients. It had, however, almost wholly fallen into neglect, when its use was revived in Great Britain, in the first 1 Edinb. Med. and Surg. Journal, xiv. 262. * Christison on Poisons, 3d edit. p. 791. Edinb. 1836. 124 dunglison's new remedies. quarter of the present century, as an excellent agent in rheumatic and gouty affections. That it is highly esteemfd as a therapeutical agent is shown by the number of officinal works into which it has been admitted. Amongst others, it is in the pharmacopasias of Austria, the United States, Amsterdam, and Anvers, and in the Ba- tavian, Belgic, Brunswick, Danish, Dublin, Spanish, Edinburgh, Paris, Ferrara, Geneva, Hamburg, Hannoverian, London, Lisbon, Russian, Saxon, Swedish, and Wirtemberg. Several chemists have investigated the composition of the plant. Pelletier and Caventou believed that they had found veratrine in it ; but, from the examination of Geiger and Hesse, it appears that the alkaloid, discovered by those gentlemen, was not veratrine, but a peculiar piinciple, colchicine, which is found in every part of the plant; crystallises in slender needles, is inodorous, and of a very bitter, and afterwards biting taste. Introduced into the nose, it does not occasion sneezing like veratrine. It has but a feeble alkaline reaction ; but neutralises acids completely, and forms with them crystallisable salts, which have also a bitter pungent taste. It dissolves with tolerable facility in water. For therapeutical purposes, the root or bulb, (cormus,) as well as the flowers and seeds of the colchicum have been administered. The fresh root has a somewhat disagreeable smell, and a bitterish acrid taste. When chewed for any length of time, it excites the secretion of saliva and thirst; destroys the feeling of the tongue; causes a sense of burning in the mouth and lips; constriction of the fauces, hiccup, violent pains in the abdomen, vomiting, diarrhoea, and discharge of blood upwards and downwards. By drying, the bulbs lose somewhat of their efficacy. The seeds have of late come much into use. They are inodorous, but of a very acrid taste. Their agency is like that of the bulb, and — some think — they are more equable in their effects. To ensure this, how- ever, they must be gathered wholly ripe, when they first become entirely black. They have been highly recommended by Dr. Wil- liams and others. The flowers are the mildest part of the plant. They have like- wise been successfully administered by several English physicians. EFFECTS ON THE ECONOMY IN HEALTH. In its effects, colchicum resembles digitalis in one thing, that it renders the pulse less frequent, 1 according to Thomson and Wallis; but, in other respects, Osann and Riecke 2 think it agrees more with the squill. In moderate doses, the different parts of the plant that have been mentioned act as diaphoretics, diuretics, and cathartics. 1 Art. Colchicum, Encyc. Wurterb. der med. Wissensch. viii. 136. Berlin, 1832. * Op. cit. S. 142. COLCHICUM AUTUMNALE. 125 On the digestive organs, they are conceived to produce less debili- tating effects than the squill. Sir Everard Home ascribes much of the griping and nauseating effect, that sometimes follows the use of the vinous and other tinc- tures of colchicum, which have not been carefully filtered, to the sediment which forms in them, and which may be removed without injury to the specific effect of the medicine. 1 Several experiments were made with the colchicum on healthy individuals. In the first case, 160 drops of the vinous tincture of the seeds were taken in 24 hours by a young man, aged 18: the first dose being 50 drops, the last 60. Seven copious evacuations were produced" with loss of appetite and debility, for 24 hours, In the second case, a youth, 17 years old, took 170 drops in 9 hours, in doses of 70, 30, and 40 drops; nausea and vomiting, and six copious evacuations followed. Third case ; a youth, aged 15, took 130 drops in 10 hours, and in four doses ; the first of 40 drops, and the last three of 30 : vomiting and only one stool were the result. Fourth case; a youth, aged 12, took 60 drops in two doses, after an interval of eight hours: nine copious watery evacuations were produced. Fifth case ; a youth, aged 17, took 40 drops at bed-time, 30 drops next morning, and 30 drops seven hours after — in all, 100 drops in 19 hours : vomiting and faintness, and five copious evacu- ations were the result. The same boy afterwards took 70 drops at one dose, which were followed by vomiting and headach,but not by purging. Sixth case ; a boy, aged 10, took 80 drops in 24£ hours, in four doses, of 20, 15, 25, and 20 drops: great sickness and vo- miting, and nine evacuations resulted. EFFECTS ON THE ECONOMY IN DISEASE. The diseases in which colchicum is recommended, are as follows: In gouty and rheumatic cases, it has been supposed to be almost a specific. Numerous practitioners have testified to its valuable agency in such affections; among these. may be named Mr. Want, Dr. Johnson, Dr. Williams, Mr. Battley, Dr. Armstrong, Sir Eve- rard Home, Sir C. Scudamore, Mr. Haden, Dr. Copland, Dr. Graves, Sir Henry Halford, Dr. Wallis, Dr. Barlow, 2 and Mr. Wigan, 3 in England ; and Locher-Balher, Kahleis, Gumpert, Plasse, Weber, Klokow, Biermann, &c. in Germany. 4 1 Brande's Dictionary of Mat. Med. p. 189. Lond. 1839. 2 Art. Gout, in Cyclopaedia of Practical Medicine. 3 Lancet, and Med. Gaz. June 30, 1838. In rheumatic gout, Mr. Wigan gives it in the dose of eight grains every hour, until "active vomiting, pro- fuse purging, or ahundant perspiration takes place, or at least until the sto- mach can hear no more." Thus administered, he pronounces it to be " the most easily managed, the most universally applicable, the safest, and the most certain specific (?) in the whole compass of our opulent Pharmaco- poeia." * Riecke, Op. cit. and Richter's Specielle Therapie, x. ISO. Berlin, 1828. 126 dunglison's new remedies. Colchicum is presumed to be the active ingredient of the cele- brated gout remedy — the Eau medicinale d'Husson — which has been considered to be formed of two ounces of the colchicum root, macerated in eight ounces of Sherry wine; the dose being from twenty to eighty drops. In acute rheumatism, as well as in various inflammatory affec- tions, colchicum was proposed by the author's friend, Mr. Charles T. Haden, 1 as an excellent sedative to reduce the excited organic action, which he conceived it capable of effecting to such an ex- tent, that blood-letting might generally be rendered unnecessary in febrile and inflammatory disorders; 2 yet, in the very cases in which it was esteemed so appropriate by Mr. Haden and by Carminati, 3 it is regarded unadvisable by others. Thus, Riecke, 4 speaking of its use in acute rheumatism, says that it was at one time given in that disease under the most opposite circumstances, but that it was soon found necessary to restrict its employment within nar- rower limits, and to pretermit it when any considerable febrile con- dition existed. We have often exhibited the different preparations of colchicum in gout, and frequently with decided advantage; but very often it has failed altogether. In our own person, it has never appeared to prevent or to modify the paroxysm. In acute, and the same may be said of chronic rheumatism, its advantages have not been by any means clearly marked in our experience, yet many physicians tes- tify most strongly in its favour. Like other acronarcotics, as the actaea racemosa, when pushed to the extent of slightly affecting the system, as shown by nausea, with some cerebral confusion, it has at times effected a revulsion, which has broken in upon the morbid chain in cases of acute rheumatism. In chronic rheumatism it has exhibited less marked results: yet there is no agent, perhaps, which is so much employed in rheumatic, cases in general. In none of these cas-es, according to most observers, need any sensible evacuation be produced by it, although some, we have seen, have affirmed — and such is the result of our observation — that it is more efficient when it evinces its influence upon the skin or alimentary canal. 5 The vinous tincture of the seeds has been extolled in the tetanus of warm climates, by Dr. W. G. Smith, 6 of Port-au Prince. He begins with 3ss. and increases the dose every half hour, repeating 1 Practical Observations on Colchicum Autumnale in Inflammatory Dis- eases. Lond. 1820 2 See, also, Dr. Lewins, in Edinb. Med. and Surg. Journal for April, 1837, and in Brit, and For. Medical Review, for Oct. 1837, p. 565. 3 Memor. dell' Instituto del Regno Lombardo-Venet. 1819. * Op. cit. S. 143. 5 See Wood and Bache's Dispensatory, Art. Colchicum; and Lewins, Op. citat. 6 Amer. Journ. of the Med. Sciences, for Nov. 1535, p. 66. COLCHICUM AUTUMNALE. 127 it until emesis or catharsis has been produced. The remedy is then discontinued. In dropsy, colchicum was used of old with good results; and it has been employed in modern times. Carminati gives the details of a case of dropsy supervening- in scarlatina, and Plasse, one of hydrothorax, in which it was advantageously prescribed. In such cases, it may be well to push the remedy until it affects the bowels. In chronic bronchitis it has been given by many physicians, and especially by Drs. Armstrong 1 and Hastings, 2 with advantage. By Ritton 3 it has been advised as an extremely efficacious remedy in leucorrhoea, in the dose of five grains of the powder three times a day ; and in several spasmodic diseases it has been extolled by Raven. Mr. Tait 4 speaks in exalted terms of it in scarlatina — the dose, to children from four to six years of age, being three or four drops of the vinum colchici every three or four hours. Mr. Fosbroke advises it in ischuria; Elliotson saw favourable effects from it in obstinate prurigo; Bullock gave it in erysipelas; and by Chisholm and Baumbach 5 it was exhibited successfully against tapeworm. The colchicum is sometimes applied externally as a liniment to rheumatic joints, in the form of the tincture of the seeds or bulb. 6 Of late, it has been recommended by Mr. Wansborongh in gout; 7 two drams of the tincture of the seeds being added to giv. of a spirit lotion. It is affirmed, however, that the local use of morphine had the same effect, 8 — the part being bathed in hot water for a minute, and then lint being applied, spread with simple cerate, on which about three grains of acetate of morphine were distributed. Still more recently, Mr. Laycock 9 has advised the tincture of the root as an external application in rheumatism, alone or combined with the tinctura camphorae. It has been used in the author's clinique at the Philadelphia Hospital, and often with advantage; but whether much or any of the benefit was produced by the col- chicum, the author was unable to decide. MODE OF ADMINISTERING. Colchicum is not so frequently given in substance, although we often prescribe it in this form. The dose of the powdered root is from three grains to ten, given several times in the day. The offi- 1 Pathology of Consumptive Diseases. Lond. 1822. 2 Inflammation of the Mucous Membrane of the Lungs. Lond. 1821. s Lancet, August 2, 1834. 4 American Journal of the Medical Sciences, May, 1838, p. 205. 6 Rust's Ma«azin, B. xxi. S. 270; and Osann, in art. Colchicum, in Encyclopad. Worterb. der raedicin. Wissenschaft. B. viii. S. 136. Berlin, 1832. 8 Dictionnaire de Maiiere Medic, par MM. Merat & De Lens, ii. 361. 7 Lancet, July 29, 1837. 8 Ibid. August 5, 1837. 9 Lond. Med. Gaz. March 16, 1839. 128 dunglison's new remedies. cinal preparations of this country and Great Britain are; — the acetimi colchici (United States and London); the oxymel colchici (Dublin)-; the syrupus colchici (United States and Edinburgh); the vintim colchici radicis (United States and London); and the extracturn colchici aceticum (London). These are made from the bulb. The officinal preparations from the seeds are the tinctura semi- num colchici (Dublin); and vinum colchici seminis (United States). 1 The London Pharmacopoeia has, likewise, a spiritus se- minis colchici ammoniatus or tinctura colchici composita, which is much used by the English physicians; and is formed by mace- rating two ounces and a half of bruised colchicum seeds in a pint of aromatic spirit of ammonia. Battley recommends an Extracturn colchici e succo bulborum recenter expresso, and such a prepara- tion is in the Pharmacopoeia of Austria. 2 The dose is two grains every two hours. Dr. A. T. Thomson recommends a saturated vinous tincture, made by macerating an ounce and a half of the dried bulb in twelve ounces of white wine. From thirty to sixty minims to be given to gouty patients when in pain. The dose of the powdered root or seed is, as we have said, from three to ten grains; of the acetum colchici, from thirty minims to one fluid drachm; of the syrupus colchici, from one fluid dram to half a fluid ounce; of the vinum colchici radicis, from fifteen mi- nims to one and a half fluid dram; and of the vinum colchici seminis, from one to two fluid drams. Dr. Copland 3 suggested the use of the fresh flowers in the form of vinegar, tincture, &c, as milder than the seeds or bulbs, and yet equally efficacious in rheumatic and other affections; but they are not employed. Mistura Colchici. Mixture of Colchicum. &. Magnes. sulphat. gj to gij. Aqua? menth. crisp. Jx. Solve in Adde Acet. colchic. 3j ad §iss. Syrup, croc. gj. Magnes. Bviij. M. To be well shaken. Three table spoonfuls to be administered, so that from four to six evacuations may be produced in twenty-four hours. Given in paroxysms of gout. Sir C. Scudamore. •Dunglison's General Therapeutics, Philad. 1836; and Dispensatory of Messrs. Wood and Bache. * Jourdan's Pharmacopee Universelle, i. 436. Paris, 1828. 3 Lond. Med. Repos. 1823. Solve in CORTEX ADSTRINGENS BRASILIENSIS. 129 Guttce. Colchici Composite^. Compound Drops of Cholchicum. &. Extract, aconit. 9i. to ^ss. Vin. sem. colchic. §ss. M. Fifteen, twenty, thirty, or forty drops to be given three times a day. Weber. 5<. Tinctur. sera, colchic. guaiac. sirapl. aa. giij. M. Dose — Thirty or forty drops three times a day, in chronic rheu- matism. Blasius. B<. Tinct. sem. colchic. digit, aa. £ij. Sp. aether, nitric 3j. M. Dose — Twenty drops on sugar. Hildenbrand. Pihdce Colchici. Pills of Colchicum. £. Pulv. colchic. gr. iij. Saponis medic, q. s. ut fiat pimla. Dose — Three daily, increasing the quantity to five or six. RlTTON. Linimentum Colchici et Camphorce. &. Tinctur. rad. colchic. Camphors, aa. partes sequales. M. Laycock. CORTEX ADSTRINGENS BRASILIENSIS. This bark was introduced into Germany, in the year 1818, by Schimmelbusch, a merchant, who carried it from Brazil, where it had long been used internally as well as externally, as an excellent astringent. 1 According to Von Martins, 2 it is the bark of the acacia jurema, but this is not certainly determined. 3 Merrem 4 affirms, that the genuine bark is in more or less flat pieces, at times in half, or complete rolls, from four to twelve inches long; from an inch to two inches und a half broad, and from one to four lines thick : these arc more frequently straight than crooked. The bark may be sepa- rated into two parts, an outer, which is rough, and an inner rind ' Von Schlectentlal, in Encyclop. Wiirtcrb. dermedicin. Wissenschaft. B, viii. S. 538. Berlin, 1832. 2 Reise, ii. 788. 3 Riccke, Dip neuern Arzneimittel, S. 146. 4 Ueber den Cortex adstringens Brasiliensis. Koln, 1828. 8 — a dungl 9 130 dunglison's new remedies. of a smooth fibrous character : the two are but loosely connected together. The outer bark is of a grayish brown colour, traversed by longitudinal and transverse furrows, having, here and there, white and grayish white crusty growths, covered with a foliated lichen. The inner bark is of a dark red brown on its outer sur- face, and, after the outer bark has been separated, is somewhat smooth : on the inner side, it is of a brighter reddish brown, and, probably owing to the laceration of the woody splinters, somewhat fibrous. The younger bark is smooth in the fracture, and of a dull splendour. The older bark, which is thicker, is unequal, and may often be separated into fibrous layers, which are readily lacerable. When chewed, it has a tolerably strong astringent, somewhat bitter and disagreeable taste, but it does not excite nausea, or leave any arriere-gout. It has scarcely any smell. In its chemical relations, it resembles the ratanhy. 1 EFFECTS ON THE ECONOMY. Merrem, who made numerous experiments with this bark, affirms, that whilst it possesses the properties of astringents in general, and to a high degree, it is rather sedative than exciting, agrees with the digestive organs, and aids the peristaltic action. He employed it, first, with more or less success, in hemorrhage — in epistaxis, haemoptysis, and metrorrhagia; and Gunther 2 found it very effica- cious in profuse menstruation arising from atony of the uterus. Secondly; in mucous discharges, as leucorrhoea, blennorrhoea, &c. Thirdly ; in inflammatory and exanthematous affections — as cy- nanche, urticaria, and in periodical erysipelas of the face. Fourthly ; in nervous diseases, especially when combined with disturbance of the menstrual function, and leucorrhoea: and, fifthly; in weakness and catarrhs of the genital organs, bladder, and rectum. The In- dians consider, that the bark affects especially the generative appa- ratus, and, from the experiments of Merrem, it would seem, that its agency is more particularly exerted in cases of leucorrhoea ; and in many, after the cinchona had been administered without effect. 3 MODE OF ADMINISTERING. Merrem prescribed it in various forms. He gave the powder in doses of from £j to 3ss, three or four times a day, mixed with water. It appeared to him to act most beneficially in cases of mu- cous discharges unaccompanied by disorder of the digestive func- tions ; and he found that the powder was better borne by some * See the analysis by Hofrath Trommsdorff, in Brande's Archiv. B. xxxiii. S. 260; and Dierbach in Heidelberg. Annalen, B. x. H. 3. S. 357. Heidelb. 1834. 2 In Harless Rhein-Westphal. Jahrbuchern, B. viii. St. 1, S. 72; and Brande's Archiv. Band xi. S. 200. * Osann, in Encyc. Wurterbuch der medicin. Wissensch. viii. 541. CREOSOTON. 131 than the decoction, which is somewhat singular, as the woody matter is more apt, in such cases, to disagree. He rarely gave it com- bined with aromatics, and never found the combination of use. To form the decoction, an ounce of the coarsely powdered bark was boiled with sixteen ounces of water, down to gviij ; and to this an ounce of syrup was added. The dose was from one to two spoon- fuls every two hours. Merrem also prepared an extract, and a tincture, in the same manner as these preparations are made of the cinchona ; of the former he took from one to two drams, dis- solved it in six ounces of an aromatic water, and added §ss of syrup. Of the mixture, a spoonful was given every hour. Externally, the decoction was injected three times a day in leucorrhoea, and in blennorrhoea ; or, in the former disease, a sponge imbued with the decoction, was introduced, and kept there for some time. It has been applied, also, as an astringent to ulcers. Mistura Corticis Brasiliensis Adstringentis. Mixture of the Astringent Bark of Brazil. fy. Decoct, cort. adstring. Brazil. §vij. Copaib. cum vitelli ovi q. s. subact. Tinct. ferri pomati aa. ^ij. Syrup, balsam. §j. M. Dose. — A spoonful every two hours, in obstinate gonorrhoea and leucorrhoea. Merrem. &. Cort. adstring. Brasil. ^ss. Coque cum aquae fontan. q. s. Sub fin. coction. adde Herb, sabin. |ss. Colaturse §viij. adde Syrup, cort. aurant. ^j. Dose. — A spoonful every hour, in cancer of the uterus, and in the hemorrhage thence arising:. Merrem. CREOSOTON. Synonymes.— Creosoturn, Kreosoton, Kreosotum, Creasoton, Creosote, Cre- asote, Kreosote, Kreasote. German. — Kreosot. This substance was first discovered, a few years ago, by Reichen- bach, of Blansko. and is extensively employed as a therapeutical agent. Its marked chemical properties suggested, that it might be possessed of a decided influence on the economy, and numerous experiments were immediately instituted to test the accuracy of the notion. These were of the most opposite character, and it is not 132 dunglison's new remedies. surprising, as in every similar case, that there should have been great discrepancy in the results, and in the opinions deduced there- from. There can be no doubt, however, that the creosote forms a valuable addition to the list of our remedial agents. MODE OF PREPARING. The process given by Koene, 1 is esteemed one of the best for preparing it on a large scale ; — almost the only way in which it is formed : we consequently meet with it only in commerce; — being rarely made in the shops. Tar, derived from pit-coal, is distilled in a retort provided with a long tube, having a large mouth. Under this is placed a receiver. The oil, which comes over first, swims on water; and it is neces- sary to remove, from time to time, ihe products of the distillation, until an oil is obtained, which sinks in water. When this is the case, the product is collected. The heavy oil, obtained during the distillation, condenses not only in the receiver, but in the tube of the retort, where it unites with the naphthaline, forming a butyra- ceous substance. By applying a gentle heat, the mass will drop into the receiver. The product is now allowed to remain in a cool place for some hours, after which it is pressed. The expressed naphthaline still contains oil, which is separated by heating it with its own weight of acetic acid, until it melts. After allowing it to cool, the crystallised naphtha is pressed, and the acid adhering to the creosote is saturated with subcarbonate of potassa. The creosote, is now to be shaken for a quarter of an hour with phos- phoric acid, the proportions being half an ounce of the acid to twenty ounces of the oil. The mixture ought then to be agitated with its bulk of water, and afterwards be distilled with a graduated heat, care being taken to separate the oil which floats on the sur- face. The rectified oil is now to be dissolved in its own volume of a hot solution of caustic potassa. s. g. 1.120. When it has been allowed to cool for half an hour, the supernatant oil is again re- moved, and the heavy oil again treated with caustic potassa, only a fourth part of the solution being, however, employed this time. On uniting the solutions of potassa, a slight excess of diluted phos- phoric acid is added, and the free creosote, which floats on the sur- face, is separated. It is again rectified ; and the first product — which is chiefly water — being rejected, the creosote comes over pure. M. Koene recommends the substance, thus prepared, to be preserved in bottles, covered with black paper. A protracted and complex process, like the above, necessarily makes the drug expensive, especially as the quantity obtained is 1 Annales de Chimie et de Physique. Juillet, 1835. See Cormack on Creosote, p. 36. Lond. 1S36; or the Amer. edit, in Dunglison's American Medical Library ; also, Turner's Chemistry, 5ih edit. p. 872. CREOSOTON. 133 but small. M. Koene procured by it ten drams from thirty-two ounces of tar. M. Lemere, one of the first Parisian pharmaciens who made pure creosote, obtained from eight hundred pounds of tar about six pounds of creosote. Reichenbach generally prepared it from the tar of the beech by six distillations ; dissolving it afterwards in a solution of caustic potassa three times, setting it free successively by sulphuric acid. 1 Giordano 2 has recommended the following simplified mode for obtaining it. Distil wood tar from the willow, at an elevated tem- perature, from a tinned copper retort, until the residue has the con- sistence of a soft pitch. Re-distil the liquor passed over till its residue resembles the former. The liquor, neutralised by subcar- bonate of potassa, or lime-water, is re-distilled till all the oil of creo- sote has passed over. The oil is dissolved in caustic potassa, from which, after simmering a little, in a porcelain vessel, and cooling, the eupione, which floats, is easily separated. The same opera- lion is repeated with the eupione, to remove all the oil that is united with it. The saponaceous liquor, treated with dilute sulphuric acid, is distilled into water, from which the creosote is separated, and the water saturated with creosote is kept for external use, or re-distilled for a concentrated acetic acid of a pungent and most agreeable odour. Creosote is a colourless, transparent fluid. Its refractive power is very great, and in angular glass vessels it is beautifully irides- cent. Its odour is penetrating, and disagreeable, but not offensive: many compare it to that of castor. It adheres to every thing, and is somewhat permanent. Its taste is at first very burning and caustic to the tongue ; but on admixture with the saliva, it becomes somewhat sweetish. It has an oleaginous feel, and is of about the consistence of oil of almonds. Its specific gravity, at 68° Fahr., is 1.037. It boils at 397°, and at— 17° does" not congeal. When placed on paper, it forms a greasy spot, which, however, dis- appears after a while, and can be removed by the application of a heated body, without any residue. It is a non-conductor of electri- city. With water at 08°, it unites in two different proportions ; — one of the combinations consisting of 1| parts of creosote and 100 of water ; the other of 10 parts of water and 100 parts of creosote. The taste of the first mixture— creosote water — is very burning at first, and afterwards sweetish, like that of pure creosote, but of 1 For an account of this and other products of the destructive distillation of vegetable matter, see Cormack, Op. cit. Reichenbach's observations and experiments are contained in a work entitled " Das Kreosot in chemischer, physischer und medicinischer Bezichung, von Dr. K. Reichenbach, u. s. w. Zweite mit Nachtragen und Zusatzen von Sehweigger-Seidel verm. Aus- gabe. Leipz. 1835;" and Annales de Chimie, liii. 325. Paris, 1S33. 2 Annali di Medicina, Aprile, 1835, and Br. and For. Med. Rev. July, 1836, p. 283. For the process of Calderini, see Edinb. Med. and Surg. Journ. for Oct. 1834; and for that of M. Cozzi, see Journal de Chimie Me- dicate, and American Journal of Pharmacy, Jan. 1839, p. 339. 134 dunglison's new remedies. course weaker. A drop of creosote in 10,000 parts of water pro- duces a marked impression on the tongue, and has a smoky smell. Litmus and turmeric paper are not in the least changed by it ; so that it has neither an acid nor an alkaline reaction. At both poles of the galvanic battery, it furnishes numerous and striking combi- nations. It does not possess the property of the ordinary empy- reumatic oils, of becoming yellow and inspissated. It dissolves iodine, phosphorus, and sulphur. Acetic acid at 1.070, and alcohol, dissolve it in all proportions. Ether and petroleum likewise com- bine with it in all proportions. With potassa, it forms two or three combinations, one of which crystallises. Resins and resinous bodies either decompose creosote, or it decomposes them. With balsams, fixed and volatile oils, camphor, and the vegetable alkaloids it unites readily. It coagulates albumen, and its antiseptic property is most remarkable, whence its name, from xge«s, flesh, and <™&, I preserve:— o-wTo;, "preserver." Fresh meat, placed in creosote water for half an hour or an hour, and then taken out and dried, may be exposed to the heat of the sun without undergoing putrefaction. Nay, when flesh has begun to be putrid, the process ceases after it has been washed with creosote water, and if suffered to remain immersed in it for an hour, it does not subsequently pu- trefy. There can be but little doubt, consequently, that creosote is the main antiseptic and conservative principle of the pyroligneous acid, and of tar water. From the experiments made by Reichenbach to determine the exact components of the flesh on which the creo- sote acts, he arrived at the following results. It unites with the albumen and red particles of the blood in the flesh, which it coagu- lates, without acting on the fleshy fibre, which serves merely as the frame-work for the coagulated matters ; and it is well known that dried albumen does not putrefy, but becomes hard, brittle, and transparent. EFFECTS ON THE ECONOMY IN HEALTH. Reichenbach has properly remarked that the excessive burning pain in the tongue, which creosote causes, must have at once sug- gested it to be a poisonous substance. It was soon found that plants, sprinkled with creosote water, died ; that fish placed in it were convulsed: and that small animals, as wasps and fiies, died when touched with pure creosote. If a small quantity of it be spread upon the hand, and washed off a minute afterwards, the place is found to present a white appearance, but without pain or in- flammation. In the course of a few days, the place becomes dry, and the cuticle desquamates. When creosote is applied to a part where the epidermis is deficient, or to a wound, instantaneously an extremely violent burning pain is experienced, which continues for eight or ten minutes, but if the part be carefully washed, it gradu- ally ceases. The cause of this is conceived to be the property which creosote possesses of congulating albumen; and, where CRE0S0T0N. 135 blood is flowing, of arresting it. If the rapid disturbance, which it. excites, affects important organs, death results sooner or later according to their importance in the economy ; relief, however, may be afforded by those substances that dissolve coagulated albu- men, as caustic alkalies, acetic acid, the veins ; no special symptoms were induced by it, but this appeared to be owing to the blood being instantaneously coagulated by it, which not only prevented the farther progress of the creosote, but also of the blood, hence no evil consequences resulted ; and it is probable, as Riecke has suggested, 1 that the weaker the solution of creosote, within certain limits, the greater may be its effect on the mass of blood. Corneliani, 2 an Italian physician, has also instituted a series of 1 Die ncuem Arzneimittel, u. s. w. S. 153. 2 Giornale delle Scienze Medico-Chirunriche, No. 8. Febrajo, 1835; Brit, and Foreign Med. Review, p. 265, Jan. 1836, and Journ. de Chimie Medi- cate, Fev. 1836. 136 dunglison's new remedies. experiments with creosote on lambs, rabbits, &c. All these animals bore small doses of creosote — however unwillingly it might be taken — without any remarkable results, and without loss of appe- tite. Large doses, however, immediately occasioned general torpor, sudden inclination to pass the urine, paralysis — especially of the lower extremities — with or without convulsions, and frequently the ejection of a bloody foam. When the doses were large, and it was but little diluted, death took place in a few minutes, and on exami- nation, the inner lining of the stomach was generally found cor- roded, yet not so constantly as to allow of death being ascribed to that circumstance. It followed, farther, from his experiments, that pure creosote ap- plied to a denuded nerve, or injected only in small quantities into a vein, may occasion death suddenly, and that the application of the creosote to extensive wounded surfaces in the same animals may be ultimately followed by fatal consequences. Where a very large dose of creosote was administered, immediate death was produced without organic lesion. In the trials made with it by Dr. Elliotson, 1 he found no action produced upon the bowels; but it sometimes augmented the quan- tity of urine. He once saw it, in doses of a minim three times a day, cause micturition nine times in an hour. In another case, in doses of three minims, it produced severe strangury. According to Simon, when applied to the muscles, it destroys the surface like a caustic. Miiller and Reiter, in their experiments, found that it speedily rendered the muscular fibres of a dirty whitish ap- pearance, and readily lacerable. When applied to the fresh blood of the hog, it converted the colour in an instant to an ashy gray ; after which it became black and quickly coagulated. Mixed, either pure, or diluted, with blood, it thickens it, the mixture assumes a brown red colour, and it is found studded with small white points, which are nothing more than coagulated albumen. On exposing the coagulum to the air, it assumes a yellowish red colour. Reich, on the other hand, who appears to have made many experiments with creosote, both in internal and external dis- eases, affirms, that he has never observed any caustic effect from it ; from which assertion, as Riecke has remarked, 2 the only inference to be deduced is, that he must always have applied it largely diluted. Fremanger likewise asserts, that when pure creosote is applied to the epidermis, it does not destroy it; but merely occa- sions more or less redness of the skin. When applied to a suppu- rating surface, it caused, instantaneously, the formation of a white pellicle, owing to its coagulating the albumen contained in the secretion from the wound. Adventitious tissues, with which it is brought in contact, are destroyed by it. When placed between the lips of a wound it prevents healing by the first intention, by coagu- 1 Medico-Chirurg. Transact, vol. xix. Lond. 1835. 2 Op. cit. S. 154. CREOSOTON. 137 lating the albumen, and, consequently, it may be employed in all cases where it is desirable to prevent the growing together of parts. Fremanger is, indeed, disposed to refer all its efficacy to the action, which it exerts on albumen. Its long continued use often occasions an inflammatory condition which, as Dr. J. L. Da Luz 1 observes, has nothing in common with the disease, for the cure of which it may have been prescribed. In a case of porrigo favosa treated by it recently by the author, febrile irritation supervened, and the head was covered by an arti- ficial eruption, which induced, however, a new action in the inter- mediate system of the scalp, and after its subsidence, the porrigo was cured. Dr. Cormack, of Edinburgh, has likewise instituted various ex- periments on the lower animals to test the physiological effects of creosote. 2 In three experiments, about twenty-five drops of pure creosote were injected into the venous system of dogs. All the animals died. In every case of poisoning by it, which he has ob- served, Dr. Cormack found the following to be the symptoms: — Its first deleterious action was a powerful one of sedation on the heart ; the vital energies of that organ seeming to be instantaneously para- lysed. In some instances, hurried and sonorous respiration went on for more than a minute after the heart had ceased to beat. In general, one or two convulsions, resembling the tetanic, preceded death ; and, almost invariably before expiring, the animal uttered one or more shrill cries. In every instance, the atony of the heart immediately after death was very striking. From other experiments it appears, that when creosote is injected into the arteries the deleterious effects are of a much milder cha- racter, and if the dose is not large, the animal may experience but little inconvenience ; a circumstance, which proves the importance of a thorough admixture with the blood before the poisonous article reaches the heart ; such admixture not taking place, to the neces- sary extent, when the poison is injected into the veins, but being readily effected when injected into the arteries, and consequently distributed through the capillary or intermediate system. When taken for any length of time, the urine acquires a blackish hue, and in some cases it can be recognised in the urine. 3 EFFECTS ON THE ECONOMY IN DISEASE. Creosote has been administered in various diseases, and the fol- lowing may be esteemed a summary of the therapeutical experi- ments made with it. 1. Hemorrhage. The discovery of creosote happened at a time, when the Aqua binelli enjoyed more confidence as a styptic than it 1 Jornal da Soeiedade das Sciencas Medicas de Lisboa. torn. v. Lisboa, 1S37 ; reviewed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. 2 Op. cit. p. 86< * Dr. Macleod, in Medical Gazette, xvi. 599, and xvii. 653. 138 dunglison's new remedies. does now ; and the fancied probability, that the nostrum was in- debted to the creosote for its properties, gave rise to many experi- ments with the latter in cases of hemorrhage. One of the first, who instituted experiments with it on rabbits, was G. Simon. Not being able to obtain any striking results from the aqua binelli, he tried the creosote, pure, as well as in the form of creosote water, and of an emulsion prepared with gum arabic ; and from the results of these he was led to affirm, that although creosote occasioned the coagulation of the albumen of the blood, it acted no better as a styptic than cold water. With the aqua binelli he was not able to coagulate albumen. The rapid separation of the albumen in the form of a reddish gray coagulum under the influence of the creo- sote, he found to be of no advantage, as the mass remained soft and pulpy; and the wound in the vessel could not close, but was im- mediately opened by the stream of blood. Neither did he esteem it adapted for arresting trifling hemorrhages; for, when very much diluted, it is still too exciting to the injured parts, and markedly delays their union. This, indeed, might, he thinks, be expected from the fact, that pure creosote, when placed on the skin for ten or twenty minutes, induces superficial inflammation. The experiments of other physicians have been decidedly more favourable. Miiller and Reiter, 1 for example, in theirs, found that creosote was far more efficacious than the aqua binelli, for, when the latter was prescribed, it was always necessary to have recourse to other agents, before the hemorrhage was arrested. In their ex- periments on dogs, they found the hemorrhage from a divided crural vein quickly cease, when a compress of cotton, wetted with creosote, was placed on the vessel, with a moderate degree of pres- sure. Three days afterwards, the crural artery was exposed on the same dog, and divided : but it was afterwards necessary to tie it, as the creosote, in consequence of the excessive hemorrhage, could not be brought into immediate contact with the vessel, but merely acted on the superficial layer of blood, and therefore did not arrest the hemorrhage. The crural artery of a young and tolerably strong dog was cut a short distance above its division, compression being at the same time exerted upon the trunk. The artery did not bleed. Nine minutes afterwards, a compress of cotton soaked in creosote was applied immediately to the divided extremity of the artery, with some degree of pressure. When the compress was removed, the bleeding was entirely arrested, and the wounded surface was dry, and had an ashy gray hue. In an old dog, hemorrhage from a divided crural artery was arrested by the same means, but not so speedily. When the artery was examined, it was found to be wholly closed, having a navel-like depression at the extremity, which disappeared when the vessel was pressed upon, and ultimately became conical. 1 Schmidt's Jahrbuch, cited in Encyclographie dcs Sciences Medicales, Mars, 1837. CREOSOTON. 139 Within the vessel was a conical coagulum, which could be readily- detached ; and for the space of a line, the artery appeared inflamed through its coats. In arteries that had been divided for a longer time, the union was likewise complete ; but there was this difference, that the in- flammation at the end of the vessel had disappeared, and a pointed fibrous caruncle was observed in the vessel, which was doubtless the fibrinous portion of the previous coagulum. From their experiments, Muller and Reiter were led to confirm the haemostatic properties of creosote, both when the hemorrhage occurs from veins and from arteries. The arteries divided were of considerable size, larger than the radial artery of an adult male. They consider pressure indispensable to occasion the creosote to act immediately on the artery; and the arrest of the hemorrhage, they ascribe, — not alone to the coagulation of the blood, but to the con- traction of the arteries. In parenchymatous hemorrhage, the aqua creosoti was generally sufficient ; as well as in tolerably extensive wounds of the surface. Horing, also, obtained satisfactory results from his experiments on animals. He exposed, on an old cat, the crural artery and vein of the right side; made a small incision into the latter, and pressed upon it to stop the copious flow which ensued : he then applied over the wound, for two minutes, a small compress of lint, wetted with a solution of creosote — two drops to one hundred of water — and the bleeding ceased. The artery was now opened, and a similar compress placed upon it with the same result. Two days after- wards, a second experiment was made of the same kind, except that, owing to the struggles of the animal, a larger opening was made into the crural artery. In this case, it was necessary to apply the compress for four minutes before the hemorrhage ceased. In another cat, a large transverse incision was made on the inner sur- face of the right thigh, above the middle, by which muscles, arte- ries, veins, and nerves were divided. Two large compresses of lint, wetted with a solution of creosote, were then pressed on the parts for five minutes, and the bleeding entirely ceased. The like result was obtained in the case of an old horse, whose jugular vein was opened. But the creosote solution did not succeed in wholly arresting the hemorrhage in the same horse, when an opening was made into the crural vein and artery. To these experiments on animals may be added some that were instituted on the human subject, and which testify, more or less, to the efficacy of creosote as a haemostatic. Hahn applied it in some insignificant cases, but saw no better effect from it than from cold water. Most found it speedily arrest slight hemorrhages from small vessels. Horing applied it successfully in a case of epistaxis, which had obstinately resisted other agents,— two plugs of lint, dipped in a solution of creosote being inserted in the nostrils, after which the hemorrhage soon ceased. Fichtdauer employed it with equally advantageous results in violent bleeding from leech bites, after 140 dunglison's new remedies. several haemostatics had been used in vain ; and Heyfelder extols it for arresting hemorrhage from'large wounded surfaces. Berthelot differs with Fremanger and Simon, who affirm that union by the first intention is prevented by it. The results of his obser- vation were entirely opposite. Miguet applied it successfully as a haemostatic in fresh wounds on man and animals. Both pure creo- sote and a solution of it were, however, unsuccessfully used by Bardili in hemorrhage from the arteria tibialis postica, which he ascribed to the blood having lost its albumen, owing to the exces- sive discharge. Reich and Hauff found injections with creosote water very useful in haemorrhagia uteri. Schneider had a case of hemorrhage that had continued for seven hours in a man eighty years old, and which proceeded from the gums of the upper jaw ; the blood oozing as from the pores of a sponge. He directed the man to take as much aqua creosoti into his mouth as he was able; and after three repetitions the hemorrhage ceased, and did not recur. Kohler 1 endeavoured to test the haemostatic operation upon him- self. He made an incision in his forearm an inch long, and three or four lines deep, to which he applied creosote water. A lanci- nating pain was felt in the wound, but no other sensible effect. A drop of pure creosote was now let fall between the lips of the wound : this was followed by a sensation of burning and drawing; for a moment, coagulated flakes of a whitish gray colour covered the wound, and there was a temporary cessation to the flow : it soon, however, recurred. After a time the hemorrhage ceased ; but not sooner — Kohler thinks — than if cold water had been applied. The feeling of burning and drawing continued, however, for some time ; the edges of the wound were somewhat swollen, and oede- matous, and, in about four hours, were covered with a yellowish brown lymph; but there seemed to be no delay in the cicatrisation. J. L. da Luz 2 found it an excellent styptic in capillary hemor- rhage ; but in hemorrhage from great vessels it does not prevent a recurrence of the bleeding. In haemoptysis, too, the internal use of creosote has been found beneficial. Santini 3 prescribed it in a desperate case with complete success, and with Schmalz it was equally effective ; on the other hand, it was of little avail in Guitti's hands. 2. Burns. — Most used creosote with decided relief in burns of the second and third degree, applied by means of rags wetted with creosote water. Berthelot also cured two cases quickly with it; the slightly burnt places becoming desiccated ; the more severe healing by the formation of a crust. Guitti applied both creosote water and creosote ointment with advantage in burns which had proceeded to profuse suppuration ; hence, it has been advised, — 1 Neue wissenschaftlich. Annalen, u. s. w. B. i. H. 3. S. 285. Berlin, 1835. 2 Op. cit. 3 Gazetta Therapeutica di Verona, Mars, 1834; and Amer. Journal of the Med. Sciences, Feb. 1836, p. 502. CRE0S0T0N". 141 3. In -profuse suppuration, on the authority of Levrat and Ber- thelot, but according to J. L. da Luz, 1 it has no marked influence on the secretion of pus, and is therefore useless in suppurating ab- scesses. In otorrhoea it. has been especially beneficial. 4. Lesions of the integuments. — According to Reichenbach, creosote is of essential service in the intertrigo of children, as well as in the excoriation induced by lying. In the latter case, Guitti used it with success. Hahn also frequently employed it. In cases where ulceration had not taken place, he washed the parts several times a day with creosote water, and was of opinion that he had prevented, in some cases, the occurrence of ulceration. Where ulceration had already taken place, he covered the parts with linen rags folded two or three times, which he soaked in creosote water, and fixed them on by means of adhesive straps. The superficial ulcers soon healed ; and the deeper were transformed into hollow surfaces, secreting a homogeneous serous fluid, but no pus. Horing employed creosote water with advantage in sore nipples ; and in sprains and contusions, the creosote ointment has been re- commended by Dr. Fife. 2 5. In chilblains, whether ulcerated or not, Hahn 3 used creosote washes successfully ; — the affection yielding in a few days : and Dr. Herndon 4 regards the creosote ointment as the best remedy in that affection with which he is acquainted. 6. Ulcers. — Fissures of the skin and superficial ulcers, according to Hahn, were changed, under the application of the creosote water, into a blackish brown scab, which adhered for a long time, and when it fell off, left the parts healed ; or by occasioning too much shrinking of the parts, gave rise to fresh inflammation and suppu- ration. Deeper ulcers were affected in the same manner as those caused by long lying. The efficacy of this agent \a atonic and varicose ulcers, espe- cially of the leg, has been attested by Levrat, Berthelot, Rossi, Hechenberger, and others ; but Guitti, Heyfelder, and Schmalz were less satisfied with it. Very recently, a case of indolent ulcer, between the knee and ankle, accompanied with a good deal of inflammation, was cured, in five weeks, by the application of a solution of creosote (ten drops to the ounce of water), with me- thodical compression to the limb, by means of a bandage. 5 Meister found the application of creosote water, in cases of carious, scrofu- lous, syphilitic, fistulous, and sanious ulcers, to be striking, and almost uniformly useful. Heyfelder, likewise, found it extraordi- narily useful in scrofulous ulcers, and Dr. Cormack 6 states, that he had recently an opportunity of seeing a case of this kind treated by Dr. Shortt, in the Royal Infirmary of Edinburgh, 1 Op. cit. 2 Lond. Med. Gazette, April 7, 1838, p. 66. 3 Gazette M£dicale de Paris, Dec. 1834. 4 American Med. Intelligencer, for March 15, 1838, p. 425. 6 Boston Medical and Surgical Journal, July 3, 1839, p. 332. 6 Op. cit. p. 106. 142 dunglison's new remedies. where an extensive scrofulous ulcer of the hip, after resisting a variety of treatment, at last yielded to creosote, and was ulti- mately completely cicatrised. On the other hand, Otto tried both the pure creosote and the watery solution in ulcers of various kinds, especially in the scrofulous ; the ulcers very generally put on, in the course of twenty-four hours, a cleaner appearance; still they did not cicatrise, on which account Otto prefers, in old ulcera- tions at least, the use of a solution of chloride of lime; for notwith- standing creosote diminished and improved the character of the suppuration from scrofulous ulcers, and rendered them cleaner, it did not ameliorate the genera] condition ; after the diminution of the suppuration, local pains, loss of sleep, and slight febrile move- ments generally supervening. On these accounts, Otto does not think creosote applicable to scrofulous ulcers in general. In scrofulous caries, many observers depose to the good effects of creosote. Among these may be mentioned Hahn, Coster, Ritgen, Fremanger, and HaufF. In fistulous ulcers— also of syphilitic origin — several physicians have employed it beneficially. Dr. Fife, 1 of Newcastle-upon-Tyne, found it useful not merely in obstinate but in malignant ulcers. In no case of ulceration, he affirms, in which he tried it, did it disappoint his expectations. In a sloughing carbuncle, the alcoholic solution, (thirty drops to the ounce,) mixed with carrot poultices, was applied with advantage by Dr. Herndon, 2 of Culpeper C. H., Virginia. In scurvy and in scorbutic ulcers, M. Coen 3 found its use followed by excellent results, and he refers to cases in which it has been ad- ministered internally with very great advantage. J. L. da Luz 4 considers it an excellent cleansing remedy in atonic ulcers, but its prolonged use, he thinks, retarded cicatrisation. In hospital gangrene, he esteems it the best antiseptic, and the most powerful means for checking its terrific progress. In gangrenous or sloughing ulcers, Hahn used it. Several times a day be penciled the slough with pure creosote, and, in the inter- vals, fomented it with creosote water. According to Reichenbach, two offensive affections of the labia pudendi — the consequences of infiltration of blood — were cured by it ; and Reich and Sir Francis Smith 5 treated with success cases of cancrum oris, and the former, one of scorbutic ulceration of the gums. In herpetic ulcers, Horing and Berthelot observed favourable effects from the creosote water ; and it has been found especially useful in carcinomatous and syphilitic ulcers, in which it has been often employed. In cancer of the uterus, Wolff injected creosote water, in two cases, into the vagina. In one, the pain was so great, that, on the 1 London Medical Gazette, April 7, 1838, p. 65. 2 Amer. Med. Intelligencer, March 15, 1838, p. 425. 3 Giomale per servire &c. di Venezia, 1836. 4 Jornal da Sociedade das Sciencas Medicas de Lisboa, T. v. Lisboa, 1837; noticed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. 5 Dublin Journal of Med. Science, for May, 1837. CREOSOTON. 143 ninth day, after six pints of creosote water had been used, it was obliged to be discontinued. In the other case, the treatment was continued twenty-six days, and sixteen pints were used : in it, also, the pain was sensibly aggravated. The secretion was not improved in either case ; nor was metrorrhagia prevented by it ; for one of the patients died immediately after an attack of this kind : the other lingered a long time. Heyfelder found injections of creosote water, in conjunction with the extractum calendulse, of no use in cancer uteri. On the other hand, in a case of superficial ulceration of the os uteri with copious discharge of a puriform mucus, which had been treated unsuccessfully by other agents, for several months, Hahn found an injection of creosote water effectual in fourteen days. Tealier 1 has likewise given a case of superficial ulcerations around the os uteri, to which nitrate of silver had been applied at least twenty times without inducing a cure. By touching the ulcers with lint fixed upon the end of a probe, and dipped in a mixture of one part of creosote and three parts of water, excessive pain was induced, but this gradually passed away, and in six days the signs of ulceration had disappeared. It is more than doubtful, however, whether either of the two last cases was carcinomatous. In a case of cancer of the breast, a solution of creosote was ap- plied by the same gentleman. This excited, instantaneously, vio- lent pain, but after a time the pain ceased, and relief was obtained. Rossi saw a cancerous ulcer of the face healed by creosote oint- ment, but it soon broke out again. The same gentleman cured a fungous tumor on the alveolar margin of the right os maxillare — which had occasioned the loss of all the teeth of that side except one, and which even the actual cautery had not prevented from returning — by a collutory of six drops of creosote in six ounces of water. Heyfelder saw creosote used without effect in a case of cancer of the skin, and Cormack 2 in a case of lupus of the nose. On the other hand, Guitti cured an ulcer, in appearance cancerous, by the application of pure creosote, for which, at a later period, the solu- tion was substituted, and Marchal ha* published a case of cancer of the lip in which he believes he accomplished a cure by means of creosote. 3 Garbiglietti cured a fungous ulcer with caries of the fibula by creosote, but it is questionable whether the ulcer was carcinoma- tous ; and Meisinger saw a cancer of the face improved by the use of creosote ointment. It has been before remarked, that Meisinger used creosote with advantage in syphilitic ulcers. Hahn also applied creosote water 1 Revue Medicale, Fevrier, 1834. For similar cases, see Dr. Friese, in Berlin, medk-in. Zeitung, Nro. 13, 1837. 2 Op. cit. p. 115. * Gazette Medicale de Paris, Fev. 1S35. 144 dunglison's new remedies. in primary syphilitic sores ; the small, superficial ulcers healed soon, the larger and deeper remained stationary. In a phagedenic ulce- rated bubo, the spreading was arrested, but this was all. According to Heyfelder, creosote — probably the pure — excited, in a case of primary syphilitic ulcer, in a plethoric individual, violent inflam- mation, and so much sensibility, that it was obliged to be discon- tinued. Bert helot cured a chancre, which had resisted caustics and other cicatrising agencies, in a few days, by creosote water-. Rehfeld, also, treated secondary syphilitic ulcers successfully with it, giving, however, at the same time, the corrosive sublimate, in- wardly. Chronic venereal ulcers have in some cases yielded to it, after they had resisted every other kind of treatment. 1 Dr. Burkner, of Breslau, 2 reports a case, which, after having proved rebellious to every kind of general and local management that could be devised, at length yielded to the application of pure creosote, by means of a camel's hair brush. The character of the secreted pus immediately improved ; the wound began to heal by granulations from the base, and, at the end of four weeks, Dr. Burkner found his patient quite well. In condylomata it has been equally successful. By the appli- cation of creosote water, Hahn found them contract and disappear; but the more obstinate required to be penciled with pure creosote. Heyfelder, Reich, 3 Fricke, and Coen, 4 also found the creosote effica- cacious in these cases. The last gentleman but one had the most fre- quent opportunities for observation : by him the creosote, in a dilute state, was applied to the top of the condyloma by means of a pencil. In cases of small condylomata, touching them once or twice was sufficient for their removal ; in larger, it had to be more frequently repeated. In some obstinate cases, it required two or three weeks before the condylomata disappeared ; but when once they fell off, they did not return. 7. Gonorrhoea and Fhwr albvs. — Most extols creosote water as a remedy in gleet. He applies it either in the way of injection or by small tents wetted with it and introduced into the urethra. In fluor albus, he strongly recommends both the internal and external use of it. Reich injected creosote water in a case of gonorrhoea, and in one of malignant fluor albus ; yet its agency in these cases was doubtful as copaiba was given at the same time. Hahn 5 also used injections of creosote water in the second state of gonorrhoea, and in gleet ; but he did not think that the discharge ceased sooner under its agency than under the ordinary means ; whilst, in some cases, the inflammation was even augmented. In two cases of benign fluor albus, after many other remedies had been employed in vain, Schmalz saw good effects from the use of a solution of 1 Cormack, Op. citat. p. 107. See, also, Kunchel, in Bulletin Gener. de Therapeutique, p. 313. Paris, 1833. 8 Casper's Wochenschrift, Sepr. 9, 1837, S. 583. 3 Hufeland's Journal, Jan. 1834, and Revue Medicale, Mai, 1834. 4 Giornale per servire a progressi della patologia, &c. di Venezia, An. 1836. 6 Gazette Medicale de Paris, Dec. 1834. CREOSOTON. 145 creosote ; but in a third case it afforded no relief. Dr. Elliotson 1 gave it internally to a female labouring under gonorrhoea, at first, in the dose of two minims to an ounce of water, and afterwards in the dose of four, six, and even eight minims, but no good resulted from its use. We have administered it not unfrequently in leucorrhoea and other mucous discharges, and when persevered in, it has at times appeared to be of decided service. 2 Recently Dr. Robert Dick, 3 of Glasgow, has called the attention of the profession to its use in the chronic stage of gonorrhoea, and in gleet. He thinks its beneficial effects are more obvious than those of copaiba. He administered it in doses of two drops with loaf sugar beaten in a syrup with water. 8. Chronic cutaneous affections. — Reich treated a case of crusta lactea externally by creosote, and internally by calomel and the black sulphuret of mercury. The result was favourable. In the itch, it was recommended by its discoverer. Wolff, too, saw three cases of not very recent itch, cured in eight days by lotions of creo- sote water. Reich and Coen 4 likewise extol the water and the ointment in inveterate itch. J. L. Da Luz 5 also considers it as valuable as sulphur, but Otto did not find the water particularly efficacious. He gives strong testimony, however, in its favour, in herpetic eruptions ; in a very short time, it induced evident im- provement, and often removed the affection in from eight to four- teen days. When the cases were more chronic, a longer time was of course required for the cure. He never administered it, however, without attaining his object. His rule was, to bathe the affected parts twice a day with creosote water, and in particular cases he directed, in addition, general baths of warm water. The eruption generally disappeared very rapidly under this management, but it readily recurred unless general bathing was used at the same time. It again yielded, however, very readily to creosote water. Grand- jean, Reich, and Koehler, also employed the water successfully in herpes ; aud Guitti found both the water and the ointment most serviceable in herpetic affections when combined with appropriate internal treatment. Heyfelder recommends that alterative drinks, as the decoctum sarsaparillae, should be combined with them. Even in herpes exedens, the external application of oeosote was found effectual by Ritgen, Grandjean, and Rossi. W T olff 6 cured a case of ancient impetigo in about eight weeks, by a solution of creosote (3ss. to §v. of distilled water.) At first, the application caused so much heat and inflammation, that in eight days it was 1 Lancet, for Dec. 1835, p. 435. 2 See, also, Coen, in Giornale per servire, &c. di Venezia. 1836. 8 ficlinb. Med. and Surg. Journ. Apl. 1838, p. 602. 4 Op. cit. 6 Jornalda Sociedade das Sciencas Medicas de Lisboa, torn. v. Lisboa, 1837, noticed in Zeitschrift fur die scsammtc Medicin. Oct. 1838. S. 224. 6 Medicin. Zeilung, u. s. w. No. 30. 1834. 8— b dungl 10 116 dunglison's new remedies. obliged to be discontinued, and afterwards it was alternated with fomentations of warm water from day to day until the cure was completed. Dr. Herndon of Culpeper C. H.," Va., derived much benefit from the ointment in psoriasis. In a case of acne rosacea of seven years' standing, accompanied with headach, nervousness, thirst in the morning and acid eruc- tations, for which the patient was put under treatment for a month without success, Dr. Elliotson 1 determined on trying creosote. The advantage was soon manifest, as in three days the eruption was evidently diminished. At first, she took two minims three times a day ; this was gradually augmented to twenty minims ; the farther increase of the dose being prevented by the supervention of giddiness and tremors. At the end of seven months, she was dis- charged ; the eruption being scarcely perceptible, and the dyspeptic symptoms entirely removed. In a chronic pustular disease, not curable by antiphlogistics, the same gentleman observed better effects than from any previous remedy. 2 Dr. Copland, it is affirmed, found a saturated solution in water answer well as a lotion in porrigo favosa. 3 We have often used in porrigo, both creosote water and creosote ointment (see the formulas at the end of the article) ; they have always appeared to us sufficiently strong, and when the quantity of creosote was increased, so much inflammatory irritation was induced that they had to be discontinued for a time. 9. In a case of chronic inflammation of the free edge of the eye- lids, with several ulcerated spots, a cure was effected by Coster, by the use, twice a day, of a dilute solution of creosote, (gtt. xij ad aquae destillat. gij) applied by means of a camel's hair pencil. The cure was effected in ten days. In different kinds of ophthalmia, M. Sanson used the creosote, but never observed the disease to be modified by the treatment. 4 10. In a case of prolapsus vagina, Schlesier tried the external use of a solution of creosote. After astringent injections, and the application of the decoctum ratanhiae by means of a sponge had been used in vain, he injected diluted creosote for seven weeks, omitting it only at the time of menstruation. It excited a burning sensation of a few minutes' duration. At the expiration of the time mentioned, the prolapsus had strikingly diminished, and the great sensibility of the prolapsed parts had disappeared. Owing, however, to the supervention of irritation in the urinary bladder, it had to be discontinued when there was every prospect of ultimate success. 11. Dr. Buttmann, 5 of Vietz, circle of Landsberg, has given the case 1 Lancet, July 4, 1834, p. 459. 2 Medico-Chirurg. Transact, xix. 237. Lond. 1835. 3 Gully's Edition of Magendie's Formulary, p. 204. Lond. 1835. See, also, Sir F. Smith, in Dublin Med. Journ. for May, 1837, and J. L. Da Luz, Op. cit. 4 Compt rendu des Seances de la Societe de Medecine, Seance du 7 Mars, 1834. ' Beitragen zum Sanitats-Berichte des Frankfurter Regierungs-Bezirks: and Medicinische Zeitung, Dec. 7, 1836, S. 252. CREOSOTON. 147 of an old lady, upwards of seventy years of age, who had laboured for several years under oedema of both legs to such an extent as to interfere materially with progression. She experienced lancinating pains in both feet, and irregular paroxysms of fever. Many external and internal remedies had been used in vain, when Dr. Butt man n, by way of experiment, applied cataplasms of creosote, soon after which the swelling, very much to his astonishment, gradually dis- appeared, and with it the febrile attacks. 12. In toothach from carious teeth, creosote has often been used, being applied to the hollow of the tooth by means of a pencil, or of cotton imbued with it. The testimony in its fa- vour has been very great, — Coster, Reich, Hahn, Kneisel, Hey- felder, Fichtbauer, Hauff, Otto, Guitti. Kobler, Meisinger, 1 and numerous others. Some have advised a collutory of creosote, but this is more disagreeable, whilst, it is less efficacious than creosote applied immediately to the carious tooth. It excites instantaneously acute pain and a considerable secretion of saliva. The pain is often relieved by it, but it generally recurs ; and perhaps the ad- vantage derived from this agent is not greater than from the stronger essential oils. As a palliative it is very useful. In rheu- matic toothach, the insertion of a little cotton, imbued with creo- sote, in the ear of the same side, has been found serviceable. 2 13. In deafness, apparently owing to a deficient secretion from the meibomian follicles, advantage has been found from the use of the creosote, after the ear had been syringed. Perhaps as good a form as any is that recommended by Mr. Curtis, 3 which consists of one dram of creosote to four drams of lard. A little of this oil is inserted into the meatus night and morning, with a camel's hair pencil. He considers the preparation contra-indicated in cases of otorrhcea, where there is any pain or inflammation. So far we have spoken mainly of the external use of creosote. Reference has been made to its internal administration in cases of haemoptysis and fluor alb-ns only. In the following diseases, it has been chiefly given internally: — 14. Phthisis. — Reichenbach excited considerable expectations from the use of creosote in phthisis, — pulmonary, laryngeal, and bronchial ; and as in so intractable a disease every suggestion is immediately and eagerly embraced, numerous trials were instituted with it, the results of which were by no means accordant. Reich 4 affirmed, that he gave it both in laryngeal and tubercular phthisis with distinguished success. In a case in which the disease ap- peared to be considerably advanced, the offensive expectoration was changed into one of a tasteless, mucous character, although the fever 1 Mcdicin. Jahrbuch. des k. k. Osterrcich. Staates, B. xv. S. 553. Wien, 1834. 2 Riecke, Op. cit. S. 167. 8 London Lancet, vol. i. p. 328, 1838-9 ; and Mr. Wright, ibid. p. 5S0. 4 Hufeland's Journal, Jan. 1834; and Revue Medicale, Mai, 1834. 148 dunglison's new remedies. and the night sweats experienced no modification. Subsequently, haemoptysis supervened, with violent fever; on which account the dose of creosote was diminished. Under the use of the remedy the condition of the patient appeared to improve. — except the cough, which was not mitigated ; an anodyne was consequently substi- tuted for the creosote; under which, his patient — a female — im- proved so much, that Reich was led to believe she might be saved, although the cough still remained severe and frequent. In another case, the creosote allayed the hectic fever, and transformed the purulent expectoration into one of a mucous character: yet, al- though the general condition of the patient seemed to be improved, the cough and uneasiness of the chest continued almost unchanged. Grandjean also had a case of phthisis in the third stage, the expec- toration of which was soon diminished ; the pain in the side re- moved ; the appetite, sleep, and strength restored, under the admi- nistration of creosote; but the result of the case is not known. Levrat asserts, that he found creosote highly useful in chronic bronchitis, and in some kinds of phthisis. Hechenberger saw good effects from the inhalation of creosote in the form of vapour in a case of ulcerated lungs ; five, ten, or fifteen drops of creosote, ac- cording to the degree of tolerance of the lungs, being dropped into hot water in an appropriate vessel, and the vapour received through the tube of an inverted funnel. Hechenberger was of opinion, that this mode of exhibiting creosote prevented the disagreeable effects apt to be induced by its internal use ; and farther experiments have confirmed his view. In the chronic mucous affections of the lungs of old people it appears to have been especially useful. On the other hand, Elliotson 1 derived no favourable results from his trials with creosote in phthisis; even inhalation of the vapour was gene- rally unattended with any advantage ; yet, he is of opinion that it may be useful where there are only one or two ulcers in the lungs, and there is no tendency to their farther production, as well as where there is much secretion from the bronchial mucous mem- brane. Either no advantage, or an injurious influence was derived from its use in phthisis, by Rehfeld, Haupt, Treumann, Giinther, Schmalz, Meisinjjer, Otto, Kohler, 2 and others. The published experiments by Wolff, in the Charite at Berlin, cannot be esteemed more favourable. It was tried in eleven cases of phthisis tuberculosa, of which one was in the first, eight were in the second, and two in the third stage. In two cases, there was scarcely any advantage after the remedy had been given for four- teen days. In one case, it had to be discontinued on the eleventh day, owing to the supervention of obstinate vomiting. The case ultimately terminated unfavourably, in six cases, the symptoms appeared to be aggravated, and the patients died soon afterwards. In two cases, in which the disease was in its second stage, death 1 Medico-Chirurg. Transact, xix. 221; Lond. 1835. a Hecker's neuen wissecscbaft. Annal. B. i. H. 3. CREOSOTON. 149 supervened unexpectedly early, on the fourth and seventh day of the treatment, — in one case by suffocation ; in the other, by sudden hydrothorax. The pulse, according to Wolff, was generally in- creased under its use ; the hectic augmented ; the urinary secretion diminished ; the expectoration neither changed in quantity nor quality; the cough not mitigated; or the dyspnoea diminished: on the other hand, they were, in four cases, manifestly increased : once epistaxis occurred, and twice hsemoptysis. From the results of all his trials, Wolff is disposed to think, that creosote should be banished from our list of agents employed in phthisis ; both as respects the radical and the palliative treatment ;* but although they may not sanction us in placing much value on creosote in the treatment of phthisis, it may be improper to ostra- cise it altogether, 8 as according to the testimony of others it would seem to have rendered essential service. Rampold and Spath assert, that they have derived advantage from it, in confirmed phthisis where no inflammatory complication was present ; — the expectoration and colliquative sweats being diminished under its use. M. Petrequin 3 from his trials with it considered its effects to be more beneficial — as might be presumed — in incipient than in con- firmed phthisis ; but in no case did he observe any thing approach- ing the radical cures described by some. He indeed gives the pre- ference to the tar water, (see Aqua Picea.) 15. In bronchorrhoea or that state of the bronchial mucous mem- brane, which consists in a profuse secretion without inflammation, the inhalation of creosote has been found of essential service. 4 16. Rheumatism and Gout. — The success, obtained by Reich 5 from a tincture of soot in gouty and rheumatic affections, and the probability that the efficacy might depend chiefly on the creosote it contained, induced him to prescribe this remedy internally in those diseases. He made the first trial upon himself. After exposure to cold he was attacked with lancinating pain in the whole of the right leg, for the removal of which the ordinary remedies were em- ployed in vain ; it yielded to the use of creosote given for nine days. He relates another case of rheumatism and one of atonic gout, in which creosote was equally successful. Marcus, of Ha- dersleben, recommends it in cases of rheumatism, unaccompanied by excitement of the vascular system, or tendency to congestion and febrile reaction. It is proper, however, to observe, that he combined other agents with it, so that his experiments are by no means decisive as to the efficacy of the creosote. Of the three patients, to whose cases he refers, one only was cured ; the other experi- 1 See, aleo, Kuhler, in Rust's Magazin, B. xlvi. and Amer. Journ. of ihe Med. Sciences. Feb 1837, p. 497. 2 Riecke, Op. cit. S. 170. 3 Gazette Medicale de Paris, Nov. 1836. * Elliotson, in Med. Chirurg. Transact, xix. 221. Lond. 1835. 5 Hufeland's Journal, Jan. 1S34, and Revue Med. Mai, 1834. 150 dungltson's new remedies. enced improvement. Karsten found none of the advantages, de- scribed by Reich in rheumatic and gouty cases, from its use. In a case of rheumatic headach, Tschepke found surprising advan- tage from frictions with creosote, and plugging the ear with cotton dipped into it. The creosote immediately excited acute pain, and some rubefaction of the skin ; and as the burning ceased, the pain ceased along with it. In Most's experience, lotions of creosote water greatly alleviated the pain of the joints in rheumatism and atonic gout. 17. In vomiting not arising from inflammation or other organic disease of the stomach, Elliotson 1 found creosote very efficacious. Even in the Asiatic cholera and in sea sickness, it appeared to allay the vomiting. In various affections of the stomach, as in cardi- algia and gastrodynia, it may be found useful. 2 In cases of vomit- ing from nervous excitability it has been affirmed to excel all known medicines. 3 After Ur. Elliotson had recommended it, Dr. Shortt tried it in about a dozen cases, and found it equally successful, as did also Prof. A. T. Thomson of London, Dr. Bodington of Er- dington in Warwickshire, and many others. Dr. John Walker of Glasgow, in a case published by him 4 does not appear however to have been equally fortunate, and with Dr. Paris it entirely failed. 5 Our own success has been by no means as great as that of Dr. Elliotson. In many cases, indeed, it has developed irritability of the stomach, where it did not previously exist. Dr. Elliotson admits that in large doses it seems to excite vomit- ing, and that when given in such quantities with a view to check it, no good, but evil, results from giving a large dose. As a pre- ventive of sea sickness it has been highly extolled by Dr. Elliotson, and by Mr. A. B. Maddock. 6 It has been administered also as an excitant to relieve gastrodynia and flatulence, and where hydrocyanic acid and creosote have been separately tried unsuccessfully, Dr. Elliotson recommends, that they should be combined. 18. Several portions of tmnia having been observed to be dis- charged after the administration of creosote, Kraus was induced to prescribe it as a powerful anthelmintic. This he did in numerous cases, and with the best success; from five to eight drops being given to adults with oleum ricini ; or where the bowels were not freely opened with half a drop or a drop of croton oil. 19. In diabetes meUitus, creosote was first given by Berndt, 7 and with striking success. One or two cases of the same kind are 1 Medico-Chirurjjical Transactions, vol. xix. and Lancet, Aug. 20, 1836. 2 Riecke, Op. cit. S. 172. 3 Cormack, Op. cit. p. 133. 4 Lancet, Dec. 19, 1835, p. 447. See also Mr. Taylor, Ibid, Aug. 15, 1835, and Dr. Macleod, in Lond. Med. Gazette, xvi. 598, and xvii. 653. 5 Pharmacologia, 8th edit, append. Lond. 1838. 6 Amer. Journ. of the Med. Sciences, Feb. 1838, p. 496. 7 Kleinert's Repertorium, Jan. 1835, and Lancet, July 18, 1835. CREOSOTON. 151 related by Gadolin ; but Rehfeld used it without advantage. Di\ Elliotson agrees with Berndt in the opinion, that it is sometimes of use in diabetes, and may even be greatly instrumental in accom- plishing a cure. 1 20. Dr. Elliotson 2 tried creosote in nervous diseases. In some cases of epilepsy, the paroxysms appeared to be rendered less fre- quent and more mild ; but in the generality of cases, they returned with fresh violence. In soma cases, the remedy had no influence on the disease ; in others it appeared to aggravate it. In neuralgia great advantage was at times derived from it, although, here, again, it was frequently of no service. Dr. Elliotson also observed good effects from it in hysteria, where there was no inflammatory com- plication ; in spasmodic erethism of the nervous system, and in palpitation ; and Dr. Herndon, 3 of Virginia, used it with much benefit as an inhalation in hysteric croup (thirty drops to the quart of hot water). In asthma, dependent upon morbid excitability of the bronchial mucous membrane, Dr. Elliotson 4 found its inhalation to be often useful. 21. In two cases of chronic glanders, the same gentleman 5 ac- complished a cure in the course of a few weeks, by the sedulous use of an injection of a dilute solution of creosote (gtt. 1 ad aq. §j.) thrown up the affected nostril ; combining the treatment, in one of the cases, with the internal use of the remedy ; and a similar case of success is given in a recent number of a British medical periodical. 6 MODE OP ADMINISTERING. The dose for internal use is one or two drops, given several times a day, in gum water. 7 In cases of tapeworm, the dose should be larger. Some give it in emulsion, but this form is objectionable on account of the disagreeable taste. It is best administered in pill. Externally, it is at times applied pure; at others diluted, — com- monly with water, with or without the addition of spirit of wine, or in the form of ointment. Carminati 8 affirms, that oil and mu- cilage, when combined with it, render it milder, but that vinegar increases its action. Dr. Cormack, 9 however, doubts the assertion in regard to vinegar. In three comparative experiments, which he made with a view of testing the justice of Carminati's conclusion, 1 Medico-Chirurgical Transactions, xix. 132-135. Lond. 1835. * Op. cit. 3 Amer. Med. Intelligencer, Mar. 15, 1838, p. 425. 4 Op. cit. 6 Lancet, for June 20, 1833. 6 Ibid, Jan. 20, 1839, p. 145. 7 It may be well to remark, that the fluidram contains one hundred and fifty drops of creosote. 8 Op. citat. 9 Op. citat. p. 88. 152 dunglison's new remedies. there was no apparent difference in the activity of creosote when given with acetic acid or alone. He was led to believe, however, that the addition of albumen caused it to act more powerfully, which, if true, is singular. The inhalation of creosote vapour may be accomplished by dif- fusing a few drops of creosote through water, or a mucilaginous liquid, in an ordinary inhaling vessel, or in the mode described under the head of Chlorine. 1 Pilulce Creosoti. Pills of Creosote. ?(. Creosot. 3j. Succ. glycyrrhiz. Gum. galban. aa. Jss. •Pulv. lad. althaea?, 3y. Fiat massa in pilulas cxx. dividenda. Dose. — Six pills four times a day. In consumption. Reich. *. Creosoti, Succ. liquirit. aa. §i. Pulv. rad. althaeas, ^ij. Fiat mass, in pil. cxx. dividend. Dose. — Five pills morning and evening, in atonic gout. Reich. Haustus Creosoti. Creosote Draught. 5<. Creosot. rr\,. iv. ad x. Misturae camphorae, Infus. gentian, compos, aa. f. gvj. M. fiat haustus. Brande. 2 Mistura Creosoti. Mixture of Creosote. 5<. Creosot. gtt. v. Mucilag. gum. arab. ^iij. Syrup, altheeae, 3j. M. Dose. — A spoonful every three hours in haemoptysis. Santini. Tinctura Creosoti pro Gingivis. Tincture of Creosote for the Gums. 5<. Creosot. ^j. Spiritus vini rectificati, §ij. M. As much of this to be added to cold water as is necessary to give it a piquant taste, with which the teeth may be washed and the mouth rinsed. Used in cases of faetor of the mouth from carious teeth, and to limit the caries. Buchner. 1 See page 107. 2 Dictionary of the Materia Medica, p. 201. Lond. 1839. CRE0S0T0N. 153 B*. Creosot. Alcohol, aa. £ss. M. To be applied to carious teeth. Radius. 5<. Creosot. p. i. Alcohol, p. viij. M. This is the ordinary strength of the tincture. Used where frac- tions of a drop of pure creosote are prescribed. Lotio Creosoti. Lotion of Creosote. 5<. Creosot. ^ss. Aqua; destillat. %v. M. Used as a lotion in impetigo sparsa and itch. Wolff. The author has occasionally found a lotion composed off. 3ss of creosote to Oj of water too irritating. 5<. Creosot. gtt. xij. Aq. destillat. fij. M. To be applied by means of a hair pencil twice a day to inflamed eyelids. Coster. &. Creosot. gtt. iv. Aq. destillat. 3ij. M. In irritation of the gums. Fremanger. *. Creosot. £ss. Gum. arab. ^iss. Aquae camphor, gxss. M. Used every two hours in cases of aphthous ulceration of the mouth. Magendie. *. Creosot. gtt. x. Aceti, 3ij. Aquae footis, ^ij. M. Used in cases of phagedenic ulceration, and to chancres ; applied by means of a camel's hair pencil. Shortt. 1 Unguentum Creosoti. Ointment of Creosote. B<. Cerati, Ol. amygdal. dulc. aa. ^j. Creosot. gtt. xxx. M. A dressing in scrofulous caries. Fremanger. The Unguentum Creosoti of the London Pharmacoposia is com- posed of half a fluidram of creosote to an ounce of lard. 2 1 Cormack, Op. cit. p. 112. 2 Brande, Op. cit. p. 202. 154 dunglison's new remedies. Linimentum Creosoti. Liniment of Creosote. fy. Creosot. gtt. v. — xx. 01. olivar. ^ss. M. To be rubbed two or three times a day on the diseased parts, in chronic herpes. Corneliani. CUBEB^E. Synonymes. Piper Cubeba, P. Cubebarum, P. Caudatum, Cubebs. French. Poivre a queue, Cubebe. German. Kubebenpfeffer, Schwaazpfeffer. Cubebs are the fruit of the piper cubeba, which grows in India, Java, Guinea, &c. Sex. System, Diandria Trigynia ; Nat. Ord. Piperacece. The corns of this plant have been long known in the shops ; and in the old Wirtemberg Pharmacopoeia, they figure as calefacient, inciting, discutient, antinervous, and carminative agents, which seem to have a specific action in vertigo ; hence they ob- tained the name "Schwindelkorner" or "grains for vertigo." They had however fallen into oblivion, until they were re-introduced in modern times into practice, especially by the English physicians and surgeons. The shell of the dried berry has a weak taste, but smells agree- ably ; the kernel has a bitter aromatic flavour which is biting at first, but afterwards cooling. The corns were analysed by Tromms- dorf and by Yauquelin ;* but the most recent analysis is by Monheim. 2 He found, in 100 parts, of lignin 64.0 ; of extractive matter 6., of Kubebin 6, of a matter like wax 3, of green volatile oil 2.5; of yellow volatile oil 1.0, of balsamic resin — which, accord- ing to Vauquelin, is very analogous to the balsam of copaiba — 1.5, and of chloride of sodium 15.5. [?] The woody matter reduced to ashes contained much carbonate and muriate of potassa and soda. The kubebin appeared to Monheim to be identical with the pipe- rine, but to be united with an acrid soft resin. EFFECTS ON THE ECONOMY. In addition to the general excitant properties of the peppers, the action of cubebs is exhibited on the urinary and genital organs. Under their use, the secretion of urine is augmented, and it becomes of a darker colour, and assumes an aromatic odour. Cubebs have been advised, in modern times— first, in cases of gonorrhea, in 1 Memoir, du Museum, vi. 225. 2 Riecke. Die neuern Arzneimittel, S. 176. CUBEB^E. 155 which they have been esteemed a specific by many. Yet that which applies to the copaiba is equally applicable to the cubebs. Although the revulsive effect induced by both on the kidneys may mitigate the inflammatory condition of the lining membrane of the urethra, which constitutes gonorrhoea — in violent inflammatory cases, and in the early stages of ordinary cases, they may be inju- rious, and there are many cases on record in which bad conse- quences appear to have resulted from their improper administration. Still, there are many physicians who administer both them and the copaiba in every stage of the disease. Of 50 patients, treated by Mr. Broughton 1 by the cubebs, 10 were cured in from 2 to 7 days; 17 in from 8 to 14; 18 in from 15 to 21 ; 1 on the 55th day ; and in 4 only was no success obtained. In the chronic stage of gonorrhoea, M. Ricord 2 prescribes the cubebs in combination with the peroxide of iron, and in addition the patient is directed to inject, four times a day, a solution com- posed of aq. destillat. §viij. argent, nitrat. gr. ij. It has been affirmed, that different evils have ensued from the use of cubebs; which ought to suggest care in their administration: for example, — ardor urinae, fever, inflammation of the urethra, blad- der and testicles, retention of urine, cutaneous eruptions, &c. 3 In the blennorrhoea of females the cubebs are equally extolled by many practitioners, as well as in leucorrhcea. 4 Secondly , Spitta found them very efficacious in old and obstinate cases of coryza, when given in the form of lozenges : they are said, likewise, to have been administered with advantage in defective audition, caused by a catarrhal affection of the Eustachian tube. Thirdly. Rosen found the chewing of cubebs very serviceable in cases of aphonia. Fourthly. They have been prescribed successfully in cases of chronic rheumatism. Fifthly. Ptil 5 gave them with striking ad- vantage in intermittent fever. Sixthly. In India, they are re- garded to be aphrodisiac. 6 According to Dr. Paris, it is important to keep the bowels open during their use, for when hardened faeces are allowed to accumu- late, the spice insinuates itself into the mass, and occasions exco- riations in the rectum. 7 MODE OF ADMINISTERING. Cubebs are commonly given in the form of powder, and in doses of from 1 to 2 and even 4 drams, repeated once or oftener in the 1 Medico-Chirnrgical Transactions, xii. 1. Lond. 1822. 2 L;i Lancette Franchise, No. 33. Paris, 1838. 8 Lond. Med. and Physical Journal, Mar. 1832, and Merat & De Lens, Diet. Univers. de Matiere Medicale, &c. Art. Piper Cubeba. 4 Edinb. Med. and Surg. Journal, xviii. 319. 6 Recueil de Med. Chirurg. et Pharm. Mililaire, xvi. • Merat & De Lens, Art. cit. 7 Brande, Dictionary of Materia Medica, p. 205. Lond. 1839. 156 dunglison's new remedies. day. Lozenges, boluses, and electuaries, are likewise prepared of them, and by some a tincture has been recommended. In conse- quence of the disorder at times induced by them in the digestive function, Velpeau proposed that they should be given in the form of glyster, to the amount of one or two drams of the powder, sus- pended in five or six ounces of an oily vehicle, and this method has its advantages. 1 To attain the same object, M. Dublanc, Junr., prepared an oleo-resinous extract, one-sixteenth part of the weight of which possessed equal virtues with one part of the cubebs; five grains, three times a day, acting like the ordinary quantity of the powdered cubebs. 2 Electuarium Cubebarum. Electuary of Cubebs. 5<. Piper cubeb. pulv. ^ss. Mellis despum. q. s. Fiat electuarium. Dose. — A tea-spoonful three or four times a day, in Catarrhus vesicas, C. urethra?, &c. Radius. b<. Balsam, copaib. 3ivss. Subige cum Vitello ovi unius, et • Adde Pulv. cubebar, ^ivss. Conserv. rosar. .gss. M. fiat electuarium. Dose. — A tea-spoonful three or four times a day. Vogt. 9c. Balsam, copaib. Pulv. cubeb. aa. ^ij. Aluminis, 3j. Extract, opii, gr. v. M. Dose — A dram night and morning in the pulp of a prune. The quantity may be rapidly increased to two drams morning and evening. Trochisci Cubebarum. Lozenges of Cubebs. Admisce Pulv. cubeb. ^ij. Balsam, tolut. gr. vj. Syr. balsam, peruv. Succ. glycyrr. aa. ^j. Gum. arabic. q. s. ut fiat massa in tiochiscos pond. gr. x. dividenda. Used in coryza. S pitta. 1 Archives Generates de Medecine, xiii. 47. 8 Journ. de Chiraie Medicale, iii. 491, and Journ. de Pharmacie, xiv. 40. CUBEBS. 157 Boll Cubebarum. Boluses of Cubebs. &. Balsam, copaib. Gum. arab. pulv. aa. 3'j. Aqua? flor. aurant. Qij. Teren 'o bene mixtis adde Cubebai. pulv. gij; Misce, et fiant boli No. vj. Dose — One, three times a day. Henschel. M. Labelonye 1 has recently proposed the following method for separating- all the principles of the cubebs from the ligneous matter. The cubebs, reduced to a coarse powder, are placed in an appa- ratus for displacement and exhausted by ether, which dissolves the wax, volatile oils and balsamic resin. The residue is submitted to the action of hydro-alcohol at 20° (.935), which dissolves the ex- tractive principle and chloride of sodium. The alcohol and ether are separated by distillation in part, and separately. Evaporation of the hydro-alcoholic solution is then carried on in a water bath until it possesses the consistence of a soft extract, to which the ethereal product is added ; the evaporation being continued for a short time, the ether is completely volatilised, and a strongly aro- matic extract is obtained, as consistent as honey. This it is im- proper to subject any longer to the action of heat, on account of the contained volatile oils; the presence of which in all cases interferes with complete desiccation. One part of this extract is conceived to be equal to five of the cubebs. This extract can be readily mixed with water by means of mu- cilage, and can be administered in potions, injections, &c. The best form of exhibition, according to M. Labelonye is in lozenges, or in an emulsive syrup. Trochisci Extracti Hydro-alcoholici cetherei Cubebarum. Lozenges of the ethereal hydro-alcoholic extract of Cubebs. 9<. Ext. hydro-alcohol, aether, cubebar. §viij. Alcohol, Oij. Solve et adde Sacchar. alb. in pulv. ten. fej. 01. raentha? pip. gtt. xviij. . Pour the mixture into flat vessels upon a stove, and allow the alcohol to evaporate at a moderate heat. When the mass is com- pletely desiccated, reduce it to fine powder, and add a sufficient quantity of mucilage of gum tragacanth to form lozenges — 18, 12, ( .), or 6 grains each. Most persons, he says, can swallow with facility those weighing eighteen grains, and containing six grains of the extract ; ten of these are equivalent to half an ounce of the powder. 1 Bulletin General de Therapcutique, and Amer. Journ. of Pharm. 2d series, vol. 2. p. 316. Philad. 1837. 358 dunglison's new remedies. Syrupus Extracti Hydro-alcoholici cetherei Cubebarum . Syrup of the ethereal hydro-alcoholic extract of Cubebs. B<. Ext. hydro-alcohol, aether, cubebar. £iij. Suspende ope mucilaginis in Aq. menthse pip. ftj. Adde Sacchar. alb. ftij. M. of this syrup cc valent to ten of powdered cubebs Dose — A tea-spoonful. M. Labelonye, envelopes the extract also in sugar, as in the ordi- nary sugar-plumb. DELPHINJNA. Synonymes. Delphininum, Delphininium, Delphinia, Delphium, Delphia, Delphinine, Delphioe. German. — Delphinin. This alkaloid was discovered in 1819, by MM. Feneulle and Lassaigne,' and, almost at the same time, by Brandes, 2 in the seeds of the Delphinium Staphisagria, in which it is united with acetic acid. As a therapeutical agent, it has been chiefly recommended by Turnbull ; but he did not employ it in its pure state. METHOD OP PREPARING. The plan recommended by Magendie 3 is to boil a portion of the seeds of the delphinium, cleared of their coverings, and reduced to a fine paste, in a little distilled water; to pass the decoction through a linen cloth and filter. Pure magnesia is now added, and it is boiled for some minutes ; the filtration is repeated ; and the resi- dues washed carefully and digested in highly rectified alcohol. On evaporating the alcoholic tincture, the delphinine is obtained in the form of a white powder, having some crystallised points. This is esteemed the most simple mode ; but if a large quantity be required, the following plan is advised — on account of the time and patience necessary to decorticate the seeds. Submit the uncleaned seeds, when well bruised, to the action of weak sulphuric acid. Precipitate the liquor by ammonia, and re- dissolve in alcohol the delphinine, which is still slightly coloured. 1 Annales de Chimie, torn. xi. xii. and Journal de Pharmacie, vi. 47 and 366. 2 Schweigger's Journal der Chimie, xxv. 369. 3 Formulaire, &c. DELPHININA. 159 To purify it, draw off the alcohol by distillation, dissolve the resi- duum in muriatic acid, and boil with magnesia. The plan recommended by Couerbe, and adopted by Turnbull, 1 is to evaporate a saturated tincture of the seeds to the consistence of a thin extract, and then to treat it with water acidulated by sul- phuric acid. This solution, when filtered, is to be precipitated by ammonia. The precipitate — after being freed from its water — is to be taken up with alcohol, and again reduced to the consistence of an extract, which is likewise to be dissolved in acidulated water ; to this solution, filtered, a small quantity of nitric acid is to be added, as long as any precipitate is thrown down. The liquid, freed from this precipitate, is again to be subjected to precipitation, by ammonia, and the powder dried. This is the delphinine of commerce ; but like veratrine, it is a compound substance, and consists of resinous matter, staphysagrine and delphinine ; the delphinine is obtained by treating the powder with ether, which takes up the delphinine, and leaves the staphysagrine. When in a state of purity, delphinine is white, pulverulent, and devoid of smell ; but like veratrine, when applied to the mucous membrane of the nose, it occasions sneezing, along with an abun- dant secretion of mucus. Its taste is at first bitter, and afterwards acrid, and it acts upon animals in the same manner as — but more energetically than — the seeds whence it is prepared. It is very sparingly soluble in water, but yet in sufficient quantity to com- municate a bitter taste to the fluid. In alcohol and ether it dissolves readily, and these solutions have the property of rendering syrup of violets green, and of restoring the blue colour of litmus, when reddened by acids. It combines readily with acids, and forms neutral salts, which are possessed of much bitterness and acridity, and it may be precipitated from solutions of these in the form of a jelly by the addition of an alkali. EFFECTS ON THE ECONOMY. From the experiments of Orfila' J with this substance, it appears to belong to the class of acro-narcotic poisons. In the dose of about five grains it proves fatal to dogs ; and the fatal result is more speedily induced when the delphinine is dissolved in weak acetic acid ; the animal, in the latter case, dies in the space of from forty to fifty minutes. When diffused through water introduced into the stomach of a dog, and retained there by a ligature placed around the gullet, efforts to vomit supervened, with restlessness, giddiness, immobility, slight convulsions, and death in two or three hours. In this case, the mucous membrane of the stomach was generally found injected. 1 On the Medical Properties of the Natural Order Ranunculaceae. chapter 2. Lond. 1835. 2 Nouveau Journal de Med. x. ; and Toxocolojne Gen. i. 739. 160 dunglison's new remedies. From his administration of delphinine and its salts, Turnbull concludes, that the pure alkaloid has little effect on the mucous membrane of the stomach and bowels. It may be given, he says, in some cases, to the extent of three or four grains a day, in doses of half a grain each, without exciting vomiting; in this quantity, however, it sometimes operates upon the bowels, but causes very little irritation. In most instances it acts as a diuretic, and occa- sions a considerable flow of pale urine. When taken to the extent of a few grains, it induces heat and tingling in various parts of the body, similar to those produced by rubbing it upon the skin ; and its other effects are very nearly the same as those of the salts of veratrine. The preparations of delphinine have been used in the same diseases as those of veratrine, and they appear to exert a similar action : the test laid down by Turnbull, in the case of the veratrine, applies equally to the delphinine; — namely, that unless a solution of delphinine in alcohol, in the proportion of four grains to a dram, occasions a distinct sensation of heat and pricking, when rubbed for three or four minutes on the forehead, the specimen ought not to be used, as no beneficial effect would arise from its application. When rubbed upon the skin, it gives rise to a sensation of burning, not unlike that which manifests itself a short time after the appli- cation of a blister, but not to an unpleasant degree, unless the fric- tion has been carried too far. The effects of the delphinine differ also from those of the veratrine in being generally more powerful and durable. The diseases in which the delphinine has been chiefly used, like the veratrine, are — tic douloureux, paralysis, and rheumatism. In the first of these, when the affection is seated in the tongue, or at the point where the infra-orbitar nerve escapes from its foramen, the use of delphinine, according to Turnbull, is to be preferred, because it can be applied to the tongue, or rubbed on the gums, without occasioning irritation of the mucous membrane. He thinks it, also, upon the whole, better adapted for the treatment of paralytic cases than veratrine, but principally on account of the property it has "of exciting the circulation in the diseased part." MODE OF ADMINISTERING. The manner of applying delphinine is the same as that recom- mended for veratrine. It may be used either in the form of oint- ment or in solution in alcohol, and the proportions to be employed, in either case, may vary from ten to thirty or more grains to the ounce, according to the severity of the affection, for the treatment of which it is prescribed. The duration of the frictions should also be the same, or until the pungent sensation, produced by the rubbing, exhibits itself. DIOSMA CRENATA. 161 DIOSMA CRENATA, (FOLIA.) Synonymes. — Barosma Crenata, (folia;) Agothosma Crenatum (folia;) Bocchoe, Bocho, Boocho, Buchu Leaves. German.— Buccublatter ; Duftstrauchblatter. This plant is indigenous at the Cape of Good Hope. It belongs to the natural family Rutacese ; class Pentandria, order Mono- gynia. The smell of the leaves is penetrating and peculiar, but re- sembling that of rue and camphor. By some, it has been com- pared to that of the oil of juniper. The name appears to be derived from the smell, — $k>s, "divine," and oa-^, "odour." The taste of the leaves is aromatic, somewhat pungent, and, in the opinion of Btichner, resembling that of peppermint ; without any particular bitterness, yet disagreeable. According to the analysis of Buchner, the most important constituents appear to be a volatile oil of a greenish yellow colour, a peculiar principle — diosmine, and a semi- resinous substance. The diosmine is a very tenacious adhesive matter, similar to the Peruvian balsam, and can be drawn out in fine threads. It has the same smell as the leaves, only somewhat weaker; the taste is pungent and bitter. The semiresinous matter has a resinous lustre; is of a dark brown colour, becomes fluid when heated, and burns with a flame. Its odour is not remarkable: the taste is somewhat pungent and sourish. 1 EFFECTS ON THE ECONOMY. The Hottentots have long used the leaves of several varieties of diosma both internally and externally; but they give the preference to the diosma crenata. Through them its virtues became known to the European settlers. It was first brought to the notice of Bri- tish practitioners by the notorious Richard Reece, who is more known for the part he took in the farce of Joanna Southcoat than for any thing else. In Germany, it was chiefly promulgated by Jobst, who published an extract from Reece's observations in the Repertorium of Buchner. 2 EFFECTS ON THE ECONOMY IN HEALTH. Bardili instituted experiments for testing the action of the remedy on the healthy organism. It first acts as an excitant on the sto- mach, whence arises a feeling of increased heat in that organ, and 1 See Journal de Chimie Medicale, iii. 13, and Journal de Pharmacie, xiii. 106. * Band. xxii. S. 51. 8— C dungl 11 162 dunglison's new remedies. the appetite becomes augmented ; from the stomach, the excitement spreads to the vascular system ; the heat of the body is increased ; the pulse becomes more frequent, and the transpiration is favoured. It acts, likewise, on the urinary secretion ; the urine is separated in larger quantity, contains flocculi, deposites a purulent (?) sediment, and exhales an aromatic odour. On the digestive function, it seems to produce somewhat of a constipating effect. Bardili thinks, that he has also witnessed some narcotic operation in his experi- ments. The same results were produced by the diosma on animals. EFFECTS ON THE ECONOMY IN DISEASE. The inhabitants of the Cape administer this agent as a stomachic, and the Dutch physicians give it with success in indigestion. It is said, also, to have afforded essential service in chronic cases of rheumatism and arthritis. Autenrieth extols it in rheumatic pains, which have had their foundation in repelled itch ; and its utility in chronic rheumatism has been confirmed by Jackson and others. It has been extolled, moreover, in haematuria, calculous pains, and in irritated and suppurative conditions of the bladder, urethra, and prostate. We have repeatedly administered it, but have observed no other effects than those of a moderate excitant and tonic. Reece found it efficacious in incontinence of urine, and in catarrhus vesicae ; and he gave it — united with tincture of cubebs — in spas- modic stricture of the urethra, gonorrhoea, swellings of the pros- tate, and impotence. By the inhabitants of the Cape of Good Hope, the buchu leaves are often applied externally, both in the form of liniment and of baths, in luxations and rheumatic pains, — as well as of fomenta- tions and cataplasms, in wounds, especially the contused. ' It may be remarked, that this— like almost every other astringent remedy — has been given in cholera ; and the Riga physicians assert, frequently with favourable results. MODE OF ADMINISTERING. The dose of the powder is 3ij in the day ; this, at least, is the common dose at the Cape. The infusion necessarily contains more of the volatile oil than the decoction ; but, on the other hand, the latter has more of the diosmine : as respects their action, however, there is not much difference. A vinegar, oxymel, liniment, extract, and tincture of the diosma have been advised. The Dublin Pharmacopoeia has an infusum buchu. (§ss of the leaves to foss of water); dose giss: and a tinctura buchu (§ij of the leaves to ifcj of proof spirit) ; dose 3ij or 5iij. ELECTROPUNCTURA. 163 Tnfusum Diosmce, Crenatcz Compositum. Compound Infusion of Buchn. 5<. Fol. diosm. crenat. uvse ursi, aa. ^ss. Aq. fervid, §viij. Digere leni calore in vase clauso per semihoram. Colafuree adde Syiup. seneg. 3ss. Dose. — One or two spoonfuls every two hours, in blennorrhea, and in atony and paralysis of the bladder. Clarus. ELECTROPUNCTURA. Synonyme— Electropuncture* This consists in a union of acupuncturation with electricity, The idea of the conjunction appears to have originated with Ber- lioz ; but Sarlandiere was, doubtless, the first who put it in practice, although J. Cloquet has contested the priority with him — a matter, by the way, as in all such cases, of extremely small moment. The operation consists in employing acupuncturation in the usual way, either with a single needle, or with two or more; and making a communication between them and the prime conductor of an elec- trical machine ; or they may be made to form part of the circuit in the discharge of a Leyden jar. In this way, the electrical influence may be graduated from the simple aura to a full shock. Sarlandiere appears to have employed electropuncture with great success, but he restricts its use to rheumatic or neuralgic pains, uncomplicated with organic mischief or inflammation : when such complications exist, he advises bloodletting and general antiphlogistics to be pre- mised. 1 Guersent thinks it better, in all these cases, to use simple acu- puncturation, and only to employ electropuncture, when the first proves to be inadequate, as in paralysis, and in tremors produced by the immoderate use of mercury ;— in all cases, indeed, in which the malady depends on a diminution of the nervous energy. A case of success from its use, in paralysis of the right arm, in which volun- tary motion and sensibility were destroyed, has been recently pub- lished. 2 The patient was, in the first instance, subjected to the use of blisters and moxas along the course of the radial nerve, from which he obtained some advantage. The remedy which succeeded 1 E. Grafe, Art. Electropunctura, in Encyclopad. WOrterb. der medi- cinisch. Wissensch. x. 550. Berlin, 1834. 2 La Lancette Franchise, Dec. 20, 1836; and American Med. Intelli- gencer, Oct. 16, 1837, p. 265. 164 dunglison's new remedies. best, however, was electropuncture along the nerves from the shoulder to the hand. At first, the punctures were but little felt, but afterwards they were very painful. The sensibility, mobility, and strength of the fingers and hand gradually returned ; and, three months after his admission, the patient left the hospital com- pletely cured. Magendie affirms, that he has treated many cases of incomplete amaurosis with great success by this agency. He employed it, however, in the form of what has been more properly termed gal- vanopuncture ; by fixing a needle in the frontal nerve, and another in the superior maxillary, and making these communicate respec- tively with the poles of a galvanic pile of twelve pairs of plates, each six inches square. Whenever the contact was made, the pa- tient experienced a painful commotion in the course of the nerves, and at the bottom of the orbit; the light became better appreciated, and the pupil contracted. We have frequently used both electropuncture and galvano- puncture in rheumatic and neuralgic affections; but do not think the advantages were more marked than those of simple acupunc- ture, whilst the suffering from the operation was certainly greater. In cases of asphyxia, galvanopuncture has been proposed to arouse the dormant energies. The effect of electricity, in the dif- ferent forms in which it is adopted in medicine, on the functions of sensibility and muscular contraction, could not fail to suggest it early to observers as a fit agent for this purpose; but it is rarely at hand, and, therefore, seldom available. J. P. Frank, Thillaye, 1 and others have highly recommended it; — the latter gentleman, on the strength of numerous experiments on animals. As the object, in these cases, is to arouse the respiratory muscles to action, the electric shock may be passed through the shoulders or the chest in any direction. Neither common nor galvanic electricity is possessed of any power to restore the action of the involuntary muscles. We have frequently attempted to re-excite the action of the heart, in- testines, fibres of the uterus, &c. soon after the cessation of re- spiration and circulation, by means of the galvanic stimulus, but without the slightest success, although the voluntary muscles re- sponded to it energetically. Besides, were the action of the heart re-excited by it, this could be but momentary. A necessary stimu- lating agency to that viscus is distension by the proper fluid, and unless the respiratory movements were restored, and conversion of venous to arterial blood effected, so that the latter could reach the left heart, the action of that organ could not be maintained. Every attempt, therefore, is properly made to restore the action of the respiratory muscles, so that haematosis may be accomplished. 2 1 Archives Generates de Medecine, xii. 2 Art. Asphyxia, by the author, in the American Cyclopaedia of Practical Medicine, part x. p. 48ti, Sept. 18:;6. ELECTROPUNCTURA. • 165 M. Leroy d'Etioles 1 has suggested galvanopuncture in a manner which, at the first aspect, appears most formidable ; but which is really less so than it seems to be, in consequence of the impunity with which fine needles can be made to penetrate, as we have seen, 2 even the most important organs. He introduced an acupuncture needle on each side between the eighth and ninth rib, until it reached the fibres of the diaphragm. He then established a gal- vanic current between the needles by means of a pile of twenty-five or thirty pairs of plates, an inch in diameter. The diaphragm im- mediately contracted, and an inspiration was accomplished. He then interrupted the circle, when the diaphragm, urged by the weight of the abdominal viscera, and aided by gentle pressure made on the abdomen by the hand, returned to its former position, and an expiration was effected. In this way, the two respiratory acts were made to succeed each other, and regular respiration was reinduced. A continuous current was likewise employed in some cases, but the respiratory movements were irregular, and nothing like natural respiration resulted. Leroy tried his method on animals asphyxied by submersion, and when they had not been under water more than five minutes, they were often restored. These experiments were witnessed by Magendie. 3 On different occasions, M. Leroy asphyxied animals of the same kind, and ap- parently of the same strength, and whilst those that were left to themselves perished, those that were treated by galvanism reco- vered. As an aid, therefore, to pulmonary insufflation, and an important one, galvanism, combined or not with acupuncturation, might be advantageously employed in asphyxia, but as has been already re- marked, it can rarely be available. Certainly no time should be lost in adopting the other energetic and indispensable measures that are demanded. 4 It has been recommended, that as only a very small apparatus is necessary, batteries, consisting of a few plates, might be kept wherever there are station-houses for the reception of persons in a state of asphyxia. 5 The suggestion is good ; and they might also with propriety form a part of the cabinet of appa- ratus of the private practitioner ; but whilst an assistant is preparing the apparatus for action, the practitioner should be assiduously engaged in applying other means of resuscitation. 6 1 Magendie's Journal de Physiologie, tom. vii. 1827; torn. viii. and torn. ix ; also Recherehes Experimentales sur J'Asphyxie, Paris, 1829; and Bourgeois, Observations sur la possibility du retour a la vie dans plusieurs cas d'Asphyxie. Paris, 1829. * See Art. Acupuncture. 8 Journal de Pbysiolo^ie, ix. * See Art. Asphyxia, Op. cit. p. 486. 6 Kay, in Edinb. Med. and Surg. Journ. xxix. and in his work on Asphyxia. Lond. 1834. 6 See Most, Art. Galvanismus, in Encyklopad. der gesammten medicio. und chirurgisch. Praxis, u. s. w. 2te Auflage. Leipz. 1836. 166 dunglison's new remedies. EMETINA. Synonymes. Emetinum, Emetia, Emeta, Emetine. German. — Emetin, Brechstoff. In the year 1817, MM. Pelletier and Magendie, 1 by a series of chemical and physiological experiments, discovered, that the various kinds of ipecacuanha are indebted for their emetic properties to a peculiar substance to which they gave the name Emetine. This substance possesses the emetic power in a very concentrated state, and has neither the disagreeable smell, nor the nauseous taste of the ipecacuanha. They considered, therefore, that it might be advantageously substituted for ipecacuanha on all occasions. There are two varieties of the active principle — the coloured and the pure, which, as Magendie remarks, 2 bear the same relation to each other as moist sugar does to the white and crystallised. Ipe- cacuanha, derived from the cephaelis ipecacuanha, contains the most emetine. Emetine has been received into many of the Pharmacopoeias, as the Parisian, Batavian, Hannoverian, &c. MODE OF PREPARING. 1. Coloured Emetine. — Powdered ipecacuanha is digested with ether at 60° (.720) to dissolve the fatty matter, whence it derives its disagreeable odour, and which possesses no emetic virtue. When the powder yields nothing more to the ether, it is exhausted by means of alcohol, the alcohol is then evaporated in a water-bath, and the residue is dissolved in cold water. It thus loses some of the wax, and a little fatty matter, which still adhered to it ; it is then only necessary to mix it with the carbonate of magnesia, whereby it loses its gallic acid, — to redissolve it in alcohol, and to evaporate to dryness. By a similar process, M. Boullay obtained from the roots, leaves, flowers, and seeds of the viola odorata, an active, alkaline, bitter and acrid principle, similar to emetine from ipecacuanha, which he denominates emetine of the violet, indigenous emetine ox violine. According to Orfila, it possesses highly poisonous qualities. 3 2. Pure emetine. — This is obtained by substituting calcined magnesia, for the carbonate used in the process just described, in such quantity, that the acid existing in the liquid may be neutral- ised, and that which is associated with the emetine be separated from it. The precipitate of magnesia and emetine must now be washed 1 Journal de Pharmacie, iii. 145, and Magendie's Formulaire pour la pre- paration de plusieuts nouveaux medicamtns, &c. 2 Op. cit. 3 Journal de Pharmacie, Janvier, 1824. EMETINA. 167 with a little very cold water, to remove the colouring matter, which is not combined with the magnesia ; and after being carefully dried it must be treated with alcohol, which dissolves the emetine. The emetine, obtained by the evaporation of the alcohol, must then be dissolved in a dilute acid, and treated with pure animal charcoal. After this purification, the emetine must be precipitated by a salifi- able base. The waters, used to wash the magnesian precipitate, still contain emetine, which may be separated by a second series of operations. Coloured emetine appears in the form of reddish brown, trans- parent scales; is almost inodorous, and of a bitter, but not nau- seous taste. It can withstand the heat of boiling water without experiencing change; is very deliquescent, soluble in water, and not crystallisable. Pure emetine has a white and frequently a somewhat yellowish appearance ; is pulverulent, and does not deliquesce, like the former, in the air. In cold water, it is but little soluble ; more so in warm. In ether and alcohol it dissolves readily. Its taste is feebly bitter. It has an alkaline reaction, is dissolved by all the acids — diminishing their acidity, but without wholly neutralising them. With the acids it forms crystallisable compounds, from which it may be precipitated by galls, which are the best agents for ob- viating the effects of emetine, when given in too large a dose. EFFECTS ON THE ECONOMY IN HEALTH. According to Magendie, 1 from half a grain to two or three grains of coloured emetine given to dogs and cats, excited vomiting, at times followed by a long sleep. In larger doses, ten grains for ex- ample, it occasioned, in dogs, repeated vomiting, after which the animal fell asleep, and generally died in twenty-four hours. On dissection, violent inflammation was found in the lungs, and in the mucous membrane of the stomach and bowels throughout their whole extent. The effects were the same when the emetine was injected into the jugular vein, or absorbed from any part of the body. In a healthy man, two grains of coloured emetine, taken fasting, produced repeated vomiting, to which succeeded decided disposition to sleep. Even a quarter of a grain at times induced nausea and vomiting. It acted also on the bowels. The effects of pure emetine are analogous, but more powerful ; two grains were sufficient to kill a strong dog. EFFECTS ON THE ECONOMY IN DISEASE. The same effects are induced on the morbid as on the healthy economy. Magendie recommends the administration of the coloured eme- tine — as the pure is much too dear — in every case where it is 1 Op. citat. 168 dunglison's new remedies. desirable to excite vomiting-, and especially where ipecacuanha is indicated. It has not, however, been much used, except by Ma- gendie himself. Lerminier, who prescribed it, says that one or two grains of coloured emetine are equal in strength to from ten to twenty of ipecacuanha ; but that he observed no difference in their operation. The obvious advantages it possesses are — the convenient and agreeable form under which it may be administered, and the circumstance, that several spurious sorts of ipecacuanha are frequently passed off in commerce, and occasion, in consequence, considerable disappointment in the mind of the practitioner. The employment of the active principle of course precludes these incon- veniences. 1 Prollius, of Wolfhagen, has frequently administered the pure emetine, which he recommends as a substitute for ipecacuanha, on the grounds above mentioned ; and he properly adds, that the price is not a matter of so much moment as it might seem to be by reason of the very small quantity required to produce the desired effects. MODE OF ADMINISTERING. To produce vomiting, three grains of the coloured emetine may be dissolved in any vehicle, and given in divided doses, at short intervals. Of the pure emetine, Magendie found, in a man eighty- five years of age, one-sixteenth of a grain sufficient to induce vo- miting. He remarks, however, that the man was easily made to vomit. Prollius found the medium dose of the pure emetine, for an adult, to be from two-sixteenths to three-sixteenths of a grain ; sometimes it was requisite to give another sixteenth. Very rarely was it necessary to give more than four-sixteenths, or one-fourth of a grain. As, on account of its sparing solubility, pure emetine, when given alone, might be restricted in its operation, Prollius adds an equal portion of tartaric acid and a little sugar. Mistura Emetina, Vomitoria. Emetic Mixture of Emetine. 9<. Emetin. colorat. gr. iv. Infus. fol. aurant. ^ij. Syrup, flor. aurant. £ss. M. Dose. — A dessert-spoonful every half hour; to excite vomiting. Any simple distilled water and syrup may be substituted for those of the orange flowers. Magendie. Pastilli Emetince Pectorales. Pectoral Lozenges of Emetine. B<. Emetin. colorat. gr. xxxij. Sacchar. alb. %'\w. Mucilag. q. s. ut fiant pastilli, pond. gr. ix sing. 1 Clinique Medicale, vol. i. Paris. 1823. EUPHORBIA LATHYRIS. 169 These lozenges are commonly coloured red, to distinguish them from those of ipecacuanha. A little carmine may be added for this purpose. Given in cases of catarrh, hooping-cough, chronic diarrhoea, (fee. Dose. — One pastile occasionally. Magendie. Pastilli Emetince Vomit or ii. Emetic Lozenges of Emetine. &. Emetin. colorat. gr. xxxij. Sacch. alb. ^ij. Mucilag. q. s. ut fiant pastill. pond. gr. xviij. Dose. — One of these lozenges taken fasting is generally enough to make a child vomit: three or four are required for an adult. Magendie. Mistura Ernetince Purificalce Vomitoria. Emetic Mixture of Purified Emetine. 5«. Emetin. purif. in pauxil. acid. nitr. solut. gr. j. Infus. flor. tiliae, ^iij. Syrup, althaea?, 3j. M. Dose. — A dessert-spoonful to be given every quarter of an hour, until vomiting is induced. Magendie. EUPHORBIA LATHYRIS. Synonymes.— Cataputia Minor, Lafhyris, Tithymalus Latifolius, Caper Spurge, Garden Spurge, Mole Plant. The oil of this plant, which is indigenous in France, and is monoecious, has been recently recommended in medicine. Although the euphorbia is not a native of this country, it is sometimes met with in situations where it has the appearance of growing wild. It is easily cultivated, and in some parts of New Jersey, where it has been introduced, is found in abundance. 1 The oil, obtained from the seeds, resembles in colour the oleum ricini, but is less dense. It has no odour when newly prepared, and no perceptible taste. It is soluble in sulphuric ether, insoluble in alcohol, and forms a soap with the alkalies. Its s. g. is .920. effects on the economy in disease. Dr. Charles Calderini found, that, in the dose of from four to eight drops, it acted as a cathartic on the adult, without occasioning ' Scattergood, in Philad. Journ. of Pharmacy, iv. 124, Philad. 1S33. See, also, Journal de Chiraie Medicale, ii. 178. 170 dunglison's new remedies. colio or tenesmus. In half the quantity, it proved cathartic to children. He gave it in sugared water, or in the form of an emul- sion ; and was of opinion that it might be advantageously substi- tuted for castor oil, especially for children. After him, it was employed by M. Grimaud, and subsequently by M. Bally, 1 who carried the dbse as far as ten drops. Louis Frank 2 has suggested its employment in cases of taenia, hysteralgia, ascites, &c. It would appear from the remarks of Mr. Scattergood, that the oil, obtained from the beans grown in this country, does not possess the mild qualities ascribed to the European article. Six, eight, ten, and twelve drops were given to several individuals as a cathartic; and, although administered in conjunction with aromatic oils, and in one or two cases with an alkali in the form of soap, it invariably produced nausea, and even vomiting. Mr. Scattergood adds, that he has been informed by the manufacturer, Mr. Thomas Bellangee, of Cross wicks, New Jersey, that when administered in small quan- tities, and repeated at intervals of half an hour or an hour, it ope- rates on the bowels freely as a cathartic, without producing much nausea. Pichonnier 3 has proposed the following formula for a cathartic mixture. Mistura Olei Euphorbia. Mixture of the Oil of Euphorbia. 5<. Olei euphorb. lathyr. gtt. viij. Pulv. gum. arab. 3j. Sacchar. jfij. Aquae distillat. ^iij. M. FERRI PRiEPARATA. Synonymes. Preparations of Iron. French. — Les Preparations de Fer. German. — Eisenpraparate. I. FERRUM ARSENIATUM. Synonymes. Arsenias Ferri; Ferrum Arsenicicum Oxydulatum. French. — Arseniate de Fer. German. — Arsensaures Eisenoxydul, Arseniksaures Eisenoxvdul. This preparation has been recommended by Mr. Carmichael, 4 who often applied it externally in cases of cancerous ulcers. Na- 1 Journal Universel des Sciences Medicales, xli. 254. 2 Journal de Pharmacie, xi. 273 ; and Merat & De Lens, Diet, de Mat. Med. iii. 183. Paris, 1831. 3 Journal de Chimie Medicale. Paris, 1827. 4 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. FERRI PR.EPARATA. 171 tu rally, it presents itself in small, clear, bluish green crystals, of a regular octaedral shape, and is called scorodite. Artificially, it is formed by double decomposition. METHOD OF PREPARING. Glaser gives the following formula for its preparation. Eight ounces of semivitrified white arsenic, sprinkled with a little spirit of wine and reduced to fine powder, are mixed with as much puri- fied saltpetre. The mixture is placed in an uncovered Hessian crucible, which should only be half filled with it, and then be placed in a wind furnace. At first, a slight degree of heat is applied, under which the mass soon melts, giving off copious red fumes, the inha- lation of which should be carefully avoided. The process had better, therefore, be carried on in the open air, or in a laboratory that has a chimney with a good draft. When the mass no longer gives off red fumes, and flows tranquilly, the crucible must be carefully removed from the fire, the contents be suffered to cool somewhat, and boiling distilled water be poured upon them : under active boiling they will dissolve altogether. Hot water, sufficient to fill the crucible, is now added, and the whole is allowed to remain at rest for twenty-four hours ; at the expiration of which time a considerable quantity of beautiful crystals of acid arseniate of potassa is found on the sides of the crucible. The fluid, holding the salt in solution, is now filtered into a clean porcelain or glass vessel ; the crystals are collected, dried carefully in the shade, and put away amongst the poisons as the Arsenias potassce. acidus. The fluid poured from the crystals and filtered is now diluted with distilled water, and a solution of pure sulphate of iron added thereto so long as any precipitate is thrown down. The bluish green precipitate, insoluble in water, is the ferrum arseniatum, which must be collected on a filter, washed and dried in the shade. The process must be conducted with the greatest care, and the vessels used be cautiously cleansed or broken, for fear that mischief may arise. In these chemical operations, the acid of the saltpetre is decomposed by being heated with the arsenious acid or white arsenic, a part of its oxygen is taken by the latter, and arsenic acid is thereby formed, which unites with the potassa of the saltpetre and forms acid arseniate of potassa; the nitric acid being converted into nitrous acid is given off in the form of red fumes : by admix- ture of a solution of sulphate of iron with the solution of the acid arseniate of potassa, a double decomposition ensues, the result of which is the formation of sulphate of potassa and arseniate of iron, which last, being insoluble, falls to the bottom of the vessel. EFFECTS ON THE ECONOMY. According to Carmichael, this preparation acts more powerfully on the vitality of cancerous formations than any other agent, and 172 dunglison's new remedies. the dead slough caused by it is much deeper than that caused by the application — which was at one time so much celebrated — called "Plunket's caustic." He allows, however, that the greatest caution should be observed in its use. Of late, he has employed a compound of the arseniate of iron with phosphate of iron ; half a dram of the former to two drams of the latter. This mixture must be applied very thin by means of a camel's hair pencil, and not over the whole surface of the ulcer when it is extensive. MODE OF ADMINISTERING. The compound just mentioned may be applied in the form of ointment, in the following manner: Unguentum Ferri Arseniatis Compositum. Compound Ointment of Arseniate of Iron. £. Ferri arseniat. £ss. phosphat. jij. Ung. cetacei. 3 vi. M. This ointment must be spread on lint and applied to the ulcer. Werneck gives it the preference over all the usual arsenical prepa- rations. The arseniate of iron has likewise been administered in- ternally in cancerous affections. The following formula may be used. Pilules, Ferri Arseniati Composites. Compound Pills of Arseniate of Iron. £. Ferri arseniat. gr. iij. Extract, gentian. 3j. Pulv. glycyrrhiz. 3ij. Syrup, cujusvis q. s. ut fiat Massa, in pilulas xlviii dividenda. Dose. — One, three times a day. II. FERRUM BROMATUM. Synonymes. — Bromated, or Bromide of, Iron ; — in solution, Hydrobromate of Iron, Ferri Hydrobromas. French. — Bromine de Fer. German. — Bromeisen. METHOD OF PREPARING. This preparation is made by heating equal parts of bromine and iron filings under water. As soon as the fluid becomes of a greenish color it is filtered, and evaporated to dryness: the reddish residue — again dissolved in water and evaporated— is the bromide of iron. FERRI PR.EPARATA. 173 It has a brick-red colour ; dissolves readily in water, is deliquescent in the air, and has a very styptic taste. 1 EFFECTS ON THE ECONOMY AND MODE OF ADMINISTERING. Magendie has prescribed it successfully in cases, in which the preparations of bromine have been indicated. (See Brominum, p. 88.) He recommends the following formula. Pilulce Ferri Bromati. Pills of Bromide of Iron. £. Ferri bromat. pulv. gr. xij. Confect. rosar. gr. xviij. Gum. arab. gr. xij. Fiat massa in pilulas xx dividenda. Dose. — Two, morning and evening. Magendie. &. Ferri bromat. 3j. Extract, glycyrrhiz.. ut fiat massa in pilulas lx dividenda. Dose. — One or two, morning and evening, in cases of scrofula and hypertrophy — of the uterus especially. Werneck. III. FERRUM CARBONATUM PRiECIPITATUM. Synonymes. — Ferri Carbonas Praecipitatus, F. Subcarbonas, Ferrum Car- bonicurn Oxydulatum, Oxydum Ferri Fuscum, Deuto-Carbonas Ferri Fuscus, Crocus Martis Aperiens, Ferri Sesquioxydum, Subcarbonate of Iron, Sesquioxide of Iron, Peroxide of Iron. French. — Souscarbonate de Fer, Safran de Mars Aperitif. German. — Kohlensaure Eisenoxydul. This preparation, which is officinal in the British, American, and other pharmacopoeias, is formed by adding a solution of car- bonate of soda to a solution of sulphate of iron : the precipitate is the carbonate, or subcarbonate, or — as it is now called in the London Pharmacopoeia — the sesquioxide of iron, which must be washed with water, and dried. EFFECTS ON THE ECONOMY. The precipitated carbonate of iron possesses the properties of the chalybeates in general, and has been highly recommended as a tonic, wherever such remedies are indicated. We introduce it here, mainly on account of the favour which it has received, of late years, as a remedy for neuralgia. Thirty years ago, its use was strongly advised in cancer and carcinomatous ulcerations of the ' Magendie, Formulaire pour la preparation, &c, de plusieurs nouveaux medicamens, derniere edit. 174 dunglison's new remedies. uterus, by Mr. Carmichael ; x and, subsequently, by Rust, Voelker, and Kopp ; as well as in a case of lupus of the ala nasi, by Key ; 2 but, in similar cases, it proved unsuccessful in the hands of Clarke, El. Voti Siebold, Meissner, Richter, and others. 3 In chronic ner- vous diseases, of a spasmodic nature, and especially in tic doulou- reux of the face, it was first highly extolled by Mr. Benjamin Hutchinson, about twenty years ago. 4 who published several cases of cure effected by its agency. Soon afterwards, cases, equally fortunate in their termination, were published by various observers, by Drs. A. T. Thomson, 3 Stewart Crawford, 5 R. Macleod, 7 Mr. J. E. Beale, 8 and many others, and its efficacy is now almost univer- sally admitted. Dr. Rowland 9 has often witnessed the most happy results from its exhibition, even after various powerful medicines had been tried in vain. Dr. Elliotson 10 published several cases, in which the remedy, in large doses, had been efficacious ; and he remarks, that true chronic neuralgia, not arising from cold, and coming on in a vio- lent, stabbing, plunging form, aggravated by the least shake of the patient, and by touching the surface, is best treated by the sub- carbonate of iron. He observes, however, in a recent publication, 11 that he does not recollect that he ever cured the disease, but in almost every case improved it, and caused it to disappear for a time. In one of the severest cases of neuralgia, under the form of hemicrania, which we ever witnessed, and which had rendered the patient's life miserable for years, the subcarbonate of iron, in large doses, proved, in our hands, entirely successful. The patient had been bled repeatedly; and when we saw her, she was under the most favourable circumstances for the exhibition of the remedy, with the surface pale and cool; the pulse small; complaining much of debility, and yet suffering under the most intense head- ach, which the least light and noise rendered almost intolerable ; yet, after she had persevered in the use of the remedy for a month, in large doses, the symptoms gradually disappeared, and she has since remained entirely well. It need scarcely be said, that where plethora exists, or febrile irritation supervenes, it must be re- 1 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. 2 Laocet. xiv. 92. 3 Osann. in Encyclopad. Wurterb. der medicinisch. Wissenschaft. x. 424. Berlin, 1834. 4 Cases of Tic Douloureux successfully treated. Lond. 1820. 6 Medical and Physical Journal, Feb. 1823. 6 Ibid. 7 Ibid. June, 1823. 8 Ibid. Sept. 1823. 9 Treatise on Neuralgia, by Richard Rowland, M. D., p. 84. Lond. 1838; and the reprint in the editor's American Medical Library. 10 Medico-Chirurgieal Transactions, xv. 161. 11 Principles and Practice of Medicine, &c. by John Elliotson, M. D. ; with Notes, &c. by Nathaniel Rogers, M. D. p. 507. Lond. 1839. FERRI PR^EPARATA. 175 moved ; the subcarbonate rarely, however, disagrees with the sto- mach, and where it does, the inconveniences are removed by the addition of an aromatic, or the administration of a cathartic. The subcarbonate of iron, in large doses, has, likewise, been found a valuable agent in a kindred condition of the nervous sys- tem — chorea. Dr. Elliotson 1 affirms, that he has had — he should suppose — forty cases, in succession, all cured by it; but perseve- rance in its use is demanded, the affection generally disappearing when the remedy has been given about six weeks or two months; but in some obstinate cases, it has been necessary to continue it for twelve weeks. Like other tonics, it has been prescribed in intermittents, and not long ago, M. Gimon, 2 physician at Thouars, published two cases, elucidative of the effects of large doses in long protracted intermittents, complicated with ascites and enlargement of the spleen. One of these occurred in a boy nine years old, and the other in a young man of twenty-one. Both had taken the sulphate of quinine in large doses, but ineffectually. To the former, he pre- scribed twelve grains of the subcarbonate in the twenty-four hours, augmenting the dose by six grains daily. The treatment was com- menced in the latter end of July, 1835, and the quantity taken in the day was pushed progressively to one ounce. In six months, the traces of ascites and splenocele had disappeared, and the cure was complete. The medicine was discontinued by gradually dimi- nishing the dose. In the second case, the same dose was pre- scribed, in the first instance, and it was ultimately carried to six drams, with complete success. More recently, still, Dr. Steyman 3 has recommended the carbo- nate of iron for the treatment of hooping-cough, in the dose of half a grain at the least, to be taken every three hours with sugar, and increased to as many grains as, and more than, the number of years of the child's age. It should not, he advises, be administered in the first stage of the disease ; and, in all cases, should be pre- ceded by an emetic. The great efficacy of this preparation — as of every tonic — in diseases that are paroxysmal, aj^ears to consist in the new impres- sion which it makes upon the nerves of the stomach, and, through them, upon those of the whole system ; but to effect the revulsion to the requisite extent, it appears to be necessary — as in the cases of the artemisia and the indigo in epilepsy — to keep up the effect of the remedy by gradually increasing the dose. MODE OF ADMINISTERING. The dose of the subcarbonate of iron, in cases of neuralgia and chorea, should be large. Mr. Hutchinson prescribed it in the 1 Op. citat. p. 515. * Journal des Connoissances Medico-Chirurgicales, Mai, 1837. 3 Mediein. Correspondenz-Blatt, and Gazette Medicale de Paris, June 20, 1838. 176 dunglison's new remedies. quantity of 3ss to 3ij twice a day ; but where it fails to remove the complaint in those doses, Dr. Elliotson recommends, that it should be increased gradually to one or two ounces. We have never found it necessary to carry it so high. The best vehicle is molasses. The following formulae have been recommended. 1 Pulvis Ferri Sesquioxydi — (P. Ferri Carbonati Prcecipitati.) Powder of Sesquioxide of Iron. 5<. Ferri sesquioxydi, gr. x. Pulv. cinnam. corap. gr. v. M. fiat pulvis mane et meridie sumendus. Boli Ferri Sesquioxydi. Boluses of Sesquioxide of Iron. 5<. Ferri sesquioxydi, gr. x. Pulv. Valerianae, Jss. Syrup, zingib. q. s. Fiat bolus. Pilulce Ferri Sesquioxydi. Pills of Sesquioxide of Iron. &. Ferri sesquioxydi, Extract, anthemid. aa. gss. Misce et divide in pilulas xij, quarum sumat binas ter quotidie. 5f. Ferri sesquioxydi, 3j. Pilul. aloes cum myrrha, £ss. Misce et divide in pilulas xviij : duse bis terve indies sumendae. Electuarium Ferri Sesquioxydi. Electuary of Sesquioxide of Iron. 5<. Ferri sesquioxyd. Contecl. aurant. aa. 3j- Syrupi zingib. q. s. ut fiat electuarium cujus sumatur cochleare minimum bis vel tei die. IV. FERRUM CARBURETUM. Synonymes. — Ferri Carburetum, F. Carbonatum, F. Supercarburetum; Graphites, Plumbago, Carbo mineralis. Black Lead, Carburet of Iron. French. — Carbure de Fer, Graphite, Crayon noir, Plombagine. German. — Kohleustoffeisen, Graphit, Reissblei. This well known substance was formerly considered to be slightly astringent and desiccative. By Weinhold, 2 it has been ad- vised strongly in certain cutaneous affections, but although it has been received into various pharmacopoeias of continental Europe, as the Antwerp, Bavarian, Brunswick, Spanish, Parisian, Finnish, 1 Brande, Dictionary of the Materia Medica, p. 248. Lond. 1839. 2 Der Graphit als ein neu eutdecktes Mittel gegen Flechten. Leipz. 1809. FERRI PRjEPARATA. 177 Prussian, Saxon, and Swedish, it has never been recognised as a therapeutical agent in this country or in Great Britain. MODE OP PREPARING. As crude graphite is frequently very impure from the attached matrix, the Prussian Pharmacopoeia has a formula for its purifica- tion, the product of whfch bears the name graphites depuratus. With this view, the graphite must be very finely pulverised ; a pound of it is boiled in a proper quantity of common water, for an hour, the water is then decanted, and two ounces of nitric acid and of muriatic acid, and eight ounces of common water are poured upon the graphite. This mixture is digested for twenty-four hours, frequently shaking it ; the acid fluid is then poured off, and, after the residuum has been washed by an appropriate quantity of com- mon water, it is dried. EFFECTS ON THE ECONOMY. The internal use of graphite produces no perceptible change on the organic functions, except that according to Weinhold, under its protracted use, the urinary secretion is augmented, and a dispo- sition to micturition excited. He found, however, that in herpetic and other cutaneous affections, it occasioned a very favourable modification in the eruption, and wholly removed it. In conse- quence of the results of his observations, he published a monograph in which he recommended the graphite to physicians in those affec- tions. He employed it as well internally as externally. The urine, he asserts, after its administration, commonly began to make a de- posite, and this continued until some change in the cutaneous affection announced its approaching cure. In cases of complication of herpes with other affections, Wein- hold combined it with other remedies ; in syphilitic eruptions ad ling corrosive sublimate, &c. The efficacy of the graphite in herpetic and other cutaneous affections, has also been attested by many other respectable physi- cians, as Horn, Heim, Ruggieri, Brera, Bernstein, Hildenbrand, Riehter, Hufeland, Marc, 1 &c. This gave occasion to its admis- sion into the Prussian Pharmacopoeia, yet it has not the confidence of physicians, even in those countries into the pharmacopoeias of which it has been received, and is consequently but little used. Its use in chronic cutaneous diseases is said to have been sug- 1 Riecke, Die neuern Arzneimittel, u. s. w. Stuttgart, 1837, S. 214; see, also, Weinhold, in Hufeland's Journal, B. xxxiv. St. 1. S. 118; Heim, in Horn's Archiv. 1810, xii. 326, and Ibid, 1811, B. 1. S. 91; Huber, in Med. Chir. Zeilung, 1811, No. 68, S. 282 ; Hufeland, Journ. der prakt. Heilkunde, B. xxxviii. St. 6; Bernstein, Ibid, B. xli. St. 5 ; Mayer, Ibid, B. lx. St. 2, and Osann, in Encyclop. Worterb. der Med. Wissensch. x. 434. Berlin. 1834. 8— d dungl 12 178 dunglison's new remedies. gested by the circumstance, that, in Venice, the makers of crayons are speedily cured of any such affections under which they may labour. 1 METHOD OF ADMINISTERING. Internally, graphite is given in doses of from five to fifteen grains, from two to four times daily ; and the dose may be augmented, according to circumstances, to a dram in the day. It is given in powder, or in the pilular form. Externally, it is applied in the form of ointment or plaster — from 3rj to 3vj of the graphite to an ounce of the constituent. Pirivis Ferri Carbureti. Powder of Carburet of Iron. 5^. Ferri carburet, pur. Sacch. alb. aa. ^ss. M. Divide in partes aequal. vi. Dose. — One every two hours — in lichen leproides. HlLDENBRAND. Electuarium Ferri Carbureti. Electuary of Carburet of Iron. 9<. Ferri carburet, pur. ,§ss. Mellis despumat. ,§ij. M. Fiat electuarium. Dose. — A coffee-spoonful morning and evening. Weinhold. PilulcB Ferri Carbureti. Pills of Carburet of Iron. 9<. Ferri carburet, pur. Extract, dulcamar. aa. £j. M. fiant pilulae, pond. gr. ij. Dose. — Six, three times a day. Maerker. 5t. Ferri carburet, gij. Flor. zirjci. 3ss. Axung. porcin. 3J. M. Mayer. Unguentum Ferri Carbureti. Ointment of Carburet of Iron. ?<. Ferri carburet, pur. Sulphur, depurat. aa. ^ij. Axung. porcin. q. s. ut fiat unguentum. Brera. 1 Merat & De Lens, in Diet, de Mat. Med. Art. Carbone. FERRI PR.EPARATA. 179 Emplastrum Ferri Carbureti. Plaster of Carburet of Iron. 5<. Ferri carburet, depur. ^ij. Emplast. sapon. 3iv. Misce intime. Weinhold. V. FERRUM CYANURETUM. Synonymes. — Ferri Cyanuretum.F. Cyanogenatum, F. Oxydulatum Hydro- cyanicum, F. Borussias, Ferro Sesquicyanidum, F. Percyanidum, Ferro- cyanas Oxydi Ferri, Ferri Ferrocyanas, Ferrum Zooticum, F. Borussicum, Coeruleum Borussicum, C. Beroliniense, Prussiate of Iron, Cyanuret or Iron ; Prussian Blue. French. — Trito-hydro-ferro-cyanate de Fer; Deutoxicyanure de Fer Hy- drate; Tritohydrocyanate Ferrure de Fer, Prussiate de Potasse et de Fer,. Bleu de Prusse. German. — Cyaneisen, Blaustoffeisen, Blausaures Eisenoxydul, Eisenblau- saures Eisenoxyd, Eisencyanurcyanid, Berliner Blau, Pariser Blau. In commerce, this preparation with us bears the name " Prus- sian blue," but in Germany it is called "Pariser Blau." It is not in a state of purity, and. consequently, that which the apothecary- prepares is best adapted for internal use. MODE OF PREPARING. The form given by Buchner is as good as any. The ferrocyanate of pofassa, as commonly met with in commerce, is dissolved in warm distilled water, and to the clear filtered solution is gradually added,, in a glass vessel, a solution of chemically pure sulphate of iron so long as a precipitate is thrown down. After the precipitate has fallen to the bottom of the vessel, and the supernatant fluid, which contains sulphate of potassa, has been poured off, the precipitate is first digested with dilute sulphuric or muriatic acid, in order to dis- solve the excess of oxide of iron ; the beautiful dark blue precipitate is then collected on a filter, carefully washed with boiling water, and dried. The cyanuret of iron is of a beautiful deep blue colour, and de- void of odour and taste. It is decomposed by heat, and is insoluble in water, alcohol, ether, oils and dilute acids. Potassa and soda decompose it. According to Zollickoffer it adheres firmly to the tongue, which Riecke thinks, though erroneously, is owing to its containing argil. EFFECTS ON THE ECONOMY. Of the effects of the cyanuret of iron on the human economy m health we have no evidence. Cotillon gave it to various animals, but observed no action from it. It has been given, and not without 180 dunglison's new remedies. success, in several diseases ; and Dr. L. W. Sachs, who has not ^infrequently administered it, considers it one of the most important ohalybeates with which we are acquainted. He thinks it probable, that the hydrocyanic acid has not much agency; yet it certainly seems to differ from all the other preparations of iron. It has been especially recommended in epilepsy by Kirckhoff 1 of Ghent. In very obstinate cases, not dependent upon organic mis- chief, he succeeded entirely with it ; with the adult he commenced with half a grain daily, and raised the dose gradually to three four, and even six grains and upwards. When the patient -was plethoric, he premised bloodletting, or applied leeches, from time to time, to the temples. Hildenbrand and Gergeres confirm afe efficacy in epilepsy. In intermittent fever Zollickoffer 2 found the cyanuret of iron so 30cacious, that he even gave it the preference over the cinchona ; acd his experience has been confirmed by that of Eberle, 3 Hosack 4 -and others. Wutzer, in Germany, also exhibited it successfully; ana Stosch gave it advantageously, in combination with cinchona ^and rhubarb, in a case of obstinate intermittent. Sachs likewise tried it frequently, but as often without as with success. When it has proved efficacious in intermittents the dose has been by no means large. Some have given six or eight grains every four hours during the apyrexia, and even as much as a scruple has been ad- ministered. Sachs found it several times efficacious when four >dose& of two grains each were taken. Riecke 5 affirms that his father obtained essential service from it in the leucophlegmatic con- ditions resulting from intermittent fever. Zollickoffer extols the cyanuret also in remittent fever, and there may doubtless be periods when it may be administered with benefit, but it is not often used. He recommends it also in dysentery, 6 when fthe inflammatory condition has passed away, either spontaneously or under the efforts of art; and Sachs remarks, that in those atonic conditions of the intestinal canal, which supervene on dysentery, it may doubtless be of great service. Gergeres administered it suc- cessfully in chronic "diarrhoea. L. W. Sachs enters into a long theoretical disquisition on the precise action of the remedy, in which there is doubtless much that is speculative. He used it, he says, with success, in many cases which it would be difficult to classify under any formal nosology; their common bond, however, was, that they were dependent upon "nervous disorders, especially of the plastic functions of the abdominal organs, the mischief appearing first of all to be gastric." In such affections, he found a combina- tion of the cyanuret of iron with rhubarb especially serviceable. He 1 Journal de Chimie Medicale, iii. 285. 2 American Medical Recorder, v. 540. * Materia Medica, 2d edit. i. 233. 4 New York Medical and Physical Journal, 1823. 5 Op. cit. S. 217. * Chapman's Philadelphia Journal, Aug. 1823. FERRI PR.3SPARATA. 181 gave in not less than two grains for a dose, which he gradually- augmented to six grains three times a day. Dr. Moll saw decidedly good effects from its use in a case of immoderate menstruation from atony of the uterus with general elevation of the nervous excitability, after he had employed the remedies commonly recommended un- successfully. He found it also extremely beneficial to children of a strumous habit, and great torpor. Stosch found it serviceable in a case of scrofula, in which haema- tosis was imperfectly accomplished, and Dr. Bridges 1 found great advantage from it in a case of severe and protracted facial neu- ralgia. Externally, the cyanuret of iron has been used in the form of ointment, in cases of ill conditioned, torpid and foul ulcers, and even of noli me tangere. Stosch applied it in a case of fungous ulcer with marked advantage; forming it into a paste with water and applying it in that form. MODE OF ADMINISTERING. Pulvis Ferri Cyanureti. Powder of Cyanide of Iron. ic Ferri cyanuret. gr. iij ad xxxvj. Sacchar. alb. £ij. M. et divide in pulveres vj. Dose. — A powder two or three times a day, in epilepsy. Kirckhoff. *. Ferri cyanuret. gr. j, iv, vj ad xij. Sacch. alb. 3j. Fiat pulvis, in partes xij aequales dividendus. Dose. — A powder every two hours, in epilepsy. HlLDENBRAND. £. Ferri cyanuret. Pulv. gnaiac. aa. 3j. Misce et divide in chartulas xij. Dose. — One three times a day. — Employed successfully in inter- mi ttents. 2 PUuIcb Ferri Cyanureti. Pills of Cyanide of Iron. *. Gum. amnion. Rad. rhei, Ext. taraxac. aa. £j. Ferri cyanuret. gr. xviij ad xxxvj. M. et fiatmassa in pilulas lxdividenda. Dose. — Four to six, twice a day, in disorder of the ganglionic system. Radius, according to L. W. Sachs. 1 Wood & Bache's Dispensatory, Art. Ferri Ferrocyanas. * Ellis's Formulary, 5th edit. p. 161. Philad. 1838. 182 dunglison's new remedies. Unguentum Ferri Cyanureti. Ointment of Cyanide of Iron. B<. Ferri cyanuret. 3j. Unguent, cetacei, ^j. M. et fiat unguentum. Applied to foul ulcers. VI. FERRUM IODATUM. Synonymes. — Ferri Iodidum, Ferri Toduietum, Iodated Iron, Iodide of Iron, Ioduret of Iron, Protoioduret or Protoiodide of Iron. French. — Iodure de Fer, Protoiodure de Fer. German. — Iodeisen. FERRUM HYDRIODATUM. Synonymes. — Ferri Hydriodas, Ferrum Hydroiodicum Oxydulatum, Hydrio- dated Iron, Hydriodate of Iron, Hydriodate of Protoxide of Iron. French. — Hydriodate de Fer. German. — Hydriodsaures Eisenoxydul. Although attention had been directed, several years ago, to this preparation, it was not much used, until Prof. A. T. Thomson, 1 of the London University, recommended it strongly in a special monograph a few years since. It has been lately received into the London Pharmacopoeia. MODE OF PREPARING. The following method is recommended by Dr. Thomson. One part of iron wire should be rubbed in a porcelain or wedgwood mortar, with about three or four parts of iodine, gradually adding distilled water, until fifteen parts of the fluid have been used : the whole is then to be introduced into a Florence flask, with an addi- tional portion of wire and of distilled water. This excess of iron is a matter of indifference in the preparation of the hydriodate, and in that of the iodide it is necessary for preserving the combination from decomposition during the evaporation of the solution. These materials are next to be boiled together, until the fluid acquires a pale greenish colour, when it must be filtered. This solution con- tains a hydriodate of the protoxide of iron; and, if the exact quan- tity of the iodine be previously ascertained, so as to enable us to procure the solution of a definite strength, it may be kept in this state for medicinal use. In general, however, the solution is evapo- rated to dryness, and for this purpose it may be poured into a clean flask, containing a piece of iron wire sufficiently long to reach from 1 Some observations on the preparation and medicinal employment of the Ioduret and Hydriodate of Iron, 8vo. pp. 64. Lond. 1834. FERRI PRiEPARATA. 183 the bottom to the surface of the fluid, and the boiling should be continued until the bulk of the solution be reduced to one third. It must then be filtered, after which the evaporation should be con- tinued to dryness. It is necessary to break the flask as soon as the mass is cold, in order to obtain the solid iodide, which should be immediately transferred to a dry bottle, accurately fitted with a ground stopper. The bottle should not hold more than two ounces of the preparation ; for when it is large and not full, the iodide deliquesces nearly as rapidly as when it is exposed to the free action of the atmosphere. When the flask is broken, and the iodide bot- tled before the mass is cold, deliquescence also takes place, a peroxide of the metal is formed, and iodine is evolved. The plan proposed by Mr. Durand, 1 of Philadelphia, after that by MM. Baup and Caillot, 2 for preparing the solution of the proto- iodide of iron (hydriodate of protoxide of iron) is the following : — Take of iodine 3x, iron filings, perfectly pure and unoxidised, 3v, distilled water gxiiss. Put the iodine into a porcelain capsule, with one half the quantity of water, add the iron filings by small portions, stirring the mixture with a glass rod. The combination soon takes place ; heat is evolved with the disengagement of a small quantity of vapour of iodine, and the mixture acquires an orange colour, which gradually deepens to a dark red. When the whole of the iron has been added, the capsule is put in a sand bath or over the flame of a spirit lamp and heated slowly; continuing to stir the liquid. An iodureted hydriodate of iron is first produced, which, under the action of heat, soon passes to the state of a simple hydriodate. This point is indicated by the entire discoloration of the solution. In this state it is filtered ; and the dregs and filter are carefully washed with the remaining half of the distilled water, previously heated to the boiling point. In this manner, a solution forming twelve and a half fluid ounces is afforded, one ounce of which represents one dram of iodide of iron. The solution, which is at first colourless, acquires a deep red colour by standing, and precipitates some oxide of iron ; by which it is reduced to the state of an iodureted hydriodate of iron ; but it may be easily restored to its former state by heating it again with a small quantity of iron filings, until the liquid becomes colourless. The iodide of iron is obtained by evaporating to dryness the fil- tered solution, taking care, towards the end, to stir incessantly with an iron spatula, and to detach the salt from the bottom of the cap- sule as it forms. The heat must be managed most carefully, diminishing it gradually, and removing the capsule quickly from the fire as soon as the odour of iodine is evolved. The solution of this salt, when the iodide is well prepared, is of a light orange colour, and deeper in proportion to the decomposition which some parts may have undergone towards the end of the operation. 1 Philad. Joum. of Pharmacy, iv. 287. Philad. 1833. * Ibid, i. 201. 184 dunglison's new remedies. The iodide requires to be well secured from the influence of the atmosphere, both on account of its deliquescent property, the rapid oxidation which the metal undergoes when deliquescence occurs, and the consequent decomposition which takes place. It is im- portant to prevent this, as the peroxide of iron is inert as a medi- cinal agent ; whilst the free iodine extricated during its operation, according to Dr. Thomson, alters altogether the virtues of the medicine. This partial decomposition of the iodide is rendered immediately apparent on dissolving it in twenty times its weight of distilled water, and filtering: instead of a permanent, clear, very- pale greenish yellow, we obtain an ochre-coloured, completely in- soluble precipitate. Much of the iodide, usually prepared, is of this description, and to this may, doubtless, be referred some of the disappointment and discrepancy amongst practitioners as to the operation of the medicine in cases apparently similar. Even when the iodide has been carefully prepared, it often contains a little free iodine ; but, according to Thomson, it is chiefly owing to the carelessness of assistants and apprentices in compounding prescrip- tions, by frequently exposing the iodide to the air, that its proper- ties, and, consequently, its medicinal powers, are impaired : hence, it is preferable to keep it in solution, or in the form of hydriodate, which it becomes, whenever water is added to it. If the solution be prepared with a definite quantity of iodine, r described, it will keep without changing its characters ; but as it usually made, by dissolving the iodide in distilled water, it require to be rendered neutral by the following means : — Introduce into flask the solution of any given strength, and place in it two o three doubles of clean and soft iron wire, sufficiently long to ex- tend to the surface of the fluid ; boil it for a few minutes, and then leave it at rest, until the solution becomes clear, after which it may be either decanted off from the precipitate which forms, or filtered : no farther change takes place in a solution thus treated, provided it be kept in a blackened or a green bottle, however long it may be preserved. In this process, the wire affords iron to saturate any free iodine present in the solution, or that may have been extri- cated by the formation of the peroxide of iron in the iodide ; and a perfectly neutral solution being thus obtained, by the immediate conversion of the newly formed iodide into the hydriodate of the protoxide, no subsequent change takes place so long as the solution is kept secluded from the light. The best proportions, according to Dr. Thomson, for forming the medicinal solution, are three grains of the dry solid iodide to each fluidram of distilled water. If the water be not either distilled or filtered rain water, perfectly free from foreign ingredients, and particularly if it contain any earthy or saline carbonates, decomposition instantly takes place, iodine is extricated, and a carbonate of iron, which rapidly passes into the state of a peroxide of that metal, is precipitated. When iodide of iron is carefully prepared, it is of an iron gray colour, foliated texture, brittle, and exhibits a crystalline arrange- FERRI PR.EPARATA. 185 merit similar to metallic antimony, except that it is darker. In the dry state, it is inodorous ; but, when moist, it smells somewhat of iodine : the taste, when dry, is simply styptic ; when moist, some- what acrid, before it impresses the gustatory organs. At 350° of Fahrenheit it fuses ; and, at a higher temperature, is decom- posed, — the iodine being volatilised, and the iron remaining in the state of oxide. It dissolves in all proportions in water, — the changes supervening, which have been already indicated. It is decomposed by chlorine, the mineral acids, oxide of arsenic, me- conic acid — consequently by opium and laudanum — gallic acid, and tannin, the pure and carbonated alkalies, different metallic salts, and by the infusions of digitalis, belladonna, hyoscyamus, tobacco, amylaceous substances, &c: such substances ought not, therefore, to be given in combination with it. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made on his own person, Dr. Thomson states the following to be the physiological effects of the hydriodate of iron. When taken in doses of from three to five grains, it makes no sensible impression on the stomach, although it sharpens the appe- tite, and improves the digestive function: it seems to stimulate moderately the digestive canal through its entire length ; for it opens the bowels ; and, whilst it produces the black colour of the alvine discharges characteristic of all the preparations of iron, it corrects their foetor. When it does not affect the bowels, it aug- ments the action of the kidneys, increasing the flow of urine ; and if the solution be taken two or three times a day, for several days successively, the presence of both the iodine and the iron can be readily detected in the urine. The temperature of the skin is mo- derately elevated, and the insensible perspiration increased. On one occasion, having taken ten grains for a dose, it almost imme- diately caused an uneasy sensation at the epigastrium, accompanied with nausea that continued for several hours, and a slight degree of headach. These symptoms were relieved by a copious evacua- tion, which was perfectly black. Two hours after taking the me- dicine, a large quantity of urine was discharged ; which, on being tested, displayed the presence of both the iodine and the iron. The experiments on animals, made by Dr. Cogswell, 1 induced him to infer : — 1. That the iodide of iron acts as a local stimulant, possessing the power of effecting peculiar disorganisation. 2. That its action is more particularly directed to the tract of the alimentary canal. 1 Essay on Iodine, p. 132. Edinb. 1837. 186 dunglison's new remedies. When added to blood out of the body, the iodide of iron pro- motes its coagulation. 1 EFFECTS ON THE ECONOMY IN DISEASE. From the chemical composition of the iodide of iron, Dr. Thom- son considered it might be specially adapted for cases in which augmented activity of the capillary, or intermediate system, with a tonic effect, might be indicated, and particularly in scrofulous affec- tions, tabes mesenterica, chlorosis, incipient scirrhus, rickets, ame- norrhcea, bronchocele, atonic dyspepsia, — indeed, in all cases ac- companied by debility. In such affections, he conceives the iodide will act more efficiently than any of the other preparations of iron. In secondary syphilis, it may be combined, he suggests, with iodide of potassium ; and in incipient cancer, its efficacy, is aided by the administration of arsenic at the same time. Dr. Thomson has found it serviceable in atonic gastric dyspepsia, when com- bined with bicarbonate of potassa, and taken at the moment of ad- mixture, in the dose of from three to eight grains or more. 2 A great advantage it possesses is its ready solubility, owing to which it can enter the circulatory system with facility, and modify the condition of the fluids. In chronic scrofulous cases, it produces all the good effects of the preparations of iron, without any of the concomitant and subsequent symptoms that are so apt to super- vene, especially in impressible individuals. Where the case is accompanied by vascular erethism, or fulness, they must be re- duced before the iodide can be esteemed appropriate. In chlorosis, occurring in strumous habits, it has been found most serviceable. Its efficacy in cancer is elucidated by Dr. Thomson, by the de- tails of a case of scirrhous mamma, which, after protracted and fruitless treatment by other agents — as by other preparations of iron combined with conium — ultimately yielded to a combination of the hydriodate of iron and conium. Some cases are also detailed in which the hydriodate of iron was very effective in removing old syphilitic affections, especially of the skin. Prior to the publication of Thomson, Pierquin had given the iodide in cases of leucorrhoea and amenorrhea, and Eager 3 had re- commended it in scrofula. Ricord 4 found the very best effects from its internal use in cases where tonics required to be combined with antisyphilitic remedies, especially where any scrofulous vice (lymphatisme) constituted a complication. He administered it like- 1 Magendie, Lecons sur le Sang, &c. 1837; and translation in the Lancet, Jan. 26, 1839. 2 London Dispensatory, and Brande's Dictionary of Mat. Med. p. 252. Lond. 1839. 3 Dublin Journal of Medical Science, 1834; also, Cogswell on Iodine, p. 138, Edinb. 1837. 4 J. J. L. Rattier, in La Lancette Franchise, Fev. 4, 1837. FERRI PR^EPARATA. 187 wise with great success, to remove the consequences of syphilis, and found it advantageous in atonic ulcers of the legs and in spreading ulcers of the throat, which had been aggravated or had not yielded to mercury. The strength of M. Ricord's solution was half a dram of the iodide to §viij of water, given, we presume, in the twenty-four hours. M. Ricord 1 also uses it in the form of injection in cases of blen- norrhcea. Wherever, indeed, tonic astringent injections are needed, the iodide, in his opinion, should occupy the first rank. Its use, he thinks, can only be contra-indicated when there is much inflam- mation or pain in passing the urine, or when cystitis exists. The strength of the injection should be three grains to the ounce of water. In consequence of its promoting the coagulation of the blood out of the body, Magendie 2 prescribed it recently in the form of injec- tion (3i to ft>ij of water) employed several times a day in a case of severe uterine hemorrhage. The hemorrhage ceased. We have frequently given this remedy in public and private practice, and have considered it especially adapted for those cases in which there appears to be torpor in the system of nutrition, as in cases of asthenic dropsy, old visceral engorgements, and indeed of hypertrophy of any kind, accompanied by deficient action in the intermediate system of vessels. In oligsemia, where there is paucity of red globules in the blood, and the fluid is altogether too thin, it would seem to be especially indicated, from its property, mentioned above, of promoting the coagulating of the blood, and therefore, of inspissating it. Hence in all cases of scorbutic, hy- dropic and other dyscrasies, and in hemorrhages occurring in such pathological conditions of the system, we have prescribed it largely and with the very best effects. It appears to us, indeed, to be the best remedy we possess wherever a sorbeficient and tonic are indicated. MODE OF ADMINISTERING. The dose of the iodide of iron, administered in the cases above referred to, was generally three or four grains two or three times a day. Liquor Ferri Iodldi. Solution of Iodide of Iron. fy. Ferri iodidi, gr. xxiv. Aquse destillat. sj. M. Dose. — An ordinary tea-spoonful contains about three grains. A. T. Thomson. 1 J. J. L. Rattier, in La Lancette Franchise, Fev. 16, 1S37; see, also, Revue Medicale, Janvier, 1838. and American Med. Intelligencer, Sep. 15, 1838, p. 195. 1 Op. cit. 188 dunglison's new remedies. The following formulae are recommended by Pierquin :* Vinum Ferri Iodidi. Wine of Iodide of Iron. 9<. Vin. Bordegalens. B5j. Ferri iodidi, gss. M. Dose. — A spoonful morning and evening. Tinctura Ferri Iodidi. Tincture of Iodide of Iron. 5;. Feni iodidi, Sfij. Alcoholis, Aquae, aa. §ij. M. Dose. — A spoonful morning and evening. Trochisci Ferri Iodidi. Lozenges of Iodide of Iron. 5<. Ferri iodidi, 3J. (^ss.) Croci pulv. gss. (jjij.) Sacchar. alb. gviij. (|iv.) M. fiant Trochisci No. 240, (120.) Dose. — Six to ten daily. Solutio Ferri Iodidi. (French, Eau dHHydriodate de Fer.) Solution of Iodide of Iron. 5<. Ferri iodidi, ^ss. Aquae, Ibij. M. Added to enemata, lotions, and injections. B<. Ferri iodidi, ^ss ad £ij. Aquae destillat. ffij. M. To be added to a general bath in cases of leucorrhosa, ame- non-ncea, &c. Pierquin. Unguentum Ferri Iodidi. Ointment of Iodide of Iron. 9c. Ferri iodidi, 3i ss - Adipis suillae, |j. M. ul fiat unguentum. A piece of the size of a hazelnut to be rubbed, morning and evening, on the inner part of the thigh, in cases of leucorrhoea and amenorrhoea. 1 Journal de Chimie Medicale, p. 310, Mai, 1831. FERItl PR^EPARATA. 189 VII. FERRUM NITRATUM. Synonymes.— Ferri Nitras, Nitrate of Iron. LiaUOR FERRI PERSESQUINITRATIS. Synonymes. — Liquor seu Solutio Nitratis Ferri, Liquoi Ferri Nitrici Oxy • dati, Solution of Persesquinitrate of Iron, Solution of Nitrate of Iron. MODE OF PREPARING. This preparation, which has been introduced within the last few years into practice, may be formed in the following manner. Take of small chips or pieces of iron wire, an ounce and a half; nitric acid, three ounces by measure; water twenty-seven ounces; muriatic acid, one dram. Put the iron info an earthenware vessel, and pour on the nitric acid, previously diluted with fifteen ounces of the water. Set the vessel aside till the whole of the acid has united with the iron, so as to form a persesquinitrate, then decant the liquid from the portion of iron, which remains undissolved; strain and filter. Add the muriatic acid with the remainder of the. water, or with as much of that liquid as will increase the whole solution to thirty ounces. When the process is finished — which takes some hours — the liquid has a red colour, so dark, that when viewed by reflected light, it seems almost black. Three ounces of nitric acid of the usual strength (1.4) generally dissolve an ounce of iron, so that when the process is completed, a portion of the metal remains undissolved. The solution then con- sists entirely of the persesquinitrate of iron ; and, if speedily de- canted, it may be preserved in that state, but if allowed to stand for a few hours longer on the iron, it will undergo a further change, becoming gradually converted into pernitrate and pro- tonitrate of iron. The first of these is insoluble, and renders the liquid turbid ; and the latter, which remains dissolved, has not the medical properties that render the persesquinitrate valuable. When the solution contains nothing but nitric acid and peroxide of iron, it slowly undergoes decomposition on standing, so that, at the end of a few weeks, the whole liquid begins to become turbid. The addition of some muriatic acid prevents this decomposition, and the quantity sufficient for this purpose is too small to affect the medi- cinal powers of the persesquinitrate. The solution, when properly prepared, is of a beautiful dark red colour, when viewed with transmitted light. Its taste is very astringent, and not at all caustic. 1 • Mr. Kerr, in American Journal of the Medical Sciences, for May, 1832, cited from Edinb. Med. and Surgical Journal. 190 uunglison's new remedies. effects on the economy in health. This preparation greatly resembles the solution of the muriate of iron in its medicinal properties. Mr. Kerr considers, that to an astringent power, it unites the property of diminishing the irrita- bility and tenderness of the mucous membranes with which it comes in contact. Kopp administered it with the Greatest success in many cases of chronic diarrhoea that had resisted every approved remedy. The fasces were blackened by it, as by the preparations of iron in general. He remarks, however, that it must be continued for some time. The dose he gave was ten drops several times a day in oatmeal gruel, and this was gradually raised to twenty and twenty- five drops. When the cure was accomplished, the remedy was gradually diminished, until it was left off altogether. Dr. Graves 1 speaks in equally high terms of the persesquinitrate in these cases ; and very recently Dr. T. C. Adam of Lenawee county, Michigan, has recorded the remarkable assistance, which he has derived from its use in the treatment of several diseases, espe- cially diarrhoea, and other affections of the mucous membranes accompanied by discharges. 2 In chronic diarrhoea depending mainly on an excess in the sensibility of the organic nerves which supply the digestive tube, Dr. Adam rarely orders less than fifteen drops at the commencement, and after a few days' employment of the remedy, he increases the quantity to twenty, twenty-five and thirty drops. In leucorrhcea occurring in such as are pale, exanguious, feeble and languid, the internal, conjoined with the external, use of the persesquinitrate has been found very advantageous. In these cases, Dr. Adam adds such a quantity of water as a diluent as will still leave in the vagina a gentle degree of heat or smarting. Dr. Adam recommends it also in cases of aphthous sores; and he affirms that its application has afforded relief in toothach. It is doubtless a powerful astringent, but it is questionable whether it possess any advantage over the solution of the muriate of iron. VIII. FERRUM OXYDATUM HYDRATUM. Synonymes. — Hydras Ferricus, Hydro-oxide of Iron, Hydroxide of Iron, Hydrated Oxide of Iron, Hydrated Peroxide of Iron, Hydraled Tritoxide of Iron. German. — Eisenoxydhydrat. The hydrated oxide of iron has been recently introduced into practice as an antidote to white arsenic. Dr. Bunsen, of Goettingen, had already made frequent experiments with it, which satisfied 1 Clinical Lectures, Amer.Med. Library Edition, p. 128. Philad. 1838. 2 American Journal of the Medical Sciences, May, 1839, p. 61. FERRI PR^PARATA. 191 him that it was an efficacious agent, when, along with Di. Ber- thold, 1 he subjected it to fresh trials. The results of their inves- tigations were published, and since then it has received due atten- tion every where. METHOD OF PREPARING. The best mode of preparing it, according to Dr. Bunsen, is to take a solution of pure sulphate of iron, increase its dose of oxygen by treating it with nitric acid, and precipitate the oxide by adding pure ammonia in excess, washing the precipitate. In order not to deprive the precipitate of its water, and to diminish its loose state of aggregation as little as possible, it is not filtered, but is put aside for a few days, until the precipitate is wholly deposited, after which the supernatant fluid is poured off. It is then kept in well- stopped vessels. Riecke 2 has added the formula for pharmaciens, which is recom- mended by Von Specz. £. Vitrioli ferri puri crystallizati libram ; teratur in pulv. subliliss. et detur in vas. porcellan. aut murrhinum, impositum balneo arenas, dein adde acidi nilrici concentrati Bss ; terantur ope baculi vitrei usque dum massa resolvitur in pultem ; nunc, igne animate-, massae pultacese calidae affunde sensim terendo, sensim acid, nitric, concentrat. q. s. donee nullum amplius evolvatur gas nitrosum. Massa tunc leni igne evaporetur ad siccitatem et solvatur demum in aq. destill. q. s. ; solutioni filtratse instilletur am- monia -puree q. s. donee precipitatio cesset ; stent nunc per horam unam alteramve et liquor limpidus a sedimento bruneo decantetur; massae resi- du32 f'undum petenti adfunde aq. destillat. ftiij et agitentur; nunc filtra, et prsecipitatum in filtro aq. destill. q. s. edulcora donee aqua insipida de- fluat. Preecipitatum bene edulcoratum in umbra siccatum convertat. in pulv. subtilissim. qui servetur base vitreo bene clauso. 3 Lassaigne advises it to be prepared as follows: — Take iron filings; pour gradually upon them four times their weight of the nitric acid of commerce in small portions. Heat is thereby de- 1 Das Eisenoxydhydrat, ein Gegengift der arsenigen Saure. Gutting. 1834. 2 Die neuern Arzneimittel, S. 227. Stuttgart, 1837. 3 " Take of pure crystallised sulphate of iron a pound : rub it into a subtle powder, and place it in a porcelain or glass vessel in a sand-bath; then add half a pound of concentrated nitric acid ; stir them with a glass rod until the mass is resolved into a soft paste; then — the fire being raised — pour gradually on the hot pultaceous mass concentrated nitric arid, until no more nitrous gas is evolved. Let the mass be evaporated by a gentle heat to dry- ness, and at last be dissolved in a sufficient quantity of distilled water. Into the filtered solution drop/wre ammonia as long as any precipitate oc- curs; let it now stand for an hour or two, and then pour off the limpid liquor from the brown sediment. On the residuary mass, remaining at the bottom, pour three pounds of distilled water, and shake them together: filter and wash the precipitate on the filter with distilled water, until the water is tasteless. The well-washed precipitate dried in the shade forms a subtle powder, which may be kept in a well-closed vessel." 192 dunglison's new remedies. veloped, and deutoxide of azote, which is transformed by the atmospheric air into nitrous acid vapours. When the evolution of gas has ceased, ten or twelve parts of water are added ; the mix- ture is then filtered, and ammonia added until the mixture begins to exhibit an alkaline reaction. The precipitate, thus formed, is the hydrated oxide of iron, which is collected on the filter, and washed with boiling water until it is tasteless, and ceases to exhibit any alkaline characters. The mode of preparation, recommended by Majeste, agrees with this, except that he boils one part of iron filings with four of nitric acid and four of muriatic acid. EFFECTS ON THE ECONOMY. If a solution of arsenious acid be decomposed by fresh precipi- tated oxyhydrate of iron suspended in water, traces of arsenic can no longer be detected in the filtered liquid, made acid and tested by a stream of sulphuretted hydrogen gas. To throw down one part of arsenic, in this manner, requires a quantity of the oxyhydrate, which contains at least ten or twelve parts of oxide of iron. Yet, even where a smaller quantity is employed, the arsenious acid is almost wholly separated, as a stream of sulphuretted hydrogen gas affords only very slight traces of sulphuret of arsenic in the filtered and acidulated liquid. When the substances are previously heated, or the arsenious acid is exposed in small portions to the precipi- tating agent, the reaction is still slighter. If a few drops of am- monia be added to water in which the oxyhydrate of iron is sus- pended, and the mixture be digested with finely powdered arsenious acid, an insoluble arsenite of iron is formed ; a circumstance, which would encourage the belief— even had it not been sanc- tioned by experience — that freshly prepared oxyhydrate of iron may serve as an antidote to arsenic : the union between it and arsenious acid forming — as we have seen — an insoluble compound, devoid of all poisonous influence on the economy, and only ex- citing gastric oppression, when given iti large doses. Accurate microscopical investigation in the experiments on ani- mals that had taken arsenious acid in the solid form mixed with the oxyhydrate, exhibited to the discoverer of the antidote, that, under the influence of the animal heat and the peristaltic motion, it had become completely converted into the arsenite of iron, and thus rendered innocuous. Such was the result of the observations of Boulet, 1 Orfila, Chevalier, Lassaigne, Soubeiran & Miquel, 2 Nonat, Borelli & Demaria, 3 Lesueur, Boulay fils, 4 Mo nod 5 , and 1 Gazette Medicale de Paris, 1834. * Bullet. General de Therap. Dec. 1834. 3 Br. and For. Med. April, 1836, p. 594. * Journal Hebdom. des Progres des Sciences Medic. Mars 14, 1835. 6 Gazette Medicale, Aug. 22, 1835, and Annales d'Hygiene, &c. xiv. 134. FERRI PRiEPARATA. 193 Specs. On the other hand, the experiments of Brett, 1 Reginald Orton, 2 and Cramer, were unfavourable; but Messrs. Bnnsen and Berthold remark, that the experiments of those gentlemen cuuld not be expected to be successful, as they were made with doses of arsenic of from two to nine grains ; and the stomach of the rabbit cannot retain more than from one-ninlh to one-half the quantity of the antidote prepared according to their formula, which is neces- sary to neutralise that quantity of the poison. Messrs. Bunsen and Berthold, from the results they have ob- tained, recommend the oxyhydrate as the chief antidote in all cases of poisoning by arsenic; and they advise emetics to be asso-. ciated with it — along .with the agents hitherto employed— first, when the quantity of the poison taken has been considerable, and, therefore, a very large quantity of the antidote is demanded; secondly, when, at the same time, substances containing tannin, as infusion of green* tea, or sulphuretted hydrogen, developed after the eating of eggs, may be suspected in the alimentary canal ; as these substances are closely related to the antidote, and may weaken its action ; and, thirdly, when, prior to taking the poison, the stomach has been overloaded with food, and is, therefore, capable of receiving only a small quantity of the antidote. But, whether vomiting may be excited or not, recourse must be had to the oxyhydrate as speedily as possible. Tepid mucilaginous drinks may also be given to envelope the particles of arsenic that may exist in the compartments of the stomach. If the quantity of the poison taken be unknown, the antidote may be administered in a considerable dose, and if the patient should vomit, it may be ex- hibited afterwards in smaller quantity. But, if no vomiting should arise, it is recommended that he should continue to take the oxyhydrate until the arsenite of iron formed has had time to pass into the intestinal tube; and even after this it may be persevered with in small doses for a time, as portions of arsenic may possibly remain behind unchanged. With the same view, the oxyhydrate may be thrown up in the way of clyster, whenever it is presumable that the compound formed by the oxyhydrate and the arsenic has reached the lower portion of the bowels. To aid this, cathartics may be administered. Of these, castor oil, which would first sug- gest itself, might interfere, it has been conceived, with the opera- tion of the. antidote. The sulphate of magnesia, or any of the neutral salts, should have the preference. The antidote may be given suspended in water. Experience has shown Messrs. Bunsen and Berthold, that from ten to twenty parts of the hydrated oxide of iron are more than sufficient to convert one part of arsenious acid into the basic salt of iron. As the quantity of arsenic in the stomach and intestines can 1 Lond. Med. Gaz. xv. 220. 2 Lancet, Nov. 8, 1334. 9-a dungl 13 194 dunglison's new remedies. scarcely ever be appreciated, it is considered by them advisable to allow the patient to take as large doses of. the oxyhydrate as the stomach can tolerate ; and it is of essential importance that it should be taken as hot as it can be borne. When the arsenious acid has been swallowed in the undissolved state — in the form of powder, or in larger or smaller pieces — it is necessary, in order to aid its solution, and to effect a speedy union with the oxide of iron, to add a small quantity of pure ammonia to the antidote, until a slight alkaline reaction is evinced. As the ammonia does not enter into the composition of the salt formed, and, consequently, only plays a secondary part, ten or twenty drops may be sufficient for the purpose. The various experiments that have been instituted on animals have shown the protective power of the hydrate'd peroxide; it must be borne in mind, however, in all such experiments made on dogs, that they readily reject the poison by vomiting ; but if the poison be retained in the stomach by a ligature passed round the oesophagus, it exerts its accustomed deleterious effects. 1 It would seem, also, that the same result occurs if the dose of the arsenic be too small to induce vomiting. The animal may then die of the poison. 2 It would appear, that cases have occurred, in which this anti- dote has saved the lives of some who might have been destroyed without its agency. Buzorini 3 had a case in which about thirty- five grains of arsenic had been swallowed, and where it was suc- cessful, although twenty-four hours had elapsed since the poison had been taken ; but this cannot be regarded as very satisfactory, inasmuch as the patient might probably have been saved by ordi- nary means. In another case, which was also treated by the antidote at a late period, marked alleviation of the sufferings was induced. Three cases are, also, related by Majeste, two by Bineau, 4 one by Benoist, and one by Geoflroy, 5 of Paris, which were treated successfully in the same manner. The subject of the last was a hair-dresser, thirty-five years of age, who, in a pa- roxysm of delirium tremens, swallowed a dram and a half of arsenic. Half an hour afterwards the antidote was given, sus- pended in water. He drank, in twelve hours, all the tritoxide produced by the decomposition of five ounces and five drams of the tritosulphate of iron. He had no violent colic ; and, twenty- four hours afterwards, experienced scarcely any uneasiness. 1 MM. Miquel and Soubeirain, Bullet. General de Therapeutique, Dec. 1834. See on this subject, Dr. Joseph E. Muse, in Amer. Med. Intelligencer, for April 2, 1838. 2 Dr. Robert B. Hall, in Amer. Med. Intelligencer, for Sept. 15, 1838, p. 181. 3 La Lancette Francoise, Nov. 17, 1835. 4 Journal des Connaissances Medico-Chirurg. Nov. 1835. 5 Journal de Med. et de Chirurg. Pratiq. Sept. 1835; and Br. and For. Med. Rev. April, 1836, p. 572. FERRI PR^EPARATA. 195 A successful case has, also, been related by Mr. John Robson, house surgeon to the Warrington Dispensary. 1 Dr. Richard H. Thomas, of Baltimore, 2 has published a case, in which it was believed that twenty grains of arsenic had been taken, and which was relieved by the hydrated peroxide, adminis- tered six hours after the poison was swallowed: there was no vo- miting ; but thirst, burning pain, and exquisite tenderness at the epigastrium existed, denoting eso-gastritis. Half a fluid ounce of the hydrate, which was in the wet state, and about the consistence of thick cream, was given in a tumbler of cool water, and the dose was directed to be repeated every ten or fifteen minutes in two ounces of water : eight ounces of the suspended hydrate were taken in the twenty-four hours, after which «the patient seemed free from disease. " The length of time — six hours" — says Dr. Thomas, "before any very severe symptoms supervened, and before the antidote was administered, at first caused me to think that the pa- tient might have been deceived. Professor Von Specs, of Vienna, however, asserts, 'that a dram of arsenic, in powder, does not pro- duce its deadly effects on the system in less than six or eight hours, while the same quantity, dissolved in warm water, destroys life in a much shorter time.' In the present instance, it was swallowed in a dry state, covered with sugar. The prompt relief, which fol- lowed the exhibition of the peroxide, is also confirmatory of the impression that the poison was really taken." More recently, a case has been published by Dr. Deville, 3 .which was treated by this remedy, but as the patient vomited much, and the vomited matters were not examined, it is doubtful what was the agency of the oxide. Between five and six hours elapsed be- fore it could be procured. It has been recommended by Meuser, Riecke, and others, that the hydrated peroxide should be kept in the shops, ready mixed with a definite quantity of water, in order that it may be always at hand, so as to be administered without delay ; and the recom- mendation is good. Even if not to be trusted to alone, the evi- dence is quite sufficient to show, that it ought to be regarded as an important element in the treatment of every case in which arsenic has been taken. Instead of the pure hydrated peroxide, Von Specs 4 employed sub- stances in which the peroxide is known to exist in considerable quan- tity, and which require no previous preparation, as rust of iron, and 1 Lond. Med. Gazette, Nov. 5, 1836; also, Amer. Joum. of the Med. Sci- ences, p. 222, May, 1837. 2 Ameriean Medical Intelligencer for July 16, 1838, p. 167. 3 Revue Medicale Franc, et Etrangere, Sept. 1838 ; see, also, Br. and For. Med. Rev., and Johnson's Medico-Chirurgical Review for April, 1839; and American Journal of the Medical Sciences, May, 1839, p. 243. 4 Med. Jahrbiicher des k. k. o. St. B. xix. S. 621. Wien, 1836 ; and Ibid. B. xx. S. 149. Wien, 1836. See, also, Br. and For. Med. Rev., July, 1837, p. 237; and Amer. Journ. Med. Sciences, Feb. 1838, p. 519. 196 dunglison's new remedies. haematite, (red iron ore,) and, from his experiments, he is led to conclude, that although these substances do not prevent all the bad effects of arsenic on the system, they may — in the absence of the hydrated peroxide — be employed as antidotes to that poison. The rust of iron has the advantage of being readily procurable. FILIX MAS. Synonymes. Aspidiura Filix Mas, Athyrium Filix Mas, Polypodium Filix Mas, Ma e Fern. French. Fougere Male. German. Farrenkraut, Johanniswurzel. The root of the male fern has Ions' been celebrated — since Dioscorides indeed — as an anthelmintic ; and especially for the destruction of taenia. 1 For these properties, it has been introduced into most of the Pharmacopoeias. It was the basis of Madame Nouffer's celebrated remedy for taenia, which was purchased by Louis XVI. in 1775, for 18,000 francs. We notice it here, on account of the proposition of Peschier, 2 of Geneva, to administer the ethereal extract, which has since been carried into effect, and apparently with the best results. It appears to possess the advantage of being by no means unpleasant to the taste, and to be accompanied by none of the disagreeable effec;s, that are associated with the action of most of the other vermifuges. To prepare the extract, the root is cut small, and digested for ten or twelve days, in the cold, in a sufficient quantity of sulphuric ether, — the tincture is then pressed, concentrated by distillation, and the ether thereby fully removed. From a pound of the root, about eighteen drams of a brownish green, thick extract are obtained, which possesses the repulsive odour of the plant, and has an acrid taste. In Germany, the extract is geneially prepared according to the formula of the Prussian Pharmacopoeia, which is as follows — Take an ounce of the powdered root, and pour thereon eight ounces of the sulphuric ether of commerce ; close the vessel, shaking it occa- sionally, and let it stand until the fluid has acquired a yellowish colour; then separate the fluid as before described ; distil oft' the sulphuric ether until only a, third remains, and evaporate the remainder, in a water bath, until a thin brownish yellow colored extract remains. This extract contains not only the volatile oil of the fern, but 1 Merat & De Lens, Diet, de Mat. Med. Art. Polypodium. 8 Nouvelle Biblioiheque Medicale, Sept. 1828, p. 151, and Biblioth. Univer. xxxi. 324, 1826. PILIX MAS. 197 also a fixed oil, tannin, acetic and gallic acids, a mu co-saccharine matter, green and red colouring matter, and a semi-resinous sub- stance. By some it is called the Oleum Filicis Maris. The active constituents of the fern are highly concentrated in it ; and as the result of numerous trials, it was found, that from eighteen to twenty grains, given at night, and the same quantity in the morning fast- ing destroyed taeniae, so that on the administration of a cathartic, the parasite was discharged — often in the form of a ball. Not unfrequently, indeed, it was voided before the cathartic was given. In Germany, this new preparation has been chiefly recommended by Hufeland, who maintained, that in rapidity, certainty and gen- tleness of action, it exceeds all known means, and many other physicians have testified to the accuracy of this opinion. Radius, 1 who frequently prescribed it, says he never gave it without bring- ing away large pieces of the worm, but frequently the head remained behind. 2 Buchner 3 thought, that the extract might be prepared with alcohol, but many physicians have objected to this menstruum, — that it does not dissolve the fixed oil. MODE OF ADMINISTERING. The extract is commonly given in the form of pill ; emulsion does not answer, because the active constituents are apt to be enveloped and masked in this form. In Geneva, it is now fre- quently united with castor oil, this renders it unnecessary to give a cathartic after it. For the cathartic when needed, they advise in Bern, infusion of senna with epsom salts, manna, and aniseed. 4 To children it may be given in syrup. Mel Filicis Maris. Honey of the Male Fern. 5<. Ext. aether, filicis maris, gss. Mellis rosat. gss. M. Half of this to be taken on going to bed ; the other half early in the morning fasting. Radius. 1 Auserlesene Heilformeln, u. s. w. Leipz. TS36. 2 See, also, Ebers, in Hufeland & Osann's Journal, Ixvi. St. 1. S. 43, and Gazette de Sante, Sept. 25, 1828. 3 Repertorium fur Pharmacie, xxiii. 433, xxvii. 337, and Funk, ia medicin. Zeitung, Mai, 17, 1837, S. 102. * Hufeland und Osann's Journal, lxiv. St. 1. S. 133. 198 dunglison's new remedies. FUCUS CRISPUS. SyNONYMES. Lichen Carrageen; Chondrus Crispus, Sphosrococcus Crispus, Ulva Crispa, Chondrus Polymorphus, Irish Moss, Carrageen or Corigeen Moss. French. Mousse d'Irlande, Mousse Perlee. German. Krauser Tang, Seetang. Although the carrageen or Irish moss has long been used in Ireland, it was but little employed in other parts of Europe, or in this country, until within the last few years. Of late, it has been used precisely in those cases in which the Lichen Islandicus, or Iceland moss has been deemed appropriate. In Germany, the first trials were made with.it in the year 1833, by Von Grafe of Berlin, and the results were given to the world in his report for that year 1 of the Clinical surgical and ophthalmic Institute, attached to the Frederick William University. The fucus crispus, which belongs to the natural family algae, exists in the Atlantic Ocean, on the coasts of England, Ireland, western France, Spain and Portugal, and as far as the tropics. It is also a native of the United States. It is met with more abund- antly, however, in Ireland, where it is used by the poor as an article of diet. It is thrown on the shore by the waves, and is gathered at the time of the ebb. The Irish moss, when fresh, is green, and somewhat resembles the Iceland moss ; but when dried, as we meet with it in com- merce, it is of a bright yellow, and resembles laminae of horn, crisped, translucent and frequently containing small shells, calca- reous concretions, and grains of sand. It has not much taste ; the smell seems to betray iodine, which, however, has not been detected in it. When the moss is chewed, it feels like so much cartilage, but, by the moisture and warmth of the mouth, it soon loses its brittleness. It contains little sea salt, but a good deal of sulphate of soda. 2 The jelly obtained from it is transparent and colourless; its taste is by no means disagreeable ; it keeps several days, and is not con- verted by muriatic acid into mucus, like the jelly which is ob- tained from laud plants. In its nature it is esteemed to be nearly allied to animal mucus. 3 It is easy of digestion, is readily borne by weak and irritable stomachs, and exerts a soothing influence on the air passages and the intestinal canal. In order to obtain it, the moss is cut small, carefully cleared from impurities, boiled with the selected vehicle, and strained. Von Grafe 1 Bericht iiber das klinische chir. auajpnarztliche Institut. der k. Friedr. With. Univers. fur d. J. 1833. Berl. 1834. 2 E. Grafe in Art. Fucus, Encyclopad. Wurterb. der medicinischen Wissenschaft. xiii. S. 1. Berlin, 1835. 3 Lucae, in Riecke, Die neuern Arzneimittel, S. 234. Stuttgart, J837. FUCUS CRISPUS. 199 obtained, from nine ounces of milk boiled with half a dram of the moss, five ounces of jelly ; and as much from a dram and a half of the moss and twelve ounces of water. The formula, commonly used by him, is given below. To this jelly may be added any dietetic or remedial agent, which may be considered indicated in the particular case. 1 EFFECTS ON THE ECONOMY. The fucus crispus is used in the affections that are considered to be benefited by the Iceland moss. As a diet, it is given in con- sumptive cases, and wherever there is erethism in the respiratory or digestive apparatus. In diarrhoea it is sometimes given along with astringent or other remedies. The jelly has been advised as a diet in scrofulous cases. Von Grafe affirms that he has often found it serviceable in hoarseness, in dry spasmodic cough, consumption, diarrhoea, and dysentery, in the intestinal pain, which remains after inflammation and ulceration of these parts, and after poison has been taken ; in diseases accompanied by much emaciation, and in the prostration ensuing on serious diseases and operations. In similar affections it has been extolled by Hufeland. 2 On the other hand, Heyfelder affirms that not only he, but many physicians of his acquaintance have used the moss without either good or evil results in phthisis, as well as in erethism of the respiratory and digestive organs ; and Riecke 3 remarks, that as it makes a very agreeable jelly, when boiled with milk, and with the addition of a little of the aqua laurocerasi, it may do for cases where we must prescribe " ut fecisse aliquid videamur. The truth is that it can render no more service than other sub- stances which contain a similar principle, and accordingly but few prescribe it with any other view than as a demulcent and nutri- tious aliment, in cases where such is needed. MODE OF ADMINISTERING. Decoctum Fuci Crispi. Decoction of Irish Moss. Add* &. Fuci crispi elect, et concis. ^ss. Lact. vaccin. recent. ,^ix. Coq. ad remanent, colatur. £v. Sacchar. albissim. ^ss. ad ,^i. Aq. amygdal. amar. concentr. 9i. To be taken in the course of the day. VoN Graefe. 1 See L. Feuchtwanger, in Philad. Journ. of Pharm. vi. 204. Philad. 1833-4. 2 Hufeland und Osann's Journ. der practisch. Heilkund. B. 77, St. 5, p. 135. 3 Op. cit. S. 235. 200 dunglison's new remedies. *. Fuci crispi elect, et eoncis. ^iss. Coq. cum aq. font, sjxij. ad remanent, colat. §v. Syrup, rubi. idsei giss. ad ^ij. Aq. amygd. amar. concentr. 9j. To be used through the day. When employed as diet Von Grafe allows from ten to eighteen ounces of the jelly in the day. 5<. Fuci crisp, (elect, et eoncis.) 3ss. Coque cum aq. font. q. s. ad reman. ^ vj. Colatur. adde Sodse phosphai. giss. Syrup opii, 3ij. ad ^iij. Dose. — A spoonful every two hours in cases of haemoptysis, between the attacks. Clarus. &. Lactis vaccini, gxxiv. Fuci crisp. Qiv. Sacch. alb. §j. Cort. cinnam. cont. 9j. Coque per minut. x. leni igne ; filtr. et exprime. Beral. B<. Fuci crisp, (elect, et eoncis.) ^ij. Coque cum lactis ffij. ad consist, gelatin. Tere cum Sacch. alb. ^ij. Amygdal. amar. No. 2. To be used in the course of the day, and daily. Htjfeland. FULIGO. Synonymes. — Fuligo Splendens, F. Ligni, Soot, Woodsoot. French. — Suie. German- — Gianzruss, Spiegelruss, Kaminruss, Ofenruss, Russ. The discovery of creosote, and its extensive application to the treatment of disease, gave occasion to the resuscitation of this article — much employed by the ancients, but subsequently fallen into oblivion. The older physicians frequently used soot as an exciting, diaphoretic agent in cachexia of every kind, in chronic rheuma- tism, cutaneous affections, and especially in the evil results of their sudden repercussion ; in glandular indurations, rickets, exostoses, &c. It has also been employed as a domestic remedy, in colic, and in the simple and dysenteric diarrhoea, and cholera of children. Several modern recommendations — as by Schutte and Weisenberg — remained unheeded until the attention of physicians was recently FULIGO. 201 drawn to it, especially by Bland. 1 He is of opinion, that the costly — and by no means easily prepared — creosote may be wholly replaced by soot. Both are products of the dry distillation of organic substances; their odours are analogous, and as soot is much cheaper and more easily obtained, it deserves, he thinks, to be tried more extensively in therapeutics. The soot has a nause- ously empyreumatic, more or less bitter and acrid, saline taste. EFFECTS ON THE ECONOMY. Bland 2 has exhibited the soot in different diseases, especially in the form of ointment, or in decoction, with excellent and rapid effects, in herpes, itch, tinea, gutta rosacea, and pruritus vulvae ; and he asserts, that he even healed a cancer of the breast by fre- quent ablution with a tepid decoction of it, and an ointment com- posed of equal parts of lard and soot with one eighth part of the extract of belladonna ; but the same applications were of no benefit in a case of cancer of the nose, and in one of cancer of the uterus. He also cured a scabby eruption of the mucous membrane of the nose by an ointment of soot. In diphtheritis, he used, in two cases, a decoction of soot as a mouth-wash with the best effects. In confirmation of Blaud's remarks, Yoisin asserts, that he cured a case of cancer of the face by the soot ointment. Dr. J. R. Marinus 3 has found it very efficacious in chronic erup- tions (dartres), and in tinea. Carron du Villards 4 advises a collyrium prepared from soot in cases of strumous ophthalmia. He infuses two ounces of soot in boiling water, rilters and evaporates to dryness; the shining resi- duum is then infused in very strong boiling vinegar, and to every twelve ounces of the liquid, twenty-four grains of extract of roses are added. A few drops of this solution, in a glass of tepid water, form an excellent resolutive collyrium, which may be made stronger or weaker at pleasure. He has, also, in cases of spots on the cornea, used soot — either blown into the eye alone, or mixed with powdered su^ar-candy, and has seen good effects from it. United with butter it forms an eyesalve, not inferior, he says, per- haps to any other. As, in the treatment of specks on the cornea by dropping laudanum into the eye, the organ quickly becomes accus- tomed to it, Carron du Villards advises, that the eye should be excited to a more lively action by means of the combination of soot and tincture of opium given below. It is, he says, an energetic agent and may be applied by means of a pencil to the granulations 1 Revue Medicale, Juin, 1834, ef Janvier, 1S35, and Dr. E. Grafe, in Grate und Wuliher's Journal, xxiii. 310. Berlin, 1835. 2 Journal des Connaissanees Medico-Chirurjj. Mai, 1834. 3 Bulletin Medical. BeJffe, Nov. 1838, p. 2S9. 4 Gazette Medicale, Janvier, 1831 ; see, also, Baudelocque, on its use in Scrofulous Ophthalmia, in Bulletin General de T herapeutique. Mars, 1834. 202 dunglison's new remedies. on the cornea. He likewise recommends a decoction of soot as an injection in discharges which are the consequence of chronic in- flammation of the vagina. Recently, M. Andre Gibrin 1 has detailed to the Academie Royale de Medeeine of Paris, six cases of chronic inflammation of the bladder in which soot was beneficially used in the way of injection. He took from the chimney two ounces of compact soot, broke it up, washed it, and boiled it in a pound of water. The decoction was filtered through paper, and injected into the bladder twice a day. The good effect supervened so closely on the administration of the remedy, that there could be no doubt as to the cause. The pain ceased, and the patient obtained sleep to which he had been for some time a stranger. The urine gradually became clear, and recovered its natural appearance. To these remarks it may be added, that, according to Schutte, an ointment composed of two partsof fresh butter or hog's lard, and one part of soot, is a popular and efficacious remedy on the Rhine for cases of porrigo, itch, and herpes ; not more than a dram being rubbed in at a time. Weisenberg ascribes to the soot a protective power against contagious affections of the skin, and recommends, especially, lotions of soot water, — partly as a preventive agent, and partly as a therapeutical application in itch. But the soot has not been used, of late, externally only; its in- ternal use, in the form of the old tincture of soot, has been revived. This was long known under the name of "soot drops" and "fit drops," and was employed as an antispasmodic in hysterical and other affections; but its employment has been extended, and it is given in chronic rheumatism, chronic affections of the chest, sup- pressed cutaneous eruptions, in many cases under precisely the same notions that prevailed years ago. From thirty to sixty drops of the following tincture are given several times in the course of the day. MODE OF ADMINISTERING. Mistura Fuliginis. Tinctura Fuliginis (Clauderi.) Mixture of Soot. £. Fulig. splend. §ss. Potassse carbonat. §iss. Ammonia? carb. £ij. Aq. sambuc. §ix. Digere leni calore. Filtra. Dose. — From thirty to sixty drops several times a day. 1 Bulletin de l'Academie, 15 Mars, 1837. PULIGO. 203 Lotio Fuliginis. Lotion of Soot. &. Fulig. splend. manip. maj. ij. Coque cum aq. font, ftj per semihoratn. Cola cum expressione. Used as a wash, several times a day, in herpetic, psoric and syphilitic ulcers. Blaud. Unguentum Fuliginis. Ointment of Soot. £. Fulig. splend. Adipis, aa. ^ss. Extract, belladon. £]. M. exacte, To be spread upon lint or tents in cases of cancers. Blaud. £. Axung. porcin. Fulig. splendent, aa. §ij. Coque leni igne per horas vj. As a dressing in cases of tinea, and of foul ulcers. Blaud. 5<. Carbon, pulv. Sulph. depur. aa. %]. Fulig. splend. Cort. Peruv. flav. aa.gss. Cerati simplicis q. s. ut fiat unguentum. A dram to be rubbed in, once or twice a day, in cases of tinea. Carron du Villards. *. Opii, gij. Caryoph. arom. gj. Fulig. splend. loti, ^ss. Aq. cinnam. sviij. Alcohol is, %\v. Digest in a gentle heat for six days ; filter and express the residuum. Applied in cases of specks on the cornea. Carron du Villards. *. Fulig. gij. Album, ovi, No. vj. Tere simul. As a dressing for herpes and tinea. It is the Pommade resolu- tive of Sainte Marie. 1 &. Fulig. .liss. Zinni sulphat. gvj. Adipts, 5iv. M. Applied in cases of tinea. It is the Pommade contre la teigne, of Bories. 2 1 Nonvean Formulaire Medical et Pharmaceutique. Paris et Lyon, 1820. * Formulaire de Montpellier. Montpellier, 1822. 204 dunglison's new remedies. GALEOPSIS GRANDIFLORA (SUMMITATES.) Synonymes. — Galeopsis Ochroleuca, G. Villosa, G. Segetum, Herba Side- ritidis. German. — Grossbliithigen Hohlzahns, Grossblumigte Hanfnessel. This plant, which belongs to the natural family Labiatae, and in the Linnaean system to Didynamia Gymnospermia, grows in the western part of Germany, in sandy cornfields. 1 EFFECTS ON THE ECONOMY. The fresh plant has a peculiar, feeble, balsamic smell, and a somewhat bitter and saltish taste, and has been considered, in Germany, to be worthy of a distinguished place amongst the "bitter resolvents." It has been much sold as a nostrum, under the name of "Blank- enheimer Tea," (Blankenheimer Thee), or " Lieber's pectoral and phthisical herbs," (Liebersche Brust oder Auszehrungskranter), and enjoyed great re pute. In the Ardennes, also, particularly in the district of Malmedy, it has been long employed as a popular remedy. In the year 1828, Lejenne 2 directed attention to the therapeutical importance of this plant. According to his observa- tion, it is very useful in diseases of the mucous membrane of the respiratory and digestive organs, and especially in chronic pulmo- nary catarrh, even when it exists to such a degree as to merit the name Phthisis mucosa (Schleimschwindsucht.) In actual phthisis the affection seemed to him to be diminished by it; the hectic being moderated, the expectoration rendered easier, or the cough assuaged. Lejenne generally boiled half an ounce of the plant in a pint of water down to half; sweetened the decoction with sugar or honey, and directed the whole to be taken in the twenty-four hours. In other cases, in which a milk diet was appropriate, the decoction was made with an equal quantity of milk. Wesener 3 found it advantageous in phthisis mucosa, and in chronic pulmonary catarrh. Giinther, who had many opportunities for observing the action of the remedy, affirms, that the Lieberschen Krauter not unfrequently produced some amelioration in phthisis, especially in scrofulous phthisis, but he never saw any actual recovery there- from. It seemed to him to moderate the colliquative sweats, and to facilitate and diminish the expectoration. In one case especially, of scrofulous phthisis, in the last stace, it appeared to be of essential sprvice, and to prolong: life; and from all his observations he is disposed to infer, that if it is not the sole or the main remedy 1 Von Schleehtendal, in Encyclopad-Worterb. der medicin. Wissenschaft. xiii. 115. Berlin, J835. 2 Annates Generales des Sciences physiques, p. 331. Sepr. 1820. 3 Hufeland und Osann's Journ. der pract. Heilk. 1823 and 1S24. GALEOPSIS GRANDIFLORA. 205 to be employed in every stage of phthisis, it may be used with 'advantage throughout the disease as a supporting agent. Riecke 1 asserts, that he has seen many cases in which the Lieberschen Krauter were of great. service in thoracic affections threatening phthisis. In one case, which promised to terminate unfavourably in a short time, owing to the complication of violent haemoptysis with hectic fever, and in which an experienced phy- sician had exhausted every effort of art, they were given with the best effect. The thoracic affection ceased, and at this time — a period office or six years since the use of the remedy — the patient — an officer — is capable of performing his military duties without difficulty. On the other hand, Richter affirms, that in two cases in which he administered the galeopsis, no benefit resulted from it. In this country it has not been employed ; so that we can only judge from the testimony afforded by the German writers. This, as they themselves admit, 2 is not yet sufficient to enable them to lay down any positive rules as to the exact indications and counter-indica- tions that must regulate its employment. It is probably of no farther service than as a mild bitter, and its place may, therefore, be supplied, perhaps advantageously, by many of the tonics that are admitted into the lists of our remedial agents. Geiger 3 sub- jected it to analysis, and found in it 2,765 parts of fatty matter, wax and chlorophylle; 0.247 of a brown bitterish resin, insoluble in ether ; 0.312 of a yellowish stimulating and bitter resin, soluble in ether ; yellow bitter extractive matter, soluble in ether, and a brownish matter insoluble therein ; phosphate and malate of lime; salts of potassa; muco-saccharine matter and fecula, and 65.882 of ligneous matter. METHOD OF ADMINISTERING. &. Summitat. galeopsid. grandif. Jj. Boil in a pint of water for a quarter of an hour and strain. To be used in the twenty-four hours. Wesener. 5<. Summitat. galeop. grandifl. Rad. althteae, aa. ^j. glycrrliiz. gij. M. The fourth part of this to be boiled in a pint and a half of water. To be used daily in chronic catarrh, and in the expectoration produced by the softening of pulmonary tubercles. Radius. 4 The galeopsis versicolor, and the galeopsis villosa, which have also been examined by Geiger, 5 appear to be possessed of the same virtues as the galeopsis grandijlora. 6 1 Die neuern Arznemittel, u. s. w. S. 241. Stuttgart, 1837. 2 Op. cit. S. 241. 3 Magaz. liir Pharmacie, ix. 134. 4 Auserlesene Heilformeln, u. s. w. Leipz. 1836. 6 Allgem. med. Annalen, S. 1141. 1825. fl Ricliter's Specielle Therapie, 13. x. S. 397. Berlin, 1828. 206 dunglison's new remedies. GENTIANINA. Synonymes. — Gentianeina, Gentiania, Geutia, Gentianeine, Gentianinum, Gentianin, Gentianin'e. This peculiar bitter principle of the root of the gentiana lutea, or yellow gentian, was discovered at the -same time by M. Henry, 1 Chef de la Pharmacie centrale of Paris, and by M. Caventou. Their results, indeed, were so identical, that it almost seemed as if they had acted in concert, and they therefore agreed to furnish them conjointly. According to these gentlemen, the gentiana lutea contains — 1. A very fugacious odorous principle; 2. A yellow bitter principle, (gentianine ;) 3. A matter identical with birdlime ; 4. A fixed oil; 5. A greenish substance; 6. A free organic acid; 7. Uncrystallisable sugar; 8. Gum; 9. A yellow colouring matter; and, 10. Woody fibre. 2 Schrader discovered, in addition, a resin- ous and narcotic principle, and M. Planche affirms, that he de- tected the latter. METHOD OP PREPARING. Powdered gentian is digested in water in the cold. At the end of forty-eight hours a yellowish green tincture is obtained, which must be filtered, and the liquid be sufficiently concentrated by ex- posure to heat in an open vessel. It then forms, on cooling, a yellow crystalline mass, which possesses strongly the taste and odour of gentian. This mass is digested in alcohol, until it ceases to yield a lemon colour. The products of the washings are added together, and exposed to a slight heat ; the yellow crystalline mass reappears, which, towards the end of the evaporation, becomes solid. The mass is very bitter. It is then redigested in weak alcohol, which redissolves all, except a certain quantity of oily matter. This last alcoholic solution contains, in addition to the bitter principle of the gentian, its odorous matter, and also an acid substance. By evaporating the liquor to dryness, dissolving the residue in water, adding a little well burned and washed magnesia thereto, and by boiling and evaporating in a water bath, the greater part of the odorous matter of the gentian may be driven off. The bitter acid is also taken up by the magnesia, and the yellow bitter principle remains partly free, and partly combined with the magnesia, to which it gives a beautiful yellow colour. The greater part of the bitter principle may then be obtained pure and isolated, by boiling the magnesia in ether, and evaporating the solution. If it be desirable to separate still more of the bitter principle, which the ether has failed to take from the magnesia, this may be done 1 Journal de Pharmacie, torn. v. 2 Journal General de Medecine, torn, lxxiv, and Magendie's Formulaire. GENTIANINA. 207 by digesting in enough oxalic acid to make the liquor acidulous. The acid unites with the magnesia, and the bitter principle which is set free may be obtained by the means above mentioned. Gentianine is yellow, inodorous, and possesses very strongly the aromatic bitterness of gentian, especially when dissolved in an acid. It is very soluble in ether and in alcohol ; and may be sepa- rated from them by spontaneous evaporation, in the form of very small, yellow, needle-like crystals. It is much less soluble in cold water, which it renders, however, very bitter. Boiling water has more action on it. Its colour is much deepened by the dilute alka- lies, which dissolve rather more of it than water does. Acids weaken its yellow colour. Concentrated sulphuric acid carbonises it, and destroys its bitterness. When exposed in a glass tube to the heat of boiling mercury, it is partly decomposed, and partly sublimed, in the form of small, yellow, crystalline needles. It does not sensibly change the colour of litmus paper, either when blue, or reddened by an acid, but seems to be neutral. Henry and Caventou esteem it an acid ; Richard, an alkali. It would seem that the experiments of MM. Trommsdorf and Leconte have demonstrated decisively, that gentianine, prepared according to the process of M. Henry, cannot be regarded as the active part of gentian. 1 Professor Dulk, of Konisberg, recommends the following process for separating it : — The coarse powder of the root is treated with alcohol ; the alcohol is distilled off, and the residuum dissolved in water. The solution is filtered ; and the undissolved matter, treated with ether, furnishes a clear tincture, from which, by spontaneous evaporation, is procured the gen- tianine of M. Henry, entirely insipid. The aqueous solution has a very bitter taste, and is fermented to separate the sugar, which cannot easily be done in any other manner. The liquid is then precipitated by the neutral acetate of lead; and the precipitate is separated : into the bitter liquid filtered is poured basic acetate of lead, and a little ammonia, to precipitate the combination of vege- table matter with the oxide of lead ; but care must be taken not to add too much ammonia, because the latter, as a stronger base, will withdraw the vegetable matter from the oxide of lead. A yellow precipitate is obtained, which is washed in small quantities of water, as in a larger quantity the combination is decomposed. The precipitate is dissolved in water, and decomposed by a current of sulphuretted hydrogen gas. It is filtered, and the solution eva- porated, at a moderate temperature, to dryness: the residue is treated with alcohol, s. g. .820; filtered, and by evaporation a mass is procured, which presents no trace of crystallisation. This gentianine is a brownish yellow matter. Dried and tritu- rated, it affords a yellow powder, and possesses the bitter taste of the root in the highest degree. It is hygrometric ; almost insoluble in absolute alcohol ; more soluble in common alcohol, and very 1 Journal de Pharraacie, Dec. 1838. 208 dunglison's new remedies. soluble in water. It reddens litmus paper ; heated, it melts, swells up, and burns without any residuum. It. contains no azote. In its reaction and relation to bases, it approaches the acids. EFFECTS ON THE ECONOMY. Gentianine, according to the experiments of Magendie, is not possessed of any poisonous qualities. Several grains, injected into the venous system, produced no apparent effect. He himself swal- lowed two grains dissolved in alcohol, and the only inconvenience which he experienced, was an extremely bitter taste, and a slight sense of heat in the stomach. It does not seem to possess any ad- vantages over the gentian itself. MODE OF ADMINISTERING. Magendie recommends a tincture and a syrup. Either of them may be substituted for the officinal tincture of gentian, wherever the latter is considered to be indicated. The syrup he regards as one of the best bitters that can be prescribed in scrofulous affec- tions, and he asserts, that he has observed permanently good effects from it. He does not give the dose of the gentianine, — which Radius 1 fixes at from one to four grains twice a day. Tinchira Gentianince. Tincture of Gentianine. Digere. Alcohol. 24° (.903) |j. Gentianin. gi. v. Syrupus Gentianince. Syrup of Gentianine. Syrup, simplic. fej. Gentianin. gr. xvj. M, Magendie. Magendie. GRANATUM (CORTEX RADICIS). Synonymes. Punica Granatum, Malogranatum, Pomegranate, (the bark of the root.) French. Grenadier, Balaustier. German. Granatbaum. (Granatwurzelrinde.) The Punica Granatum appears to be a native of the northern coast of Africa, whence it was transported to Italy at the time of 1 Auserlesene Heilformeln, u. s. w. Leipz. 1836. GRANATUM. 209 the Carthaginian wars. It is now cultivated in all civilised regions, where the climate is sufficiently warm to allow the fruit to ripen. It belongs to the natural family Myrtacese, and, in the Lin- nsean system, to the class Icosandria, order Monogynia. All the parts of the plant contain more or less tannin. The bark of the root is externally of a yellowish gray or ash colour ; inter- nally it is yellow, and has an astringent taste. According to Latourde Trie, 1 it contains wax, chlorophylle, a considerable quan- tity of resin, gallic acid, tannin, fatty matter, and a peculiar matter called Grenadine, — in German, Granatin. This grenadine is, in its pure state, of a white colour ; inodorous, and of a sweetish taste ; so much so indeed, that, according to Magendie it might be presumed to be a variety of sugar, except that it differs from ordinary sugar in being devoid of the property of fermenting. According to the degree of its purity, it crystallises in grains, tufts or stars. When thrown on red-hot coals, it consumes without any residuum, and smells like burnt bread. It is fusible, and by a moderate heat may be almost wholly sublimed. It neither reacts as an acid nor an alkali, and is readily soluble in water. Cold alcohol dissolves only traces of it, but boiling alcohol dissolves it readily, — a property, which is to be taken advantage of in the formation of crystals. In ether it is insoluble. Nitric acid, with the assistance of heat, converts it into oxalic acid. An ounce of the bark yields six grains of the grenadine; but it is not settled, whether it contains the whole of the medical properties of the bark. Cenedella, 2 from whom we have the most recent analysis of the bark of the pomegranate root, also found the grenadine discovered by Latour. This substance is readily prepared. The bark in powder is treated with ether, and afterwards with boiling alcohol, and the fluid is evaporated to the consistence of a soft extract. By treating this extract with water, the grenadine is dissolved without difficulty, and it may be purified by suffering it to crystallise fre- quently from alcohol. EFFECTS ON THE ECONOMY. The therapeutical properties of the different parts of the pome- granate tree were known to the writers of antiquity. They employed not only the bark of the root as a remedial agent, but also the flowers (Flores Balaustiorum, Balaustes, Balaustia,) " Balaustine Flowers," the whole fruit (Po?na Granati, Malo- Cfranata, Granata, Mala Pitnica, Fr. Grenades.) " Pomegra- nate ;" the rind of the fruit (Malicorium, Malichorium, Mala- corium,) and the seeds. Dioscorides, Pliny, Celsus and Marcellus 1 Journal de Pharmacie, Fev. 1828, p. 109. 2 Qiornale di Farraacia, Agosto, 1831, p. 55. See, also, Journal de Phar- macie, i.\. 219 ; x. 352; and xvii. 503; and Prof. Dierbach, in Heidelberg, klin. Annaltn, B. x. H. 3, S. 365. Heidelb. 1834. 9— b dungl 14 210 dunglison's new remedies. Empiricus speak of the employment of the bark of the root in taenia. 1 In more modern times, the Punica granatum had been greatly neglected, although the juice of the fruit was recommended by Frederick Hoffman against worms in children. In India, it has been long held in great estimation as a remedy in cases of tape- worm, and its efficacy having been noticed by some English physi- cians, it was recommended to the attention of European physicians, especially by Buchanan, 2 Fleming and Breton. 3 About the same time, a monograph was published by Gomez, a Portuguese physi- cian, which appears to have had considerable agency in extending the reputation of the remedy, especially in Germany, where his monograph was translated into the Journal of Gerson and Julius. 4 Gomez directs two ounces of the fresh rind of the root to be boiled in a pint and a half of water down to a pint; and of this decoction two or three spoonfuls to be taken for a dose ; the first early in the morning fasting, and then every half hour until the whole is used. The efficacy of the preparation he tested on fourteen cases, from which it appeared, that the worm could not withstand the action of the remedy more than forty-eight hours. He found it to exert most efficacy, when portions of the worm were perceptible in the evacuations, a period when the patient generally suffers most in- convenience. If the exit of the worm did not take place on the first day, after the use of the agent, the decoction was continued on the second day, when the worm was generally discharged. Did this, however, not happen, a farther continuance of the remedy was of no avail ; and he thought it better to intermit it until the appearance of fresh portions of the worm in the evacuations. Gomez also administers the dried rind in pills. If the dose be too large, or the appropriate dose be too frequently repeated, nausea, vomiting and diarrhoea at times supervene ; should this be the case, the proper course is obvious. In countries, where the fresh rind can be obtained, Gomez advises, that it should be used ; in colder countries, the dried rind, which is obtained from more southern regions, will have to be employed. According to Breton, the latter acts more powerfully; the dried rind loses more than half its weight, and two ounces of it may be esteemed equal to three of the fresh. The strong testimony, adduced in its favour by Gomez, gave occasion to numerous trials with it in England, France, Germany and Italy, which were generally attended with favourable results. Such favourable testimony has been afforded by Boiti, Marchese, 1 Merat & De Lens, Diet, de Mat. Medical. Art. Punica Granatum. * Edinb. Med. and Surg. Journal, iii. 22, 1827. 3 Medico-Chirurg. Transact, xi. 31. 4 Magazin, u. s. w. vi. 427, and Journal Coroplementaire des Sciences Medicales, xvi. 24, 1823. GRANATUM. 21 1 Calabro, Majoli, Chevallier, Deslandes, Merat, 1 Pichonnier, Man- drux, Claret, Bayle, Delaporte, Gendrin, Grimaud, Chapotin, Bourgeoise, Housson, Goupil, Ferrus, Wolff, Kostler, Meisinger, Berthold, and others. 2 On the other hand, Keibel 3 complains of its uncertainty; and, in the Polyclinical Institute of the University of Berlin, it was given without advantage; but Osann, in his report of that Institution, is disposed to refer the want of success to some imperfection in the rind employed, which, he remarks, is found to vary greatly in its character, as met with in the shop of the apothecary. It would appear, also, that it is not unfrequently mixed with the rind of the root of the Boxtree, and the Guelder rose (Wasserhollunder.) To introduce more precision on this matter, Wolff recommends that the druggists should purchase the bark of the root of the genuine East India, or at all events the Portuguese, tree. Boiti 4 advises that the root should be obtained from mountainous regions, where the tree grows wild ; that it should be taken only from young trees, and that it should not be more than an inch thick, that it should be carefully separated from the woody portion, and be col- lected in the spring of the year, when the tree has most sap, and be dried in the shade. Chevallier 5 , also advises, that only the rind of the root of the wild tree should be used. Gendrin, Montault and Pichonnier all affirm, that the fresh rind was alone certain in its operation ; the dry frequently disappointing them. "According to Breton, the rind of the trunk is to be preferred to that of the root, because it preserves its virtues longer. Chevallier recommends, before the decoction of the pomegranate tree bark is administered, that a gentle cathartic of castor oil with lemon juice should -be premised. This may be taken the evening before, the patient fasting during the following day. The decoction he directs to be made of two ounces of the rind macerated for twenty-four hours, in two pints of water, and then boiled until a pint of the strained liquor remains. This must be divided into three portions, which are taken in half hourly doses. The first and second doses with many persons excite vomiting, but this need not prevent the ad- ministration of the third, as it rarely produces the same effect. This quantity of the decoction commonly occasions three or four evacuations, preceded by slight colic pains; at other times, but one evacuation is produced, with which the worm is usually expelled. The period that elapses between the administration of the last dose of the remedy and the commencement of its operation is from a quarter of an hour to a whole hour — rarely longer. Cenedella advises that the bark of the root should be macerated 1 Du Taenia &c. et de sa cure radicale par l'ecorce de la racine de Grena- dier. Paris, 1832; and Merat & De Lens. Op. cit. 8 Riecke, Die neuern Arzneimiltel, S. 247. * Rust's Magazin, xvi. St. 3. S. 566. 4 Revue Encyclop. xxxii. 234. 6 Journal de Chimie Medicale, i. 378; 1825. 212 dunglison's new remedies. before boiling ; that the decoction should be made in earthen, not in metallic, vessels, and that it should be filtered or strained whilst hot, different constituents — which are probably efficacious — being deposited as the liquor cools. According to Constant, the rind is commonly prepared in France in the following manner. The rind of the fresh root — or the bruised root dried — is mace- rated through the night in from a pint and a half to a quart of water; the liquor is then boiled to one half, strained, and in the morning, a third part is taken lukewarm, fasting, and repeated every three hours until the whole has been administered. The quantity of the rind, used for the decoction, is, in the case of the adult, §j ; of children, from six to fifteen years old, 3vj ; and of those under six years of age, gss. At times, however, it has been ad- ministered in much larger doses. A girl, twenty-four years of age, had suffered from taenia from her infancy and had frequently passed fragments of worms in her evacuations. She took two ounces of the bruised bark of the pomegranate root, boiled in two pounds of water, at thrice, with half an hour's interval between the doses, but without effect. The dose was now increased to three ounces, and two tapeworms were expelled ; so that in two days, and without any abdominal disturbance, the patient took the decoction of five ounces of the bark of pomegranate root. 1 To ensure the proper action of the decoction, it must be given as directed above, without the addition of sugar or syrup, which changes its properties. During its operation, the patient should drink nothing, except when the tormina are urgent, and then a little of any aromatised water, without sugar, may be taken. The remedy should be given only on days in which portions of tasnia are evacuated, or on the following morning* and the alimentary canal should be free from every evidence of inflammatory irritation. By some, as by Latour de Trie, and Ferrus, an infusion of the rind has been found serviceable ; and Deslandes recommends an Ex- tr actum spirituosum, and an Extractum aquosum corticis radicis granatorum. Ferrus, Berthold, Goupil, and others, have published cases in which, along with the expulsion of the tasnia, various neuroses were removed under the use of the rind, and accordingly it has been thought, that it might be usefully employed in such affections where no tasnia exists ; — in epilepsy and hysteria, for example. Decoctum Corticis Radicis Granati. Decoction of Pomegranate Root Bark. £. Corticis radicis granati, 3*ij. Aquse, flsjj. Boil to a pint and a half. 1 Professor Forget, in Gazette des Hdpitaux. Fev. 19, 1839, and Lond. Med. Gazette, Apl. 20, 1839. GTUACO. 213 Dose. — gij every half hour. Three or four doses are usually- sufficient to expel the worm. 1 The formula, quoted by Dr. Paris 2 from Dr. Ainslie's Materia Medica of Hindoston, directs the decoc- tion to be prepared with §ij of the fresh bark, boiled in a pint and a half of water, until only three quarters of a pint remain. Electuarium Corticis Radicis Granati. Electuary of Pomegranate Root Bark. #. Extract, spirit, cort. rad. granat. ^vj. Aquae riorum tiliae a Succi. citr. aa. ^iij. Gum. tragac. q. s. ut fiat electuarium. Dose. — One half, from half hour to half hour. Deslandes. Mistura Extracti Corticis Radicis GranatL Mixture of Pomegranate Root Bark. 5<. Extract, spirit, cort. rad. granat. ^vj. Aquae menthse r Aquae flor. tiliae 3 Succ. citr. aa. 31J. M. To be divided into four parts, one of which may be taken every quarter of an hour. Deslandes. GUACO. Svnonymes.— Huaco, Eupatorium Huaco. It would appear, that owina 1 to some extracts in the Allgemeine Zeitung, the attention of the German physicians had been directed to this article as an important agent in the cure of epidemic cho- lera; and various testimonials have been brought forward in its favour, which, as Riecke 4 properly suggests, may not be confirmed by farther experience, and yet the circumstance may have led to the introduction of a valuable article into the catalogue of medi- cinal agents. Many species of the genus Eupatorium, and of the kindred genus Mikania, — which has been recently separated from it, be- longing to the natural family Composite, (Synantheresc, sub- division Corymbifersc,) and, in the Lynnaean system, to Syn- 1 Jourdan's Pharmacopee Universelle, i. 638. Paris, 1828 2 Pharmacologic, Beck's American Edition, p. 380. New York, 1831. 3 Any simple aiomatic water may be substituted for this. 4 Die neuern Arzneimittel, u. s. w. S. 250. Stuttgart, 1337. 214 dunglison's new remedies. genesia jEqualis,) have been prized in various parts of America, especially in cases of the bites of serpents. This is especially the case with the Eupatorium ayapana, (E. triplinerve.) According to Martins, a quantity of the bruised leaves is applied to the scari- fied wound, and the application of fresh leaves is renewed, over and over again, until the patient is freed from the dangerous symp- toms, and especially from the violent suffering. At the same time, a few spoonfuls of the expressed juice are administered every now and then. The Mikania opifera, (Eupatorium crenatum,) — in Brazil termed Erva da cobra — and the Eupatorium saturejcB- folium, (Mikania saturejcefolia,) also belong to the many Synan- therese, which, in South America, are reputed specifics against the bites of serpents. The most important species appears to be that called, in Peru, Guaco, or Huaco, which is held there in high con- sideration, as well as in Colombia, New Grenada, and Venezuela, not only in these cases, but in the prevention of hydrophobia. 1 This is presumed to be the mikania guaco of Humboldt. The guaco was made known to us, forty or fifty years ago, by Mutis, 2 who refers to its effects in cases of the bites of serpents. EFFECTS ON THE ECONOMY. Of the efficacy of the guaco in the Indian cholera, M. E. de Chaniac, Officier de Sante in the French navy, and Dr. Chabert, physician to the military hospital in Mexico, have published the results of their experience. When the brig Adonis, on her voyage from Havana to Mexico, in the year 1833, arrived at Vera Cruz, some of her crew were attacked with the cholera, which prevailed at the time in Mexico. Of all the remedies employed, the guaco was found the most beneficial ; its effects, indeed, were so wonderful, that it was regarded almost as a specific. Its action is chiefly ex- erted on the heart and the circulation, which it renders more energetic. All the patients, to whom it was exhibited in the com- mencement of the disease, were saved, and even of those, in whom the cholera had already reached a certain stage, the greater part were saved, as soon as a free and complete reaction was esta- blished. Dr. Chabert, who first administered the guaco in cholera, as well as in yellow fever, observes on its use in the former disease: — In simple cases, a small tea-cupful of a warm decoction of guaco was given every half hour, until a general diaphoresis and proper 1 See W. R. Johnson, in Silliraan's Journal, xxiv. 279 and 388, .New Haven, 1833; and Ibid, xxvii. 17J, New Haven, 1835; also, Dr. Hancock, in Quarterly Journal of Science, &c. from January to June, 1830, p. 333. Dr. Hancock affirms, that the names Guaco and Bejuco de Guaco were given — in the parts of America where he sojourned — to different species of Aristolochia. 3 Virev, in Bulletin de la Societe de Pharmacie, vi. 241; and Riecke, Op. cit. 251. GUACO. 215 warmth of surface supervened, which was kept up for some days, when the remedy was gradually discontinued. To allay the thirst, the decoction was given, diluted with two-thirds, or half, water. In dangerous cases of cholera algida, with coldness, loss of pulse, &c, a spoonful of the spirituous tincture was mixed with six or eight spoonfuls of water, and, every quarter of an hour, a spoonful of this mixture was given alternately with a small cupful of the decoction. When the pulse returned, the warmth became restored, and the perspiration re-established ; the tincture was omitted, and the de- coction continued alone at longer intervals. In the majority of cases, after the cessation of the cholera symptoms, pain was expe- rienced in the epigastrium, with burning thirst, which yielded when the decoction was diluted with half or two-thirds water. When the decoction could not be retained by the stomach, it was given in clyster. Bloodletting, general and local, was employed along with other external means, but nothing was given internally, except the guaco. To make the decoction ; — two drams of the stalks, and half a dram of the leaves, were boiled in two pints of water, down to one. The tincture was prepared like other tinctures. In consequence of the communications of Chabert and De Cha- niac, as well as of the parallel drawn by Harless, 1 between the cholera and the effects of the bites of serpents, Professor Beckers, of Miinchen, recommended that experiments should be made with the guaco ; and it was accordingly tried in Miinchen, but not with as favourable results as had been expected. Romerio asserts, that it was given in the stadium asphycticum, in the form of infusion, made of half an ounce of the stalks, but with uncertain results. It appeared to combine the effects of the valerian and ipecacuanha, yet it excited less vomiting than the latter. The tincture appeared to render greater service. It was given in the dose of a coffee- spoonful every half hour, and, subsequently, every hour, and every two hours. It would appear, that in the district of Prague, its administration was attended with very favourable consequences. 2 To account for the different results, it is affirmed, that different drugs are met with in commerce under the name guaco. Riecke says, that M. Jobst had sent him two kinds, which were evi- dently from different plants; the one variety was obtained from Hamburg and Bordeaux, the other from Paris ; descriptions of which are given by Riecke. The truth, probably, is, that this, like most of the cholera specifics which have been brought forward, is efficacious in certain cases of the disease, but that its efficacy has been egregiously exaggerated. 1 Die Indische Cholera u. s. w. Braunschweig, 1831. 2 Riecke, Op. cit.S. 256. 216 dunglison's new remedies. HIPPOCASTANUM, (CORTEX.) Synonymies. — iEseulus Hippocastanum, Castanea Equina, C. Pavina, Horse Chestnut, Buck Eye, (the Bark.) French. — Marronier, Marronier d'Inde. German. — Rosscastanien, (Rinde.) The tree, whence this bark is derived, is the JEsculus Hippo- castanum, or Horse Chestnut — of the natural family Hippocas- taneae; in the Linnaean system, class Heptandria, order Mono- gynia — which is wild on the mountains of Asia Minor and Persia, and grows in this country, as well as in Europe. The bark has a very astringent taste, is somewhat bitter, and contains a great deal of tannin. Canzoneri thinks he discovered a peculiar principle in it, which he calls JEsculine, but the existence of this is contested. EFFECTS ON THE ECONOMY, The cortex hippocastani has long been advised as an astringent, but without receiving much attention. 1 In modern times, it has been proposed by Zanuichelli, Hufeland, Voigtel, and others, as the best substitute for the cinchona. These recommendations have caused the bark to be more frequently administered of late, in Europe, by which means it has been discovered to accord almost entirely in its effects with the willow bark ; the latter, however, appears to be more effective, and to agree better with the digestive organs. In the wars of Napoleon, when bark was very scarce, it was much employed. Hufeland and Voigtel recommend it, especially in intermittents. Sinogowitz 2 advises that it should be given after the removal of intermittents by the quinine, to prevent a relapse; and, also, in combination with diuretic agents, in the cases of dropsy which often succeed that disease. Kriigelstein found it always extremely efficacious in atonic gout, and in removing the weakness of the digestive apparatus that remains after attacks of gout. The Austrian. Brunswick, Danish, Russian, and Saxon pharmaco- poeias 3 have an aqueous extract of the bark, which Voigtel admi- nistered with good results in intermittent fever, and which he often found serviceable in chronic discharges from the mucous mem- branes. It agrees better with the stomach than the powder or the decoction. Externally, the decoction has been advised as a good astringent. 1 Merat & De Lens, Art. iEsculus Hippocastanum. 2 Rust's Magazin, B. xxix. H. i. p. 84. 3 Pharmacopee Universale, ii. 14. Paris, 1828. HIPPOCASTANUM. 217 . MODE OF ADMINISTERING. Decoctam Corticis Hippocastani. Decoction of Horse Chestnut Bark. £. Cort. hippocastan. |jiss. Coque cum aquse commun. ^xviij. ad reman, colat. ^ix; cui refrigerat. adde Spir. sulph. aether. sjj — ij. Syr. cort. aurant. gj. M. To be used during the apyrexia. Voigtel. Pulvls China, Factilius. Factitious Powder of Bark. £. Cortic. hippocast. salic. gentian, rubr. Calam. arom. ' Caryophyll. aa. gij. Misce et fiat pulvis. Hufeland 1 affirms, that this powder is an adequate substitute for the cinchona in three cases out of four. HUFELAND, AND PRUSSIAN PHARMACOPOEIA. Decoctum Chinee. Factitice. Decoction of Factitious Bark. £. Pulv. gross, cort. salic. hippocast/ aa. §ss. Rad. calam. Caryophyll. aa. ^ij. Coque cum aq. fontan. 5xvi. ad reman, colat. §viij. Prussian Pharmacopoeia. Decoctum Hippocastani Acidum. Acid Decoction of Horse Chestnut. 5<. Cort. hippocast. pulv. ^vj. Coque cum Acid, sulphur, dilut. 3j et Aquse font. $x. Ad colat. §vj. Used in the after treatment of intermittents. Sinogowitz. Electuarium Corticis Hippocastani. Electuary of Horse Chestnut Bark. 5«. Cort. hippocast. pulv. ^ss. Rad. calam. aromat. gss. Roob. juniperi, ^iij. M. fiat electuarium. A tea-spoonful to be taken every hour, or every two hours, in dropsies supervening on intermittent fever. Sinogowitz. 1 Atmenpharmacopoe. 4te Ausgab. Berl. 1825. 218 dunglison's new remedies. HYDRARGYRI PRiEPARATA. Synonymes. — Preparations of Mercury. French. — Les Preparations de Mercure. German. — Q,uecksilberpraparate. I. HYDRARGYRI BROMIDUM. Synonymes. — Hydrargyrum Bromatum, Bromide of Mercury. German. — Bromquecksilber. Mercury unites with bromine in more than one proportion. A solution of hydrobrornate of potassa produces, with a solution of nitrate of protoxide of mercury, a white precipitate, which resembles calomel ; and appears to be a bromide of quicksilver, answering to the protoxide ; [Hydrargyrum Bromatum, Hydrargyri Proto- bromidum ; German, Quecksilberbromiir.) On the other hand, the bromide which is formed by the direct union of bromine with mercury, corresponds probably to the peroxide. A white substance results, which can be sublimed by heat, is soluble in water, alcohol, and especially in ether ; is coloured red or yellow by the alkalies, and exhibits considerable resemblance to corrosive sublimate ; (Hydrargyrum perbromatum, H. perbromidum, H. deutobromi- dum. German, Quecksilberbromid.) EFFECTS ON THE ECONOMY. The effects of these preparations on the sound and diseased organism are not yet well known. They have, however, been employed by some physicians. The protobromide strongly resem- bles calomel in its properties. In the dose of one or two grains, it produces no effect in health, even when taken fasting. In a higher dose — four or five grains, and upwards — it purges moderately, augmenting, at the same time, the secretion of urine. When used in recent syphilitic affections, in the way of friction on the gums, or internally, in the form of pill, it cures them like calomel ; but it does not seem to affect the mouth as speedily or as severely as calomel. 1 The deutobromide resembles the bichloride of mercury in its action, — producing, in too strong a dose, vomiting and purging, with colic and cramp of the stomach; affecting the mouth, and exciting violent salivation. Werneck, of Austria, has administered it frequently in syphilis. In recent cases, he prescribes the deuto- bromide in the form of pill, beginning with the one-twentieth of a grain. This dose he increases by two twenty-fifths every two days; the chancres being covered at the same time with compresses, wetted with a solution formed of six grains of the same substance 1 Bulletin General de Therapeutique, No. 14, Juillet 30, 1837. HYDRARGYRI CYANURETUM. 219 to a pint of distilled water. After a few days' treatment, he re- marked, that the sores assumed a better appearance ; and from twenty to thirty days were sufficient to effect their entire cicatrisa- tion : the total quantity of the bromide administered was about five grains. It was rarely necessary to carry it as high as ten or twelve grains. It has been believed that the deutobromide of mercury is less liable to affect the salivary glands than the deutochloride of mercury, and to affect less severely the stomach and chest. 1 Desorgues has recommended the second (?) preparation as a pro- phylactic and curative agent in syphilis. It was, doubtless, also, Riecke suggests — the second preparation, which was administered with excellent effects by Prieger, in porrigo favosa, of an obsti- nate character. He terms the preparation bromas mercurii, but the true bromate is probably insoluble in ether. 2 The first of the following formulas is recommended by Prieger. Guttce Hydrargyri Perbromidi. Drops of Perbromide of Mercury. *. Bromatis mercurii, (vel potius hydrargyri perbromidi,) gr. vj. Solve in iEther. sulphuric, giij. M. Dose. — Ten to twenty drops, according to the age of the patient, daily, in water. 5<. Hydrargyr. deuto-bromid. gr. j. iEther. sulphuric, £j. M. Dose. — Ten to twenty drops in barley water, a short time after taking dinner ; — in syphilis. Werneck. II. HYDRARGYRI CYANURETUM. Synonymes.— Hydrargyri Piussias, H. Bicyanidum, H. Borussias, Hydrar- gyrum Cyanogenatum, H. Hydrocyanicum, Cyanide, or Prussiate, or Hydrocyanate, or Bicyanide of Mercury. French. — Cyanure ou Hydiocyanate ou Prussiate de Mercure. German. — Cyanquecksilber, Blaustoffquecksilber, Blausaures Q,uecksilber. This mercurial preparation is contained in the pharmacopoeias of the United States, Dublin, London, Belgium, Paris, Ferrara, &c. METHOD OF PREPARING. According to Proust and Gay-Lussac, two parts of good and finely powdered Prussian blue must be boiled with one part of deutoxide of mercury and eight parts of water, until the mixture acquires a bright yellowish tint. It is then filtered; and the filtered 1 Bulletin General de Therapeutique. No. 14, Juillet 30, 1837. 2 Die neuern Arzneimittel, S. 261. Stuttgart, 1837. 220 dunglison's new remedies. liquor, which is the hydrocyanate of deutoxide of mercury — con- taining, however, some iron — is digested or boiled with an excess of the deutoxide of mercury, whereby the oxide of iron is com- pletely precipitated. As, however, the hydrocyanate is combined with an excess of the oxide of mercury, this must be saturated with free hydrocyanic acid, and the solution be evaporated to induce crystallisation. In this mode the cyanide is formed: The formula of the Pharmacopoeia of the United States, into which the cyanuret has been introduced to serve in the preparation of the hydrocyanic acid, is the same as that adopted in the Codex Medicamentarius of Paris, which was recommended by Berzelius. It is as follows : — Take of red oxide of mercury, three ounces ; ferrocyanate of iron, (Prussian blue,) six ounces ; distilled water, three pints. Put the oxide of mercury and the ferrocyanate of iron, previously pow- dered and thoroughly mixed together, into a glass vessel; and pour upon them two pints of the distilled water. Then boil the mixture, stirring constantly, till it becomes of a yellowish colour ; after which filter through paper. Wash the residue in a pint of the distilled water, and filter as before. Mix the solutions, and evaporate by the fire till a pellicle appears ; then set the liquor aside that crystals may form. To purify the crystals, dissolve them again in dis- tilled water; filter; evaporate the solution, and set it aside to crystallise. 1 The former of these methods is, doubtless, the best, as it ensures uniformity, whilst the Prussian blue of commerce being of variable strength, the cyanuret, made after the latter formula, must be so likewise. Schrader directs it to be prepared by mixing a solution of the red oxide or deutoxide of mercury with hydrocyanic acid, filtering and evaporating. 2 The cyanuret of mercury forms white, opake, four-sided prisms. It is inodorous, and its taste is extremely disagreeable and metallic. It is decomposed by heat; is readily soluble in water, and becomes converted thereby into hydrocyanate of mercury. It is insoluble in alcohol. The cyanuret of mercury contains, at times, ferrohydrocyanate of potassa, proceeding from the Prussian blue, with which it has been prepared. 3 EFFECTS ON THE ECONOMY IN HEALTH. According to Co'ullon, the poisonous action of the cyanuret of mercury is as rapid as that of the hydrocyanic acid; but, in the 'Wood and Bache's Dispensatory, Art. Hydrargyri Cyanuretum ; see, also, Mr. Ellis, in Journal of the Philadelphia College of Pharmacy, vi. 24. Philad. 1834-5. 2 See a new process for its preparation, by MM. Chevallier and Deles- champs, in Journ. de Chimie Medicale. Janv. 1830. 3 Orfila, Toxicologic, i. 331. HYDRARGYRI CYANURETUM. 221 dose of from two to five grains, M. Ittner found it produce on dogs only signs of indisposition, tremors, &c l It is one of the sub- stances which Magendie, 2 in his experiments, found to promote the coagulation of the blood. EFFECTS ON THE ECONOMY IN DISEASE. Parent, 3 who frequently used this preparation, prefers it greatly to corrosive sublimate, in consequence of its greater solubility, and the capability of more readily affecting the organism by it. In his experience, syphilis yields more readily under its use than under that of any of the mercurials. He did not observe pains in the abdomen accompanying its protracted employment, which he so frequently witnessed when the sublimate was taken. Another ad- vantage which it possesses, is, that it is not so readily decomposed. No salt, no alkali — not even caustic alkali — disturbs it; neither do substances that contain azote or gallic acid, which speedily con- vert the sublimate into calomel. Moreover, the cyanuret of mercury appears to acton the animal textures differently from sublimate. AVhen the latter is placed in contact with flesh, it becomes quickly changed, in part, into calomel ; whilst the cyanuret preserves the flesh equally well, without being decomposed. The hydrocyanic acid appears to play no important part in the action of the remedy. According to Olivier's experiments. 4 the cyanuret, like the corro- sive sublimate, acts as a powerful excitant to the tissues on which it is applied. He saw a man destroyed by inflammation of the in- testines, who had taken twenty-three grains of it. The cyanuret of mercury was first, perhaps, recommended in Italy, (Brera), and Spain. Mendoza especially made many trials with it, from which he was induced to conclude, that it is the best agent we possess in venereal affections — an opinion in which he was joined by several of his professional brethren in Malaga. He advises, that laudanum should be added to it, on account of its lia- bility to excite vomiting. When too large doses were administered, or when the patient was unusually impressible, Mendoza found that the nervous system became especially disordered — as indicated by syncope, oppression, anxiety, and convulsions. Chaussier, likewise, as well as Thaer and Horn proposed the cyanuret as a remedial agent, at an early period. On the other hand, Wendt, Cullerier, and Plisson complain of its little efficacy; whence it has been inferred that the preparation must differ; when prepared, in- deed, according to the first form, it always contains more or less iron. 5 Neumann 6 advised it in chronic inflammation of the lungs, and 1 Merat & De Lens, Diet, de Mat. M<'d. Art. Cyanogene. 2 Lecjons sur le Sang; and translation in Lond. Lancet, Jan. 20th, 1839, p. 636. 3 Journ. de Cliimie Medicale, viii. 473. * Fbid. i. 269. 6 Riecke, Uie neuern Arzneimiltel, u. s. w. S. 264. Stuttgart, 1837. •Hufeland und Osann's Journal, lv. 66. 222 dunglison's new remedies. of the membranous organs of the chest, abdomen and ovaries. In particular cases, its use has to be soon pretermitted, in consequence of its powerful action, even in small doses — as one eighth of a grain three times a day — on the salivary glands. In other cases, it can be continued long without the supervention of any unpleasant con- sequences. In the Charite, at Berlin, it was used with advantage in a case of obstinate cephalalgia, the origin of which was syphi- litic. Biett has employed it externally — in the form of the ointment given below — in cases of humid tetter, accompanied with inflam- mation and itching. Parent recommends it to be applied in cases of chancre, and Brera uses it in solution, as a gargle, in syphilitic ulceration of the fauces. MODE OF ADMINISTERING. The cyanuret of mercury may be given in pills or in solution ; Horn gave it in powder, but this form is less appropriate. The dose is from one sixteenth of a grain to a grain several times a day. As a gargle, half a grain to a grain may be dissolved in §j of wa- ter ; as an ointment from one and a half to two grains to 3j of lard. Chaussier used it in friction on the soles of the feet, in the same •way as the corrosive sublimate. Solutio Hydrargyri Cyanureti. Solution of Cyanide of Mercury. (Synonyme. — Liqueur Antisyphilirique de Chaussier.) r<. Hydrargyri cyanuret. gr. viij. Aquae distillat. ftj. Each ounce contains half a grain of the cyanuret. Chaussier 1 and Parent. B<. Hydrarg. cyanuret. 9ss. Solve in Aq. distillat. ftj. Adde Tinctura? opii, 3j. M. Dose. — Morning and evening a spoonful, in a decoction of sar- saparilla or barley. Mendoza and Parent. PilulcB Hydrargyri Cyanureti. Pills of Cyanide of Mercury. $<. Hydrarg. cyanuret. gr. v. Opii puri, J)ss. Mica* panis, £j. Mellis, q. s. ut riant pilulae xcvj. Dose. — One to four, three times a day. Parent. 1 Rattier, Formulaire Pratique des H6pitaux civils de Paris, 3eme edit. Paris, 1827. HYDRARGYRI PROTO-IODURETUM. 223 Gargarisma Hydrargyri Cyanureti. Gargle of Cyanide of Mercury. 5<. Hydrarg.cyanuret.^ss. Decoct, len. sem. lini, (vel rad. althseae), ffij. M. et fiat gargarisma. Parent. 5<. Hydrarg. cyanur. 9ss. Decoct, hordei, Kj. Mellis rosati, %]. M. et fiat gargarisma. Unguentum Hydrargyri Cyanureti. Ointment of Cyanide of Mercury. 5<. Hydrarg. cyanur. gr. xij. Adipis, ^j. M. et fiat unguentum. Brera. Brera. 5<. Hydrarg. cyanuret. gr. xvj. Adipis,^j. 01. limonis, gtt. xv. M. From half a dram to a dram, to be rubbed in, in cases of tetter. Biett. III. HYDRARGYRI PROTO-IODURETUM. Synonymes. — Hydrargyrum Iodatum flavum, H. Iodidum, H. Iodidulatum, H. Iodatum (in contradistinction to the Periodatum), Iodidum Hydrar- gyrosum, Hydrargyri Proto-iodidum, Proto-iodide or Proto-ioduret of Mercury. French. — Proto-iodure de Mercure. German. — Gelbes Iodquecksilber, Gelbes Q,uecksilberiodid, Protoiodur des Quecksilbers, Q,uecksilberiodidul, Iodquecksilber im Minimum des Iods. method of preparing. According to Tiinnermann, the best method of preparing the Proto-ioduret is the following : — Take of the nitrate of protoxide of mercury, (not tinged yellow by the admixture of the nitrate of peroxide) 28.25 parts, and 16.5 parts of Iodide of potassium; rub them together for some minutes in the dry state, and afterwards with a little distilled water, gradually adding the water so as to dissolve the saltpetre formed. The mixture is then passed through the filter, and the yellowish green precipitate of iodide of mercury is well washed, and then dried by a gentle heat. The objection to this process is the difficulty of obtaining the mercurial salt at a minimum of oxidation, and the consequent lia- bility of the resulting compound to contain uncertain quantities of the deuto-iodide. M. Boutigny 1 to avoid these disadvantages re- commends the following form. 1 Bulletin General de Therapeutique, and American Journ. of Pharmacy, 2d vol. 2d series, p. 326. Philad. 1837. 224 dunglison's new remedies. 5<. Hydrarg. proto-chlorid. 3 iij & gv. Potassii iodidi, 3 i j & giv. Pulverise the iodide in a glass mortar, and add the calomel ; place the mixture in a porcelain capsule, and pour over it ten or twelve ounces of boiling distilled water. After cooling, decant the fluid, collect the precipitate on a filter, and wash with distilled water. Dry in the shade and keep in a well-stopped bottle. The proto-iodide, thus prepared, may, according to M. Boutigny, sometimes contain a minute portion of mercury or its protochloride, but the quantity of either is so small as to be of no moment. In the new London Pharmacopoeia, it is prepared by rubbing to- gether an ounce of mercury and five drams of iodine, adding gradu- ally as much alcohol as may be sufficient until globules are no longer visible. The powder is dried immediately by a gentle heat, access of light being excluded, and it is kept in a well stopped vessel. 1 The proto-iodide, according to Thomson, consists of 250 parts of mercury, and 156 parts of iodine. It has a greenish yellow colour, and is a preparation holding the same relation to iodine and mer- cury, that calomel holds to chlorine and mercury ; it is more vola- tile, however, than calomel, but like it is almost insoluble in water. EFFECTS ON THE ECONOMY. This preparation has been less used than the deuto-ioduret, to be described next. Tunnermann remarks, as the results of his experience, that its action in respect to the mercury, is analogous to that of calomel, except that it appears to excite more the lympha- tic and glandular systems. When given in conjunction with a generous animal diet, he found it very efficacious in a case of scro- fulosis, where colliquative sweats had appeared ; and in a second case, also, it rendered essential service. In one of the cases, he gave it internally in the dose of from one twelfth to one half a grain three times a day ; in the other of from one half a grain to a grain. He directed it also to be rubbed, in the form of ointment, on the tumefied glands of the neck. Pelletan likewise found it serviceable in the cure of obstinate glandular swellings, when used in the form of ointment in combination with morphine, as well as in cases of obstruction of the liver. Biett recommends an ointment of the protoioduret in the treatment of chronic venereal ulcers, the cica- trisation of which it expedites; Lugol 2 advises it in phagedenic scrofulous ulcers, which present a syphilitic aspect ; and Poiret 3 re- commends it strongly in cases of psoriasis; the patient using at the same time simple alkaline or vapor baths alternately. According to the experience of Ricord, 4 in the syphilitic affections of children, 1 Brande, Dictionary of Materia Medica, p. 289. Lond. 1839. 2 Essays on the effects of Iodine in scrofulous diseases, &c. by Dr. O'Shaughnessy, p. 170. Lond. 1831. 3 Gazette des Hdpitaux, Juillet 20, 1837; see, also, Bulletin General de Therapeutique, Juillet, 1837. * La Lancette Francaise, No. 65., 1834. V HYDRARGYRI PROTO-IODURETUM. 225 especially of a cutaneous character, it is to be preferred to other forms of mercurial, and is not apt to be followed by the bad effects, which in adults, often supervene on the use of other preparations. 1 METHOD OF ADMINISTERING. On account of its insolubility, it is given only in the form of powder or pill, to the extent of from one-twelfth to half a grain, twice or thrice a day. Externally, it is applied, for the same rea- sons, in the form of ointment only. Pilules Hydrargyri Todidi. — (Pharmac. Londin.) Pills of the Iodide of Mercury. £. Hydrarg. iodidi, gj. Confect. rosee canines, ^iij. Zingiberis contritse, gj. M. PilulcB Hydrargyri Proto-Iodureti Composites. Compound Pills of Proto-Iodide of Mercury. 5<. Hydrarg. proto-iodur. gr. vj. Extract, opii, gr. iv. Lactucarii, gr. xxiv. Ext. guaiac. gr. xlviij. M. Fiant pilulae xlviij. Dose. — For a chilu, half a year old. one pill ; for older children, two, three, or four. In the syphilis of children. Ricord. 3i. Hydrarg. protc-iodur. gr. j. Ext. junip. gr. xij. Pulv. glycyrrhiz. q. s. Divide in pulv. viij. Dose. — At first, two, morning and evening; afterwards, three or four. Magendie and Biett. Pulveres Hydrargyri Proto-Jodureti. Powders of the Proto-Iodide of Mercury. 5<. Hydrarg. proto-iodur. gr. i, (iv, vj, vel viij.) Magnes. alb. 3j. M. Et divide in part. xij. Dose. — A powder three times a day. Unguentum Hydrargyri Proto-Iodureti. Ointment of the Proto-Iodide of Mercury. fy. Hydrarg. proto-iodur. gr. vj. Morphin. acetat. gr. viij. Adipis, 3j. M. In obstinate glandular swellings. Pelletan. 1 Cogswell's Essay on Iodine, p. 158. Edinb. 1837. 9 — c dungl 15 226 dunglison's new remedies. 5<. Hydrarg. proto-iodur. 9j. Adipis, §iss.' M. In old venereal ulcers. Magendie and Biett. 5<. Hydrarg. proto-iodur. ^ij. (ve\ iij, vel iv.) Adipis, §ij. M. As a dressing to phagedaenic and scrofulous ulcers. Lugol. When this salve is first prepared, it is of a canary yellow, some- times of a greenish, colour. By time, it becomes of an orange hue, when it must be thrown aside, as, owing to the formation of the deuto-ioduret, it has become as corrosive as the ointment of cor- rosive sublimate. 9*. Hydrarg. proto-iodureti, 3j. Adipis, :$j. M. To be rubbed morning and evening on the parts affected. Poiret. Unguentum Hydrargyri Iodidi. — (Loud. Pharm.) Ointment of Iodide of Mercury. ?<. Hydrargyr. iodid. 5J. Cera? alba?, §ij. Adipis, 3vj. M. IV. HYDRARGYRI DEUTO-IODURETUM. Synonymes.— Hydrargyrum Iodatum Rubruro, H. Biniodidum, H. Perioda- tum, Todidum Hydrargyricum, Deutoiodide of Mercury, Biniodide of Mereury. French.— Deuto-Iodide de Mercure, Periodure de Mercure. German. — Rothes Iodquecksilber, Iodquecksilver im Maximum, Quecksil- beriodid, Deuto-Iodur des Q,uecksilbers. METHOD OF PREPARING. According to Tiinnermann, this beautiful preparation may be obtained by double decomposition, by mixing 137 parts of corrosive sublimate with 165 parts of iodide of potassium, rubbing them together, for a time, in the dry state, and afterwards with water, to dissolve the chloride of potassium formed. To prevent a solution of the precipitate in this«alt, the mixture is put into a glass vessel, and agitated with a considerable quantity of water, until the super- natant liquid appears entirely clear, for which purpose a few minutes suffice. It is now filtered; the residue on the filter well washed, and gradually dried by warm air. By this process, the potassium unites with the chlorine of the mercury, and the mer- cury with the iodine in the dry way; the water is only useful in removing the chloride of potassium. The following is the process recommended in the London Phar- macopoeia : — An ounce of mercury and ten drams of iodine are to 1 Tiinnermann uses only ^ss. HYDRARGYRI DEUTO-IODURETUM. 227 be rubbed together, alcohol being gradually added until the glo- bules are no longer visible. The powder is to be dried with a gentle heat, and kept in a well-stopped vessel. The deuto-ioduret of mercury is a beautiful vermilion-coloured powder, which, when moderately heated, becomes yellow, but, when exposed to the air, is gradually restored to red, and is volatilised. When volatilised, it crystallises in beautiful rhomboidal leaves, which, at a higher temperature, are of a golden yellow hue; but at the ordinary temperature of a shining red. The deuto-iodide is insoluble in water ; but soluble in alcohol and ether. It contains 250 parts of mercury, and 3L2 of iodine. EFFECTS ON THE ECONOMY. This preparation, which was introduced into practice by the French physicians, has been particularly recommended in syphilis complicated with scrofula. Biett found it very efficacious in scro- fulo-venereal ulcers, in syphilitic swellings of the lymphatic glands, and in inveterate itch. He administered it also internally, dis- solved in alcohol or ether, in scrofulous affections complicated with syphilis, and with advantage. In its effects, it resembles the cor- rosive sublimate, whilst the proto-ioduret resembles calomel. Rayer, 1 indeed, considers the deuto-iodide more active than the corrosive sublimate. Paillard found it very efficacious in chronic cutaneous eruptions. He dipped a camel's hair pencil in a weak solution of the deuto-ioduret in ether, and penciled the parts with it three or four times a day. In this way, he cured several squa- mous, tuberculous, and other eruptions, exciting scarcely any pain. As, however, this mode of applying it often failed, he employed 3j mixed with 3J of oil of almonds in the same manner. If the cor- rosive action was considerable, a sense of heat soon arose in the part, which gradually terminated in burning pain. The neigh- bouring parts were also hot, painful, and tumefied; and, in the course of an hour, an effusion of serum took place; but, in four or five hours, the pain always disappeared. If applied on the cheeks or lips, salivation at times ensued suddenly. Scabs formed, which fell off in a feAv days, and exposed a red surface, much disposed to cicatrise. When frequently applied, symptoms oc- curred, which were probably the consequences of its being ab- sorbed, namely, fever, colic, diarrhoea, and dysentery. -Breschet 2 applied it, in the form of ointment, with great success, in a case of obstinate ulceration, presumed to be carcinomatous, at the angle of the eye. Blasius recommends it internally and externally in lupus. Tun nermann used it with advantage, in the form of ointment, for 'Treatise on Skin Diseases, by Dr. Willis, p. 79. See, also, Paine, Journal des Connaissances Medicates, Oct. et Nov. 1838, & Janvier, 1839. * Lugol's Essays on Iodine, by O'Sliaughnessy, p. 204. 228 dunglison's new remedies. Riecke, 1 likewise, employed it as a discutient, (gr. xvj to §j of lard,) in a case of ganglion in the region of the knee — whence vio- lent pain proceeded along the nerves when it was pressed upon — and in two cases of goitre, with great success. Whenever it has to be applied over an extensive surface, as in the disease last men- tioned, it has generally to be discontinued soon, in consequence of the supervention of inflammation of the cutaneous surface. In the form of a weak ointment — composed of the deuto-iodide gr. ij, cerate 9ij, almond oil 3j — it has been used in opacity of the cornea. 2 Recently, Kopp has published some favourable cases of the the- rapeutical application of the deuto-ioduret. The ointment, given below, he found very efficacious in luxuriant, chronic, scrofulous, and syphilitic sores, as well as in condylomata, and venereal blotches. Not less useful did he find it in many other skin dis- eases, and particularly in herpes. In one case, in which he ad- ministered it in the last affection, he found a coexistent goitre, which had been there for several years, almost wholly disappear; and he, consequently, afterwards prescribed it frequently lor the latter affection. He also used it, with excellent effect, in ophthal- mia tarsi, and, where there was a disposition to the formation of hordeolum, a little of the second ointment, given hereafter, was ap- plied at bed time to the edges of the eyelids. Lastly, he advises friction with the first ointment in chronic rheumatic pains, and in cases of induration of the glands, especially of the liver. After the friction has been continued for some time, an eruption occasionally appears. We have frequently administered the deuto-ioduret in public and in private practice, in cases where an active sorbefacient appeared to be needed, and where a combination of remedies so potent as mercury and iodine suggested itself. In chronic glandular en- largements, especially of the liver and spleen, and in habits where the use of mercury was not contra-indicated, both the deuto-ioduret and the proto-ioduret have, in our hands, proved extremely ser- viceable. Perhaps there are no preparations belonging to the class of sorbefacients, which, uuder the circumstances in question merit more attention. MODE OF ADMINISTERING. The deufo ioduret of mercury is given internally in the form of powder or pill, or dissolved in alcohol or ether, in the dose of one sixteenth to one fourth of a grain daily. Externally, it is applied in the form of ointment. 1 Die neuern Arzneimittel, u. s. w. S. 270. 2 Giafe und Wallher's Journ. fur Chirurg. Bd. xiii, cited by Pereira, Ele- ments of Materia Medica, pt. i, p. 4S3. Lond. 1839. HYDRARGYRI DEUTO-IODURETUM. 229 Pihdce Hydrargyri Deuto-Iodureti. Pills of the Deuto-Ioduret of Mercury. 5=. Hydrarg. deuto-iodur. in syrup, commun. pauxill. terendo bene distribuend. gr. v. Micae panis alb. Pulv. sacch. alb. aa. q. s. ut fiant pilulse lx. Dose. — Two. morning and evening, drinking afterwards a cup- ful of oatmeal gruel. The dose to be raised gradually. Blasius. Tinctura Hydrargyri Deuto-Iodureti. Tincture of Deuto-Ioduret of Mercury. fy. Hvdrarg. deuto-iodur. 9j. Alcohol 36° (.837) gissJ M. Dose. — Ten to twenty drops in a glass of distilled water. Magkndie and Biett. JEther Sulphuricus cum Hydrargyri Deuto-iodur eto. Sulphuric Ether with Deuto-Ioduret of Mercury. £. Hydrarg. deuto-iodur. 9j. iEther. sulphur, giss. M. Administered like the last. Magendie and Biett. Unguentum Hydrargyri Deuto-Iodureti* Ointment of Deuto-Ioduret of Mercury. 5'. Hydrarg. deuto-iodur. subtiliss. trit. gr. vj. Adipis, 3vj. M. Kopp. 5«. Hydrargvr. deuto-iodur. subtiliss. pulv. gr. § to i. Adipis. 9ij. Cera? albae, gr. ij. M. fiat unguentum. For an eye salve. Kopp. 5<. Hydrargyri deuto-iodur. gr. xv. Adipis, ^ss. M. exactissime. Fiat ung. As a dressing in lupus. Blasius. 5<. Hydrarg. deuto-iodur. gr. xv. Adipis, 3ij. 01. bergamot. gtt. x. M. To be rubbed on the parts in chronic cutaneous affections. Biett. &. Hydrarg. deuto-ioduc. 9j. Adipis, ^iss. M. To be spread thin on lint in old venereal ulcerations. Biett. 230 dunglison's new remedies. INDIGUM. Synonymes — Indicum, Indicus Color, Pigmentum Indicum, Indigo. German. — Indig. This well-known colouring material is obtained from several species of the genus Indigofera, (I. tinctoria, I. anil, I. disperma, I. argentea, and I. hirsuta,) belonging to the natural family Legu- minosse, and, in the Linneean system, to the class Diadelphia, order Decandria. As we receive it, it is in small, solid, brittle masses, of a deep azure colour, without smell or taste, and assuming a coppery lustre on being rubbed. It is entirely soluble in sulphuric acid, and is wholly consumed on burning coals. According to the analysis of Chevreul, 100 parts of the Guatemala indigo of com- merce contain only 45 parts of pure indigo, or indigo-blue — with which no therapeutical experiments have as yet been made ; the greater part of the residue consists of a green matter soluble in spirit of wine, (indig o- gr een ;) and a red resin, (indigo-red ;) the rest is extractive matter, gum, and some carbonate of lime, oxide of iron, argillaceous and siliceous earth. With hydrogen, pure indigo forms isatic acid, which has considerable resemblance to the hydrocyanic. EFFECTS ON THE ECONOMY. The natives of the countries where the different kinds of indigo grow, employ it occasionally as a therapeutical agent, especially in diarrhoea and intermittent fever. It is only within the last few years that attention has been paid to it in Europe. Professor Von Stahly, 1 of Ofen, appears to have first employed it with success in various spasmodic diseases, especially in epilepsy. To these cases Lenhossek alludes, in detailing certain trials which he himself had made with it. In 1833, Grossheim 2 made known a case, in which he found it extremely useful. A lady, twenty-eight years of age, had suffered for eleven years with violent hysterical convulsive attacks, for which she had employed almost every remedial agent. The attacks began with a feeling of heaviness over the whole body, with slight convulsive twitchings of the limbs, which extended to the trunk, and were followed by total, or almost total, loss of con- sciousness : this, after an uncertain period, terminated in a coma- tose state, from which she was gradually restored — but in a languid condition — to perfect consciousness. Under the use of indigo for half a year, with pediluvia, which had been previously employed without advantage, she completely recovered. These results gave occasion to the institution of experiments, 1 Hecker's neue Annalen, B. i, H. 1. Berlin, 1835. 2 Mediscinische Zeitung, No. 51, 1833. INDIGUM. 231 touching the remedial properties of indigo, in the Charite at Berlin, the results of which have been given by Roth. 1 In most of the cases, the indigo excited nausea, and even vomiting, preceded by a metallic taste on the tongue. At times, the vomiting was so violent and prolonged, that it was necessary to discontinue it ; but gene- rally, on continuing the use of the indigo, the vomiting ceased in three or four days, and diarrhoea took its place. All the patients did not vomit, and many escaped the diarrhoea. When once diarrhoea occurred, however, it commonly persisted so long as the indigo was used. The evacuations were seldom entirely fluid, but usually semifluid, and of a dark bluish-black colour. While the vomiting and purging continued, more or less uneasiness was ex- perienced in the digestive apparatus. The vomiting and diarrhoea were frequently accompanied by pains in the stomach and bowels, which were commonly mild, but occasionally so violent that the indigo had to be discontinued. In every patient at the Charite, the urine was of a dark violet hue. Stahly affirmed, that the perspira- tion was coloured blue, but this Roth never observed. He re- marked, moreover, that after the use of indigo for several weeks, certain patients were easily thrown into slight convulsions, similar to those caused by the use of the nitrate of strychnine, and that they were affected with slight subsultus tendinum. Almost all the patients, indeed, who took indigo, were at first more frequently attacked with spasms than prior to the use of the remedy. In the beginning, the attacks of the disease were, in all cases, stronger, but of less duration, than previous to its employment. These changes continued for one, two, three, and even as long as eight weeks, whether the patients took small or large doses of indigo. At the expiration of this time, all the epileptic symptoms were diminished in intensity and duration, until the last attacks were mere premonitions. The number of epileptic cases, treated by indigo, which Roth had an opportunity of observing in the Charite, was twenty-six; of these, nine were cured, eleven improved, and six remained un- cured. Dr. Ideler, 2 who instituted the experiments at the Charite, has also yiven publicity to the results ; and his testimony accords with that of Roth. It is proper to observe, however, that of the nine cases cured, three experienced relapses in from eight to twelve months ; but from causes, according to Riecke, 3 which, of them- selves, might have induced epilepsy. Dr. Strahl, 4 of Berlin, likewise experimented with the indigo, but his results were by no means favourable. In ten cases of old 1 Hecker's neue Annalen, B. i, Heft. 1. Berlin, 1835. 2 Medicinische ZeitUDg, No. vi. and Lancet, June 6, 1835. 3 Op. cit. S. 276. 4 Hecker's Neue wissenschaftliche Annalen, 1836; and Edinb. Med. and Surs;. Journal, 1837. 232 dungltson's new remedies. standing- epilepsy, the indigo was not of the slightest service, and the same may be said of two cases of St. Vitus's dance. In four cases of hysteria, it excited violent nephralgia, and in one of the cases only, after the affection of the kidney was removed, was the patient cured. The indigo acted, however, signally on the uterus; in two cases of spasmodic affections complicated with amenorrhcea, the latter derangement was removed, whilst the spasms, even after the recurrence of the catamenia, still continued. In the Charite of Berlin, the purest Guatemala indigo of commerce was used, and it may be a question, whether Strahl did not employ one of feebler powers. It is worthy of remark, that he observed a dark green colour of the urine during its use, whilst in the cases in the Charite, a dark violet hue was constantly noticed. Favourable cases are also detailed by Drs. Mankiewicz, of Nackel, 1 and Hohnhorst, of Frankfort. 2 Dr. Noble, of Versailles. 3 administered it in three cases, in which the disease had continued for four, twelve, and twenty years re- spectively. At the time of making known the results, a month had elapsed in the first case and two months in the second, since an attack had been experienced, and the last case he considered en- tirely cured. In the first patient, who was eighteen years old, four drams occasioned vertigo, slight deprivation of vision, and convul- sions similar to those produced by strychnine ; and in both the other cases, diarrhoea was induced, which ceased, however, as soon as the indigo was discontinued or the dose reduced one half. He gave it in the dose of one dram gradually increased to four drams daily. The observations of Rech, of Montpellier, were not as favourable to the indigo. In none of the epileptics to whom he gave it was there any thing more thin a slight amelioration. In the Hospice d'Hommes Incurables du Faubourg St. Martin, trials were also made with it by Dr. Blanche. Often cases five were either cured or improved. One of these had existed for three years, and the paroxysms recurred every five or six days ; but after the administra- tion of the indigo, he had no return at the expiration of five months ; in a second case, a youth fifteen years old — who had been epileptic from birth, and had regularly one or two paroxysms a day, from the 19th of July, when the exhibition of the indigo was begun with until the middle of August, when the results were published — had only two insignificant attacks. The improvement in the other three cases was not as marked, yet it was unquestionable. The other five children experienced no improvement, yet no inconve- nience was sustained, although the indigo was given in doses of four, six, and eight drams in the day. It was administered in wa- ter or in a tisane; and in one or two cases it excited vomiting, but 1 Medicin. Zeitung. Mai 31, 1837, S. 109. 2 Ibid. S. 110. 3 Bulletin General de Therapeutique, 1836. INDIGUM. 233 after having been discontinued, it was borne subsequently. In all it induced tormina, and acted upon the bowels, but did not interfere with the appetite or any of the other functions. Very recently, Dr. Benjamin F. Hardy, 1 one of the senior resident physicians at the Philadelphia Hospital, has published the results of some trials made with the indigo, which, so far as they go, con- firm its antiparoxysmal power. Two of the seven cases reported were apparently cured, two ameliorated, and three without any de- cisive results — the medicine not having been continued perhaps for a sufficient length of time. In these cases, the indigo was com- menced in the dose of 3j, which was usually doubled daily until the patient, took giji daily, which quantity was persevered in for some weeks. In some of the cases the faeces, urine, and perspira- tion were all coloured blue. In other trials, instituted in the same excellent charity, with the indigo, the results were not as favourable. It is obvious indeed, that a wide difference must exist amongst cases of epilepsy, and that where the organic modifications are considerable, as indi- cated by concomitant mania or idiocy, but little can be expected from any remedy; but even in such hopeless cases, the number of paroxysms appears to have diminished under its use. Where the cerebral affection is slight and more functional than organic, the indigo, like the artemisia and other remedies extolled in epilepsy, may be useful. Its main efficacy, perhaps — as we have said of the Ferrum Carbonatum Prascipitatum (p. 175) — consists in the new impression which it makes, in adequate doses, upon the nerves of the stomach, and through them upon those of the whole system ; but to effect the revulsion to the proper extent, it is necessary that the dose should be augmented day by day, and the remedy be con- tinued in large doses for a sufficient length of time. MODE OF ADMINISTERING. As the indigo is extremely light, the powder is too bulky for ad- ministration ; it is taken with disgust, and is apt to excite vomiting. On this account, the form of electuary was selected in the Charite. It was generally combined with the pulvis aromaticus, or thepulvis Doveri. As to the dose, Roth advises, that it should be commenced in grains but be elevated to drams, nay even to one or more ounces in the day. In the Charite* the following formulas were generally employed : — Pulvis Tndigi. Powder of Indigo. *. Indig. subtilissim. pulver. Jss. Pulv. aromat. gr. v. M. et fiat pulvis. A powder to be given four times a day. 1 American Medical Intelligencer, for July 15, 1839, p. 122. 234 dunglison's new remedies. Electuarium Indigi. Electuary of Indigo. 5<. India;, pulv. aquae guttis nonnullis subact. ^ss. Pulv. aromat. gss. Syr. simpl. §j. M. et fiat electuarium. To be used in the course of the day. Ideler. IODTNUM. Synonymes. — Iodiniurn, Iodium, Iodura, Iodina, Iodine. French. — lode. German. — Iod. Iodine was accidentally discovered, in the year 1812, by Courtois, a manufacturer of saltpetre at Paris, but it was chiefly through the labours of Gay-Lussac and Sir Humphry Davy, 1 that the chemical relations of this elementary body were appreciated. The discoverer first detected it in the mother waters of soda obtained from sea-weed ; and as it was found to exist chiefly in several of the sea-weeds, and especially in the sponges, it struck Coindet, 2 that experiments might be made with it in goitre ; from these he obtained such valuable results that its reputation soon spread abroad, and it was employed in various other diseases, — often with the most marked advantage. By experience, too, the injurious effects which it is generally considered capable of inducing were appreciated, so that, it could be administered more satisfactorily than at an earlier period. By the continued investigations of the chemist, iodine was found to be more largely distributed than was at first imagined. It was discovered in many of the marine mollusca, in sea-water, and in several mineral waters. METHOD OF PREPARING. Iodine is obtained from the mother waters of the soda derived from sea-plants, in which it exists in the form of hydriodate of potassa. The waters are procured by burning different kinds of weeds which grow on the sea-shore, lixiviating the ashes, and con- centrating the liquor. To obtain the iodine from this liquor, an excess of concentrated sulphuric acid is added to it, and the whole 1 Annales de Chimie, lxxxviii. xc. and torn. xci. and Philos. Transact. 1814 and 1815. 2 Bibliotheque Universelle, Juillet, 1820, p. 190. IODINUM. 235 is boiled gently in a glass retort furnished with a receiver. The sulphuric acid lays hold of the basis of the hydriodic salt, and of the hydrogen of the hydriodic acid ; whence result sulphate of potassa, water, sulphurous acid and iodine ; the last passing over into the receiver in violet fumes with a little acid, and there becoming con- densed. To purify the iodine, it may be washed with water, con- taining a little potassa, and be redistilled. 1 Iodine is solid at the ordinary temperature, of a foliated appear- ance, metallic lustre ; of a grayish black colour similar to that of plumbago, and friable. Its taste is hot, notwithstanding its sparing solubility in water. It is soluble in 7000 parts of that fluid, and the solution has an orange yellow colour. Its specific gravity is 4.946 at 62° of Fahrenheit. Its smell is similar to that of chlorine, with which it accords in its property of destroying- vegetable colours. It possesses, in a high degree, electro-negative properties. It colours the skin yellow, which colour gradually disappears. It fuses at 220° Fahrenheit. The vapour is of a beautiful violet colour, whence its name (iu$n<;, 'blue'). It is soluble in ether and in alcohol ; forms an acid both with oxygen and hydrogen, and enters into numerous chemical combinations. 2 EFFECTS ON THE ECONOMY IN HEALTH. Soon after the discovery of iodine, and the accurate investiga- tions of Gay-Lussac, Magendie 3 instituted a series of experiments in order to appreciate its action on the animal organism. It was injected into the veins without any apparent effect. Several dogs were made to swallow it; they vomited, but it exerted no farther effect. He himself swallowed a coffee-spoonful of the tincture, and perceived no other result than a disagreeable taste, which continued for several hours, but gradually disappeared. In larger doses, how- ever, the effects were markedly injurious. Orfila 4 likewise instituted several experiments on dogs, from which he concludes : — that iodine, introduced into the stomach in moderate quantity, acts as a gentle stimulant, but may excite vomiting: — that in the dose of a dram, it almost always killed the animal in four or five days, when the oesophagus had been tied to prevent vomiting, and that in the part of the mucous membrane with which it came in contact, ulcers were gradually formed : — that when administered in the dose of from two to three drams, when the oesophagus was not tied, it excited vomiting for several hours, even when a part of the poison had been evacuated by the bowels ; — that it seldom caused death 1 For the method employed by Soubeiran, see Journal de Pharmacie, Janvier, 1837 ; for that by Barruel, see Bussy, Ibid. 2 See, on Iodine and its combinations, Mr. Duhamel, in Philad. Journal of Pharmacy, vi. 101. Philad. 1823--4. 3 Formulaire pour la preparation,' &c. de plusieurs nouveaux Medicamens. 4 Toxicologic, i. 556. 236 dunglison's new remedies. when given in the dose of one or two drams, the animal rejecting it by repeated vomiting ; that it does not destroy life when applied externally, and that it must be classed amongst the irritant poisons. Dr. Cogswell,' in repeating one of Orfila's experiments, in which seventy-two grains of iodine were introduced into a wound on the back of a doi; without much effect on the health of the animal, did not attain exactly the same results. He introduced a scruple of iodine into the cellular tissue of the thigh of an adult rabbit, through a small opening made in the skin. The animal manifested no symptom of pain, and was able to make use of the limb as freely as before the operation, but, in the course of a fortnight, it gradually lost flesh, exhibiting an emaciated look, and the hair dropped off from many parts of the head. At the end of this time, thick adhesive pus was found distending the cavity of the wound, from which the iodine had entirely disappeared. Dr. Cogswell properly suggests, however, the possibility, that the irritation of a large abscess might have been the sole origin of the animal's unhealthy appearance. To discover the effects, which it induces on man, Orfila took two grains fasting. An extremely disagreeable taste, with some nausea, was the only consequence. On the next day, early, he took four grains, when he immediately experienced a sense of constriction and heat in the throat, which continued for a quarter of an hour ; soon afterwards he vomited a liquid yellowish matter, in which iodine was easily perceptible. Except a slight degree of oppression felt during the day, he observed no change in any of the functions. On the second day thereafter, he took six grains fasting, after which, he soon experienced a sense of heat, constriction of the throat, nausea, eructation, increased flow of saliva, and pain at the pit of the stomach ; ten minutes afterwards, he was attacked with copious bilious vomiting, and slight colic pains, which continued for an hour, and were removed by two emollient glysters. The pulse which, prior to the experiments, beat sixty times in the minute, became more frequent, beating from eighty-three to ninety, and was much stronger. The breathing was tolerably free ; but from time to time, there appeared to be a great obstacle to the dilatation of the chest on inspiration. The urine was higher coloured. All the symptoms were removed by the copious use of gum water as drink, and of emollient glysters. Dr. Gully says, that he has given as much as three drams of the tincture daily, and did not observe any effect. Dr. Kennedy, 2 of Glasgow, exhibited, within eighty days, nine hundred and fifty- three grains of iodine in the form of tincture, the doses having been so proportioned, that, towards the last, the patient — a girl — did not seem to be in any way particularly affected. 1 Experimental Essay on Iodine and its compounds. Bv C. Cogswell, A. B. M. D. p. 21. Edinb. 1837. 2 Lond. Med. Repository for 1822. IODINUM. 237 Dr. Buchanan 1 has given half an ounce of the iodide of potas- sium within twelve hours, without any unpleasant result, provided diluents were largely taken at the same time. It has been con- ceived, that where iodine proves -mischievous, it is owing to its being in a free state, and that it then operates as a corrosive poison. The tincture of iodine, and the iodurelted hydriodates, are esteemed to be objectionable on this account. 2 From experiments, instituted by Jorg 3 on himself and on other healthy individuals, it appeared to him, that iodine, first of all, acts as a stimulant on the intestinal canal ; soon afterwards, it excites, also, the different glands in the cavity of the mouth and stomach, the pancreas, the liver, and even the urinary and genital organs. An afflux of blood to the respiratory organs likewise ensues, which extends even as far as the Schneiderian membrane. There is no doubt whatever that the iodine enters into the blood, and, in this way, doubtless produces its modifications on the system of nutrition. Two drams, according to Dr. Buchanan, 4 were given to a young man labouring under gonorrhoea, and, as soon as the medicine made its appearance in the urine, blood was drawn from the arm. On examining it, both the serum and the crassamentum were found deeply impregnated with iodine. The same dose was given to a boy affected with dropsy of the knee-joint. About five hours after the dose had been taken, a very small puncture was made into the joint, and upwards of twelve ounces of synovia drawn off by a cupping-glass. The synovia contained iodine in abundance. To an old man, who had a very large hydrocele, two drams of iodide of potassium weregiven over night, and the same quantity the following morning: on tapping him some hours after he had taken the last dose, more than thirty ounces of serum were drawn off, containing a large quantity of iodine. 5 Dr. Gardner' 5 observed the action of iodine on the human body when administered in particular doses, and pointed out the dis- advantages attendant upon an improvident use of the article. The most striking inconveniences were induced in the digestive organs: it excited diarrhoea, and, at times, obstinate constipation ; gastro- dynia and violent vomiting, especially when food was received into the stomach. The emaciation occasioned by it, is, according to some, a striking phenomenon; and may attain an incredible extent ; yet 1 Lond. Med. Gazette, July, 1836. See, also, Fuster, in Bullet. General de Therap. Fev. 1837, & Sep. 1837. g Biaude's Dictionary of the Materia Medica, p. 323. Lond. 1839. s Materialen zu einei kunft. Heilmittellehre, u. s. w. i. 473. 1824. 4 Op. cit. 6 Brande, Op. citat. p. 321, Lond. 1839. See, also, M. Cantu, in Journal de Chimif Medicale, ii. 291 & 394 ; and Bennersclieidt, Ibid. iv. 383. • Essay ou the Effects oi" Iodine, &c. Lond. 1824. 238 dunglison's new remedies. it is proper to remark, that Lugol. 1 in his frequent employment of iodine in scrofula, never observed this result: he affirms, indeed, that emaciated patients became stronger under its use ; that the stout did not grow leaner, and that they who held the medium po- sition, in these respects, acquired strength under its employment, — results which have been confirmed by others, and which would, therefore, seem to show that this, as well as some of the other un- pleasant effects ascribed to iodine, may have been owing to an in- cautious use of the article. In addition to the above effects, Gairdner noticed anxiety, de- pression of spirits, and other symptoms similar to those of hypo- chondriasis; obscurity of vision; hardness of hearing; palpitations; and tremors of the limbs, particularly of the hands, which last symptom indicated the full effect of iodine on the constitution. Dr. Gairdner found, however, that the remedy was extremely vari- able in its effects ; and that it might frequently be given in large doses, for a long time, without disadvantage, whilst, at other times, the unpleasant symptoms supervened rapidly; indicating that much must depend upon the peculiar impressibility of the indi- vidual. Coindet, 2 who, as we have remarked, first used the iodine as a therapeutical agent, speaks of many of the above-mentioned phe- nomena as resulting from the administration of iodine ; these he considers evidences of the saturation of the organism, as the effect on the mouth is an index of the same thing in the case of mer- cury. It appears, however, to be never necessary, in the admi- nistration of iodine, to induce a saturation of the organism in order that the full sanative influence of the remedy shall be elicited. On the contrary, it seems to be advisable to avoid such saturation ; and, accordingly, whenever there are the slightest indications of it, the dose of the iodine should be diminished, or it should be dis- continued for a time; after which — according to the results of numerous cases — its curative agency, when it is resumed, is ex- erted afresh, and more decidedly. Several physicians, indeed, advise that frequent intermissions should be made in the use of the agent, in order that its action may be more certain. According to the observations of Coindet and Formey, iodine, when administered internally, occasions increase of appetite ; but no influence is perceptible on the condition of the bowels and uri- nary organs ; or on the perspiratory apparatus. On the other hand, when breathed for a few instants, the vapours of iodine twice caused in M. Chevallier 3 violent colic, which readily yielded to gum water and laudanum. Raspail, however, under analogous 1 Memoire sur l'emploi de l'lode dans les Maladies scrofuleuses. Paris, 1S29; and Observations on the Effects of Iodine, p. 17, Johnson's trans- lation. Lond. 1824. 2 Bibliotheque universelle, Mars, Avril, Mai, et Septembre, 1821. 3 Journ. General de Med. ciii. 336. IODINUM. 239 circumstances, experienced no other inconvenience than a disagree- able taste in the back part of the mouth. According to Lugol, the vapour disengaged from tincture of iodine poured into the water of a bath, is liable to induce a state of "iodic intoxication," and even of cerebral congestion. He affirms, that it exerted a power- ful diuretic influence on all his patients, the urinary secretion being so much augmented, that many of them, contrary to their usual habit, were compelled to rise from bed several times in the night to discharge their urine. In upwards of a third it had a cathartic effect, producing six or seven evacuations in the day, and occasionally tormina. In several, ptyalism ensued. Others, and especially females, complained of gastrodynia, which was always removed by the wine of cinchona, of which two or three ounces were taken shortly after the iodine. Dr. Manson, 1 who used the tincture of iodine, occasionally found it produce sickness of stomach, and Mr. Delisser affirms, that, in two months, he gave one thousand and nineteen grains of iodine to a female affected with cancer of the mamma, — the doses, at cer- tain periods, amounting to thirty grains in the twenty-four hours. The consequences were anorexia, quick pulse, ulceration of the mouth, and fcetor of the breath, of a different kind, however, from that which arises from mercury. It would appear, that the effects of the remedy vary according to the form in which it is administered, and it is proper to observe, in viewing the different results obtained by Lugol and Coindet, that the latter commonly gave the tincture of iodine, whilst the former prescribed the solution in water, with a little muriate of soda. Lugol also observes, that the appetite of his patients was very much increased by it. Eager, who likewise administered the watery solution, but rarely observed diarrhoea and emaciation ; and, in general, indeed, the appetite and nutrition improved under it. At times, ulceration took place in the mouth, whereby the breath assumed a mercurial foetor, and salivation has been observed from it, according to Manson, 2 Winslow, 3 Ely, 4 Mackall, 5 and others ; but Riecke 6 suggests, that this, perhaps, only occurred in those, who, along with the use of iodine internally, had employed the ioduret of mercury externally. On the genital organs, Eager found it to act as an excitant ; it augmented the activity of the uterus, and rendered the catamenia more abundant. It is asserted, too, to have increased the sexual appetite, but this is questionable ; during its use, indeed, the testes in men, and the mammas in 1 Medical Researches on the Effects of Iodine. Lond. 1825. 2 Op. citat. p. 61. 3 Lond. Med. Gaz. for 1836, p. 401. * Ibid. p. 480. 8 Medico-Chirurg. Review, Jan. 1836. 6 Die neuern Arzneimittel, u. s. w. S. 282. 240 dunglison's new remedies. women, have been observed to disappear ;* but this, as we shall see, is certainly not a common occurrence. 2 On the other hand, it has been imagined to cause sterility. Two cases are detailed by Dr. Robe H. Rivers, 3 in which barrenness succeeded to its admi- nistration. Magendie. on giving it as an emmenagogue to a young lady of unsuspected virtue, brought on abortion. 4 Krirrer several times observed, even when the tincture was given in small doses, considerable metrorrhagia, epistaxis, haemop- tysis, obstinate diarrhrjea. leucorrhoea, &c. supervene under its use. Cases of suppression of the hemorrhoidal flux are asserted to have been restored by it. 5 Jahn 6 found, in the bodies of two persons, who had long made use of iodine, wasting of the fat ; softness and laxity of all the organs and tissues ; diminution and disappearance of the glands, and glandiform bodies, — the mesenteric glands ; suprarenal cap- sules, & ., — and the cellular tissue appeared to exist in smaller quantity. In the case of a female, who died from the excessive use of the tincture, Zinck 7 found the bowels inflated with gas ; in some parts highly inflamed ; in others, exhibiting an approach to sphacelation, both within and without: the inner membrane of the stomach displayed redness, growing deeper from the cardiac to- wards the pyloric orifice, where the organ looked as if it had undergone corrosion ; the liver was large and reddened ; and there was ecchymosis of the spleen. Dr. Christison 8 is of opinion that iodine is capable of inflaming the latter organ. From the testimony of many observers, it can scarcely be doubted that the iodine disease, or iodosis, or iodism, as it has been termed, may become dangerous to life : generally, however, it is not really so much so as it appears, and is considered to be, and the evil consequences may be readily avoided by proper foresight. Cases, however, have occurred, in which its use has been followed by fatal results f hence the necessity of circumspection in the em- ployment of so energetic a therapeutical agent. To avoid evil consequences, Wutzer advises that the iodine should be immediately discontinued, whenever a feeling of in- creased heat in the pharynx and stomach is experienced imme- diately after it is taken; but as this evidence cannot be available 'Christison, Treatise on Poisons, p. 180; Cogswell on Iodine, p. 47; Edinb. 1837. 2 Pereira, in Lond. Med. Gaz. vol. xvii; and Diet, de Mat. Med., par Metat & De Lens, Art. lode. 3 American Journal of the Medical Sciences, Aug. 1831, p. 546. 4 Formulary. Gully's edit. p. 105. ' See Ashwell, in Guy's Hospital Reports, vol. i.; and Cogswell, Op. cit. p. 43. 6 Archiv. fur medicin. Erfahrung, i, 342, 1829; and Journal Complement, du Diet, des Sciences Medicales, xxxv. 362. 7 Journ. Complem. du Diet, des Sciences Medicales, xviii. 231. 8 Treatise on Poisons. • Sir B. Brodie, Lancet, Mar. 30, 1839. IODINUM. 241 in small children, attention should be paid, whether, after the medicine has been taken, the temperature of the skin becomes more elevated ; the pulse quicker, and whether there is any evi- dence of pain when pressure is made On the epigastric region. He, moreover, advises, that it should not be given internally to children at the breast. It has been affirmed, that if the iodine be combined with small doses of opium, all the disadvantages, immediate and remote, may be avoided ; and it is always more advisable to give it in small doses for a longer, than in very large for a shorter, period. At times, it will happen, that in chronic affections — in which it is chiefly used — its beneficial agency may not be decidedly manifested until after the lapse of four or five months ; and it is important to bear this in mind, as both practitioner and patient are apt to become dissatisfied, unless the remedy exhibits its action more speedily. When the iodine acts beneficially, the appetite is augmented, or is not deteriorated ; digestion improves, so that the patient is able to take more food, and experiences less inconvenience therefrom : the secretion of the bile is increased, and the evacuations are more copious, and of a yellower hue; the peristaltic action goes on more energetically, and the patient gains strength. Such, at least, are the signs that are considered by many to indicate that the iodine agrees ; but the absence of all disagreeable consequences is a suffi- cient index. To remove the symptoms of iodine disease, or iodosis, (iodkrank- heit,) general or local bloodletting has been employed ; with warm bathing, the use of milk, emulsions of gum arabic, and the like, with rigid diet and rest. The preparations of hydrocyanic acid have also been given with advantage in the palpitation, tre- mours, and other nervous symptoms that sometimes follow the use of iodine. Precaution is requisite in the case of impressible, and also — it has been conceived — in robust persons, 1 for fear of the supervention of hypersemias. It is advisable, too, during its administration, to let the diet be sparing, and devoid of all heating qualities. Kolley 2 remarks, that iodine occasionally exerts a most unfavourable influ- ence on the nervous system, so that in those, who are easily ex- citable, unusual pains may be brought on by the use of even three or four drops of the tincture ; — these pains, at times, ending in vio- lent spasms. Such persons exhibit the impressibility, even under very minute doses, by fidgetiness, or restlessness of the limbs, so that they can scarcely be kept quiet: after a time, numbness and heaviness in all the limbs : heaviness of the head, and a species of inebriation 3 succeed, with violent cephalalgia, spasms, tremors of ' Riecke, Op. cit. S. 284. 2 Journal Complementaire, xvii. 307. 3 Giddiness was observed by Dr. Manson, (Researches on the Effects of Iodine, p. 6t, Load. 1825;) Ashwell, (Guy's Hospital Reports, i. 136;) and 9 — d dungl 16 242 dunglison's new remedies. the limbs, paralysis, 1 prostration, spasms, depravation of vision, and disposition to lamentation and distress. Some of these nervous symptoms we have occasionally noticed, when the dose of iodine has been rapidly augmented. Where the person is liable to gastric uneasiness, caution is requisite in the use of the remedy, as it not unfrequently occasions dyspepsia and violent gastrodynia. All febrile and purely inflammatory diseases, according to Kolley, forbid its use. Of late, Dr. Andrew Buchanan 2 affirms, that he has never wit- nessed any of the unpleasant symptoms that have been ascribed to the iodine. He asserts, that he has never seen its use "followed by wasting of the testicles or mammas, by palpitations, faintness, ex- cessive debility, hurried, anxious breathing, dinginess of the sur- face, copious clammy sweats, increased menstrual discharge, or an oily appearance of the urine, which are enumerated amongst the symptoms characterising the supposed affection, termed iodism." As regards the wasting of the mammas and testicles, Mr. Pereira suspects it to be very rare. He has seen iodine administered, he remarks, in some hundreds of cases, and never met with one in which atrophy of either organ occurred. Magendie, also, remarks, that he has never witnessed these effects, although they are said to be frequent in Switzerland. 3 Our own experience accords with that of those gentlemen. We have prescribed, and seen it pre- scribed, largely, both in public and in private ; yet no such results have ever supervened. In the Philadelphia Almshouse, great attention was paid to the condition of the testes, in several cases in which it was administered, yet no clear case of atrophy occurred. 4 EFFECTS ON THE ECONOMY IN DISEASE. Iodine exhibits itself as a most efficacious remedy in a variety of diseases, in which it is desirable to augment the activity of the ab- sorbent system. In referring to its use in the following diseases, the remarks apply not only to the pure iodine, but to the hydrio- dates of the alkalies, especially the hydriodate of potassa ; the medical properties of which accord with those of iodine. Bronchocele. — The very first experiments made with iodine were on goitre. Coindet recommended it strongly in that affec- tion, and Pormey 5 first introduced it into Germany. Coindet gave, in the first instance, the tincture internally, and he remarked, that about a week after the commencement of its use, the skin over the Lugol, (Essays on the Effects of Iodine in Scrofulous Diseases, O'Shaugh- nessy's translation, p. 73, Lond. 1831.) 1 Sir B. Brodie. Lancet, 1832; Manson, Op. citat. ; and Sir A. Cooper, Lancet, ii. 147. 2 Lond. Med. Gaz. July 2, 1836. 3 Pereira, Elements of Materia Medica. pt. i. p. 114. Lond. J839. 4 Dr. A. M. Vedder, in American Medical Intelligencer, for Sept. 1, 1S38. 5 Bemerk. uber den Kropf, u. s. w. Berlin, 1820; and Hufeland's Journal, B. Ii. St. 4, S. 91. IODINUM. 243 goitre generally became less tense, the substance of the tumour felt softer, without the tumefaction having abated; the particular por- tions of the gland became more distinct, and separated from each other; and less and less hard, until gradually a diminution was perceptible. Frequently the goitre disappeared completely, in the space of from six to ten weeks, under the continued use of the remedy. At an after period, he employed the iodine externally, in which form of administration, the evil consequences, sometimes induced by it, are less to be apprehended ; and often its internal and external administration were combined. The efficacy of iodine in bronchocele, has received the most am- ple confirmation. Cases have been published by Hufeland, Grafe, Baup, Helling, Ziegler, Yollmer, Reiss, Paulitsky, Hirscb, Ulrich,. Jager, Barchewitz, Meissner, Voo-el, Wutzer, Seiler, Ficinus, Nieu- stadt, Hoffmann, De Carro, J. Reid, Manson, Elliotson, Lugol, and numerous others. 1 We have administered it in fifteen cases of soft goitre, and in every on<^ the disease was removed. In two of the cases, it recurred, but the hypertrophy was again dispersed under - the use of the remedy. It has been recommended by some, that its exhibition should be preceded by a bleeding ; and as the abstraction of blood facilitates absorption, this may be advisable, especially where but little, if any, effect seems to be induced by it, after it has been administered for some time. Reid advises, that we should commence with its ex- ternal administration ; and, at a later period, conjoin with it the internal. Although cases have been published, in which iodine has not answered the purpose of the prescriber, there can be no ques- tion, that it is the most efficacious agent in goitre, that we possess, but when the tumour has acquired a cartilaginous hardness, al- though it may be diminished under the use of the remedy, it can rarely, or never, be wholly removed. Under such circumstances, however, every other remedy would be found equally fruitless. Glandular affections. — Besides the affections of the thyroid gland, there are others of different glandular bodies, in which iodine exhibits itself efficacious. Jahn used friction with it in induration of the liver, with advantage. Wutzer gave it in two cases of induration of the spleen, but no precise deductions could be made as to its individual efficacy, owing to its having been combined with other remedies. Milligan relates three cases of enlargement of the liver or spleen in children in which he gave the tincture with success, after mercurials had been used ineffectu- ally. M. Eusebe de Salle 2 and Jahn employed it with success in enlargement of the testes; Riecke, 3 too, found it of essential service in a case of great induration and enlargement of the testicle, which ' Richtor's Spocielle Therapie. Berlin, 1528, S. 2l4, and Dictionnaire de Matiere Medic-ale, &c. par MM. Merat & De Lens, Art. lode. 2 Journal Complement, xix. 193, and Journal Universel, xi. 346. 'Die neuern Arzneimittel, u. s. w. S. 286. 244 dunglison's new remedies. in the opinion of several physicians would require an operation. Jahn found it useful in a case of strumous induration of the sub- maxillary gland, and in one of tumefaction of the prostate, the consequence of mismanaged gonorrhoea. Krimer employed it beneficially in cases of tumefaction and induration of the mesen- teric glands ; and Cerchari 1 found an ointment, composed of a scruple of iodine and an ounce of unguentum rosatum, very effi- cacious in the cure of enlarged tonsils. He applies it to the tonsils morning and evening, by means of a small brush ; and he asserts that under its use the tonsils will in two months be restored to their natural dimensions. Any inflammation must be subdued before the ointment is had recourse to. Sir B. Brodie 2 has used it sucessfully in similar cases; the en- larged tonsils being touched every day with a camel's hair pencil dipped in the tincture. Of its administration in other glandular affections, mention will be made presently. Scrofula. — Soon after the introduction of iodine into the materia medica, it was used externally in scrofulous affections; and at an early period was prescribed by Gordon, Sir A. Halliday, 3 and others, in such diseases, especially when combined with mercury. Their observations were confirmed by Magendie, Baup, 4 Sablairoles, Ba- ron, Brera, Manson, and others. Wutzer used it in many cases of scrofula, and found it especially useful in the lymphatic (pastosen) form. In irritable cases, he was cautious of employing it as well as in hyperaemic conditions; and he found that when aggravation of the symptoms occurred, some concealed inflammatory disposition was the cause. More recently, Lugol 5 has contributed to the more extensive employment of iodine in scrofula, and has especially re- commended the watery solution of iodine internally, and baths of iodine externally. The fortunate results of his trials, in the Hopi- tal St. Louis, were corroborated by a committee appointed for the purpose, by the Royal Academy of Sciences. It afforded eminent service in the different forms of scrofula; but in scrofulous caries it merely induced improvement, never entire cicatrisation. Lugol regards iodine as the most efficacious remedy we possess in scrofula. Eager, in speaking of Lugol's method of managing scrofula, pro- perly lays great stress on the accompanying regimen — nutritious diet, cleanliness, bathing and exercise in the open air — which he re- gards as indispensable to a fortunate issue. He prefers the watery solution of iodine internally to all other remedies. Lugol and Eager unite, with the internal use of iodine, the external, in the form of ointment or solution; for example in fistulas they employ it as an injection. To excite ulcers to cicatrisation, after appropriate 1 American Journal of Pharm. 2d series ii. S3. Philad. 1837. 2 Lancet, Mar. 30, 1839, p. 38. 3 Lond. Med. Repos. Sept. 1821. 4 Bibliotheque UniverseJle, Dec. 1881. 6 Essay on the Effects of Iodine, &c. p. 48. IODINUM. 245 pressure and injections have failed, Eager recommends that the skin, which has separated, at the margins of the ulcers, from the subjacent parts, should be destroyed by caustic or removed by the knife, but that this should not be practised until the scrofulous tendency has been somewhat got under. As a caustic, Eager re- commends, pulv. calcis viv. 3vj ; potass, caustic. 3v, to be made into a paste with spirit of wine, and to be applied a few lines thick ; the skin will be destroyed in about five minutes. According to the same observer, iodine has exhibited its efficacy in various cases of periostitis, scrofulous swellings of the joints, and necrosis. In scrofulous ophthalmia, it was less beneficial. In scrofulous dis- charges from the nose and ear, iodine injections were commonly of service. Baudelocque 1 likewise extols the preparations of iodine in scrofula; but in scrofulous affections of the bones, and especially in caries, as well as in scrofulous diseases of the skin, it appeared to him to be inefficacious. Many cases have been related by Zinck, Maunoir, Manson, Weihe, Benaben, Bayle, and others, in which white swellings of the joints, of a scrofulous character, have been removed by its use. Wutzer has likewise offered favourable testimony in regard to it in affections of the bones, some of which were of a strumous nature. In several cases, so much disorganisation had occurred, that the loss of the whole limb was to be apprehended, y£t the iodine arrested the destruc- tive process, and the limbs were preserved. In various scrofulous affections, the tincture of iodine was given by Dr. Kiihne 2 with great success, and without any evil consequences. He made it, however, of half the usual strength, beginning with three drops, and gradually increasing the dose to fifteen. In tumefaction of the joints, the iodine, administered externally, has afforded essential service. Wutzer was of opinion, that the tincture of iodine might frequently be applied externally with greater advan- tage than the ointment ; the alcohol readily evaporating and leav- ing the iodine on the skin ; for which reason he recommends that the tincture should be applied repeatedly by means of a camel's hair pencil. Tubercles. — The efficacy of iodine in scrofulous affections gave rise to the belief that it might be serviceable in tubercles. Brera and Calloway administered it frequently in mesenteric tubercles with great success, and the observations of Krimer, referred to above, correspond with theirs. It has also been given with advan- tage in cases of pulmonary tubercles. It was suggested, in such affections, by Dr. Baron, and a case is related by Mr. Baden of ap- parent tubercles in which it was markedly useful ; 3 similar examples are detailed by Jahn, Waldack, and others ; and Berton affirms, that 1 Etudes surla Maladie Scroplnileuse. Paris, 1834; and London Lancet, May, 25, 1839, p. 350; see, also, Cogswell on Iodine, p. 75. 2 Medicinisclie Zeitung, No. 34. 24 August, 1836. Berlin. 3 Formulary — the Author's edition, p. 37. Lond. 1824. 246 dunglison's new remedies. he has found inhalations of the vapour of iodine of decided efficacy in confirmed phthisis, as well as in certain forms of catarrh. It has likewise been advised in the form of vapour by Sir James Murray, 1 and by Sir C. Scudamore 2 in phthisical affections. The addition of a little tincture of conium was found by the latter gen- tleman to be beneficial in subduing the irritating qualities of the gas. His formula is the following : iodin. gr. viij, potass, iodid. gr. iij, alcohol. §ss, aquae distillat. §vss. M. Of this solution, from one dram to six, and from twenty to thirty-five minims of a saturated tincture of conium are used in each inhalation, which is continued from half an hour to forty minutes. Sir Charles con- siders it better to add the conium at the time of employing the in- halation. At the temperature of 90°, the volatile properties of iodine are given off very sensibly, but the conium requires more heat, and that of 120° is not too much for the iodine. A learned reviewer in the British and Foreign Medical Review, 3 affirms, that his own experience leaves him no doubt as to the great value of the practice as a palliative in phthisis, and as an important remedy in bronchitis. It is true, however, he adds, that the relief has often been as great from the simple aqueous as from the medicated inhalation. Our own experience has not been favourable to it, and Mr. Pereira 4 says he has repeatedly tried it in phthisis as well as in other chronic pulmonary complaints, but never with the least benefit. The inhalation may be practised in the method recom- mended under the head of Chlorine, (page 107.) The inhalation of iodine has been dreaded, because, in some in- stances, troublesome irritation of the larynx has followed its use; but Dr. Corrigan 5 considers, that this injurious effect has resulted from the defective means of inhalation hitherto employed. Used in the manner he has recommended, and which we have described — under the article referred to above — gradual in its evaporation, and ultimately combined with a large portion of aqueous vapour, its use, he says, is positively free from any injurious irritative effects. The vapour he found to diminish most remarkably the profuse and wast- ing purulent expectoration of phthisis. The effects of iodine, thus used, on the digestive function were also very gratifying. In all the cases in which Dr. Corrigan employed it, the appetite and state of the intestinal canal were improved. It acted as a most useful tonic to the digestive organs, without any of the irritation, which its internal use, in the ordinary form, at times produces. It likewise greatly 1 On Temperature, Aliment, &c. 1829. 2 Cases illustrative of the efficacy of various medicines administered by- inhalation in pulmonary consumption, 2d edit. Lond.; and Lond. Med. Ga- zette, Feb. 17, 1838, p. 804. 3 April, 1838, p. 606. 4 Elements of the Materia Medica, Pt. i. p. 120. Lond. 1839. 5 Dublin Journal of Medical Science, for March, 1839, p. 103; and Lond. Med. Gaz. for Apl. 6, 1839, p. 50. TODINUM. 247 alleviated the cough, so that the patient was enabled to obtain hours of sound and refreshing- sleep ; and he consequently con- siders, that even should its use be of little avail against the destruc- tive scrofulous ulceration, which constitutes phthisis, the palliative good, which is derived from it, renders it a valuable addition to our list of remedies. Dr. Corrigan has had his apparatus at work from eight to twelve hours in the twenty-four ; and his mode of managing it is as follows: — at night, when the patient is settling to sleep, the apparatus is suspended from the roof of the bed ; and, when once arranged, it continues its work quietly and silently for four or five hours, while the patient, asleep, is all this time inhaling the medicated air. In the morning, for three or four hours before the patient rises, it is again at work ; and, if necessary, in the midday, while the patient reclines on the bed, with the curtains drawn round three of the sides. The rate of evaporation, which generally gives a sufficiently strong impregnation to the air, is when the tincture of iodine drops from the cotton wick at the rate of from six to eight drops per minute. At this rate, about six drams of the tincture will be evaporated in an hour, and as every particle of the iodine is diffused in watery vapour through the air, there are thus diffused in the minutest state of division through the air, in every hour, about thirty grains of iodine. " If we suppose the patient to inhale only one twentieth of the iodine evaporated he will inhale in each hour, and apply to the diseased surfaces, one grain and a half of iodine in a state of the most minute division or solution." "This quantity we know" — adds Dr. Corrigan — "is quite suffi- cient to exert a decided action upon scrofulous ulceration ; for we find on reference to Lugol's valuable work on the employment of iodine in scrofula, that in external scrofulous ulceration, the prepa- ration of iodine which is found beneficial, is a solution which con- tains only about three grains of iodine in each pint of fluid. The duration of the inhalation can, of course, be extended at pleasure." Fontana affirms, that he has observed decided benefit from iodine in a case of phthisis mucosa; when given in the form of the sy- rupus iodalus, and combined with the external application of the ointment of tartarised antimony. Duverney has communicated some cases, which appeared favourable to the prophylactic agency of iodine in incipient or threatened phthisis, but he himself con- siders, that his observations have not been sufficiently numerous to effect the demonstration. We have frequently administered iodine, in various forms, in pulmonary tubercles, but it must be confessed, not with that decided advantage, which the well known sorbefacient virtues of the remedy, and the recorded observations of others, might seem to promise. We have never witnessed, on the other band, the evil, which Riecke 1 mentions, that it may under particu- lar circumstances, occasion the speedy development of phthisis, 1 Dip neuern Arzneimittel, u. s. w. S. 289; see, also, Gunther, in Har- less's Neue Jahrb. B. xii. St. 3. S. 161. 248 dunglison's new remedies. where tubercles exist in the lungs. He refers to a case by Haser, as corroborative of his opinion. A woman, fifty years old, was affected with anchylosis spuria, for which an ointment of iodine was recom- mended ; but it had not been employed more than three weeks, and not more than a dram of the hydriodate of potassa had been rubbed in, when symptoms of phthisis tuberculosa rapidly supervened, which, in half a year, terminated in death. There does not appear, however, in this case, to have been any thing more than a coinci- dence. In tubercles of the liver iodine has been regarded worthy of special consideration. 1 Dropsy. — Many trials have been made with iodine in cases of dropsy, owing to its powerful sorbefacient agency. 2 Bradfield and Bardsley exhibited it frequently with success in hydrothorax and ascites ; and Kissam, in a case of dropsy, dependent probably upon induration of the liver. Dr. Coster 3 says he has removed many dropsies by giving internally from six to fifteen drops for a dose of a mixture composed of iodin. gr. hi., potass, hydriod. gr. vi., aquae, sj. Aided by an ointment composed of fifteen grains of iodine, with double the quantity of hydriodate of potassa, to an ounce of lard. This to be placed inside the thighs after removing the cuticle by a blister. The armpits and soles of the feet were also rubbed with the ointment. The same plan is recommended by Dr. Osborne. 4 Jahn regards iodine as one of the most important agents of modern discovery, and as an extremely valuable antihydropic. 5 He first used it in a case of hydrocele, in which it was doubtful whether degeneration of the testicle had not been a precursor. The effect of the ointment of hydriodate of potassa left nothing to be desired; and, accordingly, he afterwards employed it in all cases of hydrocele of the tunica vaginalis, which he met with, even in the new born, united with mercury or extract of cicnta, and in every case, which was not of too chronic a character, it exhibited its sanative powers. The only unfavourable effects induced by it were a temporary disappearance of the testicle; in some cases; and a humid cutaneous eruption of the scrotum. He also found the iodine extremely useful in hydrotho- rax and ascites ; especially in those cases of dropsy which succeed to exanthematous diseases, and that it acted more speedily and powerfully when combined with some diuretic. He found, farther, that the iodine was followed by the most beneficial results in the hydrocephalus of children — as well chronic as acute — especially when the latter form had attained its full 1 Riecke, Op. cit. S. 290. 2 Dr. Wra. Stokes, in Amer. Journal of the Med. Science?, May, 1834, p. 543, from London Med. and Surg. Journal. 3 Journal de Phannacie, 1834. 4 On the Nature and Treatment of Dropsical Diseases, 2d edit. p. 48. Loud. 1S37; and Amer. Med. Library edit. Philad. 1S3S. * Elliotson, in Lancet, 1830—31. IODINUM. 249 development, that is, when the inflammatory stage was over, and the accumulation of fluid was the prominent condition. In these cases, he commonly used the iodine in the form of the hydriodate of potassa, made into an ointment, and rubbed on the head. Fre- quently, however, he gave the iodine also internally, in combina- tion with calomel and digitalis ; but it may be objected to this combination, that iodine with calomel forms corrosive sublimate and the proto and deuto-iodurets of mercury, so that, in very small doses, it might affect the stomach too violently. 1 M. Ricord 2 em- ployed the tincture of iodine with success in iive cases of hydro- cele ; — the tincture being diluted with distilled water, and applied by means of compresses wetted with it, and in which the scrotum was enveloped. He uses it of four different strengths — 3J,'5ij, 3iij, and 3vj of the tincture, to §iij of water. In hygroma, or dropsy of the bursa? mucosa? of the joints, an ointment of the iodide of potassium (.gij ad axung. §j) has been most successfully used by M. Reynaud. 3 The limb is kept at rest, and morning and evening, or three times a day, friction is made with this quantity of ointment ; after which the knee — the joint commonly affected — is covered with a large flaxseed poultice. From some trials made with the iodide of lead, there was reason to believe it more efficacious than the iodide of potassium. The treat- ment was generally successful in about a fortnight. As to its efficacy in nervous diseases, the testimony is somewhat discordant. Manson 4 and Elliotson 5 found it useful in paralysis, but Dr. Bardsley failed with it. Chorea was removed by Gibney 6 and Bardsley; and Franklin, 7 by very large doses, relieved a case of epilepsy. The intimate affinity between iodine and the urinary organs, has given occasion to its employment in Incontinence of Urine. — Corter cured two cases by the tincture of iodine. Cutaneous Diseases. — Cases of dry, scaly tetter were treated, commonly, by Tiinnermann, with an ointment made of the iodide of potassium, applied to the affected parts three or four times a day. For the most part, an increase of the evil was at first a pretty sure harbinger of a radical cure; when this attained a certain de- gree, a change in the organic actions of the skin succeeded ; the remedy was then pretermitted, and the parts were washed a few times with soap, when the eruption faded away, and disappeared. In moist tetter, Tunnermann applies only a very weak salve, with which the parts are touched daily two or three times: in the 1 Riecke, Op. cit. S. 291. •Journal des Connoissances Med.-Chirurg. Janvier, 1833. 3 Cabissol, in Bulletin General de Therapeutique, Fev. 1838. * Op. cit. 6 Lancet, 1830-31. 6 Ibid. 1827-8, p. 54. 7 Lancet, 1830, and Cogswell, Op. cit. p. 24. 250 dtjnglison's new remedies. intervals, he envelopes them in dry linen rag. The pain, which is always induced by the application, soon passes away. Magendie, Gimelle, and Jeffray 1 have likewise applied it successfully in tetter. In chronic cutaneous diseases, in general, the various pre- parations of iodine are valuable remedies. They enter, as we have seen, the mass of blood, modify the condition of that fluid, and, in this manner, exert a new impression upon the capillaries of the diseased portions of the dermoid system. We have often employed them in these cases with success, and similar testimony has been afforded by MM. Biett, Gimelle, Kolley, Locher-Balber, and others. Brehme succeeded in removing, rapidly and completely, a case of inveterate porrigo favosa, and ophthalmia thereon dependent, by an ointment of iodine. Amenorrhea. — According to Coindet, iodine is a powerful em- menagogue, and the possession of this property has likewise been ascribed to it by Brera, 2 who frequently administered it successfully in amenorrhoea ; and Formey and Nieustadt confirm his observa- tions. Sablairoles cured three cases by frictions with iodine oint- ment on the breast, conjoined with the internal use of iodine. It was necessary, however, to give it in large doses, and for a long time. Locher-Balber 3 found the iodine, at times, of use in those troublesome cases, which occasionally precede the establishment of menstruation ; as well as Golis, who was, however, often deterred from its use, in such cases, by the evil consequences it produced on the respiratory organs, — such as dry cough, or cough accompanied by bloody sputa. Degeneration of the Ovaries. — Rochling observed a marked effect from the use of iodine in induration of the ovary. Jahn cured, by an ointment of iodine and mercury, an enormous dege- neration of the ovaries, which gave rise to two tumours, each of the size of the head ; and Messrs. Thetfotd, 4 Klaproth, 5 Jewel, 6 and Ashwell 7 were equally successful. Baron employed the iodine beneficially in a case of dropsy of the ovarium. Of hypertrophy of the mammce, Delfiz 8 details a case which resulted favourably; and in hypertrophy of the thymus gland — the asthma thymicum of Kopp — iodine baths have recently been advised by Dr. Fingerhuth. In hypertrophy of the ventricles of the heart, Magendie long ago recommended it. In scirrhus of the uterus, mammce, &c, it has been advised by Heun, Klaproth, Hennemann, Von dem Busch, 9 Ullmann, 1 Cogswell, Op. cit. p. 80. 2 Saggio Clinico sull' Iodic 3 Hecker's Litter. Annal. i. 275; and Cogswell on Iodine, p. 77. 4 Transactions of the Dublin College of Physicians, v. 510. Dublin, 1828. 5 Revue Medicale, Mars, 1824. 6 Op. cit. 7 Guy's Hospital Reports, vol. i. 8 Froreip's Notizen, B. xiii. No. 5, S. 73. 9 Hufeland's Journal, B. lx. St. 2, S. 81. ioDijsruM. 251 Hill, Benaben, Magendie, Bermont, Hammer, Elwert ; and, from the recorded observations, it would seem that great efficacy ought to be ascribed to it, both when internally and externally administered, Jahn extols it much in incipient scirrhus of the stomach, when combined with the application of leeches, and Riecke 1 asserts, that his father found an ointment of iodine ex- traordinarily useful in a case of induration of the pancreas; and, also, in a case of scirrhus of the pylorus. In induration of the female mammas, not of a malignant nature, he likewise found it frequently of essential assistance. Magendie extols it in cancer of the tongue ; and Benaben and Triistedt employed it successfully in stricture of the urethra, supervening on badly managed gonor- rhoea. In several cases of chronic disease of the liver, attended with jaundice, Dr. Abercrombie 2 found an ointment composed of 3ss of iodine, and an ounce of lard, of great benefit; and Dr. Milligan prescribed it, in the form of tincture, with good effect in three cases of hypertrophy of the spleen. 3 Leucorrhcea. — A Parisian physician made the observation, that during the employment of iodine in goitre, obstinate and protracted leucorrhcea disappeared ; this induced him to try the remedy in the latter disease, and he found it very efficacious. Goeden and Broglio, likewise, observed it useful in malignant fluor albus; and Benaben, Richond, 4 De Salle, Caswall, 5 and Broglio, in gonorrhoea. The last two individuals gave it especially in those cases, in which, without any marked inflammation, a deeply rooted gonorrhoea ex- isted, with ulcers in the urethra and prepuce, not apparently of a syphilitic character. In chronic fluor albus, it was used by Muller 6 with marked success. A young female had long suffered under this affection, which had reduced her strength, and did not yield to any of the means that had been employed, when the ointment of hydriodate of potassa was rubbed — morning and evening — on the inner surface of the thighs. After this plan had been continued for four weeks, the disease entirely ceased. MM. Gimelle and Jewell are also advocates for it. In discharges from the nose, iodine, in the form of hydriodate of potassa, has been used with advantage by Dr. EUiotson 8 and by Mr. George Fayrer 9 — given internally, as well as employed in the form of injection, Oj ad aquas §iv.) 1 Op. cit. S. 292. 2 On the Stomach, Edinb. 1828; and Amer. edit. Philada. 3 Cogswell, Op. cit. p. 83. * Archives Generates de Medecine, vol. iv. 6 Lund. Med. Gazette for 1834. 6 Wochenscrift fur die gesammte Hoilkunde, No. 40, S. 633. Oct. 1836. 7 Revue Medicate, vii. 249; and Practical Observations on Leucorrhcea, &c. by Geo. Jewell, p. 80. Lond. 1830. 8 Lancet, Feb. JO, 1838, p. 725. 9 Ibid. Feb. 24, p. 786. 252 dunglison's new remedies. In secondary syphilis, iodine has been recommended by Tyrrel, Saville, De Salle, Schlesier, 1 and numerous others; — especially when the disease is complicated with scrofula, and the effects of mercurials. Wallace 2 has likewise communicated some for- tunate results from the administration of the hydriodate of po- tassa in secondary syphilis, and Ebers 3 has confirmed his obser- vations. More recently, Mr. Bullock 4 has reported the particu- lars of eleven cases of secondary syphilitic diseases, of a formi- dable character, relieved by the hydriodate of potassa, given internally, in doses of eight grains three times a day, in camphor mixture. The symptoms were : — destruction of the uvula and soft palate, or nodes, with nocturnal pains in the tibia, ulna, frontal and malar bones, and affection of the bones of the nose, or rupia and other tubercular eruptions. The period of cure was from one to two months. Mr. Mayo 5 has described it as efficacious in cer- tain disorders, which are the consequence of syphilis, as emacia- tion, with ulcers of the skin; ulcerated throat, affections of the bones, &c, occurring in those to whom mercury had been given. An iodine suppository appeared to Mr. Keate 6 to be beneficial in enlarged prostate. In different forms of rheumatism, iodine has been given with success by Dr. Clendenning, 7 in the Mary-le-bone Hospital, and a series of cases in which it was employed has been published by him. Sir B. Brodie 8 twice relieved rheumatism by the tincture, although, in one of the cases, only temporarily. Cases of acute rheumatism, treated successfully by the iodide of potassium, used internally and externally, have been published by Dr. Mackay 9 and Mr. Wardleworth. 10 In gout, too, it has been prescribed. Jahn found it extremely effective in dispersing gouty tophi. Valentin found, that when iodine was given in a case of goitre, complicated with gout, the tumefaction of the joints and the depositions gradually disappeared. Adopting the hint, he gave it in several cases of gout, with the effect of always mitigating the disease, and, at times, of completely curing it. Gendrin used the iodine not only in chronic gouty swellings with success, but also in acute cases. Ebers likewise confirms the efficacy of iodine in gout. In co.valgia, Buchanan recommends the tincture of iodine to be applied by means of a small brush, as well as in a case of false 1 Casper's Wochenschrift. Feb. 4, 1837, S. 78. 2 Treatise on the Venereal Disease. Lond. 1833. 3 Medicinische Zeitung, Oct. 5, 1S36, S. 201 and 207. 4 Edinb. Med. and Surg. Journal, Jan. 2, 1837. See, also, Cogswell on Iodine, p. 80 ; and Laycock, Lond. Med. Gazette, Mar. 2, 1S39, p. S21. 5 Lond. Med. Gaz. xi. 249. 6 Lancet, for 1832-3, p. 672. 7 Lond. Med. Gazette, May, 1835. 8 Lancet, for 1832-3. 9 Ibid. Mar. 2, 1839, p. 830. 10 Ibid. Mar. 30, 1839. IODINUM. 253 joint, of which he has detailed a successful instance. A similar case has also been given by Treusen. In adiposis, Von Grafe 1 prescribed it, and not without advan- tage. The case was accompanied by great voracity and sense of suffocation. Bleeding and cathartics were premised. In stomacace, or a scorbutic state of the gums, the use of iodine has been recommended by Friedrich ; as well as in mercurial sali- vation, by Kluge, Knod, 2 Klose, 3 Graves, 4 and others ; yet its efficacy appears to be somewhat doubtful in the last affection. Heyfelder found it of no value in three cases. In cases of hydrocele, Velpeau 5 prefers a solution of iodine to wine as an injection. He employs the tincture in the proportion of from one to two drams to an ounce of water. He treated suc- cessfully twenty cases by this method. Mr. J. R. Martin, 6 of India, appears, however, to have anticipated him in this application of the remedy. Up to the time of the presentation of his paper to the Medical and Physical Society of Calcutta, (January, 1835,) he had used it successfully in upwards of ninety cases. More recently, he has communicated to the Medical and Physical Society of Cal- cutta the results of his subsequent experience. The number treated since March, 1832, at the Native Hospital, was seven hundred and seventy-seven : of these, seven hundred and sixty-six had a solu- tion of tincture of iodine injected. In order to ascertain whether it was by mere stimulation that the cure by the tincture of iodine was obtained, Mr. Martin treated ten cases with a common urethra syringeful of undiluted Port wine, and one with diluted tinctura lyttae, in the same proportion as that of iodine, 3ij to water §vj. Of this, two drams were inject- ed and retained ; the pain during twenty-four hours was excessive, and the inflammation, although not proportionate to the pain, was much longer in subsiding than when the tincture of iodine solution was used : this was also remarkably apparent in the cases treated with the undiluted Port wine. Of the seven hundred and sixty-six cases treated, it does not appear that more than four failed. 7 For hydroceles containing from six to thirty ounces of fluid, two drams of the solution of tincture of iodine are sufficient; for those 1 Walther und Grafe's Journal fur Chirurgie. B. ix. St. 3. S. 367. 1 Gazette des H6pitaux, July 18, 1837. 8 Medicinische Zeituog, No. 34, 1836. See, also, Amer. Journal Med. Sciences, Feb. 1834, p. 533. 4 Dublin Journal Med. Science, Jan. 1834. 1 Archives Generales de Medecine, Jan. 1837; La presse Medicale, Mai, 1837. See, also, Amer. Med. Intelligencer, July 15, 1837, p. 138; and Oct. 16, p. 263. 8 Amer. Journal of the Medical Sciences, Nov. 1837, p. 238. T Quarterly Journal of the Calcutta Med. and Physical Society, for Jan. 1837; cited in Amer. Journal of the Med. Sciences, for Feb. 1839, p. 485. 254 dunglison's new remedies. containing from thirty to sixty ounces, three drams ; and for those of a larger size, four to five drams. When the hydrocele contains less than three ounces, 3j of the injection is sufficient. 1 The cure is effected much sooner by the iodine ; and if any in- filtration takes place, it is readily absorbed. Highly favourable results have also been obtained by MM. Oppenheim 2 and Fricke, 3 and the method has been largely em- ployed in this country, and with equal advantage. Two successful cases are likewise reported by Dr. Stewart. 4 It is said by Coindet and Formey to have been efficacious in cases of impotence ; and, lastly, Mr. Key 5 regards it as one of the most efficacious remedies we possess in checking or controlling the ulcerative process — the most active phagedenic ulcers often yield- ing in a surprising manner to its influence, and assuming a healthy, granulating appearance. With regard to the relative value of the preparations of iodine, Dr. A. Buchanan 6 is inclined to place them in the following order : — Iodide of starch, hydriodic acid, (iodine,) and iodide of potassium; although he admits, that the superiority he ascribes to the first is, perhaps, owing to his having prescribed it most frequently. The action of all of these is, however, similar. The only mode, he thinks, of explaining the similarity of action on the body of sub- stances so dissimilar in nature, is by considering the hydriodic acid as the active principle; free iodine being immediately converted in the stomach into hydriodic acid. In the Glasgow Infirmary, they are in the habit of preparing a liquid hydriodic acid ; by dissolving three hundred and thirty grains of the iodide of potassium in giss of distilled water; and two hundred and sixty-four grains of tartaric acid in a like quan- tity: the solutions are then mixed, and when the bitartrate of po- tassa has subsided, the fluid is filtered. Water enough is then added to make §yj and 3ij. Each dram of this liquid acid contains five grains of iodine. The acid, thus prepared, is, however, very liable to change, and necessarily variable in its effects. 7 Lastly; from his researches on the effects of the various prepa- rations of iodine, Dr. Cogswell 8 infers, 1. That iodine and hydrio- date of potassa act very much in the same way, but that there is still a difference, not merely in point of power, but of specific pro- perties. 2. That, whatever be the proper action of the iodide of sulphur, its facility of decomposition gives it a resemblance to 1 Dujat, in Gazette Medicale de Paris, Sept. 1838. 2 Zeitschrift fur die gesammte Medicin. August, 1838, S. 389. 3 Ibid. S. 405. * India Journal of Medicine, May, 1836. 6 Medico-Chirurgical Transactions, xix. « Med. Gazette, July 2, 1836. * Guibourt, in Revue Medicale, Aout, 1837 ; and Bulletin General de Therapcutique, Sept. 1837. 8 Essay on Iodine, p. 167. Edinb. 1837. IODINIJM. 255 iodine. 3. That the iodides of carbon, so far as examined, have an action peculiar to themselves : and, 4. That, in those metallic iodides which were submitted to examination, the preponderance of power is on the side of the bases. METHOD OF ADMINISTERING. The iodine is not easily given internally in substance — in the form of pill or powder ; neither are these forms to be recommended, Coindet preferred it in the form of tincture; and this is one of the most common modes in which it is administered. When, however, the tincture is taken with water, a great part of the iodine is thrown down, and, it has been conceived, may thus exert a noxious influ- ence on the stomach ; but in the small doses in which it is taken, such an effect can scarcely be anticipated. It would seem, how- ever, that, in the generality of cases, when iodine has disagreed, it has been in the form of tincture. For this reason, of late years, iodine has been given more in watery solution ; and, to promote the solution, the iodide of potassium, (q. v.) is added ; or a little salt, according to Lugol's prescription. An ethereal solution is also pre- scribed. Externally, it is applied in the form of tincture, ointment, or watery solution, or in baths, or fumigations. Frictions with iodine readily occasion a considerable irritation of the skin, which commonly soon passes away, when the friction is suspended for a time. After bathing a part, painful rubefaction of the skin often ensues, which is usually followed by perspiration and sleep. The iodine is given internally, in the dose of one-eighth of a grain to a grain, twice or thrice a day. The following are some of the forms in which the pure iodine is administered internally and externally. Tinctura Iodini. Tincture of Iodine. (Synonyme. — Tinctura seu Alcohol Iodii.) 5<. Iodini, gr. xlviij. Solve in alcohol 35° (s. g. .842) sj. To be given in some mucilaginous or saccharine fluid, or in wine and water. Coindet and Magendie. Mr. Durand, an able pharmacies of Philadelphia, finds, that forty grains of the iodine and 3x of rectified spirit form a saturated solu- tion. Based on this fact, the following formula has been given, which does not seem, however, to possess any advantages over the simple tincture. g<. Iodin. optim. »}ij. Spirit, vini rect. ^j. Spirit, lavand. comp. gij. Dose. — Ten to twenty drops twice a day, gradually increasing it to forty. 1 1 Ellis's Medical Formulary, 5th edit. p. 91. Philad. 1838. DUNGLISON S NEW REMEDIES, Tinctura ^Etherea Iodini. Ethereal Tincture of Iodine. Synonymes. — Tinctura Iodii iEtherea. {French. — Ether iodure.) 5<. JEther. sulphuric, ^i. Iodini, gr. vj. M. Dose. — Eight or ten drops, two or three times a day. Magendie. Decoctum Cinchonce cum Tinctura Iodini. Decoction of Cinchona with Tincture of Iodine. r<. Decoct, cinchon. %x. Tine, iodin. gtt. xc. M. Dose. — Two spoonfuls, three times a day. In scrofulous ulcers. Rey. Mistura Iodini. Mixture of Iodine. Solve et adde &. Iodin. gr. v. Alcohol. £ij. Aq. cinnam. giiss. Syrup, simpl. ^iss. M. To be taken in the twenty-four hours, in dram doses. Syrupus Iodini. Syrup of Iodine. £. Tinctur. iodin. gr. vj. Syrup, simpl. ^ij. M. Henry. Solutio Iodini. (Lugol's.) (French. — Boisson iodee.) Solution of Iodine. (1. For internal use.) A. B. C. *. Iodin. gr. $. gr. f. gr. j. Sodae muriat. gr. xij. gr. xij. gr. xij. Aquae distill. ffij. B5j. ftj. Solve. (2. For external use.) A. B. C. $<. Iodin. gr. ij. gr. iij. gr. iv. Aq. distill. ftj. Kj. ftj. Solve. Lugol gives formulae for the solution of the three different strengths above. IODINUM. 257 Unguentum Iodini. Unguentum Iodatum, Ointment of Iodine. French.— Pornmade d'lode. German. — Iodsalbe. $t. Iodin. gr. iij. Adipis, gij. M. Linimentum Iodini. Liniment of Iodine. 9<. Linim. sapon. comp. §j. Tinct. iodin. &. M. Manson. Cataplasma Iodini. Cataplasm of Iodine. 3<. Tinct. iodin. ^ss. Pulv. sem. lin. gj. Farin. avenae, §iij. Aquae destillat. q. s. ut fiat cataplasma. Used as a cataplasm in scrofulous tumours and goitre. The Iodide of Starch, Iodidum seu Ioduretum Amyli, Amylum Iodatum ; French, Iodine d'Amidon ; German, Iod- starkmehl, Iodstarke, Starkmehl- oder Satzmehliodiire, has been ex- tolled by Dr. Andrew Buchanan, 1 of Glasgow. It is prepared of iodine gr. xxiv. ; starch, in fine powder, §j. The iodine is first triturated with a little water, and the starch is gradually added, the trituration being continued till the compound assumes a uni- form blue colour. The iodide is then dried with a heat so gentle as not to drive off the iodine, and it must be afterwards kept in a well stopped bottle. Iodine, in the usual forms of exhibition, cannot in general be safely given in larger doses than four or six grains doily, whilst, in the above formula, Dr. Buchanan has given as much as seventy- two grains daily. Professor Forget, of Strasbourg, has published the case of a youth seventeen years of age, who took in 48 days, 139 ounces, or nearly nine pounds, of this iodide, containing 3336 grains, or nearly six ounces, of iodine, — being nearly sixteen grains a day. 2 An Iodide or Ioduret of Quinine, Iodidum Quinince, is formed by precipitating sulphate of quinine by means of hydriodate of potassa. It is a yellow precipitate, soluble in alcohol, and crys- 1 Lond. Med. Gazette, July 2, 1836; see, also, Soubeiran, in Revue Medi- cale, Aout, 1837. 2 Gazette des H6pitaux, Fev. 19, 1S39, and Lond. Med. Gaz. April 20, 1839, p. 127. JO— d dungl 17 25S dunglison's new remedies. tallises from this solution in quadrangular prisms. It has been employed for the cure of scrofulous tumours, in cases where iodine and tonics are indicated. 1 The Iodide on Ioduret of Sulphur, Iodidum seu Ioduretum Snlphuris — prepared by mixing 125 parts of iodine with 16 of sul- phur, and then gently heating the mixture over a slow fire or spirit lamp, until they fuse into one mass — has been strongly re- commended in tinea capitis; in the proportion of ten grains of the iodide to an ounce of lard. A writer, in an English periodical 2 affirms, that he was induced to make trial of it in some obstinate cases, and was much astonished at the remarkable power it pos- sessed over the disease. He rubbed it on the head night and morn- ing - , and increased the strength of the ointment according as the affected part was able to bear the stimulus, until the iodide bore the proportion of half a dram to the ounce of lard or spermaceti cerate. Fumigations of iodine and sulphur have been used advan- tageously in certain atonic ulcers, and chronic cutaneous diseases. 5 With this view, the sulphur and the iodine may be combined extem- poraneously — say half a dram of the iodine to an ounce of sulphur. The other preparations of iodine are contained in different parts of this volume. LACTUCARIUM. Synonymes. Lettuce Opium, Thridace. German. Lattich-Opiura. The ancient Greek and Roman physicians were well aware of the hypnotic property of the common garden lettuce {lactuca sativa), the milky juice of which contains the lactucarivm. It would appear, however, that Dr. J. R. Coxe, of Philadelphia, was the first to propose the use of the inspissated juice in medicine. 4 Dr. Duncan, Senr., of Edinburgh, subsequently paid particular attention to the subject, and recommended it as a remedy in phthisis, in place of opium. 5 The properties of the juice have also been investigated by M. Frangois, 6 a French physician. 1 Journal de Chimie Medicale, Mars, 1836. 2 Lond. Med. Gazette, for Sept. 9, 1837, p. 879. 3 London Lancet, vol. i. 1838; and Encvclographie des Sciences Medi- cales, Aout, 1838. 4 Wood and Bache's Dispensatory. 6 Observations on Consumption, 2d edit. Edinb. 1816. 6 Archiv. General, de Medecine, 1825. Journal Univer. xl. 254, and xli. 147. LACTUCARIUM. 259 METHOD OF PREPARING. There are three kinds of lactucarium. The first and best, but the most costly, is obtained from incisions made into the stalks, whence the juice exudes, which is subsequently dried in the air. This preparation has a bitter taste, soon becomes of a brown colour and solid, has a gummy fracture, but absorbs moisture from the air, becoming soft and clammy. The second variety is obtained by expression of the selected stalks, and subsequent desiccation of the obtained fluid, either in the air or by artificial warmth. This is said to be the variety most commonly met with in commerce ; J and the third variety is prepared in the same manner as any common extract, from all parts of the plant. This is the Thridace of some. The first is the strongest and most uniform, and therefore to be preferred. Chemical examination shows that the lactucarium contains neither morphine nor narcotine, as had been supposed. EFFECTS ON THE ECONOMY. To investigate these, Rothamel 2 instituted experiments with the Paris lactucarium. Half a grain to a grain produced no effect. From three to five grains occasioned a peculiar indescribable feeling of lightness over the whole body, without any narcotic symptoms or modification in the pulse : from six to eight grains increased this sensation, and caused dilatation of the pupils. The same doses, repeated at intervals of three or four hpurs, through the day, diminished the number of pulsations of the heart, and the sleep was disturbed. From ten to fifteen grains caused more in- disposition, nausea, oppression in the epigastrium, cold sweats, anxious respiration, cold sensation in the chest, great dulness, vertigo, considerable dilatation of the pupils, yawning and stretch- ing, slow pulse, disturbed sleep, general prostration ; the tongue to be coated with mucus ; disagreeable taste ; loss of appetite ; pains in the shoulders and bones, and uncertain gait; all which symptoms were speedily removed by a few drops of acetic ether or a glass of Rhenish wine. Coffee was much less efficacious. The lactucarium has been extolled by numerous physicians as equally effective with opium, whilst it is not — they assert — followed by the signs of narcosis and other inconveniences, so often induced by the latter. Accordingly it is frequently given where a pure sedative is needed — to allay cough, and where much nervous excitement is present. 9 1 Riecke, Die neuren Arzneimittel, S. 313. See also Meraf & De Lens, Diet, de Mat. Med. art. Lactuca Sativa. 4 Ferussac's Bulletin des Sciences MeJicales, xxii. 101. Paris, 1830. 260 dunglison's new remedies. mode of administering. The lactucarium is given internally, either in the solution or pill, in the .dose of from one third of a grain to three grains. Ex- ternally, it has been applied in the form of plaster or of ointment. Mistura Lactucarii. Mixture of Lactucarium. 5<. Lactucar. 9j. Mucilag. gum. aca^. q. s. ad subactionem. Perfecte unitis adfunde Aq. fontan. §vj. Syrup, rub. idaei, 3ss. M. Dose. — Two spoonfuls every two hours, in spasmodic cough, sleeplessness and hysteria. HlLDENBRAND. Solve Acid, boracic. ^ij. Lactucarii, 9j. Aq. destillat. fvj. Syrup, papav. ss. M. Dose. — A small spoonful — in cases of "spastic haemoptysis." ROTHAMEL. MAGNES. Synonvmes.— Magnet. French,— Aimant, Pierre d'Aimant. The natural magnet was employed of ol 1 both externally and internally, and in the most diversified forms and affections. 1 The artificial magnet has been used within the last century only, and always with a view to its magnetic action. It is generally on the diseased part, or around it, that the magnet is applied, and the application is made for a longer or shorter time according to circumstances — being at times drawn along the nerves of the affected part, at others applied in a more prolonged manner. It is on the nervous system — and chiefly through the influence of the imagination —that the magnet exerts its efficacy. Accor- dingly, the class of diseases in which it ha# been found most bene- ficial are those termed "nervous and spasmodic." 2 This is 1 Art. Aimant, in Diet. Univers. de Matiere Medicale par Merat & De Lens. 2 See the Author's General Therapeutics, p. 58. Philad. 1836. MAGNES. 261 strikingly shown by the published observations of MM. Andry and Thouret, 1 Commissioners of the Societe Royale de Medecine, ap- pointed to examine into this matter. In cases of spasms, palpitations, convulsions, epilepsy, tremors, cramps, neuralgia, rheumatism, &c. the only agent employed was the magnet, and it was wholly successful. These gentlemen, however, were disposed to infer that the magnet exerts an incontestable magnetic action on the nervous system, to which, in part at least, the curative agency must be ascribed, and their conclusions were thought to be corroborated by cases observed by Alibert, Cayol, Chomel, Recamier, &c. The celebrated Laennec, 2 who employed the magnet in the manner re- commended by Halle, that is, by establishing a magnetic current through the diseased parts by means of several magnetised plates, affirms, that he frequently found it moderate the pain in pulmonary neuralgia, diminish the oppression in nervous asthma, suspend spasmodic hiccough, and exhibit its utility in simple neuralgia of the heart, and in angina pectoris. In the last disease, the applica- tion of a small blister under the anterior plate appeared to render the effects of the magnet more marked. It is not many years since considerable interest was excited in London by the success, said to have been obtained in the treatment of neuralgia, toothach, and other affections of the nerves, by the application of the ordinary magnet or mineral magnet, as it was termed by Dr. Blundell who employed it. 3 It would appear, too, that owing to a considerable demand for loadstone, the conductors of the Bulletino delle Scienze Mediche, 4 of Bologna, were led to make inquiries concerning the uses to which it was put. From these it appeared, that the Ex-Bey of Algiers, whilst at Leghorn, in 1831, mentioned to a Catholic dig- nitary, Father Campagnoli, who was suffering under gout, that the application of the loadstone was an oriental remedy for the disease, and of certain efficacy. He immediately procured a piece of load- stone, as he had been subject to regular and frequent attacks of gout since 1S05, and its application removed the next paroxysm. Since this time, he has always had recourse to the same remedy, and has found, that the attacks come on less frequently and severely, and that they invariably yield, so that he has rejected all his former plans of treatment. On the first symptom he goes to bed, and places the loadstone in close contact with the pained part ; he pre- sently falls asleep, and awakes free from pain, and able to walk. The loadstone he uses weighs five pounds, and has smooth sides. 1 Mem de la Societe Royale de Medecine de Paris, pour 1776, p. 531, and Thouret, Art. Aimant, in Encycloped. Method. Partie Medicale, i. 421. Paris, 1786. 2 Traite de l'Auscultation Mediate, 2d edit. torn. ii. 8 See Lancet for 1833, and American Journal of the Medical Sciences, Nov. 1833, p. 247. < Marzo et Aprile, 1835; and British and Foreign Medical Review, July, 1836, p. 246. 262 dungltson's new remedies. He has recommended this plan to other gouty individuals, who have experienced similar relief. We have witnessed the application of the mineral magnet re- peatedly, in nervous diseases in persons of highly impressible habits ; but except in such, and apart from the effects of the imagi- nation, we have seen no beneficial results. MANNITUM. Synonymes. Saccharum Manna?, Mannita, Mannite. German. Mannit, Mannazucker, Mannastoff. This principle, which was first discovered by Proust, belongs to the varieties of sugar that are not susceptible of fermentation, and constitutes the chief ingredient of manna. Its presence is not con- fined, however, to that substance. It is met with in several other vegetable juices — cucumbers, melons, celery, beets, &c. Yet in these it is first found after fermentation, so that chemists have been disposed to regard it as a product of fermentation. 1 METHOD OF PREPARING. Mannite is commonly procured from manna. Manna in la- chrymis, as it is obtained in commerce, is treated with boiling alcohol, filtered, and suffered to crystallise ; by rest and refrigera- tion mannite is precipitated in small beautifully white needles. The manna in tears consists almost wholly of mannite. Common manna, on the other hand, contains but little thereof, and in its place has a yellow extractive matter to which cathartic proper- ties have been assigned ; the coarse manna consists almost wholly of the latter. To obtain the mannite, the manna in tears is conse- quently selected. Should the administration of mannite, as a remedial agent, become more common, it may be worth the trouble to enquire, whether it might not be advantageous to prepare it from the vege- table juices above mentioned. Mannite, prepared in the above manner, is of a white colour; soluble in five parts of cold water, and in almost every proporion in boiling water; it seems to be entirely insoluble in cold absolute alcohol ; is somewhat more so in boiling alcohol, and still more so in boiling alcohol which contains water. At from 221° to 230° Fahrenheit, it melts into a colourless, adhesive fluid, and crystal- lises on cooling. When more strongly heated, it burns, and is decomposed like sugar. From its alcoholic solutions it separates 1 Art. Mannite, in Merat & De Lens, Diet, de Mat. Med. MANNITUM. 263 on cooling, in white, silky, shining, needle-shaped crystals, collected in stelliform roundish masses. When mannite is dissolved in an equal weight of boiling water, and the fluid is evaporated by a strong fire and rapid ebullition, until a small portion placed on a cold glass plate rapidly becomes solid, it may be poured out into shapes. The taste of the sugar of manna is feeble, but agreeably sweet ; it is inodorous, or at least nearly so. According to Liebig, man- nite consists of 40.0228 of carbon, 7.6234 of hydrogen, and 52.3537 of oxygen. The granatine of the pomegranate root agrees so much with the mannite in its properties, that both may be regarded as the same substance. EFFECTS ON THE ECONOMY. According to Magendie, 1 mannite may be advantageously substi- tuted for manna; as it possesses the cathartic property without the nauseous flavour* The dose is two drams for children, and, at times, as much as half an ounce ; but, in the latter case, Magendie always found the catharsis too active: for this reason he considers the latter to be the best dose for the adult. He recommends, that a syrup should be prepared from it, and that this should be pre- scribed both as a cathartic for children at the breast, and as an addition to other articles in cases of pulmonary catarrh. M. Solon has likewise spoken favourably of the therapeutical advantages of the sugar of manna. He administered it in three cases of gastricism — in two of them combined with castor oil — in which it induced, in a few hours, critical evacuations; and in a case of peritonitis, occasioned by obstinate constipation, its use was followed by the best effects. In the last case, the inflammation completely disappeared, without any other agency, when the con- stipation yielded. It was found, likewise, of essential service in convalescence from bronchitis and pneumonia. Only in two cases of females — the one labouring under ascites — the other under phlegmasia dolens, did the mannite fail to have any aperient agency. This, it was presumed, was probably owing to both of the patients having been habituated to the use of powerful cathar- tics, and to there not being enough of the preparation to admit of the administration of the appropriate quantity. According to Solon, mannite may be given in the dose of one or two ounces dissolved in from two to four ounces of a hot aromatic water, the solution to be taken warm, otherwise it forms a stiff, adhesive mass; or it may be added to the ordinary cathartic potions. He assigns it the preference over manna and castor oil; first, because it has an agreeable saccharine taste, and secondly, because it is always equally good, whilst those substances are often deterio- rated, and on that account uncertain in their effects. It appeared 1 Formulaire, &c. dein. edit. 264 dunglison's new remedies. to him to be peculiarly adapted for cases in which it was desirable to evacuate the intestines with as little excitation as possible. Magendie in his recent lectures on the blood, classes mannite amongst the substances that promote the coagulation of that fluid. 1 MORPHINA. Synonymes. — Morphinum, Morphium, Morpheum, Morphia, Morphine, Pa- paverine. 2 German. — Morphin. The discovery of this principle is ascribed to Seguin, and Ser- tiirner. who were engaged in the chemical analysis of opium upwards of thirty years ago, and although the former may have first detected it, the latter deserves the credit of having improved our acquaintance with it, and of having attracted to it the attention of chemists and physicians. METHOD OF PREPARING. The following is M. Robiquel's method 3 : — he boils a very con- centrated solution of opium with a small quantity of magnesia — ten grains of the latter to a pound of opium — for a quarter of an hour. By this means, a tolerably copious, grayish precipitate is formed, which is collected on the filter, and washed with cold wa- ter. The well dried precipitate is then digested with weak alcohol for some time, at a temperature short of ebullition ; by which means a very small quantity of morphine, and a considerable quan- tity of colouring matter, are separated. The liquid is then filtered, and the residue washed with a little cold alcohol. It is then boiled for some time in pure alcohol, and filtered again whilst the liquid still boils. On cooling, the morphine is obtained, which, by repeated crystallisation, may be freed from the attached colouring matter. The process of Hottot is greatly followed in France. It is a modification of that used by Sertiirner, and similar to that adopted in the Pharmaconceia of the United States, and in the new London Pharmacopoeia. In this, opium is exhausted by tepid water, and the clear liquid is evaporated to a density of 2° of Beaume. Whilst the liquid is still tepid, a small quantity of ammonia is added, in order to render 1 Leijons sur le Sang, &c. &c. Translation in Lond. Lancet for Jan. 26, 1839, p. 636. * Jahn's HandwOrterbuoh der Ohemie, B. iii. S. 150. 3 Annales de Chimie et de Physiq. v. 276. MORPHINA. 265 it neutral or even slightly ammoniacal. In this manner, a brown, resinoid precipitate is thrown down, which contains only traces of morphine and narcotine. The liquor is filtered, and by the addi- tion of a fresh quantity of ammouia to it when cold, crystalline morphine is thrown down, which, when collected, dissolved in alcohol, and evaporated, is set aside to crystallise. 1 Dr. F. Bache regards the process of the U. S. Pharmacopoeia, as an improvement upon the last, and as being essentially the same with that of Dr. Edward Staples, which was published in the Journal of the Philadelphia College of Pharmacy. 2 Mr. Brande considers the process proposed by Robertson and Gregory to be the simplest and the best. 3 Chloride of calcium is added to a strong aqueous solution of opium to precipitate the acids by which the alkaloids are held in solution ; it is then filtered and evaporated to thy consistency of syrup, and set aside to crystallise, the crystals are strongly pressed to squeeze out the mother liquor, which contains narcotine and other impurities. The pressed crys- tals are then purified by solution, crystallisation, and the action of animal charcoal, till they are obtained colourless; they consist of the hydrochlorates of morphine and codeine ; they are dissolved in hot water, and ammonia is added, which throws down morphine, and which, being separated upon a filter, may be redissolved in boiling alcohol, and obtained in crystals. The liquor, from which the morphine has been precipitated, contains codeine, together with hydrochlorate of ammonia, and some morphine; it must be evapo- rated until it crystallises, and the crystallised mass must be dis- solved in a small quantity of water, and be decomposed by excess of a solution of caustic potassa ; codeine is thrown down, and, when redissolved in ether, may be obtained in crystals. See Codeine. Tilloy, Petit, and others, have obtained morphine on the large scale from the domestic opium. 4 Morphine is composed of oxygen, hydrogen, carbon, and azote. The crystals are completely white, translucent, almost transparent, and slightly opaline ; they are wholly inodorous. In the form of powder, morphine is of loose texture, and as fine as magnesia. It melts at a trifling degree of heat, and very much resembles, in this state, melted sulphur; but it crystallises again on cooling. It is sparingly soluble in water; and in cold water scarcely at all so. Boiling water, according to Choulant, dissolves one eighty-second part ; according to Jahn, only one four hundredth ; and according to Bally, 5 it is even less soluble than strychnine, which, he says, 1 Journal de Pharmacie, x. 479. 2 Vol. i. p. 15: see the excellent Dispensatory of the United States, by Drs. Wood & Bache, 4th edit. Phil. 1839. For Faure : s process, see Journal of the Philadelphia College of Pharmacy, ii. 71. Philad. 1831. 3 Dictionary of Materia Medica, p. 383. Lond. 1839. 4 Art. Morphine, in Merat & De Lens, Diet, de Mat. Med. ' Memoire de 1'Academie Royale de Medecine, i. 99. 366 dunglison's new remedies. requires 6000 parts of water for its solution. It is more readily soluble in alcohol, and still more so in ether, as well as in fixed and volatile oils; the solutions have a nauseous, bitter taste. It is alkaline in its nature. The crystals appear to be rectangular four- sided prisms. With all the acids it forms peculiar, readily soluble, and very bitter salts, of which the sulphate, acetate, and muriate are the most used. EFFECTS ON THE ECONOMY IN HEALTH. Generally — it has been affirmed — morphine acts on the nervous system like opium, but does not exert the same agency on the vas- cular system. Magendie 1 asserts, that it possesses all the advan- tages of opium without any of ifs disadvantages. Bally 2 took especial pains to investigate the effects of morphine on the organ- ism, and the results he communicated to the Academie Royale de Medecine, of Paris. The most, striking was its action on the brain, which, when sufficient doses were administered, appeared to cause death by sanguineous apoplexy, as Bally had an opportunity of observing in one case, on dissection. In this there were no traces of injection of the membranes of the brain, whilst under -the arach- noid much albuminous serum was effused, and there was an ex- travasation of blood into the left hemisphere of the brain. This result is especially to be apprehended in those persons who have experienced an apoplectic attack previously. Bally found, moreover — which does not accord with our experience — that the morphine was more soothing and soporific in small doses than in larger. It occasioned, in the latter case, cerebral confusion, vertigo, perversion of the senses, and a feeling of "electric agency, which com- menced in different parts of the trunk and also in the extremities; but no delirium supervened, and the intellectual faculties experi- enced no alteration. In consequence of these effects on the senso- rium, the energy of the motory apparatus suffered. By long administration, morphine, like opium, excited troublesome tremors. The pupils Bally found contracted under its use, when larger doses were given, which is entirely opposed to the ordinary effect of narcotic agents. Not unfrequently when morphine was con- tinued, the soothing and soporific effect was preceded, for some days, by restlessness, and loss of sleep. Very often it excited headach. On the vascular system it did not act as an excitant — neither rendering the pulse quicker, more frequent, nor tenser. The opposite effect seemed, indeed, to be induced by it. It has no action, Bally affirms, as an emmenagogue ; produces no diapho- resis — which does not, by the way, at all accord with our obser- vation — does not even augment the animal heat, or redden the 1 Formulaire pour la Preparation, &c. de plusieurs nouveaux Medicamens. 2 Revue Medicale, Fevriei, 1824, and Mem. de la Societe Royale de Medecine, i. 142. M0RPHINA. 267 face, but frequently causes itching either over the whole sur- face of the body, or topically; in the latter case, the sensation being chiefly felt in the face, neck', loins or genitals. At times, the itching is associated with an eruption of conical weals or bumps, which are either red or of the ordinary colour of the skin, and can generally be detected more readily by the touch than the sight. On the organs of respiration the morphine exerts no influence; and as to its effects on the digestive organs, it may be remarked, that it has no agency on the mouth, pharynx, or cesophagus, except that ptyalism has been observed to result from it. The tongue is not made red or dry, nor are the tonsils. It does not excite thirst ; but, at times, there is a sense of bitterness in the mouth, which is a fore- runner of its effects on the stomach. The appetite is not diminish- ed, except when the emetic properties of the morphine are developed in a high degree. Vomiting is not caused by large doses only, but in many individuals by small doses, and it may be very violent. Commonly, morphine causes constipation, on which, at times, diarrhoea supervenes. Yery frequently, also, colic is induced by it. Morphine possesses, according to Bally, vermifuge properties. In men he found it to excite frequently ischuria, but not in women. The urine, however, exhibited no change of character. 1 Our own views of its action — when no idiosyncrasy interferes with its ordinary operation — is that it exerts a decided sedative influence on the nervous and sanguiferous systems ; and this ac- cords with the experiments instituted on animals by Mr. Blake. 2 He found, when it was introduced into the veins of an animal, that it exhibited its effects upon the heart, by rendering its pulsations slower and diminishing the pressure of the arterial system. As in the case of opium, the system may, under excessive pain or long continued use, be so habituated to its action as to bear very large doses. Mr. Lin gen, 3 of Hereford, has published a case in which a female, under a painful affection, took scruple, and, according to her own report, half dram doses of the acetate; and Mr. Teevan, 4 of London, one of a gentleman, labouring under a disease of the spinal cord, attended with violent spasms of the muscles of the chest, abdomen, and inferior extremities, who took, on one occasion, twenty-five grains in the twenty-four hours. EFFECTS ON THE ECONOMY IN DISEASE. Morphine, it is thought, may often be administered advantage- ously, not only where opium is indicated, but where it disagrees. Riecke 5 remarks, that where diaphoresis is needed it cannot sup- plant opium, but in this we apprehend he is mistaken, at least in •Richter's Specielle Therapie, 2ie Auflage, S. 358. Berlin, 182S. 2 Edinb. Med. and Surg. Journ. April, 1839, p. 344. 3 Lond. Lancet, Jan. 26, 1839, p. 680. * Ibid, for Feb. 9, 1839, p. 738. 6 Die neuern Arzneirailtel, u. s. w. S. 327. 268 dunglison's new remedies. febrile and inflammatory diseases. In such cases we have observed a sedative dose of opium succeed in restoring the cutaneous transpira- tion more effectually than any other agent, by allaying the patho- logical condition on which the suppression of perspiration was dependent. With many persons and in many cases it possesses decided advantages over opium, but we have often found where opium disagreed, morphine and its preparations did so likewise. As a general rule, it may be said, morphine is proper, where opium, in sedative doses, is demanded ; hence it is had recourse to in febrile and inflammatory diseases, where there is much pain or sleeplessness — singly or combined, and in the various neurotic affections. On account of the very sparing solubility of morphine in water, it is but seldom prescribed ; although Bally — in opposition to many experimenters— asserts, that he has found it equally efficacious with its salts. As, however, this result is doubtless owing to the existence of acid in the stomach, and, consequently, is liable to un- certainty, it is advisable to give the salts of morphine the prefer- ence, which are administered in nearly the same doses as the pure morphine itself. METHOD OF ADMINISTERING. Pure morphine is only given internally in the form of powder or of pill, beginning with from one sixteenth to one fourth of a grain once or twice a day, and gradually increasing the dose to one grain and a half. If its use has been discontinued for some days, the dose, when resumed, must be again small, and be gradually increased. Hauslus MorphincB. [Potio Narcotica.) Draught of Morphine.. Bt. Morphin. gr. \ Aq. destillat. §j. Syrup, papav. jj. M. To be taken at bedtime. Enema Morphines. (Injectio Leniens.) Injection of Morphine. §f. 01. amygdal. dulc. Ol. lilior. aa. §ss. Morphinoe, gr. ij. To allay pain in the ear, the suffering in acute blennorrhag'a, and the tenesmus in hemorrhoids, &c. Brera. 1 1 Ricettario Clinico. Padova, 1825. MORPHINE ACETAS. MORPHINES ACETAS. 269 Synonymes. — Morphium Aceticum, Acetas Morphei, Acetate of Morphine. French. — Acetate de Morphine. German. — Essigsaures Morphin. METHOD OF PREPARING. The acetate of morphine is obtained by mixing morphine and acetic acid in an appropriate vessel, and gradually evaporating to dryness, at a temperature of about 90° Fahr. This mode of pre- paration is required, owing to the difficulty of obtaining the acetate crystallised, in consequence of its extreme deliquescence. Crys- tallised acetate of morphine may, however, be prepared by dis- solving morphine in alcohol, saturating with acetic acid, filtering the solution, and evaporating gradually in a vessel covered over with thin rag. The acetate crystallises in an arborescent manner on the sides of the vessel. The acetate of morphine is one of the substances, which, in the experiments of Magendie, 1 were found to promote the coagulation of the blood. METHOD OF ADMINISTERING. The dose of this article is from a quarter of a grain and less, to a grain or more. Its strength does not vary materially from that ol pure morphine. Liquor Morphince Acetatis. Solution of Acetate of Morphine. 5t. Acetat. morphin. gr. xvj. Aquae destillatae, ^vj. Acid, acetic, ^ij. M. This formula was proposed by the author 3 as a substitute for the " gouttes calmanles" of Magendie, 3 which permit the deposition of the morphine when kept for a short time. The dose is from six to twenty-four drops. £. Morphin. acetat. gr. xvj. Aquae disiillat. 3j. Acid, acetic, gtt. iij vel. iv. Alcohol. 3j. Fiat solutio. Magendie. 1 Lecons sur le Sang, &c, and translation, in London Lancet, Jan. 26, 183?). p. 636. 2 Formulary, &c, translated from Magendie, by C. T. Haden, Esq., 2d edit., by Robley Dunglison, M. D. p. 14. Lond. J824. Amer. edit. Philad. 1825. 3 Formulaire, &c. 270 dunglison's new remedies. Syrupus Morphince Acetatis. Syrup of Acetate of Morphine. 9*. Morphinae acetatis, gr. iv. Syrupi simplic. Bj. Dissolve the salt in half a dram of water, acidulated with a few drops of acetic acid ; filter, and add it to the syrup. This syrup is recommended and used in Paris, in place of the syrupus papaveris. It has the advantage of being always of uni- form strength. Magendie. The acetate of morphine has been much used endermically in the diseases mentioned under the head of Morphine. A quarter or half a grain or more is placed on some part of the skin, whence the cuticle has been removed ; and it may be repeated, as the case may require. In the severer neuralgic and neurotic cases, the quantity applied in this way is sometimes very large. In a case of hydrophobia reported by Dr. Burne, 1 of London, ten grains at a time were sprinkled on a blistered surface, with excellent tranquil- lising effects. At times, when applied to a blistered surface for several days in succession, a papular eruption has been observed, which quickly becomes vesicular, proceeding from the edges of the blister, and gradually spreading over the entire surface. 2 It has been likewise proposed to inoculate with morphine. If the point of a lancet, dipped in an aqueous solution of morphine, be inserted horizontally, about one line in depth beneath the epi- dermis, and be allowed to remain there a few seconds, the follow- ing effects, according to M. Lafargue, are observed: — About a minute and a half after the operation, a small pimpje, with a diffuse rosy areola, and slightly itching : in about twenty minutes, the pimple becomes about four lines in diameter, and one line in thick- ness, and is flattened : its colour is somewhat deeper than that of the skin ; it is hard ; the areola very red, and about an inch and a half in diameter; its heat is increased, but the sensation of itching remains about the same. During the first hour, the pimple and its areola are at their highest degree of development, after which they gradually disappear. The general effects, which M. Lafargue experienced from thir- teen punctures thus made on the anterior part of his forearm, were,— -heaviness of the head, frequent yawnings, clamminess of the mouth, and an invincible desire to sleep; yet the quantity of muriate of morphine employed could not have exceeded a quarter of a grain. He considers, that the inoculation of morphine may supersede the use of blisters and ammoniacal plasters, and that it deserves employment more particularly where the object of the physician is to produce the local effects of morphine. Its effects 1 Lond. Med. Gaz., April, 14, 1838. 2 Dr. A. T. Thomson, in Lond. Lancet, for Jan. 19, 1839, p. 622. MORPHINE ACETAS. 271 as a rubefacient are marked, and hence its probable utility in superficial neuralgia, and in chronic rheumatism. The experiments of Lafargue were repeated by M. Martin Solon, with nearly the same results. 1 The acetate may, also, be applied in the form of ointment ; and it is frequently added to glysters, in cases of chronic diarrhoea. Hildenbrand recommends the following ointment to be rubbed on the pubes in cancer of the uterus. Unguentum Morphince Acetatis. Ointment of Acetate of Morphine. * 5t. Morphina 1 acetat. gr. iv. Ung. bydrarg. ciner. simpl. aa. gij. A piece, the size of a pea, to be rubbed on the pubic region twice daily. Dr. Francis Gerard, of Avignon, has found the acetate so highly useful in Asiatic cholera, that he prefers it to all other remedies. Of ninety-nine patients treated thereby, eighty-one were cured. He found, when given early, that it especially checked the vomit- ing, and moderated the subsequent reaction, after which the other symptoms gradually ceased. When, however, the resources of art had been long postponed, the effects of the remedy were less marked ; the vomiting and the other symptoms persisted longer ; the supervening reaction was much more tardy, and frequently ended in a state of collapse, which, under the most trifling impru- dence, produced an unfortunate result. Gerard administered the acetate at first in the dose of one-fourth of a grain every half hour, until the serious symptoms were removed, and he omitted it as soon as the spasms and the diarrhoea and vomiting had ceased, or as soon as reaction ensued. A solution of acetate of morphine, which he terms liquor opii, has been proposed by Mr. Houlton. 2 He prepares it as follows: — Take two ounces and a half of the best Turkey opium ; thirty-two fluid ounces of Beaufoy's acid, the strength of pickling vinegar : macerate with a gentle heat for six days, frequently shaking the vessel ; then filter, and evaporate the fluid to the consistence of the extracts of the pharmacopoeia, finishing the evaporation by the spontaneous method. This Mr. Houlton employs under the name extract um opii aceticum. To the above extract he adds alcohol five fluid ounces; distilled water thirty-five fluid ounces; mace- rating for eight days, and filtering. This liquor opii is about the strength of the tinctura opii in sedative property, and Mr. Houlton affirms, from his observations, 1 Bulletin de l'Academie Rovale de Medecine, Nos. 1 and 7. 1836-7. 1 Lond. Med. Gazette, Aug. 12, 1837. 272 DUNGLISON'S NEW REMEDIES. that it is in no respect inferior to Battley's liquor opii sedativus, — a secret preparation, which has been much used. MORPHINE SULPHAS. Synonymes. — Morphium SulphUricum. French. — Sulfate de Morphine. German. — Schwefelsaures Morphin. METHOD OF PREPARING. Morphine is dissolved in dilute sulphuric acid. The solution is then evaporated by heat, and suffered to crystallise, which it does in silken tufts. EFFECTS ON THE ECONOMY. The general effects on the economy in health and disease re- semble those of the acetate of morphine, to which it is perhaps to be preferred on account of its greater uniformity. There is an advantage, however, in retaining both preparations in the materia medica, as when the system becomes accustomed to the one, the other may be substituted, ■ In his experiments on the blood Magendie 1 found that the sulphate of morphine — unlike the acetate and the muriate — opposed the coagulation of that fluid. A syrupus morphines, sulphatis, a liquor morphines svlphatis, and an uneruentum morphines sulphatis may be formed in the same manner as with the acetate of morphine. The common form for the solution of sulphate of morphine is the following : — 2 Liquor Morphines Sulphatis. Solution of Sulphate of Morphine. &. Morphin. sulph. gr. ij. Aquae distillat. 3 i j - Fiat solutio. Dose. — A tea-spoonful (which is considered to be equivalent to about twelve or fourteen drops of laudanum,) to be repeated as occasion may require. 1 Lemons sur le Sang, &c. ; and translation in London Lancet, January 26. 1839. 2 The Medical Formulary, &c. By B. Ellis, M. D. p. 132. Philadelphia, 1838. MORPHINE SULPHAS. 273 The muriate* and the citrate of morphine axe likewise occasion- ally used; but they possess no advantage over the preparations described above. The former is officinal in the last London Pharmacopoeia. Many years ago, Dr. Porter, of Bristol, recommended a liquor morphince citratis to be prepared in the following manner: — Beat four ounces of the best crude opium in a mortar, with two ounces of crystallised citric acid ; mix well with a pint of boiling water; filter after twenty-four hours' maceration. Dr. Paris speaks well of this preparation. 2 Magendie recommends the substitution of the following process : 5<. Morphin. pur. gr. xvi. Acid, citric, crystalliz. gr. viij. Aquae destillat. §j. Tinct. coccinel. q. s. Fiat solutio. Dose. — Six to twenty-four drops in the twenty-four hours. A tartrate of morphine was suggested by Mr. Haden 3 as a sub- stitute for the liquor opii sedativus, of Battley. Mr. Haden made it by macerating the dregs remaining after making the tincture of opium in a solution of tartaric acid. Forty drops acted in all respects like twenty of the liquor opii sedativus. It neither stimu- lated nor induced costiveness. Of late the bimeconate of morphine has been brought before the notice of the profession by Mr. Squire, 4 but he has not given the formula for its preparation. Impressed with the idea that the combination of the active principle of opium, as prepared by nature, would prove more beneficial as a therapeutical agent than the artificial salts, he instituted a number of experiments, with the view of procuring the bimeconate as free from the other ingredients of opium as possible; and he asserts that at length he obtained a tolerably pure salt, which, from the trials that have been made with it, has fully answered his expectations as to its superior medi- cinal power over the other preparations of opium. The salt is given in solution, made nearly of the same strength as laudanum. Dr. Macleod, who made trial of it, asserts, that it appeared to him to be a very mild and efficient preparation, rarely producing headuch or other discomfort ; and that it repeatedly answered, in the most satisfactory manner, where opium had 'disagreed, and succeeded in some cases where the other salts of morphine — the acetate and hydrochlorate — had failed to give relief. ' For Dr. Wrn. Gregory's mode of preparing the muriate, see Edinb. Med. and Surg. Journ. for April, 1331; Amer. Journ. for Aug. 1831, p. 531; and Philad. Journal of Pharmacy, iii. 124. See, also, Mi. M. Robertson, in Edinb. Med. and Sur?. Journ. April, 1832. 2 Pharmacolosia, 4th Amer. 7th Lond. edit. By Dr. J. B. Beck, p. 439. New York, 1831. 5 Translation of Magendie's Formulary, 2d edit. By Robley Dunglison, M. D. &c. p. 19. Lond. 1824. * Lond. Med. Gaz. Mar. 9, 1839. 10— e duvgl 18 274 dunglison's new remedies. Equally strong testimony in its favour is afforded by Dr. A. T. Thomson, who details three cases — one of neuralgic pain of tho left side of the face; another of wakefulness, without any apparent cause, and a third of anomalous pain of the hip and thigh, all benefited strikingly by its use. NARCOTINA. Synonymes. — Narcotinum, Narcotine, Opiane, Matter or Salt of Derosne. French. — Matiere ou Sel de Derosne, Sel Essentiel d'Opium. German. — Narkotin, Opiao, Derosne's Opiumsalz. On this substance, which is one of the immediate principles of opium, and which has attracted the attention of many chemists and therapeutist^, much uncertainty exists with regard to its precise properties. It seems, that it has not hitherto been found except in opium. METHOD OF PREPARING. It is commonly obtained, either from the aqueous extract of opium, by means of ether, which only dissolves the narcotine, and consequently requires but to be evaporated to obtain it ; or from crude opium, which has been exhausted by cold water ; it may hence be obtained from the residue after the preparation of the aqueous extract of opium of the shops. With this view, the opium is twice treated with boiling acetic acid at 2° or 3° ; it is precipitated by ammonia, and the washed precipitate is purified by treating it with hot alcohol at 40° and a little animal charcoal; the liquid is then filtered, and the pure nar- cotine is precipitated on cooling. It crystallises in very white needles ; is devoid of taste and smell; fusible in the manner of resins, and very slightly soluble in water ; soluble, with the aid of heat in alcohol, and in the volatile and the fixed oils ; very soluble in ether, which distinguishes it from morphine ; very soluble also in cold acetic acid, whence it is precipi- tated on heating the solution — another mode of separating it from morphine. It is coloured of a vivid red by nitric acid ; and is ana- logous, in some respects, to the crystallisable resins or sub-resins of M. Bonastre. 1 EFFECTS ON THE ECONOMY IN HEALTH. These have been so contradictory, that it has been conceived, 1 Merat & De Lens, Diet, de Mat. Med. Art. Narcotine. NARCOTINA. 275 the same preparations cannot have been used by different ob- servers. 1 According to Magendie, 2 morphine is the anodyne principle of opium, and morphine the exciting. When a grain of narcotine, dissolved in oil was given to a dog, it produced a state of stupor, which superficial observers might readily confound with sleep; but it differed evidently from sleep ; the animal's eyes were open ; the respiration was not deep as in sleep, and it was impossible to arouse it from its sluggish condition. Death generally took place in twenty-four hours. When combined with acetic aid, it produced quite different effects. Animals could bear a dose of even twenty- four grains without dying, and whilst under its influence, they were agitated by convulsions like those which camphor induces — exhibiting the same signs of fright, the same backward motions, foaming at the mouth, convulsions of the jaws, &c. When mor- phine and narcotine were both given at the same time, the different effects of each occurred together. A grain of morphine, for exam- ple, and a strain of narcotine dissolved in acetic acid, were placed in the pleura of a dog. The animal soon became drowsy and fell asleep under the influence of the morphine, but a singular and re- markable strife appeared to go on for an hour and a half, between the stimulating effects of the narcotine and the anodyne effects of the morphine. At length, however, the animal slept soundly, being probably, Magendie suggests, under the influence of the morphine alone. His opinion is, that narcotine is injurious when not united with an acid, and very exciting when so united. M. Orfila — the celebrated toxicologist — it appears, has enter- tained various views upon the action of narcotine ; at one time considering it inert, at another to possess the same action as mor- phine; and, at another, to concur, when combined with morphine, in the properties of opium, but to a slight degree — since opium, deprived of narcotine, is not less deleterious — and to possess another modus operandi than opium, without, however, our being able to regard it as the exciting principle. 3 Owing to all these uncertainties connected with it, narcotine is little if at all employed in medicine. It would seem, however, that the exciting properties of opium do not appertain exclusively to it ; for, as has been elsewhere remarked, there are many persons, who are as disagreeably affected by morphine alone as they are by opium which contains both morphine and narcotine. 1 Ibid, and Diet, des Sciences Medicales, xxxiv. 298. 9 Formulaire pour la Pr6paration, &c. de plusieurs nouveaux Medica- mens. 3 Merat & De Lens, Op. cit., and Orfila, Toxicologic Generale, ii. 69. 276 dunglison's new rem i dies. NUX VOMICA. Synonymes — Vomic Nut, Poison Nut, Bachelor's Buttons. French. — Noix Vomique. German. — Krahenaugen. EXTRACTUM NUCIS VOMICAE SPIR1TU0SUM. Synonymes.— Extractum Nucis Vomicae Resinosum, E. Nucis Vomicae Alcoliolicum, Spirituous, Resinous or Alcoholic Extract of Nux Vomica. French.— Extrait Alcoolique de Noix Vomique. German. — Geistiges Extrakt der Krahenaugen. In the year 1809, Mage n die discovered that one entire class of vegetables — the bitter strychnos — has the power of exciting the spinal marrow, without implicating, except indirectly, the func- tions of the brain. 1 Since then, many have confirmed the observa- tions of Magendie, and have attended especially to its agency in various diseases. The preparation of the strychnos most used — if we except the active principle — has been the alcoholic extract of the nux vomica. METHOD OF PREPARING. Take any quantity of rasped nux vomica ; exhaust it by repeated macerations in alcohol of 40° (.817), and evaporate it slowly to the consistence of an extract. Alcohol of less strength may be used, but, according to Magendie, the product will be proportionally less active. A dried alcoholic extract is made by dissolving in water the alcoholic extract made by means of alcohol at 36° (.837); filtering and evaporating in appropriate dishes, as in making the dry extract of bark. EFFECTS ON THE ECONOMY. According to Magendie, a grain of this extract, absorbed from any part of the body, or mixed with food ? promptly destroys a dog of considerable size, by inducing paroxysms of tetanus, which, by their continuance, arrest the respiration sufficiently long to induce complete asphyxia. When the dose is much stronger, the animal appears to die entirely from the action of the nux vomica on the nervous system. 2 If an animal be touched whilst under the action of the substance, it experiences a commotion similar to that of a strong electric shock, and this takes place each time the contact is renewed. On dissection no morbid appearances exist which can account for death. 1 Examen de Paction de quelques vegetaux sur la moelle epiniere. Paris 1809; and Formulaire, &c. 2 Segalas. in Journal de Physiologie, par Magendie, Oct. 1822. NUX VOMICA. 277 When introduced into the frog's stomach, Dr. Lombard, 1 of Geneva, found that it produced tetanic convulsions, which, in a few hours, caused death. The contractions of the heart were sometimes strong 1 and complete, sometimes irregular, tumultuous, and intermitting; always diminished in frequency. Applied to the heart itself, it slightly stimulated it, rendering the pulsations more energetic and frequent, whence Dr. Lombard concludes that the nux vomica cannot be used with advantage in any diseases of the heart ; for, although it diminishes the frequency of the pulsa- tions, it renders them irregular. The action of the extract on healthy man is the same as that described by Magendie, and if the dose be sufficiently large, death speedily follows with the same symptoms. 2 In those that are affected with paralysis the effect is also the same, but what is singular, it is particularly manifested on the paralysed parts by tetanic convulsions, and a feeling of creeping, which indicate the operation of the remedy ; a local perspiration is also often observed to break out on some parts of the body. When administered in cases of hemiplegia the contrast between the two sides of the body is rendered striking; whilst the sound side remains at rest, the other may be violently agitated ; tetanic shocks may supervene and a copious perspiration break out. In a female, Magendie saw the affected side covered by a peculiar eruption, whilst the other side afforded no trace of it. There is a difference even between the two sides of the tongue, a decidedly bitter taste being occasionally per- ceived on the one, whilst the other exhibits nothing similar. If a much larger dose be given, both sides of the body partici- pate, but unequally, in the tetanic spasms, so that the patient is sometimes thrown out of bed by the violence of the contractions. When given in very small doses, it has not immediately any per- ceptible effects, and some days elapse before its advantageous or noxious properties can be appreciated. According to Magendie 3 the extract may be given in all diseases that are attended with debility, general or local, and in paralysis of all kinds, general or partial. He himself observed excellent effects from it in marked cases of debility of the genital organs, incontinence of urine, &c. He also used it in several cases of partial atrophy of the upper and lower extremities with advantage. As regards its administration in cases of paralysis succeeding to apoplexy, he remarks, that it should not be given until some time after the coup de sang" in the brain, which occasioned the palsy ; and that even then beneficial results can be expected only when no marked organic mischief exists ; indeed, in the latter case, he con- ' Gazette Medicalc de Paris, Oct. 10, 1835. 1 See the details of two cases of poisoning by nux vomica, in Lond. Med. Rep. xix, 418 and 456: Christison on Poisons, and Brande, Dictionary of Materia Medica, p. 375. Lond. 1839. 3 Formnlaire pour la Preparation, &c. de plusieurs nouveaux M6di- camens, &c. 278 dunglison's new remedies. siders the disease irremediable, and that bad effects might result from pushing the remedy. The efficacy of the alcoholic extract of mix vomica in various forms of paralysis has been confirmed by many observers. Eveti before Magendie had employed it, Fouquier 1 had given it in several cases of paralysis, with the most satisfactory results. Since then we have had the testimonies of Chauffart, 2 Gendron, 3 Perrussel, Recamier, Mauricet, Baxter, 4 Galli, Hauff, Wenneis, Burkard, Petrequin, s Gellie, 6 and numerous others in its favour. Our own experience with it in cases of hemiplegia has not been limited; yet although we have succeeded in inducing tetanic move- ments in the limb, we have not been satisfied that much advantage has been derived from it; 7 nor are the results of the experiments and observations of Jahn by any means in accordance with those of the practitioners just mentioned. He tried it in numerous cases of paralysis, but affirms, that he did not see any good effect from it, and with the exception of two cases, did not notice the slightest action, although the extract was carefully prepared according to the formula given by Magendie. Yet, he remarks, he was by no means sparing in the dose. In the two cases in which a change seemed to be induced, there was an evident increase of the paralysis. This discrepancy, as well as other evidences of the same contra- riety of experience, must doubtless have been owing to difference in the strength and quality of the preparation; and hence the value of the strychnine — its active principle — which is not liable to the same uncertainty. 8 In cases of partial paralysis, as' in colica pictonum, amaurosis, 9 palsy of the rectum, &c, both the alcoholic extract of the nux vomica and its active principle have been used and with good effect (see Strychnina.) Cazenave gave the extract successfully in a case of St. Vitus's dance, which had resisted every other remedy. Sir Charles Scudamore found it useful in neuralgia, especially in neuralgia faciei. Vogt gave it — not without advantage — in cardialgia ; Hil- denbrand in epilepsy; by the Russian and Polish physicians it was administered advantageously in choleric diarrhoea ; and by many it has been strongly advised in chronic diarrhoea and dysen- 1 Bulletin de la Faculte de Medecine, &c. vol. v. 1818. 2 Journ. Gener. de Med. Oct. 1824. s Journ. General. Nov. 1829. * New York Medical Repos. vol. viii. 6 Gazette Medicale de Paris, Nov. 3, 183?. 6 La Lancette Franchise, Aout 29, 1837. 7 See, also, Chauffari, in Op. cit. 8 Richter^s Specielle Therapie, a. s. w. B. x. S. 352. Berlin, 1828. 9 Petrequin & Miquel, in Bulletin General de Therapeutique, Juillet, 1838. NUX VOMICA. 279 tery 1 as well as i.n dyspepsia, in the varieties termed pyrosis and gastrodynia, especially when they appeared to proceed from morbid irritability of the nerves of the stomach. 2 MODE OF ADMINISTERING. The best form for exhibiting the alcoholic extract of the nux vomica, according to Magendie, is in pill, when we are desirous of inducing the tetanic convulsions. Each pill may contain a grain of the extract. One or two pills may be given at first, and the dose be daily augmented until the required effect be induced. It may then be discontinued to avoid accidents. It is better, he thinks, to give the pills in the evening, as night is the most favour- able time for observing the phenomena we are desirous of inducing. It is sometimes necessary to increase the dose to twenty or thirty grains, before the tetanic effects supervene, but commonly from four to six grains are sufficient. Esquirol saw two cases, in one of which death took place after eighteen grains; in the other, after five ; the stomach and bowels were found inflamed. Elliotson began with half a grain of a well prepared extract, and increased, the dose every day, or every other day, by a quarter of a grain ; but none of the patients bore a greater quantity than seven grains, and few more than four. If from any cause the administration of the remedy has been in- terrupted for some days, it is necessary to recommence with the small doses, and to increase them again gradually as before. When it is desirable to produce only the slow effects of the remedy, a grain or half a grain daily is sufficient. Magendie directs a tincture to be made from the extract — the Tinctura Nucis Vomica, T. Strycknos. T. Nucum Vomicari'm, which has been introduced into some of the pharmacopoeias. It is made by taking three grains of the dried alcoholic extract of the nux vomica, and dissolving it in an ounce of alcohol at 36° (.837). It is given by drops, and in mixtures, in those cases, in which the alcoholic extract itself is indicated. Tinctura Nucis Vomica, Composita. Compound Tincture of Nux Vomica. *. Extract, nuc. vomic. spir. gr. xxiv. Camph.orae, 5jj. Tinct. pyrethri. sj. M. Dose. — Twenty drops, four times a day, with arnica tea, in cases of paralysis. Vogt. 1 Most's Encyclop&die, 2te Auflage, Art. Dysenteria, i. 573. Leipz. 1836. Geddings' N. American Archives, No. 2, Nov. 1834. Dr. Roots, in St. Thomas's Hospital Reports, No. iii. for April, 1336 ; and Hufeland, in Bally, Bull. Gener. de Therap. Fevrier, 1838. 2 Mellor. in Med. Gaz. Mar. 4, 1837, p. 850. Dr. H. S. Melcombe, ibid. Mar. 25, 1837, p. 964; and Amer. Med. Intell. July 1, 1837, p. 124. Dr. M. Huss, in Zeitschrift fur die gesammte Medicin. May, 1837, 393, and Amer. Med. Intell. Aug. 1, p. 162. 280 dunglison's new remedies. *. Tinct. nucis vomicae, Tinct. cantharid. Napth. phosphorat. 1 ^ij. M. s Dose. — Thirty drops, three or four times a day, with arnica tea, in the paralysis of torpid subjects. Vogt. Mistura Nucis Vomica. Mixture of Nux Vomica. &. Extract, nuc. vomic. spirit, gr. ij — iv — vj. Aqua? melissae, gvj. Mucilag. gum. acac. £ss. M. Dose. — Two spoonfuls, every two hours, in epilepsy. HlLDENBRAND. A similar form is recommended by Richter 2 in dysentery. Two table-spoonfuls every two hours. Pilala Nucis Vomica. Pills of Nux Vomica. *. Ext. nuc. vomic. spirit. 9j. Ext. glycyrrhiz. Svij. Misce et riant pilulse lxxx. Dose. — Two to six, two or three times a day, in paralysis. Pulveres Nucis Vomica. Powders of Nux Vomica. £. Bismuth, nilrat. prsecip. Ext. nucis vomica? spirit, aa. gr. ss. Magnes. carbonat. gr. iij. Sacch. alb. gr. xv. 01. menth. pip. gtt. ij. Misce, et fiat pulvis. Dose. — One, every three hours, in cramp of the stomach. Vogt. 5*. Gum. arabic. Sacchar. aa. gr. xij. Pulver. nucis vomic. gr. iij. M. et fiat pulvis. Dose. — One of these powders, to be repeated according to cir- cumstances in the twenty-four hours, in diarrhoea and dysentery. HUFELAND. Embrocatio Nucis Vomica. Embrocation of Nux Vomica. B(. Tinct. nucis vomicae, £j. Liquor, ammon. caust. gij. M. To be rubbed on the paralysed limbs, and on the surface in cholera. See Strychnina and its preparations. 1 The Naphtha phosphorala, .ZEther sulphuricus phosphoratus, is made by dissolving twenty-eight grains of phosphorus in four ounces of rectified ether. * Die specielle Therapie, ii. 133. Berl. 1821. OLEUM CROTONIS. 281 OLEUM CROTONIS. Synonymes— Oleum Tiglii, Croton Oil. French. — Huile de Pignon d'lnde. German. — Krotonol. The seeds of the Croton Tiglium — a tree indigenous in the Molucca Isles, Ceylon, Java, &c. and which belongs to the class -Monoecia, order Monadelphia of i innaeus. and to the natural family Euphorbiacese — are characterised by their acrid drastic properties — which, indeed, belong to the whole family. These seeds were .carried by the Dutch to Europe, two centuries ago, and were ad- mitted into the old Pharmacopoeias, under the names Graria Tiglii, G. Tilli, G. Molluccae, &c. being prescribed as a drastic cathartic, but owing to their too violent operation, which frequently induced unpleasant results, they fell subsequently into entire disuse. The oil of croton was also introduced into Europe about the same period, and was occasionally used internally. It had, however, sunk into total neglect, when attention was recalled to it by Dr. Con well, a physician in the English East India Company's service at Madras, by whom its employment was reintroduced into Europe ; and, in a short time, it acquired so much repute as an active cathartic, that it was received into various Pharmacopoeias. 1 Croton oil is a thickish fluid, of a honey yellow colour, has a disagreeable smell, and a very acrid burning taste, so that it excites inflammation of the tongue and fauces. It is a fixed oil, having a very acrid matter associated with it, which appears to have acid qualities, and is probably identical with the iatrophic acid. 2 In absolute alcohol, it is almost wholly soluble ; in common alcohol, only partly so ; and in ether and turpentine wholly so. EFFECTS ON THE ECONOMY. Croton oil holds a distinguished place amongst cathartics, inas- much as it can be given in small doses; and, in cases of great torpor of the intestines, its action is very certain. Even a drop commonly produces eight or ten fluid evacuations ; but at times, in unusual torpor of the canal, as many as four or five drops, and even more, have been given in the course often or twelve hours. Like most of the drastic cathartics, it occasions tormina, but these are less distressing than the burning sensation it commonly excites in the pharynx, which is least felt when the oil is given in the form of pill or lozenge. Not unfrequently, also, it causes nausea, often ending in vomiting in delicate persons, or where the dose has been large, but without 1 Recherches sur les proprietes medicinales et l'emploi de l'huile du Cro- ton Tiglium, &c. Paris, 1824. 2 Riecke, Die neuero Arzneimitte), u. s. w. S. 343. 282 dunglison's new remedies. interfering materially with the cathartic effect. At times, it is formed into a soap with caustic soda — iSapo olei crotonis — which is given in doses of from one to three grains. This soap is- said to be less excitant and to occasion less pain than the pure oil, and it has the advantage, that the dose can be better apportioned. As with other cathartics, the incautious employment of the cro- ton oil may occasion inflammation of the intestinal canal, and therefore, it need scarcely be said, its use during inflammation of the canal is contra-indicated. It does not appear to affect any other secretory organs than those of the bowels, although some phy- sicians affirm that they have remarked an increase of the urine after its use. Like other active cathartics, it has been employed as an anthel- mintic, especially in cases of tape worm, by Poccinotti, and others, and with success. 1 Croton oil has likewise been employed externally as a revellent or counter-irritant — at times to induce a cathartic effect, but in this respect it is uncertain. 2 Rubbed on the surface in small quantity, it induces inflammation of the skin, which gradually disappears of itself. When the friction is longer continued, pustules are caused, which, when they are numerous, run together or are confluent, and around the spot where the confluent eruption is seated, papulae or pimples appear over a wider extent, which are transformed into pustules, and are surrounded by a red base or areola. When the pustules are discrete, they dry up more rapidly than when they run together; and in the latter case they commonly forming scabs. Friction readily excites pustulation on the head, face, neck, chest, and on those parts of the extremities where the skin is thin. Where it is thicker, the effect is of course induced with more difficulty. Commonly the eruption is perceptible in twelve hours after the first friction, but at times not till a later period : very rarely is the second friction ineffectual. In the course of from three to six days the eruption again disappears. The pain usually commences in about an hour after the rubbing, being at first nothing more than a slight itching and burning, which gradually, but markedly, augments ; yet the eruption is never so painful as that caused by the ointment of tartarised anti- mony, or by the plaster of the same agent, with which it is capable of fulfilling the same indications. These frictions with croton oil are adapted for all cases in which local counter-irritation is required. They have been recommended of late by many physicians — as by Andral, 3 Elliotson, Hutchinson, 4 1 Richter's Specielle Therapie, B. x. S. 248. Berlin, 1S28. 2 See a case of Ileus cured in this manner, by Dr. Susewind, of Lutzerath, in Casper's Wochenschrift fur die gesamrate Heilkunde, Jun. 24, 1837, S. 404. 3 Gazette Medicale, Janv. 1832, and Archives Generales, Aotit, 1833. 4 London Lancet, May, 1833, and Dr. Sauer, in Medicin. Zeitung, Aug. 10, 1836, S. 158, and Amer. Med. Intell., Nov. 1, 1837, p. 286. OLEUM CROTONIS. 283 Short, Landsberg, Romberg, and others, in the following affections: In chronic inflammations, and such as have a tendency to exsuda- tion ; in chronic rheumatic and gouty diseases, in aphonia, 1 and chronic hoarseness, 2 phthisical affections, especially in incipient phthisis ; and in the neuroses — as spasmodic asthma, hoopingcough, paralysis, &c. The croton oil has likewise been used as a direct excitant. Cam- panelli 3 gives a case of paralysis of the upper eyelid, which was promptly relieved by the application of four drops of croton oil to the affected lid, and the eyebrow. MODE OF ADMINISTERING. Internally, the dose is from one eighth to one fourth and one half a drop, given every three or two hours, or more frequently, if necessary. The dose is rareiy carried higher except in desperate cases, and in mental affections, for which it is peculiarly appro- priate. It may be given either in the form of emulsion or of pill. Hahnemann 4 and Hufeland recommended it as a substitute for castor oil, which is expensive in Germany ; advising, that a drop of the croton oil should be added to an ounce of the oil of poppies, and that the mixture should be called Oleum Riciid Officinale. This preparation is well adapted for emulsions. When applied externally, to excite an eruption, from four to six drops or even more may be rubbed in twice a day. In women and children, a single application maybe sufficient; but if the skin be thick and insensible, it will be well to rub it previously with flannel, or to apply first a rubefacient, especially when it is desirable to pro- duce the effect speedily. On the other hand, where the skin is ex- citable, the croton oil should be mixed with an equal portion of some mild fixed or volatile oil before being used. Emulsio Olei Crotonis. Emulsion of Croton Oil. fy. Olei crotonis, gtt. iij. Olei amygdal. Sss. Gum. acac. sjij. Misce sensim terendo cum Syrup, flor. aurant. ,|j. Aq. chamaem. oV. M. Dose. — A spoonful every two hours, until it operates — shaking the vial. Phoebus. 5 1 Romberg, in Woclienschrift fur die gesammte Heilkunde, 1835. 2 Or. Sauer, in Medic. Zeitung. Aug. 10, 1836, S. 158. "Annali Universali di Medicina, July, 1835. * Apotheker Lexicon, B. ii. Abth. 1. S. 203. 6 Handbuch der Arzneiverordnungslelire. Th. ii. Berlin, 1836. 284 DUNGLISON S NEW REMEDIES. 3<. Olei ciotonis, gtt. i — ij. Olei cham. simpl. git. ij. Terendo raisce cum Mucilag. gum. arabic. Syrup, amygdal. aa. 5ss. M. Dose. — A tea-spoonful every two hours — shaking the vial. LOCKSTAEDT. Plhilfe Olei Crotonis. Pills of Croton Oil. 5*. Olei crotonis, gtt. iv. Mica? panis q. s. ut riant pilula? viij. Dose. —One, or two, or more. fy. Olei crotonis, gtt. v. Saponis, Gum. acacia?, aa. 9j. Misce et fiant pilulse xx. Dose. — One to three. Sundelin. 5-. Olei croton. gtt. ii. Mica? panis vel Saponis, 5j. M. et divide in pilulas viij. Dose. — One to four. Haastus Olei Crotonis. Draught of Croton Oil. 9<. Tinct. ol. croton. f. sjss. Syrup. Mist, acacia?, aa. f. 3'j- Aqua? destill. f. 5ss. Fiat haustus. After swallowing a little milk, this draught must be taken very quickly, and be washed down with the same diluent. Njmmo. Mistura Olei Crotonis. Mixture or Emulsion of Croton Oil. B<. Olei crotonis, gtt. ii. Mucilag. acac. £ij. Aqua?, 3j. M. Dose. — A fourth part, every two hours, until the desired effect is induced. Mistura Olei Crotonis Saponacea. Saponaceous Mixture of Croton Oil. &. Olei crotonis, gtt. viij. Potassa? pura?, gr. vj. Aqua? destillat. £ij. M. Dose. — Three to six drops. 1 1 Ellis's Medical Formulary, 5th edit. p. 37. Philad. 183S. OLEUM JECINORIS ASELLI. 285 5*. 01. crotonis, gtt. ij. Sacch. alb. gij. Gum.'arab. 3ss. Tinct. card. f. £ss. Aquas destillat. gx. M. Dose. — Two dessert-spoonfuls, to children ; to be repeated every three or four hours if necessary. Trochisci Olei Crotonis. Lozenges of Croton Oil. 5<. Olei crotonis, gtt. ij. Sacch. alb. 5j. Mucilag. gum. acacias, q. s. ut fiant Trocbisci, non torrendi, No. viij. Dose. — One every two hours, until the desired effect is induced. Seiler. 1 JSapo Olei Crotonis. Soap of Croton Oil. &. Olei crotonis, partes ij. Liquor, potassse, partem j, Triturate in the cold, and when the mixture has acquired the proper con- sistence, run it into moulds of pasteboard, and, in the course of a few days, remove it by slices. Dose. — Two or three grains in water, or in the form of pill. Caventotj. Pope 2 recommends a Tinctura Granorum Tiglii, or a tincture of the seeds, to be made of two ounces of the seeds from which the rinds have been carefully removed, with one ounce of alcohol. This is allowed to digest for six days, and is then filtered. The smallest dose for an adult is twenty drops. This preparation, he says, has the advantage of excluding the more acrid drastic matter contained in the epidermis and husk, whilst the kernel affords cathartic material enough to act powerfully and certainly. OLEUM JECINORIS ASELLI. Synonymes.— Oleum Morrhuae, O. Jecoris Aselli, Codliver Oil. French. — Huile de Morue, Huile de Foie de Poisson. German. — Stockfisch Leberthran, Berger Thran, Gichtthran, Leberthran. The animal fat, which appears under this name in commerce, is obtained from several of the fishes belonging to the genus Gadus, 1 Hufeland's Journal, B. lix. St. 4. S. 134; und Rust's Magazin, B. xviii. St. 2, S. 358. * Medico-Chirurgical Transactions, p. i. vol. xiii. 286 DUNGLISODl's NEW REMEDIES. order Malacopterygii thoracici, but especially from the codfish { Gadus morrkua) ; the Torsk ( Gadvs callarias) ; the Coalfish, (Gadus carbonarius), and the Burbot (Gadus lota.) Several varieties of the oil are met with in commerce, which differ from each other by their brighter or darker hue, and by their greater or less transparency. The clearest sort is admitted into the shops of continental Europe, especially, under the name Oleum jecinoris aselli album seu depuratum ; as a remedial agent it is more used than the darker variety, although several physicians affirm, that they have found the latter more efficacious. 1 METHOD OF PREPARING. According to Riecke, 2 the oil is obtained by exposing to the sun the livers of the fishes above mentioned, cut in slices, and collecting the fixed oil that runs out. That which is first obtained resem- bles fine olive or poppy oil, and is called the yellow codliver oil — Oleum Jecinoris Aselli flavum (German. — Hellblanker Leber- thran.) If the livers are running gradually to putrefaction, the oil becomes of a chestnut brown colour — Oleum jecinoris aselli sub- fuscqflavurn — (German. Braunblanker Thraii) ; and, again, after the oil has been obtained by the above methods, some can still be procured by boiling the livers, which constitutes the Oleum jeci- noris aselli fuscum. EFFECTS ON THE ECONOMY. The properties of codliver oil are said to be different in the dif- ferent varieties met with in commerce. The colour varies from a bright yellow to a reddish brown ; and the oil is sometimes clear, but, at others, more or less turbid. The bright has the consistence of poppy oil ; the brown is thicker. The smell is weaker in the former; in the latter, it resembles that of old salt herrings. The taste of the brown is an empyreumatic bitter ; and resembles train oil ; is somewhat acrid, and remains for a time on the tongue ; that of the clearer oil is much less disagreeable. Litmus paper is feebly reddened by the clear ; considerably so by the brown variety. Both sorts are soluble in alcohol and ether. Codliver oil has long been used as a popular remedy in northern Germany, especially in Westphalia — as well as in Holland arid England; but it is only of comparatively late years, that it has attracted the attention of physicians. In England, it appears to have been first recommended by Percival, and in Germany by Schenk. 3 When administered internally, it excites a disagreeable taste in the mouth, and nausea. Yet patients soon become accus- 1 See M. Tanfflier, in Gazelle Medicale de Paris, Aout 12, 1837. 2 Die neuern Arzneimittel, u. s. w. S. 351. s Hufeland's Journal, lv. 31. OLEUM JECINORIS ASELLI. 287 tomed to it ; and Riecke 1 affirms that he has frequently seen child- ren take it without repugnance. When the nausea is once overcome, the oil does not oppress the stomach, except when it is embar- rassed, or the digestive powers are greatly enfeebled. Nor does it seem to destroy the appetite by continued use. Yet many per- sons, especially adults — less so children — according to Kopp, reject it immediately. It is necessary for the digestive powers to be energetic when it has to be given for any length of time. To those, whose digestive organs are very irritable, Kopp recommends that Bourdeaux wine should be taken after it. Codliver oil has no manifest effect on any of the secretions, ex- cept occasionally on the urinary and cutaneous depurations; and on the healthy organism it appears to excite no marked change. In strumous affections, however, its favourable influence is said to be striking, as well as in rachitic, rheumatic, and gouty disorders. In such cases, it is said, by the German writers, to excite powerfully the reproductive or nutriiive functions, when administered for a proper length of time. 2 The favourable effects are, in general, not rapidly exhibited ; and to produce a cure, according to Kopp, the remedy must be persisted in for at least four weeks, and commonly for some months. Kopp suggested, that owing to the similarity of the effects of this oil to those of iodine, its efficacy might be owing to its containing the latter, and some chemical investigations, made by him in the year 1836, confirmed the suggestion. 3 The quantity is extremely small, but — Kopp supposes— like the steel in chalybeate waters, as the iodine is commingled naturally with the oil, it may exert a much greater effect than if it were added artificially in the like quantity. As respects its administration in disease, it has been employed — especially in Germany — as a domestic remedy in 1. Rheumatism, in which its reputation has been favourable. In the year 1835, Brefeld wrote a monograph on the codliver oil, in which, resting upon numerous indigenous and foreign experi- ments, he maintained it to be a remedy of great and specific efficacy in every form of chronic and actual rheumatism ; and since then his testimony has been corroborated by that of Schenk, Spiritus, Morin*oo?, inner bark, and §»£«, root. 2 Journal de Pharmacie, & Amer. .Tourn. of Pharraac. vol. ii. new series, p. 240. See. also, M. Boullier, in Gazette Medicale de Paris, 17 Juin, 1837. 3 Bulletin Medical Beige, Mai, 1836. 4 Bulletin Medical Beige, Oct. 1835. PIPERINUM. 295 Hospital St. Pierre, Bruxelles; yet M. Leonhard 1 is satisfied, from his various trials, that it does not possess any febrifuge virtue ! METHOD OF PRESCRIBING. It may be given in the form of pill or of powder, like the qui- nine. It was administered at the hospital at Bruxelles, in one case, in the way of lavement ; — twenty-four grains being given in three lavemens. The paroxysm returned, but was less violent. In two days afterwards, the same quantity was administered in the same manner, and the fever did not recur. PIPERINA. Synonymes. — Piperinum, Piperine. German. — Piperin, Pfefferstoff. This substance was discovered by M. Oerstadt, in the year 1819, in the black pepper, (Piper nigrum. 2 ) It is found, also, in the Piper lo?igum, and it has been presumed to be the same, or an analogous principle with the cubebine of the Piper cubeba. M. Oerstadt at first regarded it as a vegetable alkali, but M. Pelletier subsequently analysed it, and proved it not to be such, but to bear a consider- able analogy to resins, and to be of a peculiar nature. 3 Piperine has not been much used, except in Italy: it has been highly extolled there in the cure of intermittents, by Meli 4 and many others. METHOD OF PREPARING. Let two pounds of black pepper, bruised, be digested, at a gentle heat, in three pounds of alcohol, at 36° (.837). This mixture must afterwards be raised to ebullition, then suffered to remain at rest, and grow cold ; when it must be decanted, and the operation be repeated with fresh alcohol. The two solutions must then be mixed together, and two pounds of distilled water and three ounces of muriatic acid be added thereto. The liquor becomes turbid, and a precipitate, of a deep gray colour, is thrown down, which is com- posed, in a great measure, of fatty matter. The deposit being separated, crystals may be collected on the filter and sides of the 1 Encyclographie des Sciences Medicales, Mai, 1838. 9 Journal de Physique, No. 2, 1820, & Gazette de Sante, Mai 25, 1820. 3 Examen chimique du Poivre, par J. Pelletier, 8vo. Paris. 4 Annali Univers. di Medicina, xxvii. 161, & xxviii. 22. 296 dunglison's new remedies. vessel. These are the piperine. On adding- water until the liquid is no longer rendered turbid, a fresh quantity is obtained. The above process, which is that of Meli, is the same as one described by M. Pelletier. He has likewise procured it by the following- method : — After having exhausted the pepper by alcohol, and evaporated the alcoholic tinctures, a fatty or resinous matter is obtained: this must be subjected to the action of boiling- water, which must be added again and again, until it passes off colour- less. By dissolving this fatty matter — thus purified by washing in alcohol —by the aid of heat, and leaving the solution to itself for some days, a multitude of crystals are obtained, which may be purified by solution in alcohol and ether, and by repeated crystalli- sation. The alcoholic mother waters, left to themselves, will furnish fresh crystals. This crystalline matter is piperine. Piperine presents itself in the form of four-sided prisms, two of which — parallel to each other — are evidently broader than the others. In the pure state, it is of a white colour, and translucent; it is frequently, however, coloured yellow by portions of resin being combined with it. It is inodorous, and of a feeble taste of pepper ; fuses readily by heat ; is not volatile, and is scarcely soluble in cold water, but somewhat more so in hot. In respect to its solubility in alcohol, testimony is discordant. According to Magendie, it dissolves very readily therein ; according to C. G. Gmelin, it is soluble only in small quantity in cold, but in tolerable proportion in hot alcohol, as well as in ether and in the volatile oils. The solutions taste acrid and peppery, and do not react on vege- table colours; — which shows that it is not an alkaloid, as the dis- coverer conceived. With acids, it forms no intimate chemical combinations ; acetic acid, indeed, dissolves it in considerable quantity, but it is in great part precipitated by water, and by eva- poration the whole of the acid escapes. EFFECTS ON THE ECONOMY. Piperine — as has already been remarked— has been exhibited chiefly by the Italian physicians for the cure of intermittent fever. Its employment was, doubtless, suggested by the use of pepper corns as a popular remedy in that disease. According to Riecke, 1 the antiperiodic virtue of pepper is exhibited upon the healthy economy; a k\v pepper corns taken before the expected appear- ance of the menses, arrests them for several days. Of this, he him- self has had no experience ; but he affirms that the females, in a district of southern Germany, have great confidence in their virtues. Meli, 2 who treated many cases of intermittent with piperine, 1 Die neuern Arzneimittel, S. 361. 2 Nuove Esperienze, &c, Milan. 1S23, 8vo., & Annali Universal! di Me- dicina, xxvii. 161, and xxviii. 22. PIPERINUM. 297 considers it as the best of all febrifuges, the quinine not excepted. He forms twenty grains into ten pills, and gives these at intervals during tho apyrexia. The efficacy of the oleum acre piperis in the same complaint, he ascribes to the piperine it contains. The febrifuge virtue of piperine has been confirmed by many- other Italian physicians ; by Brandolini, Bertini, Gordini, Torelli, and others. According to Brandolini, from forty to fifty grains are generally required to effect a cure. Bertini gave it in three doses during the apyrexia, to the extent of a scruple, made into pills with a bitter extract : after two or three doses, the fever was generally arrested. Gordini affirms, that relapses occurred less frequently after the use of piperine than after that of the sulphate of quinine. On the other hand, in the hospital at Turin, Christin was dis- appointed in it, and such seems to have been the result of the trials made by Chiappa. 1 In the year 1823, he administered it in ten or twelve cases, but was unable to detect any great antiperiodic property ; not more than a fourth part of the sick experienced benefit, whilst, on the others, the cinchona acted like a charm. In general, a burning sensation was experienced in the stomach after taking it, as well as in the throat, with the same kind of feeling occasionally in the rectum, and in the whole abdomen ; and in two young individuals, the eyes were made red, and the eye-lids, nose, and lips were swollen. Piperine has, likewise, been employed by others besides the Italian physicians. Dr. Blom, of Utrecht, has given it in inter- mittents, but not with as much success as the quinine. According to him, the remedy, soon after it is taken, particularly in very im- pressible persons, occasions a sense of internal heat, especially in the epigastric region, and not unfrequently it causes perspiration, especially on the upper lip. Blom is, however, doubtful, whether these effects are ascribable to the piperine, or to a portion of the resin of the pepper remaining united with it. He is of opinion, that both in general debility, and in debility of the digestive appa- ratus, piperine merits a preference over the sulphate of quinine, both because it can be better borne by the stomach, and because it acts more tonically upon it. In inflammatory intermittents, as well as in those with gastric complications, the piperine is to be avoided. Magendie suggests that it should be given in blennorrhoea, in place of the cubebs. METHOD OP ADMINISTERING. PilnlcB Piperina. Pills of Piperine. *. Piperin. gr. xij. Extract, gentian, q. s. ut fianf pilulae xij. Dose. — One every hour during the apyrexia of fever. 1 Riecke, Op. cit. S. 361. 298 dunglison's new remedies. PLATINUM. Synonyme.— Platina. The Preparations of Platinum are not given here, as they are not used. According to Magendie, they possess analogous proper- ties to those of the salts of gold. See Auri Prceparata. PLUMBI IODIDUM. Synonymes.— Plumbi Ioduretum, Iodide or Induret of Lead. French. — Iodure de Plomb. German. — Bleiiodid. MODE OF PREPARING. This preparation may be made by adding a solution of one hun- dred parts of hydriodate of potassa to a solution of seventy-five parts of the acetate of lead. The iodide is a fine yellow powder, insoluble in cold, but per- fectly soluble in boiling water, from which it is precipitated, on cooli acid. EFFECTS ON THE ECONOMY. The iodide of lead is not an irritant, when applied even to a denuded surface. 1 M. Paton* administered twelve grains of it to a cat of moderate size. In four hours the animal did not appear to experience any inconvenience ; twelve more grains were then given ; in twelve hours the animal became uneasy, and constantly refused every kind of food. It appeared to suffer in the kidneys ; subsequently, it was attacked with violent colic, which caused it to jump to great heights. Three days after taking the iodide, it died, suffering dreadfully. The dissection was made twelve hours after- wards, when no traces of irritation were perceptible. M. Paton examined the interior of the stomach chemically, but was unable to detect any of the iodide, nor could any portion of it be dis- covered in the faeces. He then boiled the intestines and their contained matters in distilled water; the liquid was filtered and decolourised by charcoal, but no effect was induced by the tests for lead. The matter remaining on the filter was digested in dilute nitric acid : the solution was filtered, and a precipitate obtained on pouring in a solution of chromate of potassa. The liquid was eva- 1 Eager, in Dublin Journal for 1834. 2 British Annals of Medicine, Mar. 3, 1837; and Journal de Chimie Medical, Jan. 1837. PLUMBI TANNAS. 209 porated; the residue calcined along with what was left by the evaporation of the water, and the whole brought in contact with dilute nitric acid. Nitrous gas was disengaged, and the solution responded to reagents like the solutions of the salts of lead. M. Paton infers, that the iodide of lead introduced into the stomach is partly absorbed, and that it is this portion which causes death, — the remainder passing into the intestines, and admitting of detec- tion by the method described. When given internally, in the dose of a quarter or half a grain, Velpeau thought that it occasioned, in one instance, irritation in the alimentary canal ; but Dr. O'Shaughnessy thinks that this result must have been owing to idiosyncrasy, as ten grain doses can be borne with perfect impunity. The experiments of Dr. Cogswell 1 show, that it is by no means an active agent. Owing to its not exciting cutaneous irritation — like iodine, and the iodide of potassium — the iodide of lead has been applied externally. Velpeau 2 treated three cases of enlarged glands with very gratifying success, although the patients had used frictions with other prepa- rations of iodine ineffectually. Similar good effects were observed by Guersent, Roots, and others. Unguentum Plumbi Iodidi. (rharm. Lond.) Ointment of Iodide of Lead. 5<. Plumbi iodid. %']. Adipis, Sviij. M. Applied to scrofulous and other indolent swellings in the way of friction. PLUMBI TANNAS. Synonymes. — Tannate of Lead. French. — Tannate de Plomb. German. — Gerbstoffblei. Autenrieth 3 has strongly recommended the tannate of lead in cases of paratrimma ad decubilum, that is, of sores produced by lying, and its advantages have been confirmed by others. METHOD OP PREPARING. The tannate is formed by precipitating an infusion of oak bark by acetate of lead, according to the following formula. 1 Essay on Iodine, p. 142. Edinb. 1837. 1 Lugol, Essays on Iodine, &c, by O'Shaughnessy, p. 206. 'British Annals of Medicine, June 2, 1837; and Journ. de Chitnie Medicale, Mars, 1837. 300 dunglison's new remedies. *. Cortic. querc. gross, pulv. gj. Coque cum Aquae comraun. 3 v ii j . Ad colaturce 31V. adrnisce acetum plumbicum quamdiu prsecipatum inde oritur. Liquor filtretur per chartam bibulara. Preecipitatum in charta remanens ad consistentiam unguenti tenuioris exsicca. 1 The ointment is used, spread upon lint, three times a day. More recently, Dr. Tott has recommended the ointment in cases of decubitus gcmgramosus, or sloughing sores produced by lying. 2 In one case, in which it appeared to be inefficacious, he took two drams of the dried precipitate, mixed it with an ounce of ungu- entum rosatum, and applied this unguentum jjlumbicotannicum with success. POTASSA CHLORAS. Synonymes.— Kali Chloricum, Chloras Kalicus Depuratus, Alcali Vegeta- bile Salito-dephlogisticatum, Chloruretum Potassse Oxidatum, Haloidum Oxygenatum, Murias Potassse Hyperoxygenaturn seu Oxygenatum, Oxy- geno chloruretum Potassii. Potassa? Euchloras, Chlorate of Potassa, Chlo- rate of Protoxide of Potassium. French. — Chlorate de Potasse. German. — Chlorsaures Kali. METHOD OF PREPARING. Tn the chemical manufactories, the chlorate of potassa is pre- pared bypassing chlorine gas into a solution of carbonate of po- tassa. In this way, chlorate of potassa is obtained mixed with more or less muriate of potassa. The salt prepared in the labora- tories, before it is adapted for medical use, should be purified by recrystallisation. It is to be observed, that when the adequate quantity of chlorine gas is not employed in the preparation, the re- sulting compound is analogous to the chlorides of soda and lime, and in action it agrees rather with those preparations than with the true chlorate of potassa. This may tend to explain the dis- crepancy in the experience of different physicians. The chlorate of potassa crystallises in white leaves, having the 1 "Take of oak bark, in coarse powder, an ounce; boil in eight ounces of water, until, when strained, four ounces remain: add acetate of lead as long as any precipitate falls: filter the liquor through bibulous paper, and dry the precipitate remaining on the paper to the consistence of a thin oint- ment." * Grafe und Walther's Journal der Chirurgie, B. xxiv. S. 676, Berlin, 1836; and Gazette Medicale, Jan. 1837. POTASS^E CHLORAS. 301 splendour of mother of pearl, or in four or six-sided tables, having a specific gravity of 1.989. It is permanent in the air, and has a cool, saline, disagreeable taste, similar to that of saltpetre. Six parts are soluble, at the ordinary temperature, in 100 parts of water. When exposed to heat oxygen escapes, and chloride of sodium remains. When beaten forcibly in a mortar, it crackles, emits light, and sparks. When rubbed lightly with inflammable sub- stances, or when struck, it inflames readily, and hence its well known employment in the formation of matches. EFFECTS ON THE ECONOMY. These have not been completely tested, in the opinion of some at least. 1 L. W. Sachs, who has frequently administered it, is of opinion, that in the chlorate of potassa the direct effect of the alkali is rendered milder by the chloric acid, whilst the alkali modifies that of the acid ; in this manner, the caustic property of the alkali is destroyed ; whilst the liquifying or resolvent (fluidisirende) pro- perty is moderated, but not removed. On the other hand, by the union of the chloric acid with the alkali, the powerful excitant action on the nerves, which the former exerts, is at the same time markedly moderated, although certainly not destroyed ; the mode in which it is exerted, he thinks, is probably changed. By such a union, a medicine has been supposed to be formed, which acts chiefly on the nervous system, and which is capable of mitigating and probably of removing any morbid erethism therein, with the hyperesthesia thereby induced. Such is the opinion of certain therapeutists. Others imagine, that it is capable of purifying the mass of blood in consequence of the chlorine which it contains ; but a salt of chloric acid is not possessed of the same properties as chlorine; and, accordingly, when we have found occasion to administer it. we have never wit- nessed any of the effects ascribed to it ; nor have we seen any evi- dence of the modus operandi on the nervous system mentioned above, or of its imparting oxygen to the blood as supposed by some. 2 From its excitant properties, and under the notion that it may act upon the blood, and through the blood on the functions of nu- trition as an excellent alterative, the chlorate of potassa has been recommended in chronic cutaneous diseases in general, as well as in hepatic and syphilitic affections. It has also been occasionally administered in cases of chronic asthenia. Kohler 3 employed it in several cases of tubercular phthisis, and although the general results of his experiments were unfavourable, he thinks it ought to be admitted into the number of those remedies 1 Riecke, Die neuem Ar/neimittel, S. 300. 2 See Stevens on the Blood, p. 296. London, 1832. 3 Rust's Magazin, B. xlvi. 302 dunglison's new remedies. that are useful in phthisis, although its stimulating action on the circulating and pulmonary systems cannot be denied. Its use is contra-indicated where the fever runs high, and where there is any sign of inflammation of the lungs, or tendency to haemoptysis. Sachs, in accordance with the views before mentioned, in regard to its antineuropathic properties, has advised it in cases of proso- palgia. He affirms, that in a great many instances it afforded essential relief. Chisholm appears to have been one of the earliest to prescribe it in neuralgia faciei ; and, after him, Herber, and sub- sequently, B. Schaffer, Jos. Frank, Meyer, and others, employed it both as a curative and palliative agent in that disease. Recently, it has been advised in obstinate rheumatism of the ner- vous kind, by Knod von Helmenstreit ; and Eyr has extolled it in ulceration of the mouth after violent salivation. Sachs administered it in the dose of from' three to six grains, three or four times a day, but some give it in a much larger quan- tity. It may be administered either in the form of powder or of solution. Solulio Potasses Chloratis. Solution of Chlorate of Potassa. Synonymes.— Solutio Muriatis Potassa^ Oxygenati, Liquor ad Ulcera Atonica. &. Potasses chlorat. 3j. Aquae destillat. £xij. M. To be applied to indolent ulcers, by means of lint dipped in it, or of a camel's hair pencil, to excite the tissues. Swediaur. 1 Potas Potassa, Chloratis. Drink of Chlorate of Potassa. Synonymes. — Potus Oxygenatus. {French. — Tisane Oxygenee.) $t. Solut. potass, chlorat. B5ij. Aquae, &iv. M. Given internally, in cases of general asthenia. Dose. — One or two pints a day. Swediaur. Mistura Potassa Chloratis. Mixture of Chlorate of Potassa. &. Potassae chlorat. giss. Aquae destill. simpl. ^iv. Solve. Dose. — A spoonful every two hours. Helmenstreit. Eyr dissolves twenty-five grains of the chlorate of potassa in four ounces of distilled water, and administers a spoonful three times a day. 1 P^arm, Med. Pract. Bruxelles, 1817. 2de edit. POTASS^E CHLORAS. 303 5r. Potass, chlorat. 3j. Aqua? destillat. 31V. Syrup, althaea:, J;j. M. Dose. — A table-spoonful four times a day. Koehler. POTASSII BROMIDUM. Synonymes. — Kalium Bromatum, Bromide of Potassium. In Solution, Hydrobromate of Potassa, Potassas Hydrobromas, Kali Hydrobromicum. French. — Bromure de Potasse. * German.— Bromkalium, Kaliumbromid, Bromwasserstoffsaures Kali. METHOD OP PREPARING. According to Liebig, this preparation can be readily made by dissolving bromine in spirit of wine, and adding caustic alkali until the spirit begins to change colour, then evaporating and heating to redness. In the London Pharmacopoeia, the bromide is directed to be made by adding first an ounce of iron filings, and afterwards two ounces of bromine to a pint and a half of distilled water. The mixture is set aside for half an hour, and frequently stirred with a spatula : a gentle heat is then applied, and when a greenish colour is produced, two ounces and a dram of carbonate of potassa, dissolved in a pint and a half of water, are poured in : what remains is filtered and washed with two pints of boiling distilled water, and again filtered. The mixed solutions are then evaporated, that crystals may form. Liebig says it crystallises in four-sided shining tables; according to Balard, 1 commonly in tubes, and at times in long rectangular parallelopipedons. It has a pungent taste. By heat it crepitates, and melts into a red hot flux, without experiencing change. It is more soluble in hot than in cold water ; producing, during its solu- tion, evident cold, and becoming converted into hydrobromate of potassa. It is also soluble in alcohol, although in small quantity. The solution of hydrobromate of potassa dissolves no more bromine than pure water. EFFECTS ON THE ECONOMY. The bromide of potassium excites the same phenomena as bro- mine, but with less intensity. From one dram and a half to 3ij is needed to kill a dog. The animal appears to suffer; is restless, and gradually falls into a state of prostration. In smaller doses it appears to act powerfully on the human stomach. The bromide, 1 Annales de Chimie. loro. xsxii. 304 dunglison's new remedies. like bromine, seems first to have been applied to therapeutical pur- poses by Pourche. 1 Two cases of scrofulous tumours are reported by him to have been removed by friction with an ointment com- posed thereof, and a cataplasm sprinkled with an aqueous solution of it. In a third patient, chronic otorrhcEa and scrofulous tume- faction of the testicle yielded to the same agency, combined with the internal use of bromine. A very.large goitre was reduced two thirds by it. Pourche prescribed the bromide internally in the form of pill, in the dose of four to eight grains in the day. Magendie 2 employed the preparations of bromine in scrofula, in amenorrhaea, and in hypertrophy of the ventricles of the heart. Prieger recommended an ointment of the "Kali bromicum" in inveterate porrigo favosa as well as in obstinate and malignant tetter, and with good success ; and Dr. Williams 3 in cases of en- larged spleen. The last gentleman suggests, that it possesses "unusual, if not specific powers in the cure of diseases of the spleen !" It was owing to these results that the bromide was in- troduced into the London Pharmacopoeia of 1836. 4 Dr. Williams also gave it with success in a case of ascites. MODE OF ADMINISTERING. Solutio Potass ii Bromidi. Solution of Bromide of Potassium. $<. Potassii bromidi, gr. xviij. Aquae lactucae destillat. ^iij. Syrup, althaeas, §j. M. To be given in the course of the twenty-four hours : in table- spoonfuls. Magendie. Unguentum Potassii Bromidi. Ointment of Bromide of Potassium. *. Adipis, 3j. Kalii bromat. gr. xxxvj. M. Half a dram to a d am to be rubbed on scrofulous swellings. Magendie. M. Pourche employs 3j of the bromide to the ounce of lard. *. Axung. 3j. Potassii bromid. gr. xxiv. Bromini liquid, gr. vi ad xij. M. Magendie. 1 Journ de Chimie Medicale, iv. 594; see, also, Bulletin General de Therapeutique, No. 14, Juillet, 30, 1837. 2 Formulaire, Ed. cit. 8 Elements of Medicine, i. 338. * Pereira, Elements of Materia Medica, Pt. i. p. 2S7. Lond. 1839; and Brande's Diet, of Mat. Med. p. 126. Lond. 1839. POT ASSII CYANIDUM. 305 POTASSII CYANIDUM. Synonymes. — Potassii Cyanuretum, Cyanide, or Cyanuret of Potassium. French. — Cyanure de Potassium. German. — Cyankalium. This preparation was proposed by MM. Robiquet and Villerme, 1 as a substitute for the hydrocyanic acid. It is, in their opinion, far more certain in its effects than that preparation. METHOD OF PREPARING. The cyanide of potassium is formed whenever potassa is cal- cined with an animal matter, as in the preparation of the Prussian blue. It is commonly prepared, after the process of Robiquet, by exposing- to long continued heat the ferruginous prussiate of po- tassa. The cyanuret of iron is completely decomposed, and that of the potassium remains. The residuum, after this strong calcina- tion, constitutes a solid, blackish mass, which consists wholly of the cyanide of potassium, soiled by the iron and the charcoal be- longing to the cyanuret of iron. The mass is dissolved in water, when the iron and charcoal are deposited ; whilst the cyanide of potassium dissolves, and is transformed into hydrocyanate of potassa. When the process has been well conducted, the solution is per- fectly colourless, and retains no portion of iron. M. Chevallier 2 considers this process to be impracticable, as the cyanide decom- poses water on coming in contact with it. The result, therefore, must be hydrocyanate of potassa; and, on heating this, all the hydrocyanic acid escapes, and the residue is merely potassa. He prepares the salt by calcining the ferro-hydrocyanate of potassa, and then separating the cyanide from the quadricarburet of iron by pure alcohol, on distilling which the cyanide is obtained very pure. Pure cyanide of potassium is white and transparent; it may be fused in the fire without being decomposed, and keeps for an in- definite period, provided it be kept dry. EFFECTS ON THE ECONOMY. MM. Robiquet and Villerme performed some experiments on animals in the presence of Magendie. 3 A tenth of a grain de- stroyed a male linnet in a minute; less than a grain killed a guinea pig in two or three minutes : a small drop of the hydro- 1 Bulletins de la Societe Medieale d'Emulation, Juillet, 1823. 2 Journ. de Chiinie Medieale, and Journal of Phila. College of Pharmacy, 1832. 3 Formulaire pour la Preparation &c. de plusieursNouveaux Medicamens, &c. 10— g dungl 20 306 dunglison's new remedies. cyanate of potassa, containing only the hundredth part of a grain of the cyanide in solution, caused a linnet to drop down dead in half a minute. Haifa dram, containing five grains of the cyanide, killed a dog of large size in a quarter of an hour. Magendie proposes, that the cyanide of potassium should be dis- solved in eight times its weight of distilled water, when it becomes transformed into hydrocyanate of potassa. To this solution, he gives the name medicinal hydrocyanate of potassa, and advises, that it should be given under the same circumstances, and in the same doses, as the medicinal hydrocyanic acid, (see page 3.) He farther suggests, that, to render it wholly independent of the action of the small portion of alkali contained in the cyanide, a few drops of some vegetable acid may be added, or it may be prescribed with an acid syrup. The dose of the cyanide is a quarter of a grain at first, gradually increased to a grain and more. M. Bally gave it to fifty-two indi- viduals labouring under different diseases ; it produced no effect on thirty-five; and, on the others, the result was neither constant nor salutary, so that he is not. inclined to place more reliance upon the cyanide than upon the hydrocyanic acid. By Dr. Lombard, 1 of Geneva, it has been applied externally, with success, in some cases of facial neuralgia. He uses it by fric- tion, in the form of watery solution, or of ointment, according to circumstances. The watery solution is in the strength of from one to four grains to the ounce of water ; and the ointment is composed of from two to four grains of the cyanide to an ounce of lard. The aqueous solution, however, is considered by Dr. Lombard to be the most prompt in its effects. Dr. Lombard regards the cyanide to be contra-indicated, where the nervous affection is complicated with inflammatory action. He has found it, also, a useful remedy in chronic rheumatism. In sciatic neuralgia, it was not successful. In white swelling, attended with acute pains, poultices, moistened with the solution, gave great relief. Dr. Lombard, indeed, affirms, that the soothing properties of the cyanide are superior to those of any remedy known. Lotions of hydrocyanic acid are not to be compared with it, — the acid being decomposed with facility, and not devoid of danger. MM. Trousseau and Rullier 2 also recommend the cyanide, in the proportion of four grains to an ounce of water, as a local applica- tion in various forms of neuralgia. M. Andral 3 employed the cyanide with complete success in a case of most intense cephalalgia, which, for ten months, had re- sisted the most powerful remedies, as bleeding, a seton in the neck, blisters and shsapisms. It was employed in solution, in the pro- 1 Gazette des Hdpitaux, & Lond. Med. Gaz. Sept. 1831. 2 Lond. Med. and Surgical Journ. Dec. 15, 1832; and Araer. Journ. of the Med. Sciences, May, 1833, p. 238. 3 Gazette Medicale, Jan. 1832. POTASSII CYANIDUM. 307 portion of from six to eight grains to the ounce of distilled water ; and compresses, wet with the solution, were applied, for eight days, to the forehead and temples. MODE OF ADMINISTERING. Mistura Potassii Cyanidi. Mixture of Cyanide of Potassium or of Hydrocyanate of Potassa. (Pectoral Mixture, of Magendie.) g;. Potass, bydrocyan. med. jj. Aquae destillat. Oj. Sacchar. purif. o ]SS ' M. Dose. — About five drams (a table-spoonful) night and morning. (Pectoral Potion.) 5«. Potass, hydrocyan. med. gtt. xv. Infus. hederi terrestr. ^ij. Syrup, althaea?, §j. M. Dose. — Five grammes (a tea-spoonful) every three hours. Magendie. 5<. Potassii cyanid. gr. $. Aquae lactucae, Sjij. Syrup, althaeae, |j. M. Dose. — Five drams (a table-spoonfnl) every two hours. Magendie. Syrupus PotasscB Hydrocyanalis. Syrup of Hydrocyanate of Potassa. &. Potass, hydrocyanat. medic. 3j. Syrupi, U5j. This syrup may be added to pectoral draughts, and may be sub- stituted for other syrups. PUuIcb Potassii Cyanidi. Pills of Cyanide of Potassium. &. Potassii cyanid. Amyli aa. gr. iv. Syrup, q. s. ut fiat massa in pilulas viij dividenda. Dose.— A pill night and morning, in convulsions, dyspnoea, &c. Hospital of La Pitie'. 1 • Ryan's Formulary, 3d edit. p. 392. Lond. 1839. 308 dltnglison's new remedies. POTASSTI IODIDUM. Synonymes. — Kalium Iodatura, Kali Hydroiodinicum, K. Hydroiodicum, Hydroiodas Kalicus, Potassii Ioduretum, Iodide or Ioduret of Potassium. In solution — Potassse Hydriodas, Potassii Proto-hydriodas, Potassii Pro- toxidi Hydriodas, Hydriodate of Potassa. French. — Hydriodate de Potasse, Iodure de Potasse. German. — Iodkalium, Iodwasserstoffsaures Kali. METHOD OF PREPARING. According to Tun nermann, the iodide of potassium is best pre- pared in the following manner : One part of pure iron filings, with four parts of iodine, is put into a glass vessel — by many, into a glass retort — and six or eio-ht parts of water are poured thereon ; gentle warmth is then applied, and the mixture is frequently shaken until the liquid appears clear and almost colourless. In this way, hydriodate of protoxide of iron is formed, which is dissolved in the water. It is now filtered ; the residuum washed several times on the filter with distilled water, and, under the application of a moderate heat, a concentrated solu- tion of potassa is added, by small portions at a time, until a precipi- tate is no longer thrown down. In this process, the potassium separates the iodine from the hydriodic acid ; the oxygen of the former unites with the hydrogen of the latter; protoxide of iron is precipitated, and carbonic acid given off, — heat being required for its entire disengagement, to prevent the formation of a carbonate of protoxide of iron with excess of acid, which would be soluble in the water. It is then filtered, the residue washed on the filter with distilled water, and the liquid evaporated so as to form crystals. Those chemists or pharmacie?is, who are not very accurate in their preparations, evaporate the mother waters to dryness, satisfy- ing themselves, that although the saline residuum contains car- bonated alkali, it may answer for external use ; which is decidedly objectionable. To prevent the loss of the iodide, owing to its ad- mixture with the carbonate of potassa, in the mother waters, Tiinuermann finds it most advantageous to neutralize it with the hydriodic acid, which may be prepared in the following manner : Dissolve about one dram of iodine in not very strong spirit of wine, and pass a stream of sulphuretted hydrogen into the solution, until it is wholly deprived of colour. The hydrogen unites with the iodine, — the hydriodic acid, thus formed, remaining dissolved, whilst the sulphur is precipitated. The liquor is then filtered, the sulphur washed with a little water, and the spirit and superfluous sulphuretted hydrogen gas are driven off by heating it in a glass vessel placed in a sand bath. The remaining fluid is diluted with water, filtered, and a warm alkaline ley added, until litmus paper is only feebly reddened. By evaporation, the iodide of potassium is POTASSII IODIDTJM. 309 obtained, which, by repeated solution in water, evaporation of the solution, and filtration, is obtained entirely pure. 1 The process of Turner is, to take any quantity of a solution of caustic potassa, and to add to it gradually, at a gentle heat, iodine sufficient to neutralise the alkali ; then evaporating to dryness, calcining strongly, dissolving in water, and crystallising. Dr. William Gregory 2 suggested an improvement on the process of Turner, which has been regarded one of the simplest. 3 It con- sists in adding iodine to a hot solution of potassa until the fluid assumes a yellowish brown colour, then evaporating, and heating the residuum to low redness, in a platinum crucible. The mass, which at first consists of iodide of potassium and iodate of potassa, thus loses all its oxygen, and becomes converted into iodide of potassium. e%The formula of Caillot and Baup is — to take ten parts of iodine and fifty of distilled water ; put them into a mattrass, and add, in small successive portions, of pure iron filings, five parts, shaking the vessel each time. The liquor is then heated until it loses its colour, filtered, and the substance on the filter washed with boiling water, until the liquid is tasteless ; the liquor, and the various liquids used in the washings, are united, and the whole is heated in a sand bath. When the temperature approaches that of ebullition, enough of a solution of subcarbonate of potassa is added, to precipitate all the oxide of iron ; it is then filtered, and the sub- stance on the filter washed until it is completely exhausted. All the liquors are then united, tested by reddened litmus paper, and if there be any excess of base, a little hydriodic acid is added. It is then evaporated in a sand bath, until a slight pellicle forms ; the fire is now discontinued, and the salt is suffered to crystallise. Lastly, the crystals are washed with a little water, and then dried. 4 The iodide of potassium crystallises in beautiful cubes. These are readily fused, and are volatilised at a red heat. They do not decompose, even when heated with access of air. They are readily soluble in water, and in alcohol, and the addition of the iodide facilitates greatly the solution of the iodine. It would seem, that a slight contamination of iodide of potassium with carbonate of potassa is exceedingly common, as it can with difficulty be avoided in the manufacture of the salt; but Christison 5 affirms, that he has examined specimens, where the carbonate, with its accompanying water, amounted to 90 parts in the 100. " Can we wonder, then," he asks, " that practitioners should complain of the iodide of potassium, that they have given it for months, nay, 1 Rieckc. Die neuem Arzneimitte), S. 305. Stuttgart, 1837. 2 Etlinb. Med. and Surg. Journ., xxxvi. 369, for Oct. 1831. 8 Cogswell, on Iodine, p. 85. * Jourdan's Pharmacopee Universelle, i. 6fi2. Paris, 1828; also the Lond. Pharmacopoeia, and Brande's Dictionary of Materia Medica, p. 317. Lond. 1839. s Edinb. Med. and Surg. Journal, April, 1838. 310 dunglison's new remedies. even for years, without observing any effect either on the constitu- tion, or on the disease for which it was administered ?" EFFECTS ON THE ECONOMY. As respects the action of the iodide, and its administration in disease, it is scarcely necessary to do more than refer to what has been said under the head of iodine. On the whole, its effects appear to accord with those of iodine ; at least, no difference is perceptible on the organism. It has been supposed, that it is to be preferred to pure iodine, where the object is to act especially on the urinary organs. 1 For external use, the iodide of potassium is usually pre- ferred to pure iodine. It is constantly given internally, and often in combination with the latter; the solubility of which, as was before remarked, is aided by it. Many of the following formulae contain both one and the other. Dr. Buchanan asserts, that he has given the iodide of potassium in doses of §ss, and the only precaution he observed was to make the patient drink freely of diluents. It was chiefly to determine some physiological questions that he gave it in such large doses. Two drams of it were taken by a young man affected with gonor- rhoea, and as soon as the medicine made its appearance in the urine, blood was drawn from the arm. On examining the blood, both the serum and crassamentum were found deeply impregnated with iodine. 2 According to recent experiments of Magendie, 3 the iodide is one of the substances that promote the coagulation of the blood. METHOD OF ADMINISTERING. Liquor vel Solutio Potassii Iodidi. Solution of Iodide of Potassium. (Synonymes. — Potio resolveDS ex Iodio. Solution de Coindet, Coindet's Solution.) B<. Potassii iodidi, gr. xxxvj. Aquae destillat. gj. Solve. Dose. — Same as that of the tincture of iodine. Coindet and Magendie. 5<. Potassii iodidi, 3j. Aqua? destillat. ,§j. Solve. Dose. — Fifteen drops three times a day, gradually increased to forty-five: in cases of ovarian dropsy, — frictions with iodine oint- ment being used at the same time. Elliotson. 1 Riecke, Die neuern Arzneimittel, u. s. w. S. 306. See, also, Cogswell on Iodine, p. 96. 2 Lond. Med. Gaz. July 2, 1836. 3 Lec,ons sur le Sang; & translation in Lancet, for Jan. 26, 1839, p. 636. POTASSII IODIDUM. 311 Liquor vel Solutio Hydriodatis Potassa Iodureta. Solution of Ioduretted Hydriodate of Potassa. &. Iodin. 9j. Potassii iodid. 9ij. Aq. destillat. ^vij. Solve. Dose. — Six drops early in the morning, and in the middle of the day, in a gkss of sugared water. In tetter, scirrhus, &c. Lugol. Lugol has a solution of three strengths for internal use. I. II. III. 5<. Iodin. gr. f. gr. i. gr. li. Potass, iodid. gr. iss. gr. ii. gr. iiss. Aq. destillat. §viij. Iviij. Iviij. Dose. — Two-thirds, daily, at first ; afterwards, the whole. Lugol recommends this threefold solution in the same cases as his threefold solution of iodine ; the first being continued from fourteen days to three weeks ; the second, from the fourth or fifth week of the treatment to its termination ; the third, the strongest, he did not often use. As Riecke has observed, it would be better to have in the hospitals but one solution, which might be prescribed in varied doses. Liquor Potassii Iodidi Compositus. — (Lond. Pharmacopoeia.) Compound Solution of Iodide of Potassium. £. Iodin. gr. v. Potass, iodid. gr. x. Aquae destillat. §xx. M. Dose. — f. 3ij to f. 3vj. Tinctura lodinii Composite/,. — (Lond. Pharmacopoeia.) Compound Tincture of Iodine. *. Iodin. §j. Potass, iodid. ,$ij. Sp. rectif. Oij. M. Dose. — Ten minims. Mistura Hydriodatis Potassa Iodureta. Mixture of Ioduretted Hydriodate of Potassa. &. Iodin. gr. ss. Potass, iodid. ^ss. Syrup, papav. 3ss. Aq. destillat. ffiss. Dose. — Two table-spoonfuls three times a day ; in complication of syphilis with scrofula. Tyrrel. 5«. Iodin. gr. iss. Potassii iodid. gr. iij. Solve in Aqua? menth. pip. 3iv. 312 dunglison's new remedies. Dose. — A spoonful two or three times a day. To children, a tea-spoonful. In cases of cancrum oris ; also, in dropsy, in gleet, and leucorrhoea. On renewing the prescription, the dose of the iodine may be increased one half, and of the iodide one grain, each time. Coster and Friedrich. Mistura Potassii lodidi. Mixture of Iodide of Potassium. fy. Potass, iodid. £iv. Aquae lactucse destill. §viij. menth. pip. ^ij. Syrup, altheeae, ^j. M. Dose. — A spoonful morning and evening, in a little water, in- creasing the dose to two spoonfuls. In cases of hypertrophy of the ventricles of the heart. Magendie. £. Potass, iodid. giv. Aq- destill. lactuc. ^viij. flor. naphth. ^ij. Tinct. digit. £j. ad ^ij. Syr. althaea?, |iss. M. Dose. — Morning and evening, a spoonful, in a little water. In hypertrophy of the ventricles of the heart, with quickening of the heart's action. Magendie. It. Lign. quassias. Rad. gentian, aa. 3j. Aquee fervent. §xvj. Macera per horam et colse. Liquor, colat. add. Potass, iodid. gr. xxxvj. Potassae carbonat. ^ij. M. Dose. — A table-spoonful three times a day, in a glass of water. CUMMING. Pilulce Potassii lodidi. Pills of Iodide of Potassium. 5<. Potass, iodid. gr. xv. Aq. destillat. q. s. Pulv. spong. ust. Ext. dulcamar. aa. 3ij. Pulv. rad. glycyrr. q. s. Fiant pilulae clxxx. Dose. — Six, two or three times a day, in scrofula, goitre, &c. Vogt. Ungaentum Iodinii Compositum. — (Pharm. Lond.) Compound Ointment of Iodine. — Ioduretted Ointment. £. Iodin. 3ss. Potass, iodid. 3j. Spirit, rectif. f. gj. Adipis. gij. Rub the iodine and iodide with the spirit; and mix with the lard. POTASSII IODIDUM. 313 Unguentum Potassii Iodidi. Ointment of Iodide of Potassium. &. Potass, iodid. gss; Adipis, §iss. M. Half a dram at first, and, subsequently, a whole dram to be rubbed in. In goitre, scrofulous glandular affections, &c. Magendie. This ointment is generally too weak, unless combined with the internal use of iodine in some form. $<. Potass, iodid. 9j. Adipis. ,§ss. M. The wounded parts to be smeared with it two or three times a day: in moist tetter — serpigo. Between the applications, to be dressed with dry lint. Tuennermann. In dry tetter, the ointment applied is formed of 3j to 3iss of the iodide to gj of lard. Unguentum Kali Hydroiodici. (Pharmacop. Borussic.) Ointment of Hydriodic Kali. 5<. Potass, iodid. gj. Magnes. carb. gr. vj. Aq. destillat. guttas nonnullas M. terendo cum, Ung. rosat. 3j. M. Or, 5<. Potass, iodid. Sodse carbon, depur. sice. aa. gss. Ung. rosat. giv ad ^vj. M. A piece of the size of a small bean, to be rubbed in, morning and evening. In chronic enlargement of the testis. Walther. 5<. Potass, iodid. £ss. Ext. opii. 9ss. Cerat. gj. M. As a dressing in malignant cancerous ulcers. Unguentum Potassii Iodidi Ioduretum. Ointment of Iodu retted Iodide of Potassium. B«. Iodin: gr. xij. Poiass. iodid. 9iv. Adipis, gij. M. In scrofulous ophthalmia, ulcers, &c. Lugol. *. Iodin. gr. xv. Potass, iodid. .^j. Tinct. opii. gij. Adipis, sij. M. In painful scrofulous ulcers, white swellings, &c. Lugol. 314 dunglison's new remedies. Emplastrum Potassii Iodidi loduretum. Plaster of Ioduretted Iodide of Potassium. B<. Iodin. Potass, iodid. aa. 9ss. ad 9j. Emplaslr. hydrarg. Seu Saponis. 3 ij. Applied in syphilitic and gouty swellings of the bones. Ebers. Lotio Potasses Hydriodatis Iodureta. Lotion of Ioduretted Hydriodate of Potassa. £. Iodin. gr. i. ad ij. Potassii iodid. gr. ij. ad iv. Solve in Aquae destillat. §viij. This solution was commonly used by Lugol externally, to be injected under the eyelids in strumous ophthalmia, fistulas, &c. Lugol. £. Iodin. £ss. Potassii iodidi. §j. Solve in Aq. destillat. £vj. This "rubefacient solution of iodine," may be used two or three times a week, when the last prescription loses its effect, or when it is desirous to stimulate more actively. It is also added to baths — three or four ounces to an ordinary bath — as well as to poultices, being mixed with an ordinary cataplasm. Lugol. if. Iodin. ^j. Potass, iodid. §ij. Solve in Aquae destillat. §ij. This " caustic iodine solution" has to be used when the last loses its efficacy. It occasions a crust on the parts. Lugol employs it chiefly, when the skin on the edges of the ulcers is greatly hyper- trophied, red, and fungous, as well as in phagedenic or spreading tetters. It may be applied two or three times a week, or daily, should the case require it. Lugol. Collyrium Potasses, Hydriodatis loduretum. Collyrium of Ioduretted Hydriodate of Potassium. it. Iodin. gr. ss. ad i. Potassii iodid. 9ss. Solve in Aq. rosar. §iij. M. To be applied four times a day, in cases of scrofulous ophthalmia, with ulceration of the conjunctiva and cornea. Magendie. POTASSII IODO-HYDRARGYRAS. 315 POTASSII IODO-HYDRARGYRAS. Synonymes. — Iodo-Hydrargyrate of Potassium. Iodhydrargyrate of Ioduret of Potassium. Dr. A. Charming, 1 who has highly extolled this preparation in various diseases, affirms, that this, with other new salts, was dis- covered by Bonsdorf, of the University of Finland, in 1826; and it is a fact well known to the chemist, that iodine, chlorine, &c. enter into combinations so as to form both acids and bases. By experiment, Dr. Channing. ascertained, that a solution of eight grains of the pure iodide of potassium in ten or fifteen minims of water, would combine with a fraction less than eleven grains of the deuto-iodide of mercury, maintaining the combination in solu- tion, when diluted with water or alcohol to any extent. If n.ore than eleven grains of the deuto-iodide be added, although a small excess is dissolved in the concentrated solution, on diluting with water, it is promptly precipitated. It would appear, therefore, as Dr. Chan- ning has remarked, that in preparing this salt for administration, the labour of crystallising it, in order to obtain a solution of a de- finite strength, is wholly unnecessary; inasmuch as a solution, combining a fraction more than eight grains of the iodide of potas- sium with eleven grains of the iodide of mercury, may be used as containing twenty grains of the iodo-hydrargyrate of potassium. If it be desirable to obtain the preparation in a crystallised form, it is important, that the definite proportions of the two iodides be observed, and particularly that there be no excess of the iodide of mercury ; for the saturated solution of eight grains of the iodide of potassium will dissolve, and enter into combination with more than thirteen grains of the iodide of mercury, forming similar crystals soluble in alcohol, but in water precipitating more than two grains of the iodide of mercury. EFFECTS ON THE ECONOMY. These are similar to those of the iodides of mercury, but, ac- cording to Dr. Charming, in a less degree. The iodo-hydrargyrate is not, however, much employed, experience seeming to have shown, that it possesses no essential, if, indeed, any advantages over those preparations. Puche 2 has recently recommended it as not being so subject to produce salivation, or pains in the bones, as the other combinations of mercury and iodine. 1 American Journal of the Medical Sciences, Feb. 1834, p. 388. 2 Journal des Connaissances des Medicales, Oct. et Nov. 1838, and Jan- vier, 1839, and Annales de Chimie, Oct. 1838. 316 dunglison's new remedies. method of administering. Mistura Potassii Iodo-Hydrargyratis. Mixture of Iodo-Hydrargyrate of Potassium. ?<. Hydrarg. deuto-iodid. gr. iv. Potassii iodid. £)j. Aquae destillat. 3J. M. Dose. — Five drops three times a day. Channing. Tinctura Potassii Iodo-Hydrargyratis. Tincture of Iodo-Hydrargyrate of Potassium. &. Potass, iodo-hydrarg. gr. j. Spiritus vini tenuioris 3J. M. Dose. — Ten drops three times a day. Channing. Solutio lod-Hydrargyratis lodureti Potassii. Solution of Iod-Hydrargyrate of Ioduret of Potassium. £. Hydrarg. biniodid. gr. viij. Potassii ioduret. gr. viij. Aquae destillat. 5*viij. Dose. — f. 3ij to f. gij in twenty-four hours. Puche. Pilulce, lod-Hydrargyratis lodureti Potassii. Pills of Iod-Hydrargyrate of Ioduret of Potassium. £. Hydrarg. biniodid. gr. viij. Potassii ioduret. gr. viij. Sacchar. lact. gr. lxiv. Aquae gum. q. s. ut fiant pilulae xxxij. Dose. — One to eight, daily. Puche. QUININA. Synonymes.— Chininum, Chinium, Quininum, Quinium, Quinia, Kininum, Quina, Sal Essentiale Cortieis Peruviani. French.— Quinine, Kinine". German. — Chinin. (iuinine is, doubtless, a most important gift from modern analy- tical chemistry to medicine. Not many years have elapsed since the discovery of this substance, and yet, by general consent, it is now regarded as one of the most valuable remedies in the cata- logues of the materia medica. The honour of the discovery — which had been facilitated by the investigations of other chemists, as to the composition of the cinchona barks — belongs to Pelletier and QUININA. 317 Caventou, (1820 -; 1 ) and so rapidly and extensively was its efficacy promulgated, that in the year 1826, in two laboratories in Paris for the preparation of quinine, fifty-nine thousand ounces of the sul- phate — the form best known, and most frequently prescribed — were prepared. For this discovery, the Royal Academy of Sciences of Paris awarded MM. Pelletier and Caventou the Monthyon prize of ten thousand francs. Quinine is obtained from the yellow bark by a similar process to the one described for the separation of the cinchonine. 2 In the pure state, it is of a white colour, and appears commonly in the form of powder ; it crystallises, however, in silky, shining, tufted needles. In both cases, it contains from three to four per cent, of water., By a gentle heat, this escapes, and the quinine melts into a transparent fluid, which, on cooling, is translucent, and similar to a resin. When melted in vacuo, it has a crystalline appearance. In a strong heat, it is decomposed. It has a very bitter taste ; and is soluble in two hundred parls of boiling water; a portion being precipitated on cooling. It requires a much larger proportion of cold water to dissolve it. In alcohol, it is far more soluble than in water. It is, likewise, soluble in ether, and somewhat so in oils. It exhibits an alkaline reaction, — restoring the colour of reddened litmus paper, and neutralising the acids. The observations of Piorry and Lavollee 3 and of Q,uevenne 4 show, that the quinine, as well as its sulphate, passes into the urine of patients Who use it in any considerable quantity. EFFECTS ON THE ECONOMY. Of the effects of quinine we shall speak at some length, under the head of sulphate of quinine, with which it seems to accord entirely in medicinal agency. Several physicians, who have ex- perimented in regard to the efficacy of pure quinine and its salts, have found the first in no respect inferior to the last. Such was the experience of Niewenhuis and Elliotson, the latter of whom ex- hibited the quinine in large doses — as much as five grains every four hours. A French physician, Blegnie, 5 even gives the prefer- ence to the pure quinine— because- it possesses, he thinks, equal efficacy, is cheaper, easier taken, and better borne than the sul- phate. He advises, that after each dose an acidulous drink should be taken, to render its solution in the stomach more rapid. Wutzer 6 1 Annales de Chimie et de Physique, xv. 289 & 337. 2 See page 116. 3 Gazette Medicale, 1836, p. 73. * L'K.xperience, Juillet, 1S38. 5 Riecke, Die neuern Arzneimitiel, S. 1J8. See, also, Bally, in Ma- gendie's Journal de Physiologie, ii. 236. • Isis, p. 441, 1829. 31S dunglison's new remedies. and Harles 1 have also recommended the more frequent use of pure quinine. It may be given either in the form of powder or pill, or in alco- holic solution. Tinctura Quinince. Tincture of Quinine. &. Quinin. 9j. Solve in alcohol, ^ss. Dose. — Twenty to forty drops every two hours. Wutzer. QUININE ACETAS. Synonymes. — Chiniura Aceticum, Acetas Chinii, Acetas Chinini, Acetas Chinicus, A. Quinias, A. Quinae, A. Quinini, A. Quinii, A. Kinini, Ace- tate of Quinine. French. — Acetate de Quinine. German. — Essigsaures Chinin. This preparation has only recently been introduced into practice, but it is not much employed. It is prepared by saturating quinine with concentrated acetic acid diluted with water, and evaporating the neutral solution, by gentle heat, to crystallisation. It appears in the form of very delicate, needle-shaped, snow- white, satiny, and shining crystals ; tastes very bitter ; and is with difficulty soluble in cold water, but readily so in hot. Wutzer and Sundelin 2 assert, that it acts like the other salts of quinine, but merits no preference. QUININE CITRAS. Synonymes. — Quinini Citras, Quiniffi vel Quinse vel Quinii, vel Chinini, vel Kinini Citras, Citras Chinicus, Citrate of Quinine. French. — Citrate de Quinine German. — Zitronsaures Chinin. MODE OF PREPARING. This preparation is formed, like the acetate of quinine, from an aqueous solution of citric acid and pure quinine, or by the decom- 1 Heidelberg klinisch. Annalen, B. v. H. 4, S. 573. 2 Isis, p. 441, 1S29: also, Heidelb. klinisch. Anna]. B. v. H. 4, S. 575. QUINllOE FERROCYANAS. 319 position of a hot solution of sulphate of quinine, by means of an acid citrate of soda. 1 It forms needle-shaped prisms, of a white colour, which are by no means readily soluble in water. EFFECTS ON THE ECONOMY. The acetate and the citrate of quinine have been esteemed and are adapted for those excitable persons with whom the sulphate does not seem to agree. The citrate has been prescribed by many Italian physicians, and found to be very efficacious. 2 Magendie considers it, when it contains an excess of acid, advisable for those cases, where the union of a tonic with an antiseptic property is in- dicated. He considers, that the following syrup may be substituted, in certain cases, for the syrwpus antiscorbuticus? Syrupus Quinines Citratis. Syrup of Citrate of Quinine. &. Syrup, sacchar. clarif. Ibj. Q,uinin. acetat. acid. gr. xxxvj. M. Dose. — Two spoonfuls in the twenty-four hours. QUININiE FERROCYANAS. Synonymes. — Chinium Ferrocyanogeriatum, Ferrocyanas Chinii, &c. French. — Ferrocyanure de Quinine. German. — Eisenblausaures Chinin. METHOD OF PREPARING. This is obtained by the decomposition of sulphate of quinine by 1 Guleani, in Annali Universali di Medicina, Luglio, 1832, and Heidelb. Klinisch. Annal. B. x. H. i. S. 34. Heidelb. 1834. 2 Beraudi, in Bulletin General de Therapeutique, Nov. 1838. 3 This syrup is directed by the Codex Medicamentarius of Paris to be f>repared in the following manner. Take of the fresh leaves of the coch- earia, water trefoil, cress, horseradish, and bittei oranges cut, of each one pound ; cinnamon, an ounce and a half, white wine, four pints. Macerate for two days in a tin cucurbit, covered with a well luted capital: Distil, in a sandbath, a pint of fluid ; to which add two pounds of white sugar, and make into a syrup. Pass through a cloth, without straining, what remains in the cucurbit ; let the liquor rest, decant and boil to the consistence of syrup, with two pounds of white sugar. When cold, clarify and mix with the other. 320 dunglison's new remedies. the impure salt is treated with warm spirit of wine, and the clear solution is evaporated. 1 It forms needle-shaped, confused crystals, of a greenish yellow colour, and very bitter taste, recalling that of the hydrocyanic acid. It dissolves readily in spirit of wine, not so in water; and is de- composed by hot water. EFFECTS ON THE ECONOMY In this combination, the antifebrile properties of the quinine are said to be even superior to those of the other preparations ; yet the remedy has not got into much use. It has been employed mainly by a few of the French practitioners. Cerioli, 2 an Italian physi- cian speaks in high terms of its efficacy in periodical diseases, even where the sulphate has failed. He gave it in the dose of from two to eight grains, in the day ; and Gouzee 3 gives the history of three cases completely cured by the administration of a single grain, half an hour before the paroxysm. aUININiE MURIAS. Synonymes. — Chinium Muriaticura, Ch. Salitum seu Hydrochloricum, Hydrochloras Chinii, H. Chinicus. French. — Muriate de Quinine. German. — Salzsaures Chinin. Perhaps, next to the sulphate of quinine, this salt has most fre- quently been employed in practice. METHOD OF PREPARING. It is obtained by dissolving pure quinine in dilute muriatic acid, or by the decomposition of the sulphate of quinine dissolved in warm water by means of a solution of muriate of baryta, which is added so long as a white precipitate is thrown down ; the hot mixture is then filtered ; the precipitate washed, and the clear fluid evaporated, by a gentle heat, to crystallisation, so long as crystals shoot on cooling ; these are collected, washed in cold water, and purified by repeated crystallisation. It forms fine, needle-shaped, white, silky crystals, of a mother of 1 See Bertozzi's Method, in Philad. Journ. of Pharmacy, vol. 2, new series, p. 82. Philad. 1837. * Annali Universali di Medicina, Luglio, 1832, and Archives Generates de Medecine, Dec. 1832. 8 Observateur Medicale Beige, Jan. 1834. aUININiE PHOSPHAS. 321 pearl lustre ; does not dissolve readily in water, but more so than the sulphate. EFFECTS ON THE ECONOMY. In this respect, the muriate agrees with the sulphate of quinine, and in those of weak digestive powers is better borne. Spielman 1 asserts, that it is a more speedy and effectual remedy for intermit- tent fever than the sulphate, and it is more soluble. It is, however, more expensive. The dose is generally considered to be the same as that of the sulphate. It is better given in solution than in powder. Spielman rates the dose at from half a grain to a grain. QUININE NITRAS. Synonymes. — Chinium Nitricurn, Nitras Chinii, &c. Nitrate of Quinine. French. — Nitrate de Quinine. German. — Salpetersaures Chinin. METHOD OF PREPARING. This salt is obtained, like the muriate, by the addition of nitric acid to quinine ; or by the decomposition of nitrate of baryta by sulphate of quinine. It is, at first, a fluid oil-like mass, which gradually becomes solid. In union with water, it forms crystals. It dissolves with difficulty in water, but readily in alcohol. QUININiE PHOSPHAS. Synonymes.— Chiniura Phosphoricum, Phosphas Chinii, Ph. Chinini, Phos- phate of Quinine. French. — Phosphate de Quinine. German. — Phosphorsaures Chinin. METHOD OF PREPARING. In the mode of preparation it accords with the preceding forms ; 1 Allgemein. medicinisch. Zeitung, and Journal des Connais. Medic. F6vrier, 1836 ; see, also, Prof. Dierbach, in Heidelb. klinisch. Annal. B. x. H. i. S. 33. Heidelb. 1834. ll_a dungl 21 322 dunglison's new remedies. dilute phosphoric acid being- added to quinine, or phosphate of ba- ryta, to the sulphate of quinine. 1 It appears in the form of needle-shaped prisms, of a mother of pearl lustre, which are, like the muriate of quinine, dissolved readily in water, and spirit of wine. Harles, 2 however, affirms, that in the neutral condition it is soluble, with difficulty, in water. The phosphate is regarded by some to stand next to the sulphate in medicinal efficacy. QUININiE SULPHAS. Synonymes. — Chinium Sulphuricum, Disulphas Quinse, Sulphas Chinii, Sulphas Quinicus, Sulphate of Quinine. French. — Sulfate He Quinine. German. — Schwefelsaures Chinin, Chininsulphat. This preparation of quinine is by far the most frequently admi- nistered. It is in fine, silky, flexible needles, and, at times, in rect- angular columns. Its taste is extremely bitter, and resembles that of yellow bark. Exposed to a moderate heat, it loses its crystalline form, in consequence of the escape of its water of crystallisation. It is only slightly soluble in cold water, requiring 470 parts of water at the ordinary temperature, and 30 parts of boiling water for its solution. In alcohol, it is very soluble, but only slightly so in ether. With sulphuric acid, it forms a snpersulphate, which is much more soluble in water than the neutral salt, and hence we usually add a few drops of dilute sulphuric acid to our mixtures of the sulphate of quinine. METHOD OF PREPARING. This salt is generally prepared on a large scale in the chemical laboratories of France ; whence we obtain it. A formula has been admitted, however, into the Pharmacopoeia of the United States, which is taken from the process of M. Henry, junr., 3 for which he received a prize from the Academie Royale des Sciences, of Paris. It is as follows — Take of yellow bark, in powder, a pound ; lime, in powder, four ounces; sulphuric acid, alcohol, animal charcoal, distilled water, each a sufficient quantity. Boil the bark for half an hour with eight pints of the distilled water, acidulated with a 1 Winkler, in Buchner's Repert. and Philad. Journ. of Pharmacy, new series, vol. 2. p. 12. Philad. 1837. 2 Heidelb. klinisch. Annal. B. x. H. i. S. 36. Heidelb. 1834; and Journal de Chimie Medicale, 1837. 3 Journal de Pharmacie, vii. 296. Juiller, 1821 Q.UININJE SULPHAS. 323 fluid ounce of the sulphuric acid. Strain the decoction through linen ; then boil the residue with the same quantity of acidulated water, and filter as before. Mix the filtered liquors, and gradually add the lime, stirring constantly. Wash the precipitate with dis- tilled water, and having dried it, digest it in alcohol with a moderate heat. Pour oft' the tincture, and repeat the digestion several times, till the alcohol is no longer rendered bitter. Mix the tinctures, and distil over the alcohol, till a brown viscid liquid remains in the retort. Upon this substance, removed from the retort, pour as much sulphuric acid, largely diluted with water, as may be suffi- cient for its perfect saturation. Then add the animal charcoal, and having evaporated the liquor sufficiently, filter it while hot, and set it aside to crystallise. 1 It results from the calculations of Pelletier and Caventou, that from a quintal of cinchona, two pounds, one dram and thirty grains of sulphate of quinine may be obtained, which makes two drams, sixty-six grains and a sixth per pound, or thirteen grains and two sixths per ounce; and as the sulphate of quinine is com- posed of nine parts and nine tenths of sulphuric acid, to ninety and a tenth of quinine, it follows, that if the dose of cinchona in sub- stance be two drams, we should administer to the patient three grains and nine thirty secondths of a grain of the sulphate of qui- nine ; not taking into account a small quantity of sulphate of cin- chonine, which may be mixed with it. Four grains of the salt are, consequently, more than an equivalent for the dose of the cinchona often prescribed in substance. Those practitioners, therefore, who prescribe thirty-six or seventy-two grains of the sulphate, give the representative of about twenty-seven drams of cinchona' in the former case, and of fifty-four in the latter. 2 EFFECTS ON THE ECONOMY. The effects of the preparations of quinine on the healthy organism, have not been much investigated. According to Caventou, they produce a general excitement, similar to that caused by coffee, and Wittmann affirms, that the sulphate induces an excitement similar to that of a paroxysm of fever. Hirschel, 3 too, asserts, that in a child, four years of age, to whom the sulphate was given in a case of intermittent, a general chilliness of some minutes' duration super- vened immediately on the taking of the remedy, succeeded, in the course of half an hour, by general heat, and this again by a gentle' perspiration, in all respects resembling a mild attack of fever. The excitant action of the salts of quinine formed by the vege- table acids is said to be less striking. The sulphate of quinim, in large doses, appears, in some cases, to 1 Wood & Bache ; s Dispensatory, Art. Qu'nia? Sulphas. J Jounlan's Pharmacopee Universelle, ii. 375. Paris, 1828. 3 Hufeland's Journal, B. lxi. St. 6. S. 140. 324 DUNGLISOIV'S NEW REMEDIES. possess narcotic properties, yet it cannot be classed amongst poisons, as it has been given to healthy individuals in very large doses, without any unpleasant effects. Bally, 1 for instance, gave it to the extent of 110 grains in the day without any inconvenience. Dr. Thomas Fearn, 2 who administered it largely, regards it to be more narcotic than sedative, — usually, he thinks, stimulating in small doses, but in large doses the stimulant effects not being ob- vious, but rather the reverse. When Mr. Scott, 3 a medical gentleman and a martyr to dys- pepsia, took the quinine in very large doses, under the idea that his malady was intermittent neuralgia, he found several singular phenomena induced thereby. He was directed to commence with two grains three times a day, until he arrived at twenty grains for a dose, that is, a dram a day. Until the doses were increased to fourteen or sixteen grains, he did not experience any peculiar effects, but he now began to feel heat of skin, dryness of mouth and fauces, and obstinate constipation. He likewise lost the power of naming substantives; was obliged for a long while to consider what familiar things were called, and was unable to cast up a line of six or eight figures correctly. His perceptions of quantity were likewise impaired, so that in prescriptions he wrote ounces for drams, drams for grains, &c. &c. He still, however, persevered, with the quinine until he took 9j four times a day, but he was una- ble to continue these excessive doses long, the untoward symptoms augmenting, so that he was often unable to stand, and fell several times in the streets. In impressible individuals, the sulphate and the muriate not un- frequently induce a sense of anxiety, restlessness, vertigo, confusion, depravation of vision, tinnitus aurium, and, in many cases, tran- sient deafness, all which symptoms appear to be of a neuropathic character, and, it has been affirmed, occur more frequently in females, especially in those who are pregnant or suckling — and in persons of slender and delicate conformation. 4 In certain cases, the quinine and its salts seem to have caused ptyalism — the saliva being inodorous, and the teeth firm ; and when calomel has been given along with it, it has been conceived, that ptyalism has ensued sooner than it otherwise might have done. The most striking agency of quinine and its salts, is in cases of periodical diseases of all kinds ; and especially in intermittent fever : they have now, indeed, almost wholly taken the place of the cinchona, over which they possess many points of preference. In the first place, their bulk is much loss; they therefore do not op- press the stomach so much, whilst the impression of the cinchona 1 Revue Medicale, v. 244. Juillet, 1821. 2 Transylvania Journal of Medicine, Oct., Nov., and Dec. 1836. p. 708, and Amer. Med. Intell., June 15, 1837, p. 109. 3 Lond. Med. and Physical Journal, March, 1833. 4 Riecke, Die neuern Arzneimittel, S. 120. QUININE SULPHAS. 325 on that organ not unfrequently interferes with its antipyretic pro- perties. In malignant fevers, too, it is often impossible to introduce the requisite quantity of cinchona into the organism, to prevent the succeeding paroxysm, and the life of the patient is consequently placed in the greatest danger. In this case, the sulphate of quinine is invaluable ; possessing, as it does, the febrifuge virtues of the cinchona in such a concentrated state, that but a small quantity is required to produce equal efficacy with a large quantity of the powdered cinchona. In such cases, indeed, the latter is apt to dis- agree with, or be rejected by the stomach, before its full influence can be exerted. In these pernicious fevers, that occur especially in Italy and Holland, the sulphate of quinine has supported life in innumerable cases where the cinchona, in substance, might have failed, and has thereby best exhibited its sanative agency. 1 In these cases, the quinine is administered without regard to compli- cations, which, in less urgent cases, might be allowed to interfere with its administration. Another advantage, ascribed to the qui- nine, is, that in cases of paroxysmal fevers, in which the attacks follow each other so closely, that the second commences before the first has terminated, it may be given during the paroxysm, a time at which the cinchona would be apt to occasion oppression of the stomach and vomiting. It has likewise been found advantageous in large doses — twelve to thirty grains daily — in engorgement of the spleen, consequent on intermittent fever. 2 Besides their febrifuge property, the salts of quinine possess a tonic virtue, which adapts them for numerous cases in which that class of remedies is indicated. Yet there are many who think that the cinchona is better calculated for such cases than the quinine, and who administer the latter to prevent the paroxysms of an inter- mittent, but have recourse to the cinchona, when they are desirous of fortifying the system to prevent a relapse. There are cases, too, which resist the quinine and its preparations, and which sub- sequently yield to the cinchona in substance, but this may be owing to the quantity of lignin, or woody matter in the bark in substance, aiding the quinine of the cinchona in producing that new impression on the nerves of the stomach, which is necessary to break in upon the paroxysmal catenation. In its antiseptic virtues, also, the sulphate of quinine is inferior to the cinchona. It has been doubted, indeed, whether it possess any such virtues at all. Lastly : there is an advantage possessed by the sulphate of quinine, — that in irritable or impressible persons, it may be ex- hibited endermically, and thus no disorder be induced in the digestive powers. It need scarcely be said, that the cinchona is not adapted for this mode of administration. 1 Repertorio Medico-Chirurgica por 1'anno 1822, Torino. No. 22. Med. Chirarg. Zcitung, B. ii. S. 137, 1823; & Richter's Specielle Therapie, B. x. S. 326, Berlin, 1828. * Bulletin General de Therapeutique, Nov. 30, 1837. 326 dunglison's new remedies, mode of administering. The sulphate of quinine may he administered internally in the form of powder or pill, and in solution in water, alcohol, or syrup. The average dose in the. twenty-four hours of apyrexia, is from four to ten grains ; yet it has been given frequently to a much greater extent. As in the case of the cinchona, it has also been advised that a large dose should be given immediately before the expected paroxysm, so as to render the frequent administration during the apyrexia unnecessary ; this dose need not be so great as the combined doses would amount to. so that there may be eco- nomy in the plan. Dupasquier, Elliotson, 1 ourselves, and many others, have found this course eminently successful ; but some ob- ject, to it. A case of severe remittent has been detailed by Dr. Thomas Fearn, 2 in which he gave, at one dose, three tea-spoonfuls — weighing thirty-two grains. At the end of an hour, there was a diminution in the frequency of the pulse — "the invariable effect of large doses of quinine, when its operation is favourable." The dose was repeated, and at the end of another hour, it was again given, making ninety-six grains in two hours. Dr. Fearn remarks, that his usual practice in remittent fever had been to give three doses of twenty grains each, with an interval of an hour between. Generally, between the paroxysms, several doses are administer- ed; and, according to the particular case, the efficacy of the salt of quinine is attempted to be increased by the addition of antimonials, laxatives, carminatives, &c, and in pernicious or malignant in- termittents especially, of opium or morphine. By many, a combination of the quinine with moderate doses of the cinchona is highly recommended. Chapman advises its union with piperine : a combination with the alcoholic extract of cin- chona has also been advised. Mr. Sherwin, 3 of Hull, affirms, that a piece of apple, chewed for a moment, immediately annihilates the bitter taste left by the sulphate of quinine. The sulphate of quinine may be used in the way of enema, and endermically, when the condition of the stomach forbids its internal employment. As an enema, four grains or more may be mixed with starch, and be thrown up a short time before the paroxysm, or at the inception ojf the same. In this way it has been found efficacious. 4 In administering the sulphate, or muriate of quinine endermi- cally, a space on the surface of the body is deprived of its cuticle by means of a blister, and on this denuded portion the agent is applied either in the form of powder or of ointment. In testimony of the efficacy of this mode of administering the salts of quinine, 1 Medieo-Chirurgical Transactions, xii. 543, Lend. 1824. 1 Op. cit. 3 Lond. Med. Gazette, April 1, 1S37. 4 Richter, Op. cit. S. 331. Berlin. Medicin. Zeitung, Jan. 4, 1837. QUININE SULPHAS. 327 many observers have come forward, — Lesieur, Lembert, Martin, Wesche, Lehmann, Reilingh, Stratingh, Lieber, and others. From four to eight grains may be placed on the denuded part once or oftener in the day. Dr. Lieber, of Berlin, seems to have prescribed the salt most frequently in this way : he mentions, that of sixty cases, in which he employed it, only eight or ten were unsuc- cessful ; and there was reason to believe, that in these cases the internal administration of the sulphate of quinine would have failed also. In the case of adults, he applies a blister in the evening — of the size of a dollar — over the epigastric region : in the morning, during the apyrexia, the blister is cut; the cuticle removed, and five or six grains— in children two grains — of the sulphate are sprinkled over the denuded surface. The whole is then covered with adhesive plaster, which must extend to the breadth of a finger, over the edges of the blistered part. The sprinkling of the sulphate always occasions a violent burning sensation, but if it be applied in the form of ointment this evil is avoided, or at least diminished. The pain, however, speedily disappears. Some hours after the application of the remedy, op- pression is felt in the stomach, with a desire to vomit, without, however, vomiting supervening; borborygmi, or uneasiness in the bowels, and frequently fluid dejections, with augmented secretion of saliva, which, in some cases, continues for several days. In the course of from twelve to twenty-four hours after the appli- cation, a very bitter taste is generally perceived over the whole tongue, similar to that of the quinine ; and if the application has been made sufficiently long before the anticipated paroxysm, it may be entirely prevented, or be rendered much milder. After the effect has been produced, the adhesive plaster may be kept applied for some days, and, if the sore is not healed, it may be dressed with simple applications. In only two cases did Dr. Lieber observe any extensive or offensive suppuration ; and both healed under simple dressings with dry lint. Rubbing the quinine on the gums has, likewise, been occasionally recommended, as well as frictions with the alcoholic solution on these as well as other portions of the surface of the body — the thighs, groins, and pit of the stomach ; ] and it has been advised in cases of intermittent cephalalgia, and in iralgia, to be snuffed up the nostrils. 2 1 Dr. Schuster, cited in Amer. Journ. May, 1832, p. 242; and Antonini, Journal des Connoissances, Oct. 1838. 2 B. St. Hilaire, in Gazette Medicale de Paris, Mars 26, 1836. 328 DUNGLISON'S NEW REMEDIES. Syrupus Quinince Sulphcitis. Syrup of Sulphate of Quinine. £. Q,uinin. sulphat. gr. xvj. Syrup, simplic. 3viij. M. Dose. — A spoonful. Magendie. Syrupus QuinincB Sulphatis Compositus. Compound Syrup of Sulphate of Quinine. 5<. Quinin. sulphat. gr. xvj. Acid sulphur, dilut. gtt. v. Syrup, limonis, ^viij. M. Dose. — Same as the last. Tin dura Quini?ice Sidphatis. Tincture of Sulphate of Quinine. 3<. Quinin. sulph. gr. vj. Solve in Alcohol. 34° (.847) |j. Dose. — 5j or 3ij, immediately before an attack of fever. Magendie. Guttce Quinincb Sulphatis et Opii. Drops of Sulphate of Quinine and Opium. £. Quinin. sulphat. (seu acetat.) gr. xij. Solve in Spirit, vini rectif. (seu liq. anodyn. Hoffman.) ^ss. Adde Tinct. opii simpl. gtt. xij. Dose. — Morning and evening, twenty drops, in the summer fevers of Europe. Schmidt. Pulveres Quinines Sulphatis. Powders of Sulphate of Quinine. B<. Quinin. sulphat. gr. iij. ad. xij. Sacchar. alb. Jjij. Misce etfiat pulvis in partes vj. cequales dividendus. Dose. — A powder morning and evening, in nervous debility and in intermittents. Radius 1 advises, that the powders should be taken in coffee, by which means the bitter taste is almost wholly counteracted. Radius. Pulveres Quinmce Sulphcitis et Soda, Carbonatis. Powders of Sulphate of Quinine and Carbonate of Soda. B<. Quinin. sulphat. gr. j. — ij. Sodae carbonat. gr. iv. — v. Sacch. alb. 9j. Misce et fiat pulvis. 1 Auserlesene Heilformeln, u. s. w. Leipz. IS36. QUININE SULPHAS. 329 Dose. — A powder, morning and evening, in scrofulous oph- thalmia. Yon Ammon. Pulveres Quinince Sulphatis et Antimonii Tartr cutis. Powders of Sulphate of Quinine and Tartarised Antimony. 5<. Q,uinin. sulphat. gr. x. Potass, et antim. tartrat. gr. iij. Sacchar. alb. gr. xxiij. Misce exacte, et divide in partes sex a>quales. Dose. — One, every two hours, during the apyrexia, in cases of obstinate interrnittents. Gola. 1 Pulveres Quinince Sulphatis et Opii. Powders of Sulphate of Quinine and Opium. Sc Opii puri, gr. j. Q,uinin. sulph. gr. iij. Sacchar. alb. Gum acac. aa. gr. vj. M. fiat pulvis. To be taken a short time before the paroxysm in malignant interrnittents. Neumann. Pulveres .Quinince /Sulphatis et Morphines Sulphatis. Powders of Sulphate of Quinine and Sulphate of Morphine. £. GluiDiii. sulph. gr. ij. ad vj. Morphinse sulph. gr. i ad j. Divide in dos. iv. Magendie. Pulveres Quinince Sulphatis Compositi. Compound Powders of Sulphate of Quinine. 5<. Q,uinin. sulph. gr. j. Pulv. cinchon. optim. gr. XV. Pulv. rhei, Oleosacchar. menth. aa. gr. v. Misce et fiat pulvis. Eight of these to be given in cases of intermittent fever. Naumann. B<. Quinin. sulph. gr. J. Chocolat. gr. vij. Sacchar. lact. gr. ij. Misce. Fiat pulvis tertiis omnibus horis sumendus. In debility of the stomach. Kopp. Pilulce Quinince. Sulphatis. Pills of Sulphate of Quinine. 5<. Q,uinin. sulphat. gr. v. — xij. Succ. glycyrrhiz. £j. Misce et fiant pilulae xij. To be given, according to prescription, in nervous diseases. Radius. 1 Annali Univers. di Medicina, torn. 35. 330 dunglison's new remedies. Pilules Quinines. Sulphat is Co?npositce. Compound Pills of Sulphate of Quinine. 9<. Quinin. sulphat. gr. x. — xv. Acid, phosphoric. sicc.Bij. Pulv. rad. althseae, (vel rhei,) 3iv. Ext. ceDtaur. minor, (vel gentian.) ^ij. Misce et fiant pilulae lx. Dose. — Three to six pills, two or three times a day, in cases of nervous debility, with disposition to hemorrhage, as after abortion. Radius. 5<. Quinin. sulphat. gr. xv. Pulv. cinnam. gss. Extract, cinchonas q. s. ut fiant pilulae xxx. Dose. — Four pills every two to four hours. Henschel. &. Quinin. sulphat. gr. xij. Extract, trifol. 9j. Pulv. rad. calarn. aromat. q. s. Fiant pilulae xij. Dose. — One or two, every two hours. Hildenbrand. Mistura Quinince Sulphatis. Mixture of Sulphate of Quinine. g<. Quinin. sulphat. gr. xij. Acid, sulph. dil. gtt. v. Aquas cinnam. simpl. |vj. Syrup, cinnam. |j. M. Dose. — A table-spoonful. Pulv is Sternutatorius ex Quinince. Sulphate. Sternutatory Powder of Sulphate of Quinine. £. Quinin. sulphat. gr. xv. Tabaci sternutator. com. §j. M. To be snuffed up the nostrils in the course of five or six days, in cases of intermittent headach. 5<. Quinin. sulphat. gr. vj. Pulv. sacchar. pur. 3J. Pulv. rad. iridis, ^iss. M. Small pinches of this to be snuffed up the nose at night. 13. St. Hilaire. Unguentum Quinince Sulphatis. Ointment of Sulphate of Quinine. 5<. Quinin. sulphat. |j. Alcohol (3S° ad 40°) q. s. (gij.) Acid, sulphuric, q. s. (gtt. lxxx.) Adipis suill. §iv. M. Half an ounce at a time to be rubbed on the groins in malignant intermittents. It is likewise placed in the axilla. Antonini. QTJININiE, ET CINCHONINE, TANNAS. 331 Vinum Quinines. Wine of Quinine. 5<. Quinin. sulphat. gr. xij. # Vin. Mader. &ij. M. The wine of quinine may also be made extemporaneously, by adding two ounces of the tincture to each pint bottle of wine. GlUININiE, ET CINCHONINE, TANNAS. Synonyme. — Tannate of Quinine, and Cinchonine. Dr. Otto 1 has recently drawn the attention of physicians to the efficacy of the Tannates of Quinine and Cinchonine, as recom- mended by Dr. Ronander, the secretary to the Swedish Medical Association. He regards them as the most active ingredients in the cinchonas ; and affirms that he has cured by their agency several cases of obstinate intermittent, which had resisted the use of sulphate of quinine and other powerful remedies. He found them likewise very useful in typhus and in states of general weak- ness and tendency to putrescency, where the sulphate of quinine seemed to be ineffectual. Dr. Ronander's experiments establish the belief that the tannin of the cinchonas may be instrumental in developing their full febrifuge powers. 2 The tannate of quinine is also a cheaper remedy than the sulphate. On separating the quinine from cinchona by means of acids, a resinous constituent of the bark remains behind, which affords no more quinine, but yet possesses considerable febrifuge power, and on that account has been much used by the Dutch physicians. Two grains of this residuum are said to act as well as one grain of quinine. Truessink adduces a series of observations of different physicians, all of which confirm this, and he cites the experience of American physicians with this residuum. According to Chap- man, 3 a grain of this may be given every two hours during the apyrexia, in the form of pill. Strathing ascribes its efficacy to the quinine still contained in it. In Italy, several physicians have found the mother waters or lees after the preparation of quinine, when boiled to the consistence of syrup, very efficacious in inter- mittei.ts ; and Roux recommends it highly for practice amongst 1 Dublin Journal of Medical Science, Sepr. 1836. 2 Revue Medicale, Mai, 1837, and Araer. Med. Intelligencer, Oct. 16, 1837, p. 270. s Elements of Therapeutics, 6th edit. ii. 292. Philad. 1831. 332 dunglison's new remedies. the poor. Buchner advises the lees, evaporated to dryness — which he terms Chininum Resino-sulphuricum — to be introduced as a cheap, and, at the same time, efficacious preparation of cin- chona, which may be used in charitable institutions, rubbed with sugar as a powder, or dissolved in alcohol, in place of the sulphate of quinine. These experiments and propositions, as Riecke 1 ob- serves, merit more consideration than they have yet received; for the quinine, notwithstanding its price is much less than formerly, is yet so dear, that its administration does not adapt it well for charitable institutions, whilst the residue, which possesses valuable properties, is generally thrown away, and in this manner the price of the quinine is enhanced. Serturner 2 thinks he discovered, besides the quinine and the cin- chonine, other alkaloids of cinchona, especially one, which he calls Chinioidine, or Chinoidine, and which excels in medicinal properties all the other preparations of cinchona. Henry and Delondre — the French chemists — affirm that the chinioidine is nothing more than quinine, cinchonine, and a peculiar yellow resinous matter, inti- mately adherent to that alkaloid. It appears, also, from the experi- ments of different physicians with the presumed new alkaloid, that it essentially resembles the preparations already mentioned in its medical properties. A Resina Chinas Prasparata is recommended by Plagge, which is prepared from the mother waters or lees of the quinine, by means of precipitation by a carbonated alkali, extrac- tion by alcohol, and removal of the alcoholic liquor by distillation. It is said, likewise, to possess markedly curative powers in inter- mittents. The pharmacopoeia of the United States gives a formula under the title Quinige Sulphas Impurus, which consists in evaporating the liquor poured off the crystals of sulphate of quinine to the consistence of a pilular mass. This has been known for years in Philadelphia under the name of Extract of Quinine, and its active ingredients appear to be sulphate of quinine and sulphate of cin- chonine, which are prevented from crystallising by a peculiar resinoid substance united with them. Dr. Wood 3 asserts, that he has seldom found intermittents resist twenty-four grains of the impure sulphate, given between the paroxysms; although a larger quantity may be employed with safety and greater certainty of success. We have never pre- scribed it. ' Die neuern Arzneimittel, u. s. w. S. 130. 2 Hufeland's Journal, Jan. 1829. a Art. Quinioe Sulphas Impurus, in Wood and Bache's Dispensatory. SALICINA. 333 SALICINA. French. — Salicinum, Salicine, Salicin. German. — Salicin. The tonic virtues of the bark of the willows have been known for ages, and it has been regarded as one of the best substitutes for the cinchona in eleemosynary institutions. It was not much valued, however, in more modern times, until the discovery of an active principle in it again attracted to it the attention of practitioners. This discovery if not made, was perfected, by Leroux, 1 an apothe- cary at Vitry, in France, who first obtained the salicine in a pure state in 1828, after it had been procured in an impure form by- some German and Italian chemists. 2 It is prepared, by preference, from the salix helix, but it is found likewise in the barks of other varieties of the willow — the Salix alba, S. vitellina, S. purpurea, S. lambertiana, S. pentandra, S. polyandra, S. fragilis, S. viminalis, &c, and in the leaves and barks of several varieties of poplar, — the populus tremula, P. tremuloides, P. alba, and P. grgeca. 3 METHOD OF PREPARING. According to the method of Leroux, three pounds of dried and powdered willow bark (salix helix) are boiled for three quarters of an hour in fifteen pounds of water, to which four ounces of subcarbo- nate of potassa have been added. To the cold decoction are added two pounds of liquid subacetate of lead. The mixture is permitted to settle, is filtered, treated with sulphuric acid, and the remaining lead precipitated by a stream of sulphuretted hydrogen gas. The excess of acid is neutralised by carbonate of lime : it is then again filtered, the fluid inspissated, and neutralised by dilute sulphuric acid. It is deprived of its colour by ivory black, and filtered whilst boiling. It is then twice crystallised — if still coloured after the first crystalli- sation — and dried in obscurity. This process yields about an ounceof salicine. Braconnot 4 obtains it by adding subacetate of lead to a decoction of the bark, precipitating the excess of lead by sulphuric acid, eva- porating the colourless liquid that remains, adding near the end of the process a little animal charcoal previously washed, and filter- ing the liquor while hot. The salicine is deposited, on cooling, in a crystalline form. 5 The following plan has been advised by Messrs. Fisher and ' Annalcs dc Chimie, &c. xliii. and Journal de Chimie Mcdicale, torn. vi. 2 Dictionnaire de Mat. Med. par Merat & De Lens, art. Salicine. 3 Riecke, Die neuern Arzneirniltel, S. 365. 4 Journal de Chimie Medicale, Janvier, 1831. 5 For Peschier's method, see Annales de Chimie, vol. xliv. and Amer. Journ. Med. Sciences, May, 1831, p. 256. 334 dunglison's new remedies. Tyson, of Baltimore. 1 Willow bark is boiled with caustic lime in water ; the decoction is filtered and sulphate of zinc added, so long as it produces a precipitate. The liquid, having been again filtered, is evaporated to the consistence of an extract, and the residue is treated with alcohol. The tincture, thus obtained, if carefully evaporated, yields crystals of salicine, which may be purified by washing with a saturated solution of the same principle, in cold water. Salicine forms very tine silky masses of white crystals, which have the appearance of mother of pearl. It bears a distant resem- blance to the sulphate of quinine, yet it is not so loose and delicate. It is permanent in the air, inodorous, and has a strong, enduring, bitter taste, with a striking accompanying balsamic flavour, like the bark of the willow. 2 One hundred parts of cold water dissolve six parts of salicine. In warm water it is more soluble, and also in alcohol ; but it is not soluble either in ether or the essential oils. It exhibits no alkaline reaction. By admixture with sulphuric acid salicine acquires a beautiful red colour. EFFECTS ON THE ECONOMY. The well known effects of the barks of the willows gave occasion to the immediate employment of salicine in cases of intermittent fever. Miquel 3 appears to have been one of the first — if not the first — who instituted experiments with it; and he satisfied himself, that it merits a distinguished place amongst our febrifuge agents, although it requires larger doses than the quinine. Soon after- wards it was given by other physicians — by Husson and Bally, Girardin, Magendie, Blaincourt, Graff, Linz, Stegmayer, Amelung, Stam, Galarna, Van Sneek, Blom, Grafe, Von dem Busch, Kromb- holz, Pleischl, and others. The sentiments, respecting its value, are discrepant; some class- ing it far beneath the quinine, whilst others assign it even a higher position. Its general properties are certainly analogous to those of quinine; but it in no respect merits a preference/ not even in the article of price : for, although an equal weight of salicine may cost less, it requires so much more to produce the same effect, that the cost is perhaps equal. Still as M. Pleischl, 5 of Prague, has suggested, even if the sali- cine were much the dearer of the two, it might be better to use it, 1 Journal of the Philadelphia College of Pharmacy, iii. 214. 2 MM. Pelouze and Jules Gay Lussac, in Annales de Chimie, vol. xliv. 3 Gazette Medicale de Paris, Janv. 1830; see, also, Annales de Chimie, xliii. and xliv. * Richelot, in Archives Generales de Medeeine, Sepr. 1833: see, also, Prof. Dierbach, in Heidelb. klinisch. Annal. B. x. H. 1. S. 62. Heidelb. 1834. 8 Medicinisch. Jahrbucher des k. k. 0. Staat. 1835; and Br. and For. Med. Rev. for Apl. 1836, p. 576. SALICINA. 335 because it is of home manufacture, and can be obtained in war as well as in peace. MODE OF ADMINISTERING. The ordinary dose of salicine, in a case of intermittent, is about four or six grains every three hours during the period of intermis- sion ; in the febres larvatse, or masked fevers, smaller doses may be given, but in the very violent fevers at Calvi, in the Island of Corsica, Levy found it often necessary to give from forty to fifty grains in the twenty-four hours. Of thirty cases of quotidian and tertian infermittents, twenty were cured by the use of the salicine ; ten required afterwards the sulphate of quinine. He considers it to be preferable to the sulphate of quinine in intermittents that are accompanied by irritation in the primes viae : he never saw it rejected or produce vomiting ; and in cases of manifest irritation of the digestive tube, it has been borne perfectly well. 1 Salicine is generally given in intermittents, in the form of powder. In other affections, to obtain its febrifuge or tonic agency, one or two grains may be given four or five times a day — gradually aug- menting the dose. In cases of asthenia of the digestive organs, Yon dem Busch prescribes a powder of salicine and sugar, with the addition of cin- namon ; and lozenges of salicine, sugar, gum arabic, and oil of peppermint. In cases of copious secretion from the mucous mem- branes, especially in chronic bronchitis and leucorrhoea, he directs the salicine to be combined with a decoction of the polygala amara. or of the lichen islandicus. In intermittents, Stegmayer advises it to be associated with small doses of tartrate of antimony and potassa. Pulveres fSalicince. Powders of Salicine. *. Salicin. gr. xij. Sacch. alb. 9ij. Misce et fiat pulvis in partes iv sequales dividendus. Dose. — One, three times a day. Krombholz. Pulveres Salicinai Compositi. Compound Powders of Salicine. 9<. Salicin. gr. xv. Antim. et potass, tartrat. gr. j. Sacchar. alb. J}iiss. Misce et fiat pulvis, in partes x sequales dividendus. Dose. — A powder every two hours. Stegmayer. 1 Archives Medicales de Strasbourg, and Gazette Medicale de Paris, F6vr. 25, 1837. 336 dunglison's new remedies. Misiura SalicincB. Mixture of Salicine. &. Rad. polygal. amar. gvj. Coque cum aquse fontanse 3xij. ad remanent. 3 viij. Colaturse adde Salicin. gr. viij. ad x. M. Dose. — One or two spoonfuls every two hours. Von dem Busch. SAPO COCONEUS. Synonymes. — Soap of the Cocoanut Oil, Sapo Cacaotinus. French. — Savon de Cacoa. German. — Cocosnussulseife. This soap has been much employed in Europe, of late years more especially, as a cosmetic, and it seems well adapted for the pur- pose, except for its peculiar odour, which is by no means agreeable, but may be masked by the addition of some sweet-scented oil. Our object in mentioning it here is to state, that the veteran Hufeland extolled it highly as an efficacious and innoxious application in herpes, not only from numerous trials of it made by himself, but by others, and he affirms, that when it does not effect a cure, it allays the distressing burning and itching. The soap is dissolved in warm water, and the affected part washed with it three or four times a day. SAPO MOLLIS. Synonymes. — Sapo Viridis, S. Niger, S. Kalicus, Soft Soap. French. — Savon Noir, Savon Mou. German. — Schmierseife, Griine Schmierseife. Under this name a soap is used, which is formed by a union of oil with potassa. It is the "sapo ex oleo et -polassd confectus" of the London Pharmacopoeia, and has of late been brought forward in Germany as a remedial agent in cases of itch, 1 and has been employed in many hospitals. 1 Pfeuffer, Beobachtungen iiber die Kralze und ihre Behandlung durch die Schmier- oder griine Seife. Bamberg, 1833. SAPO MOLLIS. 337 MODE OP ADMINISTERING. The treatment of itch by soft soap is directed by Pfeuffer to be carried into etfect in the following manner. Attention is paid to the general health of the patient for a day before the soap is applied. His whole body, with the exception of the head, face, and genital organs, is then besmeared with it, and the application is repeated, morning and evening, for six days. According to the extent of surface of the patient's body, at first two rubbings, of from four to six ounces, are used; at the third and fourth, from two to three ounces, and from the fifth to the seventh inclusive, from half an ounce to an ounce ; but after this, the soap is applied only to those parts which are affected with the eruption or itching. On the eighth day the patient takes a bath of tepid soap and water, and the body and bed linen, which have not been shifted during the cure, may now be changed for cleaner. In dry and warm seasons, the patient is able to leave the infirmary on the tenth day, cured ; but in moist and cold, not until the twelfth or fourteenth. The cure of the eruption is generally effected in seven days, that is, by fourteen rubbings. During the period of treat- ment, the patient must remain in bed, avoid exposure to draughts of air, and reside in a chamber whose temperature is from 73° to 77° of Fahrenheit. On account of the strong smell of the soap, not more than ten patients ought to be permitted to occupy the same room. A full diet may be allowed them. From six to eight hours after the first or second rubbing, a sense of tension and pricking is felt in the skin, which, at times, gradually augments until it amounts to a feeling of burning heat. About the fifth or sixth rubbing, the skin appears of a scarlet hue, without the temperature being materially elevated. In several cases, irritative fever ensues, which disappears in the course of twenty-four hours, with augmented secretion of urine. Miliary vesicles form in groups; sweating takes place freely; the sleep which may have been disturbed for a night or two recurs; the skin desquamates, and the patient does not find his strength in the least exhausted. Should the inflammation of the skin occur earlier than the sixth rubbing, the friction must be pretermitted. Pfeuffer, however, never observed this to be the case. In scrofulous and syphilitic dyscrasies, it may happen, that the friction will have to be repeated once more, and that the patient may have to remain from two to four weeks in the institution. It very generally happens, that this plan excites inflammation of the skin and desquamation of the cuticle: when this is not the case, no change whatever is produced in the eruption. In order to mitigate the distressing feeling of burning produced by the rubbing, one part of flowers of sulphur may be added to two parts of the soft soap. In those cases, in which the disease has existed for years, with II— b dungl 22 338 dunglison's new remedies. greater or less intervals, and in those who were strumous in their youth, or were at a subsequent period affected with syphilis; — in all cases, indeed, in which the cutaneous affection has become, as it were, habitual, Pfeuffer directs, that a cathartic should be pre- mised, and that in the course of the cure, a quart of the decoction of the woods should be taken. This mode of treatment, according to Pfeuffer, is contra-indicated by febrile conditions, especially of the synochal kind ; acute cuta- neous affections; pulmonary and abdominal catarrhs ; pulmonary and abdominal phthisis; chronic headach ; and hereditary or acquired tendency to epilepsy. In such cases, he prefers the internal and external use of sulphur; and, after the cure, the esta- blishment of issues. The great recommendation of this plan of treatment, in hospitals and infirmaries, is said to be its cheapness, although it strikes us, that there cannot be any marked difference in this respect between it and the treatment by sulphur, which is greatly used, on this very ground, in many of the eleemosynary establishments of Germany at this time. 1 The efficacy of Pfeuffer's plan of treatment has been confirmed by numerous observers, — by Graff, Bermann, and Cramer, who is said to have first recommended the soap in scabies ; and by Sicherer, Seytfer, Cless and others, all of whom agree as to its excellence ; they regard it as one of the best methods of treatment in use. SECALE CORNUTUM. Synonymes. — Ergota, Clavis Secalinus, Calcar, Secalis Mater, Secale Luxurians, Ustilago, Clavis Siliginis, Spurred Rye, Corned Rye, The Spur, Ergot, Hornseed. French. — Seigle ergotee, Ble cornu. German. — Mutterkorn, Gebarpulver. The effects, which this substance is capable of exerting on the uterus, are so well known as not to need any lengthened description. Its employment in parturition having been first revived in this coun- try, there are but few who are ignorant of its reputed properties. Certain effects have, however, been ascribed to it, in very recent times, which require mention. The spurred rye or ergot — the latter being the common name it bears from its " spurred" appearance 2 — is generally considered to 1 H. Vezin, Ueber die Kratze und ihre Behandlung nach der englischen Methode, Osnabruck, 1836. See, also, American Medical Intelligencer, Aug. 15, 1839, p. 158. •French, ergot, "aspui." SECALE CORNUTUM. 339 be the result of a disease in rye, occurring most frequently when a hot summer succeeds a rainy spring. Decandolle, however, regards it as a parasitic fungus, and calls it Sclerotium clavus ; whilst Leveille esteems it to be a fungus giving a coating to the diseased grain — the medical virtues residing in the coating. This fungus he calls Sphacelia segetum. Brande refers it to the natural order, Fungacece, and terms it Spermoe'dia clavus, and in the last edition of the London Pharmacoposia, it is referred to the Acinula clavus of Fries; 1 but, according to Lindley, Fries has no such plant in any of his works, and the only species of acinula known, acinula candicans, is found on the rotten leaves of the common alder, and among melting snow; its organization is of another kind from that of the spermoe'dia; and Fries, who regards the other as a morbid state of the grain of certain grasses, con- siders acinula as a true fungus. 2 Recently, Mr. Smith and Mr. Quekett have maintained, that the ergot is not a fungus, but a diseased state of the grain occasioned by the growth of a fungus not previously detected — to this fungus Mr. Q,uekett gives the name Ergotaetia 3 abortans. 4 By the micros- cope, they discovered sporules, sporidia, or jointed bodies, which appeared "to be the reproductive particles of the fungus. EFFECTS ON THE ECONOMY. The effects produced on the animal economy by the ergot, when eaten as food, are extremely injurious : the aggregate of the symp- toms has been termed Ergotism. At times, they are limited to vertigo, spasms and convulsions, with a peculiar tingling or formi- cation in the arms and legs, which has given the affection the name' among the Germans of Kriebelkrankheit, or "creeping disease." Most commonly, the limbs waste away, lose sensation and the power of motion, and separate from the body by dry gangrene — constitut- 1 Syst. Mycol. 1 Brande's Dictionary of the Materia Medica, p. 233, Lond. 1839. See, also, Venus, Grundriss der medicin. Receptirkunst, u. s. w. S. 347. Weimar, 1838. 3 From ergota, and mthc, " cause." * London Lancet, June 22, 1839, p. 465. See, also, an abridgment of a communication read by Mr. duekett before the Linnscan Society, Nov. 4, 1S38, with illustrative woodcuts, in American Journal of Pharmacy, for July, 1839, p. 116. For remarks on an insect met with in the diseased grain, see a paper by Mr. Muller, of Butler county. Pa., with comments by Dr. Carson, in Amer. Journal of Pharmacy for Jan., 1839, p. 269. M. De- bourge considers, that the ergot is an animal product from the telephorous family. The insect deposits a liquid of its own formation on a grain of rye and produces the ergot; whence it follows, he conceives, that the ergot may be produced at pleasure by expressing this liquid upon all the grains of rye that are within a certain period of their maturity. Socieles Savanles, in Encyclographie des Sciences Medicales, Avril, 1838. 340 dunglison's new remedies. ing gangrenous erethism or mildew mortification} These, how- ever, are the toxical, not the therapeutical effects of the agent. 2 The extraordinary property, ascribed to the ergot, of assisting the parturient efforts has long been credited in Germany. Its old Ger- man names, Mutterkorn (" wombgraiu") and Gebarpulver ("par- turient powder") are sufficient evidences of this notion ; but, for a long time, this was rather a matter of popular than of scientific belief, although the " pulvis parturientis" of the Marburg Pharma- copoeia consisted principally of ergot. About eighty years ago, it was recommended in this country by Dr. John Stearns, of Saratoga county, New York, and since that time the weight of testimony, adduced in its favour on both sides of the Atlantic, has be Hoffman, in Berk Med. Zeifung, June 29, 1S36. 2 Duparcque, Revue Medirale, Mars, 1838. 3 Von Busch, Op. cit. i. 105. 4 Philad. Journ. of Med. and Phys. Science, v. 44. 6 System of Midwifery. 6 Lancet, April 15, 1837. 7 Ibid, April 22, 1S37. 8 Enriotti, in Repertorio Medico-Chirurgico del Piemonte, and Journal des Connoissances, Mars, 1838. 9 Annali Universali di Medicina, Feb. 1831, and Ryan, Medical Formu- lary, p. 264, 3d edit. Lond. 1839. 10 Miiller in Rust's Magazine, B. xl. H. iii. and Amer. Journ. of the Med. Sciences, Feb. 1835, p. 527; and Ryan, Op. cit. 11 Mojon, Op. cit. 12 Duparcque, Op. cit. 13 See some remarks on this subject, by the Author, in American Medical Intelligencer, vol. i. p. 219. u Amer. Journal of the Medical Sciences, Nov. 1833, p. 279. 15 Revue Medicale, Fevrier et Mars, 1839; in Encvclogiaph. des Sciences Medicates, Avril, 1829. SECALE CORNUTUM. 345 essentially an excitant of the spinal marrow ; and he conceives, that its action on the uterus, bladder, and muscles of the lower extremities is but secondary, from a reflex action transmitted from the spinal marrow to those organs through the nerves distributed to them. He has given the details of some cases of paraplegia, which seemed to be relieved by the ergot ; an infusion of fifteen grains in water being given at first in the course of the day, and the dose being gradually augmented. M. Allier fits, 1 from having observed, as he believed, contraction of the fibres of the bladder under the administration of ergot, has recommended it highly in cases of retention of urine ; and feels himself justified in inferring, from the results of varied observation, that it is capable of restoring to the bladder the contractility it may have lost owing to immoderate distension of its coats by accumula- tion of urine : — that its action has been evinced in cases in which this kind of paralysis has resisted all known therapeutical agents ; and that, owing to the fugacious character of its operation, it ought to be administered at short intervals, in broken doses, and these long continued. M. Allier recommends, that it should be commenced in the quan- tity of a scruple, divided into six equal parts, that the dose should be afterwards raised to forty grains, and then gradually diminished to a scruple ; and afterwards discontinued by degrees in eight or ten days after the cure, to consolidate it. MODE OF ADMINISTERING. The great difference that has been observed in the effects of the secale cornutum has led to the belief, that there must be much difference in the article, and that every care must be taken to have it good. Dr. Ryan, 2 indeed, affirms that not one druggist or chemist in a hundred has it genuine. It must be recently pulverised, too, if we.are desirous to count upon its action when given in this form. 3 When prescribed with the view of augmenting the parturient energy, it is most commonly perhaps given in powder, in the dose of from ten to twenty grains, repeated every twenty minutes until the effect upon the uterus is elicited. Professor Von Busch 4 found the best results when it was given in the dose often grains at short intervals — from ten to fifteen minutes. In one case it was requi- site to repeat it eight times ; in four cases, six doses were sufficient ; in twelve, five; in thirty-three, four, and in the remainder of the one hundred and seventy-five cases, three and less; the smallest quantity exhibited was a single dose often grains; the largest, nine 1 Journal des Connoisances Medico-Chirurgicales, Nov. 1838. 2 Formulary, p. 264. 3 Allier, Op. cit. * Op. cit. S. 106. 346 dunglison's new remedies. doses often grains. Dr. Ryan 1 says the maximum dose is a dram and a half; but it, obviously, cannot be thus limited. Dr. Hooker, who considers, that the ecbolic and the narcotic properties of the ergot may be separated^ recommends, in these cases, the clear infusion, which possesses, he conceives, the former property only. The powder of course contains both. Dr. Bishop, of New Haven, 2 asserts, that he has never seen but once any unpleasant effects from the use of the ergot, and then he gave it in powder ; the labour was protracted and narcotism induced. In New Haven, he remarks, it is the general practice to administer the infusion, and in that form it is considered safe and effective in parturition. It is proper, however, to remark, that the form of infusion as well as of decoction was found by Dr. Jbrg to be highly un- pleasant to the stomach, and it could not be repeated in his experiments, which, it must be remembered, were not made on the parturient female — in large doses for any length of time, without irritating the bowels, producing loss of appetite, and general impairment of the digestive function. Notwithstanding this we believe both the infusion and decoction to be desirable forms of administration, in the cases under consideration. As to the form of tincture, Mr. Battley affirms, that spirit will not extract the active property, and Dr. Ryan 3 states, that he has certainly found the tincture to fail in the majority of cases. Mr. Battley prefers the watery extract. For the purpose of inducing premature labour, it has been neces- sary to give it in larger doses. Dr. Paterson 4 gave it in the form of the infusion below, until the patient took six drams of the medicine. The infusion was likewise given by Dr. F. Rams- botham, 5 and the quantity each of his patients took varied from two to twelve drams. When the secale cornutum is given with other views, the usual dose is 10 or 15 grains of the powder given three or four times a day; the results of the observations of Dr. Cottman 6 have shown however, that in 30 grain doses its sedative effects are more marked. This, too, was the dose in which it was administered by Dr. Hooker. In such cases, the tincture, and the light oil described by Dr. Hooker may also be prescribed: the latter in the dose of ten tp thirty drops. 1 Op. cit. * American Medical Intelligencer, Dec. 15, 1837, p. 330. 3 Op. cit. p. 266. * Lond. Med. Gaz., June 1. 1839, p. 333. 6 Ibid, June 15, 1839, p. 421. * American Medical Intelligencer, Sept. 1, 1839, p .161. lnfunde. SECALE CORNUTUM. 347 Infusum Secalis Cornuti. Infusion of Ergot. Secalis cornuti, gj. Aquae ferventis, ^iv. Dose. — One third, to be repeated every 15 or 20 minutes, in de- ficiency of uterine contractions. It. Secalis cornuti, ^ss. Aquae ferventis, gxxiv. Colaturae adde Syrup, simpl. £j. Dose. — Two ounces every three or four hours, to induce prema- ture labor. Paterson. #. Secalis cornuti, Jss. lnfunde per semihoram in Aquas bullientis, §iss. et cola. This quantity to be taken for a dose, and repeated every four hours. F. Ramsbotham. Decoctum Secalis Cornuti. Decoction of Ergot. 5<. Secalis cornuti, ^j. Aquae, Oijss. Coque ad Oij. et cola. Dose. — A table-spoonful every quarter of an hour. Tinctura Secalis Cornuti. Tincture of Ergot. 5<. Secalis cornuti, §ijss. Spirit, tenuioris, Oj. Macera per dies quatuordecim et cola. Dose. — Twenty mimims to two drams, two or three times a day, as a sedative agent. Guy's Hospital, j Pulveres Secalis Cornuti Compositi. Compound Powders of Ergot. (Antihemorrhagic Powders. — Ryan.) 5<. Secalis cornuti, £ss. Pulv. cinnam. comp. 9ss. Sacch. purif. s>ss. M. et divide in chartulas x. Dose. — One every hour or every second or third hour in active hemorrhage from any outlet. In leucorrhoea and gleet, one may be given three or four times a day, and should they fail the following may be substituted. 348 dunglison's new remedies. 5<. Secalis cornuti, £)ij. Pulv. cubebar. §j. P. cinnam. c. £ss. Saccbar. purif. 3j. M. et divide in chartulas viij. Dose. — One, three or four times a day. Ryan. SOD.E CHLORIDUM. Synonymes. — Soda Chlorinata, Sodae Cbloruretum, Chloruretura Oxidi Sodii, Sodae Oxymurias, Natrum Chloratum, N. Chloricura, N. Oxymuriati- cum, Chloride of Soda, Hypochlorite of Soda, Labarraque's disinfecting Liquid ; Chloruret of Soda, Chlorite of Soda, Chlorinated Soda. French. — Chlorure de Soude, Chlorure d'Oxide de Sodium. German. — Chlornatron. This preparation resembles in almost all respects the chloride of lime. (See Calcis Chloridum p. 83.) Both it and the chloride of potassa were associated by Berthollet under the common name Eau de Javelle, or bleaching liquor, and it has of late generally received the name of Liqueur de Labarraque. METHOD OF PREPARING. Labarraque 1 recommended it to be prepared directly by passing a current of chlorine into a solution of subcarbonate of soda. The following is the formula in the last London Pharmacopoeia for the Liquor Sodce Chlorinatm, the Liquor Sodce Chloridi, Aqua. Natri Oxymuriatici. German, Oxydirt-salzsaures Natronwas- ser, or Labarraque's disinfecting liquid. "Take of carbonate of soda, a pound ; distilled water forty-eight fluid ounces ; chloride of sodium, four ounces; binoxide of manganese, three ounces; sul- phuric acid, four ounces. Dissolve the carbonate of soda in two pints of the water; then put the chloride of sodium and binoxide of manganese, rubbed to powder, into a retort, and add to them the sulphuric acid, previously mixed with three fluid ounces of water, and cooled. Heat, and transmit the chlorine first through five fluid ounces of water, and afterwards into the solution of carbonate of soda above directed." When the solution of chloride of soda is properly prepared, it has a yellow colour, a sharp, saline, and astringent taste, and an odour of chlorine. By careful evaporation, it yields crystals which produce the original liquid when re-dissolved. When the solution 1 Gazette de Sante, April 25, 1826. S0D/E CHLORIDUM. 349 is exposed to air, and allowed to evaporate spontaneously, it gives out chlorine, and yields crystals of carbonate of soda. 1 EFFECTS ON THE ECONOMY. In its general remedial agency, the chloride of soda resembles the chloride of lime, and has been administered both internally and ex- ternally in the same cases. It is preferred, however, for internal, whilst the chloride of lime is generally chosen for external, use. By Bouillaud, Chomel and others it has been given, with ad- vantage, in typhous fevers ; and by Kretschmar, 2 Lalesque, Colson, and Gouzee 3 in intermittents : 4 ten cases are reported by the last named gentleman; in two, the intermittent yielded immediately; two others were cured after a slight return ; in one there were four attacks, gradually diminishing; in two cases, the severity of the paroxysms abated, but it was thought necessary to have recourse to the sulphate of quinine; in two others no effect was produced, and in one, the disease was aggravated. Gouzee infers, that these cases prove the febrifuge properties of the chloride of soda to be less marked that those of the sulphate of quinine, and, therefore, that it ought not to be trusted to, except in the slighter cases, and where the patients are easily susceptible of the effects of medicine, — as women and children. In like manner, it has been found useful in scrofulous affections, and in various diseases in which the chloride of lime has proved serviceable. See Calcis chloridum. MODE OF ADMINISTERING. From ten drops to a dram may be given internally for a dose, mixed with plain or sugared water. The form in which it was prescribed by Gouzee, in inter- mittents, was a mixture, composed of half a dram of the chloride to four ounces of distilled water. This was taken by spoonfuls during the apyrexia ; so that the last dose should be swallowed shortly before the next paroxysm was expected. The patients were restricted to their beds, or at least to their chambers. When applied externally, it is rarely used pure or diluted with so little as one half water, except in cases of asphyxia, and gan- grene, and for dressing old ulcers, &c. Most commonly it is diluted with five to ten parts of water, and in this strength is applied to ulcers of various kinds, burns, cutaneous diseases, &c. When used as a disinfecting a^ent, itjismost commonly diluted with ten, twenty or thirty times its weight of water. 1 Faraday, Quarterly Journal of Science, N. S. ii. 84, cited by Brande, Dictionary of the Materia Medica, p. 508, Lond, 1839. * Venus, Grundriss der medicin. Receptirkunst, S. 67. Weimar, 1838. J Revue Medicale, Fevricr, 1836. 4 Riecke, Die neuern Arzneimittel, S. 334. 350 dunglison's new remedies. SPILANTHUS OLERACEUS. Synonymes. — Spear-leaved Spilanthus. French. — Cresson de Para. German. — Falsche Fleckblume. This plant, which is a native of South America, being an annual of very rapid growth, succeeds well in the climate of the United States. A tincture of it has been much recommended in France and Germany, as an arcanum, in toothach. Of late, its preparation has become known. Riecke 1 terms it the Tinctura Spilanthi oleracei composita, (Paraguay — Roux, Paratinktnr.) It is pre- pared in the following manner. Take of the leaves and blossoms of the inula bifrons — a species of elecampane growing in Italy and the southern Pyrenees — one part ; the blossoms of the spilanthus oleraceus, obtained from South America, and from which the Drs. Bahi formerly made their elixir odontalgicum,., four parts ; roots of the anthemis pyrethrum, one part; alcohol at 33° (s. g. .863) eight parts. The solid matters are divided into small pieces, and with the alcohol are placed in a flask for digestion, which is closed ; the mixture is suffered to digest for a fortnight, at the expiration of which time it is filtered, and then preserved in closed vessels. 2 This tincture is said to relieve toothach instantaneously, when applied to the gums and tooth, and Hufeland affirms, that multitu- dinous experiments in Berlin have proved its value. If the relief be transient, the application must be repeated. It contains nothing narcotic, or which can injure the teeth ; and consequently no unusual precaution is requisite in its use. Heyfelder, who often tried it, considered it very uncertain, — at first affording relief, but afterwards none at all. STRYCHNINA. Synonymes. — Strychninum, Strychnia, Strychna, Strychnine, Vauqueline. French. — Strychnine. German.— Stry chn in. This alkaloid was discovered by Pelletier and Caventou 3 in the mix vomica, St. Ignatius's bean, upas tieute, and in the wood of the strychnos colubrina ; and experiment has shown, that these sub- stances are indebted for their medicinal properties to it. 4 1 Die neuern Arzneimittel, S. 395. 8 Journal de Pharmacie, ix. 586. s Annales de Chimie, Tom. viii. ix. & x. 4 Magendie, in Annales de Chimie, x. 1 76, 1819. STRYCHNINA. 351 In those different substances, strychnine is found associated with another principle analogous to it in its properties — brucine.' In the St. Ignatius's bean, there is less brucine than in the nux vomica, so that it is best adapted for the preparation of strychnine ; but it is not as easily obtained, and consequently the nux vomica is almost always — if not always — used. METHOD OF PREPARING. A solution of liquid subacetate of lead is added to a solution of the alcoholic extract of nux vomica in water, until a precipitate is no longer thrown down; the foreign matters being thus precipi- tated, the strychnine remains in solution with a portion of colouring matter, and sometimes an excess of acetate of lead. The lead is now separated by sulphuretted hydrogen ; and the fluid is filtered and boiled with magnesia, which unites with the acetic acid, and precipitates the strychnine. The precipitate is next washed in cold water, and re-dissolved in alcohol to separate it from the excess of magnesia, and by evaporating the alcohol, the strychnine is obtained. If it be not perfectly white, it must be re-dissolved in acetic or hydrochloric acid, and reprecipitated by means of magnesia. Strychnine, obtained by crystallisation from an alcoholic solution, which has been diluted by means of a small quantity of water, and left to itself, appears under the form of microscopic crystals, consti- tuting foursided prisms, terminated by pyramids with four flattened or depressed faces. When crystallised rapidly, it is white and granular, is insupportably bitter to the taste, and leaves an after taste similar to that caused by certain metallic salts; it has no smell, and is not changed by exposure to the air; is neither fusible nor volatile ; for, when subjected to the action of heat, it does not fuse until the moment of its decomposition and carbonisation, and it is decomposed by a degree of heat inferior to that which destroys most vegetable substances. When exposed to the naked fire, it swells, becomes black, and yields an empyreumatic oil, a little water, acetic acid, carbonic acid, and carburetted hydrogen. Distilled with deutoxide of copper, it gives out much carbonic acid, and only slight traces of azote. It is composed, therefore, of oxygen, hydro- gen and carbon. Although strychnine has so strong a taste, it is scarcely soluble in water. At 50° Fahr. 6667 parts of water dissolve but one of it; boiling water dissolves a little more than double, so that it may be said to be soluble in 2500 parts of boiling water. It is remarkable, however, that a solution, made in the cold, and containing, there- fore, only etfVtfth P art °f i [s weight, may be diluted 100 times, and still retain a very decidedly bitter taste. It is pretty soluble in strong alcohol, little so in weak, and not greatly so in ether or fixed oils, although they acquire a bitter taste from it. On the other 1 See page 78. 352 dunglison's new remedies. hand, it is very readily soluble in volatile oils, and the hot satu- rated solution, on cooling, deposits crystals. It has an alkaline reaction, and forms, with acids, salts which are mostly crystallisable, and insupportably bitter, and are more soluble than pure strych- nine. 1 EFFECTS ON THE ANIMAL ECONOMY IN HEALTH. The effects of strychnine on man and animals resemble, on the whole, those of the spirituous extract of nux vomica, except that they are more intense. According' to Magendie. one eighth of a grain is sufficient to kill a strong dog. Pope, who made experiments on dogs, found, that T Vth of a grain was enough to paralyse the lower limbs of a small dog in four or five minutes, and in half an hour to kill it. Ohristison 2 considers strychnine the strongest poison after the hydrocyanic acid. He injected a solution of a third of a grain in alcohol into the thorax of a wild boar, and in ten minutes the animal died. A dog was destroyed by jth of a grain in two minutes; and he believes that the same effect would be induced on a man by half a grain introduced into a wound. Lembert 3 observed similar results from placing a grain in the thorax of a small dog, and from three grains introduced into the cellular tissue of a larger animal, on which tetanic spasms were induced in the thoracic muscles. Mr. Blake 4 injected a grain of strychnine, dissolved in a small quantity of acetic acid, into the veins of a dog. The first effect of the poison was to induce general convulsions in about thirty seconds after its injection, the action of the heart being at the same time rendered irregular, which Mr. Blake presumes was owing to the convulsive struggles of the animal. All external signs of life ceased in about a minute and a half after the injection of the poison — the heart still continuing to beat. He found, that when strych- nine was introduced into the circulation in so small a quantity as not to produce any general symptoms, it did not appear to exert the least influence on the heart. That the action of strychnine is analogous to that of the nux vomica, has been proved by the experiments of Segalas, 5 Andral, 6 Bardsley, 7 Redlich, Sandras, Liiders, Hennemann and numerous others. 8 It affects especially the spinal marrow and the ganglionic system, — less strikingly the brain ; small doses excite the gan- 1 Magendie's Formulaire, &c. * Treatise on Poisons, 3d edit. Edinb. 1836. 3 Essai sur la Methode endermique, Paris, 1828, 8vo. 4 Edinburgh Medical and Surgical Journal, Apl. 1S39, p. 338. 6 Magendie's Journal de Physiologie, ii. 4. •Ibid, Juillet, 1S23. 7 Hospital facts and observations, illustrative of the efficacy of strychnia, brucia, &c. Lond. ]830. 8 Petrequin, Gazette Medicare de Paris, No. 44, Nov. 1838. STRYCHNINA. 353 glionic system; larger, the spinal marrow; consequently, it has been properly imagined, that it might be an efficacious remedy in nervous diseases, which are dependent upon spasmodic disorder in the ganglionic system, or on diminished sensibility and torpor of the nerves of motion. The following are the effects observed by Oppler from the inter- nal use of the nitrate of strychnine: — a sensation of warmth and itching in the epigastrium; eructation; nausea; vertigo; slight excitement like that of intoxication ; great vividness, with more or less confusion of mind; dull pain over the eyes; spots before the same; dilatation of the pupils; diplopia; tinnitus aurium; difficult articulation and deglutition ; slight trismus; sense of formication in the paralysed parts; convulsive motions or twitchings, at times in those parts, at others over the whole body, similar to electric shocks ; tremors of the muscles; occasionally violent spasms; tetanus; asthma; palpitations; febrile heat ; general sweating ; prostration; pale or livid countenance; pulse, sometimes full and frequent, at others small and contracted ; great sensibility over the whole body; involuntary laughter, succeeded always by difficulty of breathing and convulsions. The sleep was generally interrupted by convul- sions ; the secretion of urine scanty, and occasionally suppressed. These symptoms came on gradually, and disappeared in the same manner, when the dose was moderate, in the course of some hours. Large doses induce death by a sudden shock to the nervous system ; smaller doses, when continued for a long time, may destroy by causing apoplexy, of which Oppler saw many examples in his experiments on animals. 1 Dr. Blumhardt, of Stuttgart, 2 has published a case of poison- ing by strychnine, which occurred lo him in Stuttgart, and which is perhaps the only fatal case on record, of which we have the details. He was called to a young man, seventeen years old, who had swallowed two scruples of strychnine after his dinner. A short time afterwards, experiencing great restlessness, he repented of what he had done, and immediately took four grains of tartar emetic, which excited considerable vomiting. When the physician arrived, about a quarter of an hour after he had taken the strych- nine, he found the patient on his back in bed, with his head thrown back, rigid and incapable of motion, but with a constant inclination to turn towards the right side. He could only move the upper limbs freely. The countenance was pale and haggard ; the tem- perature of the skin natural, and the pulse quick and contracted. Consciousness remained unaffected ; the speech was rendered difficult by an occasional contraction of the muscles that move the lower jaw; but it could not properly be said to be interrupted; deglutition was untouched. The trismus, however, became more 1 See, also, Tanquerel des Planches, Essai sur la Paralysie de Plomb. Paris. 1834. 2 Medicinisch.Corresnondenz Blatt, in Encyclog. des Sciences Mcdicaleb, Sept. 1837. 11— c dungVZZ 354 dunglison's new remedies. and more frequent and violent, and the respiration thereby unequal and suspended; the pulse was small, suppressed and quick. The remedies — employed to save him — as the tincture of iodine and the acetate of morphine were of no avail. With the periodical trismus was now associated spasmodic agitation of the whole body, to which — after a short interval — succeeded opisthotonos with violent symptoms of suffocation ; the trismus attained the highest degree, and the upper extremities were deprived of the influence of volition. With the increase of the general tonic spasm, the respiration was always more difficult and oppressed, and for a time wholly ceased; the pulsation of the heart and arteries became irregular, less distinct and at length imperceptible. In this condition, the skin acquired a bluish appearance ; the countenance was puffed, and of a violet hue ; the lips dark blue, the neck swollen, the eyes protruded, fixed and directed towards the right side; the pupils enlarged, and immovable, and the conjunctiva injected. At this period, the patient was entirely unconscious ; but from this condition he awoke once, and all the symptoms became mitigated ; during this remis- sion, the muscles, influenced by the spinal marrow, remained cramped, except the upper extremities, which could be moved voluntarily. In a quarter of an hour, the tetanic attack returned in its violence, with intense commotion of the whole body; this ended in asphyxia, from which he again recovered to consciousness. The same thing happened in a third attack. In the fourth, he succumbed under the power of the poison. The whole scene from the taking of the poison to the occurrence of death lasted an hour and a half. During the last attack, as doubt existed whether he was really dead, the median vein of the left arm, which was turgid, was opened, and after the vessel was emptied of its thick, black blood, which resembled that of an animal, several bubbles of air, from the size of a pea to that of a small cherry, were forced out by pressure. The dissection was made twenty hours after death. In spite of the elevated summer heat, there were no signs of putrefaction ; the whole body was uncommonly rigid. The muscles of the back were of a brownish red colour, almost like that of smoked meat. On opening the spinal canal, a considerable quantity of thick, dark coloured blood, like that of an animal, flowed out. The plexus venosi spinales were turgid with the same kind of blood, as well as the vessels of the pia mater. Under this membrane, especially in the cervical portion, some watery fluid was effused. The upper portions of the spinal marrow were soft, even pappy in some places, but lower down it became gradually harder. Within the cavity of the cranium, the same turgid condition of vesselsexisted; all the veins of the dura mater appeared as if injected ; the veins of the pia mater were likewise engorged ; and the whole mass of the brain indicated an unusual supply of blood, so that the cortical substance appeared quite blue. The cerebellum was softer than usual. STRYCHNINA. 355 poverty of blood was perceptible. The heart was shrunken and empty, as well as the large vessels of the thorax. The stomach was full of solid food, which appeared to have undergone no change: its blood vessels contained a considerable quantity of blood, and the mucous coat exhibited marked redness over its whole surface; but it was especially concentrated about the cardia and the fundus; the small intestine was likewise redder than natural, as is commonly the case in those who have died whilst digestion was going on. The liver was tolerably supplied with blood ; the gall bladder empty. When strychnine is used endermically, as is not unfrequently done, the course of the phenomena is somewhat different. G. H. Richter, employed it in this way in many cases of hemiplegia, in one of which it occasioned symptoms of actual poisoning. When the dose exceeded a quarter of a grain, a feeling arose in the part to which it was applied as if needles were run into the skin; this gradually spread over the whole limb; the temperature of the body was augmented; the pulse quickened, full and hard ; the breathing constrained ; pain was experienced in the same side of the head ; the secretion of urine was increased, and a general perspiration broke out, which persisted for about an hour, after which the pricking of the surface, and the excitement of the vessels ceased. To these symptoms — and seldom later than two hours after the application of the agent — convulsive movements succeeded in the paralysed limbs like those induced by electricity, which aug- mented in violence and frequency with the increase of the dose, being strongest and most severe during the night, at which time the limbs were moved involuntarily. When awake, a feeling of stiff- ness was experienced in all the limbs, which passed off when they were used. On digestion, defecation, and the appetite, the nitrate of strychnine seldom exerted any influence. Only in one case — in which no effects were induced on the nervous system, when the dose was gradually carried to three grains — was obstinate consti- pation produced. In general, when it was begun with in the dose of one-eighth of a grain, and on the next day one-fourth was given, on the third day one-half, and afterwards the dose was increased daily by the fourth of a grain, until one and a quarter was given, — the following unpleasant symptoms supervened. The patient expe- rienced twitchings earlier than before, and first in the paralysed limbs. As these, became, from minute to minute, more violent, a penetrating pain was felt in the occiput, with vertigo and tinnitus aurium. The twitchings now extended over the affected arm, and, subsequently, to the sound side, whereupon the vertigo and headach augmented, and insensibility, with difficult and stertorous breathing, ensued. The pulse now became very full, hard, slow, and intermitting; the countenance bluish red and turgid; the paialvsed lower extremities of a marbled blue; the pupils very much dilated and the mouth open : the convulsions being occasion- ally so strong as to toss him to and fro on the bed. When these 356 dunglison's new remedies. phenomena declared themselves, Richter removed the dressing, from the surface, which appeared inflamed, and still contained a quantity of strychnine, that had not been absorbed; the parts were then washed, and sprinkled Immediately — according to Lembert's and Lesieur's recommendation — with two grains of the acetate of morphine ; the face was washed with cold water, the soles of the feet brushed, and other excitants administered. 1 Morphine appears to be the most powerful antidote: under its use, the dangerous symptoms rapidly disappear, consciousness returns; the patient sleeps for some hours, and a general perspiration breaks out, after which he awakes with a feeling of dulness, and with stiffness of the limbs, which soon, however, vanish. In respect to the topical application of strychnine by the endermic method, A. L. Richter 2 remarks, that the preparations of strychnine produce much more powerful local effects than those of morphine ; they maintain the abraded portions of the skin in an inflamed state, promote suppuration more than the morphine, and occasion violent itching and burning, with a feeling as if needles were run into the skin. Artus recommends, from his investigations, pure baryta (Aetzba- ryt) as an antidote. It forms an insoluble precipitate with strych- nine, and he esteems it to be more certain than the tinctures of iodine and bromine recommended by Donne, 3 the muriate of baryta, or the infusions of tar and galls recommended by Raspail. 4 The effects, referred to above, were chiefly obtained from the administration of the nitrate of strychnine, but they may be es- teemed applicable to all the preparations of strychnine, as we know nothing of any difference in their agency. It is probable, however, that the salts of strychnine, owing to their greater solubility, may have more action than the strychnine itself, although the muriatic and acetic acids, which are almost always present in the stomach, it might be presumed, would readily unite with it. EFFECTS ON THE ECONOMY IN DISEASE. The following remarks apply equally to the pure strychnine, and its salts, and to the alcoholic extract of mix vomica, to which the reader is referred, (see page 276.) It has been administered in 1. Paralysis, especia'ly in that arising from the action of lead, in which Bally, Lembert, Bardsley, Andral, Rayer and Tanquerel, 5 have employed it beneficially. In paraplegia and hemiplegia, it has been prescribed by Lesieur, G. H. Ritchter, Romberg, Bards- 1 See some experiments, relative to the action of strychnine on the nervous system, by Dr. H. Stannius, in Mailer's Archiv. Heft. ii. 1837; and Brit, and For. Med. Review for Jan. 1838, p. 221. 2 Die endermatische Methode, u. s. w. Berlin, 1835. 8 Journal de Chimie Med. v. 494, Paris, 1829. 4 Nouveau Systeme de Chimie organique. Paris, 1833. 8 Gazette Medicale, pour 1835, p. 383. STRYCHNINA. 357 ley, Bally, Lafaye, Oesterlen, Reinhardt, Heyfelder, Faye, Mart, Schaible, Raciborski, A. T. Thomson, 1 Gellie, 2 and numerous others. 3 From the results of their observations it would seem, that strych- nine is most efficacious in paraplegia ; less so in hemiplegia, although it has often been given with advantage in the latter affection; but its administration in hemiplegia requires special circumspection, particularly when the paralysis has succeeded to apoplexy. 4 Romberg affirms, that, as a general rule, in cases of paralysis dependent upon disease of the central organs of the nervous system, he has never seen any striking effect from the endermic use of strychnine, and that great care is needed lest it should react inju- riously on the brain. He considers it especially adapted for cases of paralysis, that are dependent upon some affection of the spinal marrow induced by mechanical concussion ; as well as for the local paralysis that succeeds rheumatism, suppressed exanthems, &c. Mr. Pereira 5 has seen it very serviceable in that shaking or trembling action of the muscles, which is produced by habitual intoxication. G. H. Richter cured a case of aphonia by it, and it has been much used, and successfully, in amblyopia and amaurosis, by Short. Liston, Guthrie, Middlemore, 6 Henderson, Mart, Petrequin 7 and others. In these cases, it is generally used endcrmically on the temporal region. Dr. Stevenson, 8 derived benefit from it — when applied in this way — in cases of amaurosis of many years' duration. Half a grain was repeated twice a day until tremors of the limbs were produced. He employed it in the same manner in other cases of local paralysis. In cases of amaurosis, Henderson advises, in addition, that a solu- tion of strychnine should be dropped into the eye. It has likewise been gfiven successfully in cases of paralysis of the bladder by Schaible, Bally, Hennernann, Behrend 8 and others, and in paralysis of the facial nerve. 9 In high grades of paraplegia, the internal use of the remedy is to be preferred, but in general the endermic administration is more advisable. In paralysis of the limbs, a spot is selected in the vicinity of the spinal marrow. Strychnine is likewise given in other affections. Very favorable reports have been made as to its efficacy in ' Lond. Med. Gaz. April, 1831. 2 La Lancette Franchise, Aoiit 29, 1837. 8 Petrequin, Gazette Medicale, Nov. 1S38. 4 See Bally, Considerations sur la Strychnine, &c. in Bullet. General de Therapeutique, Fev. 1838. 6 Medical Gazette, Vol. xix. 8 Midland Medical and Surgical Reporter, May and August, 1831. 7 Bulletin General de Therap. Juillet. 1838. 8 Transactions of the Medical and Physical Society of Calcutta, Vol. v. 9 Medicin. Zeitung, Sep. 1837. S. 190. 10 Dr. O'Brien, Med. Chirurg. Review, and L'Experience, Nov. 1838. 358 dunglison's new remedies. 2. Neuralgia. Mart found it beneficial in tic douloureux and in nervous headach, and Magnus in a case of neuralgia of the arm. 3. Traumatic tetanus. In this disease, it has been recommended by Liiders. 4. In Hysteria, Hypochondriasis, and Dyspepsia? it lias been advised by Schmidtmann and Basedow, but morphine appears to render more essential service. 5. In Chorea, Romberg saw good effects from it. It has likewise been advised in epilepsy' 1 and catalepsy. Fricke has administered it successfully in — 6. Syphilitic Osteocopi. It has also been given with benefit in cases of 7. Dysentery and Diarrhoea, 3 by Bardsley, 4 Recamier, Geddings, and others, and it has been used endermically in cholera, — two or three grains being applied to a blistered surface on the nape of the neck. By MM. Dreyfus, Grimaud d'Angers and Potton it was given internally in the same affection to allay vomiting: — a quar- ter to half a grain being added to three ounces of water and prescribed in the dose of a spoonful every hour. 5 Dr. Ryan, 6 asserts, that he has repeatedly known a few of the pills — the for- mula for which is given below — check a profuse diarrhoea with rice coloured evacuations, and even when the extremities were blue in malignant cholera. Lastly. From its efficacy in analogous affections of the digestive mucous membrane, Dr. Stokes 7 thinks there is good reason to hope, that it may prove useful in bronchitis. It has been employed, indeed, in all the cases in which the alcoholic extract of nux vomica has been found of service, than which it is of course to be more relied upon, in consequence of its greater uniformity ; the nux vomica itself being often found unequal. (See page 278.) METHOD OF ADMINISTERING. Pure strychnine is best exhibited internally, in the form of pill, or in spirituous solution; but if a little acid, especially the acetic, be added to it, it may be given in watery solution, as in this way a salt of strychnine may be formed extemporaneously. The dose is from one sixteenth to one eighth of a grain, which may be gradu- ally increased until a grain is taken. In ordinary cases, it will be sufficient to raise the dose to half a grain, two or three times a day, but if any circumstance should arise to cause its discontinuance, it 1 See, also, Dr. Melcombe, in Lond. Med. Gaz. for Mar. 4, 1837. p. 850. 2 Brofferio, in Repertorio Medico-chir. di Torino, 1S25, and Revue Medi- cale, ivi 4S8, Paris, 1825. 3 Op. cit. 4 N. American Archives, No. 2, Nov. 1834. 6 Merat & De Lens, Diet, de Mat. Med. Art. Strychnine. 6 Formulary, 3d. Edit. p. 335, Lond. 1839. 7 Treatise on diseases of the Chest, p. 125, Dublin 1837, and Araer. Med. Library Edit., Philad. 1838. STRYCHNINA. 359 ought not to be recommenced in doses as large as the last, but with small doses, as at the beginning. In the endermic application of the remedy, we sprinkle, twice a day, a quarter of a grain on the denuded surface, and slowly increase the quantity to half a grain, should this be necessary. If the larger doses do not act more bene- ficially, if will be advisable to discontinue the remedy for a few days — after which the smaller doses may again exert a signal influ- ence — rather than to carry the dose still higher. Pilulce. Strychnines. Pills of Strychnine. 5<. Strychnin, pur. gr. ij. Conserv. rosar. £ss. Divide in pilulas xxiv. Dose. — One to two, morning and evening. Magendie. S<. Strychnine, gr. j. Confect. ros. gss. Pulv. glycyrrhiz, 9ss. Divide in pilulas xij. Dose. — One, night and morning. The quantity may be increased to four or five daily. Ryan. Tinctnra Strychnines. ?;. Strychnin, pur. gr. iij. Alcohol, 36° (.837) |j. M. Dose. — Six to twenty-four drops, twice or thrice a day. Magendie. Mistura Strychnines. (Potion Stimvlante.) Mixture of Strychnine. r>. Aq. destillat. ,^ij. Strychnin, gr. i. Sacch. alb. gij. Acid. acet. gtt. ij. M. Dose. — A dessert-spoonful, morning and evening. Magendie. Collyrium Strychninm. Collyrium of Strychnine. r>. Strychnin, gr. ij — iv — vj — viij. Acid. acet. dil. Aq. destillat. aa. §j. M. Two drops to be let fall into the eye, a few times a day, in amaurosis. Henderson. 360 dungltson's new remedies. STRYCHNINE ACETAS. Synonymes. — Strychnium Aceticum, Acetate of Strychnine. German. — Essigsaures Strychnin. In addition to the acetate, formed extemporaneously, as mentioned under strychnine, the proper acetate of strychnine has been admi- nistered, especially by Luders and Fricke. It may be made, like the acetate of quinine, from the direct combination of the strych- nine with acetic acid. According to Thenard, it is very soluble, and crystallises with difficulty. Even when diluted 40,000 times, its solution occasions a sense of bitterness on the tongue. The following formulas have been given by the physicians cited. Guttce Acetatis Strychnines. Drops of Acetate of Strychnine. 5<. Strychnin, acet. gr. iij. Alcohol. 3j. Aq. cinnam. sjvij. M. Dose. — Five drops, twice a day, gradually increasing the dose. LlJEDERS. Tinctura Acetatis Strychnines. Tincture of Acetate of Strychnine. 5<. Strychnin, acet. gr. iss. Alcohol, 3ss. M. Dose. — From three or four, to twenty or thirty drops, to be taken at bed-time, in cases of syphilitic pains of the bones. FRtcKE. STRYCHNINE IODAS. Synonymes. — Strychnina Iodata, Strychnium Iodicum, Iodate of Strych- nine. German. — Iodsaures Strychnin, METHOD OF PREPARING. The preparation of this salt, according to Magendie, is easy. It is sufficient to add a concentrated solution of iodic acid to powdered strychnine; in a moment the mass swells up, absorbs water, becomes thicker and at times very consistent. It is now treated with boiling alcohol, filtered, and left to spontaneous evaporation. In this way, beautiful crystals of iodate of strychnine are obtained. The iodic acid, proper for this preparation, is obtained, according to STRYCHNINE NITRAS. 361 Geiger, in the following manner. Nine parts of the iodate of baryta are boiled with two parts of oil of vitriol, previously diluted with ten times as much water, for half an hour. It is then filtered, and evaporated by a gentle heat to the consistence of a thin syrup, and is exposed to the air for spontaneous evaporation. The iodate of strychnine may likewise be formed by double decomposition, by mixing a soluble iodate, as iodate of soda, with a solution of sulphate or muriate of strychnine. The iodate of strychnine is precipitated, which may be treated with boiling alcohol, and crystallised as above directed. The iodate is of a white colour, crystallises in beautiful prismatic needles : it is but slightly soluble in cold water, but more so in boil- ing water and alcohol. EFFECTS ON THE ECONOMY. "This salt," says Magendie, "is one of the most active with which I am acquainted. A single grain is sufficient to destroy a strong dog under tetanic symptoms. It acts, likewise, powerfully on the diseased organism. I gave it to several persons with a success which far exceeded my expectations. It proved effectual in some old paraplegic affections, which had been esteemed incurable, and after all the usual remedies had been administered in vain." He gave it in pills, each of which contained one eighth of a grain. One of these was prescribed night and morning, and the dose was gradually increased, until ultimately a grain was taken in the twenty-four hours. The greatest circumspection was, how- ever, necessary in its use. Magendie is of opinion, that the hydriodate of strychnine might be advantageously introduced into medicine. It is prepared by mixing a solution of iodide of potassium with a concentrated solu- tion of acetate of strychnine : a white crystalline powder is precipi- tated, which is soluble in alcohol, and is the pure hydriodate of strychnine. It does not appear to have been as yet used in medicine. STRYCHNIN7E NITRAS. Synony.mes. — Strychniurn Nitricum, Nitrate of Strychnine. German.— Salpetersaures Strychnin. This preparation of strychnine has been more used in Germany than any other. It has been received into the Prussian ] harma- coposia, (Landcspharmakopoe,) where it is directed to bu prepared in the following manner: 362 dunglison's new remedies. method of preparing. On eight pounds of nux vomica sixteen pounds of spirit of wine (Kornbranntwein) are poured, and the liquid is distilled to one half. The nux vomica is then freed from the liquor by filtering, is dried and reduced to coarse powder. This is digested two or three times with a sufficient quantity of the spirit, and after digestion it is strained. The tinctures are then subjected to distillation, and what remains is evaporated along with the fluid that remained after the boiling ; to this, acetate of lead, dissolved in a sufficient quantity of distilled water, is added so long as a precipitate falls. The fluid, separated as much as possible from the precipitate, by means of the filter, is now evaporated to one half, by a gentle heat. When cold, it is mixed with two ounces of calcined magnesia, and is suffered to stand for three days, when the deposit is separated by the aid of the filter, and is washed, and dried. This, after having been rubbed to powder, is digested two or three times in alcohol, and the tinctures are subjected to distillation, until only a few ounces remain. The strychnine, which, on cooling, appears in the retort in the form of a white powder, is separated by the filter, washed two or three times with rectified spirit of wine diluted with an equal quantity of common water, and is neutralised by a proper quan- tity of dilute nitric acid. The filtered fluid is evaporated by a gentle heat so as to allow the formation of crystals. These crystals are needle-shaped, colourless, of a silky splendour, and a very bitter taste; they are soluble with difficulty in alcohol, but dissolve in ether. METHOD OF ADMINISTERING. The dose and mode of administering the nitrate of strychnine are the same as in the case of the pure strychnine. Its endermic appli- cation will sometimes succeed when the internal administration has been more limited in its results. The experiments instituted by Dr. Stannius, and others, and referred to in a former page (356,) were with the nitrate of strychnine. Magendie found, in his experiments, that this salt completely prevented the coagulation of the blood. 1 1 Lecjonssur le Sang; and translation in Lond. Lancet, Jan. 26, 1839, p. 637. STRYCHNINE SULPHAS. 363 STRYCHNINE SULPHAS. Synonymes.— Strychnium Sulphuricum, Sulphate of Strychnine. German. — Schwefelsaures Strychnin. The same effects have been observed from this preparation as from the others. It is also dispensed in the same forms and doses. It may be obtained by the simple union of strychnine with sulphuric acid. According to Pelletier, 1U0 parts of the alkaloid saturate 10.486 of the acid. It is soluble in less than sixteen parts of cold water, and crystallises, when neutral, in transparent cubes ; when acid, in needles. Its taste is extraordinarily bitter. It is decom- posed by every soluble salifiable base. SULPHURIS CARBURETUM. Synonymes. — Sulphuretum Carbonii, Carboneum Sulphuratum, Alcohol Sul- phuris, Bisulphuretum Carbonii, Sulphuret of Carbon, Carburet of Sulphur. French. — Sulfure de Carbon, Carbure de Soufre, Soufre Carbure, Alcool de Soufre. German. — Schwefelalcohol, Schwefelkohlensloff, fliissiger Kohlenschwe- fel, Kohlensulfurid. The carburet of sulphur or sulphuret of carbon was discovered by Lampadius in the year 1796. It is a transparent and colourless fluid at the ordinary temperature, has a very penetrating and dis- agreeable odour; and a taste, cooling at first, but afterwards burn- ing, acrid, and somewhat aromatic. Its specific gravity is 1.263. It boils at 134° of Fahrenheit. It is not decomposed at the highest temperatures; but volatilises rapidly in the air, and burns readily. It is not soluble in water, but is so in alcohol, ether, and in the fixed and volatile oils. Water separates it immediately from those solu- tions. It unites intimately with the alkalies; but, of the acids, the aqua regia — which is a mixture of the nitric and muriatic acids — alone; lays hold of it. It dissolves potassa, camphor, sulphur, and phosphorus. Lampadius, in the first instance, regarded the sulphu- ret of carbon as a compound of sulphur and hydrogen; it is now, however, decided, that it consists of sulphur and carbon, — according to Vauquelin, in the proportion of 85 or 86 to 15 or 14 ; according to Berzelius, and Marcet, of 84.84 to 15.16. MODE OF PREPARING. The following method is recommended by Mitscherlich :' 1 Elemens de Chimie, traduits par M. B. Valerius, i. 156, Bruxelles, 1835 364 dunglison's new remedies. The temperature, at which sulphur enters into ebullition is not sufficient to make the two substances combine, but if burning coals be placed in contact with vapours of sulphur, the combination lakes place immediately. With this view, a tube of porcelain may be used, or, what is better, one of cast iron, lined internally with a coat of clay by running it several times through a paste of clay and water, and heating the tube each time. In this manner, the crust of dry clay will become strong enough to prevent the sulphur from attacking the iron. The tube is then filled with strongly calcined coals, and is heated, to redness in an oblong furnace. One end of the tube is closed by a cork, and a small hole is made at the upper part of the tube, through which the sulphur is introduced, and which is closed by a plug. The other end, which has passed through the furnace, is likewise closed by a large cork, traversed by a glass tube. To make the stoppers close the tube hermetically, they are boiled with glue. The long glass tube passes into a large jar, through a hole in which it is adapted hermetically by means of a cork. The ordinary aperture of the jar is closed by a cork in which a tube is fitted hermetically, which passes through the window. At the bottom of the jar is contained a little water. The long tube, passing from the furnace to the jar, may be kept cool by water made to drop upon it, or by covering it with snow or ice. When the charcoal is heated to redness, small fragments of sul- phur are dropped in, from time to time, by means of the aperture before mentioned, which must be carefully closed each time after- wards. The sulphur, in melting, runs towards the hottest parts of the tube, to which a slight inclination has been given in placing it in the furnace. It enters into ebullition, and is transformed into sulphureous vapour, which, by passing over the hot coals, com- bines with them: the sulphuret of carbon, or carburet of sulphur formed, condenses in the long tube, from which it runs into the jar, and falls to the bottom of the water. As the coal always retains a little hydrogen, the sulphur likewise unites with it, to form a gaseous body, which is carried off by the tube passing through the window. The carburet of sulphur is preserved in well-stopped bottles, and is covered with about an inch of water, whence it can be best ob- tained for use by means of a small glass or ivory syringe. EFFECTS ON THE ECONOMY. The carburet of sulphur holds a place amongst the transient or diffusible stimulants. 1 Its most marked effects are said to consist in its " exciting the function of cutaneous transpiration to copious sweating ; increasing the secretion of urine, elevating the tempera- 1 Wutzer, Journal de Chimie Med.; and Amer. Journ. Med. Sciences* Nov. 1831, p. 215. SULPHURIS CARBURETUM. 365 ture of the body, quickening the pulse, and causing congestions towards the head and those parts of the body whose vitality may have been already somewhat augmented." 1 Its most striking agency is exhibited in the more active exercise of the functions of the skin. According to Mansfeld, it acts likewise as an emmena- gogue ; but, in this respect, probably only like similar excitants. On account of its great volatility, it produces on the skin the feeling of considerable cold. The discoverer of the carburet of sulphur first recommended it as a remedial agent. 3 He particularly advised it, both internally and externally, in rheumatic and gouty affections. In Freiberg, a mixture of one part of camphor, two of carburet of sulphur, and four of spirit of wine, is a very common external application in rheumatic pains. Kappe found decided advantage from it in gout and rheumatism, and Mansfeld and Wutzer, resting upon a series of observations, maintain, that in rheumatism unaccompanied by fever, or where the fever is slight, it exceeds every other remedy of the class. Dr. Otto, 3 of Copenhagen, prescribes four drops of a mix- ture composed of one part of the carburet of sulphur, and four parts of highly rectified spirit of wine, to be taken every two hours: and he directs the affected parts to be rubbed with an embrocation, com- posed of one part of the sulphuret of carbon, and four parts of olive oil. The cure, he states, was ordinarily effected in from eight to fifteen days. In deep-rooted dyscrasies, however, these gentlemen found no advantage" from it. On the other hand, in trials at the Berlin Charity, it was found to be of no avail in chronic rheu- matism, although it was used for a long time, and given in by no means small doses. Mansfeld, also, employed it in cases of after-pains, rubbed, with- out admixture, on the abdomen ; and he affirms, that good effects resulted from it, even when the secale cornutum had failed. In hysteric fainting, the same gentleman found it very useful when internally exhibited. Lampadius, likewise, recommended it in fainting, as well as in asphyxia. Krimer found it extremely efficacious in asphyxia from carbonic acid, but he frequently thought it necessary to premise blood-letting. In this way, he treated eleven cases; and only one case — in which apoplexy had already supervened — terminated fatally. The same physician ex- hibited it in some cases of drunkenness, attended with loss of con- sciousness, and found its effects very beneficial. He gave it with great advantage once in a case of goitre; and, in incarcerated hernia, no agent, he says, facilitates so much the taxis as the cold produced by dropping the carburet of sulphur on the tumour. 1 Riecke, Die neuern Arzneimittel, S. 109. 2 Luinpatlius, in Bulletin des Sciences Medicales de Ferussac, xi. 315. 3 Annates de Chernie Medicale, and Amer. Journal of the Med. Sciences, for Nov. 1836, p. 222. 366 dunglison's new remedies. Lampadins found, that slight burns were instantaneously cured by- it. Clarus recommends it in hypertrophy of the coats of the sto- mach, and in contraction of the oesophagus — administered ac- cording to the formula given below. Every thing, indeed, says Riecke, encourages the further trial of the sulphuret as a remedial agent. 1 MODE OF ADMINISTERING. Internally, the carburet of sulphur may be given in doses of from one drop to four, every five or ten minutes, in cases of fainting and asphyxia ; but where such a rapid analeptic agency is not de- manded, it may be given every two or three hours. It may be administered dropped on sugar, or in a spoonful of sugared water or barley water. Clarus thinks it is best given in cow's milk. Externally, it is either applied pure, when a rapid development of cold is needed — as in cases of burns and incarcerated hernia — or dissolved in alcohol or oil. Gattce Sidphiiris Carbureti. Drops of Carburet of Sulphur. 5<. Sulphur, carbur. gij. iEther. sulphur. ,§j. M. Dose. — A few drops on sugar. Lampadius. B=. Sulphur, carbur. 3j. Sp. vini rectif. ^ss. M. Dose. — Four to six drops, every two hours, in cases of rheu- matism. Wutzer. £. Sulphur, carbur. 3j. Sp. virj. rectif. 31J. M. Dose. — Five, ten, or fifteen drops, three times a day, in cases of rheumatism. Wutzer. Mistura Sulphvris Carbureti. Mixture of Carburet of Sulphur. 5<. Sulphur, carbur. 9j. Lact. vaccin. 5vj. Sacch. alb. ^ij. M. Dose. — A table-spoonful, four times a day, or oftener. Clarus. Embrocatio Sulphuris Carbureti. Embrocation of Carburet of Sulphur. £. Sulphur, carbur. ^ss. Olei amygd. dulc. ^j. M. To be rubbed in, in cases of old gouty nodes. Mansfeld and Otto. 2 1 Die neuern Arzneimittel, u. s. w. S. 110. 2 Bibliothek for Laeger, 1835, and Biit. and For. Med. Review, July, 1836, p. 252. SULPHURIS IODIDUM. 367 £. Sulphur, carbur. ^ij. 01. oliv. seu Linim. ammon. camphor. §ij. M. To be rubbed in, in cases of rheumatism. Wutzer. £. Camphor. £ij. Solve ia Sulphur, carbur. Iss. Adde Sp. vini rectif. £j. M. To be used in friction, in cases of rheumatism, and especially in rheumatic odontalgia. SULPHURIS IODIDUM. Synonymes. — Sulphuris Ioduretum. Sulphuris Iodatum, Ioduret, or Iodide of Sulphur. French. — Soufre Iodure, Iodure de Soufre. German.— Iodschwefel. MODE OF PREPARING. The iodide of sulphur, first described by Gay Lussac, and to which brief allusion has already been made, (p. 258,) crystallises in needles, eagerly attracts water, and is thereby readily decom- posed. EFFECTS ON THE ECONOMY. Biett has exhibited this agent in squamous, pustular, and papular diseases of the skit). It has been found especially effective in psoriasis, in the form of frictions. Patients, who had been long affected with diseases of this kind, which had resisted every other remedy, were cured in four or five months by the iodide of sulphur alone. To prevent relapses, Biett advises that the frictions should be continued after the eruptions have scaled off. He found it equally efficacious in the lepra vulgaris of Willan ; and in acne — the gutta rosacea of Alibert — when the inflammation of the skin had passed away. Even the acne indurata was often completely cured by it. He found it also beneficial in inveterate porrigo of the scalp. 1 At times, after the rubbing, a diffuse red inflammation of the skin arises, with subsequent desquamation ; and, in particular cases, the inflammation extends even to the subjacent cellular 1 Cazenave et Schedel, Maladies de la Peau, p. 219; and Cogswell on Iodine, p. 120, Edinb. 1837. See, also, page 25S of this volume. 368 dunglison's new remedies. membrane. In old standing lepra, Rayer 1 prefers it for external use to calomel and white precipitate, and he ranks it highly with the iodides of mercury, for the cure of lupus non exedens ; and by Dr. Volmar 2 it has been used, with great success, in herpes pustu- losis labialis. The iodide of sulphur is likewise extolled by Lugol as a very active therapeutical agent. Cless affirms, that in chronic squamous affections of the skin, especially in psoriasis, he has employed it with advantage, but he was not able to cure lepra vulgaris with it. The inhalation of the vapour of this substance has been employed in humoral asthma, by Dr. Copland, 3 with temporary advantage. For its farther uses, see page 258. MODE OF ADMINISTERING. Magendie gives formulae for the ointments used by Biett. One contains five parts of iodide of sulphur, to ninety-six parts of lard; another eight parts of the iodide to one hundred and forty-four parts of lard. In porrigo of the scalp, Biett advises an ointment of from one to five scruples of the iodide to eleven pounds of lard, of which a dram is used at each time of rubbing:. TANNICUM purum. Synonymes — Tanninum, Principium Adstringens, P. Scytodephicum, Tan- nin. German. — Tannin, Gerbestoff, Gerbsaure. This article, in its pure state, has been subjected to experiment very recently only. METHOD OF PREPARING. According to Buchner, 4 Tannin should be prepared for medical use in the following manner. From eight to twelve parts of hot water must be poured on one part of powdered galls, and the mixture be allowed to digest for an hour, frequently agitating it. The infusion must then be filtered, 1 Diseases of the Skin, p. 634. 2 Die neuesten Entdeckung. in d. Mat. Med.; cited by Pereira, Elements of Materia Medica, Pt. i. p. 270. Lond. 1839. 3 Diet, of Practical Medicine, Art. Asthma. * Repertorium,B. xxxiv, H. 3, also, A. W. Buchner, Neueste Entdeckung. ilber die Gerbsaure, u. s. w. Frankf. 1833, and Dierbach, in Heidelberger klinische Annalen, B. x. H. 3, S. 339, Heidelb. 1834. TANNICUM PURUM. 369 and the residue be again treated in the same manner with a little hot water. The different infusions, which generally pass through the filter turbid, must be mixed together, and a little dilute sulphuric acid be added by drops, constantly shaking the mixture, so long as any precipitate of tannin follows. The tannin is deposited, in this way, very soon in a collected yellowish white, gelatiniform mass, which by the influence of air gradually assumes a brown colour. After the fluid is poured off, the residue is washed twice with cold water acidulated with sulphuric acid ; carbonate of baryta, or carbonate of potassa, is then added to it in small portions, carefully shaking the mixture, until there is no farther effervescence, and until a portion of the mass dissolved in water and tested by muriate of baryta affords no more evidence of the presence of sulphuric acid. The yet moist mass is then put into a retort with alcohol of about ninety per cent., which is added repeatedly in small portions ; the alcohol is made to boil, to dissolve the tannin and separate it from the sulphate of baryta or sulphate of lime; the alcoholic solution is then poured off clear, and by a gentle heat evaporated to dryness. Tannin, prepared in this manner, is friable, resinoid, almost as shining as glass, of a pale yellow colour, translucent, reducible, by rubbing, to a white powder, of an astringent taste, soluble in water, alcohol and ether, reddening litmus paper, and forming salts with a base, like an acid. EFFECTS ON THE ECONOMY. Tannin is a strong astringent, 1 which has hitherto been mainly used in uterine hemorrhage, and especially by the Italian physi- cians. Porta 2 was, perhaps, the first who tried it. He found it very efficacious in cases of uterine hemorrhage not dependent upon any organic mischief in the uterus. It exhibits its powers, according to him, even in small doses — as of two grains, and is well borne by the stomach. Ferrario, 3 likewise administered it with advantage in the same affection, but he does not consider it adapted for cases in which either partial or general plethora, or local excitement of the uterus, or any organic disease, exists : it is indicated only where pure atony is present. He gives it in the form of powder or pill, in two grain doses, six times a day. The effect, according to him, is generally good: the hemorrhage diminishes and soon ceases, and, at the same time, the strength augments, and recovery succeeds, without any disturbance of the functions. Giadorow 4 details two cases of diabetes cured by it, when given in combination with opium, as in the prescription at the end of the article. The first patient was cured in ten ; the second in twelve days. 1 See, on the action of this agent, Mitschorlich, Medicinische Zeitung, No. 43, 1833. and Bullet. General de Therap. Mars 30, 1837. 2 Delpech, Memorial des HOpitaux du Midi. &c. Fevrier, 1829, p. 51. 8 Annali universali di Medicina, Gennajo, 1829. 4 Annali universali di Medicina, and Gazette Medicale, Sep. 15, 1832. 1 1— d dungl 24 370 dunglison's new remedies. According to Ricci, 1 tannin has frequently been employed in Italy both in internal and external hemorrhages. On the other hand, G. A. Richter 2 affirms, that he has given it in habitual metror- rhagia without any advantage whatever. Within the last year or two, M. Cavarra 3 has instituted many experiments on animals, as well as on himself, from which he concludes, that when tannin is placed in contact with certain parts of the living economy, it exerts upon them the same chemico-vital action, which it does on an inert organic tissue, or, in other words, it tans them as it tans leather. " These parts," he says, " are the mucous membranes of the urethra, vagina, intestines and lungs. The action of the tannin appears to be, to cause such a condensation or contraction in them, that the glands with which they are studded no longer afford passage for the mucus which they secrete." M. Cavarra, asserts, that he has proved these positions by nume- rous experiments and demonstrations. When tannin is taken inter- nally, its immediate effect is constipation, by arresting the secretion from the mucous membrane. When it has reached the stomach, it is absorbed, and carried into the current of the circulation. There exists between this organ and the vagina, the urethra, and the lungs no communication except through the circulatory system, and, consequently, the tannin — it is fair to presume — must be absorbed to cure leucorrhaea, gonorrhoea, and the most obstinate chronic catarrhs. M. Cavarra concludes, that of all the effects of tannin, two of the most surprising are, the cures operated by it in cases of the most obstinate nervous coughs, and the excellent action it exerts in phthisis. Farther experiments are, however, demanded before this last point can be admitted. From our knowledge of the pro- perties of tannin, it is not easy to see how it, or any other astringent, can be of much service in the latter malady. According to Hiiter, tannin prepared from dried galls, in the form of ointment or diluted with distilled water, is very serviceable in most cases of Egyptian ophthalmia. In the hyperemesis, induced by ipecacuanha or emetine, it may be administered as an antidote. According to the experiments of Magendie, 4 tannic acid is one of the substances that oppose the coagulation of the blood. METHOD OF ADMINISTERING. It may be given in the form of pill, or draught, or as a lavement, and in the dose of from a quarter of a grain to two grains, without 1 Bulletin des Sciences Medicales, Sept. 1828. 2 Arzneimittellehre, Supplement, p. 60, also Cavalier, in Archiv. Generates xix. 589. * Bulletin de l'Academie Royale de Medecine, Janvier, 1837; also, Dunglison's Medical Intelligencer, Oct. 16, 1837, p. 258, and Bulletin Gene- ral de Therapeutique, Mars 30, 1837. * London Lancet, Jan. 26, 1839, p. 636. TANNICUM PURUM. 371 producing any unpleasant constipation, but its effects must be observed with care. 1 Injectio Tannici. Injection of Tannin. £. Vin. rubr. §vj. Tannic, gr. xx. M. Given in chronic blennorrhea or what is called, an old gleet. 2 Ricord. Pomatum Tannici. Pomatum of Tannin. (Liparole de Tannin.) fy. Adipis Suill. Jxij. Tannic, £ij. Aquae pur. gij. Dissolve the tannin in the water, by triturating them in a glass mortar ; add the fat and mix. 3 Beral. Lotio Tannici. Lotion of Tannin. {Hydrolotif de Tannin, pour Purethre.) &. Aquae destillat. ^viij. Tannic, gr. xxxij. Solve. Employed in obstinate blennorrhea. Beral. Pilulm Tannici. Pills of Tannin. g<. Tannic, in pulv. gr. vj. Gum acac. in pulv. gr. xij. Sacchar. pulv. gr. lxxij. Syrup, q. s. ut fiat massa in pilulas pond. gr. iv. sing. Dose. — One to four, morning and evening, where an astringent is needed. Cavarra. Pulveres Tannici et Opii. Powders of Tannin and Opium. 5<. Tannic. 9ij. Pulv. opii. gr. £. Misce et divide in pulveres tres. Dose. — One, morning, noon and night; gradually increasing the quantity of tannin to four scruples daily, Giadorow. 1 Cavarra, in Bulletin General de Therapeutique, Mars. 30, 1837. 8 La Lancette Francaise,No. 33, Paris, 1838. 3 Bulletin General de Therapeutique, Janvier, 1838. 372 DUNGLISON S NEW REMEDIES. THUYA OCCIDENTALS (FOLIA.) Synonymes. — Thuya, American Arbor vilae. French. — Thuya du Canada, Cedre blanc. German. — Blatter des gemeinen Lebensbaumes. The leaves of the thuya — of the natural family coniferas ; — sexual system, monoecia monadelphia, have been long used as an article of the Materia Medica 1 , but they had of late fallen into oblivion until the Homceopathists restored them to notice. Hahnemann advises that condylomata should be touched with the expressed juice, and Jahn in his homoeopathic experiments found it was not unworthy the attention of experimenters. In two cases in which several celebrated agents had been fruitlessly em- ployed, he applied the juice of the thuya with apparent advantage: he does not, however, consider those cases to be decisive, as the patient had taken mercury for a long time, and perhaps the effects began only to be evident, whilst the thuya was administered. Fricke likewise made trial of it, as well as of the tinctura thuyce, which he formed of five parts of spirit of wine, and one part of the juice ; but his trials were not favourable. Even in a dilute form, the tincture acted so powerfully as an excitant, on the parts surrounding the condylomata, that it could not be continued, but after three, four or six weeks' use, was obliged to be put aside, and other approved remedies substituted for it. Generally, in the course of a few days, the parts of the skin, surrounding the condylomata, became sore and very painful, and the condylomata either remained as before, or began to increase in size ; in a few cases only did they disappear under the use of the dilute tincture, and then more slowly than Fricke had noticed from other agents. The testimony of Dr. Kohler, of Warsaw, is, however, entirely opposite. For five years, he says, the tincture of thuya was em- ployed by many physicians of that city, both in hospital and private practice, and with the most decided success. Riecke, 2 too, affirms, that in the year 1831 he had treated a great number of patients with it, always with the best effect ; and without the occurrence of a relapse, or the least sign of inflammation, excoriation or other inconveniences supervening. It was commonly but necessary to apply the remedy for a fortnight or three weeks, in order that the removal of every condylomatous growth should be effected. In the generality of cases, the internal use of mercury was conjoined, but even where the external employment of the thuya was alone had recourse to, the result was entirely satisfactory. Riecke not only touched the condylomata with the tincture, but kept constantly applied to them lint dipped in it, and without the supervention of any unpleasant consequences. 'Wood and Bache's Dispensatory, 4th edit. Philad. 1839. 2 Die neuern Arzneimittel, S. 394. UREA. 373 Tt would seem to be probable, from these discordant results, that there must have been some difference in the preparation. The following form was used by Riecke : 3<. Folior thuyae Occident, f i. Contunde et tere in mortario vitreo affundendo sensim sensimque spiritus vini ffiss. Massam immitte in cucurbitam vitream ; digere per aliquot dies, dein cola et serva. 1 Riecke remarks, that he never found it necessary to dilute this tincture. UREA. Synonymes. — Urieum, Nephrine. French. — Uree, Extrait savonneux de Purine. German. — Harnstoff. This immediate principle of the urine of men and quadrupeds was discovered in an impure state by Rouelle, in 1773 ; and since then it has been studied by Cruikshanks, Fourcroy and Vauquelin, Berzelius and Proust more especially, — by the last of whom it was obtained pure. 2 METHOD OF PREPARING. Urea is obtained by placing a mixture of equal volumes of urine, reduced to the consistence of syrup, and nitric acid at 20° in a refrigerative bath ; by which means the crystallised nitrate of urea is precipitated. On decomposing this — washed in the cold and dissolved in water — by carbonate of potassa, reducing it almost to dryness, and treating the residue by alcohol at 40°, which takes up the urea, crystals may be obtained by evaporation, which may subsequently be procured colourless by the agency of animal char- coal. M. Henry, 3 who was not satisfied with the scanty product yielded by this process, recommends the following: Add to fresh urine a slight excess of subacetate of lead; a precipitate is thus formed, which consists of oxide of lead united to the various acids of the urine, together with the mucus, and a great part of the animal mat- 1 " Take of the leaves of the thuya occidentalis, an ounce; bruise and rub in a glass mortar, gradually adding of spirit of wine, half a pint ; put the mass into a glass cucurbit ; digest for some days ; then filter and keep for use." * Annales de Chimie et de Physique, x. 369, and Merat & De Lens, Art. Uree. 3 Journal de Pharmacie, xi. 161, Paris, 1829. 374 dungltson's new remedies. ter ; the decanted liquid is then treated with sulphuric acid in slight excess to separate the lead, and afterwards, in the progress of the evaporation, to decompose the acids of soda and lime, that may have been formed. After having separated the white precipitate, concentrate rapidly over a steady fire, adding a portion of animal charcoal daring the ebullition. When the whole has become a clear syrup, pass it through linen of close texture, and then reduce it one third by evaporation. On cooling, the liquid is converted into a yellow mass, crystallised in needles, formed of a great proportion of urea and some salts. The crystals being drained and pressed are added to those obtained from the mother waters treated in a similar manner. They are next treated with a very small quantity of car- bonate of soda, with the view of separating any remaining acetate of lime, and then digested in alcohol of 38° to 40°. The alcoholic solution being filtered, and the alcohol separated by distillation, the urea remains, which may be crystallised afresh from water, if necessary. 1 Urea, as thus obtained, is in silky or prismatic needles, very soluble, and of a cooling taste. EFFECTS ON THE ECONOMY. The experiments of M. Segalas have established, that urea is devoid of any noxious action on animals into whose veins it has been injected, and, consequently, that we cannot ascribe the serious symptoms to it, which arise from the absorption of urine in certain morbid cases. They demonstrate farther, what has been confirmed by the trials of Fouquier, that urea is a diuretic, and, therefore, might be useful in dropsy: the latter gentleman employed it, also, but unsuccessfully in diabetes. 2 According to the author's friend, M. Fee, 3 urea is received into the lists of the materia medica in the Batavian Pharmacopoeia, and in some others less known. MODE OF ADMINISTERING. Urea has been given in solution in distilled water, sweetened, in the dose of twenty-four to thirty grains, and even as high as several drams in the day. 1 Manual of Materia Medica and Pharmacy ; by MM. H. M. Edwards and P. Vavasseur, p. 231, Philad. 1829. 2 Journal de Physiol, de Magendie, ii. 344, & Formulaire pour la Prepaia lion, &c. de plusieurs nouveaux Medicamens. s Cours d'Hist. Naturelle Phann. ii. 764: cited in Merat & De Lens, Diet, de Mat. Med. Art., Uree. VERATRINA. 375 VERATRINA. Synonymes.— Veratria, Veratrinum, Veratrine. French. — Veratrine. German. — Veratrine, Sabadillin. This alkaloid, which was discovered in 1819, by MM. Pelletier and Caventou, 1 and almost at the same time by Meissner, 2 is com- monly prepared from the seeds of the veratrum sabadilla. It is contained in several of the plants belonging to the family Colchi- caceae. METHOD OP PREPARING. The seeds of the veratrum sabadilla are repeatedly treated with boiling alcohol. These tinctures, filtered when almost boiling, allow whitish flakes of wax to be deposited on cooling ; the dis- solved matters, brought to the consistence of an extract, are now dissolved in cold water, and filtered, whereby a small quantity of fatty matter remains on the filter. The solution is then slowly evaporated, when a yellowish orange-coloured precipitate is formed, which possesses the characters of the colouring matter found in almost all woody vegetables. On adding a solution of acetate of lead to the still deeply coloured liquid, a new and very abundant yellow precipitate is thrown down, which can be separated by means of the filter. The liquor, now nearly colourless, contains, besides other substances, acetate of lead, which had been added in excess; this is separated by means of a stream of sulphuretted hydrogen : the liquor is then filtered, and concentrated by evapora- tion ; treated by magnesia, and again filtered. The magnesian precipitate is digested in boiling alcohol, and on evaporating the alcoholic liquors, a pulverulent, extremely acrid matter is obtained, which possesses all the properties of the alkalies. It appears at first yellowish ; but, by solutions in alcohol, and subsequent pre- cipitations, caused by pouring water into the alcoholic solutions, it is obtained in the form of a very white and perfectly inodorous powder. 3 Veratrine is scarcely at all soluble in cold water; but boiling water dissolves one-thousandth part of its weight, and becomes sensibly acrid. It is very soluble in ether, and still more so in alcohol. It is not soluble in alkalies, but is so in all the vegetable 1 Annalcs de Chimie et de Physique, xiv. GO. 2 Colbert's Annalen der Physik, lxv. 335. 3 Magen die's Formulaire pour la Preparation, &c. de plusieurs nouveaux Mcdicamens. Veratrine has been received into the London Pharmacopoeia. See Brande's Diet, of Mat. Med. p. 46S. London, 1839. For M. Righini's method of obtaining what M. Soubeiran calls "medi- cinal veratrine," see Journal de Pharmacie, Oct. 1837. 376 dunglison's new remedies. acids : with these it forms uncrystallisable salts, which, on evapo- ration, present the appearance of gum. The sulphate alone affords rudiments of crystals, when its acid is in excess. Nitric acid com- bines with it ; but, if added in excess, it does not colour it red, as in the case of morphine, brucine, and impure strychnine, but very rapidly resolves the vegetable substance into its elements, and gives rise to a yellow detonating matter. Veratrine has an alkaline reaction. When exposed to heat, it liquefies at a temperature of 122° Fahrenheit, and has then a waxy- appearance. On cooling, it forms a translucent mass, having the appearance of amber. When distilled on the naked fire, it swells up, is decomposed, and forms water, much oil, and leaves behind a bulky coal. The taste of veratrine is very acrid, but without bitterness. Of late, new light has been thrown on veratrine by the investi- gations of Couerbe. According to him, when prepared in the mode above mentioned, it still contains several other substances, sabadillin, veratri?i, gum resin of the sabadilla, and a black, greasy substance, which unites the other matters, and conceals their properties. The following is the form given by Couerbe for obtaining veratrine in its greatest purity : — Sabadilla seeds are treated with boiling alcohol at 36° (.847) and after they have been exhausted in this manner, the liquor is distilled to obtain the extract, which contains a greenish fatty matter in great quantity. This extract is treated with dilute sulphuric acid, and the solution is suffered to boil a few minutes, when it is filtered. In this manner, the veratrine, sabadillin, the gum resin, and the brown colouring matter are dissolved ; and, by precipitation with potassa, all these matters are obtained. It is sufficient to treat the precipitate again with alcohol, and distil it, in order to obtain the impure veratrine, which is subjected to purification, by being dis- solved afresh in dilute sulphuric acid, precipitated by an alkali, and dried. In this manner, a delicate white powder is obtained, of very acrid taste, with an alkaline reaction, uniting with acids without forming crystals, — in short, the veratrine of authors, in its greatest purity. In order to separate the substances newly discovered by Couerbe, the veratrine must be dissolved in water acidulated by sulphuric acid, and to the solution nitric acid is added by drops, so long as there is a precipitation of very tenacious matter — the black greasy substance above mentioned. The fluid is then decanted ; preci- pitated by potassa or ammonia, and the precipitate washed with cold water. It is then treated with alcohol, to separate any in- organic salts which it may contain ; the alcohol is next evaporated, when a matter — in appearance resinoid — is obtained, which con- tains all the above-mentioned constituents of the common or im- pure veratrine, with the exception of the dark greasy matter which was separated by the nitric acid. VERATRINA. 377 By means of boiling- water, two of the constituents are sepa- rated — the sabadillin and the gum resin : the first crystallises from the liquid on cooling - , and the second is procured by suffering the mother waters of the sabadillin to evaporate in vacuo, or by a gentle heat, to dryness. The water has left two other matters un- dissolved, the pure veratrine and the veratrin. By treatment with ether, which dissolves the former, they may be separated : the vera- trin remains undissolved. Pure veratrine does not crystallise, but unites with acids, form- ing combinations that readily crystallise. It is white, solid, and friable, and fuses at 212° Fahrenheit. It is not soluble in water, but is readily so in ether and alcohol. The sulphate forms long, loose needles, fuses on the application of heat, and loses thereby two atoms of water. It contains 100. parts of veratrine, and 14.66 of water. The muriate of veratrine is very soluble in water and alcohol, but is easily decomposed by heat. According to Couerbe, pure veratrine agrees in its properties with the impure, and is the active principle of the latter. Sabadillin, obtained in the mode above mentioned, forms small crystals, which appear to be hexaedral prisms. It is of a white colour, and very acrid. It is not volatilisable ; fuses at 200° of the centigrade scale, and loses thereby two atoms of water. It dissolves completely in water and alcohol, but in ether it is wholly insoluble. The sulphate of sabadillin crystallises in prismatic needles, is fusible, and contains four atoms of water, which may be driven off by simple fusion. The sabadillin agrees in its effects with vera- trine, but is weaker. The gum resin — (sabadillin-monohydrat,) is yellowish, un- crystallisable, and feebly alkaline. When it is entirely dry, it is easily reduced to powder. Alcohol dissolves it in every proportion, as well as water and acids. It requires a temperature of 165° cent, to fuse it. Sulphuric ether dissolves only traces of it. In its properties, it bears much resemblance to the sabadillin, but differs essentially from it in not being crystallisable. Its composition varies but little from that of the sabadillin. The veratrin, 1 whose effects on the animal economy are not yet known, is of a brownish colour, is insoluble in water and in ether, but not so in alcohol ; fuses at 185° of the centigrade scale. Con- centrated acids decompose it, and nitric acid converts it into oxalic. Simon, an apothecary of Berlin, has recently affirmed, that he has found two alkaloids in the veratrum album ; one of which pos- ' Riecke properly animadverts on the nomenclature of Couerbe. Ac- cording to him, we have to distinguish not only the veratrine of commerce — that which was previously esteemed the simple alkaloid — but, also, the pure veratrine, (la veratrine,) and the veratrin, (le veratrin.) The slight differ- ence in the terms is insufficient to obviate confusion. Riecke, Die neuern Arzneimittel u. s. w. S. 400. Stuttgart, 1337. 378 dunglison's new remedies. sesses the property of being precipitated from its solution in acetic or phosphoric acid by the sulphuric acid and its salts, like baryta; hence he has given it the name barytin} EFFECTS ON THE ANIMAL ECONOMY. Regarding the effects of veratrine on animals, Magendie 2 has the following remarks: — A very small quantity of acetate of veratrine placed in the nostrils of a dog, instantly excited violent sneezing, which continued for a long time. One or two grains, placed in the mouth, immediately occasioned profuse ptyalism. When a small quantity was introduced into any part of the intestinal canal, and the body was opened to notice its effects, the intestine was observed to be much indurated, and to relax and contract alternately for a certain length of time. The part of the mucous membrane, with which the veratrine is made to come in contact, is inflamed ; the irritation spreads, and vomiting and purging are excited. In much stronger doses, the circulation is accelerated, as well as the respi- ration, and tetanus supervenes, soon followed by death. The effects are still more rapid, if one or two grains be thrown into the cavity of the pleura, or tunica vaginalis. In less than ten minutes death occurs, preceded by tetanic convulsions. The same quantity thrown into the jugular vein, induced tetanus and death in a few seconds. Dissection showed, that, even in this case, the veratrine had acted on the intestinal canal, the mucous membrane of which was found injected. The lungs, also, exhi- bited traces of inflammation and engorgement. Veratrine, in large doses, would, doubtless, exhibit the same effects on the human organism. The taste is very acrid, but with- out bitterness : it excites a copious flow of saliva, even when a small quantity only has been introduced into the mouth. Although it has no smell, it must not be brought too close to the nose, when in the state of powder, as it occasions, even in very minute quan- tity, violent sneezing, which may prove dangerous. A quarter of a grain immediately induces copious evacuations, and, in a some- what larger dose, more or less violent vomiting. According to Turnbull, who has immoderately, we think, ex- tolled this remedy, its effect is very different, according as it is ex- hibited internally or externally. Externally, it may be applied for weeks and months, without the supervention of any of the effects that succeed its internal administration. Exhibited in this way, it diminishes internal nervous excitement, assuages pain, but does not act on the intestinal canal. In dropsical cases, it is stated to be • Pharmaceut. Centralblatt. 1837, p. 191, & Medicinische Annalen, B. iv. H. i. S. 9. Heidelb. 1838. 2 Journal de Physiologie Experiment, i. 56; & Formulaire pour la Prepa- ration, &c. de plusieurs Medicamens. VERATRINA. 376 one of the greatest promoters of the urinary secretion that we pos- sess. The part of the skin on which it is rubbed, either in solution or ointment, even when the friction has been continued for a long time, exhibits no evidence of irritation : when, however, the dose of veratrine has attained a certain extent, the patients feel a con- siderable degree of heat, and a kind of pricking sensation in the rubbed part, when it may be concluded, that the veratrine is active, pure, and genuine: under a more prolonged use of the remedy, this feeling of warmth and pricking extends over the surface of the whole body ; and, in some cases, involuntary twitchings have been observed in the muscles of the mouth and eyelids. These symp- toms, however, pass off, when the frictions are discontinued for a day or two. Only in a few cases, according to Turnbull, was any eruption induced by its application. The endermic use of the remedy, always, however, excited so much irritation as to prevent its repetition. Thus much for Turnbull : — His views and experience have by no means been confirmed by the generality of observers. The external application of veratring cannot always be used without local irritation ensuing. An Eng- lish physician, labouring under rheumatism of the arm, rubbed upon it an ointment composed of twenty grains of veratrine to an ounce of lard ; and, immediately afterwards, so much pain was in- duced in the part, that he was obliged to take opium to obtain rest ; an eczematous eruption subsequently appeared on the arm, but the rheumatism remained uncured. Ebers applied it ender- mically, but witnessed nothing more than a violent burning in the part, such as is commonly the case with other agents. He fre- quently observed the pricking sensation mentioned by Turnbull, and often to such an extent as to be almost insupportable. Ac- cording to the trials of Ebers, its diuretic effect was not restricted to dropsy, but was usually evinced in other diseases. The senso- rium appears never to have been implicated, but when applied in small doses over the pit of the stomach it produced striking effects on the spinal marrow, and the nerves connected therewith, as on the nerves of the thorax and abdomen : violent pain was expe- rienced, which spread through the whole extent of the nerves dis- tributed to the parieties of the abdomen, with a sense of traction along the spinal marrow, twitchings, great anxiety, orthopncoa, nausea and vomiting, and a feeling, which the patient was unable to describe, except that it was almost insupportable. When given internally, veratrine soon caused nausea, retching, vertigo, and complete loss of appetite; so that Ebers soon aban- doned its internal use, and, like Turnbull, gave the preference to the external. Owing to the presumed effects of veratrine on the nervous system, and especially on the spinal marrow, and the nerves con- nected with it, its use was suggested in nervous diseases — particu- larly in neuralgia, prosopalgia, and ischias — in which it is said to 380 dunglison's new remedies. have been found most efficacious by Turnbull, Ebers, 1 Briick, Suffert, 2 Professor S. Jackson, 3 Cunier, 4 and others. In no class of diseases, according to the first of these writers, have the beneficial effects of the ointment of veratrine exhibited themselves more strikingly, and by no other remedy has the same amount of relief been induced in so short a time. Even in tic douloureux, a single friction is said to have been sufficient to remove the disease without relapse. Two circumstances have here chiefly to be borne in mind,— -first, the extent of the pain, for when it is not concentrated on a point, but spreads along the branches of the nerves, the cure is easier, and a weaker ointment is needed ; and, secondly, the duration of the affection. In long protracted cases, a complete cure is far more difficult, and can, in general, be effected only after a long period. The paroxysms, however, may be relieved by an ointment composed of from twenty to forty grains to an ounce of lard. In this case, it must be strongly rubbed in, so as to excite itching of the skin : care must be taken, however, that the oint- ment does not touch the conjunctiva, as the smallest quantity of veratrine would induce violent inflammation. Ebers, likewise, found advantage from its use in chorea, hypochondriasis, and hysteria ; and Turnbull in paralysis. Both extol it in rheumatism and gout, in relation to which Ebers remarks, that the remedy has appeared to him more efficacious when the nervous system, or some nervous branches, were predominantly affected, and when the gastric affection was entirely removed. In the cases treated by veratrine, relief was sooner obtained, and the cure was more speedy and complete, than where other agents were employed ; the secre- tion of urine was augmented ; restlessness disappeared ; and sleep returned, without any evidences of narcosis. As regards acute rheumatism, Turnbull remarks, that the veratrine is not to be pre- ferred to antiphlogistics : in these cases, a weaker ointment must be used, (ten grains to the ounce:) in chronic cases, the quantity may be carried much higher ; and — especially when extensive organic changes have supervened in the parts — it must be con- tinued for a great length of time. In lumbago, ischias, and rheu- matism of the chest, not more than one or two rubbings were generally necessary. In gout, according to Turnbull, it may be exhibited both internally and externally; in the former mode of administration, he compares its efficacy with that of colchicum: the latter method has been recommended, also, by Sir C. Scuda- 1 Casper's Wochenschrift, 1837. No. 47. 2 Berlin. Medicin. Centralzeitung, 1837, p. 670, & Heidelberg. Medicin. Annal. B. iv. H. 1, S. 11. 3 American Journal of Pharmacy, vol. iii. new series, p. 186. Philad. 1838. 4 Bulletin Medical Beige, Dec. 1837, & Bullet. General de Therap. Dec. 1838. See, also, Forcke, Physiologisch-therapeutische Untersuchungen iiber das Veratria. Hannov. 1837 : cited in Bib. Generate, Encyclographie des Sciences Medicales, Aout, 1838. VERATRINA. 381 more. It was, likewise, found very advantageous by Bardsley 1 in chronic rheumatism. Veratrine would seem, however, to have been most efficacious iic cases of dropsy. " Unadulterated veratrine," says Ebers, " act? often on the urinary secretion with magical powers, and it may seem fabulous, when I remark, that friction with a very weak oint- ment of veratrine two or three times in the twenty-four hours on the inner part of the thigh, or the back, epigastric region, or around the navel, has excited such a copious secretion of urine, that the patients, under its long continuance, began to feel weak; and the anasarca, and even the dropsical accumulation in the abdomen, in a short time almost disappeared — circumstances which indicate the caution that ought to be observed in apportioning the dose, when we are satisfied of the goodness of the article.'"' He properly re- marks, however, that the veratrine, by augmenting the secretion of urine, may not remove the dropsy, but, by occasioning the absorp- tion of the effused fluid, it allows the physician to examine as to the existence of organic mischief. Ebers gave the veratrine in many of the lighter hydropic cases, which follow intermittents and other forms of fever, and often with great and rapid success ; like- wise in twenty-four more serious cases, fifteen of Which recovered, and one experienced relief: eight very complicated cases termi- nated fatally, and in four of these diuresis occurred; in four not. Fricker 2 likewise obtained very good effects from the use of an ointment of veratrine in dropsy: but, on the other hand, Spath found it of no avail. Turnbull observed, from the internal use of veratrine, as well as from its application to the pit of the stomach, a diminution in the frequency and force of the pulsations of the heart ; and in cases where these were more excited than natural, restoration of a regular circulation. He exhibited it, consequently, in heart dis- eases, especially in those of gouty and rheumatic diatheses, in simple nervous and gouty palpitation, and as a diuretic in organic heart diseases, in which it frequently seemed to afford relief. The observation of Turnbull — that by the external application of veratrine, in chronic rheumatism, with swellings of the joints, these disappeared — induced him to try it in glandular swellings ; he found, that in goitre, in swellings of the mammary glands un- accompanied with pain, in buboes, and in scrofulous tumours of various parts, even in cases in which iodine had failed, it rendered essential service. It has, according to him, the advantage, that the skin is not subsequently irritated by it, and when, after the rubbing, the superfluous ointment is washed off with soap and water, the affected parts can soon afterwards be exposed to the air. Of an 1 Hospital Facts and Observations, illustrative of the efficacy of Strychnia, Brucin, Veratria, Iodine, &c. Lond. 1S30. * Wurtemb. Medic. Correspondenzblatt, B. vi. S. 157 & 341 ; & Heidelb. Medicin. Annal. B. iv. H. i. S. Jo. 2S2 dunglison's new remedies. ointment formed often grains of veratrine to half an ounce of lard, a piece, about the size of a nut, is rubbed in for ten minutes twice a day, and every week the strength of the ointment is increased. Magendie 1 recommends, that the veratrine should be given, also, as a drastic cathartic, especially where a speedy action on the bowels is needed. Prescribed with this view, it has been found effective in several aged persons, in whom a collection of excre- ment had formed in the large intestine. Turnbull advises it in the opposite condition of the bowels — in diarrhoea — given in the dose of half a grain — a disease in which, it is well known, our ordinary cathartics often prove extremely serviceable. It would appear, that veratrine is an article which is frequently adulterated. Such, at least, is the opinion of many practitioners, and in this way they account for the discordance amongst ob- servers as to its virtues. 2 The veratrine, with which Ebers made his first trials, was obtained from the French laboratories ; it ex- hibited the whole power of this heroic agent. On employing, how- ever, a new preparation, he found it entirely useless ; and after- wards, with another, he derived all the benefit obtained from the first. The observations of Ebers would induce us to give further trials to the veratrine; but we must confess, that our experience, thus far, has by no means confirmed the eulogiums of Turnbull ; and this is the general sentiment, we think, of the profession. It has often been used externally by ourselves, as well as by many other American physicians, but has almost always fallen short of the mark. Riecke 3 affirms, that he has not seen the slightest effect from the application of the veratrine ointment. 4 MODE OP ADMINISTERING. Yeratrine may be given either in pills or in spirituous solution ; the dose being from one-twelfth to one-sixth of a grain several times a day. Externally, it is best administered in the form of ointment, or endermically. In the latter case, Ebers generally strews two grains on the denuded skin. PilnlcB Veratrince. Pills of Veratrine. 5<. Veratrin. gr. ss. Guram. acaciae, Syrup, gum. acac. q. s. ut fiant pilulae vj. pond. gr. j. Dose. — One pill, to be repeated two or three times a day, ac- cording to circumstances. Magendie. 1 Formulaire pour la Preparation, &c. de plusieurs nouveaux Medica- mens. 2 Ebers, & Riecke, Die neuern Arzneimittel, u. s. w. S. 407. * Op. cit. * See, on the preparation, employment, action, and medicinal virtues of veratrine, Ebers, in Hufeland's Journal, B. lxxxvi. 1838. VERATRINA. 3S3 *. Veratrin. gr. ij. Pulv. rad. glycyrr. gr. xij. Ext. hyoscyam. gr. vj. M. fiant pilulse xij. Dose. — One, three times a day. Turnbull. Tinctura Veratrince. Tincture of Veratrine. 5<. Veratrin. gr. iv. 1 Spiritus vini, ^j. M. Dose. — Ten, fifteen, twenty, to twenty-five drops in a glass of water. — Given in dropsy. Magendie. 2 Unguentum Veratrince. Ointment of Veratrine. £. Veratriaae, gr. v. x. vel xx. Axungiae, gj. Misce intime. For external use. The size of a hazel-nut to be carefully rubbed in, morning and evening, or oftener, for from five to fifteen minutes. Turnbull. 5<. Veratrin. Bj. Tere cum 01 olivee, 3j. Et adde Unguent, cetacei, Jvij. Misce. Solutio Veratrince. Solution of Veratrine. 5<. Veratrinae, gr. j. Aquae destillat. §ij. M. A dessert-spoonful to be taken in one or two ounces of sugared water, in cases of tic douloureux. Magendie. Linimentum Veratrince. Liniment of Veratrine. &. Veratrin. gr. viij. Solve in Alcohol. Linim. sapon. aa. ^ss. The Sulphate of Veratrine — veratrince sulphas — possesses the same virtues as veratrine. Magendie gives the following form for internal administration : — 1 Iu the Pharmacopee Universelle, of Jourdan, (ii. 643,) there is the seri- ous error of directing giv. in the preparation of this tincture, in place of four grains ! * Magendie recommends that the tincture should also be used externally, in cases of dropsy or gout. 384 dunglison's new remedies. Solutio Veratrince. Sulpkatis. Solution of Sulphate of Veratrine. £. Veratrinae sulphat. gr. j. Aquae destillat. £ij. Misce. Dose. — 3j to 3iv in a mixture. The preparation has been sug- gested as a substitute for the Eau medicinalc cTHusson. ZINCI CHLORIDUM. Synonymes. — Zinci Chloruretum, Zincum Chloratum, Z. Muriaticum (Oxydatura,) Chloride, or Chloruret, Hydrochlorate, Muriate, or Butter of Zinc. German. — Zinkchlorid, Salzsaures Zinkoxyd. MODE OF PREPARING. The chloride of zinc results, — if to any given quantity of pure muriatic acid, pure oxide of zinc be added by the aid of gentle heat, until no more is dissolved : the solution is then filtered, and evaporated in a porcelain dish to dryness ; whereby a jelly-like — and, by high drying — firm, white, and, by careless drying, light brownish substance remains, of an austere, sourish, metallic taste, which must be rubbed to powder, and preserved in a closely stopped vessel. The chloride of zinc is very deliquescent in the air, forming the butler of zinc, (butyrum zinci ; German, Zinkbutter.) It is very soluble in water. EFFECTS ON THE ECONOMY. The chloride of zinc has been exhibited both internally and ex- ternally, but chiefly in the latter mode, especially in this country. Papengnth 1 found a very dilute solution useful in flabby scrofu- lous ulcerations, applied in the form of lotion ; and in sinuous ulcers, in the form of injections. It has been especially recommended as a caustic, that does not exert any disagreeable influence, like the corrosive sublimate, arsenic, or the potassa fusa ; — never causing violent pain in the affected parts, or any kind of irritative fever; or disordering the digestive organs, as some of the articles just mentioned. Hanke, indeed, advises that arsenic should be entirely banished from therapeutics as a caustic agent, and that the chloride of zinc should be substituted for it. He employed it with success in old, atonic 1 Nouveau Journal de Medecine, 1819. ZINCI CHLORIDUM. 385 ulcerations on the feet, in the strength of two grains to the ounce of distilled water: with this he wetted lint, and applied it two or three times a day. With like success he used it in old syphi- litic ulcers, with extremely morbid surfaces and secretions : the chloride destroyed the degenerate formation, and effected cica- trisation. In scrofulous and malignant herpetic ulcers, he pre : scribed a concentrated solution ; in pityriasis he used it as a wash, and in wounds and ulcerations, with fungous formations, he ap- plied it in a concentrated state : in phagedenic ulcers of the face, it effected a more certain cure than the method of Cosme, — the chlo- ride being strewed a line thick, in a dry state, over the whole sur- face of the ulcer, the edges surrounded with adhesive plaster, and a plaster placed over the chloride of zinc, with compresses and an appropriate bandage. In naevi materni, angiectasis, &c, he applied it in the same manner, as well as in the pustule maligne, (Milz- brandkarbunkel.) Mr. Callaway, 1 of Guy's Hospital, London, employed it with considerable success in the cure of cutaneous and subcutaneous naevi materni. It was directed to be rubbed on the part until the skin became slightly discoloured, and to be repeated at intervals. Dr. Alexander lire has found it extremely useful in the varieties of erosive ulcer called lupus, which were often speedily checked, and the disease permanently cured by the local use of the chloride. He applied it in a paste, made with one part of the chlo- ride and two or three parts of the anhydrous sulphate of lime — a modification of Canquoin's formula, (see below,) which he recom- mended upwards of two years ago. 2 One or two applications of the paste were generally sufficient to produce a proper eschar, and when this was detached, the sore was treated with water dressing. 3 In a late British periodical, a case is related by Dr. Davidson, 4 of malignant ulcer under the left ear, which was cured by the un- mixed chloride of zinc, applied repeatedly until the ulcer assumed a healthy character. Hanke used it likewise for the formation of issues, which it establishes in from six to eight hours; and, lastly, to excite rube- faction on the surface, either applied in the form of a solution of the chloride in water or wine, or mixed with oil or lard into an ointment, and rubbed on the skin : in this way, a gritty kind of eruption of a scarlet hue is induced, which is said to have afforded relief in paralysis of the limbs. Wendt, Vogt, and Canquoin have highly extolled the chloride as a caustic, and it has been largely employed by the physicians and surgeons of this continent, especially in the Philadelphia Alms- house, and Pennsylvania Hospital, in similar cases to those men- tioned above. 1 British Annals of Medicine, May 19, 1837. 1 Lond. Med. Gazette, Dec. 1 ( J, 1835. 3 Ibid. Dec. 3, 1836. * Edinb. Med. and Surg. Journ. Jan. 1838. 12— f dungl 25 386 dunglison's new remedies. Dr. Davidson 1 is of opinion, that the chloride of zinc is only superior to many other caustics in cases where the destruction of a considerable thickness of texture is required, or where the removal of an excrescence by a caustic is preferred by the patient to the knife: the nitrate of silver seems, he considers, to be supe- rior in promoting a sound action, when the unhealthy surface or stratum of the ulcer is superficial. Hanke 2 has, likewise, used the chloride of zinc internally, in cases of epilepsy, with advantage, as well as in St. Vitus's dance ; and has prescribed it, united with hydrocyanic acid, in prosopalgia. Hufeland, also, extols the solution of the chloride in all those neu- roses in which the oxide of zinc is indicated, and especially in such patients as are not readily impressible. 3 MODE OF ADMINISTERING. Guttce Zinci Chloridi. Drops of Chloride of Zinc. 5<. Zinci. chlorid. gr. j. Sp. aether, muriat. ^ij. Solve. Dose. — Five drops, every four hours, in a little sugared water; gradually increasing the dose to ten drops. Lotio Zinci Chloridi. Lotion of Chloride of Zinc. B<. Zinc, chlorid. gr. viij. Ext. aloes aquos. ^ij. Aquee destill. %iv. Solve. Applied to the dressings, in cases of atonic, scrofulous ulcers. Vogt. The chloride of zinc may be applied as a caustic, by means of a moistened hair pencil, either alone, or mixed with an equal portion of oxide of zinc, or sulphate of lime, or according to the following forms : — Canquoiti's Caustic Pastes. A. B. C. 5«. Zinci chlorid. p. i. i. i. Farinse tritici p. iv. iij. ij. Aqua? fontan. 4 q. s. at fiat pasta. 9c. Zinci chlorid. p. j. Farina? tritic. p. iss. Butyri antimonii, p. ss. Aq. font. q. s. ut fiat pasta. 1 Op. cit., and American Journal of the Med. Sciences, May, 1839, p. 238. 2 Rust's Magazine, xxii. 373; and Journal de Pharmacie, xvi. 549. 3 See Merat & De Lens, Art. Zinc, (Chlorure de.) 4 To each ounce of the chloride of zinc twenty-four to thirty drops of water being added. ZINCI CYANIDUM. — ZINCI FERROH YDROCYANAS. 387 ZINCI CYANIDUM. Synonymes. — Zincum Cyanogenatum, Z. Borussicum, Z. Zooticum, Z. Hydrocyanicurn, Z. Cyanuretum. Hydrocyanate, Prussiate, or Cyanuret of Zinc. French. — Cyanure de Zinc. German. — Cyanzinc, Blausaures Zynkoxydul, Blaustoffzink, Zinkcyanur. This preparation was used in Germany for a long time before the process was made known. 1 METHOD OF PREPARING. According to Kunze, it is directed, in the Leipzic shops, to be prepared as follows : 2 Any quantity of pure sulphate of zinc is dissolved in ten times as much distilled water ; the fluid is then filtered, and decomposed by a solution of hydrocyanate of potassa, or hydrocyanate of lime ; added by drops so long as a precipitate is formed. This precipi- tate, which consists of cyanide of zinc, must be carefully washed, dried, and preserved in a glass jar, from which the entrance of light is prevented. 3 The hydrocyanate of zinc has the appearance of a white, taste- less powder, which is insoluble in water and spirit of wine, but dissolves in the stronger acids, with the disengagement of hydro- cyanic acid. Well prepared and rubbed, it has a strong odour of hydrocyanic acid. When moistened, or exposed to heat, it exhales hydrocyanic acid. As to its medicinal effects and mode of administering, they are analogous to those of the following preparation: they are, there- fore, given together. ZINCI FERROHYDROCYANAS. Synonymes— Cyanuretum Ferrozincicum, Zincum Ferrohydrocyanicum, Ferro-Hydrocyanate, or Ferrocyanate of Zinc. German. — Eisenblausaurer Zink, Blausaures Eisenoxydul-Zinkoxyd, Zink- eisencyaniir, Cyaneisenzink. METHOD OF PREPARING. According to Schindler, 4 this preparation is best made by the mutual decomposition of boiling hot solutions of eighty-three parts 1 Magendie, Forrnulaire pour la Preparation, &c. de plusieurs nouveaux Medicamens, &c. 2 Riecke, Die neuern Arzneimiuel, u. s. w. S. 410. Stuttgart, 1837. 3 For M. Pelletier's method, see Magendie, Forrnulaire. &c. * Riecke, Op. cit. S. 411. 38S dunglison's new remedies. of sulphate of zinc, and sixty parts of ferrocyanate of potassa. If the sulphate of zinc be not entirely free from iron, it has a bluish lustre, which, after long washing with lime water, becomes of a reddish hue. If the bluish colour be manifested, some more sul- phate of zinc must be added, and it must be digested until the pre- cipitate appears entirely white. Ferrohydrocyanate of zinc forms a white, insoluble, almost in- odorous powder, which is somewhat soluble in the stronger acids, without exhaling a smell of hydrocyanic acid in the cold ; but, by boiling, hydrocyanic acid is slowly disengaged. EFFECTS ON THE ECONOMY. Hufeland recommends the cyanide, or perhaps, the ferrocyanate of zinc in nervous diseases. According to him, from one to four grains may be given for a dose, two or three times a day. without any injurious effects; — the only inconvenience being, at times, slight nausea, but no diarrhoea, or disposition to obstructions, and no narcotic symptoms. In cardialgia, it afforded, in his hands, essential service, as well as in some cases of epilepsy, and in paralysis. Henning, 1 likewise, found it useful in cramp of the stomach, in hysteria, and in spasmodic diseases of children, in- duced by worms. In epileptic attacks from teething, he also gave it with advantage; — the dose being from half a grain to a grain, three or four times a day. Clarus gave the cyanide (?) of zinc in epilepsy, but he observed no other result than less frequent and less severe attacks. Pohl saw no very decided effect from the remedy, which he gave in the dose of from one-fourth to half a grain. In the Berlin Polyclinic Institute, advantage accrued from it in two cases of St. Vitus's dance ; it was begun with in the dose of one- third of a grain twice a day, which was gradually raised to four- teen grains a day. Klokow gave the cyanide of zinc — which Riecke suggests 2 was the cyanuret of zinc and potassium, (Cyan- zink-cyankalium,) — in spasmodic affections, beginning at first with one-tenth of a grain, as larger doses occasioned colic, diarrhoea, and vomiting; and, when the patient became accustomed to it, gradually augmenting the dose to half a grain. Success, he affirms, followed its administration. 3 Muhrbeck gave it, in violent periodical cephalalgia in the region of the left frontal sinus, with great benefit. He began with one-twelfth of a grain, and gradually raised the dose to a grain and a half. Muller and Giinther confirm the reports of its efficacy in St. Vitus's dance : the first gave daily a grain ; the latter, from half a grain to a grain, four times a day. Kopp, who properly distinguishes the two preparations from each other, instituted experiments with each. The ferrocyanate of ' Hufeland's Journal, 1823. 2 Op. cit. S. 413. 8 Hufeland und Osann's Journal, B. lxx. St. 2. ZINCI FERROHYDROCYANAS. 389 zinc he used with advantage in cramp of the stomach, general nervous disorders, nervous debility, neuralgia, nervous headach, and nocturnal pains in the bones. He gave it in the form of powder, with some sugar of milk, every two hours, or four times a day, in doses of one-twelfth to one-eighth of a grain, gradually increasing the dose. According to his observations, it occasions, with many persons, obstructions, but does not disorder the stomach. Kopp found the cyanide of zinc still more efficacious in the same disorders. Impressible patients, who suffered under unusual sen- sibility of the abdomen, took four powders daily, of one-sixteenth of a grain each, with marked benefit. In one case of neuralgia, in a man, he elevated the dose very gradually to half a grain four times a day. When, however, this quantity was exceeded, and the patient took five-eighths of a grain four times a day, hyperasmia occurred in the head, with constipation. In two cases of chorea of one side of the body, the ferrocyanate had no effect whatever. Riecke 1 asserts, that his father used it several times in scirrhus of the pylorus with advantage. MODE OF ADMINISTERING. The cyanide (?) was applied externally, by Von Ammon, in scrofulous and incipient rheumatic inflammation of the eyes, as well as in catarrhal inflammation of the eyelids: he prescribed it suspended by means of gum arabic in a mixture of cherry-laurel water and tinctura opii. On account of the insolubility of both the cyanide and the ferro- cyanate, they are best given in the form of pill or powder. The common dose of the cyanide is from one-sixteenth to one- twelfth of a grain several times a day, gradually increasing the dose to one quarter of a grain ; of the ferrocyanate, the dose is from one to four grains two or three times a day. Riecke 2 advises — to prevent confusion — that when these articles are ordered, thoy should be respectively denominated, Zincum bydrocyanicurn sine ferro, and Zincum /e/ro-hydrocyanicum. PilulcB Zinci Cyanidi. Pills of Cyanide of Zinc. &. Zinci cyanid. gr. xv. Succ. glycyrrh. 3'\j. Misce et fiant piluloe lx. Dose. — One, morning, noon, and night, gradually increasing the quantity. Kopp. Rt. Zinci cyanid. gr. vj. Magnesias, gr. iv. Pulv. cinnain. gr. iij. Misce. This dose to be repeated every four hours, in nervous affections of the stomach, especially in cases of cramp. Henning. 1 Op. cit. S. 414. 2 Ibid. 390 dunglison's new remedies. ZINCI IODIDUM. Synonymes. — Zincum Iodatura, Zinci Ioduretum, Iodide, or Ioduret of Ziuc. German.— Iodzink. This preparation is made by boiling together iodine and zinc in atomic proportions, or rather with an excess of zinc, in a flask of water, down to dryness, and subliming the residue. Iodide of zinc is thus procured in beautiful, colourless, prismatic crystals. 1 The iodide of zinc is very deliquescent, and cannot easily be retained in the solid form. When heated in open vessels, it is re- solved into iodine and oxide of zinc. It is very liable to undergo spontaneous decomposition. It has a caustic taste, and, when applied to a denuded surface, gives rise to considerable smarting. Dr. Ure 2 recommends an oint- ment, formed of a dram of the iodide to an ounce of lard, in cases where the external use of the iodide of potassium is indicated. Proutet advises it as a collyrium in scrofulous ophthalmia, of the strength of fifteen grains to six ounces of distilled water : and it has been employed to form an astringent injection, in the proportion of a grain to an ounce of water. 1 Annales de Chimie, xci. % Diet, of Chemistry, 2d edition, p. 516. SUPPLEMENT. I.— COMPRESSTO. Synonymes. — Compression, Methodical Compression. German. — Druck. This valuable method of modifying the condition of the capillary or intermediate system of vessels, and, through it, the function of nutrition, has lately become more extensively employed in the treatment of disease. As a sorbefacient, in various hypertrophies, it has long been used wherever its agency was applicable, and its effects have been very de- cided. 1 Of late years, however, it has been proposed in inflammatory and other affections, in which it had been previously esteemed inappli- cable. Upwards of twenty years ago, it was highly recommended in rheumatic affections by Dr. William Balfour, 3 of Edinburgh, and nume- rous cases were brought forward by him, and by others, to attest its efficacy. Since then, it has been advised by Guerin, 3 in cases of phleg- monous erysipelas of the extremities; by Velpeau, 4 in severe burns and phlebitis, and in inflammation of the synovial apparatus; 5 and still more recently, Mr. James Allan 6 has related three cases of phlegmasia bene- fited by a similar treatment; — two were of erysipelas of the lower ex- tremities, and one of the face. In these, compression was of speedy and permanent benefit — the pain caused by it being very transient. He states, moreover, that he has found the bandage of very great service in removing the pain and swelling of joints affected with acute rheumatism, after the more active degree of inflammation had passed away. In cases of external inflammation, compression acts probably in two ways; — first, by diminishing the circulation in the intermediate system of vessels concerned in the pathological condition ; and, secondly, by 1 Clinique Medicale de l'H6pital Necker, p. 247, Paris, 1835; or the translation in the American Medical Library, first year 1 . See, also, the author's General Therapeutics, p. 228. Philad. 1836. 1 A new Mode of curing Rheumatism and Sprains without debilitating. Eclinb. 1816. s Journ. Analyt. i. 93. * Ibid., and Bulletin General de Therapeutique, No. 16, Aout 30, 1836. 5 Nouv. Bib. Med., Aout, 1826; and Merat & De Lens, Diet, de Mat. Med., Art. Compression. 9 British Annals of Medicine, Jan. 27, 1837. 392 dunglison's new remedies. SUPPLEMENT. restoring (one to the over-dilated vessels; for it is in erysipelatous affec- tions, in which this form of hyperaemia more especially exists, that we have found it of greatest advantage. At this very time, we have cases of erysipelas of the extremities under treatment by compression, which are greatly benefited. We are constantly, also, in the habit of employing compression, under the circumstances mentioned by Mr. Allan, in arthri- tic affections, which are usually attended with great effusion, and with the most satisfactory results. From an observation of the good effects resulting from compression in analogous cases, it occurred to Dr. Fricke, 1 of Hamburg, that it might be employed with advantage in cases of orchitis, or swelled testicle, (hernia humoralis;) which is frequently very tedious, and requires means that are by no means easy of application. He, accordingly, had recourse to it, and the result was most satisfactory: he found that "the disease could be removed by it in a simple, easy, and surprisingly rapid way." He is of opinion, that, generally speaking, compression may be employed in every kind of inflammatory enlargement of the testicle, whatever may have been its cause, and at all stages of the disease. In many cases, the pain was at first, in some degree, increased ; and in some — especially when applied too tightly — it induced great pain; but this never continued long, the patient, in a short time, finding himself so much relieved as to be able to leave his bed and walk about the room. In many cases of recent origin, a single application of the compression was found sufficient; but when the disease was of longer duration — say from three to eight days — it was found necessary to repeat the compres- sion two or three times. Swelling of the spermatic cord, if not very considerable, did not contraindicate its use; nor did other coexistent local affections, as buboes, ulcers, &c. When a general febrile state accompanied the orchitis, comoression was found to be the best means for removing it, where the vascular action, at least, was not too consi- derable; although, in extremely rare cases, such was the effect of the compression itself. When the pain was very severe, it was generally owing to the com- pression having been too strong, and the same was the case with certain signs of gastric derangement that occasionally supervened. In these cases, it was necessary to suspend the remedy, until the derangement was removed, by the use of an emetic, or the application of a poultice to the stomach. These cases were, however, extremely infrequent. The good effects of compression exhibited themselves very soon after its employment, and the speedy abatement of the pain was always the surest sign of its efficacy. If the pain continued for some hours to any considerable degree, a general disorder of the system might, be looked for as explaining the cause of the failure of success. In the summer of 1835, Dr. Fricke treated, in this manner, seventeen cases. Of these were cured; — in one day, one; in two days, four; in three days, four; in four days, two; in five days, three; in nine days, one ; and in ten days, two. The three last were severe and unfavour- able cases. For the purpose of compression, Dr. Fricke employs sticking plaster, 1 Zeitschrift fur die gesammt. Medicin. B. i. H. 1, Hamburg, 1S36. See, also, Brit, and For. Med. Rev. for July, 1836, p. 253. COMPRESSIO. 393 made very adhesive, but not of too irritating materials, and spread on strips of linen, of the breadth of the thumb. No preparatory measures, as leeches, cataplasms, &c. are required. In slighter cases, the patient may stand before the surgeon leaning against the wall, or he may sit on the edge of a bed or sofa, in such sort that the scrotum may hang freely down. If the scrotum and neigh- bouring parts are much covered with hair, it must be removed; but, generally speaking, this is unnecessary. The following is the method he adopts of applying the compres- sion : — The surgeon takes the scrotum in one hand, and separates the dis- eased from the sound testicle; whilst, with the other, he gently stretches the skin of the scrotum over the former: the spermatic cord is isolated in the same manner. If the swelling of the testicle be considerable, it must be held by an assistant. The surgeon now applies the first strip over the isolated spermatic cord, about a finger's breadth above the tes- licle, holding the end of the strip with his thumb, and passing it round the cord. He proceeds in the same manner with the second strip, which must cover the former either in part or altogether. The first part of the process must be carefully done ; the strips must compress the cord closely; for this purpose, the cord must be kept approximated to the skin, which must be tightly stretched over it; otherwise, when the other extremity of the testicle is compressed, the upper end will be apt to slip upwards through the loose rings of adhesive plaster, which will not only occasion pain, but render the whole operation abortive. In this manner the surgeon proceeds, applying strip after strip, the last always lying over its precursor by a third of its width, until the thickest part of the testicle — where it begins rapidly to decrease in diameter — is reached. The mode of procedure is now changed ; the surgeon lays hold of the part of the testicle already covered, and passes his strips longitudinally from above downwards over the lower portion of the testicle. In this way, the rest of the testicle is closely enveloped and compressed. The proper degree of compression will, in most cases, be indicated by the speedy disappearance of the pnin which had previously existed. When both testicles are affected, they must both be included in the circular strapping — the testicle already covered serving as a point of support for the other — as there is not room enough for the application of the circular strips over the second, in the same way as over the first. In some cases, where the skin is irritable, ulcerations take place : small slits may then be cut in the placer, and a Goulard lotion be applied. Generally speaking, the patient may leave his bed immediately after the strapping has been attached, and walk about the room; and, where the inflammation has not been great, he may even attend to light labour out of doors. When the strapping becomes loose, it may have to be reapplied, but often one application is sufficient. In orchitis, caused by blows or pressure, compression is regarded by Dr. Fricke as the best agency. If the inflammation runs very high, he usually applies leeches, in the first instance, and keeps on poultices for a day or two; but, in slighter cases, he has recourse immediately to com- pression. The principal advantages, which he considers this mode of 394 dunglison's new remedies. SUPPLEMENT. treating orchitis to have over others, are: First. The speedy removal of the pain ; Secondly. The quick removal of the disease itself; Thirdly. The simplicity of the plan, and the slight trouble given thereby to the patient; Fourthly. Its small expense: and, Fifthly. The comparatively slight care and attendance required on the part of the surgeon. The two last points, as he properly remarks, are of considerable importance in hospital practice. Since this plan of treating orchitis was suggested by Fricke, it has been successfully employed by our hospital and other surgeons, although by no means extensively adopted. Several cases, too, have been men- tioned by M. Dechange,' of Liege, formerly chef de cliniqve chirurgicale at the Hopital de Baviere. Of twelve cases of acute orchitis, thus treated, three were cured in three days; and the remainder before the seventh day. Of late, Compression of the arteries, as an antiphlogistic agent, has been revived by Goyrand, Malapert, and others ; the object being to prevent the afflux of blood to a part labouring under hyperemia. The origin of this idea has been a matter of recent controversy ; a but, as Dezeimeris 3 has remarked, it certainly is not due to the gentlemen who have engaged in it. Blaud compressed the carotid in brain fever ; Auten- rieth did the same, before Blaud, in cases of convulsions ; Earl, in epi- lepsy ; Livingston and Kellie, in rheumatism ; Ludlow, in gout ; and Parry, of Bath, half a century earlier, employed compression of the vessels in different diseases, with the clearest appreciation of its modus operandi. Still more recently, Allier 4 has published a case of intermittent neu- ralgia of the lobe of the right ear, cured by compression of the primitive carotid of the same side : half an hour before the paroxysm, the com- pression was exerted, with interruptions of five minutes every quarter of an hour. He has, also, reported a case of neuralgia of the orbito-frontal nerve ; and, subsequently, of the nervus pudendus superior, respectively cured by compression of the carotid, and abdominal aorta. The com- pression of the carotid of the affected side was continued for the whole forenoon, with pauses of five minutes every quarter of an hour. For the pudic neuralgia, the abdominal aorta was compressed for the space of three quarters of an hour: the neuralgia, in both instances, gradually ceased. Lastly : M. Allier 5 employed compression of both carotids in a case of hydrophobia at the commencement of an attack; immediately, the convulsion ceased, and the patient became apparently exanimate. The family were alarmed, and would not permit a repetition of the experi- ment. The case ended fatally. In paroxysmal diseases, the ratio medendi of compression is not the same as in inflammatory diseases. In the latter, the flow of blood towards the inflamed part is prevented by the compression of the arterial vessels proceeding to it ; but when compression is exerted on the vessels 1 Bulletin Medical Beige, Aout, 1838, p. 218. 2 Gazette Medicale de Paris, No. 46, Nov. 18, 1837, and No. 47. 3 Ibid. 4 L'Experience, No. 16, Jan. 20. 183S. 6 Ibid. C0NTRA-IRRITAT10. 395 in neuralgia and congenerous diseases, the new impression caused by the resulting irregularity in the circulation, and the modification in the nervous function induced thereby, break in upon the morbid catenation like the different agents that are classed under the head of antispasmo- dics, of which class we have elsewhere endeavoured to show — what, by the way, is not now contested by any eminent therapeutist — that we have none that can be regarded in any other light than as indirect agents. 1 II.— CONTRA-IRRITATIO. Synonymes. — Counter-irritation, Counter-action. German. — Gegenreizung. It is not the object of the author to enter into an explanation of the therapeutical application of counter-irritants, or revellents in general. This he has done at considerable length elsewhere; 2 but to refer to some agents not mentioned in the body of the work, to which attention has been revived, or first directed, of late years more especially. 1. AMMONIATED COUNTER-IRRITANTS. Gondret's Ammonical Ointment ; Granville's Counter-irritants — Antidynous 3 Counter-irritants. Ammonia has long been used in different formula? for exciting rube- faction and vesication of the cutaneous surface. When two parts of liquid ammonia are united with one pirt of suet and one part of oil of sweet almonds, the mixture forms the pommade ammoniacale of Gondret, which has been used for a long time to excite a speedy revulsion in cases of chronic affections of the brain, incipient cataract, amaurosis, &c, as well as to cauterise the integuments deeply. 4 To the advantages of this preparation, as well as of derivation in various diseases, M. Gondret has recently recalled the attention of practitioners in an ex professo treatise. 5 Since the appearance of M. Gondret's last woik, Dr. Granville 6 has 1 General Theiapeutics, p. 380. 2 Ibid. p. 333. 3 A term coined by Dr. Granville. It ought to be " Antodynous," from av-n, '■'• against," and oSwvj, "pain." 4 Considerations sur l'ernploi du feu en medecine, suivies de 1'expose d'un moyen epispastique propre a suppleer la cauterisation, et h remplacer l'usage des cantharides, Paris, 1819; & Nouv. Biblioth. Med. iii. 441, 1828. 6 Gondret, Traite theorique et pratique de la Derivation contre les affec- tions les plus communes en g6neral, telle que la Plelhore, l'Inflammation, l'Hemorrhagie, &c. Paris, 1837. 8 Counter-irritation, its Principles and Practices, illustrated by one hun- dred Cases of the most painful and important Diseases effectually cured by external Applications. London, 1838; and American Medical Library edi- tion. Philad. 1838. 396 dunglison's new remedies. — SUPPLEMENT. published a treatise on counter-irritation, which has given rise to much attention on both sides of the Atlantic, — partly in consequence of the strong encomiums he has passed on certain counter-irritant applications employed by him, and still more in consequence of the mystery which he threw around them, by keeping their preparation a secret, until the united voice of the profession had expressed the mingled feelings of sur- prise, indignation, and regret, which such conduct on the part of an individual, holding an elevated position in the ranks of the profession, naturally engendered. It is due, however, to Dr. Granville to remark, that on subsequently publishing his formula?, he stated that he addressed his work to ihe public to impress all with the value of the agency, but that it would have been unwise in him to give precise formula? to those who could not estimate the proper proportions of the ingredients; that every physician can apportion them; and that he had never concealed the formulas from his friends, and always intended to give them to the world." Dr. Granville describes two sorts of ammoniated lotions, of different degrees of power, which are prepared in the following manner: Each kind of lotion consists of three ingredients: — 1st. The strongest liquor of ammonia, A. 2d. Distilled spirit of rosemary, B. 3d. Spirit of camphor, C. These are made as follows : A. The strongest liquor of ammonia. — Saturate a given quantity of distilled water, contained in a glass receiver surrounded by ice, with ammoniacal gas, obtained in the usual way from a mixture of equal parts of hydrochlorate of ammonia and recently slaked lime, both reduced to a fine powder. The water may be made to take up nearly 800 times its bulk of ammoniated gas under the circumstances described; its specific gravity will then be about 872, and 100 pnrts of it will contain thirty- three parts of real ammonia, according to Sir H. Davy's tables. This solution of ammonia will, therefore, be more than three times the strength of the liquor ammonicB of the Pharmacopoeia of London, 100 parts of which, at a specific gravity of 960, contains only ten parts of real am- monia. Dr. Granville, therefore, called his " liquor ammonia? fortissimus." B. Distilled Spirit of Rosemary. — Take two pounds of the tips or small leaves of fresh rosemary, and eight pints of alcohol; leave the whole in infusion for twenty-four hours in a well covered vessel, and after adding as much water as will just prevent the empyreumatic smell, distil over seven pints. The Pharmacopoeia of London directs the essential oil of rosemary to be distilled instead with rectified spirit. Such a preparation Dr. Granville found unsuited for his purpose. C. Spirit of Camphor. — To four ounces of pure camphor add two pints of alcohol, so as to dissolve the camphor, which solution should be filtered. The three ingredients, thus prepared, every medical man should keep always ready at hand, in well-stoppered glass bottles, so as to be able to make, extemporaneously, a counter-irritating lotion of any requisite strength, according to the nature of the case. But for ordinary purposes, Dr. Granville advises that both a milder and a stronger ammoniated lotion should be kept ready prepared for use. 1 London Lancet, Oct. 27, 1S33. CONTRA-IRRITATIO. 397 Lotto Arnmoniata Mitior. The Milder Ammoniated Lotion. Assuming the quantity of lotion desired to be divided into eight parts, then the proportions of the ingredients will stand thus: A — four eighths. B — three eighths. C — one eighth^ or as follows: 5<. Liq. amnion, fortiss. §j. Spirit, rorismarin. gvj. camphor. 31J. M. Lotto Arnmoniata Fortior. The Stronger Ammoniated Lotion. If the quantity desired be also divided into eight parts, then the pro- portions of the ingredients run as follows: A — five eighths. B — two eighths. C — one eighth, or as follows : *. Liq. ammon. fortiss. gx. Spirit, rorismar. .jfss. camph. ^ij. M. Although the changes of proportion here may be deemed trifling, yet the strength of the lotion is such, that Dr. Granville never employs it, except in cases of apoplexy, and for the purpose of cauterisation. Directions in Mixing the Ingredients. — A and B are gradually mixed together. The mixture becomes opalescent and somewhat turbid, and a peculiar, highly agreeable, ethereal smell is given out, different from the individual odour of either ingredient, although the extreme pungency of the ammonia is still discernible. " I have strong reasons to believe," says Dr. Granville, " that, at this point of the operation, some particular change takes place, which imparts to the mixture of the two ingredients some of its valuable peculiarities as a counter-irritant described in my work ; but what that change is, it is not my business to enter upon in this place : suffice it to say, that in a great number of experiments made with the ingredients separately, (for each of them acts as a counter-irri- tant on the skin,) and with them combined, the effects were uniformly different ; those in the former case being found unequal to the production of those complete results which I trust I have justly promised to the profession. Ammonia alone (however strong) will not give rise to the effects I have described, though it has often stopped internal pain, and produced small blisters ; but never has it succeeded in almost imme- diately producing a full vesication, as I have seldom failed to produce with the two ingredients mixed together, particularly after the third ingredient has been added." Before, however, that third ingredient is so added, it is desirable to clear the previous mixture, by the addition of a small quantity of alcohol, and to set the whole in a cool place. All the various precautions here mentioned may, upon an emergency, be dispensed with, when an imme- diate action is required, either to arrest pain or relieve deep-seated inflammation. But for the more delicate uses, particularly for instan- taneous vesication, Dr. Graiiville recommends that the preparations should be obtained in the manner specified. The lotion must always be kept in bottles with a glass stopper. 398 dunglison's new remedies. — SUPPLEMENT. EFFECTS ON THE ECONOMY IN HEALTH. The stronger of these lotions is a powerful agent. It gives rise in a few minutes to vesication over the whole surface to which it may be applied; almost as rapidly, indeed, as if boiling water were placed upon the part. It need scarcely be said, that the strength of these lotions may be regulated so as to produce either full vesication, or simply rubefaction, by varying the quantity of the liquor ammonioe. The mode of applying these counter-irritants is, as in the case of the 0!pum Sinapis, (p. 292,) first to impregnate with them a piece of cotton or linen, folded six or seven times, or a piece of thick and coarse flannel ; and then lay either of these on the spot, pressing with the hand, at the same time, very steadily and firmly on the compress, over which there should be placed a thick towel, doubled several times, so that not only the evaporation of the lotion may be impeded ; but the hand, employed in pressing the application to the part, may not suffer from direct or indi- rect contact with the liquid. Care must be taken that the ammonia does not reach the eyes or nose. 1 As a general rule, the application should seldom be kept on longer than from one to six or eight minutes; and Dr. Granville affirms, it has often happened to him to find, that loss than a minute was sufficient to produce the desired alleviation of pain and spasm. But, in order to excite the higher degrees of counter-irritation, as vesication and cauteri- sation, as many as ten or twelve minutes may be necessary. EFFECTS ON THE ECONOMY IN DISEASE. There can be no doubt, that the ammoniated counter-irritants are valu- able agents in all those diseases, which are capable of being benefited by a sudden and powerful revulsion. It is chiefly, as we have elsewhere stated, 2 when the diseased action has been prolonged for a considerable period, and in affections, which belong to the neuralgic class, that rapid revulsions are productive of the most marked advantage. When the disease is of an acute character — as in the different phlegmasiae — revul- sives, which are more prolonged in their action, are — as a general rule — preferable. It is in the first class of affections, that his lotions are chiefly extolled by Dr. Granville ; he urges the importance of the sudden vesication effected by them in the treatment of many serious disorders; and affirms that they arrest " nervous and muscular pain almost imme- diately, provided it does not depend on structural disease." 3 There is perhaps no agent — he remarks — except boiling water, which can, in the space of between three and ten minutes, give rise to as ample a vesica- tion. But as powerful and effective a revulsion can be accomplished by the actual cautery in various forms, and especially — as we shall see — in that of the moxa. This we say from observation ; and it is a result to which just theory would lead us. 1 Granville, Op. cit. Amer. edit. p. 39. 2 General Therapeutics, p. 341. 3 Lancet, Oct. 27, 1838. C0NTRA-IRR1TATI0. 399 The ammoniated lotions are, however, devoid of the painful mental impression, which the dread of actual fire occasions; although we doubt not that, in many of the cases above referred to, such mental impression may exert an important agency in the cure. I)r. Granville gives the following, not very classically arranged, list of diseases, which, in the course of nine years, have appeared to him to be benefited by his counter-irritants. " A. Principally affecting the Nervous System. 1. Acute neuralgia \ P ri ° lca . > Tic douloureaux. ° I permanent ^ 2. Spasms $'."■.„ ) 5%P*; n n r> i • \ including > fet. Vitus s Dance. 3. Convulsions} £ Hysterics. 4. Cramp. 5. Brow-ague. 6. Tetanus or lock-jaw. 7. Highly acute toothach. 8. Nervous headach. B. Principally affecting the Mvscles and Tendinous Tissues. 9. Rheumatism. 10. Lumbago. 11. Swelled and highly painful articulations. C. Principally affecting the Circulation. 12. Headach from fulness of blood in the head. 13. Congestions and sudden attacks of blood in the head. 14. Sore throat. 15 Earlv in a ' °^ tne tracnea an d bronchia. en in ^ a„ m ,• " f b. of the lungs and their membranes. \ r, ° flammation. J fc of ^ ^ ^ pericardium< { Consump- D. Diseases of a Mixed Character. 16 SuDDressed ^out I a ' Effecting tne heart. PP ' " 6 ' ) °- Affecting the stomach. 17. Genuine gout. 18. Paralytic debility. E. Accidental, Mechanical, and Cutaneous Derangements. 19. Violent sprains. 20. Pimples. 21. Biles. 22. The ringworm." Dr. Granville does not affirm, that all these disorders, and their modi- fications, have yielded to the ammoniated counter-irritants ; or that the counter-irritants were always the sole agents employed. On the con- trary, a few of them, he says, on particular occasions, resisted that agency ; others were only momentarily benefited ; and a few more re- 400 DUNGLISON'S NEW REMEDIES. SUPPLEMENT. quired the simultaneous employment of ordinary and internal remedies to assist in, and complete, the cure. Among the exceptions to the general rule of success, he enumerates chronic tic douloureux; chronic rheumatism of long standing; epilepsy, dependent on organic mischief in the hrain, or any part of the spinal apparatus; and rheumatic gout, in persons whose constitution has been completely shaken by that disorder, or by any other previous disease, although, even in this case, some good was obtained from using the am- moniated counter-irritants. The second and fourth of these disorders are of that number which require, in addition to the ammoniated appli- cations, an appropriate internal treatment. The other two, Dr. Gran- ville has found to be only partially relieved, but never cured by counter- irritating lotions. 1 In many of the disorders, referred to by Dr. Granville in the table given above, his ammoniated counter-irritants have biien employed both in public and private in this country, and especially, perhaps, in this city. The effect in nervous and spasmodic diseases, in neuralgic and deep-seated rheumatic pains, has at times been very striking. Severe pains have yielded rapidly, as described by Dr. Granville ; hyperemia? of particular organs have been diverted elsewhere, especially after blood- letting and sedatives had been premised ; and, in short, whenever revel- lents, sudden and rapid in their action, have been demanded, the ammo- niated counter-irritants have effected every thing that similar powerful revellents were capable of accomplishing, — but no more. We are in the habit of having recourse to the moxa in congenerous affections, and — as we have before remarked — with equally satisfactory results. There is one objection, too, that applies to the use of these strong lotions ; — the sloughs and sores induced by them are often considerable, and remarkably difficult to heal. This, it is true, may be partly pre- vented, by being careful that the application is not too long continued ; but, with the greatest caution, these results will, at times, supervene. When such is the case, simple dressings, with emollient poultices, will be found the best applications. 2. MOXA. Synonyme. — Moxiburium. By the term moxa, the Chinese and Japanese designate a cottony sub- stance, which they prepare by beating the dried leaves of the artemisia chinensis, a kind of mugwort. With this down they form a cone, which is placed upon the part intended to be cauterised, and is set fire to at the top. This mode of exciting counter-irritation has been long practised by the Chinese and Japanese, and by the ruder nations of the old world ; but it was not much employed in Great Britain and France until about the commencement of the seventeenth century, when it was introduced 1 Op. cit. p. 29. MOXA. 401 through the agency of a physician 1 who had resided in India. It fell again, however, into disuse, until attention was redirected to it, during the last century, by Pouteau 2 and Dujardin, and, at the commencement of this century, by Percy and Laurent, 3 Lsrrey and others.* MODE OF PREPARING. Various agents have been used by different people, in " moxibustion," for so the mode of cauterisation has been termed, which consists in placing some combustible substance on a part of the body, and suffering it to burn down. From the earliest ages, the Nomades employed the fat wool of their flocks, as well as certain spongy substances growing upon oaks, 5 or springing from the hazel ; 6 the Indian the pith of the reed 7 , and flax or hemp impregnated with some combustible material ; s the Persian, the dung of the goat ; the Armenian, the agaric of the oak ; the Chinese and Japanese, the down of the artemisia ; the Thessalian, dried moss; 9 the Egyptians, the Arracanese, and several oriental nations, cotton ;'° the Ostiaks" and the Laplanders, 1 - the agaric of the birch ; and the aborigines of this continent, rotten and dried wood. Hippocrates' 3 was in the habit of employing fungi and flax for the same purpose. In modern times, also, various substances have been used for the fabrication of the rnoxas. Whatever article is selected, it ought to be a spongy, light, vegetable matter; readily combustible, and so prepared as to burn down slowly. In Germany, they use the tinder — amadou — which is known to be an agaric prepared for the purpose ; and it is not uncommonly employed in our hospitals, — a small disc or cylinder being placed on the part, and set fire to. The match used by artillerists was recommended by Percy, 14 after Bontius: 15 it is composed of hemp steeped in a solution of nitre. He likewise proposed the pith of the sun- flower — helianthus annuus — recommending, that the stalk should be cut into cylinders of the desired length, the bark being left on ; so that, 1 Ten Rhyne, Medit. de veteri Medicin. ; Dissert, de Anthritide, Lugd. Bat. 1672; and Kaempfer's History of Japan, translated by Scheuchzer, vol. ii. append, sect. iv. Lond. 172S. 2 Melanges de Chirurgie, p. 49. 3 Dictionnaire des Sciences Medicales, Art. Moxibustion. * See, for a history of the moxa, the author's translation of Baron Larrey's Memoir on the use of the Moxa. Lond. 1822. 6 Hippoc. lib. de Affect, cap. xxx. 6 Paulus yEginet. lib. vi. cap. 49. 7 Kuimpfer, vol. ii. app. sect. iv. p. 36. 8 Bontius de Medicina Indorum, p. 32. 9 Percy, in Pyrotechnic Chirurgicale pratique, p. 12. 10 Prosper. Alpin. de Medicina yEgyptiorum, lib. iii. cap. 12. •' Voyages de M. Pallas, iv. 68. 12 Acerbi's Travels through Sweden, Finland, and Lapland, ii. 291, and LiniKKUs, in Lachesis Lapponica, translated by Sir James Smith, i. 274. 13 De Affect, cap. viii. " Op. cit. p. 77. Paris, 1811. ,6 Op. cit. p. 32. Paris, 1645. 12 — v dungl 26 402 dunglison's new remedies, -supplement. when ignited, it may burn in the centre and be held with the hand.' This, he calls moxa de voleurs. 3 The moxa, used by Larrey, and very generally employed by many practitioners, is made by taking a quantity of cotton wool, pressing it somewhat closely together, and rolling over it a piece of fine linen, which is fastened at the side by a few stitches. Larrey advises, that it should have the shape of a truncated cone — the form usually adopted — and be about an inch long. Commonly the cylinder is shorter than this; six or eight lines— as, when above six lines high, the combustion is not felt — and about four or five lines broad. The moxas, employed by Dr. Sadler, 3 of St. Petersburg, are about half an inch in diameter, and three quarters of an inch in height. They are composed of a nucleus formed of the pith of the sunflower, wrapped in layers of cotton, of various thickness, and surrounded with an external envelope of thin muslin; both of the latter being previously steeped in a solution of nitre. They are held, while burning, by means of two long hair pins, the legs of which are slightly bent, in order to accommodate them to the shape of the moxa ; and, when the latter is burned down to the place where it is held by the first hair-pin, it can be held with the other, and retained in its proper position. With this last view, Larrey 4 has a special porte-moxa, consisting of a ring to receive the cylinder, with a handle attached to it, and three small supports or knobs of ebony, placed beneath the ring, to prevent the heated metal from acting upon the surface. Of late years, a plan for raising vesication on the surface has been adopted, which, as Dr. Granville remarks, must be regarded as a kind of moxa. 5 This, he admits, is equally successful with the one he proposes, and which we have already described, (p. 396,) in forming a rapid vesi- cation ; " but it is, at the same time, so complicated, and attended by such intense pain," that, in practice, he says, it will not bear comparison with the preparations which he recommends. A piece of linen or paper, being cut of the requisite size, is immersed in spirit of wine, or brandy. It is then laid on the part to be blistered, care being taken that the moisture from the paper or linen does not wet the surrounding surface. The flame of a lighted taper is applied quickly over the surface, so as to produce a general ignition, which is exceedingly rapid. At the con- clusion of this operation, the cuticle is found detached from the true sktn beneath. In the application of the various moxas, or of most of them, their agency can be so graduated as to produce either simple rubefaction, vesi- cation or the formation of an eschar. Where it is desirable to pmduce the first result only, the cylinder of cotton may be removed when the pain becomes somewhat severe ; or the burning material may be held close to the surface, and be moved gradually along it. In this manner, a counter-irritant effect may be exerted along the spine or any extensive surface. Any burning substance — a lighted coal for example — will 1 Art. Moxibustion, in Diet, des Sciences Medicales. * Merat & De Lens, Diet, de Mat. Med.. Art. Moxa. 8 Zeitschrift fur die gesarnmte Metlicin. B. iii. H. ii. & iii. and British and Foreign Medical Review, July, 1837, p. 217. 4 The author's translation of his Essay on the Moxa, p. 5. 6 Counter-irritation, its Principles and Practice, Amer. Med. Library edit. p. 21 and p. 42. Philad. 1838. GALVANISMUS. 403 answer for this purpose. When vesication is needed, it must be kept on longer ; and if it be desirable to produce an eschar, the moxa may have to remain on until it is wholly consumed. Larrey,' indeed, advises, that the blowpipe should be occasionally employed to hasten the combustion. When the integument has once become disorganised, the slough will be thrown off in due time, leaving an ulcer. Larrey says the sloughing can be prevented by the application ofliquid ammonia 2 to the burnt surface, after the moxa has been removed. This will do when the disorganisation is partial ; but we know, from experience, that it often fails. EFFECTS ON THE ECONOMY IN DISEASE. The moxa — in its different forms — is doubtless a most valuable agent, where rapid counter-irritation is indicated. It resembles, indeed, in its action, the ammoniated counter-irritants of which we have already treated, and is applicable to the same diseases; — the only difference between them — when cauterisation is effected — being, that the agent in the case of the ammoniated lotion is a potential, in that of the moxa an actual, cauterant. The moxa must be regarded as one of our most valuable revellents. III. GALVANISMUS. Synonymes. — Galvanism, Electricitas Animalis, E. Galvanica seu Metal- lica, Irritamentum Metalloruin seu Metallicum. French. — Galvanisrne. The ordinary effects of common and galvanic electricity and of electro-majrnetism are so well known, as to require but little com- ment. They are decidedly excitant; and, like all excitants, when applied to a part of the frame, are counter-irritant or revellent. All have been employed in paralysis — general and local, — amaurosis, deafness and dumbness of recent duration, asthma, rheumatism, neu- ralgia, &c. The effect, however, which galvanism exerts on the con- tractility of the muscular fibre, and the great similarity, in its agency, to the nervous influence, 3 has led to its employment more frequently in the various nervous and spasmodic diseases referred to, and in others belonging to the same class. Resting on his views of the absolute identity between the nervous and the galvanic fluids, 4 Dr. Wilson Philip employed it in many diseases, and especially in asthma. In a paper read by him before the Royal Society of London, in Janu- ary, 1816, he details some experiments, which ho made on rabbits. The eighth pair or pneumogastric nerves were divided by incisions 1 Op. citat. p. 5. » Ibid. p. 9. 3 See the author's Physiology, i. 88, 3d edit. Philad. 1838. * Experimental Inquiry into the Laws of the Vital Functions, Lond. 1817. 404 dunglison's new remedies. SUPPLEMENT. made in the neck. After the operation, the parsley, which the animals had eaten, remained unchanged in their stomachs, and after evincing much difficulty of breathing they seemed to die of suffocation. But when, in other animals, whose nerves had been divided, the galvanic agency was transmitted along the nerve, below its section, to a disc of silver, placed closely in contact with the skin of the animal, opposite to its stomach, no difficulty of breathing occurred. The galvanic action being kept up for twenty-six hours, the rabbits were then killed and the parsley was found digested. The removal of dyspnoea in these cases led Dr. Philip to employ gal- vanism as a remedy for asthma; and, by transmitting its influence from the nape of the neck to the pit of the stomach, he gave decided relief in every one of twenty-two cases, of which four were in private practice, and eighteen in the Worcester infirmary. The power employed varied from ten to twenty-five pair of plates. Since then, galvanism has been repeatedly used in such cases, and at times with marked relief. Com- monly, however, the plates described hereafter, are employed for this purpose. The disease is unquestionably in the majority of cases dependent upon erethism of the pneumogastric nerves ; all the phenomena indicate, that there is a spastic constriction of the small bronchial tubes, occasioned by irritation at the extremities or in the course of the nerve. The new impression made by the galvanic agency, breaks in upon the concentration of nervous action, by exciting other portions of the nervous system, in the same manner as we observe spasms or ordinary cramp relieved, or paroxysmal diseases warded off", by agents that are capable of suddenly impressing some part of the nervous system. Not long after these researches of Dr. Philip, galvanism was employed satisfactorily by Mr. Mansford 1 in a congenerous disease — epilepsy — and his plan was afterwards — although tardily — extended to some other paroxysmal disorders. The mode of application, recommended by Mansford, is as follows: A portion of the cuticle, of the size of a sixpence, is removed by means of a small blister on the back of the neck, as close to the root of the hair as possible; and a similar portion is removed from the hollow, beneath, and on the inside of, the knee, as the most convenient place. To the excoriated surface on the neck, a plate of silver, varying — according to the age of the patient — from the size of a sixpence to that of a half crown, is applied, having attached to its back part a handle or shank, and to its lower edge — and parallel with the shank — a small staple, to which the conducting wire is fastened. This wire passes down the back, until it reaches a belt of chamois leather, buttoned round the waist; it then follows the course of the belt to which it is attached, until it arrives oppo- site the groin of the side on which we desire to employ it ; it then passes down the inside of the thigh, and is fastened to the zinc plate in the same manner as to the silver one. The apparatus, contrived in this way, is thus applied. A small piece of sponge, moistened in water, and corresponding in size to the blistered part of the neck, is first placed directly upon it; over this, a large piece of the same size as the metallic plate, also moistened, is laid, and next to this, the plate itself, which is secured in its situation by a strip of adhesive plaster passed through ! Researches into the nature and causes of Epilepsy, &c, Bath, 18J9. GALVANISMUS. 405 the shank in its back ; another above, and another beiow it. If these be properly placed, and the wire, which passes down the back be allowed sufficient room that it may not drag, the plate will not be moved from its position by any ordinary motion of the body. The zinc plate is fastened in the same manner, but in place of the second layer of sponge, a piece of muscle answering in size to the zinc plate is interposed ; that is — a small piece of moistened sponge being first fitted to the exposed surface below the knee, the piece of muscle moistened, or — what we have found equally effectual and less inconvenient — a piece of moistened flannel' follows, and on this the plate of zinc. The apparatus, thus arranged, will continue, according to Mr. Mans- ford, in gentle and uninterrupted action from twelve to twenty-four hours, according to circumstances. " This last is the longest period that it can be allowed to go unremoved ; the sores require cleaning and dressing, and the surface of the zinc becomes covered with a thick oxide, which must be removed to restore its freedom of action : this may be done by scraping or polishing; but it will be better if removed twice a day, both for the greater security of a permanent action, and for the additional comfort of the patient." The adoption of this plan of treatment in cases of tic douloureux, the confidence reposed by Laennec in the use of galvanic plates on the breast and back in angina pectoris and similar neuralgic affections of the chest, and the communications of Drs. Harris and Chapman, brought it into very extensive use, so that ample trial was given to it in this country both in public and private practice. In three cases, it was — to employ the lan- guage of Professor Chapman 2 — " triumphantly directed" by Dr. Harris; but it was only found effectual in affections of the face; and in these cases it had to be persevered in for some time before marked benefit was experienced. 3 About the same period, this mode of applying galvanism was recommended by Dr. Miller, 4 of Washington University, Baltimore, and a case of paraplegia and another of general paralysis were adduced by him in which it was found highly efficacious. There are doubtless — as we have observed — cases in which the exci- tant and revulsive agency of galvanism may be employed with advantage, but they are not so numerous as was at one time believed. We have used the plates extensively — in neuralgic cases especially — but have not experienced so much success, as to induce us to advise them frequently, under the inconvenience that necessarily accompanies their employment. They are, indeed, at this time, but little used. Some years ago, Professor Von Hildenbrand, of Pavia, 5 recommended, in cases of frontal neuralgia, an anodyne metallic or galvanic brush, which appears to have been as effectual in his hands as the galvanic plates in those of Dr. Harris. It consists of a bundle of metallic wires not thicker than common knitting needles, firmly tied together by wire of the same material, so as to form a cylinder of about four or five inches long, and an inch or three fourths of an inch in diameter. This 1 Dr. Chapman says soft buckskin or parchment. American Journal of the Medical Sciences, Aug. 1834, p. 311. 2 Op. citat. p. 311. 3 Dr. Harris, in Amet. Journal of the Medical Sciences, Aug. 1834, p. 384. 4 Ibid. p. 321. 6 Edinburgh Medical and Surgical Journal, April, 1833. 406 dunglison's new remedies. SUPPLEMENT. is applied to the pained part, previously moistened with a solution of common salt; and, according to Von Hildenbrand, it at times produces relief so instantaneous, that it appears to the patients to act like a charm. In his first experiments, he employed brushes constructed of two kinds of metal, — for instance, of silver and copper wire, copper and zinc wire, or zinc and brass wire, the individual wires being mutually commingled ; but he subsequently ascertained, that bundles of wires of one and the same metal produced an effect scarcely less speedy, and that solid metallic bodies acted in a similar manner, but in a much feebler degree. The nature of the metal he thinks occasions no difference. It is not probable, however, that, in these cases, galvanism is the agency concerned. Like the metallic tractors of Perkins, the effect is probably induced by the new nervous impression made through the excited imagination of the patient. Animal Magnetism — Mesmerism, Neurogamia, Biogamia, Biomag- netismus, Zoomagnetismus, Tellurismus, Exoneurism, as it has been termed — exerts an anodyne influence in probably the same manner. In highly impressible persons, more or less prolonged impressions made upon the senses — as by the operator looking steadfastly in the eyes of the patient; holding her thumbs or hands in his at the same time, or making passes in front of her — will induce an hysteric or hysteroid condition, in which the patient may fall into what is called " magnetic sleep," of a very sound, and at times cataleptic, character: during the existence of this sleep, she may be insensible to certain irritants, and yet extremely alive to others, so that operations — as the extraction of teeth, and even others of a more serious character — may be performed without eliciting the ordinary evidences of feeling. In cases of delirium tremens, accom- panied by watchfulness, in which we have the whole nervous system extremely impressible, sleep may be at times induced by the employ- ment of this agency, which has resisted the ordinary anodynes.' Lastly. Of late years, it has been proposed to introduce into the rectum, in cases of constipation, a kind of galvanic suppository, made of two metals — zinc and copper — and various forms of instruments have been devised by the prolific imaginations of the inventors; those intended for the rectum simply, were doubtless of advantage, at times, by virtue of the excitation they induced in the nerves of the mucous membrane. Others, formed somewhat like a bassoon — and so arranged as to have one metal in the mouth and the other in the rectum connected together by metal — did not appear to act differently from those of the simpler form. Both have gone into disuse, and — as we have said elsewhere 2 — if their efficacy on the frame has not been well marked, they have not failed to minister to the pockets of their inventors. 1 Dr. Vedder, in American Medical Intelligencer, Feb. 1, 1839, p. 331. 2 General Therapeutics, p. 248, Philad. 1S30. INJECTIONS INTO THE EUSTACHIAN TUBE. 407 III. INJECTIONS OF AIR, VAPOUR OF ETHER, &c. INTO THE EUSTACHIAN TUBE. An important improvement, in the understanding and treatment of diseases of the ear, has resulted from the attention that has been paid, of late, to the pathological conditition of the Eustachian tube, and the means through it of rectifying certain morbid states of the organ of hearing. A mystery has been thrown, or attempted to be thrown, over the diseases of the ear, and as a consequence, they have furnished largely to empiricism; so that an exclusive aurist has been, too often, perhaps, esteemed synonymous with an exclusive empiric. Now, that the phy- siology of the outer and middle ear is better understood, their patholo- gical relations are no longer environed with the same difficulties. The attention of the surgeon has to be first directed to the meatus externus, and if he discovers any obstacle, — as hardened cerumen, — which prevents the vibrations of a sonorous body from reaching the membrana tympani, such obstacle must be removed. If no defect exists there, he inquires into the state of the Eustachian tube, to detect, whether it be pervious so as to permit a free passage for the air from the throat to the middle ear — any impediment to which is a common cause of deafness ; and, lastly, if ths tube is found in a state of integrity, his attention is turned to the condition of the nerve, to discover whether the defect — organic or func- tional — be seated there. Such are the main subjects of inquiry in cases of deafness; although the condition of the membrana tympani, of the ossicles, and the mastoid cells become interesting incidental objects of inquiry. Chronic inflammation of the Eustachian tube occasionally gives rise to stricture or narrowness of the tube ; and, at others, to obstruction of the tube by means of mucus, or to accumulation of mucus in the tympanic cavities. In the former case, catheterism is demanded; in the latter, injections of air, in addition. For the purpose of catheterism, various instruments have been em- ployed. The catheter of Itard is a conical silver tube, curved at the extremity, with a slight enlargement to prevent laceration of the mem- brane. Kramer's instrument is a modification of that of Itard ; the curve is more gradual, and the enlarged or button point is omitted. It is made of silver, six inches long, and of a calibre varying from the size of a small crow-quill to that of a large goose-quill. The extremity is well rounded, and it is curved, only to the distance of five lines from the point, exactly at an angle of 144°, so as to correspond with the lateral situ- ( Reduced One half. 1 ation of the mouth of the Eustachian tube. It is of the same calibre throughout its whoh length, ;i nd provided with a funnel-shaped dila- tation at the outer extremity, half an inch in length, to admit the pipe of the injecting syringe, &c To this part is attached a ring, on 408 DUNGLISOn's NEW REMEDIES. SUPPLEMENT. the same level with the beak of the catheter, by means of which the situation of the beak can be ascertained, when the instrument is intro- duced. The catheter is farther graduated in inches, which is convenient in repeated introductions. 1 When it is requisite to sound the Eustachian tube, a piece of catgut may he passed through the instrument. The catheter recommended recently by Mr. Pilcher 3 admits of being passed farther into the tube, and has a more gradual curve. Deleau employs a flexible elastic gum catheter, which the patient learns readily to pass into the Eustachian tube, and, by turning down the outer extremity, is able to inflate the tube with his own breath. This we have seen done repeatedly. The silver instrument being slightly warmed and oiled, is introduced, with its convexity upwards, along the floor of the nostrils until the point reaches the pharynx ; it is then gently turned, so that the point shall be outwards and a little upwards, the aperture of the Eustachian tube being above the level of the floor of the nose ; in this way, the tube enters, and is readily felt by the operator to have done so. The instrument is then carried onwards, until its farther progress is prevented by the narrowness of the tube. Mr. Pilcher's instrument is of such dimensions as to frequently occupy three quarters of an inch of the tube; but if it be pushed beyond the fibro-cartilaginous portion — or that part of the tube, which readily admits it — the mucous membrane may be lacerated, and pain will cer- tainly be produced. 3 When Mr. Pilcher's catheter is fairly introduced, it will remain with- out support, an advantage it possesses — in the opinion of its proposer — over those of Itard and Kramer, which require a frontal bandage to retain them in situ. Itard's is represented in the accompanying figure. It consists of a middle piece ntade of metal, bent so as to fit the arch of WML the forehead, and slightly padded within ; to this are attached two straps, which fasten with a buckle. To the centre of the middle piece, a pair of forceps are attached, which move in a ball and socket joint, and the blades of which are brought together by a screw. The bandage is applied, before the catheterism is commenced ; and when the instrument is introduced, the forceps are brought down, and screwed tight on the catheter, so as to retain it in position. Through the catheter, thus introduced, aurists were in the habit of introducing lukewarm water through the Eustachian tube into the cavity 1 Kramer, on Diseases of the Ear, chap. 2, Amer. Med. Library Edit. Philad. 1838. 2 A Treatise on the Structure, Economy and Diseases of the Ear, p. 304, Lond. 1838. 3 Op. cit. p. 305. INJECTIONS INTO THE EUSTACHIAN TUBE. 409 of the tympanum ; but owing to certain objections that apply to the employment of fluids, Deleau 1 suggested the air-douche or injections of air for the purpose of clearing the cavity ; and this is regarded by Kramer 3 as a great improvement. With the view of increasing and regulating the force with which the air is sent into the cavity, both these gentlemen invented air-pressers or condensers. The figure beneath represents that of Kramer. c b is a cylinder, 10i inches high, made of molten brass ; the diameter of its calibre is 44 inches, and it is fastened at b with strong screws, on a strong oaken stand of the height of an ordinary stool. Within the cylinder c b is a pump barrel of wrought brass screwed into it, which measures lOh inches in height, and 24 inches in diameter, rising at d <7 3 inches out of the cylinder, so that the whole machine a b is about 13 inches high. In the piston of the pump barrel, there is a valve for the passage of the air, which besides passes in at the opening situate at d. There is a second valve in the bottom of the pump barrel, through which the air is forced into the interior of the cylinder. When air is injected into the tympanum, it may be heard to strike against the membrane, and to rush through the cavity into the mastoid cells, and thus may become a means of exploring the condition of the middle ear. Mr. Pilcher, rt however, observes, that from his daily experience of the great facility with which air and fluids may be introduced into the tym- panum, and regulated, both as to quantity and force, by means of a com- mon syringe accurately fitted to the catheter, he does not hesitate to declare his conviction, that the ceremony and inconvenience of the air-press may 1 Sur le Cathete-isme de la trompe d'Eustache, &c, Paris, 1828; Itard in Mem. de l'Academ. Royale de Medecine, Tom. v. Fasc. 4, Paris, 1836; and translation in Medical and Surgical Monagraphs, vol. 1, p. 75. of Amer. Med. Library, p. 86, Philad. 1838. 2 Op. citat. p. 164. 3 Op. cit. p. 307. 410 DUNGLISON's NEW REMEDIES. — SUPPLEMENT. be dispensed with. He recommends that the operator should merely steady the instrument with his left hand, whilst he uses the syringe with his right. By this means, any fluid or gas injected through the catheter, may be brought in contact, with the mucous membrane, and thus stimu- late the nerves of the cavity. Nor is the air-press entirely devoid of danger. Very recently, a case has been detailed in which, after " pumping air" four times through the nostrils into the Eustachian tube, immediately on removing the instru- ment from the nostril, the patient fell back in the chair and never spoke afterwards. 1 The sudden shock to the nervous system was probably the cause of death ; and it has been suggested, that to avoid too great a degree of pressure, the nozzle of the tube of the air-press should be held during the operation so loosely in the dilated end of the catheter, that there may be room for air to regurgitate; 3 and likewise, that instead of sending in the air by dovches or charges — it should be transmitted in a gentle and continued stream. Another circumstance, which shows the importance of care, is the fact, that the mucous membrane may be ruptured, and serious emphyse- matous tumefaction be occasioned. It is proper, moreover, to observe, that the results of 25S cases, treated by Itard 3 are far from encouraging. Of these, but two cases of cure are said to have been effected, and in this result, according to Itard, other causes concurred; whence he infers, first, that as a means of exploring obstructions of the tympanum by the crepitation, which often accom- panies them, douches of air can afford no certain index ; and secondly, that as a mechanical agent for deterging or evacuating obstructing matters, they can only dislodge and force them together; and, consequently, that both in the second and first point of view, douches of air do not deserve the confidence of" the profession. 4 The vapour of acetous ether has recently been injected into the middle ear, in cases of nervous deafness, of which Kramer 5 manes two varieties, noise in the ear constituting the essential point of difference between them. The noise in the ear belongs, without exception, to the erethitic form, whilst it is foreign to the torpid. In cases of nervous deafness, Itard proposed to introduce ethereous vapour through the catheter, and to gene- rate this vapour in an apparatus, in which the ether is dropped on a saucer of red hot iron, by the heat of which it is vapourised. The ether is, how- ever, decomposed in this manner, so that it is not ethereous vapour, which enters the tympanum, but an acrid very irritating kind of gas, which, according to Kramer, is well suited to the torpid form of nervous deaf- ness, but is positively injurious in the erethitic variety. He considers the attempt to vapourise acetous ether in a flask, placed in warm water, and connected by means of a tube with the cavity of the tympanum, to belong to the same class of methods, which act in too irritating and inju- rious a manner, owing to the vapour being given off far too rapidly. This 1 London Med. Gazette, July 6, 1839, p. 538, and American Medical Intel- ligencer, Aug. 15, 1839, p. 150. 1 British and Foreign Medical Review, July, 1839, p. 95. * Op. citat. 4 See, on this subject, Mr. T. Wharton Jones, in Lond. Med. Gaz., Aug. 3 & 10. 1839. 6 Op. citat. 211. INJECTIONS INTO THE EUSTACHIAN TUBE. 411 inconvenience he proposes to remedy, in the erethitic form of nervous deafness, in the following way. A large glass flask — represented in the accompanying figure — holding about ten quarts is firmly and closely stopped with a cork through which are passed two brass tubes, each provided with a cock ; one of these tubes is connected above with a funnel for dropping in the fluid, and the other with an air-tight tube to conduct the vapour, generated and inclosed within the flask, into the cavity of the tympanum. When the apparatus is to be used, the cork is to be firmly fixed into the neck of the flask, with the two tubes attached, and the cocks closed ; the proper quantity of ether is then to be poure»! into the funnel, and forced into the flask by a gentle expiration, where it is converted into thin vapour at the ordinary temperature of the room. This vapour fills the interior of the flask equably, and is, indeed, in a state of slight condensation, so that when the metallic tip of the tube is connected with the catheter, and the cock is opened, the vapour issues with a whizzing sound. Having previously introduced the catheter, through the nose, into the mouth of the Eustachian tube, and placed it in connection with the tube of the vapour apparatus, the patient is to sit near a table, and leaning his arm upon it, with the corresponding hand he is to hold the tube of the apparatus, in such a manner that it may remain in close connection with the catheter. Each sitting occupies a quarter of an hour, and is repeated daily, applying the vapour alternately to the right and to the left ear. It is unnecessary to make use of warm water to pour into the flask, as the ordinary temperature of the room is sufficient to vapourise the ether. In the torpid form of nervous deafness this method of procedure does not answer, owing to the necessity of greater excitement than it is capa- ble of effecting. In such case, a modification of the apparatus of Itard has been proposed by Kramer. In consequence of the metallic saucer in Itard's becoming cool more than once during a single sitting, and re- 412 DUNGLISON'S NEW REMEDIES. — SUPPLEMENT. quiring to be exchanged for a hot one ; as a necessary consequence the temperature of the vapour generated never remains, for a moment, the same, but varies extremely; immediately after the insertion of the red- hot saucer, the vapour issues burning hot into the ear, and, in a few minutes sinks to a very low temperature. These evils Kramer proposes to rectify in the following manner. The floor on which the bell-glass of the apparatus rests is substituted by a thin metal plate, which is warmed, at pleasure, by an oil lamp placed beneath, so that the ethereous fluid falling on it, is thus conducted through the catheter into the middle ear. Through the cover of the apparatus, a thermometer, with a metallic scale, passes down almost to the bottom, and indicates the temperature at which the ethereous vapour passes into the ear. After a sitting or two — if the individual is to be benefited by the plan in either form of deafness, an improvement ought to be perceptible. This course of treatment, aided, occasionally, by attention to the state of the system, has, in Kramer's hands, been attended with satisfactory results, and has been adopted with advantage by others with a more or less modified apparatus.' The only published case, in this country, of the successful application of the acetous ether in erethitic deafness, is by Dr. Bolton, of Rich- mond, Virginia. 3 The hearing distance was amazingly improved by it, and the success far exceeded the operator's most sanguine expectations. The vapour proves, however, at times too irritating, or occasions results by no means to be desired. The Author was applied to in one case in consequence of inflammation having supervened in the mucous membrane, which subsequently extended, in the erysipelatous form, over the cutaneous surface. It yielded, however, to appropriate treat- ment. 1 Pilcher, Op. cit. p. 318. 'American Medical Intelligencer, April 1, 1839, p. 1. INDEX NEW REMEDIES. Acctum ligneum, 15. Acid, auric, 66. Hydriodic, liquid, 254. Hydrocyanic, 1. Hydrocyanic, medi- cinal, 1, 11. Lactic, 13. Of milk, 15. Oxymuriatic, liquid, 109. Prussic, 1. Pyroligneous, 15. Pyrolignic, 15. Acide hydrocyanique, 1. Lactique, 13. Prussique, 1. Pyroacetique, 15. Pyro- ligneux, 15. Pyrolignique, 15. Acidum aceticum empyreumaticum, 15. Borussicum, 1. Caincae, 83. Hydro- cyanicum, I. Lacteum, 13. Lactis, 13. Ligni pyro-oleosum, 15. Marinum de- phlogislicatum, 103. Muriaticum oxy- genatum, 103. Muriaticum oxygenatum ad contagia, 103. Prussicum, 1. Pyro- aceticum, 15. Pyrolignosum, 15. Zoo- ticum, 1. Zoolinicum, 1. Aconita, 19. Aconite, extract of, alcoholic, 22. Extract of, ammoniated, 22. Aconitine, 19. Acqua Binclli, 32. Acupuncturation, 23. Acupuncture, 23. jEsculine, 216. jEsculus hippocastanum, 216. jEther hydrocyanicus, 30. Prussicus, 30. Agaric blanc, 73. Agaricus albus, 73. Agothosma crenatum, 161. Aimant, 260. Air douches into the Eustachian tube, 409- Akonitin, 19. Akupunktur, 23. Alaunerde, reinc, 43. Alcali vegctabile salito-dcphlogislicatum, 300. Alcool de soufre, 3G3. Alcohol Ralph oris, 363. Alcxitcrium cliloricum, 103. Alumina, pure, 43. Alumine lactice, 43. Ammonia, arseniate of, 45. Ammoniaque, arseniate d', 45. Ammoniated counter-irritants, 395. Ammonium arsenicum, 45. Arseniksaures, 45. Amylum iodatum, 257. Antidynous counter-irritants, 395. Aqua amygdalarum, 31. Balsamica arte- rialis, 32. Binelli, 32. Chlorini, 109. Natri oxymuriatici, 348. Oxygenata muriatica, 109. Oxygen-omuriatica, 109. Oxy muriatica, 109. Picis, 33. Arbor vitse, American, 372. Argent, chlorure d', 39. Cyanure d', 41. Iodure d', 42. Oxide d\ 42. Et d'am- moniaque, chlorure d', 39. Argenti chloridum, 39. Cyanidum, 41. Ioduretum, 42. Muriatico-ammoniati liquor, 40. Oxidum, 42. Et ammoniaci chloruretum, 39. Et ammonise chlori- dum, 39. Praeparata, 36. Argentuin chloratum, 39. Cyanogena- tum, 41. Divisum, 41. Iodatum, 42. Limatum,41. Muriaticum, 39. Muria- ticum amtnoniatum, 39. Oxydatum, 42. Salitum, 39. Ar<;il, pure, 43. Armoise commune, 48. Arnica, 45. Montana, 45. Plauensis, 45. Arniquc, 45. Arsenias pntassoc acidus, 171. Arsenic, iodide of, 47. Arscnici indidum, 47. Arscnikiodilr, 47. Artemisia vulgaris, 48. Extractum resi- nosum, 51. Asparayi officinalis turioncs, 53. Asparagus shoots, 53. Aspidium filix mas, 196. 414 INDEX OF NEW RKtlKDIES. Athyrium filix mas, 196. Auri chloretum, 60. Ctiloretum cum chlo- reto natrii, 63. Chloridum, 6(J. Chlo- ruretum, 60. Cyanidum, 58. Cyanu- retum, 58. Iodidum, 59. Murias, 60. Nitromurias, 65. Oxydum, 66. Prte- parata, 54. Pulvis, 59. Terchloridum, 60. Teroxidum, 66. Et sodii chloru- rctum, 63. Et sodii perchloruretum, 63. Aurico-natricum murias, 63. Aurum chloratum, 6'». Cliloratum natro- naturn, 63. Limatutn, 59. Metallicum, 59. Muriaticum, 60, 63. Muriaticum natronatum, 63. Nitrico-muriaticum, 65. Oxydatum, 66. Oxydulalum muri- aticum, 60. Salituin, 60. Bachelor's buttons, 276. Balaustier, 208. Ballota lanata, 67. Bark, resinous constituent of the, 331. Barosma crenata, 161. Baryi iodati hydras, 69. Iodidum, 69. Baryt hydriodsaurer, 69. Baryta, hydriodate of, 69. Barytin, 378. Baryum, iodide of, 69. Beifusswurzel, 48 Gemeiner, 48. Berberina, 70. Bergerthran, 285. Berliner Biau, 179. Betoine des Savoyards, 45. Bignonia catalpa, 72. Binellisches Wasser, 32. Biogamia, 406. Biomagnetismus, 406. Bisulphuretum carbonii, 363. Bitter almonds, water of, 31. Bittermandelwasser, 31. Blausaure, 1. Blausaures Eisenoxydulzinkoxyd, 387. Blaustoffeisen, 179. Blaustoffquecksilber, 219. Blaustoffsilber, 41. Blaustoffzink, 387. Ble cornu 338. Bleiiodid, 298. Bleu de Prusse, 179. Blue, Prussian, 179. Bocchoe, 161. Bocho, 161. Bole, Armenian, 43. Boletus Albus, 73. Laricis,73. Purgans,73. Boocho, 161. Brayera anthelmintica, 73. Brechstoff, 166. Brom, 74. Brotne. 74. Bromeisen, 172. Bromiduin potassii, 303. Bromiue, 74. Bromkalium, 303. Bromqueckailber, 218. Brucine, 78. Buccubliitter, 161. Buchu, 161. Buckeye, 216. Coeruleum Beroliniense, 179. Borussicum, 179. Cahincse radix, 80. Cainanse radix, 80. Cainca root, 80. Caincoe acidum, 83. Calcar, 338. Calcaria chlorata, 83. Chloricn, 83. Chlo- return, 83. Calcarise clilorum, 83. Calcii oxycliloruretum, 83. Oxydichloru- retum, 83. Proto-chloruretum, 83. Calcis bichloruretum, 83. Chloridum, 83. Hypochloris, 83. Oxytnurias, 83. Calcium, oxide de, chlorure d', 83. Pro- toxichlorure de, 83. Calendula Alpina, 45. Officinalis, 92. Sa- liva, 92. Calenduline, 93. Caltha Alpina, 45. Saliva, 92. Calx chlorinata, 83. Oxymurialica, 83. Caninanae radix, 80. Carbo animalis, 95. Carnis, 95. Mineralis, 176. Carbon, sesqui-iodide of, 99. Sesqui-iodu- ret of, 99. Carboneum sulphuratum, 363. Carbonis sesqui-iodidum, 99. Sesquiiodu- rclum,99. Carbure de soufre, 363. Carburet of sulphur, 363. Carrageen moss, 198. Castanea equina, 216. Pavina, 216. Catalpa, 72. Arborea, 72. Arborescens, 72. Cordifolia, 72. Tree, 72. Cataputia minor, 169. Catawba tree, 72. Catheterism of the Eustachian tube, 407. Cedre blanc, 372. Cetrarine, 99. Charbon animal, 95. Charcoal, animal, 95. Chaux, chlorure de, 83. Chlorate de, 83. Muriate suroxigene ou oxigene de, 83. Oxichlorure de, 83. Oximuriate de, 83. Souschlorate He, 83. Chestnut, horse, 216. Chimaphila, 101. Chimophila, 101. Chinicus citras, 318. Hydrochloricus, 320. Chinii acetas, 318. Ferrocyanas, 319. Hydrochloras, 320. Nitras, 321. Phos- phas, 321. Chinin, 316. Chinin, eisenblausaures, 319. Essigsaures, 318. Phosphorsaures, 321. Saltpeter- saures, 321. Salzsaures, 320. Zitron- saures, 318. Chinini citras, 318. Phosphas, 321. Chininum, 316. :ndex of new remedies. 415 Chinioidine, 332. Chinium, 316. Aceticum, 318. Ferrocy- anogenatum,319. Hydrochloricnm, 320. Muriaticum, 320. Nitricum, 321. Phos- phoricum, 321. Salitum, 320. Chinoidine, 332. Chiococcae radix, 80. Chlor, 103. Chloras kalicus depuratus, 300. Chlorate de potasse, 300. Chlore, 103. Eau de, 109. Liquidc, 109. Chlorgas, 103. Chlorgold, 60. Chlorgoldnatronium, 63. Chlori aqua, 109. Liquor, 109. Chloride of soda, 348. Of zinc, 384. Chlorine, 103. Solution of, 109. Chlorini aqua, 109. Chlorinurn, 103. Chlorkalk, 83. Chlornatron, 348. Chlorsilber, 39. Chlorum, 103. Chlorure d'oxide de sodium, 348. De soude, 348. Chloruretum oxidi sodii, 348. Potassse oxidatum, 300. Chlorwasser, 109. Chondrus crispus, 198. Polymorphus, 198. Chrysanthemum, 92. Cinchonine, 115. Clavis secalinus, 338. Siliginis, 338. Cocosnussolseife, 336. Codeine, 118. Codliveroil,285. Colchicine, 124. Colchicum, 123. Autumnale, 123. Colchique, 123. Compression, 391. Methodical, 391. Contra-irrilatio, 395. Cortex adstringens Brasiliensis, 129. Counter-action, 395. Counter-irritant lotions, Granville's, 395. Ammoniatcd, 395. Antidynous, 395. Gondrel's, 395. Granville's, 395. Counter irritation, 395. Crayon noir. 176. Creasote, 131. Creosote, 131. Cresson de Para, 350. Crocus martia apcriens, 173. Croton oil, 281. Crusadinha raiz, 80. Cubtbaimn extracti hydro-alcoholici ffithe- rei syrupus, 158. Cubcbine, 295. Cubebs, 154. Cyanather, 30. Cyanciscn, 179. Cyaneisenzink, 387. Cyanidum potussii, 305. CyanUulium, 305. Cyanquecksilber, 219. Cyansilber, 41. Cyanure de zinc, 387. Cyanuretum tcrrozincicum, 387. Cyanwasserstoffsaure, 1. Cyanzink, 387. Delphmine, 158. Derosne's opiumsalz. 274. Diosma crenata, 161. Diosmine, 161. Doronic d'Allemagne, 45. Doronicum Germanicum, 45. Plantaginis folio, 45. Druck, 391. Duitstrauchblatter, 161. Eau d'amandes ameres, 31. De goudron, 33. Medicinale d'Husson, 126. Eisencyanurcyanid, 179. Eisenoxyd, eisenblausaures, 179. Eisenoxydhydrat, 190. Eisenoxydul arseniksaures, 170. Blau- saures, 179. Hydriodsaures, 182. Koh- lensaures, 173. Eisenpraparate, 170. Electricitas animalis, 403. Galvanica seu metallica, 403. Electro-magnetism, 403. Electropunctura, 163. Elixir odontalgicum, 350. Emetina, 166. Ergot, 338. Ether, hydrocyanic, 30. Acetous, injec- tions of, into the Eustachian tube, 410. Prussic, 30. Euphorbia lathyris, 169. Eupatorium huaco, 213. Exoneurism, 406. Extractum opii aceticum, 271. Extrait savonneux de 1'urine, 373. Fallkraut, 45. Farrenkraut, 196. Fer, arseniate de, 170. Bromure de, 172. Carbiire de, 176. Hydrate dcutocyanure de, 179. Hydriodate dc, 182. lodure de, 182. Preparations de, 170. Proto- iodure de, l v 2. Souscarbonate de, 173. Triiohydmcyanate ferrure de, 179. Tri- to-hydro-ferro-cyanate de, 179. Fern, mule, 196. Ferri arsenias, 170. Borussias, 179. Car- bonas prsecipilatus, 173. Carburetum, 176. Cyanuretum, 179. Deutocarbonaa fusi.us, 173. Ferrocyanas, 179. Hydri- orlns, 182 H\drobromas, 172. Iodidum, 182. luduretum, 182. Nitratis liquor, 189. Nitrici oxydali liquor, 189. Oxydi ferrocyanas, 179. Oxydum fuscum, 173. Percyunidum, 179. Persesquinitratis liqix.r, 189. PraBpaiata, 170 Sesqui- cv.inidiim, 179. Sesquioxydum, 173. Siibc.irbnnas, 173. Supercarburetum, 176. Ferrum nrs. niatum, 170. Arsenicicum oxydulatum, 170. Borussicum, 179. 416 INDEX OF NEW REMEDIES. Ferrum — continued. Brumatum, 172. Carbonatum, 176. Car- bonatum praecipitatum, 173. Carboni- cum oxydulatum, 173. Carburetum, 176. Cyanogenatum, 179. Cyanuretum, 179. Hydriodatum, 182. Hydroiodi- cutn oxydulatum, 182. Iodatum, 182. Nitratum, 189. Oxydatum hydratum, 190. Oxydulatum hydrocyanicum, 179. Zooticum, 179. Filix mas, 196. Fleckblume falsche, 350. Fleischkoble,95. Fougere male, 196. Fucus crispus, 198. Fuligo, 200. Ligni, 200. Splendens, 200. Fumigatio muriatico-oxygenata, 103. Fumigation de clilor, 103. De Guyton, 103. Guytonienne, 103. Hygienique, 103. Fungus of the larch, 73. Laricis, 73. Galeopsis grandiflora, 204. Ochroleuca, 204. Segetum, 204. Versicolor, 205. Villosa, 204. Galvanic brush, 405. Plates, 404. Suppo- sitory, 406. Galvanism, 403. Galvanopuncture, 164. Gebarpulver, 338. Gegenreizung, 395. Gentianine, 206. Gerbsaure, 368. Gerbestoff, 368. Gerbstoffblei, 299. Gichtthran, 285. Glanzruss, 200. Gold, chloride of, 60. Cyanide of, 58. Cyanuret of, 58. Iodide of, 59. Me- tallic, 59. Muriate of, 60. Natrum chlorid, 63. Natrum saizsaures, 63. Oxide of, 66. Oxydirtes, 66. Oxydttl saizsaures, 60. Peroxide of, 66. Prapa- rate, 54. Pulver, 59. Saltpetersalzsaures, 65. Saizsaures, 60. Tercyanide of, 58. And soda, hydrochlorate of, 63. And soda, muriate of, 63. And sodium, chlo- ride of; 63. Gondret's counter-irritants, 395. Granutbaum, 208. Granatin, 209. Granatum, 208. Granatwurzelrinde, 208. Granville's counter-irritants, 395. Graphite, 176. Grenadier, 208. Grenadine, 209. Guaco, 213. Haloidum oxygenatum, 300. Hanfnessel, grossblumigte, 204. Harnstoff, 373. Herba sideritidis, 204. Herbe h pisser, 101. Herbstblume, 123. Herbslzeitlose, 123. Ilippocastanum, 216. Huhlzahns, grossbliithigen, 204. llolzcssig, 15. Ilolzsaure, 15. Brenzliche oder brandige, 15. Hornseed, 338. Horse chestnut, 216. Huaco, 213. Huile de foie de poisson,285. De Morue, 285. De pignon d'Inde, 281. Volatile de moutarde, 291. Hydrargyri bicyanidum, 219. Borussias, 219. Bromidum, 218. Deutobromidum, 218. Cyanurelum, 219. Deutoiodure- tnm, 226. Iodidulatum, 223. Iodidum, 223. Perbromidum, 218. Praeparata, 218. Protobromidum, 218. Proto-iodi- dum, 223. Proto-ioduretum, 223. Prus- sias, 219. Hydrargyrum biniodidum, 226. Broma- tum, 218. Cyanogenatum, 219. Hydro- cyanicum, 219. Iodatum, 223. Ioda- tum flavum, 223. Iodatum rubrum, 226. Perbromatum, 218. Periodatum, 226. Hydras ferricus, 190. Hydriodate of potassa, 308. Hydriodic acid, liquid, 254. Hydrocyanate ol potassa, 306. Hydrocyanicus aether, 30. Hydrocyansaure, 1. Hydroiodas kalicus, 308. Indicum, 230. Indicus color, 230. Indigo, 230. Infusum picis liquidae, 33. Picis empy- reumaticre liquidse, 33. Injections of air, &c. into the Eustachian tube, 407. Tod, 231. lode, 234. lodarsen, 47. Iodarsenik, 47. Iodbaryum, 69. Iodeisen, 182. Iodide of quinine, 257. Of starch, 257. Of sulphur, 258. Of zinc, 390. Iodidum amyli,257. Hvdrargyricum, 226. Hydrargyrosum, 22"3. Piumbi, 298. Potassii, 308. Quininse, 257. Iodine, 234. Iodkalium, 308. Iodquecksilber, gelbes, 223. Im maximum, 226. Im minimum des Iods, 223. Rothes, 226. lodschwcfel, 367. Iodsilber, 42. Iodstarke, 257. Iodstarkmehl, 257. Iodum, 234. lodure d'amidon, 257. De soufre, 367. Ioduret of sulphur, 258. Ioduretum amyli, 257. INDEX OF NEW REMEDIES. 417 Iodzink, 390. Iron, arsenate of, 170. Bromatcd, or bro- mide of, 172. Carburet of, 176. Cva- nuret of, 179. Hydriodate of, lb2 Hy- drobromateof,172. Hvdro-oxide of, 190. Iodide of, 182. Ioduret of, 182. Ni- trate of, solution o<, 183. Oxide of, liy- drated, 130. Peroxide of, 173. Peroxide of, hydrated, 190. Persesquinitrate of, solution of, 189. Protoiodide of, 182. Protoioduret of, 182. Protoxide of, hy- driodate of; 182. Prussiato of, 179. Sen- quioxirie of, 173. Subcarbonate of, 173. Trkoxide of, by dialed, 139. Irritaineiituiii metalloium seu mctallicum, 403. Jolianniswurzel, 136, Kaliiucas radix, 80. Kali chloricum, 300. Chlorsaures, 300. Hydrobromicmn, 303. Hydroiodinicmn, 3U8. Iodwasserstoffsaures, 308. Brom- wasserstoffsaures, 303. Hydioiodicum, 306. Kalium bromatum, 303. Bromid, 303. iodatum, 308. Kalkchlorid, 83. Kaminruss, 200. Kinine, 316. Kininum, 316. Kodein, 118. Koble, tbieriscbe, 95. Kohlenschwefel, fliissiger, 363. Kohlenstoffeisen, 176. Kohlensulfurid, 363. Kralienaugen, 276. Geistiges Extrakldcr, 276. Kreasote, 131. Kreosote, 131. Krotonol, 281. Kubebeiipfefier, 154. Kubebin, 154. Labarraque's disinfecting liquid, 348. Lactucariurn, 258. Lathy r is, 16.). Laltichopium, 258. Lead, black, 176. Iodide of, 238. 'Pan. r.ale of, 2J9. Lebensbaume, gemeinc, 372. Lebertbran, 285. Lconurus lariata, 67. Leopard's bane, 45. Lcrsciienschwamm, 73. Lettuce opium, 258. Lichen carrageen, 198. Lime, chloride of, 83. Liqueur desinfectante de Luburraque, 91. Liquor acidi muriatici oxygenati, 109. Alexiterius oxygenatus, 109. Disinfect- ing, of F,al>airaquc,91. Morphirice cilra- tis, 273. Opii, 271. Opii Bcdativus, 272. Sodoe chloridi, 348. Sodre chlori- nate, 348. 13— e Magnes, 260. MagiK-1,260. Magnetism, animal, 406. Malogranatmu, 203. Mannastoff, 262. Mannazucker, 262. Mannite, 262. Marigold, garden, 32. Single, 92. Marrouier. 216. D'lnde, 21(5. Matiere de Derosne, 274. Matter of Derosne, 274. Mercurc, eyanure de, 219. Deuto-iodide de, 226. liydrooyanate de, 219. Perioduro de, 226. Preparations de, 218. Proto- iodure de, 223. Prussiate de, 219. Mercury, bicyanide of, 219. Biniodide of, 226. firomidc of, 218. Cvanide of, 219. Deutoioriide of, 226. liydrocya- nate of, 219. Preparations of, 2*18. Proto-iodide of, 223. Proto-ioduret of, 223. Prussiate of, 219. Mesmerism, 406. Milchsaure, 13. Moleplant, 169. Morpbei acetas, 269. Morpheum, 264. Morpbin essigsaures, 269. Pehwefel- saurcs, 272. Morphinte bimeconas, 273. Sulphas, 272. Tori ras, 273. Morphine, 264. Aretate of, 263. Birne- couale of; 273. Citrate of, 273. Muri- ate of, 273. Sulfate de, 272. Moiphinuin, 264. Morphiurn, 264. Moit aux chit ns, 123. Moss, carrageen, 198. Corigecn, 198. Irish, 198. Mousse d'Irlande, 196. Perlee, 198. Moxa, 400. Moxiburiuin, 400. Mugwort, 4Si Muride, 74. Murigene, 103. Mustardsccd oil, 291. Mutterkorn, 336. Nadelstich, 23. Narcotine, 27 i. Narda ecltica altera, 45. Narkotin, 274. Natruni cbloratum, 348. Chloricum, 348. Oxymuriaticum, 348. Ncphrine, 373. Neurogamia, 406. Noix vomique, 27G. Exfrait alcooliquc dc, 276. Nux vomica, 276. Extract alcoholic of, 276. Ofenruss, 200. Oil, codlivei, 285. Croton,281. Ofmus- tard seed, 291. Oleum uuhcrcum flortim arnicje, 45. jEthereum Beminum sinapis, 291. Cro- 27 dungl 418 INDEX OF NEW REMEDIES. Oleum — continued. tonis, 281, Jecinoris aselli, 285. Morr- hua?, 285. Sinapis, 291. Tiglii, 281. Volatile seminum sinapis, 291. Opiane, 274. Opium, lettuce, 258. Or, chlurure d',60. Cyanure d\ 58. Divide, 5J. Metallique, 59. Muriate d', 60. Preparations d', 54. Proto-iodure d',59. El sonde hvdrochlorate d', 65. Etsoude, muriate d', 63. Oxydirt-salzsaures Natromvasser, 348. Panacea lapsnrum, 45. Papaverine, 264. Paraguay roux, 350. Paratinktur, 350. Pariscr blau, 179. Plcfferstoff, 295. Phloridzine, 294. Pierre d'aimant, 260. Pigmentum indicum, 230. Piper ciudatum, 154. Cubeba, 154. Piperine, 295. Pipsissewa, 101. Platinum, 29S. Plomb, iodurc de, 298. Tannate de, 299. Plombagine, 176. Plumbago, 176. Plumbi iodidum, 298. Ioduretum, 298. Tannas, 299. Pneumokatliarterion, 90. Poison nut, 276. Poivre a. queue, 154. Polypodium filix mas, 196. Polyporus officinalis, 73. Pomegranate, 208. Potassa, chlorate of, 300. Hydrocyanate of, 306. Hydriodate of, 308. Hydriodate of, ioduretted, 309. Hydrobromate of, 303. Potassae chloras, 300. Euchloras, 300. Hydrobromas, 303. Murias hyperoxy- genatum, 300. Murias oxygenatum, 300. Potasse bromure de, 303. Hydriodate de, 308. Iodure de, 308. Potassii bromidum, 303. Cyanidum, 305. Cyanuretum, 305. Iodidum, 308. Iodo- hydrargyras, 315. Ioduretum, 308. Oxygeno-chloruretum, 300. Proto-hy- driodas, 308. Protoxidi hydriodas, 308. Potassium, bromide of, 303. Cyanide of, 305. Cyanuret of, 305. Iodide of, 308. Iodo-hydrargyrate of, 315. Ioduret of iodohydrargyrate of, 315. Ioduret of, 308. Protoxide of, chlorate of, 300. Potio picea, 33. Poudre de blanchement, 83. De Tennant, 83 Powder, bleaching, Tennant's, 83. Principium adstringens, 368. Scytodephi- cum, 368. Prussiate de potasse et de fer, 179. Ptarmica montana, 45. Fulvis ad fumigationes muriaticus, 103. Punica granatum, 208. Pyrola umbellata, 101. Pyrole en ombelle, 101 . Quecksilber blausaures, 219. Bromid, 218. liromur, 218. Deutoiodiir des, 226. Iodid, 226. Iodid gelbes, 223. Iodi- dul, 223. Praparate, 218. Protoio- diir des, 223. Quina, 316. Quinia, 316. Quinice sulphas impurus, 332. Quinina, 316. Quinine, 316. Acetate of, 318. Citrate of, 318. Extract of, 332. Ferrocyanure de, 319. Nitrate of, 321. Quinine, phosphate of, 321. And cincho- nine, tannate of, 331. Quininum, 316. Quinium, 316. Raiz crusadinha, 80. Preta, 80. Reissblei, 176. Resina chinse praeparata, 332. Ringelblume, 92. Rosscastanien, 216. Russ, 200. Rye, corned, 338. Spurred, 338. Sabadillin, 375,377. Saccharum manna?, 262. Safran batard, 123. De mars aperitif, 173. Des pres, 123. Saffron meadow, 123. Sal essentiale corticis Peruviani, 316. Salicinc, 333. Salt of Derosne, 274. Sapo cacaotinus, 336. Coconeus, 336. Kalicus, 336. Mollis, 336. Niger, 336. Viridis, 336. Satzmehliodur, 257. Savon de cacoa, 336. Mou, 336. Noir, 336. Schmierseife, 336. Grune, 336. Schwanzpfeffer, 154. Schwefelalcohol, 363. Schwefelkohlenstoff, 363. Schwererde, iodsvasserstoffsaure, 69. Secale cornutum, 338. Luxurians, 338. Secalis mater, 338. Seetang, 198. Seigle ergotee, 338. Sel de Derosne, 274. Essentiel d'opium, 274. Senfol, ffitherisches, 291. Serperitariao Braziliensis radix, 80. Silberammonium salzsaures, 39. Silberoxyd, 42. Silber, oxydirtes, 42. Praparate, 36. Sal- miak, 39. Salzsaures, 59. Zertheil- tes, 41. Silver, chloride of, 39. Cyanide of, 41. Iodide of, 42. Ioduret of, 42. Metal- lic, 41. Muriate of, 39. And ammo- nia, chloride of, 39. And ammonia, chloruret of, 39. INDEX OP NEW REMEDIES. 419 Sinapis oleum, 291. Soap of the cocoanut oil, 336. Soft, 336. Soda chlorinata, 348. Chloruret of, 348. Chlorite of, 348. Hypochlorite of, 348. Sodae chloridum, 348. Chloruretum, 348. Oxymurias, 348. Sodium, auro-lerchloride of, 63. Solutio alexiteria oxygenata, 109. Soot, 200. Souci, 92. Ordinaire, 92. Soufre carbure, 363. Iodure, 367. Species pro vaporibus superoxydi inuriati- ci, 103. Sphserococcus crispus, 198. Spiegelruss, 200. Spilanthus oleraceus, 350. Spear-leaved, 350. Spiritus salis marini dephlogisticatus, 103. Sponsa solis, 92. Spur, the, 338. Spurge, caper, 169. Garden, 169. Starch, iodide of, 257. Starkmehliodur, 257. Stockfisch leberthran, 285. Strychnin essigsaures, 360. Iodsaures, 360. Salpetersaures, 361. Schwefelsaures, 363. Strychnine, 350. Acetate of, 360. Hy- driodate of, 361. lodate of, 360. Ni- trate of, 361. Sulphate of, 363. Slrychninum, 350. Strychnium, 350. Suffitus chlorini, 103. Oxymuriaticus, 103. Suie, 200. Sulfure de carbon, 363. Sulphuret of carbon, 363. Sulphuretum carbonii, 363. Sulphuris carburetum, 363. Iodidum, 258, 367. Iodurelum, 367. Tabac de Montagne, 45. Des Savoyards, 45. Des Vosges, 45. Tang krauser, 198. Tannas plumbi, 299. Tannicum purum, 368. Tannin, 368. Tar water, 33. Tellurismus, 406. Terra aluminis, 43. Aluminosa pura, 43. Argillacea pura, 43. Bolaris, 43. Si- gillata, 43. Theerwesscr, 33. Thierkohle, 95. Thonerde, reine, 43. Thridace 258. Thuya, 372. Du Canada, 372. Occiden- talis, 372. Tithymalus latifolius, 169. Tue-chien, 123. Ulva crispa, 198. Urea, 373. Uree, 373. Uricura, 373. Ustilago, 338. Vauquelirie, 350. Veratrine, 375. Sulphate of, 383. Verrucaria, 92. Vieillotte, 123. Vinaigre de bois, 15. Votnic nut, 276. Wasserstoffblausaure, 1. Wiesensafran, 123. Winter green, 101. Wintergrun, holdenbluhtigen, 101. Wohlverlei, 45. Wohlverleiol, 45. Wolfstrapp wolliger, 67. l Woodsoot, 200. Zeitlose, 123. Zinc, butter of, 384. Chloride of, 384. Cyanuret of, 387. Ferrocyanate of, 387. Ferrohydrocyanate of, 387. Hydro- chlorate of, 384. Hydrocyanate of, 387. Iodide of, 390. Muriate of, 384. Prus- siate of, 387. Zinci butyrum, 384. Chloiidum, 384. Chloruretum, 384. Cyanidum, 387. Cyanuretum, 387. Ferrohydrocyanas, 387. Iodidum, 390. Ioduretum, 390. Zincum Borussicum, 387. Chloralum, 384. Cyanogenatum, 387. Ferrohy- drocyanicum, 387. Hydrocyanicum, 387. Iodatum, 390. Muriaticum (oxy- datum) 384. Zooticum, 387. Zinkbutter, 384. Ziokchlorid, 484. Zinkcyanur, 387. Zinkeisenblausaurer, 387. Zinkeisencyaniir, 387. Zinkoxyd, eisenoxydul, 387. Zinkoxyd salzsaures, 384. Zinkoxydul blausaures, 387. Zoomagnetismus, 106. INDEX DISEASES AND THEIR REMEDIES. Abdomen, inflammation of the (hydrarg. cyanur.) 222. Abscesses, suppurating (creosoton) 141. Acidity of the stomach (argilla) 43. Acne (sulphur, iodid.) 367. Indurata (sulphur, iodid.) 367. Rosacea (acid, hydrocyan.) 10. Rosacea (creosoton) 146. Adiposis (ballota lanata) 68. (Iodinum) 253. After pains (sulphuris carburetum) 365. Amaurosis (acupunct.) 27. (Ammoniated counter-irritants) 395. (Galvanismus) 403. (Nux vomica) 278. (Strychnina) 357. Incomplete (electro-punct.) 164. Amblyopia (strychnina) 357. Amenorrhcea (artcmisia)52. (Brominum) 77. (Cainca? radix) 81. (Calendula) 94. (Ferr. iodid.) 186. (Iodinum) 250. (Po- tassii bromid.) 304. (Secale cornutum) 344. (Sulphuris carburetum) 365. Anasarca (acid, hydrocyan.) 9. (Acupunct.) 272. Aneurism (acupunct.) 28. Angiectasis (zinci chlorid.) 385. Angina pectoris (galvanism) 405. (Mag- net) 261. Anthrax, malignant (chlorin. aq.) 112. Aphonia (chlorin.) 106. (Cubebtr) 155. (Ol. croton) 283. (Strychnina) 357. Aphtha;, asthenic (chlorin. aq.) 114. Aphthous sores (liq. ferr. persesquinit.) 196. Ulceration (creosoton) 153. Arthritis, chronic (brominum) 77. (Com- pressio) 391. Arthrocace (ol. jecinor. aselli) 288. Ascites (acupunct.) 27. (Oaincn* radix) 81. (Euphorb. ol.) 170. (Iodinum) 248. Asphyxia (acupunct.) 20. (Galvano punc- Asphyxia — continved. tur.) 164. (Sulphuris carburetum) 365. Asthenia, chronic (potassse chloras) 301, 302. Asthma (bignonia catalpa) 72. (Creoso- ton) 151. (Galvanism) 405. (Ol. cro- ton) 283. Humoral (sulphur, iodid.) 368. Nervous (magnet) 261. Pulveru- lentum (acid, hydrocyan.) 9. Spasmodic (acid, hydrocyan.) 8. (Iodinum.) 250. Atrophy (brucina) 79. (Ol. jecinor. aselli) 288. Partial (nux vomica) 277. Biles (ammoniated counter-irritants) 399. Bladder, atony of the (diosma) 163. Ca- tarrh of the (cort. adstring. brazil.) 130. Diseases of the (diosma) 162. Inflammation of the (fuligo) 202. Bleeding from leech bites (creosoton) 139. Blennorrhea (acid, hydrocyan.) 10. (Chi- maphila) 102. (Cort. adstring. brazil.) 130, 131. (Ferr. iodid.) 18. (Piperina) 297. (Tannicum purum) 371. Of the bladder, (diosma) 163. Of the eye (cal- cis chlorid.) 88. (See gonorrhoea.) Boils, see biles. Bones, pains in the (zinci ferrohydrocy anas) 389. Tumors of the (auri prre par.) 58. Bowels, painful affections of the (acid hydrocyan.) 9. Brain, chronic affections of the (ammo niated counter-irritants) 394. Bronchi, dilatation of the (chlorin.) 106 Inflammation of the (ammoniated coun tcr-irritantc) 399. Bronchitis (ncid. hydrocyan.) 8. (Iodi num) 246. (Mannitum) 263. (Strych nina) 358. Chronic (aq. piceu) 36 422 INDEX OF DISEASES AND THEIR REMEDIES. Bronchitis — continued. Ciironic (chlorin.) 106, 107. Chronic (colchicum) 127. Chronic (creosoton) 148. Chronic (galeopsis) 204. Chronic (salicina) 335. Bronchocele (ferr. iodid.) 186. (See goitre.) Bronchorrhcea (creosoton) 148. Bubo, ulcerated (creosoton) 144. Burns (calcis chlorid.) 86, 91. (Creoso- ton) 140. (Sodas chlorid.) 379. (Sul- phuris carburetum) 365. Severe (com- pressio) 390. Cachexia (acid, pyrolign.) 17. (Chlorid.) 108. Mercurial (auri praspar.) 56. (See Dyscrasy. Calculous pains (diosma) 162. Calculus (chirnaphila) 101. Phosphatic (acid. lact.) 14. Cancer (acid, pyrolign.) 17. (Aur. nitrico- muriat.) 66. (Auri. praspar.) 58. (Cal- cis chlorid.) 185. (Calendula) 93. (Ferr. arseniat.) 179. (Ferr. carb. prase.) 173. (Ferr. iodid.) 186. Of the heart (calen- dula) 93. Of the breast (creosoton) 143. Of the breast (fuligo) 201. Of the face (creosoton) 143. Of the integuments (calendula) 93. Of the lip (creosoton) 143. Open (carbo animalis) 97, 98. Of the skin (creosoton) 143. Of the tongue (iodin.) 251. Of the uterus (auri pras- parat.) 58. Of the uterus (calendula) 93, 94. Of the uterus (creosoton) 142. Of the uterus (morphinas acetas.) 271. Cancerous ulcers (chlorin. aq.) 114. (Po- tass, iodid. 313. Of the face (creosoton) 143. Cancrum oris (acid, pyrolign.) 17, 19. (Calcis chlorid.) 85. (Chlorin. aq.) 113, 114. (Creosoton) 142. Carbuncle, sloughing (creosoton) 142. Oarbunculus malignus (aq. chlorin.) 112. 114. Cardialgia (artemisia) 52. (Calendula) 94. (Nux vomica) 278. (Zinci ferro- hydrocyanas) 3S8. Carditis (ammoniated counter-irritants) 399. Varies of bones (acid, pyrolign.) 17. Of the fibula, &c. (creosoton) 143. Scro- fulosa (ol. jecinor. aselli) 288. Scrofu- lous (creosoton) 142, 153. Of the teeth (calcis chlorid.) 87. Cjtalepsy (strychnina) 358. Catamenia, obstruction of the. (See Ame- norrhcea.) Cataract, disintegrated (carbo animalis) 97. Incipient (ammoniated counter-irri- tants) 394. Catarrh, chronic (acid, hydrocyan.) 8. (Aq. picea) 34. (Chirnaphila) 102. (Chlo- rin.) 106, 108. Catarrh, pulmonary (galeopsis) 204. (Man- nitum) 263. Catarrhus urethras (cubebas) 156. Vesicae (aq. picea) 36. Vesicae (caincce radix) 82. Vesicas (cubebas) 156. Vesicas (diosma) 162. Cephalalgia (acupunct.) 28. Chronic (ar- temisia) 52. Intermittent (quininas sul- phas) 327, 330. Nervous (acid, hydro- cyan.) 9. Periodical (zinci ferrohydro- cyanas) 388. Syphilitic (hydrarg. cy- anur.) 222. (See'headach.) Chancre (creosoton) 144, 153. (Hydrarg. cyanur.) 222. Chaps (ol. jecin. aselli) 289. Chest, diseases of the (chlorin.) 105. Af- fections of the (fuligo) 202. Chilblains (calcis chlorid.) 86, 92. (Cre- osoton) 141. Chlorosis (artemisia) 52. (Ferr. iodid.) 186. Cholera (creosote) 150. (Diosma) 162. (Guaco) 214. Morphinas acetas.) 271. (Nux vomica) 280. (Strychnina) 358. Morbus (artemisia) 52. Chorea (acid, hydrocyan.) 9. (Ferr. carb. prase ) 175. (Iodinum) 249. (Ol. jecinor. aselli) 289. (Strychnina) 358. (Veratri- na) 380. (Zinci ferrohydrocyanas) 389. Colic, hysterical (ol. sinapis) 293. Colica pictonum (nux vomica) 278. Condylomata (creosoton) 144. (Hydrarg. deuto-iodur.) 228. (Thuya occidenta- lis) 372. Congestions in the head (ammoniated counter-irritants) 399. Constipation (galvanism) 406. (Veratri- na) 382. Contagion (calcis chlorid.) 89. (Chlorin.) 109. Contusions (acupunct.) 28. (Creosoton) 141. Convulsions (ammoniated counter-irritants) 399. (Auri praspar.) 54. (Magnet) 261. (Compression of arteries) 394. (Potass, cyanid.) 307. During dentition (chlo- rin. aq.) 111. Hysterical (indigum) 230. Convulsive affections (acupunct.) 27. Dis- eases of childhood (artemisia) 51. Cornea, granulations on the (fuligo) 201. Obscurity of the (calcis chlorid.) 88. Opacity of the (hydrarg. deuto-iodur.) 228. Opacity of the (ol. jecinor. aselli) 288. Spots on the (fuligo) 201. Coryza (cubebas) 155, 156. Cough (lactucarium) 259. Nervous (tan- nicum purum) 370. Spasmodic (lactu- carium) 260. Spasmodic, dry (fucus crispus) 199. Violent (asparag. turion.) 53. Coxalgia (iodinum) 252. Coxarthrocace (ol. jecinor. aselli) 289. Cramp (ammoniated counter-irritants) 399. (Magnet) 261. Of the stomach (nux vomica) 280. Of the stomach (zinci ferrohydrocyanas) 388. INDEX OF DISEASES AND THEIR REMEDIES. 423 Croup, hysteric (creosoton) 151. Crusta lactea (asparag. turion.) 54. (Cre- osoton) 145. Cutaneous diseases (arsenias ammonias) 46. (Acid, hydrocyan.) 10. (Asparag. turion.) 54. (Auri cyanidum) 59. (Cal- cis chiorid.) 87. (Chlorin.) 108. (Chlo- rin. aq.) 113. (Creosoton) 145. (Ferr. carbur.) 177. (Fuligo) 201. (Kydrarg. deuto-iodur.) 227. (Iodid. sulph.) 258. (Iodinum) 249. (01. jecinor. aselli) 289. (Potassas chloras) 301. (Sodae chiorid.) 349. (Sulphur, iodid.) 367. Syphilitic (hydrarg. proto-iodur.) 225. Cynanche (cort. adstring. Brazil.) 130. Tonsillaris. (Sec Sore throat.) Deafness (acid, pyrolign.) 17. (Creosoton) 147. (Galvanism) 403. Erethitic ner- vous (injections of vapour of acetous ether) 410. Nervous (injections of va- pour of acetous ether) 410. Nervous, torpid (injections of vapour of ether) 410. Debility (ferr. iodid.) 186. (Nux vomica) 277. (Piperina) 297. General (quinines et cinchoninte tannas) 331. Nervous (Quininse sulphas) 328, 330. Paralytic (ammoniated counter-irritants) 399. Decubitus gangreenosus (plumb, tannas) 300. Delirium tremens, (magnetism, animal) 406. Dentition (chlorin. aq.) 111. Diabetes mellitus (creosoton) 150. (Tan- nicum purum) 369. (Urea) 374. Diarrhoea (acid, pyrolign.) 17. (Argilla) 43, 44. (Artemisia) 52. (Carbo ani- malis) 97. (Fucus crispus) 199. (Indi- gum) 230. (Liq. ferr. persesquinit.) 190. (Strychnina) 358. (Veratrina) 382. Choleric (nux vomica) 278. Chronic (ferr. cyanuret.) 180. Chronic (mor- phines acetas) 271. Chronic (nux vomi- ca) 278, 280. Diathesis phthisica (chlorin. aq.) 113. Diphlheritis (fuligo) 201. Diplopia (acupuncl.) 28. Discharges from the nose (iodinum) 257. Offensive (acid, pyrolign.) 17, 18. Disinfection (chlorin.) 109. (Chlorin. aq.) 114. Dropsy (acid, hydrocyan.) 9. (Acid, pyro- lign.) 17. (Asparag;. turion.) 54. (Au- rmn muriat.) 62. (Aur. tnuriat. natron.) 64. (Auri prmparat.) 58. (Ballota la- nata) 67, 68. (Caincic radix) 81. (Chi- maphila) 101, 103. (Chlorin. aq.) 113. (Colchicum) 127. (Ferr. iodid.) 187. (Hippocastanom) 216. (Iodinum) 248. (Ol. ainapis) 293. (Urea) 374. (Vera- trina) 375, 383. Of the ovary (iodin.) 250. After scarlatina (colchicum) 127. Dumbness (galvanism) 403. Dyscrasy (ferr. iodid.) 187. (Sulphuris carburetum) 365. After intermittents (ferr. cyanur.) 180. (See Cachexia.) Dysentery (argilla) 43. (Artemisia) 52. (Calcis chloridum) 84. (Ferr. cyanur.) 180. (Fucus crispus) 199. (Nux vo- mica) 279, 280. (Secale cornutum) 344. (Strvchnina) 358. Putrid (chlorin. aq.) 112." Dyspepsia (acid, lact.) 14. (Argil.) 43. (Berberina) 71. (Carbo auimalis) 97. (Chimaphila) 102. (Diosma) 162_. (Ferr. iodid. 186. (Hippocastanum) 216. (Nux vomica) 279. (01. sinapis) 293. (Pipe- rina) 297. (Quininee sulphas) 329. (Strychnina) 358. Dysphagia (artemisia) 52. Spasmodic (acid, hydrocyan.) 8. Dyspnosa (galvanism) 404. (Potass, cya- nid.) 307. Dysuria (chimaphila) 101. Eclampsia infantum (artemisia) 51, 53. Eczema (ol. jecinor. aselli) 289. Engorgements, visceral (ferr. iodid.) 187. Enteralgia (acid, hydrocyan.) 9. Enteritis (acid, hydrocyan.) 8. Epilepsy (acid, hydrocyan.) 9. (Acu- punct.) 28. (Ammoniated counter-irri- tants) 399. (Artemisia) 49. (Compres- sion of arteries) 394. (Creosoton) 151. (Ferr. cyanur.) 180, 181. (Galvanism) 405. (Granatum) 212. (Indigum) 230. (Iodinum). 249. (Magnet) 261. (Nux vomica) 278. (Strychnina) 358. (Zinci chiorid.) 386. (Zinci ferrohydrocyanas) 388. Epistaxis (cort. adstring. Brazil.) 130. (Cre- osoton) 139. (Secale cornutum) 344. Erethism, gangrenous, 340. Morbid (po- tassae chloras) 301. Ergotism, 339. Erysipelas (chlorin. aq.) 113. (Colchicum) 127. (Compressio) 390. Of the face. (Cort. adstring. Brazil.) 130. Eustachian tube, obstructed. (Injections of air) 407. Exanthemata, febrile (chlorin. aq.) 112. Exanthematous diseases (cort. adstring. Brazil.) 130. Excoriation from lying (creosoton) 141. Of the skin (ol. jecinor. aselli) 289. Syphilitic (aururn mclallieum) 60. Excrescences, syphilitic (aurum mctalli- cum) 60. Eye, black (calcis chiorid.) 86. Fainting, hysteric (sulphuris carburetum) 365. Febrile affections (colchicum) 126. Dis- eases (morphine) 268. Fever, brain (compression of arteries) 394. Gastric (artemisia) 52. Gastric (chlorin. 424 INDEX OF DISEASES AND THEIR REMEDIES. Fever — continued aq.) 113. Hectic (chlorin. aq.) 113. Intermittent (cctrarine) 100. Intermit- tent (chlorin. aq.) 112. Irritative (chlo- rin. aq.) 111. Nervosa (chlorin. aq.) 111. Paroxysmal (quinines sulphas) 324. 328, 32 .1, 330. Petechia! (aq. chlo. rin.) 112. Putrid (acid, pyrolign.) 17. Putrid (chlorin. aq.) 112. Summer (qui- ninae sulphas) 328. Typhous (sodae chloridum) 34:). Fissures of the skin (creosoton) 141. (01. jecinor. aselli) 289. Fistulce (acid, hydrocyan.) 10. (Calcis chlorid.) 85. (Oi. jecinor. aselli) 291. (Potass, iodid.) 314. Flatulence (creosoton) 150. Fluor albns. (Sec Leucorrltwa.) Fcetor oris (calcis chloridum) 84, 89, 90. (Chlorin. aq.) 113. Frost bites (calcis chlorid.) 86, 91. Fungous tumour (creosoton) 143. Fungus of the neck of the uterus (aur. nitricomuriat.) 66. Ganglion (acupunct.) 30. (Hydrarg. deuto- iodur.) 223. Ganglionic system, disorder of the (ferr. cyanur.) 131. Gangrene (acid, pyrolign.) 17. (Calcis chlorid. 86. Hospital (calcis chlorid.) 85, 91. Hospital (creosoton) 142. Of the lungs (chlorin.) 106. Of the scro- tum (calcis chlorid.) 85. Gastralgia with acid (cinchonin.) 117. Gastricism (carbo animalis) 97. (Manni- tum) 263. Gastritis (codeine) 122. Gastrodynia (acid, hydrocyan.) 9. (Acu- punct.) 28. (Creosoton) 150. (Nux vomica) 279. (01. sinapis) 293. Gastromalacia (acid, pyrolign.) 17. Chlo- rin. aq.) 113. Genital organs, anatomy of the (cubebte) 155. Debility of the (cort. udstring. Brazil.) 130. Debility of (nux vomica) 277. Glanders, chronic (creosoton) 151. Glands, enlarged (carbon sesqui-iodid.) 99. Enlarged (plumbi iodid.) 299. In- duration of the (hydrarg. deuto-iodur.) 228. Mammary, enlarged (veratrina) 381. Meibomian, copious secretion from the (calcis chlorid.) 88. Mesenteric, en- larged (iodinum) 244. Of the neck, in- flamed (hydrarg. deuto-iodur.) 227. Scrofulous swellings of the (calcis. chlo- rid.) 87. Strumous swellings of the (chlorin. aq.) 114. Submaxillary, en- larged (iodinum) 244. Tumefied, stru- mous (hydr. proto-iodur.) 224. Glandular affections (aurum muriat.) 62. (Iodinum) 243. (Veratrina) 381. Gleet (creosoton) 144. (Secale cornutum) 347. Old (tannicum purum) 371. Goitre (brominum) 77. (Calcis chlorid.) 87, 92. (Hydrarg. deuto-iodur.) 228. (Iodinum) 242, 257. (Potassii bromid.) 304. (Potass, iodid.) 312. Scirrhous (carbo animalis) 97, 98. (Sulphuris carburetum) 3G5. (Veratrina) 381. Gonorrhoea (auri prcepar.) 57. (Calcis. chlorid) 84. (Calcis chlorid.) 89, 90. (Chlorin. aq.) 114. (Creosoton) 144. (Cubebae) 154. (Diosma) 162. (Secale cornutum) 344. (See Biennorrhcsa.) Gout (acupunct.) 28. (Ammoniated coun- ter-irritants) 399. (Ballota lanata) 63. (Colchicum) 125, 126. (Compression of arteries) 394. (Creosoton) 149, 152. (Iodinum) 252. (Magnet) 261. (Moxa) 400. (01. croton.) 283. (01. jecinor. aselli) 287. (Sulphuris carburetum) 365, 366. (Veratrine) 280. Atonic (hippocastanum) 216. Chronic (chi- maphila) 101, 103. Chronic (diosma) 162. Suppressed (ammoniated counter- irritants) 399. Gouty swellings of bones (potass, iodid.) 314. Gravel, white (acid, lact.) 14. Growths, morbid (baryum iodaturn) 70. Gums, scorbutic ulceration of the (creoso- ton) 142, 152. Gutta rosacea (fuligo) 201. (Sulph. iodid.) 367. Hsemituna (diosma) 162. (Secale cornu- tum) 344. Haemoptysis (cort. adstring. Brazil.) 130. (Creosoton) 140, 152. (Galeopsis) 205. (Lactucarium) 260. (Secale cornutum) 344. Head, determinations to the (chlorin. aq.) HI. Headach, intermittent (quinintE sulphas) 327, 330. Nervous (strychnina) 358. Nervous (ammoniated counter-irritants) 399. (See Cephalalgia.) Hearing, defective from otorrhcea (cubebae) 155. Heart, active diseases of the (aconitin.) 21. Diseases of the (asparag. turion.) 54. Enlargement of the (acid, hydrocyanic) 9. Hypertrophy of the (asparag.tu- rion.) 54. Hypertrophy of the (bro- minum) 77. Hypertrophied (iodin.) 250. Hypertrophy of the (potass, bro- mid.) 304. Hypertrophy of the (potass, iodid.) 312. Palpitation of the (asparag. turiones) 53. Spasmodic affections of the (acid, hydrocyan.) 8. Hectic fever (chlorin. aq.) 113. Hemicrania (acid, hydrocyan.) 9. Hemiplegia (nux vomica) 278. (Strych- nina) 356. Hemorrhage (aq. binelli) 32. (Cort. ad- string. Brazil.) 130. (Creosoton) 137. (Ferr. iodid.) 187. (Secale cornutum) 344. (Tannicum purum) 370. Active INDEX OF DISEASES AND THEIR REMEDIES. 425 Hemorrhage — continued. (acid, hydrocyan.) 8. Capillary (creo- soton) 140. From the gums (creosoton) 140. From leech bites (creosoton) 139. From the lungs. (See Hemoptysis.) Uterine (creosoton) 140. Uterine (ferr. iodid.) 187. Uterine (Secale cornutum) 344. Uterine (tannicum purum) 368. Hepatic diseases. (See Liver affections.) Hernia humoralis. (See Orchitis.) Incar- cerated (sulphuris carburetum) 365. Herpes (acid, hydrocyan) 10. (Calcis chlorid.) 87. (Chlorin. aq.) 114, 115. (Creosoton) 145, 154. (Ferr. carbur.) 176. (Fuligo) 201. (Hydrarg. cyanur.) '222. (Hydrarg. deuto-iodur.) 228. (01. jecinor. aselli) 239. (Potass, bromid.) 304. (Potass, iodid.) 311. (Sapo coco- neus) 336. Exedens (creosoton) 145. Phagedenic tuberculous (arsenic, iodat.) 48. Herpetic ulcers (creosoton) 142. Hiccough, spasmodic (magnet) 261. Hoarseness (fucus crispus) 199. (01. cro- ton) 283. Hooping cough (acid, hydrocyan.) 8, 12. (Ferr. carb. preec.) 175. (01. croton) 283. Hordeolum (hydrarg. deuto-iodur.) 228. Hydrocele (acupunct.) 29. (Chlorin.) 108. (lodinum) 248. (Iodinum) 253. Hydrocephalus (iodinum) 248. Hydrocyanic acid, poisoning by (chlorin.) 107. "(Chlorin. »q.) 113. Hydrophobia (chlorin. aq.) 113. (Compres- sion of the arteries) 394. Hydrothorax (acid, hydrocyan.) 8. (Col- chicurn) 127. (Iodinum) 248. Hygroma (iodinum) 249. Hyporamia (ammoniated counter-irritants) 400. (See Inflammation.) Hypeisesthcsia (potassce chloras) 301. Hypcremesis (tannicum purum) 370. Hypertrophy (barvum iodatum) 70. (Ferr. bromat.) 173. (Ferr. iodid.) 187. Ol the coats of the stomach (sulph. carbu- ret.) 366. Of the heart (brominum) 77. Of the heart (iodin.) 250. Of the heart (potass, bromid.) 304. Of the heart (po- tass, iodid.) 312. Of the mammce (iodi- num) 250. Of the spleen (iodin.) 251. Of the thymus (iodin.) 250. Hypochondriasis (auri praeparat.) 54. (Chlorin.) 108. (Strychnina) 358. Vc- ratrina) 380. Ilysteralgia (euphorb. ol.) 170. Hysteria (creosoton) 151. (Fuligo) 202. (Granatum) 212. (Lactucarium) 260. (Strychnina) 358. (Veratrina) 380. (Zinci fcrrohydrocyanas) 388. Hysteric croup (creosoton) 151. Fainting (sulphuris carburetum) 365. Convul- sions (indigum) 230. Hysterics (ammoniated counter-irritants) 399. Impetigo (acid, hydrocyan.) 10, 12. (Ar- son, iodat.) 48. (Creosoton) 145, 153.) (Ol.jecin. aselli) 289. Impotence (cubebae) 155. (Diosma) 162. (Iodinum) 254. (Nux vomica) 277. Incontinence of urine (iodin.) 249. (Nux vomica) 271. Indigestion. (See Dyspepsia.) Indurations, glandular, chronic (carbo animalis) 97. (Hydrarg. deuto-iodur.) 228. Of the pancreas (carbo animalis) 97. Of the pancreas (iodin.) 251. Chro- nic (calendula) 94, 95. Chronic, of the mammce (carbo animalis) 97. Inflammation (aconitin.) fel. (Compres- sion of arteries) 394. Of the bronchia. (See Bronchitis.) Chronic (acid, hydro- cyan.) 8. Chronic (baryum iodatum) 70. Chronic (ol. croton) 283. Chronic, of the eustachian tube (catheterism) Chronic, of the mouth and fauces (chlo- rin. aq.) 115. External (compressio) 390. Of the heart. (See Caiditis.) Internal (acid, hydrocyan.) 8. Of the liver (chlorin. aq.) 113. Of the lungs (ammoniated counter-irritants) 399. Of the lungs. (See Pneumonia.) Of the pleura (ammoniated counter-irritants) 399. Synovial (compressio) 390. Tho- racic (acid, hydrocyan.) 8. Of the tra- chea (ammoniated counter-irritants) 399. Inflammatory diseases (colchicum) 126. (Cort. adstring. Brazil.) 130. (Morphina) 268. (Ol. sinapis)293. Integuments, lesions of the (creosoton) 141. Intermittent (cetrarine) 100. (Chlorin. aq.) 112. (Cinchonin.) 117, 118. (Cu- bebae) 155. (Ferr. carb. praec.) 175. (Ferr. cyanur.) 180, 181. (llippocasta- num) 216. (Indigum) 230. (Phlorid- zina) 294. (Piperina) 296. (Quinina) 316. (Quinina? ct cinchon. tannas) 331. (Quinina? sulphas) 324, 328, 329, 330. (Quinine sulphas impurus) 333. (Re- sina cliinse praspar.) 332. (Salicina) 334, 335. (Soda? chlorid.) 349. Intertrigo of children (creosoton) 141. Iodum, 240. lodkrankhcit, 240. lodosis, 24". Iralgia (quinincc sulphas) 327. Ischias (ol. sinapis) 293. (Veratrina) 379. Ischuria (colchicum) 127. Itch (calcis chlorid.) 187. (Chlorin. aq.) 114,115. (Creosoton) 145, 153. (Fu- ligo) 201. (Sapo mollis) 336. Joints, swelled (ammoniated counter-irri- tants) 399. (Calcis chlorid.) 87, 92. Kricbelkrankheit, 339. 426 INDEX OF DISEASES AND THEIR REMEDIES. Labia pudendi, infiltration of (creosoton) 142. Labour, premature, inducing (secale cor- nutum) 343, 347. Lcechbites, hemorrhage from (creosoton) 139. Lepra (arsen. iodat.) 48. (Auri praeparat.) 58. (Carbon, sesqui-iodid.) 99. (Chlo- rin.) 108. (Sulphur, iodid.) 367. Leucorrhcea (chlorin. aq.) 114. (Colchi- cum) 127. (Cort. adstring. Brazil.) 130, 131. (Creosoton) 144. (Cubebae) 155. (Ferr. iodid.) 186. (Iodinum) 251. (Liq. Ferr. persesquinit.) 190. (Salicina) 335. (Secale cornutum) 344, 347. Lichen leproides (ferr. carbur.) 178. Liver, affections of the (potassae chloras.) 301. (Berberina) 71. (Chlorin.) 108. (Iodin.) 251. Induration of the (hy- drarg. deuto-iodur.) 228. Indurated (iodinum) 243. Inflammation of the (chlorin. aq.) 113. Obstruction of the (hydrarg. proto-iodur.) 224. Tubercles of'the (iodinum) 248. Lumbago (acupunct.) 28. (Ammoniated counter-irritants) 373. (Veratrine) 380. Lungs, gangrtne of'the (chlorin.) 106. Lupus (hydrarg. deuto-iodur. 227.) (Zinci chlorid.) 385. Non exedens (sulphur, iodid.) 368. Of the ala nasi (ferr. carb. prase.) 174. Of the nose (creosoton) 143. Luxations (diosma) 162. Lymphatism (ferr. iodid.) 186. Measles (chlorin. aq.) 112. Mammae, hypertrophied (iodinum) 250. Menorrhagia (cort. adstring. Brazil.) 130. (Ferr. cyanur.) 180. Mental affections (auri prreparat.) 54. Metritis (acid, hydrocyan.) 8. Metrorrhagia (cort. adstring. Brazil.) 130. Miasmata, destroying (calcis chlorid.) 89. Milzbrandkarbunkel (chlorin. aq.) 112. (Zinci chlorid.) 3S5. Mortification, mildew, 340. Mouth, inflammation of the, chronic (chlo- rin. aq.)115. Offensive conditions of the (calcis chl >rid.) 87. Ulceration of the (calcis chlorid.) 85. Naevi materni (zinci chlorid.) 385. Nephralgia (chirnaphila) 101. Nephritis (acid, hydrocyan.) 8. Nervous coughs (tannieum purum) 370. Nervous diseases (auri praeparat.) 54. (Cort- adstring. Brazil.) 130. (Creosoton) 151- (Ferr. carb. prase.) 174. (Ferr. cyanur.) 180. (Fuliffo) 202. (Iodinum) 249. (Magnet) 260, 262. (Morphina) 268. (Morphinae acetas) 270. (01. sinapis) 293. (Quinina; sulphas) 329. (Zinci ferrohydrocyanas) 389. (Veratrina) 379. Chronic (acid, hydrocyan.) 8. Nervous excitement (lactucarium) 259. Neuralgia (acid, hydrocyan.) 9, 10. (Aco- nitin.) 21. (Ammoniated counter-irri- tants) 398. (Asparag. turion.) 53. (Com- pression of arteries) 394. (Creosoton) 151. (Delphinin.) 160. (Elcctropunct.) 163. (Ferr. carb. praec.) 173. (Ferr. cyanur.) 181. (Galvanism) 405. (Mag- net) 261. (Morphinae acetas) 270. (Morphin. bimeconas) 274. (Moxa) 400. (Nux vomica) 278. (01. sinapis) 293. (Potass. cyanid.)306. (Strychnina) 358. (Veratrina) 376. (Zinci ferrohydrocya- nas) 389. Of the abdomen (codeina) 121. Faciei (artemisia) 52. Faciei (codeina) 122. Faciei (potassae chlo- ras) 302. Faciei. (See Tic Doulou- reux.) Frontal (galvanism) 405. Of the heart (magnet) 261. Pulmonary (magnet) 261. Neuroses (ol. croton) 283. Nipples, excoriated (acid, pyrolign.) 17. Sore (creosoton) 141. Nodes, gouty (sulphur, carb.) 3C6. Noma (chlorin. aq.) 113. Odontalgia (ammoniated counter-irritants) 399. (Ol. sinapis) 293. (See Toolhuch.) Odour, offensive (calcis chlorid.) 88. ffidema (creosoton) 147. Of the feet (acupunct.) 28. Offensive evacuations (calcis chlorid.) 89. Ophthalmia (acid, hydrocyan.) 10. (Acu- punct.) 27. (Creosoton) 146. Ca- tarrhal (calcis chlorid.) 88, 91. Chronic (calcis chlorid.) 8S. Egyptian (tanni- eum purum) 370. Neonatorum (calcis chlorid.) 88. Purulent (calcis chlorid.) 88. Rheumatic (zinci ferrohydrocyanas) 389. Scrofulous (auri praeparat.) 57. Scrofulous (aurum rnuriat.) 62. Scrofu- lous (calcis chlorid.) 88, 91. Scrofulous (potass, iodid.) 313. Scrofulous (quinine? sulphas) 339. Strumous (fuligo) 201. Strumous (ol. jecinor. aselli) 288. Tarsi (acid, pyrolign.) 17. Tarsi (creosoton) 146. Tarsi (hydrarg. deuto-iodur.) 228. Tarsi (zinci ferrohydrocyanas) 389. Tarsi (zinci iodinum) 390. Orchitis (compressio) 391. Osteocopi, syphilitic (strychnina) 358. Otalgia (ol. sinapis) 293. Otorrhcea (creosoton) 141. (Cubebae) 155. (Potassii bromid.) 304. Ovaries, degenerated (iodin.) 250. Dropsy of the (iodin.) 250. Inflammation of the (hydrarg. cyanur.) 222. Ozcena (calcis chlorid.) 85. (Carbo ani- malis) 97. (Iodinum) 251. Pain, anomalous, of hip and thigh (mor- phin. bimeconas) 274. Nervous and muscular (ammoniated counter-irri- tants) 398. Nervous and muscular (moxa) 400. Nocturnal, in the bones INDEX OF DISEASES AND THEIR REMEDIES. 427 Pain — continued. (zinci ferrohydrocyanas) 389. Severe (acid, hydrocyan.) 10. Palpitations (magnet) 261. (Veratrina) 381. Pancreas, induration of the (carbo anima- lis) 97. Paralysis (acupunct.) 28. (Arnica) 45. (Brucina) 79. (Delphinin.) 160. (Gal- vanism) 405. (Electropunct.) 163. (Iodi- num) 249. (Nux vomica) 277, 280. (Strychnina) 356. (Veratrina) 380. (Zinci chlorid.) 385. (Zinci ferrohydro- cyanas) 388. Of the bladder (diosma) 163. Of the bladder (secale cornutum) 345. Of the bladder (strychnina) 357. Of the upper eyelid (ol. croton) 283. Of the facial nerve (strychnina) 357. Lead (brucina) 79. Partial (nux vomi- ca) 278. Of the rectum (nux vomica) 278. Succeeding 1 to apoplexy (nux vo- mica) 277. Paralytic debility (ammoniated counter- irritants) 399. Paraplegia (secale cornutum) 345. (Strych- nina) 356. Paroxysmal diseases (secale cornutum) 344. Parturient efforts defective (secale cornu- tum) 341. Pericarditis (ammoniated counter-irritants) 399. Phlebitis (compressio) 390. Phlegmasia (compressio) 390. Phthisis (acid, hydrocyan.) 8. (Acid, py- rolign.) 17. (Aq. picea) 34. (Calcis chlorid.) 84. (Chlorin.) 105, 106. (Oreo- soton) 147, 152. (Fucus crispus) 199. (Galeopsis) 204. (Iodinum) 246. (Ol. croton) 283. (Ol. jccinor. aselli) 288. (Potassse chloras) 301. (Tannicum pu- rum) 370. Cough of (codeina) 122. Mucosa (galeopsis) 204. Mucosa (iodi- num) 247. Pituitosa (chimaphila) 102. Sweats of (boletus laricis) 73. Pica (caincae radix) 82. Pimples (ammoniated counter-irritants) 399. Pityriasis (zinci chlorid.) 385. Plague (chlorin. aq.) 111. Prevention of (chlorin. aq.) 114. Plcuritis. (See inflammation of the pleura.) Pleurodyne (acupunct.) 28. Pneumonia (mannitum) 263. Chronic (hydrarg. cyannrct.) 221. Poisoning by arsenic (ferr. oxyd. hydrat.) 192. By hydrocyanic acid (chlorin. aq.) 113. Polypi cartilaginous (carho onimalis) 97. Mucous (carbo animalis) 97. Porrigo (acid, pyrolign.) 17. (Carbon, sesqui-iodid.) 99. (Fuligo) 202. (Ol. jecin. aselli) 288. Favosa (creosoton) 146. Favosa (hydrarg. bromid.) 219. Porrigo — continued. Favosa (iodinum) 250. Favosa (potassii bromid.) 304. Scrofulous (auri praepa- rat.) 57. (See Tinea.) Prolapsus vaginae (creosoton) 146. Prosopalgia (ol. sinapis) 293. (Potassae chloras) 302. (Veratrina) 379. (Zinci chlorid.) 386. Prostate, disease of the (diosma) 162. En- largement of the (carbo animalis) 98. Enlarged (iodinum) 244. Enlarged (iodinum) 252. Prurigo (colchicum) 127. Pruritus pudendi muliebris (calcis chlorid.) 87. Vulvae (fuligo) 201. Psora. (See Itch.) Psoriasis (chlorin.) 108. (Creosoton) 146. (Hydrarg. proto-iodur.) 224. (Sulphur, iodid.) 367. Pustule maligne (zinci chlorid.) 385. Putrefaction, checking (calcis chlorid.) 88. Putrescency, tendency to (quininae et cin- chonin. tannas) 331. Pyrosis (nux vomica) 279. Rectum, catarrh of the (cort. adstring. Brazil.) 130. Remittent fever (ferr. cyanur.) 180. Rhagades (ol. jecin. aselli) 289. Rheumatic pains (hydrarg. deuto-iodur.) 228. Rheumatism (acupunct.) 26. (Ammo- niated counter-irritants) 399. (Ballota lanata) 68. (Cainca? radix) 82. (Chlo- rin.) 108. (Colchicum) 125, 126. (Com- pression) 390. (Compression of arte- ries) 394. (Creosoton) 149. (Delphi- nin) 160. (Electropunct.) 163. (Fuli- go) 202. (Galvanism) 403. (Todinum) 252. (Magnet) 261. (Morphinae acetas.) 271. (Moxa) 400. (Ol. croton.) 283. (Ol. jccinor. aselli) 287. (Ol. sinapis) 293. (Potassae chloras) 302. (Potass, cyanid.) 306. (Sulphuris carburetum) 365, 366. (Veratrina) 3S0. Articular (aconit.) 22. Chronic (chimaphila) 101. Chronic (cubebae) 155. Chronic (dios- ma) 162. Rickets (ferr. iodid.) 186. (Ol. jecinor. aselli) 287. Ringworm (ammoniated counter-irritants) 399. Roseola (chlorin. aq.) 112. St. Vitus's dance (ammoniated counter-ir- ritants) 399. (Liq. argent, muriat. am- nion.) 40. (Artemisia) 51. (Nux vomi- ca) 278. (Zinci chlorid.) 386. Salivation, mercurial (calcis chlorid.) 86, 91. Mercurial (iodinum) 253. Profuse (auri pneparat.) 54. Scabies (acid, pyrolign.) 17. (Chlorin.) 108. (See itch.) Scarlatina (acid, pyrolign.) 17. (Calcis chlo- 428 INDEX OF DISEASES AND THEIR REMEDIES. Scarlatina — continued. rid.) 87. (Chlorin. aq.) 112. (Chlorin. aq.) 114. (Colchicum) 127. Sciatica (acupunct.) 28. (Potass, cyanid.) 306. Gouty (acid, hydrocyan.) 9. Rheumatic (acid, hydrocyan.) 9. Scirrhus (auri praspar.) 58. (Ferr. iodid. 186. (Potass, iodid.) 311. Of the lips (carbo animalis) 97. Of the mammae (calendula) 93. Of the mammas (carbo animalis) 97. Of the mammae (iodin.) 250. Of the prostate (carbo animalis) 98. Of the pylorus (acid, hydrocyan.) 10. Of the pylorus (auri prseparat.) 58. Of the pylorus (zinci ferrohydrocyanas) 389. Of the stomach (artemisia) 52. Of the stomach (iodin.) 251. Of the tongue (auri praeparat.) 58. Of the uterus (acid, hydrocyan.) 10. Of the uterus (auri prffipar.) 58. Of the uterus (iodin.) 250. Scrofula (acid, pyrolign.) 17. (Auri cy- anidum) 59. (Auri praepar.) 56, 57. (Brominum) 77. (Chlorin.) 108. (Ferr. bromat.) 173. (Ferr. cyanur.) 181. (Ferr. iodid.) 186. (Fucus crispus) 199. (Gentianin.) 203. (Hydrarg. deuto- iodur.) 227. (Iodinum) 244. (01. jecin. aselli) 287. (Potassii bromid.) 304. (Potass, iodid.) 312. Scrofulosis (hydrarg. protoiodur.) 224. Scrofulous affections (sodse chloridum) 349. Diathesis (carbo animalis) 97, 98. Diseases (baryum iodatum) 70. Habit ferr. cyanur.) 181. (Aurum mur. na. tronat.) 64. Swellings (calcis chlori- dum) 84. Swellings (carbo animalis) 98. Swellings (chlorin. aq.) 114. Swel- lings (iodid. quinin.) 258. Swellings (iodinum) 257. Swellings (plumbi iodid.) 299. Swellings (potassii bromi- dum) 304. (Veretrina) 381. Swellings of the glands (calcis chlorid.) 87. Tu- mefaction of the upper lip (aur. muriat. natronat.) 64. Ulcers (potass, iodid.) 313. Scurvy (creosoton) 142. Seasickness (creosote) 150. Sensibility, unusual, of the abdomen (zinci ferrohydrocyanas) 389. Serpents, bites of (caincae radix) 82. (Gu- aco) 213. Serpigo (potass, iodid.) 312. Sleeplessness (lactucarium) 260. (Mag- netism, animal) 406. (Morphin. bime- conas) 279. Sloughing ulcers (calcis chlorid.) 85. Small-pox (calcis chloiid.) 85. (Chlorin. aq.) 112. Sore throat (ammoniated counter-irritants) 399. Spasmodic diseases (acid, hydrocyan.) 9. (Acupunct.) 27. (Colchicum) 127. (In- Spasmodic diseases— continued. digum) 230. (Magnet) 260. (Zinci ferrohydrocyanas) 388. Spasmodic erethism (creosoton) 151. Spasms (ammoniated counter-irritants) 399. (Magnet) 261. Sphacelus (acid, pyrolign.) 17. Spina ventosa (ol. jecinor. aselli) 288. Spleen, diseases of the (potass, bromid.) 304. Engorgement of the (quininae sul- phas) 325. Enlarged (hydrarg. deuto- iodur.)228. Enlarged (iodin.) 251. In- durated (iodinum) 243. Sprains (creosoton) 141. Violent (ammo- niated counter-irritants) 399. Staubasthma (acid, hydrocyan.) 9. Stomacace (iodinum) 253. Stomach, coats of the, hypertrophy of the (sulph. carbur.) 366. Irritation of (co- deina) 122. Neuropathic disorders of (acid, hydrocyan.) 19. Stricture of the Eustachian tube (catheter- ism) 407. Of the urethra (iodin.) 251. Spasmodic, of the urethra (diosma) 162. Struma varicosa (carbo animalis) 97. Suffocation, sense of (acid, hydrocyan.) 8. Suppuration, profuse (creosoton) 141. Sweating, profuse (boletus laricis) 73. Syphilis (argenti praeparat.) 37. (Auri cyanidum) 59. (Auri praeparat.) 54, 56. (Aurum muriat.) 62. (Chlorin.) 108. (Hydrarg. bromid.) 219. (Hy- drarg. cyanur.) 221. (Hydrarg. deuto- iodur.) 227. Secondary (ferr. iodid.) ]86. Secondary (iodinum) 252. With scrofula (potass, iodid.) 31]. Syphilitic affections (potassae chloras) 301. Eruptions (ferr. carb.) 177. Excoria- tions (aurum metallicum) 60. Excres- cences (aurum metallicum) 60. Oste- ocopi (strychnina) 358, 360. Swellings of the bones (potass, iodid.) 314. Ulcers (aurum metallicum) 60. Tabes mesenterica (ferr. iodid.) 186. Taenia (acid, hydrocyan.) 10. (Brayera anthelmintica) 74. (Creosoton) 150. (Euphorb. ol.) 170. (Filix mas) 196. (Granatum.) 210. (Ol. croton) 282. Tarsi inflamed, chronic (creosoton) 146, 153. Teeth, caries of the (calcis chlorid.) 87. Testes, enlarged (iodinum) 243. Enlarged (potass, iodid.) 313. Scrofulous swell- ing of the (potassii bromid.) 304. Tetanus (acid, hydrocyan.) 9. (Ammoni- ated counter-irritants) 399. (Colchicum) 126. Traumatic (strychnina) 358. Tetter (iodinum) 249. (See Herpes.) Thoracic inflammation (hydrarg. cyanur.) 222. Thymus, hypertrophied (iodin.) 250. Tic douloureux (acid, hydrocyan.) 9. (Aconitin.) 21. (Ammoniated counter- INDEX OF DISEASES AND THEIR REMEDIES. 429 Tic duuloureaux — continued. irritants) 399. (Delphinin) 160. (Gal- vanism) 405. (Strychnina) 358. (Ve- ratrina) 380, 383. (See Neuralgia.) Tinea (calcis chlorid.) 87, 92. (Chlorin. aq.) 114, 115. (Fuligo) 201. (Iodid. sulph.) 258. Tongue, induration ofthe(auri prajparat.) 58. Tonsils, enlarged (iodinum) 244. Toothach (acid, hydrocyan.) 10. (Acid, pyrolign.) 17. (Acupunct.) 28. (Creo- soton) 147, 153. (Liq. ferr. persesqui- nit.) 190. (Magnet) 261. (Spilanthus oleraceus) 350. Rheumatic (sulph. car- bur) 367. Tophi, gouty (iodinum) 252. Tremors (Magnet) 261. (Strychnina) 357. From mercury (electro-punct.) 163. Trismus (ammoniated counter-irritants) 399. Tubercles (iodinum) 245. (01. jecinor. aselli) 288. Of the lung (chlorin.) 106. (Iodinum) 245. Mesenteric (iodinum) 245. Tumors of the bones (auri. praeparat.) 58. Of the mammas (ol. jecinor. aselli) 289. Scrofulous (iodid. quinin.) 258. Scrofu- lous (iodinum) 257. Typhoid fever (aq. chlorin.) 112. Typhus (calcis chlorid.) 84. (Chlorin. aq.) 112. (Quininee et cinchoninae tannas) 331. (Sodae chloridum) 339. Abdomi- nalis (chlorini aq.) 112. Bilious (calcis chloridum) 84. Ulceration of the mouth (calcis chlorid.) 85. Ulcerative process (iodinum) 254. Ulcers (chlorin. aq.) 115. (Creosoton) 141. (Ol. jecinor. aselli) 291. (Sodse chlori- dum) 349. Atonic (creosoton) 141. Atonic (iodid. sulph.) 258. Atonic (zinci chloridum) 385. Cancerous (ca- lendula) 94, 95. Cancerous (chlorin. aq.) 114. Cancerous (ferr. carb. prose.) 173. Cancerous (hydrarg. deuto-iodur.) 227. Cancerous of the face (creosoton) 143. Carious (creosoton) 141. Erosive (zinci chlorid.) 385. Fistulous (creoso- ton) 141. Gangrenous (calcis chlori- dum) 84. Gangrenous (creosoton) 142. Herpetic, &c. (acid, pyrolign.) 16, 18. Ulcers — continued. Herpetic (creosoton) 142. Herpetic (zinci chlorid.) 385. Indolent (creoso- ton) 141. Malignant (creosoton) 142. Malignant (zinci chlorid.) 385. Of the mouth after salivation (potasses chloras) 302. Phagedenic (zinci chlorid.) 385. Sanious (creosoton) 141. Scorbutic (cre- osoton) 142. Scrofulous (creosoton) 141. Scrofulous (hydrarg. protoiodur.) 224, 226. Scrofulous (iodinum) 256. Scro- fulous (zinci chlorid.) 385. Sloughing (creosoton) 142. Sloughing, from lying (plumb, tannas) 300. Syphilitic (aurum metallicum) 60. Syphilitic (creosoton) 142. Syphilitic (ferr. iodid.) 187. Sy- philitic (hydrarg. cyanuret.) 222. Sy. philitic (hydrarg. proto-iodur.) 224. Sy- philitic, old (zinci chlorid.) 385. Torpid, foul, &c. (calcis chlorid.) 84. Torpid, foul (ferr. cyanur.) 181,182. Varicose (creosoton) 141. Urethra, diseases of the (diosma) 162. Mu- cous membrane of the, tumefied (carb. anim.) 98. Urinary organs, diseased (chimaphila) 101. Urine, incontinence of (diosma) 162. (Iodin.) 249. Retention of (secale cor- nutum) 345. Urticaria (cort. adstring. Brazil.) 130. Uterus, cancers of the (ferr. carb. prcec.) 174. Neck of the, fungus of the (aur. nitrico-muriat.) 66. Pain of the (acid, hydrocyan.) 10. Spasmodic pains of the (acid, hydrocyan.) 9. Vagina, inflammation o: the (fuligo) 202. Varicose veins (acupunct.) 28. Venereal infection, prevention of (chlorin. aq.) 114. Vomiting (acid, hydrocyan.) 9. (Argilla) 43. (Creosote) 150. (Strychnina) 358. Chronic (artemisia) 52. Chronic (calen- dula) 94. Obstinate (calendula) 94. Worms (caincee radix) 81. (Ol. croton.) 282. (Zinci fcrrohydrocyanas) 388. Wounds (calcis chlorid) 85. Contused (diosma) 162. From dissection (calcis chlorid.) 85. From gunpowder (calcis chlorid.) 86. Painful (acid, hydrocyan.) « 3B S" i* IPS' / \w o *° %;^?\/ . r>5^> ' '^9 ^ / *$fa. * ** smE^- ^ -iiSfe- ***** J «§Stov. ^^ ^4x&:< *bv* r«2lnla. **/* • » V o V^ 1 A ^ o « o * >6* ^ a5» ;'€ ^-^ ^. * •^t,^^ .c°\*>?^% °* ^ » ^ .-^:. ' ^^ w •v\. **^v V 9 *o o * . ; o » <0' >* J. **, -.■ ' £° >, XS ' '*JH*- \/ ^ Va "* ' ^ -^ ' • ^ v .* v ^. -. **<*' • **"* 0< V'^^/V 5 **-^ c °* * ^ '. ^^ * ^ v -w 4* • 0«0, ^ % + *0< v ** v \ • •fe, * AT <*> '• • £. %^ ' * -titer- °" J*\-'^ikX /.^^ acfe*- ^« <^' s?/^ %/-?W^v^ V v HECKMAN BINDERY INC. ^ NOV 89 W N. MANCHESTER. INDIANA 46062 JIT Q, y .. °* * •• ?"+* • ^^ # a LIBRARY