i f.^BOQOOQOO Of»OtX10000COCOCOeo? 1 I ¥+-**r*- ■&* ■ ■ I J» ^^H • ■ ■ H 1111111111111111 ^HHHl «£ls 1111111111111 HBbNR B3£SSS£2SSS3vyn9 Book . G ? 5 Copyright If. COPYRIGHT DEPOSIT: ■ :6V * 0K3f«a ■MlirMMT ^H THERAPEUTICS MATERIA MEDICA and The Practice of Medicine Arranged Alphabetically by Topics for Convenient Reference. Affording in condensed, but sufficiently descriptive form, the latest and best scientific summary, for practical purposes, of general medical information from standard chemical, pharmaceutical and therapeutical By S: V. CLEVENGER, M. D., Author of Medical Jurisprudence of Insanity ; Physician to the Alexian and Reese Hospitals ; formerly Medical Superintendent of the Illinois Eastern Hospital for the Insane and Patholo- gist of the Cook County Insane Asylum for Chicago. > » < « l,1 T-r > -T-^j=s. l-ufllHttott ^ubltahittg (Erjmpattg, ATLANTIC CITY, N. J., U. S. A. n& LIBRARY of CONGRESS/ Two Copies rteceivto I MAR g 1905 fU4SS Ou AAc. NO! COPY B. L COPYRIGHT, 1905, By Shohal V. Clevenger. "^1^ Mercantile Printing Co. WILMINGTON, DEL. PREFACE. Usefulness and reliability were kept constantly in view in the construction of this book; pedanticisms, serving merely to fill space in so many text books, robbing the time of the student, are especially omitted ; nor is there adherence to any cumbrous system for consistency sake. The impossibility of making a work of this kind conjoin all the compendious qualities of the heavier tomes is compensated by its free- dom from the dignified drivel of the average Therapeutics. Any appearance of enthusiastic endorsement of proprietary articles in a few instances can be compared with the unhesitating denunciation of many such compounds emanating from the same manufacturers. They never subsidize an author to praise one of their medicines and condemn the rest. The publications of such reputable houses as those of Squibb and Merck have been freely used with their permission, to advantage ; but this work, while embodying information from many sources, to be found in no other single volume, is intensely original, particularly with topics upon which the author has been forced to be familiar through antagonizing some of the worst and most powerful elements in large cities. Under Prescribing, Therapeutics, etc., other dissertations occur that are usually included in a preface or introduction. THERAPEUTICS, MATERIA MEDICA, AND PRACTICE of MEDICINE. Abducens Nerve, Sixth Pair, Paralysis. Owing to greater length of this nerve it is more liable to paralysis from disease of brain base, especially syphilitic gumma. As it controls the external rectus eye muscle, eye pulls inwardly, convergent squint or strabismus. Iodide of potassium, biniodide of mercury, strychnia. Aberration, Mental. Any abnormal mental state, usually temporary. Abortion prevention. Antiseptic cotton tampons. Small doses of ergot con- stringe the bleeding vessels, also the uterine cervix, large doses contract the entire uterus, hence inappropriate. Asa- fetida to allay nervousness. Cascara as a laxative. Habitual cases liable to be syphilitic. When miscarriage inevitable asepsis, antisepsis and complete removal of materials induc- ing hemorrhage, as retained placenta and membranes, then ergot and sustentation. Prolonged rest. Aboulomania. Loss of will power unaccompanied with other mental impairment. Incurable. Abrasion. Borax, boracic acid, carbolic acid 3% salve or oint- ment, flexible collodion, traumaticin, gutta percha solution, court plaster moistened with water and not by tongue, if 6 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. bleeding abrasion styptics. To determine minute abrasions that are best touched with nitrate of silver in holding au- topsy to avoid infection through hands, hold them over open bottle of stronger water of ammonia, the fumes will locate cuts and abrasions by the sting of the ammonia. Abscess. Evacuate if advisable, sometimes can be aborted with antiphlogistine or similar glycerine-kaolin compounds; ich- thyol, guiacol or carbolated ointment 3%. Peroxide of hy- drogen to destroy pus, antiseptic washes afterward or boric acid; iodoform, though its odor advertises the user. Tonics if debilitated. Absinthe. Wormwood liquor. To be avoided as liable to induce a habit as bad as that of cocaine taking. The French gov- ernment has found it necessary to restrict the sales of ab- sinthe owing to the demoralization it has caused. It rapidly debauches and frenzies. Abstracts. A formerly suggested substitute for extracts to enable a few drug manufacturers, who had debased the extracts and fluid extracts to almost worthlessness, to secure a high price for "assayed" drugs, but re-standardization of extracts dropped this tricky name from the pharmacopoeia. Squibb, of Brooklyn, N. Y., makes standard drug preparations few manufacturers have equalled. Every druggist knows this and every doctor should know it. Acacia. Gum Arabic, an old fashioned and useful demulcent frequently combined as a vehicle in emulsions, mixtures, confections, syrups and soothing draughts in inflammatory conditions of mouth, throat, stomach or intestines. It is nourishing, as Africans and apes sometimes subsist on it. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 7 Acetanilid, see also Antifebrin. To be used, if at all, with caution as it is the ingredient in many headache powders that has killed so many by heart paralysis. It is antipyretic, but when given for reducing fever it must be watched in its effects, and it is safer to use this remedy only in hospitals where attending physicians and trained nurses can regulate the administration of medi- cines. As an analgesic mainly in headache it certainly does relieve the pain quickly in most cases, also that of toothache, but it is in no sense curative of anything; all it can do is to* afford time by the lessening of pain, to enable other means if practicable to be brought to the aid of the patient to re- move the cause of the disease, which mere pain alleviators cannot do. Strictly speaking it is not an antirheumatic for it has no influence upon uric acid and merely blunts rheumatic pains temporarily. Dose: 3 to 10 grains, powder, alcoholic or hot water solution, cooled and sweetened. Maximum dose 15 grains or a dram daily. It is incompatible with so many drugs it is safer to give it by itself, but if united with other milder analgesics as antipyrine, etc., the entire dose of the combi- nation must not exceed the usual acetanilid dose in weight. Antidotes are stimulants, hot coffee, atropine, strych- nine, oxygen. Acetic Acid, the base of Vinegar. Not used internally in concentrated form, the glacial is sometimes used to cauterize warts. Antidotes are alkalies, soap and water, milk. Recently used as a solvent and me- dium for drugs. Squibb holds that a 10% acetic acid men- struum is quite the equal of a 41% alcohol menstruum for the extraction and preservation of the medicinal properties of drugs. 8 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Acetonaemia. The cause of diabetic coma. Acetozone. A proprietary form of Benzoyl-Acetyl Peroxide, on trial in typhoid fever. Achillea. A mild tonic, in little use. Acholia. Pernicious Jaundice. Achorlon Schonleinii. Fungus parasite, cause of Tinea Favosa or scalp crust. Acidity of Stomach. Alkalies, as bicarbonate of soda, lime water, vichy, seid- litz powder, etc. Acids, Dilute. Much in vogue in former days as tonics and alteratives, but abuse causing untoward effects the dilute acids are little used now in medicine. Muriatic, Nitric and Nitro-muriatic acids have been used in liver disorders and stomach disturbances where ex- cess of alkalinity was present and as hyperacidity is the most frequent condition in gastritis the acids have been empi- rically and improperly used in dyspepsias, intensifying the disease. Dilute phosphoric acid was sold extensively under the name of Horsford's Acid Phosphate. Occasionally a "Sure Germ Killer" containing this or some other simple sub- stance is extensively advertised and gulped by dupes. Dilute sulphuric acid was also taken as a "lemonade," but that made from the citric acid of lemons is far better. This mineral acid was also used by the British in India as a THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 9 preventive of Asiatic Cholera, the germ of which requires an alkaline culture medium. Acinesis. Loss of power of movement. Acne. Any treatment usually disappointing, particularly at puberty. Fowler's solution internally and antiphlogistine externally are the simplest and most effective, but many other things have been used and in most instances failed to effect a remedy. Such are zinc oxide, salicylic acid, ich- thyol. Ordinary acne may be regarded as at times physi- ological, hence the difficulty of doing any thing for it in young people. Really it should often be considered if it were proper to do anything more than to use gentle laxa- tives, unless accompanied by need for antaphrodisiacs. There are several varieties of acne, so that treatment must differ for the various forms, miliaria or the warty white sort must be opened, rosacea or red patches may require iodide of potassium internally and ichthyol externally. Ergot gives temporary relief but it is questionable if it should be con- tinued. The entire list of skin disease remedies has been recommended in the different acnes, especially rosacea. Aconite. In its various forms has done more harm than good in medicine. It is a powerful depressant and has taken away the chances for life in many cases of pneumonia, neuralgia, toothache, etc. Quacks have secured great reputations for curing rheumatism by rubbing aconite into painful spots, a proceeding at which the educated doctor would stand aghast. A man who was making quite a sum by his infalli- ble rheumatism cure when correctly informed of the liabili- ties he risked abandoned his "Sure Cure" in fright. But the doubt may always remain with even the reputable practi- 10 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. tioner who has allayed pain with aconite, in case a patient dies, that the disease might have run a different course had nothing been given. Acromegaly. Giantism, or great enlargement of bones and other parts. Incurable. An example of how an utterly illogical supposed etiology may not only get into text books but be copied and circulated unchallenged, is afforded by the as- cription of acromegaly to an enlarged pituitary gland. It would be as sensible to claim that it was owing to an en- larged toe, or tooth. The pituitary body is merely embryo- nal and without function, though one good clinician un- wisely assigned an oxygenating property to it. Ancients regarded it as the seat of the soul, about as justifiably. Acrophobia. Fear of high places. Incurable. Actinomyces. The fungus cause of actinomycosis, infecting jaws, ears, neck and face. Actinomycosis. Rare in man, usually communicated from "lumpy jaw" disease of cattle. The "ray fungus" causing it can be at- tacked with potassium iodide mainly, but other remedies tried are ichthyol, sodium salicylate by mouth, locally ap- plied or by injection into place infected. Acute Delirious Mania. A fatal insanity with high temperature, called also De- lirium Grave and improperly known as Typhomania. It lias nothing to do with typhoid as many mistakenly suppose from that name. 11 Acute Mania. Beginning stage of mania, which inside of a year is usually recovered from, if not ignorantly dosed with hyp- notics, especially chloral and opium. Acute Melancholia. Beginning stage of melancholia, with same prognosis as above. Addison's Disease. Tuberculosis of supra-renal capsules with progressive, anemia, prostration and bronzing of skin. Treatment: one of the supra-renal capsule preparations, such as Merck's dried, or adrenalin. Debility can be met with appropriate tonics, as quinine, iron and strychnia. In a disease that is organically destructive we can expect palliation at best, and never a complete cure. Adenitis. Inflammation of lymphatic glands. Calomel internally for acute case, for subacute iodide of potassium internally and ichthyol externally. Scrofulous cases syrup of iodide of iron. Adenoids, Post-nasal. Interfere with breathing. Astringents, alkalines, anti- septics, amputation. Adeps Lanae Hydrosus, see Lanolin or Lanum. Adhesive plasters. The most common being the diachylon or lead plaster, but numerous preparations of rubber, etc., are also made. Ordinary Ichthyocolla or court plaster has minor uses for cuts and abrasions. Adonidin. Adonin. From Adonis Vernalis. Substitute for Digi- talis. Dose, a twentieth to a quarter of a grain. 12 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Adreniline, see Supra-renal capsule. Adynamia. Loss of vitality. As the causes and consequences vary widely it is best to study them out and remove them if possible. Ordinary tonics are useful, though some vice of the system may un- derly the trouble. After-pains. Morphine, as the need for it is but temporary. Avoid relaxation as passivity may induce hemorrhage or postpone involution. Agalactia. Deficiency or absence of milk. Usually due to run-down system. Tonics, fresh air, rest, good food, especially cow's milk, plenty of drinking water, to which may be ascribed the reputation of beer as a galactagogue. Agaricine. Formerly used for night-sweats in phthisis. Dose: a twelfth of a grain. Little used. Age. A natural decay, universal with birth and growth, man- ifest however at no invariable age in the same species, but inevitable after adult life. Mentioned as some physiolo- gists, who should know better, suggest excision of the colon and similar idiotic means of preventing old age. Their ideas partake of senility. The notion is credited to Metchnikoff, that senility is caused by the phagocytes that destroy hostile germs in the body turning traitor and eating up the cells of the old per- son-. The more sensible view does not seem to have oc- cured to those who repeated this guess at physiology, that THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 13 the phagocytes merely continued their regular performance of destroying foreign or defunct materials wherever found. Senility is plainly the period of dissolution, and instead of the phagocytes being enemies, they are still loyal but over- whelmed with the presence of broken down cells from the decaying organism in which they live. Agoraphobia. Fear of open spaces. Incurable. Agraphia. Inability to write through lesion of motor writing part of speech center in brain cortex. Usually associated with incurable brain disease. Ague, see Intermittent Fever. Agurin. A combination of sodium acetate and sodium theobro- mate, a new diuretic. Dose 5 to 15 grains 2 or 3 times a day. Said to be superior to diuretin and inferior to digi- talis in diuretic effect. Ainhum. Tropical endemic causing gradual amputation of little toe. Airol. An unstable bismuth vulnerary. Not much used. Alalia. Loss of power of speech, complete or incomplete. Cur- able or not, according to how seriously the brain is involved. Hysterical aphonia may disappear spontaneously, but in- jury to speech center of brain is incurable. 14 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Albargin. A silver nitrate with gelatine, like protargol. Not much used. Albinism. Congenital pigment absence, causing white hair and pink eyes. Stigma of degeneracy. Alboferin. One of the multitude of albumin and iron combina- tions. Albuminuria, see Nephritis, Scarlatina, Eclampsia, Ure- mia. Alcohol. In liquors a stimulant to the failing heart and circula- tion, but dangers of habit forming are to be kept in view. As a diluent in medicines only the pure ethyl alcohol should be used as the many poisonous alcohols such as wood spirit are frequently confused with the medicinal al- cohol. The chances of buying adulterated liquors are greater than that pure ones can be secured at any price. Dealers often say that what they sell they would not use themselves, even though not abstainers, and druggists are readily im- posed upon in liquor purchase. Alcoholic acute poisoning. Treat as other acute poisoning with purges and vomits. Alcoholic gastritis. Lime water and milk. Treat as ordinary gastritis. Alcoholism, see Inebriety. Alexander's Operation. There are two of this name. One attempts to cure epi- THERAPEUTICS, MATEKIA MEDICA AND PRACTICE. 15 lepsy by ligation of the carotid arteries, cutting off part of the anterior brain circulation, and the other refers to short- ening the uterine round ligaments, the function of which in quadrupeds is to prevent the falling forward of the uterus. Both these operations are condemned as useless. Aletris Cordial. Secret. Alexia. Loss of power of understanding printed or written words. Word blindness. Brain lesion seldom cured. Alkalithia. Antirheumatic, composition not fully stated. Dose: teaspoonful. Allochiria. Transferred reflex. A foot sole tickle causes the other leg to jump. A spinal disorder usually incurable as the le- sion is a destructive one. Allopathy. A designation sometimes improperly used by a regular physician to distinguish himself from the homeopath, un- aware that it was an epithet falsely indicating that he used other than similar things to the disease as remedies. The regular, which was also originally conferred in derision but which term can be used as not including irregulars, uses any sensible means of relieving sickness, from whatsoever source. . The regular is the school of most intelligence, the only scientific and honest, and contains the fewest quacks. Those who claim to practice both regular and irregular methods are irregular only. Almond, Bitter- Flavor, see Oil. 16 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Almond, Sweet. For making Emulsions. Aloes. In doses of from i to 10 grains of the purified Socotrine or in the form of Aloin a half to two and a half of Merck's, or in combination with any one of the multitude of aloin compound pills it acts upon the lower bowel and to some extent upon the pelvic sympathetic generally, so that in bitters containing aloes it soon gains the credit of being an abortifacient. Alopecia, loss of hair. All hair restoratives are humbugs. Aluminium Acetate. External antiseptic to wash foul wounds. Dubious for internal use. Aluminium Aceto-tartrate. Disinfectant and Astringent for air passages. Half to 2% solutions or as snuff with half its weight of powdered boracic acid. Aluminium Sulphate. Caustic, Antiseptic, Astringent, for fetid ulcers and dis- charges. Solutions i to 20 or 1 to 100 or concentrated. Alums. The ammonium or potassium alum has emetic proper- ties in 1 to 2 dram doses. It is styptic and astringent and as Burnt Alum, alumen exsiccatum, it is a caustic through its affinity for the water of the tissues. Amaurosis. Total loss of vision, which if due to atrophy of optic nerves is not curable, but there is a hysterical amaurosis THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 17 often mistaken for the serious eye trouble, but even the hys- terical form may in time progress into the incurable one. Nitroglycerine and electricity may possibly do good, but promises cannot be made. Tonics also may be needed. Antisyphilytics at times. Amaxophobia. Fear of riding in vehicles. Allied to other dreads in sane persons. This fear is more common than supposed, and is incurable. Amblyopia. Partial loss or dimness of vision. Remove cause, which may be from smoking too much, hysterical, some constitu- tional disease or a removable functional disorder as anemia. Amenorrhoea. Absence or arrest of the menses. Nothing has been more foolishly and improperly treated than amenorrhoea. In the vast majority, especially young girls, the menses may be at intervals of a month, six months or even a year or more at the outset, and the child be healthy, needing absolutely no treatment of any kind, and in other cases of amenorrhoea there may be simple anemia which rest or a tonic may remove. The need of blood is at the root of many instances, so hematic tonics, any kind of an iron preparation, Glide's pepto-mangan es- pecially, will restore the function. Local treatment in most cases is simple malpractice, and in young girls unless a strong evident reason for it local operative or even digital examination means are not only inadvisable but cruel in af- ter effects, which any conscientious physician can readily imagine. Even where over anxious mothers request such manipulation of a child it is best to refuse, save in rare in- stances. The usual list of menstrual restoratives are aborti- facients and set up pelvic congestion and in non-pregnancy doing little to restore the menses. In insanity the menses 18 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. stop, as a rule, but return with mental recovery; amenor- rhoea in them is a mere symptom, and is ignorantly re- garded as a cause by the inexperienced. Local treatment of amenorrhoea in the insane is improper, at the mildest. It should be also remembered that sometimes menses are normally absent, and that there are instances of vicarious menstruation. Amentia. Without mind, obsolete term. Amimia. Loss of ability to gesticulate. Ammonia salts generally. Other than the bromide, such as phosphate and salicy- late, are inferior to others in use, the sulpho-ichthyolate or Ichthyol and valerianate being exceptions, which see. Ammonia Water, Dilute. There are various strengths ranging from 10 to 25% of the stronger water of ammonia in plain water, but if not so strong as to blister and strong enough otherwise the di- lute ammonia water is very useful in neutralizing ivy poison and the stings of insects, if promptly used. The aromatic spirits of ammonia is a superb heart stimulant in any variety of faintness other than congestive or apoplectic, the dose being a teaspoonful in a glass of water. Ammonium and Iron Tartrate. Dubious use. Ammonium Benzoate. Inferior antilithic. Dose 10 to 30 grains. Ammonium Carbonate. In solution furnishes household ammonia. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 19 Ammonium Chloride. Muriate of Ammonia, Sal Ammoniac. Xot much used as medicine. Pharmaceutical uses greater. Ammonium Embelate. Anthelmintic for tape worm. Dose 3 to 6 grains. Not much used. Ammonium Fluoride. Dubious Alterative. Ammonium Ichthyol-sulphonate, see Ichthyol. Ammonium Iodide. Unstable powder. Free iodine likely formed in solu- tion. Ammonium Phosphate. Inferior antirheumatic. Ammonium Salicylate. Inferior to Salicylate of Sodium. Ammonium Sulpho-ichthyolate, see Ichthyol. Ammonium Valerianate, see Valerianate. Ammonol. Composition not fully divulged, it is based on the idea that ammonia can correct the heart depression in an anal- gesic, but great caution must be used in these sorts of pain alleviators. Amnesia. Memory loss, usually from brain disease. Amnesic Aphasia. Inability to use words through memory failure in brain disease. 20 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Amylene Hydrate. A fair hypnotic but destined to extinction owing to its offensive odor, and the fact that we have better hypnotics. Amyl Nitrite. As it is so volatile it is best to use amyl nitrite in the pearls to break up impending attacks of epilepsy or hysteri- cal convulsions. The dose is three to ten drops by inhala- tion. See that the inhalation is complete, instead of only partial, through keeping mouth closed at the time it is ap- plied to the nostrils. Break the pearls in a handkerchief held to nose. When the fit has begun the amyl nitrite is of no use. It breaks up an oncoming attack only, merely postponing it, as a rule. Amyloform. Formaldehyde and starch substitute for iodoform. Anakesis. An old English pile suppository, quite effective, made of astringents opium and powdered slippery elm, conically moulded. Anal Fissure. Antiseptics, astringents, cautery. Anal Fistula. Antiseptic surgery, peroxide of hydrogen, healing from inwards. Anasarca. Dropsy usually from heart, liver or kidney disease, though some nervous swelling may be mistaken for dropsy. Anemia. Ordinary bloodlessness improves with iron tonics, the green sickness of young girls may require arsenic in addi- tion. Under nutrition through organic disease may also be THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 21 the cause of anemia. See also Hematoclysis, Chlorosis, Progressive Pernicious Anemia, Beri-Beri, Leukaemia, Leucocytosis. Anemia, Spinal. Irritability of the cord, hysterical spine, a painful pro- longed disorder hard to remedy, and sometimes a paraple- gia. Tonic and eliminative treatment and fresh air. Anesthesia. Absence of sensation, often due to nerve functional or organic impairment. Frequent hysterical symptom. Anesthesin. One of the orthoform group of anesthetics, in the ex- perimental stage. Anesthetics. The British Medical Association Committee of 190 1 concludes that the percentage rather than quantity of chlo- roform is to be regarded. A small quantity will kill in con- centrated form while a comparatively large amount is abso- lutely safe in a vapor below 2%, and while this suffices in most cases to induce anesthesia, or even less, as small a quantity as 1% or less will maintain anesthesia. The com- mittee insists that inhalers must supply definite percentages with air admixture. Bonneau recommends the drop by drop of chloroform method and keeping the neck muscles where tonicity is just apparent, tested by moving the head gently from side to side, watching also the respiration, face and pupil, and cornea sensitiveness. Germany research suggests ether also drop by drop, as safer than chloroform, sometimes the ether may be preceded by morphine or chloroform. Squibb's chloroform remains safe and standard. Schleich's mixture has been abandoned. The Vienna or A. C. E. mixture is still used. Nitrous oxide 22 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. gas has been long used by dentists with safety, even where there was weak heart, and it is coming into more use in surgery. Spinal injections of cocaine are less popular for several reasons; the puncture is cruel and may be septic; it is no advantage to have the patient conscious; it has no advan- tage over other anesthetic methods. A limited field for it may be where general anesthesia was improper. Marvel claims that ethyl bromide preliminary to ether hastens anesthesia, the average time being 25 seconds. Ethyl chloride -J to 1 dram is used both as preliminary and for full anesthesia, the latter on a towel cone for 15 to 35 seconds. Girard of France confines it to minor operations. Caution should govern use of new anesthetics as many fa- tal records are against former experiments. Local anesthesia through sprays and ethereal prepara- tions are used. Menthol, carbolic acid and freezing locally anesthetize. Cocaine hydrochlorate, 3% and stronger, and substitutes, are used in eye surgery. Anidrosis. Absence of sweating, sometimes one-sided. In various nervous diseases. Usually incurable. Anorexia. Aversion to food, usually in melancholia. Artificial feeding by tube in throat through nose most successful. Anthrarobin. Substitute for chrysarobin. Disused. Anthrax. Malignant pustule, Charbon, Contagious carbuncle. A dangerous skin disease which may also assume a constitu- tional form. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 23 Cautery and large doses of quinine and whisky have saved some. Anthrax, non-contagiosa. Carbuncle accompanies run down system. Tonics re- quired, but the pustules burrow and reform at new points, to prevent this dip a burnt match in nitric acid and push it to the bottom of each deep burrowing pustule. This de- struction of the centres of infection heals the carbuncle quicker than other means, meanwhile aseptic and antiseptic care. Aneurism. Vascular dilatation from degeneration of muscular coat and. hence a serious ailment. Certain hysterical states simulate aneurismal troubles. Ergot and iodide of potas- sium are often given but usually unavailingly. Angina Pectoris. Agonizing spasm of the heart, due to coronary artery disease. The paroxysms may be lessened by amyl nitrite inhalation, nitro-glycerine or morphine hypodermically re- peated doses if necessary. Iodide of potassium has remedied some cases. Angiomata or Angiosarcomata. Vascular sarcomata. Incurable. Angioneurotic Edema. Sudden puffiness of face or other parts, without pain, lasting a few hours or days. A nervous complaint, liable to recur in winter and morning due to overexertion, cold or exposure. Treatment consists in rest, laxatives, tonics or removal of any apparent cause or associated ailment. If throat attacked suffocation may follow, but usually there is recovery. 24 THERAPEUTICS, MATERIA MEDIOA AND PRACTICE. Angioneurotic Gangrene, Symmetrical. Reynaud's Disease. Fingers or toes of both sides per- ish from spasm of arterioles. Some cases recover, others suffer painful increase of the trouble until death. It has fol- lowed upon injury to the spinal cord, and is a tropho-neu- rosis. Antifebrin. The first form in which acetanilid appeared. Claims are made that this secret form of acetanilid is purer than the of- ficial kind, and that death is not so likely from its use in headache powders, but this is the manufacturer's claim. It is best to avoid such dangers altogether. Antikamnia. A secret powder containing acetanilid or antifebrin, caffeine and bicarbonate of soda, according to several an- alyses. As a rule when a Greek or Latin name expresses appli- cation of medicine to a pathological state, and worse yet when the name is in the plain vernacular, as "King of Pain," "Fever Buster" or the like, the nostrum can be classed in a certain category aside from the scientific and honest. Antimonial Powder. James' Powder. Obsolescent. Antimony and Potassium Tartrate. Tartar Emetic. In the form of wine of antimony or in combination with syrups tartar emetic has been long used as an expectorant to promote relaxation of mucous membranes. So it is known as a depressant expectorant. An alcoholic stimu- lant is expectorant in an opposite way by causing dryness of the air passages. So depressant expectorants are to be given when a cough is dry, and stimulating expectorants THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 25 when the cough is attended with too much mucus expec- toration. Antimony salts in general. Out of date, disused more yearly. Antinosine. Sodium salt of Nosophen. Soluble. Antiseptic in vesical catarrh, externally in tenth to half per cent solution. Antipathies. May exist without insanity, even absurd ones, but cer- tain aversions characterize several forms of insanity, and are always serious for they may be acted upon. Antiphologistine. Glycerinated clay with aromatic and other antiseptics, useful to promote watery derivation to the surface from deep tissues, as in pleurisy, pneumonia, bruises, etc. Antipyrine. A fairly safe antipyretic, sometimes used as an anal- gesic. Soluble in i part water, 2 parts alcohol. Weaker than some more dangerous antipyretics. Dose 10 to 20 grains. Enormous number of incompatibles. When aggregates of antipyretics are prescribed, do not exceed the dose of any one of the ingredients. Antipyrene Salicylate, see Salipyrine. Antispasmin. Too unstable. Antitoxin. An attempt is being made to standardize the antitoxins for the pharmacopoeia revision, but the fluctuations of such an advancing science will force physicians to ascertain for themselves from reputable manufacturing pharmacists 26 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. mainly, and from current medical literature, what serums give the best results and in what strengths to use them. Diphtheria antitoxin approaches uniformity and is the most commonly used. Anti-tetanic serum has encouraging reports, some practitioners withdraw the spinal fluid and in- ject the serum in its place, intravenous injections of carbolic acid have also been tried but the results are disputed. The British government in India is reporting on the action of antivenene in snake bites. Typhoid fever antitoxin is still experimental. A new dysenteric antitoxin is named bac- teriolysin. Tubercle treatment is tending toward anti- streptococcic serum, which shows also a multiplicity of streptococci. Aronson's antistreptococcic serum is used in Germany for streptococcus infection. Dosage ranges from 20 to 60 cc. In erysipelas small, often repeated doses are used if no pericarditis or pleuritis. This serum is negative in scarlet fever, but injections of normal blood serum are being tried in Germany and Austria not only in scarlet fever but in other infectious diseases, and the results are reported as favorable. Smallpox serum treatment is inconclusive. Erysipelas has also been treated with diphtheria antitoxin. Improvement rapidly followed in septicaemia after-treat- ment with antistreptococcus serum two years old, prepared and dessicated at the Pasteur Institute, Paris. Puerperal fever and malignant endocarditis have been also favorably reported upon as modified by anti-streptococcus serum. Yersin's serum is used for bubonic plague. Dr. Emil Mayer of New York City is experimenting with Dunbar's hay fever antitoxin. A multitude of worthless antitoxins are discussed, started by over enthusiastic but honest workers, besides the many for commercial purposes regardless of merit. Antitoxin, Diphtheria. From serum of blood subjected to poison of diph- 27 theria. Dose as preventive in children 200 to 250 antitoxic units, ordinary cases 600 to 1,000 units, severe cases or those seen late, 1,500 to 3,000 units, given hypodermically and re- peated in about 8 hours if necessary. Adults about twice as much. The different brands vary in strength. Antivenene for snake bites, see Antitoxins. Anuria. The hysterical suppression of urine ends with a copious flow of limpid, colorless urine, but in nephritis anuria is a dangerous symptom of uremia, and should be combatted by heat or stimulants to the kidney region. A tablespoon- tul of turpentine mixed with flaxseed poultice in flannel ap- plied to the small of the back has promoted recovery, even when eclamptic convulsions had begun. Aphasia. Disordered faculty of language from brain disease, most often incurable and associated with hemiplegia. Aphonia. Hysterical speechlessness can be treated by assurances of recovery, tonics, electricity. Humbug works "miracles" in hysteria. Aphthae. Stomatitis, little ulcers in the mouth, beginning as ves- icles. Any astringent weak antiseptic mouth wash, and at- tention to general health. A little calomel rubbed on the spots, alum and myrrh or eucalytpus and borax mouth washes. Apiol. Merck makes an oily liquid soluble in alcohol, and Chapoteaut makes capsules of Apioline, the dose being 5 to 28 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 10 minims of the liquid and 2 or 3 capsules daily, in am- menorrhoea, but it is illogical to hold that so strong a pelvic congestant could be of use in dysmenorrhoea. The main use has been to produce miscarriage, and often such things suggestively warn pregnant females against taking the medi- cine. Most often when these or similar abortifacients are taken the menses would have appeared anyway but the medicine gets the credit. Apollinaris Water. An artificial carbonated ferruginous water, wrongly claimed to be a natural spring water. Apomorphine, Hydrochlorate. As an emetic hypodermically a twentieth to a tenth of a grain, but not useful otherwise. Apoplexy. During the stroke while patient unconscious,, face con- gested, breathing hard, merely elevate head, loosen neck- wear, avoid crowds around patient and meddlesome activ- ity. If prolonged brisk purg*ation can be tried. Differen- tial diagnosis between congestion, clotting or hemorrhage of brain can rarely be made until later in the apoplectic seizure. The practice of giving iodide of potassium at once is bad and even later it may dissolve clots and restart brain hemorrhage. Months after an apoplexy if paralysis or other results appear will be time enough for absorbents to be given. Apoplexy, Threatened. As indicated by flushed face, dizziness, weakness. Avoid stimulants. Use ergot and cathartics to reduce blood volume in head. Appendicitis. Pain in line between navel and upper spine of ilium, THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 29 right side, often confused with calculi, renal and hepatic, and abdominal rheumatism and colic. Full calomel and laxative dosage has aborted appendicitis and made opera- tion unnecessary. Surface derivation also. Appendicitis Blood Test. Available only if leucocytosis marked, but typhoid fever and fecal impaction are to be excluded. Arheol. Sandalwood oil preparation. Not much used. Arcus Senilis. Formerly assumed to be a symptom of atheroma. The white ring around the cornea of the eyeball presumed to be a fatty degeneration, but it can exist independently. Arecoline Hydrobromate. Myotic in i% solution. Argentamine. Dubious antiseptic and astringent. Like Silver Ni- trate. Argenti Nitras, see Nitrate of Silver. Argonin. Silver casein compound for urethral medication. Des- tined to a short life in materia medica. Argyll-Robertson Pupil. Reflex iridoplegia. Non-response of pupil to light. An early symptom of locomotor ataxia. Argyrol. Egg yolk and silver nitrate. Not much used. Aristochin. 96% quinine. 30 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Aristol. Largely iodine. Odorless substitute for Iodoform, but unreliable, especially when pure. Arnica. Old fashioned sedative lotion 2 superseded by witch hazel. Aromatic Spirit of Ammonia. Eligible heart stimulant. Dose, a dram in glass of water. Aromatic Syrup of Rhubarb. Laxative for infants. Dose one dram. Aronson's Anti-streptococcus Serum, see Antitoxins. Arrhenal. An inferior arsenical preparation. Arrow Root. Infant food and dusting powder. Arsenauro. Said to be a gold and arsenic compound, but unsatis- factory, as even in small doses much pain in the abdomen is induced, and no known other results. Arsen-hemol. Dubious substitute for arsenite of potash and iron. Arsenic bromides, chlorides, iodides and mercury pre- parations. Not proven to be sufficiently useful to survive as medi- cines. Arsenous Acid, see Fowler's Solution. Except as a one per cent solution externally for can- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 31 cers in some cases it is better to use arsenic in the form of Fowler's solution, as less apt to irritate the stomach. As a poison it is a painful gastro-intestinal destroyer of tissues. The best antidotes, as dialyzed iron, or saccharated oxide of iron, is seldom handy, so throw ammonia water on tincture of iron and collect the precipitate on a strainer and use it wet. Arterio-sclerosis. Iodide of potassium given as a routine measure, not al- ways effective. Nitro-glycerine to overcome functional in- sufficiency of vessels. Asafoetida. Good antispasmodic and sedative for hysterical, even inducing sleep or pain-relief, when their origin is in ner- vousness. Dose about five grains in pills. Asarum or Canada Snakeroot. Mentioned to indicate how once popular remedies have fallen into disuse. It is a wild ginger with stimulant and diuretic properties. Ascarides, see Worms. Ascites. Abdominal dropsy from liver, heart or renal disease. Cathartics reduce the dropsical swelling and the ignor- ant suppose that a cure has been made enabling quacks to rob some patients. The swelling returns and tapping may be necessary, after emptying the bladder, but death is inevitable. The distention depends upon the organic de- struction of which the dropsy is a mere symptom. Asphyxia. Artificial respiration, oxygen, electricity, nitro-glyce- rine, mustard, amyl nitrate, cold and hot douches. 32 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Aspidospermine. Respiratory stimulant, Antispasmodic. Used in dys- pnoea, asthma, spasmodic croup, etc. Dose I to 2 grains in pills. Aspirin. Acetyl-salicylic Acid. Used same as Sodium Salicy- late. Astasia and Abasia. Hysterical inability to stand and walk, though muscles not paralyzed. Asteatosis. Absence of oily materials in skin rendering it harsh and dry. Inunctions of fatty medicaments, as lanolin, cacao but- ter, etc. Asthenic Bulbar Paralysis. Fatal affection of the medulla oblongata. Asthenopia. Weakness of sight, often a mere local expression of general weakness requiring rest and tonics. Asthma. This is a mere symptom of several widely different ail- ments. It may arise as a hysterical manifestation, it may be caused by rheumatism decreasing the lumen of bronchial tubes, or a sudden swelling of the bronchial mucous mem- brane, or reflex asthma may include forms which like whooping-cough are paroxysmal. Iodide of potassium has proven very useful in some cases of asthma, completely disposing of the symptoms af- ter a few weeks use of 5 grains thrice daily. Change of elevation or of climate makes radical changes for the bet- ter; the air of a valley would be insupportable to one who THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 33 breathed comfortably on the adjoining mountain, another found life at sea or on the coast endurable and inland or hill life distressing. Several bio-physical considerations are in- volved in such phenomena, related to weight and moisture of air. Difficult breathing may be due to many things, some- times phthisis, bronchitis, rheumatism, impaired nerves, susceptibility to seasonal and climatic influences, elevations, atmospheric changes, impurities in the air. as in '"hay fever." The list of drugs recommended is excessive, mostly useless. Nitre paper burnt and inhaled in some paroxysms gives relief, iodide of potassium in some cases in small con- tinued doses ; change of elevation to mountain or seaside, localities free from rag-weed in hay-asthma, etc. Asafoeti- da allays nervous asthma often. Heart or stomach disease may cause asthma. Astigmatism. Error of optic refraction due to imperfect curvature of eye ball, requiring specially made glasses. Asylum Ear. A dropsical auricle of the insane, called also the insane ear. The left ear is the one most frequently affected, and it is of bad prognosis as to recovery from the insanity, es- pecially when both ears are involved. Ataxia. Inability to regulate movements accurately, as walking, due to a variety of causes from disorder of different parts of the brain or to circulatory causes. Its significance mav be trivial or serious according to the cause. Ataxia, Hysterical. A curable anesthetic co-ordination loss resembling lo- comotor ataxia, and often mistaken for it, occurring only in females. 2 34 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Ataxia, Locomotor, see Locomotor Ataxia. Atheroma, see Arterio-sclerosis. Atheromata. Old name for wens, but as the name resembles athe- roma it has been disused, Atheromatous Insanity. An apathetic mental derangement in the elderly, re- sembling senile dementia and paretic dementia superficially, with convulsions and temporary paralyses, depending upon atheromatous brain arteries. Incurable. Athetosis. Spasmodic cramping movements of the hand due to destructive lesion of the brain base, occasionally simulated by hysteria. Atonicity, General. Lack of strength may be owing to imperfect elimina- tion, an autointoxication. Strychnia and eliminants may restore the normal tone. Atonicity, Intestinal. Often from abuse of cathartics. Cod liver oil daily and occasional vegetable cathartics as cascara, rhubarb, podo- phyllin and aloes with strychnine and quinine. The tonics may be required to secure peristalsis, the passive bowels re- fusing action without them. Atoxyl. An amido-benzene compound of arsenic. Not used much. Atrophy. Usually due to an organic incurable decay. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 35 Atropine. Main use as a mydriatic for eye surgeons. Sometimes combined with morphine in the proportion of one one-hun- dredth of a grain of atropine to an eighth of morphine, but then caution is to be used in increasing the morphine dose not to also exceed a fiftieth of a grain of atropine. It was formerly much used as a respiratory stimulant in the last stages of phthisis, and as a temporary relief for nasal congestion as in a severe cold. Cold cure nostrums based upon atropine locally applied are instantly effective but dangerous in overdoses, atropine poisoning following too much use. Belladonna was also called the opium of the bladder, but of late years other methods of allaying pain due to cys- titis, etc., have been used instead of analgesic means. Anti- septics, cathartics, hot applications, unirritating diuretics, as Buchu, etc., are now preferred. Auditory Disturbances. From brain disease, inner, middle or outer ear. Im- pacted cerumen is the most frequent cause of gradual deaf- ness, easily removed by dissolving the ear wax in water and glycerine equal parts, hours later using an ear spoon. Bi- carbonate of soda solution also disintegrates the wax. Noises in the ear if throbbing are caused by arterial congestion; if persistent, by venous engorgment; if music or voices hallucination, then there is brain cortex irritation, and danger of insanity. Derivation is useful though tem- porary in effect in all these cases. Salines especially. Aurantii Corticis Syrupus. Syrup of orange peel. A good vehicle, especially for iodide of potassium. Auto-Intoxication or Autotoxaemia. Self pollution from retained excretory materials, re- 36 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. sponsible for many sicknesses and insanities, or complicat- ing them. Evacuation and sustaining the strength are necessary. Backache. Frequent in women, and of no particular significance, but quackery take advantage of the mistaken popular idea that any backache means kidney disease inducing unin- formed to take stimulant diuretics which sometimes produce a kidney inflammation that would not have existed had the patent medicine been left alone. Rheumatism is the most frequent cause of backache, see Lumbago. Constipation also, especially in women. Bacteriolysis see Antitoxins. Balanitis. Inflammation of glans penis and prepuce. Antiseptics and astringents. Baldness. Incurable. New theories exploded daily, fuzzy crops anxiously watched with hand glass after applying most re- cent fake hair restorer unavailingly. Balsam Copaiba. Obsolete for gonorrhoea. Some as Copaiba. Balsam Peru. Flavor for expectorants. Barley Water. Gruel or thin diet for invalids and infants. Barber's Itch. Mentagra. Hairs affected must be pulled out and strong antisep- tics as can be borne applied to pustules, with general anti- sepsis and avoidance of infecting others. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 37 Barkers. In the latter part of the 18th century a religious hys- terical epidemic like the more modern Christian Science humbug spread through the United States, the craze con- sisting in barking like dogs. Basedow's Disease, see Exophthalmic Goitre. Basham's Mixture. Solution of iron and ammonium acetate. Routine treatment in Bright's disease. Dose half an ounce diluted. Baptisia. Irritant emeto-cathartic. Bateman's Drops. A patent paregoric containing about two grains of opium to the fluid ounce. Baths. Useful under the direction of honesty and intelligence associated with a medical education, but most of the hydro- therapeutical and all of hydropathy and other water-cures are quackish. Batteries. The dry chloride of silver cells are the lightest and therefore most portable, while affording ample current strength for all medical purposes. Battey's Operation. Normal oophorectomy. A cruel surgical fad, as reme- dial as would be cutting out an eye or slicing off a nose. Wherever the shock of this mutilation has restored the mind it has proven temporary and Goodell reports insanity in- duced by the ablation. Male castration is equally nonsen- sical. 38 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Bechol. An expectorant containing a sixteenth of a grain of morphine acetate to the dram. Imitators treble the quan- tity of morphine. Bed-sores. Soap and water cleanliness, antiseptics and astringents. Bea-wetting. Enuresis. Incontinence in -children. Arouse several times at night, no liquids afternoon and night, elevate hips in bed, warmth to surface, ergot. In aged or paralytics soft rubber catheter with precau- tions to avoid cystitis, by antisepsis and sterilized catheter or other instruments. Strychnine in suitable cases may strengthen enough to benefit. Beef, Wine and Iron. Ink. The worthlessness of the mixture masked by the catchy title that appeals to ignorance. Beer. Adulterants dangerous to the kidneys, liable to be in most so-called malt liquors. Hops were used in the past centuries. Belladonna. As little useful as atropine, which is derived from it. In the form of a belladonna plaster it can be applied to an inflamed breast to aid pressure, with or without phytolacca decandra, reputed to be good in mastitis, and a rapid abate- ment of the inflammation can be looked for. Simple mas- titis has been mistaken for cancer and a surgeon was pre- vented from operating by pressure disposing of the "can- cer." THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 39 Bell's Palsy. Facial nerve paralysis, from exposure, rheumatism, in- jury or syphilis. Strychnia, iodide of potassium, anti-rheu- matics, Faradic electricity. Benzanilide. Discredited antifebrile. Benzine from Coal Tar. Benzol. Antispasmodic and Anticatarrhal, in whoop- ing" cough, influenza, etc. Dose 2 to 10 minims every 3 hours on sugar or in capsules. Benzoic Acid. Feebly antiseptic and expectorant, used mainly as an adjuvant in expectorants for bronchitis. Dose 10 to 30 grains 6 times daily. For external use in wound dressing 1 to 100. Incompatible with salts of metals, bromine or chlorine. Benzoin. Dubious Antirheumatic. Benzolyptus. Secret. Benzonaphthol. Disused antiseptic. Benzophenoneid. Pyoktanin substitute, not much used. Benzosol. Guiacol Benzoate. Intestinal antiseptic and also for bronchial affections. Dose 3 to 10 grains. Benzoyl combinations. Anelide, Eugenol, Guiacol, Phenetidine tried in tuber- culous affections with little success. 40 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Benzoyl-pseudatropine Hydrochlorate, see Tropacocaine Hydrochlorate. Benzoylsulphonic Imide. Garantose,- Saccharin, Gluside. See Saccharin. Berbenne. Carbonate, Phosphate or Sulphate. Dubious use. Beri-Beri. A form of infectious neuritis with chlorosis. No mi- croorganism found. Beta-lsoamylene. Pental. Beta Naphthol. Alone or with camphor, benzoic acid or salicylic acid it was used for antiseptic purposes, but has fallen into dis- use through better preparations. Betol. Discredited substitute for salol. Betul-01. Methyl salicylate from betula lenta oil, free from the toxic products of synthetic salicylate of methyl derived from salicylic acid made from carbolic acid. Betula-Ol is non- irritant, analgesic and antiseptic, for external use only in rheumatism, myalgia, neuralgia, a few drops applied with camel's hair pencil. Bezold's Disease. Rupture of mastoid abscess into sternomastoid region. Bichloride of Mercury. Corrosive Sublimate. Antiseptic and Antisyphilitic. Soluble in 20 parts of water, 5 alcohol, 6 ether, 14 glycerine. Dose one-thirty sec- ond of a grain to maximum of an eighth of a grain. Should 41 not be given undiluted; the usual administration being in connection with a solution of potassium iodide which con- verts the corrosive sublimate into biniodide of mercury. In- travenous injections of mercuric chloride are certain to cause coagulation of blood in the circulation with embolism, which as often happens may be carried to the brain and in- duce paralysis. Even hypodermic use of corrosive subli- mate by the liberation of concentrated multiple globuli of metal can set up chronic symptoms from cerebral capillary plugging. As a surgical antiseptic one part to a thousand parts of water, or stronger, though not usual to exceed one in five thousand, it acts as a germicide partly by the coagulation of albumen in the organisms, but also by enveloping spores, cocci, etc., with the liberated very small metallic mercury globules, imprisoning them from activity; but when such vegetable micro-organisms are released from the metal by heat or water washings the antiseptic is proven not to have destroyed them, as they can be made active in cultures again. Antidotes are Alkalies, which precipitate yellow oxide of mercury, and white of egg, but if not handy any viscid substance as mucilage or syrup, even soap-suds, may be used, but too often the damage is done before any antidote has been used. Biliary Calculi. Sodium phosphate, olive oil, operative surgery, mor- phine in paroxysms, sometimes surgical anesthesia. Bilious Fever, see Remittent fever. Biliousness. Malaise due to acute auto-intoxication. Headache, loss of appetite and jaundice often relieved by cathartic as seidlitz powder, rochelle salts, a dose of calo- 42 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. mel, draughts of lemonade. Recurrences may need pro- longed cod-liver oil, Carlsbad salt, as the patient may tend to chronic intestinal poisoning. Bismuth Preparations. Very doubtful value if the testimony is carefully ex- amined. They are usually given in a routine way and at autopsies the bismuth has been found occluding the pylorus and compacted into a large mass nearly filling the stomach. The few instances wherein bismuth subnitrate or carbonate is really of service are obscured by the routine and care- less administration of what may be a fairly good drug if more rationally prescribed. Bites and Stings of Insects. Dilute ammonia water applied at once, bicarbonate of soda, lime water. Citronella and pennyroyal odors drive mosquitoes away. Bites of Rabid Animals. Pasteur treatment, see Hydrophobia. Bites of Venomous Reptiles. Supporting treatment as stimulants, quinine, strych- nine. Inject into wound 30 grains permanganate of potas- sium in 4 ounces distilled water. Ligate member above wound to localize venom. Bitters. Like liqueurs, cordials and similar concoctions are safer unused. Blackberry. The astringency useful in diarrhoea is in the root and not in the berry, so the several blackberry preparations fla- vored with the juice depend upon other things, such as brandy, for astringency. unless the root also is used. 43 Black Eyes. Ecchymoses. Cold or hot application, no leeching or cutting which is harmful. Recovery in time if not meddled with. Black Haw, see Viburnum prunifolium. Black-Heads, see Comedones. Bladder Inflammation, see Cystitis, Irritation. Bladder Irritability, causing 1 frequent voiding, may be due to nervousness, pregnancy, diabetes, change of diet or fluids used, hence the treatment is according to the cause. Bladder Paralysis. Strychnia if spinal, catheter if distended, antiseptic pre- cautions. Blaud's Pills. Ancient effective carbonate of iron form if freshly made, otherwise resembling cast iron. Later more eligible ferru- ginous preparations have superseded these pills. Blennorrhoea Neonatorum. Gonorrhoeal infection of eyes of new born, see Con- junctivitis, gonorrhoeal. Blepharitis marginalis, sore eye lids. Resinol is the safest, surest and most rapid. A similar ointment can be made of ten grains of Resorcin, and three drams each of Lanolin and vaseline. Borax or Boracic Acid solution wash. Blood Root. Sanguinaria. Irritant and violent emetic and convul- sant. Formerly in sternutatories and expectorants. Little used. 44 THERAPEUTICS, MATERIA MEDIOA AND PRACTICE. Boracic Acid, also called Boric Acid. More soluble than borax, and used for same purposes, dissolves in water 26, glycerine 10 and alcohol 15 parts. Borax. Biborate of Sodium. Tetraborate and Pyroborate. Soluble in water 25, glycerine 1 part, but insoluble in alcohol. Too much neglected as an external antiseptic and foolishly inappropriately used too much internally. Its chief uses are as ingredient of eye wash or application in solution any strength to sore mucous membranes, but it is useless in epilepsy or other complaints internally. Butchers have been accused of using it to preserve meats and it disturbs diges- tion and depresses generally the entire system, mainly by stopping assimilatory fermentation. Boils. Furuncles. Antiphlogistine externally in early stages will abort boils. Poultices are usually filthy promotors of sepsis. Af- ter evacuation, collodion. Boldea. Suggested alterative and hypnotic but unused. bolus. Horse pill or "gob," the large sized form of administer- ing drugs went out of use when little sugar pills came in. Absurdly huge overdosing being followed by a mere pre- tence. Bonalgur Capsules. For gonorrhoea, containing benzoic acid and gurjun oil, a balsam resembling copaiba. Bone-Marrow extract. As a contribution to organo-therapy Phospho- Albu- men is superior. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 45 Borolanolin. Boric acid and lanolin. Borolyptol. Partly secret combination of antiseptics and aromatics. Borax and Eucalyptol, etc. Boro vaselin. Boric acid and vaseline. Bougies. Medicines for the urethra have been moulded in the form of bougies, but they are not satisfactory. Brain Abscess. Prognosis bad. Brain Anemia. Tonics. Brain Clot. Iodide of potassium. Brain Compression. With apathy and memory impairment, with or without paralysis. Raising the depressed bone. Brain Concussion. Usual symptoms unconsciousness and vomiting at first and later headaches, sleeplessness and eye troubles. Keep quiet, avoid over-heating and stimulants. Regulate bowels and use as little medicine as possible as drug habits easily formed after head injury. Brain Congestion. Active catharsis, as ten grains each of calomel and jalap; old fashioned but effective treatment. Hot foot baths or applications, cold to head but do not freeze the brain. 46 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Brain Contusion. Liable to be complicated with compression or concus- sion or later to form abscesses. Treat as Concussion. Brain Embolism. Iodide of potassium. Brain Fever, see Meningitis. Brain Thrombus. Iodide of potassium. Brain Tumor. Diagnosed by dizziness, nausea or vomiting, choked optic disk, severe headache or localized pain in head, in ad- vanced cases paralysis, convulsions, coma. If the tumor is syphilitic it may be treated with anti-syphilitics, trephining is foolish in most tumor cases especially syphilitic, as they are likely to be multiple. Prognosis bad in all brain tumor instances. Exostoses may be diagnosed by X rays and if found treated as compression. Brain Sclerosis. Incurable. Brain Softening. Incurable. But this term is often used to designate in- sanity. There is no insanity associated in any way with that name. Brandy. Formerly made by distilling grape juice. Artificially, artistically and remorselessly made by chemical combining at present. Brayerin, see Koussein. Breasts inflamed, see Mastitis. 47 Breath, Fetid. From decayed teeth, neglected bowels, indigestion, dia- betes, ozena, suggest dentistry, mouth washes, cathartics, peptenzyme, etc. Bright's Disease. Nephritis. Unless your patient is in a hospital, where diet can be regulated, you will have difficulty in enforcing your notions as to what should and is not to be eaten. Nephritis cases are often irritable and obstinate, and will refuse to restrict their diet in any way; some of them get crazes and eat inor- dinately, and as what is taken does not affect them so badly as expected 11 might be well to compromise the diet with reference to practicability. Pressure to the kidneys can be lessened by eating sparingly, but oftener; but it is not clear that lessened pressure is desirable. Too little pressure is apt to block the kidneys through inaction. Plenty of water and no stimulants should be taken, and beer, especially, is to be avoided, as, with or without the commercial salicylic acid put in it by dealers or brewers, beer is poison to the kidneys when there is a tendency to inflammation. When a heavy beef-steak meal has been eaten the fibrin of the blood has increased in the menses, with congestive pains, in some cases of women with nephritis, and that sort of meat food invariably proves bad for them, sooner or later; that is, one or two gorges of beef may not be followed by immediate results, and on the other hand may seem to allay some faulty nutritive symptoms, but edema, vomiting or uremic symptoms may appear, which with other sorts of meat are not so liable. Mutton or pork chops and particularly fried bacon or ham are tolerated better, but abstinence from meat altogether is safer. The idea that eggs should be avoided seems to me to be based upon an altogether erroneous con- ception of nephritic pathology; because albumen is voided too much it is not the cause of the inflammation, and the 48 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. body should be resupplied with what has been wasted. As to milk, the books recommend good milk is best as an ex- clusive diet, but there is often an aversion to it and needless distress has been occasioned by forcing it upon patients, even if peptonized, unless the patient is in extremis, and hydremia can follow too exclusive a milk diet, of the city supply sort. If blood clotting were a factor in the exacerbation of nephritis we could seek something that would tend to ''thin the blood," as popularly expressed, and ordinary sassafras has a deserved reputation for producing anemia; however as hydremia is an occasional feature of Bright's disease routine dosing in the absence of too much fibrin in the blood would be unreasonable. Whatever is likely to irritate the kidneys is to be avoid- ed; even with rheumatoid pains it is well to abstain from salicylates or lithia salts, and the old fashioned Basham's Mixture can be supplanted by phospho-albumen or Gude's pepto-mangan if anemia is to be combatted. When dig- italis and strychnia, or nitro-glycerine are taken the size of the dose and the frequency of administration should be con- stantly adjusted to the needs of the patient. Give enough and no more, and seek to discontinue remedies of every sort as soon and for as long a time as possible. This necessity is seen in instances where overdosing has hastened death or prevented recuperative means from acting; needless daily dosings of strythnia, etc., were kept up till the patient had formed a habit and was using absurdly great quantities, which, had the medicine been at once withdrawn, when the particular occasion for it passed, it would have availed to prolong life when the next or succeeding attacks warranted its use. And similarly with diuretics, for they have been much misused ; sweeping the kidneys with scoparius has re- moved broken down tissue for the moment only to hasten the further destruction. If empirics would only ascertain THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 49 what effect medicines have, instead of jumping at conclu- sions that any kidney remedy will answer in any kidney dis- ease, there would be prolongation of life and some hope of ultimate recovery in many renal disease cases, instead of their being cut short so often by "doing something" when doing nothing would have afforded the patient a better chance for his life. But Ignorance rushes in where Knowl- edge fears to tread, or hesitates. Patients have been afforded temporary relief from dys- pnoea by a timely dose of digitalis, but by the continuation of the drug, when it should have been withdrawn, the heart has been forcibly squeezed down and the patient suffocated, and this in a hospital between visits of the attending physi- cian, the interne not wishing to assume authority to stop the nurse from giving more digitalis. The quantity of albumen fluctuates in nephritic urine between a half of one per cent to fifteen per cent or more, and the tube casts, hyaline, granular and waxy, also vary in numbers, usually a decrease in this output being attended by an abatement of the discomfort and most evident symp- toms, which over indulgence in beer or meat diet may speed- ily recall. The severe gastritis of nephritis may cause ulcer of the stomach, and loads of bismuth are too often given in such cases until the pylorus is blocked by it and the diagnosis of cancer obstruction is likely. Oxalate of cerium, a grain or even five grains, dry on the tongue allays the nausea, but comfort is surer after a vomit, which is one of nature's ways of atoning for kidney deficiency by converting the stomach into a substitute for the bladder, which cannot be reached by the urine through proper routes. Stomach washing could occasionally be used with advantage if the habit were not so easily formed that there would be danger of the entire economy adjusting to- this sort of artificial evacuation. There would appear to 50 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. be something very alluring about giving the kidneys a rest through this sort of assisted evacuation, but the question should be seriously asked if more harm than good may not subsequently be done. This incessant regard for the pa- tient's future should be had instead of resorting off-hand to some flashy temporary relief likely to give later inconven- ience. Bicarbonate of soda, vichy water or lime water in plain water or with buttermilk, allays the stomach acidity for the time, but after awhile this hyperacidity is likely to abate either in an intermission or through bowel adapta- tion, periodical watery diarrhoeas occurring instead of the vomiting and sometimes the acridity of the discharge is such as to cause burning sensations in the rectum with more or less proctitis. Liver congestion is a feature worth relieving by period- ical, not too often small doses of calomel, and idiosyncracy is in nothing so well marked as in the amounts of calomel people can, or cannot, tolerate. A single tenth of a grain may affect one; three or four pills containing a tenth of a grain may induce free evacuations in another, and these tenths are best given in divided doses, say in an hour or half hour apart, so that the physiological effect may be secured without overdosing. Back ache more often indicates constipation or rheu- matic lumbago, but the popular idea is that back ache means Bright's disease and the patent medicine knaves are prompt to seize upon this fallacy and print striking pictures of sufferers bending over in agony, holding their backs, and beneath are certificates of some fake nostrum having re- lieved this condition. The trouble might have been ordi- nary colic, and the "Bright's disease remedy only disguised peppermint, or rheumatic back pains may have also been dubbed Bright's disease and the "Infallible Kidney Cure" consist in a little wintergreen which is good for acute rheu- matic complaints, and another certificate swells the columns THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 51 of praise of the faker who lets ignorance diagnose its own disorders and prescribe his trash. Back ache is not evidence of nephritis. Deep pressure over the renal region may pain the nephritic, and normal persons also, though less readily. An old trick of horse dealers is to make it appear that a horse they are buying has kidney trouble by pressure each side of the spine near the haunches, any horse winces under such squeezing, though in some inflamed kidneys the pain may be greater on pres- sure. The patent medicine gulper's logic suggests to him, and I have heard him say: "Well, if the advertised remedy removes the disorder, whatever it happens to be, even if not properly diagnosed, then good is always done by it." The educated doctor can see a hundred fallacies in that sort of reasoning: The patent medicine vender is just as apt to use the worst kind of salicylates instead of wintergreen in his desire to cure rheumatism of the back that was mistaken for Bright's disease, and not only fail to help the suffering but add to it and even set up an inflammation where one did not exist before. At a time when couch grass was on the market in abundance as a ''Kidney remedy," though not under that name, the incessant stimulation of the kidneys self prescribers indulged in created thousands of real kid- ney diseases where they did not exist before. In cases where time enough is afforded, as when ne- phritis begins in youth following diphtheria, a vicarious ad- justment appears to struggle into development, judging from the feet perspiring so much that stockings quickly de- composed, and similar cases of hyperidrosis, bromidrosis or osmidrosis, may be studied with reference to kidney insuffi- ciency. Veterinary surgeons look for kidney disease in horses that perspire much over kidney regions of the back. The stomach troubles of nephritis, usually hyperacidity at first, and periodical nausea and vomiting later, the uri- nous odor and taste of the vomited, watery, frothy contents 52 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. of the stomach, plainly relate to the diverted kidney func- tion ; but all such attempts at compensation, unless one kid- ney remains intact, are insufficient; but even then there also appear compensatory cardiac and hepatic hypertrophy, and now and then anemia to such an extreme that blood de- struction rather than mere hydremia accounted for the symptoms. Some patients claim that saliva accumulates rapidly and if swallowed it nauseates. It may be that the salivary glands excrete urine which would account for the vomiting of ne- phritics. The sudden onset of edema of the legs, or anasarca, with the attendant disappearance of distressing dyspnoea, point to changes in the chemistry of the blood as a cause of the osmotic outpour of serum into extra vascular spaces, the dropsy. As search and speculation has completely failed to ac- count for eclampsia, it is proper to suggest that instead of something being added to the blood in so called uremia there is likely to have been abstraction of an important al- buminous ingredient affecting cerebral vessels, to the point of practical decapitation, just as the headless chicken and epileptic spasms are produced, and hysterical convulsions by cramping down of the arterioles. Depriving the blood of a nutrient constituent is the same as cutting off brain blood supply to the convulsing degree, the volume being maintained, the heart acts upon its contents differently from its irregularity in fainting. Blood can be radically changed in nutritive function by either adding to it some foreign ma- terial as any urine constituent, or by taking from it a neces- sary ingredient, or by reducing its quantity; in any such case rendering it poisonous to the nervous system. Excretion of urea by the kidneys is imperfect in nephri- tis and of course the proportionate uric acid is not voided as it should be. In uremia four-tenths per cent of urea is THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 53 found in the blood, but this is not considered enough to ac- count for the toxic symptoms. The chemistry of uremic in- toxication remains unknown; it is not urea, nor uric acid, nor is it ammonium carbonate as was once suggested. Pot- ash salts were guessed at as in excess but not proven. Diminished alkalescence was first noted by von Jaksch, the diminishing taking place greatly on the approach of uremic symptoms. But the attempt to establish this theory of acid intoxication has failed. Though uric acid may be in excess in uremia it is also in other conditions, so the dimin- ished alkalescence is probably a secondary condition of the blood in uremia. An autotoxaemic theory is now tentative- ly held, though the alkaline idea may be re-examined with reference to idiosyncracy, some being affected in one organ or in one way by chemical differences in the secretions where another might be susceptible in another organ or way, or proof against any impression under similar conditions. Resisting powers vary widely, we know. The stress of a pathological state may fall upon one or more defective organs in one person and be totally resisted by another. I have had some eclamptic patients survive a convulsion and at a subsequent confinement have cerebral disorders, as though predispisition lit the way to how ure- mia should manifest itself. Alkalescence refers to carbonates, bicarbonates and al- bumens in solutions by acid phosphates. Phosphates exist as neutral or alkaline salts of sodium, calcium and magnes^ him in the plasma, and in various combinations, as lecethin nuclein, in the red and white blood cells. In anemia p 2 5 is diminished, and there is a parallelism of this and K in these conditions. In leukaemia Na and p 2°5 are increased and K is diminished. The Na and K are principally combined with CI in blood, but Na as carbonates and phosphates. Both nephritics and diabetics are susceptible to blood poisoning, and this fact could be taken as explaining* that the unaccus- 54 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. tomed toxicity of the blood of whatever nature, or, for that matter, the mere failure of the blood in its quantitative nu- triment for the brain and nervous system generally through changing its character, negatively or positively, by abstrac- tion or surplus of some constituents, and these even normal ones, suffice to cause convulsions. Uric acid Haig has demonstrated to be a tissue irritant and certainly an inflamed kidney would be precisely the place to suffer from such irritation in excreting amounts which healthy kidneys could void safely. Then in origin there is a certain similarity between gouty and nephritic exacerbations, the main difference being as to the parts af- fected. It is safe to assume that kidney irritation should be spared the nephritic as far as possible, and whatever will help uratic elimination without substituting rasping of its own would be advisable to adopt, so it will not do to give salicylates whether pure or not, nor lithia salts, and the only available uric acid eliminant that will unirritatingly assist excretion is piperazine, (Schering), or the piperazine water, or Gicht Wasser as it is known in Germany. It is a strong organic alkali and it would be proper to seek to restore the blood alkalescence in uremic states by using piperazine, in addition to expecting it to harmlessly prevent kidney irrita- tion from uric acid. The limited trials I have given this remedy in nephritis encourage me to expect more from it in future in the alleviation of paroxysms, if not the establish- ment of intermissions. In the present state of our know- ledge we can leave the blatant quack to claim the ability to cure any disease. Instead of plying the hypertrophied weak heart with digitalis or nitro-glycerine on all indications, it would be best to give for temporary effect a little good, wine at times, the stronger alcoholics or beer are to be avoided, and as champagne is not only gouty, but affords oxaluria kidney irritation, it, also, is contraindicated. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 55 Remembering" to withdraw medicines of all kinds as soon as indications are met the following aids to defective function can be resorted to with advantage: Phospho-albumen, or Glide's pepto-mangan when there is anemia instead of the old fashioned perchloride of iron or its vehicle Basham's mixture, because those modern preparations are swifter and more effective and less objec- tionable. Strychnine sulphate in one sixtieth of a grain doses thrice daily if needed to strengthen the heart's action, with or without digitalis fluid extract, two minim doses, also thrice daily; and to raise the arterial pressure to ensure elim- ination through kidneys and perspiration, which latter is often suppressed in nephritics, the glonoin or nitro-glycerin pills may be used in from one hundredth, or less, of a grain, up to as much as a fiftieth of a grain once to thrice daily. Avoid direct diuretics as too hard on the kidney struct- ure, the digitalis, strychnia and glonoin act as indirect diu- retics by increasing- blood pressure to the kidneys. Iodide of potassium is mentioned in the old literature as increasing the arterial lumen and thus relaxing spasm and helping elimination, but Haig-'s suggestion that it cleared the blood of uric acid is just as likely to account for what little aid it affords. Probably in small doses it may act in several ways, even as an antiseptic, though the notion that a septic cause of nephritis exists, in view of urine being the fluid by which septic and other pathological products are carried from the system, would render asepsis of these or- gans, the kidneys, as practicable as to render the lower bowel aseptic. A surgeon suggested the use of ureteral catheters in connection with injections through them to the kidney pelves, to "cure Bright's disease by throwing anti- septics into the kidney to destroy the germs of the disease." As brilliant a method as the other flashy surgical resort to decapsulation; cutting the kidney capsule to admit of 56 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. greater circulation. There is no evidence of any good hav- ing followed such severe operations, but on the other hand deaths have been hastened. Notwithstanding the great achievements of surgery in the recent past, slicing is not a means of curing everything, and the physician may have abundant reasons against the use of the knife in some dis- eases. There is one surgical aid that has given good tempo- rary results, and that is normal salt solution introduced di- rectly into subcutaneous spaces by large hypodermic injec- tions, though the same large amounts have acted for resus- citation when injected into the rectum. An easily remembered formula for the normal salt solu- tion is a teaspoonful of salt to a pint of water, then boiled and used at a Fahrenheit temperature of a hundred degrees, introduced into veins, arteries, subcutaneous cellular spaces, as the right infra-mammary, or into the bowels, with anti- septic precautions. Seven-eighths of one per cent, or 92 grains to the quart of water, making the solution six tenths per cent, have also been laid down as resembling the salt proportion in blood serum, and another form has been used of 30 grains each of chloride of sodium and potassium bi- carbonate to a pint of water at a temperature of 104 F. de- grees, injected into the right infra-mammary space, or a dram each of acetate and chloride of soda to the pint of water. Doses internally of calomel and jalap, ten grains of each, were the old fashioned and effective means of securing quick full evacuations, and may still be used when indicated and practicable. The hot water and salty bowel injection may not only answer for these more severe remedial means but where there has been insomnia previously it has induced natural sleep with abatement of other symptoms. Muhlenberg of Pennsylvania has applied turpentine on flannel with flaxseed poultice diluent, say a handful of 57 ground flaxseed with hot water and a tablespoonful of tur- pentine in a flannel applied over the kidneys to stimulate them to action in cases of impending or actual convulsions from urinary suppression, though it is likely that any other rubefacient might answer in less degree. Even dry cupping by drawing blood to the surface could relieve the congested organs if used over the kidneys on the back, or, as a tem- porary expedient in the absence of better means, either the hot water bottles, or warm applications, or vigorous rub- bing of the back could take away some of the congestion from the kidneys; though nitroglycerine, strychnia and dig- italis would be surer, though, of course, medicines cannot be taken by the mouth if the patient is unconscious, as dur- ing an uremic convulsion. If these remedies are given when the first indication of obstruction of the kidneys occur they may avert the seizure. Calomel as a purge has often un- loaded the system through the bowels in time to relieve im- pending kidney congestion, or hasten recovery after an at- tack. If there is one curative or preventive means that is su- perior to every other in the care of one afflicted with Bright's disease it is living as simply as possible, in diet and especially in drinking, and as near a complete out door life as can be had, or the patient can be induced to take. The invigorating air of the seashore, away from the city, is the most recuperative. The free ozone and other constituents of ocean breezes, to say nothing of the relief from the heat of summer, brace up patients in this complaint, as in many others, so as to, at least, prolong their davs. There are numerous sea coast and other spots on this continent where long intermissions if not recoveries in ne- phritis can be obtained, and it should be better known that Carlsbad and similar European resorts have absolutely nothing to honestly offer the patient, beyond competent medical service similar to what can be secured elsewhere, in 58 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. comparison to the aid the nephritic can get from an out door life with plain unirritating diet, with little or no meat or liq- uors, and where possible pure milk as an exclusive diet, for years if necessary. Bromacetanilide. Disused antineuralgic. Brom-ethyl. Ethyl Bromide. Bromide of Ammonium. The most useful salt of all the bromides, as it to some extent is a cardiac stimulant and corrects somewhat the de- pressant bromide tendency, while avoiding the gastric de- rangement sure to ensue in using bromide of potassium and to a less degree in the use of bromide of sodium. The am- monium salt effloresces readily and so the solution should be complete by over-saturation. 10 to 30 or more grains thrice daily can be given in epilepsy in water. Bromides of sodium, potassium, iron and strontium. In some nostrums these salts are united and a flourish of trumpets made as to their curative properties in epilepsy. Such claims are unfounded. Lyrebird's bromides contain these, and a bromide Elixir has also chloral and cannabis Indica. Strontium bromide is a comparatively recent addition to pharmacy and prescribed for epilepsy by inexperienced, if conscientious, doctors. It is valueless as a special bromide compared to others. The Bromides may be given in doses of 5 grains up to 30 grains according to indications, but bromism and de- pression and anemia must be avoided by not too frequent use. Bromidia. Secret preparation. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 59 Bromidrosis. Offensive sweat, usually of feet and symptom of uremia or rheumatism. Dilute ammonia water, tannic acid, boric acid, formal- dehyde, alum, witch hazel, hydrastis, potassium perman- ganate, sodium bicarbonate, benzoic acid. Bromine. Rarely used. Bromipin. Substitute for bromides, but, as remarked under Hy- drobromic Acid, the salts of the bromides are the best form for administration, especially the ammonium bromide. Bronchitis. Derivation and removal of all injurious influences, avoidance of too frequent use of mere palliative medicines, probably the most useful persistent treatment would be with cod liver oil which appears to lubricate the bronchial tubes and lessen the irritation. Chapoteaut's Morrhuol capsules with occasional use of his morrhuol and creosote capsules will be found helpful. Change of climate may be impera- tive. Guiac tablets or lozenges, Brown Mixture, Potassium iodide, carbonate of ammonia, Thiocol, Terpin hydrate, Ter- pinol, Guiacol. Bronchocele, see Goitre. Brown Mixture. Mistura Glycyrrhizae Composita. An old fashioned paregoric and antimonial depressant expectorant, still useful in some coughs, but it is not to be used steadily or in large doses, as nausea or paregoric habit may be induced. Brucine. Strychnine is better. 60 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Bruises. Any vegetable astringent wash, as arnica, witch hazel, camphor or antiseptics. Bryonia. An uncertain, irritant and poisonous cathartic super- seded by jalap. Its glucoside Bryonin has been suggested in hemorrhage. Bromo-caffeine, soda or seltzer. These salts, usually effervescent, might be both useful and agreeable to take occasionally for symptomatic treat- ment of headaches, but unfortunately the tendency is for pa- tients to rely upon them and increase the doses, whereas the disease itself should be removed, and persistent use of these depressants, the bromides, even when corrected by the heart stimulant caffeine, increase the bowel atonicity upon which the autotoxaemia often depends. This sort of "relief" re- sembles that of the bankrupt resorting to liquor to drown his worry. Bromocoll. Substitute for bromide of potassium. Dose I to 5 grams per day or increased to 30 grams per day. Bromoform. Similar to chloroform, on trial for whooping-cough 1 to 7 drops according to age 3 or 4 times daily, in hydro- alcoholic solution or in emulsion. Poisoning has occurred through incompatible prescribing by precipitating the bro- moform. Bromo-hemol. Dubious nerve-tonic and sedative. The idea appearing to be that iron will atone for the bromism. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 61 Bromol. Internal antiseptic, but not in use. Bubo. Inflammation of lymphatic glands of groin or axilla. Antiphlogistine if early. Calomel in small continued doses, mercury and lead plaster, ichthyol, creolin, formalde- hyde, carb.olic acid, iodine, iodoform, iodoformogen, iodole. Bubonic plague, see Plague. Buchu. As a sedative to the kidneys and bladder and with other more active diuretics the fluid extract is useful, in the dose of a teaspoonful in half glassful of water. Bulimia. Ravenous appetite of insanity. Bullae. Lumps, pea to Ggg size containing opaque liquid. Bunion. Relieve pressure and treat as localized rheumatism. The bunion is an exostosis, the periosteum is inflamed or de- stroyed, so chiropody or surgery is of no use. Burns. First degree. Carbolic acid 3% salve, bicarbonate of soda solution or dry, collodion, traumaticine, gutta percha solution, boracic acid, resinol, court plaster, lead plaster. Second and third degrees. Carron oil, made from lin- seed oil and lime water with antiseptic and aseptic precau- tions. The main need is to exclude the air, so that immer- sion of the burned part in water completely is an excellent means of relief from pain, covering with some oily substance that will not also introduce germs. The anesthesia of car- 62 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. bolie acid is at once soothing and otherwise beneficial in preventing decomposition, but it must be ointment. It is highly improper to use Salicylic acid as it is not only irri- tating but it destroys the integument, facts too often lost sight of in regarding its slight antiseptic property. Bursin. Suggested in place of ergot which is much better. Bursitis. Use ichthyol externally, or tincture of iodine paint. Butyl-Chloral Hydrate or Croton-chloral Hydrate. Formerly given in neuralgia, but its pungent odor and failures are discrediting it. Buxine. Antifebrile but unused. Cacao Butter. Oleum Theobroma, a vegetable fat used as a cerate and vehicle. Cacodylic Acid. Practically arsenous acid. Cactina. A preparation of Cactus grandiflorus. Cactus grandiflorus. Night blooming cereus. Cardiac stimulant substitute for Digitalis. Cade, Oil of. Juniper Tar used in skin diseases externally. Cadmium and Cesium salts. Not established as of any value. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 63 Caffeine, Theine or Guaranine. The citrated containing 50% caffeine dose is of 2 to 10 grains, the hydrobromate of caffeine injection 4 to 10 min- ims solution. Hbr. Caf. 10 parts to hydrobromic acid 1 part, distilled water 3 parts. As a heart stimulant or for headache relief, though for this there are better things; see Headaches. Cajeput Oil. Formerly used in skin diseases. Calabar Bean. Physostigma, from which eserine the myotic used by oculists is obtained. Calamus. Sweet Flag. Weak aromatic stimulant tonic. Calcium Bromide. Dubious substitute for Potassium Bromide. Calcium Carbonate. Chalk. In chalk mixture with catechu or kino as astringents in diarrhoea, main use. Calcium Chloride. Chloride of lime. A disinfectant and deodorant in minor degree. It takes up moisture from the air in slaking and when drying the at- mosphere of a place is desirable it can be used, but it gives out a pungent odor of its own. Calcium Glycerino-Phosphate. Very doubtful utility. Calcium Hypophosphites. Not assimilable in my opinion. 61 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Calcium Lactophosphate. If any result follows its use faith cure likely to be the cause. Calcium Permanganate. Potassium permanganate better. Calcium Phosphate. Useless. Calcium Salicylate. Diarrhoea and gastro-enteritis. Dose 8 to 24 grains. Calcium Sulphide or Sulphite. There are better things for flatulence. Calculi, Biliary. Gall stones causing intense suffering of hepatic colic, blocking duct of gall bladder. See Biliary Calculi. Calculi, Renal. During the passage of a kidney stone through the ure- ter to the bladder there is intense pain, and the advance from kidney downwards can be gradually traced across the abdo- men till the stone falls into the bladder when there is instant relief and if overdoses of morphine have been given they become evident at this time. It is often necessary to give hypodermics of a quarter to a half grain of morphine during the acute stage, but regard must be had to the accumulated quantity not to exceed toleration, and as the stone ap- proaches the bladder the patient should be encouraged to do with less morphine. Piperazine is probably the best uric acid solvent, but general antirheumatic treatment with salicylates and lithia salts assist in preventing renal calculi forming. Calicolo. Secret preparation. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 65 Calisaya Bark. A species of Cinchona yielding quinine. Callosities. Circumscribed hardening of the skin. Salicylic acid and ichthyol with lanoline and petroleum, rubbed in. Calomel. Hydrargyri chloridum mite. Formerly used as a cathartic in 10 grain doses, but in small doses as a tenth of a grain, repeated at intervals until the physiological effect desired has been induced, or until a couple of grains in all have been taken, it acts as an altera- tive where faulty elimination especially hepatic exists. Com- bined with bicarbonate of soda and sugar its action is more rapid, as the alkali reduces it to black oxide and the sugar to metal in the bowels and it is in these forms all mercurous salts pass into the circulation. The nonsense as to conver- sion into corrosive sublimate is owing to that more active and poisonous salt of mercury contaminating the mercurous or mild chloride before it was given. I tested the stocks of several drug stores and found corrosive sublimate in the calomel dispensed by the majority. The supposition that lemon juice or vinegar converts calomel into hydrargic chloride is also wrong as even mu- riatic acid will not attack mercury when cold, nor can gas- tric juices change the salt. Intestinal alkalies reduce calo- mel and corrosive sublimate to metal finely divided. As a cathartic to quickly relieve cerebral congestion, as after a sunstroke, 10 grains of calomel and 10 grains of jalap can be given in one dose. This sort of derivation takes the place of the antiquated bleeding. Incompatibles are numerous but the lists as given in the books are uniformly wrong as not based upon correct chem- ical or physiological information. In doubt use single remedies to avoid incompatibilities. 66 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. Calumba, or Calumbo. An old fashioned mild tonic, incompatible with too many things to be combined and as small doses of quinine are superior and answer all such purposes, this old drug- can be put in the curiosity shop, particularly as it is often im- pure. Camphene. Pure oil of turpentine. Campho Phenique. Antiseptic, expensive. Camphor. As spirits for external application to enable patients to satisfy their desire to "do something," and work off their surplus restlessness, it may be allowed, but otherwise the main use of camphor is in combinations such as liniments and with other materials as in making monobromate pills, a good anaphrodisiac. Sexual function is depressed by camphor but it is not well to use it direct for this purpose for it upsets digestion and can even cause gastric ulcer. It is too freely used by the public. Camphoric Acid. Angina, coryza, bronchitis locally in half to 6% solu- tions. Cystitis half to 2% solutions injected into bladder. Night sweats of phthisis up to 30 grains. Camphor Monobromate, see Monobromate of Camphor. Cancers. G. Betton Massey of Philadelphia has been using acu- puncture electrically, forcing mercury by cataphoresis into the growth. His methods have been so strictly ethical re- lying upon his results as presented to the profession that he is less known than many who have undeservedly large prac- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 67 tices in that specialty through having found quasi-ethical means of advertising themselves. He is on the staff of the Oncological Hospital, Philadelphia. An "Alexander Method" is announced to physicians from Boston, by circulars. It is some sort of a solution for hypodermic use. Radium has failed, and it may transpire that causticity, maybe of peculiar kinds, is at the root of all the x-ray, Fin- sen and other light applications, the justification for using which is still under discussion. Arsenic pastes are old cau- teries and recently cocaine has been added to allay pain. Multitudes of harmless tumors have been called cancer and operated upon as such, on the other hand malignant diseases have destroyed as many more unrecognized as such. If the embryonal nature of real carcinomata accounts for these false growths they are to the body what professional poli- ticians are to a community, and treatment should have been by eradication and prevention several hundred years before the patient was born. In general terms cancer treatment consists in extirpation, antisepsis, deodorants, palliatives, analgesics, with rarely, here and there, alteratives such as the x-ray or Massey's cataphoresis accomplishing some good. Lupus vulgaris appears to afford the most recoveries under the x-ray treatment. Cancrum Oris. Foul ulcers inside the lips and cheek. Systemic septic conditions may secondarily arise therefrom, possibly ne- phritis, etc. Cannabine. Peroxide of hydrogen and other suitable antisepsis. Nervous sleeplessness and mania, one to two grains. But habit must be avoided. Cannabis Indica. So rarely pure that in prescribing" it you can seldom be sure of getting it, and as its action is harsh, varying with dif- ferent stocks, it is better to use other delirefacients or some- thing less in the line of faith cure according to whichever ex- treme the cannabis may attain, of too great or too little ac- tivity. Cannabis Indica Cigarettes. In Chapoteaut's list. Possibly as useful as any form of Indian Hemp and as this hypnotic has been found as an in- gredient in ordinary cigarettes the habit may be treated ac- cordingly. Those addicted are being excluded from all re- sponsible positions, being regarded as not even fit for food for gunpowder. Cannabinone. Weak, disagreeable hypnotic. Cantharides. For fly blisters these crushed Spanish flies are useful, but should never be used internally as they destroy the gen- ito-urinary tract. Much suffering and danger of death has been occasioned by taking Spanish fly preparations, often put in patent medicines to increase the sexual function. It causes bloody urine and agonizing pain. It should not be used in hair tonics or other than to blister. Small fly blis- ters over the vertebrae centers of spinal nerves whose peri- pheries are the seats of pain may occasionally be used to give relief, if not left on too long. Capsicum, Cayenne pepper. As a rubefacient plaster or in tincture in rectal injection for antidoting opium poisoning. Carbamide, see Urea. Useless. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 69 Carbolic Acid. Phenol. Soluble in water 15, olive oil 2 parts, and freely in alco- hol, glycerine, chloroform, ether. Too strong for pill form and must be highly diluted if taken internally, as a drop to a tumblerful of water in tablespoonful dose to arrest fermen- tative diarrhoea in infants. When used as an internal anti- septic insufficient attention has been paid to the bad second- ary or as sometimes called undesirable effects. Typhoid fever cases have been killed with antisepsis addressed to the intestines while forgetting that other parts were liable to be affected by the poison, as the blood. Mainly useful as an external antiseptic in various percentages of strength, as with vaseline or cosmoline 3 to 5 per cent it is admirable for burns, even cleaner and better than Carron Oil, it anesthe- tizes gently and allays active symptoms after burns, when thus used. It is incompatible with so many things that it is best used with a mere diluent. As carbolic acid is tolerated in tetanus some have claimed that this antiseptic was the real agent for good in serums, a supposition that was not very complimentary to the able bacteriologists engaged in antitoxin research. Carbonated Bath Salts. After the Nauheim treatment valvular disease of the heart can be treated with artificial salts. The Triton Com- pany at Saragota Springs, N. Y., prepare salts for these baths. Carbuncle. While malignant pustule or charbon, the frightful sheep plague, has been included under the designation carbuncle, certainly the ordinary boil like infection of the neck or hand, severe thoug-h it may be, that also is known as carbuncle must be a much weaker form of anthrax, for charbon proper is almost certain death while carbuncle may at most be 70 THERAPEUTICS, MATERIA MEDIOA AND PRACTICE. prostrating, but is seldom fatal. There may be as in ery- sipelas, cerebral secondary infection causing brain sepsis, delirium, paralysis or dementia from ordinary carbuncle. For treatment see Anthrax. Cardamomom. Aromatic to flavor medicines or disguise bad breath, otherwise its alleged tonic or other virtues are too feeble. Cardiac Arythmia. Chronic heart irregularities may accompany organic nervous or brain disease. Irritable heart or palpitations are usually due to some functional depression as neurasthenia, indigestion, hysteria. Cardiac Weakness. Digitalis, if pulse weak and rapid, for sustaining. Aro- matic Spirits of Ammonia or Alcoholics for quick stimula- tion. Cardol. A blistering: oil. & Caries. Decay of teeth or bones. Dentistry may reach the needs of teeth decay, but spi- nal or other bone caries often depends upon tuberculosis passed to the suppurative stage. Phosphorus and lime, sep- arately, lime phosphates or hypophosphites are foolishly the- oretical and inert. Out door life exclusively affords the only relief possible, but usually damage to the bones has pro- gressed too far for repair. The arrest of further decay is all that can be hoped for, and that cannot be promised in any treatment. Ordinary surgical caries as in periosteal injury may be circumscribed in some instances, by iodides, mercury, anti- sepsis, operations, etc. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 71 Carnogen. Secret compound. Ordinary food is cheaper to build up the system than is prepared foods. Carpaine. Alkaloid from Carica papaya, said to be useful in aortic insufficiency and stenosis, subcutaneously a sixth grain daily or every other day. Carron Oil. Linimentum Calcis. Solution of lime and flaxseed oil, eight to seven parts. Useful in recent burns applied on cot- ton batting. Carvacrol. An origanum phenol antiseptic. The iodide employed as iodoform. Cascara sagrada. Fluid extracts in dose of a quarter to a full teaspoonful can be used as a laxative, but the various elixirs on the mar- ket seek to divest it of bitterness, and they are variable from inertness to fair results. Cascara is claimed to be an intestinal tonic and as such it acts to overcome bowel inertia, so that small doses each morning for awhile act better than a single large dose to overcome constipation. Cassia. Cinnamon, a carminative. Castanea. Chestnuts. Tannin astringent. Castor Oil. Mild and speedy cathartic. Dose dram to an ounce. Applicable to impactions or irritating accumulations. 72 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Castration. A criminally ignorant suggestion for the "cure" of in- sanity. Catalepsy. Amyl nitrite inhalations, hypodermics of nitro-glycer- ine. Cataphoresis. Some medicines can be forced beneath the skin by elec- tric currents. Cataract. Opacity of the crystalline lens. Alleged absorbants are dubious if not worse. Excision and suitable glasses are most reliable. Catarrh. Of nasal and pharyngeal passages, sometimes extend- ing through Eustachian tubes to middle ear causing deaf- ness frequently fail to yield to simple antiseptic care, in some localities, mainly moist places near inland lakes, but are at once benefited by change to dry locality. Whether rhinitis, pharyngitis, laryngitis or otitis the treatment of the catarrhal forms are very unsatisfactory, the best being change of locality to a dry climate, sometimes a high altitude or a torrid plane. Astringents and constrin- gents, especially alums and belladonna are merely palliative and finally disappoint. Catarrh Snuff. Dangerous cocaine nostrum. Catechu. The tincture combined with chalk mixture in diarrhoea. Cathartinic Acid. A Cassia laxative. Dose 4 to 6 grains. 73 Cayenne Pepper. Capsicum. Celery. Too feeble to be other than quackish, and if it does happen to be strong look out for opium or bromides. The name with various modifications is used in patent medicines with whisky or worse. Cellulitis. Antiphlogistine externally. Derivatives internally. Cephalalgia, see Headaches. Ceratine. Ichthyol, turpentine and beeswax, for eczema, indolent* and varicose ulcers. Cerebral Anemia. Treat as any other anemia with tonics, as phospho-al- bumen, Glide's pepto-mangan, etc. Cerebral Hemorrhage. Await results. More harm in medication than with- holding it. Much of the treatment recommended in text- books is foolish, such as phosphorus or potassium iodide. Avoid stimulants, keep head high, loose neck wear. Cerebral Hyperaemia. Congestion of Brain. Hot foot baths, Ergot; Jalap and Calomel, 10 grains each. Cerebral Tumors. If syphilitic iodide of potassium and mercurials in large doses. But most brain growths, even if syphilitic, are in- curable. No operation should be performed on the brain except under the advice of a competent neurologist. Sur- 74 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. geons alone are not equipped for brain surgery with requis- ite information. Notwithstanding the Horsley assumptions. Cerebraux. Irritable mental alteration of long standing head injury. Cerebro-spinal meningitis, see Meningitis. Cerevisine. Yeast. Cerium oxalate. The dry powder on the tongue a grain to four or five grains at a time allays nausea, especially that of pregnancy and often prevents vomiting, but in many cases it is merely palliative as nausea is a mere symptom of widely differing complaints. Cerumen, Impacted. Ear-wax hardened in ear. Peroxide of hydrogen, bicarbonate of soda solution, half glycerine and half water solution to soak wax and crumble it, then wash it out. Cetrarin. Experimental. Chafing. Intertrigo. Corn-starch, Magnesia, Talcum powder, Lycopodium. In extreme cases mix a little calomel with the dusting pow- der, and add boric acid if antisepsis needed. Chalazion. Small tumor from closure of Meibomian duct of eyelid. Excision. Chalk, see Calcium Carbonate. Chamomile. Old fashioned medicine. No particular value. Com- THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. 75 pounds of similar name are secret. One widely advertised is made up of strychnia, arsenic and vehicles to enable its "powerful concentration." Chancre. The primary ulcer of syphilis. Cocaine and formaldehyde. Also constitutional treat- ment. Chancroid. A non-syphilitic venereal ulcer. Calomel as dusting powder. Cautery also if necessary. No ointments. Chapping. Any antiseptic ointment or lotion. Charbon. Anthrax, malignant pustule, contagious carbuncle. Charcoal. A dentifrice can be made of the powder, not well to take internally as flatulence is not helped by it and digestion is deranged, while it is not antiseptic enough to be of ser- vice. Chenopodium. Wormseed, a not very reliable anthelmintic. Cherry Laurel Water. A diluent with the taste of bitter almonds or prussic acid. Slight sedative expectorant. Dose 30 minims to a fluid dram. Chicken-pox. Varicella. Contagious eruption, symptoms mild. Keep child in house and avoid medicines. Chilblains, Frostbite. Any antiseptic mild wash or ointment. Also arnica or witch hazel. 76 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. Chinaphenin. Quinine and phenacetine, for malaria. Chinoline. Antiseptic derived from quinine. Little used. Chinosol. Antiseptic, not much used. Chinotropin. Quinic acid and urotropin derivative, not much used. Chlonia. Secret. Chloasma, Hepatic. Liver-spots. Calomel internally. Chloasma Uterine. Resembles liver-spots but due to uterine disorder, which if corrected may cause the spots to disappear. Chloasma, Lentigo, Ephilides, Freckles. The irritating mercuries recommended are harmful and temporary. Chloralamid. The best hypnotic in use, though not strong enough in some cases. It should take the place entirely of chloral hy- drate as safer and having the same dose and effect as a sleep producer; it does not irritate the stomach as does chloral hydrate, nor is it an irritant to any mucous membrane. In melancholia it sustains and does not debauch nor tend to habit forming as when chloral is taken. It does not depress the heart or circulation hence is useful in all prostrating dis- orders as the insomnia of neurasthenia, hysteria, the climac- teric, etc., and likely enough it is because of this heart stim- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 77 ulation that it fails in such active disorders as delirium tre- mens or acute mania. The Elixir, a proprietory preparation, but not secret, enables ready administration in tablespoonful doses, but for general use as in hospital it is best to make up an aqueous solution measuring about 5 grains of the crystals to an ounce of water, as it is provokingly slow to dissolve, requir- ing occasional shakings of the bottle and a day or so to pre- pare the watery solution. A little alcoholic facilitates solu- tion. The chloralamid once thus prepared and given in doses affording 15 to 30 grains has given much satisfaction to physicians using it, and I feel surprise that any chloral re- mains in use when 15 grains has killed and the poisonous dose of chloralamid is beyond 120 grains. An amount not necessary to use. Chloral Camphor. Antiseptic, expensive. Chloral Hydrate. Widely known and used and when as pure as Merck manufactures it is far less harmful, but while it will continue to be used through familiarity with it the untoward effects should be as widely recognized. It is harsher in action than chloralamid and not as safe to use. Alcohol splits it into a poison, and if there is anything wrong with the heart or stomach it makes the trouble worse. It will if continued in use derange digestion so as to prevent insanity from recov- ering. It tends to depress and in this is opposite in effect to chloralamid. Its range of incompatibles is great and the chloral habit is readily formed and not readily broken, lead- ing more often to opium and other habits. Chloralose. A hypnotic which owing to its bitter disagreeable taste and the dangers of its use is not favored much. 78 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Chloretone. Hypnotic and anesthetic, taste disagreeable, on trial in vomiting of pregnancy and sea sickness, also with adrenalin in rhinology. Chloride of Sodium. Purchasers of spring waters read that this mysterious chemical occurs in the analysis, often unaware that it is merely common table salt. Chlorides, Piatt's. Solution of several chlorides. Excellent deodorant and disinfectant for sick-room, though expensive. Chlorine Water. Disinfectant. Chlorororm. Anesthetic. See Anesthetics. Chloroform Poisoning. Ammonia, amyl nitrite, strychnine, artificial respira- tion, fresh air. Chlorosis, Green sickness, see Anemia. Choked disk. Interference with return of blood in retinal veins, symp- tom of inflammation of optic nerve or brain tumor. Cholera Mixtures. Usually old fashioned astringents with chloroform and opium doing more harm than good through preventing evacuation of fermenting irritating materials upon which the diarrhoea depended. Sulpho-carbolate of zinc is better as it stops the fermentation. Cholera, see Diarrhoea. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 79 Chondrus. Carrageen or Irish Moss. A delicate diet sea weed. Chordee. Mono-bromate of Camphor. Chorea, St. Vitus' Dance. Fowler's Solution or Arsenite of Potassium, freshly made. Choroiditis. Inflammation of choroid coat of eye. Antisyphilitics. Christian Science. Homeopathy without sugar pills. Chromic Acid. A strong caustic, more liable to abuse than use. Chrysarobin, see Chrysophanic Acid. Chrysophanic Acid. Chrysarobin. External use only, dangerous to the eyes. Parasiticide and in skin diseases, 2 to 10 per cent ointment or paint. Chyluria. Milky urine. Many things mistaken for this, phosphatic diabetes among them. Ascertain by analysis exact condition and treat accordingly. A parasite the Filaria Sanguinis Chylu- ria of the tropics causes milky urine. Treatment is iodide of potassium and thymol. Cicutine, see Coniine. Cimicifuga. Black Snakeroot, Black Cohosh. For antispasmodic in dysmenorrhoea best form is fluid extract 15 to 45 minims. Still better in combination, see Viburnal. 80 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Cinchona. The variability of barks render quinine the only sen- sible form to use. Cinchonism. Too much quinine. Bromides. Cinnamic Acid. Used unavailingly in phthisis. Circular Insanity. Alternating mania apparent recovery and melancholia. A chronic and incurable insanity. Cirrhosis of Liver. Calomel. Citrate of Magnesia, Effervescent. A pleasant substitute for Seidlitz powders. Citrine Ointment. Nitrate of mercury ointment used in ophthalmology. Citrophen. About the same as phenacetine. Phenetidin citrate. Claustrophobia. Dread of closed spaces. Climacteric Insanity. Occuring in women at the menopause. Coca Erythroxylon. The leaf which contains cocaine. Wines containing the leaves of this plant necessarily include the alkaloid, as cin- chona does quinine. Cocaine. Dangerous in rhinology and is being dropped. It has 81 injured the cornea, but has been used in herniotomy. The cocaine habit has grown alarmingly. Cocaine Hydrochlorate. A local anesthetic in small amounts, a drop of a 3 per cent solution taking away feeling in the eye ball, enabling operations to be made. Very dangerous in other attempts to use it. Catarrh snuffs with it soon ruin the user. The cocaine habit is sim- ply fiendish, and irresponsible. Murders and thefts are prompted by its fury to get increasing amounts to appease appetites that are unappeasable. Notwithstanding the fur- ious nature of the addiction it is an easier habit to get rid of than almost any other drug using. Large doses of chloral- amid at proper intervals have broken up the inclination to use the cocaine. The habit merges at times with the opium addiction, modifying it. Coca wines or any coca compound depends on financial successes derived from fastening the habit of using it. Some manufacturers of these inhuman concoctions actually give tickets for their drinks freely, expecting to get people in their clutches in this way. Cocculus Indicus. Source of picrotoxin. Coccygodynia. Pain in coccygeal region may yield to anti-rheumatics but too often it is incurable and the morphine habit is in- duced. Operations do no good as the real seat of the dis- ease may be in the spinal cord many inches above the sac- rum. Hysteria, injuries, tumors may originate it. Cocoanut. Juice is a digestant. 82 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Codeine. Practically it is merely a weak morphine, so that when you hear of its being recommended for the cure of the opium habit you may get an idea of the corners some of our uncon- scionables turn in imposing upon the sick. Cod Liver Oil. Oleum Morrhuae. Stone's Swampscott cod liver oil by expression of the cold fresh livers, is best when on the market, but as the Massachusetts General Hospital uses it and what remains is sold it is not always to be had. The Lofoden varieties claim next attention, but often rancidity and adulteration or substitution renders many oils unfit for use. Emulsions pre- tend to disguise taste and prevent regurgitation, this is done sometimes by the emulsion omitting the oil, and at best emulsions are very unsatisfactory in all respects. The oil should be taken pure without disguise if good effects are to be had at all, but Chapoteaut makes a very readily taken Morrhuol capsule with and without creosote which is ef- fective in bronchial coughs, lubricating and reducing irri- tation in bronchitis and pulmonary affections. For chronic constipation cod liver oil is excellent in af- fording mechanical relief by lubrication, with no after effect as with other means. Coffee. Relieves anemic headache. Colchicine-Salicylate. Some preparations under this title contain the impure salicylic acid. Capsules of this kind intended to imitate the pure colchi-sal are harsh in action and should not be used. Colchicum. Colchicum preparations are antiquated in the treatment of gout, and their action may be through irritating deriva- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 83 tion to the intestines. With far better uric acid solvents, as piperazine, at hand the unsatisfactory and dangerous col- chicum derivatives can be less used. Colchi-Sal. Colchicine in methyl salicylate from betula lenta. Gouty and rheumatic conditions, often relieves promptly, but care must be used to secure the capsules that contain the pure oil and even then the heart may be badly affected by over- dosing. An imitation with the more scientific name of col- chicine salicylate also copying the appearance of the col- chisal packages is deadly in comparison. Colds. Hot foot bath, derivatives and time allay nasal conges- tion. Ergot if severe and especially avoid debauching ace- tanilid, cocaine or opium cold or catarrh cures or snuffs. Antirheumatics sometimes relieve. Colic, Hepatic? see Calculi? Biliary. Colic? Intestinal. Peppermint, compound spirits of ether, caraway, cham- omile, coriander, cloves, spearmint, castor oil, seidlitz pow- der, bicarbonate of soda. Externally mustard plaster to ab- domen, hot applications, warm water enemas. Colic? Renal. Hot baths, iodide of potassium, acetate of potassium. Collargol. Colloidal Silver, Argentum Crede. Dubious Antiseptic. Collodion? Styptic. 20 per cent tannic acid. Used for stopping hemorrhage. Colocynth. Drastic hydragogue cathartic. The compound extract 84 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. of colocynth combined with calomel, extract of jalap and gamboge has been a favorite with old practitioners in re- lieving portal congestion and liver torpidity. Color Blindness. May be congenital or from either a functional or or- ganic brain lesion. Coma. So many different causes it is folly to prescribe without knowing to what the coma may be due, and then it is usually beyond the power to aid. Head injury, last stages of dia- betes, as acetonaemia, apoplexy, etc., more likely to make medicines injurious. Comedones. Black-heads. Squeeze out the parasites from the pimples, an old fash- ioned watch key is best for this, and wash face with soap and water. The cosmetic columns of newspapers written by "beauty" quacks are filled with silly instructions on this point, mainly aimed at selling some nostrum. Communicated Insanity. One lunatic may impart delusions to another. Compound cathartic pills. Even the "Improved" are unpopular through causing griping pain. Compound Spirits of Ether. Hoffman's Anodyne. Cardiac stimulant anodyne, and antispasmodic. Dose 30 minims to 2 fluid drams in sweet- ened water. Compound Stillingia Liniment Merrill. Revived ancient rubefacient applied to throat and chest in colds, coughs, bronchitis, incipient pneumonia. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 85 Compound Syrup of Sarsaparilla. Vehicle for potassium iodide, rather worthless other- wise. Compound Syrup of Squills. Hive Syrup containing seneka, squill and tartar emetic. Expectorant, emetic, diaphoretic. Used in croup. Dose 10 drops to fluid dram according to age repeated till vomiting begins. In false croup small doses will relax and end the spasm upon which the choking depends, and in membran- ous croup if the air passages are obstructed any emetic may relieve that symptom, but cannot cure the diphtheria. Condylomata. Wart-like excresences around vulva or anus. Calomel, resorcin, formaldehyde, caustics. Condy's Disinfecting Fluid. Permanganate of Potassium solution, used long before any other antiseptic treatment. Conessine. Astringent alkaloid. Unused. Coniine Hydrobromate. Dose one sixtieth to a twelfth of a grain, for same use as Conium. Injection in tetanus dose a twentieth to an eighth of a grain. Conium. Hemlock. Antispasmodic. Motor Depressant. Use- ful in active mania with insomnia. Squibb's fluid extract in 15 minim doses up to half a dram to remove the excitement and enable sleep. In tetanus it has not been sufficiently used, and judiciously given would have been beneficial but the antitoxin will be exclusively used hereafter.' Conium 86 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. has also been used in asthma, sciatica and whooping cough. Dose extract a half to one grain, fluid extract 2 to 5 minims. Conjunctival eczema. Resinol or a resorcin salve. Conjunctivitis. Borax saturated solution used freely, boracic acid, resi- nol, avoid mineral salts as liable to damage vision. Constipation. Aperients, laxatives, cathartics, hydragogues according to severity, but continued use of these, especially patent medicines, is liable to set up intestinal paralysis so that im- mense doses have to be taken. Cod liver oil and abdominal massage right to left and downwards are the best means sometimes conjoined with strychnine and other tonics to im- part strength to the bowels where they are inert. Sometimes an incarcerated hernia may be the real trouble behind an obstinate constipation. Fothergill's dis- covery that camp diarrhoea was really a constipation is worth considering, see Diarrhoea. Consumption, see Phthisis. Convallaria. Lilly of the Valley. Substitute for Digitalis. Influence does not persist as does Digitalis. Convallamarin. Gluco'side from Convallaria majalis. Resembles Digi- talis in action, not cumulative. Dose half a grain increased to 5 grains. Convolvulin. A glucoside and powerful purgative. Dose one and a half to 3 grains. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 87 Convulsions. From teething press tooth through with thumb or ringer or cut gums of child ; if from indigestion as infant fed on im- proper diet, empty stomach and bowels with emetic and cas- tor oil. Hot water bath helps to relax spasms. Sometimes brain growths cause fits for which little or nothing may be done. If fit is epileptic do nothing as a rule unless amyl ni- trite can be used early enough. If eclampsia of parturient there should be delivery as soon as possible whether pre- mature or full time, albumen in urine of such cases often coagulates solid in test tube with a little heat. Often such cases are killed with veratrum, aconite, gelsemium, hyo- scyamus or other barbarous narcotics. Uremic convulsions see Bright's Disease. Copaiba. Obsolescent. Copper Acetate. Doubtful use. Copper Arsenite. Dubious Antiseptic. Copper Sulphate. Blue Vitriol. Doubtful use otherwise than as a water purifier of algous and other vegetable forms. A compara- tively small amount suffices to remove vegetable impurities from drinking water places, about an ounce of bluestone to a well or cistern full of water. One part to a million parts is the official estimate of purifying power. Corns. Shave and apply salicylic acid with collodion, cannabis Indica may be added to allay pain. Pressure must be re- moved or corn cannot be cured. $8 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Cornutine. The active principle of ergot, but too poisonous. It has been used in doses of a twelfth to a half grain. Cornutine Citrate. From Ergot. Hemostatic. Dose an eighth of a grain in pills. Corrosive Sublimate, see Bichloride of Mercury. Coryza. A cold in the nose. Recovers in a few days. A hun- dredth of a grain of atropine to half a dram of cosmoline, vaseline or other vehicle has afforded instant relief, but such amelioratives are apt to be abused by sufferers, and they must not use it too much or often. Constringents of the mucous membranes as adrenaline and cocaine while effec- tive are still more dangerous. A few drops of fluid extract of ergot would be safer than all though less marked in ef- fect. Cotarnine Hydrochlorate, see Stypticin. Cotoin. From coto bark, astringent in diarrhoea. Cotton Root Bark. Ustilaigo Maidas. Substitute for Ergot. Cough. Avoid morphine, much heroin, codeine or acetanilid depressants. Use Guiac lozenges, morrhuol and creosote, expectorants with prussic acid as cherry laurel water, pru- nus virginiana, or brown mixture, cod liver oil. Loose coughs use stimulants, dry coughs depressants as tartar emetic, etc. La grippe cough allayed with a single drop of creosote in eight ounce mixture of half whiskey and half simple syrup. Tablespoonful doses ad lib. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 89 Sometimes a headache may be the most prominent ef- fect of a cough and this in turn may be from undiagnosed pulmonary disease, even tuberculosis. Coxe's Hive Syrup. Similar to Compound Syrup of Squills. Crab Louse. Blue ointment or a grain of corrosive sublimate in 2 ounces of water a tablespoonful applied to the pubes. Cramp. Hot water and rubbing. Cream of Tartar. Bitartrate of potassium. Cathartic, diuretic and re- frigerant. Dose in dropsy a dram several times daily, in water. Creatine. A muscle extract for muscular atony. Useless Cretinism. Goitrous idiocy, may be a little improved by thyroid doses. Creolin. Coal Tar Creosote. Disinfectant, Deodoriser. The first form of cresols. Creosotal. For croup, measles and pertussis. Dose i to 5 grains in very young, up to 15 grains every 3 hours in adult. With peppermint water and glycerine. Creosotol, see Creosote Carbonate. Creosote. In cod liver oil syrups such as maltine, creosote in 90 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. small amounts is a good expectorant for bronchial or pul- monary affections. Chapoteau's capsules of morrhuol and creosote allay bronchitis and hacking coughs and are good also in the dry throat coughs of fall and winter. An effec- tive la grippe cough mixture is a drop of creosote to four ounces each of whisky and syrupus simplex. Tablespoonful doses. Creosote Carbonate. Creosotol. Antitubercular. Dose 20 minims thrice daily, increased. Creosote Phosphite. Phosphotal. Antitubercular. Same as Creosote., No improvement on it. Creosote Valerianate. Intestinal Antiseptic. Dose 3 to 10 minims. Cresalols. Salicylate of cresol. Internal antisepsis, not much used. Cresols. Antiseptic substitute for carbolic acid. Lysol an eligi- ble form. Croton Chloral Hydrate, see Butyl. Croup, False. Laryngismus Stridulus. Hot applications to throat, usually abates as rapidly as it began, so the last thing done or the last doctor called in gets credit for cure. True croup, diphtheritic or membran- ous begins slowly and attracts less attention, see Diphtheria. Crurin. Bismuth and chinolin. Not much used. Crust head. Remove with olive oil. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 91 Cubebs. Superceded in gonorrhoea by better remedies. Cunderango. Worthless vegetable, advertised as a remedy for cancer. Cupping, Dry. This substitute for the old wet cupping is a useful de- rivative. Glasses with rubber bulbs render the operation an easy one. Curarine. Alkaloid of curare, the paralysant. Seldom used. Curcuma, Tumeric. Disused jaundice remedy. Curetting. Has occasionally caused septicaemia through denuded membranes. Nor is it advisable in simple dysmenorrhoea when many such instances are merely spasmodic and promptly abate with asafetida, cimicifuga or viburnum, es- pecially viburnal. Cuts. Collodion, traumaticin, court plaster. Cyanosis. Congestion with heart failure from acetanelide, anti- kamnia, etc. Stimulants quickly. Cypridol. Mercury biniodide in aseptic oil. Kind of oil not stated. Cypripedium. Gentle nervous stimulant or antispasmodic. Not much used. 92 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Cystitis. Bladder Inflammation. Wash bladder with injections of mild antiseptics such as borax solution, and give buchu internally, with small amount atropine. Make catheter aseptic. Cystisine. Disused diuretic. Dacryocystitis. Inflammation of tear sac near inner canthus of eye. Dacryops. Stoppage of lacrymal duct, forming blue tumor. Open with needle. Damiana. Worthless alleged aphrodisiac. Dandelion. Taraxacum. Diuretic, seldom used. Dandruff. Leads to baldness. Treatment unsatisfactory, tonics usually. Daturine. Datura stramonium alkaloid, resembles hyoscyamine. Deafness. Most cases due to cerumen impaction which can be dis- solved out with peroxide of hydrogen or sodium bicarbon- ate solution, some due to suppuration of middle ear often due to scarlatina, best cared for by destroying pus with pe- roxide of hydrogen, germs with boracic acid the crust from which can be removed next day with half glycerine and half water. The recurring lymphatic inflammation is checked with small doses of calomel at intervals or When attack im- pends. Perforation of membrane impairing hearing should THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 93 not be supplemented by artificial tympanic apparatus which invariably irritate and do no good. A small stringy roll of cotton along external meatus helps convey sounds to the inner ear. If deafness due to Eustachian tube catarrh, pharyngeal antisepsis or change of climate is best. If Menierre's Dis- ease final complete deafness is unavoidable. Aurists can best determine such matters. Deafness may be due to hys- teria, suddenly appearing and disappearing. Debility. Tonics and correcting any systemic trouble. Degeneracy. Deviation from a standard physical or mental type, as idiocy, the criminal too poor or witless to defy the law, po- litical and other heartless thieves, great trust and stock mag- nates, and other forms of defective mentality based on con- genital defects as a rule. Incurable. Delirium. A mere symptom of many differing ailments, usually in the course of fever. It is best to abide the course of the dis- ease and not give depressants, but if constipation or other blood poisoning the delirium may abate when the cause is removed. Delirium Tremens. Hot water externally and internally in abundance, no more stimulants than needed to sustain, but strychnia and quinine and broths or trophonine. Strait jackets cause pneumonia to which inebriates are specially liable. Sulfo- nal allays excitement but constipates and weakens. Delphinine. Resembles aconitine. 94 THERAPEUTICS/MATERIA MEDICA AND PRACTICE. Delusion. A faulty idea, as a mistake, one of the commonest of occurrences, as at times the entire world may be wrong and only one man right, as Galileo, Copernicus, Newton, etc. Grotesque delusions most often held by insane but no ac- curate criterion as to sane and insane delusions. The Czar, Mrs. Mary Faker Eddy and Dowie are divine among cer- tain anthropoids. Dementia. As generally used by alienists it means a serious loss of mentality, though the term may be qualified by affixes. Some books gravely advise drugs that are nonsensical for such an ailment. There are many kinds of dementia, mostly incurable, and medicine is useless in all of them. Dermatalgia. Painful skin. Rheumatism. Dermatitis. Skin inflammation from various causes. Antiseptics, the most useful being boracic acid solution. A nervous form called Duhring's disease with vesicles can be treated with arsenic and asafetida. Dermatol. Bismuth Subgallate. Dusting powder. Deret's Elixir. Tannin and mercury biniodide in wine. Stomatitis, erythema and diarrhoea said to be avoided in its use. Dose a tablespoonful. Developmental Insanities. Occur at critical physiological periods, as puberty, the climacteric, and senility. Diabetes Mellitus. Thousands of useless medicines reported on. Fat and THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 95 lean types, the latter with pancreas impairment, sometimes cancerous. Pancreatine supplies the deficient secretion. Abstinence from potatoes and other starchy food commonly practised, but occasionally it is best to allow some to be eaten. Piperazine on trial. Saccharine instead of sugar when sweetening desired. Diabetes Insipidus. Valerian or asafoetida. Diabetin. Levulose. Substitute for sugar in Diabetes. Dialysed Iron. From lessened styptic taste presumed advantage over other iron, but little used. Diarrhoea. Summer complaints or intestinal fermentations are of- ten so slight as to need no medicine at all hence if let alone the looseness disappears. The dishonest way to treat this ailment is to give a billionth of a grain of any kind of ho- meopathic wind and ascribe the recovery to that powerful "medicine." Quiet rest and strict diet with avoidance of the foolish astringents usually taken ensure recovery in the majority of cases, but when the fermentation is severe and passages rapid, frequent and profuse, catechu or kino tinct- ures with chalk mixtures can be used, but these do not re- move the cause as will two to five grain pills of sulpho-car- bolate of zinc taken after each passage till the diarrhoea is checked. The combined astringency, antisepsis and anti- ferment afford the best results. Formerly the best thing for infantile cholera was very small doses of bichloride of mercury in water, say teaspoonful doses after each passage of a solution of half a grain of corrosive sublimate in a pint of water. But five grains of sulpho-carbolate of zinc in a 96 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. glass of water for cholera infantum, teaspoonful doses make a milder anti-ferment useful in most cases. The milk may- be the offending substance, but that means the particular milk used. Sometimes it answers to change to the milk of one cow. Sterilizing or boiling is useful where the milk is very bad, but as by heat important nutritive constituents and useful digestive micro-organisms are also destroyed, the baby it not getting proper diet in boiled or sterilized cases, the so-called Pasteurizing process. In the cities the adulteration of milk is a serious matter in infant sickness. Often formalin is put in the milk to preserve it and it de- stroys its digestibility to say nothing of the infants it also destroys. A simple test for this preservative is to set a spec- imen of the milk aside for a few days in summer, and if it does not sour then formalin or some other preventive of fer- mentation has been used in it. Remember that internal antisepsis may be carried too far, the use of too much or too strong diarrhoea mixtures is pernicious, particularly such as contain morphine or opium. A valuable contribution to our knowledge of the causes and prevention of chronic diarrhoea, that is too little known, was made by Dr. Fothergill of London. He treated a great many cases of camp diarrhoea in soldiers returned from the Crimea and on autopsy found invariably the transverse co- lon solidly impacted, leaving room only for watery passages around these accumulations, so that really the diarrhoea was a disguised constipation and by using Turkey rhubarb steadily, having the patient carry a small piece and chew off and swallow a small portion occasionally during the day, he was enabled to break up this bad bowel habit in time. A modern means would be abdominal massage. A small can- non ball rolled across the waist below the navel, from right to left at any convenient time of day or night is a good anti- constipation massage. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 97 Diastase. For starchy digestion. The Taka-diastase is reliable. Digestants. Physiologically peptone is intermediate in formation between albumen before and after digestion. Commercial peptone contains much albumose and little true peptone. Foods contain proteids, carbohydrates, fats, salts and water. The last two diffuse through any mucous mem- brane, but the others have to be digested by means of sa- liva, gastric juice, bile, pancreatic juice, and intestinal juice. Proteids by gastric and pancreatic juice; fats by bile and pancreatic juice; starch by saliva and pancreatic juice; cane sugar by intestinal juice. The essential ferments are ptyalin in saliva, pepsin in gastric juice, trypsin in pancreatic juice, invertin in intestinal juice. Numerous preparations derived from animal and vegetable sources are made and combined for different kinds of indigestions, the most generally appli- cable being peptenzyme. Digitalein. Combines digitalin and digitoxin. Digitalis. Best form for administration is the fluid extract I to 3 minims or tincture 10 to 20 minims. The German Digitalin of Merck, not the Eclectic is adapted to injections; the dose is a tenth to a half grain. Infusions are variable in strength, and no advantage over tinctures. Given too often or in too large a dose, digi- talis will squeeze the heart empty, arrested in systole, with suffocation of the patient. Weakness of the heart with rapid pulse is the main indication for its use, guardedly in hypertrophy or stenosis, and a slow, strong pulse is a con- traindication. Digitoxin is of occasional use where prompt- ness is wanted but is too powerful for repeated use, unless 98 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. closely watched. Patients allowed their own discretion in the use of digitalis are apt to take too much. Many alleged deaths from heart disease have been directly due to over doses of digitalis. Digitoxine. Most active glucoside from digitalis. Dose one two- hundred and fiftieth of a grain. Enema an eightieth of a grain. For rapid stimulation of the heart. Dionin. Practically morphine. Dioviburnia. Partly secret. Diphtheria. Diphtheria antitoxin, see Antitoxin Diph- theria. Diplopia. Double vision as in strabismus. Dipsomania, see Inebriety. This form of recurring drunkenness is a periodical in- sanity, which notwithstanding its severity has been success- fully treated. Diuretin. Unstable diuretic. Dizziness, see also Vertigo. May proceed from heart weakness, anemia, congestion, ataxia, ear disease, stomach distress as hunger, indigestion, etc. Treat accordingly. Dobeirs Solution. Alkaline nasal wash varying widely as to amounts of borax, bicarbonate of soda, carbolic acid and glycerine to the pint of water. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 99 Impure glycerine irritates and even pure promotes ca- tarrh instead of relieving it. The addition of a dram of com- mon salt to the pint of warm water improves it, and as car- bolic acid is too strong it can be also left out and eucalyptus in some form added. The average formula for Dobell's so- lution gives 2 drams each of the borax and soda and 24 grains of carbolic acid to the pint of water. Dogwood. Piscidia Erythrina. Variable unreliable hypnotic. Donovan's Solution. Mercuric iodide and arsenic iodide each i%. Dose i to 10 minims. Dormiol. Amylene chloral. Pungent taste, not in much favor as a hypnotic. Double Consciousness. Sensationalists confuse states that are readily under- stood by brain physiologists. In epilepsy at different times the patient may seem to act as though having two distinct mentalities or character. A head injury can cut off certain groups of acquired or inherited propensities and change the character permanently. Similarly a spasm of arterioles in the brain as in epilepsy or hysteria cuts off brain areas tem- porarily and causes changed mental action. The supersti- tious and those who "confuse knowledge with meaningless words" call such double conscious states, subliminal and other idiotic terms. Doubting Insanity. Patients who cannot decide anything for themselves, though apparently otherwise sane. Dover's Powder. Opium, ipecac and sulphate of potassium, the last being .or U 100 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. used to assist by the hardness of its particles in grinding the powder, so when a syrup of Dover's powder is made it seems absurd to retain an inert ingredient as the sulphate. Dracontium. Skunk Cabbage. Unreliable emeto^cathartic and narcotic. Disused. Drunkenness, see Inebriety. Dropsy. A mere symptom of several diseases. The initial fault may be heart, liver, kidney or nervous disease. Cathartics remove the water through the bowels but so doing does not cure the disease nor prevent return of the dropsy as ignor- ance is led to suppose. Sometimes strong cathartics are used. Duboisine Sulphate. Mydriatic. Much stronger than Atropine. Not useful in mental disease as sometimes claimed by inexperienced. Dumbness. Usually from never having heard speech. The dumb may be taught to speak by watching lip motions and imitat- ing them. Malformations also may cause dumbness. Duotal. Guiacol. Dymal. Didymium salicylate. Drying antiseptic for burns, in- tertrigo, eczema, hyperidrosis. Dysentery. Avoid opium and ipecac. Food should be liquid as beef tea or trophonine, fruit juices without seeds, soft boiled eggs, no exertion, microscope determines amebsecoli. Dr. Jay of Chicago studied dysentery specially and says the THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 101 large dosage of of text books like Osier's are hurtful. The rectum denuded of membrane can tolerate injections of ten to twenty grains of bisulphate of quinine and two drams of salt to the quart of warm water alternately morning and evening. Castor oil is the main reliance and may have to be re- sorted to for years after an attack, especially when head- aches indicate autotoxaemia. Tablespoonful doses once to thrice daily at first to occasionally when abdominal or other pain. Strychnia, quinine and digitalis as needed if weak, but avoid habit of using them too often. Relapses are likely. Solid food has to be slowly and guardedly resumed months after the attack. Calomel may suffice for minor cases and assists in severe dysentery. Since the Spanish war the trop- ical kind has become endemic in many southern states. Dysmenorrhoea. Painful Menses. Viburnal. Avoid opium-, bromides, chloral and depres- sants generally as acetanilide, antikamnia, etc. Hot water bag to abdomen. Saline cathartics. Dyspepsia, see Indigestion. Dysphagia. Difficult swallowing. Throat paralysis, obstruction, etc. Dyspnoea. Difficult breathing, from hysteria, heart disease, dropsy, asthma, etc. Dysuria. Strangury. Suppressed urination. Hot water to back, turpentine a tablespoonful in bread or flaxseed poultice to back, mustard poultice, dry cups to back. Salines, diuretics, diaphoretics. In uremia saline normal injections. 102 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Earache. Congestion aggravates the pain of all earaches and if this is treated the pain frequently departs, so a hot foot bath, quick saline purge, mustard to nape of neck or back of ear, or a dose of ergot is more sensible than pouring laudanum and sweet oil drops in the ear to cake and afford fungus soil. Calomel aids in clearing the lymphatic congestion. Ear Diseases. See Deafness and Furunculosis. Echinacea Angustifolia. Said to be alterative in scrofulous and syphilitic affec- tions, Merrill makes a normal tincture the dose of which is 5 to 15 drops thrice daily, diluted, also externally 10 to 15% dilution, for eczema, and as an antiseptic. Echinol. A concentrated fluid preparation of echinacea angusti- folia, ten times the strength of the crude drug, for making ointments and other local applications. Echitone. Echinacea angustifolia, viola tricolor and iris versicolor, for eczematous conditions. Advertised to physicians, prob- ably depends on first named ingredient. Echolalia. Insane repetition of words of others. Eclampsia, see Convulsions. Eclecticism. An obsolescing off shot from Thompsonianism in which it was taught that minerals from the ground denoted death and should not be used, but plants grew above the ground and indicated life and are alone fit for medicine, in ignorance of minerals forming on the earth's surface and of some THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. 103 plants beneath. Gradually many of the silly tenets of eclec- ticism have been abandoned and regular respectable medi- cine is mainly taught in its schools, until eclectic differ from regular physicians mostly in name though materia medica and indications for therapeusis are a little antiquated and illogical. Ecstasy. A hysterical cataleptic state. Ecthyma. Pustular skin infection. Tonics and antiseptics. Ectropion. Eversion of eye lid. Eczema. An immense dermatological held by itself in diversity of causes, appearances and modes of treatment. Astrin- gents, alteratives, antiseptics, emollients, antirheumatics, tonics, caustics, alkalies, etc., have all and more been used. Oil of cade, picric acid, sulphur, ichthyol, zinc oxide, mer- curic salts, resorcin, pyrogallol, chrysarobin, salicylic acid, tannates are among these. Edema, see Dropsy. Edema of Glottis, see also Laryngitis. Tartar Emetic in some form, as syrup of squills com- pound, if laryngitis dry. Edema may be lessened by ergot or adrenaline. Intubation or tracheotomy may be neces- sary. A bloodless tracheatome, a sort of intubation process externally, is advertised by Huston Brothers Company, 35 Randolph St., Chicago, the merits of which physicians must judge for themselves, as I know nothing about it personally. 104 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Elaterin. Hydragogue Cathartic. Dose a twentieth to a twelfth of a grain. Elaterium. Drastic purgative. Dose one eighth to a half grain. Merck's Eleterin dose is a twentieth to a twelfth of a grain. Electricity. All currents can be used in diagnosis of real or pretend- ed paralyses and thus are useful in medico-legal cases. The applications, however, being quite an art as well as a science, based mainly on the differences between anodal and catho- dal milliamperage reactions of healthy and diseased muscles and nerves, determinable with the galvanometer and galvan- ism. For such purposes the galvanic and faradic batteries made by the Chloride of Silver Dry Cell Battery Company of Baltimore, Maryland, are most portable and complete. I have used a set for twenty years with entire satisfaction. Static electricity by means of the large revolving glass wheels or plates is so surprising and pyrotechnic that it can exert a faith-cure influence in some minor cases, among in- experienced, and in addition the static breeze will relax the spasm of the meningeal arteries upon which hysterical and some other autotoxaemic headaches depend. This form of current is strongly stimulant and where there had been res- toration of diseased tissue without accompanying restora- tion of function as in a few instances of cerebral or spinal paralyses, it proves useful to build up muscular tone. Faradic electricity is more handy in general practice, and the little buzzing apparatus is usually at hand among country practitioners and can be used for stimulation the same as the static current applications, in resuscitations of THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 105 opium narcotized and to arouse apparently drowned or as- phyxiated. Galvanic electricity requires considerable skill and care in cautery and other work of surgery, opthalmology, opera- tive gynecology, and in forcing medicines into tissues be- low the skin : cataphoresis. Electropoise. Quack trinket, similar to Oxydonor. Elephantiasis. Swollen misshapen skin. Xo remedy found. Embolism, Cerebral, see Brain. Emetin. An alkaloid and a resinoid confused with one another. Emissions. Monobromate of camphor in most cases. Emphysema, Pulmonary. Accumulation of air in cellular tissue of lungs. Iodide of potassium, empirically. Empyema. Pus in body cavity, as the chest. Evacuation, antiseptic washes, potassium iodide, strychnia and quinine. Encephalitis. Inflammation of brain. Treat as Brain Hyperemia, which see. Endarteritis. Inflammation of artery lining. Rheumatic, syphilitic or traumatic. 106 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Endocarditis. Inflammation lining membrane of heart, often rheumatic. Calomel and seidlitz powder, antirheumatics. See An- titoxins. Endometritis. Inflammation lining of uterus. Ichthyol, ergot, iodine, mercuric chloride, formalde- hyde, hydrastine. Enteralgia. Intestinal pain. Peptenzyme. Enteritis. Intestinal inflammation. Heat to abdomen, calomel, sulpho-carbolate of zinc if fermentative diarrhoea. Entropion. Inversion of the edge of the eyelid. Enuresis, see Bed Wetting. Ephedrine. Alkaloid mydriatic in place of homatropine. Ephilides. Freckles. Corrosive sublimate often used externally, but the freckles return and electrolysis has also been used. Trouble- some, expensive and uncertain are all attempts at treatment. Epididimitis and Orchitis. Testicle inflammation. Fine cut tobacco in bread poultice to scrotum, strap- ping testes with lead plaster strips, morphine if necessary. Epilepsy. Bromide of ammonium constantly with occasional in- tervals. If fit anticipated inhalation of nitrite of amyl pearls may cut short the attack for the time, but aside from ab- staining from cheese, bacon, much other meat or indigesti- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 107 ble vegetables, tobacco, liquors, little can be done for epi- lepsy in general. Colonies are increasing for their care. Avoid nostrums and the multitude of nonsensical things mentioned in medical journals and text books. In rare cases a brain operation or nitro-glyeerine have done good. Prob- ably not one epileptic among ten thousand recovers. Epistaxis. Nose bleed. Pledget between upper lip and front up- per teeth, pressure on blood vessels there sometimes arrests blood, severe cases adrenilin. Epsom Salts. Sulphate of magnesia, which with glauber salts, the sul- phate of soda, both cheap and common, are main ingred- ients in ''mineral waters." Epithelioma. Skin cancer. Surgery and caustics. Ergoapiol. The name indicates a union of ergot and apiol which are antagonistic in action, see Apiol. Ergot. Secale cornutum. Fluid extract is the best form, the dose of which is fif- teen minims to a dram. Merck makes an aseptic ergot for hypodermic use. The varied usefulness of ergot is far beyond its ordinary reputation. In obstetrics to close the uterus after the con- tents are safely expelled dram doses are given, but a too early dose will interfere with delivery by neck or irregular contraction as well as the body of the organ, though some promote regular contraction with it during passivitv in de- livery. An irrational use of ergot is in the first months of gestation to produce miscarriage. The ovum is too small to be more than firmly grasped by the ergotized womb at 108 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. this time, and at various stages if hemorrhage occur ergot is actually given in small doses to cramp down enough on the bleeding vessels to stop the threatened abortion. Headaches of the menopause or where there is throb- bing or other indication of hyperaemia may be relieved by ergot, ten to sixty minims of the fluid extract. In spinal meningitis the congested spinal vessels are constringed and pain relieved by ergot, in exophthalmic goitre the gland has become reduced by constant doses of this drug, and the pro- truding eyes have receded to a normal appearance owing to the lessened blood-vessel calibre induced in the gland and among the post ocular vascular tissues engorgement of which caused the protrusion. It is a good hemostatic in some cases especially internal, as in typhoid fever intestinal per- foration. Post partum hemorrhage is controlled by it, if no offending material is left in the uterus to renew the bleed- ing, which is often the case. In large doses it may cause abortion in later months of gestation, though the cervix is also firmly closed unless resisted by vis a tergo, and an or- dinary dose is more likely to prevent miscarriage for this reason. Ergotine. Bonjean. Alcohol purified aqueous extract of ergot. Dose 3 to 10 grains. Ergotinine. When pure it is inert. Ergotism. Poisoning by ergot. Spasms, paralyses and insanity. Ergotole, Liquid ergot for injection 5 to 10 minims. Eriodyctyon. Yerba Santa. Obsolete. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 109 Erotomania. Excessive sexual desire. Erysipelas. Ichthyol, resorcin externally and jaborandi internally, or piloerapine hypodermics. See also Antotixins. Erythema. Rose rash, roseola? mild inflammation of skin. Antiseptic washes or ointments. Erythroxylon coca. The plant from which the alkaloid cocaine is derived. Erythrol Tetranitrate. Xitrite of amyl is better. Erythromelalgia. Redness, swelling and pain in an extremity. A vaso- motor neurosis. Erythrophloeine. Suggested substitute for digitalis. Abandoned. Esederine. Calabar bean alkaloid, six times weaker than eserine. Unused. Eserine. Myotic. Mentioned also as motor paralysant in te- tanus, etc., but Conium maculatum is better to allay motor excitement and the tetanus anti-toxine is now effective and safer. Ether. Anesthetic. Ethyl Bromide. Can be used as a local anesthetic in spraying surface, 110 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. but not internally, as alarming symptoms are occasioned by it. Ethylene Bromide is too poisonous for any medical pur- poses. Ethyl Chloride. Local anesthetic, minor and dental surgery as spray. In tubes held in hand six inches away, heat of hand forces gas- eous spray out in jet, but it is highly inflammable. Has been used to start general anesthesia. Ethyl Iodide. Hydriodic Ether. Too unstable to be useful. Eudoxine. Bismuth salt of nosophen, on trial as intestinal antisep- tic and astringent. Eugallol. Pyrogallol Monacetate. Used in chronic obstinate psoriasis. Eugenol. Eugenic Acid, Caryophyllic Acid. Local anesthetic, antiseptic. Eumenol. Emmenagogue. Eucaine. Local anesthetic in eye surgery, resembles cocaine in effect. Eucaine A is irritant, B is not when properly used. Eucalyptol. Aromatic antiseptic oil. Eumorphol. A morphined rabbit or mouse serum tried as a remedy for the morphine habit, results dubious. Eunatrol. On trial for biliary lithiasis. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Ill Euonymin. Resin from euonymus atropurpureus, hepatic stimulant, used in constipation from hepatic torpor, not so active as podophyllin. Dose one half to 3 grains. Euonymus atropurpureus. Wahoo. An eligible form of this is Wyeth's elixir, a good hepa- tic tonic alterative in teaspoonful doses several times daily, a cholagogue laxative in liver disorders somewhat like calo- mel in its effects. Eupatorium. Old tonic, emetic and aperient. Little used. Eupeptic Hypophosphltes. Secret preparation. Euphorbia. Old emetic. Seldom used. Euphorin, Merck. Phenyl-ethyl urethane. Anodyne, antiseptic, internally in rheumatism, dusting powder in venereal diseases. Dose 8 to 15 grains twice or thrice daily. Euphthaimine Hydrochlorate. Transitory mydriatic. Euquinlne or Euchinin. Malaria and pertussis substitute for quinine. Euresol. Resorcin substitute. Eurobin. Chrysarobin substitute. Europhen. Not Euphorln. A cresol iodide antiseptic for surgery, like idoform. 112 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. Exalgin. Dangerous analgesic. Exodyne. Mixture of acetanilide, sodium salicylate and sodium bicarbonate. Exophthalmic Goitre. A nervous disorder with protruding eyes, enlarged neck under the chin from swollen thyroid gland, and rapid heart action. Ergot, digitalis, asafetida. Thyroid gland preparations invariably make this disease worse, notwithstanding rou- tine text books speak of it as among the remedies for ex- ophthalmic goitre. Expertism. Formerly it was something of an honor to be called as an expert medical witness into court, but owing to general inability to judge of specialist's qualifications lawyers have been able to impose the grossest ignorance upon juries as expertness, and corporations in damage suits develop special adroit perjurers to act with their own trained witnesses, while plaintiffs rarely are able to pay court costs, and most calamity lawyers swindle their experts if they risk contin- gent pay. So expertism has evolved into degradation. Facial Hemiatrophy. Diminishing muscles of half the face. Incurable. Facial Nerve. Seventh Pair, Paralysis. See Bell's Palsy. Fainting. Usually from inability of the heart to propel blood enough to the head, hence paleness of face and need for placing head low, the opposite of apoplexy with congested THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 113 face. Aromatic spirits of ammonia, or inhalation of am- monia. Stimulants can be given in fainting, but would be improper in apoplexy or head congestion. Faith Cure. Suggestive therapeutics seems to have taken its place, though it survives under various disguises, in Eddyism, Dowieism, Homeopathy, etc. Faradism, see Electricity. Farcy or Glanders. Deadly contagious disease caught from glandered horses usually by the nostril pus being blown in the face of the one inoculated causing ulcers due to bacillus mallei, most die in acute stage, few survive the chronic. Treatment curet and caustics, quinine and stimulants in large doses. Favus. Scald Head. Resorcin with tar and sulphur ointments, or formalde- hyde and olive oil. Feeble Mindedness. Schools for these unfortunates exist over the union, State institutions are at Waltham, Mass., Syracuse, N. Y., Elwyn and Polk, Pa., Vineland, N. J., Columbus, Ohio, Ft. Wayne, Ind., Lincoln, 111. Private schools in cities may be found through directories. One at Kalamazoo, Michigan, by Dr. C. T. Wilbur is a good one, and as these places are increasing yearly information as to the nearest one can be secured by communicating with any above mentioned. Thyroid treatment has done something for a small per- centage of cases but alienists are best equipped to advise its administration. Fel Bovinum. Ox Gall. Used where deficiency of bile presumed, supposed tonic 114 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. and laxative. Dose 5 to 10 grains of the dried preparation. It enters into the composition of several digestants. Feniculum. Fennel. Ancient aromatic carminative. Oil of Fennel dose 5 to 15 drops to expel flatus. Ferratin. Iron tonic. Acid albuminate of iron. Ferropyrine. Iron tonic and astringent. Ferro-Salicylata. Salicylic acid from wintergreen oil. tincture of iron chloride, citrate of ammonium, for rheumatism. Ferrum Sanguinis. Blood iron. Capsules of 25 centigrams, dose 2 to 4 cap- sules before meals. Fever. A mere symptom of different diseases. Rarely advis- able to reduce the temperature with antipyretics. Fevers are of many kinds and at first nearly all seem alike, but de- velop differently, and there is nothing to do save to watch developments, ordinarily, unless attendant conditions point to the nature of the fever, as septic, malarial, puerperal, ty- phoid and so on. Eruptive fevers require watching and fre- quent examinations till their diagnosis is certain. Felon. Inflammation of periosteal bone covering. Incision should be carried down to the bone to let out the burrowing pus. Then antiseptics can be used. Poultices are dirty and worse than useless. THERAPEUTICS, MATERIA MEDICA A.ND PRACTICE. 1 1 5 Fibroma. Soft connective tissue tumors. Excision. Filarla Mediensis. Guinea Worm. Usually under skin of foot like a coil of string, from drinking water in which larva of dracunculus mediensis oc- cur. Inject i to ,1,000 corrosive sublimate and a few days later cut out the worm. Filaria sanguinis hominis. Parasite cause of elephantiasis. Filicic Acid. Inert. Filix Mas. Male Fern. Tape worm anthelmintic. Dose of powder i to 3 drams. of ethereal extract 12 to 24 grains. Ficker's Typhoid Diagnostic. A modification of the Gruber-Widal test does away with living bacilli, the microscope and delay. Merck pre- pares a specially treated and sterilized typhoid culture, with the apparatus and full instructions for using. The aggluti- nation and clearing being similar to the Widal test. Figs. The small seeds of figs make them a mechanical laxa- tive, just as berries are for the same reason. A syrup, how- ever, is a mere flavor. The advertised ''syrup of figs" con- tains senna. Finsen Light. Positive Finsen Light in skin diseases are the chemical rays to kill bacteria in the skin, perhaps by the inflammation the light causes, hence maybe no better than any irritant. Negative Light treatment is the exclusion of chemical 116 THERAPEUTICS, MATBRIA MEDICA AND PRACTICE. rays by using red rays to modify dangerous symptoms of small pox, the secondary fever and its suppuration. Useful- ness dubious, and light declared by some to be harmful in small pox. Firwein. Secret. Fissured Nipples. Clean after each nursing and dust corn starch on nipple. Using ointments, antiseptics and other offensive applica- tions will sicken the infant. Fissures, see Anal Fissures. Fistula, see Anal Fistula. Flatulence. Abdominal and stomach wind. Carminatives as pep- permint, or bicarbonate of soda or seidlitz powder, if diar- rhoea sulpho-carbolate of zinc. Flaxseed. The whole seed in boiling water allowed to cool and flavored with lemon makes a useful demulcent drink in var- ious ailments such as throat affections. The ground seed is used for poultices. Fleas. The penetrating sand flea or jigger is killed by chloro- form and may then be dug out with a blunt needle. The common flea may be treated with ammonia water. Fleming's Tincture of Aconite. Very strong preparation, being 79% where the ordi- nary tincture is 35%. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 117 Flexible Collodion. Contains 20 grains Canada turpentine and 10 grains of castor oil to the ounce. Folie a Deux. Similar insanity in associated persons. Usually in- curable. Food Adulterations. A frequent cause of disease. Borax, boracic acid, sali- cylic acid in meats, also sodium sulphite, debilitate and de- stroy appetite even in small doses. Liquors are particularly dangerous from adulterations. Foods and Dietetic Products. Most of them are too expensive. Liebig's Extract of Beef has been accused of being practically concentrated urine, and students of the subject in general could gain in- formation from the official inquiry into the nature of canned beef bought for the American army in Cuba. Side lights were thrown on other food preparations. Most prepared and predigested foods are foolish, innutritious, costly fads. Trophonine is an exception. Foot Baths. With hot water afford a prompt derivative means of re- lieving head congestion, ear-ache from hyperemia and warming the circulation. An aid to other derivative meth- ods as catharsis, etc. Forcible Feeding of Insane. The nasal tube is best with funnel into which may be poured suitable liquid food, stomach pumps are out of date. Formaldehyde. Aqueous solution of formaldehyde gas, about 35 per cent. General antiseptic, but internally as when used to 118 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. preserve milk it destroys digestion. It hardens tissues and is therefore used in preserving anatomical specimens. Anti- dote ammonia acetate and inhalations of ammonia. Formol and Formalin are brands of formaldehyde, for trade purposes. Formin. Same as Aminoform and Urotropin. On trial as uric acid solvent. Formin Salicylate, see Saliformin. Fowler's Solution. The best form for the administration of arsenic, but must be freshly made as it deteriorates by chemical union with glass of bottle. Many failures to secure effects of ar- senic are due to solution being too old. Dose one minim to 5 minims daily for acne of bromism in epilepsy, in chorea the beginning dose can be 5 minims gradually increased to 15 or 20 and if conjunctivitis, gastric or kidney disorder withdraw remedy awhile and commence again with smaller dose. Dilute with water. Frambesia. Raspberry like papules, epidemic and contagious in the tropics. Mild antiparasitics and tonics. Frangula. Buckthorn. Contains a cathartic glucoside Frangulin supposed identical with active principle of Senna. Dose of fluid ex- tract half a dram to 2 drams. Freligh's Tonic. Secret. Probably strong tincture mix vomica mainly. Friedreich's Ataxia. Inability to regulate movements clue to congenital mal- formation of the spinal cord. Incurable. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 119 Frier's Balsam. Compound Tincture of Benzoin. Ancient vulnerary, pectoral and application to ulcers and chaps. Benzoin, aloes, storax, tolu. alcohol. Xot much used now. Frostbite. Rub with" snow, later turpentine, camphor, ichthyol, carbolized vaseline. Fuchsine. Because this stain changes the appearance of histologi- cal specimens it has been irrationally suggested for nephri- tis, anasarca, etc. Fucus Vesiculosus. This sea weed contains iodine which was the effective agent when used as anti-fat, but it proved dangerous when taken to reduce weight, as several deaths were occasioned by it. Furuncle of Nose. Open with needle and apply camphophenique or other strong antiseptic. Furunculosis. These little "cat-boils" usually appear in the left ear, sometimes as far in as the membrane, they are due to the burrowing of micrococci at the roots of the hairs, pus forms and crop after crop grows till extirpated, then the right ear is often infected. Ear spoons, pins, or other instruments abrade the surface and make new places for infection. A couple of weeks ends the nuisance, even if no treatment, un- less there is diabetes or some depressed state of the system. Erysipelas or mastoiditis have sometimes followed. Anti- sepsis of the external ear is the proper treatment. 120 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Gaduol. Alcoholic Extract of Cod Liver Oil. A wine of cod liver oil is also made with Gaduol, but many of these kinds of substitutes for the pure oil are unsatisfactory. Gaiacophosphal. Guiacol 92% and organic phosphorus 7%, capsules, solution and tubes. Galactorrhoea. Excess of Milk. All medicines taken by mother affect nursing child. Bandaging helps to reduce size of breast but is painful. Af- ter weaning iodide of potassium, ergot and atropine inter- nally or camphor and lanoline externally or a belladonna plaster over breast. Galbanum. Ancient expectorant, intermediate in power between ammoniac and asafetida. Seldom used. Gall of Ox. Fel Bovinum. Laxative, Digestive where as in typhoid fever there may be biliary deficiency. Gall Stone- see Biliary Calculi. Galvanism, see Electricity. Gamboge. Mainly for use in Compound Cathartic Pills. Gangrene. Phagedena. Mortification. Dry and moist necrosis, formerly a formidable hospital plague, but modern antisepsis has almost eradicated it. An- tiseptics in strength graded to severity of tissue damage. Garantose. A saccharine for diabetics. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 121 Gastralgia, Gastrodynia. Stomach pain. Heat to surface, peptenzyme, compound spirits of ether, bicarbonate of soda, seidlitz powder ordinarily, but if stom- ach cancer or ulcer is the cause of the pain flaxseed tea with, if unavoidable, morphine. Gastric Ulcer. Avoid solid food and bismuth. Use mild astringents and antiseptics and if hyperacidity bicarbonate of soda. Er- got occasionally. Flaxseed tea lemonade. Trophonine is the best liquid food. Rectal feeding fails and inflames bowel. Gastritis. Inflammation of Stomach. If alcoholic stop stimulant. Use lime water and plenty of buttermilk, bicarbonate of soda, vichy water. Try to live on buttermilk or peptonized milk. Avoid greasy food, pastry, steak, cabbage, cheese, liquors. Gaultheria. Wintergreen, increasingly used internally and exter- nally in rheumatism. Gelanthum. A new vehicle for skin-disease medicines. Gelsemium. An active but too dangerous depressant, which has killed more pneumonia and neuralgic patients than can ever be justified by the little good it may have done. General Paralysis. Obsolete term for insanity now called paretic dementia. Gentian. A bitter used as an adjuvant in tonics and as a tobacco substitute with those who endeavor to break the habit, also in some inebrietv cures. 122 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Geosote, see Guiacol Valerianate. Geranium. Astringent. Geum. Water Avens. Tonic and astringent. Gillenia. Mild emetic, substitute for ipecacuanha. Dose of pow- dered root 20 or 30 grains repeated every 20 minutes till it vomits. Gin. Popularly suposed to be a kidney and bladder remedy as juniper is slightly diuretic and the berries were formerly distilled in alcohol to make schnapps, but modern cheap methods make gin from a few drops of juniper oil in poor alcohol. Ginger. Zingiber. Carminative stimulant, useful in flatulence or colic. Gingivitis. Inflammation of the gums. Bicarbonate of soda and tincture of myrrh, alum, bo- rax. Ginseng. Panax quinquefolium. This root has a psychological value as demonstrating what credulity will do among an unscientific people. The Chinese venerate it as miraculously able to cure all diseases, while white quacks occasionally prescribe it, but it has very feeble tonic properties and is demulcent, some falling into the habit of chewing it. One writer attaches importance to the fact that 400,000,000 people believe in ginseng as a medi- cine, a matter of as much importance as that none of them believe in Christian science. Superstition works with or without so called medicines. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 123 Glanders, see Farcy. Glandular Enlargement. Adenitis. Lymphatic gland in- flammation. Calomel hourly in tenth grain doses. If persistent syrup of iodide of iron. Glauber's Salts. Sulphate of soda, a frequent ingredient of popular mineral waters. Glaucoma. Eye ball hardness and progressing blind- ness. Ophthalmologists use eserine, cocaine, pilocarpine, atro- pine leeching and warm fomentations, but with little if any result. Glioma. Incurable tumor composed of cortical brain substance. Globus Hystericus. Feeling of a ball rising in throat preceding hysterical convulsions. Glonoin. Xitro-glycerine. Vascular stimulant increasing peri- pheral blood pressure, hence useful in nephritis, vasomo- tor weakness, epileptic and hysterical convulsions, amau- rosis, etc. Dose a hundredth of a grain. Glossitis. The acute inflammation of the tongue can be treated with ice locally but if abscesses they should be evacuated. The lesser form yields to mild antiseptic mouth washes. A variety called leucoplacia or map tongue with white veins erroneously supposed to be syphilitic needs no treatment. 124 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Glosso-labio-lingual Paralysis. Progressive medulla destruction. Fatal. Glossy Skin. A rare atrophic affection usually of fingers due to in- jury of nerve, which recovers in time, unless mischievous treatment used. Gluside, see Garantose. Glutannol. Tannin and vegetable fibre. Not much used. Glutol. Formaldehyde Gelatin. External vulnerary. Gluton. Specially treated gelatin. Not much used. Glycero-Phosphates. Organic glycerophosphates of nerve substance com- bined with lime, etc. Glycogen. Liver starch, a French preparation advertised as a rem- edy in diabetes, typhoid fever, cachexia, septic troubles to aid phagocytosis. Extensive claims are made for its thera- peutic value. On trial. Capsules of one grain and tubes for hypodermic use. Glyco-Heroin, see Heroin. Glycosal. Suggested substitute for salicylic acid. Glyco-thymoline, see Glycerine. A secret antiseptic. Glycosuria. Sugar in the urine is not always an indication of dia- 125 betes mellitus for it occurs often to a limited degree in var- ious ailments especially mental, as in melancholia. Glycerine. Abstracts water from surfaces hence useful externally as with clay in such things as Antiphlogistine, Antithermo- line, Glyco-Kaolin or similar mixtures of clay and glycerine, but for internal use as an ingredient of a tonic or antiseptic it is apt to cause catarrh of the mucous membranes. Cot- ton dipped in glycerine makes an excellent vaginal tampon applied to the uterus to reduce engorgement. In a few min- utes a watery discharge is produced from the congested or- gan which greatly relieves prolapse, inflammation and the bearing down pains of pelvic congestion. Glycerine Suppositories. Induce a watery discharge from the lower bowel a few minutes after insertion, and are often better than medicines or enemas in relieving constipation of lower colon. Glycerine Tonic, see Glycerine. Glycozone. Secret. Glycyrrhiza. Licorice root from which stick licorice is made, which is the extract. Goa Poder. Source of chrysophanic acid. Godfrey's Cordial. A dangerous paregoric containing- a grain of opium to the fluid ounce. Goiter, see Exophthalmic Goiter. The kind that involves structure more than function is unchangeable. 126 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Gold Salts. The various chlorides, iodides, monobromides, cyan- ides, etc., are not satisfactory as medicines. Gonorrhoea. Copaiba and cubebs in urinary medication have been poor antiseptics, occasioning stomach catarrh and kidney disorders. The bladder and urethra being infected by var- ious micro-organisms, especially the gonococcus, the rat- ional medication is by direct antiseptis, and if permissible also indirect or internal. Several new preparations are urged as filling the requirements for both these desirable means of destroying germs, but such things as uriform are still on trial. This preparation consists of ammonium formaldehyde as a base associated with sandal wood and saw palmetto. In cystitis, urethritis, prostatic disease, and especially in gon- orrhoea a direct antiseptic is badly needed. Formaldehyde is too strong and the bichloride of mercury has to be diluted too much to be useful. The least harmful antiseptic for such purpose is probably borax or boric acid, small well diluted amounts of carbolic acid have been injected in cystitis, but all these are trivial in effect upon gonorrhoea. Douches of permanganate of potassium once or twice daily have recent- ly come into use with varying success. As the mercury globules appear to roll foreign particles within, enveloping them, and as undoubtedly micrococci would thus be washed away from a mucous surface it occurred to me that filling the urethral canal with mercury, the liquid metal, would of- fer more chances of removing the gonococci than any other means. The metal is not absorbed, but would gravitate out as soon as permitted to do so. and complete distention of the urethral canal with the metal could be repeated with whatever accessory means desired. The removed mercury should be resublimed or some other effective means should be used to rid the liquid of the germs, which are not de- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 127 stroyed but are enveloped by the metal, enabling their re- moval. Acids that when cold do not unite with mercury could burn the cocci and the metal be fitted for use again by washing with water. Peroxide of hydrogen, whether under one or more names, as deutoxide, hydrogen dioxide, or when mixed with glycerine, is sometimes erroneously supposed to be a germ- icide, but it can only destroy pus or remove the pabulum upon which the germs feed, rendering them merely latent. Gonosan and light diet with salines also used. Gonosan. A preparation of Kava-Kava and Santal-wood Oil in treating gonorrhoea said to relieve pain and shorten attack. Dose 2 capsules, 4 or 5 times a day. Gossypium. Cotton. Seeds used in southern states as an alterative and the bark of the root said to be used by negroes to cause abor- tion. Goulard's Extract. Lead acetate solution. Other things can be substituted for this old astringent, as it is likely to induce lead poison- ing. Gout. Piperazine, lithium citrate, sodium salicylate, Chapa- teau's colchisal. Avoid high living and liquors. Ordinary colchicum and the articial salicylates are irritating and worse than useless especially when combined. Potassium iodide and diuretics are useful. But treatment should not only be alkaline internally and externally, out saturating, as a little merely increases pain by calling the uric acid from where it is deposited in the joints and circulating it through the system en route toward elimination, but it should be 128 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. seen that actual elimination and entire neutralization oc- curs, so treatment must be prolonged. Granati Radicis Cortex. Pomegranite rind, tape worm anthelmintic. The best form is Tanret's Pelletierine, a syrup arranged in single doses. Granular eyelids. Trachoma. Infectious, so public towels should not be used. Boric acia solution, weak corrosive sublimate solution, resinol. Caustics leave unsightly scars. Granulations, Exuberant. Proud flesh. Dried alum, nitrate of silver, blue stone, or other caus- tic. Granuloma Fungoides. Inflammatory fungoid neoplasm. No treatment found, beyond quinine and antipyrin to relieve the itching. Gravel, Renal, see Calculi. From nephrolithiasis or rheumatism. Piperazine and lithia. Graves' Disease. Exophthalmic goitre. Green Sickness, see Chlorosis. Green Soap. Sapo viridis. Seldom referred to in literature but is still used in hos- pitals. In Merck's German Index it is called Sapo kalinus venalis, for disinfectant cleansing. Formerly in eczema. Grindelia. Formerly tried in bronchial troubles and now used in ivy poisoning. In the latter it seems of some service when the fluid extract of Grindelia robusta is painted on the poi- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 129 soned surface, but probably its effects are those of all vege- table astringents, an improvement upon the puckering lead applications in such cases. Grippe. Influenza. La Grippe. Guacamphor. Guiac and camphoric acid. Dose 3 to 20 grains for night sweats. Guarana. Paullinia. Effects similar to tea and coffee, if active principle is not identical with caffeine. Formerly used for headaches, but a cup of coffee will answer as well. Guiac. Lozenges containing guiac are good in tonsilitis, sore throats and coughs of various sorts. It is a good internal antiseptic, excess causes diarrhoea, with benefit to rheumatic conditions. Guiacol. Of late years Guiacol in a variety of forms and combi- nations has been urged justifiably for internal antisepsis, mainly for the air passages. It is used in phthisis and bron- chitis. Also 5% ointment in lumps, spread over parotid and scrotum. Guiacol Benzoate, Carbonate, Phosphite and Valeria- nate. With other Guiacol preparations are mainly addressed to the same ends as Guiacol. Guiacophosphal, see Guiacol Phosphite. Gummata. Syphilitic tumor, often in brain and multiple. Iodide of 130 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. potassium and mercurials the only treatment, operations useless. Gymnastics. When applied as treatment gymnastics are in the un- fortunate predicament of the most elaborate apparatus be- ing controlled by ignorant charlatanry, while the little that is useful about it the competent physician or surgeon does not take the trouble to learn. If the gymnast would co- operate with the doctor good might be done, but masseurs seldom care to do so. Habit-chorea. St. Vitus dance grown into a habit. Curable by dis- cipline, making the child wash its face every time it grim- aces or makes silly motions. Hair Falling Out, see Alopecia. Hallucination. An unreality seen, heard, smelled, felt, tasted, indicat- ing brain cortex derangement, not necessarily insane. Hamamelis. Same as witch hazel or Pond's Extract. This has taken the place of the old fashioned arnica flowers in alcohol, as a domestic cure-all for bruises. A slight sedative effect ap- pears in both these plants, but the alcohol is the main sooth- er by refrigerating evaporation. Hay Fever. Pollantin is an antitoxic serum from the pollen of plants causing the asthma, autumnal catarrh, rose fever, etc. Fritz- sche Brothers, N. Y., 37 Barclay St. advertise it to physi- cians, but as it is new and on trial not much can be said about it at present. See also Asthma. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 131 Headache. The most frequent cause of recurring sick headaches is auto-toxaemia. Women especially confined to the house and not sufficiently enough out of doors to oxygenate their blood permit their bowels to become irregular and the sys- tem simply rebels at the overload of poison retained. The only sensible treatment is to induce regularity, but this is not an easy matter, then especially is to be avoided the in- stituting of a habit of reliance upon cathartics, for soon enor- mous doses have to be used from the bowel paralysis. Me- chanical lubrication with a morning dose, repeated twice daily if necessary, of a tablespoonful of Stone's Swampscott cod liver oil after meals, preceded each morning by a tea- spoonful of Carlsbad salts in powder in a cup of water*before breakfast, and if the bowels become too much relaxed the salts can be less often used, but as a rule the Carlsbad which is merely Epsom and Glauber salts, affect purification of the secretions more than acting as a laxative. Continuing this course steadily for a year or more if needed will free the pa- tient from liability to these distressing cephalalgias. Anti- rheumatics have to be taken in addition at times as rheumatic headaches are of this same autotoxaemic class. Then there may be hysterical involvement, for hysteria is also a toxae- mia of the nervously constituted, in such cases neglect of treatment is apt to occur if the patient is not managed. Or- dinarily anything will cure a hysterical headache for the time, a mental impression, a static electrical breeze, a scold- ing or surprise, and the patient may even forget that she has a headache. Avoid opiates, acetanilides, bromides and other debauching drugs. A common form of intractable headache is from astigmatism or other eye disease. A properly fitted pair of glasses disposes of the headache. Half sided head- aches occur in degenerates as epileptiform spasms in which one side of the face may be suffused with blood, the angio- 132 THERAPEUTICS, MATERIA MED1CA AND PRACTICE. paralytic kind, or there may be extreme pallor of half the face, the angiospastic kind. Pressure on the carotid on the side of the redness relieves this latter headache for awhile, and so may doses of ergot remedy the flushed kind, and ni- trite of amyl may break up both. But as autotoxaemia is the exciting cause of these epileptic like paroxysms a thorough cleaning out is imperative, and yet so inert may be the bowels from habitual atonicity that large doses of strychnia may be required to enable the cathartic to act. The cod liver oil and salts treatment may then be maintained. There are rheumatic headaches, those due to congestion from worry or overstudy, and anemic headaches which food or a cup of coffee dispose of. The cause of the head pain must be in- telligently sought and treated properly, and the pernicious practice of treating all headaches alike with acetanilid or other "headache" powder, is quackish in the extreme, and there are vastly more deaths from using such dangerous stuffs than the public or even physicians are aware. In fewer cases headaches may occur from strong light in read- ing, from medicines taken, as quinine, potassium iodide, or stimulants, or a severe cough may propel blood to the head, severe vomiting may do the same. After ovariotomy head- aches occur from a readjustment attempt of the circulation, and at the climacteric a normal atrophy of the ovaries dis- turbs the circulation similarly causing not only headaches but general nervous disturbances. Ergot at such times aids equilibration of the blood course. After dysentery auto- toxemic intestinal states induce headaches and mental weak- ness, which prompt tablespoonful doses of castor oil clear off surprisingly well. If necessary such doses can be taken for long periods with benefit. Headache Powders. Almost invariably dangerous as they contain acetani- lide, disguised. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 133 Heart Diseases. The custom of reiving upon digitalis for the many forms of cardiac ailments in harmful. Even where it may be suitable for the time it is not a drug that should be in- definitely used, nor should glonoin be continued too long for in a recurrence where it would be of value its habitual use deprives it of good effects. As for heart depressants my conviction is that they are barbarous, and will eventually be disused. See also Valvular Heart Disease. Hebephrenia. Insanity of puberty, a developmental defect, character- ized by silly behavior, offensive speech and mischievousness. Work in open air especially on a farm affords best chance of recovery which amounts to 50% of cases. Hebra's Itch Ointment. Unguentum Sulphuris Compositum. Hedeoma, Pennyroyal. Domestic emmenagogue, acting mainly by setting the mind at rest as something was being done to restore the menses which returning naturally the pennyroyal tea had the credit. Lately its perfume is used to keep off mosqui- toes and fleas, but citronella is less unpleasant for this pur- pose. Hedonal. Hypnotic, on trial. Dose 15 to 30 grains, but the taste is disagreeable, and its bulkiness makes the powder difficult to use. Helenin. Demulcent antiseptic. Obsolescent. 134 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Helleborein. Glucoside substitute for digitalis and local anesthetic. Seldom used. Helmitol. Antiseptic and diuretic. Dose 15 to 20 grains 3 or 4 times daily in prostatitis. Hematemesis. Vomiting of blood. May be in consumption, stomach ulcer, or from teeth. Hysterical girls may suck their gums forcibly till they bleed to excite sympathy. It is seldom useful to do anything in blood spitting. Salt does not stop it. Styptics seldom reach the source. Hematoxylon. Logwood. Coloring material, astringent, not fit for medicine. Hematuria. Bleeding from the bladder. May be renal, vesical or urethral. Remedies addressed to such parts to stop bleeding are rarely of use, save occas- ional styptics in the urethra, or a dilute bladder injection of astringents. Hemianopsia. Loss of half the visual field in both eyes. Hemicrania, see Headaches. Half sided headache, sufferers usually predisposed by heredity, and acute attacks due to autotoxemias. Clean out and strengthen. Hemiplegia, see Paralysis. Half sided paralysis, usually from brain lesion. Hemlock. Conium Maculatum. Hemocytolysis. Rapid destruction of blood cells, from general burns, THERAPEUTICS, MATERIA MEDICA AND PRACTICE 135 snake poison, arsenic, toadstools, quillia saponaria, solanum and other motor depressants, and leads to hemiglobinuria; guiacol in excess, nitrites, as in manufacture of nitro-gly- cerin and amyl nitrite; nitro-benzol, potassium chlorate, and bromides, pyrogallic acid, antifebrine, acetanilid, antipyrine, carbon monoxide and prussic acid poisoning, also electrocu- tion, lightning stroke, etc. Hemogallol. Dubious Tonic Hemoglobine. Red coloring principle of blood, which owing to its or- ganic iron has been given in anemia and chlorosis, in doses of one and a half drams to 3 drams daily. Its complexity is seen in its containing 636 atoms of carbon, 1025 of hydro- gen, 164 of nitrogen, 181 of oxygen, 3 of sulphur and 1 of iron. But as an exception to other metals and minerals, iron, whether organic or inorganic is readily taken up in the sys- tem, accounting for the success of the multitude of iron pre- parations, regular and irregular. Hemol. Another minor blood tonic. Hemoptysis. Blood spitting, see Hematemesis. Hemorrhages. Ligation, styptics, astringents, pressure, protectives. Hemorrhagic Diathesis. Liability to hemorrhage from skin, etc. Glauber salts in full cathartic doses and ergot internally to stop hemor- rhage for the occasion, but nothing can be done for the habit. Hemorrhoids. Piles. According to degree, sometimes prolapsed requiring 136 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. support and return, sometimes excision. Carbolic acid di- lute injections may clot blood and by venous emboli cause death. Ordinarily a suppository called Anakesis made of slippery elm and astringents relieves. Resinol for itching piles. Henbane. Hyoscyamus. Hepatic Torpor. Calomel, euonymus atropurpureus, mineral acids, strychnia, quinia, rhubarb, podophyllum, bicarbonate of soda. Heroin. One of the numerous disguised opium derivatives, used in allaying cough which it does promptly, but the numer- ous heroin habitues indicate that it is being abused. As could have been anticipated from its derivation, heroin is too closely allied to morphine not to furnish victims to a heroin habit. Its recommendation as an antaphrodisiac is unreasonable, morphine will destroy genesic desire also, but should not be used for that purpose ordinarily. Stops irri- tating coughs so readily the query can be raised if it may be safe in the end to use a paralysant that allows mucus to ac- cumulate and finally choke. As a temporary resort, and temporary only, heroin certainly gives relief. The best way is when giving a cough medicine in which there may be heroin, to continue the same medicine but without the her- oin, not informing the patient of the change to enable the good effect of the mental impression to remain. Were you to tell some hysterical case that you had taken away the heroin that allayed the cough, at once there would be a paroxysm that would not occur otherwise. The dose is a twelfth of a grain, combined usually with expectorants. Heromal. A malt extract mixture with hypophosphites and her- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 137 oin. Questionable value as heroin is dangerous, the hypo- phosphites useless as an alterative and malt extract expen- sive. Herpes. Often mistaken for chancroids, small vesicles later forming pustules, harmless, not constitutional or due to venereal disease. Same as fever sores around mouth. Calomel dry as dusting powder. Do not use washes or ointments. Avoid moisture, keep cleansed. Lasts about ten days. Bad recurring cases may need tonics. Herpes Zoster. Vesicles most often on one side in course of deranged intercostal, lumbar and trifacial nerves. In opthalmic va- riety the eye may be destroyed. Pain always present, re- quiring alleviation even morphine must be used. Recovers in three weeks. A paint is useful made up of a dram of ichthyol to an ounce of collodion. Galvanism also relieves pain. Tonics later. Hetol. Sodium cinnamate. On trial in pulmonary tubercu- losis. Hexamethylene Preparations, see Formin. Hiccough. Phrenic nerve and diaphragm spasm. Stops when pa- tient suddenly surprised or required to keep tongue out. If dependent on serious lesion it may end fatally in spite of all attempts at relief. Amyl nitrite inhalations in bad cases. Hidebound Disease. Scleroderma. Stiffened integument. Tonics and locally oil applica- tions. 138 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Highmore Antrum Disease. Dentistry in most instances, antiseptics and antlphlo- gistics. Homatropine Hydrobromate. Transitory mydriatic. Sometimes used in night sweats of phthisis. Homeopathy. Suggestive therapeutics, or faith cure with sugar pills. False homeopathy ignorantly risks regular medicines, pre- tending they are homeopathic, particularly alkaloids be- cause they can be used in minute doses. Homicidal Insanity. Degenerate periodical impulse to kill, but with no other symptom of insanity. Incurable. The lawyers may be rec- onciled to nature, whose laws they so often find inconven- ient, in this case by knowing that the true homicidal impulse sufferer seeks to be controlled and avoids murder. Hops. Humulus lupulus. The slight hypnotic influence of hops has not induced pharmacists to make much out of lupuline or other hop pre- parations. It is singular that patent medicine fakers have not taken advantage of the popular superstition that hops are great sleep producers to put on sale some murderous morphine compound and call it a hop mixture. Hordeolum. Stye, Resinol and evacuation of pustule, boric acid wash or borax water. Hot Water. Mentioned as a reminder that its external use and oc- casional internal use are too often neglected in favor of less effective medicines. It is alterative as a derivative, stimu- THERAPEUTICS, MATERIA MED1CA AND PRACTICE. 139 lant to vital processes, evacuant as an enema and hypnotic also by enema or as a foot bath and a reliever of pain and sedative by distributing the circulation. It aids elimination by the pores. Hives. Urticaria. Nettle rash, pink elevations of skin with intense itching, from diet indiscretions, some more liable than others after eating crustaceans as lobsters, or berries. Drugs affect cer- tain people in this way. Acute cases get well in a few days and chronic cases practically incurable. Atropin, arsenic, pilocarpine internally and antiseptics externally, alkaline baths, anti-rheumatic methods. Hive Syrup. Compound Syrup of Squills. Hoarseness. Lemon juice and syrup, guiac lozenges, cod liver oil, morrhuol and creosote, hot applications to neck, turpentine or mustard to throat, elixir terpen hydrate, hoarhound candy. Hoffman's Anodyne. Compound Spirits of Ether. Holocaine Hydrochlorate. Local anesthetic like cocaine. Homatropine. Resembles atropine but effects transient, dilates pupil rapidly for shorter time. Used in night sweats of phthisis. The salts are hydrobromide hydrochloride, salicylate and sulphate. Homatropine prescribed in same doses and forms as atropine. Huxham's Tincture. Compound tincture of cinchona which as the "cinchona rubra cure for drunkenness," about 1885 made its proprie- 140 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. tor, D'Unger, rich and increased the number of drunkards, as his tincture was strongly alcoholic. Hux-SaL Huxley's antiseptic salt, for making non-toxic solu- tions, i in 20. A combination of aromatic and other anti- septics. Hydracetine. Abandoned substitute for chrysarobin. Allied to phe- nylhydrazine used in micro-chemical glucose test. Hydrangea. Root used in calculous affections, removing gravel and attendant pain. Dose fluid extract half an ounce to 2 ounces. Hydrargyrum, see Mercury. Hydrastine. Alkaloid of hydrastis candensis, insoluble in water con- stringes uterus, used in metrorrhagia, typhoid, dyspepsia, hemorrhoids, aphthae, skin diseases. The nitrate and tar- trate soluble in hot alcohol and water. Hydrastinine. Oxidation product of hydrastine. Hydrochloride most used for uterine hemorrhage, dysmenorrhoea, hypoder- mically 1 grain in 10% solution. Hydrastis Canadensis. Golden Seal. A fairly useful drug that has been diverted to useless directions. As an astringent to mucous surfaces it acts blandly and efficiently, and its astringency can be referred to the tannin existing so universally in many plants. As to its alleged tonic or anti-epileptic power it is simply too feeble for demonstration. In hemorrhages, gonorrhoea and leucorrhoea in females and as an injection in the male ure- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 141 thra it acts as a mild efficient astringent. Of the various hydrastine preparations one made by Merrill that holds its solvency, even when mixed with other things, is called Mer- rill's fluid hydrastis, and can be used in the proportion of 5 to 10 percent dilutions in water as an injection in male gon- orrhoea, but there is no good reason to use hydrastis inter- nally. An alkaloid is berberine. Hydrazine. Allied to hydroxylamine hydrochloride. Dangerous cancer applications. Hydriodic Acid. Doubtful if any advantage over iodide of potassium. Hydrobromic Acid. No advantage over bromides. Hydrocele. Scrotal Dropsy. Surgery. Hydrocephalus. Water on the brain. Infantile cases are tubercular and usually die early. Medicines useless. Hydrophobia. Rabies. Pasteur Institute as soon as possible. One can be found in each of the following places: Chicago, Baltimore, Atlanta, New Orleans, St. Louis, Pittsburg, Ann Arbor, Michigan. The treatment consists in hypodermic injec- tions of a specially prepared virus of different strength for 15 to 21 days according to severity of case. It is well toler- ated and harmless even though suspicion of hydrophobia may not be justified. By far the most frequent bites conveying rabies are by dogs, then follow cats, horses, skunks, wolves, cows, calves, asses, coyotes, rats, mules, pigs, sheep and human beings. 142 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. At the Institutes patients are classified as first, those bitten by animals recognized and ascertained to be rabid by the test experiment made in the laboratory or by the death of other animals or persons bitten by the same animal ; second, persons bitten by animals recognized to be rabid by the symptoms of disease shown during life; third, persons bit- ten by animals strongly suspected to be rabid. The mortal- ity was formerly placed at 88 per cent, but the Pasteur treat- ment has reduced it to less than half of one per cent. Mad-stones are survivals of ancient superstition and bad reasoning. They may affect the imagination of cases where the bites were not rabid, but supposed to be. There is a spurious hydrophobia, a mere nervous disorder in weak minded persons, in which they snap, growl, bite and bark as they think rabid dogs do. A mere hysteria and dementia. See Lyssaphobia. Ordinary pumice stone or any similar porous material previously soaked in any green coloring matter, vegetable juice or permanganate of potassium and made to adhere with cerate or anything that is sticky, has been used not only by quacks but occasionally by graduates in medicine to reach the demand of the ignorant for a madstone. Placed in water the coloring is washed out and the bitten person tells of how the stone sucked out the "rank, green pizen" from the wound. It is as good as Christian science or other humbuggery, but like it, it will not answer in real cases. Quick cautery and the Pasteur Institute is far safer. Hydrochloric Acid. Muriatic Acid. Caustic, diluted dose 5 to 10 minims used when gastric juice feeble or as hepatic stimulant, but used less every year. Hydrocyanic Acid. Prussic Acid. So liable to decomposition and so deadly a poison it is best to use only the plant preparations in which this acid is found, as wild cherry, etc. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 143 Hydrogen Dioxide. When freshly made without preservatives is best for antiseptic purposes, to volumes, 3%, but when used as a depilatory, hemostatic or bleaching purposes quicker results are secured with a 30 volume solution of 9%. Hydroleine. Partly secret. Hydronapthol. Beta-napthol derivative. Enteric fever, diarrhoea, ty- phoid fever, 3 or 4 grains every 2 hours. External antisep- tic 1% in glycerine and alcohol. Hydrotherapy. An attempt to make the old quackery of hydropathy respectable, but the temptation seems irresistible to use water treatment as a cure-all, when it does more harm than good. Hydrothorax. Pleurisy. Calomel and other purges. Antiphlogistine, aspira- tion. Hydrozone. Partly secret. Hygiene. Consists in how to maintain health and prevent disease. The average air necessary for health is 3,000 cubic feet per hour, and water consumption per individual 16 to 20 gallons per day, increased by manufactures by 15 gallons per day. Hyoscine. Internally a hundredth to a thirtieth of a grain, in pills or solution, subcutaneously a two hundred and fiftieth to a fiftieth of a grain. As a mydriatic a 1% solution. 144 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. Hyoscine hydrobromide. Soluble in water or alcohol. Sedative and hypnotic too often used in mental diseases. Has been used in asthma and neuralgias. Hyoscyamia. A dangerous drug in any of its forms, and for all its al- leged purposes there are better medicines that can induce sleep or calm without the risk of habit forming. Its use in insanity or to cure drug addictions is to be condemned as pernicious in both cases; insanity can be confirmed by its use, and no drug habit was ever broken up by it for substi- tuting one narcotic for another is not a cure, and the habitue is likely to return to the original drug, as morphine, and add the hyoscyamia, hyoscine or other delirifacient to it. Some conscientious and well informed specialists in nervous and mental diseases think that it has a legitimate temporary use occasionally, but careful consideration will enable them to find many better and safer methods of doing without any hyoscyamia drug. Hyoscyamus or henbane preparations are the thick liq- uid, hyoscine in doses of a two-hundredth of a grain, hyo- scine hydrobromate crystals used as hyoscine, the alkaloid hyoscyamine crystals and amorphous, and their sulphates, in one-eighth grain doses, except the crystalline which even in a thousandth of a grain sometimes gives marked results of an unpleasant delirious nature. The eclectic hyoscyamin differs from all these. Hyperesthesia. Extreme tenderness of skin, usually hysterical unless circumscribed when it may indicate spinal lesion. Hyperidrosis. Excessive sweating, from faulty innervation. Boracic acid externally especially in stockings for feet excessive THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 145 sweating. Hot water sponge in axilla awhile stays sweating under the arms for a few hours. Dilute ammonia and tan- nin also used. Hypermetropia. Far-sightedness. Hypnal. Antipyrine and chloral, hypnotic and analgesic. Not much used. Hypnone. Weak hypnotic, not much used. Hypnotism. Most effective with weak minded. Mostly humbug. Hypertrichosis. Superfluous hair. Reversion to monkey skin, especially the nevus pilosus or hairy mole. Depilatories and electroly- sis, cautiously, as bad scarring or malignant conditions sometimes result. Duhring's depilatory is barium sulphide 2 drams, pulverized starch and pulverized zinc oxide each 3 drams, made into a paste with water and spread on the hairy part ten or fifteen minutes, then oiled to allay irritation, re- peated weekly or more often. Electrolysis expensive, troublesome and requires careful experienced technique. The Baltimore dry chloride of silver cells and apparatus are excellent for such purposes. Hypertrophic Rhinitis. Stoppage of nose from overgrowth of lining. Surgery. Hypnopyrin. Hypnotic. Not much used. Hypochondriasis. In this hysterical disorder the patient tries to account for his discomfort by imagining he has all sorts of diseases 146 THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. which he has not, and goes from one doctor and treatment to another; morbid minded on the subject and incapable of reason. It is a mental malady and faulty assimilation and elimination is at the root of it. Tonics, cathartics and car- minatives give the best results. Liquor and morphine should be avoided as apt to create habits. Also see Neurasthenia. Patent medicine is a habit with some hypochondriacs. Hypophosphites. Not assimilated either alone or in combination. They are inert and should long ago have been dropped as obso- lete. Hysteria. A vast range of nervousness is included in this term, see my Medical Jurisprudence of Insanity. Acute attacks may be treated with nitrite of amyl inhalations, but the dis- ease itself is an autotoxaemia liability in a predisposed per- son. A thorough cleaning out and strengthening up in a rational manner will afford the best results. Strong mental impressions work wonders in the hysterical temporarily, causing apparent cures of paralysis, blindness, deafness, con- vulsions. Religious fakers have great influence over such emotional unstable notoriety loving patients. Elixir of valerianate of ammonia and asafoetida are safe remedies for them, and bromides, chloral, opium, cocaine and liquors are dangerous to them. Most of the certificates of the whisky and cocaine or morphine patent medicine effects are written by hysterics and clergy ignorant of human nature, chemis- try, or the rudiments of medicine. Several mental diseases, not all, are amenable to treatment by reasoning with the pa- tients, not with nonsensical dishonest hypnotic mystery but by open manly instruction in the nature of the complaint and the need of cultivating self control. These views are based on trials I published in my Clinical and Pathological THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 117 Reports on Insanity in the Chicago Medical Journal and Examiner in 1884. Hysteria can be bettered by reasoning with the patient, the penalty being that the practitioner has to suffer financially, as his services are cut short by recover- ies, or the patient resorts to quacks who will pander to her perverted condition. Emotionalism is dangerous to hys- teria and feeds the disease, but the dishonest oversight is better rewarded as a rule, except in earning self respect, which is, by some, valued above riches, which too often de- grade and never satisfy. Ice. Small pieces of cracked ice held in the mouth till the sharp edges are melted and then swallowed allay nausea and prevent vomiting often. Rubber caps containing ice can be used in cerebral congestion or the headaches and delirium of pyrexia or traumatism, but too prolonged applications are harmful. Appenditicis is treated with ice applications. Icterus, see Jaundice. Idiocy. Absence of intellect usually from birth, a more pro- found imbecility. Ichthalbin. Ichthyol albuminate. Internal antiseptic. Dose 10 to 30 grains. Ichthargan. Silver Ichthyol. External in gonorrhoea, unstable. 0.02 to 0.1% solutions. Ichthoform. Formal-Ichthyol. Internal antiseptic. Dose 15 to 30 grains. 148 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Ichthyocolia. Isinglass. Gelatine from fish swimming-bladders, often the trans- parent mineral mica is improperly called isinglass. Court or ichthyocolia sticking plasters are made from this gela- tine. Ichthyodine and Iscarol. Cheap ichthyol substitutes. Not much used. Ichthyol. A thick brown liquid, bituminous odor, containing easily assimilable sulphur, soluble in water. Antiphlogistic, antiseptic, alterative. Uses: internally in phthisis, skin dis- eases; externally in 5 to 50 per cent lotions or ointments in erysipelas, burns, chilblains, carbuncle, rheumatism, peri- tonitis, etc., 10 per cent with glycerine on tampons or in suppositories in uterine and vaginal inflammation; 1 to 3 per cent solutions or 1 to 2 minim bougies in gonorrhoea; pure in ivy poisoning. A number of allied preparations derived or fabricated have Ichthyol as a base, as Ichthalbin, Ichthargan, Ichtho- form, Ichthyol Albuminate, the same as Ichthalbin, and a synthetic substitute called Thiol is also made. Ichthyosis. Skin covered with reptile like scales, which itch dis- tressingly. As it is a failure of development like moles noth- ing can be done for it beyond mitigation, as with resorcin ointments externally and oils internally, sometimes iodide of potassium, antirheumatics and increase of perspiration. Igazol. A formaldehyde preparation. Not much used. Ignatia. Resembles nux vomica and is but little used. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 149 Illusions. Misinterpreted perceptions occurring in sanity and in- sanity. The common mistake is made that illusions pertain only to one sense, when any sense may be involved in false sights, sounds, tastes, feelings, odors, a magnifying glass causes illusions, for instance. Imbecility. A lesser grade of idiocy, congenital or acquired. Impetigo. An inflammatory pustular skin disease. Ichthyol, salicylic acid, calomel, resorcin, pine tar, an- tiseptics externally and tonics internally. Impotence. If occurring during period of life when it should be un- usual then there are two opposite causes which must be properly considered and treated to remedy the condition. The local debility may be owing to a generally run down system, and this probably is the most frequent cause, in which case strychnia, quinia and iron tonics and especially phospho-albumen will speedily restore the function, but if rhis local and general debility is due to excess in venery, and excess in one may not be the same as in another, then rest of the function is needed, and inono-bromate of cam- phor is the best suppressor of irritable genesic desire. This drug stops self abuse and many a prospective dement lias brightened up from using it when the mental and bodily depression were due to masturbation. It is well to recollect these two opposite methods of treating impotence. And too early ejaculations are impotence of over excitement needing the mono-bromide to prolong the act in a few over-excitable persons. The practice of using cocaine on the glans is per- nicious. Phospho-albumen increases the semen quantity and erethism, hence is to be used in the opposite condition 150 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. of debility and erection failure from constitutional and not genital over exercise. Phosphorus or cantharides are highly injurious and many nostrums are based thereon, such as damiana, "mor- mon elder," and similar rascally things. Incompatibility. As modern materia medica contains increasingly num- bers of articles the affinities of which are not fully known the scientific physician is inclined to prescribe single remedies, especially as adulterations of drugs is more common also rendering it impossible to predict what the resulting com- pound will be. Prescribe single remedies and be sure they are what you ordered. Incontinence or Urine. Enuresis. See Bladder conditions. Inco-ordination. Inability to regulate movements owing to impairment of the nerves or centers of control. The cerebellum is not the only organ whose lesion produces inco-ordination, as older text books assert, as regulation of bodily movements depends upon many different parts of the cerebro-spinal nervous system. Indigestion. If intestinal or failure to digest starchy foods use pep- tenzyme, taka-diastase, lacto-peptine, tyalid, but if dyspep- sia due to meat indigestion Fairchild's or other pepsin will answer, though peptenzyme suffices for this also. There are indigestion troubles due to organic or functional causes not removable by digestants. Cancer, ulcer, sickness, aton- icity, overloading, fermentation, etc. Bismuth has been re- sorted to too much in such instances. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 151 Inebriety. Wars, pestilences, famines, floods, volcanic eruptions, disasters in which thousands are destroyed at a time, it is claimed have furnished fewer victims than has alcohol. Ap- proximately a third of all insanity and other decrepitude, pauperism and crime are charged to it. Considering its too ready assimilation, physiologically and chemically the trouble may be resolved into the revolutions and disintegra- tions naturally following upon attempts to substitute for the animal and vegetable food to which man and his remotest animal ancestry have grown accustomed and adjusted, the concentrated, dangerous carbo-hydrate food, variously di- luted and known as wines, liquors, etc. Nor is the matter even so simple, for 85 per cent of all the liquor sold in the United States as whisky is not whisky at all, according to Dr. H. W. Wiley, of the U. S. Bureau of Chemistry (Proc. Am. Med. Assoc, 1904). Besides the assumed ethyl alcohol, the base of pure spirits, there are to be found in liquors the still more poisonous amyl alcohol or potato spirits, fusel oil; and the aroma is due to acetic and valeric ethers of the deadly butyl as well as amyl alcohols. Between the distillery and the saloon-keeper the quantity, color, odor and taste are arranged with the view of greatest profit, until the stuff drunk ceases to be a simple wine, beer, whisky or brandy, but contains cocculus Indicus, salt, cop- peras, opium, Indian hemp, strychnine, tobacco, darnel seed, logwood, salts of zinc, lead, alum, litharge, lime, soda, pot- ash, catechu, oak-bark, sloe leaves, earths to decolorize, sweetening agents and flavoring ethers, and, since the Eng- lish parliamentary act describing the above adulterants (35 and 36 Victoria, chapter 94.) in use in 1872, there have been found such things as commercial salicylic acid, the kidney destroyer, prune juice the laxative, and glycerine enough to create catarrh of the entire alimentarv canal. 152 THERAPEUTICS, MATERIA MEDlCA AND PRACTICE. The guzzling of our European ancestry, hundreds of years back and to recent periods, amounted to a continued pestilence killing off the unfit and not only enabling the hardiest drinkers to survive, but implanting upon their de- scendants a similar ability to swill all sorts of intoxicants and live. When savages encounter alcoholics for the first time they are so fascinated and powerless to resist taking it that they succumb so rapidly as to scare even the Indian agents into fear that there will be no occupants of the gov- ernment reservations, and when chronic politicians array themselves on the side of temperance and humanity the dan- gers to their profits must have been great. Similarly the Feejee islanders were killed off by measles to which Europ- eans had become immune, practically, leaving survivors among these primitive people who could also transmit their ability to have measles with the indifference of the Europ- ean of our day; and yet, no doubt, measles as well as other epidemics, including the alcoholic plagues, slaughtered off our rude progenitors as a frost kills off flies. Here and there are offspring of these immune races who revert to the susceptibility of their remote fore-fathers in disposition to take too much drink and to suffer for it. These weaklings fill our jails, poor-houses and asylums, and sprinkle the streets with tramps and town drunkards ; while the Germanic, Celtic or Latin peoples, generally, may drink quite as much, if not more, and yet be sober. The Russian Slav moujik remains in the beginning stage of this harden- ing process, where society was in the times described by Sir Walter Scott, when dinners were ended by a sleep under the table. And naturally the people regarded being ''drunk as a lord" as an indication of respectability. Ignorance of the consequence and of the composition of the drink, falling in with the custom of a place, as in treat- ing, may start a drinking habit; and all are not affected THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 153 alike. Some can stand huge amounts, and neuropaths are fuddled by small amounts, and also experience other bad effects of liquor. Alcohol is often taken for the first time by means of patent medicine and the surprise and "gratitude" of the user is something like that of Dicken's Pip, when he first tasted champagne and wanted to fall down and worship it. The testimonials from "distinguished'' uninformed statesmen, actresses, nuns, preachers read very much alike for the good feeling imparted by cocaine, morphine, bad whisky and similar debauching elevators of spirits. Any one who would instruct these gulpers of patent medicines would have his labor for his pains and be invited to "mind his own busi- ness." Even druggists who occasionally attempt advice as to the bad after effects of these nostrums are suspected of sinister designs and made to suffer pecuniary loss, but the plausible mercenary vender of such things is eagerly be- lieved because credulous ignorance, the kind that is so very ignorant it does not know that it is the least ignorant, is studied by the "business" disposition on the look out to give the people what they think they want, if they pay for it, no matter what harm it may do. Thousands of these self be- guiled slowly sink away from notice in the back alleys, in- sane asylums and other avenues of oblivion. Attempts to rescue them are resented if they have a dollar left, and libel suit bluffs are threatened against anyone who specifically exposes the ingredients of these insidious poisons. Every evil similarly A^aunts itself and virtuously denies harmfulness, while deriding would-be protectors and even injuring them if the profits of the evil are threatened by the growth of en- lightenment. Here and there the medical press has assailed for many years these infamous concoctions, but their audacity in- creased till actuallv disguised whisky was sold as a cure for 154 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. inebriety, and the crowning damnability was reached in a compound advertised for that purpose that actually held a grain of morphine to four ounces, of which a third was al- cohol. A report of the Massachusetts State Board of Health in 1896, and a public document, No. 34 of the Analyst of that State, afforded the percentages of alcohol, morphine and co- caine, ranging from twelve to fifty per cent of alcohol, in many cases, was met by deep silence until the lay press be- gan to take the matter up, in some cases because advertise- ments were refused them, whereupon ingredients and pro- portions were somewhat changed so as to falsify the exact figures if recent purchases were made of the stuff, enabling a foothold for the bluff about libel suits. The bare fact tha't the patent medicine syndicate has strength enough, or money enough, to see that congress passes no law interfer- ing with their profits from their dupes, such as compelling the exact formula to be placed upon the label, shows that intelligence, and that only, will defeat the degradation in store for a people enticed by "infallible" and "sure cures" through their instructors and educators, the daily news- paper, paid by these patent medicine manufacturers to de- ceive the people, a large proportion of whom at this day may be heard to say: "It must be true, because I saw it in a newspaper." Then these "public educators" explain that the valu- able principles in herbs are extracted by alcohol, so its pres- ence in patent medicines is no more objectionable than in fluid extracts. A mere bamboozling trick, for in legitimate drugs alcohol is a minor ingredient, and generally absent or in such trival quantity, as compared to the dose, that it cuts no figure, but in patent medicines the alcohol is the chief ar- ticle therein. A great step toward making a community more tern- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 155 perate would be taken were publicity of the truth in such matters made fashionable. It has been the fad to have rant- ing temperance meetings where pledges were signed, and of as much use as promises not to have typhoid fever. The growth of intelligence may eventually cut off the patent medicine source of creating drunkenness. To begin with, drinking may be a mere custom, appar- ently innocent as far as the majority is concerned; it may be a mistake or even a vice, deliberately indulged in at first by recklessness, or it may be a habit acquired through the in- fluence of others. In any event a harmful and useless habit may become fastened, and from the instant that it is so fas- tened and cannot be shaken off and begins to undermine the health, mentality, morality and welfare generally, it from that instant becomes a disease and must be so regarded and treated thereafter. Not with neglect or disgust, not with en- treaties, with reproaches, the policeman's club or the tem- porary jailing, but with every means at the command of ad- vanced medicine. Acute cases as accidental poisinmg, by emptying stomachs and bowels, up and down, and a thor- ough washing externally to get rid of the pernicious alco- hol remaining, for fear the system may grow accustomed to its presence and erect a desire for the poison. The chronic case to be treated by more prolonged, but essentially the same means, less energetically, but acting similarly to cleanse and sustain. The old fashioned drunkards' retreat was a mere differ- entiation from jailing, its idea was that the drunkard was a bad man and only nteded a little time to repent and "re- form." I know of a great municipal establishment of the kind with a patriotic name, run by ecclesiastical politicians. Weekly a pious ignoramus would "lecture" to the inmates on the injuriousness of the "vice," as if these poor devils did not know all about it far beyond what any one could tell 156 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. them, reminding me of the advice the constable of Great Stoughton, Huntingdonshire, would interpolate in 1744 as to the wickedness of being infested by devils when he was recorded as receiving 8s 6d for beating them from an insane woman. The opium and whisky crazed sufferers were visited daily by a burly medical politician who gave them more oaths than medicine, and who built himself a house out of materials intended by the city to be used in constructing a similar place for female drunkards. Large salaries were se- cured by these "humanitarians," and the founder of this special prison for drunken sinners was the renowned deacon and dean of a medical school who at one time dominated medicine in America with sixteenth century ideas. The self-righteous denouncer of the disease idea of in- ebriety helps the bar-keeper retain his business by making rational treatment unpopular with such lies as that virility is destroyed by cures. Alcoholism once fastened as a habit is a true disease, just as is the opium habit, the eating of clay, the irresistible craving for arsenic, the cathartic habit from overdosing un- til the bowels refuse to move unless swept by strong hyda- g-ogues. Drunkenness, whether continuous or intermittent, is as much of a disease as leprosy, small pox, cholera or any such ailment, against which will-power is so futile that will- power is itself destroyed and in some instances the brain structure is visibly changed, as a severe head wound or in- flammation could change it, in such cases rendering the re- covery impossible; whether we refer to the insanity, the stoppage of liquor or the brain destruction. In a long chap- ter of my Medical Jurisprudence of Insanity I detail these matters, including a summary of the pathology of alcohol- ism. The hard drinker experiences deranged sensations, pains, cramps, numbness, aches, empty gnawing feeling in his abdomen, stomach burnings, crawlings, creepings. ting- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 1 57 lings, at the base of which are circulatory disturbances, to be abated usually only by more of the poison that caused the disease. The blood vessels are involved in fibroid thickening and fatty degeneration through checking of oxidation. Muscular tremors point to the nervous involve- ment, the mentality is dulled and business cannot be attend- ed to without stimulation. Sleeplessness, irritability, forget- fulness and change in moral character increase. Mendacity is sometimes a product of inebriety until the drunkard can- not be believed on oath, particularly where the opium haibt is added. Huss described the paralytic and anaesthetic forms of chronic alcoholism, and others detail the pathology of multiple neuritis of alcoholism, sometimes known as poly- neuritis, more apt to afflict tipplers, those who drink small quantities of liquor but who take it often, and also women who are inclined to be fat are most prone to polyneuritis. Motor weakness, sensory disturbances and incoordination with wrist-drop and foot-drop are commonly the symptoms. Among other derangements we find stomach catarrh, liver cirrhosis, acne rosacea, arterial kidney changes inducing the granular kidney. An alcoholic paraplegia may follow upon the neuritis by secondary changes in the spinal cord and from atrophy of the muscles. Hardening of the brain membranes with wasting of brain substance and adhesions occur in advanced cases. Alcoholic epilepsy has been rec- ognized, but each amnesic drunk seems epileptic in char- acter. Other alcoholic derangements are Delirium tremens, Alcoholic Paretic Dementia, Alcoholic trance states in which loss of consciousness occurs for long periods of time, Dipsomania or the periodical drunkenness, Oinomania or false dipsomania in one who merely drinks till his saturation point is reached, and not from an irresistible impulse, as does the dipsomaniac, Chronic alcoholic insanity with spec- ial characteristic delusion of marital infidelity and persecu- tion, and Alcoholic Dementia. 158 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Stoppage of liquor may in some instances show that a weak heart had been braced up by liquor stimulation, but instead of this fact being recognized the leaving off of the drink is most likely to be blamed, and of course the saloon- keeper will blame the heart weakness upon the cure if one has been taken. Other destructive changes in the system may have been masked by drink to become apparent when liquor was stopped. Syphilis has been rendered latent by drink helping the disease to resist treatment, so with drink stoppage the syphilis breaks out afresh and cures can be blamed for inducing a syphilis which the patient may have inherited. Consumption as it is popularly called, or tuber- culosis, has certainly been kept in check for many years by the use of alcoholics, and the disease would make rapid headway as soon as abstinence was enforced. So consump- tion has actually been an accusation blamed upon medical treatment of chronic alcoholism. Sociologically Alcoholism is a plague. A few years ago the board of guardians at Stockholm published the re- sults of its inquiry into the causes of poverty. It found that drunkenness is responsible for 52 per cent of the cases. In 6 per cent of these cases both parents were drunkards, in 39 per cent only the father, and in 7 per cent the mother only. The children of such parents have to be supported by the poor-rates. The vast army of tramps is recruited by whisky, which shares with consumption the credit of murdering a large part of the race. Drunkenness as a disease is compelling a place in medi- cal works and practice. When properly provided for there will be fewer inebriates in jail and more in hospitals. Alco- holism is not a delusion to be disposed of by mind-cure or belief, which will no more cure disease than it will create one. The hypochondriac who thinks his hand is glass can- not by his fancy make it so. The chronic drunkard is like THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 159 the insane, the paralytic or epileptic, to be cured if cure is at all possible by efficient medical means and not by signing pledges, being scolded, or preached to. Where there re- mains an impression in the public mind to the contrary it can be accounted for by its retention of stubborn ignorant beliefs, which even in educated minds have slain thousands, and the lingering disposition to punish instead of to treat inebriety as a vice rather than disease, results from ignor- ant belief. A proper medical cure may be summed up as a general cleansing of the system from the poison and from the effete products of faulty nutrition, and at the same time it is neces- sary to renovate to tone up beyond the need of resorting to the false aid that alcohol has heretofore afforded. Imprison- ment cures nothing, craving is not overcome by will power ; certain drugs, methods and discipline can be used in the patient's behalf to break up the nervous habit and rythm of inebriety. Many false "cures" entice patients and disappoint them terribly, for they merely resort to temporary expedients in treating the drunkard in his acute stage, from which he will recover anyway, but the great impeller to drink, the intense desire, and the pathological condition upon which it depends remains untouched by the mere soaking in mud, steam, electrical or other fake baths. Too many physicians in try- ing to suppress the alcoholic desire in themselves, have re- sorted to opium and found that instead of one there are now two masters, and still worse some advertised "cures" act- ually substitute morphine or hyoscyamus, chloral hydrate, or some equally pernicious habit for the alcoholic. There are instances of actually giving something worse than the disease, like curing freckles with small pox. Legions of poor fellows have turned on the gas unlit, in such places, or butted their brains out against stone walls, to release them- selves from suffering. 160 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. It might be thought that long incarceration as a term in the penitentiary should enable full "reform" or recovery, whichever way it may be regarded, but it is not so. One pa- tient voluntarily immured himself for six months in the Chicago city "home" and went on a spree the first day of regaining liberty. But he was finally cured by medical means. There are unfortunates who are past recovery, neuro- tics with strong heredity doomed from birth to mental deg- radation through the first unfavorable influence encounter- ed, and to such nothing more fatal exists than whisky. An insufficient amount for another could precipitate insanity in them. Also there are brain destroyed drunkards who may be released from the whisky habit only to reveal the real mental state which was previously ascribed to drunkenness. Of course such instances are paraded as results of attempts at cure. Then there are alcoholophiles who remain addic- ted to liquor, in spite of every proper cure on earth. These are said to have whisky on the brain. And it is a remark- able psychological state that can have all desire for a poison removed and yet return to it. Certainly there is something initially rotten in the make up of such a person. The most famous and successful treatment of drunken- ness and other addictions is that of Dr. Leslie E. Keeley, at Dwight, Illinois. He was graduated at Rush Medical Col- lege, which is now a branch of the Chicago University. As with every one who has accomplished great things in the world many misconceptions are extant concerning him. Most of the unfavorable criticism has come from the whisky dealers whose profits have been materially reduced, and who in many cases have been forced into some more honor- able occupation, through communities having been made sober which previously were drunken. The fact that Dr. Keeley controlled the management of his method instead THERAPEUTICS, MATERIA MBDICA AND PRACTICE. 1()1 of "ethically" giving it to the medical profession has caused him to be mistakenly classed with secret nostrum venders. I enjoyed personal familiarity with Dr. Keeley and his methods. Both were unexceptionable. At the time of the issue of my large volumes on the Medical Jurisprudence of Insanity I told Dr. Keeley that I thought the time had come when the medical profession should properly estimate him and the great good he had done in the world, especially as some 17,000 physicians had undergone the treatment for inebriety and were ready to attest its benefits, so I inti- mated my intention of describing his system and the re- markably favorable results he had secured, with all other information calculated to make him and his work better ap- preciated among medical men, but he advised me against so doing, remarking that years must pass before the unjust prejudices against him were overcome, and meanwhile he would not permit friends to be also sacrificed in his defence. The effort to have him better understood, he claimed, would fail and react upon any one brave or honest enough to try to explain. So at this time, before I also, as he has. have done my life-work and passed on with "the innumerable caravan," I would like to give physicians a clear idea of the "Keeley Treatment," or, as popularly known, the "Keeley Cure," as I understand it, direct from its founder. While Dr. Keeley may not have been first in the claim that inebriety was a disease, he is certainly the first one to logically and persistently act upon that assumption consis- tently and to the exclusion of every other view of the sub- ject. In this he received no assistance from any medical source, as the vice theory dominated physicians as well as the laity. He worked steadily in this direction amidst the invariable discouragements, jeers and harrassments, and he also noticed that whenever he attempted to impart his ideas and methods to medical men that he met only opposition, 162 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. derision and misunderstandings, and even such formulas as he gave openly to doctors shortly became changed beyond recognition, as the principles were but vaguely grasped, and, as a rule, most physicians are poor pharmacists and notor- iously write incompatible prescriptions. A few pharmacists with clearer knowledge of compounding built upon some of these earlier and cruder prescriptions of Dr. Keeley and the market became flooded with fake inebriety cures. Then commercialism took a hand and put in ingredients out of which the most profit could be made, and high-priced ma- terials were omitted, so the original compounds were fear- fully debauched, some even with opium, until the doctor saw that his best efforts were to be wasted unless a different course were tried. He was not satisfied with his partial suc- cesses during many years experimenting without recom- pense, and even after he felt certain that he was justified in seeking- paying patients he lacked some essential in the treatment that caused him to take only volunteer unremu- nerative cases for several years more, when finally he knew that he had the method reasonably perfected. His friend and confidant at this time was the well known Dr. J. Adams Allen, the president of Rush Medical College of Chicago, and to him the doctor detailed his hopes and difficulties and plainly askec him if under the circumstances it would not be best to indefinitely withhold the completed process until he had fully demonstrated its value by many recoveries under the treatment. Allen agreed with him that at this stage his per- fected formulas might share the fate of their predecessors, and that he would be blamed for the failure of others to use the medicines properly, to say nothing of his being out of pocket for the years of labor and expense he had undergone already. The thought that the whole system was likely to be destroyed by the carelessness, cupidity and ignorance of others, notwithstanding the fact that many capable and con- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 163 scientious physicians would, within from twenty to forty years, rescue its remains and establish it for future genera- tions, as a contemplation was not satisfactory to Dr. Keeley, so he sought the means of demonstrating the sufficiency of the methods, the means for which could not be secured from any medical source whenever he proposed to give the pro- cess and formulas to the profession. Thus the entire matter would have perished, and to this day been unknown as the great success it is had not the proposal reached him to form a stock company on business principles, as he knew that in- ventors of surgical instruments require capital to put them on sale, and if unprotected the profits go to rivals who watch for evidences of success. The question was, with the doc- tor, should he make public the formulas and for years fight to defend and justify and explain them against detractors, ad captandum essayists, sophistication, patent medicine makers on the lookout for fake combinations to impose upon the public, as well as manufacturers of proprietary af- fairs who put false formulas on their labels, but who thus pass muster as ethical? Should he receive nothing for his outlay and be supremely ethical and see his name wiped from the invention and another grow rich on the wreck of it, the semblance put into some lying commercial shape, while he remained poor? Or should he retain the formula to some future and more promising time? He was simply forced to be. what business men call "practical," and under all the circumstances it was advisable to accept the suggestion of a stock company to shorten by hundreds of years the introduction of this inestimable bless- ing to humanity. A Chicago newspaper publisher was anxiously looking out for inebriety cures, and among others had been fooled by D'Unger's "Cinchona Rubra'' cure, which doubtless was based on crude ideas of Keeley's methods. Editor Medill 164 THERAPEUTICS, MATERIA MEDIOA AND PRACTICE. sent five "old soakers" to Keeley for trial and they were returned metamorphosed into gentlemen, and after a suffi- cient lapse of time to convince Medill of the permanancy of their recovery the Daily Tribune voluntarily advertised the Dwight institution until soon there was not room in the town for applicants for treatment, and subsidiary institutes had to be started in the various states of the union and else- where to care for the hundreds of thousands who have un- dergone the treatment. Armour the Chicago beef packer sent 200 patients, employes in whom he was interested and whom he wished to restore to health. A Keeley League has been formed as a practical means of rescuing others from drunkenness, and it has a membership of 30,000. The Dwight home office began in the year 1880, and altogether probably a half million persons have taken the course of treatment, and among these are seventeen thousand physi- cians who would otherwise have been mere wrecks of hu- manity. Naturally the prevailing instinct among these res- cued ones would be to try to forget their lives of foolish dissi- pation and disgrace, and, as a rule, they did not shout their cure from the house-top. Many felt impelled, however, to honestly give credit where it was due, even though at some fancied disadvantage through unfriendly comments, but, as the evidences of cure were to be seen among the people everywhere, it became possible to point to these as instances of the Keeley cure, .instead of to themselves, and thus ap- pease a conscience not at all satisfied with keeping silence on the subject, while feeling grateful for a service no money could requite. Gratitude is a sentiment not altogether lost to the world, and probably from experiencing so much of its absence the medical man is most likely to develop it as not wishing to be wanting in what he regrets that he does not find in others. So from the custom of roundly abusing the Keeley treatment as unethical and fakey, and repeating THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 165 all sorts of silly lies that interested bar-keepers busily spread to fight what threatened to, and often did actually put them out of business, there grew a disposition to listen to stories of recovery, to probably regard them as exceptional and to put the cure on the same footing with others generally, as accidental, as due to hypnosis, to the X ray, to confinement, to putting nauseants in the food, anything, everything that had been utter failures heretofore. Nothing was suggested as an explanation of the cures except what was imagined without actually visiting the institution itself. At D wight can be seen an orderly, respectable assembly, occupied ex- actly as any hotel guests employ their time, conversing free- ly coming and going, with not the slightest restraint upon their movements. Sometimes a newcomer, hilariously drunk, attempts to make himself funny, and remarks are dropped here and there, to the effect that: "I suppose I was like that myself at one time." But the next morning the fun has departed, and the matriculant sits around in amaze- ment at the effect of a few preliminary doses of medicine. "Why," remarked one such patient, "I never would have believed it possible that I could breakfast without first drinking whisky, and I actually relish my food, too!" Far from being in the least detrimental to health the toning up secured in the course of treatment is beneficial to health. Preliminarily it is ascertained whether B right's dis- ease, diabetes, or other ailment is present or absent, by rou- tine analyses such as hospitals use with general physical ex- ploration, so that friends of the patient will not fancy that diseases the patient brought with him were ascribable to the treatment. There is no loss of virility from the system. That accusation of saloon-keepers has a slim, frail founda- tion in the previously recklessly immoral drunkard when sobered up becoming ashamed of his previous behavior, and, at least, assuming an appearance of decency, which the whisky dealer prefers to interpret as impotency, and the lik®. 166 THEKAPEUTICS, MATERIA MEDICA AND PRACTICE. The patient usually remains at the institute four or five week and after the period of remorse and shamed reminis- cence is over he finds hope reviving, his mind clear and ac- tive, thought consecutive, appetite good, eyes, complexion, morals better, "feels ten years younger," sleeps regularly and with every added year wonders more and more at the metamorphosis wrought in his entire nature for the better. In making autopsies of the alcoholic insane at the county asylum of Chicago, where I was pathologist, I found as badly disorganized tissues in the brain substance as though the lunatic had suffered a direct head injury, and in fact drunkenness can produce insanity with the characteris- tics of head injury, as observed in my Medical Jurispru- dence of Insanity. So, of course, it is unreasonable to sup- pose that when alcoholism has destroyed the brain that any- thing can be done to save the lunatic. If the brain is intact aftei drunkenness then there is hope for the treatment being- effective, and the test can be applied to a great extent as to how much is left of the man when he is cured. There is a chronic alcoholism, a chronic alcoholic insanity, and the de- generate from birth, the dispsomaniac. About two- thirds of the chronic alcoholics have not passed to the brain-de- stroyed stage, and for these there is great hope from the Keeley treatment, there are even a few among the chronic alcoholic insane who may at least be greatly benefited if not restored mentally; such must be in the functionally poisoned stage, rather than in that of brain degradation, but naturally lunatics are not good material to work upon, regardless of whether they drank because they were insane, as do the dipsomaniacs, or whether they put their brains beyond re- pair by liquor. While the formulae are the property of the company, there is no secret about the method adopted at Keeley in- stitutes, which are open to the inspection of the public and especially physicians. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 167 Patients in such places are not under restraint or other supervision than medical oversight. Hypodermics are given four times daily, between 8 a. m. and 7.30 p. m. De- lirium tremens cases, of course, require more care. A tonic is administered internally in teaspoonful doses several times a day. The alcohol is voluntarily given up, by the patient himself, through the influence of the medicine purification of the system, the poisonous waste products that had pre- viously been retained being eliminated by the kidneys, sweat glands, bowels, etc. Then the nervous, circulatory and other organs are restored to their original, unpoisoned states, as before drinking had been begun; a surprising statement to make, but every "graduate" of this system can verify it. This process of withdrawal and elimination is usually accomplished during the first week of the treatment, after which the progress is quite noticeable. Xo apomorphia or other nauseant is used at any time, for such temporary ex- pedient accomplishes nothing of value, and as to hypnotic or other foolish methods the visitor to an institute would ever after laugh at such an idea. It is possible to cure the drunkard, but not the lunatic whose brain is torn to pieces with corrosive liquors, and these no institute will undertake to treat. Infantile Cerebral Palsy. Paralysis of a limb, with failure of development through brain fever in infancy, or injury to the head. Infantile Spinal Paralysis. Inflammation or injury to the spinal cord of an infant may result in paralysis of one or more members usually a leg, with failure of development of the affected part. 168 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Ingluvin. A digestive ferment from chicken gizzards, inferior to other digestants. Ingrowing Toe-nail. Cocaine the tender spots and pare center of nail, anti- septics, astringents, removal of nail. Inflammation. External superficial and a few deep as pneumonia, pleurisy may be favorably modified by the mixture of clay and glycerine called antiphlogistine, antithermoline, glyco- kaolin, etc. Influenza. La Grippe. Quinine, salicylic acid, terpin hydrate, creosote and morrhuol capsules of Chapoteau. For cough a single drop of Beeehwood creosote in 2 oz whisky and 2 oz simple syrup, tablespoonful doses, ad lib. The best description of La Grippe is in Niemeyer's Practice. Insanity. Though insanity consists of symptoms of bodily dis- eases the general practitioner has had no opportunity to be- come familiar with the subject, as asylum experience is ab- solutely necessary to a physician in studying psychiatry. The assistant physicians in asylums are usually the best alienists, the superintendent having too many executive duties to have time for purely medical. Hence superinten- dents should be appointed from among assistant physicians but always from other asylums to prevent temptations to intrigue against the superintendent of the same asylum. Politics convert places for the ostensible care of sick and paupers, especially for insane into veritable hells on earth, and one of the best evidences of the animal conditions of so- ciety is that such things as political asylums are possible. THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. 169 Humanity is actually offensive to the management of such institutions and when restraints are removed even the pre- tense of humanity is thrown off in torturing patients for amusement. Twenty-five years personal observation and study enabled me to publish details of such crimes in the chapter on Treatment in my 1400 pages Medical Jurispru- dence of Insanity. Diagnosis is only possible to the alienist, and medical treatment is in the vast majority of cases highly improper by others than alienists, who carefully avoid such things as chloral, which inflames the stomach, destroys digestion and perpetuates the insanity, and opium or other such baneful hypnotic liable to foster a habit worse often than the mental ailment. Just as all foreigners look alike to the untraveled so does all insanity to the inexperienced. Physicians in hos- pitals for insane are amused and shocked at the improprie- ties practiced by physicians without knowledge of psychia- try. Needless suffering and deaths result from this inexper- ience and misplaced confidence. Psychiatry is now as re- spectable a branch of medicine as surgery, and as exact in agreement of recorded experience, so that the claim of any- one that nothing is known about insanity betrays as gross ignorance as to assert that no one knows mathematics, or similar assertions of callow development. The different forms of insanity are incidentally briefly mentioned in this work, but of course, inadequately as compared to treatises on insanity. These are best when written by alienists, next best by neurologists, and poorest of all when attempted by poli- ticians, whatsoever called, even though with the advantage of being favored by a well-known publisher who advertises his wares beyond their deserts. Insolation, see Thermic Fever. 170 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Insomnia. Sleeplessness. Seek and remove the cause if possible rather than take narcotics. A hot bath, or foot bath, hot enema, a stimulant in weak heart, ergot in cerebral congestion. Chloralamid and sulfonal are the most reliable. Intercostal Neuralgia. Often mistaken for heart pain. Three tender spots in course of nerve, hysterical most liable. Rubefacients be- tween shoulder-blades. Intermittent Fever. Full doses of quinine an hour or half hour before the return of the chill is to be expected. Substitutes for quinine are unsatisfactory. If it congests the head too much take bromide of potassium with it. Calomel may assist anti- periodic treatment. Intertrigo, see Chafing. Intravenous Injections. Used only in extremis as in cholera collapse, prolong- ing life but a short time. The practice of using mercuric chloride intravenously injected in. my opinion cannot be too strongly condemned. The corrosive sublimate necessarily forms minute emboli by coagulating the albuminous plasma, the clots blocking the lesser vessels, and in two instances I have seen the mercurial tremors after such intravenous in- jections, resembling the chorea induced in animals by the multiple cerebral emboli of minute seeds being injected into the circulation. Intussusception. Bowel obstruction from folding intestine inside itself. Knee-chest position, massage, inflating through colon, antiseptics, oily lubricants as olive or cod liver, opiates and in some cases operation. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 171 Iodide of Potassium, see Potassium Iodide. Iodides, Colorless. Practically de-iodized. lodipin. 10 per cent, and 25 per cent. Iodized Sesame Oil. 10 and 25% iodine. Substitute for iodide of potassium. Dose of 10%, 1 to 2 fluid drams, hypodermic dose of 25%, 20 to 40 minims. Iodine. Soluble in 30 parts chloroform, 10 alcohol, 4 ether, 65 glycerine, nearly insoluble in water. Externally in 4 per cent ointment or in tincture to paint skin in erysipelas, and some skin affections, but its desquamative effects prevent continued use. It is doubtful if any of the fancy preparations of Iodine for internal use have any advantages over, or are as good as, ordinary iodide of potassium, while being more expensive. There are Iodopin 10 per cent, the iodized sesame oil of Merck, containing 10 per cent of Iodine said to enable iodine to penetrate the remotest tissues, another 25 per cent pre- paration of the same for hypodermic use. a fluid-dram of the 10 per cent internally and 20 to 40 minims of the 25 per cent hypodermically. Iodine Vasogen. For inunctions, the claim being that it is more readily absorbed. lodo-bromides, Partly secret compounds and dubious use. Iodoform. A useful but odoriferous powder for external applica- tion to ulcers, but the smell betrays the nature of the disease many times, and even though used to prevent wound sup- 172 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. puration where syphilis is not concerned the public asso- ciate the odor with that disease, so that in the patient's in- terest it is well to bear this in mind. Many poisoning in- stances. lodo-hemol. Suggested substitute for potash salt. lodole. Same as the German Jodol, and several similar iodoform disguises claimed to be odorless have proven to be less sat- isfactory to iodoform, an Iodoformogen or Iodoform Al- buminate of Knoll is one of these articles described in Merck's Digest. Idozen is a secret substitute for iodoform. lodyloform. lodylin. Iodoform substitutes made with iodine, albumen, gela- tin and bismuth. Not much used. lodo-nucleoid. Substitute for potassium iodide, 9^% iodine with nu- clein in organic combination. Dose 10 to 20 grains. On trial. lodothyrine, or Thyro-iodine. A dry preparation of thyroid gland, for goiter it should not be used and in myxedema it is inferior to other thyroid preparations. Ipecac. Emetic 10 to 15 grains. Iridoplegia. Paralyzed, and therefore dilated, pupil. Irish Moss. Chondrus or Carrageen. THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. 173 Iritis. Dilate pupil and give iodide of potassium and mercur- ials. Iron by Hydrogen. Quevenne's Iron, Reduced Iron, Steel. Obsolete as medicine. Iron, generally. Many inferior forms of iron and its salts or compounds exist in the market, due to the fact that almost anything with iron in it can serve as a tonic to some extent. Even a few iron nails allowed to rust in water make a ferruginous drink not wholly useless in anemia. The multitude of iron springs, artesian waters, and fake mineral preparations owe financial success to this fact. So anything with iron makes a tonic of less value than the more eligible ones with man- ganese. These inferior hematics are: Iron arsenate, car- bonate, citrate, glycerino-phosphate, hydrate, unstable, hy- pophosphite. oxalate, oxide, succinate, sulphate, valerian- ate, tartrate. Peptonized Iron and Manganese are more useful, and some of the Elixirs such as the Elixir of strychnia, quinia and iron pyrophosphate or citrate are convenient forms for good tonic medicines in teaspoonful doses. The Tincture of the Chloride of Iron is still used by adherents of the old methods, but its injury to the teeth requiring it to be taken by means of a tube, and the fact that an acid chalybeate is not desirable in gastritis with hydrochloric acid excess in the stomach, cause the muriate of iron to be put with the less useful ferruginous tonics, remembering that any thing with iron in it no matter how inferior answered very well in former days. Diedrich's Ferro-Mangan was a good tonic but the swiftest in effects and probably the best iron manganese proprietory preparation to-day is Gude's Pepto-Mangan, in 174 THERAPEUTICS, MATERIA MP^DICA AND PRACTICE. polygonal eleven ounce bottles, tablespoonful doses or less. Improved forms of Blaud's carbonate of iron pills when fresh and properly made were the very best iron form for quick results, but unfortunately they became hard in a little while and as usually dispensed were therefore inert. Physicians differ as to the value of dialysed iron, the dose of which is 10 to 30 minims, the probabilities being that some makes may be serviceable, just as any iron form may be, while in the main it is inferior. Isopral. A new hypnotic, on trial, dose 10 to 15 grains, pungent, burning taste with anesthesia of tongue. Itch. Caused by itch mite usually on wrist and between fin- gers. Sulphur ointment. Itching, see Pruritus. Itch, Pubic. Mercurial ointment, but mercuric chloride wash is cleaner though it must be used cautionsly. One grain to the thousand. Ivy Poisoning. Dilute ammonia water at once neutralizes toxicoden- dric acid in vesicles. Solution of bicarbonate of soda ap- plications, fluid extract grindelia robusta astringent reduces swelling, Dobell's solution, saline purge. Piperazine for alkalinizing internally. Do not use lead washes or opium. Izal. On trial for phithisis. Jaborandi, see also Pilocarpus. Produces profuse perspiration and salivation, weakens heart action, pilocarpine hydrochlorate alkaloid salt best for THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 175 use in Bright's disease if heart strong enough, in uremia and puerperal eclampsia, parotitis, agalactia, diabetes insipidus urine lessened by diaphoresis, dropsy if heart not too weak, pleuritic and meningitic exudations, amblyopia from alcohol and tobacco, in keratitis and other eye diseases, diphtheria and erysipelas, remembering the heart precaution, and while both salivary and sudoriferous glands are stimulated by large doses a small dose checks profuse ptyalism or perspi- ration. Dose of pilocarpine hydrochlorate a fiftieth to a half grain. Hypodermically a sixth of a grain. The fluid extract of pilocarpus is usually worthless. Atropia antag- onizes in doses of a hundredth of a grain. Strychnia sus- tains the heart action and morphine controls the vomiting. Jaborine another alkaloid from pilocarpus acts like atropine, the reverse of pilocarpine. Artificial respiration also needed in poisoning by pilocarpine. Jacksonian Epilepsy. Localized spasms at times without loss of consciousness. jalap. Cathartic, useful for relieving brain congestion, as after sunstroke. Dose 10 to 30 grains, or 10 grains with an equal amount of calomel. Jambul. Not much used. James' Powder. Emetic and purgative, formerly used as alterative and diaphoretic but going out of use. Jamestown Weed. Stramonium or Thornapple. Dangerous narcotic and delirifacient. Formerly used for asthma, mania and epilepsy. Discredited and disused. 176 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Jaundice. Causing yellowness of eyes and skin. Icterus. Blood or liver disorder, in some instances from ob- structed gall duct see Calculus, renal; liver cirrhosis, ab- scess of liver, acute yellow atrophy, echinococcus cyst of liver, ascites, etc. Elixir of Euonymus atropurpureus, calo- mel. Jequerity. Abrin alkaloid, both too dangerous outside of ophthal- mology specialism as eye destruction liable in its use. Jiggers. Sand Fleas. Chloroform kills them and they can then be dug from the skin with a blunt needle. Jounod's Boot. Vacuum apparatus to draw blood to foot, little used now as accidents as fainting or worse produced. Juglans. Butternut. Mild cathartic, little used. Jujube Paste. Commonly gum arabic and sugar with the jujube left out. Demulcent for pectorals and as good as real jujube paste. Jumpers. An endemic sometimes, as with the Maine Jumpers who reacted violently if touched or spoken to suddenly. A hysterical spasmodic tic convulsif. Religious emotion may produce it in camp meetings. Juniperus Virginiana. Red Cedar. Resembles savine but weaker, little used. Juvenile Insanity. Moral Imbecility. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 177 Katatonia. Insanity alternating mania, catalepsy and melancholia. Seldom benefited, tends to complete loss of mind in demen- tia. Nitrite of amyl may temporarily help. Kava-Kava, see Gonosan. Keloid. Fibrous skin tumors, not malignant, frequent among negroes. No treatment, excision temporary relief. Keratitis. Corneal inflammation. Borax or boric acid wash. Keratosis Pilaris. Horny skin. Use alkalines, salicylic acid applications with ointments and soft soap washings. Kermes Mineral. Antimony Sulphurated. Obsolete. Kidney Disease. See Bright's Disease. Popular idea that pain in back indicates kidney disease erroneous, also that diabetes is lo- cated in the kidneys. Kino. Astringent in diarrhoea. Dose tincture I to 3 drams, used in chalk mixture usually. Kleptomania. Uncontrollable impulse to steal. The law usually per- mits the rich a monopoly of this disease. With the poor it is theft, legally, but in psychiatry rich and poor are equally liable to the disorder. Kneipp Cure. Sanctified water cure. 178 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Knight's Solution. Secret eczema remedy. Kola. A suggested substitute for strychnia but at present with cocaine it enables debauchery in the guise of a popular drink. Koumys. Imitation Mare's Milk, fermented as made in Tartary. Practically carbonated buttermilk is about as nutritious and assimilable while much cheaper. Kousso. As an anthelmintic the fluid extract dose is I to 4 fluid drams, but Koussein of Merck, amorphous, is a powder soluble in alcohol but only slightly so in water; the dose is 15 to 30 grains divided into 4 parts to be given at intervals of half hour, followed by castor oil ; children half this quan- tity. Krameria. Astringent and mild tonic. Little used. Kryogenin. Antipyretic. Dose 3 to 20 grains. Kryophine. Like Phenacetine. Kugloids. Quinine glycerophosphate with benzoates of creosote and eucalyptol. For bronchial complaints. Labarraque's Solution. Solution of chlorinated soda. Disinfectant and deodor- ant. Dose 10 minims to a dram diluted, externally to foul ulcers. THERAPEUTICS, MATERIA MEDICA A!ND PRACTICE. 179 Lactagol. Extract of cottonseed meal on trial as a galactagogue. Lactophenln. Antipyretic and analgesic similar to phenacetine. Lachrymation. Overflow of tears due to closure of nasal tear duct. Probe. Lactic Acid. Doubtful if of much or any use, as a caustic other things are better. Lactopeptine. A useful digestant in intestinal dyspepsia. Peptenzyme is similar. Lactophenin. Like Phenacetine. Lactose. Milk Sugar. Lactucarium. Being largely inert from age and other causes, has been made the means of pushing morphine in disguise through lactucarium expectorants and sedatives. Lactucine. From lactuca virosa, sedative. Dymond quoted by Helbing suggests hyoscyamine in extracts of various spec- ies of lactuca. Lactyl-Phenetidin, see Lactophenin. Lagophthalmos. Eye protrusion so that lids cannot be closed. Lanolin. Wool fat, numerous makes of which of various grades 180 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. are in the market used as an ointment excipient, having the advantage of ready absorption through the skin. Lanum. Hydrous Wool-Fat, U. S. P. Largjn. Silver albumin for gonorrhoea. Not much used. Laryngitis. Inflammation of internal larynx. Heat or rubefacients externally, antiphlogistine to throat, guiac lozenges, creosote and morrhuol capsules, cod liver oil, calomel and salines. Laryngismus Stridulus, see Croup. Laudanum. Tincture of opium. Dose 5 to 30 minims. Laughing Gas. Nitrous oxide anesthetic, useful in dentistry and can be used more in surgery with advantage. Lavage. Washing out the stomach with a tube and funnel, the old fashioned stomach pump dirty and complicated, dis- used. In some cases of putrid atonic stomach washings are very effective, but the hysterical are liable to form a habit of wanting the process too often. Lax Skin. Dermatolysis. Elastic skin, allied to fibroma molluscum. Treatment is excision. Lead Acetate. Old fashioned astringent. It has occasioned lead poi- soning so often that vegetable astringents are better for medical use. For ivy poison it is not useful, and in collyria THERAPEUTICS, MATERIA MEDICA AKD PRACTICE. 181 will cause corneal opacity. Did much harm in injections for gonorrhoea. Lead iodide and nitrate are equally unserviceable. Lead Plaster. Adhesive plaster. Excludes air from wounds, but not otherwise antiseptic. Lead Poisoning. Iodide of potassium, acetate of potassium, hot baths. Lecethine. Organic phosphorus from brains, testes, etc. Nutri- tive stimulant. Leeches. Passing out of use. Majority of practitioners do not know which end of the leech to apply. Some are poisonous, and in all cases better things than leeches can be found for congestion relief. When applied to eyelid the black eye is made worse. Before going out of use altogether the better derivative position was found to be the temple for eye ecchy- moses. Lemons. The same as limes or citric acid, derived from either, in cases of so called liver troubles, bilious attacks, headaches, malaise, etc., often afford relief and in some instances act much as calomel would to alter secretions. Nor is lemon juice incompatible with mercurials. And in rheumatic or other uric acid affections lemon juice appears to act as an alkali instead of acid, forming an exception to the rule that acids should be avoided in rheu- matism. Lenigalloi. On trial in place of Pyrogallol for chronic eczema. 182 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Lenirobin. Mild substitute for chrysarobin for external use. Lentigo, see Chloasma. Leprosy. Incurable. Leptandra. Culver's Root. When used at all is prescribed in the form of Leptan- drin mostly, as a chologogue and alterative in I to 3 grains, and purgative 8 grains. Not much in use. Leucocytosis. The attempt to rid blood of bacteria and toxic causes. Leucomia, see Keratitis. Leucomaines and Ptomaines. First are alkaloids from decomposition of living albu- minoid tissues, latter are alkaloids from putrefaction. Leucoplacia. White patches in mouth, sometimes can- cerous. Antiseptic mouth washes. Leucorrhoea. Astringent and antiseptic douches, boro-glyceride sup- positories, hydrastine vaginal suppositories, ichthyol sup- positories. Tonics if weak. Leukemia, Leucemia or Leucocythemia. Great increase in white blood corpuscles. Fatal. Trauma a direct cause, spleen, bones, bad hygiene, syphilis, malaria, rachitis, tuberculosis, and transformations from pernicious anemia. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 183 Leukoderma. Vitiligo. Piebald skin, irregular white spots. No treatment. Paint may hide the blemish. Leukoma. Opaque white cornea. Surgery. Levico Water. A spring water containing arsenic and iron. Fowler's solution is far better and cheaper. Lice. Pediculi. Mercurial ointment or weak mercuric chloride wash. Lichen. Papular skin disease. Alkalines, antiseptics, antirheumatics, tonics, ichthyol particularly. Lichen Ruber. Itching papules. Antiseptics. Lichen Scrofulosis. Cod liver oil and tonics. Lipoma. Tumor of fat. Potassium iodide internally and ichthyol and chrysaro- bin externally. Lithaemia, see Rheumatism. Lithiasis, see Calculi. Lime Sulphurated. So called Calcium Sulphide, offensive with smell of hy- drogen sulphide used chiefly in boils, carbuncles, etc., dose a quarter grain to 2 grains, doubtful utility. Lime Water. Calcium Hydrate Solution or Aqua Calcis. Diluted 184 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. one half or less with water, milk or buttermilk corrects stomach acidity. Comparatively harmless and should there- fore be more frequently used than things that in time injure digestion. Mixed with linseed oil lime water makes Carron Oil an application for relieving the pain of burns. Liniments. Soap and chloroform more useful. Linseed. Meal for poultices, whole flaxseed for demulcent drink. Liquid Air. Used as cautery of cancerous growths. Liquorice. Glycyyrrhiza. Listerine. One of the numerous weaker antiseptics, made of aro- matics and borax. Lithium. In the form of citrates the lithium tablets have proven most useful as a minor remedy in rheumatism. Many spring waters are sold as carbonates of lithia, but the strength of these vary greatly leading to the inference that druggists or others fill up their lithia water receptacles with plain water, or that if marked lithia effects are secured the carbonate has been added to the water in the form of bicarbonate in larger quantity than can be found naturally in any spring water. The best effects are secured from a slightly aperient lithia water in which a small portion of glauber and epsom salts occur, this is the case with the Geneva Lithia Water from Geneva springs near Rochester, New York, but the temptations to substitute are so great and so easily done THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 185 that you can seldom be certain that a genuine spring water is to be had, despite the most solemn assurances of venders. Other Lithium salts such as the Benzoate, Bromide, Iodide, Salicylate are fancy additions to the overburdened Dispensatory. Lobelia. Obsolete. Lock-jaw, see Tetanus. Locomotor Ataxia. Tabes Dorsalis. Sclerosis of the posterior spinal cord columns. Symptoms are loss of the pupillary reflex to light, pu- pil does not contract in bright light, but does for accommo- dation, the Argyll-Robertson pupil, lancinating, sharp shooting pains down the legs, loss of knee reflex, anesthesia of feet and legs, inco-ordination of movements, etc. Avoid opiates and the long list of useless often harmful remedies, very little can be done for the disease as it pro- gresses to paralysis and death from some intercurrent dis- ease like pneumonia. Anti-syphilitic medicine may be vig- orously tried and it sometimes improves the case. Ergot and galvanism of spine descending current 15 or more milliamperes relieves pain often. Cathartics at intervals, special gymnastics calling into use muscles otherwise but little used. Thousands of theories as to treatment exploded. Loretin. One of the' numerous substitutes for Iodoform. Losophan. A Cresol antiseptic with 80 per cent iodine. Lues Venerea, see Syphilis. 186 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Lugol's Solution. Compound solution of iodine. Iodine 5, potassium iod- ide, 10, water 85. Dose 1 to 5 minims, diluted. Lumbago. Rheumatism of back, see Backache. Lunar Caustic. Silver Nitrate. Aside from its caustic uses it is astringent in the propor- tion of 10 grains or less to the ounce of water as an applica- tion with a camel's hair pencil to the fauces and tonsils when inflamed. Sometimes the relief obtained is immediate. Many things, however have been erroneously called tonsili- tis, and the rheumatic form is alleviated by guiac tablets or lozenges allowed to melt on the tongue before swallowing. Lupulin. Alkaloid from hops. Dose 2 to 15 grains. Little used. Lupus Erythematosus. Reddish skin patches. Treatment mild stimulating ointments as sulphur and tar. X ray. Lupus Vulgaris. Skin tuberculosis one form. Skin cancer. Extirpation, silver nitrate, pyrogallic acid, arsenious acid caustic, chlo- ride of zinc, X rays. Lycetol. Alleged uric acid solvent. Lycopodium. Dusting powder. Lymphadenoma, see Pseudo-leukemia. Lymphangitis. Inflammation of lymphatic vessel. Ichthyol externally and syrup of iodide of iron inter- nally, quinine and other tonics and stimulants according to severitv of attack. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. J 87 Lysoform. Lysol and formaldehyde. Not much used. LysJdlne. Another alleged uric acid solvent. Lysol. A saponaceous 50% cresol antiseptic and disinfectant, one of the best as it is effective, comparatively safe, non- caustic and cheap. For making instruments aseptic, also hands of surgeon, deodorizing, etc. Soluble in water it makes a clear, transparent, unctuous solution more convenient and safer than any other anti- septic. For weak antisepsis a solution of J to£% suffices. The usual surgical strength being 1 to 2% for operating. As a disinfectant it is used in 5% solution. It also deodorizes and has no offensive properties. Lyssaphobia. Fear of hydrophobia causing weak minded persons to bark, etc., in hysterical ignorance that barking is not a symptom of hydrophobia. Lysulphol. Sulphur lysol and soap. Not much used. Macrotin, see Cimicifugin. Magnesium Carbonate. Insoluble; Antacid, Antilithic. Dose 30 to 120 grains. Magnesium Oxide, Light. Light or calcined magnesia. Soluble in dilute acids and carbonic acid water. Antacid, Laxative, Antilithic. For stomach acidity and accompaniments of headache, dyspep- sia, etc., externally ulcers and abrasions, tooth powders. Large doses laxative. 10 to 60 grains dose. 188 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Magnesium Sulphate. Epsom Salts. Soluble 2 parts water. Dose a half to one ounce. Other magnesium salts or preparations are chemical reagents of doubtful medical utility. Maizavena. Corn silk, saw palmetto, oats, sandalwood oil. Tea- spoonful doses for cystitis, enlarged prostate, gonorrhoea, etc. Malaria, see Intermittent Fever and Remittent Fever. Mai de Mer, see Sea-sickness. Male-Fern, Oleoresin. Filix mas, a gram of the oleoresin representing about 14 grams of the root. Anthelmintic, unpleasant but safe. For tape worms Merck's Extract can be used 2 to 4 drams in 3 portions half-hourly, in capsules, followed by calomel and jalap if needed. See Tanret's Pelletierine for eligible syrup for tape worm. Malignant Pustule, see Anthrax. Malt Extracts. Vehicles for cod liver oil, cascara, and some other medi- cines. Minor tonic and nutrient by itself. Expensive. Manganese. Useful only in connection with iron tonics. Mania. Insanity with mental excitement. Sulfonal or Squibb's fluid extract of conium maculatum in quarter to half dram doses. Avoid opiates and chloral hydrate especially as the latter ruins digestion and forms a habit. Plenty of fresh air and out door exercise often re- sults in good sleep at night. Stimulants are better than de- pressants, the bromides add to the debility and supporting THERAPEUTICS, MATERIA MEDICA AND PRACTICE 189 treatment is needed for exhaustion finally sets in. Whisky may calm and act as a sedative where depressants have but temporary effect. Marasmus. Infant malnutrition. Sanitary surroundings, pure milk, tonics, removal of any constitutional cause if possible. Massage. As with many other remedial means the value of mas- sage has been misunderstood and practitioners have missed chances to benefit patients materially through natural skep- ticism and disgust induced by the extravagant claims of masseurs and the fact that most of them will use massage in cases where it is plainly useless. In their desire to get fees the real advantage of massage to the patient is of no con- sideration. Hence we see it applied by badly educated rub- bers, in and out of "massage parlors" and barber shops, solely as a fad and for profit and without the least reference to helping the sick person. At times even the most ignorant and useless treatment of any sort may exert a mental influ- ence, accidentally assisting a case particularly of minor ail- ments; but on the other hand you can observe instances of superficial rubbing, such as any granny can give, effleurage, where deep pressure is appropriate, blood pressed toward the heart and brain when those organs were already en- gorged, and the reverse operation of emptying brain vessels by downward pressure on the arteries in cases of faintness from too little blood in the head. The fact is massage is both a science and an art, but subsidiary to, or collateral with, all the other medical arts and sciences. To administer it properly requires an intimate knowledge of anatomy, physiology and pathology, and had practitioners recognized and availed themselves of what massage offers as an adju- vant in treatment, educated masseurs would have found 190 THERAPEUTICS, MATEIUA MEDICA AND PRACTICE. enough employment as assistants of physicians to enable them to give up the dishonest claim that all diseases can be treated by massage. The only function of the masseur is as an assistant to the physician; as a separate practitioner de- ciding for himself what disorders should be massaged he is most often a quack, like the "osteopath" who would never have sprung up at all if physicians had used the assistance of the masseur and not ignored the help it would have af- forded him, which the public has imperfectly realized and which the "osteopath" ignorantly applies with all the arro- gance of the financially successful and rascally charlatan. The way to kill the impudent harmful "osteopath" is to in- telligently employ the educated masseur, letting him agree to his subordinate position and discrediting him if he as- sumes to be a "cure-all" and refuses no case however in- appropriate for massage treatment, as long as a fee is ob- tainable. In treating chronic rheumatism, for instance, a combi- nation of massage, superheated air and medicines has worked surprising benefits to the patient, but the business problems are awkward: the hot-air man tries to steal such patients from the doctor, and in some few instances hot-air treatment by itself has been sufficient, then the masseur sneers at the inability of medicine to remedy all cases and makes unjustifiable promises to the sufferer, which some- times are fulfilled accidentally, and the osteopath laughs at all of them and literally and figuratively pulls the legs of vic- tims, who when their means are exhausted go back to the regulars or dispensaries, in some cases apologizing for pat- ronizing such unpromising practitioners as they no longer had the means to employ advertising and other high priced quackery. The mutual attitude of the doctor, masseur and hot-air man, thus is one of silence as to, if not condemnation of, THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 191 one another. The patient is left to flounder in ignorance, occasionally helped by a quack, because the doctor was not equipped with apparatus or information which in a few in- stances may have been legitimately used. Nor is it neces- sary for the physician to have all the accessory means for helping disease any more than he need own health resorts, springs or dispensaries. A conscientious regard for his pa- tient's welfare will suggest the employment of such means as are helpful without regard to how the ignorant may be influenced to false estimates of the subsidiary means and incline to substitute it for your general oversight of the case. Tapotement or rapid tapping over parts is now a part of massage but an apparatus was made for performing it in treating supra-orbital neuralgia in 1875 m France, and since then tapping machines have been more or less used in au- ral and facial massage, but mechano-neural treatment, vi- bratory stimulation, mechanical massage and treatment with other apparatus for similar purposes are being advertised to both doctors and patients until their claims perplex the practitioner, and when he reads announcements of cures by vibrations of disorders impossible to benefit by any means he is apt to grow disgusted and denounce the entire matter as a fake. To sift out the real from the false in any- thing is always difficult, and this is merely one of the in- stances. The manufacturers of the machines would sell everyone a set of jigglers and tossers if possible, and physi- cians would put them in the scrap heap. Meanwhile the little good they do is seen by some students and made use of, thus forcing the machinery into qualified recognition. Of course the mechanical treatment tries to secure every- thing whether suitable for that method or not. Business instinct prompts the doctor to reciprocate in kind and do as the charlatans do, but higher intelligence would reconcile the physician to abandon his practice altogether rather than sink to their level. 192 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Gymnastics or Swedish movements, in some few dis- orders, specially applicable, appear to be useful ; but, as with other measures, the inclination is to use them as cure-alls. In locomotor ataxia resort to muscle using differing from the ordinary, has been tried with not very encouraging re- sults, the idea being to develop such centers in the spinal cord as are not concerned in ordinary movements, thereby effecting a sort of derivative stimulation. In writers' cramp, or paralysis, exercise other than the habitual does no good, and excess of athletics is apt to impart heart hypertrophy and an uncomfortable over development of the muscles, which, in sedentery work, such as those perform, as a rule, after college graduation, becomes further pathological, necessitating exuviation before adjusting to the new habits of office or other quiet life; a painful disorganizing process. Mastitis, Mammitis. Inflammation of the breasts. Phytolacca decandra and externally belladonna oint- ment or plaster. Mastoiditis. Inflammation of the mastoid cells sometimes after sup- purative ear disease, may, if antiseptic treatment fails, re- quire surgery to excavate the abscess if one forms. Matico. Diuretic, fluid extract dose half a dram. Mild, unre- liable and obsolescent. Measles. An eruptive mild fever with catarrh of throat, nose, eyes and ears. Keep child in the house, give nothing but a little calomel. Measles recovers soonest when let alone. Medico-legal matters. Formerly such things as equity, science, learning, in the THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 193 better sense of the words were involved in court issues, but with the evolution of all things, good and bad, mere adroit- ness, chicanery and absence of humane considerations gov- ern most proceedings. Juries and judges are openly bought, an imitator of Lord Jeffreys once ruled Chicago in the in- terests of burglars, gamblers, politicians and similar crimi- nals, and it required a revolution to defeat him. He took bribes from corporations and cruelly abused the innocent plaintiffs against them. States Attorneys as a rule, with few exceptions, try to condemn every one indicted, and indict every one arrested, regardless of innocence or guilt, to "make a record of convictions" often to offset their release of wealthy criminals. I have personally known of immense efforts in Chicago of assistant state's attorneys to hang im- beciles and insane, whom they knew to be such. Abraham Lincoln with his honesty, mercifulness and ability without claptrap should be the type for emulation, but the blood- thirsty Jeffreys is more frequently copied. Megendie's Solution. Morphine 16 grains to the ounce of distilled water, for hypodermic use. The assertion is made that solutions of morphine change to apomorphine solutions in time. Melachol. Secret. Melancholia. This insanity is accompanied with toxaemias self en- gendered and it is a puzzle to combat them without depress- ing the patient further. Hot baths are cleansing but they exhaust, cathartics are needed but they have to be used in such large doses that when they operate the patient is often in a collapse. It is advisable to tone the system up at the same time these cleansing measures are used, and melan- choliacs can stand large doses of strychnia, quinine and 194 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. phospho-albumen enabling them to take cathartics and ton- ics better. Chloralamid is the best hypnotic. Membranous Croup. Diphtheria. Meniere's Disease, see Deafness. Meningitis, Brain Fever, Cerebro-spinal fever. Ergot, calomel, bromide of potassium, saline cathartics, ice to head, antipyrine, chloralamid. Mentagra, see Barber's Itch. Menopause. Circulatory disturbance in the climacteric or change of life period. Ergot, chloralamid, valerianates, asafoetida. Menorrhagia. Excessive menstruation. Ergot and rest in ordinary cases. Severe instances styptics, tampons, rarely uterine applications. Menthol. From oil of peppermint. Refrigerant, anthelmintic, an- tiseptic and incidentally slightly anesthetic especially to mu- cous surfaces. Very soluble in alcohol, insoluble in water or glycerine, also dissolves in 4 parts olive oil, which is sometimes used on tampons or externally as an antiseptic, analgesic, anaesthetic or stimulant; in diarrhoea, vomiting, chronic bronchitis, influenza, asthma, catarrh, nasal diph- theria internally, and outwardly toothache, crystal in tooth, migraine, neuralgia, pruritus ani et vulvae. Dose 3 to 5 grains. Menthol is the main ingredient in several headache and neuralgia external applications. It has been used for internal antisepsis in typhoid with debatable results, but as an anthelmintic with success in the anemia of Puerto Rico, ignorantly written Porto Rico, the anemia being due to THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 195 uncinariasis, a tropical parasite destructive of blood corpus- cles. Menthol Valerianate, see Validol. Mercuro-iodo-hemol, Substitute for iodide of mercury, on trial. Mercurol. Antiseptic and astringent, but as it must be made fresh as wanted it is not valuable enough to warrant the trouble. Mercury. The old fashioned blue mass contains 33 per cent of metallic mercury finely divided into globules, but these di- visions are very irregular as may be seen under the micro- scope, some of the globules flowing together in larger masses. If the stock is old these are still larger, accounting for the differences in effect of the separate stocks. Calomel is better for any purpose for which blue mass was formerly used. The ointment, Unguentum Hydrargyri, or blue oint- ment, used as an external application in parasitic destruc- tion and inunction in syphilis, also varies in the division of the metal and also may not contain the 50 per cent of metal. Improvements have been made by using Lanolin as an ex- cipient, and Squibb made oleates of mercury, but even these vary in the number of globules to the ounce, though labelled as having certain percentages. The metal has a tendency to precipitate from the oleic acid and to gather at the bottom of the bottles, as may be seen by simple inspection. Oleates are, however, more active than blue ointment, the division of metal being much finer, the minute globules being absorbed by the skin, but in metallic masses where the liquid has flown together there is no absorption even when the metal is beneath the skin. The finer the division the more active 196 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. the mercurial, and this applies to the salts of mercury as well, as the mercuric decomposes into much finer metallic globules than the mercurous salts, the bichloride releasing extremely small globules in the alkaline fluids and intestinal sugar than the mild chloride, and the first named is corres- pondingly more active, meriting its title of corrosive subli- mate. Hydrargic Plaster is hardly useful enough to be re- tained in the pharmacopeoia. The Ammoniac and Mercury Plaster is practically ob- solete. Ammoniated Mercury is so rarely used as to also war- rant its being dropped. From researches into the properties of the mercurials, published by me in various medical and scientific journals, the last article being in the Journal of the American Medical Association, Feb. 22 and 29, 1896, I was able to make sug- gestions as to the rationale of this class of medicine among which from observations under the microscope of the be- havior of the metallic particles in the human body, was the phagocyte like effect of the metal in enveloping debris, or any minute foreign particles, thus suppressing their patho- genic activity, if any, and enabling elimination of disease producing germs or products. This in turn suggested to me the idea of using the fluid metal mercury by pouring it into the urethra by gravitation, or introducing the pure metal by bougies, catheters or any other means, so as to come in di- rect contact with the gonococci, envelop them and by agi- tation cause the crypts of the urethra to be filled by the met- al which with the cocci can be subsequently poured and ex- pressed from the canal. Any later use of the same metal should be only after subliming or subjecting it to acid strong enough to destroy the germs without affecting the metal. In this way I think the entire canal can be thoroughly THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 197 cleansed with no danger of mercurial or any other poison- ing or bad result. Much nonsense is current concerning the effect of mer- curials. One mistake is that acids may not be used when calomel is taken. Calomel is unaffected by anything in the stomach or by what may be taken, except an alkali, such as bicarbonate of soda, which I recommended to be taken with sugar, in an article published twenty-five years ago. since which this mode of administration has come into common use. I also showed that the customary dose of the mercur- ials at that time was unnecessarily large and recommended the tenth grain calomel doses thereafter. Whenever calomel seems to be converted into corrosive sublimate in the system it is because the mercuric salt exis- ted in the dose of calomel as an impurity before it was taken. So lemons or vinegar can be safely used when calomel is taken and if any harshness seem referable to any combina- tions formed it is wholly due to impure calomel having been taken. The higher salts always decompose into oxides and metal in the body just as the lower salts do, that is the bi- chlorides, biniodides and other mercuric preparations split into the yellow oxide of mercury, and calomel and other mercurous salts decompose into the black oxide of mercury in the alkaline secretions and then further pass into the fine- ly divide metallic state by the action of physiological sugars, the main difference being that the higher salts break up more minutely than the lower, calomel liberating globules about the size of those in blue mass only vastly more uni- form, explaining the similarity of effects of calomel and blue pill. Mercury Chloride, Hydrargyri chloridum mite, see Calomel. Mercury Bichloride, Corrosive Sublimate or Hydrar- gyri chloridum corrosivum, see Bichloride of Mercury. 198 THERAPEUTICS, MATERIA MEDRJA AND PRACTICE. Mercury Cyanide, seldom used, obsolete. Mercury Imido-succinate, see Mercury Succinamide. Mercury Iodide, Red. The active Biniodide used as an antisyphilitic in tenth grain to quarter grain doses. Mercury Iodide, Yellow. In old pharmacopoeias called the Green Iodide until the microscope revealed that the green color was owing to the mixture of the pure yellow Mercury Protiodide with metallic mercury decomposed from it forming the impure green. It is used for the same purpose as the red iodide but is milder, being allied to calo- mel as a mercurous salt while the red iodide is mercuric and hence related to corrosive sublimate. The yellow can be given in half grain to 2 grain doses, but not combined with iodides or iodine as it may form the mercuric salt before taken internally. Mercury Oxide, Black. Too unstable for use. calomel is better. Mercury Oxide, Red. This highly poisonous salt is not used internally, and in my opinion is a subnitrate, for which I gave reasons in the articles on Mercury mentioned. A 10 per cent irritating ointment is made with it. Mercury Oxide, Yellow. Being derived from the mer- curic salts this oxide is more active than the black and being equally unstable it decomposes into finely divided metal un- der all circumstances. It is not used internally, an ointment has 10 per cent and the oleates various percentages, but they split up so readily this property should be taken account of when using it. Mercury Oxycyanide. Active germicide, more poison- ous than sublimate. Six tenths of one per cent solutions to wounds, but of doubtful superiority to mercuric chloride. Mercury Salicylate. Doubtful as any value to the over- burdened list of fancy medicines. Mercury Succinimide. Improperly suggested for hypo- dermic use in syphilis. See Corrosive Sublimate. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 199 Mercury Sulphate, Basic. This is Turpeth Mineral, the subsulphate of mercury and unfit for any use in medi- cine with so many purer and more eligible preparations. It is practically obsolescent even as an emetic. Mercury Tannate. A useless fancy article. Mercury Ammonium Chloride. White Precipitate. Only used as an ointment with 10 per cent of the ammon- iated mercury, and this old preparation can be spared. Mesotan. For local application of salicylic acid in rheumatism. 10 to 20% in olive oil or castor oil. Methyl alcohol. Poisonous wood alcohol. Methylene Blue. Aniline substitute for quinine. Dubious usefulness. Methyl-morphine. See Codeine. Merely disguised but weak morphine. Methyl Rhodin. Substitute for salicylates. On trial. , Methyl salicylate. Synthetic oil of wintergreen. Cheaper but more dan- gerous than the natural oil. Metritis. Inflammation of the uterus. Antiseptic and astringent washes or suppositories as ichthyol, internally ergot and salines. Metrorrhagia. Hemorrhage from uterus. Same treatment as menorrhagia, but if foreign sub- stance in uterus it should be removed to stop bleeding. Migraine, see Headache. 200 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Milk Leg, see Phlegmasia Alba Dolens. Milk of Magnesia. Liquid Magnesia, 24 grains to fluid ounce. Antacid. Dose 1 to 4 fluid drams. Milk, Sterilized. Von Behring says that the usual sterilization of milk is to be condemned since fresh milk contains anti-bodies which protect the infant against infection from colon-bacillus. Milk Sugar. Weak diuretic and nutritive, used as excipient wnere bulk and harmlessness desirable as in placebos and homeo- pathic preparations. Mind Cure. Impudent lying ignorance endeavoring to impose upon stupid ignorance. Such superstition is also preyed upon in mental telepathy, mind reading, theosophy, etc. Were there any truth in the ability of any one to read the mind of an- other as such fakes claim, the fakirs would instantly black- mail millionaires instead of scaring negroes out of dimes with their supernatural power. Molluscum. Waxy white or pink elevations with dark center, like vaccine sore. Tonics may relieve without incision, or zinc and mercurial ointment. Monobromate of camphor. In pills of either 3 or 5 grains, once to thrice daily, they are unequalled as a sedative to over activity of the genital functions or sexual desire. At puberty some young men are in danger of insanity from this cause and monobromate given judiciously will calm this erethism and brighten up the intellect, enabling proper sleep and absence from irritating THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 201 physiological conditions. Neurasthenia has been caused by masturbation and the monobromate pills will stop this pro- pensity enabling the patient to gather strength of mind and body, where tonics in such cases merely add fuel to the fire. Monoplegia. Paralysis of single group of muscles. Monsel's Solution. Subsulphate of iron solution. Styptic. Dose 3 to 10 drops diluted. Stops bleeding applied to surface injured, not antiseptic enough alone to prevent ulcers and sloughs from forming later. Monospasm. Spasm confined to a single group of muscles. Proto- spasm is where a general spasm follows on a monospasm. Moral Imbecility. Maliciously mischievous children and the money sharks and politicians who are without scruples. Under "business" they excuse acts from petty larceny to murder. Crime con- sists in being caught. Morning Sickness. Nausea of Pregnancy. A grain or two of oxalate of cerium dry on the tongue. Morphine. Alkaloid from Opium, which see. Dose an eighth to a half grain, and is more convenient and definite than opium as a medicine but equally terrible as a habit. Main antidotes are permanganate of potassium internally and tincture of capsicum by the rectum, with stimulants and tonics, as strychnia. The commonly prescribed sulphate is the best form for use, the Hydrochlorate being prescribed when other chlo- rine compounds are used by would-be careful practitioners 202 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. lacking experience in chemistry and who imagine that the trifling amounts of sulphates, etc., in salts of the kind, while theoretically incompatible are practically so, when they are not, and solubility differences are trifling. Morphinism. The opium habit. Reduce to slight discomfort point, cleanse with hot baths and cathartics, but support at the same time as in mel- ancholia, give strychnia aid. chloralamid for sleep, and never withdraw when intercurrent disease. When the point of discomfort on the small dose is reached then wait on that sized dose until it is tolerated as a point of comfort and then reduce still further and so con- tinue. Nothing is a cure when one narcotic is substituted for another. Morphine Poisoning, See Opium Poisoning. Mousette's Pills. Aconite about one three hundreth of a grain to each pill, dose two to three pills daily for neuralgia. Old prac- titioners anxiously and skilfully watched the effects of such deadly stuff as aconitine upon pain in honest endeavors to relieve it, when a brisk cathartic would have disposed at once of the poison upon which the pain depended. The an- cient treatment was like sealing up a sewer outside of the house. Muira-puama. Alleged aphrodisiac. Mumps. Parotiditis. Calomel a tenth of a grain hourly for the first day or two. Keep the patient in the house and isolate as it is con- tagious. It recovers in a few days even if nothing done, but in adults there is danger of orchitis. A five per cent ointment of guiacol spread over the THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 203 parotid region, and if orchitis threatened, also over the scro- tum has been recommended as a means of reducing the dan- gers and period of parotiditis. Muscarine Nitrate or Sulphate. Antispasmodic and antihydrotic. Night sweats, anti- dote to atropine. Music. Sentimental ignorance periodically "discovers" thai all insane and sick can be cured by music. It is a survival from the savage beating of drums to scare away the devils that cause sickness. One political asylum head availed himself of the catchiness of the idea to have concerts for ''graft." Musk. Antispasmodic, stimulant in doses of 3 to 10 grains or tincture half to a fluid dram. Seldom used as ammonia an- swers the purpose as well. Mustard. Emetic in teaspoonful doses, in plaster, papers or leaves, charta sinapis, allays nausea and abdominal pain. Powder in hot foot bath adds to rubefacient and derivative effect. Myalgia. Pain in muscles, usually rheumatic Mydrine. Evanescent mydriatic made up of ephidrine and hom- atropine hydrochlorates. 10 per cent solution in diagnosis. Myelitis. Spinal cord inflammation, see Meningitis. In syphilitic treat accordingly, otherwise as meningitis. Surgical myelitis refers to inflammation of the marrow of bones, often tubercular. Xeurologically it means inflam- 204 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. mation of some portion of the spinal cord, gray or white matter, both are serious diseases and apt to be chronic. Iodides, ergot, antiphlogistics, cathartics may aid, but cord myelitis tends to paralysis or worse. Myocarditis. Heart muscle inflammation. Diagnosis difficult, ends in degeneration and liability to rupture. Treat as endocar- ditis. Myoma. Muscle tumors. Excision. Myotonia. Congenital chorea like inco-ordination. Incurable. Myoclonia or myoclonus could apply to the same, which has been called Thompson's Disease. Though clonic grimaces more properly fall under that division, such are also incur- able though not congenital. Habit chorea liable to be con- fused with tonic and clonic disorders of other kinds. Myrrh. Astringent. Carminative, Cathartic, Emmenagogue. Dose 5 to 20 grains or tincture half to 2 fluid drams. There are also pills of Aloes and Myrrh and a tincture of the same. Not much used except with other things or as an astringent application of the tincture of Myrrh to tender and loose gums in dentistry. Myrtol. Ethereal drops 5 to 15 minims on sugar or otherwise in bronchitis, tonsillitis, cystitis, etc. Mysophobia. Fear of contamination. Some patients wash their hands hundreds of times daily. Treatment seldom helpful. Sea travel, bicycle riding, out door life. Usually incurable. THERAPEUTICS, MATERIA MEDICA AND PRACTICE 205 Mysticism. Tendency to credulity and love of mystery are rever- sions to savage terrorism. Negro hoodooism is an example. It is also a symptom of some insanities, as paranoia, or per- version of reasoning. Uncultivated and illogical delight in deceiving themselves, assisting fakirs in hoodwinking them. Myxoma. Mucous polypi are formed of this connective tissue growth. Excision. Myxoedema. A mucous dropsy, causing puffiness of face and hands and stupidity. Thyroid preparations are remarkably suc- cessful in this disorder, probably originating the idea that thyroids were good in obesity, as myxoedema resembles obesity superficially. Naevus. Mother's marks, moles, red due to arterial, blue to ven- ous blood. Electrolysis judiciously if at all. Most cases are best not treated. Napelline. Alkaloid from aconitum napellus, dose a sixth of a grain. In morphinism to substitute one horrible habit for another. Naphthaline. Soluble in 20 parts alcohol, 3 ether, 8 oil turpentine, 2 chloroform, 8 olive oil, insoluble in water or glycerine. Has been used internally in intestinal catarrh, worms, cholera, typhoid fever, and externally in skin diseases. Dose 2 to 8 grains in powder or capsule; for tape worm 15 grains fol- lowed some hours later by castor oil. Maximum dose 30 grains. As an internal antiseptic it cannot be used in suffi- cient quantities to aid. 206 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Naphthoic Alpha. Disagreeable taste, but little soluble in water, soluble in alcohol or ether. Antifermentative, Antiseptic, used in diarrhoea, typhoid fever. Dose 2 to 5 grains. Seldom used. Naphthol, Beta. Soluble in 1 part alcohol, 2 ether, 25 chloroform, 40 glycerine, 12 olive oil, almost insoluble in water. Antisep- tic internally and for skin diseases as psoriasis externally. Dose 3 to 8 grains, maximum 10 grains. Not so often used as formerly. Naphthol, Beta, Benzoate. Same purposes as other Naphthols, dose 5 to 15 grains. Narcotile. Anesthetic. Not much used. Nargol. Silver and nucleic acid for gonorrhea. Not much used. Nausea. Ice swallowed, mustard to abdomen, oxalate of cerium a grain dry on the tongue. If fermentation, atonic indiges- tion a vomit induced by copious water drinking and any emetic or lavage washing out of the stomach are better than merely smothering the sensation of nausea. Nephritic Deafness. Morf says half the nephritics are deaf. How many are deaf without nephritis not estimated. Nephritis, see Bright's Disease. Nephroson. Diuretic elixir. Compound of vegetable diuretics. Dose 5 to 10 drops diluted. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 207 Nervous Exhaustion, see Neurasthenia. Nervousness. Irritability. Fresh air, avoid medicines except a little asafoetida. Change the conditions producing nervousness, as late hours, idleness, inane life, too much or too little food, liquors, tea, coffee, etc. Bromides debilitate, opiates and cocaine de- bauch. Nettle Rash, see Urticaria. Neuralgia. See also Headache. Usually an autotoxaemia, requir- ing cleansing in the most effective manner that will not in- duce the habit of taking cathartics. Pure cod liver oil. not emulsions or silly substitutes, and salines establishing regu- larity of bowels, with bathing and any other means of main- taining regularity and cleanliness of habits. The various acetanilide, antikamnia, opiate and cocaine wines and simi- lar preparations are given only by careless, ignorant or de- signing who have not proper regard for the future of the pa- tient. Often those who have developed considerably in a particular branch of mechanical medicine, as surgery, mas- sage, etc., may not have the requisite experience or infor- mation as to the perniciousness of administering such ad captandum drugs, and give them for their immediate effects. The eradication of the disease, usually an autotoxaemia, is the greatest service to render, but the average patient wants theatrical instantaneous results without regard to his future, and the consequence is that superficial and even debauching temporary dosing is better in demand than honorable logi- cal study and removal of sickness. Rarely a neuralgia may be from organic defects, as tu- mors or deformities of structure, but the majority can be helped as indicated above. 208 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Neurasthenia. Sometimes anemia treatment suffices, but the bedrid- den habit may be hard to break up. It is best to get the pa- tient out of doors as soon as possible and to clean out the system at the same time it is toned up. Salines and Phos- pho-albumen, or strychnia and quinine are valuable. Care to be used that hysterical peculiarities are recognized, for firm- ness and insistence upon staying out of bed and exercising out doors cut this sort of ''neurasthenia" short. The mind is more involved than in diseases that resemble this hysteri- cal "nervous prostration." Neuritis. Inflammation of a nerve. If alcoholic withdrew cause, similarly if from lead poi- soning. Antiphlogistine, anti-rheumatics and if indicated anti-syphilitics. Neurodin. Secret antineuralgic and antipyretic. Neuroma. Nerve tumor, neuro-fibroma, painful tumors. The most intense suffering is from an urethral caruncle in the female, a small scarlet wart like angio-neuroma, rendering micturi- tion excrutiatingly painful. Cocaine relieves pain instantly locally in 3% solution, but excision is the only relief of a permanent kind. I caused one to disappear with ergot fluid extract, buchu and atropine, the excrescence becoming a white fibroid without sensitiveness. Neurosine. Secret. Nickel Bromide. Useless in epilepsy. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 209 Nicotine. Nauseant depressant alkaloid of tobacco, a twentieth of a grain in strychnia poisoning. Seldom used. Night sweats. Quinine, other tonics, atropia, spirits of nitrous ether. Night terrors of children. From obstructed breathing, adenoids at times, imper- fect cerebral circulation from scarlatina, diphtheria, etc. Nipples, Rubber. For infants should not be vulcanized, nor when used for teeth cutting should they be perforated, as the air sucked in causes colic. Nipples, see Fissures. Nirvanin. Local anesthetic. Probably as unscientific as its name. Nitre Paper. Old fashioned method of allaying asthmatic suffering was by soaking "brown paper," wrapping bibulous paper, in a strong solution of saltpetre, drying the paper and set- ting it afire in a pan covered with a tin funnel through the small end of which the asthmatic inhaled the gases given off. Nitric Acid. Escharotic, after cocaine on syphilitic ulcer, or in burn- ing out the pits in which the carbuncle germs and pus bur- row. Antidote alkalies. Nitro-glycerine. Glonoin. Like amyl nitrite but more enduring in effects. Vas- cular dilator and lessener of blood pressure, diffusing cir- 210 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. dilation, increasing heart rapidity. In angina pectoris ar- terial tension is relieved, in epilepsy and hysteria paroxysms may be anticipated and prevented though amyl nitrite is better for prompt action, spasmodic asthma, whooping cough, false croup, neuralgic dysmenorrhoea, sea sickness, nausea, cold stage of ague, syncope, chloroform poisoning, tense pulse from any cause as autotoxemia, pale migraine, convulsions generally, chronic interstitial nephritis, tetanus, either the amyl nitrite or nitro-glycerine according to the rapidity of effect desired, prove useful. The glass pearl iorm for amyl nitrite and the tablet or pilule form for glon- oin are best. The dose of nitro-glycerine is a hundredth of a grain, sometimes less and seldom more. The spirit of glonoin contains i% in alcohol, the dose being a half to 10 minims. So powerful a medicine naturally attracted the at- tention of irregulars, who with such dangerous things as acetanilide, opium and glonoin work apparent miracles, and make widespread misery; so, to enable their little pills to get credit for demonstrable effects the homeopaths made a ten per cent tincture, see H. Phar. 2nd ed. Phila., 1883, p. 235, to pour on their sugar pills to "potentialize" them, in direct opposition to Hannemann's idea that "potency" in- creased as the cause decreased, so that a single itch scab should cure all diseases in the world, hence a grain of nitro- glycerine diluted by the Atlantic ocean should consistency be medicine for them in drop doses. Their 10% tincture has blown up some of their "doctors" and patients, though not all of them, for material enough for generations of them and similar faith curists remain unexploded. Nitro-muriatic Acid. Nitro-hydrochloric Acid. Aqua Regia. One fifth strength of the concentrated is the dilute acid, used internally sometimes for jaundice, biliary calculi in doses of 5 to 20 minims well diluted. This has been im- THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 211 properly used for "dyspepsia" as a routine remedy, when there may have been already too much acid in the stomach. Nitrous Oxide. Laughing gas. Used by dentists for safe anesthesia, and not enough in surgery in which it could with advantage replace chloroform and ether for short anesthesia. It is particularly useful in weak heart indications against ordi- nary anesthetics. Norwood's Tincture. Veratrum viride. Dose 5 minims tri-hourly to lower pulse. Depressant like aconite and as unsafe, paralyses heart. Nose-bleed, see Epistaxis. Nosophen. Tetraiodo-phenolphtalein. Surgical antiseptic contain- ing 60 per cent of iodine. Odorless, tasteless, insoluble. Well spoken of by surgeons. Nourry's lodinated Wine. About three fourths grain iodine and a grain and a half of tannin to the tablespoonful. Substitute for iodide of potassium. N Rays. Nonsense rays. The sensational claim being made for these N rays that thought and other brain functions could be measured by them. The plethysmograph measures the blood pressure as affected by exertion of any sort, but this is not spiritual enough to suit the illogical mystics. Nuciein. Organotherapy preparation. 212 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Numbness. A symptom of circulatory and nerve impairment in a variety of disorders, functional and organic, trivial and ser- ious. Nutgall. Galls. Astringent. Nutmeg. Aromatic, Carminative. Dose 5 to 20 grains; in over- doses acts as an abortifacient by causing pelvic congestion, as does apiol. Also has narcotic poisonous effect in over- dose. Ergot and stimulants counteract undue influence mentioned. Nutrient Reflex. Vaso-motor arrangement by which blood-supply is regulated by waste, explained in neurological journals and books written by me during thirty years, waiting for the plagiarist with influence enough to make a sensational an- nouncement of his "discovery." Nux Vomica. Stomachic, Tonic. Strychnine is better as it is less variable. Nystagmus. Eye ball oscillations side to side. Bad prognosis. Nymphomania. Abnormal sexual desire in females. Monobromate of camphor, salines, light food, no liq- uors. Oakum. Coarse but efficient surgical absorbent, the tar while odoriferous makes it a fair antiseptic. Used empirically in hospitals and for packing splint boxes from early times. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 213 Obesity, Fatness. Numerous remedies have been tried with no result. Thyroid may in some cases where the fat is a degeneracy stigma, but the most certain reducer of size is in out door lengthy walks, or an exclusively out door life. I have known this to reduce the weight from 250 to 180 lbs in six months. Anti-fat nostrums are injurious as founded on the iodine in kelp or fucus vesiculosus, several deaths have occurred from its use, through colliquitive diarrhoeas induced. Phytoll- acca berries, and alternating acid and alkaline salt treatment failed. Odontalgia, see Toothache. Oedema, see Edema, or Dropsy. Oil, Betula. Oil of sweet birch, uses and dose same as oil of Gaul- theria. Anti-rheumatic. Oil of Bitter Almond. Contains prussic acid poison. Oil of Cade. Juniper Tar. Old fashioned external in psoriasis, fa- vus, etc. Oil of Cajuput. Stimulant, Diaphoretic, Carminative. Seldom used. Dose 5 to 20 minims. , Oil, Castor. Cathartic dose half to a fluid ounce. Antagonizes auto- toxemias especially as indicated by headaches in post-dys- enteric states. Oil, Cod Liver, see Cod Liver Oil. 214 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Oil, Croton. Virulent purge. Dose one drop. Externally as a pus- tulant, irritant. Oil, Eucalytus. Aromatic antiseptic much used as Eucalyptol in the popular weaker antiseptics with borax, etc. Oil of Gaultheria. Wintergreen. Good antirheumatic when pure. Dose 5 to 20 minims. Oil of Juniper Berries. Old diuretic, seldom used. Oil of Mustard. The true oil of mustard is exceedingly pungent, and is an old fashioned sternutatory. Quackery made use of it as "Electricity Bottled" to smell in colds. An eighth of a drop with much water is an internal dose as a carminative. Sel- dom used. Oil, Olive. Rarely obtainable pure; usually cotton seed oil is sold as olive oil. The old use of this oil favored mouldy growths in ears when combined with laudanum for ear drops. As an intestinal lubricant to promote gall stone passage or as a laxative, cod liver oil is better. Oil of Pine Needles, Pinus Sylvestris. Oil of Scotch Fir. Antiseptic, Antirheumatic, used by inhalation with steam in lung diseases. Externally in rheu- matism. Little used. Oil, Pinus Pumilio. Mountain Pine Oil. About the same as above. Little used. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 215 Oil of Rosemary. Stimulant, Diuretic, Carminative. Dose 2 to 5 minims in capsules. Seldom used. Oil 9 Santal. Sandal wood oil. Internal antiseptic, anticatarrhal, anti-gonorrhoeal. Dose 5 to 20 minims. Irritating more or less. Oil of Tar. Externally, but not much in use. Oil of Thyme. Externally, but thymol more useful. Oil of Wintergreen, see Oil of Gaultheria. Oleate of Cocaine. 5 and 10 per cent, local anesthetic. Oleate of Mercury. 20 and 40 per cent. Externally in skin diseases, pedi- culi, and inunction. Oleoresin, Capsicum. Rubefacient, stimulant in flatulence. Externally in pain of> neuralgia and rheumatism. Capsicum and Capsine plas- ters are kept in stock by druggists. Oleoresin of Male Fern, see Male Fern. Onychia, Inflammation of the matrix of a nail. Ichthyol, carbolic acid, opium tincture, cocaine, anti- phlogistine. Operative Remedies. Trephining the skull should be done rarely and with neurological advice, as there are many problems of diag- nosis, brain localization, cerebral topography and general neurological clinical experience not usually studied by the 216 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. average practitioner and still less by the surgeon who too often unadvisedly and rashly operates, sanctioned by the ig- norance of such matters on the part of the laity, who accord to flashy surgery a reverence they are incapable of extend- ing to medical knowledge as they cannot grasp the logical training and deep study of the many branches that go to make up medicine as a whole, inasmuch as these become reasoning processes of the highest kind, indemonstrable to the superficial, but operative measures they can see and fancy that they can understand. Depressed fractures of the skull should be remedied by replacing the bones, but it is malpractice to trephine in cerebral hemorrhage, and many apoplexies are of this nature. Trephining has often been performed on the wrong side of the head, through interpre- ting symptoms without neurological knowledge. Opera- tions for appendicitis have been improperly made when there was biliary calculus instead, and even dysentery or abdominal rheumatism has been called appendicitis by sur- geons prepared to operate. The gravid uterus has been cut down upon for tumor. But the worst blunder is in emascu- lating the insane to "cure the insanity" without reference to alienistic literature which would inform the too ready knifer that Battey's operation has made lunatics, and that where the shock of an operation has temporarily cleared the mind the subsequent relapse of the insane woman deprived of healthy ovaries is too frequent to warrant this mutilation. Even respectable gynaecological surgical literature depre- cates the taking out of normal ovaries as likely to have bad after mental results. Of course diseased ovaries, if really diseased and not merely superficially diagnosed as such may be properly removed, but healthy ovaries no more than eyes, ears or noses can be destroyed to "cure insanity." A few decades ago cart loads of clitorides were cut off for all kinds of ailments, and Stevens' ocular muscle cutting THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 217 followed for the cure of as many conditions as patent medi- fines allege. Ophthalmia, see Conjunctivitis. Ophthalmoplegia. Paralysis of one or more muscles controlling eye-ball movements. As syphilis is most frequent cause, antisyph- ilitics can be tried, and later strychnia. Jpium. Varies in quantity, which should not be less than 9 per cent, of morphine, that it is better to use that alkaloid in- stead. Less used yearly by more intelligent and conscientious prescribers, as the havoc it has made in the world weighs heavily against its benefits. Opium Habit, see Morphinism. Opium Poisoning. Internally 4 grains potassium permanganate neutralize 3 grains of morphine, and 6 grains for each fluid ounce of laudanum. Hypodermically 15 minims of 5% solution hourly or oftener till improved. Rectal injections of tincture of capsicum half an ounce to a pint of water arouses interest in the performances, and it is not attended with inflammation subsequently. Opodeldoc. Ancient liniment, superseded by other external appli- cations. Optic Atrophy. Death of the optic nerve with inevitable, incurable blindness. Orchitis, see Epididymitis. 218 THEEAPEUTICS, MATERIA MEDICA AND PRACTICE. Orexin Tannate. Appetite promoter and stomachic. On trial for sea- sickness. Organotherapy. Thyroid gland, testicular substance, as phospho-albu- men, and suprarenal gland are decidedly useful, but a long list of worthless affairs said to be from other organs are based often on nitro-glycerine, and are for the most part dishonest or ignorantly foisted on a therapeutically ridden profession. Orphol. Bismuth Beta-Naphtholate. Orthoform. Local and internal anodyne and antiseptic, chief use on external wounds, burns, toothache to allay pain, pure or in ointment. Dose 8 to 15 grains. Orthopnoea, Distressed breathing in any other than an upright posi- tion, usually because fluids press upon the lungs in lying down, during serious organic disease with dropsy. Osmidrosis or Bromidrosis. Offensive perspiration, usually of feet. Rheumatism or uremia the cause. As it is hyperidrosis decomposed later boracic acid in the shoes may prevent some of the offensive- ness. Charcoal also, pulverized. Osteoma. Bone Tumor. The X ray is useful in photographing the location of such hard substances in the brain or elsewhere. Osteomalacia. Bone softening. The usual calcium nostrums prescribed are worthless, tonics in general can be tried, with suitable food. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 219 Osteopathy. Ignorant massage. Otalgia, see Earache. Otitis. Suppuration of the middle ear after scarlet fever or measles should be treated early with boracic acid and pe- roxide of hydrogen, as neglect entails necrosis, abscesses, deafness and even insanity. Otorrhoea, see Deafness. Ovarden. Dried extract of ovary. Doubtful organo-therapy pre- paration. Ovariin. From cow ovary. Doubtful usefulness. Ovaritis. Oophoritis. Inflammation of the ovaries. Ovaralgia or pain in the. ovary may be due to prolapse and by replacement relieved, but inflamed ovaries require derivation externally and internally. Calomel, salines, cas- cara, heat to abdomen, rubefacients and even cantharidal blister plasters over ovaries. Ovo-Ferrin. A much advertised egg-iron tonic. Iron in any form will act as a tonic, more or less. Oxalate of Cerium. Anti-nauseant in doses of I to 5 grains, dry on the tongue. Oxalic Acid. Improperly used in medicine. 220 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Oxaphor. 50 per cent solution of oxidation product of camphor, used in cardiac dyspnoea and asthma. Aromatic spirits of ammonia will answer as well for the former ailment. Ox-gall, see Fel Bovinum. Oxide of Zinc Ointment. Antiseptic for ulcers. Oxydonor. Quack trinket, nickel plated cylinder containing as- phaltum, to cure all diseases by tying it to the patient's leg. Oxygen. Inhalations to resuscitate asphyxiated, and in collapse of pneumonia. Oxymethylene, see Formaldehyde. Ozena. Fetid nose disease. Antiseptics, antisyphilitics, peroxide of hydrogen, bo- rax, etc. Palpitation. Often a stomach rather than a heart trouble. Bicarbo- nate of sodium, digestants, digitalis or aromatic spirits of ammonia, asafoetida. Panax, see Ginseng. Pancreatin. For intestinal indigestion, and as the lean type of dia- betes is associated with pancreas disease, functional or or- ganic, as in cancer of that gland, the free use of pancreatine should mitigate though it may not fully relieve this glyco- suric disorder. Dose 5 grains and upward. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 221 Pankreon. Peptonizing Powder. , Panopepton. An alcoholic, rather strong, with foods said to be pre- digested. Not a triumph of its kind as is Trophonine. Papain. Papayotin. From Carica Papaya, Pawpaw. Enzyme said to be similar to pepsin but acting in alkaline, acid or neutral solution, soluble in water or glycerine, to aid diges- tion, but it appears not to be much in favor for such pur- poses, and as for the claim that it dissolves false membranes and can be used in diphtheria, it cannot attack this systemic disease even though it may dissolve the membrane which is a mere incident and not even an essential one in diphtheria, and as for cataract absorption the higher grade of ophthal- mologists rely still upon surgery, while charlatans proclaim "removal of cataract by digesting the false tissue." Pappilloma, see Warts. Paraformaldehyre. Same as Trioxymethylene. A formaldehyde fancy pre- paration, disguised with a new name. Paraldehyde. Hypnotic. Not much used. Suffocative. Paralysis. Before a paralysis can be treated properly its location and cause must be known, and in most cases the paralysis cannot be cured and meddlesome dosing is harmful or merely to earn fees. Paralysis from brain hemorrhage in its early stage is best let alone; many months afterwards, if in one not too old, massage, or electrical stimulation may im- prove a fourth of the cases, and make a decided improve- 222 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. merit in one case in a hundred. Similarly in embolic cases, but in the hemiplegias of brain syphilis in the young much can be done with iodide of potassium and mercurials if treatment is soon enough, if too much destruction of brain tissue has occurred the full recovery can not be obtained. Paralyses of children attended with an alteration in the size of the leg or arm, or its failure to grow are incurable. Spinal cord destruction causes incurable paralysis. Paralysis Agitans. Shaking Palsy. Incurable. Hot bathing and riding in vehicles amelior- ate. Parametritis. Inflammation of tissues around uterus, see Metritis. Paranoia. Logical Perversion. Formerly incorrectly called monomania. Often homi- cidal. Incurable insanity. Paraplegia. Spinal paralysis of both legs. Paregoric. Camphorated Tincture of Opium. Dose for infants 5 minims, adults a dram. Pareira. In great favor 200 years ago as a diuretic, antilithic and in cystitis. Seldom used now. Paresis, see Paretic Dementia. Paronychia, see Felon. Parotiditis, see Mumps. Parotitis, see Mumps. Passiflora. Used in dysmenorrhoea. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 223 Pautauberge's Solution of Creosote and Hydrochloro- -phosphate of lime. Doubtless a fair substitute for other creosote prepara- tions, but the lime salt is not assimilable. Paw-paw. , The ordinary paw-paw is said to have digestant powers, but the kind called Carica papaya is remarkable in this re- spect, for albumenoids. Pediculi, see Lice. " Pelletierine. For tape worm several preparations of the kind. A good syrup is that of Tanret's Pelletierine. Pemphigus. Inflammatory skin disease? with vesicles and pigmentation. Arsenic and quinine internally and ichthyol and zinc oxide externally. Pennyroyal. Hedeoma. Emmenagogue, dose of oil 2 to 10 minims. Also used to prevent bites of fleas and mosquitoes. Peppermint. Carminative, aromatic, dose of oil a drop to 5 drops, troches contain a sixth of a drop, spirits dose 5 to 15 min- ims. Pepsin. Multitudinous pepsins more or less nasty or inert are marketed even in such silly forms as with beer or chewing gum. When the people learn that rotten stomachs of hogs are the source of many of these popular pepsins they will cease purchasing them. Some eligible preparations such as Fairchild's are found useful, but as these have 224 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. been mistakenly applied to intestinal indigestion as well as stomachic, they are liable to lose esteem. An instance of where instruction of the purchasers would eventually prove more profitable than in permitting them to think that pep- sin could be universally applied. Pepsin? Dialysed. Dose 2 pearls. # Peptenzyme. Whether in Elixir, tablet or powder form peptenzyme is an excellent intestinal digestant, relieving abdominal pains swiftly. Reed and Carnrick, the manufacturers, have made a special study of digestants and a trial of this one will sustain my claim that their research has been successful. Pepto-Mangan, Gude. An eligible, effective iron-manganese tonic. Peptonates, see Digestants, Peptone Wine. Digestant. Peptonized Foods. By means of peptonizing powder sometimes contained in tubes, enough in each tube or small glass vial to pepton- ize a pint of milk, a readily assimilable special diet can be made in short order time. Milk by the cold or hot process adapted to Bright's disease treatment and feeding, milk gruel, jelly, punch, lemonade, also peptonized beef and oys- ters. Digested or pancreatized would be more appropriate as a designation for the process. See Digestants. Peptonizing Powder. Pancreaticus Compositus. A mixture of 20 parts pan- creatin and 80 parts sodium bicarbonate. 25 grains will "peptonize" a pint of milk. 225 — j Perdynamin. An albumen iron. Perkins' Tractors. About 1800 a Connecticut man named Perkins claimed the ability to cure all diseases with his "tractors," a couple of little metal tubes held in the hands. Multitudes in Eu- rope, including 8 professors, 40 physicians and 30 clergy- men certified to the miraculous cures made by the tractors. It was proven that wooden cylinders also "cured," when the sick thought they were metal. The craze died out to be re- placed in time by various forms of Eddyism. Pericarditis. Inflammation of the heart sac. Digitalis in small doses, calomel diuretics, aspiration for exudate. Keep up strength by nourishment and stimulants. Periositis. Inflammation of bone membrane covering. Iodide of potassium, mercuric chloride or biniodide, syrup of iodide of iron. Such things as calcium phosphate and glycerino-phosphates are silly. See also Felon. Peritonitis and Perimetritis. Peritoneal inflammation. Magnesium sulphate, calomel, morphine, in large and frequent doses as symptoms indicate, and ichthyol exter- nally with heat to abdomen. With pelvic effusion as in cel- lulitis of uterine affections, a large cantharides plaster, the serum evacuated later from incision in most dependent part, and the surface dressed with 1% to 3% carbolized vaseline. Chronic perimetritis treat with iodide of potassium. The simultaneous use of calomel, magnesia sulphate and mor- phine to allay pain is more seemingly incompatible than really so, as emunctories must be kept open in spite of the tendency of drugs to close them. 226 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Permanganate of Potassium, see Potassium Perman- ganate. Perosmic Acid. Improperly used in medicine, no value in epilepsy, as prescribed by some inexperienced persons. Perspiration, Offensive and Excessive, see Bromidrosis and Hyperidrosis. Pertussis. Whooping Cough. Of the many things recommended few are even useful and most are depressing. Among things tried are ichthyol, potassium bromide, antipyrine, bromoform. If the irritat- ing germs lie at the base of the tongue probably Chapoteau's morrhuol and creosote capsules may be as effective as any good harmless antiseptics applied locally. Morphine is bad, and if bromides are used they must not be in excess, heroin is objectionable for steady use. Creolin inhalations help some cases. Calomel to prevent head congestion from se- vere cough. Petrolatum. Cosmo-line or vaseline. Phenacetin. One of the safest of the modern group of pain allevia- tors. In addition to its analgesic properties it is antipyretic, but almost insoluble. Dose 5 to 15 grains, cautiously as even the weakest of this class of anti-neuralgics may have a bad effect upon the heart, especially when weak. Phenacoll Hydrochlorate. Practically a soluble Phenacetin. Dose 5 to 15 grains. Phenalgin. A dangerous antineuralgic. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 227 Phenazone, see Antipyrine. Phenol, see Carbolic Acid. Phenol Salicylate, see Salol. Phenosalyl. A mixture of carbolic, salicylic and lactic acids with menthol. Phenyl-acetamide, see Acetanilide. There are phenyl prefixes to various drugs such as an- tipyrine, euphorin, orexine tannate, etc. Pharyngitis. Throat Inflammation. Cod liver oil and creosote, guiac, nitrate of silver 8 gains to an ounce of water painted on tonsils and fauces, ex- ternally heat, an antiphlogistine or blisters; rubefacients in minor cases. Phenic Acid. Carbolic Acid. Phenol Sodique. Carbolate of soda. Antiseptic. Phlebitis. Vein inflammation. Calomel internally and ichthyol, morphine and bella- donna externally. Phlegmasia alba dolens. Milk leg, femoral phlebitis from obstruction by throm- bosis after delivery or in typhoid fever. Carbonate of am- monia, anti-pyrine, digitalis, hydrochloric acid internally, hamamelis, ichthyol and antiseptics generally externally. Phlegmon. Boils. Antiphlogistine aborts, ichthyol collodion or other pro- tective, alteratives and tonics internally if debilitated. A phlegmonous erysipelas may appear in diabetes and end fa- ta;'--" 228 THERAPEUTICS, MATERIA MEOICA AND PRACTICE. Phosphates. Inorganic not assimilable, only useful as medicines if in plant or meat form. Phosphites similarly ineligible. Phosphatol. Neutral phosphite of creosote. Suggested for tubercu- losis, 4 to 6 capsules daily. Phosphaturla. Excess of phosphates in urine. Tonic treatment and rest, minor antiseptics internally. Phospho-Albumen. A proprietary preparation of the testes of cattle and sheep in which the theorizing of Brown-Sequard is carried out to a practical result. It is the best organo-therapic com- pound to be had and quick results are secured with it in neurasthenia, sexual debility, anemia from any cause and in incipient melancholia, especially in the aged. In some cases there have been inert syrups substituted for the genuine, or rarely fermentation spoils the real article, but when the proper article is secured and appropriately used physicians have uniformly been pleased with its effects. Phosphoric Acid. Too poisonous and concentrated to use. Phosphorus. Too dangerous to use pure or disguised as a medicine, especially as an aphrodisiac, causes fatty degeneration of kidneys and liver with bloody urine and great suffering. Phosphorus poisoning. The French oil of turpentine is used antidotally in preference to other oils, but with discouraging results. Old ozonized oil of turpentine is mentioned as antidotal and prophylactic. Bamberger used three grains of sulphate of copper every five minutes in acute cases claiming that a THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 229 chemical union was secured resulting in an inert product. To prevent emesis so as to be able to continue the dosing af- ter all the good had been secured by vomiting, opium has been added to the sulphate treatment. Permanganate of potassium douches have been used bv von Jaksch, but a third of the cases died. Fatty food or medicines must be avoided as oils render the phosphorus soluble. Jaw necrosis is usually from inhaling- the poison as in match making, so a change of occupation is necessary in such cases, and sur- gery claims the discussion of that trouble. Usually in cases of chronic poisoning the damage is beyond repair. Fatty degeneration of the liver, kidneys and heart result from chronic phosphorus poisoning. In my opinion all the good possible to obtain from an eliminant in instances where the poison lurked in the tissues, would be secured from con- tinuous minute doses of calomel, say tenth grain doses four or five times daily till constitutional mercurial effects ob- served. The last Czar Alexander, it is said, was slowly poisoned with phosphorus in his food. As an ingredient of aphrodisiacs great irritation of the genito-urinary tract has been set up, ending sometimes in complete loss of sexual function, paralysis and death. Many quack aphrodisiacs on the market contain poisonous doses of phosphorus. Photophobia. Light causing pain in eyes. Head injury or serious eye disease or neurasthenia. Darkened room and otherwise suitable treatment, mainly intelligent watchfulness without over medication. Phthisical Insanity. Angry, suspicious mania occasionally found with phth- isis. Some recover mentally to relapse physically. Phthisis. Consumption. See also Tuberculosis. Exclusively out-door life especially in pine tree moun- tains. All other treatment as cod liver oil morrhuol and 230 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. creosote merely palliative. The usual quack method is to play upon the well-known hopefulness of consumptive pa- tients and promise to cure them with some "recent wonder- ful discovery," gauging the time by estimation of how long the victim's money can be secured, the usual medicine being wild cherry bark or cherry laurel water, the prussic acid in which allays the cough a little but is no more curative than a lid on a volcano puts out its fires. Physio-medical. Title of a quack system. Physostigma. Calabar Bean. Eserine is an alkaloid. Contracts pupil, used in oph- thalmology, antagonist atropine. Other uses as a paraly- sant not encouraging. Phytolacca Root. Poke root, Phytollacca decandra. One of the very few survivals from Eclectisism, somewhat alterative and popu- larly favored as a remedy in mastitis. Dose I to 5 grains, fluid extract 1 to 5 minims. At one time the berries were said to have an anti-fat effect, based on a homoeopath's fairy story of birds eating them and growing thin, but time and trials placed this among other anti-fats, discredited. Pichi. Fluid extract on trial for renal and vesical catarrh and calculi. Picric Acid. No use in medicine, notwithstanding it may appear in some formularies. It has been used to heal ulcers from burns and in ingrowing toenails, but it is very doubtful if other things are not better and less poisonous. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 231 Picrotoxin. Cocculin. Supposed usefulness based on a weak theory that a stain might change pathological conditions. Pilocarpus. Jaborandi. Violent diaphoretic, other uses less. Said to abort ery- sipelas, and the severe sweating has markedly relieved chronic rheumatism so that patent medicines were based upon it until so many deaths occurred from such "rheuma- tism cures" that the nostrums became unpopular. Dose 10 to 30 grains, fluid extract 10 to 30 minims. Pilocarpine hydrochlorate is freely soluble in water or alcohol and can be given hypodermically or internally in eighth or quarter grain doses in dropsy, uremic convulsions, coryza, asthmatic dyspnoea, croup, orchitis, atropine poisoning, painful rheu- matism but not when fasting or the heart is weak, nor should the dose exceed a third of a grain. It is not a remedy that can be carelessly used owing to its prostrating effects. Pineapple. Juice is digestant. Piperazine. Diethylene-diamine. This valuable remedy for rheu- matism and gout was imitated at one time to the detriment of its reputation. Schering's is the genuine. The crystals are freely soluble in water, and the dose is 5 grains several times daily. Its harmlessness and ability to dissolve uric acid in all parts of the body, even calculi, and its diuretic effect enables it to excrete gouty and rheumatic products effectively. A more expensive but very eligible carbonated water in quart bottles called Gicht Wasser in Germany and Piperazine Water here, contains Phenacoll to further the painless excretion of uric acid. Piperazine is a strong or- ganic alkali and considering the ability it has to reduce the 232 THERAPEUTICS, MATERIA MEDIOA AND PRACTICE. irritating influence of uric acid it may prove to be useful in Bright's disease exacerbations or as a preventive of par- oxysms ascribable to uric acid kidney irritation, which sometimes alone is sufficient to cause albuminurea. It has been recommended in diabetes mellitus but its rationale in this disease is not clear, though we may accept the empirical findings from whatever reliable clinical reports there may be in the future. Its alkalinity suggests its use internally in poison oak or ivy in connection with external alkalies to neutralize the toxicodendric acid found by Maisch in the vesicles of this eruption. There is but one make of piper- azine that has therapeutic value, that of Schering. Lehn & Fink, New York city, import the genuine crystals and water. Pjperin. Stomachic in feeble digestion. Seldom used. Pityriasis. Dandruff. Vaseline. Many "cures" are petroleum disguised. Plague, Bubonic, Oriental or Egyptian. Malignant Polyadenitis. Antitoxin. Piatt's Chlorides, see Chlorides Piatt's. Pleurisy. Pleural inflammation. Calomel internally and antiphlogistine and heat exter- nally with aspiration of effusion if extensive. Pleurodynia. Neuralgia of chest, usually left infra-mammary in hys- terical, with three painful points along course of intercostal nerve when pressed. Small fly-blister between shoulder blades, asafoetida internally, autotoxaemic treatment if se- vere. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 233 Pneumonia. The multitudinous remedies for this disease indicate their general worthlessness, and the theories advanced for their use vary between timidly tentative, audaciously ignor- ant, speculative, and evasively pedantic. Dr. Ad Captan- dum, at a meeting of the Chicago Medical Society in 1903, with a full attendance of newspaper reporters, announced that there was no treatment for pneumonia, and that medicines were injurious in that complaint. He was about a genera- tion too late in the originality of the assertion, and as un- warrantably extreme in one way as was Dr. Nestor in his opposite practice of poisoning all diseases, including pneu- monia, but of existence. Bleeding has gone out of fashion, and were it reinstated as a means of reducing sthenic condi- tions the routinists would be sure to misapply it and commit murder again. But the idea of "bleeding into one's own veins" with depressants, is so taking that the physiological necessity for so doing is not properly considered, and a re- sidence in a badly conducted county asylum or poor-house enable this sort of routine dosing to be followed out logical- ly to the "death from exhaustion" as recorded and ascribed to insanity or a chronic ailment, instead of to the depress- ants used to stun the patient and his symptoms into quietude. While the heart is feebly fluttering to pump blood through obstructed lungs the empiricist with the sanction of old grannies gives veratrum "to quiet the heart." While lungs are oppressed for moving space, hot, wet, heavy poultices add to the difficulty; then a jump is made with complacent confidence to ice packs, soon to be abandoned through the skeptics proving that nothing was accomplished by them. Dry heat seems to be finding more favor. Because a stimu- lant happened to save some practically moribund case at an opportune time forthwith stimulants are poured down at in- appropriate times. Oliver Wendall Holmes has well said 234 THERAPEUTICS, MATERIA MEDICA AND PRACTICE; that a doctor may have all the science and learning of medi- cine, but without common sense he is a poor physician; one may be versed in pathology and be a poor therapeutist, an- other may have materia-medica at his finger ends and be unable to apply his knowledge. The great difficulty is that where so many branches of learning have to be simultan- eously called into requisition the uncommon sense of an Abernethy, Graves, or John Hunter are needed to utilize them and then to make matters worse when, as in pneu- monia, there are unknown and shifting factors at work, even they would with all our modern facilities be non-plussed, so it befalls that only our cock-sure omniscients of either the very old or the very new cults dare predict and lay out "in- fallible" rules for the guidance of ordinary mortals such as we are, to practice by routine. In backwoods regions there are still cases treated with lobelia, veratrum, tartar-emetic, opium or whiskey as specifics, but the thoughtful doctor watches symptoms and meets indications, lifting prostration and remembering that sapping strength is no way to care for a disorder of weakness. A hemorrhage may cause noisy, violent delirium and the old method would have been to take more blood, the modern to knock the patient down with de- pressants, but the common sense plan would be to sustain judiciously, without overdoing it, until nature had a chance at restoration. A dose of calomel at the start, or minute doses frequently used could appropriately be given with a view to lessening obstruction of any viscera, nor would diar- rhoea be a contraindication as Fothergill demonstrated that obstructed bowels are accompanied in some instances with diarrhoea, and there can be congested capillaries needing at- tention though distant organs may be relaxed. As a rule antipyretics in pneumonia are bad and have undoubtedly determined the struggling heart to stop its efforts altogether, in many cases. The fact is pneumonia is precisely such THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 235 ground as is dreaded by the most accomplished, conscien- tious and practical medical man, but most presumptuously and unhesitatingly trodden by the rule-of-thumb practition- er who parrot-like has his routine by heart, or who has the latest foolish fad in treatment, incapable of judging of its applicability generally or specially. A generalized treatment to be varied with individual needs would be: Glycerinized antiseptic osmotic paste to chest, thick and hot, renewed when dry. Calomel and other laxatives, but the calomel is an excellent antiseptic itself. Weakness combat with strych- nia. Deplete as little as possible for the disease does that too much. Depressants are murderous. Rapid pulse and high fever can be expressions of weakness to be treated with judicious sustentation or such antifebrile means as will not paralyze the heart. Podagra? see Gout. Podophyllum. May Apple. The extract 2 to 5 grains or the resin Podophyllin an eighth to a half grain as a cathartic, usually combined. Poisoning. General rules may be stated that in a large number of poisoning cases especially as with caustics like carbolic acid, sulphuric or muriatic acid destruction of tissues is swift and impossible to remedy, so that antidotes are usually too late. By understanding the general principles poisoning may be antagonized, more or less successfully, off hand. Alkalines and alkaloids are neutralized by acids and vice versa, but this is not enough, for deleterious combinations may still remain, so that elimination up or down and enveloping the poison in some material that will obtund or modify it, are remedial means. Soap suds, flaxseed, slippery elm, mo- lasses; but oils render carbolic acid more active. Under each special poison antidotal means are mentioned or the 236 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. generalization may be used of neutralizing and ejecting, by cathartics, emetics or stomach washing. If esophagus burned by lye or acids care must be used to not tear the damaged tissue further. Violent vomiting can do this. Nar- cotic poisons require stimulation, and excitants need de- pressants. Polyneuritis. Inflammation of nerves with rheumatoid pains and wrist drop, usually caused by tippling alcoholics and mis- taken for rheumatism. Pomegranite. Best form for use as Pelletierine. Pond's Extract. Witch Hazel. Porrigo. Ringworm of the scalp, see Ringworm. Potassa Sulphurated. Formerly used in skin diseases, but its offensiveness and other remedies answering as well or better tends to omit it from recent medical usage. Potassium Acetate. The old sal diureticus. Soluble in one part of water or two of alcohol. Dose ioto 60 grains. Well known diuretic and in large doses cathartic, useful in dropsy and as an ad- juvant in rheumatism. Potassium and Sodium Tartrate. Rochelle or Seignette Salt. Soluble in one and a half parts water, popular laxative, ingredient Seidlitz Powder. Dose 2 to 8 drams. Potassium Antimoniate. Has been used in pneumonia and puerperal fever for its diaphoretic and seditive effect, but it can be harmful in any THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 237 treatment, as it merely saps strength and does not destroy the cause of such ailments. Potassium Arsenite. For administering arsenic the best form is Fowler's so- lution, the Liquor Potasii Arsenitis, most effective when freshly made and liable to deteriorate with age, to which fact many failures in its use may be referred. The liquor attacks the glass containing it as may be readily seen by inspection of the dimmed bottles in which it is kept. This changes the chemical nature of the liquor, lessening its value as a medi- cine. The fresh arsenite of potash is effective in chorea, per- nicious intermittent fever, obstinate anemias as chlorosis where iron seems ineffective and in some skin affections. To antagonize the eruptions of bromism in epilepsy necessitat- ing long use of bromides, a drop or two of Fowler's solution daily often keeps the complexion clear. A miserable habit, however, consists in overdosing with arsenic. Potassium Bicarbonate. Not much used as there are better things as antacid diu- retic or antilithic. Dose 20 to 60 grains, usually taken ef- fervescent with tartaric or citric acid. Potassium Bichromate. Caustic and doubtful use otherwise. Potassium Bisulphate. Aperient, but the sulphate is more commonly used. Potassium Bitartrate. Cream of Tartar. Soluble in 200 parts water, the neutral tartrate is much more soluble. Cathartic, diuretic and cooling. Dose 1 to 8 drams. Potassium Bromide. Soluble in 2 parts water. Dose 5 to 60 grains. Much 238 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. used in epilepsy and is the base of many quack nostrums for "Fit Cures," indeed Niemeyer announced its usefulness from rinding that quacks were first to try it. It should not be used for indefinite periods as it destroys blood corpuscles and degrades activity and mentality. In epilepsy any bro- mide will prevent fits for long periods, though it cannot cure the disease. It is given in this disease in spite of its bad af- ter effects, as an unavoidable alternative. In other com- plaints it should be sparingly and temporarily used particu- larly in such debilities as neurasthenia. Potassium Carbonate. Pearlash. Not used in medicine by itself, though formerly its dose was 10 to 30 grains. It has pharmaceutical uses as in mak- ing neutral mixture the solution of citrate of potassium, ere. Potassium Chlorate. Contains much oxygen, soluble in 17 parts water. Dose 10 to 20 grains. Formerly used as gargle or spray to ton- sils in diphtheria and in troches for sore throat, but it has fallen into disuse. Peroxide of hydrogen is more successful in oxidation of pus, etc. Potassium Citrate. Formerly much used in doses of 10 to 40 grains in rheu- matism and fevers, still more commonly as effervescent draught made of lemon juice and 15 grains of carbonate of potassium or 20 grains of the bicarbonate with water. This neutral or saline mixture was much used as a cooling draught in fevers with a dry skin to promote diaphoresis, but nowadays instead of temporizing with fevers the aim is to abort them and occasionally the patient is removed with the disease, though the general trend of science is to lessen the frequency and severity of fevers. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 239 Potassium Cyanide. Doubtful utility. Potassium Glycerino-Phosphate. Alleged ''nerve tonic." Potassium Guiacol-sulphonate, see Thiocol. Potassium Hydrate. Caustic Potassa. Seldom used except externally, and as a caustic it is inferior to silver nitrate as the flowing of caustic potash extends the destruction of tissue undesirably. Potassium Hypophosphite. Not assimilable. Explodes easily. Potassium Iodide. Soluble in about one part water. A semi-saturated so- lution would be better for dispensing and prescribing as the efflorescence would be avoided through temperature changes redepositing- the salt. Instead of grain for minim this would afford a grain to two minims of water. Sometimes iodine is liberated coloring the solution and this offends the stomach of some patients. The best vehicle is milk, as the taste is better disguised by it. In syphilis, doses can be increased from 5 grains thrice daily by adding a grain to each day's dosage, until by the twentieth day twenty four grains are used in each dose. If nausea or the iodide headache appears a return to the mini- mum dose can be made and gradually increased again. An old fashioned treatment for headache was to sip a solution of potassium iodide till 5 or 10 grains were taken, but it would depend upon the cause of the headache whether this would avail or not. Lumbago yields to a small dose of the iodide often, and formerly it was the favorite remedy in rheumatic disorders. 240 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Haig thinks it relieves arterial tension, and it is used oc- casionally with diuretics in Bright's disease, but its main use will be in syphilis, for which it is the nearest to a specific we have. Fancy substitutes fail to give the good results of the iodide. Much of the alleged intolerance for it is hysteri- cal as can be ascertained by not informing the patient that iodide is being used. See also Iodine. Potassium Nitrate. Saltpeter; niter. Formerly much used in rheumatism, fevers, etc., little used now, occasionally as niter paper made by soaking bibulous paper such as used for filtering, in so- lution of saltpeter, drying, and inhaling the fumes from burning the paper, to relieve asthmatic paroxysms. Potassium Permanganate. Disinfectant, deodorant, soluble in 18 parts water, in- ternally in opium poisoning one or two grains in solution. Urethral douche in gonorrhoea, deodorant in cancer, ozena, antiseptic and oxidizing in diphtheria, scarlet fever, septi- cemia. Solution a dram to the pint. Test for organic im- purities in drinking water, a permanganate solution being discolored by organic matter. Potassium Phosphate. Doubtful use. Potassium Salicylate. The pure salicylate of soda is preferable for the same purposes and more commonly used. Potassium Sulphate. ,Mild purgative, magnesium sulphate more commonly used. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 241 Potassium Tartrate. Soluble Tartar. Diuretic, laxative. Dose 15 grains to 2 drams. Pox, see Syphilis. Presbyopia. Aged sight. Hyperopia, myopia or astigmatism. Pro- per glasses. Prescribing. In the choice between muriate and sulphate of quinine the custom is to prescribe the sulphate, merely because it is more commonly used. Some prescribers carefully select a sulphate if other sulphates are in the same prescription and a muriate in case hydrochloric acid or a muriate goes with the quinine salt. Such care is like straining at gnats, for the small amout of radicle with the quinine is too trivial to af- fect result in any degree. And often a direful ''swallowing of camels" in the way of pharmacy blunders is performed by these same finiky prescription writers. The day of the old "shot gun" prescription is past, in which a slop of every- thing was poured in hope that some article might help the case; also there was "polypharmacy" in which many things were put together so that the combined effect would be in- creased. In a few instances, as when laxatives, cathartics and tonics are used together there is a little justification for uniting several things in one dose, but as a rule there are so many objections to polypharmacy that at this time single remedies are more favored. Suppose, for instance, you pre- scribe an emulsion containing cod liver oil, strychnia and quinine. The dose must be adjusted to the strongest in- gredient, and even then it is common for the strychnia or quinia symptoms to appear from overdosage in the effort of the patient to increase the oil dose. Emulsions are, anyway, faulty vehicles, for the oil is reduced often to the vanishing 242 THERAPEUTICS, MATERIA MEDICA AND 1'RACTICE. point and a lot of useless trash like "hypo-phosphites" which are not assimilated are associated with strychnia, which is the real tonic, and often a harmful one, used in this disguised manner; then if there is oil in the emulsion it regurgitates and is tasted more than if a full dose of good oil were taken, like that of the Swampscott, Mass., cold pressed oleum morrhuae, or occasional brands of Lofoden. Stone's Swampscott is the most reliable, but not always readily obtained as the Massachusetts General Hospital has the first claim to what is made and the surplus only, if any, goes to the market. The form in which medicine is given may affect results, and a little thought should convince the physician that there are effective and eligible forms that would give the best re- sults. For example, an elixir in one case, a tincture in an- other, capsules, the fluid extract, the solid extract or in some cases even the crude drug itself, and it is the duty of the doc- tor to study out these matters. Mere copying of a prescrip- tion, blindly, brands the copyist as uneducated, and danger- ously so, for errors in amounts and in names are very com- mon in printed formularies, and blind prescribers are more than apt to have dead patients in consequence. This is one of the troubles in patent medicines, the self prescriber and the patent medicine advertiser are apt to be equally ignorant of the nature of drugs, and the latter aims as a rule to make money out of the gullible public that diagnoses its own ail- ments, and with all the confidence of children or savages, which they are in such particulars, they gulp all sorts of abominable concoctions, about as monkeys try sips of this, that or the other forest product, testing edibility at the risk of life, and sick monkeys are common in the woods and cities in consequence. Great hospitals are building up to cure human simians of drug habits, and a life time may be spent in trying to be cured of the drug habit induced in the THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 243 attempt to cure the previous drug habit. One falls into the chloral habit in prescribing for himself against the whisky habit, goes to a fake institute and is cured of the chloral habit with opium, then at another place his opium habit is relieved by substituting the hyoscyamus habit, and if any money is left it is likely to be spent in resuming trials of all the former stuffs combined till the madhouse or death ends the farce. Effective prescribing demands that the prescription be filled properly, and the careless or indifferent prescription writer who thinks his duty is complete in scrawling any- thing on a paper and getting his fee, is not only a fraud, but deceives himself more and more, as he persists in this method of automatically going through routine motions, which in half the instances are absurdly futile. To be certain as to whether your patient gets what you order you may not only have to become acquainted with the druggist and his stock but his idiosyncracies also. The psychology of dispensing and the dispensers are to be looked to. The temptation to substitute, to prescribe over the counter and abuse the doctor who retorts by dispensing his own medicines, to recommend the other thing as ''just as good," to encourage the sale of debauching patent medi- cines and to use cheap, worn out inert materials may be ir- resistible according to whether the doctor does or does not look out for his patient's interest, which in time should prove to be identical with his own. If the doctor does not know or care about the difference between the cheap commercial kidney-ripping salicylic acid and that made from the plant-oils, which costs more, but is effective and does no harm, the druggist often spares him- self a quarrel with the customer by using the worthless com- mercial article to enable him to compete with his brother pharmacist who would undersell him. Nor it this all. The 244 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. key note to harmony between patient, doctor and druggist starts with the doctor knowing what he is about, and to pro- tect the patient the prescriber may have to know nearly as much chemistry and pharmacy as the druggist, and in addi- tion have to raise the intelligence of the patient. Were it not so murderous political pharmacy would be amusing; at the Chicago county asylum, when I was path- ologist there in 1882 and later, the drugs were absurd rub- bish, the fluid extracts as strong as cold tea. the lice grew fat on what was bought for mercurial ointment, for it was lard; quinine and calomel could be swallowed by the hand- ful without effect and yet amazing prices were charged up for these things. Beer, whisky and cigars were of good grades, charged up as ''sundry drugs." and consumed by the county commissioners and their riff raff political friends. A great howl would be raised were lkjuors prescribed for the patients. In other public institutions whisk)' in the ward medicine closets disappeared, though the patients had none. As to proprietary compounds the subject is by no means a simple one for honesty at one end of the considera- tion merges into patent medicine disguises at the other end. The reputable manufacturing pharmacist has facilities for making the very best medical preparations, the nature of which he frankly reveals, but often the process of manufac- ture is such that therein lies much of the superiority of the medicine, and even were this process described it could not be imitated without great expense and the manufacturer does not feel ethically bound to instruct rivals, though he defers to the ethical feelings, real or assumed, of the medical profession, and the highest type of scientific manufacturer of medicines makes valuable additions to our therapeutic knowledge at great expense, employing capable chemists who love their science and who live only to discover and in- vent. Nothing can be happier in the way of furthering THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 245 medicine as an art or science than in such a combination be- tween commerce and research, though the devoted student is seldom adequately recompensed. There is a recognition of this high standard of pharmaceutical manufacturing among the better informed physicians, but, alas, they also know that imitators who are dishonest succeed in deceiving the less well posted physicians by advertising synthetical compounds or other matters that are in some cases mere mixtures of honest coal tar derivatives, attaching some mon- grel Greek-like name, usually one that in which the jargon intimates the disease to which it is addressed. Then secret remedies with morphine or cocaine are disposed of under semi-scientific titles, and misleading formulas are printed on the label. Inexperienced and young practitioners are liable to prescribe some rascally preparation by the mere name having a scientific sound and years afterward find, as he learns better, that he has unintentionally made opium fiends through his carelessness and the trap set for him by some proprietary medicine compounder of the lower grade. Blindly using all proprietary preparations is as foolish as to neglect the rare instance of a patent medicine being useful. Condemning both sweepingly is still more foolish. The Illinois board of pharmacy, in 1904, sent out pre- scriptions to 139 druggists in Chicago. In 31 the drug was pure, in 23 it was absent, in 85 it was adulterated. Priapism. Erection from chordee, satyriasis, or spinal injury. Cold bathing mornings, warm baths at night, monobro- mate of camphor, cathartics, in spinal disease or injury in- volving the erector Tenter in the cervico-dorsal region er- got and conium with dry cupping over shoulder blades. Proctitis. Rectal inflammation. Antiseptics, demulcents, resinol or resorcin, ichthyol, see also Piles. 246 THERAPEUTICS, MATERIA MEDICA AND PRACTICE; Progressive Pernicious Anemia. Any excessive anemia. Intestinal intoxication, lesions gastro-intestinal tract, chronic gastritis, stenosis of pylorus, carcinoma and gastric ulcer, intestinal parasites, repeated hemorrhages, malaria, syphilis, prolonged diarrhoea, filth diseases, starvation, bad hygienic conditions. Prolapsus Ani. Falling of rectum. Replacement carefully and slowly with greased cloth, then astringent douches or suppositories like anakesis. Strychnia internally. Prolapsus Uteri. Falling of the womb. Supporting cotton tampons and astringents. Tonics. Propionyl-phenetidin, see Triphenin. Propylamine, so called. Trimethylamine, Solution. Doubtful use. Prostatic Enlargement. Prostatitis andProstatorrhoea. These disorders of the prostate gland tax the ingenuity of surgeons and physicians; in general terms antiphlogis- tics, antiseptics, massage or vibrations to reduce the size of the gland, but all cases are difficult to improve, due to the tendency of the prostate to retrograde changes, as it is a homologue of the uterus and hence rudimentary. Calomel, ichthyol, belladonna, iodoform, suprarenal capsule, ergot. The gleety discharge is subsequent to gonorrhoea. Protargol. Silver 83% with protein, for gonorrhoea. Protonuclein. One of the organo-therapy preparations that has not proven to be useful, at least in my experience and that of others who tried it. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 247 Prunes. Slightly laxative, old fashioned laxative prune juice and a pinch of senna leaves. Prunus Virginiana. Wild Cherry. The prussic acid in this plant, in bitter almonds and cherry laurel is sedative and pleasant to the taste, used in expectorants. Cherry Pectoral made a fortune for its con- coctor and advertiser. Prurigo. Intense general itching. Anti rheumatics succeed best, though many cases in- tractable. Hot air to over 300 degrees Fahrenheit, salicylic washes, resorcin, ichthyol, strychnia internally in senile cases. Pruritus. Similar to Prurigo. Treatment as for prurigo, sometimes mercurial oint- ment if due to lice or pubic lice, and sulphur ointment if itchmite the cause. Uric acidaemia itching indicate anti- rheumatics, as piperazine, lithia, hot bathing, bicarbonate of sodium washes. Pseudo-Leukaemia. Lymphadenoma. Hodgkin's Dis- ease. Anemia with enlarged lymph glands and spleen, with- out leucocytosis. Fowler's solution internally and hypo- dermically. Psoriasis. Dry Tetter. Scaly, itchy, cracking skin inflammation. Arsenic, al- kalies, potassium iodide, thyroids, internally and chrysaro- bin. pyrogallic acid, salicylic acid, ichthyol, resorcin exter- nally. Pterygium. Vascular growth from inner canthus toward cornea. 248 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Dissect conjunctiva and push blood vessels of growth be- neath it. Ptomaines, see Leucomaines. Ptosis. Dropped eyelid paralysis. Puerperal Convulsions. Eclampsia. Puerperal Fever. A septicemia. Antitoxin, calomel, antipyretics, anti- septic washes. Puerperal Mania. As little medicine as possible. The disease is self limi- ted and often recovers in a few months when the patient should be taken home at once, unlike other insane cases which should remain till fully convalesced. The reason is that surrounding's impress the peurperal convalescent un- duly if unpleasant. Avoid opiates, chloral, bromides, hyo- scyamia, etc. Pulsatilla. Paralysant, dilates pupil, diaphoretic and diuretic. Al- kaloid anemonin resembles aconite. Not much used. In coughs it admits of mucus accumulating, instead of being expelled. Pumpkin Seed. Anthelmintic. Dose i to 2 drams, variable results. Purpura. Purple patches of skin, remaining when pressed. When bleeding, iron salts and supra-renals, antirheu- matics and arsenic. Pyelitis. Inflammation of the kidney pelvis, see Bright's Disease. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 249 Pyemia. Surgical Fever, Septicemia with pus in blood. Strong supporting treatment as stimulants and quinine. Mild antiseptics internally and strong ones to any abscesses. Pyoktannin, Blue. Dubious use in internal cancers. Pyoktannin, Yellow. Weaker than blue and used in skin diseases, with doubt- ful results. Pyramidon. Suggested substitute for antipyrine. Pyranum. Benzoic and salicylic acids with thymol. Pyrethrum. Pellitory. Old sialagogue, little used now. Pyrethrum roseum is an insecticide, sold as insect powder. Pyridine. Tar oil from distilled bones, for inhalation. Doubtful value as respiratory sedative, bad heart effect, not much used. Pyrogallic Acid. Pyrogallol. Soluble in 2 parts water, 1 alcohol. 2 ether. Externally only, usually in 5 to 10 per cent ointment. Skin diseases. Several pyrogallol preparations are known as Pyrogallol Disalicylate, the Saligallol; Mono-acetete, Eu- galiol. Tri-acetate, Lenigallol. Pyrogallol Oxide. Psoriasis, chronic eczema, lupus ery, 10 per cent salve with vaselin and lanolin. 250 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. - Pyromania. Incendiarism of insane. The inclination to burn prop- erty is associated with epilepsy sometimes, particularly at puberty, but it is not like mysophobia or other morbid im- pulses, for the pyromaniac is insane. Pyrosis. Gastrorrhoea. Heart-burn. Acidity of stomach on which belchings and other symp- toms depend are corrected with alkalies as lime water, bi- carbonate of sodium, magnesia, vichy; usually a gastritis needing dieting mainly on buttermilk. Quassia. Infusion injection formerly used to destroy pin worms in children, but quinine is better. Otherwise quassia is an- tiquated. Quiliaja. Soap Bark. Expectorant, Antiparasitic. Dose 10 to 30 grains. The deleterious effects of this drug which is too much used to create foam on soda water, should restrict its use. Saponin, its alkaloid is more poisonous than medicinal. Quinalgen. Doubtful use. Quinidine. Quinine is better. Quinine. Sulphate usually prescribed. Antiperiodic or antima- larial, Tonic half to grain thrice daily. Injection in dysen- tery destroys amoeba coli in doses of 3 to 8 grains of bisul- phate which is more soluble. An antimalarial 10 to 20 grains according to severity of intermittent fever, to be taken as near as can be estimated an hour or half hour be- fore the expected chill as at that time trie Plasmodium is best THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 251 attacked. For children's pin worms two grains of quinine in capsule used as rectal suppository, continued till relieved, once to twice daily. Quinine Sulphate. Most useful. Quinine Bisulphate. More soluble. Quinine salts in general. Other than those mentioned above are of doubtful use. Quinsy. Suppurative inflammation of tonsils, see Tonsi- litis, suppurative. Rabies, see Hydrophobia. Rachitis. Rickets. Tonics, thyroid, proper food and sanitation. Lime salts are not assimilated from the phosphites or hypophosphites mentioned in text books and phosphorus is nonsense. Phos- pho-albumen may help rachitis, but nothing is sure in such a deep seated defectiveness. Radium and Radio-Activity. Becqueral rays from uranium substances led to the dis- covery of polonium, actinium, and radium, the latter most easily obtained, not free, but combined with other elements. Radium chloride and carbonate being sold by Leon Faval of Newark, N. J. Radium acts as does sunlight and the X ray in photo- graphy, and is on trial in treating cancers. Rectal Food Suppositories. Worthless as nutriment and cause proctitis. Tropho- nine is effective per oram. 252 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Remittent Fever. Bilious Fever. Continued Malarial Fever with remissions. Quinine, Citric acid, calomel, euonymus, cathartics, ar- senic. Renal Calculi, see Calculi. Renal Dropsy, see Dropsy. Renal Hemorrhage, see Hematuria. Resin of Jalap. Dose i to 3 grains. Resin of Podophyllum. In habitual constipation small doses best, eighth to quarter grain, but drug habit can be formed in bowel atoni- city. as well as otherwise and long dependence upon cathar- tics paralyses the intestines in time. Resin of Scammony. Drastic purgative 3 to 8 grains. Little used. Resinol. Ointment very prompt in relief of pruritus ani or vul- vae. Resorcin is probable base, with lanolin, oil of Cade, etc. Also useful for sore eye lids. Resorcin. Most useful as external application antiseptic in 5 to 30 per cent solution or ointment, in inflammatory diseases of the eye, the skin and mucous surfaces especially, but pre- parations are made with difficulty, the most eligible being the proprietary ointment called Resinol, which is the best antipruritic in prurkis ani, and as an application to the eye lids in tarsal ophthalmia the scaliness and granulations are quickly disposed of. and rapid improvement of any ocular external inflammation is secured from its use. fHERAPEUTICS, MATERIA MEDICA AND PRACTICE. 253 Resorts. The majority are fashionable places for dissipation. The medicinal springs about as valuable as seidlitz powder or iron scraps in water. The U. S. Agricultural Department has been overhauling the mineral waters on sale generally and reports them as mainly worthless fads. Rest Treatment. In a few cases this may avail, but in the greater num- ber of neurasthenics and melancholies it can be pernicious, as the tendency is to hysterical helplessness. Retinitis, Albuminuric. In Bright's Disease, associated with arterial degenera- tive changes. Rhagades. Painful cracks in the skin, see Fissures. Rheumatin. Salicylic acid and quinine. Rheumatism. Salicylic acid, oil of wintergreen, sodium salicylate, po- tassium iodide, bicarbonate of sodium and other alkalies, ci- trate of lithium, cascara sagrada, piperazine, phenacetine. phenacoll, dry cups, hot applications, massage, hot air, jabo- randi, abstinence from meat; proper exercise and out door oxygenation of tissues, plenty of water internally and exter- nally, methyl salicylate, colchi-sal, guiac, guiacol. The fleet- ing pains of tertiary syphilis and alcoholic neuritis are mis- taken at times for rheumatism. Rhodalline. Thiosinamine. Rhubarb. Dose as laxative 10 to 20 grains, cathartic 20 to 40 grains, usually in pills combined with other laxatives as 254 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. aloes. The aromatic syrup dose is half an ounce upward, the compound powder 30 to 120 grains. Rhus poisoning, see Poison Ivy. Ringworm. Tinea Circinata. Soap and water cleansing, epilation of infected hairs, antisepsis, tincture of iodine, tincture muriate of iron, ink, salicylic acid, chrysarobin, ichthyol, formaldehyde, peroxide of hydrogen, betanaphthol, resorcin, carbolic acid, corrosive sublimate, in diluted applications of ointments or lotions. Rochelle Salts, see Potassium and Sodium Tartrate. Roentgen Rays. Stimulant in lupus treatment, on trial for other affec- tions. Most useful in diagnosis. Roseola. Macular syphiloderm. Rubidium and Ammonium Bromide. Dubious value as a bromide salt in place of the potas- sium, sodium or ammonium bromides. Rubidium Iodide. Doubtful substitute for Potassium Iodide. Rubus. Blackberry. The root or bark contains the astringent principle that renders blackberry so popular as a diarrhoea remedy. It is really the varieties of tannic acid in all vege- table astringents that act in such cases. The berry lacks this astringency, hence blackberry brandy so called depends upon the tannin in the brandy flavored with the berry juice. The pharmaceutical preparations are the fluid extract in doses of half a dram to a dram, and the syrup two to four drams. THERAPEUTICS, MATERIA MEDICA AXD PRACTICE. 255 Saccharin. Benzoyl-sulphonic Imide, Garantose. Used in tablets each of which is equal in sweetness to a large lump of sugar, for use in tea, coffee, etc., of diabetics. But in time the per- sistency of this flavor remaining long after being taken palls on the taste as everything tastes sweet that is eaten. Salicin. Soluble in 30 parts of water, Antirheumatic. Dose 10 to 30 grains. Salicylated Collodion. With extract of cannabis indica, a modified form of the national formulary "corn collodion." useful as an applica- tic n to corns. Salicylic Acid. Derived from oil of wintergreen, Gaultheria procum- bens, and from other plants as Spiraea ulmaria, meadow sweet, etc. The salicylic acid derived from carbolic acid is harm- ful, and has no proper place in medicine, but is often dis- pensed unless care is used in specifying the natural, as the artificial is much cheaper, and you can always get sand at sugar prices if you cannot tell sand from sugar. The main use of salicylic acid though better prescribed as a salicylate of sodium, is in treating rheumatism, in doses of 10 to 40 grains. Externally it can be used as an antiseptic in some cases, and is sold mixed in absorbent cotton, but its ability to macerate the skin should be kept in mind, raw surfaces are produced by it, so it is not good in burns nor in many other instances where its properties are not fully known. This skin-destroying faculty makes it useful as a corn eradicator, and it is the base of myriad "corn cures," united with collo- dion, cocaine or cannabis Indica. 256 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. It is readily soluble in alcohol or ether and but sparing- ly in water. Saliformin. Dubious uric acid solvent. Salipyrine. Antipyrine Salicylate. Not readily dissolved. Anti- rheumatic, Analgesic. Dose 10 to 30 grains in cachets. Salligallol. Pyrogallol Disalicylate, vehicle for dermics in 2 to 15 per cent solution externally. Salocreol. Creosote and salicylic acid. On trial. Salol. Phenol Salicylate. Formerly used for typhoid fever, diarrhoea, rheumatism, etc., but falling into disuse as either liberating too much carbolic acid or, most frequently pass- ing undissolved through the bowels. Salophen. A salol salt. Not much used. Salt, Epsom, see Magnesium Sulphate. Salt, Glauber's, see Sodium Sulphate. Saltpeter, see Potassium Nitrate. Salt, Rochelle, see Potassium and Sodium Tartrate. Salt, Seignette, see Potassium and Sodium Tartrate. Sanatogen. An infant food. Sanguinaria. Blood Root. Expectorant, Emetic. Little used at THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 257 present. Dose 3 to 30 grains. Sanguinarine the alkaloid is in twelfth grain doses, and the nitrate and sulphate are also used in expectorants occasionally. Sanitariums. Many reputable and useful sanitariums exist scattered over the Union where medical attention is honest and ap- propriate, but as wealth is usually arrogant as well as ignor- ant, and truckling is thus induced to pander to prejudices for mere gain, of course the result is an abundance of fake institutions where the wealthy ass gets what he thinks suits his case and is appropriately robbed. Hysteria is coddled in such places, if it has money, and degeneracy is the sure re- sult, one of the multitude of evidences that poverty more often than wealth is likely to develop the fittest to survive. There are what are called sanitarium cranks, who prefer life in some institution where their peculiarities are studied with sole reference to making money out of them regardless of the real good or harm done. This vampyre spirit has grown and has proven so suitable a means of piracy that it is act- ually respectable, quite as much so as ''graft," "boodleism" or the New York pirate trade which good old King William and Governor Bellomont failed to suppress because the community including the clergy were on so low a plane that reformers were shot if too- energetic among them. The atmosphere of such places is disgusting, every- where is calculation as to how much is likely to be made out of the patient and what kind of humbuggery is best suited to his case. He is pumped to ascertain his fads, his ignor- ances, his superstitions and gullibility generally, so as to ad- just the squeeze to the possible limit. The disorder, if one exists, is of minor consequence, except as an element affect- ing the time in which the patient can be most swiftly robbed; if rest cure is likely to be the surest means of imprisoning the victim to the extent of his cash then he is kept abed, re- 258 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. gardless of its perniciousness in his particular case as tend- ing to neurasthenia. I have seen a lot of rich hysterical bed- ridden who should be up and about, but their money insured the presence of schemers instead of the physician who would have given honest advice and treatment. Santal-Midy. Pure sandalwood oil in capsules, for genito-urinary ca- tarrhs and inflammation. Dose, several capsules of 5 min- ims each, daily. Santal-Wood Oil, see Gonosan. Santonin. Anhydrous Santoninic Acid. Dose 2 to 4 grains as anthelmintic; children of two years a quarter to a half grain. Troches are made with half a grain in each. Saponin, see Quillaja. Sarcina infection of stomach. Mild internal antisepsis or anti-ferment as sulpho-car- bolate of zinc. Sarcoma. Flesh Cancer. Prognosis bad. Treatment unsatisfactory. Sarsaparilla. No medicinal value except in the imagination of the uninformed public, and as commonly marketed it is sasafras root the syrups of both having about the same flavor. Sar- saparilla is a good vehicle for disguising iodide of potas- sium, the compound decoction, fluid extract, compound fluid extract, and compound syrup are the preparations. The latter being most often used as a flavoring vehicle. Sassafras. Substitute for sarsaparilla. The tea of this root de- praves the blood and causes anemia. THERAPEUTICS, MATERIA MEDICA ASD PRACTICE. 259 Satyriasis, see Priapism. Savme. Emmenagogue, but dangerous. Dose fluid extract 5 to 20 minims, Oil 1 to 5 minims. Scabies, see Itch. Scald Head, see Favus. Scalds, see Burns. Scammony. Griping, harsh cathartic. Scarlatina. Scarlet Fever. Symptomatic treatment and care and as little medicine as possible. Antipyretics if temperature too extreme, but conserve strength with quinine. Antiseptics in gargle or externally if suppuration. Otitis pus destroyed with perox- ide of hydrogen and boric acid. After effects of scarlatina are sometimes deafness, meningitis, blindness, mental de- fects. The contagium is usually conveyed by milk. Sciatica. Most often due to rheumatism. In acute attacks strong antirheumatics and cathartics, and in chronic cases hot air massage and piperazine. When from injury of sciatic nerve there is danger of forming the morphine habit. Nerve stretching by knee to chest, hypodermics of Duquesnel aco~ nitine in the sheath of the nerve and other heroic means have been used with not very encouraging success. The rheumatic kind is more amenable to treatment. Auto- toxaemias and alcoholism or lead poisoning may also cause sciatica. Ergot internally and antiphlogistine externally benefit some. Scirrhus. A hard connective cancer often of breast, see Cancer. 260 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. ScleritJs. Inflammation of sclerotic of eye. Potassium iodide, salicylates, wash with solution of boric acid and 5 grains to the ounce, of pilocarpine hydro- chlorate in distilled water. Scleroderma. Hide bound skin disease with patches of hardening. Strychnia, arsenic, and externally salicylic acid. Diffi- cult to treat. Sclerosis. Hardening of structures, secondary to inflam- mation or softening. Iodide of potassium, arsenic, syrup iodide of iron. Us- ually beyond remedy. Scopalamine Hydrobromate. Mydriatic. No good results in hypodermics for insane. Scoparius. Broom. Severe diuretic and purgative. See also Spar- teine. Scorbutus, see Scurvy. Scrofula. A tuberculosis of the lymphatic glands. Calomel, arsenic, iodides, ichthyol, iodine vasogen. Scurvy. Spongy, bleeding gums, and debility from im- proper diet. v egetables, fruits especially lemons, limes, oranges. Antiseptic mouth washes and astringents, as borax, eucalyp- tol, alum, tannic acid. Tonics. Sea-sickness. Mai de Mer. Quiet and diet. Much harm has been done by brom- ism and similar silly dosing for this disorder. THERAPEUTICS, MATERIA MEDIC A AND PRACTICE. 261 Seborrhoea, see Pityriasis. Greasy excessive secretion of sebaceous glands can be washed off with soap and water and astringents used to scalp with lanoline. Seidlitz Powder. Effervescent laxative salts, rochelle salts, bicarbonate of soda and tartaric acid. Senecio Aureus. Ragwort. Eclectic emmenagogue. Senega. Old stimulating expectorant and diuretic, not much used now. Senile Dementia. An insanity of old age, but not the only one to which the aged are liable, so every insanity of the aged is not senile dementia. Loss of memory of recent events, suspiciousness, sometimes aversion to relatives apoplectiform attacks, con- vulsions and paralyses, with liability to undue influence and the making of improper wills or gifts. Sometimes assault young girls and make silly marriages. Incurable. Senna. Dose I to 4 drams of the leaflets. Old fashioned but prompt and efficient purgative and its safety made it popu- lar, in spite of its griping. It was often taken with prune juice and enabled a purgative to be given in cooked prunes without the knowledge of the patient. "A pinch of senna leaves" being the dose. Cascara sagrada has largely super- seded its use. Septicaemia, see Antitoxins. Septoforma. A formaldehyde preparation unscientifically named. 262 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Serpentaria. Virginia Snakeroot. Old fashioned nauseating fever remedy. Seldom used. Shingles, Herpes Zoster. Due to eruption usually on skin of ribs from nervous conditions. Resinol and tonics. Shock. Stimulants and tonics. Sidonal. A patented piperazine quinate. Silver Chloride. Little use if any generally as a medicine and no use at all in epilepsy. Silver Citrate. Too unstable as Antiseptic or Astringent. Silver Cyanide. No use in epilepsy and little if any otherwise in medi- cine. Silver Iodide. Doubtful antisyphilitic. Silver Lactate. Actol. Dubious Antiseptic. Silver Nitrate, see Nitrate of Silver. Silver Oxide. Useless as medicine. Explosive. Singultus. Hiccough. Sleeplessness, see Insomnia. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 263 Smallpox. Variola. Ichthyol and lanoline ointment to prevent pitting. Vac- cination in early stage thought to reduce severity. Dark- ened room, the Finsen light treatment on trial. Antiseptics, antipyrine, morphine, chloralamid, ergot for hemorrhage. Sneezing, Excessive. As in hay asthma, adrenalin or suprarenal capsule. Re- cent alleged antitoxin for hay fever. Danger in catarrh snuffs containing cocaine requiring increasing dose and forming habit. Soap Liniment. Soap, camphor, oils of rosemary and origanum in alco- hol, superseded in i860 the old fashioned similar liniment called opodeldoc. Sociological Therapeutics and Prophylaxis. As with everything else in the world empirical remedies have been used for social maladies before causes were known. The favorite treatment for criminality, pathological social conditions, was killing, in all instances. Only diag- nostic ability was so poor that health was mistaken for dis- ease, and the latter for health. Among many other mis- treated cases the insane were considered as vagabonds, pos- sessed of devils, the hysterical forlorn and aged were burned as witches, and even at this day drunkards, the deliberate poison products of commerce, are abandoned to the mur- derous saloon-keeper who is often rewarded with political positions and enabled to control the funds of the sick, in- sane and paupers in public institutes provided for them, and to thus absolutely chase his victims to their graves. Criminality or social pathology is certainly infantile when the most monstrously deranged human specimens are actually set up as models for imitation. Reptile hearted 264 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Napoleons who filled the earth with death and woe are wor- shipped as "great," and those who amass colossal fortunes by heartless wholesale robbery and starvation of communi- ties are looked up to, feared, respected, and their names per- petuated as philanthropists. The Lombroso school of anthropologists catering to sensationalism, though not to the extent of Nordau, exag- gerate the importance of a study of the submerged classes, as though all criminals were among the poverty stricken, awkward, unsuccessful, caught, whereas the most dangerous are the sleek, the highly successful, the fitter to survive, whom society protects, emulates and practically worships. A mental warp may enable one to suppress every decent sentiment in the ability to amass wealth, while the owner- ship of an inconveniently superior intellect has prevented its possessor from doing more than earn a living, and the world seems to begrudge him that. Too many interfering scruples are likely to divest one of the money making ca- pacity while utter inconsideration for others and an eye single for "Business" tends to success, as sharks are suc- cessful. Sodium Acetate. Diuretic. Soluble in 2 parts water. Dose 15 grains to dram. Same use as Potassium Acetate. Sodium Arsenate. Fowler's Solution is a better form for Arsenic adminis- tration. Sodium Benzoate. Dubious antirheumatic. Sodium Bicarbonate. Alkaline, Antacid, minor Antirheumatic. It is the household salaeratus and a component of baking powders. 265 An English farmer's method of easing rheumatic pains is to apply a hot solution of bicarbonate of sodium to the affected muscles and joints. In rendering the blood and secretions alkaline uric acid may be deprived of its activity in rheuma- tism. The dose internally is 10 to 40 grains. It enters largely into the composition of many spring waters and is the bulk of Seidlitz Powder. Sodium Bisulphate. Antiseptic. Soluble in 4 parts water. Dose 10 to 30 grains, sore mouth, diphtheria, yeasty vomiting, externally in skin diseases. Sodium Borate. Borax, Sodium Biborate, Sodium Tetraborate. Anti- septic. Soluble in 25 parts water. Useful in sore nose, con- junctivitis, cystitis, and as an eye wash, but its alleged use in amenorrhoea, epilepsy or for rheumatism is unjustified. It is useful as a household antiseptic for external use. Sodium Bromide, see Bromides. Sodium Cacodylate. Fowler's Solution of Arsenic is better. Sodium Carbonate. Quality varies so much it was dried by driving off water of crystalization for making pills, but it has no advantage over the bicarbonate or other antirheumatics. The impure, undried carbonate of soda is known as sal soda or washing crystals. Sodium Chlorate. Formerly used in diphtheria. Seldom used now. Sodium Cinnamate. Hetol. Theoretical Antitubercular for injections. Fresh air is better. 266 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Sodium Citrate. Former diuretic and antilithic. Not much used now. Sodium Ethylate, Liquid. Escharotic for warts. The dry is similarly used. Any caustic will do as well. Sodium Fluoride. Foolishly recommended in epilepsy by inexperienced, and doubtful if it has any legitimate medical use otherwise. Sodium Formate. Used in surgical tuberculosis by injection. Sodium Glycerino-phosphate. Theoretical, unassimilable alleged tonic for neuras- thenia. Sodium Hydrate. Caustic Soda. Inferior as caustic owing to spreading too far. Sodium Salicylate. It is well to specify "Natural" or "From Oil of Winter- green" in prescribing this useful antirheumatic. The com- mercial synthetic or artificial sodium salicylate should not be used in medicine. Dose 5 to 40 grains. Sodium Santoninate. Anthelmintic less powerful than santonin. Dose 2 to 6 grains in keratinized pills, children I to 3 grains. Sodium Sulphate. Glauber's Salt. Ingredient of many spring waters upon which cathartic property depends. Harsher and more grip- ing than Epsom Salts, the Sulphate of Magnesia. Dose crystals 2 to 8 drams, dried 1 to 4 drams dissolved in suffi- cient water, about a glassful. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 267 Sodium Sulphite. Soluble in 4 parts water. Antiseptic. Used in skin dis- eases, sore mouth, sarcina ventriculi and chronic mercurial affections. Dose 10 to 60 grains, well diluted, in aromatized solution. Less used yearly. Sodium Sulphocarbolate. Soluble in 6 parts water. Antiseptic, Disinfectant. Used internally in some forms of dyspepsia, in phthisis, ty- phoid fever, dysentery, and externally in gonorrhoea, putrid wounds, etc. Dose 5 to 20 grains, and for external use a half to one per cent solution. Internal antisepsis has not afforded in practice the satisfaction anticipated. Sodium Thiosulphate. Sodium Hyposulphite. Soluble in one part water, used in parasitic skin diseases, sore mouth, diarrhoea, flatulent dyspepsia. Dose 5 to 20 grains. Sodium Hypophosphite. Unassimilable. Explosive. Sodium Hyposulphite, see Sodium Thiosulphate. Sodium Iodide. Potassium Iodide preferred for all purposes. Sodium Metavanadate. Dubious substitute for arsenous acid in other forms. Sodium Nitrate. Chili Saltpetre. Externally in rheumatism in water 1 to 3 solution. Internally in inflammatory condition of the intestines, dysentery, etc. Dose 10 to 60 grains. Not much used, and in rheumatism bicarbonate of soda is doubtless better and cheaper. 268 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Sodium Nitrite. Antispasmodic used in angina pectoris, etc., but glonoin or amyl nitrite are more commonly used. Dose I to 3 grains. Sodium Phosphate. Formerly used in rheumatism, before salicylates proved to be better. In 1900 many deaths were caused in England before traced to arsenic as an impurity in phosphate of soda which had been widely sold. It is at present used mostly as a biliary stimulant in doses of 5 to 40 grains. Little in use. Sodium Pyrophosphate. There are better things for lithiasis. Piperazine for example. Softening of the Brain. An old term to designate many mental derangements by those who know nothing about insanity diagnosis or pathology. Solution Aluminum Acetate. -8% basic aluminum acetate. External antiseptic 1 to 15. Little used. Solution Ammonium Acetate. Spirit Mindererus. Diaphoretic, Antipyretic, Diuretic. Dose half to 8 fluid drams according to effect desired and age of patient, warmth in bed promotes sweating, and mov- ing about or coolness of surface diuresis. Solution Arsenic and Mercuric Iodides. Donovan's Solution. Dose 5 to 10 minims well diluted, after meals. Seldom used. Solution Calcium Hydrate. Lime Water, Aqua Calcis. Dose 1 to 4 fluid ounces. Externally in Liniment. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 269 Solution Donovan's, see Solution, Arsenic and Mercuric Iodides. Solution Fowler's, see Potassium Arsenite. Solution Gutta Percha, see Traumaticin. Solution Hydrogen Peroxide. 3% H 2 °2 affording ten volumes of available oxygen, miscible with water alcohol or glycerine. Disinfectant, de- odorant. Used chiefly externally in wounds, abscesses, es- pecially to destroy pus in the ear. See Hydrogen peroxide also. Solution Iodine Compound. Lugol's Solution. 5% iodine, 10% potassium iodide. Alterative. Dose 2 to 10 minims. Solution Iron Chloride, Ferric. Z/.Syc Styptic, chiefly in post-partum hemorrhage: fluid dram to the pint. Solution Iron Nitrate. 6.2% Ferric Nitrate. Internal astringent. Dose 5 to 15 minims, diluted well. Solution Iron Subsulphate, Ferric. Monsel's Solution. Styptic externally pure or in strong solution. Solution, Iron and Ammonium Acetate. Basham's Mixture. Hematinic, Diuretic. Astringent. Formerly used in Bright's disease, rather empirically in routine way. Solution, Labarraque's, see Solution of Soda, Chlori- nated. 270 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Solution Lead Subacetate. Goulard's Extract. 25%. Astringent, Antiseptic. Used chiefly to make cerate and lead water, the diluted solution. Too free use induces lead poisoning. Solution Lugol's, see Solution, Iodine, Compound. Solution Magnesium Citrate. A pleasant substitute for Seidlitz Powders, Laxative, Refrigerant. Dose 6 to 12 fluid ounces. Effervescent. Solution Mercury Nitrate Mercuric. 60%. Caustic. Externally only, pure. Solution Monsel's, see Solution, Iron Subsulphate. Solution Potassium Arsenite, see Solution, Fowler's, also Potassium Arsenite. Solution, Potassium Hydrate. Potassa Solution. 5% K O H. Antacid, Antilithic, but little used. Dose 5 to< 20 minims well diluted. Solution Soda Chlorinated. Labarraque's Solution. 2.6% available Chlorine. Dis- infectant. Externally in 3 to 10% solution. Internal use antiquated. Solution Sodium Arsenate. 1%. Alterative. Dose 3 to 10 minims. Fowler's So- lution better. Solution Sodium Hydrate. Soda Solution. Similar to Solution Potassium Hydrate. Solution Trimethylamine, 10%. So called Propylamine. Uses, Rheumatism, Chorea. Dose 10 to 45 minims. Doubtful efficiency. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 271 Somatose. Tonic nutrient for invalids. Taste slightly offensive and not so useful as Trophonine. Somnoform. Ethyl and methyl chloride and ethyl bromide. General anesthetic. Not much used. Sore Throat, see Tonsillitis. Sparteine Sulphate. Soluble in water or alcohol. Heart stimulant, Diuretic, in place of Digitalis. Dose a quarter to one grain. Spasm of Glottis, see Laryngismus Stridulus. Spearmint. Oil 2 to 5 minims, spirits 15 to 40 minims or Water. Vehicle. Spermatorrhoea. Emission involuntary. Monobromate of camphor, cathartics, cold bath in morning and warm bath at night, light diet. Spinal Conoussion. A cause of Erichson's Disease, a derangement of the cord by injury. Spirillum Fever, see Anthrax. Spirit, Mindererus, see Solution, Ammonium Acetate. Spirit, Nitrous Ether. Sweet Spirits of Niter. Diuretic. Dose half dram to one and a half drams, diluted. A popular and effective pro- moter of urine flow. Spleen Enlargement. Quinine, iodide of potassium, arsenic if curable, which is not always. 272 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Splenic Fever, see Anthrax. Sprain- Rest, hot water soaking, antiphlogistine, reduce dislo- cation if any. Squill. Compound Syrup most used, old cough mixture, nau- seating expectorant. Dose 20 to 60 minims. Much used formerly for children in croup. Staphisagria. Stavesacre. Old Parasiticide. Too poisonous as there are safer preparations of other things. Stiff neck. Torticollis. Usually incurable. Stillingia. Queen's Root. Alterative. Dose fluid extract 15 to 60 minims. Little used. Stings of insects. Dilute ammonia water. Stings of reptiles, see Bites, also see Antitoxins. St. Jacob's Oil. Contains aconite, according to Squibb. Patent medi- cine may poison with no one to blame, while educated phy- sicians would fear to use such stuff. Stomatitis, see Aphthae. Strabismus. Squint. May be due to rheumatism or syphilis, indicating its treatment. Stramonium Leaves, or Seed. Seldom used. Delirifacient. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 273 Strangury, see Dysuria. Streptococcus, see Antitoxins. Stricture, Urethral. Surgical dilatation, if spasmodic sedatives. Strontium Arsenite, Bromide and Iodide. These salts have a temporary place in medicine, as have also the Salicylate, Lactate, etc. Strophanthus. Heart tonic, as Digitalis. Dose of tincture 3 to 10 min- ims. Dose of Strophanthin, one-two hundred and fortieth oi a grain to a sixtieth. Strophulus. Tooth or gum rash of infants. Ichthyol externally, spirits of nitrous ether and acetate of potassium internally. Struma, see Scrofula. Also designates goiter. Strychnine. Alkaloid. Strong and effective tonic, often combined in elixirs with quinine and iron, affording prompt and satis- factory results. Dose a sixtieth to a fifteenth of a grain. Nux vomica too variable. The arsenate, arsenite and hyposphite can be disregard- ed as rot very useful. Strychnine Nitrate. Affords combined glonoin and strychnine effect. Dose same as Strychnia. Strychnine Sulphate. Same as the alkaloid and most used. Stye, see Hordeolum. 274 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Styptjcln, Merck. New Styptic, on trial. Several preparations, doses small. Sublamin. A suggested substitute for corrosive sublimate. Suggestion. Mental impressions during treatment may retard or aid, according to individual temperament or the nature of the suggestion. Much drug gulping is practically faith cure. Eventually instruction will replace the present imperfect re- liance upon suggestion. Sulfonal. Hypnotic. Dose 15 to 45 grains. Useful in acute mania, delirium tremens, and dynamic states generally, but Chloralamid is better in melancholia. An unpleasant effect is the prolongation of its influence into the daytime follow- ing, with a stupid lassitude and constipation. But even with these drawbacks it is safer and more reliable than many of the suffocants used as narcotics. It is second to Chloralamid in usefulness. These two hypnotics are of com- plementary value. The Chloralamid where there is sleep- lessness from depression and especially where the heart needs sustaining; the Sulfonal when there is fury and strength to spare. It is practically insoluble but may be mixed with the sugar before pouring coffee over it and the patient may not know that the sulfonal is in the cup from which he drinks his coffee, when it is desired that he should not know that he is taking medicine. Sulpho-carbolate of zinc. Internal astringent in intestinal fermentative diar- rhoeas, dose 5 grains in pill after each discharge. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 275 Sulphur. Precipitated, Lac Sulphuris Milk of Sulphur. Dose one or two drams. Laxative. Sulphur, Flowers of. External use in scabies, etc. Sulphuric Acid. The very starting point of chemical manufacturing, but has a limited use per se in medicine, except as a solvent for other things. The 10 per cent, dilute has been used in phth- isical sweats, intestinal complaints and as a destroyer of the cholera bacillus, internally 15 to 30 minims well diluted. Its range of incompatibles is great. Sulphur Iodide. 80% iodine. Antiseptic, Alterative internally in scrof- ula and skin diseases in doses of 1 to 4 grains, externally in 5% to 10% ointments in eczema, psoriasis, prurigo, etc. Sulphurous Acid. Antiseptic in 15 minim doses or externally in 10 to 25 per cent solution. Not often used. Summer Complaint, see Diarrhoea. Sunburn. Cold cream or other grease as preventive or to allay inflammation. Sunstroke, see Thermic Fever. Suppuration, see Abscess. Suprarenal Capsule. Adrenalin. Various grades and strengths of this powerful prepara- tion are marketed, hence the dosage varies with each speci- men. Used in Addison's Disease, and as a styptic in nasal 276 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. hemorrhages such as operative means induce. It acts strongly on the heart and must be used with caution. Suprarenal Extract. Powerful hemostatic and constringent in congestions, but adrenaline chloride is purer and more available for all purposes, in rhinology, edema of glottis, etc. Surgical Fever, see Pyemia. Svapnia. Disguised opium. Sweating, see Bromidrosis, Hyperidrosis. Swooning, see Syncope. Sycosis. Hair follicle suppuration as in ringworm. Sulphur, ichthyol, oil of cade with lanoline. Syncope. Fainting. Aromatic spirits of ammonia, whisky, amyl nitrite pearl inhalation. Synovitis. Joint-lining inflammation. Anti-rheumatics, antisypbilitics, massage, hot air. Syphilis. Iodide of potassium and mercurials, usually biniodide of mercury. The substitutes are disappointing. Syphilitic Dementia. Stupidity, obstinacy, headaches, fleeting pains and paralyses. If promptly treated with iodide of potassium and mercury recovery may occur, otherwise incurable. Syringomyelia. Congenital malformation of spinal cord, causing inco- ordination. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 277 Syrup Hydriodic Acid. Dubious usefulness. Syrup Hypophosphltes. The official and proprietary preparations of Hypophos- phites can be readily spared as ineligible and inert when compounded with strychnia and then they are dangerous if not dishonest, as the title is misleading and dosage cannot be properly adjusted. Syrup, Iron Iodide. 10% Ferrous Iodide. Alterative, Hematinic, Anti scrofulous. Dose 15 to 30 minims. Syrup of Iron, Quinine and Strychnine Phosphates. An Elixir of these drugs is more useful. Syrup of Lime. Antacid, little used. Antidote to carbolic acid poison. Dose 30 to 60 minims. Syrup Roborans. Alleged alterative and substitute for iodides. Dubious usefulness. Tabes Dorsalis. Locomotor Ataxia. Tabes Mesenterica. Tuberculosis of Mesentery. Tachiol. Silver fluoride. Antiseptic. Tachycardia. Rapid painful heart, transitory vagus paresis. In ex- ophthalmic goiter. Hoffman's anodyne, digitalis, ergot. Taka-Diastase. Diastase discovered bv Takamine. Soluble in water. 278 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Starch digestant, used in amylaceous dyspepsia. Dose i to 5 grains. Tamarinds. A laxative fruit used in confectio sennae. Tannalbin. Dry Albuminate of Tannin. Intestinal astringent and diarrhoeal. Dose 15 to 30 grains hourly, after emptying ali- mentary canal of offending materials whose evacuation alone often in children ends gastro intestinal disturbance and even convulsions due to it. Tannic Acid. Astringency of most vegetation depends on tannin. Used in preparing styptic collodion 20 per cent, glycerite 20 per cent, ointment also 20 per cent and in troches 1 grain. Large range of incompatibles. General use in pharmacy preparations. Tannigen. Triacetyl-tannin. Intestinal astringent. Dose 5 to 30 grains. Tannin, see Tannic Acid. Tannoform. Tannin-formaldehyde. Antiseptic and Deodorant in hyperidrosis, bromidrosis, wet eczema, ozena, etc. Pure or 25 to 50% triturations. Tannopine. Intestinal Astringent. Dose 3 to 15 grains. Tanocol. Intestinal astringent, a gelatine tannate in one ounce bottles, Dose *]\ to 15 grains 3 to 5 times daily in diarrhoea. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 279 Tape Worm, see Worms. Tar. Ointment 50%, Syrup Dose i to 4 fluid drams. Taraxacum. Dandelion. Bitter hepatic stimulant, not much used. Tartar Emetic, see Antimony and Potassium Tartrate. Tartar, see Potassium Tartrate. Tartaric Acid. Main modern use in Seidlitz powder making. Tartrate of Potassium and Sodium, see Rochelle Salts. Telangiectasis. Overgrowth of capillaries, acquired, resembling the nevus, which is congenital. Electrolysis. Telepathy. Mind Reading. Superstitious nonsense of ignorant and illogical, some- times pretended by the designing. Tenesmus. Bearing down, straining, see Dysentery and Dysuria. Terebene. Expectorant, Antiseptic, Antifermentative. Internally in bronchitis, flatulent dyspepsia, emphysema, phthisis, dys- pnoea, externally in skin diseases, uterine cancer, gangren- ous wounds. Inhalation in phthisis. Dose 4 to 30 minims with syrup or on sugar. Terpin Hydrate. Expectorant, Antiseptic, used in bronchial affections. The best form for administration is in the Elixir. If Heroin is used with it there should be a return to the plain Terpin Hydrate. 280 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Tetanus. Lock-jaw. Tetanus antitoxine quickly, keep wound open, washed with strong antiseptics. Gonium maculatum antagonizes the spasms. Tetany. Hysterical Cramps. Mental impression suffices to remedy, as in the case of a young girl with opisthotonus hysteria, when white hot iron application to spine was mentioned in her hearing there were no more spasms, Quackery also may end the attacks. Tetra-ethyl-ammonium Hydroxide. Unstable, dubious uric acid solvent. Tetraiodo-phenolphtalein, see Nosophen. Tetraiodo-pyrrole, see lodole. Tetter. General popular term for any skin disease. Thalline Sulphate. Antiseptic, Antipyretic in typhoid fever, malarial fever. Dose 3 to 8 grains, alleged use in gonorrhoea also, but doubtful benefit. Thallium Acetate. Used in phthisical night sweats. Dose I to 3 grains at bedtime. Theine, see Caffeine. Theobromine. Alkaloid. Diuretic, Nerve stimulant. Dose 5 to 15 grains. Theobromine Salicylate. Merck claims this to be stable and uniform and a pow- erful diuretic and genito-urinary antiseptic. Dose 15 grains. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 281 Other Theobromine salts unstable, decompose on ex- posure, so no use in medicine. Therapeutics. The application of remedies to diseases is of earlier date than medicine itself, simply because from the earliest of be- nighted times, before anyone knew what was the matter when one was sick, everyone knew what to do for it. Out of the multitude of guessed at, hap-hazard, non- sensical, often harmful dosing, drugging and mummery so unhesitatingly used by ignorance it would be remarkable if among the thousand slain some did not escape and a few even happen to be benefited. Upon this latter admission, forthwith, the hap-hazard doser claims justification, and be- cause all persons are not killed by Indian and Pennsylvania Dutch "pow-wow," granny's "roots and yarbs," and so on, therefore it is not necessary to know what you are about to be able to cure diseases. The Indian uses his mysterious methods, for which so many "civilized" have regard because they like to be mysti- fied, in all his doings as well as in treating disease. He beats a drum and shoots off guns to scare away the devil of small- pox, but he also does the same to frighten away the goblin that swallows the sun in an eclipse; and just as the sun is preserved by the Indian medicine man's noises, so is the sick man restored by the same wonderful power, and fees are as complacently collected by him for his work as white ignor- ance pockets money for telling you that there is no disease, but you are cured of what you did not have. Scientific medicine may use the results of empiricism, or even empiricism itself, intelligently, but charlatanry de- fies logic and cares for no results but cheating. Unscientific medicine is divisible into Indian and Old Granny methods. Regulars and irregulars have, at times, practised one or both of these, to a great or less extent. For 282 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. example some of the doctors in the benighted Pennsylvania Dutch regions finding it impossible to instruct their patients away from witchcraft ideas, yield to their un-American ig- norance enough to pow-wow or charm away disease, giving legitimate remedies, however, at the same time. About as rarely as apples are found in the gutter, so may humbuggery "cure" disease; therefore, argue those in- capable of logical reasoning, we should practice humbug- gery upon patients, not realizing that therefore, also, we should seek apples in the gutter and not on trees. But the most astounding statement is often heard, from those, even, who do not want to be humbugged themselves, that as quackery is preferred to honest medicine the people should be allowed to have humbug treatment, and honest doctors should become dishonest. Such notions keep Africa, Asia and heathendom generally degraded, and would send Eng- land and America after them were no one to oppose such knavery. The real physician, who loves his profession and does not wish to drag it in the mud of commercialism; who regards the welfare, lives and health of his fellow-mortals more than money, and who has enough of the stuff martyrs are made of to stick to honest methods, in the belief that thereby he can accomplish more good, should be prepared to be misunderstood, to be unappreciated and to see the re- wards of merit showered upon ignorant, presumptuous, harmful quackery. If big-minded men like Savonarola, Lu- ther, Washington, William III, Abernethy, Hunter, Mr- chow, Pasteur and many earnest thinkers in varied pursuits, had lowered themselves to that contemptible level, where would we be to-day? To the fact that hundreds of thous- ands of single-hearted, honest thinkers in ages past fought humbuggery and were often defeated by it, you owe to-day the shelter over your head, the shirt upon your back and the food you eat. If your progeny is to endlessly descend to THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 283 far-off ages which idea would you rather have prevail for them to live under, the one in which greed and ignorance will fatten upon their sufferings, and while pretending to help them really harm them, or where enlightenment goes hand in hand with mercy? The cart has been put before the horse, in this old world of ours continually, as we evolved from childish, savage ways of thinking and doing things. Results are mistaken for causes, things having nothing to do with either cause or effect have been literally worshipped as the "whole thing." What to do in any and all cases have been confidently as- serted by impudence and gulped by ignorance, both being too lazy or imbecile to study out what was the matter before trying to do any thing for it. So therapeutics, or what to do, preceded pathology, or what was the matter, though every baby thinks he knows what is the matter, when instead of the moon he bawls for he needs a spanking, and untrained unmedical people are just as sure as the baby is that they know both what ails them and what they should do for it. The grave-yards are choked with self-dosers, patent medi- cine gulpers, people who treated themselves for fancied ail- ments, diagnosed with infantile ability symptoms they dwelt upon as important, that were of no consequence, and passed over as unimportant things the educated doctor regards with alarm. It is granted that an engine needs an instructed en- gineer, but the body which is more complicated than any engine can be treated by Indians and old grannies. Blind- ness may take refuge in the claim that the body cannot be regarded as an engine; then, it may be asked, why oil it and dope it and scour it upward and downward with your roots and "yarbs" and opiates, and other things of which you know as little as of the body? Whatever contributes to the recovery of a sick person may be included under Therapeutics. Therefore even the 284 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. withholding of drugs, at times, may be a therapeutic means, giving nature a chance to help, and instruction in all that pertains to medicine assists in determining when to dose and when to refrain from dosing. So Therapeutics can be very comprehensive in discussing the sick person, remedies for him, his environment and what it contains toward helping or hindering recovery. Aside from merely generalising the effects of drugs, then, the patient himself, his idiosyncarasies, the logicality, or want of it, of all concerned, such as patient, doctors, nurses; their psychology, superstitions, training, all are legitimate subjects in a therapeutical discussion. But ob- serving the proper proportionate regard for things of the most importance, to avoid wandering afield, justifies the average work on therapeutics in restricting itself closely to materia-medica and the influence of drugs upon disease. Nevertheless the entire matter needs vigorous overhauling in the very nature of things. The fact is that most of our books on therapeutics have been written by young, inex- perienced men who merely copy from predecessors without being able to eliminate the errors or preserve any better bal- ance in topic handling. On the other hand this very juven- ility assures a far better knowledge of modern chemistry than the old practitioner possessed, so from that standpoint many compilations of medical infants have the chemistry, inorganic especially, brought down to date, as a rule, though in everything else, pedanticism, blunder perpetuating, owl- ish nonsense and ignoring of important discoveries become apparent to the practitioner of a few years experience out of college. Away back in the days of pure empiricism, when bleed- ing and great calomel dosing were mainstays, Philadelphia was our medical center, and a few bright men such as Rush, Maisch, Stille, though not contemporaneous, and several THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 285 others, began the publication of important and, at that time, really valuable treatises on several medical subjects, but later occupants of their college chairs have overhauled these musty tomes, often with reference solely to personal prece- dence, even where it entailed the misleading of readers. Some valuable discovery may have been made by one outside of a particular clique, and this needed ignoring, even though in- jury of the discoverer was occasioned, precisely as naval and military politicians seek to destroy merit, fearing that the pretender will be eclipsed. Often some callow son-in-law of a publisher thrusts his immature, but prettily printed, rub- bish upon learners, and where anything of worth happens to be included it is most likely to be plagiarized, often with de- traction of the real author. Taking the books themselves the dispensatories are great expensive affairs which sell so readily that any real re- vision requiring outlays of many thousands of dollars would be looked upon as commercial nonsense; and the word "Business" justifies crimes of omission as well as those of commission. The fault then really lies with a medical com- munity that is satisfied with this state of things, content to remain a hundred years behind in many respects to appease the vanity of some incapable who has foisted himself as "authority" and who has business acumen enough to be able to intrigue against competition, though multitudes per- ish in consequence. As for the works on materia-medica and therapeutics their chief and obvious faults are pedanti- cism and uselessness due to insufficient study, to incorrect legendary assumption and bad logic. The practitioner has to outgrow his books, and in thumbing them over in riper years, he smiles at the old lies. the gravely asserted rot, the emphasis placed upon trifles and how things of prime importance were left out from var- ious motives, usually because the writer knew nothing of 286 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. them or did not like the way in which the one who had made the important contribution wore his hair or because he pro- nounced bronchitis differently from the acceptable way. The most frequent cause of dislike, however, was due to failure to worship at the shrine of some self elected authority who had pull enough to secure a school professorship or had married money enough to be able to assert himself, like the monkey who owns and climbs a pole from the top of which he may look down upon other monkeys. One who essays a protest against an accepted condition of things has a thankless task before him, the doctrinaire, the kicker, the reformer, are disagreeable folks and often wrong in their methods even if right in their intentions; the ancient way of rewarding messengers of unwelcome truths to royalty was to kill them. Nowadays it only needs the sneer to accompany mention of a "reformer" and he is slain in estimation. But it is always at the risk of being slain that battles are won, and whoso is content with complacent ig- norance and retrogradation is practically dead anyway. All this is preliminary to asking for a better regard of the interest of the patient, and that we should never lose sight of the fact that any medical work should place the care of the sick person as first and foremost ; and the least regard should be given literary or any other kind of swagger, for youngsters in medical writing think it necessary to display their learning, even though it has no relation to the subject in hand. And when a medical author arrives at the limit of his information he should stop. Which sounds trite, but books are crammed with what their writers know nothing about in their desire to "complete" a description of a certain group of subjects. If writers would but confine their efforts to matters in which they are versed they would benefit the world and confer immortality upon their work instead of oblivion. Even with concerted action as when a collabo- 287 rated Practice, a cyclopaedia of medicine by several authors, is published, how wonderfully unsatisfactory it is, from well known causes. A few good articles by competent special- ists, and these may not have been on topics with which they were most familiar, are smothered among groups of per- functorily written essays, not as good as many graduating theses, exhibiting how fallible is "authority" in assigning topics to writers and in selecting the most competent stu- dents of special subjects. If, then, "authority" fails in judging as to where knowl- edge lies, how impossible will it be for any writer to com- pass all that there may be in so vast a science, art, or what- ever it may be, as Therapeutics. Thermal Fever. The prostration and high temperature demand stimu- lating and tonic treatment, such as whisky, quinine, strych- nine and in aged persons a cautious use of digitalis. Ice ad- ministered in small pieces by the mouth, and applied to the head and wrists assist in cooling the system and reducing the fever. The shock of sudden immersion of the body into ice water must be remembered as too severe unless the case is extreme and needs such rousing, but guardedly and grad- ually ice applications can be extended to other parts of the body beside the wrists and head if not done to excess as is often practised. The former division of cases of heat prostration into asthenic and dynamic led to so many deaths by improper use of heart depressants like acetanilid, antifebrin and the many "headache powder" disguises of these dangerous drugs, that in the absence of very clear differential diagnosis it would be far safer to treat all cases as prostrated and needing sustentation, as in reality the vast majority do, and anyway the dynamic instances soon pass to the debility stage which depressants will but have made extreme, if used. 288 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Therein. A synthetic diuretic, on trial. Thermodin. Antipyretic, Analgesic. Dose 5 to 20 grains. Thigenol. Ichthyol substitute. 10% sulphur in organic combina- tion. Thiocol. Potassium Guiacol-sulphonate. Soluble. Antituber- cular, Anticatarrhal, said to be unirritating. Dose 5 to 20 grains. Thiol. Synthetic ichthyol and less expensive than ichthyol. Thiosinamine. Urea compounds are of doubtful justification, more theoretical than useful. Thread Worms, see Worms. Thrombus. Clot in blood vessel. Thrush, see Aphthae. Caused by a fungus, oidium albicans. Thuya Occidentalis. Arbor Vitae. Ancient terebinthinate, lately Merrill advertises a nor- mal tincture thuja useful in so many different ailments that it is puzzling as to rationale and why any one need be sick at all. It is probably as useful as tar or turpentine as an an- tiseptic. Thymol. Thymic Acid. Used internally in rheumatism, gout, chyluria. worms, particularly the Puerto Rico uncinariasis THERAPEUTICS, MATERIA MEDICA AND PRACTICE 289 parasite that causes anemia, and in gastro-intestinal fermen- tation. Externally for skin diseases, toothache, ulcers, wounds, mouth wash and inhaled in coughs, bronchitis, coryza. Dose I to 10 grains. Thyroidectin. An antagonist of thyroid extract, made from the blood of animals deprived of thyroid glands, said to control the paroxysms of exophthalmic goiter. The claims sound rather theoretical but it is worth trying their justification in the absence of any other help for this distressing organic defect. Dose one or two capsules after meals. Thyroid Gland. This very useful substance has been prepared for med- ical use under a variety of names. Its principal uses are in cretinism, imbecility, faulty development of mind or body in children, due to other than trauma or syphilis. In myxe- dema it is excellent and is said to be useful as an anti-fat, but it is not proper to use it in exophthalmic goitre as it in- creased the disease. Merck makes Thyraden and Thyroidin dried extracts, and the Phospho-Albumen Co. a Thyroid Extract in tablets. Thyro-iodine, see lodothyrine. Tic Doloureux. Trigeminal Neuralgia? see Neuralgia. Tinea Tonsurans or Circinata, see Mentagra and Ring Worm. Tinnitus Aurium. Ringing in the ears. Often due to wax accumulation, see Cerumen impac- tion. Congestion of blood vessels relieved by ergot, calo- mel, hot foot baths, cathartics, sometimes want of blood in 'the head as in anemia, or to various ear or brain diseases. 290 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Tobacco. Nauseant depressant. In epididymitis a bread or flax- seed poultice containing fine cut tobacco relieves the pain and reduces the inflammation, but if left on too long vomits and slows the heart. The habit of smoking and chewing if continued into old age subtracts from the heart muscle strength at a period when such weakening is prejudicial, but by that time the habit is fastened. Stimulants are better for the old. Toluene. Toluol. Benzine like odor used topically in diphtheria as Loefrler's Solution containing Toluene 18, solution iron chloride 2, menthol 5, alcohol 30 parts applied with swab every three hours. Tongaline. Secret. Tonsillitis. Treat same as pharyngitis. Calomel, guiac, antirheu- matics, astringent as nitrate silver 8 grains to ounce of water painted on tonsils with camel hair pencil. Toothache. Dentistry. Exclude air from exposed nerve by wax or cotton plug, apply creosote to cavity. Ergot reduces throb- bing pain, antiseptic mouth washes, cathartics, antirheu- matics. Avoid opiates and acetanilids. Torticollis. Wry Neck, see Stiff neck. Trachoma. Granular eye-lids, see Conjunctivitis. Resinol ointment ordinarly relieves. Severe granula- tions may need granulations cauterized with blue-stone, cop- per sulphate. Infectious through towels. Antiseptics. Trance. Lethargy, Ecstasy. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 291 Transitory Frenzy. Technically includes definite fury and unconsciousness. Traumaticin. Solution of gutta-percha in chloroform used in den- tistry and surgery as protective covering for bleeding sur- faces, also as vehicle for dermics. Traumatic Insanity. A defined set of symptoms after head injury, sometimes homicidal and suicidal. Traumatic Neuroses. Neurasthenia or hysterical from injury. Tremor or Trembling. Many functional or organic causes, usually indicating weakness, as after debauch, when a stimulant stops the tre- mor, during debility as in aged when a tonic may answer, but in organic disease of brain or spinal cord little can be done. See also Chorea. Trichiasis. Eye lash irregularity rubbing against the irritating eye- ball. Surgery. Trichinosis. Dangerous boring parasite from eating raw meat, passes from intestines to anterior spinal muscles, where they encapsulate. Prevention is easier than remedy. Anti- septics and pain relief. Triferrol. A ferruginous tonic. Dose tablespoonful. Trikresol. Antiseptic and disinfectant, said to be three times as ef- fective and a third as toxic as carbolic acid. 292 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Tri-iodides. Partly secret. Tri-iodo-cresol, see Losophan. Trimethylamine Solution, see Solution, Trimethylamine. Trional and Tetronal. Improved sulfonal, but apparently not so well known or used as much. Numerous poisoning cases. Trioxymethylene. Escharotic for warts. Generates formaldehyde gas on heating. Triphenin. Propionyl-phenetidin. Antipyretic, Antineuralgic, on trial reported prompt and no after effects. Dose 4 to 10 grains. Trismus. Lock-jaw. A localized symptom of tetanus. Trismus Neonatorum. Lock-jaw in new born. Caused by using septic instruments as scissors in cut- ting naval cord. Triticum. Couch grass. Old diuretic not much used now except in quack remedies for ignorant to dose their kidneys with. Tropacocaine Hydrochlorate. Benzoyl-pseudatropine Hydrochlorate. Substitute for and said to be less poisonous than cocaine, less reliable as mydriatic. Used 3% solution with 0.6% sodium-chloride solution. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 293 Trophoneuroses. Impaired nerves controlling- nutrition, causing wasting and sloughing of tissues, usually symmetrical. Trophonine. An excellent predigested nutriment in liquid form, that can be used in all complaints where strength must be con- served and solid food must not be taken. In gastric ulcer, dysentery and other conditions requiring concentrated liq- uid food. For gastric wounds it is safer than solids and more effective than food suppositories, which cause inflam- mation and are innutritious beside. Trypsin. Practically pancreatin. Tuberculosis. See also Phthisis. Out door life as much as possible, avoidance of germs which arise from dried sputum, are the simple therapeusis and prophylaxis of "consumption." Open air sanitariums are springing up all over the country, but all cases nearly can be cared for at their own homes if windows are left open day and night, winter and summer in sleeping rooms, though city air is not good in any instance, as it is too much laden with impurities of all kind and a city sanitarium is simply foolishness. The best site would be a pine tree dis- trict on a mountain, such as New Mexico and Colorado af- ford. Many a case of incipient and even worse "consump- tion" has been completely cured by exclusively out-door life, such as a tramp lives. I recollect a photographer who intended to throw away his life in a tramp along the Yel- lowstone river among hostile Indians in the middle of the last century but returned unharmed with healed up lungs within the year. Another took a similar tramp to reduce his weight, which, was somewhere about 250 pounds, and got 294 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. rid of all that was superfluous, about 70 pounds, in one spring and summer. The average consumptive is so hopeful, a condition recognized by Hippocrates and called the spes phthisica,that he falls an easy prey to pretenders, who rob him cruelly. The various serums from that of Koch to those in use to-day are failures, but occasionally a sure cure fraud or fool is a can- didate for ovations. A good cod liver oil with or without creosote is the best to allay many symptoms, and whisky cer- tainly conserves tissues against destructive diseases as phth- isis. The toleration for alcoholics is strong in consumption. Tuberculin. A toxine of Koch. Very dubious usefulness. Tumors, see Cancers. Turpentine, Chian. Externally in cancer. Turpentine. Used in scarlet fever, especially with nephritis. Also in pneumonia after giving calomel. Antiseptic and rubefac- ient on flannel to back or abdomen with linseed meal poul- tice to relieve congestion of bowels or kidneys. Turpeth Mineral. Yellow Sulphate of Mercury. Emetic and too poisonous for medical use. Tyalid. A starch digestant from the salivary glands of bovines. Effective. Tyloma, see Callosity. Tympanites. Air distention of abdomen, sometimes in peritonitis. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 295 Typhoid Fever. Intestinal disease from foul water con- taining typhoid bacillus. Begins with stupidity and headaches, tenderness right iliac region, bowel gurgling, appetite loss, fever rising in evening, nosebleeding sometimes prostration lasting usually six weeks, yellow diarrhoea at times. Strict milk diet, ex- clusively, as solid food rasps the sore intestines and may tear them open. So call abortive treatment more often aborts the patient. No antipyretics unless temperature con- tinues over 103 degrees Fahrenheit, and if constipation an enema corrects it and lowers temperature. Constipation also causes headache increase, so that enemas are better than headache medicine in such cases. If hemorrhage from bowels antipyrine or ergot. Mild antiseptics and not too much of them internally, for overdosing with antiseptics was as bad as the disease when that method was first intro- duced. Use mouth wash for sordes. Whisky and quinine if debility, supporting treatment in convalescence, quiet and slow return to other food in convalescence. At the outset doses of calomel abridge the disease and modify it. Six weeks is the usual duration, the third week being the crisis, after which subsidence of the fever is favorable. Salol splits into carbolic acid and salicylic acid or oftener does not dis- solve but passes through the bowels inert. Labarraque's solution or 5% Lysol solution for disinfecting stools, urine, laundry, etc. Animal broths make a good culture medium for typhoid germs. Typhus Fever. Ship or Jail Fever. Epidemic in wretched countries like Russia, where there is more religion than sanitation or mercy. Infectious continued fever not related to typhoid. 296 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Ulcer of Stomach. Avoid too much bismuth and feed with trophonine. Rectal feeding inflames rectum. Ulcers, see also Abscess. Antiseptics and caustics, sometimes tonics. Ulmaria. Ethyl and Amyl salicylates, for external use in gout and rheumatism. Unguentum Hebrae. Boro-vaseline or boro-lanoline. Uranium Nitrate. Doubtful use in diabetes. Urea. Carbamide. Doubtful use in cirrhosis, pleurisy, calcu- lus, etc. Urecedin. Secret. Uremia. A pathological condition to arbitrarily include pheno- mena attending renal disturbance, such as eclampsia or con- vulsions in Bright's disease and the puerperal uremia. The nature of the blood deterioration has not been definitely as- certained. Generally the blood contains materials that should have been excreted by the kidneys and which other organs as the skin and bowels insufficiently compensate. The salivary glands, stomach, axillae, soles of the feet also sur- charge with urea when the kidneys are insufficient. Uremic bronchitis with its frothy mucus exudate and danger of ed- ema of the glottis is a laryngeal dropsy, convulsions could be due to their blood deterioration or dropsy of the br.ain, THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 297 practically the same thing as to results. The determining factor being as to the organ most exercised. Talking can congest the larynx and worry or mental over application the brain. Elaterium, calomel, sulphate of sodium, potassium ace- tate, pilocarpine hydrochloride, dry cups and turpentine or mustard to back, or hot applications to back if urine scanty. Amyl nitrite, nitro-glycerine, digitalis, strychnia, normal salt solution injections subcutaneously or by enema. Strych- nia nitrate hypodermically. Urethane. Ethyl carbamide, on trial as a hypnotic. Urethritis. Inflammation of the urethra. Antiseptics and astringents locally, calomel internally. Uricacidemia, see Rheumatism, Gout. Uridrosis. Urine sweat. Sweat normally contains small quantities of urea, in Bright's disease and cholera the sweat glands eliminate an excess of urine constituents, deposited on the skin, little scales of urea may be seen alongside the nostrils, and the skin smells urinous. Hot baths remove the offensiveness. Uriform. Ammonium-formaldehyde. Internal antiseptic in uri- nary diseases, as cystitis, urethretis, prostatitis, etc. Dose teaspoonful. Urol. Quinate of urea, suggested for rheumatism and gout. l>ropherin Benzoate. Theobromine and Lithium Benzoate. 298 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Uropherin Salicylate. Theobromine and Lithium Salicylate. Both these salts are diuretic with 50% theobromine. Unstable. Dose 5 to 15 grains. Urosin. Quinate of lithium. Urotropin. Formin. Antiseptic from formaldehyde and ammonia. Expen- sive. Urticaria. Hives. Nettle Rash. Eruption like nettle stings. Ammonia, Ichthyol, Re- sorcin. Carbolic acid ointments, 3% in lanoline. Cathartics. Ustilago Maydas. Corn ergot. Resembles secale cornutem in therapeutic effect, quick- er and harsher. Uterine Colic. Viburnal, asafoetida, valerianate of ammonia, if from prolapse replace. Uterine congestion. Glycerine tampons. Uterine Inflammation, see Metritis. Uterine Prolapse, see Prolapsus Uteri. Uterine Subinvolution. Ergot, rest, support of organ with tampons. Uva Ursi. Bearberry. Old Diuretic, not much used. Uvula or soft palate relaxation or elongation. Astringents as nitrate of silver 8% solution, or alum. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 299 If chronic a small piece of the tip can be excised, but care taken not to make the uvula too short as it modifies the voice. Vaccination. Small ivory lancets with lymph at the end enough for a single vaccination are the safest to use, as septic instruments such as needles are dispensed with. With such precaution syphilis or tuberculosis must be in the blood previously if it manifests itself, and cannot be blamed upon the vaccination, as it properly was at times when arm to arm transfers of lymph were made. Vaginismus. Spasm of vagina muscles with pain. If habitual, forcible distention after anesthesia, other- wise monobromate of camphor, internally and locally co- caine infrequently. Vaginitis. Inflammation of the vagina. Boro-glyceride suppositories, aseptic washes or douches, astringents as ichthyol, hydrastine, potassium per- manganate, boric acid. Valerian. The offensive odor of Valerian preparations prevent their becoming popular with either physicians or patients, but in the form of an elixir of valerianate of ammonia in teaspoonful doses as needed, its efficiency and harmlessness in all hysterical cases commends it to the neurologist. As a nerve sedative it is vastly preferable to opium or the bro- mides. Valerianic Ether. Antispasmodic, in spherical capsules. Valvular Heart Disease. Bad-Nauheim treatment, see Carbonated Bath Salts. 300 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Vapo-cresoline. Apparatus for vaporizing cresol to inhale in whooping cough and infectious disorders of the respiratory organs. Varicella, see Chicken Pox. Varicocele. Enlarged veins of scrotum and spermatic cord. Ergot internally and ichthyol externally. Support scrotum. Varicose Veins. Dilated veins. Ichthyol, resorcin, and if ulcerated antiseptics exter- nally and tonics internally. Variola, see Small Pox. Vasogen. A vehicle for applying iodine, ichthyol, mercury, creo- sote, etc. Veronal. Hypnotic. Crystals soluble in 145 parts water at 68 de- grees F., and 12 parts boiling water. Dose 10 grains. Simi- lar to trional but less dangerous. Verruca, see Warts. Vertigo. Dizziness. Variable causes, as anemia or hyperemia of brain, ear diseases, brain diseases, stomach or heart derangement, so that very opposite methods of treatment may be required in different cases. A hot foot bath or cathartic if too much blood in head, a stimulant if too little blood there. Venene. For snake bites, see Antitoxins. Venereal Diseases, see Chancre, Gonorrhoea and Syph- ilis. fHERAPEUTICS, MATERIA MEDICA AND PRACTICE. 301 Veratrine. Exceedingly irritating to mucous membranes and be- ing so poisonous and temporary in effect and of dubious medical use generally it could be spared from materia med- ica with other injurious outworn things. Veratrum Viride. American hellebore. A cardiac depressant that may be shelved with old granny black hellebore as a mere poison. Vibrations. Like all new means useful in a limited number of cases the exploiters are claiming to be able to cure everything with it. The machines can be used with advantage in ameliorating paralysis agitans, liver torpidity and similar disorders, though I hold that instruction is more service- able to the patient, however resented and unprofitable pe- cuniarily to the doctor. Viburnal. A compound of viburnum prunifolium and cimicifuga for dysmenorrhoea. Dose tablespoonful in hot sweetened water hourly before menstrual period. The practice of giv- ing morphine for painful menses leads to the habit of using opiates. Viburnum avoids this. Viburnum Compound. Another uterine sedative. Viburnum Opulus. Cramp Bark. Antispasmodic, but the prunifolium is preferred. Viburnum Prunifolium. Black Haw. Uterine nerve sedative, particularly when with cimicifuga as in viburnal. Dose fluid extract 15 to 60 minims. 302 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Vichy Water. Bicarbonate of soda solution. Vioform. Iodoform substitute. Vitiligo. Leukoderma. Vitogen. Secret. External use. Vomiting and Nausea. Cerium oxalate, small pieces of ice held in mouth until corners are melted and then swallowed, a solution contain- ing a drop of creosote or carbolic acid to the pint of water, tablespoonful doses, antiferments, emetics, cathartics, lemon juice in bilious cases. Vulvar Pruritus. Resinol or resorcin ointment. Vulvitis. Inflammation of vulva, see Vaginitis. Wahoo, see Euonymus Atropurpureus. Warts. Papillomata, Verrucae. Trim and cauterize with silver nitrate or any acid. Sali- cylic acid in paste will soften warts and formaldehyde disin- tegrate them by the opposite process of hardening them. Water-brash. Eructations usually from Gastritis. Alkalies and buttermilk diet. Water Cure, see Hydrotherapy. Water of Bitter Almond. Contains one per cent of hydrocyanic acid. Used chiefly as a vehicle. Dose 10 to 20 minims. THERAPEUTICS, MATERIA MEDICA AKD PRACTICE. 303 Waters, Mineral. The chemical bureau of the government department of agriculture procured specimens of all the advertised spring waters and found the most of them to be fraudulent. The use of such waters by those who can afford them constitutes a fad or superstition. Ignorance of the rudiments of chem- istry enable the people to be imposed upon. Even when pure such waters for the most part have merely glauber or epsom salts in varying amounts. Wens. Sebaceous Cysts. Dissect out the capsule for if this membrane remains the wen will grow again. White-Leg, see Phlegmasia Alba Dolens. White Precipitate, see Mercury Ammonium Chloride. Whites, see Leucorrhoea. Whitlow, see Onychia. Whooping Cough, see Pertussis. Widal's Test for Typhoid Fever. A few c.c. of blood serum from patient, if a few drops of active culture of bacillus typhosus added and the bacteria are pptd in flakes, leaving the supernatent fluid clear, there is typhoid fever. See also Ficker's Typhoid Diagnostic. Wild Cherry Bark. Sedative. Depends upon hydrocyanic acid for flavor, odor and effects. Dose fluid extract 20 to 60 minims, in- fusion 1 to 4 ounces, Syrup 1 to 4 drams. Expectorant and frequent ingredient of cough medicines. Quacks use it in "Consumption Cures" as it allays the throat irritability a little and the uninformed imagine that therefore a remedy has been found for an incurable disease. 304 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. Wintergreen, see Gaultheria. The oil is useful in rheumatism, if pure. Witch Hazel. Hamamelis, Pond's extract. Lotion for injuries and burns of minor degree. Wool-sorter's Disease, see Anthrax. Worms. Intestinal parasites of various kinds. Ascarides or round worms, santonin 3 grains, calomel 4 grains in sugar, or a teaspoonful of a mixture of equal parts of spigelia and senna fluid extracts and syrup. For oxyuris or thread or seat worms, the simple introduction once or twice daily up the rectum of a capsule containing 2 grains of quinine, after a bowel movement. For tape worms Tanret's Pelletierine Syrup on an empty stomach with cathartic later, or oleoresin of male fern a dram and a half with 15 minims each of turpentine and chloroform in an ounce of acacia mucilage, half at night, rest next morning, with purge later, or tannate of Pel- letierene and koussein each 15 grains in 3 capsules, dose one to three according to age with cathartic later, 5 grains of thymol hourly and castor oil at beginning and end of dos- ing six to ten times. The young practitioner is discomfited by an old granny diagnosing and treating children for "worms" when there is an intestinal trouble, with paleness about the mouth and picking at the lips, with irritability and sleeplessness, and many an old practitioner overlooks such simple matters but is reminded of old granny success again when she slyly rids the youngster of the worms, but all such things are mere matters of experience and we seldom if ever hear of the mul- titude of cases in which old granny was not only in error but harmed the child in ignorant attempts to relieve it of worms it did not have. THERAPEUTICS, MATERIA MEDICA AM> PRACTICE. 305 Wounds. Antiseptics, protectives. Writer's Cramp. Spasm of hand muscles when attempting to write, through overuse of the hand in one predisposed. Incurable. Massage and tonics with rest palliates. Writer's Paralysis. An extreme condition of writer's cramp, same prog- nosis and palliation. Wry-Neck, see Torticollis or Stiff neck. Xanthoxylum. Prickly Ash. Diaphoretic alterative. Dose fluid ex- tract 15 to 60 minims. Little used. Xeroform. Tribromphenol-bismuth. Half bismuth, Surgical and intestinal antiseptic. Externally infected wounds and bu- boes, internally diarrhoeas. Dose 5 to 15 grains. X Ray, also Roentgen Ray. Useful in diagnosis to enable certain opaque parts, as bones, hard tumors, metallic and some other foreign ma- terials to be seen in deep parts of the body, other tissues being rendered practically transparent. In therapeutics the stimulation afforded by the ray seems to have removed, more or less permanently, lupus vulgaris, and has been tried in pulmonary tuberculosis and some other complaints, but with how much success remains to be discovered from the mass of contradictory writings. Yellow Fever. Indigenous to Cuba, nearly eradicated by sanitary measures. Calomel, antiseptics, antipyretics and symp- 306 THERAPEUTICS, MATERIA MEDICA AND PRACTICE. tomatic treatment, avoiding stimulants unless collapse or exhaustion. Yersin's Serum, see Antitoxins. Yohimbin. Aphrodisiac. Tablets containing a twelfth of a grain, i to 3 daily. Zinc Acetate. Formerly used in eye washes and gonorrhoea, but has been superceded by more useful and less injurious sub- stances. Opacity of the cornea has been caused by it and lead acetates. It was formerly an ingredient of quack gon- orrhoea remedies. Zinc Bromide. Dubious use. Zinc Carbonate. Used for wounds, ulcers, skin diseases, also face pow- der in which it is less injurious than lead preparations. Zinc Chloride. Antiseptic. Tuberculous joints i to 1,000 or stronger. Zinc Iodide. Soluble. Dose i to 2 grains. Scrofula and Syphilis. Zinc Oxide. Ointment 5 to 20% for wound and skin diseases. Zinc Permanganate. Soluble in water with residue. Antiseptic. Use 1 to 4,000 in gonorrhoea solution injected, but instability ren- ders ordinary permangante of potassium preferable. Ex- plosive. THERAPEUTICS, MATERIA MEDICA AND PRACTICE. 307 Zinc Phosphide. Useless in sexual exhaustion and other things for which it has been tried on mistaken theoretical grounds. Zinc Sulphate. White Vitriol. Emetic in doses of 10 to 30 grains. Zinc Sulphocarbolate. Effective antiferment in diarrhoeas caused by gastro- intestinal fermentation. Dose 2 to 4 grains after each dis- charge. It is used also as an astringent wash in foul ulcers. Zinc Valerianate. Decomposes on exposure, so not available in the ner- vous affections for which it has been advised in a routine way by neurologists who do not verify their formularies as to results secured. The bad smelling elixir of ammonia is better than a valerianate prescribed by mere name and which if it acts at all does so by faith cure. Zomol. Juice of 200 times its weight of raw meat, in scales. Zoster. Shingles. OTHER WORKS OF THE SAME AUTHOR. Medical Jurisprudence of Insanity. 2 volumes, 1400 pages; sheep, $12.00; cloth, $10.00. Describes all forms of Insanity and its Treat- ment. Complete from the Medical as well as Legal sides. Based on asylum experience and the literature of all languages. Exact, Reliable, Standard. Law and Insane Asylum Libraries value it as leading all books on the subject. Highly endorsed by Journals on the subject of Insanity such as the American Journal of Insanity, London Journal of Mental Science, Journal of Nervous and Mental Disease, also law periodicals as the New York Law Journal, American Lawyer, Albany Law Journal, etc. Published by The Lawyers' Co-operative Pub- lishing Co., Rochester, N. Y. For sale by The Evolution Publishing Company, Atlantic City, N. J. The Evolution of Man and His Mind. 623 pages ; cloth, $5.00. A Popular series of easily read essays describing the gradual development of animals, man and mental- ity, reviewing the discoveries of all evolutionists. Written for all classes of readers, especially medical, and technical terms avoided or explained. Favorably reviewed generally. Ordered by prin- cipal University Libraries, as Pennsylvania, Princeton, Clark, Cornell, Michigan, Harvard, etc., indicating recognition of the value of the work, scientifically and educationally. Mentioned as encyclopaedic, intensely interest- ing and readily understood. Published by The Evolution Publishing Company, Atlantic City, N. J, OTHER WORKS OF THE SAME AUTHOR. Spinal Concussion. Surgically considered as a cause of spinal in- juries and neurologically restricted to designate a form of the traumatic neuroses, for which was sug- gested the term Erichsen's Disease. Sir John Eric Erichsen, surgeon extraordinary to the queen commended this book as an improve- ment upon his celebrated Concussion of the Spine, a historical classic in the advance of medicine, concern- ing a subject involving billions of dollars in damage suits against railways, and necessarily arousing bitter partisanship. This book is impartial but as it is also truthful it is not welcome to professional perjurers and organized incorporated criminality. Published by the F. A. Davis Publishing Com- pany, Philadelphia, Pa. Cloth $1.50. 400 pages. For sale by The Evolution Publishing Company, Atlantic City, N. J. A Treatise on the Method of Government Surveying. 200 pages, cloth $2.50. Originally published in 1874 this book has run through several editions and is still standard in universities and with surveyors and and civil engineers for practical field use. Published by D. VanNostrand Co., N. Y. Artistic Anatomy, and the Sciences useful to the Artist. Lectures delivered at the Art Institute, Chicago; published serially in the American Lithographer, 1887. Comparative Physiology and Psychology. 247 pages. Out of print. Published in 1884. A discussion of the relations of the mind and body of man and animals. Too technical in chemi- cal and biological studies for general reading. The later work Evolution of Man and His Mind is a popular form of these subjects. VanNostrand's Engineering Magazine : — Engineering Instruments of Aluminum, Feb., 1874 ; Construction of a Mean Noon Sun Dial, July, 1874; American Cartography, May, 1875. Chicago Medical Gazette. Feb. 20th, 1880: — Therapeutic Action of Mer- cury ; Guide to Post Mortem Examinations of the Brain ; Editorials. American Journal of Microscopy, June and July, 1880, Examination of Tissues after the Administration of Mercury. Chicago Medical Journal and Examiner : — Mechanical Therapeutics, Chemistry and Toxicology of Mercury, April, 1880 ; Cerebral Anatomy Simplified, Nov. 1880; Schmidt on Yellow Fevei, April, 1881; Medical Electricity, vice president address Chicago Electrical Society, Nov. 1881 ; Insanity in Chicago, Nov. 1883 ; Asylum Reports, 1883, to 1885 ; Rea sons for resigning position of pathologist, 1 884. Journal of Nervous and Mental Disease : — Cerebral Topography, Oct. 1879; The Sulcus of Rolando as an Index to the Intelligence of Ani- mals, April, 1880 ; Plan of the Cerebro- Spinal Nervous System, '■ >ct. 1880. Sidereal Messenger : — Optical Appearances of Comets, March, 1887. Open Court: — Numerous scientific articles, (887. Alienist and Neurologist : — An Infant Prodigy, July, 1890. Philadelphia Times and Register: — Address to Chicago Academy of Medicine, Oct. II, 1890 ; Medico- Legal Testimony, July 9, 1892; Acid Prevention of Cholera, Sept. 10, 1892, Dec. 7, 1892, Boodler Insane Asylums, 1893. Science, N. Y. : — Probable Branchial Origin of the Thyroid and Thymus Glands, June 25, 1881 ; Hunger, the Primitive Desire, Jan. 1881 ; Con- tributions to Comparative Psychology, May, July, 1881 ; Celestial Photo- micrography, Sept. 2, 1892; Brain and Skull Correlations, Oct. 21, 1892; Comparative Longevity, Jan. 27, 1893; Unconscious Cerebra- tion, Feb. 10, 1893. American Naturalist : — Origin and Descent of the Human Brain, July, 1881; Disadvantages of the Upright Position, July, 1883, a lecture delivered to Chicago University Club, April, 1882 and Philadelphia Academy of Natural Sciences, May 23, 1883; The Coming Man, July, 1891 ; Cere- brology and Phrenology, July, 1888 ; Language and Max Miiller, Nov. 1891 ; Analogies, March, 1892 ; Brain Centers, Sept. 1892. Journal of the American Medical Association : — Sleep, Sleeplessness and Hypnotics, March 10, 1894; Conservative Brain Surgery, June 29, 1895 ; Post Alcoholism, Oct. 1895 '■> The Mercurials, Feb. 22, 29, 1895; Treatment of the Insane, Oct. 24, 1896 ; Pain and Its Therapeusis, Jan. 30, 1897. And many other articles, of which some are reproduced in the books above mentioned. £»£a**5 ~^V ■ ^1 H V£:*'M>: ^1 ■