* sal, Ne Se TENE ie, Paap Pe AS) OS Raley mast eangleta: ‘ Aste AAR ameeitcte, "As Nee. eames Coco een en ed ~e AED ADT OTD 6 Year eae Bet PoE ARR CaN Ke DENTE a Meat Meat: Aha Seer tee rn we ge orem wit Seat pet Ae By Ro sek mn merarayy Sern tt Dee . AGE Rt eimmater ron-? Srey AeA AMY ARS eaten Wey neheane e Se ae Neate mode Stam a Prone soneria WON RNR TANT wanna wate MEV MEME Aree ae ery Meike, NEW ey Ra eet la ata od F < ‘ “ aewen re ergy 2 - Ati NNckion gt albendcRyinawe siwioc chown, bed tae “ . Fe , enaicu hy eee irae mete Pretty Se EMP eta et tr ——— SSS —— —— — — — ss —= st —= NMI VETERINARY MATERIA MEDICA AND THERAPEUTICS BY Kenelm Winslow, M.D.; M.D.V.; B.A.S. (Harv.) FORMERLY INSTRUCTOR IN ZOOLOGY, BUSSEY (AGRICULTURAL) INSTITUTE AND ASSISTANT PROFESSOR OF THERAPEUTICS, VETERINARY SOHOOL (BOTH) OF HARVARD UNIVERSITY e SIXTH EDITION, REVISED AND ENLARGED New York WILLIAM’ R. JENKINS CO. PUBLISHERS 851-853 SixtH AVENUE 1908 . rev ERE ROEENC—encer LIBRARY of CONGRESS lwo Gopies! received SEP 9 1908 Se a a (40 GLASS OU AAG Mu Use iz? CopyRiGHT, 1901, 1905 By WILLIAM R. JENKINS CopYRIGHT, 1907, 1908, By WiLLiam R. JENKINS Co, [Registered at Stationers’ Hall, London] Printed inthe United States of America PRINTED BY THE PRESS OF WILLIAM R. JENKINS Co. New YorK PREFACE TO THE SIXTH EDITION In this edition the chief change consists in the entire revision and almost complete rewriting ot tnat part ot the text treating of Physiological Action of Drugs. This is required by the many elaborate investigations of the newer school of pharmacologists, of which Prof. Arthur R. cpaiey is the foremost English exponent. Our conception of the action of many of the inorganic agents—of the salts especially—has undergone a radical transformation owing to the fact that we now know that the salts are usually for the most part dissociated into electric positive and negative elements (ions), in the weak solutions present in the tissues, and that they thus form chemical combinations to which their pharmacological action is due. The action of a salt, then, is commonly that of its ions, and not that of its molecules or atoms. Among the revolutionary results of recent pharmaco- logical experiments, to which we would call special atten- tion in this revision, are those pertaining to the action of alcohol, ether and chloroform. Furthermore, readers will note the many additions to and changes in the physiological sections under iron, iodine, opium, caffeine, strychnine, pilocarpine, digitalis, veratrine, quinine and adrenalin. Also in the articles on Feeding and Counter-Irritants. The wonderful experiments of Pawlow and others have upset the hitherto accepted teachings of the action of drugs PREFACE TO SIXTH EDITION on the digestive organs and have wiped out the class of drugs known as cholagogues., _ Finally, many therapeutic additions (see p. 752 et seq.) have been made in the constant endeavor of author and publisher to keep the book up to date. KENELM WINSLOW. August, 1908. : PREFACE TO THE FIFTH EDITION. In accordance with the hitherto expressed desire of the author and publisher to keep this work at its highest point of efficiency, it has seemed necessary to again present a new and revised edition—the fourth edition of 1906 being exhausted. In the present revision the most notable feature is the substitution of a section on Condensed Treatment of Dis- eases Of the Domestic Animals for the Index of Diseases and Remedial Measures, at the end of the book. In the preparation of this matter, very considerable time and pains have been taken to render this section a reflection and epitome of all that is most modern and progressive in veteri- nary therapeutics. Special indications for treatment, including drugs and therapeutic agents other than drugs, in the different phases and stages of all the important diseases of the domestic animals, are to be found. These diseases embrace not only medical and surgical disorders, but those of the EYE, SKIN and EAR. If the attempt has been in any degree successful, this new addition to the book should prove one of its most valuable features both to practitioners and students. Moreover, many changes have been made in the text in consonance with recent advances in our knowledge of the action of drugs. KENELM WINsLOW. PREFACE TO FOURTH EDITION In the preparation of the fourth edition of this work, very considerable revision was made necessary on account of the many changes made in the eighth decennial revision of the United States Pharmacopeceia of September, 1905. To what an extent revision was required will be realized when it is known that there have been 123 additions, 106 changes in the strength of preparations, and 139 changes in the official title of drugs in the new Pharmacopceia. Thus the doses of many preparations have suffered the most radical change; e.g., the dose of tincture of aconite is three times what it formerly was, and that of the tincture of strophanthus is but half the former dose. Some of the most familiar of our old friends are scarcely recognizable by their new names, e.g., Acetphenetidum (phenacetin), Arseni Tri- oxidum (acidum arsenosum), Phenol (acidum carbolicum), Spiritus Glycerylis Nitratis (Spiritus Glonoini), ete. All Extracta Fluida have been changed. Thus no longer we write Extracti Nucis Vomice Fluidi, but Fluidextracti Nucis Vomice. The official names of many salts are altered: hydrochlorate into hydrochloride; hydrobromate into hydrobromide ; and valerianate into valerate ; with cor- responding changes in the Latin terminations. While some of the changes in the new Pharmacopeia do not affect vet- erinarians, yet professional prudence and pride demand that the veterinary practitioner conform to many of them to avoid mistakes in dosage and nomenclature. PREFACE TO FOURTH EDITION In revising the General Index it was decided to make it a pronouncing vocabulary. That a professional knowledge of the proper pronunciation of drugs and terms of pharmacology is deplorably absent will be appreciated the moment attention is directed to the matter. So many teachers disregard the subject, it follows that every practi- tioner has a pronunciation of his own—each equally incorrect. : Notwithstanding the short time which has elapsed since the last edition of this book, a number of additions have been made to keep it abreast of the times. Since the work has become the recognized authority in Veterinary Materia Medica and Therapeutics, and is the standard text-book on the subject in the veterinary colleges of the United States, the author and publisher feel it their duty to constantly revise its pages in order to hold the book up to that stand- ard which it has hitherto attained. KENELM WINSLOW. August, 1906. PREFACE TO FIRST EDITION. The writer wishes to acknowledge his indebtedness to the works of Brunton, Wood, Hare, Edes, Ring®r, Bar- tholow, White and Mann, in human medicine; and to those of the following veterinary writers: Finlay Dun, Fried- berger and Fréhner, Ellenberger, Koch, Cagny, Miiller; and to the leading veterinary periodicals. ” ‘“c< The matter on “ properties,” ‘description,’ and, in many cases, “derivation,” is according to the U. 8. Phar- macopeeia, while the important preparations of both the U.S. and British Pharmacopeeias are included. The classi- fication and arrangement of drugs employed in this book are modifications of those adopted by W. Hale White in his excellent treatise on Materia Medica, Pharmacology and Therapeutics. KENELM WINSLOW. CONTENTS. PRELIMINARY CONSIDERATIONS. .........ccceccces ob Grtetahe: tetavelalatete PP SIMPLE antec Ak Sea ea ed citie ab ald Siete aie desis Va dleeeecacedeen MGA OL AGhIOM OL MITE Stars aataial daal svelte vessiclsieyetsictlciietete cles ele ¢ POLIO OL WENOS stead saec ee hee detc.aned wOdcaes eacace nae sie arRMAEI TA OM OE TIT UE <5) Pehl a S cigiace c were als clei iala cw ale ererers ala d's. CANA ACTIONS OR’ DRUGS anmterdatsccte bats oa erereee Olesen be es Drugs Acting on the Digestive Organs eee ee eseeeeeee eee eeesese a ss eS: > GHionMap ema S's Sapa as selon eenetba x ache ones <¢ os S82, - NOBVEIMRMR MEIN: fasc coerced fixie See's 0 870s ae ss #8), RCS PEMAMGER OTOANSS 7055 Os. Wales siocice aos “ “s i Ueinbeage Gir rari, 2.) ere cata ees ania s cs es «* Sexual Organs........ Eclatahciste siclkete ae eieiets +3 nhuencing Motabolistamsocds3o2s0.ccs sues -Ocan« anes “ e° Proil y: Picts sags odes curse poannece cases cé Acting on the Skin i INCOMPATIBILITY 2.35 c.cecce SER Terao ahe he’ o. orale aac chose torah arabes oc ‘PRESCRIPTION WRITING a | CLASSIFICATION ee ae | vu CONTENTS PAGE TN ORGANIC PA GENUS ipece xstsysi61e ole cteie lcictela isles sierelele eiipinis FeO OO OOOC 117 HGH TABLE MEU GS st stants cniate viaieialeinieie olaln pieteials Wa'clw »\s Wie bey slaleieaie Senne BMS LAU Moye cicts'« als aah sos ae eax le ata alates aa csos se 's's winieie sp ieio ene GENERAL THERAPEUTIC MEASURES...... atelsieictetacetestetsicloteeisteteiere sio® SOO. Poodtand Weeding ss. «26°. salle en sicises.cles anes \siainiv euler 679 WOUNPErAITCIDATIUSS onic |oitereie a) =iste\cinietelelsiete & 2/5) a ciepatelete siete eons go eeOUB Cold ed leah 5 oc sinrei coi, lelgsotwcaiooncieliatere eroheie lates tle G cinemas awretaite 704 Disinfectants, Antiseptics and Deodorants’ :as(sia)iete eeiotstonteieter ret WENGHECHION; pemiccivcticciens Solon e att SONG teers Satetede ete tete efalatalatais 728 TP AMSLUSIOMT.«' os isjercic bre eyo.» «.e\e tele m scveleis oterstereete teats siaetehiisicaieie 732 Intravenous Saline Infusions. ..........cceeeeeeeceeee pesisenien ako Hy podertmcgelyais: .:. = =: Sse sta nein/elemeteeeeeieetets sin/oiate niet 735 PATI GOLOCL YSIS: fefejeicteee oie! wleteie. cyeilevers ope toee Pakelatene tote enatetet ares aiatojacceVereresetere 736 Kunsel’s Treatment for Milk Fever in Cows......... Graken eiete 737 DUS VARE 56 ss fsite wdls'sd idule eee een er ea eietaies ole, elec eraitataege 732 Serum Therapy. s,c\0<\s2 in aaseinarer artes Si vies 0.910 s\n » ps = c yr.20.-- == 97.320 = Zv. Di. .-Now, 5 drachms’ of quinine sulphate will not dissolve in 16 ounces of sweet spirit of nitre, so that we will add enough diluted sulphuric acid to dissolve the quinine. We do not know how much sulphuric acid will be required, so we write after acid sul- phuric, Q. 8., for quantum sufticiat, 7.e., as much as suffices (to dissolve, understood). Again, we do not know exactly how much bulk the quinine will take up when dissolved in the nitre ; nor what amount of acid will be required. Yet, on the other hand, we want to fill our bottle. To get over these difficulties we will write after sweet spirit of nitre ad, underlined (to); in other words, we order the druggist to take of sweet spirit of nitre enough to (make, understood) a pint. The Latin for quinine is quinina, genitive quinin-e, of quinine. The Latin for sulphate is sulphas, genative sul- phat-is, of sulphate. The Latin for spirit of nitrous ether is spiritus, genitive spiritus, of spirit; nitrosus, genitive nitros-i, of nitrous; ether, genitive ether-is, of ether. The Latin for sulphuric acid diluted is acidum, genitive acid-i, of acid; sulphuricus, genitive sulphuric-i, of sulphuric; dilutus, genitive dilut-i, of diluted. . 106 ; PRESCRIPTION WRITING We may now write our prescription as follows: - Quinine sulphatis.............. ZV. Di. Acidisulphurici diluti.......... Q. S. Spiritus ztheris nitrosi ad...... Oi. Misce, ae (Furnish 3 i. bottle for measure). Signa. Small bottleful three times daily in half a pint of water. JOHN SMITH. Abbreviated : R Quin Jsulphse. cease ewes visable Acid, sulphide, or... occ 0. 8.- Spts. wether, nitrosi ad........ Oi. : M. te S. (as above). We will write a prescription for a mixture containing 12 doses of chloral and potassium bromide for a dog. The quautity of the mixture given at each dose will be a tea- spoonful. Now, there are six teaspoonfuls in one ounce. We will order a 2-ounce bottle, which will, therefore, hold 12 doses of a teaspoonful each. The dose of chloral is gr.v. 5 xX 12 = gr.60, or Zi. The dose of potassium bromide is gr.x. 10 X 12 = gr.120, or 3ii. Then we will order enough water to fill the bottle. The Latin for chloral is chloral, genitive chloral-is, of chloral; Latin for potassium bromide is potassium, genitive potassi-i, of potassium; bromidum, genitive bromid-i, of bromide; Latin for water is aqua, genitive aqu-e, of water. ki e Chioraillisiet..iti otra aces sia ee eicree au Potasstnbromidinee ss eee 311 A QUERHAGhY eniese ace SY. Peja Secersigletsistave Zs Mo ren Signa. Teas. in 1 tablespoonful of water every 3 hours. JOHN SMITH, A drench is a mixture which is given the horse in one dose. We will write a prescription for a horse, containing ether, chloroform and laudanum, to be administered as a drench. The Latin for ether is ether, genitive wiher-is, of ether; PRESCRIPTION WRITING 107 dose, Zi. The Latin for chloroform is shloroformum, geni- tive chloroform-i, of chloroform; dose, 311. The Latin for laudanum is finctura opii; tinctura, genitive tinctur-e, of tincture; opium, genitive opi-i, of opium; dose, 311. The prescription reads : Augberisis. 220. x0 Meade SNe prin ara Zl alot LOR aa y.5 55 sateaysintciacs,- uso gen 3.11. PENG Gb UEC OP. teetey dresses ea laisse oe Z il. Misce et fiat haustus. ienaslatad .(Misce) mix, ba and (fiat) let there be made (haustus) a dreuch. (Abbreviated) M. et f. haust. Sig. Give at oncein one dose in pint of water. JOHN SMITH. In writing a prescription for powders, we may either write for one powder and direct the druggist to dispense several more like it, or write for the whole amount of the ingredients and order them divided into the required num- ber of doses or papers. In the first case we will write for a powder containing one dose of each of the drugs. For example, we may write a prescription for calomel and santonin, with sugar of milk as an excipient, since the dose of the drug is inconveuiently small. This powder is suitable for a medium-sized dog. The Latin for calomel, or the lower chloride of mercury, is hydrargyrum, genitive hydrargyr-, of mereury; chlori- dum, genitive chlorid-i, of chloride; mute, genitive mit-is, of lower ; dose, gr.ii. The Latin for santonin is santoninum, genitive santonin-i, of santonin; dose, gr.i. The Latin for sugar of milk is saccharum, genitive sacchar-i, of sugar; lac, genitive lac-tis, of milk; amount, gr.x. The prescription will read; ' Hydrargyri chloridi mitis.......... ra ney PS RUTGCLOMUNEET in gan geialo eta bia’ wists aye ance gr.i MAMCHATIIACEIS. oa aun siecle scenes cma +e gr.x Misce et fiat pulvis 1; dispense pulveres tales vi, 108 PRESCRIPTION WRITING Translated: Mix, and let there be made powder 1; dis- pense powders such vi. 5 (Abbreviated) M. et f. pulv. 1; dispense pulv. tales vi. Sig. Give one powder every two hours. JOHN SMITH. In the second case, if we write a prescription for six powders, we multiply the dose of the ingredients in each powder by 6, and then order the prescription to be dispensed in six papers. Hydrarg.chilorid, anitis, 2207 60. se gr. xii. Santonin.”s5iise nie ae ienore gr.vi. Sacchachise yas tatecretees seer Zi. Misce et divide in chartulas numero..vi. Translated: Mix and divide into papers in number vi. (Abbreviated) M. et div. in ch’t. No. vi. Sig. (as before). To write the above in the metric system. The dose of calomel is gr.ii. = .12 gm. .12 x 6 =.72, or gr.xii. The dose of santonin is gr.i. = .06 gm. .03 X 6 = .86 gm., or gr.vi. The amount of sugar of milk used as an excipient in each powder is gr.x. .06 x 10 =.6 gm., the amount prescribed in each powder. The amount necessary for six powders is .6 X 6 = 3.6 gm., approximately 4 gm. ‘s Solidsin Gm. Liquids in Ce. Hydrarg. chlorid. mitis..... | 72 Santonin W004. eee | 36 Sach. lachise: cscs ane 4 M. et div. chit. mneNoOwe. nc vi Sig. (as before). We will write a prescription for a horse, in the form of a powder, containing dried iron sulphate, nux vomica and sodium bicarbonate. The Latin for iron sulphate (dried) is ferrum, genitive ferr-i, of iron; sulphas, genitive sulphat-is, of sulphate; exsiccatus, genitive exsiccat-i, of dried; dose, Zi. The Latin for nux vomica is nua, genitive nuc-is, of nut; vomica, genitive vomic-e, of vomica; dose, 31. The PRESCRIPTION WRITING 109 Latin of sodium bicarbonate is sodium, genitive sodi-i, of sodium ; bicarbonas, genitive bicarbonat-is, of bicarbonate. We will order a sufficient quantity of the ingredients to make thirty powders. The dose of iron and nux vomica is 31. X 80 = Ziii., Zvi. The dose of sodium bicarbonate msi, < 30. 3 vii.ss. Ferri sulphatis exsiccati Pulveris nucis vomice........4& Ziii., 3 vi. Sodii, bicarbonais sea.c «asa. Z vii.ss. Misce et divide in chartulas xxx. Translated : Mix and divide into papers xxx. (Abbreviated) M. et div. inch’t. xxx. Sig. Giveone powder three times daily on the food. JOHN SMITH. In order to avoid the expense of having powders divided into papers, we may frequently direct one dose to be weighed by the druggist, and a measure to be furnished holding the quantity. Ferri sulph. exsicc. Pulv. nucis vom..... ACES OSE aa Ziii., 3 vi. POG (DICAED chia aceite bce eiale' a 2 vii.ss. Misce et fiat pulvis. Translated : Mix and let there be made a powder. (Abbreviated) M.etf. pulv. (Furnish measure holding 3 ss.) Sig. Give measureful on food three times daily. ; JOHN SMITH. To transform this prescription into terms of the metric system: 71. = Gm.30.; 31. = Gm.4. Hence Ziii., Zvi. = Gm.114; 2 viiss. = Gm.225. Bs Solidsin Gm. Liquids in Ce. Ferri sulph. exsicc. Pulvy,; nucis vom,..:. 53. aa 114 OGL DIGRED, .<. 255 ssacses ee M. et f. pulv., etc. S. (as before). 110 PRESCRIPTION WRITING Electuaries are not suitable preparations in which to prescribe powerful drugs, as we cannot secure any degree of accuracy in thedosage. This happens because we do not usually know the exact amount of excipient which will be required to make the paste of the proper consistency. We will write for an electuary containing potassium chlorate, licorice and molasses. The Latin for potassium chlorate is potassium, genitive potassi-i, of potassium ; chloras, genitive chlorat-is; of chlorate ; dose, 311. The Latin for powder of licorice root is (powder has been given before) glycyrrhiza, genitive glycyrrhizc, of licorice ; radix, genitive radic-is, of root. The Latin for molasses is syrupus, genitive syrup-i, of syrup ; fuscus, genitive fusc-t, of brown; dose of licorice root and molasses immaterial. They are used as excipients. Potassii chloratis Pulveris glycyrrhizez radicis ..a4.. Ziv. SyPupl Fuses. oe lan eck cues cern eae Q.S. Misce et fiat electuarium. Translated: Mix and let there be made an electuary. (Abbreviated) M. et f. electuarium. (Weigh 3 vi. as sample). S. Give amount equal to sample every 2 hours smeared on teeth. JOHN SMITH. We cannot tell precisely what quantity of potassium chlorate will be administered in the 3 vi. ordered in this prescription, but we can be assured that it will not be larger than 3 drachms, which is a small dose for the horse. Suppositories are occasionally prescribed to dogs. The excipient is cacao butter, of which about 15 grains is required. We will write a prescription containing iodoform and extract of Belladonna root, to be dispensed in suppos- itories for a medium-sized dog. The' Latin for iodoform is iodoformum, genitive todoform-i, of iodoform; dose, gr.3. The Latin for extract of belladonna root is belladonna, genitive belladonn-e, of belladonna; extractum, genitive extract-i, of extract; radix, genitive radic-is, of root; dose, er.z- The Latin for cacao butter is olewm theobroma ; PRESCRIPTION WRITING LET olenm, genitive ole-i, of oil; theobroma, genitive theobrom- atis, of theobroma. The quantity of cacao butter may be safely left to the discretion of the pharmacist. We will multiply the dose by ten, to make ten suppositories. DOMOEGRTN pa teat cote atresia din Svea: osc s gr.v. Extracti belladonne radicis ......gr.ii.ss, Olei theobromatis., siaasd.=sc0ess Q.S. Misce et fiant suppositoria x. Translated: Mix and let there be made suppositories x. (Abbreviated) M. et f. suppos. x. Sig. Introduce one into the bowel every 4 hours. JOHN SMITH. In writing prescriptions for ointments the degree of dilution of the medicinal substance, or substances, must be determined. In case the dilution is done in percentage, the metric system is particularly useful. Summar a eeee ip pail doses. Hydagogue og * Also in Hop eibeanons croup (roup) of Gat (gr.x.), and in. that’ of foals, calves and pigs (gr. xxx.), it is useful when ¢ given in solution w. ‘ith an equal dose of the tincture of thloride of iron. ‘ . cA: ee 132 INORGANIC AGENTS cathartic in large doses. It should be given in solution and is useful in dropsies, more particularly of renal origin ; also in catarrhal jaundice, and as a laxative for foals and calves. In cases where the urine of the horse is thick, stringy and high-colored, potassium bitartrate will cause it to regain its normal state. It may be easily administered in either food or drinking water, and its diuretic effect is enhanced when the salt is given with a large amount of water. Sodium. (The metal is not employed in medicine.) | Sop1rr Hyproxipum. Sodium Hydroxide. NaOH. (U.S.P.) Synonym.—Soda caustica, B.P.; soda, sodium hydrate, caustic soda, natrum causticum, S. hydricum, E.; soude caustique, Fr.; natron etznatron, G. Derivation.—It is made from liquor sode by evapora- tion, and run in moulds. Properties.—Dry, white, translucent pencils, or fused masses, showing a crystalline fracture; odorless, and having an acrid and caustic taste. Exposed to the air it rapidly deliquesces, absorbs carbon dioxide, and becomes covered with a dry coating of carbonate. Soluble in 1.7 parts of water; very soluble in alcohol. Liquor Sopit Hyproxip1. Solution of Sodium Hydroxide. (U.'8.:& B: P.) An aqueous solution of sodium hydroxide, containing about 5 per cent. of hydroxide. — Synonym.—Solution of sodium hydrate, E.; natrum hydricum solutum, soude caustique liquide, Fr.; liquor natri caustici, P. G.; zetznatron lauge, G. Derivation.—An aqueous solution of sodium carbonate is boiled with calcium hydrate, and the supernatant liquid is siphoned off. Na,CO, + Ca(OH), = 2 NaOH + CaCO, Properties.—A clear, colorless liquid, odorless, having a very acrid and caustic taste, and a strongly alkaline reaction. SODIUM CARBONATE 133 Dose.—H. & C., %ss.-i. (15.-30.); Sh. & Sw., 3 s8.-i. (2.-4.); D., Nv.-xx. (.3-1.8). Action and Uses.—Sodium hydroxide and its solution resemble compounds of potassium, but are used chiefly for chemical and pharmaceutical purposes. Liquor sodii hydroxidi should be given largely dilutea with water. In poisoning by the caustic alkalies or soap lye, use emetics or stomach pump; and give vinegar, diluted acetic acid, lemon juice and demulcents. Sopm Carponas. Sodium Carbonate. Na, CO, 10 H.O. Otiese & BP) Synonym.—Washing soda, sal soda, carbonas sodicus, E.; natrum carbonicum crudum, P. G.; carbonate de soude, Fr.; kohlensaures natron, soda, G. Derivation.—Made by Leblane’s process. Three steps: Ist. Salt and sulphuric acid heated together. 2 Na Cl + 50, = Na, SO, +. 2 HCl. 2nd. Sodiur: sulphate is heated with carbon. Na,SO, + 4C = Na,S + 4C0O. 3rd. Sodium sulphide heated with chalk. Na, S + Ca CO, = Na, CO,+ CaS. Properties.—Colorless, monoclinic crystals, odorless aud having a strongly alkaline taste. In dry air the salt efflor- esces, loses about half its water of crystallization and becomes a white powder. Soluble in 1.6 parts of water and in 1.02 parts of glycerin. Reaction alkaline. Sopm Carsonas Exsiccatus. Dried Sodium Carbonate. Na,CO,. (U.S: & BSP) Synonym.—Natrum carbonicum siccum, P. G.; carbo- nate de soude, Fr.; getrocknete soda, G. Derivation.—Sodium carbonate (200 gm.) is broken into small fragments and allowed to effluresce in dry air. It is then heated to drive off water of crystallization, till it weighs 100 Gm. 134 INORGANIC AGENTS Properties.—A loose, white powder, corresponding in solubility to sodium carbonate. Reaction alkaline. Action of sodium carbonate similar to the hydrate, but infrequently employed in medicine. Dose.—H. & C., 3ii-vi. (8.-24.); Sh. & Sw., gr.xx.-xl (1.8-2.6); D., gr.v.-xx. (.3-1.3). Given in large amount of water. Sopm Bricarsonas. Sodium Bicarbonate. Na HCO,. (U. 5.20 Beek) Synonym.—Soda, baking soda, sodium sesquicarbonate, natrum carbonicum acidulum, bicarbonas sodicus, sodium hydrocarbonate, bicarbonate of soda, E.; natrum bicarboni- cum, P. G.; bicarbonate de soude, sel digestive de vichy, Fr.; - doppelkohlensaures natron, G. Derivation.—Pass CO, through a solution of sodium carbonate. Na, CO, + CO, + H,O = 2 Na HCO,. Properties—A white, opaque powder, odorless, and having a cooling, mildly alkaline taste. Permanent in dry, but slowly decomposed in moist air. Soluble in 11.3 parts of water, insoluble in alcohol and ether. Slight alkaline reaction. Incompatibles.—Decomposed by acid and acid salts, as bismuth subunitrate. Dose.—H.., 3 ss.-ii. (15.-60.); Sh. & Sw., 3 ss.-i. (2.-4.); D., or.v.-xxx. (.3-2.). GENERAL ACTION OF SODIUM SALTS. Sodium and its salts are not nearly so poisonous as similar potassium compounds, because they are less depress- ing to the circulatory, muscular and nervous systems, but death has occurred after enormous doses. The salts possess a local paralyzing action on nerve and muscular tissue. They are absorbed and eliminated more slowly than the corre- sponding potassium compounds. Sodium salts alkalize the blood and urine, but are only slightly diuretic. Sodium SODIUM BICARBONATE 135 earbonate, phosphate, and sulphate diminish the solids in the bile and, therefore, increase its fluidity Sopium BIcARBONATE. Action External.—Sodium bicarbonate lessens irrita- bility of the skin in itching and burns. Action Internal.—When sodium bicarbonate is given internally it neutralizes gastric acidity, whether it be normal, abnormal from indigestion and fermentation, or excessive (hyperchlorhydia.) It does not in any event stimulate an increase of normal acid gastric juice, as has hitherto been taught. Its constant administration weakens the digestive powers and creates anemia, general cachexia, and scorbutic symptoms. Sodium bicarbonate liberates carbonic dioxide in the stomach, whch is a sedative and peristaltic stimulant, thus expelling gas and relieving pain in the viseus. It dis- solves mucus and thins the biliary secretion. It is, there- fore, useful in catarrh of the gastro-intestinal tract. Blood.—The blood is made more alkaline. Kidneys.—The urine is alkalized, but the salt is only feebly diuretic (“salt action,” p. 140). Uses External.—In aqueous solution (1-50) sodium bi- carbonate relieves itching in urticaria, prurigo and chronic eczema. It also allays the pain of slight burns and of acute rheumatism. For this purpose cloths should be soaked in saturated solutions and placed upon the affected parts. Added to water (51.-Oi.) in which instruments are to be boiled, it prevents rusting. Uses Internal.—Sodium bicarbonate is one of the most useful remedies in gastric or intestinal indigestion associated with abnormal acidity, or flatulence and distress, It does not always remove the cause of indigestion, however, and, there- fore, should be combined with agents which do: e.g., cathar- tics, antiseptics, carminatives and stomachics. For this reason sodium bicarbonate is often prescribed to dogs with bismuth, subearbonate, salol or beta naphtol; to horses with gentian or nux vomica and ginger. Sodium bicarbonate is of value in alkalizing the blood in acute rheumatism, and in threatened coma in diabetes mellitus; large doses of the salt given in solution by the mouth or intravenously, neutralize diacetic acid in the blood and may avert a fatal ending. 136 INORGANIC AGENTS The salt assists the action of calomel, with which it should be generally conjoined, since it stimulates the flow of bile and aids the alkaline intestinal juices in transform- ing the inactive chloride into the active oxide. Sodium \earbonate is occasionally given in acute bronchitis, but it is distinctly inferior to the corresponding potassium salt in thinning and increasing bronchial secretions. This salt is highly recommended in the treatment of hzeemoglobinzeemia (azoturi a) in horses, when given in quanti- ties of 10-30 ounces daily. Theoretically, sodium bicarbo- nate is of benefit in this disease, by neutralizing acid pro- ducts of metabolism which lead to solution of the heemo- globin. Sodium bicarbonate relieves thirst in polyuria of horses, when placed in their drinking water, and should be added to the food of cattle and sheep, when they are ee fed (in fattening), to avert calculus. Administration.—Sodium bicarbonate may be given in solution or on the tongue or food in the pure state. Sopir Sutpuas. Sodium Sulphate. Na, SO, 10H,0. (U.8::& Es) Synonym.—Glauber’s salts, sulfas sodicus (natricus), sal mirabile Glauberi, sulphate of soda, E.; sulfat de soude, sel de Glauber, Fr.; Glaubersalz, G. Derivation.—Neutralize the residue left in the manu- facture of HCl from salt, with sodium carbonate. 2 Na HSO, + Na, CO,=2 Na;SO, + CO, + H,0. Properties.—Large, colorless, transparent, monoclinic prisms, or granular crystals, odorless, and having a bitter, saline taste. The salt effloresces rapidly in the air, and finally loses all its water of crystallization. Soluble in 2.8 parts of water; insoluble in alcohol; soluble in greene Dose.—C., thi.-iss. (500.-750.) ; H. (laxative), 3 ii.-iv. (60.-120) ; Sh., % 5, li.-iv. (60.-120.). Action Internal.—Digestive Tract.—The action of the saline cathartics depends upon the slow absorption of certain acid ions or anions (sulphates, phosphates, tartrates, and citrates) as compared with others (chlorides, promnades, and iodides). The latter, being readily absorbed into the blood, cause diuresis. The former salts fail of absorption—to any considerable extent—in the bowel, and so their solutions in- = — ~. SODIUM SULPHATE Sa erease the fluidity of the ingesta and aid in the expulsion of feces. Peristaltic action is also excited through increase of the mass of intestinal contents. Concentrated (hypertonic) solutions of the saline pur- gatives withdraw water from the blood vessels of the bowels because the solution in the intestines has a greater osmotic pressure than the blood. When the solution in the bowel be- comes sufficiently diluted to be isotonic with the blood some absorption and diuresis occurs (“salt action,” see p. 140). The blood and urine first become concentrated, and thirst is induced by the action of the saline purgatives in both with- drawing water from the blood and in preventing absorption of water from the food. Later diuresis may take place, especially when absorp- tion of the saline occurs through failure of purgation. The basic ion, or kation, of some salts is less absorbable than that of others (as Mg), and when such a basic ion is eombined with an acid ion of slow absorption (as in Mg SO,) the purgative effect is naturally at its maximum. Any cholagogue action, formerly attributed to the saline purgatives, has been proved to be wanting. The saline cath- artics are sometimes called hydragogues. Sodium sulphate is not used much in human practice on account of its nauseating taste and it is said to produce more griping. For the larger animals it is sometimes pre- ferred to the magnesitim salt in veterinary medicine. Sodium sulphate is the principal ingredient of Carlsbad salts, which have recently come into vogue with veterinarians, although long valued in human medicine. The formula for the arti- ficial Carlsbad salts (Sal carolinum factitium), which is the preparation commonly used, is as follows: R Sodii sulphatis exsiccati .......... 40.0 Sod biGarbonabis. .:).). riekiesnsiaieie eis 2ODLO MGOGie TCMMOTT Glia, ranks afte ete chy ohevene 15.0 IPGbASSIT EAS MUPM DUS cso onie cles citer. cee 2.0 M. et fiat pulvis. Sig. One to two heaping tablespoonfuls on the food two or three times daily for horses. Sodium sulphate is thus given as Carlsbad salts or alone in small doses as a laxative, but in constipation asso- ciated with indigestion and malnutrition, gentian, powdered rhubarb, iron and other stomachies and tonics are often combined; while, in fever, small doses of Glauber’s salts are 138 INORGANIC AGENTS useful in promoting the activity of the skin and kidneys, and for this purpose may be given with spirit of nitrous ether, to which diluted sulphuric acid and the compound tincture may be added to improve appetite and digestion. Glauber’s salts are useful in aiding the action of peristaltic agents, as aloes. Small doses are given to horses in their drinking water while the aloes is acting. Sodium sulphate is of benefit in the treatment of diar- rhoea, dysentery and overloaded and impacted colon of horses when given in frequent and repeated doses in connection with linseed oil. An enema, consisting of one pound of Glauber’s salts in 2 quart of water, to which two ounces of oil of turpentine and four ounces of glycerine may with advantage be added, should be injected high into the bowel to secure rapid pur- gation in horses suffering with colie. Glauber’s and Epsom salts are the most common pur- gatives given to ruminants. It is therefore impossible to enumerate special indications for their employment in the ‘ase of these animals. To assist the action, one teaspoonful each of ginger and molasses are given with each ounce of Glauber’s or Epsom salts, and often an equal weight of sodium chloride. When a speedy action is desired, Glau- ber’s salts should be administered with a large amount of water and thirst should be encouraged by the addition of common salt. When, on the other hand, it is essential to remove fluid and morbid effusions from the body, the purgative salt should be exhibited in concentration and the patient should be deprived of water to a considerable ex- tent. Glauber’s and Epsom salts are not used so commonly im canine practice as calomel and eastor oil, but find more favor with German than English-speaking veterinarians. Sometimes salts are serviceable in irritable states of the bowels in dogs (piles, duodenitis and intestinal eatarrh) iu teaspoonful doses; and when given every second day, as a laxative, in eczema. Vomiting, however, not uncommonly follows the ingestion of salts by dogs. Carlsbad salts form a good eathartie for cage birds. About 3 grains are added to an ounce of their drinking water in the case of small birds. lt eis SODIUM CHLORIDE 139 Sopizt Cutoripum. Sodium Chloride. NaCl. CU. Sete By P.) . Synonym.—Common or table salt, muriate of soda, sal commune or culinare, chloruretum sodicum, E.; natrium ehloratum purum, P. G.; chlorure de sodium, sel commun, sel de cuisine, Fr.; chlornatrium, kochsalz, G. Derivation.—Mined in a native state and obtained by evaporation of brine, spring or sea water. Properties.—Colorless, transparent, cubical crystals, or a white, crystalline powder, odorless, and having a purely saline taste. Permanent in dry air. Soluble in 2.8 parts of water; almost insoluble in alcohol; insoluble in ether or chloroform. Reaction neutral. Dose.—Cathartic, C., Tbss.-i (250.-500.); Sh.,35 i.-ii. (30.-60.). Action Hxternal.—Salt is a stimulant to the skin when applied in concentrated solution. Action Internal—Salt is an essential constituent of food, and necessary to the composition of HCl in the gastric juice, and of blood plasma from which it is constantly elim- inated in the urine. Herbivorous animals require sodium chloride in addition to that contained in their food; for blood is rich in common salt, while vegetables abound more especi- ally in potassium salts. The potassium salts, according to Bunge, on entering the blood bring about a chemical reaction, whereby sodium chloride circulating in the plasma is split; the chlorine in sodium chloride combines with potassium, while the acid set free from the potassium salt unites with sodium, and both products are swept away with the urine, thus removing sodium chloride from the blood. This is only replaced by that taken as food.* Animals deprived of salt suffer from anemia, general weakness and cedema. Stomach and Intestines.—Salt has caused gastro-enter- itis and death in enormous doses. Large doses oceasion emesis in dogs. Irritation of the stomach is caused by with- drawal of water from the mucous membranes by strong * Some doubt is cast upon this hypothesis by Lapicque who relates that African tribes, living wholly upon vegetables, use wood ashes (chiefly potassium) in place of table salt. 140 INORGANIC AGENTS solutions (osmotic action). ‘This is called “ salt action” and is common to all salts of the alkalies. Salt in the food often improves digestion—probably by bettering the taste of the food and exciting the appetite and so, reflexly, stimulating the flow of gastric juice. On the same principle that the sight, taste, and smell of food are the chief factors in the first secretion of HCl. Salt acts in the bowels as a mild hydragogue purgative. It is unfit as a cathartic for horses or dogs, but is useful for cattle and sheep when combined with magnesium or sodium sulphate. Salt creates thirst and, therefore, promotes the indigestion of water. A large supply of water flushes the system and removes deleterious and imperfectly oxidized matters. Blood.—The red corpuscles are augmented by salt. Metabolism.—Salt solutions in the blood withdraw fluid lymph from the tissues by osmotic action. In this way they appear to stimulate tissue change as there is an increased elimination of nitrogen in the urine. Vascular tension is thus augmented and activity of the malpighian bodies, and therefore diuresis results. This is another example of “ salt action” and is common to the other salts of the alkalies. Sunzmary.—Emetiec, cathartic, digestive. Uses Hxternal.—aA solution consisting of one ounce each of salt, nitre and sal ammoniac, in one quart of water, may be used on bruises and sprains as a stimulant and refrig- erant lotion. Severe hemorrhage, collapse and _ surgical shock are treated most successfully by injections of hot normal salt solution into a vein, under the skin, or into the rectum. The solution maintains the proper salinity of. the blood, replaces the mass of blood lost, and supplies heat. The solution is made by adding one heaping teaspoonful of salt to a quart of boiled water at a temperature of 100° to 105° F. From 2 to 4 quarts may be given to horses, and from 14 to 1 pint to dogs. (See p. 732.) Salt is an efficient antidote externally and internally to silver nitrate. Uses Internal.—Salt is a serviceable emetic for dogs, when zine sulphate is not at hand, in emergencies and pois- cning. One teaspoonful may be stirred into a cup of Iuke- warm water with a tablespoonful of mustard. It is a useful SODIUM PHOSPHATE 141 addition to Epsom salts, since it increases thirst and the ingestion of water. and assists purgation in overloaded conditions of the first and third stomachs of ruminants. One-half pound of salt is administered to cattle with one- half to one pound of Epsom salts, one-quarter pound of ginger and a pint of molasses in two quarts of water. The habitual ingestion of salt is prejudicial to ascarides and diminishes the secretion of mucus in which they live. It is even more efficacious in destroying oxynrides inhabiting the lower bowels. Enemata containing | to 2 tablespoonfuls of salt to the pint of water are employed for this purpose. Salt should be constantly kept in the feed boxes of horses and cattle. Animals convalescing from acute diseases, and those with feeble digestion, need salt particularly. Horses are commonly given a bran mash once a week, with plenty of salt to enhance its laxative and hygienic action. Dogs usually procure sufficient salt in their ordinary food, but it should be added to their diet in the treatment of obesity. Repeated doses of salt aid the absorption of serous pleural effusions. Soprt Puospnas. Sodium Phosphate. Na, HPO, + 12H,0. (U. 8. & B. P.) Synonym.—Phosphas sodicus (natricus), sal mirabile perlatum, phosphate of soda, E.; natrum phosphoricum, P. G.; phosphate de soude, Fr.; phosphorsaures natrum, G. Derivation.—Digest bone ash with sulphuric acid. Ca, 2PO, + 2 H, SO, = Ca H, 2 PO, (acid calcium phos- phate) + 2 Ca SO, Filter and add sodium carbonate to filtrate. Ca H, 2 PO, + Na,CO,= Na, H PO, + H,O + CO + Ca HPO,. Evaporate, and sodium phosphate crystallizes out. Properties.—Large, colorless, monoclinic prisms, odor- less, and haying a cooling, saline taste. The crystals effloresce in the dry air and gradually lose 5 molecules of 149 {INORGANIC AGENTS their water of crystallization. Soluble in 5.8 parts of water; insoluble in aleohol; slightly alkaline reaction. Dose.—Same as sodium sulphate; D., 3i-ii. (4-8.), as laxative. The phosphate resembles the sulphate, but is a milder purgative and is wrongly thought to be an hepatic stimu- lant. It is indicated in jaundice due to duodenitis, and as a laxative for foals and calves. It is occasionally prescribed in rickets as a source of phosphorus, but the calcium phos- phate is more appropriate. Sopit Sutpuis. Sodium Sulphite. Na, SO, 7 H,O. (U3. Bee Synonym.—Natrum sulfuriosum, sulfis sodicus (natricus), sulphite of soda, E.; sulfite de soude, Fr.; schwefligsaures natron, G. Derivation.—Saturate a solution of sodium carbonate or hydrate with sulphurous anhydride gas. Na, CO, + SO,= Na, SO, + CO, Properties.—Colorless, transparent, monoclinic prisms, odorless, and having a cooling, saline, sulphurous taste. In air the salt effloresces, and is slowly oxidized to sulphate. Soluble in 4 parts of water; sparingly soluble in alcohol ; Neutral or feebly alkaline. Dose.—H. & C., 31. (30.); Sh. & Sw., 3ss.-i. (2.-4.); D., gr.v.-xxx. (.3-2.). Sopit Bisutpuire. Sodium Bisulphite. NaHSO;. (U.S. P.) Derivation.—Obtained from sodium carbonate or bicar- bonate and sulphurous anhydride gas. Properties. Opaque, prismatic crystals, or a granular powder, exhaling an odor of sulphur dioxide and having a disagreeable, sulphurous taste. Exposed to the air the salt loses sulphur dioxide and is gradually oxidized to sulphate. Soluble in 4 parts of water and in 72 parts of alcohol ; reac- tion. acid. Dose.—Same as sodium sulphite. a ——s SODIUM THIOSULPHATE 1438 Sopir TurosutpHas. Sodium Thiosulphate. Na, 8, O, SE Oss (CUPS. Pe: ) Synonym.—Sodium hyposulphite, hyposulphate of soda, E.; natrum subsulfurosum (hyposulfurosum, P. G.; hypo- sulphis sodicus, hyposulfite de soude, sulfite solfuré de soude, Fr.; unterschwe fligsaures natron, G. . Derivation.—Dissolve sulphur in a_ boiling aqueous solution of sodium sulphite. Properties.—Colorless, transparent, monoclinic prisms, odorless, and having a cooling, afterwards bitter, taste. Permanent in air below 33° C. (91.4° F.), but efflorescent in dry air above that temperature. Soluble in 0.65 part of water; insoluble in aleohol; slightly soluble in oil of tur- pentine ; reaction neutral. Dose.—Same as sodium sulphite. Administration—The sulphites are given in solution, or may be added in powder to the food of horses. ACTION OF THE SULPHITES BISULPHITES AND HYPOSULPHITES Action Haternal.—These salts are antisepties, deodor- izers and parasiticides externally and in the digestive tract. The antiseptic action is due to the destructive effect of the sulphites in withdrawing oxygen from organic matter to oxidize themselves into sulphates. Given internally, 96 per cent. of sodium sulphite escapes in the urine as a sulphate, while but 3 per cent. is eliminated unchanged. It has been taught that the sulphites are converted into sulphur dioxide (SO,) by the acids in the stomach but this is very doubtful. Uses.—A 15 per cent. solution or ointment of the sul- phites are used against pruritis and parasitic skin diseases. The salts are recommended in indigestion with fermentation, flatulence and foul-smelling feeces and in general septic con- ditions, but have proved as useless ag most other drugs in the latter states. Sternberg found that neither the sulphites nor hyposulphites exerted any germicidal action on bacteria in culture media. 144 INORGANIC AGENTS The other sodium salts are of no particular value in veterinary practice except sodium bromide See Bromine, p. 241.) Ammonium.* Ammonium is not employed in medicine. Ammonia (NH) exists in the free state as a gas, and is used in medi- cine in solution in water or alcohol. Aqua Ammonia. Ammonia Water. (U.S. P.) Synonym.—Liquor ammonie, B. P.; spirits of harts- horn, E.; liquor ammonii caustici, P. G.; spiritus salis am- moniaci causticus,° ammonia aqua soluta, ammoniaque liquide, eau (solution, liqueur) d’ammoniaque, Fr.; sal- maikgeist, «etzammoniak, ammoniakflissigkeit, G. An aque- cus solution of ammonia (NH3), containing 10 per cent., by weight, of the gas. Properties.—A colorless, transparent liquid, having a very pungent odor, an acrid, alkaline taste, and a strongly alkaline reaction. Spec. gr. 0.960. Derivation Evolve ammonia gas by heating am- monium chloride with calcium hydrate, and pass it into water. 29 NH, Cl+ Ca(OH), = 2NH, + 2 H,O-+ Ca Cl. Dose.—H. & ©:, 3 ss--1.. (15.-30.)5 Sh. t& Sw. situ (4.-8.);, D.,. 1 x.-=e Ges). PREPARATION. Linimentum Ammonie. Ammonia Liniment. (U.S. & B. P.) Ammonia water, 250; cottonseed oil, 600; alcohol, 50. (U.S. P.) Aqua Ammoni# Forttur. Stronger Ammonia Water. | (U.S. PB.) Synonym.—Liquor ammoni fortis, stronger solution of ammonia, B. P.; eau d’ammoniaque forte, Fr.; starker salmiakgeist, G. An aqueous solution of ammonia (NH3), containing 28 per cent., by weight of the gas. Derivation.—Same as aqua ammoniz. Properties.—A colorless, transparent liquid, having an *The radical Ammonium (NH,) of the Ammonium compounds is not a metal although it resembles so closely—in physical, chemical, and physiological properties —~the other alkaline metals, that it is usnally classed with them. See ee STRONGER AMMONI\ WATER 145 excessively pungent odor, a very acrid and alkaline taste, and a strongly alkaline reaction. Spec. gr.0.901. Dose.—H. & C., 3 ii.-vi. (8.-24.); Sh. & Sw., 31. (4); D., NLy.-x. (.3-.6). . PREPARATION. Spiritus Ammonice. Spirit of Ammonia. (U.S. P.) Synonym. —Spiritus ammoniaci caustici dyondii, ammoniated alco- hol, E.; liquor ammoniz caustici spirituosus, P. G.; alcoolé d’ammo- niaque, liqueur d’ammoniaque vineuse, Fr.; weingeistige ammoniak- flussigkeit, G. An alcoholic solution of ammonia (NH;), containing 10 per cent., by weight, of the gas. Properties.—A colorless liquid, having a strong odor of ammonia, and a spec. gr. of about 0.810. This preparation combines the stimulating properties of ammonia and alcohol. Dose.—H. & C., 3 ss.-i. (15.-30.); Sh. & Sw., 3i.-ii, (4.-8.); D., ™x.- xx. (.6-1.3). AMMONIA PREPARATIONS. Action External—Ammonia is a powerful irritant in stronger solution, or gas. If it is applied for a sufficient time, hyperzemia, vesicatiou and sloughing ensue. Action Internal.—Stomach.—lf swallowed in concentrated solution death may take place instantaneously from cedema and spasm of the glottis. Otherwise, more or less extensive inflammation of the alimentary canal will follow, according to the amount ingested. Diluted vinegar and lemon juice, together with the white of egg, or sweet oil, should be given as antidotes. Tracheotomy may be indicated, if there is glottic obstruction. Ammonia, in passing through the mouth, throat, gullet and stomach, reflexly stimulates the heart and respiration before absorption can occur. Ammonia is an antacid in the stomach, but should not be employed in gastric irritability. Respiratory Tract.—Inhalation of stronger ammonia through the nostrils causes reflex stimulation of the heart and respiration by irritation of the nasal branches of the fifth nerve. Care must be exercised to prevent inflammation 146 INORGANIC AGENTS of the air passages. Ammonia stimulates the respiratory centre when it is injected into the blood. Given under the skin in lethal doses, ammonia causes death by paralysis of the respiratory centres. Circulation.—It is probable that ammonia only acts re- flexly to stimulate the heart through irritation of the stom- ach, when it is ingested. If given intravenously or subeu- taneously, ammonia stimulates directly the heart muscle, and probably the accelerator and vasomotor centres, making the cardiac pulsations stronger and quicker and increasing vascular tension. Rarely the vagus centre is stimulated and the heart’s action slowed, Lethal doses paralyze the cardiac muscle. Ammonia differs from alcohol in being more evan- escent as a stimulant, in not affecting the brain nor meta- bolism, and in not acting as a food. Blood.—The normal blood contains ammonia, which is supposed to aid in maintaining its fluidity. The action on the blood is unknown. Ammonia is thought to prevent coagu- lation of blood within the vessels in conditions favorable to thrombosis. Nervous System.—An intravenous injection of a lethal dose of ammonia occasions tetanic convulsions in animals, owing to stimulation of the reflex and motor functions of the cord. Medicinal doses excite the spinal reflex and motor centres. Where ammonia is appled directly to nerve tissue it excites in dilute solution, but paralyzes functional activity in concentration.. The brain is unaffected by the therapeutic administration of ammonia. Elimination.—Ammonia -combines with acid in the stomach and is absorbed into the blood. Ammonia and its ear- bonate are oxidized in the body and transformed into urea, in. which form ammonia compounds escape in the urine. Urea being the most active diuretic there is some augmented flow. The urine is, however, not alkalized as by the salts of the other alkaline metals. Summary.—Heart and respiratory stimulant and ant- acid. Externally, rubefacient, vesicant, and escharotie. Uses.—The indications for ammonia are closely in ac- cord with its physiological actions. Externally.—It is frequently used in stimulating lini- AMMONIUM CARBONATE 147 ments. One part each of water of ammonia and oil of tur- pentine, may be combined to advantage with 4 to 6 parts of camphor liniment. Ammonia water is one of the. best remedies to relieve pain and antagonize the action of insect bites, as stings of bees and wasps. It should be applied directly to the poisoned part. Internally.—Ammonia is indicated when rapid stimula- tion of the heart and respiration is desirable. In emer- gencies it may be given intravenously (aq. ammon. fort. 1; water, 4 parts); or by inhalation. It is serviceable in the treatment of prussic acid and aconite poisoning, syncope, collapse and shock following surgical operations; also in snake bites. The spirit of ammonia may be prescribed in fevers as a stimulant. Ammonia is inferior to ammonium carbonate or the aromatic spirit in the care of colic and tympanites. AmmMonit Carponas. Ammonium Carbonate. NH, HCO, Nit, NH,CO, (U.S. &B.P.) Synonym.—Volatile salt, sal volatile siccum, carbonas ammonicus, E.; ammonium carbonicum, P. G.; carbonate d’ammoniaque, alkali volatil concret, sel volatil d’ Angleterre, Fr.; fluchtige, laugensalz, reines hirchhornsalz, kohlensiures ammonium, G. Derivation.—A mixture of ammonium chloride’ or sulphate, and calcium carbonate, is sublimed and resub- limed. Ammonium carbonate, so-called, is a mixture of ammonium carbonate and bicarbonate. 4 NH, Cl + 2 CaCO, = NH, HCO, .NH,NH, CO, + 2 CaCi, + NH, + H.O. Properties.— White, hard, translucent, striated masses, having a strongly ammoniacal odor without empyreuma, and a sharp saline taste. On exposure to the air the salt loses both ammonia and carbonic dioxide, becoming opaque, and is finally converted into friable, porous lumps, or a white powder. Soluble in about 5 parts of water. Alcohol only dissolves the carbonate (NH, NH, CO.,). 148 INORGANIC AGENTS Dose.—H., 3ii. (8.); C., Ziii-vi. (12.-24.); Sh. & Sw., gr.xy.-xl. (1.-2.6); D., gr.iii.-x. (.2-.6); D.; emetic, gr.xv. (1.). PREPARATION. Spiritus Ammonice Aromaticus. Aromatic Spirit of Ammonia. (UL 8. & BOBS) Synonym.—Sal volatile, alcoolat ammoniacal aromatique, aromatischer ammoniak geist, G. Amnionitim carbonate. -eticeisits sate te eeicte . of AmMMONIa, WALET 5, <:cc.as cicieteleeleiteeletres eter ete 90 Oil of Temion: se: chronic form of poisoning or mercurialism. This condition is characterized by fetor of the breath and soreness of the gums, making mastication painful. The gums are swollen and bleed easily; the tongue swells and salivation ensues. The teeth become loosened, the salivary and parotid glands enlarge, the temperature is elevated, and if the condition continues, there are: ulceration of the mouth (due to irrita- tion produced by mercury eliminated in the saliva), necrosis of the jaw, general weakness, a watery condition of the blood, cedema, anzemia and cachexia, prostration and death. Local poisoning, as exhibited by paraly sis of the hand and forearm, has oceurred in a man who applied the ointment of red iodide of mercury to cattle. There is a tendency for mercury to eecumulate in the liver and kidneys, chiefly, and also in the. tissues generally, when given in large doses, or in smaller doses when continued for a considerable period. The prevailing fashion of administering calomel in small and repeated doses, may lead to mercurialism if purga- tion does not occur. Stomach and Intestines.—Calomel and preparations of metallic mereury are most commonly used for their action. on the digestive tract. Exactly what chemical changes they undergo is uncertain. Calomel was thought to be converted Pn tee Oe eee ee GENERAL ACTION OF MERCURY AND ITS SALTS 213 into mercuric chloride in the stomach, but this appears to be improbable. It is also surmised that the alkaline juices in the duodenum convert calomel into the gray oxide. Sufficient evidence of this is lacking. It is more probable that these insoluble preparations do not remain long enough in the stom- ach to be irritating (although vomiting is occasionally caused by calomel), but pea an irritating cha therefore purgative effect in the bowels owing to some of the mercury combining with proteids of the intestinal mucous membrane. Some of the preparation is thus absorbed, as an albuminate of mer- eury, while the larger portion is swept out with the feces. Calomel and mercuric chloride are also intestinal antiseptics. The mercurial purges have always enjoyed a great repu- tation in the treatment of so-called biliousness and torpid liver, the supposition being that they stimulated the liver and flow of bile. But experiments on man and animals show that they exert no apparent effect on the liver or biliary secretion. Their indubitable efficacy is due to their cathar- tic and intestinal antiseptic action, as such conditions (biliousness, etc.) are not owing to liver disorder but to in- digestion. The purgative action of calomel and mercury is assisted by salines, which increase the amount of fluid in the bowels, and aid in the expulsion and prevent the absorption of mer- cury. ‘The saline should be given four hours after the ad- ministration of calomel to cattle. Blood and Metabolism.—It is stated that calomel may be absorbed unchanged from the intestines by leucocytes to some extent. It is probable, however, that mercury prepara- tions are chiefly absorbed as albuminates and even metallic mereury is oxidized, when in contact with the tissues, and absorbed. Small doses of mercury apparently increase the nutrition and weight of healthy animals and also the hemo- globin, and red corpuscles. Mercury is sometimes called an antiphlogistic, as it has been supposed to combat the effect cf inflammations. A fart of this result may be attributed to the antiseptic action of the salts of mercury in the intestines by preventing fermentation and absorption of toxic material. For want of a better term to explain the beneficial actions of mercury on the tissues, that vague term “ alterative ” is fre- 214 INORGANIC AGENTS quently applied. Mercury (and calomel in particular) is diuretic, stimulating the secreting cells of the kidneys, and increasing the amount of urine. Elimination—Mercury is eliminated very slowly, mainly by the ceeum and colon (after its absorption), but also by the kidneys, liver, salivary glands, and, in fact, by every conceivable channel. In thus stimulating the elimi- native activities of the various glands, mercury has been termed a deobstruent. It has been surmised that its alter- ative effect depends, in part, upon this action in stimulating —to use the old term—the emunctories. SUMMARY OF ACTIONS OF MERCURY AND ITS SALTS. External.—Antiseptic, germicide, irritant, caustic, para- siticide, antipruritic and sorbefacient. 7 Internal.—Antiseptic, purgative, antiphlogistic, alter- ative and diuretic (calomel). USES OF MERCURY AND ITS SALTS. Hydrargyrum cum creta is similar to calomel in its effects, but very much milder, unless it contains the black oxide of mercury, when its action is much intensified. The same may be said of massa hydrargyri. Either preparation may be given dogs as a laxative in indigestion with vomiting and diarrheea; or to foals and ealves with intestinal indiges- tion and diarrhcea, particularly if accompanied with jaun- dice. The oleatum or unguentum hydrargyri are rubbed into the skin to cause resolution of chronic inflammatory swellings, and also to kill animal and vegetable parasites. As the former action is due to absorption, large quantities, will lead to poisoning when applied over an extensive surface. We can use other and safer remedies, as creolin, tar or sulphur ointment, for parasiticides. It is to be remembered in this connection that grease alone will kill lice and other parasites cn the skin. On account of their sorbefacient properties, the oleate and blue ointment of mercury are applied over chronically enlarged glands, swollen joints, and thickened tendons. In view of their parasitic action, these prepara- HYDRARGYRI CHLORIDUM CORROSIVUM. 215 tions are employed to kill the fungus of favus and ring- worm, and to destroy lice and the acari of mange, when in- habiting circumscribed areas. Itching in skin diseases, as Etachic | eczema and psoriasis, is relieved by either blue oint- ment or the oleate of mercury. HYDRARGYRI OXIDUM RUBRUM ET FLAVUM The official ointments of the red and yellow mercuric oxides are prescribed, as stimulant and antiseptic prepara- tions, in chronic PI corneal ulcers (gr. 1.-11. of the yellow oxide to 3 i. of vaseline), granular lids and sealy skin diseases. They are also employ ed on indolent ulcers, swollen glands and old granulating surfaces. When used on mucous membranes, or raw surfaces, the official ointments should be diluted with equal parts of lard. HYDRARGYRI CHLORIDUM CORROSIVUM. External.—Corrosive sublimate is of value mainly as an antiseptic on the unbroken skin. It is germicide in solutions containing 1 part to 500, or 1000, of water. Ap- plied to mucous membranes, or raw surfaces, it is antiseptic in solutions varying in strength from 1-10,000 to 1-1,000. In the larger cavities of the body, as the vagina, solu- tions should not be used in strength greater than 1-5000 or 1-3000. Recent experiments by Harrington and Walker go to show that corrosive sublimate is much less active than . commonly believed. A 1-1000 solution requires more than ten minutes’ contact to kill common forms of pus cocci, so that dipping the hands for a few seconds in such solutions does more harm than good in inducing a false security which does not exist. They conclude by saying that, as the result of their experiments, ‘‘ corrosive sublimate in any of the strengths commonly employed is a much overrated disinfectant, and under the best of conditions is so uncer- tain in its action that it would be of advantage to abandon its use altogether in surgery.”’ These men are known to be careful and trustworthy investigators and their findings agree with the results obtained by many great surgeons. In view of the ease with which corrosive sublimate combines 916 INORGANIC AGENTS with albumin, it is best not to rely upon this agent for wound disinfection, but to employ normal salt solution for cleansing, followed by hydrogen dioxide. It is only fair to state, however, that corrosive sublimate is still regarded as their antiseptic sheet anchor by many good surgeons for the irrigation of infected wounds and cavities, and for skin disin- fection. For hand and skin disinfection Harrington’s solution * of corrosive sublimate is perhaps the most effective of any in existence. Mercuric bichloride, even in the weaker solution, is too damaging to the serous membrane of the peritoneal cavity, and there is too much danger of absorption to warrant us in usin it in intra-abdominal operations. As a caustic, satu- rated solutions are injected into fistulous tracts: e. g., fistule of the withers, ‘‘ quittor ” and “ poll evil,” to destroy their so-called pyogenic membranes, and hasten repair. There is not much danger of absorption when used in-this way. Corrosive sublimate is very useful as a parasiticide, in ~ destroying lice, rmgworm and the fungus of favus, in solu- tion (1-500 on the unbroken skin. It also relieves itching in pruritus, prurigo and urticaria, but is generally inferior to earbolic acid in this respect. Bichloride solutions may be used in the septic uterus (after removing placental or membranous remains, with the hands, forceps or curette), in the strength of 1-3000 or 1-5000. Apart from the body, corrosive sublimate in solution (1-500 or 1-1000) is one of the cheapest and most effective disinfectants for premises infected with the contagion of glanders, anthrax, ete. The walls and floors of stables (after thorough cleansing and washing with soft soap and boiling water), clothing and all paraphernalia, not metallic, can be disinfected by washing or soaking in solutions of bichloride. Before operations, the operative field should be sterilized by scrubbing with green soap and then with Harrington’s solution * after the * Harrington’s solution consists of: Commercial alcohol (94 per cent.), G40 ¢.¢; commercial hydrochloric acid, 60 c¢.c.; corrosive subli- mate, 0.8 gm. It is the most powerful preparation for skin disinfection known, rendering the skin sterile in most cases after application for two minutes. HYDRARGYRI CHLORIDUM MITE 217 hair has been shaved from the part. During an operation, irrigation with corrosive (1-3000) solution or boiled normal salt solution is commonly practised. In epizéotic abortion, in addition to quarantining the diseased animals, their dis- charges and the premises should be disinfected, and both the well and sick female animals should be washed twice daily about the genital regions with a solution of corrosive subli- mate. Yellow wash, made by the addition of 30 gr. of mer- eurie bichloride to 1 pint of lime water, is sometimes em- ployed as a stimulant application in chronic eczema, and to relieve itching. It contains the yellow oxide of mercury. In purulent conjunctivitis, frequent irrigation with a 1-1000 solution of corrosive sublimate is of the greatest service. Internal.—Corrosive sublimate is of value in minute doses as a blood tonic, and is recommended as an antiphlo- gistic agent in inflammatory diseases of serous membranes, as pleuritis, meningitis, and arthritis. It is probably inferior to calomel for this purpose. We at least know that calomel is an efficient cathartic in inflammatory diseases. Mercurie bichloride is employed as an intestinal anti- septic in the treatment of dysentery and diarrhcea with mu- cous or vile smelling discharges. In these conditions, irri- gation of the rectum with a 1-5000 solution is of advantage. This solution should be drained off through the rectal tube and followed by an injection of plain boiled water. Administration.—Corrosive suolimate is given in the form of a pill or ball. If exhibited in solution to the large animals, it must be diluted with 2 quarts of water. HYDRARGYRI CHLORIDUM MITE. External.—Calomel is of use in chronie eczema when applied over small patches in its pure state, or as ‘ black wash.” The latter consists of one drachm of calomel in one pint of lime water, forming the black oxide of mercury, and is a very efficient preparation to relieve itching and promote recovery in chronic eczema, by mild stimulation. Calomel is of benefit when blown into the eye once or twice a week, stimulating and hastening absorption of opacities of the cornea following keratitis. It is the best agent to arrest 218 INORGANIC AGENTS thrush when worked up into the commisure of the hoof, between the frog and the bars, and retained in place by oakum packing. Internal.—Calomel is a purgative, intestinal antiseptic, diuretic and alterative. It is also used for its remote anti- phlogistie effects. It is particularly adapted to dogs, and is given in a single dose, or often, to better advantage, in half- grain doses, repeated every two hours till purgation occurs. Tor diarrhea or vomiting in dogs, calomel is useful in removing the source of irritation, in being antiseptic and easily borne by an irritable stomach. In accordance with the theory that calomel is transformed by the alkaline intestinal secretions into the grey mercurous oxide it has been the cus- tom to combine sodium bicarbonate with it in order to tacili- tate this transformation. Sufficient evidence to substantiate the occurrence of the transformation is wanting and the clinical value of the combination is doubtful. The adminis- tration of calomel should be followed by oil, salines or other eatharties, if purgation does not occur within twenty-four hours after its ingestion, otherwise mercurialism may occur. In heptogenous jaundice, with light-colored feces, gas- tro-duodenitis or constipation, calomel is a valuable remedy for dogs. In the jaundice occurring as a form of influenza in horses, nitro-muriatie acid is more effective. Calomel is one of the best remedies for the treatment of dysentery, un- less there is great weakness. It should be continued in re- peated small doses till the character of the discharge changes. Foals and calves, with indigestion and diarrhea, may be given calomel to advantage to remove the source of irritation in the digestive tract. Calomel must be combined with a sinall dose of aloes, or with linseed oil, to form an effective cathartic for the horse. As aloes acts on the large, and ealo- mel on the small, intestines, the above combination secures a general purgative influence. ; Cattle are given calomel, followed by the administration of salines, to produce free catharsis. As a remedy for round worms, 1 to $ grain each of santonin and calomel, with 5 grains of sugar of milk, are administered to dogs four times, at half hour intervals, and followed by eastor oil. Lumbri- coid worms in the horse may. be treated by conjoining 2 HYDRARGYRI IODIDUM RUBRUM 219 drachms of santonin with 1 drachm of calomel, given in the form of a ball to the fasting animil, and repeated once on the following day if necessary. Calomel was formerly very frequently used, and is occasionally prescribed to this day in the treatment of enteritis, pleuritis, meningitis, peritonitis, pericarditis, and iritis, for its antiphlogistic and alterative action in supposedly diminishing inflammatory exudations. At the present time these actions are very much ques- tioned, and any beneficial effects accruing from the nse of calomel in inflammatory diseases are now ascribed to its action as a purgative and intestinal antiseptic in destroying and eliminating toxins from the bowels. Calomel is of value in inflammatory diseases when given at the onset of the attack. In dropsy (ascites of dogs), calomel sometimes acts as a useful diuretic, when combined with digitalis and squill in pill form. Administration.—Calomel is given to cattle on the tongue or in gruel ; to horses in ball, on the food, or on the tongue: to dogs in pill, tablet or on the tongue; to fowl on the food (gr.i.). The compound cathartic pill is a good purga- tive preparation for occasional use. Two to three pills for large dogs; one to two pills for smaller animals. HYDRARGYRI IODIDUM RUBRUM. The red mercuric iodide is a favorite remedy in veterinary practice. It causes absorption of morbid exuda- tions through its counter-irritant, local absorbent and alter- ative effect, in combining the action of iodine and mercury. It is employed with 8 to 10 or 12 parts of lard or vaseline, and is of value in the treatment of periostitis with osseous deposits, especially for splints. Spavin and ringbone are treated with red iodide of mercury alone, but are generally cured more effectively by rest, firing, and blistering. The red iodide of mercury ointment is also of use for enlarged glands, chronic swelling about tendons, joints or burse; and applied about the throat in chronic laryngitis and “roaring.” The ointment is rubbed on splints every third 220 INORGANIC AGENTS day, or until vesication is produced, and the hair begins to drop out, when its use is stopped fora time. Like other mercury preparations, the red iodide must not be employed in large quantities over an extensive surface. It is much more irritant locally than blue ointment. UNGUENTUM HYDRARGYRI NITRATIS. Citrine ointment is similar to unguentum hydrargyri ammoniati (white precipitate ointment), but more power- ful, and should be diluted with equal parts of lard: These preparations are used for their stimulant action in granular lids, chronic eczema, pityriasis, and for their anti-parasitic effect in ringworm. SECTION VII. Arsenum. Arsenic is not used in the metallic state in medicine. ArsENI Trioxipum (U.S. P.) Actpum Arsenosum. Arsenous Acid. As,O.. Synonym.—Acidum arseniosum, B. P.; acidum arsenic- osum, P. G.; arsenic trioxide, white arsenic, arsenicum album, arsenic, arsenious anhydrid, E.; acid arsenieux, arsenic blanc, fleurs d’arsenic, Fr.; arsenicsaure, weisser arsenic, G. Derivation.—Arsenical ores are roasted veh purified by sublimation. Properties.—A heavy solid, occurring either as an opaque, white powder, or in irregular masses of two varieties; the one amorphous, transparent and colorless, like glass ; the other crystalline, opaque, or white, resembling porcelain. Both are odorless and tasteless. The glassy variety dissolves slowly in 30 parts of water; the porcelain-like in 80 parts of water. Arsenous acid is sparingly soluble in alcohol, but soluble in glycerin, hydrochloric acid and solutions of the SOLUTION OF POTASSIUM ARSENITE 221 alkali hydrates and carbonates. When heated to 424° F., arsenous acid is completely volatilized without melting. Incompatibles.— Lime water, salts of iron and magnesia. Dos?.—H., gr.i.-v. (.06-.3) ; Sh. & Sw., gr.i-ii. (.06-.12) ; D., gr-z-qy (.002-.006. ) Liquor Porasm ArsENITIs. Solution of Potassium Arsenite. (U. 8. PB.) (Fowler's Solution.) Synonym.—Liquor arsenicalis, B. P.; liquor kali arseni- cosi, P.G.; solutio arsenicalis Fowleri, kali arsenicosum solutum, arsenical solution, E.; liqueur arsenicale de Fowler, Fr.; Fowlers’che tropfen, G. Arsenous acid, 10 gm.; potas- sium bicarbonate, 20 gm.; compound tincture of lavender, 30 Cc; distilled water to make 1000 Ce. Strength, 1 part of arsenous acid in 100. . Dose.—H. & C., 311.-%i. (8.-30.); Sh. & Sw., 31 -ii. (4.-8.) ; D., TW ii.-x. (.12-.6). Usual dose for H., 2 ss. (15.). Liquor Actp1 ArsENosI. Solution of Arsenous Acid. (U3 22°) Synonym.—Liquor arsenici hydrochloricus, B.P.; hydro- chloric solution of arsenic, E.; liqueur arsenicale hydrochlo- rique, Fr.; chlorarsenik-losung, G. Arsenous acid, 10 em.; diluted hydrochloric acid, 50 Ce.; distilled water, a sufficient quantity to make 1000 Ce. Strength, 1 part of arsenous acid in 100. _ Dose.—Same as Fowler’s solution. ACTION OF ARSENICAL COMPOUNDS. External.—Arsenous acid acts as a caustic on raw sur- faces and mucous membranes. It produces considerable pain, and may lead to poisoning. In frogs poisoned by 922 INORGANIC AGENTS. arsenic the epidermis peels off very rapidly, owing to degeneration of its lower layers. Internal. —Digestive Tract. —Arsenic, when given in minute doses, improves the appetite, and increases ~hoth the motion and secretions of the stomach and duodenum. In larger amounts, arsenic is an irritant, causing loss of appetite, nausea and digestive disturbance. In toxic doses arsenic produces gastro-enteritis. Blood.—Arsenic is absorbed into the blood, and in some forms of anemia increases notably the ona of red corpuscles, and to some extent the hemoglobin. Circulation.—It is said that arsenic stimulates the pulse rate when given in minute doses. In large doses it has a local depressing action on the heart and" probably on the vasomotor centre—lowering the force and frequency of the heart and reducing blood pressure. The nerve endings, ganglia, and mameele of the heart are alike paralyzed, and this action takes place when the heart is removed from the body. Respiration.—In small doses arsenic quickens the breathing and stimulates the respiratory centre; whereas in lethal amounts the respiration fails through lowered blood pressure and exhaustion. Nervous System.—The nervous apparatus is powerfully influenced by arsenic. Toxie doses cause paralysis of the spinal tracts, in frogs, with loss of sensation, motion, and reflex action, and the brain nerves are also depressed. The nerve trunks are chiefly affected in the higher animals. There is peripheral neuritis and trophic changes occur. Medicinal doses of arsenic are stimulant to the nervous system generally Metabolism.—Therapeutie doses probably diminish tissue change and the elimination of urea and carbonic dioxide. Large doses, on the other hand, increase metabolic processes and Ate escape of nitrogenous waste. Elimination.—Arsenie is. eliminated slowly by most channels, but mainly by the urine and to a less extent by the mucous membrane of the respiratory and di- gestive tracts. Traces are found in the milk, sweat, tears and saliva. It exists in, and can be recovered from, the ACTION OF ARSENICAL COMPOUNDS 998 bodies of animals years after their death from toxic amounts of arsenic. Summary.—Arsenic is unfortunately one of the drugs whose physiological action—so far as we know it—does not throw any light, in many instances, upon its therapeutic effects. In altering the condition of the patient for the better, in some diseases, it is described by that vague and otherwise indefinable term, “alterative.” Toxicology.—The lower animals, as the horse and cow, are proportionately not nearly so susceptible to the poisonous effects of arsenic as the human subject; 135 grains is the smallest fatal dose reported in man. Amounts larger than a drachm appear to be required to cause death in the horse, although much smaller quantities have produced death when repeated a number of times. Mild toxic action is seen following therapeutic doses of arsenic when the physiological limit is reached. This condition is characterized by loss of appetite (nausea and vomiting in dogs), watery discharge from the nose and eyes, puffiness of the eyelids, indigestion with mild colic, and diarrhoea. The pulse may be accelerated and harder than normal. Acute Poisoning begins with bilious, mucous, or bloody purging and colic. There is vomiting in dogs. Thirst is excessive ; the urine is high-colored and albuminous; the pulse is feeble, small and frequent ; the respiration is rapid and difficult from abdominal pain; the extremities are cold, and there is great weakness of the limbs. Collapse, with convulsions and coma, often close the scene in from five to twenty hours to three days. A sub-acute form of poisoning occasionally occurs after a remission from the acute attack, only to be followed by death in from two to five days. In the interim, cutaneous eruptions may appear. Rarely, death takes place within an hour or two, in coma, collapse or convulsions. Chronic Poisoning, such as is seen in the human subject living in apartments furnished with arsenical wall paper or fabrics, or in those working in arsenic, is rarely observed 2994 INORGANIC AGENTS in animals and would not be likely to occur save in those living in the immediate vicinity of chemical works. In this condition there are symptoms similar to those noted above as occurring in the milder form of arsenic poisoning, together with gradual loss of strength and flesh, local paralysis or paraplegia, ind anesthesia. Fatty degeneration of the liver, kidneys, heart, stomach and muscles, in cases of chronic arsenical poisoning, is found after death. . The post-mortem changes observed after acute poisoning, are as follows: The gastric mucous membrane, especially the villous portion in horses, is swollen, softened and covered with patches of « deep crimson or dark brown color. There is rarely ulceration. The upper portion of the small intestines, and in horses sometimes the whole of the intes- tinal tract, is similarly affected with that of the stomach. There is generally a wide-spread fatty degeweration of the stomach, bowels, internal organs and muscles. The treatment of acute poisoning depends mainly upon the use of the official freshly prepared arsenic antidote (ferri oxidum hydratum cum magnesia) in large quantities. If this can not be obtained, an antidote can be prepared by precipitating Monsel’s Solution, or the tincture of the chloride of iron, with sodium bicarbonate or ammonia. Dialyzed iron may be precipitated with an alkali. In either case the precipitate should be washed in a filter of muslin and given in large amounts. If vomiting has not occurred, zine sulphate should be given, or the stomach pump or siphon resorted to, and the stomach well washed out. The after-treatment is carried out with castor oil, demulcents, opium and external heat. Sweet spirit of nitre is to be prescribed, with considerable water, to flush out the kidneys. Uses 'External.—A paste containing 1 part each of arsenous acid and gum arabic, with 5 parts of water, is used to destroy warts and morbid growths. Arsenous acid, diluted with 5 parts of lard, may be employed to slough out fistulous tracts. In any case, there is danger of poisoning through absorption, if a sufficient amount of arsenic is used ; USES OF ARSENICAL COMPOUNDS © 225 but, on the other hand, the danger is slight if a large enough quantity is applied to cause rapid sloughing. Arsenic is the principal constituent of so-called “sheep-dips”’ employed to kill ticks and other parasites in the wool. Finlay Dun recommends 23 Ibs. of arsenous acid with an equal amount of pearl ash, soft soap, and sulphur, dissolved in 10 gallons of boiling water and added %o 90 gallons of co!ld water. This quantity will suffice for dipping 100 sheep. The sheep are submerged, except their heads, for a few seconds, and placed on a grating to drain into a tub, from which the water flows back into the first receptacle. The excess of water in their fleeces is squeezed out with the hands and a scraper. Sheep have been poisoned after dipping, by eating grass and fodder on which they have drained ; therefore the sheep should always be kept on clean floors or yards in the open air and sunlight until they have become thoroughly dry. Sulpho-naphtol (1-100) or creolin are preferable for this purpose, singe they are as effective and safer. Uses Internal.—Arsenic is of the greatest service in the treatment of indigestion in horses associated with malnutri- tion and staring coat. In this condition, arsenous acid is often combined with sodium bicarbonate and nux vomica, and may be given in powder on the food. It is also of value in atonic diarrhcea, and is used in both the serous and dysenteric varieties. In diminishing tissue change, and in acting as a blood tonic, arsenic is believed to improve the condition, endurance, and wind in horses, and is popularly prescribed by dealers and others. The classical case of the arsenic-eating peasants of Styria seems to corroborate this view. These people appear to be very robust and healthy. Five grains of arsenic was given experimentally to one of them without producing any untoward effect. Arsenic seems to influence favorably diseased mucous membranes of the respiratory tract, to improve their nutrition, and hasten absorption and repair in diseases of the air passages. Coryza, ozcena, chronic 226 INORGANIC AGENTS cough, asthma, emphysema and “ broken wind”’ are greatly benefitted by a course of arsenic, and in chronic conditions the treatment should be sustained for months in small doses. “Thick wind” and convalescence from acute bronchitis, pneumonia or influenza are favorably influenced by arsenic. Arsenic is one of the best agents we can prescribe in general debility and anzemia and may be conjoined with bitters or iron. Arsenic is indeed the next best remedy to iron in anemia, and, in pernicious anemia and leukemia, it is the remedy offering the greatest chances of improvement, when given in gradually increasing doses until horses are taking as much as two ounces of Fowler’s Solution, twice or thrice daily ; and dogs one-half a dram. In dry, scaly skin diseases, arsenic is the most successful internal remedy, but should not be prescribed in moist con- ditions associated with a proliferation of new cells, or exudate of serum or other liquid. Itis particularly useful in chronic squamous, or papular eczema, lichen, acne and chronic urticaria, when given for a considerable length of time in small doses. In the human subject, arsenic is almost a specific in chorea, but does not seem to yield such good results in that disease in dogs, usually associated with distemper. Fowler's Solution should be given to dogs with chorea, in doses of two or three drops three times daily, and gradually increased till the physiological limit is reached. The same treatment should be tried in diabetes mellitus in dogs. Large single doses of arsenous acid (3ss.) are sometimes given with calomel (3i.) and aloes (3Ziv.), in a ball to horses to kill round worms. . Administration.—Arsenic is given to horses as Fowler's Solution, or arsenous acid, on the food. If continued for a long time, arsenic must be prescribed in small doses once daily, or iniarger doses once in two or three days. Arsenic is exhibited to dogstin tablet or pill, and as Fowler’s Solu- tion. The administration of Fowler’s Solution secures more rapid and accurate results than that of white arsenic. ANTIMONY SULPHIDE 227 Antimonium. (The metal antimony is not used in medicine.) AnTImMonir SuLpHipuM. Antimony Sulphide. Sb,S.. (Non-official.) Synonym.—Autimony trisulphide, E.; stibium oxydatum, oxydum antimonicum vel stibicum; oxyde d’antimoine, Fr.; antimonoxyd, G. Derivation.—Native antimony sulphide, purified by fusion, and as free from arsenic as possible. Properties. —Steel-gray masses of a metallic lustre and a striated, crystalline fracture, forming a black, or grayish- black, lustreless powder; without odor or taste, and per- manent in the air. Insoluble in alcohol or water. ANTIMONII SULPHIDUM PuriFicaTumM. Purified Antimony Sulphide. Sb,S,. (Non-official.) Synonym.—Antimonium nigrum purificatum, B.P.; puri- fied antimony trisulphide, E. . Derivation.—Antimony sulphide, 100 ; purified by macer- ation in ammonia water, 50; washing and drying, U.S. P. Properties.—A heavy, grayish-black, lustreless powder ; without odor or taste, and permanent in the air. Insoluble in water or alcohol. Dose.—The antimony sulphides should not be used in medicine. Dose would be twice or thrice that of tartar emetic. ANTIMONIUM SULPHURATUM. Sulphurated Antimony. (Bz P-) Synonym.—Kermes Mineral. Chiefly antimony trisul- phide (Sb,S,), with a very small amount of antimony trioxide. Deriwvation.—Boil purified antimony sulphide, 100, with solution of soda, 1200. (U.S. P.) Sb,S, +4Na OH = Na 228 INORGANIC AGENTS SbO, + Na,SbS, + 2 H,O. Strain and add sulphuric acid to the hot liquor as long as precipitation occurs. NaSbO, + Na,SbS, + 2 H,SO, = Sb,S, + 2 Na,SO, + 2 H,O. Properties. — An amorphous, reddish-brown powder, becoming lighter in color on exposure to the light, and having neither odor or taste. Insoluble in water or alcohol. GOLDEN SULPHUR. (Non-ofticial.) A yellow, insoluble powder, is another compound of antimony, consisting of a mixture of antimony trisulphide and trioxide, Dose.—Neither kermes mineral nor golden sulphur are suitable for internal use. The dose would be twice or thrice that of tartar emetic. AntimontI Oxipum. Antimony Oxide. Sb,O,. (Non-official.) (Antimony Trioxide.) Derivation—Pour a solution of chloride of antimony into water. The oxychloride of antimony is precipitated. Sb Cl, + HO =SbOCI+2H CI. The precipitate is treated with carbonate of sodium, and the result is washed and dried. 2SbOCl-+ Na, C O, = Sb, O, + 2 NaCl + CO.,. Properties.—A heavy, grayish-white powder, without odor or taste, and permanent in the air, Almost insoluble in water and insoluble in alcohol. Dose.—Would be twice that of tartar emetic, but the oxide is inappropriate for internal use. Antimont ET Portassit Tarrras. Antimony id Potassium Tartrate. 2K (SbO)C,H,O,+ H,O. (U.S. P.) Synonym.—Autimonium tartaratum, B.P.; tartar emetic, tartarated antimony, tartarus emeticus, stibio-kali tartaricum, E.; antimonii potassio-tartras, antimonium tartarizatum, tartarus stibiatus, P.G.; tartrate de potasse et d’antimoine émétique, tartre stibié, Fr.; brechweinstein, G. ANTIMONY AND POTASSIUM TARTRATE A229 Derivation.—Make a paste with cream of tartar, anti- mony trioxide, and water. Set aside 24 hours, boil in water 15 minutes and crystallize. 2K HC,H,O, + Sb,O, = 2K (SbO) C,H,O, + H,O. Properties.—Colorless, transparent crystals of the rhom- bic system, becoming opaque and white on exposure to the air; or a white, granular powder, without odor, and having a sweet, afterwards disagreeable, metallic taste. Soluble in 17 parts of water ; insoluble in alcohol. Dose.—H. & C., Zii-iv. (8.-15.); emetic, pigs, gY.iv.-x. (.24-.6); D., gr.1,-4. (.006-.03) ; emetic, D., gr.i-ii. (.06-.12). PREPARATIONS, Vinum Antimonii, Wine of Antimony. (U.S. P.) Synonym.—Vinum antimoniale, B.P. Antimony and potassium tartrate, 4 gm.; boiling distilled water, 65 Cc.; alcohol, 150 Cc.; white wine to make 1000 Cc. (U.S. P.) Dose for Dogs.—Mv.- 3 i. (.3-4.). Syrpus Scillee Compositus. Compound Syrup of Squill.° (U. 8.) Synonym.—Hive syrup. Fluid extract of squill, 80 Cc.; fluid extragt of senega, 80 Cc.; antimony and potassium tartrate, 2 gm.; precipitated calcium phosphate, 10 gm.; sugar, 750 gm.; water to make 1000 Cc. Dose for Dog.—Mv.-xxx. (.3-2.) ACTION OF ANTIMONII ET POTASSIL TARTRAS. Tartar emetic is the only antimony compound suitable for internal use. The sulphide and oxide of antimony are insoluble, save in the hydrochloric acid of the gastrie juice, and are not so certain or reliable in their action as tartar emetic. Kermes mineral and golden sulphur, containing variable amounts of antimony trisulphide and trioxide, are even more uncertain and unreliable than antimony sulphide or oxide. Keternal.—Tartar emetic is irritant, and when rubbed into the skin produces a pustular eruption and often slough- ing and destruction of tissue. Internal.—Stomach and Bowels.—Tartar emetic is a gastro-intestinal irritant, causing salivation and nausea in 230 INORGANIC AGENTS small doses, vomiting and diarrheea in large quantities; while toxic amounts are followed by vomiting (in carnivora), serous or bloody purging, great depression of the cir- culation and respiration, muscular weakness, collapse and death. Uneasiness, nausea, colic and death have been reported in horses only after enormous doses of tartar emetic by the mouth. The horse and ruminants are comparatively insus- ceptible to the action of tartar emetic. The writer has observed a cow, however, in which nausea and actual vomi- tion occurred, following a therapeutic dose of kermes mineral in electuary. Tartar emetic is a powerful but slowly acting emetic (attended with a good deal of nausea) in dogs. Tartar emetic has been recovered in the first vomitus following its intravenous injection. It also expels the contents of a ladder artificially replacing the normal stomach. These results go to show that tartar emetic acts both as a specific emetic upon the vomiting centre, and locally as a specific irritant and an emetic upon the mucous membrane of the stomach. Tartar emetic is eliminated in great part by the mucous membrane of the alimentary canal. Circulation.—The principal action of antimony is exerted upon the heart and vessels. The heart muscle is weakened and vascular tension markedly lowered by large doses of tartar emetic. This action depends upon the in- fluence of antimony on the cardiac muscle itself, and possibly upon the vagus nerve-endings in the heart. Vascular tension is lowered through depression of the heart and of the peripheral vasomotor nerves or muscle of the vessel walls. Whether the vasomotor centre is also depressed is uncertain. The pulse is reduced in foree and frequency by large doses of tartar emetic. Following lethal amounts, the heart be- comes flabby and relaxed, and death oceurs in diastolic arrest. The preceding remarks apply only to the action of tartar emetic upon carnivora. Antimony was formerly a very popular drug when ACTION OF ANTIMONY AND POTASSIUM TARTRATE 231 general depressant and depletant treatment was in vogue, because of its powerfully depressing action upon the circu- lation. Respiratory Organs.—Small doses of antimony increase secretion of bronchial mucus. Toxic amounts weaken the respiratory movement by lowering the functional activity of the respiratory and vagus centres, and cause a copious outpouring of serous and mucous secretion into the bronchial tubes, which has the effect of drowning an animal in his own secretions. This action is only seen in horses after intravenous injection of toxic quantities of tartar emetic. The respiration is slow and labored in poison- ing. : Nervous System.—Large doses of antimony depress the functional. activity of the brain and sensory tract of the spinal cord. Larger doses produce loss of reflex action and anesthesia, owing to the influence of antimony upon the sensory side of the cord; while in toxic amounts, antimony is a general paralyzant to all the spinal centres and to the motor nerves. Muscles—In carnivora and man, antimony lessens muscular strength and relaxes spasm through its depressing action upon the motor nerves and muscular tissue. Elimination.—Antimony is mainly eliminated by the mucous membrane of the stomach and bowels, but ‘also by the kidneys, bronchial mucous membrane, and other channels. Toxicology.—The symptoms are those described under “ Action on the Stomach and Bowels.” The fecal discharges in man are copious and of the rice water appearance char- acteristic of Asiatic cholera. If vomiting is not free, zine sulphate should be given, or the stomach washed out. Tannic acid should be administered as a chemical antidote, together with the use of external heat, alcohol, strychnine and mor- phine subcutaneously, and demulcents by the mouth. Uses Hxternal.—Tartar emetic is used in ointment, in the strength of 1-4, over chronically enlarged and rheumatic jomts of cattle. It is also employed over the sides of the 232, INORGANIC AGENTS chest in cattle, to produce counter-irritation and pustulation in the strength of 1 part to 12 of lard. Internal.—The therapeutic value of tartar emetic is limited mainly to canine practice. Antimony is still pre- scribed largely by the Germans as a general and circulatory depressant and expectorant for horses. General depressant, treatment has gone out of vogue and is not usually indi- cated in inflammatory affections, and even if it were, anti- mony does not exert such an action in any considerable degree upon horses or ruminants. Aconite is amuch more valuable and efficient circulatory depressant than antimony for the horse. There are three indications for antimony in canine practice: Ist, as an emetic; 2nd, as a general depressant in inflammatory diseases and in strong patients; 3rd, as an expectorant in acute bronchitis. The first indication is generally attained more promptly and safely by zinc sulphate. The second and third indications may be combined by prescribing antimony in the first, or dry stage of acute bronchitis in dogs, in the form of hive syrup. For example: i. Syr. Scilla Co. Sp’t's. Aather. NibrOsis ..c.0\sers 5 eelesieletcins aa 3 ss. M. Liq. Ammon. Acetatis........ se eeeere ad 3 iv. Ss. Teaspoonful every 2 hours. Antimony may be employed as an emetic in bronchitis to clear the stomach and upper part of the respiratory tract of secretions, and to reduce the force and frequency of the heart. Ipecac is, however, a better and safer agent for this purpose, and antimony is generally counter-indieated in the second, or exudative stage of bronchitis. The Germans prescribe tartar emetic very commonly to horses as a parasiticide against round worms and tape worms. Four or five drachms are given in aqueous solution to the fasting animal, and followed by the administration of a dose of oil. PHOSPHORUS 233 SECTION VIIL Phosphorus. PxospHorvs. Phosphorus. P. (U.S. & B. P.) Derivation.—Digest bones in sulphuric acid, or treat bone ash with sulphuric acid; filter and evaporate. Ca, (PO,), (bone ash) + 2 H,S O, = Ca H, (PO,), (acid calcium phosphate) + 2 Ca So,. Heat acid calcium phosphate, charcoal, and sand to- gether, and distil over phosphorus into water. Heat breaks up Ca H,(PO,), into Ca (PO,), (calcium metaphosphate) + 2 H,O. Then: 2 Ca (PO,), + 2 SiO, + 10C = P, + 2 CaSiO, +10C 0. Properties.—A translucent, nearly colorless solid, of a waxy lustre, having at ordinary temperature about the con- sistency of bees’ wax. By long keeping, the surface becomes red and occasionally black. It has a distinctive but dis- agreeable odor and taste. It should not be tasted except in a state of great dilution. When exposed to the air it emits white fumes which are luminous in the dark, and have an odor somewhat resembling garlic. On long exposure to the air, it takes fire spontaneously. Insoluble in water, or nearly so ; soluble in 350 parts of alcohol, in 80 parts of ether, in about 50 parts of any fatty oil, and very soluble in chloro- form and carbon disulphide. Besides the official form there are several other allotropic forms of phosphorus, including the red, or amorphous, the black, and the crystallized metallic phosphorus. Red phosphorus is non-poisonous, owing to its insolu- bility preventing its absorption in the digestive tract. Sw., gr.z45-s; (.0006-.003) ; D., gr.zt5-s'5 (.0006-.008). 234 INORGANIC AGENTS PREPARATIONS, Oleum Phosphoratum. Phosphorated Oil. (B.P.). Phosphorus, 1 gm.; expressed oil of almond. and ether, of each a sufficient quantity to make 100 gm. (U.S. P.) Pilulae Phosphori. (U.S. P.) Each pill contains gr. 1/100 of phosphorus. Pilula Phosphori. (B. P.) 2 per cent. phosphorus. Dose.—D., pills, i.-ii. ACTION OF PHOSPHORUS. Internal.—The sole physiological action of phosphorus which would suggest, and in some manner explain, its therapeutic use is that on bones. Phosphorus, when given in small doses to growing animals, apparently stimulates the bone-making cells (osteoblasts) and the growth of denser bone, both from cartilage and periosteum. In older animals the lamelle of spongy tissue are made thicker and, in fowl, the marrow cavity may be. wholly obliterated by the de- position of hard bone through the ingestion of phosphorus. If ealcium salts be withheld from the food the activity of the osteoblasts continues but the new bone is soft and of the nature of bones in rickets. The precise mode of action of phos- phorus on normal and diseased bones (rickets and osteomal- acia) has yet to be determined. * There appears to be clinical evidence that phosphorus is a nerve stimulant and, in man, it is said that large doses cause mental exhilaration, increased capacity for work and excite sexual desire. Experiments with phosphorus on ani- mals show no special action of the drug on the nervous system. Phosphorus is absorbed largely in an unchanged condition in solution in fatty matter in the bowels and as vapor. Some of the phosphorus is probably converted in the bowels and blood into phosphureted hydrogen (PH;) and further oxidized into phosphoric acid in the body. Its fate ry. 7 Ae rae ACTION OF PHOSPHORUS 235 is unknown, but some phosphorus i is eliminated as vapor from the lungs and some in organic compounds in the urine. The toxic action of phosphorus differs decidedly from its therapeutic effect and so does the action of pure phos- phorus from its compounds. The action of phosphates, phosphoric acid and hypophosphites is not at all that of phosphorus. Most of the hypophosphites are eliminated unchanged in the urine and do not act as phosphates, as formerly ‘be- leved. They appear to have little more influence than sodium chloride, except the iron salt, where the metallic ion acts as other iron compounds. Phosphoric acid stimulates digestion and secretin formation, like other mineral acids, but is inferior in this respect to hydrochloric acid. It has been given internally for its supposed action as a phosphate, but the organic phosphate compounds of the body cannot be built from the inorganic salts. Calcium hypophosphate, lactophosphate and _ glycero- phosphate act similarly to calcium phosphate (page 158). Toxicology.—The symptoms of poisoning do not ordi- narily appear until some hours after ingestion of toxic doses. Then abdominal pain, nausea and vomiting (in those animals in which it is possible) and purging occur. The breath, yomitus and fecal discharges may be luminous, and have the odor of phosphorus. There is fever, anorexia and thirst. This condition is followed by an intermission in which the patient appears to be recovering, only to be succeeded by jaundice, hemorrhages (due to fatty degeneration of vessels and blood poor in fibrinogen), nervous symptoms, as delir- ium, coma and convulsions, and death. The urime rarely becomes albuminous in eareltes but contains leucin and tyrosin. The heart muscle is directly paralyzed by lethal doses. Grave, destructive metabolic changes (autolysis) occur in the tissues—especially the liver. There is general fatty de- generation of the viscera and muscles. The blood is disor- ganized, and there are widespread ecchymoses. Jaundice follows closure of the common, or hepatie duct, or smaller biliary tubules (owing to proliferation of interstitial tissue, seen also in the stomach and kidney), and disorganization 236 INORGANIC AGENTS of the blood. There is rapid atrophy of the liver, and phosphorus poisoning in man is often indistinguishable dur- ing life from acute yellow atrophy of the liver. Nitrogenous elimination is increased. Imperfectly decomposed products of metabolism, as leucin and tyrosin, occur in the urine; also an excess of urea and ammonia and often blood, bile and fat and sarcolactic acid. It is a matter of dispute whether the fat deposited in the cells of the tissues is formed there (fatty degeneration), or is conveyed thence from that already existing in the subeutaneous tissue. Chronic poison- ing, attended with necrosis of the jaw and other symptoms, and occurring among workers in phosphorus, is unlikely to occur in the lower: animals. Acute poisoning is treated by emptying the stomach with a stomach tube or copper sul- phate; the latter forming an insoluble phosphide of copper. Cathartics should also be administered. Permanganate of potash or hydrogen dioxide should be employed as anti- dotes, for their oxidizing action. Old turpentine is usually recommended as the antidote, but only the French variety is of any value, and that is generally unobtainable. Demul- cents and opium are in order after evacuant and antidotal treatment has been carried out, but oil should never be given in phosphorus poisoning, as it assists the solution and absorption of the poison. Uses.—Phosphorus is indicated as a stimulant to the growth of bone in rachitis and osteomalacia, as a nerve stimulant and tonic in conditions of nervous exhaustion and impaired vitality, due to excessive activity of the sexual organs or otherwise. It is used empirically in treatment of boils, acne, and psoriasis, and has been prescribed with alleged advantage as a general stimulant in pneu- monia. : Administration.—Phosphorus may be given in pill or ball, with cacao butter, or in the official preparations to dogs, and in a_ saturated alcoholic solution to horses. Phosphide of zine represents the action of phosphorus, and yields phosphureted hydrogen in its decomposition in the body. It may be given to dogs (gr.1-10) in the form of pills. CHLORINE 237 SECTION Ix. Chlorine. Cutorum. Chlorine. Cl The gas is not official. Liquor CHtori Composirus. Compound Solution of Chlorine, Chlorine Water. (U.S. P.) Synonym.—Aqua chlori, chlorum solutum, aqua oxy- muriatica, solution of chlorine, E.; aqua chlorata, P. G.; eau chlorée, chlore liquide, Fr.; chlor-wasser, G. An aqueous solution of chlorine (Cl), containing at least 0.4 per cent. of the gas. Derivation.—Generate chlorine gas with hydrochloric acid, 18; potassium chlorate,5; and water to make 1000. Heat in flask. Properties.—A. clear, greenish-yellow liquid, having the suffocating odor and disagreeable taste of chlorine, and leaving no residue on evaporation. Incompatible with salts of silver and lead. The preparation deteriorates on keeping. Dose.—Not used internally. Catx CuuorinaTa. Chlorinated Lime. Ca Cl,O,, Ca Cl.,. (Os Boe-B. 2) Synonym.—Calx chlorata; calearia chlorata, P. G.; chloris calcicus, chloruretum calcis, calcii hypochloris, chlo- ride of lime, hypochloride of calcium, bleaching powder, E.; chlorure de chaux, poudre de Tennaj}t, ou de Knox, Fr.; chlorkalk, bleichkalk, G. A preparation often improperly called “chloride of lime.” It should contain not less than 3% per cent. of avail- able chlorine. Derivaiion.—Pass chlorine gas over calcium hydrate, 238 INORGANIC AGENTS when chlorinated lime, a mixture of calcium chloride and hypochlorite, results. 2 Ca O,H, + 2 Cl, = Ca Cl,O,, Ca Cl, + 2H,O. It may also be regarded as a mixture of lime and chlorine. 2 Ca O,H, + 2 Cl, = 2 Ca O,2 Cl, + 2 H,0. Properties.—A. white, or grayish-white granular powder, exhaling the odor of hypochlorous acid, having a repulsive saline taste, and becoming moist and gradually decompos- . ing on exposure to air. In water or in alcohol it is only par- tially soluble. It evolves chlorine on exposure to the air or on addition of an acid. Chlorinated lime possesses an alkaline reaction and bleaching properties. Dose.—Only of value externally. PREPARATION. Liquor Calcis Chlorinate. Solution of Chlorinated Lime. (B. P.) This solution should yield about 3 per cent. of chlorine. Liquor Sop® CxHiLormat®. Solution of Chlorinated Soda. (U.S. & B. P.) Synonym. — Liquor sodz chlorinate, Labarraque’s solution, E. An aqueous solution of several chlorine com- pounds of sodium, containing at least 2.6 per cent., by weight, of available chlorine. Derivation.—A solution of sodium carbonate, 150; chlo- rinated lime, 75; in water to make 1,000. Properties.—A clear, pale, greenish liquid, haying a faint odor of chlorine and a disagreeably alkaline taste. Dose.—Only of value externally. ACTION AND USES OF CHLORINE. Chlorine gas, in the presence of organic matter and moisture, unites with the hydrogen of water and sets free nascent oxygen. When chlorine comes in contact with sul- — phuretted hydrogen, it removes and destroys the compound. Chlorine is thus a powerful oxidizing disinfectant agent and deodorizer. One-quarter of 1 per cent. of chlorine in solution is an effective germicide. When chlorine gas is ACTION AND USES OF CHLORINE 239 inhaled undiluted, it is an irritant to the respiratory tract, producing sometimes spasm of the glottis, or severe bron- chitis, and at other times a condition of narcotism, with death from paralysis of the respiratory center. In contact with living tissues, chlorine replaces the hydrogen of proteid compounds and forms hydrochloric acid with the hydrogen thus set free. The symptoms of poisoning are explained by the local irritation of the hydrochloric acid thus formed. In dilute form it is stimulant, antiseptic, and deodorant in rela- tion to the body. Chlorine gas may be generated from salt and black oxide of manganese, 1 part each; with commercial sulphuric acid and water, 2 parts each. | The spores of most bacteria are killed after three hours’ exposure to a moist atmosphere containing 0.3 per cent. of chlorine gas. Chlorine may be used to advantage in this manner as a substitute for sulphur fumigation. Chlorine water is employed, well diluted, for the same purposes and with the same results as the solution of chlorinated soda. Chlorinated lime varies much in strength. To be of any value it should be so irritating to the eyes that it cannot be held near the face. It owes its medicinal value to the hypochlorite of lime which it contains. If the compound is “very moist, it is because calcium chloride preponderates. Chlorinated lime is often employed as a deodorizer, standing about premises in vessels, but is of no practical value unless it comes directly in contact with bacteria or sulphureted compounds which it is desirable to destroy. It is the best and cheapest germ destroyer we possess for disinfecting premises and other appurtenances, apart from the body, as walls and floors of buildings, faecal and other discharges, sewers, privies and cesspools. A 10 per cent. solution is to be employed on the floors, walls and other parts of buildings. The pure compound may be mixed with manure and dis- charges. Even a 1 per cent, solution is germicidal, and may be employed to wash blankets, harness and other parapher- nalia. It is said not to harm woolen or cotton fabrics, in the latter solution. One or two pounds of chlorinated lime is a useful disinfectant when put in privy vaults once a week, One or two ounces of chlorinated lime will render drinkable 65 gallons of putrid, bad smelling water, after a 949 INORGANIC AGENTS few hours have elapsed for precipitation following the use of the compound. Upon the body, a 2 or 3 per cent. solution of chlorinated lime is employed as a stimulant, deodorant, and antiseptic, for decubitus, foul-smelling and gangrenous sores, severe burns and indolent ulcers. It is used in 10 per cent. solution as a parasiticide in ringworm and scabies. A 1 per cent. solution forms a valuable wash in ulcerative stomatitis. Chlorinated lime may be prescribed, with an equal amount of lard, upon ulcers when a stimulat- ing action is desired. Chlorinated lime (gr.-xv. in 3 ii. of sterile water) is one of the most effective antidotes for snake bite, when injected in several places in the region of the lesion. Its internal administration is undesirable. The solution of chlorinated soda is a slight caustic, deodorizer and antiseptic preparation on indolent, sloughing, foul- smelling surfaces. It may be prescribed in sore throat, or ozeena, aS a Spray, or injected into the uterus, vagina or rectum. It is commonly diluted with 8 to 10 parts of water. Bromine. Bromum. Bromine. Br. Derivation.—From seaweed and mineral springs. Properties.—Heavy, dark, brownish-red liquid, volatiliz- ing with the production of an irritating vapor. Solublein 30 parts of water, and readily soluble in alcohol and ether. Of no value in veterinary medicine. Potassi BromipuM. Potassium Bromide. K Br. (U.S. & B. P.) . Synonym.—Kalium bromatum, P.G.; bromkalium, G. Derivation.—Obtained from liquor potassxz, bromine, and charcoal by the sanie process described in making potassium iodide (p. 247). Properties. — Colorless, or white, cubical crystals, or granules; odorless, and having a pungent, saline taste. Permanent in the air. Soluble in about 1.6 parts of water and in 200 parts of alcohol. | lel oe we ACTION OF THE BROMIDES QA Dose.—H. & C., 5 i.-ii. (30.-60.) ; Sh. & Sw., 3 ii-iv. (8.-15.) ; D., gr.v.-3 1. (.3-4.). *Sop11 Bromipum. Sodium Bromide. NaBr. (U. S. é& Py Bs). Synonym.—Bromure de sodium, Fr.; bromnatrium, G. Derivation.—Similar to potassium bromide. Liquor sode is used instead of liquor potasse. Properties.—Colorless, or white, cubical crystals, or a white, granular powder; odorless, and having a saline, slightly bitter taste. From air the salt attracts moisture without deliquescing. Soluble in 1.2 parts of water, and in 13 parts of alcohol. Dose.—Same as potassium bromide. ACTION OF THE BROMIDES, External.—N one. Internal.—Digestive Tract.—The bromides, when in- gested in concentrated form, may induce nausea and vomit- ing through irritation of the stomach produced by with- drawal of water from the gastric mucosa. This “ salt action ” i; common to other salines. In a large, single dose, the bromides cause in horses muscular weakness, dulness and staggering gait, and the respiration slowed. The urine is increased in quantity and sexual desire diminished. Brom- ism may be produced in man, or the lower animals, by the continuous administration of the bromides. This condi- tion is characterized by general weakness and unsteady gait, mental dulness, indigestion, fetid breath, cutaneous anss- thesia, loss of sexual power, and occasionally an acneform .eruption. Death has never been caused in man by the bromides. : Nervous System.—The bromides are essentially depres- sant to nerve tissue. Therapeutically, this depressing action is seen particularly in relation to the motor centres of the middle region of the cerebral cortex; to the intellectual areas in the anterior cerebral region (in man); and in lessening reflex action. The whole nervous system is depressed, but the motor tract in the brain and the sensory nerves are the *Ammonii bromidum, lithii bromidum, calcii bromidum and strontii bromidum are also official. These salts are given in the same doses as sodium bromide. 942 INORGANIC AGENTS first to succumb to the influence of the bromides. Intellection is clouded, and dulness and mental apathy are observed in man after large amounts. Reflex action is diminished owing to interference to the passage of impulses from the sensory to motor cells of the cord and, later, to depression of the sen- sory nerves. Finally, with the continuous administration of large doses the motor area of the spinal cord, the motor nerves, and muscles fall under the depressing action of these agents. Circulation.—Potassium bromide is a powerful depres- sant to the heart in toxie doses. Medicinal doses injected into a vein induce weakness of the heart, but therapeutic amounts, given by the mouth, exert no appreciable effect upon the cireulation. ‘The depressing action of potassium bromide upon the heart is due wholly to the potassium ion ; the bromine ion is not a heart depressant. There is practically no dif- ference in the action of therapeutic doses of potassium, sodium, strontium, or ammonium bromides. Ischemia of the pia is seen under the influence of bromides. This is the result of depression of the cerebrum and sleep, and not the cause of sleep. The old idea that the beneficial action of the bromides, in relieving nervous excitability and in causing sleep, was due to the production of vasomotor spasm and cerebral anzemia, is now exploded. Temperature-—The temperature’ falls, following the action of toxic amounts of the bromides, owing to lessened muscular movements. Sexual Organs.—The bromides diminish sexual desire and power. In so doing they either depress the spinal centres or lessen peripheral sensibility of the genito-urinary tract. Elimination.—The bromides are eliminated ‘unchanged by all channels and are found in the sweat, urine, eae saliva, intestinal secretions, etc. Elimination begins imme- diately but may not keep pace with continuous administra- tion, and bromism may occur. Uses Internal.—The bromides, being particularly useful in the treatment of functional nervous diseases, do not pos- sess nearly the value in veterinary medicine that they have a =e a eS IODINE 243 in human practice. Moreover, their use is limited mainly to canine disorders, as bromides have little influence upon diseases of horses. Bromides are especially indicated in irritation of the motor area of the cerebral cortex (convulsions), in géneral nervous excitability, and in corditions due to exalted reflex nervous excitabilty, in cerebritis, and in conditions due to exalted reflex action in dogs. The bromides are indeed the best agents we can use to cure fits or convulsions in dogs. They should be combined with chloral and given, if necessary, per rectum. The bromides are useful in canine chorea, in connection with Fowler’s Solution. With chloral the bromides are antidotes to strychnine poisoning. Sexual excitement in all animals may be allayed by the bromides. The bromides are occa- sionally of value in reflex cough, palpitation of the heart, and asthma, but are inferior to other agents in these disorders. Potassium bromide is recommended in the treatment of tetunus of the horse, but opium, belladona and cannabis indica are generally more effectual. If the bromides are used they should be given with chloral. Iodine. Iopum. Iodine. I. (U.S. & B. P.) Synonym.—lodinum, U.S. P. 1870; iodum, P. G.; iode, er; jod., G. Derivation.—lodine is a non-metallic element (Hallogen, existing in combination in the animal, vegetable and mineral kingdoms. It occurs in seaweed, from which it is obtained by distillation. It is also mined in the form of iodates and iodides. Properties.—Iodine occurs in heavy, bluish-black, dry and friable rhombic plates, having a metallic lustre, a distinctive odor, and sharp, acid taste. It is soluble in 5,000 parts of water, and in 10 parts of alcohol; very soluble in ether and in solutions of potassium iodide. Iodine volatilizes on heating, with the formation of a 944 INORGANIC AGENTS a purple vapor. With starch, iodine forms an insoluble biue compound. Dose.—H. & C., 3ss.-i. (2.-4.); Sh. & Sw., gr.x.-xx, (.6-1.3). Not often used in solid state. PREPARATIONS. Liquor Iodi Compositus. Compound Solution of Iodine. (Lugol’s Solution.) (U.S. P.) Todine, 5; potassium iodide, 10; water to make 100. (1-20). : Dose.—H. & C525) Al-nve(Ss 2154 D., Tii-x. (.12-.6). Should be given in one quart of water to the larger animals. Tinctura Todi. (U.S.P.) Todine, 70; alcohol to make 1,000. Dose.—H. %& fomastnoterh se. (tls 15.) D. Mi.-v. ee Tincture Fodi. (B. P.) Dose.—Same as U. S. P. tincture. Unguentum Todi. 1-25. .(U. 8. & B. P.) Too weak for most veterinary purposes. . Action External.—Iodine acts as a slow, moderate and prolonged irritant upon the skin and mucous membranes. The yellow stain produced by iodine may be removed by am- monia water, alkalies and sodium hyposulphite. A small amount of iodine is absorbed through the unbroken skin, and it is thought to have a special resolvent and alterative action over and above that of other counter irritants. Whether this be true or not, its easy mode of application makes it a very - convenient irritant for local uses. Action Internal.—Iodine produces gastro-intestinal irri- tation and inflammation in large doses; and in toxic quanti- ties induces colic, vomiting in animals capable of the act, and purging and saliv ation. The pulse becomes rapid and weak; there is often suppression of urine, and occasionally nephritis. Widespread fatty degeneration has been found after fatal poisoning in the lower animals. If there is much IODINE 945 starchy material in the bowels, the fecal discharges may be of a bluish color. Aphrodisiac action has been noted in man, following small doses of iodine. The treatment of acute poisoning is embraced in the use of starch by the mouth, or raw eggs, external heat; strychnine, alcohol, and atropine subcutaneously. Chronic poisoning by iodine and iodides (iodism), in man, commonly causes symptoms analogous to a severe cold in the head, with pain over the frontal sinus, sore throat, running at the eyes and nose, gastric indigestion, together with an acneform, and occasion- ally purpuric, or furuncular eruption. These more frequent symptoms of iodism occur more often after the administration of potassium iodide than after that of iodine. The physiological action of the iodides is simi- lar to that of iodine, which is transformed into iodides in the body. But the iodides are usually preferred for internal use since they are locally so much less irritating. Both iodine and potassium iodide are readily absorbed from mucous mem- branes, and are found in all the tissues and fluids of the body. Iodine is absorbed as iodides and, perhaps, in loose combination with albumin (iodoalbuminates)—and elimi- nated as iodides by all the usual channels, as well as by the mucous membranes. The kidneys eliminate the greater amount, but iodine is found in the saliva and gastric juice after it has ceased to be present in the urine. The effect of iodine on the thyroid gland probably accounts for much of its influence on the body. Iodine is essential for normal thyroid activity. Glandular hyperplasia (simple goitre) is a physiological reaction to a deficiency of iodine. The iodine content of the gland varies inversely with the degree of en- largement. Giving iodine in simple goitre in puppies causes reduction of the glandular hyperplasia. An excess of iodine ingested in goitre will produce the same symptoms (thyro- toxic) as occur in morbid conditions where an excess of thyroid secretion is formed (exophthalmiec goitre in man) v1. €., rapid heart, tremors, wasting, excitement, ete. Uses EHxternal.—lodine is of most value applied exter- nally, or locally, while potassium iodide is administered internally because it is not irritating to the digestive organs. Although potassium iodide does not exactly represent the 246 INORGANIC AGENTS action of iodine, yet it is usually preferable for the reason just stated. Potassium.iodide renders iodine soluble and prevents its precipitation in fluids within and without the body; it is therefore combined with iodine, when concen- trated solutions are desirable. Six parts of potassium iodide and twelve parts of iodine are added to one hundred parts of water, or ointment, to make a suitable counter-irritant preparation for the horse. A useful tincture for veterinary purposes contains 15 parts of iodine and 18 parts of potas- sium iodide in 100 parts of alcohol. Iodine is employed in aqueous and alcoholic solution, or in ointment, as above, either painted upon or rubbed into the skin over enlarged glands, rheumatic swellings about the joints, or upon the chest in chronic pleuritis. It is also of value in straius, bruises, periostal inflammation and muscular rheumatism. In the horse, severe sprains and inflammation of joints, bones, and periosteum are treated more satisfactorily by blistering agents. Iodine is « valuable disinfectant and parasiticide, with equal parts of alcohol in alopecia areata, and particularly in ringworm and favus in dogs, when the tincture is applied locally. Iodine is applied externally, in the form of the tincture, on patches of chronic mange, eczema, and psoriasis. Todine is often recommended for erysipelas, but is in- ferior to ichthyol for this purpose. Jodine is injected into joints, synovial sacs, abscesses, and cavities of the body to promote healing through its antiseptic and irritant action; ts cause adhesive inflammation, and in this manner to close cavities and to prevent the accumulation of fluids in them. The official tincture is commonly used for injections. The tincture of iodine may be injected undiluted directly into the substance of enlarged glands,* in amounts varying from 15 to 30 drops, to assist their absorption. If the tinc- wre is injected into the subcutaneous tissue, abscess may ensue. Ozcena may be treated to advantage by irrigation with a solution containing one drachm of the tincture of iodine to the pint of normal salt solution. In inflammation of the upper air passages, iodine is sometimes beneficial as *In goitre in dogs, calves and lambs, injections of tincture of iodine (x.) may be made every other day for 10 to 20times—if painting on the tincture extern- ally and potassium iodide or dessicated thyroid glands (gr. iii. in capsules thrice daily) internally are unsuccessful, POTASSIUM IODIDE 247 a stimulant and antiseptic inhalation, which is produced by adding one-half a drachm of iodine to the pint of boiling water. Uses Internal.—lodine is thought to act more satisfac- torily than potassium iodide in the treatment of diabetes insipidus or polyuria of the horse, in which it often appears to be a specific. Administration.—Iodine may be combined with gentian and iron in the form of a ball, as recommended by Finlay Dun, or better, as Lugol’s Solution, which is less irritating and more active. Porassit Jopipum. Potassium Iodide. KI. (U.S.&B. P.) Synonym.—J odkalium, G. Derivation.—lodine is dissolved in hot liquor potasse. 61+ 6KOH=5KI+KI0,+3H,0. The evapo- rated residue is heated with charcoal to remove O from K I O, (Potassium Jodate). KIO, +38C= KI+3CO. The result is purified by crystallization. Properties.— Potassium iodide occurs in colorless, trans- parent or translucent, cubical crystals; or as a white, gra- nular powder, having a slight odor of iodine, and a bitter, saline taste. Permanent in dry air, but slightly delique- scent in moist air. It is soluble in 0.75 part of water; in 18 parts of alcohol, and 2.5 parts of glycerin. Dose.—H., Zii-iv. (8.-15.); C., Zvi. (24); Sh. & Sw, gr.xv.-xxx. (1.-2.); D., gr.ii-x. (.12-.6). PREPARATION. Unguentum Potassii Iodidi. (U.S. & B. P.) 10 per cent., U.S. P. Unimportant in veterinary practice. Sep Ioprpum. Sodium Iodide. NaI. (U.S. & B. P.) Synonym.—lodure de sodium, Fr.; jodnatrum, G. Derivation.—Made from sodium hydrate in the sama manner as potassium iodide. ~ 248 INORGANIC AGENTS Properties.—Oceurs in colorless, cubical crystals, or as a white, crystalline powder, without odor, and having a bitter, saline taste. Soluble in .6 part of water and in 3 parts of alcohol. Dose.—Same as potassium iodide. Syrurus Hypriopicr. Syrup of Hydriodic Acid. (T8207 Contains 1.3 per cent. of H I. Derivation.—Potassium iodide, 13; potassium hypo- phosphite, 1; tartaric acid, 12; water, 15; diluted alcohol and syrup of each a sufficient quantity to make 1,000. Properties.—A colorless, odorless, syrupy liquid, of a sweet, acid taste. Dose.—D., MW xv.-5 1. (1.-4.) Action External.—Potassium iodide is not absorbed un- less rubbed into the skin with fat, and is not a local irritant, and therefore possesses very little value as an external appli- cation. Action Internal.—Potassium iodide and iodine are both described by that unsatisfactory term, alterative. In certain diseases, as in rheumatism, iodine and the iodides alter nutrition and cause absorption of exudates in some unknown manner; hence the term alterative. In addition to this action, potassium iodide forms soluble compounds with the lead and mereury salts, and hastens elimination in poison- ing by these metals. It is often taught that potassium iodide liberates iodine in the tissues, and that the latter forms soluble compounds with albumin, ‘which are then readily eliminated; thus explaining the effect of potassium iodide in aiding resolution of morbid exudation and inflammatory thickenings. Free iodine is certainly formed in the body as it escapes into the stomach after administration of. iodides. Supposed elimination of free iodine from the mucous mem- branes and.skin is said to account for irritation of these parts after prolonged and excessive doses (iodism). Like other salts of the alkalies (see “ Sodium Chloride” the iodides are diuretics and, in concentration, may cause nausea and vomit- ing. The iodides are rapidly absorbed and mostly eliminated as such chiefly by the urine; but also by mucous membranes, and in milk, sweat, tears, ete. 2 USES OF IODIDES 249 Uses Internal.—Potassium iodide is useful in causing ab- sorption of enlarged, lymphatic glands, and its action should be assisted by the application of iodine or red mercuric iodide externally. Potassium iodide, in small doses, dimin- ishes congestion and increases the fluidity and amount of secretion in acute laryngitis, acute and subacute bronchitis, and appears to possess an alterative action in improving the condition and nutrition of the bronchial mucous membranes. It resembles ammonium chloride in the latter respect. Itis also of value in asthma, chronic bronchitis, unassociated with copious secretion. Chronic pleuritis, pericarditis, and ascites are treated with potassium iodide, which assists ab- _ sorption, and occasionally exerts a diureti¢ effect. Tardy resolution of pneumonie consolidation is hastened by potas- sium iodide. Endocarditis with cardiac hypertrophy is said to be benefited by potassium iodide and digitalis. Champignon, or scirrhus cord of horses, is sometimes cured by the sorbefacient powers of potassium iodide in full doses. Potassium iodide is of value in goitre of dogs, calves and sheep when tincture of iodine is used externally (see p, 246). “Roaring” and “ thick wind” may be cured by the administration of potassium iodide. Potassium iodide is the drug commonly given for aneurism. Probably it is only of use when this is of syphilitic origin and not in animals. Potassium iodide is the best remedy known for actinomyco- sis. It should be given to the larger animals in doses of 3 drachms daily, or in the same dose as Lugol’s Solution, until iodism appears, when the dose may be reduced to one-half this amount. + Potassium iodide is one of the many remedies prescribed in chronic rheumatism.* Potassium iodide has a clinical reputation for its power to aid absorp- tion and resolution in inflammation or effusions of the brain or cord, in hemiplegia, paraplegia and meningitis. Summary.—Ilodine and potassium iodide resemble one another in many respects. Iodine is a local irritant, potas- *Potassium iodide has given good results in the treatment of periodic ophthalmia in horses with the first attack. They are given one ounce daily for two to three days, and kept in the dark with cold compresses over the eyes. 250 INORGANIC AGENTS sium iodide is not. The known physiological action of potassium iodide and iodine does not explain their medi- cinal uses. In combating certain diseases, in an inexplic- able manner, they are known as alteratives. In man, iodine is superior to potassium iodide in the treatment of scrofula. In the horse, iodine is considered of more value in the treatment of diabetes insipidus; while in both man and the lower animals, potassium iodide is regarded as more valuable in chronic rheumatism. In subacute rheumatism, one prescribes equal parts of sodium salicylate and iodide. The action of iodine in benefiting local disorders, when applied externally, is due to its counter irritant effect, rather than to absorption. :; Administration.—Potassium iodide is given in solution. Sodium iodide and syrup of hydriodic acid are simply sub- stitutes for potassium iodide. Ioporormum. JIodoform. CHI,. (U.S. & B. P.) -Derivation.—Alcohol, potassium carbonate, iodine, and water are heated together. C,H,O + 2 KHCO, + 8I= 2 CHI, + 2 KI + 2CO,+ 3 H,O. Todoform contains over 90 per cent. of iodine. Properties.—Small, lemon-yellow, lustreless crystals of the hexagonal system; having a peculiar and very penetrat- ing persistent odor, somewhat resembling that of saffron and iodine, and an unpleasant and slightly sweetish and iodine-like taste. Very slightly soluble in water; soluble in 52 parts of alcohol, and in 5.2 parts of ether. Very soluble in chloroform, benzine, fixed and volatile oils. . PREPARTIONS. Unguentum Iodoformi. Ointment of Iodoform (1-10). U.S. & B. P.) Suppositoria Iodoformi. (B. P.) (Each containing 3 grs. of iodoform.) Action External.—lodoform is an antiseptic, local anzs- thetic, stimulant, protective, and dessicant agent. While iodoform does not inhibit the growth of germs outside the body—many of the bacteria growing in iodoform itself—it is nevertheless a valuable antiseptic. This result may IODOFORM 251... probably be accounted for by the decomposition of iodoform on moist wounds, with the liberation of free iodine; by its absorption of exudates on which germs live; and possibly by neutralizing toxins. Iodoform is particularly useful in septic and suppurating wounds. When applied over exten- sive surfaces, absorption and poisoning may occur. The symptoms of iodoform poisoning are most diverse. Symptoms of gastro-intestinal irritation are seen in poisoning in dogs, as vomiting and diarrheea, together with nervous symptoms, as convulsions, stupor and sleep. The -pulse may be very rapid or infrequent; the temperature high or normal. Jodoform is in part absorbed unchanged, but the greater part is transformed into free iodine and iodides in the body. The symptoms are the resultant of the iodoform and iodine. The cerebral excitement is due to iodoform, while rapid pulse may follow stimulation of the thyroid by iodine. Iodine is eliminated in the urine in iodo- form poisoning and can easily be discovered by the starch test. General fatty degeneration of the internal organs is found after death. The local dessicant effect of iodoform on raw surfaces assists the antiseptic action, and the local anesthetic properties combine to make iodoform the best antiseptic powder we possess, barring the odor. Action Internal.—The internal action of iodoform pos- sesses no therapeutic value. Care must be observed to prevent animals licking off iodoform from the surface of the body. One drachm will poison a dog weighing ten pounds. Elimination.—Iodoform is eliminated in the form of iodine and iodides by all the secretions, chiefly by the urine as iodides, Uses External.—lodoform is of value applied over suppurating and septic surfaces, sores, and ulcers, where it hinders the growth of bacteria, stimulates unhealthy granulations, relieves pain, possibly neutralizes toxins, and certainly produces a vile odor. For this reason one of its substitutes should be employed when an antiseptic powder is desirable for use upon dogs living in or about dwellings. Iodoform is commonly employed in its purity. It may be mixed in any proportion with boric acid, or with tannic acid (1-8), for its astringent effect. It is valuable in 252 INORGANIC AGENTS foul of the foot in cattle, or in foot rot in horses, with equal parts of alum or tannic acid. Combined with collodion (1-15), it forms a useful dressing for sealing small wounds or abrasions upon the hands. The anesthetic action of iodoform is taken advantage of to relieve pain in fissure of the rectum, and hemorrhoids. Zuill recommends the fol- lowing combination by insufflation in the early stages of inflammation of the frontal sinuses : Todoform, Magnesia, Silver Nitrate—equal parts. Three grains may be used in suppositories for the smaller animals. Iodoform may cause healing in abscess— injected into the cavity with glycerin or vaseline--(1-10), using 2-4 drachms of the mixture for smaller animals, or 1 ounce for the larger animals. Jodoform is very efficacious in the treatment of local tuberculous lesions. Lodoform coms bined with lard or oil (1-10), is an excellent agent for burns ° which are not so extensive as to endanger the patient through absorbtion and iodoform poisoning. Iopotum. Iodol. C,I,.NH. (U.S. P.) Synonym.—Tetraiodopyrrol. Derivation.—Action of iodine on pyrrol in solution in alcohol. Contains 88.9 per cent. of iodine. Properties.—Crystalline, shining, light, grayish-brown powder. Tasteless and odorless. Practically insoluble in water; soluble in 9 parts of alcohol, and in ether and fatty oils. The surgical use of iodol has led to poisoning through absorption, but the latter is so slow that the danger is exceedingly slight. Iodol is suitable for all purposes in which iodoform is indicated. It is too expensive for general use, but is preferable for application to dogs, on account of its lack of odor. Aristotum. Aristol. C,,H,,0,1,. (Non-official). Synonym.—Dithymol diiodide. Derivation.—Made by the action of thymol in a solution ORTHOFORM 253° of sodium hydroxide, on iodine, dissolved in a solution of potassium iodide. Contains 45.8 per cent. of iodine. Properties.—Light reddish, or tawny-brown crystalline powder. Possesses peculiar iodine-like odor, and is insol- uble in water, soluble in ether, fats, and slightly soluble in alcohol. Aristol is inferior as an antiseptic to either iodoform or iodo]. It is used with some benefit in dry skin diseases, as psoriasis, in powder or ointment. Other antiseptic dusting powders include acetanilid, bismuth sub- nitrate, salol and boric acid. Acetanilid has been shown to be a good antibacterial agent. It is cheap and may be applied pure, and it is an efficient substitute for iodoform. A few cases of poisoning have been reported following its extensive surgical use. Bismuth subnitrate and salol may induce poisoning when used over large surfaces. They are dessicants and feeble antiseptics. Boric acid is harmless and mildly antiseptic. OrtTHorormM. Orthoform. Orthoform is the methyl-erster of meta-amido-para- oxy-benzoic acid. It occurs as a white or dirty yellow, light powder, sparingly soluble in water and alcohol but more so in glycerin and solutions of the mineral acids. It may be combined with iodoform, aristol, boric acid, salicylic acid, carbolic acid, turpentine and iodine without incom- patibility. Action.—Externally, othoform exerts a powerful anes- thetic effect on raw surfaces, but has little action on intact mucous membranes and none on the unbroken skin. It is also a mild antiseptic, of about the same value as boric acid. It is but feebly toxic and poisoning does not occur unless large quantities are applied over abraded surfaces. In the dog, 15 grains per 2 pounds of body weight have proved toxic when given by the mouth ; and 7} grains per 2 pounds of live weight are required to induce fatal poisoning. It appears to be a cerebro-spinal paralysant in these large 954 INORGANIC AGENTS doses. The anesthetic action of medicinal doses is usually prolonged, varying from a few hours to two or three days. Orthoform has been used extensively in human medicine for the past few years, and cases of poisoning have been of rare occurrence and none fatal, although as much as two or three ounces have been applied on ulcerated surfaces in a week’s time. Occasionally the drug produces an erythema or dermatitis owing to peculiar susceptibility of the patient. On the other hand, orthoform has been used successfully in the treatment of dermatitis following ivy poisoning in the human. Uses.—Orthoform is valuable chiefly for its power in relieving pain when applied to raw surfaces. It is an excellent application for burns. In superficial burns, ortho- form may be combined to advantage with ichthyol, of each 10 per cent., in lanolin. In burns of the second and third degree, the use of orthoform and boric acid, equal parts, forms an excellent remedy. Orthoform is serviceable in relieving pain and irritation of ulcers, hemorrhoids ‘and fissures of the rectum. In human practice it is largely employed in connection with diseases of the nose, ear and throat to arrest pain after operations, and in ulceration and inflammation of these parts,.as sore throat. Nasal gleet in horses should be benefited if not cured by the in- sufflation of the powder. Orthoform is commonly used in ointment containing 10 to 20 per cent. of the drug. It may be blown pure into cavities or applied as a saturated solution in collodion. It may be sprayed on a part with an atomizer in 5 per cent. solution with equal parts of alcohol and water. It has been injected into the bladder in cystitis mixed with water. In ulceration and other painful affec- tions of the stomach, orthoform will give relief owing to its local anesthetic action. It may be administered mixed with — water and syrup in the dose of 0.5-1.0 (74-15 gr.) for dogs. It is an expensive drug at present. SULPHUR 255 SECTION X. Sulphur. | OFFICIAL VARIETIES. Sutpaur Susiimatum. Sublimed Sulphur. S. (U.S. &.B:P:) Synonym. — Flowers of sulphur, flores sulphuris, E.; fleurs (creme) de soufre, Fr.; schwefelblumen, schwefel- blithe, G. Derivation.—Obtained from native sulphur by‘sublim- ation. Properties.—A fine, yellow powder, having a slightly characteristic odor and. a faintly acid taste. Insoluble in water; slightly soluble in absolute alcohol; more readily soluble in benzine, benzol, oil of turpentine and many other oils; also in ether, chloroform, and in boiling, aqueous solutions of alkaline hydrates. PREPARATIONS. _ Sulphur Lotum. Washed Sulphur. S. (U.S. P.) Synonym.—Sulphur depuratum, flores sulphuris loti, P. G.; soufre lavé, Fr.; gereinigte schwefelblumen, G. Derivation.—Obtained from sublimed sulphur which is treated with diluted ammonia water to wash out sulphurous and sulphuric and other impurities. Properties.—A fine, yellow powder, without odor or taste. Solu- bility, same as sublimed sulphur. Pulvis Glycyrrhizcee Compositus. Compound Powder of Glycyrrhiza. (U7 S423) Senna, 180; glycyrrhiza, 236; washed sulphur, 80; oil of fennel, 4; sugar, 500. Dose,—logs (laxative), 3 ss.-i. (2.-4.). Unguentum Sulphuris. Sulphur Ointment. (U.S. & B. P.) Washed sulphur, 150; benzoinated lard, 850 (U.S. P.) 256 INORGANIC AGENTS Sulphur Precipitatum. Precipitated Suiphur. S. (U.S. & B. P.) Synonym. —Lac (magisterium) sulphuris, milk of sulphur, E.; soufre précipité, lait de soufre, Fr.; Schwefelmilch, G. Derivation.—Obtained from a solution of sublimed sulphur, 100; in boiling calcium hydrate, 50; by precipation with hydrochloric acid. Jalcium sulphide and hyposulphite are formed. 125+ 38Ca0O,H, = 2 CaS, + Ca 8,0; + 3H.,0. Then: 2 CaS; + CaS, 0; + 6H Cl= 3 Ca Cl, + 128 + 3 H.0. Dose (of sublimed, washed or precipitated sulphur).— H. & C., Zii-iv. (60.-120.); Sh. & Sw., 3i-ii. (80.-60.); -D., 3 ss.-iv. (2.-15.). Larger doses laxative; smaller for constitutional actio Precipitated sulphur is the best preparation for inter- nal use, as it occurs in a finer state of division and is more readily acted upon by the digestive juices. It may contain traces of sulphides or sulphuretted hydrogen, owing to the method of preparation. Action External.—Sulphur has no action upon the skin when applied in the pure state. The ointment is the most effective agent in destoying acari which produce mange, grease, and scab. Sulphur does not kill acari as readily as a sulphide which is formed by the addition of an alkali. When sulphur ointment is rubbed into the skin it causes considerable irritation and an- artificial eczema. Sulphur is converted into sulphuretted hydrogen and sulphurous acid by living tissue, and this transformation may occur to some extent when sulphur is rubbed into the skin with fat. Action Internal.—Digestive Organs.—Sulphur is not acted upon by the stomach, but is somewhat dissolved by the alkaline intestinal juices, and converted in part into sulphides (10 to 20 per cent. of sulphur is absorbed as sul- phides) and sulphuretted hydrogen. The sulphides, to- gether with sulphuretted hydrogen, are absorbed into the blood. Minute traces of sulphuretted hydrogen are elim- inated by the lungs and skin, while oxidation of sulphides occurs in the tissues and they are eliminated as sulphates SULPHUR 257 and unknown organic sulphur compounds. The sulphides and sulphuretted hydrogen act as laxatives, and in all probability sulphur itself exerts a mild, mechanical irritation upon the bowels. Peristaltic motion and intestinal secre- tions are both slightly increased. The fecal discharges are soft and pasty, and offensive flatus containing sulphuretted hydrogen escapes from the intestines after the administra- tion of sulphur. Constitutional Action.—Sulphur acts remotely during its elimination in stimulating the functions of the skin and respiratory mucous membranes,—so-called alterative action. Sulphur causes disorganization of the blood, and depresses and paralyzes the central nervous system (see p. 261) after the continuous administration of colossal doses. Ordinary therapeutic quantities of sulphur have no effect of this kind. Uses External.—Sulphur is mainly of service externally as a local stimulant and parasiticide in skin diseases. The female acarus, which produces mange (acariasis), bores under the epidermis and lays her eggs in the burrows, while the male insect remains upon the surface. It is essential, there- fore, to remove the epidermis in order to expose the ova and female to the action of sulphur. The hair should be first shaved and the parts soaked and scrubbed with green soap and water. All cloths or brushes used in this opera- tion should be burned or disinfected by boiling. Sulphur acts most efficiently in ointment, as fat fills up the burrows and deprives the insects of air. The official ointment is used in mange, but a combination with an alkali is morn serviceable, unless there is active irritation of the skin, or eczema. The following ointment is recommended : REM P UNE ap rae tratsatet eink Rereisiece whey cootsiotel si siaieans 2 parts. Potassimny Garbonarees «coc clerete ssie's«c 1 part. MAR sere ele rel stata taateraestetstcls iala A srteideysaves's 8 parts In obstinate cases of ringworm or mange, the prepara- tion mentioned by Brunton is of value. This consists of one part each of sulphur and oil of cade, with two parts gach of green soap and lard. True mange in the dog, if 258 CO INORGANIC AGENTS extensive and of long duration, is. practically incurable by any drug. Sulphur ointment is of benefit in chronic eczema and acne, for its local stimulant and alterative action. Uses Internal.—Sulphur is commonly used for its laxa- tive action in the treatment of young animals and dogs suffering with constipation and hemorrhoids. It may be of service in chronic bronchitis with copious secretion. Sul- phur is frequently prescribed internally for its action in chronic diseases of the skin, and is thought to exert a bene- ficial alterative action. Sulphur is also recommended in chronic rheumatism. Disinfectant Action.—When sulphur ae combus- tion, sulphurous anhydride (SO). is evolved, and the latter combining with water forms sulphurous acid. SO, + H,O = H,SO, Sulphurous acid, and, in a less degree, sulphurous anhydride, are germicidal, and are in common use as disin- fectants. Sulphurous acid owes its germicidal action to two properties. Chiefly to its being a powerful reducing agent, by which it is oxidized into sulphuric acid, and also to the acidity of both compounds. In withdrawing oxygen from organic matter it is poisonous to protoplasm in general and to bacteria in particular. Bacteriological experiments, how- ever, show that sulphur fumigation, as ordinarily employed for disinfection, is of little worth for destroying disease germs. Disinfection by formaldehyde or chlorine gas is to be preferred. Sole reliance should never be placed upon sulphur fumigation, but premises should be treated as recom- mended in the section on antiseptics and disinfectants (p. 418). In employing sulphur as a disinfectant, animals must be removed from the premises, and communication with the outer air should be excluded as far as possible. Three pounds of roll or flowers of sulphur, mixed with 2 ounces of aleohol, should be employed for every 1,000 cubic feet of air space to be disinfected. The premises which are being disinfected should be closed for six hours. Alcohol is employed to ignite the sulphur and also to form steam by its combustion. ‘The latter unites with sulphurous anhydride to make the more potent sulphurous acid. SULPHUROUS ACID 259 If steam can be introduced into the apartment, together with sulphur fumes, the effect is vastly more efficient. The sulphur and alcohol may be placed in an iron or earthen- ware vessel, floating in a tub of water to avoid danger of fire. The sulphur not infrequently fails to burn freely, and combustion is secured more certainly by placing flowers of sulphur with alcohol in. an iron vessel which should rest upon a stand in a large iron pot. A lighted alcohol lamp is then put under the smaller iron vessel, containing the sul- phur, and the lamp is ignited. The lamp insures complete combustion of the sulphur and the outer iron pot prevents the surrounding premises from catching fire. Sulphurous anhydride has been employed for its local antiseptic and stimulant action, in inflammatory diseases of the upper air passages in horses. For this purpose it is burned in such quantities that the vapor is capable of being inspired because largely diluted with air. With such dilu- tion the antiseptic action is lost, and there is. danger of producing considerable irritation, and the procedure is of doubtful value. The same treatment has been pursued in verminous bronchitis of lambs and calves, caused by the Strongylus filaria and S. micrurus. Local treatment, with tracheal injection, is more efficient. Actipum SouLpHurosum. Sulphurous Acid. H,SO,. (UO. 8). & Bs P) Synonym.—Acide sulfureux, Fr.; schwefelige siure, G. Derivation.—Charcoal, 20, and sulphurie acid, 80, are heated together and the sulphurous anhydride evolved is passed into water. 4H,SO, + 2C =4S0O, + 200, + 4 H,O. 4S0, + 4H,O = 4H,SO,. Properties.—A colorless liquid of the characteristic odor of burning sulphur, and of a very acid, sulphurous taste. It should contain not less than 6.4 per cent., by weight, of sul- phurous anhydride, and not more than 93.6 per cent. of water. 260 INORGANIC AGENTS Dose.—H. & C., 3i.-ii. (30.-60.); Sh. & Sw., 31.-i. (4.-8.) ; D., 3ss.-1i. (2.-8.). Actions and Uses.—Sulphurous acid decomposes organic matter, abstracts oxygen, and is transformed into sulphuric acid. The amount of sulphuric acid formed from the medi- cinal solution is not sufficient to interfere with its action in or upon the body. Sulphurous acid is a deodorant, deoxi- dizer, parasiticide and disinfectant externally. Solutions (1-4) are used as local stimulant and antiseptic applications to wounds, ulcers, or sores with foul discharges, and to kill the fungus growths producing ringworm. Sulphurous acid is employed as an antiseptic in indi- gestion, associated with flatulence, and has the same effect and value as the sulphites and hyposulphites which are used for the same purposes. Potassa SutpHurata. Sulphurated Potassa. (U.S. & BP.) Synonym.—Potassii sulphuretum, potassii sulphidum, liver of sulphur., E.; foie de soufre, Fr.; kalischwefel- . leber, G. Derivation.—Powdered and dried potassium carbonate, 200, is mixed with sublimed sulphur, and heated in a ecru- cible. Potassa sulphurata is a mixture of potassium hypo- sulphite and sulphide. © 3 KjC O; + 8 S=K,S,03; -+-- 2 K,8, + 3 CO,. Properties.—Irregular pieces of a liver-brown color, which by exposure to the air gradually absorb moisture, oxygen, and carbonic dioxide, and change to greenish-yellow. and finally to a gray mass containing potassium carbonate, hyposulphite and sulphate. The compound has.a faint odor of hydrogen sulphide, and a bitter alkaline taste. Soluble in 2 parts of water, with the exception of a small residue. Dose.—H. & C., 5 11.-iv. (8.-15.); D., gr.i.-x. (.12.6). Action Internal—Sulphurated potassa is composed chiefly of potassium trisulphide (K,8,) and of potassium thiosulphate (K,S,O;). Its action is that of the sulphides generally. These give off H,S in the bowel, which leads to purging and local irritation. When injected into a vein the —- , SULPHURATED POTASSA 261 sulphides induce -two notable phenomena in toxic doses. — First, they cause convulsions in mammals—owing to action on the cerebrum—and, in lethal doses, paralysis of the re- spiratory and vasomotor centres. Second, they produce alter- ation in the hemoglobin of the red corpuscles with formation of a body like methemoglobin and ealled sulpho-hemogoblin. In frogs this happens during life but in mammals apparently comes on immediately after death. Externally the sulphides in solution dissolves the horny epidermis and hair, and leads to irritation of the skin after prolonged action. The sulphides undergo oxidation in the blood and escape in the urine as sulphates and organic sulphur compounds and in the breath and sweat as hydrogen sulphide. Sulphurated potassa has been administered internally as a substitute for sulphur, but is only of value externally. Action and Uses External.—Sulphurated potassa is one of the most serviceable agents we possess in the treatment of chronic forms of skin diseases, as acne, lichen, but particularly eczema of the horse and dog. It is locally stimulant, alterative (?), and parasiticide. There is only one drawback to its general use, which is its exceedingly dis- agreeable odor. Peruvian balsam is frequently substituted for this reason in the treatment of skin diseases in dogs. A solution, ‘‘ yellow lotion,” is used in different strengths (1-8 to 1-15), according to the amount of stimulation which the skin will endure. The “ yellow lotion,” is a good agent for killing lice upon the skin. The following prescription will be found of benefit in canine practice: BR Potasse Sulphurate ................ 3 ii. ss. O@hlopalisn Mprccywitsate ve le se cinch ree onSSa OIURPATIISIE Fe totem aerate ciate yatele okereree Mii. ATEN BEE 9 5, rel 2tS ap dele o siatd-die ute eleta ga, < 3 iv. M. 8. External use. The chloral relieves itching and the anise disguises to some extent the odor of hydrogen sulphide. 262 INORGANIC AGENTS SECTION XI. Acids. Acipum Hyprocatoricum. Hydrochloric Acid. H Cl. (U.S. & B. P.) (Muriatie Acid.) Synonym.—Acidum hydrochloratum, 8. chlorhydricum, E.; acide chlorhydrique S. muriatique, Fr.; salzsaiire, G. A liquid composed of 31.9 per cent., by weight, of abso- lute hydrochloric acid, and 68.1 per cent. of water. (U.S. P.) Derivation.—Distil together sulphuric acid, sodium chloride and water. The resulting hydrochloric acid gas is passed into distilled water, while acid sodium sulphate remains in the retort and is further acted upon by sodium chloride. 2 Na Cl + H,S O, = H Cl + Na HSO,; then: Na HSO, + Na Cl = H Cl + Na,SO,. Properties.—A colorless, fuming liquid, of a pungent odor and an intensely acid taste. Spee. gr., about 1.163 at 15° ©. (59° F.) Miscible, in all proportions, with water and alcohol. Incompatibles.—Alkaline and other carbonates, and lead and silver salts. . c PREPARATIONS. ACIDUM HYDROCHLORICUM DILUTUM, ACIDUM NITROHYDROCHLORICUM, ACIDUM NITROHYDROCHLORICUM DILUTUM. Acidum Hydrochloricum Dilutum. Diluted Hydrochloric Acid. (U. S. & B. P.) . (Diluted Muriatie Acid.) Derivaution.—Hydrochloric acid, 100; distilled water, 219. Diluted hydrochloric acid contains 10 per cent. of absolute hydrochloric acid. (U.S. P.) Properties.—It does not fume in the air and is without odor. Spec. gr., 1.050. Otherwise corresponds to hydrochloric acid. (U.S. P.) Dose.—H., 3i.-ii. (4.-8.); C., Zii-iv. (8.-15.); Sh., 3 ss.-i. (2.-4.); Sw. & D., ™x.-xxx. (.6-2.). SULPHURIC ACID 263 | Acipum SutpHuricum. Sulphuric Acid. H,SO,. (USS.40..5.- EF.) Synonym.—Oil of vitriol, E.; acide sulphurique, huile de vitriol, Fr.; schwefelsaiure, vitrioldl, G. A liquid composed of not less than 92.5 per cent. by weight of absolute sulphuric acid, and not more than 7.5 per cent. water. Derivation.—Sulphurous anhydride (U.S. P.), generated by roasting iron pyrites, or sulphur, is passed into leaden chambers. Nitric acid is introduced with steam, and the sulphurous anhydride undergoes oxidation and hydration. 2 HNO, + 280, + H,O = 2 H,SO, + N,O,. The nitrous acid combines with oxygen and water in the air, and is re-transformed into nitric acid, acting con- tinually as a carrier of oxygen to sulphurous anhydride. Properties.—A. colorless liquid, of oily consistence, ino- dorous, and very caustic and corrosive. Spec. gr. not below 1.835. Miscible, in all proportions, with water and alcohol, with evolution of so much heat that the mixing requires great caution. (U.S. P.) Incompatibles. — Alkalies and carbonates, calcium and lead salts. PREPARATIONS, AcipUuM SULPHURICUM DiLUTUM, ACIDUM SULPHURICUM AROMATICUM. Acidum Sulphuricum Dilutum. Diluted Sulphuric Acid. (Urs2e&- Be Pi) Derivation.—Sulphuric acid, 100 gm.; distilled water, 825 gm. Properties — Diluted sulphuric acid contains 10 per cent.. by weight, of absolute sulphuric acid. Spec. gr. about 1.070, (U.S. P.) Dose.—H., 3i-ii. (4.-8.); C., 3ii.-iv. (8 -15.); Sh., 3ss.-i. (2.-4.); Sw. & D., Mx.-xxx. (.6-2 ). Acidum Sulphuricum Aromaticum. Aromatic Sulphuric Acid. (Uc 8: &B:-P,) Synonym.—Tinctura aromatica acida, P. G.; elixir vitrioli Myn- sichti, elixir of vitriol, E.; élixir vitriolique, teinture (alcool) aromatique sulphurique, Fr.; sdure aromatische tinctur, Mynsicht’s elixir, G. 2.64. INORGANIC AGENTS Derivation.—Sulphuric acid, 111 Ce.; tincture of ginger, 50 Ce.; oil of cinnamon, 1 Ce.; alcohol to make 1,000 Cc. (U.S. P.) Properties.—Aromatic sulphuric acid contains about 20 per cent., by weight, of official sulphuric acid, partly in form of ethyl sulphuric acid. Spec. gr. about 0.939. (U.S. P.) Dose.—H., 3 ss.-i. (2.-4.); C., 3i.-ii. (4.-8.); Sh., ™xv.-xxx. (1.-2.); Sw. & D., Mv.-xv. (.3-1.). Acipum Nirricum. Nitric Acid. HNO, (U.S. & B.P.) Synonym.—Acide azotique, Fr.; salpetersdure, G. A liquid composed of 68 per cent., by weight, of abso- lute nitric acid, and 32 per cent. of water. Derivation.Seven parts of sodium or potassium nitrate are distilled with fonr parts of sulphuric acid and water. KNO, + H,SO, = KHSO, + HNO.. Properties.—A colorless, fuming liquid, very caustic and corrosive, and having a peculiar, somewhat suffocating odor. Spec. gr. about 1.414. (U.S. P.) Incompatibles.—Alkalies and carbonates, iron sulphate, lead acetate and alcohol. PREPARATIONS. AcipUM NITRicum DiLuTUM, AciIDUM NITROHYDROCHLORICUM, AcIDUM NITROHYDROCHLORICUM DILUTUM. I, Acidum Nitricum Dilutum. Diluted Nitric Acid. (U.S. & B. P.) Derivation.—Nitric acid, 100; distilled water, 580. Diluted nitric acid contains 10 per cent., by weight, of absolute nitric acid. Spec. gr. about 1.057. (U.S. P.) Dose.—H., 3 i.-ii. (4.-8.); C., 3ii.-iv. (8.-15.); Sh., 3ss.-i. (2.-4.); Sw. & D., Mv.-xxx. (.3-2.). , II. Acidum Nitrohydrochloricum. Nitrohydrochloric Acid. (U.S. P.) (Nitromuriatic Acid.) Derivation.—Nitric acid, 180; hydrochloric acid, 820. Chemical composition uncertain. Properties.—A golden yellow, fuming and very corrosive liquid, having a strong odor of chlorine. The strong acid should always be freshly prepared and should be used in preference to the diluted acid. It may be made off hand by mixing 4 parts of nitric acid with 16 parts “Wree PHOSPHORIC ACID 265 . of hydrochloric acid. The mixture should remain in an open bottle nob more than half full, until the fumes pass off. Dose.—H., ™xx.-xl. (1.3-2.6); D., Miii.-v. (.2-.3). HI, Acidum Nitrohydrochloricum Dilutum. Diluted Nitrochloric Acid, (U.S. & B. P.) (Diluted Nitromuriatic Acid.) Synonym.—Acidum chloro-nitrosum, P. G.; aqua regia S. regis, — acide chloro-azotique S. chloro-nitreux, eau Regales, Fr.; salpetersalz- sdure, kénigswasser, G. Derivation. — Nitric acid, 40; hydrochloric acid, 180; distilled water, 780. Properties.—A_ colorless, or pale yellowish liquid, having a faint odor of chlorine and a very acid taste. Completely volatilized by heat. (U.S. P.) Dose.—H., 3i.-ii. (4.-8.); C., Zii-iv. (8.-15.); Sh., 38.-i. (2.-4.)3 Sw. & D., Mv.-xxx. (.3-2.). Acipum PuospHoricum. Phosphoric Acid. H,P O,. CU S.405 35.. P2) A liquid composed of not less than 85 per cent., by weight, of absolute orthophosphoric acid (H,P O,), and not more than 15 per cent. of water. (U.S. P.) Derivation.—Heat phosphorus with diluted nitric acid till nitrous fumes cease. P, + 5 HNO, + 2H,O = 3H, 2, + 5 NO. Properties.—A colorless liquid, without odor, but having a strongly acid taste. Spec. gr. not below 1.710. Miscible, in all proportions, with water or alcohol. (U.S. P.) PREPARATION. Acidum Phosphoricum Dilutum. Diluted Phosphoric Acid. (U.S. & B. P.) Derivation.—Phosphoric acid, 100; distilled water, 750. (U.S. P.) Diluted phosphoric acid contains 10 per cent., by weight, of absolute orthophosphoric acid. Spec. gr. about 1057. Dose.—H., 3i.-ii. (4.-8.); C., Zii.-iv. (8.-15.); Sh., 38s-*. (2.-4.); D., Wv.-xxx. (.3-2.) 266 INORGANIC AGENTS Actpum Aceticum. Acetic Acid. H C,H,0O,. (U.S. & B. P.) Synonyn.—Acetum purum, — acetum destillatum, P.G.; acide acétique dilué, Fr.; reiner essig, G. A liquid composed of 36 per cent., by weight, of absolute acetic acid, and 64 per cent. of water. Devrivation.— Distillation of dry sodium acetate with snlphuric acid and erystallization of the distillate. Na OC, HO, + H, SO, = HG, BO; Nad so. Properties. —A clear, colorless liquid, having a strong, vinegar-like odor, a purely acid taste and a strongly acid reaction. Spee. gr. about 1.048. Miscible with water or alcohol in all proportions. PREPARATION, _ Acidum Aceticum Dilutum, Diluted Acetic Acid. (U.S. & B. P.) Synonym.—Acetum concentratum, — acide acétique, Fr.; ver- diinnte essigsdure, G. . Derivation.—Acetic acid, 100; distilled water, 500. Diluted acetic acid contains 6 per cent., by weight, of absolute acetic acid. Spee gr. about 1008. Not employed internally except in the form of official aceta. Vinegar is impure diluted acetic acid, made by destructive distillation of wood, or by acetous fermentation and oxidation of alco- holic solutions, as cider. ; C.H,O H + O. = HC.H;0, + H»™. A temperature of 80° F., and the presence of the ferment or mould (Mycoderma aceti), are necessary. Acipum AcrtTicum GuLAcIALE. Glacial Acetic Acid. H C,H,O,. Synonym.— Acidum aceticum, P. G.; acidum aceticum concentratum, acetum gla¢iale, — acide acétique concentrée, esprit de vinaigre, vinaigre glacial, Fr.; essigsiure, eissesig, G. Derivation.—Same as acetic acid. Properties.—A clear, colorless liquid of a strong vinegar- like odor, and a very pungent, purely acid taste. Contains about 99 per cent. of absolute acid. Not used internally. TARTARIC ACID 267 Acipum Tarraricum. Tartaric Acid. H,C,H,O,. (U.S. &B.P.) Synonym.—Sal essentiale tartari,— acide tartrique, acide de tartre, Fr.; weinsdure, weinsteinsiiure, G. Derivation. — Boil acid potassium tartrate or argol (incrustation in wine casks) with chalk to form calcium tartrate. 2K HC,H,O, + CaC O, = CaC,H,O, +.K,C,H,O, + H,O + CO,. Add calcium chloride, which precipitates more calcium tartrate, and decompose with sulphuric acid. fie O, + Ca.C,H.0O, = H,C,H,0, +:Ca 8 O,. Evaporate solution. Calcium sulphate crystals separate and are removed, while tartaric acid crystallizes on further evaporation. Properties. -— Colorless, translucent, monoclinic prisms, or crystalline crusts, or a white powder; odorless, having a purely acid taste, and permanent in the air. Soluble in about .8 part of water, and in 2.5 parts of alcohol. Not commonly used in Veterinary medicine. Dose.—H., 3 ii.-iv. (8.-15.); D., gr.x.-xxx. (.6-2.). Acipum Cirricum. Citric Acid. H,C,H,O, (U.S. & B. P.) Synonym.—Acidum citri S. limonum, 8. limonorum, — acide citrique, acide du citron, Fr.; citrouensaure, G. Derivation.—Usually prepared from the lemon (Citrus lemonum), or lime (Citrus bergamia). Boiling lemon juice (containing 7 per cent. of citric acid) is treated with chalk to form calcium citrate. 2 H,C,H,O, + 3 CaCO, = Ca, (C,H,0,), + 3 CO, + 3 H,0. Calcium citrate is boiled with sulphuric acid and the resulting citric acid is obtained by filtration, evaporation and crystallization. Ca, (C,H,O,), + 3H,S O, = 2 H,OC,H, O,+ 38CaS O, Properties. — Colorless, translucent, right - rhombic prisms; odorless, having an agreeable, purely acid taste; efflorescent in warm air and deliquescent when exposed to 268 INORGANIC AGENTS moist air. Soluble in 0.63 parts of water and in 1.61 parts of alcohol. Dose.—H., 3 ii.-iv. (8.-15.); D., gr.x.-xx. (.6-1.3). PREPARATION. Syrupus Acidi Citrici. Syrup of Citric Acid. (U.S. P.) Citric Acid, 10; water, 10; spirit of lemon, 10; syrup to make 1000, Dose.—A4 lib. Acipum Lacticum. lactic Acid. H C,H,O,,. (U. 8) & BP) Synonym.—Acide lactique, Fr.; milchsaure, G. An organic acid, usually obtained by subjecting milk- sugar or grape-sugar to lactic fermentation. Composed of 75 per cent., by weight, of absolute lactic acid, and 25 per cent. of water. Properties.—A colorless, syrupy liquid, odorless, of a purely acid taste. Spec. gr. about 1.213. Freely miscible with water, alcohol, or ether. Dose.—H., 3 ii-iv. (8.-15.); D., W)xxx.- 31. (2.-4.). Other acids to be found in other sections. Action External.—The concentrated mineral acids are powerful escharotics, but in dilution are stimulant, astrin- geut, rubefacient, or vesicant, according to their strength. Acids have a great «ffinity for the alkaline juices of the tissues and blood, and weak acid solutions are thus neutral- ized. Strong acids coagulate albumin, probably by combin- ing with alkalies, which hold albumin in solution, and pre- cipitating especially the globulins of the tissues. When mineral acids are present in abundance the albumin first coagulated is afterwards dissolved (except nitric acid), and the corrosive action of the acids is extensive. Acids further destroy tissue by combining with water, for which they have also a great affinity, particularly sulphuric and phosphoric acids. The former withdraws water to such an extent that the tissues are carbonized and blackened. Sulphuric acid is more destructive of tissue and acts more extensively than ACTION OF ACIDS 269 the other mineral salts. Nitric acid is less caustic, and hydrochloric acid is the least corrosive. Nitric acid stains the parts yellow, and hydrochloric, white. The vegetable acids, as citric and tartaric acids, are slightly caustic, but are ee to the skin, and still more so to raw sur Pee and mucous membranes. An ounce of tartaric acid has caused death in man through its local effect. The action of the caustic alkalies is more widespread than that of the mineral acids. Diluted sulphuric and nitric acids are astringents, because of their power of condensing tissues, and also hemostatics in causing compression of blood vessels by contraction of the tissues about them. Nitric acid is com- monly employed externally, because its effect is limited by its own eschar, which is not dissolved by an excess of acid. Hydrochloric acid has no astringent effect and is not used externally for its caustic properties. The acids are antiseptic, but are less appropriate than other agents in most cases, on account of their irritant action. Free hydro- ehloric acid as it exists in the gastric juice (0.2-0.3 of 1 per cent.) 1s a powerful antiseptic ae even germicide. Action Internal.—Alimentary Canal.—The classical ex- periments of Pawlow have materially altered our concep- tions of the action of acids. We have shown (p. 18) that indirectly, by stimulating the formation of secretin in the stomach and intestines, they excite the activity of all ‘the glands giving rise to the secretions concerned with di- gestive activity. They all aid digestion. Hydrochloric acid is particularly serviceable in gastric anacidity, being the natural acid of the gastric juice. The mineral acids also possess a certain degree of antiseptic action on the contents of the digestive tract. Diluted acids are called refrigerants in imparting a sense of coolness to the skin and mucous mem- brane of the mouth, and, by augmenting the secretion of saliva, relieve thirst in eee The acids exert a local stimu- lant and astringent action upon the intestinal canal. Nitric acid is particularly a stimulant, sulphuric acid an astringent. Constitutional Action.—Almost all living matter poss- esses an alkaline or neutral reaction. An animal dies from acid poisoning even before its blood becomes neutral. The constitutional action of acids is seen after absorption of di- 270 INORGANIC AGENTS lute solutions. Acids are immediately converted into salts— as acid can not exist as such in the tissues or blood. In the ease of herbivora the fixed alkalies of the tissues and blood _ thus neutralize acid as it is absorbed. When the alkalies of the blood and tissues are consumed the animal dies. Her- bivora are very susceptible to acid poisoning, as in them the lessened alkalinity of the blood renders it unable to carry carbonic acid from the tissues to the lungs. When the tissues become flooded with carbonic dioxide, dyspnea, heart weakness, depression of the vasomotor centre, and death by failure of the respiration ensue. Carnivora are more resistant to acid poisoning because they possess a protective power whereby they are able to liberate free ammonia from their tissues and thus neutralize absorbed acid and save—to a considerable extent—the fixed alkalies in their blood and tissues. Acid is absorbed from the digestive tract as acid salts and in this form eliminated by the kidneys, which may lead to renal irritation and the presence of albumin and blood in the urine. . The urine of herbivora therefore becomes strongly acid and contains large quantities of the salts of the alkalies; that of carnivora holds an excess of ammonia and—to a ict de- an increase in potassium and sodium salts. The organic acids are also absorbed as salts of the , alkalies but do not usually reduce the alselinttyy of the blood or render the urine acid. * “ They are oxidized into carbonates in the tissues and may even alkalize the urine by their eliminaton as alkaline carbonates. The vegetable salts are infrequently used in veterinary medicine. The effect of the mineral acids on the body is due almost wholly to their hydrogen ion, to which gree they owe their activity. USES OF ACIDS OTL Diluted phosphoric acid relieves thirst and forms an agreeable cooling drink in fevers. Phosphoric acid is used as a tonic and reconstituent, but experiments have shown that phosphorus compounds of the body can not be built from inorganic forms of phosphorus. Poisoning.—If acid is spilled on the skin, alkalies should be applied, and in case of sulphuric acid the excess of acid should first be rubbed off, and then large quantities of very dilute alkaline solutions or soapsuds should be employed to avoid evolution of heat when the acid combines with water. When acids are swallowed, there is excoriation and sloughing of mucous membranes, difficulty in swallowing, vomiting of dark brown material and mucus (in animals capable of the act), severe colic, pain on movement, consti- pation, or, rarely, bloody diarrhoea. Occasionally some acid flows into the larynx during deglutition and cedema and suffocation rapidly ensue, There is inflammation of the upper part of the digestive canal, thirst, and collapse, with weak pulse and cold extremities. Softening, sloughs, hemorrhage and perforation of the mucous membrane of the mouth, gullet and stomach and small intestines are found post mortem. Treatment.—Soapsuds, sodium bicarbonate, lime water, magnesia, or other alkalies. Demulcents, as milk, white of ego, gum arabic and linseed tea. Opium and stimulants. _ Wash out the stomach with a large amount of alkaline solution. ; Uses External. — Strong mineral acids are used as caustics. One part of sulphuric acid is mixed with three parts of sulphur, or asbestos, to form a paste for the destruc- tion of morbid growths. The application of sulphuric acid is somewhat dan- gerous, as it is difficult to limit the action, and it is not by any means the best escharotic, nor so good as nitric acid, which produces less extensive destruction of tissue, and is a useful agent for the removal of tumors, for the cauterization of bites inflicted by rabid animals, and for the treatment of foul, sloughing wounds or foot-rot. yi INORGANIC AGENTS The action of nitric acid may be limited by surrounding the part to which the strong acid is applied with oil, or by washing the acid off with soapsuds. Glacial acetic acid is frequently employed to remove warts and small excres- cences. It is not so powerful as sulphuric or nitric acid. The acids in weak solution (31.-Oi.) are useful in relieving irritation of the skin, as in urticaria, for their astringent action upon piles, and to stop slight hemorrhages. Vinegar diluted with 3 parts of water may be used for the same purposes. Nitric acid (Tv.-xxx. to 71. of water) is a good antiseptic, stimulant and astringent application to indolent ulcers, wounds, or, in the mouth, for ulcerative or mercurial stomatitis. Uses Internal.—The acids are all of value in digestive disorders. Hydrochloric acid is useful in fever, to relieve thirst and aid digestion, when a few drops may be put in the drinking water. Hydrochloric acid is especially indi- cated for gastric indigestion with deficiency in the secretion of gastric juice, in convalesence, and for fermentation and tympanites in chronic-gastritis. Hydrochloric acid should be given after feeding, and is often combined with bitters. It acts as an antiseptic in addition to aiding digestion. Hypersecretion of hydrochloric-acid, or hyperchlorhydria, is said to be characterized by acid reaction of the secretion in the month, and a desire to lick alkaline earthy matters. It is best treated by alkalies after feeding. All the acids are. serviceable in the treatment of diarrhoea and intestinal indi- gestion. Aromatic sulphuric acid (with opitm) is more particularly valuable as a remedy for watery purging. Nitric and nitrohydrochlorie acids are of more use in diarrhoea with indigestion, jaundice, ‘and disordered hepatic functions. The latter acid is often combined with nux vomica in the treatment of intestinal indigestion, and is a valuable remedy in catarrhal jaundice of dogs. The mineral acids are of service in preventing the formation of phos- phatie calculi in horses. . -— + © ae BORIC ACID Ma Sulphuric acid is utilized in acute lead poisoning, as an antidote, to form insoluble sulphates in the bowels. The acids are given for their remote astringent action in arrest- ing or preventing hemorrhage (purpura) from internal organs, and in diminishing excessive sweating and mucous discharges; but are inferior to other agents in the treatment of these conditions. Administration. —The acids should all be thoroughly diluted with water for internal use. - Acipum Boricum. Boric Acid. H,BO, (U.S.&B. P.) Synonym.—Boracie acid, E.; acide borique, Fr.; acidum boracicum, sal. sedativum Hombergu, boérsadure, G. Derivation.—Made by evaporation and crystallization of solutions obtained by passing steam issuing from rocks in voleanic regions of Italy, through water; or by the action of hydrochloric or sulphuric acids upon borax. Na, B,O, (borax) + 10H,0+ 2H Cl=4H,BO,+2NaCl + 5H.,0. Recovered by filtration and recrystallization. Properties.—Transparent, colorless scales, of a some- what pearly lustre, or, when in perfect crystals, six-sided triclinic plates, slightly unctuous to the touch; odorless, . having a faintly bitterish taste, and permanent in the air. Soluble in 25.6 parts of water and in 15 parts of alcohol; also soluble in 10 parts of glycerin. It is feebly acid. Dose.—Foals ani calves., gr.xx.-xxx. (1.3-2.). PREPARATION. Glyceritum Boroglycerini. Glycerite of Boroglycerin. (U.S. P.) Synonym.—Glycerinum acidi borici, B. P.; glycerite of glyceryl borate, solution of boroglyceride. Boric acid, 310; glycerin to make 1,000. Solution prepared by heat (302° F.) Unguentum Acidi Borici, (10 per cent.) (U.S. & B. P.) Sop Boras. Sodium Borate. Na,B,O,. (U.S. P.) Synonym.—Borax, B.P.; natrum biboricum, boras, boras sodicus, E.; borate de soudre, Fr.; borsaéures natron, G. 274 INORGANIC AGENTS Derivation.— Natural deposits of the crude article occur as incrustations on shores of lakes in Nevada and California, which are purified by calcination and crystallization. Borax is also made by boiling boric acid with sodium carbonate. 4+ H,B O; + Na,C O; = Na.B,O, + C O,:+ 6 H, O. Properties.—Colorless, transparent, monoclinic prisms, or a white powder, inodorous and having a sweetish, alka- line taste. Slightly efflorescent in warm, dry air. Soluble in 16 parts of water at 59° F., and in 0.5 part of boiling water; insoluble in alcohol. At 176° F. it is soluble in one part of glycerin. Borax is slightly alkaline. ACTION OF BORIC ACID AND BORAX. Boric acid and borax are essentially mild, non-irritating antiseptics. These agents are practically harmless, as ordi- narily employed, yet death in man has been reported from absorption of a 5 per cent. solution of boric acid used for irrigation of the large cavities of the body, and fatalities have resulted from its external use and from the ingestion of quantities of boric acid. Three drachms of boric acid may be given daily to dogs, without causing any untoward effect. In man, borie acid poisoning has been exhibited by feeble pulse, subnormal temperature, vomiting, erythema and swelling of superficial parts, muscular weakness, involuntary evacuations, coma, anid disordered respiration. Boric acid is eliminated by the urine, sweat, saliva and feces. Borax tends to alkalize the urine, but neither borax nor borie¢ acid are diuretics. Borie acid and borax, like other antiseptics, relieve itching and destroy parasites upon the skin. Borie aeid exerts an antiseptic action upon the contents of the digestive tract and upon the urine. It is thought to possess some emmenagogue action. USES OF BORIC ACID AND BORAX. The value of boric acid and borax is chiefly surgical. 5 They are employed more commonly upon the mucous mem- Pa i ee USES OF BORIC ACID AND BORAX 275 branes of the eyelids, mouth, nose, vagina, urethra and bladder, for their non-irritating, antiseptic properties, and also to relieve itching and to destroy parasites upon the skin. Boric acid is in more frequent use than any other agent in simple catarrhal conjunctivitis, and may be com- bined to advantage with cocaine as follows: f Cocamss Hy drochlorss « «oi... 5 see cent bs gr.v.-X. Oey POET, ania vas oe a0 /a via sla we sv ee Fea ib: eo Od RET EO cain ev iona ea sincae oie ¢ eae vlan Zi. M ; S. Eye lotion. Borax is perhaps more appropriate in the mouth, being alkaline. It is applied by swab, in saturated solution, for aphthous and other forms of stomatitis. A saturated solu- tion (4 per cent.) of boric acid is useful as an injection for ozcena, cystitis and vaginitis. Borax in saturated solution assuages pruritus ani and vulve, and is employed as an application for ringworm. Boroglyceride is indicated for burns and wounds. A serviceable antiseptic dressing is made by soaking gauze in a boiling saturated solution of boric acid. The dried gauze contains boric acid, which crystallizes upon it as the solution cools. One part of boric acid in combination with four parts of zinc oxide forms a soothing, protective dusting powder for chafed surfaces, intertrigo, erythema and moist eczema in dogs. Boric acid is prescribed in 10 per cent. ointment for burns, eczema and psoriasis. It is perhaps the best remedy for canker of the ear in dogs (otitis externa). The ear should be syringed out with a 2 per cent. solution, dried with absorbent. cotton, and powdered with pure boric acid. The internal uses of boric acid are unimportant. It has been recommended and given as an emmenagogue, and as an intestinal antiseptic in fermenta- tive diarrhoea of foals and calves. Boric acid is often administered in human medicine to acidify the urine and disinfect the genito-urinary tract, although not so efficient as urotropin. 276 INORGANIC AGENTS SECTION XII. Class 1.—Carbon. Carbon is represented officially as follows: Carspo AntmMaALIs. Animal Charcoal. (U.S. P.) Synonym. — Bone black, E.; charbon, Fr.; thier (or) knochen-kohle, G. Derivation.—Bones freed from fat are exposed to great heat in close iron cylinders till ammoniacal vapors pass off. The resulting charcoal is pulverized and contains about 10 per cent. of carbon and 88 per cent. of calcium phosphate and carbonate. Properties. —Dull, black, granular fragments, or a dull black powder; odorless, nearly tasteless, and insoluble in water or alcohol. Dose.—H. & C., %i.-ii. (30.-60.); Sh. & Sw., Zii-iv. (8.- 15.); D., gr.xx.- 31. (1.3-4.). PREPARATION. Carbo Animalis Purificatus. Purified Animal Charcoai. (U.S. P.) Derivation.—Animal charcoal, 100, is boiled with hydrochloric acid, 300, and water to remove ash. Result filtered and residue on filter paper washed and dried. Properties.—A dull, black powder, odorless and tasteless; insoluble in water, alcohol or other solvents Dose.—Same as above. Carso Lieni. Charcoal. (U.S. & B. P.) Synonym.—W ood charcoal. Derivation.—Soft wood is charred by piling it in heaps, igniting, and covering it with sand and turf to prevent rapid combustion. Properties.—A black, odorless and tasteless powder, free from gritty matter. Insoluble in water or alcohol. Dose.—Same as animal charcoal. CHARCOAL Be Action.—Charcoal is essentially a Deodorant and Ab- sorbent. It possesses the power to absorb gases like other porous substances. Ordinarily it holds oxygen and when it comes in contact with decomposing matter it gives up its oxygen and at the same time absorbs the gaseous products of the decomposing substance. In this way it hastens the fermentation by oxidation and, while not a sufficiently power- ful oxidizer to act as a germicide or antiseptic, yet it may favor the growth of erobic rather than anerobic organisms. The latter particularly produce foul-smelling and _ toxic bodies. So it may be seen that charcoal acts directly to absorb gases and indirectly to prevent the formation of the more undesirable fermentations. It was formerly thought that charcoal only acted as an absorbent in the dry state but it is almost as efficient when wet. Charcoal is not absorbed and escapes from the bowels unchanged. ‘There is no material difference between the action of wood and animal charcoal. Externally charcoal acts as a Dessicant, Deodorant, and, indirectly, as an Antisep- tic by absorption of the body fluids on which germs subsist. If administered continually in large quantities charcoal may produce mechanical obstruction in the bowels, and it is therefore employed in conjunction with laxatives. Uses Hxternal.—Charcoal is applied as a dusting powder with astringents and antiseptics upon ulcers, galled and raw surfaces. The following combination is useful: charcoal, 4 parts; salicylic acid, 2 parts; burnt alum, 1 part. It is also used in flaxseed meal poultices upon foul, sloughing parts. Uses Internal.—Charcoal is employed occasionally in indigestion, chronic gastric and intestinal catarrh, and diarrhea, accompanied by flatulence and mucous discharges. Charcoal possesses the power of attracting and holding alkaloids in its substance, and so may be used in large doses as an antidote in poisoning by alkaloidal drugs, as opium, nux vomica and aconite. Its action is slow, and other means, as tannic acid, emetics and the stomach tube, are more efficient. 278 INORGANIC AGENTS CARBONEI DisutpHipum. Carbon Disulphide. C§,. (0.8.2) Synonym.—Carbonii bisulphidum, bisulphide of carbon, carbon sulphide, E.; carboneum sulphuratum, alcohol sul- furis, P. G.; sulfure de carbone, Fr.; schwefelkohlenstoff, G. Derivation. — Obtained from carbon and sulphur by distillation. Properties.—A clear, colorless, highly refractive liquid; very diffusive, having a strong, characteristic, but not fetid odor, and a sharp, aromatic taste. Soluble in 535 parts of water; very soluble in alcohol, ether, chloroform, and fixed volatile oils. Spec. gr. 1.268 to 1.269. Carbon disulphide vaporizes readily and is highly inflammable. . Actions and Uses.—Carbon disulphide is a rapid and powerful anzsthetic when inhaled, and also locally, when applied in spray upon the skin. It produces muscular weakness, coma, and, rarely, convulsions in toxic doses. It has been used as a counter-irritant in the form of vapor, to cause absorption of enlarged lymphatic glands. Favorable results have been reported by Perroncito, with carbon disulphide given in gelatine capsules to horses to destroy the larve of the bot fly (istrus equi). Three cap- sules, containing 10 grams each, for a horse, or 8 grams each for a colt, should be given at hour intervals, and followed in 12 hours by a pint of oil. Class 2.—Alcohol, Ether and Chloroform. AucoHot. Alcohol. C,H,OH. (U.S. P.) Synonym.—Spiritus rectificatus, B. P.*; spiritus vini rectificatissimus, alcohol vini, rectified spirit, E.; alcool, Fr.; weingeist, G.; spiritus, P. G. * Rectified spirit (B. P.) contains 90 per cent. of pure alcohol by volume (85.65 per cent. by weight). There are four official dilutions in the B, P. containing 70, 60, 45 and 20 per cent. of alcohol by volume respectively. ALCOHOL 279 Alcohol is derived directly from fruit sugar, and indi- rectly from starch. The grains, as wheat, rye, corn; and potatoes, supply starch most economically. The starch in these substances is converted into glucose by heating with very dilute sulphuric acid, or by fermentation with malt. Glucose is further acted upon by yeast containing the Torula cerevisixe, which converts 15 per cent. of glucose into alcohol. and carbonic dioxide. C,H,,O, = 2C,H,O H + 2C O.. The weak alcohol resulting is subjected to repeated distillation until sufficiently pure and concentrated. In the natural fermentation of {fruit sugar in grape juice, during the formation of wine, the amount of alcohol is self-limited to 15, rarely 20 per cent., since the ferment is killed by an amount of alcohol greater than this. Derivation.—The official alcohol is derived from rectified spirit, by maceration, first with anhydrous potassium car- bonate, then freshly fused calcium chloride, and finally by distillation. Properties.—A liquid composed of about 92.3 per cent., by weight, or 94.9 per cent., by volume, of ethyl alcohol (C,H,O H), and about 7.7 per cent., by weight, of water (U. S. P.) A transparent, colorless, mobile and volatile liquid, of a characteristic, rather agreeable odor, and a burning taste. Spec. gr. about .820 at 15° C. (59° F.). Miscible with water in all proportions and without any trace of cloudiness. Also miscible with ether or chloroform. It is readily volatile at low temperatures, and boils at 78° C. (172.4° F.). It is inflammable and burns with a blue flame. Dose.—H. & C., 3i.-iii. (30.-90.); Sh. & Sw., 3 ii-iv. (8.-15.); D., 31.-ii. (4-8). PREPARATION, Alcohol Dilutum. Diluted Alcohol. (U.S. P.) A liquid composed of about 41 per cent., by weight, or about 48.6 per cent., by volume, of absolute ethyl alcohol (C2 Hs O H), and about 59 per cent. of water. (U.S. P.) Derivation.—Alcohol, 500; distilled water, 500. x 280 INORGANIC AGENTS AtcoHnot ApsotutumM. Absolute Aleohol. C,H,O H. (U, S&B. P.) . Ethyl alcohol, containing not more than 1 per cent., by weight, of water. Derivation.—Percolation of the purest alcohol through quicklime, out of contact with the air, and redistillation in vacuo. Properties.—Transparent, sol eTIeS. mobile and volatile liquid, of a characteristic, rather agreeable odor, and a burning taste. Very hydroscopic. Spec. gr. uot higher than 0.797 at 15° C. (69° F.) ALCOHOL Droporatum. Deodorized Alcohol. (Non-ofiicial.) A liquid composed of about 92.5 per cent., by weight, or 95.1 per cent., by volume, of ethyl alcohol (C, H, O H), and about 7.5 per cent., by weight, of water. Derivation.—Distillation of alcohol with about 2 per per cent. of pure fused sodium acetate. Properties.—Similar to alcohol, except as regards odor. Spiritus Frumentt. Whisky. (U.S. P.) Synonym. — Eiau-de-vie de grains, Fr.; whiskey korn- branntwein, G. . Derivation.—An alcoholic liquid obtained by the distil- lation of the mash of fermented grain (usually of mixtures of corn, wheat and rye), and at least two years old. Properties. —An amber-colored liquid, having a distine- tive odor and taste, and a slightly acid reaction. Its specific gravity should not be more than 0.930, nor less than 0.917, corresponding, approximately, to an alcoholic strength of 44 to 50 per cent., by weight, or 50 to 58 per cent., by volume. Contains no more than traces of fusel oil. The alcoholic liquors owe their flavor or bouquet to ethers which are only developed in course of time. The amylic alcohol, ALCOHOL 281 or fusel oil in whiskey is therefore converted into ethers, which give the characteristic flavor to whiskey. Dose.—H. and C., 3ii.-iv. (60.-120.); Sh. & Sw., 3i.-ii. (80.-60.); D., 3i.-iv. (4.-15.). Sprrirus Vint Gauuici. Brandy. (U.S. & B. P.) Synonym.—Spirit of French wine, E.; eau-de-vie, cognac, Fr.; Frantzbranntwein, G. Derivation.—An alcoholic liquid obtained by the distil- lation of the fermented unmodified juice of fresh grapes, and at least four years old. Brandy is somewhat astringent and is often not made from the distillation of wine, but is a factitious preparation. Native brandy is said to be purer, but is usually inferior in flivor to that of foreign manufacture. Brandy contains 59- 47 per cent. of absolute alcohol by weight; 46-55 per cent. by volume. Dose.—Same as that for whiskey. Spiritus JUNIPERI Composirus. Compound Spirit of Juniper. (U:-S..P.) Derivation.—Oil of juniper, 8; oil of caraway, 1; oil of fennel, 1; alcohol, 1,400; water to make 2,000. Compound spirit of juniper is similar to gin in its thera- peutic action. Contains about 15 per cent. more alcohol. Gin is made by distillation of fermented malt and juniper berries. Gin differs from the other alcoholic preparations therapeutically in being more diuretic. Dose.—Same as that for whiskey. Rum. (Not official.) Rum is made from a fermented solution of molasses by distillation. It contains, by weight, from 40 to 50 per cent. of absolute alcohol. Rum does not differ physiologically from alcohol. There is no authoritative Latin name for rum. Dose.—Same as that for whiskey. 282. INORGANIC AGENTS Vinum AtBum. White Wine. (U. 5:23 Derivation.—An alcoholic liquid made by fermenting the juice of fresh grapes, the fruit of Vitis vinifera (nat. ord. vitacez), free from seeds, stems, and skins. Properties. — A pale amber or straw-colored liquid, having a pleasant odor, free from yeastiness, and a fruity, agreeable, slightly spirituous taste, without excessive sweet- ness or acidity. The Pharmacopeeia directs that the wine should contain from 7 to 12 per cent., by weight, of absolute aleohol. California Hock and Reisling, Ohio Catawba, Sherry, Muscatel, Madeira and the stronger wines of the Rhine, Mediterranean, and Hungary, come within the phar- macopceial limits. Wines containing more than 14 per cent. of alcohol, are usually fortified, 7. e., have alcohol or brandy added to them, and much imported Sherry and Madeira contain 15 to 20 per cent., by weight, of absolute alcohol. Vinum Ruprum. Red Wine. (U.S. P.) Derivation.—An alcoholic liquid made by fermenting the juice of fresh colored grapes, the fruit of Vitis vinifera (nat. ord. vitaceze), in presence of their skins. Properties.—A deep-red liquid, having a pleasant odor, free from yeastiness, and a fruity, moderately astringent, pleasant and slightly acidulous taste, without excessive sweetness or acidity. Should contain not less than 7, nor more than 12 per cent., by weight, of alcohol. Native Claret, Burgundy, Bordeaux, and Hungarian wines may be included within the pharmacopeeial limits of vinum rubrum. Port (vinum portense) is fortified with brandy during fermenta- tion, and contains 15 to 25 per cent., by weight, of absolute alcohol. Port is astringent from tannic acid in the grapes, skins and stalks, or the astringency may be due to logwood. Red wines are said to be rough, contain tannic acid and therefore are astringent. Dry wines are those which con- tain little sugar. The wines develop ethers with age, and these improve their flavor and action. eee ALCOHOL 283 Champagne contains about 10 per cent. of absolute al- cohol and carbonic acid gas, which acts as a local sedative upon the stomach. Ale, stout and beers contain from 4 to § per cent. of alcohol, together with bitters and malt extracts. Cider contains 5 te 9 per cent. of absolute alcohol. Imported Sherry (vinum exericum, B. P.), 15 to 20 per cent. of absolute aleohcl. Alcohol is the solvent most commonly employed in pharmacy, dissolving alkaloids, resins, volatile oils, balsams, oleo-resins, tannin, sugar, some fats and fixed oils. Action External.—When applied in dilution to mucous membranes raw surfaces or wounds, alcohol is a stimu- lant and local anesthetic; while in concentration, it is irri- tant and even caustic, coagulating mucus and albumin. If alcohol is allowed to evaporate from the unbroken skin, cooling of the surface and contraction of the superficial blood vessels ensue, with diminished secretions of sweat; but when alcohol is rubbed into the skin, it is absorbed, takes up water, hardens the integument and causes temporary vascular dilatation. Alcoholic aqueous dilutions containing 60 to 70 per cent. of absolute alcohol are among the most valuable skin disinfectants. Absolute alcohol, or the undiluted commercial alcohol, have no germicidal action on dry bacteria, and alcohol in less than 40 per cent. strength is too weak. Alcohol is equal in germicidal action to 3 per cent. carbolic acid solution. Action Internal.—Alecohol acts locally upon the mucous membrane of the alimentary canal, as described above, and if swallowed in concentration it produces congestion and white patches in the mouth by coagulating albumin upon the mucous membrane. The secretion of saliva is increased. In small doses the more powerful alcoholic liquors, as whis- key and brandy, aid digestion by stimulating locally the gastric circulation, secretion, movement and appetite. Aleohol, except in great dilution, tends to inhibit the action of the digestive ferments—gastric and pancreatic— and in so far antagonizes its beneficial influence on gastric digestion just noted. So, while often aiding digestion, al- cohol may fail on this account in some cases. In large amounts, aleohol destroys the action of the peptic and pancreatic ferment, causes inflammation of the 984 INORGANIC AGENTS walls of the stomach and perverts the normal secretion into a mucous discharge. Alcohol is slightly astringent in the di- gestive tract, and may relieve pain by its local anesthetic action upon the stomach, and spasm, by stimulating the neryous mechanism controlling the stomach and bowels, and so co-ordinating the peristaltic movements. Circulation—A tremendous change in the position and practice of the profession in regard to the stimulant action of alcohol has been wrought by the accumulating evidence of experimenters. It is no longer regarded as a heart stim- ulant from a physiological standpoint although in disease it has not altogether lost its reputation in this respect. At present it is impossible to explain this contradictory condi- tion. The reason for the supposition that alcohol is a heart stimulant was based on its action in increasing the pulse — rate in man. In animals diluted alcohol does not affect either the rate or force of the heart, except in poisonous doses, when the pulse is slowed and weakened owing to weakening of the cardiac systole and dilatation of the heart cavities. In man the increased pulse rate is attributable to muscular and mental activity produced by alcohol. The blood. pressure is not materially altered by medic- inal doses of aleohol. There is, however, marked dilatation of peripheral vessels following the use of alcohol, as seen in the flushing of the face in man. Whether this is due to action on the central or periph- eral vasomotor system is unknown. The dilatation of vessels is certainly not general or blood pressure would be lowered. But there is a redistribution of blood occasioned by alcohol, which appears to be of signal value in certain morbid con- ditions as chills. In fever the slowing of the pulse, some- times produced by alcohol, is thought to be due to its quieting effect on the central nervous system. There is a transient stimulation of the heart induced by the ingestion of strong alcoholic solutions in acting re- flexly on the circulatory centres through irritation of the upper alimentary mucous membrane. Large doses of alcohol depress and paralyze the vaso- constrictor centres and heart muscle. —— ALCOHOL 285 Respiration.—The respiration is not appreciably in- fluenced by medicinal doses of alcohol in animals. In man slight reflex stimulation occurs, with increase in rate, owing to peripheral excitation of the alimentary tract. Enormous doses paralyze the respiratory centres. Temperature-—The temperature, both in health and fever, may be lowered by alcohol, because alcohol causes re- Jaxation of the peripheral blood vessels and loss of heat by radiation from the skin.” The larger the quantity of alcohol ingested, the greater the fall of temperature. In alcoholic narcosis, vasomotor paralysis and dessened move- ments lead to great loss of heat, particularly if the animal be at the same time exposed to cold. In small. doses, alcohol may sometimes increase the temperature in man by leading to excitement and muscular movements, but the sensation of warmth perceived in man following the use of alcohol is generally fallacious, and is simply due to flushing of the vessels of the skin and stomach. Some of the lowest temper- atures ever observed have been in drunken persons exposed to cold. Tissue Change.—Metabolic activity is not altered to any degree by the action of alcohol in ordinary amounts. In serving as a non-nitrogenous food, of course, aleohol may influence carbonic dioxide exhalation as do other foods of its kind. But the drug does not exert a specific depressing action on the blood corpuscles or cell protoplasm to hinder oxidation, as was formerly thought. Deductions drawn from the action of alcohol on tissue change as shown by carbonic dioxide and urea elimination are faulty. Alcohol increases or diminishes tissue change and oxidation only in proportion as it stimulates or interferes with muscular movement. In the elimination of nitrogen that es- caping as uric acid is greater than normal, while that as urea is relatively less. Nervous System.—Moderate doses of alcohol stimulate, while excessive quantities depress and paralyze the nervous system. This action is similar to that exerted upon the circulatory organs. The local effects of alcohol upon the peripheral nerves resembles the action after absorption upon the system generally. The nervous system is affected in nearly the same order and manner as by anesthetics, and 286 } INORGANIC AGENTS the same stages may be observed. The stages include the stimulant, depressant and paralytic. The law of dissolution is demonstrated by alcohol, as the more highly organized centres, and those more recently developed in the process of evolution, are the first to succumb, and following out this order the medulla, the first of the higher centres to be devel- oped, is the last to be influenced by the drug. In accordance with this law the cerebrum is first acted upon. The period of excitement is brief and is due in a considerable degree to the increased cerebral circulation and flushing of the brain. It is essential to emphasize the fact that by far the most apparent and decided action of alcohol is one of depres- sion upon the nervous system as a whole. Many experi- menters—as Schmiedeberg and Bunge—affirm that alcohol acts only as a depressant to the nervous system from the very outset. An increasing mass of evidence corroborates this view. The apparent enhanced mental activity in man is, ac- cording to this theory, simply due to lack of inhibitory con- trol over the higher cerebral centres. Hence the freedom of speech and lack of modesty. Similarly the activity of the spinal reflex centres is thought to follow failure of inhibition. The mental excitement in man is chiefly due to exciting surroundings and does not occur in many persons nor in animals. While the fact that aleohol is no more a nervous than a circulatory stimulant is now being generally accepted, the author has not yet seen fit to change his original statements in this book. i , Alcohol has certainly an apparent primary stimulating effect on nerve centres and it is yet to be positively proven that alcohol has no real: actual stimulating effect on the nervous system. The stimulating influence .of alcohol upon the spinal centres is more marked in the lower animals than in man, because the brain is proportionately small and poorly developed in the former. The primary stimulating effect of alcohol is shown in man by increased mental activity and apparent brilliancy, but acute reason- ing and judgment are not enhanced, and in many cases there is almost immediate mental confusion and drowsi- ness induced. In man there is emotional excitement and the functions of speech and imagination are stimulated ALCOHOL 287 in the primary stage, but depression is soon noted in the loss of judgment and reasoning power, emotional conirol, decent restraint and speech. The patient cries, shouts, sings or laughs and talks inccherently. In the lower animals the stimulation of the higher and seusory psychical cerebral centres, with exhilaration, is rarely observed, but depression is seen in stupor and muscular incodrdination. Stimulation of the cerebral motor centres is shown by motor excitement. In man, following the symptoms described above, there is incoordination of muscular movements, first of those more highly and recently organized, such as are employed in writing, and then the muscular movements more remotely developed are affected, and the person is unable to walk, and finally there is complete paralysis of the motor centres and muscles. The staggering and uncertain gait of drunken people occurs not only because the cerebral motor and cerebellar centres are depressed by alcohol, but also because of loss of sensation and touch, or muscular sense, which is essential in maintaining the equilibrium. In relation to the spinal cord, primary stimulation of the reflex centres is more marked in anima!s than in man, as has been pointed out. In animals this stimulation causes motor excitement, so that the patient trembles, jumps about, or strikes out with the feet. Depression of the reflex centres occurs in the latter stage of poisoning, and is exhibited by involuntary defecation and micturition; sensation and voluntary motion are lost. The motor nerves and muscles are not generally paralyzed, except by the local action of alcohol. The medulla finally becomes depressed and paralyzed, so that respiration, which is first stimulated, now fails, and the heart muscle becomes paralyzed and stops beating. The action of alcohol upon the nervous system may be summarized with a fair degree of accuracy, as stimulation and then depression of the parts enumerated below, and in the following order : . 288 INORGANIC AGENTS ; Cerebral psychical centres. Spinal centres. Cerebral sensory centres. Sensory, reflex and motor. Cerebral motor centres. Medullary centres. Cerebellum. Vasomotor (early depression). Respiratory. Horses and dogs are comparatively susceptible to alco- fol, ruminants slightly so. An amount of alcohol equivalent to a pint of whiskey has killed a sound horse, while four ounces of whiskey will cause death in dogs if vomition be prevented by ligature of the cesophagus. Primary motor excitement is followed by unsteady, stag- gering gait, ‘and coma in fatal eases. Skin.—Alcohol dilates the peripheral vessels, and there- fore brings more blood to the sudoriparous olands, and ex- cites their functional activity. It is thus a diaphoretie. Kidneys.—Aleohol acts as a diuretic. The exact mode of this action is unknown. Nutrition.—Aleohol is a food, mee like other non-nitrog- enous foods, supplies force and energy in its’oxidation, takes the place of fats and carbohydrates, and may form fat in the body. It also protects food and tissue proteids from combustion. We are ignorant of the fate of alcohol after absorption, but we do know that the greater portion is de- composed and is not eliminated. Alcohol is most advant- ageous as a food in fever, or in conditions associated with weak digestion, since it is readily absorbed and assimilated. Alcohol causes dulness and lessened power for mental or physical work in man, and in normal conditions is not desirable food unless there is a deficiency in the ordinary diet. In acting as a substitute for fat and carbohydrates, alcohol assists the accumulation of fat. Elimination.—When alcohol is ingested in ordinary doses it is practically all eee and none but the most trivial amount is eliminated, 7. e., five to ten per cent. The greater the quantity absorbed the larger the amount elimin- meg by the urine, breath, sweat and feeces, both relatively and absolutely ; but under no circumstances after the most enormous doses does the elimination exceed 25 per cent. of the quantity ingested. Milk is not affected in quality or quantity through the ingestion of alcohol by the animal secreting it. ALCOHOL 989 Summary.—Aleohol is externally refrigerant, astring- ent, anhidrotie and antiseptic, and if applied so that ob- sorption occurs, it is rubefacient. On raw surfaces it is slightly anesthetic. Alcohol is internally a stomachic, car- minative and slight local anesthetic in the digestive tract. Aleohol is only reflexly a heart stimulant through its irri- tant action on the alimentary tract before absorption. In dilution and after absorption it is not a heart stimulant. Alcohol is a narcotic and its chief action is in progressively depressing and paralyzing nerve centres. It supplies force and is a food. Alcohol is a diuretic, diaphoretic, and anti- pyretic in dilating peripheral vessels and in causing sweat- ing. . Acute Poisoning.—In coma and muscular relaxation, the treatment consists in the external application of heat and counter-irritants; while strychnine, digitalis and atropine should be given subcutaneously and followed up with am- monia by the mouth. Uses External.—Aleohol is applied to the unbroken skin, on cotton or lint, to bruises, for its local refrigerant and astringent action in relieving pain and congestion. Diluted to 70 per cent. strength, aleohol forms an antiseptic and local anesthetic application to wounds, and like most antiseptics, relieves itching, particularly when combined with 1 to 2 per cent. of carbolie acid. Alcohol diluted with one-third part of water makes one of the best known agents for hand dis- infection. It is relied upon entirely in some of the best hospitals in the country, in addition to thorough scrubbing in soap and water. Uses Internal.—Digestive Tract.—Aleohol is a useful remedy to promote appetite and assist digestion. The drug should be given immediately before eating or with the food, properly diluted, and often advantageously with egg and milk during fever or convalescence from acute diseases. Aleohol is frequently combined with bitters, as compound tincture of gentian, when employed as a stomachic. Acute Diseases.—Aleohol finds its greatest field of use- fulness in the treatment of febrile diseases, notably influenza and strangles and pneumonia in horses. In such conditions it flushes the vessels of the skin and distributes the blood 290 INORGANIC AGENTS more equally, allowing the heart to receive more blood and thus overcoming internal congestion. It is impossible to reconcile the clinical remedial effects of alcohol with its action on healthy animals. The results of recent researches—especially as showing an absence of stimulation of the circulation and respiration by alcohol— has led to its lessened use as a therapeutic remedy. Never- theless the enormous practical experience of some of the most acute clinicians of the past and present, that alcohol renders service in the diseases named herein, does not permit one to hastily sweep it aside as a therapeutic agent. We may summarize its worth in acute diseases as follows: It is a food and one which is not only digestible but which in itself may aid digestion. It has more food value than sugar. It dilates peripheral vessels and equalizes the - circulation. In man one of its most potent effects is probably in acting as a narcotic and quieting the nervous system. A high temperature does not contra-indicate its use but it is not desirable in the early stages of acute inflammatory disorders. Alcohol is particularly serviceable in asthenic diseases—as purpura—and in continued fevers associated with much depression—as in puerperal and other forms of septicemia. In fevers aleohol sometimes causes the heart to beat more slowly. Whether this be due to stimulation of the inhibitory apparatus or invigoration, directly or indirectly, of the weakened organ, we do not know. The pulse, respiration and nervous system are our euides, and the object is to bring the functions into a more normal condition. Alcohol should therefore reduce the fre- quency of the pulse and respiration, when they are too rapid, and should cause the animal to become quieter. If these results are obtained, the use of the drug should be persisted in; if otherwise, administration should be stopped. Small and repeated doses are more appropriate in fever. Alcohol is one of the most rapidly effective agents at our command in syncope and eardiae failure from various causes—as surgical shock, severe hemorrhage, collapse, ex- haustion, snake bite, and following exposure to cold. In these conditions it should be given in the form of spirits diluted with only an equal part of very hot water. It may act in 5 i ALCOHOL 291 these cases by stimulating reflexly the medullary, cardiac and respiratory centres by its irritant action on the alimentary tract. From our physiological data alcohol should not be of service in such conditions as a stimulant. Its narcotic action in serving as a nervous sedative in lessening anxiety and pain and so offsetting the effects of shoek—may account in some measure for its worth. Thus morphine is the best drug to use in surgical shock—even better than alcohol. Af- ter exposure to cold it is easy to explain the benefit derived from alcohol in its action in dilating the peripheral vessels and directly antagonizing the results of cold. Experiments ov. healthy animals regularly receiving moderate doses of alcohol have proved that they are more susceptible to innoc- ulation with bacteria and toxins than controls. In disease, however, clinicians greatly differ on this point, Hare even going so far as to cjaim his experiments show that alcohol increases the power of the blood to overcome germs in disease. Here again the results of the effects of aleohol in health and disease clash. Alcohol is a chemical antidote in earbolic acid poisoning, and besides overcomes the shock produced by the latter; undiluted whiskey or brandy may be used. Administration.—Veterinary practitioners are fortu- nately exempt from any moral considerations in relation to their medicinal use of alcohol. Rum, gin and whiskey are more commonly employed than the other alcoholic prepara- tions, although diluted alcohol is practically as valuable. Gin is indicated when a diuretic action is important. Brandy, being more astringent, is given to dogs with diar- rhoea, and, combined with cracked ice in small quantities, relieves vomiting. Sherry may also be administered to dogs with advantage. The dose of the various alcoholic liquids depends upon the quantity of alcohol contained in them. Animals will usually take alcoholic preparations volun- tarily if largely diluted with water, milk or gruel. Whiskey should be diluted with about 4 parts of water when given in drench, unless the reflex action is desired, when it is admin- istered in considerable doses with an equal amount of hot water. Diluted alcohol, undtluted whiskey or brandy are in- jected subcutaneously when a rapid action is imperative. 292 INORGANIC AGENTS Airugr. . Ether, (C,:H,),0. ss 2) Synonym. — Ather purus, B. P.; ether fortior, pure ether, E.; éther hydrique pur, Fr; reiner ether, G. A liquid composed of about 96 per cent., by weight, of absolute ether or ethyl oxide [(C,H,),O], and about 4 per cent. of alcohol containing a little water. Derivation.—Obtained by distillation of alcohol with sulphuric acid. There are two steps in the production of ether; sulphovinic acid and water are formed in the first step. H,S 0,4 C,H,O = C,H, 428 0,7, O03 au phovinie acid is then further acted upon by alcohol. 0.H,, H 8:0, + CE, Of =(CHD 0 hse distillate is freed from water by agitation with calcium oxide and chloride, and subjected to redistillation. Properties. — A transparent, colorless, mobile liquid, having » characteristic odor and a burning and sweetish taste. Spec. gr. .725 to .728 at 59° F. Soluble in about 10 dimes its volume of water at 59° F. Miscible in all propor- tions with alcohol, chloroform, benzine, benzol, fixed and volatile oils. Ether boils at about 37° C. (98.6° F.), and it should therefore boil when a test tube, containing some broken glass and half filled with it, is held for some time in the hand. Ether is highly volatile and inflammable; its vapor, when mixed with air and ignited, explodes violently. The color of light blue litmus paper moistened with water should not be changed when the paper is immersed in ether for 10 minutes. Upon evaporation ether should leave no residue. Ether is a solvent for fats, oils, alkaloids, resins, gutta percha and gun cotton. Ether vapor is heavier than air, and, consequently, etherization should never be done above a light or fire. Dose.—H. & C., 3 i.-ii. (30.-60.); Sh. & Sw., 3 ii-iv. (8.-15.); D., WLx.- 3 i. (.6-4.). PREPARATIONS. ABther Purificutus. (B. P (Ether freed from most of its alcohol ae water.) Spiritus Attheris, Spirit of Ether. (U.S. & B. P.) Ether, 325; alcohol, 675. (U.S. P.) Dose—Same as for ether. omy. ETHER 293 Spiritus Ztheris Compositus. Compound Spirit of Ether. (eUn S2 ca bree es) ; Synonym.—Hoffman’s anodyne. Ether, 325; alcohol, 650; ethereal en, 25, (U.S. P.) Dose.—Same as for ether. Action Eaternal.—Ether evaporates rapidly from the skin, and abstracts so much heat in the process that the superficial parts are cooled, benumbed, and even frozen. This action is taken advantage of in spraying ether from an atomizer upon the skin (with or without cocaine injection) to cause local anesthesia in minor surgical operations, as opening abscesses. The spray should not be applied more than a few minutes, or freezing, damage to the tissues, and retardation of the healing process will ensue. If ether is applied with friction, or if evaporation from the skin is prevented by bandaging, it will act as a rubefacient. Action Internal.—Digestive Organs.— Ether is an ir- ritant to the mucous membrane of the digestive tract, and should be given only when considerably diluted with water. Ether stimulates secretion, motion, and increases local blood supply of the stomach. Ether, in concentration, resembles aleohol and ammonia in stimulating the heart reflexly, by its irritant action upon the alimentary canal, before it ‘has time to be absorbed. It relieves pain and spasm in the di- gestive tract by codrdinating or restoring nervous control over the stomach and bowels. Circulation.—Ether is reflexly a stimulant to the heart and vasomotor centres through peripheral irritation of its vapor, as in the case of alcohol. Some authorities allow no direct stimulating action (Cushny). In poisonous doses, or after prolonged inhalation, the circulation becomes depressed and weak. Nervous System.—KEther is chiefly depressant to nerve centres. Its apparent primary stimulation of the central nervous system is somewhat doubtful and many experi- menters deny that it directly stimulates the nerve centres at all. Ether depresses and abolishes the functions of ali the great nerve centres in the following order, and with the fol- lowing results: 1. The cerebrum (with loss of consciousness). 2. Sensory spinal tract (loss of sensation). 294. INORGANIC AGENTS 3. Motor spinal area (loss of motion and partial loss of reflex action). 4. Sensory medullary centres. 5. Motor medullary centres (failure of respiration). Ether does not affect the nerves or muscles when inhaled or ingested. Ether depresses the action of the nerves, how- ever, when applied locally. | Respiration.—The respiratory centre is stimulated by inhalation or ingestion of therapeutic quantities of ether. Paralysis of the respiratory centre occurs in the last stage of ether poisoning. Ether vapor is irritant to the respira- tory mucous membrane, and causes coughing and choking during inhalation. It is not an appropriate anesthetic, there- fore, in inflammatory conditions of the respiratory tract, be- cause its vapor is given in greater concentration than in chloroform. In giving ether by the drop method undue irri- tation of the lungs is avoided and such conditions as bronchitis, pulmonary edema and pneumonia. Ether vapor excites the peripheral ends of the trifacial nerve in the face, and the vagus nerve in the lungs, so that temporary arrest of respiration often occurs when a fresh supply of ether is added during inhalation. Temperature.—The temperature of the body may be raised during the stage of excitement and struggling, but prolonged etherization leads to loss of heat, owing to evapo- ration of ether from the lungs, and general depression of the nervous system. Elimination.—FEther is eliminated principally from the lungs. Recent experiments indicate that ether causes con- traction of the renal arteries, with diminution in the size of the kidneys, suppression of urine and albuminuria. Ether damages the kidneys, however, less than chloroform, which sometimes leads to fatty degeneration. Acetone has been found in the urine of 90% of patients in human practice within 18 hours of etherization (through a closed cone). Death may sometimes occur in coma, follow- ing ether anesthesia, with rapid pulse and breathing and the odor of acetone in the breath. This occurs less often than with chloroform (which see, under Metabolism). Uses.—Apart from its value as an anesthetic, ether is mainly of service for two purposes. First: in collapse, CHLOROFORM 295 syncope, or “ sinking spells,” due to poisoning, or natural causes. Ether may “be given by the mouth, or subcutan- eously into the eS tissue, to avoid abscess, It is to be compared with, and is an efficient substitute for, ni- troglycerine, or aa nitrite, as a rapid, circulatory stimu- lant. Ether should not be given as a stimulant, however, when such an agent is required during or following anes- thesia. Second: In spasmodic colic or tympanites, ether relieves pain, spasm and flatulence. The following prescrip- tion will be found useful for the horse: R AEENE EIS soos sin o hfe 3 sx wishes peers st dep set adel 5 i CHUGEGTOR ADI Scan 2 nea eae eeh aaah wateceteL ots Eat MEITG: OPM Cectins ater kes Hae tale cottons’. ves ay die M. et f. haustus. S. Give at once in a pint of cold water. Ether is a good antispasmodic remedy for asthma, hic- cough or “thumps,” in the horse, and has a narcotic action upon tape and lumbricoid worms. When used for the latter purpose, ether should be followed by.a purge. Ether may be employed in the enema to narcotize and remove the Oxyuris curvula of the horse. Administration.—Ether should be given in gelatine cap- sules; mixed with two parts of cracked ice and water; or with equal parts of brandy or whiskey, to avoid undue irritation of ether and its vapor upon the mucous membranes during deglutition. CuLororormum. Chloroform. CHCl,. (U.S. &B. P.) Synonym.—Chloroformum purificatum, purified chloro- form, E.; chloroformium, P. G.; formylum trichloratum, ehloroforme pur, Fr.; reines chloroformum, G. A liquid consisting of 99 to 99.4 per cent. , by weight, of absolute chloroform, and 1 to 0.6 per cent. of aleohol, Derivation.—Alcohol and water are heated in a still to pat. ©. (100° F’.), when chlorinated lime is added and Plorctonn 3 is evolved. The chemical action is very compli- eated. Chloroform, free from chlorinated compounds, is also made from acetone and chlorinated lime by distillation. Calcium acetate, hydrate and chloride result as bye products. 20,H,O + 6 C2 0-Cl, = 2 C H Cl, + Ca (C,H,0,). i+ 2Ca O.H, + 3 Ca Cl. 296 INORGANIC AGENTS For tests and purification, vid. U. S. P. Properties.—A heavy, clear, colorless, mobile and diffus- ible liquid, of a characteristic, ethereal odor, and a burning, sweet taste. Spec. gr. not below 1.490 at 15° C. (59° F.). Soluble in about 200 times its volume of cold water, and in ail proportions in alcohol, ether, benzol, benzine and the fixed and volatile oils. Chloroform is volatile even at a low temperature, and boils at 60° to 61° C. (140° to 141.8° F.). It is not inflammable, but its vapor in the presence of a naked flame undergoes decomposition with the formation of noxious gases, chiefly chlorine. This has caused death during chloroform inhalations. Chloroform is a solvent for fats, resins, oils, balsams, gutta percha, wax and many alka- loids. Dose.—H. & C., 3 1.-11. (4.-8.) ; Sh. and Sw. > i =x omer. (1:3-2..) 5 SD.) Mise (ADS); PREPARATIONS. Aqua Chloroformi. (U.S. & B. P.) (Saturated Solution.) Used as vehicle in cough and diarrhea mixtures for dogs. Linimentum Chloroformi. (U.S. & B. P.) Chloroform, 300; soap liniment, 700. (U.S. P.) Spiritus Chloroformi. (U.S. & B. P.) Chloroform, 60; alcohol, 940. (U.S. P.) Dose.—H. & C., 3 i.-ii. (30.-60.); Sh. & Sw., 3 ii-iv. (8.-15.); D., 5 SS.-i. (2-4.). Action Baternal——Chloroform acts as a rubefacient if rubbed into the skin, or prevented from evaporation by bandaging. In evaporating from the surface it produces mild refrigeration. Chloroform penetrates the skin more easily than many other agents, and is employed for. this ‘reason to aid the absorption of belladonna and other drugs used in liniments. Chloroform possesses some local anzes~ thetic action upon mucous membranes, raw surtaces, or when rubbed into the skin. Action Inter irritant in concentration, but, properly diluted, stimulates the flow of saliva and increases the secretions, motion, and blood supply of the stomach. Chloroform has a local anzes- thetic and antiseptic action in the alimentary canal, and by its stimulant effect in restoring the normal state of nervous i CHLOROFORM 297 - and muscular tissue, relieves spasm, pain and flatulence in the stomach and small intestines. Circulation.—Chloroform exerts an ever increasing de- pressing influence upon the heart muscle, its ganglia, and the vasomotor centres. Vasomotor depression leads to dilatation of the arte- rioles and leaking of blood into the veins, with consequent venous engorgement (particularly of the abdomen), and arterial anemia. Failure of respiration in chloroformiza- tion is secondary to cerebral anemia, and chloroform kills, primarily by vasomotor depression. (Leonard Hill and Hare. ) The ventricles dilate and all cardiac muscular contrac- tility is lost in fatal poisoning. Death, however, occurs almost invariably in healthy animals during chloroform in- halation from respiratory failure associated with circula- tory depression. The heart usually continues to beat after cessation of breathing. Death from syncope occurs occa- sionally, and circulatory depression is greater and occurs more suddenly than with ether. Rarely sudden death occurs in the beginning of anesthesia from reflex inhibitory arrest of the heart produced by the inhalation of concentrated chloroform vapor. The degree of concentration is of the ut- most importance. A great deal of chloroform may be given for a long period if it is greatly diluted with air. It is not the amount but the rapid absorption of concentrated vapor which kills. With ether the vapor may be greatly concentrated with- out danger; with chloroform the difference between the neces- sary concentration for anesthesia and that which means danger is slight. As chloroform anesthesia proceeds, the pulse becomes rapid from the depressing effect of chloro- form upon the vagus centre. Respiration.—Chloroform does not markedly affect the respiration, when inhaled in proper dilution for an ordinary period, or when ingested in small doses, but after long con- tinued inhalation, or when large quantities have been swal- lowed, depression and paralysis of the respiratory centre ensues. Since asphyxia leads to inhibition and heart fail- ure—besides being dangerous in itsel{—the respiration should 298 INORGANIC AGENTS always be watched as carefully during chloroform as in ether inhalation. Nervous System.—Chloroform depresses the nervous system as described under ether; that is, the cerebrum, sen- sory and motor spinal tract, and sensory and motor centres of the medulla. Chloroform, although generally following the order noted, affects the nervous system more rapidly, ivregularly and persistently than ether, and therefore is more dangerous. It occasionally happens that some of the reflexes are abolished by chloroform before sensation has been an- pulled, and irritation of a sensory nerve produced during operation may reflexly stimulate the inhibitory centres (in- stead of increasing vascular tension as in health), and so cause heart failure. Operations should never be performed, therefore, under chloroform until complete anesthesia is se- cured. The nerves are not influenced by the constitutional action of chloroform, although the latter is a local irritant and anesthetic to them. Temperature.-—The temperature is reduced by the con- tinual inhalation of chloroform through its depressing action on the heat producing centres, and because heat loss is in- creased by evaporation of chloroform from the lungs. Antiseptic Action.—Chloroform prevents the growth of micro-organisms, but does not influence that of the unorgan- ized digestive ferments. Chloroform’s antiseptic properties may be utilized in preserving solutions for subcutaneous injection. Saturated aqueous solutions are used for this purpose. Metabolism.—Death occasionally follows chloroform- ization from fatty degeneration of the heart, liver and kid- neys. Chloroform apparently leads to imperfect oxidation of nitrogenous bodies and to production of acid‘in the tis- sues ith the formation of acetone which is eliminated in the breath and urine. Death occurs in coma in acetone pois- oning from chloroform, as happens in diabetes mellitus. “Elimination. —Chloroform is chiefly eliminated by the lungs and slightly by the kidneys, but is also decomposed in part in the body. Uses Eaternal.—Chloroform is employed in liniment to relieve pain and produce counter-irritation in muscular rheu- matism and strains. ————— ANESTHESIA 299 Uses Internal.—Chloroform is of service internally in the treatment of four conditions: 1. Intestinal colic, and flatulence. 2. Spasm, as in spasm of the diaphragm in horses. 3. Diarrhea. 4. Cough. Chloroform alleviates pain in colic by restoring the functions of the nervous and muscular mechanism of the bowels, by relieving spasm, and also by its local anesthetic action. It stimulates motion and secretion; it is an antiseptic in the digestive tract, and, in these ways, overcomes flatulence. Chloroform should be combined with opium in diar- rhoea and colic. It is administered in spirit or water to assuage cough. Administration.—Chloroform may be administered in 5 parts of glycerin; in emulsion with white of egg or accacia; or as the spirit, diluted with water. AN ASTHESIA. Anesthesia is commonly divided into three stages: the stimulant, anesthetic and paralytic. The so-called “ law of dissolution ”’ is illustrated by anesthetics, as the more highly organized (cerebral) centres are the first to succumb, while the lower centres (medulla) are the last to be affected. The anesthetics resemble other narcotics in producing a primary condition of stimulation of the nervous system, which is followed by depression. In the first stage of. anesthesia there is often struggling and excitement. This is partly due to the physiological action of the drug and partly to fright. In this stage the functions of the brain are stimulated and then depressed. The higher functions are the first to be excited, and the effect produced is very similar to that of beginning alcoholic intoxication. The lower motor functions are next stimulated, inducing struggling and motor excite- ment.* In the first stage of etherization, the local irritant action of the vapor causes choking and coughing, and also induces struggling. The respiratory and cardiac centres are temporarily stimulated, the pulse and respiratory move- ments are increased in force and frequency, and blood ten- sion is raised. ‘The smaller animals may vomit during the * As recent researches show ether, like alcohol, to be depressing to nerve centres from the outset it is probable that the excitement in anzsthesia is due to the local irritation of the throat and fright. With the drop method of etherization in man there is little or no struggling and excitement. 300 INORGANIC AGENTS first stage of anesthesia. A subdivision of the first stage, sometimes described as the anodyne stage, occurs when sensation is lost, before consciousness and _ voluntary motion. Short operations, as extraction of teeth, have been done by men upon themselves in the anodyne stage of anzs- thesia, without pain. The anesthetic stage is that condition characterized by absence of consciousness, sensation, motion, and partial loss of reflex action, and is that state suitable for operations. The stimulating action of the anesthetic has ceased and there is now depression of the cerebral functions, the motor and sensory tract of the cord, and, to a partial extent, the reflex centres. The muscles are com- pletely relaxed, and the patient lies absolutely motionless. The conjunctive fail to respond to irritation, 7.e., winking is not produced when the conjunctival membrane is lightly touched with the finger. Occasionally the muscles are seen to be rigid and twitching during this stage of etherization, although sensation and consciousness are absent. The respiration and pulse should not be particularly altered during the anesthetic stage, unless danger threatens. In the last stage, narcosis, or poisoning, is beginning, and there is Heprescion of the three great medullary centres, controlling the heart, respiration and vascular tension, and also the lowest reflex centres of the cord, so that the urine and feces are passed involuntarily. Micturition frequently occurs in the first stages of anesthesia and should not of itself be con- sidered a danger signal. The pulse becomes rapid, feeble and irregular; the breathing is at first stertorous, and then the respiratory movements become shallow and weak, with considerable intervals intervening between them. The pupils are often dilated. The pupil is said to be a guide during anesthesia, especially with chloroform, since ae is contracted during the anesthetic stage and dilates quickly when danger approaches. Death, however, occurs in animals with either dilated or contracted pupils. With the former, probably from asphyxia; with the latter, from syncope; and the pupil should not be regarded as an unfailing sign. The foregoing stages are conventional, and are’ not in any case so clearly defined in practice as they are described theoreti- cally upon paper. The first stage may be either absent or prolonged, and the last stage should not be reached at all. ANZSTHESIA 301 COMPARISON OF ETHER WITH CHLOROFORM. ETHER. More diffusible. Inflammable. Irritating; may induce bronchitis, pulmonary edema and_pneu- monia, unless properly di- luted (see drop method, p. 306). Administered slightly _— diluted with air. Reflexly, stimulant to heart, ex- . cept in enormous quantities. Reflexly, stimulent to vasomotor centres, except as above. Respiratory centres not so easily depressed as by chloroform. Larger quantity required. Less rapid; stage of struggling and excitement longer. More expensive. Fatal from respiratory failure. CHLOROFORM. Vapor heavier. Less irritating. Not inflammable. More danger from shock during imperfect anzsthesia. Depresses powerfully, heart, res- piratory and vasomoter centres in large doses. Acts more quickly, and persistently. Smaller quantity required. Cheaper. Proportion of deaths to inhala- tions, 5 times greater than with ether.* Death occurs from respiratory failure combined with circula- tory depression, or later from fatty degeneration of the inter- nal organs, or from coma due to acetone poisoning. Occasionally fatality results from reflex inhibitory arrest of the heart. profoundly, It will be seen that all the advantages are in favor of chloroform, except that of safety. sive than chloroform, but cheaper than a funeral.” “Ether is more expen- (Edes. ). ACCIDENTS AND DANGERS ATTENDING ANZXSTHESIA. Respiratory failure and asphyxia may occur from giv- ing too much of the anesthetic and from mechanical ob- struction in the air passages. The tongue may fall back upon the epiglottis and prevent the free entrance of air. The latter accident is obviated by pulling the tongue forward with the hand, or, in the case of the smaller animals, by means of forceps, or suture passed through the tongue. Mucus, blood or vomitus may obstruct the mouth, pharynx, larynx, or trachea, and should be removed if possible by swabbing with absorbent cotton. To prevent excessive se cretion of mucus in the air passages, it is wise to give tropine subcutaneously fifteen minutes before etheriza- tion. The head should be extended and the lower jaw of the patient held forward during anesthesia, and no impediment to the free movement of the chest is allow- * The mortality is about 1 in 3.500 chloroformizations : and about 1 in 16,000 ether- izations in human practice. Chloroform is 31-2 times more depressant to nerve centres, and 8 times more depressant to the heart than ether. 302 INORGANIC AGENTS able. Struggling is to be avoided, as far as_ possible, since it leads to irregular respiration and asphyxia, and causes the anesthetizer to push the inhalation, strains the heart, and favors cardiac dilatation, with chloroform. Struggling may be prevented to some extent by giving the anesthetic well diluted with air at the outset. Asphyxia results also from tetanic fixation, or relaxation of the res- piratory muscles. The signs of asphyxia include cyanotic mucous membranes, muscular twitchings, shallow, feeble, slow and irregular breathing, with long intervals between the respiratory movements, and dilation of the pupils. If death occurs, the heart continues to beat after the breath- ing stops. The condition of the diaphragm during etheriza- tion is an important guide. At first the contractions of the diaphragm are so vigorous that the viscera are forced backward, and the abdominal wall bulges outward during inspiration. As the inhalation is prolonged the diaphragm becomes flaccid and powerless, the respiratory movements are shallow, and the breathing thoracic. The abdominal contents may then be drawn forward during inspiration into the thoracic cavity, so that the abdomen is retracted (Hare). When the latter condition is seen, etherization should be stopped instantly. | Heart failure occurs more frequently with chloroform, but does occasionally result from the action of ether upon animals with a fatty or otherwise weak heart. Cardiac depression is shown by a weak, irregular and rapid pulse, and pallor of the mucous membranes. The respiratory movements are sustained after the heart ceases to beat in fatal cases. Operations should never be done under chloroform before the patient is fully under the influence of the anesthetic, as irritation of a sensory nerve caused by even a slight surgical procedure may cause death by reflexly stimulating the vagus and inhibiting the heart. Such an accident is not likely to occur with ether, and minor operations are often done with safety during the first stage of anesthesia (primary anesthesia) when con- —— ACCIDENTS AND DANGERS ATTENDING ANESTHESIA 303 sciousness and sensation are lost and the muscles begin to relax. Shock from hemorrhage, or prolonged and severe sur- gical operations, may lead to fatalities during anesthesia, and it sometimes occurs when an operation is begun before the patient is fully under the influence of an anzsthetic— particularly chloroform—as described above. In practice, these causes of danger, 7.e., respiratory failure, circulatory depression and shock, are usually combined. We have already seen that asphyxia leads to circulatory disorder, and both may be associated with surgical shock. The following embraces the proper treatment of all these conditions, and should be followed in every case where danger threatens during anesthesia: 1, Remove the anzesthetic and allow plenty of fresh air. 2. See that there is no mechanical obstruction to the movements of the chest, or to the free entrance of air. Pull forward the tongue and lower jaw and extend the head. 3. Invert small animals, particularly with chloroform, to allow blood to flow to the brain. 4. Use forced, artificial respiration with bellows and rubber tube introduced into larynx. Practice ordinary artificial respiration in small animals by carrying the fore- legs outward and forward till they meet in front of the head, and then bring them back till they touch, and com- press the sides of the chest. These movements should be re- peated twenty times a minute. Massage over the heart, together with artificial respiration, is useful in sudden ecar- diac arrest in small animals. Artificial respiration may be done in the horse by two persons compressing intermittently one side of the chest with the knees and hands. Rhythm- ical traction of the tongue, at intervals of five seconds, has proved successful in restoring respiration. Dash hot or cold water or ether upon the chest or epigastrium; or use the faradic battery to stimulate respiration by moving the electrodes over the chest and abdomen. Stretch the sphincter ani apart by placing the thumbs in rectum and separating them with force. This is a powerful reflex stimulus to heart and respiration. 304 INORGANIC AGENTS 5. Give subcutaneous injections of strychnine and digi- talis. Administer nitroglycerin on the tongue, or inhalation of amyl nitrite. In chloroformization, give strychnine and atropine hypodermatically ; and, in shock, saline infusion as below. Do not use alcohol or ether as stimulants, for their action resembles that of the anesthetics. 6. Use hot (115° F.), high, rectal injections of salt solution (one heaping teaspoonful to the quart) in case of surgical shock with feeble pulse and subnormal temperature resulting from hemorrhage or other cause. Two to four quarts for large animals, and one pint to one quart for smaller animals. Saline infusion is still more efficient. (See “Saline Infusion,” p. 732.) CHOICE OF AN ANAESTHETIC. Ether and chloroform are the only anesthetics of any importance in veterinary medicine. The A. C. E. mixture, — containing alcohol (one part), chloroform (two parts), and ether (three parts), possesses no particular value, and is not so safe as ether. While chloroform is inferior to ether in the matter of safety, it may be given to horses by an experienced and careful persor without much danger. It is commonly the most suitable anzsthetic for the horse, for the following reasons: It is less expensive; whereas several pounds of costly ether are required to produce anesthesia, a few ounces of chloroform will accomplish the same result. Chloroform inhalation is much easier of administration, more rapid, and causes less struggling. It may be used without any special inhaler, and may be given to animals in the upright position. It should not be given if fatty heart is suspected. Chloroform may be employed for all animals during parturition, as it is less dangerous in this condition and because only enough is needed to produce relaxation of parts to relieve pain, to assist dilatation of the os and manual operations done to rectify faulty position of the foetus. Chloroform is indicated in all cases where the actual . PRACTICAL ANESTHESIA 305 cautery is used in the neighborhood of the mouth. Ether is the most suitable anesthetic for cats and dogs, unless the animal is suffering from bronchitis, emphysema or asthma, when chloroform is more appropriate. Chloroform, being more rapid and less irritating, may in any case be employed to begin anwsthesia, which should then be maintained by ether. The use of anesthetics is contraindicated in anemia if the hemoglobin is reduced below 59 per cent. PRACTICAL ANASTHESIA. The horse should be starved for twelve hours, and should receive a cathartic twenty-four hours before anzs- thetization, in order to afford more room for the respiratory movements and prevent accidents in casting.* A specially constructed inhaler, or nose bag, strapped about the head, may be employed for convenience. Harger recommends placing a sponge wrapped loosely in flannel, in the upper nostril, as the animal lies upon his side upon the ground, and after a few minutes a similar sponge is introduced into the lower nostril. Chloroform is then administered in continuous drop doses from a bottle having a cork nicked upon the side sufficiently to allow the anesthetic to flow out in this small quantity. The nostrils should be previously smeared with vaseline to afford protection from the irritation of the chloroform. If the operation is prolonged, anesthesia may be carried on with ether. It is not essential to cast a horse before chloroformization, but the animal should be con- trolled with side lines, and a twitch should be placed upon the nose, unless an inhaler is used. Since there is com- monly more or less struggling, it is, however, more satisfac- tory to cast an animal before anesthesia is begun. The writer has given chloroform in several instances to horses in the standing position until they fell or were pushed over upon a straw bed, with the aid of only one assistant. In thus producing anesthesia, a sponge covered with a towel was used, and this was saturated with about half an ounce * Hypodermic injections of morphine (see footnote, p. 391) fifteen minutes’ before anesthesia is often of advantage. It diminishes excitement and allows ot the use of asmaller amount of the anesthetic. It is very important that all pre- liminary procedures should be done—as casting, preparation of the operative field, etc.—before the chloroform is begun, to lessen the necessary amount of the anes- thetic. A drachm or two of chloroform may be placed on each sponge as an initial dose, to hasten the anesthesia, while after this the method of constant dropping is to be preferred. 306 INORGANIC AGENTS of chloroform, and held at first three inches from the animal’s nose, in order that the vapor should be thoroughly diluted with air. From half a drachm to a drachm of chloroform should be added from time to time, always allowing plenty of air, and inhalation may be continued for an hour with comparative safety. The anezsthetizer should give his whole attention to the work, and watch carefully the respiration, pulse and pupil, for any sign of danger. If any arise, the anesthetic should be removed and treatment pursued as recommended in the previous section. Dogs should be fasted for twelve hours before etheriza- tion, in order to avoid vomiting during anesthesia. It is necessary to muzzle dogs before anesthesia is begun. This may be done by tying a strong tape about the nose, bringing both ends up between the ears, over the top of the head, and then tying them together in a knot, and finally carrying the ends down, one on either side of the neck, and fastening them underneath. A wire muzzle may be used to control the dog more conveniently, and the ether is then poured upon @ sponge within the muzzle and the muzzle is covered with cloth to keep out the air. More recently the writer has found the following method and appliance most suitable for dogs and small animals. A thin metal cone open at both ends (rolled over to present smooth edges) and taper- ing—to fit the general outline of an animal’s nose—is used. Inside this is a second cone made of coarse wire mesh, and between the two are placed several layers of gauze or towelling. Ether is given by the drop method. That is, a wedge-shaped piece is cut from the cork of the ether bottle or can, and a little piece of gauze is laid in this, which acts like a wick and allows a continual dropping when the bottle is inverted. This is the safest method and requires the least ether. The cone may be held in place by a strap over the back of the head. Dogs may also be anesthetized by placing them in a covered pail, tight box or barrel, or by driving them into : USES OF ANESTHESIA 307 their kennels, and dropping in cloths, sponges, or absorbent material saturated with chloroform, while excluding the | outer air. The smailer animals can be destroyed in a humane and satisfactory manner by this method. USES OF ANSTHESIA. Anesthetics are not employed as frequently as is desirable in veterinary medicine. Anzesthesia entails skilled assistance, increased expense, and danger; but, on the other hand, facilitates rapidity and asepsis during opera- tions by lessening struggling, and should be employed to relieve suffering where a local anzsthetic is impracticable. The owner of an animal should be made to understand the extra risk and expense attending operations under anesthe- sia, and his consent should be secured before using ether or chloroform. The general indications for anesthetics embrace all severe, prolonged, and delicate operations. The more special indications are as follows: In abdominal opera- tions, as ovariotomy, herniotomy and reduction of hernia. In operations for retained testicle, scirrhus cord, castration, and in dystocia to cause dilatation of a rigid and otherwise urdilatable os, to assist the operator in remedying faulty positions of the foetus by relaxation of the parts, and to facilitate instrumental delivery in bitches. Anesthesia is also indicated in removal of tumors, in arytenectomy, excision of the eyeball or parts of the hoof, extraction of teeth, reduction of dislocations, setting of fractures, and to relieve severe pain in colic, and to overcome spasm in chorea and hiccough, or convulsions due to poison or natural causes. Chloroform is used to destroy sick, injured or aged horses, but is not so rapid, convenient, or effective as the 44 calibre revolver, or rifle. The bullet should be directed toward a point upon ‘he forehead at the intersection of two imaginary lines drawn from either eye up to the root of the opposite ear. 308 INORGANIC AGENTS Class 3.—Nitrites. Sprritus ASrHERIS Nrrrost. Spirit of Nitrous Ether. (U.S. & B. P.) Synonym. —Sweet spirit of nitre, spiritus nitri dulcis, spiritus nitrico-ethereus, H.; éther azoteux alcoolisé, liqueur anodine nitreuse, Fr.; versiisster sallpetergeist, G. An alcoholic solution of ethyl nitrite (C,H,NO,), yieid- ing, when freshly prepared, not less than 11 times its own volume of nitrogen dioxide (NO). Derivation.—Dissolve sodium nitrate, 770, in water; add deodorized alcohol, 550; introduce sulphuric acid, 520, previously diluted with water; distil in flask and condense. Wash distillate with ice water to remove alcohol, with cold solution of sodium carbonate to remove traces of acid; agitate with potassium carbonate to remove traces of water ; filter, and add sufficient deodorized alcohol to make the mixture weigh 22 times the weight of the nitrous ether to which it was added. Froperties. — A clear, mobile, volatile, inflammable liquid, of a pale-yellowish or faintly greenish-yellow tint, having a fragrant ethereal and pungent odor, free from acidity, and a sharp, burning taste. Spec. gr. 0.820. Mixes freely with water and alcohol. Dose.—H. and C., % i.-iv. (30.-120.); Sh. and Sw., 3 i.-iv. (8.-15.); D., Nx.- 31. (6-4). Smaller doses every two hours, diarphoretic. Larger doses, repeated three times daily, diuretic. Amyuis Nirris. Amyl Nitrite. C,H,,NO, (U.S. P.) Synonym.—Amy] nitris, B.P.; amylum nitrosum, amyl- ether nitrosus, amylo-nitrous ether, E.; azotite d’amyl, Fr.; amylnitrit, G. A liquid containing about 80 per cent. of amyl (prin- cipally iso-amyl) nitrite, together with variable quantities of undetermined compounds. ee ae ee ee eee SPIRIT OF GLYCERYL TRINITRATE 309 Derivation.—Obtained through distillation of nitric acid and amylic alcohol. Distillate purified hy sodium carbonate. HNO, + ©,H,, OH = C,H,,NO, + 2 H,O. Properties.—A. clear, yellow or pale-yellow liquid, of a peculiar ethereal, fruity (banana) odor, and a pungent, aromatic taste. Spec. gr. 0.870 to 0.880. Dose (by inhalation).—H., 3ss.-i. (2.-4.); D., Mii.-v. (.12-.3). When given internally the smaller doses should be used dissolved in alcohol. Spiritus Giyceryiis Nirratis. Spirit of Glycery] Trinitrate, Spirit of Glonoin. O©,H, (N O,),. (U.S. P.) Synonym.—Liquor trinitrini, B.P.; spiritus glonoini, propenyltrinitrate, glonoin trinitrate, spirit of nitroglycerin, trinitrate of glyceryl, trinitin, E. An alcoholic solution containing one per cent., by weight, of nitroglycerin. It is probably decomposed in the blood with the formation of potassium and sodium nitrite. Derivation. — Nitroglycerin is obtained by dropping pure glycerin upon a mixture of sulphuric and nitric acids, kept cool by ice, and purified by washing with water. The official one per cent. solution is not explosive unless it becomes concentrated by evaporation to an extent exceeding 10 per cent. Properties. — A clear, colorless liquid, possessing the odor and taste of alcohol. Caution should be exercised in tasting it, since even a small quantity is liable to produce a violent headache. Spee. gr. .826 to .832. Dose.—H., 3. s8.-i. (2.-4.); D., TlLi.-1i. (.06-.12). ACTION OF THE NITRITES. Exiernal.—Spirit of uitrous ether, like ether, produces a cooling and local anesthetic action, owing to its evapora- tion upon the skin. Amyl nitrite has a slight depressing action upon the peripheral ends of the sensory nerves. Internal.—The actions of spirit of nitrous ether, amyl 310 INORGANIC AGENTS nitrite and nitroglycerin are essentially the same. Spirit of nitrous ether should contain 4 per cent. of ethyl nitrite. Analysis of 68 samples taken at random from drug stores, resulted in showing that a teaspoonful of the best specimen contained as much ethyl nitrite as a pint of the worst, with all manner of variations between these extremes. To be of value as a nitrite, sweet spirit of nitre should be freshly prepared by a reliable chemist. Circulation.—The important action of the nitrites centres upon the heart and blood vessels. The arteries and veins all over the body (but particularly of the head and belly) become relaxed and blood tension is lowered by the nitrites. This action is no doubt peripheral, and is due to direct depression of the unstriated muscle of the vessel walls. The heart beats more rapidly in consequence of the lessened vascular resistance and direct depression of the in- hibitory centre and because a diminished blood pressure indirectly depresses the vagus centre and often stimulates the accelerator. The arterioles being dilated in the heart, as elsewhere, there follows an increased cardiac blood supply, nutrition and force. It is probable that the nitrates also stimulate the cardiac ganglia, and increase the force as well as the rapidity of the heart. This is shown by the fact that in small doses blood pressure is raised by the nitrates, de- spite the vascular dilatation. Poisonous doses depress the heart muscle and the pulse becomes slow and weak. Nervous System.—The nitrites depress the spinal motor centres. This is more marked in the frog than mammals, however. Neither the motor nor sensory nerves nor cere- brum appear to be influenced by medicinal doses of nitrites. Reflex excitability is lessened. Muscles—Amy1 nitrite paralyzes both unstriated and striated muscular tissue when applied locally; and the ni- trites, when administered internally, relieve spasm of mus- cular tissue by their depressing action upon the motor nerves and muscles. Kidneys.—Nitrites often increase the flow of urine by widening the renal arteries supplying the glomerules. But the general lowering of blood pressure may prevent an in- erease of local pressure in the kidney, when urinary secre- tion will be diminished. ee ACTION OF THE NITRITES 311 Blood.—In poisoning by the nitrites, the oxidizing power of the blood is lost. Both the venous and arterial blood become of a chocolate hue from the conversion of the normal oxy-hemoglobin into meth-hemoglobin. The latter yields up oxygen very sparingly. Respiration.—The respiratory movements may be in- ereased both in force and frequency by medicinal doses of nitrites, but paralysis of the respiratory centre and asphyxia occurs in fatal poisoning. Elimination.—The nitrite group rapidly escape in the urine as nitrites and nitrates of the alkalies. The amyl, of amyl nitrite, is completely oxidized in the body, while of nitroglycerin part is eliminated unchanged in the urine. Summary.—The nitrites dilate arterioles, increase the rate of the heart-beat, depress the spinal motor area, and lessen reflex action. They relieve spasm and may increase the secretion of urine. Poisoning.—F atal poisoning is extremely rare as an accidental occurrence. Recovery from a quantity 120 times greater than the normal dose of nitroglycerin, has been reported in human practice. The physiological effects of the nitrites are more noticeable in man, owing to his bare skin. Immediately following the inhalation of amy] nitrite, the face becomes extremely flushed, and throbbing of the vessels of the head, with a feeling of tremendous pressure and headache, ensue. These symptoms are due to vascular dilatation. There is dizziness, the heart is rapid and violent, and the pulse full, frequent and easily compressible. The respiratory movements are increased. These symptoms occur after a full medicinal dose. In poisoning there is pallor, vomiting in man, trembling, weakness, cyanosis and failure of respiration and_ heart. The treatment is included in the administration of ammo- niacal and alcoholic stimulants, together with the subcuta- neous injection of ergotin, strychnine and atropine, to restore the vascular tone. The nitrites differ sufficiently to call for a word con- cerning their individual characteristics. It is important to emphasize the fact that their action, as a whole, is transient. Amyl nitrite diminishes vascular tension, as shown by the sphygmograph, within a minute of its inhalation, and this 312 INORGANIC AGENTS condition lasts for 2 to 4 minutes, with variations of from 10 to 30 minutes. The same action of nitroglycerin occurs within 6 minutes and lasts from half to, rarely, an hour and a half. Good spirit of nitrous ether lowers tension from 45 to 60 minutes. In addition to this difference in degree, spirit of nitrous ether differs somewhat in kind of action. It is more stimulant to the heart, and more diuretic, owing to the ether it contains. For the same reason sweet spirit of uitre increases the secretions and motion of the upper part of the digestive tract, relieves spasm and is of some value in indigestion and mild colic. In stimulating the activity of the sweat glands, following its action in dilating peripheral vessels, sweet spirit of nitre is a useful diarphoretic and mild febrifuge. It has been pointed out that spiritus ztheris nitrosi is far from being a reliable preparation as a nitrite, and there- fore nitroglycerin or amyl nitrite are preferable where rapid and certain vascular dilatation is essential. USES OF THE NITRITES. Internal.— Respiratory Diseases.—No drug is more effi- cient than spirit of nitrous ether, in the treatment of acute diseases of the respiratory tract, as coryza, pharyngitis, laryngitis and bronchitis. Its value lies in its power of dilating peripheral vessels, equalizing the circulation and preventing local congestions. In assisting diarphoresis and diuresis, sweet spirit of nitre hastens elimination of toxines and cools the body; and in both ways is useful in abating fever. The following prescription may be of service in canine practice in febrile conditions : PROT CL ACOMIUEL =, «6,4. 2 cas ole) ora avonehoaier ste mae ees ase TILXXiv. Spiritus zetheris nitrosi.................. 3 Vis POtASSIOLOMIIG Ie ctx) i: <:s ala ace ete eer tede Z ss. Lag) Ammoniiacetatis ad... 2. gece Ziv. Sig. Teaspoonful in water every 2 hours. ~~ —_ USES OF THE NITRITES 313 In asthenic and febrile diseases, as influenza, sweet spirit of nitre is of worth, combined with tonic doses of quinine and alcoholic stimulants. The nitrites are the most successful remedies in reliey- ing dyspnoea, when due to spasm of the bronchial tubes, or ‘congestion of the lungs. They relax the bronchioles and avert congestion by vascular dilatation and equalization of the circulation. Thus the dyspnea occurring in pneumonia, acute pulmonary cedema, asthma and chronic bronchitis, are advantageously treated by half-hourly or hourly doses of nitroglycerin. Amyl nitrite, in dilating peripheral vessels and blanching the lungs, has proved the most successful remedy in hemoptysis. Cardiac Diseases.—These are comparatively rare in the lower animals; but, in general, it may be said that no remedy is more useful for its transient action in the severe dyspneea of cardiac diseases than nitroglycerin. The passing engorgement of the right heart and lungs is relieved by nitroglycerin, which tends to distribute the blood about the body in its proper channels, and thus takes the load off the heart temporarily. Nervous Diseases.—Nitrite of amyl is invaluable in warding off epileptic seizures in man, when warning of their approach is given the patient. As this warning cannot be detected in the lower animals, the nitrites are of less value, but may be combined with the bromides as prophylactic agents. The nitrates exert their favorable effect in this condition by preventing cerebral vasomotor spasm, which is thought to occur in epilepsy. Amyl nitrite is useful in relieving hiccough or ‘“ thumps” in horses. Diseases of Urinary Organs.—Spirit of nitrous ether is useful as a diuretic in carnivora, when the urine is concen- trated and irritating to the bladder. It is also a valuable remedy, for the same reason, in acute cystitis of all animals, when it may be combined to advantage with potassium citrate, or acetate and tincture of aconite. Summary.—We may summarize the therapeutical indi- eations for the nitrites as follows: 1. To dilate peripheral arterioles and equalize the cir- _eulation in internal congestions. 314 INORGANIC AGENTS 2. To stimulate the heart. 3. To relieve spasm of vascular, nervous, or muscular origin. 4. To increase the secretion of urine. Administration.—Sweet spirit of nitre is given by the mouth, diluted with water, and often combined with alco- holic stimulants’ (whiskey ), diarphoretics (liq. ammon. acetatis), diuretics (potassium nitrate), and bitters (quinine). Amyl nitrite is administered usually by inhalation to the larger animals, from a sponge; or two or three drops are given by inhalation from a bit of linen or cotton to the smaller animals. It may be given internally on sugar to the smaller animals, or in spirit to the larger patients. The spiritus glonoini is the only preparation of nitroglycerin in use. It may be dropped undiluted upon the tongue of the conscious or unconscious animal. The tongue of the smaller animals may be frequently moistened with a small stick dipped in the solution, or it may be given in pill or tablet. Class 4.—Chloral. CuioraLum HypRATUM. (U. 8.) CuitoraL Hyprate. Chloral. C,H Cl,0 + H,O. Synonym.—Chloral hydras, B. P.; hydrate of chloral, E.; chloratum hydratum crystallisatum, P. G.; hydrate.de chlo- ral, Fr.; chloralhydrat, G. A crystalline solid, composed of trichloraldehyde, or chloral with one molecule of water. Derivation.—Dry chlorine gas is passed into aaclens alcohol until the latter is saturated. Aldehyde and hydro- chlorie acid first result, C,H,O H + 2Cl = C,H,O + 2HCL The chlorine gas then acts upon the aldehyde, abstracting 3 atoms of hydrogen and replacing 3 atoms of chlorine, and so forms chloral. C,H,O + 6Cl = C,H Cl,O + 3H Cl. Chloral is purified first by distillation with sulphuric acid, and then with lime, and when mixed with water forms chloral hydrate (C,H Cl,O + H,O). 7 ee eee Pe ee ee ee ’ 4 ¢ } CHLORAL SLs Properties.—Separate, rhomboidal, colorless and trans- parent crystals, having an aromatic, penetrating and slightly acrid odor, and a bitterish, caustic taste. Slowly volatilized when exposed to the air. Freely soluble in water, alcohol or ether; also in chloroform, benzol, benzin, carbon disul- phide, fixed and volatile oils. It liquifies when triturated with about an equal quantity of camphor, menthol, thymol or carbolic acid. Chloral is decomposed by caustic alkalies, alkaline earths and ammonia, chloroform being formed, and a formate of the base produced. Dose.—H. & C., 3 i.-ii. (30.-60.); Sh. & Sw., 3 i.-ii. (4.-8.); D., gr.v.-xx. (.3-1.3). Action External.—Chloral is a strong irritant applied locally in concentration to the skin and mucous membranes, and if injected under the skin may cause abscess and sloughing. It is a powerful antiseptic, and relieves itching, especially in combination with camphor. Action Internal.—Alimentary Canal. —Chloral produces severe irritation of the mucous membrane in concentrated solution (20 per cent. or over), and large doses may cause vomiting in dogs. The writer has seen intense glossitis and stomatitis follow the breaking of a gelatine capsule, contain- ing chloral, in the mouth of a horse. Blood.—Chloral is absorbed into the blood unchanged. It was formerly thought that the action of chloral was due to chloroform produced by the decomposition of the former in the alkaline blood. C,H ClO + KHO=CH CI, + K C #H O, (formic acid). It is now known that the blood is not sufficiently alka- line to decompose chloral, and that chloroform is not found in the blood, tissues or excretions, except in the case of the urine, when it is strongly alkaline. Moreover, chloral acts as usual upon a frog when the blood of the batrachian is replaced by a neutral saline solution. Heart and Blood Vessels.—Chloral in large doses depres- ses the action of the heart muscle, its contained ganglia, and the vasomotor centres. It also produces local paralysis of the vascular walls. Blood pressure is therefore lowered. 316 INORGANIC AGENTS In small medicinal doses the circulation is not infinenced materially, but in poisoning the pulse at first is accelerated and then becomes slow, weak and irregular, and the heart is arrested in diastole. Nervous System—The salient action of chloral is exerted upon the brain and cord. Like other narcotics, the depress- ing effect may be preceded by a transient and unimportant excitation of the brain and cord; but this commonly passes unnoticed, and the prominent action of chloral consists, in ordinary doses, in depressing the sensory and motor centres of the brain, and-in larger doses, .the spinal reflex activity and the motor tract of the cord. Mo- derate therapeutic doses cause, therefore, dulness and sleepiness (with contracted pupils) in the lower animals, while doses approaching the toxic point produce insensi- bility, coma, paralysis of the inferior cornua, with loss of reflex action and muscular power, so that the animal falls; paraplegia, dilated pupils and anesthesia. These symptoms may occur and be followed by recovery. The anesthesia is of spinal origin. Neither the sensory nerves, motor nerves, nor muscles are affected prenpe in the later stages of poisoning. Insensibility to pain is said, by Brunton, to follow the action of chloral upon the gray matter of the cord, by pre- venting the transmission of painful sensations through this tract. It is uncertain whether chloral acts as an hypnotic by its direct depressing influence upon the brain tissue, or by inducing cerebral anezemia in causing the blood to be with- drawn from the cerebrum into the dilated periphery) arte- rioles. Respiration.—The respiration is not interfered with by moderate medicinal doses of chloral, but toxic quantities depress and paralyze the respiratory centre. The respira- tory movements become deep, regular, accelerated (26) and full, with large therapeutic doses, but with toxie doses, slow, irregular and shallow. Death occurs more commonly from arrest of respiration, yet primary heart failure, or both. combined, may lead to a fatal result. , CHLORAL 317 Temperature.—The temperature may be elevated at first, but soon falls, owing to diminished heat production and increased loss, through heart failure and vascular dilatation. Elimination.—Chloral is eliminated by the urine, in part unchanged and in part as urochloralic acid. Metabolism.—Chloral in large doses leads to increased destruction of the proteids of the. body and imperfect oxida- tion of their products, together with fatty degeneration of the internal organs. These tissue changes are caused by the production of urochloralic acid in the tissues. Summary.—Chloral is a local stimulant and antiseptic, and relieves itching. It is a powerful depressant to the cere- brum, vasomotor and respiratory centres, inferior cornua, heart muscle and its ganglia. Acute Poisoning.—Large doses produce insensibility, eoma, and complete loss of muscular power, so that the animal falls. There is general anesthesia, and the pupils dilate. The pulse is weak, at first frequent, later infrequent and irregular. The respiration may be primarily quickened, but subsequently becomes slow, shallow and irregular. The animal sweats, sways, gapes and trembles and sometimes falls to the ground, the sphincters are relaxed and involuntary defecation occurs, but recovery commonly follows. With doses. greater Hin 4 ounces, horses die in a generally anzs- thetic and paralyzed state. In man, death has followed the ingestion of 10 grains of chloral, and several fatalities have occurred after doses of 20 or 25 grains, although these are exceptional cases. The fatal dose for dogs is said to be from 2 to 6 drachms. Treatment.—Emetics and the stomach tube, shouting at and beating the animal, external heat. Five times the ordi- nary dose of strychnine and atropine subcutaneously. Strong, hot coffee and alcohol by the rectum. Amzyl nitrite inhala- tions. Administration.—Chloral has been given intravenously. subcutaneously, and irtratracheally, as well as by the mouth and rectum. The common way of administering it is in solution per orem or rectum. It may cause abscess if in- jected under the skin, or thrombi when thrown into a vein. Experiments of Dr. Muir* appear to show that chloral may * Jour. Compar. Med. and Vet. Archives, April, May, 1900. 318 INORGANIC AGENTS be safely given intrajugularly ; one ounce dissolved in two ounces of sterile water and repeated once in an hour if de- sirable. If given in ball, the chloral may prove too irritating in the digestive tract. It should be diluted at least 10 tmes, and is given by the mouth with glycerin and water, or weak syrup, or with boiled starch solution by the rectum. Uses External.—Chloral may be employed as a stimu- lant, antiseptic, and slight local anesthetic, in solution (1 to 4),upon ulcers and wounds. It may be used with an equal part of camphor diluted with 8 parts of ointment, to relieve itching. A 4 to 8 per cent. aqueous solution forms an excellent antiseptic preservative for anatomical specimens, and chloral may be added to urine for this purpose. Uses Internal.—Chloral is used for three purposes in veterinary practice: 1. First and foremost, to relieve spasm. 2. To assuage pain. 3. To procure sleep. In human medicine chloral is mainly employed as an hypnotic, but a purely soporific action is rarely required for the lower animals. The spasmodic conditions benefited by chloral include colic, convulsions, chorea, epilepsy, asthma, canine distemper, spasmodic cough, rigidity of the uterine os in the first stage of labor, hysteria, cerebritis (to relieve motor excitement), tetanus, and strychnine poisoning. In spasmodic colic, chloral is inferior to opium as an anodyne, but has the advantage of not inducing constipation. It may be employed in colic, by the rectum, combined with mor- phine given under the skin, as recommended for procuring anesthesia. It is the best remedy we possess for the treat- ment of convulsions in dogs, apart from anesthetics. Ether may be administered during the convulsion, and chloral simultaneously, or between the attacks, in gr.y.-xx., per rectum, and repeated if necessary. Chloral is only indicated in chorea when the movements are so severe that the animal cannot secure sleep or rest. In distemper in dogs, chloral is used for the same purpose, when there is excessive cough 4 : 7 ACETANILID 319 and restlessness. Chloral is given per rectum in tetanus, so as to keep the animal continually narcotized, and may be employed in conjunction with tetanus antitoxin. Spasm of the os uteri is relieved by chloral when given per rectum in frequently repeated doses, until the safe physiological limit is reached. Chloral is inferior to ether or chloroform as an anesthetic, because it is not so safe, nor is the anzesthesia so complete, but it relieves pain effectually, and is more easily administered. It is combined, in order to produce anesthesia, with small doses of morphine, which decidedly enhance the anodyne action of chloral. To prepare a horse for surgical operation, 3 grains of morphine sulphate and 1 grain of atropine sulphate may be injected under the skin, and followed in 10 minutes by an enema containing | ounce of chloral, Class 5.—Antipyretics and Analgesics. AcETanitipum. Acetanilid. C,H,N HC,H,O. (U.S. & B.P.} Synonym.—Phenylacetamide, antifebrin. An acetyl derivative of aniline. Derivation.—Glacial acetic acid and auiline are distilled together, and the residue is purified by repeated crystalliza- tion. H C,H,0O, + C,H,N H, = C,H,N H. C,H,0 + H,0. Properties.— White, shining micaceous crystalline lami- ne, or a crystalline powder, odorless, having a faintly burning taste, and permanent in the air. Soluble in 194 parts of water, and in 5 parts of aleohol; also soluble in 18 parts of ether, and easily soluble in chloroform. Dose.—H., 31.-11. (4.-8.); Sh. & Sw., 3ss.-i. (2-4); D, 2V.lil.-vil. (.2-.5). ACETPHENETIDINUM, ACETPHENETEDIN. Phenacetin. CaN ORR 19): (U2 8:P.) Synonym.—Phenacetinum, B. P.; para-acetphenetidin, C,H,0 C,H.N H C,H,O + H,0 (178.63). 320 INORGANIC AGENTS Derivation.—Obtained by the action of glacial acetic acid upon paraphenetitin, a phenol derivative. H C,H,0, + C,H,O C,H,N H = C,H,O C,H,N HC,H,O + H,O. Properties. — Glistening, colorless, tasteless, odorless, scaly crystals. Practically insoluble in water (1-925), soluble in 12 parts of alcohol, and in glycerin, chloroform and acetic acid. Antipyrina. Antipyrin. C,H, (C H,), C,H N.O. (U28,P3 Synonym.—Phenazonum, B. P.; phenyl-dimethyl-pyra- zolone. Derivation.—Phenyl-hydrazine is acted upon by aceto- acetic ether, when phenyl-monomethyl-pyrazolone, ethyl alcohol and water result. HNN HCH 4 CHCOC HCO0 CH=. (C H,) C,H,.N,O + C,H,OH + H,O. Then C,H, (C H,) C,H,N,O + C H, I (methyl iodide) = C,H, (C H,), C,H N,O + HI. Properties.—Colorless, odorless, scaly crystals, of a bit- terish taste and alkaline reaction. Soluble in about its own weight of water, alcohol and chloroform. Incompatibles.— Spirit of nitrous ether, iron sulphate, chloride and iodide; salicylates, tannin, chloral, calomel, and a large number of drugs. Dose.—H. & C., 3iii.-iv. (12.-15.) ; Sh. & Sw., 31. (4.). D., gr.v.-xx. (.3-1.3). ACTION OF ACETANILID, ANTIPYRIN AND PHENACETIN. External. — Acetanilid and antipyrin are antiseptics. Solutions of the latter contract vessels and exert a locai anesthetic and hemostatic state. Internal_—These substances exert no action upon the digestive tract, but acetanilid possesses a decided antiseptic influence upon bacteria within the alimentary canal. pt i i ie ie : \ ACTION OF ACETANILID, ANTIPYRIN AND PHENACETIN 321 Blood.—These agents have no influence upon the binod, in moderate medicinal doses, but in large doses (except anti- pyrin) they diminish the ozonizing power of the blood, re- duce the hemoglobin of the red Tepito change it to methzemoglobin, and alter the color of the blood to a brown- ish-red hue. In large toxic quantities, administered continu- ously, they cause disintegration of the red corpuscles and elimination of the. blood-coloring matter in the urine. Heart and Blood Vessels——In ordinary therapeutic doses these drugs do not alter the normal condition of the heart or blood vessels, but in large medicinal doses they first stimulate and then slow and depress the force of the heart by action (probably) upon the heart muscle. Phenacetin is the least, and acetanilid the most depressant. Antipyrin is said to stimulate the heart and increase blood pressure in minute quantities. These three antipyretics decidedly diminish blood tension in large medicinal doses, owing to depression of the heart and of the vasomotor apparatus. Nervous System.—Usual therapeutic doses of these sub- stances exert a sedative action upon the sensory nerves and sensory tract of the spinal cord. They are therefore anal- gesics, although not comparable in this respect to opium. Poisonous quantities of these drugs diminish muscular power, lessen reflex action and cause paralysis. Experi- ments apparently show that acetanilid paralyzes the motor nerves, antipyrin the motor nerve endings, while motor de- pression seems to be of spinal origin in the case of phen- acetin. The brain is undoubtedly influenced by these agents, as evidenced by coma and convulsions in poisoning, but exact knowledge is wanting in relation to the action upon the brain. The functions of the cerebral cortex are thought to be de- pressed by antipyrin, and the special senses to be first stimu- lated and then paralyzed by this drug. Temperature.—Acetanilid, antipyrin and phenacetin are essentially antipyretics. W hile they do not invariably lower temperature, even in large doses in normal animals, they do so very materially in animals suffering from fever. They apparently depress the activity of the calorefacient centres 322 INORGANIC AGENTS (probably in the corpora striata), and therefore diminish heat production. Testimony is at variance in regard to their action upon heat loss. They frequently induce diar- phoresis, but it is generally accepted that heat dissipation is increased to a greater extent than would be accounted for by sweating, and that it occurs even when. diarphoresis does not take place. Experimenters vehemently disagree as to which preponderates—increased heat loss or lessened heat- production—in causing antipyresis. Respiration.—The respiratory functions are unaffected by therapeutic doses of these medicines. In lethal doses respiration is quickened, owing to the greater work thrown upon the respiratory centre by the altered condition of the blood, and this vital centre is ultimately paralyzed. Kidneys.—The drugs under consideration produce slight diuresis in moderate medicinal doses. In poisoning, the ivine may become dark-colored by the hematin escaping from the disintegrated red blood corpuscles. Antipyrin lessens the nitrogenous products of tissue waste in the urine, and also diminishes the amount of tat secretion. Acetanilid, on the other hand, increases the excretion of urea. - Elimination.—Antipyrin is rapidly eliminated un- changed in the urine in some animals; in others it is oxidized. Acetanilid escapes in part unchanged and in part as different oxidation products in different animals; while phenacetin is chiefly eliminated as such and as glycuronate of phenetidine. Poisoning.—Toxic doses of these drugs cause, in the lower animals, nervous excitement and convulsions, and sometimes coma, loss of consciousness, staggering gait, muscu- lar failure, sweating, rapid, feeble respiration, weak pulse, cyanosis, occasional vomiting in dogs, fall of temperature and general paralysis. Treatment.—External heat, alcoholic stimulants by the mouth, rectum, or under the skin; strychnine, and atropine subcutaneously. Administration. Antipyrin is given in solution by the mouth, rectum, or under the skin. Acetanilid and phen- acetin can be administered in powder, tablet, pill or ball; or : : ACTION OF ACETANILID, ANTIPYRIN AND PHENACETIN 323° in solution in alcoholic liquor. Acetanilid is to be preferred for horses on account of its much greater cheapness.* The average dose of acetanilid is one drachm for a horse, and three to five grains for a dog; and the dose of phenacetin is twice, and of antipyrin three times greater than that of acetanilid. Uses External.—Acetanilid is employed as an antiseptic dusting powder undiluted. A ten per cent. solution of anti- pyrin may be applied as a hemostatic upon bleeding surfaces. Uses Internal.—There are three indications for the use of these agents: 1. To lower temperature in fever. 2. To relieve pain. 3. To lessen motor excitement and spasm. They are not so valuable in veterinary practice as in human medicine, since the lower animals rarely suffer from neuralgic pain, which is the special variety of suffering alleviated by these drugs. Phenacetin is the most serviceable for dogs, as it is less toxic, more sedative, and more permanent in its antipyretic action than antipyrin or acetanilid. Dogs suffering from distemper are greatly relieved by small and repeated doses of phenacetin, which lessen fever, cough and restlessness. In acute diseases, as pneumonia, these antipyretics may be occasionally employed to advantage when the temperature rises above 104° Far., and remains there any length of time. They are generally inadvisable in asthenic, febrile diseases, since they are too depressant in their action upon the heart and have no effect in removing the cause of the disease. The hyperpyrexia of insolation may be treated with these agents, in combination with cold, externally and per rectum. For the relief of pain their scope is limited in veterinary practice to that of a rheumatic character. Motor distur- bances, including convulsions, chorea and spasm, may be abated by the antipyretics, but they are usually inferior to chloral, opium, or other antispasmodics. Phenacetin, combined with codeine or heroin, in powder or tablet, is a useful remedy for cough in dogs. q * Phenacetin is now more desirable, as less depressant, since the patent on it has expired. 324 INORGANIC AGENTS Class 6.—Antiseptics. Actpum CarBpoLticum Crupum. Crude Carbolic Acid. Synonym.—Acide phénique cru, Fr.; rohe carbolsaure, G. Derivation.—A liquid consisting of various constituents of coal tar, chiefly cresol and phenol, obtained by fractional | distillation at a temperature between 302° F. and 392° F., and twice rectified at a temperature between 338° F, ae 374° F. Properties.—A nearly colorless, or reddish-brown liquid of a strongly empyreumatic and creasote-like odor, having a benumbing, blanching and caustic effect upon the skin or mucous membrane, and gradually turning darker on ex- posure to the air and light. Soluble in 15 parts of water. The aqueous solution has a slight acid reaction. Puenou (U.S. P.) *Acipum Carpoticum. Carbolic Acid. C,H,O H. (B. P.) Synonym.—Phenie acid, phenol, phenyl alcohol, pheny- licum erystallisatum, E.; acide phénique, acide carbolique, hydrate de phényle, Fr.; carbolsaure, phenylsiure, phenyl alkohol, G. Derivation. — Obtained from crude carbolic acid by agitation with caustic soda, heating to 338° F., and adding hydrochloric acid. Then by agitation with sodium chloride, digestion with calcium chloride, and distillation at a tempe- rature between 336° F. and 374° F., and finally by crystalli- zation. Properties.—Colorless, interlaced, or separate, needle- shaped crystals, or a white crystalline mass, sometimes acquiring a reddish tint; having a characteristic, somewhat aromatic odor, and when copiously diluted with water, a sweetish taste with a slightly burning after-taste. Delique- scent on exposure to damp air. Soluble in about 15 parts of water, and very soluble in alcohol, ether, chloroform, glycerin, fixed and volatile oils. Faintly acid reaction. *The U.S. P., 1905, recognizes only ‘“‘Phenol”’ as the cia name for car- bolic acid. CARBOLIC ACID 325 Phenol crystals melt when heated, but solidify again on cooling. A 95 per cent. sclution of carbolic acid crystals, in alcohol, remains fluid at the ordinary temperature. The erystals are also liquified by the addition of about 8 per cent. of water. Dose.—H. & C., gr.xv.-xxx. (1.-2.); Sh. & Sw., gr.v.-x. (.8-.6); D., gr.ss.-1. (.03-.06). PREPARATIONS. Unyuentum Acidi Carbolici. Ointment of Carbolic Acid. (B. P.) Unguentum Phenolis. (U.S. P.) Phenol, 3; ointment, 97 (U.S. P.); 4 per cent., B. P. Glyceritum Acidi Carbolici. Glycerite of Carbolic Acid. (B. P.) Glyceritum Phenolis. (U.S. P.) Phenol, 20; glycerin, 80. Acidum Carbolicum Liquefactum. Wiquified Carbolic Acid. (B. P.} Phenol Liquefactum. (U.S. P.) Carbolic acid liquified by addition of 10 per cent. of water. Dose.—Same as acidum carbolicum. Action External. —Carbolic acid causes burning pain when applied to the skin or mucous membranes, and this action is followed by local anesthesia and the production of a dry white spot. If used in sufficient quantity, it leads to sloughing, but the escharotic effect is superficial, since the acid coagulates albumin, which forms a protective coating to the underlying parts. Carbolic acid is an antiseptic and disinfectant, and, in proper solution, acts as a sedative upon the peripheral sensory nerves, and is one of the most efficient agents in relieving itching. It checks the growth of both organized (bacteria) and unorganized (digestive) ferments. Strong solutions (1-2 per cent.) kill most bacteria, but a considerable time is required to destroy the organisms of certain diseases and those relating to putrefaction. Some hours are required to kill anthrax spores, by even a 5 per cent. solution. Two per cent. solutions destroy the digestive ferments. The lower forms of vegetable parasites, growing upon the skin, perish by the application of carbolic acid. 326 INORGANIC AGENTS Action Internal.— Alimentary Canal.—Carbolic acid exerts a local, anesthetic action upon the sensory nerve endings in the stomach, and may act to a certain extent in the diges- tive tract as an antiseptic, hindering abnormal fermentation, but is, in this respect, inferior to creolin, napthol and nap- thalin. It is probably converted into a sulpho-carbolate in the stomach. In concentration, carbolic acid is a powerful gastro-intestinal irritant. Blood.—Carbolie acid is absorbed into the blood and probably circulates in part as an alkaline carbolate of sodium and potassium. Heart and Blood Vessels—Phenol, in poisonous doses, paralyzes the vasomotor centre and later depresses the heart. The effect upon the vessels is the more important and promi- nent, but neither action is observed after medicinal doses. Respiration.—Therapeutic doses do not influence the respiratory functions, but toxic quantities make the respira- tory movements rapid and shallow at first, owing to stimula- tion of the respiratory centre and peripheral vagi, while death occurs after lethal amounts from paralysis of the respiratory centre. Nervous System.—Vhe brain is depressed by toxic doses of carbolic acid, and svuapor and coma occur. The convul- sions appearing in carbolic acid poisoning are due to pri- mary stimulation of the spinal motor area, which is finally depressed and paralyzed. When locally applied, carbolic acid depresses and paralyzes the peripheral sensory nerves. Temperature.—Carbolic acid, in medicinal doses, slightly lowers temperature both in health and fever, but is not suffi- ciently antipyretic to be suitable for such a purpose in prac- tice. It depresses heat production and increases heat loss. Elimination.—Carbolic acid is eliminated by all ordinary channels, but mainly by the kidneys. The urine becomes dark colored—a very characteristic sign—even after large medicinal doses. Phenol normally occurs in small quan- tities in the urine of man and animals. Three grains have been recovered from the urine passed in 24 hours by a ee CARBOLIC ACID 327 horse, and is thought to be a product of intestinal ferment- ation. In large toxic doses most of the carbolic acid is eliminated in the urine unchanged. Part, however, is oxidized into two bodies—pyrocatechin and hydroquinone— and these, as well as phenol, unite with sulphuric and elycuronic acids in the tissues. Thus phenol is: eliminated in the urine as double sulphates and glycuronates of phenol, pyrocatechin and hydroquinone. The last two are unstable and further undergo oxidation into dark substances, color- ing the urine, which grows darker on exposure to the air. The normal sulphates are absent in the urine following earbolic acid poisoning. Toxicology.—Carbolic acid ranks as one of the most powerful poisons—together with prussic acid and _nitro- benzole—in existence. Several cases of death in man have occurred after the ingestion of one-half an ounce of carbolic acid ; and the smallest fatal human dose on record appears to be about one drachm. One or two drachms are fatal to dogs, and a dose as small as 15 grains is said to have caused the death of a dog, while the lethal amount for the horse is about one ounce. Many cases of accidental poisoning have occurred from absorption of carbolic acid when applied externally for surgical purposes in dressings or solutions upon raw surfaces. The symptoms are the same as when absorption occurs from the digestive tract. Extensive local sloughing, after continuous treatment with moist carbolic applications, is occasionally seen. Dogs and cats are particularly susceptible to the action of phenol. The milder symptoms of poisoning include dulness, loss of appetite, muscular weakness and trembling, and dark-colored urine having the odor of carbolie acid. After lethal doses death may be instantaneous through respiratory arrest, the heart continuing to beat for a time. The mcre ordinarv symptoms in severe poisoning in all animals are: trembling, rarely vomiting and purging, restlessness, salivation, loss of muscular power (animal reels and falls), diminution of sensibility, anesthesia, dyspnoea; the breathing is rapid, 328 INORGANIC AGENTS shallow and stertorous; the pulse is. weak, irregular, and usually frequent; the temperature is lowered, and there are the usual symptoms of collapse, with insensibility, coma, loss of reflex action, general paralysis, occasional convul- sions and death. Sometimes hematuria, albuminuria and hemoglobinuria have been observed. The condition resem- bles apoplexy, but the mucous membrane of the mouth is stained white in patches after ingestion of pure acid, dark with crude acid, and the odor of the poison lingering about the animal, together with the dark, green-colored urine, are characteristic of phenol poisoning. The urine may be clear when first voided, but becomes dark on standing. The absence of carbolic acid in the urine affords certain evidence that the case is not one of poisoning by this drug. Post-mortem éxamination reveals hard, whitish or brownish or black patches and sloughs upon the mucous membrane of the mouth, gullet, stomach, and even the small intestines. The blood is dark from asphyxia, and imperfectly coagu- lated. There is occasionally fatty degeneration of the liver and kidneys. The odor of the acid remains not longer than twenty-four hours. Treatment.—Emetics are usually valueless on account of the anesthetic condition of the mucous membrane of the stomach. We use, therefore the stomach pump or tube, and, as antidotes, pure whisky or brandy, to avert the local escharotic effect and as a stimulant. Washing the stomach with 10 per cent. solution of alcohol has proven most efficient. Epsom or Glauber’s salts do not form in- soluble sulphocarbolates in the body, and are there- fore useless. For collapse, heart and respiratory fail- ure,—digitalis, strychnine, atropine, ether, and brandy sub- cutaneously, are to be employed, together with heat ex- ternally. Mucilaginous drinks are also useful. The local caustic action of carboliec acid on the skin or mucous mem- branes can be prevented by the immediate application of strong (96 per cent.) alcohol to these parts. Of late years alcohol has also been regarded and widely given as a phy- siological and chemical antidote in carbolic poisoning. In CARBOLIC 4 SID 329 experiments, cited by Thornton,* on dogs with mixtures of toxic doses of carbolic acid and alcohol, and with the ad- ministration of poisonous doses of the acid followed by alcohol, the results go to show that alcohol does not in any way lessen or alter the poisonous effect of carbolic acid except in preventing the corrosive action on the stomach His conclusions are somewhat weakened, however, by the fact that doses of alcohol were used which in themselves might be toxic (4 to 9 ounces). It is certainly well to give pure whiskey or brandy in a large dose by the mouth after carbolic acid has been swallowed, for two reasons: to pre- vent the corrosive action of the acid on the mucous mem- branes, and to act as a circulatory stimulant, even if there is not any other specific effect produced. Administration.—Carbolie acid is commonly given in- ternally, diluted several hundred times with water. Uses External.—A solution of ecarbolic acid (1-20) is frequently used in surgery to disinfect the unbroken skin, while a weaker solution (1-50) is more suitable as an antiseptic upon raw surfaces and mucous membranes. While corrosive sublimate has enjoyed chief popularity as a surgical antiseptic for many years on account of its cheap- ness and supposed superior bactericidal properties, recent experiments (see p. 215) have shown that the value of cor- rosive sublimate is much over-estimated, so that: carbolic acid has again resumed almost the importance it originally had in Listerian days in surgical work. Pure carbolic acid is occasionally used as a caustic to destroy small growths, as warts, and the lining membrane of fistule of the poll, withers, or lateral cartilages ; to swab out a septic uterus, and as a local anesthetic upon the skin. A drop of pure acid, or a line drawn with a brush along a proposed path of incision, may render a hypodermic puncture or superficial incision painless. Carbolic acid with glycerin (1-16) is one of the most excellent preparations for applying to sluggish * Progressive Medicine, p. 345, Dec., 1901. 330 INORGANIC AGENTS ulcers and old sinuses and fistule.. The glycerin appears to entirely offset the corrosive action of the acid, and the result is a stimulation of the pyogenic membrane and pro- motion of healing which often can not be obtained by any other remedy. Itis equally effective in canker and foul ‘in the foot of cattle, and in foot rot of sheep (1 part in 10 of glycerin). Injection of ten to thirty drops of a two per cent. solution into the substance of boils, acne, glandular swell- ings, erysipelatous inflammatory patches, poisoned wounds, joints affected with chronic synovitis, and inflamed burse, will often assist recovery and may abort the lesion. In acute inflammation, the injections are made twice daily ; in chroni¢ conditions, once every other day; and if there is a large extent of surface involved, several injections are done at one time. Bacelli’s treatment of tetanus with carbolic acid has met with remarkable success of late. One drachm of the pure acid in solution (5 to 10 per cent.) should be injected in the region of the neck and shoulders of the horse every two hours during the first 32 hours, and less frequently afterward. As much as 36 drachms may be given to the horse in 24 hours, for there appears to be a special tolerance for carbolic acid acquired in tetanus. One of the best agents which can be used in the treat- ment of septic wounds is carbolie acid in } to § of 1 per per cent. aqueous solution. Aseptic gauze or absorbent cotton are wrung out in the solution and applied to the part and covered with oil paper, silk or other waterproof material and so kept continuously wet. Instruments are frequently placed in carbolic acid solution (1-40) during surgical operations, although it is sufficient to boil them in water for ten minutes and keep them in the boiled water, or place them in a pure atmos- phere upon boiled towels. Carbolized gauze is prepared from unbleached cotton gauze medicated with half its weight of a mixture consisting of carbolic acid, 1; resin, 3; and paraffin, 4 parts. Plain gauze, sterilized by baking at a temperature of 140° C. for two hours, is preferable, and avoids the danger of absorption and poisoning. CARBOLIC ACID 331 The glycerite of carbolic acid is employed as a local application in stomatitis, upon the ulcerations of actinomy- cosis with iodine, and also upon the skin to destroy ringworm. It is inferior, however, to tincture of iodine for fia latter purpose. -Two pér cent. solutions are recommended to kill lice and the acari of scab and mange. Carbolic acid is the most serviceable remedy we possess to relieve itching. Two per cent. solutions may be employed upon the unbroken skin, but the strength should not be greater than half this amount upon excoriated surfaces. i sub-acute moist eczema of . dogs, carbolic acid with zine ointment (gr.5-51.), or the following prescription, will be found of value in relieving itching and promoting recovery : R DTEIUTIGICE wtaleuete teats ete iors sceveretal eco esct ens. » 3 ss. - PAGE OSLO elner aos eotets SR ENE Yop A oe tv 3 ii. Acid..Carbol ...... (Ob on Oooo BBO TOE (oi Boe nthe eth fe wc atala ci/ae oh nleie se ent 3 iv. M. Sig. External use. (Shake.) Care should always be taken not to apply carbolic preparations over any considerable extent of raw surface, and to muzzle dogs in the event of an opportunity being afforded them to lick off any undue amount of the acid. A. solution (1-50) in boiling water forms an efficient anti- septic and sedative inhalation for horses suffering from eatarrh of the upper air passages. One of the most excellent remedies for burns consists of a two per cent. solution of eatbolie acid in carron oil. It relieves pain and lessens sup- puration, although carbolic acid in oil possesses little anti- septic property, because phenol is so much more soluble in oil than in the watery protoplasm of bacteria. Good results have been reported with intratracheal injections in vermin- ous bronchitis of foals and calves, consisting of the fol- lowing: AGIA GAT DOLIGI™ cutee etc as oo cle eens iere eos TXX. Ol skerebiaG iM AGe ace sites o1els srerceel oe cheese Sie Chloratormis seco ee te i ee ee ess. M. Sig. Give at one injection intratracheally. 332 INORGANIC AGENTS Crude carbolic acid may be used to disinfect infected buildings and their contents, and, in two per cent. solution with whitewash, can be applied to walls after cleaning. Uses Internal.—Kvidence has been accumulating of late as to the value of carbolic acid in general diseases of bacterial origin. Not only has Bacelli’s treatment proven successful in many cases of tetanus, but in human’ medicine numerous favorable reports have been made upon the use of carbolic acid when given in large doses in dilution by the mouth in the treatment of surgical sepsis, influenza, erysipelas, ete. Moreover, the subcutaneous injection of 2 drachms (8 cc.) of a 3 per cent. aqueous solution of carbolic acid every ten days into all pregnant cows during the prevalence of epi- zootic abortion is a valuable prophylactic measure. In the carbuncle form of anthrax in man, the injection of carbolic acid solution has yielded successful results and it may be tried in cattle. But speedy destruction of anthrax patients in veterinary practice is usually the only wise procedure. Loeally, carbolic acid may exert an antiseptic and anesthetic action in the stomach. Carbolic acid is sometimes of service in relieving vomiting and gastric pain caused by flatulence in dogs, and in counteracting intestinal fermen- tation and diarrhoea in all animals. In diarrhcea of dogs, grain doses are combined to advantage with bismuth sub- nitrate in powder, capsule, or pill. ©o st) Oo CREOSOTE Crreosotum. Creosote. (U.S. &B. P.) Synonym.—Kreosotum, P.G.; kréosote, Fr. ; kreosot, G. Derivation.—A. mixture of phenols and phenol deriva- tives, chiefly guaiacol and creosol, obtained during the dis- tillation of wood tar, preferably of that derived from the beech, Fagus sylvatica Linné. (Nat. ord. cupuliferz.) Properties.—An almost colorless, yellowish or pinkish, highly refractive, oily liquid, having a penetrating, smoky odor, and a burning, caustic taste. Usually becoming darker in tint on exposure to the light. Spec. gr. not below 1.070 at 59° F. Soluble in about 150 parts of water, but without forming a perfectly clear solution. Freely soluble in al- cohol, ether, chloroform, acetic acid, fixed and volatile oils. Dose.—H., xv.-xxx. (1.-2.); C., 3ss.-1. (2.-4.); Sh. and Sw., Mv.-xv. (.3-1.); D., Mss.-i1. (.03-.12). Action and Uses.—The action of creosote upon animals is. practically the same as that of carbolic acid in kind, but is much less toxic. The antidotes (soluble sulphates) and treatment of poisoning are also similar. Hxternally, creosote is as effective a germicide as carbolic acid, but the latter is usually preferred, being much cheaper. Creosote may be ap- plied in the same strength for its local antiseptic, parasit- icide, and local anesthetic action. Internally, creosote is administered, as is carbolie acid, to check vomiting and to act as an intestinal antiseptic.* Outside of the body, creosote is employed in inhalation in inflammatory diseases of the upper portion of the respiratory tract, and to kill parasites in the air passages. Intratracheal injection may be substi- tuted for inhalation in the latter condition. Given internally in wine or spirit, creosote is of value in bronchitis with fetid or excessive secretion, in addition to its use by inhalation. Creotinum. OCreolin. (Non-official. ) Derivation.—Obtained from soft coal by dry distilla- tion. Composition very complex. Is said to contain cresol and higher homologues of phenol. * And in its elimination by the bronchial mucosa it may kill filaria. Neumann advises creosote (3 ii.), benzine (5.x.), and water (2qts.) ; of the mixture for sheep, 1 teaspoonful daily, by the mouth, for 8 days for verminous bronchitis. 334 INORGANIC AGENTS Properties.--Dark-brown, syrupy, alkaline liquid, of a tarry taste and odor. Nearly soluble in alcohol; soluble in chloroform and ether. When added to water, creolin forms a white emulsion containing in suspension as much as 12 per cent. of the drug. ) Dose.—H. and C., 2 ss.-i. (15.-30.), in single dose. For continuous use—H. and C., 31.-i1. (4.-8.); D., Mi.-v. (.06-.3). Action Hxternal.—Creolin is a powerful and useful dis- infectant, antiseptic, and parasiticide. It forms a slippery coating upon the skin. Strong solutions are not caustic, but may cause a dermatitis when continuously applied. Creolin generally represents carbolic acid, but is much more efficient as a germicide, less irritating, and does not endanger animal life from absorption.* Aqueons solutions (emulsions), containing from } to 1 per cent., are employed for antiseptic purposes. . Action Internal.—Creolin is eliminated by all channels, giving the secretions a tarry odor, and coloring the urine brown. One or two drachms of creolin (a lethal dose of carbolic acid), when given daily to dogs for weeks at a time, produce no bad effects. It is a good intestinal antiseptic, and better than carbolic acid. ; Uses.—Creolin is employed mainly outside of the body, and is a useful general antiseptic for surgical purposes in 1 per cent. solution. Antiseptic poultices, so valuable upon septic sloughing parts, are best made by soaking clean gauze in a 1 per cent. aqueous solution of creolin, and applying the same, covered by a waterproof protective. Creolin solutions are not to be recommended for instru- ments during operations, as the fluid is so turbid that they cannot be seen by the operator. A 2 per cent. solution is useful for a vaginal or uterine injection; a 1 per cent. solution for irrigation of the bladder in cystitis, or eye in keratitis and conjunctivitis; and a 4 per cent. solution for intestinal irrigation in dysentery. As a parasiticide, 2 per cent. solutions, cr 10 pe cent. ointments or soaps, may be used to kill lice, fleas, and acari of seab and mange. With alcohol (1-10-20) creolin is remedial in alopecia areata. _ .*Creolin, to avoid toxic effects, should be pure, That made by Merck is a reliable article. LYSOL 305 © Sheep are dipped to advantage in 2 per cent. solutions, to destroy ticks, instead of the more dangerous arsenical liquids. Creolin (of Merck) may be used internally, as an intestinal antiseptic and anthelmintic. One ounce given on an empty stomach, in a quart of water, is one of the most effective vermifuges for the horse. Lysotum. Lysol.* Derivation—From that part of tar oil which boils between 190° and ‘200° C., by dissolving in fat and saponi- fying in alcohol. Properties. — A clear, brown, oily liquid, of a feeble, creosote-like odor. Soluble in water, forming a clear, frothy, soapy fluid, and in alcohol, chloroform, and glycerin. Lysoi contains 50 per cent. of cresol. Lysol is used as a substitute for creolin, in 3 to 2 per cent. aqueous solution. It is a powerful antiseptic, and is stated to be more efficient and half as poisonous as creolin, and only } as toxic as carbolic acid. Lysol solutions do not obscure instruments, nor damage the hands of the operator. The drug is undoubtedly a very useful one. NapuTot. Naphtol. C,H,OH. (U.S. P.) Synonym.—Beta naphtol. A phenol occurring in wood tar, but usually prepared artificially from naphthalin. Derivation.—Naphthalin is treated with strong sulphuric acid. B-naphthalin sulphonic acid is formed (C,,H, H SO,). The latter acid is dissolved in water with milk of lime, and the resulting calcium salt is recovered by crystallization. The crystals are then dissolved in water and treated with sodium carbonate, when sodium naphthalin-sulphonate (C,, H.SO,Na) results. The latter is mixed with fused sodium hydroxide, when sodium naphtol (C,, H, O Na) and sodium sulphite are obtained. Hydrochloric acid is added to the * A preparation, Liquor Cresolis Compositus (U.S. P.), is now official and re- presents lysol. It has the advantage of being c heaper ‘than’ lysol. 336 INORGANIC AGENTS former, and naphtol results, which is further purified by sublimation and recrystallization. Properties. — Colorless, or pale buff-colored, shining, crystalline lamine, or a white, or yellowish-white, crystalline powder; having a faint phenol-like odor, and a sharp and pungent but not persistent taste. Permanent in the air. Soluble in about 1,000 parts of water, and in 0.75 parts of alcohol; also very soluble in ether, chloroform, or solutions of caustic alkalies. Adige oe Be eee is a powerful disinfectant, antiseptic and parasiticide. It is a useful application exter- nally in 10 per cent. ointment, for mange and ringworm. Internally it is employed to kill round and tape worms, and as an antiseptic in intestinal fermentation. It should be given in keratin coated pill (to avoid irritating the stomach), ‘or capsules, to dogs, and in ball to horses. NaPHTHALENUM. Naphthalene. C,,H, (U.S. P.) Synonym.—Naphtalin. Derivation.—A hydrocarbon obtained from coai tar by distillation between 356° F. and 482° F. The impure naph- talin resulting is treated with sulphuric acid and sodium hydroxide, and is further purified by distillation with steam, and then by mixture with strong sulphuric acid, and finally by redistillation. Properties. — Colorless, shining, transparent lamine, having a strong characteristic odor resembling that of coal tar, and a burning aromatic taste; slowly volatilized on exposure to the air. Insoluble in water; soluble in 15 parts of alcohol; very soluble in ether, chloroform, carbon disul- phide, and fixed and volatile oils. Dose.-H., 3 11.-iv. (8.-15.); D., gr.i.-xx. (.06-1.3). Actions and Uses.— Naphtalin, like other coal tar pro- ducts, is an antiseptic and parasiticide. It may be used as an antiseptic dressing powder upon wounds, or in 10 per RESORCIN Soy cent. ointment for parasitic skin diseases. Naphtalin is almost insoluble in the digestive tract, and acts as an anti- septic, therefore, throughout this canal. It is of service in intestinal fermentation, diarrhcea, dysentery, and, as a ver- micide, in combination with castor oil. Naphtalin is administered to dogs in starch wafers or gelatine capsules ; and to horses in ball or electuary. Resorcinou. Resorcin. C,H,(O H),. (U.S. P.) Synonym.—Resorcinum. Metadioxybenzol. Derivation.—A. diatomic phenol formed by the action of fuming sulphuric acid upon benzine, whereby benzine meta- disulphonie acid [C,H,(HS O,),] resultx. The latter is neutralized by milk of lime; calcium sulphate is expressed, and sodium carbonate is added. The process is continued by filtration, aud the filtrate evaporated to dryness. The residue is heated with sodium hydrate, with the formation of sodium resorcin [C,H, (O Na),]. Sulphurous acid is driven off from sodium resorcin by boiling, and the result is extracted with ether; impure resorcin is recovered by distillation, and is purified by sub- limation or by recrystallization from water. . Properties.—Colorless, or faintly reddish, needle-shaped erystals, or rhombic plates; having a faint, peculiar odor, and a disagreeable, sweetish, and afterward pungent taste. Resorcin acquires a reddish or brownish tint on exposure to light and air. Soluble in 0.6 part of water, and in 0.5 part of alcohol; readily soluble in ether or glycerin, and very slightly soluble in chloroform. Dose.—H., 3 i.-1i. (4.-8.); Foals and Calves, 3 ss.-i. (2.-4.); D., gyr.ii.-v. (.12-.3). Action and Uses.—Resorcin was originally employed as an antipyretic, but is not now used for this action, being too depressing to the heart. It is an efficient antiseptic, exter- nally and internally; possesses a slight local anesthetic effect, and is not nearly so irritating topically as phenol. 338 INORGANIC AGENTS Externally it is of value in scaly skin diseases, as psoriasis, in solution (1-4),in glycerin. Internally, resorcin is of worth in fermentation and indigestion, given in a large amount of water an hour or two after eating - FoRMALDEHYDE. CH OH. (Non-official.) Synonym.—Formic aldehyde. Derivation.—Obtained by partial combustion of wood alcohol, without ignition, by evaporation of the spirit in contact with a hot, platinized, asbestos plate. 2CH,OH8H | +0O,=2CHOH + 240. Properties.—Formaldehyde is a pungent gas, having a spec. gr. of 1.6; soluble in water, forming a clear, colorless, stable solution when kept in glass-stoppered bottles, but volatilizing on exposure to the air. Formalin is the com- mercial name for an aqueous solution containing 40 per cent. of formaldehyde gas. PREPARATION, Liquor Formaldehydi. (U.S. P.) Formalin. Containing not less than 37 per cent. of formaldehyde gas. Action and Uses.—Formaldehyde and formalin are powerful microbicides. A 1 per cent. solution of formalin will kill Staphylococcus pyogenes aureus in about an hour; B. typhosus in 40 to 50 minutes; B. coli communis in 30 to 40 minutes; B. anthracis and 8S. cholerz in less than 15 minutes. Clothes soaked in cultures of B. typhosus, 8. cho- lerzee and Staphylococcus pyogenes aureus, and-then for 24 hours in a 1 per cent. solution of formalin, were found to be comnletely sterile (Slater). Trillat and Robinson have apparently shown that formaldehyde gas has wonderful disinfectant and penetrating properties, destroying all pathogenic bacteria in ordinary rooms containing the micro- organisms buried under mattresses, between blankets, in in clothing and other articles, in the air, dust, and morbid ‘ secretions. Harrington has proved, however, that the pene- , FORMALDEHYDE goo - trating power of formaldehyde is nil in the case of moist substances, and that sterilization is not always complete when micro-organisms are imbedded in, or covered by, dry pervious material. Still, formaldehyde is the best practical disinfectant now known for the sterilization of infected premises.* The gas is most effective between 60° and 70° F., but will act at other temperatures. It is not so operative in damp air, and the premises should be closed tight from the outer air, in order that the disinfection may be thorough. The premises containing the gas should be sealed from 4 to 24 hours. Formaldehyde vapor is extremely pungent and irritating to the mucous membranes, causing running of the nose and eyes in those exposed to its influence; but some ex- perimenters have subjected animals to formaldehyde vapor (of disinfectant strength) for hours without causing their death. In Harrington’s experiments two rabbits were killed by formaldehyde in the disinfection of a room, and exhibited the following post-mortem appearances: Congestion and hemorrhage of the buccal mucous membrane; intense bron- ehitis with hyperemia, and consolidation of the lung with a purulent and slightly fibrinous exudate. There was also congestion of the abdominal organs, including the liver, kid- neys and spleen. As death may occur, it is certainly unwise to attempt the disinfection of premises with formaldehyde, when inhabited by men or animals. The smaller insect pests and animal parasites are sometimes killed by formaldehyde disinfection, but not invariably so. Internal Action.—Solutions of formaldehyde are in- tensely irritant. Nausea, vomiting, coma with slow pulse, and death have followed its ingestion. The red blood cells are altered in form, and destructive changes have been noted in the liver and kidneys. Formaldehyde escapes unchanged in the urine. Formic aldehyde vapor is not injurious to clothing, metals, or other like articles, as are sulphurous anhy- dride or chlorine gas, and it bids fair to supersede all other agents for the gaseous disinfection of premises infected with * It does not kill rats, but burning sulphur is effective for this purpose. 3840 INORGANIC AGENTS pathogenic bacteria. Formaldehyde gas may be generated by evaporating formalin in a vessel over a lamp, or other form of heating apparatus. "i Harrington states that the evaporation of 110 ec. of formalin is sufficient to kill all pathogenic micro-organisms within 24 hours, in 1,000 cubic feet air space. Formalde- hyde gas may be liberated most readily by mixing 64 ounces of potassium permanganate with each pint of formalin. This should be only done in deep, tin vessels to avoid the effects of great frothing. This quantith of formalin and potassium permanganate is necessary to disinfect each 1,000 cubic feet of air space. A solidified formaldehyde is also on the market to which one need only add hot water, to free the gas. In veterinary disinfection one may spray formalin in five per cent. solu- tion with a force pump all over the floors, walls, fixtures, ete. Rubber gloves should be used to protect the hands. Formalin, in + to 2 per cent. solution, is perhaps the most powerful antiseptic that has been used for surgical purposes, but, when used in such strength upon raw sur- faces and mucous membranes it produces pain and irrita- tion and coagulates albumin so as to shut off the underlying parts from participating in the antiseptic action. These stronger solutions, although formerly employed for surgical uses, should be confined to skin disinfection or where an escharotic action is desired on sloughing tissues. . Ordinarily the strength of an aqueous solution should not exceed 1-2000, or at most 1-1000, for application to raw surfaces or mucous membranes, and even in this dilution applications sometimes produce considerable pain and irritation, and, for this reason, are contraindicted for ordinary surgical use. HEXAMETHYLENAMINE 341 Success is reported from the use of formalin on sloughing surfaces of malignant growths and foul ulcers. A 4 per cent. solution is increased to 10 per cent. and finally to pure formalin, the solutions being applied on cotton saturated with the drug and retained on the part for thirty minutes each day. A 5 per cent. solution of formalin is serviceable for sterilizing catheters, instruments and sutures, for the preservation of pathologic specimens, for the disinfection of stables, and in the treatment of canker of the feet in horses. PREPARATIONS. Hexamethylenamina. WHexamethylenamine. Cs His Ni. (U.S. P) (Urotropin. ) Urotropin occurs in colorless, transparent crystals, soluble in 1.2 parts of water and in 14 parts of alcohol; odorless, of a sweet, afterward bitter taste, and slight alkaline reaction. It is made by combining solu- tions of ammonia and formaldehyde, and was first introduced into medicine by Nicolaier in 1895. Urotropin appears to be decomposed in the kidneys with the liberation of formaldehyde, and thus disinfects the urinary tract. It is, in fact, considered the best urinary antiseptic in human medicine and has been used with the greatest success in the treatment of all infectious diseases of the urinary passages, especially acute and chronic pyelitis and cystitis. It renders normal a putrid urine containing pus or mucus, is a solvent for uric acid and is slightly diuretic. These actions should be of value in similar diseases of animals, especially of dogs. The drug may be given in from 8 to5 grain doses thrice daily in solution, in canine pract:ce. It should now be bought more cheaply under its official name than by its trade name, urotropin. In diabetes mellitus of the human urotropin is often beneficial in reduc- ing the loss of glucose in the urine ; it should be tried in this disease in dogs. Glutol (Formalin Gelatin). Glutol is a coarse, white powder, without odor or irritating pro- perties, and is prepared by dissolving gelatin in water and drying the solution in formalin vapor. It is a most valuable antiseptic powder in liberating formaldehyde gas in contact with living cells. Glutol forms a scab when dusted over fresh wounds, preventing infection, and is serviceable in the treatment of infected wounds, abscesses, boils (after paracentesis), sinuses and other surgical conditions. It was first brought into use by Dr. C. L. Schleich, in 1896. 342 INORGANIC AGENTS Class '7.—Miscellaneous Carbon Compounds. Actpum Hyprocyanicum Di.vurum™. Diluted Hydrocyanic Acid. HCN. (U.S. &B. P.) Synonym. — Prussic acid, acidum hydrocyanatum, s. borussicum, E.;* acide cyanhydrique, s. hydrocyanique, Fr.; cyanwasserstoffsiure, blausadure, G. Derivation. — A liquid composed of 2 per cent., by weight, of absolute hydrocyanic acid, and 98 per cent. of water. Obtained by distillation of potassium ferrocyanide, 20; sulphuric acid, 8; and water, 65; into distilled water. The following reaction first occurs: K, Fe C,N, + 2H,8 O,=2K,S 0, + H, Fe C,N,; then on the application of | heat, the hydroferrocyanic acid resulting in the first reaction reacts with the remaining potassium ferrocyanide and sul- phuric acid, as follows: H, Fe C,N, + K, Fe O,N, + H,S O,=6HCN+K,S8S O, + K, Fe (Fe CO, Nj). Diluted hydrocyanic acid can also be made by mixing hydrochloric acid, 5; with distilled water, 55; silver cyanide, 6. Shake together in a glass-stoppered bottle. Ag CN + HCl= HCN+AgCl. When the precipitate of silver chloride falls, pour off the clear, supernatant fluid. Properties.—A. clear, colorless liquid, of a characteristic taste and odor, resembling those of bitter almond. It is very unstable and is apt to be inert as obtained from ordi- nary drug stores. It should be kept in inverted glass-stop- pered dark bottles. Incompatibles.—Salts of iron, copper and silver; sulphides and red mercuric oxide. Dose.—H. & C., V1 xx.-xl. (1.3-2.6); Sh., Tx.-xv. (.6-1.) ; Sw., Tii-v. (.12:.3); D., Mi.-111. (.06-.2). Action External. —Prussic acid is absorbed to some extent through the unbroken skin; paralyzes the peripheral sensory nerves, and acts as a local anesthetic. If the finger * Scheele’s prussic acid contains 4 to 5 per cent. of the pure hydro- cyanic acid, 9 DILUTED HYDROCYANIC ACID B43 is held over a bottle containing the acid, it soon becomes anesthetized. Upon mucons membranes, or raw surfaces, prussic acid is rapidly absorbed and exhibits its usual con- stitutional action. Action Internal.—Alimentary Canal.—Hydrocyanic acid exerts a sedative effect upon the mucous membrane of the stomach and upper portion of the digestive tract. It is absorbed into the blood, but we are ignorant of its fate or mode of elimination. Blood.—In poisoning, the blood becomes first of a bright arterial hue, and later assumes a dark, venous color. The first condition is due to the fact that the tissues do not absorb oxygen owing to changes in the protoplasm which interfere with cell respiration; probably also in part because the blood is hurried so rapidly through the dilated peripheral vessels that it does not have time to yield up its oxygen. The dark color of the blood is probably owing to asphyxia and accumulation of carbonic dioxide, following the paralytic action of prussic acid upon the respiratory centre. A substance called, cyanohemoglobin is formed outside the body by hydrocyanic acid when shaken with blood. The acid appears to deoxydize the normal oxyhemoglobin, and blood thus treated has no ozon- izing property. Cyanohzmoglobin was thought to account for the action of prussic acid, but it does not exist within the body in the blood of poisoned animals. The red blood corpuscles are altered in shape by the action of prussic acid upon blood withdrawn from the vessels. They generally become rounder, then granular, and finally disintegrate and liquefy. But these changes do not occur in the blood during life. The general action of prussic acid is altogether inde- pendent of any influence upon the blood, since the same toxic effect is produced upon the bloodless, or “salt frog” (vessels containing normal salt solution), as upon the normal batrachian. Nervous System and Muscles.—Prussic acid first stimu- Jates the hind-brain—as shown by convulsions, and excita- tion of the vagus, respiratory and vasomotor centres—and then paralyzes the whole nervous system. The brain, cord 344 INORGANIC AGENTS and nerves become paralyzed by large doses. The convul- sions occurring in poisoning are shown by experiments to be due probably to stimulation of the hind-brain, although they have been attributed to altered cerebral circulation and to asphyxia. They are, however, pre- sent during that period of poisoning when the blood is of a bright arterial hue. The spinal cord is paralyzed at a period after coma and convulsions have appeared. The peripheral nerves and muscles are paralyzed directly by toxic doses, and not through the mediation of the central nervous apparatus. This is proved by shutting off the blood supply containing the drug, from a frog’s leg, and leaving the nervous connections intact, when no effect of prussic acid is observed upon the limb. Heart and Blood Vessels. — Death sometimes occurs instantaneously from large lethal doses of prussic acid, owing to diastolic arrest of the heart. This action is due probably to paralysis of the heart and its contained ganglia, and also to irritation of the vagus centre. Moderate non- toxic doses stimulate the vagus centre of the medulla, and slow the pulse without diminishing the force of the heart. When the vagi are previously divided, this action does not occur, but after large doses slowing of the heart is observed whether the vagi are cut or not; thus showing that the heart muscle, or its ganglia, are directly influenced. Mode- rate doses of prussic acid first stimulate, and then depress the vasomotor centre. Arterial pressure is therefore prima- rily raised considerably, but this is followed by a fall to, or below, the normal. Toxic doses stimulate the vasomotor centre very briefly, and this action is succeeded by profound depression and paralysis of the centre, accompanied by a great diminution of blood tension. Respiration.—Inhalation of the pure acid will cause death in a confined atmosphere, and even inhalation of the medicinal solution will induce the physiological symptoms - of the drug. The respiratory centre is usually depressed from the beginning, by prussic acid, and the respiratory DILUTED HYDROCYANIC ACID 345 movements are therefore lessened in frequency throughout the period of its action. Rarely, there is a primary transient stimulation of the centre, so that the breathing is increased in frequency. In the latter stage of poisoning, the breathing is feeble and shallow, and only occurs at long intervals. If death does not supervene immediately from diastolic arrest of the heart, it comes on more slowly by asphyxia. The respiratory movements become less frequent and forcible, the animal giving an occasional gasp, until finally the breathing ceases altogether, while the heart continues to beat for a time. Summary.—Prussic acid in any considerable dose exerts a transient stimulation upon the hind-brain, followed by brain, spinal cord, nerves, muscles, and the three great medullary centres controlling the heart, respiration and ves- sels. Topically applied, hydrocyanic acid also paralyzes nerves and muscles, and acts therapeutically as a local sedative and anesthetic. Toxicology.—Prussic acid is one of the mest powerful poisons in existence. Death may be instantaneous, or life may be prolonged for over an hour after a lethal dose. More commonly the animal survives for a few minutes, and we observe the following symptoms in dogs: The animal falls, froths at the mouth, the respiration is of a gasping character and occurs at infrequent intervals. There is un- consciousness, the pupils become dilated, there are muscular tremblings, and clonic or tonic spasms. Defeecation and micturition occur, and erections often ensue in the male. Respiration ceases before the cardia¢ pulsations. Three stages may be distinguished in fatal poisoning. First: a very short period elapses before the symptoms appear. There are giddiness, diffieult breathing, and slow pulse in this stage. Second: the pupils dilate, vomiting may occur, and the animal utters loud cries. Spasmodic defecation, micturition and erections may be present, with convulsions and unconsciousness. Third: the last stage is characterized by collapse, spasms, general paralysis and 346 INORGANIC AGENTS death. The subacute form of poisoning may ensue and prove fatal, or, owing to the volatile character of the drug, complete recovery may take place within one-half or three- quarters of an ‘hour. Occasionally dogs continue to be paralyzed for several days and get well. The minimum fatal dose recorded in man is ;%, of a grain of pure acid, or about 50 drops of the medicinal solution. Four to five drachms of the diluted acid frequently, but not invariably, cause subacute poisoning and death, in horses, within an hour. One to two drachms of the pharmacopeeial prepara- tion usually kills dogs within ten minutes. _ Prussic acid is commonly used to destroy the domestic animals. Two to four drachms of the medicinal acid are to be given to dogs and cats of the ordinary size, and certain, painless, and. rapid death will occur if a fresh preparation of the drug can be obtained. The unopened, half-ounce vial, kept by druggists, is recommended. Big dogs, horses, and the other larger animals are not killed rapidly, nor sometimes at all, by great quantities of the diluted acid. Hence, shooting is a more humane and preferable mode of death for them. In the experience of the writer, one to two drachms of prussic acid saturated with potassium cyanide, failed to kill a horse, when injected directly into the jugular vein. The odor of the acid lingers about the animal for a few hours after death; the eyes are fixed and staring; the pupils dilated; the teeth are clinched tight and covered with froth, while the blood is of a very dark color. The treatment embraces emptying the stomach by large doses of promptly acting emetics, or by the stomach tube, or pump; atropine, ether, and brandy subcutaneously, and inhalations of ammonia, together with artificial respiration, and hot and cold douches upon the chest. - Uses.—Prussic acid is indicated for three therapeutic purposes : . 1. To relieve gastric pain and vomiting, by its paralyz- ing action upon the peripheral sensory nerves of the stomach. POTASSIUM CYANIDE 347 2. To stop coughing. 3. To allay itching by means of its local, sedative action upon the cutaneous sensory nerve-endings. As a medicine it is not of much value, but is used in veterinary practice as a cough remedy, when the symptom is of reflex origin, or is caused by chronic or verminous bronchitis; and the acid is often conjoined with chloroform, or opium, in some form. Prussic acid is a dangercus remedy to apply to the skin, as absorp- tion may occur, or the acid may be lapped off by the patient. Solutions containing, of the diluted acid, 3ss.-i. to Zi. of water, are, however, sometimes employed to relieve pruritus. Porasstt Cyanipum. Potassium Cyanide. KON. (Wes:-d5: 5; P;) Synonym.—Cyanure de potassium, Fr.; cyankalium, G. Derivation.—Made by heating together potassium ferro- cyanide and carbonate. Properties.—White, opaque, amorphous pieces ; or a white, granular powder, odorless when perfectly dry, but in moist air exhaling the odor of hydrocyanic acid. Taste sharp and alkaline, and in moist air the salt deliquesces. Reaction very strongly alkaline. Solutions stain and destroy clothing. Soluble in about 2 parts of water; sparingly soluble in alcohol. Dose.—H., gyr.i.-ii. (.06-.12); D., gr.=1, (.006). Action and Uses.—Potassium cyanide is transformed, in the stomach and blood, into prussic acid, and resembles the latter in its action, but is much slower. Death has been caused in man by 5 grains of the salt. ARGENTI CyanipuM. Silver Cyanide. AgCN. (U.S. P.) A white, insoluble, tasteless, odorless powder, used for making prussic acid. 348 INORGANIC AGENTS Prunus Virerniana. Wild Cherry. (U.S. P.) Synonym.—Ecorce de cerisier de Virginie, Fr.; wild- kirschenrinde, G. The bark of the wild cherry, indigenous in the United States, contains a ferment (emulsin) which, in the presence of water, acts on a glucoside (amyegdalin, C,, H,, N O,) con- tained in the bark, with the formation of hydrocyanie acid, glucose and a volatile oil. A fluid extract, infusion and syrup of prunus virginiana are official. The latter prepara- tion is sometimes employed in cough mixtures for dogs, on account of its sedative action. The entire value of the drug depends upon the minute amount of prussic acid formed in it. The official hydrocyanic acid is more reliable, but syrupus pruni virginianz (U.S. P.) may be used as a vehicle for more efficient remedies. Perrotatum. (U.S. P.) (Three varieties.) -1.—Perrotatum Liquipum. Liquid Petrolatum. (U.S. P.) Derivation.—A. mixture of hydrocarbons, chiefly of the marsh-gas series, obtained by distilling off the lighter and more volatile portions from petroleum, and purifying the residue when it has the desired consistence. Properties.— A colorless, or more or less yellowish, oily, transparent liquid, without odor or taste; or giving off, when heated, a faint odor of petroleum. Spee. gr. about 0.875 — 0.945. Insoluble in water; scarcely soluble in cold or hot aleohol, or cold absolute alcohol; but soluble .in boiling absolute alcohol, and readily soluble in ether, chloroform, carbon disulphide, oi] of turpentine, benzin, benzol, and fixed and volatile oils. ?.—Prrrotatum.* Petrolatum. (U.S. P.) Synonym.— Vaseline, cosmoline. Derivation.—A mixture of hydrécarbons, chiefly of the é * The 1905 edition of the U.S. P recognizes simply Petrolatum, which now includes both the Petrolatum Molle and Spissum. ma! HARD PETROLATUM 349 marsh-gas series, obtained by distilling off the lighter and more volatile portions from petroleum, and purifying the residue when it has reached the desired melting point. Properties.—A fat-like mass of about the consistence of an ointment, varying in color from yellowish to light amber, laving not more than a slight fluorescence, even after being melted; transparent in thin layers, completely amorphous, and without odor or taste; or giving off, when heated, a faint odor of petroleum. The melting point of petrolatum ranges between 45° and 48° ©. (113° and 118.4° F.). In other respects soft petrolatum has the solubility of liquid petrolatum. Petrrotatum Atzsum. White Petrolatum. A colorless mixture of hydrocarbons, chiefly of the methane series, obtained by distilling off the lighter and more volatile portions from petroleum, and purifying the residue. A white, unctuous mass, of about the consistency of an oint- ment, transparent in thin layers, completely amorphous; without odor or taste. Otherwise it resembles, in solubility, petrolatum. Action and Uses.—Petrolatum is a valuable emollient. It soothes, protects and softens parts to which it is applied, and is superior to animal and vegetable fats and oils in not becoming rancid, and therefore irritant and malodorous. Petrolatum may be used alone, or as an excipient in the preparation of ointments, but does not aid the absorption of drugs (as. do alcohol, glycerin, chloroform, and animal oils and fats), for it is not itself absorbed even when adminis- tered internally. Petrolatum exerts a demulcent action upon the mucous membrane of the alimentary tract, and may be prescribed in electuary or capsule in inflamma- tion thereof. Petrolatum is sold universally under the pro- prietary names of vaseline and cosmoline, and is often com- bined with antiseptics for medicinal and surgical purposes yn skin diseases and upon inflamed mucous membranes, blistered and abraded surfaces and sores. It is one of the most useful agents in lubricating instruments, protecting 350 INORGANIC AGENTS metal from rust, preserving leather, and is sometimes employed as a vehicle for electuaries. RutGoLtene. (Non-official.) Rhigolene is a petroleum product prepared by repeated distillation until the liquid boils at 64.4° F. It evaporates at a lower temperature than any other substance, except cymogene, and is employed as a spray to induce numbness and local aneesthesia of a part in minor surgical operations, such as paracentesis of an abscess or the use of the actual cautery. Artuyiis Cutoripum. (U.S.P.) C, H; Cl. Ethyl chloride is in more common use for the same pur- poses. It is a colorless, mobile, very volatile liquid; slightly soluble in water but readily soluble in aleohol. It is made by the action of HC] gas upon absolute ethyl alcohol. It is usu- ally sold in glass tubes with a screw or lever-spring metal top enabling the fluid to be sprayed upon the surface of the body in any desired amount. On account of its great volatility and rapid evaporation it abstracts heat and freezes a part, and so acts as a local anesthetic. It is convenient for minor surgical operations, as opening abscess or boil, or aspiration. The vapor is very inflammable. Ethyl chloride is also used to produce trans- ient, general anesthesia. 1 or 2 drachms may be used for dogs. It is exceedingly rapid in its effects and a safe anzes- thetic for short periods. It is sprayed into the neck of a funnel, the large end being partly filled with: absorbent cotton and held tightly over the nose. Recovery is also extremely rapid. Ethyl chloride is often sold under the name of “kelene.” It is used frequently as a preliminary to ether in human practice and is more agreeable to inhale. Plenty of air should be allowed, except at the outset. I PART II. VEGETABLE DRUGS, SECTION I.—DRUGS ACTING UPON THE BRAIN. Class 1.—Depressing the Brain. Orium. Opium. (U.S. & B. P.) Derivation.—The concrete, milky exudation obtained by incising the unripe capsules of Papaver somniferum Linné (Nat. ord. Papaveracez), and yielding in its normal, moist condition, not less than 9 per cent. of crystallized morphine, when assayed by the official process (U.S. P.) Opium is procured from Turkey, Asia Minor, Persia, India and Egypt. The Smyrna, or Turkey opium is the more common variety used in the United States. It occurs in irregular, globular masses, covered with poppy leaves and capsules of a species of dock, weighing from } to 1 pound. Properties.—Irregular, or sub-globular cakes, with the remnants of poppy leaves and fruits of a species of rumex adhering to the surface; plastic, or of a harder consistency; chestnut-brown or darker, and somewhat shining; internally showing some tears and fragments of vegetable tissue. It has a sharp, narcotic odor, and a peculiar, bitter taste. It yields its medicinal properties to water, alcohol, and diluted acids, forming dark brown solutions. Ether extracts its principles in part. Constituents.—There are nineteen or more alkaloids; the three first are used in human medicine, but narceine is of no value in veterinary medicine. Morphine. 2,5—22.8 per cent. Thebaine, .15— 1. percent. Codeine, ere Narcotine. Ta —10;. (8 Narceine. shee oe Papaverine. 1, ND 351. 352 VEGETABLE DRUGS In addition to these, the following exist in minute quan- tity, but some are merely “pharmaceutical curiosities ”:— Protopine. Organic Acids. . Cryptopine. Meconic Acid. Oxynarcotine, Lactic Acid, Hydronarcotine, Pectin. ‘Laudanosine. Gum. 50. per cent. Laudaine. Resin. Phoeadine. Glucose. Codamine. Fixed Oils. Meconodine. A Volatile Oil. Gnoscopine. Odorous Bodies. Lanthopine. Caoutchouce. Water. 15.—25. per cent. nou Salts. Neutral Bodies. Calcium Salts. Meconin. Magnesium Salts. Meconoisin. Impurities.—Starch, molasses, leaves, fruit, stones and water. Incompatibility.—Solutions of lead acetate and sub- acetate, and of copper and arsenic salts, precipitate mecon- ates, sulphates and coloring matters, but the opium remains physiologically active. Ferric chloride produces a deep red color with opium, by its union with meconic acid. Tannin compounds precipitate codeine tannate. Alkalies, their car- bonates and ammonia precipitate morphine and narcotine. Dose.—H., 31.-ii. (4.-8.); C., 3ii-iv. (8.-15.); Sh., gr.x.- xxx, (.6-2.); Sw., gr.v.-xx. (.3-1.3); D., gr.ss.-ili. (.03-.2). Opi Putvis. Powdered Opium. (U.S. P.) Opium dried at a temperature not exceding 85° C. (185° F.), and reduced to a fine powder. Powdered opium, for pharmaceutical or medicinal purposes, when assayed should yield not less than twelve (12) nor more than twelve and a half (12.5) per cent. of crystallized morphine. Any powdered opium of a higher percentage may be brought within these limits by admixture with powdered opium of a lower percentage in proper proportions. Oniy those are mentioned here which are applicable to veterinary practice. POWDERED OPIUM 353 Dose.—Same as for opium, but preferable to the crude drug. PREPARATIONS. Extractum Opii. Extract of Opium. (U.S. & B. P.) Powdered opiut 100 listilled water, 1000; sugar of milk, a sufficient quantity. Made by trituration, filtration, and evaporation. Assayed to contain 20 per cent. of morphine. (U.S. P.) Dose.— About one-half that of powdered opium. H., 3 ss.-i. (2.-4.); C., 3i.-ii. (4.-8.); Sh., gr.v.-xv. (.3-1.); Sw., gr.iiss.-x. (.15-.6); D gr.14-i.ss. (.015-.09). Pulvis Ipecachuanhe et Opii. Powder of Ipecac and Opium. (U.S. P.) Synonym.—Dover’s powder, E.; pulvis ipecacuanhz opiatus, s, pulvis Doweri, P. G.; poudre de Dower, Fr.; Dower’sches pulver, G. Tpecac, 10; powdered opium, 10; sugar of milk, 80. The most diarphoretic compound of opium. Dose.—H., 3 ss.-i. (15.-30.); D., gr.iii.-xv. (.2-1.). Tinctura Ipecacuanhe et Opii. Tincture of Ipecac and Opium. GU Seb.) Synonym.—Liquid Dover’s powder. Tincture of deodorized opium, 1000; fluid extract of ipecac, 100; diluted alcohol, a sufficient quantity to make 1000. Made by evapora- tion and filtration. : Dose.—Same as Dover’s powder. Tinetura Opii. Tincture of Opium.* (U.S. & B. P.) Synonym.—Laudanum, tinctura meconii, tinctura thebaice, E.; tinctura opii simplex, P. G.; teinture d’opium, teinture thébaique, Fr.; einfache opiumtinktur, G. Powdered opium, 100; alcohol, 400; water, 400; diluted alcohol to make 1000. Made by trituration, maceration with precipitated cal- cium phosphate, and percolation. (U.S. P.) Dose.—H., 3 i.-ii. (30.-60.); C., 3 ii.-iii. (60.-90.); Sh. & Sw., 3 ii.-vi, {8.-24.); D., Miii.-xx. ( 2-1.3). Tinctura Opti Camphorata, Camphorated Tincture of Opium. (OSS RE.) Synonym.—Tinctura camphorze composita, B. P.; paregoric, elixir paregoricum, paregoric elixir, E.; tinctura opii benzoica, P. G.; élixir. parégorique, Fr.; benzéesaurehaltige opiumtink:tur, G. * Both the tincture and deodorized ee son opium are standardized to contain 1.2-1.25 gm. of morphine in lu Cc. (U.S 354. VEGETABLE DRUGS Powdered opium, 4; benzoic acid, 4; camphor, 4; oil of anise, 4; glycerin, 40; diluted alcohol to make 1000. Made by maceration and fltraplon. (Ws. Dose.—D., 3 i.-iv. (4.-15.). Opium Deodoratum. Deodorized Opium. (U.S. P.) Synonym.—Opium denarcotizatum. Powdered opium (containing 12-12.5 per cent. of morphine), 500; purified petroleum benzin, q.s. Made by repeated maceration, agita- tion and percolation with purified petroleum benzin. The petroleum benzin removes narcotic and odorous principles, which cause nausea and disagreeable after-effects in opium. Contains 12-12.5 of morphine. Dose.—Same as powdered opium. The eighth (last) edition of the U.S. P. has introduced Opium Granulatum (granulated opium); made by drying opium at a tempera- ture not exceeding 85° C. (185° F.) and reducing it to a coarse (No. 20) powder. It should not yield less than 12 nor more than 12.5 per cent. of crystallized morphine. Dose, same as deodorized opium. Tinctura Opii Deodorata. Tincture-of Deodorized Opium. (U.S. P.) Granulated opium, 100; purified petroleum benzin, 75; alcohol, 200; water to make 1000. Made by percolation with water, agitation with purified petroleum benzin, and evaporation. Dose.—Same as tincture of opium, but less nauseating. Extractum Opti Liquidum. (B. P.) (Contains °4 per cent. of morphine.) Dose.—Same as laudanum. Vinum Opii. (U.8. P.) Dose.—Same as laudanum. Morpntna. Morphine. C,, H,, NO, + H,O. (U.S. & B.P.) Derivation.—An alkaloid obtained from opium. 1. Macerate opium in cold water, forming a solution of morphine meconate. 2. Add calcium chloride to precipitate calcium meconate and resins. 3. Evaporate solution remain- ing, which contains morphine hydrochlorate, till it crystal- lizes; press in flannel to remove narcotine and coloring matter; redissolve ; filter; evaporate and crystallize repeat- edly. 4. Decolorize by digestion with charcoal. 5. Preci- pitate with ammonia and wash, when pure morphine is separated from codeine. Properties.—Colorless or white, shining prismatic crys- tals, or fine needles, or crystalline powder; odorless and MORPHINE HYDROCHLORIDE 355 having a bitter taste ; permanent in the air; soluble in 4,350 parts of water. : Dose.-—Same as salts of morphine, but the latter are preferable on account of their solubility. Morpain# Hyprocatoripum. Morphine Hydrochloride. CN Of) Cl -- 3 H,0:. (0. S&B Py Derivation. — Morphine is stirred with hot distilled water, to which hydrochloric acid is gradually added. Mor- phine hydrochlorate crystallizes out on cooling. Properties.— White, feathery needles of a silky lustre; or minute, colorless, needle-shaped crystals; odorless and having a bitter taste. Permanent in the air. Soluble in 24 parts of water and in 62 parts of alcohol. Very slightly soluble in ether or chloroform. ‘ Incompatibility.—Incom patible with all agents containing tannin, alkaline carbonates, lime water, salts of copper, mer- cury, zine and lead; and with Fowler’s solution of arsenic. Dose.—H. & C., gy.iii.-x. (.2-.6); Sh., gr.ss.-ii, (.03-.12); . Sw., gr.1,-} (.006-.03); D., gr.3-4 (.008-.03). - Subcutaneously.—H., gr.iii.-iv. (.2-.24); D., gr.3-1 (.008- .03). 124 parts of morphine hydrochloride correspond to 100 parts of morphine. MorpHin® Acetas. Morphine Acetate. C,,H,,N 0,C,H,O, + 3H,O. (U.S. &B. P.) wverivation.—Morphine is dissolved in acetic acid and water, and the solution evaporated and crystallized. Properties.—A white, or faintly yellowish-white, crystal- line, amorphous powder, having a faint, acetous odor and bitter taste. It slowly loses acetic acid on exposure to the air, and should be kept in dark, amber-colored, well-stop- pered vials. Soluble, when freshly prepared, in 2.5 parts of water, and in 47.6 parts of alcohol. Dose.—Same as morphine hydrochloride. 356 VEGETABLE DRUGS Morpuin® SutpHas. Morphine Sulphate. (C,,H,,N 0,), EES O72 5 EO! (US aa ee) Derivation—Morphine is stirred into boiling distilled water; diluted sulphuric acid is added until neutralization is attained, and the sulphate crystallizes out on cooling. Properties.—White, feathery, acicular crystals of a silky lustre; odorless and having a bitter taste. Permanent in the air. Soluble in 21 parts of water, and in 702 parts of alcohol. Dose.—Same as hydrochloride. 125 parts of morphine sulphate correspond to 100 parts of the pure alkaloid. The official salts of morphine may be used interchange- ably. The acetate is more soluble, but less stable, than the sulphate, which is sufficiently soluble for practical purposes, and is in more common use. Liquor Morrain® Hyprocsatoripi. (B. P.) One per cent. Dose.—H., 3 vi.- 3 ii. (24.-60.); D., Ti_x.- 31. (.6-4.). Liquor Morpainm Aceratis. (B. P.) Same strength and dose as above. Insectio Morpuin® Hypopermica. (B. P.) One per cent. Dose.—Same as liquor morphini hydrochloridi. Supposirorta Morpuinm (B.P.) ° (Gr.4 morphine.) Dose.—Dog, 1 per rectum. CopEiIna. Codeine. O©,,H,,NO,+ H,O. (U.S. & B. P.) Derivation.—An alkaloid obtained from opium by evapo- ration of the ammonineal liquid, after the precipitation of HEROIN Bol morphine. The residue is added to water, precipitated by potassium hydrate, and redissolved in ether, from which codeine crystallizes out on evaporation. Properties.—W hite, or nearly transparent, orthorhom- bic prisms, or octohedral crystals; odorless, and having a faintly bitter taste; slightly efflorescent in warm air. Soluble in 80 parts of water, and in 3 parts of alcohol; also soluble in 30 parts of ether and in 2 parts of chloroform. Dose.—D., gr.}-ii. (.015-.12). HEROIN. (Diacetylmorphine.) This remedy, derived from morphine, was first intro- duced by Dreser, in 1898, and is now used extensively in human medicine as a substitute for morphine and codeine. Heroin occurs as a white, odorless, crystalline powder, possessing a slightly bitter taste and alkaline reaction. Practically insoluble in water, but readily soluble in weak acidulous solutions. Heroin hydrochloride is a white, crystalline, odorless powder, soluble in 2 parts of water. Heroin surpasses both morphine and codeine therapeutically in many ways. It increases markedly the inspiratory and expiratory force, while lessening the number of the respiratory movements, and exerts a special sedative influence on the respiratory mucous membranes. The drug acts also as a general motor depressant hypnotic and analgesic, but is not comparable to morphine in these respects. The after-effects of small medicinal doses (nausea, constipation, ete.) are slight. Heroin is particularly valuable in the treatment of all varieties of cough affecting the human subject, and should prove useful in canine practice. Heroin may be administered in powder, pill or tablet, the hydrochloride in solution, every few hours. The dose of either is, tor the dog, gr./,-1 (.0025-.01). 358 VEGETABLE DRUGS Oprrum AND MOoRrPHINE. The action of morphine and opium is practically the same, with some exceptions to be noted. Action External—Opium may be absorbed to a slight extent from the unbroken skin, and causes a mild, anodyne action. Absorption readily occurs from mucous membranes and raw surfaces, with resulting characteristic effects. Action Internal.— Digestive Tract.—Opium diminishes the two principal activities of the digestive organs, namely, secretion and motion. Secretions all over the body are decreased, except that of sweat. The action upon the ali- mentary tract in lessening secretion, is partly a local one and partly constitutional, following the absorption of the drug. The mouth is made dry, thirst is increased and appe- tite impaired. Opium is absorbed rather slowly from the stomach and bowels, and stimulates the splanchnic nerve centre of the sympathetic system, which inhibits the move- ments of the stomach and intestines, and thus lessens peri- staltic action of these organs. Opium is directly opposed to belladonna in this respect, as the latter drug paralyzes the intestinal inhibitory apparatus (splanchnic endings), and so increases peristalsis. In diminishing both secretion and motion, opium causes constipation in health, but is most useful in relieving vomiting and diarrhoea. In toxic doses, opium may induce diarrhoea from paralysis of the splanchnic inhibitory centre. Blood and Elimination. — Morphine circulates in the blood as such. The greater part of opium is decomposed in the body, a portion being destroyed by the liver, while some is probably burned up in the blood.. The smaller part is eliminated, chiefly by the kidneys, but also in the other secretions. It is found in the gastric juice after hypo- dermic injection, and therefore washing out the stomach assists elimination and recovery in opium poisoning. Nervous System.—The most important action of opium is exerted upon the nervous system. It is necessary to OPIUM AND MORPHINE 359 study the drug from the comparative standpoint in order to obtain a full understanding of its effects. The brain of man, being more highly developed and sensitive, in comparison with other parts of the nervous system, than the brain of the lower animals, it follows that this organ is more power- fully influenced in man, while the spinal cord is often mainly impressed in the lower animals. We may take the action of opium on the frog, at one end of the scale, as exhibiting the most active spinal symp- toms; while in man, at the other end of the scale, cerebral phenomena predominate. The other animals occupy an intermediate position; the action upon the horse and rumi- nants is something between that exerted upon the frog and man, and the influence upon dogs approaches more nearly that seen in human beings, only that a relatively greater dose is required to produce the same result, as the brain is not so highly organized or sensitive to the action of. medi- cines. The brain of the horse is only one-twelfth as large, in proportion to their respective body-weights, as that of man, and it follows that the spinal cord of the horse is more readily affected by opium, in accordance with the general law that the more highly developed a part is, the more easily is it influenced by therapeutic agents. Opium exerts first a stimulating, and then a depressing action upon the brain and spinal cord, and in studying the action comparatively it will be noted that the influence upon the cord in the frog, horse, ruminant, and to some extent in the dog, preponderates frequently over the effect of the drug upon the brain, for the reasons stated above. Action Upon the Frog.—In non-poisonous doses, sleep is produced and diminished spinal reflex activity, followed by a period of reflex excitement. Toxic doses of 1 or 2 grains of morphine, injected under the skin, cause at first a condition where convulsions occur, if the animal is artificially irri- tated; later they come on spontaneously. This state is followed by general paralysis, respiratory failure and death. The convulsions are shown to be due mainly to stimulation 360 VEGETABLE DRUGS of the receptive and transmitting cells of the spinal cord, as in strychnine poisoning. Action Upon Horses.—Three grains of morphine, injected subcutaneously, occasion sometimes drowsiness, and at other times produce no visible effect. Four to six grains, given in the same way, cause restlessness, a rapid pulse, and moisture of the skin. The animal paws the ground and walks in arhythmical manner about the stall. The pupils are dilated. Large doses (12 grains) are followed by in- creased excitement aggravated by noises, sweating, ptyalism, muscular rigidity, staggering gait, trembling and delirium; while still larger doses (four drachms of the extract of opium) cause violent trembling, convulsions, insensibility to pain and external irritation, without coma; or (morphine, gr. 36 under the skin), rarely, stupor for several hours (3 hours), dilated pupils and blindness, followed by delirium and rest- lessness, continuing for a longer time (7 hours) and ending in recovery. Horses have recovered from an ounce of opium, but 23 ounces of the drug, and 100 grains of mor- phine have proved fatal. The action of opium upon the horse differs from that upon man and dogs in the more frequent occurrence of restlessness and motor excitement due to stimulation of the cerebral and spinal motor centres; and in dilatation instead of contraction of the pupil. The rationale of the latter phenomenon has not been discovered. Action Upon Ruminants —These animals are compara- tively insusceptible to opium. Ounce doses of the drug cause, in cattle, restlessness, excitement, hoarse bellowing, dry mouth, nausea, indigestion and tympanites. Sheep are affected in much the same manner. One to two drachms of morphine have led to fatality in cattle. Fifteen to thirty grains of the alkaloid comprise a lethal dose for sheep. Swine are variously influenced; sometimes excited, some- times dull and drowsy. Action Upon Birds.—Birds, as represented by chickens, ducks and pigeons, are exceedingly insusceptible to opium. This is chiefly due to the slow absorption from the crop. OPIUM AND MORPHINE 361 Pigeons cannot be given enough opium by the mouth te cause death, but 8 to 10 grs. of morphine per orem, or 2 of 3 grs. hypodermatically, will prove fatal. The toxic symp- toms in birds are exhibited by unsteadiness, difficult breathing and failure of respiration, convulsions and death. The pupils are unaffected, and sleep does not ensue. Action Upon Dogs.—When 8 or 10 grains of morphine are given to a moderate sized dog, coma comes on, from which the animal may recover. One half a grain injected under the skin of a dog weighing 25 lbs., causes nausea, vomiting and perhaps purging, sleep deepening into coma, contracted pupils, and shallow breathing; the condition lasting for several hours and followed by recovery. Opium rarely exerts an hypnotic action upon cats, but rather motor excitement. Lethal doses (average, 4 grains of morphine sulphate subcutaneously to the pound, live weight, for dogs; 2 to 3 grains sometimes kill small dogs), increase the frequency of the pulse, cause vomiting, unsteadiness, contracted pupils, motor excitement, as twitching of the limbs, followed by coma, respiratory failure and death. Recovery from full doses of opium is accompanied in dogs by general physical and mental depression and lassitude, as in man. There are muscular weakness, loss of natural spirit, timidity, and nausea, lasting for several hours. The action of opium upon dogs differs from that upon man only in degree. The dose required is proportionately larger. There is often more preliminary excitement and symptoms of reflex irritation, as muscular twitching. These animals do not sweat, and the pupils are not so continuously con- tracted in poisoning. Failure of the drug to produce sleep, and the presence of nausea, retching, dreams, delirium, hallucinations, occasionally observed in dogs, are common to man. Convulsions rarely occur in either men or dogs. Action Upon Man.—In man, a small dose of morphine (4 gr.) causes usually a sense of well-being, together with itching of the nose, and later, of the skin generally, dryness of the mouth (occasionally there may be nausea, vomiting 362 VEGETABLE DRUGS and faintness), followed by sleep, or a pleasant, dreamy state. After-effects may be absent, or consist of nausea, headache, coated tongue and constipation. If the dose is larger, sleep comes on quickly, the pupils are contracted, the respiratory movements and pulse become slow, and the skin is moist. With lethal doses, sleep deepens into coma, from which the patient can at first be aroused; the coma becomes pro- found, the pulse feeble and rapid, the respiration stertorous, slow and imperfect. The mucous membranes are cyanotic, the face livid, the pupils dilate, and the surface is covered with clammy sweat. Death occurs from respiratory failure, oceasionally preceded by convulsions. One-eighth of one grain of morphine is the smallest fatal human dose recorded. The action of opium upon man, as compared with that upon the horse and ruminants, is characterized by its predominant depressing effect upon the higher mental functions. The motor centres of the brain and cord are only slightly influenced. General Action of Opium Upon the Nervous System.— The action of opium on the nervous system may be summar- ized as follows: 1. On the cerebrum. The predominant action of opium on man and the dog consists in depression of the higher brain centres with the production of nervous sedation and sleep. In the hind-brain depression cf the perceptive centres gives relief from pain. In the fore-brain depression of the centres for intelleect—especially of will and attention— causes sleep. The middle or motor area of the brain is com- monly not affected until paralyzed in fatal poisoning. In horses and eats, however, toxic doses do stimulate the cere- bral motor centres. A primary stimulant stage in the action of opium on the brain of man is sometimes evident. In this there is a feeling of well-being and enhanced mental powers. But the stimulation is brief and rarely uni- form, imagination being increased at the expense of reason and judgment. This stage is often wholly absent. In the lower animals—other than dogs—the sedative and hypnotic effect of opium is less certain and may be completely want- ing. In a general way small and moderate doses cause cere- OPIUM AND MORPHINE 363 bral depression, while large doses give rise to spinal reflex | excitability in the lower animals—especially in the horse, ass, cattle and cats. 2. On the spinal cord. Small medicinal doses depress the motor cells, but large and toxic amounts stimulate the motor cells indirectly and cause convulsions—probably—as in strychnine poisoning—by increasing the activity of the receptive and transmitting cells of the cord. Convulsions, caused by spinal and cerebral motor stim- ulation, rarely occur in man or dogs but are common after - toxic amounts in horses, cattle and cats. The result of a fatal dose is paralysis of the central nervous system, includ- ing the respiratory and, to much less degree, the vagus and inhibitory centres. The unique and inestimable value of opium depends upon its anodyne action. Relief from suffering is often in- duced without the production of sleep. Muscular weakness is present in man and dogs, but even this evidence of depression may be absent in horses and rumi- nants, yet pain be effectually relieved. | Initial stimulation of the vomiting centre may cause emesis; but, as depression of the centre rapidly ensues, the act becomes later improbable. The excitability of the motor — and sensory nerves is slightly increased, but otherwise the nerves are not affected except in poisoning, when the sensory, and later the motor nerves are paralyzed. The muscles remain uninfluenced. Respiration.—Opium does not influence the respiratory functions ‘in small therapeutic doses, but large doses make the respiratory movements slower and feebler, and death oc- curs from the direct depressing and paralyzing action of the drug upon the respiratory centres’ in the medulla. Circulation.—Small doses commonly produce little effect upon the heart. Large doses first increase the force and then slow the heart’s action, while toxie quantities de- press the organ. The cardiac muscle is’ primarily 364 VEGETABLE DRUGS stimulated, with acceleration of the pulse, but depression soon follows more or less synchronously with stimulation of the vagus centre‘and endings, so that the pulse becomes infrequent. Finally, before death, depression of the inhibi- tory apparatus occurs, and this, coexisting with depression of the heart itself, produces a feeble, rapid pulse, character- istic of the last stage of opium poisoning. Death occurs with diastolic arrest of the heart owing to failure of the cardiac muscle, although fatality is mainly due to the more powerful effect of the drug upon the respiratory centre. The action of opium upon the vasomotor system is unimportant. Immediately after the administration of large doses there is a slight primary stimulation, followed in the toxic stage by some depression of the vasomotor centres in the spinal cord and medulla. Pupil.The pupil of the horse is widely dilated by large doses of opium. The pupil in the dog occasionally remains unchanged, and often dilated before undergoing contraction. Contraction of the pupil is a charactistic physiological effect of large doses of opium in man and the dog. In birds the pupil is unaffected. These various con- tradictory phenomena are at present inexplicable. In man, contraction of the pupil is brought abqut by stimulation of the pupillary centre in the floor of the aqueduct of Sylvius, and through it, the oculomotor nerves. Dilatation, preceding death, occurs from depression of the centre. Kidneys and Metabolism.—The excretion of urea appears to be diminished by opium in man, but varies’ greatly in animals, Temporary retention of urine may follow the administration of a considerable dose of opium, owing to diminished sensibility of the bladder. The amount of urine voided may be greater or less than normal; more commonly the latter. Opium lessens the secretion of bile. The elimination of carbonic dioxide is diminished by the hypnotic action of opium, but is increased if there is OPIUM AND MORPHINE 365 general excitement and muscular activity following the use of the drug. Skin.—Opium induces mild diarphoresis in man; occa- sionally sweating occurs in horses, but not at all in dogs. Temperature.—The bodily temperature may be slightly increased by large medicinal doses of opium, but is dimin- ished by toxic quantities. Toxicology.—The symptoms of poisoning have already been sufficiently described in previous sections. The treat- ment embraces irrigation of the stomach, or the use of emetics, as apomorphine hydrochlorate under the skin, and the subcutaneous injection of strychnine, ene- mata of hot, strong, black coffee; leading the animal about, slapping him, or using the faradic current.. Dr. Moor, of New York, has apparently found in potassium permanganate the most efficient antidote for opium and morphine. Ten to fifteen grains, dissolved in eight ounces of water, should be given by the mouth, to large dogs. One to two drachms of potassium perman- ganate may be administered to horses in two or three pints of water. Permanganate solution oxidizes and destroys morphine, and should be acidulated with a little vinegar or diluted sulphuric acid, after the ingestion of morphine salts. The antidote has been recommended to be given subcutan- eously after absorption, or hypodermic injection of morphine, but this is not of the slightest use. Morphine Contrasted with Opium.—Opium is more con- stipating, more sudorific, and more apt to disturb the digestion than morphine. Morphine is more anodyne and soporific; more readily absorbed and more suitable for use under the skin. | Synergists.—Belladonna aids the action of opium and yet is antagonistic to it. It assists opium in its anodyne action and lessens nausea, indigestion, and constipation following the action of the latter drug. Belladonna and atropine are antagonistic to opium in stimulating the brain and respiration, and increasing peristalsis. Small doses of 366 VEGETABLE DRUGS belladonna combined with opium do not interfere with the soporific action of the latter, notwithstanding the exciting influence of the former upon the brain. The bromides also promote the sedative and hypnotic action of opium, and lessen the depression and nausea following its administra- tion. Opium often acts profoundly when combined with chloral, and this combination is occasionally used to induce anesthesia (p. 819). Chloroform and ether are frequently prescribed with opium to secure an additional antispasmodic and anodyne action in colic. The astringents and mineral acids enhance the effect of opium in diarrhoeal disorders. Codeine.—Codeine in large doses causes motor excite~ ment and convulsions in dogs and cats, but physiological experiments conducted by various observers have otherwise yielded diverse results. This is explicable, since so-called codeine is frequently in part morphine. Codeine is inferior to morphine as an anodyne and hypnotic, but is a useful sedative in relieving bronchial irritation and cough, and in the doses commonly employed does not induce indigestion, nausea or constipation. The writer would particularly recommend it for dogs suffering with bronchitis, combined with phenacetin in powder or tablet. The other alkaloids of opium are not of sufficient therapeutic value to warrant their consideration in this work. Administration.—Morphine sulphate is employed under the skin where an immediate effect is required. The prepa- rations more frequently used in veterinary practice include laudanum and the deodorized tincture, powdered opium, extract of opium, and the salts of morphine. One-quarter grain of the latter is equivalent to one grain‘of opium. Paregoric is useful in canine practice for cough mixtures. Dover’s powder combines the expectorant and diarphoretie action of ipecac with the sedative, antiphlogistic and sudo- rific influence of opium, but the former drug has little effect upon the horse. The preparation may be serviceable, how- ever, in the first stage of catarrhal affections of the respira-~ tory tract in dogs. INDICATIONS FOR THE INTERNAL USE OF OPIUM 367 Fluid preparations are generally desirable in securing more rapid absorption, but opium produces the best result in diarrhoea, when given in pill or ball. Enemata composed of thin, boiled starch solution and laudanum at the body temperature are to be recommended in diarrhoea of the young, dysentery and pain arising from strangury or disease of the genito-urinary organs. Opium suppositories are of value in canine practice for the same purposes, and will relieve irritation and pain caused by piles. Uses External.—Opium is applied externally in various ways. In the form of laudanum it is sprinkled on poultices and prescribed in liniment (laudanum and soap liniment, equal parts) for its anodyne action, but has probably little medicinal virtue upon the unbroken skin. On raw surfaces, sores and ulcers, opium does relieve pain, and for this pur- pose laudanum may be conjoined advantageously with lead water (1-25). INDICATIONS FOR THE INTERNAL USE OF OPIUM. 1. To relieve pain and spasm. 2. To lessen secretions. 3. To allay motor excitement, diminish muscular action, and prevent hemorrhage. 4, To abort inflammation. 5. To act as a stimulating and supporting agent. The sudorific action of the drug upon the lower animals is slight and comparatively unimportant. Among the pre- ceding indications the first three naturally follow from the physiological action of opium, while the latter two are deduced solely from clinical experience. 1. Although the anodyne and sedative action of opium is not so marked in its influence upon veterinary patients as in human subjects, yet it is by far the most valuable agent we possess for relieving pain of any description, parti- cularly when combined with atropine. In spasmodic colic of horses, opium arrests pain by preventing irregular and violent peristaltic action. It may be given as morphine 308 VEGETABLE DRUGS (with atropine), subcutaneously; or as laudanum, with ether and chloroform in a drench, simultaneously with an aloes ball. In this affection opium actually assists the action of the purgative by overcoming spasm. Pain directly antagonizes the effect of opium, and repetition of the dose is both justifiable and necessary until relief is obtained. Hypodermic medication is therefore safer when the dose has to be repeated, in enabling the practitioner to decide that failure to relieve pain is due to insufficient dosage rather than to delayed absorption from the digestive canal. Opium is indicated in all forms of pain and in motor excitement in cerebritis and meningitis. The pains and spasmodic contractions resulting from acute or traumatic meningitis are benefited by opium ; also neuralgic and rheu- matic pains. The spasms of eclampsia and tetanus are eased when opium is combined with chloral in enema, or when morphine is injected under the skin. Clonie spasm of the diaphragm in horses (“Thumps”’) is also treated suc- cessfully with opium. Morphine under the skin is useful in asthma in dogs. . 2 and 3. Opium is invaluable in lessening secretion, motion and pain in various digestive disorders. Gastric digestion is inhibited by the action upon secretion and motion, and opium should not be administered immediately after the ingestion of food, unless the demand for it at that time is imperative. Excessive vomiting in dogs may be combated with opium and bismuth, or with morphine hypodermatically. Opium quiets peristalsis and secures rest of the canal in gastritis and gastro-enteritis. In superpurgation and in all forms of diarrhoea and dysentery, opium is the remedy par excellence. (Laudanum in dose of 5-10 drops for large birds is an efficient remedy for diarrhcea in poultry). Its administra- tion in these disorders should be accompanied, or preceded, by an oleaginous (horse), saline (herbivora), or mercurial (horse and dog) purgative; and its action may be assisted INDICATIONS FOR THE INTERNAL USE OF OPIUM 369 | by astringents, alkalies, mineral acids, and intestinal antisep- tics in various combinations suited to the particular case. Peritonitis, enteritis, and acute obstruction of the bowels are treated most successfully with opium, which quiets the bowels, relieves pain and facilitates the vis medatrix nature, besides acting as an antiphlogistic in the first-mentioned diseases. By preventing muscular activity and allaying general excitability, opium is the most effective hzmostatic in all internal hemorrhages, and it quiets the heart most effectively in acute endocarditis. Cough, as a symptom of irritation within the res- piratory tract, is more commonly treated by some form of opium than by any other drug. When cough is irrita- tive or excessive, and is not remedial in removing secre- tion, then it is very properly controlled by opium. If, on the other hand, respiratory movements are weak, or cyanosis threatens from retained secretions, opium is dis- tinctly contraindicated, since it depresses the respiratory centres and lessens the irritation produced by the secre- tions in the bronchial tubes, which would otherwise cause coughing and expulsion of the exudate. Opium, especially when combined with belladonna, notably diminishes secretions, so that this combination is peculiarly appropriate in the treatment of cough and exuda- tion, and it is only when increasing moist rales are found to exist during this medication that it should be stopped. Pleuritic cough causes intense pain and accomplishes nothing, so that opium here affords great relief without inducing bad results. 4. Opium possesses antiphlogistic action in aborting and combating inflammation. Reflex excitability is less- ened by opium, and therefore irritation of nerve centres, which would otherwise cause vascular dilatation, stasis, and inflammation, is prevented by the drug. This is at least the theory. Opium and quinine are the two remedies having the most popular clinical reputation for aborting colds and inflammation, and the latter agent also diminishes reflex axcitability. Inflammation of serous membranes is thought 370 VEGETABLE DRUGS to be that form most favorably influenced by opium, as peri- tonitis, enteritis und meningitis, for which purpose the drug is frequently combined with calomel. But opium is also an extremely useful antiphlogistic remedy in coryza, bronchitis, pneumonia and pleurisy, and in inflammations of the mucous coat of the digestive canal, as gastritis and dysentery. A single full dose should be given at the earliest possible stage of these disorders, and the patient should be ees as aioe as possible to secure the best result. 5. Opium stimulates and supports the system in a manner not explicable on physiological grounds. It often conserves life in a remarkable way in patients weakened by long continued disease, and in those suffering from loss of blood following surgical operation, parturition, or other natural causes. Opium in some form (often as codeine) is the most useful remedy in diabetes mellitus, in dogs, in reducing the loss of glucose in the urine. Contra-indications.—In respiratory diseases associated with cyanosis or excessive exudation, in very high fever and obstinate constipation. The drug must be used with cau- tion in the treatment of the aged and very strong. APoMORPHINE HyprocHLoripuM. Apomorphine Hydrochlo- , ride.’ C,,H,,N O,H Cl. (U0. 8. & B. P.) Derivation.—The hydrochloride of an artificial alkaloid, obtained by heating morphine (or codeine) in hermetically closed tubes, with an excess of pure hydrochloric acid. The morphine thus loses one molecule of water; C,,H,,N O, = @,H,,N.0, + H,0. Properties. — Minute, grayish- white, shining, griatlee crystals, without odor, having a faintly bitter taste, and ac quiring a greenish tint upon exposure to light and air. Soluble in about 45 parts of water, and about 45 parts of alcohol; very little soluble in ether or chloroform. It should be kept in small, dark, amber-colored vials. (U.S: P-) Dose.—Emetic. nae «) QT-zI5-71, (.002-.006), subentancoai : D., by the mouth, gr.4-+ (.008-.012); D., expectorant, gr.z'p-z'5 (.0015-.0024), by the apni, APOMORPHINE B71 PREPARATION. Injectio Apomorphincee Hypodermica, (B. F. One per cent. Dose.—tv-x (.3-.6). Action Internal.—Small doses (gr.;45-31,) cause vomiting in dogs, while larger doses produce salivation and trembling in addition to vomition. Very large quantities (e1.4-5) occa- sion first great excitement; the dog howls, runs and jumps about, the pupils are dilated and the slightest noise excites great alarm. Then the animal weakens in the hind legs, becomes paraplegic, falls and goes into convulsions. The breathing, at the beginning rapid, becomes weak and slow. Death ensues from respiratory failure. Nervous System.—The drug primarily stimulates the brain and induces delirium and excitement, but secondarily causes cerebral paralysis. The origin of the convulsions is not ascertained. Apomorphine is a direct local paralyzant to the muscles, acting upon their substance or upon the motor nerve endings. Circulation.—Medicinal doses do not alter the force, but may increase the rate and tension of the pulse by stimula- tion of the cardiac accelerator nerves and vasomotor centres. Toxic doses paralyze the heart muscle and lower blood pressure. Respiration. — The respiratory movements are at first markedly increased by large doses of apomorphine. The reason for this is uncertain. Lethal doses depress and paralyze the respiratory centre. The breathing then be- comes feeble and infrequent. The agent causes a copious outpouring of a watery fluid from the blood vessels of the respiratory mucous membrane, and is, therefore, an expec- torant. Vomiting Centre. — This is stimulated by therapeutic doses of apomorphine, but paralyzed by toxic doses, so that vomiting may not occur in poisoning. Apomorphine does not act locally upon the stomach. 372 VEGETABLE DRUGS | Uses.—Apomorphine is a reliable, prompt and powerful emetic. The alkaloid is generally given under the skin and can be administered along with zinc sulphate or other emetic in poisoning. In narcotic poisoning, as with chloral or opium, apomorphine—like other emetics—may fail to act efficiently. In the first stage of acute bronchitis, apomor- phine is useful in canine practice, and again in the later stage, when the animal becomes choked with exudation. The drug, in a mild emetic dose, will aid recovery by causing violent expiratory efforts during vomition, and these tend to expel secretions, which is furthermore assisted by the action of the alkaloid in rendering the secretions less viscid. Chronic dry bronchitis of dogs is likewise benefited by amomorphine. Apomorphine is the best remedy known for pica: C., gr.-ii, subcutaneously, once daily for 3 days; foals, gr.-i.-iii. once or twice weekly, given under the skin. The alkaloid decomposes in crystal, and rapidly in solu- tion, becoming toxie and of a green hue. Solutions should be freshly prepared and are said to be prepared by the addition of a few drops of hydrochloric acid. Class 2.—Stimulating the Brain. BELLADONNe® Fora. Belladonna Leaves. (U.S. & B. P.) Synonym.—Deadly nightshade, E.; folia S. herba bella- donne, feuilles de belladonne, Fr.; tollkraut, tollkirschen blatter, wolfkirschen-blatter, G. Derivation. —The leaves of Atropa Belladonna Linné (Nat. ord. solanacez). Leaves from 10 to 15 em. long, from 5 to 10 em. broad; broadly ovate, equilaterally narrowed into a petiole, tapering at the apex. entire on the margin, smooth, thin; the upper surface brownish-green, the lower surface greyish-green; both surfaces whitish punctate; odor slight; taste bitterish, disagreeable. Constituents.—Two alkaloids; 1, atropine, the chief one, representing the action of belladonna; and, 2, hyoscyamine. Atropine is now considered to be an artificial product of hyoscyamine, and therefore the latter to be the natural BELLADONNA ROOT 373 alkaloid. Belladonna leaves contain about 0.46 per cent. atropine. Dose.—H. & C., 3 ss.-i. (15.-30.); D., gr.i.-v. (.06-.3). PREPARATIONS. Extractum Belladonne Foliorum. Extract of Belladonna Leaves. (U.S. & B. B.) Made by percolation and evaporation to pilular consistence. Used in preparing the unguenitum belladonnz. Contains 1.4 per cent. of mydriatic alkaloids. Dose.—H. & C., gr.x.-xx. (.6-1.38); Sh. & Sw., gr.ii.-iv. (.12-24.); D., gr.4-4 (.008-.03). Tinctura Belladonnee Foliorum. Tincture of Belladonna Leaves. (UN Ss a> B*) Belladonna leaves, 100, diluted alcohol to make 1,000. Made by maceration and percolation. (U.S. P.) Dose.—D., Mv.-xxx. (.3-2.). Unguentum Belladonne, Belladonna Ointment. (U.S. & B. P.) Extract of belladonna leaves, 10; diluted alcohol, 5; benzoinated lard, 85. (U.S. P.) i BELLADONN® Raptix. Belladonna Root. Synonym.—KRacine de Belladonne, Fr.; wolfskirschen- wurzel, tollkirschen-wurzel, G. Derivation.—The root of Atropa Belladonna Linné (nat. ord. solanacez). In cylindrical, somewhat tapering, longi- tudinally wrinkled pieces, 10 to 25 mm. or more in thickness ; externally brownish-gray, internally whitish ; fracture nearly smooth and mealy, not radiating or showing medullary rays in the thicker roots, only in the layer near the bark; nearly inodorous, taste sweetish, afterwards bitterish and strongly acrid. Constituents.—Same as leaves. Contains 0.2 to 0.6 per cent. atropine. PREPARATIONS, Fluidextractum Belladonne Radicis. Fluidextract of Belladonna Root. (02.8. F2) Made by percolation with alcohol and water, and evaporation. One cc. of the extract = one gm. of belladonna root. Standarizod so that 100 cc. of the fluidextract contain 0.5 gm. of mydriatic alkaloids. The most reliable preparation. O74 VEGETABLE DRUGS. Dose.—H., 3 i.-ii. (4.-8.); C., 3 ii.-tii. (8.-12.); Sh. & Sw., ™x.-xv. (.6-1.); D., Mi.-iii. (.06-.2). Linimentum Belladonne. Belladonna Liniment. (U.S. & B. P.) Camphor, 50; fluidextract of belladonna to make 1,000. (U.S, P.) Atropina. Atropine. C,,H,, N O,. (ULSre BPs An alkaloid obtained from belladonna. As it occurs in - commerce, it is always accompanied by a small proportion of hyoseyamine extracted along with it, from which it cannot readily be separated. Derivation.—Atropine is obtained from a strong tincture of the root. Slaked lime is added, which splits up atropine malate and precipitates lime malate. The excess of lime is precipitated by sulphuric acid, and coloring matters by potassium carbonate, which also sets free atropine. The atropine is dissolved in chloroform, recovered on evapora- tion, and purified by digestion with warm alcohol and char- coal. Properties.— White, acicular crystals, or a more or less amorphous white powder; without odor, having a bitter, acrid taste, and gradually assuming a yellowish tint on exposure to air. Soluble in 130 parts of water, 3 parts of alcohol, 16 parts of ether, 4 parts of chloroform, and about 50 parts of glycerin. At about 108° C. (226.4° F.) it melts, forming a colorless liquid. At about 140° C. (284° F.) it begins to give off white, acrid fumes, and when ignited, it is consumed without leaving a residue. It has a markedly alkaline reaction; its saturated aqueous solu- tion acquires a pink color upon the addition of a drop of phenolphtalein. Incompatibles. —Decomposed by sodium or potassium hydrate. Dose.—H., gr.ss.-iss. (.03-.09); average dose, gr.i. (.06) ; C., gri-il (.06-.12); Sh. & Sw., gr.si-7 (.003-.005) ; D., ort y-y (.0005-.001). ATROPINE SULPHATE ao. ArrRopIN® SutpHas. Atropine Sulphate. (C,,H,,NO,), H,SO,. (U. 8: & B. P.) Derivation. — Atropine is dissolved in sulphuric acid and treated with ether, when the insoluble sulphate settles out. Properties. — A oa indistinctly crystalline powder, without odor; having a very bitter, nauseating taste, and permanent in the air. Soluble in 0.4 parts of water, 6.2 parts of alcohol, 2,270 parts of ether, or 694 parts of chloro- form. At 187° C. (309° F.) the salt melts, forming a brown- ish-yellow liquid. When ignited, it chars, emits acrid vapor, and is completely consumed. The salt is neutral to litmus paper. Dose. ae: or.i.-1ss. Be .09).+C. Bre -li. (.06-.12); Sh. & Sw., gr. 1015 x (.004-.005) ; D., gr.zt,-345 (.0005-.002), average dose, gr.jt, ( 0006). ACTION OF BELLADONNA AND ATROPINE. External.—Belladonna is ordinarily not absorbed from the unbroken skin, but when applied to raw surfaces and mucous membranes, or, to a less extent, when rubbed into the skin with camphor (linimentum belladonnz), chloroform, alcohol, etc., it depresses the sensory nerve endings and produces a local anodyne action. Thus applied it also depresses the peripheral motor nerve fibres, and is some- times injected into spasmodically contracted muscles for relief of spasm. The vessels are said to be first contracted and then dilated by the local action of the drug, and the secretions of the skin are diminished. Internal.— Digestive Tract.—The action of belladonna, if any, on the secretory functions of the stomach and bowels is unknown. Small doses of the drug depress the peripheral terminations of the intestinal inhibitory nerve (splanchnic), so that peristalsis is increased by the normal stimuli. It is stated that both minute and large doses apparently lessen intestinal peristalsis; the former by primary stimulation of 376 VEGETABLE DRUGS the splanchnic nerve endings, the latter fe direct depressant action upon the unstriated muscle of the intestinal wall. Circulation.—Belladonna is readily absorbed into the blood, but has no particular action upon this fluid within the body. Dilute solutions of atropine paralyze and stop corpuscular movement in the blood withdrawn from the vessels. The characteristic action of belladonna upon the circulation consists in depression of the peripheral pneumo- gastric fibres in the heart, so that the frequency of the pulsa- tions is increased.* There is also, probably, a slight stimu- lation of the cardiac muscle, or its contained ganglia. SBella- donna is therefore a heart stimulant, by increasing the num- ber of its beats without diminishing their force. Large doses sometimes give rise to primary slowing of the pulse, owing to stimulation of the inhibitory apparatus. Blood pressure is exalted synchronously with the increased frequency of the heart, and is due to cardiac stimulation and also to stimula- tion of the spinal and medullary vasomotor centres, with con- striction of blood vessels of the abdomen.t In poisoning, vascular tension is considerably lowered because of paralysis of the vasomotor centres, smooth muscles (or ganglia) of the vessel walls (with vascular dilation), and the heart muscle itself. Nervous System.—Cerebrum.—Belladonna is classed as a delirifacient by some authorities,—notably Wood. It stim- ulates the brain incoérdinately, and large doses produce restlessness, nervous excitement and delirium in man, and cccasionally delirium in the lower animals. Stimulation is succeeded by exhaustion and some depression, with stupor rather than coma. Spinal Cord.—Belladonna appears to exert a double action (stimulant and depressant) upon the spinal cord. The spinal vasomotor and respiratory centres are stimulated. Large doses cause complete loss of motion and _ reflex action in the frog, lasting for several days, and followed by reflex excitability and convulsions. Poisoning in mammals is exhibited by less paralyzant action accom- * Occasionally the heart is slowed by belladonna. Perhaps by pri- mary stimulation of the peripheral vagi. + Dilatation of the vessels of the skin occurs at the same time but this is insufficient to reduce blood pressure. In man this is shown by flushing of the skin and a bright rash on the face and neck after large doses. ACTION OF BELLADONNA AND ATROPINE 377 panied by more convulsive movements. Various explana- tions have been offered to reconcile these phenomena. The prevalent theory is that, following complete paralysis of the spinal cord, the motor and sensory tracts recover before the inhibitory centres, so that normal stimuli pass through the latter unrestrained and result in convulsions. Nerves—The action of belladonna upon the nerve end- ings is extremely important, and represents, to a consider- able degree, the therapeutic value of the drug. The peripheral motor nerve terminations, and, to a less extent, their trunks, are depressed and paralyzed. This is never so complete, however, but that there is some voluntary power left in an animal fatally poisoned. Depression and loss of function of the afferent nerves come on more slowly, and exist to a less degree. Belladonna, then, when applied locally or given internally, is an anodyne, but is far inferior in this respect to opium; and, whereas opium acts centrally, belladonna acts peripherally. The terminations of all secre- iory nerves are also depressed and paralyzed by be!ladonna, and secretions are therefore diminished. Secretions.—Dryness of the mouth is one of the first physiological symptoms following the administration of belladonna. This is due to paralysis of the peripheral terminations of the secretory nerve (chorda tympani) of the submaxillary gland, and of the secretory nerve endings of the other salivary and mucous glands in connection with the mouth. Another characteristic effect of belladonna consists in the production of dryness of the skin, which follows the action of the drug in paralyzing the peripheral nervous filaments supplying the secretory cells of the sudoriparous glands. In the same manner the tracheal and bronchial secretions are diminished, and also the secretion of milk (anti-galactagogue action), by depression of the terminations of the secretory nerves. The drug does not exert any decided influence upon the secretions of the digestive tract, as before stated. The amount of urine is sometimes increased after the ingestion of small doses of 378 VEGETABLE DRUGS belladonna, but is considerably lessened, or suppressed, in poisoning by the drug. Experiments upon man show that the urinary solids are increased: urea and uric acid to a slight extent; sulphates and phosphates to a considerable degree. ; Muscles and their Nerves.—Atropine is an antispasmodic in its effect upon involuntary muscle. It depresses both the unstriped fibres and their motor nerve endings. Toxic doses cause paralysis of the smooth muscles. Voluntary muscles are not affected by any doses of atropine, although the motor nerves controlling them are depressed by toxic amounts of the alkaloid. In regard to the effect of the drug upon the intestines, experimental and clinical evidence appear to yield quite contradictory results. It seems probable that any dose of atropine will depress, to a greater or lesser extent, the activity of the intestinal muscle, but, as there is at the same time depression of the inhibitory nerve endings (splanchnies), there is also a tendency .to increased peristalsis through the greater sensitiveness of the gut to stimuli. As the result of careful experiments, it appears that minute doses of atropine stimulate the splanchnics and lessen peristalsis; that moderate doses increase markedly peristalsis by paralyzing the splanchnics; and that large doses stop all movement of the bowel by paralyzing the intestinal musculature. Other experiments by reliable men and clinical experience negative these conclusions. . é Atropine has been used successfully to produce three diverse actions on the bowel: (1) to quiet intestinal move- ment in inflammation of the bowels; (2) to relieve spasm in . colic and spastic conditions generally ; (8) very commonly to aid catharsis in sluggish states of the intestines. In practice, small doses will often move the bowels effectively, while, on the other hand, enormous doses (gr.1-12, instead of the usual dose of gr.1-100) have recently proved success- ful in moving the bowels in obstinate constipation (in ACTION OF BELLADONNA AND ATROPINE oto. . human patients) due to obstruction,* when all other means failed. Conversely, it is, and has been, the common practice to give atropine with morphine to prevent peristalsis in peritonitis and with apparently satisfactory results. It is at present impossible to reconcile these apparently conflicting facts, but it is readily conceivable that the resultant of the opposing actions of atropine on the bowels in either stimu- lating peristalsis by depression of the inhibitory apparatus, on the one hand, or, in lessening peristalsis by depression of the muscle, on the other, may depend as much upon the condition of the gut as upon the dosage, and that, according to the physiological or pathological state, one or the ‘other of these opposing actions will preponderate. The action upon the inhibitory nerve of the heart is similar to that exerted upon the inhibitory nerve of the bowels. The pneumogastric terminations are depressed in the heart by moderate doses, while the heart muscle is paralyzed by large quantities of belladonna. A like depressing influence is believed to be exerted upon the efferent nerve endings of the unstriped muscles of the bladder, urethra, uterus and vagina, as well as upon the muscles of these organs. Belladonna acts medicinally as an antispasmodic in relation to the muscles. Respiration.—Small doses of atropine do not affect the respiration. Large therapeutic doses make the respiratory movements quicker and deeper, by stimulation of the medullary and spinal respiratory centres. Fatal doses produce respiratory failure and asphyxia, owing to paralysis of the respiratory centre and the peripheral vagus filaments concerned with the respiratory movements. Belladonna also paralyzes the peripheral fibres of the pneumogastric nerve in the bronchial tubes and acts therapeutically as follows: 1. As a respiratory stimulant; the drug is generally inferior to strychnine in this respect. 2. As an antispasmodic, by * It 1s probable in these cases that the obstruction was due to spasm, and not mechanical. 380 VEGETABLE DRUGS depressing the efferent vagus endings in the bronchial tubes and relaxing spasm of the smooth muscle of their walls. 3. As a sedative, by depressing the afferent vagus fibres and diminishing the irritation produced by secre- tion, so that cough is allayed. 4. As an agent lessening secretion. Temperature.—Moderate doses of belladonna cause a. rise of temperature, while fatal doses lessen bodily heat. The first phenomenon is produced by stimulation of the spinal thermogenic centres, while the latter effect follows the vasomotor paralysis which occurs after lethal doses. - An elevation of 2-5.4° F. has been noted in dogs after full doses of atropine, while a greater fall of temperature has been observed in the same animal in fatal poisoning. Elevation of temperature is accompanied by increased heat. loss, caused by radiation from the dilated cutaneous vessels. Eye.—The action of belladonna upon the eye affords another illustration of the depressing action of the drug upon the nerve terminations. The oculomotor nerve end- ings are paralyzed by belladonna, and therefore dilation of the pupil ensues. The mydriatic action is exhibited, whether the drug be given by the mouth or dropped directly into the eye. In the former case, the drug does. not act through the nervous system, but locally upon the peripheral filaments of the third nerve through the medium of the blood. The muscular fibres of the iris are unaffected by belladonna. The terminations of the sympathetic and and the trigeminus may be stimulated, which would also produce dilation of the pupil. These latter actions are not definitely determined, while it is known that the dominant effect consists in depression of the oculomotor nerve end- ings, as before stated. Paralysis of accommodation follows paralysis of the terminations of the third nerve in the ciliary muscle, and therefore vision is disturbed. Intra- ocular tension is increased by large and continuous dosage of belladonna, and an artificial pieuoume may be thus produced. PHYSIOLOGICAL RELATIONS OF BELLADONNA 381 Elimination. —Belladonna is eliminated by the kidneys and bowels; traces have been found in the milk. It is, however, chiefly oxidized in the body. Summary.—1t will be observed that belladonna, gener- ally speaking, first stimulates and then depresses the nerve centres, while it chiefly paralyzes the motor nerve termina- tions, including the inhibitory (vagus and splanchnic), the secretory (chorda tympani, etc.), and, to a-less extent, the sensory nerves. Secondary depression of the cerebrum is not so profound as that of the great medullary centres, especially the respiratory centre, and there is sometimes a slight and brief stimulation of the motor nerves of the smooth muscles, viz., vagus, splanchnic, and possibly vaso- motor nerves. Full medicina! doses depress the peripheral filaments of the inhibitory and secretory uerves aud the motor nerves of the unstiiped muscles, as well as tue muscles themselves, lessen the functional activity of the volun- tary motor system, and, to a less degree, that of the afferent nerves. The pulse becomes quickened because of paralysis of the peripheral vagus endings and stimulation of the heart or its ganglia; the blood tension is augmented because of the increased cardiac action and stimulation of the vasomotor centres; and the respiration is accelerated because of excitation of the respiratory centres. The temperature is elevated owing to the circulatory exaltation and stimulation of the heat-producing centres. Slight delirium may be pee from the exciting action of the drug upon the cerebral motor centres. The spinal cord is unaffected by therapeutic doses. Locally applied, belladonna is a direct paralyzant to nerves, muscles, vessels and cells. PHYSIOLOGICAL RELATIONS OF BELLADONNA TO OTHER DRUGS. A medicinal dose of atropine stimulates, while morphine depresses, the brain, respiratory functions, and intestinal peristalsis. This antagonism ceases when poisonous doses 382 VEGETABLE DRUGS of the two drugs are combined, and therefore atropine should be given with caution in the treatment of opium narcosis, so as not to aggravate the already existing central nervous depression, particularly of the respiration. Mor- phine relieves pain, causes sweating, and contracts the pupil centrally. Atropine dilates the pupil, produces dry- ness of the skin, and depresses the functions of sensory nerves through its peripheral action. Atropine antagonizes physostigma in so far as the latter stimulates the peripheral oculomotor nerve fibres, the vagi, diminishes blood pres- sure, depresses the respiratory centres, and stimulates the unstriated muscle of the intestines, and the secretions of the stomach, bowels and bronchial tubes. Atropine is antagonistic—in part—to pilocarpine, which stimulates secretory nerve terminations in the sweat and salivary glands, the peripheral oculomotor filaments, and the nerve endings in the involuntary muscle of the heart, stomach, intestines and uterus. Atropine counteracts the influence of aconite and muscarin (the poison of fungi) upon the heart, and the action of the latter principle in producing spasm of the pulmonary vessels. Toxicology.—Toxie doses of belladonna cause in animals dryness of the mouth, increased frequency of the pulse and respiration, elevation of temperature, dilation of the pupil and partial blindness, restlessness, nervousness, delirium, twitching of the muscles (occasionally erythema), and fre- quent micturition. These symptoms are succeeded, in fatal poisoning, by fall of temperature, retention of urine, muscular weakness, staggering gait, partial anzesthesia, convulsions and paralysis (one preponderating ‘over the other), weak, slow, irregular respiration, feeble, rapid pulse, paralysis of the sphincters, stupor and death. Death occurs mainly from asphyxia, but is due in part to cardiac failure. The physiological test consists in placing a drop of the urine (secreted by the poisoned animal) into the eye of a healthy animal, when mydriasis should follow if the case be one of belladonna poisoning. Three-quarters of a grain of USES OF BELLADONNA 383 atropine under the skin has proved fatal to dogs. Two grains of atropine produce mild toxic symptoms in the horse. Small dogs are slightly pone by gr.,|; of atro- pine ; medium sized dogs by gr.;',, given hypodermatically. Cattle are as susceptible as horses, although herbivora are not so easily influenced as carnivora. The pulse in dogs is greatly accelerated, sometimes as high as 400, while the pulse rate of the horse is not generally more than doubled. Rodents, as guinea pigs and rabbits, and pigeons, are parti- cularly insusceptible to belladonna, in regard to its effect upon the pupil, circulation, ete. The treatment of poisoning includes the use of the stomach pump, emetics, cardiac stimulants, and pilocarpine under the skin. Also external heat, general faradism and artificial respiration. Post-Mortem Appearances. — These are not generally characteristic, except of asphyxia. The blood is dark and poorly coaguable. There is congestion of the lungs, general passive hyperemia, and sometimes ecchymoses in the brain, cord, and their membranes. Congestion of the retina is said, liowever, to be pathognomonic of belladonna poisoning. Administration.— The fluid extract of belladonna root is the official preparation more commonly used for horses. The alcoholic extract of the leaves is given in pill or suppo- sitory to dogs, and in electuary to horses. Atropine sul- phate is employed under the skin when a rapid effect is desired. Uses Hxternal.—Local application of belladonna is more effective when combined with internal medication of the same drug. Belladonna is the best remedy for mammitis, applied by massage in the form of liniment, and given by the mouth. It relaxes spasm, contracts the blood vessels, and lessens inflammation and congestion ; paralyzes the secretory nerves and so diminishes the amount of milk, vascular tension, pain and glandular activity. In fissure of the rectum, and in hemorrhoids, belladonna (with opium) in ointment or suppository, allays spasm and pain. Lini- 384 VEGETABLE- DRUGS ment of belladonna is useful in rheumatic or neuralgic pain, and rubbed upon the throat, in cases of pharyngitis and laryngitis, affords a serviceable application, when combined with the internal administration of the drug. Uses in Connection With the Hye.-—In examination of the fundus of the eye, the media, or lens, for cataract, the pupil may be dilated to advantage with a weak solution (gr.5/)- 5 1.) of atropine sulphate. A drop will suffice, and no trace of its effect will remain after the second day. A strong solution (gr.iv.- Zi.) is essential to completely paralyze the iris and ciliary muscle. In the normal animal, accommodation is paralyzed and vision disturbed for 8 or 12 days after the use of this solution. Atropine is particularly useful in keratitis and iritis. In the former disease, photophobia and blepharospasm are diminished by the paralyzing action of atropine upon the trigeminus, and pain, congestion and inflammation are diminished by contraction of the peri- pheral blood vessels. In central perforating ulcer of the cornea, with protrusion of the iris, atropine, by dilating the pupil, draws the iris away and prevents its permanent adhesion (anterior synechia) to the cornea, while the per- foration is becoming filled with lymph and the anterior chamber is being restored. Strong solutions of atropine instilled at frequent intervals, are useful in iritis by (1) paral, zing and securing rest of the iris and ciliary muscles; (2) in lessening local blood supply, congestion and inflam- mation, and in preventing adhesions of the posterior sur- faces of the iris to the anterior capsule of the lens (posterior synec!: 2), which both limits the normal variation in the pupillary diameter and interferes with the nutrition of the lens, «nd so predispose to cataract. Atropine is contra- indicated in glaucoma, Uses I.ternal.—The general indications follow directly from our knowledge of the physiological action of the drug. They are as follows:--1. To stimulate the respiration and circulation. 2. To diminish secretion. 3. To relieve spasm and pain. USES OF BELLADONNA 885 1, Acute diseases, as pneumonia, bronchitis, influenza, cerebro-spinal meningitis, etc., are frequently treated at the outset with belladonna, with the intent of cutting short the inflammatory process by producing general vascular con- traction. There does not seem to be sufficient physiological - or clinical evidence to warrant this practice (except in coryza, pharyngitis and laryngitis), and there are other drugs (ergot) which accomplish the purpose, were it desirable, more effi- ciently. In the second stage of acute diseases, as pneu- monia, belladonna is a valuable agent in combination with strychnine, to stimulate respiration, prevent effusion and vasomotor and cardiac depression. Belladonna is of service also as a respiratory, cardiac and vasomotor stimulant in poisoning by various drugs, including opium, chloro- form, ether, aconite, prussic acid, physostigma and pilocar- pine. Recent experiments by Reichert (Therapeutic Monthly, May, 1901) and others show that atropine, while stimulating the respiratory centre exerts a powerful depressing action on the pulmonic motor fibres of the vagi, and that in opium poisoning atropine, instead of strengthening, actually lessens respiratory power. Strychnine undoubtedly is a much better antidote in this condition. In surgical shock, with low temperature, owing to vasomotor paralysis and vascular dilatation, atropine is a most potent remedy, combined with digitalis, 2. Belladonna is employed therapeutically to diminish excessive sweating and salivation, mercurial or otherwise. It is recommended in serous, or watery diarrhoea. Cidema of the lungs is combated most successfully with atropine (combined with strychnine) subcutaneously. In the second stage of acute respiratory diseases, as bronchitis, influenza, canine distemper, and pneumonia, belladonna diminishes secretion, irritability and cough, and stimulates the heart and respiration. It may be associated with opium to in- crease the sedative effect. 3. Belladonna does not have much influence over spasm of the voluntary muscles, unless injected (atropine) into their 086 VEGETABLE DRUGS substance. Rheumatic lameness. and cramps and spasm due to injury of nerves, may be treated in this manner. Spasm of involuntary muscle is, however, more easily over- come, and this action is of exceeding therapeutic importance. Intestinal spasmodic colic of horses succumbs most readily when atropine is given with morphine under the skin. In peritonitis and enteritis, full and repeated doses of atropine, with morphine, assist in paralyzing the smooth muscular fibres of the intestines, and in quieting peristaltic move- ment. Paradoxical as it may seem, large doses of atropine have been recently used in human medicine, and with re- markably good results, in the treatment of intestinal ob- struction from impacted feces, and even in invagination and twist, on the assumption that the inhibitory splanchnic fibres of the gut are paralyzed by these large quantities given under the skin (see ‘“‘ Action on Muscles and Nerves”). Cough, stridulus breathing, and spasm, associated with acute pharyngitis and laryngitis, are influenced favorably by belladonna, in the first stage. The drug acts locally to paralyze the ends of the motor nerves in the throat, relieves spasm, and also contracts the peripheral vessels and over- comes congestion and inflammation. It may be given to horses in electuary, and also applied in liniment or oint- ment externally. The following prescription is suitable for horses suffering from pharyngitis or laryngitis. R Extract. Belladonnez Rad. FI.............. ZA. Puly. PotassusChloratises. ceteris 2 ii. Pulw. Glyeyrrltizas aii). hae etn eRe RY. Syrupr Fusel io. dots cas nice be racine Q. S.* M. et f. electuarium. Sig. Give + ounce every two hours. (Furnish + ounce for sample dose. ) In bronchitis and asthma, belladonna also allays spasm and lessens secretion, irritation and cough. Other. spasmo- dic conditions benefited by belladonna are, “thumps,” lead colic, convulsions (with bromides), spasm of the rectum owing to fissure or other causes, and incontinence of HYOSCYAMUS 387 urine due to spasm of the neck of the bladder. Pal- pitation of the heart is relieved by the sedative action of the mydriatic upon the unstriated cardiac musele. Tetanus is favorably influenced by extract of belladonna given in electuary. In this section may be included the effect of small doses of belladonna in paralyzing the inhi- bitory (splanchnic) nerve terminations in the bowels, and thus assisting the action of peristaltic stimulants, as aloes and strychnine. Pills containing aloin (gr.), extractum belladonne alcoholicum foliorum (gr.}), and extractum cas- care sagradee (gr.3), form a useful laxative combination in chronic constipation of dogs. Hyoscyamus. Hyoscyamus. (U.S. P.) Synonym. — Hyoscyami folia, B. P.; henbane, herba hyoscyami, E.; feuilles de jusquiame noire, Fr.; bilsen- krant, G. The leaves and flowering tops of Hyoscyamus niger Linné (nat. ord. solanacez), collected from plants of the second year’s growth. Habitat. — Indigenous to England, the Continent, and Asia, and naturalized in the northern part of the United States. Description —lLeaves ovate, or ovate-oblong, up to 25 em. long and 10 em. broad; sinuate-toothed; the teeth large, oblong or triangular, grayish-green, and, particularly on the lower surface, glandular-hairy ; midrib prominent; flowers nearly sessile, with an urn-shaped, five-toothed calyx, and a light yellow, purple-veined corolla; odor heavy, narcotic; taste bitter and somewhat acrid. Constituents.—Two alkaloids: hyoscyamine C,,H,,N O,, and hyoscine. The first resembles atropine in composition and action. Impure, amorphous, commercial hyoscyamine is a dark-brown fluid and contains as its active principle mainly hyoscine. Incompatibility.—Incompatible with caustic alkalies and 388 VEGETABLE DRUGS vegetable acids, lead acetate and silver nitrate. Hyoscyamus may be given in pill with the two latter mineral salts. Dose.—H. & C., %8s8.-i. (15.-30.); D., gr.v.-xv. (.3-1.). PREPARATIONS. Extractum Hyoscyami. Extract of Hyoscyamus. (U.S. & B. P.) Made by maceration and percolation with diluted alcohol, and evaporation to pilular consistency. The extract should contain 0.3 per cent. of mydriatic alkaloids. Dose.—H. & C., gr.xx.- 3 i. (1.3-4.); D., gr.ss.-ii. (.03-.12). Fluidextractum ag Fluidextract of Hyoscyamus. (U.S.7P;) Made by maceration, percolation with alcohol and water, and evaporation, so that 1 cc. = 1 gm. of hyoscyamus. Each 100 ce. of fluidextract contains 0.075 gm. of alkaloids from hyoscyamus. Dose.—H. & C., 3ss.-i. (15.-30.); D., Mv.-xv. (.3-1.). Tinctura Hyoscyami. Tincture of Hyoscyamus. (U.S. & B. P.) Hyoscyamus, 100; diluted alcohol to make 1000. Made by mace- ration and percolaticn. Standardized to contain 0.007 gm. of mydriatic alkaloids in each 100 ce. of the tincture. (U.S. P.) Dose.—D., 3i.-iv. (4.-15.). The dose of hyoscyamus preparations is generally two to four times that of similar belladonna preparations. Succus Hyoscyant. Juice of Hyoscyamus. (B. P.) Dose.—Same as tincture. HyoscyamMin® SuLtpHas. Hyoscyamine Sulphate. (C,,H.,, N O;), HS O.. The neutral sulphate of an alkaloid obtained from hyo- scyamus. Derivation.—Hyoscyamine is derived from hyoscyamus seed. The latter are treated with ether to extract fat,.and then distilled with alcohol and sulphuric acid. The liquid residue is neutralized with caustic soda and precipitated with tannic acid. The precipitate is mixed with lime and extracted with alcohol. The resulting alcoholic solution is first treated with sulphuric acid, then with caustic soda, and HYOSCAMINE HYDROBROMIDE 389 finally with ether, which dissolves the alkaloid. The latter is recovered by distillation. Properties.—White, indistinct crystals, or a white pow- der, without odor, and having a bitter, acrid taste. Deli- quescent in damp air. Soluble in 0.5 part of water, and in 2.5 parts of alcohol; very slightly soluble in ether or chloroform. Dose.—H., gr.i.-i1. (.06-.12); D., gr.1; - 315 (.001-.002). Hyoscyamin® HypROBROMIDUM. _ Hyoscyamine Hydrobromide. O©,,H,,N O,H Br. (U.S. P.) The hydrobromide of an alkaloid obtained from hyo- scyamus. Properties. — A yellowish-white, amorphous, resin-like mass, or prismatic crystals, having, particularly when damp, a tobacco-like odor, and an acrid, nauseous and bitter taste. Deliquescent on exposure to the air. Soluble in about 0.3 part of water, 2 parts of alcohol, 3,000 parts of ether, or 250 parts of chloroform. Dose.—H.., gr.i.-ii. (.06-.12); D., gr.g4-34, (.001-.002). Hyoscinz Hypropromipum. Hyoscine Hydrobromide. CHW OH Bro: (U0. S..Pc& B. P.) The hydrobromide of an alkaloid obtained from hyo- scyamus. Properties. — Colorless, transparent, rhombic crystals ; odorless and having an acrid, slightly biter taste. Perma- nent in the air. Soluble in 1.9 parts of water, and in 13 parts of alcohol; very slightly soluble in ether or chloro- form. Dose.—H., gr.t-+ (.001-.015); D., gr.z45-74, (.0004-.0006). Action Internal.—The action of hyoscyamus is a resui- tant of that of its two alkaloids, hyoscine and hyoscyamine. The latter is practically atropine, except that its mydriatic action is shorter. Hyoscine, in poisonous doses, is a power- 390 VEGETABLE DRUGS ful depressant to the cerebrum, respiratory centre, spinal reflex centres, and motor tract. It differs from atropine in being a cerebral sedative, and in its greater paralyzant action upon the spinal cord. ‘The tetanic stage succeeding spinal paralysis, observed in tropine poisoning, does not ensue with hyoscine. The latter alkaloid slightly depresses and slows the heart, and does not paralyze the vagus termi- nations, nor depress the motor and sensory nerves or muscles. The circulation is but slightly influenced, and vasomotor depression only occurs in the latter stage of lethal poisoning. Death occurs from paralysis of the respiratory centres. Poisoning in animals is exhibited by loss of muscular power, slowing and failure of respiration, dryness of the mouth, stupor and asphyxia. The pulse may be.infrequent, the pupils are dilated and the skin is moist rather than dry. Delirium and convulsions sometimes occur in man. The effect of the combined action of hyoseyamine and hyoscine in hyoscyamus is shown when we compare the drug with belladonna. Hyoscyamus is more of a cerebral sedative and hypnotic, and less of a heart and respiratory stimulant. It is said to possess more power in overcoming spasm, and grip- ing of cathartics, and in aiding intestinal movement. Hyoscyamus is also thought to exert a more pronounced an- tispasmodic action than belladonna upon the smooth muscles of the bladder and urethra. Uses.—Hyoscyamus is generally applicable in the same disorders for which belladonna is indicated. In relieving some sorts of spasm, hyoscyamus is more efficient than bella- donna, as in spasmodic colic, spasm of the bladder, and griping caused by cathartics. Tetanus, chorea, and epilep- tic convulsions in dogs, are benefited by henbane, but the drug does not possess a curative action. Hyoscyamine may be combined to advantage with strychnine, subcutaneously, in impaction of the bowels in horses. The former drug depresses the inhibitory nerve endings (splanchnic), and assists the stimulant action of strychnine upon the intestinal muscle. Repeated small doses of oil will facilitate peristal- sis In this condition. Hyoscine hydrobromide is indicated in spasmodic affections and in nervous and sexual excite- ment. It is a powerful drug and should be employed at the outset in small doses. To avoid contamination with hyo- scamine is difficult, and the preparation of Merck is to be — INDIAN CANNABIS 391 recommended.* Hyoscine has not been employed to any extent in veterinary practice. It is used in human medicine as a hypnotic and sedative in mania and delirium of the insane. It causes no unpleasant after-effects. Cannapis Inpica. Indian Cannabis. (U.S. & B. P.) The flowering tops of the female plant of the Cannabis sativa Linné (nat. ord. urticacee), grown in the East Indies. Synonym.—Indian hemp, E.; chanvre indien, Fr.; in- discher hanf, G.; herba cannabis indice, P. G. | Haschisch is a confection of the drug. Arabian habi- tués of this preparation are frequently impelled by its in- fluence to deeds of violence. They are called ‘“ hascha- schins ”’; hence the English, assassins. Gunjab, or ganga, is the dried plant used in India for smoking. Churrus is the resin and epidermis scraped off the leaves. Bhang consists of the young leaves, flowering and fruiting tops and resin resulting from the first season’s growth. Habitat.—The official cannabis is indigenous to Asia, but the common hemp plant (Cannabis sativa) grows in America and many other parts of the world. Description.—Branching, compressed, brittle, about 5 em. or more long, with a few digitate leaves, having linear- lanceolate leaflets, and numerous, sheathing, pointed bracts, each containing two small pistillate flowers, sometimes with the nearly ripe fruit; the whole more or less agglutinated with a resinous exudation. It has a brownish-green color, a peculiar narcotic odor and a slightly acrid taste. Incompatibility.—Water precipitates the active resinous principles. Lemon juice and other vegetable acids are the most efficient antidotes. * Scopolamine is identical with hyoscine and is so named because obtained from Scopola atropoides. Scopolamine, or hyoscine, with morphine under the skin (after Korff) have been employed to some extent as general anzesthetics in human surgery to replace ether or chloroform. Hyoscine (or scopolamine) is sometimes given to horses to aid the action of chloroform and prevent its excitement. One hour before operation gr. 1-6 to 1-3 may be injected under the skin for this purpose. To produce general anesthesia in dogs, morphine is given with hyoscine in 2 doses—one 2 hours, and the other 15 minutes, before operation. Thus morphine, gr. ss., with hyoscine gr. 1-100, are injected subcutaneously for this purpose and will generally suffice for the performance of ordinary operations—although a few whiffs of ether may be required in addition. Dogs are comparatively insusceptible to scopolamine. It has been estimated by Bernardini that morphine may be given to the extent of gr. 1-6 to each 2.2 lbs. of live weight ; and hyoscine from gr. 1-120 to gr. 1-15 to each 2.2 lbs. live weight for dogs. 392 VEGETABLE DRUGS Constituents.—The active principle of cannabis indica is Cannabinol (O H CO,,H,,C O H), a red oil or resin boiling at a high temperature, which apparently exerts the charac- teristic action (Marshall) of cannabis indica on man and animals. But the therapeutic value of the principle has not been sufficiently studied to enable it to be used as a substitute for the crude drug or its preparations. PREPARATIONS, Extractum Cannabis Indice, Extract of Indian Cannabis, (U.S. & B. P.) Made by maceration and percolation with alcohol, and by evapora- tion to a pilular consistence. Dose.—H., 3 i.-ii. (4.-8.); D., gr.14-i, (.015-.06). Fluidextractum Cannabis Indice, Fluidextract of Indian Cannabis. (U.S. P.) Made by maceration and percolation. The alcohol is distilled off from the last part of tne percolate, and the residue is dissolved in the first part (700 Cc.), and enough alcohol is added to make 1 Cc. of the fluid extract equal 1 gm. of the crude drug. Dose.—H., 3 iv.-vi. (16.-24.); D., Mii.-x. (.12-.6), Administration.—The extract is given in ball, pill, electuary or suppository ; or the fluid preparations may be used. Tinctura Cannabis Indice. Tincture of Indian Cannabis. (S26. B: P:) Indian cannabis, 100; alcohol to make 1,000 Cc. Made by macera- tion and percolation. (U.S. P.) Dose.—D., ™xx.-xxx. (1.3-2.). Action External.—Cannabis indica exerts a considerable irritant action when applied to mucous membranes. This is followed by local anesthesia. Action Internal.—Indian hemp is a distinct depressant to the functions of the brain and cord in poisonous doses, although therapeutically stimulating these organs in small quantities, and producing in man a kind of intoxication and mild delirium. The reflex activity of the spinal cord is primarily increased, but this is succeeded by diminution of reflex movement, and, after large doses, by anesthesia and loss of voluntary motion. The sensory tract (centres and - a INDIAN CANNABIS 393 - nerves) is depressed by considerable therapeutic doses. Our knowledge of the detailed physiological action of the drug is imperfect. The action of cannabis comes on slowly and continues for a long time. A horse receiving, under the direction of the writer, at the Harvard Veterinary Hospital, 3 ounce of the solid extract, became drowsy. Sleep after a few hours deepened into stupor, and stupor into coma, The respiration became slow, the pulse slightly accelerated, and the animal so anesthetic that amputation of the penis was done on the following day without producing the slight- est pain or struggling. The animal had to be supported in slings, and only recovered after three days. Frequently neither constipation, anorexia, or other deleterious after- effects follow the action of this drug. The following are extracts from experiments of Muir* with cannabis indica : Gelding, 8 years old; condition poor. Gave two doses of fluid extract (Park & Davis, normal liquid) undiluted of 12.5 cc. each (about 3 drachms) intrajugularly, twenty minutes apart. Became rapidly nervous and excitable, increased by sounds or touch. In half an hour from first dose he became sleepy and stupid. A third dose of 15 cc. (4g ounce) was injected into the jugular about an hour after the first and caused sweating and a sleepy condition, in which the animal jerked and twitched his head as if dreaming. The: temperature dropped to 96° F., and the sleepy state, alternating with excitement when annoyed, lasted three hours, when delirium supervened and continued for six hours, at which time all the symptoms disappeared. Pony, 575 pounds; condition fair. Received 15 cc. (144 ounce) of the fluid extract intravenously. In two minutes became delirious; in ten minutes was asleep against stall. In half an hour fell to floor and slept there for eighteen hours and could not be aroused. Temperature fell to 92.5° F. Respiration regular; pulse from 42 to 30 during experiment. Gelding. 1050 pounds; in good condition. Given 45 cc. of fluid extract intravenously. In three minutes rearing. kicking. snorting and going on like one mad. He ran back and forth along one side of his stall like a caged tiger with sweat rolling off him and cutting and bruising himself, being apparently anesthetic, He endeavored to bite * Jour. Comp. Med, and Vet, Archives, April and May, 1900. 394 VEGETABLE DRUGS or strike anyone approaching and remained delirious and excitable for twelve to twenty-four hours. Gelding, 650 pounds. 30 cc. of fluid extract injected into jugular. In four minutes became unsteady ; in twelve minutes he was asleep ; in half an hour he fell and so slept for eighteen hours. Temperature dropped to 91.8° F. from normal; the pulse was accelerated and the respiration slightly so. Muir deduces from his experiments that as much as 50 ce. (Z iss.) of the fluid extract may be given with safety intravenously. In the human being, cannabis induces very: peculiar mental phenomena, including hallucinations, a sense of double consciousness, and great prolongation of time, so that minutes are drawn out into hours, and hours into days. Sometimes sexual excitement, exaltation, and hilariousness are exhibited; at other times a dreadful premonition of im- pending death seizes the human subject. The drug is not fatal, except in colossal doses, but the effects may appear alarming. Intrajugular injection into a small dog, of five drachms of the fluid extract (10 minims of which proved active in man) only caused death after several hours (Hare). Preparations of Indian hemp vary greatly in strength, many being entirely inert, and this fact constitutes one of the principal objections to its use. ‘The practitioner is recommended to experiment until he secures a reliable preparation, and use no other thereafter. Uses.—Cannabis is indicated for the relief of: A, pain ; 2, spasm; 3, nervous irritability. It is not comparable to morphine as an analgesic, on account of the uncertainty and slowness of its action, and because anesthesia is only pro- duced by an unwarrantably large dose. It is only superior to opium in not causing constipation, anorexia and indiges- tion, and is therefore sometimes given in colic to horses, for the relief of pain and spasm. The permanency of the action of Indian hemp suggests its use in conditions of long continued pain or spasm. In thirty-five cases of tetanus in the human being, treated with cannabis, twenty-one recovered and fourteen died. The results reported in veter- CAFFEINE 395 inary practice have been almost as favorable; over half the cases have recovered when subjected to this medication. Medication has, however, usually very little influence in tetanus. Recovery appears to be largely a matter of chance, even with antitoxin. Cannabis Indica is occasionally em- ployed as a sedative for irritable cough, and to relieve the spasms of chorea. CaFFEINA. Caffeine. C,H,,N,O, + H,O. (U.8.:.& BR) Pe) Synonym.—Theine, guaranine, E.; coffein, G.; caféine, Fr. A feebly basic, proximate principle, obtained from the dried leaves of Thea sinensis Linné (nat. ord. ternstroemia- cez), or from the dried seeds of Coffea arabica Linné (nat. ord. rubiacez), and found also in other plants. Habitat.—Indigenous to Africa, and cultivated in other tropical countries. Derivation—Crushed coffee is treated with successive portions of boiling water, and the resulting solution is precipitated with lead acetate and filtered. Hydrogen sul- phide decomposes the excess of lead acetate remaining in the filtrate. The latter is then concentrated by evaporation and neutralized with ammonia water. Caffeine crystallizes on cooling. The alkaloid is purified by charcoal and recrys- tallization. Properties.—Fleecy masses of long, flexible, white crys- tals, possessing a silky lustre, without odor, having a bitter taste, and permanent in the air. Soluble in 80 parts'of water, 33 parts of alcohol, 555 parts of ether, or 7 parts of chloroform. Also soluble in about 2 parts of boiling water, and very soluble in boiling alcohol. Caffeine is neutral to litmus paper. Caffeine exists, curiously enough, as the active principle of the national non-alcoholic beverages in use all over the world. Coffee contains .6-2.2 per cent. of caffeine, together with glucose, fat, vegetable casein, tannic acid, and an empyreumatic oil developed by roasting, 7. e., ‘ 396 ; VEGETABLE DRUGS caffeone. Tea contains 1.36-3. per cent. of caffeine, or theine, and also a volatile oil and tannic acid. Guarana (the seeds of Paullinia cupana) contains 4 tc 5 per cent. of caffeine; maté, or Paraguay tea (the leaves of Ilex paraguayensis), contains .45-1.2 per cent. Caffeine is found in kola nut (the fruit of Sterculia acuminata), used as a beverage in Africa, and now as a nervous stimulant in human medicine, and is allied to theobromine, occuring in chocolate beans, and to cocaine, existing in coca leaves. Incompatibility.—Caffeine is incompatible with mercury salts, potassium iodide and tannic acid. Dose.—H. and C., 3i-ii. (4-8.); D., gr.-ss.-iii. (.03-.2), according to size. CaFFEINA Cirrata. Citrated Caffeine. (U.S. P.) Derivation.—Dissolve citric acid (50) in hot, distiiled water (100); add caffeine (50) and evaporate the resulting solution, on a water bath, to dryness, constantly stirring towards the end of the operation. Reduce the product to a fine powder and transfer it to well-closed bottles. Properties.—A white powder, odorless, having a purely acid taste and acid reaction. One part of citrated caffeine forms a clear, syrupy solution, with about 3 parts of water. Upon dilution with water this yields a white precipitate (caffeine), which redissolves when about 25 parts of water have been added. It is also soluble in a mixture of two volumes of chloroform and 1 volume of ether. Dose.—-H., gr.xv.-xxx. (1.-2.); D., gr.i.-vi. (.06-.36). Action Internal.—Caffeine has no particular action upon the digestive tract, except in large quantities, when it may cause gustro-intestinal irritation. The effect of caffeine and raw coffee is identical, but when the latter is roasted, aroma- tic oils, or an empyreumatic oil, are developed (caffeone). It is impossible to separate completely the action of caffeine from caffeone in boiled coffee. Recent investigations appear to show that the oil (caffeone), of which there is from one to CAFFEINE 397° one-half drachm in a cup of the beverage, has no physiolo- gical action except to disturb digestion and cause bilious- ness. This result is not in accord with the general belief, and it is probable that caffeine possesses a transient action in stimulating intestinal peristalsis, the cerebral functions, and in lessening vascular tension. Circulation. Caffeine stimulates the heart muscle and vasomotor centres. The action of the heart is strengthened and accelerated after moderate doses in most cases. Some- times the stimulating action on the vagus ‘centre overcomes that on the heart and the pulse is somewhat slowed. Blood tension is enhanced. In poisoning the pulse becomes weak and irregular and the heart stops in diastole. Nervous System.—Caffeine is a certain and direct stim- ulant to the higher nervous centres. In moderate doses it _ produces wakefulness and restlessness (action of tea and coffee at night on man), and increases the capacity for mental and physical work (see muscles). In the lower ani- mals caffeine often causes the most intense cerebral excite- ment and mania in large doses. The alkaloid affects the spinal cord like strychnine, and toxic quantities produce restlessness, increased reflex excitability and convulsions in the lower animals. It is undetermined whether the convul- sions are of cerebral or spinal origin. The motor and sensory nerves are unaffected by medicinal doses. Caffeine opposes the depressant action of opium and alcohol. It antagonizes alcohol in stimulating the highest or controlling functions of the brain, the reasoning faculties, perception of sensory impressions and association of ideas, and greater accuracy of touch and capacity for physical exertion. Muscles.—The injection of caffeine solution into a frog’s leg causes a stiffness and hardness of the muscles like that seen in rigor mortis. On muscle fibres, removed from the body, it acts in the same way by coagulating the muscle pro- teids. In small quantities in the body it acts to stimulate the ability of the muscle to contract and its capacity and en- durance for work. The action of tea and coffee, in enabling men to perform more physical work, has hitherto been ascribed to the acticn of caffeine on the nervous system, but is now attributed to its effect on the muscles themselves. Kidneys.—The kidneys primarily contract for two or . three minutes with corresponding diminution in the flow of = 398 VEGETABLE DRUGS urine, after the subcutaneous injection of small doses of caffeine. This effect is independent of the general vascular condition, and is followed by an increase in the volume of the kidneys, with accompanying augmentation of the urinary secretion, as shown by experiments with Roy’s oncometer. The renal cells are directly stimulated, and it is thought that caffeine also increases the blood supply of the malpighian bodies. The drug is therefore a local diuretic and (with theobromine) is the most efficient and powerful. No other drug can produce such a flow of urine. Respiration.—The respiratory centres are stimulated (along with the vagus and vasomotor) by caffeine in mod- erate doses, and depressed by toxic amounts. Metabolism.—Caffeine increases tissue change and therefore the elimination of urea and carbonic dioxide—con- trary to the time honored teaching. Toxicology.—Caffeine is a spinal and muscle poison to the frog. Tetanic convulsions occur in the batrachian sim- ilar to those produced by strychnine, but there is also mus- cular rigidity. These phenomena follow the direct stimula- tion of the spinal motor tract and muscles, and are succeeded by paresis. In man, stimulation of the cerebral cortex oc- eurs, while both stimulation of the brain and cord are ob- served in the domestic animals. The symptoms of poison- ing in dogs, cats and mammals generally, are restlessness, cccasionally vomiting in dogs, rapid breathing, primary re- duction followed by rise in temperature, clonic or tonic convulsions, muscular weakness, and general paresis. Death occurs from respiratory failure. The minimum fatal dose is about 1 gr. to 1 lb. of live weight in the cat. Administration.—Caffeine and its ordinary salts are decomposed by water and therefore should not be ‘given sub- eutaneously. The alkaloid is best administered in solution with sodium salicylate, or benzoate, for use under the skin as follows :— BR SOAP CUTED 5 io). 0:5 2 015,014 si stocctlo tate ea eet gr.xl Bedi Ralicylatis ”.°.'s\% Jcjtecte ersten gY.XxX PAGE Oa bin 2e, ose bo devote fons sales es tuetns teas 3 i. M S. Give fifteen drops hypodermically to horse. Three drops to dog. On . | : : | CAFFEINE 399 R @aihemmeot se cartaets siaisis's Sicheveticavatore Statels HOdMePeNSOMALIS ss «2s ciclets clacic ests 3 aa gY.Xxv. INGE 8dr eat GOSS MOREA OT ee Bp Txlv. M. S. Give one-half, under the skin, to horse. The soluble citrate may be given internally, but it is not a definite or reliable preparation, and inferior to caffeine, which may be administered in solution with a little citric acid, or as above. Uses.—Three indications for the use of caffenie may be deduced from our knowledge of its physiological action. 1. To stimulate the brain. 2. To stimulate the heart. 3. To cause diuresis. 1. Its application as a cerebral stimulant is very lim- ited in veterinary medicine. It acts thus as an antidote to opium poisoning. One and a half grains of caffeine will save eats poisoned by the minimum fatal dose (gr. 1$) of mor- phine. 2. Caffeine possesses particular value in the treatment of dropsy of cardiac origin in dogs, because of its diuretic action, as well as Gronnie ne effect upon the heart. The therapeutic indications are much the same as for digitalis, but caffeine differs from digitalis in the following particu- lars: Does not prolong diastole. Is not cumulative. Does not slow the heart. More transient in its effect. Nor regulate the heart. Caffeine, in combination with acetanilid and other modern coal tar products, is useful in preventing their de- pressing action upon the heart. Furthermore, caffeine, tea and coffee are serviceable in the treatment of acute asthenic diseases in the horse (influenza), dog (distemper), and in foals and calves, acting as nervous and cardiac stimulants and perhaps restraining tissue waste. 3. Diuretic property of caffeine renders it appro- priate in aiding the absorption of pleuritic effusion, ascites, and dropsies, particularly of cardiac and renal origin, and in the hepatic form as well. 406 VEGETABLE DRUGS: SECTION II.—DRUGS ACTING ON THE SPINAL CORD. Class 1.—Stimulating the Inferior Cornua. Nux Vomica: Nux Vomica. (U.S. & B. P.) Synonym.—Semen nucis vomice, poison nut, Quaker button, E.; noix vomique, Fr.; krihen-augen, brechnuss, G. The seed of Strychnos nux-vomica Linné (nat. ord. Loganiacez). Description. — About 25 mm. in diameter, orbicular, grayish, or greenish-gray, soft, hairy, of a silky lustre, with a slight ridge extending from the centre of one side to the edge; internally horny, somewhat translucent, very tough, with a large circular cavity into which the heart-shaped, nerved cotyledons project. It is inodorous and persistently bitter. Constituents.—Two alkaloids. 1. Strychnine, 0.2-0.6 per cent. 2. Brucine (C,,H,,N,O,), 0.5-1.0 per cent. Similar in action to strychnine, but weaker and slower. Both alkaloids exist in combination with igasuric acid. Brucine occurs in rectangular octohedral crystals; is soluble in alcohol, in 7 parts of chloroform, and possesses a bitter taste. With sulphuric and nitric acids a beautiful blood-red color is developed. Nux vomica should yield not less than 1.25 per cent. of strychnine (U. S. P.) Dose—H. & ©., 3i.-ii. (4.-8.); Sh., gr.xx.-xl]. (1.3-2.6); Sw., gr.x.-xx. (.6-1.3); D., gr.i.-i1. (.06-.12). PREPARATIONS. Extractum Nucis Vomice. Extract of Nux Vomica. (U.S. & B. P.) Made by maceration with alcohol, water and acetic acid; percola- tion with alcohol and water, and evaporation. Standardized to contain 5 per cent. of strychnine. (U.S. P.) Dose.—H. & C., gy.vii.-xv. (.5-1.); Sh., gr.ii.ss.-v. (.15-.3); Sw., gr.i.-ii. (.06-.12); D., gr.4-4 (.008-.016). STRYCHNINE 401. Fluidextractum Nucis Vomice. Fluidextract of Nux Vomica. CU, S. B) Made by digestion and percolation with alcohol, water and acetic acid. The alcohol is distilled off and the solution evaporated. Alcohol and water are added so that the fluidextract shall contain 1 per cent. of strychnine. Dose—H. & C., 3i.-ii. (4.-8.); Sh., ™xx.-xxx. (1.3-2.); Sw., ™x.- xx. (6-1.3); D., Mi -ii. (.06-.12). Tinctura Nucis Vomice. Tincture of Nux Vomica. (U.S. & B. P) Made by solution of the extract of nux vomica, 20, in alcohol, and water to make 1,000. (U.S. P.) Contains 0.1 per cent. strychnine. Dose,—D., Mv.-x. (.3-.6). Srrycunina. Strychnine. ©,, H,,N,O, (U.S. & B. P.) An alkaloid obtained from nux vomica, and also obtain- able from other plants of the natural order Loganiacese. Derivation. — Nux vomica seeds are powdered and strychnine is extracted with water acidulated with hydro- chloric acid. The solution is concentrated and strychnine precipitated with lime. It is then redissolved in boiling alcohol and the crystals are deposited upon concentration of the solution. Properties.—Colorless, transparent, octohedral, or pris- matic crystals, or a white, crystalline powder; odorless, and having an intensely bitter taste, perceptible in even highly dilute (1 in 700,000) solution. Permanent in the air. Soluble in 6,700 parts of water, and in 110 parts of alcohol; in 2,500 parts. of boiling water, and in 12 parts of boiling alcohol; also soluble in 7 parts of chloroform, but almost insoluble in ether. Upon ignition, it is consumed, leaving no residue. No coloration is produced with nitric or sul- phuric acid, but a drop of the latter and a grain of potassium bichromate, added to a crystal of strychnine upon a porce- lain plate, yields a beautiful violet, changing into purplish- red and cherry-red, and finally to orange or yellow. Dose.—Same as strychnine sulphate or nitrate (minimum quantities), which are preferable on account of their greater solubility. 402 VEGETABLE DRUGS *SrrycHNin® Supwas. Strychnine Sulphate. (C,,H,,N,O,);-HS 0, +o OF (Use. Bee) Derivation —Made by the action of sulphuric acid on strychnine. Properties.—Colorless, or white, prismatic crystals, odor- less, and having an intensely bitter taste, perceptible in highly dilute (1 in 700,000) solution. Efflorescent in dry air. Soluble in 50 parts of water and in 109 parts of aleohol; 2 parts of boiling water and in 8.5 parts of boiling alcohol. Almost insoluble in ether. Upon ignition, it is consumed, leaving no residue. On adding potassium or sodium hydrate to an aqueous solution of the salt, a white precipitate is thrown down, which should conform to the test for strych- nine. Dose.—H., gyr.ss.-i.ss. (.03-.09); C., gr.i.-ii1. (.06-.18); Sh., gr.4t-1 (.015-.03); D., gr.z45-zyp (-0005-.0015). The dose of strychnine should be proportioned to the. weight in the case of all animals, but more particularly dogs. Otherwise, convulsive attacks or a fatal result may occur. The dose can be accurately determined, according to Feser, by the following data: Dose per kilo (2lbs. 80z. 119.9gr. avoirdupois) live weight: Horse, sheep and cattle.... .0001-.0002 (gr.g45-345) SWINGS a seis cuits @ xiv amianeres -0002-.0003 (gr.s45-sho) DOGS Mi biede wer eles clare soe -0001 (gr-sd0) In accordance with the foregoing figures, dose for Horse weighing 1,000 Ibs. is .045-.09 (gr.?-13) 00 6é Dog * 1 “ 0045 = (gt.7's) se 6“ 50 ** §** 00225 (gr.s'z) és “6 25 « «© 00112 (gr.es) . . “ “ 10 “ * .00045 (gr.ztz) Moreover, these doses may be given every three hours without producing poisoning by their cumulative action. Notwithstanding the foregoing figures, caution should be exercised in prescribing strychnine to dogs, as these animals * Strychnine Nitras—Strychnine Nitrate, occurring in colorless, odorless, glistening needles, is now official. Has very bitter taste; soluble in 42 parts of water. Dose same as Strychnine Sulphate. Strychnine Hydrochloridum (B. P.). Dose same as Strychnine Sulphate. | STRYCHNINE SULPHATE 403 appear sometimes extremely susceptible to strychnine, and it is therefore advisable to begin with a minimum dose (gr.1/,29) in small animals. The dose of one grain should not be ordinarily exceeded in the case of horses, as one and one-half grains proved fatal in an exceptional case. If animals are depressed by disease or shock, they will often bear much larger doses than could ordinarily be administered with safety. Action Eaternal.—sStrychnine is a powerful antiseptic, but is of no practical value on account of its poisonous prop- erties. Brucine is a local anesthetic. Action Internal.—Digestive Tract.—Strychnine and nux vomica act as bitter stomachics in increasing vascularity, appetite, gastric secretion and motion. In addition to this they improve the local tone of the alimentary canal; prob- ably by exciting the various spinal centres. Strychnine also stimulates the intestinal muscular tunic and therefore in- ereases peristaltic action. Circulation.—Experiments on animals show that the chief action of strychnine on the circulation consists in stim- ulation of the vasomotor centres with increase of blood pres- sure. Clinically, however, strychnine appears to accelerate and strengthen the heart-beat and this is thought to result from excitation of the cardiac ganglia and muscle. In pois- oning, blood tension is still further enhanced through as- phyxia and muscular movements occasioned by convulsions. ‘Nervous System and Muscles.—The effect of strych- nine, which stands préeminent before all others, consists in the production of greatly exaggerated reflex action. Under its influence slight sensory stimuli result in the most marked and uncontrollable motor impulses (convulsions). It is proved also that afferent impulses must reach the cord through the sensory tract for convulsions to occur. Section 404 VEGETABLE DRUGS of the spinal cord from the brain in animals shows conclu- sively that strychnine convulsions are of spinal origin. Ingenious experiments furthermore indicate that the tract in the spinal cord—which is acted upon to cause in- creased motor responses to sensory stimuli—is situated be- tween the entrance of the sensory roots into the cord and the motor cells of the inferior cornua. Or, more precisely, the seat of strychnine action appears to be immediately adjoining the afferent side of the inferior cornual cells. Increased reflex excitability produced by strychnine has been heretofore attributed to the direct stimulating action of the drug on the motor tract of the cord. This is appar- ently not the case, for, when a solution of strychnine is ap- plied to the cord at the level of the cells controlling the fore- legs, and the forelegs are irritated, there is increased con- traction of the hind as well as the fore limbs. The motor cells of the hind limbs, in this experiment, are not directly acted upon by strychnine at all. The action of strychnine on the cord is thought to be indirect. . . | That in some way it removes the natural resistance to the passage of afferent impulses to the motor cells and there- fore a greater force remains to be expended on the motor cells (Cushny). To put it more briefly, strychnine increases the conductivity of the cord for sensory impulses. In fatal strychnine poisoning general paralysis ensues through depression of the spinal sensory and motor centres. This may be immediate after enormous doses, with absence of convulsions; or appear at the end of fatal poisoning. The motor nerve endings are also paralyzed but this is secondary in mammals to the more important paralysis of the motor and sensory spinal centres. The voluntary muscles and af- ferent nerves are unaffected by strychnine. Se ee eae eee STRYCHNINE SULPHATE 405 Respiration.—It is probable that strychnine is the most powerful and effective respiratory stimulant we possess. Through its influence the respiratory movements are quick- ened and strengthened by therapeutic doses. It is likely the action, as upon other spinal centres, is indirect, 7. ¢., the res- piratory centres are made to respond more forcibly to sensory stimuli. Organs of Special Sense.-—The sense of sight, smell, hearing and touch is rendered more acute by strychnine. Elimination.—Strychnine escapes to some extent un- changed, and also.as strychnic acid, in the urine. It ap- pears within half an hour of ingestion and may be discoy- ered in the urine from 3 to 8 days thereafter. The greater part of strychnine is probably oxidized in the body. While the drug is not cumulative, in the sense of producing sudden and violent action following its continual use in gradually increasing doses, yet a tolerance for it can not be acquired. Administration.—For tonic purposes, strychnine may be given to dogs in pills or tablets, and to horses in solution dropped on the tongue. Nux vomica is given to horses upon the food in the form of powder, or in fluid extract upon the tongue; while the tincture is more appropriate for dogs. When large doses of strychnine are used, or an immediate action is desired in acute diseases and emergencies, the alkaloid should be given under the skin. . Toxicology.—One-twentieth of a grain of strychnine nitrate, injected subcutaneously by the writer into a dog weighing 25 Ibs., caused uneasiness and excitement, with protrusion of the eye-balls, and in the space of ten minutes, tetanic convulsions. The breathing was shallow and almost imperceptible, the pulse rapid and iregular, the lips were covered with foam, the tail was stiff and extended, the ears laid back, and there was general muscular rigidity, the animal lying on his side in a state of opisthotonos. This 406 VEGETABLE DRUGS’ condition lasted about three minutes, and was followed by a period of relaxation. But the slightest noise or irritation of the skin brought on convulsions. The convulsions became less frequent and violent, and ceased altogether within half an hour. The same animal was given gr.1/4,) of the alkaloid on the following day, but without producing any appreciable result. One-tenth of a grain, given on another day and in the same manner, caused immediate uneasiness and restless-. ness, and in ten minutes induced a severe convulsion, lasting for three minutes, in which the animal was so rigid that he could be lifted bodily without bending. The ears were drawn back, the limbs were extended and stiff, the tail was straight and rigid, and there was twitching of the muscles of the jaw and limbs. The corners of the mouth were drawn back (risus sardonicus), the mouth was covered with foam, and there was some trismus. ‘The breathing was nearly suppressed, owing to tetanic spasm of the respiratory muscles. Following this convulsion, the jaw dropped, the muscles re- laxed and another attack could not be produced by noises or external irritation. Some twitching of the temporal muscles persisted. Evidently the second stage of poisoning had en- sued, and the motor nerves and cells of the inferior cornua had become paralyzed. Death occurred in general paralysis within half an hour, and without any recurrence of convul- sions or tetanic condition. Death takes place more com- monly in strychnine poisoning from asphyxia, during a con- vulsion, and is caused by spasm of the respiratory muscles, or, more rarely, by spasm of the glottis. Sometimes death ensues, after enormous doses, in general paralysis from de- pression of the spinal nerve centres—without the occurrence of convulsions. Rarely death occurs from exhaustion be- tween the paroxysms. When strychnine is given medici- nally in large doses the appearance of restlessness, excite- ment, and muscular twitchings, should warn one of the danger of approaching poisoning. rl — — STRYCHNINE SULPHATE 407 The lethal dose for dogs has been set at gr.}-gi-} (Kaufmann). This is much too large, as evidenced by the experiment mentioned above. The fatal amount varies greatly in accordance with the weight of an animal; probably less than gr.z', would kill toy terriers, and cases are reported where they have been destroyed by gr.,!; of the alkaloid. The therapeutic dose should therefore be proportioned as advised, to the weight of the animal. Five to eight grains of nux vomica will kill dogs. The minimum fatal dose of strychnine for man is one- half a grain. Usually four to seven grains constitute a lethal quantity, but recovery has ensued following the ingese tion of 22 grains, after a full meal. Horses.—The toxic symptoms in horses resemble those already described in the dog. They do not appear for some time (20 minutes to 6 hours), depending on the rapidity of absorption when the drug is swallowed, and include excite- ment, muscular spasm and convulsions, increased frequency of the pulse, and difficult respiration: Death occurs in con- vulsions or in the interim between them. The minimum fatal dose of strychnine, when given under the skin, is about 13 to 8 grains, and when swallowed, 3 to 5 grains of the alkaloid, or 1 to 2 ounces of nux vomica. Cattle are similarly affected with horses and dogs. There are exhibited muscular spasms, frequent pulse, diffi- cult respiration, sensitiveness to light, sounds and external stimuli, protrusion of the eye-balls and convulsions. The fatal dose, by the mouth, varies greatly owing to difficulty of absorption in the complicated and capacious digestive apparatus of these ruminants. This is true of all medicines. When given under the skin, the lethal dose is a little larger than that for horses. The fatal dose for swine is said to be from gr.t-or.3. Chickens are comparatively insusceptible; also guinea pigs and some monkeys. Strychnine poisoning differs from tetanus in the fact that muscular rigidity is continuous in the latter, but disan- pears to a considerable degree, if not completely, in the 408 VEGETABLE DRUGS periods between the convulsions, in the case of strychnine poisoning. Moreover, in tetanus the body and limbs are less, and the jaw more affected ; while in strychnine poison- ing the condition is reversed. Treatment.—The treatment embraces the use of chemical antidotes, as iodine or its salts, or tannic acid; animal char- coal and emetics or the stomach tube, before absorption has occurred. The best physiological antidote is chloral in large doses per rectum. Chloroform and nitrite of amyl may also be given by inhalation, and quiet and rest enforced. Artificial respiration is of service in paralysis, but not in convulsions, unless air be forcibly driven into the trachea through a canula. Calabar bean and gelsemium both depress the inferior cornua, but neither are of much value jn strychnine poisoning. Post-Moriem. Appearances.—These are simply those of asphyxia, with the usual congestive lesions and dark fluid blood, except that sometimes spinal hyperzemia is ob- served. Uses. Internal.—The indications for the employment of strychnine may be directly deduced from its physiological actions. The indications are as follows: 1. To stimulate the heart and respiration. 2. To stimulate the spinal cord; more particularly the motor cells of the inferior cornua. 3. To stimulate appetite, digestion, and intestinal peri- stalsis in atonic conditions. 1. Strychnine is the best remedy we can employ to stimulate the heart, respiration and nervous system, and to promote appetite and digestion in acute diseases. ‘ No better drug can be used in the treatment of pneumonia and influ- enza in horses. Strychnine should not be used continuously, but only to bridge over a period of weakness or collapse. It may be combined in the first stages of pneumonia with nitrites, as spirit of nitrous ether, or nitroglycerin. The latter dilate arterioles, equalize the circulation by prevent- ing venous stasis, and engorgement of the right heart; while STRYCHNINE PCISONING 409 strychnine is preferable to digitalis as a heart stimulant, because it does not so powerfully contract the arterioles. Strychnine is useful in influenza by counteracting nervous depression and improving the appetite and digestion. In collapse and shock, following surgical operations, or in ether and chloroform poisoning, strychnine is invaluable as a cardiac and respiratory stimulant, given in large doses subcutaneously. In chronic heart disease, strychnine is a useful remedy. The alkaloid has proved extremely service- able in chronic bronchitis, emphysema, and in that combi- nation of these disorders, often associated with asthma and known as “broken wind” or ‘“‘ heaves,” in horses. The beneficial effect in these diseases is explained by the stimulating action of the drug on the respiratory centres, and the favorable influence exerted on digestion. 2. In mild cases of chorea in dogs, strychnine is pre- scribed to advantage with Fowler’s solution. In accordance with its physiological action, strychnine is indicated in various paralyses of spinal origin, but should not be used where there is irritation or inflammation of the spinal motor tract. It is employed in hemiplegia and paraplegia, result- ing from hemorrhage, after the lapse of several weeks, when irritation produced by the clot has passed away. Strychnine is said to be efficacious in the after-treatment of cerebro- spinal meningitis of horses, and also in the paraplegia of cattle (from parturient fever), and that of dogs resulting from various and often undiscovered causes. Strychnine is serviceable in the paralysis of lead poisoning, and in that form caused by traumatism or toxemia following influenza, distemper in dogs, aud rheumatism. When injected into the muscular tissue, the alkaloid is believed to stimulate the peripheral nerves aud muscular fibres, and is employed with benefit in localized paralyses affecting groups of muscles before atro- phy has occurred, as in “roaring” in horses. Hither retention or incontinence of urine, resulting from atony or paralysis of the bladder, may be relieved by strych- nine; also prolapse of the rectum induced by similar causes. 410 VEGETABLE DRUGS Strychnine has proved curative in some cases of amaurosis, when injected in the region of the temple. 3. Strychnine or nux vomica, associated with iron and arsenic, form the most generally satisfactory tonic combina- tion for the horse and dog, particularly with reference to the digestion. Atonic forms of indigestion and constipation, the accompaniments of anzmia, are those amenable to the influence of the drug, which stimulates peristalsis, and there- fore hinders fermentation, prevents relaxation, and so over- secretion from loss of vascular tone. ‘ Strychnine is a valuable remedy in overloaded rumen and omasum, and chronic tympanitis of cattle; or in over- loaded and impacted large intestines of the horse. It should be given subcutaneously in these conditions, and frequently in combination with pilocarpine and eserine. Constipation, and, on the other hand, diarrhoea, are benefited by strychnine when they are due to atony of the intestinal muscular coat. It is more commonly in the former disorder that the drug finds its usefulness. The aloin, strychnine and belladonna pills, with cascara sagrada, are useful in habitual constipation in dogs, but the weaker formula, containing gr.;4, of strychnine, should be employed. The value and application of strychnine in ano- rexia and atonic digestive disorders has been sufliciently treated above. Class 2.—Depressing the Inferior Cornua. PuysostTigmMa. Physostigma. (U.S. P.) Synonym.—Physostigmatis semen, B. P. ; Calabar or ordeal bean, faba physostigmatis, 8. faba Calabarica, E. The seed of Physostigma venenosum. Balfour (nat. ord. leguminosz). Habitat.—Calabar and the region of the mouth of the Niger, in Western Africa. Description—About 25 to 80 mm. long, 15 to 20 mm. ——s a PHYSOSTIGMA 411 broad, and 10 to 15 mm. thick; oblong and somewhat reni- form; testa granular, chocolate-brown, with a broad, black groove extending over the entire length of the convex edge. Embryo with a short, curved radicle and two large, white, concavo-convex cotyledons; inodorous; taste bean-like. Constituents.—The principal constituent is the alkaloid physostigmine, or eserine. There are also the alkaloids calabarine, a product resulting from the decomposition of eserine, and eseridine,.similar in action to eserine, but weaker; and a neutral principle, physoterin, resembling cholesterine. Calabar Bean Dose.—H., gy.xv.-xxx. (1.-2.); D., gr.d-i. (O17 6). The official preparations are the extract and _tinc- ture of physostigma, but physostigmine is solely used in veterinary medicine, since it is more certain and generally free from calabarine, which produces, in toxic doses, a tetanic condition followed by paralysis. PuysosTiaMIn® SaLicyLas. Physostigmine Salicylate C,H N.O.6,H,0;. (Us8. P.) Synonym.—Hserine salicylate. The salicylate of an alkaloid obtained from physostigma. Derivation.—Physostigmine is obtained from the alco- holic extract of Calabar bean by: dissolving the extract in water, adding sodium bicarbonate, shaking the mixture with ether, and evaporating the ethereal liquid. The salicylate of the alkaloid—the most stable salt—is made by adding physostigmine to a solution of salicylic acid in boiling distilled water, when the salt crystallizes on cooling. Properties.—Colorless, or faintly-yellowish, shining, aci- cular, or short, columnar crystals; odorless, and having a bitter taste. Soluble in 150 parts of water, and in 12 parts of alcohol; in 30 parts of boiling water, and very soluble in boiling alcohol. (U.S. P.) : Dose. —H: & C., gr.iss.-iii. (09-18); D., gr.zigp-ay (.0006-.002). 412 VEGETABLE DRUGS Given usually intravenously or subeutaneously to horses. PHYSOSTIGMINE SULPHAS. Physostigmine Sulphate. (U.S) ae Synonym.—KEserine sulphate. The sulphate of an alkaloid obtained from physostigma. Properties.—A white, or yellowish-white, micro-crystal- line powder, odorless, and having a bitter taste. It is very deliquescent when exposed to moist air, and gradually turns reddish by exposure to air and light. Very soluble in water and in alcohol. Dose.—H. & C., gr.i.ss.-iii. (.09-.18); D., graia-sr (.0006-.002). Given usually intravenously or subcutaneously to horses. PHYSOSTIGMINE. Action Internal.—Alimentary Tract.—The flow of saliva is at first stimulated, whether by direct excitation of the salivary cells or not, is undetermined. Salivation ceases when the gland is deprived of blood by general vascalar con- traction. The peristaltic action of the stomach and bowels is increased by the direct local action of the alkaloid on the muscles or ganglia of their walls. There are three stages, in reference to this action, observed in poisoning. First there is stimulation of peristaltic action, then tetanic contraction and diminution of the intestinal calibre, and finally relaxation and dilatation of the bowels. The secretions in the digestive tract are augmented with the expulsion of considerable mucus per rectum. When the alkaloid is given to horses, under the skin, within the trachea or intravenously, defe- cation and expulsion of gas commonly occurs in the space of half an hour, occasionally in a few minutes, and is often considerable in amount (11-20 lbs. of faeces). Circulation. —Eserine is readily absorbed, but exerts no - — -_—" ~~ FF” PHYSOSTIGMINE 413 influence on the blood. Moderate doses render the cardiac pulsations slower and more forcible, and increase vascular tension. Large toxic doses cause the heart to beat more rapidly and less forcibly. The first effect is due probably to stimulation of the peripheral vagi and heart muscle, and possibly the involuntary muscular fibres in the vessel walls. The second phenomenon follows depression of the heart and peripheral vagi, and terminates in cardiac paralysis and diastolic arrest. The action on the circulation is entirely subordinate to the influence of the drug upon the nervous system, and is unimportant from a therapeutical standpoint. Nervous System and Muscles.—The essential physiolo- gical action of physostigmine consists in depressing the cells of the inferior cornua. This has been abundantly and di- rectly proved by application of the alkaloid to the spinal cord. The superior columns are finally depressed; per- ception of pain is wanting, but that of touch persists. The sensory nerves are rot affected, and the motor nerve trunks but slightly. The muscular tremors are due to stimulation of the voluntary muscles themselves, or to the motor nerve endings. These are characteristic of physostigma poisoning in animals, but are not so frequently observed in man. Calabarine may be present in old preparations of physo- stigma, from decomposition of physostigmine, and acts like strychnine on the spinal cord. In poisoning by such, cala- barine may induce convulsions. The involuntary muscles throughout the body are stimulated, including those of the stomach, intestines, bronchial tubes, heart, blood vessels( ?), spleen, uterus, bladder and iris. In the case of some of these organs, it has not been decided whether the muscles them- selves, or the motor nerve terminations, are affected. Respiration.—The respiration is not disturbed by medi- cinal doses. Toxic quantities at first quicken, and then 414 VEGETABLE DRUGS retard the respiratory movements, and death occurs from asphyxia, before cessation of the heart, owing to paralysis of the medullary and spinal respiratory centres. The accel- eration of breathing is due to the stimulation of the pulmo- nary vagal endings, and possibly to constriction of the unstriped muscle of the bronchial tubes. Secretions.—Secretion is generally increased, including that of the salivary, gastric, intestinal, sudoriparous and. lachrymal glands. In this respect eserine is antagonistic to atropine. Eye.—Physostigmine is a myotic, applied locally or administered internally. Intraocular tension is diminished and there is spasm of accommodation (see footnote, p. 45). In all probability contraction of the pupil is brought about by stimulation of the circular muscular fibres of the iris or of the oculomotor nerve endings. Eserine is thus directly antagonistic to atropine in its effect upon the eye, but they resemble each other in that they both exert a local action and do not affect the irides of birds. Enormous doses of physostigmine paralyze the oculomotor nerves and dilate the pupil. Elimination.—Kserine is rapidly absorbed and elimin- ated, mainly by the urine, but also in the other secretions. . Towicology.—Physostigma has been called “ordeal bean,” because native Africans suspected of crime are given the erude drug. Vomiting it, they are proved innocent and survive the ordeal. Retaining it, they die, and so are pro- perly and primitively punished. Animals poisoned by Cala- bar bean exhibit muscular tremors which continue through- out the toxic period, and are often so violent as to simulate convulsions. Soon there is loss of muscular power and the animal falls or lies down. The respiration becomes rapid, labored, and stertorous; the pulse is increased in frequency by large toxic doses, and the temperature slightly elevated. There are salivation and sweating. The pupil is sometimes contracted and, when enormous lethal doses have been injected, dilated. Vomiting occurs in animals capable of Oe ————— ——— ~ PHYSOSTIGMINE 415 the act, and loud peristaltic noises are heard, followed by the expulsion of feeces, mucus and flatus, with colicky pains and tenesmus. Reflex action is diminished or abolished, but sensation is preserved until late in the toxic period. The muscles are completely relaxed and powerless, notwith- standing the tremors which afflict them. The breathing becomes weak and irregular, and death occurs from res- piratory failure. _ In experiments of Winslow and Muir conducted inde- pendently and at different times the following cases may be of interest : A healthy gelding, weighing 1,050 lbs., was strapped upon the dis- secting table and given three grains of eserine sulphate intrajugularly. Within a few minutes slight muscular tremors appeared in the neck; the pulse rose to 120, the respiration was 24, and the temperature nor- mal. There was slight sweating. The pulse soon fell to 60, and was strong and hard, while the respiration became rapid and labored. No other symptoms developing within twenty-five minutes after the first dose, three grains of the alkaloid were administered in the same man- ner as before. The pulse became more frequent (78), the respiration (48) was difficult, and the muscular tremors increased in violence till they resembled convulsions. Sweating was profuse, while saliva dropped freely from the mouth. The respiration and pulse were now reduced in frequency and became weaker. The pupils were unaffected, but the eyes were staring. Half an hour after the second dose in- creased peristaltic action was evidenced by loud noises and the expul- sion of gas and dung. Recovery began in two hours from the exhibi- tion of the second dose. It is possible that the severe muscular tremors were caused by contamination of the eserine with calabarine, as the former was not a fresh preparation. An aged express horse, suffering for a week from impaction of the colon, was given twelve minims of a commercial extract of calabar bean. He fell down almost immediately, perspired freely, exhibited muscular tremors, and expired within a few minutes. The writer is unable to state the minimum fatal dose for horses, but eserine should be used with caution in weak subjects.— WINSLOW. 416 VEGETABLE DRUGS A gelding, 800 lbs., poorly nourished, temperature normal, pulse 60, was given physostigmine sulphate gr.114 (0.1) in 14 drachm of water intrajugularly. Muscular tremors and colic came on in seven minutes; in eleven minutes defecation occurred, the heart became more rapid and colic increased. Passages from the bowels were frequent for two hours—about fifteen in all—the feces weighing twenty pounds in the aggregate. All symptoms abated after three hours from the time of receiving the drug.—MurIR.* . A gelding, thirteen years old, in good condition and weighing 1,205 lbs., temperature and pulse normal, was given 3 grains (0.18) of eserine sulphate under the skin. After thirty-two minutes elapsed, defecation began and continued with the expulsion of considerable mucus and flatus until six passages had occurred within one hour and twenty minutes. During this time the pulse had increased in frequency and the animal was restless and pawing the ground. An hour and a half after the first dose, a second dose of 3 grains (0.18) was given in the same way. In twenty minutes muscular tremors and weakness became marked, for the first time, and great distress was evident, the patient appearing to be in much pain ; the respiration short, jerky and labored, and nostrils distended and working. The evacuations continued until twenty-three had been passed from the time of receiving the first dose and until one and one-half hours after the second dose. The feeces were quite liquid and contained much mucus and during passage were attended with considerable straining. The weight of feces aggregated 17 lbs. Four hours after the last dose all symptoms disappeared.— MuIR.* Summary. — Full medicinal doses of physostigmine (gr.1} 3), given subcutaneously or intravenously, produce slight to considerable colic, increased peristalsis and mucous secretion, muscular tremors and weakness, and frequent defzecation—beginning in ten to twelve minutes after intra- venous use, about thirty minutes or more after injection under the skin—and being twice as copious when the * Jour. of Comp. Med. and Vet. Archives, Jan. and Feb., 1899. es PHYSOSTIGMINE eer AlT former mode of administration is employed than after the latter. Moreover, the disagreeable accompaniments of purging last twice as long (five hours) after the hypodermic method than after the intravenous injection (two and a half hours). Muir deduces from his experiments that physos- tigmine is a safe and active cathartic for the horse and is free from evil after-effects; that along with increased peris- talsis and mucous evacuation from the bowels there are: colic and more rapid pulse-rate with muscular tremors and weakness; that eserine acts more quickly and effectively when injected into the external jugular vein, and that it may be safely given in this manner in a dose of 3 grains dissolved in 30 minims of water, to horses in fair con- dition and of average weight. The toxic line is closely approached, however, when physostigmine is used in this way, and we should be careful not to cross it by exceeding the dose. Barium chloride acts as rapidly and without the unpleasant accom- paniments of purgation caused by eserine, so that the former is generally preferable as a cathartic for use by the intravenous method. The minimum fatal dose is stated to be from gr.;',-;'; for dogs, and gr.,',-s; for cats. The treatment should be pursued with emetics, or the stomach pump, and the anti- dote, atropine. The latter will prevent death in rabbits when given five minutes after the administration of three times a minimum fatal dose. Atropine should be given under the skin, together with alcoholic stimulants, digitalis, and ammonia by the mouth. Artificial respiration should be practised and external heat applied. The essential action of atropine in antagonizing eserine,.consists in stimulation of the respiratory centres, while it depresses the peripheral cardiac vagi, and so, to a certain extent, counteracts the primary influence of eserine on the heart. Large doses of atropine may only exaggerate the secondary depression of eserine upon the peripheral vagi in the heart, and so hasten 418 VEGETABLE DRUGS a fatal result. Strychnine is antagonistic to eserine in stimu- lating the respiratory centres and inferior cornua. Uses External.—Physostigmine has been injected empir- ically, but it is asserted with good results, into chronic dropsical effusions of joints and bursz of tendons in horses, after removal of the fluid by aspiration. From .05-.1 gm. is used, dissolved in 5,-10. gm. of sterile water; and this treat- . ment is followed by cold applications for several days after- wards. Uses Internal.—Three physiological actions of eserine are put to therapeutical uses. 1. The myotic action on the eye. 2. Stimulation of the involuntary muscles. 3. Depression of the inferior cornua. {. * Eserine is useful, in alternation with atropine, to break up adhesions to the iris; to lessen intraocular tension in glauvoma; and to prevent prolapse of the iris ~ and staphyloma, after wounds and ulcers of the cornea. It is also employed to contract the pupil and shut out the light in photophobia, and to antagnoize the influence of atropine on the eye. The action of eserine is, however, not nearly so powerful or persistent as that of atropine on the eye, and is somewhat painful. It is employed in I per cent. solution. 2. Physostigmine is mainly of value for its action in rapidly stimulating the unstriated muscles of the alimentary canal. In obstinate constipation ot horses it is particularly useful; 1 gr. of eserine sulphate being given intravenously with 3 ers. of pilocarpine sulphate; the latter to increase the intestinal secretions. Strychnine sulphate (gr.1) may be added to counteract the depressing action of eserine on the respiratory centres and inferior cornua. Physostigmine is prescribed in obstruction of the bowels, from twist or intussusception in the horse, and while there is danger that the condition may be aggravated by the increased intestinal movement, yet it may be. employed when high rectal injections and eievation of * See page 45, PHYSOSTIGMINE 419. the hind quarters of the patient fail. The alkaloid, in com- bination with pilocarpine, is serviceable for its speedy action in flatulent colic and impaction of the cecum, colon, and rectum in horses, and has been employed to expel calculi and foreign bodies from the intestines. Physostigmine is contraindicated in spasmodic colic, when it may increase the trouble by exciting intense peri- staltic contractions. Its employment is also attended with some danger in overloaded or greatly distended stomach or bowels, in view of possible rupture of these organs. The drug, like other purgatives, may aggravate the damage pro- duced by twist or intussusception. In atonic conditions of the stomach and bowels, and in indigestion due to chronic intestinal catarrh, small and repeated doses of eserine are sometimes of benefit. In cat- tle, eserine (gr -i.) and pilcocarpine (gr.-ill.) subcutaneously are of great value in impaction of the rumen and omasum, in acute gastritis, and in parturient apoplexy, to quickly empty the digestive canal. Eserine has been employed in chronic bronchitis, asth- ma and emphysema, to improve the tone of the bronchial mucous membranes and expel secretions. 3. Eserine is one of the drugs commonly used in the treatment of tetanus in human and veterinary practice, with only a moderate degree of success. It must be employed early, given every three or four hours, and pushed to the physiological limit. Chorea and epilepsy have been treated with eserine without any pathological basis, as far as epil- epsy is concerned, and with little therapeutic advantage in either instance. In some cases of paraplegia, resulting from myelitis, a favorable effect has been obtained in man. Eserine is an appropriate purgative (hypodermatically) in acute encephalitis. Physostigmine and pilocarpine are the two best anti- dotes in atropine poisoning. Eserine has been used in 420 VEGETABLE DRUGS strychnine poisoning, but is inferior to chloral, bromides and anesthetics, and while it is antagonistic to a certain extent, and alters the character of strychnine convulsions, yet animals die more quickly when poisoned by both strych- nine and eserine, than by strychnine alone. GELSEMIUM. Gelsemium. (U.S. & B. P.) Synonym.— Radix gelsemii, yellow jessamine, E.; racine de jasmin jaune, Fr.; gelber jasmin-wurzel, G. The rhizome or roots of Gelsemium sempervirens (Linné) Persoon (nat. ord. Loganiacez). Habitat.—Southern United States. Description.—Cylindrical, long, or cut in sections, mostly from 5 to 15 mm. and occasionally 3 ecm. thick, the roots much thinner; externally light yellowish-brown, with pur- plish-brown longitudinal lines; tough; fracture splintery; bark thin, with silky bast-fibre closely adhering to the pale, yellowish, porous wood, which has fine medullary rays, and in the rhizome a thin pith; odor aromatic, heavy; taste bitter. Constituents.—The most important is the first alkaloid. 1. Gelsemine, O,,H,,N,O,,, A colorless, crystallizable, bitter principle, soluble in alcohol and ether, and slightly in water. 2. Gelseminine, a brown, amorphous, bitter alkaloid. 3. Gelseminic acid. 4. A volatile oil. Dose.—H., 3i.-i1. (4.-8.); D., gr.v.-x. (.3-.6). PREPARATIONS. Fluidextractum Gelsemii. Fluidextract of Gelsemium. (U.S. P.) Made by maceration, percolation and evaporation, so that 1 Cc. = 1 Gm. of the crude drug. Dose.—H., 3i.-ii. (4.-8.); D., Mv.-x. (.3-.6). Tinctura Gelsemii. Tincture of Gelsemium. (U.S. & B. P.) Gelsemium, 100; alcohol and water to make 1,000. Made by maceration and percolation. (U.S. P.) Dose.—H., 3s.-i. (15.-30.); D., Mxv.- 3 i. (1.-4.). GELSEMINE 421 Gelsemina. Gelsemine, (Non-official and uncertain in strength.) Dose.—H., gr. 1-4 (.015-.03); D., gr.go-35 (.001-.002), Action Eaternal.—None. Action Internal.—Gelsemium exerts no action on the digestive apparatus, or on the blood, after its absorption; neither does it affect the circulation in medicinal doses, but in toxic quantities it directly depresses the heart. The influence of the drug on the vasomotor system is unknown. Nervous System and Muscles. —The prominent effect of gelsemium is directed on the nervous system, as evidenced by paralysis and convulsions after large doses. Both the convulsant and paralyzant action are of spinal origin. That the convulsions are not cerebral is shown by the fact that they occur below the point of section in mammals (under the influence of the drug), with divided spinal cord. That they are not peripheral is- proved by their occurrence in the hind extremities when the posterior aorta is tied before the ° animal is poisoned. The paralyzant action of gelsemium is due to direct depression of the cells of the inferior cornua, and this is followed, in the later stages of poisoning, by depression of the motor nerve endings and spinal sensory tract, with general anesthesia. The cause of the secondary convulsions is undeter- mined. A tetanizing principle in gelsemium, antagonistic to gelsemine, such as we find in physostigma, has been thought to be the cause of the convulsions. The muscles, motor (except those of the face) and sensory nerves are unaffected by gelsemium. Respiration.—Gelsemium, in toxic doses, progressively weakens and paralyzes the medullary and spinal respiratory centres, and death occurs from asphyxia. Eye.—In peisoning, in animals, there is dilatation of the pupil prodaced i in the latest stages of the toxic period. In man, there i is, in addition to this, paralysis and drooping of the ee siice (ptosis), and paralysis of the recti muscles with 422 VEGETABLE DRUGS strabismus. These symptoms have been attributed with apparent reason to paralysis of the motor cells in the floor of the fourth ventricle and aqueduct of Sylvius, since they are a prolongation of the spinal motor tract. As the pupil is dilated, however, by the application of much smaller doses than are required by the mouth, it seems probable that mydriasis results from local paralysis of the oculo- motor nerve endings. Toxicology.—Poisoning in animals is exhibited by mus- - cular weakness, especially in the fore legs, staggering gait and falling. These symptoms are followed by convulsive movements of the muscles of the head, fore legs, and some- times of the hind legs. The respiration is slow and difficult, the pulse feeble; temperature is reduced, and there is sweating. Consciousness is preserved until the occurrence of asphyxia. Death takes place from respiratory failure, with almost simultaneous cardiac arrest. Morphine sub- cutaneously has proved a successful antidote. Respiratory and heart stimulants should be employed in poisoning by gelsemium, such as strychnine, atropine, alcohol, and digi- talis, together with artificial respiration, after evacuation of the stomach. Uses.—Gelsemium possesses little value in veterinary medicine. There is no therapeutic use to which it has been put that cannot be filled to better advantage by some other remedy. Thus, gelsemium has been employed as a cardiac depressant and antipyretic in acute diseases (pneumonia and pleurisy), but its other actions are disadvantageous and it is inferior to aconite, veratrum viride, or the modern anti- pyretics. In spasmodic diseases, irritable cough, vesical irri- tation, tetanus, chorea, etc., it is less satisfactory as a motor depressant than opium, belladonna, chloral, and bromides. Zuill, however, reports very successful results in horses from gelsemine (.08 Gm.) in tetanus. The dose should be given under the skin every half hour till muscular relaxation occurs. The drug has been used considerably to relieve rheumatic and neuralgic pains, but these succumb morte | t . TOBACCO 493. readily to opium, coal tar products, ete. AS a mydriatic, gelsemine is not to be compared with atropine for general purposes, but its action is more transient. A solution (gr. 8- 5 i.) is instilled (in man) in drop doses every fifteen minutes for one hour, and then every thirty minutes for two hours, to secure wide dilatation of the pupil; or discs, containing er. 1/399 of gelsemine (with gelatine) are used for application to the eye. SECTION III.—DRUGS ACTING CHIEFLY ON THE MOTOR NERVES. Class 1.—Depressing the Motor Nerves. Taspacum. ‘Tiobacco. Synonym.—Tabaci folia, B. P. The commercial dried leaves of Nicotiana Tiabacum Linné (nat. ord. solanacez). Habitat.~—Tropical America. Cultivated in various temperate and tropical parts of the earth. Description.—The leaves are up to 50 Cm. long, oval or ovate-lanceolate, acute, entire, brown, friable, glandular- hairy, of a heavy, peculiar odor and a nauseous, bitter and acrid taste. Constituents.—Chiefly nicotine, C,) H,, N,. (0.7-5.-10 per cent.). . ... 2. seas i. otis sice gr.v. PACICE DOPICI ,H2.0,9), converted in time into (2) emodin (C,;H,,)O;), a glucoside, to which the drug owes its purgative action. Frangulin yields emodin, a constituent of rhubarb as well, and rham- nose (C,H,.0;), by hydrolysis. Dose.—D., 3 ss.-i. (2.-4.). PREPARATIONS. Fluidextractum Frangule. Fluid extract of Frangula, Made by maceration and percolation with alcohol and water, and evaporation, so that lec. of the preparation = 1 gm. of the crude drug. Dose.—D., 3ss.-i. (2.-4.). Ruamnvus Pursutana. (U. S. P.) Synonym.—Cascara Sagrada, B. P. Actions and Uses.—The buckthorns are laxatives in the doses employed in medicine. The fresh bark of R. frangula produces violent gastroenteritis (frangulin), and the same effect is produced by the bark of cascara sagrada, so that both should be kept a year before using. _ Frangula is rarely employed, but Cascara sagrada is probably the best purgative for chronic constipation in dogs. The dose does not require to be increased on repetition. On the contrary, the tone of the bowels is improved by the drug. It has a very bitter taste and is apt to cause griping so that cascara is commonly given with aromatics. Fluidextractum Rhamni Purshiane Aromaticum (U. 8S.) D. TM xv-xxx; or Syrupus Cascare Sagrade Aromaticus (B. P.),-D. 5 ss.-11,, are the best preparations. t)-35 (-0005-.0012), by mouth or sub- cutaneously. PREPARATIONS. Vinum Colchict Radicis. Wine of Colchicum Root. (Non-official.) Made by percolation of colchicum root (400) with alcohol (150), and white wine to make 1000. Dose.—Twice that of colechicum corm. Vinum Colchict. (B. P.) Dose.—Twice that of the root. Cotcnict SemMEN. Colchicum Seed. (U.S. P.) Synonym.—Colchici semina, B.P.; semences de col- chique, Fr.; zeitlosensamen, G.; semen colchici, P.G. The seed of Colchicum autumnale Linné (nat. ord. Liliacez). Description. —Subglobular, about 2 Mm. thick, very slightly pointed at the hilum ; reddish-brown, finely pitted, internaily whitish ; very hard and tough; inodorous; tasve bitter and somewhat acrid. Constituents.—1, colchicine, 3 per cent.; 2, colchiceine ; 3, a fixed oil, 6-8 per cent.; 4, starch; 5, sugar; 6, gum. Dose.—Same as corm, or a little larger. PREPARATIONS, Fluidextractum Colchict Seminis. Fluidextract of Colchicum Seed. . (U.S. P.) Made by maceration and percolation with alcohol and water, and evaporation, so that 1 cc. = 1 gm, of colchicum seeds. Dose.—H. & C., 3ss.-ii. (2.-8.); Sh., ™x.-xx. (.6-1.3); Sw. & D., MLii.-viii. (.12-.5). Vinum Colchici Seminis. Wine of Colchicum Seed. (U.S. P.) Made by maceration of colchicum seed, 100; alcohol, 150; and white wine to make 1000. Dose.—H. & C., 3.iii:- 3 i. (12.-30.); D., ™x.-xxx. (.6-2.). COLCHICUM 633, Tinetura Colchici Seminis.. Tincture of Colchicum Seed. (U. §..& B. P.) Made by maceration and percolation of colchicum seed, 100; with aleohol and water to make 1000. (U.S. P.) Dose.—H. & C.,, 3iii.-5 i. (12.-30.) ; D.,..1x.-xxx. (.6-2.). Action External.—Colchicum is an irritant to the skin and mucous membranes. Action Internal.—Digestive Organs.—Colchicum and colchicine are identical in action without regard to their method of introduction into the system. Colchicum is es- sentially a gastro-intestinal irritant in large doses. This irritant action may explain all its effects on other organs. Full medicinal doses occasion anorexia, nausea, colicky pains, loud intestinal rumblings (borborygmi), and purging. Col- chiceine appears to closely resemble colchicine physiologi- cally. Neither the circulation, nervous system, respiration, nor temperature are affected by colchicum save in poisonous doses. Circulation.—Toxie doses reflexly influence the circula- tion, but colehicum does not appear to affect it directly until late in poisoning, when the vagus endings become depressed and paralyzed and the pulse is weak and rapid. Nervous System.—Toxic quantities depress and paralyze the motor cells of the inferior cornua in the spinal cord, and also depress the sensory nerves. Death occurs from paralysis of the respiratory centres. Kidneys.and Elimination.—It is doubtful whether col- chicum exerts any decided or uniform action on the kidneys. Experiments relating to this matter are perplexingly con- flicting. Sometimes the urinary solids are increased—urea more than uric acid—and sometimes not. In _ poisoning, nephritis and hematuria occasionally result from the elimina- tion of colchicum. Toxicology.—Colchicum is a very poisonous drug. Acci- dental lethal poisoning occasionally occurs among herbivora from eating meadow saffron at pasture, or in hay. In such 634 VEGETABLE DRUGS cases it is naturally impossible to estimate the quantity of the plant ingested. Two and one-half drachms of the wine of the root, and one-half grain of the alkaloid, have proved fatal to man. Two drachms of the corm have killed a dog, and one-tenth of a grain of colchicine has destroyed a cat. The symptoms of poisoning comprise: anorexia, nausea, dulness, salivation, violent vomiting (in carnivora), purging, at first watery, then mucous and often bloody, and accom- panied by great tenesmus, tympanites, and colic. There are often such nervous symptoms as tremors, stupor, coma, and paralysis. The animal becomes very weak, the respiration is slow and feeble, the pulse rapid and imperceptible, the skin is cold and covered with a clammy sweat, and death occurs in collapse following severe gastro-enteritis. After the injection of large doses of colchicine, increasing the amount does not aggravate the symptoms. Post-Mortem Appearances.—The mucous membrane of the stomach and intestines is swollen, congested, and eroded. Sometimes free blood is found within their lumen. There is also acute hyperzmia of the kidneys. Treatment.—This consists in the use of the stomach pump, emetics, and cathartics, unless there has been free purging and vomiting. Tannic acid is the best chemical antidote, but 1s not wholly satisfactory. It should be used, however. Demulcents (oil and egg albumin) and opium relieve the local irritation, pain nae purging. Stimulants, as atropine, strychnine, and ‘alcohol, together with external heat, combat collapse. Administration.—The crude drug is not suitable for use. The wine of the root is the best preparation. Uses.—It is difficult to estimate the therapeutic value of eolehicum. It is called an alterative by many authorities, for want of a better term to describe a drug whose physiolog- ical actions do not explain its medicinal virtues. Colchicum is the most successful single remedy for gout in human medicine, but does not possess so great a value in veterinary practice. It is sometimes used with considerable advantage STARCH 635: in the treatment of subacute and chronic rheumatism, and in that form complicating influenza in horses. Potassium iodide is generally prescribed with colchicum in these disorders, and also in pericarditis and pleurisy of rheumatic origin. Colchicum is commonly believed to be a serviceable diuretic in various diseases (although this hypothesis is not physiologically substantiated). It is there- fore recommended in hemaglobinzemia and swelling of the legs in horses; in cerebral congestion ; ascites; pleural and pericardial effusions, and dropsies, as an eliminative. Col- chicine, subcutaneously, is especially lauded in rheumatism. SECTION XVII.—VEGETABLE DRUGS ACTING MECHANICALLY. Amyium. Starch. ©,H,,0, (U. 8. & B. P.) Synonym.—Corn starch, E.; fecule (amidon) de froment, de blé, Fr.; kraftmehl, weizenstirke, G. The fecula of the seed of Zea Mays Linné (nat. ord. Graminez). Habitat.—Tropical Asia and Africa, but cultivated in tropical, sub-tropical and temperate countries. Description.—In irregular, angular masses, which are easily reduced to a fine powder ; white, inodorous and taste- less; insoluble in ether, aleohol or cold water. Under the microscope appearing as granules, nearly uniform in size, more or less angular in outline, with indistinct striae and with a distinct hilum near the centre. Constituents.—1, starch-granulose ; 2, starch-cellulose. PREPARATION. Glyceritum Amyli, (U.S. P.) (See p. 581.) Glycerinnm Amyli. (B. P.) Action and Uses.—Starch is a mechanical protective externally, used as a dusting powder, alone or with zine oxide (1-4), in chafing, erythema, and moist eczema. The 6386 VEGETABLE DRUGS glycerite of starch is a serviceable demulcent. Boiled starch paste, mixed with glue, is used to stiffen bandages by paint- ing the mixture on in layers with a brush. Boiled starch gruel (2 tablespoons of starch to a pint of water) is a suitable diet for diarrhoea, and is frequently injected into the rectum as a demulcent in diarrhcea and dysentery, and as a vehicle for enemata. Starch is an antidote to iodine. It is utilized in pharmacy as a vehicle to suspend insoluble powders or oils, and in mucilage (1-40, B.P.), as a basis for ointments. Zine oxide, one part; starch and vaseline, each 3 parts, form a very satisfactory preparation for acute eczema in dogs, which does not rub off so readily as zinc ointment. Oxtzeum THEOBROMATIS. Oil of Theobroma. (U.S. & B. P.) Synonym.—Butter of cacao, E.; beurre de cacao, Fr.; cacaobutter, G.; oleum (butyrum) cacao, P.G. A fixed oil expressed from the seed of Theobroma Cacao Linné (nat. ord. Sterculiacez). Properties. — A yellowish-white solid, having a faint, agreeable odor, and a bland, chocolate-like taste. Readily soluble in ether or chloroform. Constituents.—1, olein; 2, stearin; 3, laurin; 4, arachin; 5 elycerides of formic, butyric, and acetic acids. Uses. — Cacao butter melts at the temperature of the body, and is chiefly used as an excipient for suppositories and electuaries. It also has a demulcent action and may be employed on raw surfaces or in inflammation of.the throat and digestive tract. Gossypium Puriricatum. Purified Cotton. (U.S. P.) Synonym.—Absorbent cotton, H.; hombyx, lana gossypii, — coton, Fr.; baumwolle, G. The hairs of the seed of Gossypium herbaceum Linné, and of other species of Gossypium (nat. ord. Malvacez), PYROXYLIN Gay - freed from adhering impurities and deprived of fatty — matter. Habitat.—Tropical Asia and Africa; cultivated in sub- tropical and tropical countries, mostly in the Southern United States. Description.— White, soft, fine filaments, appearing under the microscope as hollow, flattened and twisted bands, spirally striate and slightly thickened at the edges ; inodor- ous and tasteless; insoluble in ordinary solvents, but soluble in copper ammonium sulphate solution. Uses.—Absorbent cotton is used as a cheap, convenient and cleanly substitute for ordinary sponges; to make poult- ices by soaking it in antiseptic solutions (as creolin 1-2 per cent.) and placing it between layers of gauze ; and for surgi- cal dressings. Oakum, consisting of the fibres of old rope, is often employed as a cheap absorbent material, saturated with tar, _ in packing horses feet. Tow,—the coarser unbleached fibres of flax ; and lint,— the scrapings of soft, loosely woven linen,—are also utilized as absorbent substances for surgical purposes. Pyroxytinum. Pyroxylin. ' (U.S. & B. P.) Synonym.—Gun cotton, soluble gun cotton, colloxylin. Derivation—Made by maceration of purified cotton, 100; in a mixture of nitric acid, 1400; and sulphurie acid, 2200; at a temperature of 32° OC. (90° F.), until a sample is soluble in a mixture of 1 volume of alcohol and 3 volumes of ether; washing with cold and boiling water, draining, and drying in small pellets. PREPARATIONS. Collodium. Collodion. (U.S. & B. P.) Pyroxylin, 40; ether, 750; alcohol, 250. Made by solution, agita- tion, and decantation of clear portion. Collodium Cantharidatum. Cantharidal Collodion. (U.S. P.) Synonym.—Blistering collodion. Made by percolation of cantharides, 60; with chloroform, distilla- 638 ‘VEGETABLE DRUGS tion of the chloroform and evaporation of the residue until it weighs 15 (Gm,), and solution in flexible collodion, 85. Collodium Flexile. Flexible Collodion. (U.S. & B. P.) Mix collodion, 920; Canada turpentine, 50; and castor oil, 30. (U2S.2) Collodium Stypticum. Styptic Collodion. (U.S. P.) Mix tannic acid, 20; alcohol, 5; ether, 25; add collodion to make 100. Action and Uses.—Collodion, when painted on dry skin, rapidly dries and leaves a thin, protective coating. Itisa usefnl agent to seal and secure coaptation of small wounds and to keep them aseptic. Also to protect abraded surfaces, as fissures of teats. Flexible collodion is less apt to crack. Collodion contracts the superficial tissues and will often abort boils when applied directly over them. Collodion is employed as a vehicle for the application of many other agents, as corrosive sublimate, carbolic acid, iodoform, ete. Eurxorsium. Euphorbium. (Non-official.) The dried juice of a cactus-like plant, Euphorbium resinifera, growing in Morocco and regions contiguous to the Atlas Mountains. Obtained by incising the stems and branches. Description.—In dull yellowish tears, of the size of peas; odorless ; taste acrid; powder of a grayish color ; insoluble in water, but soluble in alcohol, ether and oil of turpentine. Constituents.—1, an acrid resin (C,,H,,O,), 38 per cent., the active principle ; 2, euphorbon. : Action and Uses.—EKEuphorbium is an intense irritant, both externally and internally. It is sometimes employed in veterinary medicine as a constituent of vesicating prepara- tions to enhance their effect, but if applied alone it is liable to cause extensive irritation, sloughing, and destruction of tissue. Euphorbium may, however, be safely applied in tincture (1-16), or in ointment with cantharides, as a vesicant for horses. The following combination is recommended as a powerful blister for the latter animals. Euphorbium and cantharides, each two parts; corrosive sublimate, one part; ADRENALIN 639 - vaseline, eight parts; cerate, twelve parts. There is no danger of absorption and genito-urinary inflammation from the use of euphorbium, as with cantharides. SECTION XVIII—MEDICINAL AGENTS OF ANIMAL ORIGIN. GLANDUL® SUPERENALES Siccm. Dessicated Suprarenal Glands): CU: Sy. Ps) The dried glands of the sheep or ox free from fat and powdered. Dose.—H., 31. (4.); D., gr.iv. (.25). AprEeNnALin. (Non-official.)* This is an active principle of the suprarenal glands, and was discovered by Dr. Jokichi Takamine + and made public in 1901. It is a light, white, microcrystalline substance, slightly soluble in cold water, more so in hot. It has a somewhat bitter taste and produces a benumbing of the tongue. Adrenalin is permanent in powder, but changes color and is oxidized in aqueous solution. It is said to be the active principle of the suprarenals, but non-toxic, which ean not be said of the glands or their extracts (and not of adrenalin). Adrenalin is from 825 to 1,000 times more powerful than the glands in its physiological effect. Solu- tions may be boiled without impairing their therapeutic activity. Action.—The most important action is exerted upon the circulatory apparatus, which is comparable to that of digi- talis but much more rapid and transient, lasting not more than ten minutes when given intravenously. The. drug acts very uncertainly when given by the mouth—except locally on the digestive Joi eo of poor absorption. The force of the heart is increased * but the rate decreased (by *Epinephrin is but another form of adrenalin—identical with it physiologically but differing slightly from it chemically. + Therapeutic Gazette, April 15, 1901. { The secreting part of the adrenals is derived in embryo from the sympathetic system. Its secretion (adrenalin) acts in the body to always and everywhere stimulate sympathetic nerve endings. By this 640 AGENTS OF ANIMAL ORIGIN excitation of the heart muscle and vagus centre) and blood pressure is more markedly heightened than by any other known drug, owing in part to central vasomotor stimulation but chiefly to excitation of the muscular coat of the vessels. The blood vessels are, however, not constricted uniformly over the entire body but principally those of the abdominal organs—controlled by the splanchnics—are contracted, while the pulmonary and cerebral vessels are unaffected by the systemic action of the drug. Respiration is also strength- ened, and both voluntary and involuntary muscles are stimu- lated by adrenalin. But, as in the case of the vessels, so the action on involuntary muscles is not uniform. Thus the muscles of the stomach, bowels and bladder are inhibited in their action and in poisoning lose all movement. On the other hand, the uterus, vagina, vas deferens, seminal vesicles, and éxternal genital organs are contracted. So are the radi- ating fibres of the pupil, which is dilated, and the eyeball protudes. Large doses of the adrenal gland cause poisoning with failure of the heart and respiration and paralysis of the VAL 5 PEON, In poisoning by large doses of the adrenal gland, there have been observed vomiting, restlessness, tremors, para- plegia, from action on the spinal cord or muscles or both, dyspnea and death. Glycosuria has also been induced by the subcutaneous injection of the suprarenal extract, and stimulation of: the secretions of the salivary, esophageal, bronchial and lachrymal glands and of the bile. The pre- dominant and valuable effect of adrenalin and extracts of the adrenals consists in the complete blanching of mucous membranes and raw surfaces after the local application of these substances. Adrenalin is undoubtedly the most power- ful astringent and hemostatic known, owing to its stimula- tion of the involuntary muscles of the blood vessels. Subcutaneous injection of a 1 to 1000 solution causes blanching over an area about two inches in diameter within a minute. and lasts for six to twelve hours. Solutions con- taining adrenalin to the amount of 1 to 5000, 1 to 10,000, or even 1 to 20,000, will produce an ischemia after their hypo- action adrenalin contracts blood vessels, dilates the pupil, stimulates the heart muscle, and relaxes the bowels. ee: ADRENALIN 641 _dermie use within a few minutes and lasting for three to six hours. Neither eechymoses nor sloughing occur after the proper injection of the drug. Secondary hemorrhage does not ordinarily appear after the use of adrenalin, but it will prevent the secondary relaxation, congestion and pain some- times seen following the use of cocaine. Uses.—Haternal.—Adrenalin chloride is commonly sold in a 1 to 1000 aqueous solution in the shops. It has proven of most value when combined with cocaine for subcutaneous use in operative work. One part of the 1-1000 solution may be added to nine parts of normal salt solution (one heaping teaspoonful of sodium chloride to the quart of sterile water), te which is added 1 per cent. of cocaine, or more if desired. _A stronger solution of adrenalin chloride than this (1 to 10,000) is not usually desirable in operative work, because lt is irritating, and in some instances when stronger solu- tions were used so much ischemia was produced that the blood vessels could not be found and ligated and secondary hemorrhage ensued. It is usually sufficient to add Mx.-xx. adrenalin solution (1-1000) to 5ss. of cocaine solution. The combination of cocaine with adrenalin is coming into general favor and marks a distinct progress in_ local anvesthesia. Four advantages are claimed for this com- bination; 1, that the operation is made comparatively blood- less; 2, that the cocaine is retained in the operative field a longer time, owing to the contracted state of the vessels, and does not escape into the general circulation; this is a double advantage—in prolonging anesthesia and in preventing sys- temie effect of cocaine; 3, that adrenalin is a circulatory stimulant and will offset the toxic action of cocaine; 4, that adrenalin counteracts the vascular relaxation seen sometimes after the use of cocaine.* Adrenalin has also proven of great service in arresting hemorrhages from wounds, mucous membranes and cavities of the body. A solution equivalent to a 1 to 5000 of ad- renalin in sterile salt solution may be applied for this purpose directly to the bleeding surface, or gauze saturated with it may be packed into wounds and cavities, as the nose, uterus * Some able surgeons fear secondary hemorrhage from the use of adrenalin, 642 AGENTS. OF ANIMAL ORIGIN and vagina. Adrenalin chloride is useful also in many in- flammatory diseases of the eye and nose in the same strength. Catarrhal conjunctivitis, keratitis, episcleritis and iritis yield to its influence, particularly when it is combined with other astringents on account of its transient action; with atropine in iritis. Adreualin chloride in a 1 to 5,000 solu- tion containing 2 percent. of boric acid forms a useful prep- aration for general application in infiammations of mucous membranes. j ’ Internal_—Adrenalin is employed internally to arrest bleeding from the stomach, intestines and uterus. Its local application in hemorrhage from the bladder, rectum, nose, vagina and uterus is, however, much more effective. The drug is said to have yielded good results in human practice in the treatment of diabetes insipidus and purpura hemor- rhagica. It is not of benefit for the arrest of internal hemorrhage other than in the digestive tract. This follows because it does not contract the vessels of the brain and lungs and because its effect in increasing general blood ten- sion is inimical to its local effects in constricting vessels. Reichert, as the result of his experiments on morphinized dogs, believes that adrenalin is a valuable and rapidly acting stimulant to the heart, vasomotor system and respiration in poisoning by opium and anesthetics. The latest experimental and clinical studies show ad- renalin is of chief value for internal use in conditions of greatly reduced blood pressure, as in poisoning by ether and chloroform inhalation, by chloral, and in surgical shock. Here it is now considered the most efficient remedy. Bossi has artificially produced osteomalacia in sheep by removal of one adrenal gland. Treatment has likewise been successful in osteomalacia in the human, and in rickets in puppies by intermuscular injection of 1-1,000 adrenalin — solution (n.v-xv t.1d.). Administration.—Adrenalin is preferable to the so- called suprarenal extracts, the dried and powdered suprarenal capsules of sheep and oxen. When the drug is given by the mouth or rectum, its action on the system at large is slow and uncertain, owing to the tardiness of absorption, pre- sumably due to the vascular constriction it occasions and to CANTILARIDES 643 - its rapid decomposition. Intravenous injection is most ef- fective in solutions of 1 to 10,000, or more dilute, in normal salt solution. Subcutaneous injection is somewhat uncertam owing to slow absorption, through vascular constriction. But the 1-1,000 solution (H., 5i.; D., Mx.) may be injected deep into the muscle with certain effect and without irritation. A stronger solution than 1 to 10,000 may cause an abscess if the drug be given hypodermically. The doses of adrenalin chloride in 1 to 1000 solution are: Dogs, m10.-60. (0.6-4.0) ; horses, 5 1-4 (1.-15.)* Adrenalin should be repeated once in two hours when given internally as an hemostatic. CantTHaris. Cantharides. (U.S. &B. P.). _Synonym.—Spanish flies, blister beetles, muscz hispan- ice, E.; cantharides, Fr.; spanische fliegen, canthariden, G.; eantharides, P.G. Cantharis is the beetle, Cantharis vesicatoria De Geer (class Insecta; order Coleoptera). Habitat—Southern Europe, Germany and Russia; living chiefly on Oleaceze and Caprifoliacee. Description.—About 25 Mm. long and 6 Mm. broad; flattish cylindrical, with filiform antenne, black in the upper -part, and with long wing-cases, and ample, membranous, transparent, brownisl wings, elsewhere of a shining, cop- pery-green color. The powder is grayish-brown, and con- tains green shining particles. Odor strong and disagreeable ; taste slight, afterwards acrid. Constituents.—1, the active principle is cantharidin, C,9H,20, (2 per cent.), in colorless scales, insoluble in water, soluble in alcohol, ether, chloroform, oils, acetic acid and acetic ether; it is found ey in the generative organs, egos, and blood of the beetles; 2 2, a volatile oil; 3, a bland, green oil; 4, acetic and uric acids, extractives and salts; cantharides deteriorates with age and should be kept un- powdered in tightly stoppered bottles. Dose.—H. & C., gr.v.-xx. (.3-1.3); Sh. & Sw., gr.iv.- Watton (2 orch 3, D).; gr iii. (.06-.12). *The high cost of adrenalin forbids its use for horses, save in ex- ceptional cases. 644 AGENTS OF ANIMAL ORIGIN PREPARATIONS, Tinctura Cantharidis. Tincture of cantharides. (U.S. & B. P.) Made by percolavion of cantharides, 100; with alcohol to make 1000: "(GU SLE.) et . Dose.—H. & C., 3 ii-iv. (8.-15.); D., Mii.-xv. (.12-1.). Ceratum Cantharidis. (U.S. P.) Cantharidis powdered, 320; petrolatum, wax, rosin and lard to make 1000. Unguentum Cantharidis. (B. P.) Action External.—Cantharides, by virtue of cantharidin, is an intense irritant. When applied to the skin in ointment it produces no effect for several hours, but after that time causes dilatation of the cutaneous vessels, hyperemia, and blisters, which appear in from 3 to 12 hours. The blisters soon break, discharge their serous contents, and then dry and crust the surface. If the action of cantharides is main- tained continuously; if the application is repeated, or covered with a bandage; or if the skin was previously inflamed, then inflammation of the deeper-seated parts ensues, followed by suppuration, sloughing, loss of tissue, destruction of hair follicles, and scars. The drug is thera- peutically a rubefacient and vesicant, and counter-irritant, in oceasioning dilatation of the superficial vessels, and reflexly, contraction of those in the remote underlying parts. Cantharides acts more powerfully on the skin of horses and dogs, than on that of cattle and swine. If applied over an extensive surface, absorption and poisoning may occur. Action Internal.—Cantharides affects mainly the diges- tive and genito-urinary tracts. It is a violent gastro-intes- tinal irritant. Toxic doses cause vomiting, in animals capable of the act, at first bilious (and containing greenish specks of the wings and wing cases), then mucous, and finally bloody. There is purging in all, associated with great pain and straining, of a mucous, fibrinous, and often hemorrhagic character. There are salivation, swelling and pain in the salivary glands. The gastro-enteritis is accompanied by general prostration, and feeble, rapid pulse. A few hours after the occurrence of the preceding symptoms there is CANTHARIDES 645 enovgh absorption of cantharidin to induce lumbar pain, followed by frequent, scanty and painful micturition (stran- gury). The urine is albuminous and often bloody. Can- tharides is eliminated chiefly by the kidneys, but also to some extent by the other excretory organs, including the skin. Sexual excitement may be present in poisoning. It is more common with small than large toxic doses. There are erections and great heat in the penis, and even inflam- mation and sloughing of the organ. Abortion is precipitated in the pregnant, and “heat” is hastened in the non- pregnant female. Stupor, coma, and collapse close the scene after lethal doses. Twenty grains of cantharides have killed a man ; forty, a dog; and one drachm has destroyed a horse. The treatment includes the use of emetics or the stomach pump; opium, to relieve pain and.strangury; albuminous, mucilaginous drinks; and, in collapse, external heat, alco- holic stimulants, strychnine and atropine under the skin. Oils and fats dissolve cantharidin and must not be given in poisoning as demulcents. Post-Mortem Appearances.—Swelling, congestion, ecchy- moses, and erosion of the gastro-intestinal mucous membrane are observed after death by cantharides. There are, more- over, lesions of acute nephritis and cystitis, with inflam- mation of the whole genito-urinary mucous membrane. Hyperemia of the brain and spinal cord have also been reported. Uses External.—Cantharides is employed more frequently than any other counter-irritant, to cause blistering, in veter- inary practice. The reader is referred to the section on counter-irritants (p. 696) for an account of their actions. The action of cantharides is too tardy and irritating, and there is too much danger of absorption and poisoning to recommend it for the production of counter-irritation over an extensive area (chest and abdomen) in acute pulmonary congestion, pneumonia, bronchitis, colic, enteritis and peritonitis. Mustard, turpentine, and external heat are generally preferable in these disorders. 646 AGENTS OF ANIMAL ORIGIN A blister of cantharides is serviceable in pericarditis and pleuritis with effusion, and, applied over the throat in severe, acute laryngitis, may obviate the necessity of tracheo- tomy. Again, blisters are useful on the poll in inflammation of the brain and its membranes; and over the spine in myelitis and meningitis; over the lumbar region in para- plegia. A cantharidal application is often efficacious in.muscular or joint rheumatism when placed over the affected area, or near by, in acute conditions. Furthermore, a cantharides blister is of advantage in acute diseases of the ear, when rubbed in above and behind this organ; and will relieve pain in the stomach, and vomiting when applied to the epigastrium. Cantharides is the remedy usually employed in the treatment of diseases of the bones, joints, burs, ligaments, and tendons. In exostoses, as spavin and ringbone, the ointment is used most effectively after the actual cautery, to secure absorption and resolution, or anchylosis. Cantharidal ointment is often sufficient, together with complete rest, in the treatment of synovitis, and strains of tendons and liga- ments. A cantharides blister is, sometimes, beneficial in hastening the formation of abscess, (“strangles”’); or to aid their resolution after paracentesis ; also to stimulate indolent ulcers or wounds; and to assist absorption of traumatic indurations, when applied around these lesions. The actual cautery, followed by a cantharides blister, will cause sweil- ing and close the opening in the abdominal parietes of small umbilical hernias of foals and calves. Likewise, blisters are valuable in closing and sealing punctured wounds into joints and synovial cavities.* Can- tharides is commonly employed in ointment (1 to 4-8) made by melting and mixing the excipients in a double boiler ; i.e., over a water bath, and stirring in thoroughly the powdered drug. The following is a good preparation: * The U.S. P. cerate may be used, as it is a powerful preparation. Its strength is 32 per cent. cantharides. CANTHARIDES: 647 Pulv. Cantharidis. Ss. External use. More powerful ointments are made with powdered euphor- bium and cantharides, each 2 parts; corrcsive sublimate, 1 part ; vaseline, 8 parts; cerate, 12 parts; or, Tar and resin, each 4 parts ; yellow wax, 3 parts ; cotton- seed oil, 10 parts ; powdered euphorbium, 2 parts; canthar- ides, 6 parts. The technique of blistering consists in Hy the hair and washing the part to be blistered, and rubbing the blister long and thoroughly'into the skin. The animal should be controlled by tying up the head, or using a cradle, or side-bar attached to the halter and surcingle, to prevent horses from biting the blistered area. The tail should be tied up if the blister is applied within its reach. Dogs should be muzzled, but are apt to rub the sore spot. The serum discharged from the blister must be continually sponged off with soap suds and water, to prevent excoriation of the subadjacent skin, or the latter may be covered with a solution of resin in alcohol, by means of a brush. The blister is washed off in 36 or 48 hours after its application, and vaseline should thereafter be kept on the part. The use of cantharidal blisters is contraindicated in weak or young animals; on the flexures of joints; or deli- cate skin on the inner aspect of the upper part of the limbs; on acutely inflamed areas ; and in renal disease. Uses Internal. —Cantharides is rarely administered internally. It is sometimes successful in stopping incon- tinence of urine, when due to relaxation of the neck of the bladder, and it may be used as a stimulant in chronic cystitis and pyelitis. Cantharides is recommended to increase sexual desire in cows and mares, but it has usually to be given in toxic doses to produce an aphrodisiac action. The tincture should be employed when the drug is exhibited internally. 648 AGENTS OF ANIMAL ORIGIN Aveps. Lard. (U.S. & B. P.) Synonym.—Adeps preparatus, B.P.; axungia, axungia porci s. poreina, prepared lard, hog’s lard, E.; axonge, graisse de pore, Fr.; schweineschmalz, G.; adeps suillus, P.G. The prepared internal fat of the abdomen of Sus Serofa Linné (class Mammalia; order Pachydermata), purified by washing with water, melting, and straining. Properties.—A. soft, white, unctuous solid, having a faint odor free from rancidity, and a bland taste; insoluble in water ; slightly soluble in alcohol ; readily soluble in ether, chloroform, carbon disulphide, or benzin. Spec. gr. about 0.932. PREPARATIONS. Ceratum. Cerate. (U.S. P.) Synonym.—Cerat simple, Fr.; einfaches cerat, wachssalbe, G. White wax, 300; white petrolatum, 200; benzoinated lard, 500. Unguentum. Ointment. (U.S. P.) Synonym.— Unguentum simplex, B.P.; simple ointment, E.; pommade simple, Fr.; wachssalbe, G. Lard, 800; white wax, 200. (ioSak.) Ceratum Resince. (See p. 506.) Adeps Benzoinaius. (See p. 612.) Sevum Preparatum. - Prepared Suet. (U.S. & B. P.) Synonym.—Sevum preparatum, B.P.; mutton suet, E.; suif, Fr.; tale, hammeltalg, G.; sebum, P.G. The internal fat of the abdomen of Ovis aries Linné (class Mammalia; order Ruminantia), purified by melting and straining. Properties.—A. white, solid fat, nearly inodorous, and having a bland taste when fresh, but becoming rancid on prolonged exposure to the air. Insoluble in water or cold alcohol; soluble in about 60 parts of ether, and slowly in 2 parts of benzin. Constituents.—1, olein; 2, stearin ; 3, palmitin ; 4, hircin. HYDROUS WOOL FAT 649 Apvrrs Lanz Hyprosus. Hydrous Wool Fat. (U.S. &B. P.) Synonym.—Lanolin, cesypum, The purified fat of the wool of sheep (Ovis aries, Linné ; class Mammalia; order Ruminantia), mixed with not more than 30 per cent. of water. Properties.—A_ yellowish-white, or nearly white ointment- like mass, having a faint, peculiar odor. Insoluble in water, but miscible with twice its weight of the latter, without losing its ointment-like character. Constituents.—1, cholesterin, C,,H,, (OH); 2, ethers of oleic, stearic, palmitic and other acids. Avrprs Lanm. (U.S. & B. P.) (Wool fat without water.) ACTION AND OSE OF LARD, SUET, AND HYDROUS WOOL FAT. - Lard is used mainly as a basis of ointments and cerates, Benzoin is commonly added to it to prevent or retard ran- cidity. Lard is inferior to petrolatum as a lubricant. It is rarely given internally as an antidote to caustic alkalies, and as a demulcent. Suet is contained in certain ointments and plasters. It is harder than lard and becomes rancid on prolonged exposure. Lanolin is not subject to rancidity, but possesses no particular medicinal action. It is indicated where wbsorption of some drug is desired (mercury, potassinm lodide) by inunction, as it is believed to be more readily absorbed from the skin than any other fat. Lanolin is used as a basis cf ointments. It may be mixed with twice its weight of water without losing its ointment consistency. Cera Fuava. Yellow Wax. (U.S. & B. P) Synonym.—-Cera citrina, beeswax, B.P.; cire jaune, Fr.; gelbes wachs, G. A peculiar, concrete substance prepared by Apis melli- fica Linné (class Insecta ; order Hymenoptera). 650 AGENTS OF ANIMAL ORIGIN Properties. — A yellowish to brownish-yellow solid, having an agreeable, honey-like odor, and faint, balsamic taste. Spec. gr. 0.955-0.967. It is brittle when cold; by the heat of the hand it becomes plastic. Insoluble in alcohol; sparingly soluble in cold alcohol, but completely soluble in ether, chloroform, fixed and volatile oils. Constituents. —1, myricin or myrical palmitate (C,,H,,, C,,H,,0.,), a spermaceti-like substance; 2, cerin or cerotic acid (C,,H,,0,), an imperfectly saponifiable waxy body ; 3, hydrocarbons (C,,H,, and C..H.,,); 4, an alcohol (C,,H,,O) ; 5, ceryl alcohol (C,,H,,O). Cera ALBA. White Wax. (U.S. & B. P.) Synonym.—Cire blanche, Fr.; weisses wachs, G. Yellow wax, bleached by exposure to air, light and | moisture. Properties.—A yellowish-white solid, somewhat trans- lucent in thin layers, having a slightly rancid odor, and an - insipid taste. Spee. gr. 0.965-0.975. Solubility and com- position the same as those of yellow wax. Uses.—Yellow and white wax are used as bases for plasters, ointments and cerates, since they do not decompose nor melt at the temperature of the body. CretTacreuM. Spermaceti. (U.S. & B. P.) A peculiar, concrete, fatty substance, obtained from (the sperm whale) Physeter macrocephalus Linné (elaee Mam-. malia ; order Cetacea). Habitat —Indian and Pacific Oceans. Properties. — White, somewhat, translucent, slightly unctuous masses of a sealy-crystalline fracture and a pearly lustre ; odorless, and having a bland, mild taste. It becomes yellow and rancid by exposure to the air. Spec. gr. about 0.945. Insoluble in water, nearly so in cold alcohol ; soluble in ether, chloroform, carbon disulphide. fixed and volatile oils. HONEY 651 Constituents.—1, chiefly a fat, cetin or cetyl palmitate (C,,H,,C,,H,,0,), composed of cetylic alcohol (C,,H,,OH) and palmitic acid (HC,,H,,0,); 2, sperm oil, a small quantity. PREPARATION. Unguentum Cetacet. (B. P.) Spermaceti, white wax, and olive oil, Made by melting and mixing. Action and Uses.—Spermaceti resembles wax. Itis used as an emollient and as a basis for plasters, ointments, and cerates. It is rarely used alone. Met. Honey. (U.S. & B. P.) Synonym.—Miel, Fr.; honig, G. A saccharine secretion deposited in the honeycomb by Apis mellifica Linné (class Insecta ; order Hymenoptera). Properties.—A. syrupy liquid of a bright yellowish to a pale-yellowish-brown color; translucent when fresh, but gradually becoming opaque and crystalline; having a char- acteristic, aromatic odor, and a sweet, faintly acrid taste. Nearly soluble in water. Constituents.—1, grape sugar (dextrose); 2, fruit sugar (glucose); 3, a volatile oil; 4, wax; 5, formic acid, a trace. Fresh honey contains sucrose or cane sugar, which is changed into grape and fruit sugars, PREPARATION, Mel Depuratum. Clarified Honey. (U.S. & B. P.) Synonym.—Mel depuratum, P. G.; miel despumé, mellite simple, Fr.; gereinigter honig, G. : Derivation.—Melt honey with two per cent. of its weight of paper- pulp in water bath ; skim, strain, and add five per cent. of its weight of glycerin. Dose.—Ad lib. Honey is employed as an excipient in electuaries and confections. It is a demulcent and mild laxative for young 652 AGENTS OF ANIMAL ORIGIN animals. Oxymel (clarified honey, 8 parts ; water and acetic acid, each 1 part) is a soothing preparation for the throat. SaccHarum Lactis. Sugar of Milk. (B,,H,,0,, + H,O.) (U.S. 6 BE Synonym.—Lactose, lactin, milk sugar, E.; sucre de lait, Fr.; milchzucker, G. A peculiar, crystalline sugar obtained from the whey of cows’ milk, by evaporation, and purified by recrystallization. Properties.—White, hard, crystalline masses, yielding a white powder, feeling gritty on the tongue; odorless, and having a faintly sweet taste. Permanent in the air. Soluble in about 6 parts of water; insoluble in alcohol, ether, or chloroform. _ Dose.—Ad lib. Uses.—Sugar of milk is less soluble and therefore less sweet than cane sugar. It is harder, and thus assists in the subdivision of drugs, and serves as a vehicle in the making of powders and triturates. It also forms the basis of homceo- pathic preparations. Sugar of milk is a considerable diuretic and may be given to dogs in 2 to 4 drachm doses daily, in solution in the drinking water, for dropsy of renal or cardiac origin. PepsinumM. Pepsin. (U.S. & B. P.) A proteolytic ferment or enzyme obtained from the glandular layer of fresh stomachs from healthy pigs, and capable of digesting not less than 3000 times its own weight of freshly coagulated and disintegrated egg albumin. Derivation.—The chopped mucous membrane of a pig’s stomach is macerated for several days in a weak, aqueous solution of hydrochloric acid, with frequent stirring. The pepsin is precipitated from this solution by the addition of sodium chloride and rises to the surface. The floating mix- ture is skimmed off, drained, pressed and dried. Sometimes the surface of the clean mucous membranes of the stomach of pigs, calves, or sheep is simply scraped off and dried. PEPSIN 653 Properties.—A fine, white, or yellowish-white, amorphcus powder, or thin, pale yellow or yellowish, transparent or translucent grains or scales, free from any offensive odor, and having a mildly acidulous or slightly saline taste, usually followed by a suggestion of bitterness. It slowly attracts moisture when exposed to the air. Soluble, or for the most part soluble, in about 100 parts of water, with more or less opalescence ; more soluble in water acidulated with hydrochloric acid ; insoluble in alcohol, ether or chloroform. Dose.—D., Calves and Foals, gr.x.- 3 i. (.6-4.). PREPARATIONS. Glycerinum Pepsint. (B. P.) (Contains hydrochloric acid, 3 i. = gr.v. pepsin.) Dose.—D., 31 -ii. Pepsinum Saccharatum. Pepsin, 1; sugar of milk, 9. A weak preparation of little value. Action and Uses.—Pepsin is of some value in the treat- ment of dogs and young animals. It assists the digestion of proteids in the stomach, but has no action on fat or carbo- hydrates of the food. The drug should usually be given along with hydrochloric acid, which converts any pepsinogen, in the gastric tubules, into pepsin. Pepsin contains the unorganized digestive ferment of the gastric juice, but is not by any means the pure ferment, which has never been isolated. Much of the commercial pepsin is inert, or is composed largely of mucus, albumin and peptone, which later gives the preparation a musty odor and causes it to absorb moisture when exposed to the air, and to become sticky. Pepsin is serviceable in gastric indigestion of young animals, which is sometimes accompanied by diarrhcea, and in dyspepsia and feeble digestion caused by acute illness. Its use must not be long persisted in, as the normal functions of the stomach will fail from lack of use. Pepsin is administered in pill, or solution with hydrochloric acid. 654 AGENTS OF ANIMAL ORIGIN PANCREATINUM. Pancreatin. (U.S. P.) Synonym.—Zy mine, B.P. A mixture of the enzymes naturally existing in the pan- creas of warm-blooded animals, usually obtained from the fresh pancreas of the hog (Sus Scrofa Linné; class Mam- malia; order Pachydermata). Derivation.—Chopped hog’s pancreas is macerated in a dilute aqueous solution of hydrochloric acid for 48 hours, and pancreatin, which is separated by adding a saturated solution of sodium chloride, rises to the surface and is skimmed off, drained, washed, and when nearly dry, is diluted with sugar of milk until 10 grains will exactly emulsify 2 drachms of cod-liver oil. Properties. — A yellowish, yellowish-white or grayish, amorphous powder; odorless, or having a faint, peculiar, not unpleasant odor, and a somewhat meat-like taste. Slowly and almost completely soluble in water ; insoluble in alcohol. Dose.—D., gr.v.-xv. (.8-1.). Action and Uses.—Pancreatin fulfils a fourfold fanctien by virtue of the four ferments contained in it. It digests proteids by means of the ferment, trypsin; it decomposes and emulsifies fat owing to the ferment, steapsin; it converts starch into sugar’ by reason of the ferment, amylopsin ; it coagulates milk through the action of a milk-curdling fer- ment. Pancreatin is thus more useful than pepsin on account of its more extended actions. It does not digest food in an acid medium, but may aid digestion in the stomach, before much gastric juice has been secreted, during the first half hour after the ingestion of food. Pancreatin acts more efficiently in intestinal indiges- tion because of the presence of an alkaline secretion. For this reason pancreatin is commonly prescribed with sodium bicarbonate, and, if given for intestinal indigestion, it is administered in pill or tablet to dogs one or two hours after feeding. It is indicated in diarrhoea, when the fecal. move- OXGALL 655 ments contain particles of undigested food, and in other forms of deficient digestion due to general disease. Pan- creatin is more especially valuable to digest food previous to its administration by the mouth or rectum (see Artificial Feeding, p.694.) For this purpose a good preparation can be made extemporaneously by washing and cutting up a fresh pig’s pancreas, soaking it in absolute alcohol for 24 hours, pressing out the alcohol, macerating it in ten times its weight of glycerin for 48 hours, and filtering. The filtered glycerin extract is added in the proportion of 31. tothe pint of warm milk, with a little sodium bicarbonate, to artificially digest it. Fret Bovis. Oxgall. (U.S. P.) Synonym.—Fel tauri, inspissated oxgall, E. The fresh bile of Bos Taurus Linné (class Mammalia ; order Ruminantia). Properties.—A brownish-green or dark green, somewhat viscid liquid, having a peculiar, unpleasant odor, and a dis- agreeable, bitter taste. Spec. gr. 1.018 to 1.028. It is neutral, or has a slightly alkaline reaction. Dose.—D., gr.v.-xv. (.3-1.). PREPARATION. Fel Bovis Purificatum. Purified Oxgall. (U.S. P.) Synonym.—Fel bovinum purificatum, B.P.; fiel de boeuf purifie, Fr.; gereinigte ochsengalle (rindsgalle), G. Evaporate oxgall, 300, to 100; add alcohol, 100. The alcohol is dis- tilled off from the decanted and filtered solution, and the remainder evaporated to pilular consistence. Properties,—A yellowish-green, soft solid, having a peculiar odor and a partly sweet and partly bitter taste. Very soluble in water and alcohol, Dose.—Same as for 6xgall. Action and Uses.—Purified oxgall contains all the active elements of bile,—biliary acids, coloring matter and choles- terin. One part of oxgall represents about fifteen parts of bile. Most of the bile ingested is absorbed from 656 AGENTS OF ANIMAL ORIGIN the stomach (where it may act as a simple bitter), and small intestines, and is carried to the liver. From the liver it is not only excreted again into the bowel but it also stimu- lates the secreting cells at the liver (by means of bile acids) and increases the secretion of bile. Bile is in fact che only certain cholagogue known Bile has but a feeble antiseptic action, yet it excites the secretion of the pancreatic fat-splitting ferment and aids the absorption of fat in the food. In thus aiding digestion it prevents the fetid feces seen in biliary obstruction. Bile, moreover, assists the solubility and action of certain cathar- ties, viz., podophyllum, rhubarb, scammony, aloes and jalap —and has a laxative action itself, probably through the irrita- tion of bile acids on the large intestines. Bile is indicated medicinally in obstruction to the normal flow of bile—to aid intestinal digestion—and also to facilitate the action of the eatharties noted above. It may be used also to advantage in enema for dogs with chronic constipation and impacted feces (2 drams to 2 ounces of water). Internally it is given to dogs in pills 2 hours after meals. Papain. (Non-official.) . Synonym.—Papayotine, papaya, papayine, papoid. A digestive ferment obtained from the juice of the unripe fruit of Carica papaya (Papaw), an herbaceous tree growing in the East and West Indies. Papain or papayotine are often used to describe the dried juice itself, which exists in the form of a powder similar to that of gum arabic. Pa- pain occurs in the form of:a white, or greyish-white, nearly tasteless powder, soluble in glycerin and water. Papain is said to digest both proteids and carbohydrates, in either an acid or alkaline medium, and is recommended in gastric or intestinal indigestion in pill or powder. It has also been used to destroy pyogenic membrane of fistule and abscess, in 5 per cent. solution; or tumors and malignant growths, injected into the tissues in 10 per cent. solution. This latter use is accompanied by pain and febrile temperature, although the substance is said to merely dissolve diseased tissues with- out caustic effect. Papain may be given to dogs, foals, or calves in doses of gY.11.-x. (.12- 65" s0te therapeutic value is doubtful. | | : COD LIVER OIL 657 Oteum Morruvuz. Cod liver oil. (U.S. & B. P.) Synonym.—Oleum jecoris ascelli, P.G.; oleum hapatis morrhuz, cod oil, E.; huile de morue, huile de foie de morue, Fr.; leberthran, stockfischleberthran, G. A fixed oil obtained from fresh livers of Gadus Morr- hue Linné and other species of Gadus (class Pisces; order Teleostei; family Gadide). Habitat.—North Atlantic Ocean. Properties.—A pale-yellow, thin, oily liquid, having a peculiar, slightly fishy, but not rancid odor, and a bland, slightly fishy taste. Spec. gr. 0.920-0.925. Scarcely soluble in alcohol, but readily soluble in ether, chloroform or carbon disulphide ; also in 2.5 parts of acetic ether. Brown oils are not desirable therapeutically. Constituents.—1, glycerin oleate, 70 per cent.; 2, pal- -mitin and stearin, 25 per cent.; 3, oleic, margaris, palmitic, stearic, butyric and acetic acids, in small quantities; 4, bili- ary matter, as cholic, fellinie and bilifellinic acids; 5, gaduin (C3;H,,0,); 6, morrhuol, a crystalline substance containing iodine, phosphorus and bromine; 7, traces of iron, lime, and magnesia; 8, decomposition products or eadaverie alkaloids, in brown oils. ; Dose. H. & C., 5 u.-iv. (60.-120.) ; Sh. & Sw., 3 ee.-i. (15.-30.) ; D. & C., 3 i.-iii. (4.-12.). Action Internal.—Cod liver oil resembles other oils in aiding nutrition, the accumulation of fat, and the mainten- ance of bodily heat, but surpasses them in three particulars: 1, cod liver oil is more easily absorbed; this has been proven comparatively by injecting various oils into separate ligated portions of the living animal bowel; 2, cod liver oil is more readily oxidized after absorption; this is shown by the fact that it reduces and therefore changes the color of potassium permanganate solutions more quickly than other oils; 3, cod liver oil increases the number of red blood corpuscles in anzemia; this has been demonstrated by blood- counts, but not by comparison with the effect of other oils. The ease of absorption is thought by some to be due to biliary principles which aid the diffusion of substances through a mucous membrane (osmosis) when the latter is moistened by bile; by others it is attributed to the presence of free acids in the oil which would tend to saponify and 658 AGENTS OF ANIMAL ORIGIN emulsify the drug. The medicinal superiority of cod liver oil has led many writers to classify it as an alterative, and special properties have been referred to the minute traces of iodine, phosphorus, and bromine in the oil. These agents exist in too infinitesimal an amount to exert much therapeu- tic action. ; It is probable that no one constituent, or group of con- stituents, yet separated from the oil truly represent its medicinal effect. Cod liver oil is inferior to other oils in one respect, however, and this consists in its liability to cause nausea, indigestion, diarrhoea and vomiting, in large doses and in some patients. Administration.—Cod liver oil may be given pure, or if this does not agree, it may be exhibited in various ways: 1, with an equal quantity of lime water and a little syrup; 2, with ether (Vx.), small animals; 31. to large animals; or with whiskey ; 3, shaken with white of an egg, or mucilage of tragacanth, and a few drops of oil of peppermint; 4, to dogs, in one of the proprietary emulsions, or with malt extract. The oil should be given after feeding and adminis- tration begun with the smaller doses as recommended above. Uses.—Cod liver oil is indicated generally in conditions of malnutrition occurring primarily; in the course of chronic diseases; or following acute diseases. It is especially indi- cated in diseases of the respiratory tract, when it improves the nutrition of the mucous membranes, as well as the general nutrition. Thus cod liver oil is one of the best remedies in tardy convalescence from canine asthma and distemper; from influenza, bronchitis, pneumonia and strangles in horses ; also in “ heaves,” emphysema, or broken wind in horses. Carron oil is cheaper and very efficient in the latter disorder, given on the food. Cod liver oil is valuable in the treatment of chronic bron- chitis, chronic eczema, and chorea of dogs; and in rickets, anzemia, weakness, and emaciation in all young animals. It often proves curative in various forms of muscular and chronic articular rheumatism, and facilitates the absorption ICTHYOL : 659 of chronically enlarged glands. The use of cod liver oil is contra-indicated in hot weather, and in animals suffering from indigestion or acute diarrhoea. It is often beneficial, however, in chronic diarrheea: Linseed oil, oil cake, and cottonseed meal may often be conveniently and properly substituted for cod liver oil, in the case of the larger patients; while morrhuol (gr.iii. = 1 teaspoonful cod liver oil?) given in pills, or lipanin (oleic acid, 6; olive oil, 100) may be exhibited in drachm doses to dogs when cod liver oil does not agree. IcTHYOLUM. Icthyol. (Non-official.) Synonym.—Ammonium icthyol sulphonate. | Derivation.—A bituminous quartz occurring in the Tyrol Mountains, containing the fossil remains of fish, is distilled with strong sulphuric acid, and sulphurous acids are removed from the distillate by sodium chioride, while sulphonic acid separates out. The latteris usually saturated with ammonia, forming icthyol; but similar preparations are made by the combination of sulphonic acid with sodium, lithium and zine. Properties.—A. thick, dark, reddish-brown liquid, of a tarry consistency, and possessing a peculiar, disagreeable odor, and hot, bituminous taste. It is soluble in water, glycerin, alcohol, benzol, fats and fixed oils. Constituents.—Icthyol contains about 10 per cent. of sulphur; also an inseparable volatile oil, to which its dis- agreeable odor is due. Action and Uses.—Icthyol is one of the most widely use- ful drugs recently introduced into medicine. It is particu- larly valuable in the treatment of acute and chronic diseases of the skin and subadjacent tissues, accompanied with inflammation, pain, swelling, and induration ; also in epider- mal proliferation. Icthyol is supposed to readily permeate the skin, and there act to relieve inflammation and pain, and aid resolution. It is one of the most successful remedies in 660 AGENTS OF ANIMAL ORIGIN chronic eczema and urticaria; in erysipelas, muscular and articular rheumatic disorders; and in bruised and strained muscles, tendons and ligaments. The drug has proved of great worth in the treatment of frost bites, burns, and in causing absorption of lymphatic enlargements. Icthyol is recommended as a cure for sarcoptic mange and scab. It is doubtful whether the drug is an antiseptic, but is stimulant to the skin, anodyne, and resolvent, locally. Icthyol is most satisfactorily applied to the unbroken skin in ointment, with lanolin or lard, 25 to 50 per cent. Solu- tions in water, glycerin, oils or alcohol, are sometimes employed of various strengths. Icthyol is rarely given internally for chronic rheumatism. Thiol is a substitute for icthyol, lacking the unpleasant odor of the latter medicament. Thiolis derived from brown- colored paraftin or gas-oils, by a complicated process, and consists of a mixture of sulphuretted hydrocarbons. The drug exists in two forms: 1, thiolum liquidum, a thin, brownish-black liquid, soluble in water and glycerin; 2, thiolum siccum, occurring in lustrous scales. Thiol is cheaper than icthyol and is said to be as efficacious as the latter. This remains to be proved. Liquid thiol is employed in 10 per cent. aqueous solution or in ointment ; and thiolum siccum in powder, dusted on inflamed parts, as in acute moist eczema. DOSES OF DRUGS. In the following table three doses are usually given for each drug. The first dose is for horses and cattle, in both the apothecaries’ and metric systems of weights and measures. The second dose is for sheep and swine, in both the apothe- caries’ and metric systems of weights and measures. The third dose is for dogs (and alsw cats) in both the apothecaries’ and metric systems of weights and measures. Letters are used to signify the name of the animal for which the dose is intended. Thus: H., Horses; C., Cattle; Sh., Sheep; Sw., Swine; D., Dogs (which also includes cats in most cases). The following abbreviations are also employed : Ib., pound ; pt., pint; oz., ounce; dr., drachm ; m., minim; gr., erain; gm., gram; cc., cubic centimeter. These doses are suitable for animals of average weight. Dose Table. Aceraniuip.—H, & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., dr. 4-1 (gm. 2.-4,). D., gr. 3-7 (gm. .2-.5). ACETUM Opli.—H., oz. 1-2 (cc. 30.-60.). C., oz. 2-3 (cc. 60.-90.) Sh. & Sw., dr. 2-6 (cc. 8.-24.). D., m. 3-20 (cc. .2-1.3). Acip, ARSENOUS.—H. & C., gr. 2-3 (gm. .12-.2); single dose, gr. 5-10 (gm. .3-.6). Sh. & Sw., gr. 1-2 (gm. .06-.12). D., gr. ~-5 (gm. .002-.006), Aocip, Benzoic.—H., dr. 2-4 (gm. 8.-15.). D., gr. 5.-15 (gm. .3-1.). Acip, Boric.—H., dr. 2-4. (gm. 8.15.). D., gr. 5-15 (gm. .3-1.). Acip, CARBOLIC.—H. & C., gr. 15-30 (gm. 1.-2.). Sh. & Sw., gr. 5-10 (gm. .3-.6). D., gr. 4-1 (gm. .03-.06). Acip, Citric.—H., dr. 2-4 (gm. 8.-15.). D., gr. 10-20 (gm. .6-1.3). Acip, GALLic —H. & C., dr. 2-4. (gm. 8.-15.). Sh. & Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-20 (gm. .3-1.3). ACID, HYDRIODIC (syrup of).-—D., dr. 1 (cc. 4.). 662 | DOSE TABLE Acip, Hyprocutoric (dilute).—H., dr. 1-2 (ce. 4.-8.). C., dr. 2-4 (ce.8.- 15.). Sh.& Sw., m. 15-20 (cc. 1-1.3). Sw. & D., m. 5-20 (cc. .3-1.8). Acip, Hyprocyanic (dilute).—H. & C., m. 20-40 (cc. 1.3-2.6). Sh., m. 10-15 (cc. .6-1.). Sw., m, 2-5 (ce. .12-.3). D.,m. 1-3 (cc. .06-.2). Acip, Lactic.—H. & C., dr. 2-4 (cc. 8.-15.). D., dr. 4-1 (ce. 2.-4.). Acip, Nirric (dilute).—H., dr. 1-2 (ce. 4.-8.). C., dr. 2-4(8.-15.). Sh., dr 4-1 (ce. 2.-4.) Sw. & D., m. 5-30 (ce. .3-2.). Acip, NITROHYDROCHLORIC.—H., m.. 20-40 (cc. 1.3-2.6). D., m. 3-& (cc. .2-.3). Acip, NITROHYDROCHLORIC (dilute).—H., dr. 1-2 (cc. 4.-8.). C., dr. 2-4 (cc. 8.-15.). Sh., dr. 4-1 (ce. 2.-4.). Sw. & D., m. 5-30 (.3-2.). AcID, PHOSPHORIC (dilute).—H., dr. 1-2 (cc. 4.-8.). C., dr. 2-4 (cc. 8.- 15.). Sh. & Sw., dr. $1 (ce. 2.-4.). D., m. 5-30 (.3-2.). AoIp, SALICYLIC.—H. & C., dr. 2-8 (gm, 8-30). Sh., dr. 1-4 (gm. 4.-15.), Sw., dr. $-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). Acrp, SULPHURIC (dilute).—H., dr. 1-2 (cc. 4.-8.). ©., dr. 2-4 (ce. 8. 15.). Sh., dr. 4-1 (cc. 2.-4.). Sw. & D., m. 1u-30 (cc. .6-2.). Acip, SULPHURIC, AROMATIC.—H., dr. 4-1 (cc. 2.-4.). C., dr. 2.-4. (cc. 8.-15.). Sh., m. 15-30 (cc. 1.-2.). Sw. & D., m. 5-15 (ce. .3-1.). Acip, SULPHUROUS.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., dr. 4-2 (cc. 2.-8.}. Acip, Tannic.—H. & C., dr. 4-4 (gm. 2.-15.), Sh. & Sw., dr. 4-1 (gm. 2.- 4.). D., gr. 1-15 (gm. .06-1.). Acip, TARTARIC.—H. & C., dr. 2-4 (gm. 8.-15.) D., gr. 10-30 (gm. .6-2.). ACONITE.—H., gr. 3-20 (gm. .2-1.3). D., gr. 74-2 (gm. .006-.12). ACONITE, Extract of Leaves.—H., gr. 3-6 (gm- .2-.4). D., gr. 4-1 (gm. .08-.06). . AconitE, Extract of.—H., gr. 1-3 (gm. .06-.2)- D., gr. 4-4 (gm. .006- 015). AconitTE, Fluidextract of.—H., m. 3-20 (cc. .2-1.3). D., m. 74-2 (cc. .006-.12). ? ACONITE, Tincture of.—H., m. xx.-3i. (1.3-4.). C., 38s.-iss (2.-6.); Sh. & Sw., m. x.-xx. (.6-1.3). D., m. ii.-x. (.12-.6). ACONITINE NITRATE (Squibb).—H., gr. #5 (gm. .002). D., gr. s35-<4 om. .0003-.0006). ADRENALIN SOLUTION.—(By mouth), H., dr. 2-4 (cc. 8.-15.). D, 1110-60 (cc. 0.6-4.). ALOES.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh., oz. $-1 (gm. 15.-30.). Sw., dr. 2-4 (gm. 8.-15). D., gr. 20-60 (gm. 1.8-4.), DOSE TABLE 663 ALOIN.—H. & C., dr. 2-3 (gm. 8.-12.). D., gr. 2-20 (gm. .12-1.3). ALuM.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 20.-60. (gm. 1.3-4.). D., gr. 5-10 (gm. .3-.6). Emetic, dr. 1 (gm. 4). AMMONIA, Aromatic Spirit of. —H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., dr. 4-1 (cc. 2.-4.) AMMONIA, Spirit of.—H. & C., oz. 4-1 (cc. 15.30.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., m. 10-20 (cc. .6-1.3). Ammonia, Water of.—H. & C., oz. 4-1 (ce. 15.-30.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 10-20 (cc. .6-1.3). Ammonia, Stronger Water of.—H. & C., dr. .2-6. (cc. 8.-24.). Sh. & Sw., dr. 1 (cc. 4.). D., m. 5-10 (ce. .3-.6). AmmoniacumM.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 5-30 (gm. .3-2.) AMMONIACUM, Mixture of.—D., oz. 4-1 (cc. 17.-30.). AMMONIUM, Solution of Acetate.—H. & C., oz. 2-4 (cc. 60.-120.). D., dr. 2-8 (cc. 8.-39.). AMMONIUM BENZOATE.—H., dr. 2-4 (gm. 8.-15.). D., gr. 5 15 (gm. .3-1.), AMMONIUM CARBONATE.—H., dr. 2 (gm. 8.). C., dr. 3-6 (gm. 12.-24). Sh. & Sw., gr. 15.-40. (gm. 1.-2.6). D., gr. 3-10 (gm. .2-.6). Emetic, D., gr. 15 (gm. 1). AMMONIUM CHLORIDE.—H., dr. 2 (gm. 8.). C., dr. 3-6 (gm. 12.-24.) Sh. & Sw., gr. 15-40 (gm. 1.-2.6). D., gr. 3-10 (gm. .2-.6). AMMONIUM VALERIANATE.—D., gr. 2-5 (gm. .12-.3). AMYL NITRITE.—H., dr. 4-1 (cc. 2.-4.). D., m. 2-5 (ce. .12-.38), by inhalation. ANISE.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8.-12.). D., gr. 10-30 (gm. .6-2.). ANISE, Oil of.—H., m. 29-30 (cc. 1-3-2.). D., m. 1-5 (cc. .06-.3). ANISE, Spirit of.—D., dr. 1-2 (cc. 4.-8.). ANTIMONY AND POTASSIUM TARTRATE.—H., dr. 2-4 (gm. 8.-15.). Sw., emetic, gr. 4-10 (gm. .24-.6). D., gr. 4-4 (gm. .006-.03). Emetic, D., gr. 1-2 (gm. .06-.12). ANTIMONY, Wine of.—D., m. 5-60 (cc. .3-4.) ANTIPYRIN.—H. & C., dr. 3-4 (gm, 12.-15.). Sh. & Sw., dr. 1 (gm. 4). D., gr. 5-20 (gm. .3-1.3). ANTISTREPTOCOCCUS SERUM.—H.., 20-50 cc. ANTITOXINS, Tetanus.—H., 20 cc. (See p. 742.) APOMORPHINE HYDROCHLORATE.—D., emetic subcutaneously, gr. 35-,5 (gm. .002-.006); by mouth, gr. 4-1 (gm. .008-.012). D., expectorant, gr. 45-s5 (gm. .0015-.0024). 664 ‘DOSE TABLE . ArEcA Nut.—H., oz. 4-1 (gm. 15.-30.). Lamb, dr. 1 (gm. 4.). D., gr. 15-60 (gm. 1.-4.) Fowl, gr. 10-40. ARECA, Fluid Extract of.—Dose same as nut. ARECOLINE HYDROBROMATE.—H. & C., gr. 2-14 (gm. .04-.1), subcutane- ously. ARNICA FLOWERS.—H. & C., oz. 4-1 (gm. 15.-80.). D., gr. 10-20 (gm. .6- 1.3). ARNICA, Tincture of. —H. & C., oz. 1 (cc. 30... D., m. 15-40 (cc. 1-2.6). Arnica Root.—H. & C., oz. 4-1 (gm. 15.-30.). D., gr. 10-20 (gm. .6-1.3). Arnica Root, Fluidextract of.—H. & C., (oz. 4-1 (cc. 15.-30.) D.,m. 10-20 (cc. .6-1.3). ARNIcA ROOT, Tincture of.—H. & C., dr. 4 (cc. 15.). D., m. 7-20 (ce. .5- 1.3). ARNICcA Root, Tincture of (B. P.)—H. & C., oz. 1-2 (cc. 30.-60.). D., dr. 4-1 (cc. 2.-4.). ARSENIC.—See Acid, Arsenous. ARSENIC, Fowler’s Solution of.—H. & C., dr. 2-8 (cc. 8.-30.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., m. 2-10 (cc. .12-.6). ASAFETIDA.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.- 8.). D., gr. 3-10 (gm. .2-.6). ASAFETIDA, Emulsion of.—D., oz. 4-1 (cc. 15.-30.) ASAFETIDA, Pill.—D., (1.-4.). ASAFETIDA, Tincture of.—H. & C., oz. 2-4 (cc. 60.-120.). D., dr. 4-1 (cc. 2.-4.). Aspipium, Fluidextract of (B. P.).—H. & C., dr. 3-6 (cc. 12.-24.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., m. 15-60 (ce. 1.-4.). ASPIDIUM, Oleoresin of.—H. & C., dr. 3-6 (cc. 12.-24.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., m. 15-60 (qe. 1.-4.). ATROPINE SULPHATE.—H., gr. 1-14 (gm. .06-.09). C., gr. 1-2 (gm. .06-.12). Sh. & Sw., gr. J5-Hs (gm. .004-.005). D., gr. d5-dy (gm. .0005-.002). Average dose, D., gr. ;45 (gm. .0006). BaLsAM OF Peru.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 1-2 (ce. 4.-8.). D., m. 10-30 (ce. .6-2.) Barium CHLORIDE.—H., dr. 2-4 (gm. 8.-15.). Intravenously, gr. 15- 30 (1.-2.). BELLADONNA, Alcoholic Extract of Leaves.—H. & C., gr. 10-20 (gm. .6- 1.3). Sh. & Sw., gr. 2-4 (gm. .12-.24). D., gr. 3-4 (gm. .008-.03). DOSE TABLE 665 BELLADONNA, Tincture of Leaves.—D., m. 15-30 (cc. 1.-2.). BELLADONNA Root, Fluid Extract of.—H., dr. 1.2 (cc. 4.-8.). C., dr. 2-3 (cc. 8.-12.). Sh. & Sw., m. 10-15 (cc...6-1.). D., m. 1-3 (ce. .06-.2). BENzOIN, Tincture of.—H., oz. 1 (cc. 30.). D., dr. 4-1 (cc. 2.-4.) BETULA, Oil of.—See Gaultheria. BISMUTH SALICYLATE.—D., gr. 5-10 (gm. .3-.6). BIsMUTH SUBCARBONATE.—H., dr. 2-4 (gm. 8.-15.). D., gr. 10-30 (gm. 6-2). BISMUTH SUBNITRATE.— Dose same as subcarbonate. Branpy.—H. & C., oz, 2-4 (cc. 60.-120.). Sh. & Sw., oz. 1-2 (cc. 30.-60.). D., dr. 1-4 (cc. 4.-15.). Bucuu, Fluidextract of.—H., 0z.1-2 (cc. 30.-60.). D.,m.5-30 (cc. .3-2.). BUCKTHORN (Rhamnus Catharticus), Syrup of.—D., oz. 1-2 (cc. 30.-60.). Cats, oz. 4-1 (cc. 15.-30.). CAFFEINE.—H., 3i.-ii. (gm. 4.-8.). D., gr. +-3 (gm. .03-.2). CAFFEINE, Citrate of.—H., 3 ii.-iv.(gm. 8.-15.). D., gr. 1-6 (gm. .06-.36). CaLamus.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2.3 (gm. 8.- 12.). D., gr. 15-60 (gm. 1.-4.). CALAMUS, Fluidextract of.—Dose same as Calamus. CaLcium, Precipitated Carbonate of.—H.., oz. 1-2 (gm. 30.-60.). C., oz. 2-4 (gm. 60.-120). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 10-60 (gm. 6-4). . CALCIUM CHLORIDE.—H. & C., oz. 4-1 (gm. 15-80). D., gr. 5-20 (gm. ees): CaLcium, LACTOPHOSPHATE, Syrup of.— Foals and Calves, oz. 4-1 (ce. 15.-30.). D., dr. 1-4 (cc. 4.-15.) CALCIUM, Precipitated Phosphate of.—H., dr. 2-4 (gm. 8.-15.). C., oz. 41 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-20 (gm. .3-1.3). CALOMEL.—See Mercury. CALUMBA.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). CALUMBA, Fluidextract of.—Dose same as Calumba. CaLuMBA, Tincture of.—H. & C., oz. 2-4 (cc. 60.-120.). T., dr. 1-4 (ce. 4.-15.). CampuHor.—H., dr. 1-3 (gm. 4.-12.). C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 15-60 (gm. 1.-4.). D., gr. 3-20 (gm. .2-1.3). CaMPHoR, Monobromated. ~ D., gr. 2-10 (gm. .12-.6). Campuor, Spirit of.—H., oz. 1-2 (cc. 30.-60.). D., dr. 4-1 (cc. 2.4). 666 DOSE TABLE CanNnaBIS INDICA, Extract of.—H., dr. 1-2 (gm. 4.-8.). D., gr. 3-1 (gm. .015-.06). CANNABIS INDICA, Fluidextract of.—H., dr. 4-6 (cc. 15.-24.). D., m, 3-10 (cc. .2-.6). CANNABIS INDICA, Tincture of.—D., m. 15-30 (cc. 1.-2.). CANTHARIDES.—H. & C., gr. 5-20 (gm. .3-1.3\. Sh. & Sw., gr. 4-8 (gm. .24-.5). D., gr. 1-2 (gm. .06-.12). CANTHARIDES, Tincture of.—H., dr. 2-4 (cc. 8.-15.). D., m. 2-15 (ce. .12-1.). CapsicuM.—H., gr. 20-60 (gm. 1.3-4.). C., dr. 1-2 (gm. 4.-8.). D., gr. 1-8 (gm. .06-.48). Capsicum, Fluidextract of.—Dose same as Capsicum. Capsicum, Oleoresin of.—H., m. 10-30 Ses 6-2.). C., dr. 3-1 (cc. 2.-4.). D., m. 4-1 (cc. .015-.06). Capsicum, Tincture of.—H., dr. 2-4 (cc. 8.-15.). €., oz. 4-1 (cc. 15.-30.). D., m. 5-60 (cc. .3-4.). CARBON BISULPHIDE.—H., dr. 2-4 (cc. 8.-15.). Carpamon.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8- 12.). D., gr. 10-30 (gm. .6-2.). CARDAMON, Fluidextract of.—Dose same. (Non-official.) CaRDAMON, Compound Tincture of.—D., dr. 1-2 (cc, 4.-8.). CARDAMON, Tincture of.—D., dr. 1-2 (cc. 4.-8.). CaASCARA SAGRADA.—D., gr. 5-30 (gm. .3-2.). CaASCARA SAGRADA, Fluidextract of.—D., m. 5-30 (cc. .8-2.). CASCARA SAGRADA (Solid) Extract of.—D., gr. 2-8 (gm. .12-.5). CASCARILLA.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.- 8.). D., gr. 10-30 (gm. .6-2.). Castor O1L.—H. & C,, pt. 1 (cc. 500.). Sh. & Sw., oz. 2-4 fea: 60.-120.). D., dr. 1-2 (cc. 4. 8.), Fowl], dr. 1 (cc. 4.). CaTECHU.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-80 (gm. .3-2.). CaTECHU, Fluidextract of (non-official).—Dose same as Catechu. CatTEecHu, Tincture of.—H. & C., oz. 1-2 (cc. 30.-60.). Foals, Calves and Sheep, oz. 4-1 (cc. 15.-30.). D., dr. 4-2 (cc. 2.-8.). CERIUM OXALATE.—D., gr. 3-5 (gm. .2-.3). CHALK, Compound Powder of.—D., gr. 10-60 (gm. .6-4.). DOSE TABLE 667 CHALK MIXTURE.—D., oz. 1-2 (cc. 30.-60.). CHALK, PREPARED.—H., oz. 1-2 (gm. 30.-60.), C., oz. 2-4 (gm. 60. -120.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 10-60 (gm. .6-4.). CHARCOAL (Wood, and animal, purified).—H. & C., oz. 1-2 (gm. 30.- 60.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., gr. 20-60 (gm. 1.3-4.). CHLORAL.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D.. gr. 5-20 (gm. .3-1.3). CHLOROFORM.—H. & C., dr. 1-2 (cc. 4.-8.). Sh. & Sw., m. 20-30 (cc. 1.3-2.). D., m. 2-20 (cc. .12-1.3). CHLOROFORM, Spirit of.—H. & C., oz. 1-2 (30.-60.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., dr. 4-1 (cc. 2.-4.) CINCHONA BARK.—H., dr. 2-4 (gm. 8.-15.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-4 (gm. 4.-15.). D., gr. 10-60 (gm. .6-4.). CINCHONA, Compound Tincture of.—H., oz. 2-4 (cc. 60.-120.). D., dr. 4-4 (cc. 2.-15.). CINCHONA, Extract of.—H., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). CincHona, Fluidextract of.—H., dr. 2-4 (cc. 8.-15.). C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 1-4 (cc. 4.-15.). D., gr. 10-60 (cc. .6-4.). CINCHONINE SULPHATE, Tonic Dose.—H., gr. 20-60 (gm. 1.3-4.). C., dr. 3-14 (gm. 3.-6.). Sh. & Sw., gr. 6-15 (gm. .36-1.). D., gr. 14-24 (.1-.15). ; CINCHONINE SULPHATE, Antipyretic Dose.—H., dr. 24-5 (gm. 10.-20.). Sh. & Sw., gr. 40-50 (gm. 2.6-3.3). D., gr. 7-15 (gm. .5-1.). CINCHONIDINE SULPHATE.—Dose same as Cinchonine Sulphate. CocAINE HYDROCHLORATE.—H., gr. 5-10 (gm. .3-.6). D., gr 1-2 (gm. .008-.045). Cop LIVER OiL.—H.., oz. 2-4 (cc. 60.-120.). Sh. & Sw., oz. 4-1 (cc. 15.-30.). D., dr. 1-3 (ce. 4.-12.). CoDEINE.—D., gr. 4-2 (gm. .015-.12). CoLcHicine.—H. & C., gr. 1-4 (gm. .01-.03). D., gr. 74;-45 (gm. .0005- .0012). Cotcuicum Corm.—H. & C., dr. 4.2 (gm. 2.-8.). Sh., gr. 10-20 (gm. .6- 1.3). Sw. & D., gr. 2-8 (gm. .12-.5). COLCHICUM CoRM, Fluidextract of.—Dose same as Colchicum. CoLcHicum CorM, Tincture of.—H. & C., dr. 3-8 (cc. 12.-30.) D., m. 10-30 (cc. .6-2.). CoLcHicuM CorM, Wine of.—H. & C., dr. 3-8 (ec. 12.-30.). D., m. 10-30 (cc. .6-2.), COLLARGOL (Colloidal Silver).—See p. 180. 668 | DOSE TABLE CoLocyNTH --D., gr. 3-8 (gm. .2-.5). CoLOCYNTHIN.—H., dr. +-1 (gm. 2.-4.). D., gr. +1 (gm. .015-.06). CONIINE HyDROBROMATE.—H & C., gr. 3-14 (gm. .045-.1). Sh. & Sw., gr. 1-2 (gm. .012-.024). D., gr. go-s's (gm. .001-.002). Contum.—H. & C., dr. 1-2 (gm.-4.-8.). Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-5 (gm. .12-.3). Contum, Fluidextract of.—Dose same as Conium. Contum, Extract of.—H. & C., gr. 12-24 (gm. .72-1.5). Sh. & Sw., gr. 2-4 (gm. .12-.24). D., gr. +1 (gm. .015-.06). CONVALLARIA, Fluidextract of.—H. & C., dr. 1-2 (cc. 4.-8.). D., m. 5-10 (cc. .3-.6). COPPER SULPHATE.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). D., gr. 1-2 (gm. .06-.12). Emetic—D., gr. 6-20 (gm. .36-1.8). CORROSIVE SUBLIMATE.— (See Mercury.) Cotton Root BaRK.—(See Gossypium.) CREASOTE.—H., m. 15-30 (cc. 1.-2.). C., dr. 4-1 (ec. 2.-4.). Sh. & Sw., m. 5.-15 (cc. .8-1.). D., m. 4-2 (ec. .08-.12). CREOLIN.—H. & C., dr. 1-2 (cc. 4.-8.). D.,m. 1-5 (cc. .06-.3). Single dose as anthelmintic. H., oz. 4-1 (cc. 15.-30.). CROTON O1r.—H., m. 15-30 (cc. 1.-2.). C., dr. +1 (cc. 2.-4.). Sh & Sw., m. 5-10 (cc. .3-.6). D., m. 4-3 (cc. .03-.2). DIGITALEIN.—H., gr. 4-} (gm. .008-.015). D., gr. 45 (gm. .0006). DIGITaLin.—H., gr. 4-4 (gm. .015-.03). D., gr. 4-35 (gm. .001-.002). DIGITaLis.—H., gr. 10-60 (gm. .6-4.). C., dr. 4-14 (gm. 2.-6.). Sh. & Sw., gr. 5-15 (gm. .3-1.). D., gr. 4-3 (gm. .038-.2). DIGITALIS, Fluidextract of.—Dose same as Digitalis. DIGITALis, Extract of.—H., gr. 5-10 (gm. .3-.6). D., gr. 4-4 (gm. .008- 05). ; DiGIrauis, Infusion of.—H. & C., oz. 2-6 (cc. 60.-180.). Sh. & Sw., oz. 4-1 (cc. 15.-30.). D., dr. 1-4 (ce. 4.-15.). DIGITALIS, Tincture of..-H. & C., dr. 2-4 (cc. 8.-15.). Sh. & Sw., dr. 4- 14 (cc. 2.-6.). D., m. 5-80 (cc. .3-2.). DOVER’s POWDER.—H., oz. 4-1 (gm. 15.-30.). D., gr. 5-10 (gm. .3-.6). Dover’s Powder, Liquid.—H., oz. 3-1 (cc. 15.-30.). D., m. 5-10 (ce. .3-.6). : ELATERIN.—D., gr. 35-7 (gm. .003-.005). ee ee ee DOSE TABLE 669 Ereot. -H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., dr. 4-1 (gm. 2.-4.). ErGotT, Fluidextract of.—Dose same as Ergot. Eraot, Extract of (Ergotin).—H. & C., gr. 20-60 (gm. 1.3-4.). D., gr. 2-10 (gm. .12-.6). Eraor, Tincture of.—H. & C., oz. 4-2 (cc. 15.-60.). Sh. & Sw., dr. 1-4 (cc. 4.-15.). D., dr. 4-2 (cc. 2.-8.). ESERINE.— (See Physostigmine. ) ETHER.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., m. 10-60 (cc. .6-4.). ETHER, Spirit of, and Compound Spirit of.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., m. 10-60 (cc. .6-4.). ETHER, NITROUS, Spirit of (Sweet Spirit of Nitre).—H. & C., oz. 1-4 (ce. 30.-120.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., m. 10-60 (cc. .6-4.) EUCALYPTUS, Fluidextract of.—H., oz. 2-3 (cc. 60.-90.). D., dr. 4-2 (cc. 2.-8.). Evca.yPptus, Oil of.—H., dr. 2-4 (ce. 8.-15.). D., m. 5-20 (ec. .3-1.3). EUCALYPTOL.—Dose same as Oil of Eucalyptus. FENNEL.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. &Sw., dr. 2-3 (gm. 8.-12.). D., gr. 10-20 (gm. .6-1.3). FEL Bovis.—(See Oxgall.) FENUGREEK.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-3 (gm. 8.- 12.). D., gr. 10-30 (gm. .6-2.). FRANGULA, Fluidextract of.—D., dr. 4-1 (cc. 2.-4.). GaAMBOGE.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-14 (gm. 30.-45.). Sh. & Sw., gr. 20-60 (gm. 1.3-4.). D., gr. 5-10 (gm. .3-.6). GAULTHERIA, Oil of.—H. & C., dr. 2 0z.1 (cc. 8.-30.). Sh. & Sw., dr. + 2 (ce. 2.-8.). D., m. 5-15 (cc. .3-1.). GELSEMINE. —H.., gr. +-4 (gm. .015-.03). D., gr. 4-35 (gm. .001-.003). GELSEMIUM. —H.., dr. 1-2 (gm. 4.-8.). D., gr. 5-10 (gm. .3-.6). GELSEMIUM, Fluidextract of.—Dose same as Gelsemium. GELSEMIUM, Tincture of.—H., oz. 4-2 (cc. 15.-60.). D., m. 15-60 (cc. 1.-4.). GENTIAN.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). GENTIAN, Fluidextract of.—Dose same as Gentian. 670 DOSE TABLE GENTIAN, Compound Tincture of.—H. & C., oz. 1-4 (cc. 30.-120.). D., dr. 1-4 (cc. 4.-15.). GINGER.—H.., dr. 2-0z. 1 (gm. 8.-30.). C., oz. 1-4 (gm. 30.-120.). Sh. & Sw., dr. 1-2 (gm. 4-8). D., gr. 5-15 (gm. .3-1.). GincER, Fluidextract of.—Dose same as Ginger. GINGER, Oleoresin of.—One-fifth dose of Ginger. GLYCERIN.—H. & C., oz. 1 (ce. 80.). D., dr. 4-1 (cc. 2.-4.). GLYCYRRHIZA.—See Liquorice. GossyPiuM Root, Fluidextract of Bark of.—H. & C., oz. 4-1 (cc. 15.- 30.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., dr. 4-1 (cc. 2.-4.). GRANATUM (Pomegranate).—D., dr. 4-14 (gm. 2.-6.). GRANATUM, Fluidextract of.—Dose same as granatum. GRANATI RADICIS CorTEX, Fluid Extract of.—D., dr. 4-2 (cc. 2.-8.). HAMATOXYLON, Extract of.—H. & C., dr. 3-4 (gm. 2.-15.). Sh. & Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-15 (gm. .3-1.). H 2MATOXYLON, Fluidextract of.—H. & C., oz. 4-14 (cc. 15.-45.) Sh. & Sw., dr. 14-3 (ce. 6.-12.). D., m. 15-45 (ce. 1.-3.). HAMAMELIS, Fluidextract of.—H. & C., oz. 1-2 (cc. 30.-60.). D., dr. 4-2 (cc. 2.-8.). HAMAMELIS, Water of.—Same doses as fluidextract. HyYDRASTIN.—H., gr. 15-30 (gm. 1.-2.). D., gr. 3-5 (gm. .2-.3). HYDRASTINE HYDROCHLORATE.—H., gr. 1-2 (gm. .06-.12). D., gr. j-4 gm. .005-.01). HyYDRASTIS, Fluidextract of.—H. & C., dr. 2-oz. 1 (cc. 8.-30.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., m. 5-60 (ce. .3-4.). Hyprastis, Glycerite of.—Dose same as Fluid Extract. Hyprastis, Tincture of.—H., OZ, 1-2 (cc. 30.-60.). D., dr. +2 (ce. 2.-8.). HYOscINE HYDROBROMATE.—H., gr. 4-} (gm. .01-.015). D., gr. 45-345 (gm. .0004-.0006). HYOSCYAMINE HYDROBROMATE AND SULPHATE.—H.., gr. 1-2 (gm. .06-.12). Ds gr. @0780 (gm. .001-.002). ‘ Hyoscyamus.—H. & C., oz. 4-1 (gm. 15.-30.). D., gr. 5-15 (gm. .3-1.). HyoscyaMus, Fluidextract of.—Dose same as Hyoscyamus. Hyoscyamus, Extract of.—H. & C., gr. 20-60 (gm. 1.3-4.). D., gr. 4-2 (gm. .03-.12). Hyoscyamus, Tincture of.—D., dr. 1-2 (ce. 4.-8.). HyoscyaMmus, Succus of.—D., dr. 1-2 (cc. 4.-8.). HYPOPHOSPHITES, Compound Syrup of.—D., dr. 1 (ce. 4.). IopInE.—H. & C., dr. 4-1 (gm. 2.-4.).. Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-5 (gm. .12-.3). ' DOSE TABLE 671 IODINE, Compound Solution of.—H., dr. 2-4 (cc. 8.-15.). D., m. 2-10 (ce. .12-.6). IopINE, Tincture of.—H., dr. 2-4 (cc. 8.-15.). D., m. 2-10 (ce. .12-.6). Tprcac.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. .8-15.). Sh., dr. 441 (gm. 2.-4.). D., gr. 4-2 (gm. .03-.12). Emetic—D. & Sw., gr. 15-30 (gm. 1.-2.). Cats, gr. 5-12 (gm. .13-.72). Ipecac, Fluidextract of.—Dose same as Ipecac. IPECAC, Syrup of.—D., Expectorant, m. 15-60 (cc. 1.-4.). Ipecac, Wine of.—D., Expectorant, m. 15-60 (ce. 1.-4.). TRON AND AMMONIUM CITRATE.—D., gr. 5-10 (gm. .3-.6). Iron, Carbonate, Saccharated.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., (gr. 20-30 (gm. 1.3-2.). D., gr. 1-5 (gm. .06-.3). Tron, Chloride, Solution of.—H. & C., dr. 2-4 (cc. 8.-15.). Sh. & Sw., m. 10-20 (ce. .6-1.8). D., m, 2-10 (.12-.6). Tron, Chloride, Tincture of.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., m. 20-80 (ce. 1.3-2.). D., m. 5-60 (cc. .3-4.). Tron, Iodide, Syrup of.—D., m. 5-10 (cc. .5-6.). TRON, (and) Quinine Citrate.—D., gr. 5-10 (gm. .3-.6). TRON, Reduced.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. 8-15). Sh. & Sw., gr. 20-30 (gm. 1.3-2.). D., gr. 1-5 (gm. .06-.3). TRON, (and) Strychnine Citrate.—D., gr. 1-2 (gm. .06-.12). Tron, Sulphate and Dried Sulphate.—H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., gr. 20-30 (gm. 1.3-2.). D., gr. 1-5 (gm. .06-.3). JABORANDI.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. &Sw., dr. +1 (gm. 2.-4.). D., gr. 5-60 (gm. .3-4.). JABORANDI, Fluidextract of.—Dose same as Jaborandi. JALAP.—Sw., dr. 2-4 (gm. 8.-15.). D., dr. 1-2 (gm. 4.-8.). Cats, dr. 1-1 (gm. 2.-4.). JALAP, Fluidextract of.—Dose same as Jalap. JALAP, Resin of.—Sw., dr. 3-1 (gm. 2.-4.). D., gr. 15-30 (gm. 1.-2.). Cats, gr. 7-15 (gm. .5-1.).. JUNIPER, Compound Spirit of. —H. & C., oz. 2-4 (cc. 60.-120.). D., dr. 1-4 (ce. 4.-15.). JUNIPER, Oil of.—H. & C., dr. 1-2 (ce. 4.-8.). D., m. 2-10 (cc. .12-.6). KAMALA.—H., oz..1 (gm. 30.). D., dr. 4-2 (gm. 2.-8.). Kino.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). 672 DOSE TABLE Kino, Fluidextract of.—Dose same as Kino. Kino, Tincture of.—H. & C., oz. 1-2 (cc. 30.-60.). Foals, Calves and Sheep, oz. 4-1 (cc. 15.-30.). D., dr. 4-2 (cc. 2.-8.). Koussin.—D., gr. 5-40 (gm. .3-2.6). Kousso.—Small dogs, dr. 4-1 (gm. 2.-4). Large dogs, dr. 2-4 (gm. 8.-15.) Ixousso, Fluidextract of.—Dose same as Kousso. KRAMERIA.—H., oz. 4-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 1-2 (gm. 4.-8.). D., gr. 5-30 (gm. .3-2.). KRAMERIA, Fluidextract of.—Dose same as Krameria. KRAMERIA, Extract of.—H. & C., dr. 2-3 (gm. 8.-12.). Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). D., gr. 5-10 (gm. .3-.6). KRAMERIA, Tincture of.—H. & C., oz. 1-2 (cc. 30.-60.). Foals, Calves and Sheep, oz. 4-1 (cc. 15.-30.). D.. dr. 4-2 (cc. 2.-8.). LEAD AcETATE.—H. & C., dr. 1 (gm. 4.). Sh. & Sw., gr. 15-20 (gm. 1.- 1.8). D., gr. 1-2 (gm. .06-.12). Lime, Solution of (Lime Water).—H. & C., oz. 4-6 (cc. 120.-180.). Calves and Foals, oz. 2 (cc. 60.). D., dr. 1-8 (cc. 4.-30.). LINSEED O1L.—H., pt. 4-1 (cc. 250.-500). C., pt. 1-2 (cc. 500.-1000.). Sh. & Sw., oz. 6-12 (cc. 180.-360.). Dogs and Cats, oz. 4-2 (cc. 15.-60.). LiQUORICE.—Ad lib. Liguoricg, Fluidextract of.—Ad lib. Liquorice, Extract of.—Ad lib. LIQUORICE, Compound Powder of.—D., dr. 1-2 (gm. 4.-8.). LirHiumM CARBONATE.—D., gr. 3-10 (gm. .2-.6). LITHIUM CITRATE.—D., gr. 5-20 (gm. .3-1.3). Maanesta.—Foals and Calves, dr. 1-2 (gm. 4.-8.). D., gr. 5-60 (gm. .3-4.). MAGNESIUM CARBONATE.—Dose same as Magnesia. MAGNESIUM SULPHATE.—H. (laxative), oz. 2-4 (gm. 60.-120/). C. (pur- gative), lb. 1-2 (gm. 500.-1000.); (laxative), oz. 3-4 (gm. 90.-120.). Calves, dr. 2-3 (gm. 8.-12.). Sh., oz. 4-6 (gm. 120.-180.). D., dr. 1-4 (gm. 4.-15.). MALE FERN, Oleoresin and Fluid Extract of.—H. & C., dr. 3-6 (cc. 12.- 24.). Sh. & Sw., dr. 1-2 (cc. 4.-8.). D., m. 15-60 (cc. 1.-4.). MENTHOL.—D., gr. 2 (gm. .12). MERCURY WITH CHALK.—Foals and Calves, gr. 10-15 (gm. .6-1.). D., gr. 1-10 (gm. .06-.6). x ee DOSE TABLE 673 MERcouRY, Corrosive Chloride of.—H. & C., gr. 5-8 (gm. .3-.5). Sh. & Sw., gr. 3 (gm. .12). D., gr. 33-4 (gm. .002-.008). MeERcuRY, Iodide of (red).—Dose same as Corrosive Chloride. Mercury, Mass of (Blue Pill).—D., gr. 1-10 (gm. .06-.6). Mercury, Mild Chloride of.— H., dr. 4-1 (gm. 2.-4.). C., dr. 5-6 (gm. 20.-24.). D., gr. #-4+ (gm. .006-.03), in divided doses; gr. 3-5 (gm. .2-.8), in. single doses. METHYL SALICYLATE.—H., dr. 2-8 (cc. 8.-30). D., m. 5-15 (cc. .3-1.). MORPHINE AND ITS Sauts.—H. & C., gr. 3-10 (gm. .2-.6). Sh., gr. 4-2 (gm. .03-.12). Sw., gr. 4-4 (gm. .006-.03). D., gr. 4-4 (gm. .008- 03). Semsataneoual ye. gr. 3-4 (gm, .2-.24). D., gr. 4-1 (gm. .008-.02). MorRRHUOL.—D., gr. 1-5 (gm. .06-.5). MustTarp.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 4-2 (gm. 2.-8.). D., gr. 10-15 (gm. .6-1.). Emetic—D., oz. 4 (gm. 15.). MyrRuH, Tincture of.—H. & C., 3i.-ii. (30.-60.). Sh. & Sw., 3 iii.-vi. (12.-24.). D., 3ss.-i. (2.-4.). NAPHTHALIN.—H., dr. 2-4 (gm. 8.-15.). D., gr. 1-20 (gm. .06-1.3). NaPHTOL.—H., dr. 2-3 (gm. 8.-12.). D., gr. 1-10 (gm. .06-.6). NicotineE.—H. & C., gr. g-s5 (gm. .001-.003). NITROGLYCERIN (1 per cent. solution). TH. & e.. dr. 4-1 (cc. 2.-4.). D., m. 1-2 (cc. .06-.12). Nux Vomica.—H. & C., dr. 1-2 (gm. 4.-8.). Sh., gr. 20-40 (gm. 1.3-2.6). Sw., gr. 10-20 (gm. .6-1.3). D., gr. 1-2 (gm. .06-.12). Nux Vomica, Extract of.—H. & C., gr. 2-15 (gm. .12-1.) Sh., gr. 23-5 (gm. .15-.3). Sw., gr. 1-2 (gm. .06-.12). D., gr. §-+ (gm. .008-.015). Nux Vomica, Fluidextract of.—Dose same as Nux Vomica. Nux Vomica, Tincture of.—D., m. 5-10 (cc- .3-.6). OLIvE O1L.—H. & C., pt. 1-2 (cc. 500.-1000.). D., oz. 2-4 (cc. 60.-120.). OPIUM, Camphorated Tincture of (Paregoric).—D., dr. 1-4 (cc. 4.-15.). Opium, Extract of.—H., dr. 4-1 (gm. 2.-4.). C., dr. 1-2 (gm. 4.-8.). Sh gr. 5-10 (gm. \.3-.6). Sw., gr. 2-10 (gm. .12-.6). D., gr. $4 (gm. .01-.08). Opium, Powder.—H., dr. 1-2 (gm. ici C., dr. 2-4 (gm. 8.-15.). Sh., gr. 10-20 (gm. .6-1.3). Sw., gr. 5-20 (gm. .3-1.3). D., gr. 4-3 (gm. .93-.2). Opium, Tincture of.—H., oz. 1-2 (cc. 30.-60.). C., oz. 2-3 (ec. 60.-90.). Sh. & Sw., dr. 2-6 (cc. 8.-24.). D., m. 3-30 (cc. .2-2.). Opium, Wine of.—Dose same as Tincture. 674 ‘DOSE TABLE OxGALL.—D., gr. 5-15 (gm. .3-1.). PANOREATIN.—D., gr. 5-15 (gm. .3-1.). Papain. —Foals, Calves and Dogs, gr. 2-10 (gm. .12-.6). PELLETIERINE TANNATE.—D., gr. 2-5 (gm. .12-.3). PEPPERMINT, Oil of.—H. & C., m. 15-30 (cc. 1.-2.). D., m. 1-5 (cc. .06-.3). PEPPERMINT, Spirit of.—H. & C., dr. 2-4 (cc. 8.-15.). D., m. 13-80 (cc. 1.-2.). PrEpsin.—Dogs, Foals and Carves, gr. 10-60 (gm. .6-4.). PHENACETIN.—H., dr. 2-3 (gm. 8.-12.). D., gr. 5-10 (gm. .3-.6). PHOSPHORATED OIL.—H., dr. 2-3 (cc. 8.-12.). D., m. 1-5 (ce. .06-.3). PHOSPHORUS.—H., gr. 1-2 (gm. .06-.12). C., gr. 2-3 (gm. .12-.2). Sh, Sw. & D., gr. z45-s55 (gm. .0006-.003). PHOSPHORUS, Spirit of.—D., m. 7-20 (ce. .5-1.3). PuysosTigma.—H., gr. 15-30 (gm. 1.-2.). D., gr. +1 (gm. .015-.06). PrysosTiGMA, Fluidextract of.—Dose same as Physostigma. PHYSOSTIGMINE SULPHATE AND SALICYLATE.—H. & C., gr. 14-3 (.09-.18). D., gr. gso-a'o (Gm. .0006-.002), subcutaneously and intravenously. PILOCARPINE AND ITS SALTS.—H. (purgative), gr. 2-5 (gm. .12-.3). C. (purgative), gr. 5-10 (gm. .3-.6). H. (diarphoretic; dangerous), gr. 6-12 (gm. .36-.72). Sh., gr. 1 (gm. .06). D., gr. 4-4 (gm. .006- .02). PILocaRpus.—H. & C., dr. 2-4 (gm. 8.-15.). Sh. & Sw., dr. 4-1 (gm. 2.-4.). D, gr. 5-60 (gm. .3-4.). PiLocarpus, Fluidextract of.—Dose same as Pilocarpus. PODOPHYLLIN.— H. & C., dr. 152 (gm. 4.-8.). D., gr. 1-2 (gm. .06-.12). POMEGRANATE.—See Granatum. Potassium ACETATE.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., dr. 4- 1 (gm. 2.-4.) D., gr. 5-20 (gm. .3-1.3). ; POTASSIUM BICARBONATE.—Dose same as Acetate. POTASSIUM BITARTRATE.—H. & C., oz. 4-1 (gm. 15.-30.). Sh. & Sw., oz. + (gm. 15.). D., dr. 4-1 (gm. 2.-4.). POTASSIUM BROMIDE.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2- 4(gm. 8.-15. D., gr. 5-60 (gm. .3-4.). ; POTASSIUM CARBONATE.—H. & C., oz. 4-1 (gm. 15.-30 ). Sh. & Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-20 (gm. .3-1.3). ee a EE ee DOSE TABLE 675 POTASSIUM CHLORATE.—Dose same as Carbonate. POTASSIUM CITRATE.—Dose same as Carbonate. PotassIuM HYDROXIDE, Solution of.—H. & C., oz. 4-1 (cc. 15.-30.). Sh. & Sw., dr. 3-1 (ce. 2.-4.). D., m. 5-20 (ce. .8-1.3). Potassium JopIDE.—H., 3ii.-iv. (8.-15). C., 3vi. (24). Sh. & Sw,, Pie eV eee (ls S.)s) oD. OT 1h. Calie=/6.))< Potassium NITRATE.—Dose same as Carbonate. Quassi4, Extract of.—H., dr. 1-2 (gm. 4.-8.). D., gr. +3 (gm. .03-.2) QuassiA, Fluidextract of.—H. & C., oz. 1-2 (cc. 30.-60.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., m. 15-60 (ce. 1.-4.). QuassiA, Tincture of.— oz. 2-4 (cc. 60.-120.). D., dr. 4-2 (cc. 2.-8.). QuassuNn.—D., gr. 4-4 (gm. .008-.02). QuERCUS ALBA.—H., oz. 3-1 (gm. 15.-30.). C., oz. 1-2 (gm. 30.-60.). Sh. and Sw., dr. 1-2 (gm. 4.-8.). D., ‘gr. 10-30 (gm. .6-2.). QUERCUS ALBA, Fluidextract of.—Dose same as Quercus Alba. QUINIDINE.—Tonic dose—H. (gr. 20-60 (gm. 1.3-4.).. C., dr. #14 (gm. 3.-6.). Sh. & Sw., gr. 6-15 (gm. .36-1.). D., gr. 14-24 (gm. .1-.15), Antipyretic dose—H., dr. 24-5 (gm. 10.-20.). Sh. & Sw., gr. 20-40 . (gm. 1.3-2.6). D., gr. 7-15 (gm. .5-1.). QUININE AND ITS SALTs.—Tonic dose—H., gr. 15-60 (gm. 1.-4.) C., dv. 4-14 (gm. 2.-6.). Sh. & Sw., gr. 5-10 (gm. .3-.6). Dogs and Cats, gr. 1-2 (gm. .06-.12). Antipyretic dose—H. & C., dr. 2-4 (gm. 8.- 15.) Sh. & Sw., gr. 20-40 (gm. 1.3-2.6). Dogs and Cats, gr. 5-10 (gm. .3-.6). QUINOIDIN.—Dose three or four times that of Quinine. ReEsorcin.—H., dr. 1-2 (gm. 4.-8.). Foals and Calves, dr. 4-1 (gm. 2.-4.), D., gr. 2-5 (gm. .12-.3). RHAMNUS CATHARTICUS, Syrup of.—D., oz. 1-2 (cc. 30.-60.). Cats, oz. 4-1 (cc. 15.-30.). RHAMNUS CATHARTICUS, Fluidextract of.—D., dr. 4-1 (cc. 2.-4 ) RHUBARB.—Stomachic —H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr.1 (gm. 4.). D., gr. 5-10 (gm. .3-.6). Purgative—Foals, Calves and Dogs, dr. 1-2 (gm. 4.-8.). Fowl, gr. v.-vii. in pill. RHUBARB, Fluidextract of.—Dose same as Rhubarb. RHUBARB, Compound Powder of.—Foals and Calves, oz. 4-1 (gm. 15.-30.). SABINA, Fluidextract of.—H., oz. 1-2 (cc. 30.-60.). -D., m. 5-15 (ce, .3-1.). SaBina, Oil of. —H. & C., dr. 2-4 (cc. 8.-15.). D., m. 1-5 (cc. .06-.3). 676 DOSE TABLE Saticin.—H. & C., dr. 2-8 (gm, 8.-30.). Sh., dr. 1-4 (gm. 4.-15. Sw. dr. 3-1'(gm. 2.-4.). D., gr. 5-30 (gm. 3-2). : Bee mer | dr. 4-4 (gm. 1.-15.). D., gr. 1-3 (gm. .06-.2). P i Tt ba ay g (g ). Puppies, Suro 0B)” dr. 3-4 (1.-15.). D., gr. 1-3 (.06-.18). Puppies, gr. 4-4 SAvin.—See Sabina. Scammony.—D., dr. 1-2 (gm. 4.-8.). Cats, dr. +1 (gm. 2.-4,). ScammMony, Resin of.—D., dr. 4-1 (gm. 2.-4.), Cats, gr. 15-30 (gm. 1.-2.). SENNA.—H. & C., oz. 4-5 (gm. 120.-150.). Sh. & Sw., oz. 1-2 (gm. 30.- 60.). D., dr. 1-4 (gm. 4.-15.). Fowl, gr. xv.-xx. in pill. SENNA, Fluidextract of.—Dose same as Senna. SENNA, Syrup of.—D., dr. 1-4 (4.-15.). Serum, Antistreptococcus.—See p. 663. SILVER NiTRATE.—H. & C., gr. 5-10 (gm. .3-.6). Sh. & Sw., gr. 1-2 (gm. .06-.12). D., gr. 3-4 (gm. .008-.03). SopiuM BICARBONATE.—H. & C., oz. 4-2 (gm. 15.-60.). Sh. & Sw., dr. +1 (gm. 2.-4.).. D., gr. 5-30 (gm. .3-2.). Sopium CARBONATE.—H. & C., dr. 2-6 (gm. 8.-24.). Sh. & Sw., gr. 20- 40 (gm. 1.3-2.6). D., gr. 5-20 (gm. .3-1.3). : SopiumM CHLORIDE.—Purgative—Cattle, Ib. 4-1 (gm. 250.-500.). Sh., oz. 1-2 (gm. 30.-60.). Sopium BromipE.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 gm, 8.-15.). D., gr. 5-20 (gm. .3-4.). Sopium HypDRoxIpDB, Solution of.—H. & C., oz. 4-1 (cc. 15.-30.). Sh. & Sw., dr. 4-1 (cc. 2.-4.). D., m. 5-20 (ce. .3-1-3), SopIuM PHOSPHATE.—C., lb. 1-14 (gm. 500.-750.). H. & Sh., oz. 2-4 (gm. 60.-120.). D., dr. 1-2 (gm. 4.-8.). SopiIum SALICYLATE.—H. & C., dr. 2-8 (gm. 8.-30.). Sh., dr. 1-4 (4.-15.). Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). SopiuM SULPHATE.—C., Ib. 1-14 (gm. 500.-750.). H., oz. 2-4 (gm. 60.- 120.). Sh., oz. 2-4 (g. 60.-120.). D., dr. 1-4 (gm, 4.-15.). Sopium SULPHITE, BISULPHITE AND THIOSULPHATE.—H. & C., oz. 1 gm. 30.).* Sh. & Sw., dr. 4-1 (gm. 2.-4.). D., gr. 5-30 (gm. .3-2.). SQuILL.—H., dr. 1-2 (gm. 4.-8.). C., dr. 2-4 (gm. 8.-15.). Sh., gr. 15- 30 (gm. 1.-2.). D., gr. 1-5 (gm. .06-.3). SQUILL, Fluidextract of.—Dose same as Squill. SQUILL, Tincture of.—H., dr. 6-12 (cc. 24.-48.). C.,0z. 14-3 (cc. 45.-90.). Sh., dr. 14-3 (cc. 6.-12.). D., m. 5-80 (cc. .3-2.). } DOSE TABLE 677 SQuILL, Syrup of.—H., oz. 4 (cc. 15.). D., dr. 4-1 (cc. 2.-4.). SQuILL, Compound Syrup of.—D., m. 5-30 (cc. .3-2.). STROPHANTHUS, Tincture of.—H. & C., dr. 1-4 (cc. 4.-15.), D., m. 2-10 (cc. .12-.6). STROPHANTHIN.—H., gr. 4-4 (gm. .012-.03). D., gr. sto-ds (gm. .0006- .001). STRYCHNINE AND ITS SALTS.—H., gr. 4-2 (gm. .03-.12). C., gr. 2-3 (gm. .12-.2). Sh., gr. #-1 (gm. .015-.06). D., gr. zdo-e5 (gm. .0005-.001). SuLPHUR.—H. & C., oz. 2-4 (gm. 60.-120.). Sh. & Sw., oz. 1-2 (gm. 30.- G0}: Dez dr: 1-4 (gm, 2.-15.). TALLIANINE (intravenously ).—H. & C., dr. 24-5 (cc. 10.-20.). Sh. & Sw., m. 25-dr. 24 (cc. 5.-10.). D., m. 30-75 (cc. 2.-5.). Cats, m. 15-80 (ce. 1.-2.). TaRaxacum.—H. & C., oz. 1-2 (gm. 30.-60.). Sh. & Sw., dr. 2-4 (gm. 8.-15.). D., dr. 1-2 (gm. 4.-8.). TARAXACUM, Fluidextract of.—Dose same as Taraxacum. TaRaxacuM, Extract of.—H. & C., dr. 1-4 (gm. 4.-15.). D., gr. 5-30 (gm. .3-2.). TEREBENE.—H. & C., dr. 2-6 (cc. 8,-24.). D., m. 5-15 (cc. .8=1.). TERPIN HypraTE.—H., dr. 4-2 (gm. 2.-8.). D., gr. 5-20 (gm. .3-1.3). Teranus ANTITOXIN.—See p. 663. : THymo..—H., dr. 4-2 (gm. 2.-8.). Sh. (single dose), 3 ss.-iiss. D., gr. 1-15 (gm. .06-1.). TURPENTINE, Oil of.—Carminative—H. & C., oz. 1-2 (cc. 30.-60.). Sh. . and Sw., dr. 1-4 (cc. 4.-15.). D., m. 10-30 (cc. .6-2.). Anthelmintic —H. & C., oz. 2-4 (cc. 60.-120.). “Ds, dr. 3-4 (ce. 2.-15.). Diuretic— H. & C., dr. 2-6 (cc. 8.-24.). VALERIAN.—H. & C., oz. 1-2 (gm. 30.-60.). D., gr. 10-60 (gm. .6-4.). VALERIAN, Fluidextract of.—Dose same as Valerian. VALERIAN, Tincture of.—D., dr. 4-2 (ce. 2.-8.). VALERIAN, Ammoniated Tincture of.—D., dr. 4-2 (cc. 2.-8.). VALERIAN, Oil of.—H., dr. 4-1 (cc. 2.-4.). D., m. 2-5 (cc. .12-.3). VALERIANATE OF AMMONIUM.—D., gr. 2-5 (gm. .12-.3). VALERIANATE OF IRON.—D., gr. 1-3 (gm. .06-.2). VALERIANATE OF ZINC.—D., gr. 1-3 (gm. .06-.2). scales —H., gr. +2 (gm. .03-.12). C., gr. 2-5 (gm. .12-.3). D., gr. 2 Pee .0012-.006). 678 ' DOSE TABLE VERATRUM.—H. & C., dr. §-1 (gm. 2.-4.). Sh. & Sw., gr. 20-30 (gm, 1.3-2.). D., gr. 25-1 (gm. .006-.06). VERATRUM, Fluidextract of.—Dose same as Veratrum. VERATRUM, Tincture of.—H. & C., oz. 4-1 (cc. 15.-30.). Sh. & Sw., dr. 2-4 (cc. 8.-15.). D., m. 5-10 (cc. .3-1.) WHISKEY.—H. & C., oz. 2-4 (cc. 60.-120.). Sh. & Sw., oz. 1-2 (cc. 30.- 60.). D., dr. 1-4 (ee. 4.-15.). WILD CHERRY, Syrup of.—D., dr. 1-4 (cc. 4.-15.). WINTERGREEN, Oil of.—See Gaultheria. Zinc AceTaTE.—H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., gr. 10-20 (gm. .6-1.3). D., gr. 2-3 (gm. .12-.2). ZINC OxiDE.—H. & C., dr. 1-2 (gm. 4,-8.). D., gr. 5-10 (gm. .3-.6). ZINC PHOSPHIDE.—D., gr. -4 (gm. .006). Zinc SULPHATE.—H. & C., dr. 1-2 (gm. 4.-8.). Sh. & Sw., gr. 10-20. (gm. .6-1.3). D., gr. 23 (gm. .12-.2). Emetic—D., gr. 10-15 (gmx reese GENERAL THERAPEUTIC MEASURES. Food and Feeding. In order to comprehend the rationale of feeding in dis- ease it is essential to know something of the principles of feeding in health. A food has been defined as “‘ that which, being innocuous in relation to the tissues, is a digestible, absorbable substance that can be oxidized in the body and decomposed in such a way as to give up to the body the forces it contains.” A complete food is composed of organic and inor- ganic constituents. The inorganic matters, with the ex- ception of common salt, and rarely phosphate of lime and sodium, are usually present in sufficient quantity in ordinary food. The organic components of vegetable food stuffs are divided into nitrogenous and non-nitrogenous classes. These are analogous to the constituent parts of the animal body into which they are transformed. The greater portion of animal tissue is made up of nitrogenous elements, while the larger part of plants is composed of non-nitrogen- ous material. Among the nitrogenous elements the most important are the’proteids. Gluten of flour is an example of a vegetable proteid ; while white of egg, casein of milk, and fibrin of blood represent animal proteids. Fat exists as such in both plants and animals. A single, chemical com- pound, as protein, is known as a nutrient in relation to feed- ing. The nutrients of importance are proteids, fat, and carbohydrates. The first two are common to animal and plant structure; the latter to plants alone. A complete food contains the three nutrients just mentioned and inor- ganic substances. Carbohydrates include such bodies as sugar, starch, and cellulose, or woody matter of plants. 679 680 GENERAL THERAPEUTIC MEASURES Proteids consist of carbon, hydrogen, oxygen, nitrogen, and sulphur, united in different proportions. Carbohydrates are composed of carbon, hydrogen and oxygen. Fat is similar in composition to carbohydrates, but in its combustion out- side the body yields approximately* two and a half times as much heat as that produced by an equal weight of carbo- hydrate. Fat as arutrient, is therefore empirically regarded as equivalent to two and‘a half times the same weight of carbohydrate material. The percentage of digestibility of the common food stuffs has been determined experimentally and is pretty uniform in all healthy animals. In 100 Ibs. of hay there are approximately : Per cent. Lbs. Lbs. digested. digested. Brobelni: crac cststeeas ore Dat -56 5.4 Carbohydrates...... 67.3 60 40.4 |e ee SS aR: te Aaa ame 2.5 -48 1.2 If we multiply the 1.2 lbs. of digestible fat by 2.5 to reduce it to the same terms as carbohydrates according to the empirical premises stated above, we have 3 lbs. of carbo- hydrates. The total amounts of carbohydrates digestible in 100 lbs. of hay is therefore 40.4 lbs. + 3 lbs. = 48.4 lbs. of nou-nitrogenous matter. The nitrogenous nutrient consists of 5.4 lbs. of digestible protein, and the proportion of the latter to the digestible non-nitrogenous material is as 1 to 8. This proportion in any given fodder is called the nutritive ratio, or the relation of the nitrogenous to the non-nitrogenous nutri- ents. The nutritive ratio is of the greatest importance, as it enables us to compose a proper ration with almost any kinds of fodder at hand, by so adjusting them that we secure the right proportion of nutrients. The proper nutritive ratio is indeed that proportion of nutrients which has been found to be most economically and physiologically valuable in any given class of animals and for any given purpose. The nutritive ratio varies accordingly for different animals and for the same animals under different conditions. Such ratios * More nearly, 2.25. FOOD AND FEEDING 681 have been formulated by means of physiological experiments on healthy animals as employed for economic purposes. It is self-evident that nutritive ratios cannot be laid down for diseased animals, and we must content ourselves with observing how disease alters, in a general way, the requirements of the normal animal. The following table of nutritive ratios suitable for the animals and purposes named, is taken from Armsby’s ‘“ Cattle Feeding.” The nutritive ratio is estimated for 1000 lbs. live weight per diem. Nutritive Total lbs. of Ratio. Nutrients. IENOTSES ab, WOTKi ries e ste o3)s le say) 13.00 Horses heavily worked..... Ig, aes 17.00 IVETU GLI ae COWRSit eras s cielatot al so dhs Teest so. 15.40 AD KEMGE ALY CESGR tec, rive ctereie ole Mee ag eA 8.85 Sheep: for) wool). .coc. 3/6 « esa 9 11.70 For example, the nutritive ratio, or the proportion of Ibs. of proteids to lbs. of carbohydrates and fat for horses at work, should be as one to seven; and the total number of Ibs. of pure fat (transformed into terms of carbohydrates), carbohydrates, and protein required to support 1000 lbs. of live weight of horses at work, per diem, is thirteen. Horses doing hard work, and all animals’ supplying nitrogenous products, as wool and milk,* demand more nitro- gen in their food. The proteids, as we have seen, constitute a large proportion of the solids and fluids of the body. The protein absorbed into the blood is utilized in two ways. One part is Energy-forming, the circulatory protein of Voit. The other part is Tissue-building or the Organic Protein of Voit. That part which is devoted to energy-producing is not transformed into tissue but is split up (katabolized) by the cells, or enzymes within the cells (chiefly of muscles), and thus produces heat or energy. The other part is directly built into living protoplasm. If the amount of circulatory protein is deficient, then the organized protein is called upon, the tissues are robbed of their substance, and the body emaciates. When a larger *Apart from requirements for mere maintenance, the several nut- rients should be increased in proportion to the quantity and richness of the milk yield. See Winslow on Clean Milk, published by W. R. Jenkins & Co, 682 GENERAL THERAPEUTIC MEASURES ainount of protein is contained in the blood, we have a proportionately larger elimination of nitrogenous matter in the urine, as equilibrium is soon established in the adult animal of constant weight, so that the amount of nitrogen eliminated equals that ingested. In young and growing ani- mals a portion of the nitrogen does not reappear in the urine, but is utilized in tissue formation. This also applies to previously starving animals on being well fed. An excess of circulating protein, besides being wasteful economically, is harmful in causing various disordered conditions, result- ing.in the formation of products of imperfect oxidation. The vegetable proteids are transformed into bodies of simpler chemical composition in the stomach and are there converted in part by the gastric juice, but chiefly by pan- ereatic (trypsin), biliary and intestinal ferments in the intes- tines, into peptone, proteoses, and possibly acid and alkali and native albumin. The epithelial cells of the intestines possess the power not only to absorb the peptone, but to transmute it into more complex isomeric compounds, as serum albumin, serum globulin and fibrinogen; special cells being employed in the formation of particular compounds. Any peptone not so converted by the intestinal epithe- lium becomes a poison, when absorbed into the entero-hepatic circulation, but its toxicity is destroyed by the liver cells. In regard to the metabolism and fate of proteids, energy is not only directly liberated by the decomposition of the energy-producing protein in the muscle cell but is also formed by the functional activity of cell protoplasm in which kata- bolic changes occur. So that the tissue-building protein is eventually an energy-producer as well. Elimination of ni- trogenous matter is not increased by muscular activity, nor proteid metabolism, as carbohydrates furnish the fuel for the mechanical work—with increase of CO, and H,O elimina- tion. The katabolism of protein in muscles then goes on independently of, and is not augmented by, muscular con- tractions. In the course of the metabolic processes in the muscles there are intermediate products set free—as kreatin, leucin, glycocoll, sarcolactie acid, ete. These products are finally split up (katabolized) or synthetized (anabolized) in the FOOD AND FEEDING 683 liver with the formation of urea, uric acid, phosphates, sul- phates, ete., as end-products, with the liberation of heat. From its absorption to the final urea stage each gram of pro- tein liberates energy or heat equal to 4100 calories.* This heat formation is of extreme importance in stimu- lating and sustaining nervous action. The following réle is played by protein as a nutritive :— 1. It is the building material for cell protoplasm of tissues of all kinds. 2. It forms energy directly by undergoing destruction without tissue-building. 3. It may be so transformed (through its H and C), that it is deposited as fat. A dog ean live on lean meat (pure protein) for months and gain in weight. Carbohydrates in the food, as sugar and starch, are digested in part by the salivary ferment (ptyalin), but chiefly by the pancreatic ferment (trypsin) in the intestines, and are converted by them into glucose. The glucose is then absorbed by the small intestines, passes thence as glucose into the enterohepatic circulation and is oxidized in all the cells of the body but chiefly in the liver, muscles and pan- ereas—in the form of glucose and glycogen and _ with the production of heat equal to 4180 calories for each gram of carbohydrates. Carbon dioxide and water are formed as end-products. Sugar metabolism is under the control of a medullary centre. The heat production, as in the case of the combustion of proteids, is of great importance in sustain- ing nerve action. Fat in the food is emulsified by the bile and by the pan- creatic and intestinal secretions and is absorbed as fatty acids, glycerol and soaps by special cells of the intest- inal mucous membrane and passes into the lymphatics as emulsions of fat; thence into the thoracie duet, and is finally oxidized into carbonic dioxide and water with production of heat and energy. In what part of the body oxidation of fat occurs is unknown. In the combustion of 1 gram of fat heat equal to 9400 calories is liberated. *The calorie is that amount of heat required to raise 1 gram of water 1 degree cent. 684 GENERAL THERAPEUTIC MEASURES Carbodydrates do not directly furnish tissue elements, but do so indirectly in preventing decomposition (to some extent) of protein in the body, and in Jessening its consump- tion. In this way the comparatively inexpensive carbohy- drates will compensate for an insufficient ration of costly proteids. j It is asserted that this action of carbohydrates’ is explained by the fact that these nutrients have a greater affinity for oxygen than proteids and so are the first to undergo combustion. The term albuminoid was formerly used as synonymous with proteid, but is now employed to include nitrogenous bodies (gelatin) derived from protein in the body but not convertible into proteids. These bodies do not take the place of proteids, but appear to fulfil the functions of circu- lating protein, and, like carbohydrates, conserve protein consumption, but are not tissue builders. Carbohydrates aid directly in the production of fat. Fat in the food may be directly assimilated as such if there is a sufficient carbohydrate and proteid ration to protect it from decomposition. The réle carbohydrates play includes: 1. The formation of tissue indirectly by protecting the proteid elements from combustion with an insufficient nitrogenous diet. 2. The generation of heat, energy, or mechanical work. 3. The production of fat. Carbohydrates cannot be relied upon as sole articles of food. The fat of the body is derived from the decomposition of proteids and carbohydrates, and directly from fat con- tained in the food. Fat lubricates the tissues, and’ a reason- able accumulation serves as a store of potential energy to be ealled upon in time of need, when its action is similar to that of carbohydrates. The main source of muscular energy, movement, or mechanical work, is thought to zeside in the carbohydrates, because with excessive muscular work there is increased evolution of heat, carbonic dioxide and water, but no material increase in excretion of nitrogen in the urine. In so far as muscular energy and power depend upon a good FOOD AND FEEDING 685 machine, in so far do the proteids aid the work of the machine by keeping it in good repair and working order. From this point of view the proteids represent the mechan- ism by which the work is done; the carbohydrates the fuel necessary for its performance. It must be kept in mind that this is but a general statement, since muscular work is also done by protein, and may be wholly done by it, as shown by dogs living on lean meat. The exact relative value of carbohydrates and proteids in the production of the vital forces is still sub judice. The classes of food stuffs for the larger animals em- brace both green and dry fodder, consisting of the whole plant minus the roots ; parts from which the more valuable portions have been removed, as straw; tubers and roots containing a large percentage of water; the seeds or grains, constituting the most concentrated fool; and the seed coverings or chaff. Refuse and bye-products of manufacture are extensively used, as bran, cottonseed meal, linseed meal, and brewers’ grains. In addition, animal matter, as flesh meal, bone meal, and dried blood, are sometimes of value. Pasture grass may be taken as a standard of comparison for green fodders. In 100 lbs. of grass there are approximately digestible : POOLE. ce delwelp ine ate Uae wise wesc ener \s 2.5 lbs TOP React mco GoD Oo ODE OOONUBC. CUCOCODROLSe 07B.. ‘S$ Carbohydrates Eiafaiattielatsieieie sferayeteislatelsi=(satq 15.000" Green clover contains ‘considerably more, green rye slightly more, and green oats somewhat less protein; while in green corn fodder there is only about half as much pro- tein. Roots, as compared with green pasture grass, possess only one-third the quantity of protein and solids. Potatoes, however, have double the nutritive value of roots. Com- parison is made in reference to protein, as that is by far the most valuable nutrient, and the amount of carbohydrates and fat do not vary much in similar kinds of fodder. Meadow hay, including such common varieties as timo- thy and red top, may be taken as a standard of comparison 686 GENERAL THERAPEUTIC MEASURES for dry fodder. In 100 lbs. of hay there are approximately digestible : . Proteins ck sod Sees a see eaten eines 5.4 lbs. Wat fo ei bos hab os Aas ne ae eee tert Carbohydrates ..:.4¥o:-.nt oot enw ieee 40.4 “ Clover hay has double the amount, and rowen or after- math about one-third more protein than is contained in ordinary meadow hay. Oats may be selected as a standard of comparison for grains. 100 lbs. of oats contain of diges- tible nutrients as follows: PYOUCTI sen.c an sores cymes cinso Orsi eit ai ee 10.0 lbs. Biaitits av eeeaite cles neato sters wie see cierante 4.5 ¢ Carbohydrates: jsace cee oes eeee Any Ons Corn yields slightly less protein and considerably more carbohydrates and fat, while cottonseed meal contains nearly three times as much protein, and four times as much fat as are found in oats. Bran (or shorts) has approximately the same chemical composition as oats. The straw of wheat, barley, rye, oats, and corn have a somewhat similar value. In 100 lbs. of wheat straw there are digestible : IPROULCIIN.,. cieie ce rog ois getorerenersiore cieivisteiebeiers 0.8 Ibs. BAB: eet irvinc ma create aise tear eRe ar Carbohydratess: 32). ' Coane dase b es eaiet 36.00 ‘* In order to compare the composition of food with that of the tissues into which it is converted, we submit the following : PERCENTAGE COMPOSITION OF LIVE ANIMAL. IN 100 LBS. OF LIVE OX THERE ARE: IPTOLEITs <1 cree os o.daie tlawestetst storer mitieys 8.7 lbs. NUL eteie oto) sie's. « 0% bre cla ete eve mete etn ne 1OSSE Cs PAG Nh OS OOO DG Ore Omen ook: Bons AWiBLETB ic teres sears (a, otc levaieembeiotererolarcleneieltie 66) 254 Certain of the fodders are especially adapted or other- wise for the various domestic animals. Green clover is prone to fermentation and the formation of flatulency if given in large quantities to any animal. A sudden change FOOD AND FEEDING 687 from dry to luxuriant green food is always undesirable for a similar reason. Green grass cut short by a lawn mower should not be given horses, as it is swallowed in an unmasti- cated condition and leads to indigestion and colic. Potatoes and roots are more suitable for ruminants than for horses; yet upon the latter they act as natural and agreeable laxa- tives, and form a palatable addition to dry fodder, particu- larly carrots. The best variety of hay for horses consists of good bright timothy or herds grass with a slight admix- ture of red top and clover. Carrots should be sliced longi- tudinally to prevent choking when given to horses. Clover hay is dusty and apt-:to provoke “heaves” in horses, and that, together with rowen, is more appropriate for ruminants. Bran is but poorly digested by horses, yet acts favorably as a laxative when given once or twice a week mixed with boiling water and plenty of salt, constituting a “ bran mash.” Bran takes the place of oats as a nitrogenous food for rumi- nants, and is less expensive. Cottonseed meal, being extremely rich in nitrogen, and usually in oil or fat, is not easily digested by any animal, but may be given in quanti- ties of a quart or two to ruminants, and from half a pint to a pint to horses, daily. Cottonseed meal is supplied cattle to compensate for a deficiency of nitrogen in the food, while in horses it acts as a slight laxative and may improve the general condition. Straw and corn fodder are not readily digested by horses unless cut and steamed, but are suitable for ruminants and are often preferable to a poor quality of hay. The demands of the system for food vary in relation to tissue change, which is diminished by rest, increased by work, and either accelerated or decreased by disease. The requirements for nutriment are greater during the growing period and for the formation of the various natural products, as milk or wool. The state of the digestive organs and assimilative powers guide us in selecting the kind and quan- tity of food desirable. In acute disease it is advisable to feed little and often, the food being prepared in the most digestible and palatable form, and in as great a variety as 6388 GENERAL THERAPEUTIC MEASURES attainable. We may restrict the diet as a whole or in part. Starving diminishes circulatory protein, increases tissue waste, weakens an animal, and lessens the natural resistance against disease. Restricting the diet is useful in controlling unmanageable animals, in diminishing sexual excitement, und in the treatment of plethora when combined with proper exercise. In most acute inflammatory diseases, as in acute laminitis, a restricted laxative diet is desirable, as steamed oats with bran and salt, roots and green fodder. In acute indigestion, or in acute inflammation of the alimentary tract, and in acute nephritis, all food should be withheld for at least 24 hours. In acute peritonitis all food is contraindi- cated, by the mouth. In the milder forms of acute gastro- enteritis we must restrict the diet to small quantities of easily digested food, as cracked or steamed oats, chopped hay and gruels, with the addition of a little green fodder or roots for horses; while carnivora are given milk and lime water. In chronic digestive disorders the food must be readily digest- ible and assimilable, and of a nitrogenous character, since anemia and malnutrition follow the defective digestion and absorption. In chronic indigestion or gastro-enteritis of horses, Zuill recommends A (boiled, sealded or steamed, and allowed to stand 12 hours), 2 parts; bran, 1 part; ne malted barley, 1 part. The addition of salt and a little ereen fodder to this ration is palatable and desirable. The dietary for constipation in horses should consist of bran mashes twice a week with plenty of salt; roots and green fodder at frequent intervals, combined with suitable exercise and appropriate drug treatment. Dogs suffering from con- stipation may be given raw liver twice a week, or may be put on an occasional or exclusive diet of one of the com- mercial dog breads or biscuits. These are laxative and are invaluable in eczema of dogs. Avoid oatmeal, and feed bread, soup and milk in acute eczema. If constipation is very obstinate, total abstinence from all food, water ex- cepted, for a time, followed by the use of lean meat with salt and beef tea, are indicated till the bowels are emptied man- ually or by enemata. The ration for diarrhcea embraces the partial restriction of water, which increases the bulk and fluidity of the intestinal contents and so stimulates the move- — FOOD AND FEEDING 689 ments of the bowels. If the diarrhcea is so severe as to en- * danger life, an abundance of pure or boiled water should be allowed in order to compensate for the loss of fluid: from the blood. Theoretically, an albuminous diet is indicated in diar- rhea because of the loss from the blood and tissues, and because intestinal digestion is disordered and starchy food would be undigested and cause fermentation, ete. Practi- eally, a certain amount of starchy food seems to be service- able in the treatment of diarrhcea. Horses and cattle should be given cooked flour or barley gruel and roasted oatmeal and eracked oats. Coarse foods, as bran and straw and green fodder, are not allowable. Swine should be supplied with gruels of boiled milk and barley, flour or oatmeal (strained). Fowl! with diarrhoea may be fed on boiled rice and given a few drops of laudanum two or three times daily. Dogs and eats should have boiled milk, boiled rice or strained rice eruel, cooked lean meat and crackers. Beef juice and white of ege in water are of value. Young calves, with diarrhea, should receive whey, broths and rice flour gruel. These di- etaries should be employed in conjunction with other meas- ures, as the preliminary use of a laxative, rest, quiet, and external heat and drug treatment. Young suckling animals, as foals and calves, may be fed on cooked and strained oat- meal or barley gruel made with milk, if the mother’s milk does not agree. In severe attacks of gastro-enteritis, or in gastric or intestinal ulceration with hemorrhage from the stomach or bowels (after preliminary starving), the food should be bland. and fluid, as soaked bread, oatmeal, barley or flour gruels, linseed tea (made by boiling linseed in a muslin bag immersed in water), and small quantities of green fodder for the larger animals; while milk and lime water, white of egg and water, broths and beef juice are indicated for carnivora. In the latter animals we may have to resort to predigested food given by the mouth, or, if vomiting is persistent, by the rectum. ‘ The diet in cases of catarrhal jaundice should be easily digestible, bland, and such as will not require much bile for its digestion. The larger patients should be given gruels, 690 GENERAL THERAPEUTIC MEASURES steamed cracked oats, young and tender green food, cooked potatoes, together with alkalies and other appropriate - remedies. Dogs are allowed milk and lime water, crackers, bread and cooked lean meat. Feeding in hemoglobinemia or “black water” of horses must be restricted to the use of eruels, green fodder and a little hay in the early stages of the disorder. Food is usually withheld 12 hours before surgical operations, and this, in addition to the administra- tion of a cathartic, will prevent injury in casting the larger animals, which might follow were the digestive tract over- full. It will also lessen the danger of intestinal fermentation and absorption of toxins from the bowels, which may occur after operation owing to an enfeebled digestive action. If dogs are starved before surgical operation, vomiting is pre- vented during or after etherization. Water alone may be restricted to advantage in obesity, cardiac disease with cedema, or in the treatment of chronic exudations, as in hydrothorax. Water may be allowed in these conditions only once daily, or even every other day ; and this treatment may be combined with the use of saline cathartics in strong animals. The specific gravity and density of the blood and the tendency to absorption from the tissues and cavities is increased. By the same process the quantity of blood is diminished and the load put upon the heart is lessened, both of which may prove beneficial in cardiac diseases. A full, or restorative diet should be especially rich in protein. Generous feeding is distinctly in order in the treat- ment of general debility, malnutrition, anemia, weakness of the digestive organs, convalescence from acute diseases and in animals particularly sensitive to cold, or in those which sweat easily. A full diet is also useful in overworked animals and in those subject to losses from increased secre- tion, excretion, or exudation, as in chronic suppuration, diarrhea, albuminuria, ascites and oedema. A restorative diet for herbivora includes grain, as corn, bran, oats and cottonseed meal; hay and grass, with occasionally beef meal, milk and eggs. For omnivora, corn, potatoes, FOOD AND FEEDING 691 blood, beef meal, milk and soups. For carnivora, meat extracts, cream, milk, eggs, broths and meat juice. In most wasting diseases, fat, protein and water are the food elements especially needful. An abundance of water stimulates the appetite, secretions, excretions, tissue changes and vital processes generally. Salt should be given freely as an aid to digestion in increasing the formation of hydrochloric acid, and indirectly that of pepsin. Alcohol, being a nutritive and capable of easy absorption, assimila- tion and decomposition in the body, forms a most valuable adjunct to a restorative diet. A deficiency of lime in the food is occasionally the cause of rickets in the young, and fragilitas ossium in the old, but more frequently these diseases are due to defective digestion, assimilation, or excessive lactation. Bone meal may be fed to advantage in such affections. It contains both lime and phosphoric acid and should be given in small quantities (1 tablespoonful to large animals ; 1 teaspoonful to small patients) on the food in connection with the administration of hydrochloric acid and bitters. In fever a restricted diet is often iuiecessary in the more acute stages, with loss of appetite, diminished secretions, and movements of the stomach, but as soon as convalescence sets in the increased tissue waste produces an excessive demand for food and the digestive organs may become over- taxed. The initial dietetic treatment of fevers consists in the use of oats, bran mashes, and gruels, with the addition of a small quantity of grass or roots for horses. The change from this diet should be very gradual to a dry, coarse fodder, in order to avoid digestive disorders. The bitters, alcohol, ~ hydrochloric acid, and salt, together with a copious supply of water, will furthermore aid convalescence. Carnivora, with fever, should be fed milk, beef juice, broth, bread, oat- meal and a small quantity of cooked lean meat. Obesity is treated most advantageously by proper feed- ing. A certain amount of fat is essential in the body in lubricating the tissues, in acting as a protection against cold, in serving as an enveloving and shielding cushion to the un- 692, GENERAL THERAPEUTIC MEASURES derlying tissues, and finally in supplying a store of nutrition. Animals living in cold climates are covered symetrically by fat, but those indigenous in hot countries have accumulations of fat in masses to avoid over-heating the body. This is seen in the hump of the camel, zebu and Brahmin bull. When the camel is severely taxed, the fat is consumed and the hump be- comes loose and flabby. House dogs overfed and insufiici- ently exercised, horses, and other anima!s kept for breeding ~ purposes, are those most commonly afflicted with obesity. Fat in the body may be formed from fat, albuminoids, and carbohydrates of the food. Carbohydrates, if in excess of the needs of the economy, protect the fat in the food from decomposition and so enable it to be stored in the body. Protein may also protect the consumption of fat of the food, for it is broken up into nitrogenous and non-nitrogenous elements, and the latter may be transformed into body fat. The accumulation of fat proceeds most readily when there is an abundance of fat in the food, in addition to the other nutrients; less so when the ration consists of fat and albu- minoids, or of carbohydrates and albuminoids; and least of all with a diet consisting of pure protein. The latter, then, is the food to be approached as near its purity as advisable. If protein ration is followed too closely, digestive disorders, loss of strength and nervous disturbances are likely to occur. The fat resulting from the decomposition of a pure protein fodder is usually not sufficient to supply the needs of the body, and the organized fat is gradually called upon to supply the deficiency in the food. Exercise, cathartics, diuretics and diarphoretics, to- gether with venesection, are synergistic measures. As emaciation proceeds, we must add more and more non- nitrogenous material to our ration. Fat is said to accumu- late most readily in the vicinity of vascular areas where the flow of blood is retarded, and therefore oxidation, combustion, and molecular activity diminished. Exercise, on the other hand, stimulates the circulation, while deprivation of water makes the blood-current more rapid by decreasing the EE ee FOOD AND FEEDING 693 amount of blood. Both therefore favor the destruction of fat. Vogel has reported good results in reducing obesity by the use of the following rations. From 19 to 26 weeks are required for a cure. DAILY RATION FOR THE HORSE. GGT eta: WAL taeda act eouareceicearie aeebaleloees i tbs RS ULEUWWaeralece etei onal = alereverercnarcre aie eiuiet areictevonetereene an MVE Crease cis alaierae'e o/s lelote Gasteteratanve.kaielera> a HERR C CREA, oe Pala ae.” naraenseenls yet ee 1.“ eRe ralshte oh tia Saas 1g «6 Gay ok) o dorsi telcos seine Fee Mantndalers a RAG orepersteiiers 5. escapee mi vare atetac sels sities dete 1 teaspoonful. WseamraMneatic pe epsstee fepaesciats 8 fst fo 5 alee ts 114 lbs TABBAG Ts oh latn cn tee cke weds Medea metine naa tsS Tlzae ee Hiab retire cis cap taferecorctavereteatevciets ciate cya) stevens 3 OZ Animals suffering from fatty degenerative changes do not stand such a rigid diet as the foregoing. These ani- mals are affected with a weak heart, due to fatty degenera- tion of the myocardium, with atrophy of its muscular fibres. They have dyspneea on exertion. The cardiac insufficiency leads, in its turn, to secondary troubles, as catarrh of the digestive and respiratory organs, and disorder of the liver and kidneys, following general passive congestion. The treatment should be directed in such cases to lessening the amount of blood and the work put upon the heart, by limit- ing the ingestion of water, and by strengthening the heart with appropriate stimulants. The activity of the skin should be excited by frequent grooming and the use of diar- phoretics, while the activity of the kidneys should be en- hanced by the employment of diuretics. We are prevented ' 694 GENERAL THERAPEUTIC MEASURES from feeding an exclusively nitrogenous diet in these cases, as the oxidizing power of the blood is not sufficient to de- compose it, neither is it safe or advisable to quickly remove the fat, as cardiac failure might ensue. Small quantities of water are allowed, given two hours after feeding. The gen- eral ration should be rich in proteids and also contain a moderate amount of fat and carbohydrates. ARTIFICIAL FEEDING. ' Artificial feeding consists in the introduction of food into the body other than in the ordinary way by the mouth. Rectal feeding is the only procedure of much value. The agents employed must be bland, and capable of easy absorp- tion and assimilation. If the food is at all irritating, tenes- mus and ejection quickly occur. From two to four ounces of liquid nourishment may be given to small or medium- sized dogs; from four to eight ounces to large dogs. One quart may be employed for horses. The nutrient enema should be introduced into the bowel through a flexible rubber tube carried up into the colon. An hour before the enema is given the bowel is to be washed out thoroughly with cold water. The nutrient injection should not be given oftener than once in six hours, and if the bowel is irritable, not oftener than once in twelve hours. The absorptive power of the rectum is slight, but that of the colon is con- siderably greater. Predigested food is most valuable. Leube’s Beef Peptone may be used. A bullock’s pancreas is finely chopped and rubbed up with eight ounces of gly- cerin. This extract will keep fresh several weeks in a cold place. To one-third of the extract are added five ounces of finely chopped beef, and the mixture is ready for immediate use. The peptonizing powders of Fairchild Brothers & Foster are most convenient in preparing digested food. Each powder consists of five grains of pancreatic extract and fifteen grains of sodium bicarbonate. A useful nutrient enema for a large dog may be made of two eggs and six ounces of milk. Four to six eggs may be FOOD AND FEEDING 695 added to a quart of milk for use as an enema for a horse. The mixture is then to be peptonized and introduced into the rectum at the temperature of the body. In using the pep- tonizing powders, one is placed in a quart glass jar together with a teacupful of cold water. Then a pint of the mixture to be peptonized is poured into the jar, and the latter placed in a vessel containing water as hot as the hand will easily bear. The jaris kept in the hot water for twenty minutes and put on ice. When the mixture is used it should be heated to 100° F. If predigested food is to be given by the mouth, it is well not to keep the glass jar immersed in hot water more than five minutes, as otherwise the taste will be bitter and disagreeable. A small dose of laudanum is always useful to prevent the expulsion of enemata. Brandy may be added in the proportion of one ounce to the pint of milk after peptonizing. The addition of salt to egg-albumin greatly facilitates absorption. Gruels of all kinds, and broths, may be peptonized, as well as milk. Itis not essen- tial, however, to peptonize milk and other fluids, although absorption is rendered somewhat more complete. The di- gestive powers of the large intestines are but slight. Sugar is absorbed unaltered; undigested proteids (with certain exceptions) and fat are not absorbed. Peptones, soluble proteids, as milk, meat juice, egg albumin, and emulsified fat are absorbed. Nevertheless, absorption from the lower bowel is trivial compared with that from the stomach and in- testines generally, and as the extent of surface with which rectal injections come in contact is small, and their sojourn short, it follows that rectal feeding cannot take the place of normal alimentation. In tetanus, paralysis of muscles of deglutition, fracture of the jaw in horses, persistent vomiting and convulsions in dogs, and in all animals refusing food, rectal feeding is in- dicated. It is, possible to feed animals through a stomach tube (or catheter), and, in hospital cases, this method may be preferable. ; 696 GENERAL THERAPEUTIC MEASURES Counter-Irritants. A counter-irritant is an irritant which acts counter, or against an existing irritation, result of irritation, or pain. In applying a “twitch” to a horse, we are inflicting an irri- tation to relieve some other source of irritation elsewhere. It is taken for granted that the damage and pain caused by the artificial irritant are not so severe as those already ex- isting. The amount of injury produced by an irritant depends upon the nature of the material, its strength, the duration of its action, the mode of application, and the part to which it is applied. We may consider the effects oc- casioned by a mild and increasing action following the continued use of a single agent, or representing the action of materials of different degrees of potency. There first appears redness of the skin, accompanied by some burning or pain (rubefacient action), and if the irritation progresses there is a serous exudate poured out into the | mucous layer of the skin. This leads to swelling and cedema. Greater irritation causes more exudation of serum and an elevation of the epidermis in a circumscribed area or areas, and the formation of blebs or blisters (vesication).: If the irritation ceases at this point, the blisters break open and their contents dry on the surface, covering the parts with a thick scab. Synchronous with vesication we observe i similar process attacking the hair follicles. The hairs are loosened aud fall, but as the papille are usually unaffected, the growth of hair is soon renewed. The recovery of hair is facilitated by the application of grease to parts. Certain agents cause circumscribed inflammation of the gland orifices of the skin, with the formation of pustules (pustulants), as croton oil, and these create necrosis of the hair papille, and, therefore, permanent loss of hair. If the irritant is severe, suppuration follows vessication ; or, if an ordinary irritant is applied vith violent friction, is covered with a bandage, or placed over an already inflamed part, the same result COUNTER-IRRITANTS 697 happens. The terms referring to the degree of action in- herent in agents are as follows: 1. A rubefacient, causing hyperemia. 2. A vesicant, or 2pispastic, inducing blistering. 3. A pustulant, creating pustules. 4. An escharotic, or caustic, occasioning death of the tissues. The same agent, as has already been pointed out, may produce one or more of these actions according to circum- stances. The inner aspect of limbs and the flexures of joints are peculiarly sensitive, owing to the thinness of the skin over these areas. If a counter-irritant is rubbed properly into the skin it may penetrate into the mucous layer. Reference has been made to the local influence of irri- tants. We will now direct attention to their remote effect. It is certainly known that irritation of the surface decidediy affects distant organs. Brown-Séquard noted contraction of vessels in one arm when the other was immersed in cold water. Severe burns of the surface are followed by duo- denal ulcers. The preceding and succeeding remarks enable ~ us to partially account for the remote influence of counter- irritants, but although we know their practical value, it is not within our present knowledge to offer theories wholly explaining their effect. The influence of counter-irritants may be summed up in reflex action; 7. e., the production and conduction of an impulse from the periphery to nerve centres, thereby modi- fying the nerve functions and blood supply in distant parts. The skin is commonly the point of application. It nor- mally is an organ of protection, respiration, secretion and special sense, and, through its medium, a regulator of tem- perature, responding to such natural stimuli as heat, cold, moisture and dryness. Such an unnatural and considerable stimulation as is produced by counter-irritants consequently creates very sensible alterations in the bodily functions. 698 GENERAL THERAPEUTIC MEASURES Extensive counter-irritation causes the breathing to become slower and deeper by reflex stimulation of the respiratory centre, and also by making the respiratory movements more painful, if the application be made to the chest wall. The circulation is likewise affected by stimulation of the vagus and vasomotor centres, and both the foree of the heart and blood pressure are increased, unless the irritation is very widespread and severe, when the reverse happens. The ab- dominal vessels are those constricted; the vessels of the skin and limbs are unaffected. In accordance with the foregoing remarks, the use of considerable heat, together with mustard or turpentine, is of great value in conditions of vital depres- sion, surgical shock, collapse and coma. Moreover, the effect on local blood supply is still greater and full of importance, since it may explain the beneficial action obtained in the ordinary use of counter-irritants. In experiments conducted upon animals, it has been observed that when sinapisms are placed over the head, the blood vessels in the pia mater are first dilated, but soon contract and remain in that condition for some time. Likewise there was seen, following energetic counter-irritation of the chest, anemia of the underlying parts, including the muscles, pleur a, and even the pulmonary tissue. It is essential to bear in mind, then, that while counter-irritants Induce local congestion in their immediate vicinity, they also cause reflexly vascular contraction in more remote areas. In accordance with this demonstration, the importance of these agents in remote inflammation lies not so much in their bringing blood to the surface, as in forcing it out of distant parts. This fact is not generally appreciated. The use of the word “ drawing” signifies the common idea of a counter-irr itant, and implies the first proposition. Temperature is not materially affected by the therapeu- tic use of counter-irritants, and they are not necessarily contraindicated in fevers. Experiments, however, appear to show that mild counter-irritation may lead to-a slight elevation of body-heat, owing to stimulation of the ealorifa- cient centres, while extensive and prolonged action lowers temperature by depression of the heart and heat centres, and because more blood flows through the peripheral vessels owing to constriction of the vessels in the abdominal organs. Counter-irritants notably relieve pain. This result is not only due to overcoming congestion, but occurs when pain COUNTER-IRRITANTS : 699 is purely neuralgic. The phenomenon is not altogether ex- plicable. The subduing influence of a twitch in the case of pain inflicted upon a horse is an analogous example. Wechs- berg, in some late experiments, notes, as a most striking effect of counter-irritants, edematous infiltration of the skin, subeutaneous tissue and muscle in sub-adjacent parts, with compression of blood vessels in the deeper-lying structures. He attributes the relief of pain afforded by counter-irritants tc anemia and rapid compression brought to bear on the nerves in these underlying parts. Still this explanation does not interpret the relief of pain sometimes seen in parts remote from the point of appli- cation of counter-irritants. In disease of internal organs Head has constantly found certain corresponding areas of skin tenderness. This be- eause both the internal organ and the skin area are innervated from the same segment of the brain or cord. Theoretically and practically counter-irritation of a skin area affects the internal organ corresponding (by nervous connection) to it more than other parts. These areas of skin tenderness for diseased internal organs, and for application of skin irritants to relieve these conditions, have been mapped out in man. In the case of the chest and belly they are situated pretty nearly over the site of the internal organ. In the head the sensitive skin-sites are not over the diseased part. Pain is usually referable to the peripheral ends of an affected nerve. It is good practice to apply counter-irrita- tion directly over a deep-seated inflammation or seat of pain (see above), but in assuaging superficial pain it is found, that where the treatment can be made over the root of the painful nerve, better results are obtained. In pain in the chest wall a blister should be placed next the spine over the root of the spinal nerve involved ; in pain in the head in man, counter-irritation is\ applied over the back of the neck. Counter-irritation should be done over the temple, in pain in the eye(iritis) ; behind the ear, for pain in that organ. In the treatment of enlarged glands and in acute inflam- mations, as abscess, boils and carbuncles, by counter-irri- tants, the application should be about the lesions rather than directly upon them. Among other actions accomplished by counter-irritants are: possible stimulation of trophic nerves and nutrition of 700 GENERAL THERAPEUTIC MEASURES a part; augmentation of tissue change, locally and gener- ally, and dilatation of vessels (when applied after the sub- sidence of acute inflammation or in chronically inflamed parts), with renewed activity of the circulation and conse- quent absorption of inflammatory exudations. The local action of skin irritants increases the leucocytes and opsinins in the inflammatory area (acted upon) and leads to bacterial destruction. ‘The toxins are also more rapidly removed by their influence. Furthermore, counter-irritants reflexly over- come spasm and pain occurring in colic, by stimulating and replacing normal peristaltic action in place of abnormal local- ized contractions. In like manner they excite uterine con- tractions by stimulation of the involuntary muscular fibres of the womb. INDICATIONS FOR COUNTER-IRRITANTS. 1. To overcome congestion and inflammation in remote parts. 2. To promote absorption of inflammatory products locally. 3. To relieve pain. 4, To stimulate the heart, respiration and nervous functions. Rubefacients—In this class are included the volatile oils—turpentine, oil of wintergreen, ete.—alcohol, chloro- form, balsams, resins, iodine, tincture of camphor, tincture of cantharides, mustard, and heat. These agents are used when it is desirable to stimulate the nervous system rapidly, and to relieve pain and congestion. To attain this end, we employ comparatively mild agents in order that we may apply them over an extensive surface without causing seri- ous or permanent results. Mustard is rubbed with warm water into a thin paste (a sinapism), and rubbed over the chest of horses in congestion of the lungs, in acute bron- chitis, or in the first stage of pleuritis, to obtund pain and lessen congestion. Sinapisms also relieve obstinate cough, revive failing respiration, and stimulate reflexly the vital functions in collapse, shock and narcotic coma. Applied over the cardiae region, they avert syncope. To assist the action of mustard, we often cover the application with hot blankets, and then with dry ones. Stimulating liniments are sometimes preferred. One volume of oil of mustard COUNTER-IRRITANTS WO may be combined with fifteen volumes of oil of turpentine; or ammonia water, thirty parts, and oil of turpentine, fifteen parts, are added to spirit of camphor and soap liniment, each fifty parts. Turpentine is more valuable in abdominal disorders in horses. Itis sprinkled on hot blankets, and applied as a stupe to stop pain, spasm, and stimulate normal peristalsis in colic; and to relieve pain and congestion in enteritis, peritonitis, diarrhcea and other difficulties. The beneficial result accruing from the use of external counter-irritants in bowel troubles is often facilitated by the injection of hot (115° F.) rectal enemata. Stimulating liniments are serviceable in aiding resolu- tion of swelling following the acute stage of cellulitis, lym- phangitis, neuritis, mammitis, rheumatism, strains and bruises. They are often employed in laryngitis. In chronic skin diseases, as eczema, mild counter-irritants (tar, oil of cade, Peruvian balsam, etc.) substitute an active reparative process, tend to aid absorption of exudation and induration, and relieve pain and itching. The tincture of iodine may abort incipient inflammatory lesions, as boils and abscess, by means of its counter-irritant and antiseptic properties. VESICANTS AND THE ACTUAL CAUTERY Cantharides, red iodide of mercury, and croton oil, are more commonly used in veterinary medicine to cause blis- tering. Reference will be had, hereafter, to cantharidal blisters. Blisters and the cautery are especially indicated to cause resolution of inflammatory products and modifica- tion of inflammatory processes; to secure fixation and rest of parts, aud to relieve pain. It is impossible to enumerate all the conditions in which they are useful. In the treat- ment of severe sprains, as curb and “ breakdown;” and in exostoses, as ringbone and spavin, the actual cautery (firing) is used before and in conjunction with blistering to exagger- ate the counter-irritant effect. Absorption is attained in the foregoing conditions by the production of an acute inflam- 702 GENERAL THERAPEUTIC MEASURES mation, with increase of vascularity, tissue change and fatty degeneration. In “breakdown,” the formation of scar tissue is thought (without reason) to assist in supporting the limb. Sometimes, on the other hand, osseous deposit is unabsorbed, but anchylosis and freedom from pain in a diseased joint is secured by the enforced maintenance of rest and fixation of the joint, together with the production of new bone. In exudative diseases of serous membranes, as pleuritis, pericarditis, peritonitis, meningitis, arthritis, and synovitis, blisters facilitate absorption and recovery after the acute stage is over. This favorable result is not due to loss of serum, but to modification of the inflammatory process. In the first three diseases named above, blisters—flying blist- ers—may be applied in spots every few days in different places over the affected area. Blisters reflexly stimulate the nerve centres in menin- gitis, in addition to their action on the inflammatory lesion. They should be applied over the poll or spine according to the location of the trouble. Absorption in chronically enlarged glands is assisted by blisters. They also hasten “ripening” of suppurating glands or abscess when this process is slow, and hasten their resolution after evacua- tion of pus. The blister should be rubbed on about the inflamed area in these lesions. Vesicants are also valuable in pharyngitis and laryngitis for severe cases, when stimulating liniments are ineffectual ; and, in lessening pain, exudation and swelling of the throat, may avert the necessity of tracheotomy. A blister applied about the coronet in diseases of the feet is serviceable in stimulating the growth of the hoof and promotes repair in navicular disease, laminitis, and cartilaginous quittor, after the acute stage is passed. In arthritis and synovitis, the whole diseased area, with the exception of the flexure of the joint, is covered with a blister. Since it is often impossible to immobilize a part, in veterinary practice, by splints, blisters are sometimes employed for this end after reduction of dislocations. COUNTER-IRRITANTS 705 The hair should be clipped from an area to be blis- tered, the skin washed with soap and water, and the animal | tied up or restrained in some way from biting the part. It is the custom to cover immediately the surrounding parts with grease, but protection from the acrid discharge can be secured more effectively by frequent sponging with soap suds and water; or painting the skin, under the blistered surface, with a solution of resin in alcohol. Grease is not so good a protective, since it is a solvent for cantharides. Vaseline should be applied following the active stage. Caustics or Escharotics are agents which destroy tissue. They comprise such substances as the caustic alkalies, min- eral acids, silver nitrate; iron, zinc and copper sulphates ; ferric, zinc and mercuric chlorides; carbolic acid, arsenic, together with the actual cautery. They are indicated in the treatment of exuberant granulations, morbid growths, septic, sloughing and necrotic parts, pyogenic membranes, fistulous tracts, and for the destruction of poisons, as in rabid dog and snake bite. Escharotics stimulate and modify nutrition in unhealthy wounds and ulcers. Many form chemical com- pounds with the tissue elements. Heat oxidizes animal tissues, and also coagulates albumin and abstracts water from them. The alkalies produce greasy compounds with the pro- teids, saponify the fats and withdraw water from the tissues. They are the most widely destructive agents. Silver nitrate forms an insoluble albuminate with the tissues to which it is applied, and protects the underlying structures from further action. It is most superficial in its action, but possesses specific properties in altering the condition of unhealthy wounds for the better. Extreme heat, exemplified by the white-hot iron, acts as a counter-irritant in stimulating reflexly the nervous system ; in increasing the vascularity cf surrounding parts, and in favoring revulsion of blood; in aiding absorption and resolution, and in relieving pain apart from its direct destructive effect. Caustics may be applied in either the solid or liquid state, and in various forms, as 704 GENERAL THERAPEUTIC MEASURES the stick, powder, paste and ointment. Caustics are some- times employed to stop hemorrhage. (See Styptics, p. 63.) The reader is referred to the articles on special agents for further details). . Suppurants—Any of the more active counter-irritants, as croton oil, may induce suppuration. Under this head “may be mentioned setons and issues of rowel. A seton is a piece of tape or other material, introduced through an in- cision in the skin, and thence under the skin in the connect- ive tissue, and finally out through the skin at a short distance from the point of entrance. The loose ends are then knotted together, and the whole loop is drawn through the wound once daily to keep up constant irritation and suppuration. An issue of rowel is a piece of gauze or tow, which is passed into an incision, where the substance remains, and causes continual irritation and suppuration. To intensify their irritant action, both setons and issues of rowel may be. first saturated with cantharides ointment or oil of turpentine. They have been employed in acute disease of the eye, men- ingitis, “‘strangles,” and in joint and shoulder lameness, near the seat of trouble. Setons and issues of rowel are bar- barous and dirty, and fortunately are becoming obsolete. Cold and Heat. Cold.—Cold and heat are only relative terms. As used here, they refer, respectively, to a thermal intensity below or above that of the body. Cold is usually applied by means of water in some form. In veterinary practice we are limited in the employment of cold air, as a medium, to the use of free ventilation and protection of animals from the solar heat.* Cool air is especially desirable in the treatment of most febrile affections by lowering temperature and serv- ing as a stimulus to the respiratory, circulatory and nervous functions generally. Locally, cold causes contraction of the peripheral vessels and muscles of the skin, forcing out fluids from the part and reducing local temperature. This is more *The cold air treatment—of pneumonia, especially—is now ex- ceedingly popular in human medicine. The patients are kept outdoors even in the coldest weather under shelter and well-covered. Reduction of fever and stimulation of the vital centres are among the chief ad- vantages accruing. The same treatment applies to animals. In pneu- monia of horses an abundance of fresh, cold air should be secured with the animal well blanketed and the limbs bandaged. COLD AND HEAT 705 distinctly noticeable in congested areas. If the application is very severe or long continued, the vessels lose their tone, become paralyzed, and we have passive congestion, inflam- mation, and finally death. Ordinarily, reaction sets in after the use of cold, more particularly if followed by heat, when an active hyperemia is substituted for the ischemia. This is brought about both by reflex stimulation of the heart by the cold, and local dila- tion of the vessels. Therefore, when we wish to constringe parts, we use moderate cold continuously ; but, by alternat- ing cold and heat we may accelerate the blood supply, and by first forcing out, and then bringing back the fluids of the tissues, we can maintain such an activity of the circulation that even solid exudations are absorbed. Cold, locally, lessens nervous irritability and pain directly, and, also, by contracting the afferent vessels, it diminishes the impact of the blood on sensitive parts. Moderate heat is said, never- theless, to produce much the same result by relaxing the capillaries of the collateral circulation, thus draining off the blood and relieving tension in the inflamed part. Tissue change is diminished, locally, by the action of cold. Sup- puration and sloughing proceed but slowly under its retard- ing influence. Acute abscess is converted into wnat might be logically termed a “cold abscess” in the most literal sense of the word. Remotely, moderate cold applied to the body for a short period actually increases general tempera- ture by stimulating reflexly the heat centres, increasing oxidation and lessening radiation from the contracted super- _ ficial vessels. If cold is in contact with the whole body for a longer time, the temperature gradually sinks and the reduction continues for some hours, when, in healthy ani- mals, the temperature rises above normal. Such effects are much more pronounced in pyrexia. The action upon the nervous system is exceedingly important therapeutically. The most powerful stimulating action is exerted upon the centres of innervation controlling the circulatory, respira- tory, digestive and excretory organs. In fever, this treatment 706 GENERAL THERAPEUTIC MEASURES invigorates the failing digestive functions, relieves the nerv- ous irritability by cooling the blood going to the great nerve centres in the medulla, and strengthens and stimulates the entire pervous organization. Cold applications and drinks stimulate the circulation reflexly, increase blood tension, and, therefore, the secretion of urine in fever, which is very im- portant for the elimination of toxins. Locally, heat and cold are often used interchangeably in medicine. In human practice it is a rule to be guided in the choice of one or the other by the desire of and effect upon the patient, and this should apply, as far as possible, in veterinary practice. Cold is employed, locally, in congestions of superficial parts, . and tends to abort inflammation and relieve pain. Tn meningitis, rubber ice bags or continual irrigation of the head and spine are used. Laryngitis may be success- fully treated by ice poultices (cracked ice and sawdust in linen bags) or by thin rubber ice bags surrounding the throat. In the same way are treated sprained tendons, capped hocks, broken knees, recent curbs, and lymphangitis. In fact, most superficial inflammatory surgical affections are benefited by cold applications. Ice and ice water are useful in checking venous or capillary hemorrhage, although hot water is often more serviceable. Cold water enemata are valuable in atonic constipation, diarrhoea, and to reduce temperature in fever. In the uterus, ice in small lumps will arrest metrorrhagia, and, in the rectum, aid in reducing prolapse. Ice bags, placed along the spine over the sym- pathetic ganglia, will cause dilatation of arterioles in regions corresponding to the point of application. MODES OF EMPLOYING COLD WATER.* Ablution is the simplest method of applying water to the surface of the body. It is merely bathing. Water at the temperature of 50° to 60° F. is applied by a rough, coarse *The writer is much indebted to the writings of Simon Baruch in connection with uses of water. COLD AND HEAT _ TOF cloth. The water is thrown on in considerable quantities, beginning with the head and going rapidly over the neck, trunk and limbs successively, rubbing the skin briskly all the while with the cloth. Two attendants are required for the application of an,ablution to the larger animals. The patient is finally dried and warmly blanketed. The process may be repeated each half hour in fever, or twice daily as a tonic measure in chronic diseases. The rationale consists in the stimulus afforded by the cold to the nervous system, accompanied by contraction and subsequent dilatation of the peripheral blood vessels, with consequent cooling of the blood and increased radiation of heat from the surface. In most hydriatic methods for reducing temperature in fever, friction of the skin should be the sine qua non, as otherwise the physical cooling of the body is confined entirely to the periphery, the contraction of the surface vessels driving the blood inward to the vital organs. The superficial muscles then act as non-conductors, and heat production being stimu- lated reflexly by the cold, an actual increase of internal temperature may obtain. It is only by securing dilatation of the superficial ves- sels by friction that the result first described can be prevented, for after the first shock the peripheral vessels dilate, an increased supply of blood is brought to the sur- face, is rapidly cooled and courses inward, only to be replaced by more over-heated blood. The internal temperature is thus lowered, and instead of an internal congestion being brought about, as may happen when the skin is simply exposed to cold, we have a constant withdrawal of heated blood from the interior. In this perpetual interchange not only does cooling of the blood and body occur, but the cir- culation is equalized and congestions are overcome. The Sheet Bath—Whole baths are impracticable for our larger patients, and the sheet bath may be substituted to advantage for antipyretic and other purposes to which the cold bath is adapted. A cloth soaked in cold water, or ice poultice, is placed on the poll to prevent determination of 708 GENERAL THERAPEUTIC MEASURES blood to the head, and a linen sheet, wet in water, of from 50° to 80° F., is placed over the animal, the surface being rubbed, while dashing on the sheet water at the temperasure of 50° to 60° F. This process is continued for fifteen ox: twenty minutes, unless rigor is induced. The method is valuable in the treatment of fever and insolation. The gen- eral rationale is the same as in the case of ablutions, but the antipyretic effect is more marked and permanent. The sheet may be covered, while wet, by blankets, and converted into ‘a wet pack. The Wet Pack is applicable for general or local use, and for various purposes. A linen sheet is dipped in water at a temperature of 50° to 70° F., and wrung out very thoroughly. A cold application is put on the head and the sheet applied and covered with dry woolen blankets. The duration of application is from one quarter to three hours, according to the object in view. If it is used as a strictly antipyretic measure, it should be changed frequently. The wet pack differs materially from other hydriatic procedures in that reaction occurs slowly, for there is no artificial stimulus in the shape of friction to accelerate it. The primary contrac- tion of the vessels is succeeded by partial dilatation of them, when the blood from the interior of the over-heated body is cooled on the surface by contact with the sheet and by vaporization of the water. Vascular contraction again occurs owing to the cooling, forcing the chilled blood inward. So there is continual interchange of cooled and heated blood, until the wet sheet has become thoroughly warmed. After the wet pack is removed, the skin should be dried and the patient well blanketed. The interchange of blood is useful in relieving conges- tion of the internal organs, in aiding nutrition by bringing to the periphery nutriment absorbed from the gastro-intes- tinal tract, and for its tonic effect on the nervous system. In fever, it abates cerebral hyperemia, delirium and excite- ment, and promotes rest and quiet. The Priessnitz Poultice* is similar to the wet pack, but a * The Priessnitz’scher umschlag (poultice) of the Germans is often defined as acold water compre-s, without waterproof covering. It must be renewed fre- quently, as it soon dries. Its effect is cooling and not as a poultice in supplying moist heat, and it does not aid phagocytosis (see page 712). a a i a ae COLD AND HEAT 709 waterproof protective is interposed between the wet blanket, sheet, sponges or cloths on the inside and outside woolen cov- erings. Evaporation is thus prevented, but not vaporization. Such an application may be used with safety in febrile dis- eases, aS pleuritis and pneumonia. If it is not renewed frequently, hyperemia of the surface occurs, and this may be beneficial in aborting or relieving internal congestion. It then acts as an ordinary poultice, and is of value in various local inflammations resulting from strains, blows and bruises; also, in laryngitis. Besides relieving internal congestion, the Priessnitz poultice stimulates absorption, removes in- duration and hastens suppuration, locally. The wet pack and Priessnitz poultice are more appropriate for practical use than the other methods in veterinary practice, since the evaporation from the hair of animals contraindicates methods suitable in human medicine. Cold Baths are only practicable for the smaller animals. Dogs may be immersed in water at 90° F., which is rapidly cooled down to 60°. The bath should last about fifteen minutes, the surface of the body being rubbed constantly. Ice water should be frequently poured over the head. After removal from the water, the patient must be thoroughly dried, wrapped in warm blankets, and a stimulant given if necessary. Such treatment may be used as an antipyretic measure if the temperature is over 103° F. in the rectum. Douches.—A. douche is a forcible impact of water against - the surface of the body. Itis not used for its antipyretic effect, but acts as a stimulant to the nervous system at large, whereby the respiratory action is deepened and strength- ened, and the circulation invigorated. The douche is given advantageously in the treatment of coma, of alcohol, chloro- form, ether or opium, applied to the head. The water may be dashed from a pail or applied by means of a garden hose or from atap. Rheumatic lameness and peripheral para- lysis are suitable cases for the douche treatment, followed by vigorous rubbing and dry bandaging. Syncope may often be quickly relieved by douching of the head and chest. 710 GENERAL THERAPEUTIC MEASURES Local Baths are good, especially in inflammatory condi- tions of the feet in horses. Tubs may be employed for the animals to stand in, the water being changed frequently or being kept cool by ice. It is not advisable to allow animals to stand in large bodies of water on account of the danger _ they incur of “catching cold” from surface evaporation, The value of the local use of water in acute laminitis is worth mentioning here. After the shoes have been re- moved the extreme pain may be alleviated by standing the horse in quite hot water, sufficient to reach up to or above the foot-locks. Good results are obtained by changing to ice water after the first day and continuing this for several days, in this way causing a contraction of the arteries, lessening the amount of blood supplied tc the part and the danger of chronic laminitis and dropped sole. If con- venient to a running stream, about the same results may be obtained by standing the animal in it. Irrigation with cold water is done in inflammatory dis- eases of the joints, tendons and feet. Running water may be permitted to flow continuously through perforated rubber tubes, connected with a tap, or used as siphons and closed at their distal extremities. The holes may be made in the tube with red-hot needles. The rubber tubes should be wound about the limb or part and held in position by band- ages. lLeiter’s expensive block tin tubes are easily bent and rendered useless by the movements of our patients. The treatment of lacerated wounds by means of a stream of water from a convenient hydrant, causes the part to granulate quickly and greatly facilitates the healing process, but care should be taken not to allow the water to run over the wound more than three or four hours at a time each day, otherwise the part will become “ water- logged” and tend to break down and slough rather than to fill in with healthy granulation tissue. Cold Drinks are both refreshing and antipyretic in action. Cool water should be placed where the patient can take it as he desires. In stomatitis, tetanus and angina, cool water COLD AND HEAT Til is distinctly grateful and comforting. In the latter two dis- eases, it should be arranged so that the animal can reach it without bending the neck. The mouth can be rinsed out continually, removing decomposing food and mucus, the thirst be slaked and heat and inflammation relieved. Cold Enemata are valuable antipyretic agencies. From five to fifteen quarts of cold water may be thrown up through a flexible rubber tube, six feet long, far into the bowel of the horse. Evaporating Solutions. — Ethyl chloride or ether spray may be applied for a short time by means of an atomizer, to induce local anesthesia of a part, through the powerful refrigeration produced in their evaporation, and is most satisfactorily empioyed in conjunction with cocaine injections. One turn of a cotton or linen bandage, or a single thickness of similar stuff, put about a part and wet continuously with cold water, forms a good evaporating medium in allaying superficial inflammation and pain. A mixture of clay, and equal parts of water, vinegar and diluted solution of lead acetate, make a cheap and efficient cooling application for external use in the treatment of bruises and sprains. The paste should be removed as quickly as it dries. Refrigerants.—Certain medicines either produce a sub- jective feeling of coolness or actually cause it, applied exter- nally. or given internally. The subjective sensation is due to some inexplicable action on the local nerve supply. Some are stimulants and astringents, and diminish the circulation in the part. Externally, acetate of lead, chloride of am- monium, nitrate of potash, and vinegar, are used most frequently as refrigerants. The mineral acids and salts of potassium and sodium, especially potassium nitrate, are administered more com- monly, internally, both for their cooling effect and to allay thirst. 712 GENERAL THERAPEUTIC MEASURES HEAT Water at a moderate degree of heat—what is termed lukewarm—. e., 86° to-95° F., applied to the body, stimu- lates the action of the skin, relaxes peripheral vessels and diminishes nervous excitability, pain and spasm in neigh- boring parts. Water at a temperature of 112° to 120° F. contracts blood vessels of underlying parts, relieving con- gestion and pain. Such a degree of heat resembles cold in its effect, and they may often be used interchangeably. Still stronger heat has much the same effect as excessive cold, only acting more quickly, causing dilatation of the vessels, pain, inflammation and destruction of tissue. The action of powerful heat on the whole body, or upon single organs, is similar to that of counter-irritants. Mild, moist heat is beneficial in the treatment of wounds in poorly vascular parts where there is a tendency to indolent granulation, as about the feet in horses. Again, in low grades of inflamma- tion with induration, as in strains of tendons, where mod- erate heat tends to stimulate the circulation and hasten absorption. In the treatment of abscess and burns, with destruction of tissue and suppuration, moist heat applied locally macerates the dead tissue, hastens sloughing and relieves pain, and in softening parts prevents the burrow- ing of pus and the formation of deep-seated pockets and sinus’s. . A modern view of poulticing is that it aids the migra- tion of leucocytes, and therefore is productive of good in assisting their phagocytic action.* The abscess can thus be more speedily formed and more quickly defined. Herein heat differs from cold. In irritable and spasmodic troubles of muscular origin in various organs, heat is distinctly reme- dial, as in pelvic and abdominal pain and colic, when employed in the form of rectal injections. Heat may, in many conditions, be used interchangeably with, or in the place of, cold, according to the preference of the practitione:, * Hot applications increase exudation, congestion, collection of leucocytes and opsinins, locally. All these results are inimical to bacterial growth. ee COLD AND HEAT 713 or the effect upon the patient. As, for instance, in the case of pneumonia, pleuritis, angina, and in checking hemorr- hage. Heat may be utilized in simply preventing the natural radiation of it from the body. Thus, simple, warm, dry blankets, applied all over the surface of the body, may abort catarrhal or rheumatic conditions by merely causing reten- tion of the body heat, dilatation of the peripheral vessels and equalization of the circulation. Covering a portion of the skin with such dense preparations as tar, pitch or collo- dion, in mild superficial inflammatory lesions, is said to produce favorable results by restraining radiation and in- creasing heat and blood supply in the part. Even thickened teudons and indurated glands may be benefited thereby. The Priessnitz poultice continuously applied has a similar action. In vasomotor paralysis, seen in collapse, following loss of blood or poisoning, and in shock due to traumatism or surgical operation, heat is eminently a life-saving means. In such conditions the loss of vascular tone and dilatation of the vessels leads to dangerous, and even fatal, cooling of the body. Heated dry blankets, or those wrung out in hot water, should be applied to the larger animals, together with hot rectal injections; while the smaller animals may be placed in baths at the temperature of 105° F., till the tem- perature becomes normal. Such treatment should be com- bined with the use of vascular and eardiae stimulants, atropine, digitalis and strychnine, and saline infusions. ‘MODES OF APPLYING HEAT. Poultices ov Cataplasms.*—Cataplasms are compositions for the local application of heat and moisture. They are made, commonly, of flaxseed meal, bran, oatmeal, bread, potatoes and carrots. One or other of these is stirred up in boiling water until a thick, pasty consistency is reached. This mass may then be applied, while very hot, directly to _.# Cataplasma Kaolini (U.S. P.) consists of kaolin, or porcelain clay, and is appilac externally as a poultice. It acts to retain the body heat and is very similar to “* Antiphlogistine,” an excellent substitute for the ordinary poultice, 714 GENERAL THERAPEUTIC MEASURES the part when we wish to produce a softening of the tissues, as in abscess or tender feet in horses, and the whole is covered by acloth. In poulticing horses’ feet, the material— usually bran and flaxseed meal, equal parts—is mixed in a pail, with boiling water, and spread on a piece of bagging (double thickness, and about two feet square), in sufficient quantity to surround and cover the entire foot. The bag- sing is then folded and tied about the pasterns, and over around the front. and sole of the foot. The whole should occasionally be immersed in water to prevent drying of the poultice. When a poultice is used merely for its continued heat, in relieving heat and congestion, the material should be enclosed in a flannel bag, in order the longer to retain and radiate its warmth. A very hot poultice acts as a counter-irritant in con- tracting blood vessels in more remote parts, besides its effect in abating pain. A warm, moist poultice causes a mild local hyperemia, softens broken down and dead tissues, and aids suppuration and sloughing. Poultices are not employed very much, except in the treatment of horses’ feet, as they are clumsy, laborious contrivances, and difficult to keep in place. If long-continued, they cause tissues to become swollen, sodden and macerated, destroying their vitality. Antiseptic poultices are made by soaking sheet cotton, gauze or other absorbent material, in: hot antiseptic solutions, as corrosive subiimate, 1-1000; creolin or lysol, 1-100. The material is very lightly wrung out, wrapped about with dry gauze, covered with oil paper, silk or rubber protective, and applied to the part with a bandage. Anti- septic poultices are useful in thé treatment of septic injuries, and when there is much pain, destruction of tissue, slough- ing and suppuration. Otherwise, poultices are decidedly contraindicated in the case of wounds, as dry antiseptic or aseptic absorbent dressings are far preferable in securing one of the cardinal requirements in the process of healing. i.e., dryness. As substitutes for ordinary poultices, we have spongio-pilene, counter-irritants, stupes and fomentations. COLD AND HEAT 715 Spongio-pilene occurs in sheets, about an inch in thickness, made of a mixture of sponge and felt, backed with a flexible covering of gutta-percha. Its main objection is the expense. It forms, when soaked in water, a cleanly and easily applied poultice for non-suppurating parts. Counter-irritation, as has been pointed out, is produced by hot poulticing as well as by drugs. A combization of the two is obtained in stupes. Stupes, Stupa.—A stupe consists of a flannel or other cloth, wrung out in plain or medicated hot water, and ap- plied to the skin. These are often covered by waterproof protection, the better to retain heat. In the veterinary art, hot blankets are often applied over the whole chest or abdo- men to relieve internal congestion and pain in pleuritis, pneumonia and colic. Turpentine stupes are more in favor with abdominal troubles. These are made by simply sprink- ling oil of turpentine over the hot blankets, or by saturating flannel cloths in turpentine and wringing them out in very hot water. To get a very active counter-irritant effect, a mustard paste may be rubbed over the chest, and then hot blankets applied. Hot Water Bags, made of rubber, and enclosing water at a temperature of 120° F., may be placed along the spine, and by stimulating the cord and sympathetic ganglia, cause sti- mulation of the vaso-constrictors in regions corresponding to the controlling areas over which the heat is applied. In this manner inflammatory conditions of the throat, chest, and abdomen are said to have been aborted, and internal hemor- rhage effectually arrested. Conversely, cold may be used over the spine to dilate distal arterioles. Fomentations are simply local baths. As technically employed, the word refers to bathing parts with plain or medicated hot water, by means of sponge or cloths. They may be used to cleanse wounds or parts of dried discharges ; they act as counter-irritants if very hot, or as mild, stimulat- ing, scothing and softening applications if warm. In order . to prvduce much effect, besides a mere detergent one, they £16 GENERAL THERAPEUTIC MEASURES. should be applied for a considerable length of time—one half hour at least—and be followed by drying and bandag- ing. Fomentations reduce swelling and pain, and hasten repair in bruises, strains and local inflammatory lesions. Injections of hot water are employed to cleanse wounds, stop bleeding and relieve pain and spasm. Injections may be thrown into the rectum or vagina at a temperature of 115° to 120° F. In the vagina, hot water may stop post- partum hemorrhage, pain and congestion in the pelvis, by producing uterine contractions, and atonic constriction of vessels in neighboring parts, which lasts for several hours following its use. Hot rectal injections (115° F.) subdue abdominal and pelvic pain or spasm, as intestinal or renal colic and spasm of the neck of the bladder. The heat per se in such injections may be invaluable in shock and collapse as noted above. The water may either be led off through a rubber tube, from a stop-cock in a pail or reservoir, placed a few feet above the patient, or else siphonage may be done off-hand through a bit of small-sized hose. Having hung a pail filled with water three or four feet above the patient, the hose is filled with water, and, closing the ends to keep it full, the upper part is put in the pail, while the lower, smooth and greased, is passed into the rectum or vagina; or water may be poured through a large tin funnel into the upper end of the tube. The ordinary fountain syringe is the best appa- ratus for smaller animals. Dry Heat may be applied by means of hot blanket, hot water bags, hot salt or sand in cloth bags, a flatiron or hot, wet cloths between waterproof coverings. Dry heat is often preferable to moist heat for simply relieving pain and con- gestion, as animals are less apt to become chilled by drafts and evaporation from the surface afterwards. It is gener- ally more difficult to obtain, however. Inhalations of plain or medicated steam are given for their local effect on the mucous membranes of the upper air passages. The moist heat has a socthing action on the OO a a ee COLD AND HEAT ; ay nerves, and tends to loosen dry exudations. Agents may be incorporated in the inhalation having a sedative, stimulating or antiseptic action. (Vid. “Agents Acting on the Respiratory Organs,” pp. 47, 48.) The technique consists in placing a bucket containing a boiling mash under the horse’s nose, or in pouring cool water over a heated brick or iron in the bottom of a pail. The practice of tying a bag over a horse’s head, and steam- ing him therein, is bad, if the animal is suffering from respiratory troubles, as insufficient pure air is obtainable. A dog may be placed on the seat cf a cane bottomed chair, and covered loosely with a sheet over the whole, the steam being generated in a vessel beneath. Hot Baths at a temperature of 98° to 110° F. are imprac- ticable for larger animals. They can be given to the smaller animals in collapse, shock, rheumatism, and to abort cold after exposure. Glowing heatis applied by means of heated metal, and is treated under the section on counter-irri- tation. ACTION OF HEAT CONTRASTED WITH THAT OF COLD. The action of intense heat or cold on animal tissue is very similar in effect, producing vasomotor paralysis, con- gestion, inflammation, destruction of tissue and death. Even the sensations to which they give rise resemble each other so closely, that the coolies on first handling ice said they could not hold it because it burned their fingers. Strong heat (115° to 120° F.) contracts blood vessels in underlying parts and overcomes pain and congestion. Heat of this degree approaches cold in similarity of action. A moderate degree of heat dilates vessels, while cold of like intensity contracts them. Moderate heat relieves pain by relaxing tissue, diminishes vascular tension by dilating efferent ves- sels of the collateral circulation, and draining off blood from the congested areas. Moderate cold, on the other hand, accomplishes a similar result in benumbing nervous sensa- tion and lessening the impact of blood in the painful region 718 GENERAL THERAPEUTIC MEASURES by constringing the afferent vessels. Tissue change is increased by moderate heat, but decreased by cold applied locally, or generally in fever. Swelling of tissue is reduced by cold directly ; only indirectly by heat, which may, indeed, increase it. Softening and sloughing of parts, suppuration and “ripening” of abscesses and “ cleaning off” of wounds, are facilitated by moderate heat, but hindered by cold. . Disinfectants, Antiseptics and Deodorants. Disinfectants, or germicides, are agents which destroy the micro-organisms, causing infectious and contagious dis- eases, fermentation and putrefaction. Antiseptics are agents which prevent the growth and development of the micro- organisms, occasioning fermentation, putrefaction and dis- ease; more especially the micrococci producing suppuration. Deodorizers, or deodorants, are agents which destroy or counteract a foul odor. They are not necessarily anti- septic or disinfectants. Considerable confusion exists in relation to the terms disinfectant and antiseptic, because the latter is often described as an agent which inhibits the growth, or destroys the life of the micro-organisms of fer- mentation, putrefaction, and disease. This definition makes antiseptics synonymous with disinfectants. The distinction exists, however, according to common usage, that while dis- infectants may, in dilution, act as antiseptics, antiseptics are not often disinfectants, and in the nature of things are not strong enough to kill germs, although they may hinder their growth. Antiseptics may then be regarded as a subdivision of disinfectants. The two terms are unnecessary and mis- leading, as either might embrace both interference with the growth and destruction of micro-organisms. Disinfection may fall short of sterilization; 7. e, death of all germs. Boiling a fluid containing micro-organisms wholly kills them; but, while disinfectants may destroy the germs of disease, they often fail to kill more resistant and harmless organisms, as the spores of B. subtilis. a DISINFECTANTS, ANTISEPTICS AND DEODORANTS . 719 A discrimination between disinfectants and _anti- septics may be made in relation to their connec- ticn with the body. Those agents employed to kill germs, in matter distinct from the living body, are disinfectants ; while those agents applied on the surface, or introduced within the body, may be classed as antiseptics, since they can rarely be used in such strength as to kill all micro-organisms without injuring or killing their host. DISINFECTANTS AND DISINFECTION. Air, sunlight, heat and water are naturally the best dis- infectants. Air scatters and dilutes micro-organisms, making them pathologically inactive. There is no more effective way to disinfect a stable, in which animals are living, than by free ventilation with pure air. It is well known that ani- mals are less liable to contract infections diseases in the comparatively pure air of the country than in closely crowded and ill-ventilated city buildings. Likewise, the contagious diseases of children mostly occur in winter, when they are herded together in schools and in poorly ventilated dwellings. To attempt to disinfect the air surrounding a patient is the height of absurdity. The generation of chiorine and sulphurous acid gases for this purpose, although recom- mended in text books, is futile, and by irritating the respira- tory mucous membrane, accomplishes more harm than good, since a congested surface offers a more suitable field for bacterial growth. Air, on the other hand, may be a medium of infection when contaminated with dust containing patho- genic bacteria (B. tuberculosis). Sunlight is prejudicial to the vitality of bacteria. Whereas, the bacilli of tubercu- losis will live almost indefinitely in dark, damp places, they quickly succumb to sunlight and dry air. Sunlight and pure air are, then, imperative for both the immediate and pre- ventive treatment of germ diseases. Heat is the most 720 GENERAL THERAPEUTIC MEASURES powerful ageney for disinfection at our command. Dry heat, to be efficacious, must be applied at a temperature of 140° C. (284° F.) for three hours to kill all bacteria and spores; but this degree of heat scorches most fabrics and destroys many materials. Boiling water quickly kills all non-spore-bearing pathogenic bacteria, and these include most of the organisms causing the common contagious and infectious diseases (tuberculosis and anthrax excepted). Two hours of continuous boiling will not destroy the most resistant of micro-organisms—the spores of the hay ba- cillus—but moist or saturated steam, at 230° F., will infallibly kill any spores whatsoever within a few minutes. Fire is the most complete disinfectant, because it not only destroys germs, but their food and products. Water, like air, dilutes germs and aids oxidation and destruction of organic matter ; but, again like air, drinking water may be the source of in- fection when sufficiently contaminated. MECHANICAL MEANS OF PROCURING ASEPSIS. The placing of sole reliance upon chemical agents for surgical antisepsis, in relation to the body, is a common error. These agents may damage denuded tissue, and do not reach the micro-organism buried in the tissues. Therefore, it is impossible to render infected, living tissue absolutely aseptic, or sterile, by merely bathing it with chemical solu- tions. Far more efficacious is mechanical cleansing of the skin with soap, water and the scrubbing brush, and even of infected raw surfaces with gauze and corrosive sublimate solution,* supplemented, if necessary, by the knife, caustic and drainage, to remove necrosed tissue and septic material. CHEMICAL AGENTS. Mercuric bichloride, carbolic acid, quicklime, chlori- nated lime, sulphurous acid, and chlorine, are more fre- quently employed as disinfectants. Corrosive sublimate — * Harrington’s solution, see p. 216. ——— DISINFECTANTS, ANTISEPTICS AND DEODORANTS 721 solutions are decomposed by keeping, and by contact with albumin and ammonia. Acids, or common salt, added to bichloride solutions prevent, in a measure, this decomposi- tion; but, nevertheless, mercuric bichloride is rendered unfit for the disinfection of masses of decomposing albuminous matter, as manure. One of the best solutions, employed by the Paris Disinfection Service, is composed of corrosive sublimate, 2 grammes; tartaric acid, 4 grammes; and water, 1 litre (1-500), colored with 5 drops of a 5 per cent. solution of indigo carminate. An English solution, in common use, consists of corrosive sublimate, 1 ounce; hydrochloric acid, 2 ounces, and water to make 3 gallons (1-768). The usual strength of corrosive stblimate solutions, for disinfection, varies from 1-500 to 1-1000. These solutions are suitable for articles made wholly, or in part, of leather, rubber and fur; for blankets, cotton and woolen fabrics, and for floors, walls, and wood work of stables. Surgical instruments, and other metallic implements and fixtures, are injured by corro- sive sublimate solutions. Carbclic acid is more expensive than corrosive sublimate, and less efficient in cases where the latter is applicable. Carbolic acid can, however, be used to disinfect albuminous material and metallic substances. It is employed on animal excreta in 5 per cent. aqueous solution (about 8 ounces to the gallon of hot water). This solution will cause the hands to dry, crack and fissure if they are immersed in it for any length of time. Chlorinated lime and quicklime are good disinfectant agents to mix with animal evacuations. In fact, bleaching powder is probably the best and cheapest disinfectant we possess for use in privies, drains, sinks, cesspools, and sewers, and for the destruction of micro-organisms on floors, and in feces and urine. A few pounds of this preparation may be thrown into privies or cesspools once a week, and the pure compound, or a saturated solution, may be scattered over floors or mixed with manure. A 1 per cent. solution is used to dis- infect harness, which should be washed and greased directly 722 GENERAL THERAPEUTIC MEASURES afterwards. Stagnant and putrid water may be rendered drinkable, after some hours, by the addition of 1 to 2 ounces to each 65 gallons of water. Chlorinated lime is a powerful deodorant as well as disinfectant, but is of no value in either capacity unless the compound contains so much chlorine gas that the face cannot be held near it without the production of great irritation to the eyes. Bleaching powder should be placed upon decomposing animal bodies, and sheets wet with a saturated solution should be wrapped about the car- casses of animals dead from contagious diseases, to prevent infection during transportation. Disinfection by sulphurous acid and chlorine gas is done to destroy germs which cannot be reached by other metheds. Three pounds of sulphur and two ounces of turpentine or alcohol (to afford moisture and aid combustion) are needful for every 1000 cubic feet of air space. Sulphur is generally burned in an iron vessel placed on sand, or floating in a tub of water. If the building is sufficiently tight to insure proper disinfection, it is difficult to secure combustion of the proper amount of sulphur. To obviate this, the sulphur may be saturated with turpentine, ignited and placed in an iron kettle on a tripod over an alco- hol lamp. Chlorine is disengaged from chlorinated lime, to which is added crude muriatic acid, one pound of former to three of latter for every 5,000 cubic feet of air space. Buildings must be tightly sealed and made completely irre- spirable for animals during the space of three hours. Sul- phurons acid disinfection is not of much value, and has been discarded by most health authorities both here and abroad. It certainly will not kill the spores of anthrax and tuberculosis, and should never be allowed ‘to teplace thorough mechanical cleansing and disinfection with other chemical agents, but may be utilized as an additional safeguard. Chlorine gas is more reliable. Formaldehyde is now being employed by most boards of health for general disinfectant purposes, and it appears to be the best means of gaseous disinfection. (See p. 338.) DISINFECTANTS, ANTISEPTICS AND DEODORANTS 723 ANTISEPTICS. It is perhaps well to consider here the sources of infection and the natural defenses or immunity possessed by animals against parasitic invasion. Pathogenic micro- organisms are commonly brought in contact with the body through the agency of the air, drinking water and food, and insects (flies and mosquitoes), and gain entrance by means of the air passages, digestive canal and blood ; but even in the two former cases, the micro-organisms are in a certain sense outside of the body, since it is not easy for them to penetrate the intact and healthy ciliated mucous membrane of the re- spiratory tract. But when the mucous membrane is damaged by inflammation, and the ciliz becomes paralyzed, and abnormal secretions are formed, then a favorable opportunity is offered for their growth and entrance into the circulation. In the digestive tract the hydrochloric acid of the gastric — juice and bile* act as natural antiseptics, while the liver is thought to destroy toxins resulting from bacterial life. When digestion is in a normal condition, putrefaction and fermentation do not occur; but when its activity is diminished, and the secretion of the digestive juices is Jessened, and the hepatic functions are depressed, then a chance is offered for bacterial growth, fermentation and absorption of toxins, or even actual transmigration of micro-organisms through the intestinal walls. To these natural agencies of defense, which may be likened to out- lying pickets shielding the animal from bacterial invasion, we must add the intrinsic power of resistance vested in the tis- sues, blood serum (opsinins) and leucocytes in combating mi- -cro-organisms ; and the production of antitoxins in the body, antagonizing the toxins formed by bacterial action. Micro- organisms are always to be found on the surface of the body and within its natural cavities open to the air, but patho- * Recent experiments in human patients show that many forms of pathogenic bacteria may live in bile. It is but moderately bactericidal. 724 GENERAL THERAPEUTIC MEASURES 2 genic bacteria are less likely to do harm if the animal is in a healthy condition. A limited number of bacteria (micro- cocci) may even exist within the blood in health, and this fact accounts for suppuration occurring when the tissues are severely injured, without solution of continuity. The internal use of antiseptics is of comparatively little value, except when these agents come in direct contact with germs in the digestive tract. This follows because it 1s impossible to administer antiseptics in suthcient amount to seriously interfere with bacterial growth in the tissues, without imjur- ing or even killing the patient. There is certainly known but a single instance (malaria) where the exhibition of an antiseptic will inhibit the develop- ment of micro-organisms of a general infectious disease, and so absolutely arrest it. It is very possible, however, that mereury as a specific remedy in syphilis, salicylates in rheu- matism, and carbolic acid in tetanus, act therapeutically as internal antiseptics. Antiseptics are of benefit in rendering the contents of the digestive tube more or less aseptic, and (after absorption) they exert some antiseptic action on the mucous membrane of the respiratory tract (volatile oils), and also on the urinary tract (urotropin), during their elimination. The principal agents used as antiseptics for surgical purposes are: corrosive sublimate, earbolic acid, creolin, lysol, hydrogen dioxide, potassitim’ permanganate, zine chloride, iodoform, salicylic acid, aristol, iodol, and boric acid. Those employed internally inelide naphtol, salol, creolin, carbolic acid, bismuth salicylate and subnitrate, quinine, salicylic acid, and many others. For a more de- tailed description the reader is referred to special articles on these agents in the preceding pages. DEODORIZERS OR DEODORANTS. Deodorants are not of any practical value in simply exchanging one odor for another, but, as in the ease of chlorine, they sometimes actually destroy compounds which give rise to the stench. Sewer and other malodorous gases, resulting from foul decomposing matter and excreta, may be DISINFECTANTS, ANTISEPTICS AND DEODORANTS 725 freer from bacteria than ordinary air, and are not usually the carriers of micro-organisms, nor the cause of specific infectious diseases. These gases do, however, occasion in- definite symptoms of ill-health. Deodorizers, which are also disinfectants, are of service in destroying noxious emanations and their source; but, to accomplish this, it is necessary that they come into direct contact with putrefying material, and should not be placed about the habitations of man or animals, with the ridiculous idea that they are achieving more than the production of a vile odor. PRACTICAL DISINFECTION. The premises occupied by animals suffering from con- tagious diseases, together with all articles contained therein, such as harness, blankets, stable implements, and evacua- tions, must be disinfected after the removal of all animals and isolation of the sick. The excreta should be mixed with milk of lime (1 part of freshly slacked quicklime, with 2 parts, by volume, of water), or with pure chlorinated lime. The floors and walls must be scraped and washed. Boiling water should then be poured over every available part of the premises, and these brushed with a saturated solution of chlorinated lime.* Clothing may be treated by boiling in water, or by soaking in a solution of corrosive sublimate (1-500), or carbolic acid (1-20), for twelve hours. Harness is disinfected by washing with soap and water, and then with a 2 per cent. crude carbolic¢ acid or ereolin, or 1-1000 corrosive solution. Valueless articles are given to the flames. Stable and metallic instruments and fixtures are to be freed from dirt, scrubbed with soap and hot water, drenched with boiling water, and then with a 5 per cent. crude carbolic acid or creolin solution. Gaseous disinfection is now in order to kill micro- organisms in remote and inaccessible places. Live steam is the most efficient means at our disposal for this pur- pose, when a suitable apparatus for its application to * Or all available parts of infected stables should be saturated with one of the following solutions by means of a small hand force-pump, or brush: 5 per cent. formalin, 1 to 500 corrosive sublimate, or 5 per cent. carbolie acid. 726 GENERAL THERAPEUTIC MEASURES woodwork, haymows, etc., is obtainable. In place. of this we may resort to formaldehyde, chlorine or sulphurous acid gas. The walls are finally painted or covered with white- wash containing 2 per cent. of crude carbolic acid. Healthy animals, which have not been exposed to infection, may now be allowed to return to their disinfected quarters. SURGICAL ANTISEPSIS AND ASEPSIS. It may be fitting, and not out of place, to briefly outline here the use of antiseptics and asepsis in veterinary surgery. Since the days when Lister introduced antisepsis, surgery has advanced in a manner which appears, however, like retrogression. It is now conceded that asepsis can be attained more satisfactorily and safely without the general use of antiseptics. For antiseptics, as has been noted, inflict a certain amount of damage upon denuded surfaces, and, in so far, lessen the resistance of the body to the inroads of bacteria. Modern surgery attempts to secure a comparative asepsis by mechanical cleanliness, which is more efficient, simpler, and harmless to the body. Antisep- tics are indicated to assist asepsis in the toilet of the unbroken skin, and when sepsis has already occurred, or is unavoidable. The gross neglect of aseptic precautions, often . seen in the operations of veterinary surgery, would be con- sidered criminal practice in human surgery. Asepsis is, nevertheless, very difficult to secure in the lower animals living among filthy surroundings and lying on fecal discharges. In addition to these disadvantages, the trouble of controlling animal-movements during operation, and of keeping dressings in place, make the attainment of asepsis embarrassing and frequently impossible. The more common administration of anesthetics would facilitate asepsis by preventing movements of the patient and contact of the operative field with dirt. But there are all degrees of infection, and while, with the best methods of securing cleanliness at our command, it is impossible to completely sterilize normal skin and DISINFECTANTS, ANTISEPTICS AND DEODORANTS 727 tissues, yet the surgical result may be perfect. Therefore, in surgical operations, we should endeavor to procure as small an amount of infection, or dosage of micro-organ- isms, as possible, consistent with existing environment and conditions. The following aseptic technique is especially applicable in the case of any surgical operation undertaken upon a non- infected part. If it is possible to carry out all the details, and the result is successful, healing will take place without suppuration. Operations upon suppurating and infected areas should be conducted with cleanliness, and antiseptics are more de- sirable, particularly hydrogen dioxide in full strength, after thorough cleansing with normal salt solution. To prepare the surface of the body for operations, the hair is first clipped and shaved, the skin is thoroughly scrubbed with a brush, green soap and water for five minutes, and then with 70 per cent. alcohol. After the skin is incised there is no further necessity for antiseptics unless the wound is already infected, or becomes so by exposure to impure air or contact with dirt. The hands of the operator, including the finger nails, should be brushed until clean with green soap and water, and then with 70 per cent. alcohol. It is well for all participating in an operation to wear thin rubber surgical gloves after thorough hand-disin- fection—in pus cases, to prevent contamination of the hands; in clean cases, to avoid infection of the wound from the hands. If gloves are not worn in operating upon clean cases, they are all the more useful in dressing or operating upon pus cases to avoid contamination of the hands which later might give rise to wound infection when the naked hands come in contact with a clean wound. Instruments are thoroughly scrubbed with soap and water, and boiled for ten minutes in an aqueous solution of sodium bicarbonate (1 teaspoonful to the quart), and then placed in a solution of carbolic acid (1-40), or removed to a sterile towel. New sponges only should be employed, which have been previ- 728 GENERAL THERAPEUTIC MEASURES ously cleansed, and then soaked in carbolie acid (1-40) solution, or pieces of sterile gauze may be used. If irrigation is desirable, normal salt solution (1 heaping teaspoonful to the quart of sterile water) is appropriate. Nothing else but this is allowable within the non-infected abdominal cavity.* Sutures of silk, and needles, are pre- pared by boiling in water for thirty minutes. The area about the operative field is to be surrounded with cloths, or towels, which have been boiled or baked, and instruments and sponges may be laid on these. 4 Dressings may consist of gauzet which has been exposed for three hours to dry heat at 140° C. (284° F.), or placed in an oven of an ordinary cooking stove, in closed tin cans, until it becomes scorched and slightly brown. The same gauze may be used for sponges. Unsterilized articles are not to be suffered to come in contact with the operator, or wound, during the operation. _ Wound infection from exposure to the air and other media, is prevented by immediate dressing and bandaging, or by collodion applications. ° Venesection. Venesection, or blood-letting, formerly abused, has, for that reason, fallen into almost complete disuse. ‘This is un- fortunate, since blood-letting is a valuable and often life- saving measure. The indications for venesection are chiefly limited to conditions associated with a general high arterial pressure and local engorgement of some organ. In such cases venesection very rapidly reduces general blood-tension to a point lower than that existing in the engorged region, so that congestion is relieved. A full, in- compressible pulse is said to indicate the desirability of *It may be noted here that the peritoneum of the horse is so extremely delicate and liable to infection, as compared to that of man and dogs, that most abdominal operations are practically contraindi- cated in the case of this animal. + Sterile gauze is now sold by all druggists. VENESECTION 729 venesection in severe acute disorders—in accordance with the above—but this is not by any means invariably the fact, as will be shown. Venesection leads to a reduction of temperature, and vascular tension is lowered for from 3 to 48 hours, accord- ing to the quantity of blood withdrawn, but the blood vessels quickly adjust themselves to the smaller mass of blood, and the original quantity of this vital fluid is soon restored (24 to 48 hours) through absorption from the tissues and ali- mentary canal. The heart beats more rapidly, owing to the lessened resistance in the vessels, and venesection is accom- panied by nausea and prostration. The blood is less dense and more fluid after blood- letting, and for this reason, if inflammatory processes follow, exudation is more apt to ensue. The fibrin is first regained, then the normal number of white, and finally that of red corpuscles, in from one to five weeks. Circulatory depress- ants—as veratrum viride—accomplish much the same results as blood-letting, by causing general reduction of vascular tension and relief from local congestion, thus “bleeding an animal into its own veins”’ without loss of blood, it is true, but with less rapid and certain effect. Cathartics, diuretics and diarphoretics also lower blood pressure by abstraction of fluid from the vessels, but their action is slow. The following disorders are those most suitable for treatment by venesection when they exist in an alarming form in robust animals : Cerebral congestion. In insolation | gthenic pneumonia. and tympanitis. Sthenic pleuritis. Apoplexy, particularly parturient | [yticaria. apoplexy of cows. Lymphangitis. Encephalitis. Hemoglobinemia. Acute cerebral meningitis. Bacterial, Active pulmonary congestion and | Toxzmia-~ Mineral, apoplexy. | Vegetable. Passive pulmonary congestion in (Followed by saline infusion. ) cardiac disease. Venesection from the jugular in cerebral congestion is, 730 GENERAL THERAPEUTIC MEASURES in fact, a species of local blood-letting by directly draining blood away from the brain; and it preserves life by pre- venting pressure on, and paralysis of, the great vital medul- lary centres controlling the respiration and heart. Moderate blood-letting is sometimes advisable in the early stages of severe inflammatory attacks of the brain or its mem- branes. In cerebral congestion, and dyspnoea due to gastric tympany and pressure on the diaphragm, bleeding may give relief. Blood-letting is particularly applicable in the treat- ment of parturient apoplexy of cows, and, when the disease has once occurred, it may be employed as a prophylactic measure in plethoric animals immediately before parturition, Venesection alleviates dangerous pulmonary congestion, removes the venous load on the right heart, and relieves dyspnoea and cyanosis by making it possible for the heart to force a smaller quantity of blood through the less obstructed lungs. A feeble and easily compressible pulse does not neces- sarily contraindicate venesection in engorgement of the lungs, for this condition leads to stasis in the pulmonary circulation, prevents the proper flow of blood into the left ventricle, and thus causes arterial anemia. Therefore, so far from contraindicating blood-letting, this condition urg- ently demands it. Alarming dyspnoea, great cyanosis, together with a general plethoric state, should guide us in blood-letting in sthenic pneumonia and pulmonary conges- tion, rather than the state of the pulse. Venesection is serviceable in advanced cases of cardiac disease in dogs— with failing compensation, venous engorgement of the lungs, and dyspnoea—by relieving the obstruction to the right heart. Moderate blood-letting is occasionally useful in severe cases of acute pleuritis, laminitis, lymphangitis and urticaria in plethoric horses. Finally, in various toxzemias, blood-letting drains away both the blood and its contained poison. The mass of blood removed may be advantageously replaced by injection —_— = — VENESECTION 731 of normal salt solution into a vein or under the skin. This method is not in prevalent use in veterinary medicine, but is applied wtth notable success in human practice. Every veterinary practitioner should be competent to bleed an animal. An amount greater than 4 of the total quantity of blood should not be withdrawn. The total quantity of blood is-equal to about 13.5 per cent. of the body weight in horses ; to 2.2 per cent. of the body weight of fat swine; to 6.6 per cent. of the body weight in dogs, and to 7.7 per cent. of the body weight in man. Large horses or cattle may be bled to the extent of from 4 to 6 qts.; smaller subjects, 2 to 4 qts. ; sheep, } to 1 pt.; dogs, 4 oz. to 1 pt. Blood-letting is generally done to animals in the upright position by shaving the hair and cleansing the skin over the jugular vein in the upper part of the neck. The vein is made prominent by pressure below the site of operation, and a fleam, or knife carefully guarded, is plunged into the vein, making a good cleanincision. The blood should be quickly withdrawn and carefully measured and the effect on the pulse noted, and the blood-letting maintained until there is noticeable reduction in the vascular tension and other symptoms, for the relief of which venesection is employed. The bleeding is arrested by suturing the lips of the wound and by pressure with a bandage. Local Blood-letting, or Scarification, is often useful in relieving tension and pain in locally congested or inflamed tissues, and may even avert death of the part. Further- more, stasis is removed and exudation from the engorged vessels may be prevented, while a fresh supply of arterial blood flows in to reinstate the vital processes. Scarification is practiced by making numerous small, parallel incisions into the skin, fascia or other tissues in the long axis of a limb or part. In inflammation of the perios- teum it is necessary to puncture this membrane. Bleeding is facilitated by warm poulticing, and is arrested by packing the incisions with sterile gauze. 132 GENERAL THERAPEUTIC MEASURES INDICATIONS. Lampas. Mastitis. Glossitis. Laminitis. Periostitis. (To secure blood for miscroscopic Cellulitis. examination. ) Conjunctivitis. Sometimes the veins leading from an inflamed area are opened, thus securing local abstraction of blood; e. g., the digital veins in laminitis; the milk veins in mammitis. Searification, or puncture, is indicated in the above- mentioned conditions whenever there is great swelling, pain and tension in the affected parts, and not otherwise. Transfusion. Transfusion is the transfer, directly or indirectly, of blood from one living animal to another. In this process the blood must be obtained from an animal of the same species as the patient,* but even then disintegration of the blood corpuscles follows, resulting in nephritis from the extra work put upon the kidneys in their effort to eliminate the destruction-products of the transfused blood. Embol- ism and sepsis are added dangers even when the blood ig defibrinated, after removal from the body of the host, and only the serum is injected into the patient. The injection of warm, normal salt solution(.6 of 1 per cent.) has been found to fill all the indieations for trans- fusion of blood, and yet is free from the dangers and diffi- culties besetting the latter. Saline Infusion. Saline infusions are intended to replace the normal blood plasma, and, therefore, should contain approximately the amount of sodium chloride—.6 of 1 per cent.—contained in this fluid. The solutions should be filtered and’ boiled previous to their use, when this is possible, and are made *Crile, of Cleveland, has very recently (1907), in 225 experiments upon animals, shown the great superiority and feasibility of blood transfusion over saline infusion in hemorrhage. “The hitherto existing dangers are eliminated by bringing the intima of the artery of the donor in direct contact with that of the vein of the recipient, so the blood will not touch any foreign body. This is accomplished by a special device (Annals of Surgery, Sept. 1907). TRANSFUSION 733 by adding a heaping teaspoonful of sodium chloride to the ouart of sterile water, which is used at a temperature of usually 103° to 115° F., according to the mode of introdue- tion and circumstances.* Simple distilled and ordinary water are noxious to the tissues, while salt solution is entirely innocuous unless it contains three times the quantity of sodium chloride nor- mally present in the blood. Mode of Introduction.—Saline infusions are introduced within the body (1) by intravenous injection; (2) by injec- tion into muscular tissue (hypodermoclysis) ; and (3) by rectal injection (enteroclysis). Jutravenous injection is the most rapid and certain method, but not so simple and practicable as hypodermo- elysis. Aay superficial vein which can be readily seen and isolated, may be utilized; preferably the jugular or internal saphena vein in animals; the median basilic, or cephalic, at the bend of the elbow in man. The apparatus consists of a glass funnel or rubber bag connected by four or more feet of rubber tubing, with a canula or curved piece of glass tubing 4 inches long and } inch in diameter for horses; } inch in diameter for dogs. The apparatus should be boiled immediately before using. The vein is made prominent by manual pressure exerted by * The true proportion of sodium chloride in blood plasma of mam- mals is .8 per cent., or 123 grains to the quart. 0.6 of 1 per cent. of sodium chloride is not really ‘‘ normal’ for mammals, but was deduced from that found in the plasma of frogs. The injection of a too dilute saline solution will cause the red blood cells to swell and part with their hemoglobin and will lead to great sweating and diuresis in the effort of nature to restore the plasma to its proper composition. A more exact solution for saline infusion consists of : Sodium chloride, .8 per cent.; potassium chloride, .08 per cent.; calcium chloride, .02 per cent.; water, 100. In emergencies, ordinary table salt (which contains a slight amount of calcium chloride, causing its deliquescence), in the proportion of 123 grains to the quart or a level teaspoonful to pint of sterile water, may be employed for intravenous infusion or hypoder- moclysis. 734 GENERAL THERAPEUTIC MEASURES an assistant, or by a bandage, applied proximally to the seat of operation. The hair is shaved from the part, which is cleansed, and an incision 13 to 2} inches long is made by lifting a fold of the skin directly over the vein and snip- ping off the top of the fold with scissors parallel to its long axis. The sheath of the vein is exposed, raised by dissecting forceps, and divided. The vein is then lifted from its bed with an aneurism needle, and two silk or catgut liga- tures are drawn under it about an inch apart. The vein is now incised longitudinally, and, as the blood begins to spurt out, the distal ligature is tied about the vessel. The canula | is next passed into the incision in the vein toward the heart and the proximal ligature is tied, with the first part of a surgeon’s knot, about the vein and canula, holding the latter in place and preventing leaking of the salt solution from the vessel. When the injection is completed, the tube is with- drawn and the proximal suture is tied on the heart side of the incision, and thus the vessel is occluded on either side of the seat of operation. The apparatus is filled with salt solution—including the funnel, tubing, and canula—at a temperature of 103° to 110° F. before its introduction into the vein,and the funnel should be kept full during its use to prevent the entrance of air into the vessel. Any pressure, previously employed between the incision and the heart, should of course be removed before beginning the injection. A little clean absorbent cotton may be placed at the bottom of the funnel before the salt solution is poured into it, if the solution has not been previously filtered. In using the ap- paratus the funnel is raised about two feet above the vein. The quantity of salt solution to be injected will vary from a few ounces to two pints in the case of dogs; from one to many quarts for horses. Enormous quantities of normal salt solution may be introduced into the blood without harm, even an amount equal to four times that of the blood, providing the inflow is not too rapid; 7. e., exceeding one fluid drachm to the pound of live weight in fifteen minutes. When this amount is exceeded the heart and kidneys cannot HYPODERMOCLYSIS . 735 take care of the great quantity of fluid in the vessels and tissues. A return to the normal volume, force, and rate of the pulse, and of color to the mucous membranes, will lead us to stop the saline infusion. The use of intravenous saline injections is frequently followed by a reaction within half an hour, characterized by a severe rigor, succeeded by sweat- ing, labored breathing, a strong pulse and increased urinary secretion. Hypodermoclysis. Injection of warm (103° to 105° F.) normal salt solution into the muscular tissue of the neck, abdomen or flank, is done aseptically with the same apparatus employed for in- travenous saline infusions, using a large hollow needle to thrust under the skin directly into the muscular tissue, instead of the glass tube for intravenous injection; or a fountain syringe filled with saline solution and attached to a sterile aspirating needle may be used; or a reversed aspirator apparatus may be utilized: «e., by filling the jar with salt solution and forcing the air into the jar, thus displacing the fluid. The fountain syringe is the best apparatus. Hypodermoclysis may be employed in the same cases as intravenous infusion, and is a better method on account of its simplicity. We are guided as to the quantity of solution desirable by the same indica- tions noted above as referring to intravenous saline injec- tions. Hypodermoclysis may be done in several places, and absorption is assisted by massage. Salt solutions are injected under the udder in females, and are occasionally thrown into the peritoneal cavity, particularly after opera- tions in this region, before closing the abdominal walls. 736 GENERAL THERAPEUTIC MEASURES Enteroclysis. Enteroclysis applies to slow, rectal injection of normal salt solution (105° to 120° F.) to secure absorption. This. method may be applied in cases not so urgent as to demand intravenous saline infusion or hypodermoclysis, more espe- cially moderate degrees of hemorrhage, shock, collapse and circulatory depression, when the intrinsic heat of the injec- tion is valuable in restoring the normal bodily temperature. USES. INDICATIONS FOR SALINE INFUSIONS. Grave hemorrhage. Bacterial. Shock, traumatic, operative, and | Toxeemia <~ Mineral. electric. Vegetable. Suppression of urine. In threatened death from any Severe diarrhoea. accidental cause. Eclampsia. In any disease with feeble heart Purpura hemorrhagica. and low vascular tension. Hemoglobinemia. Hypodermoclysis, or the intravenous injection of saline infusions, find their greatest usefulness as life-saving meas- ures in severe hemorrhage. While these methods are not in vogue in veterinary practice, they have become recognized procedures of great practical value in human medicine. The indications, following hemorrhage, are to fill up the vessels and to restore vascular tension, since danger is imminent, not from loss of blood corpuscles, but from lack of a cireu- lating medium. There is a sufficient number of red cor- puscles to carry on the respiratory and oxygen-bearing functions even after the greatest loss of blood possible from ordinary causes. In fact, respiration is but slightly im- paired in human subjects suffering from pernicious anemia, when there is a 90 per cent. reduction in the normal number of red corpuscles, «nd two-thirds of the blood may be with- drawn from animals and replaced with normal salt solutions without serious damage resulting. In shock there is general *Since writing the above, favorable reports of the use of saline infusions have been accumulating. Thus G. W. Dunphy (Amer. Vet. Review, June, 1905) writes that he treated two cases of purpura hemorrhagicain the horse by: injection of 6 liters of normal salt solution (see p. 733) following the removal of 5 liters of blood trom the jugular (by means of a trocar and canula), and, at the end of twenty-four hour s, “bled 2 more liters and injected 3 more liters of salt solution with very happy results. “He also demonstrates the wonderful life-saving in fluence of intravenous saline infusion after the loss (by a horse) of 25 liters of blood. KUNSEL’S TREATMENT tol vasomotor paralysis, so that most of the blood collects in the abdominal veins, while the ventricles and arteries are emptied. In this condition saline infusions (105° to 110° F.) are of infinite value, because absorption of drugs from the digestive canal and subcutaneous tissue is impaired. Saline infusions greatly dilute the blood—and, therefore, poisons in the blood—in toxemia, while they increase the activity of the kidneys and elimination of toxins. The intrinsic heat of the injections is thought to stimulate antitoxin formation, and the restoration of vascular tension is believed to assist the natural bodily resistance of the patient. A great variety of disorders have been treated success- fully in human medicine with saline infusions, on this basis, including: septicaemia, pneumonia, uremia, diabetic coma, purpura hemorrhagica, tetanus, ulcerative endocarditis, pyelitis ; acute alcohol, ether, chloroform, carbonic monoxide, arsenic and mushroom poisoning; and toxemias resulting from acute infectious disorders. The same treatment might be applied to hemoglobinzmia and other toxeemias peculiar to the domestic animals. Venesection for the purpose of removing the poisoned blood should, in most cases, be resorted to prior to practising saline injection in the toxeemias. Excluding shock and hemorrhage, where heat is invaluable, saline infusions are generally given at the temperature of 103° F. by the rectum, under the skin, or into a vein. Kunsel’s Treatment for Milk Fever in Cows. This special form of treatment merits the attention of the veterinary profession because of the remarkably suc- cessful results which have been almost universally secured in the case of milk fever, which is not only a very common disease, but one which has hitherto baffled the best thera- peutic attempts of the veterinarian. Following the Schmidt treatment with his intramammary injections of potassium iodide—which was productive of great diminution of the mortality of milk fever, but was often followed by local 738 GENERAL THERAPEUTIC MEASURES injury to the udder—M. Kunsel, of Lucerne, in March, 1903, made his first report of the method under discussion. This consists in the following: A tank of compressed oxygen, which can be had of any of the wholesale drug houses, is connected by rubber tubing six feet in length to a milking tube and firmly wired to the nozzle on the tank and to the tube, which should be boiled previous to use. The udder of the cow affected with milk fever should be stripped of milk and thoroughly washed with warm water and soap and the teats cleansed with 70 per cent. alcohol or some other effective antiseptic. The milking tube is then introduced into one of the upper teats and the oxygen gas is allowed to flow slowly into the teat until the corresponding quarter of the udder is tense and well distended. While pinching the teat to prevent the escape of gas, the tube is withdrawn and a strip of bandage or tape is bound about the lower part of the teat to retain the oxygen. The same procedure- is repeated in each of the remaining teats. The ligatures on the teats may be permitted to remain in place for an hour and a half, when they should be removed. The inflation of the udder may be repeated in six hours, if necessary, owing to non-improvement of the patient. As synergistic measures, the subcutaneous injection of one-half grain of strychnine nitrate, the use of enemata to empty the bowels, and cathe- terization are important in aiding recovery. The animal should also be comfortably propped up with bags of hay. If oxygen can not be readily obtained, the use of a bicycle pump connected with a milking tube may be employed with much success ; some veterinarians claining that the results are as good as with the use of oxygen, pro- viding the air is pure which is pumped into the udder.* This * Very convenient arrangements are now commonly sold at a small price for Chamber containing sterile cotton (through which theair is filtered) and a milking tube for introduction into the teat. They may be used by the laity, and their omik Jover should not be milked for ton or twelve, houre after inflation oF the udder, and only partially milked for several days following this time. Either or indatin has frequently ica fo.a renewal of the Glecaso in ita worst form. The use of the tape to retain the injected air is said to be unnecessary, provided one compresses the teat for a few minutes after inflation. This needs further endorse- ment before general acceptance. LAVAGE 739 purity of the air may be attained by blowing the air through a wash bottle containing 2 per cent. carbolic acid solution. Light massage of the udder should follow the inflation. The results of the Kunsel treatment are wonderful. Kunsel reported a series of twenty-two cases of milk fever, without a death, following the use of his method. Similar results have been secured in this country. The rationale of the treatment has yet to be elucidated. Various hypotheses have been advanced, such as the effect of the oxygen on a hypothetica) anzrobic bacillus in the udder ; the-action of the oxygen on the blood and general metabolism in destroying toxic products in the economy ; the action of air-compression in the udder in overcoming congestion in this part, and thus preventing anemia of the central nervoussystem ; and a pos- sible stimulation of the secretory function of the mammary gland with elimination of toxins. The fact that injection of milk into the mammary gland has produced a condition simu- lating milk fever appears to augur a local cause of the disease, Lavage. Lavage is a term applied to washing out the stomach with the stomach tube. This process, while an every-day occurrence in human medicine, has been too long neglected in Veterinary practice. Fortunately, new interest has been awakened in this useful procedure by Phillips, of St. Louis, who has perfected a tube and demonstrated the prac- ticability of its use.* The passage of the tube is chiefly of value in acute indigestion of the horse, with gastric flatulence and disten- tion, where pain and danger of rupture of the organ are averted by permitting escape of gas. By further washing out the stomach in such conditions, and in gastritis and engorgement, toxic, fermenting ingesta are immediately removed and the evil results, as tympanites and loca’ inflammation of the stomach and of the intestines, are pre- vented. In choking, as by oats, the passage of the tube may afford relief, while in poisoning the washing out of the stomach is the one essential treatment. Gastric indiges- *Amer. Vet. Review, May, 1904. 740 GENERAL THERAPEUTIC MEASURES tion and flatulence are shown by colic, distention in the region of the stomach, difficulty in thoracic breathing and eructations of gas by the mouth, or attempts at retching and vomiting. To pass the tube, the horse may be backed into a stall. The operator stands to the animal’s left and an assistant, holding up the horse’s head and the distal end of the tube, to the patient’s right. The tube is placed in warm water and the surface is dusted with powdered slippery elm or smeared with vase- line. The left nostril of the horse is also lubricated in the same way. The operator pushes the tube gently along the floor of the left nasal fossa with the left hand, while guiding its direction with the right hand. The first obstruction is likely to be met, when the tube has been entered about a foot, by its contact with the tur- binates. The point of the tube should then be held down- wards, by the pressure of the right forefinger pushed as far as possible into the nostril, while the outer part of the tube is lifted upward to force the point down into the pharynx. When the tube enters the pharynx attempts at swallowing are likely to occur and these are just what are needed to close the epiglottis over the larynx and to force the tube into the gullet. If swallowing is not evident it may be brought on by pushing the end of the tube gently backward and forward into the pharynx, and, when an attempt at deglutition occurs, the tube should be thrust forward. If the tube goes into the trachea instead of the cesophagus, it will meet with little resistance and expired ait may be felt coming from it, while coughing often results. If itis in the gullet, the tube will be held more firmly by its walls and only fetid gas may escape with stomach contents. It should by these means be definitely established then that the tube is in the gullet before introducing it farther. The tube should be made with white marks on the rubber to show when it may be expected to have reached the gullet and again the stomach. SERUM THERAPY T41 During the course of passing the tube it must be well lubricated. When the stomach is reached the gas may have already escaped and fluid contents may be siphoned off by filling the tube with warm water from a funnel or syringe, holding the distal end tightly closed and lowering it to the ground so as to permit of the escape of stomach contents by siphonage. If the contents are largely solid, the stomach must be repeatedly filled with 2 to 4 quarts of warm water and allowed to escape again by lowering the outer end of the tube to the ground. If the flow stops, owing to choking of the tube, it may be started again by injection of water into the tube with a syringe or pump. The latter must not be used to suck out the contents of the stomach except so far, if necessary, as to start the siphonage. Thestomach should thus be repeatedly washed until the water comes away clear. If water is injected with a syringe, care must be taken to avoid forcing air into the stomach. When passage of the tube becomes impossible through one nostril, the other one may be tried. Phillips reports failure to pass the tube in the horse in only 5 per cent. of trials. The tube is best made of red Para rubber and long enough to reach from the stomach to the ground when in place. Serum Therapy.* Antitoxic Serum. —'The microscopic parasites which cause infectious diseases—of which the bacteria are the most common—do so chiefly through the production of cer- *In the use of serum therapy the strictest aseptic precautions are to be used. The animal is prepared by shaving off the hair from the part and the skin is washed with soap and water and then with alcohol and water, 2 parts of the former and 1 part of the latter, or with 5 per cent. carbolic acid wa‘ery solution, which is harder on the hands. The syringe and needle must be boiled for five minutes before using. When many animals are injected at one time, it may be sufficient to wipe off the needle after each injection with the alcohol solution. The puncture may be covered with collodion to advantage. Glass syringes, with asbestos packing on plunger, are most suitable for boiling, the needle connected by rubber tubing. 742 GENERAL THERAPEUTIC MEASURES tain complex, poisonous, proteid bodies called toxins, which combine with the cells of the vital organism and destroy their vital functions. Indeed, all the classic symptoms of some of the infectious diseases may be caused by injection of the toxins of the bacteria which cause these diseases; such is the case with tetanus and diphtheria. Under favor- able circumstances, however, when the dose of toxins is not too large, the animal organism reacts against these toxins through the possession of antitoxic principles in the fluids of the body or by means of the secretion of antitoxins by the cells of the animal tissues. The antitoxins set free from the cells then combine with the toxins in the blood and so prevent the toxins from uniting with the cells of the body and thus destroying them. The subject is a very intricate one and is as yet in a some- what nebulous state and we here present but the briefest and ecrudest outline of the present and generally accepted hy pothesis. To illustrate the method of artificially manufacturing antitoxins, we will take as an example the production of tetanus antitoxin. Tetanus Antitoxin.—Tetanus bacilli are grown in bouillon for two or three weeks in an incubator, when the culture is filtered free of bacilliand furnishes tetanus toxins. % ocx /esseieie atnuahe 147 ran kogaehilheah meyers sw ocre sae 149 VEMOras soot ties crensielce 535 Ammonio ferric alum...... 64 JATMMO MINN Jes ete eects 144 acetate, solution of..... 150 DENWZOBECS «./-10/0 ulnexaie dake 513 Gat DONALC cei. emits cele eters 147 chlo’ridie:.. ds <0 setae arle 149 ich’thyol sul’phonate ... 659 ATTY GAlIN os. 1c, 0lelecejeieieehaiencicke 610 Any ylis Niveris) selene erieeaats 308 Amy] Ticker ite: <.j.)sis misiets ela nie 308 Amylie al’cohol .: <2... 280 PNAdhiveles Ayano io woos oc 635 Aneesthe’ sia,’ Ga.. .siteicewiekie 299 dangers! Of ... . 19; 67, 718; 723 ATGISTAASORUES) |..c:c0 lero locals) = 15 ATIPISDASIOOG GAGES: we ore/srero-!e/ «1 534 Antistreptococ’cic serum ... 745 ANtitox In telaAnUs) 3.4 se. c< 742 A DHTODIS TACHI ance celeste celts 57 Apomorphin’ hydrochlo’- GL CUUDTN ee ete eee cnet trel anata eve 370 Apomor’phine hydrochlo’ride 370 PPOLGSPING Foray hectttarare-edeicietet eee 575 PROUT AY So creo tstereiete oman efelotelerots ma iy AMMO’ NI PS ivscls. © as ois Fs 144 TOMTIOT ee ote alate 144 SAINT SBE rec chorea han cakes sacle ones 532 CANDY DIVO Wa cotelsl ache whalers 547 PAGE Ag'ua, chloroform’i,. ©. <2... .'. 296 Gest atta ss woe sesaeete alaly; hydroge’nii diox’idum 19 men’the piperi’te ..... 529 men’the vir’idis ....... 530 ANCE TR Sato chico atte''sh seus ateta htieeae 77 ATpaiivade ct atclre oh aie 524, 611 AW aDieraclde ois tancce te ee 611 Areas: ele. vce o's. a-sh oes eee 636 Araro’ba powder .......... Bae AT GIGANS fos '3i56 cde Sapshe o cisereie 616 BUUBG Wales noo here ein eraaveletarene 616 Arecalines \.7.... omens coun 616 Hydrobro’'mate:, 4.5.2.1) 617 Argen’ti cyan’idum 176; 347 TOMTOM ei ad cielo ets renee 176 DAGCTAS se eitandie eiaeee a ears 175 TT ELAS GUIS. 5s ererceres 176 MA GTAS MEM SUS) a aic-ereiheyers 176 GRAIN octane islzre ete eine 176 ATP ONIN: ticle wiciaey sioieuk wane ae 175 AEEVT ON siete cs store ahk cheteveveles ace 180 AYZISTON aie. chet terecrsicna storeate 252 Aristo TUM vet. cece ctoaaies sieve 252 ARENT GAR Osea Sei crash hereceraro keds 522 HOWETS re eile ca cvncercae 522 TOOE: orst noes are alone aioreva 522 Arnicwy Tar dix. sis aie: 23 522 HOLMER) Ao uere thera area 522 ATVI CTI: ete corearcicrar tose tee 522 Aromatic bitters: 22.660... 16 OLS po a eae iereorer ae 71, 497 » spirit of ammonia...... 148 APONTAGIES eS o's 'ocn le ome ce tre 16 AT/SOnie ENIOR LOU) char. cieretere 220 Te SETI Ghar terse Gotheg Male eter otad 220 administration of ...... 226 ANIC OUG\5 steratsio tela 196, 224 Fowler’s solution of.... 221 PIVOTS 4 55 see htee ties 220 AVON ESIC oO CIE Cacrorseat et 220 Ar’senous or arse’nous acid. 220 SOMMICION™ OL '<, Saretopotetelacedere 221 Ar’senum or arse’num...... 220 ATtificial, TeeAINg! ...:<2). .ijs-8 694 IASAUTCCIGA. scare caw ante Reels ware PMS OOtL TGA. «se des stohaisitre eres 537 Asepsis, means of procuring. 720 SITET CAL citore: cctekrenceerate 726 PESTO IY CAEN. "Wh shane tat cattetrel< oo alalenet ota 615 ASP G IMGT. | 2 eNelers cis! 4 a/etetotalete 615 JAA HHT 10 ee BIHAR Or ecm C 615 ASERINGONCS sae sence a dclarelet eons ALTODIN A 2) alatsletere a ciate ovateterait aoa 840 PAGE Atropine sulphas ....... 2.4 °305 At‘TOPING (65253 Ava cslestaimees 374 At’ropine sul’phate ........ 375 Bacelli’s treatment ........ 330 Baking Soda: % ste s.ceeees 134 Balsam of Pers ss ss saades 510 Of TOM) 2545225252544 2% 511 OF MiP se 455 Ros sone 505 Bal sama tes orecede saat see 72 Bal’samum Peruvia’num ... 510 Toluta‘nmum 2F 23.8350. pk: BANS: « Peneted Altstet ha teie toe 80 Barba’does al’oes .......... 564 PATVAV OM cit. ce eee eee ee 565 Berit chlo rwiduny 2s. ees. 160 Baer: NS a hee ee 160 Ba rium: chloride’. ss e.cn~e.< 160 Bares mile. 2)te sea e eee ee 540 Basil’icon ointment ........ 506 Basis 2a 235 Sede ea he eee 89 Baths; ‘cold: (252s senses 709 HOU Se Pere cod awa od eons vali SHECH Adah c bce dd kets nits oes 707 BOCns Fas dae lsd dcderera ate 283 BSMACON NA+ ks Aen eee 372 Belladon’ne fo’lia ......... 372 GA GUX 4? VP ee tote te 373 Benzo’ic acid ..510, 511, 512, 513 Ben’ zoinated lard «22.5. .28 2: 512 BON ZONA To Paleo cc choles 512 Benzyl’ic ben’zoate ........ 511 Gin namatel¢ oo..bies eae e 511 Ber Derimest ik... cee cos 558, 560 Be ta tapthol * ic. acco. cet 335 Be’tal nut or be’tel nut..... 616 BANS tae te eee ec ieteie eis 391 Bichlo’ride of mer’cury..... 208 Bile, drugs acting on....... 26 Bis*tmuU tht: sci cee 189 salic’ylate or salicylate. 190 SUbDCATD ONALE oes f= 189 SUDSAalAtet wan eee eect. 190 Sibnittrate. 5... cee. 190 Subpsalic’ Wialteu sere os 190 Bismu’thi subcarbo’nas .... 189 SD Salas, Wane arene. 190 SUDMIGEEAS tl seis clemteeereea is 190 SUPSAITC VIAS yerc cre wcrenets.< 190 ISMN SNe Saeco eeiet 189 IL LberS ort | Se ea coe 16 BlACKSMuUsStard ay. ce cjereeasterere 515 VESTA ce et Sreccueee wo ave Seton DAI Black-leg vac’cine ......... 752 Bleaching powder ......... 237 GENERAL INDEX PAGE Bleeding’ .sisieescees eee ete 728 LOCAL AAU ere Toll: Blister- beetles! *s.03.0-2- 643 Blistering collo’dion ....... 637 Blood, drugs acting on..... 32 vessels, drugs acting on. 36 Blue mass: 3) ss75 7253S ee 206 DUT. saseed ets aensoa. 206 BLONOW Si sessed ovacae 186 ommtment);? #227 ieecaeee 207 Vitriok 24:5 ses5 325) 186 Bodily heat, drugs _ in- HUeCHCINE vsx..=s 2 eee 60 Bow «25 vee eSe aes sls 80 BO USES. a cee ee eee 80 Bone black ssi /seae ase 276 Boracic aed sooner ceee 273 BO ray oseeae see hae eee 273 BO Tic Herd 232s. Bhatia 273 Boroglyc’eride, solution of.. 273 Boroglyc’erin, gly’cerite of.. 273 Brain, drugs acting on...... 38 Brandy: 23 22 testcase se 281 Bray Corae «so voialeetat eee ote 619 Bronrides. orn eis a eae aie ceaerei ote 240 Bro’ MINE. we Waa eet oeee 240 Brolmumr 92a anoeede eee 240 Bronchial tubes, drugs in- flueneins ‘theo? 2 Sa 49 Bronehiagl- spasms... sae 50 Bru'cine! “leet 2hes seek oe ene 400 Bueeo ve oe EER ae ae ee 540 Butehw. * 295 Chio'rumy ©. 2.2si2).s Sale oe Stele ote ABT Cho aeozues icc. tn etcs sees 26 Choles’terin ...... aie lato teve oteite 602 Chrysaro’bin;....'* Sea ERE 577 Chrysarobpimuim Jee csc tie ee 511 Chinystophanme®. ste etree ol 515, 577 Chrysophan’ic acid.575, 577, 578 Chrysotoxin'” 24.42 s'esis sess 625 Cour Tse e246 assecielisiee ss 391 Clder Bhrk ie ea bbteleis maisicce 283 Cincho nay's2 dace sieleioter eee Al6 TOG. 344: veal wea ce es 479 TUDTA s24xacie tecievee a ALD Cincho’ne cortex .......... 476 CGINCHOMIGUN As toterete ts telete ote 483 Cinchonidi’ne sul’phas .... 483 Cincho’nidine ~~)... %%5 477, 483 Sulphate + - 2 cs vieisweis @ 483 Cinchoni’‘nine sul’phas .... 483 @in’chonine «2.2426 ees ie o's 477 Sulphate: 72 c ss selec 483 Gin’ chonismy +2... ore +s + % 1s 486 Cinchotan’nic acid ......... 478 (Ghankere) | a iy Seno coacicracs 519 GITMNAMVEIN + sidvesssc cies 10 ek nse 510 Cinnam’‘ic acid.«......... 510, 511 Circulation, drugs acting on 32 Cit’rated caffeine ......... 396 Git TIE TAGIOLUSS taisiclals ee biste/e' 267 Cit’rine ointment .......... 210 Oia Ariliiitie 2aG 52 bo aooGJodauS 586 Classifications s.inercmiiersia'e ss 113 Clys ters: Grit ieeaeeietels ore ene Bp SU) COG GAAS. fc ala deaeeeiieters sie 431 Cocai’/ne hydrochlo’ridum .. 431 Co’caine or coca’ine........ 431 COME Al S55 ccd rere eens atone 6 356 Gods AiVer Oll.«c.ace-tetotene raters 656 Coffee 25255 et Seh we weer 396, 397 ColcGhicveIme “sjae's sicrerstevetatees 632 GCol’chiGine Sseict.ais 2 ters rete she are 632 Gol’chiewim' $%..6 3 me eete 631 GOT whe cssis.& s htarwle tee etee as 631 SCO! (Se iie we cies Blaine 632 Cold as a remedy.......... 704 DALHS! Ra aicvelcve broke tiers tereterere 709 TIMES 03. i.rac octets te ete atetes 710 ONES INACA Wictarelelclstajeteiete vere 711 GENERAL INDEX PAGE Collar’gal....sc22rccc ces 190 Col’lidine .<15254..¢s5%% eee 423 Colloi’dal silver ........... 180 Collo/@iatiesniieelnee ore 79, 637 Collo‘dion 3.4 427 Coni’/nine hydrobro’mas ... 427 Condi Wim 5 Seen sees CAEL ee 427 Conall lamar in gave tet teeters 456 CWonvalasriayeic. wie: erect ere 455 Conval’larin, s\.\..0 eee ele 456 Conivolsviulim ire see ee terere teens 584 Copper v2. a eer tre ici S.C 186 acetate c.vs-skeeiceniae 188 sul’pliate. . sri. c,etetein tater 186 COD IDEAS ohersie. copes eesti 193 Corian derijscaclaenicien eee 533 Coriandrin fructus ie seers 533 Coriandrium? 335... eee 533 Cor’nuting: \)os;,-ccr se eee 625 Corros’ive mercur’ie chlo’- TUS! oo solos ¥oc0 ee oe 208 Cos’moline’ |. ccc. eniteretanen 348 Cotton’ 4.42). eee or 636 abSOrbent)). 2 scicrsvesiste ever 636 DUPUEM. oo ieee aenerertenen® 636 Toot Wank ye os. cee oere 630 seed Oil sek a eee ee 602 Soll bhavkeMeabhel gaara cm 5 ac 637 Counter-irritants ...62, 696, 715 GENERAL INDEX Woxsi Hive SYTUD. fs vee ccs MreAmMPOls LAT CALs se.c «0c)s ok Cré’de’s ointment Cre’olin Creoli’‘num Cre’osote _Creoso’tum Cre’ta prepara’ta Croton oil seeds Cro’tonol eee eee eee Owe Ce ee WC AO ar tr @ 0) ©) 0/6) ey o'si a ee « 606 6 oe Sree, OLe 8 650, at ajel a ofe « ed ee ee | a) wale eo je 4) ¢ ae 66 666 © 610) 0X0 ay 6 @ 66 10 6/6948) 68 Cryp’topin ©’ ca. Cumulative action Cu’pri ace’tas sul’phas Cu’pric sul’phate Cu’prum ee O19 OL Reel @ 6a 6 2 016 ale ee Oa w erere aa ey ee ed Seale ps «6166 6 ee Dalmatian insect powder... Deadly nightshade Decoc’ta Decoc’tions Definitions of drugs Del’phinine Delphinoi’dine Delphin’isine Demul’cents Deo’dorants Deo’dorized o’pium Deo’dorizers Der’matol Diach’ylon plaster Diarphoret’ics Digestion Digestive organs, drugs act- ing on Diges’tives Digita’lein Digita’lin Digita’lis fo’lia Digito’nin Digito’phyllin Digitox’in Diosphe’nol Disease, affecting the action OL TETUSSP acai See eee Disinfectants ...... 67, 718, Disinfec’tion, practical oes eeeee ee eee ew eeee ee ee ee ey ey ©, Ce! 6F 6,0) o/ 6,5) ©, 60) 6 6 6ku 6 16 6 wie) 8) 6, ey ene ereletehe 6: eC i a .¢.(G\'e 6 0° 6 a6) 6 Bie 6/66 843 PAGE Displacement or percolation. 73 Dissolu’tion, law of, 11, 39, 286, 299, 362 Distilled oils’ +4. Saas 71, 497 WATER ..60 esa eer ahi by PD TUNSUIGS) wort rrote ci consnttecieie Bien 52 Domestic measures ........ 92 DOSAZe sn oe coe cinta eee 10 Masetable> <2 c's ss. cy kee ee 661 Douch’es ap ehexsuete utes ateseeseen eae 709 Dover's: powder... 2.22.75. 353 TD TASTCLGS) Tiare aaa cs othe arate 24 DD PAUSES eye cle vels cictce eee ele oe 81 1D Site) 00 ClO ee at eee ea ee 81 DiriedF alma. oo c5 sc peer ee 167 ceal’cium sul’phate ..... 160 fer’rous sul’phate ..... 193 so’dium car’bonate .... 133 Drop ehalKsy i.e saheveere 153 Drugs acting on the— bodily “heat: Jsicimsen ee « 60 DOO te eee eG eee 32 vessels “occ... 0.62% 36 PITT & sos cue nik tec eee See 38 Circwlabioni: Testers, ote 536 Fer’rous car’bonate, mass of 194 sacchara‘ted ...:.. 194 Fer’rous i’odide, syrup of... 194 SIP PRATC iro oe ein owas ciel 193 GRIGG 2 2 Farsi eidcneters 193 EXSIGCANEUM So curerne calets 193 eranula’ted .....5... 193 PRESTON EA! tke Menorais) atscloreisieyets 192 TECUC UUM! \ootclet ene /ereta.eueys 192 MLW AIG ACIONs sic. «vise wees 538 EPR RGTAN 2s ice co 3 ond cer abchesereseie 615 HST AIBK: AITLAS oss tedeteaeloucletet eve leliens 615 HPTLC AGT AECUO © alert rere woe oo epete 615 BRUKCCIOUS s. ctclcere sole, cove crete 71, 79 Na MSOSUIS oo sical ctote alete oherelehede 610 OU GE rar. skis abe ee wlcboers 569 Fleming’s tincture ........ 460 Flexible collo’dion: ... 0.0... 638 hies: Spanish os. schclenese <'slve 643 Flowers of sulphur ........ 255 TLC ERETAIGEA ms crttere cee ctclel ars 78 Pluidextracts. 2.05.65... Penny >) Fluidextrac’tum aconi’ti ... 460 belladon’ne rad’icis .... 373 DU CHWS Sha este cl teh eletetaice 540 CONANT ro oan sto elel el ov etens 563 calm aes ee shee wteee 558 can’nabis in’dice ...... 392 CAP SICI? 52 asd Awe s ects 526 CINCO MH TS Se. cio ceeles e's 478 COME ee Coie oer ciae 428 CONVALA TIC’. Wei ets viele are's eo 456 PAGE Fluidextrac'tum cus’so ........ 619 GIP VLA IIS is. c'< wae Sere 446 OEP OWE Sonics sae estieeene 626 CUCRIIMO LIV, sce ee eet eee 519 GRAMS GSS alo o's 'o 5 Selene 574 Selsem ald cas tie coos 420 SUPA Ney | ai ycicicrpen eae 553 SIVGYLUR Ze foes eee ee 609 ZOSSYDal TAQICIS sus .ee 630 STON lite sn: os wie e eee 620 hamamelidis:, . stew os0e 601 WALA EIS) esos sc eysccuenthe 560 MVOSCYCAMU? (L5e crete icislene 388 ipnecacuan he, issn 2 sss 472 panera’. ro". eievere Siete aici 599 Ni CIS AVON IGE iss. « 401 UOC APSD I Gees oss -cets eo islove 440 CITA SUSI AME es Sos >. \a.acenels so 6 555 GQUEIPGUS Peale ciett os es 595 rham’ni purshian’e . 573 MELO eee siatecis Ol slave alae, ous 575 SAE Te siete aye cucic! aie eb e.see 543 SCM er pa eie wiG ale: ois 6 ie! oiens 457 SQnalasae waiters hale ecient « 579 GC AUTERCATICH Bike ats lace tal s:je\avacereh etc 559 ALOT Mee alas, i.) spe toialons 535 Welaaibas peer tte ieee kts 465 VATVE UD OTIS VG o's te 0 vo to "0, bse 527 Meenie wl fue wus | sass... 533 MOST ICSU pcs oh od os oh sp eile) das 533 PUP MUI STOCKS os are era alevclareleve'e s 534 HDONTETICLA ws oieie ce ctele ee cro stolen 715 Homenta tions, 2. 25. ."Ssceos 715 Food and feeding .......... 679 CSE UELN EUG) (Lomi: AN aie eae ea 694 MipAM NMA cts eo athe eae 690 ins Diack water \. 2025: 690 in chronic indigestion .. 688 Hs CONStipAtwON,.. se.che ore 688 Food in convalescence...... 690 mm Gebi lity) se a oeeaks 690 ine CiaTrhnea os oeses 688, 689 ins fever. 2.5 ee 691 in gastroenteritis ..688, 689° in hemorrhage from stomach and bowels.. 689 IN GAWTGIGE eisisc. ctoeiels ote 689 i WAM UNILIS: oe ntae eee 688 ill, ODESILY ocho ee 691 Mormal’dehyde .. ....c6e 06s 338 BiOrANAalING asic ee e'.o ee 308 HDT Mic. waAGial owiehe eles 535, 651 For'mic aldehyde ............. 338 BOM SIOVEL ow nr hays ctoreters ssteeme 445 846 PAGE Fowler’s solution .......... 221 Wran’2ula) 2h . <2. ee eran css 606 PEPSI Sie Ss ae ewes 653 Glyceritum amyli ......... 607 GIYiGYTANUIN:. saci nes 609 Glycyrrhi’va> obese eee oe 609 Glyeyrrhi’zin 2.5 teens cece 609 GO’ AGDO WCET: pci.’ alerelote cree eto 577 Golden).seal® -...... -e8ee see 560 SUlpPMUEes Hy. Wisk wcless ek ee 229 Gossyp lil vcortex: ../.). oo ae 630 GENERAL INDEX PAGE Gossyp’ium purifica’tum ... 636 Goulard’s extract .......... 171 Grane tum... cue. 620 Gran’ulated fer’rous_ sul’- DD AEC cs jo ofeue skeletons 194 Gray powder ........ se iae 206 Gregory’s powder ......... 576 Green. hel’lebore :...:..'. eee 464 GYeen “SOAD. osc deetaoa seman 604 ViUTIOl: see eee 193 GUaTramMay ciccicvee cclice tees 396 Guara/mine) 05.7.6 sine e eens 395 Gum) ar’abie’ 4.22% 52208 ce 611 Gum-réesi'N& “ac. .eek ewes wesc 72 GUuM-TES INS as ele oles eaters 72 GUT’ MT. 2. isle /s SRR eats ee 72 Gun cotton, soluble ........ 637 Gun aly 2 i cies oreeiero ere were me 392 GUT ER: 1s aves htetsio Bote ic tere ovale 91 Habit, influencing action of GY WES. x ec Store oretererenge 14 Fige’mateinir’. 4). cis tis sree ee 600 FASMACIN ICS: 4)... -Shisss crows < rets 33 Hamatox’ylin’ sicic 04. «vce 600 Hiematox ylony s1. -emctastatererens 600 IFizemMOostatiCse... cij.clesiwes Gisceiehe 63 Hamame’lidis fo’lia ....... 601 Hard S0ap ihe aceon 603 Harrington’s solution ..216, 720 Maschtisehsts si. oie saison eins 391 HLATESHORN "ys. csuscreeieieiere saree 144 HAUS tus ae ee eee ee a Heart, drugs acting on ..34, 445 Heat ican eh aero 712 bodily, drugs acting on. 60 Heavy magnesia .......... 165 Hel’lebore, American ...... 464 Hemides’mus ss 2 fie cks tus cers 472 Henvlock “vay eee cake 427 Elemp; ¢imdiam®..y. visieieiete ais 391 Hen’ bane» ic tebe ot ess eae 387 | SEPOrOIn 5s Hise eee Re BE Her’oin hydrochlo’ride 357 Hexamethylenam’ina ...... 341 Bin cin, Sack Geter tseeea ee 648 FRIVeGXSYTUP “i js jalete sus o's ete erenelans 229 EOC ie Sa ae cic eee nee 282 Hoffman’s anodyne ........ 293 Homolle’s digita’lin ........ 446 PLONE Ys <5) shove. everic he atehetateieeene 651 clarified.) isc scccretinie ss 651 ELONEYA 2 syairiatiietereleieie’s cltetesai ciate 80 Mot. baths: Ssdectee eck eases 717 GENERAL PAGE Hot water pags © ...53.6.06.0. 715 ERY OOTASOLWCS. tices bie ee ata o 25 Hydrarg’yri chlo’ridum cor- TOS TAVIUIGRE (fava save oe a a0 208 chlo’ridum mi’te ...... 209 io didim. Tu’ Drum. % ss <« 209 MIU Tsar, tates st cress S's & ai8 208 ox idum flavum. <,. 2s ..<: 207 ox’idum ru’brum ...... 207 subchlo’ridum .: ....:. 209 EMO PAre VEU os ot ie. bs eo als 206 Hydrare’yrum ammonia’tum 210 GUND eCreta- asc ew ank sos. 206 RV CUE SA GIN 5 os erate saree sl eoata.e 561 RV GGAS CHIE? 562 ks cleus: os ot 560 Hydrasti’ne hydrochlo’ridum 561 IEP YCNAS CUTS, ) avelaia clels sesejere ores 560 iy drated alumina ..c 6620 167 Hydrio’dic acid, syrup of .. 248 Efydrochilo‘rie’ ‘acids .4<; <0. 262 solution of arsenic .... 221 Hydrocyan’ic acid, diluted.. 342 Hy’drogen diox’ide, solution Ole shy Sa, hncgete oieee ealoie ns 119 perox’ide, solution of .. 119 Hy drous: wool fat siicn se 649 Hydro’xide, potas’sium .... 122 SOMA’ yak are couse or Serehens” a a2 Hyosci’ne hydrobro’mide .. 389 EW ZOSGING? os, cyorstel oh scstsic,e ee Be. $89 Hy’oscine hydrobro’mide .. 389 Hyoscy’amine ......... 372, 388 hydrobro’mide <.....2. 389 BWM ALG 2s whos creis one 6 388 Eiyoscy ami fo'lia: .. i366... 387 ER VOSCY/ATINUS bc) ata assists thee 387 Hypnotics ..... abe rye Vi Sirens SUe%s 40 Hypodermat’ic injections .. 7 Hypodermoc’lysis ...... faowlas Etypophos’phites 2% 547 TALIM AM 2 oo see ee eee hs ee cs 636 NAVA SOL. eo eeien eieiererel oe 739 Law of dissolution, 11, 39, 286, 299, 362 Tax’ Avives oy. ky. ac eiteeeeser eas. a6 24 Tyead' + *. Hi te score totewemastere es 170 AG CLALC © <5. 7ele ce temeietone ss, » 171 car’ ponaten (i... eee es 172 VOGIde7\. 55... seers eels 172 OlntmMent %<.'i5 sista 173 NV UVALC eee... che cieteet meee 172 ON Tae Kn Sok bie ee 170 Plaster tac Cees aoe eee 171 poisoning) .<.).\.. 1c eee 173 subac’etate, ce’rate of.. 172 GENERAL INDEX PAGE ead. soliutign OF 5% 2e.. deere 171 SUGAT OT” s.S 4.sre Vaointeiens ival AWALTEE 95s oe teats Meee 172 WaAbeTe 24 Sh jette we wi ttenete bya Lev’ant or levant’ wormseed 621 hevisa/ tion "ssh e week Gai ee Light mapne’sia’ .......0.5 164 ily of svalley, 224.2 455 EAMG eo. ke So. oie ee eee 155 ehlorina ted 4% br ceeen< 237 chioTide ok Ae ee eee 159 lin dmMent hk eee 156 phos’phate, precip’itated 157 Solution Vor? eae ee cee 155 SVT UPrOL ene hee eee 156 WAITED) ic citsrescteistarste steraiake 155 Tininien tay = fee ec ascleeate oD isintiments 3. sak eee cet cite 79 Linimen’tum ammo’nie .... 144 belladon’ne ....5....06 374 Cal Gis ar ake eee 156 cam/phore +h oe cae 548 chloroform! 2a. 296 SADOMIS' 24 Geman ee 604 THOVAIS 5 look eects 604 terebinthi‘ne 9:2... 0025. 499 Min'’Seed £8.55 Mien 610 OlULWOL sah cs elo anctone eter 569 TNO“ eins Ssh .t ks evar tree eae 569 Pel bar ee Ae oe Steen 610 Liquid petrola’tum ........ 348 Li’quor ac’idi arseno’si .... 221 AMMO’ NIB Yoo s. es eee 144 aceta’tis! | ioe ore 150 Li’quor ammo’nie for’tis .. 144 arsenjca’lis Ree 221 arsen’ici hydrochlo’ricus 221 Calicis: "Shae! hoa 155 chlotrimnate)- 2.28 a atitane 238 chlo’ri compos’itus..... 230 cre’solis compos’itus'... 335 fer’ri ..s, «els oi sistact stats 68 ELV HEf AO COC eR RACINE NCL ee 353 ReWletierine sya <2 baie See 620 Pepper, cay’enne or cayenne’ 525 ROG Pemtae chs hotel adel cistchento 525 IPCPDENIMIN iy cs wie so c-e vie cee Sie 528 WiAUCTE or atavaysiolere'e elacere: prolele 529 TACT OsSSo NON acer a Wega erent by Maes AS ei 652 SHG GCHATATC CN Nerchaieraiaix cists 653 Sacchara tum. > 505 Pix ursun’ dica\. ince s = 504 ITC et tetas ores) oe stetei's, 5) oe 507 MEST et atte peeetetenls choise 507 Plasma, drugs acting on.... 32 Plaster Of spars. 7.) 160 Plasters 6.220 eiearceree aie’ 79 Phim’ Ditace tases jc scieiemie tet, 2 s lero GarbOMas cee eels cs 172 NCH ObKeRbh OW eG AA Scio co OOO 172 THICRIAIS ee ehe otetesneiatevenenetetes 172 OX TGUME SS ereeteoerel 170 1Zhhhei4ovbo e aA eee oo PAGGo SOUS 170 Pneumogastric, drugs acting (6) EAE Arita Pecyoro. crap oid 34 Pod Op WyAIN es fey are ore eleretersts 588 Podophyllin’ic acid ........ 588 Podophy lumi ~ haiascseseletsletarerbe 25 SINPPIOW sr. «dota sicleaword cislere 24 USES Of 5 fa eidiratorcie’s 28 Purified Cotton < 5.2. s.)ocere 636 0p. at 236211 I RR eR Lo 655 Bus tulamiseaes cei dae 62, 697 PAV TO’ CDMA earn a) otleierate erasetehenets 624 PAV TCIM stake ain ss efat daveterenere 423 PAGE Pyracatcenhini’. .asaletees ce 598 Pyroacav lie ACG) <7 aeiatarctenrar 594 Pyroaval loi trees Ain teretersietare 594 PVT OR Vu | Weittalocic te state sbtie’ ee 637 PPV TOX VU MITE P yncla aremeevetaral delle 637 Quarter evil vac’cine....... 752 (OUTASISIST Porter eters eters 555 QUACSTIMAN GE Xirctetoree.a aida atone ete 555 CUTETICINE 02. tee eretete sf eecaiores 595 Quercitanynic acid’... . << 595 QUE CHG gd Ta is Sate acartenare 595 Quercus alias centers oceadieuets 595 Quevenne’s digita’lin ...... 446 QUICKSHVET") eons sc eke mile sie 206 CUTE AMEN tocratncaie se erate sicie 477 QUT TCLA Cigar crarckevercieiel sues oie 478 GQUTTY CTT oe i ratcta oleate atarenaray« 477 Quinidi’ne sul’phas ........ 482 Qa UMMC ee acrceatareta sterereteta cs 477 Sulphate: “c)/s- ec. overs siete 482 Ouniibigat Lode Be teg sae aoe see ATT Quini’ne bimuria’tis car’ba- HTASY Pee. eters slatestererees 482 DISUU MHASH tte sie se ere 480 hydrobroimas* .. 2.6 481 hydrochlo’ridum ....... 481 SIU PRASH a yeni cus Revete 479 VICRASH Gy natromarcestace ss, 5 482 Qui’nine (or kwin-een)..... ATT DUSTIN ATC etetaie cr escrecsis <:c 480 Hy droprosmMate. 2... - 481 bydrochlo'tate ...5...2(. 481 nydrochlorvde J... .6.6 481 SIMD MATS TC tern o eke: aleve eters 479 WAIKON ATOM s..)wiscrc.teterere net 482 GENO MING “Jae oslo wrcte tiers 477, 482 (Out ovey ole ath cae Pom Aa OO 482 Rational therapeu’tics ..... 1 Re ctalt LECMiNS” Wee) tevesel eyes 694 DT] CCUIOM Si seecene ene eretens 9 Rectified oil of turpentine... 499 FLeGunCAtiOn “os s.< acleansaae 75 Red corpuscles, drugs acting OTM aber cone oc apevciete laa atete toto 33 hed, cincho Nar ook ceteteiots 479 mercu’rie ox’ide ....... 207 DOD DOI tarot ctevers ot teres cots 525 precipitate. fleas sexes 207 OIMtMEeN tyes soere ae 207 WWINTO te ea teitce ss vounie arate sie 282 RGGuGedl ITO =i ere lee clae son LOZ 854 PAGE Refrig’Crants: ds cise eilowi 711 Remote action: 62.2.) es vlatare 2 Res(in' ice caters seecescucens 506 Plaster vis ios s.cceteaucne Meter 506 Resi’najalarpeer sy. oe ates chee 583 podophiylliteesset sees s 588 SCAMMO MIT) SLs tebe eseice 583 FROST MO wes iatereat a atetel eens ee ee ak RESINS cherie ths ate sieie sie eee 71 RESO Cinta ised. ceo ee optus 337 FResonicinol acne saca eee 337 FLESONCH MUM eo oe elite 337 Respiratory organs, drugs ACUUMERON fare cele elena 46, 471 mucous membrane, drugs acting on...... 46 PUTS MAMMA ees eieiee ie ole eee 572 UNA IMAMO SE so cre ious ate heueielsieie 574 Rham’nus cathar’ticus .... 574 HAtANAMy 402 Simmacligmlialey "asm anon: dsaadc 401 Suliplnate ss. sapere is 402 Stu pes? sia. «one oe eee trenle 715 Styp’tic collo’dion ...... 501, 591 St CLES swat els oars eheje setters 63 Sty PTO ee sieka ce slete. cree net tenes 510 Subcutaneous injections ... 7 Sub’limate, corrosive ...... 208 Sublimed sulphur .......% 255 Sue’cus, hyoscy’ami ....... 388 STilslepnuls jiobSsSencncnoda 65 GENERAL INDEX PAGE | UCLA Ses hetero tte seh tnenceaalta 648 © MOUTON Yavctete ctervtoraicdelave ae 648 ROUSE ny Sop cxctater ete ace ag ener 613, CATS Mri shettuete sein werent 613 OL smile APA Fede ae ere 652 OF TEAS wy Axecinserecie cite 171 Sulp ht ess sos aera rene 255 flowers Of+ +. ieee 255 liver of + Jae Nacsa 260 AK 05a 60000 Wie eae pA icie coc rs oc 255 MUNK NOL HHS Ais oe eee 256 COIN WHEN TS ee cs caeete eters 255 precipitated’ * sec cee 256 Precipitates eee 256 SiHolubakeWinbnae” BiNy ees ce acto 255 Sublimed “Avo lecccat eres 255 washed Accra econ 255 Sulphur rievacid’ "Se ene see 263 aromacich- eee easter 263 diluted < Patan smeke 263 either *-'o.0.0 2 Years Sas ee 292 Sul’phurated potas’sa ...... 260 Sulphu’rous or sul’phurous AGCUOES Aareste soe ee ite ene 25 SUNPDOSUEG TVG |e oteron tele reteeate 79 STV CONUMNI « vicssce ue aterer sists 607 TOCOLOT INT ere ae here 250, 252 MOLPNN Wels wees ree 356 SUPDOSULONTCSy win ielereltvenenels tis) SUP PUFAWIS fee sistcieter ey eyelerete 704 Surgical asepsis and anti- SODSIS ro rere eis 726 Sweat, drugs influencing the secretion of..... 65 Sweeti ilar sina: Ceca erates 563 Ol see 602 SPIT Ol Tate me err 308 Symbols and signs ...... 90, 91 Synthet’ic oil of wintergreen 496 Sym Ups) Sinus lene tyes 614 SY TUD rie cee eiemele etek ik SVMUDS: {He tra seoe seek 77, 614 Syru’pus aca’cie ......,... 612 ac’idi hydriod’ici ..*... 248 CAN Meh 542 eer hou, 613 eal’cii lactophospha’tis. 158 CALECISL? s, Kh ths cee te ree 156 fern: iotdidi« os... ... 742 The’baine (the-ba-in) ..... 351 eine? (thei) ©. isie! sets sisi 395 Theobro’ma, oil of ........ 636 AIT ANCUULICS. 1c c\elsiclcia'ets'« p cie il GeMMITION: Of tyes «jee il CMP AMA laretsieia skp ie’ eral 1 MOEN rae ole atarsteraate: sie il EAGLON Al votes wile chelates sles 1 Meri ACH y&.cs te Meeisiosipleseiale 614 SERA oe: cps ieee eAeheie: eraeh erate 660 Mhymol .ChieMIOl)s cs ete rete cre 551 SPST TTT 1G ACT a tars lntete ocolehalelal » 580 Tinctu‘ra, aconrti* o.\, + scie% 459 al’oés et myr’rhe ..524, 566 ar mica. t6.. selate. oe cides 523 BSAeh Idee, axis ope eee 538 belladon’ne folio’/rum.. 373 DenZoL ni Ce ete sty ie eke 512 compos itd ls .> eae 512 LCC Cee nate nie ee A 541 calum{ Dee 2. Seine eae 558 Tinctu’ra can’nabis \in’dice. 392 GANDNALA GIS ee tstet-ts stake ate 644 GAD’ SICH a octetatalele tafsValenssche 526 CANGAATHOCNI citer: soe aeeiere 533 COMPOS 1 | oie sieve 533 GASGCALIC LHe ls clateversioie' cies 557 PAGE Tinctu’ra-cat’echu. .....cese0- O96 CINGHO Nees cas oeguteo ets 479 COMPOS «siete sales 479 col’chici sem’inis ...... 633 GEMINI ee «is ete eiietn art 624 OTRAS rec crovere erste nue 446 er’gote ammonia’te ... 626 fer Tr ChlOTiGi ys woscnasic 195 perchla Tigi, ... 353 deodora’te ........ 354 CUA Seok tacts ere © 555 SUMED ai teie eos ate 457 StrOphan thi seroma eee 453 WALLIAMS Pi aie. ceetsivtes sc ys 535 ammonia’te ~..... 535 PUNGENT reneteteterel wiets.< ats cietese 77 MEAT GIUTIT CRW otal tenet Svareeersiss cle si Tite AROWAG EOL Wa ern cPae ieceerals 0.4% 423 saaaaanoects soe 68 Ves'icants, .2/ occu ee 62 Vessels, drugs acting on.... 36 Vienna paste a2 - aera 123 Wa ace eis s tack Pulte See tT Witle2ars’). ss «ade ot dee 78 Vimuny al’bum.i.. +. se soe 282 antimo’ nil” .'.33.0)./0eGee 229 eolchich”. -......9. 2a 632 FAC ICIS. | si.) wa. eee 632 Sem/inis, | 6 .o/s..ctetee 632 ipecacuan*he: 0... 3 eee 473. ODI Aeae tao addaeo ee 354 porten’se: <.:cc0 .) eee 282 EU Drums ise ootaeercrereee 282 XerleuM “ss. wees 283 Vit’ riol. bite ...4 suas tee 186 SHESON: « ws aievd- otetola cere 193 Volatile oils. sc ase 211 WAX. ovayccrerse a.crcne arene 650 WiIneD . cca va chs reemenoes 282 ¢ sy GENERAL INDEX 859 PAGE PAGE VIET CU ICHELTY nis ec lec.c cece cress S4Sr ANG AGCLALG) cicateece sce ees ac 184. WUAIING) PWC T © cc etc cece ces 282 ear’bonate, precip’itated 183 ISL 6 So} Ope Sees 282 GHG TIS cers ners a ote eters 182 VTS 5 Ao 8 Oe ere 77 ORC SESS cepa lo a ee 184 Wintergreen, oil of ........ 495 OINTMENT. .oe te oe 184 arucial Ol Of- soc. 'o.6. 496 phos PHIDEL =. >. s ac.ce. v 236 Synthetic oil of <2... 496 SMT DINALE™ sro eee oie earths 183 Nwineminazel .. of ole SST Tee 601 VEMOT AUC. Fe are ctele, clearer overs 536 NMwogietat. hydrous <2. ..0.0.. 649) | Ain’ el, ACeiaS’ ets eras itists 184. WMOTMISCEM “Soo. os ccec sce ee 621 carbo’nas precipata’tus. 183 Gil OL ae rthe cacaa te 621 CHIG{VIGHIMNS Gre ncte se assets 182 OMAGITIN “yess ssis tr sialesee ss 184 Wellow> jas mine” s..0..06s. 420 PHOS pPHiduUM 2. Ase 236 MeETCU TIG OX IGE oo. 207 SIMUDASM Os sayeisveucrerors cies 183 SAS Teta atute ae a csheauave. verse 216 Viel CLAS Maree) ale ciepat 536 PEDLOW “WK Sele Sle cc widielcree ie ere 649 PAO ALT S60 eats EASE ROCIO OS oc 182 ATC OTDOLY parevehel e cict siepste a apie ya se 527 BUEN «crete creteterataiel e’avescierevete sass LS 2e eA Tl Cm clei ster etessinvelecleieisle.ere 654 ore pr: rs OA ye r ae BO ee ae, ee See bes ie teens Teer Are errrerrerrrearar ty pe Ae nO Ce UN Re ey saat muen hotest teen pe er UT Ime he te Ad aOR ey ae SENS Peete er AE Te POP en ph mXnn 0 Lanta aneieioee = parent Oe ae PA amr Hp Aes eke tears RAR BE EN FENTON OF mea net tries any eecieieditanchesistis patente ieterat eee ae aaieeiaheata te tae toate: oN mee, etme PLN OG Tarte oe ee oa eere se eam e en ete ip anata tas: Se IR ee CREE nny Serety Dene aT er ee Craenys seer tw Sere eeey SO nie te ee ed ae ee ENS er eee ences MT RUM aK Onna au RG hee A AWaasoe See ee epee Are re eee AN ot ee Sek UNG RaQ Ame REE Seedichet hh eta aiid cere ear een Ores Solehehceneh atamtae oki ek een eee FRR ee Fe A Ay ROA ELSA Ace eh He Kt! EPROP AT Le RU NR NB Ee are eek eee ee Seer hee fae ered ners Ppa waar an Sear arenes nab aenes enemy Bmaper en ae el ae one ptamed aN gene a Teter sph ia ee ANG ts Teese nN ey PnP Ate Abe ei ay se Pune te ta Ns ae er eC ravers sw rene SPR a ase ee OF a ae SA A ey erage Unie nH eo ace, Sy, rou ee aim esens ode Mee pees aie Pe ar aoe TpHiy ik awae a PP Neen a oe PEO pe a ae OM MEE A FO are eeny, Fiat ee ge eese er eer Porreers Pon ataee “eee Carers Ste umcnnee mes. AON RAY ME Hee ad Primm ng 9 “San ay Hae NG eee Peete sgt a Se BeF Sie Rae ae te ayn iee tas eA nee Me Sra meayte the PA peas ldelpnittededgh inte Pete ee igekencatede cbt poe ein elec tht a iceraeaen Ee NRG me ena 1g EV ENRRAWAL.A = hi nek SVEN ee, HORNE tiny oie Winner irae : ROE mm Pa PUR Sg TG Ue Ag FO FEI LTA ap yeh SERS ORI ANNE ae Eyer ee eee tiene tal ke ho Ter Sedathatiniatede tie bcpneiaiainiheh nd dete y Fits Syrebiewtemmerh Mane nee: Bere ee een case Re rwne Fiabe he RUHR UREA EmE CUR ae ap RbaT LE Ai aS et MUN My He MRE A mh oy we SSS ENS oRAL AW LW RYE: WY RRENWPar ure wereey soci ieians SSNs Mme a We ED oN et ARNON iy mebhireeina ce, trans eer. PORE BW se og PENT ue aR ana Oe ones <0 Fon ene aresarsiarne eee La ER we er pe tote” gh FO AN a8 BO erat gt gen ‘ a ER ER RY Vee OK ey ne to ERs h pA ee “Wee taste ee calibionts bal keen rn wear et pte aeaetae Ah ar Peay be ssi ites Teh e eRe tn Ae Ueda Ny wre g Nads EP OAS (omar yey epeg eh ita eee RA ONE EE fn geatat Parco a eet haan eras Para gegen A RF eras peas ST ee Coane Ceres peares Rede ent ene fet eee aa sere OMIA PAN NE be HOT Ag PO tt ae aR Ene ray ar ee aa es wets rene apes LBs ons PANES ARE IS 68 FUR EPL I ha dS 0 Se Be geae sega see fat RS Gish Em Qa RR cee Line we SUN paring PA eas Feicinctpcpe he Seal aI det eal cor Pie tee eae UNA Re RYN ER fea ete BA meas ences ~ reve ae 1 ten hibtividRptlict hina Grtded, stb bette ik ete Wee Sek pera Grr cen enna ee eres Soa SESSA LENG Ne we Perret SANT ELIE Hyer ee iniblndeatbtintetidedeioa teen ibeth priehgeedanbelk Gere tee Te ah stieathMinctintteltirncind-lapdss Moten aca a a ee eS apbintinddhleeahbtn damier Tees sietnde-theltnid- Inet inlahent see tee ee tahiahhdandentendti-hiity Gethin eetiokeite hr TT Sv ease Men Be Soy “ney Abe soy egi e eH BH YG EP Wt MN Ate giSes wld swve Wed FE WOK c Ain Ne bags oe by Rg ENERO brary Been ery OcLK SSE SHUN HR Mr OSCAR Deu ra oy bare UT Coddidenn-tchnh ath etahleh ta dedication haere rte atritten a ET ee re Sten deen iinnn anave WoSE are Sete F Aug arehe twa LS Fenn Foley MAE EAY 1450 UTI HER OAY OT Ry Esty ee eedl Te Fed ees ery harKb PELE BES dae beat ae te eer ee) rare ae Sry seen? BSE a PEON eae ae Pere eer harwe® Mae ne head CR amy ere acne Wee Wig Nance sg at 2 eae ise rere are te oe Re Sere pera 05 ear ipsweut al eee GR ge spy Ed ee ae erate SEGA UE Eee BUS she any Ge corey ae eeu ge a re rs OM neg One Re gte aCe det Bas Bee IC ee Yar ane ee RT IRAE Be ae PPE INTO 0™ A PU oise a Ae 8 oy mete tTe> array err aan beleaeee tes Pe Geer ney | eg <0. et es are ue . HAEGME Ware AN AY RGeE DTC aL AWE SN SRR: Pa RIES EHO HE Hy Pm SNR ig aay malware ms Hae BE EEN ay aI ony ye Ae ee ete = Pew ede dy seeps ra ae Ce Ca ere Aly Woe Bo ata, Percy ae ‘wenn ce